DDI_THA_2005_MICS_v01_M
Daniel Clarke
Rhiannon James
2008-02-06
NADA
Version 2.0
Slightly edited version of UNICEF's DDI ref. DDI-MICS-THA- UNICEF-2006-v1.0
Multiple Indicator Cluster Survey 2005-2006
MICS3 2005-2006
THA_2005_MICS_v01_M
National Statistical Office of Thailand
Ministry of Social Development & Human Security
Ministry of Education
Ministry of Public Health
NADA
United Nations Children's Fund
United Nations Development Programme
United Nations Educational, Scientific and Cultural Organization
UNICEF Thailand Country Office
Hancioglu, Attila
Multiple Indicator Cluster Survey - Round 3 [hh/mics-3]
The Thailand Multiple Indicator Cluster Survey (MICS) December 2005 - February 2006 was developed for the first time to collect data on the situation of all children in Thailand to be used as tools in monitoring and evaluation of child development in Thailand.
Version 1.0: Edited data used for final report
The Multiple Indicator Cluster Survey (MICS) is a household survey programme developed by UNICEF to assist countries in filling data gaps for monitoring human development in general and the situation of children and women in particular. MICS is capable of producing statistically sound, internationally comparable estimates of social indicators. The current round of MICS is focused on providing a monitoring tool for the Millennium Development Goals (MDGs), the World Fit for Children (WFFC), as well as for other major international commitments, such as the United Nations General Assembly Special Session (UNGASS) on HIV/AIDS and the Abuja targets for malaria.
Survey Objectives
The 2006 Thailand Multiple Indicator Cluster Survey has as its primary objectives:
- To provide up-to-date information for assessing the situation of children and women in Thailand;
- To furnish data needed for monitoring progress toward goals established by the Millennium Development Goals (MDG), the goals of A World Fit for Children (WFFC) and other internationally agreed upon goals, as a basis for future action at national and provincial level; and
- To contribute to the improvement of data and monitoring systems on the situation of children and women in Thailand and strengthening technical expertise for the design, implementation, and analysis of such systems.
Survey Content
MICS questionnaires are designed in a modular fashion that can be easily customized to the needs of a country. They consist of a household questionnaire, a questionnaire for women aged 15-49 and a questionnaire for children under the age of five (to be administered to the mother or caretaker). Other than a set of core modules, countries can select which modules they want to include in each questionnaire.
Survey Implementation
The survey was implemented by the National Statistical Office of Thailand, with the support and assistance of UNICEF and other partners. Technical assistance and training for the surveys is provided through a series of regional workshops, covering questionnaire content, sampling and survey implementation; data processing; data quality and data analysis; report writing and dissemination.
Thailand
The survey was designed to produce estimates for indicators at the national level, by urban and rural disaggregation, for each of the 4 regions of Thailand (North, Northeast, Central, and South) and by individual province for 26 (out of 76 total) targeted provinces (note: additional data collections were performed for the targeted provinces during March-May 2006; separate results publications for each province are pending).
- Households
- Women aged 15-49
- Children under 5 years of age
The survey covered all de jure household members (usual residents), all women aged 15-49 years resident in the household, and all children aged 0-4 years (under age 5) resident in the household.
Sample survey data [ssd]
The Thailand Multiple Indicator Cluster Survey included the following modules in the questionnaires:
HOUSEHOLD QUESTIONNAIRE : Household characteristics, household listing, orphaned and vulnerable children, education, child labour, water and sanitation, disability and salt iodization.
WOMEN'S QUESTIONNAIRE: Women's characteristics, child mortality, tetanus toxoid, maternal and newborn health, marriage, contraception, and HIV/AIDS knowledge.
CHILDREN'S QUESTIONNAIRE: Children's characteristics, birth registration and early learning, child development, breastfeeding, care of illness, immunization and anthropometry.
National Statistical Office of Thailand
The Thailand Multiple Indicator Cluster Survey (MICS) was carried out by a sample survey method that used a stratified two stage sampling plan. The primary sample units (PSUs) consisted of blocks (in municipal areas) or villages (in non-municipal areas). The secondary sample units consisted of collective households systematically drawn from a household listing. The plan is designed to provide estimates of situation indicators for children and women at the national level, for municipal and non-municipal areas, and for four regions: Central (including Bangkok), North, Northeast and South. The household listing is obtained from The Basic Household Information Survey conducted every two years by the National Statistical Office (NSO). In the survey, members of each household located in the block/village samples are counted.
Data on basic household information from the survey are to be used as the sample frame in various survey projects of the NSO. Data from the 2006 Basic Household Information Survey were used as the frame for household samples in the Thailand MICS. Thirty collective household samples per block/village sample were selected in both municipal and non-municipal areas. Field staff then created a Listing of Household Samples by adding together all the names of household heads and the addresses. After a household listing was carried out within the selected 30 households in each block/village, a systematic sample of households was drawn. For national-level results, sample data were weighted in accordance with sampling plan.
A block is an operational boundary in a municipal area that is made up of approximately 100 to 200 households. Blocks are established on a map so that field staff know the exact area they are to cover in the survey.
A village is an administrative unit, a community, in a non-municipal area governed by a village head (Phuyaiban) or a district head (Kamnan).
The MICS national-level report included 1,449 block/village samples. Thirty collective household samples per block/village samples were selected and a total of 43,470 household samples were obtained.
For MICS provincial-level reports, 1,032 block/village samples were selected and 30,960 household samples were included.
More detailed information on the sample design is available in Appendix A of the Survey Final Report.
Face-to-face [f2f]
The questionnaires for the Thailand MICS were structured questionnaires based on the MICS3 Model Questionnaire with some modifications and additions. A household questionnaire was administered in each household, which collected various information on household members including sex, age, relationship, and orphanhood status.
In addition to a household questionnaire, questionnaires were administered in each household for women age 15-49 and children under age five. For children, the questionnaire was administered to the mother or caretaker of the child.
The questionnaires were translated into Thai by the NSO MICS coordinators in September 2005.
In addition to the administration of questionnaires, fieldwork teams tested salt used for cooking in the households surveyed for presence of iodine, and measured the weight and height of children under 5 years of age.
Pretesting:
The Thai Multiple Indicator Cluster Survey (MICS) questionnaires went through two pre-tests, first in Ratchaburi province and later in Ayutthaya province. Based on the results of the two pre-tests, modifications on wording and terminology in the Thai version were made to make them more suitable for the Thai population.
The first pre-test in Ratchaburi province was held during October 10-12, 2005. The interview was conducted by the National Statistical Office (NSO) MICS coordinators themselves to determine if the interviewee would understand the questions/wording used and to find out if there were any problems with particular modules. Results from the first pre-test were discussed among the NSO MICS coordinators, and the questionnaires were revised accordingly.
During the pre-test survey in Ratchaburi province, the NSO MICS coordinators obtained information on maternal and child health from the staff of Health Centre IV on topics such as birth registration for children born in hospitals, child vaccination, maternal tetanus prevention, contraception and antenatal care. The knowledge and information obtained from this process were used to improve the questionnaires and prepare field work manuals.
The second pre-test in Ayutthaya province was carried out by field staff using the revised questionnaires under the observation of the NSO MICS coordinators. Before commencing the test survey, field staff were provided with training on definitions and the survey's objectives.
Again, results from the pre-test, especially in relation to questions that interviewees did not understand or did not want to answer, were discussed among the NSO MICS coordinators and field staff. These related to questions that were considered either sensitive or difficult to answer due to the degree of detailed information required. In the case of child vaccination, respondents were asked what kind of vaccines the child had received, and when and how many times the child had received the vaccines. The discussion contributed positively to the interview process and the accuracy of the survey results. It took about 2-2.5 hours per household to finish all three questionnaires.
After the second pre-test, a final revision was made to both the questionnaires and the field work manuals to be used in the Thailand MICS.
Training:
In November 2005, before data collection, a three-day training programme was provided to 145 field staff from the North and Northeast regions in Khon Kaen province, and in Krabi province for 160 field staff from the South and Central (including Bangkok) regions. The NSO MICS coordinators and representatives from UNICEF Thailand participated in both training sessions as observers. Instructors from the Ministry of Public Health provided information on antenatal care, attendance at birth, child vaccination, maternal tetanus vaccination and oral rehydration treatment for children with diarrhoea. The knowledge and information acquired through the training were useful for the interview process and the accuracy of the survey results.
Fieldwork:
Administratively, Thailand is divided into 76 provinces, including Bangkok (Metropolis). In Bangkok, the field work was carried out under the responsibility of the Director of the Data Management Division of the Bangkok Metropolitan Administration (BMA), while Provincial Statistical Officers were responsible for the field work undertaken in the other 75 provinces. In each province, data were collected by three teams of four field staff, three interviewers and one supervisor.
The fieldwork began in December 2005 and concluded in February 2006. Also, additional data collections were performed for 26 targeted provinces during March-May 2006 (separate provincial reports are pending).
Each enumeration team included one supervisor. The supervisor provided advice on field work, helped in solving problems arising during the field work, and checked the completeness of data after the survey. The NSO MICS coordinators also provided overall supervision, with continuous visits to the field.
Survey weights are population based weights and have not been normalized.
After the fieldwork, the team supervisor checked the data collected during the interview for completeness. Then the Provincial Statistical Officer in each province and the Director of the Data Management Division of the Bangkok Metropolitan Administration randomly rechecked the data before sending all the questionnaires to the National Statistical Office (NSO) for processing.
Upon receiving the questionnaires from the 76 provinces, the collected data were entered on 30 microcomputers by data entry operators and data entry supervisors at the Thai NSO, using CSPro software. In order to ensure quality control, editing and structural checks, all questionnaires were double entered for verification and internal consistency checks were performed, followed by secondary editing. The data entry and verification used CSPro programme applications that were developed under the global Multiple Indicator Cluster Survey (MICS) project by UNICEF to be used as standard processing procedures worldwide. In Thailand, the standard CSPro programme was modified appropriately to the Thai version questionnaires. The modification was done by NSO staff that had been trained on data processing by MICS experts from UNICEF.
Data entry and data verification for the national level report began in February 2006 and was completed in April 2006. For the provincial reports, the process was completed in June 2006. Data were analysed using the Statistical Package for Social Sciences (SPSS) software programme, Version 14, and the model syntax and tabulation plans developed by UNICEF for this purpose.
Data editing took place at a number of stages throughout the processing, including:
a) Office editing and coding
b) During data entry
c) Structure checking and completeness
d) Secondary editing
e) Structural checking of SPSS data files
Of the 43,440 households selected for the sample, 42,302 were found to be occupied. Of these, 40,511 were successfully interviewed, yielding a response rate of 95.8 percent. In the interviewed households, 37,187 eligible women (aged 15-49) were identified. Of these eligible women, 36,960 were successfully interviewed, yielding a response rate of 99.4 percent. In addition, 9,444 children under the age of 5 were listed as being eligible in the households. The mothers and/or caretakers of 9,409 of these children (99.6 per cent) were successfully interviewed.
Differentials in response rates by areas showed 94.9 percent of the households in municipal areas and 96.9 percent in non-municipal areas. Participant differentials in response rates were observed, with the highest in the North Region (98.8 percent), followed by the Northeast Region (98.1 percent), and the South and the Central regions' same low response rate of 93 percent.
The sample of respondents selected in the Thailand Multiple Indicator Cluster Survey (MICS) is only one of the samples that could have been selected from the same population, using the same design and size. Each of these samples would yield results that differ somewhat from the results of the actual sample selected. Sampling errors are a measure of the variability between all possible samples. The extent of variability is not known exactly, but can be estimated statistically from the survey results.
The following sampling error measures are presented in this appendix to the Survey Final Report (attached in the External Resources) for each of the selected indicators:
- Standard error (se): Sampling errors are usually measured in terms of standard errors for particular indicators (means, proportions etc). Standard error is the square root of the variance. The Taylor linearization method is used for the estimation of standard errors.
- Coefficient of variation (se/r) is the ratio of the standard error to the value of the indicator
- Design effect (deff) is the ratio of the actual variance of an indicator, under the sampling method used in the survey, to the variance calculated under the assumption of simple random sampling. The square root of the design effect (deft) is used to show the efficiency of the sample design. A deft value of 1.0 indicates that the sample design is as efficient as a simple random sample, while a deft value above 1.0 indicates the increase in the standard error due to the use of a more complex sample design.
- Confidence limits are calculated to show the interval within which the true value for the population can be reasonably assumed to fall. For any given statistic calculated from the survey, the value of that statistics will fall within a range of plus or minus two times the standard error (p + 2.se or p - 2.se) of the statistic in 95 percent of all possible samples of identical size and design.
For the calculation of sampling errors from MICS data, SPSS (Statistical Package for Social Sciences) Version 14 Complex Samples module has been used. In addition to the sampling error measures described above, the tables also include weighted and un-weighted counts of denominators for each indicator.
Sampling errors are calculated for indicators of primary interest, for the national total, for the regions, and for urban and rural areas. Three of the selected indicators are based on households, 8 are based on household members, 13 are based on women, and 15 are based on children under 5. All indicators presented in the Final Report are in the form of proportions.
A series of data quality tables and graphs are available to review the quality of the data and include the following:
Age distribution of the household population
Age distribution of eligible women and interviewed women
Age distribution of eligible children and children for whom the mother or caretaker was interviewed
Age distribution of children under age 5 by 3 month groups
Age and period ratios at boundaries of eligibility
Percent of observations with missing information on selected variables
Presence of mother inthe household and person interviewed for the under 5 questionnaire
School attendance by single year age
Sex ratio at birth among children ever born, surviving and dead by age of respondent
Distribution of women by time since last birth
Scatterplot of weight by height, weight by age and height by age
Graph of male and female population by single years of age
Population pyramid
The Thailand Multiple Indicator Cluster Survey (MICS) covered a large number of samples from all 76 provinces in the country. It was expected that data deviation could possibly occur from the work of the field staff, or the interviewees. Therefore, the National Statistical Office (NSO) operated a post enumeration survey (PES) in Bangkok and 22 provinces selected from all four regions to aid data users in their consideration of data quality. The PES consisted of 150 block/village samples, in both municipal and non-municipal areas. Collective household samples – 20 households per block/village for a total of 3,000 household samples – were selected from the listing of household samples of the MICS survey. Staff were sent in to repeat the survey in these areas. Matching of questionnaires from the actual survey and the repeated survey was carried out and data were analysed for deviation.
Users of the data agree to keep confidential all data contained in these datasets and to make no attempt to identify, trace or contact any individual whose data is included in these datasets.
Thailand National Statistical Office. 2006. Thailand Multiple Indicator Cluster Survey December 2005- February 2006. Bangkok, Thailand: National Statistical Office.
Survey datasets are distributed at no cost for legitimate research, with the condition that we receive a description of any research project that will be using the data prior to authorizing their distribution. Copies of all reports and publications based on the requested data must be sent to UNICE: thailandao@unicef.org.
Requests for access to the datasets may be made through the website www.childinfo.org.
The National Statistical Office of Thailand and UNICEF provide these data to external users without any warranty or responsibility implied. The National Statistical Office of Thailand and UNICEF accept no responsibility for the results and/or implications of any actions resulting from the use of these data.
hh
Data collected at the household level (MICS Household questionnaire: Household information panel, Water and sanitation, household characteristics, Salt iodization)
0
78
hl
Data collected at the household member's level (MICS Household Questionnaire: Household listing, Child labour, Support to Orphaned and Vulnerable Children and Child Disability)
0
135
wm
Data collected at the women's level (MICS Women's Questionnaire: Women's Information Panel, Child mortality, Tetanus toxoid, Maternal and newborn health, Marriage, Contraception, HIV/AIDS knowledge)
0
180
ch
Data collected at the children's level (MICS Under Five Children's Questionnaire: Under Five Child Information Panel, Birth registration and early learning,Breastfeeding, Care of Illness, Immunization, Anthropometry and Child development)
0
248
Interview and HH identification
Characteristics of dwelling
Water and sanitation
Characteristics of the head
Members characteristics
Education
Children's living arrangements
Child mortality
Maternal and newborn health
Nutrition
Child health
Source and cost of supplies
Contraception
Child protection
Marriage/union
HIV-AIDS
Wealth Index
Asset ownership
Weighting coefficients
Others
Antenatal care
Care seeking behaviour
Child labor
Salt iodization
Early child development
Early learning
Security of tenure
Durability of housing
Insecticide treated nets (ITN)
Child discipline
Support to orphans and vulnerable children
Sexual behaviour
Condom use
Child disability
Maternal mortality
Tetanus toxoid
Vitamin A
Assistance at delivery
Polygyny
Unmet need
Attitudes towards domestic violence
Female genital mutilation/cutting
Malaria
Insecticide treated nets (ITN)
Newborn health
Immunizations
Birth registration
Early marriage
Polygyny
Anthropometry
Cooking fuels
Diarrhoea
Acute respiratory infection
Disposal of child's stools
Breastfeeding
Cluster number
Cluster number
Cluster number
Cluster number
Cluster number
We are from (COUNTRY-SPECIFIC AFFILIATION). We are working on a project concerned with family health and education. I would like to talk to you about this. The interview will take about (NUMBER) minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. During this time I would like to speak with the household head and all mothers or others who take care of children in the household. May I start now? If permission is given, begin the interview. Cluster number:
Households
Unique identifier for the cluster in which the household exists
Household number
Household number
Household number
Household number
Household number
Household number:
Households
Houshold number within the cluster
Region
Region
Region
Region
Region
Region:
Households
2
Central (include BKK.)
3
North
4
Northeast
5
South
Changwat/Province
Changwat/Province
Changwat/Province
Changwat/Province
Changwat/Province
Area
Area
Area
Area
Area
Area:
Households
1
Urban
2
Rural
PSU_NO
PSU_NO
PSU_NO
PSU_NO
PSU_NO
Day of interview
Day of interview
Day of interview
Day of interview
Day of interview
Day/Month/Year of interview:
Households
Month of interview
Month of interview
Month of interview
Month of interview
Month of interview
Day/Month/Year of interview:
Households
Year of interview
Year of interview
Year of interview
Year of interview
Year of interview
Day/Month/Year of interview:
Households
Respondent HH questionnaire
Respondent HH questionnaire
Respondent HH questionnaire
Respondent HH questionnaire
Respondent HH questionnaire
Respondent to HH questionnaire:
Households
99
Missing
Number of household members
Number of household members
Number of household members
Number of household members
Number of household members
Total number of household members:
Households
Total eligible women
Total eligible women
Total eligible women
Total eligible women
Total eligible women
No.of women eligible for interview:
Households
Women interviews completed
Women interviews completed
Women interviews completed
Women interviews completed
Women interviews completed
No.of women questionnaires completed:
Households
Total children under 5
Total children under 5
Total children under 5
Total children under 5
Total children under 5
No.of children under age 5:
Households
Child interviews completed
Child interviews completed
Child interviews completed
Child interviews completed
Child interviews completed
No.of under-5 questionnaires completed:
Households
Enu. Result
Enu. Result
Enu. Result
Enu. Result
Enu. Result
After all questionnaires for the household have been completed, fill in the following information: Result of HH interview:
Households
1
Completed
2
Not at home
3
Refused
4
HH not found/destroyed
6
Others
Total number of Women 15-49
Total number of Women 15-49
Total number of Women 15-49
Total number of Women 15-49
Total number of Women 15-49
Are there any other persons living here - even if they are not members of your family or do not have parents living in this household? Including children at work or at school? If yes, insert child's name and complete form. Then, complete the totals below.
Households
Total number of Children 5-14
Total number of Children 5-14
Total number of Children 5-14
Total number of Children 5-14
Total number of Children 5-14
Households
Total number of children Under 5 years
Total number of children Under 5 years
Total number of children Under 5 years
Total number of children Under 5 years
Total number of children Under 5 years
Households
Total number of Very Sick
Total number of Very Sick
Total number of Very Sick
Total number of Very Sick
Total number of Very Sick
Total number of mothers dead
Total number of mothers dead
Total number of mothers dead
Total number of mothers dead
Total number of mothers dead
Total number of mothers very sick
Total number of mothers very sick
Total number of mothers very sick
Total number of mothers very sick
Total number of mothers very sick
Total number of father dead
Total number of father dead
Total number of father dead
Total number of father dead
Total number of father dead
Total number of fathers very sick
Total number of fathers very sick
Total number of fathers very sick
Total number of fathers very sick
Total number of fathers very sick
Have any usual member of your household died in the last 12
Have any usual member of your household died in the last 12
Have any usual member of your household died in the last 12
Have any usual member of your household died in the last 12
Have any usual member of your household died in the last 12
Check HL5: any children 0-17? Yes Continue to OV2 No Next Module
I would like you to think back over the past 12 months. Has any usual member of your household died in the last 12 months?
Households
1
Yes
2
No
9
Missing
Of those who died is there any one between the ages of 18 an
Of those who died is there any one between the ages of 18 an
Of those who died is there any one between the ages of 18 an
Of those who died is there any one between the ages of 18 an
Of those who died is there any one between the ages of 18 an
(Of those who died in the past 12 months) were any of these people between the ages of 18 and 59?
Households
1
Yes
2
No
9
Missing
If yes ,were any seriously ill for 3 of the 12 months befor
If yes ,were any seriously ill for 3 of the 12 months befor
If yes ,were any seriously ill for 3 of the 12 months befor
If yes ,were any seriously ill for 3 of the 12 months befor
If yes ,were any seriously ill for 3 of the 12 months befor
(Of those who died in the past 12 months and were between the ages of 18 and 59) were any of these people seriously ill for 3 of the 12 months before he/she died?
Return to the Household Listing and check the following: 1. Check totals for HL9 and HL11. At least one mother or father dead. Go to OV8 No mother or father dead 2. Check totals for HL8A. At least one adult aged 18-59 very sick 3 of last 12 months. Go to OV8 No adult aged 18-59 very sick 3 of last 12 months 3. Check totals forHL10A and HL12A. At least one mother or father ill 3 of last 12 months. Go to OV8 No mother or father ill 3 of last 12 months. Go to Next Module
Households
1
Yes
2
No
9
Missing
Main source of drinking water
Main source of drinking water
Main source of drinking water
Main source of drinking water
Main source of drinking water
What is the main source of drinking water for members of your household?
