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Man's information panel

MWM1. Cluster number _ _ _

MWM2. Household Number _ _

MWM3. Man's name and line number: ____ _ _

MWM4. Supervisor's name and line number: ____ _ _ _

MWM5. Interviewer's name and number: ____ _ _ _

MWM6. Day/Month/Year of interview _ _ /_ _ /201_

Check man's age in HL6 in List of Household Members, Household Questionnaire: If age 15-17, verify in HH39 that adult consent for interview is obtained or not necessary (HL20=90). If consent is needed and not obtained, the interview must not commence and 06 should be recorded in MWM17.

MWM7. Record the time: hours and minutes _ _:_ _

MWM8. Check completed questionnaires in this household: Have you or another member of your team interviewed this respondent for another questionnaire?
MWM9A. Hello, my name is your name. We are from [National Statistical Office]. We are conducting a survey about the situation of children, families and households. I would like to talk to you about your health and other topics. This interview usually takes about [number minutes]. We are also interviewing mothers about their children. 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?

MWM9B. Now I would like to talk to you about your health and other topics in more detail. This interview will take about number 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?

MWM17. Result of man's interview
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Man's background: MWB

MWB1. Check the respondent's line number (MWM3) in man's information panel and the respondent to the household questionnaire (HH47):
MWB2. Check ED5 in education module in the household questionnaire for this respondent: highest level of school attended:
MWB3. In what month and year were you born?

MWB4. How old are you?
Probe: How old were you at your last birthday? If responses to MWB3 and MWB4 are inconsistent, probe further and correct. Age must be recorded.
MWB5. Have you ever attended school or any early childhood education programme?

MWB6. What is the highest level of school you attended?

MWB7. Did you complete that (grade/year)?

MWB8. Check MWB4: Age of respondent:
MWB9. At any time during the current school year did you attend school?

MWB10. During this current school year, which level and grade or year are you attending?

MWB11. At any time during the previous school year did you attend school?

MWB12. During that previous school year, which level and grade or year did you attend?

MWB13. Check MWB6: Highest level of school attended:
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MWB14. Now I would like you to read this sentence to me. Show sentence on the card to the respondent. If respondent cannot read whole sentence, probe : Can you read part of the sentence to me?

MWB15. How long have you been continuously living in (name of current city, town or village of residence) ?
If less than one year, record 00 years.
MWB16. Just before you moved here, did you live in a city, in a town, or in a rural area?
Probe to identify the type of place. If unable to determine whether the place is a city, a town or a rural area, write the name of the place and then temporarily record '9' until you learn the appropriate category for the response.
MWB17. Before you moved here, in which region did you live in?

MWB18. Are you covered by any health insurance?

MWB19. What type of health insurance are you covered by?
Record all mentioned.
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Mass media and ICT: MMT

MMT1. Do you read a newspaper or magazine: Almost every day, at least once a week, less than once a week or not at all?
If 'at least once a week', probe: Would you say this happens almost every day? If 'Yes' record 3, if 'No' record 2.
MMT2. Do you listen to the radio almost every day, at least once a week, less than once a week or not at all If 'at least once a week', probe: Would you say this happens almost every day? If 'Yes' record 3, if 'No' record 2.
MMT3. How often do you watch television: Would you say that you watch almost every day, at least once a week, less than once a week or not at all? If 'at least once a week', probe: Would you say this happens almost every day? If 'Yes' record 3, if 'No' record 2.
MT4. Have you ever used a computer or a tablet from any location?

MMT5. During the last 3 months, did you use a computer or a tablet at least once a week, less than once a week or not at all?
If 'at least once a week', probe: Would you say this happens almost every day? If 'Yes' record 3, if 'No' record 2.
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MMT6. During the last 3 months, did you:










MMT7. Check MMT6[C]: is 'Yes' recorded?
MMT8. Check MMT6[F]: is 'Yes' recorded?
MMT9. Have you ever used the internet from any location and any device?

MMT10. During the last 3 months, did you use the internet at least once a week, less than once a week or not at all?
If 'at least once a week', probe: Would you say this happens almost every day? If 'Yes' record 3, if 'No' record 2.
MMT11. Do you own a mobile phone?

MMT12. During the last 3 months, did you use a mobile telephone at least once a week, less than once a week or not at all?
Probe if necessary: I mean have you communicated with someone using a mobile phone. If 'at least once a week', probe: Would you say this happens almost every day? If 'Yes' record 3, if 'No' record 2.
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Fertility: MCM

MCM1. Now I would like to ask about all the children you have had in your life. I am interested in all of the children that are biologically yours, even if they are not legally yours or do not have your last name. Have you ever fathered any children with any woman?
This module should only include children born alive. Any stillbirths should not be included in response to any question.
MCM2. Do you have any sons or daughters that you have fathered who are now living with you?

