DDI_NPL_2000_BCHIMES_v01_M Social Statistics Section Accelerated Data Program 2012-03-12 NADA Version 1.0 - Central Bureau of Statistics - Original documentation of the study. Version 2.0 - Edtied version by ADP based on Version 1.0 of CBS downloaded from http://cbs.gov.np/nada/index.php/catalog on 18 February 2013. Between Census Household Information Monitoring and Evaluation System 2000 BCHIMES 2000 NPL_2000_BCHIMES_v01_M Central Bureau of Statistics UNICEF/Nepal

United Nations Children's Fund - Nepal

United Nations Children's Fund - Nepal NADA UNICEF Government of Nepal National Data Archive, Publication, Distribution and Library Section Other Household Survey [hh/oth] This survey is the continuation and improvement recommended by the evaluation committee on Nepal Multiple Indicator Surveillance (NMIS), which completed its sixth cycle in 1997-98. Version 03: Cleaned, edited and anonymized final dataset. Education HIV/AIDS Nutrition Although various socio-economic surveys are being conducted in Nepal, at times these surveys do not coincide with the planning and reporting cycles of HMG and UN agencies. Also, different surveys have different objectives, but the data from a comprehensive survey that covers indicators related to women and children is always valuable. A comprehensive Nepal Family Health Survey was conducted in 1996, which provided data for the mid-decade review in retrospect. Current data and indicators relating to issues of women and children are needed for gender specific planning and policy formulation. These data can also be used in planning other national-level programmes which are to begin in the middle of next year. This has led to the planning and execution of the present survey to generate data and indicators related to issues of women and children. The primary objective of the Between Census Household Information for Monitoring and Evaluation System (BCHIMES) was to provide social indicators on issues related to women and children. This survey has come up with indicators on issues related to women and children for an end-decade assessment of progress of this decade and provide benchmark data for the next programme cycle. Nepal National coverage Urban/Rural areas Ecological zones Sub-regions All eco-development regions of the Hills and Terai For mountain eco-development regions: Eastern, Central & Western Mountains combined in one group Mid- and Far-western Mountains combined in another group Kathmandu Valley Household as well as individual The survey covered all selected household members, all women aged 15-49 years resident in the household, and all children aged 0-4 years (under age 5) resident in the household. Sample survey data [ssd] The scope of the BCHIMES includes: HOUSEHOLDS: Household Characteristics, Education, Water Supply, Sanitation, Salt Iodisation, INDIVDUALS: Demographic and Social Characteristics, Family Planning, Ante-Natal and Delivery Care, Information education and communication, Childhealth, STD/HIV/AIDS, Breastfeeding, Care of Acute Respiratory Infections (ARI), Diarrhoea, Vitamin A, Immunisation Branch Statistics Offices The NMIS evaluation report suggested that instead of two cycles per year in NMIS one survey be carried out every year with detailed analysis that would have wide-ranging dissemination and plans of data use. In the future, BCHIMES (Between Census Household Information, Monitoring and Evaluation System) will be conducted on a regular basis to generate needed data. The following suggestions were also made in the NMIS evaluation report for the effective design of the sample: - For every new study, always select a new sample so as to minimise the Hawthorne effect. - In order to minimise the standard error of the estimate, always try to make the cluster size small, i.e., around 50, as compared to an average cluster size of 120 for the NMIS cycles. Thus, the new sample design should limit the average cluster size to 50 or smaller and a new sample should be drawn for a new study every time for the minimisation of the Hawthorne effect. Domains of estimation A sample design to provide district level estimates was desirable keeping in view the decentralisation programme of the His Majesty's Government of Nepal. However, as the sample size needed for this would be very large and the survey undertaking also huge as well as expensive, it was decided that the size of the survey should provide national as well as some sub-regional estimates. Under the guidance of the Steering Committee as well as the discussion between the CBS personnel and UNICEF led to the conclusion that a minimum of 13 estimates is needed for different geographic areas and these are 1. Five eco-development regions each from the Terai and Hills; 2. Estimates for the Kathmandu Valley; and finally 3. Two estimates for the mountain region, for which the Central, Eastern and Western Mountain regions would be combined as one and the other would be the combination of the Mid-western and Far-western Mountain regions. Although there are some variations within these mountain regions, regions having comparable characteristics would be combined as one. Since the number of households was the basis of the selection of our sample, we used average size of the household as an indicator to provide the similarity between these combined areas. For example, the average household size was 5.5 in both the Far-western and Mid-western Mountains. Likewise, the average household size for the Eastern, Central and Western Mountains is, respectively, 5.3, 5.0 and 4.8. That is, the average household size was slightly higher in the Far-western and the Mid-western regions and was slightly lower in the others including the Eastern, Central and Western Mountains. In other words, the areas that were combined were quite close in terms of average household size. Stratification In domains with urban areas, the stratification was done according to urban/rural residence. Although the urban/rural estimates for these domains would be of interest, it would have increased the sample size considerably. Thus, at this stage, there were no plans to obtain urban/rural estimates for these 13 domains of estimation. Note, however, that the urban/ rural estimates could be available for the national level, as well as for the Hills and Terai. Because the sample was selected separately for each domain, there was a built-in stratification for the Hills, Terai and Mountains as well as the development regions for most of the domains of study. Estimation of sample size Estimates of the sample size, to a large extent, depend on the variable under study. As some variables have a larger variation, sample size estimates depend on the variables. To circumvent this problem, statisticians usually resort to estimating the sample size for variables where the largest sample size is needed and use this as the required minimum sample size. Also, because most of the sample survey use the cluster sample approach, it was necessary to make an allowance of about 2 for the design effect. The magic figure of 2 was based on the design effect calculated for different variables in the Nepal Family Health Survey 1996. It was estimated that a sample size of 800 was adequate for most of the variables, taking into account a design effect factor of 2. This sample size of 800 was regarded as the minimum sample size required for the domain of analysis. Since there are 13 domains, a total of 13x800 = 10400 households were required. Sample frame The sample frame for this study was the data from the 1991 Census data on Households for VDCs and their wards. When the census was undertaken in 1991 there were only 31 urban areas in Nepal. However, after 1991 Census, the government declared new municipalities. As a result, there are currently 58 municipalities, of which one is a metropolitan city and three are sub-metropolitan cities. The census data was updated to take into account the change in urban areas. Allocation of the sample In domains that have urban areas, the urban sample was be allocated proportionately. Urban and rural samples were selected separately using a PPS (Probability Proportional to Size) method. Examples for this are provided in Table A1, page 161 of the Report on the Situation of Women, Children and Households, Between Census Household Information, Monitoring and Evaluation system (BCHIMES), March-May 2000. The total number of clusters surveyed was 208 with an average cluster size of 50, providing a sample size of nearly 10,400. Likewise, the number of urban clusters will be 27 and the number of rural clusters will be 181. The proportion of urban clusters was 13 percent (See Table A1, Appendix 1 of the Report on the Situation of Women, Children and Households). Selection procedure used For any given domain, the districts were arranged according to the code for districts provided by the Central Bureau of Statistics. If the code of a district is lowest, it appears first in the list. Within the district, VDCs are listed in an alphabetical order. For each VDC, there will be nine wards, for which there is data regarding number of households, total population, males and females. Initially, the number of households in a domain was cumulated. The total number of households in a domain is divided by the number of clusters selected in the domain. This provided the systematic interval. Then, a random number between 1 and the systematic interval was selected for the first selection. Once the first selection was made, the systematic interval was added to that for the second selection and so on, until the last selection for the domain was made. If a domain consisted of urban and rural areas, then the selection was made separately for the urban and rural areas. Obviously, a proportionate allocation of sample was done for urban as well as rural areas within a domain. Note that a cluster size of 50 was used for the purpose of data collection. In fact, a number of wards will have a population well over 50, and in some cases a ward could have a population substantially less than 50. In some cases, some wards may have to be split and other wards merged to provide a cluster size of around 50. Distribution of the samples A total of 208 clusters (10,295 households), with 181 rural clusters (87%) and 27 urban clusters (13%s) were selected from 69 districts for the survey. The average cluster size was 50 households per cluster. Since the sample was stratified by region, it is not self-weighting; hence, sample weights were used for reporting national-level results. Face-to-face [f2f] Questionnaires were administered to households, currently married women aged 15-49 years, children aged 6-15 years, and children under 5 years of age in each selected household. The questionnaires were based on the Multiple Indicator Cluster Survey (MICS) model questionnaire. The English version of the questionnaires was translated into Nepali. The questionnaires were pre-tested in February 2000. Based on the results of the pre-test, modifications were made in the wording and translation. The Household Questionnaire includes the following modules: - Household Information Panel - Household Schedule - Education Module - Drinking Water - Sanitation and Latrine The Individual Questionnaire includes the following modules: - Individual Questionnaire Control - Demographic and Social Characteristics - Family Planning - Ante-Natal and Delivery Care - STD/HIV/AIDS - Breastfeeding - Care of Acute Respiratory Infections (ARI) - Diarrhoea - Vitamin A - Immunisation Recruitment, training and fieldwork Fourteen (14) teams were mobilised for data collection. Each team consisted of a team leader/supervisor, field data editor, and three female interviewers. A total of 71 field workers were mobilised for data collection. Team leaders/supervisors and field data editors were the permanent staff of CBS who were deputed for the survey. These field supervisors and editors were stationed at the central office or at different branch-level offices of the CBS. Likewise, seven female interviewers were also deputed from the central office of CBS. These deputed female interviewers collected data in Kathmandu Valley. Thirty-six (36) female interviewers were recruited at three different districts, namely, Surkhet, Sunsari and Kathmandu. These 36 interviewers were distributed among 12 teams and sent to districts for data collection. The job of data collection was allocated to each interviewer so that each team visited districts in the Terai, Hills and Mountains. The first training of interviewers was carried out in the second week of Falgun 2057, i.e., from 19 to 24 Feb 2000, and the field test was held on 25-26 Feb, 2000. This training was held in Kathmandu for the Kathmandu Valley teams as well as for trainers. A total of 11 field workers and seven trainers participated. A field test of the questionnaire was also carried out but because most of the questions were used in previous surveys, only minor changes were needed and especially with order-and-skip questions. This training also provided the opportunity for trainers to interact with interviewers and prepared them for conducting the training at Surkhet and Inaruwa. The training in Inaruwa and Surkhet was held from 28 Feb to 5 March. Altogether 30 participants divided into six teams participated at each training site. One day was used for field practice and one half-day was allocated for the discussion of field problems. The fieldwork started on 7 March 2000 and ended on 30 May 2000. That is, all data collection was completed in 82 days. Supervision was done by the BSO Supervisors, BSO chief, Officials from CBS. The main role of supervisors are to take care of data callection and give necessary instruction to the enumerators if needed. The data was collected by 14 teams, each made up of three female interviewers, one field editor, and one supervisor. Because of the equal allocation of sample size for all the domains, the proportionality of the sample allocation was not met and, thus, sample weights needed to be calculated for the national as well as the Hill, Terai and Mountain region estimates. Final weights/ raising factors depended on the number of households interviewed in each domain. For the calculation of sample weights, the module developed by UNICEF was used. For detail, please have a look at Appendix I Table A1 of the Report on the Situaltion of Women, Children and Households, Between Census Household Information, Monitoring and Evaluation System (BCHIMES), March - May 2000. The data was collected by 14 teams, each made up of three female interviewers, one field editor and one supervisor. The data entry programme was generated using EPI Info version 6.04. The data was entered twice and was validated using the validation programme in EPI Info in order to avoid data entry errors. During the process of validation, a substantial amount of data needed to be verified from the actual questionnaire. Once the validation check was completed, the data was checked for internal consistency using a check programme not used during the data entry stage. This process also required substantial time and problems had to be rectified by going through the questionnaire several times with different checks. Thus processed, the data was converted into SPSS system files and were tabulated using the SPSS versions 10.0 and 7.5. Of the 10,295 households sampled, 10,269 households were successfully interviewed, yielding a household response rate of 99.7 %. In the interviewed households, 9,983 eligible women (currently married and 15-49 years of age) were identified and 9,424 of them were successfully interviewed, yielding a women's response rate of 94.4 %. Overall, the response rate was 94.1%. Details of the response rate and reasons for non-response for geographical regions are shown in Table 16.1 and Table 16.2 from the Report on the Situation of Women, Children and Households, Between Census Household Information, Monitoring and Evaluation System, BCHIMES, March-May 2000. The household response rate varied from 98.7% to 100% and women's response rate varied from 87.3% to 100% for regions. A high response rate for households and women was observed in the Hills (96% overall), followed by the Mountains (94.5% overall). Kathmandu Valley had a 100% response rate in households as well as in the women's questionnaire. The Terai had the lowest response rate of 91.9 % overall. Within the Terai region, the Central Terai had the lowest response rate for both households and women's questionnaire (98.7% and 87.3%, respectively). The overall response rate in the Central Terai was 86.2 %. The main reason for women's low response rate in the Terai region was because the fieldwork in the Terai region took place at the time of Holi (Festival of Colour) when most Terai women were celebrating at their maternal homes. Only 26 households (0.3 %) could not be interviewed. Hence, the reason for nonresponse in the household questionnaire is not mentioned here. Table 16.2 presents the non-response rate by reasons of non-response for the women's questionnaire by regions. Overall, 559 women could not be interviewed at the time of the survey, yielding a nonresponse rate for women of 5.6%. The main reason for non-response for the women's questionnaire was the unavailability of women in the household (3.76%). The children's questionnaire collected information on children under 5 years of age of currently married women aged 15-49 years by interviewing the women. This questionnaire omitted to include a question regarding the total number of children under 5 years of age, to verify whether there were more eligible children under 5 than was identified in the household questionnaire. As a result, the denominator to compute the percentage that completed the children's questionnaire was taken from the data in the household questionnaire. Hence, the percentage that completed the children's questionnaire may be slightly lower than the figures in Table 16.3 of the same report. The overall percentage completed (at minimum) in ARI/diarrhoea, vitamin A and immunisation modules were 92.3%, 