Republic of Mali

Woman's information panel: WM

This questionnaire is to be administered to all women age 15 through 49 (see Household Listing Form, column HL7). A separate questionnaire should be used for each eligible woman.

WM1. Cluster number: _ _ _

WM2. Household number: _ _

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

WM5. Interviewer name and number
WM5A. Field editor's name and number
WM6. Day/month/year of interview _ _ / _ _ / _ _ _ _

WM6. Day/month/year of edit _ _ / _ _ / _ _ _ _

If you have not already done so, introduce yourself to the respondent:
We are from the Ministry of Health and the Ministry of the Economy and Finance. We are working on a project concerned with family health, education, nutrition and household expenses. I would like to talk to you about these subjects. The interview will take some time. All the information we obtain will remain strictly confidential and your answers will never be shared with anyone other than our project team.

May I start now?

WM7. Result of woman's interview

WM8. Field edited by Team Leader:
WM9. Data entry clerk (name and number):
WM9A. Field edited by Supervisor:
WM10. Record the 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 and correct WB1 and/or WB2 if inconsistent.
WB3. Have you ever attended school or kindergarten?

WB4. What is the highest level of school you attended?

WB5. What is the highest grade 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 sentence on the card to the respondent. If respondent cannot read whole sentence, probe: Can you read part of the sentence to me?
WB8. How often do you read a newspaper or magazine: almost every day, at least once a week, less than once a week or not at all?

WB9. Do you listen to the radio almost every day, at least once a week, less than once a week or not at all?

WB10. 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?

Desire for last birth: DB

DB0. Now I would like to ask you some questions about all the births you have had in your lifetime. Have you ever given birth?

DB0A. Of these (total number) births that you have had, when did you give birth the last time (even if he/she died)?
The month and year must be recorded.
Check DB0A. Did the women have her latest birth in the last two years, that is since (day and month of interview) in 2007 (or in 2008 if year of interview is 2010)
DB1. When you got pregnant with (name), did you want to get pregnant at that time?

DB2. Did you want to have a baby later on, or did you not want any (more) children?

DB3. How much longer did you want to wait?

Maternal and newborn health: MN

This module is to be administered to all women with a live birth in the 2 years preceding date of interview.
Record name(s) of child(ren) born in last two years here ____
Use this child's name in the following questions, where indicated.

MN1. Did you receive any antenatal care during your pregnancy with (name)?

MN1A. Did you receive an antenatal check-up card during your pregnancy with (name)?

MN2. Whom did you see?
Probe: Anyone else? Probe for the type of person seen and circle all answers given.
MN2A. How many months pregnant were you at your first antenatal visit?

MN3. How many times did you receive antenatal care during this pregnancy?

MN4. As part of your antenatal care 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?

[D] Were you weighed?

[E] Was your height measured?

MN5. Do you have a card or other document with your own immunizations listed?
May I see it please?
If a card is presented, use it to assist with answers to the following questions.
MN6. When you were pregnant with (name), did you receive any injection in the arm or shoulder to prevent the baby from getting tetanus, that is convulsions after birth?

MN7. How many times did you receive this tetanus injection during your pregnancy with (name)?
If 7 or more times, record '7'.
MN8. How many tetanus injections during last pregnancy were reported in MN7?
MN9. Did you receive any tetanus injection at any time before your pregnancy with (name), either to protect yourself or another baby?

MN10. How many times did you receive a tetanus injection before your pregnancy with (name)?
If 7 or more times, record '7'.
MN11. How many years ago did you receive the last tetanus injection before your pregnancy with (name)?

MN12. Check MN1 to see if woman received antenatal care during this pregnancy:
MN13. During any of these antenatal visits for the pregnancy, did you take any medicine in order to prevent you from getting malaria?

MN14. Which medicines did you take to prevent malaria?
Circle all medicines taken. If type of medicine is not determined, show typical anti-malarial to respondent.
MN15. Check MN14 for medicine taken:
MN16. During this pregnancy, how many times did you take SP/Fansidar/Maloxine?

MN16A. During this pregnancy, did you take any iron, folic acid?

MN16B. During this pregnancy, did you receive an insecticide-treated mosquito net?

MN17. Who assisted with the delivery of (name)?
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.
MN18. Where did you give birth to (name)?
Probe to identify the type of source. If unable to determine whether facility is public or private, write the name of the place.
(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?

MN21. Was (name) weighed at birth?

MN22. How much did (name) weigh?
Record weight from health card, if available.
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) to the breast?
If less than 1 hour, record '00' hours. If less than 24 hours, record hours. Otherwise, record days.
MN26. In the first three days after delivery, was (name) given anything to drink other than breast milk?

