[Mongolia]

Woman's information panel: WM

This questionnaire is to be administered to all women aged 15-49 years in the household. A separate questionnaire should be used for each eligible woman.

WM1. Cluster number: _ _ _

WM2. Household number: _ _

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

WM5. Interviewer name and number
WM6. Date of interview (year/month/day) _ _ _ _ / _ _ / _ _

If greeting has not already been read to this woman, then read the following:
We are from the National Statistical Office of Mongolia and working on a project concerned with family health, education, and living situation. I would like to talk to you about your health and other topics nearly 40 minutes. According to the Article 5, Paragraph 4 of the Mongolian State Law on Confidentiality of an Individual" and Article 22, Paragraph 3 of the Mongolian State Law on Statistics all the information we obtain will remain strictly confidential.

If greeting has already been read to this woman, then read the following:
Now I would like to talk to you more about your health and other topics. The interview will take about 40 minutes. According to the Article 5, Paragraph 4 of the Mongolian State Law on Confidentiality of an Individual" and Article 22, Paragraph 3 of the Mongolian State Law on Statistics all the information we obtain will remain strictly confidential.

Shall we start the interview?

WM7. Result of interview

WM8. Field editor name and number:
WM9. Data entry clerk name and number:
WM10. Interview started at
Woman's Background: WB

WB1. Please tell me the date of your birth?

WB2. How old are you?
Probe: How old were you at your last birthday? Always check if WB1 and WB2 are consistent.
WB3. Have you ever attended school/pre-school?

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

WB5. What is the highest grade you completed at this level of school?

WB6. Check WB4 and WB5 to see if the highest level of school attended is a secondary school and the highest grade completed is 1-4 for the woman.

WB7. Please read this sentence to me.
Show the sentence on the card to the woman. If cannot read at all, probe: Can you read some parts of the sentence to me?
WB7A. Please write this sentence to me.
Read the sentence on the card to the woman. If cannot write at all, probe: Can you write some parts of the sentence to me?
Access to mass media and use of information/communication technology: MT

MT1. Check EB7 to see if the woman is able to read.
MT2. How often do you read a newspaper or magazine? Almost every day, at least once a week, at least once a month, or not at all?

MT3. Do you listen to the radio or FM? Almost every day, at least once a week, at least once a month, or not at all?

MT4. How often do you watch television? Almost every day, at least once a week, at least once a month, or not at all?

MT6. Have you ever used a computer?

MT7. Have you used a computer in the last 12 months?

MT8. During the last one month, how often did you use a computer? Almost every day, at least once a week, at least once a month, or not at all?

MT9. Have you ever used the internet?

MT10. Have you used the internet in the last 12 months?

MT11. During the last one month, how often did you use the internet? Almost every day, at least once a week, at least once a month, or not at all?

Child mortality: CM

All questions of this module refer only to live births.

CM1. I would like to talk with you about all the births you have had during your life. Have you ever given birth?

CM2. What was the date of your first birth?
I mean the very first time you gave birth, even if the child is no longer living with you or is no longer living or whose father is not your current husband/partner.
Go to CM4 if year of first birth is known. Otherwise, continue with CM3.
CM3. How many years ago (in complete years) did you have your first birth?

CM4. Do you have any children to whom you have given birth who are now living with you?

CM5. How many sons are now living with you? How many daughters are now living with you?
If none, enter '00'.
CM6. Do you have any children whom you have given birth who are alive but now not living with you?

CM7. How many sons are alive but now not living with you? How many daughters are alive but now not living with you?
If none, enter '00'.
CM8. Have you ever given birth to a child who was born alive but later died?
If none, probe: I mean, to a child who ever breathed, cried or showed other signs of life ? even if he/she lived only a few minutes or hours?
CM9. How many boys have died? How many girls have died?
If none, enter '00'.
CM10. Sum numbers provided in CM5, CM7, and CM9.
CM11. Thus, you have had in total (total number of births) live births/no live births during your life. Is this correct?

CM12: What was the date of your last birth? I mean the very last time you gave birth, even if the child is not now living with you or is no longer living or whose father is not your current husband/partner.
Birth year and month of the last birth must be recorded.
CM13. Check CM12 to see if the last birth occurred within the last 2 years, that is, since (month and day of interview) in 2008
If the child has died, take special care when referring to this child by name in the following modules.
Continue with module DB.


Desire for last birth: DB

This module is to be administered to all women with a live birth in the 2 years preceding the date of the interview.
Check CM13 in module CM and copy the name of the last-born child ____
Use this child's name in the following questions as required

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 to have a child?

Maternal and newborn health: MN

This module is to be administered to all women with a live birth in the 2 years preceding the date of the interview.
Check CM13 in module CM and copy the name of the last-born child ____
Use this child's name in the following questions as required.

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

MN2. Whom did you see for antenatal care?
Probe: Anyone else? Probe for the types of persons seen. Record all that apply.
MN2A. When did you have your first antenatal visit?

MN3. How many times did you receive antenatal care?

