[Macedonia]

Woman's information panel: WM

This questionnaire is to be filled for all women aged 15 to 49 (see Household List, column HL7). A separate questionnaire should be used for each woman qualified.

WM1. Cluster number: _ _ _

WM2. Household number: _ _

WM3. Woman's name:
WM4. Woman's line number: _ _

WM5. Interviewer's name and number
WM6. Day/month/year of interviewing: _ _ / _ _ / _ _ _ _

Repeat the introduction if you haven't read it to this woman already:
We are from Ipsos Strategic Puls. We are working on a project related to family health and education. I would like to talk to you about these issues. The interview will last about 30 minutes. All information obtained will remain strictly confidential and your answers will only be analysed as group data by the project team without any direct correlations to your personal data.

If you have already read it to this woman at the beginning from the household questionnaire, then read the following:
We are working on a project related to family health and education. I would like to talk to you about these issues. This interview will last about 30 minutes. All information obtained will remain strictly confidential and your answers will only be analysed as group data by the project team without any direct correlations to your personal data.

Can we start now?

WM7. Result of woman's interview

WM8. Editor in the field (name and number):
WM9. Data entered by (name and number):
WM10. Record the momentary time.
Woman's Background: WB

WB1. In what month and year were you born?

WB2. How old are you?
Probe: How old were you at your last birthday? Compare age with the given date and immediately correct WB1 and/or WB2 if the answers are not consistent.
WB3. Have you ever attended school or preschool?

WB4. What is the highest level of education that you attended?

WB5. What is the highest grade/year you completed at that level?
If less than 1 grade, enter "00"
WB6. Check WB4:
WB7. Now I would like you to read this sentence to me.
Show the sentence on the card to the respondent. If the respondent cannot read whole sentence, probe: Can you read one part of the sentence to me?
Child mortality: CM

Questions CM0 ? CM12 refer to live births only.

CM0. Check in WM1, for cluster number:
CM0A. Now I want to ask you about the births you have had during your lifetime. How many live born children have you had in your entire life?
What I mean is have you given birth to a child who ever breathed or cried or shown any signs of life ? even if that child had lived for only few minutes or hours?
If none, circle '00'.
CM0B. When did you gave your last birth (even if the child has died)?
Month and year must be recorded.
CM1. Now I'd like to ask you about all the births you have given in your lifetime. Have you ever given any birth?

CM2. What is the date of your first birth?
What I mean is the very first time you gave birth, even if the child is not alive anymore, or even if his/her father is not your current partner.
Move to CM4 only if the year of her first birth is given, if not, continue with CM3.
CM3. How many years ago did you first give birth to a child?

CM4. Are any sons or daughters you have given birth to living with you now?

CM5. How many sons are living with you? How many daughters are living with you?
If none, record '00'.
CM6. Are there any sons or daughters you have given birth to who are alive but are not living with you?

CM7. How many sons are alive but are not living with you? How many daughters are alive but are not living with you?
If none, record '00'.
CM8. Have you ever given birth to a boy or girl that was born alive but later died?
If the answer is ?No? probe: What I mean is given birth to a child who breathed, or cried, or showed any other signs of life, even if it had lived for only a few minutes or hours?
CM9. How many boys have died? How many girls have died?
If none, record '00'.
CM10. Sum all the answers in CM5, CM7, and CM9 and write down the total number of live born children.
CM11. Let's make sure I have understood you correctly, you have had (total number in CM10) live born children in total during your lifetime. Is this right?

CM12: Out of all these (total number in CM10) live born children you have had, tell me when did you deliver the last one (even if that child has died)?
Month and year must be recorded.
CM12A. Sometimes women have pregnancies that might not end with a live birth.
Have you ever had any pregnancy that was miscarried, ended in a stillbirth, or that was aborted?

CM12B. How many miscarriages have you had during your lifetime?By miscarriage, I mean an early and involuntary end of pregnancy within the first 5th month of pregnancy

CM12C. How many of your pregnancies have ended with a stillbirth?
By stillbirth, I mean a birth that took place after the 5th month of pregnancy, but the child did not show any signs of life.

