Community Survey in Family Planning Communication (Wife)

Area and Sample code

Name of householders: ______

Name of respondent:______

Address: ______Do ______Kun______EupMyon ______Dong-Li ______

Date of Time of Name of Result of Interview Remarks Visit Interview Interviewer (reason if any) First From: Completed Visit To: Incomplete Second From: Completed Visit To: Incomplete Third From: Completed Visit To: Incomplete

1973 5. School of Public Health, Seoul National University Instructions for interviewers on the following table

a. Whom do you live with?

b. How do you related with them?

c. Ages and the date of birth for each of them?

d. Male or female?

e. Married, single, divorced, widow or separated?

List of household members No. Name Relationship Existence, Date of Age Full Sex Marital with non- birth Animal age status householder existence (specify symbol of Lunar or of year residence Solar) 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15

Fertility ? Formal Induced Spontaneous Still Death Pregnant Pregnancy birth abortion abortion Birth after live birth

Living Children Boys Girls 1. Is ?? that these are such people who control their births by some means? Have you ever heard of the words, family planning? 1) No (skip to Q. 3) 2) Yes

1-1 There are many contraceptive methods. Have you ever heard of any of them? 1) None (skip to Q.3) 2) Yes

1-2 If yes, then which of them have you heard of? Would you please tell me all you have ever heard of?

1-3 If yes, then do you know how to use or what they are? (caution: ask each method one by one)

1-4 If yes, do you fell they are good or bad for your health?

1-5 If yes, how many neighbors do you know who are using each methods you mentioned?

1-6 (if yes) Where do you have to go to get each of them if you want to practice family planning?

Questions of 1’s are for this table

Table II. Knowledge Know Perception No. of Place of service on how of each neighbors who contraceptives method are using she knows Loop 1. D.K. 1. Good 1. D. K. 1. Health center 2. Yes 2. Bad 2. Yes (No. of 2. F. P. worker 3. Other person) 3. clinic 4. drug store 5. others 6. D.K. Oral pill Rhythm Vasectomy Basic Tem. Condom Pessary Coitus Interruptus 2. (if yes to Q. 1-3) Have your ever practiced F. P.? 1. No 2. Yes

2-1. (If no) do you know about the idea of F. P.? Is there any reason for not practicing F. P. even though you know the idea of F. P.? 1. Husband’s objection 2. Parent—in-law’s objection 3. Fear of injury in health 4. Did not know the best way 5. Did not know where to go 6. Did not have any time 7. Want more boys 8. Want more girls 9. sterility, pass the time of live for child birth, Newlywad.

2-2 (Caution: ask this Q. mentioning each reason above) If those objections are salved appropriately could you practice the family planning? 1. Yes 2. No

2-3 Then, are they any reason for impossibility of practicing F. P.?

2-4 What is the main motive of practicing F. P.?

2-5 Then, did you start to practice F. P. as soon as you decide to do it or after awhile? 1. as soon as I decided 2. after a while (how many months or weeks after since you made your mind?)

2-6 You took a little bit of time (tell the exact gap) to start practice. Could you please kindly recall the reason that made you take time?

2-7 Have you ever stopped to practice F. P. by any reason? 1. No 2. Yes

2-8 (If yes) There should have some reasons to stop it. What are they? 3. There are people who agree and disagree on F. P. What do you think of it? 1. Agree 2. Disagree 3. Agree according to circumstances

4. Assuming you are just married and could have the exact number of children you want, how many children would you like to have? (Total No. of children) Boys_____ Girls_____ Without caring about boys or girls _____ 4-1 If you kept giving birth to girls, what would you do? Would you keep giving birth until you had a boy or stop after you had a certain number of girls? 1. Until a boy is born 2. Stop after ( ) girls 4-2 Have you and your husband ever talked the number of children you would like to have? 1. Yes 2. No (Why?) 4-3 Have you and your husband ever talked about using contraception to keep from getting pregnant too often? 1. No (Why?) 2. Yes 4-4 (If yes) Do you and your husband agree on whether or not to practice family planning, or is there some difference of opinion between you on this? a. about the idea of F. P. ; b. about specific method: 1. complete agreement 1. complete agreement 2. some disagreement 2. some disagreement (What is the nature of this disagreement)

4-5 If there are some disagreement between you and your husband on F. P., whose opinion do you have to follow? 1. Husband’s opinion 2. Wife’s opinion 3. Both equally 4-6 When you get old whom will you depending upon, son, daughter, or your couple alone? 1. son and daughter-in-law 2. daughter and son-in-law 3. couple alone. 5. Have you ever discussed about family planning with others? (mainly whom with) Could you tell me the names? 1. 2. 3. 4. 5. 6. (Caution: to only the women who have experiences of contraceptive on the Table III) Are there anybody who knows that you are practicing F. P.? 1. Parent-in-law 2. Own parent 3. Husband 4. Children ( ) 5. Husband’s friends ( ) 6. Wife’s friends ( ) 7. Others 6-1 Then, how did they know about it? I told them Through husband Guessing Other N/A Parent-in-law Own parent Husband’s friends Husband Wife’s friends Children

7. Have you ever recommended to practice F. P. to your neighbors? 1. No 2. Yes 7-1. (If yes) To whom did you tell them go? 1. F. P. worker 2. Doctor 3. Health center 4. Others 5. None of them 7-2. What method have you recommended mainly? 1. Method (______No. of persons) 2. None of them 8. Have you ever met people who are object in F. P., and those who are agree upon F. P.? 1. Only those who agree 2. Only those who are object 3. Both of them 8-1. (in case of those who are object) How credible do you think they are? 1. very credible 2. some what credible 3. not credible 8-2. Have you ever persuade people those who are object to F. P. to change their mind? 1. No 2. Yes 9. Have you heard anything about following contraceptives from your neighbors? Contraceptives None Yes (what about?) Loop Oral pill Vasectomy Condom Others 10. Have you ever heard of or seen the F. P. program through the followings? How often do you heard about and see it? Could you kindly recall the past experiences please? Almost Almost Several time Once None every every in a year or week month twice Radio T.V. Newspaper Happy Home Other Magazine ? or slides Poster Pamphlet Leaflet Meeting Lecture Neighbors Visit of F.P. ?

