DDI_UZB_2006_MICS_v01_M Croft, Trevor Aleksandar Zoric Rhiannon James 2008-02-25 NADA Uzbekistan MICS 2006 v0.1 Slightly edited version of UNICEF's DDI ref. DDI-UZB-CSO-MICS2006/1.0-v0.1 Multiple Indicator Cluster Survey 2006 MICS3 2006 UZB_2006_MICS_v01_M State Statistical Committee of the Republic of Uzbekistan State Statistical Committee of the Republic of Uzbekistan UNICEF, Uzbekistan Country Office UNICEF Regional MICS coordinator UNICEF Regional M&E officer Strategic Information Section, Division of Policy and Planning, UNICEF NYHQ NADA UNICEF UNFPA Rayganat Makhmudova Djamila de Vaulgrenant Hancioglu, Attila Multiple Indicator Cluster Survey - Round 3 [hh/mics-3] The Multiple Indicator Cluster Survey, Round 3 (MICS3) is the third round of MICS surveys, previously conducted around 1995 (MICS1) and 2000 (MICS2). Many questions and indicators are consistent and compatible with the prior round of MICS (MICS2) but less so with MICS1, although there have been a number of changes in definition of indicators between rounds. Details can be found by reviewing the indicator definitions. Version 1.0: Edited data used for preliminary report Household members Education Water and sanitation Household characteristics Child labour Salt iodization Women's background Child mortality Maternal and newborn health Marriage and union Contraception HIV/AIDS Birth registration Early learning Vitamin A Breastfeeding Care of illness Immunization Anthropometry Sexual behaviour Durability of housing Source and cost of supplies Child development Disability Maternal mortality The Multiple Indicator Cluster Survey (MICS) is a household survey programme developed by UNICEF to assist countries in filling data gaps for monitoring human development in general and the situation of children and women in particular. 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 Uzbekistan Multiple Indicator Cluster Survey has as its primary objectives: - To provide up-to-date information for assessing the situation of children and women in Uzbekistan - To furnish data needed for monitoring progress toward goals established in the Millennium Declaration, the goals of A World Fit For Children (WFFC), and other internationally agreed upon goals, as a basis for future action; - To contribute to the improvement of data and monitoring systems in Uzbekistan and to strengthen technical expertise in 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 conducted by the State Statistical Committee of the Republic of Uzbekistan, 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. Uzbekistan The survey is a nationally representative for households, women, and children of Uzbekistan. Households (defined as a group of persons who usually live and eat together) De jure household members (defined as memers of the household who usually live in the household, which may include people who did not sleep in the household the previous night, but does not include visitors who slept in the household the previous night but do not usually live in the household) Women aged 15-49 Children aged 0-4 The survey covered all de jure household members (usual residents), all women aged 15-49 years resident in the household, and all children aged 0-4 years (under age 5) resident in the household. Sample survey data [ssd] The Uzbekistan Multiple Indicator Cluster Survey included the following modules in the questionnaires: HOUSEHOLD QUESTIONNAIRE : Household characteristics, household listing, education, child labour, water and sanitation, and salt iodization, with optional modules child disability and maternal mortality and durability of housing. WOMEN'S QUESTIONNAIRE: Women's characteristics, child mortality, maternal and newborn health, marriage, contraception, and HIV/AIDS knowledge, with optional module for sexual behavior. CHILDREN'S QUESTIONNAIRE: Children's characteristics, birth registration and early learning, vitamin A, breastfeeding, care of illness, immunization, and anthropometry, with an optional module for child development and immunization module by data from medical institution. State Statistical Committee The sample for the Uzbekistan Multiple Indicator Cluster Survey was designed to provide estimates for a large number of indicators on the situation of children and women at the national level, for urban and rural areas, and for six geo-economical regions of the country, as follows: 1. Western: (Republic of Karakalpakstan & Khorezm oblast) 2. Central: (Bukhara, Navoi & Samarkhand oblasts) 3. Southern: (Kashkadarya & Surkhandarya oblasts) 4. Central-Eastern: (Jjizzakh, Syrdarya & Taskentskaya oblasts) 5. Eastern: (Andizhan, Namangan & Fergana oblasts) 6. Tashkent city Regions were identified as the main sampling domains and the sample was selected in three stages. At the first stage, 375 primary sampling units were selected with probability proportional to size from a master frame of 14,799 enumeration areas called "mahala" produced by a countrywide population review, conducted by the State Statistical Committee (SSC) in 2002. The list of selected enumeration areas served as the frame for the second stage of selection. Each enumeration area was assigned a measure of size equal to the desired number of "standard segments" it contains by dividing the population size of the enumeration area by 500 and rounding to the nearest whole number. One segment was randomly selected on the basis of a sketch-map prepared for each enumeration area. After a household listing was carried out within the selected segments, a systematic sample of 10,505 households was drawn. All selected enumeration areas were successfully visited. The distribution of clusters between sampling domains is not proportional to the distribution of population and, consequently neither is the fi nal household distribution. The sample is therefore not a self-weighting household sample. For reporting national level results, sample weights are used. Following standard MICS data collection rules, if a household was actually more than one household when visited, then a) if the selected household contained two households, both were interviewed, or b) if the selected household contained 3 or more households, then only the household of the person named as the head was interviewd. No replacement of households was permitted in case of non-response or non-contactable households. Adjustments were made to the sampling weights to correct for non-response, according to MICS standard procedures. The sampling procedures are more fully described in the sampling design document and the sampling appendix of the final report. No major deviations from the original sample design were made. All sample enumeration areas were accessed and successfully interviewed with good response rates. Face-to-face [f2f] The questionnaires for the Uzbekistan 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. The household questionnaire includes household characteristics, education, child labour, water and sanitation, and salt iodization, with optional modules child disability, maternal mortality and durability of housing. 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 women's questionnaire include women's characteristics, child mortality, maternal and newborn health, marriage, contraception, and HIV/AIDS knowledge, with optional modul for sexual behavior. The children's questionnaire includes children's characteristics, birth registration and early learning, vitamin A, breastfeeding, care of illness, immunization, and anthropometry, with an optional module for child development and county specific immunization module by data from medical institution The questionnaires were developed in English from the MICS3 Model Questionnaires, and were translated into Russian and Uzbek. After an initial review the questionnaires were translated back into English by an independent translator with no prior knowledge of the survey. The back translation from the Russian and Uzbek version was independently reviewed and compared to the English original. Differences in translation were reviewed and resolved in collaboration with the original translators. The English and Russian and Uzbek questionnaires were both piloted as part of the survey pretest. All questionnaires and modules are provided as external resources. Twenty eight persons, expected to act as fieldwork supervisors and editors during the main fieldwork, were trained for eight days, including a two days fieldwork exercise to conduct interviews in both Uzbek and Russian. At this time weight measurements were also taken. This fieldwork exercise was conducted in one urban area of the Tashkent and one rural area of the Zangiatinski rayon of Tashkent oblast. Participants conducted interviews working in teams composed of two people, that allowed them observe and support each other. A total of 117 household interviews were conducted, including completion of the 146 individual women's questionnaire and 55 questionnaires for children under-5. Each team performed five to ten household interviews. After the completion of the field exercise one day was dedicated reviewing survey questionnaires and discussing issues and concerns participants met during the interview. Based on the results of the pre-test, final editing was performed to the wording and translations of the questionnaires, as well as lessons were learnt about logistical arrangements of the field data collection. The data was collected by 15 teams; each comprised of three to four female interviewers, one female editor/measurer, one supervisor and one driver. Interviewing was conducted by teams of interviewers. Each interviewing team comprised of 3-4 female interviewers, a field editor and a supervisor, and a driver. Each teams used a 4 wheel dirve vehicle to travel from cluster to cluster (and where necessary within cluster). Senior staff from the SSC and two national fieldwork coordinators coordinated and supervised the field work activities. An external supervision programme was set up to monitor and provide assistance to the survey field work activities. The role of the supervisor was to coordinator field data collection activities, including management of the field teams, supplies and equipment, finances, maps and listings, coordinate with local authorities concerning the survey plan and make arrangements for accomodation and travel. Additionally, the field supervisor assigned the work to the interviewers, spot checked work, maintained field control documents, and sent completed questionnaires and progress reports to the central office The field editor was responsible for reviewing each questionnaire at the end of the day, checking for missed questions, skip errors, fields incorrectly completed, and checking for inconsistencies in the data. The field editor also observed interviews and conducted review sessions with interviewers. Responsibilities of the supervisors and field editors are described in the Instructions for Supervisors and Field Editors, together with the different field controls that were in place to control the quality of the fieldwork. Field visits were also made by a team of central staff on a periodic basis during fieldwork. The senior staff of SSC also made 3 visits to field teams to provide support and to review progress. The Uzbekistan Multiple Indicator Cluster Survey sample is not self-weighted. Essentially, by allocating equal numbers of households to each of the regions, different sampling fractions were used in each region since the size of the regions varied. For this reason, sample weights were calculated and these were used in the subsequent analyses of the survey data. The major component of the weight is the reciprocal of the sampling fraction employed in selecting the number of sample households in that particular sampling domain Sample weights were calculated for each of the datafiles. Sample weights for the household data were computed as the inverse of the probability of selection of the household, computed at the sampling domain level (urban/rural within each region). The household weights were adjusted for non-response at the domain level, and were then normalized by a constant factor so that the total weighted number of households equals the total unweighted number of households. The household weight variable is called HHWEIGHT and is used with