Households
11
Piped into dwelling
12
Piped into yard or plot
13
Public tap/standpipe
21
Tubewell/borehole
31
Protected well
32
Unprotected well
41
Protected spring
42
Unprotected spring
51
Rainwater collection
61
Tanker-truck
81
Surface water
91
Bottled water
96
Other
99
Missing
Main source of water used for other purposes (if bottled wat
Main source of water used for other purposes (if bottled wat
Main source of water used for other purposes (if bottled wat
Main source of water used for other purposes (if bottled wat
Main source of water used for other purposes (if bottled wat
What is the main source of water used by your household for other purposes such as cooking and handwashing?
Households
11
Piped into dwelling
12
Piped into yard or plot
13
Public tap/standpipe
21
Tubewell/borehole
31
Protected well
32
Unprotected well
41
Protected spring
42
Unprotected spring
51
Rainwater collection
61
Tanker-truck
81
Surface water
96
Other
99
Missing
Time to get water and come back
Time to get water and come back
Time to get water and come back
Time to get water and come back
Time to get water and come back
How long does it take to go there, get water, and come back?
Households
995
On premises
998
DK
999
Missing
Person fetching water
Person fetching water
Person fetching water
Person fetching water
Person fetching water
Who usually goes to this source to fetch the water for your household? Probe: Is this person under age 15? What sex?
Circle code that best describes this person.
Households
1
Adult woman
2
Adult man
3
Female child (under 15)
4
Male child (under 15)
8
DK
9
Missing
Treat water to make safer for drinking
Treat water to make safer for drinking
Treat water to make safer for drinking
Treat water to make safer for drinking
Treat water to make safer for drinking
Do you treat your water in any way to make it safer to drink?
Households
1
Yes
2
No
8
DK
9
Missing
Boil
Boil
Boil
Boil
Boil
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
Households
?
Missing
A
Boil
Add bleach/chlorine
Add bleach/chlorine
Add bleach/chlorine
Add bleach/chlorine
Add bleach/chlorine
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
Households
?
Missing
B
Add bleach/chlorine
Strain it through a cloth
Strain it through a cloth
Strain it through a cloth
Strain it through a cloth
Strain it through a cloth
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
Households
?
Missing
C
Strain it through a cloth
Use water filter
Use water filter
Use water filter
Use water filter
Use water filter
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
Households
?
Missing
D
Use water filter
Solar disinfection
Solar disinfection
Solar disinfection
Solar disinfection
Solar disinfection
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
Households
?
Missing
E
Solar disinfection
Let it stand and settle
Let it stand and settle
Let it stand and settle
Let it stand and settle
Let it stand and settle
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
Households
?
Missing
F
Let it stand and settle
Other
Other
Other
Other
Other
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
Households
?
Missing
X
Other
DK
DK
DK
DK
DK
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
Households
?
Missing
Z
DK
Kind of toilet facility
Kind of toilet facility
Kind of toilet facility
Kind of toilet facility
Kind of toilet facility
What kind of toilet facility do members of your household usually use? If "flush" or "pour flush", probe: Where does it flush to?
If necessary, ask permission to observe the facility.
Households
11
Flush to piped sewer system
12
Flush to septic tank
13
Flush to pit (latrine)
14
Flush to somewhere else
15
Flush to unknown place/not sure/DK where
22
Pit latrine with slab
23
Pit latrine without slab/open pit
95
No facilities or bush or field
96
Other
99
Missing
Toilet facility shared
Toilet facility shared
Toilet facility shared
Toilet facility shared
Toilet facility shared
Do you share this facility with other households?
Households
1
Yes
2
No
9
Missing
Households using this toilet facility
Households using this toilet facility
Households using this toilet facility
Households using this toilet facility
Households using this toilet facility
How many households in total use this toilet facility?
Households
10
Ten or more households
98
DK
99
Missing
Religion of head
Religion of head
Religion of head
Religion of head
Religion of head
What is the religion of the head of this household?
Households
1
Buddhist
2
Muslim
3
Christian
6
Other religion
7
No religion
9
Missing
Language
Language
Language
Language
Language
What is the mother tongue/native language of the head of this household?
Households
1
Thai
2
Other Languages
3
Missing
Ethnic group of head
Ethnic group of head
Ethnic group of head
Ethnic group of head
Ethnic group of head
To what ethnic group does the head of this household belong?
Households
1
Thai
2
Cambodia
3
Loas
4
China
5
Myanmar
6
Other Ethnic
7
Hill Tribe
9
Missing
Head of occupation
Head of occupation
Head of occupation
Head of occupation
Head of occupation
1
Government Officer
2
State Enterprises Officer
3
Private Officer
4
Business
5
Agriculturist
6
Labourer
7
Other
9
Missing
Mean of income
Mean of income
Mean of income
Mean of income
Mean of income
1
Lower 10000
2
10000-19999
3
20000-29999
4
30000-39999
5
40000-49999
6
Upper 50000
9
Missing
Number of rooms for sleeping
Number of rooms for sleeping
Number of rooms for sleeping
Number of rooms for sleeping
Number of rooms for sleeping
How many rooms in this household are used for sleeping?
Households
99
Missing
Main material of floor
Main material of floor
Main material of floor
Main material of floor
Main material of floor
Main material of the dwelling floor:
Record observation.
Households
11
Earth/sand
21
Wood planks
22
Palm/bamboo
31
Parquet or polished wood
32
Vinyl or asphalt strips
33
Ceramic tiles
34
Cement
35
Carpet
36
Marble
37
Polished stone
96
Other
99
Missing
Main material of roof
Main material of roof
Main material of roof
Main material of roof
Main material of roof
Main material of the roof.
Record observation.
Households
11
No roof
12
Thatch/palm leaf
13
Sod
22
Palm/bamboo
23
Wood Planks
31
Metal
33
Calamine/cement fiber
34
Ceramic tiles
35
Cement
36
Roofing shingles
96
Other
99
Missing
Main material of wall
Main material of wall
Main material of wall
Main material of wall
Main material of wall
Main material of the walls.
Record observation.
Households
11
No walls
12
Cane/palm/trunks
13
Dirt
24
Plywood
25
Carton
26
Reused wood
27
Bamboo
31
Cement
32
Stone with lime/cement
33
Bricks
34
Cement blocks
36
Wood planks/shingles
37
Zinc
38
Tile
39
Shera wood
96
Other
99
Missing
Type of fuel using for cooking
Type of fuel using for cooking
Type of fuel using for cooking
Type of fuel using for cooking
Type of fuel using for cooking
What type of fuel does your household mainly use for cooking?
Households
1
Electricity
2
Liquid propane gas (LPG)
4
Biogas
5
Kerosene
6
Coal/lignite
7
Charcoal
8
Wood
9
Straw/shrubs/grass
10
Animal dung
11
Agricultural crop residue
96
Other
97
No Cooking
99
Missing
Food cooked on stove or open fire
Food cooked on stove or open fire
Food cooked on stove or open fire
Food cooked on stove or open fire
Food cooked on stove or open fire
In this household, is food cooked on an open fire, an open stove or a closed stove?
Probe for type.
Households
1
Open fire
2
Open stove
3
Closed stove
6
Other
9
Missing
Does the fire stove have a chimney or a hood
Does the fire stove have a chimney or a hood
Does the fire stove have a chimney or a hood
Does the fire stove have a chimney or a hood
Does the fire stove have a chimney or a hood
Does the fire/stove have a chimney or a hood?
Households
1
Yes
2
No
9
Missing
Cooking location
Cooking location
Cooking location
Cooking location
Cooking location
Is the cooking usually done in the house, in a separate building, or outdoors?
Households
1
In the house
2
In a separate bulding
3
Outdoors
4
Terrace
6
Other
9
Missing
Electricity
Electricity
Electricity
Electricity
Electricity
Does your household have:
Households
1
Yes
2
No
9
Missing
Radio
Radio
Radio
Radio
Radio
Does your household have:
Households
1
Yes
2
No
9
Missing
Television
Television
Television
Television
Television
Does your household have:
Households
1
Yes
2
No
9
Missing
Mobile phone
Mobile phone
Mobile phone
Mobile phone
Mobile phone
Does your household have:
Households
1
Yes
2
No
9
Missing
Non-mobile phone
Non-mobile phone
Non-mobile phone
Non-mobile phone
Non-mobile phone
Does your household have:
Households
1
Yes
2
No
9
Missing
Refrigerator
Refrigerator
Refrigerator
Refrigerator
Refrigerator
Does your household have:
Households
1
Yes
2
No
9
Missing
Computer
Computer
Computer
Computer
Computer
Watch
Watch
Watch
Watch
Watch
Does any member of your household own:
Households
1
Yes
2
No
9
Missing
Bicycle
Bicycle
Bicycle
Bicycle
Bicycle
Does any member of your household own:
Households
1
Yes
2
No
9
Missing
Motorcycle or scooter
Motorcycle or scooter
Motorcycle or scooter
Motorcycle or scooter
Motorcycle or scooter
Does any member of your household own:
Households
1
Yes
2
No
9
Missing
Animal-drawn cart
Animal-drawn cart
Animal-drawn cart
Animal-drawn cart
Animal-drawn cart
Does any member of your household own:
Households
1
Yes
2
No
9
Missing
Car or truck
Car or truck
Car or truck
Car or truck
Car or truck
Does any member of your household own:
Households
1
Yes
2
No
9
Missing
Boat with motor
Boat with motor
Boat with motor
Boat with motor
Boat with motor
Does any member of your household own:
Households
1
Yes
2
No
9
Missing
Salt iodization test outcome
Salt iodization test outcome
Salt iodization test outcome
Salt iodization test outcome
Salt iodization test outcome
We would like to check whether the salt used in your household is iodized. May I see a sample of the salt used to cook the main meal eaten by members of your household last night?
Once you have examined the salt, circle number that corresponds to test outcome.
Households
1
No colour
4
Colour
6
No salt in home
9
Missing
Packet of salt
Packet of salt
Packet of salt
Packet of salt
Packet of salt
The packet of salt when purchased?
1
Bag had iodine label
2
Bottle had iodine label
3
Bag/bottle had not iodine label
6
DK
9
Missing
Type of salt
Type of salt
Type of salt
Type of salt
Type of salt
1
Coarse
2
Refined
PPM from lab test
PPM from lab test
PPM from lab test
PPM from lab test
PPM from lab test
Household sample weight
Household sample weight
Household sample weight
Household sample weight
Household sample weight
Recoded variable
De jure household members (usual residents)
REGR factor score 1 for analysis 1
REGR factor score 1 for analysis 1
REGR factor score 1 for analysis 1
REGR factor score 1 for analysis 1
REGR factor score 1 for analysis 1
Recoded variable
Children aged 0-4
wealth index quintiles
wealth index quintiles
wealth index quintiles
wealth index quintiles
wealth index quintiles
Recoded variable
Children aged 0-4
1
Poorest
2
Second
3
Middle
4
Fourth
5
Richest
Household Head's education
Household Head's education
Household Head's education
Household Head's education
Household Head's education
Recoded variable
De jure household members (usual residents)
1
None
2
Primary
3
Secondary +
The variable is created from information collected on educational level in the HL file. See makehh.sps in the data processing folder under technical information.
Sex of household head
Sex of household head
Sex of household head
Sex of household head
Sex of household head
Recoded variable
Households
1
Male
2
Female
9
Missing/DK
The variable is created from information collected in the HL file. See makehh.sps in the data processing folder under technical information.
Cluster number
Cluster number
Cluster number
Cluster number
Cluster number
We are from (COUNTRY-SPECIFIC AFFILIATION). We are working on a project concerned with family health and education. I would like to talk to you about this. The interview will take about (NUMBER) minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. During this time I would like to speak with the household head and all mothers or others who take care of children in the household. May I start now? If permission is given, begin the interview. Cluster number:
Households
Unique identifier for the cluster in which the household exists
Household number
Household number
Household number
Household number
Household number
Household number:
Households
Houshold number within the cluster
Line number
Line number
Line number
Line number
Line number
FIRST, PLEASE TELL ME THE NAME OF EACH PERSON WHO USUALLY LIVES HERE, STARTING WITH THE HEAD OF THE HOUSEHOLD. List the head of the household in line 01. List all household members (HL2), their relationship to the household head (HL3), and their sex (HL4). Then ask: ARE THERE ANY OTHERS WHO LIVE HERE, EVEN IF THEY ARE NOT AT HOME NOW? (THESE MAY INCLUDE CHILDREN IN SCHOOL OR AT WORK). If yes, complete listing. Then, ask questions starting with HL5 for each person at a time. Add a continuation sheet if there are more than 15 household members. Tick here if continuation sheet used
De jure household members (usual residents)
Line number
Line number
Line number
Line number
Line number
Child's line number:
Children aged 0-4
Relationship to the head
Relationship to the head
Relationship to the head
Relationship to the head
Relationship to the head
What is the relationship of (name) to the head of the household?
De jure household members (usual residents)
1
Head
2
Wife or Husband
3
Son or Daugher
4
Son/Daughter in law
5
Grandchild
6
Parent
7
Parent in law
8
Brother or sister
9
Brother/sister in law
10
Uncle/Aunt
11
Niece/nephew by blood
12
Niece/nephew by marriage
13
Other relative
14
Adopted/foster/stepchild
15
Not related
97
Inconsistent
98
DK
99
Missing
Sex
Sex
Sex
Sex
Sex
Children aged 0-4
1
Male
2
Female
Age
Age
Age
Age
Age
How old is (name)? How old was (name) on his/her last birthday?
Record in completed years 98=DK* * See instructions: to be used only for elderly household members (code meaning "do not know/over age 50").
De jure household members (usual residents)
Less than 1 year
97
97+
98
DK
99
Missing
Nationalily
Nationalily
Nationalily
Nationalily
Nationalily
1
Thai
2
Not Thai (Hill tribe, Minority group)
3
Other (Specify)
4
No Citizenship
8
DK
9
Missing
Line number of eligible women
Line number of eligible women
Line number of eligible women
Line number of eligible women
Line number of eligible women
Circle Line no. if woman is age 15-49
De jure household members (usual residents)
Not eligible
Line number of mother/caretaker for child labor module
Line number of mother/caretaker for child labor module
Line number of mother/caretaker for child labor module
Line number of mother/caretaker for child labor module
Line number of mother/caretaker for child labor module
For each child age 5-14:
Who is the mother or primary caretaker of this child?
Record Line no. of mother/caretaker
De jure household members (usual residents)
Not eligible
Line number of mother/caretaker for child health module
Line number of mother/caretaker for child health module
Line number of mother/caretaker for child health module
Line number of mother/caretaker for child health module
Line number of mother/caretaker for child health module
For each child under 5:
Who is the mother or primary caretaker of this child?
Record Line no. of mother/caretaker
De jure household members (usual residents)
Not eligible
Member ill 3 months in last 12 months
Member ill 3 months in last 12 months
Member ill 3 months in last 12 months
Member ill 3 months in last 12 months
Member ill 3 months in last 12 months
If age 18-59 years
Has (name) been very sick for at least 3 months during the past 12 months?
De jure household members (usual residents)
1
Yes
2
No
8
DK
9
Missing
Mother alive
Mother alive
Mother alive
Mother alive
Mother alive
For children age 0-17 years ask HL9-HL12
Is (name's) natural mother alive?
De jure household members (usual residents) aged 0-17 (under 18)
1
Yes
2
No
8
DK
9
Missing
Mother line number in HH
Mother line number in HH
Mother line number in HH
Mother line number in HH
Mother line number in HH
For children age 0-17 years ask HL9-HL12 If alive:
Does (name's) natural mother live in this household?
Record Line no. of mother or 00 for 'No'
De jure household members (usual residents) aged 0-17 (under 18)
Not eligible
97
Inconsistent
99
Missing
Mother ill 3 months in last 12 months
Mother ill 3 months in last 12 months
Mother ill 3 months in last 12 months
Mother ill 3 months in last 12 months
Mother ill 3 months in last 12 months
For children age 0-17 years ask HL9-HL12A If mother does not live in household:
Has (name's) mother been very sick for at least 3 months in the past 12 months?
De jure household members (usual residents) aged 0-17 (under 18)
1
Yes
2
No
8
DK
9
Missing
Father alive
Father alive
Father alive
Father alive
Father alive
For children age 0-17 years ask HL9-HL12 If alive:
Is (name's) natural father alive?
De jure household members (usual residents) aged 0-17 (under 18)
1
Yes
2
No
8
DK
9
Missing
Father line number in HH
Father line number in HH
Father line number in HH
Father line number in HH
Father line number in HH
For children age 0-17 years ask HL9-HL12
Does (name's) natural father live in this household?
Record Line no. of father or 00 for 'No'
De jure household members (usual residents) aged 0-17 (under 18)
Not eligible
97
Inconsistent
99
Missing
Father ill 3 months in last 12 months
Father ill 3 months in last 12 months
Father ill 3 months in last 12 months
Father ill 3 months in last 12 months
Father ill 3 months in last 12 months
For children age 0-17 years ask HL9-HL12A If father does not live in household:
Has (name's) father been very sick for at least 3 months in the past 12 months?
De jure household members (usual residents) aged 0-17 (under 18)
1
Yes
2
No
8
DK
9
Missing
Total number of Women 15-49
Total number of Women 15-49
Total number of Women 15-49
Total number of Women 15-49
Total number of Women 15-49
Are there any other persons living here - even if they are not members of your family or do not have parents living in this household? Including children at work or at school? If yes, insert child's name and complete form. Then, complete the totals below.
Households
Total number of Children 5-14
Total number of Children 5-14
Total number of Children 5-14
Total number of Children 5-14
Total number of Children 5-14
Households
Total number of children Under 5 years
Total number of children Under 5 years
Total number of children Under 5 years
Total number of children Under 5 years
Total number of children Under 5 years
Households
Total number of Very Sick
Total number of Very Sick
Total number of Very Sick
Total number of Very Sick
Total number of Very Sick
Total number of mothers dead
Total number of mothers dead
Total number of mothers dead
Total number of mothers dead
Total number of mothers dead
Total number of mothers very sick
Total number of mothers very sick
Total number of mothers very sick
Total number of mothers very sick
Total number of mothers very sick
Total number of father dead
Total number of father dead
Total number of father dead
Total number of father dead
Total number of father dead
Total number of fathers very sick
Total number of fathers very sick
Total number of fathers very sick
Total number of fathers very sick
Total number of fathers very sick
Line number
Line number
Line number
Line number
Line number
For household members age 5 and above
De jure household members (usual residents)
Ever attended school
Ever attended school
Ever attended school
Ever attended school
Ever attended school
For household members age 5 and above
Has (name) ever attended school or preschool?
De jure household members (usual residents)
1
Yes
2
No
9
Missing
Highest level of school attended
Highest level of school attended
Highest level of school attended
Highest level of school attended
Highest level of school attended
What is the highest level of school (name) attended?
Children aged 0-4
Preschool/kindergarten
1
Primary
2
Secondary
3
Higher
6
Non-standard curriculum
8
DK
9
Missing
Highest grade at level
Highest grade at level
Highest grade at level
Highest grade at level
Highest grade at level
For household members age 5 and above
What is the highest grade (name) completed at this level?
De jure household members (usual residents)
No education
97
Inconsistent
98
DK
99
Missing
Currently attending school during the school year (2004-2005
Currently attending school during the school year (2004-2005
Currently attending school during the school year (2004-2005
Currently attending school during the school year (2004-2005
Currently attending school during the school year (2004-2005
For household members age 5-24 years
During the (2004-2005) school year, did (name) attend school or preschool at any time?
De jure household members (usual residents) aged 5-24
1
Yes
2
No
9
Missing
Reason of no attended school
Reason of no attended school
Reason of no attended school
Reason of no attended school
Reason of no attended school
1
Far from home
2
No Birth Certificate
3
No Citizenship
4
No Money
5
Language Problem
6
Sick/Disability
7
Member HH have sick
8
Finish at School
9
Other
98
DK
99
Missing
Days attended school in last week
Days attended school in last week
Days attended school in last week
Days attended school in last week
Days attended school in last week
For household members age 5-24 years
Since last (day of the week), how many days did (name) attend school?
Insert number of days in space below.
De jure household members (usual residents) aged 5-24
8
Interview during school holidays
9
Missing
Level of education attended
Level of education attended
Level of education attended
Level of education attended
Level of education attended
For household members age 5-24 years
During this/that school year, which level and grade is/was (name) attending?
De jure household members (usual residents) aged 5-24
Preschool/kindergarten
1
Primary
2
Secondary
3
Higher
6
Non-standard curriculum
8
DK
9
Missing
Grade of education attended
Grade of education attended
Grade of education attended
Grade of education attended
Grade of education attended
For household members age 5-24 years
During this/that school year, which level and grade is/was (name) attending?
De jure household members (usual residents) aged 5-24
No education
97
Inconsistent
98
DK
99
Missing
Attended school last year (2003-2004)
Attended school last year (2003-2004)
Attended school last year (2003-2004)
Attended school last year (2003-2004)
Attended school last year (2003-2004)
For household members age 5-24 years
Did (name) attend school or preschool at any time during the previous school year, that is (2003-2004)?
De jure household members (usual residents) aged 5-24
1
Yes
2
No
8
DK
9
Missing
Level of education attended last year
Level of education attended last year
Level of education attended last year
Level of education attended last year
Level of education attended last year
For household members age 5-24 years
During that previous school year, which level and grade did (name) attend?
De jure household members (usual residents) aged 5-24
Preschool/kindergarten
1
Primary
2
Secondary
3
Higher
6
Non-standard curriculum
8
DK
9
Missing
Grade of education attended last year
Grade of education attended last year
Grade of education attended last year
Grade of education attended last year
Grade of education attended last year
For household members age 5-24 years
During that previous school year, which level and grade did (name) attend?