89.4 % and 91.1%, respectively (Table 16.3). As in the case of the household questionnaire and women's questionnaire, the children's questionnaire also had a low percentage completed in the Central Terai region. The percentage completed (at minimum) for ARI/diarrhoea, vitamin A, and immunisation modules in the Central Terai region were 85.7%, 82.5% and 85.7 %, respectively. Of the 10,269 households interviewed, 14,947 children aged 6-15 years were identified and information on 14,588 children could be gathered, yielding a response rate of 97.6% for the education module (Table 16.4, page 152 of same report). The response rates ranged from 94% to 100% for sub-regions. The response rate was highest in the Hills (99%) as compared to 96.5% for both the Terai and the Mountains. This sampling design is same as that used in the Family Health Survey 1996 and thus the variance estimation formula used in NFHS1996 is also valid for this design. The NFHS 1996 report uses the Jackknife method of estimation of standard errors for complex rates and proportions such as mortality rates. The application of this technique to NMIS data has provided for errors quite close to other estimation formulae. The initial formatting of the Jackknife method is time-consuming in EXCEL, but once set up for one variable, it can be used for other variables by substituting the new data. In fact, this method of variance estimation was used in this survey. Note: For the formula and details of the computations, please check Tables A.2, A.3 and A.4 of the Report on the Situation of Women, Children and Households, Between Census Information, Monitoring and Evaluation System (BCHIMES), March - May 2000. Confidentiality of the respondents is guaranteed by Article 8 of Statistics Act 1958. Restriction on publication of information and details Any information or details relating to any person, family, firm or company, which has been supplied, obtained or prepared pursuant to section 3, section 4, section 5, section 6 ot section 7, or any part of such information or details, shall not be disclosed or published directly except to the Director General or to any officer of the Bureau without the written person or of his authorised representative supplying such information or details. For the purpose of instituting any suit under this Act, nothing mentioned in sub-section (1) shall be deemed to prevent production of such information before any court of law. Director General Publication Distribution and Library Section Use of the dataset must be acknowledged using a citation which would include: - the Identification of the Primary Investigator - the title of the survey (including country, acronym and year of implementation) - the survey reference number - the source and date of download Example: Central Bureau of Statistics (CBS), Nepal. Between Census Household Information Monitoring and Evaluation System 2000. Ref. NPL_2000_BCHIMES_v01_M. Dataset downloaded from http://cbs.gov.np/nada/index.php/catalog on [date]. The dataset has been anonymized and is available as a Public Use Dataset. It is accessible to all users for statistical and research purposes only, under the following terms and conditions: 1. The data and other materials will not be redistributed or sold to other individuals, institutions, or organizations without the written agreement of the Central Bureau of Statistics (CBS). 2. The data will be used for statistical and scientific research purposes only. They will be used solely for reporting of aggregated information, and not for investigation of specific individuals or organizations. 3. No attempt will be made to re-identify respondents, and no use will be made of the identity of any person or establishment discovered inadvertently. Any such discovery would immediately be reported to the CBS. 4. No attempt will be made to produce links among datasets provided by the CBS or among data from the CBS and other datasets that could identify individuals or organizations. 5. Any books, articles, conference papers, theses, dissertations, reports, or other publications that employ data obtained from the CBS will cite the source of data in accordance with the Citation Requirement provided with each dataset. 6. An electronic copy of all reports and publications based on the requested data will be sent to the CBS. The Central Bureau of Statistics, Nepal bears no responsibility for any outcomes or for interpretations or inferences arising from the use of the dataset. ARI Diarrheoa This dataset belongs to Individual Questionnaire Control. This file contains data related to diarrhoea disease. It is asked to those children who are of age up to 5 years. 0 38 Education The file contains data related to 300: Education Module. This module is asked of children 6-15 years of age only. 0 33 HH members The file contains data related to Module 200: Household Schedule of the Household Questionnaire. 0 22 Household The file contains data related Modules 100: Household Information Panel, 400: Drinking Water, 500: Sanitation and Latrine and 600: Salt. 0 69 Immunization The file contains data related to Module 1000: Immunisation of the Individual Questionnaire. Information on immunisation of children aged 12-23 months is obtained from mothers/ caretakers. 0 55 Vitamin A The file contains data related to Module 900: Vitamin A of the Individual Questionnaire. Information is obtained for children aged 6 months to 5 years of age. 0 20 Women The file contains data related to Modules 200: Demographic and Social Characteristics, 300: Family Planning, 400: Ante-Natal and Delivery Care, 500: STD/HIV/AIDS, 600: Breastfeeding and Vitamin A, question 809 of Module 800: Diarrhoea, questions 901 & 902 of Module 900: Vitamin A and questions 1018 - 1022 of Module 1000: Immunization of the Individual Questionnaire. 0 188 Urban/Rural Residence Urban/Rural Residence Urban/Rural Residence Urban/Rural Residence Urban/Rural Residence District All women of the household who are of age group 15-49 1 Urban 2 Rural Ecological Zones Ecological Zones Ecological Zones Ecological Zones Ecological Zones 1 Terai 2 Hills 3 Mountain Ecological Development Region Ecological Development Region Ecological Development Region Ecological Development Region Ecological Development Region 1 Eastern Terai 2 Central Terai 3 Western Terai 4 M-Western Terai 5 F-Western Terai 6 E+C+W Mountains 7 F+MW Mountains 8 KTM Valley 9 E. Hills 10 C. Hills 11 W. Hills 12 M.W. Hills 13 F.W. Hills District District District District District District 1 Taplejung 2 Panchthar 3 Illam 4 Jhapa 5 Sankhuwasabha 6 Tehrathum 7 Bhojpur 8 Dhankuta 9 Morang 10 Sunsari 11 Solukhumbu 12 Khotang 13 Okhaldhunga 14 Udayapur 15 Saptari 16 Siraha 17 Dhanusha 18 Mahottari 19 Sarlahi 20 Sindhuli 21 Ramechap 22 Dolkha 23 Sindhupalchok 24 Kavre 25 Lalitpur 26 Bhaktapur 27 Kathmandu 28 Nuwakot 30 Dhading 31 Makwanpur 32 Rautahat 33 Bara 34 Parsa 35 Chitwan 36 Gorkha 37 Manang 38 Lamjung 39 Tanahu 40 Kaski 41 Syangja 42 Gulmi 43 Palpa 44 Nawalparasi 45 Rupandehi 46 Kapilbastu 47 Agrakhachi 49 Myagdi 50 Baglung 51 Parbat 52 Rukum 53 Rolpa 54 Pyuthan 55 Salyan 56 Dang 57 Jumla 60 Kalikot 62 Jajarkot 63 Dailekh 64 Surkhet 65 Banke 66 Bardiya 67 Bajhang 68 Bajura 69 Achham 70 Doti 71 Kailali 72 Darchula 73 Baitadi 74 Dadeldhura 75 Kanchanpur Cluster Number Cluster Number Cluster Number Cluster Number Cluster Number Cluster Number Record ID Record ID Record ID Record ID Record ID Line Number of the Person Line Number of the Person Line Number of the Person Line Number of the Person Line Number of the Person Line number of the Respondent Woman ID Woman ID Woman ID Woman ID Woman ID All women of age 15-49 in the selected household Child ID Child ID Child ID Child ID Child ID All children of aged below 5 years Gender of the Child Gender of the Child Gender of the Child Gender of the Child Gender of the Child Gender of the child Children up to 5 years of age 1 Male 2 Female Age of the Child Age of the Child Age of the Child Age of the Child Age of the Child Age of the child Children up to 5 years of age Unit of Time Months or Years Unit of Time Months or Years Unit of Time Months or Years Unit of Time Months or Years Unit of Time Months or Years Children up to 5 years of age M Month Y Year Cough and Cold Last Two Weeks Cough and Cold Last Two Weeks Cough and Cold Last Two Weeks Cough and Cold Last Two Weeks Cough and Cold Last Two Weeks Has (name) suffered from cough and cold during last two weeks? Children up to 5 years of age 1 Yes 2 No Signs and Symptoms of ARI-1st Signs and Symptoms of ARI-1st Signs and Symptoms of ARI-1st Signs and Symptoms of ARI-1st Signs and Symptoms of ARI-1st What signs and symptoms did you notice when the child was sick with cough and cold? (Multi-response up to 3) Children up to 5 years of age 1 Coughing 2 Blocked/ running nose 3 Fever 4 Breathing fast 5 Difficulty breathing 6 Chest in-drawing 7 Problems eating/ drinking 8 Others Signs and Symptoms of ARI-2nd Signs and Symptoms of ARI-2nd Signs and Symptoms of ARI-2nd Signs and Symptoms of ARI-2nd Signs and Symptoms of ARI-2nd What signs and symptoms did you notice when the child was sick with cough and cold? (Multi-response up to 3) Children up to 5 years of age 1 Coughing 2 Blocked/ running nose 3 Fever 4 Breathing fast 5 Difficulty breathing 6 Chest in-drawing 7 Problems eating/ drinking 8 Others Signs and Symptoms of ARI-3rd Signs and Symptoms of ARI-3rd Signs and Symptoms of ARI-3rd Signs and Symptoms of ARI-3rd Signs and Symptoms of ARI-3rd What signs and symptoms did you notice when the child was sick with cough and cold? (Multi-response up to 3) Children up to 5 years of age 1 Coughing 2 Blocked/ running nose 3 Fever 4 Breathing fast 5 Difficulty breathing 6 Chest in-drawing 7 Problems eating/ drinking 8 Others Things Given to Drink-1st Things Given to Drink-1st Things Given to Drink-1st Things Given to Drink-1st Things Given to Drink-1st During (Name's) ARI what did you offer him/her to drink? Children up to 5 years of age 1 Breast milk 2 Cereal soup 3 Yogurt 4 Fruit juice 5 Cow/ buffalo/ canned milk 6 Water with feeding 7 Plain water 8 Other fluids 9 Nothing Things Given to Drink-2nd Things Given to Drink-2nd Things Given to Drink-2nd Things Given to Drink-2nd Things Given to Drink-2nd During (Name's) ARI what did you offer him/her to drink? 9 Children up to 5 years of age 1 Breast milk 2 Cereal soup 3 Yogurt 4 Fruit juice 5 Cow/ buffalo/ canned milk 6 Water with feeding 7 Plain water 8 Other fluids 9 Nothing Things Given to Drink-3rd Things Given to Drink-3rd Things Given to Drink-3rd Things Given to Drink-3rd Things Given to Drink-3rd During (Name's) ARI what did you offer him/her to drink? Children up to 5 years of age 1 Breast milk 2 Cereal soup 3 Yogurt 4 Fruit juice 5 Cow/ buffalo/ canned milk 6 Water with feeding 7 Plain water 8 Other fluids 9 Nothing Place of Treatment Place of Treatment Place of Treatment Place of Treatment Place of Treatment Where did you seek for (name's) treatment? Children up to 5 years of age 1 Nowhere, no treatment 2 Home treatment 3 HP/ SHP 4 PHC/ Hospital 5 Ayurvedic Center/ Hospital 6 VHW 7 FCHV 8 Private Clinic/ Nursing Home 9 Medical Shop 10 Faith Healers 11 Others Number of Times ARI Last Year Number of Times ARI Last Year Number of Times ARI Last Year Number of Times ARI Last Year Number of Times ARI Last Year How many times has this child suffered from ARI during last year? Children up to 5 years of age Diarrhoea in Last Two Weeks Diarrhoea in Last Two Weeks Diarrhoea in Last Two Weeks Diarrhoea in Last Two Weeks Diarrhoea in Last Two Weeks Has (name) had diarrhoea in last two weeks? If No, go to Q808. Children up to 5 years of age 1 Yes 2 No Blood in the Stool Blood in the Stool Blood in the Stool Blood in the Stool Blood in the Stool Was there any blood in (name's) stool during his/her diarrhoea? d801 = 1 1 Yes 2 No Things Given to Drink during Diarrhoea-1st Things Given to Drink during Diarrhoea-1st Things Given to Drink during Diarrhoea-1st Things Given to Drink during Diarrhoea-1st Things Given to Drink during Diarrhoea-1st During (name's) diarrhoea, what did you offer him/her to drink? d801 = 1 1 Breast milk 2 Cereal soup 3 Yogurt 4 Fruit juice 5 Nun-Chhini-Pani 6 Cow/ buffalo/ canned milk 7 JJ/ Nav Jeevan/ ORS Packet 8 Water with feeding 9 Plain water 10 Other fluids 11 Nothing Things Given to Drink during Diarrhoea-2nd Things Given to Drink during Diarrhoea-2nd Things Given to Drink during Diarrhoea-2nd Things Given to Drink during Diarrhoea-2nd Things Given to Drink during Diarrhoea-2nd During (name's) diarrhoea, what did you offer him/her to drink? d801 = 1 1 Breast milk 2 Cereal soup 3 Yogurt 4 Fruit juice 5 Nun-Chhini-Pani 6 Cow/ buffalo/ canned milk 7 JJ/ Nav Jeevan/ ORS Packet 8 Water with feeding 9 Plain water 10 Other fluids 11 Nothing Things Given to Drink during Diarrhoea-3rd Things Given to Drink during Diarrhoea-3rd Things Given to Drink during Diarrhoea-3rd Things Given to Drink during Diarrhoea-3rd Things Given to Drink during Diarrhoea-3rd During (name's) diarrhoea, what did you offer him/her to drink? d801 = 1 1 Breast milk 2 Cereal soup 3 Yogurt 4 Fruit juice 5 Nun-Chhini-Pani 6 Cow/ buffalo/ canned milk 7 JJ/ Nav Jeevan/ ORS Packet 8 Water with feeding 9 Plain water 10 Other fluids 11 Nothing Fluids Given More Less or Same Fluids Given More Less or Same Fluids Given More Less or Same Fluids Given More Less or Same Fluids Given More Less or Same During diarrhoea was the child offered none, less same or more amount of liquid than usual? d801 = 1 1 None 2 Less 3 Same 4 More Food Given during Diarrhoea Same More or Less Food Given during Diarrhoea Same More or Less Food Given during Diarrhoea Same More or Less Food Given during Diarrhoea Same More or Less Food Given during Diarrhoea Same More or Less During diarrhoea did s/he eat/fed none, less, same or more than usual? d801 = 1 1 None 2 Less 3 Same 4 More Place Taken for Treatment Place Taken for Treatment Place Taken for Treatment Place Taken for Treatment Place Taken for Treatment Where did you seek for (name's) treatment? d801 = 1 1 Nowhere, no treatment 2 Home treatment 3 HP/ SHP 4 PHCC/ Hospital 5 Ayurvedic Center/ Hospital 6 VHW 7 FCHV 8 Private Clinic/ Nursing Home 9 Medical Shop 10 Faith Healers 11 Others Money Spent on Travel Money Spent on Travel Money Spent on Travel Money Spent on Travel Money Spent on Travel How much cost did you incur in (name's) treatment ? If nothing was incurred write 0000 in total cost. If only total cost is available mention that in appropriate column. d801 = 1 Money Spent on Examination Money Spent on Examination Money Spent on Examination Money Spent on Examination Money Spent on Examination How much cost did you incur in (name's) treatment ? If nothing was incurred write 0000 in total cost. If only total cost is available mention that in appropriate column. d801 = 1 Money Spent on Medicine Money Spent on Medicine Money Spent on Medicine Money Spent on Medicine Money Spent on Medicine How much cost did you incur in (name's) treatment ? If nothing was incurred write 0000 in total cost. If only total cost is available mention that in appropriate column. d801 = 1 Money Spent on Admission Money Spent on Admission Money Spent on Admission Money Spent on Admission Money Spent on Admission How much cost did you incur in (name's) treatment ? If nothing was incurred write 0000 in total cost. If only total cost is available mention that in appropriate column. d801 = 1 Money Spent on Others Money Spent on Others Money Spent on Others Money Spent on Others Money Spent on Others How much cost did you incur in (name's) treatment ? If nothing was incurred write 0000 in total cost. If only total cost is available mention that in appropriate column. d801 = 1 Money Spent on Faith Healers Money Spent on Faith Healers Money Spent on Faith Healers Money Spent on Faith Healers Money Spent on Faith Healers How much cost did you incur in (name's) treatment ? If nothing was incurred write 0000 in total cost. If only total cost is available mention that in appropriate column. d801 = 1 Money Spent on Total Money Spent on Total Money Spent on Total Money Spent on Total Money Spent on Total How much cost did you incur in (name's) treatment ? If nothing was incurred write 0000 in total cost. If only total cost is available mention that in appropriate column. d801 = 1 Number of Times Diarr Last Year Number of Times Diarr Last Year Number of Times Diarr Last Year Number of Times Diarr Last Year Number of Times Diarr Last Year How many times has this child suffered from diarrhoea during last year? Children up to 5 years of age Weight of the Child Weight of the Child Weight of the Child Weight of the Child Weight of the Child Urban/Rural Residence Urban/Rural Residence Urban/Rural Residence Urban/Rural Residence Urban/Rural Residence All children of age 6-15 years only 1 Urban 2 Rural Ecological Zones Ecological Zones Ecological Zones Ecological Zones Ecological Zones All children of age 6-15 years only 1 Terai 2 Hills 3 Mountain Ecological Development Region Ecological Development Region Ecological Development Region Ecological Development Region Ecological Development Region All children of age 6-15 years only 1 Eastern Terai 2 Central Terai 3 Western Terai 4 M-Western Terai 5 F-Western Terai 6 E+C+W Mountains 7 F+MW Mountains 8 KTM Valley 9 E. Hills 10 C. Hills 11 W. Hills 12 M.W. Hills 13 F.W. Hills District District District District District District All children of age 6-15 years only 1 Taplejung 2 Panchthar 3 Illam 4 Jhapa 5 Sankhuwasabha 6 Tehrathum 7 Bhojpur 8 Dhankuta 9 Morang 10 Sunsari 11 Solukhumbu 12 Khotang 13 Okhaldhunga 14 Udayapur 15 Saptari 16 Siraha 17 Dhanusha 18 Mahottari 19 Sarlahi 20 Sindhuli 21 Ramechap 22 Dolkha 23 Sindhupalchok 24 Kavre 25 Lalitpur 26 Bhaktapur 27 Kathmandu 28 Nuwakot 30 Dhading 31 Makwanpur 32 Rautahat 33 Bara 34 Parsa 35 Chitwan 36 Gorkha 37 Manang 38 Lamjung 39 Tanahu 40 Kaski 41 Syangja 42 Gulmi 43 Palpa 44 Nawalparasi 45 Rupandehi 46 Kapilbastu 47 Agrakhachi 49 Myagdi 50 Baglung 51 Parbat 52 Rukum 53 Rolpa 54 Pyuthan 55 Salyan 56 Dang 57 Jumla 60 Kalikot 62 Jajarkot 63 Dailekh 64 Surkhet 65 Banke 66 Bardiya 67 Bajhang 68 Bajura 69 Achham 70 Doti 71 Kailali 72 Darchula 73 Baitadi 74 Dadeldhura 75 Kanchanpur Cluster Number Cluster Number Cluster Number Cluster Number Cluster Number Cluster Number All children of age 6-15 years only Record ID Record ID Record ID Record ID Record ID All children of age 6-15 years only Line Number of the Person Line Number of the Person Line Number of the Person Line Number of the Person Line Number of the Person Line number of the Respondent All children of age 6-15 years only Child ID for Education Module Child ID for Education Module Child ID for Education Module Child ID for Education Module Child ID for Education Module All children of age 6-15 years only Gender of the Child Gender of the Child Gender of the Child Gender of the Child Gender of the Child Sex All children of age 6-15 years only 1 Male 2 Female Age of the Child Age of the Child Age of the Child Age of the Child Age of the Child Age All children of age 6-15 years only Ever Gone to School Ever Gone to School Ever Gone to School Ever Gone to School Ever Gone to School Has s/he ever attended school? (Circle appropriate codes) 1=Yes (Go to Q303) 2=No (Go to Q302) All children of age 6-15 years only 1 Yes 2 No Why Not-1st Why Not-1st Why Not-1st Why Not-1st Why Not-1st Why did not s/he go to school? Multiple response questions record up to 3 responses. Ask from section 400. All children of age 6-15 years only who never attended school (ed301 = 2) 1 Child was sick 2 Had to help in HH chores 3 School too far 4 Teachers not good 5 Child not willing 6 Language problem 7 Can not afford 8 Girls shouldn't be educated 9 Others Why Not-2nd Why Not-2nd Why Not-2nd Why Not-2nd Why Not-2nd Why did not s/he go to school? Multiple response questions record up to 3 responses. Ask from section 400. All children of age 6-15 years only who never attended school (ed301 = 2) 1 Child was sick 2 Had to help in HH chores 3 School too far 4 Teachers not good 5 Child not willing 6 Language problem 7 Can not afford 8 Girls shouldn't be educated 9 Others Why Not-3rd Why Not-3rd Why Not-3rd Why Not-3rd Why Not-3rd Why did not s/he go to school? Multiple response questions record up to 3 responses. Ask from section 400. All children of age 6-15 years only who never attended school (ed301 = 2) 1 Child was sick 2 Had to help in HH chores 3 School too far 4 Teachers not good 5 Child not willing 6 Language problem 7 Can not afford 8 Girls shouldn't be educated 9 Others Currently in School Currently in School Currently in School Currently in School Currently in School Is s/he currently attending school? Circle appropriate codes. 