MSAS R6 Questionnaire CODES for FTF
DISTRICT CODES 01 Balaka 05 Blantyre 09 Thyolo 13 Lilongwe 17 Salima 21 Nkhata Bay 25 Rumphi 02 Machinga 06 Chiradzulu 10 Chikwawa 14 Ntchisi 18 Mchinji 22 Neno 26 Karonga 03 Zomba 07 Nsanje 11 Ntcheu 15 Dowa 19 Mzimba 23 Mwanza 27 Chitipa 04 Mangochi 08 Mulanje 12 Dedza 16 Kasungu 20 Nkhotakota 24 Likoma 28 Phalombe OTHER COUNTRY 71 Mozambique 72 South Africa 77 Other country ______
RELATIONSHIP CODES 00 No one 09 Biological sister 19 Male cousin 28 Other relative: Male 01 Self 10 Biological brother 20 Female cousin 29 Other relative: Female 02 Spouse 11 Half brother 21 Niece 41 Teacher 03 Son 12 Half sister 22 Nephew 42 Head teacher 04 Daughter 13 Mother's brother 23 Sister's husband 43 Village headman 05 Biological mother 14 Mother's sister 24 Brother's wife 44 Neighbor 06 Biological father 15 Father's brother 25 Spouse's mother 45 Friend 07 Step mother 16 Father's sister 26 Spouse's father 46 Other 08 Step father 17 Mother's parent 27 Spouse's other wife 88 Don't know 18 Father's parent
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SECTION AA: MIGRATION
Codes for Migration Roster:
DISTRICT CODES:
01 Balaka 08 Mulanje 15 Dowa 22 Neno 02 Machinga 09 Thyolo 16 Kasungu 23 Mwanza 03 Zomba 10 Chikwawa 17 Salima 24 Likoma 04 Mangochi 11 Ntcheu 18 Mchinji 25 Rumphi 05 Blantyre 12 Dedza 19 Mzimba 26 Karonga 06 Chiradzulu 13 Lilongwe 20 Nkhotakota 27 Chitipa 07 Nsanje 14 Ntchisi 21 Nkhata Bay 28 Phalombe
OTHER COUNTRY: 71 Mozambique 72 South Africa 77 Other country ______
CODES FOR QUESTION AA5: MAIN REASON MOVED TO VILLAGE/AREA:
SCHOOL REASONS 01 Quality of this school 02 PSLE/JSCE/MSCE better at this school 03 Other reason this school 04 Poor quality of previous school 05 Problems with teachers at previous school 06 Problems with students at previous school 07 Other reason previous school 08 Attend secondary school
OTHER REASONS 09 Death: Parent/Guardian 10 Death: Other HH member 11 Illness: Parent/Guardian 12 Illness: Other HH member 13 Biological parents: Separated/Divorced 14 Lower crop yields: Draught/Disease/Price drops 15 Loss of livestock 16 Job loss/Business failure (non-farming) 17 Economic opportunity: Self 18 Economic opportunity: Parent(s) 19 Economic opportunity: Other HH member 20 Fostered for other reason 21 Conflict with family members 22 Other relatives needed help 23 Moved with parents 24 Rejoined parents 25 Marriage 26 Other [Enter Line # and specify] 88 Don't know
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ENGLISH R5 - Qs SECTION A: RESPONDENT'S BACKGROUND QUESTIONS RESPONSES SKIPS
A0 RECORD THE TIME INTERVIEW BEGINS a. HOUR USE 24 HOUR TIME b. MINUTES
Script_A [READ:] I would like to ask you a few questions about yourself: your age, schooling, and where you live.
A0a A1 What is your current age? AGE IN COMPLETED YEARS
DON'T KNOW 88
NEW Q A2 What is the highest level of education you have NEVER ATTENDED SCHOOL 0 → A28 completed? DID NOT COMPLETE STANDARD 1 1 SOME PRIMARY 2 COMPLETED PRIMARY 3 SOME SECONDARY 4 COMPLETED SECONDARY 5 SOME TERTIARY 6
A4 A3 What is the highest standard or form that you have a. STANDARD ever attended? b. FORM
[CHECK A3: IF HIGHEST STANDARD ATTENDED IS 7 OR LESS → A16; ELSE ASK A4] A4a A4 Did you ever take the MANEB (PSLCE) exam? NO 0 → A8 YES 1
NEW Q A5 How many times did you take the MANEB ONE 1 (PSLCE) exam? TWO 2 THREE OR MORE 3
NEW Q A6 Did you pass the MANEB (PSLCE) exam? NO 0 YES 1 RESULTS NOT YET OUT 2 → A8
A4b modif A7 The last time you took the MANEB (PSCLE) exam, a. ENGLISH what were your grades for …? [READ ALL OPTIONS] b. CHICHEWA
[Grades: A, B, C, D, F] c. ARITHMETIC [66 = Not yet received grades] [77 = Subject not in exam] d. SCIENCE AND TECHNOLOGY [88 = Don't know] e. SOCIAL AND ENVIRONMENTAL SCIENCES
[CHECK A3: IF HIGHEST FORM ATTENDED IS 2 OR HIGHER ASK A8; ELSE → A16] A4c A8 Did you ever take the JSCE exam? NO 0 → A12 YES 1
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NEW Q A9 How many times did you take the JSCE exam? ONE 1 TWO 2 THREE OR MORE 3
NEW Q A10 Did you pass the JSCE exam? NO 0 YES 1 RESULTS NOT YET OUT 2 → A8
A4d modif A11 The last time you took the JSCE exam, what were a. MATHEMATICS your grades for …? [READ ALL OPTIONS] b. CHICHEWA
[Grades: A, B, C, D, F] c. GEOGRAPHY [66 = Not yet received grades] [77 = Subject not in exam] d. HISTORY [88 = Don't know] e. AGRICULTURE
f. FRENCH
g. SOCIAL DEVELOPMENT
h. LIFE SKILLS
i. ENGLISH
[CHECK A3: IF HIGHEST FORM ATTENDED IS 4 ASK A12; ELSE → A16] A4e A12 Did you ever take the MSCE exam? NO 0 → A16 YES 1
NEW Q A13 How many times did you take the MSCE exam? ONE 1 TWO 2 THREE OR MORE 3
NEW Q A14 Did you pass the MSCE exam? NO 0 YES 1 NOT YET RECEIVED GRADES 77 → A16
A4f modif A15 The last time you took the MSCE exam, what were a. MATHEMATICS your grades for …? [READ ALL OPTIONS] b. CHICHEWA
[Grades: 1, 2, 3, 4, 5, 6, 7, 8, 9] c. GEOGRAPHY [66 = Not yet received grades] [77 = Subject not in exam] d. HISTORY [88 = Don't know] e. AGRICULTURE
f. FRENCH
g. SOCIAL DEVELOPMENT
h. LIFE SKILLS
i. ENGLISH
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A6a A16 Are you currently attending school? NO 0 [IF SCHOOL TERM HAS ENDED ASK:] YES 1 → A20 Did you attend the 3rd term of the recent school year?
A6a1 A17 What was your age when you stopped attending AGE school? DON'T KNOW 88
A6a2 A18 How many years ago did you stop attending NUMBER OF YEARS school? LESS THAN 1 YEAR AGO 0 DON'T KNOW 88
A6aa modif A19 What are the reasons that you stopped attending school when you did?
[DO NOT READ LIST; CIRCLE ALL MENTIONED. TICK MOST IMPORTANT REASON]
[IF MORE THAN ONE RESPONSE ASK:] Which of these is the most important reason?
MARRIAGE/BIRTH 1 Marriage 1 [___] 2 Pregnancy 2 [___] 3 Had baby/was nursing baby 3 [___] SCHOOL ISSUES 4 Finished primary school 4 [___] 5 Not selected to secondary school 5 [___] 6 Finished secondary school 6 [___] 7 Not doing well at school 7 [___] 8 Didn't like school/rather do something else 8 [___] 9 Problems with/afraid of other students 9 [___] 10 Problems with/afraid of teacher 10 [___] 11 Travel/distance to school 11 [___] 12 Parents/guardian didn't want 12 [___] FINANCIAL/WORK ALL 13 Financial/Costs 13 [___] → A28 14 No money for development funds 14 [___] 15 Needed to work at home/fields 15 [___] 16 Needed to work/earn money 16 [___] ILLNESS/DEATH 17 Respondent was sick/ill 17 [___] 18 Illness: Parent/guardian 18 [___] 19 Illness: Other HH member 19 [___] 20 Death: Parent/guardian 20 [___] 21 Death: Other HH member 21 [___] HOUSEHOLD ISSUES 22 Biological parents: Separated/divorced 22 [___] 23 Needed to look after brothers/sisters 23 [___] OTHER ISSUES 24 Hunger 24 [___] 25 Other ______25 [___] 88 DON'T KNOW 88 [___]
A6b A20 What is the name of the school you [are currently/were recently] attending?
[CHECK REFERENCE-SHEET : Is the school SAME SCHOOL AS REFERENCE-SHEET 0 attended last interview the same as the current DIFFERENT SCHOOL 1 school? CIRCLE: ] SAME SCHOOL, DIFFERENT NAME 2
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A6b1 A21 What district is this school in? DISTRICT [USE DISTRICT CODES]
A6b2 A22 Is this a primary or a secondary school? PRIMARY SCHOOL 1 SECONDARY SCHOOL 2 → A24 [IF NEITHER ASK:] TERTIARY INSTITUTION 3 → A26 Is this a tertiary education institution?
A7a A23 In which standard [are you currently/were you STANDARD → A27 recently] enrolled?
A7b A24 In which form [are you currently/were you recently] FORM enrolled?
NEW Q A25 What t ype of secondary school is this? NATIONAL BOARDING SCHOOL 1 DISTRICT BOARDING SCHOOL 2 ALL DISTRICT DAY SCHOOL 3 → A27 COMMUNITY DAY SCHOOL 4 PRIVATE SCHOOL 5
NEW Q A26 What year of tertiary education [are you YEAR currently/were you recently] attending?
A7c A27 Are you a day student, or a boarder at school, or a DAY STUDENT 1 boarder somewhere else? BOARDER AT SCHOOL 2 BOARDER SOMEWHERE ELSE 3
NEW Q A28 Have you ever participated in a literacy program or NO 0 any other program that involves learning to read or YES 1 write (not including primary school)?
NEW Q A29 Have you ever participated in a vocational training NO 0 program such as carpentry, tinsmithing, tailoring, YES 1 photoprocessing, or any other vocational training program?
A10 A30 [CHECK A16: IF ATTENDS SCHOOL ASK:] Now let's talk about the village/area in which you live while you attend school. What is the name of that village/area?
[ELSE ASK:] Now let's talk about the village/area in which you live. What is the name of that village/area?
[CHECK REFERENCE-SHEET: Is the village/area SAME VILLAGE/AREA 0 from last interview the same as the current SAME VILLAGE/AREA BUT CHANGED NAME 1 village/area? CIRCLE :] DIFFERENT VILLAGE/AREA 2 → A32
NEW Q A31 Have you lived in this village/area your whole life? NO 0 YES 1
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[CHECK A16: IF ATTENDS SCHOOL ASK A32; ELSE → A36] A12 A32 Do you live in another village/area during those NO 0 → A36 times that you are not in school? YES 1
A13 A33 Where is the village/area you live in when you are SAME TRADITIONAL AUTHORITY (T/A) 1 not in school? SAME DISTRICT 2 [READ RESPONSES 1-4] ANOTHER DISTRICT 3 ANOTHER COUNTRY 4 DON'T KNOW 88
A13a A34 Which village/area do you consider your primary VILLAGE/AREA IN A30 0 → A36 home? OTHER VILLAGE/AREA 1
A13b A35 What is the name of the village/area that you consider your primary home?
Script_AA A36 Now I would like to ask you about the different [FILL IN MIGRATION ROSTER] places where you have lived since the last time you were interviewed.
SECTION B: RESPONDENT'S BIOLOGICAL MOTHER QUESTIONS RESPONSES SKIPS
Script_B [READ:] Now I would like to ask you a few questions about your family, including your mother, father and siblings. Let's start with your biological mother.
[CHECK REFERENCE-SHEET: IF BIOLOGICAL MOTHER WAS ALIVE → B1; ELSE ASK B0] B0 B0 Was your biological mother alive on [reference- NO 0 → B6 sheet: date last interview]? YES (Reference-sheet incorrect) 2 DON'T KNOW 88 → B6
B1 B1 Is your biological mother still living? NO 0 YES 1 → B3 DON'T KNOW 88 → B6
B1a B2 In what month and year did she die? MONTH ALL DON'T KNOW 88 [CHECK: month and year of mother's death should YEAR → B6 be between date of last interview and date of the current interview] DON'T KNOW 8888
B3 B3 [CHECK A16: IF ATTENDS SCHOOL ASK:] Does your biological mother reside in the household in which you live while you attend school? NO 0 [ELSE ASK:] YES 1 Does your biological mother reside in the household in which you live?
B5 B4 What is your biological mother's current marital NEVER MARRIED 0 status? MARRIED: BIOLOGICAL FATHER 1 [IF MARRIED/IN UNION, ASK:] MARRIED: OTHER PERSON 2 With your biological father or someone else? SEPARATED 3 DIVORCED 4 WIDOWED 5 DON'T KNOW 88
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B9a B5 Since [reference-sheet: date last interview], has NO 0 your biological mother given birth to any children? YES 1 DON'T KNOW 88
C15 B6 How many living brothers does your biological TOTAL NUMBER mother have? DON'T KNOW 88
SECTION C: RESPONDENT'S BIOLOGICAL FATHER QUESTIONS RESPONSES SKIPS
Script_C [READ:] Now I would like to ask you about your biological father.
[CHECK REFERENCE-SHEET: IF BIOLOGICAL FATHER WAS ALIVE → C1; ELSE ASK C0] C0 C0 Was your biological father alive on [reference- NO 0 → C8 sheet: date last interview]? YES (Reference-sheet incorrect) 2 DON'T KNOW 88 → C8
C1 C1 Is your biological father still living? NO 0 YES 1 → C3 DON'T KNOW 88 → C8
C1a C2 In what month and year did he die? MONTH ALL → C8 [CHECK: month and year of father's death should YEAR be between date of last interview and date of the current interview] DON'T KNOW 88
C3 C3 [CHECK A16: IF ATTENDS SCHOOL ASK:] Does your biological father reside in the household in which you live while you attend school? NO 0 [ELSE ASK:] YES 1 Does your biological father reside in the household in which you live?
C5 C4 What is your biological father's current marital NEVER MARRIED 0 → C7 status? MARRIED 1 SEPARATED 2 → C7 DIVORCED 3 → C7 WIDOWED 4 → C7 DON'T KNOW 88 → C7
[CHECK B5: IF MARRIED TO BIOLOGICAL MOTHER → C6] C6 C5 Is your biological father currently married to your NO 0 biological mother? YES 1 DON'T KNOW 88
C7 C6 In total, how many women is your biological father TOTAL NUMBER currently married to? DON'T KNOW 88
C11a C7 Since [reference-sheet: date last interview], how TOTAL NUMBER many living children has your biological father had with other women besides your biological mother? DON'T KNOW 88
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[CHECK A16: IF ATTENDS SCHOOL ASK C8; ELSE → D0] C16 C8 During the first school term of this school year, who paid the most for your […]? [READ ALL OPTIONS] [USE RELATIONSHIP CODES]
a. School supplies (notebook, pencil, paper, a. SCHOOL SUPPLIES bag) b. School uniform (clothing to wear to school) b. SCHOOL UNIFORM
c. Shoes for school c. SHOES FOR SCHOOL
d. Food/snack money for school d. FOOD/SNACK MONEY
e. Tutoring/extra lessons e. TUTORING
f. Basic necessities (soap) f. BASIC NECESSITIES
[CHECK A22: IF ATTENDS SECONDARY OR TERTIARY ASK C9; ELSE → C10] C16a C9 Who pays your school fees? [USE RELATIONSHIP CODES]
[RECORD ALL MENTIONS] a. PERSON 1 [IF NO ONE ELSE, ENTER '00'] b. PERSON 2
c. PERSON 3
[CHECK A22: IF ATTENDS PRIMARY OR SECONDARY ASK C10; ELSE → D0] C17 C10 [IF ATTENDS PRIMARY ASK:] NO 0 Do you think you will be able to continue to YES 1 → C12 secondary school? DON'T KNOW 88 → C12 [IF ATTENDS SECONDARY ASK:] Do you think you will be able to continue to post- secondary education?
C18 C11 [IF ATTENDS PRIMARY, ASK:] NOT DOING WELL AT SCHOOL 1 What is the main reason that you think you will not DON'T LIKE SCHOOL 2 continue on to secondary school? PARENTS/GUARDIAN DON'T WANT TO 3 ALL FINANCIAL/COSTS 4 [IF ATTENDS SECONDARY, ASK:] NEED TO WORK/EARN MONEY 5 → D0 What is the main reason that you think you will not TRAVEL/DISTANCE TO SCHOOL 6 continue on to post-secondary school? OTHER ______7 DON'T KNOW 88 [DO NOT READ LIST; CIRCLE MAIN REASON]
C19 C12 [IF ATTENDS PRIMARY ASK:] [USE RELATIONSHIP CODES] If you do attend secondary school, who will pay your school fees? a. PERSON 1 [IF ATTENDS SECONDARY ASK:] If you do attend post-secondary school, who will b. PERSON 2 pay your school fees? c. PERSON 3 [RECORD ALL MENTIONS] [IF NO ONE ELSE, ENTER '00']
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SECTION D: HOUSEHOLD CHARACTERISTICS QUESTIONS RESPONSES SKIPS
D0 [CHECK A16: IF ATTENDS SCHOOL READ:] [FILL IN HOUSEHOLD ROSTER] Now I would like to ask about the household in which you live while you are attending school.
[ELSE READ:] Now I would like to ask about the household in which you live.
D23 D12 What types of activities does the head of your household do to support the family? Does s/he do […]? [READ ALL OPTIONS] NO YES DK
a. Subsistence farming a. 0 1 88 b. Commercial farming b. 0 1 88 c. Animal husbandry c. 0 1 88 d. Salaried employment d. 0 1 88 e. Temporary: kwacha or in kind/ganyu e. 0 1 88 f. Skilled artisan f. 0 1 88 g. Market vendor/sellers g. 0 1 88 h. Domestic/cook/garden worker h. 0 1 88 i. Other ______i. 0 1 88
D13 Does the head of your household receive external NO 0 → D14 financial support or remittances from someone YES 1 who is not resident in the household?
[USE RELATIONSHIP CODES] [IF YES:] Who provides this support? a. PERSON 1 [RECORD RELATIONSHIP TO HOUSEHOLD HEAD] b. PERSON 2 [IF NO ONE ELSE, ENTER '00'] c. PERSON 3
D23c D14 Is your current household the same household as NO 0 the one you lived in [reference-sheet: date last YES 1 → D16 interview]?
D23e D15 What is the main reason you left your previous household?
[DO NOT READ LIST; TICK ALL REASONS MENTIONED. CIRCLE MAIN REASON]
SCHOOL REASONS 1 Quality of this school 1 [___] 2 PSLE/JSCE/MSCE better at this school 2 [___] 3 Other reason this school______3 [___] 4 Poor quality of previous school 4 [___] 5 Problems with teachers at previous school 5 [___] 6 Problems with students at previous school 6 [___] 7 Other reason previous school______7 [___] 8 Attend secondary or tertiary school 8 [___] OTHER REASONS 9 Death: Parent/Guardian 9 [___] 10 Death: Other HH member 10 [___] 11 Illness: Parent/Guardian 11 [___] 12 Illness: Other HH member 12 [___] 13 Biological parents: Separated/Divorced 13 [___] 14 Lower crop yields: Draught/Disease/Price drops 14 [___] 15 Loss of livestock 15 [___] 16 Job loss/Business failure (non-farming) 16 [___] 17 Economic opportunity: Self 17 [___] 18 Economic opportunity: Parent(s) 18 [___] 19 Economic opportunity: Other HH member 19 [___] 20 Fostered for other reason 20 [___] 21 Conflict with family members 21 [___] 22 Other relatives needed help 22 [___] 23 Moved with parents 23 [___] 24 Rejoined parents 24 [___] 25 Marriage 25 [___] 26 Other ______26 [___] 88 DON'T KNOW 88 [___]
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D23f D16 Has any member of your current household died NO 0 → E1 since this time last year? YES 1 DON'T KNOW 88 → E1
D23g D17 Who in your current household has died since this [USE RELATIONSHIP CODES] time last year? a. PERSON 1
[RECORD RELATIONSHIP TO RESPONDENT] b. PERSON 2
[IF NO ONE ELSE, ENTER '00'] c. PERSON 3
SECTION E: HOUSING CHARACTERISTICS QUESTIONS RESPONSES SKIPS
E1 E1 Does your household have any of the following?
