Mics questionnaire for individual women
Thailand 2019
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. Day/month/year of interview:
_ _ / _ _ / 2562
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 and other topics. This interview usually takes about 20 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 and other topics in more detail. This interview will take about 20 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): Is this respondent also the respondent to the Household Questionnaire?
[] 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=02-08 (Go to WB15)
[] 2 ED5=00, 01, 98 or blank (Go to WB14)
[] 2 ED5=00, 01, 98 or blank (Go to WB14)
WB3. In what month and year were you born?
Date of birth
_ _ Month
[] 98 DK month
_ _ _ _ Year
[] 9998 DK year
_ _ Month
[] 98 DK month
_ _ _ _ Year
[] 9998 DK year
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?
[] 000 Early childhood education (Go to WB14)
[] 1 Primary _ _
[] 2 Lower secondary _ _
[] 3 Upper secondary _ _
[] 4 Certificate (VCE/TCE) _ _
[] 5 Diploma (HVC/CTV/HTC) _ _
[] 6 Bachelor degree _ _
[] 7 Master degree _ _
[] 8 Doctoral degree _ _
[] 1 Primary _ _
[] 2 Lower secondary _ _
[] 3 Upper secondary _ _
[] 4 Certificate (VCE/TCE) _ _
[] 5 Diploma (HVC/CTV/HTC) _ _
[] 6 Bachelor degree _ _
[] 7 Master degree _ _
[] 8 Doctoral degree _ _
WB7. Did you complete that (grade/year)?
[] 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 2562-63 school year did you attend school?
[] 1 Yes
[] 2 No (Go to WB11)
[] 2 No (Go to WB11)
WB10. During the 2562-63 school year, which level and grade or year are you attending?
[] 1 Primary _ _
[] 2 Lower secondary _ _
[] 3 Upper secondary _ _
[] 4 Certificate (VCE/TCE) _ _
[] 5 Diploma (HVC/CTV/HTC) _ _
[] 6 Bachelor degree _ _
[] 7 Master degree _ _
[] 8 Doctoral degree _ _
[] 2 Lower secondary _ _
[] 3 Upper secondary _ _
[] 4 Certificate (VCE/TCE) _ _
[] 5 Diploma (HVC/CTV/HTC) _ _
[] 6 Bachelor degree _ _
[] 7 Master degree _ _
[] 8 Doctoral degree _ _
WB11. At any time during the 2561-62 school year did you attend school?
[] 1 Yes
[] 2 No (Go to WB13)
[] 2 No (Go to WB13)
WB12. During the 2561-62 school year, which level and grade or year did you attend?
[] 1 Primary _ _
[] 2 Lower secondary _ _
[] 3 Upper secondary _ _
[] 4 Certificate (VCE/TCE) _ _
[] 5 Diploma (HVC/CTV/HTC) _ _
[] 6 Bachelor degree _ _
[] 7 Master degree _ _
[] 8 Doctoral degree _ _
[] 2 Lower secondary _ _
[] 3 Upper secondary _ _
[] 4 Certificate (VCE/TCE) _ _
[] 5 Diploma (HVC/CTV/HTC) _ _
[] 6 Bachelor degree _ _
[] 7 Master degree _ _
[] 8 Doctoral degree _ _
WB13. Check WB6: Highest level of school attended:
[] 1 WB6=02 to 08 (Go to WB15)
[] 2 WB6=1
[] 2 WB6=1
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 city, town or village of residence)?
If less than one year, record '00' years.
Years _ _
[] 95 Always/since birth (Go to WB18)
[] 95 Always/since birth (Go to WB18)
WB16. Just before you moved here, did you live in a city, in a town, or in a rural area?
Probe to identify the type of place. If unable to determine whether the place is a municipality (urban) or non-municipality (rural), write the name of the place and then temporarily record '9' until you learn the appropriate category for the response.
(Name of place) ____
[] 1 Municipal
[] 2 Non-municipal
[] 2 Non-municipal
WB17. Before you moved here, in which region did you live in?
[] 01 Bangkok
[] 02 Central
[] 03 North
[] 04 Northeast
[] 05 South
[] 96 Outside of Thailand (specify) ____
[] 02 Central
[] 03 North
[] 04 Northeast
[] 05 South
[] 96 Outside of Thailand (specify) ____
WB18. Are you covered by any health insurance?
[] 1 Yes
[] 2 No (Go to next module)
[] 2 No (Go to next module)
WB19. What type of health insurance are you covered by?
