DDI_BRA_2003_WHS_v01_M
2012-01-24
NADA
Version 01 (January 2012)
World Health Survey 2003
WHS 2003
BRA_2003_WHS_v01_M
World Health Organization (WHO)
NADA
World Health Organization
Multi-Country Studies, Measurement and Health Information Systems
World Health Survey [hh/whs]
WHO has developed and implemented a Survey Programme and a World Health Survey to compile comprehensive baseline information on the health of populations and on the outcomes associated with the investment in health systems; baseline evidence on the way health systems are currently functioning; and, ability to monitor inputs, functions, and outcomes.
The Survey Programme was developed in individual countries through consultation with policy-makers and in collaboration with the people involved in routine HIS. It was complementary to their efforts, to ensure periodic data input in a cost-effective way so that important gaps in health information are covered. It also established a baseline for efforts to scale-up health activities.
The World Health Survey has been completed in 70 countries and the data sets have been cleaned and weighted and prepared for analysis by country teams. The majority of the data sets are ready and have been distributed to the partners in the countries with the basic tabulations and discussions are in progress to interpret the results. Many countries have produced a country report.
World Health Survey (WHS)
Different countries have different health outcomes that are in part due to the way respective health systems perform. Regardless of the type of health system, individuals will have health and non-health expectations in terms of how the institution responds to their needs. In many countries, however, health systems do not perform effectively and this is in part due to lack of information on health system performance, and on the different service providers.
The aim of the WHO World Health Survey is to provide empirical data to the national health information systems so that there is a better monitoring of health of the people, responsiveness of health systems and measurement of health-related parameters.
The overall aims of the survey is to examine the way populations report their health, understand how people value health states, measure the performance of health systems in relation to responsiveness and gather information on modes and extents of payment for health encounters through a nationally representative population based community survey. In addition, it addresses various areas such as health care expenditures, adult mortality, birth history, various risk factors, assessment of main chronic health conditions and the coverage of health interventions, in specific additional modules.
The objectives of the survey programme are to:
1. develop a means of providing valid, reliable and comparable information, at low cost, to supplement the information provided by routine health information systems.
2. build the evidence base necessary for policy-makers to monitor if health systems are achieving the desired goals, and to assess if additional investment in health is achieving the desired outcomes.
3. provide policy-makers with the evidence they need to adjust their policies, strategies and programmes as necessary.
Brazil
The survey sampling frame must cover 100% of the country's eligible population, meaning that the entire national territory must be included. This does not mean that every province or territory need be represented in the survey sample but, rather, that all must have a chance (known probability) of being included in the survey sample.
There may be exceptional circumstances that preclude 100% national coverage. Certain areas in certain countries may be impossible to include due to reasons such as accessibility or conflict. All such exceptions must be discussed with WHO sampling experts. If any region must be excluded, it must constitute a coherent area, such as a particular province or region. For example if ¾ of region D in country X is not accessible due to war, the entire region D will be excluded from analysis.
Households and individuals
The WHS will include all male and female adults (18 years of age and older) who are not out of the country during the survey period. It should be noted that this includes the population who may be institutionalized for health reasons at the time of the survey: all persons who would have fit the definition of household member at the time of their institutionalisation are included in the eligible population.
If the randomly selected individual is institutionalized short-term (e.g. a 3-day stay at a hospital) the interviewer must return to the household when the individual will have come back to interview him/her. If the randomly selected individual is institutionalized long term (e.g. has been in a nursing home the last 8 years), the interviewer must travel to that institution to interview him/her.
The target population includes any adult, male or female age 18 or over living in private households. Populations in group quarters, on military reservations, or in other non-household living arrangements will not be eligible for the study. People who are in an institution due to a health condition (such as a hospital, hospice, nursing home, home for the aged, etc.) at the time of the visit to the household are interviewed either in the institution or upon their return to their household if this is within a period of two weeks from the first visit to the household.
Sample survey data [ssd]
SAMPLING GUIDELINES FOR WHS
Surveys in the WHS program must employ a probability sampling design. This means that every single individual in the sampling frame has a known and non-zero chance of being selected into the survey sample. While a Single Stage Random Sample is ideal if feasible, it is recognized that most sites will carry out Multi-stage Cluster Sampling.
The WHS sampling frame should cover 100% of the eligible population in the surveyed country. This means that every eligible person in the country has a chance of being included in the survey sample. It also means that particular ethnic groups or geographical areas may not be excluded from the sampling frame.
The sample size of the WHS in each country is 5000 persons (exceptions considered on a by-country basis). An adequate number of persons must be drawn from the sampling frame to account for an estimated amount of non-response (refusal to participate, empty houses etc.). The highest estimate of potential non-response and empty households should be used to ensure that the desired sample size is reached at the end of the survey period. This is very important because if, at the end of data collection, the required sample size of 5000 has not been reached additional persons must be selected randomly into the survey sample from the sampling frame. This is both costly and technically complicated (if this situation is to occur, consult WHO sampling experts for assistance), and best avoided by proper planning before data collection begins.
All steps of sampling, including justification for stratification, cluster sizes, probabilities of selection, weights at each stage of selection, and the computer program used for randomization must be communicated to WHO
STRATIFICATION
Stratification is the process by which the population is divided into subgroups. Sampling will then be conducted separately in each subgroup. Strata or subgroups are chosen because evidence is available that they are related to the outcome (e.g. health, responsiveness, mortality, coverage etc.). The strata chosen will vary by country and reflect local conditions. Some examples of factors that can be stratified on are geography (e.g. North, Central, South), level of urbanization (e.g. urban, rural), socio-economic zones, provinces (especially if health administration is primarily under the jurisdiction of provincial authorities), or presence of health facility in area. Strata to be used must be identified by each country and the reasons for selection explicitly justified.
Stratification is strongly recommended at the first stage of sampling. Once the strata have been chosen and justified, all stages of selection will be conducted separately in each stratum. We recommend stratifying on 3-5 factors. It is optimum to have half as many strata (note the difference between stratifying variables, which may be such variables as gender, socio-economic status, province/region etc. and strata, which are the combination of variable categories, for example Male, High socio-economic status, Xingtao Province would be a stratum).
Strata should be as homogenous as possible within and as heterogeneous as possible between. This means that strata should be formulated in such a way that individuals belonging to a stratum should be as similar to each other with respect to key variables as possible and as different as possible from individuals belonging to a different stratum. This maximises the efficiency of stratification in reducing sampling variance.
MULTI-STAGE CLUSTER SELECTION
A cluster is a naturally occurring unit or grouping within the population (e.g. enumeration areas, cities, universities, provinces, hospitals etc.); it is a unit for which the administrative level has clear, nonoverlapping boundaries. Cluster sampling is useful because it avoids having to compile exhaustive lists of every single person in the population. Clusters should be as heterogeneous as possible within and as homogenous as possible between (note that this is the opposite criterion as that for strata). Clusters should be as small as possible (i.e. large administrative units such as Provinces or States are not good clusters) but not so small as to be homogenous.
In cluster sampling, a number of clusters are randomly selected from a list of clusters. Then, either all members of the chosen cluster or a random selection from among them are included in the sample. Multistage sampling is an extension of cluster sampling where a hierarchy of clusters are chosen going from larger to smaller.
In order to carry out multi-stage sampling, one needs to know only the population sizes of the sampling units. For the smallest sampling unit above the elementary unit however, a complete list of all elementary units (households) is needed; in order to be able to randomly select among all households in the TSU, a list of all those households is required. This information may be available from the most recent population census. If the last census was >3 years ago or the information furnished by it was of poor quality or unreliable, the survey staff will have the task of enumerating all households in the smallest randomly selected sampling unit. It is very important to budget for this step if it is necessary and ensure that all households are properly enumerated in order that a representative sample is obtained.
It is always best to have as many clusters in the PSU as possible. The reason for this is that the fewer the number of respondents in each PSU, the lower will be the clustering effect which increases sample variance and effectively reduces our estimating power. WHO requires an absolute maximum of 50 respondents per PSU, and ideally would suggest 20-30. This means that for a sample size of 5000 respondents, 100- 200 PSU clusters should be taken into the sample. Calculating that, roughly, one fifth of the total number of PSU clusters in a country will be randomly selected into the survey sample, the sampling frame should consist of 500-1000 PSU clusters.
PROBABILITY SAMPLING
Probability sampling means that every single individual in the sampling frame has a known and non-zero chance of being selected into the survey sample. Non-probability methods of sampling such as quota or convenience sampling and random walk, may introduce bias into the survey, will throw survey findings into question, and are not accepted by WHO.
The probability of selection into the survey sample for each cluster will be proportional to its relative size. Systematic Sampling Systematic sampling is the ordered sampling at fixed intervals from a list, starting from a randomly chosen point. Typically, systematic sampling is not used at the first stage of sampling (selection of PSUs) because it renders the estimation of sampling error difficult.
Systematic sampling is recommended at the SSU, TSU, and household selection stages of sampling. Systematic sampling may be linear or circular.
SELECTION OF HOUSEHOLDS
The Household is a device used to get at the individual. The household is the sampling unit while the individual is the observational unit. While it would be preferable to randomly select from a list of all eligible persons in a country, such lists, with a few exceptions, are not available, so we must employ a final cluster, the household, to get at our observational units.
Households will be selected from lists of dwelling units. Non-probabilistic methods of household selection such as the random walk are not acceptable. Such lists are typically available from population registries, household listings, voter lists and census list. As it is essential to include all households in the sampling frame, an assessment of the methodology employed to select households must be made:
- How much has the population changed since these lists were made?
- Completeness of coverage. Are there unregistered populations (e.g. slums)
- Population shifts
- Changes in Registry
QUALITY
Almost all lists will suffer from routine problems. WHO recommends that survey institutions manually enumerate all the households in the sampling units randomly selected into the survey sample. If existing lists or registries will be used, then a detailed analysis of their quality must be made and they must be updated to ensure that there is no exclusion of households from the survey sampling frame.
SELECTION OF INDIVIDUALS FROM HOUSEHOLD ROSTER
All members of each household selected into the survey sample will be enumerated on the household roster. A member of the household is defined as someone who usually stays in the household, sleeps and shares meals, who has that address as primary place of residence, or who spends more than 6 months a year living there. Country-specific variations in this standard definition are allowed in consultation with WHO.
KISH TABLES
The respondent for the survey will be selected among all eligible members of the household using Kish tables. Kish tables provide a method by which each eligible person in a household has an equal probability of selection into the survey sample. It is extremely important for the representativeness of the survey sample and the integrity of the survey that the Kish tables are properly implemented. All interviews where the Kish selection method is not properly implemented will be rejected. The Kish technique allows adequate representation for all the persons in the household.
Face-to-face [f2f]
Participation in the survey is voluntary and the respondent can refuse to be interviewed. The interviewer is responsible for explaining what the survey is about, providing all the necessary information, and making sure the respondent understands the implications of his / her participation before giving his / her consent. The information given should be simple and clear and adapted to the respondent's level of understanding.
Consents must be documented by asking the respondents to sign an Informed Consent Forms ( Household Informant Consent Form; Individual Consent Form) before doing the interview. These forms must mention who will be doing the study, the types of questions that will be asked, why the study is being done, and who will have access to the information provided. The interviewer must check that the respondent has read and understood the form before signing, and should offer to go over it with him /her emphasizing the different items mentioned. If the respondent is illiterate or unable to read for himself / herself (e.g. due to a visual impairment), the form will be read and explained to him / her. In cases where it is not appropriate for the respondent to sign the form, the interviewer alone will sign the form.
In cases where the respondent is being dissuaded from, or coerced into, participating in the study by a third party such as a spouse, relative or any other member in the community, the interviewer should make it clear that it is the respondent alone who must decide whether or not s/he wishes to be interviewed.
FIELD SUPERVISION
The role of the supervisor is to monitor the progress and quality of the data collection, and ensure that interviewers are performing work. This includes handling the logistics of the survey, coordinating with other staff, recruiting and training additional interviewers, and supervision.
Supervision must be given to interviewers before, during, and after the interview. Supervisors must not only check that contact procedures are followed correctly but that interviews are conducted appropriately. They should be present for 10 interviews and ensure that standardized interviewing techniques are observed when asking questions, clarifying, probing and giving feedback in a non-directive manner. After the interview has been conducted, they must also check that data is coded and entered correctly. Supervisors must give feedback and debrief on a regular basis, in order to update the organization responsible for the study on the progress of the survey and any problems that have arisen.
Countries has provided WHO with the population sizes, probabilities of selection and sampling weights of all sampling units for each stage of the sampling process Since clusters are often of unequal size, sampling weights are necessary to be able to reconstruct population estimates from our sample estimates.
The weights essentially describe the number of persons in the sampling frame represented by each person in the cluster (i.e. each person in County 1 represents 12.5 people, each person in County 2 represents 9.1 persons etc.). Weights for SSUs, TSUs, etc. are calculated in the same way. The probability of selection of the elementary unit, the household, is not proportional to the number of people in the household. Rather, the household level weights will be generated at the time of respondent selection within the household. The number of households selected within each chosen sampling unit will be proportional to the total number of households in that sampling unit. All households in each unit will have equal probability of selection.
The proper and complete enumeration and description of the entire household is a critical component of the survey process. The household roster must be completed for all households selected randomly into the survey sample, whether they agreed to participate in the survey or not. It is only in this way that we can collect the basic information required to estimate the non-response bias in the survey.
The requirement of augmenting the survey sample size to adjust for estimated non-response is necessary to ensure that we have adequate persons in the sample to have the power to make precise estimates. This does not, however, account for the bias that is created by non-response, since non-responders are often different from responders with respect to key variables that are linked to the domains under study in the survey. All effort, therefore, must be made to minimise non-response, and to interview as many people in the survey sample as possible. A detailed discussion of refusal conversion methods, survey awareness raising, and call-backs is found in the WHS Survey Manual.
There are two possible scenarios of non-response:
1) The interviewer completes the household roster and the randomly chosen respondent refuses to participate.
2) The interviewer is refused access to the household and is unable to fill in the household roster.
In second scenario, sites must ensure that, at least, pages 00.1 and 00.3 of the Coversheet are completed for the household. In addition, if available from census information, the number of adult (18 years of age or older) males and females in the household, and their respective ages should be provided. It is important to note that the completion of the household roster serves a purpose above and beyond providing a list from which a respondent will be selected.
The demographic and other information collected in the household roster and requested from sites serves to calculate the denominators for statistical analysis of the survey data; without the information in the household roster, we would not be able to determine the health-related outcome rates in your country.
World Health Organization (WHO)
Citation requirement is the way that the dataset should be referenced when cited in any publication. This will guarantee that the data producer gets proper credit, and that analytical results can be linked to the proper version of the dataset.
The citation should include at least the primary investigator, the name and abbreviation of the dataset, the reference year, and the version number (and website address and date of download when the dataset was obtained on-line).
The user of the data undertakes to carry out work on the data of the WHO surveys, in accordance with the following conditions:
(1) He/she undertakes to keep confidential any information concerning individual persons or households.
(2) He/she undertakes not to distribute the data to any other user.
(3) He/she undertakes to use the data for scientific research only.
The undersigned will provide a reference of all publications based on the data to the WHO co-ordination team and will include the following acknowledgement: "This paper uses data from the WHO World Health Surveys / Multi-Country Survey Study (as appropriate)."
See also the citation requirement.
The user of the data acknowledges that the original collector of the data, the authorized distributor of the data, and the relevant funding agency bear no responsibility for use of the data or for interpretations or inferences based upon such uses.
Brazil-ID
5000
8
WHS-Brazil_F2
5000
101
WHS-Brazil_F3
18722
16
WHS-Brazil_F4
0
27
WHS-Brazil_F5
5000
681
WHS-Brazil_F6
0
26
WHS-Brazil_F7
0
29
Identification
Identification
Identification
Identification
Identification
5000
18400101
18425020
18412560.5
7217.545
country code
country code
country code
country code
country code
5000
BRA
Household probability weight
Household probability weight
Household probability weight
Household probability weight
Household probability weight
5000
2407.577
23111.215
9063.959
1971.527
Probability weight
Probability weight
Probability weight
Probability weight
Probability weight
5000
2751.517
83078.414
22267.461
10697.738
5000
11
32
20.896
8.101
5000
1
250
125.5
72.175
Post-stratified probablity weight
Post-stratified probablity weight
Post-stratified probablity weight
Post-stratified probablity weight
Post-stratified probablity weight
5000
6211.747
141360.828
38701.115
19857.471
Post stratified household weight
Post stratified household weight
Post stratified household weight
Post stratified household weight
Post stratified household weight
5000
4440.531
37395.875
14799.815
3305.851
Identification
Identification
Identification
Identification
Identification
Would you please tell me if there are any members of the household who have ever worked or been trained in a Health-Related field?
5000
18400101
18425020
18412560.5
7217.545
If retest interview, indicate number of days
If retest interview, indicate number of days
If retest interview, indicate number of days
If retest interview, indicate number of days
If retest interview, indicate number of days
If retest interview, indicate number of days between initial and
retest
5000
Sysmiss
Rotation Code
Rotation Code
Rotation Code
Rotation Code
Rotation Code
5000
A
B
C
D
interviewer ID
interviewer ID
interviewer ID
interviewer ID
interviewer ID
4996
4
1111
3115
1834.695
459.125
name of interviewer
name of interviewer
name of interviewer
name of interviewer
name of interviewer
5000
Aline Mora
Ana Paula
Andreia
Andreia Lu
Andreia Ri
Andreia Sa
Andréia Lú
Calaudia M
Camila Luh
Carlos Rez
Claudia Ma
Cláudia Ma
Edilair Go
Eelida
Elba Maria
Eleida
Emilia Emi
Fabiana Ba
Fabio Lima
Fca. Rosil
Fernanda A
Fernando A
Fernando a
Fábio Lima
Gabriela
Gabriela C
Ganyony Pi
Ganyony S.
Giseli Nog
Giselle Ca
IsaBEL Cri
Isabel Cri
Ivana
Joana Pere
Lara Alons
Laura Garc
Leon Markm
Leon Neto
Lucylanne
Ludimilla
Marcia Maz
Marcia Vir
Maria Virg
Maria do C
Marina Ata
Mario Carv
Marisley
Marisley S
Marisley V
Marisley s
Minela
Mirela
Priscila M
Rafaela C.
Rafaela La
Raulino
Regina Lop
Rita Aquin
Rita Isacu
Samantha
Samantha M
Silvia
Sonia Dias
Sonia Lans
Sonia de O
Suely
Tania
Tania Nubi
Vanessa Ma
Vinicius F
Willane Ba
adirlene
aline
aline mora
ana
ana paula
ana paula\
andreia
andreia lu
andria
andréia
andréia lú
antonio
antonio ca
bianca
bruno
camila
carlos
carlos alb
carlos edu
carolina
carolina b
christiane
claudia
claudia Ma
claudia ma
clauida
cláudia
cláudia ma
cristiane
danto
danton
dantos
darin
denise
deuzirene
dila
edilair
edilair go
edna
eilda
elba
elba mari
elba maria
elba perei
elida
elisabeth
elisaneth
elizabeth
emilia
emília
enereida
enresto
ernest
ernesto
eva
fabiana
fabiana b.
fabiana ba
fabio
fca rosile
felipe
fernada
fernanda
fernando
fernando a
francisca
fábio
g.s.pinhei
gabriela
ganyony
garyeny
geremy
gisele gou
giseli
giseli nog
giselle
giselle ca
gleider
gleides
gçeodes
idilair
isabel
isabel cri
isabela
ismenia
ivana
joana
jochbed
jochebed
karin
karla
lara
lara alons
larisley
lauRA
laura
lcylane
leocilia
leocília
leom
leon
lidiane
lourenco
lourenço
luacylane
luciana
lucineide
lucmilla
lucylane
lucylanne
lucylenne
ludimila
ludmilla
luiciana
mara
marcelo
marcia
maria
maria atan
maria clar
maria de l
maria do c
maria virg
mariana
marina
marina ata
mario
marisley
marisley S
mariza
marlucia
marysley
max
max atauha
mayra
mayra quei
mecia
melissa
melissa br
mercia
mercia cri
michele
michelle
minela
mirela
miriam
mirian
munela
márcia
neide
nereida
nereide
nereirde
nerelva
paula
paulo
paulo borg
priscila
priscila m
rafaela
rafaela c.
raulino
regina
regina lop
resete
rita
rita aquin
rita de ca
rita,
ronaldo
rosa
rosa maria
rosete
rosete per
roseti
rosilene
rosite
rute
ruth
samantha
samnatha
sergio
sergio san
silvana
silvane
silvia
silvia lei
silvia let
simone
sonia
stela
suely
sully
sérgio
tania
teresinha
terezinha
vanessa
vanessa ma
vera
vinicis
vinicius
vinícius
walkiria
walkíria
wilane
wiliam
willaim
willam
willan
willane
willani
williM
william
willian
willliam
zilda
Élida
Élida Murt
total calls
total calls
total calls
total calls
total calls
5000
1
9
1.392
0.735
date of final results (dd/mm/yyyyy)
date of final results (dd/mm/yyyyy)
date of final results (dd/mm/yyyyy)
date of final results (dd/mm/yyyyy)
date of final results (dd/mm/yyyyy)
5000
01/01/2003
01/02/2003
01/04/2003
01/06/2003
01/07/2003
01/09/2003
01/10/2003
01/11/2003
02/01/2003
02/02/2003
02/04/2003
02/06/2003
02/07/2003
02/09/2003
02/10/2003
03/01/2003
03/02/2003
03/03/2003
03/04/2003
03/05/2003
03/07/2003
03/09/2003
04/01/2003
04/02/2003
04/03/2003
04/04/2003
04/09/2003
05/01/2003
05/02/2003
05/03/2003
05/04/2003
05/05/2003
05/06/2003
05/07/2003
05/09/2003
06/02/2003
06/03/2003
06/04/2003
06/06/2003
06/09/2003
07/02/2003
07/03/2003
07/04/2003
07/06/2003
07/09/2003
08/02/2003
08/03/2003
08/04/2003
08/09/2003
09/01/2003
09/02/2003
09/03/2003
09/04/2003
09/08/2003
09/09/2003
10/02/2003
10/03/2003
10/04/2003
10/05/2003
10/06/2003
10/09/2003
11/01/2003
11/02/2003
11/03/2003
11/04/2003
11/06/2003
11/09/2003
12/01/2003
12/02/2003
12/03/2003
12/04/2003
12/08/2003
12/09/2003
13/01/2003
13/02/2003
13/03/2003
13/04/2003
13/08/2003
13/09/2003
14/01/2003
14/02/2003
14/03/2003
14/04/2003
14/08/2003
14/09/2003
14/10/2003
15/01/2003
15/02/2003
15/03/2003
15/05/2003
15/06/2003
15/07/2003
15/08/2003
15/09/2003
15/10/2003
16/01/2003
16/02/2003
16/03/2003
16/07/2003
16/08/2003
16/09/2003
16/10/2003
17/01/2003
17/02/2003
17/03/2003
17/05/2003
17/06/2003
17/08/2003
17/10/2003
18/01/2003
18/02/2003
18/03/2003
18/05/2003
18/07/2003
18/08/2003
18/09/2003
18/10/2003
19/01/2003
19/02/2003
19/03/2003
19/05/2003
19/08/2003
19/09/2003
19/10/2003
20/01/2003
20/02/2003
20/03/2003
20/05/2003
20/08/2003
20/09/2003
21/01/2003
21/02/2003
21/03/2003
21/05/2003
21/06/2003
21/09/2003
22/01/2003
22/02/2003
22/03/2003
22/06/2003
22/08/2003
23/01/2003
23/02/2003
23/03/2003
23/08/2003
24/01/2003
24/02/2003
24/03/2003
24/04/2003
24/05/2003
24/07/2003
24/08/2003
25/01/2003
25/02/2003
25/03/2003
25/04/2003
25/05/2003
25/07/2003
25/08/2003
26/01/2003
26/02/2003
26/03/2003
26/04/2003
26/05/2003
26/06/2003
26/08/2003
27/01/2003
27/02/2003
27/03/2003
27/04/2003
27/08/2003
28/01/2003
28/02/2003
28/03/2003
28/04/2003
28/05/2003
28/06/2003
28/08/2003
29/01/2003
29/03/2003
29/04/2003
29/05/2003
29/06/2003
29/08/2003
30/01/2003
30/03/2003
30/08/2003
30/09/2003
31/01/2003
31/03/2003
31/05/2003
31/08/2003
Final result code
Final result code
Final result code
Final result code
Final result code
5000
6
date of editing (dd/mm/yyyyy)
date of editing (dd/mm/yyyyy)
date of editing (dd/mm/yyyyy)
date of editing (dd/mm/yyyyy)
date of editing (dd/mm/yyyyy)
5000
01/03/2003
01/04/2003
01/07/2003
01/08/2003
01/09/2003
01/10/2003
02/04/2003
02/06/2003
02/08/2003
02/09/2003
02/10/2003
03/04/2003
03/06/2003
03/07/2003
03/09/2003
04/02/2003
04/03/2003
04/04/2003
04/06/2003
04/07/2003
04/08/2003
04/09/2003
05/05/2003
05/06/2003
05/08/2003
05/09/2003
06/02/2003
06/03/2003
06/04/2003
06/05/2003
06/06/2003
06/08/2003
07/03/2003
07/04/2003
07/05/2003
07/07/2003
07/08/2003
07/09/2003
08/02/2003
08/04/2003
08/05/2003
08/08/2003
08/09/2003
09/03/2003
09/04/2003
09/05/2003
09/06/2003
09/07/2003
10/03/2003
10/04/2003
10/06/2003
10/07/2003
10/10/2003
11/02/2003
11/03/2003
11/04/2003
11/05/2003
11/06/2003
11/07/2003
11/08/2003
12/03/2003
12/05/2003
12/06/2003
12/08/2003
13/03/2003
13/05/2003
13/06/2003
13/08/2003
13/11/2003
14/02/2003
14/03/2003
14/04/2003
14/05/2003
14/07/2003
14/08/2003
14/10/2003
15/04/2003
15/05/2003
15/07/2003
15/09/2003
15/10/2003
16/04/2003
16/05/2003
16/06/2003
16/07/2003
16/09/2003
16/10/2003
17/02/2003
17/03/2003
17/04/2003
17/06/2003
17/07/2003
17/09/2003
17/10/2003
18/02/2003
18/03/2003
18/04/2003
18/06/2003
18/07/2003
18/08/2003
18/09/2003
19/02/2003
19/03/2003
19/05/2003
19/08/2003
19/09/2003
20/02/2003
20/03/2003
20/05/2003
20/08/2003
21/02/2003
21/03/2003
21/04/2003
21/05/2003
21/07/2003
21/08/2003
21/09/2003
21/10/2003
22/03/2003
22/04/2003
22/05/2003
22/07/2003
22/09/2003
22/10/2003
23/03/2003
23/05/2003
23/06/2003
23/07/2003
23/09/2003
23/10/2003
24/02/2003
24/03/2003
24/04/2003
24/06/2003
24/07/2003
24/09/2003
24/10/2003
25/02/2003
25/03/2003
25/04/2003
25/05/2003
25/06/2003
25/07/2003
25/08/2003
25/09/2003
26/02/2003
26/03/2003
26/05/2003
26/06/2003
27/02/2003
27/03/2003
27/04/2003
27/05/2003
27/06/2003
27/08/2003
28/02/2003
28/03/2003
28/04/2003
28/05/2003
28/06/2003
28/07/2003
28/08/2003
28/10/2003
29/04/2003
29/05/2003
29/07/2003
29/08/2003
29/09/2003
29/10/2003
30/04/2003
30/05/2003
30/06/2003
30/07/2003
30/08/2003
30/09/2003
30/10/2003
31/03/2003
31/07/2003
31/10/2003
Data entry 1st date (dd/mm/yyyyy)
Data entry 1st date (dd/mm/yyyyy)
Data entry 1st date (dd/mm/yyyyy)
Data entry 1st date (dd/mm/yyyyy)
Data entry 1st date (dd/mm/yyyyy)
5000
01/07/2003
01/08/2003
01/09/2003
01/10/2003
02/06/2003
02/07/2003
02/08/2003
02/09/2003
02/10/2003
03/04/2003
03/06/2003
03/07/2003
03/09/2003
03/10/2003
03/11/2003
04/06/2003
04/07/2003
04/08/2003
04/09/2003
04/11/2003
05/05/2003
05/06/2003
05/08/2003
05/09/2003
05/11/2003
06/03/2003
06/05/2003
06/06/2003
06/08/2003
06/10/2003
06/11/2003
07/03/2003
07/05/2003
07/07/2003
07/08/2003
07/10/2003
08/04/2003
08/05/2003
08/07/2003
08/08/2003
08/09/2003
09/02/2003
09/04/2003
09/05/2003
09/06/2003
09/07/2003
09/09/2003
09/10/2003
10/03/2003
10/06/2003
10/07/2003
10/08/2003
10/09/2003
11/03/2003
11/04/2003
11/06/2003
11/07/2003
11/08/2003
11/09/2003
12/04/2003
12/05/2003
12/06/2003
12/08/2003
12/09/2003
13/01/2003
13/03/2003
13/04/2003
13/05/2003
13/06/2003
13/08/2003
13/10/2003
13/11/2003
14/02/2003
14/03/2003
14/04/2003
14/05/2003
14/07/2003
14/08/2003
14/09/2003
15/04/2003
15/05/2003
15/07/2003
15/08/2003
15/09/2003
15/10/2003
16/04/2003
16/05/2003
16/06/2003
16/07/2003
16/09/2003
16/10/2003
17/02/2003
17/03/2003
17/04/2003
17/06/2003
17/07/2003
17/09/2003
17/10/2003
18/02/2003
18/03/2003
18/05/2003
18/06/2003
18/07/2003
18/08/2003
18/09/2003
19/02/2003
19/03/2003
19/05/2003
19/08/2003
19/09/2003
19/11/2003
20/02/2003
20/03/2003
20/05/2003
20/08/2003
20/10/2003
21/02/2003
21/05/2003
21/07/2003
21/08/2003
21/10/2003
22/04/2003
22/05/2003
22/07/2003
22/08/2003
22/09/2003
22/10/2003
23/05/2003
23/06/2003
23/07/2003
23/09/2003
23/10/2003
24/02/2003
24/03/2003
24/04/2003
24/06/2003
24/07/2003
24/09/2003
24/10/2003
25/02/2003
25/04/2003
25/06/2003
25/07/2003
25/08/2003
25/09/2003
26/02/2003
26/02/2203
26/05/2003
26/06/2003
26/07/2003
26/09/2003
27/02/2003
27/05/2003
27/06/2003
27/08/2003
28/02/2003
28/04/2003
28/05/2003
28/07/2003
28/08/2003
28/09/2003
28/10/2003
29/04/2003
29/05/2003
29/07/2003
29/08/2003
29/09/2003
29/10/2003
30/04/2003
30/05/2003
30/06/2003
30/07/2003
30/09/2003
30/10/2003
31/07/2003
31/10/2003
Data entry 2nd date (dd/mm/yyyyy)
Data entry 2nd date (dd/mm/yyyyy)
Data entry 2nd date (dd/mm/yyyyy)
Data entry 2nd date (dd/mm/yyyyy)
Data entry 2nd date (dd/mm/yyyyy)
91
01/10/2003
04/11/2003
07/10/2003
10/09/2003
15/09/2003
17/09/2003
18/09/2003
19/09/2003
24/09/2003
25/09/2003
26/09/2003
29/09/2003
psu
psu
psu
psu
psu
Sampling Information
Primary Sampling Unit (PSU) Name/Code
5000
-2105199480
2125090375
136279094.628
1200825676.511
ssu
ssu
ssu
ssu
ssu
Sampling Information
Secondary Sampling Unit (SSU) Name/Code
5000
tsu
tsu
tsu
tsu
tsu
Sampling Information
Tertiary Sampling Unit (TSU) Name/Code
5000
qsu
qsu
qsu
qsu
qsu
Sampling Information
Quarternary Sampling Unit (QSU) Name/Code
5000
settings
settings
settings
settings
settings
Sampling information: Additional information
Setting
4840
160
1
Urban
2
Peri-urban/Semi-urban
3
rural
4
Other
Sysmiss
Specify
Specify
Specify
Specify
Specify
latitude N/S
latitude N/S
latitude N/S
latitude N/S
latitude N/S
The Geocoding information is recorded for the cluster that the respondent belongs to, in
the smallest sampling unit above the household level.
Latitude
5000
N
S
latitude (degree)
latitude (degree)
latitude (degree)
latitude (degree)
latitude (degree)
The Geocoding information is recorded for the cluster that the respondent belongs to, in
the smallest sampling unit above the household level.
Latitude
4980
20
32
17.1
8.061
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Sysmiss
latitude (decimal degree)
latitude (decimal degree)
latitude (decimal degree)
latitude (decimal degree)
latitude (decimal degree)
The Geocoding information is recorded for the cluster that the respondent belongs to, in
the smallest sampling unit above the household level.
Latitude
5000
125
98000
52729.36
30056.751
longitude (E/W)
longitude (E/W)
longitude (E/W)
longitude (E/W)
longitude (E/W)
Longitude
5000
W
longitude (degree)
longitude (degree)
longitude (degree)
longitude (degree)
longitude (degree)
Longitude
5000
34
66
44.804
5.872
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
59
61
63
66
longitude (decimal degree)
longitude (decimal degree)
longitude (decimal degree)
longitude (decimal degree)
longitude (decimal degree)
Longitude
5000
99773
46600.356
27943.679
waypoint
waypoint
waypoint
waypoint
waypoint
Waypoint
5000
1
center of gravity of the cluster
2
In front of the household
3
Nearby location
Sysmiss
Time begin section 0400 - Household roster
Time begin section 0400 - Household roster
Time begin section 0400 - Household roster
Time begin section 0400 - Household roster
Time begin section 0400 - Household roster
Household roster
In order to determine whom to interview, I need to know who lives at this address. Let me assure you that any information you provide is strictly confidential. I would like the age, sex, education, marital status and relationship to you of each of the members of this household who live here. Please include people who may presently be in an institution due to their health (hospital, nursing home etc.) for a short or long period.
All the males in the househo9ld should be entered first, from oldest to youngest. All the females should then be entered, from the oldest to the youngest female.
Don't forget to include yourself in the appropriate order.
You have said there are (REPEAT LISTING); does that include everyone living here at the present time or who is in an institution because of their health?
IF NO, CORRECT LISTING Now, I will use a selection procedure - I am going to number the persons in household to determine whom we need to interview - (it will take a second)
4995
00:93
06:25
07:00
07:10
07:30
07:35
07:40
07:45
07:48
07:50
07:51
07:55
07:59
08:00
08:01
08:02
08:03
08:04
08:05
08:06
08:09
08:10
08:12
08:13
08:14
08:15
08:17
08:18
08:20
08:21
08:23
08:24
08:25
08:26
08:27
08:28
08:29
08:30
08:31
08:32
08:33
08:34
08:35
08:36
08:37
08:38
08:40
08:41
08:42
08:43
08:45
08:46
08:47
08:48
08:49
08:50
08:51
08:52
08:53
08:54
08:55
08:56
08:57
08:58
08:59
09:00
09:01
09:02
09:03
09:04
09:05
09:06
09:07
09:08
09:09
09:10
09:11
09:12
09:13
09:14
09:15
09:16
09:17
09:18
09:20
09:21
09:22
09:23
09:24
09:25
09:26
09:27
09:28
09:29
09:30
09:31
09:32
09:33
09:34
09:35
09:36
09:37
09:38
09:39
09:40
09:41
09:42
09:43
09:44
09:45
09:46
09:47
09:48
09:49
09:50
09:51
09:52
09:53
09:54
09:55
09:56
09:57
09:58
09:59
10:00
10:01
10:02
10:03
10:04
10:05
10:06
10:07
10:08
10:10
10:11
10:12
10:14
10:15
10:16
10:17
10:18
10:19
10:20
10:21
10:22
10:23
10:24
10:25
10:26
10:27
10:28
10:29
10:30
10:31
10:32
10:33
10:34
10:35
10:36
10:37
10:38
10:39
10:40
10:41
10:42
10:43
10:44
10:45
10:46
10:47
10:48
10:49
10:50
10:51
10:52
10:53
10:54
10:55
10:56
10:57
10:58
11:00
11:01
11:02
11:03
11:04
11:05
11:06
11:07
11:08
11:09
11:10
11:11
11:12
11:13
11:14
11:15
11:16
11:17
11:18
11:19
11:20
11:21
11:22
11:23
11:24
11:25
11:26
11:27
11:28
11:30
11:31
11:32
11:33
11:34
11:35
11:36
11:37
11:38
11:39
11:40
11:42
11:43
11:44
11:45
11:46
11:47
11:48
11:49
11:50
11:51
11:52
11:53
11:54
11:55
11:56
11:57
11:59
12:00
12:01
12:02
12:03
12:04
12:05
12:06
12:07
12:08
12:10
12:11
12:12
12:14
12:15
12:16
12:17
12:18
12:19
12:20
12:21
12:22
12:23
12:24
12:25
12:28
12:29
12:30
12:32
12:33
12:34
12:35
12:37
12:38
12:40
12:41
12:42
12:43
12:45
12:48
12:50
12:52
12:53
12:55
12:58
12:59
13:00
13:01
13:02
13:03
13:04
13:05
13:06
13:07
13:08
13:10
13:11
13:12
13:13
13:14
13:15
13:16
13:17
13:18
13:19
13:20
13:21
13:22
13:23
13:25
13:26
13:27
13:28
13:30
13:31
13:32
13:33
13:35
13:36
13:37
13:38
13:39
13:40
13:41
13:42
13:43
13:44
13:45
13:46
13:47
13:48
13:49
13:50
13:51
13:52
13:53
13:54
13:55
13:56
13:57
13:58
13:59
14:00
14:01
14:02
14:03
14:04
14:05
14:06
14:07
14:08
14:09
14:10
14:11
14:12
14:13
14:14
14:15
14:16
14:17
14:18
14:19
14:20
14:21
14:22
14:23
14:24
14:25
14:26
14:27
14:28
14:29
14:30
14:31
14:32
14:33
14:34
14:35
14:36
14:37
14:38
14:39
14:40
14:41
14:42
14:43
14:44
14:45
14:46
14:47
14:48
14:49
14:50
14:51
14:52
14:53
14:54
14:55
14:56
14:57
14:58
14:59
15:00
15:01
15:02
15:03
15:04
15:05
15:06
15:07
15:08
15:09
15:10
15:11
15:12
15:13
15:14
15:15
15:16
15:17
15:18
15:19
15:20
15:21
15:22
15:23
15:24
15:25
15:26
15:27
15:28
15:29
15:30
15:31
15:32
15:33
15:34
15:35
15:36
15:37
15:38
15:39
15:40
15:41
15:42
15:43
15:44
15:45
15:46
15:47
15:48
15:49
15:50
15:51
15:52
15:53
15:54
15:55
15:56
15:57
15:58
15:59
15:70
16:00
16:01
16:02
16:03
16:04
16:05
16:06
16:07
16:08
16:09
16:10
16:11
16:12
16:13
16:14
16:15
16:16
16:17
16:18
16:19
16:20
16:21
16:22
16:23
16:24
16:25
16:26
16:28
16:29
16:30
16:31
16:32
16:33
16:34
16:35
16:36
16:37
16:38
16:39
16:40
16:42
16:43
16:44
16:45
16:46
16:47
16:48
16:49
16:50
16:51
16:52
16:53
16:54
16:55
16:56
16:57
16:58
16:59
17:00
17:01
17:02
17:03
17:04
17:05
17:06
17:07
17:08
17:09
17:10
17:11
17:12
17:13
17:14
17:15
17:16
17:17
17:18
17:19
17:20
17:21
17:22
17:23
17:24
17:25
17:26
17:27
17:28
17:29
17:30
17:31
17:32
17:33
17:34
17:35
17:36
17:37
17:38
17:39
17:40
17:41
17:42
17:43
17:44
17:45
17:47
17:48
17:49
17:50
17:52
17:53
17:54
17:55
17:56
17:57
17:58
17:59
18:00
18:01
18:02
18:03
18:04
18:05
18:06
18:07
18:08
18:10
18:12
18:13
18:14
18:15
18:16
18:17
18:18
18:20
18:21
18:22
18:23
18:24
18:25
18:28
18:29
18:30
18:33
18:35
18:36
18:37
18:38
18:40
18:41
18:44
18:45
18:46
18:47
18:48
18:49
18:50
18:51
18:52
18:53
18:54
18:55
18:56
18:58
19:00
19:03
19:04
19:05
19:06
19:07
19:08
19:10
19:11
19:12
19:13
19:15
19:16
19:17
19:18
19:19
19:20
19:22
19:23
19:25
19:26
19:27
19:28
19:30
19:34
19:35
19:36
19:37
19:39
19:40
19:43
19:44
19:45
19:48
19:50
19:51
19:52
19:54
19:55
19:56
19:57
20:00
20:01
20:03
20:05
20:07
20:09
20:10
20:15
20:20
20:30
20:32
20:35
20:39
20:40
20:45
20:46
20:50
20:58
21:00
21:03
21:10
21:11
21:35
21:50
22:05
Kish table code
Kish table code
Kish table code
Kish table code
Kish table code
head of household
head of household
head of household
head of household
head of household
To be asked to all households
Who is the person who provides the main economic support for the
household?
The Household Questionnaire is to be administered to the "Household Informant", identified in Q0501.
5000
400
409
401.94
2.827
Household informant
Household informant
Household informant
Household informant
Household informant
To be asked to all households
The Household Questionnaire is to be administered to the "Household Informant", identified in Q0501.
5000
Sysmiss
Have mosquito bed
Have mosquito bed
Have mosquito bed
Have mosquito bed
Have mosquito bed
The Household Questionnaire is to be administered to the "Household Informant", identified in Q0501.
Malaria Prevention: Use of (bed) nets
Do you have a mosquito bed-net in the house?
5000
1
Yes
5
No
8
Do not know
Sysmiss
bed nets treated with insecticide
bed nets treated with insecticide
bed nets treated with insecticide
bed nets treated with insecticide
bed nets treated with insecticide
The Household Questionnaire is to be administered to the "Household Informant", identified in Q0501.
Malaria Prevention: Use of (bed) nets
Were the bed-nets treated with insecticide, a product that kills insects?
5000
1
Yes
5
No
8
Do not know
Sysmiss
when were bed nets treated
when were bed nets treated
when were bed nets treated
when were bed nets treated
when were bed nets treated
The Household Questionnaire is to be administered to the "Household Informant", identified in Q0501.
Malaria Prevention: Use of (bed) nets
Were the bed-nets treated with insecticide, a product that kills insects?
If Yes: When was the last time the bed-net was (re-)treated with this product?
5000
1
within last 6 months
2
7-12 months
3
more than 1 year ago
8
Do not know
Sysmiss
No of Children under 5
No of Children under 5
No of Children under 5
No of Children under 5
No of Children under 5
The Household Questionnaire is to be administered to the "Household Informant", identified in Q0501.
Malaria Prevention: Use of (bed) nets
Can you please tell me how many children aged under 5 years live in this household?
5000
how many children slept under mosquito bed
how many children slept under mosquito bed
how many children slept under mosquito bed
how many children slept under mosquito bed
how many children slept under mosquito bed
The Household Questionnaire is to be administered to the "Household Informant", identified in Q0501.
Malaria Prevention: Use of (bed) nets
How many of these children slept under a mosquito (bed) net last night?
5000
Number of pregnant
Number of pregnant
Number of pregnant
Number of pregnant
Number of pregnant
The Household Questionnaire is to be administered to the "Household Informant", identified in Q0501.
Malaria Prevention: Use of (bed) nets
Can you please tell me how many women who live in this household are currently pregnant?
5000
No of pregnant slept under bed net
No of pregnant slept under bed net
No of pregnant slept under bed net
No of pregnant slept under bed net
No of pregnant slept under bed net
The Household Questionnaire is to be administered to the "Household Informant", identified in Q0501.
Malaria Prevention: Use of (bed) nets
How many of the pregnant women in this household slept under a mosquito bed-net last night?
5000
No of other slept under bed net
No of other slept under bed net
No of other slept under bed net
No of other slept under bed net
No of other slept under bed net
The Household Questionnaire is to be administered to the "Household Informant", identified in Q0501.
Malaria Prevention: Use of (bed) nets
How many other persons who live in this household slept under a mosquito bed-net last night? (That is, all the other household members except for young children or pregnant women).
5000
Anyone in institution due to health conditions
Anyone in institution due to health conditions
Anyone in institution due to health conditions
Anyone in institution due to health conditions
Anyone in institution due to health conditions
Is there anyone in your house who is in an institution (hospital, after care home, home for the aged, hospice etc.) due to their health condition?
4999
1
1
Yes
5
No
Sysmiss
household member 1 in institution
household member 1 in institution
household member 1 in institution
household member 1 in institution
household member 1 in institution
Is there anyone in your house who is in an institution (hospital, after care home, home for the aged, hospice etc.) due to their health condition?
RECORD LINE NUMBERS from Household Roster of all household
members currently in an institution due to their health condition
18
4982
400
401
402
403
406
407
408
Sysmiss
household member 2 in institution
household member 2 in institution
household member 2 in institution
household member 2 in institution
household member 2 in institution
Is there anyone in your house who is in an institution (hospital, after care home, home for the aged, hospice etc.) due to their health condition?
RECORD LINE NUMBERS from Household Roster of all household
members currently in an institution due to their health condition
1
4999
402
Sysmiss
household member 3 in institution
household member 3 in institution
household member 3 in institution
household member 3 in institution
household member 3 in institution
Is there anyone in your house who is in an institution (hospital, after care home, home for the aged, hospice etc.) due to their health condition?
RECORD LINE NUMBERS from Household Roster of all household
members currently in an institution due to their health condition
5000
Sysmiss
household member 4 in institution
household member 4 in institution
household member 4 in institution
household member 4 in institution
household member 4 in institution
Is there anyone in your house who is in an institution (hospital, after care home, home for the aged, hospice etc.) due to their health condition?
RECORD LINE NUMBERS from Household Roster of all household
members currently in an institution due to their health condition
5000
Sysmiss
household member 5 in institution
household member 5 in institution
household member 5 in institution
household member 5 in institution
household member 5 in institution
Is there anyone in your house who is in an institution (hospital, after care home, home for the aged, hospice etc.) due to their health condition?
RECORD LINE NUMBERS from Household Roster of all household
members currently in an institution due to their health condition
5000
Sysmiss
needs care because of a long term illness
needs care because of a long term illness
needs care because of a long term illness
needs care because of a long term illness
needs care because of a long term illness
Is there anyone in your home, a child or adult) who needs care because of a long-term physical or mental illness or disability, or is getting old and weak?
4999
1
1
Yes
5
No
Sysmiss
How much care does this person need
How much care does this person need
How much care does this person need
How much care does this person need
How much care does this person need
How much care does this person need?
419
4581
1
Needs help/ watching all the time (day and night)
2
Cannot be without help/ watching or be left alone at home for more than an hour
3
Can be left on his/her own at home for several hours but requires accompaniment when leaving home
4
Needs some help at home and sometimes needs to be accompanied when leaving home
Sysmiss
Time end section 0500
Time end section 0500
Time end section 0500
Time end section 0500
Time end section 0500
4997
07:03
07:05
07:35
07:39
07:40
07:45
07:50
07:51
07:55
07:58
08:00
08:03
08:04
08:05
08:06
08:07
08:08
08:10
08:11
08:12
08:14
08:15
08:16
08:17
08:18
08:20
08:22
08:24
08:25
08:26
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08:29
08:30
08:31
08:32
08:33
08:34
08:35
08:36
08:37
08:38
08:40
08:41
08:42
08:43
08:44
08:45
08:46
08:47
08:48
08:49
08:50
08:51
08:52
08:53
08:54
08:55
08:56
08:57
08:58
08:59
09:00
09:01
09:02
09:03
09:04
09:05
09:06
09:07
09:08
09:09
09:10
09:11
09:12
09:13
09:14
09:15
09:16
09:17
09:18
09:19
09:20
09:21
09:22
09:23
09:24
09:25
09:26
09:27
09:28
09:29
09:30
09:31
09:32
09:33
09:34
09:35
09:36
09:37
09:38
09:39
09:40
09:41
09:42
09:43
09:44
09:45
09:46
09:47
09:48
09:49
09:50
09:51
09:52
09:53
09:54
09:55
09:56
09:57
09:58
09:59
10:00
10:01
10:02
10:03
10:04
10:05
10:06
10:07
10:08
10:09
10:10
10:11
10:12
10:13
10:14
10:15
10:16
10:17
10:18
10:19
10:20
10:21
10:22
10:23
10:24
10:25
10:26
10:27
10:28
10:29
10:30
10:31
10:32
10:33
10:34
10:35
10:36
10:37
10:38
10:39
10:40
10:41
10:42
10:43
10:44
10:45
10:46
10:47
10:48
10:49
10:50
10:51
10:52
10:53
10:54
10:55
10:56
10:57
10:58
10:59
11:00
11:01
11:02
11:03
11:04
11:05
11:06
11:07
11:08
11:09
11:10
11:11
11:12
11:13
11:14
11:15
11:16
11:17
11:18
11:19
11:20
11:21
11:22
11:23
11:24
11:25
11:26
11:27
11:28
11:29
11:30
11:31
11:32
11:33
11:34
11:35
11:36
11:37
11:38
11:39
11:40
11:41
11:42
11:43
11:44
11:45
11:46
11:47
11:48
11:49
11:50
11:51
11:52
11:53
11:54
11:55
11:56
11:57
11:58
11:59
12:00
12:01
12:02
12:03
12:05
12:06
12:07
12:08
12:09
12:10
12:11
12:12
12:13
12:14
12:15
12:16
12:17
12:18
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12:20
12:22
12:23
12:24
12:25
12:26
12:27
12:28
12:29
12:30
12:32
12:33
12:34
12:35
12:36
12:37
12:38
12:39
12:40
12:41
12:42
12:43
12:44
12:45
12:46
12:47
12:48
12:49
12:50
12:51
12:52
12:53
12:54
12:55
12:57
12:58
12:59
13:00
13:01
13:02
13:03
13:05
13:06
13:07
13:08
13:09
13:10
13:11
13:12
13:13
13:14
13:15
13:16
13:17
13:18
13:19
13:20
13:21
13:22
13:23
13:24
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13:39
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13:41
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13:45
13:46
13:47
13:48
13:49
13:50
13:51
13:52
13:53
13:54
13:55
13:56
13:57
13:58
13:59
14:00
14:01
14:02
14:03
14:04
14:05
14:06
14:07
14:08
14:09
14:10
14:11
14:12
14:13
14:14
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14:21
14:22
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14:24
14:25
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14:28
14:29
14:30
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14:33
14:34
14:35
14:36
14:37
14:38
14:40
14:41
14:42
14:43
14:44
14:45
14:46
14:47
14:48
14:49
14:50
14:51
14:52
14:53
14:54
14:55
14:56
14:57
14:58
14:59
15:00
15:01
15:02
15:03
15:04
15:05
15:06
15:07
15:08
15:09
15:10
15:11
15:12
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15:20
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15:39
15:40
15:41
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15:44
15:45
15:46
15:47
15:48
15:49
15:50
15:51
15:52
15:53
15:54
15:55
15:56
15:57
15:58
15:59
16:00
16:01
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16:37
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16:48
16:49
16:50
16:51
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16:53
16:54
16:55
16:56
16:57
16:58
16:59
16:93
17:00
17:01
17:02
17:03
17:04
17:05
17:06
17:07
17:08
17:09
17:10
17:11
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17:30
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17:33
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17:35
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17:37
17:38
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17:49
17:50
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17:53
17:55
17:56
17:57
17:58
17:59
18:00
18:01
18:02
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18:05
18:06
18:07
18:08
18:09
18:10
18:11
18:12
18:13
18:14
18:15
18:16
18:17
18:18
18:20
18:21
18:22
18:23
18:25
18:26
18:27
18:28
18:29
18:30
18:32
18:33
18:34
18:35
18:36
18:37
18:38
18:39
18:40
18:41
18:42
18:43
18:44
18:45
18:46
18:47
18:48
18:50
18:51
18:53
18:54
18:55
18:56
18:57
19:00
19:01
19:02
19:03
19:04
19:05
19:06
19:07
19:10
19:11
19:12
19:13
19:14
19:15
19:16
19:17
19:18
19:19
19:20
19:22
19:23
19:24
19:25
19:27
19:28
19:30
19:32
19:33
19:34
19:35
19:37
19:38
19:39
19:40
19:43
19:45
19:46
19:47
19:50
19:51
19:52
19:53
19:54
19:55
19:56
19:57
19:59
20:00
20:01
20:02
20:04
20:05
20:07
20:09
20:10
20:11
20:12
20:13
20:14
20:16
20:20
20:22
20:24
20:26
20:32
20:35
20:36
20:40
20:43
20:45
20:51
20:55
21:01
21:03
21:08
21:10
21:14
21:16
21:40
21:45
Name of CHIP
Name of CHIP
Name of CHIP
Name of CHIP
Name of CHIP
Community Health Insurance Programs [CHIP]
Joining the plan
You indicated that someone in your household has health insurance with a
[CHIP]. What is the name of the [CHIP]?