[READ LIST] NO YES DK
a. Mattress a. 0 1 88 b. Sofa b. 0 1 88 c. Table c. 0 1 88 d. Chairs d. 0 1 88 e. Paraffin/gas lamp e. 0 1 88 f. Television f. 0 1 88 g. Radio g. 0 1 88 h. Cell phone h. 0 1 88 i. Mosquito net i. 0 1 88 j. Bicycle j. 0 1 88 k. Motorcycle k. 0 1 88 l. Car l. 0 1 88 m. Tin roof m. 0 1 88 n. Electricity n. 0 1 88 o. Boat/Canoe o. 0 1 88 p. Sewing machine p. 0 1 88 q. Books to read q. 0 1 88 [IF HAS BOOKS ASK:] r. How many books? r. 888
s. How many of these books are for children? s. 888
E1a E2 What is the main source of lighting in your NO LIGHTING 0 household? FIRE 1 CANDLE 2 PARAFFIN/GAS LAMP 3 ELECTRICITY 4 TORCH 5
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E1b E3 Does anyone in your household own a market NO 0 stall? YES 1 DON'T KNOW 88
E1c E4 Does anyone in your household rent a market NO 0 stall? YES 1 DON'T KNOW 88
E2 E5 I'm now going to read a list of animals. How many of the following animals does your household own? [READ LIST] NUMBER DK
a. Goats a. 888
b. Poultry b. 888
c. Sheep c. 888
d. Cattle d. 888
E3 E6 Does anyone in your household own farm land? NO 0 YES 1 DON'T KNOW 88
E4 E7 Does anyone in your household rent farm land? NO 0 YES 1 DON'T KNOW 88
E5 E8 Does the land your household works have NO 0 irrigation other than rain-water? YES 1 NO LAND WORKED 2 → E10
E6 E9 Did your household fertilize the crops that were NO 0 just harvested? YES 1 NO CROPS HARVESTED 2
E8 E10 What is the main source of drinking water for Piped (dwelling/compound) 1 → E12 members of your household? Piped (public/shared) 2 Open well: protected (dwelling/compound) 3 → E12 Open well: protected (public/shared) 4 Open well: unprotected (dwelling/compound) 5 → E12 Open well: unprotected (public/shared) 6 Borehole (dwelling/compound) 7 → E12 Borehole (public/shared) 8 Spring/river/pond/dam 9 Other______10
E9 E11 How long does it take to go to that source get a. HOURS water, and come back? b. MINUTES [If less than 1 hour: record 00 hours and record the minutes] DON'T KNOW 88
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E10 E12 What kind of toilet facility does your household Flush toilet 1 have? VIP pit latrine (lid, cement floor, fly trap) 2 Standard pit latrine (cement floor) 3 Traditional pit latrine (mud floor) 4 No facility/bush/field/throw away 5
E11 E13 What is the main flooring material used in your Natural (earth/sand/mud/dung) 1 household? Rudimentary (wood/broken brick) 2 Finished (polished wood/cement/tile) 3 Other______4
E12 E14 What is the type of fuel mainly used for cooking in ELECTRICITY 1 your household? PARAFFIN 2 CHARCOAL 3 FIREWOOD 4 STRAW 5 OTHER ______6
E13 E15 What is the total number of rooms in your ROOMS household or compound, including bedrooms, living rooms, and rooms in which you eat?
SECTION F: RESPONDENT'S CHARACTERISTICS QUESTIONS RESPONSES SKIPS
Script_F [READ:] Now I would like to ask a few questions about your religious practices.
F4 F1 What religion are you? NO RELIGION 0 → Sect G CATHOLIC 1 [If Muslim: ask if Quadiriya or Sukutu] QUADIRIYA MUSLIM 2 [If Christian: ask what denomination] SUKUTU MUSLIM 3 "JUST MUSLIM" 4 CCAP 5 CHURCH OF CHRIST 6 BAPTIST 7 ANGLICAN 8 PENTECOSTAL/CHARISMATIC 9 SEVENTH DAY ADVENTIST 10 JEHOVA'S WITNESS 11 INDIGENOUS CHRISTIAN 12 INDIGENOUS NON-CHRISTIAN 13 "JUST CHRISTIAN" 14 OTHER ______15
F5 F2 When was the last time you attended religious NEVER 0 → F4 services at a church or mosque? 6 MONTHS AGO OR MORE 1 → F4 2-5 MONTHS AGO 2 → F4 IN THE LAST MONTH 3 IN THE LAST WEEK 4 TODAY 5
[IF CHRISTIAN ASK F3; ELSE → F4:] ONCE 1 F6 F3 In the last month, how regularly did you attend LESS THAN ONCE A WEEK 2 religious services? ONCE A WEEK 3 2-3 TIMES PER WEEK 4 EVERYDAY 5
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F8 F4 In the previous week, how often did you pray NOT AT ALL 0 during the day? ONCE 1 A FEW TIMES 2 ONCE A DAY 3 A FEW TIMES PER DAY 4 5 TIMES PER DAY, EVERYDAY 5
SECTION G: SCHOOLING AND USE OF SKILLS QUESTIONS RESPONSES SKIPS
Script_G G0 Now I would like to ask you some things about [FILL IN SCHOOLING ROSTER] your schooling.
[CHECK A16: IF ATTENDS SCHOOL ASK G11; ELSE → G16] G3 G11 How long did it take you to get to school today/the a. HOURS last day you went to school? b. MINUTES [If less than 1 hour: record 00 hours and record the minutes] DON'T KNOW 88
G4 G12 Do you have […]? [READ LIST] NO YES
a. School uniform a. 0 1 b. Shoes for school b. 0 1 c. Own bag for books c. 0 1 d. Own pens/pencils d. 0 1 e. Exercise/work book e. 0 1 f. All of your textbooks f. 0 1
G36 G13 In the last week you attended school, did you use G14 G15 textbooks in class for the following subjects? [ASK IF G13 = YES] [ASK FOR ALL] Did you share the book Do you have [READ LIST] with other pupils? textbooks you can use at home?
NOYES N/A NOYES NO YES a. Chichewa a. 01 9 a. 0 1 a. 0 1 b. English b. 01 9 b. 0 1 b. 0 1 c. Life Skills c. 01 9 c. 0 1 c. 0 1 d. Mathematics d. 01 9 d. 0 1 d. 0 1 e. Agriculture e. 01 9 e. 0 1 e. 0 1 f. Geography f. 01 9 f. 0 1 f. 0 1 g. History g. 01 9 g. 0 1 g. 0 1 h. French h. 01 9 h. 0 1 h. 0 1 i. Social Development i. 01 9 i. 0 1 i. 0 1
NEW Q G16 In your everyday life, how often do you usually ALMOST EVERY DAY 1 read newspapers, magazines, books or AT LEAST ONCE A WEEK 2 pamphlets? AT LEAST ONCE A MONTH 3 [Read response options one time through] LESS THAN ONCE A MONTH 4 NEVER 5
NEW Q G17 In your everyday life, how often do you usually ALMOST EVERY DAY 1 read directions or instructions? AT LEAST ONCE A WEEK 2 AT LEAST ONCE A MONTH 3 LESS THAN ONCE A MONTH 4 NEVER 5
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NEW Q G18 In your everyday life, how often do you usually ALMOST EVERY DAY 1 read diagrams or maps? AT LEAST ONCE A WEEK 2 AT LEAST ONCE A MONTH 3 LESS THAN ONCE A MONTH 4 NEVER 5
NEW Q G19 In your everyday life, how often do you usually ALMOST EVERY DAY 1 read any other written materials? AT LEAST ONCE A WEEK 2 Specify: ______AT LEAST ONCE A MONTH 3 LESS THAN ONCE A MONTH 4 NEVER 5
NEW Q G20 In your everyday life, how often do you usually ALMOST EVERY DAY 1 write letters, memos or notes? AT LEAST ONCE A WEEK 2 AT LEAST ONCE A MONTH 3 LESS THAN ONCE A MONTH 4 NEVER 5
NEW Q G21 In your everyday life, how often do you usually ALMOST EVERY DAY 1 write text messages? AT LEAST ONCE A WEEK 2 AT LEAST ONCE A MONTH 3 LESS THAN ONCE A MONTH 4 NEVER 5
NEW Q G22 In your everyday life, how often do you usually fill ALMOST EVERY DAY 1 in forms? AT LEAST ONCE A WEEK 2 AT LEAST ONCE A MONTH 3 LESS THAN ONCE A MONTH 4 NEVER 5
NEW Q G23 In your everyday life, how often do you usually ALMOST EVERY DAY 1 write anything else? AT LEAST ONCE A WEEK 2 Specify: ______AT LEAST ONCE A MONTH 3 LESS THAN ONCE A MONTH 4 NEVER 5
NEW Q G24 In your everyday life, how often do you usually ALMOST EVERY DAY 1 calculate prices, costs or budgets? AT LEAST ONCE A WEEK 2 AT LEAST ONCE A MONTH 3 LESS THAN ONCE A MONTH 4 NEVER 5
NEW Q G25 In your everyday life, how often do you usually ALMOST EVERY DAY 1 calculate fractions, decimals or percentages? AT LEAST ONCE A WEEK 2 AT LEAST ONCE A MONTH 3 LESS THAN ONCE A MONTH 4 NEVER 5
NEW Q G26 In your everyday life, how often do you usually use ALMOST EVERY DAY 1 a calculator? AT LEAST ONCE A WEEK 2 AT LEAST ONCE A MONTH 3 LESS THAN ONCE A MONTH 4 NEVER 5
NEW Q G27 In your everyday life, how often do you usually ALMOST EVERY DAY 1 listen to the radio? AT LEAST ONCE A WEEK 2 AT LEAST ONCE A MONTH 3 LESS THAN ONCE A MONTH 4 NOT AT ALL 5
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NEW Q G28 In your everyday life, how often do you usually ALMOST EVERY DAY 1 watch television? AT LEAST ONCE A WEEK 2 AT LEAST ONCE A MONTH 3 LESS THAN ONCE A MONTH 4 NOT AT ALL 5
[CHECK A16: IF ATTENDS SCHOOL PROCEED TO SECTION H; ELSE → SECTION K]
SECTION H: CLASSROOM PRACTICES AND EXPERIENCES QUESTIONS RESPONSES SKIPS
[READ:] Now we would like to ask you about your experiences in the classroom. For these questions we want you to think about your experience during the last week you attended school.
H1 H1 How often does your teacher encourage pupils to express their opinions in NEVER 0 class? SOME DAYS 1 [Read response options one time through] EVERYDAY 2
H2 H2 How often does your teacher encourage pupils to have discussions in class? NEVER 0 SOME DAYS 1 EVERYDAY 2
H3 H3 How often does your teacher encourage pupils to work together on class NEVER 0 assignments? SOME DAYS 1 EVERYDAY 2
H4 H4 How often does your teacher work individually with pupils to help them with their NEVER 0 lessons and assignments? SOME DAYS 1 EVERYDAY 2
H5 H5 How often does your teacher assign homework? NEVER 0 SOME DAYS 1 EVERYDAY 2
H6 H6 How often does your teacher praise pupils when they do well in class? NEVER 0 SOME DAYS 1 EVERYDAY 2
H7 H7 How often does your teacher scold pupils when they do not understand their NEVER 0 lessons? SOME DAYS 1 EVERYDAY 2
H8 H8 How often does your teacher tease or mock pupils based on their intelligence? NEVER 0 SOME DAYS 1 EVERYDAY 2
H9 H9 How often does your teacher tease or mock pupils based on their appearance or NEVER 0 general cleanliness? SOME DAYS 1 EVERYDAY 2
H10 H10 If some of the class does not understand something, how often does the teacher NEVER 0 call on other pupils to help explain it to the class? SOME DAYS 1 EVERYDAY 2
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SECTION I: HOUSEHOLD SUPPORT OF STUDENTS' SCHOOLING QUESTIONS RESPONSES SKIPS
I1 I1 During the current/recent school year, has anyone in your household NO 0 discouraged or prevented you from attending school? YES 1
I2 I2 During the current/recent school year, has anyone in your household helped you NO 0 with your schoolwork or lessons? YES 1
I3 I3 During the current/recent school year, has anyone in your household talked to NO 0 your teacher about your performance in school? YES 1
I4 I4 During the current/recent school year, has anyone in your household been a NO 0 member of the school committee or attended PTA meetings? YES 1
SECTION J: SCHOOLING ENGAGEMENT AND ATTACHMENT QUESTIONS RESPONSES SKIPS
[READ:] Now we would like to ask you about your participation and interest in school. For these questions we would like you to tell us if you disagree or agree with the following statements.
J1 J1 You do not attend school regularly. Do you: DISAGREE 1 [J1-J8: read options 1 and 2 ONLY] AGREE 2 NO OPINION/DON'T KNOW 88
J2 J2 You are attentive in class. Do you: DISAGREE 1 AGREE 2 NO OPINION/DON'T KNOW 88
J3 J3 You rarely complete the tasks that are assigned to DISAGREE 1 you in class. Do you: AGREE 2 NO OPINION/DON'T KNOW 88
J4 J4 Education is not important to you. Do you: DISAGREE 1 AGREE 2 NO OPINION/DON'T KNOW 88
J5 J5 You respect your teachers. Do you: DISAGREE 1 AGREE 2 NO OPINION/DON'T KNOW 88
J6 J6 There is no adult at school whom you can talk to if DISAGREE 1 you have a problem. Do you: AGREE 2 NO OPINION/DON'T KNOW 88
J7 J7 You study at home even if you do not have an DISAGREE 1 exam. Do you: AGREE 2 NO OPINION/DON'T KNOW 88
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J8 J8 Your teacher would not notice if you were absent DISAGREE 1 from school. Do you: AGREE 2 NO OPINION/DON'T KNOW 88
SECTION K: HOUSEHOLD LABOR, EMPLOYMENT AND SAVINGS QUESTIONS RESPONSES SKIPS
Script_P1 [READ:] I would like to ask you about some activities that people do to help their families or to support themselves.
P1 K1 Yesterday, how much time did you spend doing a. HOURS household chores, such as cooking, cleaning, laundry, collecting firewood, water? b. MINUTES
[If less than 1 hour: record 00 hours and record the minutes] NO CHORES DONE 0
P2 K2 Excluding household chores, are you currently NO 0 working without receiving pay, or for kwacha or YES 1 → K3a some other form of payment? (Include work you did outside the household on your own family's farm or business.)
P3 K3 In the past 12 months, excluding household NO 0 → Sect L chores, did you ever work without receiving pay, YES 1 → K3b or for kwacha or some other form of payment? (Include work you did outside the household on your own family's farm or business.)
Script_P4a K3a [READ:] Now I would like to ask you some questions about the different types of work ―unpaid, for kwacha or some other form of payment ― that you might have done in the past 12 months, starting with the work you → K4 are currently doing.
Script_P4b K3b [READ:] Now I would like to ask you some questions about the different types of work ―unpaid, for kwacha or some other form of payment ― that you might have done in the past 12 months, starting with the last work that you did.
K4 [INSTRUCTIONS: Complete questions K5-K19 for EACH work/job done in the TOTAL JOBS IN past 12 months, starting with the current or most recent one. If more than 3, PAST 12 MONTHS: record the total number of work/jobs done in the past 12 months and ask K5-K19 only about the 3 most recent.]
1st job 2nd job 3rd job
P4 K5 What type of work [are/were] you doing?
[Circle only one type of work in each column]
SUBSISTENCE FARMING 1 1 1 1 COMMERCIAL FARMING 2 2 2 2 ANIMAL HUSBANDRY 3 3 3 3 SALARIED EMPLOYMENT 4 4 4 4 TEMPORARY: KWACHA OR IN KIND/GANYU 5 5 5 5 SKILLED ARTISAN 6 6 6 6 MARKET VENDOR/SELLERS 7 7 7 7 DOMESTIC/COOK/GARDEN WORKER 8 8 8 8 OTHER 9 9 9 9 (SPECIFY OTHER)
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P5 K6 In what month and year did you start doing this type of work?
a. MONTH START WORK a. a. a.
b. YEAR START WORK b. b. b.
DON'T KNOW 88 88 88
P6 K7 Do/did you do this work for a member of your family, for someone else, or are you self- employed?
WORK FOR FAMILY1 1 1 1 WORK FOR SOMEONE ELSE 2 2 2 2 SELF-EMPLOYED3 3 3 3
P7 K8 Is/was this work seasonal, throughout the year, or does it depend on the work-load?
SEASONAL WORK1 1 1 1 THROUGHOUT THE YEAR 2 2 2 2 DEPENDS ON WORKLOAD 3 3 3 3 DON'T KNOW 88 88 88
P8 K9 How many months did you do this work on the past year?
NUMBER OF MONTHS
LESS THAN 1 MONTH 0 0 0 DON'T KNOW 88 88 88
P9 K10 How many days in the week do/did you do this work, on average?
NUMBER OF DAYS
DON'T KNOW 88 88 88
P10 K11 How many hours a day do/did you do this work, on average?
NUMBER OF HOURS
DON'T KNOW 88 88 88
P11 K12 Are/were you paid in kwacha for doing this work?
NO 0 0 0 0 → K15 YES 1 1 1 1
P13 K13 Are/were you paid daily, weekly, monthly, or on what basis?
DAILY 1 1 1 1 WEEKLY 2 2 2 2 EVERY TWO WEEKS 3 3 3 3 MONTHLY4 4 4 4 SEASONAL5 5 5 5 OTHER 6 6 6 6 (SPECIFY OTHER) DON'T KNOW 88 88 88
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P12 K14 The last time you were paid, how much did you receive in kwacha for doing this work?
KWACHA
DON'T KNOW 88 88 88
P15 K15 Are/were you paid in-kind for doing this work?
NO 0 0 0 0 → K17 YES 1 1 1 1
P16 K16 On a daily basis, how much would you say the in- kind pay you receive/received for your work is worth in kwacha?
KWACHA
DON'T KNOW 88 88 88
P17 K17 Did you ever spend a night away from your village/area because of this work during the past year?
NO 0 0 0 0 → K19 YES 1 1 1 1
P18 K18 How long did this work keep you away from your village/area during the past 12 months?
a. DAYS a. a. a.
b. WEEKS b. b. b.
c. MONTHS c. c. c.
DON'T KNOW 88 88 88
P19 K19 In what month and year did you stop doing this type of work?
a. MONTH STOP WORK a. a. a.
b. YEAR STOP WORK b. b. b.
STILL DOING THIS WORK 0 0 0 DON'T KNOW 88 88 88
[CHECK: IF K4 IS MORE THAN 1, GO BACK TO K5; ELSE, PROCEED TO K20]
P20 K20 Currently, or in the past 12 months, have you REVISED worked outside the household […]? TRANSLATION NO YES
a. On the family farm a. 0 1 b. In a family business b. 0 1 c. In any other family economic activity c. 0 1
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P21 K21 Do you decide how the money you earn will be NO 0 used? YES 1 DON'T EARN MONEY 2
NEW Q K22 Have you saved, or put money aside to use at a NO 0 → Sect L later time, in the past 12 months? YES 1
NEW Q K23 In the past 12 months, in which of the following K24 places have you saved your money? [ASK IF K23 = YES] About how much money do you [READ LIST] currently have saved in this NO YES place?
a. At home (under the mattress, in a box, hole a. 0 1 a. MK in the ground) b. With a friend b. 0 1 b. MK
c. With parents/guardian c. 0 1 c. MK
d. Savings group d. 0 1 d. MK
e. Bank account e. 0 1 e. MK
f. Shopkeeper f. 0 1 f. MK
g. Other ______g. 0 1 g. MK
NEW Q K25 What are you saving for? EMERGENCIES 1 PERSONAL ITEMS (e.g. clothes) 2 [DO NOT READ LIST; CIRCLE ALL MENTIONED] HOUSEHOLD EXPENSES (e.g. food, rent) 3 SCHOOL FEES FOR SELF 4 SCHOOL FEES FOR OTHERS 5 SCHOOL SUPPLIES 6 OWN BUSINESS 7 FAMILY BUSINESS 8 AGRICULTURAL INPUTS (e.g. seeds) 9 MEDICAL/HEALTH EXPENSES FOR SELF 10 MEDICAL/HEALTH EXPENSES FOR OTHERS 11 GIFTS 12 TRANSPORT/TRIPS 13 GENERAL FUTURE USE 14 OTHER ______15
SECTION L: MARRIAGE AND THE MARRIAGE PROCESS QUESTIONS RESPONSES SKIPS
Script_Q [READ:] Now I would like to ask some questions about marriage.
Q1 L1 Have you ever been married or lived with NO 0 → L3a someone as if married? YES 1
Q1a L2 What is your current marital status? Are you now MARRIED/LIVING TOGETHER 1 …? SEPARATED 2 [READ LIST] DIVORCED 3 WIDOWED 4
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Q2 L3 Now, I would like you to think back to all of your NUMBER OF TIMES relationships. How many times have you been married or lived with someone as if married?
Q2a L3a [CHECK REFERENCE-SHEET AND L1; CIRCLE:] MARRIAGE RECONCILIATION = NO AND L1 = NO 0 → Sect M MARRIAGE RECONCILIATION = NO AND L1 = YES 1 → L3b MARRIAGE RECONCILIATION = YES 2 → MarrRec
Script_Q4 L3b [READ:] Now I would like to ask you some questions about your marriage(s) or the time(s) you lived together with someone as if married, starting with the first person you ever married/lived with.
1st marriage 2nd marriage 3rd marriage
Q3 L4 Name of spouse or partner:
Q4 L5 What age were you when you first married [NAME]?
AGE
DON'T KNOW 88 88 88
Q5 L6 What age were you when you first started living with [NAME]?
AGE
DON'T KNOW 88 88 88
Q6 L7 Compared to your age, how old is [NAME]?
YOUNGER THAN YOU 1 1 1 1 ABOUT THE SAME AGE 2 2 2 2 1-4 YEARS OLDER 3 3 3 3 5-9 YEARS OLDER 4 4 4 4 10 OR MORE YEARS OLDER 5 5 5 5 DON'T KNOW 88 88 88 88
Q7 L8 What is [NAME]'s level of schooling?