Record all mentioned.
[] A Community health insurance
[] B Health insurance through employer
[] C Social security/compensation fund
[] D Private health insurance
[] E Universal health-care coverage scheme
[] F Government officer
[] G Local administrative organization
[] H State enterprises or independent agencies
[] X Other (specify) ____
[] B Health insurance through employer
[] C Social security/compensation fund
[] D Private health insurance
[] E Universal health-care coverage scheme
[] F Government officer
[] G Local administrative organization
[] H State enterprises or independent agencies
[] X Other (specify) ____
Fertility: 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 in CM12 is 'Yes'.
CM14A. Check CM11: How many live births?
[] 0 No live births, CM11=00 (Go to CM14B)
[] 1 One live birth, CM11=01 (Go to CM15A)
[] 2 Two or more live birth, CM11=02 or more (Go to CM15B)
[] 1 One live birth, CM11=01 (Go to CM15A)
[] 2 Two or more live birth, CM11=02 or more (Go to CM15B)
CM14B. Have you ever been pregnant?
[] 1 Yes
[] 2 No (Go to next module)
[] 2 No (Go to next module)
CM14C. What was the result of the most recent pregnancy?
[] 1 Stillbirth (baby born without signs of life) (Go to next module)
[] 2 Miscarriage (Go to next module)
[] 2 Miscarriage (Go to next module)
CM15A. In what month and year was your child born?
Month and year must be recorded
Month and year of last birth
Month _ _
Year _ _ _ _
Year _ _ _ _
CM15B. Of these (total number in CM11) births, in what month and year was the last child born?
Month and year must be recorded
Month and year of last birth
Month _ _
Year _ _ _ _
Year _ _ _ _
CM16A. Check CM11: How many live births?
[] 1 One live birth, CM11=01 (Go to CM17)
[] 2 Two or more live birth, CM11=02 or more
[] 2 Two or more live birth, CM11=02 or more
CM16B. Of these (total number in CM11) births, in what month and year was the first child born?
Month and year of first birth
Month _ _
[] 98 DK month
Year _ _ _ _
[] 9998 DK year
[] 98 DK month
Year _ _ _ _
[] 9998 DK year
CM16C. Check CM16B: Is year recorded?
[] 1 Yes (Go to CM17)
[] 2 No
[] 2 No
CM16D. How many years ago did you have your first birth?
Probe by asking:How old is your first child now? How old was you when you had your first child? (Take current respondent?s age into consideration)
Completed years _ _
CM17. Check CM15A/B: Last birth occurred within the last 2 years, that is, since (month of interview) in B.E. 2560?
If the month of interview and the month of birth are the same, and the year of birth is B.E. 2560, consider this as a birth within the last 2 years.
[] 0 No live births in the last 2 years (Go to next module)
[] 1 One or more live births in the last 2 years
[] 1 One or more live births in the last 2 years
CM18. Record name of the last born child.
If the child has died, take special care when referring to this child by name in the following modules.
Name of last born child ____
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 next module)
[] 2 No, CM17=0 or blank (Go to next module)
DB2. When you got pregnant with (name), did you want to get pregnant at that time?
[] 1 Yes (Go to next module)
[] 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 any more children?
[] 1 Later
[] 2 No more/none
[] 2 No more/none
DB5. If you did not wish to have (name of last child) (or wanted later), what was the main reason you did not prevent (or delay the) pregnancy?
[] 01 Safe period calculation birth control but pregnant
[] 02 Other birth control method but pregnant
[] 03 Recently gave birth / post miscarriage
[] 04 Forced to have sex
[] 05 Not expected to have sex
[] 06 Forgot to take birth control pills
[] 07 Not afforded to buy birth control pills / contraceptive device
[] 08 Far service centre
[] 09 No time to seek birth control services
[] 10 Unfriendly service centres / workers
[] 11 Thought she was too old / menopause
[] 12 Not knew how to prevent pregnancy
[] 96 Other (specify)
[] 02 Other birth control method but pregnant
[] 03 Recently gave birth / post miscarriage
[] 04 Forced to have sex
[] 05 Not expected to have sex
[] 06 Forgot to take birth control pills
[] 07 Not afforded to buy birth control pills / contraceptive device
[] 08 Far service centre
[] 09 No time to seek birth control services
[] 10 Unfriendly service centres / workers
[] 11 Thought she was too old / menopause
[] 12 Not knew how to prevent pregnancy
[] 96 Other (specify)
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 next module)
[] 2 No, CM17=0 or blank (Go to next module)
MN2. Did you see anyone for antenatal care during your pregnancy with (name)?
