MICS questionnaire for individual women

Questionnaire for Women Age 15-49 years

Woman's information panel: WM

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

WM1. Cluster number: _ _ _

WM2. Household number: _ _

WM3. Woman's name:

Name ____

WM4. Woman's line number: _ _

WM5. Interviewer's name and number ID code:

Name ____ _ _

WM6. Day/month/year of interview _ _ / _ _ / 201 4

Repeat greeting if not already read to this woman:
We are from the Statistical Office of The Republic of Serbia. We are conducting a survey about the situation of children, families and households. I would like to talk to you about these subjects. The interview will take about 15 minutes. All the information we obtain will remain strictly confidential and anonymous.

If greeting at the beginning of the household questionnaire 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. This interview will take about 15 minutes. Again, all the information we obtain will remain strictly confidential and anonymous.

May I start now?

[] Yes, permission is given (Go to WM10 to record the time and then begin the interview.)
[] No, permission is not given (Circle "03" in WM7. Discuss this result with your supervisor.)

WM7. Result of woman's interview

[] 01 Questionnaire Completed
[] 02 Woman Not at home
[] 03 Refused
[] 04 Questionnaire Partly completed
[] 05 Woman Incapacitated
[] 96 Other (specify) ____

WM8. Field editor's name and ID code:

Name ____ _ _

WM10. Record the time.

Hours and minutes _ _ : _ _

Woman's background: WB

WB1. In what month and year were you born?

Date of birth
_ _ Month
[] 98 DK month
_ _ _ _ Year
[] 9998 DK year

WB2. How old are you?
Probe: how old were you at your last birthday? Compare and correct WB1 and/or WB2 if inconsistent.

Age (in completed years) _ _

WB3. Have you ever attended school or preschool?

[] 1 Yes
[] 2 No (Go to WB7)

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

[] 0 Preschool (Go to WB7)
[] 1 Primary
[] 2 Secondary
[] 3 Higher

WB5. What is the highest grade you completed at that level? If the first grade at this level is not completed, enter "00".

Grade/Year _ _

WB6. Check WB4:

[] Secondary or higher (WB4=2 or 3) (Go to next module)
[] Primary (WB4=1) (Continue with WB7)

WB7. Now I would like you to read this sentence to me.
Show sentence on the card to the respondent. If respondent cannot read whole sentence, probe: Can you read part of the sentence to me?

[] 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 (specify language) ____
[] 5 Blind/visually impaired

Fertility/ birth history: CM

[IPUMS note: There are slight variations in the fertility/birth history module depending on whether the country included a full birth history module as a part of the child questionnaire. Divergences are noted below.]

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

[] 1 Yes
[] 2 No (Go to CM8)

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, or the father is not your current partner.
Skip to CM4 only if year of first birth is given. Otherwise, continue with CM3.

Date of first birth

_ _ Month
[] 98 DK month
_ _ _ _ Year (Go to CM4)
[] DK year 9998

CM3. How many years ago did you have your first birth?

Completed years since first birth _ _

CM4. 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 CM6)

CM5. How many sons live with you? How many daughters live with you?
If none, record "00".

_ _ Sons at home
_ _ Daughters at home

CM6. 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)

CM7. How many sons are alive but do not live with you? How many daughters are alive but do not live with you?
If none, record "00".

_ _ Sons elsewhere
_ _ 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 a child who ever breathed or cried or showed other signs of life -- even if he or she lived only a few minutes or hours?

[] 1 Yes
[] 2 No (Go to CM10)

CM9. How many boys have died? How many girls have died?
If none, record "00".

_ _ Boys dead
_ _ Girls dead

CM10. Sum answers to CM5, CM7, and CM9.

Sum _ _

CM11. Just to make sure that I have this right, you have had in total (total number in CM10) live births during your life. Is this correct?