NO SCHOOL0 0 0 0 SOME PRIMARY1 1 1 1 COMPLETED PRIMARY 2 2 2 2 SOME SECONDARY 3 3 3 3 COMPLETED SECONDARY 4 4 4 4 TERTIARY5 5 5 5 DON'T KNOW 88 88 88 88
Q8 L9 Did [NAME] or his family promise to make a payment to your family when you got married?
NO 0 0 0 0 → L12 YES 1 1 1 1 DON'T KNOW 88 88 88 88 → L12
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Q9 L10 How much was promised in total? [READ LIST]
a. KWACHA a. a. a.
b. CATTLE b. b. b.
c. GOATS c. c. c.
d. POULTRY d. d. d.
e. OTHER e. e. e.
(SPECIFY OTHER)
Q10 L11 How much has been paid so far?
NONE 0 0 0 0 SOME 1 1 1 1 MOST 2 2 2 2 ALL 3 3 3 3
Q11 L12 Was the mediation of ankhoswe involved in your marriage with [NAME]?
NO 0 0 0 0 YES 1 1 1 1
Q12 L13 Was [NAME] chosen for you, or did you choose each other?
CHOSE EACH OTHER 0 0 0 0 CHOSEN BY SOMEONE ELSE 1 1 1 1
[MALES → L18; FEMALES, ASK:] NEW Q L14 In your marriage to [NAME], were you a chimeta masisi (replacement for a deceased wife)?
NO 0 0 0 0 YES 1 1 1 1 DON'T KNOW 88 88 88 88
NEW Q L15 In your marriage to [NAME], were you a mbiriya or nthena (bonus wife)?
NO 0 0 0 0 YES 1 1 1 1 DON'T KNOW 88 88 88 88
NEW Q L16 Was your marriage to [NAME] (part) payment of a debt?
NO 0 0 0 0 YES 1 1 1 1 DON'T KNOW 88 88 88 88
NEW Q L17 Were you kidnapped into the marriage to [NAME]?
NO 0 0 0 0 YES 1 1 1 1
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NEW Q L18 Were you forced into the marriage with [NAME] due to pregnancy?
NO 0 0 0 0 YES 1 1 1 1
Q12a L19 What type of marriage ceremony did you have with [NAME]? [CIRCLE ALL THAT APPLY]
NONE (LIVING TOGETHER) 0 0 0 0 RELIGIOUS1 1 1 1 TRADITIONAL2 2 2 2 CIVIL 3 3 3 3 OTHER 4 4 4 4 (SPECIFY OTHER)
NEW Q L20 After your marriage to [NAME], where did you and your spouse live?
SAME VILLAGE AS YOUR FAMILY 0 0 0 0 SAME VILLAGE AS SPOUSE'S FAMILY 1 1 1 1 OTHER LOCATION 2 2 2 2
NEW Q L21 At the time of your marriage to [NAME], did both of your families approve of the marriage?
BOTH FAMILIES APPROVED 1 1 1 1 ONLY MY FAMILY APPROVED 2 2 2 2 ONLY MY SPOUSE'S FAMILY APPROVED 3 3 3 3 NEITHER FAMILY APPROVED 4 4 4 4
NEW Q L22 Before you got married to [NAME], did you …? NOYES NOYES NOYES
a. Talk to [NAME] about how to prevent HIV? a. 0 1 a. 0 1 a. 0 1 b. Get tested for HIV? b. 0 1 b. 0 1 b. 0 1 c. Share your HIV status with [NAME]? c. 0 1 c. 0 1 c. 0 1 d. Talk to [NAME] about being faithful? d. 0 1 d. 0 1 d. 0 1 e. Talk to [NAME] about condoms? e. 0 1 e. 0 1 e. 0 1
Q13 L23 Are you still married/living together as if married with [NAME]?
NO 0 0 0 0 YES 1 1 1 1 → L27
Q14 L24 Did you separate or become divorced or widowed from [NAME]?
SEPARATED1 1 1 1 DIVORCED2 2 2 2 WIDOWED3 3 3 3
Q15 L25 What age were you when you became [widowed/ separated/ divorced] from [NAME]?
AGE
DON'T KNOW 88 88 88
NEW Q L26 Why did your marriage to [NAME] end? [DO NOT READ OPTIONS]
INFIDELITY1 1 1 1 ABANDONED BY [NAME] 2 2 2 2 DISAGREEMENT/FIGHTING 3 3 3 3 FINANCIAL TROUBLE 4 4 4 4 ALL Page 24 of 61 MSAS R6 Questionnaire Version 7 Aug. 2013 Adol ID: [__|__|__|__|__|__]
FAMILY PRESSURE 5 5 5 5 → Sect M POLYGYNY6 6 6 6 LACK OF CHILDREN 7 7 7 7 OTHER ______8 8 8 8
Q16 L27 Does [NAME] reside in the household in which you live?
NO 0 0 0 0 → L30 YES 1 1 1 1
Q17 L28 Does [NAME] ever spend the night away from your village/area because of work?
NO 0 0 0 0 → L30 YES 1 1 1 1 DON'T KNOW 88 88 88 → L30
Q18 L29 How long did this work keep [NAME] away from your village/area during the past year?
a. DAYS a. a. a.
b. WEEKS b. b. b.
c. MONTHS c. c. c.
DON'T KNOW 88 88 88
Q19 L30 [MALES → Sect M; FEMALES, ASK:] Does [NAME] have other wives?
NO 0 0 0 0 → Sect M YES 1 1 1 1 DON'T KNOW 88 88 88 88 → Sect M
Q20 L31 In total, how many other wives does [NAME] have?
NUMBER OF WIVES
DON'T KNOW 88 88 88
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NEW Q L32 Are you the first wife, second wife, or some other rank?
FIRST WIFE1 1 1 1 SECOND WIFE2 2 2 2 OTHER RANK3 3 3 3
SECTION M: CONTRACEPTIVE USE QUESTIONS RESPONSES SKIPS
HC3 modif M0 Now I would like to talk about family planning – the various ways or methods that a couple can use to delay or avoid a pregnancy.
[First : Circle Code 1 for each method mentioned spontaneously. Second : Proceed down the column, reading the name and description of each method not mentioned spontaneously; circle Code 2 if method recognized after reading description, and Code 3 if not recognized.]
M1 Which ways or methods have you heard about? [IF M1 IS YES:] M2 [FOR METHODS NOT MENTIONED SPONTANEOUSLY, ASK:] Have [you/ you and Have you heard of [METHOD]? your partner] ever used [METHOD]?
a. PILL: Women can take a pill every day to YES, SPONT 1 NO 0 avoid becoming pregnant. YES, RECOG 2 YES 1 NOT RECOG 3 MALES ONLY: DON'T KNOW 88
b. IUD: Women can have a loop or coil placed YES, SPONT 1 NO 0 inside them by a doctor or a nurse. YES, RECOG 2 YES 1 NOT RECOG 3 MALES ONLY: DON'T KNOW 88
c. INJECTABLES: Women can have an YES, SPONT 1 NO 0 injection by a health provider that stops them YES, RECOG 2 YES 1 from becoming pregnant for one or more NOT RECOG 3 MALES ONLY: months. DON'T KNOW 88
d. IMPLANTS: Women can have several small YES, SPONT 1 NO 0 rods placed in their upper arm by a doctor or YES, RECOG 2 YES 1 nurse which can prevent pregnancy for one NOT RECOG 3 MALES ONLY: or more years. DON'T KNOW 88
e. MALE CONDOM: Men can put a rubber YES, SPONT 1 NO 0 sheath on their erect penis before sexual YES, RECOG 2 YES 1 intercourse. NOT RECOG 3
f. FEMALE CONDOM: Women can place a YES, SPONT 1 NO 0 thin, transparent rubber in their vagina before YES, RECOG 2 YES 1 sexual intercourse. NOT RECOG 3 MALES ONLY: DON'T KNOW 88
g. RHYTHM METHOD: Every month that a YES, SPONT 1 NO 0 woman is sexually active she can avoid YES, RECOG 2 YES 1 pregnancy by not having sexual intercourse NOT RECOG 3 MALES ONLY: on the days of the month she is most likely to DON'T KNOW 88 get pregnant.
h. WITHDRAWAL: Men can pull out their penis YES, SPONT 1 NO 0 from the vagina before ejaculation. YES, RECOG 2 YES 1 NOT RECOG 3
i. EMERGENCY CONTRACEPTION: As an YES, SPONT 1 NO 0 emergency measure, women can take pills YES, RECOG 2 YES 1 up to three days after having unprotected sex NOT RECOG 3 MALES ONLY: to avoid getting pregnant. These pills are DON'T KNOW 88 also called "morning-after pills".
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NEW Q M3 Are [you/your partner] currently doing something or NO 0 → M8 DHS 310 using any method to delay or avoid getting YES 1 pregnant? CURRENTLY PREGNANT 2 → M8
NEW Q M4 Which method are [you/your partner] using? PILL 1 DHS 311 IUD 2 [CIRLCE ALL MENTIONED] INJECTABLES 3 IMPLANTS 4 MALE CONDOM 5 FEMALE CONDOM 6 RHYTHM METHOD 7 WITHDRAWAL 8 TRADITIONAL METHOD 9 OTHER (SPECIFY)______10 [MALES ONLY:] DON'T KNOW 88
NEW Q M5 [CHECK M4: Ask M5 if answer YES to PILL, IUD, INJECTABLES, IMPLANTS, MALE CONDOM, or DHS 332 FEMALE CONDOM; else → M6. If more than one method mentioned in M4, record each separately.]
Method 1 Method 2
a. RECORD METHOD FROM M4 a. a.
b. Where did you obtain [CURRENT METHOD] b. b. Facility code the last time? listed → M6 [USE FACILITY CODES] [ENTER '00' IF [ENTER '00' IF FACILITY CODE FACILITY CODE NOT LISTED ON NOT LISTED ON CODES SHEET] CODES SHEET] [IF FACILITY NOT LISTED ON CODES SHEET, RECORD THE NAME AND DISTRICT OF FACILITY:] FACILITY NAME b2. b2.
DISTRICT OF FACILITY b3. b3. [USE DISTRICT CODES]
c. What type of facility is this? [PROBE TO DETERMINE SOURCE]
PUBLIC SECTOR GOVERNMENT HOSPITAL 1 1 1 GOVERNMENT HEALTH CENTRE 2 2 2 GOVERNMENT HEALTH POST 3 3 3 MOBILE CLINIC/OUTREACH 4 4 4 HSA 5 5 5 CBDA/DOOR-TO-DOOR 6 6 6 OTHER PUBLIC7 7 7 CHAM/MISSION HOSPITAL8 8 8 HEALTH CENTRE 9 9 9 MOBILE CLINIC/OUTREACH 10 10 10
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PRIVATE MEDICAL SECTOR PRIVATE HOSPITAL/CLINIC/DOCTOR 11 11 11 PHARMACY 12 12 12 MOBILE CLINIC/OUTREACH 13 13 13 CBDA/DOOR-TO-DOOR 14 14 14 OTHER PRIVATE MEDICAL 15 15 15 OTHER SOURCE BLM (MARIE STOPES) 16 16 16 YOUTH DROP-IN CENTRE 17 17 17 SHOP 18 18 18 CHURCH 19 19 19 TRADITIONAL HEALER 20 20 20 FRIEND/RELATIVE 21 21 21 OTHER SPECIFY ______22 22 22
NEW Q M6 [MALES → SECT N; FEMALES, ASK:] NO 0 → SECT N DHS 719 Does your [husband/partner] know that you are YES 1 using a method of family planning? NO CURRENT PARTNER 77 → SECT N DON'T KNOW 88
NEW Q M7 Would you say that using contraception is mainly MAINLY RESPONDENT 1 ALL DHS 720 your decision, mainly your [husband's/partner's] MAINLY HUSBAND/PARTNER 2 → SECT N decision, or did you both decide together? JOINT DECISION 3 OTHER ______4
NEW Q M8 Do you know of a place where you can obtain a NO 0 → SECT N method of family planning? YES 1
NEW Q M9 a. Where is that? Any other place?
[USE FACILITY CODES; RECORD ALL a1. Facility code MENTIONED] listed → M10 [ENTER '00' IF FACILITY CODE NOT LISTED [IF FACILITY NOT LISTED ON CODES ON CODES SHEET] SHEET, RECORD THE NAME AND DISTRICT OF FACILITY:]
FACILITY NAME a2.
DISTRICT OF FACILITY a3. [USE DISTRICT CODES]
b. What type of facility is this? [PROBE TO DETERMINE SOURCE]
PUBLIC SECTOR GOVERNMENT HOSPITAL 1 1 GOVERNMENT HEALTH CENTRE 2 2 GOVERNMENT HEALTH POST 3 3 MOBILE CLINIC/OUTREACH 4 4 HSA 5 5 CBDA/DOOR-TO-DOOR 6 6 OTHER PUBLIC 7 7 CHAM/MISSION HOSPITAL 8 8 HEALTH CENTRE 9 9 MOBILE CLINIC/OUTREACH 10 10 PRIVATE MEDICAL SECTOR PRIVATE HOSPITAL/CLINIC/DOCTOR 11 11 PHARMACY 12 12 MOBILE CLINIC/OUTREACH 13 13 CBDA/DOOR-TO-DOOR 14 14 OTHER PRIVATE MEDICAL 15 15
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OTHER SOURCE BLM (MARIE STOPES) 16 16 YOUTH DROP-IN CENTRE 17 17 SHOP 18 18 CHURCH 19 19 TRADITIONAL HEALER 20 20 FRIEND/RELATIVE 21 21 OTHER SPECIFY ______22 22
NEW Q M10 If you were interested in obtaining family planning, EASY 1 do you feel it would be easy, difficult or not DIFFICULT 2 possible to go to a place where you can obtain NOT POSSIBLE 3 family planning? DON'T KNOW 88
SECTION N: RESPONDENT'S BIRTH HISTORY QUESTIONS RESPONSES SKIPS
Script_BH1 [READ:] Now I would like to ask you a few questions about any children you may have had.
BH1 N1 [FEMALES:] Have you ever given birth? NO 0 → N9 [MALES:] Has a girl ever given birth to a child that YES 1 was yours? [MALES ONLY:] DON'T KNOW 88 → N16
BH2 N2 [FEMALES:] How many times have you given TOTAL BIRTHS birth? [MALES:] How many times has a girl given birth to a child that was yours, that you know of?
[MALES → N15; FEMALES, ASK:] NEW Q N3 Has your menstrual period returned since you NO 0 → N5 gave birth to your most recent child? YES 1
NEW Q N4 For how many months after that birth did you not MONTHS have a period? DON'T KNOW 88
NEW Q N5 Have you begun to have sexual intercourse again NO 0 → N7 since you gave birth to your most recent child? YES 1
NEW Q N6 For how many months after that birth did you not MONTHS have sexual intercourse?
LESS THAN ONE MONTH 0
DON'T KNOW 88
NEW Q N7 How many months after you gave birth to your MONTHS most recent child did you start using the Pill? DIDN'T USE 77 DON'T KNOW 88
NEW Q N8 How many months after you gave birth to your MONTHS most recent child did you start using injectables? DIDN'T USE 77 DON'T KNOW 88
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NEW Q N9 Are you pregnant now? NO 0 → N13 YES 1 UNSURE/DON'T KNOW 88 → N13
NEW Q N10 When did your last menstrual period start? DATE [if known] MONTH YEAR
[IF DATE NOT KNOWN, ENTER:] DAYS AGO
WEEKS AGO
YEARS AGO
BEFORE LAST BIRTH 77
NEVER MENSTRUATED 99
NEW Q N11 After the child you are expecting now, would you HAVE ANOTHER CHILD 1 DHS 702 like to have another child, or would you prefer not NO MORE CHILDREN 2 → N15 to have any more children? UNDECIDED/DON'T KNOW 88
NEW Q N12 After the birth of the child you are expecting now, MONTHS 1 DHS 703 how long would you like to wait before the birth of YEARS 2 another child? SOON/NOW 3 → N16 AFTER MARRIAGE 4 → N16 OTHER 5 → N16 DON'T KNOW 88 → N16
NEW Q N13 Would you like to have [a/another] child, or would HAVE A/ANOTHER CHILD 1 DHS 702 you prefer not to have any [more] children? NO (MORE) CHILDREN 2 → N15 CAN'T GET PREGNANT 3 → N16 UNDECIDED/DON'T KNOW 88 → N16
NEW Q N14 How long would you like to wait from now before MONTHS 1 DHS 703 the birth of [a/another] child? YEARS 2 SOON/NOW 3 → N16 AFTER MARRIAGE 4 → N16 OTHER 5 → N16 DON'T KNOW 88 → N16
NEW Q N15 [CHECK M3 and N9: IF M3=YES OR N9=YES → N16; ELSE, ASK:] DHS 707 [CHECK N10/N12 : IF WANTS A/ANOTHER Not married 1 CHILD, ASK:] FERTILITY-RELATED REASONS You have said that you do not want [a/another] Not having sex 2 child soon. Can you tell me why you are not using Infrequent sex 3 a method to prevent pregnancy? Hysterectomy 4 Can't get pregnant 5 [CHECK N10/N12 : IF WANTS NO (MORE) Not menstruated since last birth 6 CHILDREN, ASK:] Breastfeeding 7 You have said that you do not want any (more) Up to God/fate 8 children. Can you tell me why you are not using a OPPOSITION TO USE method to prevent pregnancy? Respondent opposed 9 Husband/partner opposed 10 Others opposed 11 [PROBE] Any other reason? Religious prohibition 12 LACK OF KNOWLEDGE [CIRCLE ALL REASONS MENTIONED] Knows no method 13 Knows no source 14
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METHOD-RELATED REASONS Side effects/health concerns 15 Lack of access/too far 16 Costs too much 17 Preferred method not available 18 No method available 19 Inconvenient to use 20 Interferes with body's normal processes 21 OTHER Specify ______22 Don't know 23
NEW Q N16 [CHECK N1: IF N1=YES, ASK:] DHS 713 If you could go back to the time before [you/your NUMBER OF CHILDREN partner] gave birth and could choose exactly the number of children to have in your whole life, how NONE 0 → N18 many would that be? UP TO GOD/FATE 77 → N18 DON'T KNOW 88 → N18a [CHECK N1: IF N1=NO/DK, ASK:] If you could choose exactly the number of children to have in your whole life, how many would that be?
NEW Q N17 How many of these children would you like to be NUMBER OF BOYS DHS 714 boys, how many would you like to be girls, and for how many would it not matter if it's a boy or a girl? NUMBER OF GIRLS
WOULD NOT MATTER [CHECK THAT THE SUM MATCHES THE TOTAL NUMBER OF CHILDREN IN N16] DON'T KNOW 88
NEW Q N18 Does your partner want the same number of SAME NUMBER 1 DHS 722 children that you want, or does [he/she] want more MORE CHILDREN 2 or fewer than you want? FEWER CHILDREN 3 NO CURRENT PARTNER 77 DON'T KNOW 88
BH2a N18a [CHECK REFERENCE-SHEET AND N1; CIRCLE:] BIRTH HISTORY RECONCILIATION = NO AND N1 = NO 0 → Sect O BIRTH HISTORY RECONCILIATION = NO AND N1 = YES 1 → N18b BIRTH HISTORY RECONCILIATION = YES 2 → BirthRec
Script_BH3 N18b [FEMALES - READ:] Now I would like to ask you some questions about the time(s) you have given birth. Let’s start with the very first time. [MALES - READ:] Now I would like to ask you some questions about the time(s) a girl gave birth to a child that was yours. Let’s start with the very first time.
[Check number of births in N2: write the name of each child in N19 and then complete questions N20 to N64 for each birth. If number of births in N2 is more than 3, record the responses on the notes sheet at the end of the questionnaire]
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1st birth 2nd birth 3rd birth
BH3 N19 First name of child
BH4 N20 Is [NAME] male or female?
MALE 1 1 1 1 FEMALE 2 2 2 2 DON'T KNOW 88 88 88
BH4a N21 Was the birth …?
SINGLE 1 1 1 1 TWINS 2 2 2 2 MORE (SPECIFY HOW MANY)
BH5 N22 In what month and year was [NAME] born?
a. BORN: MONTH a. a. a.
b. BORN: YEAR b. b. b.
DON'T KNOW 88 88 88
NEW Q N23 [Females:] At the time you became pregnant with DHS 228 [NAME], did you want to become pregnant then, did you want to wait until later, or did you not want to have any (more) children at all?
[Males:] At the time the mother of [NAME] became pregnant with [NAME], did you want to have a child then, did you want to wait until later, or did you not want to have any (more) children at all? THEN 1 1 1 1 LATER 2 2 2 2 NOT AT ALL3 3 3 3
BH6 N24 [Females:] Did you receive any antenatal care prior to [NAME]’s birth? [Males:] Did the mother of [NAME} receive any antenatal care prior to [NAME]'s birth?