MN27. What was (name) given to drink?
Probe: Anything else?
MN28. After (name)'s birth, did a health professional or village birth attendant examine you?

MN29. How many days or weeks after delivery did you have your first health check-up?
Record "00" days if same day
Illness Symptoms: IS

IS1. Check Household Listing, column HL9
Is the respondent the mother or caretaker of any child under age 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: Any other symptoms? Keep asking for more signs or symptoms until the mother/caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, but do not prompt with any suggestions
IS3. When do you wash your hands?

Contraception: CP

CP1. I would like to talk with you about another subject -- family planning.
Are you pregnant now?

CP2. Some couples use various ways or methods to delay or avoid a pregnancy. Are you currently doing something or using any method to delay or avoid getting pregnant?

CP3. What are you doing to delay or avoid a pregnancy?
Do not prompt. If more than one method is mentioned, circle each one.
Unmet need: UN

UN1. Check CP1. 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 at that time?

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

UN4. Now I would like to ask some questions about the future. After the child you are now expecting, would you like to have another child, or would you prefer not to have any more children?

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

UN7. How long would you like to wait before the birth of (a/another) child?

UN8. Check CP1. Currently pregnant?
UN9. Check CP2. Currently using a method?
UN10. Do you think you are physically able to get pregnant at this time?

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

Check UN11. "Never menstruated" mentioned?
UN13. When did your last menstrual period start?

Female genital mutilation/cutting: FG

FG1. Have you ever heard of female circumcision?

FG2. In some countries, there is a practice in which a girl may have part of her external genitals cut. Have you ever heard about this practice?

FG3. Have you yourself ever been circumcised?

FG4. Now I would like to ask you what was done to you at that time. Was any flesh removed from the genital area?

FG5. Was the genital area just nicked without removing any flesh?

FG6. Was the genital area sewn closed?
If necessary, probe: Was it sealed?
FG7. How old were you when you were circumcised?
If the respondent does not know the exact age, probe to get an estimate
FG8. Who performed the circumcision?

FG9. Do you have a least one living daughter?

FG10. Are some of your daughters circumcised?
If yes: How many?

FG11. Which of your daughters was circumcised the most recently?
Record name of daughter
FG12. Now I would like to ask you some questions about what was done to (name) at that time: Was any flesh removed from the genital area?

FG13. Was the genital area nicked without removing any flesh?

FG14. Was the genital area sewn closed?
If necessary, probe: Was it sealed?
FG15. How old was (name) when this happened?
If respondent does not know age, probe to get an estimate.
FG16. Who performed the circumcision?

FG17. Do you think that this practice should be continued or should it be discontinued?

Attitudes toward domestic violence: DV

DV1. 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:

[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?

[F] If she becomes unfaithful?

[G] If she doesn't respect his relatives?

Marriage/union: MA

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

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

MA3. Besides yourself, does your husband/partner have any other wives or partners or does he live with other women as if married?

MA4. How many other wives or partners does he have?

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?

Sexual behavior: SB

Check for the presence of others. Before continuing, ensure privacy with respondent.

SB1. Now I would like to ask you some questions about your sexual activity in order to gain a better understanding of some important life issues.
The information you supply will remain strictly confidential.
How old were you when you had sexual intercourse for the very first time?

SB2. The first time you had sexual intercourse, was a condom used?

SB3. When was the last time you had sexual intercourse?
Record answers in days, weeks or months if less than 12 months (one year). If more than 12 months (one year), answer must be recorded in years.
SB4. The last time you had sexual intercourse, was a condom used?

SB5. What was your relationship to this person with whom you last had sexual intercourse?
If 'boyfriend' or 'fiancé', then ask: Were you living together as if married? If 'yes', circle '02', '03' or '04'. If 'no', circle '05'.
SB6. How old is this person?
If response is DK, probe: About how old is this person?
SB7. Have you had sexual intercourse with any other person in the last 12 months?

SB8. The last time you had sexual intercourse with this other person, was a condom used?

SB9. What is your relationship to this person?
If 'boyfriend' or 'fiancé' then ask: Were you living together as if married? If 'yes', circle '02', '03', or '04'. If 'no', circle '05'.
SB10. How old is this person?
If response is DK, probe: About how old is this person?
SB11. Other than these two persons, have you had sexual intercourse with any other person in the last 12 months?

SB12. In total, with how many different people have you had sexual intercourse in the last 12 months?
If number of partners is 95 or more, write '95'
SB13. In total, with how many different people have you had sexual intercourse in your lifetime?
If a non-numeric answer is given, probe to get an estimate. If number of partners is 95 or more, write '95'.
SB14. In the last 3 months, have you had any abnormal vaginal discharge (bad odor, abnormal color/volume) or any genital ulcers?

