DDI_SLE_2005_MICS_v01_M James, Rhiannon Croft, Trevor 2008-01-16 NADA Sierra Leone MICS 2005 v0.1 Slightly edited version of UNICEF's DDI ref. DDI-SRL-UNICEF-MICS2005-v0.1 Multiple Indicator Cluster Survey 2005 MICS3 2005 SLE_2005_MICS_v01_M Statistics Sierra Leone UNICEF Sierra Leone Ministry of Development and Economic Planning Ministry of Education, Science and Technology Ministry of Energy and Power (Water Division) Ministry of Health and Sanitation Ministry of Information and Broadcasting NADA Statistics Sierra Leonne Sengeh, Paul Multiple Indicator Cluster Survey - Round 3 [hh/mics-3] The Multiple Indicator Cluster Survey, Round 3 (MICS3) is the third round of MICS surveys, previously conducted around 1995 (MICS1) and 2000 (MICS2). Many questions and indicators are consistent and compatible with the prior round of MICS (MICS2) but less so with MICS1, although there have been a number of changes in definition of indicators between rounds. Details can be found by reviewing the indicator definitions. Version 1.0: Edited data used for final report Household Listing Education water and Sanitation Household Characteristics Insecticide Treated Bednets Support to children made vulnerabel by HIV/AIDS Child Labour Child Discipline Child Disability Maternal Mortality Salt Iodization Child Mortality Tetanus Toxoid Maternal and Newborn health Marriage/Union Contraception Female Genital Cutting Domestic Violence Sexual behaviour HIV/AIDS Birth Registration and early learning Child Development Vitamin A Breastfeeding Care of Illness Malaria Immunisation Anthrpometry 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 2005 Sierra Leone Multiple Indicator Cluster Survey has the following primary objectives: - To provide up-to-date information for assessing the situation of children and women in Sierra Leone; - To furnish data needed for monitoring progress toward goals established by the Millennium Development Goals and the goals of A World Fit For Children (WFFC) as a basis for future action; - To contribute to the improvement of data and monitoring systems in Sierra Leone and to strengthen technical expertise in the design and implementation of these systems and analysis of the information they generate. 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 Statistics Sierra Leone with financial and technical support from UNICEF Sierra Leone 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. Sierra Leone The survey is nationally representative and covers the whole of Sierra Leone 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 Sierra Leone Multiple Indicator Cluster Survey included the following modules in the questionnaires: HOUSEHOLD QUESTIONNAIRE : Household characteristics, household listing, orphaned and vulnerable children, education, child labour, water and sanitation, household use of insecticide treated mosquito nets, and salt iodization, child discipline, child disability and maternal mortality. WOMEN'S QUESTIONNAIRE: Women's characteristics, child mortality, tetanus toxoid, maternal and newborn health, marriage, female genital cutting, contraception, HIV/AIDS knowledge, domestic violence and sexual behavior. CHILDREN'S QUESTIONNAIRE: Children's characteristics, birth registration and early learning, vitamin A, breastfeeding, care of illness, malaria, immunization, child development and anthropometry. Statistics Sierra Leone The primary objective of the sample design for the Sierra Leone MICS3 was to produce statistically reliable estimates of most indicators at the national level, for urban and rural areas, and at the province level. The design of the sample allows the estimation of indicators at district level - however, such estimates are likely to be very imprecise, since the sample size was not determined to enable district-level estimates. A multi-stage, stratified cluster sampling approach was used to select the survey sample. The 2004 census frame was used for the selection of clusters. Census enumeration areas (EAs) were defined as primary sampling units (PSUs), and were selected in each district using pps sampling procedures. The stages of the sampling approach are described below. Description of sampling approach for Sierra Leone MICS3 Stage 1: Selection of EAs The list of all EAs in Sierra Leone was ordered using implicit stratification according to the following variables: province; district; chiefdom; and, population size. 320 EAs were then selected using stratified systematic sampling, thus yielding a self-weighting sample. Selected EAs were then classified as rural (population of the settlement were the EA is located is < 2,000) or urban (population of the settlement where the EA is located is = 2,000). Stage 2: Selection of households A list of all households in each of the 320 selected EAs as enumerated during the 2004 census was prepared using data contained in the 2004 Population and Housing Census registers. A team of listers/verifiers visited each of the 320 EAs to update the household lists in the EA by verifying each of the households on the list and adding any new households that have been formed in order to control for out-movers, non-existent households, and/or new households. This task produced an updated listing of households in all selected EAs. The newly updated listing of households in each EA was then sequentially numbered from 1 to n (the total number of households in the enumeration area of interest) at the Statistics Sierra Leone Office. Sampling experts then selected 25 households in each EA using systematic selection procedures. (Information extracted from final report: Statistics Sierra Leone and UNICEF-Sierra Leone 2007. Sierra Leone Multiple Indicator Cluster Survey 2005, Final Report. Freetown, Sierra Leone: Statistics Sierra Leone and UNICEF-Sierra Leone.) Face-to-face [f2f] The questionnaires for the Sierra Leone MICS3 were structured questionnaires based on the MICS3 Model Questionnaire with some modifications and additions. A household questionnaire was administered in each household, which collected various information on household members including sex, age, relationship, and orphanhood status. In addition to a household questionnaire, questionnaires were administered in each household for women age 15-49 and children under age five. For children, the questionnaire was administered to the mother or caretaker of the child. English is the only written language in Sierra Leone; for this reason, questionnaires were written in English and verbally translated by enumerators into the language preferred by the respondent (generally Krio, Timne, Mende or Limba), using standardized, pre-tested key words. The questionnaires were pre-tested in the Western Area in September 2005. Based on the results of the pre-test, modifications were made to the wording of the questions, the response categories, and the key words. Information extracted from final report: Statistics Sierra Leone and UNICEF-Sierra Leone 2007. Sierra Leone Multiple Indicator Cluster Survey 2005, Final Report. Freetown, Sierra Leone: Statistics Sierra Leone and UNICEF-Sierra Leone. The data were collected by fourteen teams, each composed of one or two female enumerators, two or three male enumerators, one driver and a supervisor. Interviewing was conducted by teams of interviewers, each team comrising one supervisor. 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 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 in the MICS global manual, see www.childinfo.org Of the 8,000 households selected for the sample, only 7,125 were found to be occupied. Of the 7,125 occupied households, 7,078 were successfully interviewed for a household response rate of 99.3 per cent. In the interviewed households, 9,257 eligible women (aged 15-49) were identified. Of these, 7,654 were successfully interviewed, yielding a response rate of 82.7 per cent. The response rate for the Questionnaire for Children Under Five was 88.9 per cent; mothers/caretakers of 5,246 children under five were successfully interviewed, from among 5,904 children under five who were identified in the interviewed households. Overall response rates of 82.1 percent and 88.3 percent are calculated for the women's and under-5's interviews, respectively Estimates from a sample survey are affected by two types of errors: 1) non-sampling errors and 2) sampling errors. Non-sampling errors are the results of mistakes made in the implementation of data collection and data processing. Numerous efforts were made during implementation of the 2005 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 2005 MICS is only one of many possible samples that could have been selected from the same population, using the same design and expected size. Each of these samples would yield results that differe somewhat from the results of the actual sample selected. Sampling errors are a measure of the variability in the results of the survey between all possible samples, and, although, the degree of variability is not known exactly, it can be estimated from the survey results. The sampling erros are measured in terms of the standard error for a particular statistic (mean or percentage), which is the square root of the variance. Confidence intervals are calculated for each statistic within which the true value for the population can be assumed to fall. Plus or minus two standard errors of the statistic is used for key statistics presented in MICS, equivalent to a 95 percent confidence interval. If the sample of respondents had been a simple random sample, it would have been possible to use straightforward formulae for calculating sampling errors. However, the 2005 MICS sample is the result of a multi-stage stratified design, and consequently needs to use more complex formulae. The SPSS complex samples module has been used to calculate sampling errors for the 2005 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 four regions. For each statistic, the estimate, its standard error, the coefficient of variation (or relative error -- the ratio between the standard error and the estimate), the design effect, and the square root design effect (DEFT -- the ratio between the standard error using the given sample design and the standard error that would result if a simple random sample had been used), as well as the 95 percent confidence intervals (+/-2 standard errors). Details of the sampling errors are presented in the sampling errors appendix to the final report. A series of data quality tables and graphs are available to review the quality of the data and include the following: Age distribution of the household population Age distribution of eligible women and interviewed women Age distribution of eligible children and children for whom the mother or caretaker was interviewed Age distribution of children under age 5 by 3 month groups Age and period ratios at boundaries of eligibility Percent of observations with missing information on selected variables Presence of mother inthe household and person interviewed for the under 5 questionnaire School attendance by single year age Sex ratio at birth among children ever born, surviving and dead by age of respondent Distribution of women by time since last birth Scatterplot of weight by height, weight by age and height by age Graph of male and female population by single years of age Population pyramid The results of each of these data quality tables is shown in the appendix of the final report. The generral rule for presentation of missing data in the final report tabulations is that a column is presented for missing data if the percentage of cases with missing data is 1% or more. Cases with missing data on the background characteristics (e.g. education) are included in the tables, but the missing data rows are suppressed and noted at the bottom of the tables in the report (not in the SPSS output, however). Users of the data agree to keep confidential all data contained in these datasets and to make no attempt to identify, trace or contact any individual whose data is included in these datasets. Survey datasets are distributed at no cost for legitimate research, with the condition that we receive a description of 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 the Statistics Sierra Leone and UNICEF Sierra Leone: statistics@statistics.sl psengeh@unicef.org Statistics Sierra Leone and UNICEF provides these data to external users without any warranty or responsibility implied. Statistics Sierra Leone 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, Water and sanitation, Household characteristics, Household use of insecticde treated nets and Salt iodization) 0 103 hl Data collected at the household member's level (MICS Household questionnaire: modules Household listing, Child labour, Child discipline, Support to Orphaned and Vulnerable Children, Child Disability, Maternal Mortality) 0 140 wm Data collected at the women's level (MICS Women's questionnaire: modules Women's Information Panel, Child mortality, Tetanus toxoid, Maternal and newborn health, Marriage/union, Contraception, HIV/AIDS, Female