the HH data and the HL data. Sample weights for the women's data used the un-normalized household weights, adjusted for non-response for the women's questionnaire, and were then normalized by a constant factor so that the total weighted number of women's cases equals the total unweighted number of women's cases. Sample weights for the children's data followed the same approach as the women's and used the un-normalized household weights, adjusted for non-response for the children's questionnaire, and were then normalized by a constant factor so that the total weighted number of children's cases equals the total unweighted number of children's cases. Data editing took place at a number of stages throughout the processing (see Other processing), including: a) Office editing and coding b) During data entry c) Structure checking and completeness d) Secondary editing e) Structural checking of SPSS data files Detailed documentation of the editing of data can be found in the data processing guidelines Of the 10,505 households selected for the sample, 10,349 were found to be occupied. Of these, 10,198 were successfully interviewed resulting in a household response rate of 98.5 percent. In the interviewed households, 14,205 women (age 15–49) were identifi ed. Of these, 13,919 were successfully interviewed, yielding a response rate of 98 percent. In addition, 5,039 children under age fi ve were listed in the household questionnaire. Questionnaires were completed for 4,986 of these children, which corresponds to a response rate of 98.9 percent. Overall response rates of 96.6 and 97.5 are calculated for the women’s and under-5’s interviews respectively There are no significant differences in response rates according to regions and urban rural residence. Household, woman and children questionnaires’ response rates are all 95 percent or higher across different regions and urban and rural areas. Estimates from a sample survey are affected by two types of errors: 1) non-sampling errors and 2) sampling errors. Non-sampling errors are the results of mistakes made in the implementation of data collection and data processing. Numerous efforts were made during implementation of the 2006 MICS to minimize this type of error, however, non-sampling errors are impossible to avoid and difficult to evaluate statistically. Sampling errors can be evaluated statistically. The sample of respondents to the 2006 MICS is only one of many possible samples that could have been selected from the same population, using the same design and expected size. Each of these samples would yield results that differe somewhat from the results of the actual sample selected. Sampling errors are a measure of the variability in the results of the survey between all possible samples, and, although, the degree of variability is not known exactly, it can be estimated from the survey results. The sampling erros are measured in terms of the standard error for a particular statistic (mean or percentage), which is the square root of the variance. Confidence intervals are calculated for each statistic within which the true value for the population can be assumed to fall. Plus or minus two standard errors of the statistic is used for key statistics presented in MICS, equivalent to a 95 percent confidence interval. If the sample of respondents had been a simple random sample, it would have been possible to use straightforward formulae for calculating sampling errors. However, the 2006 MICS sample is the result of a multi-stage stratified design, and consequently needs to use more complex formulae. The SPSS complex samples module has been used to calculate sampling errors for the 2006 MICS. This module uses the Taylor linearization method of variance estimation for survey estimates that are means or proportions. This method is documented in the SPSS file CSDescriptives.pdf found under the Help, Algorithms options in SPSS. Sampling errors have been calculated for a select set of statistics (all of which are proportions due to the limitations of the Taylor linearization method) for the national sample, urban and rural areas, and for each of the five regions. For each statistic, the estimate, its standard error, the coefficient of variation (or relative error -- the ratio between the standard error and the estimate), the design effect, and the square root design effect (DEFT -- the ratio between the standard error using the given sample design and the standard error that would result if a simple random sample had been used), as well as the 95 percent confidence intervals (+/-2 standard errors). Details of the sampling errors are presented in the sampling errors appendix to the report and in the sampling errors table presented in te external resources. A series of data quality tables and graphs are available to review the quality of the data and include the following: Age distribution of the household population Age distribution of eligible women and interviewed women Age distribution of eligible children and children for whom the mother or caretaker was interviewed Age distribution of children under age 5 by 3 month groups Age and period ratios at boundaries of eligibility Percent of observations with missing information on selected variables Presence of mother inthe household and person interviewed for the under 5 questionnaire School attendance by single year age Sex ratio at birth among children ever born, surviving and dead by age of respondent Distribution of women by time since last birth Scatterplot of weight by height, weight by age and height by age Graph of male and female population by single years of age Population pyramid The results of each of these data quality tables is shown in the appendix of the final report and is also given in the external resources section. The general rule for presentation of missing data in the final report tabulations is that a column is presented for missing data if the percentage of cases with missing data is 1% or more. Cases with missing data on the background characteristics (e.g. education) are included in the tables, but the missing data rows are suppressed and noted at the bottom of the tables in the report (not in the SPSS output, however). Users of the data agree to keep confidential all data contained in these datasets and to make no attempt to identify, trace or contact any individual whose data is included in these datasets. Andrey Zaharchenko State Statistical Committee of the Republic of Uzbekistan. Multiple Indicator Cluster Survey: Household , household listing, women and children's files, 2006 [Computer file]. Tashkent, Uzbekistan: State Statistical Committee of the Republic of Uzbekistan [producer], 2006. Tashkent, Uzbekistan: State Statistical Committee of the Republic of Uzbekistan and New York: Strategic Information Section, Dvision of Policy and Planning, UNICEF [distributors], 2006. Survey datasets are distributed at no cost for legitimate research, with the condition that we receive and approve the objectives of any research project that will be using the data prior to authorizing their distribution. Copies of all reports and publications based on the requested data must be sent to UNICEF tashkent@unicef.org. Requests for access to the datasets may be made through the website www.childinfo.org. SSC and UNICEF provides these data to external users without any warranty or responsibility implied. SSC and UNICEF accepts no responsibility for the results and/or implications of any actions resulting from the use of these data. hh Data collected at the household level (MICS Household questionnaire: modules Household information panel, Household listing form, Education module, Water and sanitation module, Household characteristics module, Salt iodization module) 0 86 hl Data collected at the household member's level (MICS Household questionnaire: modules Household listing, Child labour, Child Disability, Maternal Mortality) 0 135 wm Data collected at the women's level (MICS Women's questionnaire: modules Women's Information Panel, Child mortality, Maternal and newborn health, Marriage/union, Contraception (and unmet need), HIV/AIDS, Sexual behaviour) 0 220 ch Data collected at the children's level (MICS Under Five Children's questionnaire: modules Under Five Child Information Panel, Birth registration and early learning, Child development, Vitamin A, Breastfeeding, Care of Illness, Immunization, Anthropometry, Immunization module by data from medical institution) 0 326 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 Antenatal care Care seeking behaviour Child labor Salt iodization Early child development Early learning Support to orphans and vulnerable children Sexual behaviour Condom use Child disability Maternal mortality Vitamin A Assistance at delivery Unmet need Newborn health Immunizations Birth registration Early marriage 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 Interviewer number Interviewer number Interviewer number Interviewer number Interviewer number Interviewer name and number: Households Supervisor Number Supervisor Number Supervisor Number Supervisor Number Supervisor Number Supervisor name and number: Households 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 Area Area Area Area Area Area: Households 1 Urban 2 Rural Region Region Region Region Region Region: Households 1 Western 2 Central 3 Southern 4 Central East 5 East 6 Tashkent Result of HH interview Result of HH interview Result of HH interview Result of HH interview Result of HH interview After all questionnaires for the household have been completed, fill in the following information: Result of HH interview: Households 1 Completed 2 Not at home 3 Refused 4 HH not found/destroyed 6 Other Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent to HH questionnaire: 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 Data editor Data editor Data editor Data editor Data editor Data editor: Households Data entry clerk Data entry clerk Data entry clerk Data entry clerk Data entry clerk Data entry clerk: Households Total number of Women 15-49 Total number of Women 15-49 Total number of Women 15-49 Total number of Women 15-49 Total number of Women 15-49 Are there any other persons living here - even if they are not members of your family or do not have parents living in this household? Including children at work or at school? If yes, insert child's name and complete form. Then, complete the totals below. Households Total number of Children 5-14 Total number of Children 5-14 Total number of Children 5-14 Total number of Children 5-14 Total number of Children 5-14 Households Total number of children Under 5 years Total number of children Under 5 years Total number of children Under 5 years Total number of children Under 5 years Total number of children Under 5 years Households Main source of drinking water Main source of drinking water Main source of drinking water Main source of drinking water Main source of drinking water What is the main source of drinking water for members of your household? 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 71 Cart with small tank/drum 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 71 Cart with small tank/drum 81 Surface water 96 Other 99 Missing Time to get water and come back Time to get water and come back Time to get water and come back Time to get water and come back Time to get water and come back How long does it take to go there, get water, and come back? 