De jure household members (usual residents) aged 5-24
No education
97
Inconsistent
98
DK
99
Missing
Have any usual member of your household died in the last 12
Have any usual member of your household died in the last 12
Have any usual member of your household died in the last 12
Have any usual member of your household died in the last 12
Have any usual member of your household died in the last 12
Check HL5: any children 0-17? Yes Continue to OV2 No Next Module
I would like you to think back over the past 12 months. Has any usual member of your household died in the last 12 months?
Households
1
Yes
2
No
9
Missing
Of those who died is there any one between the ages of 18 an
Of those who died is there any one between the ages of 18 an
Of those who died is there any one between the ages of 18 an
Of those who died is there any one between the ages of 18 an
Of those who died is there any one between the ages of 18 an
(Of those who died in the past 12 months) were any of these people between the ages of 18 and 59?
Households
1
Yes
2
No
9
Missing
If yes ,were any seriously ill for 3 of the 12 months befor
If yes ,were any seriously ill for 3 of the 12 months befor
If yes ,were any seriously ill for 3 of the 12 months befor
If yes ,were any seriously ill for 3 of the 12 months befor
If yes ,were any seriously ill for 3 of the 12 months befor
(Of those who died in the past 12 months and were between the ages of 18 and 59) were any of these people seriously ill for 3 of the 12 months before he/she died?
Return to the Household Listing and check the following: 1. Check totals for HL9 and HL11. At least one mother or father dead. Go to OV8 No mother or father dead 2. Check totals for HL8A. At least one adult aged 18-59 very sick 3 of last 12 months. Go to OV8 No adult aged 18-59 very sick 3 of last 12 months 3. Check totals forHL10A and HL12A. At least one mother or father ill 3 of last 12 months. Go to OV8 No mother or father ill 3 of last 12 months. Go to Next Module
Households
1
Yes
2
No
9
Missing
Child's line number
Child's line number
Child's line number
Child's line number
Child's line number
Return to the Household Listing and check the following: 1. Check totals for HL9 and HL11. At least one mother or father dead. Go to OV8 No mother or father dead 2. Check totals for HL8A. At least one adult aged 18-59 very sick 3 of last 12 months. Go to OV8 No adult aged 18-59 very sick 3 of last 12 months 3. Check totals for HL10A and HL12A. At least one mother or father ill 3 of last 12 months. Go to OV8 No mother or father ill 3 of last 12 months. Go to Next Module List all children aged 0-17 below. Record names, line numbers and ages of all children, beginning with the first child and continue in order in which listed in the household listing module. Use a continuation sheet if there are more than 4 children age 0-17 in the household. Ask all questions for one child before moving to the next child. Line number (from HL1)
Children living in households with at least one child considered as an orphan or asa child made vulnerable by HIV/AIDS
Child's age
Child's age
Child's age
Child's age
Child's age
Age (from HL5)
Children living in households with at least one child considered as an orphan or asa child made vulnerable by HIV/AIDS
Less than 1 year
97
97+
98
DK
99
Missing
Did you receive any medical support in the 12 months
Did you receive any medical support in the 12 months
Did you receive any medical support in the 12 months
Did you receive any medical support in the 12 months
Did you receive any medical support in the 12 months
I would like to ask you about any formal, organized help or support that your household may have received for (name) and for which you did not have to pay. By formal organized support I mean help provided by someone working for a program. This program could be government, private, religious, charity, or community-based. Remember this should be support for which you did not pay.
Now I would like to ask you about the support your household received for (name). In the last 12 months, has your household received any medical support for (name), such as medical care, supplies or medicine?
Children living in households with at least one child considered as an orphan or asa child made vulnerable by HIV/AIDS
1
Yes
2
No
8
DK
9
Missing
Did you receive any emotional or psychologigal support the 1
Did you receive any emotional or psychologigal support the 1
Did you receive any emotional or psychologigal support the 1
Did you receive any emotional or psychologigal support the 1
Did you receive any emotional or psychologigal support the 1
In the last 12 months, has your household received any emotional or psychological support for (name), such as companionship, counseling from a trained couselor, or spiritual support, which you received at home?
Children living in households with at least one child considered as an orphan or asa child made vulnerable by HIV/AIDS
1
Yes
2
No
8
DK
9
Missing
Did you receive any emotional or psychologigal support in la
Did you receive any emotional or psychologigal support in la
Did you receive any emotional or psychologigal support in la
Did you receive any emotional or psychologigal support in la
Did you receive any emotional or psychologigal support in la
Did your household receive any of this support in the past 3 months?
Children living in households with at least one child considered as an orphan or asa child made vulnerable by HIV/AIDS
1
Yes
2
No
8
DK
9
Missing
Did you receive any material support in the last 12 months
Did you receive any material support in the last 12 months
Did you receive any material support in the last 12 months
Did you receive any material support in the last 12 months
Did you receive any material support in the last 12 months
In the last 12 months, has your household received any material support for (name), such as clothing, food or financial support?
Children living in households with at least one child considered as an orphan or asa child made vulnerable by HIV/AIDS
1
Yes
2
No
8
DK
9
Missing
Did you receive any material support in the last 3 months
Did you receive any material support in the last 3 months
Did you receive any material support in the last 3 months
Did you receive any material support in the last 3 months
Did you receive any material support in the last 3 months
Did your household receive any of this support in the past 3 months?
Children living in households with at least one child considered as an orphan or asa child made vulnerable by HIV/AIDS
1
Yes
2
No
8
DK
9
Missing
Did you receive any social support in the 12 months
Did you receive any social support in the 12 months
Did you receive any social support in the 12 months
Did you receive any social support in the 12 months
Did you receive any social support in the 12 months
In the last 12 months, has your household received any social support for (name), such as help in household work, training for a caregiver, or legal services?
Children living in households with at least one child considered as an orphan or asa child made vulnerable by HIV/AIDS
1
Yes
2
No
8
DK
9
Missing
Did you receive any social support in the last 3 months
Did you receive any social support in the last 3 months
Did you receive any social support in the last 3 months
Did you receive any social support in the last 3 months
Did you receive any social support in the last 3 months
Did your household receive any of this support in the past 3 months?
Children living in households with at least one child considered as an orphan or asa child made vulnerable by HIV/AIDS
1
Yes
2
No
8
DK
9
Missing
Did you receive for child schooling in the 12 months
Did you receive for child schooling in the 12 months
Did you receive for child schooling in the 12 months
Did you receive for child schooling in the 12 months
Did you receive for child schooling in the 12 months
Check OV8 for age of child: Age 0-4. next child Age 5-17. OV18
In the last 12 months, has your household received any support for (name's) schooling, such as allowance, free admission, books or supplies?
Children living in households with at least one child considered as an orphan or asa child made vulnerable by HIV/AIDS
1
Yes
2
No
8
DK
9
Missing
Line number
Line number
Line number
Line number
Line number
To be administered to mother/caretaker of each child in the household age 5 through 14 years. For household members below age 5 or above age 14, leave rows blank. Now I would like to ask about any work children in this household may do.
Children aged 5-14
Worked in past week
Worked in past week
Worked in past week
Worked in past week
Worked in past week
During the past week, did (name) do any kind of work for someone who is not a member of this household? If yes: For pay in cash or kind?
Children aged 5-14
1
Yes, paid
2
Yes, unpaid
3
No
9
Missing
Hours worked in past week
Hours worked in past week
Hours worked in past week
Hours worked in past week
Hours worked in past week
If yes:
Since last (day of the week), about how many hours did he/she do this work for someone who is not a member of this household?
If more than one job, include all hours at all jobs.
Children aged 5-14
98
DK
99
Missing
Worked in past year
Worked in past year
Worked in past year
Worked in past year
Worked in past year
At any time during the past year, did (name) do any kind of work for someone who is not a member of this household? If yes: For pay in cash or kind?
Children aged 5-14
1
Yes, paid
2
Yes, unpaid
3
No
9
Missing
Helped with household chores in past week
Helped with household chores in past week
Helped with household chores in past week
Helped with household chores in past week
Helped with household chores in past week
During the past week, did (name) help with household chores such as shopping, collecting firewood, cleaning, fetching water, or caring for children?
Children aged 5-14
1
Yes
2
No
9
Missing
Hours spent on chores in past week
Hours spent on chores in past week
Hours spent on chores in past week
Hours spent on chores in past week
Hours spent on chores in past week
If yes:
Since last (day of the week), about how many hours did he/she spend doing these chores?
Children aged 5-14
98
DK
99
Missing
Did other family work in past week
Did other family work in past week
Did other family work in past week
Did other family work in past week
Did other family work in past week
During the past week, did (name) do any other family work (on the farm or in a business or selling goods in the street?)
Children aged 5-14
1
Yes
2
No
9
Missing
Hours worked on other family work
Hours worked on other family work
Hours worked on other family work
Hours worked on other family work
Hours worked on other family work
If yes:
Since last (day of the week), about how many hours did he/she do this work?
Children aged 5-14
98
DK
99
Missing
Line number from household listing
Line number from household listing
Line number from household listing
Line number from household listing
Line number from household listing
To be administered to caretakers of all children 2 through 9 years old living in the household. For household members below age 2 or above age 9, leave rows blank I would like to ask you if any children in this household aged 2 through 9 has any of the health conditions I am going to mention to you. Line no.
De jure children aged 2-14
Any serious delay sitting, standang or walking
Any serious delay sitting, standang or walking
Any serious delay sitting, standang or walking
Any serious delay sitting, standang or walking
Any serious delay sitting, standang or walking
Compared with other children, does or did (name) have any serious delay in sitting, standing, or walking?
De jure children aged 2-14
1
Yes
2
No
9
Missing
Does he have difficulty seeing in daytime or nightime
Does he have difficulty seeing in daytime or nightime
Does he have difficulty seeing in daytime or nightime
Does he have difficulty seeing in daytime or nightime
Does he have difficulty seeing in daytime or nightime
Compared with other children, does (name) have difficulty seeing, either in the daytime or at night?
De jure children aged 2-14
1
Yes
2
No
9
Missing
Does he apprea to have difficulty hearing
Does he apprea to have difficulty hearing
Does he apprea to have difficulty hearing
Does he apprea to have difficulty hearing
Does he apprea to have difficulty hearing
Does (name) appear to have difficulty hearing? (uses hearing aid, hears with difficulty, completely deaf?)
De jure children aged 2-14
1
Yes
2
No
9
Missing
When you ask him to do something, does he understand what y
When you ask him to do something, does he understand what y
When you ask him to do something, does he understand what y
When you ask him to do something, does he understand what y
When you ask him to do something, does he understand what y
When you tell (name) to do something, does he/she seem to understand what you are saying?
De jure children aged 2-14
1
Yes
2
No
9
Missing
Does he have difficulty walking or moving
Does he have difficulty walking or moving
Does he have difficulty walking or moving
Does he have difficulty walking or moving
Does he have difficulty walking or moving
Does (name) have difficulty in walking or moving his/her arms or does he/she have weakness and/or stiffness in the arms or legs?
De jure children aged 2-14
1
Yes
2
No
9
Missing
Does he have fits, become rigid or los consciousnes
Does he have fits, become rigid or los consciousnes
Does he have fits, become rigid or los consciousnes
Does he have fits, become rigid or los consciousnes
Does he have fits, become rigid or los consciousnes
Does (name) sometimes have fits, become rigid, or lose consciousness?
De jure children aged 2-14
1
Yes
2
No
9
Missing
Does he learn to do thing like other
Does he learn to do thing like other
Does he learn to do thing like other
Does he learn to do thing like other
Does he learn to do thing like other
Does (name) learn to do things like other children his/her age?
De jure children aged 2-14
1
Yes
2
No
9
Missing
Can says recognizable words
Can says recognizable words
Can says recognizable words
Can says recognizable words
Can says recognizable words
Does (name) speak at all (can he/she make him or herself understood in words; can say any recognizable words)?
De jure children aged 2-14
1
Yes
2
No
9
Missing
Speech in any way different from normal
Speech in any way different from normal
Speech in any way different from normal
Speech in any way different from normal
Speech in any way different from normal
For 3-9 year olds:
Is (name)'s speech in any way different from normal (not clear enough to be understood by people other than the immediate family)?
De jure children aged 2-14
1
Yes
2
No
9
Missing
Can he name at least one object
Can he name at least one object
Can he name at least one object
Can he name at least one object
Can he name at least one object
For 2 year olds:
Can (name) name at least one object (for example, an animal, a toy, a cup, a spoon)?
De jure children aged 2-14
1
Yes
2
No
9
Missing
Compared to other children does he appear mentally backward,
Compared to other children does he appear mentally backward,
Compared to other children does he appear mentally backward,
Compared to other children does he appear mentally backward,
Compared to other children does he appear mentally backward,
Compared with other children of the same age, does (name) appear in any way mentally backward, dull or slow?
De jure children aged 2-14
1
Yes
2
No
9
Missing
Region
Region
Region
Region
Region
Region:
Households
2
Central (include BKK.)
3
North
4
Northeast
5
South
Changwat/Province
Changwat/Province
Changwat/Province
Changwat/Province
Changwat/Province
Area
Area
Area
Area
Area
Area:
Households
1
Urban
2
Rural
PSU_NO
PSU_NO
PSU_NO
PSU_NO
PSU_NO
Day of interview
Day of interview
Day of interview
Day of interview
Day of interview
Day/Month/Year of interview:
Households
Month of interview
Month of interview
Month of interview
Month of interview
Month of interview
Day/Month/Year of interview:
Households
Year of interview
Year of interview
Year of interview
Year of interview
Year of interview
Day/Month/Year of interview:
Households
Respondent HH questionnaire
Respondent HH questionnaire
Respondent HH questionnaire
Respondent HH questionnaire
Respondent HH questionnaire
Respondent to HH questionnaire:
Households
99
Missing
Number of household members
Number of household members
Number of household members
Number of household members
Number of household members
Total number of household members:
Households
Total eligible women
Total eligible women
Total eligible women
Total eligible women
Total eligible women
No.of women eligible for interview:
Households
Women interviews completed
Women interviews completed
Women interviews completed
Women interviews completed
Women interviews completed
No.of women questionnaires completed:
Households
Total children under 5
Total children under 5
Total children under 5
Total children under 5
Total children under 5
No.of children under age 5:
Households
Child interviews completed
Child interviews completed
Child interviews completed
Child interviews completed
Child interviews completed
No.of under-5 questionnaires completed:
Households
Enu. Result
Enu. Result
Enu. Result
Enu. Result
Enu. Result
After all questionnaires for the household have been completed, fill in the following information: Result of HH interview:
Households
1
Completed
2
Refused
3
Not at home
4
HH not found/destroyed
6
Others
Main source of drinking water
Main source of drinking water
Main source of drinking water
Main source of drinking water
Main source of drinking water
What is the main source of drinking water for members of your household?
Households
11
Piped into dwelling
12
Piped into yard or plot
13
Public tap/standpipe
21
Tubewell/borehole
31
Protected well
32
Unprotected well
41
Protected spring
42
Unprotected spring
51
Rainwater collection
61
Tanker-truck
81
Surface water
91
Bottled water
96
Other
99
Missing
Main source of water used for other purposes (if bottled wat
Main source of water used for other purposes (if bottled wat
Main source of water used for other purposes (if bottled wat
Main source of water used for other purposes (if bottled wat
Main source of water used for other purposes (if bottled wat
What is the main source of water used by your household for other purposes such as cooking and handwashing?
Households
11
Piped into dwelling
12
Piped into yard or plot
13
Public tap/standpipe
21
Tubewell/borehole
31
Protected well
32
Unprotected well
41
Protected spring
42
Unprotected spring
51
Rainwater collection
61
Tanker-truck
81
Surface water
96
Other
99
Missing
Time to get water and come back
Time to get water and come back
Time to get water and come back
Time to get water and come back
Time to get water and come back
How long does it take to go there, get water, and come back?
Households
995
On premises
998
DK
999
Missing
Person fetching water
Person fetching water
Person fetching water
Person fetching water
Person fetching water
Who usually goes to this source to fetch the water for your household? Probe: Is this person under age 15? What sex?
Circle code that best describes this person.
Households
1
Adult woman
2
Adult man
3
Female child (under 15)
4
Male child (under 15)
8
DK
9
Missing
Treat water to make safer for drinking
Treat water to make safer for drinking
Treat water to make safer for drinking
Treat water to make safer for drinking
Treat water to make safer for drinking
Do you treat your water in any way to make it safer to drink?
Households
1
Yes
2
No
8
DK
9
Missing
Boil
Boil
Boil
Boil
Boil
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
Households
?
Missing
A
Boil
Add bleach/chlorine
Add bleach/chlorine
Add bleach/chlorine
Add bleach/chlorine
Add bleach/chlorine
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
Households
?
Missing
B
Add bleach/chlorine
Strain it through a cloth
Strain it through a cloth
Strain it through a cloth
Strain it through a cloth
Strain it through a cloth
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
Households
?
Missing
C
Strain it through a cloth
Use water filter
Use water filter
Use water filter
Use water filter
Use water filter
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
Households
?
Missing
D
Use water filter
Solar disinfection
Solar disinfection
Solar disinfection
Solar disinfection
Solar disinfection
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
Households
?
Missing
E
Solar disinfection
Let it stand and settle
Let it stand and settle
Let it stand and settle
Let it stand and settle
Let it stand and settle
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
Households
?
Missing
F
Let it stand and settle
Other
Other
Other
Other
Other
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
Households
?
Missing
X
Other
DK
DK
DK
DK
DK
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
Households
?
Missing
Z
DK
Kind of toilet facility
Kind of toilet facility
Kind of toilet facility
Kind of toilet facility
Kind of toilet facility
What kind of toilet facility do members of your household usually use? If "flush" or "pour flush", probe: Where does it flush to?
If necessary, ask permission to observe the facility.
Households
11
Flush to piped sewer system
12
Flush to septic tank
13
Flush to pit (latrine)
14
Flush to somewhere else
15
Flush to unknown place/not sure/DK where
22
Pit latrine with slab
23
Pit latrine without slab/open pit
95
No facilities or bush or field
96
Other
99
Missing
Toilet facility shared
Toilet facility shared
Toilet facility shared
Toilet facility shared
Toilet facility shared
Do you share this facility with other households?
Households
1
Yes
2
No
9
Missing
Households using this toilet facility
Households using this toilet facility
Households using this toilet facility
Households using this toilet facility
Households using this toilet facility
How many households in total use this toilet facility?
Households
10
Ten or more households
98
DK
99
Missing
Religion of head
Religion of head
Religion of head
Religion of head
Religion of head
What is the religion of the head of this household?
Households
1
Buddhist
2
Muslim
3
Christian
6
Other religion
7
No religion
9
Missing
Language
Language
Language
Language
Language
What is the mother tongue/native language of the head of this household?
Households
1
Thai
2
Other Languages
3
Missing
Ethnic group of head
Ethnic group of head
Ethnic group of head
Ethnic group of head
Ethnic group of head
To what ethnic group does the head of this household belong?
Households
1
Thai
2
Cambodia
3
Loas
4
China
5
Myanmar
6
Other Ethnic
7
Hill Tribe
9
Missing
Head of occupation
Head of occupation
Head of occupation
Head of occupation
Head of occupation
1
Government Officer
2
State Enterprises Officer
3
Private Officer
4
Business
5
Agriculturist
6
Labourer
7
Other
9
Missing
Mean of income
Mean of income
Mean of income
Mean of income
Mean of income
1
Lower 10000
2
10000-19999
3
20000-29999
4
30000-39999
5
40000-49999
6
Upper 50000
9
Missing
Number of rooms for sleeping
Number of rooms for sleeping
Number of rooms for sleeping
Number of rooms for sleeping
Number of rooms for sleeping
How many rooms in this household are used for sleeping?
Households
99
Missing
Main material of floor
Main material of floor
Main material of floor
Main material of floor
Main material of floor
Main material of the dwelling floor:
Record observation.
Households
11
Earth/sand
21
Wood planks
22
Palm/bamboo
31
Parquet or polished wood
32
Vinyl or asphalt strips
33
Ceramic tiles
34
Cement
35
Carpet
36
Marble
37
Polished stone
96
Other
99
Missing
Main material of roof
Main material of roof
Main material of roof
Main material of roof
Main material of roof
Main material of the roof.
Record observation.
Households
11
No roof
12
Thatch/palm leaf
13
Sod
22
Palm/bamboo
23
Wood Planks
31
Metal
33
Calamine/cement fiber
34
Ceramic tiles
35
Cement
36
Roofing shingles
96
Other
99
Missing
Main material of wall
Main material of wall
Main material of wall
Main material of wall
Main material of wall
Main material of the walls.
Record observation.
Households
11
No walls
12
Cane/palm/trunks
13
Dirt
24
Plywood
25
Carton
26
Reused wood
27
Bamboo
31
Cement
32
Stone with lime/cement
33
Bricks
34
Cement blocks
36
Wood planks/shingles
37
Zinc
38
Tile
39
Shera wood
96
Other
99
Missing
Type of fuel using for cooking
Type of fuel using for cooking
Type of fuel using for cooking
Type of fuel using for cooking
Type of fuel using for cooking
What type of fuel does your household mainly use for cooking?
Households
1
Electricity
2
Liquid propane gas (LPG)
4
Biogas
5
Kerosene
6
Coal/lignite
7
Charcoal
8
Wood
9
Straw/shrubs/grass
10
Animal dung
11
Agricultural crop residue
96
Other
97
No Cooking
99
Missing
Food cooked on stove or open fire
Food cooked on stove or open fire
Food cooked on stove or open fire
Food cooked on stove or open fire
Food cooked on stove or open fire
In this household, is food cooked on an open fire, an open stove or a closed stove?
Probe for type.
Households
1
Open fire
2
Open stove
3
Closed stove
6
Other
9
Missing
Does the fire stove have a chimney or a hood
Does the fire stove have a chimney or a hood
Does the fire stove have a chimney or a hood
Does the fire stove have a chimney or a hood
Does the fire stove have a chimney or a hood
Does the fire/stove have a chimney or a hood?