[] 1 Yes
[] 2 No (Go to MN7)
[] 2 No (Go to MN7)
MN3. Whom did you see?
Probe: Anyone else? Probe for the type of person seen and record all answers given.
Health professional
[] A Doctor
[] B Nurse/midwife
[] C Practical nurse/nurse's aide
[] B Nurse/midwife
[] C Practical nurse/nurse's aide
[] X Other (specify) ____
MN4. How many weeks or months pregnant were you when you first received antenatal care for this pregnancy?
Record the answer as stated by respondent. If "9 months" or later, record 9.
[] 1 Weeks _ _
[] 2 Months 0 _
[] 998 DK
[] 2 Months 0 _
[] 998 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] Was your blood pressure measured?
[] 1 Yes
[] 2 No
[] 2 No
[B] Did you give a urine sample?
[] 1 Yes
[] 2 No
[] 2 No
[C] Did you give a blood sample?
[] 1 Yes
[] 2 No
[] 2 No
MN7. Do you have a health handbook or other document with your own immunisations listed?
If yes, ask: May I see it please? If a health handbook is presented, use it to assist with answers to the following questions.
[] 1 Yes (handbook or other document seen)
[] 2 Yes (handbook or other document not seen)
[] 3 No
[] 8 DK
[] 2 Yes (handbook or other document not seen)
[] 3 No
[] 8 DK
MN7A. When you were pregnant with (name of last child), did you receive a screening test for thalassemia?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
MN8. When you were pregnant with (name), did you receive any injection in the arm or shoulder to prevent the baby from getting tetanus, that is, convulsions after birth?
[] 1 Yes
[] 2 No (Go to MN11)
[] 8 DK (Go to MN11)
[] 2 No (Go to MN11)
[] 8 DK (Go to MN11)
MN9. How many times did you receive this tetanus injection during your pregnancy with (name)?
_ Number of times
[] 8 DK (Go to MN11)
[] 8 DK (Go to MN11)
MN10. Check MN9: How many tetanus injections during last pregnancy were reported?
[] 1 Only 1 injection
[] 2 2 or more injections (Go to MN19)
[] 2 2 or more injections (Go to MN19)
MN11. At any time before your pregnancy with (name), did you receive any tetanus injection either to protect yourself or another baby?
Include DTP (Tetanus) vaccinations received as a child if mentioned.
[] 1 Yes
[] 2 No (Go to MN19)
[] 8 DK (Go to MN19)
[] 2 No (Go to MN19)
[] 8 DK (Go to MN19)
MN12. Before your pregnancy with (name), how many times did you receive a tetanus injection?
If 7 or more times, record '7'. Include DTP (Tetanus) vaccinations received as a child if mentioned.
_ Number of times
[] 8 DK
[] 8 DK
MN13. Check MN12: How many tetanus injections before last pregnancy were reported?
[] 1 Only 1 injection (Go to MN14A)
[] 2 2 or more injections or DK (Go to MN14B)
[] 2 2 or more injections or DK (Go to MN14B)
MN14A. How many years ago did you receive that tetanus injection
MN14B. How many years ago did you receive the last of those tetanus injections?
The reference is to the last injection received prior to this pregnancy, as recorded in MN12. If less than 1 year, record '00'.
_ _ Years ago
[] 98 DK
[] 98 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
[] A Doctor
[] B Nurse/midwife
[] C Practical nurse/nurse's aide
[] B Nurse/midwife
[] C Practical nurse/nurse's aide
Other person
[] G Community health worker
[] H Relative/friend
[] H Relative/friend
[] X Other (specify) ____
[] Y No one
[] Y No one
MN20. Where did you give birth to (name)?
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) ____
Home
[] 11 Respondent's home (Go to MN23)
[] 12 Other home (Go to MN23)
[] 12 Other home (Go to MN23)
Public medical sector
[] 21 Government hospital
[] 22 Government clinic/health centre
[] 26 Other public (specify) ____
[] 22 Government clinic/health centre
[] 26 Other public (specify) ____
Private medical sector
[] 31 Private hospital
[] 32 Private clinic
[] 36 Other private (specify) ____
[] 32 Private clinic
[] 36 Other private (specify) ____
[] 76 DK public or private
[] 96 Other (specify) ____ (Go to MN23)
[] 96 Other (specify) ____ (Go to MN23)
MN21. 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 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
MN22A. Check CM11: Number of children?
