Mics questionnaire for individual women
Social Indicator Sample Survey 2018
Mongolia 2018
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Woman's information panel: WM
WM1. Cluster number: _ _ _
WM2. Household number: _ _
WM3. Woman's name and line number:
Name ____ _ _
WM4. Supervisor's name and number:
Name ____ _ _ _
WM5. Interviewer's name and number:
Name ____ _ _ _
WM6. Date of interview (year/month/day):
2018 / _ _ / _ _
Check woman's age in HL6 in list of household members, household questionnaire: If age 15-17, verify in HH33 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 WM17.
WM7. Record the time:
Hours : minutes _ _ : _ _
WM8. Check completed questionnaires in this household: Have you or another member of your team interviewed this respondent for another questionnaire?
[] 1 Yes, interviewed already (Go to WM9B)
[] 2 No, first interview (Go to WM9A)
[] 2 No, first interview (Go to WM9A)
WM9A. 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, education and other topics. This interview usually takes about 20-50 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?
WM9B. Now I would like to talk to you about your health, education and other topics in more detail. This interview will take about 20-50 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?
[] 1 Yes (Go to woman's background module)
[] 2 No/not asked (Go to WM17)
[] 2 No/not asked (Go to WM17)
WM17. Result of woman's interview.
Discuss any result not completed with Supervisor.
[] 01 Completed
[] 02 Not at home
[] 03 Refused
[] 04 Partly completed
[] 05 Incapacitated (specify) ____
[] 06 No adult consent for respondent age 15-17
[] 96 Other (specify) ____
[] 02 Not at home
[] 03 Refused
[] 04 Partly completed
[] 05 Incapacitated (specify) ____
[] 06 No adult consent for respondent age 15-17
[] 96 Other (specify) ____
Woman's background: WB
WB1. Check the respondent's line number (WM3) in woman's information panel and the respondent to the household questionnaire (HH47):
[] 1 WM3=HH47
[] 2 WM3 does not equal HH47 (Go to WB3)
[] 2 WM3 does not equal HH47 (Go to WB3)
WB2. Check ED5 in education module in the household questionnaire for this respondent: Highest level of school attended:
[] 1 ED5 greater than 105 or (ED5=105, ED6=1) (Go to WB15)
[] 2 ED5 less than 105 or (ED5=105, ED6=2) (Go to WB14)
[] 2 ED5 less than 105 or (ED5=105, ED6=2) (Go to WB14)
WB3. In what year and month were you born?
Date of birth
_ _ _ _ Year
[] 9998 DK year
_ _ Month
[] 98 DK month
[] 9998 DK year
_ _ Month
[] 98 DK month
WB4. How old are you?
Probe: How old were you at your last birthday? If responses to WB3 and WB4 are inconsistent, probe further and correct. Age must be recorded.
Age (in completed years) _ _
WB5. Have you ever attended school or any early childhood education programme?
[] 1 Yes
[] 2 No (Go to WB14)
[] 2 No (Go to WB14)
WB6. What is the highest level and grade or year of school you have attended?
If Master's first grade - 21, second grade -22. If Doctor, grade is 30 code, regardless of course.
[] 000 Early childhood education (Go to WB14)
[] 1 Secondary school _ _
[] 3 Vocational training center (technicum) _ _
[] 4 University, institute/college _ _
[] 1 Secondary school _ _
[] 3 Vocational training center (technicum) _ _
[] 4 University, institute/college _ _
WB7. Did you complete that (grade/year)?
[] 1 Yes
[] 2 No
[] 2 No
WB7B. Did you complete that school?
[] 1 Yes
[] 2 No
[] 2 No
WB8. Check WB4: Age of respondent:
[] 1 Age 15-24
[] 2 Age 25-49 (Go to WB13)
[] 2 Age 25-49 (Go to WB13)
WB9. At any time during the current school year (2018/2019) did you attend school?
[] 1 Yes
[] 2 No (Go to WB11)
[] 2 No (Go to WB11)
WB10. During this current school year (2018/2019), which level and grade or year are you attending?
If Master's first grade - 21, second grade -22. If Doctor, grade is 30 code, regardless of course.
[] 1 Secondary school _ _
[] 3 Vocational training center (technicum) _ _
[] 4 University, institute/college _ _
[] 3 Vocational training center (technicum) _ _
[] 4 University, institute/college _ _
WB11. At any time during the previous school year (2017/2018) did you attend school?
[] 1 Yes
[] 2 No (Go to WB13)
[] 2 No (Go to WB13)
WB12. During that previous school year (2017/2018), which level and grade or year did you attend?
If Master's first grade - 21, second grade -22. If Doctor, grade is 30 code, regardless of course.
[] 1 Secondary school _ _
[] 3 Vocational training center (technicum) _ _
[] 4 University, institute/college _ _
[] 3 Vocational training center (technicum) _ _
[] 4 University, institute/college _ _
WB13. Check WB6, WB7: Respondent's attended 5th or more grade of General education school?
[] 1 (WB6 greater than 105) or (WB6=105 and WB7=1) (Go to WB15)
[] 2 (WB6 less than 105) or (WB6=105 and WB7=2)
[] 2 (WB6 less than 105) or (WB6=105 and WB7=2)
WB14. 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?
[] 1 Cannot read at all
[] 2 Able to read only parts of sentence
[] 3 Able to read whole sentence
[] 4 No sentence in required language/braille (specify language) ____
[] 2 Able to read only parts of sentence
[] 3 Able to read whole sentence
[] 4 No sentence in required language/braille (specify language) ____
WB15. How long have you been continuously living in (name of current place of residence)?
If less than one year, record '00' years.
Years _ _
[] 95 Always/since birth (Go to end of module)
[] 95 Always/since birth (Go to end of module)
WB16. Just before you moved here, did you live in a capital city, in aimag center, soum center, or in a rural area?
[] 1 Capital city
[] 2 Aimag center
[] 3 Soum center
[] 4 Rural area
[] 5 Overseas (Go to WB17A)
[] 2 Aimag center
[] 3 Soum center
[] 4 Rural area
[] 5 Overseas (Go to WB17A)
WB17. Before you moved here, in which aimag did you live in?
[] 01 Arkhangai (Go to end of module)
[] 02 Bayan-ulgii (Go to end of module)
[] 03 Bayankhongor (Go to end of module)
[] 04 Bulgan (Go to end of module)
[] 05 Gobi-altai (Go to end of module)
[] 06 Dornogovi (Go to end of module)
[] 07 Dornod (Go to end of module)
[] 08 Dundgovi (Go to end of module)
[] 09 Zavkhan (Go to end of module)
[] 10 Uvurkhangai (Go to end of module)
[] 11 Umnugovi (Go to end of module)
[] 12 Sukhbaatar (Go to end of module)
[] 13 Selenge (Go to end of module)
[] 14 Tuv (Go to end of module)
[] 15 UVS (Go to end of module)
[] 16 Khovd (Go to end of module)
[] 17 Khuvsgul (Go to end of module)
[] 18 Khentii (Go to end of module)
[] 19 Darkhan-uul (Go to end of module)
[] 21 Orkhon (Go to end of module)
[] 22 Govisumber (Go to end of module)
[] 02 Bayan-ulgii (Go to end of module)
[] 03 Bayankhongor (Go to end of module)
[] 04 Bulgan (Go to end of module)
[] 05 Gobi-altai (Go to end of module)
[] 06 Dornogovi (Go to end of module)
[] 07 Dornod (Go to end of module)
[] 08 Dundgovi (Go to end of module)
[] 09 Zavkhan (Go to end of module)
[] 10 Uvurkhangai (Go to end of module)
[] 11 Umnugovi (Go to end of module)
[] 12 Sukhbaatar (Go to end of module)
[] 13 Selenge (Go to end of module)
[] 14 Tuv (Go to end of module)
[] 15 UVS (Go to end of module)
[] 16 Khovd (Go to end of module)
[] 17 Khuvsgul (Go to end of module)
[] 18 Khentii (Go to end of module)
[] 19 Darkhan-uul (Go to end of module)
[] 21 Orkhon (Go to end of module)
[] 22 Govisumber (Go to end of module)
WB17A. Before you moved here, in which country did you live in?
[] 01 South Korea
[] 02 America
[] 03 Czech
[] 04 China
[] 05 Japan
[] 06 Russia
[] 07 Germany
[] 08 England
[] 96 Other (specify) ____
[] 02 America
[] 03 Czech
[] 04 China
[] 05 Japan
[] 06 Russia
[] 07 Germany
[] 08 England
[] 96 Other (specify) ____
Access to mass media and use of information/communication technology: MT
MT1. How often do you read a newspaper or magazine: every day, at least once a week, at least once a month, 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.
[] 0 Not at all
[] 1 Less than once a week
[] 2 At least once a week
[] 3 Every day
[] 1 Less than once a week
[] 2 At least once a week
[] 3 Every day
MT2. How often do you listen to the radio: every day, at least once a week, at least once a month, 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
[] 0 Not at all
[] 1 At least once a month
[] 2 At least once a week
[] 3 Every day
[] 1 At least once a month
[] 2 At least once a week
[] 3 Every day
MT3. How often do you watch television: every day, at least once a week, at least once a month, 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
[] 0 Not at all
[] 1 At least once a month
[] 2 At least once a week
[] 3 Every day
[] 1 At least once a month
[] 2 At least once a week
[] 3 Every day
MT4. Have you ever used a computer, a notebook or a tablet from any location?
[] 1 Yes
[] 2 No (Go to MT9)
[] 2 No (Go to MT9)
MT5. During the last 3 months, how often did you use a computer, a notebook or a tablet: every day, at least once a week, at least once a month, 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
[] 0 Not at all (Go to MT9)
[] 1 At least once a month
[] 2 At least once a week
[] 3 Every day
[] 1 At least once a month
[] 2 At least once a week
[] 3 Every day
MT6. During the last 3 months, did you do any of the following actions on a computer, a notebook or a tablet:
[A] Copy or move a file or folder?
[] 1 Yes
[] 2 No
[] 2 No
[B] Use a copy and paste tool to duplicate or move information within a document?
[] 1 Yes
[] 2 No
[] 2 No
[C] Send e-mail with attached file, such as a document, picture or video?
[] 1 Yes
[] 2 No
[] 2 No
[D] Use a basic arithmetic formula in a spreadsheet?
[] 1 Yes
[] 2 No
[] 2 No
[E] Connect and install a new device, such as modem, camera or printer?
[] 1 Yes
[] 2 No
[] 2 No
[F] Find, download, install and configure software?