When joined CHIP (dd/mm/yyyy)
When joined CHIP (dd/mm/yyyy)
When joined CHIP (dd/mm/yyyy)
When joined CHIP (dd/mm/yyyy)
When joined CHIP (dd/mm/yyyy)
Community Health Insurance Programs [CHIP]
Joining the plan
When did these household members first join [that CHIP]?
Reason for joining CHIP
Reason for joining CHIP
Reason for joining CHIP
Reason for joining CHIP
Reason for joining CHIP
Community Health Insurance Programs [CHIP]
Joining the plan
What was the main reason for joining [that CHIP]?
expect renewal
expect renewal
expect renewal
expect renewal
expect renewal
Community Health Insurance Programs [CHIP]
Joining the plan
Do you expect membership in [that CHIP] will be renewed?
5000
1
Yes
5
No
Sysmiss
household members join CHIP
household members join CHIP
household members join CHIP
household members join CHIP
household members join CHIP
Community Health Insurance Programs [CHIP]
Payments and Benefits
Did your household members join the [CHIP]…
5000
1
Individually
2
As a family
3
As members of a cooperative or credit program
4
Other (specify)
How high is contribution
How high is contribution
How high is contribution
How high is contribution
How high is contribution
Community Health Insurance Programs [CHIP]
Payments and Benefits
How high is the [contribution] compared to benefits you get from the [CHIP]?
5000
1
Too high
2
High
3
About right
4
Low
5
Very low
Sysmiss
How difficult is it to pay the CHIP
How difficult is it to pay the CHIP
How difficult is it to pay the CHIP
How difficult is it to pay the CHIP
How difficult is it to pay the CHIP
Community Health Insurance Programs [CHIP]
Payments and Benefits
How difficult is for your household to pay the [CHIP] [contribution]?
5000
1
Very difficult
2
Difficult
3
Not too difficult
4
Easy
5
Very easy
Sysmiss
Know where to ask questions
Know where to ask questions
Know where to ask questions
Know where to ask questions
Know where to ask questions
Community Health Insurance Programs [CHIP]
Communication and Information
If someone in your household had questions about the [CHIP], would they know whom to ask or where to go?
5000
1
Yes
5
No
Sysmiss
How difficult to reach the person
How difficult to reach the person
How difficult to reach the person
How difficult to reach the person
How difficult to reach the person
Community Health Insurance Programs [CHIP]
Communication and Information
How difficult is it to reach that person or place when information is needed?
5000
1
Very difficult
2
Difficult
3
Not too difficult
4
Easy
5
Very easy
Sysmiss
How much healthy should contribute
How much healthy should contribute
How much healthy should contribute
How much healthy should contribute
How much healthy should contribute
Community Health Insurance Programs [CHIP]
Attitudes towards risk pooling.
How much do you think healthy people in [the country] should contribute
to pay for the health care used by sick people?
5000
1
None of the cost
2
Some of the cost
3
Half of the cost
4
Most of the cost
5
All of the cost
Sysmiss
how much should people contribute
how much should people contribute
how much should people contribute
how much should people contribute
how much should people contribute
Community Health Insurance Programs [CHIP]
Attitudes towards risk pooling
How much do you think people in [the country] should contribute to pay
for the health care used by poor people when they become sick?
5000
1
None of the cost
2
Some of the cost
3
Half of the cost
4
Most of the cost
5
All of the cost
Sysmiss
Can you please tell me how many rooms there are in your home?
Can you please tell me how many rooms there are in your home?
Can you please tell me how many rooms there are in your home?
Can you please tell me how many rooms there are in your home?
Can you please tell me how many rooms there are in your home?
Permanent Income Indicators (Higher Income Countries).
I would like to quickly ask you a few questions about your home. Remember that any information you provide will be kept confidential.
Can you please tell me how many rooms there are in your home?
4992
8
30
5.763
2.162
How many cars are there in your household?
How many cars are there in your household?
How many cars are there in your household?
How many cars are there in your household?
How many cars are there in your household?
Permanent Income Indicators (Higher Income Countries).
I would like to quickly ask you a few questions about your home. Remember that any information you provide will be kept confidential.
How many cars are there in your household?
4991
9
11
8.353
3.026
How many televisions are there in your household?
How many televisions are there in your household?
How many televisions are there in your household?
How many televisions are there in your household?
How many televisions are there in your household?
Permanent Income Indicators (Higher Income Countries).
I would like to quickly ask you a few questions about your home. Remember that any information you provide will be kept confidential.
How many televisions are there in your household?
5000
7
1.735
0.977
Does anyone in your household have a bicycle?
Does anyone in your household have a bicycle?
Does anyone in your household have a bicycle?
Does anyone in your household have a bicycle?
Does anyone in your household have a bicycle?
Permanent Income Indicators (Higher Income Countries).
I would like to quickly ask you a few questions about your home. Remember that any information you provide will be kept confidential.
Does anyone in your household have a bicycle?
4962
38
5
1
Yes
5
No
Does anyone in your household have a video cassette recorder?
Does anyone in your household have a video cassette recorder?
Does anyone in your household have a video cassette recorder?
Does anyone in your household have a video cassette recorder?
Does anyone in your household have a video cassette recorder?
Permanent Income Indicators (Higher Income Countries).
I would like to quickly ask you a few questions about your home. Remember that any information you provide will be kept confidential.
Does anyone in your household have a video cassette recorder?
4989
11
1
Yes
5
No
Sysmiss
Does anyone in your household have a stereo system?
Does anyone in your household have a stereo system?
Does anyone in your household have a stereo system?
Does anyone in your household have a stereo system?
Does anyone in your household have a stereo system?
Permanent Income Indicators (Higher Income Countries).
I would like to quickly ask you a few questions about your home. Remember that any information you provide will be kept confidential.
Does anyone in your household have a stereo system?
4991
9
1
Yes
5
No
Sysmiss
Does anyone in your household have a DVD player?
Does anyone in your household have a DVD player?
Does anyone in your household have a DVD player?
Does anyone in your household have a DVD player?
Does anyone in your household have a DVD player?
Permanent Income Indicators (Higher Income Countries).
I would like to quickly ask you a few questions about your home. Remember that any information you provide will be kept confidential.
Does anyone in your household have a DVD player?
4991
9
1
Yes
5
No
Sysmiss
Does anyone in your household have a video camera?
Does anyone in your household have a video camera?
Does anyone in your household have a video camera?
Does anyone in your household have a video camera?
Does anyone in your household have a video camera?
Permanent Income Indicators (Higher Income Countries).
I would like to quickly ask you a few questions about your home. Remember that any information you provide will be kept confidential.
Does anyone in your household have a video camera?
4990
10
1
Yes
5
No
Sysmiss
Does anyone in your household have a washing machine for clothes?
Does anyone in your household have a washing machine for clothes?
Does anyone in your household have a washing machine for clothes?
Does anyone in your household have a washing machine for clothes?
Does anyone in your household have a washing machine for clothes?
Permanent Income Indicators (Higher Income Countries).
I would like to quickly ask you a few questions about your home. Remember that any information you provide will be kept confidential.
Does anyone in your household have a washing machine for clothes?
4986
14
1
Yes
5
No
Sysmiss
Does anyone in your household have a washing machine for dishes?
Does anyone in your household have a washing machine for dishes?
Does anyone in your household have a washing machine for dishes?
Does anyone in your household have a washing machine for dishes?
Does anyone in your household have a washing machine for dishes?
Permanent Income Indicators (Higher Income Countries).
I would like to quickly ask you a few questions about your home. Remember that any information you provide will be kept confidential.
Does anyone in your household have a washing machine for dishes?
4986
14
1
Yes
5
No
Sysmiss
Does anyone in your household have a vacuum cleaner?
Does anyone in your household have a vacuum cleaner?
Does anyone in your household have a vacuum cleaner?
Does anyone in your household have a vacuum cleaner?
Does anyone in your household have a vacuum cleaner?
Permanent Income Indicators (Higher Income Countries).
I would like to quickly ask you a few questions about your home. Remember that any information you provide will be kept confidential.
Does anyone in your household have a vacuum cleaner?
4989
11
1
Yes
5
No
Sysmiss
Does anyone in your household have a refrigerator?
Does anyone in your household have a refrigerator?
Does anyone in your household have a refrigerator?
Does anyone in your household have a refrigerator?
Does anyone in your household have a refrigerator?
Permanent Income Indicators (Higher Income Countries).
I would like to quickly ask you a few questions about your home. Remember that any information you provide will be kept confidential.
Does anyone in your household have a refrigerator?
4987
13
1
Yes
5
No
Sysmiss
Does anyone in your household have a fixed line telephone?
Does anyone in your household have a fixed line telephone?
Does anyone in your household have a fixed line telephone?
Does anyone in your household have a fixed line telephone?
Does anyone in your household have a fixed line telephone?
Permanent Income Indicators (Higher Income Countries).
I would like to quickly ask you a few questions about your home. Remember that any information you provide will be kept confidential.
Does anyone in your household have a fixed line telephone?
4988
12
1
Yes
5
No
Sysmiss
Does anyone in your household have a mobile / cellular telephone?
Does anyone in your household have a mobile / cellular telephone?
Does anyone in your household have a mobile / cellular telephone?
Does anyone in your household have a mobile / cellular telephone?
Does anyone in your household have a mobile / cellular telephone?
Permanent Income Indicators (Higher Income Countries).
I would like to quickly ask you a few questions about your home. Remember that any information you provide will be kept confidential.
Does anyone in your household have a mobile/cellular telephone?
4990
10
1
Yes
5
No
Sysmiss
Does anyone in your household have a computer?
Does anyone in your household have a computer?
Does anyone in your household have a computer?
Does anyone in your household have a computer?
Does anyone in your household have a computer?
Permanent Income Indicators (Higher Income Countries).
I would like to quickly ask you a few questions about your home. Remember that any information you provide will be kept confidential.
Does anyone in your household have a computer?
4989
11
1
Yes
5
No
Sysmiss
LO/ Internet access
LO/ Internet access
LO/ Internet access
LO/ Internet access
LO/ Internet access
Permanent Income Indicators (Higher Income Countries).
I would like to quickly ask you a few questions about your home. Remember that any information you provide will be kept confidential.
Does anyone in your household have LO/Internet access?
4989
11
1
Yes
5
No
Sysmiss
LO/ music box
LO/ music box
LO/ music box
LO/ music box
LO/ music box
Permanent Income Indicators (Higher Income Countries).
I would like to quickly ask you a few questions about your home. Remember that any information you provide will be kept confidential.
Does anyone in your household have LO/ music box?
4988
12
1
Yes
5
No
Sysmiss
LO/ microwave
LO/ microwave
LO/ microwave
LO/ microwave
LO/ microwave
Permanent Income Indicators (Higher Income Countries).
I would like to quickly ask you a few questions about your home. Remember that any information you provide will be kept confidential.
Does anyone in your household have LO/ microwave?
4985
15
1
Yes
5
No
Sysmiss
LO/ anybody employed in the house
LO/ anybody employed in the house
LO/ anybody employed in the house
LO/ anybody employed in the house
LO/ anybody employed in the house
Permanent Income Indicators (Higher Income Countries).
I would like to quickly ask you a few questions about your home. Remember that any information you provide will be kept confidential.
Does anyone in your household have LO/ anybody employed in the house
4989
11
1
Yes
5
No
Sysmiss
LO/second home
LO/second home
LO/second home
LO/second home
LO/second home
Permanent Income Indicators (Higher Income Countries).
I would like to quickly ask you a few questions about your home. Remember that any information you provide will be kept confidential.
Does anyone in your household have a second home?
4989
11
1
Yes
5
No
Sysmiss
total household expenditure
total household expenditure
total household expenditure
total household expenditure
total household expenditure
Household Expenditure:
I would like to quickly ask you a few questions about your home. Remember that any information you provide will be kept confidential.
For all questions in this section report all values in local currency, whether paid in cash or in kind.
In the last 4 weeks, how much did your household spend in total?
4647
353
35000
695.835
1050.637
Amount spend on food
Amount spend on food
Amount spend on food
Amount spend on food
Amount spend on food
Household Expenditure:
I would like to quickly ask you a few questions about your home. Remember that any information you provide will be kept confidential.
For all questions in this section report all values in local currency, whether paid in cash or in kind.
In the last 4 weeks, how much did your household spend on food, including such things as [rice], meat, fruits, vegetables, and cooking oils? Include the value of any food that was produced and consumed by the household, and exclude alcohol, tobacco and restaurant meals.
4878
122
4500
263.002
227.06
Spent on Housing
Spent on Housing
Spent on Housing
Spent on Housing
Spent on Housing
Household Expenditure:
I would like to quickly ask you a few questions about your home. Remember that any information you provide will be kept confidential.
For all questions in this section report all values in local currency, whether paid in cash or in kind.
In the last 4 weeks, how much did your household spend on housing, gas, electricity, water, telephone, and heating fuel?
4963
37
9890
210.914
331.632
Spent on Education
Spent on Education
Spent on Education
Spent on Education
Spent on Education
Household Expenditure:
I would like to quickly ask you a few questions about your home. Remember that any information you provide will be kept confidential.
For all questions in this section report all values in local currency, whether paid in cash or in kind.
In the last 4 weeks, how much did your household spend on education fees and supplies?
4954
46
9407
67.715
269.157
Health care costs
Health care costs
Health care costs
Health care costs
Health care costs
Household Expenditure:
I would like to quickly ask you a few questions about your home. Remember that any information you provide will be kept confidential.
For all questions in this section report all values in local currency, whether paid in cash or in kind.
In the last 4 weeks, how much did your household spend on health care costs, excluding any insurance reimbursements?
4957
43
6850
93.25
267.432
Insurance Premiums
Insurance Premiums
Insurance Premiums
Insurance Premiums
Insurance Premiums
Household Expenditure:
I would like to quickly ask you a few questions about your home. Remember that any information you provide will be kept confidential.
For all questions in this section report all values in local currency, whether paid in cash or in kind.
In the last 4 weeks, how much did your household spend on voluntary insurance premiums or prepaid health plans?
4906
94
6380
32.221
151.289
Other Goods and services
Other Goods and services
Other Goods and services
Other Goods and services
Other Goods and services
Household Expenditure:
I would like to quickly ask you a few questions about your home. Remember that any information you provide will be kept confidential.
For all questions in this section report all values in local currency, whether paid in cash or in kind.
In the last 4 weeks, how much did your household spend on all other goods and services?
4955
45
14450
42.867
268.778
Care required staying overnight
Care required staying overnight
Care required staying overnight
Care required staying overnight
Care required staying overnight
Household Expenditure:
I would like to ask you more specific questions about how much your household spent on health services. When answering these questions, think about all of the times that any household member used a health service in the last 4 weeks. Please exclude costs to be reimbursed by insurance and any transportation costs.
In the last 4 weeks, how much did your household spend on care that required staying overnight in a hospital or health facility?
4986
14
4500
4.019
93.74
Care by doctors nurses and trained midwives
Care by doctors nurses and trained midwives
Care by doctors nurses and trained midwives
Care by doctors nurses and trained midwives
Care by doctors nurses and trained midwives
Household Expenditure:
I would like to ask you more specific questions about how much your household spent on health services. When answering these questions, think about all of the times that any household member used a health service in the last 4 weeks. Please exclude costs to be reimbursed by insurance and any transportation costs.
In the last 4 weeks, how much did your household spend on care by doctors, nurses, or trained midwives that did not require an overnight stay?
4976
24
1450
5.325
37.892
Household spend on traditional healers
Household spend on traditional healers
Household spend on traditional healers
Household spend on traditional healers
Household spend on traditional healers
Household Expenditure:
I would like to ask you more specific questions about how much your household spent on health services. When answering these questions, think about all of the times that any household member used a health service in the last 4 weeks. Please exclude costs to be reimbursed by insurance and any transportation costs.
In the last 4 weeks, how much did your household spend on care by traditional or alternative healers?
4984
16
1620
1.643
30.309
Amount spent on dentists
Amount spent on dentists
Amount spent on dentists
Amount spent on dentists
Amount spent on dentists
Household Expenditure:
I would like to ask you more specific questions about how much your household spent on health services. When answering these questions, think about all of the times that any household member used a health service in the last 4 weeks. Please exclude costs to be reimbursed by insurance and any transportation costs.
In the last 4 weeks, how much did your household spend on dentists?
4979
21
5000
21.388
136.622
Amount spent on Medication or drugs
Amount spent on Medication or drugs
Amount spent on Medication or drugs
Amount spent on Medication or drugs
Amount spent on Medication or drugs
Household Expenditure:
I would like to ask you more specific questions about how much your household spent on health services. When answering these questions, think about all of the times that any household member used a health service in the last 4 weeks. Please exclude costs to be reimbursed by insurance and any transportation costs.
In the last 4 weeks, how much did your household spend on medication or drugs?
4964
36
2000
40.673
83.838
Amount spent on health care
Amount spent on health care
Amount spent on health care
Amount spent on health care
Amount spent on health care
Household Expenditure:
I would like to ask you more specific questions about how much your household spent on health services. When answering these questions, think about all of the times that any household member used a health service in the last 4 weeks. Please exclude costs to be reimbursed by insurance and any transportation costs.
In the last 4 weeks, how much did your household spend on health care products such prescription glasses, hearing aids, prosthetic devices, etc.?
4983
17
2700
9.645
75.289
Diagnostic and Laboratory tests
Diagnostic and Laboratory tests
Diagnostic and Laboratory tests
Diagnostic and Laboratory tests
Diagnostic and Laboratory tests
Household Expenditure:
I would like to ask you more specific questions about how much your household spent on health services. When answering these questions, think about all of the times that any household member used a health service in the last 4 weeks. Please exclude costs to be reimbursed by insurance and any transportation costs.
In the last 4 weeks, how much did your household spend on diagnostic and laboratory tests such as X-rays or Blood tests?
4980
20
2400
5.792
58.604
other
other
other
other
other
Household Expenditure:
I would like to ask you more specific questions about how much your household spent on health services. When answering these questions, think about all of the times that any household member used a health service in the last 4 weeks. Please exclude costs to be reimbursed by insurance and any transportation costs.
In the last 4 weeks, how much did your household spend on any other health care products or services that were not included above?
4973
27
2700
4.378
60.201
overnight stay in hospital
overnight stay in hospital
overnight stay in hospital
overnight stay in hospital
overnight stay in hospital
Household Expenditure:
I would like to ask you more specific questions about how much your household spent on health services. When answering these questions, think about all of the times that any household member used a health service in the last 4 weeks. Please exclude costs to be reimbursed by insurance and any transportation costs.
In the last 12 months, how many times did members of your household go to a hospital and stay overnight?
4981
19
88
0.436
2.033
Household costs associated with overnight stay
Household costs associated with overnight stay
Household costs associated with overnight stay
Household costs associated with overnight stay
Household costs associated with overnight stay
Household Expenditure:
I would like to ask you more specific questions about how much your household spent on health services. When answering these questions, think about all of the times that any household member used a health service in the last 4 weeks. Please exclude costs to be reimbursed by insurance and any transportation costs.
In the last 12 months, how much did the household pay for all costs associated with overnight stays in a hospital? Please exclude any expenses in the last 4 weeks that you have already told me about, and exclude any reimbursement from insurance.
1193
3807
20000
194.954
986.15
Current Income of household
Current Income of household
Current Income of household
Current Income of household
Current Income of household
Household Expenditure:
I would like to ask you more specific questions about how much your household spent on health services. When answering these questions, think about all of the times that any household member used a health service in the last 4 weeks. Please exclude costs to be reimbursed by insurance and any transportation costs.
In the last 12 months, which of the following financial sources did your household use to pay for any health expenditures?
Current income of any household members.
4948
52
1
Yes
5
No
Sysmiss
Savings
Savings
Savings
Savings
Savings
Household Expenditure:
I would like to ask you more specific questions about how much your household spent on health services. When answering these questions, think about all of the times that any household member used a health service in the last 4 weeks. Please exclude costs to be reimbursed by insurance and any transportation costs.
In the last 12 months, which of the following financial sources did your household use to pay for any health expenditures?
Savings (e.g. bank account).
4947
53
1
Yes
5
No
Sysmiss
payment or reimbursement
payment or reimbursement
payment or reimbursement
payment or reimbursement
payment or reimbursement
Household Expenditure:
I would like to ask you more specific questions about how much your household spent on health services. When answering these questions, think about all of the times that any household member used a health service in the last 4 weeks. Please exclude costs to be reimbursed by insurance and any transportation costs.
In the last 12 months, which of the following financial sources did your household use to pay for any health expenditures?
Payment or reimbursement from a health insurance plan.
4947
53
1
Yes
5
No
Sysmiss
Sold items
Sold items
Sold items
Sold items
Sold items
Household Expenditure:
I would like to ask you more specific questions about how much your household spent on health services. When answering these questions, think about all of the times that any household member used a health service in the last 4 weeks. Please exclude costs to be reimbursed by insurance and any transportation costs.
In the last 12 months, which of the following financial sources did your household use to pay for any health expenditures?
Sold items (e.g. furniture, animals, jewellery, furniture).
4947
53
1
Yes
5
No
Sysmiss
family members
family members
family members
family members
family members
Household Expenditure:
I would like to ask you more specific questions about how much your household spent on health services. When answering these questions, think about all of the times that any household member used a health service in the last 4 weeks. Please exclude costs to be reimbursed by insurance and any transportation costs.
In the last 12 months, which of the following financial sources did your household use to pay for any health expenditures?
Family members or friends from outside the household.
4947
53
1
Yes
5
No
Sysmiss
Borrowed from someone
Borrowed from someone
Borrowed from someone
Borrowed from someone
Borrowed from someone
Household Expenditure:
I would like to ask you more specific questions about how much your household spent on health services. When answering these questions, think about all of the times that any household member used a health service in the last 4 weeks. Please exclude costs to be reimbursed by insurance and any transportation costs.
In the last 12 months, which of the following financial sources did your household use to pay for any health expenditures?
Borrowed from someone other than a friend or family.
4945
55
1
Yes
5
No
Sysmiss
Other
Other
Other
Other
Other
Household Expenditure:
I would like to ask you more specific questions about how much your household spent on health services. When answering these questions, think about all of the times that any household member used a health service in the last 4 weeks. Please exclude costs to be reimbursed by insurance and any transportation costs.
In the last 12 months, which of the following financial sources did your household use to pay for any health expenditures?
Other
4946
54
1
Yes
5
No
Sysmiss
Time end section 0800
Time end section 0800
Time end section 0800
Time end section 0800
Time end section 0800
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Identification
Identification
Identification
Identification
Identification
Would you please tell me if there are any members of the household who have ever worked or been trained in a Health-Related field?
18722
18400101
18425020
18412040.366
7251.39
gender
gender
gender
gender
gender
18722
1
Female
2
Male
18722
1
2
3
4
5
7
8
9
10
11
12
13
relationship
relationship
relationship
relationship
relationship
Household roster
In order to determine whom to interview, I need to know who lives at this address. Let me assure you that any information you provide is strictly confidential. I would like the age, sex, education, marital status and relationship to you of each of the members of this household who live here. Please include people who may presently be in an institution due to their health (hospital, nursing home etc.) for a short or long period.
All the males in the househo9ld should be entered first, from oldest to youngest. All the females should then be entered, from the oldest to the youngest female.
Don't forget to include yourself in the appropriate order.
Household member's relationship to informant
18694
28
1
himself / herself
2
wife or husband
3
son or daughter
4
son or daughter in law
5
grand child
6
parent
7
parent in law
8
brother or sister
9
co-wife
10
grand parent
11
other relative
12
not related
13
don't know
Sysmiss
age
age
age
age
age
Household roster
In order to determine whom to interview, I need to know who lives at this address. Let me assure you that any information you provide is strictly confidential. I would like the age, sex, education, marital status and relationship to you of each of the members of this household who live here. Please include people who may presently be in an institution due to their health (hospital, nursing home etc.) for a short or long period.
All the males in the househo9ld should be entered first, from oldest to youngest. All the females should then be entered, from the oldest to the youngest female.
Don't forget to include yourself in the appropriate order.
Age
18709
13
98
29.742
20.196
education
education
education
education
education
Household roster
In order to determine whom to interview, I need to know who lives at this address. Let me assure you that any information you provide is strictly confidential. I would like the age, sex, education, marital status and relationship to you of each of the members of this household who live here. Please include people who may presently be in an institution due to their health (hospital, nursing home etc.) for a short or long period.
All the males in the househo9ld should be entered first, from oldest to youngest. All the females should then be entered, from the oldest to the youngest female.
Don't forget to include yourself in the appropriate order.
Education
18599
123
1
No formal schooling
2
less than primary school
3
primary school completed
4
secondary school completed
5
high school (or equivalent) completed
6
college / pre-university / university completed
7
post graduate deegree completed
Sysmiss
marital status
marital status
marital status
marital status
marital status
Household roster
In order to determine whom to interview, I need to know who lives at this address. Let me assure you that any information you provide is strictly confidential. I would like the age, sex, education, marital status and relationship to you of each of the members of this household who live here. Please include people who may presently be in an institution due to their health (hospital, nursing home etc.) for a short or long period.
All the males in the househo9ld should be entered first, from oldest to youngest. All the females should then be entered, from the oldest to the youngest female.
Don't forget to include yourself in the appropriate order.
Marital status
18679
43
1
Never married
2
Currently married
3
Separated
4
Divorced
5
Widowed
6
Chohabiting
Sysmiss
Ever worked or trained in health field
Ever worked or trained in health field
Ever worked or trained in health field
Ever worked or trained in health field
Ever worked or trained in health field
Household roster
In order to determine whom to interview, I need to know who lives at this address. Let me assure you that any information you provide is strictly confidential. I would like the age, sex, education, marital status and relationship to you of each of the members of this household who live here. Please include people who may presently be in an institution due to their health (hospital, nursing home etc.) for a short or long period.
All the males in the househo9ld should be entered first, from oldest to youngest. All the females should then be entered, from the oldest to the youngest female.
Don't forget to include yourself in the appropriate order.
Ever worked or trained in a health-related field
18659
63
1
Yes
5
No
Sysmiss
Eligible person
Eligible person
Eligible person
Eligible person
Eligible person
Household roster
In order to determine whom to interview, I need to know who lives at this address. Let me assure you that any information you provide is strictly confidential. I would like the age, sex, education, marital status and relationship to you of each of the members of this household who live here. Please include people who may presently be in an institution due to their health (hospital, nursing home etc.) for a short or long period.
All the males in the househo9ld should be entered first, from oldest to youngest. All the females should then be entered, from the oldest to the youngest female.
Don't forget to include yourself in the appropriate order.
Eligible person
18722
not eligible
1
eligible
Whs respondent
Whs respondent
Whs respondent
Whs respondent
Whs respondent
5007
R
covered by health insurance
covered by health insurance
covered by health insurance
covered by health insurance
covered by health insurance
I would like to ask you some questions about health insurance. When we say someone is "covered by health insurance", we mean that he or she is enrolled with an
organization that pays for health care costs if he or she gets sick or injured.
Is this person covered by any kind of health insurance plan?
1739
16983
1
Yes
5
No
Sysmiss
covered by mandatory health insurance
covered by mandatory health insurance
covered by mandatory health insurance
covered by mandatory health insurance
covered by mandatory health insurance
I would like to ask you some questions about health insurance. When we say someone is "covered by health insurance", we mean that he or she is enrolled with an
organization that pays for health care costs if he or she gets sick or injured.
Is this person covered by any mandatory health insurance plans?
13956
4766
1
Sysmiss
covered by voluntary health insurance
covered by voluntary health insurance
covered by voluntary health insurance
covered by voluntary health insurance
covered by voluntary health insurance
I would like to ask you some questions about health insurance. When we say someone is "covered by health insurance", we mean that he or she is enrolled with an
organization that pays for health care costs if he or she gets sick or injured.
Is this person covered by any voluntary health insurance plans?
13958
4764
1
2
Sysmiss
How much for voluntary insurance
How much for voluntary insurance
How much for voluntary insurance
How much for voluntary insurance
How much for voluntary insurance
I would like to ask you some questions about health insurance. When we say someone is "covered by health insurance", we mean that he or she is enrolled with an
organization that pays for health care costs if he or she gets sick or injured.
How much does your household pay for this person’s voluntary health insurance each year?
2109
16613
9000
620.478
803.078
Covered because of relationship to someone
Covered because of relationship to someone
Covered because of relationship to someone
Covered because of relationship to someone
Covered because of relationship to someone
I would like to ask you some questions about health insurance. When we say someone is "covered by health insurance", we mean that he or she is enrolled with an
organization that pays for health care costs if he or she gets sick or injured.
Is this person covered by insurance only because of his/her relationship to someone else who has health insurance?
2607
16115
1
5
Sysmiss
who is enrolled in the insurance plan that gives this person insurance
who is enrolled in the insurance plan that gives this person insurance
who is enrolled in the insurance plan that gives this person insurance
who is enrolled in the insurance plan that gives this person insurance
who is enrolled in the insurance plan that gives this person insurance
I would like to ask you some questions about health insurance. When we say someone is "covered by health insurance", we mean that he or she is enrolled with an
organization that pays for health care costs if he or she gets sick or injured.
Who is enrolled in the insurance plan that gives this person health insurance?
1476
17246
400
999
489.669
210.973
Identification
Identification
Identification
Identification
Identification
Would you please tell me if there are any members of the household who have ever worked or been trained in a Health-Related field?
Questionnaire completed
Questionnaire completed
Questionnaire completed
Questionnaire completed
Questionnaire completed
Questionnaire completed
Each adult member of the household who has ever worked or been trained in a Health-Related field.
1
Yes
2
No, respondent not found
3
No, respondent refused
Main occupation or occupational trainingMain occupation or occupational training
Main occupation or occupational trainingMain occupation or occupational training
Main occupation or occupational trainingMain occupation or occupational training
Main occupation or occupational trainingMain occupation or occupational training
Main occupation or occupational trainingMain occupation or occupational training
How would you best describe your main occupation or occupational training?
1
Medical doctor (including psychiatrist, gynecologist, ophthalmologist, etc.)
2
Dentist, dental surgeon or oral/dentistry or periodontist
3
Pharmacist or pharmaceutical chemist
4
Nurse professional
5
Midwife professional or matron
6
Optometrist or optician
7
Physiotherapist, chiropractor or podiatrist
8
Medical assistant
9
Nutritionist or dietician
10
Dental associate (assistant, hygienist or technician)
11
Pharmaceutical assistant or technician
12
Nursing associate or auxiliary
13
Nursing aide, community health workers, hospital aide or dental aide
14
Midwife associate or auxiliary or traditional birth attendant
15
Sanitarian or health inspector
16
Traditional medicine practitioner
17
Faith healer
18
Other health occupation than above : Specify __
19
Other occupation (such as administrator, driver, sweeper, etc.)
Worked during 12 months
Worked during 12 months
Worked during 12 months
Worked during 12 months
Worked during 12 months
Have you worked during the last 12 months?
1
Yes
5
No
Place where usually worked over the last 12 months
Place where usually worked over the last 12 months
Place where usually worked over the last 12 months
Place where usually worked over the last 12 months
Place where usually worked over the last 12 months
How would you best describe the place where you usually worked over the last 12 months?
1
Public hospital (government, including military or railroad hospital)
2
Private hospital (for profit/not for profit)
3
Public health centre (including dental clinic, palliativile clinic,health post etc.
4
Private health centre, including dental clinic, palliative care centre, mobile clinic, health post, doctor's office etc.
5
Private home-based services) nursing, Medical etc.
6
Public health training or research institution (including medical faculty, dental college, etc.
7
Private health training or research institution (including medical faculty, dental college etc.
8
Laboratory centre
9
Pharmacy
10
Other health services (including district health administration, etc.)
11
Non-health services area
Hours per week
Hours per week
Hours per week
Hours per week
Hours per week
How many hours a week do you usually work at this location, excluding unpaid mealtimes and on-call hours?
First main type of work
First main type of work
First main type of work
First main type of work
First main type of work
Select and rank the two main type of work that you usually perform at this location.
1
Direct patient care (health diagnosis, surveillance, procedures, interventions, etc.)
2
Administration / supervision/care coordination
3
Teaching / health education/research
4
Laboratory / diagnostic procedures
5
Dispensing (medications / health products)
6
Other health-related activities (such as attending in ward, assisting medical practitioners, etc.)
7
Consultation with agencies / professionals
8
Other non-health activities (such as driving car, maintaining equipment, etc.)
First main type of work
Second type of work
Second type of work
Second type of work
Second type of work
Second type of work
Select and rank the two main type of work that you usually perform at this location.
1
Direct patient care (health diagnosis, surveillance, procedures, interventions, etc.)
2
Administration / supervision/care coordination
3
Teaching / health education/research
4
Laboratory / diagnostic procedures
5
Dispensing (medications / health products)
6
Other health-related activities (such as attending in ward, assisting medical practitioners, etc.)
7
Consultation with agencies / professionals
8
Other non-health activities (such as driving car, maintaining equipment, etc.)
Second main type of work
Method of salary payment
Method of salary payment
Method of salary payment
Method of salary payment
Method of salary payment
How would you describe the method by which you are usually paid at this location?
1
Salary (such as weekly or hourly wage, etc.)
2
Salary plus bonus
3
Fee-for-service (according to type of service provided only)
4
Capitation (fixed amount per patient)
5
Capitation plus fees for extra services
6
Other methods
7
Not paid
Regularly worked at another location over past 12 months
Regularly worked at another location over past 12 months
Regularly worked at another location over past 12 months
Regularly worked at another location over past 12 months
Regularly worked at another location over past 12 months
In addition to your main job location, have you regularly worked at another location over the last 12 months?
1
Yes
5
No
Description of other place of work
Description of other place of work
Description of other place of work
Description of other place of work
Description of other place of work
If also worked at an other location
How would you best describe this other place where you worked?
1
Public hospital (government, including military or railroad hospital)
2
Private hospital (for profit/not for profit)
3
Public health centre (including dental clinic, palliative care centre, mobile clinic, health post, etc.
4
Private health centre, including dental clinic, palliative care centre, mobile clinic, health post, doctor's office etc.
5
Private home-based services (nursing, medical, etc.)
6
Public health training or research institution (including medical faculty, dental college, etc.
7
Private health training or research institution (including medical faculty, dental college, etc.
8
Laboratory centre
9
Pharmacy
10
Other health services (including district health administration etc.)
11
Non- health services area
How many hours a week of work at other location
How many hours a week of work at other location
How many hours a week of work at other location
How many hours a week of work at other location
How many hours a week of work at other location
If also worked at an other location
How many hours a week do you usually work at this other location
excluding unpaid mealtimes and on-call hours?
First main type of work at second job location
First main type of work at second job location
First main type of work at second job location
First main type of work at second job location
First main type of work at second job location
If also worked at an other location
Select and rank the two main type of work that you usually perform at this location?
1
Direct patient care (health diagnosis, surveillance, procedures, interventions, etc.)
2
Administration / supervision/care coordination
3
Teaching / health education/research
4
Laboratory / diagnostic procedures
5
Dispensing (medications / health products)
6
Other health-related activities (such as attending in ward, assisting medical practitioners, etc.)
7
Consultation with agencies / professionals
8
Other non-health activities (such as driving car, maintaining equipment, etc.)
First main type of work (second job location)
Second type of work at second job location
Second type of work at second job location
Second type of work at second job location
Second type of work at second job location
Second type of work at second job location
If also worked at an other location
Select and rank the two main type of work that you usually perform at this location?
1
Direct patient care (health diagnosis, surveillance, procedures, interventions, etc.)
2
Administration / supervision/care coordination
3
Teaching / health education/research
4
Laboratory / diagnostic procedures
5
Dispensing (medications / health products)
6
Other health-related activities (such as attending in ward, assisting medical practitioners, etc.)
7
Consultation with agencies / professionals
8
Other non-health activities (such as driving car, maintaining equipment, etc.)
Second main type of work (second job location)
Method of salary payment at second job
Method of salary payment at second job
Method of salary payment at second job
Method of salary payment at second job
Method of salary payment at second job
If also worked at an other location
How would you describe the method by which you are usually paid at this other location?
1
Salary (such as weekly or hourly wage, etc.)
2
Salary plus bonus Go to Q0917
3
Fee-for-service (according to type of service provided only)
4
Capitation (fixed amount per patient)
5
Capitation plus fees for extra services
6
Other methods
7
Not paid
Reason not worked over last 12 months
Reason not worked over last 12 months
Reason not worked over last 12 months
Reason not worked over last 12 months
Reason not worked over last 12 months
What is the main reason you have not been working over the last 12 months
1
Looked but can't find a job
2
Doing unpaid work / voluntary activities
3
Studies / training
4
Caring for family / Homemaker
5
Retired / too old to work
6
Ill health
7
Other
Worked for at least 6 months in another country
Worked for at least 6 months in another country
Worked for at least 6 months in another country
Worked for at least 6 months in another country
Worked for at least 6 months in another country
Over the last 2-3 years, did you worked for at least 6 months in a country other than this one?
1
Yes
5
No
Highest level of schooling completed
Highest level of schooling completed
Highest level of schooling completed
Highest level of schooling completed
Highest level of schooling completed
What was the highest level of schooling you completed?
1
No formal schooling
2
Less than primary school
3
Primary school completed
4
Secondary school completed
5
High school (or equivalent) completed
6
College/ pre-university/ University completed
7
University post-graduate degree completed
In what year did you reach this level
In what year did you reach this level
In what year did you reach this level
In what year did you reach this level
In what year did you reach this level
In what year did you reach this level?
Which country did you reach highest level of schooling
Which country did you reach highest level of schooling
Which country did you reach highest level of schooling
Which country did you reach highest level of schooling
Which country did you reach highest level of schooling
In what country did you reach this level?
1
Country of residence
2
Other country
Number of days of proffesional training/continuing education program
Number of days of proffesional training/continuing education program
Number of days of proffesional training/continuing education program
Number of days of proffesional training/continuing education program
Number of days of proffesional training/continuing education program
In the past 12 months, have you been on any professional training or continuing education programmes?
Average earnings per week
Average earnings per week
Average earnings per week
Average earnings per week
Average earnings per week
Thinking over the past year, can you tell me what have been your
average earnings? (Please, tell me the amount per week, per month or per one year, whichever is easiest for you).
7
Refusal
8
Do not know
Average earnings per month
Average earnings per month
Average earnings per month
Average earnings per month
Average earnings per month
Thinking over the past year, can you tell me what have been your
average earnings? (Please, tell me the amount per week, per month or per one year, whichever is easiest for you).
7
Refusal
8
Do not know
Average earnings per year
Average earnings per year
Average earnings per year
Average earnings per year
Average earnings per year
Thinking over the past year, can you tell me what have been your
average earnings? (Please, tell me the amount per week, per month or per one year, whichever is easiest for you).
7
Refusal
8
Do not know
Identification
Identification
Identification
Identification
Identification
Would you please tell me if there are any members of the household who have ever worked or been trained in a Health-Related field?
5000
18400101
18425020
18412560.5
7217.545
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20:45
20:46
20:50
20:51
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21:07
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21:19
21:24
21:25
21:30
21:40
22:00
31:52
48:17
Mother tongue
Mother tongue
Mother tongue
Mother tongue
Mother tongue
Respondent’s Socio Demographic Characteristics
I would like to start by asking you some background questions before asking you questions on your health. This information is confidential and will only be used for research purposes.
What is your mother tongue?
5000
6
ALEMAO
ESPANHOL
HUNGARO
INGLES
ITALIANO
PORRUGUE
PORTUGUE
alemao
portuges
portugue
Sex -- Male/female
Sex -- Male/female
Sex -- Male/female
Sex -- Male/female
Sex -- Male/female
Respondent’s Socio Demographic Characteristics
I would like to start by asking you some background questions before asking you questions on your health. This information is confidential and will only be used for research purposes.
Record sex as observed.
5000
1
Female
2
Male
Age in years
Age in years
Age in years
Age in years
Age in years
Respondent’s Socio Demographic Characteristics
I would like to start by asking you some background questions before asking you questions on your health. This information is confidential and will only be used for research purposes.
How old are you? (Years)
5000
18
95
41.7
16.292
Age range
Age range
Age range
Age range
Age range
Respondent’s Socio Demographic Characteristics
I would like to start by asking you some background questions before asking you questions on your health. This information is confidential and will only be used for research purposes.
If you don’t know/don’t want to tell me your age could you tell me the age range if I read the different options to you (choose what is most appropriate)?
5000
1
18-19
2
20-29
3
30-39
4
40-49
5
50-59
6
60-69
7
70+
Sysmiss
Weight in kilos
Weight in kilos
Weight in kilos
Weight in kilos
Weight in kilos
Respondent’s Socio Demographic Characteristics
I would like to start by asking you some background questions before asking you questions on your health. This information is confidential and will only be used for research purposes.
What is your weight in Kilos?
4844
156
32
162
66.448
13.957
Weight in pounds
Weight in pounds
Weight in pounds
Weight in pounds
Weight in pounds
Respondent’s Socio Demographic Characteristics
I would like to start by asking you some background questions before asking you questions on your health. This information is confidential and will only be used for research purposes.
What is your weight in Pounds?
5000
height in cms
height in cms
height in cms
height in cms
height in cms
Respondent’s Socio Demographic Characteristics
I would like to start by asking you some background questions before asking you questions on your health. This information is confidential and will only be used for research purposes.
What is your height in Centimeters?
4481
519
115
202
164.8
9.306
Height in (feet)
Height in (feet)
Height in (feet)
Height in (feet)
Height in (feet)
Respondent’s Socio Demographic Characteristics
I would like to start by asking you some background questions before asking you questions on your health. This information is confidential and will only be used for research purposes.
What is your height in Feet/Inches?
5000
Height in (inches)
Height in (inches)
Height in (inches)
Height in (inches)
Height in (inches)
Respondent’s Socio Demographic Characteristics
I would like to start by asking you some background questions before asking you questions on your health. This information is confidential and will only be used for research purposes.
What is your height in Feet/Inches?
5000
Marital Status
Marital Status
Marital Status
Marital Status
Marital Status
Respondent’s Socio Demographic Characteristics
I would like to start by asking you some background questions before asking you questions on your health. This information is confidential and will only be used for research purposes.
What is your current marital status?
5000
1
never married
2
currently married
3
separated
4
divorced
5
widowed
6
cohabiting
education
education
education
education
education
Respondent’s Socio Demographic Characteristics
I would like to start by asking you some background questions before asking you questions on your health. This information is confidential and will only be used for research purposes.
What is the highest level of education that you have completed?
5000
1
No formal schoolong
2
less than primary school
3
primary school completed
4
secondary school completed
5
high school completed
6
college completed
7
post graduate degree completed
Years of formal education completed
Years of formal education completed
Years of formal education completed
Years of formal education completed
Years of formal education completed
Respondent’s Socio Demographic Characteristics
I would like to start by asking you some background questions before asking you questions on your health. This information is confidential and will only be used for research purposes.
How many years of school, including higher education, have you completed?
4953
47
30
6.65
4.882
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
30
Sysmiss
Background
Background
Background
Background
Background
Respondent’s Socio Demographic Characteristics
I would like to start by asking you some background questions before asking you questions on your health. This information is confidential and will only be used for research purposes.
What is your [ethnic group/ racial group/ cultural subgroup/ others] background?
5000
ASIAN
BLACK
DON'T KN
INDIGENO
MULATTO
WHITE
current job
current job
current job
current job
current job
Respondent’s Socio Demographic Characteristics
Now, I would like to ask you a few questions about your work status.
What is your current job?
5000
1
Government employee
2
Non-government employee
3
Self-employed
4
Employer
5
Not working for pay
main occupation
main occupation
main occupation
main occupation
main occupation
Respondent’s Socio Demographic Characteristics
Now, I would like to ask you a few questions about your work status.
During the last 12 months, what has been your main occupation?
2567
2433
1
Legislator, Senior Official, or Manager
2
Professional
3
Technician or Associate Professional
4
Clerk
5
Service or sales worker
6
Agricultural or fishery worker
7
Craft or trades worker
8
Plant/machine operator or assembler
9
Elementary worker
10
Armed forces
Sysmiss
reason not working
reason not working
reason not working
reason not working
reason not working
Respondent’s Socio Demographic Characteristics
Now, I would like to ask you a few questions about your work status.
What is the main reason why you are not working for pay?
2430
2570
1
Homemaker / caring for family
2
Looked but cant find a job
3
Doing unpaid work / voluntary activities
4
Studies / training
5
Retired / too old to work
6
Ill health
7
Other
Sysmiss
Time end section 1000
Time end section 1000
Time end section 1000
Time end section 1000
Time end section 1000
5000
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21:33
21:42
22:02
31:45
Time begin section 2000
Time begin section 2000
Time begin section 2000
Time begin section 2000
Time begin section 2000
4996
00:95
03:52
05:05
06:27
07:13
07:15
07:43
07:45
07:48
07:50
07:59
08:00
08:02
08:03
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28:28
rate your health
rate your health
rate your health
rate your health
rate your health
Health State Descriptions Time Begin
Overall Health
The first questions are about your overall health, including both your physical and your mental health.
In general, how would you rate your health today?
4997
3
1
Very good
2
Good
3
Moderate
4
Bad
5
Very Bad
Sysmiss
work or household activities
work or household activities
work or household activities
work or household activities
work or household activities
Health State Descriptions Time Begin
Overall Health
The first questions are about your overall health, including both your physical and your mental health.
Overall in the last 30 days, how much difficulty did you have with work or household activities?
4990
10
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
difficulty in moving around
difficulty in moving around
difficulty in moving around
difficulty in moving around
difficulty in moving around
Health State Descriptions Time Begin
Now I would like to review different functions of your body. When answering these questions, I would like you to think about the last 30 days, taking both good and bad days into account. When I ask about difficulty, I would like you to consider how much difficulty you have had, on an average, in the past 30 days, while doing the activity in the way that you usually do it. By difficulty I mean requiring increased effort, discomfort or pain, slowness or changes in the way you do the activity. Please answer this question taking into account any assistance you have available.
Mobility
Overall in the last 30 days how much difficulty did you have with moving around?
4998
2
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
vigorous activities
vigorous activities
vigorous activities
vigorous activities
vigorous activities
Health State Descriptions Time Begin
Now I would like to review different functions of your body. When answering these questions, I would like you to think about the last 30 days, taking both good and bad days into account. When I ask about difficulty, I would like you to consider how much difficulty you have had, on an average, in the past 30 days, while doing the activity in the way that you usually do it. By difficulty I mean requiring increased effort, discomfort or pain, slowness or changes in the way you do the activity. Please answer this question taking into account any assistance you have available.
Mobility
In the last 30 days, how much difficulty did you have in vigorous activities, such as running 3km (or equivalent) or cycling?
4434
566
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
self-care, such as washing & dressing
self-care, such as washing & dressing
self-care, such as washing & dressing
self-care, such as washing & dressing
self-care, such as washing & dressing
Health State Descriptions Time Begin
Now I would like to review different functions of your body. When answering these questions, I would like you to think about the last 30 days, taking both good and bad days into account. When I ask about difficulty, I would like you to consider how much difficulty you have had, on an average, in the past 30 days, while doing the activity in the way that you usually do it. By difficulty I mean requiring increased effort, discomfort or pain, slowness or changes in the way you do the activity. Please answer this question taking into account any assistance you have available.
Self Care
Overall in the last 30 days, how much difficulty did you have with self-care, such as washing or dressing yourself?
4999
1
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
maintaining general appearance
maintaining general appearance
maintaining general appearance
maintaining general appearance
maintaining general appearance
Health State Descriptions Time Begin
Now I would like to review different functions of your body. When answering these questions, I would like you to think about the last 30 days, taking both good and bad days into account. When I ask about difficulty, I would like you to consider how much difficulty you have had, on an average, in the past 30 days, while doing the activity in the way that you usually do it. By difficulty I mean requiring increased effort, discomfort or pain, slowness or changes in the way you do the activity. Please answer this question taking into account any assistance you have available.
Self Care
In the last 30 days, how much difficulty did you have in taking care of and maintaining your general appearance (e.g. grooming, looking neat and tidy etc.)
4994
6
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
amount of pain/discomfort
amount of pain/discomfort
amount of pain/discomfort
amount of pain/discomfort
amount of pain/discomfort
Health State Descriptions Time Begin
Now I would like to review different functions of your body. When answering these questions, I would like you to think about the last 30 days, taking both good and bad days into account. When I ask about difficulty, I would like you to consider how much difficulty you have had, on an average, in the past 30 days, while doing the activity in the way that you usually do it. By difficulty I mean requiring increased effort, discomfort or pain, slowness or changes in the way you do the activity. Please answer this question taking into account any assistance you have available.
Pain and Discomfort
Overall in the last 30 days, how much of bodily aches or pains did you have?
4998
2
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
Bodily discomfort
Bodily discomfort
Bodily discomfort
Bodily discomfort
Bodily discomfort
Health State Descriptions Time Begin
Now I would like to review different functions of your body. When answering these questions, I would like you to think about the last 30 days, taking both good and bad days into account. When I ask about difficulty, I would like you to consider how much difficulty you have had, on an average, in the past 30 days, while doing the activity in the way that you usually do it. By difficulty I mean requiring increased effort, discomfort or pain, slowness or changes in the way you do the activity. Please answer this question taking into account any assistance you have available.
Pain and Discomfort
In the last 30 days, how much bodily discomfort did you have?
4997
3
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
concentrating / remembering things
concentrating / remembering things
concentrating / remembering things
concentrating / remembering things
concentrating / remembering things
Health State Descriptions Time Begin
Now I would like to review different functions of your body. When answering these questions, I would like you to think about the last 30 days, taking both good and bad days into account. When I ask about difficulty, I would like you to consider how much difficulty you have had, on an average, in the past 30 days, while doing the activity in the way that you usually do it. By difficulty I mean requiring increased effort, discomfort or pain, slowness or changes in the way you do the activity. Please answer this question taking into account any assistance you have available.
Cognition
Overall in the last 30 days, how much difficulty did you have with concentrating or remembering things?
4995
5
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
learning a new task
learning a new task
learning a new task
learning a new task
learning a new task
Health State Descriptions Time Begin
Now I would like to review different functions of your body. When answering these questions, I would like you to think about the last 30 days, taking both good and bad days into account. When I ask about difficulty, I would like you to consider how much difficulty you have had, on an average, in the past 30 days, while doing the activity in the way that you usually do it. By difficulty I mean requiring increased effort, discomfort or pain, slowness or changes in the way you do the activity. Please answer this question taking into account any assistance you have available.
Cognition
In the last 30 days, how much difficulty did you have in learning a new task (for example, learning how to get to a new place, learning a new game, learning a new recipe etc.)?
4982
18
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
personal relationships / participation
personal relationships / participation
personal relationships / participation
personal relationships / participation
personal relationships / participation
Health State Descriptions Time Begin
Now I would like to review different functions of your body. When answering these questions, I would like you to think about the last 30 days, taking both good and bad days into account. When I ask about difficulty, I would like you to consider how much difficulty you have had, on an average, in the past 30 days, while doing the activity in the way that you usually do it. By difficulty I mean requiring increased effort, discomfort or pain, slowness or changes in the way you do the activity. Please answer this question taking into account any assistance you have available.
Interpersonal Activities
Overall in the last 30 days, how much difficulty did you have with personal relationship or participation in the community?
4995
5
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
dealing with conflicts / tension with others
dealing with conflicts / tension with others
dealing with conflicts / tension with others
dealing with conflicts / tension with others
dealing with conflicts / tension with others
Health State Descriptions Time Begin
Now I would like to review different functions of your body. When answering these questions, I would like you to think about the last 30 days, taking both good and bad days into account. When I ask about difficulty, I would like you to consider how much difficulty you have had, on an average, in the past 30 days, while doing the activity in the way that you usually do it. By difficulty I mean requiring increased effort, discomfort or pain, slowness or changes in the way you do the activity. Please answer this question taking into account any assistance you have available.
Interpersonal Activities
In the last 30 days, how much difficulty did you have in dealing with conflicts and tensions with others?
4993
7
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
wear glasses or contact lenses
wear glasses or contact lenses
wear glasses or contact lenses
wear glasses or contact lenses
wear glasses or contact lenses
Health State Descriptions Time Begin
Now I would like to review different functions of your body. When answering these questions, I would like you to think about the last 30 days, taking both good and bad days into account. When I ask about difficulty, I would like you to consider how much difficulty you have had, on an average, in the past 30 days, while doing the activity in the way that you usually do it. By difficulty I mean requiring increased effort, discomfort or pain, slowness or changes in the way you do the activity. Please answer this question taking into account any assistance you have available.
Vision
Do you wear glasses or contact lenses?