1=Yes (Ask Q304) 2=No (Q311) All children of age 6-15 years only who have ever attended school (ed301 = 1) 1 Yes 2 No Ever Studied at Pre-School Ever Studied at Pre-School Ever Studied at Pre-School Ever Studied at Pre-School Ever Studied at Pre-School Did the child attend preprimary school earlier? All children of age 6-15 years only who are currently attending school (ed303 = 1) 1 Yes 2 No Grade Currently In Grade Currently In Grade Currently In Grade Currently In Grade Currently In Which grade child is currently attending? All children of age 6-15 years only who are currently attending school (ed303 = 1) Grade 0 1 Grade 1 2 Grade 2 3 Grade 3 4 Grade 4 5 Grade 5 6 Grade 6 7 Grade 7 8 Grade 8 9 Grade 9 10 Grade 10 11 Grade 11 Type of School Type of School Type of School Type of School Type of School Which school child is currently attending? All children of age 6-15 years only who are currently attending school (ed303 = 1) 1 Public 2 Private 3 Madarsa 4 Others Which Year in Grade 1 Which Year in Grade 1 Which Year in Grade 1 Which Year in Grade 1 Which Year in Grade 1 What year did s/he enter grade 1? All children of age 6-15 years only who are currently attending school (ed303 = 1) 98 DK Time Taken to Reach the School Time Taken to Reach the School Time Taken to Reach the School Time Taken to Reach the School Time Taken to Reach the School How much time does s/he spend on commuting to school?(in minutes) (in minutes) All children of age 6-15 years only who are currently attending school (ed303 = 1) Child Attended School in Last Three Days Child Attended School in Last Three Days Child Attended School in Last Three Days Child Attended School in Last Three Days Child Attended School in Last Three Days Did s/he go to school during last three days (except holidays)? If 0 go to 310 For 1, 2, 3, ask from section 400. All children of age 6-15 years only who are currently attending school (ed303 = 1) None 1 One 2 Two 3 Three Why did not Child Attend School-1st Why did not Child Attend School-1st Why did not Child Attend School-1st Why did not Child Attend School-1st Why did not Child Attend School-1st If the child did not attend any classes in last three school days ask why did this child did not go to school these days? Multiple response questions record up to three responses. ed309 = 0 1 Child was sick 2 Had to help in HH chores 3 School is too far 4 Teachers not good 5 Child not willing 6 Language problem 7 Others Why did not Child Attend School-2nd Why did not Child Attend School-2nd Why did not Child Attend School-2nd Why did not Child Attend School-2nd Why did not Child Attend School-2nd If the child did not attend any classes in last three school days ask why did this child did not go to school these days? Multiple response questions record up to three responses. ed309 = 0 1 Child was sick 2 Had to help in HH chores 3 School is too far 4 Teachers not good 5 Child not willing 6 Language problem 7 Others Why did not Child Attend School-3rd Why did not Child Attend School-3rd Why did not Child Attend School-3rd Why did not Child Attend School-3rd Why did not Child Attend School-3rd If the child did not attend any classes in last three school days ask why did this child did not go to school these days? Multiple response questions record up to three responses. ed309 = 0 1 Child was sick 2 Had to help in HH chores 3 School is too far 4 Teachers not good 5 Child not willing 6 Language problem 7 Others Type of School Prev Went to Type of School Prev Went to Type of School Prev Went to Type of School Prev Went to Type of School Prev Went to Which school did s/he attend in the past? ed309 = 1 1 Public 2 Private 3 Madarsa 4 Others Which Year Prev in Grade 1 Which Year Prev in Grade 1 Which Year Prev in Grade 1 Which Year Prev in Grade 1 Which Year Prev in Grade 1 What year did s/he enter grade1? If the child attended only preprimary school then write 97. ed309 = 1 97 Only pre-school 99 Missing Highest Grade Completed Highest Grade Completed Highest Grade Completed Highest Grade Completed Highest Grade Completed What grade did s/he complete? ed309 = 1 Grade 0 1 Grade 1 2 Grade 2 3 Grade 3 4 Grade 4 5 Grade 5 6 Grade 6 7 Grade 7 8 Grade 8 9 Grade 9 10 Grade 10 11 Grade 11 Ever Prep School Ever Prep School Ever Prep School Ever Prep School Ever Prep School Did the child attend preprimary school earlier? ed309 = 1 1 Yes 2 No Which Year Did S/He Dropped Out Which Year Did S/He Dropped Out Which Year Did S/He Dropped Out Which Year Did S/He Dropped Out Which Year Did S/He Dropped Out Which year did s/he drop out? ed309 = 1 99 Missing Main Reasons for Dropping Out-1st Main Reasons for Dropping Out-1st Main Reasons for Dropping Out-1st Main Reasons for Dropping Out-1st Main Reasons for Dropping Out-1st What are the main reasons for discontinuing? Multiple response question, record up to 3 responses. ed309 = 1 1 Completed desired schooling 2 Further schooling not available 3 Too expensive 4 Had to help at home/farm 5 School or teacher not good 6 All male teachers 7 Parents did not want 8 Had to repeat the grade /FAILED 9 Not willing to attend 10 Language problem 11 Got married 12 Scarcity of textbooks 13 Others Main Reasons for Dropping Out-2nd Main Reasons for Dropping Out-2nd Main Reasons for Dropping Out-2nd Main Reasons for Dropping Out-2nd Main Reasons for Dropping Out-2nd What are the main reasons for discontinuing? Multiple response question, record up to 3 responses. ed309 = 1 1 Completed desired schooling 2 Further schooling not available 3 Too expensive 4 Had to help at home/farm 5 School or teacher not good 6 All male teachers 7 Parents did not want 8 Had to repeat the grade /FAILED 9 Not willing to attend 10 Language problem 11 Got married 12 Scarcity of textbooks 13 Others Main Reasons for Dropping Out-3rd Main Reasons for Dropping Out-3rd Main Reasons for Dropping Out-3rd Main Reasons for Dropping Out-3rd Main Reasons for Dropping Out-3rd What are the main reasons for discontinuing? Multiple response question, record up to 3 responses. ed309 = 1 1 Completed desired schooling 2 Further schooling not available 3 Too expensive 4 Had to help at home/farm 5 School or teacher not good 6 All male teachers 7 Parents did not want 8 Had to repeat the grade /FAILED 9 Not willing to attend 10 Language problem 11 Got married 12 Scarcity of textbooks 13 Others Household weight Household weight Household weight Household weight Household weight Urban/Rural Residence Urban/Rural Residence Urban/Rural Residence Urban/Rural Residence Urban/Rural Residence 1 Urban 2 Rural Ecological Zones Ecological Zones Ecological Zones Ecological Zones Ecological Zones 1 Terai 2 Hills 3 Mountain Ecological Development Region Ecological Development Region Ecological Development Region Ecological Development Region Ecological Development Region 1 Eastern Terai 2 Central Terai 3 Western Terai 4 M-Western Terai 5 F-Western Terai 6 E+C+W Mountains 7 F+MW Mountains 8 KTM Valley 9 E. Hills 10 C. Hills 11 W. Hills 12 M.W. Hills 13 F.W. Hills District District District District District District 1 Taplejung 2 Panchthar 3 Illam 4 Jhapa 5 Sankhuwasabha 6 Tehrathum 7 Bhojpur 8 Dhankuta 9 Morang 10 Sunsari 11 Solukhumbu 12 Khotang 13 Okhaldhunga 14 Udayapur 15 Saptari 16 Siraha 17 Dhanusha 18 Mahottari 19 Sarlahi 20 Sindhuli 21 Ramechap 22 Dolkha 23 Sindhupalchok 24 Kavre 25 Lalitpur 26 Bhaktapur 27 Kathmandu 28 Nuwakot 30 Dhading 31 Makwanpur 32 Rautahat 33 Bara 34 Parsa 35 Chitwan 36 Gorkha 37 Manang 38 Lamjung 39 Tanahu 40 Kaski 41 Syangja 42 Gulmi 43 Palpa 44 Nawalparasi 45 Rupandehi 46 Kapilbastu 47 Agrakhachi 49 Myagdi 50 Baglung 51 Parbat 52 Rukum 53 Rolpa 54 Pyuthan 55 Salyan 56 Dang 57 Jumla 60 Kalikot 62 Jajarkot 63 Dailekh 64 Surkhet 65 Banke 66 Bardiya 67 Bajhang 68 Bajura 69 Achham 70 Doti 71 Kailali 72 Darchula 73 Baitadi 74 Dadeldhura 75 Kanchanpur Cluster Number Cluster Number Cluster Number Cluster Number Cluster Number Cluster Number Record ID Record ID Record ID Record ID Record ID Line Number of the Person Line Number of the Person Line Number of the Person Line Number of the Person Line Number of the Person Line number of the Respondent Individual ID Number Individual ID Number Individual ID Number Individual ID Number Individual ID Number Number of members in the Household Number of members in the Household Number of members in the Household Number of members in the Household Number of members in the Household HH Member's Name All memeber of the hh selected Household member's name Relationship Relationship Relationship Relationship Relationship Relationship 1 Head 2 Spouse 3 Son/daughter 4 Daughter-in-law 5 Parents 6 Grand child 7 Others relatives 8 Others non-relatives Gender Gender Gender Gender Gender Gender 1 Male 2 Female Age in Completed Years Age in Completed Years Age in Completed Years Age in Completed Years Age in Completed Years Age in completed yrs Unit of Age - Months or Years Unit of Age - Months or Years Unit of Age - Months or Years Unit of Age - Months or Years Unit of Age - Months or Years M Months Y Years Under Five Under Five Under Five Under Five Under Five Age under 5 1 Yes 2 No 15-49 Currently Married Woman 15-49 Currently Married Woman 15-49 Currently Married Woman 15-49 Currently Married Woman 15-49 Currently Married Woman currently married women (15-49) 1 Yes 2 No Able to Read and Write Able to Read and Write Able to Read and Write Able to Read and Write Able to Read and Write For persons 6 years or older Can s/he read and write? If No, go to 211 Persons 6 years or older 1 Yes 2 No How Known How Known How Known How Known How Known For persons 6 years or older If yes how did s/he learn to read and write? Persons 6 years or older who can read and write (hl208 = 1) 1 Formal 2 Informal Highest Grade Completed Highest Grade Completed Highest Grade Completed Highest Grade Completed Highest Grade Completed For persons 6 years or older If s/he attended school highest level of grade completed Persons 6 years or older who can read and write (hl208 = 1) Grade 0 1 Grade 1 2 Grade 2 3 Grade 3 4 Grade 4 5 Grade 5 6 Grade 6 7 Grade 7 8 Grade 8 9 Grade 9 10 Grade 10 11 Grade 11 12 Grade 12 13 Grade 13 14 Grade 14 15 Grade 15 16 Grade 16 Child between 6 to 15 Child between 6 to 15 Child between 6 to 15 Child between 6 to 15 Child between 6 to 15 Tick here if the child is between 6-15 years 1 Yes 2 No Birth Registered Birth Registered Birth Registered Birth Registered Birth Registered Has the child's birth been registered? Childred 5 years or under 1 Yes 2 No Reasons for No Registration Reasons for No Registration Reasons for No Registration Reasons for No Registration Reasons for No Registration Why was the birth not registered? Childred 5 years or under 1 DK 2 No time 3 No need 4 Too far 5 Others Household weight Household weight Household weight Household weight Household weight Urban/Rural Residence Urban/Rural Residence Urban/Rural Residence Urban/Rural Residence Urban/Rural Residence 1 Urban 2 Rural Ecological Zones Ecological Zones Ecological Zones Ecological Zones Ecological Zones 1 Terai 2 Hills 3 Mountain Ecological Development Region Ecological Development Region Ecological Development Region Ecological Development Region Ecological Development Region 1 Eastern Terai 2 Central Terai 3 Western Terai 4 M-Western Terai 5 F-Western Terai 6 E+C+W Mountains 7 F+MW Mountains 8 KTM Valley 9 E. Hills 10 C. Hills 11 W. Hills 12 M.W. Hills 13 F.W. Hills District District District District District District 1 Taplejung 2 Panchthar 3 Illam 4 Jhapa 5 Sankhuwasabha 6 Tehrathum 7 Bhojpur 8 Dhankuta 9 Morang 10 Sunsari 11 Solukhumbu 12 Khotang 13 Okhaldhunga 14 Udayapur 15 Saptari 16 Siraha 17 Dhanusha 18 Mahottari 19 Sarlahi 20 Sindhuli 21 Ramechap 22 Dolkha 23 Sindhupalchok 24 Kavre 25 Lalitpur 26 Bhaktapur 27 Kathmandu 28 Nuwakot 30 Dhading 31 Makwanpur 32 Rautahat 33 Bara 34 Parsa 35 Chitwan 36 Gorkha 37 Manang 38 Lamjung 39 Tanahu 40 Kaski 41 Syangja 42 Gulmi 43 Palpa 44 Nawalparasi 45 Rupandehi 46 Kapilbastu 47 Agrakhachi 49 Myagdi 50 Baglung 51 Parbat 52 Rukum 53 Rolpa 54 Pyuthan 55 Salyan 56 Dang 57 Jumla 60 Kalikot 62 Jajarkot 63 Dailekh 64 Surkhet 65 Banke 66 Bardiya 67 Bajhang 68 Bajura 69 Achham 70 Doti 71 Kailali 72 Darchula 73 Baitadi 74 Dadeldhura 75 Kanchanpur Cluster Number Cluster Number Cluster Number Cluster Number Cluster Number Cluster Number Record ID Record ID Record ID Record ID Record ID Interview day Interview day Interview day Interview day Interview day Interview month Interview month Interview month Interview month Interview month Interview year Interview year Interview year Interview year Interview year Sex of the HH Head Sex of the HH Head Sex of the HH Head Sex of the HH Head Sex of the HH Head Gender of the household head All household head in the selected household 1 Male 2 Female Sex of the Household head Religion of the HH Head Religion of the HH Head Religion of the HH Head Religion of the HH Head Religion of the HH Head Religion of HHH All household head 1 Hindu 2 Buddhist 3 Islam 4 Christian 5 Others Religion of the household head Ethnic of the HH Head Ethnic of the HH Head Ethnic of the HH Head Ethnic of the HH Head Ethnic of the HH Head Caste Ethnicity of HHH All household head 1 Brahmin 2 Chhetri 3 Newar 4 Gurung Ghale 5 Magar 6 Rai Limbu 7 Tamang Sherpa 8 Muslim 9 Tharu 10 Yadav 11 Others: Hills 12 Others: Terai 13 Others: Mountains Ethnicity of the household head Mother Tongue Mother Tongue Mother Tongue Mother Tongue Mother Tongue Mother Tongue All household head 1 Nepali 2 Maithali 3 Bhojpuri 4 Abadhi 5 Newari 6 Tharu 7 Rai-Kirati 8 Magar-Gurung 9 Sherpa 10 Others: Pahadi 11 Others: Terai 12 Others: Himali Mother Tongue of the Household head Revisit Necessary Revisit Necessary Revisit Necessary Revisit Necessary Revisit Necessary Revisit Necessary Enumerator 1 Yes 2 No Interview Completed Interview Completed Interview Completed Interview Completed Interview Completed Interview Complete? Enumerator 1 Yes 2 No Reasons for Incomplete Interview Reasons for Incomplete Interview Reasons for Incomplete Interview Reasons for Incomplete Interview Reasons for Incomplete Interview Reasons for no/or incomplete interview Enumerator 1 Refusal 2 No hh member 3 No competent person 4 Entire hh empty 5 Others Reasons for not completing questionnaire Main Source of Drinking Water Main Source of Drinking Water Main Source of Drinking Water Main Source of Drinking Water Main Source of Drinking Water What is the main source of drinking water in this household? (Circle appropriate code) Circle appropriate code All household head from the selected household 1 Piped in dwelling 2 Public tap 3 Private tubewell 4 Public tubewell 5 Private dugwell 6 Public dugwell 7 Pond-river-stream 8 Stone tap 9 Neighbors private ta 10 Neighbors tubewell 11 Others Main source of drinking water Sufficient Water from the Source Sufficient Water from the Source Sufficient Water from the Source Sufficient Water from the Source Sufficient Water from the Source Is water sufficient from that source? All household head from the selected household 1 Yes 2 No Months per Year Available from the Source Months per Year Available from the Source Months per Year Available from the Source Months per Year Available from the Source Months per Year Available from the Source For how many months water available from that source? ............months All household head from the selected household Time Taken to Fetch Water from the Source-Trip Time Taken to Fetch Water from the Source-Trip Time Taken to Fetch Water from the Source-Trip Time Taken to Fetch Water from the Source-Trip Time Taken to Fetch Water from the Source-Trip How long it takes to bring one trip of water? ...............minutes (if at house write 000 and ask question 405) All household head from the selected household Time taken to fetch water Trips Fetched Water by Male Trips Fetched Water by Male Trips Fetched Water by Male Trips Fetched Water by Male Trips Fetched Water by Male How many drinking water trips made yesterday for this household consumption? 