[] 1 Yes
[] 2 No
[] 2 No
[G] Create an electronic presentation with presentation software, including text, images, sound, video or charts?
[] 1 Yes
[] 2 No
[] 2 No
[H] Transfer a file between a computer and other device?
[] 1 Yes
[] 2 No
[] 2 No
[I] Write a computer program in any programming language?
[] 1 Yes
[] 2 No
[] 2 No
MT7. Check MT6[C]: Is 'Yes' recorded?
[] 1 Yes, MT6[C]=1 (Go to MT10)
[] 2 No, MT6[C]=2
[] 2 No, MT6[C]=2
MT8. Check MT6[F]: Is 'Yes' recorded?
[] 1 Yes [MT6[F]=1 (Go to MT10)
[] 2 No, MT6[F]=2
[] 2 No, MT6[F]=2
MT9. Have you ever used the internet from any location and any device?
[] 1 Yes
[] 2 No (Go to MT11)
[] 2 No (Go to MT11)
MT10. During the last 3 months, how often did you use the internet: every day, at least once a week, at least once a month, 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.
[] 0 Not at all
[] 1 At least once a month
[] 2 At least once a week
[] 3 Every day
[] 1 At least once a month
[] 2 At least once a week
[] 3 Every day
MT11. Do you own a mobile phone?
If response is "yes", probe: Is it a simple/analogue phone or a smartphone?
[] 1 Yes, smartphone
[] 2 Yes, simple/analogue
[] 3 No
[] 2 Yes, simple/analogue
[] 3 No
MT12. During the last 3 months, how often did you use your mobile phone: every day, at least once a week, at least once a month, 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.
[] 0 Not at all
[] 1 At least once a month
[] 2 At least once a week
[] 3 Every day
[] 1 At least once a month
[] 2 At least once a week
[] 3 Every day
Fertility/Birth history: CM
CM1. Now I would like to ask about all the births you have had during your life. Have you ever given birth?
This module and the birth history should only include children born alive. Any stillbirths should not be included in response to any question.
[] 1 Yes
[] 2 No (Go to CM8)
[] 2 No (Go to CM8)
CM2. Do you have any sons or daughters to whom you have given birth who are now living with you?
[] 1 Yes
[] 2 No (Go to CM5)
[] 2 No (Go to CM5)
CM3. How many sons live with you?
If none, record '00'.
_ _ Sons at home
CM4. How many daughters live with you?
If none, record '00'.
_ _ Daughters at home
CM5. Do you have any sons or daughters to whom you have given birth who are alive but do not live with you?
[] 1 Yes
[] 2 No (Go to CM8)
[] 2 No (Go to CM8)
CM6. How many sons are alive but do not live with you?
If none, record '00'.
_ _ Sons elsewhere
CM7. How many daughters are alive but do not live with you?
If none, record '00'.
_ _ Daughters elsewhere
CM8. Have you ever given birth to a boy or girl 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?
[] 1 Yes
[] 2 No (Go to CM11)
[] 2 No (Go to CM11)
CM9. How many boys have died?
If none, record '00'.
_ _ Boys dead
CM10. How many girls have died?
If none, record '00'.
_ _ Girls dead
CM11. Sum answers to CM3, CM4, CM6, CM7, CM9 and CM10.
_ _ Sum
CM12. Just to make sure that I have this right, you have had in total (total number in CM11) births during your life. Is this correct?
[] 1 Yes (Go to CM14)
[] 2 No
[] 2 No
CM13. Check responses to CM1-CM10 and make corrections as necessary until response to CM12 is 'Yes'.
CM14. Check CM11: How many live births?
[] 0 No live births, CM11=00 (Go to end of module)
[] 1 One or more live birth, CM11=01 or more
[] 1 One or more live birth, CM11=01 or more
Fertility/birth history: BH
BH0. Now I would like to record the names of all of your births, whether still alive or not, starting with the first one you had.
Record names of all of the births in BH1. Record twins and triplets on separate lines.
BH0. BH line number _ _
BH1. What name was given to your (first/next) baby? ____
BH2. Were any of these births twins?
[] 1 Single
[] 2 Multiple
[] 2 Multiple
BH3. Is (name of birth) a boy or a girl?
[] 1 Boy
[] 2 Girl
[] 2 Girl
BH4. In what year and month was (name of birth) born?
Probe: What is (name of birth)'s birthday?
Year/month/day _ _ _ _ / _ _ / _ _
BH5. Is (name of birth) still alive?
[] 1 Y
[] 2 N (Go to BH9)
[] 2 N (Go to BH9)
BH6. How old was (name of birth) at (his/her) last birthday?
Record age in completed years.
Age _ _
BH7. Is (name of birth) living with you?
[] 1 Yes
[] 2 No
[] 2 No
BH8. Record household line number of child (from HL1)
Record '00' if child is not listed.
Line No _ _ (Go to next birth/Go to BH10)
BH9. How old was (name of birth) when (he/she) died?
If '1 year', probe: How many months old was (name of birth)? Record days if less than 1 month; record months if less than 2 years; or years
Unit
[] 1 Days
[] 2 Months
[] 3 Years
[] 2 Months
[] 3 Years
Number _ _
BH10. Were there any other live births between (name of previous birth) and (name of birth), including any children who died after birth?
[] 1 Yes (Add birth)
[] 2 No (Next birth)
[] 2 No (Next birth)
BH11. Have you had any live births since the birth of (name of last birth listed)?
[] 1 Yes (Record birth(s) in birth history)
[] 2 No
[] 2 No
CM15. Compare number in CM11 with number of births listed in the birth history above and check:
[] 1 Numbers are the same (Go to CM17)
[] 2 Numbers are different
[] 2 Numbers are different
CM16. Probe and reconcile responses in the birth history until response in CM12 is 'Yes'.
CM17. Check BH4: Last birth occurred within the last 2 years, that is, since (month of interview) in (year of interview minus 2)?
If the month of interview and the month of birth are the same, and the year of birth is (year of interview minus 2), consider this as a birth within the last 2 years.
[] 0 No live births in the last 2 years (Go to end of module)
[] 1 One or more live births in the last 2 years
[] 1 One or more live births in the last 2 years
CM18. Copy name of the last child listed in BH1.
If the child has died, take special care when referring to this child by name in the following modules.
Name of last born child ____
Miscarriage, Stillbirth and Abortion: AB
AB0A. Check CM11: Has the woman given birth a baby?
[] 1 Yes, CM11 not equal to 0 (Go to AB1)
[] 2 No, CM11=0
[] 2 No, CM11=0
AB0. Have you ever been pregnant?
[] 1 Yes
[] 2 No (Go to end of module)
[] 2 No (Go to end of module)
AB1. For women, some pregnancies may end up with miscarriage, stillbirth, missed abortion or abortion. I would like to talk to you about this.
Have you had any cases of pregnancy ending up with miscarriage, stillbirth, missed abortion or abortion?
[] 1 Yes
[] 2 No (Go to end of module)
[] 2 No (Go to end of module)
AB2. When was the last time you had miscarriage, stillbirth, missed abortion or abortion?
_ _ _ _ Year
_ _ Month
[] 98 DK
_ _ Month
[] 98 DK
AB3. Check AB2: If miscarriage, stillbirth, missed abortion or abortion occurred withing the last 2 years preceding the survey, that is, since (month of interview) in (year of interview minus 2)?
[] 1 No miscarriage, stillbirth, missed abortion or abortion occurred within the last 2 years (Go to end of module)
[] 2 A miscarriage, or stillbirth, or missed abortion or abortion occurred within the last 2 years
[] 2 A miscarriage, or stillbirth, or missed abortion or abortion occurred within the last 2 years
Pregnancies resulted in miscarriage, stillbirth, missed abortion or abortion [Up to four entries]
AB4. What was the year and month of your last miscarriage, or stillbirth, or missed abortion, or abortion?
_ _ _ _ Year
_ _ Month
[] 98 DK
_ _ Month
[] 98 DK
AB5. At how many week did your pregnancy terminate?
_ _ Weeks
AB6. Did your pregnancy end with a miscarriage, or a stillbirth, or a missed abortion or an abortion?
[] 1 Miscarriage
[] 2 Stillbirth
[] 3 Missed abortion
[] 4 Abortion
[] 2 Stillbirth
[] 3 Missed abortion
[] 4 Abortion
AB7. In the last two years, have you had any other cases of pregnancy which ended with miscarriage, stillbirth, missed abortion or abortion?
[] 1 Yes (Go to next column)
[] 2 No (Go to AB8)
[] 2 No (Go to AB8)
AB8. Check AB6: Did the woman have abortion in the last two years?
[] 1 Had abortion (AB6 = 4)
[] 2 Did not have abortion (AB6 not equal to 4) (Go to end of module)
[] 2 Did not have abortion (AB6 not equal to 4) (Go to end of module)
AB9. Where was your last abortion performed?
If response is "Private hospital" probe: Was it a hospital in Ulaanbaatar, or in aimag/soum? Was it an in-patient hospital or an out-patient clinic?
Public hospital
[] 11 Tertiary level hospital (1st, 2nd, 3rd, mother and child health center)
[] 12 Secondary level hospital (aimag/district hospital)
[] 13 Maternity hospital
[] 15 Soum level hospital/family health center
[] 12 Secondary level hospital (aimag/district hospital)
[] 13 Maternity hospital
[] 15 Soum level hospital/family health center
Private hospital
[] 21 Ulaanbaatar hospital in-patient hospital
[] 22 Out-patient clinic
[] 23 Aimag/soum hospital in-patient hospital
[] 24 Out-patient clinic
[] 30 Ngo's hospital
[] 22 Out-patient clinic
[] 23 Aimag/soum hospital in-patient hospital
[] 24 Out-patient clinic
[] 30 Ngo's hospital
Other
[] 31 At home/at someone else's place
[] 96 Other (specify) ____
AB10. Who performed your last abortion?
Health professional
[] 01 Gynaecologist
[] 02 Physician
[] 03 Family/Soum doctor
[] 04 Midwife
[] 05 Auxiliary midwife
[] 06 Nurse
[] 02 Physician
[] 03 Family/Soum doctor
[] 04 Midwife
[] 05 Auxiliary midwife
[] 06 Nurse
[] 96 Other (specify) ____
[] 09 Myself
[] 09 Myself
AB11. What method was used to perform your last abortion?