NO 0 0 0 0 YES 1 1 1 1 DON'T KNOW 88 88 88
BH7 N25 Who provided the antenatal care before [NAME]’s birth? [PROBE:] Was there anybody else? [CIRCLE ALL MENTIONED] DOCTOR 1 1 1 1 CLINICAL OFFICER 2 2 2 2 NURSE/MIDWIFE 3 3 3 3 TRADITIONAL BIRTH ATTEND (TBA) 4 4 4 4 HEALTH SURV. ASSIST. (HSA) 5 5 5 5 OTHER 6 6 6 6 (SPECIFY OTHER) DON'T KNOW 88 88 88
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BH8 N26 [Females:] How many times did you get antenatal care before [NAME] was born? [Males:] How many times did the mother of [NAME] get antenatal care before [NAME] was born? ONE TIME1 1 1 1 TWO TIMES2 2 2 2 THREE OR MORE TIMES 3 3 3 3 DON'T KNOW 88 88 88
BH9 N27 [Females:] Where did you give birth to [NAME]? [Males:] Where did the mother of [NAME] give birth to [NAME]? HOSPITAL1 1 1 1 HEALTH CENTRE 2 2 2 2 IN A HOME3 3 3 3 OTHER 4 4 4 4 (SPECIFY OTHER) [MALES ONLY:] DON'T KNOW 88 88 88
BH10 N28 Did anyone assist with [NAME]'s birth?
[CIRCLE ALL MENTIONED]
NO/UNASSISTED 1 1 1 1 DOCTOR 2 2 2 2 NURSE/MIDWIFE 3 3 3 3 TRADITIONAL BIRTH ATTEND (TBA) 4 4 4 4 HEALTH SURV. ASSIST. (HSA) 5 5 5 5 FRIEND/RELATIVE 6 6 6 6 OTHER 7 7 7 7 (SPECIFY OTHER) [MALES ONLY:] DON'T KNOW 88 88 88
NEW Q N29 [FEMALES:] Did you return to your home village when [NAME] was born? [MALES:] Did the mother of [NAME] return to her home village when [NAME] was born?
NO 0 0 0 0 → N31 YES 1 1 1 1 STILL LIVING IN HOME VILLAGE 2 2 2 2 → N31 [MALES ONLY:] DON'T KNOW 88 88 88 88 → N31
NEW Q N30 [FEMALES:] How long did you stay in your home village? [MALES:] How long did the mother of [NAME] stay in her home village? [IF LESS THAN 2 MONTHS, ENTER WEEKS]
a. DAYS a. a. a.
b. WEEKS b. b. b.
c. MONTHS c. c. c.
[MALES ONLY:] DON'T KNOW 88 88 88
BH11 N31 How much did [NAME] weigh at birth?
KILOGRAMS ... DON'T KNOW 88 88 88
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BH11a N32 What size was [NAME] at birth compared to other children born in your village?
[READ RESPONSE OPTIONS 1-5] VERY LARGE1 1 1 1 LARGER THAN AVERAGE 2 2 2 2 AVERAGE3 3 3 3 SMALLER THAN AVERAGE 4 4 4 4 VERY SMALL5 5 5 5 DON'T KNOW 88 88 88 88
NEW Q N33 In the first three days after delivery, was [NAME] DHS 462 given anything to drink other than breast milk?
NO 0 0 0 0 → N35 YES 1 1 1 1 [MALES ONLY:] DON'T KNOW 88 88 88 88 → N35
NEW Q N34 What was [NAME] given to drink? DHS 463 [PROBE:] Anything else? [CIRCLE ALL LIQUIDS MENTIONED]
MILK (OTHER THAN BREASTMILK) 1 1 1 1 PLAIN WATER2 2 2 2 SUGAR OR GLUCOSE WATER 3 3 3 3 GRIPE WATER4 4 4 4 SUGAR-SALT-WATER SOLUTION 5 5 5 5 FRUIT JUICE6 6 6 6 INFANT FORMULA 7 7 7 7 TEA 8 8 8 8 HERBAL INFUSION 9 9 9 9 HONEY 10 10 10 10 PORRIDGE/DAWARE 11 11 11 11 OTHER 12 12 12 12
BH12 N35 Was [NAME] ever breastfed?
NO 0 0 0 0 → N38 YES 1 1 1 1 [MALES ONLY:] DON'T KNOW 88 88 88 88 → N38
NEW Q N36 How long after birth did [you/your partner] first put DHS 461 [NAME] to the breast?
[IF LESS THAN ONE HOUR, a. MINUTES a. a. a. RECORD MINUTES IF LESS THAN 24 HOURS, b. HOURS b. b. b. RECORD HOURS OTHERWISE, RECORD DAYS] c. DAYS c. c. c.
[MALES ONLY:] DON'T KNOW 88 88 88
BH13 N37 How many months was [NAME] breastfed?
MONTHS
LESS THAN 1 MONTH 0 0 0 STILL BREASTFEEDING 77 77 77 DON'T KNOW 88 88 88
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BH14 N38 How many months after birth did [NAME] first get food/drink other than breastmilk?
MONTHS
LESS THAN 1 MONTH 0 0 0 NEVER/NOT YET 77 77 77 DON'T KNOW 88 88 88
BH15 N39 Is [NAME] still alive?
NO 0 0 0 0 YES 1 1 1 1 → N41 DON'T KNOW 88 88 88 88 → Sect O
BH16 N40 How old was [NAME] when he/she died?
a. YEARS a. a. a. ALL b. [IF LESS THAN 1 YEAR:] MONTHS b. b. b. → N55
LESS THAN 1 MONTH 0 0 0 DON'T KNOW 88 88 88
BH17 N41 How old is [NAME] now?
a. YEARS a. a. a.
b. [IF LESS THAN 1 YEAR:] MONTHS b. b. b.
LESS THAN 1 MONTH 0 0 0 DON'T KNOW 88 88 88
BH18 N42 Does [NAME] usually live with you?
NO 0 0 0 0 YES 1 1 1 1 → N44
NEW Q N43 Who is [NAME]'s primary caregiver? [RECORD RELATIONSHIP TO RESPONDENT]
RELATIONSHIP CODE
BH19 N44 [MALES → N47; FEMALES, ASK:] Does [NAME]'s father live with you?
NO 0 0 0 0 YES 1 1 1 1 → N47
NEW Q N45 How often does [NAME] see [his/her] biological father?
NEVER 0 0 0 0 ONCE A YEAR/EVERY FEW YEARS 1 1 1 1 ONCE A MONTH/EVER FEW MONTHS 2 2 2 2 ONCE A WEEK/EVERY FEW WEEKS 3 3 3 3 EVERY DAY/EVERY FEW DAYS 4 4 4 4 DON'T KNOW 88 88 88 88
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NEW Q N46 Does [NAME]'s father provide financial support?
NO 0 0 0 0 YES, A LITTLE 1 1 1 1 YES, A LOT2 2 2 2
NEW Q N47 Did/does [NAME] attend nursury school/preschool (nkaka)?
NO 0 0 0 0 YES 1 1 1 1 DON'T KNOW 88 88 88 88
NEW Q N48 [CHECK N41: IF YOUNGER THAN 5 → N53; ELSE, ASK:] Has [NAME] started primary school?
NO 0 0 0 0 → N53 YES 1 1 1 1 DON'T KNOW 88 88 88 88 → N53
NEW Q N49 How old was [NAME] when [he/she] first enrolled in standard 1?
YEARS
DON'T KNOW 88 88 88
NEW Q N50 Is [NAME] currently enrolled in primary school?
NO 0 0 0 0 → N53 YES 1 1 1 1 DON'T KNOW 88 88 88 88 → N53
NEW Q N51 [CHECK N50:] [CHILDREN ENROLLED IN SCHOOL, ASK:] In what standard is [NAME] currently enrolled?
[CHILDREN NOT ENROLLED IN SCHOOL, ASK:] What was the highest standard attended by [NAME]?
88 88 88
[CHECK N50: CHILDREN NOT ENTROLLED IN SCHOOL → N53] NEW Q N52 What primary school does [NAME] attend?
NAME OF PRIMARY SCHOOL
DON'T KNOW 88 88 88
NEW Q N53 [CHECK N41: IF OLDER THAN 5 → N55; ELSE, ASK:] Did you, [NAME]'s [father/mother], or other adult (age >15) in the household do any of the following with [NAME] in the past three days?
a. Read books or look at pictures?
NO 0 0 0 0 YES 1 1 1 1 DON'T KNOW 88 88 88 88
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b. Tell stories to [NAME]?
NO 0 0 0 0 YES 1 1 1 1 DON'T KNOW 88 88 88 88
c. Sing songs?
NO 0 0 0 0 YES 1 1 1 1 DON'T KNOW 88 88 88 88
d. Take [NAME] outside the household, compound, yard, or enclosure? NO 0 0 0 0 YES 1 1 1 1 DON'T KNOW 88 88 88 88
e. Play with [NAME]?
NO 0 0 0 0 YES 1 1 1 1 DON'T KNOW 88 88 88 88
f. Spend time with [NAME] naming, drawing, and/or counting things? NO 0 0 0 0 YES 1 1 1 1 DON'T KNOW 88 88 88 88
NEW Q N54 Was [NAME] left alone or in the care of another child age 10 years old or younger at any time in the previous week?
NO 0 0 0 0 YES 1 1 1 1 DON'T KNOW 88 88 88 88
BH22 N55 Do you have a card/health passport where [NAME]'s vaccinations are written down?
NO 0 0 0 0 YES 1 1 1 1 DON'T KNOW 88 88 88 88
N55a [If card/health passport is available, copy information for N56-N64. If card/health passport is unavailable, ask respondent about each vaccination:] Has [NAME] received any of the following vaccinations?
BH23 N56 BCG for TB (at birth) NO 0 0 0 0 YES 1 1 1 1 DON'T KNOW 88 88 88 88
BH24 N57 Polio 0 (at birth) NO 0 0 0 0 YES 1 1 1 1 DON'T KNOW 88 88 88 88
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BH25 N58 Polio 1 (at 6 weeks) NO 0 0 0 0 YES 1 1 1 1 CHILD TOO YOUNG/HAD DIED 77 77 77 77 DON'T KNOW 88 88 88 88
BH26 N59 Polio 2 (at 10 weeks) NO 0 0 0 0 YES 1 1 1 1 CHILD TOO YOUNG/HAD DIED 77 77 77 77 DON'T KNOW 88 88 88 88
BH27 N60 Polio 3 (at 14 weeks) NO 0 0 0 0 YES 1 1 1 1 CHILD TOO YOUNG/HAD DIED 77 77 77 77 DON'T KNOW 88 88 88 88
BH28 N61 DPT/Pentavalente 1 (at 6 weeks) NO 0 0 0 0 YES 1 1 1 1 CHILD TOO YOUNG/HAD DIED 77 77 77 77 DON'T KNOW 88 88 88 88
BH29 N62 DPT/Pentavalente 2 (at 10 weeks) NO 0 0 0 0 YES 1 1 1 1 CHILD TOO YOUNG/HAD DIED 77 77 77 77 DON'T KNOW 88 88 88 88
BH30 N63 DPT/Pentavalente 3 (at 14 weeks) NO 0 0 0 0 YES 1 1 1 1 CHILD TOO YOUNG/HAD DIED 77 77 77 77 DON'T KNOW 88 88 88 88
BH31 N64 Measles/MMR (at 9 months) NO 0 0 0 0 YES 1 1 1 1 CHILD TOO YOUNG/HAD DIED 77 77 77 77 DON'T KNOW 88 88 88 88
SECTION O: SOCIAL CAPITAL AND CELL PHONE USE QUESTIONS RESPONSES SKIPS
Script_R1 [READ:] Some adolescents belong to community or school groups. Now we would like to know if you belong to any organizations in your community or school.
R3 O1 Since January 1st 2013, have you participated in NO 0 → O2a any organized sports activities? YES 1
R4 O2 Of the last 7 days, how many days did you DAYS participate in organized sports activities? [max=7]
Script_R16 O2a [READ:] Now we would like to ask you some questions about cell phones and internet use.
R16 O3 Have you ever used a cell phone? NO 0 → O14 YES 1
R17 O4 Do you own/have a cell phone? YES, MY OWN 1 YES, WHICH I SHARE WITH OTHERS 2 NO, BUT HAVE REGULAR ACCESS 3 NO, BUT HAVE ACCESS IN AN EMERGENCY 4 NO, NEITHER OWNERSHIP, NOR ACCESS 5 → O14
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R17 O5 Do you own/have a SIM card? YES, MY OWN 1 YES, WHICH I SHARE WITH OTHERS 2 NO, BUT HAVE REGULAR ACCESS 3 NO, BUT HAVE ACCESS IN AN EMERGENCY 4 NO, NEITHER OWNERSHIP, NOR ACCESS 5
R17 O6 Do you own/have a power source for charging? YES, MY OWN 1 YES, WHICH I SHARE WITH OTHERS 2 NO, BUT HAVE REGULAR ACCESS 3 NO, BUT HAVE ACCESS IN AN EMERGENCY 4 NO, NEITHER OWNERSHIP, NOR ACCESS 5
R18 O7 Do you have a cell phone with you now? NO 0 YES 1
R19 O8 Who else uses the cell phone that you use? a. 1st PERSON
b. 2nd PERSON [USE RELATIONSHIP CODES IF NO ONE ELSE, ENTER '00'] c. 3rd PERSON
R20 O9 What do you use this phone for? MAKING CALLS 1 FLASHING 2 SENDING TEXT MESSAGES 3 [DO NOT READ LIST; CIRCLE ALL MENTIONED] TRANSFERRING AIRTIME 4 PLAYING GAMES 5 AS A CALCULATOR 6 AS A FLASHLIGHT 7 BROWSING THE INTERNET 8 OTHER ______9
R21 O10 Did you use a cell phone in the past week? NO 0 → O14 YES 1
R22 O11 In the past week, […]? None 1-5 6-10 11 +
a. How many text messages did you send? a. 0 1 2 3
b. How many text messages did you receive? b. 0 1 2 3
c. How many times did you flash someone? c. 0 1 2 3 d. How many times did you receive a flash d. 0 1 2 3 e. How many calls did you make? e. 0 1 2 3 f. How many calls did you receive? f. 0 1 2 3
R23 O12 How much money did you spend on airtime in the MK past week?
R24 O13 Who paid for the airtime? a. 1st PERSON
b. 2nd PERSON [USE RELATIONSHIP CODES IF NO ONE ELSE, ENTER '00'] c. 3rd PERSON
R25 O14 Have you ever heard of the internet? NO 0 → Sect P YES 1
R26 O15 Have you ever used the internet? NO 0 YES 1
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SECTION P: SELF-REPORTED HEALTH AND NUTRITION QUESTIONS RESPONSES SKIPS
UMOYO / HEALTH STATUS
Script_HA1 [READ:] Now I would like to ask you a few questions about your health.
HA1 P1 Overall, how would you rate your health in the past RECORD CLOSEST NUMBER year? FROM UMOYO SCALE [Show the respondent the diagram at the start [min=1, max=10] of the section and explain:] “For example, if this end of the line [show #1] means lots of health problems like serious diarrhea and really bad fevers, and this end [show #10] means no health problem at all, where would you place yourself?
HA2 P2 Overall, how would you rate your health in the past RECORD CLOSEST NUMBER month? FROM UMOYO SCALE [Repeat diagram and explanation as in P1] [min=1, max=10]
NEW Q P3 In the past year, did you go to a health facility to YES 1 get any type of health services? NO 2 → Sect Q
NEW Q P4 Now I would like to ask about your visits to health [FILL IN HEALTH SERVICES SHEET] facilities in the past year.
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SECTION Q: STIs AND HIV/AIDS QUESTIONS RESPONSES SKIPS
HC10 Q1 What can a person do to avoid or reduce their Abstain from sex 1 chances of gettind AIDS? Use condoms 2 [PROBE:] Anything else? Limit sex to one partner/stay faithful to one 3 partner Limit number of sexual partners 4 [DO NOT READ LIST; CIRCLE ALL MENTIONED Avoid sex with prostitutes 5 SPONTANEOUSLY] Avoid sex with persons who have many 6 partners Avoid sex with homosexuals 7
Avoid sex with persons who inject drugs 8 intravenously Avoid blood transfusions 9 Avoid sharing razors/blades 10 Avoid kissing 11 Avoid mosquito bites 12 Seek protection from traditional practitioner 13
Men can get circumcised 14 Other (specify) ______15 Don't know any mode of transmission 88
HC11 Q2 Is it possible for a healthy-looking person to have NO 0 the AIDS virus? YES 1 DON'T KNOW 88
HC12 Q3 During the last 12 months, have you had a disease NO 0 which you got through sexual contact? YES 1 NO SEXUAL CONTACT 77 DON'T KNOW 88
HC13 Q4 Sometime people experience a bad smelling NO 0 abnormal genital discharge. During the last 12 YES 1 months, have you had a bad smelling abnormal DON'T KNOW 88 genital discharge?
HC14 Q5 Sometimes people have a genital sore or ulcer. NO 0 During the last 12 months, have you had a genital YES 1 sore or ulcer? DON'T KNOW 88
SECTION R: HIV/AIDS RISK PERCEPTION QUESTIONS RESPONSES SKIPS
HD1 R1 How worried are you currently that you might catch A LOT 1 HIV/AIDS? SOME 2 A LITTLE 3 NO WORRY 4 RESPONDENT HAS HIV/AIDS 5 → R3 DON'T KNOW 88
HD2 R2 Do you think that your chances of getting GREAT 1 HIV/AIDS (in the future) are great, moderate, MODERATE 2 small, or that you have no chance at all? SMALL 3 NO CHANCE 4 DON'T KNOW 88
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HD3 R3 If we took a group of 10 people from this area, just NUMBER normal people whom you found working in the fields or in homes, how many of them do you think DON'T KNOW 88 would now have HIV/AIDS?
HD4 R4 If we took a group of 10 people like yourself, for NUMBER instance people who are your age and live nearby, how many of them do you think would now have DON'T KNOW 88 HIV/AIDS?
HD5 R5 Do you personally know someone with HIV/AIDS? NO 0 YES 1
HD6 R6 Do you personally know someone who has died of NO 0 HIV/AIDS? YES 1
HD7 R7 Do you know a place where people can go to get NO 0 tested for HIV? YES 1
SECTION S: GENDER NORMS & GIRLS AGENCY QUESTIONS RESPONSES SKIPS
[READ:] Do you agree or disagree with the following statements?
M5 S1 It is as important for girls to complete secondary DISAGREE 1 school as it is for boys. Do you: AGREE 2 NO OPINION/DON'T KNOW 88 [S1-S5: read options 1 and 2 ONLY]
M6 S2 When a family cannot afford to send all children to DISAGREE 1 school, it is better to send boys than girls. Do you: AGREE 2 NO OPINION/DON'T KNOW 88
M7 S3 When a husband and wife disagree about the DISAGREE 1 number of children to have, the husband's opinion AGREE 2 matters more. Do you: NO OPINION/DON'T KNOW 88
M8 S4 A girl should get married when she finds an DISAGREE 1 appropriate spouse, even if she is still in school. AGREE 2 Do you: NO OPINION/DON'T KNOW 88
M9 S5 Girls are as intelligent as boys. Do you: DISAGREE 1 AGREE 2 NO OPINION/DON'T KNOW 88
M10 S6 Sometimes a husband is annoyed or angered by things that his wife does. In your opinion, is a husband justified in hitting or beating his wife in the following situations?
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[READ LIST] NO YES DK
a. If she goes out without telling him a. 0 1 88 b. If she neglects the children b. 0 1 88 c. If she argues with him c. 0 1 88 d. If she refuses to have sex with him d. 0 1 88 e. If she burns the food e. 0 1 88 f. If she has an extra marital affair f. 0 1 88
Script_Z2 [READ:] I am going to read you a few more statements. Please think about your feelings and tell me if you agree or disagree with the following about yourself.
Z1 S7 [MALES → S11; FEMALES, ASK:] In an intimate relationship, I feel that the sexual DISAGREE 1 needs and enjoyment of my husband or boyfriend AGREE 2 are more important than my own.
Z2 S8 I tell my husband or boyfriend what I honestly think DISAGREE 1 even when he might disagree. AGREE 2 NO HUSBAND/BOYFRIEND 9 → S16
Z2a S9 The main reason I agreed to my partner's proposal DISAGREE 1 is because he would give me money or gifts I AGREE 2 need.
Z2b S10 In my marriage/intimate relationship, I almost DISAGREE 1 always do what my husband/boyfriend says. AGREE 2
Z3 S11 [FEMALES → S16; MALES, ASK:] I think it is important for a young man to act like he DISAGREE 1 is sexually active even if he is not. AGREE 2
Z4 S12 In an intimate relationship, I feel that my sexual DISAGREE 1 needs and enjoyment are more important than my AGREE 2 wife's or girlfriend's.
Z4a S13 The main reason I proposed to my partner is DISAGREE 1 because I wanted to have sex. AGREE 2 NOT APPLY 9
Z4b S14 In my marriage/intimate relationship, my DISAGREE 1 wife/girlfriend almost always does what I say. AGREE 2 NOT APPLY 9
Z4c S15 I think that if a husband wants to have sex but his DISAGREE 1 wife refuses, it is OK for the husband to have sex AGREE 2 with her anyway, even if it takes a little force.