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 21 Ventilated Improved Pit latrine (VIP) 22 Pit latrine with slab 23 Pit latrine without slab/open pit 31 Composting toilet 41 Bucket 51 Hanging toilet/hanging latrine 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 Mother tongue of head Mother tongue of head Mother tongue of head Mother tongue of head Mother tongue of head What is the mother tongue/native language of the head of this household? Households 1 Uzbek 2 Russian 3 Karakalpak 4 Tajik 5 Kirgiz 6 Other Language 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 31 Parquet or polished wood 32 Vinyl or asphalt strips 33 Ceramic tiles 34 Cement 35 Carpet 96 Other 99 Missing Main material of roof Main material of roof Main material of roof Main material of roof Main material of roof Main material of the roof. Record observation. Households 12 Thatch/palm leaf 14 Earther cover 21 Rustic mat 23 Wood Planks 31 Metal 32 Wood 33 Calamine/cement fiber 34 Ceramic tiles 35 Cement 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 22 Stone with mud 23 Uncovered adobe 24 Plywood 26 Reused wood 31 Cement 32 Stone with lime/cement 33 Bricks 34 Cement blocks 35 Covered adobe 36 Wood planks/shingles 96 Other 99 Missing Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking What type of fuel does your household mainly use for cooking? Households 1 Electricity 2 Liquid propane gas (LPG) 3 Natural gas 4 Biogas 5 Kerosene 6 Coal/lignite 7 Charcoal 8 Wood 9 Straw/shrubs/grass 10 Animal dung 11 Agricultural crop residue 96 Other 99 Missing Food cooked on stove or open fire Food cooked on stove or open fire Food cooked on stove or open fire Food cooked on stove or open fire Food cooked on stove or open fire In this household, is food cooked on an open fire, an open stove or a closed stove? Probe for type. 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 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 The electric heater for water The electric heater for water The electric heater for water The electric heater for water The electric heater for water Does your household have: Households 1 Yes 2 No 9 Missing Table Table Table Table Table Does your household have: Households 1 Yes 2 No 9 Missing Chair Chair Chair Chair Chair Does your household have: Households 1 Yes 2 No 9 Missing Mirror Mirror Mirror Mirror Mirror Does your household have: Households 1 Yes 2 No 9 Missing The washing machine The washing machine The washing machine The washing machine The washing machine Does your household have: Households 1 Yes 2 No 9 Missing The vacuum cleaner The vacuum cleaner The vacuum cleaner The vacuum cleaner The vacuum cleaner Does your household have: Households 1 Yes 2 No 9 Missing The video tape recorder The video tape recorder The video tape recorder The video tape recorder The video tape recorder Does your household have: Households 1 Yes 2 No 9 Missing The armoir The armoir The armoir The armoir The armoir Does your household have: Households 1 Yes 2 No 9 Missing Furniture set Furniture set Furniture set Furniture set Furniture set Does your household have: Households 1 Yes 2 No 9 Missing 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 Computer Computer Computer Computer Computer Does any member of your household own: Households 1 Yes 2 No 9 Missing Tractor Tractor Tractor Tractor Tractor Does any member of your household own: Households 1 Yes 2 No 9 Missing Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of this household own any land that can be used for agriculture? Households 1 Yes 2 No 9 Missing Unit (hectares, handred hectares) Unit (hectares, handred hectares) Unit (hectares, handred hectares) Unit (hectares, handred hectares) Unit (hectares, handred hectares) How many hectares of agricultural land do members of this household own? Households 1 Hectares 2 hundred hectares 9 DK How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agricultural land do members of this household own? If more than 97, record '97'. If unknown, record '98'. Households 97 More than 97 98 Don't know 99 Missing Does this household own any livestock, heds, or animals Does this household own any livestock, heds, or animals Does this household own any livestock, heds, or animals Does this household own any livestock, heds, or animals Does this household own any livestock, heds, or animals Does this household own any livestock, herds, or farm animals? Households 1 Yes 2 No 9 Missing Number of cattle Number of cattle Number of cattle Number of cattle Number of cattle How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of Goats Number of Goats Number of Goats Number of Goats Number of Goats How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of sheep Number of sheep Number of sheep Number of sheep Number of sheep How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of chickens Number of chickens Number of chickens Number of chickens Number of chickens How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of rabbits Number of rabbits Number of rabbits Number of rabbits Number of rabbits How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of Camels Number of Camels Number of Camels Number of Camels Number of Camels How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 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 Not iodized 0 PPM (no colour) 2 Less than 15 PPM (weak colour) 3 15 PPM or more (strong colour) 6 No salt in home 7 Salt not tested 9 Missing Education of household head Education of household head Education of household head Education of household head Education of household head Recoded variable De jure household members (usual residents) 3 Incomplete Secondary 4 Complete Secondary 5 Secondary special 6 Higher education 9 None/Primary/Non-standard/Missing/DK 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. Household sample weight Household sample weight Household sample weight Household sample weight Household sample weight Recoded variable De jure household members (usual residents) Wealth index score Wealth index score Wealth index score Wealth index score Wealth index score 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 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) 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 9 Missing 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) 97 97+ 98 DK 99 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 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) 97 Inconsistent 99 Missing Father alive Father alive Father alive Father alive Father alive For children age 0-17 years ask HL9-HL12 If alive: Is (name's) natural father alive? 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) 97 Inconsistent 99 Missing 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 Has (name) ever attended school or preschool? Children aged 0-4 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 1 Primary 2 Secondary 3 Secondary Special 4 Higher 6 Non-standard 8 DK 9 Missing Highest grade at level Highest grade at level Highest grade at level Highest grade at level Highest grade at level What is the highest grade (name) completed at this level? Children aged 0-4 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 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 1 Primary 2 Secondary 3 Secondary Special 4 Higher 6 Non-standard 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 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 1 Primary 2 Secondary 3 Secondary Special 4 Higher 6 Non-standard 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 97 Inconsistent 98 DK 99 Missing Line number Line number Line number Line number Line number To be administered to mother/caretaker of each child in the household age 5 through 14 years. For household members below age 5 or above age 14, leave rows blank. Now I would like to ask about any work children in this household may do. 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 Line number from household listing Line number from household listing Line number from household listing Line number from household listing Line number from household listing Administer to each adult household member. Copy name and line number of each adult (age 15 or over) in the household. If one of these adults is not at home, another adult may respond for him/her. Indicate this by placing a '1' in MM3, and insert line number of proxy respondent in MM4. For household members below age 15, leave rows blank De jure household members (usual residents) Is this proxy report Is this proxy report Is this proxy report Is this proxy report Is this proxy report Is this a proxy report? De jure household members (usual residents) 1 Yes 2 No 9 Missing Line number of proxy Line number of proxy Line number of proxy Line number of proxy Line number of proxy Line no. of proxy respondent (from household listing HL1) De jure household members (usual residents) How many sisters (born to the same mother) How many sisters (born to the same mother) How many sisters (born to the same mother) How many sisters (born to the same mother) How many sisters (born to the same mother) How many sisters (born to the same mother) have you ever had? De jure household members (usual residents) 98 Don't know How many of these sisters ever reached age 15? How many of these sisters ever reached age 15? How many of these sisters ever reached age 15? How many of these sisters ever reached age 15? How many of these sisters ever reached age 15? How many of these sisters ever reached age 15? De jure household members (usual residents) 98 Don't know How many of these sisters are alive How many of these sisters are alive How many of these sisters are alive How many of these sisters are alive How many of these sisters are alive How many of these sisters (who are at least 15 years old) are alive now? De jure household members (usual residents) 98 Don't know How many of these sisters have died How many of these sisters have died How many of these sisters have died How many of these sisters have died How many of these sisters have died How many of these sisters who reached age 15 or more have died? De jure household members (usual residents) 98 Don't know How many of these died while pregnant or during childbirth How many of these died while pregnant or during childbirth How many of these died while pregnant or during childbirth How many of these died while pregnant or during childbirth How many of these died while pregnant or during childbirth How many of these dead sisters died while pregnant, or during childbirth, or during the six weeks after the end of pregnancy? De jure household members (usual residents) 98 Don't know Interviewer number Interviewer number Interviewer number Interviewer number Interviewer number Interviewer name and number: Households Supervisor Number Supervisor Number Supervisor Number Supervisor Number Supervisor Number Supervisor name and number: Households 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 Area Area Area Area Area Area: Households 1 Urban 2 Rural Region Region Region Region Region Region: Households 1 Western 2 Central 3 Southern 4 Central East 5 East 6 Tashkent Result of HH interview Result of HH interview Result of HH interview Result of HH interview Result of HH interview After all questionnaires for the household have been completed, fill in the following information: Result of HH interview: Households 1 Completed 2 Not at home 3 Refused 4 HH not found/destroyed 6 Other Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent to HH questionnaire: 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 Data editor Data editor Data editor Data editor Data editor Data editor: Households Data entry clerk Data entry clerk Data entry clerk Data entry clerk Data entry clerk Data entry clerk: Households Main source of drinking water Main source of drinking water Main source of drinking water Main source of drinking water Main source of drinking water What is the main source of drinking water for members of your household? 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 71 Cart with small tank/drum 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 71 Cart with small tank/drum 81 Surface water 96 Other 99 Missing Time to get water and come back Time to get water and come back Time to get water and come back Time to get water and come back Time to get water and come back How long does it take to go there, get water, and come back? 