MICS questionnaire for children under five

MICS5, Bangladesh 2012-13

Under-five child information panel: UF

This questionnaire is to be administered to all mothers or caretakers (see List of Household Members, column HL9) who care for a child that lives with them and is under the age of 5 years (see List of Household Members, column HL6).
A separate questionnaire should be used for each eligible child.

UF1. Cluster number: _ _ _

UF2. Household number: _ _

UF3. Child's name: Name ____

UF4. Child's line number _ _

UF5. Mother's/caretaker's name:

Name ____

UF6. Mother's/caretaker's line number: _ _

UF7. Interviewer's name and number:

Name ____ _ _

UF8. Day/month/year of interview

_ _ / _ _ / 201 _

Repeat greeting if not already read to this respondent:
We are from Bangladesh Bureau of Statistics. We are working on a project concerned with family health and education. I would like to talk to you about (child's name from UF3)'s health and well-being. The interview will take about 30 minutes. All the information we obtain will remain strictly confidential and your answer will never be shared with anyone other than our project team.

If greeting at the beginning of the household questionnaire has already been read to this person, then read the following:
Now I would like to talk to you more about (child's name) health and other topics. This interview will take about 30 minutes. Again, all the information we obtain will remain strictly confidential and your answer will never be shared with anyone other than our project team.

May I start now?

[] Yes, permission is given (Go to UF12 to record the time and then begin the interview.)
[] No, permission is not given (Circle '03' in UF9. Discuss this result with your supervisor)

UF9. Result of interview for children under 5
Codes refer to mother/caretaker.

[] 01 Completed
[] 02 Not at home
[] 03 Refused
[] 04 Partly completed
[] 05 Incapacitated
[] 96 Other (specify) ____

UF10. Field editor's name and number: Name ____ _ _

UF11. Data entry clerk's name and number: Name ____ _ _

UF11A. Data entry clerk (Second) name and number:

Hour and minutes _ _ : _ _

UF12. Record the starting time of interview.

Age: AG

AG1. Now I would like to ask you some questions about the development and health of (name).
On what day, 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. Month and year must be recorded.

Date of birth
_ _ Day
[] 98 DK day
_ _ Month
20 _ _ Year

AG2. How old is (name)?
Probe: How old was (name) at his / her last birthday? Record age in completed years. Record '0' if less than 1 year. Compare and correct AG1 and/or AG2 if inconsistent.

Age (in completed years) _

Birth Registration: BR

BR1. Does (name) have a birth certificate?
If yes, ask: may I see it?

[] 1 Yes, seen (Go to next module)
[] 2 Yes, not seen (Go to next module)
[] 3 No
[] 8 DK

BR2. Has (name)'s birth been registered with the civil authorities?

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

BR3. Do you know how to register (name)'s birth?

[] 1 Yes
[] 2 No

Early childhood development: EC

EC1. How many children's books or picture books do you have for (name)?

[] 00 None
[] 0 Number of children's books _
[] 10 Ten or more books

EC2. I am interested in learning about the things that (name) plays with when he/she is at home.
Does he/she play with:
If the respondent says "yes" to the categories above, then probe to learn specifically what the child plays with to ascertain the response.

[A] Homemade toys (such as dolls, cars, or other toys made at home)?

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

[B] Toys from a shop or manufactured toys?

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

[C] Household objects (such as bowls or pots) or objects found outside (such as sticks, rocks, animal shells or leaves)?
If the respondent says "YES" to the categories above, then probe to learn specifically what the child plays with to ascertain the response

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

EC3. Sometimes adults taking care of children have to leave the house to go shopping, wash clothes, or for other reasons and have to leave young children.
On how many days in the past week was (name):
If 'none' enter '0'. If 'don't know' enter '8'.

[A] Left alone for more than an hour?

_ Number of days left alone for more than an hour

[B] Left in the care of another child, that is, someone less than 10 years old, for more than an hour?

_ Number of days left with other child for more than an hour

EC4. Check AG2: Age of child.

[] Child age 0, 1 or 2 (Go to next module)
[] Child age 3 or 4 (Continue with EC5)

EC5. Does (name) attend any organized learning or early childhood education programme, such as a private or government facility, including kindergarten or community child care?

[] 1 Yes
[] 2 No (Go to EC7)
[] 8 DK(Go to EC 7)

EC7. In the past 3 days, did you or any household member age 15 or over engage in any of the following activities with (name):
If yes, ask: Who engaged in this activity with (name)?
Circle all that apply.

[A] Read books to or looked at picture books with (name)?