DDI_SOM_2006_MICS_v01_M James, Rhiannon Croft, Trevor 2008-02-12 NADA Somali MICS 2006 v0.2 Slightly edited version of UNICEF's DDI ref. DDI-SOM-UNICEF-MICS-2006-V1 Multiple Indicator Cluster Survey 2006 MICS3 2006 SOM_2006_MICS_v01_M UNICEF Somalia Support Centre Pan Arab Population and Family Health Project Strategic Information Section, Division of Policy and Planning, UNICEF NYHQ NADA UNICEF WHO UNFPA Global Fund Chief of Social Policy and Planning Section, UNICEF Somalia Rhiannon James 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 members Education Water and sanitation Household characteristics Child labour Salt iodization Women's background Tetanus toxoid Child Mortality Birth History Maternal and newborn health Marriage and union Contraception HIV/AIDS Children's background Birth registration Early learning Vitamin A Breastfeeding Care of illness Immunization Anthropometry Malaria Female genital cutting Attitudes towards domestic violence Maternal mortality The Multiple Indicator Cluster Survey (MICS) is a household survey programme developed by UNICEF to assist countries in filling data gaps for monitoring human development in general and the situation of children and women in particular. The Pan Arab Population and Family Health Project(PAPFAM) is a programme conducted to enable national health institutions in the Arab region to obtain a timely and integrated flow of reliable information suitable for formulating, implementing, monitoring and evaluating the family health and reproductive health policies and programs in a cost-effective manner. MICS and PAPFAM are capable of producing statistically sound, internationally comparable estimates of social indicators. The current round of MICS/PAPFAM is focused on providing a monitoring tool for the Millennium Development Goals (MDGs), the World Fit for Children (WFFC), as well as for other major international commitments, such as the United Nations General Assembly Special Session (UNGASS) on HIV/AIDS and the Abuja targets for malaria. Survey Objectives The 2006 Somali Multiple Indicator Cluster Survey (MICS)/Pan Arab Population and Family Health Project(PAPFAM) has as its primary objectives: - To provide up-to-date information for assessing the situation of children and women in Somalia - To furnish data needed for monitoring progress toward goals established in the Millennium Declaration, the goals of A World Fit For Children (WFFC), and other internationally agreed upon goals, as a basis for future action; - To contribute to the improvement of data and monitoring systems in Somalia and to strengthen technical expertise in the design, implementation, and analysis of such systems. Survey Content Following the MICS global questionnaire templates, the questionnaires were designed in a modular fashion customized to the needs of Somalia. The questionnaires 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). Survey Implementation The Somalia MICS/PAPFAM was carried out by UNICEF with the support and assistance the Ministry of Planning and International Cooperation of the Somali Transitional Federal Government, the Ministry of National Planning and Coordination of Somaliland and the Ministry of Planning and International Cooperation of Puntland. Technical assistance and training for the survey was provided through a series of regional workshops organised by UNICEF and PAPFAM, covering questionnaire content, sampling and survey implementation; data processing; data quality and data analysis; report writing and dissemination. Somalia The Somali 2006 MICS/PAPFAM covers all regions of Somalia. For the purposes of this survey, the analysis refers to the North West Zone, the North East Zone and Central South Zone according to prewar boundaries for Somaliland and Puntland and does not imply any recognition of administrative boundaries by the United Nations or the League of Arab States. 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. The survey also included a full birth history module which covered all live births born to ever-married women aged 15-49. Sample survey data [ssd] The scope of the 2006 Somali MICS/PAPFAM Survey includes: HOUSEHOLD: Household characteristics, household listing, orphaned children, education, child labour, water and sanitation, household use of insecticide treated mosquito nets, salt iodization and maternal mortality. WOMEN: Women's characteristics, child mortality, birth history, tetanus toxoid, maternal and newborn health, marriage, polygyny, female genital cutting, contraception, HIV/AIDS knowledge and domestic violence. CHILDREN: Children's characteristics, birth registration and early learning, vitamin A, breastfeeding, care of illness, malaria, immunization and anthropometry. Women Care (Middle Shabelle) Sean Deveroux Human Rights Organisation (Lower Juba) Natural Resource Management and Information Centre (Bakool) African Rescue Committee (Middle Juba) Community Care Centre (Bay Region) Community Research and Development Group (Benadir Region) Himilo Relief, Rehabilitation and Development Association (Gedo Region) Hiran HIV/AIDS Prevention and Child Protection (Hiran Region) Training and Research Group (Somaliland) Ministry of Planning and International Cooperation The principal objective of the sample design was to provide current and reliable estimates on a set of indicators covering the four major areas of the World Fit for Children declaration, including promoting healthy lives; providing quality education; protecting against abuse, exploitation and violence; and combating HIV/AIDS. The population covered by the 2006 MICS/PAPFAM is defined as the universe of all women aged 15-49 and all children aged under 5. A sample of households was selected and all women aged 15-49 identified as usual residents of these households were interviewed. In addition, the mother or the caretaker of all children aged under 5 who were usual residents of the household were also interviewed about the child. The 2006 MICS/PAPFAM collected data from a nationally representative sample of households, women and children. The primary focus of the 2006 MICS/PAPFAM was to provide estimates of key population and health, education, child protection and HIV related indicators for the country as a whole, for the North West, North East and Central South Zones and for urban and rural areas separately. Somalia is divided into 18 regions. Each region is subdivided into districts, and each district into settlements and towns. The sample frame for this survey was based on the list of settlements developed from the 2005-2006 UNDP Settlement Survey and WHO vaccination campaign data. The Sampling design follows a 4 stage-sample approach. The first stage is the selection of the districts in each of the 18 regions of the country selected using probability proportional to size (pps). The second stage is the selection of the secondary sampling units which are defined as permanent and temporary settlements. The third stage is the selection of the cluster(s) within the settlement and the fourth stage is the selection of the households to be interviewed. Once the districts had been selected great efforts went into compiling a complete list of permanent and temporary settlements within these districts. The main source was the WHO immunisation campaign data, this data was later backed up by the UNDP settlement survey for at least two out of the three zones. Other sources also contributed such as FAO data on water points which could act as proxy for surrounding nomadic areas and temporary settlements. Finally lists were shown to the NGO partners implementing the survey and UNICEF staff on the ground for additional contributions to recent movement of internally displaced persons and nomads. The settlement lists were then sorted into urban and non urban. The first two stages of sampling were thus completed by selecting the required number of clusters from each of the 3 zones by urban and rural areas separately. Mapping and Listing Activities For settlements over the estimated size of 150 households some form of segmentation through sketch mapping was necessary. For several district capitals it was possible to use maps from UN Habitat to assist the personnel deployed in sketch mapping. However for most of the larger non-urban settlements there were no maps available. The most important aspect of the sketch mapping was to divide the settlements into roughly equal sizes by estimating the number of households and to clearly delineate the segments using identifiable boundaries. Once sketch maps were prepared survey coordinators were then in a position to randomly select the cluster(s) where household would be selected. It must be added at this point that finding people trained in cartographic techniques is rare in Somalia. Thus the quality of the maps varied significantly across the country and resources and time also did not allow for a full household count. Selection of Households For the final stage of sampling, the Somali MICS/PAPFAM had no other option than to use the method used in MICS 2 of the Expanded Program for Immunization (EPI) random walk method; the expense of household/dwelling listing would simply be too considerable. Whilst the EPI method is quick and approximately self-weighting, it is recognised that this is not a probability sample, and so cannot ensure objectivity of household selection. In order to try and avoid the subjectivity involved in selecting households some measures were put in place. For example instead of relying on an arbitrary decision regarding the central point of a cluster, supervisors selected at least three or four possible starting points and then randomly choose one of them. Moreover only supervisors were able to select and number the households, not interviewers. Significant time was spent training supervisors on how to select households in order to avoid some of the criticisms typically directed towards this method. For clusters falling in nomadic areas (the temporary settlements) the survey teams were instructed to interview the first 24 households that they came across. Typically nomads do not move in large numbers, therefore in order to ensure representation of nomads in the sample it was necessary to assume a more purposive method of sampling for this group. No major deviations from the original sample design were made. All clusters were accessed and successfully interviewed with good response rates. Face-to-face [f2f] The questionnaires for the Somali MICS/PAPFAM were structured questionnaires based on the MICS3 Model Questionnaire with some modifications and additions. A household questionnaire was administered in each household, which collected various information on household members including sex, age, relationship, and orphanhood status. In addition to a household questionnaire, questionnaires were administered in each household for women age 15-49 and children under age five. For children, the questionnaire was administered to the mother or caretaker of the child. The questionnaires were developed in English from the MICS3 Model Questionnaires, and were translated into Af-Somali. Differences in translation were reviewed and resolved in collaboration with the original translators. The English and Somali questionnaires were both piloted as part of the survey pretest. The questionnaires contained the following modules: HOUSEHOLD: Household characteristics, household listing, orphaned children, education, child labour, water and sanitation, household use of insecticide treated mosquito nets, salt iodization and maternal mortality. WOMEN: Women's characteristics, child mortality, birth history, tetanus toxoid, maternal and newborn health, marriage, polygyny, female genital cutting, contraception, HIV/AIDS knowledge and domestic violence. CHILDREN: Children's characteristics, birth registration and early learning, vitamin A, breastfeeding, care of illness, malaria, immunization and anthropometry. The pretest for the survey took place in July 2006 in each zone. Approximately ten percent of the total sample size was pre-tested; the three pre-tests combined lasted between 1 to 2 weeks. The pre-tests were conducted by the survey coordinators with the assistance of future supervisors and interviewers. The largest complaint regarding the questionnaires in the pretest was the length. For a household, the minimum time the questionnaires were completed in was one and a quarter hours, the maximum time was around two and a half hours. Supervisors noticed however that in the latter days of pre-testing interviewers gained much more speed. Therefore in the first week of data collection it was necessary to allow more time for survey teams to complete clusters but the time steadily reduced as fieldwork continued. Interviewing was conducted by teams of interviewers. Each interviewing team comprised of 4 female interviewers and 4 male interviewers, a field editor and a supervisor. Each team used 4 wheel drive vehicles to travel from cluster to cluster (and where necessary within cluster). The role of the supervisor was to coordinate field data collection activities, including management of the field team, supplies and equipment, finances, maps and listings, coordinate with local authorities concerning the survey plan and make arrangements for accommodation and travel. Additionally, the field supervisor assigned the work to the interviewers, spot checked work, maintained field control documents, and sent completed questionnaires and progress reports to the central office The field editor was responsible for reviewing each questionnaire at the end of the day, checking for missed questions, skip errors, fields incorrectly completed, and checking for inconsistencies in the data. The field editor also observed interviews and conducted review sessions with interviewers. Responsibilities of the supervisors and field editors are described in the Instructions for Supervisors and Field Editors, together with the different field controls that were in place to control the quality of the fieldwork. The Somali MICS also recruited field coordinators who were responsible for coordinating the work of several field teams. Field visits were made by coordinators throughout fieldwork. Planning, monitoring and evaluation staff of UNICEF also made regular visits to field teams to provide support and to review progress. The Somali MICS Coordinator visited several field teams during data collection across the country. 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 found in the global MICS manual http://www.childinfo.org/mics/mics3/manual.php Of the 6000 households selected for the sample 5969 were successfully interviewed for a household response rate of 99.5 percent. In the interviewed households, 7277 women (age 15-49) were identified. Of these, 6764 were successfully interviewed, yielding a response rate of 93 percent. In addition, 6373 children under age five were listed in the household questionnaire. Of these, questionnaires were completed for 6305 which corresponds to a response rate of 98.9 percent. Overall response rates of 92.5 percent and 98.4 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 2005-2006 MICS to minimize this type of error, however, non-sampling errors are impossible to avoid and difficult to evaluate statistically. Sampling errors can be evaluated statistically. The sample of respondents to the 2006 MICS is only one of many possible samples that could have been selected from the same population, using the same design and expected size. Each of these samples would yield results that differe somewhat from the results of the actual sample selected. Sampling errors are a measure of the variability in the results of the survey between all possible samples, and, although, the degree of variability is not known exactly, it can be estimated from the survey results. The sampling erros are measured in terms of the standard error for a particular statistic (mean or percentage), which is the square root of the variance. Confidence intervals are calculated for each statistic within which the true value for the population can be assumed to fall. Plus or minus two standard errors of the statistic is used for key statistics presented in MICS, equivalent to a 95 percent confidence interval. If the sample of respondents had been a simple random sample, it would have been possible to use straightforward formulae for calculating sampling errors. However, the 2005-2006 MICS sample is the result of a multi-stage stratified design, and consequently needs to use more complex formulae. The SPSS complex samples module has been used to calculate sampling errors for the 2005-2006 MICS. This module uses the Taylor linearization method of variance estimation for survey estimates that are means or proportions. This method is documented in the SPSS file CSDescriptives.pdf found under the Help, Algorithms options in SPSS. Sampling errors have been calculated for a select set of statistics (all of which are proportions due to the limitations of the Taylor linearization method) for the national sample, urban and rural areas, and for each of the five regions. For each statistic, the estimate, its standard error, the coefficient of variation (or relative error -- the ratio between the standard error and the estimate), the design effect, and the square root design effect (DEFT -- the ratio between the standard error using the given sample design and the standard error that would result if a simple random sample had been used), as well as the 95 percent confidence intervals (+/-2 standard errors). Details of the sampling errors are presented in the sampling errors appendix to the 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. UNICEF Somalia Support Centre UNICEF Somalia, Multiple Indicator Cluster Survey: Household , household listing, women, children's and birth history files, 2006.Nairobi provided by New York: Strategic Information Section, Division of Policy and Planning, UNICEF, www.childinfo.org. Survey datasets are distributed at no cost for legitimate research, with the condition that we receive an abstract or a detailed description of any research project that will be using the data prior to authorizing their distribution. Copies of all reports and publications based on the requested data must be sent to UNICEF Somalia: somalia@unicef.org Requests for access to the datasets may be made through the website: www.childinfo.org UNICEF provides these data to external users without any warranty or responsibility implied. 