[] 1 Only 1 child (Go to MN23)
[] 2 2 or more children
[] 2 2 or more children
MN22B. Was this caesarean section the first or repeat caesarean section?
[] 1 First
[] 2 Repeat
[] 2 Repeat
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)
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/less than 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
MN32. 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
[] 2 Larger than average
[] 3 Average
[] 4 Smaller than average
[] 5 Very small
[] 8 DK
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 a health handbook is available, record weight from health handbook.
[] 1 From health handbook (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, record '00' hours. If less than 24 hours, record hours. Otherwise, record days.
[] 000 Immediately
[] 1 Hours _ _
[] 2 Days _ _
[] 998 DK/don't remember
[] 1 Hours _ _
[] 2 Days _ _
[] 998 DK/don't remember
MN38. In the first three days after delivery, was (name) given anything to drink other than breast milk?
[] 1 Yes (Go to MN39A)
[] 2 No (Go to next module)
[] 2 No (Go to next 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 Plain water
[] C Sugar or glucose water
[] D Antiflatulent syrup (gripe water)
[] E Sugar-salt-water solution
[] F Fruit juice
[] G Infant formula
[] H Tea/infusions/traditional herbal preparations
[] I Honey
[] J Prescribed medicine
[] X Other (specify) ____
[] Y Not given anything to drink
[] B Plain water
[] C Sugar or glucose water
[] D Antiflatulent syrup (gripe water)
[] E Sugar-salt-water solution
[] F Fruit juice
[] G Infant formula
[] H Tea/infusions/traditional herbal preparations
[] I Honey
[] J Prescribed medicine
[] X Other (specify) ____
[] Y Not given anything to drink
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 No
[] 8 DK or not sure
[] 2 No
[] 8 DK or not sure
CP2. Couples use various ways or methods to delay or avoid getting pregnant.
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 next module)
[] 2 No (Go to next module)
[] 2 No (Go to next module)
CP4. What are you doing to delay or avoid a pregnancy?
Do not prompt. If more than one method is mentioned, record 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
[] L Periodic abstinence/rhythm
[] M Withdrawal
[] N Contraceptive patch
[] O Emergency contraceptive pill
[] 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
[] L Periodic abstinence/rhythm
[] M Withdrawal
[] N Contraceptive patch
[] O Emergency contraceptive pill
[] X Other (specify) ____
CP5. From where did you or your partner receive this?
Probe to identify the type of place. If unable to determine whether public or private medical facility, write the name of the place and then temporarily record 'W' until you know the proper category for such response.
(Name of place) ____
Public medical facility
[] A Public hospital
[] B SHPH/public health centre
[] C Health volunteers (CHV/VHV)
[] D Mobile medical unit
[] E Other public medical facility (specify) ____
[] B SHPH/public health centre
[] C Health volunteers (CHV/VHV)
[] D Mobile medical unit
[] E Other public medical facility (specify) ____
Private medical facility
[] F Private hospital
[] G Private clinic
[] H Mobile clinic
[] I Other private medical facility (specify) ____
[] G Private clinic
[] H Mobile clinic
[] I Other private medical facility (specify) ____
Other source
[] J Relative/friend
[] K Store/market
[] L Pharmacy
[] K Store/market
[] L Pharmacy
[] W DK public or private
[] X Other (specify) ____
[] Y Not applicable
[] X Other (specify) ____
[] Y Not applicable
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 No more/none (Go to UN14)
[] 8 Undecided/DK (Go to UN14)
[] 2 No more/none (Go to UN14)
[] 8 Undecided/DK (Go to UN14)
UN6. Check CP4: Currently using 'Female sterilization'?
[] 1 Yes, CP4=A (Go to UN14)
[] 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 Does not want to wait (soon/now)
[] 994 Says she cannot get pregnant (Go to UN12)
[] 995 After marriage
[] 996 Other
[] 998 DK
[] 2 Years _ _
[] 993 Does not want to wait (soon/now)
[] 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 UN14)
[] 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 method?
[] 1 Yes, CP2=1 (Go to UN14)
[] 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 UN14)
[] 2 No
[] 8 DK (Go to UN14)
[] 2 No
[] 8 DK (Go to UN14)
UN12. 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
[] 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
UN13. Check UN12: 'Never menstruated' mentioned?
