BECHIMES2000 DDI-NPL-CBS-BCHIMES-2000-v02 Central Bureau of Statistics 2012-03-12 Nesstar Publisher Between Census Household Information Monitoring and Evaluation System 2000 BCHIMES 2000 NPL-CBS-BCHIMES-2000-v1 Central Bureau of Statistics UNICEF/Nepal

UNICEF/Nepal

(c) 2000, Central Bureau of Statistics, Government of Nepal Nesstar Publisher UNICEF Government of Nepal Directorof Publication, Disseminaiton and Library Section Other Household Survey [hh/oth] This survey is the continuation and improvement recommended by the evaluation committee on Nepal Multiple Indicator Surveillance (NMIS), which completed its sixth cycle in 1997-98. Version 1 : Cleaned, edited dataset for internal use. Education HIV/AIDS Nutrition Nepal National coverage Urban/Rural areas Ecological zones Sub-regions All eco-development regions of the Hills and Terai Kathmandu Valley Household as well as individual The survey covered all selected household members, all women aged 15-49 years resident in the household, and all children aged 0-4 years (under age 5) resident in the household. Sample survey data [ssd] Branch Statistics Offices Face-to-face [f2f] Because of the equal allocation of sample size for all the domains, the proportionality of the sample allocation was not met and, thus, sample weights needed to be calculated for the national as well as the Hill, Terai and Mountain region estimates. Final weights/ raising factors depended on the number of households interviewed in each domain. For the calculation of sample weights, the module developed by UNICEF was used. For detail, please have a look at Appendix I Table A1 of the Report on the Situaltion of Women, Children and Households, Between Census Household Information, Monitoring and Evaluation System (BCHIMES), March - May 2000. The data was collected by 14 teams, each made up of three female interviewers, one field editor and one supervisor. The data entry programme was generated using EPI Info version 6.04. The data was entered twice and was validated using the validation programme in EPI Info in order to avoid data entry errors. During the process of validation, a substantial amount of data needed to be verified from the actual questionnaire. Once the validation check was completed, the data was checked for internal consistency using a check programme not used during the data entry stage. This process also required substantial time and problems had to be rectified by going through the questionnaire several times with different checks. Thus processed, the data was converted into SPSS system files and were tabulated using the SPSS versions 10.0 and 7.5. A relational database programme was written in Epi Info package (a word processing database and statistics programme for public health) for data entry and SPSS (Statistical Package for Social Science) was used for data processing. For generating analytical tables in particular, a General Tables Command within the Custom Tables of SPSS was used. In order to maximize the quality of data entry, all records were entered twice by different data-entry operators and the Epi Info Validate Programme was used to validate every record. Beside these, other consistency and structural checks were carried out to ensure the quality of data. Director General Central Bureau of Statistics (CBS), Nepal. Between Census Household Information Monitoring and Evaluation System 2000, Version 1, information provided by the National Data Archive: www.cbs.gov.np/nada." The dataset is for internal use only. The Central Bureau of Statistics, Nepal bears no responsibility for