Iraq 2018

Under-five child information panel: UF

UF1. Cluster number: _ _ _

UF2. Household number: _ _

UF3. Child's name and line number:
UF4. Mother's/caretaker's name and line number:
UF5. Interviewer's name and number:
UF6. Supervisor's name and number:
UF7. Day/month/year of interview
UF8. Record the time:

Check respondent's age in HL6 in list of household members, household questionnaire:
If age 15-17, verify that adult consent for interview is obtained (HH33 or HH39) or not necessary (HL20=90). If consent is needed and not obtained, the interview must not commence and '06' should be recorded in UF17. The respondent must be at least 15 years old.


UF9. Check completed questionnaires in this household: Have you or another member of your team interviewed this respondent for another questionnaire?

UF10A. Hello, my name is (your name). We are from Central Statistical Office (CSO) and Ministry of Health. We are conducting a survey about the situation of children, families and households. I would like to talk to you about (child's name from UF3)'s health and well-being. All the information we obtain will remain strictly confidential and anonymous. If you wish not to answer a question or wish to stop the interview, please let me know. May I start now?
UF10B. Now I would like to talk to you about (child's name from UF3)'s health and well-being in more detail. Again, all the information we obtain will remain strictly confidential and anonymous. If you wish not to answer a question or wish to stop the interview, please let me know. May I start now?

UF17. Result of interview for children under 5
Under-five's background: UB

UB0. Before I begin the interview, could you please bring (name)'s Birth Certificate, National Child Immunisation Record, and any immunisation record from a private health provider? We will need to refer to those documents.

UB1. On what day, month and year was (name) born?

UB2. How old is (name)?

UB3. Check UB2: Child's age?
UB4. Check the respondent's line number (UF4) and the respondent to the household questionnaire (HH47):
UB5. Check ED10 in the education module in the household questionnaire: Is the child attending ECE in the current academic year 2017-18?
UB6. Has (name) ever attended any early childhood education programme, such as child development programme early child development and kindergarten?

UB7. At any time since October 2017, did (he/she) attend (programmes mentioned in UB6)?

UB8A. Does (he/she) currently attend (programmes mentioned in UB6)?
UB8B. You have mentioned that (name) has attended an early childhood education programme this school year. Does (he/she) currently attend this programme?

UB9. Is (name) covered by any health insurance except the public health services?

UB10. What type of health insurance is (name) covered by?

Birth registration: BR

BR1. Does (name) have a birth certificate?

BR2. Has (name)'s birth been registered with the civil registration office for registering births and deaths?

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

Child discipline: UCD

UCD1. Check UB2: Child's age?
UCD2. Adults use certain ways to teach children the right behavior or to address a behavior problem. I will read various methods that are used. Please tell me if you or any other adult in your household has used this method with (name) in the past month.

[A] Took away privileges, forbade something (name) liked or did not allow (him/her) to leave the house.

[B] Explained why (name)'s behavior was wrong.

[C] Shook (him/her).

[D] Shouted, yelled at or screamed at (him/her).

[E] Gave (him/her) something else to do.

[F] Spanked, hit or slapped (him/her) on the bottom with bare hand.

[G] Hit (him/her) on the bottom or elsewhere on the body with something like a belt, hairbrush, stick or other hard object.

[H] Called (him/her) dumb, lazy or another name like that.

[I] Hit or slapped (him/her) on the face, head or ears.

[J] Hit or slapped (him/her) on the hand, arm, or leg.

[K] Beat (him/her) up, that is hit (him/her) over and over as hard as one could.

UCD3. Check UF4: Is this respondent the mother or caretaker of any other children under age 5 or a child age 5-14 selected for the questionnaire for children age 5-17?
Child functioning: FCF

FCF2. I would like to ask you some questions about difficulties (name) may have.
Does (name) wear glasses or contact lenses (medical)?

FCF2. Does (name) use a hearing aid?

FCF3. Does (name) use any equipment or receive assistance for walking?

FCF4. In the following questions, I will ask you to answer by selecting one of four possible answers. For each question, would you say that (name) has: 1) no difficulty, 2) some difficulty, 3) a lot of difficulty, or 4) that (he/she) cannot at all.

FCF5. Check FCF1: Child wears glasses or contact lenses (medical)?
FCF6A. When wearing (his/her) glasses or contact lenses (medical), does (name) have difficulty seeing?
FCF6B. Does (name) have difficulty seeing?