[] 1 Mentioned, UN12=C (Go to next 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
[] 994 Before last birth
[] 995 Never menstruated
[] 2 Weeks ago _ _
[] 3 Months ago _ _
[] 4 Years ago _ _
[] 993 In menopause/has had hysterectomy
[] 994 Before last birth
[] 995 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
[] 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 burns the food?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
[F] If she neglects household chores?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
Victimisation: 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) (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 'DK/Don't remember', probe: Did it happen once, twice, or at least three times?
[] 1 One time
[] 2 Two times
[] 3 Three or more times
[] 8 DK/don't remember
[] 2 Two times
[] 3 Three or more times
[] 8 DK/don't remember
VT4. Check VT3: One 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, a knife
[] B Yes, a gun
[] X Yes, something else
[] B Yes, a 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
[] 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
VT8A. Did you or anyone else report the incident to other agencies other than the police?
[] 1 Yes, respondent reported
[] 2 Yes, someone else reported
[] 3 No, not reported (Go to VT9A)
[] 8 DK/not sure (Go to VT9A)
[] 2 Yes, someone else reported
[] 3 No, not reported (Go to VT9A)
[] 8 DK/not sure (Go to VT9A)
VT8B. To which agencies did you or anyone else report the incident?
Record all the answers that apply.
[] A Village headman/subdistrict headman/sao/municipality (Go to VT9A)
[] B OSCC 1300 hotline (Go to VT9A)
[] C Damrongtham (ombudsman) centre (Go to VT9A)
[] D Foundation (Go to VT9A)
[] E Shelters for children and families (Go to VT9A)
[] F Provincial MSDHS office (Go to VT9A)
[] X Other (specify) (Go to VT9A)
[] B OSCC 1300 hotline (Go to VT9A)
[] C Damrongtham (ombudsman) centre (Go to VT9A)
[] D Foundation (Go to VT9A)
[] E Shelters for children and families (Go to VT9A)
[] F Provincial MSDHS office (Go to VT9A)
[] X Other (specify) (Go to VT9A)
VT9A. Apart from the incident(s) just covered, have you in the last three years, that is since (month of interview) (year of interview minus 3), been physically attacked?
VT9B. In the same period of the last three years, that is since (month of interview) (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 One time (Go to VT12A)
[] 2 Two times (Go to VT12B)
[] 3 Three or more times (Go to VT12B)
[] 8 DK/don't remember (Go to VT12B)
[] 2 Two times (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 In 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 In 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 (Go to VT19)
[] 2 No (Go to VT19)
[] 8 DK (Go to VT19)
VT18. Was a knife, a gun or something else used as a weapon?
Record all that apply.
[] A Yes, a knife
[] B Yes, a gun
[] X Yes, something else
[] B Yes, a 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
VT19A. Did you or anyone else report the incident to other agencies other than the police?
[] 1 Yes, respondent reported
[] 2 Yes, someone else reported
[] 3 No, not reported (Go to VT20)
[] 8 DK/not sure (Go to VT20)
[] 2 Yes, someone else reported
[] 3 No, not reported (Go to VT20)
[] 8 DK/not sure (Go to VT20)
VT19B. To which agencies did you or anyone else report the incident?
Record all the answers that apply.
[] A Village chief/subdistrict headman/sao
[] B OSCC 1300 hotline
[] C Damrongtham (ombudsman) centre
[] D Foundation
[] E Shelters for children and families
[] F Provincial MSDHS office
[] X Other (specify)
[] B OSCC 1300 hotline
[] C Damrongtham (ombudsman) centre
[] D Foundation
[] E Shelters for children and families
[] F Provincial MSDHS office
[] X Other (specify)
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] Ethnic or immigration origin?
[] 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 or belief?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
[F] Disability?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
[G] Poor status?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
[H] Work position?
[] 1 Yes
[] 2 No
[] 8 DK
[] 2 No
[] 8 DK
[X] For any other reason?
[] 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
[] 98 DK
[] 98 DK
MA3. Besides yourself, does your (husband/partner) have any other wives or partners or does he live with other women as if married?
[] 1 Yes
[] 2 No (Go to MA7)
[] 2 No (Go to MA7)
MA4. How many other wives or partners does he have?
_ _ Number (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 next module)
[] 2 Yes, formerly lived with a partner
[] 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
[] 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 month and year did you start living with your (husband/partner)?
MA8B. In what month and year did you start living with your first (husband/partner)?
Date of (first) union
_ _ Month
[] 98 DK Month
_ _ _ _ Year
[] 9998 DK Year
[] 98 DK Month
_ _ _ _ Year
[] 9998 DK Year
MA9. Check MA8A/B: Is 'DK year' recorded?