genital mutiliation/cutting, Sexual behaviour, Attitudes towards domestic violence) 0 225 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, Vitamin A, Breastfeeding, Care of Illness, Immunization, Anthropometry, Malaria, Child development) 0 277 Interview and HH identification Characteristics of dwelling Water and sanitation Characteristics of the head Members characteristics Education Child mortality Maternal and newborn health Nutrition Child health Contraception Child protection Marriage/union HIV-AIDS Wealth Index Asset ownership Weighting coefficients Others Antenatal care Care seeking behaviour Child labor Salt iodization Early child development Early learning Insecticide treated nets (ITN) Child discipline Support to orphans and vulnerable children Sexual behaviour Condom use Child disability Maternal mortality Tetanus toxoid Vitamin A Assistance at delivery Polygyny Attitudes towards domestic violence Female genital mutilation/cutting Malaria Insecticide treated nets (ITN) Newborn health Immunizations Birth registration Early marriage Polygyny Anthropometry Cooking fuels Diarrhoea Acute respiratory infection Disposal of child's stools Breastfeeding Cluster number Cluster number Cluster number Cluster number Cluster number We are from (COUNTRY-SPECIFIC AFFILIATION). We are working on a project concerned with family health and education. I would like to talk to you about this. The interview will take about (NUMBER) minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. During this time I would like to speak with the household head and all mothers or others who take care of children in the household. May I start now? If permission is given, begin the interview. Cluster number: Households Unique identifier for the cluster in which the household exists Household number Household number Household number Household number Household number Household number: Households Houshold number within the cluster 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 Rural 2 Urban Region Region Region Region Region Region: Households 1 East 2 North 3 South 4 West District District District District District 11 Kailahun 12 Kenema 13 Kono 21 Bombali 22 Kambia 23 Koinadugu 24 Port Loko 25 Tonkolili 31 Bo 32 Bonthe 33 Moyamba 34 Pujehun 41 Western Rural 42 Western Urban 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 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 Total adults very sick Total adults very sick Total adults very sick Total adults very sick Total adults very sick Total mothers dead Total mothers dead Total mothers dead Total mothers dead Total mothers dead Total mothers very sick Total mothers very sick Total mothers very sick Total mothers very sick Total mothers very sick Total fathers dead Total fathers dead Total fathers dead Total fathers dead Total fathers dead Total fathers very sick Total fathers very sick Total fathers very sick Total fathers very sick Total fathers very sick 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 Religion Religion Religion Religion Religion What is the religion of the head of this household? Households 1 Christian 2 Muslim 3 Traditional 6 Other religion 7 No religion 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 12 Dung 21 Wood planks 22 Palm/bamboo 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 11 No roof 12 Thatch/palm leaf 13 Sod 21 Rustic mat 22 Palm/bamboo 23 Wood Planks 24 Plastic Sheeting 31 Metal 32 Wood 33 Calamine/cement fiber 34 Ceramic tiles 35 Cement 36 Roofing shingles 96 Other 99 Missing Main material of wall Main material of wall Main material of wall Main material of wall Main material of wall Main material of the walls. Record observation. Households 11 No walls 12 Cane/palm/trunks 13 Dirt 21 Bambo with mud 22 Stone with mud 23 Uncovered adobe 24 Plywood 25 Carton 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 Water Pump Water Pump Water Pump Water Pump Water Pump 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 Boat with a motor Boat with a motor Boat with a motor Boat with a motor Boat with a motor Does any member of your household own: Households 1 Yes 2 No 9 Missing Household has mosquito nets Household has mosquito nets Household has mosquito nets Household has mosquito nets Household has mosquito nets Does your household have any mosquito nets that can be used while sleeping? Households 1 Yes 2 No 9 Missing Number of mosquito nets Number of mosquito nets Number of mosquito nets Number of mosquito nets Number of mosquito nets How many mosquito nets does your household have? If 7 or more nets, record '7'. Households 7 7 or more 9 Missing Long-lasting mosquito net - Brand A Long-lasting mosquito net - Brand A Long-lasting mosquito net - Brand A Long-lasting mosquito net - Brand A Long-lasting mosquito net - Brand A Is the net (are any of the nets) any of the following brands: Read each brand name, show picture card, and circle codes for Yes or No for each brand. If possible, observe the net to verify brand. Households 1 Yes 2 No 8 DK 9 Missing Long-lasting mosquito net - Brand B Long-lasting mosquito net - Brand B Long-lasting mosquito net - Brand B Long-lasting mosquito net - Brand B Long-lasting mosquito net - Brand B Is the net (are any of the nets) any of the following brands: Read each brand name, show picture card, and circle codes for Yes or No for each brand. If possible, observe the net to verify brand. Households 1 Yes 2 No 8 DK 9 Missing Pre-treated - Brand C Pre-treated - Brand C Pre-treated - Brand C Pre-treated - Brand C Pre-treated - Brand C Is the net (are any of the nets) any of the following brands: Read each brand name, show picture card, and circle codes for Yes or No for each brand. If possible, observe the net to verify brand. Households 1 Yes 2 No 8 DK 9 Missing Pre-treated - Brand D Pre-treated - Brand D Pre-treated - Brand D Pre-treated - Brand D Pre-treated - Brand D Is the net (are any of the nets) any of the following brands: Read each brand name, show picture card, and circle codes for Yes or No for each brand. If possible, observe the net to verify brand. Households 1 Yes 2 No 8 DK 9 Missing Other - Brand E Other - Brand E Other - Brand E Other - Brand E Other - Brand E Is the net (are any of the nets) any of the following brands: Read each brand name, show picture card, and circle codes for Yes or No for each brand. If possible, observe the net to verify brand. Households 1 Yes 2 No 8 DK 9 Missing Other - Brand F Other - Brand F Other - Brand F Other - Brand F Other - Brand F Is the net (are any of the nets) any of the following brands: Read each brand name, show picture card, and circle codes for Yes or No for each brand. If possible, observe the net to verify brand. Households 1 Yes 2 No 8 DK 9 Missing Other brand specified net Other brand specified net Other brand specified net Other brand specified net Other brand specified net Is the net (are any of the nets) any of the following brands: Read each brand name, show picture card, and circle codes for Yes or No for each brand. If possible, observe the net to verify brand. Households 1 Yes 2 No 9 Missing Other brand unknown net Other brand unknown net Other brand unknown net Other brand unknown net Other brand unknown net Is the net (are any of the nets) any of the following brands: Read each brand name, show picture card, and circle codes for Yes or No for each brand. If possible, observe the net to verify brand. Households 1 Yes 2 No 9 Missing Net was pre-treated Net was pre-treated Net was pre-treated Net was pre-treated Net was pre-treated Check TN3 for brand of net(s). Go through the above list in order until one box is checked and follow instructions: 1. Long-lasting treated net (brand A or brand B) mentioned? Go to Next Module 2. Pre-treated net (brand C or brand D) mentioned? Go to TN6 3. Other net (brand E, brand F or any other net, or an unknown brand) mentioned? Continue with TN5 When you got the (most recent) net, was it already treated with an insecticide to kill or repel mosquitoes? Households 1 Yes 2 No 8 DK 9 Missing Months ago net obtained Months ago net obtained Months ago net obtained Months ago net obtained Months ago net obtained How many months ago was the (most recent) net obtained? If less than 1 month ago, record '00'. If answer is "12 months" or "1 year", probe to determine if net was obtained exactly 12 months ago or earlier or later. Households 95 More than 24 months ago 98 Not sure 99 Missing Net soaked or dipped since obtained Net soaked or dipped since obtained Net soaked or dipped since obtained Net soaked or dipped since obtained Net soaked or dipped since obtained Since you got the net(s) has it (have any of these nets) ever been soaked or dipped in a liquid to kill/repel mosquitoes? Households 1 Yes 2 No 8 DK 9 Missing Months ago net soaked or dipped Months ago net soaked or dipped Months ago net soaked or dipped Months ago net soaked or dipped Months ago net soaked or dipped How long ago was the most recent soaking/dipping done? If less than 1 month, record '00'. If answer is "12 months" or "1 year", probe to determine if net was treated exactly 12 months ago or earlier or later Households 95 More than 24 months ago 98 Not sure 99 Missing HH member died in past 12 months HH member died in past 12 months HH member died in past 12 months HH member died in past 12 months HH member died in past 12 months Check HL5: any children 0-17? Yes Continue to OV2 No Next Module I would like you to think back over the past 12 months. Has any usual member of your household died in the last 12 months? Households 1 Yes 2 No 9 Missing Dead members were aged 15-59 Dead members were aged 15-59 Dead members were aged 15-59 Dead members were aged 15-59 Dead members were aged 15-59 (Of those who died in the past 12 months) were any of these people between the ages of 18 and 59? Households 1 Yes 2 No 9 Missing Dead members were sick 3 months Dead members were sick 3 months Dead members were sick 3 months Dead members were sick 3 months Dead members were sick 3 months (Of those who died in the past 12 months and were between the ages of 18 and 59) were any of these people seriously ill for 3 of the 12 months before he/she died? Return to the Household Listing and check the following: 1. Check totals for HL9 and HL11. At least one mother or father dead. Go to OV8 No mother or father dead 2. Check totals for HL8A. At least one adult aged 18-59 very sick 3 of last 12 months. Go to OV8 No adult aged 18-59 very sick 3 of last 12 months 3. Check totals forHL10A and HL12A. At least one mother or father ill 3 of last 12 months. Go to OV8 No mother or father ill 3 of last 12 months. Go to Next Module Households 1 Yes 2 No 9 Missing Total children aged 2-14 years Total children aged 2-14 years Total children aged 2-14 years Total children aged 2-14 years Total children aged 2-14 years Review the household listing and list each of the children aged 2-14 years below in order according to their line number (HL1). Do not include other household members outside of the age range 2-14 years. Record the line number, name, sex, age, and the line number of the mother or caretaker for each child. Then record the total number of children aged 2-14 in the box provided (CD7). Total children aged 2-14 years Households Rank number of child (from response box) Rank number of child (from response box) Rank number of child (from response box) Rank number of child (from response box) Rank number of child (from response box) Use this table to select one child between the ages of 2 and 14 years, if there is more than one child in that age range in the household. Look for the last digit of the household number from the cover page. This is the number of the row you should go to in the table below. Check the total number of eligible children (2-14) in CD7 above. This is the number of the column you should go to. Find the box where the row and the column meet and circle the number that appears in the box. This is the rank number of the child about whom the questions will be asked. Record the rank number in CD9 below. Finally, record the line number and name of the selected child in CD11 on the next page. Then, find the mother or primary caretaker of that child, and ask the questions, beginning with CD12. Record the rank number of the selected child from table 2 above Households Child line number Child line number Child line number Child line number Child line number Identify eligible child aged 2 to 14 in the household using the tables on the preceding page, according to your instructions. Ask to interview the mother or primary caretaker of the selected child (identified by the line number in CD6). Write name and line no. of the child selected for the module from CD3 and CD2, based on the rank number in CD9. One selected child per household aged 2-14 97 Inconsistent Took away privileges Took away privileges Took away privileges Took away privileges Took away privileges All adults use certain ways to teach children the right behaviour or to address a behaviour problem. I will read various methods