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 21 Ventilated Improved Pit latrine (VIP) 22 Pit latrine with slab 23 Pit latrine without slab/open pit 31 Composting toilet 41 Bucket 51 Hanging toilet/hanging latrine 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 Mother tongue of head Mother tongue of head Mother tongue of head Mother tongue of head Mother tongue of head What is the mother tongue/native language of the head of this household? Households 1 Uzbek 2 Russian 3 Karakalpak 4 Tajik 5 Kirgiz 6 Other Language 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 31 Parquet or polished wood 32 Vinyl or asphalt strips 33 Ceramic tiles 34 Cement 35 Carpet 96 Other 99 Missing Main material of roof Main material of roof Main material of roof Main material of roof Main material of roof Main material of the roof. Record observation. Households 12 Thatch/palm leaf 14 Earther cover 21 Rustic mat 23 Wood Planks 31 Metal 32 Wood 33 Calamine/cement fiber 34 Ceramic tiles 35 Cement 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 22 Stone with mud 23 Uncovered adobe 24 Plywood 26 Reused wood 31 Cement 32 Stone with lime/cement 33 Bricks 34 Cement blocks 35 Covered adobe 36 Wood planks/shingles 96 Other 99 Missing Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking What type of fuel does your household mainly use for cooking? Households 1 Electricity 2 Liquid propane gas (LPG) 3 Natural gas 4 Biogas 5 Kerosene 6 Coal/lignite 7 Charcoal 8 Wood 9 Straw/shrubs/grass 10 Animal dung 11 Agricultural crop residue 96 Other 99 Missing Food cooked on stove or open fire Food cooked on stove or open fire Food cooked on stove or open fire Food cooked on stove or open fire Food cooked on stove or open fire In this household, is food cooked on an open fire, an open stove or a closed stove? Probe for type. 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 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 The electric heater for water The electric heater for water The electric heater for water The electric heater for water The electric heater for water Does your household have: Households 1 Yes 2 No 9 Missing Table Table Table Table Table Does your household have: Households 1 Yes 2 No 9 Missing Chair Chair Chair Chair Chair Does your household have: Households 1 Yes 2 No 9 Missing Mirror Mirror Mirror Mirror Mirror Does your household have: Households 1 Yes 2 No 9 Missing The washing machine The washing machine The washing machine The washing machine The washing machine Does your household have: Households 1 Yes 2 No 9 Missing The vacuum cleaner The vacuum cleaner The vacuum cleaner The vacuum cleaner The vacuum cleaner Does your household have: Households 1 Yes 2 No 9 Missing The video tape recorder The video tape recorder The video tape recorder The video tape recorder The video tape recorder Does your household have: Households 1 Yes 2 No 9 Missing The armoir The armoir The armoir The armoir The armoir Does your household have: Households 1 Yes 2 No 9 Missing Furniture set Furniture set Furniture set Furniture set Furniture set Does your household have: Households 1 Yes 2 No 9 Missing 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 Computer Computer Computer Computer Computer Does any member of your household own: Households 1 Yes 2 No 9 Missing Tractor Tractor Tractor Tractor Tractor Does any member of your household own: Households 1 Yes 2 No 9 Missing Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of this household own any land that can be used for agriculture? Households 1 Yes 2 No 9 Missing Unit (hectares, handred hectares) Unit (hectares, handred hectares) Unit (hectares, handred hectares) Unit (hectares, handred hectares) Unit (hectares, handred hectares) How many hectares of agricultural land do members of this household own? Households 1 Hectares 2 hundred hectares 9 DK How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agricultural land do members of this household own? If more than 97, record '97'. If unknown, record '98'. Households 97 More than 97 98 Don't know 99 Missing Does this household own any livestock, heds, or animals Does this household own any livestock, heds, or animals Does this household own any livestock, heds, or animals Does this household own any livestock, heds, or animals Does this household own any livestock, heds, or animals Does this household own any livestock, herds, or farm animals? Households 1 Yes 2 No 9 Missing Number of cattle Number of cattle Number of cattle Number of cattle Number of cattle How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of Goats Number of Goats Number of Goats Number of Goats Number of Goats How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of sheep Number of sheep Number of sheep Number of sheep Number of sheep How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of chickens Number of chickens Number of chickens Number of chickens Number of chickens How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of rabbits Number of rabbits Number of rabbits Number of rabbits Number of rabbits How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of Camels Number of Camels Number of Camels Number of Camels Number of Camels How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing 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 3 Incomplete Secondary 4 Complete Secondary 5 Secondary special 6 Higher education 9 None/Primary/Non-standard/Missing/DK 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) 3 Incomplete Secondary 4 Complete Secondary 5 Secondary special 6 Higher education 9 None/Primary/Non-standard/Missing/DK 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. Education of household head Education of household head Education of household head Education of household head Education of household head Recoded variable De jure household members (usual residents) 3 Incomplete Secondary 4 Complete Secondary 5 Secondary special 6 Higher education 9 None/Primary/Non-standard/Missing/DK 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. Household sample weight Household sample weight Household sample weight Household sample weight Household sample weight Recoded variable De jure household members (usual residents) Wealth index score Wealth index score Wealth index score Wealth index score Wealth index score 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 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 Interviewer number Interviewer number Interviewer number Interviewer number Interviewer number Interviewer name and 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 4 Partly completed 5 Incapacitated 6 Other Month of birth of woman Month of birth of woman Month of birth of woman Month of birth of woman Month of birth of woman 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 Initial 2 Average 3 Average - special 4 Highest 6 Non-standard 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 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 98 DK 99 Missing 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 9998 DK 9999 Missing Abortions Abortions Abortions Abortions Abortions sometimes a pregnancy doesn't mature by live birth. otherwise, can be ended by abortion, miscarriage or stillbirth. Now i will ask about each of them separately. How many abortions have you had? Women aged 15-49 Misscarriage Misscarriage Misscarriage Misscarriage Misscarriage sometimes a pregnancy doesn't mature by live birth. otherwise, can be ended by abortion, miscarriage or stillbirth. Now i will ask about each of them separately. How many miscarriages? Women aged 15-49 Stillbirth Stillbirth Stillbirth Stillbirth Stillbirth sometimes a pregnancy doesn't mature by live birth. otherwise, can be ended by abortion, miscarriage or stillbirth. Now i will ask about each of them separately. How many stillbirth have you had? Women aged 15-49 Live birth in last 2 years Live birth in last 2 years Live birth in last 2 years Live birth in last 2 years Live birth in last 2 years Check CM11: Did the woman's last birth occur within the last 2 years, that is, since (day and month of interview in 2003)? If child has died, take special care when referring to this child by name in the following modules. No live birth in last 2 years. Go to MARRIAGE/UNION module. Yes, live birth in last 2 years. Continue with CM13 Name of child_______________________ 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 Vitamin A dose after last birth Vitamin A dose after last birth Vitamin A dose after last birth Vitamin A dose after last birth Vitamin A dose after last birth This module is to be administered to all women with a live birth in the 2 years preceding date of interview. Check child mortality module CM12 and record name of last-born child here _____________________. Use this child's name in the following questions, where indicated. In the first two months after your last birth [the birth of name], did you receive a Vitamin A dose like this? Show 200,000 IU capsule or dispenser. Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 1 Yes 2 No 8 DK 9 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 23 Government maternity hospital 26 Other public 31 Private hospital 32 Private clinic 33 Private maternity home 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" 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 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 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 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 Did you want to wait later or not want any more children Did you want to wait later or not want any more children Did you want to wait later or not want any more children Did you want to wait later or not want any more children Did you want to wait later or not want any more children At the time you became pregnant did you want to become pregnant <u>then</u>, did you want to wait until <u>later</u>, or did you <u>not want</u> to have any more children? Women aged 15-49 1 Then 2 Later 3 Not want more children 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: Female condom Current method: Female condom Current method: Female condom Current method: Female condom Current method: Female condom Which method are you using? Do not prompt. If more than one method is mentioned, circle each one. Women aged 15-49 ? Missing H Female condom Current method: Diaphragm Current method: Diaphragm Current method: Diaphragm Current method: Diaphragm Current method: Diaphragm Which method are you using? Do not prompt. If more than one method is mentioned, circle each one. Women aged 15-49 ? Missing I Diaphragm Current method: Foam/jelly Current method: Foam/jelly Current method: Foam/jelly Current method: Foam/jelly Current method: Foam/jelly Which method are you using? Do not prompt. If more than one method is mentioned, circle each one. Women aged 15-49 ? Missing J Foam/Jelly Current method: Lactational amenorrhea method Current method: Lactational amenorrhea method Current method: Lactational amenorrhea method Current method: Lactational amenorrhea method Current method: Lactational amenorrhea method Which method are you using? Do not prompt. If more than one method is mentioned, circle each one. 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 Prefer to have or not to have any more children Prefer to have or not to have any more children Prefer to have or not to have any more children Prefer to have or not to have any more children Prefer to have or not to have any more children a. Now I would like to ask some questions about the future. Would you like to have (a/another) child, or would you prefer not to have any (more) children? b. If currently pregnant: Now I would like to ask some questions about the future. After the child you are now expecting, would you like to have another child, or would you prefer not to have any (more) children? Women aged 15-49 1 Have (a/another( child 2 No more /none 3 Says she cannot get pregnant 8 Undecided/don't know 9 Missing Desired waiting time (units) Desired waiting time (units) Desired waiting time (units) Desired waiting time (units) Desired waiting time (units) How long would you like to wait before the birth of (a/another) child? Women aged 15-49 1 Months 2 Years 9 Special Desired waiting time (number) Desired waiting time (number) Desired waiting time (number) Desired waiting time (number) Desired waiting time (number) How long would you like to wait before the birth of (a/another) child? Women aged 15-49 93 Soon/now 94 Says she cannot get pregnant 95 After marriage 96 Other 98 Don't know 99 Missing Able to get pregnant Able to get pregnant Able to get pregnant Able to get pregnant Able to get pregnant Check CP1: Currently pregnant? Go to Next Module Not currently pregnant or unsure? Continue with CP4E Do you think you are physically able to get pregnant at this time? Women aged 15-49 1 Yes 2 No 8 Don't know 9 Missing Age at first sexual intercourse Age at first sexual intercourse Age at first sexual intercourse Age at first sexual intercourse Age at first sexual intercourse Check for the presence of others. Before