MCM3. How many sons live with you?
If none, record '00'.
MCM4. How many daughters live with you?
If none, record '00'.
MCM5. Do you have any sons or daughters that you have fathered who are alive but do not live with you?

MCM6. How many sons are alive but do not live with you?
If none, record '00'.
MCM7.How many daughters are alive but do not live with you?
If none, record '00'.
MCM8. Have you ever fathered a son or daughter who was born alive but later died?
If 'No' probe by asking: I mean, to any baby who cried, who made any movement, sound, or effort to breathe, or who showed any other signs of life even if for a very short time?

MCM9. How many boys have died? If none, record '00'.
MCM10. How many girls have died? If none, record '00'.

MCM11. Sum answers to MCM3, MCM4, MCM6, MCM7, MCM9 and MCM10.
MCM12: Just to make sure that I have this right, you have fathered in total (total number in MCM11) live births during your life. Is this correct?

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MCM13. Check responses to MCM1-MCM10 and make corrections as necessary until response in MCM12 is 'Yes'.

MCM14. Check MCM11: How many live births fathered?
MCM15. Did all the children you have fathered have the same biological mother?

MCM16. In all, how many women have you fathered children with?

MCM17. How old were you when your first child was born?

MCM18A. In what month and year was the child you have fathered born?
MCM18B. In what month and year was the last of these (total number in MCM11) children you have fathered born even if he or she has died? Month and year must be recorded.

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Attitudes toward Domestic Violence: MDV

MDV1. 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:

MDV1A. If she goes out without telling him?

MDV1B. If she neglects the children?

MDV1C. If she argues with him?

MDV1D. If she refuses to have sex with him?

MDV1E. If she burns the food?

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Victimization: MVT

MVT1. Check for the presence of others. Before continuing, ensure privacy.
Now I would like to ask you some questions about crimes in which you personally were the victim.
Let me assure you again that your answers are completely confidential and will not be told to anyone.
In the last three years, that is since (month of interview) (year of interview minus 3), has anyone taken or tried taking something from you, by using force or threatening to use force?
Include only incidents in which the respondent was personally the victim and exclude incidents experienced only by other members of the household.
If necessary, help the respondent to establish the recall period and make sure that you allow adequate time for the recall. You may reassure:
It can be difficult to remember this sort of incidents, so please take your time while you think about your answers.

MVT2. Did this last happen during the last 12 months, that is, since (month of interview) (year of interview minus 1)?

MVT3. How many times did this happen in the last 12 months?
If 'DK/ don't remember', probe: Did it happen once, twice, or at least three times?
MVT4. Check MVT3: One or more times?
MVT5A. When this happened, was anything stolen from you?
MVT5B. The last time this happened, was anything stolen from you?

MVT6. Did the person(s) have a weapon?

MVT7. Was a knife, a gun or something else used as a weapon? Record all that apply.
MVT8. Did you or anyone else report the incident to the police?
If 'Yes', probe: Was the incident reported by you or someone else?
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MVT9A. Apart from the incident(s) just covered, have you in the last three years, that is since (month of interview) (year of interview minus 3), been physically attacked?
MVT9B. In the same period of the last three years, that is since (month of interview) (year of interview minus 3), have you been physically attacked?
If 'No', probe: An attack can happen at home or any place outside of the home, such as in other homes, in the street, at school, on public transport, public restaurants, or at your workplace.
Include only incidents in which the respondent was personally the victim and exclude incidents experienced only by other members of the household. Exclude incidents where the intention was to take something from the respondent, which should be recorded under MVT1.
MVT10. Did this last happen during the last 12 months, that is, since (month of interview) (year of interview minus 1)?

MVT11. How many times did this happen in the last 12 months?
If DK/Don't remember, probe: Did it happen once, twice, or at least three times?
MVT12A. Where did this happen?
MVT12B. Where did this happen the last time?

MVT13. How many people were involved in committing the offence?
If DK/Don't remember, probe: Was it one, two, or at least three people?
MVT14A. At the time of the incident, did you recognize the person?
MVT14B. At the time of the incident, did you recognize at least one of the persons?

MVT17. Did the person(s) have a weapon?

MVT18. Was a knife, a gun or something else used as a weapon? Record all that apply.
MVT19. Did you or anyone else report the incident to the police?
If 'Yes', probe: Was the incident reported by you or someone else?
MVT20. How safe do you feel walking alone in your neighborhood after dark?

MVT21. How safe do you feel when you are at home alone after dark?

MVT22. In the past 12 months, have you personally felt discriminated against or harassed on the basis of the following grounds?








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Marriage/Union: MMA

MMA1. Are you currently married or living together with someone as if married?

