Cluster number
Household number
Line number
Woman's line number
Interviewer number
Supervisor number
Day of interview
Month of interview
Year of interview
Respondent to another questionnaire
Consent
Result of woman's interview
Start of interview - Hour
Start of interview - Minutes
End of interview - Hour
End of interview - Minutes
Interview completed in private
Language of the Questionnaire
Language of the Interview
Native language of the Respondent
Translator used
Household interviewer
Introduction MM Listing
Other brother/sisters
Finish
Month of birth of woman
Year of birth of woman
Age of woman
Ever attended school
Highest level of school attended
Highest grade attended at that level
Ever completed that grade/year
Attended school during current school year
Level of education attended current school year
Grade attended at that level during current school year
Attended school previous school year
Level of education attended previous school year
Grade attended at that level during previous school year
Can read part of the sentence
Duration of living in current place
Place of living prior to moving to current place
Region prior to moving to current place
Covered by health insurance
Type of health insurance: Health insurance through employer
Type of health insurance: Other privately purchased commercial health insurance
Compulsory/Universal Health Insurance
Voluntary Health Insurance
Type of health insurance: Other
Type of health insurance: No response
Frequency of reading newspaper or magazine
Frequency of listening to the radio
Frequency of watching TV
Ever used a computer or a tablet
Computer / tablet usage in the last 3 months
During the last 3 months: Copy or move a file or folder
During the last 3 months: Use a copy / paste in document
During the last 3 months: Send e-mail with attached file
During the last 3 months: Use a basic arithmetic formula in a spreadsheet
During the last 3 months: Connect and install a new device
During the last 3 months: Install and configure software
During the last 3 months: Create an electronic presentation
During the last 3 months: Transfer a file
During the last 3 months: Write a computer program
Ever used internet
Internet usage in the last 3 months
Own a mobile phone
Mobile phone usage in the last 3 months
Ever given birth
Any sons or daughters living with you
Sons living with you
Daughters living with you
Any sons or daughters not living with you
Sons living elsewhere
Daughters living elsewhere
Ever had child who later died
Boys dead
Girls dead
Children ever born
Confirm total number of children ever born
Check total number of children ever born
Pregnancy that was miscarried, ended in a stillbirth, or that was aborted
How many miscarriages have you had during your lifetime?
How many cases have your pregnancies ended with a stillbirth
How many abortions have you had during your lifetime
Live births in last two years
Any other live births
Wanted last child then
Wanted child later or did not want more children
Received prenatal care
Prenatal care provider: Doctor
Prenatal care provider: Nurse/Midwife
Prenatal care provider: Other qualified
Prenatal care provider: Traditional birth attendant
Prenatal care provider: Other
Prenatal care provider: No Response
Weeks or months pregnent at first prenatal care - unit
Weeks or months pregnant at first prenatal care - number
Did any health worker offer you pregnancy insurance policy
Times received prenatal care
Blood pressure
Urine sample
Blood sample
Urine analysis for hidden infection
Assistance at delivery: Doctor
Assistance at delivery: Nurse / Midwife
Assistance at delivery: Other qualified
Assistance at delivery: Traditional birth attendant
Assistance at delivery: Relative / Friend
Assistance at delivery: Other
Assistance at delivery: No one
Assistance at delivery: No response
Place of delivery
Delivery by caesarean section
Decision made to have caesarean section
After the birth, baby was put directly on the bare skin of mothers chest
Baby was wrapped up before being placed on mothers chest
Baby was dried or wiped soon after birth
Time baby was bathed - unit
Time baby was bathed - number
Size of child at birth
Weighed at birth
Weight from card or recall
Weight at birth (Kilograms)
Menstrual period returned since the birth of child
Ever breastfeed
Time baby put to breast - unit
Time baby put to breast - number
Within first 3 days after delivery, child given anything to drink other than breast milk
Child given to drink: Milk (other than breast milk)
Child given to drink: Plain water
Child given to drink: Sugar or glucose water
Child given to drink: Gripe water
Child given to drink: Sugar - salt - water solution
Child given to drink: Fruit juice