[] 1 Dilation and curettage/evacuation
[] 2 Manual vacuum aspiration
[] 3 Electric vacuum aspiration
[] 4 Pill/medicine
[] 5 Rivanol solution
[] 6 Other (specify) ____
[] 8 DK
[] 2 Manual vacuum aspiration
[] 3 Electric vacuum aspiration
[] 4 Pill/medicine
[] 5 Rivanol solution
[] 6 Other (specify) ____
[] 8 DK
Desire for last birth: DB
DB1. Check CM17: Was there a live birth in the last 2 years?
Copy name of last birth listed in the birth history (CM18) to here and use where indicated:
Name ____
[] 1 Yes, CM17=1
[] 2 No, CM17=0 or blank (Go to end of module)
[] 2 No, CM17=0 or blank (Go to end of module)
DB2. When you got pregnant with (name), did you want to get pregnant at that time?
[] 1 Yes (Go to DB5)
[] 2 No
[] 2 No
DB3. Check CM11: Number of births:
[] 1 Only 1 birth (Go to DB4A)
[] 2 2 or more births (Go to DB4B)
[] 2 2 or more births (Go to DB4B)
DB4A. Did you want to have a baby later on, or did you not want any children?
DB4B. Did you want to have a baby later on, or did you not want more children?
[] 1 Later
[] 2 No more
[] 2 No more
DB5. When you decided to get pregnant with (Name), did maternity allowance (monetary allowance for mothers and children) influence your decision?
[] 1 Yes
[] 2 No
[] 2 No
Maternal and newborn health: MN
MN1. Check CM17: Was there a live birth in the last 2 years?
Copy name of last birth listed in the birth history (CM18) to here and use where indicated:
Name ____
[] 1 Yes, CM17=1
[] 2 No, CM17=0 or blank (Go to end of module)
[] 2 No, CM17=0 or blank (Go to end of module)
MN2. Did you see anyone for antenatal care during your pregnancy with (name)?
[] 1 Yes
[] 2 No (Go to MN6A)
[] 2 No (Go to MN6A)
MN3. Whom did you see?
Probe: Anyone else? Probe for the type of person seen and record all answers given.
Health professional
[] D Gynaecologist
[] E Physician
[] I Family/soum doctor
[] J Midwife
[] C Auxiliary midwife
[] K Nurse
[] E Physician
[] I Family/soum doctor
[] J Midwife
[] C Auxiliary midwife
[] K Nurse
[] X Other (specify) ____
MN4. How many weeks pregnant were you when you first received antenatal care for this pregnancy?
Weeks _ _
[] 98 DK
[] 98 DK
MN5. How many times did you receive antenatal care during this pregnancy?
Probe to identify the number of times antenatal care was received. If a range is given, record the minimum number of times antenatal care received.
_ _ Number of times
[] 98 DK
[] 98 DK
MN6. As part of your antenatal care during this pregnancy, were any of the following done at least once:
[A] Measuring blood pressure
[] 1 Yes
[] 2 No
[] 2 No
[B] Urine sample
[] 1 Yes
[] 2 No
[] 2 No
[C] Blood sample
[] 1 Yes
[] 2 No
[] 2 No
[D] Test for STIs/Smear
[] 1 Yes
[] 2 No
[] 2 No
[E] Weight measurement
[] 1 Yes
[] 2 No
[] 2 No
[F] Test for syphilis
[] 1 Yes
[] 2 No
[] 2 No
[G] Ultrasound
[] 1 Yes
[] 2 No
[] 2 No
[H] Hepatitis B and C (HBV, HBC) markers
[] 1 Yes
[] 2 No
[] 2 No
[I] Test for positive/negative blood (to identify Rh group)
[] 1 Yes
[] 2 No
[] 2 No
[J] Test for tuberculosis (TB test)
[] 1 Yes
[] 2 No
[] 2 No
MN6A. Did you take any of the following supplements during your pregnancy with (name)?
[A] Iron supplement
[] 1 Yes
[] 2 No
[] 2 No
[B] Folic acid
[] 1 Yes
[] 2 No
[] 2 No
[C] Multi-nutrient supplement
[] 1 Yes
[] 2 No
[] 2 No
[D] Multi-vitamins such as "Prenatal" or "Elevit"
[] 1 Yes
[] 2 No
[] 2 No
MN6B. Check MN6A [A]: Took iron supplement during pregnancy?
[] 1 Yes, MN6A [A]=1
[] 2 No, MN6A [A]=2 (Go to MN19)
[] 2 No, MN6A [A]=2 (Go to MN19)
MN6CA. How many days did you take the iron supplement?
_ _ _ Number of days
[] 998 DK
[] 998 DK
MN19. Who assisted with the delivery of (name)?
Probe: Anyone else? Probe for the type of person assisting and record all answers given.
Health professional
[] D Gynaecologist
[] E Physician
[] I Family/soum doctor
[] J Midwife
[] C Auxiliary midwife
[] K Nurse
[] E Physician
[] I Family/soum doctor
[] J Midwife
[] C Auxiliary midwife
[] K Nurse
Other
[] F Traditional practitioner
[] G Public health worker
[] G Public health worker
[] X Other (specify) ____
[] Y No one
[] Y No one
MN20. Where did you give birth to (name)?
Probe to identify the place of delivery. If unable to determine whether public or private, write the name of the place and circle '76'.
(Name of place) ____
Public hospital
[] 21 Tertiary level hospital (1st, 2nd, 3rd, mother and child health center)
[] 22 Secondary level hospital (aimag/district hospital)
[] 23 Maternity hospital
[] 24 Soum level hospital/family health center
[] 22 Secondary level hospital (aimag/district hospital)
[] 23 Maternity hospital
[] 24 Soum level hospital/family health center
Private hospital
[] 31 Ulaanbaatar
[] 32 Aimag/soum
[] 32 Aimag/soum
Other
[] 11 At home (Go to MN23)
[] 12 At someone else's place (Go to MN23)
[] 12 At someone else's place (Go to MN23)
[] 76 DK public or private
[] 96 Other (specify) ____ (Go to MN23)
[] 96 Other (specify) ____ (Go to MN23)
MN21. Was (name) delivered by caesarean section?
[] 1 Yes
[] 2 No (Go to MN23)
[] 2 No (Go to MN23)
MN22. When was the decision made to have the caesarean section?
Probe if necessary: Was it before or after your labour pains started?
[] 1 Before labour pains
[] 2 After labour pains
[] 2 After labour pains
MN23. Immediately after the birth, was (name) put directly on the bare skin of your chest?
If necessary, show the picture of skin-to-skin position. [Image omitted]
[] 1 Yes
[] 2 No (Go to MN25)
[] 8 DK/don't remember (Go to MN25)
[] 2 No (Go to MN25)
[] 8 DK/don't remember (Go to MN25)
MN23A. That time, did your child have a hat worn?
[] 1 Yes
[] 2 No
[] 8 DK/don't remember
[] 2 No
[] 8 DK/don't remember
MN23B. That time, did your child covered with blanket?
[] 1 Yes
[] 2 No
[] 8 DK/don't remember
[] 2 No
[] 8 DK/don't remember
MN24. Before being placed on the bare skin of your chest, was the baby wrapped up?
[] 1 Yes
[] 2 No
[] 8 DK/don't remember
[] 2 No
[] 8 DK/don't remember
MN25. Was (name) dried or wiped soon after birth?
[] 1 Yes
[] 2 No
[] 8 DK/don't remember
[] 2 No
[] 8 DK/don't remember
MN26. How long after the birth was (name) bathed for the first time?
If "immediately" or less than 1 hour, record '000'. If less than 24 hours, record hours. If "1 day" or "next day", probe: About how many hours after the delivery? If "24 hours", probe to ensure best estimate of less than 24 hours or 1 day. If 24 hours or more, record days.
[] 000 Immediately/within 1 hour
[] 1 Hours _ _
[] 2 Days _ _
[] 997 Never bathed
[] 998 DK/don't remember
[] 1 Hours _ _
[] 2 Days _ _
[] 997 Never bathed
[] 998 DK/don't remember
MN33. Was (name) weighed at birth?
[] 1 Yes
[] 2 No (Go to MN35)
[] 8 DK (Go to MN35)
[] 2 No (Go to MN35)
[] 8 DK (Go to MN35)
MN34. How much did (name) weigh?
If the Maternal and newborn health booklet is available, record weight from the Maternal and newborn health booklet.
[] 1 From booklet (KG) _ . _ _ _
[] 2 From recall (KG) _ . _ _ _
[] 99998 DK
[] 2 From recall (KG) _ . _ _ _
[] 99998 DK
MN35. Has your menstrual period returned since the birth of (name)?
[] 1 Yes
[] 2 No
[] 2 No
MN36. Did you ever breastfeed (name)?
[] 1 Yes
[] 2 No (Go to MN39B)
[] 2 No (Go to MN39B)
MN37. How long after birth did you first put (name) to the breast?
If less than 1 hour after birth, record '000' hours. If less than 24 hours, record hours. Otherwise, record days.
[] 000 Immediately
[] 1 Hours _ _
[] 2 Days _ _
[] 998 DK/do not remember
[] 1 Hours _ _
[] 2 Days _ _
[] 998 DK/do not remember
MN38. In the first three days after delivery, was (name) given anything to drink other than breast milk, such as water (other than breast milk), other mother's milk etc.?
[] 1 Yes (Go to MN39A)
[] 2 No (Go to end of module)
[] 2 No (Go to end of module)
MN39A. What was (name) given to drink?
Probe: Anything else? 'Not given anything to drink' is not a valid response and response category Y cannot be recorded.
MN39B. In the first three days after delivery, what was (name) given to drink?
Probe: Anything else? 'Not given anything to drink' (category Y) can only be recorded if no other response category is recorded.
[] A Milk (other than breast milk)
[] B Water
[] C Sugar or glucose water
[] E Sugar-salt-water solution
[] F Fruit juice
[] G Infant formula
[] H Tea/milk infusions
[] I Honey
[] J Prescribed medicine
[] K Other mother's milk
[] X Other (specify) ____
[] Y Nothing to drink was given
[] B Water
[] C Sugar or glucose water
[] E Sugar-salt-water solution
[] F Fruit juice
[] G Infant formula
[] H Tea/milk infusions
[] I Honey
[] J Prescribed medicine
[] K Other mother's milk
[] X Other (specify) ____
[] Y Nothing to drink was given
Post-natal health checks: PN
PN1. Check CM17: Was there a live birth in the last 2 years?
Copy name of last birth listed in the birth history (CM18) to here and use where indicated:
Name ____
[] 1 Yes, CM17=1
[] 2 No, CM17=0 or blank (Go to end of module)
[] 2 No, CM17=0 or blank (Go to end of module)
PN2. Check MN20: Was child delivered in a health facility?