4979
21
1
Yes
5
No
Sysmiss
seeing and recognizing person from across road
seeing and recognizing person from across road
seeing and recognizing person from across road
seeing and recognizing person from across road
seeing and recognizing person from across road
Health State Descriptions Time Begin
Now I would like to review different functions of your body. When answering these questions, I would like you to think about the last 30 days, taking both good and bad days into account. When I ask about difficulty, I would like you to consider how much difficulty you have had, on an average, in the past 30 days, while doing the activity in the way that you usually do it. By difficulty I mean requiring increased effort, discomfort or pain, slowness or changes in the way you do the activity. Please answer this question taking into account any assistance you have available.
Vision
In the last 30 days, how much difficulty did you have in Seeing and recognizing a person you know across the road (i.e. from a distance of about 20 meters)?
4985
15
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
seeing and recognizing object at arms length
seeing and recognizing object at arms length
seeing and recognizing object at arms length
seeing and recognizing object at arms length
seeing and recognizing object at arms length
Health State Descriptions Time Begin
Now I would like to review different functions of your body. When answering these questions, I would like you to think about the last 30 days, taking both good and bad days into account. When I ask about difficulty, I would like you to consider how much difficulty you have had, on an average, in the past 30 days, while doing the activity in the way that you usually do it. By difficulty I mean requiring increased effort, discomfort or pain, slowness or changes in the way you do the activity. Please answer this question taking into account any assistance you have available.
Vision
In the last 30 days, how much difficulty did you have in seeing and recognizing an object at arm’s length or in reading?
4987
13
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
falling asleep, waking up during night or early in the morning
falling asleep, waking up during night or early in the morning
falling asleep, waking up during night or early in the morning
falling asleep, waking up during night or early in the morning
falling asleep, waking up during night or early in the morning
Health State Descriptions Time Begin
Now I would like to review different functions of your body. When answering these questions, I would like you to think about the last 30 days, taking both good and bad days into account. When I ask about difficulty, I would like you to consider how much difficulty you have had, on an average, in the past 30 days, while doing the activity in the way that you usually do it. By difficulty I mean requiring increased effort, discomfort or pain, slowness or changes in the way you do the activity. Please answer this question taking into account any assistance you have available.
Sleep and Energy
Overall in the last 30 days, how much of a problem did you have with sleeping, such as falling asleep, waking up frequently during the night or waking up too early in the morning?
4998
2
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
Problem with feeling rested
Problem with feeling rested
Problem with feeling rested
Problem with feeling rested
Problem with feeling rested
Health State Descriptions Time Begin
Now I would like to review different functions of your body. When answering these questions, I would like you to think about the last 30 days, taking both good and bad days into account. When I ask about difficulty, I would like you to consider how much difficulty you have had, on an average, in the past 30 days, while doing the activity in the way that you usually do it. By difficulty I mean requiring increased effort, discomfort or pain, slowness or changes in the way you do the activity. Please answer this question taking into account any assistance you have available.
Sleep and Energy
In the last 30 days, how much of a problem did you have due to not feeling rested and refreshed during the day?
4993
7
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
feeling sad, low or depressed
feeling sad, low or depressed
feeling sad, low or depressed
feeling sad, low or depressed
feeling sad, low or depressed
Health State Descriptions Time Begin
Now I would like to review different functions of your body. When answering these questions, I would like you to think about the last 30 days, taking both good and bad days into account. When I ask about difficulty, I would like you to consider how much difficulty you have had, on an average, in the past 30 days, while doing the activity in the way that you usually do it. By difficulty I mean requiring increased effort, discomfort or pain, slowness or changes in the way you do the activity. Please answer this question taking into account any assistance you have available.
Affect
Overall in the last 30 days, how much of a problem did you have with feeling sad, low or depressed?
4995
5
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
Worry or anxiety
Worry or anxiety
Worry or anxiety
Worry or anxiety
Worry or anxiety
Health State Descriptions Time Begin
Now I would like to review different functions of your body. When answering these questions, I would like you to think about the last 30 days, taking both good and bad days into account. When I ask about difficulty, I would like you to consider how much difficulty you have had, on an average, in the past 30 days, while doing the activity in the way that you usually do it. By difficulty I mean requiring increased effort, discomfort or pain, slowness or changes in the way you do the activity. Please answer this question taking into account any assistance you have available.
Affect
Overall in the last 30 days, how much of a problem did you have with worry or anxiety?
4996
4
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
Record Set
Record Set
Record Set
Record Set
Record Set
5000
A
B
C
D
H-Vignette - Set A Q-1
H-Vignette - Set A Q-1
H-Vignette - Set A Q-1
H-Vignette - Set A Q-1
H-Vignette - Set A Q-1
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Mobility and Affect
[Jan] feels nervous and anxious. He worries and thinks negatively about the future, but feels better in the company of people or when doing something that really interests him. When he is alone he tends to feel useless and empty.
Overall in the last 30 days, how much of a problem did [name of person]
have with feeling sad, low, or depressed?
1249
3751
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set A Q-2
H-Vignette - Set A Q-2
H-Vignette - Set A Q-2
H-Vignette - Set A Q-2
H-Vignette - Set A Q-2
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Mobility and Affect
[Jan] feels nervous and anxious. He worries and thinks negatively about the future, but feels better in the company of people or when doing something that really interests him. When he is alone he tends to feel useless and empty.
In the last 30 days, how much of a problem did [name of person] have
with worry or anxiety?
1247
3753
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set A Q-3
H-Vignette - Set A Q-3
H-Vignette - Set A Q-3
H-Vignette - Set A Q-3
H-Vignette - Set A Q-3
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Mobility and Affect
[Mary] has no problems with walking, running or using her hands, arms and legs. She jogs 4 kilometres twice a week.
Overall in the last 30 days, how much of a problem did [name of person]
have with moving around?
1247
3753
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set A Q-4
H-Vignette - Set A Q-4
H-Vignette - Set A Q-4
H-Vignette - Set A Q-4
H-Vignette - Set A Q-4
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Mobility and Affect
[Mary] has no problems with walking, running or using her hands, arms and legs. She jogs 4 kilometres twice a week.
In the last 30 days, how much difficulty did [name of person] have in
vigorous activities, such as running 3 km (or equivalent) or cycling?
1247
3753
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set A Q-5
H-Vignette - Set A Q-5
H-Vignette - Set A Q-5
H-Vignette - Set A Q-5
H-Vignette - Set A Q-5
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Mobility and Affect
[Anton] does not exercise. He cannot climb stairs or do other physical activities because he is obese. He is able to carry the groceries and do some light
household work.
Overall in the last 30 days, how much of a problem did [name of person]
have with moving around?
1249
3751
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set A Q-6
H-Vignette - Set A Q-6
H-Vignette - Set A Q-6
H-Vignette - Set A Q-6
H-Vignette - Set A Q-6
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Mobility and Affect
[Anton] does not exercise. He cannot climb stairs or do other physical activities because he is obese. He is able to carry the groceries and do some light
household work.
In the last 30 days, how much difficulty did [name of person] have in
vigorous activities, such as running 3 km (or equivalent) or cycling?
1249
3751
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set A Q-7
H-Vignette - Set A Q-7
H-Vignette - Set A Q-7
H-Vignette - Set A Q-7
H-Vignette - Set A Q-7
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Mobility and Affect
[David] is paralyzed from the neck down. He is unable to move his arms and legs or to shift body position. He is confined to bed.
Overall in the last 30 days, how much difficulty did [name of person]
have with moving around?
1247
3753
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set A Q-8
H-Vignette - Set A Q-8
H-Vignette - Set A Q-8
H-Vignette - Set A Q-8
H-Vignette - Set A Q-8
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Mobility and Affect
[David] is paralyzed from the neck down. He is unable to move his arms and legs or to shift body position. He is confined to bed.
In the last 30 days, how much difficulty did [name of person] have in
vigorous activities, such as running 3 km (or equivalent) or cycling?
1246
3754
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set A Q-9
H-Vignette - Set A Q-9
H-Vignette - Set A Q-9
H-Vignette - Set A Q-9
H-Vignette - Set A Q-9
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Mobility and Affect
[Ken] loves life and is happy all the time. He never worries or gets upset about anything and deals with things as they come.
Overall in the last 30 days, how much of a problem did [name of person]
have with feeling sad, low, or depressed?
1248
3752
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set A Q-10
H-Vignette - Set A Q-10
H-Vignette - Set A Q-10
H-Vignette - Set A Q-10
H-Vignette - Set A Q-10
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Mobility and Affect
[Ken] loves life and is happy all the time. He never worries or gets upset about anything and deals with things as they come.
In the last 30 days, how much of a problem did [name of person] have
with worry or anxiety?
1247
3753
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set A Q-11
H-Vignette - Set A Q-11
H-Vignette - Set A Q-11
H-Vignette - Set A Q-11
H-Vignette - Set A Q-11
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Mobility and Affect
[Rob] is able to walk distances of up to 200 metres without any problems but feels tired after walking one kilometre or climbing up more than one flight of stairs. He has no problems with day-to-day physical activities, such as carrying food from the market.
Overall in the last 30 days, how much difficulty did [name of person]
have with moving around?
1249
3751
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set A Q-12
H-Vignette - Set A Q-12
H-Vignette - Set A Q-12
H-Vignette - Set A Q-12
H-Vignette - Set A Q-12
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Mobility and Affect
[Rob] is able to walk distances of up to 200 metres without any problems but feels tired after walking one kilometre or climbing up more than one flight of stairs. He has no problems with day-to-day physical activities, such as carrying food from the market.
In the last 30 days, how much difficulty did [name of person] have in
vigorous activities, such as running 3 km (or equivalent) or cycling?
1247
3753
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set A Q-13
H-Vignette - Set A Q-13
H-Vignette - Set A Q-13
H-Vignette - Set A Q-13
H-Vignette - Set A Q-13
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Mobility and Affect
[Vincent] has a lot of swelling in his legs due to his health condition. He has to make an effort to walk around his home as his legs feel heavy.
Overall in the last 30 days, how much of a problem did [name of person]
have with moving around?
1249
3751
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set A Q-14
H-Vignette - Set A Q-14
H-Vignette - Set A Q-14
H-Vignette - Set A Q-14
H-Vignette - Set A Q-14
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Mobility and Affect
[Vincent] has a lot of swelling in his legs due to his health condition. He has to make an effort to walk around his home as his legs feel heavy.
In the last 30 days, how much difficulty did [name of person] have in
vigorous activities, such as running 3 km (or equivalent) or cycling?
1246
3754
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set A Q-15
H-Vignette - Set A Q-15
H-Vignette - Set A Q-15
H-Vignette - Set A Q-15
H-Vignette - Set A Q-15
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Mobility and Affect
[Vivian] has already had five admissions into the hospital because she has attempted suicide twice in the past year and has harmed herself on three other
occasions. She is very distressed every day for the most part of the day, and sees no hope of things ever getting better. She is thinking of trying to end her life
again.
Overall in the last 30 days, how much of a problem did [name of person]
have with feeling sad, low, or depressed?
1249
3751
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set A Q-16
H-Vignette - Set A Q-16
H-Vignette - Set A Q-16
H-Vignette - Set A Q-16
H-Vignette - Set A Q-16
VIGNETTES FOR HEALTH STATE DESCRIPTIONS.
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Mobility and Affect
[Vivian] has already had five admissions into the hospital because she has attempted suicide twice in the past year and has harmed herself on three other
occasions. She is very distressed every day for the most part of the day, and sees no hope of things ever getting better. She is thinking of trying to end her life
again.
In the last 30 days, how much of a problem did [name of person] have
with worry or anxiety?
1248
3752
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set A Q-17
H-Vignette - Set A Q-17
H-Vignette - Set A Q-17
H-Vignette - Set A Q-17
H-Vignette - Set A Q-17
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Mobility and Affect
[Roberta] feels depressed most of the time. She weeps frequently and feels hopeless about the future. She feels that she has become a burden on others and
that she would be better dead.
Overall in the last 30 days, how much of a problem did [name of person]
have with feeling sad, low, or depressed?
1247
3753
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set A Q-18
H-Vignette - Set A Q-18
H-Vignette - Set A Q-18
H-Vignette - Set A Q-18
H-Vignette - Set A Q-18
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Mobility and Affect
[Roberta] feels depressed most of the time. She weeps frequently and feels hopeless about the future. She feels that she has become a burden on others and
that she would be better dead.
In the last 30 days, how much of a problem did [name of person] have
with worry or anxiety?
1247
3753
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set A Q-19
H-Vignette - Set A Q-19
H-Vignette - Set A Q-19
H-Vignette - Set A Q-19
H-Vignette - Set A Q-19
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Mobility and Affect
[Henriette] enjoys her work and social activities and is generally satisfied with her life. She gets depressed every 3 weeks for a day or two and loses interest in
what she usually enjoys but is able to carry on with her day to day activities.
Overall in the last 30 days, how much of a problem did [name of person]
have with feeling sad, low, or depressed?
1249
3751
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set A Q-20
H-Vignette - Set A Q-20
H-Vignette - Set A Q-20
H-Vignette - Set A Q-20
H-Vignette - Set A Q-20
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Mobility and Affect
[Henriette] enjoys her work and social activities and is generally satisfied with her life. She gets depressed every 3 weeks for a day or two and loses interest in
what she usually enjoys but is able to carry on with her day to day activities.
Overall in the last 30 days, how much of a problem did [name of person]
have with distress, sadness or worry?
1247
3753
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set B Q-1
H-Vignette - Set B Q-1
H-Vignette - Set B Q-1
H-Vignette - Set B Q-1
H-Vignette - Set B Q-1
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Pain and Personal Relationships
[Mark] has pain in his knees, elbows, wrists and fingers, and the pain is present almost all the time. It gets worse during the first half of the day. Although
medication helps, he feels uncomfortable when moving around, holding and lifting things.
Overall in the last 30 days, how much of bodily aches or pains did [name
of person] have?
1232
3768
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set B Q-2
H-Vignette - Set B Q-2
H-Vignette - Set B Q-2
H-Vignette - Set B Q-2
H-Vignette - Set B Q-2
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Pain and Personal Relationships
[Mark] has pain in his knees, elbows, wrists and fingers, and the pain is present almost all the time. It gets worse during the first half of the day. Although
medication helps, he feels uncomfortable when moving around, holding and lifting things.
In the last 30 days, how much bodily discomfort did [name of person]
have?
1233
3767
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set B Q-3
H-Vignette - Set B Q-3
H-Vignette - Set B Q-3
H-Vignette - Set B Q-3
H-Vignette - Set B Q-3
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Pain and Personal Relationships
[Elizabeth] has difficulty climbing up and down the stairs and walking. She is not able to go out as much as she would like to but has many friends who come
and visit her at home. Her friends find her a source of great comfort.
Overall in the last 30 days, how much difficulty did [name of person]
have with personal relationships or participation in the community?
1228
3772
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set B Q-4
H-Vignette - Set B Q-4
H-Vignette - Set B Q-4
H-Vignette - Set B Q-4
H-Vignette - Set B Q-4
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Pain and Personal Relationships
[Elizabeth] has difficulty climbing up and down the stairs and walking. She is not able to go out as much as she would like to but has many friends who come
and visit her at home. Her friends find her a source of great comfort.
In the last 30 days, how much difficulty did [name of person] have in
dealing with conflicts and tensions with others?
1227
3773
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set B Q-5
H-Vignette - Set B Q-5
H-Vignette - Set B Q-5
H-Vignette - Set B Q-5
H-Vignette - Set B Q-5
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Pain and Personal Relationships
[Amala] suffered a stroke three months ago. Her friends do not come and visit anymore as Amala cannot communicate with them. She is constantly upset and
shouts at her family members which causes them to avoid her.
Overall in the last 30 days, how much difficulty did [name of person]
have with personal relationship or participation in the community?
1229
3771
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set B Q-6
H-Vignette - Set B Q-6
H-Vignette - Set B Q-6
H-Vignette - Set B Q-6
H-Vignette - Set B Q-6
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Pain and Personal Relationships
[Amala] suffered a stroke three months ago. Her friends do not come and visit anymore as Amala cannot communicate with them. She is constantly upset and
shouts at her family members which causes them to avoid her.
In the last 30 days, how much difficulty did [name of person] have in
dealing with conflicts and tensions with others?
1229
3771
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set B Q-7
H-Vignette - Set B Q-7
H-Vignette - Set B Q-7
H-Vignette - Set B Q-7
H-Vignette - Set B Q-7
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Pain and Personal Relationships
[Katie] cannot remember when she last felt pain as this has not happened for the last several years now. She does not experience any pain even after hard
physical labor or exercise.
Overall in the last 30 days, how much of bodily aches or pains did [name
of person] have?
1228
3772
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set B Q-8
H-Vignette - Set B Q-8
H-Vignette - Set B Q-8
H-Vignette - Set B Q-8
H-Vignette - Set B Q-8
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Pain and Personal Relationships
[Katie] cannot remember when she last felt pain as this has not happened for the last several years now. She does not experience any pain even after hard
physical labor or exercise.
In the last 30 days, how much bodily discomfort did [name of person]
have?
1228
3772
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set B Q-9
H-Vignette - Set B Q-9
H-Vignette - Set B Q-9
H-Vignette - Set B Q-9
H-Vignette - Set B Q-9
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Pain and Personal Relationships
[Charlie] can join in any community activities that interest him, whenever he wants to, without any restrictions. He gets on well with everybody and enjoys
meeting new people.
Overall in the last 30 days, how much difficulty did [name of person]
have with personal relationship or participation in the community?
1228
3772
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set B Q-10
H-Vignette - Set B Q-10
H-Vignette - Set B Q-10
H-Vignette - Set B Q-10
H-Vignette - Set B Q-10
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Pain and Personal Relationships
[Charlie] can join in any community activities that interest him, whenever he wants to, without any restrictions. He gets on well with everybody and enjoys
meeting new people.
In the last 30 days, how much difficulty did [name of person] have in
dealing with conflicts and tensions with others?
1228
3772
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set B Q-11
H-Vignette - Set B Q-11
H-Vignette - Set B Q-11
H-Vignette - Set B Q-11
H-Vignette - Set B Q-11
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Pain and Personal Relationships
[Steve] has pain in the neck radiating to the arms that is not relieved by any medicines or other treatment. The pain is sharp at all times and keeps him awake
most of the night. During the day the pain has made him completely incapacitated. It has necessitated complete confinement to the bed and often makes him
think of ending his life.
Overall in the last 30 days, how much of bodily aches or pains did [name
of person] have?
1228
3772
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set B Q-12
H-Vignette - Set B Q-12
H-Vignette - Set B Q-12
H-Vignette - Set B Q-12
H-Vignette - Set B Q-12
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Pain and Personal Relationships
[Steve] has pain in the neck radiating to the arms that is not relieved by any medicines or other treatment. The pain is sharp at all times and keeps him awake
most of the night. During the day the pain has made him completely incapacitated. It has necessitated complete confinement to the bed and often makes him
think of ending his life.
In the last 30 days, how much bodily discomfort did [name of person] have?
1228
3772
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set B Q-13
H-Vignette - Set B Q-13
H-Vignette - Set B Q-13
H-Vignette - Set B Q-13
H-Vignette - Set B Q-13
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Pain and Personal Relationships
[Johanna] gets on well with the people she knows but has no close friends. She has not spoken to her mother in 5 years and does not want to see her. Because
of this tension, her family usually excludes her from family gatherings.
Overall in the last 30 days, how much difficulty did [name of person] have with personal relationship or participation in the community?
1229
3771
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set B Q-14
H-Vignette - Set B Q-14
H-Vignette - Set B Q-14
H-Vignette - Set B Q-14
H-Vignette - Set B Q-14
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Pain and Personal Relationships
[Johanna] gets on well with the people she knows but has no close friends. She has not spoken to her mother in 5 years and does not want to see her. Because
of this tension, her family usually excludes her from family gatherings.
In the last 30 days, how much difficulty did [name of person] have in dealing with conflicts and tensions with others?
1230
3770
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set B Q-15
H-Vignette - Set B Q-15
H-Vignette - Set B Q-15
H-Vignette - Set B Q-15
H-Vignette - Set B Q-15
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Pain and Personal Relationships
[Laura] has a headache once a month that is relieved one hour after taking a pill. During the headache she can carry on with her day to day affairs.
Overall in the last 30 days, how much of bodily aches or pains did [name of person] have?
1230
3770
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set B Q-16
H-Vignette - Set B Q-16
H-Vignette - Set B Q-16
H-Vignette - Set B Q-16
H-Vignette - Set B Q-16
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Pain and Personal Relationships
[Laura] has a headache once a month that is relieved one hour after taking a pill. During the headache she can carry on with her day to day affairs.
In the last 30 days, how much bodily discomfort did [name of person]have?
1230
3770
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set B Q-17
H-Vignette - Set B Q-17
H-Vignette - Set B Q-17
H-Vignette - Set B Q-17
H-Vignette - Set B Q-17
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Pain and Personal Relationships
[Nobu] is blind and lives in a remote rural area. His family does not allow him to leave the house because they fear he will get hurt. His family tells him that
he is a burden to them. Their criticism upsets him and he cries.
Overall in the last 30 days, how much difficulty did [name of person] have with personal relationships or participation in the community?
1230
3770
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set B Q-18
H-Vignette - Set B Q-18
H-Vignette - Set B Q-18
H-Vignette - Set B Q-18
H-Vignette - Set B Q-18
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Pain and Personal Relationships
[Nobu] is blind and lives in a remote rural area. His family does not allow him to leave the house because they fear he will get hurt. His family tells him that
he is a burden to them. Their criticism upsets him and he cries.
In the last 30 days, how much difficulty did [name of person] have in dealing with conflicts and tensions with others?
1230
3770
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set B Q-19
H-Vignette - Set B Q-19
H-Vignette - Set B Q-19
H-Vignette - Set B Q-19
H-Vignette - Set B Q-19
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Pain and Personal Relationships
[Isabelle] has pain that radiates down her right arm and wrist during her day at work. This is slightly relieved in the evenings when she is no longer working
on her computer.
Overall in the last 30 days, how much of bodily aches or pains did [name of person] have?
1227
3773
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set B Q-20
H-Vignette - Set B Q-20
H-Vignette - Set B Q-20
H-Vignette - Set B Q-20
H-Vignette - Set B Q-20
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Pain and Personal Relationships
[Isabelle] has pain that radiates down her right arm and wrist during her day at work. This is slightly relieved in the evenings when she is no longer working
on her computer.
In the last 30 days, how much bodily discomfort did [name of person]have?
1227
3773
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set C Q-1
H-Vignette - Set C Q-1
H-Vignette - Set C Q-1
H-Vignette - Set C Q-1
H-Vignette - Set C Q-1
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Vision, Sleep and Energy
[Jennifer] only reads if the text is in very large print, such as 10 lines per page. Otherwise she does not read anything. Even when people are close to her, she
sees them blurred.
In the last 30 days, how much difficulty did you think [name of person]have in seeing and recognizing a person she knows across the road ( i.e.from a distance of about 20 meters)?
1240
3760
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set C Q-2
H-Vignette - Set C Q-2
H-Vignette - Set C Q-2
H-Vignette - Set C Q-2
H-Vignette - Set C Q-2
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Vision, Sleep and Energy
[Jennifer] only reads if the text is in very large print, such as 10 lines per page. Otherwise she does not read anything. Even when people are close to her, she
sees them blurred.
In the last 30 days, how much difficulty did you think [name of person] have in seeing and recognizing an object at arm’s length or in reading?
1240
3760
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set C Q-3
H-Vignette - Set C Q-3
H-Vignette - Set C Q-3
H-Vignette - Set C Q-3
H-Vignette - Set C Q-3
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Vision, Sleep and Energy
[Paolo] has no trouble falling asleep at night and does not wake up during the night, but every morning he finds it difficult to wake up. He uses an alarm clock
but falls back asleep after the alarm goes off. He is late to work on four out of five days and feels tired in the mornings.
In the last 30 days, how much difficulty do you think [name of person] had with sleeping, such as falling asleep, waking up frequently during the night or waking up too early in the morning?
1239
3761
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set C Q-4
H-Vignette - Set C Q-4
H-Vignette - Set C Q-4
H-Vignette - Set C Q-4
H-Vignette - Set C Q-4
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Vision, Sleep and Energy
[Paolo] has no trouble falling asleep at night and does not wake up during the night, but every morning he finds it difficult to wake up. He uses an alarm clock
but falls back asleep after the alarm goes off. He is late to work on four out of five days and feels tired in the mornings.
In the last 30 days, how much of a problem did you have due to not feeling rested and refreshed during the day (e.g. feeling tired, not having energy)?
1234
3766
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set C Q-5
H-Vignette - Set C Q-5
H-Vignette - Set C Q-5
H-Vignette - Set C Q-5
H-Vignette - Set C Q-5
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Vision, Sleep and Energy
[Hector] can read words in newspaper articles (and can recognize faces on a postcard size photograph). He can recognize familiar people’s faces all the time
and picks out most details in pictures from across 20 metres.
In the last 30 days, how much difficulty did you think [name of person] have in seeing and recognizing a person she knows across the road ( i.e. from a distance of about 20 meters)?
1236
3764
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set C Q-6
H-Vignette - Set C Q-6
H-Vignette - Set C Q-6
H-Vignette - Set C Q-6
H-Vignette - Set C Q-6
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Vision, Sleep and Energy
[Hector] can read words in newspaper articles (and can recognize faces on a postcard size photograph). He can recognize familiar people’s faces all the time
and picks out most details in pictures from across 20 metres.
In the last 30 days, how much difficulty did you think [name of person] have in seeing and recognizing an object at arm's length or in reading?
1233
3767
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set C Q-7
H-Vignette - Set C Q-7
H-Vignette - Set C Q-7
H-Vignette - Set C Q-7
H-Vignette - Set C Q-7
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Vision, Sleep and Energy
[Damien] wakes up almost once every hour during the night. When she wakes up in the night, it takes around 15 minutes for her to go back to sleep. In the morning she does not feel well-rested and feels slow and tired all day.
In the last 30 days, how much difficulty do you think [name of person] had with sleeping, such as falling asleep, waking up frequently during the night or waking up too early in the morning?
1238
3762
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set C Q-8
H-Vignette - Set C Q-8
H-Vignette - Set C Q-8
H-Vignette - Set C Q-8
H-Vignette - Set C Q-8
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Vision, Sleep and Energy
[Damien] wakes up almost once every hour during the night. When she wakes up in the night, it takes around 15 minutes for her to go back to sleep. In the morning she does not feel well-rested and feels slow and tired all day.
In the last 30 days, how much of a problem did you have due to not feeling rested and refreshed during the day (e.g. feeling tired, not having energy)?
1238
3762
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set C Q-9
H-Vignette - Set C Q-9
H-Vignette - Set C Q-9
H-Vignette - Set C Q-9
H-Vignette - Set C Q-9
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Vision, Sleep and Energy
[Daniel] takes about two hours every night to fall asleep. He wakes up once or twice a night feeling panicked and takes more than one hour to fall asleep
again. Three to four nights a week he wakes up in the middle of the night and cannot go back to sleep for the rest of the night. He is fatigued all day, every day
and misses work several times a week. He cannot take part in sports or social activities.
In the last 30 days, how much difficulty do you think [name of person] had with sleeping, such as falling asleep, waking up frequently during the night or waking up too early in the morning?
1237
3763
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set C Q-10
H-Vignette - Set C Q-10
H-Vignette - Set C Q-10
H-Vignette - Set C Q-10
H-Vignette - Set C Q-10
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Vision, Sleep and Energy
[Daniel] takes about two hours every night to fall asleep. He wakes up once or twice a night feeling panicked and takes more than one hour to fall asleep
again. Three to four nights a week he wakes up in the middle of the night and cannot go back to sleep for the rest of the night. He is fatigued all day, every day
and misses work several times a week. He cannot take part in sports or social activities.
In the last 30 days, how much of a problem did you have due to not feeling rested and refreshed during the day (e.g. feeling tired, not having energy)?
1236
3764
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set C Q-11
H-Vignette - Set C Q-11
H-Vignette - Set C Q-11
H-Vignette - Set C Q-11
H-Vignette - Set C Q-11
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Vision, Sleep and Energy
[Norman] needs a magnifying glass to read small print and look at details on pictures. He also takes a while to recognize objects if they are too far from him.
In the last 30 days, how much difficulty did you think [name of person] have in seeing and recognizing a person she knows across the road ( i.e.from a distance of about 20 meters)?
1234
3766
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set C Q-12
H-Vignette - Set C Q-12
H-Vignette - Set C Q-12
H-Vignette - Set C Q-12
H-Vignette - Set C Q-12
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Vision, Sleep and Energy
[Norman] needs a magnifying glass to read small print and look at details on pictures. He also takes a while to recognize objects if they are too far from him.
In the last 30 days, how much difficulty did you think [name of person] have in seeing and recognizing an object at arm’s length or in reading?
1234
3766
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set C Q-13
H-Vignette - Set C Q-13
H-Vignette - Set C Q-13
H-Vignette - Set C Q-13
H-Vignette - Set C Q-13
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Vision, Sleep and Energy
[Antonio] can read words in newspaper articles (and can recognize faces on a postcard size photograph). He can recognize shapes and colours from across 20
metres but misses out the fine details.
In the last 30 days, how much difficulty did you think [name of person] have in seeing and recognizing a person she knows across the road ( i.e.from a distance of about 20 meters)?
1232
3768
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set C Q-14
H-Vignette - Set C Q-14
H-Vignette - Set C Q-14
H-Vignette - Set C Q-14
H-Vignette - Set C Q-14
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Vision, Sleep and Energy
[Antonio] can read words in newspaper articles (and can recognize faces on a postcard size photograph). He can recognize shapes and colours from across 20
metres but misses out the fine details.
In the last 30 days, how much difficulty did you think [name of person] have in seeing and recognizing an object at arm’s length or in reading?
1232
3768
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set C Q-15
H-Vignette - Set C Q-15
H-Vignette - Set C Q-15
H-Vignette - Set C Q-15
H-Vignette - Set C Q-15
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Vision, Sleep and Energy
[Noemi] falls asleep easily at night, but two nights a week she wakes up in the middle of the night and cannot go back to sleep for the rest of the night. On
these days she is exhausted at work and cannot concentrate on her job.
In the last 30 days, how much difficulty do you think [name of person] had with sleeping, such as falling asleep, waking up frequently during the night or waking up too early in the morning?
1235
3765
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set C Q-16
H-Vignette - Set C Q-16
H-Vignette - Set C Q-16
H-Vignette - Set C Q-16
H-Vignette - Set C Q-16
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Vision, Sleep and Energy
[Noemi] falls asleep easily at night, but two nights a week she wakes up in the middle of the night and cannot go back to sleep for the rest of the night. On
these days she is exhausted at work and cannot concentrate on her job.
In the last 30 days, how much of a problem did you have due to not feeling rested and refreshed during the day (e.g. feeling tired, not having energy)?
1235
3765
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set C Q-17
H-Vignette - Set C Q-17
H-Vignette - Set C Q-17
H-Vignette - Set C Q-17
H-Vignette - Set C Q-17
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Vision, Sleep and Energy
[Sebastian] cannot detect any movement close to the eyes or even the presence of a light.
In the last 30 days, how much difficulty did you think [name of person] have in seeing and recognizing a person she knows across the road ( i.e. from a distance of about 20 meters)?
1238
3762
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set C Q-18
H-Vignette - Set C Q-18
H-Vignette - Set C Q-18
H-Vignette - Set C Q-18
H-Vignette - Set C Q-18
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Vision, Sleep and Energy
[Sebastian] cannot detect any movement close to the eyes or even the presence of a light.
In the last 30 days, how much difficulty did you think [name of person] have in seeing and recognizing an object at arm’s length or in reading?
1237
3763
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set C Q-19
H-Vignette - Set C Q-19
H-Vignette - Set C Q-19
H-Vignette - Set C Q-19
H-Vignette - Set C Q-19
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Vision, Sleep and Energy
[Mark] falls asleep every night within five minutes of going to bed. He sleeps soundly during the whole night and wakes up in the morning feeling well-rested
and feels full of energy all day.
In the last 30 days, how much difficulty do you think [name of person] had with sleeping, such as falling asleep, waking up frequently during the night or waking up too early in the morning?
1235
3765
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set C Q-20
H-Vignette - Set C Q-20
H-Vignette - Set C Q-20
H-Vignette - Set C Q-20
H-Vignette - Set C Q-20
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Vision, Sleep and Energy
[Mark] falls asleep every night within five minutes of going to bed. He sleeps soundly during the whole night and wakes up in the morning feeling well-rested
and feels full of energy all day.
In the last 30 days, how much of a problem did you have due to not feeling rested and refreshed during the day (e.g. feeling tired, not having
energy)?
1231
3769
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set D Q-1
H-Vignette - Set D Q-1
H-Vignette - Set D Q-1
H-Vignette - Set D Q-1
H-Vignette - Set D Q-1
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Cognition and Self Care
[Helena] pays a lot of attention to the way she looks. She requires no assistance with cleanliness, dressing and eating.
Overall in the last 30 days, how much difficulty did [name of person] have with self-care, such as washing or dressing himself/herself?
1241
3759
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set D Q-2
H-Vignette - Set D Q-2
H-Vignette - Set D Q-2
H-Vignette - Set D Q-2
H-Vignette - Set D Q-2
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Cognition and Self Care
[Helena] pays a lot of attention to the way she looks. She requires no assistance with cleanliness, dressing and eating.
In the last 30 days, how much difficulty did [name of person] have in taking care of and maintaining his/her general appearance (e.g. grooming, looking neat and tidy etc.)
1241
3759
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set D Q-3
H-Vignette - Set D Q-3
H-Vignette - Set D Q-3
H-Vignette - Set D Q-3
H-Vignette - Set D Q-3
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Cognition and Self Care
[Sue] can find her way around the neighborhood and know where her own belongings are kept, but struggles to remember how to get to a place she has only visited once or twice. She is keen to learn new recipes but finds that she often makes mistakes and has to reread several times before she is able to do them properly.
Overall in the last 30 days overall how much difficulty did [name of the
person] have with concentrating or remembering things?
1238
3762
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set D Q-4
H-Vignette - Set D Q-4
H-Vignette - Set D Q-4
H-Vignette - Set D Q-4
H-Vignette - Set D Q-4
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Cognition and Self Care
[Sue] can find her way around the neighborhood and know where her own belongings are kept, but struggles to remember how to get to a place she has only visited once or twice. She is keen to learn new recipes but finds that she often makes mistakes and has to reread several times before she is able to do them properly.
In the last 30 days, how much difficulty did [name of person] have in
learning a new task (for example, learning how to get to a new place,
learning a new game, learning a new recipe etc.)?
1237
3763
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set D Q-5
H-Vignette - Set D Q-5
H-Vignette - Set D Q-5
H-Vignette - Set D Q-5
H-Vignette - Set D Q-5
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Cognition and Self Care
[Sue] is quadriplegic and must be washed, groomed, dressed and fed by somebody else.
Overall in the last 30 days, how much difficulty did [name of person]
have with self-care, such as washing or dressing himself/herself?
1239
3761
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set D Q-6
H-Vignette - Set D Q-6
H-Vignette - Set D Q-6
H-Vignette - Set D Q-6
H-Vignette - Set D Q-6
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Cognition and Self Care
[Sue] is quadriplegic and must be washed, groomed, dressed and fed by somebody else.
In the last 30 days, how much difficulty did [name of person] have in
taking care of and maintaining his/her general appearance(e.g. grooming,
looking neat and tidy etc.)
1239
3761
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set D Q-7
H-Vignette - Set D Q-7
H-Vignette - Set D Q-7
H-Vignette - Set D Q-7
H-Vignette - Set D Q-7
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Cognition and Self Care
[Malcolm] can concentrate while watching TV, reading a magazine or playing a game of cards or chess. He can learn new variations in these games with
small effort. Once a week he forgets where his keys or glasses are, but finds them within five minutes.
Overall in the last 30 days overall how much difficulty did [name of the
person] have with concentrating or remembering things?
1236
3764
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set D Q-8
H-Vignette - Set D Q-8
H-Vignette - Set D Q-8
H-Vignette - Set D Q-8
H-Vignette - Set D Q-8
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Cognition and Self Care
[Malcolm] can concentrate while watching TV, reading a magazine or playing a game of cards or chess. He can learn new variations in these games with
small effort. Once a week he forgets where his keys or glasses are, but finds them within five minutes.
In the last 30 days, how much difficulty did [name of person] have in
learning a new task (for example, learning how to get to a new place,
learning a new game, learning a new recipe etc.)?
1236
3764
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set D Q-9
H-Vignette - Set D Q-9
H-Vignette - Set D Q-9
H-Vignette - Set D Q-9
H-Vignette - Set D Q-9
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Cognition and Self Care
[Rob] is very quick to learn new skills at his work. He can pay attention to the task at hand for long uninterrupted periods of time. He can remember names of
people, addresses, phone numbers and such details that go back several years.
Overall in the last 30 days overall how much difficulty did [name of the
person] have with concentrating or remembering things?
1238
3762
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set D Q-10
H-Vignette - Set D Q-10
H-Vignette - Set D Q-10
H-Vignette - Set D Q-10
H-Vignette - Set D Q-10
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Cognition and Self Care
[Rob] is very quick to learn new skills at his work. He can pay attention to the task at hand for long uninterrupted periods of time. He can remember names of
people, addresses, phone numbers and such details that go back several years.
In the last 30 days, how much difficulty did [name of person] have in
learning a new task (for example, learning how to get to a new place,
learning a new game, learning a new recipe etc.)?
1238
3762
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set D Q-11
H-Vignette - Set D Q-11
H-Vignette - Set D Q-11
H-Vignette - Set D Q-11
H-Vignette - Set D Q-11
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Cognition and Self Care
[Theo] cannot concentrate for more than 15 minutes and has difficulty paying attention to what is being said to him. Whenever he starts a task, he never
manages to finish it and often forgets what he was doing. He is able to learn the names of people he meets but cannot be trusted to follow directions to a store
by himself.
Overall in the last 30 days overall how much difficulty did [name of the
person] have with concentrating or remembering things?
1238
3762
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set D Q-12
H-Vignette - Set D Q-12
H-Vignette - Set D Q-12
H-Vignette - Set D Q-12
H-Vignette - Set D Q-12
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Cognition and Self Care
[Theo] cannot concentrate for more than 15 minutes and has difficulty paying attention to what is being said to him. Whenever he starts a task, he never
manages to finish it and often forgets what he was doing. He is able to learn the names of people he meets but cannot be trusted to follow directions to a store
by himself.
In the last 30 days, how much difficulty did [name of person] have in
learning a new task (for example, learning how to get to a new place,
learning a new game, learning a new recipe etc.)?
1237
3763
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set D Q-13
H-Vignette - Set D Q-13
H-Vignette - Set D Q-13
H-Vignette - Set D Q-13
H-Vignette - Set D Q-13
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Cognition and Self Care
[Anne] takes twice as long as others to put on and take off clothes, but needs no help with this. Although it requires an effort, she is able to bathe and groom
herself, though less frequently than before. She does not require help with feeding.
Overall in the last 30 days, how much difficulty did [name of person]
have with self-care, such as washing or dressing himself/herself?
1236
3764
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set D Q-14
H-Vignette - Set D Q-14
H-Vignette - Set D Q-14
H-Vignette - Set D Q-14
H-Vignette - Set D Q-14
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Cognition and Self Care
[Anne] takes twice as long as others to put on and take off clothes, but needs no help with this. Although it requires an effort, she is able to bathe and groom
herself, though less frequently than before. She does not require help with feeding.
In the last 30 days, how much difficulty did [name of person] have in
taking care of and maintaining his/her general appearance(e.g. grooming,
looking neat and tidy etc.)
1237
3763
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set D Q-15
H-Vignette - Set D Q-15
H-Vignette - Set D Q-15
H-Vignette - Set D Q-15
H-Vignette - Set D Q-15
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Cognition and Self Care
[Peter] does not recognize even close relatives and gets lost when he leaves the house unaccompanied. Even when prompted, he shows no recollection of
events or recognition of relatives. It is impossible for him to acquire any new knowledge as even simple instructions leave him confused.
Overall in the last 30 days overall how much difficulty did [name of the
person] have with concentrating or remembering things?
1237
3763
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set D Q-16
H-Vignette - Set D Q-16
H-Vignette - Set D Q-16
H-Vignette - Set D Q-16
H-Vignette - Set D Q-16
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Cognition and Self Care
[Peter] does not recognize even close relatives and gets lost when he leaves the house unaccompanied. Even when prompted, he shows no recollection of
events or recognition of relatives. It is impossible for him to acquire any new knowledge as even simple instructions leave him confused.
In the last 30 days, how much difficulty did [name of person] have in
learning a new task (for example, learning how to get to a new place,
learning a new game, learning a new recipe etc.)?
1237
3763
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set D Q-17
H-Vignette - Set D Q-17
H-Vignette - Set D Q-17
H-Vignette - Set D Q-17
H-Vignette - Set D Q-17
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Cognition and Self Care
[Sandra] lives on her own and has no relatives or friends nearby. Because of her arthritis, she is house-bound. She often stays all day in the same clothes that
she has slept in, as changing clothes is too painful. A neighbour helps her wash herself.
Overall in the last 30 days, how much difficulty did [name of person]
have with self-care, such as washing or dressing himself/herself?
1238
3762
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set D Q-18
H-Vignette - Set D Q-18
H-Vignette - Set D Q-18
H-Vignette - Set D Q-18
H-Vignette - Set D Q-18
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Cognition and Self Care
[Sandra] lives on her own and has no relatives or friends nearby. Because of her arthritis, she is house-bound. She often stays all day in the same clothes that
she has slept in, as changing clothes is too painful. A neighbour helps her wash herself.
In the last 30 days, how much difficulty did [name of person] have in
taking care of and maintaining his/her general appearance (e.g. grooming,
looking neat and tidy etc.)
1237
3763
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set D Q-19
H-Vignette - Set D Q-19
H-Vignette - Set D Q-19
H-Vignette - Set D Q-19
H-Vignette - Set D Q-19
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Cognition and Self Care
[Victor] requires no assistance with cleanliness, dressing and eating. He occasionally suffers from back pain and when this happens he needs help with bathing
and dressing. He always keeps himself tidy.
Overall in the last 30 days, how much difficulty did [name of person]
have with self-care, such as washing or dressing himself/herself?
1238
3762
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
H-Vignette - Set D Q-20
H-Vignette - Set D Q-20
H-Vignette - Set D Q-20
H-Vignette - Set D Q-20
H-Vignette - Set D Q-20
VIGNETTES FOR HEALTH STATE DESCRIPTIONS
I will now read to you some descriptions of persons with varying levels of difficulties in different areas of health. I would like to know how you view each of these descriptions and rate how much of a problem or difficulty the person described has in that area of health in the same way that you described your health to me. While giving the rating, think of the person as someone who is of your age and background.
Cognition and Self Care
[Victor] requires no assistance with cleanliness, dressing and eating. He occasionally suffers from back pain and when this happens he needs help with bathing
and dressing. He always keeps himself tidy.
In the last 30 days, how much difficulty did [name of person] have in
taking care of and maintaining his/her general appearance (e.g. grooming,
looking neat and tidy etc.)
1237
3763
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
Time end section 2000
Time end section 2000
Time end section 2000
Time end section 2000
Time end section 2000
4998
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Time begin section 3000
Time begin section 3000
Time begin section 3000
Time begin section 3000
Time begin section 3000
4999
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HSV Set code
HSV Set code
HSV Set code
HSV Set code
HSV Set code
5000
A
B
HSV - Set A Q-1
HSV - Set A Q-1
HSV - Set A Q-1
HSV - Set A Q-1
HSV - Set A Q-1
Health State Valuations
Descriptions
The questions I am going to ask you now are about different states of health. I will present several different states, and I want you to try to imagine what it
would be like to live in those states.
If you look at these cards you will see that each card describes one health state. Let me begin by reading each card out loud (READ EACH CARD AND HAND IT TO RESPONDENT). Now, for each state, I am going to ask you to describe what you imagine that state would be like in terms of different aspects
of health.
Please try to imagine what it would be like to live in the following health state: Below the knee amputation in one leg, with no prosthesis but with basic crutches available.
Overall, how much difficulty would a person in this state have with selfcare,
such as washing or dressing himself / herself?
2496
2504
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
HSV - Set A Q-2
HSV - Set A Q-2
HSV - Set A Q-2
HSV - Set A Q-2
HSV - Set A Q-2
Health State Valuations
Descriptions
The questions I am going to ask you now are about different states of health. I will present several different states, and I want you to try to imagine what it
would be like to live in those states.
If you look at these cards you will see that each card describes one health state. Let me begin by reading each card out loud (READ EACH CARD AND HAND IT TO RESPONDENT). Now, for each state, I am going to ask you to describe what you imagine that state would be like in terms of different aspects
of health.
Please try to imagine what it would be like to live in the following health state: Below the knee amputation in one leg, with no prosthesis but with basic crutches available.
Overall, how much difficulty would a person in this state have with
moving around?
2495
2505
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
HSV - Set A Q-3
HSV - Set A Q-3
HSV - Set A Q-3
HSV - Set A Q-3
HSV - Set A Q-3
Health State Valuations
Descriptions:
The questions I am going to ask you now are about different states of health. I will present several different states, and I want you to try to imagine what it
would be like to live in those states.
If you look at these cards you will see that each card describes one health state. Let me begin by reading each card out loud (READ EACH CARD AND HAND IT TO RESPONDENT). Now, for each state, I am going to ask you to describe what you imagine that state would be like in terms of different aspects
of health.
Please try to imagine what it would be like to live in the following health state: Below the knee amputation in one leg, with no prosthesis but with basic crutches available.
Overall, how much of bodily aches and pains would a person in this state
have?
2483
2517
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
HSV - Set A Q-4
HSV - Set A Q-4
HSV - Set A Q-4
HSV - Set A Q-4
HSV - Set A Q-4
Health State Valuations
Descriptions:
The questions I am going to ask you now are about different states of health. I will present several different states, and I want you to try to imagine what it
would be like to live in those states.
If you look at these cards you will see that each card describes one health state. Let me begin by reading each card out loud (READ EACH CARD AND HAND IT TO RESPONDENT). Now, for each state, I am going to ask you to describe what you imagine that state would be like in terms of different aspects
of health.
Now please try to imagine what it would be like to live in the following health state: Alcohol dependence, marked by excessive drinking that cannot be controlled.
Overall, how much difficulty would a person in this state have with selfcare,
such as washing or dressing himself / herself?
2494
2506
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
HSV - Set A Q-5
HSV - Set A Q-5
HSV - Set A Q-5
HSV - Set A Q-5
HSV - Set A Q-5
Health State Valuations
Descriptions:
The questions I am going to ask you now are about different states of health. I will present several different states, and I want you to try to imagine what it
would be like to live in those states.
If you look at these cards you will see that each card describes one health state. Let me begin by reading each card out loud (READ EACH CARD AND HAND IT TO RESPONDENT). Now, for each state, I am going to ask you to describe what you imagine that state would be like in terms of different aspects
of health.
Now please try to imagine what it would be like to live in the following health state: Alcohol dependence, marked by excessive drinking that cannot be controlled.
Overall, how much difficulty would a person in this state have with
concentrating or remembering things?
2493
2507
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
HSV - Set A Q-6
HSV - Set A Q-6
HSV - Set A Q-6
HSV - Set A Q-6
HSV - Set A Q-6
Health State Valuations
Descriptions:
The questions I am going to ask you now are about different states of health. I will present several different states, and I want you to try to imagine what it
would be like to live in those states.
If you look at these cards you will see that each card describes one health state. Let me begin by reading each card out loud (READ EACH CARD AND HAND IT TO RESPONDENT). Now, for each state, I am going to ask you to describe what you imagine that state would be like in terms of different aspects
of health.
Now please try to imagine what it would be like to live in the following health state: Alcohol dependence, marked by excessive drinking that cannot be controlled.
Overall, how much of a problem would a person in this state have with
sleeping, such as falling asleep, waking up frequently during the night or
waking up too early in the morning?
2488
2512
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
HSV - Set A Q-7
HSV - Set A Q-7
HSV - Set A Q-7
HSV - Set A Q-7
HSV - Set A Q-7
Health State Valuations
Descriptions:
The questions I am going to ask you now are about different states of health. I will present several different states, and I want you to try to imagine what it
would be like to live in those states.
If you look at these cards you will see that each card describes one health state. Let me begin by reading each card out loud (READ EACH CARD AND HAND IT TO RESPONDENT). Now, for each state, I am going to ask you to describe what you imagine that state would be like in terms of different aspects
of health.
Please try to imagine what it would be like to live in the following health state: having limited long-distance vision - able to read and recognize objects at
arm’s length but not to distinguish faces across a room (i.e., at distance of 5 meters); no glasses available.
How much difficulty would a person in this state have with vigorous
activities, such as running 3 km (or equivalent) or cycling?
2494
2506
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
HSV - Set A Q-8
HSV - Set A Q-8
HSV - Set A Q-8
HSV - Set A Q-8
HSV - Set A Q-8
Health State Valuations
Descriptions:
The questions I am going to ask you now are about different states of health. I will present several different states, and I want you to try to imagine what it
would be like to live in those states.
If you look at these cards you will see that each card describes one health state. Let me begin by reading each card out loud (READ EACH CARD AND HAND IT TO RESPONDENT). Now, for each state, I am going to ask you to describe what you imagine that state would be like in terms of different aspects
of health.
Please try to imagine what it would be like to live in the following health state: having limited long-distance vision - able to read and recognize objects at
arm’s length but not to distinguish faces across a room (i.e., at distance of 5 meters); no glasses available.
Overall, how much difficulty would a person in this state have with
personal relationships or participation in the community?
2489
2511
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
HSV - Set A Q-9
HSV - Set A Q-9
HSV - Set A Q-9
HSV - Set A Q-9
HSV - Set A Q-9
Health State Valuations
Descriptions:
The questions I am going to ask you now are about different states of health. I will present several different states, and I want you to try to imagine what it
would be like to live in those states.
If you look at these cards you will see that each card describes one health state. Let me begin by reading each card out loud (READ EACH CARD AND HAND IT TO RESPONDENT). Now, for each state, I am going to ask you to describe what you imagine that state would be like in terms of different aspects
of health.
Please try to imagine what it would be like to live in the following health state: having limited long-distance vision - able to read and recognize objects at
arm’s length but not to distinguish faces across a room (i.e., at distance of 5 meters); no glasses available.
How much difficulty would a person in this state have with seeing and
recognizing a person he or she knows across the road (i.e. from a distance
of about 20 meters)?
2493
2507
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
HSV - Set A Q-10
HSV - Set A Q-10
HSV - Set A Q-10
HSV - Set A Q-10
HSV - Set A Q-10
Health State Valuations
Descriptions:
The questions I am going to ask you now are about different states of health. I will present several different states, and I want you to try to imagine what it
would be like to live in those states.
If you look at these cards you will see that each card describes one health state. Let me begin by reading each card out loud (READ EACH CARD AND HAND IT TO RESPONDENT). Now, for each state, I am going to ask you to describe what you imagine that state would be like in terms of different aspects
of health.
Now please try to imagine what it would be like to live in the following health state: Chronic lower back pain, with stiffness in the morning, problems sitting or bending and to a lesser degree walking; difficulties in all physical activities.
Overall, how much difficulty would a person in this state have with selfcare,
such as washing or dressing himself / herself?
2494
2506
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
HSV - Set A Q-11
HSV - Set A Q-11
HSV - Set A Q-11
HSV - Set A Q-11
HSV - Set A Q-11
Health State Valuations
Descriptions:
The questions I am going to ask you now are about different states of health. I will present several different states, and I want you to try to imagine what it
would be like to live in those states.
If you look at these cards you will see that each card describes one health state. Let me begin by reading each card out loud (READ EACH CARD AND HAND IT TO RESPONDENT). Now, for each state, I am going to ask you to describe what you imagine that state would be like in terms of different aspects
of health.
Now please try to imagine what it would be like to live in the following health state: Chronic lower back pain, with stiffness in the morning, problems sitting or bending and to a lesser degree walking; difficulties in all physical activities.
Overall, how much of bodily aches and pains would a person in this state
have?
2491
2509
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
HSV - Set A Q-12
HSV - Set A Q-12
HSV - Set A Q-12
HSV - Set A Q-12
HSV - Set A Q-12
Health State Valuations
Descriptions:
The questions I am going to ask you now are about different states of health. I will present several different states, and I want you to try to imagine what it
would be like to live in those states.
If you look at these cards you will see that each card describes one health state. Let me begin by reading each card out loud (READ EACH CARD AND HAND IT TO RESPONDENT). Now, for each state, I am going to ask you to describe what you imagine that state would be like in terms of different aspects
of health.
Now please try to imagine what it would be like to live in the following health state: Chronic lower back pain, with stiffness in the morning, problems sitting or bending and to a lesser degree walking; difficulties in all physical activities.