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, Child discipline, Salt iodization) 0 112 hl Data collected at the household member's level (MICS Household questionnaire: modules Household listing, Child labour and Maternal Mortality) 0 128 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 (and unmet need), HIV/AIDS, Female genital mutiliation/cutting, Sexual behaviour, Attitudes towards domestic violence) 0 269 ch Data collected at mother's or primary caretaker's level (MICS Child questionnaire: modules Birth Registration and Early Learning, Vitamin A, Breastfeeding, Care of Illness, Malaria, Immunization and Anthropometry) ) 0 295 bh Data collected at the women's level (MICS Women's questionnaire: modules Birth History) 0 162 Interview and HH identification Characteristics of dwelling Water and sanitation Characteristics of the head Members characteristics Education Children's living arrangements Child mortality Maternal and newborn health Nutrition Child health 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) Maternal mortality Tetanus toxoid Vitamin A Assistance at delivery Polygyny Unmet need Attitudes towards domestic violence Female genital mutilation/cutting Malaria Insecticide treated nets (ITN) Newborn health Immunizations Birth registration Early marriage Polygyny Anthropometry Cooking fuels Diarrhoea Acute respiratory infection Disposal of child's stools Breastfeeding Cluster number Cluster number Cluster number Cluster number Cluster number We are from (COUNTRY-SPECIFIC AFFILIATION). We are working on a project concerned with family health and education. I would like to talk to you about this. The interview will take about (NUMBER) minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. During this time I would like to speak with the household head and all mothers or others who take care of children in the household. May I start now? If permission is given, begin the interview. Cluster number: Households Unique identifier for the cluster in which the household exists Household number Household number Household number Household number Household number Household number: Households 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 8 August 9 September Year of interview Year of interview Year of interview Year of interview Year of interview Day/Month/Year of interview: Households Area with nomadic Area with nomadic Area with nomadic Area with nomadic Area with nomadic Household 1 Urban 21 Rural 22 Nomadic For the purposes of this survey, the analysis refers to the North West Zone, the North East Zone and Central South Zone according to prewar boundaries for Somaliland and Puntland and does not imply any recognition of administrative boundaries by the United Nations or the League of Arab States. Area presented by urban (district capitals), rural (rural sedentary) and nomadic (rural non-sedentary) Zone Zone Zone Zone Zone Region: Households 1 North West 2 North East 3 Central South 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 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 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 52 Roof top 53 Berkad 54 Balli 61 Tanker-truck 71 Cart with small tank/drum 81 Surface water 91 Bottled water 96 Other Main source of water used for other purposes Main source of water used for other purposes Main source of water used for other purposes Main source of water used for other purposes Main source of water used for other purposes 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 52 Roof top 53 Berkad 54 Balli 61 Tanker-truck 71 Cart with small tank/drum 81 Surface water 96 Other 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 Don't Know 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 Measure to prevent contamination Measure to prevent contamination Measure to prevent contamination Measure to prevent contamination Measure to prevent contamination Do you take any meausures to prevent contamination while handling the water or water storage containers? Household 1 Yes 2 No 8 D.K Definitions of various methods of prevention are as follows: · 'A' - Wash hands before collecting water · 'B' - Store drinking water in a clean container with cover · 'C' - Use a separate clean cup with a long handle for taking water out of the container · 'D' - Keep animals away from the container Wash Hands Wash Hands Wash Hands Wash Hands Wash Hands What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Household ? Missing A Wash Hands Store in clean container Store in clean container Store in clean container Store in clean container Store in clean container What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Household ? Missing B Container with cover Use separate container Use separate container Use separate container Use separate container Use separate container What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Household ? Missing C Use Separate container Keep animals away Keep animals away Keep animals away Keep animals away Keep animals away What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Household ? Missing D Keep animals Other Other Other Other Other What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Household ? Missing X Other D.K D.K D.K D.K D.K What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Household ? Missing Z D.K 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 Reliable drinking water supply Reliable drinking water supply Reliable drinking water supply Reliable drinking water supply Reliable drinking water supply Does your main drinking water source give you a reliable supply? Household 1 Almost no problems 2 Occasionaly Problems 3 Weekly Problems 4 Daily Problems 5 Seasonaly Supply 8 D.K 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 95 No facilities or bush or field 96 Other 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 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 Wash hands before eating Wash hands before eating Wash hands before eating Wash hands before eating Wash hands before eating Do you usually wash your hands using soap at any of the following times? Household 1 Yes 2 No Wash hands before feeding babies Wash hands before feeding babies Wash hands before feeding babies Wash hands before feeding babies Wash hands before feeding babies Do you usually wash your hands using soap at any of the following times? Household 1 Yes 2 No wash hands after defecation wash hands after defecation wash hands after defecation wash hands after defecation wash hands after defecation Do you usually wash your hands using soap at any of the following times? Household 1 Yes 2 No Wash hands after cleaning babies bottoms Wash hands after cleaning babies bottoms Wash hands after cleaning babies bottoms Wash hands after cleaning babies bottoms Wash hands after cleaning babies bottoms Do you usually wash your hands using soap at any of the following times? Household 1 Yes 2 No Wash hands before cooking food Wash hands before cooking food Wash hands before cooking food Wash hands before cooking food Wash hands before cooking food Do you usually wash your hands using soap at any of the following times? Household 1 Yes 2 No wash hands after eating wash hands after eating wash hands after eating wash hands after eating wash hands after eating Do you usually wash your hands using soap at any of the following times? Household 1 Yes 2 No 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 Main material of floor Main material of floor Main material of floor Main material of floor Main material of floor Main material of the dwelling floor: Record observation. Households 11 Earth/sand 21 Wood planks 22 Palm/bamboo 32 Vinyl or asphalt strips 33 Ceramic tiles 34 Cement 35 Carpet 96 Other 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 Mud & Grass 21 Rustic mat 22 Palm/Grass 23 Wood Planks 24 Sacking/Plastic sheets 31 Metal 32 Wood 33 Calamine/cement fiber 35 Cement 36 Roofing shingles 96 Other 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 Sticks/palm/trunks 13 Mud 21 Bambo with mud 22 Stone with mud 23 Uncovered adobe 24 Plywood 25 Carton 26 Reused wood 27 Cloth/Matting 31 Cement 32 Stone with lime/cement 33 Bricks 34 Cement blocks 35 Covered adobe 36 Wood planks/shingles 96 Other 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) 5 Kerosene 7 Charcoal 8 Wood 9 Straw/shrubs/grass 10 Animal dung 11 Agricultural crop residue 96 Other 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 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 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 Bed Bed Bed Bed Bed Does your household have: Household 1 Yes 2 No Electricity Electricity Electricity Electricity Electricity Does your household have: Households 1 Yes 2 No Radio Radio Radio Radio Radio Does your household have: Households 1 Yes 2 No Television Television Television Television Television Does your household have: Households 1 Yes 2 No Mobile phone Mobile phone Mobile phone Mobile phone Mobile phone Does your household have: Households 1 Yes 2 No Non-mobile phone Non-mobile phone Non-mobile phone Non-mobile phone Non-mobile phone Does your household have: Households 1 Yes 2 No Refrigerator Refrigerator Refrigerator Refrigerator Refrigerator Does your household have: Households 1 Yes 2 No VCD/DVD Player VCD/DVD Player VCD/DVD Player VCD/DVD Player VCD/DVD Player Does your household have: Household 1 Yes 2 No Fan Fan Fan Fan Fan Does your household have: Household 1 Yes 2 No Satellite Dish Satellite Dish Satellite Dish Satellite Dish Satellite Dish Does your household have: Household 1 Yes 2 No Watch Watch Watch Watch Watch Does any member of your household own: Households 1 Yes 2 No Bicycle Bicycle Bicycle Bicycle Bicycle Does any member of your household own: Households 1 Yes 2 No 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 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 Clock Clock Clock Clock Clock Does any member of your household own: Household 1 Yes 2 No Sewing Machine Sewing Machine Sewing Machine Sewing Machine Sewing Machine Does any member of your household own: Household 1 Yes 2 No Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of this household own any land that can be used for agriculture? Households 1 Yes 2 No How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agricultural land do members of this household own? If more than 97, record '97'. If unknown, record '98'. Households 97 More than 97 Does this household own any livestock, cattle, or animals Does this household own any livestock, cattle, or animals Does this household own any livestock, cattle, or animals Does this household own any livestock, cattle, or animals Does this household own any livestock, cattle, or animals Does this household own any livestock, herds, or farm animals? Households 1 Yes 2 No Number of camels Number of camels Number of camels Number of camels Number of camels How many of the following animals does this household have? Households 97 More than 97 98 Don't know Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls How many of the following animals does this household have? Households 97 More than 97 98 Don't know Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules How many of the following animals does this household have? Households 97 More than 97 98 Don't know Number of Goats Number of Goats Number of Goats Number of Goats Number of Goats How many of the following animals does this household have? Households 97 More than 97 98 Don't know Number of sheep Number of sheep Number of sheep Number of sheep Number of sheep How many of the following animals does this household have? Households 97 More than 97 98 Don't know Number of chickens Number of chickens Number of chickens Number of chickens Number of chickens How many of the following animals does this household have? Households 97 More than 97 98 Don't know Sleep under mosquito net Sleep under mosquito net Sleep under mosquito net Sleep under mosquito net Sleep under mosquito net What do you in your houshold to protect against malaria? Household ? Missing A Yes Keep environment clean Keep environment clean Keep environment clean Keep environment clean Keep environment clean What do you in your houshold to protect against malaria? Household ? Missing B Yes Drink clean water Drink clean water Drink clean water Drink clean water Drink clean water What do you in your houshold to protect against malaria? Household ? Missing C Yes Drain stagnant water Drain stagnant water Drain stagnant water Drain stagnant water Drain stagnant water What do you in your houshold to protect against malaria? Household ? Missing D Yes Burn dung Burn dung Burn dung Burn dung Burn dung What do you in your houshold to protect against malaria? Household ? Missing E Yes Use a spray Use a spray Use a spray Use a spray Use a spray What do you in your houshold to protect against malaria? Household ? Missing F Yes Shake cloth Shake cloth Shake cloth Shake cloth Shake cloth What do you in your houshold to protect against malaria? Household ? Missing G Yes Other Other Other Other Other What do you in your houshold to protect against malaria? Household ? Missing X Yes Nothing Nothing Nothing Nothing Nothing What do you in your houshold to protect against malaria? Household ? Missing Y Yes D.K D.K D.K D.K D.K What do you in your houshold to protect against malaria? Household ? Missing Z Yes 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 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 Long-lasting - Brand A Long-lasting - Brand A Long-lasting - Brand A Long-lasting - Brand A Long-lasting - 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 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 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 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 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 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 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 Where did you get the mosquito net Where did you get the mosquito net Where did you get the mosquito net Where did you get the mosquito net Where did you get the mosquito net Where did you get the (name of net highest in the list of nets available in the household, in TN3) mosquito net? Ask question in relation to the most effective mosquito net available in the household (Check TN3). If there is more than one net in the same category, ask question referring to the most recently obtained net. Households 12 Govt health centre 13 Govt health post 14 Village health worker 16 Other public source 21 Private hospital/clinic 22 Private physician 23 Private pharmacy 24 Mobile clinic 26 Other private medical 31 Relative or friend 32 Shop 33 Traditional practitioner 96 Other 98 DK How much did you pay for this mosquito net How much did you pay for this mosquito net How much did you pay for this mosquito net How much did you pay for this mosquito net How much did you pay for this mosquito net How much did you pay for