Z4d S16 I believe that a wife should always be obedient to DISAGREE 1 her husband. AGREE 2
Z5 S17 A woman is justified in refusing to have sex with DISAGREE 1 her husband if she is not in the mood or is tired. AGREE 2
Z5a S18 If I discovered that my [husband/wife] was having DISAGREE 1 an extra-marital relationship, and he/she did not Page 43 of 61 MSAS R6 Questionnaire Version 7 Aug. 2013 Adol ID: [__|__|__|__|__|__]
an extra-marital relationship, and he/she did not AGREE 2 end the affair, I would end our marriage. NOT APPLY 9
Z5b S19 In general, who do you think has more power in MY PARTNER 1 your relationship? WE ARE EQUAL 2 ME 3 NOT APPLY 9
Z7 S20 When you have a question for a health care NO 0 provider, do you feel comfortable asking it? YES 1
Z8 S21 In the past year, have you stood up for someone NO 0 who was being treated unfairly? YES 1
Z10 S22 In the past year, have you borrowed a book to NO 0 learn more about a subject you were interested in? YES 1
Z12 S23 [MALES → S24; FEMALES, ASK:] In the past year have you done something against NO 0 your husband's/partner's wishes because you YES 1 thought it was the right decision for you? NOT APPLY 9
Z13 S24 When you want to use the telephone, do you need NO 0 to ask permission from you parent or spouse? YES 1 NEVER USE A TELEPHONE 9
Z14 S25 If your parents/guardian were to die, would you […]? NOT [READ LIST] NO YES APPLY
a. Have the right to use the house they own? a. 0 1 9
b. Become the owner of the house they own? b. 0 1 9
c. Have the right to use the agricultural land c. 0 1 9 they own? d. Become the owner of the agricultural land d. 0 1 9 they own?
Z15 S26 [CHECK L2: IF NOT CURRENTLY MARRIED → SECT T; OTHERWISE, ASK:] If your [husband/wife] were to die, who would […]? Your Your Spouse children relatives relatives [READ LIST] You Other
a. Have the right to use the house you live in? a. 1 3 4 5 6
b. Become the owner of the house you live in? b. 1 3 4 5 6
c. Have the right to use the agricultural land you c. 1 3 4 5 6 use? d. Become the owner of the agricultural land d. 1 3 4 5 6 you use?
Z16 S27 [MALES:] If your wife were to divorce you, who would […]? [FEMALES:] If you were to divorce your husband, who would […]? Your Your Your Spouse spouse children relatives relatives [READ LIST] You Other
a. Have the right to use the house you live in?a. 1 23 4 5 6
b. Become the owner of the house you live in?b. 1 2 3 4 5 6
c. Have the right to use the agricultural land you c. 12 3 4 5 6 use? d. Become the owner of the agricultural land d. 12 3 4 5 6 you use?
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NEW SECT SECTION T: SUBJECTIVE EXPECTATIONS QUESTIONS RESPONSES SKIPS
T I will ask you several questions about the chance or likelihood that certain events are going to happen. There are 10 stones in this cup. I would like you to choose some stones out of these 10 stones and put them on the plate to express what you think the chance is of a specific event happening.
One stone represents one chance out of 10. If you do not put any stones in the plate, it means you are sure that the event will NOT happen. As you add stones, it means that you think the chance that the event happens goes up. For example, if you put one or two stones, it means you think the event is not likely to happen but it is still possible or may happen. If you pick 5 stones, it means that it is just as likely it happens as it does not happen (fifty-fifty). If you pick 7 stones, it means the event is slightly more likely to happen than not to happen. If you put 10 stones in the plate, it means you are sure the event will happen.
I would like to ask some questions about some events and you will pick the number of stones from the cup and put them on the plate for your answer as to how likely you think they may have or will occur. There is no right or wrong answer, I just want to know what you think.
T1 Pick the number of stones that reflects how likely you think it is that […]
a. You will go to the market at least once within a. STONES [0-10] the next 2 days ?
b. You will go to the market at least once within b. STONES [0-10] the next 2 weeks or 14 days ?
[If respondent did not place any stones or placed all ten stones on the plate, make sure that this means that they are certain that [event] will or will not happen.]
[Did respondent add any stones between a and b?] [IF YES → T2]
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c. Remember, as time goes by, you may find c. STONES [0-10] more time to go to the market. Therefore, you may want to add stones to the plate. Let me ask you again [repeat questions]. Now, add stones to the plate so that the number of stones on the plate reflects how likely you think it is that you will go the market at least once within 2 weeks ?
T2 Now I would like to ask you about certain events that may or may not happen in your life. Pick the number of stones that expresses how likely it is that […]
a. Females: You will get pregnant in the next a. STONES [0-10] year Males: You will make a woman pregnant in the next year
b. Females: You will get pregnant in the next b. STONES [0-10] two years Males: You will make a woman pregnant in the next two years
[Did respondent add any stones between [IF YES → c] a and b?]
Remember, as time goes by, a woman may be more likely to become pregnant. Therefore, you may want to add stones to the plate. Let me ask you again [repeat questions] . Now, add stones to the plate so that the number of stones on the plate reflects how likely you think it is that [you/your partner] will get pregnant at least once within two years ?
c. Females: You will get pregnant in the next c. STONES [0-10] five years Males: You will make a woman pregnant in the next five years
[Did respondent add any stones between [IF YES → T3] b and c?]
Remember, as time goes by, a woman may be more likely to become pregnant. Therefore, you may want to add stones to the plate. Let me ask you again [repeat questions] . Now, add stones to the plate so that the number of stones on the plate reflects how likely you think it is that [you/your partner] will get pregnant at least once within five years ?
T3 [Check birth history : If respondent has no living children → T4, else ask:]
Now I would like to ask you about some more events that may or may not happen in your life. Pick the number of stones that expresses how likely it is that […]
a. One of your children will be fostered in the a. STONES [0-10] next year ALREADY FOSTERED 77
b. One of your children will be fostered in the b. STONES [0-10] next five years ALREADY FOSTERED 77
[Did respondent add any stones between [IF YES → c] a and b?]
Remember, as time goes by, children may be more likely to be fostered. Therefore, you may want to add stones to the plate. Let me ask you again [repeat questions] . Now, add stones to the plate so that the number of Page 46 of 61 MSAS R6 Questionnaire Version 7 Aug. 2013 Adol ID: [__|__|__|__|__|__]
stones to the plate so that the number of stones on the plate reflects how likely you think it is that one of your children will get fostered within five years ?
c. Your oldest child will start school before c. STONES [0-10] his/her 7th birthday CHILD ALREADY STARTED 77 CHILD OLDER THAN 7 YEARS 99
d. Your oldest child will start school before d. STONES [0-10] his/her 9th birthday CHILD ALREADY STARTED 77 CHILD OLDER THAN 9 YEARS 99
[Did respondent add any stones between [IF YES → T4] c and d?]
Remember, as time goes by, children may be more likely to start school. Therefore, you may want to add stones to the plate. Let me ask you again [repeat questions] . Now, add stones to the plate so that the number of stones on the plate reflects how likely you think it is that your oldest child will start school before his/her 9th birthday ?
T4 [Check L2 : If respondent is not currently married → T5, else ask:]
Now I would like to ask you about some more events that may or may not happen in your life. Pick the number of stones that expresses how likely it is that […]
a. You will get divorced in the next year a. STONES [0-10]
b. You will get divorced in the next five years b. STONES [0-10]
[Did respondent add any stones between [IF YES → c] a and b?]
Remember, as time goes by, people may be more likely to get divorced. Therefore, you may want to add stones to the plate. Let me ask you again [repeat questions] . Now, add stones to the plate so that the number of stones on the plate reflects how likely you think it is that you will get divorced within five years ?
c. You will get divorced in your lifetime d. STONES [0-10]
[Did respondent add any stones between [IF YES → T5] b and c?]
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Remember, as time goes by, people may be more likely to get divorced. Therefore, you may want to add stones to the plate. Let me ask you again [repeat questions] . Now, add stones to the plate so that the number of stones on the plate reflects how likely you think it is that you will get divorced in your lifetime ?
T5 Finally, I would like to ask you about some last events that may or may not happen in your life. Pick the number of stones that expresses how likely it is that […]
a. You will complete secondary school (grade a. STONES [0-10] 12)? ALREADY COMPLETED 77 b. You will move to a different village in the next b. STONES [0-10] year
c. You will move to a different village in the next c. STONES [0-10] five years
[Did respondent add any stones between [IF YES → END] b and c?]
Remember, as time goes by, people may be more likely to move to a different village. Therefore, you may want to add stones to the plate. Let me ask you again [repeat questions] . Now, add stones to the plate so that the number of stones on the plate reflects how likely you think it is that you will move to a different village within five years ?
END RECORD THE TIME INTERVIEW ENDS a. HOUR USE 24 HOUR TIME b. MINUTES
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A36: MIGRATION ROSTER [Record date last interview from reference-sheet: Month ______Year______. Record last village/area from reference-sheet in Line # 01.] AA1 AA2 AA3 AA4 AA5 AA5a AA6 AA7 MAIN REASON MAIN REASON DISTANCE FROM Line # NAME OF VILLAGE/AREA DISTRICT VILLAGE/AREA TYPE TYPE OF MOVE MOVED TO MOVED: SPECIFY PREVIOUS AREA Line # 01: When you were What district Is this village/area a Lines # 02-10: Lines # 02-10: Lines # 02-10: Lines # 02-10: last interviewed on [date last is this village/ major urban centre, What is the main Was this a visit, a How far is this interview] you were living in area in? boma, trading centre reason that you temporary move, village/area from [IF AA5=Other (Code 26), [village/area in line AA01]. or a rural village? moved to this specify reason below:] or an indefinite the previous village/area? change in primary village/area Lines # 02-10: What is the [Use district codes 1 = Major urban centre residence? recorded in AA2? [Use codes for main name of the village/area that from migration codes 2 = Boma 1 = 10 km or less reason listed in sheet] you moved to next? 3 = Trading centre migration codes sheet] 1 = Visit 2 = 11-25 km DK = 88 4 = Rural village 2 = Temporary move 3 = 25-100 km 5 = Other ______DK = 88 3 = Indefinite change 4 = More than 100 km [Lines # 02-10: Record the name of the 88 = Don't know in primary residence village/area that respondent moved to] 88 = Don't know
[Reference-sheet: village/area] AA.01 [___|___] [___|___] [ X | X ]______X_X______[ X ] [ X ]
AA.02 ______[___|___] [___|___] [___|___]______[____] [____] AA.03 ______[___|___] [___|___] [___|___]______[____] [____] AA.04 ______[___|___] [___|___] [___|___]______[____] [____] AA.05 ______[___|___] [___|___] [___|___]______[____] [____] AA.06 ______[___|___] [___|___] [___|___]______[____] [____] AA.07 ______[___|___] [___|___] [___|___]______[____] [____] AA.08 ______[___|___] [___|___] [___|___]______[____] [____] AA.09 ______[___|___] [___|___] [___|___] ______[____] [____] AA.10 ______[___|___] [___|___] [___|___]______[____] [____] [Check: the last name of village/area recorded in AA2 should be the same as the village/area recorded in A30 or A35] [Continue to page 2 for each village/area]
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[Record date last interview from reference-sheet: Month ______Year______.] AA1 AA2 AA8 AA9 AA10 AA11 DISTANCE FROM Line # COPY: NAME OF VILLAGE/AREA LIVED PREVIOUSLY LEFT VILLAGE/AREA MONTH/YEAR LEFT HOME AREA Lines # 02-10: Lines # 02-10: Line # 01: Since What month and year did you How far is this Have you lived in [date last interview], leave [village/area] to go live village/area from this place before? have you left this village/ in another place? what you consider area to go live in to be your home another place? village/area? 0 = It is home village Lines # 02-10: Have you Month = 1-12 1 = 10 km or less 0 = Never left this village/area to go Year = 07, 08, 09, 10, 11, 12, 13 2 = 11-25 km 1 = In past 1 year live in another place? Don't know = 88 3 = 25-100 km 2 = 2-4 years ago [Check: month and year should be between 4 = More than 100 km 3 = 5 or more years [If NO → Sec on B] the date of the last interview and the date of 88 = Don't know ago the current interview] [Reference-sheet: village/area] AA.01 [ X ] [ X ] NO = 0 →Sect B YES = 1 Month:[__|__] / Year:[__|__]
AA.02 ______[____] [____] NO = 0 →Sect B YES = 1 Month:[__|__] / Year:[__|__]
AA.03 ______[____] [____] NO = 0 →Sect B YES = 1 Month:[__|__] / Year:[__|__]
AA.04 ______[____] [____] NO = 0 →Sect B YES = 1 Month:[__|__] / Year:[__|__]
AA.05 ______[____] [____] NO = 0 →Sect B YES = 1 Month:[__|__] / Year:[__|__]
AA.06 ______[____] [____] NO = 0 →Sect B YES = 1 Month:[__|__] / Year:[__|__]
AA.07 ______[____] [____] NO = 0 →Sect B YES = 1 Month:[__|__] / Year:[__|__]
AA.08 ______[____] [____] NO = 0 →Sect B YES = 1 Month:[__|__] / Year:[__|__]
AA.09 ______[____] [____] NO = 0 →Sect B YES = 1 Month:[__|__] / Year:[__|__]
AA.10 ______[____] [____] NO = 0 →Sect B YES = 1 Month:[__|__] / Year:[__|__]
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D0: RESPONDENT'S HOUSEHOLD ROSTER
[READ:] By household we mean everyone who lives with you under the same household head, who shares a common pot at mealtimes, and lives in a common compound.
D1 D2 D3 D4 D5 D8 D9 D10 D11 RELATION SCHOOLING MARITAL STATUS Line # NAME SEX AGE SHIP [AGES 2 & OLDER] [AGES 10 & OLDER] Please give me the names of all individuals What is Is (NAME) male What age is (NAME)? Has (NAME) ever How far did (NAME) go in Is (NAME) still in a. What is (NAME)'s marital b. [If married to who usually stay in your current household. (NAME)’S or female? attended school? school? school? status? [If married ask:] To a resident, relationship to household resident? D11=22, ask:] Let’s start with the head of your household. you? 0=No standard completed Who in the [If age is less than 1 1=Pre-school 11=Never married household is [Record respondent in line # 01] year old enter 00] 2=Some primary 22=Married to resident (NAME)'s [Use [Record household head in line # 02. If 3=Completed primary 29=Married to 2 or more res spouse? relationship NO = 0 → D11 NO = 0 the respondent is the household head, in [If age not certain 4=Some secondary 33=Married to nonresident codes at end of line # 02 enter "same as respondent" in circle estimated; if 5=Completed secondary 44=Separated Enter line # of roster] MALE = 1 YES = 1 YES = 1 D2 and enter "01" in D3 and DO NOT ask age not known circle 6=Tertiary 55=Divorced spouse D4-D11] DK] 7=Adult literacy program 66=Widowed DK = 88 FEMALE = 2 DK = 88 → D11 DK = 88 DK = 88 [Record first name and surname] 88=DK 88=DK If age younger than 2 → NEXT LINE # If age younger than 10 → NEXT LINE # [Respondent] H.01 ______[ 0 | 1 ] [ X ] Age [ X | X ] [ X ] [ X ] [ X ] a. [ X | X ] b. [ X | X ] [HH head] Age [___|___] H.02 ______[___|___] [____] Estimated = 1; DK = 88 [____] [____] [____] a. [___|___] b. [__|__] Age [___|___] H.03 ______[___|___] [____] Estimated = 1; DK = 88 [____] [____] [____] a. [___|___] b. [__|__] Age [___|___] H.04 ______[___|___] [____] Estimated = 1; DK = 88 [____] [____] [____] a. [___|___] b. [__|__] Age [___|___] H.05 ______[___|___] [____] Estimated = 1; DK = 88 [____] [____] [____] a. [___|___] b. [__|__] Age [___|___] H.06 ______[___|___] [____] Estimated = 1; DK = 88 [____] [____] [____] a. [___|___] b. [__|__] Age [___|___] H.07 ______[___|___] [____] Estimated = 1; DK = 88 [____] [____] [____] a. [___|___] b. [__|__] Age [___|___] H.08 ______[___|___] [____] Estimated = 1; DK = 88 [____] [____] [____] a. [___|___] b. [__|__] Age [___|___] H.09 ______[___|___] [____] Estimated = 1; DK = 88 [____] [____] [____] a. [___|___] b. [__|__] Age [___|___] H.10 ______[___|___] [____] Estimated = 1; DK = 88 [____] [____] [____] a. [___|___] b. [__|__]
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RESPONDENT'S HOUSEHOLD ROSTER, cont. D1 D2 D3 D4 D5 D8 D9 D10 D11 RELATION SCHOOLING MARITAL STATUS Line # NAME SEX AGE SHIP [AGES 2 & OLDER] [AGES 10 & OLDER] Please give me the names of all individuals What is Is (NAME) male What age is (NAME)? Has (NAME) ever How far did (NAME) go in Is (NAME) still in a. What is (NAME)'s marital b. [If married to who usually stay in your current household. (NAME)’S or female? attended school? school? school? status? [If married ask:] To a resident, relationship to household resident? D11=22, ask:] you? 0=No standard completed Who in the [If age is less than 1 1=Pre-school 11=Never married household is year old enter 00] 2=Some primary 22=Married to resident (NAME)'s [Use 3=Completed primary 29=Married to 2 or more res spouse? relationship NO = 0 → D11 NO = 0 [If age not certain 4=Some secondary 33=Married to nonresident codes at end of circle estimated; if 5=Completed secondary 44=Separated Enter line # of roster] MALE = 1 YES = 1 YES = 1 age not known circle 6=Tertiary 55=Divorced spouse DK] 7=Adult literacy program 66=Widowed [Record first name and surname] DK = 88 FEMALE = 2 DK = 88 → D11 DK = 88 DK = 88 88=DK 88=DK If age younger than 2 → NEXT LINE # If age younger than 10 → NEXT LINE # Age [___|___] H.11 ______[___|___] [____] Estimated = 1; DK = 88 [____] [____] [____] a. [___|___] b. [__|__] Age [___|___] H.12 ______[___|___] [____] Estimated = 1; DK = 88 [____] [____] [____] a. [___|___] b. [__|__] Age [___|___] H.13 ______[___|___] [____] Estimated = 1; DK = 88 [____] [____] [____] a. [___|___] b. [__|__] Age [___|___] H.14 ______[___|___] [____] Estimated = 1; DK = 88 [____] [____] [____] a. [___|___] b. [__|__] Age [___|___] H.15 ______[___|___] [____] Estimated = 1; DK = 88 [____] [____] [____] a. [___|___] b. [__|__] Age [___|___] H.16 ______[___|___] [____] Estimated = 1; DK = 88 [____] [____] [____] a. [___|___] b. [__|__] Age [___|___] H.17 ______[___|___] [____] Estimated = 1; DK = 88 [____] [____] [____] a. [___|___] b. [__|__] Age [___|___] H.18 ______[___|___] [____] Estimated = 1; DK = 88 [____] [____] [____] a. [___|___] b. [__|__] Age [___|___] H.19 ______[___|___] [____] Estimated = 1; DK = 88 [____] [____] [____] a. [___|___] b. [__|__]
RELATIONSHIP CODES: 05 Biological mother 11 Half brother 17 Mother's parent 23 Sister's husband 28 Other relative: Male 44 Neighbor 00 No one 06 Biological father 12 Half sister 18 Father's parent 24 Brother's wife 29 Other relative: Female 45 Friend 01 Self 07 Step mother 13 Mother's brother 19 Male cousin 25 Spouse's mother 41 Teacher 46 Other 02 Spouse 08 Step father 14 Mother's sister 20 Female cousin 26 Spouse's father 42 Head teacher 88 Don't know 03 Son 09 Biological sister 15 Father's brother 21 Niece 27 Spouse's other wife 43 Village headman 04 Daughter 10 Biological brother 16 Father's sister 22 Nephew
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G0: RECENT EDUCATION HISTORY [Read:] "Now I would like to ask you some things about your schooling." Current/most recent school [First ask respondent about school attendance during the current/most recent school year, 2011/2012 school year year (2013) then ask about the 2012 school year] [CURRENT SCHOOL YEAR: Check A16: If respondent attends school → G2; else ask G1] G1 Did you ever attend school during the […] school year? NO 0→ 2012 year NO 0 → G11 YES1 YES 1
G2 Did you attend the [first/second/third] term of the […] school year? First NO0 YES 1 NO 0 YES 1 Second NO0 YES 1 NO 0 YES 1 Third NO0 YES 1 NO 0 YES 1 If attended all 3 terms → G4 If attended all 3 terms → G4
G3 What are the reasons that MARRIAGE/BIRTH you did not attend school? Marriage 1[___] 1 [___] Pregnancy 2[___] 2 [___] Has baby/Nursing baby 3[___] 3 [___] [Do not read list; SCHOOL ISSUES check all mentioned] Finished primary school 4[___] 4 [___] Not selected/accepted to secondary school 5[___] 5 [___] [If the respondent provides Not doing well at school 6[___] 6 [___] more than one response, Don't like school 7[___] 7 [___] ask:] Problems with/afraid of other students 8[___] 8 [___] Which of these is the most Problems with/afraid of teacher 9[___] 9 [___] important reason? Travel/Distance to school 10[___] 10 [___] Rather do something else 11[___] 11 [___] [Circle the most Parents/Guardian don't want me to go to school 12[___] 12 [___] important reason] FINANCIAL/WORK Financial/Costs 13[___] 13 [___] No money for development funds 14[___] 14 [___] Need to work at home/fields 15[___] 15 [___] Need to work/earn money 16[___] 16 [___] ILLNESS/DEATH Adolescent sick/ill 17[___] 17 [___] Illness: Parent/Guardian 18[___] 18 [___] Illness: Other HH member 19[___] 19 [___] Death: Parent/Guardian 20[___] 20 [___]