Overall how much difficulty would a person in this state have with
moving around?
2487
2513
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
HSV - Set A Q-13
HSV - Set A Q-13
HSV - Set A Q-13
HSV - Set A Q-13
HSV - Set A Q-13
Health State Valuations
Descriptions:
The questions I am going to ask you now are about different states of health. I will present several different states, and I want you to try to imagine what it
would be like to live in those states.
If you look at these cards you will see that each card describes one health state. Let me begin by reading each card out loud (READ EACH CARD AND HAND IT TO RESPONDENT). Now, for each state, I am going to ask you to describe what you imagine that state would be like in terms of different aspects
of health.
Now please try to imagine the following health state: total blindness in both eyes, acquired as an adult.
Overall, how much difficulty would a person in this state have with
feeling sad, low or depressed?
2492
2508
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
HSV - Set A Q-14
HSV - Set A Q-14
HSV - Set A Q-14
HSV - Set A Q-14
HSV - Set A Q-14
Health State Valuations
Descriptions:
The questions I am going to ask you now are about different states of health. I will present several different states, and I want you to try to imagine what it
would be like to live in those states.
If you look at these cards you will see that each card describes one health state. Let me begin by reading each card out loud (READ EACH CARD AND HAND IT TO RESPONDENT). Now, for each state, I am going to ask you to describe what you imagine that state would be like in terms of different aspects
of health.
Now please try to imagine the following health state: total blindness in both eyes, acquired as an adult.
Overall, how much difficulty would a person in this state have with
moving around?
2493
2507
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
HSV - Set A Q-15
HSV - Set A Q-15
HSV - Set A Q-15
HSV - Set A Q-15
HSV - Set A Q-15
Health State Valuations
Descriptions:
The questions I am going to ask you now are about different states of health. I will present several different states, and I want you to try to imagine what it
would be like to live in those states.
If you look at these cards you will see that each card describes one health state. Let me begin by reading each card out loud (READ EACH CARD AND HAND IT TO RESPONDENT). Now, for each state, I am going to ask you to describe what you imagine that state would be like in terms of different aspects
of health.
Now please try to imagine the following health state: total blindness in both eyes, acquired as an adult.
Overall, how much difficulty would a person in this state have with
personal relationships or participation in the community?
2492
2508
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
HSV - Set A Q-16
HSV - Set A Q-16
HSV - Set A Q-16
HSV - Set A Q-16
HSV - Set A Q-16
Health State Valuations
Ordinal Ranking Exercise:
Now that you have described the states on these cards, what I would like you to do is to compare each card to the others and rank them according to how healthy you think somebody in each state would be overall, considering all of the different parts of health. For each state, please try to imagine what it would be like to live in that state for the rest of your life.
I will read through the cards again, and as I read them, please think carefully about which state you think is the best and which state you think is the worst.
(READ EACH CARD TO RESPONDENT AND HAND HIM/HER THE CARD.)
Now, of all of these states, please pick the one that you think would be the most healthy out of all of them. (LET RESPONDENT PICK). We will put this card at the top. And which state would you consider to be the least healthy? (LET RESPONDENT PICK). We will put this card at the bottom. Now, I would like for you to place the rest of the cards in order from the best to the worst health.
Rank 1 (BEST)
2500
88
ALC
AMP
BAK
BLI
DK
VIS
HSV - Set A Q-17
HSV - Set A Q-17
HSV - Set A Q-17
HSV - Set A Q-17
HSV - Set A Q-17
Health State Valuations
Ordinal Ranking Exercise:
Now that you have described the states on these cards, what I would like you to do is to compare each card to the others and rank them according to how healthy you think somebody in each state would be overall, considering all of the different parts of health. For each state, please try to imagine what it would be like to live in that state for the rest of your life.
I will read through the cards again, and as I read them, please think carefully about which state you think is the best and which state you think is the worst.
(READ EACH CARD TO RESPONDENT AND HAND HIM/HER THE CARD.)
Now, of all of these states, please pick the one that you think would be the most healthy out of all of them. (LET RESPONDENT PICK). We will put this card at the top. And which state would you consider to be the least healthy? (LET RESPONDENT PICK). We will put this card at the bottom. Now, I would like for you to place the rest of the cards in order from the best to the worst health.
Rank 2
2500
ALC
AMP
BAK
BLI
DK
VIS
HSV - Set A Q-18
HSV - Set A Q-18
HSV - Set A Q-18
HSV - Set A Q-18
HSV - Set A Q-18
Health State Valuations
Ordinal Ranking Exercise:
Now that you have described the states on these cards, what I would like you to do is to compare each card to the others and rank them according to how healthy you think somebody in each state would be overall, considering all of the different parts of health. For each state, please try to imagine what it would be like to live in that state for the rest of your life.
I will read through the cards again, and as I read them, please think carefully about which state you think is the best and which state you think is the worst.
(READ EACH CARD TO RESPONDENT AND HAND HIM/HER THE CARD.)
Now, of all of these states, please pick the one that you think would be the most healthy out of all of them. (LET RESPONDENT PICK). We will put this card at the top. And which state would you consider to be the least healthy? (LET RESPONDENT PICK). We will put this card at the bottom. Now, I would like for you to place the rest of the cards in order from the best to the worst health.
Rank 3
2500
88
ALC
AMP
BAK
BLI
DK
VIS
HSV - Set A Q-19
HSV - Set A Q-19
HSV - Set A Q-19
HSV - Set A Q-19
HSV - Set A Q-19
Health State Valuations
Ordinal Ranking Exercise:
Now that you have described the states on these cards, what I would like you to do is to compare each card to the others and rank them according to how healthy you think somebody in each state would be overall, considering all of the different parts of health. For each state, please try to imagine what it would be like to live in that state for the rest of your life.
I will read through the cards again, and as I read them, please think carefully about which state you think is the best and which state you think is the worst.
(READ EACH CARD TO RESPONDENT AND HAND HIM/HER THE CARD.)
Now, of all of these states, please pick the one that you think would be the most healthy out of all of them. (LET RESPONDENT PICK). We will put this card at the top. And which state would you consider to be the least healthy? (LET RESPONDENT PICK). We will put this card at the bottom. Now, I would like for you to place the rest of the cards in order from the best to the worst health.
Rank 4
2500
ALC
AMP
BAK
BLI
DK
VIS
HSV - Set A Q-20
HSV - Set A Q-20
HSV - Set A Q-20
HSV - Set A Q-20
HSV - Set A Q-20
Health State Valuations
Ordinal Ranking Exercise:
Now that you have described the states on these cards, what I would like you to do is to compare each card to the others and rank them according to how healthy you think somebody in each state would be overall, considering all of the different parts of health. For each state, please try to imagine what it would be like to live in that state for the rest of your life.
I will read through the cards again, and as I read them, please think carefully about which state you think is the best and which state you think is the worst.
(READ EACH CARD TO RESPONDENT AND HAND HIM/HER THE CARD.)
Now, of all of these states, please pick the one that you think would be the most healthy out of all of them. (LET RESPONDENT PICK). We will put this card at the top. And which state would you consider to be the least healthy? (LET RESPONDENT PICK). We will put this card at the bottom. Now, I would like for you to place the rest of the cards in order from the best to the worst health.
Rank 5 (WORST)
2500
ALC
AMP
BAK
BLI
DK
VIS
HSV - Set B Q-1
HSV - Set B Q-1
HSV - Set B Q-1
HSV - Set B Q-1
HSV - Set B Q-1
Health State Valuations
Descriptions:
The questions I am going to ask you now are about different states of health. I will present several different states, and I want you to try to imagine what it would be like to live in those states.
If you look at these cards you will see that each card describes one health state. Let me begin by reading each card out loud (READ EACH CARD AND HAND IT TO RESPONDENT). Now, for each state, I am going to ask you to describe what you imagine that state would be like in terms of different aspects of health.
Please try to imagine what it would be like to live in the following health state: Below the knee amputation in one leg, with no prosthesis but with basic crutches available.
Overall, how much difficulty would a person in this state have with selfcare,
such as washing or dressing yourself?
2494
2506
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
HSV - Set B Q-2
HSV - Set B Q-2
HSV - Set B Q-2
HSV - Set B Q-2
HSV - Set B Q-2
Health State Valuations
Descriptions:
The questions I am going to ask you now are about different states of health. I will present several different states, and I want you to try to imagine what it would be like to live in those states.
If you look at these cards you will see that each card describes one health state. Let me begin by reading each card out loud (READ EACH CARD AND HAND IT TO RESPONDENT). Now, for each state, I am going to ask you to describe what you imagine that state would be like in terms of different aspects of health.
Please try to imagine what it would be like to live in the following health state: Below the knee amputation in one leg, with no prosthesis but with basic crutches available.
Overall, how much difficulty would a person in this state have with
moving around?
2494
2506
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
HSV - Set B Q-3
HSV - Set B Q-3
HSV - Set B Q-3
HSV - Set B Q-3
HSV - Set B Q-3
Health State Valuations
Descriptions:
The questions I am going to ask you now are about different states of health. I will present several different states, and I want you to try to imagine what it would be like to live in those states.
If you look at these cards you will see that each card describes one health state. Let me begin by reading each card out loud (READ EACH CARD AND HAND IT TO RESPONDENT). Now, for each state, I am going to ask you to describe what you imagine that state would be like in terms of different aspects of health.
Please try to imagine what it would be like to live in the following health state: Below the knee amputation in one leg, with no prosthesis but with basic crutches available.
Overall how much of bodily aches and pains would a person in this state
have?
2488
2512
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
HSV - Set B Q-4
HSV - Set B Q-4
HSV - Set B Q-4
HSV - Set B Q-4
HSV - Set B Q-4
Health State Valuations
Descriptions:
The questions I am going to ask you now are about different states of health. I will present several different states, and I want you to try to imagine what it would be like to live in those states.
If you look at these cards you will see that each card describes one health state. Let me begin by reading each card out loud (READ EACH CARD AND HAND IT TO RESPONDENT). Now, for each state, I am going to ask you to describe what you imagine that state would be like in terms of different aspects of health.
Now please try to imagine the following health state: insomnia: difficulty falling asleep, waking up earlier than wanted and frequently during the night.
Overall, how much difficulty would a person in this state have with
concentrating or remembering things?
2489
2511
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
HSV - Set B Q-5
HSV - Set B Q-5
HSV - Set B Q-5
HSV - Set B Q-5
HSV - Set B Q-5
Health State Valuations
Descriptions:
The questions I am going to ask you now are about different states of health. I will present several different states, and I want you to try to imagine what it would be like to live in those states.
If you look at these cards you will see that each card describes one health state. Let me begin by reading each card out loud (READ EACH CARD AND HAND IT TO RESPONDENT). Now, for each state, I am going to ask you to describe what you imagine that state would be like in terms of different aspects of health.
Now please try to imagine the following health state: insomnia: difficulty falling asleep, waking up earlier than wanted and frequently during the night.
Overall, how much of a problem would a person in this state have due to
not feeling rested and refreshed during the day?
2491
2509
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
HSV - Set B Q-6
HSV - Set B Q-6
HSV - Set B Q-6
HSV - Set B Q-6
HSV - Set B Q-6
Health State Valuations
Descriptions:
The questions I am going to ask you now are about different states of health. I will present several different states, and I want you to try to imagine what it would be like to live in those states.
If you look at these cards you will see that each card describes one health state. Let me begin by reading each card out loud (READ EACH CARD AND HAND IT TO RESPONDENT). Now, for each state, I am going to ask you to describe what you imagine that state would be like in terms of different aspects of health.
Now please try to imagine the following health state: insomnia: difficulty falling asleep, waking up earlier than wanted and frequently during the night.
Overall how much difficulty would a person in this state have with feeling
sad, low or depressed?
2489
2511
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
HSV - Set B Q-7
HSV - Set B Q-7
HSV - Set B Q-7
HSV - Set B Q-7
HSV - Set B Q-7
Health State Valuations
Descriptions:
The questions I am going to ask you now are about different states of health. I will present several different states, and I want you to try to imagine what it would be like to live in those states.
If you look at these cards you will see that each card describes one health state. Let me begin by reading each card out loud (READ EACH CARD AND HAND IT TO RESPONDENT). Now, for each state, I am going to ask you to describe what you imagine that state would be like in terms of different aspects of health.
Now please try to imagine the following health state: arthritis in both hands and wrists, causing major pain, stiffness, swelling and deformities.
Overall, how much difficulty would a person in this state have with selfcare,
such as washing or dressing himself/herself?
2493
2507
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
HSV - Set B Q-8
HSV - Set B Q-8
HSV - Set B Q-8
HSV - Set B Q-8
HSV - Set B Q-8
Health State Valuations
Descriptions:
The questions I am going to ask you now are about different states of health. I will present several different states, and I want you to try to imagine what it would be like to live in those states.
If you look at these cards you will see that each card describes one health state. Let me begin by reading each card out loud (READ EACH CARD AND HAND IT TO RESPONDENT). Now, for each state, I am going to ask you to describe what you imagine that state would be like in terms of different aspects of health.
Now please try to imagine the following health state: arthritis in both hands and wrists, causing major pain, stiffness, swelling and deformities.
Overall how much of bodily aches and pains would a person in this state
have?
2493
2507
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
HSV - Set B Q-9
HSV - Set B Q-9
HSV - Set B Q-9
HSV - Set B Q-9
HSV - Set B Q-9
Health State Valuations
Descriptions:
The questions I am going to ask you now are about different states of health. I will present several different states, and I want you to try to imagine what it would be like to live in those states.
If you look at these cards you will see that each card describes one health state. Let me begin by reading each card out loud (READ EACH CARD AND HAND IT TO RESPONDENT). Now, for each state, I am going to ask you to describe what you imagine that state would be like in terms of different aspects of health.
Now please try to imagine the following health state: arthritis in both hands and wrists, causing major pain, stiffness, swelling and deformities.
Overall, how much of a problem would a person in this state have due to
not feeling rested and refreshed during the day?
2491
2509
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
HSV - Set B Q-10
HSV - Set B Q-10
HSV - Set B Q-10
HSV - Set B Q-10
HSV - Set B Q-10
Health State Valuations
Descriptions:
The questions I am going to ask you now are about different states of health. I will present several different states, and I want you to try to imagine what it would be like to live in those states.
If you look at these cards you will see that each card describes one health state. Let me begin by reading each card out loud (READ EACH CARD AND HAND IT TO RESPONDENT). Now, for each state, I am going to ask you to describe what you imagine that state would be like in terms of different aspects of health.
Now please try to imagine the following health state: major depression, with profound sadness, loss of pleasure in activities, slowness and irritability, poor
sleep and appetite and suicidal thoughts.
Overall, how much difficulty would a person in this state have with
personal relationships or participation in the community?
2488
2512
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
HSV - Set B Q-11
HSV - Set B Q-11
HSV - Set B Q-11
HSV - Set B Q-11
HSV - Set B Q-11
Health State Valuations
Descriptions:
The questions I am going to ask you now are about different states of health. I will present several different states, and I want you to try to imagine what it would be like to live in those states.
If you look at these cards you will see that each card describes one health state. Let me begin by reading each card out loud (READ EACH CARD AND HAND IT TO RESPONDENT). Now, for each state, I am going to ask you to describe what you imagine that state would be like in terms of different aspects of health.
Now please try to imagine the following health state: major depression, with profound sadness, loss of pleasure in activities, slowness and irritability, poor
sleep and appetite and suicidal thoughts.
Overall, how much difficulty would a person in this state have with
concentrating or remembering things?
2490
2510
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
HSV - Set B Q-12
HSV - Set B Q-12
HSV - Set B Q-12
HSV - Set B Q-12
HSV - Set B Q-12
Health State Valuations
Descriptions:
The questions I am going to ask you now are about different states of health. I will present several different states, and I want you to try to imagine what it would be like to live in those states.
If you look at these cards you will see that each card describes one health state. Let me begin by reading each card out loud (READ EACH CARD AND HAND IT TO RESPONDENT). Now, for each state, I am going to ask you to describe what you imagine that state would be like in terms of different aspects of health.
Now please try to imagine the following health state: major depression, with profound sadness, loss of pleasure in activities, slowness and irritability, poor
sleep and appetite and suicidal thoughts.
Overall how much difficulty would a person in this state have with feeling
sad, low or depressed?
2489
2511
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
HSV - Set B Q-13
HSV - Set B Q-13
HSV - Set B Q-13
HSV - Set B Q-13
HSV - Set B Q-13
Health State Valuations
Descriptions:
The questions I am going to ask you now are about different states of health. I will present several different states, and I want you to try to imagine what it would be like to live in those states.
If you look at these cards you will see that each card describes one health state. Let me begin by reading each card out loud (READ EACH CARD AND HAND IT TO RESPONDENT). Now, for each state, I am going to ask you to describe what you imagine that state would be like in terms of different aspects of health.
Now please try to imagine the following health state: quadriplegia, or paralysis from the neck down, unable to move arms or legs or use hands, but able to
breathe independently; basic wheelchair available.
Overall, how much difficulty would a person in this state have with
personal relationships or participation in the community?
2489
2511
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
HSV - Set B Q-14
HSV - Set B Q-14
HSV - Set B Q-14
HSV - Set B Q-14
HSV - Set B Q-14
Health State Valuations
Descriptions:
The questions I am going to ask you now are about different states of health. I will present several different states, and I want you to try to imagine what it would be like to live in those states.
If you look at these cards you will see that each card describes one health state. Let me begin by reading each card out loud (READ EACH CARD AND HAND IT TO RESPONDENT). Now, for each state, I am going to ask you to describe what you imagine that state would be like in terms of different aspects of health.
Now please try to imagine the following health state: quadriplegia, or paralysis from the neck down, unable to move arms or legs or use hands, but able to
breathe independently; basic wheelchair available.
Overall, how much bodily discomfort would a person in this state have?
2488
2512
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
HSV - Set B Q-15
HSV - Set B Q-15
HSV - Set B Q-15
HSV - Set B Q-15
HSV - Set B Q-15
Health State Valuations
Descriptions:
The questions I am going to ask you now are about different states of health. I will present several different states, and I want you to try to imagine what it would be like to live in those states.
If you look at these cards you will see that each card describes one health state. Let me begin by reading each card out loud (READ EACH CARD AND HAND IT TO RESPONDENT). Now, for each state, I am going to ask you to describe what you imagine that state would be like in terms of different aspects of health.
Now please try to imagine the following health state: quadriplegia, or paralysis from the neck down, unable to move arms or legs or use hands, but able to
breathe independently; basic wheelchair available.
Overall how much difficulty would a person in this state have with feeling
sad, low or depressed?
2489
2511
1
None
2
Mild
3
Moderate
4
Severe
5
Extreme
Sysmiss
HSV - Set B Q-16
HSV - Set B Q-16
HSV - Set B Q-16
HSV - Set B Q-16
HSV - Set B Q-16
Health State Valuations
Ordinal Ranking Exercise:
Now that you have described the states on these cards, what I would like you to do is to compare each card to the others and rank them according to how
healthy you think somebody in each state would be overall, considering all of the different parts of health. For each state, please try to imagine what it would
be like to live in that state for the rest of your life
I will read through the cards again, and as I read them, please think carefully about which state you think is the best and which state you think is the worst.
(READ EACH CARD TO RESPONDENT AND HAND HIM/HER THE CARD.)
Now, of all of these states, please pick the one that you think would be the most healthy out of all of them. (LET RESPONDENT PICK). We will put this card
at the top. And which state would you consider to be the least healthy? (LET RESPONDENT PICK). We will put this card at the bottom. Now, I would like
for you to place the rest of the cards in order from the best to the worst health.
Rank 1 (BEST)
2499
88
AMP
ART
DEP
DK
NS
QUA
HSV - Set B Q-17
HSV - Set B Q-17
HSV - Set B Q-17
HSV - Set B Q-17
HSV - Set B Q-17
Health State Valuations
Ordinal Ranking Exercise:
Now that you have described the states on these cards, what I would like you to do is to compare each card to the others and rank them according to how
healthy you think somebody in each state would be overall, considering all of the different parts of health. For each state, please try to imagine what it would
be like to live in that state for the rest of your life
I will read through the cards again, and as I read them, please think carefully about which state you think is the best and which state you think is the worst.
(READ EACH CARD TO RESPONDENT AND HAND HIM/HER THE CARD.)
Now, of all of these states, please pick the one that you think would be the most healthy out of all of them. (LET RESPONDENT PICK). We will put this card
at the top. And which state would you consider to be the least healthy? (LET RESPONDENT PICK). We will put this card at the bottom. Now, I would like
for you to place the rest of the cards in order from the best to the worst health.
Rank 2
2498
88
AMP
ART
DEP
DK
NS
QUA
HSV - Set B Q-18
HSV - Set B Q-18
HSV - Set B Q-18
HSV - Set B Q-18
HSV - Set B Q-18
Health State Valuations
Ordinal Ranking Exercise:
Now that you have described the states on these cards, what I would like you to do is to compare each card to the others and rank them according to how
healthy you think somebody in each state would be overall, considering all of the different parts of health. For each state, please try to imagine what it would
be like to live in that state for the rest of your life
I will read through the cards again, and as I read them, please think carefully about which state you think is the best and which state you think is the worst.
(READ EACH CARD TO RESPONDENT AND HAND HIM/HER THE CARD.)
Now, of all of these states, please pick the one that you think would be the most healthy out of all of them. (LET RESPONDENT PICK). We will put this card
at the top. And which state would you consider to be the least healthy? (LET RESPONDENT PICK). We will put this card at the bottom. Now, I would like
for you to place the rest of the cards in order from the best to the worst health.
Rank 3
2498
88
AMP
ART
DEP
DK
NS
QUA
HSV - Set B Q-19
HSV - Set B Q-19
HSV - Set B Q-19
HSV - Set B Q-19
HSV - Set B Q-19
Health State Valuations
Ordinal Ranking Exercise:
Now that you have described the states on these cards, what I would like you to do is to compare each card to the others and rank them according to how
healthy you think somebody in each state would be overall, considering all of the different parts of health. For each state, please try to imagine what it would
be like to live in that state for the rest of your life
I will read through the cards again, and as I read them, please think carefully about which state you think is the best and which state you think is the worst.
(READ EACH CARD TO RESPONDENT AND HAND HIM/HER THE CARD.)
Now, of all of these states, please pick the one that you think would be the most healthy out of all of them. (LET RESPONDENT PICK). We will put this card
at the top. And which state would you consider to be the least healthy? (LET RESPONDENT PICK). We will put this card at the bottom. Now, I would like
for you to place the rest of the cards in order from the best to the worst health.
Rank 4
2498
88
AMP
ART
DEP
DK
NS
QUA
HSV - Set B Q-20
HSV - Set B Q-20
HSV - Set B Q-20
HSV - Set B Q-20
HSV - Set B Q-20
Health State Valuations
Ordinal Ranking Exercise:
Now that you have described the states on these cards, what I would like you to do is to compare each card to the others and rank them according to how
healthy you think somebody in each state would be overall, considering all of the different parts of health. For each state, please try to imagine what it would
be like to live in that state for the rest of your life
I will read through the cards again, and as I read them, please think carefully about which state you think is the best and which state you think is the worst.
(READ EACH CARD TO RESPONDENT AND HAND HIM/HER THE CARD.)
Now, of all of these states, please pick the one that you think would be the most healthy out of all of them. (LET RESPONDENT PICK). We will put this card
at the top. And which state would you consider to be the least healthy? (LET RESPONDENT PICK). We will put this card at the bottom. Now, I would like
for you to place the rest of the cards in order from the best to the worst health.
Rank 5 (WORST)
2498
88
AMP
ART
DEP
DK
NS
QUA
Time end section 3000
Time end section 3000
Time end section 3000
Time end section 3000
Time end section 3000
4998
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Time begin section 4000
Time begin section 4000
Time begin section 4000
Time begin section 4000
Time begin section 4000
4999
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21:31
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21:43
21:47
21:50
22:15
22:30
Currently smoke
Currently smoke
Currently smoke
Currently smoke
Currently smoke
Do you currently smoke any tobacco products such as cigarettes, cigars, or pipes?
5000
1
Daily
2
Yes, but not daily
5
No, not at all
How many years
How many years
How many years
How many years
How many years
For how many years are you been smoking daily?
940
4060
88
25.183
18.812
how many each day manufactured cigarettes
how many each day manufactured cigarettes
how many each day manufactured cigarettes
how many each day manufactured cigarettes
how many each day manufactured cigarettes
On average, how many manufactured cigarettes do you smoke each day?
942
4058
88
12.495
11.802
Hand-rolled cigarette
Hand-rolled cigarette
Hand-rolled cigarette
Hand-rolled cigarette
Hand-rolled cigarette
On average, how many hand-rolled cigarettes do you smoke each day?
941
4059
88
3.667
12.735
How many each day pipeful tobacco
How many each day pipeful tobacco
How many each day pipeful tobacco
How many each day pipeful tobacco
How many each day pipeful tobacco
On average, how many pipefuls of tobacco do you smoke each day?
942
4058
88
1.527
11.088
other tobacco
other tobacco
other tobacco
other tobacco
other tobacco
On average, how many other tobacco products do you smoke each day? (excluding manufactured cigarettes, hand-rolled cigarettes, pipefuls of tobacco)
942
4058
88
1.243
10.277
ever drink alcohol
ever drink alcohol
ever drink alcohol
ever drink alcohol
ever drink alcohol
Have you ever consumed a drink that contains alcohol (such as beer, wine, etc.)?
5000
1
Yes
5
Never
How many each day - Monday
How many each day - Monday
How many each day - Monday
How many each day - Monday
How many each day - Monday
How many standard drinks of any alcoholic beverage did you have on Monday?
3838
1162
11
0.192
0.974
How many each day_Tuesday
How many each day_Tuesday
How many each day_Tuesday
How many each day_Tuesday
How many each day_Tuesday
How many standard drinks of any alcoholic beverage did you have on Tuesday?
3840
1160
11
0.189
0.951
How many each day_Wednesday
How many each day_Wednesday
How many each day_Wednesday
How many each day_Wednesday
How many each day_Wednesday
How many standard drinks of any alcoholic beverage did you have on Wednesday?
3838
1162
24
0.227
1.117
How many each day_Thursday
How many each day_Thursday
How many each day_Thursday
How many each day_Thursday
How many each day_Thursday
How many standard drinks of any alcoholic beverage did you have on Thursday?
3835
1165
20
0.239
1.182
How many each day_Friday
How many each day_Friday
How many each day_Friday
How many each day_Friday
How many each day_Friday
How many standard drinks of any alcoholic beverage did you have on Friday?
3831
1169
14
0.4
1.596
How many each day_Saturday
How many each day_Saturday
How many each day_Saturday
How many each day_Saturday
How many each day_Saturday
How many standard drinks of any alcoholic beverage did you have on Saturday?
3827
1173
30
0.858
2.376
How many each day_Sunday
How many each day_Sunday
How many each day_Sunday
How many each day_Sunday
How many each day_Sunday
How many standard drinks of any alcoholic beverage did you have on Sunday?
3829
1171
24
0.968
2.549
Number of servings of fruit per day
Number of servings of fruit per day
Number of servings of fruit per day
Number of servings of fruit per day
Number of servings of fruit per day
Now I am going to ask you about the fruit and vegetables you usually eat.
How many servings of fruit do you eat on a typical day?
1738
3262
1
2
3
4
5
6
7
8
9
10
11
Sysmiss
Number of servings of vegetables per day
Number of servings of vegetables per day
Number of servings of vegetables per day
Number of servings of vegetables per day
Number of servings of vegetables per day
Now I am going to ask you about the fruit and vegetables you usually eat.
How many servings of vegetables do you eat on a typical day?
2228
2772
1
2
3
4
5
6
7
8
9
10
11
Sysmiss
vigorous physical activities
vigorous physical activities
vigorous physical activities
vigorous physical activities
vigorous physical activities
I am going to ask you about the time you spent being physically active in the last 7 days. Please answer each question even if you do not consider yourself to be an active person. Think about the activities you do at work, as part of your house and yard work, to get from place to place, and in your spare time for recreation, exercise or sport.
Now, think about all the vigorous activities which take hard physical effort that you did in the last 7 days. Vigorous activities make you breathe much harder than normal and may include heavy lifting, digging, aerobics, or fast bicycling.
Think about only those physical activities that you did for at least 10 minutes at a time.
During the last 7 days, on how many days did you do vigorous physical activities?
4997
3
1
2
3
4
5
6
7
Sysmiss
Vigorous PA hours
Vigorous PA hours
Vigorous PA hours
Vigorous PA hours
Vigorous PA hours
How much time did you usually spend doing vigorous physical activities on one of those days? (in hours per day)
1550
3450
11
3.364
3.207
How much time in total vigorous physical activities (minutes)
How much time in total vigorous physical activities (minutes)
How much time in total vigorous physical activities (minutes)
How much time in total vigorous physical activities (minutes)
How much time in total vigorous physical activities (minutes)
How much time did you usually spend doing vigorous physical activities on one of those days? (in minutes per day)
1552
3448
50
7.53
13.144
How many days of moderate physical activities
How many days of moderate physical activities
How many days of moderate physical activities
How many days of moderate physical activities
How many days of moderate physical activities
Now think about activities which take moderate physical effort that you did in the last 7 days. Moderate physical activities make you breathe somewhat harder than normal and may include carrying light loads, bicycling at a regular pace, or doubles tennis. Do not include walking. Again, think about only those physical activities that you did for at least 10 minutes at a time.
During the last 7 days, on how many days did you do moderate physical activities?
4997
3
1
2
3
4
5
6
7
Sysmiss
Moderate PA hours
Moderate PA hours
Moderate PA hours
Moderate PA hours
Moderate PA hours
How much time did you usually spend doing moderate physical activities on one of those days? (hours per day)
3563
1437
11
2.787
2.672
How much time in total moderate physical activities (hours/minutes)
How much time in total moderate physical activities (hours/minutes)
How much time in total moderate physical activities (hours/minutes)
How much time in total moderate physical activities (hours/minutes)
How much time in total moderate physical activities (hours/minutes)
How much time did you usually spend doing moderate physical activities on one of those days? (minutes per day)
3563
1437
50
6.979
12.724
how many days did you walk
how many days did you walk
how many days did you walk
how many days did you walk
how many days did you walk
Now think about the time you spent walking in the last 7 days. This includes at work and at home, walking to travel from place to place, and any other walking that you might do solely for recreation, sport, exercise, or leisure.
During the last 7 days, on how many days did you walk for at least 10 minutes at a time?
4999
1
7
3.394
3.016
Walking - hours per day
Walking - hours per day
Walking - hours per day
Walking - hours per day
Walking - hours per day
How much time did you usually spend walking on one of those days? (in hours per day)
3279
1721
11
1.468
2.419
Walking minutes per day
Walking minutes per day
Walking minutes per day
Walking minutes per day
Walking minutes per day
How much time did you usually spend walking on one of those days? (in minutes per day)
3281
1719
55
14.322
15.051
What type of floor
What type of floor
What type of floor
What type of floor
What type of floor
What type of floor does your dwelling / house have?
4952
48
1
Hard floor
2
Earth floor
Sysmiss
Type of wall
Type of wall
Type of wall
Type of wall
Type of wall
What type of wall does your dwelling / house have?
4880
120
1
Cement, brick, stone or wood
2
Mud brick
3
Thatch and other
4
Plastic sheet
5
Metal sheet
6
Other
Sysmiss
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 this household?
5000
1
Piped water through house connection or yard
2
Public standpipe
3
Protected tube well or bore hole
4
Protected dug well or protected spring
5
Unprotected dug well or spring
6
Rainwater (into tank or cistern )
7
Water taken directly from pond-water or stream
8
Tanker-truck, vendor
How long does it take to get water and come back
How long does it take to get water and come back
How long does it take to get water and come back
How long does it take to get water and come back
How long does it take to get water and come back
How long does it take to get there, get water and come back?
770
4230
1
5
1
Less than 5 minutes
2
Between 5 to 30 minutes
3
Between 30 to 60 minutes
4
Between 60 to 90 minutes
5
More than 90 minutes
20 liter water available
20 liter water available
20 liter water available
20 liter water available
20 liter water available
Are there at least 20 litres of water per person (about one bucket) available per day (for drinking, cooking, personal hygiene etc.) in the household?
791
4209
1
Yes
5
No
Sysmiss
What type of toilet facilities
What type of toilet facilities
What type of toilet facilities
What type of toilet facilities
What type of toilet facilities
What type of toilet facilities does your household use?
4999
1
1
Flush to piped sewage system
2
Flush to septic tank
3
Pour flush latrine
4
Covered dry latrine (with privacy)
5
Uncovered dry latrine (without privacy)
6
Bucket latrine (where fresh excreta are manually removed)
7
No facilities (open defecation)
8
Other
Sysmiss
How far is the facility from your dwellings
How far is the facility from your dwellings
How far is the facility from your dwellings
How far is the facility from your dwellings
How far is the facility from your dwellings
How far is the facility from your dwelling/house?
4984
16
1
Within property / yard, used by single household
2
Within property / yard, used by multiple household
3
Outside property / yard, private
4
Outside property / yard, shared
Sysmiss
What type of fuel
What type of fuel
What type of fuel
What type of fuel
What type of fuel
What type of fuel does your household mainly use for cooking?
5000
1
Gas
2
Electricity
3
Kerosene
4
Coal
5
Charcoal
6
Wood
7
Agriculture/crop
8
Animal dung
9
Shrubs/grass
10
Other
Type of cooking stove
Type of cooking stove
Type of cooking stove
Type of cooking stove
Type of cooking stove
What type of cooking stove is used in your house?
669
4331
1
Open fire or stove without chimney or hood
2
Open fire or stove with chimney or hood
3
Closed stove with chimney
4
Other
Sysmiss
Where cooking done
Where cooking done
Where cooking done
Where cooking done
Where cooking done
Where is cooking usually done?
656
4344
1
In a room used for living or sleeping
2
In a separate room used as kitchen
3
In a separate building used as kitchen
4
Outdoors
Sysmiss
Do you heat your house when cold
Do you heat your house when cold
Do you heat your house when cold
Do you heat your house when cold
Do you heat your house when cold
Do you heat your house when it is cold?
5000
1
Yes
5
No
What type of fuel for heating
What type of fuel for heating
What type of fuel for heating
What type of fuel for heating
What type of fuel for heating
What type of fuel does your household mainly use for heating?
215
4785
1
Gas
2
Electricity
3
Kerosene
4
Coal
5
Charcoal
6
Wood
7
Agriculture/crop
8
Animal dung
9
Shrubs/grass
10
Other
Sysmiss
Type of heating stove
Type of heating stove
Type of heating stove
Type of heating stove
Type of heating stove
What type of heating stove is used in your house?
137
4863
1
Open fire or stove without chimney or hood
2
Open fire or stove with chimney or hood
3
Closed stove with chimney
4
Other
Sysmiss
Time end section 4000
Time end section 4000
Time end section 4000
Time end section 4000
Time end section 4000
5000
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55:51
Ever given birth
Ever given birth
Ever given birth
Ever given birth
Ever given birth
Now I would like to aks you about all the births you have had during your life. Have you ever given birth?
These questions are to be asked of all women respondents of reproductive (18-49) years age.
1984
3016
1
Yes
5
No
Sysmiss
Household roster line number
Household roster line number
Household roster line number
Household roster line number
Household roster line number
5000
Sysmiss
number of births to natural mother
number of births to natural mother
number of births to natural mother
number of births to natural mother
number of births to natural mother
How many children did your mother give birth to, including you ? No. of
births to natural mother:
5000
number of preceding births
number of preceding births
number of preceding births
number of preceding births
number of preceding births
How many births did your mother have before you were born? No. of
preceding births:
5000
number of succeeding births
number of succeeding births
number of succeeding births
number of succeeding births
number of succeeding births
How many births did your mother have after you were born? No. of
succeeding births:
5000
Time begin section 6000
Time begin section 6000
Time begin section 6000
Time begin section 6000
Time begin section 6000
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71:45
Arthritis
Arthritis
Arthritis
Arthritis
Arthritis
Now I would like to read to you questions about some health problems or health care needs that you and the young children in this house may have experienced, and the treatment or medical care that you may have received.
Have you ever been diagnosed with arthritis (a disease of the joints)?
4975
25
1
Yes
5
No
8
Do not know
Sysmiss
Arthritis treated
Arthritis treated
Arthritis treated
Arthritis treated
Arthritis treated
Now I would like to read to you questions about some health problems or health care needs that you and the young children in this house may have experienced, and the treatment or medical care that you may have received.
Have you ever been treated for it (referring to the disease asked about question Q6001)?
4977
23
1
Yes
5
No
8
Do not know
Sysmiss
medication for arthritis
medication for arthritis
medication for arthritis
medication for arthritis
medication for arthritis
Now I would like to read to you questions about some health problems or health care needs that you and the young children in this house may have experienced, and the treatment or medical care that you may have received.
Have you been taking any medication or other treatment for it (referring to the disease asked about in question Q6001) during the last two weeks?
4982
18
1
Yes
5
No
8
Do not know
Sysmiss
pain, aching or stiffness
pain, aching or stiffness
pain, aching or stiffness
pain, aching or stiffness
pain, aching or stiffness
During the last 12 months, have you experienced any of the following….
This introductory sentence sets time frame for the symptomatic questions related to arthritis. After setting the time frame, the interviewer must read out a series of symptoms and determine if the respondent had any of those symptoms in the last 12 months. The point of asking symptom-related questions is to screen those individuals who might have a specific health condition or disease. Because there could be a number of symptoms that characterise a given health condition, and because some symptoms may be common to different conditions, it is important that the interviewer probe for each symptom to see whether the respondent may have an active disease. It is also important that the time
period for the symptoms (“in the last 12 months”) be clearly understood by the respondent and not confused with other time frames used in this section (such as "ever" and "the last 2 weeks"), otherwise the results may not be comparable and it will be difficult to properly assess how well the health system is responding to people’s needs.
The following symptom questions focus on the most frequent form of arthritis, which is osteoarthritis. This condition is often referred to as "wear and tear" on the bones (most often felt in the knees, hands, hips and spine).
During the last 12 months, have you experienced pain, aching, stiffness or swelling in or around the joint, which were not related to an injury and lasted more than a month?
4998
2
1
Yes
5
No
Sysmiss
stiffness in joint in morning
stiffness in joint in morning
stiffness in joint in morning
stiffness in joint in morning
stiffness in joint in morning
During the last 12 months, have you experienced any of the following….
This introductory sentence sets time frame for the symptomatic questions related to arthritis. After setting the time frame, the interviewer must read out a series of symptoms and determine if the respondent had any of those symptoms in the last 12 months. The point of asking symptom-related questions is to screen those individuals who might have a specific health condition or disease. Because there could be a number of symptoms that characterise a given health condition, and because some symptoms may be common to different conditions, it is important that the interviewer probe for each symptom to see whether the respondent may have an active disease. It is also important that the time
period for the symptoms (“in the last 12 months”) be clearly understood by the respondent and not confused with other time frames used in this section (such as "ever" and "the last 2 weeks"), otherwise the results may not be comparable and it will be difficult to properly assess how well the health system is responding to people’s needs.
The following symptom questions focus on the most frequent form of arthritis, which is osteoarthritis. This condition is often referred to as "wear and tear" on the bones (most often felt in the knees, hands, hips and spine).
During the last 12 months, have you experienced stiffness in the joint in the morning after getting up from bed or after a long rest of the joint without movement?
4998
2
1
Yes
5
No
Sysmiss
length of stiffness
length of stiffness
length of stiffness
length of stiffness
length of stiffness
During the last 12 months, have you experienced any of the following….
This introductory sentence sets time frame for the symptomatic questions related to arthritis. After setting the time frame, the interviewer must read out a series of symptoms and determine if the respondent had any of those symptoms in the last 12 months. The point of asking symptom-related questions is to screen those individuals who might have a specific health condition or disease. Because there could be a number of symptoms that characterise a given health condition, and because some symptoms may be common to different conditions, it is important that the interviewer probe for each symptom to see whether the respondent may have an active disease. It is also important that the time
period for the symptoms (“in the last 12 months”) be clearly understood by the respondent and not confused with other time frames used in this section (such as "ever" and "the last 2 weeks"), otherwise the results may not be comparable and it will be difficult to properly assess how well the health system is responding to people’s needs.
The following symptom questions focus on the most frequent form of arthritis, which is osteoarthritis. This condition is often referred to as "wear and tear" on the bones (most often felt in the knees, hands, hips and spine).
How long does this stiffness last?
1055
3945
1
About 30 minutes or less
2
More than 30 minutes
Sysmiss
stiffness go away after exercise/movement
stiffness go away after exercise/movement
stiffness go away after exercise/movement
stiffness go away after exercise/movement
stiffness go away after exercise/movement
During the last 12 months, have you experienced any of the following….
This introductory sentence sets time frame for the symptomatic questions related to arthritis. After setting the time frame, the interviewer must read out a series of symptoms and determine if the respondent had any of those symptoms in the last 12 months. The point of asking symptom-related questions is to screen those individuals who might have a specific health condition or disease. Because there could be a number of symptoms that characterise a given health condition, and because some symptoms may be common to different conditions, it is important that the interviewer probe for each symptom to see whether the respondent may have an active disease. It is also important that the time
period for the symptoms (“in the last 12 months”) be clearly understood by the respondent and not confused with other time frames used in this section (such as "ever" and "the last 2 weeks"), otherwise the results may not be comparable and it will be difficult to properly assess how well the health system is responding to people’s needs.
The following symptom questions focus on the most frequent form of arthritis, which is osteoarthritis. This condition is often referred to as "wear and tear" on the bones (most often felt in the knees, hands, hips and spine).
Does the stiffness go away after exercise or movement in the joint?
1052
3948
1
Yes
5
No
Sysmiss
Back Pain
Back Pain
Back Pain
Back Pain
Back Pain
Have you experienced back pain (including disc problems) during the last 30 days?
4997
3
1
Yes
5
No
Sysmiss
How many days did you have back pain
How many days did you have back pain
How many days did you have back pain
How many days did you have back pain
How many days did you have back pain
How many days did you have this back pain during the last 30 days?
2601
2399
1
30
12.208
11.518
diagnosis of angina pectoris
diagnosis of angina pectoris
diagnosis of angina pectoris
diagnosis of angina pectoris
diagnosis of angina pectoris
Have you ever been diagnosed with angina or angina pectoris (a heart disease)?
4977
23
1
Yes
5
No
8
Do not know
Sysmiss
Angina treated
Angina treated
Angina treated
Angina treated
Angina treated
Have you ever been treated for it (referring to the disease asked about in question Q6009)?
4965
35
1
Yes
5
No
8
Do not know
Sysmiss
Medication or other treatment for angina
Medication or other treatment for angina
Medication or other treatment for angina
Medication or other treatment for angina
Medication or other treatment for angina
Have you been taking any medication or other treatment for it (referring to the disease asked about in question Q6009) during the last two weeks?
4971
29
1
Yes
5
No
8
Do not know
Sysmiss
Pain or discomfort in chest
Pain or discomfort in chest
Pain or discomfort in chest
Pain or discomfort in chest
Pain or discomfort in chest
During the last 12 months, have you experienced…
For this set of questions, the interviewer must read out a series of symptoms and determine if the respondent had any of those symptoms in the last 12 months. The point of asking symptom-related questions is to screen those individuals who might have a specific health condition or disease. Because there could be a number of symptoms that characterise a given health condition, and because some symptoms may be common to different conditions, it is important that the interviewer probe for each symptom to see whether the respondent may have an active disease. It is also important that the time period for the symptoms (in the last 12 months) be clearly understood by the respondent and not confused with other time frames used in this section (such as "ever" and "the last 2 weeks").
During the last 12 months, have you experienced pain or discomfort in your chest when you walk uphill or hurry?
4923
77
1
Yes
5
No
9
Never walks uphill or hurries
Sysmiss
pain or discomfort when walking at ordinary pace
pain or discomfort when walking at ordinary pace
pain or discomfort when walking at ordinary pace
pain or discomfort when walking at ordinary pace
pain or discomfort when walking at ordinary pace
During the last 12 months, have you experienced…
For this set of questions, the interviewer must read out a series of symptoms and determine if the respondent had any of those symptoms in the last 12 months. The point of asking symptom-related questions is to screen those individuals who might have a specific health condition or disease. Because there could be a number of symptoms that characterise a given health condition, and because some symptoms may be common to different conditions, it is important that the interviewer probe for each symptom to see whether the respondent may have an active disease. It is also important that the time period for the symptoms (in the last 12 months) be clearly understood by the respondent and not confused with other time frames used in this section (such as "ever" and "the last 2 weeks").
During the last 12 months, have you experienced pain or discomfort in your chest when you walk at an ordinary pace on level ground?
If the respondent has neither exertional pain nor pain at rest or mild physical activity (questions Q6012 and Q6013), then questions Q6014, Q6015, and Q6016 should not be asked.
1206
3794
1
Yes
5
No
Sysmiss
what do you do when you get pain while walking
what do you do when you get pain while walking
what do you do when you get pain while walking
what do you do when you get pain while walking
what do you do when you get pain while walking
During the last 12 months, have you experienced…
For this set of questions, the interviewer must read out a series of symptoms and determine if the respondent had any of those symptoms in the last 12 months. The point of asking symptom-related questions is to screen those individuals who might have a specific health condition or disease. Because there could be a number of symptoms that characterise a given health condition, and because some symptoms may be common to different conditions, it is important that the interviewer probe for each symptom to see whether the respondent may have an active disease. It is also important that the time period for the symptoms (in the last 12 months) be clearly understood by the respondent and not confused with other time frames used in this section (such as "ever" and "the last 2 weeks").
What do you do if you get the pain or discomfort when you are walking?
415
4585
1
Stop or slow down
2
Carry on after taking a pain relieving medicine
3
Carry on
Sysmiss
if you stand still, what happens to pain
if you stand still, what happens to pain
if you stand still, what happens to pain
if you stand still, what happens to pain
if you stand still, what happens to pain
During the last 12 months, have you experienced…
For this set of questions, the interviewer must read out a series of symptoms and determine if the respondent had any of those symptoms in the last 12 months. The point of asking symptom-related questions is to screen those individuals who might have a specific health condition or disease. Because there could be a number of symptoms that characterise a given health condition, and because some symptoms may be common to different conditions, it is important that the interviewer probe for each symptom to see whether the respondent may have an active disease. It is also important that the time period for the symptoms (in the last 12 months) be clearly understood by the respondent and not confused with other time frames used in this section (such as "ever" and "the last 2 weeks").
If you stand still, what happens to the pain or discomfort?
411
4589
1
Relieved
2
Not relieved
Sysmiss
location of pain (upper or middle chest) (1-checked, 5 unchecked)
location of pain (upper or middle chest) (1-checked, 5 unchecked)
location of pain (upper or middle chest) (1-checked, 5 unchecked)
location of pain (upper or middle chest) (1-checked, 5 unchecked)
location of pain (upper or middle chest) (1-checked, 5 unchecked)
During the last 12 months, have you experienced…
For this set of questions, the interviewer must read out a series of symptoms and determine if the respondent had any of those symptoms in the last 12 months. The point of asking symptom-related questions is to screen those individuals who might have a specific health condition or disease. Because there could be a number of symptoms that characterise a given health condition, and because some symptoms may be common to different conditions, it is important that the interviewer probe for each symptom to see whether the respondent may have an active disease. It is also important that the time period for the symptoms (in the last 12 months) be clearly understood by the respondent and not confused with other time frames used in this section (such as "ever" and "the last 2 weeks").
Will you show me where the pain or discomfort was?
416
4584
1
Yes
5
No
Sysmiss
location of pain (lower chest)
location of pain (lower chest)
location of pain (lower chest)
location of pain (lower chest)
location of pain (lower chest)
During the last 12 months, have you experienced…
For this set of questions, the interviewer must read out a series of symptoms and determine if the respondent had any of those symptoms in the last 12 months. The point of asking symptom-related questions is to screen those individuals who might have a specific health condition or disease. Because there could be a number of symptoms that characterise a given health condition, and because some symptoms may be common to different conditions, it is important that the interviewer probe for each symptom to see whether the respondent may have an active disease. It is also important that the time period for the symptoms (in the last 12 months) be clearly understood by the respondent and not confused with other time frames used in this section (such as "ever" and "the last 2 weeks").
Will you show me where the pain or discomfort was?
415
4585
1
Yes
5
No
Sysmiss
location of pain (Left arm) (1-checked, 5 unchecked)
location of pain (Left arm) (1-checked, 5 unchecked)
location of pain (Left arm) (1-checked, 5 unchecked)
location of pain (Left arm) (1-checked, 5 unchecked)
location of pain (Left arm) (1-checked, 5 unchecked)
During the last 12 months, have you experienced…
For this set of questions, the interviewer must read out a series of symptoms and determine if the respondent had any of those symptoms in the last 12 months. The point of asking symptom-related questions is to screen those individuals who might have a specific health condition or disease. Because there could be a number of symptoms that characterise a given health condition, and because some symptoms may be common to different conditions, it is important that the interviewer probe for each symptom to see whether the respondent may have an active disease. It is also important that the time period for the symptoms (in the last 12 months) be clearly understood by the respondent and not confused with other time frames used in this section (such as "ever" and "the last 2 weeks").
Will you show me where the pain or discomfort was?
415
4585
1
Yes
5
No
Sysmiss
location of pain (Other) (1-checked, 5 unchecked)
location of pain (Other) (1-checked, 5 unchecked)
location of pain (Other) (1-checked, 5 unchecked)
location of pain (Other) (1-checked, 5 unchecked)
location of pain (Other) (1-checked, 5 unchecked)
During the last 12 months, have you experienced…
For this set of questions, the interviewer must read out a series of symptoms and determine if the respondent had any of those symptoms in the last 12 months. The point of asking symptom-related questions is to screen those individuals who might have a specific health condition or disease. Because there could be a number of symptoms that characterise a given health condition, and because some symptoms may be common to different conditions, it is important that the interviewer probe for each symptom to see whether the respondent may have an active disease. It is also important that the time period for the symptoms (in the last 12 months) be clearly understood by the respondent and not confused with other time frames used in this section (such as "ever" and "the last 2 weeks").
Will you show me where the pain or discomfort was?
416
4584
1
Yes
5
No
Sysmiss
Asthma Diagnosed
Asthma Diagnosed
Asthma Diagnosed
Asthma Diagnosed
Asthma Diagnosed
Have you ever been diagnosed with asthma (an allergic respiratory disease)?
4985
15
1
Yes
5
No
8
Do not know
Sysmiss
Asthma Treated
Asthma Treated
Asthma Treated
Asthma Treated
Asthma Treated
Have you ever been treated for it (referring to the disease asked about in Q6017)?
4975
25
1
Yes
5
No
8
Do not know
Sysmiss
Medication or other treatment for asthma
Medication or other treatment for asthma
Medication or other treatment for asthma
Medication or other treatment for asthma
Medication or other treatment for asthma
Have you been taking any medications or other treatment for it (referring to the disease asked about in Q6017), during the last two weeks?
4980
20
1
Yes
5
No
8
Do not know
Sysmiss
wheezing or whistling breathing
wheezing or whistling breathing
wheezing or whistling breathing
wheezing or whistling breathing
wheezing or whistling breathing
During the last 12 months, have you experienced the following….
For this set of questions, the interviewer must read out a series of symptoms and determine if the respondent had any of those symptoms in the last 12 months. The point of asking symptom-related questions is to screen those individuals who might have a specific health condition or disease. Because there could be a number of symptoms that characterise a given health condition, and because some symptoms may be common to different conditions, it is important that the interviewer probe for each symptom to see whether the respondent may have an active disease. It is also important that the time
period for the symptoms (in the last 12 months) be clearly understood by the respondent and not confused with other time frames used in this section (such as "ever" and "the last 2 weeks").
During the last 12 months, have you experienced attacks of wheezing or whistling breathing?
4999
1
1
Yes
5
No
Sysmiss
attack of wheezing after physical activity
attack of wheezing after physical activity
attack of wheezing after physical activity
attack of wheezing after physical activity
attack of wheezing after physical activity
During the last 12 months, have you experienced the following….
For this set of questions, the interviewer must read out a series of symptoms and determine if the respondent had any of those symptoms in the last 12 months. The point of asking symptom-related questions is to screen those individuals who might have a specific health condition or disease. Because there could be a number of symptoms that characterise a given health condition, and because some symptoms may be common to different conditions, it is important that the interviewer probe for each symptom to see whether the respondent may have an active disease. It is also important that the time
period for the symptoms (in the last 12 months) be clearly understood by the respondent and not confused with other time frames used in this section (such as "ever" and "the last 2 weeks").
During the last 12 months, have you experienced an attack of wheezing that came on after you stopped exercising or some other physical activity?
4997
3
1
Yes
5
No
Sysmiss
Tightness in chest
Tightness in chest
Tightness in chest
Tightness in chest
Tightness in chest
During the last 12 months, have you experienced the following….