[] Yes. Check below:

[] No live births (Go to 12B)
[] One or more live births (Continue with CM12)

[] No. (Check responses to CM1-CM10 and make corrections as necessary before proceeding to CM12)

CM12. Of these (total number in CM10) births your have had, when did you deliver the last one (even if he or she has died) .

Date of last birth
Month and year ___ ___

CM12B. Sometimes pregnancies do not end with live births.
Have you ever had any pregnancy that was miscarried, ended is stillbirth or that was aborted?

[] 1. Yes
[] 2. No

CM12C. How many miscarriages did you have during your lifetime?
By miscarriage, I mean early and involuntary end of pregnancy within the first 5 months of pregnancy

[] 00 None
Number of miscarriages ___

CM12E. How many abortions did you have during your lifetime?
By abortions, I mean a pregnancy that was willingly terminated in the first 5 months of pregnancy.

[] 00 None
Number of abortions ___

CM12D. In how many cases have your pregnancies ended with a stillbirth?
By stillbirth, I mean a birth that occurred after the fifth month of pregnancy, but the child did not show any signs of life.

[] 00 None
Number of stillbriths ___

CM13.Check CM12; last birth occurred within the last 2 years, that is since (month of interview) in 2012 (if the month of interview and the month of birth are the same, and the year of birth is 2012, consider this as a birth within the last 2 years)

[] No live birth in last 2 years (Go to illness symptoms module)
[] Yes, one or more live birth in last 2 years ask for the name of the last- born child
Name of last-born child___

If child has died, take special care when referring to this child by name in the following modules. Continue with Next Module/

[IPUMS Note: If the sample includes a birth history module, respondents should proceed to the birth history module when instructed. If the sample does not include a birth history module, the respondent should proceed to CM12 when instructed.]

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 interview.
Record name of last-born child from CM13 here ____
Use this child's name in the following questions, where indicated.

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

[] 1 Yes (Go to next module)
[] 2 No

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

[] 1 Later
[] 2 No more (Go to next module)

DB3. How much longer did you want to wait? Record the answer as stated by respondent.

[] 1 Months _ _
[] 2 Years _ _
[] 998 DK

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 interview.
Record name of last-born child from CM13 here ____
Use this child's name in the following questions, where indicated.

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

[] 1 Yes
[] 2 No (Go to MN 4A)

MN2. Whom did you see?
Probe: anyone else? Probe for the type of person seen and circle all answers given.

Health professional:

[] A Doctor
[] B Nurse/midwife

Other person

[] F Traditional birth attendant

[] X Other (specify) ____

MN2A. How many weeks or months pregnant were you when you had your first check-up?
Record the answer as stated by respondent.

[] 1 Weeks _ _
[] 20 Months _
[] 998 DK

MN3. 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

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

[A] Was your blood pressure measured?

[] 1 Yes
[] 2 No

[B] Did you give a urine sample?

[] 1 Yes
[] 2 No

[C] Did you give a blood sample?

[] 1 Yes
[] 2 No

[D] Did they measure your weight

[] 1 Yes
[] 2 No

MN4A. During this pregnancy, did an auxiliary patronage nurse visit you at your home?

[] 1 Yes
[] 2 No

MN4B. During this pregnancy, did you attend any childbirth preparation programme, i.e. parenting and pregnancy education with a health care institution?

[] 1 Yes
[] 2 No (Go to MN4D)

MN4C. While you attended a preparation programme did you receive information about the following subjects:

[A] Woman's health during the pregnancy?

[] 1 Yes
[] 2 No

[B] Breastfeeding?

[] 1 Yes
[] 2 No

[C] Newborn care?

[] 1 Yes
[] 2 No

[D] Parenting skills?

[] 1 Yes
[] 2 No (Go to MN17)

MN4D. What was the main reason that you did not attend a childbirth preparation programme, i.e. parenting and pregnancy education with health care institution?

