Data Cart

Your data extract

0 variables
0 samples
View Cart


MICS questionnaire for individual women

Women's Information Panel: WM

All the women of the family of 15 - 49 years of age should be
questioned

WMID. Line number [01-12]

WM7. Result of women's interview

[] 1 Completed
[] 2 Not at home
[] 3 Refused
[] 4 Partly Completed
[] 5 Incapacitated
[] 6 Other (specify) ____

WM8. In what month and year were you born?

Birthdate:_ _ / _ _ / _ _ _ _

WM9. How old were you at your last birthday?

Age (in completed years) _ _

WM11. Have you ever attended school?

[] 1 Yes
[] 2 No (Go to WM14)

WM12. Which is the highest level of education that (name) has attended?

LEVEL:
[] 1 Primary
[] 2 Secondary
[] 3 High school
[] 8 DK
The highest finalized grade:
Grade _ _
[] 98 Don?t Know
[] 00 less than 1

WM13. Check WM11:

[] Secondary or higher (Go to next module)
[] Primary or non-standard curriculum (Continue with WM14)

Only for woman with primary education (check the Education module)
WM14. Now I would like you to read this sentence to me.

Show a sentence

[] 1 Cannot read at all
[] 2 Able to read only parts of sentence
[] 3 Able to read whole sentence
[] 5 Blind/mute, visually/speech impaired

Module of child mortality: CM1

All the women of the family from 15-49 years should be questioned
Questions refers only to LIVE births

CM1ID. Line number [01-11]

CM1. Have you ever given birth?

[] 1 Yes
[] 2 No (Go to marriage/union module)

CM2A. What was the date of your first birth? Even if the child is no longer living, or whose father is not your current partner.

Skip to CM3 only if year of first birth is given. Otherwise, continue with CM2B.

Date of first birth

_ _ Day
[] 98 DK day

_ _ Month
[] 98 DK month

_ _ _ _ Year
[] 9998 DK year

CM2B. How many years ago did you have your first birth?

Completed years since first birth _ _

CM3. Do you have any sons or daughters to whom you have given birth who are now living with you?

[] 1 Yes
[] 2 No (Go to CM5)

CM4 How many sons live with you? How many daughters live with you?

_ _ Sons at home
_ _ Daughters at home

CM5 Do you have any sons or daughters whom you have given birth who are alive but do not live with you?

[] 1 Yes
[] 2 No (Go to CM7)

CM6. How many sons are alive but do not live with you? How many daughters are alive but do not live with you?

_ _ Sons elsewhere
_ _ Daughters elsewhere

MODULE OF CHILD MORTALITY: CM2

All the women of the family from 15-49 years should be questioned
Questions refers only to LIVE births

CM2ID. Line number [01-11]

CM7. Have you ever given birth to a boy or girl who was born alive but later died?

[] 1 Yes
[] 2 No (Go to CM9)

CM8. How many boys have died? How many girls have died?

_ _ Boys dead
_ _ Girls dead

CM9. Sum answers to CM4, CM6, and CM8

Children ever born _ _

CM11. When was your last delivery (even if s/he is not living)?
If day is not known, enter '98' in space for day.

Date of last birth:
_ _ Day
[] 98 DK day

_ _ Month
[] 98 DK month

_ _ _ _ Year
[] 9998 DK year

CM12. Has the last delivery of the woman been within the year September 2003- October 2005

[] 1 Yes
[] 2 No(Go to next module)

CM13. At the time you became pregnant with (name), did you want to become pregnant then, did you want to wait until later, or did you want no (more) children at all?

[] 1 Then
[] 2 Later
[] 3 No more

Tetanus Toxoid (TT) module: TT

All the women who gave birth during the period September 2003 - October 2005 should be questioned here

TTID. Line number [01-10]

TT1. 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.

[] 1 Yes (card seen)
[] 2 Yes (card not seen)
[] 3 No
[] 8 DK

TT2. 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)?