For this set of questions, the interviewer must read out a series of symptoms and determine if the respondent had any of those symptoms in the last 12 months. The point of asking symptom-related questions is to screen those individuals who might have a specific health condition or disease. Because there could be a number of symptoms that characterise a given health condition, and because some symptoms may be common to different conditions, it is important that the interviewer probe for each symptom to see whether the respondent may have an active disease. It is also important that the time
period for the symptoms (in the last 12 months) be clearly understood by the respondent and not confused with other time frames used in this section (such as "ever" and "the last 2 weeks").
During the last 12 months, have you experienced feeling of tightness in your chest?
4997
3
1
Yes
5
No
Sysmiss
tightness in chest upon waking
tightness in chest upon waking
tightness in chest upon waking
tightness in chest upon waking
tightness in chest upon waking
During the last 12 months, have you experienced the following….
For this set of questions, the interviewer must read out a series of symptoms and determine if the respondent had any of those symptoms in the last 12 months. The point of asking symptom-related questions is to screen those individuals who might have a specific health condition or disease. Because there could be a number of symptoms that characterise a given health condition, and because some symptoms may be common to different conditions, it is important that the interviewer probe for each symptom to see whether the respondent may have an active disease. It is also important that the time
period for the symptoms (in the last 12 months) be clearly understood by the respondent and not confused with other time frames used in this section (such as "ever" and "the last 2 weeks").
During the last 12 months, have you woken up with a feeling of tightness in your chest in the morning or at any other time?
4999
1
1
Yes
5
No
Sysmiss
attack of shortness of breath without obvious cause
attack of shortness of breath without obvious cause
attack of shortness of breath without obvious cause
attack of shortness of breath without obvious cause
attack of shortness of breath without obvious cause
During the last 12 months, have you experienced the following….
For this set of questions, the interviewer must read out a series of symptoms and determine if the respondent had any of those symptoms in the last 12 months. The point of asking symptom-related questions is to screen those individuals who might have a specific health condition or disease. Because there could be a number of symptoms that characterise a given health condition, and because some symptoms may be common to different conditions, it is important that the interviewer probe for each symptom to see whether the respondent may have an active disease. It is also important that the time
period for the symptoms (in the last 12 months) be clearly understood by the respondent and not confused with other time frames used in this section (such as "ever" and "the last 2 weeks").
During the last 12 months, have you had an attack of shortness of breath that came on without obvious cause when you were not exercising or doing some physical activity?
4999
1
1
Yes
5
No
Sysmiss
diagnosis of depression
diagnosis of depression
diagnosis of depression
diagnosis of depression
diagnosis of depression
During the last 12 months, have you ever been diagnosed with depression?
4976
24
1
Yes
5
No
8
Do not know
Sysmiss
Depression treated
Depression treated
Depression treated
Depression treated
Depression treated
During the last 12 months, have you ever been diagnosed with depression?
Have you ever been treated for it? (referring to condition asked in Q6025)
4973
27
1
Yes
5
No
8
Do not know
Sysmiss
medication for depression
medication for depression
medication for depression
medication for depression
medication for depression
During the last 12 months, have you ever been diagnosed with depression?
Have you been taking any medications or other treatment for it in the last two weeks?
4980
20
1
Yes
5
No
8
Do not know
Sysmiss
Feeling of sadness, emptiness or depression
Feeling of sadness, emptiness or depression
Feeling of sadness, emptiness or depression
Feeling of sadness, emptiness or depression
Feeling of sadness, emptiness or depression
During last 12 months, have you experienced any of the following…
For this set of questions, the interviewer must read out a series of symptoms and determine if the respondent had any of those symptoms in the last 12 months. The point of asking symptom-related questions is to screen those individuals who might have a specific health condition or disease. Because there could be a number of symptoms that characterise a given health condition, and because some symptoms may be common to different conditions, it is important that the interviewer probe for each symptom to see whether the respondent may have an active disease. It is also important that the time period for the symptoms (in the last 12 months) be clearly understood by the respondent and not confused with other time frames used in this section (such as "ever" and "the last 2 weeks").
During last 12 months, have you had a period lasting several days when you felt sad, empty or depressed?
4982
18
1
Yes
5
No
8
Do not know
Sysmiss
period lasting several days when lost interest
period lasting several days when lost interest
period lasting several days when lost interest
period lasting several days when lost interest
period lasting several days when lost interest
During last 12 months, have you experienced any of the following…
For this set of questions, the interviewer must read out a series of symptoms and determine if the respondent had any of those symptoms in the last 12 months. The point of asking symptom-related questions is to screen those individuals who might have a specific health condition or disease. Because there could be a number of symptoms that characterise a given health condition, and because some symptoms may be common to different conditions, it is important that the interviewer probe for each symptom to see whether the respondent may have an active disease. It is also important that the time period for the symptoms (in the last 12 months) be clearly understood by the respondent and not confused with other time frames used in this section (such as "ever" and "the last 2 weeks").
During last 12 months, have you had a period lasting several days when you lost interest in most things you usually enjoy such as hobbies, personal relationships or work?
4989
11
1
Yes
5
No
8
Do not know
Sysmiss
period lasting several days when energy decreased or tired all the time
period lasting several days when energy decreased or tired all the time
period lasting several days when energy decreased or tired all the time
period lasting several days when energy decreased or tired all the time
period lasting several days when energy decreased or tired all the time
During last 12 months, have you experienced any of the following…
For this set of questions, the interviewer must read out a series of symptoms and determine if the respondent had any of those symptoms in the last 12 months. The point of asking symptom-related questions is to screen those individuals who might have a specific health condition or disease. Because there could be a number of symptoms that characterise a given health condition, and because some symptoms may be common to different conditions, it is important that the interviewer probe for each symptom to see whether the respondent may have an active disease. It is also important that the time period for the symptoms (in the last 12 months) be clearly understood by the respondent and not confused with other time frames used in this section (such as "ever" and "the last 2 weeks").
During last 12 months, have you had a period lasting several days when you have been feeling your energy decreased or that you are tired all the time?
1705
3295
1
Yes
5
No
8
Do not know
Sysmiss
depression more than two weeks
depression more than two weeks
depression more than two weeks
depression more than two weeks
depression more than two weeks
During last 12 months, have you experienced any of the following…
For this set of questions, the interviewer must read out a series of symptoms and determine if the respondent had any of those symptoms in the last 12 months. The point of asking symptom-related questions is to screen those individuals who might have a specific health condition or disease. Because there could be a number of symptoms that characterise a given health condition, and because some symptoms may be common to different conditions, it is important that the interviewer probe for each symptom to see whether the respondent may have an active disease. It is also important that the time period for the symptoms (in the last 12 months) be clearly understood by the respondent and not confused with other time frames used in this section (such as "ever" and "the last 2 weeks").
Was this period [of sadness/loss of interest/low energy] more than 2 weeks?
1390
3610
1
Yes
5
No
Sysmiss
depression most of the day nearly every day
depression most of the day nearly every day
depression most of the day nearly every day
depression most of the day nearly every day
depression most of the day nearly every day
During last 12 months, have you experienced any of the following…
For this set of questions, the interviewer must read out a series of symptoms and determine if the respondent had any of those symptoms in the last 12 months. The point of asking symptom-related questions is to screen those individuals who might have a specific health condition or disease. Because there could be a number of symptoms that characterise a given health condition, and because some symptoms may be common to different conditions, it is important that the interviewer probe for each symptom to see whether the respondent may have an active disease. It is also important that the time period for the symptoms (in the last 12 months) be clearly understood by the respondent and not confused with other time frames used in this section (such as "ever" and "the last 2 weeks").
Was this period [of sadness/loss of interest/low energy] most of the day, nearly every day?
1387
3613
1
Yes
5
No
Sysmiss
loss of appetite
loss of appetite
loss of appetite
loss of appetite
loss of appetite
During last 12 months, have you experienced any of the following…
For this set of questions, the interviewer must read out a series of symptoms and determine if the respondent had any of those symptoms in the last 12 months. The point of asking symptom-related questions is to screen those individuals who might have a specific health condition or disease. Because there could be a number of symptoms that characterise a given health condition, and because some symptoms may be common to different conditions, it is important that the interviewer probe for each symptom to see whether the respondent may have an active disease. It is also important that the time period for the symptoms (in the last 12 months) be clearly understood by the respondent and not confused with other time frames used in this section (such as "ever" and "the last 2 weeks").
During this period, did you lose your appetite?
1390
3610
1
Yes
5
No
Sysmiss
slowing down in thinking
slowing down in thinking
slowing down in thinking
slowing down in thinking
slowing down in thinking
During last 12 months, have you experienced any of the following…
For this set of questions, the interviewer must read out a series of symptoms and determine if the respondent had any of those symptoms in the last 12 months. The point of asking symptom-related questions is to screen those individuals who might have a specific health condition or disease. Because there could be a number of symptoms that characterise a given health condition, and because some symptoms may be common to different conditions, it is important that the interviewer probe for each symptom to see whether the respondent may have an active disease. It is also important that the time period for the symptoms (in the last 12 months) be clearly understood by the respondent and not confused with other time frames used in this section (such as "ever" and "the last 2 weeks").
During this period, did you notice any slowing down in your thinking?
1388
3612
1
Yes
5
No
Sysmiss
Schizophrenia diagnosis
Schizophrenia diagnosis
Schizophrenia diagnosis
Schizophrenia diagnosis
Schizophrenia diagnosis
Have you ever been diagnosed for a mental health problem such as schizophrenia or psychosis?
4975
25
1
Yes
5
No
8
Do not know
Sysmiss
Schizophrenia Treated
Schizophrenia Treated
Schizophrenia Treated
Schizophrenia Treated
Schizophrenia Treated
Have you ever been diagnosed for a mental health problem such as schizophrenia or psychosis?
Have you ever been treated for it ? (referring to the condition asked about in Q6035)
4968
32
1
Yes
5
No
8
Do not know
Sysmiss
Received medication for schizophrenia
Received medication for schizophrenia
Received medication for schizophrenia
Received medication for schizophrenia
Received medication for schizophrenia
Have you been taking any medications or other treatment for it during the last 2 weeks?
4977
23
1
Yes
5
No
8
Do not know
Sysmiss
feel strange unexplainable going on
feel strange unexplainable going on
feel strange unexplainable going on
feel strange unexplainable going on
feel strange unexplainable going on
During the last 12 months, have you experienced any of the following…
For the following questions, the interviewer must read out a series of symptoms and determine if the respondent had any of those symptoms in the last 12 months. The point of asking symptom-related questions is to screen those individuals who might have a specific health condition or disease. Because there could be a number of symptoms that characterise a given health condition, and because some symptoms may be common to different conditions, it is important that the interviewer probe for each symptom to see whether the respondent may have an active disease. It is also important that the time
period for the symptoms (in the last 12 months) be clearly understood by the respondent and not confused with other time frames used in this section such as "ever" and "the last 2 weeks". Confusion of the time frame may render results incomparable.
A feeling that something strange and unexplainable was going on that other people would find hard to believe?
4970
30
1
Yes
5
No
8
Do not know
Sysmiss
Feel people were too interested
Feel people were too interested
Feel people were too interested
Feel people were too interested
Feel people were too interested
During the last 12 months, have you experienced any of the following…
For the following questions, the interviewer must read out a series of symptoms and determine if the respondent had any of those symptoms in the last 12 months. The point of asking symptom-related questions is to screen those individuals who might have a specific health condition or disease. Because there could be a number of symptoms that characterise a given health condition, and because some symptoms may be common to different conditions, it is important that the interviewer probe for each symptom to see whether the respondent may have an active disease. It is also important that the time
period for the symptoms (in the last 12 months) be clearly understood by the respondent and not confused with other time frames used in this section such as "ever" and "the last 2 weeks". Confusion of the time frame may render results incomparable.
A feeling that people were too interested in you or there was a plot to harm you?
4976
24
1
Yes
5
No
6
Do not know
Sysmiss
Feel your thoughts were controlled by others
Feel your thoughts were controlled by others
Feel your thoughts were controlled by others
Feel your thoughts were controlled by others
Feel your thoughts were controlled by others
During the last 12 months, have you experienced any of the following…
For the following questions, the interviewer must read out a series of symptoms and determine if the respondent had any of those symptoms in the last 12 months. The point of asking symptom-related questions is to screen those individuals who might have a specific health condition or disease. Because there could be a number of symptoms that characterise a given health condition, and because some symptoms may be common to different conditions, it is important that the interviewer probe for each symptom to see whether the respondent may have an active disease. It is also important that the time
period for the symptoms (in the last 12 months) be clearly understood by the respondent and not confused with other time frames used in this section such as "ever" and "the last 2 weeks". Confusion of the time frame may render results incomparable.
A feeling that your thoughts are being directly interfered or controlled by another person, or your mind was being taken over by strange forces.
4969
31
1
Yes
5
No
8
Do not know
Sysmiss
Hallucinations
Hallucinations
Hallucinations
Hallucinations
Hallucinations
During the last 12 months, have you experienced any of the following…
For the following questions, the interviewer must read out a series of symptoms and determine if the respondent had any of those symptoms in the last 12 months. The point of asking symptom-related questions is to screen those individuals who might have a specific health condition or disease. Because there could be a number of symptoms that characterise a given health condition, and because some symptoms may be common to different conditions, it is important that the interviewer probe for each symptom to see whether the respondent may have an active disease. It is also important that the time
period for the symptoms (in the last 12 months) be clearly understood by the respondent and not confused with other time frames used in this section such as "ever" and "the last 2 weeks". Confusion of the time frame may render results incomparable.
An experience of seeing visions or hearing voices that others could not see or hear when you were not half asleep, dreaming or under the influence of alcohol or drugs?
4980
20
1
Yes
5
No
8
Do not know
Sysmiss
Diagnosed with Diabetes
Diagnosed with Diabetes
Diagnosed with Diabetes
Diagnosed with Diabetes
Diagnosed with Diabetes
Have you ever been diagnosed with diabetes (or high blood sugar)?
4957
43
1
Yes
5
No
8
Do not know
Sysmiss
Treatment for Diabetes
Treatment for Diabetes
Treatment for Diabetes
Treatment for Diabetes
Treatment for Diabetes
Have you ever been diagnosed with diabetes (or high blood sugar)?
Have you been treated for it? (referring to the condition asked about in Q6042)
4972
28
1
Yes
5
No
8
Do not know
Sysmiss
Medications for diabetes
Medications for diabetes
Medications for diabetes
Medications for diabetes
Medications for diabetes
Have you been taking insulin, or any other blood sugar lowering medications in the last 2 weeks?
4976
24
1
Yes
5
No
8
Do not know
Sysmiss
Program for diabetes
Program for diabetes
Program for diabetes
Program for diabetes
Program for diabetes
Are you following a special diet, exercise regime or weight control program for diabetes?
4977
23
1
Yes
5
No
8
Do not know
Sysmiss
Cough that lasted 3 weeks or longer
Cough that lasted 3 weeks or longer
Cough that lasted 3 weeks or longer
Cough that lasted 3 weeks or longer
Cough that lasted 3 weeks or longer
During the last 12 months, have you experienced any of the following…
For this set of questions, the interviewer must read out a series of symptoms and determine if the respondent had any of those symptoms in the last 12 months. The point of asking symptom-related questions is to screen those individuals who might have tuberculosis (TB). Because there could be a number of symptoms that characterise a given health condition, and because some symptoms may be common to different conditions, it is important that the interviewer probe for each symptom to see whether the respondent may have an active disease.
During the last 12 months, have you experienced cough that lasted for 3 weeks or longer?
4994
6
1
Yes
5
No
Sysmiss
Blood in sputum of phlegm or have you coughed blood
Blood in sputum of phlegm or have you coughed blood
Blood in sputum of phlegm or have you coughed blood
Blood in sputum of phlegm or have you coughed blood
Blood in sputum of phlegm or have you coughed blood
During the last 12 months, have you experienced any of the following…
For this set of questions, the interviewer must read out a series of symptoms and determine if the respondent had any of those symptoms in the last 12 months. The point of asking symptom-related questions is to screen those individuals who might have tuberculosis (TB). Because there could be a number of symptoms that characterise a given health condition, and because some symptoms may be common to different conditions, it is important that the interviewer probe for each symptom to see whether the respondent may have an active disease.
During the last 12 months, have you had blood in your phlegm, or have you coughed blood?
4996
4
1
Yes
5
No
Sysmiss
had a TB test
had a TB test
had a TB test
had a TB test
had a TB test
During the last 12 months, have you experienced any of the following…
For this set of questions, the interviewer must read out a series of symptoms and determine if the respondent had any of those symptoms in the last 12 months. The point of asking symptom-related questions is to screen those individuals who might have tuberculosis (TB). Because there could be a number of symptoms that characterise a given health condition, and because some symptoms may be common to different conditions, it is important that the interviewer probe for each symptom to see whether the respondent may have an active disease.
In the last 12 months, have you had a tuberculosis (TB) test, I mean has a doctor examined your sputum or made an X-ray of your chest?
4990
10
1
Yes
5
No
Sysmiss
Keeping medicines or drugs in the house
Keeping medicines or drugs in the house
Keeping medicines or drugs in the house
Keeping medicines or drugs in the house
Keeping medicines or drugs in the house
We are interested in knowing about the availability and use of certain medicines and drugs. Remember that whatever information you give me is confidential and will only be used for research purposes.
Do you keep any medicines or drugs in the house?
4999
1
1
Yes
5
No
Sysmiss
may I see medications
may I see medications
may I see medications
may I see medications
may I see medications
May I see what drugs or medicines you personally have been using in the last two weeks?
3556
1444
1
Yes
5
No
Sysmiss
Arthritis medicine 1
Arthritis medicine 1
Arthritis medicine 1
Arthritis medicine 1
Arthritis medicine 1
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
43
4957
12
13
12.07
0.258
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
62
4938
1
Yes
5
No
Sysmiss
Arthritis medicine 2
Arthritis medicine 2
Arthritis medicine 2
Arthritis medicine 2
Arthritis medicine 2
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
8
4992
12
13
Sysmiss
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
16
4984
1
Yes
5
No
Sysmiss
Arthritis medicine 3
Arthritis medicine 3
Arthritis medicine 3
Arthritis medicine 3
Arthritis medicine 3
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
4
4996
12
12
12
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
7
4993
1
Yes
5
No
Sysmiss
Angina medicine 1
Angina medicine 1
Angina medicine 1
Angina medicine 1
Angina medicine 1
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
56
4944
12
23
21.161
3.291
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
86
4914
1
Yes
5
No
Sysmiss
Angina medicine 2
Angina medicine 2
Angina medicine 2
Angina medicine 2
Angina medicine 2
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
19
4981
12
82
22
15.29
12
21
22
23
82
Sysmiss
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
44
4956
1
Yes
5
No
Sysmiss
Angina medicine 3
Angina medicine 3
Angina medicine 3
Angina medicine 3
Angina medicine 3
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
9
4991
12
23
17.444
5.199
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
22
4978
1
Yes
5
No
Sysmiss
Asthma medicine 1
Asthma medicine 1
Asthma medicine 1
Asthma medicine 1
Asthma medicine 1
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
55
4945
12
36
31.4
2.878
12
31
32
33
36
Sysmiss
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
61
4939
1
Yes
5
No
Sysmiss
Asthma medicine 2
Asthma medicine 2
Asthma medicine 2
Asthma medicine 2
Asthma medicine 2
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
16
4984
12
36
30.938
5.297
12
31
32
33
36
Sysmiss
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
18
4982
1
Yes
5
No
Sysmiss
Asthma medicine 3
Asthma medicine 3
Asthma medicine 3
Asthma medicine 3
Asthma medicine 3
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
7
4993
12
36
29.571
7.934
12
31
32
33
36
Sysmiss
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
9
4991
1
Yes
5
No
Sysmiss
Depression medicine 1
Depression medicine 1
Depression medicine 1
Depression medicine 1
Depression medicine 1
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
146
4854
12
51
42.13
4.531
12
22
23
41
42
43
44
51
Sysmiss
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
188
4812
1
Yes
5
No
Sysmiss
Depression medicine 2
Depression medicine 2
Depression medicine 2
Depression medicine 2
Depression medicine 2
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
45
4955
41
42
44
51
Sysmiss
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
58
4942
1
Yes
5
No
Sysmiss
Depression medicine 3
Depression medicine 3
Depression medicine 3
Depression medicine 3
Depression medicine 3
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
19
4981
41
42
44
51
Sysmiss
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
19
4981
1
Yes
5
No
Sysmiss
Schizophrenia medicine 1
Schizophrenia medicine 1
Schizophrenia medicine 1
Schizophrenia medicine 1
Schizophrenia medicine 1
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
10
4990
43
44
51
Sysmiss
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
14
4986
1
Yes
5
No
Sysmiss
Schizophrenia medicine 2
Schizophrenia medicine 2
Schizophrenia medicine 2
Schizophrenia medicine 2
Schizophrenia medicine 2
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
3
4997
41
44
51
Sysmiss
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
6
4994
1
Yes
5
No
Sysmiss
Schizophrenia medicine 3
Schizophrenia medicine 3
Schizophrenia medicine 3
Schizophrenia medicine 3
Schizophrenia medicine 3
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
2
4998
41
51
Sysmiss
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
3
4997
1
Yes
5
No
Sysmiss
Tuberculosis medicine 1
Tuberculosis medicine 1
Tuberculosis medicine 1
Tuberculosis medicine 1
Tuberculosis medicine 1
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
1
4999
61
Sysmiss
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
1
4999
1
Yes
5
No
Sysmiss
Tuberculosis medicine 2
Tuberculosis medicine 2
Tuberculosis medicine 2
Tuberculosis medicine 2
Tuberculosis medicine 2
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
5000
Sysmiss
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
5000
1
Yes
5
No
Sysmiss
Tuberculosis medicine 3
Tuberculosis medicine 3
Tuberculosis medicine 3
Tuberculosis medicine 3
Tuberculosis medicine 3
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
5000
Sysmiss
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
5000
1
Yes
5
No
Sysmiss
HIV/AIDS medicine 1
HIV/AIDS medicine 1
HIV/AIDS medicine 1
HIV/AIDS medicine 1
HIV/AIDS medicine 1
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
1
4999
72
Sysmiss
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
2
4998
1
Yes
5
No
Sysmiss
HIV/AIDS medicine 2
HIV/AIDS medicine 2
HIV/AIDS medicine 2
HIV/AIDS medicine 2
HIV/AIDS medicine 2
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
2
4998
71
72
Sysmiss
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
2
4998
1
Yes
5
No
Sysmiss
HIV/AIDS medicine 3
HIV/AIDS medicine 3
HIV/AIDS medicine 3
HIV/AIDS medicine 3
HIV/AIDS medicine 3
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
2
4998
71
Sysmiss
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
2
4998
1
Yes
5
No
Sysmiss
Diabetes medicine 1
Diabetes medicine 1
Diabetes medicine 1
Diabetes medicine 1
Diabetes medicine 1
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
136
4864
12
82
79.338
11.932
12
22
23
41
42
81
82
Sysmiss
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
148
4852
1
Yes
5
No
Sysmiss
Diabetes medicine 2
Diabetes medicine 2
Diabetes medicine 2
Diabetes medicine 2
Diabetes medicine 2
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
31
4969
12
82
79.677
12.563
12
81
82
Sysmiss
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
40
4960
1
Yes
5
No
Sysmiss
Diabetes medicine 3
Diabetes medicine 3
Diabetes medicine 3
Diabetes medicine 3
Diabetes medicine 3
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
7
4993
12
82
71.714
26.336
12
81
82
Sysmiss
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
10
4990
1
Yes
5
No
Sysmiss
Other medicine 1
Other medicine 1
Other medicine 1
Other medicine 1
Other medicine 1
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
2269
2731
12
99
86.229
29.372
12
13
21
22
23
31
32
33
36
41
42
44
51
81
82
88
99
Sysmiss
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
2256
2744
1
Yes
5
No
Sysmiss
Other medicine 2
Other medicine 2
Other medicine 2
Other medicine 2
Other medicine 2
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
1042
3958
12
99
83.654
31.474
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
1041
3959
1
Yes
5
No
Sysmiss
Other medicine 3
Other medicine 3
Other medicine 3
Other medicine 3
Other medicine 3
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
452
4548
12
99
82.546
31.975
12
13
21
22
23
31
32
33
36
41
42
44
51
99
Sysmiss
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
prescribed by medical professional
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
451
4549
1
Yes
5
No
Sysmiss
When pelvic examination
When pelvic examination
When pelvic examination
When pelvic examination
When pelvic examination
When was the last time you had a pelvic examination? (By pelvic examination, I mean when a doctor or nurse examined your vagina?)
Questions to be asked to FEMALE respondents aged 18-69 only
2597
2403
1
Within the last 3 years
2
4-5 years ago
3
More than 5 years ago
5
NEVER HAD EXAM
8
Do not know
Sysmiss
Last time PAP smear test
Last time PAP smear test
Last time PAP smear test
Last time PAP smear test
Last time PAP smear test
The last time you had the pelvic examination, did you have a PAP smear test? (By PAP smear test, I mean did a doctor or nurse use a swab or stick to wipe from inside your vagina, take a sample and send it to a laboratory?)
Questions to be asked to FEMALE respondents aged 18-69 only
1985
3015
1
Yes
5
No
8
Do not know
Sysmiss
Last time mammography
Last time mammography
Last time mammography
Last time mammography
Last time mammography
When was the last time you had a mammography, if ever? (This is an x-ray of your breasts to detect breast cancer at an early stage).
Questions to be asked to FEMALE respondents aged 18-69 only
1138
3862
1
Within the last 3 years
2
4-5 years ago
3
more than 5 years ago
5
Never had exam
8
Do not know
Sysmiss
Pregnancy checked
Pregnancy checked
Pregnancy checked
Pregnancy checked
Pregnancy checked
When you were pregnant with (NAME), did you see a health care professional to have your pregnancy checked?
Questions to be asked to women of reproductive age (18-49 years) with a live birth in last 5 years only.
602
4398
1
Yes
5
No
8
Do not know
Sysmiss
how many times saw health care professional
how many times saw health care professional
how many times saw health care professional
how many times saw health care professional
how many times saw health care professional
How many times during your pregnancy with (NAME) did you see a health care professional?
Questions to be asked to women of reproductive age (18-49 years) with a live birth in last 5 years only.
571
4429
1
36
7.877
3.119
who did you see most of the time
who did you see most of the time
who did you see most of the time
who did you see most of the time
who did you see most of the time
Who did you see most of the time?
Questions to be asked to women of reproductive age (18-49 years) with a live birth in last 5 years only.
572
4428
1
Doctor
2
Nurse or midwife
3
Auxiliary nurse or midwife
4
Traditional birth attendant
5
Other
8
Do not know
Sysmiss
Blood pressure measured during pregnancy
Blood pressure measured during pregnancy
Blood pressure measured during pregnancy
Blood pressure measured during pregnancy
Blood pressure measured during pregnancy
During your pregnancy, when you were visiting a health care provider was any of the following done at least once:
Was your blood pressure measured?
Questions to be asked to women of reproductive age (18-49 years) with a live birth in last 5 years only.
574
4426
1
Yes
5
No
8
Do not know
Sysmiss
Did you give blood sample
Did you give blood sample
Did you give blood sample
Did you give blood sample
Did you give blood sample
During your pregnancy, when you were visiting a health care provider was any of the following done at least once:
Did you give blood sample?
Questions to be asked to women of reproductive age (18-49 years) with a live birth in last 5 years only.
574
4426
1
Yes
5
No
8
Do not know
Sysmiss
Were you told about signs of pregnancy
Were you told about signs of pregnancy
Were you told about signs of pregnancy
Were you told about signs of pregnancy
Were you told about signs of pregnancy
During your pregnancy, when you were visiting a health care provider was any of the following done at least once:
Were you told about the signs of pregnancy complications and what you should do if they occur?
Questions to be asked to women of reproductive age (18-49 years) with a live birth in last 5 years only.
568
4432
1
Yes
5
No
8
Do not know
Sysmiss
HIV counseling
HIV counseling
HIV counseling
HIV counseling
HIV counseling
During your antenatal care visits for your pregnancy with (NAME), were you given any information or counselled about HIV, the virus that causes AIDS?
Questions to be asked to women of reproductive age (18-49 years) with a live birth in last 2 years only.
260
4740
1
Yes
5
No
Sysmiss
HIV testing offered
HIV testing offered
HIV testing offered
HIV testing offered
HIV testing offered
Was HIV testing offered to you at any time during your visit(s)?
Questions to be asked to women of reproductive age (18-49 years) with a live birth in last 2 years only.
261
4739
1
Yes
5
No
Sysmiss
Agreed to HIV test
Agreed to HIV test
Agreed to HIV test
Agreed to HIV test
Agreed to HIV test
Did you agree to be tested for HIV during any of your visits?
Questions to be asked to women of reproductive age (18-49 years) with a live birth in last 2 years only.
169
4831
1
Yes
5
No
Sysmiss
Received results of test
Received results of test
Received results of test
Received results of test
Received results of test
Did you receive the results of the test?
Questions to be asked to women of reproductive age (18-49 years) with a live birth in last 2 years only.
165
4835
1
Yes
5
No
Sysmiss
doctor asissted in delivery (1-checked 5-Unchecked)
doctor asissted in delivery (1-checked 5-Unchecked)
doctor asissted in delivery (1-checked 5-Unchecked)
doctor asissted in delivery (1-checked 5-Unchecked)
doctor asissted in delivery (1-checked 5-Unchecked)
When you gave birth to (NAME), who assisted in the delivery? A doctor?
Questions to be asked to women of reproductive age (18-49 years) with a live birth 2-5 years ago.
606
4394
1
Yes
5
No
Sysmiss
nurse or midwife asissted in delivery (1-checked 5-Unchecked)
nurse or midwife asissted in delivery (1-checked 5-Unchecked)
nurse or midwife asissted in delivery (1-checked 5-Unchecked)
nurse or midwife asissted in delivery (1-checked 5-Unchecked)
nurse or midwife asissted in delivery (1-checked 5-Unchecked)
When you gave birth to (NAME), who assisted in the delivery? A nurse or midwife?
Questions to be asked to women of reproductive age (18-49 years) with a live birth 2-5 years ago.
606
4394
1
Yes
5
No
Sysmiss
auxiliary nurse or midwife asissted in delivery (1-checked 5-Unchecked)
auxiliary nurse or midwife asissted in delivery (1-checked 5-Unchecked)
auxiliary nurse or midwife asissted in delivery (1-checked 5-Unchecked)
auxiliary nurse or midwife asissted in delivery (1-checked 5-Unchecked)
auxiliary nurse or midwife asissted in delivery (1-checked 5-Unchecked)
When you gave birth to (NAME), who assisted in the delivery? An auxiliary nurse or midwife (including student nurses, nurses' aides, etc.)
Questions to be asked to women of reproductive age (18-49 years) with a live birth 2-5 years ago.
606
4394
1
Yes
5
No
Sysmiss
trad. birth attendant asissted in delivery (1-checked 5-Unchecked)
trad. birth attendant asissted in delivery (1-checked 5-Unchecked)
trad. birth attendant asissted in delivery (1-checked 5-Unchecked)
trad. birth attendant asissted in delivery (1-checked 5-Unchecked)
trad. birth attendant asissted in delivery (1-checked 5-Unchecked)
When you gave birth to (NAME), who assisted in the delivery? A traditional birth attendant
Questions to be asked to women of reproductive age (18-49 years) with a live birth 2-5 years ago.
606
4394
1
Yes
5
No
Sysmiss
relative/friend asissted in delivery (1-checked 5-Unchecked)
relative/friend asissted in delivery (1-checked 5-Unchecked)
relative/friend asissted in delivery (1-checked 5-Unchecked)
relative/friend asissted in delivery (1-checked 5-Unchecked)
relative/friend asissted in delivery (1-checked 5-Unchecked)
When you gave birth to (NAME), who assisted in the delivery? A relative/friend with no medical training
Questions to be asked to women of reproductive age (18-49 years) with a live birth 2-5 years ago.
606
4394
1
Yes
5
No
Sysmiss
other (1-checked 5-Unchecked)
other (1-checked 5-Unchecked)
other (1-checked 5-Unchecked)
other (1-checked 5-Unchecked)
other (1-checked 5-Unchecked)
When you gave birth to (NAME), who assisted in the delivery? Anyone else?
Questions to be asked to women of reproductive age (18-49 years) with a live birth 2-5 years ago.
606
4394
1
Yes
5
No
Sysmiss
No one (1-checked 5-Unchecked)
No one (1-checked 5-Unchecked)
No one (1-checked 5-Unchecked)
No one (1-checked 5-Unchecked)
No one (1-checked 5-Unchecked)
When you gave birth to (NAME), who assisted in the delivery? No one
Questions to be asked to women of reproductive age (18-49 years) with a live birth 2-5 years ago.
606
4394
1
5
Sysmiss
Dont know (1-checked 5-Unchecked)
Dont know (1-checked 5-Unchecked)
Dont know (1-checked 5-Unchecked)
Dont know (1-checked 5-Unchecked)
Dont know (1-checked 5-Unchecked)
When you gave birth to (NAME), who assisted in the delivery? Anyone else?
Questions to be asked to women of reproductive age (18-49 years) with a live birth 2-5 years ago.
606
4394
1
5
Sysmiss
where given birth
where given birth
where given birth
where given birth
where given birth
Where did you give birth to (NAME)?
Questions to be asked to women of reproductive age (18-49 years) with a live birth 2-5 years ago.
605
4395
1
Hospital or maternity house
2
Other type of health facility
3
At home
4
Outside
Sysmiss
Government operated or private
Government operated or private
Government operated or private
Government operated or private
Government operated or private
Was it government operated or private?
Questions to be asked to women of reproductive age (18-49 years) with a live birth 2-5 years ago.
590
4410
1
Government operated
2
Private (including for profit and not for profit)
8
Do not know
Sysmiss
Name
Name
Name
Name
Name
Can you please tell me the name, the sex, and the date of birth of the youngest child living in this household.
Questions to be asked to households with children under 5 years.
Sex of youngest child in the household
Sex of youngest child in the household
Sex of youngest child in the household
Sex of youngest child in the household
Sex of youngest child in the household
Can you please tell me the name, the sex, and the date of birth of the youngest child living in this household.
Questions to be asked to households with children under 5 years.
1265
3735
1
Male
2
Female
Sysmiss
date
date
date
date
date
Can you please tell me the name, the sex, and the date of birth of the youngest child living in this household.
Questions to be asked to households with children under 5 years.
5000
.
01/1998
01/1999
01/2000
01/2001
01/2002
01/2003
02/1998
02/1999
02/2000
02/2001
02/2002
02/2003
03/1998
03/1999
03/2000
03/2001
03/2002
03/2003
04/1998
04/1999
04/2000
04/2001
04/2002
04/2003
05/1998
05/1999
05/2000
05/2001
05/2002
05/2003
06/1998
06/1999
06/2000
06/2001
06/2002
06/2003
07/1998
07/1999
07/2000
07/2001
07/2002
08/1998
08/1999
08/2000
08/2001
08/2002
08/2003
09/1998
09/1999
09/2000
09/2001
09/2002
09/2003
10/1998
10/1999
10/2000
10/2001
10/2002
10/2003
11/1998
11/1999
11/2000
11/2001
11/2002
12/1997
12/1998
12/1999
12/2000
12/2001
12/2002
relationship
relationship
relationship
relationship
relationship
What is your relationship with this child?
Questions to be asked to households with children under 5 years.
1265
3735
1
Parent
2
Grand Parent
3
Brother or sister
4
Other relative
5
Not related
Sysmiss
card where vaccinations written down
card where vaccinations written down
card where vaccinations written down
card where vaccinations written down
card where vaccinations written down
Do you have a card where (NAME)’s vaccinations are written down? If YES: May I see it?
Questions to be asked to households with children under 5 years.
1081
3919
1
Yes, CARD SEEN
2
Yes, BUT CARD NOT SEEN
5
No CARD
8
Do not know
Sysmiss
DPT1 (dd/mm/yyyy)
DPT1 (dd/mm/yyyy)
DPT1 (dd/mm/yyyy)
DPT1 (dd/mm/yyyy)
DPT1 (dd/mm/yyyy)
Record vaccination dates for each dose of DTP and measles
Questions to be asked to households with children under 5 years.
5000
.
01/02/2001
01/03/1999
01/03/2001
01/03/2002
01/04/2000
01/04/2002
01/06/1998
01/06/2000
01/06/2001
01/07/2003
01/08/1999
01/08/2000
01/08/2001
01/08/2002
01/08/2003
01/09/1998
01/09/1999
01/10/1998
01/10/1999
01/10/2001
01/10/2002
01/11/2001
01/12/1998
01/12/2000
02/01/2001
02/03/1999
02/03/2001
02/04/2001
02/04/2002
02/05/2000
02/05/2001
02/07/2001
02/08/1999
02/09/2002
02/10/2000
02/10/2001
02/10/2002
02/12/1999
02/12/2002
03/01/2000
03/01/2002
03/02/1999
03/02/2003
03/03/1998
03/03/1999
03/03/2000
03/04/1998
03/04/2001
03/05/1999
03/05/2000
03/05/2001
03/07/2001
03/07/2002
03/08/2000
03/08/2001
03/10/2001
03/11/1998
03/11/1999
03/12/1998
03/12/1999
03/12/2001
04/01/1999
04/01/2000
04/02/1999
04/02/2000
04/02/2003
04/03/1999
04/03/2002
04/04/1904
04/04/2000
04/04/2002
04/05/2000
04/06/1999
04/06/2002
04/07/2001
04/08/1999
04/09/1998
04/09/2000
04/09/2001
04/10/1999
04/10/2001
04/11/1998
04/11/2002
04/12/2001
05/01/1999
05/02/2001
05/02/2003
05/03/2001
05/03/2002
05/04/1999
05/05/1998
05/05/1999
05/05/2001
05/06/2000
05/06/2002
05/07/1999
05/07/2000
05/08/1998
05/08/2000
05/08/2002
05/08/2003
05/09/2001
05/09/2002
05/10/1998
05/10/2000
05/11/1999
05/11/2001
05/12/2000
05/12/2001
05/12/2002
06/01/2003
06/02/2000
06/02/2001
06/04/2000
06/04/2001
06/05/1999
06/06/2000
06/06/2001
06/07/1998
06/07/2001
06/07/2002
06/08/1999
06/08/2001
06/08/2002
06/09/2001
06/09/2002
06/10/1999
06/10/2000
06/11/2000
06/11/2001
07/01/2002
07/01/2003
07/02/2000
07/02/2001
07/02/2003
07/03/2002
07/04/1999
07/04/2000
07/04/2001
07/04/2003
07/05/1998
07/05/2002
07/06/1999
07/06/2002
07/07/1999
07/08/2000
07/08/2002
07/10/2003
07/11/2001
07/11/2002
07/12/2000
08/01/1998
08/01/2001
08/01/2003
08/02/2001
08/03/2001
08/03/2002
08/04/1998
08/04/1999
08/04/2002
08/05/1998
08/05/2000
08/05/2001
08/06/1998
08/06/2000
08/07/1999
08/07/2002
08/07/2003
08/08/2000
08/08/2002
08/09/1998
08/09/2000
08/10/2001
08/11/1999
08/11/2000
08/11/2001
08/11/2002
08/12/1998
09/01/2001
09/02/2000
09/02/2002
09/03/1999
09/03/2000
09/03/2001
09/04/1999
09/04/2001
09/04/2002
09/05/2002
09/06/1998
09/06/2000
09/06/2001
09/07/2001
09/07/2002
09/08/1999
09/08/2000
09/08/2001
09/09/1998
09/09/1999
09/09/2002
09/10/2002
09/11/1998
09/11/2001
09/12/1998
10/01/2000
10/01/2001
10/01/2002
10/01/2003
10/02/2000
10/02/2003
10/03/1999
10/03/2000
10/04/2000
10/04/2001
10/04/2003
10/05/2000
10/05/2001
10/05/2002
10/06/1999
10/06/2001
10/06/2002
10/07/2000
10/08/1999
10/08/2001
10/08/2002
10/10/2000
10/10/2001
10/10/2002
10/11/2000
10/12/2001
10/12/2002
11/01/2000
11/01/2001
11/01/2002
11/03/2000
11/03/2002
11/04/1999
11/04/2001
11/04/2002
11/05/1999
11/06/1999
11/06/2001
11/06/2002
11/07/2000
11/07/2001
11/07/2002
11/08/2000
11/09/1998
11/09/2000
11/10/1999
11/10/2002
11/11/2002
12/01/1999
12/01/2001
12/02/2001
12/02/2002
12/02/2003
12/03/1999
12/03/2002
12/04/1999
12/05/2000
12/06/1998
12/06/2001
12/06/2002
12/07/1998
12/07/2001
12/08/1998
12/08/1999
12/08/2002
12/09/2000
12/09/2001
12/09/2002
12/11/2002
12/12/1999
12/12/2001
12/12/2002
13/01/1999
13/01/2000
13/01/2001
13/01/2003
13/02/2001
13/03/2000
13/04/1998
13/04/2002
13/05/1999
13/05/2002
13/06/2001
13/06/2003
13/07/2000
13/08/1998
13/08/2001
13/09/1999
13/09/2001
13/09/2002
13/11/1998
13/11/2002
13/12/1999
13/12/2000
14/01/2002
14/01/2003
14/02/2000
14/02/2001
14/02/2003
14/03/2003
14/04/2000
14/04/2002
14/05/1999
14/05/2001
14/06/1999
14/06/2000
14/06/2001
14/06/2002
14/08/1999
14/08/2000
14/08/2001
14/10/1999
14/11/2000
14/11/2001
14/11/2002
14/12/1998
14/12/1999
14/12/2000
15/01/2001
15/01/2002
15/01/2003
15/02/2000
15/02/2001
15/02/2002
15/03/2000
15/03/2001
15/03/2002
15/04/2002
15/06/1998
15/06/2002
15/07/1998
15/07/2002
15/08/1998
15/08/2002
15/09/1999
15/09/2003
15/12/1998
16/01/2002
16/01/2003
16/02/2000
16/02/2001
16/03/2000
16/03/2001
16/04/1999
16/04/2001
16/04/2002
16/05/2000
16/05/2001
16/05/2002
16/06/1998
16/06/1999
16/06/2000
16/07/1998
16/07/1999
16/07/2001
16/08/1999
16/08/2000
16/08/2001
16/08/2002
16/09/2002
16/10/1999
16/10/2000
16/10/2001
16/11/1999
16/12/1999
17/01/2000
17/01/2001
17/01/2002
17/01/2003
17/02/2003
17/03/1999
17/04/2002
17/05/1999
17/05/2000
17/05/2002
17/06/1998
17/06/1999
17/06/2000
17/07/2000
17/07/2001
17/08/1998
17/08/1999
17/08/2000
17/09/2000
17/10/2001
17/11/1998
17/11/1999
17/12/1999
17/12/2001
17/12/2002
18/01/2001
18/02/2000
18/03/1999
18/03/2003
18/04/1999
18/05/2001
18/06/1998
18/06/2001
18/06/2002
18/06/2003
18/08/1999
18/08/2000
18/09/2000
18/10/2002
18/11/1999
18/11/2002
18/12/2001
19/01/2000
19/01/2001
19/02/2001
19/03/1999
19/03/2002
19/04/1999
19/04/2000
19/04/2002
19/05/2000
19/06/2001
19/07/1999
19/07/2000
19/08/1998
19/08/2000
19/08/2002
19/09/2000
19/10/2000
19/10/2001
19/11/2001
19/11/2002
19/12/2001
20/01/2003
20/02/2000
20/02/2001
20/02/2003
20/03/2001
20/04/2001
20/05/2002
20/06/1998
20/06/2000
20/06/2001
20/06/2002
20/07/1998
20/07/2001
20/08/1999
20/08/2001
20/08/2002
20/09/2002
20/10/1999
20/10/2000
20/11/1998
20/11/2000
20/12/2000
20/12/2001
21/01/1999
21/01/2000
21/01/2001
21/01/2002
21/02/2000
21/02/2001
21/02/2002
21/03/2000
21/03/2001
21/03/2002
21/05/2002
21/06/2000
21/07/1999
21/07/2000
21/08/2000
21/08/2002
21/09/1999
21/09/2000
21/11/2000
21/11/2001
21/11/2002
22/01/1999
22/01/2001
22/01/2003
22/02/1999
22/02/2000
22/02/2002
22/03/2000
22/04/1998
22/04/1999
22/05/2000
22/06/1999
22/07/1998
22/07/1999
22/07/2002
22/09/1999
22/09/2000
22/10/1998
22/11/2000
22/11/2002
22/12/2000
23/01/2000
23/01/2002
23/02/1999
23/02/2000
23/02/2003
23/03/1999
23/03/2000
23/03/2001
23/04/1998
23/04/1999
23/04/2002
23/05/2001
23/06/1998
23/06/1999
23/07/1999
23/07/2002
23/08/1999
23/08/2000
23/08/2002
23/09/1999
23/09/2002
23/10/1998
23/10/2000
23/10/2001
23/10/2002
23/11/1998
23/11/2000
23/12/1999
23/12/2002
24/01/2000
24/01/2001
24/04/2000
24/04/2002
24/04/2003
24/05/1999
24/05/2000
24/05/2001
24/06/2002
24/07/1998
24/07/2000
24/08/1998
24/08/1999
24/08/2001
24/08/2002
24/09/2001
24/09/2002
24/10/2001
24/10/2002
24/11/1999
24/11/2000
24/11/2002
24/12/1999
24/12/2002
25/01/1999
25/02/2001
25/03/2002
25/04/2000
25/05/1998
25/05/2000
25/05/2001
25/06/1999
25/06/2000
25/06/2001
25/06/2002
25/07/2000
25/07/2001
25/07/2002
25/08/1999
25/08/2000
25/08/2002
25/09/1998
25/10/2000
25/10/2001
25/11/1998
25/11/1999
26/01/2000
26/02/2000
26/02/2002
26/03/2001
26/03/2002
26/04/1999
26/04/2001
26/04/2002
26/06/2001
26/07/1999
26/07/2001
26/08/1998
26/08/2002
26/09/2001
26/10/2000
26/11/1998
26/11/2002
27/01/1999
27/01/2001
27/01/2003
27/02/2002
27/03/2002
27/04/1999
27/04/2000
27/04/2001
27/05/2002
27/06/2000
27/06/2001
27/06/2002
27/07/2001
27/08/1999
27/08/2001
27/08/2002
27/10/1999
27/10/2001
27/11/1998
27/11/2000
27/11/2002
27/12/1999
27/12/2000
27/12/2001
28/01/2002
28/02/2000
28/02/2001
28/02/2002
28/03/2001
28/05/1998
28/05/1999
28/06/1999
28/06/2001
28/06/2002
28/07/1998
28/08/2001
28/08/2002
28/08/2003
28/09/2000
28/10/1998
28/12/1998
28/12/1999
28/12/2000
29/01/1999
29/01/2001
29/01/2003
29/02/2000
29/03/1999
29/04/1998
29/04/1999
29/04/2002
29/05/2000
29/05/2001
29/05/2002
29/06/1999
29/06/2001
29/06/2002
29/07/2002
29/08/2000
29/08/2001
29/09/1999
29/10/1998
29/10/2001
29/11/1999
29/12/2000
30/01/2003
30/03/2000
30/03/2001
30/04/2002
30/05/2000
30/06/2000
30/07/2001
30/07/2002
30/08/1999
30/08/2000
30/08/2001
30/08/2002
30/09/1998
30/09/2002
30/11/1998
30/12/1999
30/12/2002
31/03/1999
31/03/2000
31/07/2000
31/07/2001
31/08/1999
31/08/2001
31/10/2001
31/10/2002
DPT2 (dd/mm/yyyy)
DPT2 (dd/mm/yyyy)
DPT2 (dd/mm/yyyy)
DPT2 (dd/mm/yyyy)
DPT2 (dd/mm/yyyy)
Record vaccination dates for each dose of DTP and measles
Questions to be asked to households with children under 5 years.
5000
.