any outcomes or for interpretations or inferences arising from the use of the data and information of this survey. ARI Diarrheoa.NSDstat 0 38 Nesstar 200801 Central Bureau of Statistics Version 1 Education.NSDstat The file contains data related to 300: Education Module. This module is asked of children 6-15 years of age only. 0 33 Nesstar 200801 Central Bureau of Statistics Version 3 - Cleaned, edited and anonymized final dataset HH members.NSDstat The file contains data related to Module 200: Household Schedule of the Household Questionnaire. 0 22 Nesstar 200801 Central Bureau of Statistics Version 3 - Cleaned, edited and anonymized final dataset Household.NSDstat The file contains data related Modules 100: Household Information Panel, 400: Drinking Water, 500: Sanitation and Latrine and 600: Salt. 0 69 Nesstar 200801 Central Bureau of Statistics Version 3 - Cleaned, edited and anonymized final dataset Immunization.NSDstat The file contains data related to Module 1000: Immunisation of the Individual Questionnaire. Information on immunisation of children aged 12-23 months is obtained from mothers/ caretakers. 0 55 Nesstar 200801 Central Bureau of Statistics Version 3 - Cleaned, edited and anonymized final dataset Vitamin A.NSDstat The file contains data related to Module 900: Vitamin A of the Individual Questionnaire. Information is obtained for children aged 6 months to 5 years of age. 0 20 Nesstar 200801 Central Bureau of Statistics Version 3 - Cleaned, edited and anonymized final dataset Women.NSDstat The file contains data related to Modules 200: Demographic and Social Characteristics, 300: Family Planning, 400: Ante-Natal and Delivery Care, 500: STD/HIV/AIDS, 600: Breastfeeding and Vitamin A, question 809 of Module 800: Diarrhoea, questions 901 & 902 of Module 900: Vitamin A and questions 1018 - 1022 of Module 1000: Immunization of the Individual Questionnaire. 0 188 Nesstar 200801 Central Bureau of Statistics Version 3 - Cleaned, edited and anonymized final dataset Urban/Rural Residence District All women of the household who are of age group 15-49 0 0 1 Urban 2 Rural Ecological Zones 0 0 1 Terai 2 Hills 3 Mountain Ecological Development Region 0 0 1 Eastern Terai 2 Central Terai 3 Western Terai 4 M-Western Terai 5 F-Western Terai 6 E+C+W Mountains 7 F+MW Mountains 8 KTM Valley 9 E. Hills 10 C. Hills 11 W. Hills 12 M.W. Hills 13 F.W. Hills District District 0 0 1 Taplejung 2 Panchthar 3 Illam 4 Jhapa 5 Sankhuwasabha 6 Tehrathum 7 Bhojpur 8 Dhankuta 9 Morang 10 Sunsari 11 Solukhumbu 12 Khotang 13 Okhaldhunga 14 Udayapur 15 Saptari 16 Siraha 17 Dhanusha 18 Mahottari 19 Sarlahi 20 Sindhuli 21 Ramechap 22 Dolkha 23 Sindhupalchok 24 Kavre 25 Lalitpur 26 Bhaktapur 27 Kathmandu 28 Nuwakot 30 Dhading 31 Makwanpur 32 Rautahat 33 Bara 34 Parsa 35 Chitwan 36 Gorkha 37 Manang 38 Lamjung 39 Tanahu 40 Kaski 41 Syangja 42 Gulmi 43 Palpa 44 Nawalparasi 45 Rupandehi 46 Kapilbastu 47 Agrakhachi 49 Myagdi 50 Baglung 51 Parbat 52 Rukum 53 Rolpa 54 Pyuthan 55 Salyan 56 Dang 57 Jumla 60 Kalikot 62 Jajarkot 63 Dailekh 64 Surkhet 65 Banke 66 Bardiya 67 Bajhang 68 Bajura 69 Achham 70 Doti 71 Kailali 72 Darchula 73 Baitadi 74 Dadeldhura 75 Kanchanpur Cluster Number Cluster Number 0 0 Record ID 0 0 Line Number of the Person Line number of the Respondent 0 0 Woman ID All women of age 15-49 in the selected household 0 0 Child ID All children of aged below 5 years 0 0 Gender of the Child Gender of the child Children up to 5 years of age 0 0 0 0 1 Male 2 Female Age of the Child Age of the child Children up to 5 years of age 0 0 0 0 Unit of Time Months