[] 1 Did not know it exists
[] 2 No need
[] 3 No time
[] 4 Not organized in my neighborhood
[] 5 Do not know/do not remember
[] 6 Other (specify) ____

MN17. Who assisted with the delivery of (name)? Probe: anyone else? Probe for the type of person assisting and circle all answers given.
If respondent says no one assisted, probe to determine whether any adults were present at the delivery.

Health professional:

[] A Doctor
[] B Nurse/midwife

Other person

[] F Traditional birth attendant
[] H Relative/friend
[] I Husband/partner

[] X Other (specify) ____
[] Y No one

MN18. Where did you give birth to (name)? Probe to identify the type of source. If unable to determine whether public or private, write the name of the place.
(Name of place) ____

Home

[] 11 Respondent's home (Go to MN20)
[] 12 Other home (Go to MN20)

Public sector

[] 21 Government hospital
[] 22 Government clinic/health centre
[] 23 Government health post
[] 26 Other public (specify) ____

Private medical sector

[] 31 Private hospital
[] 32 Private clinic
[] 33 Private maternity home
[] 36 Other private medical (specify) ____

[] 96 Other (specify) ____ (Go to MN20)

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

[] 1 Yes
[] 2 No (Go to MN20)

MN19A. When was the decision made to have the caesarean section? Was it before or after your labour pains started?

[] 1 Before
[] 2 After

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

[] 1 Very large
[] 2 Larger than average
[] 3 Average
[] 4 Smaller than average
[] 5 Very small
[] 8 DK

MN21. Was (name) weighed at birth?

[] 1 Yes
[] 2 No (Go to MN23)
[] 8 DK (Go to MN23)

MN22. How much did (name) weigh? If a card is available, record weight from card.

[] 1 From card (kg) _ _ _ _
[] 2 From recall (kg) _ _ _ _
[] 99998 DK

MN23. Has your menstrual period returned since the birth of (name)?

[] 1 Yes
[] 2 No

MN24. Did you ever breastfeed (name)?

[] 1 Yes
[] 2 No (Go to MN27A)

MN25. How long after birth did you first put (name) to the breast? If less than 1 hour, record "00" hours. If less than 24 hours, record hours. Otherwise, record days.

[] 000 Immediately
[] 1 Hours _ _
[] 2 Days _ _
[] 998 DK/don't remember

MN26. In the first three days after delivery, was (name) given anything to drink other than breast milk?

[] 1 Yes
[] 2 No (Go to MN27A)

MN27. What was (name) given to drink? Probe: Anything else?

[] A Milk (other than breast milk)
[] B Plain water
[] C Sugar or glucose water
[] D Gripe water
[] E Sugar-salt-water solution
[] F Fruit juice
[] G Infant formula
[] H Tea/infusions
[] X Other (specify) ____
[] Z DK

MN27A. Was the child with you in the same hospital room after birth?
If "no" probe by asking: Why was the child not in the same hospital room with you after birth?.

[] 1 Yes
[] 2 No, I did not want that though condition existed
[] 3 No, no conditions
[] 4 No, due to illness of mother and/or baby

MN27B. Did a patronage nurse visit you at your home during the 7 days after you returned home after delivery?

[] 1 Yes
[] 2 No (Go to next module)

MN27C. How many times did a patronage nurse visit you at your home during the 7 days after you returned home after delivery?

_ _ Number of times
[] 98 DK

Illness symptoms: IS

IS1. Check List of Household Members, columns HL7B and HL15:Is the respondent the mother or caretaker of any child under age 5?

[] Yes (Continue with IS2)
[] No (Go to next module)

IS2. Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take a child under the age of 5 to a health facility right away? Probe: Any other symptoms? Keep asking for more signs or symptoms until the mother/caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, but do not prompt with any suggestions

[] A Child not able to drink or breastfeed
[] B Child becomes sicker
[] C Child develops a fever
[] D Child has fast breathing
[] E Child has difficulty breathing
[] F Child has blood in stool
[] G Child is drinking poorly
[] X Other (specify) ____
[] Y Other (specify) ____
[] Z Other (specify) ____

Contraception: CP

CP0. I would like to talk with you about another subject - family planning.
Couples use various ways or methods to delay or avoid getting pregnant.
Have you heard of:

[A] Female sterilization?
Probe: Women can have an operation to avoid having any more children ("tubal ligation").