11. What are the names of meeting and club of women in this community? Any others? 1. 2. 3. 4. 5.

12. Are you a member of mother’s class? 1. Yes (skip to the No. of 12-2) 2. No 12-1. What is the reason for not entering in the mother’s class? 1. No advice received 2. No interested 3. Others 12-2 (If yes in No. 12) Do you think that the mother’s class is very necessary for this community? 1. Yes 2. No (Why?) 13. Have you ever seen a mobile clinic of F. P.? 1. No. 2. Yes (what service received?) 14. Here is a list of some things that families often have to made decision about. In your family, who usually has more influence, the husband or wife, in making decision about the following things? Husband Wife Both equally Parent-in-law 1. How many children to have 2. Whether to purchase on important furniture 3. What types of wife’s clothes to buy?

15. Who is the community do you talk with most? Anyone else? Do they practice F. P.? Name Persuasion existence? Practicing No practicing Discontinued D. K. Non-existence

15-1 Do the above people recommend you to practice F. P. or encourage not to do? (Caution: ask each of above persona mentioned)

15-2 In comparison with the living standard of you to which class do you think they belong? 1. Very similar 2. Some what similar 3. Not similar

15-3. In comparison with the schooling of you to which class do you think they belong? 1. Very similar 2. Some what similar 3. Not similar

16. In a new family planning method had just become available, who in this community would you want to ask for their opinion about it? (anyone else?) 1. 2. 3. 4. 5. 16-1 Then, from which other individuals in this community will inform to you about F. P.? Any others? 1. 2. 3. 4. 5. 17. From which other individuals in this community would you be obtained information or advice about induced abortion to adopt? Any others? 1. 2. 3. 4. 5. 18. Whom do you go to in this community when you have a patient in your family to consult? Any others? 1. 2. 3. 4. 5. 19. When you would like to buy your children’s clothes and purchase an important furniture when you are influenced by to make decision? Any others? 1. 2. 3. 4. 5. 20. Who do you go to obtain information or advice about the education of your children? Any others? 1. 2. 3. 4. 5. 21. Who else in this community has obtained information or advice about family planning from you? Any others? 1. 2. 3. 4. 5. 22. Who else in this community has obtained-information or advice about induced abortion? Any others? 1. 2. 3. 4. 5. 23. Who else in this community has obtained consultation from you when they have a patient in their family? Any others? 1. 2. 3. 4. 5. 24. Who else in this community has obtained information or advice from you when they would like to buy their clothes and purchased an important furniture? Any others? 1. 2. 3. 4. 5. 25. Who else has come to obtain information and advice form you about their children’s education? Any others? 1. 2. 3. 4. 5. 26. Who in this community does your husband talk with most? Anyone else? 1. 2. 3. 4. 5. 27. How many years of schooling did you and your husband complete? Husband Wife Illiterate Illiteracy/ available to read Elementary School Middle School High School College above 28. Do you have any religion? 1. None 4. Buddhism 2. Protestant 5. Confucianism 3. Catholic 6. Others 29. What type of job your husband have? 30. Do you work outside the home to earn any income? 1. No 2. Yes (specify)

Measurement on the knowledge level on Loop A-1. Can a women insert it herself at home? 1. Yes 2. Drug store can do 3. Must go to the doctor 4. Must go to the H.C. A-2. Can you take it off alone? 1. Yes 2. Drug store can do 3. Must go to the doctor 4. Must go to the H.C. A-3. Can a man use the loop? 1. No 2. Yes A-4. How long does it last once you insert the loop? 1. For many years unless it hurts 2. Must change into a new one often 3. Must ask to the Doctor 4. Must ask drug store 5. Any time you may make your mind with the consultations of your neighbors A-4. If there are women and men doctors who want to insert the loop to you who do you want to go? 1. Man doctor (why?) 2. Women doctor (why?) A-6. IF there is only a man doctor and the nurse can insert the loop by whom do you want to be inserted a loop? 1. Man doctor 2. Women nurse Measurement of the knowledge of Oral pill B-1. How often should pills be taken? 1. Every day in a month 2. Every day for 21 days a month starting the fifth day of menstruation 3. Only when you have a sexual intercourse B-2. May your husband can take pills for you? 1. Only women can take 2. Yes, he may B-3. How long should pills be taken? 1. After certain length of time you must stop 2. May take for a long time unless you have side-effects 3. We must ask about it to the doctors or health center 4. We must ask about it to the pharmacist 5. We must ask to your neighbors

Measurement of the knowledge of vasectomy C-1. How long does vasectomy take to be completed? 1. Takes a short time 2. Takes a long time 3. Others C-2. What is the differences between vasectomy and castration of pig? 1. Similar in principle 2. Absolutely different 3. Others C-3. Can any doctors do the vasectomy, or only specialist? 1. All the doctors can do 2. Only specialist can do D. Which of you would be better to practice F. P. husbandside or wifeside? 1. Wifeside 2. Husbandside Reason: E. What aged women, do you think, who give a birth to a child would be shameful?