or Years Children up to 5 years of age 0 0 M Month Y Year Cough and Cold Last Two Weeks Mother or caretaker Has (name) suffered from cough and cold during last two weeks? Children up to 5 years of age 0 0 0 0 1 Yes 2 No Signs and Symptoms of ARI-1st Mother or caretaker What signs and symptoms did you notice when the child was sick with cough and cold? (Multi-response up to 3) Children up to 5 years of age 0 0 0 0 1 Coughing 2 Blocked/ running nose 3 Fever 4 Breathing fast 5 Difficulty breathing 6 Chest in-drawing 7 Problems eating/ drinking 8 Others Signs and Symptoms of ARI-2nd Mother or caretaker What signs and symptoms did you notice when the child was sick with cough and cold? (Multi-response up to 3) Children up to 5 years of age 0 0 0 0 1 Coughing 2 Blocked/ running nose 3 Fever 4 Breathing fast 5 Difficulty breathing 6 Chest in-drawing 7 Problems eating/ drinking 8 Others Signs and Symptoms of ARI-3rd Mother or caretaker What signs and symptoms did you notice when the child was sick with cough and cold? (Multi-response up to 3) Children up to 5 years of age 0 0 0 0 1 Coughing 2 Blocked/ running nose 3 Fever 4 Breathing fast 5 Difficulty breathing 6 Chest in-drawing 7 Problems eating/ drinking 8 Others Things Given to Drink-1st Mother or caretaker During (Name's) ARI what did you offer him/her to drink? Children up to 5 years of age 0 0 0 0 1 Breast milk 2 Cereal soup 3 Yogurt 4 Fruit juice 5 Cow/ buffalo/ canned milk 6 Water with feeding 7 Plain water 8 Other fluids 9 Nothing Things Given to Drink-2nd Mother or caretaker Children up to 5 years of age 0 0 0 0 1 Breast milk 2 Cereal soup 3 Yogurt 4 Fruit juice 5 Cow/ buffalo/ canned milk 6 Water with feeding 7 Plain water 8 Other fluids 9 Nothing Things Given to Drink-3rd Mother or caretaker During (Name's) ARI what did you offer him/her to drink? Children up to 5 years of age 0 0 0 0 1 Breast milk 2 Cereal soup 3 Yogurt 4 Fruit juice 5 Cow/ buffalo/ canned milk 6 Water with feeding 7 Plain water 8 Other fluids 9 Nothing Place of Treatment Mother or caretaker Where did you seek for (name's) treatment? Children up to 5 years of age 0 0 0 0 1 Nowhere, no treatment 2 Home treatment 3 HP/ SHP 4 PHC/ Hospital 5 Ayurvedic Center/ Hospital 6 VHW 7 FCHV 8 Private Clinic/ Nursing Home 9 Medical Shop 10 Faith Healers 11 Others Number of Times ARI Last Year Mother or caretaker How many times has this child suffered from ARI during last year? Children up to 5 years of age 0 0 0 0 Diarrhoea in Last Two Weeks Has (name) had diarrhoea in last two weeks? If No, go to Q808. Children up to 5 years of age 0 0 0 0 1 Yes 2 No Blood in the Stool Was there any blood in (name's) stool during his/her diarrhoea? d801 = 1 0 0 0 0 1 Yes 2 No Things Given to Drink during Diarrhoea-1st During (name's) diarrhoea, what did you offer him/her to drink? d801 = 1 0 0 0 0 1 Breast milk 2 Cereal soup 3 Yogurt 4 Fruit juice 5 Nun-Chhini-Pani 6 Cow/ buffalo/ canned milk 7 JJ/ Nav Jeevan/ ORS Packet 8 Water with feeding 9 Plain water 10 Other fluids 11 Nothing Things Given to Drink during Diarrhoea-2nd During (name's) diarrhoea, what did you offer him/her to drink? d801 = 1 0 0 0 0 1 Breast milk 2 Cereal soup 3 Yogurt 4 Fruit juice 5 Nun-Chhini-Pani 6 Cow/ buffalo/ canned milk 7 JJ/ Nav Jeevan/ ORS Packet 8 Water with feeding 9 Plain water 10 Other fluids 11 Nothing Things Given to Drink during Diarrhoea-3rd During (name's) diarrhoea, what did you offer him/her to drink? d801 = 1 0 0 0 0 1 Breast milk 2 Cereal soup 3 Yogurt 4 Fruit juice 5 Nun-Chhini-Pani 6 Cow/ buffalo/ canned milk 7 JJ/ Nav Jeevan/ ORS Packet 