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Death: Other HH member 21[___] 21 [___] HOUSEHOLD ISSUES Biological parents: Separated/divorced 22[___] 22 [___] Need to look after brothers/sisters 23[___] 23 [___] Hunger 24[___] 24 [___] Other______25[___] 25 [___] Don't know 88[___] 88 [___]
Current/most recent school 2012 school year year
G4 During the term(s) that you attended school, [Record name of school:] what is the name of the school you attended? ______
[If attended more than one school during school year, indicate [Check reference-sheet: school Same school0 Same school 0 here [___] and ask about most recent school attended] attended last interview, circle:] Different school1 Different school 1
G5 Is this a primary or a secondary school? Primary 1 → G6 Primary 1 → G6 [If neither, ask:] Is this a tertiary education institution? Secondary 2 → G7 Secondary 2 → G7 Tertiary 3 → G9 Tertiary 3 → G9
G6 If PRIMARY school: What standard did you attend? STD: [____] → G9 STD: [____] → G9
G7 If SECONDARY school: What form did you attend? FORM: [____] FORM: [____]
G8 If SECONDARY school: What type of secondary school is this? National boarding school1 National boarding school 1 District boarding school2 District boarding school 2 District day school3 District day school 3 Community day school4 Community day school 4 Private school5 Private school 5
G9 During the term(s) that you attended school, were you a day student Day student1 Day student 1 or a boarder at school, or a boarder somewhere else? Boarder at school2 Boarder at school 2 Boarder somewhere else3 Boarder somewhere else 3
G10 Did you pass your exams at the end of the school year? NO 0NO 0 YES1 YES 1 Did not sit exams66 Did not sit exams 66 Results not out yet77 Results not out yet 77
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P4: USE OF HEALTH SERVICES IN PAST YEAR FACILITY CODES A. B. C. D. E. PUBLIC HOSPITAL 1 HEALTH FACILITY PRIVATE HOSPITAL 2 What service(s) did you Did you receive Did you receive any Who was/were the MISSION HOSPITAL 3 I would like to talk about each time that you went to a health seek at this facility? all the services [on top/ health provider(s) of PUBLIC HEALTH CLINIC 4 facility in the past year, starting with the last (most recent) time service(s) you instead] of what you the service(s) you PRIVATE HEALTH CLINIC 5 that you went. were seeking went to receive? received? MISSION HEALTH CLINIC 6 when you MOBILE CLINIC/OUTREACH 7 What is the name of the health facility that you went to? visited this TRADITIONAL HEALER 8 facility? RECORD ALL What type of health facility is this? RECORD SERVICE YES 1 PHARMACY 9 PERSONNEL CODES CODE(S) NO 2 THAT APPLY OTHER (SPECIFY______) 10 [RECORD FACILITY CODE OF PLACE IF AVAILABLE; YES 1 ELSE, RECORD FACILITY NAME, DISTRICT CODE, AND NO 2 IF YES, LIST SERVICE SERVICE CODES FACILITY TYPE] CODE(S) GENERAL HEALTH/ SICKNESS 1 FACILITY CODE FACILITY NAME FAMILY PLANNING 2 SERVICE PREGNANCY TEST 3 1 DISTRICT CODE CODE(S): ANTENATAL CARE 4 HIV TESTING 5 FACILITY TYPE HIV CARE/TREATMENT 6 FACILITY CODE FACILITY NAME STI TESTING (NON-HIV) 7 SERVICE STI CARE/TREATMENT 2 DISTRICT CODE CODE(S): (NON-HIV) 8 CHILD HEALTH/SICKNESS 9 FACILITY TYPE DELIVERY 10 FACILITY CODE FACILITY NAME POSTNATAL CARE 11 SERVICE OTHER REPRODUCTIVE 3 DISTRICT CODE CODE(S): HEALTH SERVICES 12 PHARMACY/VITAMINS/ FACILITY TYPE MEDICINE 13 FACILITY CODE FACILITY NAME SERVICE PERSONNEL CODES 4 DISTRICT CODE CODE(S): DOCTOR 1 CLINICAL OFFICER 2 FACILITY TYPE NURSE/MIDWIFE 3 FACILITY CODE FACILITY NAME TRADITIONAL BIRTH SERVICE ATTENDANT 4 5 DISTRICT CODE CODE(S): COMMUNITY HEALTH WORKER 5 VCT COUNSELLOR 6 FACILITY TYPE PHARMACIST 7 FACILITY CODE FACILITY NAME TRADITIONAL HEALER 8 SERVICE OTHER (SPECIFY_____) 9 6 DISTRICT CODE CODE(S): NO ONE 10
FACILITY TYPE
Page 55 of 61 MSAS R6 Questionnaire
FACILITY CODES BALAKA MACHINGA Government facilities B1 = Government facilities A1 = Balaka District Hospital B2 = Chamba Dispensary A2 = Chiendausiku Health Centre B3 = Chikweo Health Centre A3 = Kalembo Health Centre B4 = Kawinga Dispensary A4 = Kwitanda Health Centre B5 = Machinga District Hospital A5 = Mbera Health Centre B6 = Machinga Health Centre A6 = Mwima Health Post B7 = Mangamba Health Centre A7 = Namanolo Health Centre B8 = Mbonechela Dispensary A8 = Nambira Health Post B9 = Mkwepere Health Centre A9 = Namdumbo Health Centre B10 = Mlomba Dispensary A10 = Phimbi Health Centre B11 = Namanja Health Centre CHAM facilities B12 = Nayinunje Health Centre A11 = Comfort Clinic B13 = Nayuchi Health Centre A12 = Kankao Health Centre B14 = Ngokwe Health Centre A13 = Phalula Health Centre B15 = Ntaja Health Centre A14 = Ulongwe Health Centre B16 = Nyambi Health Centre A15 = Utale 1 Health Centre CHAM facilities A16 = Utale 2 Health Centre B17 = Gawanani Health Centre Private facilities B18 = Mpiri Health Centre A17 = Balaka Private Clinic B19 = Mposa Health Centre A18 = Chithandizo Private Clinic B20 = Namandanje Health Centre A19 = Maku Private Clinic B21 = Nsanama Health Centre Mission/faith-based organizations B22 = Nthorowa Health Centre A20 = Balaka Dream Clinic Private facilities NGOs B23 = Alinafe PVT A21 = Balaka BLM Clinic B24 = Lifune Maternity B25 = Liwonde Medical Clinic B26 = Machinga Pvt Clinic B27 = Madalitso Pvt Clinic B28 = Malingamoyo Pvt Clinic B29 = Nice PVT B30 = Twapochele Private Clinic B31 = Umoyo Pvt Clinic B32 = Zasintha Pvt Clinic NGOs B33 = BLM Liwonde Clinic FACILITY CODES ZOMBA - 1 MANGOCHI - 1 Government facilities Government facilities C1 = Airwing Dispensary D1 = Chikole Dispensary C2 = Bimbi Health Centre D2 = Chilipa Health Centre C3 = Chamba Health Centre D3 = Chilonga Health care C4 = Chancellor College D4 = Chiponde Dispensary C5 = Changalume Barracks D5 = Chiumbangame Health Centre C6 = Chingale Health Centre D6 = Chiunda Dispensary C7 = Chisi Island D7 = Iba Dispensary C8 = City Clinic Zomba D8 = Jalasi Health Centre C9 = Cobbe Barracks D9 = Kadango Dispensary C10 = Domasi Rural Hospital D10 = Katuli Health Centre C11 = Lambulira Health Centre D11 = Kukalanga Dispensary C12 = Likangala Health Centre D12 = Lungwena Health Centre C13 = Machinjiri Health Centre D13 = Makanjira Health Centre C14 = Magomero Health Centre D14 = Malalwi Army Marine Dispensary C15 = Makwapala Health Centre D15 = Maldeco Fisheries Clinic C16 = Matawale Health Centre D16 = Maleta C17 = Mikuyu D17 = Malombe Dispensary C18 = M'mambo Health Centre D18 = Malukula Health Centre C19 = Municipal Clinic D19 = Mangochi District Hospital C20 = Naisi Health Centre D20 = Mbalama Dispensary C21 = Namadidi Health Center D21 = Mkumba Health Centre C22 = Namasalima Health Centre D22 = Monkeybay Community Hospital C23 = Nasawa Health Centre D23 = Mtimabi Health Centre C24 = Ngwelelo Health Centre D24 = Namwera Health Centre C25 = Police College Hospital D25 = Nancholi Dispensary C26 = Sadzi Health Center D26 = Nangalamu Health Centre C27 = State House Dispensary D27 = Nankumba Health Centre C28 = Thondwe Health Centre D28 = Ngala Health Post C29 = Zilindo Health Center D29 = Nyangu Health Centre C30 = Zomba Central Hospital D30 = Phirilongwe HC C31 = Zomba Central Prison Clinic D31 = Sinyala Dispensary C32 = Zomba Mental Hospital CHAM facilities CHAM facilities D32 = Kapire Health Centre C33 = Pirimiti Rural Hospital D33 = Katema Health Centre C34 = Chilipa HC D34 = Koche Health Centre C35 = Chipini Health Center D35 = Lugola Health Centre C36 = H Parker Sharp Dispensary D36 = Lulanga Health Centre C37 = Matiya Health Centre D37 = Luwalika Health Centre C38 = Mayaka Health Centre D38 = Malembo Health Centre C39 = Namikango D39 = Mase Health Centre C40 = Nkasala HC D40 = Mpondasi Health Centre C41 = St Lukes Mission Hospital D41 = Mulibwanji Hospital C42 = Thondwe Pastrol Centre D42 = Namalaka Health Centre ZOMBA - 2 MANGOCHI - 2 Private facilities D43 = Nankhwali HC C43 = AHI Clinic D44 = Nkope Health Centre C44 = Mpunga Private Clinic D45 = Sister Martha Health Centre C45 = Chinamwali Pvt Clinic D46 = St Johns Seminary C46 = Prime Private Clinic D47 = St Martins Mission Hospital C47 = Wecare Maternity pvt. Clinic Private facilities C48 = Ku Chawe D48 = Assalam Clinic NGOs D49 = Madalitso Private Clinic C49 = Maela Health Center D50 = Mama Khadija Private Clinic Namwera C50 = Mwandamu Health Center D51 = Mphatso Private Clinic C51 = Compassionate Mission Clinic D52 = Sable Health Centre C52 = Zomba BLM D53 = Stuka Private Clinic D54 = Sukasanje Clinic D55 = Tulame Private Clinic D56 = Umodzi Clinic NGOs D57 = Billy Riordan Memorial Health Clinic D58 = Kapire Dream Centre D59 = Mangochi BLM MSAS R6 Questionnaire
FACILITY CODES BLANTYRE - 1 LILONGWE - 1 Government facilities Government facilities E1 = Bangwe Health Centre F1 = Airwing Health Post E2 = Blantyre City Assembly Clinic F2 = Area 18 Health Centre E3 = Blantyre Water Board - Mudi F3 = Area 25 Health centre E4 = Blantyre Water Board - Walker's Ferry F4 = Area 30 Police Clinic E5 = Chabvala Health Centre F5 = Bunda CollegeClinic E6 = Chichiri ESCOM Clinic F6 = Bwaila Hospital E7 = Chichiri Prison F7 = Chadza Health Centre E8 = Chikowa Health centre F8 = Chikowa Health Centre E9 = Chileka Health Centre F9 = Chileka Health Centre E10 = Chilomoni Health Centre F10 = Chilobwe/Majiga Health Centre E11 = Chimembe Health Centre F11 = Chimbalanga HC E12 = Dziwe Health Centre F12 = Chimwala HC E13 = Limbe Health Centre F13 = Chitedze Health Centre E14 = Lirangwe Health Centre F14 = Chiunjiza Health Centre E15 = Lundu Health Centre F15 = Chiwamba Health Centre E16 = Madziabango Health Centre F16 = City Assembly Health E17 = Makata Health Centre F17 = David Livingstone Memorial Clinic E18 = Mdeka Health Centre F18 = Diamphwe Health Centre E19 = Mpemba Health Centre F19 = Dickson Health Centre E20 = Namikoko Health Centre F20 = Dzalanyama/Kapombeza E21 = Ndirande Health centre F21 = Escom, Lilongwe E22 = Polytechnic F22 = Kabudula rural Hospital E23 = PVHO F23 = Kamuzu Barrak Hospital E24 = Queen Elizabeth Central Hospital F24 = Kamuzu Central Hospital E25 = Sanjika Clinic F25 = Kang'oma Health Centre E26 = Soche Maternity/Namame F26 = Katchale Health Centre E27 = South Lunzu Health Centre F27 = Kawale Health Centre E28 = Walker's Ferry Clinic F28 = Lemwe Health Centre E29 = Zingwangwa Health Centre F29 = Lilongwe City Assembly Chinsapo CHAM facilities F30 = Lilongwe City Assembly Staff Clinic E30 = Blantyre Adventist Hospital F31 = Lumbadzi Health Centre E31 = Chileka SDA Health Centre F32 = Matapila Health Centre E32 = Malabada Health Centre F33 = Mbabvi Health Centre E33 = Mlambe Hospital F34 = Mbang'ombe 2 Health Centre E34 = Soche Maternity F35 = Mbangombe Health Centre 1 E35 = Soche SDA Dispensary F36 = Ming'ong'o Health Centre E36 = St Vincent Health Centre F37 = Mitundu Community Hospital Private facilities F38 = MoH HQ E37 = Alinafe pvt Clinic F39 = Mtenthela Health Centre E38 = Amitofo Care Centre F40 = Nathenje Health Centre E39 = Arthur Garden Clinic F41 = Natural Resources College Clinic E40 = Ayali Private Clinic F42 = Ndaula Health Centre E41 = Banzi pvt F43 = New state house clinic E42 = Belton Kapyepye Memorial Clinic F44 = Nsalu Health centre E43 = Bernald Kachale Pvt Clinic F45 = nthondo Health centre E44 = Blantyre Adventist Hospital F46 = Reserve Bank of Malawi Clinci E45 = Chifundo Private Clinic F47 = Ukwe Health Centre E46 = Chilani Clinic MoH facilities E47 = Chilani Private Clinic F48 = Khongoni Health Centre E48 = Chilobwe Pvt Clinic F49 = Maluwa Health Centre E49 = Chilomoni Private Clinic F50 = Ngoni Health Centre MSAS R6 Questionnaire
BLANTYRE - 2 LILONGWE - 2 E50 = Chinjobvu Private Clinic CHAM facilities E51 = City Health Clinic F51 = Chigodi Health Centre E52 = Dalirani Clinic F52 = Chinthembwe Health Centre E53 = Dr Chilemba Surgery F53 = Chiwe health Centre E54 = Dr Dzinyemba Pvt Clinic F54 = Daeyang Luke Hospital E55 = El-Barakah Private Clinic F55 = Dzenza Health Centre E56 = Elim pvt Clinic F56 = Likuni Mission Hospital E57 = El-Shadai Private Clinic F57 = Malembo Health Centre E58 = Hale Medical Skin Clinic F58 = Malingunde Health Centre E59 = Hasco Clinic F59 = Mbwatalika Health Centre E60 = Kanjedza MASM Medi Clinic F60 = Mlale Mission Hospital E61 = L & A Private Clinic F61 = Nambuma Health Centre E62 = Limbe Central Clinic F62 = Nkhoma Mission Hospital E63 = Limbe Diagnostice Centre F63 = St Gabriel Mission Hospital E64 = Limbe Health Clinic Private facilities E65 = Limbe Muslim Jamaat Clinic F64 = Area 24 Pvt Clinic E66 = Limbe Muslim Jamat - Kachere Clinic F65 = Ali Private Clinic E67 = Limbe Muslim Jamat - Limbe Clinic F66 = Amoun Clinic E68 = Limbe Muslim Jamat - Makheta Clinic F67 = Area 36 Private Clinic E69 = Limbe Muslim Jamat - Mbayani Clinic F68 = CCK Health Clinic E70 = Limbe Private Hospital F69 = Chagogo Private Clinic E71 = Lumbira / Mitsidi Health Centre F70 = Chifundo Private Clinic E72 = Lungu Private Clinic F71 = Chigomezgo Private Clinic E73 = Makhetha Clinic F72 = Chigomezgo Private Clinic E74 = Makwasa Private Clinic F73 = Chilinde H Services E75 = Malamulo Day Clinic Amina F74 = Chimwala Clinic E76 = Malavi Private Clinic F75 = Chinese Clinic E77 = Malmed Clinic F76 = Chizikani Private clinic E78 = Malmed Health Care Services F77 = City Centre Clinic E79 = Medicare Health Centre F78 = Demera Private Clinic E80 = Merit Private Clinic F79 = Discovery Medi Clinic E81 = Michiru pvt Clinic F80 = Dopa PVT Clinic E82 = Moyo Private Clinic F81 = Family Health PVT Clinic E83 = Mt. Soche Clinic F82 = Feroz Medical Centre E84 = Mtengoumodzi Private Hospital F83 = Friendship Clinic E85 = Mwachira Private Clinic F84 = Gift of Hope Private Clinic E86 = Mwai pvt Clinic F85 = Gika PVT Clinic E87 = Mwaiwathu Clinic F86 = Good Hope private Clinic E88 = Mwaiwathu Private Hospital F87 = Hasani Medical Clinic E89 = Mwanamanga, Happiness. F88 = Ji&Jack Clinic E90 = Nancholi Clinic F89 = Kachere Clinic E91 = Naperi Clinic F90 = Kachi Private Clinic E92 = Naperi Medical Centre F91 = Kama Private Clinic E93 = Nyambadwe Private Hospital F92 = Kamatenda PVT Clinic E94 = Praises Private Clinic F93 = Kauma Medical Services E95 = Semema Private Clinic F94 = Kawale Medical Services E96 = Shifa Medical Centre F95 = Khama PVT Clinic E97 = Soche Pvt Clinic F96 = Kim's Medical Centre E98 = Sos Childrens Village Blantyre F97 = Lilongwe Private Clinic E99 = Sungani's Medical Centre F98 = Lingadzi Private Clinic E100 = Sunny Side B F99 = Malakia Private Clinic E101 = Tadala Pvt Clinic F100 = Masada Private Clinic E102 = Thandizo Private Clinic F101 = Masida Pvt MSAS R6 Questionnaire
BLANTYRE - 3 LILONGWE - 3 E103 = Tilinanu Private Clinic F102 = Masm Medi Clinic Lilongwe(Area) E104 = Truzag F103 = Maziko Private Clinic E105 = Ulemu Pvt Clinic F104 = Medical Aid Society of Malawi(Lingadzi clinic) E106 = Wehmatt Pvt Clinic F105 = Mlolera Womens Clinic E107 = Wemaht Private hospital F106 = Mphatso Private Clinic E108 = Yankho Private Clinic F107 = Mpumulo Private Clinic Mission/faith-based organizations F108 = Mt. Nkhoma Clinic E109 = Beit trust Cure International Hospital F109 = Nkhalango Clinic NGOs F110 = Nyamanda Private Clinic E110 = Kachere Rehabilitation Centre F111 = S S H Clinic E111 = Blantyre Dream Project Clinic F112 = Seventh Centre Clinic E112 = Aquid Lifeline Project F113 = SOS Medical Centre E113 = BLM Chilomoni Clinic F114 = Tachira Private clinic E114 = BLM Lunzu Clinic F115 = Tendai Private Clinic E115 = BLM Midima Clinic F116 = The Clinic E116 = BLM Ndirande Clinic F117 = Umoyo Private Clinic E117 = BLM Zingwangwa Clinic F118 = Westcliff Clinic E118 = Limbe Home Based Care Centre F119 = Yankho Private clinic E119 = Macro Blantyre Clinic Mission/faith-based organizations E120 = Madinah Social Services Clinic F120 = Blessings Hospital E121 = Ndirande BLM Clinic F121 = Mlodza/Seventh Day E122 = Zingwangwa BLM Clinic NGOs F122 = ABC Comm. Hospital F123 = Adventist health center Area 14 F124 = Area 25 BLM F125 = BLM Falls Estate Clinic F126 = BLM Area 25A Clinic F127 = BLM Kawale 1 Clinic F128 = FPAN Clinic F129 = Kawale BLM F130 = Macro Lilongwe F131 = Partners In Hope Clinic Moyo Clinic (public) MSAS ROUND 6 MARRIAGE RECONCILIATION SHEET Adol ID
[READ:] "Now I would like to ask you some questions about your marriage(s) or the time(s) you lived together with someone as if married, starting with the [person/people] you mentioned when you were last interviewed." 1st marriage 2nd marriage 3rd marriage RL 1 2011: Name of spouse or partner RL 2 2011: Females : Did [name] or his family NO….0 If 0 or 88 promise to make a payment to your YES….1 →R L4 family when you got married? Don’t know….88 2011: Males: Did you or your family promise to make a payment to [name] when you got married? RL 3 How much has been paid so far? None….0 Some….1 Most….2 All….3 RL 4 [Males RL8; Females ask] NO 0 0 0 In your marriage to [name] , were you a YES 1 1 1 chimeta masisi (replacement for a Don’t know 88 88 88 deceased wife)? RL 5 In your marriage to [name] , were you a NO 0 0 0 mbiriya or nthena (bonus wife)? YES 1 1 1 Don’t know 88 88 88 RL 6 Was your marriage to [name] , (part) NO 0 0 0 payment of a debt? YES 1 1 1 Don’t know 88 88 88 RL 7 Were you kidnapped into the marriage NO 0 0 0 with [name] ? YES 1 1 1 RL 8 Were you forced into the marriage with NO 0 0 0 [name] due to pregnancy? YES 1 1 1 RL 9 After you marriage to [name] , where Your family’s village 0 0 0 did you and your spouse live? Your spouse’s village 1 1 1 Other location 2 2 2 RL 10 At the time of your marriage to [name] , Both approved 1 1 1 did both of your families approve of the Only my family 2 2 2 marriage? Only spouse’s family 3 3 3 Neither family 4 4 4 RL 11 Before you got married to [name] , did a. Talk to [name] Yes No Yes No Yes No you…? about how to 1 0 1 0 1 0 prevent HIV? b. Get tested for HIV? 1 0 1 0 1 0 c. Share your HIV status with [name] ? 1 0 1 0 1 0 d. Talk to [name] about being faithful? 1 0 1 0 1 0 e. Talk to [name] about using condoms? 1 0 1 0 1 0 RL 12 2011: Are you still married or living NO….0 together as if married with [name] ? YES….1 If 1 → RL 12a RL 13 Why did your marriage to [name] end? Infidelity 1 1 1 ALL → Abandoned by [name] 2 2 2 next Disagreement/fighting 3 3 3 spouse or Financial trouble 4 4 4 RL 23 Family pressure 5 5 5 Polygyny 6 6 6 Lack of children 7 7 7
MSAS ROUND 6 MARRIAGE RECONCILIATION SHEET Adol ID
Other ______Respondent widowed 9 9 9
RL 12a Update: Are you still married or living NO 0 0 0 together with [name] ? YES 1 1 1 →RL1 7 RL 14 Did you separate or become divorced or Separated 1 1 1 widowed from [name] ? Divorced 2 2 2 Widowed 3 3 3 RL 15 What age were you when [name] AGE [___|___] [___|___] [___|___] divorced/separated from/widowed Don’t know 88 88 88 you? RL 16 [Check RL14: If widowed next Infidelity 1 1 1 ALL → spouse or RL23, else ask:] Abandoned by [name] 2 2 2 next Why did your marriage to [name] end? Disagreement/fighting 3 3 3 spouse or Financial trouble 4 4 4 RL2 3 Family pressure 5 5 5 Polygyny 6 6 6 Lack of children 7 7 7 Other ______RL 17 Does [name] reside in the household in NO 0 0 0 →RL20 which you live? YES 1 1 1 RL 18 Does [name] ever spend a night away NO 0 0 0 →RL20 from your village/area because of work? YES 1 1 1 Don’t know 88 88 88 →RL20 RL 19 How long did this work keep [name] Days [___|___] [___|___] [___|___] MALES away from your village/area this past Weeks [___|___] [___|___] [___|___] →next year? Months [___|___] [___|___] [___|___] spouse or Don’t know 88 88 88 RL23 RL 20 Females only : Does [name] have any NO 0 0 0 If 0→next other wives? YES 1 1 1 spouse or Don’t know 88 88 88 RL23 RL 21 Females only: In total, how many other NUMBER [____] [____] [____] wives does [name] have? Don’t know 88 88 88 RL 22 Females only: Are you the first wife, First wife 1 1 1 second wife, or some other rank? Second wife 2 2 2 Other rank 3 3 3 [READ:] “Now I would like to ask you about any new marriages or times you may have lived together with someone as if married since the time you were last interviewed.” [Check reference sheet for date of last interview] RL23 Since [date of last interview] , have you NO 0 0 0 →Sec M gotten married or lived with someone as if YES 1 1 1 →L4 FTF married whom we have not mentioned already? [Confirm that spouse or partner has not already been reported above, unless in the case of divorce and remarriage] [If RL23 is 1, return to section L of FTF questionnaire. Begin with question L4 for each new spouse.]