1Male................................................trip 2Female.............................................trip 3Children (under 15 yr.)...................trips 4Total ...............................................trips All household head from the selected household Trips Fetched Water by Female Trips Fetched Water by Female Trips Fetched Water by Female Trips Fetched Water by Female Trips Fetched Water by Female How many drinking water trips made yesterday for this household consumption? 1Male................................................trip 2Female.............................................trip 3Children (under 15 yr.)...................trips 4Total ...............................................trips All household head from the selected household Trips Fetched Water by Child Trips Fetched Water by Child Trips Fetched Water by Child Trips Fetched Water by Child Trips Fetched Water by Child How many drinking water trips made yesterday for this household consumption? 1Male................................................trip 2Female.............................................trip 3Children (under 15 yr.)...................trips 4Total ...............................................trips All household head from the selected household Trips Fetched Water Total Trips Fetched Water Total Trips Fetched Water Total Trips Fetched Water Total Trips Fetched Water Total How many drinking water trips made yesterday for this household consumption? 1 Male................................................trip 2 Female.............................................trip 3 Children (under 15 yr.)...................trips 4 Total ...............................................trips All household head from the selected household Methods used to Purify Water-1st Methods used to Purify Water-1st Methods used to Purify Water-1st Methods used to Purify Water-1st Methods used to Purify Water-1st What do you do to treat water? (upto 3 answers) upto 3 answers All household head from the selected household 1 Boil water 2 Use water purification tabs 3 Filter 4 Cover water storage vessel 5 Keep water source clean 6 Others Method used to purify water Methods used to Purify Water-2nd Methods used to Purify Water-2nd Methods used to Purify Water-2nd Methods used to Purify Water-2nd Methods used to Purify Water-2nd What do you do to treat water? (upto 3 answers) upto 3 answers All household head from the selected household 1 Boil water 2 Use water purification tabs 3 Filter 4 Cover water storage vessel 5 Keep water source clean 6 Others Methods used to Purify Water-3rd Methods used to Purify Water-3rd Methods used to Purify Water-3rd Methods used to Purify Water-3rd Methods used to Purify Water-3rd What do you do to treat water? (upto 3 answers) upto 3 answers All household head from the selected household 1 Boil water 2 Use water purification tabs 3 Filter 4 Cover water storage vessel 5 Keep water source clean 6 Others Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea Did you noticed any following diseases in your community? All household head from the selected household 1 Yes 2 No any disease seen in the community Dysentery Dysentery Dysentery Dysentery Dysentery Did you noticed any following diseases in your community? All household head from the selected household 1 Yes 2 No any disease seen in the community Jaundice Jaundice Jaundice Jaundice Jaundice Did you noticed any following diseases in your community? All household head from the selected household 1 Yes 2 No any disease seen in the community Typhoid Typhoid Typhoid Typhoid Typhoid Did you noticed any following diseases in your community? All household head from the selected household 1 Yes 2 No any disease seen in the community Cholera Cholera Cholera Cholera Cholera Did you noticed any following diseases in your community? All household head from the selected household 1 Yes 2 No any disease seen in the community Have own Toilet Facility Have own Toilet Facility Have own Toilet Facility Have own Toilet Facility Have own Toilet Facility Is this house has own toilet? All households 1 Yes 2 No Toilet facility Kind of Toilet Facility Kind of Toilet Facility Kind of Toilet Facility Kind of Toilet Facility Kind of Toilet Facility What type of latrine has this house? 2. No (Go to 510) All households with toilet (sl501 = 1) 1 Flush toilet 2 Trad pit toilet 3 Ventd improved pit 4 Pan (without flush) 5 Others Types of Toilet Children 5-14 in the HH Use Toilet Children 5-14 in the HH Use Toilet Children 5-14 in the HH Use Toilet Children 5-14 in the HH Use Toilet Children 5-14 in the HH Use Toilet Do all the children (Aged 5 to 14) use latrine? All households with toilet (sl501 = 1) 1 Yes all 2 Yes some 3 None 4 No chld 5-14 Children 5-14 using latrine Adults in the House Use Toilet Adults in the House Use Toilet Adults in the House Use Toilet Adults in the House Use Toilet Adults in the House Use Toilet Do all the adult ( >15 yrs of age) use latrine? All households with toilet (sl501 = 1) 1 Yes all 2 Yes some 3 None Adult in the household using latrine Reason for not Using Toilet Facility Reason for not Using Toilet Facility Reason for not Using Toilet Facility Reason for not Using Toilet Facility Reason for not Using Toilet Facility Why the latrine in not used? All households with toilet (sl501 = 1) 1 Smells 2 Flies-dirty 3 No-water 4 Filled-in 5 Others Reasons for not using Latrine Toilet Far from House Toilet Far from House Toilet Far from House Toilet Far from House Toilet Far from House How far is the latrine from house? All households with toilet (sl501 = 1) 1 Vicinity of hh 2 <50 feet 3 51-100 feet 4 >100 ft Distance between house and toilet Toilet far from Source of Water Toilet far from Source of Water Toilet far from Source of Water Toilet far from Source of Water Toilet far from Source of Water How far is the latrine from source of water? All households with toilet (sl501 = 1) 1 Vicinity of hh 2 <50 feet 3 51-100 feet 4 >100 ft Distance from the source of water to toilet Working Condition of Toilet Working Condition of Toilet Working Condition of Toilet Working Condition of Toilet Working Condition of Toilet Is latrine in working condition? (See) All households with toilet (sl501 = 1) 1 Yes 2 No Status of Toilet Toilet Clean Toilet Clean Toilet Clean Toilet Clean Toilet Clean Is latrine clean? See. After asking, go to 512. All households with toilet (sl501 = 1) 1 Yes 2 No cleanlyness of toilet Family Member usually goes for Defecation Family Member usually goes for Defecation Family Member usually goes for Defecation Family Member usually goes for Defecation Family Member usually goes for Defecation Where household member goes for defecation? All households without toilet (sl501 = 2) 1 In own yard 2 Bush-forest 3 Just outside yard 4 Near water source 5 In the field 6 Others Family member going for defacation Reason for not Having Toilet Facility Reason for not Having Toilet Facility Reason for not Having Toilet Facility Reason for not Having Toilet Facility Reason for not Having Toilet Facility What is the cause for not constructive latrine? All households without toilet (sl501 = 2) 1 No habit 2 Foul smell 3 No space 2 build 4 Imp not known 5 Can not afford 6 Others Reasons for not having toilet facility What done with Children-Infant Stool What done with Children-Infant Stool What done with Children-Infant Stool What done with Children-Infant Stool What done with Children-Infant Stool Where do you throw children's stool? All households 1 Outside house: indscrete 2 Throw in pit 3 Rachhan 4 In khet-bari 5 In latrine 6 No child 7 Others Place of Disposal of Household Waste Place of Disposal of Household Waste Place of Disposal of Household Waste Place of Disposal of Household Waste Place of Disposal of Household Waste Where do you throw the wastage of house? All households 1 Dung disposal pit 2 Garbage pit 3 Alongside road 4 Corner of courtyard 5 Indiscrete disposal 6 Municipality pick up area 7 Others Distance from Home of Disposal Site Distance from Home of Disposal Site Distance from Home of Disposal Site Distance from Home of Disposal Site Distance from Home of Disposal Site How far is the dustbin place from your house? All households 1 In vicinity of HH 2 <50 feet 3 50-100 feet 4 101-300 ft 5 >300 ft Everybody Wash Hands before Meals Everybody Wash Hands before Meals Everybody Wash Hands before Meals Everybody Wash Hands before Meals Everybody Wash Hands before Meals Do all the members wash hands before meal? All households 1 Yes, all 2 Yes, some 3 None Material used for Cleaning Material used for Cleaning Material used for Cleaning Material used for Cleaning Material used for Cleaning What do they use for cleaning hand? All households 1 Water only 2 Ash+water 3 Soap+water 4 Soil+water 5 Others Meterails using for cleaning Everybody Wash Hands after Defecation Everybody Wash Hands after Defecation Everybody Wash Hands after Defecation Everybody Wash Hands after Defecation Everybody Wash Hands after Defecation Do all wash hands after defecation? All households 1 Yes, all 2 Yes, some 3 None Material used for Washing Hand Material used for Washing Hand Material used for Washing Hand Material used for Washing Hand Material used for Washing Hand What do they use for hand washing? All households 1 Water only 2 Ash+water 3 Soap+water 4 Soil+water 5 Others Adults Wash Hands before Preparing Food Adults Wash Hands before Preparing Food Adults Wash Hands before Preparing Food Adults Wash Hands before Preparing Food Adults Wash Hands before Preparing Food Do all adult member wash hand before preparing meal? All households 1 Yes, all 2 Yes, some 3 None Adults Wash Hands before Feeding the Child Adults Wash Hands before Feeding the Child Adults Wash Hands before Feeding the Child Adults Wash Hands before Feeding the Child Adults Wash Hands before Feeding the Child all adult member wash hand before feeding to young children? All households 1 Yes, all 2 Yes, some 3 None 4 No child Water Storage Vessel Covered Water Storage Vessel Covered Water Storage Vessel Covered Water Storage Vessel Covered Water Storage Vessel Covered Does the household cover the water vessel? (observe yourself ) All households 1 Yes 2 No 3 Not seen 4 None remaining Leftover Food Covered Leftover Food Covered Leftover Food Covered Leftover Food Covered Leftover Food Covered Does the household cover leftover food? All households 1 Yes 2 No 3 Not seen 4 None remaining Electricity in HH Electricity in HH Electricity in HH Electricity in HH Electricity in HH Do this household have following facilities? All households 1 Yes 2 No Facility available in household Radio in HH Radio in HH Radio in HH Radio in HH Radio in HH Do this household have following facilities? All households 1 Yes 2 No Facility available in household TV in HH TV in HH TV in HH TV in HH TV in HH Do this household have following facilities? All households 1 Yes 2 No Facility available in household Phone in HH Phone in HH Phone in HH Phone in HH Phone in HH Do this household have following facilities? All households 1 Yes 2 No Facility available in household Cycle in HH Cycle in HH Cycle in HH Cycle in HH Cycle in HH Do this household have following facilities? All households 1 Yes 2 No Facility available in household Motorcycle in HH Motorcycle in HH Motorcycle in HH Motorcycle in HH Motorcycle in HH Do this household have following facilities? All households 1 Yes 2 No Facility available in household Motor Car in HH Motor Car in HH Motor Car in HH Motor Car in HH Motor Car in HH Do this household have following facilities? All households 1 Yes 2 No Facility available in household Fridge in HH Fridge in HH Fridge in HH Fridge in HH Fridge in HH Do this household have following facilities? All households 1 Yes 2 No Facility available in household Type of Oven Type of Oven Type of Oven Type of Oven Type of Oven What do you use for cooking food? All households 1 Traditional 2 Smokeless 3 Gas-kerosene 4 Others No. of Rooms used for Sleeping No. of Rooms used for Sleeping No. of Rooms used for Sleeping No. of Rooms used for Sleeping No. of Rooms used for Sleeping How many rooms are used in this household for sleeping? ……….. All households Sleeping room number Test Outcome of Iodine Reading Test Outcome of Iodine Reading Test Outcome of Iodine Reading Test Outcome of Iodine Reading Test Outcome of Iodine Reading We want to test the salt, which was used in your house. Can we see the salt, which was used in last evening? Result (Iodine content) …. PPM All households Zero 1 Less than15 2 Greater than 15 Type of Salt Type of Salt Type of Salt Type of Salt Type of Salt Type of salt used All households 1 Aayo salt 2 Tata salt 3 Shakti salt 4 Bhanu salt 5 Brandless powder 6 Crushed salt 7 Crystal salt foda 8 Crystal salt tibet 9 Others Type of salt Last time salt was bought Last time salt was bought Last time salt was bought Last time salt was bought Last time salt was bought Note if the iodine content is less than 15 PPM, as the following questions: When did you buy this salt?…….months All households with iodine content less than 15 PPM (si601 = 1) condition of salt Reasons for using Brand of Salt Reasons for using Brand of Salt Reasons for using Brand of Salt Reasons for using Brand of Salt Reasons for using Brand of Salt Why did you use this salt? All households with iodine content less than 15 PPM (si601 = 1) 1 Available here 2 Cheaper than others 3 Like brand 4 Others reason for using this salt Household weight Household weight Household weight Household weight Household weight Urban/Rural Residence Urban/Rural Residence Urban/Rural Residence Urban/Rural Residence Urban/Rural Residence 1 Urban 2 Rural Ecological Zones Ecological Zones Ecological Zones Ecological Zones Ecological Zones 1 Terai 2 Hills 3 Mountain Ecological Development Region Ecological Development Region Ecological Development Region Ecological Development Region Ecological Development Region 1 Eastern Terai 2 Central Terai 3 Western Terai 4 M-Western Terai 5 F-Western Terai 6 E+C+W Mountains 7 F+MW Mountains 8 KTM Valley 9 E. Hills 10 C. Hills 11 W. Hills 12 M.W. Hills 13 F.W. Hills District District District District District District 1 Taplejung 2 Panchthar 3 Illam 4 Jhapa 5 Sankhuwasabha 6 Tehrathum 7 Bhojpur 8 Dhankuta 9 Morang 10 Sunsari 11 Solukhumbu 12 Khotang 13 Okhaldhunga 14 Udayapur 15 Saptari 16 Siraha 17 Dhanusha 18 Mahottari 19 Sarlahi 20 Sindhuli 21 Ramechap 22 Dolkha 23 Sindhupalchok 24 Kavre 25 Lalitpur 26 Bhaktapur 27 Kathmandu 28 Nuwakot 30 Dhading 31 Makwanpur 32 Rautahat 33 Bara 34 Parsa 35 Chitwan 36 Gorkha 37 Manang 38 Lamjung 39 Tanahu 40 Kaski 41 Syangja 42 Gulmi 43 Palpa 44 Nawalparasi 45 Rupandehi 46 Kapilbastu 47 Agrakhachi 49 Myagdi 50 Baglung 51 Parbat 52 Rukum 53 Rolpa 54 Pyuthan 55 Salyan 56 Dang 57 Jumla 60 Kalikot 62 Jajarkot 63 Dailekh 64 Surkhet 65 Banke 66 Bardiya 67 Bajhang 68 Bajura 69 Achham 70 Doti 71 Kailali 72 Darchula 73 Baitadi 74 Dadeldhura 75 Kanchanpur Cluster Number Cluster Number Cluster Number Cluster Number Cluster Number Cluster Number Record ID Record ID Record ID Record ID Record ID Line Number of the Person Line Number of the Person Line Number of the Person Line Number of the Person Line Number of the Person Line number of the Respondent Woman ID Woman ID Woman ID Woman ID Woman ID Child ID for IMM Module Child ID for IMM Module Child ID for IMM Module Child ID for IMM Module Child ID for IMM Module Gender of the Child Gender of the Child Gender of the Child Gender of the Child Gender of the Child 1 Male 2 Female Day of Birth Day of Birth Day of Birth Day of Birth Day of Birth 44 Nothing 98 Date missing Month of Birth Month of Birth Month of Birth Month of Birth Month of Birth 44 Nothing 98 Date missing Year of Birth Year of Birth Year of Birth Year of Birth Year of Birth 44 Nothing 98 Date missing Card Available Card Available Card Available Card Available Card Available Is there a vaccination card for (name)? All children of age 12-23 months 1 Yes 2 No Child received vaccination BCG BCG BCG BCG BCG Is there are vaccination card for (name)? All children of age 12-23 months 1 Yes 2 No Child received vaccination Date - BCG Date - BCG Date - BCG Date - BCG Date - BCG Date of Immunisation All children of age 12-23 months 44 Nothing 98 Date missing Child received vaccination Month - BCG Month - BCG Month - BCG Month - BCG Month - BCG Date of Immunisation All children of age 12-23 months 44 Nothing 98 Date missing Child received vaccination Year - BCG Year - BCG Year - BCG Year - BCG Year - BCG Date of Immunisation All children of age 12-23 months 44 Nothing 98 Date missing Child received vaccination DPT-1 DPT-1 DPT-1 DPT-1 DPT-1 Is there are vaccination card for (name)? All children of age 12-23 months 1 Yes 2 No Child received vaccination Date - DPT1 Date - DPT1 Date - DPT1 Date - DPT1 Date - DPT1 Date of Immunisation All children of age 12-23 months 44 Nothing 98 Date missing Child received vaccination Month- DPT1 Month- DPT1 Month- DPT1 Month- DPT1 Month- DPT1 Date of Immunisation All children of age 12-23 months 44 Nothing 98 Date missing Child received vaccination Year - DPT1 Year - DPT1 Year - DPT1 Year - DPT1 Year - DPT1 Date of Immunisation All children of age 12-23 months 44 Nothing 98 Date missing Child received vaccination DPT2 DPT2 DPT2 DPT2 DPT2 Is there are vaccination card for (name)? All children of age 12-23 months 1 Yes 2 No Child received vaccination Date - DPT2 Date - DPT2 Date - DPT2 Date - DPT2 Date - DPT2 Date of Immunisation All children of age 12-23 months 44 Nothing 98 Date missing Child received vaccination