MN4. As part of your antenatal care, was any of the following done at least once:

[A] Blood pressure?

[B] Urine sample?

[C] Blood sample?

[D] STI screening?

[E] Weight measure?

MN17. Who assisted with the delivery of (name)?
Probe: Anyone else? Probe for the types of the persons assisted. Record all that apply. If the woman says she assisted herself, probe to determine whether any adults were present at the delivery.
MN18. Where did you give birth to (name)?
Probe to identify the types of the places where the birth delivered.
MN19. Was (name) delivered by caesarean section?
If the woman does not understand the meaning of caesarean section, explain it is to take the baby out by cut opening the belly.
MN19A. Were you given vitamin A within 2 months after you gave birth to (name)?

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 was (name)'s weight at birth?
Record the weight from the child's health card, if available.
MN23. Has your menstrual period returned since the birth of (name)?

MN24. Have you ever breastfed (name)?

MN25. How long after (name) was born did you first put him/her to the breast?
If less than 1 hour, enter 00 in hours. If less than 24 hours, record hours. Otherwise, record days.
MN26. During the first three days after (name) was born, was he/she given anything to drink other than breast milk?

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

IS1. Check column HL9 in Module HL in the "Household Questionnaire" to see if the woman is the mother/caretaker of any child under age of 5 years.
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 immediately?
Probe: Any other symptoms? Record all that apply. Do not prompt with any suggestions
Contraception: CP

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

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

CP3. What methods are you using to delay or avoid getting pregnant?
Probe: Any other methods? Record all that apply. Do not prompt with any suggestions.
CP3A. Have you heard of any methods that helps to delay or avoid getting pregnant?

CP3B. What methods that helps to delay or avoid getting pregnant have you heard of?
Probe: Any other methods? Record all that apply.
Unmet need: UN

UN1. Check CP1 to see if the woman is currently pregnant?
UN2. I would like to talk with 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 child 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?

UN5. Check CP3 to see if the woman is 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?

UN7. How much longer would you like to wait to have a/another child?

UN8. Check CP1 to see if the woman is currently pregnant?
UN9. Check CP2 to see if the woman is currently using any methods to delay or avoid getting pregnant?
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?

UN12. Check UN11 to see if "Never menstruation" mentioned?
UN13. When did your last menstrual period start?

Marriage/union: MA

MA1. Are you currently married or living with a partner?

MA2. How old is your husband/partner?

MA5. Have you ever been married or lived with a partner?

MA6. Are you currently widowed, divorced or separated?

MA7. How many times have you been married or lived with a partner?

MA8. In what month and year did you first marry or start living with a partner?

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

Attitudes toward domestic violence: DV

DV1. Sometimes a husband hits or beats his wife. In your opinion, is a husband justified in hitting or beating his wife in the following situations:

[A] If a wife goes out to see friends or relatives without telling her husband?

[B] If a wife neglects her children?

[C] If a wife argues with her husband?

[D] If a wife refuses to have sex with her husband?

[E] If a wife burns food?

[F] If a wife spends big amount of money without a permission from her husband?

DV2. Check MA1 to see if the woman is currently married or living with a partner.

DV3. Who usually decides how your household income will be used ? you or your husband/partner or both of you?

DV4. In a couple, who do you think should have the greater say in the following decisions ? wife or husband or both of them?

[A] Making major household purchases

[B] Making purchases for daily household needs

[C] Deciding about visits to the wife?s family or relatives

[D] Deciding what to do with the money the wife earns for her work

[E] Deciding how many children to have

[F] Deciding if the wife should be employed

DV5. I will read you some statements about pregnancy. Please tell me if you agree or disagree with them.

[A] Pregnant woman needs attention and care from the father of the child

[B] It is crucial for the mother?s and child?s health that a woman has assistance from a doctor or nurse at delivery

DV6. Do you agree or disagree with the following reactions of a husband if his wife refuses to have sex with him?

[A] Get angry and reprimand the wife

[B] Refuse to give the wife money or other means of support

[C] Use force and have sex with the wife even if she does not want to

[D] Go ahead and have sex with another woman

Sexual behaviour: SB

Check for the presence of others around. Before beginning the interview, ensure privacy.

SB1A. Check CM10 and MA5 to see if the woman never gave birth or never married.
SB1B. I would like to ask you some questions about sexual activity in order to gain a better understanding of some important life issues. The information you provide will remain strictly confidential. Have you ever had sexual intercourse?

SB1. 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?

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', probe: Were you living with him together as if married? If 'yes', circle '2'. If 'no', circle'3'.
SB6. Check MA1 to see if the woman is currently married or living with a partner.
SB7. How old was this person?
If don't know, probe: About how old was this person?
SB8. In the last 12 months, have you had sexual intercourse with any other person?

SB9. The last time you had sexual intercourse with this other person, was a condom used?