Households
1
Yes
2
No
9
Missing
Cooking location
Cooking location
Cooking location
Cooking location
Cooking location
Is the cooking usually done in the house, in a separate building, or outdoors?
Households
1
In the house
2
In a separate bulding
3
Outdoors
4
Terrace
6
Other
9
Missing
Electricity
Electricity
Electricity
Electricity
Electricity
Does your household have:
Households
1
Yes
2
No
9
Missing
Radio
Radio
Radio
Radio
Radio
Does your household have:
Households
1
Yes
2
No
9
Missing
Television
Television
Television
Television
Television
Does your household have:
Households
1
Yes
2
No
9
Missing
Mobile phone
Mobile phone
Mobile phone
Mobile phone
Mobile phone
Does your household have:
Households
1
Yes
2
No
9
Missing
Non-mobile phone
Non-mobile phone
Non-mobile phone
Non-mobile phone
Non-mobile phone
Does your household have:
Households
1
Yes
2
No
9
Missing
Refrigerator
Refrigerator
Refrigerator
Refrigerator
Refrigerator
Does your household have:
Households
1
Yes
2
No
9
Missing
Computer
Computer
Computer
Computer
Computer
Watch
Watch
Watch
Watch
Watch
Does any member of your household own:
Households
1
Yes
2
No
9
Missing
Bicycle
Bicycle
Bicycle
Bicycle
Bicycle
Does any member of your household own:
Households
1
Yes
2
No
9
Missing
Motorcycle or scooter
Motorcycle or scooter
Motorcycle or scooter
Motorcycle or scooter
Motorcycle or scooter
Does any member of your household own:
Households
1
Yes
2
No
9
Missing
Animal-drawn cart
Animal-drawn cart
Animal-drawn cart
Animal-drawn cart
Animal-drawn cart
Does any member of your household own:
Households
1
Yes
2
No
9
Missing
Car or truck
Car or truck
Car or truck
Car or truck
Car or truck
Does any member of your household own:
Households
1
Yes
2
No
9
Missing
Boat with motor
Boat with motor
Boat with motor
Boat with motor
Boat with motor
Does any member of your household own:
Households
1
Yes
2
No
9
Missing
Household sample weight
Household sample weight
Household sample weight
Household sample weight
Household sample weight
Recoded variable
De jure household members (usual residents)
REGR factor score 1 for analysis 1
REGR factor score 1 for analysis 1
REGR factor score 1 for analysis 1
REGR factor score 1 for analysis 1
REGR factor score 1 for analysis 1
Recoded variable
Children aged 0-4
wealth index quintiles
wealth index quintiles
wealth index quintiles
wealth index quintiles
wealth index quintiles
Recoded variable
Children aged 0-4
1
Poorest
2
Second
3
Middle
4
Fourth
5
Richest
Mother's line number
Mother's line number
Mother's line number
Mother's line number
Mother's line number
Recoded variable
De jure household members (usual residents)
The variable is created from information collected in the houshold listing in the HL file. See makehl.sps in the data processing external documentation.
Mother's education
Mother's education
Mother's education
Mother's education
Mother's education
Recoded variable
Children aged 0-4
1
None
2
Primary
3
Secondary +
The variable is created from information collected on educational level in the HL file. See makewm.sps in the data processing folder under technical information.
Father's line number
Father's line number
Father's line number
Father's line number
Father's line number
Recoded variable
De jure household members (usual residents)
The variable is created from information collected in the houshold listing in the HL file. See makehl.sps in the data processing external documentation.
Father's education
Father's education
Father's education
Father's education
Father's education
Recoded variable
De jure household members (usual residents)
1
None
2
Primary
3
Secondary +
The variable is created from information collected on educational level in the HL file. See makehl.sps in the data processing folder under technical information.
Household head's education
Household head's education
Household head's education
Household head's education
Household head's education
Recoded variable
De jure household members (usual residents)
1
None
2
Primary
3
Secondary +
The variable is created from information collected on educational level in the HL file. See makehh.sps in the data processing folder under technical information.
Cluster number
Cluster number
Cluster number
Cluster number
Cluster number
We are from (COUNTRY-SPECIFIC AFFILIATION). We are working on a project concerned with family health and education. I would like to talk to you about this. The interview will take about (NUMBER) minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. During this time I would like to speak with the household head and all mothers or others who take care of children in the household. May I start now? If permission is given, begin the interview. Cluster number:
Households
Unique identifier for the cluster in which the household exists
Household number
Household number
Household number
Household number
Household number
Household number:
Households
Houshold number within the cluster
Line number
Line number
Line number
Line number
Line number
Child's line number:
Children aged 0-4
Cluster number
Cluster number
Cluster number
Cluster number
Cluster number
Cluster number:
Women aged 15-49
Household number
Household number
Household number
Household number
Household number
Household number:
Women aged 15-49
Woman's line number
Woman's line number
Woman's line number
Woman's line number
Woman's line number
Woman's Line Number:
Women aged 15-49
Day of interview
Day of interview
Day of interview
Day of interview
Day of interview
Day/Month/Year of interview:
Women aged 15-49
Month of interview
Month of interview
Month of interview
Month of interview
Month of interview
Day/Month/Year of interview:
Women aged 15-49
Year of interview
Year of interview
Year of interview
Year of interview
Year of interview
Day/Month/Year of interview:
Women aged 15-49
Result of women 's interview
Result of women 's interview
Result of women 's interview
Result of women 's interview
Result of women 's interview
Result of women's interview
Women aged 15-49
1
Completed
2
Not at home
3
Refused
5
Incapacitated
6
Other (specify)
Month of birth of woman
Month of birth of woman
Month of birth of woman
Month of birth of woman
Month of birth of woman
Repeat greeting if not already read to this woman: We are from (COUNTRY-SPECIFIC AFFILIATION). We are working on a project concerned with family health and education. I would like to talk to you about this. The interview will take about (NUMBER) minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. Also, you are not obliged to answer any question you don't want to, and you may withdraw from the interview at any time. May I start now? If permission is given, begin the interview. If the woman does not agree to continue, thank her, complete WM7, and go to the next interview. Discuss this result with your supervisor for a future revisit.
In what month and year were you born?
Women aged 15-49
97
Inconsistent
98
DK
99
Missing
Year of birth of woman
Year of birth of woman
Year of birth of woman
Year of birth of woman
Year of birth of woman
Repeat greeting if not already read to this woman: We are from (COUNTRY-SPECIFIC AFFILIATION). We are working on a project concerned with family health and education. I would like to talk to you about this. The interview will take about (NUMBER) minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. Also, you are not obliged to answer any question you don't want to, and you may withdraw from the interview at any time. May I start now? If permission is given, begin the interview. If the woman does not agree to continue, thank her, complete WM7, and go to the next interview. Discuss this result with your supervisor for a future revisit.
In what month and year were you born?
Women aged 15-49
9997
Inconsistent
9998
DK
9999
Missing
Age of woman
Age of woman
Age of woman
Age of woman
Age of woman
How old were you at your last birthday?
Women aged 15-49
Have you ever attended school
Have you ever attended school
Have you ever attended school
Have you ever attended school
Have you ever attended school
Have you ever attended school?
Women aged 15-49
1
Yes
2
No
9
Missing
What is the highest level of school you attended
What is the highest level of school you attended
What is the highest level of school you attended
What is the highest level of school you attended
What is the highest level of school you attended
What is the highest level of school you attended: primary, secondary, or higher?
Women aged 15-49
1
Primary
2
Secondary
3
Higher
6
Non-standard curriculum
9
Missing
What is the highest grade completed at that level
What is the highest grade completed at that level
What is the highest grade completed at that level
What is the highest grade completed at that level
What is the highest grade completed at that level
What is the highest grade you completed at that level?
Women aged 15-49
No education
97
Inconsistent
98
DK
99
Missing
Can read part of the sentence
Can read part of the sentence
Can read part of the sentence
Can read part of the sentence
Can read part of the sentence
Check WM11: Secondary or higher. Go to Next Module Primary or non-standard curriculum. Continue with WM14
Now I would like you to read this sentence to me. Show sentences to respondent. If respondent cannot read whole sentence, probe: Can you read part of the sentence to me?
Example sentences for literacy test: 1. The child is reading a book. 2. The rains came late this year. 3. Parents must care for their children. 4. Farming is hard work
Women aged 15-49
1
Cannot read at all
2
Able to read only parts of sentence
3
Able to read whole sentence
4
Required language
5
Blind/visually impaired
9
Missing
Ever given birth
Ever given birth
Ever given birth
Ever given birth
Ever given birth
Now i would like to ask about all the births you have had during your life. Have you ever given birth? If "No" probe by asking: I mean, to a child who ever breathed or cried or showed other signs of life - even if he or she lived only a few minutes or hours?
Women aged 15-49
1
Yes
2
No
Day of first birth
Day of first birth
Day of first birth
Day of first birth
Day of first birth
What was the date of your first birth? I mean the very first time you gave birth, even if the child is no longer living, or whose father is not your current partner.
Skip to CM3 only if year of first birth is given. Otherwise, continue with CM2B.
Women aged 15-49
97
Inconsistent
98
DK
99
Missing
Month of first birth
Month of first birth
Month of first birth
Month of first birth
Month of first birth
What was the date of your first birth? I mean the very first time you gave birth, even if the child is no longer living, or whose father is not your current partner.
Skip to CM3 only if year of first birth is given. Otherwise, continue with CM2B.
Women aged 15-49
97
Inconsistent
98
DK
99
Missing
Year of first birth
Year of first birth
Year of first birth
Year of first birth
Year of first birth
What was the date of your first birth? I mean the very first time you gave birth, even if the child is no longer living, or whose father is not your current partner.
Skip to CM3 only if year of first birth is given. Otherwise, continue with CM2B.
Women aged 15-49
9997
Inconsistent
9998
DK
9999
Missing
Years since first birth
Years since first birth
Years since first birth
Years since first birth
Years since first birth
How many years ago did you have your first birth?
Women aged 15-49
97
Inconsistent
99
Missing
Any sons or daughters living with you
Any sons or daughters living with you
Any sons or daughters living with you
Any sons or daughters living with you
Any sons or daughters living with you
Do you have any sons or daughters to whom you have given birth who are now living with you?
Women aged 15-49
1
Yes
2
No
Sons living with you
Sons living with you
Sons living with you
Sons living with you
Sons living with you
How many sons live with you?
Women aged 15-49
Daughters living with you
Daughters living with you
Daughters living with you
Daughters living with you
Daughters living with you
How many daughters live with you?
Women aged 15-49
Any sons or daughters not living with you
Any sons or daughters not living with you
Any sons or daughters not living with you
Any sons or daughters not living with you
Any sons or daughters not living with you
Do you have any sons or daughters to whom you have given birth who are alive but do not live with you?
Women aged 15-49
1
Yes
2
No
Sons living not with you
Sons living not with you
Sons living not with you
Sons living not with you
Sons living not with you
How many sons are alive but do not live with you?
Women aged 15-49
Daughters not living with you
Daughters not living with you
Daughters not living with you
Daughters not living with you
Daughters not living with you
How many daughters are alive but do not live with you?
Women aged 15-49
Ever had child who later died
Ever had child who later died
Ever had child who later died
Ever had child who later died
Ever had child who later died
Have you ever given birth to a boy or girl who was born alive but later died?
Women aged 15-49
1
Yes
2
No
Boys dead
Boys dead
Boys dead
Boys dead
Boys dead
How many boys have died?
Women aged 15-49
Girls dead
Girls dead
Girls dead
Girls dead
Girls dead
How many girls have died?
Women aged 15-49
Children ever born
Children ever born
Children ever born
Children ever born
Children ever born
Sum answers to CM4, CM6, and CM8.
Just to make sure that I have this right, you have had in total (total number) births during your life. Is this correct? Yes. Go to CM11 No. Check responses and make corrections before proceeding to CM11
Women aged 15-49
Day of last birth
Day of last birth
Day of last birth
Day of last birth
Day of last birth
Of these (total number) births you have had, when did you deliver the last one (even if he or she has died)?
If day is not known, enter '98' in space for day.
Women aged 15-49
97
Inconsistent
98
DK
99
Missing
Month of last birth
Month of last birth
Month of last birth
Month of last birth
Month of last birth
Of these (total number) births you have had, when did you deliver the last one (even if he or she has died)?
Women aged 15-49
97
Inconsistent
Year of last birth
Year of last birth
Year of last birth
Year of last birth
Year of last birth
Of these (total number) births you have had, when did you deliver the last one (even if he or she has died)?
Women aged 15-49
9997
Inconsistent
Live birth in last 2 years
Live birth in last 2 years
Live birth in last 2 years
Live birth in last 2 years
Live birth in last 2 years
Check CM11: Did the woman's last birth occur within the last 2 years, that is, since (day and month of interview in 2003)? If child has died, take special care when referring to this child by name in the following modules. No live birth in last 2 years. Go to MARRIAGE/UNION module. Yes, live birth in last 2 years. Continue with CM13 Name of child_______________________
Women aged 15-49
N
No
Y
Yes
Wanted last child
Wanted last child
Wanted last child
Wanted last child
Wanted last child
At the time you became pregnant with (name), did you want to become pregnant then, did you want to wait until later, or did you want no (more) children at all?
Women aged 15-49
1
Then
2
later
3
No more
9
Missing
Has immunization card
Has immunization card
Has immunization card
Has immunization card
Has immunization card
This module is to be administered to all women with a live birth in the 2 years preceding date of interview.
Do you have a card or other document with your own immunizations listed?
If a card is presented, use it to assist with answers to the following questions.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
1
Yes (card seen)
2
Yes (card not seen)
3
No
8
DK
9
Missing
Any tetanus toxoid injection during last pregnancy
Any tetanus toxoid injection during last pregnancy
Any tetanus toxoid injection during last pregnancy
Any tetanus toxoid injection during last pregnancy
Any tetanus toxoid injection during last pregnancy
When you were pregnant with your last child, did you receive any injection to prevent him or her from getting tetanus, that is convulsions after birth (an anti-tetanus shot, an injection at the top of the arm or shoulder)?
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
1
Yes
2
No
8
DK
9
Missing
Doses of tetanus toxoid during last pregnancy
Doses of tetanus toxoid during last pregnancy
Doses of tetanus toxoid during last pregnancy
Doses of tetanus toxoid during last pregnancy
Doses of tetanus toxoid during last pregnancy
If yes: How many times did you receive this anti-tetanus injection during your last pregnancy?
How many TT doses during last pregnancy were reported in TT3? At least two TT injections during last pregnancy. Go to Next Module Fewer than two TT injections during last pregnancy. Continue with TT5
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
98
DK
99
Missing
Any tetanus toxoid injection before last pregnancy
Any tetanus toxoid injection before last pregnancy
Any tetanus toxoid injection before last pregnancy
Any tetanus toxoid injection before last pregnancy
Any tetanus toxoid injection before last pregnancy
Did you receive any tetanus toxoid injection at any time before your last pregnancy?
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
1
Yes
2
No
8
DK
9
Missing
Doses of tetanus toxoid before last pregnancy
Doses of tetanus toxoid before last pregnancy
Doses of tetanus toxoid before last pregnancy
Doses of tetanus toxoid before last pregnancy
Doses of tetanus toxoid before last pregnancy
How many times did you receive it?
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
98
DK
99
Missing
Month last tetanus toxoid received
Month last tetanus toxoid received
Month last tetanus toxoid received
Month last tetanus toxoid received
Month last tetanus toxoid received
In what month and year did you receive the last anti-tetanus injection before that last pregnancy?
Skip to next module only if year of injection is given. Otherwise, continue with TT8.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
97
Inconsistent
98
DK
99
Missing
Year last tetanus toxoid received
Year last tetanus toxoid received
Year last tetanus toxoid received
Year last tetanus toxoid received
Year last tetanus toxoid received
In what month and year did you receive the last anti-tetanus injection before that last pregnancy?
Skip to next module only if year of injection is given. Otherwise, continue with TT8.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
9997
Inconsistent
9998
DK
9999
Missing
Years ago last tetanus toxoid received
Years ago last tetanus toxoid received
Years ago last tetanus toxoid received
Years ago last tetanus toxoid received
Years ago last tetanus toxoid received
How many years ago did you receive the last anti-tetanus injection before that last pregnancy?
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
99
Missing
Antenatal care: Doctor
Antenatal care: Doctor
Antenatal care: Doctor
Antenatal care: Doctor
Antenatal care: Doctor
Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else?
Probe for the type of person seen and circle all answers given.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
?
Missing
A
Doctor
Antenatal care: Nurse/midwife
Antenatal care: Nurse/midwife
Antenatal care: Nurse/midwife
Antenatal care: Nurse/midwife
Antenatal care: Nurse/midwife
Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else?
Probe for the type of person seen and circle all answers given.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
?
Missing
B
Nurse/midwife
Antenatal care: Auxilary midwife
Antenatal care: Auxilary midwife
Antenatal care: Auxilary midwife
Antenatal care: Auxilary midwife
Antenatal care: Auxilary midwife
Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else?
Probe for the type of person seen and circle all answers given.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
?
Missing
C
Auxiliary/midwife
Antenatal care: Traditional birth attendant
Antenatal care: Traditional birth attendant
Antenatal care: Traditional birth attendant
Antenatal care: Traditional birth attendant
Antenatal care: Traditional birth attendant
Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else?
Probe for the type of person seen and circle all answers given.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
?
Missing
F
Traditional birth attendance
Antenatal care: Community health worker
Antenatal care: Community health worker
Antenatal care: Community health worker
Antenatal care: Community health worker
Antenatal care: Community health worker
Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else?
Probe for the type of person seen and circle all answers given.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
?
Missing
G
Community/health worker
Antenatal care: Relative/friend
Antenatal care: Relative/friend
Antenatal care: Relative/friend
Antenatal care: Relative/friend
Antenatal care: Relative/friend
Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else?
Probe for the type of person seen and circle all answers given.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
?
Missing
H
Relative/friend
Antenatal care: Other
Antenatal care: Other
Antenatal care: Other
Antenatal care: Other
Antenatal care: Other
Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else?
Probe for the type of person seen and circle all answers given.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
?
Missing
X
Other
Antenatal care: No one
Antenatal care: No one
Antenatal care: No one
Antenatal care: No one
Antenatal care: No one
Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else?
Probe for the type of person seen and circle all answers given.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
?
Missing
Y
No one
Weighed
Weighed
Weighed
Weighed
Weighed
As part of your antenatal care, were any of the following done at least once? Were you weighed?
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
1
Yes
2
No
9
Missing
Blood pressure measured
Blood pressure measured
Blood pressure measured
Blood pressure measured
Blood pressure measured
As part of your antenatal care, were any of the following done at least once? Was your blood pressure measured?
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
1
Yes
2
No
9
Missing
Urine sample
Urine sample
Urine sample
Urine sample
Urine sample
As part of your antenatal care, were any of the following done at least once? Did you give a urine sample?
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
1
Yes
2
No
9
Missing
Blood sample
Blood sample
Blood sample
Blood sample
Blood sample
As part of your antenatal care, were any of the following done at least once? Did you give a blood sample?
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
1
Yes
2
No
9
Missing
Counseled about AIDS or the AIDS virus
Counseled about AIDS or the AIDS virus
Counseled about AIDS or the AIDS virus
Counseled about AIDS or the AIDS virus
Counseled about AIDS or the AIDS virus
During any of the antenatal visits for the pregnancy, were you given any information or counseled about AIDS or the AIDS virus?
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
1
Yes
2
No
8
DK
9
Missing
Tested for HIV/AIDS
Tested for HIV/AIDS
Tested for HIV/AIDS
Tested for HIV/AIDS
Tested for HIV/AIDS
I don't want to know the results, but were you tested for HIV/AIDS as part of your antenatal care?
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
1
Yes
2
No
8
DK
9
Missing
Received result of HIV test
Received result of HIV test
Received result of HIV test
Received result of HIV test
Received result of HIV test
I don't want to know the results, but did you get the results of the test?
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
1
Yes
2
No
8
DK
9
Missing
Assistance at delivery: Doctor
Assistance at delivery: Doctor
Assistance at delivery: Doctor
Assistance at delivery: Doctor
Assistance at delivery: Doctor
Who assisted with the delivery of your last child (name)? Anyone else?
Probe for the type of person assisting and circle all answers given.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
?
Missing
A
Doctor
Assistance at delivery: Nurse/midwife
Assistance at delivery: Nurse/midwife
Assistance at delivery: Nurse/midwife
Assistance at delivery: Nurse/midwife
Assistance at delivery: Nurse/midwife
Who assisted with the delivery of your last child (name)? Anyone else?
Probe for the type of person assisting and circle all answers given.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
?
Missing
B
Nurse/midwife
Assistance at delivery: Auxiliary midwife
Assistance at delivery: Auxiliary midwife
Assistance at delivery: Auxiliary midwife
Assistance at delivery: Auxiliary midwife
Assistance at delivery: Auxiliary midwife
Who assisted with the delivery of your last child (name)? Anyone else?
Probe for the type of person assisting and circle all answers given.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
?
Missing
C
Auxiliary/midwife
Assistance at delivery: Traditional birth attendant
Assistance at delivery: Traditional birth attendant
Assistance at delivery: Traditional birth attendant
Assistance at delivery: Traditional birth attendant
Assistance at delivery: Traditional birth attendant
Who assisted with the delivery of your last child (name)? Anyone else?
Probe for the type of person assisting and circle all answers given.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
?
Missing
F
Traditional birth attendance
Assistance at delivery: Community health worker
Assistance at delivery: Community health worker
Assistance at delivery: Community health worker
Assistance at delivery: Community health worker
Assistance at delivery: Community health worker
Who assisted with the delivery of your last child (name)? Anyone else?
Probe for the type of person assisting and circle all answers given.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
?
Missing
G
Community/health worker
Assistance at delivery: Relative/friend
Assistance at delivery: Relative/friend
Assistance at delivery: Relative/friend
Assistance at delivery: Relative/friend
Assistance at delivery: Relative/friend
Who assisted with the delivery of your last child (name)? Anyone else?
Probe for the type of person assisting and circle all answers given.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
?