continuing, ensure privacy. Check WM9: Age of respondent is between 15 and 24? Age 25-49. Go to Next Module Age 15-24. Continue with SB1 Now I need to ask you some questions about sexual activity in order to gain a better understanding of some family life issues. The information you supply will remain strictly confidential. How old were you when you first had sexual intercourse (if ever)? Women aged 15-24 Never had intercourse 95 First time when started living with partner 97 Inconsistent 99 Missing Time since last sexual intercourse (unit) Time since last sexual intercourse (unit) Time since last sexual intercourse (unit) Time since last sexual intercourse (unit) Time since last sexual intercourse (unit) When was the last time you had sexual intercourse? Record 'years ago' only if last intercourse was one or more years ago. If 12 months or more the answer must be recorded in years. Women aged 15-24 1 Days ago 2 Weeks ago 3 Months ago 4 Year ago 9 DK/Missing Time since last sexual intercourse (number) Time since last sexual intercourse (number) Time since last sexual intercourse (number) Time since last sexual intercourse (number) Time since last sexual intercourse (number) When was the last time you had sexual intercourse? Record 'years ago' only if last intercourse was one or more years ago. If 12 months or more the answer must be recorded in years. Women aged 15-24 97 Inconsistent 98 DK 99 Missing Condom used at last sexual intercourse Condom used at last sexual intercourse Condom used at last sexual intercourse Condom used at last sexual intercourse Condom used at last sexual intercourse The last time you had sexual intercourse was a condom used? Women aged 15-24 1 Yes 2 No 9 Missing Relationship to last sexual partner Relationship to last sexual partner Relationship to last sexual partner Relationship to last sexual partner Relationship to last sexual partner What is your relationship to the man with whom you last had sexual intercourse? If man is 'boyfriend' or 'fiancée', ask: Was your boyfriend/fiancée living with you when you last had sex? If 'yes', circle 1. If 'no', circle 2. Women aged 15-24 1 Spouse/cohabitin partner 2 Man is boyfrien/fiancee 3 Other friend 4 Casual acquaintance 6 Other 9 Missing Age of last sexual partner Age of last sexual partner Age of last sexual partner Age of last sexual partner Age of last sexual partner How old is this person? If response is DK, probe: About how old is this person? Women aged 15-24 98 DK 99 Missing Sex with any other man in the last 12 month Sex with any other man in the last 12 month Sex with any other man in the last 12 month Sex with any other man in the last 12 month Sex with any other man in the last 12 month Have you had sex with any other man in the last 12 months? Women aged 15-24 1 Yes 2 No 9 Missing Condom use with prior sexual partner Condom use with prior sexual partner Condom use with prior sexual partner Condom use with prior sexual partner Condom use with prior sexual partner The last time you had sexual intercourse with this other man, was a condom used? Women aged 15-24 1 Yes 2 No 9 Missing Relationship to prior sexual partner Relationship to prior sexual partner Relationship to prior sexual partner Relationship to prior sexual partner Relationship to prior sexual partner What is your relationship to this man? If man is 'boyfriend' or 'fiancée', ask: Was your boyfriend/fiancée living with you when you last had sex? If 'yes', circle 1. If 'no', circle 2. Women aged 15-24 1 Spouse/cohabitin partner 2 Man is boyfrien/fiancee 3 Other friend 4 Casual axquaintance 6 Other 9 Missing Age of prior sexual partner Age of prior sexual partner Age of prior sexual partner Age of prior sexual partner Age of prior sexual partner How old is this person? If response is DK, probe: About how old is this person? Women aged 15-24 98 DK 99 Missing Sex with any other man in the last 12 months Sex with any other man in the last 12 months Sex with any other man in the last 12 months Sex with any other man in the last 12 months Sex with any other man in the last 12 months Other than these two men, have you had sex with any other man in the last 12 months? Women aged 15-24 1 Yes 2 No 9 Missing Number of sexual partners in last 12 months Number of sexual partners in last 12 months Number of sexual partners in last 12 months Number of sexual partners in last 12 months Number of sexual partners in last 12 months In total, with how many different men have you had sex in the last 12 months? Women aged 15-24 98 DK 99 Missing Did you hear about AIDS Did you hear about AIDS Did you hear about AIDS Did you hear about AIDS Did you hear about 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 Ever had HIV test Ever had HIV test Ever had HIV test Ever had HIV test Ever had HIV test Check MN5: Tested for HIV during antenatal care? Yes. Go to HA18A No. Continue with HA15 I do not want to know the results, but have you ever been tested to see if you have HIV, the virus that causes AIDS? Women aged 15-49 1 Yes 2 No 9 Missing Received results of HIV test Received results of HIV test Received results of HIV test Received results of HIV test Received results of HIV test I do not want you to tell me the results of the test, but have you been told the results? Women aged 15-49 1 Yes 2 No 9 Missing Asked for HIV test or was it offered to you Asked for HIV test or was it offered to you Asked for HIV test or was it offered to you Asked for HIV test or was it offered to you Asked for HIV test or was it offered to you Did you, yourself, ask for the test, was it offered to you and you accepted, or was it required? Women aged 15-49 1 Asked for the test 2 Offered and accepted 3 Required 9 Missing Know a place to get HIV test Know a place to get HIV test Know a place to get HIV test Know a place to get HIV test Know a place to get HIV test At this time, do you know of a place where you can go to get such a test to see if you have the AIDS virus? A. If tested for HIV during antenatal care: Other than at the antenatal clinic, do you know of a place where you can go to get a test to see if you have the AIDS virus? Women aged 15-49 1 Yes 2 No 9 Missing Interviewer number Interviewer number Interviewer number Interviewer number Interviewer number Interviewer name and number: Households Supervisor Number Supervisor Number Supervisor Number Supervisor Number Supervisor Number Supervisor name and number: Households 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 Area Area Area Area Area Area: Households 1 Urban 2 Rural Region Region Region Region Region Region: Households 1 Western 2 Central 3 Southern 4 Central East 5 East 6 Tashkent Result of HH interview Result of HH interview Result of HH interview Result of HH interview Result of HH interview After all questionnaires for the household have been completed, fill in the following information: Result of HH interview: Households 1 Completed 2 Not at home 3 Refused 4 HH not found/destroyed 6 Other Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent to HH questionnaire: 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 Data editor Data editor Data editor Data editor Data editor Data editor: Households Data entry clerk Data entry clerk Data entry clerk Data entry clerk Data entry clerk Data entry clerk: Households Main source of drinking water Main source of drinking water Main source of drinking water Main source of drinking water Main source of drinking water What is the main source of drinking water for members of your household? 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 71 Cart with small tank/drum 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 71 Cart with small tank/drum 81 Surface water 96 Other 99 Missing Time to get water and come back Time to get water and come back Time to get water and come back Time to get water and come back Time to get water and come back How long does it take to go there, get water, and come back? 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 21 Ventilated Improved Pit latrine (VIP) 22 Pit latrine with slab 23 Pit latrine without slab/open pit 31 Composting toilet 41 Bucket 51 Hanging toilet/hanging latrine 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 Mother tongue of head Mother tongue of head Mother tongue of head Mother tongue of head Mother tongue of head What is the mother tongue/native language of the head of this household? Households 1 Uzbek 2 Russian 3 Karakalpak 4 Tajik 5 Kirgiz 6 Other Language 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 31 Parquet or polished wood 32 Vinyl or asphalt strips 33 Ceramic tiles 34 Cement 35 Carpet 96 Other 99 Missing Main material of roof Main material of roof Main material of roof Main material of roof Main material of roof Main material of the roof. Record observation. Households 12 Thatch/palm leaf 14 Earther cover 21 Rustic mat 23 Wood Planks 31 Metal 32 Wood 33 Calamine/cement fiber 34 Ceramic tiles 35 Cement 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 22 Stone with mud 23 Uncovered adobe 24 Plywood 26 Reused wood 31 Cement 32 Stone with lime/cement 33 Bricks 34 Cement blocks 35 Covered adobe 36 Wood planks/shingles 96 Other 99 Missing Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking What type of fuel does your household mainly use for cooking? Households 1 Electricity 2 Liquid propane gas (LPG) 3 Natural gas 4 Biogas 5 Kerosene 6 Coal/lignite 7 Charcoal 8 Wood 9 Straw/shrubs/grass 10 Animal dung 11 Agricultural crop residue 96 Other 99 Missing Food cooked on stove or open fire Food cooked on stove or open fire Food cooked on stove or open fire Food cooked on stove or open fire Food cooked on stove or open fire In this household, is food cooked on an open fire, an open stove or a closed stove? Probe for type. 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 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 The electric heater for water The electric heater for water The electric heater for water The electric heater for water The electric heater for water Does your household have: Households 1 Yes 2 No 9 Missing Table Table Table Table Table Does your household have: Households 1 Yes 2 No 9 Missing Chair Chair Chair Chair Chair Does your household have: Households 1 Yes 2 No 9 Missing Mirror Mirror Mirror Mirror Mirror Does your household have: Households 1 Yes 2 No 9 Missing The washing machine The washing machine The washing machine The washing machine The washing machine Does your household have: Households 1 Yes 2 No 9 Missing The vacuum cleaner The vacuum cleaner The vacuum cleaner The vacuum cleaner The vacuum cleaner Does your household have: Households 1 Yes 2 No 9 Missing The video tape recorder The video tape recorder The video tape recorder The video tape recorder The video tape recorder Does your household have: Households 1 Yes 2 No 9 Missing The armoir The armoir The armoir The armoir The armoir Does your household have: Households 1 Yes 2 No 9 Missing Furniture set Furniture set Furniture set Furniture set Furniture set Does your household have: Households 1 Yes 2 No 9 Missing 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 Computer Computer Computer Computer Computer Does any member of your household own: Households 1 Yes 2 No 9 Missing Tractor Tractor Tractor Tractor Tractor Does any member of your household own: Households 1 Yes 2 No 9 Missing Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of this household own any land that can be used for agriculture? Households 1 Yes 2 No 9 Missing Unit (hectares, handred hectares) Unit (hectares, handred hectares) Unit (hectares, handred hectares) Unit (hectares, handred hectares) Unit (hectares, handred hectares) How many hectares of agricultural land do members of this household own? Households 1 Hectares 2 hundred hectares 9 DK How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agricultural land do members of this household own? If more than 97, record '97'. If unknown, record '98'. Households 97 More than 97 98 Don't know 99 Missing Does this household own any livestock, heds, or animals Does this household own any livestock, heds, or animals Does this household own any livestock, heds, or animals Does this household own any livestock, heds, or animals Does this household own any livestock, heds, or animals Does this household own any livestock, herds, or farm animals? Households 1 Yes 2 No 9 Missing Number of cattle Number of cattle Number of cattle Number of cattle Number of cattle How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of Goats Number of Goats Number of Goats Number of Goats Number of Goats How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of sheep Number of sheep Number of sheep Number of sheep Number of sheep How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of chickens Number of chickens Number of chickens Number of chickens Number of chickens How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of rabbits Number of rabbits Number of rabbits Number of rabbits Number of rabbits How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of Camels Number of Camels Number of Camels Number of Camels Number of Camels How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing 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 Woman's education level Woman's education level Woman's education level Woman's education level Woman's education level Recoded variable Children aged 0-4 3 Incomplete Secondary 4 Complete Secondary 5 Secondary special 6 Higher education 9 None/Primary/Non-standard/Missing/DK 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. 