that are used and I want you to tell me if you or anyone else in your household has used this method with (name) in the past month. Took away privileges, forbade something (name) liked or did not allow him/her to leave house). One selected child per household aged 2-14 1 Yes 2 No 9 Missing Explaned why something was wrong Explaned why something was wrong Explaned why something was wrong Explaned why something was wrong Explaned why something was wrong All adults use certain ways to teach children the right behaviour or to address a behaviour problem. I will read various methods that are used and I want you to tell me if you or anyone else in your household has used this method with (name) in the past month. Explained why something (the behavior) was wrong. One selected child per household aged 2-14 1 Yes 2 No 9 Missing Shook him/her Shook him/her Shook him/her Shook him/her Shook him/her All adults use certain ways to teach children the right behaviour or to address a behaviour problem. I will read various methods that are used and I want you to tell me if you or anyone else in your household has used this method with (name) in the past month. Shook him/her. One selected child per household aged 2-14 1 Yes 2 No 9 Missing Shouted yelled at or screamed at him/her Shouted yelled at or screamed at him/her Shouted yelled at or screamed at him/her Shouted yelled at or screamed at him/her Shouted yelled at or screamed at him/her All adults use certain ways to teach children the right behaviour or to address a behaviour problem. I will read various methods that are used and I want you to tell me if you or anyone else in your household has used this method with (name) in the past month. Shouted, yelled at or screamed at him/her. One selected child per household aged 2-14 1 Yes 2 No 9 Missing Gave him/her something else to do Gave him/her something else to do Gave him/her something else to do Gave him/her something else to do Gave him/her something else to do All adults use certain ways to teach children the right behaviour or to address a behaviour problem. I will read various methods that are used and I want you to tell me if you or anyone else in your household has used this method with (name) in the past month. Gave him/her something else to do. One selected child per household aged 2-14 1 Yes 2 No 9 Missing Spanked, hit or slapped him/her with bare hand Spanked, hit or slapped him/her with bare hand Spanked, hit or slapped him/her with bare hand Spanked, hit or slapped him/her with bare hand Spanked, hit or slapped him/her with bare hand All adults use certain ways to teach children the right behaviour or to address a behaviour problem. I will read various methods that are used and I want you to tell me if you or anyone else in your household has used this method with (name) in the past month. Spanked, hit or slapped him/her on the bottom with bare hand. One selected child per household aged 2-14 1 Yes 2 No 9 Missing Hit him/her on the bottom with or elsewhere with a belt Hit him/her on the bottom with or elsewhere with a belt Hit him/her on the bottom with or elsewhere with a belt Hit him/her on the bottom with or elsewhere with a belt Hit him/her on the bottom with or elsewhere with a belt All adults use certain ways to teach children the right behaviour or to address a behaviour problem. I will read various methods that are used and I want you to tell me if you or anyone else in your household has used this method with (name) in the past month. Hit him/her on the bottom or elsewhere on the body with something like a belt, hairbrush, stick or other hard object. One selected child per household aged 2-14 1 Yes 2 No 9 Missing Called him/her dumb, lazy Called him/her dumb, lazy Called him/her dumb, lazy Called him/her dumb, lazy Called him/her dumb, lazy All adults use certain ways to teach children the right behaviour or to address a behaviour problem. I will read various methods that are used and I want you to tell me if you or anyone else in your household has used this method with (name) in the past month. Called him/her dumb, lazy, or another name like that. One selected child per household aged 2-14 1 Yes 2 No 9 Missing Hit or slapped him/her on the face Hit or slapped him/her on the face Hit or slapped him/her on the face Hit or slapped him/her on the face Hit or slapped him/her on the face All adults use certain ways to teach children the right behaviour or to address a behaviour problem. I will read various methods that are used and I want you to tell me if you or anyone else in your household has used this method with (name) in the past month. Hit or slapped him/her on the face, head or ears. One selected child per household aged 2-14 1 Yes 2 No 9 Missing Hit or slapped him/her on the hand Hit or slapped him/her on the hand Hit or slapped him/her on the hand Hit or slapped him/her on the hand Hit or slapped him/her on the hand All adults use certain ways to teach children the right behaviour or to address a behaviour problem. I will read various methods that are used and I want you to tell me if you or anyone else in your household has used this method with (name) in the past month. Hit or slapped him/her on the hand, arm, or leg. One selected child per household aged 2-14 1 Yes 2 No 9 Missing Beat him/her up with an implement Beat him/her up with an implement Beat him/her up with an implement Beat him/her up with an implement Beat him/her up with an implement All adults use certain ways to teach children the right behaviour or to address a behaviour problem. I will read various methods that are used and I want you to tell me if you or anyone else in your household has used this method with (name) in the past month. Beat him/her up with an implement (hit over and over as hard as one could). One selected child per household aged 2-14 1 Yes 2 No 9 Missing Do you believe to bring up you nedd to punish him/her Do you believe to bring up you nedd to punish him/her Do you believe to bring up you nedd to punish him/her Do you believe to bring up you nedd to punish him/her Do you believe to bring up you nedd to punish him/her Do you believe that in order to bring up (raise, educate) (name) properly, you need to physically punish him/her? One selected child per household aged 2-14 1 Yes 2 No 8 Don't know/no opinion 9 Missing Salt iodization test outcome Salt iodization test outcome Salt iodization test outcome Salt iodization test outcome Salt iodization test outcome We would like to check whether the salt used in your household is iodized. May I see a sample of the salt used to cook the main meal eaten by members of your household last night? Once you have examined the salt, circle number that corresponds to test outcome. Households 1 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 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 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) 1 None 2 Primary 3 Secondary + 4 Non-standard curriculum 9 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. Religion of Household Head Religion of Household Head Religion of Household Head Religion of Household Head Religion of Household Head 1 Christian 2 Muslim 9 Other/Missing 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 Sick for 3 months Sick for 3 months Sick for 3 months Sick for 3 months Sick for 3 months If age 18-59 years Has (name) been very sick for at least 3 months during the past 12 months? De jure household members (usual residents) 1 Yes 2 No 8 Dont know 9 Missing Mother alive Mother alive Mother alive Mother alive Mother alive For children age 0-17 years ask HL9-HL12 Is (name's) natural mother alive? De jure household members (usual residents) aged 0-17 (under 18) 1 Yes 2 No 8 DK 9 Missing Mother line number in HH Mother line number in HH Mother line number in HH Mother line number in HH Mother line number in HH For children age 0-17 years ask HL9-HL12 If alive: Does (name's) natural mother live in this household? Record Line no. of mother or 00 for 'No' De jure household members (usual residents) aged 0-17 (under 18) 97 Inconsistent 99 Missing Mother sick for 3 months Mother sick for 3 months Mother sick for 3 months Mother sick for 3 months Mother sick for 3 months For children age 0-17 years ask HL9-HL12A If mother does not live in household: Has (name's) mother been very sick for at least 3 months in the past 12 months? De jure household members (usual residents) aged 0-17 (under 18) 1 Yes 2 No 8 DK 9 Missing Father alive Father alive Father alive Father alive Father alive For children age 0-17 years ask HL9-HL12 If alive: Is (name's) natural father alive? De jure household members (usual residents) aged 0-17 (under 18) 1 Yes 2 No 8 DK 9 Missing Father line number in HH Father line number in HH Father line number in HH Father line number in HH Father line number in HH For children age 0-17 years ask HL9-HL12 Does (name's) natural father live in this household? Record Line no. of father or 00 for 'No' De jure household members (usual residents) aged 0-17 (under 18) 97 Inconsistent 99 Missing Father sick for 3 months Father sick for 3 months Father sick for 3 months Father sick for 3 months Father sick for 3 months For children age 0-17 years ask HL9-HL12A If father does not live in household: Has (name's) father been very sick for at least 3 months in the past 12 months? De jure household members (usual residents) aged 0-17 (under 18) 1 Yes 2 No 8 DK 9 Missing Line number Line number Line number Line number Line number For household members age 5 and above De jure household members (usual residents) Ever attended school Ever attended school Ever attended school Ever attended school Ever attended school For household members age 5 and above Has (name) ever attended school or preschool? De jure household members (usual residents) 1 Yes 2 No 9 Missing Highest level of school attended Highest level of school attended Highest level of school attended Highest level of school attended Highest level of school attended What is the highest level of school (name) attended? Children aged 0-4 Preschool/kindergarten 1 Primary 2 Secondary 3 Higher 6 Non-standard curriculum 8 DK 9 Missing Highest grade at level Highest grade at level Highest grade at level Highest grade at level Highest grade at level For household members age 5 and above What is the highest grade (name) completed at this level? De jure household members (usual residents) 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/kindergarten 1 Primary 2 Secondary 3 Higher 6 Non-standard curriculum 8 DK 9 Missing Grade of education attended Grade of education attended Grade of education attended Grade of education attended Grade of education attended For household members age 5-24 years During this/that school year, which level and grade is/was (name) attending? De jure household members (usual residents) aged 5-24 97 Inconsistent 98 DK 99 Missing Attended school last year (2003-2004) Attended school last year (2003-2004) Attended school last year (2003-2004) Attended school last year (2003-2004) Attended school last year (2003-2004) For household members age 5-24 years Did (name) attend school or preschool at any time during the previous school year, that is (2003-2004)? De jure household members (usual residents) aged 5-24 1 Yes 2 No 8 DK 9 Missing Level of education attended last year Level of education attended last year Level of education attended last year Level of education attended last year Level of education attended last year For household members age 5-24 years During that previous school year, which level and grade did (name) attend? De jure household members (usual residents) aged 5-24 Preschool/kindergarten 1 Primary 2 Secondary 3 Higher 6 Non-standard curriculum 8 DK 9 Missing Grade of education attended last year Grade of education attended last year Grade of education attended last year Grade of education attended last year Grade of education attended last year For household members age 5-24 years During that previous school year, which level and grade did (name) attend? De jure household members (usual residents) aged 5-24 97 Inconsistent 98 DK 99 Missing Line number Line number Line number Line number Line number Return to the Household Listing and check the following: 1. Check totals for HL9 and HL11. At least one mother or father dead. Go to OV8 No mother or father dead 2. Check totals for HL8A. At least one adult aged 18-59 very sick 3 of last 12 months. Go to OV8 No adult aged 18-59 very sick 3 of last 12 months 3. Check totals for HL10A and HL12A. At least one mother or father ill 3 of last 12 months. Go to OV8 No mother or father ill 3 of last 12 months. Go to Next Module List all children aged 0-17 below. Record names, line numbers and ages of all children, beginning with the first child and continue in order in which listed in the household listing module. Use a continuation sheet if there are more than 4 children age 0-17 in the household. Ask all questions for one child before moving to the next child. Line number (from HL1) Children living in households with at least one child