the (name of net highest in the list of nets available in the household, in TN3) mosquito net? Ask question in relation to the most effective mosquito net available in the household (Check TN3). If there is more than one net in the same category, ask question referring to the most recently obtained net. Households 9996 Free 9998 DK 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 Area Area Area Area Area Households 1 Urban 2 Non Urban Regions Regions Regions Regions Regions Recoded variable Household 1 W/Galbeed 2 Awdal 3 Sanaag 4 Sool 5 Togdhere 6 Mudug 7 Nugal 8 Bari 9 Bakool 10 Bay 11 Gedo 12 Middle Juba 13 Hiran 14 Middle Shabelle 15 Lower Shabelle 16 Banadir 17 Galguduud 18 Lower Juba This variable was created during data analyses for weighting purposes only. Determined from the cluster numbers. Provinces correspond to the 18 prewar (1991) regions of Somalia. In the survey design regions were not set up as sampling domains therefore UNICEF does not recommend disaggregating data at the regional level. Education of household head Education of household head Education of household head Education of household head Education of household head Recoded variable Households None 1 Koranic 2 Primary 3 Secondary + 4 Non-formal curriculum 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 Household sample weight Household sample weight Household sample weight Household sample weight Household sample weight Recoded variable Households Wealth index score Wealth index score Wealth index score Wealth index score Wealth index score Recoded variable Households Wealth index quintiles Wealth index quintiles Wealth index quintiles Wealth index quintiles Wealth index quintiles Recoded variable Households Excluded 1 Poorest 2 Second 3 Middle 4 Fourth 5 Richest Cluster number Cluster number Cluster number Cluster number Cluster number We are from (COUNTRY-SPECIFIC AFFILIATION). We are working on a project concerned with family health and education. I would like to talk to you about this. The interview will take about (NUMBER) minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. During this time I would like to speak with the household head and all mothers or others who take care of children in the household. May I start now? If permission is given, begin the interview. Cluster number: Households Unique identifier for the cluster in which the household exists Household number Household number Household number Household number Household number Household number: Households Line number Line number Line number Line number Line number Women aged 15-49 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 Sex Sex Sex Sex Sex Children aged 0-4 1 Male 2 Female Age Age Age Age Age How old is (name)? How old was (name) on his/her last birthday? Record in completed years 98=DK* * See instructions: to be used only for elderly household members (code meaning "do not know/over age 50"). De jure household members (usual residents) 97 97+ 98 DK Line number of eligible women Line number of eligible women Line number of eligible women Line number of eligible women Line number of eligible women Circle Line no. if woman is age 15-49 De jure household members (usual residents) Not eligible Line number of mother/caretaker for child labor module Line number of mother/caretaker for child labor module Line number of mother/caretaker for child labor module Line number of mother/caretaker for child labor module Line number of mother/caretaker for child labor module For each child age 5-14: Who is the mother or primary caretaker of this child? Record Line no. of mother/caretaker De jure household members (usual residents) Not eligible Line number of mother/caretaker for child health module Line number of mother/caretaker for child health module Line number of mother/caretaker for child health module Line number of mother/caretaker for child health module Line number of mother/caretaker for child health module For each child under 5: Who is the mother or primary caretaker of this child? Record Line no. of mother/caretaker De jure household members (usual residents) Not eligible Mother alive Mother alive Mother alive Mother alive Mother alive For children age 0-17 years ask HL9-HL12 Is (name's) natural mother alive? De jure household members (usual residents) aged 0-17 (under 18) 1 Yes 2 No 8 DK Mother line number in HH Mother line number in HH Mother line number in HH Mother line number in HH Mother line number in HH For children age 0-17 years ask HL9-HL12 If alive: Does (name's) natural mother live in this household? Record Line no. of mother or 00 for 'No' De jure household members (usual residents) aged 0-17 (under 18) 97 Inconsistent 99 Missing Father alive Father alive Father alive Father alive Father alive For children age 0-17 years ask HL9-HL12 If alive: Is (name's) natural father alive? De jure household members (usual residents) aged 0-17 (under 18) 1 Yes 2 No 8 DK Father line number in HH Father line number in HH Father line number in HH Father line number in HH Father line number in HH For children age 0-17 years ask HL9-HL12 Does (name's) natural father live in this household? Record Line no. of father or 00 for 'No' De jure household members (usual residents) aged 0-17 (under 18) 97 Inconsistent 99 Missing Line number Line number Line number Line number Line number For household members age 5 and above De jure household members (usual residents) Ever attended school Ever attended school Ever attended school Ever attended school Ever attended school For household members age 5 and above Has (name) ever attended school or preschool? De jure household members (usual residents) 1 Yes 2 No 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 4 Koranic 6 Non-standard curriculum 8 DK 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) 66 Don't Have Grades 97 Inconsistent 98 DK 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 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 4 Koranic 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 66 Don't Have Grades 97 Inconsistent 98 DK 99 Missing Attended school last year (2004-2005) Attended school last year (2004-2005) Attended school last year (2004-2005) Attended school last year (2004-2005) Attended school last year (2004-2005) 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 4 Koranic 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 66 Don't Have Grades 97 Inconsistent 98 DK 99 Missing Line number Line number Line number Line number Line number To be administered to mother/caretaker of each child in the household age 5 through 14 years. For household members below age 5 or above age 14, leave rows blank. Now I would like to ask about any work children in this household may do. Children aged 5-14 Worked in past week Worked in past week Worked in past week Worked in past week Worked in past week During the past week, did (name) do any kind of work for someone who is not a member of this household? If yes: For pay in cash or kind? Children aged 5-14 1 Yes, paid 2 Yes, unpaid 3 No 9 Missing Hours worked in past week Hours worked in past week Hours worked in past week Hours worked in past week Hours worked in past week If yes: Since last (day of the week), about how many hours did he/she do this work for someone who is not a member of this household? If more than one job, include all hours at all jobs. Children aged 5-14 98 DK 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 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 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 Hours worked on other family work Hours worked on other family work Hours worked on other family work Hours worked on other family work Hours worked on other family work If yes: Since last (day of the week), about how many hours did he/she do this work? Children aged 5-14 98 DK 99 Missing Line number from household listing Line number from household listing Line number from household listing Line number from household listing Line number from household listing 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 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 have been married How many of these sisters have been married How many of these sisters have been married How many of these sisters have been married How many of these sisters have been married 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 with nomadic Area with nomadic Area with nomadic Area with nomadic Area with nomadic Household 1 Urban 21 Rural 22 Nomadic For the purposes of this survey, the analysis refers to the North West Zone, the North East Zone and Central South Zone according to prewar boundaries for Somaliland and Puntland and does not imply any recognition of administrative boundaries by the United Nations or the League of Arab States. Area presented by urban (district capitals), rural (rural sedentary) and nomadic (rural non-sedentary) Zone Zone Zone Zone Zone Region: Households 1 North West 2 North East 3 Central South 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 52 Roof top 53 Berkad 54 Balli 61 Tanker-truck 71 Cart with small tank/drum 81 Surface water 91 Bottled water 96 Other Main source of water used for other purposes Main source of water used for other purposes Main source of water used for other purposes Main source of water used for other purposes Main source of water used for other purposes 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 52 Roof top 53 Berkad 54 Balli 61 Tanker-truck 71 Cart with small tank/drum 81 Surface water 96 Other 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 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 Measure to prevent contamination Measure to prevent contamination Measure to prevent contamination Measure to prevent contamination Measure to prevent contamination Do you take any meausures to prevent contamination while handling the water or water storage containers? Household 1 Yes 2 No 8 D.K Definitions of various methods of prevention are as follows: · 'A' - Wash hands before collecting water · 'B' - Store drinking water in a clean container with cover · 'C' - Use a separate clean cup with a long handle for taking water out of the container · 'D' - Keep animals away from the container Wash Hands Wash Hands Wash Hands Wash Hands Wash Hands What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Household ? Missing A Wash Hands Store in clean container Store in clean container Store in clean container Store in clean container Store in clean container What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Household ? Missing B Container with cover Use separate container Use separate container Use separate container Use separate container Use separate container What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Household ? Missing C Use Separate container Keep animals away Keep animals away Keep animals away Keep animals away Keep animals away What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Household ? Missing D Keep animals Other Other Other Other Other What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Household ? Missing X Other D.K D.K D.K D.K D.K What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Household ? Missing Z D.K 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 Reliable drinking water supply Reliable drinking water supply Reliable drinking water supply Reliable drinking water supply Reliable drinking water supply Does your main drinking water source give you a reliable supply? Household 1 Almost no problems 2 Occasionaly Problems 3 Weekly Problems 4 Daily Problems 5 Seasonaly Supply 8 D.K 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 95 No facilities or bush or field 96 Other 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 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 Wash hands before eating Wash hands before eating Wash hands before eating Wash hands before eating Wash hands before eating Do you usually wash your hands using soap at any of the following times? Household 1 Yes 2 No Wash hands before feeding babies Wash hands before feeding babies Wash hands before feeding babies Wash hands before feeding babies Wash hands before feeding babies Do you usually wash your hands using soap at any of the following times? Household 1 Yes 2 No wash hands after defecation wash hands after defecation wash hands after defecation wash hands after defecation wash hands after defecation Do you usually wash your hands using soap at any of the following times? Household 1 Yes 2 No Wash hands after cleaning babies bottoms Wash hands after cleaning babies bottoms Wash hands after cleaning babies bottoms Wash hands after cleaning babies bottoms Wash hands after cleaning babies bottoms Do you usually wash your hands using soap at any of the following times? Household 1 Yes 2 No Wash hands before cooking food Wash hands before cooking food Wash hands before cooking food Wash hands before cooking food Wash hands before cooking food Do you usually wash your hands using soap at any of the following times? Household 1 Yes 2 No 9 Missing wash hands after eating wash hands after eating wash hands after eating wash hands after eating wash hands after eating Do you usually wash your hands using soap at any of the following times? Household 1 Yes 2 No 9 Missing Number of rooms for sleeping Number of rooms for sleeping Number of rooms for sleeping Number of rooms for sleeping Number of rooms for sleeping How many rooms in this household are used for sleeping? Households 99 Missing Main material of floor Main material of floor Main material of floor Main material of floor Main material of floor Main material of the dwelling floor: Record observation. Households 11 Earth/sand 21 Wood planks 22 Palm/bamboo 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 Mud & Grass 21 Rustic mat 22 Palm/Grass 23 Wood Planks 24 Sacking/Plastic sheets 31 Metal 32 Wood 33 Calamine/cement fiber 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 Sticks/palm/trunks 13 Mud 21 Bambo with mud 22 Stone with mud 23 Uncovered adobe 24 Plywood 25 Carton 26 Reused wood 27 Cloth/Matting 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) 5 Kerosene 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 Bed Bed Bed Bed Bed Does your household have: Household 1 Yes 2 No 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 VCD/DVD Player VCD/DVD Player VCD/DVD Player VCD/DVD Player VCD/DVD Player Does your household have: Household 1 Yes 2 No 9 Missing Fan Fan Fan Fan Fan Does your household have: Household 1 Yes 2 No 9 Missing Satellite Dish Satellite Dish Satellite Dish Satellite Dish Satellite Dish Does your household have: Household 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 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 Clock Clock Clock Clock Clock Does any member of your household own: Household 1 Yes 2 No 9 Missing Sewing Machine Sewing Machine Sewing Machine Sewing Machine Sewing Machine Does any member of your household own: Household 1 Yes 2 No 9 Missing Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of this household own any land that can be used for agriculture? Households 1 Yes 2 No 9 Missing How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agricultural land do members of this household own? If more than 97, record '97'. If unknown, record '98'. Households 97 More than 97 98 Don't know 99 Missing Does this household own any livestock, cattle, or animals Does this household own any livestock, cattle, or animals Does this household own any livestock, cattle, or animals Does this household own any livestock, cattle, or animals Does this household own any livestock, cattle, or animals Does this household own any livestock, herds, or farm animals? Households 1 Yes 2 No 9 Missing Number of camels Number of camels Number of camels Number of camels Number of camels How many of the following animals does this household have? Households 97 More than 97 99 Missing 98 Don't know Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of Goats Number of Goats Number of Goats Number of Goats Number of Goats How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of sheep Number of sheep Number of sheep Number of sheep Number of sheep How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of chickens Number of chickens Number of chickens Number of chickens Number of chickens How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Area Area Area Area Area Households 1 Urban 2 Non Urban Regions Regions Regions Regions Regions Recoded variable Household 1 W/Galbeed 2 Awdal 3 Sanaag 4 Sool 5 Togdhere 6 Mudug 7 Nugal 8 Bari 9 Bakool 10 Bay 11 Gedo 12 Middle Juba 13 Hiran 14 Middle Shabelle 15 Lower Shabelle 16 Banadir 17 Galguduud 18 Lower Juba This variable was created during data analyses for weighting