Missing
H
Relative/friend
Assistance at delivery: Other
Assistance at delivery: Other
Assistance at delivery: Other
Assistance at delivery: Other
Assistance at delivery: Other
Who assisted with the delivery of your last child (name)? Anyone else?
Probe for the type of person assisting and circle all answers given.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
?
Missing
X
Other
Assistance at delivery: No one
Assistance at delivery: No one
Assistance at delivery: No one
Assistance at delivery: No one
Assistance at delivery: No one
Who assisted with the delivery of your last child (name)? Anyone else?
Probe for the type of person assisting and circle all answers given.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
?
Missing
Y
No one
Place of delivery
Place of delivery
Place of delivery
Place of delivery
Place of delivery
Where did you give birth to (NAME)?
If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
11
Resondent's home
12
Other home
21
Government hospital
22
Government clinic/health center
26
Other public
31
Private hospital
32
Private clinic
36
Other private medical
96
Other
99
Missing
Size of child at birth
Size of child at birth
Size of child at birth
Size of child at birth
Size of child at birth
When your last child (name) was born, was he/she very large, larger than average, average, smaller than average, or very small?
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
1
Very large
2
Larger than average
3
Average
4
Smaller than average
5
Very small
8
DK
9
Missing
Child weighed at birth
Child weighed at birth
Child weighed at birth
Child weighed at birth
Child weighed at birth
Was (name) weighed at birth?
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
1
Yes
2
No
8
DK
9
Missing
Weight from card or recall
Weight from card or recall
Weight from card or recall
Weight from card or recall
Weight from card or recall
How much did (name) weigh?
Record weight from health card, if available.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
1
Card
2
Recall
7
Inconsistent
9
Missing
Weight at birth (Kilograms)
Weight at birth (Kilograms)
Weight at birth (Kilograms)
Weight at birth (Kilograms)
Weight at birth (Kilograms)
How much did (name) weigh?
Record weight from health card, if available.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
9.998
DK
9.999
Missing
Ever breastfeed
Ever breastfeed
Ever breastfeed
Ever breastfeed
Ever breastfeed
Did you ever breastfeed (name)?
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
1
Yes
2
No
9
Missing
Time baby put to breast (unit)
Time baby put to breast (unit)
Time baby put to breast (unit)
Time baby put to breast (unit)
Time baby put to breast (unit)
How long after birth did you first put (name) to the breast?
If less than 1 hour, record '00' hours. If less than 24 hours, record hours. Otherwise, record days.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
Immediately
1
Hours
2
Days
9
Missing
Time baby put to breast (number)
Time baby put to breast (number)
Time baby put to breast (number)
Time baby put to breast (number)
Time baby put to breast (number)
How long after birth did you first put (name) to the breast?
If less than 1 hour, record '00' hours. If less than 24 hours, record hours. Otherwise, record days.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
98
DK
99
Missing
Currently married or living with a man
Currently married or living with a man
Currently married or living with a man
Currently married or living with a man
Currently married or living with a man
Are you currently married or living together with a man as if married?
Women aged 15-49
1
Yes, currently married
2
Yes, living with a man
3
No, not in union
9
Missing
Age of husband/partner
Age of husband/partner
Age of husband/partner
Age of husband/partner
Age of husband/partner
How old was your husband/partner on his last birthday?
Women aged 15-49
98
DK
99
Missing
Ever married or lived with a man
Ever married or lived with a man
Ever married or lived with a man
Ever married or lived with a man
Ever married or lived with a man
Have you ever been married or lived together with a man?
Women aged 15-49
1
Yes, formerly married
2
Yes, formerly lived with a man
3
No
9
Missing
Marital status
Marital status
Marital status
Marital status
Marital status
What is your marital status now: are you widowed, divorced or separated?
Women aged 15-49
1
Widowed
2
Divorced
3
Separated
9
Missing
Married or lived with a man once or more than once
Married or lived with a man once or more than once
Married or lived with a man once or more than once
Married or lived with a man once or more than once
Married or lived with a man once or more than once
Have you been married or lived with a man only once or more than once?
Women aged 15-49
1
Only once
2
More than once
9
Missing
Month of first union
Month of first union
Month of first union
Month of first union
Month of first union
In what month and year did you first marry or start living with a man as if married?
Women aged 15-49
97
Inconsistent
98
DK
99
Missing
Year of first union
Year of first union
Year of first union
Year of first union
Year of first union
In what month and year did you first marry or start living with a man as if married?
Women aged 15-49
9997
Inconsistent
9998
DK
9999
Missing
Age at first union
Age at first union
Age at first union
Age at first union
Age at first union
Check MA6: Both month and year of marriage/union known? Go to Next Module Either month or year of marriage/union not known? Continue with MA8
How old were you when you started living with your first husband/partner?
Women aged 15-49
97
Inconsistent
98
DK
99
Missing
Currently pregnant
Currently pregnant
Currently pregnant
Currently pregnant
Currently pregnant
I would like to talk with you about another subject - family planning - and your reproductive health.
Are you pregnant now?
Women aged 15-49
1
Yes, currently pregnant
2
No
8
Unsure or DK
9
Missing
Currently using a method to avoid pregnancy
Currently using a method to avoid pregnancy
Currently using a method to avoid pregnancy
Currently using a method to avoid pregnancy
Currently using a method to avoid pregnancy
Some people use various ways or methods to delay or avoid a pregnancy. Are you currently doing something or using any method to delay or avoid getting pregnant?
Women aged 15-49
1
Yes
2
No
9
Missing
Current method: Female sterilization
Current method: Female sterilization
Current method: Female sterilization
Current method: Female sterilization
Current method: Female sterilization
Which method are you using?
Do not prompt. If more than one method is mentioned, circle each one.
Women aged 15-49
?
Missing
A
Female sterilization
Current method: Male sterilization
Current method: Male sterilization
Current method: Male sterilization
Current method: Male sterilization
Current method: Male sterilization
Which method are you using?
Do not prompt. If more than one method is mentioned, circle each one.
Women aged 15-49
?
Missing
B
Male sterilization
Current method: Pill
Current method: Pill
Current method: Pill
Current method: Pill
Current method: Pill
Which method are you using?
Do not prompt. If more than one method is mentioned, circle each one.
Women aged 15-49
?
Missing
C
PILL
Current method: IUD
Current method: IUD
Current method: IUD
Current method: IUD
Current method: IUD
Which method are you using?
Do not prompt. If more than one method is mentioned, circle each one.
Women aged 15-49
?
Missing
D
IUD
Current method: Injections
Current method: Injections
Current method: Injections
Current method: Injections
Current method: Injections
Which method are you using?
Do not prompt. If more than one method is mentioned, circle each one.
Women aged 15-49
?
Missing
E
Injections
Current method: Implants
Current method: Implants
Current method: Implants
Current method: Implants
Current method: Implants
Which method are you using?
Do not prompt. If more than one method is mentioned, circle each one.
Women aged 15-49
?
Missing
F
Implants
Current method: Condom
Current method: Condom
Current method: Condom
Current method: Condom
Current method: Condom
Which method are you using?
Do not prompt. If more than one method is mentioned, circle each one.
Women aged 15-49
?
Missing
G
Condom
Current method: Lactational amenorrhea method
Current method: Lactational amenorrhea method
Current method: Lactational amenorrhea method
Current method: Lactational amenorrhea method
Current method: Lactational amenorrhea method
Which method are you using?
Do not prompt. If more than one method is mentioned, circle each one.
Women aged 15-49
?
Missing
K
Lactational amenorrhoea (LAM)
Current method: Periodic abstinence
Current method: Periodic abstinence
Current method: Periodic abstinence
Current method: Periodic abstinence
Current method: Periodic abstinence
Which method are you using?
Do not prompt. If more than one method is mentioned, circle each one.
Women aged 15-49
?
Missing
L
Periodic abstinence
Current method: Withdrawal
Current method: Withdrawal
Current method: Withdrawal
Current method: Withdrawal
Current method: Withdrawal
Which method are you using?
Do not prompt. If more than one method is mentioned, circle each one.
Women aged 15-49
?
Missing
M
Withdrawal
Current method: Other
Current method: Other
Current method: Other
Current method: Other
Current method: Other
Which method are you using?
Do not prompt. If more than one method is mentioned, circle each one.
Women aged 15-49
?
Missing
X
Other
Ever heard of HIV or AIDS
Ever heard of HIV or AIDS
Ever heard of HIV or AIDS
Ever heard of HIV or AIDS
Ever heard of HIV or AIDS
Now I would like to talk with you about something else.
Have you ever heard of the virus HIV or an illness called AIDS?
Women aged 15-49
1
Yes
2
No
9
Missing
Can avoid AIDS by having one unifected partner
Can avoid AIDS by having one unifected partner
Can avoid AIDS by having one unifected partner
Can avoid AIDS by having one unifected partner
Can avoid AIDS by having one unifected partner
Can people protect themselves from getting infected with the AIDS virus by having one sex partner who is not infected and also has no other partners?
Women aged 15-49
1
Yes
2
No
8
DK
9
Missing
Can get AIDS through supernatural means
Can get AIDS through supernatural means
Can get AIDS through supernatural means
Can get AIDS through supernatural means
Can get AIDS through supernatural means
Can people get infected with the AIDS virus because of witchcraft or other supernatural means?
Women aged 15-49
1
Yes
2
No
8
DK
9
Missing
Can avoid AIDS by using a condom correctly every time
Can avoid AIDS by using a condom correctly every time
Can avoid AIDS by using a condom correctly every time
Can avoid AIDS by using a condom correctly every time
Can avoid AIDS by using a condom correctly every time
Can people reduce their chance of getting the AIDS virus by using a condom every time they have sex?
Women aged 15-49
1
Yes
2
No
8
DK
9
Missing
Can get AIDS from mosquito bites
Can get AIDS from mosquito bites
Can get AIDS from mosquito bites
Can get AIDS from mosquito bites
Can get AIDS from mosquito bites
Can people get the AIDS virus from mosquito bites?
Women aged 15-49
1
Yes
2
No
8
DK
9
Missing
Can avoid AIDS by not having sex at all
Can avoid AIDS by not having sex at all
Can avoid AIDS by not having sex at all
Can avoid AIDS by not having sex at all
Can avoid AIDS by not having sex at all
Can people reduce their chance of getting infected with the AIDS virus by not having sex at all?
Women aged 15-49
1
Yes
2
No
8
DK
9
Missing
Can get AIDS by sharing food with person with AIDS virus
Can get AIDS by sharing food with person with AIDS virus
Can get AIDS by sharing food with person with AIDS virus
Can get AIDS by sharing food with person with AIDS virus
Can get AIDS by sharing food with person with AIDS virus
Can people get the AIDS virus by sharing food with a person who has AIDS?
Women aged 15-49
1
Yes
2
No
8
DK
9
Missing
Can get AIDS by injection with needle already used by someon
Can get AIDS by injection with needle already used by someon
Can get AIDS by injection with needle already used by someon
Can get AIDS by injection with needle already used by someon
Can get AIDS by injection with needle already used by someon
Can people get the AIDS virus by getting injections with a needle that was already used by someone else?
Women aged 15-49
1
Yes
2
No
8
DK
9
Missing
Healthy-looking person to have AIDS
Healthy-looking person to have AIDS
Healthy-looking person to have AIDS
Healthy-looking person to have AIDS
Healthy-looking person to have AIDS
Is it possible for a healthy-looking person to have the AIDS virus?
Women aged 15-49
1
Yes
2
No
8
DK
9
Missing
AIDS from mother to child during pregnancy
AIDS from mother to child during pregnancy
AIDS from mother to child during pregnancy
AIDS from mother to child during pregnancy
AIDS from mother to child during pregnancy
Can the AIDS virus be transmitted from a mother to a baby? During pregnancy?
Women aged 15-49
1
Yes
2
No
8
DK
9
Missing
AIDS from mother to child at delivery
AIDS from mother to child at delivery
AIDS from mother to child at delivery
AIDS from mother to child at delivery
AIDS from mother to child at delivery
Can the AIDS virus be transmitted from a mother to a baby? During delivery?
Women aged 15-49
1
Yes
2
No
8
DK
9
Missing
AIDS from mother to child through breastmilk
AIDS from mother to child through breastmilk
AIDS from mother to child through breastmilk
AIDS from mother to child through breastmilk
AIDS from mother to child through breastmilk
Can the AIDS virus be transmitted from a mother to a baby? By breastfeeding?
Women aged 15-49
1
Yes
2
No
8
DK
9
Missing
Should teacher with HIV/AIDS be allowed to teach in school
Should teacher with HIV/AIDS be allowed to teach in school
Should teacher with HIV/AIDS be allowed to teach in school
Should teacher with HIV/AIDS be allowed to teach in school
Should teacher with HIV/AIDS be allowed to teach in school
If a female teacher has the AIDS virus but is not sick, should she be allowed to continue teaching in school?
Women aged 15-49
1
Yes
2
No
8
DK/not sure/depends
9
Missing
Would buy fresh vegetables from shopseller with HIV/AIDS
Would buy fresh vegetables from shopseller with HIV/AIDS
Would buy fresh vegetables from shopseller with HIV/AIDS
Would buy fresh vegetables from shopseller with HIV/AIDS
Would buy fresh vegetables from shopseller with HIV/AIDS
Would you buy fresh vegetables from a shopkeeper or vendor if you knew that this person had the AIDS virus?
Women aged 15-49
1
Yes
2
No
8
DK/not sure/depends
9
Missing
If a member became infected with the virus, would you want i
If a member became infected with the virus, would you want i
If a member became infected with the virus, would you want i
If a member became infected with the virus, would you want i
If a member became infected with the virus, would you want i
If a member of your family became infected with the AIDS virus, would you want it to remain a secret?
Women aged 15-49
1
Yes
2
No
8
DK/not sure/depends
9
Missing
Willing to care for person with AIDS in household
Willing to care for person with AIDS in household
Willing to care for person with AIDS in household
Willing to care for person with AIDS in household
Willing to care for person with AIDS in household
If a member of your family became sick with the AIDS virus, would you be willing to care for him or her in your household?
Women aged 15-49
1
Yes
2
No
8
DK/not sure/depends
9
Missing
Region
Region
Region
Region
Region
Region:
Households
2
Central (include BKK.)
3
North
4
Northeast
5
South
Changwat/Province
Changwat/Province
Changwat/Province
Changwat/Province
Changwat/Province
Area
Area
Area
Area
Area
Area:
Households
1
Urban
2
Rural
PSU_NO
PSU_NO
PSU_NO
PSU_NO
PSU_NO
Day of interview
Day of interview
Day of interview
Day of interview
Day of interview
Day/Month/Year of interview:
Households
Month of interview
Month of interview
Month of interview
Month of interview
Month of interview
Day/Month/Year of interview:
Households
Year of interview
Year of interview
Year of interview
Year of interview
Year of interview
Day/Month/Year of interview:
Households
Respondent HH questionnaire
Respondent HH questionnaire
Respondent HH questionnaire
Respondent HH questionnaire
Respondent HH questionnaire
Respondent to HH questionnaire:
Households
99
Missing
Number of household members
Number of household members
Number of household members
Number of household members
Number of household members
Total number of household members:
Households
Total eligible women
Total eligible women
Total eligible women
Total eligible women
Total eligible women
No.of women eligible for interview:
Households
Women interviews completed
Women interviews completed
Women interviews completed
Women interviews completed
Women interviews completed
No.of women questionnaires completed:
Households
Total children under 5
Total children under 5
Total children under 5
Total children under 5
Total children under 5
No.of children under age 5:
Households
Child interviews completed
Child interviews completed
Child interviews completed
Child interviews completed
Child interviews completed
No.of under-5 questionnaires completed:
Households
Enu. Result
Enu. Result
Enu. Result
Enu. Result
Enu. Result
After all questionnaires for the household have been completed, fill in the following information: Result of HH interview:
Households
1
Completed
2
Refused
3
Not at home
4
HH not found/destroyed
6
Others
Main source of drinking water
Main source of drinking water
Main source of drinking water
Main source of drinking water
Main source of drinking water
What is the main source of drinking water for members of your household?
Households
11
Piped into dwelling
12
Piped into yard or plot
13
Public tap/standpipe
21
Tubewell/borehole
31
Protected well
32
Unprotected well
41
Protected spring
42
Unprotected spring
51
Rainwater collection
61
Tanker-truck
81
Surface water
91
Bottled water
96
Other
99
Missing
Main source of water used for other purposes (if bottled wat
Main source of water used for other purposes (if bottled wat
Main source of water used for other purposes (if bottled wat
Main source of water used for other purposes (if bottled wat
Main source of water used for other purposes (if bottled wat
What is the main source of water used by your household for other purposes such as cooking and handwashing?
Households
11
Piped into dwelling
12
Piped into yard or plot
13
Public tap/standpipe
21
Tubewell/borehole
31
Protected well
32
Unprotected well
41
Protected spring
42
Unprotected spring
51
Rainwater collection
61
Tanker-truck
81
Surface water
96
Other
99
Missing
Time to get water and come back
Time to get water and come back
Time to get water and come back
Time to get water and come back
Time to get water and come back
How long does it take to go there, get water, and come back?
Households
995
On premises
998
DK
999
Missing
Person fetching water
Person fetching water
Person fetching water
Person fetching water
Person fetching water
Who usually goes to this source to fetch the water for your household? Probe: Is this person under age 15? What sex?
Circle code that best describes this person.
Households
1
Adult woman
2
Adult man
3
Female child (under 15)
4
Male child (under 15)
8
DK
9
Missing
Treat water to make safer for drinking
Treat water to make safer for drinking
Treat water to make safer for drinking
Treat water to make safer for drinking
Treat water to make safer for drinking
Do you treat your water in any way to make it safer to drink?
Households
1
Yes
2
No
8
DK
9
Missing
Boil
Boil
Boil
Boil
Boil
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
Households
?
Missing
A
Boil
Add bleach/chlorine
Add bleach/chlorine
Add bleach/chlorine
Add bleach/chlorine
Add bleach/chlorine
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
Households
?
Missing
B
Add bleach/chlorine
Strain it through a cloth
Strain it through a cloth
Strain it through a cloth
Strain it through a cloth
Strain it through a cloth
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
Households
?
Missing
C
Strain it through a cloth
Use water filter
Use water filter
Use water filter
Use water filter
Use water filter
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
Households
?
Missing
D
Use water filter
Solar disinfection
Solar disinfection
Solar disinfection
Solar disinfection
Solar disinfection
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
Households
?
Missing
E
Solar disinfection
Let it stand and settle
Let it stand and settle
Let it stand and settle
Let it stand and settle
Let it stand and settle
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
Households
?
Missing
F
Let it stand and settle
Other
Other
Other
Other
Other
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
Households
?
Missing
X
Other
DK
DK
DK
DK
DK
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
Households
?
Missing
Z
DK
Kind of toilet facility
Kind of toilet facility
Kind of toilet facility
Kind of toilet facility
Kind of toilet facility
What kind of toilet facility do members of your household usually use? If "flush" or "pour flush", probe: Where does it flush to?
If necessary, ask permission to observe the facility.
Households
11
Flush to piped sewer system
12
Flush to septic tank
13
Flush to pit (latrine)
14
Flush to somewhere else
15
Flush to unknown place/not sure/DK where
22
Pit latrine with slab
23
Pit latrine without slab/open pit
95
No facilities or bush or field
96
Other
99
Missing
Toilet facility shared
Toilet facility shared
Toilet facility shared
Toilet facility shared
Toilet facility shared
Do you share this facility with other households?
Households
1
Yes
2
No
9
Missing
Households using this toilet facility
Households using this toilet facility
Households using this toilet facility
Households using this toilet facility
Households using this toilet facility
How many households in total use this toilet facility?
Households
10
Ten or more households
98
DK
99
Missing
Religion of head
Religion of head
Religion of head
Religion of head
Religion of head
What is the religion of the head of this household?
Households
1
Buddhist
2
Muslim
3
Christian
6
Other religion
7
No religion
9
Missing
Language
Language
Language
Language
Language
What is the mother tongue/native language of the head of this household?
Households
1
Thai
2
Other Languages
3
Missing
Ethnic group of head
Ethnic group of head
Ethnic group of head
Ethnic group of head
Ethnic group of head
To what ethnic group does the head of this household belong?
Households
1
Thai
2
Cambodia
3
Loas
4
China
5
Myanmar
6
Other Ethnic
7
Hill Tribe
9
Missing
Head of occupation
Head of occupation
Head of occupation
Head of occupation
Head of occupation
1
Government Officer
2
State Enterprises Officer
3
Private Officer
4
Business
5
Agriculturist
6
Labourer
7
Other
9
Missing
Mean of income
Mean of income
Mean of income
Mean of income
Mean of income
1
Lower 10000
2
10000-19999
3
20000-29999
4
30000-39999
5
40000-49999
6
Upper 50000
9
Missing
Number of rooms for sleeping
Number of rooms for sleeping
Number of rooms for sleeping
Number of rooms for sleeping
Number of rooms for sleeping
How many rooms in this household are used for sleeping?
Households
99
Missing
Main material of floor
Main material of floor
Main material of floor
Main material of floor
Main material of floor
Main material of the dwelling floor:
Record observation.
Households
11
Earth/sand
21
Wood planks
22
Palm/bamboo
31
Parquet or polished wood
32
Vinyl or asphalt strips
33
Ceramic tiles
34
Cement
35
Carpet
36
Marble
37
Polished stone
96
Other
99
Missing
Main material of roof
Main material of roof
Main material of roof
Main material of roof
Main material of roof
Main material of the roof.
Record observation.
Households
11
No roof
12
Thatch/palm leaf
13
Sod
22
Palm/bamboo
23
Wood Planks
31
Metal
33
Calamine/cement fiber
34
Ceramic tiles
35
Cement
36
Roofing shingles
96
Other
99
Missing
Main material of wall
Main material of wall
Main material of wall
Main material of wall
Main material of wall
Main material of the walls.
Record observation.