MMA3. Do you have other wives or do you live with other partners as if married?

MMA4. How many other wives or live-in partners do you have?

MMA5. Have you ever been married or lived together with someone as if married?

MMA6. What is your marital status now: are you widowed, divorced or separated?

MMA7. Have you been married or lived with someone only once or more than once?

MMA8A. In what month and year did you start living with your (wife/partner)?
MMA8B. In what month and year did you start living with your first (wife/partner)?
Date of first marriage

MMA9. Check MMA8A/B: Is 'DK YEAR'' recorded?
MMA10. Check MMA7: In union only once?
MMA11A. How old were you when you first started living with your (wife/partner)?
MMA11B. How old were you when you started living with your first (wife/partner)?

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Adult Functioning: MAF

MAF1. Check MWB4: Age of respondent?
MAF2. Do you use glasses or contact lenses? Include the use of glasses for reading
MAF3. Do you use a hearing aid?

MAF4. I will now ask you about difficulties you may have doing a number of different activities. For each activity there are four possible answers: Please tell me if you have: 1) no difficulty, 2) some difficulty, 3) a lot of difficulty or 4) that you cannot do the activity at all.
Repeat the categories during the individual questions whenever the respondent does not use an answer category:
Remember, the four possible answers are: 1) no difficulty, 2) some difficulty, 3) a lot of difficulty, or 4) that you cannot do the activity at all.

MAF5. Check MAF2: Respondent uses glasses or contact lenses?
MAF6A. When using your glasses or contact lenses, do you have difficulty seeing?
MAF6B. Do you have difficulty seeing?

MAF7. Check MAF3: Respondent uses a hearing aid?
MAF8A. When using your hearing aid(s), do you have difficulty hearing?
MAF8B. Do you have difficulty hearing?

MAF9. Do you have difficulty walking or climbing steps?

MAF10. Do you have difficulty remembering or concentrating?

MAF11. Do you have difficulty with self-care, such as washing all over or dressing?

MAF12. Using your usual language, do you have difficulty communicating, for example understanding or being understood?

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Sexual Behaviour: MSB

MSB1. Check for the presence of others. Before continuing, make every effort to ensure privacy.
Now I would like to ask you some questions about sexual activity in order to gain a better understanding of some important life issues.

Let me assure you again that your answers are completely confidential and will not be told to anyone. If we should come to any question that you don't want to answer, just let me know and we will go to the next question.
How old were you when you had sexual intercourse for the very first time?

MSB2. I would like to ask you about your recent sexual activity. When was the last time you had sexual intercourse? Record answers in days, weeks or months if less than 12 months (one year). If 12 months (one year) or more, answer must be recorded in years.

MSB3. The last time you had sexual intercourse, was a condom used?

MSB4. What was your relationship to this person with whom you last had sexual intercourse? Probe to ensure that the response refers to the relationship at the time of sexual intercourse If Girlfriend, then ask: Were you living together as if married? If 'Yes', record 2. If No, record 3.
MSB5. Check MMA1: Currently married or living with a partner?
MSB6. How old is this person?
If response is 'DK', probe: About how old is this person?
MSB7. Apart from this person, have you had sexual intercourse with any other person in the last 12 months?

MSB8. The last time you had sexual intercourse with another person, was a condom used?

MSB9. What was your relationship to this person?
Probe to ensure that the response refers to the relationship at the time of sexual intercourse. If 'girlfriend' then ask: Were you living together as if married? If 'yes', circle '2'. If 'no', circle '3'.
MSB10. Check MMA1: Currently married or living with a partner?
MSB11. Check MMA7: Married or living with a partner only once?
MSB12. How old is this person?
If response is 'DK', probe: About how old is this person?
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HIV/AIDS: MHA

MHA1. Now I would like to talk with you about something else. Have you ever heard of HIV or AIDS?

MHA2. HIV is the virus that can lead to AIDS. Can people reduce their chance of getting the AIDS virus by having just one uninfected sex partner who has no other sex partners?

MHA3. Can people get the AIDS virus from mosquito bites?

MHA4. Can people reduce their chance of getting the AIDS virus by using a condom every time they have sex?

MHA5. Can people get the AIDS virus by sharing food with a person who has the AIDS virus?

MHA6. Can people get the AIDS virus because of witchcraft or other supernatural means?

MHA7. Is it possible for a healthy-looking person to have HIV?

MHA8. Can the virus that causes AIDS be transmitted from a mother to her baby:




MHA9. Check MHA8[A], [B] and [C]: At least one 'Yes' recorded?
MHA10. Are there any special drugs that a doctor or a nurse can give to a woman infected with HIV to reduce the risk of transmission to the baby?

MHA24. I don't want to know the results, but have you ever been tested for HIV?