purposes only. Determined from the cluster numbers. Provinces correspond to the 18 prewar (1991) regions of Somalia. In the survey design regions were not set up as sampling domains therefore UNICEF does not recommend disaggregating data at the regional level. Household sample weight Household sample weight Household sample weight Household sample weight Household sample weight Recoded variable Households Wealth index score Wealth index score Wealth index score Wealth index score Wealth index score Recoded variable Households Wealth index quintiles Wealth index quintiles Wealth index quintiles Wealth index quintiles Wealth index quintiles Recoded variable Households 1 Poorest 2 Second 3 Middle 4 Fourth 5 Richest Mother's line number Mother's line number Mother's line number Mother's line number Mother's line number Recoded variable De jure household members (usual residents) Mother's education Mother's education Mother's education Mother's education Mother's education Recoded Variable Women age 15-49 None 1 Koranic 2 Primary 3 Secondary + 4 Non-formal curriculum 5 Mother not in household 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) Father's education Father's education Father's education Father's education Father's education Recoded variable De jure household members (usual residents) None 1 Koranic 2 Primary 3 Secondary + 4 Non-formal curriculum 5 Father not in household Education of household head Education of household head Education of household head Education of household head Education of household head Recoded variable Households None 1 Koranic 2 Primary 3 Secondary + 4 Non-formal curriculum 9 Missing/DK Line number Line number Line number Line number Line number 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 Line number Line number Line number Line number Line number Women aged 15-49 Cluster number Cluster number Cluster number Cluster number Cluster number Ever married women age 15-49 who have given birth Household number Household number Household number Household number Household number Ever married women age 15-49 who have given birth Woman's line number Woman's line number Woman's line number Woman's line number Woman's line number Ever married women age 15-49 who have given birth Interviewer number Interviewer number Interviewer number Interviewer number Interviewer number Day of interview Day of interview Day of interview Day of interview Day of interview Month of interview Month of interview Month of interview Month of interview Month of interview Year of interview Year of interview Year of interview Year of interview Year of 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 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 97 Inconsistent 98 DK 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 Women age 15-49 9997 Inconsistent 9998 DK Age of woman Age of woman Age of woman Age of woman Age of woman Women age 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 age 15-49 1 Yes 2 No 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 age 15-49 1 Primary 2 Secondary 3 Higher 4 Koranic 5 Non-standard curriculum 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 age 15-49 66 Grades non-existent 97 Inconsistent 98 DK 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 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? Women age 15-49 1 Cannot read at all 2 Able to read only parts of sentence 3 Able to read whole sentence 5 Blind/visually impaired Currently married Currently married Currently married Currently married Currently married Are you currently married or living together with a man as if married? Women age 15-49 1 Yes, currently married 3 No, not in union Age of husband Age of husband Age of husband Age of husband Age of husband How old was your husband/partner on his last birthday? Ever married women age 15-49 Husband has other wives Husband has other wives Husband has other wives Husband has other wives Husband has other wives Besides yourself, does your husband/partner have any other wives? Ever married women age 15-49 1 Yes 2 No 8 D.K Number of other wives Number of other wives Number of other wives Number of other wives Number of other wives How many other wives does he have? Ever married women age 15-49 98 DK Ever married Ever married Ever married Ever married Ever married Have you ever been married or lived together with a man? Women age 15-49 1 Yes, formerly married 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 age 15-49 1 Widowed 2 Divorced Married once or more than once Married once or more than once Married once or more than once Married once or more than once Married once or more than once Have you been married or lived with a man only once or more than once? Ever married women age 15-49 1 Only once 2 More than once 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? Ever married women age 15-49 97 Inconsistent 98 DK 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? Ever married women age 15-49 9997 Inconsistent 9998 DK Age at first union Age at first union Age at first union Age at first union Age at first union How old were you when you started living with your first husband/partner? Ever married women age 15-49 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? Ever married women age 15-49 1 Yes 2 No 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? Ever married women age 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? Ever married women age 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? Ever married women age 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? Ever married women age 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? Ever married women age 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? Ever married women age 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? Ever married women age 15-49 1 Yes 2 No Boys dead Boys dead Boys dead Boys dead Boys dead How many boys have died? Ever married women age 15-49 Girls dead Girls dead Girls dead Girls dead Girls dead How many girls have died? Ever married women age 15-49 Children ever born Children ever born Children ever born Children ever born Children ever born Ever married women age 15-49 Live birth in last 2 years Live birth in last 2 years Live birth in last 2 years Live birth in last 2 years Live birth in last 2 years Check CM11: Did the woman's last birth occur within the last 2 years, that is, since (day and month of interview in 2003)? If child has died, take special care when referring to this child by name in the following modules. No live birth in last 2 years. Go to MARRIAGE/UNION module. Yes, live birth in last 2 years. Continue with CM13 Name of child_______________________ Ever married women aged 15-49 N No Y Yes Has immunization card Has immunization card Has immunization card Has immunization card Has immunization card This module is to be administered to all women with a live birth in the 2 years preceding date of interview. Do you have a card or other document with your own immunizations listed? If a card is presented, use it to assist with answers to the following questions. Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 1 Yes (card seen) 2 Yes (card not seen) 3 No 8 DK Any tetanus toxoid injection during last pregnancy Any tetanus toxoid injection during last pregnancy Any tetanus toxoid injection during last pregnancy Any tetanus toxoid injection during last pregnancy Any tetanus toxoid injection during last pregnancy When you were pregnant with your last child, did you receive any injection to prevent him or her from getting tetanus, that is convulsions after birth (an anti-tetanus shot, an injection at the top of the arm or shoulder)? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 1 Yes 2 No 8 DK Doses of tetanus toxoid during last pregnancy Doses of tetanus toxoid during last pregnancy Doses of tetanus toxoid during last pregnancy Doses of tetanus toxoid during last pregnancy Doses of tetanus toxoid during last pregnancy If yes: How many times did you receive this anti-tetanus injection during your last pregnancy? How many TT doses during last pregnancy were reported in TT3? At least two TT injections during last pregnancy. Go to Next Module Fewer than two TT injections during last pregnancy. Continue with TT5 Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 98 DK Any tetanus toxoid injection before last pregnancy Any tetanus toxoid injection before last pregnancy Any tetanus toxoid injection before last pregnancy Any tetanus toxoid injection before last pregnancy Any tetanus toxoid injection before last pregnancy Did you receive any tetanus toxoid injection at any time before your last pregnancy? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 1 Yes 2 No 8 DK Doses of tetanus toxoid before last pregnancy Doses of tetanus toxoid before last pregnancy Doses of tetanus toxoid before last pregnancy Doses of tetanus toxoid before last pregnancy Doses of tetanus toxoid before last pregnancy How many times did you receive it? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 98 DK Month last tetanus toxoid received Month last tetanus toxoid received Month last tetanus toxoid received Month last tetanus toxoid received Month last tetanus toxoid received In what month and year did you receive the last anti-tetanus injection before that last pregnancy? Skip to next module only if year of injection is given. Otherwise, continue with TT8. Women aged 15-49 who gave birth to a child in the 2 years preceding the survey Ask her to estimate how long ago she received the last dose of TT (the dose before her last pregnancy), and enter her response in years. Ask her to estimate how long ago she received the last dose of TT (the dose before her last pregnancy), and enter her response in years. Ask her to estimate how long ago she received the last dose of TT (the dose before her last pregnancy), and enter her response in years. Ask her to estimate how long ago she received the last dose of TT (the dose before her last pregnancy), and enter her response in years. Ask her to estimate how long ago she received the last dose of TT (the dose before her last pregnancy), and enter her response in years. 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 Years ago last tetanus toxoid received Years ago last tetanus toxoid received Years ago last tetanus toxoid received Years ago last tetanus toxoid received Years ago last tetanus toxoid received How many years ago did you receive the last anti-tetanus injection before that last pregnancy? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 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: private doctor Antenatal care: private doctor Antenatal care: private doctor Antenatal care: private doctor Antenatal care: private doctor Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing D Private 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: 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 Pregnancy months when first received antenatal care Pregnancy months when first received antenatal care Pregnancy months when first received antenatal care Pregnancy months when first received antenatal care Pregnancy months when first received antenatal care How many months pregnant were you when you first received antenatal care for this pregnancy? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 98 DK Times received antenatal care Times received antenatal care Times received antenatal care Times received antenatal care Times received antenatal care How many times did you receive antenatal care for this pregnancy? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 98 DK Hospital Hospital Hospital Hospital Hospital which type of health facility did you go to, to get this antenatal care? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing A Hospital MCH MCH MCH MCH MCH which type of health facility did you go to, to get this antenatal care? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing B MCH Midwife Midwife Midwife Midwife Midwife which type of health facility did you go to, to get this antenatal care? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing C Midwife Other Other Other Other Other which type of health facility did you go to, to get this antenatal care? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing X Other 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 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 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 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 Didn't feel the need Didn't feel the need Didn't feel the need Didn't feel the need Didn't feel the need What are the reasons for not seeing anyone (for ANC)? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing A No need Not convinced Not convinced Not convinced Not convinced Not convinced What are the reasons for not seeing anyone (for ANC)? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing B Not convinced Not capable financially Not capable financially Not capable financially Not capable financially Not capable financially What are the reasons for not seeing anyone (for ANC)? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing C Financially incapable Difficult to reach Difficult to reach Difficult to reach Difficult to reach Difficult to reach What are the reasons for not seeing anyone (for ANC)? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing D Difficult to reach Non-availability of medicaments Non-availability of medicaments Non-availability of medicaments Non-availability of medicaments Non-availability of medicaments What are the reasons for not seeing anyone (for ANC)? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing E Medicine not available Other Other Other Other Other What are the reasons for not seeing anyone (for ANC)? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing X ther DK DK DK DK DK What are the reasons for not seeing anyone (for ANC)? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing Z DK Took medicine in order to prevent malaria Took medicine in order to prevent malaria Took medicine in order to prevent malaria Took medicine in order to prevent malaria Took medicine in order 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 Fansidar Fansidar Fansidar Fansidar 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 DK DK DK DK DK 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 Slept under mosquito net during pregnancy Slept under mosquito net during pregnancy Slept under mosquito net during pregnancy Slept under mosquito net during pregnancy Slept under mosquito net during pregnancy During this pregnancy, did you regularly sleep under a mosquito net? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 1 Yes 2 No 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: Private Doctor assistance at delivery: Private Doctor assistance at delivery: Private Doctor assistance at delivery: Private Doctor assistance at delivery: Private Doctor Who assisted with the delivery of your last child (name)? Anyone else? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing D Private 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: 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 Ceasarian Delivery Ceasarian Delivery Ceasarian Delivery Ceasarian Delivery Ceasarian Delivery Was (name) delivered by caesarian section? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 1 Yes 2 No 8 DK Place of delivery Place of delivery Place of delivery Place of delivery Place of delivery Where did you give birth to (NAME)? If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 11 Resondent's home 12 Other home 13 Midwife's home 21 Government hospital 22 Government clinic/health center 26 Other public 31 Private hospital 32 Private clinic 36 Other private medical 96 Other Where would have gone for emergency Where would have gone for emergency Where would have gone for emergency Where would have gone for emergency Where would have gone for emergency If during your pregnancy you needed emergency obstrtic care where would you have gone? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 11 Resondent's home 12 Other home 13 Midwife's home 21 Government hospital 22 Government clinic/health center 26 Other public 31 Private hospital 32 Private clinic 36 Other private medical 96 Other 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 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 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 8 DK Weight at birth (Kilograms) Weight at birth (Kilograms) Weight at birth (Kilograms) Weight at birth (Kilograms) Weight at birth (Kilograms) How much did (name) weigh? Record weight from health card, if available. Women aged 15-49 who gave birth to a child in the 2 years preceding the survey Doctor Doctor Doctor Doctor Doctor Now I would like to ask you some questions about the 40 days period after the delivary of (name). Did you see anyone for a check-up on your health? If 'Yes' ask: Whom did you see? Anyone else? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing A Doctor Private Doctor Private Doctor Private Doctor Private Doctor Private Doctor Now I would like to ask you some questions about the 40 days period after the delivary of (name). Did you see anyone for a check-up on your health? If 'Yes' ask: Whom did you see? Anyone else? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing B Private Doctor Nurse Nurse Nurse Nurse Nurse Now I would like to ask you some questions about the 40 days period after the delivary of (name). Did you see anyone for a check-up on your health? If 'Yes' ask: Whom did you see? Anyone else? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing C Nurse Midwife Midwife Midwife Midwife Midwife Now I would like to ask you some questions about the 40 days period after the delivary of (name). Did you see anyone for a check-up on your health? If 'Yes' ask: Whom did you see? Anyone else? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing D Midwife Other Other Other Other Other Now I would like to ask you some questions about the 40 days period after the delivary of (name). Did you see anyone for a check-up on your health? If 'Yes' ask: Whom did you see? Anyone else? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing X Other None None None None None Now I would like to ask you some questions about the 40 days period after the delivary of (name). Did you see anyone for a check-up on your health? If 'Yes' ask: Whom did you see? Anyone else? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing Y None Hospital Hospital Hospital Hospital Hospital Where did you receive your post-natal checkup? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing A Hospital MCH MCH MCH MCH MCH Where did you receive your post-natal checkup? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing B MCH Midwife Midwife Midwife Midwife Midwife Where did you receive your post-natal checkup? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing C Midwife Doctor's Doctor's Doctor's Doctor's Doctor's Where did you receive your post-natal checkup? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing D Doctor Other Other Other Other Other Where did you receive your post-natal checkup? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing X Other Main reason for no postnatal checkup Main reason for no postnatal checkup Main reason for no postnatal checkup Main reason for no postnatal checkup Main reason for no postnatal checkup What was the main reason for not recieveing a post-natal checkup? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 1 No complications 2 Experienced 3 Unaware 4 Service not available 5 Costy 6 Too busy 7 Husband too busy 96 Other 98 DK Received a vitamin A dose Received a vitamin A dose Received a vitamin A dose Received a vitamin A dose Received a vitamin A dose In the first 40 days 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 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 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 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 Had fever Had fever Had fever Had fever Had fever Now I would like to talk about some specific health problems related to birth some women have. I will ask you about the time After your last delivary and in the 40 days following it. MN14A. Did you have fever? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 1 Yes 2 No Had urine trouble Had urine trouble Had urine trouble Had urine trouble Had urine trouble Now I would like to talk about some specific health problems related to birth some women have. I will ask you about the time After your last delivary and in the 40 days following it. MN14B. Did you have trouble controlling your urine? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 1 Yes 2 No Had Uti Had Uti Had Uti Had Uti Had Uti Now I would like to talk about some specific health problems related to birth some women have. I will ask you about the time After your last delivary and in the 40 days following it. Did you suffer from any of the following? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 1 Yes 2 No had Mastitis had Mastitis had Mastitis had Mastitis had Mastitis Now I would like to talk about some specific health problems related to birth some women have. I will ask you about the time After your last delivary and in the 40 days following it. Did you suffer from any of the following? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 1 Yes 2 No Had discharge Had discharge Had discharge Had discharge Had discharge Now I would like to talk about some specific health problems related to birth some women have. I will ask you about the time After your last delivary and in the 40 days following it. Did you suffer from any of the following? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 1 Yes 2 No Had Tear Had Tear Had Tear Had Tear Had Tear Now I would like to talk about some specific health problems related to birth some women have. I will ask you about the time After your last delivary and in the 40 days following it. Did you suffer from any of the following? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 1 Yes 2 No Had wound infection Had wound infection Had wound infection Had wound infection Had wound infection Now I would like to talk about some specific health problems related to birth some women have. I will ask you about the time After your last delivary and in the 40 days following it. Did you suffer from any of the following? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 1 Yes 2 No Had hemorphage Had hemorphage Had hemorphage Had hemorphage Had hemorphage Now I would like to talk about some specific health problems related to birth some women have. I will ask you about the time After your last delivary and in the 40 days following it. Did you suffer from any of the following? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 1 Yes 2 No Had depression Had depression Had depression Had depression Had depression Now I would like to talk about some specific health problems related to birth some women have. I will ask you about the time After your last delivary and in the 40 days following it. Did you suffer from any of the following? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 1 Yes 2 No 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 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 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: 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: 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 Place obtained current method Place obtained current method Place obtained current method Place obtained current method Place obtained current method Married women age 15-49 11 Gov Hospital 12 Gov health center 13 Gov health post 14 village health worker 15 Mobile clinic 16 Other public 21 Private hospital 22 Private physcian 23 Private pharmacy 24 Mobile clinic 25 Other private 31 Relative friend 32 Shop 33 Traditional practicer 41 relative outside country 42 Shop outside country 96 Other 98 DK Prefer to have or not to have any more children Prefer to have or not to have any more children Prefer to have or not to have any more children Prefer to have or not to have any more children Prefer to have or not to have any more children a. Now I would like to ask some questions about the future. Would you like to have (a/another) child, or would you prefer not to have any (more) children? b. If currently pregnant: Now I would like to ask some questions about the future. After the child you are now expecting, would you like to have another child, or would you prefer not to have any (more) children? Women aged 15-49 1 Have (a/another( child 2 No more /none 3 Says she cannot get pregnant 8 Undecided/don't know Desired waiting time (units) Desired waiting time (units) Desired waiting time (units) Desired waiting time (units) Desired waiting time (units) How long would you like to wait before the birth of (a/another) child? Women aged 15-49 1 Months 2 Years 9 Special Desired waiting time (number) Desired waiting time (number) Desired waiting time (number) Desired waiting time (number) Desired waiting time (number) How long would you like to wait before the birth of (a/another) child? Women aged 15-49 93 Soon/now 94 Says she cannot get pregnant 96 Other 98 Don't know 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 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 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 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 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 Ever circumcised Ever circumcised Ever circumcised Ever circumcised Ever circumcised Have you yourself ever been circumcised? Women aged 15-49 1 Yes 2 No Flesh removed from the genital area Flesh removed from the genital area Flesh removed from the genital area Flesh removed from the genital area Flesh removed from the genital area Now I would like to ask you what was done to you at this time. Was any flesh removed from the genital area? Women aged 15-49 1 Yes 2 No 8 DK Genital area just nicked without removing flesh Genital area just nicked without removing flesh Genital area just nicked without removing flesh Genital area just nicked without removing flesh Genital area just nicked without removing flesh Was the genital area just nicked without removing any flesh? Women aged 15-49 1 Yes 2 No 8 DK Genital area sewn closed (or sealed) Genital area sewn closed (or sealed) Genital area sewn closed (or sealed) Genital area sewn closed (or sealed) Genital area sewn closed (or sealed) Was the genital area sewn closed (or 'sealed')? Women aged 15-49 1 Yes 2 No 8 DK Number of daughters circumcised Number of daughters circumcised Number of daughters circumcised Number of daughters circumcised Number of 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 Flesh removed from the genital area: daughter Flesh removed from the genital area: daughter Flesh removed from the genital area: daughter Flesh removed from the genital area: daughter Flesh removed from the genital area: daughter Now I would like to ask you what was done to (name) at that time. Was any flesh removed from the genital area? Women aged 15-49 1 Yes 2 No 8 DK Genital area just nicked without removing any flesh: daughte Genital area just nicked without removing any flesh: daughte Genital area just nicked without removing any flesh: daughte Genital area just nicked without removing any flesh: daughte Genital area just nicked without removing any flesh: daughte Was the genital area just nicked without removing any flesh? Women aged 15-49 1 Yes 2 No 8 DK Genital area sewn closed (or sealed): daughter Genital area sewn closed (or sealed): daughter Genital area sewn closed (or sealed): daughter Genital area sewn closed (or sealed): daughter Genital area sewn closed (or sealed): daughter Was the genital area sewn closed (or 'sealed')? Women aged 15-49 1 Yes 2 No 8 DK Age of circumcision of daugher Age of circumcision of daugher Age of circumcision of daugher Age of circumcision of daugher Age of circumcision of daugher 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 Should practice be continued or discountinued Should practice be continued or discountinued Should practice be continued or discountinued Should practice be continued or discountinued Should practice be continued or discountinued 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 Type of circumcision Type of circumcision Type of circumcision Type of circumcision Type of circumcision What type of circumcision should be continued? Women age 15-49 1 Pharonic 2 Intermediate 3 Sunna 8 DK 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 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 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 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 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 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 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 Healthy-looking person to have AIDS Healthy-looking person to have AIDS Healthy-looking person to have AIDS Healthy-looking person to have AIDS Healthy-looking person to have AIDS Is it possible for a healthy-looking person to have the AIDS virus? Women aged 15-49 1 Yes 2 No 8 DK 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 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 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 Should teacher with HIV/AIDS be allowed to teach in school Should teacher with HIV/AIDS be allowed to teach in school Should teacher with HIV/AIDS be allowed to teach in school Should teacher with HIV/AIDS be allowed to teach in school Should teacher with HIV/AIDS be allowed to teach in school If a female teacher has the AIDS virus but is not sick, should she be allowed to continue teaching in school? Women aged 15-49 1 Yes 2 No 8 DK/not sure/depends 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 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 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 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 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 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 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 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 with nomadic Area with nomadic Area with nomadic Area with nomadic Area with nomadic Household 1 Urban 21 Rural 22 Nomadic For the purposes of this survey, the analysis refers to the North West Zone, the North East Zone and Central South Zone according to prewar boundaries for Somaliland and Puntland and does not imply any recognition of administrative boundaries by the United Nations or the League of Arab States. Area presented by urban (district capitals), rural (rural sedentary) and nomadic (rural non-sedentary) Zone Zone Zone Zone Zone Region: Households 1 North West 2 North East 3 Central South 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 52 Roof top 53 Berkad 54 Balli 61 Tanker-truck 71 Cart with small tank/drum 81 Surface water 91 Bottled water 96 Other Main source of water used for other purposes Main source of water used for other purposes Main source of water used for other purposes Main source of water used for other purposes Main source of water used for other purposes 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 52 Roof top 53 Berkad 54 Balli 61 Tanker-truck 71 Cart with small tank/drum 81 Surface water 96 Other 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 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 Measure to prevent contamination Measure to prevent contamination Measure to prevent contamination Measure to prevent contamination Measure to prevent contamination Do you take any meausures to prevent contamination while handling the water or water storage containers? Household 1 Yes 2 No 8 D.K Definitions of various methods of prevention are as follows: · 'A' - Wash hands before collecting water · 'B' - Store drinking water in a clean container with cover · 'C' - Use a separate clean cup with a long handle for taking water out of the container · 'D' - Keep animals away from the container Wash Hands Wash Hands Wash Hands Wash Hands Wash Hands What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Household ? Missing A Wash Hands Store in clean container Store in clean container Store in clean container Store in clean container Store in clean container What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Household ? Missing B Container with cover Use separate container Use separate container Use separate container Use separate container Use separate container What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Household ? Missing C Use Separate container Keep animals away Keep animals away Keep animals away Keep animals away Keep animals away What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Household ? Missing D Keep animals Other Other Other Other Other What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Household ? Missing X Other D.K D.K D.K D.K D.K What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Household ? Missing Z D.K 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 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 Reliable drinking water supply Reliable drinking water supply Reliable drinking water supply Reliable drinking water supply Reliable drinking water supply Does your main drinking water source give you a reliable supply? Household 1 Almost no problems 2 Occasionaly Problems 3 