Households
11
No walls
12
Cane/palm/trunks
13
Dirt
24
Plywood
25
Carton
26
Reused wood
27
Bamboo
31
Cement
32
Stone with lime/cement
33
Bricks
34
Cement blocks
36
Wood planks/shingles
37
Zinc
38
Tile
39
Shera wood
96
Other
99
Missing
Type of fuel using for cooking
Type of fuel using for cooking
Type of fuel using for cooking
Type of fuel using for cooking
Type of fuel using for cooking
What type of fuel does your household mainly use for cooking?
Households
1
Electricity
2
Liquid propane gas (LPG)
4
Biogas
5
Kerosene
6
Coal/lignite
7
Charcoal
8
Wood
9
Straw/shrubs/grass
10
Animal dung
11
Agricultural crop residue
96
Other
97
No Cooking
99
Missing
Food cooked on stove or open fire
Food cooked on stove or open fire
Food cooked on stove or open fire
Food cooked on stove or open fire
Food cooked on stove or open fire
In this household, is food cooked on an open fire, an open stove or a closed stove?
Probe for type.
Households
1
Open fire
2
Open stove
3
Closed stove
6
Other
9
Missing
Does the fire stove have a chimney or a hood
Does the fire stove have a chimney or a hood
Does the fire stove have a chimney or a hood
Does the fire stove have a chimney or a hood
Does the fire stove have a chimney or a hood
Does the fire/stove have a chimney or a hood?
Households
1
Yes
2
No
9
Missing
Cooking location
Cooking location
Cooking location
Cooking location
Cooking location
Is the cooking usually done in the house, in a separate building, or outdoors?
Households
1
In the house
2
In a separate bulding
3
Outdoors
4
Terrace
6
Other
9
Missing
Electricity
Electricity
Electricity
Electricity
Electricity
Does your household have:
Households
1
Yes
2
No
9
Missing
Radio
Radio
Radio
Radio
Radio
Does your household have:
Households
1
Yes
2
No
9
Missing
Television
Television
Television
Television
Television
Does your household have:
Households
1
Yes
2
No
9
Missing
Mobile phone
Mobile phone
Mobile phone
Mobile phone
Mobile phone
Does your household have:
Households
1
Yes
2
No
9
Missing
Non-mobile phone
Non-mobile phone
Non-mobile phone
Non-mobile phone
Non-mobile phone
Does your household have:
Households
1
Yes
2
No
9
Missing
Refrigerator
Refrigerator
Refrigerator
Refrigerator
Refrigerator
Does your household have:
Households
1
Yes
2
No
9
Missing
Computer
Computer
Computer
Computer
Computer
Watch
Watch
Watch
Watch
Watch
Does any member of your household own:
Households
1
Yes
2
No
9
Missing
Bicycle
Bicycle
Bicycle
Bicycle
Bicycle
Does any member of your household own:
Households
1
Yes
2
No
9
Missing
Motorcycle or scooter
Motorcycle or scooter
Motorcycle or scooter
Motorcycle or scooter
Motorcycle or scooter
Does any member of your household own:
Households
1
Yes
2
No
9
Missing
Animal-drawn cart
Animal-drawn cart
Animal-drawn cart
Animal-drawn cart
Animal-drawn cart
Does any member of your household own:
Households
1
Yes
2
No
9
Missing
Car or truck
Car or truck
Car or truck
Car or truck
Car or truck
Does any member of your household own:
Households
1
Yes
2
No
9
Missing
Boat with motor
Boat with motor
Boat with motor
Boat with motor
Boat with motor
Does any member of your household own:
Households
1
Yes
2
No
9
Missing
Women's sample weight
Women's sample weight
Women's sample weight
Women's sample weight
Women's sample weight
Recoded variable
Women aged 15-49
REGR factor score 1 for analysis 1
REGR factor score 1 for analysis 1
REGR factor score 1 for analysis 1
REGR factor score 1 for analysis 1
REGR factor score 1 for analysis 1
Recoded variable
Children aged 0-4
wealth index quintiles
wealth index quintiles
wealth index quintiles
wealth index quintiles
wealth index quintiles
Recoded variable
Children aged 0-4
1
Poorest
2
Second
3
Middle
4
Fourth
5
Richest
Date of interview women (CMC)
Date of interview women (CMC)
Date of interview women (CMC)
Date of interview women (CMC)
Date of interview women (CMC)
Recoded variable
Women aged 15-49
Date of birth (CMC)
Date of birth (CMC)
Date of birth (CMC)
Date of birth (CMC)
Date of birth (CMC)
Recoded variable
Women aged 15-49
Age
Age
Age
Age
Age
Recoded variable
Women aged 15-49
1
15-19
2
20-24
3
25-29
4
30-34
5
35-39
6
40-44
7
45-49
Age at first marriage/union
Age at first marriage/union
Age at first marriage/union
Age at first marriage/union
Age at first marriage/union
Recoded variable
Women aged 15-49
Marital/Union status
Marital/Union status
Marital/Union status
Marital/Union status
Marital/Union status
Recoded variable
Women aged 15-49
1
Currently married/in union
2
Formerly married/in union
3
Never married/in union
Mother's education
Mother's education
Mother's education
Mother's education
Mother's education
Recoded variable
Children aged 0-4
1
None
2
Primary
3
Secondary +
The variable is created from information collected on educational level in the HL file. See makewm.sps in the data processing folder under technical information.
Children ever born
Children ever born
Children ever born
Children ever born
Children ever born
Recoded variable
Women aged 15-49
Obtained from infomation provided in the child mortality module of the women's questionnaire. See the makewm.sps in the data processing folder under technical information.
Dead children
Dead children
Dead children
Dead children
Dead children
Recoded variable
Women aged 15-49
Obtained from infomation provided in the child mortality module of the women's questionnaire. See the makewm.sps in the data processing folder under technical information.
Cluster number
Cluster number
Cluster number
Cluster number
Cluster number
We are from (COUNTRY-SPECIFIC AFFILIATION). We are working on a project concerned with family health and education. I would like to talk to you about this. The interview will take about (NUMBER) minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. During this time I would like to speak with the household head and all mothers or others who take care of children in the household. May I start now? If permission is given, begin the interview. Cluster number:
Households
Unique identifier for the cluster in which the household exists
Household number
Household number
Household number
Household number
Household number
Household number:
Households
Houshold number within the cluster
Line number
Line number
Line number
Line number
Line number
Child's line number:
Children aged 0-4
Cluster number
Cluster number
Cluster number
Cluster number
Cluster number
Cluster number:
Children aged 0-4
Household number
Household number
Household number
Household number
Household number
Household number:
Children aged 0-4
Child's line number
Child's line number
Child's line number
Child's line number
Child's line number
Child's line number:
Children aged 0-4
Caretaker's line number
Caretaker's line number
Caretaker's line number
Caretaker's line number
Caretaker's line number
Mother's/Caretaker's Line Number:
Children aged 0-4
Day of interview
Day of interview
Day of interview
Day of interview
Day of interview
Day/Month/Year of interview:
Children aged 0-4
Month of interview
Month of interview
Month of interview
Month of interview
Month of interview
Day/Month/Year of interview:
Children aged 0-4
Year of interview
Year of interview
Year of interview
Year of interview
Year of interview
Day/Month/Year of interview:
Children aged 0-4
Result of interview for chidren under 5
Result of interview for chidren under 5
Result of interview for chidren under 5
Result of interview for chidren under 5
Result of interview for chidren under 5
Result of interview for children under 5
Children aged 0-4
1
Completed
2
Not at home
3
Refused
5
Incapacitated
6
Other
Day of birth of child
Day of birth of child
Day of birth of child
Day of birth of child
Day of birth of child
Repeat greeting if not already read to this respondent: We are from (COUNTRY-SPECIFIC AFFILIATION). We are working on a project concerned with family health and education. I would like to talk to you about this. The interview will take about (NUMBER) minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. Also, you are not obliged to answer any question you don't want to, and you may withdraw from the interview at any time. May I start now? If permission is given, begin the interview. If the respondent does not agree to continue, thank him/her and go to the next interview. Discuss this result with your supervisor for a future revisit.
Now I would like to ask you some questions about the health of each child under the age of 5 in your care, who lives with you now. Now I want to ask you about (NAME). In what month and year was (NAME) born? Probe: What is his/her birthday?
If the mother/caretaker knows the exact birth date, also enter the day; otherwise, circle 98 for day.
Children aged 0-4
97
Inconsistent
98
DK
99
Missing
Month of birth of child
Month of birth of child
Month of birth of child
Month of birth of child
Month of birth of child
Repeat greeting if not already read to this respondent: We are from (COUNTRY-SPECIFIC AFFILIATION). We are working on a project concerned with family health and education. I would like to talk to you about this. The interview will take about (NUMBER) minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. Also, you are not obliged to answer any question you don't want to, and you may withdraw from the interview at any time. May I start now? If permission is given, begin the interview. If the respondent does not agree to continue, thank him/her and go to the next interview. Discuss this result with your supervisor for a future revisit.
Now I would like to ask you some questions about the health of each child under the age of 5 in your care, who lives with you now. Now I want to ask you about (NAME). In what month and year was (NAME) born? Probe: What is his/her birthday?
If the mother/caretaker knows the exact birth date, also enter the day; otherwise, circle 98 for day.
Children aged 0-4
97
Inconsistent
98
DK
99
Missing
Year of birth of child
Year of birth of child
Year of birth of child
Year of birth of child
Year of birth of child
Repeat greeting if not already read to this respondent: We are from (COUNTRY-SPECIFIC AFFILIATION). We are working on a project concerned with family health and education. I would like to talk to you about this. The interview will take about (NUMBER) minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. Also, you are not obliged to answer any question you don't want to, and you may withdraw from the interview at any time. May I start now? If permission is given, begin the interview. If the respondent does not agree to continue, thank him/her and go to the next interview. Discuss this result with your supervisor for a future revisit.
Now I would like to ask you some questions about the health of each child under the age of 5 in your care, who lives with you now. Now I want to ask you about (NAME). In what month and year was (NAME) born? Probe: What is his/her birthday?
If the mother/caretaker knows the exact birth date, also enter the day; otherwise, circle 98 for day.
Children aged 0-4
9997
Inconsistent
9998
DK
9999
Missing
Age of child
Age of child
Age of child
Age of child
Age of child
How old was (NAME) at his/her last birthday?
Record age in completed years.
Children aged 0-4
Child has birth certificate
Child has birth certificate
Child has birth certificate
Child has birth certificate
Child has birth certificate
Does (name) have a birth certificate? May I see it?
Children aged 0-4
1
Yes, seen
2
Yes, not seen
3
No
8
DK
9
Missing
Child registered
Child registered
Child registered
Child registered
Child registered
Has (name's) birth been registered with the civil authorities?
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Reason birth not registered
Reason birth not registered
Reason birth not registered
Reason birth not registered
Reason birth not registered
Why is (name's) birth not registered?
Children aged 0-4
1
Costs too much
2
Must travel too far
3
Did not know it should be registered
4
Late, and did not want to pay fine
5
Does not know where to register
6
Other
8
DK
9
Missing
Know how to register birth
Know how to register birth
Know how to register birth
Know how to register birth
Know how to register birth
Do you know how to register your child's birth?
Children aged 0-4
1
Yes
2
No
9
Missing
Child attends early childhood education programme
Child attends early childhood education programme
Child attends early childhood education programme
Child attends early childhood education programme
Child attends early childhood education programme
BR5. Check age of child in UF11: Child is 3 or 4 years old? Yes. Continue with BR6 No. Go to BR8
Does (name) attend any organized learning or early childhood education programme, such as a private or government facility, including kindergarten or community child care?
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Hours attended education in last 7 days
Hours attended education in last 7 days
Hours attended education in last 7 days
Hours attended education in last 7 days
Hours attended education in last 7 days
Within the last seven days, about how many hours did (name) attend?
Children aged 0-4
98
DK
99
Missing
Books-Mother
Books-Mother
Books-Mother
Books-Mother
Books-Mother
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Read books or look at picture books with (name)?
Children aged 0-4
?
Missing
A
Mother
Books-Father
Books-Father
Books-Father
Books-Father
Books-Father
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Read books or look at picture books with (name)?
Children aged 0-4
?
Missing
B
Father
Books-Other
Books-Other
Books-Other
Books-Other
Books-Other
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Read books or look at picture books with (name)?
Children aged 0-4
?
Missing
X
Other
Books-No one
Books-No one
Books-No one
Books-No one
Books-No one
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Read books or look at picture books with (name)?
Children aged 0-4
?
Missing
Y
No one
Stories-Mother
Stories-Mother
Stories-Mother
Stories-Mother
Stories-Mother
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Tell stories to (name)?
Children aged 0-4
?
Missing
A
Mother
Stories-Father
Stories-Father
Stories-Father
Stories-Father
Stories-Father
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Tell stories to (name)?
Children aged 0-4
?
Missing
B
Father
Stories-Other
Stories-Other
Stories-Other
Stories-Other
Stories-Other
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Tell stories to (name)?
Children aged 0-4
?
Missing
X
Other
Stories-No one
Stories-No one
Stories-No one
Stories-No one
Stories-No one
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Tell stories to (name)?
Children aged 0-4
?
Missing
Y
No one
Songs-Mother
Songs-Mother
Songs-Mother
Songs-Mother
Songs-Mother
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Sing songs with (name)?
Children aged 0-4
?
Missing
A
Mother
Songs-Father
Songs-Father
Songs-Father
Songs-Father
Songs-Father
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Sing songs with (name)?
Children aged 0-4
?
Missing
B
Father
Songs-Other
Songs-Other
Songs-Other
Songs-Other
Songs-Other
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Sing songs with (name)?
Children aged 0-4
?
Missing
X
Other
Songs-No one
Songs-No one
Songs-No one
Songs-No one
Songs-No one
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Sing songs with (name)?
Children aged 0-4
?
Missing
Y
No one
Outside-Mother
Outside-Mother
Outside-Mother
Outside-Mother
Outside-Mother
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Take (name) outside the home, compound, yard or enclosure?
Children aged 0-4
?
Missing
A
Mother
Outside-Father
Outside-Father
Outside-Father
Outside-Father
Outside-Father
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Take (name) outside the home, compound, yard or enclosure?
Children aged 0-4
?
Missing
B
Father
Outside-Other
Outside-Other
Outside-Other
Outside-Other
Outside-Other
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Take (name) outside the home, compound, yard or enclosure?
Children aged 0-4
?
Missing
X
Other
Outside-No one
Outside-No one
Outside-No one
Outside-No one
Outside-No one
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Take (name) outside the home, compound, yard or enclosure?
Children aged 0-4
?
Missing
Y
No one
Play-Mother
Play-Mother
Play-Mother
Play-Mother
Play-Mother
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Play with (name)?
Children aged 0-4
?
Missing
A
Mother
Play-Father
Play-Father
Play-Father
Play-Father
Play-Father
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Play with (name)?
Children aged 0-4
?
Missing
B
Father
Play-Other
Play-Other
Play-Other
Play-Other
Play-Other
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Play with (name)?
Children aged 0-4
?
Missing
X
Other
Play-No one
Play-No one
Play-No one
Play-No one
Play-No one
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Play with (name)?
Children aged 0-4
?
Missing
Y
No one
Naming-Mother
Naming-Mother
Naming-Mother
Naming-Mother
Naming-Mother
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Spend time with (name) naming, counting, and/or drawing things?
Children aged 0-4
?
Missing
A
Mother
Naming-Father
Naming-Father
Naming-Father
Naming-Father
Naming-Father
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Spend time with (name) naming, counting, and/or drawing things?
Children aged 0-4
?
Missing
B
Father
Naming-Other
Naming-Other
Naming-Other
Naming-Other
Naming-Other
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Spend time with (name) naming, counting, and/or drawing things?
Children aged 0-4
?
Missing
X
Other
Naming-No one
Naming-No one
Naming-No one
Naming-No one
Naming-No one
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Spend time with (name) naming, counting, and/or drawing things?
Children aged 0-4
?
Missing
Y
No one
How many books are there in the household
How many books are there in the household
How many books are there in the household
How many books are there in the household
How many books are there in the household
Question CE1 is to be administered only once to each caretaker
How many books are there in the household? Please include schoolbooks, but not other books meant for children, such as picture books
If 'none' enter 00
Children aged 0-4
10
Ten or more books
99
Missing
How many children books or picture books do you have for him
How many children books or picture books do you have for him
How many children books or picture books do you have for him
How many children books or picture books do you have for him
How many children books or picture books do you have for him
How many children's books or picture books do you have for (name)?
If 'none' enter 00
Children aged 0-4
10
Ten or more books
99
Missing
Bowls, plate, cups ,pots
Bowls, plate, cups ,pots
Bowls, plate, cups ,pots
Bowls, plate, cups ,pots
Bowls, plate, cups ,pots
I am interested in learning about the things that (NAME) plays with when he/she is at home. What does (NAME) play with? Does he/she play with household objects, such as bowls, plates, cups or pots?
Children aged 0-4
?
Missing
A
Household objects
Sticks , rocks, animals shells, leaves
Sticks , rocks, animals shells, leaves
Sticks , rocks, animals shells, leaves
Sticks , rocks, animals shells, leaves
Sticks , rocks, animals shells, leaves
I am interested in learning about the things that (NAME) plays with when he/she is at home. What does (NAME) play with? Does he/she play with objects and materials found outside the living quarters, such as sticks, rocks, animals, shells, or leaves?
Children aged 0-4
?
Missing
B
Outside objects
Homemae toys
Homemae toys
Homemae toys
Homemae toys
Homemae toys
I am interested in learning about the things that (NAME) plays with when he/she is at home. What does (NAME) play with? Does he/she play with homemade toys, such as dolls, cars and other toys made at home?
Children aged 0-4
?
Missing
C
Homemade toys
Toys that came from a store
Toys that came from a store
Toys that came from a store
Toys that came from a store
Toys that came from a store
I am interested in learning about the things that (NAME) plays with when he/she is at home. What does (NAME) play with? Does he/she play with toys that came from a store?
Children aged 0-4
?
Missing
D
Store bought toys
No playthings mentioned
No playthings mentioned
No playthings mentioned
No playthings mentioned
No playthings mentioned
I am interested in learning about the things that (NAME) plays with when he/she is at home. What does (NAME) play with? Does he/she play with household objects, such as bowls, plates, cups or pots?
If the respondent says "YES" to any of the prompted categories, then probe to learn specifically what the child plays with to ascertain the response Code Y if child does not play with any of the items mentioned.
Children aged 0-4
?
Missing
Y
No playthings mentioned
How many time was he/her left in the care of another child
How many time was he/her left in the care of another child
How many time was he/her left in the care of another child
How many time was he/her left in the care of another child
How many time was he/her left in the care of another child
Sometimes adults taking care of children have to leave the house to go shopping, wash clothes, or for other reasons and have to leave young children with others. since last (day of the week) how many times was (name) left in the care of another child (that is, someone less than 10 years old)?
If 'none' enter 00
Children aged 0-4
98
DK
99
Missing
How many time he was left alone
How many time he was left alone
How many time he was left alone
How many time he was left alone
How many time he was left alone
In the past week, how many times was (name) left alone?
If 'none' enter 00
Children aged 0-4
98
DK
99
Missing
Child ever been breastfed
Child ever been breastfed
Child ever been breastfed
Child ever been breastfed
Child ever been breastfed
Has (name) ever been breastfed?
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Child still being breastfed
Child still being breastfed
Child still being breastfed
Child still being breastfed
Child still being breastfed
Is he/she still being breastfed?
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Child received vitamin, mineral supplements or medicine
Child received vitamin, mineral supplements or medicine
Child received vitamin, mineral supplements or medicine
Child received vitamin, mineral supplements or medicine
Child received vitamin, mineral supplements or medicine
Since this time yesterday, did he/she receive any of the following: Read each item aloud and record response before proceeding to the next item. Vitamin, mineral supplements or medicine?
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Child received plain water
Child received plain water
Child received plain water
Child received plain water
Child received plain water
Since this time yesterday, did he/she receive any of the following: Read each item aloud and record response before proceeding to the next item. Plain water?
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Child received sweetened water or juice
Child received sweetened water or juice
Child received sweetened water or juice
Child received sweetened water or juice
Child received sweetened water or juice
Since this time yesterday, did he/she receive any of the following: Read each item aloud and record response before proceeding to the next item. Sweetened, flavoured water or fruit juice or tea or infusion?
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Child received oral rehydration solution
Child received oral rehydration solution
Child received oral rehydration solution
Child received oral rehydration solution
Child received oral rehydration solution
Since this time yesterday, did he/she receive any of the following: Read each item aloud and record response before proceeding to the next item. Oral rehydration solution (ORS)?
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Child received infant formula
Child received infant formula
Child received infant formula
Child received infant formula
Child received infant formula
Since this time yesterday, did he/she receive any of the following: Read each item aloud and record response before proceeding to the next item. Infant formula?
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Child received milk
Child received milk
Child received milk
Child received milk
Child received milk
Since this time yesterday, did he/she receive any of the following: Read each item aloud and record response before proceeding to the next item. Tinned, powdered or fresh milk?
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Child received other liquids
Child received other liquids
Child received other liquids
Child received other liquids
Child received other liquids
Since this time yesterday, did he/she receive any of the following: Read each item aloud and record response before proceeding to the next item. Any other liquids?
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Child received solid or mushy food
Child received solid or mushy food
Child received solid or mushy food
Child received solid or mushy food
Child received solid or mushy food
Since this time yesterday, did he/she receive any of the following: Read each item aloud and record response before proceeding to the next item. Solid or semi-solid (mushy) food?
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Time ate solid, semisolid or soft food other than liquids
Time ate solid, semisolid or soft food other than liquids
Time ate solid, semisolid or soft food other than liquids
Time ate solid, semisolid or soft food other than liquids
Time ate solid, semisolid or soft food other than liquids
Check BF3H: Child received solid or semi-solid (mushy) food? Yes. Continue with BF5 No or DK. Go to Next Module
Since this time yesterday, how many times did (NAME) eat solid, semisolid, or soft foods other than liquids?
If 7 or more times, record '7'.