Adol ID
SECTION RN: BIRTH HISTORY RECONCILIATION
[READ:] "Now I would like to ask you a few questions about the [child/children] you mentioned when you were last interviewed." [Please verify and update the following information for previous births.] 1st birth 2nd birth 3rd birth RN1 2010 : First name of child: RN1a Correction to name of child RN2 2011: In what month and year was Born: Month [name] born? Born: Year Don’t know…88 RN2a Correction to month and year of No change 0 0 0 birth Born: Month [__|__] [__|__] [__|__] Born: Year [__|__] [__|__] [__|__] RN3 Females: At the time you became pregnant with [name] , did you want to become pregnant then, did you want to wait until later, or did you not want to have any (more) children at all? Males: At the time the mother of [name] became pregnant with [name] , did you want to have a child then, did you want to wait Then 1 1 1 until later, or did you not want to Later 2 2 2 have any (more) children at all? Not at all 3 3 3 RN4 Females : Did you return to your home village when [name] was born? NO 0 0 0 Males : Did the mother of [name] YES 1 1 1 return to her home village when Still living in home village 2 2 2 [name] was born? [Males only :] Don’t know 88 88 88 RN5 Females : How long did you stay in [If less than 2 months, enter your home village? weeks] Males : How long did the mother of WEEKS [__|__] [__|__] [__|__] [name] stay in her home village? MONTHS [__|__] [__|__] [__|__] [Males only :] Don’t know 88 88 88 RN6 In the first three days after delivery, NO 0 0 0 was [name] given anything to drink YES 1 1 1 other than breast milk? [Males only :] Don’t know 88 88 88 RN7 What was [name] given to drink? Milk (other than breastmilk) 1 1 1 [Probe :] Anything else? Plain water 2 2 2 [Circle all liquids mentioned ] Sugar or glucose water 3 3 3 Gripe water 4 4 4 Sugar-salt-water solution 5 5 5 Fruit juice 6 6 6 Infant formula 7 7 7 Tea 8 8 8 Herbal infusion 9 9 9 Honey 10 10 10 Porridge/daware 11 11 11 Other 12 12 12 RN8 Was [name] ever breastfed? NO…1 → RN 11 YES…1 Males only: Don’t know…88 →RN11 RN9 How long after birth was [name] first put to the breast? MINUTES [__|__] [__|__] [__|__] [If less than 1 hour, record mins; HOURS [__|__] [__|__] [__|__] Adol ID
If less than 24 hours, record hours; DAYS [__|__] [__|__] [__|__] Otherwise, record days] [Males only:] Don’t know 88 88 88 [Copy from RN1 /RN 1a] 1st birth 2nd birth 3rd birth First name of child ______RN10 How many months was [name] MONTHS [__|__] [__|__] [__|__] breastfed? Less than 1 month 0 0 0 Still breastfeeding 77 77 77 Don’t know 88 88 88 RN11 How many months after birth did MONTHS [__|__] [__|__] [__|__] [name] get food/drink other than Less than 1 month 0 0 0 breastmilk? Never/not yet 77 77 77 Don’t know 88 88 88 RN12 2011: Is [name] still alive? NO…0 If 0 YES…1 RN13 Don’t know…88 RN12a [If child was alive in 2011:] NO 0 0 0 →RN 13a Update: Is [name] still alive? YES 1 1 1 →RN 14 Don’t know 88 88 88 →next birth RN13 2011: How old was [name] when YEARS s/he died? [If less than 1 year:] MONTHS Missing…99 RN13a Correction and update: No change 0 0 0 ALL → How old was [name] when s/he YEARS [__|__] [__|__] [__|__] RN 29 died? [If less than 1 year:] MONTHS [__|__] [__|__] [__|__] Less than 1 month 1 1 1 Don’t know 88 88 88 RN14 How old is [name] now? YEARS [__|__] [__|__] [__|__] RN15 Does [name] usually live with you? NO 0 0 0 YES 1 1 1 RN16 Who is [name] ’s primary caregiver? [Record relationship to respondent] Relationship code [__|__] [__|__] [__|__] RN17 [Males RN20, else ask:] Females: Does [name] ’s father NO 0 0 0 usually live with you? YES 1 1 1 → RN20 RN18 Females: How often does [name] Never 0 0 0 see his/her biological father? Yearly/every few years 1 1 1 Monthly/every few months 2 2 2 Weekly/every few weeks 3 3 3 Daily/every few days 4 4 4 Don’t know 88 88 88 RN19 Females: Does [name] ’s father No 0 0 0 provide financial support? Yes, a little 1 1 1 Yes, a lot 2 2 2 RN20 Did/does [name] attend nursery NO 0 0 0 school/preschool ( nkaka )? YES 1 1 1 Don’t know 88 88 88 RN21 [Check RN14: If younger than 5 NO 0 0 0 →RN26 RN26, else ask:] YES 1 1 1 Has [name] started primary school? Don’t know 88 88 88 →RN26 RN22 How old was [name] when s/he YEARS [__|__] [__|__] [__|__] first enrolled in standard 1? Don’t know 88 88 88 RN23 Is [name] currently enrolled in NO 0 0 0 primary school? YES 1 1 1 Don’t know 88 88 88
Adol ID
[Copy from RN1 /RN 1a] 1st birth 2nd birth 3rd birth First name of child ______RN24 [Check R23: Children currently enrolled, ask:] In what standard is [name] currently enrolled? [Children not currently enrolled, ask:] Standard [___] [___] [___] What was the highest standard Don’t know 88 88 88 [name] attended? RN25 [Check RN23: If child not enrolled Name of primary school ______in school RN26, else ask:] ______What primary school does [name] Don’t know 88 88 88 attend? RN26 [Check RN14: If older than 5 NO YES DK NO YES DK NO YES DK RN28, else ask:] a. Read books or look at Did you, [name] ’s father/mother, pictures? 0 1 88 0 1 88 0 1 88 or other adult (age>15) in the b. Tell stories to [name] ? 0 1 88 0 1 88 0 1 88 household do any of the following c. Sing songs? 0 1 88 0 1 88 0 1 88 with [name] in the past 3 days? d. Take [name] outside the household, compound, or enclosure? 0 1 88 0 1 88 0 1 88 e. Play with [name] ? 0 1 88 0 1 88 0 1 88 f. Spend time with [name] naming, drawing and/or 0 1 88 0 1 88 0 1 88 counting things? RN27 Was [name] left alone or in the care of another child age 10 years NO 0 0 0 old or younger at any time in the YES 1 1 1 previous week? Don’t know 88 88 88 RN28 Do you have a card/health passport where [name] ’s vaccinations are NO 0 0 0 written down? YES 1 1 1 [If card/health passport is available, check and update information for RN29-RN37. If card/health passport is not available, ask respondent for updates:] [READ:] “Last time you were interviewed, you indicated that [name] had received the following vaccinations. Is this correct? Has [name] received any additional vaccinations since the last interview?” [For RN29-RN37, use the following codes:] 2011 Update NO 0 NO 0 YES 1 YES 1 No change 2 Child too young/died 77 Child died 77 Don’t know 88 Don’t know 88 Missing 99
1st birth 2nd birth 3rd birth [Copy from RN1/RN1a] First name of child: ______2011 Update 2011 Update 2011 Update RN29 BCG for TB (at birth)
RN30 Polio 0 (at birth)
RN31 Polio 1 (at 6 weeks) Adol ID
RN32 Polio 2 (at 10 weeks)
RN33 Polio 3 (at 14 weeks)
RN34 DPT/Pentavalente 1 (at 6 weeks)
RN35 DPT/Pentavalente 2 (at 10 weeks)
RN36 DPT/Pentavalente 3 (at 14 weeks)
RN37 Measles/MMR (at 9 months)
[READ:]: “Now I would like to ask you about any children you may have had since the last time you were interviewed.” [Check reference sheet for date of last interview] RN37 Females: Since [date of last interview], have you given birth? NO 0 →Sect O Males: Since [date of last interview], has a girl given birth to a child YES 1 that was yours? Males only : Don’t know 88 →Sect O RN38 Females: How many times since [date of last interview] have you ALL given birth? TIMES: [___] → N19 Males: That you know of, how many times since [date of last interview] has a girl given birth to a child that was yours? [Confirm that births mentioned were not already reported above] [If RN38 is 1 or more, return to section N of FTF questionnaire. Ask questions N19 – N64 for each new birth.] MSAS_R6: ACASI Questionnaire ENGLISH Ver. 3 Aug 2013 Adol ID [__|__|__|__|__|__]
ENGLISH
Intro 1 script - Audio only
Practice questions
Intro 2 script - Audio only
SECTION U: ALCOHOL
NO QUESTION RESPONSE SKIP U1 Sometimes young people drink alcohol. In the past NO 0 year, have you ever drunk alcohol? YES 1
U3a In the past year, have you drunk Kachasu? NO 0 YES 1 U3d In the past year, have you drunk Chibuku or village- NO 0 brewed beer or other beer? YES 1
SECTION V: SEXUAL BEHAVIOR
NO QUESTION RESPONSE SKIP V1 I am now going to ask you some questions about NO 0 → W6 your sexual experiences. First I would like to ask you YES 1 about vaginal sex. By vaginal sex I mean when a man inserts his penis in a woman's vagina. In the past year, have you had vaginal sex?
V2 In the past year, how often was a condom used when Never 0 → V4 you had vaginal sex? Sometimes 1 Always 2 → V4 V3 Now think about the last time you had vaginal sex. NO 0 Did you use a condom? YES 1
V4 In the past month, how many times did you have Never 0 vaginal sex? 1-3 times 1 4-8 times 2 More than 8 times 3 V5 Now I would like to ask you about your sex partners. One 1 → V7 By sex partner, I mean anyone with whom you have Two 2 had vaginal sex. In the past year, how many different Three 3 partners have you had vaginal sex with? Four 4 Five or more 5 V6 You indicated you had vaginal sex with 2 or more NO 0 partners in the past year. Were you having a sexual YES 1 relationship with more than one partner during the same time period? V7 Now I would like to ask you about the age of your NO 0 recent sex partners. Do you think that any of the YES 1 partners you had sex with in the past year is more than 10 years older than you?
V8 Boys only: In the past year did you have sex with a NO 0 bar girl or sex worker? YES 1
Page 1 of 3 MSAS_R6: ACASI Questionnaire ENGLISH Ver. 3 Aug 2013 Adol ID [__|__|__|__|__|__]
V9 Girls: Now think about your husband. If you are not He does 1 married think about your boyfriend. Who usually has Both of us equally 2 more say about whether you have sex? Me 3 I do not have a husband or boyfriend 9 → W6 Boys: Now think about your wife. If you are not She does 1 married think about your girlfriend. Who usually has Both of us equally 2 more say about whether you have sex? Me 3 I do not have a wife or girlfriend 9 → W6 V10 Girls only: In this relationship, sometimes I have Disagree 0 sex when I don't want to. Agree 1 V11 Girls only: I can refuse sex with my partner if I don't Disagree 0 feel like having sex. Agree 1 V12 Boys only: In this relationship, I am entitled to have Disagree 0 sex with my partner because I proposed to her Agree 1 Not apply 9 V13 Boys only: In this relationship, I am entitled to have Disagree 0 sex with my partner when I want because I give her Agree 1 things. V14 In total, with how many different people have you One 1 had vaginal sex in your lifetime? Two 2 Three 3 Four 4 Five or more 5
SECTION W: PREGNANCIES, BIRTHS AND CONTRACEPTION
W6_Script: “Sometimes a girl has a miscarriage or a pregnancy that does not end in a live birth...”
NO QUESTION RESPONSE SKIP W6 Girls: In the past year, have you had such a NO 0 pregnancy? YES 1 Boys: In the past year, has a girl that you made Boys only: Don't know 88 pregnant had such a pregnancy?
W10_Script: “Sometimes a girl becomes pregnant when she does not want to be...”
W10 Girls only: In the past year, have you been pregnant NO 0 → Y1a when you did not want to be? YES 1
W11 Girls only: In the past year, the last time that you had such a pregnancy, what did you do? Did you ...? Do nothing and give birth 0 Attempt to remove the pregnancy 1 Successfully remove the pregnancy 2 Miscarry (without doing anything) 3 Do something else 4 W12 Boys only: In the past year, has a girl that you NO 0 made pregnant ever removed that pregnancy? YES 1 Don't know 88
Page 2 of 3 MSAS_R6: ACASI Questionnaire ENGLISH Ver. 3 Aug 2013 Adol ID [__|__|__|__|__|__]
SECTION Y: EXPERIENCES OF DOMESTIC VIOLENCE
NO QUESTION RESPONSE SKIP Y1a Now I am going to ask you about violence in your NO 0 → Conclusion home. In the past year, has anyone in your YES 1 household pushed or shaken you, thrown something at you, punched, slapped, whipped, kicked, or dragged you?
Y2a In the past month, how many times has someone in 0 times 0 → Conclusion your household pushed or shaken you, thrown 1 to 5 times 1 something at you, punched, slapped, whipped, 6 to 9 times 2 kicked, or dragged you? 10 or more times 3 Don't know 88
Y3a In the past month, did your mother or father push NO 0 or shake you, throw something at you, punch, slap, YES 1 whip, kick, or drag you?
Y3b Girls: In the past month, did your husband push or NO 0 shake you, throw something at you, punch, slap, YES 1 whip, kick, or drag you? Girls: Don't have a husband 2 Boys: Don't have a wife 2
Boys: In the past month, did your wife push or shake you, throw something at you, punch, slap, whip, kick, or drag you?
CONCLUSION
Conclusion: "If you would like to discuss any of the questions or issues raised in this survey, please feel free to discuss this with the interviewer."
Page 3 of 3
School ID: Adol ID: MSAS ROUND 6 LIFE EVENTS
INTERVIEWER’S VISIT INFORMATION Day: [___|___] Interviewer ID: [___|___|___] FOR DATA ENTRY SUPERVISOR LOGGED BY CHECKED BY ENTERED BY Month: [___|___] Result code: [___] 1=Complete; 2= Partially complete; 3=Refused INITIALS Year: 2013 Language: [___] 1=Chichewa; 2=Yao; 3=Other ______DATE
Instructions: Show the respondent the five life event cards and explain what they mean. Explain that the reverse side of each card indicates that the event has not yet occurred. Remind the respondent of the sequence he/she reported at last interview. Confirm the sequence with the respondent and ask if any additional events have occurred. Using the event codes, record the sequence of events in LE2a. Enter 0 to indicate that an event has not yet occurred. Remind the respondent of the ages he/she reported that each event occurred at last interview. For any new events, record the age at which each occurred. Enter 0 for events that have not happened yet. In LE3, establish how close together the events occurred.
Year of last interview LE1a: Sequence reported at last interview LE2a: Sequence in R6 [Copy sequence reported in LE1a and add additional events] st nd rd th th st nd rd th th 1 2 3 4 5 1 2 3 4 5 event event event event event event event event event event
LE1b: Ages reported at last interview LE2b: Ages of events in R6 [Copy ages reported in LE1b and add additional ages] 1st 2nd 3rd 4th 5th 1st 2nd 3rd 4th 5th event event event event event event event event event event
DK=88 DK=88 DK=88 DK=88 DK=88
[READ:] “Now I would like to ask you about how close together these events happened.” [Sequence reported in LE2a] LE3: Did the ______event and the ______event happen…? st nd nd rd rd th th th st nd 1 and 2 2 and 3 3 and 4 4 and 5 [Insert 1 , 2 , [Insert next rd events events events events 3 event…] event] Less than one month apart 1 1 1 1
Less than six months apart 2 2 2 2 Less than one year apart 3 3 3 3 More than one year apart 4 4 4 4 One or both not happened yet 9 9 9 9 [Make sure that answers are consistent with ages of events reported above; if not, probe respondent to resolve inconsistencies] LIFE EVENTS REFERENCE SHEET
EVENT A EVENT B School leaving Kusiyiratu sukulu Sex Kugonana
The time when the respondent permanently left The very first time the respondent had vaginal school, with no expectation of returning. sex Respondents not currently attending school have not left school if they intend to go back.
EVENT D EVENT C Pregnancy Kutenga mimba Marriage Kukwatiwa/kukwatira
The very first time the respondent got married, For female respondents: The very first time she or lived with someone as if married became pregnant, regardless of whether the pregnancy resulted in a live birth EVENT E Childbirth Kubereka For male respondents: The very first time a woman became pregnant with his child, regardless of whether the pregnancy resulted in
a live birth
Please remember that for events that can happen more than once (marriage, pregnancy, and childbirth) we are interested For female respondents: The very first time she only in the very first time the event occurred. gave birth to a live child Do not record any event more than once on the life events form. For male respondents: The very first time a woman gave birth to a live child of which he Events that have not yet occurred are marked was the father with a red X on the reverse side of each card.
MSAS_R6: Literacy and Math Questionnaire Chichewa Adol ID: [__|__|__|__|__|__]
Malawi Schooling and Adolescent Study LITERACY AND MATHEMATIC EVALUATION CHICHEWA
IDENTIFICATION
Respondent’s surname ______School ID: [__|__|__] Respondent’s firstname ______Adol ID: [__|__|__|__|__|__] Respondent’s other names ______Respondent’s other names ______Respondent’s standard/form: [__|__] Circle: 1 = In Primary 2 = In Secondary 3 = In tertiary 33 = Out of School Respondent’s sex: [____] (Male=1 Female=2)
INTERVIEWER’S FINAL VISIT DAY [__|__] INTERVIEWER [___|___|___]
MONTH [__|__] RESULT [___] 1 = COMPLETE 2 = PARTIAL COMPLETE 3 = REFUSED
YEAR [ 2 | 0| 1 | 3] LANGUAGE [___] 1 = CHICHEWA 2= YAO 3= OTHER (Specify:______)
SUPERVISOR LOGGED BY CHECKED BY ENTERED BY
INITIALS ______
DATE ______
TIME BEGUN [__|__]:[__|__] (24 HOUR TIME)
SECTION A: LITERACY EVALUATION
“Now I would like you to read this sentence to me” [Show sentences to respondent]. [If respondent cannot read whole sentence, probe:] “Can you read any part of the sentence to me?”
