Women's Information: WM

This module should be completed for each woman aged 15 ? 49 years (see column HL6 of the Household Listing). Complete separate Questionnaire for each eligible woman.
Write down cluster number, household number, name and line number of woman in correspondent cell. Write down your name, number and date of interview

WM1. Cluster number _ _ _

WM2. Household number _ _ _

WM3. Name woman ____

WM4. Line number of woman _ _

WM5. Name and number of interviewer ____ _ _


WM6. Interview day/month/year _ _ / _ _ / _ _ _ _

WM7. Outcome of interview with woman:
Repeat welcoming if not read for woman earlier:
We are from the Statistic Agency of the Republic of Kazakhstan. We work within the family health and education project. I want to discuss this with you. All received information is strictly confidential; no one will learn below answers are yours. Shall I start?

If agreed start interview. If woman disagrees with interview, thank her, finish with WM7, and go to the next interview. Discuss the result with your supervisor for further additional visit to household for interviewing the woman.

WM8. What month were you born?

WM9. How old were you at your previous birthday?

WM10. Have you ever studied in any educational institution?

WM11. What highest level did you attend: primary, secondary, specialized secondary or higher?

WM12. What highest grade/course have you completed at this level?

Child Mortality Module: CM

This module should be completed for each woman aged 15-49 years. All questions should be asked only about live births.

CM1. Now I will ask you about births you gave during your life. Did you ever give birth?
If "no", try to clarify: I mean baby who was breathing, crying or having other signs of life, even though (s)he lived for several minutes or hours?
CM2a. When did you give birth for the first time? I mean the very first birth, even if the baby died later or was born to a man who does not live with you anymore.
Go to CM3 only if the year of first birth is specified. Otherwise, continue with CM2B.
CM2B. How many years ago did you give birth first time?

CM3. Do any of your own sons or daughters reside with you currently?

CM4. How many of your own sons reside with you? How many of your own daughters reside with you?

CM5. Are there any of your living sons and daughter who do not reside with you?

CM6. How many of your living sons do not reside with you? How many of your living daughters do not reside with you?

CM7. Have you ever given birth to a live boy or girl who died later?

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

CM9. Sum up answers for CM4, CM6, and CM8
CM10 To check my notes, during your life you gave birth (total number) of times. Is it true?

CM11. When did you give last birth out of (total number) births (even if this baby died later)?
If day is unknown, enter '98' for the date.
CM12. Check CM11: Did you give last birth during past 2 years, namely from (____) ____ 2004 and later?
If the child died, pay special attention to the questions about this child in the next module.
CM13. When you become pregnant with (name), was it wanted pregnancy, you wanted it come later or you wanted no (more) children?

Maternal and newborn health module: MN

This module should be completed for each woman who gave live birth during two years preceding the interview.
Check the Child Mortality Module CM12 and write down the name of the last child ____
Use the name of this child in the following questions.

MN2. Did you seek antenatal care during this pregnancy?
If yes: Who provided antenatal care to you? Any other staff? Ask additional questions to clarify personnel providing antenatal care and circle all mentioned persons.
MN2A. How many times did you seek antenatal care during this pregnancy?

MN3. As a part of your antenatal care, have you received one of the following specific care, at least, once?

MN3A. Weight measured?

MN3B. Blood pressure measured?

MN3C. Urine tested?

MN3D. Blood tested?

MN4. During antenatal visits, did anybody speak with about AIDS and HIV?

MN5. I do not want to know the results, but were you tested for AIDS as a part of antenatal care?

MN6. I do not want to know the results, but did you get the results of the test?

MN7. Who assisted you during delivery of your last child (name)? Anybody else?
Ask additional questions to clarify the person assisted during delivery and circle all mentioned persons.

MN8. Where did you give birth to (name)?
If the source is hospital, health center, or clinic, write down the name of institution on below line. Ask type of institution and circle correspondent code.
(Name of institution) ____

MN9. When you gave birth to your last baby (name), was he large, more than average, average, below average or very little?

MN10. Was (name) weighed immediately after birth?

MN11. What was (name) weight?
Copy weight from child development card if available
MN12. Have you ever breastfed (name)?

