Model Questionnaires

Model questionnaires are produced by UNICEF as a basis for country specific questionnaire design. UNICEF MICS model questionnaires correspond to a particular round. There are major and minor differences between rounds.

Back to Questionnaires and Reports

Base Questionnaires
Round Type Image Text
Round 3 Women pdf html
Household pdf html
Children age 0-4 pdf html
Round 4 Women pdf html
Household pdf html
Children age 0-4 pdf html
Men pdf html
Round 5 Women pdf html
Household pdf html
Children age 0-4 pdf html
Men pdf html
Round 6 Women pdf html
Household pdf html
Children age 0-4 pdf html
Men pdf html
Children age 5-17 pdf html
Round 7 Women Word
Household Word
Children age 0-4 Word
Men Word
Children age 5-17 Word

Optional Modules Rounds 3-6
Round Modules Type Image Text
Round 4 Child Disability Children age 0-4 pdf html
Vaccination Records from Health Facility Children age 0-4 pdf html
Round 5 Vaccination Records from Health Facility Children age 0-4 pdf html
Round 6 Vaccination Records from Health Facility Children age 0-4 pdf html
Water Quality Household pdf html

MICS Round 7 takes a different approach between model base questionnaires and supplementary modules. The relatively short Base questionnaire is supplemented by inserting the Complementary Topics into the Base Questionnaires, selecting the topics of national priorities and relevance.

This approach is documented in the Guidlines for Customization of MICS7 Questionnaires

See the UNICEF MICS website for the most up to date questionnaires for Complemntary Topics.

Complementary Topics Round 7
Topics/Modules Type
Vaccination Records from Health Facility Health Facility
Water Quality Households
Adult Functioning Women
Men
Anthropometry for Children 5-9 Children age 5-17
Attitudes towards Domestic Violence Women
Men
Birth Registration Children age 0-4
Care-seeking and treatment of diarrhoea Children age 0-4
Care-seeking and treatment of ARI (acute respiratory illness) Children age 0-4
Discrimination Women
Men
Employment and training Women
Men
Female Genital Mutilation and Cutting Women
Food Insecurity Experience Households
Health Insurance Women
Men
Children age 0-4
Children age 5-17
Household Energy Use Households
Household Involvement in Education Children age 5-17
Human Papillomavirus (HPV) vaccinations Women
Infant and Young Children Feeding Women
Children age 0-4
Malaria Women
Children age 0-4
Households
Maternal Mortality Women
Menstrual Health and Hygiene Women
Migration Women
Men
Post-natal and newborn care: birthweight Women
Post-natal and newborn care: cord care Women
Post-natal and newborn care: infant care Women
Post-natal and newborn care: signal care Women
Post-natal and newborn care: thermal care Women
Post-emergency Households
Reproductive Care: contraception Women
Reproductive Care: decision making Women
Reproductive Care: desire for last birth Women
Reproductive Care: period return Women
Reproductive Care: sexual activity Women
Reproductive Care: unmet need Women
Safety Women
Men
Social Transfers Households
Time Use Women
Men
Children age 5-17
Tobacco Women
Men

Back to Top