01/02/1999
01/02/2000
01/02/2001
01/03/2000
01/04/2002
01/04/2003
01/06/2001
01/07/1999
01/07/2002
01/08/2000
01/08/2001
01/10/1998
01/10/2001
01/10/2002
01/10/2003
01/11/1999
01/12/1998
01/12/1999
01/12/2000
02/01/2002
02/01/2003
02/02/1999
02/02/2000
02/03/2000
02/03/2001
02/03/2003
02/05/2000
02/05/2001
02/07/2001
02/07/2002
02/08/1999
02/08/2000
02/08/2002
02/10/2000
02/10/2001
02/10/2002
02/12/1999
02/12/2002
03/01/2002
03/02/2000
03/03/1999
03/04/2001
03/05/1999
03/05/2001
03/06/2002
03/07/2001
03/09/2002
03/09/2003
03/10/2000
03/10/2002
03/11/1998
03/11/1999
03/12/2001
04/01/1999
04/02/1999
04/02/2000
04/02/2002
04/02/2003
04/03/2002
04/04/1904
04/04/2001
04/04/2002
04/05/1999
04/05/2000
04/06/2001
04/07/2000
04/07/2002
04/08/1999
04/10/1999
04/10/2001
04/10/2002
04/11/1998
04/11/2002
04/12/2001
04/12/2002
05/01/2000
05/01/2002
05/02/2002
05/02/2003
05/03/1999
05/03/2001
05/04/2001
05/05/1998
05/05/1999
05/06/2001
05/06/2002
05/07/1999
05/07/2001
05/08/1998
05/08/2002
05/09/2000
05/10/2000
05/11/1998
05/11/2001
05/12/1998
05/12/2000
06/01/1999
06/01/2000
06/01/2003
06/02/2001
06/02/2002
06/03/2003
06/04/1999
06/04/2001
06/05/1999
06/05/2002
06/06/2000
06/06/2002
06/06/2003
06/07/1999
06/08/1999
06/08/2001
06/08/2002
06/09/2001
06/09/2002
06/10/1998
06/10/1999
06/10/2000
06/11/2000
06/12/1999
06/12/2000
07/01/1999
07/01/2000
07/01/2002
07/01/2003
07/02/2002
07/03/2001
07/03/2002
07/04/2000
07/05/2001
07/05/2002
07/06/1999
07/06/2000
07/06/2001
07/07/1999
07/07/2001
07/08/2000
07/10/1999
07/10/2002
07/11/2001
08/01/2003
08/02/2001
08/03/1999
08/03/2001
08/04/1999
08/04/2000
08/05/2002
08/06/1999
08/06/2000
08/06/2001
08/06/2002
08/07/1998
08/09/1998
08/09/1999
08/10/2001
08/10/2002
08/11/1999
08/11/2000
08/11/2001
08/12/1998
09/02/1999
09/03/2000
09/03/2001
09/04/2001
09/05/2000
09/06/1998
09/06/1999
09/06/2000
09/06/2001
09/07/1999
09/07/2000
09/07/2002
09/08/1999
09/08/2000
09/09/1999
09/10/1998
09/10/2000
09/10/2001
09/10/2002
09/11/1999
09/11/2000
09/11/2001
09/11/2002
09/12/1999
09/12/2002
10/01/2000
10/02/2003
10/03/2000
10/03/2001
10/04/2001
10/04/2003
10/05/1999
10/05/2000
10/05/2001
10/05/2002
10/06/1999
10/06/2002
10/07/2000
10/07/2001
10/08/1998
10/08/1999
10/08/2001
10/09/1998
10/09/1999
10/09/2001
10/09/2002
10/10/2000
10/10/2001
10/11/1998
10/12/1998
10/12/2001
10/12/2002
10/12/2003
11/01/1999
11/04/2000
11/05/1999
11/05/2000
11/06/2001
11/06/2002
11/07/2001
11/07/2002
11/08/1998
11/08/1999
11/08/2000
11/09/2001
11/10/1999
11/10/2000
11/10/2001
11/11/1998
11/12/2001
11/12/2002
12/01/1999
12/02/1998
12/02/1999
12/02/2001
12/03/2000
12/03/2001
12/03/2003
12/04/2000
12/04/2002
12/06/2000
12/07/2001
12/08/1998
12/08/2002
12/09/2000
12/09/2001
12/09/2002
12/10/2000
12/10/2001
12/11/1998
12/11/2001
12/12/2000
12/12/2001
12/12/2002
13/01/1999
13/01/2003
13/02/2001
13/03/1999
13/03/2000
13/03/2002
13/05/2002
13/06/2000
13/06/2001
13/06/2002
13/07/1999
13/07/2002
13/08/1998
13/08/2001
13/08/2002
13/08/2003
13/09/2000
13/10/1998
13/10/1999
13/11/2000
13/11/2001
13/11/2002
13/12/1999
13/12/2002
14/01/2000
14/01/2002
14/03/2000
14/03/2002
14/04/1999
14/05/1998
14/05/1999
14/06/1999
14/06/2000
14/06/2002
14/06/2003
14/07/1999
14/08/1999
14/08/2000
14/08/2002
14/09/1999
14/10/1999
14/11/2000
14/11/2001
15/01/2001
15/01/2003
15/02/2000
15/02/2001
15/02/2002
15/03/2001
15/04/2002
15/05/2000
15/05/2001
15/05/2002
15/06/1998
15/06/1999
15/06/2000
15/06/2002
15/07/1998
15/07/2002
15/08/1998
15/08/2000
15/08/2002
15/09/1998
15/10/1999
15/10/2001
16/01/2002
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16/02/2000
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16/03/2000
16/04/2001
16/04/2002
16/05/2001
16/06/1998
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16/07/2002
16/08/1999
16/09/1999
16/09/2000
16/09/2002
16/09/2003
16/10/1999
16/10/2000
16/10/2001
16/10/2002
16/11/1999
16/11/2000
16/11/2001
16/12/1999
17/01/2000
17/02/1998
17/02/2000
17/03/2000
17/03/2002
17/04/2000
17/04/2001
17/04/2002
17/04/2003
17/05/1999
17/06/1998
17/06/1999
17/06/2000
17/06/2002
17/07/2000
17/07/2001
17/07/2002
17/08/1999
17/09/1999
17/09/2001
17/10/2001
17/10/2002
17/11/1999
17/11/2000
17/11/2002
17/12/2002
18/01/2001
18/01/2002
18/02/2002
18/02/2003
18/03/2001
18/03/2002
18/04/2001
18/06/2002
18/07/2001
18/07/2002
18/08/2000
18/08/2003
18/09/2001
18/10/1999
18/10/2000
18/11/2002
18/12/2000
18/12/2001
19/02/2001
19/02/2003
19/03/1999
19/03/2001
19/04/2001
19/05/1999
19/05/2000
19/05/2002
19/06/2000
19/07/2000
19/07/2002
19/08/1998
19/08/1999
19/08/2000
19/08/2002
19/09/2000
19/09/2002
19/10/1998
19/11/2002
19/12/2000
20/01/1999
20/01/2000
20/01/2001
20/01/2003
20/02/2002
20/03/2001
20/03/2002
20/03/2003
20/05/2000
20/05/2002
20/06/1998
20/06/2002
20/08/1999
20/09/2000
20/10/1998
20/10/1999
20/11/1999
20/11/2000
20/11/2001
20/11/2002
20/12/1999
21/01/1999
21/01/2002
21/02/2000
21/02/2002
21/03/2002
21/05/1999
21/05/2001
21/06/2002
21/07/1999
21/08/2000
21/08/2001
21/09/1998
21/09/2000
21/09/2001
21/10/2000
21/10/2002
21/11/2002
21/12/1999
21/12/2000
21/12/2001
22/01/2001
22/01/2002
22/01/2003
22/02/1999
22/02/2002
22/03/2000
22/03/2001
22/03/2002
22/04/1999
22/05/2000
22/05/2002
22/07/2002
22/09/1998
22/09/1999
22/09/2002
22/10/2001
22/10/2002
22/11/2001
22/12/1998
23/01/2002
23/01/2003
23/02/2000
23/02/2001
23/03/2000
23/03/2001
23/04/2001
23/05/2000
23/05/2002
23/06/1999
23/06/2003
23/07/2001
23/07/2002
23/08/2001
23/09/2002
23/10/1998
23/10/2000
23/10/2001
23/10/2002
23/11/1999
23/11/2000
23/11/2001
23/12/2002
24/01/2000
24/01/2001
24/01/2002
24/02/2000
24/02/2003
24/04/2000
24/04/2001
24/05/2000
24/05/2001
24/05/2002
24/06/1999
24/07/2000
24/07/2001
24/08/1999
24/08/2001
24/08/2002
24/09/1998
24/09/2001
24/11/2000
25/01/2002
25/02/2002
25/03/2002
25/04/2000
25/05/1999
25/05/2000
25/06/1998
25/06/1999
25/06/2001
25/06/2002
25/07/1998
25/08/1999
25/08/2000
25/08/2001
25/09/2000
25/09/2001
25/10/1999
25/10/2001
25/10/2002
26/01/1999
26/01/2001
26/02/2002
26/03/2001
26/04/2000
26/04/2001
26/06/2002
26/07/1999
26/07/2002
26/08/1998
26/09/2002
26/10/1998
26/10/1999
26/10/2000
26/11/1999
26/11/2001
26/11/2002
26/12/2000
26/12/2001
26/12/2002
27/01/2003
27/02/2002
27/03/2000
27/03/2002
27/04/2000
27/05/2002
27/06/2000
27/08/1999
27/08/2001
27/09/1999
27/09/2000
27/09/2001
27/10/1999
27/11/2002
27/12/2000
27/12/2001
27/12/2002
28/01/2000
28/01/2001
28/01/2003
28/02/2001
28/03/2000
28/03/2001
28/03/2003
28/05/2001
28/05/2002
28/06/1999
28/06/2001
28/06/2002
28/07/1998
28/07/1999
28/08/2000
28/09/1998
28/09/2001
28/12/1998
28/12/2000
28/12/2001
29/01/2001
29/03/2000
29/03/2001
29/04/2002
29/05/2000
29/05/2002
29/06/1999
29/06/2001
29/07/2002
29/08/2000
29/08/2001
29/10/1999
29/10/2001
29/11/1999
29/11/2000
29/11/2001
29/12/1998
29/12/2000
29/12/2001
30/01/2003
30/03/1999
30/03/2000
30/04/2000
30/04/2001
30/06/1999
30/06/2000
30/07/2001
30/07/2002
30/08/2000
30/08/2002
30/09/2002
30/10/2000
30/10/2002
30/11/1998
30/12/1998
30/12/1999
31/01/2003
31/05/1999
31/05/2000
31/07/2000
31/07/2001
31/07/2002
31/08/1999
31/08/2000
31/08/2001
31/10/2000
31/10/2001
31/10/2002
DPT3 (dd/mm/yyyy)
DPT3 (dd/mm/yyyy)
DPT3 (dd/mm/yyyy)
DPT3 (dd/mm/yyyy)
DPT3 (dd/mm/yyyy)
Record vaccination dates for each dose of DTP and measles
Questions to be asked to households with children under 5 years.
5000
.
01/01/2000
01/02/1999
01/02/2000
01/02/2002
01/03/1999
01/03/2001
01/03/2003
01/04/2000
01/06/2000
01/06/2001
01/07/2001
01/08/2001
01/10/1999
01/10/2001
01/10/2002
01/11/2000
01/11/2002
01/12/1999
02/01/2001
02/01/2002
02/01/2003
02/04/2001
02/04/2002
02/05/2000
02/07/2000
02/07/2001
02/09/1999
02/10/2000
02/10/2001
02/12/1999
02/12/2002
03/01/2000
03/01/2003
03/02/2000
03/03/1999
03/04/2000
03/04/2001
03/05/1999
03/05/2000
03/05/2001
03/05/2002
03/07/2001
03/09/2001
03/09/2002
03/10/2000
03/10/2001
03/11/1999
03/12/2000
03/12/2002
04/01/1999
04/02/1999
04/02/2000
04/02/2001
04/02/2002
04/03/2000
04/03/2002
04/06/2001
04/07/2000
04/08/2002
04/09/2000
04/09/2002
04/10/1998
04/10/1999
04/10/2000
04/11/2002
05/01/1999
05/01/2000
05/01/2001
05/01/2003
05/02/2001
05/03/2001
05/04/2000
05/05/1999
05/06/2000
05/06/2001
05/06/2002
05/10/1998
05/11/2001
05/11/2002
05/12/2001
05/12/2002
06/01/2000
06/01/2003
06/02/2001
06/02/2002
06/02/2003
06/03/2001
06/04/1999
06/04/2001
06/06/2001
06/06/2002
06/07/1999
06/07/2000
06/07/2001
06/08/1999
06/08/2001
06/09/1999
06/09/2001
06/10/1998
06/10/1999
06/11/2000
06/12/1999
06/12/2000
06/12/2002
07/01/1999
07/01/2000
07/01/2003
07/02/2002
07/03/2002
07/04/2000
07/05/1999
07/05/2001
07/06/1999
07/06/2000
07/07/1998
07/10/2002
07/11/2000
07/11/2001
07/11/2002
07/12/1998
07/12/1999
08/01/2000
08/01/2001
08/01/2002
08/02/2000
08/03/1999
08/04/2002
08/05/2000
08/05/2001
08/06/2001
08/07/2002
08/08/2000
08/08/2001
08/08/2002
08/09/1999
08/10/1999
08/10/2001
08/10/2002
08/11/1999
08/11/2000
08/11/2002
09/01/2002
09/01/2003
09/02/1999
09/03/1999
09/03/2002
09/04/1999
09/05/2000
09/05/2002
09/05/2003
09/06/2001
09/07/2000
09/08/2000
09/08/2002
09/09/1999
09/09/2002
09/10/1998
09/10/2000
09/10/2001
09/10/2002
09/11/1999
09/11/2000
09/11/2001
09/12/2002
10/01/2001
10/03/2000
10/03/2003
10/05/2001
10/06/2003
10/07/2001
10/07/2002
10/08/1998
10/08/1999
10/09/2001
10/10/1999
10/10/2000
10/11/1998
10/11/1999
10/11/2000
10/12/1998
10/12/1999
10/12/2001
10/12/2002
11/01/1999
11/01/2001
11/01/2002
11/02/2003
11/04/2002
11/05/2000
11/06/2002
11/07/2001
11/07/2002
11/08/2003
11/09/2002
11/10/2002
11/11/2002
11/12/1999
11/12/2000
11/12/2001
11/12/2002
12/01/1999
12/02/2000
12/02/2003
12/03/1999
12/04/2000
12/05/2000
12/05/2002
12/06/2000
12/07/1999
12/08/1999
12/08/2000
12/08/2001
12/08/2002
12/10/1999
12/11/2001
12/12/2000
12/12/2001
13/01/2003
13/02/2002
13/03/2001
13/03/2002
13/03/2003
13/04/1999
13/05/1999
13/05/2002
13/06/2003
13/08/1999
13/08/2000
13/08/2001
13/09/1999
13/09/2001
13/10/2002
13/11/1998
13/11/2000
13/12/2002
14/01/2000
14/01/2002
14/02/2001
14/02/2003
14/03/2000
14/03/2002
14/03/2003
14/05/2001
14/05/2002
14/05/2003
14/06/2000
14/06/2003
14/07/1998
14/07/1999
14/07/2000
14/08/1999
14/08/2000
14/08/2002
14/09/1999
14/10/1998
14/10/1999
14/10/2001
14/10/2002
14/11/1999
14/11/2002
14/12/1998
14/12/1999
14/12/2000
14/12/2001
15/01/2001
15/01/2002
15/02/2000
15/03/1999
15/03/2000
15/03/2001
15/03/2002
15/05/2001
15/05/2002
15/06/1999
15/06/2002
15/07/2002
15/08/1998
15/08/2001
15/08/2002
15/09/2002
15/10/1998
15/10/2001
15/10/2002
15/10/2003
15/12/1998
15/12/1999
15/12/2000
16/01/2001
16/02/2001
16/03/2001
16/05/2000
16/05/2001
16/05/2002
16/07/2001
16/07/2002
16/08/1999
16/08/2000
16/08/2001
16/08/2002
16/09/2002
16/10/1999
16/10/2000
16/10/2002
16/11/1999
16/12/1999
16/12/2001
16/12/2002
17/01/2000
17/01/2001
17/02/2002
17/02/2003
17/04/2000
17/04/2001
17/05/2000
17/05/2002
17/06/2000
17/06/2002
17/07/2000
17/07/2002
17/08/1999
17/08/2001
17/09/2001
17/09/2002
17/10/2001
17/11/1999
17/11/2002
18/01/2000
18/01/2002
18/02/1999
18/02/2001
18/02/2003
18/03/2002
18/03/2003
18/04/2000
18/04/2001
18/04/2002
18/05/2000
18/05/2002
18/06/1999
18/06/2001
18/06/2002
18/07/2001
18/08/1998
18/08/1999
18/08/2003
18/09/2000
18/09/2001
18/10/2001
18/10/2002
18/11/2002
18/12/2000
18/12/2001
18/12/2002
19/01/2000
19/01/2001
19/01/2003
19/02/2001
19/02/2002
19/03/1999
19/04/1999
19/04/2001
19/04/2002
19/05/1999
19/06/2000
19/06/2001
19/06/2002
19/07/1999
19/08/2000
19/08/2002
19/09/2000
19/09/2001
19/09/2002
19/10/2000
19/11/2001
19/12/2000
19/12/2002
20/02/2001
20/03/1999
20/03/2000
20/03/2001
20/03/2002
20/03/2003
20/05/2002
20/06/2000
20/07/1999
20/08/2001
20/09/2000
20/10/1998
20/10/2000
20/11/2001
20/11/2002
20/12/2002
21/01/1999
21/01/2002
21/01/2003
21/02/2000
21/02/2002
21/03/2001
21/03/2003
21/05/2001
21/05/2002
21/06/2000
21/06/2001
21/07/1999
21/07/2000
21/08/1998
21/08/2000
21/09/2000
21/09/2001
21/10/2002
21/11/2001
21/12/2001
22/01/2001
22/01/2002
22/01/2003
22/02/1999
22/03/2001
22/04/1999
22/04/2002
22/07/2002
22/08/2000
22/09/1999
23/01/2000
23/01/2001
23/01/2003
23/02/2001
23/02/2002
23/03/1999
23/04/2002
23/04/2003
23/05/2001
23/07/1999
23/07/2001
23/08/1999
23/08/2002
23/09/1999
23/09/2002
23/10/2000
23/10/2001
23/10/2002
23/11/1998
23/11/2001
23/12/2002
24/02/2000
24/03/1999
24/03/2000
24/03/2001
24/04/2000
24/05/2000
24/05/2001
24/07/2000
24/07/2001
24/07/2002
24/08/1998
24/08/1999
24/08/2001
24/08/2002
24/09/1999
24/09/2001
24/09/2003
24/10/2000
24/10/2001
24/11/1998
24/11/2000
25/01/2000
25/01/2002
25/03/1999
25/04/2000
25/04/2001
25/04/2002
25/05/1999
25/06/2002
25/07/2000
25/07/2001
25/08/1999
25/08/2001
25/09/2000
25/09/2001
25/09/2002
25/10/1999
25/10/2001
25/10/2002
25/11/1998
25/11/2002
26/01/2000
26/01/2001
26/02/2002
26/03/1999
26/03/2002
26/03/2003
26/04/1999
26/04/2002
26/05/2000
26/06/2000
26/06/2001
26/07/2000
26/08/1999
26/08/2002
26/09/2001
26/10/1998
26/10/2001
26/11/1998
26/11/1999
26/12/2001
26/12/2002
27/01/2000
27/01/2003
27/02/2002
27/02/2003
27/03/2000
27/03/2003
27/04/1999
27/04/2000
27/04/2002
27/05/2002
27/06/2000
27/06/2001
27/07/2000
27/07/2001
27/08/2002
27/09/1999
27/09/2002
27/10/1999
27/10/2001
27/11/2000
27/11/2001
27/11/2002
27/12/2000
27/12/2001
28/01/1998
28/01/2002
28/02/2002
28/05/2001
28/05/2002
28/06/1999
28/06/2000
28/06/2001
28/08/2001
28/08/2002
28/09/2001
28/10/2001
28/11/2000
28/11/2001
28/11/2002
28/12/1998
28/12/1999
28/12/2000
28/12/2001
28/12/2002
29/01/2000
29/03/2001
29/04/2002
29/05/2000
29/05/2001
29/05/2002
29/07/1999
29/07/2002
29/09/1998
29/10/1999
29/10/2001
29/11/2000
29/11/2001
29/12/1999
29/12/2000
30/01/2000
30/01/2001
30/01/2002
30/03/1999
30/05/2000
30/07/1999
30/07/2001
30/07/2002
30/08/1998
30/08/1999
30/08/2001
30/08/2002
30/09/2000
30/09/2002
30/10/1998
30/10/2000
30/11/2001
30/12/1999
30/12/2002
31/03/2000
31/03/2002
31/03/2003
31/07/2000
31/07/2002
31/08/2000
31/08/2001
31/10/2000
31/10/2001
31/10/2002
Measles (dd/mm/yyyy)
Measles (dd/mm/yyyy)
Measles (dd/mm/yyyy)
Measles (dd/mm/yyyy)
Measles (dd/mm/yyyy)
Record vaccination dates for each dose of DTP and measles
Questions to be asked to households with children under 5 years.
5000
.
01/01/8888
01/03/2000
01/03/2001
01/03/2002
01/06/1999
01/06/2000
01/06/2001
01/07/2002
01/08/2001
01/08/2002
01/12/1999
01/12/2000
02/01/2002
02/03/1999
02/03/2000
02/03/2001
02/04/2001
02/05/2001
02/06/2002
02/09/2001
02/09/2002
02/10/2001
02/10/2002
02/12/1999
03/01/2001
03/01/2003
03/02/2001
03/02/2003
03/03/2000
03/03/2001
03/04/2002
03/05/1999
03/05/2000
03/05/2002
03/06/2002
03/08/1999
03/08/2000
03/08/2001
03/09/2001
03/10/2000
03/10/2002
03/11/1999
04/01/2002
04/01/2003
04/02/2000
04/02/2001
04/02/2002
04/03/2002
04/04/1904
04/04/1999
04/04/2001
04/05/1999
04/06/1999
04/06/2002
04/06/2003
04/07/2000
04/07/2001
04/08/1999
04/08/2000
04/09/2000
04/10/2001
04/10/2002
04/11/1999
04/12/1998
04/12/2002
05/01/1999
05/01/2000
05/01/2001
05/02/1999
05/02/2001
05/03/2001
05/03/2002
05/04/2001
05/05/1999
05/05/2002
05/06/2002
05/07/1999
05/07/2000
05/07/2001
05/08/2002
05/09/2000
05/09/2001
05/10/2000
05/10/2001
05/12/2000
05/12/2002
06/01/2000
06/03/2001
06/03/2002
06/04/2000
06/05/2002
06/06/2001
06/07/2001
06/08/2001
06/08/2002
06/10/1999
06/10/2000
06/11/2001
06/11/2002
06/12/2000
06/12/2001
06/12/2002
07/01/1998
07/01/2000
07/02/2000
07/02/2002
07/03/2001
07/03/2002
07/04/2000
07/05/2001
07/05/2002
07/06/2001
07/06/2002
07/07/1998
07/07/1999
07/07/2001
07/08/2000
07/08/2001
07/08/2002
07/12/2002
08/01/2001
08/02/2000
08/02/2001
08/02/2002
08/03/2001
08/05/2000
08/05/2001
08/05/2002
08/06/1999
08/06/2001
08/07/1999
08/08/2002
08/09/2000
08/10/1999
08/10/2002
08/11/1999
08/11/2000
08/12/1999
09/01/2001
09/01/2002
09/02/2000
09/02/2001
09/03/1999
09/03/2000
09/03/2001
09/04/1999
09/04/2000
09/04/2001
09/06/2001
09/08/2000
09/09/2002
09/10/2001
09/11/2000
09/11/2001
09/11/2002
10/01/2001
10/01/2003
10/02/2002
10/04/2002
10/05/1999
10/05/2001
10/06/1999
10/07/2000
10/07/2001
10/07/2002
10/08/2001
10/10/2001
10/11/1999
10/11/2000
10/12/2001
10/12/2002
11/01/2000
11/02/1999
11/03/2002
11/05/2000
11/05/2001
11/06/2001
11/07/2001
11/08/2000
11/09/2001
11/10/1999
11/10/2001
11/11/2000
11/12/2000
12/01/1999
12/01/2000
12/01/2001
12/01/2002
12/02/2001
12/02/2002
12/02/2003
12/04/1999
12/04/2001
12/05/1999
12/05/2001
12/06/2000
12/06/2001
12/06/2002
12/07/2001
12/08/1999
12/08/2002
12/09/2001
12/11/1999
12/11/2002
12/12/2002
13/01/1999
13/01/2003
13/02/2001
13/03/2001
13/03/2003
13/04/2000
13/05/2002
13/06/2000
13/06/2002
13/08/2001
13/09/1999
13/10/1999
13/10/2001
13/11/1998
13/11/2002
13/12/2001
13/12/2002
14/01/2000
14/01/2002
14/02/2001
14/03/2000
14/03/2002
14/06/2000
14/06/2002
14/07/2000
14/08/1998
14/08/1999
14/08/2002
14/09/1999
14/09/2001
14/10/1999
14/10/2002
14/12/1999
14/12/2001
15/01/2003
15/02/2000
15/02/2002
15/03/2001
15/03/2002
15/04/2002
15/05/2000
15/05/2002
15/06/2000
15/06/2002
15/08/2000
15/08/2002
15/09/2002
15/10/2000
15/11/2002
16/01/1999
16/01/2001
16/01/2002
16/02/2001
16/03/2001
16/04/1999
16/04/2002
16/05/2002
16/06/2000
16/06/2001
16/06/2002
16/08/2000
16/08/2001
16/09/2002
16/10/1998
16/10/1999
16/10/2002
16/11/2000
16/12/1999
16/12/2002
17/01/2001
17/03/1999
17/03/2000
17/04/2001
17/04/2002
17/05/2000
17/06/1999
17/06/2000
17/06/2002
17/07/2002
17/08/2001
17/09/1998
17/09/2001
17/10/2000
17/10/2001
17/12/1999
18/01/2000
18/02/1999
18/02/2001
18/02/2002
18/03/1998
18/03/1999
18/03/2002
18/04/2000
18/04/2001
18/05/2000
18/05/2001
18/06/2001
18/07/2001
18/07/2002
18/08/2001
18/08/2002
18/09/2000
18/09/2001
18/09/2002
18/10/1999
18/10/2000
18/11/2002
18/12/2002
19/01/2000
19/01/2001
19/03/2001
19/03/2002
19/04/1999
19/04/2000
19/04/2001
19/04/2002
19/05/1999
19/06/2000
19/07/2000
19/08/1999
19/08/2000
19/09/1999
19/09/2000
19/09/2001
19/10/1998
19/10/1999
19/10/2000
19/11/2001
19/12/2001
20/01/1999
20/03/2000
20/04/1999
20/04/2001
20/06/2000
20/06/2001
20/07/2000
20/07/2002
20/08/1999
20/08/2001
20/08/2002
20/09/2000
20/10/1999
20/10/2000
20/11/2000
20/11/2001
20/11/2002
20/12/2001
21/01/2000
21/01/2003
21/02/2000
21/02/2001
21/02/2002
21/05/2002
21/06/1999
21/06/2000
21/07/2000
21/08/2000
21/08/2002
21/09/2001
21/10/2002
21/11/2001
21/12/2000
22/01/2000
22/01/2001
22/02/2000
22/02/2002
22/03/1999
22/03/2000
22/03/2001
22/04/2002
22/05/2000
22/05/2001
22/05/2002
22/07/2002
22/08/2001
22/08/2002
22/09/1999
22/09/2000
22/10/1999
22/10/2002
22/12/2000
23/01/2002
23/01/2003
23/02/1999
23/02/2002
23/03/2000
23/03/2001
23/04/2001
23/04/2002
23/05/2000
23/06/2000
23/07/2001
23/07/2002
23/08/2000
23/08/2001
23/09/1999
23/10/2000
23/10/2001
23/10/2002
23/11/2001
23/12/2002
24/01/2002
24/02/1999
24/02/2000
24/03/2000
24/04/2000
24/04/2001
24/04/2002
24/05/2000
24/05/2001
24/05/2002
24/07/2001
24/07/2002
24/08/2000
24/08/2002
24/09/2001
24/09/2002
24/10/2001
24/10/2002
24/11/2000
24/12/1999
25/01/1999
25/01/2000
25/01/2001
25/03/2002
25/04/2001
25/05/2000
25/06/1999
25/06/2002
25/07/2000
25/08/2000
25/08/2001
25/10/2000
25/11/1999
25/11/2002
26/01/2000
26/01/2003
26/02/2002
26/02/2003
26/03/2002
26/05/1999
26/05/2000
26/06/2000
26/06/2001
26/08/1999
26/09/2001
26/09/2002
26/10/2001
26/12/2000
26/12/2001
27/02/2002
27/03/2000
27/03/2001
27/04/2000
27/05/1999
27/06/2000
27/07/2000
27/07/2002
27/08/2002
27/09/1999
27/09/2002
27/10/1999
27/11/1998
27/11/2000
27/11/2001
27/11/2002
27/12/1998
27/12/2000
27/12/2001
28/01/1999
28/01/2002
28/02/2000
28/03/2000
28/03/2002
28/05/1998
28/05/1999
28/05/2001
28/05/2002
28/07/2000
28/08/2001
28/08/2002
28/09/2000
28/10/2002
28/11/2001
28/12/2000
29/01/2002
29/03/2001
29/04/1999
29/04/2002
29/05/2001
29/06/1999
29/06/2000
29/07/2002
29/08/2000
29/09/1999
29/10/2001
29/10/2002
29/11/2002
29/12/2000
29/12/2001
30/01/2001
30/01/2002
30/03/2001
30/04/2002
30/06/1999
30/07/1999
30/07/2002
30/08/2000
30/08/2001
30/09/2002
30/10/2000
30/10/2001
30/10/2002
30/11/1999
30/11/2000
30/11/2002
30/12/1999
31/01/2000
31/03/2000
31/05/1999
31/05/2001
31/07/2001
31/08/2000
31/08/2001
31/08/2002
31/10/2002
additional vaccinations not recorded
additional vaccinations not recorded
additional vaccinations not recorded
additional vaccinations not recorded
additional vaccinations not recorded
Has (NAME) received any vaccinations to prevent him/her form getting disease that are not recorded on this card.
Questions to be asked to households with children under 5 years.
920
4080
1
Yes
5
No
8
Do not know
Sysmiss
Diphtheria, tetanus, whooping cough
Diphtheria, tetanus, whooping cough
Diphtheria, tetanus, whooping cough
Diphtheria, tetanus, whooping cough
Diphtheria, tetanus, whooping cough
Has (NAME) received additional vaccinations to prevent him/her from getting diphtheria, tetanus or pertussis (whooping cough)? IF YES: How many times?
Questions to be asked to households with children under 5 years.
173
4827
1
Yes
5
No
8
Do not know
Sysmiss
If yes how many times
If yes how many times
If yes how many times
If yes how many times
If yes how many times
Has (NAME) received additional vaccinations to prevent him/her from getting diphtheria, tetanus or pertussis (whooping cough)? IF YES: How many times?
Questions to be asked to households with children under 5 years.
96
4904
1
10
2.229
1.714
Additional vaccinations not recorded to prevent measles
Additional vaccinations not recorded to prevent measles
Additional vaccinations not recorded to prevent measles
Additional vaccinations not recorded to prevent measles
Additional vaccinations not recorded to prevent measles
Has (NAME) received any vaccinations that are not recorded on this card to prevent him/her from measles?
Questions to be asked to households with children under 5 years.
170
4830
1
Yes
5
No
8
Do not know
Sysmiss
vaccinations
vaccinations
vaccinations
vaccinations
vaccinations
Did (NAME) ever receive any vaccinations to prevent him/her from getting diseases?
Questions to be asked to households with children under 5 years.
172
4828
1
Yes
5
No
8
Do not know
Sysmiss
DPT vaccination
DPT vaccination
DPT vaccination
DPT vaccination
DPT vaccination
Please tell me if (NAME) has received any of the following vaccinations: A) DTP vaccination?
Questions to be asked to households with children under 5 years.
119
4881
1
Yes
5
No
8
Do not know
Sysmiss
number of dpt vaccinations
number of dpt vaccinations
number of dpt vaccinations
number of dpt vaccinations
number of dpt vaccinations
If YES: How many times?
Questions to be asked to households with children under 5 years.
83
4917
1
8
4.096
2.477
injection to prevent measles
injection to prevent measles
injection to prevent measles
injection to prevent measles
injection to prevent measles
An injection to prevent measles?
Questions to be asked to households with children under 5 years.
113
4887
1
Yes
5
No
8
Do not know
Sysmiss
receive vitamin A
receive vitamin A
receive vitamin A
receive vitamin A
receive vitamin A
In the last 12 months did (NAME) receive a vitamin A capsule or supplement (like this)?
Questions to be asked to households with children under 5 years.
1048
3952
1
Yes
5
No
8
Do not know
Sysmiss
How many times
How many times
How many times
How many times
How many times
If YES: How many times did [NAME] received it?
Questions to be asked to households with children under 5 years.
296
4704
1
999
37.605
180.349
when was the youngest child sick
when was the youngest child sick
when was the youngest child sick
when was the youngest child sick
when was the youngest child sick
When was the last time [NAME] was sick with fever, diarrhoea, or any other illness?
Questions to be asked to households with children under 5 years.
1132
3868
1
Within the last 2 weeks
2
2 weeks-less than 1 month ago
3
1 month-3 months ago
4
More than 3 months ago
5
Never was sick
Sysmiss
Fever (hot body)
Fever (hot body)
Fever (hot body)
Fever (hot body)
Fever (hot body)
During [NAME]'s last episode of illness, did [NAME] have a fever (hot body)?
Questions to be asked to households with children under 5 years.
985
4015
1
Yes
5
No
8
Do not know
Sysmiss
cough
cough
cough
cough
cough
During [NAME]'s last episode of illness, did [NAME] have a cough?
Questions to be asked to households with children under 5 years.
983
4017
1
Yes
5
No
8
Do not know
Sysmiss
difficult or fast breathing
difficult or fast breathing
difficult or fast breathing
difficult or fast breathing
difficult or fast breathing
During [NAME]'s last episode of illness, did [NAME] have difficulty or fast breathing?
Questions to be asked to households with children under 5 years.
978
4022
1
Yes
5
No
8
Do not know
Sysmiss
diarrhea
diarrhea
diarrhea
diarrhea
diarrhea
During [NAME]'s last episode of illness, did [NAME] have diarrhea?
Questions to be asked to households with children under 5 years.
981
4019
1
Yes
5
No
8
Do not know
Sysmiss
blood in the stools
blood in the stools
blood in the stools
blood in the stools
blood in the stools
During [NAME]'s last episode of illness, did [NAME] have blood in their stools?
Questions to be asked to households with children under 5 years.
980
4020
1
Yes
5
No
8
Do not know
Sysmiss
persistent vomiting
persistent vomiting
persistent vomiting
persistent vomiting
persistent vomiting
During [NAME]'s last episode of illness, did [NAME] have persistant vomiting?
Questions to be asked to households with children under 5 years.
982
4018
1
Yes
5
No
8
Do not know
Sysmiss
unable to eat / drink
unable to eat / drink
unable to eat / drink
unable to eat / drink
unable to eat / drink
During [NAME]'s last episode of illness, was [NAME] unable to eat/drink?
Questions to be asked to households with children under 5 years.
981
4019
1
Yes
5
No
8
Do not know
Sysmiss
convulsions
convulsions
convulsions
convulsions
convulsions
During [NAME]'s last episode of illness, did [NAME] have convulsions?
Questions to be asked to households with children under 5 years.
979
4021
1
Yes
5
No
8
Do not know
Sysmiss
other
other
other
other
other
During [NAME]'s last episode of illness, did [NAME] have other symptoms?
Questions to be asked to households with children under 5 years.
987
4013
1
Yes
5
No
Sysmiss
Q6559 specify
Q6559 specify
Q6559 specify
Q6559 specify
Q6559 specify
During [NAME]'s last episode of illness, did [NAME] have other symptoms? Please specify.
Questions to be asked to households with children under 5 years.
30
2
4
Quando chora desmaia, fica roxo e duro
amigdalite
anemia
bolhas no corpo
cefaleia
chiado no peito
coceira
conjuntivite
corisa
dor abdominal
dor de garganta
dor no dedo
estado gripal
feridas na boca
garganta inflamada
gripe
infeccao de ouvido
inflamaçao da garganta
inquieto
intestino preso
nao coseguia andar
nariz escorrendo
obst.nasal cronica
otalgia
pneumonia
queda de pressao
varicela
drink more or less
drink more or less
drink more or less
drink more or less
drink more or less
During [NAME]'s last illness, was [NAME] given more than usual to drink, about the same amount, or less than usual to drink, including breastmilk?
Questions to be asked to households with children under 5 years.
959
4041
1
More than usual to drink
2
About the same to drink
3
Less than usual to drink
4
Nothing to drink
8
DK
Sysmiss
eating pattern
eating pattern
eating pattern
eating pattern
eating pattern
During [NAME]'s last illness, was [NAME] given more than usual to eat, about the same amount, less than usual, or nothing to eat?
Questions to be asked to households with children under 5 years.
975
4025
1
More than usual to eat
2
About the same to eat
3
Less than usual to eat
4
Stopped food
5
Never gave food (exclusively breastfed)
8
Do not know
Sysmiss
care or treatment for illness
care or treatment for illness
care or treatment for illness
care or treatment for illness
care or treatment for illness
During [NAME]'s last illness, did [NAME] receive any care or treatment for the illness?
If YES: Where did the child receive care?
Was it government operated or private?
Questions to be asked to households with children under 5 years.
987
4013
1
Yes
5
No
8
Do not know
Sysmiss
where received care first
where received care first
where received care first
where received care first
where received care first
During [NAME]'s last illness, did [NAME] receive any care or treatment for the illness?
If YES: Where did the child receive care?
Was it government operated or private?
Questions to be asked to households with children under 5 years.
768
4232
1
Hospital
2
Outpatient facility
3
Pharmacy
4
Private physician
5
Traditional healer
6
Other
Sysmiss
Q6563 specify
Q6563 specify
Q6563 specify
Q6563 specify
Q6563 specify
During [NAME]'s last illness, did [NAME] receive any care or treatment for the illness?
If YES: Where did the child receive care?
Was it government operated or private?
Questions to be asked to households with children under 5 years.
was it private or government operated
was it private or government operated
was it private or government operated
was it private or government operated
was it private or government operated
During [NAME]'s last illness, did [NAME] receive any care or treatment for the illness?
If YES: Where did the child receive care?
Was it government operated or private?
Questions to be asked to households with children under 5 years.
656
4344
1
Government operated
2
Private
8
Do not know
Sysmiss
How soon first received care
How soon first received care
How soon first received care
How soon first received care
How soon first received care
How soon after the illness was noticed did [NAME] first receive care?
Questions to be asked to households with children under 5 years.
761
4239
1
The same day (within 24 hours)
2
More than 24 hours later
8
Do not know
Sysmiss
Treatment for malaria
Treatment for malaria
Treatment for malaria
Treatment for malaria
Treatment for malaria
During [NAME]'s last episode of fever, did [NAME] receive any treatment for malaria? If yes, what was taken?
Questions only to be asked in malaria endemic areas.
5000
1
Yes
5
No
8
Do not know
Sysmiss
Antimalarial medicine
Antimalarial medicine
Antimalarial medicine
Antimalarial medicine
Antimalarial medicine
During [NAME]'s last episode of fever, did [NAME] receive any treatment for malaria? If yes, what was taken?
Questions only to be asked in malaria endemic areas.
5000
1
Yes
5
No
Sysmiss
Home remedy
Home remedy
Home remedy
Home remedy
Home remedy
During [NAME]'s last episode of fever, did [NAME] receive any treatment for malaria? If yes, what was taken?
Questions only to be asked in malaria endemic areas.
5000
1
Yes
5
No
Sysmiss
Remedy/Medicine from trad. healer
Remedy/Medicine from trad. healer
Remedy/Medicine from trad. healer
Remedy/Medicine from trad. healer
Remedy/Medicine from trad. healer
During [NAME]'s last episode of fever, did [NAME] receive any treatment for malaria? If yes, what was taken?
Questions only to be asked in malaria endemic areas.
5000
1
Yes
5
No
Sysmiss
Other
Other
Other
Other
Other
During [NAME]'s last episode of fever, did [NAME] receive any treatment for malaria? If yes, what was taken?
Questions only to be asked in malaria endemic areas.
5000
1
Yes
5
No
Sysmiss
told by doctor for suffering malaria
told by doctor for suffering malaria
told by doctor for suffering malaria
told by doctor for suffering malaria
told by doctor for suffering malaria
In the last 12 months did [NAME] have an episode of malaria?
Questions only to be asked in malaria endemic areas.
5000
1
Yes
5
No
8
Do not know
Sysmiss
Received treatment for malaria
Received treatment for malaria
Received treatment for malaria
Received treatment for malaria
Received treatment for malaria
During (NAME's) last episode of malaria, did (NAME) receive any treatment of take any medications for malaria?
If yes, what was taken?
Questions only to be asked in malaria endemic areas.
5000
1
Yes
5
No
8
Do not know
Sysmiss
what was taken
what was taken
what was taken
what was taken
what was taken
During (NAME's) last episode of malaria, did (NAME) receive any treatment of take any medications for malaria?
If yes, what was taken?
Questions only to be asked in malaria endemic areas.
5000
1
Yes
5
No
Sysmiss
During (NAME's) last episode of malaria, did (NAME) receive any treatment of take any medications for malaria?
If yes, what was taken?
Questions only to be asked in malaria endemic areas.
5000
1
Yes
5
No
Sysmiss
During (NAME's) last episode of malaria, did (NAME) receive any treatment of take any medications for malaria?
If yes, what was taken?
Questions only to be asked in malaria endemic areas.
5000
1
Yes
5
No
Sysmiss
During (NAME's) last episode of malaria, did (NAME) receive any treatment of take any medications for malaria?
If yes, what was taken?
Questions only to be asked in malaria endemic areas.
5000
1
Yes
5
No
Sysmiss
Other persons present during sexual health
Other persons present during sexual health
Other persons present during sexual health
Other persons present during sexual health
Other persons present during sexual health
Check if other person(s) present during section on sexual health
Questions to be asked to respondents aged 18 to 49 only.
5000
1
Yes
5
No
Sysmiss
currently married or living with a man (woman)
currently married or living with a man (woman)
currently married or living with a man (woman)
currently married or living with a man (woman)
currently married or living with a man (woman)
I would like to talk with you about another subject - your sexual life and sexual partners. I know it may be difficult to remember exactly, but I would
like you to answer the questions to the best of your knowledge, as this information is very important for the survey. I would like to assure you that
this information is all completely private and anonymous and cannot be linked to you or any partner in any way.
Are you currently married or living with a man (woman)?
5000
1
Yes
5
No
Sysmiss
Do you currently have
Do you currently have
Do you currently have
Do you currently have
Do you currently have
I would like to talk with you about another subject - your sexual life and sexual partners. I know it may be difficult to remember exactly, but I would
like you to answer the questions to the best of your knowledge, as this information is very important for the survey. I would like to assure you that
this information is all completely private and anonymous and cannot be linked to you or any partner in any way.
Do you currently have a regular sexual partner, an occasional sexual partner, or no sexual partner?
5000
1
Regular sexual partner
2
An occasional sexual partner
5
No sexual partner
Sysmiss
Does your spouse
Does your spouse
Does your spouse
Does your spouse
Does your spouse
I would like to talk with you about another subject - your sexual life and sexual partners. I know it may be difficult to remember exactly, but I would
like you to answer the questions to the best of your knowledge, as this information is very important for the survey. I would like to assure you that
this information is all completely private and anonymous and cannot be linked to you or any partner in any way.
Does your spouse (sexual partner) currently live with you in the same house?
5000
1
Yes
5
No
Sysmiss
Howlong you and your sexual partner living separately
Howlong you and your sexual partner living separately
Howlong you and your sexual partner living separately
Howlong you and your sexual partner living separately
Howlong you and your sexual partner living separately
I would like to talk with you about another subject - your sexual life and sexual partners. I know it may be difficult to remember exactly, but I would
like you to answer the questions to the best of your knowledge, as this information is very important for the survey. I would like to assure you that
this information is all completely private and anonymous and cannot be linked to you or any partner in any way.
How long have you and your spouse (sexual partner) been living separately?
5000
1
Within the last month
2
1-2 months
3
3-5 months
4
6-12 months
5
More than 1 year
6
Never lived together
Sysmiss
Ever had sex
Ever had sex
Ever had sex
Ever had sex
Ever had sex
I would like to talk with you about another subject - your sexual life and sexual partners. I know it may be difficult to remember exactly, but I would
like you to answer the questions to the best of your knowledge, as this information is very important for the survey. I would like to assure you that
this information is all completely private and anonymous and cannot be linked to you or any partner in any way.
Have you ever had sex?
5000
1
Yes
5
No
Sysmiss
Last sex
Last sex
Last sex
Last sex
Last sex
I would like to talk with you about another subject - your sexual life and sexual partners. I know it may be difficult to remember exactly, but I would
like you to answer the questions to the best of your knowledge, as this information is very important for the survey. I would like to assure you that
this information is all completely private and anonymous and cannot be linked to you or any partner in any way.
When was the last time you had sexual intercourse?
5000
1
Within the last month
2
1-2 months ago
3
3-5 months ago
4
6-12 months ago
5
More than 1 year ago
Sysmiss
Relationship with person
Relationship with person
Relationship with person
Relationship with person
Relationship with person
I would like to talk with you about another subject - your sexual life and sexual partners. I know it may be difficult to remember exactly, but I would
like you to answer the questions to the best of your knowledge, as this information is very important for the survey. I would like to assure you that
this information is all completely private and anonymous and cannot be linked to you or any partner in any way.
What was the relationship with the person with whom you last had sex?
5000
1
Spouse/Cohabiting partner
2
Boyfriend/Girlfriend/Fiancé(e)
3
Other friend
4
Casual acquaintance
5
Relative
6
Commercial sex worker
7
Other
Sysmiss
used condom
used condom
used condom
used condom
used condom
I would like to talk with you about another subject - your sexual life and sexual partners. I know it may be difficult to remember exactly, but I would
like you to answer the questions to the best of your knowledge, as this information is very important for the survey. I would like to assure you that
this information is all completely private and anonymous and cannot be linked to you or any partner in any way.
The last time you had sexual intercourse, was a condom used?
5000
1
Yes
5
No
8
Do not remeber
Sysmiss
had sex with another person
had sex with another person
had sex with another person
had sex with another person
had sex with another person
I would like to talk with you about another subject - your sexual life and sexual partners. I know it may be difficult to remember exactly, but I would
like you to answer the questions to the best of your knowledge, as this information is very important for the survey. I would like to assure you that
this information is all completely private and anonymous and cannot be linked to you or any partner in any way.
Have you had sex with another person in the last 12 months?
5000
1
Yes
5
No
Sysmiss
used condom
used condom
used condom
used condom
used condom
I would like to talk with you about another subject - your sexual life and sexual partners. I know it may be difficult to remember exactly, but I would
like you to answer the questions to the best of your knowledge, as this information is very important for the survey. I would like to assure you that
this information is all completely private and anonymous and cannot be linked to you or any partner in any way.
The last time you had sexual intercourse with this other person, was a condom used?
5000
1
Yes
5
No
8
Do not remeber
Sysmiss
HIV test
HIV test
HIV test
HIV test
HIV test
In the last 12 months, have you been tested to see if you have HIV, the virus that causes AIDS?
This question is asked to all men of reproductive age, and to women of reproductive age who have not given birth in the last two years.
5000
1
Yes
5
No
Sysmiss
HIV test results received
HIV test results received
HIV test results received
HIV test results received
HIV test results received
Have you been told the results of your test?
5000
1
Yes
5
No
Sysmiss
last time eyes examined
last time eyes examined
last time eyes examined
last time eyes examined
last time eyes examined
When was the last time you had your eyes examined by a physician or other medical professional?
Questions to be asked only to respondents aged 60 or over.
791
4209
1
Within the last 12 months
2
1-2 years ago
3
3-4 years ago
4
5 years ago
5
More than 5 years ago
6
Never
8
Do not know
Sysmiss
had cataract told by a physician
had cataract told by a physician
had cataract told by a physician
had cataract told by a physician
had cataract told by a physician
In the last 5 years, were you diagnosed with a cataract in one or both of your eyes?
Questions to be asked only to respondents aged 60 or over.
555
4445
1
Yes
5
No
8
Do not remeber
Sysmiss
eye surgery to remove cataract
eye surgery to remove cataract
eye surgery to remove cataract
eye surgery to remove cataract
eye surgery to remove cataract
In the last 5 years, have you had eye surgery to remove your cataract (s)?
Questions to be asked only to respondents aged 60 or over.
168
4832
1
Yes
5
No
Sysmiss
blurry vision
blurry vision
blurry vision
blurry vision
blurry vision
In the last 12 months, have you experienced any of the following… Cloudy or blurry vision?
Questions to be asked only to respondents aged 60 or over.
789
4211
1
Yes
5
No
8
Do not know
Sysmiss
Glare from bright lights
Glare from bright lights
Glare from bright lights
Glare from bright lights
Glare from bright lights
In the last 12 months, have you experienced any of the following… Vision problems with light, such as glare from bright lights, or halos around lights?
Questions to be asked only to respondents aged 60 or over.
781
4219
1
Yes
5
No
8
Do not know
Sysmiss
Problem with mouth/teeth
Problem with mouth/teeth
Problem with mouth/teeth
Problem with mouth/teeth
Problem with mouth/teeth
Now I would like to ask you some questions about the condition of your mouth and teeth.
During the last 12 months, did you have any problems with your mouth and/or teeth?
4999
1
1
Yes
5
No
Sysmiss
medical care or treatment for mouth or teeth
medical care or treatment for mouth or teeth
medical care or treatment for mouth or teeth
medical care or treatment for mouth or teeth
medical care or treatment for mouth or teeth
Now I would like to ask you some questions about the condition of your mouth and teeth.
During the last 12 months, did you receive medical care or treatment from a dentist or other oral health specialist for this problem with your mouth and/or teeth?
1730
3270
1
Yes
5
No
Sysmiss
medication
medication
medication
medication
medication
What type of care or treatment did you receive for this problem with your mouth and/or teeth? In particular any medication.
1190
3810
1
Yes
5
No
Sysmiss
Dental work
Dental work
Dental work
Dental work
Dental work
What type of care or treatment did you receive for this problem with your mouth and/or teeth? In particular any dental work or oral surgery.
1181
3819
1
Yes
5
No
Sysmiss
Dentures or bridges
Dentures or bridges
Dentures or bridges
Dentures or bridges
Dentures or bridges
What type of care or treatment did you receive for this problem with your mouth and/or teeth? In particular any dentures or bridges.
1151
3849
1
Yes
5
No
Sysmiss
Counseling
Counseling
Counseling
Counseling
Counseling
What type of care or treatment did you receive for this problem with your mouth and/or teeth? In particular any information or conseling on dental care/oral hygiene.
1154
3846
1
Yes
5
No
Sysmiss
other
other
other
other
other
What type of care or treatment did you receive for this problem with your mouth and/or teeth? In particular any others not already mentioned.
1151
3849
1
Yes
5
No
Sysmiss
Q6756 specify
Q6756 specify
Q6756 specify
Q6756 specify
Q6756 specify
What type of care or treatment did you receive for this problem with your mouth and/or teeth?
lost all of natural teeth
lost all of natural teeth
lost all of natural teeth
lost all of natural teeth
lost all of natural teeth
Have you lost all of your natural teeth?
4999
1
1
Yes
5
No
Sysmiss
involved in road traffic accident
involved in road traffic accident
involved in road traffic accident
involved in road traffic accident
involved in road traffic accident
In the past 12 months, have you been involved in a road traffic accident where you suffered from bodily injury?
4999
1
1
Yes
5
No
Sysmiss
When did the accident happen?
When did the accident happen?
When did the accident happen?
When did the accident happen?
When did the accident happen?
When (in the last 12 months) did the accident happen?
150
4850
1
Within the last 30 days
2
1-2 months ago
3
3-5 months ago
4
6-12 months ago
8
Do not know
Sysmiss
received any medical care
received any medical care
received any medical care
received any medical care
received any medical care
Did you receive medical care or treatment for your injuries?
150
4850
1
Yes
5
No
Sysmiss
where received care first
where received care first
where received care first
where received care first
where received care first
Where did you first receive care?
95
4905
1
On-site, ambulance
2
Hospital
3
Outpatient facility
4
Private physician
5
Traditional healer
6
Other
Sysmiss
Was it government operated or private
Was it government operated or private
Was it government operated or private
Was it government operated or private
Was it government operated or private
Was it government operated or private (if from ambulance, hospital or outpatient facility)?
86
4914
1
Government operated
2
Private( including for- profit and not- for- profit)
8
Do not know
Sysmiss
how soon received care
how soon received care
how soon received care
how soon received care
how soon received care
How soon after the traffic accident occurred did you first receive care?
88
4912
1
In 1 hour or less
2
In over 1 hour, but within 24 hours
3
More than 24 hours later
Sysmiss
suffered bodily due to fall, burn, poisoning, .
suffered bodily due to fall, burn, poisoning, .
suffered bodily due to fall, burn, poisoning, .
suffered bodily due to fall, burn, poisoning, .
suffered bodily due to fall, burn, poisoning, .
In the past 12 months, have you suffered bodily injury that limited your everyday activities in any way? This could have been due to a fall, burn, poisoning, submersion in water, or by a firearm or sharp weapon, or an act of violence from another person?
4999
1
1
Yes
5
No
Sysmiss
When bodily injury
When bodily injury
When bodily injury
When bodily injury
When bodily injury
When (in the last 12 months) did the incident happen?
380
4620
1
Within the last 30 days
2
1-2 months ago
3
3-5 months ago
4
6-12 months ago
8
Do not know
Sysmiss
received any medical care for injuries
received any medical care for injuries
received any medical care for injuries
received any medical care for injuries
received any medical care for injuries
Did you receive any medical care or treatment for your injuries?
385
4615
1
Yes
5
No
Sysmiss
source of care
source of care
source of care
source of care
source of care
Where did you first receive care?
217
4783
1
On-site, ambulance
2
Hospital
3
Outpatient facility
4
Private physician
5
Traditional healer
6
Other
Sysmiss
Government operated or private
Government operated or private
Government operated or private
Government operated or private
Government operated or private
Was it government operated or private (if from ambulance, hospital or outpatient facility)?
193
4807
1
Government operated
2
Private( including for profit and not for profit)
8
Do not know
Sysmiss
how soon received care
how soon received care
how soon received care
how soon received care
how soon received care
How soon after this injury did you first receive care?
193
4807
1
In 1 hour or less
2
In over 1 hour, but within 24 hours
3
More than 24 hours later
Sysmiss
Time end section 6000
Time end section 6000
Time end section 6000
Time end section 6000
Time end section 6000
4999
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Time begin section 7000
Time begin section 7000
Time begin section 7000
Time begin section 7000
Time begin section 7000
4998
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17:54
17:55
17:56
17:57
17:58
17:59
18:00
18:01
18:02
18:03
18:04
18:05
18:06
18:07
18:08
18:09
18:10
18:12
18:13
18:14
18:15
18:16
18:17
18:18
18:19
18:20
18:21
18:22
18:23
18:24
18:25
18:26
18:27
18:28
18:29
18:30
18:31
18:32
18:33
18:34
18:35
18:36
18:37
18:38
18:39
18:40
18:41
18:42
18:43
18:44
18:45
18:46
18:48
18:49
18:50
18:51
18:52
18:53
18:54
18:55
18:56
18:57
18:58
18:59
18:63
19:00
19:01
19:02
19:03
19:04
19:05
19:06
19:07
19:08
19:09
19:10
19:11
19:12
19:13
19:14
19:15
19:16
19:17
19:18
19:19
19:20
19:21
19:22
19:23
19:24
19:25
19:26
19:27
19:28
19:29
19:30
19:31
19:32
19:33
19:34
19:35
19:36
19:37
19:38
19:39
19:40
19:41
19:42
19:43
19:44
19:45
19:46
19:48
19:49
19:50
19:51
19:52
19:53
19:55
19:56
19:57
19:58
19:59
20:00
20:01
20:02
20:03
20:04
20:05
20:06
20:07
20:08
20:09
20:10
20:11
20:12
20:13
20:14
20:15
20:16
20:17
20:18
20:19
20:20
20:22
20:24
20:25
20:26
20:28
20:29
20:30
20:31
20:32
20:35
20:37
20:38
20:39
20:40
20:41
20:43
20:44
20:45
20:46
20:48
20:50
20:52
20:54
20:55
20:56
21:00
21:01
21:05
21:06
21:07
21:09
21:10
21:12
21:14
21:15
21:16
21:17
21:18
21:20
21:22
21:23
21:24
21:25
21:26
21:28
21:29
21:30
21:31
21:32
21:34
21:35
21:39
21:40
21:42
21:45
21:46
22:00
22:03
22:08
22:13
22:46
22:58
24:33
24:40
40:43
43:41
50:20
last time needed health care
last time needed health care
last time needed health care
last time needed health care
last time needed health care
When was the last time that either you as an adult, or a child of yours aged 12 years or less, needed health care?