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 Wealth index score Wealth index score Wealth index score Wealth index score Wealth index score 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 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 Interviewer number Interviewer number Interviewer number Interviewer number Interviewer number Interviewer name and 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 4 Partly completed 5 Incapacitated 6 Other Day of birth of child Day of birth of child Day of birth of child Day of birth of child Day of birth of child Repeat greeting if not already read to this respondent: We are from (COUNTRY-SPECIFIC AFFILIATION). We are working on a project concerned with family health and education. I would like to talk to you about this. The interview will take about (NUMBER) minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. Also, you are not obliged to answer any question you don't want to, and you may withdraw from the interview at any time. May I start now? If permission is given, begin the interview. If the respondent does not agree to continue, thank him/her and go to the next interview. Discuss this result with your supervisor for a future revisit. Now I would like to ask you some questions about the health of each child under the age of 5 in your care, who lives with you now. Now I want to ask you about (NAME). In what month and year was (NAME) born? Probe: What is his/her birthday? If the mother/caretaker knows the exact birth date, also enter the day; otherwise, circle 98 for day. 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 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 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 received vitamin A Child ever received vitamin A Child ever received vitamin A Child ever received vitamin A Child ever received vitamin A Has (name) ever received a vitamin A capsule (supplement) like this one? Show capsule or dispenser for different doses - 100,000 IU for those 6-11 months old, 200,000 IU for those 12-59 months old Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Months ago child took last Vitamin A dose Months ago child took last Vitamin A dose Months ago child took last Vitamin A dose Months ago child took last Vitamin A dose Months ago child took last Vitamin A dose How many months ago did (name) take the last dose? Children aged 0-4 97 Inconsistent 98 DK 99 Missing Place child got last Vitamin A dose Place child got last Vitamin A dose Place child got last Vitamin A dose Place child got last Vitamin A dose Place child got last Vitamin A dose Where did (name) get this last dose? Children aged 0-4 1 On routine visit to health centre 2 Sick child visit to health centre 3 National immunization day campain 6 Other 8 DK 9 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 Non-sweetened tea Non-sweetened tea Non-sweetened tea Non-sweetened tea Non-sweetened tea 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. Not sweetened tea? 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 Sweetened or salted solution Sweetened or salted solution Sweetened or salted solution Sweetened or salted solution Sweetened or salted solution 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. Sweetened or salted solution? 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 Where did you get the ORS packet Where did you get the ORS packet Where did you get the ORS packet Where did you get the ORS packet Where did you get the ORS packet Check CA2A: ORS packet used? Yes. Continue with CA4B No. Go to CA5 Where did you get the (local name for ORS packet from CA2A)? Children aged 0-4 11 Hospital 12 Govt health centre/Polyclinic 13 Govt health post/SVP 14 Village health worker/FAP 15 Mobile/outreach clinic 16 Other public source 21 Private hospital/clinic 22 Private physician 23 Private pharmacy 24 Mobile clinic 26 Other private medical 31 Relative or friend 32 Shop 33 Traditional practitioner 96 Other 98 DK 99 Missing How much did you pay for the ORS How much did you pay for the ORS How much did you pay for the ORS How much did you pay for the ORS How much did you pay for the ORS How much did you pay for the (local name for ORS packet from CA2A)? Children aged 0-4 9996 Free 9998 DK 9999 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 care: Govt Hospital Place sought care: Govt Hospital Place sought care: Govt Hospital Place sought care: Govt Hospital Place sought care: Govt Hospital From where did you seek care? Anywhere else? Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place) Children aged 0-4 ? Missing A Govt. Hospital Place sought care: Govt Health centre Place sought care: Govt Health centre Place sought care: Govt Health centre Place sought care: Govt Health centre Place sought care: Govt Health centre From where did you seek care? Anywhere else? Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place) Children aged 0-4 ? Missing B Govt. Health centre/Polyclinic Place sought care: Govt Health post Place sought care: Govt Health post Place sought care: Govt Health post Place sought care: Govt Health post Place sought care: Govt Health post From where did you seek care? Anywhere else? Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place) Children aged 0-4 ? Missing C Govt. health post/SVP Place sought care: Village health worker Place sought care: Village health worker Place sought care: Village health worker Place sought care: Village health worker Place sought care: Village health worker From where did you seek care? Anywhere else? Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place) Children aged 0-4 ? Missing D Village health worker/FAP Place sought care: Mobile/outreach clinic Place sought care: Mobile/outreach clinic Place sought care: Mobile/outreach clinic Place sought care: Mobile/outreach clinic Place sought care: 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 Place sought care: Other public source Place sought care: Other public source Place sought care: Other public source Place sought care: Other public source Place sought care: Other public source From where did you seek care? Anywhere else? Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place) Children aged 0-4 ? Missing H Other public sources Place sought care: Private hospital/clinic Place sought care: Private hospital/clinic Place sought care: Private hospital/clinic Place sought care: Private hospital/clinic Place sought care: Private hospital/clinic From where did you seek care? Anywhere else? Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place) Children aged 0-4 ? Missing I Private hospital/clinic Place sought care: Private physician Place sought care: Private physician Place sought care: Private physician Place sought care: Private physician Place sought care: Private physician From where did you seek care? Anywhere else? Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place) Children aged 0-4 ? Missing J Private phisician Place sought care: Private pharmacy Place sought care: Private pharmacy Place sought care: Private pharmacy Place sought care: Private pharmacy Place sought care: Private pharmacy From where did you seek care? Anywhere else? Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place) Children aged 0-4 ? Missing K Pharmacy Place sought care: Mobile clinic Place sought care: Mobile clinic Place sought care: Mobile clinic Place sought care: Mobile clinic Place sought care: 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 Place sought care: Other private medical Place sought care: Other private medical Place sought care: Other private medical Place sought care: Other private medical Place sought care: Other private medical From where did you seek care? Anywhere else? Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place) Children aged 0-4 ? Missing O Other private Place sought care: Relative or friend Place sought care: Relative or friend Place sought care: Relative or friend Place sought care: Relative or friend Place sought care: Relative or friend From where did you seek care? Anywhere else? Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place) Children aged 0-4 ? Missing P Relative or friend Place sought care: Shop Place sought care: Shop Place sought care: Shop Place sought care: Shop Place sought care: Shop From where did you seek care? Anywhere else? Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place) Children aged 0-4 ? Missing Q Shop Place sought care: Traditional practitioner Place sought care: Traditional practitioner Place sought care: Traditional practitioner Place sought care: Traditional practitioner Place sought care: Traditional practitioner From where did you seek care? Anywhere else? Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place) Children aged 0-4 ? Missing R Traditional practitioner Place sought care: Other Place sought care: Other Place sought care: Other Place sought care: Other Place sought care: Other From where did you seek care? Anywhere else? Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place) 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 Antibiotic Antibiotic Antibiotic Antibiotic Antibiotic What medicine was (name) given? Circle all medicines given. Children aged 0-4 ? Missing A Antibiotic Paracetamal/Panadol/Acetaminophen Paracetamal/Panadol/Acetaminophen Paracetamal/Panadol/Acetaminophen Paracetamal/Panadol/Acetaminophen Paracetamal/Panadol/Acetaminophen What medicine was (name) given? Circle all medicines given. Children aged 0-4 ? Missing P Paracetamol/Panadol/Acetaminophen Aspirin Aspirin Aspirin Aspirin Aspirin What medicine was (name) given? Circle all medicines given. Children aged 0-4 ? Missing Q Aspirin Ibupropfen Ibupropfen Ibupropfen Ibupropfen Ibupropfen What medicine was (name) given? Circle all medicines given. Children aged 0-4 ? Missing R Ibuprofen Other Other Other Other Other What medicine was (name) given? Circle all medicines given. Children aged 0-4 ? Missing X Other DK DK DK DK DK What medicine was (name) given? Circle all medicines given. Children aged 0-4 ? Missing Z DK Where did you get the antibiotic Where did you get the antibiotic Where did you get the antibiotic Where did you get the antibiotic Where did you get the antibiotic Check CA11: Antibiotic given? Yes. Continue with CA11B No. Go to CA12 Where did you get the antibiotic? Children aged 0-4 11 Hospital 12 Govt health centre/Polyclinic 13 Govt health post/SVP 14 Village health worker/FAP 15 Mobile/outreach clinic 16 Other public source 21 Private hospital/clinic 22 Private physician 23 Private pharmacy 24 Mobile clinic 26 Other private medical 31 Relative or friend 32 Shop 33 Traditional practitioner 96 Other 98 DK 99 Missing How much did you pay for the antibiotic How much did you pay for the antibiotic How much did you pay for the antibiotic How much did you pay for the antibiotic How much did you pay for the antibiotic How much did you pay for the antibiotic? Children aged 0-4 9996 Free 9998 DK 9999 Missing 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 Symptoms: Child not able to drink or breastfeed Symptoms: Child not able to drink or breastfeed Symptoms: Child not able to drink or breastfeed Symptoms: Child not able to drink or breastfeed Symptoms: Child not able to drink or breastfeed Ask the following question (CA14) only once for each caretaker. Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away? Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions. Children aged 0-4 ? Missing A Child not able to drink or breatfeed Symptoms: Child becomes sicker Symptoms: Child becomes sicker Symptoms: Child becomes sicker Symptoms: Child becomes sicker Symptoms: Child becomes sicker Ask the following question (CA14) only once for each caretaker. Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away? Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions. Children aged 0-4 ? Missing B Child becomes sicker Symptoms: Child develops a fever Symptoms: Child develops a fever Symptoms: Child develops a fever Symptoms: Child develops a fever Symptoms: Child develops a fever Ask the following question (CA14) only once for each caretaker. Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away? Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions. Children aged 0-4 ? Missing C Child develops a fever Symptoms: Child has faster breathing Symptoms: Child has faster breathing Symptoms: Child has faster breathing Symptoms: Child has faster breathing Symptoms: Child has faster breathing Ask the following question (CA14) only once for each caretaker. Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away? Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions. Children aged 0-4 ? Missing D Child has fast breathing Symptoms: Child has difficult breathing Symptoms: Child has difficult breathing Symptoms: Child has difficult breathing Symptoms: Child has difficult breathing Symptoms: Child has difficult breathing Ask the following question (CA14) only once for each caretaker. Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away? Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions. Children aged 0-4 ? Missing E Child has difficult breathing Symptoms: Child has blood in stool Symptoms: Child has blood in stool Symptoms: Child has blood in stool Symptoms: Child has blood in stool Symptoms: Child has blood in stool Ask the following question (CA14) only once for each caretaker. Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away? Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions. Children aged 0-4 ? Missing F Child has blood in stool Symptoms: Child is drinking poorly Symptoms: Child is drinking poorly Symptoms: Child is drinking poorly Symptoms: Child is drinking poorly Symptoms: Child is drinking poorly Ask the following question (CA14) only once for each caretaker. Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away? Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions. Children aged 0-4 ? Missing G Child is drinking poorly Symptoms: Other Symptoms: Other Symptoms: Other Symptoms: Other Symptoms: Other Ask the following question (CA14) only once for each caretaker. Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away? Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions. Children aged 0-4 ? Missing X Other Symptoms: Other Symptoms: Other Symptoms: Other Symptoms: Other Symptoms: Other Ask the following question (CA14) only once for each caretaker. Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away? Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions. Children aged 0-4 ? Missing Y Other Symptoms: Other Symptoms: Other Symptoms: Other Symptoms: Other Symptoms: Other Ask the following question (CA14) only once for each caretaker. Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away? Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions. 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 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 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 9999 Missing Day of OPV0 immunization Day of OPV0 immunization Day of OPV0 immunization Day of OPV0 immunization Day of OPV0 immunization (a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Polio at birth Children aged 0-4 Not given 44 Marked on card - no date given 66 Reported by mother 99 Missing Month of OPV0 immunization Month of OPV0 immunization Month of OPV0 immunization Month of OPV0 immunization Month of OPV0 immunization (a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Polio at birth Children aged 0-4 99 Missing Year of OPV0 immunization Year of OPV0 immunization Year of OPV0 immunization Year of OPV0 immunization Year of OPV0 immunization (a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Polio at birth Children aged 0-4 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 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 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 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 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 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 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 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 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 9999 Missing Day of OPV4 immunization Day of OPV4 immunization Day of OPV4 immunization Day of OPV4 immunization Day of OPV4 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 4 Children aged 0-4 Not given 44 Marked on card - no date given 66 Reported by mother 99 Missing Month of OPV4 immunization Month of OPV4 immunization Month of OPV4 immunization Month of OPV4 immunization Month of OPV4 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 4 Children aged 0-4 99 Missing Year of OPV4 immunization Year of OPV4 immunization Year of OPV4 immunization Year of OPV4 immunization Year of OPV4 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 4 Children aged 0-4 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 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 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 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 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 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 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 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 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 9999 Missing Day of DPT4 immunization Day of DPT4 immunization Day of DPT4 immunization Day of DPT4 immunization Day of DPT4 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 4 Children aged 0-4 Not given 44 Marked on card - no date given 66 Reported by mother 99 Missing Month of DPT4 immunization Month of DPT4 immunization Month of DPT4 immunization Month of DPT4 immunization Month of DPT4 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 4 Children aged 0-4 99 Missing Year of DPT4 immunization Year of DPT4 immunization Year of DPT4 immunization Year of DPT4 immunization Year of DPT4 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 4 Children aged 0-4 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 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 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 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 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 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 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 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 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 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 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 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 9999 Missing Day of mumps immunization Day of mumps immunization Day of mumps immunization Day of mumps immunization Day of mumps 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 Yellow fever Children aged 0-4 Not given 44 Marked on card - no date given 66 Reported by mother 99 Missing Month of mumps immunization Month of mumps immunization Month of mumps immunization Month of mumps immunization Month of mumps 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 Yellow fever Children aged 0-4 99 Missing Year of mumps immunization Year of mumps immunization Year of mumps immunization Year of mumps immunization Year of mumps 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 Yellow fever Children aged 0-4 9999 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 HepB vaccination Child ever given HepB vaccination Child ever given HepB vaccination Child ever given HepB vaccination Child ever given HepB vaccination Has (name) ever been given "Hepatitis B vaccination injections" - that is, an injection in the thigh or buttocks - to prevent him/her from getting Hepatitis B? (sometimes given at the same time as DPT) Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Times child given HepB vaccination Times child given HepB vaccination Times child given HepB vaccination Times child given HepB vaccination Times child given HepB vaccination How many times? Children aged 0-4 99 Missing Child ever given Measles Child ever given Measles Child ever given Measles Child ever given Measles Child ever given Measles 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 has ever been given mamps Child has ever been given mamps Child has ever been given mamps Child has ever been given mamps Child has ever been given mamps Has (NAME) ever been given "Yellow Fever vaccination injections" - that is, a shot in the arm at the age of 9 months or older - to prevent him/her from getting yellow fever? (sometimes given at the same time as 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 Please tell me if (name) has participated in any of the following campaigns, national immunization days and/or vitamin A or child health days: Date/type of campaign A Children aged 0-4 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" Measurer's identification code Measurer's identification code Measurer's identification code Measurer's identification code Measurer's identification code Measurer's identification code. Children aged 0-4 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 Information has received from medical center Information has received from medical center Information has received from medical center Information has received from medical center Information has received from medical center Have you got the information on medical institution, where immunization card is being kept? Children aged 0-4 1 Received information 2 Do not received information 9 Missing Medical center has attended Medical center has attended Medical center has attended Medical center has attended Medical center has attended Was the medical institution visited? Children aged 0-4 1 Yes 2 No There is a information in medical center There is a information in medical center There is a information in medical center There is a information in medical center There is a information in medical center Are there available immunization records for (Child's name) in that medical institution? Children aged 0-4 1 Yes 2 No Day of BCG immunization Day of BCG immunization Day of BCG immunization Day of BCG immunization Day of BCG immunization (a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization BCG Children aged 0-4 Not given 44 Marked on card - no date given 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 99 Missing Year of BCG immunisation Year of BCG immunisation Year of BCG immunisation Year of BCG immunisation Year of BCG immunisation (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 9999 Missing Day of OPV0 immunization Day of OPV0 immunization Day of OPV0 immunization Day of OPV0 immunization Day of OPV0 immunization (a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Polio at birth or OPV0 Children aged 0-4 Not given 44 Marked on card - no date given 99 Missing Month of OPV0 immunization Month of OPV0 immunization Month of OPV0 immunization Month of OPV0 immunization Month of OPV0 immunization (a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Polio at birth or OPV0 Children aged 0-4 99 Missing Year of OPV0 immunization Year of OPV0 immunization Year of OPV0 immunization Year of OPV0 immunization Year of OPV0 immunization (a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Polio at birth or OPV0 Children aged 0-4 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 or OPV1 Children