considered as an orphan or asa child made vulnerable by HIV/AIDS Age Age Age Age Age Age (from HL5) Children living in households with at least one child considered as an orphan or asa child made vulnerable by HIV/AIDS Medical support Medical support Medical support Medical support Medical support I would like to ask you about any formal, organized help or support that your household may have received for (name) and for which you did not have to pay. By formal organized support I mean help provided by someone working for a program. This program could be government, private, religious, charity, or community-based. Remember this should be support for which you did not pay. Now I would like to ask you about the support your household received for (name). In the last 12 months, has your household received any medical support for (name), such as medical care, supplies or medicine? Children living in households with at least one child considered as an orphan or asa child made vulnerable by HIV/AIDS 1 Yes 2 No 8 DK 9 Missing Psychological support (12 months) Psychological support (12 months) Psychological support (12 months) Psychological support (12 months) Psychological support (12 months) In the last 12 months, has your household received any emotional or psychological support for (name), such as companionship, counseling from a trained couselor, or spiritual support, which you received at home? Children living in households with at least one child considered as an orphan or asa child made vulnerable by HIV/AIDS 1 Yes 2 No 8 DK 9 Missing Psychological support (3 months) Psychological support (3 months) Psychological support (3 months) Psychological support (3 months) Psychological support (3 months) Did your household receive any of this support in the past 3 months? Children living in households with at least one child considered as an orphan or asa child made vulnerable by HIV/AIDS 1 Yes 2 No 8 DK 9 Missing Material support (12 months) Material support (12 months) Material support (12 months) Material support (12 months) Material support (12 months) In the last 12 months, has your household received any material support for (name), such as clothing, food or financial support? Children living in households with at least one child considered as an orphan or asa child made vulnerable by HIV/AIDS 1 Yes 2 No 8 DK 9 Missing Material support (3 months) Material support (3 months) Material support (3 months) Material support (3 months) Material support (3 months) Did your household receive any of this support in the past 3 months? Children living in households with at least one child considered as an orphan or asa child made vulnerable by HIV/AIDS 1 Yes 2 No 8 DK 9 Missing Social support (12 months) Social support (12 months) Social support (12 months) Social support (12 months) Social support (12 months) In the last 12 months, has your household received any social support for (name), such as help in household work, training for a caregiver, or legal services? Children living in households with at least one child considered as an orphan or asa child made vulnerable by HIV/AIDS 1 Yes 2 No 8 DK 9 Missing Social support (3 months) Social support (3 months) Social support (3 months) Social support (3 months) Social support (3 months) Did your household receive any of this support in the past 3 months? Children living in households with at least one child considered as an orphan or asa child made vulnerable by HIV/AIDS 1 Yes 2 No 8 DK 9 Missing School support School support School support School support School support Check OV8 for age of child: Age 0-4. next child Age 5-17. OV18 In the last 12 months, has your household received any support for (name's) schooling, such as allowance, free admission, books or supplies? Children living in households with at least one child considered as an orphan or asa child made vulnerable by HIV/AIDS 1 Yes 2 No 8 DK 9 Missing Line number Line number Line number Line number Line number To be administered to mother/caretaker of each child in the household age 5 through 14 years. For household members below age 5 or above age 14, leave rows blank. Now I would like to ask about any work children in this household may do. Children aged 5-14 Worked in past week Worked in past week Worked in past week Worked in past week Worked in past week During the past week, did (name) do any kind of work for someone who is not a member of this household? If yes: For pay in cash or kind? Children aged 5-14 1 Yes, paid 2 Yes, unpaid 3 No 9 Missing Hours worked in past week Hours worked in past week Hours worked in past week Hours worked in past week Hours worked in past week If yes: Since last (day of the week), about how many hours did he/she do this work for someone who is not a member of this household? If more than one job, include all hours at all jobs. Children aged 5-14 98 DK 99 Missing Worked in past year Worked in past year Worked in past year Worked in past year Worked in past year At any time during the past year, did (name) do any kind of work for someone who is not a member of this household? If yes: For pay in cash or kind? Children aged 5-14 1 Yes, paid 2 Yes, unpaid 3 No 9 Missing Helped with household chores in past week Helped with household chores in past week Helped with household chores in past week Helped with household chores in past week Helped with household chores in past week During the past week, did (name) help with household chores such as shopping, collecting firewood, cleaning, fetching water, or caring for children? Children aged 5-14 1 Yes 2 No 9 Missing Hours spent on chores in past week Hours spent on chores in past week Hours spent on chores in past week Hours spent on chores in past week Hours spent on chores in past week If yes: Since last (day of the week), about how many hours did he/she spend doing these chores? Children aged 5-14 98 DK 99 Missing Did other family work in past week Did other family work in past week Did other family work in past week Did other family work in past week Did other family work in past week During the past week, did (name) do any other family work (on the farm or in a business or selling goods in the street?) Children aged 5-14 1 Yes 2 No 9 Missing Hours worked on other family work Hours worked on other family work Hours worked on other family work Hours worked on other family work Hours worked on other family work If yes: Since last (day of the week), about how many hours did he/she do this work? Children aged 5-14 98 DK 99 Missing Line number Line number Line number Line number Line number 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 Delay in sitting, standing or walking Delay in sitting, standing or walking Delay in sitting, standing or walking Delay in sitting, standing or walking Delay in sitting, standing 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 Difficulty seeing Difficulty seeing Difficulty seeing Difficulty seeing Difficulty seeing 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 Difficulty hearing Difficulty hearing Difficulty hearing Difficulty hearing 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 Understands Understands Understands Understands Understands 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 Difficulty walking Difficulty walking Difficulty walking Difficulty walking Difficulty walking 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 Fits, rigid or lose conciousness Fits, rigid or lose conciousness Fits, rigid or lose conciousness Fits, rigid or lose conciousness Fits, rigid or lose conciousness Does (name) sometimes have fits, become rigid, or lose consciousness? De jure children aged 2-14 1 Yes 2 No 9 Missing Learns like other children Learns like other children Learns like other children Learns like other children Learns like other children Does (name) learn to do things like other children his/her age? De jure children aged 2-14 1 Yes 2 No 9 Missing Speaks Speaks Speaks Speaks Speaks 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 different Speech different Speech different Speech different Speech different 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 Names objects Names objects Names objects Names objects Names objects 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 Mentally backward Mentally backward Mentally backward Mentally backward 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 Rural 2 Urban Region Region Region Region Region Region: Households 1 East 2 North 3 South 4 West District District District District District 11 Kailahun 12 Kenema 13 Kono 21 Bombali 22 Kambia 23 Koinadugu 24 Port Loko 25 Tonkolili 31 Bo 32 Bonthe 33 Moyamba 34 Pujehun 41 Western Rural 42 Western Urban 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 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 Religion Religion Religion Religion Religion What is the religion of the head of this household? Households 1 Christian 2 Muslim 3 Traditional 6 Other religion 7 No religion 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 12 Dung 21 Wood planks 22 Palm/bamboo 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 11 No roof 12 Thatch/palm leaf 13 Sod 21 Rustic mat 22 Palm/bamboo 23 Wood Planks 24 Plastic Sheeting 31 Metal 32 Wood 33 Calamine/cement fiber 34 Ceramic tiles 35 Cement 36 Roofing shingles 96 Other 99 Missing Main material of wall Main material of wall Main material of wall Main material of wall Main material of wall Main material of the walls. Record observation. Households 11 No walls 12 Cane/palm/trunks 13 Dirt 21 Bambo with mud 22 Stone with mud 23 Uncovered adobe 24 Plywood 25 Carton 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 Water Pump Water Pump Water Pump Water Pump Water Pump 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 Boat with a motor Boat with a motor Boat with a motor Boat with a motor Boat with a motor Does any member of your household own: Households 1 Yes 2 No 9 Missing Total number of Women 15-49 Total number of Women 15-49 Total number of Women 15-49 Total number of Women 15-49 Total number of Women 15-49 Are there any other persons living here - even if they are not members of your family or do not have parents living in this household? Including children at work or at school? If yes, insert child's name and complete form. Then, complete the totals below. Households Total number of Children 5-14 Total number of Children 5-14 Total number of Children 5-14 Total number of Children 5-14 Total number of Children 5-14 Households Total number of Children Under 5 years Total number of Children Under 5 years Total number of Children Under 5 years Total number of Children Under 5 years Total number of Children Under 5 years Households Total adults very sick Total adults very sick Total adults very sick Total adults very sick Total adults very sick Total mothers dead Total mothers dead Total mothers dead Total mothers dead Total mothers dead Total mothers very sick Total mothers very sick Total mothers very sick Total mothers very sick Total mothers very sick Total fathers dead Total fathers dead Total fathers dead Total fathers dead Total fathers dead Total fathers very sick Total fathers very sick Total fathers very sick Total fathers very sick Total fathers very sick HH member died in past 12 months HH member died in past 12 months HH member died in past 12 months HH member died in past 12 months HH member died in past 12 months Check HL5: any children 0-17? Yes Continue to OV2 No Next Module I would like you to think back over the past 12 months. Has any usual member of your household died in the last 12 months? Households 1 Yes 2 No 9 Missing Dead members were aged 15-59 Dead members were aged 15-59 Dead members were aged 15-59 Dead members were aged 15-59 Dead members were aged 15-59 (Of those who died in the past 12 months) were any of these people between the ages of 18 and 59? Households 1 Yes 2 No 9 Missing Dead members were sick 3 months Dead members were sick 3 months Dead members were sick 3 months Dead members were sick 3 months Dead members were sick 3 months (Of those who died in the past 12 months and were between the ages of 18 and 59) were any of these people seriously ill for 3 of the 12 months before he/she died? Return to the Household Listing and check the following: 1. Check totals for HL9 and HL11. At least one mother or father dead. Go to OV8 No mother or father dead 2. Check totals for HL8A. At least one adult aged 18-59 very sick 3 of last 12 months. Go to OV8 No adult aged 18-59 very sick 3 of last 12 months 3. Check totals forHL10A and HL12A. At least one mother or father ill 3 of last 12 months. Go to OV8 No mother or father ill 3 of last 12 months. Go to Next Module Households 1 Yes 2 No 9 Missing 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 Religion of Household Head Religion of Household Head Religion of Household Head Religion of Household Head Religion of Household Head 1 Christian 2 Muslim 9 Other/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 1 None 2 Primary 3 Secondary + 4 Non-standard curriculum 5 Mother not in household 9 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) 1 None 2 Primary 3 Secondary + 4 Non-standard curriculum 5 Father not in household 9 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) 1 None 2 Primary 3 Secondary + 4 Non-standard curriculum 9 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. 