- in the last 30 days
- between 1 month and less than 1 year ago
- between 1 year and less than 2 years ago
- between 2 years and less than 3 years ago
- between 3 years and less than 5 years ago
- more than 5 years ago
- Never needed – Skip to 7020
4999
1
1
In the last 30 days
2
Between 1 month and less than 1 year ago
3
Between 1 year and less than 2 years ago
4
Between 2 years and less than 3 years ago
5
Between 3 years and less than 5 years ago
6
More than 5 years ago
7
Never needed
Sysmiss
Need for health Care
Need for health Care
Need for health Care
Need for health Care
Need for health Care
Was the last need for health care for you or for your child?
- Yourself
- Your child
5000
1
Yourself
2
Your child
Sysmiss
Availability of health care providers
Availability of health care providers
Availability of health care providers
Availability of health care providers
Availability of health care providers
Thinking of the last time you [your child] needed to see a health care provider who could treat your condition, how many were there around who you could chose from?
4896
104
88
3.93
12.04
1
2
3
4
5
6
7
8
9
10
11
88
Sysmiss
Why was health care needed?
Why was health care needed?
Why was health care needed?
Why was health care needed?
Why was health care needed?
Which reason best describes why you [your child] last needed health care?
- High fever, severe diarrhoea, or cough
- Immunization
- Antenatal consultation
- Family planning
- Childbirth
- Dental care
- Arthritis
- Asthma
- Heart disease
- Bodily injury
- Minor surgery
- Other
4897
103
1
High fever, severe diarrhea, or cough
2
Immunization
3
Antenatal consultation
4
Family planning
5
Childbirth
6
Dental care
7
Arthritis
8
Asthma
9
Heart disease
10
Bodily injury
11
Minor surgery
12
Other
Sysmiss
The last time you needed health care, did you get health care?
The last time you needed health care, did you get health care?
The last time you needed health care, did you get health care?
The last time you needed health care, did you get health care?
The last time you needed health care, did you get health care?
The last time you [your child] needed health care, did you get health care?
- Yes - SKIP TO Q7016
- No
4895
105
1
Yes
5
No
Sysmiss
Could not afford it
Could not afford it
Could not afford it
Could not afford it
Could not afford it
Which reasons best explain why you [your child] did not get
health care? Could not afford the cost of the visit.
124
4876
1
Yes
5
No
Sysmiss
No transport
No transport
No transport
No transport
No transport
Which reasons best explain why you [your child] did not get
health care? No transport.
123
4877
1
Yes
5
No
Sysmiss
Could not afford cost of transport
Could not afford cost of transport
Could not afford cost of transport
Could not afford cost of transport
Could not afford cost of transport
Which reasons best explain why you [your child] did not get
health care? Could not afford the cost of transport.
123
4877
1
Yes
5
No
Sysmiss
Inadequate Drugs or Equipment
Inadequate Drugs or Equipment
Inadequate Drugs or Equipment
Inadequate Drugs or Equipment
Inadequate Drugs or Equipment
Which reasons best explain why you [your child] did not get
health care? The health care provider's drugs or equipment are inadequate.
123
4877
1
Yes
5
No
Sysmiss
Inadequate skills
Inadequate skills
Inadequate skills
Inadequate skills
Inadequate skills
Which reasons best explain why you [your child] did not get
health care? The health care provider's skills are inadequate.
122
4878
1
Yes
5
No
Sysmiss
Previous bad treatment
Previous bad treatment
Previous bad treatment
Previous bad treatment
Previous bad treatment
Which reasons best explain why you [your child] did not get
health care?You were previously badly treated.
123
4877
1
Yes
5
No
Sysmiss
Had other commitments
Had other commitments
Had other commitments
Had other commitments
Had other commitments
Which reasons best explain why you [your child] did not get
health care? Could not take time off work or had other commitments.
124
4876
1
Yes
5
No
Sysmiss
Did not know where to go
Did not know where to go
Did not know where to go
Did not know where to go
Did not know where to go
Which reasons best explain why you [your child] did not get
health care? You did not know where to go.
123
4877
1
Yes
5
No
Sysmiss
Thought you were not sick enough
Thought you were not sick enough
Thought you were not sick enough
Thought you were not sick enough
Thought you were not sick enough
Which reasons best explain why you [your child] did not get
health care? You thought you were not sick enough.
123
4877
1
Yes
5
No
Sysmiss
You were denied health care
You were denied health care
You were denied health care
You were denied health care
You were denied health care
Which reasons best explain why you [your child] did not get
health care? You tried but were denied health care.
125
4875
1
Yes
5
No
Sysmiss
Other
Other
Other
Other
Other
Which reasons best explain why you [your child] did not get
health care? Other.
122
4878
1
Yes
5
No
Sysmiss
Where did you get care?
Where did you get care?
Where did you get care?
Where did you get care?
Where did you get care?
When you last needed health care, where did you get care?
- At a health care provider, excluding an overnight stay in hospital
- At a hospital where you stayed overnight
- At home
4712
288
1
At a health care provider,
2
At a hospital where you stayed overnight
3
At home
Sysmiss
Prescription of medicine
Prescription of medicine
Prescription of medicine
Prescription of medicine
Prescription of medicine
The last time you [your child] sought care for [refer to the CONDITIONS listed in Q7003] did the health care provider prescribe any medicine for you [your child]?
1. Yes
5. No
8. DK - If No or DK: Go to Q7020
4722
278
1
Yes
5
No
Sysmiss
Able to get medicine
Able to get medicine
Able to get medicine
Able to get medicine
Able to get medicine
Of the medicines that were prescribed for you [your child], how many of them were you able to get?
1. All of them – Skip to Q7020
2. Most
3. Some
4. Very few
5. None of them
3175
1825
1
All of them
2
Most
3
Some
4
Very few
5
None of them
Sysmiss
Why did not get medicine
Why did not get medicine
Why did not get medicine
Why did not get medicine
Why did not get medicine
Which reason best explains why you [your child] did not get all the medicines you were prescribed?
1. Could not afford
2. Could not find all medicines
3. Did not believe all the medications were needed
4. Started to feel better
5. Already had some of the medicines at home
6. Other
414
4586
1
Could not afford
2
Could not find all medicines
3
Did not believe all the medications were needed
4
Started to feel better
5
Already had some of the medicines at home
6
Other
Sysmiss
Health care in you country
Health care in you country
Health care in you country
Health care in you country
Health care in you country
How would you rate the way health care in your country involves you in deciding what services it provides and where it provides them?
4955
45
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
Satisfaction rate for countrys health care
Satisfaction rate for countrys health care
Satisfaction rate for countrys health care
Satisfaction rate for countrys health care
Satisfaction rate for countrys health care
In general, would you say you are very satisfied, fairly satisfied, neither satisfied nor dissatisfied, fairly dissatisfied or very dissatisfied with the way health care runs in your country.
4985
15
1
Very satisfied
2
Fairly satisfied
3
Neither satisfied or dissatisfied
4
Fairly dissatisfied
5
Very dissatisfied
Sysmiss
Providing help
Providing help
Providing help
Providing help
Providing help
During the past year, did you provide help to a relative or friend (adult or child), because this person has a long-term physical or mental illness or disability or is getting old and weak?
- Yes, for a person living in the same household
- Yes, for a person living in a separate household
- No
4998
2
1
Yes, for a person living in the same household
2
Yes, for a person living in a separate household
5
No
Sysmiss
Personal care
Personal care
Personal care
Personal care
Personal care
Please tell me the kind of care you provided to this person(s)?
You helped with personal care, such as going to the toilet, washing, getting dressed, or eating.
1829
3171
1
Yes
5
No
Sysmiss
Medical care
Medical care
Medical care
Medical care
Medical care
Please tell me the kind of care you provided to this person(s)?
You helped with medical care, like changing bandages and giving medicines.
1828
3172
1
Yes
5
No
Sysmiss
Household activities
Household activities
Household activities
Household activities
Household activities
Please tell me the kind of care you provided to this person(s)?
You helped with household activities such as meal preparation, shopping, cleaning, laundry.
1828
3172
1
Yes
5
No
Sysmiss
Watched over them
Watched over them
Watched over them
Watched over them
Watched over them
Please tell me the kind of care you provided to this person(s)?
You watched over them since their behaviour can be upsetting or dangerous to themselves or others.
1828
3172
1
Yes
5
No
Sysmiss
Helped them to get around outside the home
Helped them to get around outside the home
Helped them to get around outside the home
Helped them to get around outside the home
Helped them to get around outside the home
Please tell me the kind of care you provided to this person(s)?
You helped them to get around outside the home.
1830
3170
1
Yes
5
No
Sysmiss
Payment exemptions
Payment exemptions
Payment exemptions
Payment exemptions
Payment exemptions
In your dealings with private health care organizations or the government, have you ever had any difficulties: Obtaining payment exemptions or the right to special rates for health care?
5000
1
Yes
5
No
9
Not applicable
Sysmiss
Health insurance
Health insurance
Health insurance
Health insurance
Health insurance
In your dealings with private health care organizations or the government, have you ever had any difficulties: Completing or filling out applications for health insurance?
2337
2663
1
Yes
5
No
9
Not applicable
Sysmiss
Benefits from health insurance
Benefits from health insurance
Benefits from health insurance
Benefits from health insurance
Benefits from health insurance
In your dealings with private health care organizations or the government, have you ever had any difficulties: Finding out what benefits you are entitled to from your health insurance?
2193
2807
1
Yes
5
No
9
Not applicable
Sysmiss
Reimbursement from health insurance
Reimbursement from health insurance
Reimbursement from health insurance
Reimbursement from health insurance
Reimbursement from health insurance
In your dealings with private health care organizations or the government, have you ever had any difficulties: Getting reimbursements from health insurance organizations?
1188
3812
1
Yes
5
No
9
Not applicable
Sysmiss
Respectful treatment
Respectful treatment
Respectful treatment
Respectful treatment
Respectful treatment
How important is "respectful treatment" to you? This means, being shown respect when greeted by and when talking to health care providers having physical examinations conducted in a way that respects your cultural norms. Would you say it is:
- Extremely important
- Very important
- Moderately important
- A little important
- Not important
4993
7
1
Extremely Important
2
Very Important
3
Moderately Important
4
Slightly Important
5
Not Important
Sysmiss
Confidentiality of Personal Information
Confidentiality of Personal Information
Confidentiality of Personal Information
Confidentiality of Personal Information
Confidentiality of Personal Information
How important is "confidentiality of personal information" to you? This means, having information about your health and other personal information kept confidential having conversations with health care providers without other people overhearing.
- Extremely important
- Very important
- Moderately important
- A little important
- Not important
4991
9
1
Extremely Important
2
Very Important
3
Moderately Important
4
Slightly Important
5
Not Important
Sysmiss
Convenient Travel and Waiting Times
Convenient Travel and Waiting Times
Convenient Travel and Waiting Times
Convenient Travel and Waiting Times
Convenient Travel and Waiting Times
How important is "choice of health care providers" to you?
This means, being able to choose your health care provider (place or person) being able to consult for a second opinion or with a specialist if so desired.
- Extremely important
- Very important
- Moderately important
- A little important
- Not important
4989
11
1
Extremely Important
2
Very Important
3
Moderately Important
4
Slightly Important
5
Not Important
Sysmiss
Choice of care provider
Choice of care provider
Choice of care provider
Choice of care provider
Choice of care provider
How important is "convenient travel and short waiting times" to you? This means, having short travel times and convenient access to health care facilities having short waiting times for consultations and hospital admissions.
- Extremely important
- Very important
- Moderately important
- A little important
- Not important
4990
10
1
Extremely Important
2
Very Important
3
Moderately Important
4
Slightly Important
5
Not Important
Sysmiss
Involvement in decisions
Involvement in decisions
Involvement in decisions
Involvement in decisions
Involvement in decisions
How important is "involvement in decision making" to you?
This means, being involved as much as you want in deciding about your health care freedom to discuss other treatment options or care regimes if you want.
- Extremely important
- Very important
- Moderately important
- A little important
- Not important
4987
13
1
Extremely Important
2
Very Important
3
Moderately Important
4
Slightly Important
5
Not Important
Sysmiss
good quality surroundings
good quality surroundings
good quality surroundings
good quality surroundings
good quality surroundings
How important are "good quality surroundings" to you?
This means , having enough space, seating and fresh air in the waiting rooms, examination rooms and hospital wards having a clean facility (including clean toilets).
- Extremely important
- Very important
- Moderately important
- A little important
- Not important
4988
12
1
Extremely Important
2
Very Important
3
Moderately Important
4
Slightly Important
5
Not Important
Sysmiss
contact with outside world
contact with outside world
contact with outside world
contact with outside world
contact with outside world
How important is "contact with outside world " to you?
This means, having family and friends visit you as much as you want when you are a patient in hospital being able to keep in contact with family, friends and to have information about what is happening outside the hospital.
- Extremely important
- Very important
- Moderately important
- A little important
- Not important
4989
11
1
Extremely Important
2
Very Important
3
Moderately Important
4
Slightly Important
5
Not Important
Sysmiss
Clarity of Communication
Clarity of Communication
Clarity of Communication
Clarity of Communication
Clarity of Communication
How important is "clarity of communication" to you?
This means, having the health care providers explain things in a way you can understand having enough time to ask questions if you don't understand something.
- Extremely important
- Very important
- Moderately important
- A little important
- Not important
4989
11
1
Extremely Important
2
Very Important
3
Moderately Important
4
Slightly Important
5
Not Important
Sysmiss
Overnight stay in hospital
Overnight stay in hospital
Overnight stay in hospital
Overnight stay in hospital
Overnight stay in hospital
Over the last 5 years, was there ever a time you stayed overnight in a hospital or other type of long term care facility for your own health care?
4999
1
1
Yes - a hospital
2
Yes - long term care facility
5
No
Sysmiss
Child stayed overnight at hospital
Child stayed overnight at hospital
Child stayed overnight at hospital
Child stayed overnight at hospital
Child stayed overnight at hospital
Over the last 5 years, was there ever a time that one of your children aged 12 years or less stayed overnight in a hospital (for his/her own health care)?
5000
1
Yes
5
No
Sysmiss
Sex of the child
Sex of the child
Sex of the child
Sex of the child
Sex of the child
What is the sex of the child?
5000
1
Female
2
Male
Sysmiss
date of birth of the child
date of birth of the child
date of birth of the child
date of birth of the child
date of birth of the child
What is the date of birth of the child?
Did you receive health care (outpatient)
Did you receive health care (outpatient)
Did you receive health care (outpatient)
Did you receive health care (outpatient)
Did you receive health care (outpatient)
Over the last 12 months, did you receive any health care other than an overnight stay in a hospital?
3377
1623
1
Yes
5
No
Sysmiss
Child receive health care (outpatient)
Child receive health care (outpatient)
Child receive health care (outpatient)
Child receive health care (outpatient)
Child receive health care (outpatient)
Over the last 12 months was there ever a time you accompanied one of your children aged 12 years or less for health care (other than an overnight stay in a hospital)?
5000
1
Yes
5
No
Sysmiss
Sex of Child
Sex of Child
Sex of Child
Sex of Child
Sex of Child
What is the sex of the child?
5000
1
Female
2
Male
Sysmiss
Date of birth of child
Date of birth of child
Date of birth of child
Date of birth of child
Date of birth of child
What is the date of birth of the child?
Name of last health care provider visited
Name of last health care provider visited
Name of last health care provider visited
Name of last health care provider visited
Name of last health care provider visited
What was the name of the last health care provider you used in the last 12 months?
Most often visited facility run by whom
Most often visited facility run by whom
Most often visited facility run by whom
Most often visited facility run by whom
Most often visited facility run by whom
Was the last place you visited in the last 12 months:
- operated by the government
- privately operated
- NGO
- other
2340
2660
1
Operated by the government
2
Privately operated
3
NGO
4
Other
Sysmiss
Health care provider visited
Health care provider visited
Health care provider visited
Health care provider visited
Health care provider visited
Which was the last health care provider you visited?
Medical doctor (including gynaecologist, psychiatrist, ophthalmologist, etc.)
- Nurse
- Midwife
- Dentist
- Physiotherapist or chiropractor
- Traditional medicine practitioner
- Other
After Q7302, substitute the type of health care provider selected by the patient wherever you see [health care provider] in parentheses.
2342
2658
1
Medical doctor
2
Nurse
3
Midwife
4
Dentist
5
Physiotherapist or chiropractor
6
Traditional medicine practitioner
7
Other
Sysmiss
Sex of health care provider
Sex of health care provider
Sex of health care provider
Sex of health care provider
Sex of health care provider
What was the sex of [the health care provider]?
2343
2657
1
Female
2
Male
Sysmiss
Health care providers skills
Health care providers skills
Health care providers skills
Health care providers skills
Health care providers skills
In your opinion, was [the health care provider's] skill adequate for your treatment?
2341
2659
1
Yes
5
No
Sysmiss
Health care providers equipment
Health care providers equipment
Health care providers equipment
Health care providers equipment
Health care providers equipment
In your opinion, was [the health care provider's] equipment adequate for your treatment?
2323
2677
1
Yes
5
No
Sysmiss
Health care providers drug supplies
Health care providers drug supplies
Health care providers drug supplies
Health care providers drug supplies
Health care providers drug supplies
In your opinion, were [the health care provider's] drug supplies adequate for your treatment?
2229
2771
1
Yes
5
No
Sysmiss
how long it took to get there
how long it took to get there
how long it took to get there
how long it took to get there
how long it took to get there
Thinking about your last visit, how long did it take you to get there?
2343
2657
888
32.565
77.403
1
2
3
4
5
6
7
8
10
12
15
16
18
20
23
25
30
35
40
45
50
60
65
70
80
85
90
99
100
104
120
130
150
180
210
240
270
300
360
420
540
888
Sysmiss
How did you get to last visit
How did you get to last visit
How did you get to last visit
How did you get to last visit
How did you get to last visit
Thinking about your last visit, how did you get there?
[Interviewer; mark the one used for most of the travel distance.]
- Private car or motorcycle
- Public transport
- Ambulance
- Bicycle
- Walked
- Other
2333
2667
1
Private car or motorcycle
2
Public transport
3
Ambulance
4
Bicycle
5
Walked
6
Other
Sysmiss
Health care providers fees
Health care providers fees
Health care providers fees
Health care providers fees
Health care providers fees
Thinking about your last visit, how much did you or your household pay for: [Health care provider's] fees
2251
2749
8000
35.426
253.552
5
6
7
8
9
10
11
12
13
14
15
16
17
19
20
22
24
25
27
30
32
35
39
40
45
48
50
52
58
60
64
65
66
67
70
74
75
80
85
86
90
97
100
110
120
130
140
150
160
170
180
195
200
220
225
250
280
289
300
320
330
350
360
370
380
400
428
500
540
550
580
600
650
700
850
900
947
1000
1200
1500
1510
1800
2200
2800
3500
5200
8000
Sysmiss
Medicines
Medicines
Medicines
Medicines
Medicines
Thinking about your last visit, how much did you or your household pay for: Medicines
1848
3152
700
14.468
39.439
1
2
3
4
5
6
7
8
Do not know
9
Not applicable, not have
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
35
36
37
38
40
41
42
43
45
46
47
48
50
51
52
54
55
56
58
59
60
61
62
65
70
73
75
80
84
88
89
90
95
100
103
105
106
110
115
120
121
125
130
140
150
180
200
224
230
250
270
380
420
494
500
700
Sysmiss
Tests
Tests
Tests
Tests
Tests
Thinking about your last visit, how much did you or your household pay for: Tests
1789
3211
1300
7.62
48.691
1
2
3
4
5
6
8
Do not know
9
Not applicable, not have
10
11
13
14
15
16
17
18
20
21
22
25
27
29
30
32
35
39
40
50
55
56
58
60
65
70
80
89
90
99
100
102
110
120
140
150
160
165
180
200
220
230
250
270
300
350
500
600
700
1300
Sysmiss
Transport
Transport
Transport
Transport
Transport
Thinking about your last visit, how much did you or your household pay for: Transport
1104
3896
200
3.273
10.737
1
2
3
4
5
6
7
8
Do not know
9
Not applicable, not have
10
11
12
13
15
16
18
20
21
22
25
28
30
40
50
60
70
75
100
150
200
Sysmiss
Other
Other
Other
Other
Other
Thinking about your last visit, how much did you or your household pay for: Other
2194
2806
900
1.569
22.853
1
2
3
4
5
6
8
Do not know
9
Not applicable, not have
10
25
40
50
60
65
80
90
100
120
140
143
150
184
200
280
900
Sysmiss
Government discount or exemption
Government discount or exemption
Government discount or exemption
Government discount or exemption
Government discount or exemption
Did you or your household pay less than the normal health care fees because of a government discount or exemption?
5000
1
Yes
5
No
9
Not applicable, free
Sysmiss
Rate the amount of traveling time
Rate the amount of traveling time
Rate the amount of traveling time
Rate the amount of traveling time
Rate the amount of traveling time
For your [child’s] last visit, how would you rate the travelling time to the health care provider?
2322
2678
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
9
Not applicable, home care
Sysmiss
Waiting time before being attended to
Waiting time before being attended to
Waiting time before being attended to
Waiting time before being attended to
Waiting time before being attended to
For your [child’s] last visit, how would you rate the amount of time you waited before being attended to?
2341
2659
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
Rate the experience of being greeted respectfully
Rate the experience of being greeted respectfully
Rate the experience of being greeted respectfully
Rate the experience of being greeted respectfully
Rate the experience of being greeted respectfully
For your [child’s] last visit, how would you rate your experience of being greeted and talked to respectfully?
2339
2661
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
Respect of privacy
Respect of privacy
Respect of privacy
Respect of privacy
Respect of privacy
For your [child’s] last visit, how would you rate the way your privacy was respected during physical examinations and treatments?
2283
2717
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
9
Not applicable, no exam/treatment
Sysmiss
Rate the experience of how clearly health care providers communicated
Rate the experience of how clearly health care providers communicated
Rate the experience of how clearly health care providers communicated
Rate the experience of how clearly health care providers communicated
Rate the experience of how clearly health care providers communicated
For you [child’s] last visit, how would you rate the experience of how clearly health care providers explained things to you?
2342
2658
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
Time to ask questions about health problem
Time to ask questions about health problem
Time to ask questions about health problem
Time to ask questions about health problem
Time to ask questions about health problem
For your [child’s] last visit, how would you rate your experience of getting enough time to ask questions about your health problem or treatment?
2337
2663
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
Getting information about other types of treatments or tests
Getting information about other types of treatments or tests
Getting information about other types of treatments or tests
Getting information about other types of treatments or tests
Getting information about other types of treatments or tests
For your [child’s] last visit, how would you rate your experience of getting information about other types of treatments or tests?
2331
2669
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
Getting involved as much as you wanted to be
Getting involved as much as you wanted to be
Getting involved as much as you wanted to be
Getting involved as much as you wanted to be
Getting involved as much as you wanted to be
For your [child’s] last visit, how would you rate your experience of being involved in making decisions about your health care or treatment?
2326
2674
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
Being able to talk privately to health care providers
Being able to talk privately to health care providers
Being able to talk privately to health care providers
Being able to talk privately to health care providers
Being able to talk privately to health care providers
For your [child’s] last visit, how would you rate the way the health services ensured you could talk privately to health care providers?
2333
2667
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
Kept your personal information confidential
Kept your personal information confidential
Kept your personal information confidential
Kept your personal information confidential
Kept your personal information confidential
For your [child’s] last visit, how would you rate the way your personal information was kept confidential?
2051
2949
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
8
Do not know
Sysmiss
Freedom to choose health care provider
Freedom to choose health care provider
Freedom to choose health care provider
Freedom to choose health care provider
Freedom to choose health care provider
For your [child’s] last visit, how would you rate the freedom you had to choose your health care provider?
2321
2679
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
Rate the experience with the conditions and cleanliness
Rate the experience with the conditions and cleanliness
Rate the experience with the conditions and cleanliness
Rate the experience with the conditions and cleanliness
Rate the experience with the conditions and cleanliness
For your [child’s] last visit, how would you rate the cleanliness of the rooms inside the facility, including toilets?
2328
2672
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
9
Not applicable, home care
Sysmiss
Amount of space in examination and waiting rooms
Amount of space in examination and waiting rooms
Amount of space in examination and waiting rooms
Amount of space in examination and waiting rooms
Amount of space in examination and waiting rooms
For your [child’s] last visit, how would you rate the amount of space in the waiting and examination rooms?
2322
2678
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
9
Not applicable, home care
Sysmiss
Sex
Sex
Sex
Sex
Sex
In the last 12 months did you feel that you were treated worse by health care providers for any of the following reasons. Because of your: Sex
2337
2663
1
Yes
5
No
Sysmiss
Age
Age
Age
Age
Age
In the last 12 months did you feel that you were treated worse by health care providers for any of the following reasons. Because of your: Age
2337
2663
1
Yes
5
No
Sysmiss
Lack of funds
Lack of funds
Lack of funds
Lack of funds
Lack of funds
In the last 12 months did you feel that you were treated worse by health care providers for any of the following reasons. Because of your: Lack of money
2337
2663
1
Yes
5
No
Sysmiss
Social class
Social class
Social class
Social class
Social class
In the last 12 months did you feel that you were treated worse by health care providers for any of the following reasons. Because of your: Social class
2337
2663
1
Yes
5
No
Sysmiss
Skin colour
Skin colour
Skin colour
Skin colour
Skin colour
In the last 12 months did you feel that you were treated worse by health care providers for any of the following reasons. Because of your: Ethnic group or colour
2337
2663
1
Yes
5
No
Sysmiss
Illness
Illness
Illness
Illness
Illness
In the last 12 months did you feel that you were treated worse by health care providers for any of the following reasons. Because of your: Type of illness
2336
2664
1
Yes
5
No
Sysmiss
Nationality
Nationality
Nationality
Nationality
Nationality
In the last 12 months did you feel that you were treated worse by health care providers for any of the following reasons. Because of your: Nationality
2336
2664
1
Yes
5
No
Sysmiss
Name of last hospital stayed
Name of last hospital stayed
Name of last hospital stayed
Name of last hospital stayed
Name of last hospital stayed
What was the name of the last hospital or long term care facility you [child] stayed in, in the last 5 years ?
Who run the hospital
Who run the hospital
Who run the hospital
Who run the hospital
Who run the hospital
Was the hospital or long term care facility:
- operated by the government
- privately operated
- NGO
- other
1621
3379
1
Operated by the government
2
Privately operated
3
NGO
4
Other
Sysmiss
when was your last stay
when was your last stay
when was your last stay
when was your last stay
when was your last stay
When was your [child's] last overnight stay?
- In the last 4 weeks
- In the last year
- In the last 2 years
- In the last 3 years
- In the last 5 years
1616
3384
1
In the last 4 weeks
2
In the last year
3
In the last 2 years
4
In the last 3 years
5
In the last 5 years
Sysmiss
Reason for last overnight stay
Reason for last overnight stay
Reason for last overnight stay
Reason for last overnight stay
Reason for last overnight stay
Which of the following best describes the reason for your [child's] last overnight stay?
- High fever, severe diarrhoea, or cough
- Childbirth
- Arthritis
- Asthma
- Heart disease
- Bodily injury
- Minor surgery
- Other
1623
3377
1
High fever, sever diarrhea, or cough
2
Childbirth
3
Arthritis
4
Asthma
5
Heart disease
6
Bodily injury
7
Minor surgery
8
Other
Sysmiss
How long was your stay on this occasion
How long was your stay on this occasion
How long was your stay on this occasion
How long was your stay on this occasion
How long was your stay on this occasion
How long was your [child's] stay on this occasion?
- 1-2 days
- 3-5 days
- 6-14 days
- 15 days and more
1621
3379
1
4
1
1-2 days
2
3-5 days
3
6-14 days
4
15 days and more
Skill of health care provider
Skill of health care provider
Skill of health care provider
Skill of health care provider
Skill of health care provider
In your opinion, was the skill of the health care providers adequate for your [child’s] treatment?
1619
3381
1
Yes
5
No
Sysmiss
Hospitals equipment
Hospitals equipment
Hospitals equipment
Hospitals equipment
Hospitals equipment
In your opinion, was the hospital's equipment adequate for your [child’s] treatment?
1615
3385
1
Yes
5
No
Sysmiss
Drug supplies
Drug supplies
Drug supplies
Drug supplies
Drug supplies
In your opinion, were the hospital's drug supplies adequate for your [child’s] treatment?
1569
3431
1
Yes
5
No
Sysmiss
How long to get there
How long to get there
How long to get there
How long to get there
How long to get there
Thinking about your last hospital stay, how long did it take you [child’s] to get there?
1592
3408
2880
45.68
109.437
1
2
3
4
5
8
10
12
15
20
22
23
24
25
30
35
40
45
50
55
60
70
75
80
88
90
100
105
120
140
150
160
180
210
240
300
360
420
480
600
720
840
999
1080
1440
2880
Sysmiss
How you got there
How you got there
How you got there
How you got there
How you got there
Thinking about your [child’s] last hospital stay, how did you get there?
- Private car or motorcycle
- Public transport
- Ambulance
- Bicycle
- Walked
- Other
1617
3383
1
Private car or motorcycle
2
Public transport
3
Ambulance
4
Bicycle
5
Walked
6
Other
Sysmiss
How long before being admitted to hospital
How long before being admitted to hospital
How long before being admitted to hospital
How long before being admitted to hospital
How long before being admitted to hospital
For your [child’s] last hospital stay, how long from the time you needed hospital care did you wait to be admitted to hospital?
- same day
- less than 1 week
- less than 1 month
- less than 3 months
- 3 months and more
1613
3387
1
5
1
Same day
2
Less than a week
3
Less than 1 month
4
Less than 3 months
5
3 months and more
Doctors fees
Doctors fees
Doctors fees
Doctors fees
Doctors fees
Thinking about your [child’s] last hospital stay, how much did you or your household pay for: Doctor's fees
1543
3457
10000
86.767
521.359
3
7
8
Do not know
9
Not applicable, not have
10
15
20
25
30
32
35
40
50
60
70
80
100
110
120
130
150
186
200
230
250
260
275
280
300
320
333
400
450
500
566
580
600
650
700
790
800
965
1000
1030
1200
1450
1500
1600
1666
1800
1880
1900
2000
2500
2800
3000
3500
5000
5800
9000
10000
Sysmiss
Drugs
Drugs
Drugs
Drugs
Drugs
Thinking about your [child’s] last hospital stay, how much did you or your household pay for: Medicines
1325
3675
3000
24.534
133.392
2
5
6
7
8
Do not know
9
Not applicable, not have
10
11
12
13
14
15
16
18
20
21
22
24
25
28
29
30
33
35
38
39
40
43
45
46
49
50
51
56
60
68
70
73
76
78
80
90
96
100
120
130
135
150
157
175
186
190
200
240
243
250
270
280
300
308
350
380
400
500
566
600
650
800
1000
1667
2000
3000
Sysmiss
Tests
Tests
Tests
Tests
Tests
Thinking about your [child’s] last hospital stay, how much did you or your household pay for: Tests
1309
3691
3000
13.498
112.318
1
6
8
Do not know
9
Not applicable, not have
10
15
16
20
21
22
24
25
28
30
35
40
50
60
65
70
78
80
85
89
100
110
120
125
130
150
180
186
200
250
270
280
300
350
400
420
566
600
620
750
800
1000
1667
3000
Sysmiss
Transport
Transport
Transport
Transport
Transport
Thinking about your [child’s] last hospital stay, how much did you or your household pay for: Transport
1081
3919
500
7.005
30.762
1
2
3
4
5
6
7
8
Do not know
9
Not applicable, not have
10
11
12
13
14
15
16
18
20
22
25
30
33
35
40
45
50
60
70
100
115
120
130
132
140
150
170
280
400
480
500
Sysmiss
Other
Other
Other
Other
Other
Thinking about your [child’s] last hospital stay, how much did you or your household pay for: Other
1523
3477
5000
22.986
216.046
1
2
3
5
8
Do not know
9
Not applicable, not have
12
15
20
22
25
30
31
36
38
50
60
65
70
80
100
120
130
150
155
170
180
200
216
250
280
300
310
350
400
600
800
850
900
1000
1050
1500
2000
2630
3000
3500
5000
Sysmiss
Pay less because of government discount
Pay less because of government discount
Pay less because of government discount
Pay less because of government discount
Pay less because of government discount
Did you or your household pay less than the normal health care fees because of a government discount or exemption?
5000
1
Yes
5
No
9
Not applicable, free
Sysmiss
How many people slept in same room
How many people slept in same room
How many people slept in same room
How many people slept in same room
How many people slept in same room
Thinking about your [child’s] last hospital stay, how many people slept in the same room as you?
1596
3404
30
2.669
2.473
Rating of traveling time to the hospital
Rating of traveling time to the hospital
Rating of traveling time to the hospital
Rating of traveling time to the hospital
Rating of traveling time to the hospital
For your [child’s] last hospital stay, how would you rate the travelling time to the hospital?
1605
3395
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
Amount of waiting time before being attended to
Amount of waiting time before being attended to
Amount of waiting time before being attended to
Amount of waiting time before being attended to
Amount of waiting time before being attended to
For your [child’s] last hospital stay, how would you rate the amount of time you waited before being attended to?
1613
3387
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
Where you greeted and talked to respectfully during last hospital stay?
Where you greeted and talked to respectfully during last hospital stay?
Where you greeted and talked to respectfully during last hospital stay?
Where you greeted and talked to respectfully during last hospital stay?
Where you greeted and talked to respectfully during last hospital stay?
For your [child’s] last hospital stay, how would you rate your experience of being greeted and talked to respectfully?
1612
3388
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
Privacy during physical examinations and treatments
Privacy during physical examinations and treatments
Privacy during physical examinations and treatments
Privacy during physical examinations and treatments
Privacy during physical examinations and treatments
For your [child’s] last hospital stay, how would you rate the way your privacy was respected during physical examinations and treatments?
1615
3385
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
rate your experience with clear explanations
rate your experience with clear explanations
rate your experience with clear explanations
rate your experience with clear explanations
rate your experience with clear explanations
For you [child’s] last hospital stay, how would you rate the experience of how clearly health care providers explained things to you?
1613
3387
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
Was there enough time to ask questions during last hospital stay
Was there enough time to ask questions during last hospital stay
Was there enough time to ask questions during last hospital stay
Was there enough time to ask questions during last hospital stay
Was there enough time to ask questions during last hospital stay
For your [child’s] last hospital stay, how would you rate your experience of getting enough time to ask questions about your health problem or treatment?
1610
3390
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
Getting information and other types of treatments or tests
Getting information and other types of treatments or tests
Getting information and other types of treatments or tests
Getting information and other types of treatments or tests
Getting information and other types of treatments or tests
For your [child’s] last hospital stay, how would you rate your experience of getting information about other types of treatments or tests?
1602
3398
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
Rating of participation in making decisions about health care or treatment
Rating of participation in making decisions about health care or treatment
Rating of participation in making decisions about health care or treatment
Rating of participation in making decisions about health care or treatment
Rating of participation in making decisions about health care or treatment
For your [child’s] last hospital stay, how would you rate your experience of being involved in making decisions about your health care or treatment?
1593
3407
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
Ability to talk privately to health care providers
Ability to talk privately to health care providers
Ability to talk privately to health care providers
Ability to talk privately to health care providers
Ability to talk privately to health care providers
For your [child’s] last hospital stay, how would you rate the way the health services ensured you could talk privately to health care providers?
1596
3404
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
Confidentiality of personal information
Confidentiality of personal information
Confidentiality of personal information
Confidentiality of personal information
Confidentiality of personal information
For your [child’s] last hospital stay, how would you rate the way your personal information was kept confidential?
1425
3575
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
Ability to choose hospital
Ability to choose hospital
Ability to choose hospital
Ability to choose hospital
Ability to choose hospital
For your [child’s] last hospital stay, how would you rate the freedom you had to choose the health care providers that attend to you [your child]?
1598
3402
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
Rating cleanliness of rooms
Rating cleanliness of rooms
Rating cleanliness of rooms
Rating cleanliness of rooms
Rating cleanliness of rooms
For your [child’s] last hospital stay, how would you rate the cleanliness of the rooms inside the facility, including toilets?
1616
3384
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
Amount of space
Amount of space
Amount of space
Amount of space
Amount of space
For your [child’s] last hospital stay, how would you rate the amount of space you had?
1614
3386
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
Ease with which family and friends could visit during hospital stay
Ease with which family and friends could visit during hospital stay
Ease with which family and friends could visit during hospital stay
Ease with which family and friends could visit during hospital stay
Ease with which family and friends could visit during hospital stay
For your [child’s] last hospital stay, how would you rate the ease of having family and friends visit you?
1609
3391
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
Staying in contact with outside world during stay in hospital
Staying in contact with outside world during stay in hospital
Staying in contact with outside world during stay in hospital
Staying in contact with outside world during stay in hospital
Staying in contact with outside world during stay in hospital
For your [child’s] last hospital stay, how would you rate your experience of staying in contact with the outside world when you were in hospital?
1607
3393
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
Sex
Sex
Sex
Sex
Sex
In the last 5 years did you feel that you were treated worse by the health care providers at the hospital for any of the following reasons. Because of your: Sex
1620
3380
1
Yes
5
No
Sysmiss
Age
Age
Age
Age
Age
In the last 5 years did you feel that you were treated worse by the health care providers at the hospital for any of the following reasons. Because of your: Age
1620
3380
1
Yes
5
No
Sysmiss
Lack of money
Lack of money
Lack of money
Lack of money
Lack of money
In the last 5 years did you feel that you were treated worse by the health care providers at the hospital for any of the following reasons. Because of your: Lack of money
1620
3380
1
Yes
5
No
Sysmiss
Social class
Social class
Social class
Social class
Social class
In the last 5 years did you feel that you were treated worse by the health care providers at the hospital for any of the following reasons. Because of your: Social class
1620
3380
1
Yes
5
No
Sysmiss
Race
Race
Race
Race
Race
In the last 5 years did you feel that you were treated worse by the health care providers at the hospital for any of the following reasons. Because of your: Ethnic group or colour
1620
3380
1
Yes
5
No
Sysmiss
Type of illness
Type of illness
Type of illness
Type of illness
Type of illness
In the last 5 years did you feel that you were treated worse by the health care providers at the hospital for any of the following reasons. Because of your: Type of illness
1620
3380
1
Yes
5
No
Sysmiss
Nationality
Nationality
Nationality
Nationality
Nationality
In the last 5 years did you feel that you were treated worse by the health care providers at the hospital for any of the following reasons. Because of your: Nationality
1619
3381
1
Yes
5
No
Sysmiss
Record Set
Record Set
Record Set
Record Set
Record Set
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
3966
A
B
C
D
R-Vignette - Set A Q-1
R-Vignette - Set A Q-1
R-Vignette - Set A Q-1
R-Vignette - Set A Q-1
R-Vignette - Set A Q-1
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Niels] woke up with a sore back so he decided to go to the clinic. It took 30 minutes to travel to the clinic and he was seen within 5 minutes .
How would you rate his travelling time?
1004
3996
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set A Q-2
R-Vignette - Set A Q-2
R-Vignette - Set A Q-2
R-Vignette - Set A Q-2
R-Vignette - Set A Q-2
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Niels] woke up with a sore back so he decided to go to the clinic. It took 30 minutes to travel to the clinic and he was seen within 5 minutes .
How would you rate the amount of time he waited before being attended
to?
1006
3994
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set A Q-3
R-Vignette - Set A Q-3
R-Vignette - Set A Q-3
R-Vignette - Set A Q-3
R-Vignette - Set A Q-3
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Anya] took her baby for a vaccination. The nurse said hello and but did not ask for [Anya’s] or the baby’s name. The nurse also examined [Anya] and made
her remove her shirt in the waiting room.
How would you rate her experience of being greeted and talked to
respectfully?
1005
3995
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set A Q-4
R-Vignette - Set A Q-4
R-Vignette - Set A Q-4
R-Vignette - Set A Q-4
R-Vignette - Set A Q-4
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Anya] took her baby for a vaccination. The nurse said hello and but did not ask for [Anya’s] or the baby’s name. The nurse also examined [Anya] and made
her remove her shirt in the waiting room.
How would you rate the way her privacy was respected during physical
examinations and treatments?
1004
3996
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set A Q-5
R-Vignette - Set A Q-5
R-Vignette - Set A Q-5
R-Vignette - Set A Q-5
R-Vignette - Set A Q-5
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Stan] broke his leg. It took an hour to be driven to the nearest hospital. He was in pain but had to wait an hour for the surgeon and was only operated on the
next day.
How would you rate his travelling time?
1001
3999
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set A Q-6
R-Vignette - Set A Q-6
R-Vignette - Set A Q-6
R-Vignette - Set A Q-6
R-Vignette - Set A Q-6
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Stan] broke his leg. It took an hour to be driven to the nearest hospital. He was in pain but had to wait an hour for the surgeon and was only operated on the
next day.
How would you rate the amount of time he waited before being attended
to?
1001
3999
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set A Q-7
R-Vignette - Set A Q-7
R-Vignette - Set A Q-7
R-Vignette - Set A Q-7
R-Vignette - Set A Q-7
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Conrad] had bad flu. He went to the clinic. The nurse expressed concern about [Conrad]’s cough and called the doctor, who gave [Conrad] a full chest
examination behind a large screen that hid him from the view of other patients.
How would you rate his experience of being greeted and talked to
respectfully?
1001
3999
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set A Q-8
R-Vignette - Set A Q-8
R-Vignette - Set A Q-8
R-Vignette - Set A Q-8
R-Vignette - Set A Q-8
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Conrad] had bad flu. He went to the clinic. The nurse expressed concern about [Conrad]’s cough and called the doctor, who gave [Conrad] a full chest
examination behind a large screen that hid him from the view of other patients.
How would you rate the way his privacy was respected during physical
examinations and treatments?
1001
3999
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set A Q-9
R-Vignette - Set A Q-9
R-Vignette - Set A Q-9
R-Vignette - Set A Q-9
R-Vignette - Set A Q-9
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Aitor] broke his hand. He walked to the clinic because there was no transport and the journey took him several hours. He had to sleep near the clinic for two
days before seeing the doctor.
How would you rate his travelling time?
1002
3998
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set A Q-10
R-Vignette - Set A Q-10
R-Vignette - Set A Q-10
R-Vignette - Set A Q-10
R-Vignette - Set A Q-10
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Aitor] broke his hand. He walked to the clinic because there was no transport and the journey took him several hours. He had to sleep near the clinic for two
days before seeing the doctor.
How would you rate the amount of time he waited before being attended
to?
1002
3998
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set A Q-11
R-Vignette - Set A Q-11
R-Vignette - Set A Q-11
R-Vignette - Set A Q-11
R-Vignette - Set A Q-11
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Julia] was pregnant and went to the hospital coughing blood. A nurse welcomed her gently and helped her to a private room. A female doctor came to
examine her and gave her a clean gown to replace her blood-stained clothes.
How would you rate her experience of being greeted and talked to
respectfully?
1003
3997
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set A Q-12
R-Vignette - Set A Q-12
R-Vignette - Set A Q-12
R-Vignette - Set A Q-12
R-Vignette - Set A Q-12
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Julia] was pregnant and went to the hospital coughing blood. A nurse welcomed her gently and helped her to a private room. A female doctor came to
examine her and gave her a clean gown to replace her blood-stained clothes.
How would you rate the way her privacy was respected during physical
examinations and treatments?
1002
3998
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set A Q-13
R-Vignette - Set A Q-13
R-Vignette - Set A Q-13
R-Vignette - Set A Q-13
R-Vignette - Set A Q-13
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Carla]’s child became seriously sick. [Carla] called an ambulance that arrived after 10 minutes and within 5 minutes they were at the hospital and the doctors
were treating the child.
How would you rate her travelling time?
1004
3996
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set A Q-14
R-Vignette - Set A Q-14
R-Vignette - Set A Q-14
R-Vignette - Set A Q-14
R-Vignette - Set A Q-14
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Carla]’s child became seriously sick. [Carla] called an ambulance that arrived after 10 minutes and within 5 minutes they were at the hospital and the doctors
were treating the child.
How would you rate the amount of time she waited before being attended
to?
1004
3996
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set A Q-15
R-Vignette - Set A Q-15
R-Vignette - Set A Q-15
R-Vignette - Set A Q-15
R-Vignette - Set A Q-15
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Patricia] went to a crowded clinic. At first, no-one greeted her but after waiting for 5 minutes a nurse called her to the examination area where she was
examined behind a small screen that mostly hid her from the other patients.
How would you rate her experience of being greeted and talked to
respectfully?
1003
3997
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set A Q-16
R-Vignette - Set A Q-16
R-Vignette - Set A Q-16
R-Vignette - Set A Q-16
R-Vignette - Set A Q-16
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Patricia] went to a crowded clinic. At first, no-one greeted her but after waiting for 5 minutes a nurse called her to the examination area where she was
examined behind a small screen that mostly hid her from the other patients.
How would you rate the way her privacy was respected during physical
examinations and treatments?
1003
3997
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set A Q-17
R-Vignette - Set A Q-17
R-Vignette - Set A Q-17
R-Vignette - Set A Q-17
R-Vignette - Set A Q-17
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Karen] needed a blood test. It took her 45 minutes by bus to get to the clinic and she waited for 30 minutes to see the nurse.
How would you rate her travelling time?
1002
3998
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set A Q-18
R-Vignette - Set A Q-18
R-Vignette - Set A Q-18
R-Vignette - Set A Q-18
R-Vignette - Set A Q-18
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Karen] needed a blood test. It took her 45 minutes by bus to get to the clinic and she waited for 30 minutes to see the nurse.
How would you rate the amount of time she waited before being attended
to?
1003
3997
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set A Q-19
R-Vignette - Set A Q-19
R-Vignette - Set A Q-19
R-Vignette - Set A Q-19
R-Vignette - Set A Q-19
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Said] has AIDS. When he goes to his health centre the nurses do not talk to him and deliberately ignore him. During examinations, his clothes are removed
and he is made to wait, half-naked in the waiting room.
How would you rate his experience of being greeted and talked to
respectfully?
1004
3996
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set A Q-20
R-Vignette - Set A Q-20
R-Vignette - Set A Q-20
R-Vignette - Set A Q-20
R-Vignette - Set A Q-20
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Said] has AIDS. When he goes to his health centre the nurses do not talk to him and deliberately ignore him. During examinations, his clothes are removed
and he is made to wait, half-naked in the waiting room.
How would you rate the way his privacy was respected during physical
examinations and treatments?
1004
3996
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set B Q-1
R-Vignette - Set B Q-1
R-Vignette - Set B Q-1
R-Vignette - Set B Q-1
R-Vignette - Set B Q-1
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Thomas] couldn’t see well so he went to the doctor and explained the problem. [Thomas] had time to ask the doctor some questions, which the doctor
answered until [Thomas] understood almost everything.
How would you rate his experience of how clearly health care providers
explained things to him?
959
4041
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set B Q-2
R-Vignette - Set B Q-2
R-Vignette - Set B Q-2
R-Vignette - Set B Q-2
R-Vignette - Set B Q-2
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Thomas] couldn’t see well so he went to the doctor and explained the problem. [Thomas] had time to ask the doctor some questions, which the doctor
answered until [Thomas] understood almost everything.
How would you rate his experience of how clearly health care providers
explained things to him?
959
4041
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set B Q-3
R-Vignette - Set B Q-3
R-Vignette - Set B Q-3
R-Vignette - Set B Q-3
R-Vignette - Set B Q-3
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Wing] had his own room in the hospital and shared a bathroom with two others. The room and bathroom were cleaned frequently and had fresh air.
How would you rate the cleanliness of the rooms inside the facility,
including toilets?
959
4041
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set B Q-4
R-Vignette - Set B Q-4
R-Vignette - Set B Q-4
R-Vignette - Set B Q-4
R-Vignette - Set B Q-4
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Wing] had his own room in the hospital and shared a bathroom with two others. The room and bathroom were cleaned frequently and had fresh air.
How would you rate the amount of space [Wing] had?
959
4041
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set B Q-5
R-Vignette - Set B Q-5
R-Vignette - Set B Q-5
R-Vignette - Set B Q-5
R-Vignette - Set B Q-5
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Pia] went to the emergency clinic with a stomach pain. The doctor explained to [Pia] her condition and the treatment. [Pia] asked him some questions and the
doctor explained things using examples that were familiar to her until she understood everything.
How would you rate her experience of how clearly health care providers
explained things to her?
959
4041
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set B Q-6
R-Vignette - Set B Q-6
R-Vignette - Set B Q-6
R-Vignette - Set B Q-6
R-Vignette - Set B Q-6
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Pia] went to the emergency clinic with a stomach pain. The doctor explained to [Pia] her condition and the treatment. [Pia] asked him some questions and the
doctor explained things using examples that were familiar to her until she understood everything.
How would you rate her experience of getting enough time to ask
questions about her health problem or treatment?
958
4042
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set B Q-7
R-Vignette - Set B Q-7
R-Vignette - Set B Q-7
R-Vignette - Set B Q-7
R-Vignette - Set B Q-7
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Shedra] was hospitalized last year for a hip operation. Her private room had its own bathroom and was comfortable and spacious. It was cleaned by the
hospital staff daily. The bed was comfortable and the sheets were changed daily.
How would you rate the cleanliness of the rooms inside the facility,
including toilets?
959
4041
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set B Q-8
R-Vignette - Set B Q-8
R-Vignette - Set B Q-8
R-Vignette - Set B Q-8
R-Vignette - Set B Q-8
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Shedra] was hospitalized last year for a hip operation. Her private room had its own bathroom and was comfortable and spacious. It was cleaned by the
hospital staff daily. The bed was comfortable and the sheets were changed daily.
How would you rate the amount of space [Shedra] had?
959
4041
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set B Q-9
R-Vignette - Set B Q-9
R-Vignette - Set B Q-9
R-Vignette - Set B Q-9
R-Vignette - Set B Q-9
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Akiko] is in hospital after a car accident. She has lots of scratches, bruises and some broken bones. When the doctor visited her he asked to see her medical
records. He asked the nurse some questions and then he said that [Akiko] was making good progress. [Akiko] supposes that she will still stay there for another
week but is unsure.
How would you rate her experience of how clearly health care providers
explained things to her?
959
4041
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set B Q-10
R-Vignette - Set B Q-10
R-Vignette - Set B Q-10
R-Vignette - Set B Q-10
R-Vignette - Set B Q-10
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Akiko] is in hospital after a car accident. She has lots of scratches, bruises and some broken bones. When the doctor visited her he asked to see her medical
records. He asked the nurse some questions and then he said that [Akiko] was making good progress. [Akiko] supposes that she will still stay there for another
week but is unsure.
How would you rate her experience of getting enough time to ask
questions about her health problem or treatment?
958
4042
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set B Q-11
R-Vignette - Set B Q-11
R-Vignette - Set B Q-11
R-Vignette - Set B Q-11
R-Vignette - Set B Q-11
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Kamal] has a nervous breakdown and had to spend 3 months in the past year in the local hospital. He had to sleep on an uncomfortable mattress with no
sheets. There were 30 other patients in the same dormitory style ward and the toilets would smell, because they were not cleaned. He came back with a skin
infection, because he couldn’t wash regularly and there were insects in the bed.
How would you rate the cleanliness of the rooms inside the facility,
including toilets?
959
4041
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set B Q-12
R-Vignette - Set B Q-12
R-Vignette - Set B Q-12
R-Vignette - Set B Q-12
R-Vignette - Set B Q-12
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Kamal] has a nervous breakdown and had to spend 3 months in the past year in the local hospital. He had to sleep on an uncomfortable mattress with no
sheets. There were 30 other patients in the same dormitory style ward and the toilets would smell, because they were not cleaned. He came back with a skin
infection, because he couldn’t wash regularly and there were insects in the bed.
How would you rate the amount of space [Kamal] had?
958
4042
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set B Q-13
R-Vignette - Set B Q-13
R-Vignette - Set B Q-13
R-Vignette - Set B Q-13
R-Vignette - Set B Q-13
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Rose] cannot write or read. She went to the doctor because she was feeling dizzy. The doctor didn’t have time to answer her questions or to explain anything.
He sent her away with a piece of paper without telling her what it said.
How would you rate her experience of how clearly health care providers
explained things to her?
957
4043
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set B Q-14
R-Vignette - Set B Q-14
R-Vignette - Set B Q-14
R-Vignette - Set B Q-14
R-Vignette - Set B Q-14
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Rose] cannot write or read. She went to the doctor because she was feeling dizzy. The doctor didn’t have time to answer her questions or to explain anything.
He sent her away with a piece of paper without telling her what it said.
How would you rate her experience of getting enough time to ask
questions about her health problem or treatment?
957
4043
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set B Q-15
R-Vignette - Set B Q-15
R-Vignette - Set B Q-15
R-Vignette - Set B Q-15
R-Vignette - Set B Q-15
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Hans] shared his small hospital room with five other patients with no partitions between beds. The five patients shared a toilet, which was cleaned every
second day and sometimes smelt.
How would you rate the cleanliness of the rooms inside the facility,
including toilets?