[] 1 Yes, MN20=21-32 or 76
[] 2 No, MN20=11-12 or 96 (Go to PN7)
[] 2 No, MN20=11-12 or 96 (Go to PN7)
PN3. Now I would like to ask you some questions about services and care provided to you after the birth of (name).
How long did you stay at (name or type of facility in MN20) after the delivery of (name)?
If less than one day, record hours. If less than one week, record days. Otherwise, record weeks.
[] 1 Hours _ _
[] 2 Days _ _
[] 3 Weeks _ _
[] 998 DK/don't remember
[] 2 Days _ _
[] 3 Weeks _ _
[] 998 DK/don't remember
PN4. I would like to talk to you about checks on (name)'s health after delivery - for example, someone examining (name), checking the cord, or seeing if (name) is ok.
Before you left the (name or type of facility in MN20), did anyone check on (name)'s health?
[] 1 Yes
[] 2 No
[] 2 No
PN5. And what about checks on your health - I mean, someone assessing your health, for example asking questions about your health or examining you?
Did anyone check on your health before you left (name or type or facility in MN20)?
[] 1 Yes
[] 2 No
[] 2 No
PN6. Now I would like to talk to you about what happened after you left (name or type of facility in MN20).
Did anyone check on (name)'s health after you left (name or type of facility in MN20)?
If response is "Yes", probe: Was it within 3 days after birth, or in more than 3 days after birth?
[] 1 Yes, within 3 days (Go to PN12)
[] 2 Yes, in more than 3 days (Go to PN12)
[] 3 No (Go to PN17)
[] 2 Yes, in more than 3 days (Go to PN12)
[] 3 No (Go to PN17)
PN7. Check MN19: Did a health professional, traditional birth attendant, or community health worker assist with the delivery?
[] 1 Yes, MN19 = D, E, I, J, C, K, F, G
[] 2 No, MN19 = X, Y (Go to PN11)
[] 2 No, MN19 = X, Y (Go to PN11)
PN8. You have already said that (person or persons in MN19) assisted with the birth. Now I would like to talk to you about checks on (name)'s health after delivery, for example examining (name), checking the cord, or seeing if (name) is ok.
After the delivery was over and before (person or persons in MN19) left you, did (person or persons in MN19) check on (name)'s health?
[] 1 Yes
[] 2 No
[] 2 No
PN9. And did (person or persons in MN19) check on your health before leaving, for example asking questions about your health or examining you?
[] 1 Yes
[] 2 No
[] 2 No
PN10. After the (person or persons in MN19) left you, did anyone check on the health of (name)?
[] 1 Yes (Go to PN12)
[] 2 No (Go to PN19)
[] 2 No (Go to PN19)
PN11. I would like to talk to you about checks on (name)'s health after delivery - for example, someone examining (name), checking the cord, or seeing if the baby is ok.
After (name) was delivered, did anyone check on (his/her) health?
[] 1 Yes
[] 2 No (Go to PN20)
[] 2 No (Go to PN20)
PN12. Did such a check happen only once, or more than once?
[] 1 Once (Go to PN13A)
[] 2 Two or more times (Go to PN13B)
[] 2 Two or more times (Go to PN13B)
PN13A. How long after delivery did that check happen?
PN13B. How long after delivery did the first of these checks happen?
If less than one day, record hours. If less than one week, record days. Otherwise, record weeks.
[] 1 Hours _ _
[] 2 Days _ _
[] 3 Weeks _ _
[] 998 DK/don't remember
[] 2 Days _ _
[] 3 Weeks _ _
[] 998 DK/don't remember
PN14. Who checked on (name)'s health at that time?
Health professional
[] D Pediatrician
[] E Physician
[] I Family/soum doctor
[] J Midwife
[] C Auxiliary midwife
[] K Nurse
[] E Physician
[] I Family/soum doctor
[] J Midwife
[] C Auxiliary midwife
[] K Nurse
Other
[] F Traditional practitioner
[] G Public health worker
[] G Public health worker
[] X Other (specify) ____
PN15. Where did this check take place?
Probe to identify the type of place. If unable to determine whether public or private, write the name of the place and then temporarily record '76' until you learn the appropriate category for the response.
(Name of place) ____
Public hospital
[] 21 Tertiary level hospital (1st, 2nd, 3rd, mother and child health center)
[] 22 Secondary level hospital (aimag/district hospital)
[] 23 Maternity hospital
[] 24 Soum level hospital/family health center
[] 22 Secondary level hospital (aimag/district hospital)
[] 23 Maternity hospital
[] 24 Soum level hospital/family health center
Private hospital
[] 31 Ulaanbaatar
[] 32 Aimag/soum
[] 32 Aimag/soum
Other
[] 11 At home
[] 12 At someone else's place
[] 12 At someone else's place
[] 76 DK public or private
[] 96 Other (specify) ____
[] 96 Other (specify) ____
PN16. Check MN20: Was the child delivered in a health facility?
[] 1 Yes, MN20=21-36 or 76
[] 2 No, MN20=11-12 or 96 (Go to PN18)
[] 2 No, MN20=11-12 or 96 (Go to PN18)
PN17. After you left (name or type of facility in MN20), did anyone check on your health?
If response is "yes", probe: Within 3 days after birth, or more than 3 days after birth?
[] 1 Yes, within 3 days (Go to PN21)
[] 2 Yes, in more than 3 days (Go to PN21)
[] 3 No (Go to PN25)
[] 2 Yes, in more than 3 days (Go to PN21)
[] 3 No (Go to PN25)
PN18. Check MN19: Did a health professional, traditional birth attendant, or community health worker assist with the delivery?
[] 1 Yes, MN19 = D, E, I, J, C, K, F, G
[] 2 No, MN1 = X, Y (Go to PN20)
[] 2 No, MN1 = X, Y (Go to PN20)
PN19. After the delivery was over and (person or persons in MN19) left, did anyone check on your health?
[] 1 Yes (Go to PN21)
[] 2 No (Go to PN25)
[] 2 No (Go to PN25)
PN20. After the birth of (name), did anyone check on your health, for example asking questions about your health or examining you?
[] 1 Yes
[] 2 No (Go to PN25)
[] 2 No (Go to PN25)
PN21. Did such a check happen only once, or more than once?
[] 1 Once (Go to PN22A)
[] 2 Two or more times (Go to PN22B)
[] 2 Two or more times (Go to PN22B)
PN22A. How long after delivery did that check happen?
PN22B. How long after delivery did the first of these checks happen?
If less than one day, record hours. If less than one week, record days. Otherwise, record weeks.
[] 1 Hours _ _
[] 2 Days _ _
[] 3 Weeks _ _
[] 998 DK/don't remember
[] 2 Days _ _
[] 3 Weeks _ _
[] 998 DK/don't remember
PN23. Who checked on your health at that time?
Health professional
[] D Gynaecologist
[] E Physician
[] I Family/soum doctor
[] J Midwife
[] C Auxiliary midwife
[] K Nurse
[] E Physician
[] I Family/soum doctor
[] J Midwife
[] C Auxiliary midwife
[] K Nurse
Other
[] F Traditional practitioner
[] G Public health worker
[] G Public health worker
[] X Other (specify) ____
PN24. Where did this check take place?
Probe to identify the type of check.
If unable to determine whether public or private, write the name of the place and then temporarily record '76' until you learn the appropriate category for the response.
(Name of place)____
Public hospital
[] 21 Tertiary level hospital (1st, 2nd, 3rd, mother and child health center)
[] 22 Secondary level hospital (aimag/district hospital)
[] 23 Maternity hospital
[] 24 Soum level hospital/family health center
[] 22 Secondary level hospital (aimag/district hospital)
[] 23 Maternity hospital
[] 24 Soum level hospital/family health center
Private hospital
[] 31 Ulaanbaatar
[] 32 Aimag/soum
[] 32 Aimag/soum
Other
[] 11 At home
[] 12 At someone else's place
[] 12 At someone else's place
[] 76 DK public or private
[] 96 Other (specify) ____
[] 96 Other (specify) ____
PN25. During the first two days after birth, did any health care provider do any of the following either at home or at a facility:
[A] Examine (name)'s cord?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
[B] Take the temperature of (name)?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
[D] Take the temperature of you?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
[C] Counsel you on breastfeeding?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
PN26. Check MN36: Was child ever breastfed?
[] 1 Yes, MN36=1
[] 2 No, MN36=2 (Go to PN28)
[] 2 No, MN36=2 (Go to PN28)
PN27. Observe (name)'s breastfeeding?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
PN28. Check MN33: Was child weighed at birth?
[] 1 Yes, MN33=1 (Go to PN29A)
[] 2 No, MN33=2 (Go to PN29B)
[] 8 DK, MN33=8 (Go to PN29C)
[] 2 No, MN33=2 (Go to PN29B)
[] 8 DK, MN33=8 (Go to PN29C)
PN29A. You mentioned that (name) was weighed at birth. After that, was (name) weighed again by a health care provider within two days?
PN29B. You mentioned that (name) was not weighed at birth. Was (name) weighed at all by a health care provider within two days after birth?
PN29C. You mentioned that you do not know if (name) was weighed at birth. Was (name) weighed at all by a health care provider within two days after birth?
[] 1 Yes
[] 2 No
[] 2 No
PN30. During the first two days after (name)'s birth, did any health care provider give you information on the symptoms that require you to take your sick child to a health facility for care?
[] 1 Yes
[] 2 No
[] 2 No
Contraception: CP
CP1. I would like to talk with you about another subject: family planning.
Are you pregnant now?
[] 1 Yes, currently pregnant (Go to CP3)
[] 2 Not pregnant
[] 8 DK or not sure
[] 2 Not pregnant
[] 8 DK or not sure
CP2. Are you currently doing something or using any method to delay or avoid getting pregnant?
[] 1 Yes (Go to CP4)
[] 2 No
[] 2 No
CP3. Have you ever done something or used any method to delay or avoid getting pregnant?
[] 1 Yes (Go to end of module)
[] 2 No (Go to end of module)
[] 2 No (Go to end of module)
CP4. What type of method are you using?
If response if "IUD", probe: Was it inserted in your upper arm? Do not prompt. If more than one method is mentioned, circle each one.
