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:

WM4. Woman's line number: _ _

WM5. Interviewer's name and number:

WM6. Day/month/year of interview _ _ / _ _ / 2014

Good ____! My name is ____ and I am working for the Zimbabwe National Statistics Agency (ZIMSTAT). We are working on a nationwide survey concerned with the situation of children, families and households. Your household was selected for the survey. Now I would like to talk to you more about (child's name from UF3)'s health and other topics. The interview will take about 50 minutes. All the information we obtain will remain strictly confidential and your answers will never be identified.

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 30 minutes. Again, all the information we obtain will remain strictly confidential and anonymous.

May I start now?

WM7. Result of woman's interview

WM8. Team leader's name and number:

WM9. Main data entry clerk's name and number

WM10. Record start time of interview.

Woman's background: WB

WB1. In what month and year were you born?

WB2. How old are you?

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

WB3. Have you ever attended school or preschool?

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

WB5. What is the highest grade you completed at that level? If the first grade at this level is not completed, enter "00".
10 - Special primary
11 - 17 for primary
20 - Special secondary
21 - 26 for secondary
30 - Attended/currently attending higher
education
31- completed higher education

WB6. Check WB4:

WB7. Now I would like you to read this sentence to me.

Show sentence on the card to the respondent. If respondent cannot read whole sentence, probe: Can you read part of the sentence to me?

Access to mass media and use of information/communication technology: MT

MT1. Check WB7:

MT2. How often do you read a newspaper or magazine: almost every day, at least once a week, less than once a week or not at all?

MT3. Do you listen to the radio almost every day, at least once a week, less than once a week or not at all?

MT4. How often do you watch television: would you say that you watch almost every day, at least once a week, less than once a week or not at all?

MT6. Have you ever used a computer?

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

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

MT9. Have you ever used the internet?

MT10. In the last 12 months, have you used the internet?

If necessary, probe for use from any location, with any device.

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

MT12. Have you ever used a mobile or non-mobile phone?

MT13. In the last 12 months, have you used the mobile or non-mobile phone?

If necessary, probe for use from any location, with any device.

MT14. During the last one month, how often did you use the mobile or non-mobile phone: almost every day, at least once a week, less than once a week or not at all?

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?

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

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

CM6. Do you have any sons or daughters to whom you have given birth who are alive but do not live with you?

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".

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?

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

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

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?

Birth History: BH

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 line. If there are more than 14 births, use an additional questionnaire.

BH Line No. _ _

BH1. What name was given to your (first/next) baby? ____

BH2. Were any of these births twins?

BH3. Is (name) a boy or a girl?

BH4. In what month and year was (name) born?
Probe: what is his/her birthday?

BH5. Is (name) still alive?

BH6. How old was (name) at his/her last birthday?

BH7. Is (name) living with you?

BH8. Record household line number of child (from HL1)

BH9. If dead: How old was (name) when he/she died?
If "1 year", probe: How many months old was (name)? Record days if less than 1 month; record months if less than 2 years; or years if more than 2 years

BH10. Were there any other live births between (name of previous birth) and (name), including any children who died after birth?

BH11. Have you had any live births since the birth of (name of last birth in birth history module)?

[Question only asked if BH]
CM12A. Compare number in CM10 with number of births in the birth history module above and check:

CM13. Check BH4 in birth history module: Last birth occurred within the last 2 years, that is, since (month of interview) in 2012 (if the month of the interview and the month of the birth are the same, and the year of birth is 2012, consider this as a birth within the last 2 years)

If child has died, take special care when referring to this child by name in the following modules.

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?

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

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

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)?

MN2. Whom did you see?

Probe: anyone else? Probe for the type of person seen and circle all answers given.

MN2A. How many weeks or months pregnant were you when you first received antenatal care for this pregnancy?

Record the answer as stated by respondent.

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.

MN3A. Check if more than one person/code is circled in MN2

MN3B. How many times did you visit each of them?

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

[A] Was your blood pressure measured?

[B] Did you give a urine sample?

[C] Did you give a blood sample?

MN4A. Did you take any iron tablets during your pregnancy with (name)?
Show iron tablet

MN4B. For how long did you take the iron tablets?

MN4C. On average, how often did you take these iron tablets during this pregnancy?

MN4D. Where did you get the iron tablets from?
Probe: Anywhere else? Circle all providers mentioned, but do not prompt with any suggestions. Probe to identify each type of source.

MN4E. Did you take any folate tablets during your pregnancy with (name)?
Show folate tablet

MN4F. For how long did you take the folate tablets?

MN4G. On average, how often did you take these folate tablets during this pregnancy?

MN4H. Where did you get the folate tablets from?
Probe: Anywhere else? Circle all providers mentioned, but do not prompt with any suggestions. Probe to identify each type of source.