Month - DPT2 Month - DPT2 Month - DPT2 Month - DPT2 Month - DPT2 Date of Immunisation All children of age 12-23 months 44 Nothing 98 Date missing Child received vaccination Year - DPT2 Year - DPT2 Year - DPT2 Year - DPT2 Year - DPT2 Date of Immunisation All children of age 12-23 months 44 Nothing 98 Date missing Child received vaccination DPT-3 DPT-3 DPT-3 DPT-3 DPT-3 Is there are vaccination card for (name)? All children of age 12-23 months 1 Yes 2 No Child received vaccination Date - DPT3 Date - DPT3 Date - DPT3 Date - DPT3 Date - DPT3 Date of Immunisation All children of age 12-23 months 44 Nothing 98 Date missing Child received vaccination Month - DPT3 Month - DPT3 Month - DPT3 Month - DPT3 Month - DPT3 Date of Immunisation All children of age 12-23 months 44 Nothing 98 Date missing Child received vaccination Year - DPT3 Year - DPT3 Year - DPT3 Year - DPT3 Year - DPT3 Date of Immunisation All children of age 12-23 months 44 Nothing 98 Date missing Child received vaccination Polio-1 Polio-1 Polio-1 Polio-1 Polio-1 Is there are vaccination card for (name)? All children of age 12-23 months 1 Yes 2 No Child received vaccination Date - OPV1 Date - OPV1 Date - OPV1 Date - OPV1 Date - OPV1 Date of Immunisation All children of age 12-23 months 44 Nothing 98 Date missing Child received vaccination Month - OPV1 Month - OPV1 Month - OPV1 Month - OPV1 Month - OPV1 Date of Immunisation All children of age 12-23 months 44 Nothing 98 Date missing Child received vaccination Year - OPV1 Year - OPV1 Year - OPV1 Year - OPV1 Year - OPV1 Date of Immunisation All children of age 12-23 months 44 Nothing 98 Date missing Child received vaccination Polio-2 Polio-2 Polio-2 Polio-2 Polio-2 Is there are vaccination card for (name)? All children of age 12-23 months 1 Yes 2 No Child received vaccination Date - OPV2 Date - OPV2 Date - OPV2 Date - OPV2 Date - OPV2 Date of Immunisation All children of age 12-23 months 44 Nothing 98 Date missing Child received vaccination Month - OPV2 Month - OPV2 Month - OPV2 Month - OPV2 Month - OPV2 Date of Immunisation All children of age 12-23 months 44 Nothing 98 Date missing Child received vaccination Year - OPV2 Year - OPV2 Year - OPV2 Year - OPV2 Year - OPV2 Date of Immunisation All children of age 12-23 months 44 Nothing 98 Date missing Child received vaccination Polio-3 Polio-3 Polio-3 Polio-3 Polio-3 Is there are vaccination card for (name)? All children of age 12-23 months 1 Yes 2 No Child received vaccination Date - OPV3 Date - OPV3 Date - OPV3 Date - OPV3 Date - OPV3 Date of Immunisation All children of age 12-23 months 44 Nothing 98 Date missing Child received vaccination Month - OPV3 Month - OPV3 Month - OPV3 Month - OPV3 Month - OPV3 Date of Immunisation All children of age 12-23 months 44 Nothing 98 Date missing Child received vaccination Year - OPV3 Year - OPV3 Year - OPV3 Year - OPV3 Year - OPV3 Date of Immunisation All children of age 12-23 months 44 Nothing 98 Date missing Child received vaccination Measles Measles Measles Measles Measles Is there are vaccination card for (name)? All children of age 12-23 months 1 Yes 2 No Child received vaccination Date - Measles Date - Measles Date - Measles Date - Measles Date - Measles Date of Immunisation All children of age 12-23 months 44 Nothing 98 Date missing Child received vaccination Month - Measles Month - Measles Month - Measles Month - Measles Month - Measles Date of Immunisation All children of age 12-23 months 44 Nothing 98 Date missing Child received vaccination Year - Measles Year - Measles Year - Measles Year - Measles Year - Measles Date of Immunisation All children of age 12-23 months 44 Nothing 98 Date missing Child received vaccination Any Date not Mentioned in Card Any Date not Mentioned in Card Any Date not Mentioned in Card Any Date not Mentioned in Card Any Date not Mentioned in Card Has (name) received any vaccination whose dates are not recorded in the card? All children of age 12-23 months 1 Yes 2 No Child received vaccination Ever given BCG Ever given BCG Ever given BCG Ever given BCG Ever given BCG Probing questions to use when no vaccination card is available Has (name) received BCG vaccination against tuberculosis, that is, an injection in the shoulder that caused a scar? All children of age 12-23 months 1 Yes 2 No Child received vaccination Ever given DPT Ever given DPT Ever given DPT Ever given DPT Ever given DPT Probing questions to use when no vaccination card is available Has (name) ever been given ”vaccination injections” that is an injection in the thigh or buttocks to prevent him/her from getting tetanus, whooping cough, and diphtheria? Note DPT is given at the time of polio drops. All children of age 12-23 months 1 Yes 2 No Child received vaccination Number of Times DPT Number of Times DPT Number of Times DPT Number of Times DPT Number of Times DPT Probing questions to use when no vaccination card is available How many times? All children of age 12-23 months Child received vaccination Ever given Polio Drops Ever given Polio Drops Ever given Polio Drops Ever given Polio Drops Ever given Polio Drops Probing questions to use when no vaccination card is available Has (name) been given any “polio drops” to protect him/her from getting polio diseases? All children of age 12-23 months 1 Yes 2 No Child received vaccination Number of Times-Polio Number of Times-Polio Number of Times-Polio Number of Times-Polio Number of Times-Polio Probing questions to use when no vaccination card is available How many times? All children of age 12-23 months Child received vaccination Polio given in Last NID Polio given in Last NID Polio given in Last NID Polio given in Last NID Polio given in Last NID Probing questions to use when no vaccination card is available Has s/he ever been given polio drops in last National Immunisation Day? All children of age 12-23 months 1 Yes 2 No Child received vaccination Measles given Measles given Measles given Measles given Measles given Probing questions to use when no vaccination card is available Has (name) ever been given “vaccination injections,” that is, a shot in the arm after nine months of age to prevent him/her from getting measles? All children of age 12-23 months 1 Yes 2 No Child received vaccination Child weight Child weight Child weight Child weight Child weight Urban/Rural Residence Urban/Rural Residence Urban/Rural Residence Urban/Rural Residence Urban/Rural Residence 1 Urban 2 Rural Ecological Zones Ecological Zones Ecological Zones Ecological Zones Ecological Zones 1 Terai 2 Hills 3 Mountain Ecological Development Region Ecological Development Region Ecological Development Region Ecological Development Region Ecological Development Region 1 Eastern Terai 2 Central Terai 3 Western Terai 4 M-Western Terai 5 F-Western Terai 6 E+C+W Mountains 7 F+MW Mountains 8 KTM Valley 9 E. Hills 10 C. Hills 11 W. Hills 12 M.W. Hills 13 F.W. Hills District District District District District District 1 Taplejung 2 Panchthar 3 Illam 4 Jhapa 5 Sankhuwasabha 6 Tehrathum 7 Bhojpur 8 Dhankuta 9 Morang 10 Sunsari 11 Solukhumbu 12 Khotang 13 Okhaldhunga 14 Udayapur 15 Saptari 16 Siraha 17 Dhanusha 18 Mahottari 19 Sarlahi 20 Sindhuli 21 Ramechap 22 Dolkha 23 Sindhupalchok 24 Kavre 25 Lalitpur 26 Bhaktapur 27 Kathmandu 28 Nuwakot 30 Dhading 31 Makwanpur 32 Rautahat 33 Bara 34 Parsa 35 Chitwan 36 Gorkha 37 Manang 38 Lamjung 39 Tanahu 40 Kaski 41 Syangja 42 Gulmi 43 Palpa 44 Nawalparasi 45 Rupandehi 46 Kapilbastu 47 Agrakhachi 49 Myagdi 50 Baglung 51 Parbat 52 Rukum 53 Rolpa 54 Pyuthan 55 Salyan 56 Dang 57 Jumla 60 Kalikot 62 Jajarkot 63 Dailekh 64 Surkhet 65 Banke 66 Bardiya 67 Bajhang 68 Bajura 69 Achham 70 Doti 71 Kailali 72 Darchula 73 Baitadi 74 Dadeldhura 75 Kanchanpur Cluster Number Cluster Number Cluster Number Cluster Number Cluster Number Cluster Number Record ID Record ID Record ID Record ID Record ID Line Number of the Person Line Number of the Person Line Number of the Person Line Number of the Person Line Number of the Person Line number of the Respondent Woman ID Woman ID Woman ID Woman ID Woman ID Child ID Child ID Child ID Child ID Child ID Gender of the Child Gender of the Child Gender of the Child Gender of the Child Gender of the Child Children aged 6 months to 5 years of age 1 Male 2 Female Age of the Child Age of the Child Age of the Child Age of the Child Age of the Child Children aged 6 months to 5 years of age Unit for Age of the Child Unit for Age of the Child Unit for Age of the Child Unit for Age of the Child Unit for Age of the Child Children aged 6 months to 5 years of age M Months Y Years Aware of National Vit A Program Aware of National Vit A Program Aware of National Vit A Program Aware of National Vit A Program Aware of National Vit A Program Are you aware of the National Vitamin 'A' program? Children aged 6 months to 5 years of age 1 Yes 2 No Vitamin A received by the children of age 6 months to 5 years of age Knowledge of Vit A Program in Family Knowledge of Vit A Program in Family Knowledge of Vit A Program in Family Knowledge of Vit A Program in Family Knowledge of Vit A Program in Family Are any other members of your family aware of this programme? Children aged 6 months to 5 years of age 1 Yes 2 No 3 DK Vitamin A received by the children of age 6 months to 5 years of age Given Vitmain A During Last Distribution Given Vitmain A During Last Distribution Given Vitmain A During Last Distribution Given Vitmain A During Last Distribution Given Vitmain A During Last Distribution Did s/he receive Vitamin A capsule during last Oct/Nov - April/May? Children aged 6 months to 5 years of age 1 Yes 2 No Vitamin A received by the children of age 6 months to 5 years of age Capsule Given in the Hand Capsule Given in the Hand Capsule Given in the Hand Capsule Given in the Hand Capsule Given in the Hand Can you tell me the activities done during the distribution of vitamin A? Record all that applies. Children aged 6 months to 5 years of age 1 Yes 2 No 3 Don't know Vitamin A received by the children of age 6 months to 5 years of age Capsule Cut by Scissors or Other Equipment Capsule Cut by Scissors or Other Equipment Capsule Cut by Scissors or Other Equipment Capsule Cut by Scissors or Other Equipment Capsule Cut by Scissors or Other Equipment Can you tell me the activities done during the distribution of vitamin A? Record all that applies. Children aged 6 months to 5 years of age 1 Yes 2 No 3 Don't know Vitamin A received by the children of age 6 months to 5 years of age Name of the Child Written Name of the Child Written Name of the Child Written Name of the Child Written Name of the Child Written Can you tell me the activities done during the distribution of vitamin A? Record all that applies. Children aged 6 months to 5 years of age 1 Yes 2 No 3 Don't know Vitamin A received by the children of age 6 months to 5 years of age Capsule Squeezed in the Mouth Capsule Squeezed in the Mouth Capsule Squeezed in the Mouth Capsule Squeezed in the Mouth Capsule Squeezed in the Mouth Can you tell me the activities done during the distribution of vitamin A? Record all that applies. Children aged 6 months to 5 years of age 1 Yes 2 No 3 Don't know Vitamin A received by the children of age 6 months to 5 years of age Child weight Child weight Child weight Child weight Child weight Urban/Rural Residence Urban/Rural Residence Urban/Rural Residence Urban/Rural Residence Urban/Rural Residence 1 Urban 2 Rural Ecological Zones Ecological Zones Ecological Zones Ecological Zones Ecological Zones 1 Terai 2 Hills 3 Mountain Ecological Development Region Ecological Development Region Ecological Development Region Ecological Development Region Ecological Development Region 1 Eastern Terai 2 Central Terai 3 Western Terai 4 M-Western Terai 5 F-Western Terai 6 E+C+W Mountains 7 F+MW Mountains 8 KTM Valley 9 E. Hills 10 C. Hills 11 W. Hills 12 M.W. Hills 13 F.W. Hills District District District District District District 1 Taplejung 2 Panchthar 3 Illam 4 Jhapa 5 Sankhuwasabha 6 Tehrathum 7 Bhojpur 8 Dhankuta 9 Morang 10 Sunsari 11 Solukhumbu 12 Khotang 13 Okhaldhunga 14 Udayapur 15 Saptari 16 Siraha 17 Dhanusha 18 Mahottari 19 Sarlahi 20 Sindhuli 21 Ramechap 22 Dolkha 23 Sindhupalchok 24 Kavre 25 Lalitpur 26 Bhaktapur 27 Kathmandu 28 Nuwakot 30 Dhading 31 Makwanpur 32 Rautahat 33 Bara 34 Parsa 35 Chitwan 36 Gorkha 37 Manang 38 Lamjung 39 Tanahu 40 Kaski 41 Syangja 42 Gulmi 43 Palpa 44 Nawalparasi 45 Rupandehi 46 Kapilbastu 47 Agrakhachi 49 Myagdi 50 Baglung 51 Parbat 52 Rukum 53 Rolpa 54 Pyuthan 55 Salyan 56 Dang 57 Jumla 60 Kalikot 62 Jajarkot 63 Dailekh 64 Surkhet 65 Banke 66 Bardiya 67 Bajhang 68 Bajura 69 Achham 70 Doti 71 Kailali 72 Darchula 73 Baitadi 74 Dadeldhura 75 Kanchanpur Cluster Number Cluster Number Cluster Number Cluster Number Cluster Number Cluster Number Record ID Record ID Record ID Record ID Record ID Line Number of the Person Line Number of the Person Line Number of the Person Line Number of the Person Line Number of the Person Line Number of the Respondent Woman ID Woman ID Woman ID Woman ID Woman ID Interview Complete Interview Complete Interview Complete Interview Complete Interview Complete Interview complete? If yes, fill from Q117 onwards. 1 Yes 2 No Reason for No Interview Reason for No Interview Reason for No Interview Reason for No Interview Reason for No Interview Reasons for no or incomplete interview 1 Refusal 2 Not at home 3 Have no time 4 Ask again to come 5 Others 6 Went to mother's home Age in Completed Years Age in Completed Years Age in Completed Years Age in Completed Years Age in Completed Years How old are you? Write completed years. Marrried women aged 15-49 years Age at Marriage Age at Marriage Age at Marriage Age at Marriage Age at Marriage At what age were you first married? Write completed years. Marrried women aged 15-49 years Number of Sons Given Birth to Number of Sons Given Birth to Number of Sons Given Birth to Number of Sons Given Birth to Number of Sons Given Birth to How many sons have you given birth to? Write 00 if none and skip to Q205. Marrried women aged 15-49 years Sons Surviving Sons Surviving Sons Surviving Sons Surviving Sons Surviving How many of them are alive? Write 00 if none. Married women aged 15-49 who have born sons Number of Daughters Given Birth to Number of Daughters Given Birth to Number of Daughters Given Birth to Number of Daughters Given Birth to Number of Daughters Given Birth to How many of them are alive? Write 00 if none and skip to Q207. Marrried women aged 15-49 years Daughters Surviving Daughters Surviving Daughters Surviving Daughters Surviving Daughters Surviving How many of them are alive? Write 00 if none. Married women aged 15-49 who have born daughters Pregnancy Status Pregnancy Status Pregnancy Status Pregnancy Status Pregnancy Status Are your currently pregnant? No -> Skip to instructions just before Q208. Marrried women aged 15-49 years 1 Yes 2 No Months into Pregnancy Months into Pregnancy Months into Pregnancy Months into Pregnancy Months into Pregnancy How many months into pregnancy? _________ months Pregnant women aged 15-49 Age at first Pregnancy Age at first Pregnancy Age at first Pregnancy Age at first Pregnancy Age at first Pregnancy If she has never been pregnant ask Q210. If she has given at least one birth or is currently pregnant, then ask Q208. At what age did you get pregnant for the first time? Write completed years. Pregnant women aged 15-49 years Desire for More Children Desire for More Children Desire for More Children Desire for More Children Desire for More Children Do you want to have any more children (apart from current pregnancy)? No -> Skip to Q211. Pregnant women aged 15-49 years 1 Yes 2 No 3 DK How Many More How Many More How Many More How Many More How Many More How many children would you like to have? Pregnant women aged 15-49 years Ever Been to School Ever Been to School Ever Been to School Ever Been to School Ever Been to School Have you ever attended school? No -> Ask Q213. Pregnant women aged 15-49 years 1 Yes 2 No Highest Grade Completed Highest Grade Completed Highest Grade Completed Highest Grade Completed Highest Grade Completed What is the highest grade you have completed? Ask Q 214 if grade 5 or above. Pregnant women aged 15-49 years 1 Grade 1 2 Grade 2 3 Grade 3 4 Grade 4 5 Grade 5 6 Grade 6 7 Grade 7 8 Grade 8 9 Grade 9 10 Grade 10 11 Grade 11 12 Grade 12 13 Grade 13 14 Grade 14 15 Grade 15 16 Grade 16 96 Informal education Able to Read and Write Able to Read and Write Able to Read and Write Able to Read and Write Able to Read and Write Can you read and write? No -> Ask Q215 Pregnant women aged 15-49 years 1 Read only 2 Read/write 3 No read/write Times Read Papers/Magazine in a Week Times Read Papers/Magazine in a Week Times Read Papers/Magazine in a Week Times Read Papers/Magazine in a Week Times Read Papers/Magazine in a Week How often do you read a newspaper or a magazine in a week? ___ Times Q212 >= 5 Times Listen to Radio in a Day Times Listen to Radio in a Day Times Listen to Radio in a Day Times Listen to Radio in a Day Times Listen to Radio in a Day How often do you listen to radio in a day? ___ Times Pregnant women aged 15-49 years Times See TV in a Week Times See TV in a Week Times See TV in a Week Times See TV in a Week Times See TV in a Week How often do you watch television in a week? ___ Times Pregnant women aged 15-49 years Knowledge of FP Knowledge of FP Knowledge of FP Knowledge of FP Knowledge of FP There are different ways of delaying, postponing and stopping getting pregnant, and these are called family planning methods. Are you aware of any of these methods? No -> Skip to Q323 Married women of aged 15-49 1 Yes 2 No FP Methods Heard of 1st FP Methods Heard of 1st FP Methods Heard of 1st FP Methods Heard of 1st FP Methods Heard of 1st What are the methods are you aware of? fp301 = 1 1 Pills 2 Condom 3 Depo-provera 4 IUD 5 Norplant 6 Female sterilization 7 Vasectomy 8 Foaming tabs-foams 9 No sex with unsafe person FP Methods Heard of 2nd FP Methods Heard of 2nd FP Methods Heard of 2nd FP Methods Heard of 2nd FP Methods Heard of 2nd What are the methods are you aware of? fp301 = 1 1 Pills 2 Condom 3 Depo-provera 