CM12D. And how many abortions have you had during your lifetime?
By abortion, I mean a pregnancy that was voluntarily terminated within the first 5 months of pregnancy

CM12E. When did your (last) abortion took place?
Month and year must be recorded.
CM12F. Check CM12E when the last abortion took place and if:
CM12G. If the respondent has mentioned more than one abortion, i.e. CM12D is higher than 1, then ask her for the exact month and year of each mentioned abortion that took place during the last 2 years, i.e. since (the month of interviewing) 2009.Write down month and year for each abortion in CM12H, starting from the last, and for each recorded abortion ask the respondent to tell you how many weeks/months she was pregnant when she aborted and record this appropriately.

CM12H. What month and year your (last) abortion took place?

CM12I. How many Months (weeks) were you pregnant when your pregnancy was aborted?
If the respondent answers in weeks, write down on the appropriate line for weeks, otherwise just record the given months
CM13. Check CM0B or CM12: Her last birth occurred during the last 2 years, i.e., since (the day and month of interview) in 2009
If the child has passed away, please be very careful when you are referring to this child by its name in the modules that follow. If the child has passed away right after it was given birth and it did not get any name at all, refer to this child as ?the baby/the infant? and be very careful in your approach.
Continue with the next module.


Desire for last birth: DB

This module is to be filled with all the women with a live birth in the last 2 years, preceding the date of the interview.
Check the module for child mortality CM13 and record the name of the last-born child here ____
Use this child's name in the questions that follow, where indicated.

DB1. When you became pregnant with (name), did you want to get pregnant at that period?

DB2. Did you want to become pregnant sometime later, or did you not want to have any (more) children?

DB3. How much longer did you want to wait?

Maternal and newborn health: MN

This module is to be filled with all the women with live births during the last 2 years.
Record the name of the last-born child here ____
Use this child's name in the following questions, where indicated in brackets, like this: (name).

MN1. Did you see anyone for care during your pregnancy with (name of child)?

MN2. Whom did you see?
Probe: Anyone else? Probe until you are sure about the type of person seen and circle all answers given, if more than one mentioned.
MN3. How many times did you receive care during this pregnancy?

MN4. As part of your are during this pregnancy, were any of the following done at least once:

[A] Was your blood pressure measured?

[B] Did you give a urine sample?

[C] Did you give a blood sample?

MN17. Who assisted you with the delivery of (name of child)?
Probe: Anyone else? Probe for the type of person assisting and circle all answers given. If respondent says no one assisted, probe to determine whether any adults were present at the delivery and write down under 'other' if the given answer is not listed as an option.
MN18. Where did you give birth to (name of child)?
Probe to closely identify the type of place before you circle any of the given answer codes. If unable to determine whether it is a public or private institution, write the name of the place where birth was given on the line below.
(Name of place) ____

MN19. Was (name) delivered by caesarean section? That is, did they cut your belly open to take the baby out?

MN20. When (name) was born, was he/she very large, larger than average, average, smaller than average, or very small baby?

MN21. Was (name) weighed at birth?

MN22. How much did (name) weigh?
If card is available, give it a priority and copy the answer from there.
MN23. Has your menstrual period returned since the birth of (name)?

MN24. Did you ever breastfeed (name)?

MN25. How long after birth did you first put (name) on your breast for feeding?
If less than 1 hour, record '00' hours. If less than 24 hours, circle code 1 and write down the exact number of hours. Otherwise, record the number of days and circle code 2.
MN26. In the first three days after delivery, was (name) given anything to drink other than breast milk?

MN27. What else was (name) given to drink?
Probe: Anything else? Record all mentioned answers
Illness Symptoms: IS

IS1. Check Household List, column HL9 in the Household Questionnaire
Is the respondent the mother or guardian of at least one child aged under 5?

IS2. Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away?
Probe additionally: Any other symptoms? Keep asking for more signs or symptoms until the mother/guardian cannot recall any additional symptoms. Circle all symptoms mentioned, but do not prompt with any suggestions and write down all additional answers not listed in the given answer options under 'other'
Contraception: CP

CP0. Couples use different ways or methods in order to postpone or avoid pregnancy.
Have you ever heard of?