956
4044
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set B Q-16
R-Vignette - Set B Q-16
R-Vignette - Set B Q-16
R-Vignette - Set B Q-16
R-Vignette - Set B Q-16
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Hans] shared his small hospital room with five other patients with no partitions between beds. The five patients shared a toilet, which was cleaned every
second day and sometimes smelt.
How would you rate the amount of space [Hans] had?
955
4045
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set B Q-17
R-Vignette - Set B Q-17
R-Vignette - Set B Q-17
R-Vignette - Set B Q-17
R-Vignette - Set B Q-17
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Mario] has been told that he has epilepsy and that he needs to take medication. The doctor has very briefly explained what the condition is. He is very busy
and there is a queue of patients waiting to see him. Mario would like to know more about what he has, but feels that there is no time to ask questions. The
doctor says goodbye to Mario, and Mario leaves the office.
How would you rate his experience of how clearly health care providers
explained things to him?
956
4044
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set B Q-18
R-Vignette - Set B Q-18
R-Vignette - Set B Q-18
R-Vignette - Set B Q-18
R-Vignette - Set B Q-18
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Mario] has been told that he has epilepsy and that he needs to take medication. The doctor has very briefly explained what the condition is. He is very busy
and there is a queue of patients waiting to see him. Mario would like to know more about what he has, but feels that there is no time to ask questions. The
doctor says goodbye to Mario, and Mario leaves the office.
How would you rate his experience of getting enough time to ask
questions about his health problem or treatment?
955
4045
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set B Q-19
R-Vignette - Set B Q-19
R-Vignette - Set B Q-19
R-Vignette - Set B Q-19
R-Vignette - Set B Q-19
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[José] shared a hospital room with four other persons. There was a toilet for his ward located along the outside corridor. The room was only occasionally dusty
and hot, but without any fan.
How would you rate the cleanliness of the rooms inside the facility,
including toilets?
957
4043
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set B Q-20
R-Vignette - Set B Q-20
R-Vignette - Set B Q-20
R-Vignette - Set B Q-20
R-Vignette - Set B Q-20
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[José] shared a hospital room with four other persons. There was a toilet for his ward located along the outside corridor. The room was only occasionally dusty
and hot, but without any fan.
How would you rate the amount of space [José] had?
957
4043
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set C Q-1
R-Vignette - Set C Q-1
R-Vignette - Set C Q-1
R-Vignette - Set C Q-1
R-Vignette - Set C Q-1
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Simon] was speaking to his doctor about an embarrassing problem. There was a friend and a neighbour of his in the crowded waiting room and because of the
noise the doctor had to shout when telling [Simon] the treatment he needed.
How would you rate the way the health services ensured [Simon] could
talk privately to health care providers?
991
4009
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set C Q-2
R-Vignette - Set C Q-2
R-Vignette - Set C Q-2
R-Vignette - Set C Q-2
R-Vignette - Set C Q-2
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Simon] was speaking to his doctor about an embarrassing problem. There was a friend and a neighbour of his in the crowded waiting room and because of the
noise the doctor had to shout when telling [Simon] the treatment he needed.
How would you rate the way [Simon’s] personal information was kept
confidential?
991
4009
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set C Q-3
R-Vignette - Set C Q-3
R-Vignette - Set C Q-3
R-Vignette - Set C Q-3
R-Vignette - Set C Q-3
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
When the clinic is not busy, [Mamadou] can choose which doctor he sees. But most often it is busy and then he gets sent to whoever is free.
How would you rate [Mamadou’s] freedom to choose her health care
provider?
988
4012
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set C Q-4
R-Vignette - Set C Q-4
R-Vignette - Set C Q-4
R-Vignette - Set C Q-4
R-Vignette - Set C Q-4
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
The government wanted to expand the town’s clinic service. They held one meeting to discuss the expansion plans. [Chad] attended the meeting and freely
expressed his views. [Chad] then heard nothing more about what decision the government had made.
How would you rate the way health care involves [Chad] in deciding what
services it provides and where it provides them?
975
4025
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set C Q-5
R-Vignette - Set C Q-5
R-Vignette - Set C Q-5
R-Vignette - Set C Q-5
R-Vignette - Set C Q-5
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Rebecca] usually spoke to her doctor about her illness in complete privacy. Once [Rebecca] heard that the doctor spoke to [Rebecca’s] friend about her
illness. She asked her doctor not to do it again. He did not do it again.
How would you rate the way the health services ensured [Rebecca] could
talk privately to health care providers?
991
4009
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set C Q-6
R-Vignette - Set C Q-6
R-Vignette - Set C Q-6
R-Vignette - Set C Q-6
R-Vignette - Set C Q-6
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Rebecca] usually spoke to her doctor about her illness in complete privacy. Once [Rebecca] heard that the doctor spoke to [Rebecca’s] friend about her
illness. She asked her doctor not to do it again. He did not do it again.
How would you rate the way [Rebecca’s] personal information was kept
confidential?
985
4015
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set C Q-7
R-Vignette - Set C Q-7
R-Vignette - Set C Q-7
R-Vignette - Set C Q-7
R-Vignette - Set C Q-7
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
In [William] ’s town there is a large day clinic where there are several doctors and nurses. When [William] has a sensitive health problem he can see a male
rather than a female doctor or nurse.
How would you rate [William’s] freedom to choose his health care
provider?
988
4012
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set C Q-8
R-Vignette - Set C Q-8
R-Vignette - Set C Q-8
R-Vignette - Set C Q-8
R-Vignette - Set C Q-8
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Sarah] lives in [Kamf] where the local government has regular public meetings to discuss the community’s health care needs. [Sarah] participates in
identifying the community’s most important health needs. Recently, they planned to build a clinic and asked people to help decide on the services and the best
location.
How would you rate the way health care involves [Sarah] in deciding
what services it provides and where it provides them?
986
4014
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set C Q-9
R-Vignette - Set C Q-9
R-Vignette - Set C Q-9
R-Vignette - Set C Q-9
R-Vignette - Set C Q-9
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Elma] was asked to describe a serious health problem to the doctor in the middle of the waiting room. The doctor repeated everything to the nurse and all the
other patients, many of whom knew her family, could overhear everything.
How would you rate the way the health services ensured [Elma] could talk
privately to health care providers?
990
4010
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set C Q-10
R-Vignette - Set C Q-10
R-Vignette - Set C Q-10
R-Vignette - Set C Q-10
R-Vignette - Set C Q-10
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Elma] was asked to describe a serious health problem to the doctor in the middle of the waiting room. The doctor repeated everything to the nurse and all the
other patients, many of whom knew her family, could overhear everything.
How would you rate the way [Elma’s] personal information was kept
confidential?
984
4016
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set C Q-11
R-Vignette - Set C Q-11
R-Vignette - Set C Q-11
R-Vignette - Set C Q-11
R-Vignette - Set C Q-11
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
When [Penelope] had fertility problems, she had to travel from her small village to the closest town where they only had one male doctor. [Penelope] wanted
to see a female doctor but she had no choice.
How would you rate [Penelope’s] freedom to choose her health care
provider?
988
4012
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set C Q-12
R-Vignette - Set C Q-12
R-Vignette - Set C Q-12
R-Vignette - Set C Q-12
R-Vignette - Set C Q-12
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Zana] attended her town’s annual meeting on community health needs. They agreed to focus on improving health services at schools for the next year. After
the meeting, [Zana] received a letter saying which schools would benefit, but the letter did not fully explain how the schools were selected.
How would you rate the way health care involves [Zana] in deciding what
services it provides and where it provides them?
982
4018
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set C Q-13
R-Vignette - Set C Q-13
R-Vignette - Set C Q-13
R-Vignette - Set C Q-13
R-Vignette - Set C Q-13
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Alouine] had his consultation in a small private room. During the consultation, a nurse occasionally walked in and listened to the conversation. Sometimes
she forgot to close the door so people in the waiting room could overhear parts of their conversation.
How would you rate the way the health services ensured [Alouine] could
talk privately to health care providers?
989
4011
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set C Q-14
R-Vignette - Set C Q-14
R-Vignette - Set C Q-14
R-Vignette - Set C Q-14
R-Vignette - Set C Q-14
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Alouine] had his consultation in a small private room. During the consultation, a nurse occasionally walked in and listened to the conversation. Sometimes
she forgot to close the door so people in the waiting room could overhear parts of their conversation.
How would you rate the way [Alouine’s] personal information was kept
confidential?
989
4011
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set C Q-15
R-Vignette - Set C Q-15
R-Vignette - Set C Q-15
R-Vignette - Set C Q-15
R-Vignette - Set C Q-15
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
The national health service assigns all the people in [Ibrahim’s] community to the local clinic. At the clinic they have a choice of 3 doctors. If they want to
change clinics, they need to get permission.
How would you rate [Ibrahim’s] freedom to choose his health care
provider?
989
4011
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set C Q-16
R-Vignette - Set C Q-16
R-Vignette - Set C Q-16
R-Vignette - Set C Q-16
R-Vignette - Set C Q-16
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Tarek] lives near a town where the government recently built a new hospital. Before building, they didn’t consult anyone in the town or surrounding villages
about their health needs nor where to locate the hospital.
How would you rate the way health care involves [Tarek] in deciding
what services it provides and where it provides them?
982
4018
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set C Q-17
R-Vignette - Set C Q-17
R-Vignette - Set C Q-17
R-Vignette - Set C Q-17
R-Vignette - Set C Q-17
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Ken] visited the doctor regularly. His doctor always took [Ken] to a private room before discussing his illness. The doctor was aware that [Ken] was very
sensitive about his health condition and would never talk about it to anyone or in front of anyone without Ken’s permission.
How would you rate the way the health services ensured [Ken] could talk
privately to health care providers?
989
4011
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set C Q-18
R-Vignette - Set C Q-18
R-Vignette - Set C Q-18
R-Vignette - Set C Q-18
R-Vignette - Set C Q-18
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Ken] visited the doctor regularly. His doctor always took [Ken] to a private room before discussing his illness. The doctor was aware that [Ken] was very
sensitive about his health condition and would never talk about it to anyone or in front of anyone without Ken’s permission.
How would you rate the way [Ken’s] personal information was kept
confidential?
988
4012
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set C Q-19
R-Vignette - Set C Q-19
R-Vignette - Set C Q-19
R-Vignette - Set C Q-19
R-Vignette - Set C Q-19
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Nathan] lives in a town where there are lots of doctors and clinics. He tried one doctor but he didn’t like him so he changed doctors. This was easy to do
because he could go where he wanted.
How would you rate [Nathan’s] freedom to choose his health care
provider?
991
4009
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set D Q-1
R-Vignette - Set D Q-1
R-Vignette - Set D Q-1
R-Vignette - Set D Q-1
R-Vignette - Set D Q-1
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Sally]’s husband could only visit her in hospital in the evenings because of the visiting hours and because he had to look after their children. Once he brought
the children with him and the nurse, who was reading a newspaper, said she could not watch them for him. This meant [Sally] had fewer visits from her
husband.
For[Sally’s] last hospital stay, how would you rate the ease of having
family and friends visit her?
975
4025
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set D Q-2
R-Vignette - Set D Q-2
R-Vignette - Set D Q-2
R-Vignette - Set D Q-2
R-Vignette - Set D Q-2
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Sally]’s husband could only visit her in hospital in the evenings because of the visiting hours and because he had to look after their children. Once he brought
the children with him and the nurse, who was reading a newspaper, said she could not watch them for him. This meant [Sally] had fewer visits from her
husband.
For [Sally’s] last hospital stay, how would you rate her experience of
staying in contact with the outside world when she was in hospital?
974
4026
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set D Q-3
R-Vignette - Set D Q-3
R-Vignette - Set D Q-3
R-Vignette - Set D Q-3
R-Vignette - Set D Q-3
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
When [Jasmina’s] had treatment for infertility, the doctor gave her some pills and asked her to return in two weeks. He didn’t ask her whether she wanted to
know anything about her health condition nor suggest different alternatives that might have suited her better.
How would you rate [Jasmina’s] experience of getting information about
other types of treatments or tests?
974
4026
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set D Q-4
R-Vignette - Set D Q-4
R-Vignette - Set D Q-4
R-Vignette - Set D Q-4
R-Vignette - Set D Q-4
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
When [Jasmina’s] had treatment for infertility, the doctor gave her some pills and asked her to return in two weeks. He didn’t ask her whether she wanted to
know anything about her health condition nor suggest different alternatives that might have suited her better.
How would you rate [Jasmina’s] experience of being involved in making
decisions about her health care or treatment?
974
4026
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set D Q-5
R-Vignette - Set D Q-5
R-Vignette - Set D Q-5
R-Vignette - Set D Q-5
R-Vignette - Set D Q-5
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
When [Joseph] was in hospital he could have no visitors nor could he receive any presents from friends or relatives. The hospital had no telephones and he
could not get any news from outside.
For [Joseph’s] last hospital stay, how would you rate the ease of having
family and friends visit him?
973
4027
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set D Q-6
R-Vignette - Set D Q-6
R-Vignette - Set D Q-6
R-Vignette - Set D Q-6
R-Vignette - Set D Q-6
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
When [Joseph] was in hospital he could have no visitors nor could he receive any presents from friends or relatives. The hospital had no telephones and he
could not get any news from outside.
For [Joseph’s] last hospital stay, how would you rate his experience of
staying in contact with the outside world when he was in hospital?
973
4027
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set D Q-7
R-Vignette - Set D Q-7
R-Vignette - Set D Q-7
R-Vignette - Set D Q-7
R-Vignette - Set D Q-7
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Mark] had a serious health problem. The doctor prescribed the best treatment for Mark but without telling him the implications on his quality of life or the
cost. [Mark] felt powerless and was not given any information to help him to feel more in control.
How would you rate [Mark’s] experience of getting information about
other types of treatments or tests?
969
4031
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set D Q-8
R-Vignette - Set D Q-8
R-Vignette - Set D Q-8
R-Vignette - Set D Q-8
R-Vignette - Set D Q-8
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Mark] had a serious health problem. The doctor prescribed the best treatment for Mark but without telling him the implications on his quality of life or the
cost. [Mark] felt powerless and was not given any information to help him to feel more in control.
How would you rate [Mark’s] experience of being involved in making
decisions about his health care or treatment?
969
4031
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set D Q-9
R-Vignette - Set D Q-9
R-Vignette - Set D Q-9
R-Vignette - Set D Q-9
R-Vignette - Set D Q-9
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
When [Tamara] was in hospital for two weeks, her family visited her every few days during the evening visiting hours, but she was alone the rest of the day.
There was little to read or do in the hospital . Every few days, the nurses brought her a portable radio to listen to for a few hours.
For[Tamara’s] last hospital stay, how would you rate the ease of having
family and friends visit her?
972
4028
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set D Q-10
R-Vignette - Set D Q-10
R-Vignette - Set D Q-10
R-Vignette - Set D Q-10
R-Vignette - Set D Q-10
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
When [Tamara] was in hospital for two weeks, her family visited her every few days during the evening visiting hours, but she was alone the rest of the day.
There was little to read or do in the hospital . Every few days, the nurses brought her a portable radio to listen to for a few hours.
For [Tamara’s] last hospital stay, how would you rate her experience of
staying in contact with the outside world when she was in hospital?
971
4029
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set D Q-11
R-Vignette - Set D Q-11
R-Vignette - Set D Q-11
R-Vignette - Set D Q-11
R-Vignette - Set D Q-11
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Bob] had a broken arm. The doctor explained different ways of fixing it and then ordered some blood tests. [Bob] didn’t know why he needed blood tests and
was worried until the doctor explained what they were for.
How would you rate [Bob’s] experience of getting information about other
types of treatments or tests?
973
4027
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set D Q-12
R-Vignette - Set D Q-12
R-Vignette - Set D Q-12
R-Vignette - Set D Q-12
R-Vignette - Set D Q-12
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Bob] had a broken arm. The doctor explained different ways of fixing it and then ordered some blood tests. [Bob] didn’t know why he needed blood tests and
was worried until the doctor explained what they were for.
How would you rate [Bob’s] experience of being involved in making
decisions about his health care or treatment?
972
4028
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set D Q-13
R-Vignette - Set D Q-13
R-Vignette - Set D Q-13
R-Vignette - Set D Q-13
R-Vignette - Set D Q-13
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
When [Carol] was in hospital, she was allowed visitors at any time of the day. Whenever she needed to contact her family, work or friends, she could easily
get a message delivered to them.
For [Carol’s] last hospital stay, how would you rate the ease of having
family and friends visit her?
972
4028
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set D Q-14
R-Vignette - Set D Q-14
R-Vignette - Set D Q-14
R-Vignette - Set D Q-14
R-Vignette - Set D Q-14
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
When [Carol] was in hospital, she was allowed visitors at any time of the day. Whenever she needed to contact her family, work or friends, she could easily
get a message delivered to them.
For [Carol’s] last hospital stay, how would you rate her experience of
staying in contact with the outside world when she was in hospital?
972
4028
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set D Q-15
R-Vignette - Set D Q-15
R-Vignette - Set D Q-15
R-Vignette - Set D Q-15
R-Vignette - Set D Q-15
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
When [Sarah] wanted treatment for her swollen limbs, the nurses at her clinic discussed many possible treatments with her. They discussed all the pro’s and
con’s of each treatment with her and then recommended one to her.
How would you rate [Sarah’s] experience of getting information about
other types of treatments or tests?
969
4031
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set D Q-16
R-Vignette - Set D Q-16
R-Vignette - Set D Q-16
R-Vignette - Set D Q-16
R-Vignette - Set D Q-16
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
When [Sarah] wanted treatment for her swollen limbs, the nurses at her clinic discussed many possible treatments with her. They discussed all the pro’s and
con’s of each treatment with her and then recommended one to her.
How would you rate [Sarah’s] experience of being involved in making
decisions about her health care or treatment?
968
4032
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set D Q-17
R-Vignette - Set D Q-17
R-Vignette - Set D Q-17
R-Vignette - Set D Q-17
R-Vignette - Set D Q-17
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Jane] gave birth in hospital. Her husband was permitted to visit her every morning and evening. [Jane] was able to contact her family and friends once a day.
For [Jane’s] last hospital stay, how would you rate the ease of having
family and friends visit her?
971
4029
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set D Q-18
R-Vignette - Set D Q-18
R-Vignette - Set D Q-18
R-Vignette - Set D Q-18
R-Vignette - Set D Q-18
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Jane] gave birth in hospital. Her husband was permitted to visit her every morning and evening. [Jane] was able to contact her family and friends once a day.
For [Jane’s] last hospital stay, how would you rate her experience of
staying in contact with the outside world when she was in hospital?
970
4030
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set D Q-19
R-Vignette - Set D Q-19
R-Vignette - Set D Q-19
R-Vignette - Set D Q-19
R-Vignette - Set D Q-19
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Tara] is unhappy and has no energy. She gave birth to a baby girl two months ago and the doctor has told her that she may be suffering from depression. The
doctor discussed her condition with her and then suggested that she could either try some medication or, if she prefers, talk to a counsellor.
How would you rate [Tara’s] experience of getting information about
other types of treatments or tests?
974
4026
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
R-Vignette - Set D Q-20
R-Vignette - Set D Q-20
R-Vignette - Set D Q-20
R-Vignette - Set D Q-20
R-Vignette - Set D Q-20
I am now going to read you stories about people's experiences with health care services. I wanted you to think about these people's experiences as if they were your own. Once I have finished reading each story, I will ask you to rate what happened in th estory as very good, good, moderate, bad or very bad.
Use in vignettes country specific female/male first names to match sex of the respondent (with exceptions specified in the "Guide to Administration and Question by Question Specifications").
[Tara] is unhappy and has no energy. She gave birth to a baby girl two months ago and the doctor has told her that she may be suffering from depression. The
doctor discussed her condition with her and then suggested that she could either try some medication or, if she prefers, talk to a counsellor.
How would you rate [Tara’s] experience of being involved in making
decisions about her health care or treatment?
972
4028
1
Very good
2
Good
3
Moderate
4
Bad
5
Very bad
Sysmiss
Time end section 7000
Time end section 7000
Time end section 7000
Time end section 7000
Time end section 7000
4994
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Time begin section 8000
Time begin section 8000
Time begin section 8000
Time begin section 8000
Time begin section 8000
control the important things
control the important things
control the important things
control the important things
control the important things
In the last month: How often have you felt that you were unable to control the important things in your life?
5000
1
Never
2
Almost never
3
Sometimes
4
Fairly often
5
Very often
Sysmiss
could not cope with all the things
could not cope with all the things
could not cope with all the things
could not cope with all the things
could not cope with all the things
In the last month: How often have you found that you could not cope with all the things that you had to do?
5000
1
Never
2
Almost never
3
Sometimes
4
Fairly often
5
Very often
Sysmiss
Satisfied with health
Satisfied with health
Satisfied with health
Satisfied with health
Satisfied with health
How satisfied are you with your health?
5000
1
Very dissatisfied
2
Dissatisfied
3
Neither satisfied nor dissatisfied
4
Satisfied
5
Very satisfied
Sysmiss
Rank 1 (most important goal)
Rank 1 (most important goal)
Rank 1 (most important goal)
Rank 1 (most important goal)
Rank 1 (most important goal)
READ TO RESPONDENT: To answer the following question you need to understand what is meant by "Health System Goals". Five main goals have been
identified:
1. Improving the health of the population (population lives longer and with less illness)
2. Minimizing inequalities in health between people (all people should have equal chances of being healthy)
3. Improving responsiveness of the health system (this involves things like how quickly people are attended to; how respectfully people are spoken to by
medical staff; how clearly things are explained; how convenient it is to reach different health services; how clean they are; and how much freedom there is to
choose to see the doctor one wants).
4. Minimizing inequalities/disparities in responsiveness (the health system is equally responsive to all people, no matter their wealth, social status, sex, age or
religious or other beliefs)
5. Fairness in financial contribution (every household should pay a fair share towards the health system)
..
Now, I would like you to score these 5 goals in order of importance from the most important (1) to the least important (5) – Please, put the cards I will give to
you in order of importance.
INTERVIEWER: GIVE RESPONDENTS CUE CARDS, WRITE THE CODE FROM EACH CARD NEXT TO THE RANK, STARTING WITH RANK 1
AS THE MOST IMPORTANT, TO RANK 5 AS THE LEAST IMPORTANT.
Health Systems Goals
Rank 2
Rank 2
Rank 2
Rank 2
Rank 2
READ TO RESPONDENT: To answer the following question you need to understand what is meant by "Health System Goals". Five main goals have been
identified:
1. Improving the health of the population (population lives longer and with less illness)
2. Minimizing inequalities in health between people (all people should have equal chances of being healthy)
3. Improving responsiveness of the health system (this involves things like how quickly people are attended to; how respectfully people are spoken to by
medical staff; how clearly things are explained; how convenient it is to reach different health services; how clean they are; and how much freedom there is to
choose to see the doctor one wants).
4. Minimizing inequalities/disparities in responsiveness (the health system is equally responsive to all people, no matter their wealth, social status, sex, age or
religious or other beliefs)
5. Fairness in financial contribution (every household should pay a fair share towards the health system)
..
Now, I would like you to score these 5 goals in order of importance from the most important (1) to the least important (5) – Please, put the cards I will give to
you in order of importance.
INTERVIEWER: GIVE RESPONDENTS CUE CARDS, WRITE THE CODE FROM EACH CARD NEXT TO THE RANK, STARTING WITH RANK 1
AS THE MOST IMPORTANT, TO RANK 5 AS THE LEAST IMPORTANT.
Health Systems Goals
Rank 3
Rank 3
Rank 3
Rank 3
Rank 3
READ TO RESPONDENT: To answer the following question you need to understand what is meant by "Health System Goals". Five main goals have been
identified:
1. Improving the health of the population (population lives longer and with less illness)
2. Minimizing inequalities in health between people (all people should have equal chances of being healthy)
3. Improving responsiveness of the health system (this involves things like how quickly people are attended to; how respectfully people are spoken to by
medical staff; how clearly things are explained; how convenient it is to reach different health services; how clean they are; and how much freedom there is to
choose to see the doctor one wants).
4. Minimizing inequalities/disparities in responsiveness (the health system is equally responsive to all people, no matter their wealth, social status, sex, age or
religious or other beliefs)
5. Fairness in financial contribution (every household should pay a fair share towards the health system)
..
Now, I would like you to score these 5 goals in order of importance from the most important (1) to the least important (5) – Please, put the cards I will give to
you in order of importance.
INTERVIEWER: GIVE RESPONDENTS CUE CARDS, WRITE THE CODE FROM EACH CARD NEXT TO THE RANK, STARTING WITH RANK 1
AS THE MOST IMPORTANT, TO RANK 5 AS THE LEAST IMPORTANT.
Health Systems Goals
Rank 4
Rank 4
Rank 4
Rank 4
Rank 4
READ TO RESPONDENT: To answer the following question you need to understand what is meant by "Health System Goals". Five main goals have been
identified:
1. Improving the health of the population (population lives longer and with less illness)
2. Minimizing inequalities in health between people (all people should have equal chances of being healthy)
3. Improving responsiveness of the health system (this involves things like how quickly people are attended to; how respectfully people are spoken to by
medical staff; how clearly things are explained; how convenient it is to reach different health services; how clean they are; and how much freedom there is to
choose to see the doctor one wants).
4. Minimizing inequalities/disparities in responsiveness (the health system is equally responsive to all people, no matter their wealth, social status, sex, age or
religious or other beliefs)
5. Fairness in financial contribution (every household should pay a fair share towards the health system)
..
Now, I would like you to score these 5 goals in order of importance from the most important (1) to the least important (5) – Please, put the cards I will give to
you in order of importance.
INTERVIEWER: GIVE RESPONDENTS CUE CARDS, WRITE THE CODE FROM EACH CARD NEXT TO THE RANK, STARTING WITH RANK 1
AS THE MOST IMPORTANT, TO RANK 5 AS THE LEAST IMPORTANT.
Health Systems Goals
Rank 5 (least important goal)
Rank 5 (least important goal)
Rank 5 (least important goal)
Rank 5 (least important goal)
Rank 5 (least important goal)
READ TO RESPONDENT: To answer the following question you need to understand what is meant by "Health System Goals". Five main goals have been
identified:
1. Improving the health of the population (population lives longer and with less illness)
2. Minimizing inequalities in health between people (all people should have equal chances of being healthy)
3. Improving responsiveness of the health system (this involves things like how quickly people are attended to; how respectfully people are spoken to by
medical staff; how clearly things are explained; how convenient it is to reach different health services; how clean they are; and how much freedom there is to
choose to see the doctor one wants).
4. Minimizing inequalities/disparities in responsiveness (the health system is equally responsive to all people, no matter their wealth, social status, sex, age or
religious or other beliefs)
5. Fairness in financial contribution (every household should pay a fair share towards the health system)
..
Now, I would like you to score these 5 goals in order of importance from the most important (1) to the least important (5) – Please, put the cards I will give to
you in order of importance.
INTERVIEWER: GIVE RESPONDENTS CUE CARDS, WRITE THE CODE FROM EACH CARD NEXT TO THE RANK, STARTING WITH RANK 1
AS THE MOST IMPORTANT, TO RANK 5 AS THE LEAST IMPORTANT.
Health Systems Goals
Did you vote
Did you vote
Did you vote
Did you vote
Did you vote
Lots of people find it difficult to get out and vote. Did you vote in the last state/national/presidential election?
5000
1
Yes
5
No
7
Refusal
8
Do not know
Sysmiss
trust national government
trust national government
trust national government
trust national government
trust national government
How much of the time do you think you can trust the NATIONAL government to do what is right ?
5000
1
Always
2
Most of the time
3
Some of the time
4
Hardly ever
5
Never
Sysmiss
trust the local government
trust the local government
trust the local government
trust the local government
trust the local government
How about your LOCAL government? How much of the time do you think you can trust the LOCAL government to do what is right?
5000
1
Always
2
Most of the time
3
Some of the time
4
Hardly ever
5
Never
Sysmiss
how safe do you feel when you are alone at home
how safe do you feel when you are alone at home
how safe do you feel when you are alone at home
how safe do you feel when you are alone at home
how safe do you feel when you are alone at home
In general, how safe from crime and violence do you feel when you are alone at home?
5000
1
Completely safe
2
Very safe
3
Moderately safe
4
Slightly safe
5
Not safe at all
Sysmiss
how safe do you feel when walking down your street alone
how safe do you feel when walking down your street alone
how safe do you feel when walking down your street alone
how safe do you feel when walking down your street alone
how safe do you feel when walking down your street alone
How safe do you feel when walking down your street alone after dark?
5000
1
Completely safe
2
Very safe
3
Moderately safe
4
Slightly safe
5
Not safe at all
Sysmiss
anyone in your household been the victim of a violent crime
anyone in your household been the victim of a violent crime
anyone in your household been the victim of a violent crime
anyone in your household been the victim of a violent crime
anyone in your household been the victim of a violent crime
In the past year, have you or anyone in your household been the victim of a violent crime, such as assault or mugging?
5000
1
Yes
5
No
Sysmiss
how much do you have in getting the government to address issues
how much do you have in getting the government to address issues
how much do you have in getting the government to address issues
how much do you have in getting the government to address issues
how much do you have in getting the government to address issues
How much say do you have in getting the government to address issues that interest you?
5000
1
Unlimited say
2
A lot of say
3
Some say
4
Little say
5
No say at all
Sysmiss
How free do you think you are to express yourself without fear of government rep
How free do you think you are to express yourself without fear of government rep
How free do you think you are to express yourself without fear of government rep
How free do you think you are to express yourself without fear of government rep
How free do you think you are to express yourself without fear of government rep
How free do you think you are to express yourself without fear of government reprisal?
5000
1
Completely free
2
Very free
3
Moderately free
4
Slightly free
5
Not free at all
Sysmiss
Record Set
Record Set
Record Set
Record Set
Record Set
8000 vignette 1 (set A)
8000 vignette 1 (set A)
8000 vignette 1 (set A)
8000 vignette 1 (set A)
8000 vignette 1 (set A)
I am going to read you some brief descriptions of people and their situations. I would like you to listen to the descriptions and tell me how much say these
people have in getting their government to address issues of importance to each person.
For each vignette ask:
How much say [does] [name of person] have in getting the government to address issues that interest [him/her]?
Please circle one option per vignette.
[Jane] lacks clean drinking water because the government is pursuing an
industrial development plan. In the campaign for an upcoming election, an
opposition party has promised to address the issue, but she feels it would
be futile to vote for the opposition since the government is certain to win.
5000
1
Unlimited say
2
A lot of say
3
Some say
4
Little say
5
No say at all
Sysmiss
8000 vignette 2 (set A)
8000 vignette 2 (set A)
8000 vignette 2 (set A)
8000 vignette 2 (set A)
8000 vignette 2 (set A)
I am going to read you some brief descriptions of people and their situations. I would like you to listen to the descriptions and tell me how much say these
people have in getting their government to address issues of importance to each person.
For each vignette ask:
How much say [does] [name of person] have in getting the government to address issues that interest [him/her]?
Please circle one option per vignette.
[Alison] lacks clean drinking water. She and her neighbours are
supporting an opposition candidate in the forthcoming elections that has
promised to address the issue. It appears that so many people in her area
feel the same way that the opposition candidate will defeat the incumbent
representative.
5000
1
Unlimited say
2
A lot of say
3
Some say
4
Little say
5
No say at all
Sysmiss
8000 vignette 3 (set A)
8000 vignette 3 (set A)
8000 vignette 3 (set A)
8000 vignette 3 (set A)
8000 vignette 3 (set A)
I am going to read you some brief descriptions of people and their situations. I would like you to listen to the descriptions and tell me how much say these
people have in getting their government to address issues of importance to each person.
For each vignette ask:
How much say [does] [name of person] have in getting the government to address issues that interest [him/her]?
Please circle one option per vignette.
[Moses] lacks clean drinking water. He would like to change this, but he
can’t vote, and feels that no one in the government cares about this issue.
So he suffers in silence, hoping something will be done in the future.
5000
1
Unlimited say
2
A lot of say
3
Some say
4
Little say
5
No say at all
Sysmiss
8000 vignette 4 (set A)
8000 vignette 4 (set A)
8000 vignette 4 (set A)
8000 vignette 4 (set A)
8000 vignette 4 (set A)
I am going to read you some brief descriptions of people and their situations. I would like you to listen to the descriptions and tell me how much say these
people have in getting their government to address issues of importance to each person.
For each vignette ask:
How much say [does] [name of person] have in getting the government to address issues that interest [him/her]?
Please circle one option per vignette.
[Imelda] lacks clean drinking water. She and her neighbours are drawing
attention to the issue by collecting signatures on a petition. They plan to
present the petition to each of the political parties before the upcoming
election.
5000
1
Unlimited say
2
A lot of say
3
Some say
4
Little say
5
No say at all
Sysmiss
8000 vignette 5 (set A)
8000 vignette 5 (set A)
8000 vignette 5 (set A)
8000 vignette 5 (set A)
8000 vignette 5 (set A)
I am going to read you some brief descriptions of people and their situations. I would like you to listen to the descriptions and tell me how much say these
people have in getting their government to address issues of importance to each person.
For each vignette ask:
How much say [does] [name of person] have in getting the government to address issues that interest [him/her]?
Please circle one option per vignette.
[Toshiro] lacks clean drinking water. There is a group of local leaders
who could do something about the problem, but they have said that
industrial development is the most important policy right now instead of
clean water.
5000
1
Unlimited say
2
A lot of say
3
Some say
4
Little say
5
No say at all
Sysmiss
8000 vignette 1 (setB)
8000 vignette 1 (setB)
8000 vignette 1 (setB)
8000 vignette 1 (setB)
8000 vignette 1 (setB)
I am going to read you some brief descriptions of people and their situations. I would like you to listen to the descriptions and tell me how free these people
are to express themselves without fear of reprisal from their government.
For each vignette ask:
How free do you think [name] [is] to express [him-her]self without fear of government reprisal? Please circle one option per vignette.
[Bob] has political views at odds with the government. He has heard of
people occasionally being arrested for speaking out against the
government, and government leaders sometimes make political speeches
condemning those who criticize. He sometimes writes letters to
newspapers about politics, but he is careful not to use his real name.
5000
1
Completely free
2
Very free
3
Moderately free
4
Slightly free
5
Not free at all
Sysmiss
8000 vignette 2 (set B)
8000 vignette 2 (set B)
8000 vignette 2 (set B)
8000 vignette 2 (set B)
8000 vignette 2 (set B)
I am going to read you some brief descriptions of people and their situations. I would like you to listen to the descriptions and tell me how free these people
are to express themselves without fear of reprisal from their government.
For each vignette ask:
How free do you think [name] [is] to express [him-her]self without fear of government reprisal? Please circle one option per vignette.
[Kay] does not like many of the government’s policies. She frequently
publishes her opinion in newspapers, criticizing decisions by officials and
calling for change. She sees little reason these actions could lead to
government reprisal.
5000
1
Completely free
2
Very free
3
Moderately free
4
Slightly free
5
Not free at all
Sysmiss
8000 vignette 3 (set B)
8000 vignette 3 (set B)
8000 vignette 3 (set B)
8000 vignette 3 (set B)
8000 vignette 3 (set B)
I am going to read you some brief descriptions of people and their situations. I would like you to listen to the descriptions and tell me how free these people
are to express themselves without fear of reprisal from their government.
For each vignette ask:
How free do you think [name] [is] to express [him-her]self without fear of government reprisal? Please circle one option per vignette.
[Connie] does not like the government’s stance on many issues. She has a
friend who was arrested for being too openly critical of governmental
leaders, and so she avoids voicing her opinions in public places.
5000
1
Completely free
2
Very free
3
Moderately free
4
Slightly free
5
Not free at all
Sysmiss
8000 vignette 4 (set B)
8000 vignette 4 (set B)
8000 vignette 4 (set B)
8000 vignette 4 (set B)
8000 vignette 4 (set B)
I am going to read you some brief descriptions of people and their situations. I would like you to listen to the descriptions and tell me how free these people
are to express themselves without fear of reprisal from their government.
For each vignette ask:
How free do you think [name] [is] to express [him-her]self without fear of government reprisal? Please circle one option per vignette.
[Sonny] lives in fear of being harassed for his political views. Everyone
he knows who has spoken out against the government has been arrested or
taken away. He never says a word about anything the government does,
not even when he is at home alone with his family.
5000
1
Completely free
2
Very free
3
Moderately free
4
Slightly free
5
Not free at all
Sysmiss
8000 vignette 5 (set B)
8000 vignette 5 (set B)
8000 vignette 5 (set B)
8000 vignette 5 (set B)
8000 vignette 5 (set B)
I am going to read you some brief descriptions of people and their situations. I would like you to listen to the descriptions and tell me how free these people
are to express themselves without fear of reprisal from their government.
For each vignette ask:
How free do you think [name] [is] to express [him-her]self without fear of government reprisal? Please circle one option per vignette.
[Michael] disagrees with many of the government’s policies. Though he
knows criticism is frowned upon, he doesn’t believe the government
would punish someone for expressing critical views. He makes his
opinion known on most issues without regard to who is listening.
5000
1
Completely free
2
Very free
3
Moderately free
4
Slightly free
5
Not free at all
Sysmiss
8000 vignette 6 (set B)
8000 vignette 6 (set B)
8000 vignette 6 (set B)
8000 vignette 6 (set B)
8000 vignette 6 (set B)
I am going to read you some brief descriptions of people and their situations. I would like you to listen to the descriptions and tell me how free these people
are to express themselves without fear of reprisal from their government.
For each vignette ask:
How free do you think [name] [is] to express [him-her]self without fear of government reprisal? Please circle one option per vignette.
[Vito] disagrees with many of the government’s policies, and is very
careful about whom he says this to, reserving his real opinions for family
and close friends only. He knows several men who have been taken away
by government officials for saying negative things in public.
5000
1
Completely free
2
Very free
3
Moderately free
4
Slightly free
5
Not free at all
Sysmiss
Time end section 8000
Time end section 8000
Time end section 8000
Time end section 8000
Time end section 8000
Time begin section 9000
Time begin section 9000
Time begin section 9000
Time begin section 9000
Time begin section 9000
hearing problem
hearing problem
hearing problem
hearing problem
hearing problem
Did the respondent have a hearing problem?
4941
59
1
Yes
5
No
Sysmiss
vision problem
vision problem
vision problem
vision problem
vision problem
Did the respondent have a vision problem?
4941
59
1
Yes
5
No
Sysmiss
wheelchair
wheelchair
wheelchair
wheelchair
wheelchair
Did the respondent use a wheelchair?
4937
63
1
Yes
5
No
Sysmiss
cane/crutches/walker
cane/crutches/walker
cane/crutches/walker
cane/crutches/walker
cane/crutches/walker
Did the respondent use cane / crutches / walker?
4938
62
1
Yes
5
No
Sysmiss
difficulties walking
difficulties walking
difficulties walking
difficulties walking
difficulties walking
Did the respondent have any difficulties walking?
4940
60
1
Yes
5
No
Sysmiss
paralysis in the arms hands or legs
paralysis in the arms hands or legs
paralysis in the arms hands or legs
paralysis in the arms hands or legs
paralysis in the arms hands or legs
Did the respondent have paralysis in the arms, hands or legs?
4938
62
1
Yes
5
No
Sysmiss
cough continually
cough continually
cough continually
cough continually
cough continually
Did the respondent cough continually?
4936
64
1
Yes
5
No
Sysmiss
shortness of breath
shortness of breath
shortness of breath
shortness of breath
shortness of breath
Did the respondent have shortness of breath?
4937
63
1
Yes
5
No
Sysmiss
mental problem
mental problem
mental problem
mental problem
mental problem
Did the respondent have a mental problem?
4936
64
1
Yes
5
No
Sysmiss
other health problem
other health problem
other health problem
other health problem
other health problem
Did the respondent other health problem?
4936
64
1
Yes
5
No
Sysmiss
have an amputation of a limb
have an amputation of a limb
have an amputation of a limb
have an amputation of a limb
have an amputation of a limb
Did the respondent have an amputation of a limb or part of a limb?
4928
72
1
Yes
5
No
Sysmiss
The respondent cooperation was
The respondent cooperation was
The respondent cooperation was
The respondent cooperation was
The respondent cooperation was
The respondent cooperation was:
4881
119
1
Excellent
2
Very good
3
Good
4
Fair
5
Poor
Sysmiss
Accuracy and completeness of respondent
Accuracy and completeness of respondent
Accuracy and completeness of respondent
Accuracy and completeness of respondent
Accuracy and completeness of respondent
Accuracy and completeness of respondent’s answers:
4873
127
1
Very high
2
High
3
Average
4
Low
5
Very Low
Sysmiss
unusual circumstances
unusual circumstances
unusual circumstances
unusual circumstances
unusual circumstances
Any unusual circumstances or happenings during the interview:
18
1
2
3
4
5
Other comments
Other comments
Other comments
Other comments
Other comments
Any other comments:
6
2
alcoolismo
alergia, pulmão
dep. Alcoólica
filha da ent. Mal
mora há 1 mês
Time end section 9000
Time end section 9000
Time end section 9000
Time end section 9000
Time end section 9000
Identification
Identification
Identification
Identification
Identification
Would you please tell me if there are any members of the household who have ever worked or been trained in a Health-Related field?
Child No
Child No
Child No
Child No
Child No
name
name
name
name
name
What is the name of your child?
This question is to be asked to women respondens of reproductive (18-49) yrs age.
month / year of birth
month / year of birth
month / year of birth
month / year of birth
month / year of birth
What is the month and year of birth?
This question is to be asked to women respondens of reproductive (18-49) yrs age.
sex
sex
sex
sex
sex
What is the sex?
This question is to be asked to women respondens of reproductive (18-49) yrs age.
alive
alive
alive
alive
alive
Is the child still alive?
This question is to be asked to women respondens of reproductive (18-49) yrs age.
1
Yes
5
No
Age of child (Years)
Age of child (Years)
Age of child (Years)
Age of child (Years)
Age of child (Years)
What is the child's current age in years?
This question is to be asked to women respondens of reproductive (18-49) yrs age.
Age (months)
Age (months)
Age (months)
Age (months)
Age (months)
What is the child's current age in months?
This question is to be asked to women respondens of reproductive (18-49) yrs age.
Age (days)
Age (days)
Age (days)
Age (days)
Age (days)
What is the child's current age in days?
This question is to be asked to women respondens of reproductive (18-49) yrs age.
living with you
living with you
living with you
living with you
living with you
Is the child currently living with you?
This question is to be asked to women respondens of reproductive (18-49) yrs age.
1
Yes
5
No
month / year of death
month / year of death
month / year of death
month / year of death
month / year of death
Month / Year of death
This question is to be asked to women respondens of reproductive (18-49) yrs age.
age of death in days
age of death in days
age of death in days
age of death in days
age of death in days
Age at death in: Days
This question is to be asked to women respondens of reproductive (18-49) yrs age.
Age at death in months
Age at death in months
Age at death in months
Age at death in months
Age at death in months
Age at death in: Months
This question is to be asked to women respondens of reproductive (18-49) yrs age.
Age at death in years of child
Age at death in years of child
Age at death in years of child
Age at death in years of child
Age at death in years of child
Age at death in: Years
This question is to be asked to women respondens of reproductive (18-49) yrs age.
fever
fever
fever
fever
fever
Did s/he have fever?
This question is to be asked to women respondens of reproductive (18-49) yrs age.
1
Yes
5
No
continuous fever
continuous fever
continuous fever
continuous fever
continuous fever
Was the fever continuous (1) or on and off
(5)?
This question is to be asked to women respondens of reproductive (18-49) yrs age.
1
Yes
5
No
fever associated with chills/shivering
fever associated with chills/shivering
fever associated with chills/shivering
fever associated with chills/shivering
fever associated with chills/shivering
Was the fever associated with
chills/shivering?
This question is to be asked to women respondens of reproductive (18-49) yrs age.
1
Yes
5
No
convulsions
convulsions
convulsions
convulsions
convulsions
Did s/he have convulsions or fits?
This question is to be asked to women respondens of reproductive (18-49) yrs age.
1
Yes
5
No
child unconscious
child unconscious
child unconscious
child unconscious
child unconscious
Was the child unconscious for more than a
day during the illness that led to death?
This question is to be asked to women respondens of reproductive (18-49) yrs age.
1
Yes
5
No
stiff neck
stiff neck
stiff neck
stiff neck
stiff neck
Did s/he have a stiff neck?
This question is to be asked to women respondens of reproductive (18-49) yrs age.
1
Yes
5
No
cough
cough
cough
cough
cough
Did s/he have a cough?
This question is to be asked to women respondens of reproductive (18-49) yrs age.
1
Yes
5
No
type of cough
type of cough
type of cough
type of cough
type of cough
If yes, was it (1) dry, (2) productive, (3) with
blood, (4) or unknown ?
This question is to be asked to women respondens of reproductive (18-49) yrs age.
fast breathing
fast breathing
fast breathing
fast breathing
fast breathing
Did s/he have fast breathing?
This question is to be asked to women respondens of reproductive (18-49) yrs age.
1
Yes
5
No
indrawing of the chest
indrawing of the chest
indrawing of the chest
indrawing of the chest
indrawing of the chest
Did s/he have in drawing of the chest while
breathing?
This question is to be asked to women respondens of reproductive (18-49) yrs age.
1
Yes
5
No
diarrhea
diarrhea
diarrhea
diarrhea
diarrhea
Did s/he have diarrhea?
This question is to be asked to women respondens of reproductive (18-49) yrs age.
1
Yes
5
No
Visible blood
Visible blood
Visible blood
Visible blood
Visible blood
Was there visible blood in the stools?
This question is to be asked to women respondens of reproductive (18-49) yrs age.
1
Yes
5
No
Identification
Identification
Identification
Identification
Identification
Would you please tell me if there are any members of the household who have ever worked or been trained in a Health-Related field?
1
Accident
2
Suicide
3
Murder
4
War
5
Natural disaster
Name of sibling
Name of sibling
Name of sibling
Name of sibling
Name of sibling
If 2 or more births, continue here, starting with eldest child.
Name
sex
sex
sex
sex
sex
Sex
1
Sex Sibling 1
2
Sex Sibling 2
3
Sex Sibling 3
4
Sex Sibling 4
5
Sex Sibling 5
6
Sex Sibling 6
7
Sex Sibling 7
8
Sex Sibling 8
month / year of birth
month / year of birth
month / year of birth
month / year of birth
month / year of birth
Month/ Year of birth, e.g. Feb-02
1
Date of birth Sibling 1
2
Date of birth Sibling 2
3
Date of birth Sibling 3
4
Date of birth Sibling 4
5
Date of birth Sibling 5
6
Date of birth Sibling 6
7
Date of birth Sibling 7
8
Date of birth Sibling 8
age between respondent and sibling
age between respondent and sibling
age between respondent and sibling
age between respondent and sibling
age between respondent and sibling
What is the age difference (in years) between
you and [NAME]?
1
Difference in age between respondent and sibling 1
2
Difference in age between respondent and sibling 2
3
Difference in age between respondent and sibling 3
4
Difference in age between respondent and sibling 4
5
Difference in age between respondent and sibling 5
6
Difference in age between respondent and sibling 6
7
Difference in age between respondent and sibling 7
8
Difference in age between respondent and sibling 8
alive
alive
alive
alive
alive
Is [NAME] still alive?
1
Yes
5
No
contact with person
contact with person
contact with person
contact with person
contact with person
How often are you in contact with [NAME] in
person, by phone, mail or other means of
communication?
1
Weekly
2
Monthly
3
Yearly
4
Every 2-3 years
5
Every 3 years or more
age
age
age
age
age
If YES to 5108, how old is [NAME]?
age at death
age at death
age at death
age at death
age at death
If NO to 5108, how old was [NAME] when
died?
how many years ago died
how many years ago died
how many years ago died
how many years ago died
how many years ago died
How many years ago did [NAME] die?
where living / lived
where living / lived
where living / lived
where living / lived
where living / lived
Is [NAME] currently living / did [NAME]
before s/he died live in?
1
Private dwelling / house
2
Military establishment
3
Hospital
4
Nursing home
5
Other institution
6
DK
Pregnant when died Sibling
Pregnant when died Sibling
Pregnant when died Sibling
Pregnant when died Sibling
Pregnant when died Sibling
If deceased, a woman aged 15-49, was she
pregnant when she died?
1
Yes
5
No
Died during childbirth Sibling
Died during childbirth Sibling
Died during childbirth Sibling
Died during childbirth Sibling
Died during childbirth Sibling
If deceased, a woman aged 15-49 did she die
during childbirth?
1
Yes
5
No
Died within two months after end of pregnancy or childbirth -Sibling
Died within two months after end of pregnancy or childbirth -Sibling
Died within two months after end of pregnancy or childbirth -Sibling
Died within two months after end of pregnancy or childbirth -Sibling
Died within two months after end of pregnancy or childbirth -Sibling
If deceased, a woman aged 15-49 did she die
within 2 months after the end of pregnancy or
childbirth?
1
Yes
5
No
Death associated with injury- Sibling
Death associated with injury- Sibling
Death associated with injury- Sibling
Death associated with injury- Sibling
Death associated with injury- Sibling
Was the death associated with injury?
1
Yes
5
No
Cause of death- Sibling
Cause of death- Sibling
Cause of death- Sibling
Cause of death- Sibling
Cause of death- Sibling
Was it due to
1
Accident
2
Suicide
3
Murder
4
War
5
Natural disaster
Details concerning events that led to injury- Sibling
Details concerning events that led to injury- Sibling
Details concerning events that led to injury- Sibling
Details concerning events that led to injury- Sibling
Details concerning events that led to injury- Sibling
Provide details of events that led to the
injury.
What was the mechanism or cause of injury?
1
Motor vehicle
2
Pedestrian-vehicle crash
3
Motorcycle
4
Pedal cycle
5
Fall
6
Gunshot, firearm related
7
Landmine / bomblast
8
Stab / cut / pierce
9
Fire / burn
10
Poisoning
11
Near drowning / drowning / submersion
12
Other mechanism / cause of injury
Where injury occurred- Sibling
Where injury occurred- Sibling
Where injury occurred- Sibling
Where injury occurred- Sibling
Where injury occurred- Sibling
Where did the injury occur?
1
Home
2
School
3
Street/highway
4
Parking lot
5
Trade and service areas (shop, bank, etc.)
6
Farm
7
River/lake/stream/ocean
8
Industrial/construction area
9
Other public building
10
Other
Where injury occurred- Sibling Specify others
Where injury occurred- Sibling Specify others
Where injury occurred- Sibling Specify others
Where injury occurred- Sibling Specify others
Where injury occurred- Sibling Specify others
Chest pain- Sibling
Chest pain- Sibling
Chest pain- Sibling
Chest pain- Sibling
Chest pain- Sibling
Did the deceased report / experience chest
pain lasting less than 24 hrs in the month
preceding the death?
1
Yes
5
No
Paralysis of a body part- Sibling
Paralysis of a body part- Sibling
Paralysis of a body part- Sibling
Paralysis of a body part- Sibling
Paralysis of a body part- Sibling
Did the deceased experience paralysis of any
part of the body in the month preceding
death?
1
Yes
5
No
paralysis accompanied by loss of consciousness- Sibling
paralysis accompanied by loss of consciousness- Sibling
paralysis accompanied by loss of consciousness- Sibling
paralysis accompanied by loss of consciousness- Sibling
paralysis accompanied by loss of consciousness- Sibling
If yes, was the paralysis accompanied or
followed by sudden loss of consciousness?
1
Yes
5
No
Cough- Sibling
Cough- Sibling
Cough- Sibling
Cough- Sibling
Cough- Sibling
Did the deceased have a cough that lasted
more than 3 weeks?
1
Yes
5
No
Blood in the sputum- Sibling
Blood in the sputum- Sibling
Blood in the sputum- Sibling
Blood in the sputum- Sibling
Blood in the sputum- Sibling
If yes, was there blood in the sputum ?
1
Yes
5
No
Medical treatment for Tuberculosis - Sibling
Medical treatment for Tuberculosis - Sibling
Medical treatment for Tuberculosis - Sibling
Medical treatment for Tuberculosis - Sibling
Medical treatment for Tuberculosis - Sibling
Did (s)he receive any medical treatment for
tuberculosis ?
1
Yes
5
No
Diarrhoea that lasted more than a month - Sibling
Diarrhoea that lasted more than a month - Sibling
Diarrhoea that lasted more than a month - Sibling
Diarrhoea that lasted more than a month - Sibling
Diarrhoea that lasted more than a month - Sibling
Did the deceased have diarrhoea that lasted
more than a month ?
1
Yes
5
No
Rapid loss of weight - Sibling
Rapid loss of weight - Sibling
Rapid loss of weight - Sibling
Rapid loss of weight - Sibling
Rapid loss of weight - Sibling
Was there any rapid loss of weight ?
1
Yes
5
No
White patches in mouth - Sibling
White patches in mouth - Sibling
White patches in mouth - Sibling
White patches in mouth - Sibling
White patches in mouth - Sibling
Were there any white patches in the mouth ?
1
Yes
5
No