MHA25. How many months ago was your most recent HIV test?

MHA26. I don't want to know the results, but did you get the results of the test?

MHA27. Do you know of a place where people can go to get an HIV test?

MHA28. Have you heard of test kits people can use to test themselves for HIV?

MHA29. Have you ever tested yourself for HIV using a self-test kit?

MHA30. Would you buy fresh vegetables from a shopkeeper or vendor if you knew that this person had HIV?

MHA31. Do you think children living with HIV should be allowed to attend school with children who do not have HIV?

MHA32. Do you think people hesitate to take an HIV test because they are afraid of how other people will react if the test result is positive for HIV?

MHA33. Do people talk badly about people living with HIV, or who are thought to be living with HIV?

MHA34. Do people living with HIV, or thought to be living with HIV, lose the respect of other people?

MHA35. Do you agree or disagree with the following statement? I would be ashamed if someone in my family had HIV.

MHA36. Do you fear that you could get HIV if you come into contact with the saliva of a person living with HIV?

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Circumcision: MMC

MMC1. Some men are circumcised, that is, the foreskin is completely removed from the penis. Are you circumcised?

MMC2. How old were you when you got circumcised?

MMC3. Who did the circumcision?

MMC4. Where was it done?

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Tobacco and Alcohol Use: MTA

MTA1. Have you ever tried cigarette smoking, even one or two puffs?

MTA2. How old were you when you smoked a whole cigarette for the first time?

MTA3. Do you currently smoke cigarettes?

MTA4. In the last 24 hours, how many cigarettes did you smoke?

MTA5. During the last one month, on how many days did you smoke cigarettes?
If less than 10 days, record the number of days. If 10 days or more but less than a month, circle '10'. If 'every day' or 'almost every day', circle '30'.
MTA6. Have you ever tried any smoked tobacco products other than cigarettes, such as cigars, water pipe, cigarillos or pipe?

MTA7. During the last one month, did you use any smoked tobacco products?

MTA8. What type of smoked tobacco product did you use or smoke during the last one month? Record all mentioned.

MTA9. During the last one month, on how many days did you use smoked tobacco products?
If less than 10 days, record the number of days. If 10 days or more but less than a month, circle '10'. If 'every day' or 'almost every day', circle '30'.
MTA10. Have you ever tried any form of smokeless tobacco products, such as chewing tobacco, snuff, or dip?

MTA11. During the last one month, did you use any smokeless tobacco products?

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MTA12: What type of smokeless tobacco product did you use during the last one month? Record all mentioned.

MTA13. During the last one month, on how many days did you [ name of products mentioned in MTA12] ?
If less than 10 days, record the number of days. If 10 days or more but less than a month, circle '10'. If 'every day' or 'almost every day', circle '30'.
MTA14: Now I would like to ask you some questions about drinking alcohol. Have you ever drunk alcohol?

MTA15. We count one drink of alcohol as one can or bottle of beer, one glass of wine, or one shot of cognac, vodka, whiskey or rum. How old were you when you had your first drink of alcohol, other than a few sips?

MTA16. During the last one month, on how many days did you have at least one drink of alcohol?
If respondent did not drink, circle '00'. If less than 10 days, record the number of days. If 10 days or more but less than a month, circle '10'. If 'every day' or 'almost every day', circle "30".
MTA17. In the last one month, on the days that you drank alcohol, how many drinks did you usually have per day?

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Life Satisfaction: MLS

MLS1. I would like to ask you some simple questions on happiness and satisfaction. First, taking all things together, would you say you are very happy, somewhat happy, neither happy nor unhappy, somewhat unhappy or very unhappy? You can also look at these pictures to help you with your response.
Show side 1 of response card and explain what each symbol represents. Record the response code selected by the respondent. [Image omitted].
MLS2. Show the picture of the ladder.
Now, look at this ladder with steps numbered from 0 at the bottom to 10 at the top. [Image omitted]
Suppose we say that the top of the ladder represents the best possible life for you and the bottom of the ladder represents the worst possible life for you.
On which step of the ladder do you feel you stand at this time?
Probe if necessary: Which step comes closest to the way you feel?
MLS3. Compared to this time last year, would you say that your life has improved, stayed more or less the same, or worsened, overall?

MLS4. And in one year from now, do you expect that your life will be better, will be more or less the same, or will be worse, overall?

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MWM10: Record the time.
MWM11. Was the entire interview completed in private or was there anyone else during the entire interview or part of it?
MWM12. Language of the questionnaire.
MWM13. Language of the interview
MWM14. Native language of the respondent.
MWM15. Was a translator used for any parts of this questionnaire
MWM16. Check columns HL10 and HL20 in List of Household Members, Household Questionnaire: Is the respondent the caretaker of any child age 0-4 living in this household?