MN13. How much time after birth you breastfed (name) for the first time?
If less than 1 hour, write down '00' hours. If less than 24 hours, write down number of hours. If other write down days.
MN14. Do you smoke?

MN14A. Were you smoking during the pregnancy?

MN15. How many times did you smoke during last 24 hour?

MN16. Have you ever consumed alcohol beverages?

MN17. Have you ever become drunk when consuming alcohol beverages?

MN18. How many days have you consumed alcohol beverages during last 3 months?

MN19. How many times were you drunk during last 3 months?

Marriage/union module: MA

MA.1 Are you currently married/in union?

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

MA3. Have you ever been married/in union?

MA4. What is your marital status at present: widow, divorced, or separated?

MA5. Have you been married/in union only once or more than once?

MA6. What month and year you married or started living in union first time?

MA7. Check MA6:
MA8. At what age have you started living with your first husband/partner?

Reproductive behavior: RP

RP1. I want to discuss your reproductive behavior.
If you have choice, how many children would you have during your life?

RP2. Your decision to have no children or restrict their number would depend on:

RP3. Your decision to have (more) children would depend on:

RP4. What is preferable birth interval before you would have (another) baby?

Contraception module: CP

CP1. I want to change subject. I want to discuss with you family planning and your reproductive health. Are you pregnant now?

CP2. Some people use different methods to delay or avoid pregnancy. Are you doing anything or do you use any method to delay or avoid pregnancy?

CP3. What method do you use?
Do not suggest answers to respondent. If several methods are mentioned, circle each.
Attitudes toward domestic violence

DV1. Sometimes husband is angry with his wife. Do you believe he can hit his wife in the following situations:

DV1A. When she goes out without telling him?

DV1B. When she neglects the children?

DV1C. When she argues with him?

DV1D. When she refuses sex with him?

DV1E. When she burns the food?

Tuberculosis: HT

HT1. Have you ever heard about tuberculosis?

HT2. Do you know about full recovery after tuberculosis if proper treatments received?

HT3. Have you or any member of your family ever had tuberculosis?

HT4. In addition to your family members do you often communicate to anybody (neighbors, colleagues or close friends) suffering from tuberculosis?

HT5. What symptoms help to identify tuberculosis?

HT6. Which TB symptoms require seeing a doctor?

HT7. What treatment should have the person with TB diagnosed first time?

HT8. How is TB transmitted between people?

HT9. Where would you take your child with suspected TB?

HT10. Would you take care of your family member, who, let us assume, had TB treatment in the hospital, during further treatment at home?

HIV/AIDS module: HA

HA1. Let us discuss different stuff. Have you ever heard of Human Immunodeficiency Virus or the disease called AIDS?

HA2. Can you prevent this disease if you have only one uninfected sex partner, who has no other partners?

HA3. Do you believe that AIDS can be transmitted by supernatural means?

HA4. Can you prevent AIDS by properly using condoms at each intercourse?

HA5. Can AIDS be transmitted through mosquito bites?

HA6. Is it possible to protect against AIDS abstaining from sex?

HA7. Can person get AIDS through sharing food with AIDS-infected person?

HA7A. Can person get AIDS through needle used by somebody else?

HA8. Can a healthy looking person be infected with AIDS?

HA9. Can AIDS be transmitted from mother to child?

HA9A. During pregnancy?

HA9B. During delivery?

HA9C. During breastfeeding?

HA10. Can the teacher infected but not sick with this virus continue working in the school?

HA11. Would you buy fresh vegetables from the seller knowing (s)he is sick or infected with virus?

HA12. Would you keep in a secret if one of your family members would be infected with AIDS?

HA13. Would you take care of your family member at home knowing (s)he is sick with AIDS?

HA14. Check MN5: Was the woman tested for AIDS as a part of antenatal care?
HA15. I do not want to know a result, but have you ever been tested for AIDS?

HA16. I do not want to know a result, but were you informed on the results of your test?

HA17. Did you request test or it was proposed to you and agreed or it was obligatory?

HA18. At present time, are you aware of place where you can get tested for AIDS?
HA18A. If was tested for AIDS virus as a part of antenatal care: Do you know about any place in addition to any place where you can be tested for AIDS?