FCF7. Check FCF2: Child uses a hearing aid?
FCF8A. When using (his/her) hearing aid(s), does (name) have difficulty hearing sounds like peoples' voices or music?
FCF8B. Does (name) have difficulty hearing sounds like peoples' voices or music?

FCF9. Check FCF3: Child uses equipment or receives assistance for walking?
FCF10. Without (his/her) equipment or assistance, does (name) have difficulty walking 100 meters/yards on level ground?
Probe: that would be about the length of 1 football field. Note that category ?no difficulty? is not available, as the child uses equipment or receives assistance for walking.
FCF11. With (his/her) equipment or assistance, does (name) have difficulty walking 500 meters/yards on level ground?
Probe: that would be about the length of 5 football fields. Note that category ?no difficulty? is not available, as the child uses equipment or receives assistance for walking.
FCF12. With (his/her) equipment or assistance, does (name) have difficulty walking 100 meters/yards on level ground?
Probe: that would be about the length of 1 football field.
FCF13. With (his/her) equipment or assistance, does (name) have difficulty walking 500 meters/yards on level ground?
Probe: that would be about the length of 5 football fields.
FCF14. Compared with children of the same age, does (name) have difficulty walking 100 meters/yards on level ground?
Probe: that would be about the length of 1 football field.
FCF15. Compared with children of the same age, does (name) have difficulty walking 500 meters/yards on level ground?
Probe: that would be about the length of 5 football fields.
FCF16. Does (name) have difficulty with self-care such as feeding or dressing (himself/herself)?

FCF17. When (name) speaks, does (he/she) have difficulty being understood by people inside of this household?

FCF18. When (name) speaks, does (he/she) have difficulty being understood by people outside of this household?

FCF19. Compared with children of the same age, does (name) have difficulty learning things?

FCF20. Compared with children of the same age, does (name) have difficulty remembering things?

FCF21. Does (name) have difficulty concentrating on an activity that (he/she) enjoys doing?

FCF22. Does (name) have difficulty accepting changes in (his/her) routine?

FCF23. Compared with children of the same age, does (name) have difficulty controlling (his/her) behaviour?

FCF24. Does (name) have difficulty making friends?

FCF25. The next questions have different options for answers. I am going to read these to you after each question. I would like to know how often (name) seems very anxious, nervous or worried. Would you say: daily, weekly, monthly, a few times a year or never?

FCF26. I would also like to know how often (name) seems very sad or depressed. Would you say: daily, weekly, monthly, a few times a year or never?

Parental Involvement: PR

PR1. Check CB3: Child's age?
PR3. Excluding school text books and holy books, how many books do you have for (name) to read at home?

PR4. Check CB7 and ED9 in HH Questionnaire: Did the child attend any school?

PR5. Does (name) ever have homework?

PR6. Does anyone help (name) with homework?

PR7. Does (name)'s school have a school governing body in which parents can participate [such as parent teacher association or school management committee / parents association]?

PR8. In the last 12 months, have you or any other adult from your household attended a meeting called by this school governing body?

PR9. During any of these meetings, was any of the following discussed:

A. A plan for addressing key education issues faced by (name)'s school?

B. School budget or use of funds received by (name)'s school?

PR10. In the last 12 months, have you or any other adult from your household received a school or student report card (mark sheet) for (name)?

PR11. In the last 12 months, have you or any adult from your household gone to (name)'s school for any of the following reasons?

A. A school celebration or a sport event?

B. To discuss (name)'s progress with (his/her) teachers?

PR12. In the last 12 months, has (name)'s school been closed on a school day due to any of the following reasons:

A. Natural disasters, such as flood, cyclone, epidemics or similar?

B. Man-made disasters, such as fire, building collapse, riots or similar?

C. Teacher strike?

X. Other?

PR13. In the last 12 months, was (name) unable to attend class due to (his/her) teacher being absent?

PR14. Check PR12[C] and PR13: Any 'Yes' recorded?

PR15. When (teacher strike / teacher absence) happened did you or any other adult member of your household contact any school officials or school governing body representatives?

FS11. Record the time.
FS12. Language of the Questionnaire.
FS13. Language of the Interview.
FS14. Native language of the Respondent.
FS15. Was a translator used for any parts of this questionnaire?
FS16. Thank the respondent and the child for her/his cooperation. Proceed to complete the result in FS17 in the 5-17 child information panel and then go to the household questionnaire and complete HH56. Make arrangements for the administration of the remaining questionnaire(s) in this household.

Interviewer's observations ________

Supervisor's observations ________