4 IUD 5 Norplant 6 Female sterilization 7 Vasectomy 8 Foaming tabs-foams 9 No sex with unsafe person FP Methods Heard of 3rd FP Methods Heard of 3rd FP Methods Heard of 3rd FP Methods Heard of 3rd FP Methods Heard of 3rd What are the methods are you aware of? fp301 = 1 1 Pills 2 Condom 3 Depo-provera 4 IUD 5 Norplant 6 Female sterilization 7 Vasectomy 8 Foaming tabs-foams 9 No sex with unsafe person FP Methods Heard of 4th FP Methods Heard of 4th FP Methods Heard of 4th FP Methods Heard of 4th FP Methods Heard of 4th What are the methods are you aware of? fp301 = 1 1 Pills 2 Condom 3 Depo-provera 4 IUD 5 Norplant 6 Female sterilization 7 Vasectomy 8 Foaming tabs-foams 9 No sex with unsafe person FP Methods Heard of 5th FP Methods Heard of 5th FP Methods Heard of 5th FP Methods Heard of 5th FP Methods Heard of 5th What are the methods are you aware of? fp301 = 1 1 Pills 2 Condom 3 Depo-provera 4 IUD 5 Norplant 6 Female sterilization 7 Vasectomy 8 Foaming tabs-foams 9 No sex with unsafe person FP Methods Heard of 6th FP Methods Heard of 6th FP Methods Heard of 6th FP Methods Heard of 6th FP Methods Heard of 6th What are the methods are you aware of? fp301 = 1 1 Pills 2 Condom 3 Depo-provera 4 IUD 5 Norplant 6 Female sterilization 7 Vasectomy 8 Foaming tabs-foams 9 No sex with unsafe person FP Methods Heard of 7th FP Methods Heard of 7th FP Methods Heard of 7th FP Methods Heard of 7th FP Methods Heard of 7th What are the methods are you aware of? fp301 = 1 1 Pills 2 Condom 3 Depo-provera 4 IUD 5 Norplant 6 Female sterilization 7 Vasectomy 8 Foaming tabs-foams 9 No sex with unsafe person FP Methods Heard of 8th FP Methods Heard of 8th FP Methods Heard of 8th FP Methods Heard of 8th FP Methods Heard of 8th What are the methods are you aware of? fp301 = 1 1 Pills 2 Condom 3 Depo-provera 4 IUD 5 Norplant 6 Female sterilization 7 Vasectomy 8 Foaming tabs-foams 9 No sex with unsafe person FP Methods Heard of 9th FP Methods Heard of 9th FP Methods Heard of 9th FP Methods Heard of 9th FP Methods Heard of 9th What are the methods are you aware of? fp301 = 1 1 Pills 2 Condom 3 Depo-provera 4 IUD 5 Norplant 6 Female sterilization 7 Vasectomy 8 Foaming tabs-foams 9 No sex with unsafe person Source of Knowledge of FP 1st Source of Knowledge of FP 1st Source of Knowledge of FP 1st Source of Knowledge of FP 1st Source of Knowledge of FP 1st What is the source of your knowledge? Up to 3 multi responses fp301 = 1 1 Newspaper 2 Poster-pamphlets 3 Signboards 4 Radio 5 TV 6 Health workers 7 TBA 8 FCHV 10 Husband 11 Freinds 12 Neighbours 13 Others 9 NGO FP worker Source of Knowledge of FP 2nd Source of Knowledge of FP 2nd Source of Knowledge of FP 2nd Source of Knowledge of FP 2nd Source of Knowledge of FP 2nd What is the source of your knowledge? Up to 3 multi responses fp301 = 1 1 Newspaper 2 Poster-pamphlets 3 Signboards 4 Radio 5 TV 6 Health workers 7 TBA 8 FCHV 9 NGO FP worker 10 Husband 11 Freinds 12 Neighbours 13 Others Source of Knowledge of FP 3rd Source of Knowledge of FP 3rd Source of Knowledge of FP 3rd Source of Knowledge of FP 3rd Source of Knowledge of FP 3rd What is the source of your knowledge? Up to 3 multi responses fp301 = 1 1 Newspaper 2 Poster-pamphlets 3 Signboards 4 Radio 5 TV 6 Health workers 7 TBA 8 FCHV 9 NGO FP worker 10 Husband 11 Freinds 12 Neighbours 13 Others Ever Used FP Ever Used FP Ever Used FP Ever Used FP Ever Used FP Have you ever used anything or tried in any way to delay or avoid getting pregnant? 2. No -> Skip to filter box before Q305. fp301 = 1 1 Yes 2 No Method Ever Used 1 Method Ever Used 1 Method Ever Used 1 Method Ever Used 1 Method Ever Used 1 What had you done? Up to 3 responses fp303 = 1 1 Pills 2 Condom 3 Depo-provera 4 IUD 5 Norplant 6 Female sterilization 7 Vasectomy 8 Foaming tabs-foams 9 No sex with unsafe person Method Ever Used 2 Method Ever Used 2 Method Ever Used 2 Method Ever Used 2 Method Ever Used 2 What had you done? Up to 3 responses fp303 = 1 1 Pills 2 Condom 3 Depo-provera 4 IUD 5 Norplant 6 Female sterilization 7 Vasectomy 8 Foaming tabs-foams 9 No sex with unsafe person Method Ever Used 3 Method Ever Used 3 Method Ever Used 3 Method Ever Used 3 Method Ever Used 3 What had you done? Up to 3 responses fp303 = 1 1 Pills 2 Condom 3 Depo-provera 4 IUD 5 Norplant 6 Female sterilization 7 Vasectomy 8 Foaming tabs-foams 9 No sex with unsafe person Current Use of FP Current Use of FP Current Use of FP Current Use of FP Current Use of FP Are you or your husband currently doing some thing or using any method to delay or avoid your getting pregnant? 2. No -> Ask Q319. Married women not currently pregnant (dm207 = 2) 1 Yes 2 No Method Currently Using Method Currently Using Method Currently Using Method Currently Using Method Currently Using What method are you/your husband currently using? fp305 = 1 1 Pills 2 Condom 3 Depo-provera 4 Iud 5 Norplant 6 Female sterilization 7 Vasectomy 8 Foaming tabs-foams 9 No sex in unsafe per Signed Consent form for STE Signed Consent form for STE Signed Consent form for STE Signed Consent form for STE Signed Consent form for STE If no method is used/ ever used, ask from Q319. If sterilisation is used, ask Q307 and if no ther methods are used, then ask Q312. Did you/your spouse sign a consent form at the time of sterilisation? fp306 = 6 1 Yes 2 No Number of Sons at the Time of STE Number of Sons at the Time of STE Number of Sons at the Time of STE Number of Sons at the Time of STE Number of Sons at the Time of STE How many sons did you have at the time of sterilisation? fp306 = 6 Number of Daughters at the Time of STE Number of Daughters at the Time of STE Number of Daughters at the Time of STE Number of Daughters at the Time of STE Number of Daughters at the Time of STE How many daughters did you have at the time of sterilisation? fp306 = 6 Any Regret having STE Any Regret having STE Any Regret having STE Any Regret having STE Any Regret having STE Do you regret that you/your husband had the operation not to have any children? 2. No -> Skip to Q312. fp306 = 6 1 Yes 2 No Reason for Regret Reason for Regret Reason for Regret Reason for Regret Reason for Regret Why do you regret the operation? fp310 = 1 1 Resp want child 2 Spouse wants child 3 Side effects 4 Death of children 5 Others How Long Currently Using FP Methods How Long Currently Using FP Methods How Long Currently Using FP Methods How Long Currently Using FP Methods How Long Currently Using FP Methods How long have you been using the last method of family planning? __ Months fp305 = 1 Any Side Effects of FP Any Side Effects of FP Any Side Effects of FP Any Side Effects of FP Any Side Effects of FP Did you experience any side-effects? 2. No -> Ask Q318. fp303 = 1 1 Yes 2 No Side Effects of FP 1 Side Effects of FP 1 Side Effects of FP 1 Side Effects of FP 1 Side Effects of FP 1 If yes, what was it? Up to 3 multi-responses fp313 = 1 1 Weakness 2 Nausea 3 Vomiting 4 Cramps 5 Amenorrhea-delayed periods 6 Back pain 7 Others Side Effects of FP 2 Side Effects of FP 2 Side Effects of FP 2 Side Effects of FP 2 Side Effects of FP 2 If yes, what was it? Up to 3 multi-responses fp313 = 1 1 Weakness 2 Nausea 3 Vomiting 4 Cramps 5 Amenorrhea-delayed periods 6 Back pain 7 Others Side Effects of FP 3 Side Effects of FP 3 Side Effects of FP 3 Side Effects of FP 3 Side Effects of FP 3 If yes, what was it? Up to 3 multi-responses fp313 = 1 1 Weakness 2 Nausea 3 Vomiting 4 Cramps 5 Amenorrhea-delayed periods 6 Back pain 7 Others Consult With HW for Treat of Side Effects Consult With HW for Treat of Side Effects Consult With HW for Treat of Side Effects Consult With HW for Treat of Side Effects Consult With HW for Treat of Side Effects Did you go anywhere or contact any health/FP worker for the treatment of side effect? 2. No -> Ask Q318. fp313 = 1 1 Yes 2 No Where Consult for Treatment Where Consult for Treatment Where Consult for Treatment Where Consult for Treatment Where Consult for Treatment Where did you go or whom did you contact for treatment? fp315 = 1 1 Hospital-HC-PHCC 2 HP-SHP 3 Private clinic-NH 4 Faith healers 5 VHW-MCHW 6 FCHV-TBA 7 FP Services of NGO 8 Others Improve After Treatment Improve After Treatment Improve After Treatment Improve After Treatment Improve After Treatment Was their treatment/advice helpful? fp315 = 1 1 Yes 2 No Nearest Center FP Service Nearest Center FP Service Nearest Center FP Service Nearest Center FP Service Nearest Center FP Service Where is the nearest place you can get family planning service? Ask Q320. [dm207 = 1 & fp303 = 1] OR [dm207 = 2 & fp305 = 1] 1 Hospital 2 Health Center-PHCC 3 HP-SHP 4 Village clinic 5 Pharmacy 6 Private Clinic-Nursing Home 7 Others Reson for not Using FP Methods Reson for not Using FP Methods Reson for not Using FP Methods Reson for not Using FP Methods Reson for not Using FP Methods What is the main reason for not using any contraception to avoid getting pregnant? dm207 = 1 & fp303 = 2 11 Not having sex 12 Infrequent sex 13 Menopausal hysterect 14 Sub-fecund-infecund 21 Respondent opposed 22 Husband opposed 23 Others opposed 24 Religious prohibitio 31 Knows no method 32 Knows no source 41 Health concerns 42 Fear of side effects 43 Lack of access-too f 44 Time not suitable 45 Costs too much 46 Inconvenient to use 47 Interferes with body 48 Pregnant 49 Wants more child 96 Others Desire of Using FP Methods in Future Desire of Using FP Methods in Future Desire of Using FP Methods in Future Desire of Using FP Methods in Future Desire of Using FP Methods in Future Do you plan to use family planning method in future? 2. No -> Skip to Q322 3. DK -> Skip to Q322 All married women of aged 15-49 1 Yes 2 No 3 DK Which FP Methods Wants to Use Which FP Methods Wants to Use Which FP Methods Wants to Use Which FP Methods Wants to Use Which FP Methods Wants to Use Which method do you plan to use? fp320 = 1 1 Pills 2 Condom 3 Depo-provera 4 Iud 5 Norplant 6 Female sterilization 7 Vasectomy 8 Foaming tabs-foams 9 No sex in unsafe per Discussion of FP Methods With Spouse Discussion of FP Methods With Spouse Discussion of FP Methods With Spouse Discussion of FP Methods With Spouse Discussion of FP Methods With Spouse Have you and your husband ever discussed the number of children you should have? All married women of aged 15-49 1 Yes 2 No Discussion about No. of Children Discussion about No. of Children Discussion about No. of Children Discussion about No. of Children Discussion about No. of Children Have you and your husband ever discussed the use of family planning methods? All married women of aged 15-49 1 Yes 2 No Ever Heard Ghati Heri Had Nilau Ever Heard Ghati Heri Had Nilau Ever Heard Ghati Heri Had Nilau Ever Heard Ghati Heri Had Nilau Ever Heard Ghati Heri Had Nilau Have you ever heard “Ghanti Heri Haad Nilnu” radio programme? All married women of aged 15-49 1 Yes 2 No Wants to Hear By Radio-TV 1 Wants to Hear By Radio-TV 1 Wants to Hear By Radio-TV 1 Wants to Hear By Radio-TV 1 Wants to Hear By Radio-TV 1 What sort of information about family planning or health would you be interested to hear/see on radio/TV? All married women of aged 15-49 1 FP methods 2 Side effects 3 STD 4 HIV-AIDS 5 Safe motherhood 6 Diarrhea 7 ARI 8 Immunization 9 Nutrition 10 Sanitation 11 Other Wants to Hear By Radio-TV 2 Wants to Hear By Radio-TV 2 Wants to Hear By Radio-TV 2 Wants to Hear By Radio-TV 2 Wants to Hear By Radio-TV 2 What sort of information about family planning or health would you be interested to hear/see on radio/TV? All married women of aged 15-49 1 FP methods 2 Side effects 3 STD 4 HIV-AIDS 5 Safe motherhood 6 Diarrhea 7 ARI 8 Immunization 9 Nutrition 10 Sanitation 11 Other Wants to Hear By Radio-TV 3 Wants to Hear By Radio-TV 3 Wants to Hear By Radio-TV 3 Wants to Hear By Radio-TV 3 Wants to Hear By Radio-TV 3 What sort of information about family planning or health would you be interested to hear/see on radio/TV? All married women of aged 15-49 1 FP methods 2 Side effects 3 STD 4 HIV-AIDS 5 Safe motherhood 6 Diarrhea 7 ARI 8 Immunization 9 Nutrition 10 Sanitation 11 Other Suitable Time to Broadcast in Radio-TV Suitable Time to Broadcast in Radio-TV Suitable Time to Broadcast in Radio-TV Suitable Time to Broadcast in Radio-TV Suitable Time to Broadcast in Radio-TV What should be the best time to broadcast these messages? All married women of aged 15-49 1 M 6-9 2 M 9-12 3 D 12-3 4 D 3-6 5 E 6-9 6 N 9-12 ANC Services in This/Last Pregnancy ANC Services in This/Last Pregnancy ANC Services in This/Last Pregnancy ANC Services in This/Last Pregnancy ANC Services in This/Last Pregnancy Tick-mark one of the following: 1. Respondent does not have a child under 5 years of age or is not pregnant, skip to Q501. 2. Respondent has a child under 5 years of age, continue from Q401. 3. Respondent is currently pregnant, start from Q401. Did you go anywhere for antenatal care during your this/last pregnancy? 2. No -> Start asking Q420. Married women aged 15-49 who are currently pregnant or have children under 5 years of age 1 Yes 2 No Where for ANC Where for ANC Where for ANC Where for ANC Where for ANC Where did you go? ac401 = 1 1 Village Clinic 2 SHP-HP 3 Health Center-PHCC 4 Hospital 5 Private Clinic 6 Others Who Examined in ANC Who Examined in ANC Who Examined in ANC Who Examined in ANC Who Examined in ANC Who did you see? ac401 = 1 1 Doctor 2 Nurse-ANM 3 Health Assistant 4 AHW 5 MCH 6 VHW 7 Others Discussion about Place of Delivery Discussion about Place of Delivery Discussion about Place of Delivery Discussion about Place of Delivery Discussion about Place of Delivery Did the health care provider discussed about: ac401 = 1 1 Yes 2 No Discussion about Breastfeeding Discussion about Breastfeeding Discussion about Breastfeeding Discussion about Breastfeeding Discussion about Breastfeeding Did the health care provider discussed about: ac401 = 1 1 Yes 2 No Discussion about TT Discussion about TT Discussion about TT Discussion about TT Discussion about TT Did the health care provider discussed about: ac401 = 1 1 Yes 2 No Discussion about Nutrition Discussion about Nutrition Discussion about Nutrition Discussion about Nutrition Discussion about Nutrition Did the health care provider discussed about: ac401 = 1 1 Yes 2 No Discussion about Sanitation Discussion about Sanitation Discussion about Sanitation Discussion about Sanitation Discussion about Sanitation Did the health care provider discussed about: ac401 = 1 1 Yes 2 No Discussion about Iron-Folic Acid Discussion about Iron-Folic Acid Discussion about Iron-Folic Acid Discussion about Iron-Folic Acid Discussion about Iron-Folic Acid Did the health care provider discussed about: ac401 = 1 1 Yes 2 No Discussion about Danger Sign in Pregnancy Discussion about Danger Sign in Pregnancy Discussion about Danger Sign in Pregnancy Discussion about Danger Sign in Pregnancy Discussion about Danger Sign in Pregnancy Did the health care provider discussed about: ac401 = 1 1 Yes 2 No Discussion about Danger Sign in Delivery Discussion about Danger Sign in Delivery Discussion about Danger Sign in Delivery Discussion about Danger Sign in Delivery Discussion about Danger Sign in Delivery Did the health care provider discussed about: ac401 = 1 1 Yes 2 No Discussion Place to go after Danger Sign Discussion Place to go after Danger Sign Discussion Place to go after Danger Sign Discussion Place to go after Danger Sign Discussion Place to go after Danger Sign Did the health care provider discussed about: ac401 = 1 1 Yes 2 No Discussion about FP Methods Discussion about FP Methods Discussion about FP Methods Discussion about FP Methods Discussion about FP Methods Did the health care provider discussed about: ac401 = 1 1 Yes 2 No Time Taken to Reach Institution Time Taken to Reach Institution Time Taken to Reach Institution Time Taken to Reach Institution Time Taken to Reach Institution How long did it take you to get there from your home? __ Minutes 00 if less than one hour ac401 = 1 How Many Times Received ANC How Many Times Received ANC How Many Times Received ANC How Many Times Received ANC How Many Times Received ANC During this/last pregnancy how many times did you receive antenatal care? __ Times ac401 = 1 Months Pregnant in First ANC Months Pregnant in First ANC Months Pregnant in First ANC Months Pregnant in First ANC Months Pregnant in First ANC How many months pregnant were you when you first received antenatal care during your this/last pregnancy? __ Months ac401 = 1 TT Shots during Pregnancy TT Shots during Pregnancy TT Shots during Pregnancy TT Shots during Pregnancy TT Shots during Pregnancy Were you given TT shots during your this/last pregnancy? 2. No -> Go to Q410. ac401 = 1 1 Yes 2 No Times TT Shots Times TT Shots Times TT Shots Times TT Shots Times TT Shots If yes, how many times during this/last pregnancy? __ Times If less than two times, ask Q410, otherwise start with Q412. ac408 = 1 TT Shots in Prev Pregnancy TT Shots in Prev Pregnancy TT Shots in Prev Pregnancy TT Shots in Prev Pregnancy TT Shots in Prev Pregnancy Were you given any TT shots during previous pregnancy? 2. No -> Ask Q412. ac409 < 2 1 Yes 2 No Times in Prev Pregnancy Times in Prev Pregnancy Times in Prev Pregnancy Times in Prev Pregnancy Times in Prev Pregnancy If yes how many times? __ Times ac410 = 1 Received Iron Folic Acid Received Iron Folic Acid Received Iron Folic Acid Received Iron Folic Acid Received Iron Folic Acid Did you receive or buy Iron or Iron/Folic Acid combination tablets during this/last pregnancy? 2. No -> Go to Q414. ac401 = 1 1 Yes 2 No Days Took Iron Folic Acid Days Took Iron Folic Acid Days Took Iron Folic Acid Days Took Iron Folic Acid Days Took Iron Folic Acid How many days did you take them during your this/last pregnancy? __ Days ac412 = 1 211 >=7 months Experienced Any Problems during Pregnancy Experienced Any Problems during Pregnancy Experienced Any Problems during Pregnancy Experienced Any Problems during Pregnancy Experienced Any Problems during Pregnancy Did you experience any complications/problem during this/last pregnancy? 