Children aged 0-4
7
7+
8
DK
9
Missing
Child had diarrhoea in last 2 weeks
Child had diarrhoea in last 2 weeks
Child had diarrhoea in last 2 weeks
Child had diarrhoea in last 2 weeks
Child had diarrhoea in last 2 weeks
Has (name) had diarrhoea in the last two weeks, that is, since (day of the week) of the week before last?
Diarrhoea is determined as perceived by mother or caretaker, or as three or more loose or watery stools per day, or blood in stool.
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Drank fluid made from special packet (ORS)
Drank fluid made from special packet (ORS)
Drank fluid made from special packet (ORS)
Drank fluid made from special packet (ORS)
Drank fluid made from special packet (ORS)
During this last episode of diarrhoea, did (name) drink any of the following: Read each item aloud and record response before proceeding to the next item. A fluid made from a special packet called (local name for ORS packet solution)?
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Government-recommended homemade fluid
Government-recommended homemade fluid
Government-recommended homemade fluid
Government-recommended homemade fluid
Government-recommended homemade fluid
During this last episode of diarrhoea, did (name) drink any of the following: Read each item aloud and record response before proceeding to the next item. Government-recommended homemade fluid?
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Pre-packaged ORS fluid for diarrhoea
Pre-packaged ORS fluid for diarrhoea
Pre-packaged ORS fluid for diarrhoea
Pre-packaged ORS fluid for diarrhoea
Pre-packaged ORS fluid for diarrhoea
During this last episode of diarrhoea, did (name) drink any of the following: Read each item aloud and record response before proceeding to the next item. A pre-packaged ORS fluid for diarrhoea?
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Child drank less or more during illness
Child drank less or more during illness
Child drank less or more during illness
Child drank less or more during illness
Child drank less or more during illness
During (name's) illness, did he/she drink much less, about the same, or more than usual?
Children aged 0-4
1
Much less or none
2
About the same (or somewhat less)
3
More
8
DK
9
Missing
Child ate less or more during illness
Child ate less or more during illness
Child ate less or more during illness
Child ate less or more during illness
Child ate less or more during illness
During (name's) illness, did he/she eat less, about the same, or more food than usual? If "less", probe: Much less or a little less?
Children aged 0-4
1
None
2
Much less
3
Somewhat less
4
About the same
5
More
8
DK
9
Missing
Child ill with cough in last 2 weeks
Child ill with cough in last 2 weeks
Child ill with cough in last 2 weeks
Child ill with cough in last 2 weeks
Child ill with cough in last 2 weeks
Has (name) had an illness with a cough at any time in the last two weeks, that is, since (day of the week) of the week before last?
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Difficulty breathing during illness with cough
Difficulty breathing during illness with cough
Difficulty breathing during illness with cough
Difficulty breathing during illness with cough
Difficulty breathing during illness with cough
When (name) had an illness with a cough, did he/she breathe faster than usual with short, quick breaths or have difficulty breathing?
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Symptoms due to problem in chest or blocked nose
Symptoms due to problem in chest or blocked nose
Symptoms due to problem in chest or blocked nose
Symptoms due to problem in chest or blocked nose
Symptoms due to problem in chest or blocked nose
Were the symptoms due to a problem in the chest or a blocked nose?
Children aged 0-4
1
Problem in chest
2
Blocked nose
3
Both
6
Other
8
DK
9
Missing
Sought advice or teatment for illness
Sought advice or teatment for illness
Sought advice or teatment for illness
Sought advice or teatment for illness
Sought advice or teatment for illness
Did you seek advice or treatment for the illness outside the home?
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Place sought advice or treatment
Place sought advice or treatment
Place sought advice or treatment
Place sought advice or treatment
Place sought advice or treatment
Advice Govt. hospital
Advice Govt. hospital
Advice Govt. hospital
Advice Govt. hospital
Advice Govt. hospital
From where did you seek care? Anywhere else?
Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place)
Children aged 0-4
?
Missing
A
Govt. hospital
Advice Govt. health centre
Advice Govt. health centre
Advice Govt. health centre
Advice Govt. health centre
Advice Govt. health centre
From where did you seek care? Anywhere else?
Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place)
Children aged 0-4
?
Missing
B
Govt. health centre
Advice Govt. health post
Advice Govt. health post
Advice Govt. health post
Advice Govt. health post
Advice Govt. health post
From where did you seek care? Anywhere else?
Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place)
Children aged 0-4
?
Missing
C
Govt. health post
Advice Village health worker
Advice Village health worker
Advice Village health worker
Advice Village health worker
Advice Village health worker
From where did you seek care? Anywhere else?
Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place)
Children aged 0-4
?
Missing
D
Village health worker
Advice Mobile/outreach clinic
Advice Mobile/outreach clinic
Advice Mobile/outreach clinic
Advice Mobile/outreach clinic
Advice Mobile/outreach clinic
From where did you seek care? Anywhere else?
Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place)
Children aged 0-4
?
Missing
E
Mobile/outreach clinic
Advice Other public sources
Advice Other public sources
Advice Other public sources
Advice Other public sources
Advice Other public sources
From where did you seek care? Anywhere else?
Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place)
Children aged 0-4
?
Missing
H
Other public sources
Advice Private hospital/clinic
Advice Private hospital/clinic
Advice Private hospital/clinic
Advice Private hospital/clinic
Advice Private hospital/clinic
From where did you seek care? Anywhere else?
Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place)
Children aged 0-4
?
Missing
I
Private hospital/clinic
Advice Private phusician
Advice Private phusician
Advice Private phusician
Advice Private phusician
Advice Private phusician
From where did you seek care? Anywhere else?
Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place)
Children aged 0-4
?
Missing
J
Private physician
Advice Private pharmacy
Advice Private pharmacy
Advice Private pharmacy
Advice Private pharmacy
Advice Private pharmacy
From where did you seek care? Anywhere else?
Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place)
Children aged 0-4
?
Missing
K
Private pharmacy
Advice Mobile clinic
Advice Mobile clinic
Advice Mobile clinic
Advice Mobile clinic
Advice Mobile clinic
From where did you seek care? Anywhere else?
Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place)
Children aged 0-4
?
Missing
L
Mobile clinic
Advice Other private medical
Advice Other private medical
Advice Other private medical
Advice Other private medical
Advice Other private medical
From where did you seek care? Anywhere else?
Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place)
Children aged 0-4
?
Missing
O
Other private medical
Advice Relative or friend
Advice Relative or friend
Advice Relative or friend
Advice Relative or friend
Advice Relative or friend
From where did you seek care? Anywhere else?
Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place)
Children aged 0-4
?
Missing
P
Relative or friend
Advice Shop
Advice Shop
Advice Shop
Advice Shop
Advice Shop
From where did you seek care? Anywhere else?
Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place)
Children aged 0-4
?
Missing
Q
Shop
Advice Traditional practitioner
Advice Traditional practitioner
Advice Traditional practitioner
Advice Traditional practitioner
Advice Traditional practitioner
From where did you seek care? Anywhere else?
Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place)
Children aged 0-4
?
Missing
R
Traditional practitioner
Advice Other
Advice Other
Advice Other
Advice Other
Advice Other
From where did you seek care? Anywhere else?
Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place)
Children aged 0-4
?
Missing
X
Other
Given medicine to treat this illness
Given medicine to treat this illness
Given medicine to treat this illness
Given medicine to treat this illness
Given medicine to treat this illness
Was (name) given medicine to treat this illness?
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Medicine given to treat illness
Medicine given to treat illness
Medicine given to treat illness
Medicine given to treat illness
Medicine given to treat illness
Medicine Antibiotic
Medicine Antibiotic
Medicine Antibiotic
Medicine Antibiotic
Medicine Antibiotic
What medicine was (name) given?
Circle all medicines given.
Children aged 0-4
?
Missing
A
Antibiotic
Medicine Paracetamol/Panadol/Acetaminophen
Medicine Paracetamol/Panadol/Acetaminophen
Medicine Paracetamol/Panadol/Acetaminophen
Medicine Paracetamol/Panadol/Acetaminophen
Medicine Paracetamol/Panadol/Acetaminophen
What medicine was (name) given?
Circle all medicines given.
Children aged 0-4
?
Missing
P
Paracetamol/Panadol/Acetaminophenc
Medicine Aspirin
Medicine Aspirin
Medicine Aspirin
Medicine Aspirin
Medicine Aspirin
What medicine was (name) given?
Circle all medicines given.
Children aged 0-4
?
Missing
Q
Aspirin
Medicine Ibupropfen
Medicine Ibupropfen
Medicine Ibupropfen
Medicine Ibupropfen
Medicine Ibupropfen
What medicine was (name) given?
Circle all medicines given.
Children aged 0-4
?
Missing
R
Ibuprppfen
Medicine Other
Medicine Other
Medicine Other
Medicine Other
Medicine Other
What medicine was (name) given?
Circle all medicines given.
Children aged 0-4
?
Missing
X
Other
Medicine DK
Medicine DK
Medicine DK
Medicine DK
Medicine DK
What medicine was (name) given?
Circle all medicines given.
Children aged 0-4
?
Missing
Z
DK
What was done to dispose of the stools
What was done to dispose of the stools
What was done to dispose of the stools
What was done to dispose of the stools
What was done to dispose of the stools
Check UF11: Child aged under 3? Yes. Continue with CA13 No. Go to CA14
The last time (name) passed stools, what was done to dispose of the stools?
Children aged 0-4
1
Child used toilet/latrine
2
Put/rinsed into toilet or latrine
3
Put/rinsed into drain or ditch
4
Thrown into garbage (solid waste)
5
Buried
6
Left in the open
96
Other
98
DK
99
Missing
What type of symptoms would cause to take him to a health fa
What type of symptoms would cause to take him to a health fa
What type of symptoms would cause to take him to a health fa
What type of symptoms would cause to take him to a health fa
What type of symptoms would cause to take him to a health fa
Child not able to drink or breastfeed
Child not able to drink or breastfeed
Child not able to drink or breastfeed
Child not able to drink or breastfeed
Child not able to drink or breastfeed
Ask the following question (CA14) only once for each caretaker.
Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away?
Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions.
Children aged 0-4
?
Missing
A
Child not able to drink or breastfeed
Child becomes sicker
Child becomes sicker
Child becomes sicker
Child becomes sicker
Child becomes sicker
Ask the following question (CA14) only once for each caretaker.
Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away?
Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions.
Children aged 0-4
?
Missing
B
Child Becomes sicker
Child develops a fever
Child develops a fever
Child develops a fever
Child develops a fever
Child develops a fever
Ask the following question (CA14) only once for each caretaker.
Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away?
Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions.
Children aged 0-4
?
Missing
C
Child develops a fever
Child has fast breathing
Child has fast breathing
Child has fast breathing
Child has fast breathing
Child has fast breathing
Ask the following question (CA14) only once for each caretaker.
Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away?
Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions.
Children aged 0-4
?
Missing
D
Child has fast breathing
Child has difficult breathing
Child has difficult breathing
Child has difficult breathing
Child has difficult breathing
Child has difficult breathing
Ask the following question (CA14) only once for each caretaker.
Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away?
Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions.
Children aged 0-4
?
Missing
E
Child has difficult breathing
Child has blood in stool
Child has blood in stool
Child has blood in stool
Child has blood in stool
Child has blood in stool
Ask the following question (CA14) only once for each caretaker.
Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away?
Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions.
Children aged 0-4
?
Missing
F
Child has blood in stool
Child is drinking poorly
Child is drinking poorly
Child is drinking poorly
Child is drinking poorly
Child is drinking poorly
Ask the following question (CA14) only once for each caretaker.
Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away?
Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions.
Children aged 0-4
?
Missing
G
Child is drinking poorly
Child has fit, becomes rigid
Child has fit, becomes rigid
Child has fit, becomes rigid
Child has fit, becomes rigid
Child has fit, becomes rigid
Ask the following question (CA14) only once for each caretaker.
Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away?
Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions.
Children aged 0-4
?
Missing
X
Child has fit, becomes rigid
Child vomits
Child vomits
Child vomits
Child vomits
Child vomits
Ask the following question (CA14) only once for each caretaker.
Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away?
Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions.
Children aged 0-4
?
Missing
Y
Child vomits
Other
Other
Other
Other
Other
Ask the following question (CA14) only once for each caretaker.
Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away?
Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions.
Children aged 0-4
?
Missing
Z
Other
Vaccination card for child
Vaccination card for child
Vaccination card for child
Vaccination card for child
Vaccination card for child
If an immunization card is available, copy the dates in IM2-IM8 for each type of immunization or vitamin A dose recorded on the card. IM10-IM18 are for recording vaccinations that are not recorded on the card. IM10-IM18 will only be asked when a card is not available.
Is there a vaccination card for (name)?
Children aged 0-4
1
Yes, seen
2
Yes, not seen
3
No
9
Missing
Day of BCG immunization
Day of BCG immunization
Day of BCG immunization
Day of BCG immunization
Day of BCG immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization BCG
Children aged 0-4
Not given
44
Marked on card - no date given
66
Reported by mother
97
Inconsistency
98
DK
99
Missing
Month of BCG immunization
Month of BCG immunization
Month of BCG immunization
Month of BCG immunization
Month of BCG immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization BCG
Children aged 0-4
97
Inconsistency
99
Missing
Year of BCG immunization
Year of BCG immunization
Year of BCG immunization
Year of BCG immunization
Year of BCG immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization BCG
Children aged 0-4
9997
Inconsistency
9999
Missing
Day of OPV1 immunization
Day of OPV1 immunization
Day of OPV1 immunization
Day of OPV1 immunization
Day of OPV1 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Polio 1
Children aged 0-4
Not given
44
Marked on card - no date given
66
Reported by mother
97
Inconsistency
98
DK
99
Missing
Month of OPV1 immunization
Month of OPV1 immunization
Month of OPV1 immunization
Month of OPV1 immunization
Month of OPV1 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Polio 1
Children aged 0-4
97
Inconsistency
99
Missing
Year of OPV1 immunization
Year of OPV1 immunization
Year of OPV1 immunization
Year of OPV1 immunization
Year of OPV1 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Polio 1
Children aged 0-4
9997
Inconsistency
9999
Missing
Day of OPV2 immunization
Day of OPV2 immunization
Day of OPV2 immunization
Day of OPV2 immunization
Day of OPV2 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Polio 2
Children aged 0-4
Not given
44
Marked on card - no date given
66
Reported by mother
97
Inconsistency
98
DK
99
Missing
Month of OPV2 immunization
Month of OPV2 immunization
Month of OPV2 immunization
Month of OPV2 immunization
Month of OPV2 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Polio 2
Children aged 0-4
97
Inconsistency
99
Missing
Year of OPV2 immunization
Year of OPV2 immunization
Year of OPV2 immunization
Year of OPV2 immunization
Year of OPV2 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Polio 2
Children aged 0-4
9997
Inconsistency
9999
Missing
Day of OPV3 immunization
Day of OPV3 immunization
Day of OPV3 immunization
Day of OPV3 immunization
Day of OPV3 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Polio 3
Children aged 0-4
Not given
44
Marked on card - no date given
66
Reported by mother
97
Inconsistency
98
DK
99
Missing
Month of OPV3 immunization
Month of OPV3 immunization
Month of OPV3 immunization
Month of OPV3 immunization
Month of OPV3 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Polio 3
Children aged 0-4
97
Inconsistency
99
Missing
Year of OPV3 immunization
Year of OPV3 immunization
Year of OPV3 immunization
Year of OPV3 immunization
Year of OPV3 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Polio 3
Children aged 0-4
9997
Inconsistency
9999
Missing
Day of OPV4 immunization
Day of OPV4 immunization
Day of OPV4 immunization
Day of OPV4 immunization
Day of OPV4 immunization
Not given
44
Marked on card - no date given
66
Reported by mother
97
Inconsistency
98
DK
99
Missing
Month of OPV4 immunization
Month of OPV4 immunization
Month of OPV4 immunization
Month of OPV4 immunization
Month of OPV4 immunization
97
Inconsistency
99
Missing
Year of OPV4 immunization
Year of OPV4 immunization
Year of OPV4 immunization
Year of OPV4 immunization
Year of OPV4 immunization
9997
Inconsistency
9999
Missing
Day of OPV5 immunization
Day of OPV5 immunization
Day of OPV5 immunization
Day of OPV5 immunization
Day of OPV5 immunization
Not given
44
Marked on card - no date given
66
Reported by mother
97
Inconsistency
98
DK
99
Missing
Month of OPV5 immunization
Month of OPV5 immunization
Month of OPV5 immunization
Month of OPV5 immunization
Month of OPV5 immunization
97
Inconsistency
99
Missing
Year of OPV5 immunization
Year of OPV5 immunization
Year of OPV5 immunization
Year of OPV5 immunization
Year of OPV5 immunization
9997
Inconsistency
9999
Missing
Day of DPT1 immunization
Day of DPT1 immunization
Day of DPT1 immunization
Day of DPT1 immunization
Day of DPT1 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization DPT 1
Children aged 0-4
Not given
44
Marked on card - no date given
66
Reported by mother
97
Inconsistency
98
DK
99
Missing
Month of DPT1 immunization
Month of DPT1 immunization
Month of DPT1 immunization
Month of DPT1 immunization
Month of DPT1 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization DPT 1
Children aged 0-4
97
Inconsistency
99
Missing
Year of DPT1 immunization
Year of DPT1 immunization
Year of DPT1 immunization
Year of DPT1 immunization
Year of DPT1 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization DPT 1
Children aged 0-4
9997
Inconsistency
9999
Missing
Day of DPT2 immunization
Day of DPT2 immunization
Day of DPT2 immunization
Day of DPT2 immunization
Day of DPT2 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization DPT 2
Children aged 0-4
Not given
44
Marked on card - no date given
66
Reported by mother
97
Inconsistency
98
DK
99
Missing
Month of DPT2 immunization
Month of DPT2 immunization
Month of DPT2 immunization
Month of DPT2 immunization
Month of DPT2 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization DPT 2
Children aged 0-4
97
Inconsistency
99
Missing
Year of DPT2 immunization
Year of DPT2 immunization
Year of DPT2 immunization
Year of DPT2 immunization
Year of DPT2 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization DPT 2
Children aged 0-4
9997
Inconsistency
9999
Missing
Day of DPT3 immunization
Day of DPT3 immunization
Day of DPT3 immunization
Day of DPT3 immunization
Day of DPT3 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization DPT 3
Children aged 0-4
Not given
44
Marked on card - no date given
66
Reported by mother
97
Inconsistency
98
DK
99
Missing
Month of DPT3 immunization
Month of DPT3 immunization
Month of DPT3 immunization
Month of DPT3 immunization
Month of DPT3 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization DPT 3
Children aged 0-4
97
Inconsistency
99
Missing
Year of DPT3 immunization
Year of DPT3 immunization
Year of DPT3 immunization
Year of DPT3 immunization
Year of DPT3 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization DPT 3
Children aged 0-4
9997
Inconsistency
9999
Missing
Day of DPT4 immunization
Day of DPT4 immunization
Day of DPT4 immunization
Day of DPT4 immunization
Day of DPT4 immunization
Not given
44
Marked on card - no date given
66
Reported by mother
97
Inconsistency
98
DK
99
Missing
Month of DPT4 immunization
Month of DPT4 immunization
Month of DPT4 immunization
Month of DPT4 immunization
Month of DPT4 immunization
97
Inconsistency
99
Missing
Year of DPT4 immunization
Year of DPT4 immunization
Year of DPT4 immunization
Year of DPT4 immunization
Year of DPT4 immunization
9997
Inconsistency
9999
Missing
Day of DPT5 immunization
Day of DPT5 immunization
Day of DPT5 immunization
Day of DPT5 immunization
Day of DPT5 immunization
Not given
44
Marked on card - no date given
66
Reported by mother
97
Inconsistency
98
DK
99
Missing
Month of DPT5 immunization
Month of DPT5 immunization
Month of DPT5 immunization
Month of DPT5 immunization
Month of DPT5 immunization
97
Inconsistency
99
Missing
Year of DPT5 immunization
Year of DPT5 immunization
Year of DPT5 immunization
Year of DPT5 immunization
Year of DPT5 immunization
9997
Inconsistency
9999
Missing
Day of HepB1 or DPTHepB1 immunization
Day of HepB1 or DPTHepB1 immunization
Day of HepB1 or DPTHepB1 immunization
Day of HepB1 or DPTHepB1 immunization
Day of HepB1 or DPTHepB1 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization HepB1 (or DPTHepB1)
Children aged 0-4
Not given
44
Marked on card - no date given
66
Reported by mother
97
Inconsistency
98
DK
99
Missing
Month of HepB1 or DPThepB1 immunization
Month of HepB1 or DPThepB1 immunization
Month of HepB1 or DPThepB1 immunization
Month of HepB1 or DPThepB1 immunization
Month of HepB1 or DPThepB1 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization HepB1 (or DPTHepB1)
Children aged 0-4
97
Inconsistency
99
Missing
Year of HepB1 or DPTHepB1 immunization
Year of HepB1 or DPTHepB1 immunization
Year of HepB1 or DPTHepB1 immunization
Year of HepB1 or DPTHepB1 immunization
Year of HepB1 or DPTHepB1 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization HepB1 (or DPTHepB1)
Children aged 0-4
9997
Inconsistency
9999
Missing
Day HepB2 or DPTHepB2 immunization
Day HepB2 or DPTHepB2 immunization
Day HepB2 or DPTHepB2 immunization
Day HepB2 or DPTHepB2 immunization
Day HepB2 or DPTHepB2 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization HepB2 (or DPTHepB2)
Children aged 0-4
Not given
44
Marked on card - no date given
66
Reported by mother
97
Inconsistency
98
DK
99
Missing
Month of HepB2 or DPTHepB2 imunization
Month of HepB2 or DPTHepB2 imunization
Month of HepB2 or DPTHepB2 imunization
Month of HepB2 or DPTHepB2 imunization
Month of HepB2 or DPTHepB2 imunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization HepB2 (or DPTHepB2)
Children aged 0-4
97
Inconsistency
99
Missing
Year of HepB2 or DPTHepB2 immunization
Year of HepB2 or DPTHepB2 immunization
Year of HepB2 or DPTHepB2 immunization
Year of HepB2 or DPTHepB2 immunization
Year of HepB2 or DPTHepB2 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization HepB2 (or DPTHepB2)
Children aged 0-4
9997
Inconsistency
9999
Missing
Day of DPTHepB3 or HepB3 immunization
Day of DPTHepB3 or HepB3 immunization
Day of DPTHepB3 or HepB3 immunization
Day of DPTHepB3 or HepB3 immunization
Day of DPTHepB3 or HepB3 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization HepB3 (or DPTHepB3)
Children aged 0-4
Not given
44
Marked on card - no date given
66
Reported by mother
97
Inconsistency
98
DK
99
Missing
Month of DPTHepB3 or HepB3 ummunization
Month of DPTHepB3 or HepB3 ummunization
Month of DPTHepB3 or HepB3 ummunization
Month of DPTHepB3 or HepB3 ummunization
Month of DPTHepB3 or HepB3 ummunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization HepB3 (or DPTHepB3)
Children aged 0-4
97
Inconsistency
99
Missing
Year of DPTHepB3 or HepB3 immunization
Year of DPTHepB3 or HepB3 immunization
Year of DPTHepB3 or HepB3 immunization
Year of DPTHepB3 or HepB3 immunization
Year of DPTHepB3 or HepB3 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization HepB3 (or DPTHepB3)
Children aged 0-4
9997
Inconsistency
9999
Missing
Day measles or MMR immunization
Day measles or MMR immunization
Day measles or MMR immunization
Day measles or MMR immunization
Day measles or MMR immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Measles (or MMR)
Children aged 0-4
Not given
44
Marked on card - no date given
66
Reported by mother
97
Inconsistency
98
DK
99
Missing
Month Measles or MMR immunization
Month Measles or MMR immunization
Month Measles or MMR immunization
Month Measles or MMR immunization
Month Measles or MMR immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Measles (or MMR)
Children aged 0-4
97
Inconsistency
99
Missing
Year of Measles or MMR immunization
Year of Measles or MMR immunization
Year of Measles or MMR immunization
Year of Measles or MMR immunization
Year of Measles or MMR immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Measles (or MMR)
Children aged 0-4
9997
Inconsistency
9999
Missing
Child received any other vaccinations
Child received any other vaccinations
Child received any other vaccinations
Child received any other vaccinations
Child received any other vaccinations
In addition to the vaccinations and vitamin A capsules shown on this card, did (name) receive any other vaccinations - including vaccinations received in campaigns or immunization days?
