Montenegro, 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 the Statistical Office of Montenegro - MONISTAT. In cooperation with UNICEF 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. This interview will take about 20 minutes. 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. This interview will take about 20 minutes. 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 school year?
UB6. Has (name) ever attended any early childhood and preschool education programme, such as day nursery or kindergarten?

UB7. At any time since September 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 and preschool education programme this school year. Does (he/she) currently attend this programme?

Birth registration: BR

BR0A. Check UF1: Is this cluster selected for the Roma Settlement Survey (cluster numbers ranging from 301 to 333)?
BR0B. Before I continue, could you please bring (name)?s Birth Certificate, passport, or health card? We will need to refer to those documents.

BR1. Does (name) have a birth certificate?

BR1A. Does (name) have a passport or health card?

BR2. Has (name)'s birth been registered in the Birth Register?

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

BR4. What is the reason for non-registation of (name)?s birth?

Early childhood development: EC

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

EC2. I am interested in learning about the things that (name) plays with when (he/she) is at home.
Does (he/she) play with:

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

[B] Toys from a shop or manufactured toys?

[C] Household objects, such as bowls or pots, or objects found outside, such as sticks, rocks, animal shells or leaves?

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):
[A] 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?
If 'None' record '0'. If 'Don't know' record '8'.

EC4. Check UB2: Child's age?
EC5. In the past 3 days, did you or any household member age 15 or over engage in any of the following activities with (name):

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

[B] Told stories to (name)?

[C] Sang songs to or with (name), including lullabies?

[D] Took (name) outside the home?

[E] Played with (name)?

[F] Named, counted, or drew things for or with (name)?

EC5G. Check UB2: Child's age?
I would like to ask you some questions about the health and development of (name). Children do not all develop and learn at the same rate. For example, some walk earlier than others. These questions are related to several aspects of (name)'s development.

EC6. Can (name) identify or name at least ten letters of the alphabet?

EC7. Can (name) read at least four simple, popular words?

EC8. Does (name) know the name and recognize the symbol of all numbers from 1 to 10?

EC9. Can (name) pick up a small object with two fingers, like a stick or a rock from the ground?

EC10. Is (name) sometimes too sick to play?

EC11. Does (name) follow simple directions on how to do something correctly?

EC12. When given something to do, is (name) able to do it independently?

EC13. Does (name) get along well with other children?

EC14. Does (name) kick, bite, or hit other children or adults?

EC15. Does (name) get distracted easily?

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?
UCD4. Check UF4: Has this respondent already responded to the following question (UCD5 or FCD5) for another child?
UCD5. Do you believe that in order to bring up, raise, or educate a child properly, the child needs to be physically punished?

Child functioning: UCF

UCF1. Check UB2: Child's age?
UCF2. I would like to ask you some questions about difficulties (name) may have.
Does (name) wear glasses?

UCF3. Does (name) use a hearing aid?

UCF4. Does (name) use any equipment or receive assistance for walking?

UCF5. 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.

UCF6. Check UCF2: Child wears glasses?
UCF7A. When wearing (his/her) glasses, does (name) have difficulty seeing?
UCF7B. Does (name) have difficulty seeing?

UCF8. Check UCF3: Child uses a hearing aid?
UCF9A. When using (his/her) hearing aid(s), does (name) have difficulty hearing sounds like peoples' voices or music?
UCF9B. Does (name) have difficulty hearing sounds like peoples' voices or music?

UCF10. Check UCF4: Child uses equipment or receives assistance for walking?
UCF11. Without (his/her) equipment or assistance, does (name) have difficulty walking?

UCF12. With (his/her) equipment or assistance, does (name) have difficulty walking?

UCF13. Compared with children of the same age, does (name) have difficulty walking?

UCF14. Compared with children of the same age, does (name) have difficulty picking up small objects with (his/her) hand?

UCF15. Does (name) have difficulty understanding you?

UCF16. When (name) speaks, do you have difficulty understanding (him/her)?

UCF17. Compared with children of the same age, does (name) have difficulty learning things?

UCF18. Compared with children of the same age, does (name) have difficulty playing?

UCF19. The next question has five different options for answers. I am going to read these to you after the question.
Compared with children of the same age, how much does (name) kick, bite or hit other children or adults?
Would you say: not at all, less, the same, more or a lot more?