SB10. What was your relationship to this other person?
If boyfriend, probe: Were you living with him together as if married? If 'yes', circle '2'. If 'no', circle '3'.
SB11. Check MA1 and MA7:
SB12. How old was this other person?
If don't know, probe: About how old was this person?
SB13. In the last 12 months, have you had sexual intercourse with any person other than these two persons?

SB14. In total, with how many different persons have you had sexual intercourse in the last 12 months?

SB15. In total, with how many different persons have you had sexual intercourse in your lifetime?
If a non-numeric answer is given, probe to get an estimate. If 95 or more, enter '95'.
HIV/AIDS: HA

HA1. I would like to talk with you something else.
Have you ever heard of 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?

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?

HA7A. Can the AIDS virus be transmitted by sharing a syringe or needle with another person?

HA8. Can the AIDS virus be transmitted from a mother to her child in the following situations?

[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 or meat from a 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 him/her in your own household?

HA13. Check CM12 to see if the last birth occurred within the last 2 years, that is, since (month and day of the interview) in 2008?
HA14. Check MN1 to see if the woman received any antenatal care during the pregnancy with her last birth.

HA15. During any of the antenatal visits for your pregnancy with (name),

Were you given any information about the following things?

[A] Mother to child transmission of the AIDS virus?

[B] Ways of preventing from the AIDS virus?

[C] The AIDS virus testing?

HA15D. During any of the antenatal visits for your pregnancy with (name), were you offered a test for the AIDS virus?

HA16. You do not need to tell me the results. Were you tested for the AIDS virus as part of your antenatal care?

HA17. You do not need to tell me the results. Did you get the results of the test?

HA18. After you were tested, did you receive counselling?

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. You do not need to tell me the results. Have you ever been tested for the AIDS virus?

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

HA26. You do not need to tell me the results. Did you get the results of the test?

HA26A. After you were tested, did you receive counselling?

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

Tobacco and alcohol use: TA

TA1. Have you ever tried cigarette smoking, even one or two puffs?

TA2. How old were you when you smoked a whole cigarette for the first time?

TA3. Do you currently smoke cigarettes?

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

TA5. During the last one month, how many days did you smoke cigarettes?
If less than 10 days, record the number of days. If 10 or more days, circle "10". If "everyday" or "almost every day", circle "30"
TA6. Have you ever smoked any other types of smoked tobacco products such as cigars or pipe?

TA7. During the last one month, did you smoke any other types of smoked tobacco products such as cigars or pipe2?

TA8. During the last one month, how many days did you smoke any other types of smoked tobacco products such as cigars or pipe?
If less than 10 days, record the number of days. If 10 or more days, circle 10. If every day or almost every day, circle 30.
TA9. What type of smoked tobacco products did you smoke?
Probe: Any other types of smoked tobacco products? Record all that apply.
TA10. Have you ever tried any form of smokeless tobacco products, such as chewing or snuff?

TA11. During the last one month, did you use any form of smokeless tobacco products such as chewing or snuff?

TA12. During the last one month, how many days did you use any form of smokeless tobacco products such as chewing or snuff?
If less than 10 days, record the number of days. If 10 or more days, circle 10. If every day or almost every day, circle 30.
TA13. What types of smokeless tobacco products did you use?
Probe: Any other types of smokeless tobacco products? Record all that apply.
TA14. I would like to ask you some questions about alcohol.
Have you ever drunk alcohol?

TA15. How old were you when you had your first drink of alcohol?
Probe: I refer to at least one can or bottle of beer, one glass of wine, or one shot of vodka, cognac, or whisky.
TA16. During the last one month, how many days did you drink of alcohol?
If less than 10 days, record the number of days. If 10 or more days, circle "10". If "everyday" or "almost every day", circle "30"
Life satisfaction: LS

LS2. I would like to ask you some questions about the level of your satisfaction with your marriage, friendships, school, etc.
In each case, I would like to know where you would place yourself: whether you are very or somewhat satisfied, neither satisfied nor unsatisfied, or somewhat or very unsatisfied.
You can also look at these pictures to help you with your response.
Give the response card to respondent and prompt her to look at the card while and after you ask each question from LS2 to LS10. [Image omitted.]
How satisfied are you with your marriage?

LS3. How satisfied are you with your friendships?

LS4. How satisfied are you with your school?

LS5. How satisfied are you with your current job?

LS6. How satisfied are you with yourself?

LS7. How satisfied are you with where you live?
If necessary, explain that the question refers to the living environment, including the neighourhood and the dwelling.
LS8. How satisfied are you with your life, overall?

LS9. How satisfied are you with your current income?

LS10. Taking all things together, would you say you are very or somewhat happy, neither happy nor unhappy, or somewhat or very unhappy?

LS11. Compared to this time last year, would you say that your life has improved or worsened, overall?

LS12. Do you expect that your life will be better or worse in one year from now, overall?

WM11. Interview completed at.
WM12. Check column HL9 in Module HL in the "Household Questionnaire" to see if the woman is the mother/caretaker of any child under age of 5 years in this household.

Interviewer's notes

Field editor's notes

Supervisor's notes