CANNOT READ AT ALL………………………………… 1 A1 Ulimi ndi khama . ABLE TO READ ONLY PARTS OF THE SENTENCE……. 2 ABLE TO READ WHOLE SENTENCE…………………… 3 BLIND/VISUALLY IMPAIRED……………………………. 4 CANNOT READ AT ALL………………………………… 1 A2 Mwana akuwerenga bukhu . ABLE TO READ ONLY PARTS OF THE SENTENCE……. 2 ABLE TO READ WHOLE SENTENCE…………………… 3 BLIND/VISUALLY IMPAIRED….………………...... 4 CANNOT READ AT ALL………………………….……... 1 A3 Parents love their children. ABLE TO READ ONLY PARTS OF THE SENTENCE……. 2 ABLE TO READ WHOLE SENTENCE…………………… 3 BLIND/VISUALLY IMPAIRED…..………………………… 4 CANNOT READ AT ALL………………………………… 1 A4 Children work hard in school. ABLE TO READ ONLY PARTS OF THE SENTENCE….… 2 ABLE TO READ WHOLE SENTENCE………………….... 3 BLIND/VISUALLY IMPAIRED…..………………………… 4
TIME END [__|__]:[__|__] (24 HOUR TIME)
Page 1 of 9
MSAS_R6: Literacy and Math Questionnaire Chichewa Adol ID: [__|__|__|__|__|__]
SECTION B: MATHEMATICAL EVALUATION
[Instructions to Interviewer: Hand the questionnaire to the participant for the entire mathematical evaluation section and assist the participant in inserting their answers in the correct place. If the participant has questions about the problems, you may help them to understand the meaning of a question but do not assist them in finding the answer.]
TIME BEGUN [__|__]:[__|__] (24 HOUR TIME)
TICK HERE IF RESPONDENT CANNOT SOLVE ANY MATH QUESTIONS: [__] SECTION C B1 Write the missing number.
16, 17, _____, 19, ____, 21, 22, _____, _____, 25.
B2 Write these numbers in order starting from the biggest number to the smallest 7, 9, 4, 10, 3 . _____, _____, _____, _____, _____.
OPERATIONS B3 ADDITION 5 136 + 4 + 45 [_____] [_____]
SUBTRACTION 19 9 - 7 - 5 [_____] [_____] MULTIPLICATION 3 21 x 12 x 4 [_____] [_____]
DIVISION 56 ÷ 8 = [____] 489 ÷ 3 = [____]
MONEY
B4 Each banana costs 60 tambala. How much would 3 bananas cost? [______]
B5 You have 85 tambala and you want to buy a pencil that cost 65 tambala. How much change would you get? [______]
Page 2 of 9
MSAS_R6: Literacy and Math Questionnaire Chichewa Adol ID: [__|__|__|__|__|__]
“Here are a few more questions where you can use your mathematical skills. This is a multiple choice section. Circle the response (A,B,C, or D) that best answers the question.” B6 7225 A 11606 – 4381 B 3004 C 2944 D 2844
B7 Find the missing number. A 6 1 = ? B 3 3 6 C 18 D 2
B8 Change 3500 grams to kilograms and grams A 5 kg 300g B 30 kg 50g C 35 kg 0g D 3 kg 500g
B9 Write 63050 Tambala in Kwacha and Tambala
A. K6 35t
B. K6035 00t
C. K63 05t
D. K630 50t
B10 Juma had 2000 eggs. He sold 1109 eggs. How many were left? A 891 B 1891 C 991 D 901
Page 3 of 9
MSAS_R6: Literacy and Math Questionnaire Chichewa Adol ID: [__|__|__|__|__|__]
B11 The product of two factors is 255. If one of the factor is 17, what is the other factor? A. 270 B. 240 C. 19 D. 15
B12 A cell phone was bought for K10000.00 and later sold at K12500.00. What was the profit percent? A. 10% B. 20% C. 25% D. 30%
B13 Find the area of a square whose side is 18cm long. A. 28cm2 B. 56cm2 C. 196cm2 D. 324cm2
B14 Which of the following quadrilaterals is not a parallelogram? A. square B. rectangle C. trapezium D. rhombus
B15 Subtract 1 ⅛ from the sum of 2 ½ and 3/2. A. 7/8 B. 2 7/8 C. 1/2 D. 3/2
TIME END [__|__]:[__|__] (24 HOUR TIME)
Page 4 of 9
MSAS_R6: Literacy and Math Questionnaire Chichewa Adol ID: [__|__|__|__|__|__]
SECTION C: READING AND COMPREHENSION: INTERVIEWER SHEET (CHICHEWA)
[Instructions to interviewer: Hand the sheet with the Chichewa passage back to the respondent and read the following:]
“Now I am going to ask you to read a short story out loud. I will time you and stop you after one minute. When I tell you to start, read aloud. You should read as quickly as you can, but without rushing, because I am also interested in what you remember from the story. After you have read from the passage, I may ask you a few questions about it. This is NOT a test. No one else will see the result and it will NOT affect your grade or promotion in school.”
[Instructions to interviewer: While marking the Chichewa passage as the participant reads, mark words for the four different types of mistakes indicated below. Use the four symbols shown for marking. If the participant does not complete the passage in one minute or less, mark the last word read by the respondent exactly when one minute is over with a bracket “]” after the word.]
TIME BEGUN [__|__]:[__|__] (24 HOUR TIME)
TICK HERE IF RESPONDENT CANNOT READ AT ALL: [___] SECTION D
MARKINGS: MISSED / SKIPPED WORD (SLASH = /) TOTAL WORDS MIISSED [____]
SERIOUSLY MISPRONOUNCED OR INCORRECT WORD ( X) TOTAL WORDS INCORRECT[____]
REPEATED WORD (CIRCLE) TOTAL WORDS REPEATED [____]
ADDED WORD PRIOR TO (+) TOTAL WORDS ADDED [____]
Chichewa 1 2 3 4 5 6 7 8 9 10 Simoni ndi mchemwali wake Rute anayenda pa basi kukaona a
11 12 13 14 15 16 17 18 19 20 malume awo. Pamene basi imadutsa pa mlatho anamva chiphokoso. Oyendetsa
21 22 23 24 25 26 27 28 29 30 basi anayimitsa basiyo ndipo anatuluka m’basimo. Thumba lalikulu la mbatata
31 32 33 34 35 36 37 38 39 40 linali litagwa kuchokera pa mwamba pa basi. Thumbalo linang’ambika ndipo
41 42 43 44 45 46 47 48 49 50 mbatata zinangoti mbweee pa mseu. Simoni ndi Rute anathandiza kutola
51 52 53 54 55 56 57 58 59 60 mbatatazo ndi kuzibwezeretsa mu thumba. Thumbalo linali lolemera kwambiri moti
61 62 63 64 65 66 67 68 69 70 a bambo awiri anathandiza oyendetsa basi kunyamula thumbalo ndi kulikweza
71 72 73 pamwamba pa basi.
Page 5 of 9
MSAS_R6: Literacy and Math Questionnaire Chichewa Adol ID: [__|__|__|__|__|__]
CHICHEWA READING RECORD:
Interviewer: If the respondent finishes reading before one minute is over, click stopwatch when finished so you know how much time was taken. If the respondent has not finished by the time one minute has elapsed, ask him or her to stop reading. Take reading passage sheet from respondent before filling out section below.
C1 Did the respondent finish reading passage NO 0 C3 in one minute or less? YES 1
C2 Record time on stopwatch, if completed in one minute or less. Time in seconds [__|__] Note: Time should not exceed 60 seconds.
C3 Did the respondent finish the first three NO 0 SECT D sentences in the passage [past word # 26]? YES 1 C4
If no to C3 continue to section D If yes to C3 continue to C4.
CHICHEWA READING COMPREHENSION QUESTIONS:
Interviewer: Read each of the following questions out loud to respondent. Do not show questions or answers to respondent. “Now I’m going to ask you some questions about the story. Try to answer each question and tell me if you don’t know the answer.”
Question Answer – Do Not Read
C4 How did Simon and Ruth travel? Correct answer: By bus INCORRECT…...... 0 CORRECT…...... 1 DON’T KNOW...... 88
Where were they going? Correct answer: To C5 INCORRECT…...... 0 visit their uncle CORRECT…...... 1 DON’T KNOW...... 88
Why did the driver stop the bus? Correct answer: He C6 INCORRECT…...... 0 heard a loud noise. CORRECT…...... 1 DON’T KNOW...... 88
What made the loud noise? Correct answer: The C7 INCORRECT…...... 0 sack of potatoes. CORRECT…...... 1 DON’T KNOW...... 88
How did Simon and Ruth help? Correct answer: They C8 INCORRECT…...... 0 picked up the CORRECT…...... 1 potatoes and put DON’T KNOW...... 88 them back in the sack. Why did the two men help the Correct answer: The C9 INCORRECT…...... 0 driver? sack was heavy. CORRECT…...... 1 DON’T KNOW...... 88
Page 6 of 9
MSAS_R6: Literacy and Math Questionnaire Chichewa Adol ID: [__|__|__|__|__|__]
SECTION D: READING RECORD AND COMPREHENSION QUESTIONS (ENGLISH)
[Instructions to Interviewer: Hand the sheet with the English passage back to the respondent and read the following:]
“Now I am going to ask you to read a short story out loud. I will time you and stop you after one minute. When I tell you to start, read aloud. You should read as quickly as you can, but without rushing, because I am also interested in what you remember from the story. After you have read from the passage, I may ask you a few questions about it. This is NOT a test. No one else will see the result and it will NOT affect your grade or promotion in school.”
[Instructions to interviewer: While marking the English passage as the participant reads, use the same symbols for marking as used in the Chichewa passage above. However, only mark words as incorrect if they are very badly mispronounced or if they say a different word. If the respondent does not finish in one minute or less, place a bracket “]” after the last word read.]
TICK HERE IF RESPONDENT CANNOT READ AT ALL: [__] SECTION E
MARKINGS: MISSED / SKIPPED WORD (SLASH = /) TOTAL WORDS MIISSED [____]
SERIOUSLY MISPRONOUNCED OR INCORRECT WORD ( X) TOTAL WORDS INCORRECT[____]
REPEATED WORD (CIRCLE) TOTAL WORDS REPEATED [____]
ADDED WORD PRIOR TO (+) TOTAL WORDS ADDED [____]
English
1 2 3 4 5 6 7 8 9 10 A long time ago, all animals lived together in Chief
11 12 13 14 15 16 17 18 19 20 Ndapusa’s village. The village was near a big river and
21 22 23 24 25 26 27 28 29 30 a forest. They had lots of food to eat and
31 32 33 34 35 36 37 38 39 40 plenty of water to drink. One day Chief Ndapusa went
41 42 43 44 45 46 47 48 49 50 to his garden. He was sad because someone stole his
51 52 53 54 55 56 57 58 59 60 crops. He did not know who the thief was. He
61 62 63 64 65 66 67 68 69 70 told his wife about the crops. His wife was angry.
71 72 73 74 75 76 77 78 79 80 She wanted her husband to ask all the animals if
81 82 83 84 85 86 they knew who stole the crops.
Page 7 of 9
MSAS_R6: Literacy and Math Questionnaire Chichewa Adol ID: [__|__|__|__|__|__]
READING RECORD:
Interviewer: If the respondent finishes reading before one minute is over, click stopwatch when finished so you know how much time was taken. If the respondent has not finished by the time one minute has elapsed, ask him or her to stop reading. Take reading passage sheet from respondent before filling out section below.
D1 Did the respondent finish the reading NO 0 D3 passage in one minute or less? YES 1
D2 Record time on the stopwatch, if completed in one minute or less. Time in seconds [__|__] Note: Time should not exceed 60 seconds.
D3 Did the respondent finish the first five NO 0 SECT E sentences in the passage [past word YES D4 #35] ? 1 If no to D3 continue to Section E If yes to D3 continue to D4.
ENGLISH READING COMPREHENSION QUESTIONS:
Interviewer: Read each of the following questions out loud to respondent. Do not show questions or answers to respondent. “Now I’m going to ask you some questions about the story. Try to answer each question and tell me if you don’t know the answer.”
Question Answer – Do Not Read Where did all the D4 Correct answer: In Chief INCORRECT…...... 0 animals live? CORRECT…...... 1 Ndapusa’s village DON’T KNOW...... 88
Where did Chief D5 Correct answer: The INCORRECT…...... 0 Ndapusa go? CORRECT…...... 1 garden DON’T KNOW...... 88
Why was Chief D6 Correct answer: INCORRECT…...... 0 Ndapusa sad? CORRECT…...... 1 Someone stole his crops DON’T KNOW...... 88
Who was angry about D7 Correct answer: Chief INCORRECT…...... 0 the stolen crops? CORRECT…...... 1 Ndapusa’s wife. DON’T KNOW...... 88
What did Chief D8 Correct answer: Ask all INCORRECT…...... 0 Ndapusa’s wife want CORRECT…...... 1 the animals if they know him to do? DON’T KNOW...... 88 who stole his crops.
TIME END [__|__]:[__|__] (24 HOUR TIME)
Page 8 of 9
MSAS_R6: Literacy and Math Questionnaire Chichewa Adol ID: [__|__|__|__|__|__]
SECTION E: COGNITIVE SKILLS ASSESSMENT Interviewer: The following is a game. I am going to show you a few diagrammatic drawings. Each drawing contains a pattern that has one piece missing. For the missing piece, you will be shown different choices for ways to fill the blank area. I would like you to consider all the available choices and then select the piece that you think best fits into the patterned drawing that you are looking at. Think of this like a puzzle, where you need to insert the piece that best fits with the drawing you see. I will show you each drawing and different choices for the pieces that could fit. For each drawing, please indicate the piece that you see as the best one to complete the pattern. We will start with two practice puzzles.
[For each drawing, record the number of the missing piece (1, 2, 3, 4, 5, or 6) that the participant selects. If the participant says Don’t Know, record 88. If the participant does not want to answer, record 99.]
TIME BEGUN [__|__]:[__|__] (24 HOUR TIME)
PRACTICE E1 E10
PRACTICE E2 E11
E3 E12
E4 E13
E5 E14
E6 E15
E7 E16
E8 E17
E9 E18
TIME END [__|__]:[__|__] (24 HOUR TIME)
Page 9 of 9 MSAS R6 questionnaire Ver. 6 August 2013 Adol ID [__|__|__|__|__|__]
MALAWI SCHOOLING AND ADOLESCENT STUDY R6 ANTHROPOMETRY FORM
DAY MONTH INTERVIEWER ID: ADOL ID SCHOOL ID DATE: 2013 TIME: (24 HOUR TIME) SCALE NUMBER SORT ORDER START: END:
RESPONDENT'S HEIGHT
RESULT CODE: 1 = COMPLETED AT HOUSEHOLD RESPONDENT'S HEIGHT IN CENTIMETERS CM . 2 = COMPLETED AT OTHER LOCATION 3 = REFUSED 4 = RESPONDENT PHYSICALLY DISABLED 5 = OTHER RESPONDENT'S WEIGHT
RESULT CODE: 1 = COMPLETED AT HOUSEHOLD RESPONDENT'S WEIGHT IN KILOGRAMS KG . 2 = COMPLETED AT OTHER LOCATION 3 = REFUSED 4 = RESPONDENT PHYSICALLY DISABLED 5 = OTHER
RESPONDENT'S CHILDREN
Number of living children of respondent If 0 END [CHECK THAT TOTAL NUMBER OF LIVING CHILDREN MATCHES TOTAL REPORTED IN SECTION N OF QUESTIONNAIRE; RECORD NAMES OF EACH CHILD BELOW]
1st child 2nd child
NAME OF CHILD (from N19/RN1) ______
CHILD'S DATE OF BIRTH MONTH MONTH (from N22/RN2)
YEAR YEAR
CHILD'S CURRENT AGE AGE AGE (from N41/RN14) [IF <1 YEAR, ENTER '00'] [IF <1 YEAR, ENTER '00']
[IF CHILD >5 YEARS OLD → NEXT CHILD/END] [IF CHILD >5 YEARS OLD → NEXT CHILD/END]
CM RESULT CODE: CM RESULT CODE: CHILD'S HEIGHT IN 1 = COMPLETED AT HH 1 = COMPLETED AT HH CENTIMETERS . 2 = COMPLETED OTHER . 2 = COMPLETED OTHER 3 = RESP. REFUSED 3 = RESP. REFUSED [IF CHILD AGED 2 YEARS OR MEASUREMENT TAKEN: 4 = CHILD REFUSED MEASUREMENT TAKEN: 4 = CHILD REFUSED OLDER, MEASURE STANDING LYING DOWN 1 5 = CHILD DISABLED LYING DOWN 1 5 = CHILD DISABLED UP; IF YOUNGER THAN 2 YEARS, STANDING UP 2 6 = CHILD NOT PRESENT STANDING UP 2 6 = CHILD NOT PRESENT MEASURE LYING DOWN] 7 = OTHER 7 = OTHER
CHILD MEASURED ALONE RESULT CODE: CHILD MEASURED ALONE RESULT CODE: CHILD'S WEIGHT IN 1 = COMPLETED AT HH 1 = COMPLETED AT HH KILOGRAMS KG . 2 = COMPLETED OTHER KG . 2 = COMPLETED OTHER 3 = RESP. REFUSED 3 = RESP. REFUSED CHILD MEASURED WHILE 4 = CHILD REFUSED CHILD MEASURED WHILE 4 = CHILD REFUSED [IF CHILD AGED 2 YEARS OR HELD 5 = CHILD DISABLED HELD 5 = CHILD DISABLED OLDER, MEASURE ALONE; IF RESPONDENT WEIGHT 6 = CHILD NOT PRESENT RESPONDENT WEIGHT 6 = CHILD NOT PRESENT YOUNGER THAN 2 YEARS, 7 = OTHER 7 = OTHER MEASURE WHILE BEING HELD] KG . KG . NO BLANKET 1 NO BLANKET 1 INCL. BLANKET 2 INCL. BLANKET 2
COMBINED WEIGHT COMBINED WEIGHT
KG . KG . MSAS R6 questionnaire Ver. 6 August 2013 Adol ID [__|__|__|__|__|__]
RESPONDENT'S CHILDREN - CONTINUED
3rd child 4th child
NAME OF CHILD (from N19/RN1) ______
CHILD'S DATE OF BIRTH MONTH MONTH (from N22/RN2)
YEAR YEAR
CHILD'S CURRENT AGE AGE AGE (from N41/RN14) [IF <1 YEAR, ENTER '00'] [IF <1 YEAR, ENTER '00']
[IF CHILD >5 YEARS OLD → NEXT CHILD/END] [IF CHILD >5 YEARS OLD → NEXT CHILD/END]
CM RESULT CODE: CM RESULT CODE: CHILD'S HEIGHT IN 1 = COMPLETED AT HH 1 = COMPLETED AT HH CENTIMETERS . 2 = COMPLETED OTHER . 2 = COMPLETED OTHER 3 = RESP. REFUSED 3 = RESP. REFUSED [IF CHILD AGED 2 YEARS OR MEASUREMENT TAKEN: 4 = CHILD REFUSED MEASUREMENT TAKEN: 4 = CHILD REFUSED OLDER, MEASURE STANDING LYING DOWN 1 5 = CHILD DISABLED LYING DOWN 1 5 = CHILD DISABLED UP; IF YOUNGER THAN 2 YEARS, STANDING UP 2 6 = CHILD NOT PRESENT STANDING UP 2 6 = CHILD NOT PRESENT MEASURE LYING DOWN] 7 = OTHER 7 = OTHER
CHILD MEASURED ALONE RESULT CODE: CHILD MEASURED ALONE RESULT CODE: CHILD'S WEIGHT IN 1 = COMPLETED AT HH 1 = COMPLETED AT HH KILOGRAMS KG . 2 = COMPLETED OTHER KG . 2 = COMPLETED OTHER 3 = RESP. REFUSED 3 = RESP. REFUSED CHILD MEASURED WHILE 4 = CHILD REFUSED CHILD MEASURED WHILE 4 = CHILD REFUSED [IF CHILD AGED 2 YEARS OR HELD 5 = CHILD DISABLED HELD 5 = CHILD DISABLED OLDER, MEASURE ALONE; IF RESPONDENT WEIGHT 6 = CHILD NOT PRESENT RESPONDENT WEIGHT 6 = CHILD NOT PRESENT YOUNGER THAN 2 YEARS, 7 = OTHER 7 = OTHER MEASURE WHILE BEING HELD] KG . KG . NO BLANKET 1 NO BLANKET 1 INCL. BLANKET 2 INCL. BLANKET 2
COMBINED WEIGHT COMBINED WEIGHT
KG . KG .
[IF RESPONDENT HAS MORE THAN 4 LIVING CHILDREN, ENTER CHILD'S MEASUREMENTS IN NOTES SECTION BELOW]
NOTES:
SUPERVISOR: SIGN DATE
ENTERED BY: SIGN DATE