MN5. Do you have a card or other document with your own immunizations listed?
May I see it please?

If a card is presented, use it to assist with answers to the following questions.

MN6. When you were pregnant with (name), did you receive any injection in the arm or shoulder to prevent the baby from getting tetanus, that is convulsions after birth?

MN7. How many times did you receive this tetanus injection during your pregnancy with (name)?

MN8. How many tetanus injections during last pregnancy were reported in MN7?

MN9. Did you receive any tetanus injection at any time before your pregnancy with (name), either to protect yourself or another baby?

MN10. How many times did you receive a tetanus injection before your pregnancy with (name)?

If 7 or more times, record '7'.

MN11. How many years ago did you receive the last tetanus injection before your pregnancy with (name)?

If less than 1 year, record '00'.

MN12. Check MN1 for presence of antenatal care during this pregnancy:

MN13. During (any of) your antenatal visit(s) for the pregnancy with (name), did you take any medicine in order to prevent you from getting malaria?

MN14. Which medicines did you take to prevent malaria? Circle all medicines taken. If type of medicine is not determined, show typical anti-malarial to respondent.

MN15. Check MN14 for medicine taken:

MN16. During your pregnancy with (name), how many times did you take SP(Fansidar) in total?
Please include all that you obtained either during an antenatal care visit, during a visit to a health facility or from another source?

MN17. Who assisted with the delivery of (name)? Probe: anyone else? Probe for the type of person assisting and circle all answers given.

If respondent says no one assisted, probe to determine whether any adults were present at the delivery.

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

(Name of place) ____

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

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

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

MN21. Was (name) weighed at birth?

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

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

MN24. Did you ever breastfeed (name)?

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

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

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

Post-natal health checks: PN

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.

PN1. Check MN18: Was the child delivered in a health facility?

PN2. Now I would like to ask you some questions about what happened in the hours and days after the birth of (name).

You have said that you gave birth in (name or type of facility in MN18). How long did you stay there after the delivery?

If less than one day, record hours. If less than one week, record days. Otherwise, record weeks.

PN3. 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 MN18), did anyone check on (name)'s health?

PN4. 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 MN18)?

PN5. Now I would like to talk to you about what happened after you left (name or type of facility in MN18). Did anyone check on (name)'s health after you left (name or type of facility in MN18)?

PN6. Check MN17: Did a health professional, traditional birth attendant, or village health worker assist with the delivery?

PN7. You have already said that (person or persons in MN17) 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 MN17) left you, did (person or persons in MN17) check on (name)'s health?

PN8. And did (person or persons in MN17) check on your health before leaving? By check on your health, I mean assessing your health, for example asking questions about your health or examining you.

PN9. After the (person or persons in MN17) left you, did anyone check on the health of (name)?

PN10. 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?

PN11. Did such a check happen only once, or more than once?

PN12A. How long after delivery did that check happen?

PN12B. 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.

PN13. Who checked on (name)'s health at that time?

PN14. Where did this check take place? Probe to identify the type of source. If unable to determine whether public or private, write the name of the place.

(Name of place) ____

PN15. Check MN18: Was the child delivered in a health facility?

PN16. After you left (name or type of facility in MN18), did anyone check on your health?

PN17. Check MN17: Did a health professional, traditional birth attendant, or community health worker assist with the delivery?

PN18. After the delivery was over and (person or persons in MN17) left, did anyone check on your health?

PN19. After the birth of (name), did anyone check on your health? I mean someone assessing your health, for example asking questions about your health or examining you.

PN20. Did such a check happen only once, or more than once?

PN21A. How long after delivery did that check happen?

PN21B. 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.

PN22. Who checked on your health at that time? Circle all mentioned.

PN23. Where did this check take place? Probe to identify the type of source. If unable to determine whether public or private, write the name of the place.

(Name of place) ____

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?

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

Contraception: CP

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

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?

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

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

Unmet need: UN

UN1. Check. Check CP1: Currently pregnant?

UN2. Now I would like to talk to you about your current pregnancy. When you got pregnant, did you want to get pregnant at that time?

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

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

UN5. Check CP3: Currently using "female sterilization"

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

UN7. How long would you like to wait before the birth of (a/another) child? Record the answer as stated by respondent.

UN8. Check CP1: Currently pregnant?

UN9. Check CP2: Currently using a method?

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

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

UN12. Check UN11: "Never menstruated" mentioned?

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

Attitudes toward domestic violence: DV

DV1. Sometimes a husband is annoyed or angered by things that his wife does. In your opinion, is a husband justified in hitting or beating his wife in the following situations:

[A] If she goes out without telling him?

[B] If she neglects the children?

[C] If she argues with him?

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

[E] If she burns the food?