Record 'Yes' only if respondent mentions BCG, OPV 0-3, DPT 1-3, Hepatitis B 1-3, Measles, Yellow Fever vaccine(s), or Vitamin A supplements. (If yes, Probe for vaccinations and write '66' in the corresponding day column on IM2 to IM8B.)
1
Yes
2
No
8
DK
9
Missing
Child ever received any vaccinations
Child ever received any vaccinations
Child ever received any vaccinations
Child ever received any vaccinations
Child ever received any vaccinations
Has (name) ever received any vaccinations to prevent him/her from getting diseases, including vaccinations received in a campaign or immunization day?
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Child ever given BCG vaccination
Child ever given BCG vaccination
Child ever given BCG vaccination
Child ever given BCG vaccination
Child ever given BCG vaccination
Has (name) ever been given a BCG vaccination against tuberculosis - that is, an injection in the arm or shoulder that caused a scar?
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Child ever given Polio vaccination
Child ever given Polio vaccination
Child ever given Polio vaccination
Child ever given Polio vaccination
Child ever given Polio vaccination
Has (name) ever been given any "vaccination drops in the mouth" to protect him/her from getting diseases - that is, polio?
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Polio first given just after birth or later
Polio first given just after birth or later
Polio first given just after birth or later
Polio first given just after birth or later
Polio first given just after birth or later
How old was he/she when the first dose was given - just after birth (within two weeks) or later?
Children aged 0-4
1
Just after birth (within 2 weeks)
2
Later
9
Missing
Times child given Polio vaccination
Times child given Polio vaccination
Times child given Polio vaccination
Times child given Polio vaccination
Times child given Polio vaccination
How many times has he/she been given these drops?
Children aged 0-4
99
Missing
Child ever given DPT vaccination
Child ever given DPT vaccination
Child ever given DPT vaccination
Child ever given DPT vaccination
Child ever given DPT vaccination
Has (name) ever been given "DPT vaccination injections" - that is, an injection in the thigh or buttocks - to prevent him/her from getting tetanus, whooping cough, diphtheria? (sometimes given at the same time as polio)
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Times child given DPT vaccination
Times child given DPT vaccination
Times child given DPT vaccination
Times child given DPT vaccination
Times child given DPT vaccination
How many times?
Children aged 0-4
99
Missing
Child ever given Measles or MMR vaccination
Child ever given Measles or MMR vaccination
Child ever given Measles or MMR vaccination
Child ever given Measles or MMR vaccination
Child ever given Measles or MMR vaccination
Has (name) ever been given "Measles vaccination injections" or MMR - that is, a shot in the arm at the age of 9 months or older - to prevent him/her from getting measles?
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Child participated in national immunization day A
Child participated in national immunization day A
Child participated in national immunization day A
Child participated in national immunization day A
Child participated in national immunization day A
1
Yes
2
No
8
DK
9
Missing
Child's weight (kilograms)
Child's weight (kilograms)
Child's weight (kilograms)
Child's weight (kilograms)
Child's weight (kilograms)
After questionnaires for all children are complete, the measurer weighs and measures each child. Record weight and length/height below, taking care to record the measurements on the correct questionnaire for each child. Check the child's name and line number on the household listing before recording measurements. Child's weight.
Children aged 0-4
99.9
Missing
Child measured lying or standing
Child measured lying or standing
Child measured lying or standing
Child measured lying or standing
Child measured lying or standing
Child's length or height.
Check age of child in UF11: Child under 2 years old. Measure length (lying down). Child age 2 or more years. Measure height (standing up).
Children aged 0-4
1
Lying down
2
Standing up
9
Missing
Child's length or height
Child's length or height
Child's length or height
Child's length or height
Child's length or height
Child's length or height.
Check age of child in UF11: Child under 2 years old. Measure length (lying down). Child age 2 or more years. Measure height (standing up).
Children aged 0-4
999.9
Missing
Result of measurement
Result of measurement
Result of measurement
Result of measurement
Result of measurement
Result of measurement.
Children aged 0-4
1
Measured
2
Not present
3
Refused
6
Other
7
Inconsistent
9
Missing
Height for age percentile
Height for age percentile
Height for age percentile
Height for age percentile
Height for age percentile
Recoded variable
Is (name) male or female?
Children aged 0-4
Height for age z-score
Height for age z-score
Height for age z-score
Height for age z-score
Height for age z-score
Recoded variable
Is (name) male or female?
Children aged 0-4
Height for age percent of reference median
Height for age percent of reference median
Height for age percent of reference median
Height for age percent of reference median
Height for age percent of reference median
Recoded variable
Is (name) male or female?
Children aged 0-4
Weight for age percentile
Weight for age percentile
Weight for age percentile
Weight for age percentile
Weight for age percentile
Recoded variable
Is (name) male or female?
Children aged 0-4
Weight for age z-score
Weight for age z-score
Weight for age z-score
Weight for age z-score
Weight for age z-score
Recoded variable
Is (name) male or female?
Children aged 0-4
Weight for age percent of reference median
Weight for age percent of reference median
Weight for age percent of reference median
Weight for age percent of reference median
Weight for age percent of reference median
Recoded variable
Is (name) male or female?
Children aged 0-4
Weight for height percentile
Weight for height percentile
Weight for height percentile
Weight for height percentile
Weight for height percentile
Recoded variable
Is (name) male or female?
Children aged 0-4
Weight for height z-score
Weight for height z-score
Weight for height z-score
Weight for height z-score
Weight for height z-score
Recoded variable
Is (name) male or female?
Children aged 0-4
Weight for height percent of reference median
Weight for height percent of reference median
Weight for height percent of reference median
Weight for height percent of reference median
Weight for height percent of reference median
Recoded variable
Is (name) male or female?
Children aged 0-4
Flag for anthropometric indicators
Flag for anthropometric indicators
Flag for anthropometric indicators
Flag for anthropometric indicators
Flag for anthropometric indicators
Recoded variable
Is (name) male or female?
Children aged 0-4
No flag
1
Height for age
2
Weight for height
3
Weight for height, Height for age
4
Weight for age
5
Weight for age, Height for age
6
Weight for age, Weight for height
7
Weight for age, Weight for height, Height for age
Sex
Sex
Sex
Sex
Sex
Children aged 0-4
1
Male
2
Female
Highest level of school attended
Highest level of school attended
Highest level of school attended
Highest level of school attended
Highest level of school attended
What is the highest level of school (name) attended?
Children aged 0-4
Preschool/kindergarten
1
Primary
2
Secondary
3
Higher
6
Non-standard curriculum
8
DK
9
Missing
Region
Region
Region
Region
Region
Region:
Households
2
Central (include BKK.)
3
North
4
Northeast
5
South
Changwat/Province
Changwat/Province
Changwat/Province
Changwat/Province
Changwat/Province
Area
Area
Area
Area
Area
Area:
Households
1
Urban
2
Rural
PSU_NO
PSU_NO
PSU_NO
PSU_NO
PSU_NO
Day of interview
Day of interview
Day of interview
Day of interview
Day of interview
Day/Month/Year of interview:
Households
Month of interview
Month of interview
Month of interview
Month of interview
Month of interview
Day/Month/Year of interview:
Households
Year of interview
Year of interview
Year of interview
Year of interview
Year of interview
Day/Month/Year of interview:
Households
Respondent HH questionnaire
Respondent HH questionnaire
Respondent HH questionnaire
Respondent HH questionnaire
Respondent HH questionnaire
Respondent to HH questionnaire:
Households
99
Missing
Number of household members
Number of household members
Number of household members
Number of household members
Number of household members
Total number of household members:
Households
Total eligible women
Total eligible women
Total eligible women
Total eligible women
Total eligible women
No.of women eligible for interview:
Households
Women interviews completed
Women interviews completed
Women interviews completed
Women interviews completed
Women interviews completed
No.of women questionnaires completed:
Households
Total children under 5
Total children under 5
Total children under 5
Total children under 5
Total children under 5
No.of children under age 5:
Households
Child interviews completed
Child interviews completed
Child interviews completed
Child interviews completed
Child interviews completed
No.of under-5 questionnaires completed:
Households
Enu. Result
Enu. Result
Enu. Result
Enu. Result
Enu. Result
After all questionnaires for the household have been completed, fill in the following information: Result of HH interview:
Households
1
Completed
2
Refused
3
Not at home
4
HH not found/destroyed
6
Others
Main source of drinking water
Main source of drinking water
Main source of drinking water
Main source of drinking water
Main source of drinking water
What is the main source of drinking water for members of your household?
Households
11
Piped into dwelling
12
Piped into yard or plot
13
Public tap/standpipe
21
Tubewell/borehole
31
Protected well
32
Unprotected well
41
Protected spring
42
Unprotected spring
51
Rainwater collection
61
Tanker-truck
81
Surface water
91
Bottled water
96
Other
99
Missing
Main source of water used for other purposes (if bottled wat
Main source of water used for other purposes (if bottled wat
Main source of water used for other purposes (if bottled wat
Main source of water used for other purposes (if bottled wat
Main source of water used for other purposes (if bottled wat
What is the main source of water used by your household for other purposes such as cooking and handwashing?
Households
11
Piped into dwelling
12
Piped into yard or plot
13
Public tap/standpipe
21
Tubewell/borehole
31
Protected well
32
Unprotected well
41
Protected spring
42
Unprotected spring
51
Rainwater collection
61
Tanker-truck
81
Surface water
96
Other
99
Missing
Time to get water and come back
Time to get water and come back
Time to get water and come back
Time to get water and come back
Time to get water and come back
How long does it take to go there, get water, and come back?
Households
995
On premises
998
DK
999
Missing
Person fetching water
Person fetching water
Person fetching water
Person fetching water
Person fetching water
Who usually goes to this source to fetch the water for your household? Probe: Is this person under age 15? What sex?
Circle code that best describes this person.
Households
1
Adult woman
2
Adult man
3
Female child (under 15)
4
Male child (under 15)
8
DK
9
Missing
Treat water to make safer for drinking
Treat water to make safer for drinking
Treat water to make safer for drinking
Treat water to make safer for drinking
Treat water to make safer for drinking
Do you treat your water in any way to make it safer to drink?
Households
1
Yes
2
No
8
DK
9
Missing
Boil
Boil
Boil
Boil
Boil
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
Households
?
Missing
A
Boil
Add bleach/chlorine
Add bleach/chlorine
Add bleach/chlorine
Add bleach/chlorine
Add bleach/chlorine
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
Households
?
Missing
B
Add bleach/chlorine
Strain it through a cloth
Strain it through a cloth
Strain it through a cloth
Strain it through a cloth
Strain it through a cloth
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
Households
?
Missing
C
Strain it through a cloth
Use water filter
Use water filter
Use water filter
Use water filter
Use water filter
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
Households
?
Missing
D
Use water filter
Solar disinfection
Solar disinfection
Solar disinfection
Solar disinfection
Solar disinfection
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
Households
?
Missing
E
Solar disinfection
Let it stand and settle
Let it stand and settle
Let it stand and settle
Let it stand and settle
Let it stand and settle
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
Households
?
Missing
F
Let it stand and settle
Other
Other
Other
Other
Other
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
Households
?
Missing
X
Other
DK
DK
DK
DK
DK
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
Households
?
Missing
Z
DK
Kind of toilet facility
Kind of toilet facility
Kind of toilet facility
Kind of toilet facility
Kind of toilet facility
What kind of toilet facility do members of your household usually use? If "flush" or "pour flush", probe: Where does it flush to?
If necessary, ask permission to observe the facility.
Households
11
Flush to piped sewer system
12
Flush to septic tank
13
Flush to pit (latrine)
14
Flush to somewhere else
15
Flush to unknown place/not sure/DK where
22
Pit latrine with slab
23
Pit latrine without slab/open pit
95
No facilities or bush or field
96
Other
99
Missing
Toilet facility shared
Toilet facility shared
Toilet facility shared
Toilet facility shared
Toilet facility shared
Do you share this facility with other households?
Households
1
Yes
2
No
9
Missing
Households using this toilet facility
Households using this toilet facility
Households using this toilet facility
Households using this toilet facility
Households using this toilet facility
How many households in total use this toilet facility?
Households
10
Ten or more households
98
DK
99
Missing
Religion of head
Religion of head
Religion of head
Religion of head
Religion of head
What is the religion of the head of this household?
Households
1
Buddhist
2
Muslim
3
Christian
6
Other religion
7
No religion
9
Missing
Language
Language
Language
Language
Language
What is the mother tongue/native language of the head of this household?
Households
1
Thai
2
Other Languages
3
Missing
Ethnic group of head
Ethnic group of head
Ethnic group of head
Ethnic group of head
Ethnic group of head
To what ethnic group does the head of this household belong?
Households
1
Thai
2
Cambodia
3
Loas
4
China
5
Myanmar
6
Other Ethnic
7
Hill Tribe
9
Missing
Head of occupation
Head of occupation
Head of occupation
Head of occupation
Head of occupation
1
Government Officer
2
State Enterprises Officer
3
Private Officer
4
Business
5
Agriculturist
6
Labourer
7
Other
9
Missing
Mean of income
Mean of income
Mean of income
Mean of income
Mean of income
1
Lower 10000
2
10000-19999
3
20000-29999
4
30000-39999
5
40000-49999
6
Upper 50000
9
Missing
Number of rooms for sleeping
Number of rooms for sleeping
Number of rooms for sleeping
Number of rooms for sleeping
Number of rooms for sleeping
How many rooms in this household are used for sleeping?
Households
99
Missing
Main material of floor
Main material of floor
Main material of floor
Main material of floor
Main material of floor
Main material of the dwelling floor:
Record observation.
Households
11
Earth/sand
21
Wood planks
22
Palm/bamboo
31
Parquet or polished wood
32
Vinyl or asphalt strips
33
Ceramic tiles
34
Cement
35
Carpet
36
Marble
37
Polished stone
96
Other
99
Missing
Main material of roof
Main material of roof
Main material of roof
Main material of roof
Main material of roof
Main material of the roof.
Record observation.
Households
11
No roof
12
Thatch/palm leaf
13
Sod
22
Palm/bamboo
23
Wood Planks
31
Metal
33
Calamine/cement fiber
34
Ceramic tiles
35
Cement
36
Roofing shingles
96
Other
99
Missing
Main material of wall
Main material of wall
Main material of wall
Main material of wall
Main material of wall
Main material of the walls.
Record observation.
Households
11
No walls
12
Cane/palm/trunks
13
Dirt
24
Plywood
25
Carton
26
Reused wood
27
Bamboo
31
Cement
32
Stone with lime/cement
33
Bricks
34
Cement blocks
36
Wood planks/shingles
37
Zinc
38
Tile
39
Shera wood
96
Other
99
Missing
Type of fuel using for cooking
Type of fuel using for cooking
Type of fuel using for cooking
Type of fuel using for cooking
Type of fuel using for cooking
What type of fuel does your household mainly use for cooking?
Households
1
Electricity
2
Liquid propane gas (LPG)
4
Biogas
5
Kerosene
6
Coal/lignite
7
Charcoal
8
Wood
9
Straw/shrubs/grass
10
Animal dung
11
Agricultural crop residue
96
Other
97
No Cooking
99
Missing
Food cooked on stove or open fire
Food cooked on stove or open fire
Food cooked on stove or open fire
Food cooked on stove or open fire
Food cooked on stove or open fire
In this household, is food cooked on an open fire, an open stove or a closed stove?
Probe for type.
Households
1
Open fire
2
Open stove
3
Closed stove
6
Other
9
Missing
Does the fire stove have a chimney or a hood
Does the fire stove have a chimney or a hood
Does the fire stove have a chimney or a hood
Does the fire stove have a chimney or a hood
Does the fire stove have a chimney or a hood
Does the fire/stove have a chimney or a hood?
Households
1
Yes
2
No
9
Missing
Cooking location
Cooking location
Cooking location
Cooking location
Cooking location
Is the cooking usually done in the house, in a separate building, or outdoors?
Households
1
In the house
2
In a separate bulding
3
Outdoors
4
Terrace
6
Other
9
Missing
Electricity
Electricity
Electricity
Electricity
Electricity
Does your household have:
Households
1
Yes
2
No
9
Missing
Radio
Radio
Radio
Radio
Radio
Does your household have:
Households
1
Yes
2
No
9
Missing
Television
Television
Television
Television
Television
Does your household have:
Households
1
Yes
2
No
9
Missing
Mobile phone
Mobile phone
Mobile phone
Mobile phone
Mobile phone
Does your household have:
Households
1
Yes
2
No
9
Missing
Non-mobile phone
Non-mobile phone
Non-mobile phone
Non-mobile phone
Non-mobile phone
Does your household have:
Households
1
Yes
2
No
9
Missing
Refrigerator
Refrigerator
Refrigerator
Refrigerator
Refrigerator
Does your household have:
Households
1
Yes
2
No
9
Missing
Computer
Computer
Computer
Computer
Computer
Watch
Watch
Watch
Watch
Watch
Does any member of your household own:
Households
1
Yes
2
No
9
Missing
Bicycle
Bicycle
Bicycle
Bicycle
Bicycle
Does any member of your household own:
Households
1
Yes
2
No
9
Missing
Motorcycle or scooter
Motorcycle or scooter
Motorcycle or scooter
Motorcycle or scooter
Motorcycle or scooter
Does any member of your household own:
Households
1
Yes
2
No
9
Missing
Animal-drawn cart
Animal-drawn cart
Animal-drawn cart
Animal-drawn cart
Animal-drawn cart
Does any member of your household own:
Households
1
Yes
2
No
9
Missing
Car or truck
Car or truck
Car or truck
Car or truck
Car or truck
Does any member of your household own:
Households
1
Yes
2
No
9
Missing
Boat with motor
Boat with motor
Boat with motor
Boat with motor
Boat with motor
Does any member of your household own:
Households
1
Yes
2
No
9
Missing
Children's sample weight
Children's sample weight
Children's sample weight
Children's sample weight
Children's sample weight
Recoded variable
Children aged 0-4
REGR factor score 1 for analysis 1
REGR factor score 1 for analysis 1
REGR factor score 1 for analysis 1
REGR factor score 1 for analysis 1
REGR factor score 1 for analysis 1
Recoded variable
Children aged 0-4
wealth index quintiles
wealth index quintiles
wealth index quintiles
wealth index quintiles
wealth index quintiles
Recoded variable
Children aged 0-4
1
Poorest
2
Second
3
Middle
4
Fourth
5
Richest
Date of interview child (CMC)
Date of interview child (CMC)
Date of interview child (CMC)
Date of interview child (CMC)
Date of interview child (CMC)
Recoded variable
Children aged 0-4
Date of birth (CMC)
Date of birth (CMC)
Date of birth (CMC)
Date of birth (CMC)
Date of birth (CMC)
Recoded variable
Children aged 0-4
Age (months)
Age (months)
Age (months)
Age (months)
Age (months)
Recoded variable
Children aged 0-4
Age
Age
Age
Age
Age
Recoded variable
Children aged 0-4
1
< 6 months
2
6-11 months
3
12-23 months
4
24-35 months
5
36-47 months
6
48-59 months
Age
Age
Age
Age
Age
Recoded variable
Children aged 0-4
1
0-11 months
2
12-23 months
3
24-35 months
4
36-47 months
5
48-59 months
Mother's education
Mother's education
Mother's education
Mother's education
Mother's education
Recoded variable
Children aged 0-4
1
None
2
Primary
3
Secondary +
The variable is created from information collected on educational level in the HL file. See makewm.sps in the data processing folder under technical information.