[] 1 Yes
[] 2 No

[B] Male sterilization?
Probe: Men can have an operation to avoid having any more children.

[] 1 Yes
[] 2 No

[C] IUD?
Probe: Women can have a loop or coil placed inside them by a doctor or a nurse.

[] 1 Yes
[] 2 No

[D] Injectables?
Probe: Women can have an injection by a doctor or a nurse that stops them from becoming pregnant for one or more months.

[] 1 Yes
[] 2 No

[E] Implants?
Probe: Women can have one or more small rods placed in their upper arm by a doctor or nurse that can prevent pregnancy for one or more years.

[] 1 Yes
[] 2 No

[F] Pill?
Probe: Women can take a pill every day to avoid becoming pregnant.

[] 1 Yes
[] 2 No

[G] Condom?
Probe: Men can put a rubber sheath on their penis before sexual intercourse.

[] 1 Yes
[] 2 No

[H] Female condom?
Probe: Women can place a rubber sheath in their vagina before sexual intercourse.

[] 1 Yes
[] 2 No

[I] Diaphragm?
Probe: Women can insert a soft rubber cup in their vagina to block the sperm from entering u their uterus or fallopian tubes.

[] 1 Yes
[] 2 No

[J] foam/jelly?
Probe: Women may use spermicidal products (e.g. foam, jelly, cream) that can kill or prevent the sperm from moving and reaching the egg.

[] 1 Yes
[] 2 No

[L] Periodic abstinence/rhythm method?
Probe: To avoid pregnancy, women do not have sexual intercourse on the days of the month they think they can get pregnant

[] 1 Yes
[] 2 No

[M] Withdrawal?
Probe: Men can be careful and pull out before climax ("the husband keeps me" or "we keep ourselves").

[] 1 Yes
[] 2 No

[N] Emergency postcoital contraception?
Probe: As an emergency measure within three days after they have unprotected sexual intercourse, women can take special pills to prevent pregnancy ("morning after pill").

[] 1 Yes
[] 2 No

[X] Have you heard of any other ways or method that women or men can use to avoid pregnancy?

[] 1 Yes
(specify) ____
(specify) ____
[] 2 No

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

[] 1 Yes, currently pregnant (Go to CP2A)
[] 2 No
[] 8 Unsure or DK

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

[] 1 Yes (Go to CP3)
[] 2 No

CP2A. Have you ever done something or used any method to delay or avoid getting pregnant?

[] 1 Yes (Go to next module)
[] 2 No

CP2B. Why have you never done something or used any method to avoid or delay getting pregnant?

[] 1 Have not had sex before
[] 2 Wanted to get pregnant
[] 3 Husband/partner was against
[] 4 Insufficient means (too expensive)
[] 5 Uninformed
[] 6 Other
[] 8 DK(Go to next module)

CP3. What are you doing to delay or avoid a pregnancy?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 (LAM)
[] L Periodic abstinence/rhythm
[] M Withdrawal
[] X Other (specify) ____

Unmet need: UN

UN1. Check. Check CP1: Currently pregnant?

[] Yes, currently pregnant (Continue with UN2)
[] No, unsure or DK (Go to UN5)

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 UN4)
[] 2 No

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

[] 1 Later
[] 2 No more

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

[] 1 Have another child (Go to UN7)
[] 2 No more/none (Go to UN13)
[] 8 Undecided/DK (Go to UN13)

UN5. Check CP3: Currently using "female sterilization"

[] Yes (Go to UN13)
[] No (Continue with UN6)

UN6. Now I would like to ask you some questions about the future. Would you like to have (a/another) child, or would you prefer not to have any (more) children?