[] A Female sterilization
[] B Male sterilization
[] C IUD
[] D Injectables
[] E Implants
[] F Pill
[] G Male condom
[] H Female condom
[] I Diaphragm
[] J Foam/jelly
[] K Lactational amenorrhoea method
[] L Periodic abstinence/rhythm
[] M Withdrawal
[] X Other (specify) ____
[] B Male sterilization
[] C IUD
[] D Injectables
[] E Implants
[] F Pill
[] G Male condom
[] H Female condom
[] I Diaphragm
[] J Foam/jelly
[] K Lactational amenorrhoea method
[] L Periodic abstinence/rhythm
[] M Withdrawal
[] X Other (specify) ____
Unmet need: UN
UN1. Check CP1: Currently pregnant?
[] 1 Yes, CP1=1
[] 2 No, DK or not sure, CP1=2 or 8 (Go to UN6)
[] 2 No, DK or not sure, CP1=2 or 8 (Go to UN6)
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?
[] 1 Yes (Go to UN5)
[] 2 No
[] 2 No
UN3. Check CM11: Any births?
[] 0 No births (Go to UN4A)
[] 1 One or more births (Go to UN4B)
[] 1 One or more births (Go to UN4B)
UN4A. Did you want to have a baby later on or did you not want any children?
UN4B. Did you want to have a baby later on or did you not want any more children?
[] 1 Later
[] 2 None/no more
[] 2 None/no more
UN5. 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?
[] 1 Have another child (Go to UN8)
[] 2 None/no more (Go to UN13A)
[] 8 Undecided/DK (Go to UN13A)
[] 2 None/no more (Go to UN13A)
[] 8 Undecided/DK (Go to UN13A)
UN6. Check CP4: Currently using 'Female sterilization'?
[] 1 Yes, CP4=A (Go to UN13A)
[] 2 No, CP4 does not equal A
[] 2 No, CP4 does not equal A
UN7. 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?
[] 1 Have (a/another) child
[] 2 No more/none (Go to UN10)
[] 3 Says she cannot get pregnant (Go to UN12)
[] 8 Undecided/DK (Go to UN10)
[] 2 No more/none (Go to UN10)
[] 3 Says she cannot get pregnant (Go to UN12)
[] 8 Undecided/DK (Go to UN10)
UN8. How long would you like to wait before the birth of (a/another) child?
Record the answer as stated by respondent.
[] 1 Months _ _
[] 2 Years _ _
[] 993 Soon
[] 994 Says she cannot get pregnant (Go to UN12)
[] 995 After marriage
[] 996 Other
[] 998 DK
[] 2 Years _ _
[] 993 Soon
[] 994 Says she cannot get pregnant (Go to UN12)
[] 995 After marriage
[] 996 Other
[] 998 DK
UN9. Check CP1: Currently pregnant?
[] 1 Yes, CP1=1 (Go to UN13A)
[] 2 No, DK or not sure, CP1=2 or 8
[] 2 No, DK or not sure, CP1=2 or 8
UN10. Check CP2: Currently using a contraception method?
[] 1 Yes, CP2=1 (Go to UN13A)
[] 2 No, CP2=2
[] 2 No, CP2=2
UN11. Do you think you are physically able to get pregnant at this time?
[] 1 Yes (Go to UN13A)
[] 2 No
[] 8 DK (Go to UN13A)
[] 2 No
[] 8 DK (Go to UN13A)
UN12. Why do you think you are not physically able to get pregnant?
If says she cannot get pregnant, probe: How long have you been attempting to become pregnant?
[] A Infrequent sex/no sex
[] B Menopausal
[] C Never menstruated
[] D Hysterectomy (surgical removal of uterus)
[] J Has been trying to get pregnant for 1-2 years without result
[] E Has been trying to get pregnant for 2 years or more without result
[] F Postpartum amenorrheic
[] G Breastfeeding
[] H Too old
[] X Other (specify) ____
[] Z DK
[] B Menopausal
[] C Never menstruated
[] D Hysterectomy (surgical removal of uterus)
[] J Has been trying to get pregnant for 1-2 years without result
[] E Has been trying to get pregnant for 2 years or more without result
[] F Postpartum amenorrheic
[] G Breastfeeding
[] H Too old
[] X Other (specify) ____
[] Z DK
UN13A. Check UN11: Had live births?
[] 1 Yes, CM11 does not equal 0 (Go to UN13BA)
[] 2 No, CM11=0 (Go to UN13BB)
[] 2 No, CM11=0 (Go to UN13BB)
UN13BA. If you imagined that you were returning to your age when you have not had any children yet, how many children would you want to have?
UN13BB. How many children would you like to have?
[] 00 Never want/doesn't want (Go to UN13)
_ _ Number of desired children
[] 96 Other (specify) (Go to UN13)
_ _ Number of desired children
[] 96 Other (specify) (Go to UN13)
UN13C. How many boys would you like to have/would you want to have?
_ _ Boys
[] 95 Sex doesn't matter (Go to UN13)
[] 95 Sex doesn't matter (Go to UN13)
UN13D. How many girls would you like to have/would you want to have?
_ _ Girls
UN13. Check UN12: 'Never menstruated' mentioned?
[] 1 Mentioned, UN12=C (Go to end of module)
[] 2 Not mentioned, UN12 does not equal C
[] 2 Not mentioned, UN12 does not equal C
UN14. When did your last menstrual period start?
Record the answer using the same unit stated by the respondent. If '1 year', probe: How many months ago?
[] 1 Days ago _ _
[] 2 Weeks ago _ _
[] 3 Months ago _ _
[] 4 Years ago _ _
[] 993 In menopause/has had hysterectomy (Go to end of module)
[] 994 Before last birth (Go to end of module)
[] 995 Never menstruated (Go to end of module)
[] 2 Weeks ago _ _
[] 3 Months ago _ _
[] 4 Years ago _ _
[] 993 In menopause/has had hysterectomy (Go to end of module)
[] 994 Before last birth (Go to end of module)
[] 995 Never menstruated (Go to end of module)
UN15. Check UN14: Was the last menstrual period within last year?
[] 1 Yes, within last year
[] 2 No, one year or more (Go to end of module)
[] 2 No, one year or more (Go to end of module)
UN16. Due to your last menstruation, were there any social activities, school or work days that you did not attend?
[] 1 Yes
[] 2 No (Go to UN17)
[] 8 DK/not sure/no such activity (Go to UN17)
[] 2 No (Go to UN17)
[] 8 DK/not sure/no such activity (Go to UN17)
UN16?. Can you name the main reason you refrained from attending school, or going to work, or any social activities?
[] 1 Feeling unwell or in pain
[] 2 Heavy bleeding
[] 3 Poor sanitation facilities outside home
[] 4 Fear of degrading treatment by others
[] 6 Other (specify) ____
[] 8 DK
[] 2 Heavy bleeding
[] 3 Poor sanitation facilities outside home
[] 4 Fear of degrading treatment by others
[] 6 Other (specify) ____
[] 8 DK
UN17. During your last menstruation, was it difficult for you to care of personal hygiene at home?
Probe if needed: Was there anything to fear or to be anxious about?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
UN18. Did you use any materials such as sanitary pads, tampons or cloth?
[] 1 Yes
[] 2 No (Go to end of module)
[] 8 DK (Go to end of module)
[] 2 No (Go to end of module)
[] 8 DK (Go to end of module)
UN19. Were the materials reusable?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
Marriage/union: MA
MA1. Are you currently married or living together with someone as if married?
[] 1 Yes, currently married
[] 2 Yes, living with a partner
[] 3 No, not in union (Go to MA5)
[] 2 Yes, living with a partner
[] 3 No, not in union (Go to MA5)
MA2. How old is your (husband/partner)?
Probe: How old was your (husband/partner) on his last birthday?
_ _ Age in years (Go to MA7)
[] 98 DK (Go to MA7)
[] 98 DK (Go to MA7)
MA5. Have you ever been married or lived together with someone as if married?
[] 1 Yes, formerly married
[] 2 Yes, formerly lived with a partner
[] 3 No (Go to end of module)
[] 2 Yes, formerly lived with a partner
[] 3 No (Go to end of module)
MA6. What is your marital status now: are you widowed, divorced or separated?
[] 1 Widowed
[] 2 Divorced
[] 3 Separated
[] 2 Divorced
[] 3 Separated
MA7. Have you been married or lived with someone only once or more than once?
[] 1 Only once (Go to MA8A)
[] 2 More than once (Go to MA8B)
[] 2 More than once (Go to MA8B)
MA8A. In what year and month did you start living with your (husband/partner)?
MA8B. In what year and month did you start living with your first (husband/partner)?
Date of (first) union
_ _ _ _ Year
[] 9998 DK Year
_ _ Month
[] 98 DK Month
[] 9998 DK Year
_ _ Month
[] 98 DK Month
MA9. Check MA8A/B: Is 'DK year' recorded?
[] 1 Yes, MA8A/B=9998
[] 2 No, MA8A/B does not equal 9998 (Go to end of module)
[] 2 No, MA8A/B does not equal 9998 (Go to end of module)
MA10. Check MA7: In union only once?
[] 1 Yes, MA7=1 (Go to MA11A)
[] 2 No, MA7=2 (Go to MA11B)
[] 2 No, MA7=2 (Go to MA11B)
MA11A. How old were you when you started living with your (husband/partner)?
MA11B. How old were you when you started living with your first (husband/partner)?
Age in years _ _
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?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
[B] If she neglects the children?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
[C] If she argues with him?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
[D] If she refuses to have sex with him?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
[E] If she prepares tasteless meal or burns the food?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
DV2. Check MA1: Currently married or living together with someone as if married?
[] 1 Yes, MA1=1, 2
[] 2 No, MA1=3 (Go to end of module)
[] 2 No, MA1=3 (Go to end of module)
DV3. Can you say NO to your (husband / partner) if you do not want to have sexual intercourse?
[] 1 Yes
[] 2 No
[] 8 DK/not sure/depends on situation
[] 2 No
[] 8 DK/not sure/depends on situation
DV4. Who usually makes decisions related to caring about your reproductive health? For example, women's health check, family planning, antenatal care etc.
[] 1 Myself
[] 2 Husband/partner
[] 3 Jointly with husband/partner
[] 4 Jointly with others
[] 2 Husband/partner
[] 3 Jointly with husband/partner
[] 4 Jointly with others
DV5. Check CP2/CP3: Currently or ever use any methods to delay or avoid getting pregnant?
[] 1 Yes, CP1=1 or CP3=1
[] 2 No, CP2=2 and CP3=2 (Go to end of module)
[] 2 No, CP2=2 and CP3=2 (Go to end of module)
DV6. Who usually makes decisions on the method of contraception use? Yourself, or your husband/partner, or together jointly?