[F] If she commits infidelity

Marriage/union: MA

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

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

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

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

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

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

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

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?

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

Sexual behavior: SB

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

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

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

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

SB4. The last time you had sexual intercourse, was a condom used?

SB5. What was your relationship to this person with whom you last had sexual intercourse?
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".

SB6. Check MA1:

SB7. How old is this person?

If response is "DK?, probe: About how old is this person?

SB8. Have you had sexual intercourse with any other person in the last 12 months?

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

SB10. 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", then ask: Were you living together as if married? If "yes", circle "2". If "no", circle "3".

SB11. Check MA1 and MA7:

SB12. How old is this person?

If response is DK, probe: About how old is this person?

SB13. Other than these two persons, have you had sexual intercourse with any other person in the last 12 months?

SB14. In total, with how many different people have you had sexual intercourse in the last 12 months?
If a non-numeric answer is given, probe to get an estimate. If number of partners is 95 or more, write "95".

SB15. In total, with how many different people have you had sexual intercourse in your lifetime?

If a non-numeric answer is given, probe to get an estimate. If number of partners is 95 or more, write "95".

HIV/AIDS: HA

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

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

HA3. Can people get HIV because of witchcraft or other supernatural means?

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

HA5. Can people get HIV from mosquito bites?

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

HA7. Is it possible for a healthy-looking person to have HIV?

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

[A] During pregnancy?

[B] During delivery?

[C] By breastfeeding?

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

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

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

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

HA13. Check CM13: Any live birth in last 2 years?

HA14. Check MN1: Received antenatal care?

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

Were you given any information about:

[A] Babies getting the HIV from their mother?

[B] Things that you can do to prevent getting HIV?

[C] Getting tested for HIV?

Were you:
[D] Offered an HIV test?

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

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

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

HA19. Check MN17: Birth delivered by health professional (A or B)?

HA20. I don't want to know the results, but were you tested for HIV between the time you went for delivery but before the baby was born?

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

HA22. Have you been tested for HIV since that time you were tested during your pregnancy?

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

HA24. I don?t want to know the results, but have you ever been tested to see if you have HIV?

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

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

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

Maternal Mortality: MM

MM1. Now I would like to ask you some questions about your brothers and sisters, that is, all of the children born to your natural/biological mother. Please include all your sisters and brothers who are living with you, those who are living elsewhere, and those who have died.

How many children did your mother give birth to, including yourself?

MM2. Check MM1:

MM3. How many of these births did your mother have before you were born?

MM4. What name was given to your oldest (next oldest) brother or sister? ____

MM5. Is (name) male or female?

MM6. Is (name) still alive?

MM7. How old is (name)? _ _ (Go to [S2] or next sibling)

MM8. How many years ago did (name) die? _ _

MM9. How old was (name) when he/she died? _ _

MM9A. Check MM5 and MM9.

Is the sibling male or died before age 12?

MM10. Was (name) pregnant when she died?

MM11. Did (name) die during childbirth?

MM12. Did (name) die within two months after the end of a pregnancy or childbirth?

MM13. How many live born children did (name) give birth to during her lifetime? _ _

MM14. (If no more siblings go to next module)

[] Tick here if additional questionnaire used

Tobacco and alcohol use: TA

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

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

TA3. Do you currently smoke cigarettes?

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

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 a month, circle "10". If "every day" or "almost every day", circle "30".

TA6. Have you ever tried any smoked tobacco products other than cigarettes, such as cigars, water pipe, cigarillos, pipe or rolled tobacco?

TA7. During the last one month, did you use any smoked tobacco products?

TA8. What type of smoked tobacco product did you use or smoke during the last one month? Circle all mentioned.

TA9. During the last one month, on how many days did you use smoked tobacco products? 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".

TA10. Have you ever tried any form of smokeless tobacco products, such as chewing tobacco, snuff, or dip?

TA11. During the last one month, did you use any smokeless tobacco products?

TA12. What type of smokeless tobacco product did you use during the last one month?Circle all mentioned.

TA13. During the last one month, on how many days did you use smokeless tobacco products? 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".

TA14. Now I would like to ask you some questions about drinking alcohol. Have you ever drunk alcohol?

TA15. We count one drink of alcohol as one can or bottle of beer, one glass of wine, or one shot/tot of spirits (including brandy, vodka, whiskey, cane spirits, etc), one litre of opaque beer. How old were you when you had your first drink of alcohol, other than a few sips?

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".

TA17. In the last one month, on the days that you drank alcohol, how many drinks did you usually have per day?

WM11. Record the time.

WM12. Check List of Household Members, columns HL7B and HL15: Is the respondent the mother or caretaker of any child age 0-4 living in this household?

Interviewer's observations ________

Team leader's observations ________

Supervisor's observations ________