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 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 Primary 2 Secondary 3 Higher 6 Non-standard curriculum 9 Missing What is the highest grade completed at that level What is the highest grade completed at that level What is the highest grade completed at that level What is the highest grade completed at that level What is the highest grade completed at that level What is the highest grade you completed at that level? Women aged 15-49 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 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 Tetanus toxoid card Tetanus toxoid card Tetanus toxoid card Tetanus toxoid card Tetanus toxoid card This module is to be administered to all women with a live birth in the 2 years preceding date of interview. Do you have a card or other document with your own immunizations listed? If a card is presented, use it to assist with answers to the following questions. Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 1 Yes (card seen) 2 Yes (card not seen) 3 No 8 DK 9 Missing Tetanus toxoid given in pregnancy Tetanus toxoid given in pregnancy Tetanus toxoid given in pregnancy Tetanus toxoid given in pregnancy Tetanus toxoid given in pregnancy When you were pregnant with your last child, did you receive any injection to prevent him or her from getting tetanus, that is convulsions after birth (an anti-tetanus shot, an injection at the top of the arm or shoulder)? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 1 Yes 2 No 8 DK 9 Missing Times given tetanus toxoid in pregnancy Times given tetanus toxoid in pregnancy Times given tetanus toxoid in pregnancy Times given tetanus toxoid in pregnancy Times given tetanus toxoid in pregnancy If yes: How many times did you receive this anti-tetanus injection during your last pregnancy? How many TT doses during last pregnancy were reported in TT3? At least two TT injections during last pregnancy. Go to Next Module Fewer than two TT injections during last pregnancy. Continue with TT5 Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 98 DK 99 Missing Given tetanus toxoid before pregnancy Given tetanus toxoid before pregnancy Given tetanus toxoid before pregnancy Given tetanus toxoid before pregnancy Given tetanus toxoid before pregnancy Did you receive any tetanus toxoid injection at any time before your last pregnancy? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 1 Yes 2 No 8 DK 9 Missing Times given tetanus toxoid before pregnancy Times given tetanus toxoid before pregnancy Times given tetanus toxoid before pregnancy Times given tetanus toxoid before pregnancy Times given tetanus toxoid before pregnancy How many times did you receive it? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 98 DK 99 Missing Month last given tetanus toxoid before pregnancy Month last given tetanus toxoid before pregnancy Month last given tetanus toxoid before pregnancy Month last given tetanus toxoid before pregnancy Month last given tetanus toxoid before pregnancy In what month and year did you receive the last anti-tetanus injection before that last pregnancy? Skip to next module only if year of injection is given. Otherwise, continue with TT8. Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 97 Inconsistent 98 DK 99 Missing Year last given tetanus toxoid before pregnancy Year last given tetanus toxoid before pregnancy Year last given tetanus toxoid before pregnancy Year last given tetanus toxoid before pregnancy Year last given tetanus toxoid before pregnancy In what month and year did you receive the last anti-tetanus injection before that last pregnancy? Skip to next module only if year of injection is given. Otherwise, continue with TT8. Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 9997 Inconsistent 9998 DK 9999 Missing Years ago last received tetanus toxoid before pregnancy Years ago last received tetanus toxoid before pregnancy Years ago last received tetanus toxoid before pregnancy Years ago last received tetanus toxoid before pregnancy Years ago last received tetanus toxoid before pregnancy How many years ago did you receive the last anti-tetanus injection before that last pregnancy? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 99 Missing 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 Took medicine to prevent malaria Took medicine to prevent malaria Took medicine to prevent malaria Took medicine to prevent malaria Took medicine to prevent malaria During this pregnancy, did you take any medicine in order to prevent you from getting malaria? 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 SP/Fansidar SP/Fansidar SP/Fansidar SP/Fansidar SP/Fansidar Which medicines did you take to prevent malaria? Circle all medicines taken. If type of medicine is not determined, show typical anti-malarial to respondent Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing A SP/Fansidar Chloroquine Chloroquine Chloroquine Chloroquine Chloroquine Which medicines did you take to prevent malaria? Circle all medicines taken. If type of medicine is not determined, show typical anti-malarial to respondent Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing B Chloroquine Other Other Other Other Other Which medicines did you take to prevent malaria? Circle all medicines taken. If type of medicine is not determined, show typical anti-malarial to respondent Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing X Other Don't know Don't know Don't know Don't know Don't know Which medicines did you take to prevent malaria? Circle all medicines taken. If type of medicine is not determined, show typical anti-malarial to respondent Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing Z DK Times took SP/Fansidar Times took SP/Fansidar Times took SP/Fansidar Times took SP/Fansidar Times took SP/Fansidar Check MN6B for medicine taken: SP/Fansidar taken. Continue with MN6D SP/Fansidar not taken. Go to MN7 How many times did you take SP/fansidar during this pregnancy to prevent malaria? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 98 DK 99 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 Respondent's home 12 Other home 21 Government hospital 22 Government clinic/health center 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 Weight at birth Weight at birth Weight at birth Weight at birth How much did (name) weigh? Record weight from health card, if available. Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 9.998 DK 9.999 Missing Ever breastfeed Ever breastfeed Ever breastfeed Ever breastfeed Ever breastfeed Did you ever breastfeed (name)? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 1 Yes 2 No 9 Missing Time baby put to breast (unit) Time baby put to breast (unit) Time baby put to breast (unit) Time baby put to breast (unit) Time baby put to breast (unit) How long after birth did you first put (name) to the breast? If less than 1 hour, record '00' hours. If less than 24 hours, record hours. Otherwise, record days. Women aged 15-49 who gave birth to a child in the 2 years preceding the survey Immediately 1 Hours 2 Days 9 Missing Time baby put to breast (number) Time baby put to breast (number) Time baby put to breast (number) Time baby put to breast (number) Time baby put to breast (number) How long after birth did you first put (name) to the breast? If less than 1 hour, record '00' hours. If less than 24 hours, record hours. Otherwise, record days. Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 98 DK 99 Missing Currently married or living with a man Currently married or living with a man Currently married or living with a man Currently married or living with a man Currently married or living with a man Are you currently married or living together with a man as if married? Women aged 15-49 1 Yes, currently married 2 Yes, living with a man 3 No, not in union 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 Husband has other partners Husband has other partners Husband has other partners Husband has other partners Husband has other partners Besides yourself, does your husband/partner have any other wives? Women aged 15-49 1 Yes 2 No 9 Missing Number of other partners Number of other partners Number of other partners Number of other partners Number of other partners How many other wives does he have? 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 Ever heard of Female circumcision Ever heard of Female circumcision Ever heard of Female circumcision Ever heard of Female circumcision Ever heard of Female circumcision Have you ever heard of female circumcision? Women aged 15-49 1 Yes 2 No 9 Missing Ever been circumcised Ever been circumcised Ever been circumcised Ever been circumcised Ever been circumcised Have you yourself ever been circumcised? Women aged 15-49 1 Yes 2 No 9 Missing Who performed circumcision Who performed circumcision Who performed circumcision Who performed circumcision Who performed circumcision Who circumcised you? Women aged 15-49 11 Traditional circumciser 12 Traditional birth attendance 16 Other traditional erson 21 Doctor 22 Nurse/midwife 26 Other health profesional 98 DK 99 Missing Any daughters circumcised Any daughters circumcised Any daughters circumcised Any daughters circumcised Any daughters circumcised The following questions apply only to women who have at least one living daughter. Check CM4 and CM6, Child Mortality Module: Woman has living daughter? Yes. Continue with FG9 No. Go to FG16 Have any of your daughters been circumcised? If yes, how many? To which of your daughters did this happen most recently? Record the daughter's name. Women aged 15-49 No daughters circumcised 98 DK 99 Missing Daughter's age at circumcision Daughter's age at circumcision Daughter's age at circumcision Daughter's age at circumcision Daughter's age at circumcision How old was (name) when this occurred? If the respondent does not know the age, probe to get an estimate. Women aged 15-49 97 Inconsistent 98 DK 99 Missing Daughter - who performed circumcision Daughter - who performed circumcision Daughter - who performed circumcision Daughter - who performed circumcision Daughter - who performed circumcision Who did the circumcision? Women aged 15-49 11 Traditional circumciser 12 Traditional birth attendance 16 Other traditional erson 21 Doctor 22 Nurse/midwife 26 Other health profesional 98 DK 99 Missing Circumcision should continue Circumcision should continue Circumcision should continue Circumcision should continue Circumcision should continue Do you think this practice should be continued or should it be discontinued? Women aged 15-49 1 Continued 2 Discountinued 3 Depends 8 DK 9 Missing If she goes out with out telling him If she goes out with out telling him If she goes out with out telling him If she goes out with out telling him If she goes out with out telling him Sometimes a husband is annoyed or angered by things that his wife does. In your opinion, is a husband justified in hitting or beating his wife in the following situations: If she goes out with out telling him? Women aged 15-49 1 Yes 2 No 8 DK 9 Missing If she neclects the children If she neclects the children If she neclects the children If she neclects the children If she neclects the children Sometimes a husband is annoyed or angered by things that his wife does. In your opinion, is a husband justified in hitting or beating his wife in the following situations: If she neglects the children? Women aged 15-49 1 Yes 2 No 8 DK 9 Missing If she argues with him If she argues with him If she argues with him If she argues with him If she argues with him Sometimes a husband is annoyed or angered by things that his wife does. In your opinion, is a husband justified in hitting or beating his wife in the following situations: If she argues with him? Women aged 15-49 1 Yes 2 No 8 DK 9 Missing If she refuses sex with him If she refuses sex with him If she refuses sex with him If she refuses sex with him If she refuses sex with him Sometimes a husband is annoyed or angered by things that his wife does. In your opinion, is a husband justified in hitting or beating his wife in the following situations: If she refuses sex with him? Women aged 15-49 1 Yes 2 No 8 DK 9 Missing If she burns the food If she burns the food If she burns the food If she burns the food If she burns the food Sometimes a husband is annoyed or angered by things that his wife does. In your opinion, is a husband justified in hitting or beating his wife in the following situations: If she burns the food? Women aged 15-49 1 Yes 2 No 8 DK 9 Missing If she refuses to cook If she refuses to cook If she refuses to cook If she refuses to cook If she refuses to cook 1 Yes 2 No 8 DK 9 Missing If she goes out with a boyfriend If she goes out with a boyfriend If she goes out with