[] 1 Mostly herself
[] 2 Mostly husband/partner
[] 3 Jointly
[] 6 Other (specify)
[] 2 Mostly husband/partner
[] 3 Jointly
[] 6 Other (specify)
Victimization: VT
VT1. 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.
[] 1 Yes
[] 2 No (Go to VT9B)
[] 8 DK (Go to VT9B)
[] 2 No (Go to VT9B)
[] 8 DK (Go to VT9B)
VT2. Did this last happen during the last 12 months, that is, since (month of interview) of (year of interview minus 1)?
[] 1 Yes, during last 12 months
[] 2 No, more than 12 months ago (Go to VT5B)
[] 8 DK/don't remember (Go to VT5B)
[] 2 No, more than 12 months ago (Go to VT5B)
[] 8 DK/don't remember (Go to VT5B)
VT3. How many times did this happen in the last 12 months?
If response is 'DK/Don't remember', probe: Did it happen once, twice, or at least three times?
[] 1 Once
[] 2 Twice
[] 3 Three or more times
[] 8 DK/don't remember
[] 2 Twice
[] 3 Three or more times
[] 8 DK/don't remember
VT4. Check VT3: Once or more times?
[] 1 One time, VT3=1 (Go to VT5A)
[] 2 More than once or DK, VT3=2, 3 or 8 (Go to VT5B)
[] 2 More than once or DK, VT3=2, 3 or 8 (Go to VT5B)
VT5A. When this happened, was anything stolen from you?
VT5B. The last time this happened, was anything stolen from you?
[] 1 Yes
[] 2 No
[] 8 DK/not sure
[] 2 No
[] 8 DK/not sure
VT6. Did the person(s) have a weapon?
[] 1 Yes
[] 2 No (Go to VT8)
[] 8 DK/not sure (Go to VT8)
[] 2 No (Go to VT8)
[] 8 DK/not sure (Go to VT8)
VT7. Was a knife, a gun or something else used as a weapon?
Record all that apply.
[] A Yes, knife
[] B Yes, gun
[] X Yes, something else
[] B Yes, gun
[] X Yes, something else
VT8. Did you or anyone else report the incident to the police?
If 'Yes', probe: Was the incident reported by you or someone else?
[] 1 Yes, respondent reported (Go to VT9A)
[] 2 Yes, someone else reported (Go to VT9A)
[] 3 No, not reported (Go to VT9A)
[] 8 DK/not sure (Go to VT9A)
[] 2 Yes, someone else reported (Go to VT9A)
[] 3 No, not reported (Go to VT9A)
[] 8 DK/not sure (Go to VT9A)
VT9A. Apart from the incident(s) just covered, have you in the last three years, that is since (month of interview) of (year of interview minus 3), been physically attacked?
VT9B. In the same period of the last three years, that is since (month of interview) of (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 VT1.
[] 1 Yes
[] 2 No (Go to VT20)
[] 8 DK (Go to VT20)
[] 2 No (Go to VT20)
[] 8 DK (Go to VT20)
VT10. Did this last happen during the last 12 months, that is, since (month of interview) (year of interview minus 1)?
[] 1 Yes, during the last 12 months
[] 2 No, more than 12 months ago (Go to VT12B)
[] 8 DK/Don't remember (Go to VT12B)
[] 2 No, more than 12 months ago (Go to VT12B)
[] 8 DK/Don't remember (Go to VT12B)
VT11. 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?
[] 1 Once (Go to VT12A)
[] 2 Twice (Go to VT12B)
[] 3 Three, or more times (Go to VT12B)
[] 8 DK/don't remember (Go to VT12B)
[] 2 Twice (Go to VT12B)
[] 3 Three, or more times (Go to VT12B)
[] 8 DK/don't remember (Go to VT12B)
VT12A. Where did this happen?
VT12B. Where did this happen the last time?
[] 11 At home
[] 12 In another home
[] 21 On the street
[] 22 On public transport
[] 23 Public restaurant/cafe/bar
[] 26 Other public (specify) ____
[] 31 At school
[] 32 At workplace
[] 96 Other place (specify) ____
[] 12 In another home
[] 21 On the street
[] 22 On public transport
[] 23 Public restaurant/cafe/bar
[] 26 Other public (specify) ____
[] 31 At school
[] 32 At workplace
[] 96 Other place (specify) ____
VT13. How many people were involved in committing the offence?
If 'DK/Don't remember', probe: Was it one, two, or at least three people?
[] 1 One person (Go to VT14A)
[] 2 Two people (Go to VT14B)
[] 3 Three or more people (Go to VT14B)
[] 8 DK/don't remember (Go to VT14B)
[] 2 Two people (Go to VT14B)
[] 3 Three or more people (Go to VT14B)
[] 8 DK/don't remember (Go to VT14B)
VT14A. At the time of the incident, did you recognize the person?
VT14B. At the time of the incident, did you recognize at least one of the persons?
[] 1 Yes
[] 2 No
[] 8 DK/don't remember
[] 2 No
[] 8 DK/don't remember
VT17. Did the person(s) have a weapon?
[] 1 Yes
[] 2 No (Go to VT19)
[] 8 DK/not sure (Go to VT19)
[] 2 No (Go to VT19)
[] 8 DK/not sure (Go to VT19)
VT18. Was a knife, a gun or something else used as a weapon?
Record all that apply.
[] A Yes, knife
[] B Yes, gun
[] X Yes, something else
[] B Yes, gun
[] X Yes, something else
VT19. Did you or anyone else report the incident to the police?
If 'Yes', probe: Was the incident reported by you or someone else?
[] 1 Yes, respondent reported
[] 2 Yes, someone else reported
[] 3 No, not reported
[] 8 DK/not sure
[] 2 Yes, someone else reported
[] 3 No, not reported
[] 8 DK/not sure
VT20. How safe do you feel walking alone in your neighbourhood after dark?
[] 1 Very safe
[] 2 Safe
[] 3 Unsafe
[] 4 Very unsafe
[] 7 Never walk alone after dark
[] 2 Safe
[] 3 Unsafe
[] 4 Very unsafe
[] 7 Never walk alone after dark
VT21. How safe do you feel when you are at home alone after dark?
[] 1 Very safe
[] 2 Safe
[] 3 Unsafe
[] 4 Very unsafe
[] 7 Never alone after dark
[] 2 Safe
[] 3 Unsafe
[] 4 Very unsafe
[] 7 Never alone after dark
VT22. In the past 12 months, have you personally felt discriminated against or harassed on the basis of the following grounds?
[A] Ethnicity?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
[B] Sex?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
[C] Sexual orientation?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
[D] Age?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
[E] Religion and belief?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
[F] Disability?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
[G] Birthplace?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
[H] Rural-urban disparity?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
[I] Living standard (rich, poor)?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
[J] Place of current residence (apartment or outskirts ger neighborhood)?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
[K] Level of education?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
[X] Other reasons?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
VT23. During the last 12 months, or since (months of interview) of (year of interview minus 1), has anyone stolen from you something?
[] 1 Yes
[] 2 No (Go to VT25)
[] 3 DK/not sure (Go to VT25)
[] 2 No (Go to VT25)
[] 3 DK/not sure (Go to VT25)
VT24. Have you or anyone else reported this incident to the police?
If 'more than once': Have you or anyone else reported last incident to the police?
[] 1 Yes, reported herself
[] 2 Yes, someone else reported
[] 3 No, did not report
[] 8 DK/not sure
[] 2 Yes, someone else reported
[] 3 No, did not report
[] 8 DK/not sure
VT25. During the last 12 months, or since (months of interview) of (year of interview minus 1), did you lose something due to fraud?
[] 1 Yes
[] 2 No (Go to end of module)
[] 3 DK/not sure (Go to end of module)
[] 2 No (Go to end of module)
[] 3 DK/not sure (Go to end of module)
VT26. Have you or anyone else reported this incident to the police?
If 'more than once': Have you or anyone else reported last incident to the police?
[] 1 Yes, reported herself
[] 2 Yes, someone else reported
[] 3 No, did not report
[] 8 DK/not sure
[] 2 Yes, someone else reported
[] 3 No, did not report
[] 8 DK/not sure
Adult functioning: AF
AF1. Check WB4: Age of respondent?
[] 1 Age 15-17 years (Go to end of module)
[] 2 Age 18-49 years
[] 2 Age 18-49 years
AF2. Do you wear glasses or contact lenses?
Include if glasses are worn for reading.
[] 1 Yes
[] 2 No
[] 2 No
AF3. Do you use hearing aids?
[] 1 Yes
[] 2 No
[] 2 No
AF4. 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) 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) cannot do the activity at all.
AF5. Check AF2: Respondent uses glasses or contact lenses?
[] 1 Yes, AF2=1 (Go to AF6A)
[] 2 No, AF2=2 (Go to AF6B)
[] 2 No, AF2=2 (Go to AF6B)
AF6A. When using your glasses or contact lenses, do you have difficulty seeing?
AF6B. Do you have difficulty seeing?
[] 1 No difficulty
[] 2 Some difficulty
[] 3 A lot of difficulties
[] 4 Cannot see at all
[] 2 Some difficulty
[] 3 A lot of difficulties
[] 4 Cannot see at all
AF7. Check AF3: Respondent uses hearing aid?
[] 1 Yes, AF3=1 (Go to AF8A)
[] 2 No, AF3=2 (Go to AF8B)
[] 2 No, AF3=2 (Go to AF8B)
AF8A. When using your hearing aid(s), do you have difficulty hearing?
AF8B. Do you have difficulty hearing?
[] 1 No difficulty
[] 2 Some difficulty
[] 3 A lot of difficulties
[] 4 Cannot hear at all
[] 2 Some difficulty
[] 3 A lot of difficulties
[] 4 Cannot hear at all
AF9. Do you have difficulty walking or climbing steps?
[] 1 No difficulty
[] 2 Some difficulty
[] 3 A lot of difficulties
[] 4 Cannot walk/climb steps at all
[] 2 Some difficulty
[] 3 A lot of difficulties
[] 4 Cannot walk/climb steps at all
AF10. Do you have difficulty in remembering or concentrating?
[] 1 No difficulty
[] 2 Some difficulty
[] 3 A lot of difficulties
[] 4 Cannot remember or concentrate at all
[] 2 Some difficulty
[] 3 A lot of difficulties
[] 4 Cannot remember or concentrate at all
AF11. Do you have difficulty with self-care, such as washing all over or dressing?