[A] Sterilization of female?
Probe: Women can have an operation in order to avoid having more children.
[B] Sterilization of male?
Probe: Men can have an operation in order to avoid having more children.
[C] Coil?
Probe: Women can have a coil placed inside them by a doctor or a nurse.
[D] Injections?
Probe: Women can use injections from a health provider, which have effects on their hormones and stos them from getting pregnant for one or more months..
[E] Implants?
Probe: Women can have one or more small rods implanted in their upper arm (by a doctor or a nurse) and thus prevent pregnancy for one or more years.
[F] Pills?
Probe: Women can take pills on every day basis to avoid getting pregnant.
[G] Male condom?
Probe: Men can put a rubber cover on their penis before the sexual intercourse.
[H] Female condom?
Probe: Women can put a cover in their vagina before the sexual intercourse.
[I] Diaphragm?
Probe: Women can insert a soft rubber cup in their vagina to block the sperm from entering their uterus or tubes
[J] Foam, jelly?
Probe: Women may use spermicidal products (like for ex. foam, jelly, cream) that can kill or prevent the sperm from moving and reaching the egg.
[K] Lactational amenorrhea method (LAM)?

[L] Rhythm method?
Probe: Every month when the woman is sexually active, she can avoid pregnancy by not having a sexual intercourse on the fertile days in the month, i.e. days she is most likely to get pregnant.
[M] Withdrawal?
Probe: Men can be cautious and pull out before reaching climax.
[N] Urgency contraception?
Probe: As an emergency measure, within a period of 3 days, after having unprotected sexual intercourse, women can take special pills to prevent getting pregnant.
[X] Have you heard of any other ways or methods that men or women can utilise in order to avoid pregnancy?

CP1. Now I would like to talk with you about another subject ? planning the family.
Are you pregnant at the moment?

CP2. At the moment, are you doing anything or using any method to postpone or avoid pregnancy?

CP3. What are you doing to postpone or avoid pregnancy?
If more than one method is mentioned, circle each one as appropriate.
Unfulfilled need for contraception: UN

UN1. Check CP1. Is she currently pregnant?
UN2. Now I would like to talk to you about your current pregnancy. When you got pregnant, did you want to get pregnant?

UN3. Did you want to have a baby sometime later or you did not want any (more) children?

UN4. Now I'd like to ask a few questions about the future. After the child you are expecting right now, would you like to have another child, or would you rather not have any more children?

UN5. Check CP3. Currently using "female sterilization"
UN6. Now I would like to ask you about the future. Would you like to have (another) child, or you would rather not have any (more) children?

UN7. For how long would you like to wait before you give birth to (another) child?

UN8. Check CP1. Currently pregnant?

UN9. Check CP2. At the moment is she using any method?
UN10. Do you think that you are physically able to get pregnant at the moment?

UN11. Why do you think you are not physically able to get pregnant at the moment?

UN12. Check UN11. "Never menstruated" - has it been mentioned?
UN13. When did your last menstrual cycle start?

Attitudes toward domestic violence: DV

DV1. Sometimes a husband can be annoyed or irritated by things that his wife does. In your opinion, is a husband justified to hit or beat his wife in the following situations:

[A] If she goes out without telling him?

[B] If she neglects the children?

[C] If she argues with him?

[D] If she refuses to have sex with him?

[E] If she burns the food?

Marriage/union: MA

MA1. Are you currently married or living together with a man as married?

MA2. How old is your husband/partner?
Probe additionally: how old was your husband/partner on his last birthday?

MA5. Have you ever been married or lived together with a man as if married?

MA6. What is your marital status now: are you widowed, divorced or separated?

MA7. Have you been married or lived with a man only once or more than once?

MA8. In what month and year did you first marry or start living with a man as if married?

MA9. How old were you when you started living with your first husband/partner?

Tobacco and alcohol consumption: TA

TA1. Have you ever tried smoking, at least one or two puffs?

TA2. At what age did you first smoke a whole cigarette?