aged 0-4 Not given 44 Marked on card - no date given 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 or OPV1 Children aged 0-4 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 or OPV1 Children aged 0-4 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 or OPV2 Children aged 0-4 Not given 44 Marked on card - no date given 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 or OPV2 Children aged 0-4 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 or OPV2 Children aged 0-4 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 or OPV3 Children aged 0-4 Not given 44 Marked on card - no date given 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 or OPV3 Children aged 0-4 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 or OPV3 Children aged 0-4 9999 Missing Day of OPV4 immunization Day of OPV4 immunization Day of OPV4 immunization Day of OPV4 immunization Day of OPV4 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 4 or OPV4 Children aged 0-4 Not given 44 Marked on card - no date given 99 Missing Month of OPV4 immunization Month of OPV4 immunization Month of OPV4 immunization Month of OPV4 immunization Month of OPV4 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 4 or OPV4 Children aged 0-4 99 Missing Year of OPV4 immunization Year of OPV4 immunization Year of OPV4 immunization Year of OPV4 immunization Year of OPV4 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 4 or OPV4 Children aged 0-4 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 DPT1 Children aged 0-4 Not given 44 Marked on card - no date given 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 DPT1 Children aged 0-4 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 DPT1 Children aged 0-4 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 DPT2 Children aged 0-4 Not given 44 Marked on card - no date given 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 DPT2 Children aged 0-4 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 DPT2 Children aged 0-4 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 DPT3 Children aged 0-4 Not given 44 Marked on card - no date given 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 DPT3 Children aged 0-4 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 DPT3 Children aged 0-4 9999 Missing Day of DPT4 immunization Day of DPT4 immunization Day of DPT4 immunization Day of DPT4 immunization Day of DPT4 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 DPT4 Children aged 0-4 Not given 44 Marked on card - no date given 99 Missing Month of DPT4 immunization Month of DPT4 immunization Month of DPT4 immunization Month of DPT4 immunization Month of DPT4 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 DPT4 Children aged 0-4 99 Missing Year of DPT4 immunization Year of DPT4 immunization Year of DPT4 immunization Year of DPT4 immunization Year of DPT4 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 DPT4 Children aged 0-4 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 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 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 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 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 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 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 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 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 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 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 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 9999 Missing Day of mumps immunization Day of mumps immunization Day of mumps immunization Day of mumps immunization Day of mumps 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 mumps Children aged 0-4 Not given 44 Marked on card - no date given 99 Missing Month of mumps immunization Month of mumps immunization Month of mumps immunization Month of mumps immunization Month of mumps 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 mumps Children aged 0-4 99 Missing Year of mumps immunization Year of mumps immunization Year of mumps immunization Year of mumps immunization Year of mumps 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 mumps Children aged 0-4 9999 Missing Sex Sex Sex Sex Sex Children aged 0-4 1 Male 2 Female 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 1 Primary 2 Secondary 3 Secondary Special 4 Higher 6 Non-standard 8 DK 9 Missing Interviewer number Interviewer number Interviewer number Interviewer number Interviewer number Interviewer name and number: Households Supervisor Number Supervisor Number Supervisor Number Supervisor Number Supervisor Number Supervisor name and number: Households 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 Area Area Area Area Area Area: Households 1 Urban 2 Rural Region Region Region Region Region Region: Households 1 Western 2 Central 3 Southern 4 Central East 5 East 6 Tashkent Result of HH interview Result of HH interview Result of HH interview Result of HH interview Result of HH interview After all questionnaires for the household have been completed, fill in the following information: Result of HH interview: Households 1 Completed 2 Not at home 3 Refused 4 HH not found/destroyed 6 Other Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent to HH questionnaire: 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 Data editor Data editor Data editor Data editor Data editor Data editor: Households Data entry clerk Data entry clerk Data entry clerk Data entry clerk Data entry clerk Data entry clerk: Households Main source of drinking water Main source of drinking water Main source of drinking water Main source of drinking water Main source of drinking water What is the main source of drinking water for members of your household? 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 71 Cart with small tank/drum 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 71 Cart with small tank/drum 81 Surface water 96 Other 99 Missing Time to get water and come back Time to get water and come back Time to get water and come back Time to get water and come back Time to get water and come back How long does it take to go there, get water, and come back? 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 21 Ventilated Improved Pit latrine (VIP) 22 Pit latrine with slab 23 Pit latrine without slab/open pit 31 Composting toilet 41 Bucket 51 Hanging toilet/hanging latrine 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 Mother tongue of head Mother tongue of head Mother tongue of head Mother tongue of head Mother tongue of head What is the mother tongue/native language of the head of this household? Households 1 Uzbek 2 Russian 3 Karakalpak 4 Tajik 5 Kirgiz 6 Other Language 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 31 Parquet or polished wood 32 Vinyl or asphalt strips 33 Ceramic tiles 34 Cement 35 Carpet 96 Other 99 Missing Main material of roof Main material of roof Main material of roof Main material of roof Main material of roof Main material of the roof. Record observation. Households 12 Thatch/palm leaf 14 Earther cover 21 Rustic mat 23 Wood Planks 31 Metal 32 Wood 33 Calamine/cement fiber 34 Ceramic tiles 35 Cement 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 22 Stone with mud 23 Uncovered adobe 24 Plywood 26 Reused wood 31 Cement 32 Stone with lime/cement 33 Bricks 34 Cement blocks 35 Covered adobe 36 Wood planks/shingles 96 Other 99 Missing Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking What type of fuel does your household mainly use for cooking? Households 1 Electricity 2 Liquid propane gas (LPG) 3 Natural gas 4 Biogas 5 Kerosene 6 Coal/lignite 7 Charcoal 8 Wood 9 Straw/shrubs/grass 10 Animal dung 11 Agricultural crop residue 96 Other 99 Missing Food cooked on stove or open fire Food cooked on stove or open fire Food cooked on stove or open fire Food cooked on stove or open fire Food cooked on stove or open fire In this household, is food cooked on an open fire, an open stove or a closed stove? Probe for type. 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 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 The electric heater for water The electric heater for water The electric heater for water The electric heater for water The electric heater for water Does your household have: Households 1 Yes 2 No 9 Missing Table Table Table Table Table Does your household have: Households 1 Yes 2 No 9 Missing Chair Chair Chair Chair Chair Does your household have: Households 1 Yes 2 No 9 Missing Mirror Mirror Mirror Mirror Mirror Does your household have: Households 1 Yes 2 No 9 Missing The washing machine The washing machine The washing machine The washing machine The washing machine Does your household have: Households 1 Yes 2 No 9 Missing The vacuum cleaner The vacuum cleaner The vacuum cleaner The vacuum cleaner The vacuum cleaner Does your household have: Households 1 Yes 2 No 9 Missing The video tape recorder The video tape recorder The video tape recorder The video tape recorder The video tape recorder Does your household have: Households 1 Yes 2 No 9 Missing The armoir The armoir The armoir The armoir The armoir Does your household have: Households 1 Yes 2 No 9 Missing Furniture set Furniture set Furniture set Furniture set Furniture set Does your household have: Households 1 Yes 2 No 9 Missing 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 Computer Computer Computer Computer Computer Does any member of your household own: Households 1 Yes 2 No 9 Missing Tractor Tractor Tractor Tractor Tractor Does any member of your household own: Households 1 Yes 2 No 9 Missing Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of this household own any land that can be used for agriculture? Households 1 Yes 2 No 9 Missing Unit (hectares, handred hectares) Unit (hectares, handred hectares) Unit (hectares, handred hectares) Unit (hectares, handred hectares) Unit (hectares, handred hectares) How many hectares of agricultural land do members of this household own? Households 1 Hectares 2 hundred hectares 9 DK How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agricultural land do members of this household own? If more than 97, record '97'. If unknown, record '98'. Households 97 More than 97 98 Don't know 99 Missing Does this household own any livestock, heds, or animals Does this household own any livestock, heds, or animals Does this household own any livestock, heds, or animals Does this household own any livestock, heds, or animals Does this household own any livestock, heds, or animals Does this household own any livestock, herds, or farm animals? Households 1 Yes 2 No 9 Missing Number of cattle Number of cattle Number of cattle Number of cattle Number of cattle How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of Goats Number of Goats Number of Goats Number of Goats Number of Goats How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of sheep Number of sheep Number of sheep Number of sheep Number of sheep How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of chickens Number of chickens Number of chickens Number of chickens Number of chickens How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of rabbits Number of rabbits Number of rabbits Number of rabbits Number of rabbits How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of Camels Number of Camels Number of Camels Number of Camels Number of Camels How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Ever attended school Ever attended school Ever attended school Ever attended school Ever attended school Has (name) ever attended school or preschool? Children aged 0-4 1 Yes 2 No 9 Missing Highest grade at level Highest grade at level Highest grade at level Highest grade at level Highest grade at level What is the highest grade (name) completed at this level? Children aged 0-4 97 Inconsistent 98 DK 99 Missing 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 3 Incomplete Secondary 4 Complete Secondary 5 Secondary special 6 Higher education 9 None/Primary/Non-standard/Missing/DK 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'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 Wealth index score Wealth index score Wealth index score Wealth index score Wealth index score 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