a boyfriend If she goes out with a boyfriend If she goes out with a boyfriend 1 Yes 2 No 8 Dk 9 Missing If she refuses to clean the house If she refuses to clean the house If she refuses to clean the house If she refuses to clean the house If she refuses to clean the house 1 Yes 2 No 8 Dk 9 Missing Age at first sex Age at first sex Age at first sex Age at first sex Age at first sex 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 sex (units) Time since last sex (units) Time since last sex (units) Time since last sex (units) Time since last sex (units) 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 sex (number) Time since last sex (number) Time since last sex (number) Time since last sex (number) Time since last sex (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 Used condom at last sex Used condom at last sex Used condom at last sex Used condom at last sex Used condom at last sex The last time you had sexual intercourse was a condom used? Women aged 15-24 1 Yes 2 No 9 Missing Relationship to last partner Relationship to last partner Relationship to last partner Relationship to last partner Relationship to last 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 boyfriend/fiancee 3 Other friend 4 Casual acquaintance 6 Other 9 Missing Age of last partner Age of last partner Age of last partner Age of last partner Age of last 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 Had sex with other man in last year Had sex with other man in last year Had sex with other man in last year Had sex with other man in last year Had sex with other man in last year Have you had sex with any other man in the last 12 months? Women aged 15-24 1 Yes 2 No 9 Missing Used condom with prior partner Used condom with prior partner Used condom with prior partner Used condom with prior partner Used condom with prior 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 partner Relationship to prior partner Relationship to prior partner Relationship to prior partner Relationship to prior 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 partner Age of prior partner Age of prior partner Age of prior partner Age of prior 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 Other partners in past year Other partners in past year Other partners in past year Other partners in past year Other partners in past year 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 Total number of partners in past year Total number of partners in past year Total number of partners in past year Total number of partners in past year Total number of partners in past year In total, with how many different men have you had sex in the last 12 months? Women aged 15-24 98 DK 99 Missing Ever heard of HIV or AIDS Ever heard of HIV or AIDS Ever heard of HIV or AIDS Ever heard of HIV or AIDS Ever heard of HIV or AIDS Now I would like to talk with you about something else. Have you ever heard of the virus HIV or an illness called AIDS? Women aged 15-49 1 Yes 2 No 9 Missing Can avoid AIDS by having one unifected partner Can avoid AIDS by having one unifected partner Can avoid AIDS by having one unifected partner Can avoid AIDS by having one unifected partner Can avoid AIDS by having one unifected partner Can people protect themselves from getting infected with the AIDS virus by having one sex partner who is not infected and also has no other partners? Women aged 15-49 1 Yes 2 No 8 DK 9 Missing Can get AIDS through supernatural means Can get AIDS through supernatural means Can get AIDS through supernatural means Can get AIDS through supernatural means Can get AIDS through supernatural means Can people get infected with the AIDS virus because of witchcraft or other supernatural means? Women aged 15-49 1 Yes 2 No 8 DK 9 Missing Can avoid AIDS by using a condom correctly every time Can avoid AIDS by using a condom correctly every time Can avoid AIDS by using a condom correctly every time Can avoid AIDS by using a condom correctly every time Can avoid AIDS by using a condom correctly every time Can people reduce their chance of getting the AIDS virus by using a condom every time they have sex? Women aged 15-49 1 Yes 2 No 8 DK 9 Missing Can get AIDS from mosquito bites Can get AIDS from mosquito bites Can get AIDS from mosquito bites Can get AIDS from mosquito bites Can get AIDS from mosquito bites Can people get the AIDS virus from mosquito bites? Women aged 15-49 1 Yes 2 No 8 DK 9 Missing Can avoid AIDS by not having sex at all Can avoid AIDS by not having sex at all Can avoid AIDS by not having sex at all Can avoid AIDS by not having sex at all Can avoid AIDS by not having sex at all Can people reduce their chance of getting infected with the AIDS virus by not having sex at all? Women aged 15-49 1 Yes 2 No 8 DK 9 Missing Can get AIDS by sharing food with person with AIDS virus Can get AIDS by sharing food with person with AIDS virus Can get AIDS by sharing food with person with AIDS virus Can get AIDS by sharing food with person with AIDS virus Can get AIDS by sharing food with person with AIDS virus Can people get the AIDS virus by sharing food with a person who has AIDS? Women aged 15-49 1 Yes 2 No 8 DK 9 Missing Can get AIDS by injection with needle already used by someon Can get AIDS by injection with needle already used by someon Can get AIDS by injection with needle already used by someon Can get AIDS by injection with needle already used by someon Can get AIDS by injection with needle already used by someon Can people get the AIDS virus by getting injections with a needle that was already used by someone else? Women aged 15-49 1 Yes 2 No 8 DK 9 Missing Healthy-looking person can have AIDS Healthy-looking person can have AIDS Healthy-looking person can have AIDS Healthy-looking person can have AIDS Healthy-looking person can 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 female teacher with HIV/AIDS be allowed to teach in school Should female teacher with HIV/AIDS be allowed to teach in school Should female teacher with HIV/AIDS be allowed to teach in school Should female teacher with HIV/AIDS be allowed to teach in school Should female 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 Rural 2 Urban Region Region Region Region Region Region: Households 1 East 2 North 3 South 4 West District District District District District 11 Kailahun 12 Kenema 13 Kono 21 Bombali 22 Kambia 23 Koinadugu 24 Port Loko 25 Tonkolili 31 Bo 32 Bonthe 33 Moyamba 34 Pujehun 41 Western Rural 42 Western Urban 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 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 Religion Religion Religion Religion Religion What is the religion of the head of this household? Households 1 Christian 2 Muslim 3 Traditional 6 Other religion 7 No religion 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 12 Dung 21 Wood planks 22 Palm/bamboo 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 11 No roof 12 Thatch/palm leaf 13 Sod 21 Rustic mat 22 Palm/bamboo 23 Wood Planks 24 Plastic Sheeting 31 Metal 32 Wood 33 Calamine/cement fiber 34 Ceramic tiles 35 Cement 36 Roofing shingles 96 Other 99 Missing Main material of wall Main material of wall Main material of wall Main material of wall Main material of wall Main material of the walls. Record observation. Households 11 No walls 12 Cane/palm/trunks 13 Dirt 21 Bambo with mud 22 Stone with mud 23 Uncovered adobe 24 Plywood 25 Carton 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 Water Pump Water Pump Water Pump Water Pump Water Pump 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 Boat with a motor Boat with a motor Boat with a motor Boat with a motor Boat with a motor Does any member of your household own: Households 1 Yes 2 No 9 Missing Women's sample weight Women's sample weight Women's sample weight Women's sample weight Women's sample weight Recoded variable Women aged 15-49 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 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 Education Education Education Education Education Recoded variable Children aged 0-4 1 None 2 Primary 3 Secondary + 4 Non-standard curriculum 9 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. Surviving children Surviving children Surviving children Surviving children Surviving children Recoded variable 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. Religion of Household Head Religion of Household Head Religion of Household Head Religion of Household Head Religion of Household Head 1 Christian 2 Muslim 9 Other/Missing 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 Homemade toys Homemade toys Homemade toys Homemade toys Homemade 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 Child received sweetened water or juice Child received sweetened water or juice Child received sweetened water or juice Child received sweetened water or juice Child received sweetened water or juice Since this time yesterday, did he/she receive any of the following: Read each item aloud and record response before proceeding to the next item. Sweetened, flavoured water or fruit juice or tea or infusion? Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Child received oral rehydration solution Child received oral rehydration solution Child received oral rehydration solution Child received oral rehydration solution Child received oral rehydration solution Since this time yesterday, did he/she receive any of the following: Read each item aloud and record response before proceeding to the next item. Oral rehydration solution (ORS)? Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Child received infant formula Child received infant formula Child received infant formula Child received infant formula Child received infant formula Since this time yesterday, did he/she receive any of the following: Read each item aloud and record response before proceeding to the next item. Infant formula? Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Child received milk Child received milk Child received milk Child received milk Child received milk Since this time yesterday, did he/she receive any of the following: Read each item aloud and record response before proceeding to the next item. Tinned, powdered or fresh milk? Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Child received other liquids Child received other liquids Child received other liquids Child received other liquids Child received other liquids Since this time yesterday, did he/she receive any of the following: Read each item aloud and record response before proceeding to the next item. Any other liquids? Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Child received solid or mushy food Child received solid or mushy food Child received solid or mushy food Child received solid or mushy food Child received solid or mushy food Since this time yesterday, did he/she receive any of the following: Read each item aloud and record response before proceeding to the next item. Solid or semi-solid (mushy) food? Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Time ate solid, semisolid or soft food other than liquids Time ate solid, semisolid or soft food other than liquids Time ate solid, semisolid or soft food other than liquids Time ate solid, semisolid or soft food other than liquids Time ate solid, semisolid or soft food other than liquids Check BF3H: Child received solid or semi-solid (mushy) food? Yes. Continue with BF5 No or DK. Go to Next Module Since this time yesterday, how many times did (NAME) eat solid, semisolid, or soft foods other than liquids? If 7 or more times, record '7'. Children aged 0-4 7 7+ 8 DK 9 Missing Child had diarrhoea in last 2 weeks Child had diarrhoea in last 2 weeks Child had diarrhoea in last 2 weeks Child had diarrhoea in last 2 weeks Child had diarrhoea in last 2 weeks Has (name) had diarrhoea in the last two weeks, that is, since (day of the week) of the week before last? Diarrhoea is determined as perceived by mother or caretaker, or as three or more loose or watery stools per day, or blood in stool. Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Drank fluid made from special packet (ORS) Drank fluid made from special packet (ORS) Drank fluid made from special packet (ORS) Drank fluid made from special packet (ORS) Drank fluid made from special packet (ORS) During this last episode of diarrhoea, did (name) drink any of the following: Read each item aloud and record response before proceeding to the next item. A fluid made from a special packet called (local name for ORS packet solution)? Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Government-recommended homemade fluid Government-recommended homemade fluid Government-recommended homemade fluid Government-recommended homemade fluid Government-recommended homemade fluid During this last episode of diarrhoea, did (name) drink any of the following: Read each item aloud and record response before proceeding to the next item. Government-recommended homemade fluid? Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Pre-packaged ORS fluid for diarrhea Pre-packaged ORS fluid for diarrhea Pre-packaged ORS fluid for diarrhea Pre-packaged ORS fluid for diarrhea Pre-packaged ORS fluid for diarrhea During this last episode of diarrhoea, did (name) drink any of the following: Read each item aloud and record response before proceeding to the next item. A pre-packaged ORS fluid for diarrhoea? Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Child drank less or more during illness Child drank less or more during illness Child drank less or more during illness Child drank less or more during illness Child drank less or more during illness During (name's) illness, did he/she drink much less, about the same, or more than usual? Children aged 0-4 1 Much less or none 2 About the same (or somewhat less) 3 More 8 DK 9 Missing Child ate less or more during illness Child ate less or more during illness Child ate less or more during illness Child ate less or more during illness Child ate less or more during illness During (name's) illness, did he/she eat less, about the same, or more food than usual? If "less", probe: Much less or a little less? Children aged 0-4 1 None 2 Much less 3 Somewhat less 4 About the same 5 More 8 DK 9 Missing Child ill with cough in last 2 weeks Child ill with cough in last 2 weeks Child ill with cough in last 2 weeks Child ill with cough in last 2 weeks Child ill with cough in last 2 weeks Has (name) had an illness with a cough at any time in the last two weeks, that is, since (day of the week) of the week before last? Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Difficulty breathing during illness with cough Difficulty breathing during illness with cough Difficulty breathing during illness with cough Difficulty breathing during illness with cough Difficulty breathing during illness with cough When (name) had an illness with a cough, did he/she breathe faster than usual with short, quick breaths or have difficulty breathing? Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Symptoms due to problem in chest or blocked nose Symptoms due to problem in chest or blocked nose Symptoms due to problem in chest or blocked nose Symptoms due to problem in chest or blocked nose Symptoms due to problem in chest or blocked nose Were the symptoms due to a problem in the chest or a blocked nose? Children aged 0-4 1 Problem in chest 2 Blocked nose 3 Both 6 Other 8 DK 9 Missing Sought advice or teatment for illness Sought advice or teatment for illness Sought advice or teatment for illness Sought advice or teatment for illness Sought advice or teatment for illness Did you seek advice or treatment for the illness outside the home? Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Place sought 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 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 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 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 medical center Place sought care: Other public medical center Place sought care: Other public medical center Place sought care: Other public medical center Place sought care: Other public medical center 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 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 Child ill with fever in last 2 weeks Child ill with fever in last 2 weeks Child ill with fever in last 2 weeks Child ill with fever in last 2 weeks Child ill with fever in last 2 weeks In the last two weeks, that is, since (day of the week) of the week before last, has (name) been ill with a fever? Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Child seen at health facility during illness Child seen at health facility during illness Child seen at health facility during illness Child seen at health facility during illness Child seen at health facility during illness Was (name) seen at a health facility during this illness? Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Child took medicine prescribed at health facility Child took medicine prescribed at health facility Child took medicine prescribed at health facility Child took medicine prescribed at health facility Child took medicine prescribed at health facility Did (name) take a medicine for fever or malaria that was provided or prescribed at the health facility? Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Medicine provided/prescribed: SP/Fansidar Medicine provided/prescribed: SP/Fansidar Medicine provided/prescribed: SP/Fansidar Medicine provided/prescribed: SP/Fansidar Medicine provided/prescribed: SP/Fansidar What medicine did (name) take that was provided or prescribed at the health facility? Circle all medicines mentioned. Children aged 0-4 ? Missing A SP/Fansidar Medicine provided/prescribed: Chloroquine Medicine provided/prescribed: Chloroquine Medicine provided/prescribed: Chloroquine Medicine provided/prescribed: Chloroquine Medicine provided/prescribed: Chloroquine What medicine did (name) take that was provided or prescribed at the health facility? Circle all medicines mentioned. Children aged 0-4 ? Missing B Chloroquine Medicine provided/prescribed: Amodiaquine Medicine provided/prescribed: Amodiaquine Medicine provided/prescribed: Amodiaquine Medicine provided/prescribed: Amodiaquine Medicine provided/prescribed: Amodiaquine What medicine did (name) take that was provided or prescribed at the health facility? Circle all medicines mentioned. Children aged 0-4 ? Missing C Amodiaquine Medicine provided/prescribed: Quinine Medicine provided/prescribed: Quinine Medicine provided/prescribed: Quinine Medicine provided/prescribed: Quinine Medicine provided/prescribed: Quinine What medicine did (name) take that was provided or prescribed at the health facility? Circle all medicines mentioned. Children aged 0-4 ? Missing D Quinine Medicine provided/prescribed: Artemisinin-based combinations Medicine provided/prescribed: Artemisinin-based combinations Medicine provided/prescribed: Artemisinin-based combinations Medicine provided/prescribed: Artemisinin-based combinations Medicine provided/prescribed: Artemisinin-based combinations What medicine did (name) take that was provided or prescribed at the health facility? Circle all medicines mentioned. Children aged 0-4 ? Missing E Artemisinin-based combinaitions Medicine provided/prescribed: Other anti-malaria Medicine provided/prescribed: Other anti-malaria Medicine provided/prescribed: Other anti-malaria Medicine provided/prescribed: Other anti-malaria Medicine provided/prescribed: Other anti-malaria What medicine did (name) take that was provided or prescribed at the health facility? Circle all medicines mentioned. Children aged 0-4 ? Missing H Other Anti-malaria Medicine provided/prescribed: Paracetamol/Panadol/Acetaminop Medicine provided/prescribed: Paracetamol/Panadol/Acetaminop Medicine provided/prescribed: Paracetamol/Panadol/Acetaminop Medicine provided/prescribed: Paracetamol/Panadol/Acetaminop Medicine provided/prescribed: Paracetamol/Panadol/Acetaminop What medicine did (name) take that was provided or prescribed at the health facility? Circle all medicines mentioned. Children aged 0-4 ? Missing P Paracetamol/panadol/Acetaminophen Medicine provided/prescribed: Aspirin Medicine provided/prescribed: Aspirin Medicine provided/prescribed: Aspirin Medicine provided/prescribed: Aspirin Medicine provided/prescribed: Aspirin What medicine did (name) take that was provided or prescribed at the health facility? Circle all medicines mentioned. Children aged 0-4 ? Missing Q Aspirin Medicine provided/prescribed: Ibuprofen Medicine provided/prescribed: Ibuprofen Medicine provided/prescribed: Ibuprofen Medicine provided/prescribed: Ibuprofen Medicine provided/prescribed: Ibuprofen What medicine did (name) take that was provided or prescribed at the health facility? Circle all medicines mentioned. Children aged 0-4 ? Missing R Ibuprofen Medicine provided/prescribed: Other Medicine provided/prescribed: Other Medicine provided/prescribed: Other Medicine provided/prescribed: Other Medicine provided/prescribed: Other What medicine did (name) take that was provided or prescribed at the health facility? Circle all medicines mentioned. Children aged 0-4 ? Missing X Other Medicine provided/prescribed: DK Medicine provided/prescribed: DK Medicine provided/prescribed: DK Medicine provided/prescribed: DK Medicine provided/prescribed: DK What medicine did (name) take that was provided or prescribed at the health facility? Circle all medicines mentioned. Children aged 0-4 ? Missing Z DK Child given medicine before visiting health facility Child given medicine before visiting health facility Child given medicine before visiting health facility Child given medicine before visiting health facility Child given medicine before visiting health facility Was (name) given medicine for the fever or malaria before being taken to the health facility? Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Child given medicine for malaria or fever during illness Child given medicine for malaria or fever during illness Child given medicine for malaria or fever during illness Child given medicine for malaria or fever during illness Child given medicine for malaria or fever during illness Was (name) given medicine for fever or malaria during this illness? Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Medicine given: SP/Fansidar Medicine given: SP/Fansidar Medicine given: SP/Fansidar Medicine given: SP/Fansidar Medicine given: SP/Fansidar What medicine was (name) given? Circle all medicines given. Ask to see the medication if type is not known. If type of medication is still not determined, show typical anti-malarials to respondent. Children aged 0-4 ? Missing A SP/Fansidar Medicine given: Chloroquine Medicine given: Chloroquine Medicine given: Chloroquine Medicine given: Chloroquine Medicine given: Chloroquine What medicine was (name) given? Circle all medicines given. Ask to see the medication if type is not known. If type of medication is still not determined, show typical anti-malarials to respondent. Children aged 0-4 ? Missing B Chloroquine Medicine given: Amodiaquine Medicine given: Amodiaquine Medicine given: Amodiaquine Medicine given: Amodiaquine Medicine given: Amodiaquine What medicine was (name) given? Circle all medicines given. Ask to see the medication if type is not known. If type of medication is still not determined, show typical anti-malarials to respondent. Children aged 0-4 ? Missing C Amodiaquine Medicine given: Quinine Medicine given: Quinine Medicine given: Quinine Medicine given: Quinine Medicine given: Quinine What medicine was (name) given? Circle all medicines given. Ask to see the medication if type is not known. If type of medication is still not determined, show typical anti-malarials to respondent. Children aged 0-4 ? Missing D Quinine Medicine given: Artemisin-based combination Medicine given: Artemisin-based combination Medicine given: Artemisin-based combination Medicine given: Artemisin-based combination Medicine given: Artemisin-based combination What medicine was (name) given? Circle all medicines given. Ask to see the medication if type is not known. If type of medication is still not determined, show typical anti-malarials to respondent. Children aged 0-4 ? Missing E Artemisinin-based combinaitions Medicine given: Other anti-malaria Medicine given: Other anti-malaria Medicine given: Other anti-malaria Medicine given: Other anti-malaria Medicine given: Other anti-malaria What medicine was (name) given? Circle all medicines given. Ask to see the medication if type is not known. If type of medication is still not determined, show typical anti-malarials to respondent. Children aged 0-4 ? Missing H Other Anti-malaria Medicine given: Paracetamol/Panadol/Acetaminophen Medicine given: Paracetamol/Panadol/Acetaminophen Medicine given: Paracetamol/Panadol/Acetaminophen Medicine given: Paracetamol/Panadol/Acetaminophen Medicine given: Paracetamol/Panadol/Acetaminophen What medicine was (name) given? Circle all medicines given. Ask to see the medication if type is not known. If type of medication is still not determined, show typical anti-malarials to respondent. Children aged 0-4 ? Missing P Paracetamol/panadol/Acetaminophen Medicine given: Aspirin Medicine given: Aspirin Medicine given: Aspirin Medicine given: Aspirin Medicine given: Aspirin What medicine was (name) given? Circle all medicines given. Ask to see the medication if type is not known. If type of medication is still not determined, show typical anti-malarials to respondent. Children aged 0-4 ? Missing Q Aspirin Medicine given: Ibuprofen Medicine given: Ibuprofen Medicine given: Ibuprofen Medicine given: Ibuprofen Medicine given: Ibuprofen What medicine was (name) given? Circle all medicines given. Ask to see the medication if type is not known. If type of medication is still not determined, show typical anti-malarials to respondent. Children aged 0-4 ? Missing R Ibuprofen Medicine given: Other Medicine given: Other Medicine given: Other Medicine given: Other Medicine given: Other What medicine was (name) given? Circle all medicines given. Ask to see the medication if type is not known. If type of medication is still not determined, show typical anti-malarials to respondent. Children aged 0-4 ? Missing X Other Medicine given: DK Medicine given: DK Medicine given: DK Medicine given: DK Medicine given: DK What medicine was (name) given? Circle all medicines given. Ask to see the medication if type is not known. If type of medication is still not determined, show typical anti-malarials to respondent. Children aged 0-4 ? Missing Z DK Days after fever started took anti-malarial Days after fever started took anti-malarial Days after fever started took anti-malarial Days after fever started took anti-malarial Days after fever started took anti-malarial Check ML4 and ML7: Anti-malarial mentioned (codes A - H)? Yes. Continue with ML9 No. Go to ML10 How long after the fever started did (name) first take (name of anti-malarial from ML4 or ML7)? If multiple anti-malarials mentioned in ML4 or ML7, name all anti-malarial medicines mentioned. Record the code for the day on which the first anti-malarial was given. Children aged 0-4 Same day 1 Next day 2 2 days after the fever 3 3 days after the fever 4 4 or more days after the fever 8 DK 9 Missing Child slept under bednet last night Child slept under bednet last night Child slept under bednet last night Child slept under bednet last night Child slept under bednet last night Did (name) sleep under a mosquito net last night? Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Months ago mosquito net obtained Months ago mosquito net obtained Months ago mosquito net obtained Months ago mosquito net obtained Months ago mosquito net obtained How long ago did your household obtain the mosquito net? If less than 1 month, record '00'. If answer is "12 months" or "1 year", probe to determine if net was treated exactly 12 months ago or earlier or later. Children aged 0-4 95 More than 24 months ago 98 Not sure 99 Missing Brand of mosquito net Brand of mosquito net Brand of mosquito net Brand of mosquito net Brand of mosquito net What brand is this net? If the respondent does not know the brand of the net, show pictorials, or if possible, observe the net. Long lasting treated nets: Brand A Brand B Pre-treated nets: Brand C Brand D Other nets: Brand E Brand F Children aged 0-4 11 Long-lasting - OLYSET 12 Long-lasting - PERMANT 21 Pre-treated - OLYSET 22 Pre-treated - PERMANET 31 Other - POLYESTER 32 Other - NYLON 36 Other - COTTON 98 DK 99 Missing Mosquito net pre-treated Mosquito net pre-treated Mosquito net pre-treated Mosquito net pre-treated Mosquito net pre-treated When you got that net, was it already treated with an insecticide to kill or repel mosquitoes? Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Mosquito net soaked or dipped since obtained Mosquito net soaked or dipped since obtained Mosquito net soaked or dipped since obtained Mosquito net soaked or dipped since obtained Mosquito net soaked or dipped since obtained Since you got the mosquito net, was it ever soaked or dipped in a liquid to kill/repel mosquitoes or bugs? Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Months ago net soaked or dipped Months ago net soaked or dipped Months ago net soaked or dipped Months ago net soaked or dipped Months ago net soaked or dipped How long ago was the net last soaked or dipped? If less than 1 month, record '00'. If answer is "12 months" or "1 year", probe to determine if net was treated exactly 12 months ago or earlier or later. Children aged 0-4 95 Month than 24 months ago 98 DK 99 Missing 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 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 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 Yellow Fever immunization Day of Yellow Fever immunization Day of Yellow Fever immunization Day of Yellow Fever immunization Day of Yellow Fever 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 Yellow Fever immunization Month of Yellow Fever immunization Month of Yellow Fever immunization Month of Yellow Fever immunization Month of Yellow Fever 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 Yellow Fever immunization Year of Yellow Fever immunization Year of Yellow Fever immunization Year of Yellow Fever immunization Year of Yellow Fever 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 Day of Vitamin A 1 immunization Day of Vitamin A 1 immunization Day of Vitamin A 1 immunization Day of Vitamin A 1 immunization Day of Vitamin A 1 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 Vitamin A 1 Children aged 0-4 Not given 44 Marked on card - no date given 66 Reported by mother 99 Missing Month of Vitaimn A 1 imunization Month of Vitaimn A 1 imunization Month of Vitaimn A 1 imunization Month of Vitaimn A 1 imunization Month of Vitaimn A 1 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 Vitamin A 1 Children aged 0-4 99 Missing Year of Vitamin A 1 immunization Year of Vitamin A 1 immunization Year of Vitamin A 1 immunization Year of Vitamin A 1 immunization Year of Vitamin A 1 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 Vitamin A 1 Children aged 0-4 9999 Missing Day of Vitamin A 2 immunization Day of Vitamin A 2 immunization Day of Vitamin A 2 immunization Day of Vitamin A 2 immunization Day of Vitamin A 2 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 Vitamin A 2 Children aged 0-4 Not given 44 Marked on card - no date given 66 Reported by mother 99 Missing Month of Vitamin A (2) Month of Vitamin A (2) Month of Vitamin A (2) Month of Vitamin A (2) Month of Vitamin A (2) 99 Missing Year of Vitamin A 2 immunization Year of Vitamin A 2 immunization Year of Vitamin A 2 immunization Year of Vitamin A 2 immunization Year of Vitamin A 2 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 Vitamin A 2 Children aged 0-4 9999 Missing Received additional vaccinations Received additional vaccinations Received additional vaccinations Received additional vaccinations Received additional vaccinations In addition to the vaccinations and vitamin A capsules shown on this card, did (name) receive any other vaccinations - including vaccinations received in campaigns or immunization days? Record 'Yes' only if respondent mentions BCG, OPV 0-3, DPT 1-3, Hepatitis B 1-3, Measles, Yellow Fever vaccine(s), or Vitamin A supplements. (If yes, Probe for vaccinations and write '66' in the corresponding day column on IM2 to IM8B.) 1 Yes 2 No 8 DK 9 Missing Child ever received any vaccinations Child ever received any vaccinations Child ever received any vaccinations Child ever received any vaccinations Child ever received any vaccinations Has (name) ever received any vaccinations to prevent him/her from getting diseases, including vaccinations received in a campaign or immunization day? Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Child ever given BCG vaccination Child ever given BCG vaccination Child ever given BCG vaccination Child ever given BCG vaccination Child ever given BCG vaccination Has (name) ever been given a BCG vaccination against tuberculosis - that is, an injection in the arm or shoulder that caused a scar? Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Child ever given Polio vaccination Child ever given Polio vaccination Child ever given Polio vaccination Child ever given Polio vaccination Child ever given Polio vaccination Has (name) ever been given any "vaccination drops in the mouth" to protect him/her from getting diseases - that is, polio? Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Polio first given just after birth or later Polio first given just after birth or later Polio first given just after birth or later Polio first given just after birth or later Polio first given just after birth or later How old was he/she when the first dose was given - just after birth (within two weeks) or later? Children aged 0-4 1 Just after birth (within 2 weeks) 2 Later 9 Missing Times child given Polio vaccination Times child given Polio vaccination Times child given Polio vaccination Times child given Polio vaccination Times child given Polio vaccination How many times has he/she been given these drops? Children aged 0-4 99 Missing Child ever given DPT vaccination Child ever given DPT vaccination Child ever given DPT vaccination Child ever given DPT vaccination Child ever given DPT vaccination Has (name) ever been given "DPT vaccination injections" - that is, an injection in the thigh or buttocks - to prevent him/her from getting tetanus, whooping cough, diphtheria? (sometimes given at the same time as polio) Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Times child given DPT vaccination Times child given DPT vaccination Times child given DPT vaccination Times child given DPT vaccination Times child given DPT vaccination How many times? Children aged 0-4 99 Missing Child ever given Measles or MMR vaccination Child ever given Measles or MMR vaccination Child ever given Measles or MMR vaccination Child ever given Measles or MMR vaccination Child ever given Measles or MMR vaccination Has (name) ever been given "Measles vaccination injections" or MMR - that is, a shot in the arm at the age of 9 months or older - to prevent him/her from getting measles? Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Yellow Fever given Yellow Fever given Yellow Fever given Yellow Fever given Yellow Fever given 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 participated in national immunization day B Child participated in national immunization day B Child participated in national immunization day B Child participated in national immunization day B Child participated in national immunization day B 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 B Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Child participated in national immunization day C Child participated in national immunization day C Child participated in national immunization day C Child participated in national immunization day C Child participated in national immunization day C 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 C 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 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/kindergarten 1 Primary 2 Secondary 3 Higher 6 Non-standard curriculum 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 Rural 2 Urban Region Region Region Region Region Region: Households 1 East 2 North 3 South 4 West District District District District District 11 Kailahun 12 Kenema 13 Kono 21 Bombali 22 Kambia 23 Koinadugu 24 Port Loko 25 Tonkolili 31 Bo 32 Bonthe 33 Moyamba 34 Pujehun 41 Western Rural 42 Western Urban 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 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 Religion Religion Religion Religion Religion What is the religion of the head of this household? Households 1 Christian 2 Muslim 3 Traditional 6 Other religion 7 No religion 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 12 Dung 21 Wood planks 22 Palm/bamboo 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 11 No roof 12 Thatch/palm leaf 13 Sod 21 Rustic mat 22 Palm/bamboo 23 Wood Planks 24 Plastic Sheeting 31 Metal 32 Wood 33 Calamine/cement fiber 34 Ceramic tiles 35 Cement 36 Roofing shingles 96 Other 99 Missing Main material of wall Main material of wall Main material of wall Main material of wall Main material of wall Main material of the walls. Record observation. Households 11 No walls 12 Cane/palm/trunks 13 Dirt 21 Bambo with mud 22 Stone with mud 23 Uncovered adobe 24 Plywood 25 Carton 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 Water Pump Water Pump Water Pump Water Pump Water Pump 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 Boat with a motor Boat with a motor Boat with a motor Boat with a motor Boat with a motor Does any member of your household own: Households 1 Yes 2 No 9 Missing Children's sample weight Children's sample weight Children's sample weight Children's sample weight Children's sample weight Recoded variable Children aged 0-4 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 Date of interview child (CMC) Date of interview child (CMC) Date of interview child (CMC) Date of interview child (CMC) Date of interview child (CMC) Recoded variable Children aged 0-4 Date of birth (CMC) Date of birth (CMC) Date of birth (CMC) Date of birth (CMC) Date of birth (CMC) Recoded variable Children aged 0-4 Age (months) Age (months) Age (months) Age (months) Age (months) Recoded variable Children aged 0-4 Age Age Age Age Age Recoded variable Children aged 0-4 1 < 6 months 2 6-11 months 3 12-23 months 4 24-35 months 5 36-47 months 6 48-59 months Age Age Age Age Age Recoded variable Children aged 0-4 1 0-11 months 2 12-23 months 3 24-35 months 4 36-47 months 5 48-59 months Mother's education Mother's education Mother's education Mother's education Mother's education Recoded variable Children aged 0-4 1 None 2 Primary 3 Secondary 4 Non-standard curriculum 9 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. Religion of Household Head Religion of Household Head Religion of Household Head Religion of Household Head Religion of Household Head 1 Christian 2 Muslim 9 Other/Missing