[] 1 No difficulty
[] 2 Some difficulty
[] 3 A lot of difficulties
[] 4 Cannot care for self at all
[] 2 Some difficulty
[] 3 A lot of difficulties
[] 4 Cannot care for self at all
AF12. Using your usual language, do you have difficulty communicating, for example understanding or being understood?
[] 1 No difficulty
[] 2 Some difficulty
[] 3 A lot of difficulties
[] 2 Some difficulty
[] 3 A lot of difficulties
Sexual behavior: SB
SB1. 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?
[] 00 Never had intercourse (Go to end of module)
_ _ Age in years
[] 95 First time when started living with (first husband/partner)
_ _ Age in years
[] 95 First time when started living with (first husband/partner)
SB2. I would like to ask you about 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.
[] 1 Days ago _ _
[] 2 Weeks ago _ _
[] 3 Months ago _ _
[] 4 Years ago _ _ (Go to end of module)
[] 2 Weeks ago _ _
[] 3 Months ago _ _
[] 4 Years ago _ _ (Go to end of module)
SB3. The last time you had sexual intercourse, was a condom used?
[] 1 Yes
[] 2 No
[] 2 No
SB4. 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 'Boyfriend', then ask: Were you living together as if married? If 'Yes', circle '2'. If 'No', circle '3'.
[] 1 Husband
[] 2 Cohabiting partner
[] 3 Boyfriend (Go to SB6)
[] 4 Casual acquaintance (Go to SB6)
[] 5 Client/sex worker (Go to SB6)
[] 6 Other (specify) ____ (Go to SB6)
[] 2 Cohabiting partner
[] 3 Boyfriend (Go to SB6)
[] 4 Casual acquaintance (Go to SB6)
[] 5 Client/sex worker (Go to SB6)
[] 6 Other (specify) ____ (Go to SB6)
SB5. Check MA1: Currently married or living with a partner?
[] 1 Yes, MA1=1 or 2 (Go to SB7)
[] 2 No, MA1=3
[] 2 No, MA1=3
SB6. How old is this person?
If response is 'DK', probe: About how old is this person?
_ _ Age
[] 98 DK
[] 98 DK
SB7. Apart from this person, have you had sexual intercourse with any other person in the last 12 months?
[] 1 Yes
[] 2 No (Go to end of module)
[] 2 No (Go to end of module)
SB8. The last time you had sexual intercourse with this another person, was a condom used?
[] 1 Yes
[] 2 No
[] 2 No
SB9. What was your relationship to this person?
Probe to ensure that the response refers to the relationship at the time of sexual intercourse
If 'Boyfriend', probe: Were you living together as if married? If 'Yes', circle '2'. If 'No', circle '3'.
[] 1 Husband
[] 2 Cohabiting partner
[] 3 Boyfriend (Go to SB12)
[] 4 Casual acquaintance (Go to SB12)
[] 5 Client/sex worker (Go to SB12)
[] 6 Other (specify) ____ (Go to SB12)
[] 2 Cohabiting partner
[] 3 Boyfriend (Go to SB12)
[] 4 Casual acquaintance (Go to SB12)
[] 5 Client/sex worker (Go to SB12)
[] 6 Other (specify) ____ (Go to SB12)
SB10. Check MA1: Currently married or living with a partner?
[] 1 Yes, MA1=1 or 2
[] 2 No, MA1=3 (Go to SB12)
[] 2 No, MA1=3 (Go to SB12)
SB11. Check MA7: Married or living with a partner only once?
[] 1 Yes, MA7=1 (Go to end of module)
[] 2 No, MA7 does not equal 1
[] 2 No, MA7 does not equal 1
SB12. How old is this person?
If response is 'DK', probe: About how old is this person?
_ _ Age of sexual partner
[] 98 DK
[] 98 DK
STIs and HIV/AIDS: HA
HA1. Now I would like to talk with you about something else.
Have you ever heard or read about HIV or AIDS?
[] 1 Yes
[] 2 No (Go to HA37)
[] 2 No (Go to HA37)
HA2. HIV is the virus that can lead to AIDS.
Can people reduce their risk of getting HIV by having just one uninfected sex partner who has no other sex partners?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
HA3. Can people get HIV from mosquito bites?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
HA4. Can people reduce their chance of getting HIV by using a condom every time they have sex?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
HA5. Can people get HIV by sharing food with a person who has HIV?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
HA7. Is it possible for a healthy-looking person to have HIV?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
HA7A. Can people get infected with HIV by using needle or syringe used by other person?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
HA8. Can HIV be transmitted from a mother to her baby in the following ways:
[A] During pregnancy?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
[B] During delivery?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
[C] By breastfeeding?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
HA9. Check HA8[A], [B] and [C]: Is there a 'Yes' response to any of these?
[] 1 Yes
[] 2 No (Go to HA11)
[] 2 No (Go to HA11)
HA10. 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?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
HA11. Check CM17: Was there a live birth in the last 2 years?
Copy name of last birth listed in the birth history (CM18) to here and use where indicated:
Name ____
[] 1 Yes, CM17=1
[] 2 No, CM17=0 or blank (Go to HA24)
[] 2 No, CM17=0 or blank (Go to HA24)
HA12. Check MN2: Was antenatal care received?
[] 1 Yes, MN2=1
[] 2 No, MN2=2 (Go to HA17)
[] 2 No, MN2=2 (Go to HA17)
HA13. During any of the antenatal visits for your pregnancy with (name), were you given any information about:
[A] Babies getting HIV from their mother?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
[B] Things that you can do to prevent getting HIV?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
[C] Getting tested for HIV?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
Were you:
[D] Offered a test for HIV?
[D] Offered a test for HIV?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
HA14. I don't want to know the results, but were you tested for HIV as part of your antenatal care?
[] 1 Yes
[] 2 No (Go to HA17)
[] 8 DK (Go to HA17)
[] 2 No (Go to HA17)
[] 8 DK (Go to HA17)
HA15. I don't want to know the results, but did you get the results of the test?
[] 1 Yes
[] 2 No (Go to HA17)
[] 8 DK (Go to HA17)
[] 2 No (Go to HA17)
[] 8 DK (Go to HA17)
HA16. Regardless of the result, all women who are tested are supposed to receive counselling services.
After you received the result, were you given any health information or counselling related to HIV?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
HA17. Check MN20: Was the child delivered in a health facility?
[] 1 Yes, MN20=21-32 or 76
[] 2 No, MN20=11-12 or 96 (Go to HA21)
[] 2 No, MN20=11-12 or 96 (Go to HA21)
HA18. Between the time you went for delivery but before the baby was born were you offered an HIV test?
[] 1 Yes
[] 2 No
[] 2 No
HA19. I don't want to know the results, but were you tested for HIV at that time?
[] 1 Yes
[] 2 No (Go to HA21)
[] 2 No (Go to HA21)
HA20. I don't want to know the results, but did you get the results of the test?
[] 1 Yes (Go to HA22)
[] 2 No (Go to HA22)
[] 2 No (Go to HA22)
HA21. Check HA14: Was the respondent tested for HIV as part of antenatal care?
[] 1 Yes, HA14=1
[] 2 No or no answer, HA14 does not equal 1 (Go to HA24)
[] 2 No or no answer, HA14 does not equal 1 (Go to HA24)
HA22. Have you been tested for HIV since that time you were tested during your pregnancy?
[] 1 Yes (Go to HA25)
[] 2 No
[] 2 No
HA23. How many months ago was your most recent HIV test?
[] 1 Less than 12 months ago (Go to HA28)
[] 2 12-23 months ago (Go to HA28)
[] 3 2 or more years ago (Go to HA28)
[] 2 12-23 months ago (Go to HA28)
[] 3 2 or more years ago (Go to HA28)
HA24. I don't want to know the results, but have you ever been tested for HIV?
[] 1 Yes
[] 2 No (Go to HA27)
[] 2 No (Go to HA27)
HA25. How many months ago was the most recent HIV test?
[] 1 Less than 12 months ago
[] 2 12-23 months ago
[] 3 2 or more years ago
[] 2 12-23 months ago
[] 3 2 or more years ago
HA26. I don't want to know the results, but did you get the results of the test?
[] 1 Yes (Go to HA28)
[] 2 No (Go to HA28)
[] 3 DK (Go to HA28)
[] 2 No (Go to HA28)
[] 3 DK (Go to HA28)
HA27. Do you know of a place where people can go to get an HIV test?
[] 1 Yes
[] 2 No
[] 2 No
HA28. Have you heard of test kits people can use to test themselves for HIV?
[] 1 Yes
[] 2 No (Go to HA30)
[] 2 No (Go to HA30)
HA29. Have you ever tested yourself for HIV using a self-test kit?
[] 1 Yes
[] 2 No
[] 2 No
HA30. Would you buy fresh vegetables from a shopkeeper or vendor if you knew that this person had HIV?
[] 1 Yes
[] 2 No
[] 8 DK/Not sure/depends
[] 2 No
[] 8 DK/Not sure/depends
HA31. Do you think children living with HIV should be allowed to attend school with children who do not have HIV?
[] 1 Yes
[] 2 No
[] 8 DK/Not sure/depends
[] 2 No
[] 8 DK/Not sure/depends
HA32. 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?
[] 1 Yes
[] 2 No
[] 8 DK/Not sure/depends
[] 2 No
[] 8 DK/Not sure/depends
HA33. Do people talk badly about people living with HIV, or who are thought to be living with HIV?
[] 1 Yes
[] 2 No
[] 8 DK/Not sure/depends
[] 2 No
[] 8 DK/Not sure/depends
HA34. Do people living with HIV, or thought to be living with HIV, lose the respect of other people?
[] 1 Yes
[] 2 No
[] 8 DK/Not sure/depends
[] 2 No
[] 8 DK/Not sure/depends
HA35. Do you agree with the following statement?
I would be ashamed if someone in my family had HIV.
[] 1 Yes
[] 2 No
[] 8 DK/Not sure/depends
[] 2 No
[] 8 DK/Not sure/depends
HA36. Do you fear that you could get HIV if you come into contact with the saliva of a person living with HIV?
[] 1 Yes
[] 2 No
[] 7 Says she has HIV
[] 8 DK/Not sure/depends
[] 2 No
[] 7 Says she has HIV
[] 8 DK/Not sure/depends
HA37. Now I would like to ask you some additional questions about your health in the last 12 months.
Sometimes genitals odor or an abnormal discharge may occur.
In the past 12 months, did you have such symptoms?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
HA38. Sometimes genital blisters, ulcers or verruca may occur.