[] 1 Yes, MA8A/B=9998
[] 2 No, MA8A/B does not equal 9998 (Go to next module)
[] 2 No, MA8A/B does not equal 9998 (Go to next 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 _ _
HIV/AIDS: HA
HA1. Now I would like to talk with you about something else.
Have you ever heard of HIV or AIDS?
[] 1 Yes
[] 2 No (Go to next module)
[] 2 No (Go to next module)
HA2. HIV is the virus that can lead to AIDS.
Can people reduce their chance 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
HA6. Can people get HIV because of witchcraft or other supernatural means?
[] 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
HA8. Can HIV be transmitted from a mother to her baby:
[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]: At least one 'Yes' recorded?
[] 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 HA16A)
[] 8 DK (Go to HA16A)
[] 2 No (Go to HA16A)
[] 8 DK (Go to HA16A)
HA15. I don't want to know the results, but did you get the results of the test?
[] 1 Yes
[] 2 No (Go to HA16A)
[] 8 DK (Go to HA16A)
[] 2 No (Go to HA16A)
[] 8 DK (Go to HA16A)
HA16. 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
HA16A. I don?t want to know the results, but whether during your antenatal care your husband / partner was tested for 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=21-36 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 your 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)
[] 8 DK (Go to HA28)
[] 2 No (Go to HA28)
[] 8 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 or disagree 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. Check WB4 and WB5, age between 15-24 years and ever attended school?
[] 1 Yes (WB4 is 15-24 and WB5=1)
[] 2 No (Go to WM10)
[] 2 No (Go to WM10)
HA38. Did you study sexuality education in school?
Sexuality education includes birth control, safe sex, teen pregnancy, reproductive tract infections and wellbeing, etc.
[] 1 Yes
[] 2 No (Go to WM10)
[] 2 No (Go to WM10)
HA39. At what level did you first have sexuality education?
[] 1 Primary
[] 2 Lower secondary
[] 3 Upper secondary
[] 4 Vocational certificate
[] 5 Diploma/associate
[] 8 DK/Not sure
[] 2 Lower secondary
[] 3 Upper secondary
[] 4 Vocational certificate
[] 5 Diploma/associate
[] 8 DK/Not sure
HA40. In sexuality education classes, did you learn any new information?
[] 1 Yes, mostly new
[] 2 Yes, some new
[] 3 None
[] 2 Yes, some new
[] 3 None
HA41. Apart from sexuality education classes, did you have other source of sexuality information?
Probe: Any other source?
[] A Internet
[] B Movies
[] C Television
[] D Radio
[] E Book
[] F Comics
[] G Fiction
[] H Friends
[] I Older brother-sister/younger brother-sister
[] J Parents/guardian
[] X Other (specify) ____
[] Y No source
[] B Movies
[] C Television
[] D Radio
[] E Book
[] F Comics
[] G Fiction
[] H Friends
[] I Older brother-sister/younger brother-sister
[] J Parents/guardian
[] X Other (specify) ____
[] Y No source
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 Thai
[] 2 English
[] 3 Language 3
[] 2 English
[] 3 Language 3
WM13. Language of the Interview.
[] 1 Thai
[] 2 English
[] 3 Language 3
[] 6 Other language (specify) ____
[] 2 English
[] 3 Language 3
[] 6 Other language (specify) ____
WM14. Native language of the Respondent.
[] 1 Thai
[] 2 English
[] 3 Chinese
[] 4 Burmese
[] 5 Khmer/Kuy
[] 6 Malay/Jawi
[] 7 Lao
[] 8 Karen
[] 9 Hmong
[] 10 Lahu
[] 11 Mon
[] 12 Lawa
[] 13 Akha
[] 14 Nyeu
[] 15 Shan
[] 6 Other language (specify) ____
[] 2 English
[] 3 Chinese
[] 4 Burmese
[] 5 Khmer/Kuy
[] 6 Malay/Jawi
[] 7 Lao
[] 8 Karen
[] 9 Hmong
[] 10 Lahu
[] 11 Mon
[] 12 Lawa
[] 13 Akha
[] 14 Nyeu
[] 15 Shan
[] 6 Other language (specify) ____
WM15. Was a translator used for 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 5-14 selected for questionnaire for children age 5-14?)
[] 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 5-14 in this household?]
[] Yes (Go to WM17 in woman's information panel and record '01'. Then go to the questionnaire for children age 5-14 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