2. No -> Skip to Q421. ac401 = 1 1 Yes 2 No What was the Problem 1 What was the Problem 1 What was the Problem 1 What was the Problem 1 What was the Problem 1 If yes, what was the problem? ac414 = 1 1 High blood pressure 2 Odema of facer-hand 3 Aneamia 4 High fever 5 Convulsions 6 Vaginal bleeding 7 Vaginal discharge 8 Severe abdominal pain 9 Others What was the Problem 2 What was the Problem 2 What was the Problem 2 What was the Problem 2 What was the Problem 2 If yes, what was the problem? ac414 = 1 1 High blood pressure 2 Odema of facer-hand 3 Aneamia 4 High fever 5 Convulsions 6 Vaginal bleeding 7 Vaginal discharge 8 Severe abdominal pain 9 Others What was the Problem 3 What was the Problem 3 What was the Problem 3 What was the Problem 3 What was the Problem 3 If yes, what was the problem? ac414 = 1 1 High blood pressure 2 Odema of facer-hand 3 Aneamia 4 High fever 5 Convulsions 6 Vaginal bleeding 7 Vaginal discharge 8 Severe abdominal pain 9 Others Sought Help for the Problem Sought Help for the Problem Sought Help for the Problem Sought Help for the Problem Sought Help for the Problem Did you seek help for this problem? 2. No -> Skip to Q421. ac414 = 1 1 Yes 2 No Where Did You Seek Help Where Did You Seek Help Where Did You Seek Help Where Did You Seek Help Where Did You Seek Help Where did you seek help for the problem? ac416 = 1 1 Shp-hp 2 Health center-phcc 3 Hospital 4 Private clinic-nursi 5 Others Satisfied with the Services Satisfied with the Services Satisfied with the Services Satisfied with the Services Satisfied with the Services Were you satisfied with the services? 1. Yes -> Skip to Q421. ac418 = 1 1 Yes 2 No Problem with the Services 1 Problem with the Services 1 Problem with the Services 1 Problem with the Services 1 Problem with the Services 1 What was the problem with the services? Up to 3 multi responses ac418 = 2 1 No improvement 2 No trained person 3 No medicine 4 No equipment 5 Bad attitude of HW 6 Had to pay 7 No prompt service 8 Others Problem with the Services 2 Problem with the Services 2 Problem with the Services 2 Problem with the Services 2 Problem with the Services 2 What was the problem with the services? Up to 3 multi responses ac418 = 2 1 No improvement 2 No trained person 3 No medicine 4 No equipment 5 Bad attitude of HW 6 Had to pay 7 No prompt service 8 Others Problem with the Services 3 Problem with the Services 3 Problem with the Services 3 Problem with the Services 3 Problem with the Services 3 What was the problem with the services? Up to 3 multi responses Skip to Q421. ac418 = 2 1 No improvement 2 No trained person 3 No medicine 4 No equipment 5 Bad attitude of HW 6 Had to pay 7 No prompt service 8 Others Why No ANC Services 1 Why No ANC Services 1 Why No ANC Services 1 Why No ANC Services 1 Why No ANC Services 1 Why did you not go for ANC service? Up to 3 multi resposes ac401 = 2 1 Did not feel any nee 2 Poor quality service 3 Bad attitude of HW 4 Too far away 5 No time to visit 6 Family did not allow 7 Have to pay 8 Not aware 9 Dk 10 Others Why No ANC Services 2 Why No ANC Services 2 Why No ANC Services 2 Why No ANC Services 2 Why No ANC Services 2 Why did you not go for ANC service? Up to 3 multi resposes ac401 = 2 1 Did not feel any nee 2 Poor quality service 3 Bad attitude of HW 4 Too far away 5 No time to visit 6 Family did not allow 7 Have to pay 8 Not aware 9 Dk 10 Others Why No ANC Services 3 Why No ANC Services 3 Why No ANC Services 3 Why No ANC Services 3 Why No ANC Services 3 Why did you not go for ANC service? Up to 3 multi resposes ac401 = 2 1 Did not feel any nee 2 Poor quality service 3 Bad attitude of HW 4 Too far away 5 No time to visit 6 Family did not allow 7 Have to pay 8 Not aware 9 DK 10 Others Smoked Tobacco during Pregnancy Smoked Tobacco during Pregnancy Smoked Tobacco during Pregnancy Smoked Tobacco during Pregnancy Smoked Tobacco during Pregnancy Did you smoke (tobacco) while you were pregnant? Married women aged 15-49 who are currently pregnant or have children under 5 years of age 1 Yes 2 No Drank Alchohol in Pregnacy Drank Alchohol in Pregnacy Drank Alchohol in Pregnacy Drank Alchohol in Pregnacy Drank Alchohol in Pregnacy Did you drink alcohol/beer during pregnancy? 2. No -> Skip to Q424. Married women aged 15-49 who are currently pregnant or have children under 5 years of age 1 Yes 2 No How often Drank How often Drank How often Drank How often Drank How often Drank How often did you drink alcohol during last pregnancy? ac422 = 1 1 Daily 2 Once in week 3 > Once in a week 4 Occasinally 5 Others Suffer from Night Blindness Suffer from Night Blindness Suffer from Night Blindness Suffer from Night Blindness Suffer from Night Blindness Did you suffer from night blindness during your this/last pregnancy? Married women aged 15-49 who are currently pregnant or have children under 5 years of age 1 Yes 2 No Food Intake Food Intake Food Intake Food Intake Food Intake Did your food intake decrease or increase during this/last pregnancy? Married women aged 15-49 who are currently pregnant or have children under 5 years of age 1 Increased 2 Decreased 3 Same Symptoms Leading to Emergency Care 1st Symptoms Leading to Emergency Care 1st Symptoms Leading to Emergency Care 1st Symptoms Leading to Emergency Care 1st Symptoms Leading to Emergency Care 1st What signs and symptoms during pregnancy will lead you to seek emergency care? Mark all responses. Married women aged 15-49 who are currently pregnant or have children under 5 years of age 1 High blood pressure 2 Odema of facer-hand 3 Aneamia 4 High fever 5 Convulsions 6 Vaginal bleeding 7 Vaginal discharge 8 Severe abdominal pain 9 Not in correct posn 10 Others Symptoms Leading to Emergency Care 2nd Symptoms Leading to Emergency Care 2nd Symptoms Leading to Emergency Care 2nd Symptoms Leading to Emergency Care 2nd Symptoms Leading to Emergency Care 2nd What signs and symptoms during pregnancy will lead you to seek emergency care? Mark all responses. Married women aged 15-49 who are currently pregnant or have children under 5 years of age 1 High blood pressure 2 Odema of facer-hand 3 Aneamia 4 High fever 5 Convulsions 6 Vaginal bleeding 7 Vaginal discharge 8 Severe abdominal pain 9 Not in correct posn 10 Others Symptoms Leading to Emergency Care 3rd Symptoms Leading to Emergency Care 3rd Symptoms Leading to Emergency Care 3rd Symptoms Leading to Emergency Care 3rd Symptoms Leading to Emergency Care 3rd What signs and symptoms during pregnancy will lead you to seek emergency care? Mark all responses. Married women aged 15-49 who are currently pregnant or have children under 5 years of age 1 High blood pressure 2 Odema of facer-hand 3 Aneamia 4 High fever 5 Convulsions 6 Vaginal bleeding 7 Vaginal discharge 8 Severe abdominal pain 9 Not in correct posn 10 Others Symptoms Leading to Emergency Care 4th Symptoms Leading to Emergency Care 4th Symptoms Leading to Emergency Care 4th Symptoms Leading to Emergency Care 4th Symptoms Leading to Emergency Care 4th What signs and symptoms during pregnancy will lead you to seek emergency care? Mark all responses. Married women aged 15-49 who are currently pregnant or have children under 5 years of age 1 High blood pressure 2 Odema of facer-hand 3 Aneamia 4 High fever 5 Convulsions 6 Vaginal bleeding 7 Vaginal discharge 8 Severe abdominal pain 9 Not in correct posn 10 Others Symptoms Leading to Emergency Care 5th Symptoms Leading to Emergency Care 5th Symptoms Leading to Emergency Care 5th Symptoms Leading to Emergency Care 5th Symptoms Leading to Emergency Care 5th What signs and symptoms during pregnancy will lead you to seek emergency care? Mark all responses. Married women aged 15-49 who are currently pregnant or have children under 5 years of age 1 High blood pressure 2 Odema of facer-hand 3 Aneamia 4 High fever 5 Convulsions 6 Vaginal bleeding 7 Vaginal discharge 8 Severe abdominal pain 9 Not in correct posn 10 Others Symptoms Leading to Emergency Care 6th Symptoms Leading to Emergency Care 6th Symptoms Leading to Emergency Care 6th Symptoms Leading to Emergency Care 6th Symptoms Leading to Emergency Care 6th What signs and symptoms during pregnancy will lead you to seek emergency care? Mark all responses. Married women aged 15-49 who are currently pregnant or have children under 5 years of age 1 High blood pressure 2 Odema of facer-hand 3 Aneamia 4 High fever 5 Convulsions 6 Vaginal bleeding 7 Vaginal discharge 8 Severe abdominal pain 9 Not in correct posn 10 Others Symptoms Leading to Emergency Care 7th Symptoms Leading to Emergency Care 7th Symptoms Leading to Emergency Care 7th Symptoms Leading to Emergency Care 7th Symptoms Leading to Emergency Care 7th What signs and symptoms during pregnancy will lead you to seek emergency care? Mark all responses. Married women aged 15-49 who are currently pregnant or have children under 5 years of age 1 High blood pressure 2 Odema of facer-hand 3 Aneamia 4 High fever 5 Convulsions 6 Vaginal bleeding 7 Vaginal discharge 8 Severe abdominal pain 9 Not in correct posn 10 Others Symptoms Leading to Emergency Care 8th Symptoms Leading to Emergency Care 8th Symptoms Leading to Emergency Care 8th Symptoms Leading to Emergency Care 8th Symptoms Leading to Emergency Care 8th What signs and symptoms during pregnancy will lead you to seek emergency care? Mark all responses. Married women aged 15-49 who are currently pregnant or have children under 5 years of age 1 High blood pressure 2 Odema of facer-hand 3 Aneamia 4 High fever 5 Convulsions 6 Vaginal bleeding 7 Vaginal discharge 8 Severe abdominal pain 9 Not in correct posn 10 Others Symptoms Leading to Emergency Care 9th Symptoms Leading to Emergency Care 9th Symptoms Leading to Emergency Care 9th Symptoms Leading to Emergency Care 9th Symptoms Leading to Emergency Care 9th What signs and symptoms during pregnancy will lead you to seek emergency care? Mark all responses. Married women aged 15-49 who are currently pregnant or have children under 5 years of age 1 High blood pressure 2 Odema of facer-hand 3 Aneamia 4 High fever 5 Convulsions 6 Vaginal bleeding 7 Vaginal discharge 8 Severe abdominal pain 9 Not in correct posn 10 Others Place of Delivery Place of Delivery Place of Delivery Place of Delivery Place of Delivery Tick-mark the following: 1. If at least one delivery, start asking from Q427. 2. If never delivered, skip to Q501. Where did you deliver your last child? Married women aged 15-49 who have had at least one delivery 1 Home 2 Cowshed 3 Hospital-PHCC-HC 4 HP-SHP 5 Private Clinic-Nursi 6 Others Who Assisted Who Assisted Who Assisted Who Assisted Who Assisted Who assisted you in delivery? 10. No One -> Skip to Q430. Married women aged 15-49 who have had at least one delivery 1 Doctor 2 Nurse-ANM 3 HA-AHW 4 Trained TBA 5 Untrained TBA 6 VHW 7 MCHW 8 FCHV 9 Relatives-Friends 10 None 11 Others When Assisted When Assisted When Assisted When Assisted When Assisted When did they assist you? dc428 <> 10 1 During labor 2 To deliver the baby 3 To deliver the place 4 When problem occurre 5 Others HDK Used HDK Used HDK Used HDK Used HDK Used Tick-mark below: 1. If delivered at health institution, skip to Q434. 2. Otherwise, skip to Q430. If not delivered at health institutions was HDK used (show the Home Delivery Kit to the respondent) in delivery? 2. No -> Skip to Q432. dc427 = 1, 2, 6 1 Yes 2 No Where HDK obtained Where HDK obtained Where HDK obtained Where HDK obtained Where HDK obtained Where did you get it? dc430 = 1 1 VHW 2 FCHV 3 MCHW 4 Trained TBA 5 Untrained TBA 6 Pharmacy shop 7 Village shop 8 Depot holder 9 Others Instrument to Cut the Umbilical Cord Instrument to Cut the Umbilical Cord Instrument to Cut the Umbilical Cord Instrument to Cut the Umbilical Cord Instrument to Cut the Umbilical Cord What was used to cut the umbilical cord? dc427 = 1, 2, 6 1 New blade 2 Old blade boiled 3 Old blade not bolied 4 Other instruments boiled 5 Other instruments not boiled Instrument to Treat the Cord Instrument to Treat the Cord Instrument to Treat the Cord Instrument to Treat the Cord Instrument to Treat the Cord What was used to treat the cord? dc427 = 1, 2, 6 1 Nothing 2 Antiseptic 3 Ash 4 Oil-ghee 5 Cowdung 6 Besar-harro-barro 7 Others Size of Baby at Birth Size of Baby at Birth Size of Baby at Birth Size of Baby at Birth Size of Baby at Birth How big was the child at the time of delivery? Married women aged 15-49 who have had at least one delivery 1 Very large 2 Large 3 Average 4 Small 5 Very small Received Postpartum Check Up Received Postpartum Check Up Received Postpartum Check Up Received Postpartum Check Up Received Postpartum Check Up Did you receive postpartum check-up within 24 hours of delivery? Married women aged 15-49 who have had at least one delivery 1 Yes 2 No Prolonged Labor Prolonged Labor Prolonged Labor Prolonged Labor Prolonged Labor Around the time of birth did you have any of the following complications/problems? Married women aged 15-49 who have had at least one delivery 1 Yes 2 No Excessive Bleeding Excessive Bleeding Excessive Bleeding Excessive Bleeding Excessive Bleeding Around the time of birth did you have any of the following complications/problems? Married women aged 15-49 who have had at least one delivery 1 Yes 2 No Foul Smelling Vaginal Discharge Foul Smelling Vaginal Discharge Foul Smelling Vaginal Discharge Foul Smelling Vaginal Discharge Foul Smelling Vaginal Discharge Around the time of birth did you have any of the following complications/problems? Married women aged 15-49 who have had at least one delivery 1 Yes 2 No Convulsions Convulsions Convulsions Convulsions Convulsions Around the time of birth did you have any of the following complications/problems? Married women aged 15-49 who have had at least one delivery 1 Yes 2 No Where Contacted for Problem Where Contacted for Problem Where Contacted for Problem Where Contacted for Problem Where Contacted for Problem If 'no' in all categories of Q436 skip to Module 500. If 'yes' in any of the categories, ask: Where was she referred to for this/these problems? If 'nowhere', skip to Module 500 any of dc4361 - dc4364 = 1 No where 1 Trained TBA 2 Untrained TBA 3 FCHV 4 HP-SHP 5 HC-PHCC-Hospital 6 Private Clinic-Nursing Home 7 Pharmacy 8 Faith healers 9 Others 10 Home service by med practitioner Mode of Transport Used to Reach Mode of Transport Used to Reach Mode of Transport Used to Reach Mode of Transport Used to Reach Mode of Transport Used to Reach What mode of transport was used to reach the service centre? any of dc4361 - dc4364 = 1 1 Doko 2 Bullock cart 3 Tractor-truck 4 Stretcher 5 Bus-taxi 6 Others Knowledge of STD Knowledge of STD Knowledge of STD Knowledge of STD Knowledge of STD Have you ever heard of illness called STD? 2. No -> Ask Q503. Currently married women aged 15-49 1 Yes 2 No Source of Information STD 1 Source of Information STD 1 Source of Information STD 1 Source of Information STD 1 Source of Information STD 1 From which source of information have you learned about STD? Probe: Any other sources? Record the first three mentioned. ha501 = 1 1 Radio 2 Television 3 Newspaper-magazines 4 Pamphlets-posters 5 Health workers 6 FCHV 7 TBA 8 Husband 9 Schools-teachers 10 Community meetings 11 Friends-relatives 12 Workplace 13 Others Source of Information STD 2 Source of Information STD 2 Source of Information STD 2 Source of Information STD 2 Source of Information STD 2 From which source of information have you learned about STD? Probe: Any other sources? Record the first three mentioned. ha501 = 1 1 Radio 2 Television 3 Newspaper-magazines 4 Pamphlets-posters 5 Health workers 6 FCHV 7 TBA 8 Husband 9 Schools-teachers 10 Community meetings 11 Friends-relatives 12 Workplace 13 Others Source of Information STD 3 Source of Information STD 3 Source of Information STD 3 Source of Information STD 3 Source of Information STD 3 From which source of information have you learned about STD? Probe: Any other sources? Record the first three mentioned. ha501 = 1 1 Radio 2 Television 3 Newspaper-magazines 4 Pamphlets-posters 5 Health workers 6 FCHV 7 TBA 8 Husband 9 Schools-teachers 10 Community meetings 11 Friends-relatives 12 Workplace 13 Others Knowledge of AIDS Knowledge of AIDS Knowledge of AIDS Knowledge of AIDS Knowledge of AIDS Have you ever heard of illness called AIDS? 2. No -> Ask from Module 600. Currently married women aged 15-49 1 Yes 2 No Source of Information AIDS 1 Source of Information AIDS 1 Source of Information AIDS 1 Source of Information AIDS 1 Source of Information AIDS 1 From which sources of information have you learned most about AIDS? Probe: Any other sources? Record first three mentioned. ha503 = 1 1 Radio 2 Television 3 Newspaper-magazines 4 Pamphlets-posters 5 Health workers 6 FCHV 7 TBA 8 Husband 9 Schools-teachers 10 Community meetings 11 Friends-relatives 12 Workplace 13 Others Source of Information AIDS 2 Source of Information AIDS 2 Source of Information AIDS 2 Source of Information AIDS 2 Source of Information AIDS 2 From which sources of information have you learned most about AIDS? Probe: Any other sources? Record first three mentioned. ha503 = 1 1 Radio 2 Television 3 Newspaper-magazines 4 Pamphlets-posters 5 Health workers 6 FCHV 7 TBA 8 Husband 9 Schools-teachers 10 Community meetings 11 Friends-relatives 12 Workplace 13 Others Source of Information AIDS 3 Source of Information AIDS 3 Source of Information AIDS 3 Source of Information AIDS 3 Source of Information AIDS 3 From which sources of information have you learned most about AIDS? Probe: Any other sources? Record first three mentioned. ha503 = 1 1 Radio 2 Television 3 Newspaper-magazines 4 Pamphlets-posters 5 Health workers 6 FCHV 7 TBA 8 Husband 9 Schools-teachers 10 Community meetings 11 Friends-relatives 12 Workplace 13 Others Things to Avoid Getting AIDS Things to Avoid Getting AIDS Things to Avoid Getting AIDS Things to Avoid Getting AIDS Things to Avoid Getting AIDS Is there anything a person can do to avoid getting AIDS or the virus that causes AIDS? 2. No -> Ask Q507. ha503 = 1 1 Yes 2 No What Can They Do 1st What Can They Do 1st What Can They Do 1st What Can They Do 1st What Can They Do 1st What can a person do? Any other ways? Probe and record all mentioned. ha505 = 1 1 Safe sex 2 Abstain from sex 3 Use condoms 4 Only one sex partner 5 Avoid sex with prost 6 Avoid sex with