In the past 12 months, did you have such symptoms?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
HA39. Have you ever been tested for the STI?
[] 1 Yes
[] 2 No (Go to end of module)
[] 8 DK (Go to end of module)
[] 2 No (Go to end of module)
[] 8 DK (Go to end of module)
HA40. Have you been tested for STIs in the past 12 months?
[] 1 Yes
[] 2 No
[] 2 No
Cervical Cancer: CC
CC1. Did you hear or read about cervical cancer?
[] 1 Yes
[] 2 No (Go to end of module)
[] 2 No (Go to end of module)
CC2. Have you ever had any cervical cancer screening for early detection/Pap smear test?
[] 1 Yes
[] 2 No (Go to CC6)
[] 2 No (Go to CC6)
CC3. Where did you get the cervical cancer screening for early detection/Pap smear test done?
If response is "Private hospital" then probe: Was it a hospital in Ulaanbaatar, or aimag/soum?
Public hospital
[] 21 Tertiary level hospital (1st, 2nd, 3rd, mother and child health center)
[] 22 Secondary level hospital (aimag/district hospital)
[] 23 Maternity hospital
[] 24 Soum level hospital/family health center
[] 22 Secondary level hospital (aimag/district hospital)
[] 23 Maternity hospital
[] 24 Soum level hospital/family health center
Private hospital
[] 31 Ulaanbaatar hospital
[] 32 Aimag/soum hospital
[] 32 Aimag/soum hospital
[] 96 Other (specify) ____
CC4. I don't want to know the results, but did you get the results of the test?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
CC5. When was the last time you had cervical cancer screening for early detection/Pap smear test?
[] 1 Days ago _ _ (Go to CC7)
[] 2 Weeks ago _ _ (Go to CC7)
[] 3 Months ago _ _ (Go to CC7)
[] 4 Years ago _ _ (Go to CC7)
[] 2 Weeks ago _ _ (Go to CC7)
[] 3 Months ago _ _ (Go to CC7)
[] 4 Years ago _ _ (Go to CC7)
CC6. What was the main reason you did not received the cervical cancer screening for early detection/Pap smear test?
[] 01 No place for screening in the neighbourhood
[] 02 No time
[] 03 No offer from physician
[] 04 Far away from hospital
[] 05 No need
[] 06 Not appropriate
[] 96 Other (specify) ____
[] 98 DK
[] 02 No time
[] 03 No offer from physician
[] 04 Far away from hospital
[] 05 No need
[] 06 Not appropriate
[] 96 Other (specify) ____
[] 98 DK
CC7. Human PapillomaVirus vaccination is the adolescent girls to prevent from cervical cancer. Have you ever heard of vaccination for Human PapillomaVirus?
[] 1 Yes
[] 2 No (Go to end of module)
[] 2 No (Go to end of module)
CC8. Check WB4: Woman aged under 30?
[] 1 Under age of 30
[] 2 30 and over (Go to CC10)
[] 2 30 and over (Go to CC10)
CC9. Have you ever received vaccination to Human PapillomaVirus?
[] 1 Yes
[] 2 No
[] 2 No
CC10. Check WB4: Woman aged under 20?
[] 1 Under age of 20
[] 2 20 and over (Go to end of module)
[] 2 20 and over (Go to end of module)
CC11. Do you think it is appropriate for girls to take vaccination to Human PapillomaVirus?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
Tobacco and alcohol use: TA
TA1. Have you ever tried cigarette smoking, even one or two puffs?
[] 1 Yes
[] 2 No (Go to TA6)
[] 2 No (Go to TA6)
TA2. How old were you when you smoked a whole cigarette for the first time?
[] 00 Never smoked a whole cigarette (Go to TA6)
_ _ Age
_ _ Age
TA3. Do you currently smoke cigarettes?
[] 1 Yes
[] 2 No (Go to TA6)
[] 2 No (Go to TA6)
TA4. In the last 24 hours, how many cigarettes did you smoke?
_ _ Number of cigarettes
TA5. 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 30 days, circle '10'. If 'Every day' or 'Almost every day', circle '30'.
[] 0 Number of days _
[] 10 10 Days or more but less than 30 days
[] 30 Every day/almost every day
[] 10 10 Days or more but less than 30 days
[] 30 Every day/almost every day
TA6. Have you ever tried any smoked tobacco products other than cigarettes, such as cigars, pipe tobacco etc.?
[] 1 Yes
[] 2 No (Go to TA10)
[] 2 No (Go to TA10)
TA7. During the last one month, did you use any smoked tobacco products other than cigarettes, such as cigars, pipe tobacco etc.?
[] 1 Yes
[] 2 No (Go to TA10)
[] 2 No (Go to TA10)
TA8. What type of smoked tobacco product did you use or smoke during the last one month?
Record all mentioned.
[] A Cigar
[] D Pipe
[] E Roll up
[] X Other (specify) ____
[] D Pipe
[] E Roll up
[] X Other (specify) ____
TA9. During the last one month, on how many days did you use (name of products mentioned in TA8)?
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'.
[] 0 Number of days 0_
[] 10 10 Days or more but less than a month
[] 30 Every day/almost every day
[] 10 10 Days or more but less than a month
[] 30 Every day/almost every day
TA10. Have you ever tried any form of smokeless tobacco products, such as chewing tobacco, or snuff?
[] 1 Yes
[] 2 No (Go to TA14)
[] 2 No (Go to TA14)
TA11. During the last one month, did you use any smokeless tobacco products?
[] 1 Yes
[] 2 No (Go to TA14)
[] 2 No (Go to TA14)
TA12. What type of smokeless tobacco product did you use during the last one month?
Record all mentioned.
[] A Chewing tobacco
[] B Snuff
[] X Other (specify) ____
[] B Snuff
[] X Other (specify) ____
TA13. During the last one month, on how many days did you use (name of products mentioned in TA12)?
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'.
[] 0 Number of days 0_
[] 10 10 Days or more but less than a month
[] 30 Every day/almost every day
[] 10 10 Days or more but less than a month
[] 30 Every day/almost every day
TA14. Now I would like to ask you some questions about drinking alcohol.
Have you ever drunk alcohol?
[] 1 Yes
[] 2 No (Go to end of module)
[] 2 No (Go to end of module)
TA15. We count one drink of alcohol as one can or bottle of beer, one glass of wine, or one shot of vodka, cognac or whiskey or rum.
How old were you when you had your first drink of alcohol, other than a few sips?
[] 00 Never had at all (Go to end of module)
_ _ Age
_ _ Age
TA16. 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'.
[] 00 Did not have one drink in last one month (Go to end of module)
[] 0 Number of days 0_
[] 10 10 Days or more but less than a month
[] 30 Every day/almost every day
[] 0 Number of days 0_
[] 10 10 Days or more but less than a month
[] 30 Every day/almost every day
TA17. In the last one month, on the days that you drank alcohol, how many drinks did you usually have per day?
_ _ Number of drinks
Life satisfaction: LS
LS1. 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. [Image omitted].
Show side 1 of response card and explain what each symbol represents. Circle the response code selected by the respondent.
[] 1 Very happy
[] 2 Somewhat happy
[] 3 Neither happy nor unhappy
[] 4 Somewhat unhappy
[] 5 Very unhappy
[] 2 Somewhat happy
[] 3 Neither happy nor unhappy
[] 4 Somewhat unhappy
[] 5 Very unhappy
LS2. Show the picture of the ladder.
Please note that the steps on this ladder are numbered from 0 to 10. [Image omitted].
Let us consider that the highest step on the ladder represents the best life condition and wellbeing, and the lowest step on the ladder represents the worst.
Which of the ladder steps do you think you are currently standing on?
Probe if necessary: Which step comes closest to the way you feel?
Ladder step _ _
LS3. Compared to this time last year, would you say that your life has improved, stayed more or less the same, or worsened, overall?
[] 1 Improved
[] 2 More or less the same
[] 3 Worsened
[] 2 More or less the same
[] 3 Worsened
LS4. 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?
[] 1 Better
[] 2 More or less the same
[] 3 Worse
[] 2 More or less the same
[] 3 Worse
[Image omitted]
[Image omitted]
WM10. Record the time.
Hours and minutes _ _ : _ _
WM11. Was the entire interview completed in private or was there anyone else during the entire interview or part of it?
[] 1 Yes, the entire interview was completed in private
[] 2 No, Others were present during the entire interview (specify) ____
[] 3 No, Other were present during part of the interview (specify) ____
[] 2 No, Others were present during the entire interview (specify) ____
[] 3 No, Other were present during part of the interview (specify) ____
WM12. Language of the Questionnaire.
[] 1 Mongolian
[] 2 Kazakh
[] 2 Kazakh
WM13. Language of the Interview.
[] 1 Mongolian
[] 2 Kazakh
[] 2 Kazakh
WM14. Native language of the Respondent.
[] 1 Mongolian
[] 2 Kazakh
[] 3 Tuva
[] 6 Other (specify) ____
[] 2 Kazakh
[] 3 Tuva
[] 6 Other (specify) ____
WM15. Was a translator used in any parts of this questionnaire?
[] 1 Yes, the entire questionnaire
[] 2 Yes, parts of the questionnaire
[] 3 No, not used
[] 2 Yes, parts of the questionnaire
[] 3 No, not used
WM16. Check columns HL10 and HL20 in list of household members, household questionnaire:
Is the respondent the mother or caretaker of any child age 0-4 living in this household?
[] Yes (Go to WM17 in woman's information panel and record '01'. Then go to the questionnaire for children under five for that child and start the interview with this respondent.)
[] No (Check HH26-HH27 in household questionnaire: Is there a child age 5-17 selected for questionnaire for children age 5-17?)
[] Yes [Check column HL20 in list of household members, household questionnaire: Is the respondent the mother or caretaker of the child selected for questionnaire for children age 5-17 in this household?]
[] Yes (Go to WM17 in woman's information panel and record '01'. Then go to the questionnaire for children age 5-17 for that child and start the interview with this respondent.)
[] No (Go to WM17 in woman's information panel and record '01'. Then end the interview with this respondent by thanking her for her cooperation. Check to see if there are other questionnaires to be administered in this household.)
[] No (Go to WM17 in woman's information panel and record '01'. Then end the interview with this respondent by thanking her for her cooperation. Check to see if there are other questionnaires to be administered in this household.)
[] No (Go to WM17 in woman's information panel and record '01'. Then end the interview with this respondent by thanking her for her cooperation. Check to see if there are other questionnaires to be administered in this household.)
Interviewer's observations
Supervisor's observations