[] 1 Have (a/another) child
[] 2 No more/none (Go to UN9)
[] 3 Says she cannot get pregnant (Go to UN11)
[] 8 Undecided/DK (Go to UN9)

UN7. 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 Does not want to wait (soon/now)
[] 994 Says she cannot get pregnant (Go to UN11)
[] 995 After marriage
[] 996 Other
[] 998 DK

UN8. Check CP1: Currently pregnant?

[] Yes, currently pregnant (Go to UN13)
[] No, unsure or DK (Continue with UN9)

UN9. Check CP2: Currently using a method?

[] Yes (Go to UN13)
[] No (Continue with UN10)

UN10. Do you think you are physically able to get pregnant at this time?

[] 1 Yes (Go to UN13)
[] 2 No
[] 8 DK (Go to UN13)

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

[] A Infrequent sex/no sex
[] B Menopausal
[] C Never menstruated
[] D Hysterectomy (surgical removal of uterus)
[] E Has been trying to get pregnant for 2 years or more without result
[] F Postpartum amenorrheic
[] G Breastfeeding
[] H Too old
[] I Fatalistic
[] X Other (specify) ____
[] Z DK

UN12. Check UN11: "Never menstruated" mentioned?

[] Mentioned (Go to next module)
[] Not mentioned (Continue with UN13)

UN13. When did your last menstrual period start? Record the answer using the same unit stated by the respondent.

[] 1 Days ago _ _
[] 2 Weeks ago _ _
[] 3 Months ago _ _
[] 4 Years ago _ _
[] 994 In menopause/has had hysterectomy
[] 995 Before last birth
[] 996 Never menstruated

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

[B] If she neglects the children?

[] 1 Yes
[] 2 No
[] 8 DK

[C] If she argues with him?

[] 1 Yes
[] 2 No
[] 8 DK

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

[] 1 Yes
[] 2 No
[] 8 DK

[E] If she burns the food?

[] 1 Yes
[] 2 No
[] 8 DK

Marriage/union: MA

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

[] 1 Yes, currently married
[] 2 Yes, living with a man
[] 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)

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

[] 1 Yes, formerly married
[] 2 Yes, formerly lived with a man
[] 3 No (Go to next module)

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

[] 1 Widowed
[] 2 Divorced
[] 3 Separated

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

[] 1 Only once (Go to MA8A)
[] 2 More than once (Go to MA8B)

MA8A. In what month and year did you marry or start living with a man as if married?
MA8B. In what month and year did you first marry or start living with a man as if married?

Date of (first) marriage

_ _ Month
[] 98 DK month
_ _ _ _ Year (Go to next module)
[] 9998 DK year

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

Age in years _ _

Life satisfaction: LS

LS1. Check WB2: Age of respondent is between 15 and 24?

[] Age 25-49 (Go to WM11)
[] Age 15-24 (Continue with LS2)

LS2. I would like to ask you some simple questions on happiness and satisfaction.
First, taking all things together, would you say you are very happy, somewhat happy, neither happy nor unhappy, somewhat unhappy or very unhappy?
You can also look at these pictures to help you with your response. Show side 1 of response card and explain what each symbol represents. Circle the response code selected by the respondent. [Image omitted]

[] 1 Very happy
[] 2 Somewhat happy
[] 3 Neither happy nor unhappy
[] 4 Somewhat unhappy
[] 5 Very unhappy

LS3. Now I will ask you questions about your level of satisfaction in different areas.
In each case, we have five possible responses: please tell me, for each question, whether you are very satisfied, somewhat satisfied, neither satisfied nor unsatisfied, somewhat unsatisfied or very unsatisfied.
Again, you can look at these pictures to help you with your response. Show side 2 of response card and explain what each symbol represents. Circle the response code selected by the respondent, for questions LS3 to LS13. [Image omitted]

How satisfied are you with your family life?