TA3. Do you smoke cigarettes today?

TA4. During the last 24 hours, how many cigarettes have you smoke?

TA5. During the last month, for how many days have you smoked cigarettes?
If less than 10 days, write the number of days. If 10 days or more, circle "10". If "everyday" or "almost every day", circle "30"
TA6. Have you ever tried to smoke tobacco products, except cigarettes, like for example, cigars, water pipe, cigarillo or dry tobacco?

TA7. During the last month, have you consumed any type of smoked tobacco products, excluding cigarettes?

TA8. What type of smoked tobacco product did you use or smoke during the last one month?
Circle all mentioned.
TA9. During the last one month, on how many days did you use smoked tobacco products, excluding cigarettes?
If less than 10 days, record the number of days. If 10 days or more but less than a month, circle "10". If "everyday" or "almost every day", circle "30"
TA10. Have you ever tried any type of product made from tobacco, like for example tobacco chewing gum, burmut, or tobacco for soaking?

TA11. During the last month, have you consumed any type of products from non-smoking tobacco?

TA12. What type of smokeless tobacco product did you use during the last one month?
Circle all mentioned.
TA13. During the last one month, on how many days did you use smokeless 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 "everyday" or "almost every day", circle "30"
TA14. Now a few questions about alcohol consumption. Have you ever tried consuming alcohol?

TA15. One intake of alcohol refers to one can or bottle of beer, one glass of wine or a glass of Rakia, cognac, vodka, whiskey, or rum.
At what age did you drink your first glass of alcohol, excluding any time you had a few sips?

TA16. During the last month, how many days have you had at least one glass of alcohol?
If the respondent has drunk zero glasses, circle "00". If less than 10 days, write the number of days. If 10 days or more, circle "10". If "everyday" or "almost every day", circle "30"
TA17. During the last month, on days that you had alcohol, how many glasses have you mostly had?

Life satisfaction: LS

LS1. Check WB2: Is respondent's age between 15 and 24?
LS2. Now, I would like to ask you a few simple questions about 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 response card 1 to the respondent and explain what each symbol represents. Circle the answer pointed by the respondent. [Image omitted.]

LS3. Now I'd like to ask you a few simple questions about the level of your satisfaction from various fields.
For any of the questions, we have five possible answers: please let me know, for each question, are you very or somewhat satisfied, neither satisfied nor unsatisfied, or somewhat or very unsatisfied.
Once again, you can take a look at these images that might help you with your answer.
Please hand the answer card 2 to the respondent and explain what each of the symbols represents. For each question from LS3 to LS13, circle the response given by the respondent [Image omitted.]
How satisfied are you from your family life?

LS4. How satisfied are you from your friendships?

LS5. During the current (2010-2011) school year, have you attend school at all?

LS6. How satisfied (are/were) you from the school you have attended?

LS7. How satisfied are you from your current job?
If the respondent says that he/she does not have a job, circle "0" and continue with the next question. Do not probe to find out how she feels about not having a job, unless she tells you herself.
LS8. How satisfied are you from your health?

LS9. How satisfied are you with your place of living?
If necessary, explain that the questions refer to their life environment, including their neighbourhood and dwelling.
LS10. How satisfied are you from the treatment you receive by the people around you?

LS11. How satisfied are you from your looks?

LS12. How satisfied are you from your life, in general?

LS13. How satisfied are you from your current income?
If the respondent responds that he/she does not have any income, circle "0" and continue with the next question. Do not probe to find out how she feels about not having any income, unless she tells you herself.
LS14. Compared to the same period last year, would you say that, in general, your life has improved or become worse?

LS15. And in a year time from now, do you expect that your life, in general, will be improved or will get worse?

WM11. Record the momentary time.
WM12. Check Household roster, column HL9 in the Household Questionnaire.
Is the respondent a mother or a guardian to at least one child aged between 0 and 4 that lives in this household or is she a mother/guardian to at least one child aged between 2 and 9?Check if there is any presence of any other suitable women, children under 5, or children aged between 2 and 9 in the household.

Interviewer's observations

Field editor's observations

Supervisor's observations