Weekly Problems 4 Daily Problems 5 Seasonaly Supply 8 D.K 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 95 No facilities or bush or field 96 Other 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 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 Wash hands before eating Wash hands before eating Wash hands before eating Wash hands before eating Wash hands before eating Do you usually wash your hands using soap at any of the following times? Household 1 Yes 2 No Wash hands before feeding babies Wash hands before feeding babies Wash hands before feeding babies Wash hands before feeding babies Wash hands before feeding babies Do you usually wash your hands using soap at any of the following times? Household 1 Yes 2 No wash hands after defecation wash hands after defecation wash hands after defecation wash hands after defecation wash hands after defecation Do you usually wash your hands using soap at any of the following times? Household 1 Yes 2 No Wash hands after cleaning babies bottoms Wash hands after cleaning babies bottoms Wash hands after cleaning babies bottoms Wash hands after cleaning babies bottoms Wash hands after cleaning babies bottoms Do you usually wash your hands using soap at any of the following times? Household 1 Yes 2 No Wash hands before cooking food Wash hands before cooking food Wash hands before cooking food Wash hands before cooking food Wash hands before cooking food Do you usually wash your hands using soap at any of the following times? Household 1 Yes 2 No wash hands after eating wash hands after eating wash hands after eating wash hands after eating wash hands after eating Do you usually wash your hands using soap at any of the following times? Household 1 Yes 2 No 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 Main material of floor Main material of floor Main material of floor Main material of floor Main material of floor Main material of the dwelling floor: Record observation. Households 11 Earth/sand 21 Wood planks 22 Palm/bamboo 32 Vinyl or asphalt strips 33 Ceramic tiles 34 Cement 35 Carpet 96 Other 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 Mud & Grass 21 Rustic mat 22 Palm/Grass 23 Wood Planks 24 Sacking/Plastic sheets 31 Metal 32 Wood 33 Calamine/cement fiber 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 Sticks/palm/trunks 13 Mud 21 Bambo with mud 22 Stone with mud 23 Uncovered adobe 24 Plywood 25 Carton 26 Reused wood 27 Cloth/Matting 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) 5 Kerosene 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 Bed Bed Bed Bed Bed Does your household have: Household 1 Yes 2 No 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 VCD/DVD Player VCD/DVD Player VCD/DVD Player VCD/DVD Player VCD/DVD Player Does your household have: Household 1 Yes 2 No 9 Missing Fan Fan Fan Fan Fan Does your household have: Household 1 Yes 2 No 9 Missing Satellite Dish Satellite Dish Satellite Dish Satellite Dish Satellite Dish Does your household have: Household 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 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 Clock Clock Clock Clock Clock Does any member of your household own: Household 1 Yes 2 No 9 Missing Sewing Machine Sewing Machine Sewing Machine Sewing Machine Sewing Machine Does any member of your household own: Household 1 Yes 2 No 9 Missing Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of this household own any land that can be used for agriculture? Households 1 Yes 2 No 9 Missing How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agricultural land do members of this household own? If more than 97, record '97'. If unknown, record '98'. Households 97 More than 97 98 Don't know 99 Missing Does this household own any livestock, cattle, or animals Does this household own any livestock, cattle, or animals Does this household own any livestock, cattle, or animals Does this household own any livestock, cattle, or animals Does this household own any livestock, cattle, or animals Does this household own any livestock, herds, or farm animals? Households 1 Yes 2 No 9 Missing Number of camels Number of camels Number of camels Number of camels Number of camels How many of the following animals does this household have? Households 97 More than 97 99 Missing 98 Don't know Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of Goats Number of Goats Number of Goats Number of Goats Number of Goats How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of sheep Number of sheep Number of sheep Number of sheep Number of sheep How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of chickens Number of chickens Number of chickens Number of chickens Number of chickens How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Area Area Area Area Area Households 1 Urban 2 Non Urban Regions Regions Regions Regions Regions Recoded variable Household 1 W/Galbeed 2 Awdal 3 Sanaag 4 Sool 5 Togdhere 6 Mudug 7 Nugal 8 Bari 9 Bakool 10 Bay 11 Gedo 12 Middle Juba 13 Hiran 14 Middle Shabelle 15 Lower Shabelle 16 Banadir 17 Galguduud 18 Lower Juba This variable was created during data analyses for weighting purposes only. Determined from the cluster numbers. Provinces correspond to the 18 prewar (1991) regions of Somalia. In the survey design regions were not set up as sampling domains therefore UNICEF does not recommend disaggregating data at the regional level. Regional stratum and urban/rural Regional stratum and urban/rural Regional stratum and urban/rural Regional stratum and urban/rural Regional stratum and urban/rural Recoded variable Household This variable was created during data analyses for weighting purposes only. 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 age 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 age 15-49 Age Age Age Age Age Recoded Variable Women age 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 age 15-49 Marital status Marital status Marital status Marital status Marital status Recoded Variable Women age 15-49 1 Currently married 2 Formerly married 3 Never married Education Education Education Education Education Recoded Variable Women age 15-49 None 1 Koranic 2 Primary 3 Secondary + 4 Non-standard curriculum Children ever born Children ever born Children ever born Children ever born Children ever born Recoded Variable Women age 15-49 Dead children Dead children Dead children Dead children Dead children Recoded Variable Women age 15-49 Number of children surviving Number of children surviving Number of children surviving Number of children surviving Number of children surviving Recoded Variable Women age 15-49 Women's sample weight Women's sample weight Women's sample weight Women's sample weight Women's sample weight Recoded Variable Women age 15-49 The sample is not self weighting therefore survey sample weights have been created using urban and rural population estimates at the regional level. (See data processing folder under external documents which contains excel sheets and syntax files related to constructing and merging sample weights to file). Wealth index score Wealth index score Wealth index score Wealth index score Wealth index score Recoded variable Households Wealth index quintiles Wealth index quintiles Wealth index quintiles Wealth index quintiles Wealth index quintiles Recoded variable Households Excluded 1 Poorest 2 Second 3 Middle 4 Fourth 5 Richest Line number of live birth Line number of live birth Line number of live birth Line number of live birth Line number of live birth Ever married women age 15-49 who have given birth Type of pregnancy Type of pregnancy Type of pregnancy Type of pregnancy Type of pregnancy WERE ANY OF THESE BIRTHS TWINS? Ever married women age 15-49 who have given birth 1 Single 2 Multiple Sex of child Sex of child Sex of child Sex of child Sex of child IS (name) A BOY OR A GIRL? Ever married women age 15-49 who have given birth 1 Male 2 Female 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 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 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 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 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 Line number Line number Line number Line number Line number Women aged 15-49 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 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 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 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 Type of registry Type of registry Type of registry Type of registry Type of registry Has (name's) birth been registered with a notary or the municipality? or any other authorities? 1 Notary 2 Municipiality 3 Other 4 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 5 Does not know where to register 6 Other 7 No need 8 DK 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 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 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 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 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 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 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 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 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 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 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 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 Blood present in diarrohea Blood present in diarrohea Blood present in diarrohea Blood present in diarrohea Blood present in diarrohea 1 Yes 2 No 8 DK 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 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 Pre-packaged ORS fluid for diarrhoea Pre-packaged ORS fluid for diarrhoea Pre-packaged ORS fluid for diarrhoea Pre-packaged ORS fluid for diarrhoea Pre-packaged ORS fluid for diarrhoea During this last episode of diarrhoea, did (name) drink any of the following: Read each item aloud and record response before proceeding to the next item. A pre-packaged ORS fluid for diarrhoea? Children aged 0-4 1 Yes 2 No 8 DK Breastfed during diarohea Breastfed during diarohea Breastfed during diarohea Breastfed during diarohea Breastfed during diarohea During (name's) illness, did he/she breastfeed? 1 Yes 2 No 8 DK 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 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 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 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 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 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 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: Other public source Place sought care: Other public source Place sought care: Other public source Place sought care: Other public source Place sought care: Other public source From where did you seek care? Anywhere else? Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place) Children aged 0-4 ? Missing H Other public sources Place sought care: Private hospital/clinic Place sought care: Private hospital/clinic Place sought care: Private hospital/clinic Place sought care: Private hospital/clinic Place sought care: Private hospital/clinic From where did you seek care? Anywhere else? Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place) Children aged 0-4 ? Missing I Private hospital/clinic Place sought care: Private physician Place sought care: Private physician Place sought care: Private physician Place sought care: Private physician Place sought care: Private physician From where did you seek care? Anywhere else? Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place) Children aged 0-4 ? Missing J Private phisician Place sought care: Private pharmacy Place sought care: Private pharmacy Place sought care: Private pharmacy Place sought care: Private pharmacy Place sought care: Private pharmacy From where did you seek care? Anywhere else? Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place) Children aged 0-4 ? Missing K Pharmacy Place sought care: 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 Antibiotic Antibiotic Antibiotic Antibiotic Antibiotic What medicine was (name) given? Circle all medicines given. Children aged 0-4 ? Missing A Antibiotic Paracetamol/Panadol/Acetaminophen Paracetamol/Panadol/Acetaminophen Paracetamol/Panadol/Acetaminophen Paracetamol/Panadol/Acetaminophen Paracetamol/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 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: Coughing Symptoms: Coughing Symptoms: Coughing Symptoms: Coughing Symptoms: Coughing 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? ? Missing H Coughing Symptoms: Diarrhea Symptoms: Diarrhea Symptoms: Diarrhea Symptoms: Diarrhea Symptoms: Diarrhea 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? ? Missing I Diarohea 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 D.K D.K D.K D.K D.K 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 DK Fever Fever Fever Fever Fever What are the symptoms or signs of malaria? ? Missing A Fever Headaches Headaches Headaches Headaches Headaches What are the symptoms or signs of malaria? ? Missing B Headaches Chilis Chilis Chilis Chilis Chilis What are the symptoms or signs of malaria? ? Missing C Chills Neckache Neckache Neckache Neckache Neckache What are the symptoms or signs of malaria? ? Missing D Neckache Weakness Weakness Weakness Weakness Weakness What are the symptoms or signs of malaria? ? Missing E Weakness Loss of appetite Loss of appetite Loss of appetite Loss of appetite Loss of appetite What are the symptoms or signs of malaria? ? Missing F Loss of appetite Bitterness Bitterness Bitterness Bitterness Bitterness What are the symptoms or signs of malaria? ? Missing G Bitterness Vomiting Vomiting Vomiting Vomiting Vomiting What are the symptoms or signs of malaria? ? Missing H Vomiting Other Other Other Other Other What are the symptoms or signs of malaria? ? Missing X Other DK DK DK DK DK What are the symptoms or signs of malaria? ? Missing X DK Z DK 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 Day of Vitamin A (1) Day of Vitamin A (1) Day of Vitamin A (1) Day of Vitamin A (1) Day of Vitamin A (1) (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 Month of Vitamin A (1) Month of Vitamin A (1) Month of Vitamin A (1) Month of Vitamin A (1) Month of Vitamin A (1) (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 Year of Vitamin A (1) Year of Vitamin A (1) Year of Vitamin A (1) Year of Vitamin A (1) Year of Vitamin A (1) (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 Day of Vitamin A (2) Day of Vitamin A (2) Day of Vitamin A (2) Day of Vitamin A (2) Day of Vitamin A (2) (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 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) Year of Vitamin A (2) Year of Vitamin A (2) Year of Vitamin A (2) Year of Vitamin A (2) Year of Vitamin A (2) (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 Child received any other vaccinations Child received any other vaccinations Child received any other vaccinations Child received any other vaccinations Child received any other vaccinations In addition to the vaccinations and vitamin A capsules shown on this card, did (name) receive any other vaccinations - including vaccinations received in campaigns or immunization days? Record 'Yes' only if respondent mentions BCG, OPV 0-3, DPT 1-3, Hepatitis B 1-3, Measles, Yellow Fever vaccine(s), or Vitamin A supplements. (If yes, Probe for vaccinations and write '66' in the corresponding day column on IM2 to IM8B.) 1 Yes 2 No 8 DK 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 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 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 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 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 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 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 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 Heard of POLIO Heard of POLIO Heard of POLIO Heard of POLIO Heard of POLIO Have you ever heard of a disease called polio? 1 Yes 2 No 8 DK Agree to receiving a vaccine Agree to receiving a vaccine Agree to receiving a vaccine Agree to receiving a vaccine Agree to receiving a vaccine Do you agree to receiving repeat doses of polio vaccines every month? 1 Yes 2 No 8 DK Ever refused vaccination Ever refused vaccination Ever refused vaccination Ever refused vaccination Ever refused vaccination Have you ever refused to vaccinate one of your children against polio disease? 