[] 1 Yes
[] 2 No (Go to TT5)
[] 8 DK (Go to TT5)

TT3: If yes: how many times did you receive this anti-tetanus injection during your last pregnancy?

_ _ No. of times
(0-1) less than 2 doses(Go to next module)
(2) At least 2 or more(Go to TT5)
[] 98 DK (Go to TT5)

TT5. Did you receive any tetanus toxoid injection at any time before your last pregnancy?

[] 1 Yes
[] 2 No (Go to next module)
[] 8 DK (Go to next module)

TT6. How many times did you receive it?

No. of times _ _

TT7. When did you take your last dose?

_ _ Month
[] 98 DK month

_ _ _ _ Year (Go to next module)
[] 9998 DK year (Go to TT8)

TT8. How many years ago did you receive the last anti-tetanus injection before that last pregnancy?

Years ago _ _

MODULE OF MOTHERS AND NEWBORN (MODMN): MN1

All women having live births two years before the interview (september 2003-october 2005) should be interviewed in this module.

MN1ID. Line number [01-11]

MN1. In the first two months after your last birth [the birth of name], did you receive a vitamin A dose like this?

[] 1 Yes
[] 2 No
[] 8 DK

MN2. Did you see anyone for antenatal care for this pregnancy?

more than one answer is allowed

[] A Doctor
[] B Nurse/midwife
[] C Midwife assistant
[] F Traditional birth attendant
[] H Relative/friend
[] X Other (specify) ____
[] Y No one (Go to MN7)

MN3. As part of your antenatal care, were any of the following done at least once?

MN3A. Were you weighed?

[] 1 Yes
[] 2 No

MN3B. Was your blood pressure measured?

[] 1 Yes
[] 2 No

MN3C. Did you give a urine sample?

[] 1 Yes
[] 2 No

MN3D. Did you give a blood sample?

[] 1 Yes
[] 2 No

MN4. During any of the antenatal visits for the pregnancy, were you given any information or counseled about AIDS?

[] 1 Yes
[] 2 No
[] 8 DK

MN7. Who assisted with the delivery of your last child (name)?

more than one answer is allowed

[] A Doctor
[] B Nurse/midwife
[] C Midwife assistant
[] F Traditional birth attendant
[] H Relative/friend
[] X Other (specify) ____
[] Y No one

MN8. Where did you give birth to (name)?

[] 11 Your home
[] 12 Other home
[] 21 Govt. hospital
[] 22 Govt. clinic/health center
[] 32 Private clinic
[] 96 Other (specify) ____

MN9. When you last child (name) was born, was he/she very large, larger than average, average, smaller than average, or very small?

[] 1 Very large
[] 2 Larger than average
[] 3 Average
[] 4 Smaller than average
[] 5 Very small
[] 8 DK

MODULE OF MOTHERS AND NEWBORN (MODMN): MN2

All women having live births two years before the interview (september 2003-october 2005) should be interviewed in this module.

MN2ID. Line number [01-11]

MN10. Was (name) weighed at birth?

[] 1 Yes
[] 2 No (Go to MN12)
[] 8 DK (Go to MN12)

MN11. How much did (name) weigh?

Kilograms _ . _ _ _
[] 99998 DK

MN11A. Where did you get the weight from?

[] The card
[] From recall

MN12. Did you ever breastfeed (name)

[] 1 Yes
[] 2 No (Go to next module)

MN13. 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.

[] 0 Immediately
[] 1 Hours_ _
[] 2 Days _ _
[] 9 DK

(if DK circle "9" and after write 98)
[] 98 Don't know/remember

Marriage/union module: MA

Women of 15-49 years of age to be asked

MAID. Line number [01-11]

MA1. Are you currently married or living together with a man as if married?

[] 1 Yes, currently married
[] 2 Yes, living with a man
[] 3 No, not in union (Go to MA3)

MA2. How old was your husband/partner on his last birthday?

_ _ Age in years (Go to MA 5)
[] 98 DK (Go to MA 5)

MA3. Have you ever been married or lived together with a man?