Child given to drink: Infant formula
Child given to drink: Tea / Infusions
Child given to drink: Honey
Child given to drink: Prescribed medicine
Child given to drink: Other
Child given to drink: Not given anything to drink
Child given to drink: No response
Duration of staying in the health facility - unit
Duration of staying in the health facility - number
Baby's health checked before leaving health facility
Mother's health checked before leaving health facility
Baby's health checked after leaving health facility
Baby checked after the delivery was over
Mother checked after the delivery was over
Additional baby check after the delivery
Baby checked after the delivery
Number of times baby was checked
How long after delivery did the first check of baby happen - unit
How long after delivery did the first check of baby happen - number
Person checking on baby's health: Doctor
Person checking on baby's health: Nurse / Midwife
Person checking on baby's health: Other qualified
Person checking on baby's health: Traditional birth attendant
Person checking on baby's health: Relative / Friend
Person checking on baby's health: Other
Person checking on baby's health: No response
Place where baby's health was checked
Mother's health checked after leaving health facility
Mother's health checked after the delivery was over
Mother's health checked after the birth of the baby
Number of times mother's health was checked after the birth
How long after delivery did the first check of mother happen - unit
How long after delivery did the first check of mother happen - number
Person checking on mother's health: Doctor
Person checking on mother's health: Nurse / Midwife
Person checking on mother's health: Other qualified
Person checking on mother's health: Traditional birth attendant
Person checking on mother's health: Relative / Friend
Person checking on mother's health: Other
Person checking on mother's health: No response
Place where mother's health was checked
During two days after birth health care provider: Examine cord
During two days after birth health care provider: Take temperature
During two days after birth health care provider: Counsel on breastfeeding
During two days after birth health care provider observe child's breastfeeding
During two days after birth health care provider weighed child again
During two days after birth health care provider gave information on symtomps
Female sterilization
Male sterilization
IUD
Injectables
Implants
Pill
Condom
Female Condom
Diaphragm
Foam / Jelly
Periodic abstinence / Rhythm method
Withdrawal
Emergency / postcoital contraception
Other ways or methods
Currently pregnant
Currently using a method to avoid pregnancy
Ever used a method to avoid pregnancy
Current method: Female sterilization
Current method: Male sterilization
Current method: IUD
Current method: Injectables
Current method: Pill
Current method: Male condom
Current method: Female condom
Current method: Diaphragm
Current method: Foam / Jelly
Current method: Periodic abstinence / Rhythm
Current method: Withdrawal
Current metod: Emergency / postcoital contraception
Current method: Other
Current method: No response
IUD woman currently using is a postpartum IUD
Wanted to get pregnant at the time
Wanted baby later or did not want more children
Would like to have another child (currently pregnant)
Would like to have another child (not currently pregnant)
Desired waiting time (unit)
Desired waiting time (number)
Able to get pregnant
Reason: Infrequent sex / No sex
Reason: Menopausal
Reason: Never menstruated
Reason: Hysterectomy
Reason: Trying to get pregnant for 2 years or more without result
Reason: Postpartum amenorrheic
Reason: Breastfeeding
Reason: Too old
Reason: Fatalistic
Reason: Other
Reason: DK
Reason: No response
Start of last menstrual period - unit
Start of last menstrual period - number
Social activities, school or work days not attended due to menstruation
Availability of private place for washing during last menstrual period
Used any materials such as sanitary pads, tampons or cloth
Materials reusable
If she goes out with out telling husband: wife beating justified
If she neglects the children: wife beating justified
If she argues with husband: wife beating justified
If she refuses sex with husband: wife beating justified
If she burns the food: wife beating justified
If she neglects housework
Someone taken or tried taking something, by using force or threatening to use force
Victimisation happened during the last 12 months
Number of times victimisation happened in the last year
The last time that this happened, was anything stolen
Person(s) had a weapon
Offender(s) had a knife, a gun or something else used as a weapon: A knife