1 Never 2 Once 3 Several times Father Father Father Father Father Who in the household takes the decision to vaccinate the child? ? Missing A Father Mother Mother Mother Mother Mother Who in the household takes the decision to vaccinate the child? ? Missing B Mother Grandparents Grandparents Grandparents Grandparents Grandparents Who in the household takes the decision to vaccinate the child? ? Missing C Grandparents Others Others Others Others Others Who in the household takes the decision to vaccinate the child? ? Missing X 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 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 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 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 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 Where did you get the anti malaria Where did you get the anti malaria Where did you get the anti malaria Where did you get the anti malaria Where did you get the anti malaria Where did you get the (name of anti-malarial from ML4 or ML7)? If more than one anti-malarial is mentioned in ML4 or ML7, refer to the first anti-malarial given for the fever (the anti-malarial given on the day recorded in ML9). Children aged 0-4 11 Hospital 12 Govt health centre 13 Govt health post 14 Village health worker 15 Mobile/outreach clinic 16 Other public source 21 Private hospital/clinic 22 Private physician 23 Private pharmacy 24 Mobile clinic 26 Other private medical 31 Relative or friend 32 Shop 33 Traditional practitioner 96 Other 98 DK 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 Net type Net type Net type Net type Net type What TYPE is this net? 1 Long last treated net 2 Pre-treated net 3 Other net 8 DK 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 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 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 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 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 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 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 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 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 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 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 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 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 Sex Sex Sex Sex Sex Children aged 0-4 1 Male 2 Female Highest level of school attended Highest level of school attended Highest level of school attended Highest level of school attended Highest level of school attended What is the highest level of school (name) attended? Children aged 0-4 Preschool/kindergarten 1 Primary 2 Secondary 3 Higher 4 Koranic 6 Non-standard curriculum 8 DK 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 with nomadic Area with nomadic Area with nomadic Area with nomadic Area with nomadic Household 1 Urban 21 Rural 22 Nomadic All district capitols were considered as urban Zone Zone Zone Zone Zone Region: Households 1 North West 2 North East 3 Central South 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 52 Roof top 53 Berkad 54 Balli 61 Tanker-truck 71 Cart with small tank/drum 81 Surface water 91 Bottled water 96 Other Main source of water used for other purposes Main source of water used for other purposes Main source of water used for other purposes Main source of water used for other purposes Main source of water used for other purposes 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 52 Roof top 53 Berkad 54 Balli 61 Tanker-truck 71 Cart with small tank/drum 81 Surface water 96 Other 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 9995 On premises 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 Measure to prevent contamination Measure to prevent contamination Measure to prevent contamination Measure to prevent contamination Measure to prevent contamination Do you take any meausures to prevent contamination while handling the water or water storage containers? Household 1 Yes 2 No 8 D.K Definitions of various methods of prevention are as follows: · 'A' - Wash hands before collecting water · 'B' - Store drinking water in a clean container with cover · 'C' - Use a separate clean cup with a long handle for taking water out of the container · 'D' - Keep animals away from the container Wash Hands Wash Hands Wash Hands Wash Hands Wash Hands What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Household ? Missing A Wash Hands Store in clean container Store in clean container Store in clean container Store in clean container Store in clean container What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Household ? Missing B Container with cover Use separate container Use separate container Use separate container Use separate container Use separate container What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Household ? Missing C Use Separate container Keep animals away Keep animals away Keep animals away Keep animals away Keep animals away What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Household ? Missing D Keep animals Other Other Other Other Other What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Household ? Missing X Other D.K D.K D.K D.K D.K What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Household ? Missing Z D.K 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 Reliable drinking water supply Reliable drinking water supply Reliable drinking water supply Reliable drinking water supply Reliable drinking water supply Does your main drinking water source give you a reliable supply? Household 1 Almost no problems 2 Occasionaly Problems 3 Weekly Problems 4 Daily Problems 5 Seasonaly Supply 8 D.K 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 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 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 Wash hands before eating Wash hands before eating Wash hands before eating Wash hands before eating Wash hands before eating Do you usually wash your hands using soap at any of the following times? Household 1 Yes 2 No Wash hands before feeding babies Wash hands before feeding babies Wash hands before feeding babies Wash hands before feeding babies Wash hands before feeding babies Do you usually wash your hands using soap at any of the following times? Household 1 Yes 2 No wash hands after defecation wash hands after defecation wash hands after defecation wash hands after defecation wash hands after defecation Do you usually wash your hands using soap at any of the following times? Household 1 Yes 2 No Wash hands after cleaning babies bottoms Wash hands after cleaning babies bottoms Wash hands after cleaning babies bottoms Wash hands after cleaning babies bottoms Wash hands after cleaning babies bottoms Do you usually wash your hands using soap at any of the following times? Household 1 Yes 2 No Wash hands before cooking food Wash hands before cooking food Wash hands before cooking food Wash hands before cooking food Wash hands before cooking food Do you usually wash your hands using soap at any of the following times? Household 1 Yes 2 No wash hands after eating wash hands after eating wash hands after eating wash hands after eating wash hands after eating Do you usually wash your hands using soap at any of the following times? Household 1 Yes 2 No 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 Main material of floor Main material of floor Main material of floor Main material of floor Main material of floor Main material of the dwelling floor: Record observation. Households 11 Earth/sand 21 Wood planks 22 Palm/bamboo 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 Mud & Grass 21 Rustic mat 22 Palm/Grass 23 Wood Planks 24 Sacking/Plastic sheets 31 Metal 32 Wood 33 Calamine/cement fiber 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 Sticks/palm/trunks 13 Mud 21 Bambo with mud 22 Stone with mud 23 Uncovered adobe 24 Plywood 25 Carton 26 Reused wood 27 Cloth/Matting 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) 5 Kerosene 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 Bed Bed Bed Bed Bed Does your household have: Household 1 Yes 2 No 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 VCD/DVD Player VCD/DVD Player VCD/DVD Player VCD/DVD Player VCD/DVD Player Does your household have: Household 1 Yes 2 No 9 Missing Fan Fan Fan Fan Fan Does your household have: Household 1 Yes 2 No 9 Missing Satellite Dish Satellite Dish Satellite Dish Satellite Dish Satellite Dish Does your household have: Household 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 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 Clock Clock Clock Clock Clock Does any member of your household own: Household 1 Yes 2 No 9 Missing Sewing Machine Sewing Machine Sewing Machine Sewing Machine Sewing Machine Does any member of your household own: Household 1 Yes 2 No 9 Missing Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of this household own any land that can be used for agriculture? Households 1 Yes 2 No 9 Missing How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agricultural land do members of this household own? If more than 97, record '97'. If unknown, record '98'. Households 97 More than 97 98 Don't know 99 Missing Does this household own any livestock, cattle, or animals Does this household own any livestock, cattle, or animals Does this household own any livestock, cattle, or animals Does this household own any livestock, cattle, or animals Does this household own any livestock, cattle, or animals Does this household own any livestock, herds, or farm animals? Households 1 Yes 2 No 9 Missing Number of camels Number of camels Number of camels Number of camels Number of camels How many of the following animals does this household have? Households 97 More than 97 99 Missing 98 Don't know Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of Goats Number of Goats Number of Goats Number of Goats Number of Goats How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of sheep Number of sheep Number of sheep Number of sheep Number of sheep How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of chickens Number of chickens Number of chickens Number of chickens Number of chickens How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Area Area Area Area Area Households 1 Urban 2 Non Urban Regions Regions Regions Regions Regions Recoded variable Household 1 W/Galbeed 2 Awdal 3 Sanaag 4 Sool 5 Togdhere 6 Mudug 7 Nugal 8 Bari 9 Bakool 10 Bay 11 Gedo 12 Middle Juba 13 Hiran 14 Middle Shabelle 15 Lower Shabelle 16 Banadir 17 Galguduud 18 Lower Juba This variable was created during data analyses for weighting purposes only. Determined from the cluster numbers. Provinces correspond to the 18 prewar (1991) regions of Somalia. In the survey design regions were not set up as sampling domains therefore UNICEF does not recommend disaggregating data at the regional level. 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 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 Required for date of birth calculation Required for date of birth calculation Required for date of birth calculation Required for date of birth calculation Required for date of birth calculation Required for date of birth calculation Required for date of birth calculation Required for date of birth calculation Required for date of birth calculation Required for date of birth calculation Required for date of birth calculation Required for date of birth calculation Required for date of birth calculation Required for date of birth calculation Required for date of birth calculation Required for date of birth calculation Required for date of birth calculation Required for date of birth calculation Required for date of birth calculation Required for date of birth calculation 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 Women age 15-49 None 1 Koranic 2 Primary 3 Secondary 4 Non-standard curriculum Wealth index score Wealth index score Wealth index score Wealth index score Wealth index score Recoded variable Households Wealth index quintiles Wealth index quintiles Wealth index quintiles Wealth index quintiles Wealth index quintiles Recoded variable Households 1 Poorest 2 Second 3 Middle 4 Fourth 5 Richest Children 0-3 months Children 0-3 months Children 0-3 months Children 0-3 months Children 0-3 months Children 0-5 months Children 0-5 months Children 0-5 months Children 0-5 months Children 0-5 months Children 6-9 months Children 6-9 months Children 6-9 months Children 6-9 months Children 6-9 months Children 12-15 months Children 12-15 months Children 12-15 months Children 12-15 months Children 12-15 months Children 20-23 months Children 20-23 months Children 20-23 months Children 20-23 months Children 20-23 months 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 Line number Line number Line number Line number Line number Women aged 15-49 Line number of live birth Line number of live birth Line number of live birth Line number of live birth Line number of live birth Ever married women age 15-49 who have given birth Type of pregnancy Type of pregnancy Type of pregnancy Type of pregnancy Type of pregnancy WERE ANY OF THESE BIRTHS TWINS? Ever married women age 15-49 who have given birth 1 Single 2 Multiple Sex of child Sex of child Sex of child Sex of child Sex of child IS (name) A BOY OR A GIRL? Ever married women age 15-49 who have given birth 1 Male 2 Female 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 In what month and year was (name) born? Ever married women age 15-49 who have given birth 98 D.K. 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 In what month and year was (name) born? Ever married women age 15-49 who have given birth 9998 D.K. Survival status of child Survival status of child Survival status of child Survival status of child Survival status of child IS (name) STILL ALIVE? Ever married women age 15-49 who have given birth 1 Alive 2 Dead Age of alive child in years Age of alive child in years Age of alive child in years Age of alive child in years Age of alive child in years How old was (name) at his/her last birthday? Ever married women age 15-49 who have given birth 99 Missing Residence of alive child Residence of alive child Residence of alive child Residence of alive child Residence of alive child IS (name) LIVING WITH YOU? Ever married women age 15-49 who have given birth 1 Living at home 2 Away Line number of child in HH Line number of child in HH Line number of child in HH Line number of child in HH Line number of child in HH Ever married women age 15-49 who have given birth Not member of HH 99 Missing Code for age at death Code for age at death Code for age at death Code for age at death Code for age at death How old was (name) when he/she died? If '1 YR', probe: How many months old was (Name)? Ever married women age 15-49 who have given birth 1 In days 2 In months 3 In years Age at death Age at death Age at death Age at death Age at death How old was (name) when he/she died? If '1 YR', probe: How many months old was (Name)? Ever married women age 15-49 who have given birth Any live births in between Any live births in between Any live births in between Any live births in between Any live births in between Where there any other live births between (name of previous birth) and (name Ever married women age 15-49 who have given birth 1 Yes 2 No Any births since last birth Any births since last birth Any births since last birth Any births since last birth Any births since last birth Have you had any live births since the birth of (Name of last birth)? Ever married women age 15-49 who have given birth 1 Yes 2 No Any miscarriages Any miscarriages Any miscarriages Any miscarriages Any miscarriages Some pregnancies end before full term as a miscarriage, while others may result in a stillbirth. have you had a miscarriage? Ever married women age 15-49 who have given birth 1 Yes 2 No Number of miscarriages Number of miscarriages Number of miscarriages Number of miscarriages Number of miscarriages In all how many pregnancies did you have that ended in a miscarriage? Ever married women age 15-49 who have given birth 98 D.K Any still births Any still births Any still births Any still births Any still births Have you had a still birth? Ever married women age 15-49 who have given birth 1 Yes 2 No Number of still births Number of still births Number of still births Number of still births Number of still births In all how many pregnancies did you have that ended in a stillbirth Ever married women age 15-49 who have given birth 98 D.K Any birth in last 2 years Any birth in last 2 years Any birth in last 2 years Any birth in last 2 years Any birth in last 2 years Ever married women age 15-49 who have given birth 1 Yes 2 No Cluster number Cluster number Cluster number Cluster number Cluster number Ever married women age 15-49 who have given birth Household number