Breastfeeding and dietary intake: BD

BD1. Check UB2: Child's age?
BD2. Has (name) ever been breastfed?

BD3. Is (name) still being breastfed?

BD3A. Check UB2: Child's age?
BD4. Yesterday, during the day or night, did (name) drink anything from a bottle with a nipple?

BD5. Did (name) drink Oral Rehydration Salt solution such as Orosal or Nelit yesterday, during the day or night?

BD6. Did (name) drink or eat vitamin or mineral supplements or any medicines yesterday, during the day or night?

BD7. Now I would like to ask you about all other liquids that (name) may have had yesterday during the day or the night.
Please include liquids consumed outside of your home.
Did (name) drink (name of item) yesterday during the day or the night:

[A] Plain water?

[B] Juice or juice drinks?

[C] Clear soup?

[D] Infant formula, such as Humana, Bebelac, or Aptamil?

[D1] How many times did (name) drink infant formula?

[E] Milk from animals, such as fresh, tinned, or powdered milk?

[E1] How many times did (name) drink milk?

[X] Any other liquids?

[X1] Record all other liquids mentioned.

BD8. Now I would like to ask you about everything that (name) ate yesterday during the day or the night. Please include foods consumed outside of your home.
Think about when (name) woke up yesterday. Did (he/she) eat anything at that time?
If 'Yes' ask: Please tell me everything (name) ate at that time. Probe: Anything else?
Record answers using the food groups below.
What did (name) do after that? Did (he/she) eat anything at that time?
Repeat this string of questions, recording in the food groups, until the respondent tells you that the child went to sleep until the next morning. For each food group not mentioned after completing the above ask: Just to make sure, did (name) eat (food group items) yesterday during the day or the night.

[A] Yogurt made from animal milk?

[A1] How many times did (name) eat yogurt?

[B] Any baby food, such as Hipp, Frutek or Juvitana?

[C] Bread, rice, pasta, semolina/polenta, or other foods made from grains?

[D] Pumpkin, carrots, squash, or sweet potatoes that are yellow or orange inside?

[E] Potatoes, or any other foods made from roots which are white inside?

[F] Any dark green, leafy vegetables, such as spinach or Swiss chard?

[G] Apricots, sour cherries or ripe melons?

[H] Any other fruits or vegetables?

[I] Liver, kidney, heart or other organ meats?

[J] Any other meat, such as beef, pork, lamb, goat, chicken, duck?

[K] Eggs?

[L] Fish or shellfish, either fresh or dried?

[M] Beans, peas, lentils or nuts, including any foods made from these?

[N] Cheese or other food made from animal milk?

[X] Other solid, semi-solid, or soft food?

[X1] Record all other solid, semi-solid, or soft food that do not fit food groups above.

BD9. How many times did (name) eat any solid, semi-solid or soft foods yesterday during the day or night?

Immunisation Hesitancy: IH

IH1. Now I would like to talk to you about vaccination of (name).
Have you ever delayed (name)?s vaccination for any of the following reasons?

[A] (Name) could not receive the vaccine(s) because (he/she) was ill at the time of vaccination ro has an allergy to the vaccine or its components

[B] (Name) has not received the vaccine(s) because they were not available at the time when (he/she) had to receive them according to the vaccination schedule.

[C] I was occupied with other tasks.

[D] I have some doubts about the vaccine(s) and decided that (name) should not receive it/them because of this.

[E] (Name) has not yet received a vaccine(s) for other reasons not already mentioned.

IH2. Have you ever decided not to vaccinate, or refused to vaccinate (name) for any of the following reasons?

[A] (Name) could not receive the vaccine(s) because (he/she) was ill at the time of vaccination ro has an allergy to the vaccine or its components

[B] (Name) has not received the vaccine(s) because they were not available at the time when (he/she) had to receive them according to the vaccination schedule.

[D] I have some doubts about the vaccine(s) and decided that (name) should not receive it/them because of this.

[E] (Name) has not yet received a vaccine(s) for other reasons not already mentioned.

IH3. In your opinion, is the proposed vaccination calendar (age or schedule of administering vaccines) best for (name)?
Show a card with the vaccination calendar/ recommended vaccination schedule.
IH4. Does (name) have a selected pediatrician?