homos 7 Avoid blood transfus 8 Avoid injections 9 Avoid kissing 10 Avoid mosquito bites 11 Treat from traditional healers 12 Other What Can They Do 2nd What Can They Do 2nd What Can They Do 2nd What Can They Do 2nd What Can They Do 2nd What can a person do? Any other ways? Probe and record all mentioned. ha505 = 1 1 Safe sex 2 Abstain from sex 3 Use condoms 4 Only one sex partner 5 Avoid sex with prost 6 Avoid sex with homos 7 Avoid blood transfus 8 Avoid injections 9 Avoid kissing 10 Avoid mosquito bites 11 Treat from traditional healers 12 Other What Can They Do 3rd What Can They Do 3rd What Can They Do 3rd What Can They Do 3rd What Can They Do 3rd What can a person do? Any other ways? Probe and record all mentioned. ha505 = 1 1 Safe sex 2 Abstain from sex 3 Use condoms 4 Only one sex partner 5 Avoid sex with prost 6 Avoid sex with homos 7 Avoid blood transfus 8 Avoid injections 9 Avoid kissing 10 Avoid mosquito bites 11 Treat from traditional healers 12 Other What Can They Do 4th What Can They Do 4th What Can They Do 4th What Can They Do 4th What Can They Do 4th What can a person do? Any other ways? Probe and record all mentioned. ha505 = 1 1 Safe sex 2 Abstain from sex 3 Use condoms 4 Only one sex partner 5 Avoid sex with prost 6 Avoid sex with homos 7 Avoid blood transfus 8 Avoid injections 9 Avoid kissing 10 Avoid mosquito bites 11 Treat from traditional healers 12 Other What Can They Do 5th What Can They Do 5th What Can They Do 5th What Can They Do 5th What Can They Do 5th What can a person do? Any other ways? Probe and record all mentioned. ha505 = 1 1 Safe sex 2 Abstain from sex 3 Use condoms 4 Only one sex partner 5 Avoid sex with prost 6 Avoid sex with homos 7 Avoid blood transfus 8 Avoid injections 9 Avoid kissing 10 Avoid mosquito bites 11 Treat from traditional healers 12 Other What Can They Do 6th What Can They Do 6th What Can They Do 6th What Can They Do 6th What Can They Do 6th What can a person do? Any other ways? Probe and record all mentioned. ha505 = 1 1 Safe sex 2 Abstain from sex 3 Use condoms 4 Only one sex partner 5 Avoid sex with prost 6 Avoid sex with homos 7 Avoid blood transfus 8 Avoid injections 9 Avoid kissing 10 Avoid mosquito bites 11 Treat from traditional healers 12 Other What Can They Do 7th What Can They Do 7th What Can They Do 7th What Can They Do 7th What Can They Do 7th What can a person do? Any other ways? Probe and record all mentioned. ha505 = 1 1 Safe sex 2 Abstain from sex 3 Use condoms 4 Only one sex partner 5 Avoid sex with prost 6 Avoid sex with homos 7 Avoid blood transfus 8 Avoid injections 9 Avoid kissing 10 Avoid mosquito bites 11 Treat from traditional healers 12 Other What Can They Do 8th What Can They Do 8th What Can They Do 8th What Can They Do 8th What Can They Do 8th What can a person do? Any other ways? Probe and record all mentioned. ha505 = 1 1 Safe sex 2 Abstain from sex 3 Use condoms 4 Only one sex partner 5 Avoid sex with prost 6 Avoid sex with homos 7 Avoid blood transfus 8 Avoid injections 9 Avoid kissing 10 Avoid mosquito bites 11 Treat from traditional healers 12 Other What Can They Do 9th What Can They Do 9th What Can They Do 9th What Can They Do 9th What Can They Do 9th What can a person do? Any other ways? Probe and record all mentioned. ha505 = 1 1 Safe sex 2 Abstain from sex 3 Use condoms 4 Only one sex partner 5 Avoid sex with prost 6 Avoid sex with homos 7 Avoid blood transfus 8 Avoid injections 9 Avoid kissing 10 Avoid mosquito bites 11 Treat from traditional healers 12 Other What Can They Do 10th What Can They Do 10th What Can They Do 10th What Can They Do 10th What Can They Do 10th What can a person do? Any other ways? Probe and record all mentioned. ha505 = 1 1 Safe sex 2 Abstain from sex 3 Use condoms 4 Only one sex partner 5 Avoid sex with prost 6 Avoid sex with homos 7 Avoid blood transfus 8 Avoid injections 9 Avoid kissing 10 Avoid mosquito bites 11 Treat from traditional healers 12 Other What Can They Do 11th What Can They Do 11th What Can They Do 11th What Can They Do 11th What Can They Do 11th What can a person do? Any other ways? Probe and record all mentioned. ha505 = 1 1 Safe sex 2 Abstain from sex 3 Use condoms 4 Only one sex partner 5 Avoid sex with prost 6 Avoid sex with homos 7 Avoid blood transfus 8 Avoid injections 9 Avoid kissing 10 Avoid mosquito bites 11 Treat from traditional healers 12 Other What Can They Do 12th What Can They Do 12th What Can They Do 12th What Can They Do 12th What Can They Do 12th What can a person do? Any other ways? Probe and record all mentioned. ha505 = 1 1 Safe sex 2 Abstain from sex 3 Use condoms 4 Only one sex partner 5 Avoid sex with prost 6 Avoid sex with homos 7 Avoid blood transfus 8 Avoid injections 9 Avoid kissing 10 Avoid mosquito bites 11 Treat from traditional healers 12 Other Possibility of Healthy Person to Have AIDS Possibility of Healthy Person to Have AIDS Possibility of Healthy Person to Have AIDS Possibility of Healthy Person to Have AIDS Possibility of Healthy Person to Have AIDS Is it possible for a healthy-looking person to have the AIDS virus? ha503 = 1 1 Yes 2 No 3 DK Your Chance of Getting AIDS Your Chance of Getting AIDS Your Chance of Getting AIDS Your Chance of Getting AIDS Your Chance of Getting AIDS Do you think your chances of getting AIDS are small, moderate, great or that you have no risk at all? ha503 = 1 1 Small 2 Moderate 3 Great-high 4 No risk at all 5 Has aids 6 Dont know 7 Other Knowledge of HIV Testing Place Knowledge of HIV Testing Place Knowledge of HIV Testing Place Knowledge of HIV Testing Place Knowledge of HIV Testing Place Do you know the place where you could get (blood) tested for HIV? 2. No -> Skip to 600. ha503 = 1 1 Yes 2 No Ever Been Tested Ever Been Tested Ever Been Tested Ever Been Tested Ever Been Tested You do not need to tell me the results, have you ever been tested for HIV? ha509 = 1 1 Yes 2 No Whether Breastfed Last Child Whether Breastfed Last Child Whether Breastfed Last Child Whether Breastfed Last Child Whether Breastfed Last Child Tick-mark one of the following: 1. Respondent has no children under 5, stop interviewing. 2. Respondent has at least one child under 5, continue Module 600. Did you ever breastfeed your last child? 2. No -> Go to Module 700. Married women 15-49 with at least one child aged under 5 1 Yes 2 No Time after Birth Child Breastfed Time after Birth Child Breastfed Time after Birth Child Breastfed Time after Birth Child Breastfed Time after Birth Child Breastfed How long after birth did you put child to breast? __ Hours If less than one hour, write 00. bf601 = 1 Fed Colustrum Fed Colustrum Fed Colustrum Fed Colustrum Fed Colustrum Did you feed colostrum to the child? bf601 = 1 1 Yes 2 No Number of Months Breastfeeding Number of Months Breastfeeding Number of Months Breastfeeding Number of Months Breastfeeding Number of Months Breastfeeding For how many months have you been breastfeeding this child? __ Months Write 88 for still breastfeeding. If stopped breastfeeding, skip to Q606. bf601 = 1 88 Continuous feeding How long intends to Breastfeed How long intends to Breastfeed How long intends to Breastfeed How long intends to Breastfeed How long intends to Breastfeed If still breastfeeding how long do you intend to breastfeed him/her? __ Months bf604 = 88 97 Up to accessible Time Water Given to Child Time Water Given to Child Time Water Given to Child Time Water Given to Child Time Water Given to Child At what age did you give water to drink for your child? __ Months Write 88 if the child was not given water. bf601 = 1 88 Not given yet Child Fed Anything from Bottle Yesterday Child Fed Anything from Bottle Yesterday Child Fed Anything from Bottle Yesterday Child Fed Anything from Bottle Yesterday Child Fed Anything from Bottle Yesterday Was the child fed anything from the feeding bottle yesterday or last night? Write 88 if water not given yet. bf601 = 1 1 Yes 2 No When Food Supplements Given When Food Supplements Given When Food Supplements Given When Food Supplements Given When Food Supplements Given When (at what age) did you start giving other food to the child? (Age) __ Months Write 88 if no food given yet. bf601 = 1 Less than a month 88 Solid food not given yet Reason for not Breastfeeding Reason for not Breastfeeding Reason for not Breastfeeding Reason for not Breastfeeding Reason for not Breastfeeding If not currently breastfeeding, why did you stop breastfeeding the child? bf601 = 1 1 Mother ill-weak 2 Child ill-weak 3 Nipple-breast proble 4 Not enough milk 5 Mother working 6 Child refused 7 Weaning age-age to s 8 Became pregnant 9 Using contraception Symptoms Leading to Emergrency Care 1st Symptoms Leading to Emergrency Care 1st Symptoms Leading to Emergrency Care 1st Symptoms Leading to Emergrency Care 1st Symptoms Leading to Emergrency Care 1st When the child is sick what symptoms will lead you to seek cure at health institutions or a medical personnel? Record all answers. Married women 15-49 with at least one child aged 5 years and below 1 When the child cannot eat or drink 2 Chest in-drawing 3 When the fever is high 4 When the child is lethargic or unconscious 5 Difficulty in breathing or rapid breathing 6 When there is blood in the stool 7 Vomits everything s/he eats or drinks 8 When the frequency of diarrhoea is high 9 When the child is excessively thirsty Symptoms Leading to Emergrency Care 2nd Symptoms Leading to Emergrency Care 2nd Symptoms Leading to Emergrency Care 2nd Symptoms Leading to Emergrency Care 2nd Symptoms Leading to Emergrency Care 2nd When the child is sick what symptoms will lead you to seek cure at health institutions or a medical personnel? Record all answers. Married women 15-49 with at least one child aged 5 years and below 1 When the child cannot eat or drink 2 Chest in-drawing 3 When the fever is high 4 When the child is lethargic or unconscious 5 Difficulty in breathing or rapid breathing 6 When there is blood in the stool 7 Vomits everything s/he eats or drinks 8 When the frequency of diarrhoea is high 9 When the child is excessively thirsty Symptoms Leading to Emergrency Care 3rd Symptoms Leading to Emergrency Care 3rd Symptoms Leading to Emergrency Care 3rd Symptoms Leading to Emergrency Care 3rd Symptoms Leading to Emergrency Care 3rd When the child is sick what symptoms will lead you to seek cure at health institutions or a medical personnel? Record all answers. Married women 15-49 with at least one child aged 5 years and below 1 When the child cannot eat or drink 2 Chest in-drawing 3 When the fever is high 4 When the child is lethargic or unconscious 5 Difficulty in breathing or rapid breathing 6 When there is blood in the stool 7 Vomits everything s/he eats or drinks 8 When the frequency of diarrhoea is high 9 When the child is excessively thirsty Symptoms Leading to Emergrency Care 4th Symptoms Leading to Emergrency Care 4th Symptoms Leading to Emergrency Care 4th Symptoms Leading to Emergrency Care 4th Symptoms Leading to Emergrency Care 4th When the child is sick what symptoms will lead you to seek cure at health institutions or a medical personnel? Record all answers. Married women 15-49 with at least one child aged 5 years and below 1 When the child cannot eat or drink 2 Chest in-drawing 3 When the fever is high 4 When the child is lethargic or unconscious 5 Difficulty in breathing or rapid breathing 6 When there is blood in the stool 7 Vomits everything s/he eats or drinks 8 When the frequency of diarrhoea is high 9 When the child is excessively thirsty Symptoms Leading to Emergrency Care 5th Symptoms Leading to Emergrency Care 5th Symptoms Leading to Emergrency Care 5th Symptoms Leading to Emergrency Care 5th Symptoms Leading to Emergrency Care 5th When the child is sick what symptoms will lead you to seek cure at health institutions or a medical personnel? Record all answers. Married women 15-49 with at least one child aged 5 years and below 1 When the child cannot eat or drink 2 Chest in-drawing 3 When the fever is high 4 When the child is lethargic or unconscious 5 Difficulty in breathing or rapid breathing 6 When there is blood in the stool 7 Vomits everything s/he eats or drinks 8 When the frequency of diarrhoea is high 9 When the child is excessively thirsty Symptoms Leading to Emergrency Care 6th Symptoms Leading to Emergrency Care 6th Symptoms Leading to Emergrency Care 6th Symptoms Leading to Emergrency Care 6th Symptoms Leading to Emergrency Care 6th When the child is sick what symptoms will lead you to seek cure at health institutions or a medical personnel? Record all answers. Married women 15-49 with at least one child aged 5 years and below 1 When the child cannot eat or drink 2 Chest in-drawing 3 When the fever is high 4 When the child is lethargic or unconscious 5 Difficulty in breathing or rapid breathing 6 When there is blood in the stool 7 Vomits everything s/he eats or drinks 8 When the frequency of diarrhoea is high 9 When the child is excessively thirsty Symptoms Leading to Emergrency Care 7th Symptoms Leading to Emergrency Care 7th Symptoms Leading to Emergrency Care 7th Symptoms Leading to Emergrency Care 7th Symptoms Leading to Emergrency Care 7th When the child is sick what symptoms will lead you to seek cure at health institutions or a medical personnel? Record all answers. Married women 15-49 with at least one child aged 5 years and below 1 When the child cannot eat or drink 2 Chest in-drawing 3 When the fever is high 4 When the child is lethargic or unconscious 5 Difficulty in breathing or rapid breathing 6 When there is blood in the stool 7 Vomits everything s/he eats or drinks 8 When the frequency of diarrhoea is high 9 When the child is excessively thirsty Symptoms Leading to Emergrency Care 8th Symptoms Leading to Emergrency Care 8th Symptoms Leading to Emergrency Care 8th Symptoms Leading to Emergrency Care 8th Symptoms Leading to Emergrency Care 8th When the child is sick what symptoms will lead you to seek cure at health institutions or a medical personnel? Record all answers. Married women 15-49 with at least one child aged 5 years and below 1 When the child cannot eat or drink 2 Chest in-drawing 3 When the fever is high 4 When the child is lethargic or unconscious 5 Difficulty in breathing or rapid breathing 6 When there is blood in the stool 7 Vomits everything s/he eats or drinks 8 When the frequency of diarrhoea is high 9 When the child is excessively thirsty Symptoms Leading to Emergrency Care 9th Symptoms Leading to Emergrency Care 9th Symptoms Leading to Emergrency Care 9th Symptoms Leading to Emergrency Care 9th Symptoms Leading to Emergrency Care 9th When the child is sick what symptoms will lead you to seek cure at health institutions or a medical personnel? Record all answers. Married women 15-49 with at least one child aged 5 years and below 1 When the child cannot eat or drink 2 Chest in-drawing 3 When the fever is high 4 When the child is lethargic or unconscious 5 Difficulty in breathing or rapid breathing 6 When there is blood in the stool 7 Vomits everything s/he eats or drinks 8 When the frequency of diarrhoea is high 9 When the child is excessively thirsty Aware of National Vit A Program Aware of National Vit A Program Aware of National Vit A Program Aware of National Vit A Program Aware of National Vit A Program Are you aware of the National Vitamin 'A' programme? Married women 15-49 with at least one child aged 6 months to 5 years 1 Yes 2 No Knowledge of Vit A Program in Family Knowledge of Vit A Program in Family Knowledge of Vit A Program in Family Knowledge of Vit A Program in Family Knowledge of Vit A Program in Family Are any other members of your family aware of this programme? Married women 15-49 with at least one child aged 6 months to 5 years 1 Yes 2 No 3 DK Whether the IMM Card was Given Whether the IMM Card was Given Whether the IMM Card was Given Whether the IMM Card was Given Whether the IMM Card was Given If no vaccination card, then ask, was she given any vaccination card during vaccination of the child? All married women aged 15-49 with children aged 12-23 months 1 Yes 2 No Told to Keep Card Safely, Bring Next Time Told to Keep Card Safely, Bring Next Time Told to Keep Card Safely, Bring Next Time Told to Keep Card Safely, Bring Next Time Told to Keep Card Safely, Bring Next Time Was she asked to keep the card safely and bring it back the next time she brings the child for immunisation? All married women aged 15-49 with children aged 12-23 months 1 Yes 2 No Told about Protection against Disease Told about Protection against Disease Told about Protection against Disease Told about Protection against Disease Told about Protection against Disease During immunisation were you informed about the vaccine and what it protects against? All married women aged 15-49 with children aged 12-23 months 1 Yes 2 No Informed Number of Shots to be Completed Informed Number of Shots to be Completed Informed Number of Shots to be Completed Informed Number of Shots to be Completed Informed Number of Shots to be Completed During immunisation were you informed about the number of doses to be completed? All married women aged 15-49 with children aged 12-23 months 1 Yes 2 No Whether Inform the Side Effects of IMM Whether Inform the Side Effects of IMM Whether Inform the Side Effects of IMM Whether Inform the Side Effects of IMM Whether Inform the Side Effects of IMM During immunisation were you informed about the side-effects of immunisation including fever /swelling at the site of immunisation? All married women aged 15-49 with children aged 12-23 months 1 Yes 2 No Gender of the Child for BF Module Gender of the Child for BF Module Gender of the Child for BF Module Gender of the Child for BF Module Gender of the Child for BF Module Gender of the Children 1 Male 2 Female Child Age for BF Module Child Age for BF Module Child Age for BF Module Child Age for BF Module Child Age for BF Module Age of the children Child Age Unit for BF Module Child Age Unit for BF Module Child Age Unit for BF Module Child Age Unit for BF Module Child Age Unit for BF Module Unit of the children age M Months Y Years Woman weight Woman weight Woman weight Woman weight Woman weight