SB15. The last time that this happened to you, did you seek any treatment or help?

SB16. Where did you seek out this treatment or help? (If several, the first solution)

SB17. Have men ever offered you gifts or other favors in order to have sexual intercourse with you?

SB18. Has that rarely happened, happened occasionally, or happened frequently?

HIV/AIDS: HA

HA1. Now I would like to talk with you about something else.
Have you ever heard of an illness called AIDS?

HA2. Can people reduce their chance of getting the AIDS virus by having just one uninfected sex partner who has no other sex partners?

HA3. Can people get the AIDS virus because of witchcraft or other supernatural means?

HA4. Can people reduce their chance of getting the AIDS virus by using a condom every time they have sex?

HA5. Can people get the AIDS virus from mosquito bites?

HA6. Can people get the aids virus by sharing food with a person who has the AIDS virus?

HA7. Is it possible for a healthy-looking person to have the AIDS virus?

HA8. Can the virus that causes AIDS be transmitted from a mother to her baby:

[A] During pregnancy?

[B] During delivery?

[C] By breastfeeding?

HA9. In your opinion, if a female teacher has the AIDS virus but is not sick, should she be allowed to continue teaching in school?

HA10. Would you buy fresh vegetables from a shopkeeper or vendor if you knew that this person had the AIDS virus?

HA11. If a member of your family got infected with the AIDS virus, would you want it to remain a secret?

HA12. If a member of your family became sick with AIDS, would you be willing to care for her or him in your own household?

HA13. Check DB0A: Any live birth in last 2 years?
HA14. Check MN1: Received antenatal care?
HA15. During any of the antenatal visits for your pregnancy with (name), were you given any information about AIDS or the AIDS virus?

HA16. I don't want to know the results, but were you tested for the AIDS virus as part of your antenatal care?

HA17. I don't want to know the results, but did you get the results of the test?

HA18. Regardless of the result, all women who are tested are supposed to receive counseling after getting the result. After you were tested, did you receive counselling?

HA19. Check MN17: Birth delivered by health professional (A, B or C)?
HA20. I don't want to know the results, but were you tested for the AIDS virus between the time you went for delivery but before the baby was born?

HA21. I don't want to know the results, but did you get the results of the test?

HA22. Have you been tested for the AIDS virus since that time you were tested during your pregnancy?

HA23. When was the most recent time you were tested for the AIDS virus?

HA24. I don't want to know the results, but have you ever been tested to see if you have the AIDS virus?

HA25. When was the most recent time you were tested?

HA26. I don't want to know the results, but did you get the results of the test?

HA27. Do you know of a place where people can go to get tested for the AIDS virus?

HA28. Where can a person get a condom?

AW1. Check column HL7 in the household questionnaire. Record the line number and name of woman in AW2. The final results of the anemia test will be recorded in AW9.

AW2. Line number in column HL7:
Name in column HL2:

AW3. Check HL6:
Woman age 18-49?

AW4. Marital status: check code '3' circled in MA1 or MA5:

AW5. Line number of parent for caretaker of adolescent never in union.
Record '00' if not listed.

AW6. Declaration for consent to anemia test for woman age 15 - 49.
Read consent statement to each respondent. Circle code '1' in AW6 only if respondent accepts and the responsible adult/parent accepts the anemia test; and code '2' if the respondent refuses.
For women age 15 - 17 who have never been in union, ask consent of parent/identified adult in AW5 before asking consent of adolescent herself. Circle code '3' in AW6 if the parent/adult refuses. Only carry out the test if consent has been given by both the parent/adult and the adolescent respondent (Code '1').
In this survey, we are asking people all over the country to take an anemia test. Anemia is a serious health problem resulting from poor nutrition, infections, or a chronic disease. The results of this survey will help the government to establish programs to prevent and treat anemia.
For the anemia test, we need a few drops of blood from a finger. We use clean and risk-free equipment, which has not been used before and will be thrown away after each test.
The blood will be tested immediately for anemia and you will be told the results right away. The results are confidential and will not be shared with anyone outside of the survey team.
Do you have any questions?
You can say yes or no to the test. It is your decision.
Will you allow (name of adolescent) to take the anemia test?
Read the consent for anemia [test].
Circle appropriate codes and sign.

AW7. Prepare the equipment and carry out the test for the woman if consent is given and continue to AW8.

AW8. Record the result code for the anemia test.

AW9. Record the level of hemoglobin.

WM11. Record the time.
WM12. Is the respondent the mother or the caretaker of a child age 0 - 4 who is living in the household?
Check the household listing HL8.