IH5. In your opinion, can (name)?s selected paediatrician provide you with all the necessary information on vaccinations?

IH6. Do you believe in the information on vaccines that you receive from (name)?s selected paediatrician?

IH7. In your opinion, can you openly discuss with (name)?s chosen paediatrician about (his/her) vaccination?

IH8. In your opinion, taking all things together, with regards to vaccination how would you evaluate the trust that you have in (name)?s selected paediatrician?
Taking all things together, would you say that you have: 1) full trust, 2) trust, 3) no opinion, 4) no trust, or 5) have absolutely no trust in (name)?s selected paediatrician?

IH9. Has (name) ever been examined by a paediatrician who was not his/her selected paediatrician before the vaccination?

IH10. In your opinion, did the paediatrician who was not the selected and who examined (name) when he/she was supposed to be vaccinated provide you with all the necessary information about vaccinations?

IH11. Do you believe in the information on vaccines that you receive from the paediatrician who last examined (name) when (he/she) was supposed to be vaccinated?

IH12. In your opinion, can you openly discuss (name)?s vaccination with the paediatrician who was not the selected paediatrician and who examined (him/her) when (he/she) was supposed to be vaccinated?

IH13. In your opinion, taking all things together, with regards to vaccination how would you evaluate the trust that you have in? paediatrician who was not the selected paediatrician and who examined (name) when (he/she) was going to be vaccinated?
Taking all things together, would you say that you have: 1) full trust, 2) trust, 3) no opinion, 4) no trust, or 5) have absolutely no trust in the paediatrician who was not the selected paediatrician and who examined (name) when (he/she) was supposed to be vaccinated?

IH14. Some vaccines are not included in the current vaccination calendar, namely, the recommended vaccination schedule of Montenegro, while in some countries they have been given to children for many years.
Would you accept if a paediatrician suggested to you that (name) should receive one of the following vaccines:

[A] Against diarrhea caused by the rotavirus?

[B] Against the pneumococcus bacteria that causes pneumonia, sepsis or middle ear infection?

[C] Against the human papilloma virus that causes cancer of the reproductive/sexual organs?

IH15. Did (name) have a serious adverse reaction after being vaccinated for which (name) was treated in hospital?
A serious adverse reaction is a reaction that required hospital treatment or hospitalization of a child.
IH16. Do you personally know someone whose child had a serious adverse reaction after being vaccinated for which they had to be treated in hospital?

UF11. Record the time.
UF12. Language of the Questionnaire.
UF13. Language of the Interview.
UF14. Native language of the Respondent.
UF15. Was a translator used for any parts of this questionnaire?
UF16. Tell the respondent that you will need to measure the weight and height of the child before you leave the household and a colleague will come to lead the measurement. Issue the anthropometry module form for this child and complete the Information Panel on that Form.
Check columns HL10 and HL20 in list of household members, household questionnaire: Is the respondent the mother or caretaker of another child age 0-4 living in this household?
Interviewer's observations ________

Supervisor's observations ________

Anthropometry module information panel: AN

AN1. Cluster number: _ _ _

AN2. Household number _ _

AN3. Child's name and line number:
AN4. Child's age from UB2:
AN5. Mother's/caretaker's name and line number:
AN6. Interviewer's name and number
Anthropometry

AN7. Measurer's name and number:
AN8. Record the result of weight measurement as read out by the Measurer:
Read the record back to the Measurer and also ensure that he/she verifies your record.
AN9. Was the child undressed to the minimum?
AN10. Check AN4: Child's age?
AN11A. The child is less than 2 years old and should be measured lying down. Record the result of length measurement as read out by the Measurer:
Read the record back to the Measurer and also ensure that he/she verifies your record.
AN11B. The child is at least 2 years old and should be measured standing up. Record the result of height measurement as read out by the Measurer:
Read the record back to the Measurer and also ensure that he/she verifies your record.
AN12. How was the child actually measured? Lying down or standing up?
AN13. Today's date: Day/month/year:
AN14. Is there another child under age 5 in the household who has not yet been measured?

AN15. Thank the respondent for his/her cooperation and inform your supervisor that the measurer and you have completed all the measurements in this household.

Interviewer's observations for anthropometry module ________

Measurer's observations for anthropometry module ________

Supervisor's observations for anthropometry module ________