Household number Household number Household number Household number Ever married women age 15-49 who have given birth Woman's line number Woman's line number Woman's line number Woman's line number Woman's line number Ever married women age 15-49 who have given birth Interviewer number Interviewer number Interviewer number Interviewer number Interviewer number Day of interview Day of interview Day of interview Day of interview Day of interview Month of interview Month of interview Month of interview Month of interview Month of interview Year of interview Year of interview Year of interview Year of interview Year of 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 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 97 Inconsistent 98 DK 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 Women age 15-49 9997 Inconsistent 9998 DK Age of woman Age of woman Age of woman Age of woman Age of woman Women age 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 age 15-49 1 Yes 2 No 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 age 15-49 1 Primary 2 Secondary 3 Higher 4 Koranic 5 Non-standard curriculum 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 age 15-49 66 Grades non-existent 97 Inconsistent 98 DK 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 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? Women age 15-49 1 Cannot read at all 2 Able to read only parts of sentence 3 Able to read whole sentence 5 Blind/visually impaired Currently married Currently married Currently married Currently married Currently married Are you currently married or living together with a man as if married? Women age 15-49 1 Yes, currently married 3 No, not in union Age of husband Age of husband Age of husband Age of husband Age of husband How old was your husband/partner on his last birthday? Ever married women age 15-49 98 DK Husband has other wives Husband has other wives Husband has other wives Husband has other wives Husband has other wives Besides yourself, does your husband/partner have any other wives? Ever married women age 15-49 1 Yes 2 No 8 D.K Number of other wives Number of other wives Number of other wives Number of other wives Number of other wives How many other wives does he have? Ever married women age 15-49 98 DK Ever married Ever married Ever married Ever married Ever married Have you ever been married or lived together with a man? Women age 15-49 1 Yes, formerly married 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 age 15-49 1 Widowed 2 Divorced Married once or more than once Married once or more than once Married once or more than once Married once or more than once Married once or more than once Have you been married or lived with a man only once or more than once? Ever married women age 15-49 1 Only once 2 More than once 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? Ever married women age 15-49 97 Inconsistent 98 DK 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? Ever married women age 15-49 9997 Inconsistent 9998 DK Age at first union Age at first union Age at first union Age at first union Age at first union How old were you when you started living with your first husband/partner? Ever married women age 15-49 97 Inconsistent 98 DK 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? Ever married women age 15-49 1 Yes 2 No 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? Ever married women age 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? Ever married women age 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? Ever married women age 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? Ever married women age 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? Ever married women age 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? Ever married women age 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? Ever married women age 15-49 1 Yes 2 No Boys dead Boys dead Boys dead Boys dead Boys dead How many boys have died? Ever married women age 15-49 Girls dead Girls dead Girls dead Girls dead Girls dead How many girls have died? Ever married women age 15-49 Children ever born Children ever born Children ever born Children ever born Children ever born Ever married women age 15-49 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 Households 1 Urban 21 Rural 22 Nomadic Zone Zone Zone Zone Zone Region: Households 1 Somalialand 2 Puntland 3 Central South 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 52 Roof top 53 Berkad 54 Balli 61 Tanker-truck 71 Cart with small tank/drum 81 Surface water 91 Bottled water 96 Other Main source of water used for other purposes Main source of water used for other purposes Main source of water used for other purposes Main source of water used for other purposes Main source of water used for other purposes 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 52 Roof top 53 Berkad 54 Balli 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 Measure to prevent contamination Measure to prevent contamination Measure to prevent contamination Measure to prevent contamination Measure to prevent contamination Do you take any meausures to prevent contamination while handling the water or water storage containers? Household 1 Yes 2 No 8 D.K Definitions of various methods of prevention are as follows: · 'A' - Wash hands before collecting water · 'B' - Store drinking water in a clean container with cover · 'C' - Use a separate clean cup with a long handle for taking water out of the container · 'D' - Keep animals away from the container Wash Hands Wash Hands Wash Hands Wash Hands Wash Hands What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Household ? Missing A Wash Hands Store in clean container Store in clean container Store in clean container Store in clean container Store in clean container What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Household ? Missing B Container with cover Use separate container Use separate container Use separate container Use separate container Use separate container What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Household ? Missing C Use Separate container Keep animals away Keep animals away Keep animals away Keep animals away Keep animals away What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Household ? Missing D Keep animals Other Other Other Other Other What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Household ? Missing X Other D.K D.K D.K D.K D.K What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Household ? Missing Z D.K 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 Reliable drinking water supply Reliable drinking water supply Reliable drinking water supply Reliable drinking water supply Reliable drinking water supply Does your main drinking water source give you a reliable supply? Household 1 Almost no problems 2 Occasionaly Problems 3 Weekly Problems 4 Daily Problems 5 Seasonaly Supply 8 D.K 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 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 Wash hands before eating Wash hands before eating Wash hands before eating Wash hands before eating Wash hands before eating Do you usually wash your hands using soap at any of the following times? Household 1 Yes 2 No 9 Missing Wash hands before feeding babies Wash hands before feeding babies Wash hands before feeding babies Wash hands before feeding babies Wash hands before feeding babies Do you usually wash your hands using soap at any of the following times? Household 1 Yes 2 No 9 Missing wash hands after defecation wash hands after defecation wash hands after defecation wash hands after defecation wash hands after defecation Do you usually wash your hands using soap at any of the following times? Household 1 Yes 2 No 9 Missing Wash hands after cleaning babies bottoms Wash hands after cleaning babies bottoms Wash hands after cleaning babies bottoms Wash hands after cleaning babies bottoms Wash hands after cleaning babies bottoms Do you usually wash your hands using soap at any of the following times? Household 1 Yes 2 No 9 Missing Wash hands before cooking food Wash hands before cooking food Wash hands before cooking food Wash hands before cooking food Wash hands before cooking food Do you usually wash your hands using soap at any of the following times? Household 1 Yes 2 No 9 Missing wash hands after eating wash hands after eating wash hands after eating wash hands after eating wash hands after eating Do you usually wash your hands using soap at any of the following times? Household 1 Yes 2 No 9 Missing Number of rooms for sleeping Number of rooms for sleeping Number of rooms for sleeping Number of rooms for sleeping Number of rooms for sleeping How many rooms in this household are used for sleeping? Households 99 Missing Main material of floor Main material of floor Main material of floor Main material of floor Main material of floor Main material of the dwelling floor: Record observation. Households 11 Earth/sand 21 Wood planks 22 Palm/bamboo 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 Mud & Grass 21 Rustic mat 22 Palm/Grass 23 Wood Planks 24 Sacking/Plastic sheets 31 Metal 32 Wood 33 Calamine/cement fiber 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 Sticks/palm/trunks 13 Mud 21 Bambo with mud 22 Stone with mud 23 Uncovered adobe 24 Plywood 25 Carton 26 Reused wood 27 Cloth/Matting 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) 5 Kerosene 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 Bed Bed Bed Bed Bed Does your household have: Household 1 Yes 2 No 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 VCD/DVD Player VCD/DVD Player VCD/DVD Player VCD/DVD Player VCD/DVD Player Does your household have: Household 1 Yes 2 No 9 Missing Fan Fan Fan Fan Fan Does your household have: Household 1 Yes 2 No 9 Missing Satellite Dish Satellite Dish Satellite Dish Satellite Dish Satellite Dish Does your household have: Household 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 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 Clock Clock Clock Clock Clock Does any member of your household own: Household 1 Yes 2 No 9 Missing Sewing Machine Sewing Machine Sewing Machine Sewing Machine Sewing Machine Does any member of your household own: Household 1 Yes 2 No 9 Missing Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of this household own any land that can be used for agriculture? Households 1 Yes 2 No 9 Missing How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agricultural land do members of this household own? If more than 97, record '97'. If unknown, record '98'. Households 97 More than 97 98 Don't know 99 Missing Does this household own any livestock, cattle, or animals Does this household own any livestock, cattle, or animals Does this household own any livestock, cattle, or animals Does this household own any livestock, cattle, or animals Does this household own any livestock, cattle, or animals Does this household own any livestock, herds, or farm animals? Households 1 Yes 2 No 9 Missing Number of camels Number of camels Number of camels Number of camels Number of camels How many of the following animals does this household have? Households 97 More than 97 99 Missing 98 Don't know Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of Goats Number of Goats Number of Goats Number of Goats Number of Goats How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of sheep Number of sheep Number of sheep Number of sheep Number of sheep How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Number of chickens Number of chickens Number of chickens Number of chickens Number of chickens How many of the following animals does this household have? Households 97 More than 97 98 Don't know 99 Missing Area Area Area Area Area Household 1 Urban 2 Non Urban All district capitols were considered as urban Regions Regions Regions Regions Regions Recoded variable Household 1 W/Galbeed 2 Awdal 3 Sanaag 4 Sool 5 Togdhere 6 Mudug 7 Nugal 8 Bari 9 Bakool 10 Bay 11 Gedo 12 Middle Juba 13 Hiran 14 Middle Shabelle 15 Lower Shabelle 16 Banadir 17 Galguduud 18 Lower Juba This variable was created during data analyses for weighting purposes only. Determined from the cluster numbers. Provinces correspond to the 18 prewar (1991) regions of Somalia. In the survey design regions were not set up as sampling domains therefore UNICEF does not recommend disaggregating data at the regional level. Regional stratum and urban/rural Regional stratum and urban/rural Regional stratum and urban/rural Regional stratum and urban/rural Regional stratum and urban/rural Recoded variable Household This variable was created during data analyses for weighting purposes only. 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 age 15-49 Child's date of birth (CMC) Child's date of birth (CMC) Child's date of birth (CMC) Child's date of birth (CMC) Child's date of birth (CMC) Recoded Variable Women age 15-49 Women's date of birth (CMC) Women's date of birth (CMC) Women's date of birth (CMC) Women's date of birth (CMC) Women's date of birth (CMC) Recoded Variable Women age 15-49 Women's age Women's age Women's age Women's age Women's age Recoded Variable Women age 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 Age at first marriage Age at first marriage Age at first marriage Age at first marriage Recoded Variable Women age 15-49 Marital status Marital status Marital status Marital status Marital status Recoded Variable Women age 15-49 1 Currently married 2 Formerly married 3 Never married Education Education Education Education Education Recoded Variable Women age 15-49 None 1 Koranic 2 Primary 3 Secondary + 4 Non-standard curriculum 9 Missing/DK Children ever born Children ever born Children ever born Children ever born Children ever born Recoded Variable Women age 15-49 Dead children Dead children Dead children Dead children Dead children Recoded Variable Women age 15-49 Number of children surviving Number of children surviving Number of children surviving Number of children surviving Number of children surviving Recoded Variable Women age 15-49 Women's sample weight Women's sample weight Women's sample weight Women's sample weight Women's sample weight Recoded Variable Women age 15-49 The sample is not self weighting therefore survey sample weights have been created using urban and rural population estimates at the regional level. (See data processing folder under external documents which contains excel sheets and syntax files related to constructing and merging sample weights to file). Wealth index score Wealth index score Wealth index score Wealth index score Wealth index score Recoded variable Households Wealth index quintiles Wealth index quintiles Wealth index quintiles Wealth index quintiles Wealth index quintiles Recoded variable Households 1 Poorest 2 Second 3 Middle 4 Fourth 5 Richest Imputed date of birth of woman Imputed date of birth of woman Imputed date of birth of woman Imputed date of birth of woman Imputed date of birth of woman Recoded Variable Women age 15-49 Flag for date of birth of woman Flag for date of birth of woman Flag for date of birth of woman Flag for date of birth of woman Flag for date of birth of woman Recoded Variable Women age 15-49 Imputed age of woman Imputed age of woman Imputed age of woman Imputed age of woman Imputed age of woman Recoded Variable Women age 15-49 Imputed date of marriage of woman Imputed date of marriage of woman Imputed date of marriage of woman Imputed date of marriage of woman Imputed date of marriage of woman Recoded Variable Women age 15-49 Flag for date of marriage Flag for date of marriage Flag for date of marriage Flag for date of marriage Flag for date of marriage Recoded Variable Women age 15-49 Imputed age at marriage Imputed age at marriage Imputed age at marriage Imputed age at marriage Imputed age at marriage Recoded Variable Women age 15-49 Imputed date of birth of child Imputed date of birth of child Imputed date of birth of child Imputed date of birth of child Imputed date of birth of child Recoded Variable Women age 15-49 Flag for date of birth of child Flag for date of birth of child Flag for date of birth of child Flag for date of birth of child Flag for date of birth of child Recoded Variable Women age 15-49 Imputed survival status Imputed survival status Imputed survival status Imputed survival status Imputed survival status Recoded Variable Women age 15-49 1 Alive 2 Dead Imputed age at death of child Imputed age at death of child Imputed age at death of child Imputed age at death of child Imputed age at death of child Recoded Variable Women age 15-49 Flag for age at death of child Flag for age at death of child Flag for age at death of child Flag for age at death of child Flag for age at death of child Recoded Variable Women age 15-49