[] 1 Yes, formerly married
[] 2 Yes, formerly lived with a man
[] 3 No (Go to next module)

MA5. Have you been married or lived with a man only once or more than once?

[] 1 Only once
[] 2 More than once

MA6. In what month and year did you first marry or start living with a man as if married

_ _ Month
[] 98 DK month(Continue with MA8)

_ _ _ _ Year
[] 9998 DK year(Continue with MA8)

MA8. How old were you when you started living with your first husband/partner?

_ _ Age in years

Contraception module: CP


Women of 15-49 years of age to be asked, only

CPID. Line number [01-09]

CP1. Are you pregnant now?

[] 1 Yes, currently pregnant (Go to next module)
[] 2 No
[] 8 Unsure or DK

CP2. Do you use any method to prevent pregnancy?

[] 1 Yes
[] 2 No (Go to next module)

CP3. Which method are you using?

(more than one answer is allowed).

[] A Female sterilization
[] B Male sterilization
[] C Pill
[] E Injections
[] I Diaphragm
[] K Breastfeeding
[] L Periodic abstinence
[] M Withdrawal
[] X Other (specify) ____

HIV/AIDS module: HA1

Women of 15-49 years of age to be asked, only

HA1ID. Line number [01-11]

HA1. Have you ever heard of the virus HIV or an illness called AIDS?

[] 1 Yes
[] 2 No (Go to next module)

HA2. 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?

[] 1 Yes
[] 2 No
[] 8 DK

HA4. Can people reduce their chance of getting the AIDS virus by using a condom every time they have sex?

[] 1 Yes
[] 2 No
[] 8 DK

HA5. Can people get the AIDS virus from mosquito bites?

[] 1 Yes
[] 2 No
[] 8 DK

HA6. Can people reduce their chance of getting infected with the AIDS virus by not having sex at all?

[] 1 Yes
[] 2 No
[] 8 DK

HA7. Can people get the AIDS virus by sharing food with a person who has AIDS?

[] 1 Yes
[] 2 No
[] 8 DK

HA8. Is it possible for a healthy-looking person to have the AIDS virus?

[] 1 Yes
[] 2 No
[] 8 DK

HIV/AIDS module: HA2

Women of 15-49 years of age to be asked only

HA2ID. Line number [01-11]

HA9. Can the AIDS virus be transmitted from a mother to a baby?

HA9A. During pregnancy?

[] 1 Yes
[] 2 No
[] 8 DK

HA9B. During delivery?

[] 1 Yes
[] 2 No
[] 8 DK

HA9C. By breastfeeding?

[] 1 Yes
[] 2 No
[] 8 DK

HA10. If a female teacher has the AIDS virus but is not sick, should she be allowed to continue teaching in school?

[] 1 Yes
[] 2 No
[] 8 DK

HA11. Would you buy fresh vegetables from a shopkeeper or vendor if you knew that this person had the AIDS virus?

[] 1 Yes
[] 2 No
[] 8 DK

HA12. If a member of your family became infected with the AIDS virus, would you want it to remain a secret?

[] 1 Yes
[] 2 No
[] 8 DK

HA13. 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?

[] 1 Yes
[] 2 No
[] 8 DK

HA15. Have you ever been checked to see if you are HIV or AIDS infected (regardless of the
result)?

[] 1 Yes(Go to next module)
[] 2 No

HA18. Do you know of a place where you can go to get such a test to see if you have the AIDS virus?

[] 1 Yes
[] 2 No

Attitudes toward domestic violence: DV

Women of 15-49 years of age to be asked, only

DV1. 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:

DVID. Line number [01-11]

DV1A. If she goes out with out telling him?

[] 1 Yes
[] 2 No
[] 8 DK

DV1B. If she neglects the children?

[] 1 Yes
[] 2 No
[] 8 DK

DV1C. If she argues with him?

[] 1 Yes
[] 2 No
[] 8 DK

DV1D. If she refuses sex with him?

[] 1 Yes
[] 2 No
[] 8 DK

DV1E. If she burns the food?

[] 1 Yes
[] 2 No
[] 8 DK