Offender(s) had a knife, a gun or something else used as a weapon: A gun
Offender(s) had a knife, a gun or something else used as a weapon: Other weapon
Offender(s) had a knife, a gun or something else used as a weapon: No response
Incident reported to the police
Physically attacked
Attack happened during the last 12 months
Number of times attack happened in the last year
Place attack happened the last time
Number of people involved in committing the offence
At least one of the offender(s) recognized at the time of the incident
Feeling safe walking alone in neighbourhood after dark
Feeling safe at home alone after dark
In the past 12 months, felt discriminated: Ethnic or immigration origin
In the past 12 months, felt discriminated: Gender
In the past 12 months, felt discriminated: Sexual orientation
In the past 12 months, felt discriminated: Age
In the past 12 months, felt discriminated: Religion or belief
In the past 12 months, felt discriminated: Disability
In the past 12 months, felt discriminated: Any other reason
Currently married or living with a man
Age of husband/partner
Ever married or lived with a man
Marital status
Married or lived with a man once or more than once
Month of first union
Year of first union
Age at first union
Use glasses or contact lenses
Use hearing aid
Difficulty seeing, even if wearing glasses or contact lenses
Difficulty hearing, even if using a hearing aid
Difficulty walking or climbing steps
Difficulty remembering or concentrating
Difficulty with self-care, such as washing all over or dressing
Difficulty communicating
Ever heard of HIV or AIDS
Can avoid HIV by having one uninfected partner
Can get HIV from mosquito bites
Can avoid HIV by using a condom correctly every time
Can get HIV by sharing food with a person who has HIV
Can people get HIV by kissing a person who has HIV
Can people get HIV by hugging or shaking hands with a person who has HIV
Healthy-looking person may have HIV
HIV from mother to child during pregnancy
HIV from mother to child during delivery
HIV from mother to child through breastfeeding
Aware of drugs used to reduce the risk of transmission to the baby
Given information about HIV during antenatal care visit: HIV from mother
Given information about HIV during antenatal care visit: Things to do
Given information about HIV during antenatal care visit: Tested for HIV
Given information about HIV during antenatal care visit: Offered a test
Tested for HIV as part of antenatal care
Received results from test during antenatal care
Received consultation after testing during antenatal care
Offered test for HIV before delivery
Tested for HIV during delivery
Received results from test during delivery
Tested for HIV since test during pregnancy
Most recent time of testing for HIV
Ever been tested for HIV
Received results of HIV test
Know a place to get HIV test
Heard of test kit for HIV testing
Ever tested yourself using test kit
Would buy fresh vegetables from shopkeeper with AIDS virus
Children living with HIV should be allowed to attend school with other children
People hesitate to take an HIV test because they are afraid of how other people will react if the test result is positive
People talk badly about people living with HIV, or who are thought to be living with HIV
People living with HIV, or thought to be living with HIV, lose the respect of other people
Agreement with the following statement: I would be ashamed if someone in my family had HIV
Fear of getting HIV in contact with the saliva of a person living with HIV
Have you ever heard of an illness called tuberculosis or TB?
Through the air when coughing or sneezing
Through sharing utensils
Through touching a person with tb
Through food
Through sexual contact
Through mosquito bites
Other
Dk
Coughing
Coughing with sputum
Coughing for several weeks
Fever
Blood in sputum
Loss of appetite
Night sweating
Pain in chest
Tiredness/fatigue
Weight loss
Lethargy
In your opinion, can tuberculosis be cured?
If a member of your family got tuberculosis, would you want it to remain a secret or not?
Area
Oblast
Date of interview women (CMC)
Date of birth of woman (CMC)
Date of marriage of woman (CMC)
Age
Age at first marriage/union of woman
Date of birth of first child (CMC)
Date of birth of last child (CMC)
Marital/Union status of woman
Children surviving
Children dead
Woman's sample weight
Education
Health insurance
Functional difficulties (age 18-49 years)
Ethnicity of household head
Mother tongue of household head
Day of birth
Month of birth
Year of birth
Age of child
Sex of newborns
Combined wealth score
Wealth index quintile
Percentile Group of com1
Urban wealth score
Urban wealth index quintile
Percentile Group of urb1
Rural wealth score
Rural wealth index quintile