8 Water with feeding 9 Plain water 10 Other fluids 11 Nothing Fluids Given More Less or Same d801 = 1 0 0 0 0 1 None 2 Less 3 Same 4 More Food Given during Diarrhoea Same More or Less During diarrhoea did s/he eat/fed none, less, same or more than usual? d801 = 1 0 0 0 0 1 None 2 Less 3 Same 4 More Place Taken for Treatment Where did you seek for (name's) treatment? d801 = 1 0 0 0 0 1 Nowhere, no treatment 2 Home treatment 3 HP/ SHP 4 PHCC/ Hospital 5 Ayurvedic Center/ Hospital 6 VHW 7 FCHV 8 Private Clinic/ Nursing Home 9 Medical Shop 10 Faith Healers 11 Others Money Spent on Travel How much cost did you incur in (name's) treatment ? If nothing was incurred write 0000 in total cost. If only total cost is available mention that in appropriate column. d801 = 1 0 0 0 0 Money Spent on Examination How much cost did you incur in (name's) treatment ? If nothing was incurred write 0000 in total cost. If only total cost is available mention that in appropriate column. d801 = 1 0 0 0 0 Money Spent on Medicine How much cost did you incur in (name's) treatment ? If nothing was incurred write 0000 in total cost. If only total cost is available mention that in appropriate column. d801 = 1 0 0 0 0 Money Spent on Admission How much cost did you incur in (name's) treatment ? If nothing was incurred write 0000 in total cost. If only total cost is available mention that in appropriate column. d801 = 1 0 0 0 0 Money Spent on Others How much cost did you incur in (name's) treatment ? If nothing was incurred write 0000 in total cost. If only total cost is available mention that in appropriate column. d801 = 1 0 0 0 0 Money Spent on Faith Healers How much cost did you incur in (name's) treatment ? If nothing was incurred write 0000 in total cost. If only total cost is available mention that in appropriate column. d801 = 1 0 0 0 0 Money Spent on Total How much cost did you incur in (name's) treatment ? If nothing was incurred write 0000 in total cost. If only total cost is available mention that in appropriate column. d801 = 1 0 0 0 0 Number of Times Diarr Last Year How many times has this child suffered from diarrhoea during last year? Children up to 5 years of age 0 0 0 0 Weight of the Child 0 0 Urban/Rural Residence All children of age 6-15 years only 0 0 1 Urban 2 Rural Ecological Zones All children of age 6-15 years only 0 0 1 Terai 2 Hills 3 Mountain Ecological Development Region All children of age 6-15 years only 0 0 1 Eastern Terai 2 Central Terai 3 Western Terai 4 M-Western Terai 5 F-Western Terai 6 E+C+W Mountains 7 F+MW Mountains 8 KTM Valley 9 E. Hills 10 C. Hills 11 W. Hills 12 M.W. Hills 13 F.W. Hills District District All children of age 6-15 years only 0 0 1 Taplejung 2 Panchthar 3 Illam 4 Jhapa 5 Sankhuwasabha 6 Tehrathum 7 Bhojpur 8 Dhankuta 9 Morang 10 Sunsari 11 Solukhumbu 12 Khotang 13 Okhaldhunga 14 Udayapur 15 Saptari 16 Siraha 17 Dhanusha 18 Mahottari 19 Sarlahi 20 Sindhuli 21 Ramechap 22 Dolkha 23 Sindhupalchok 24 Kavre 25 Lalitpur 26 Bhaktapur 27 Kathmandu 28 Nuwakot 30 Dhading 31 Makwanpur 32 Rautahat 33 Bara 34 Parsa 35 Chitwan 36 Gorkha 37 Manang 38 Lamjung 39 Tanahu 40 Kaski 41 Syangja 42 Gulmi 43 Palpa 44 Nawalparasi 45 Rupandehi 46 Kapilbastu 47 Agrakhachi 49 Myagdi 50 Baglung 51 Parbat 52 Rukum 53 Rolpa 54 Pyuthan 55 Salyan 56 Dang 57 Jumla 60 Kalikot 62 Jajarkot 63 Dailekh 64 Surkhet 65 Banke 66 Bardiya 67 Bajhang 68 Bajura 69 Achham 70 Doti 71 Kailali 72 Darchula 73 Baitadi 74 Dadeldhura 75 Kanchanpur Cluster Number Cluster Number All children of age 6-15 years only 0 0 Record ID All children of age 6-15 years only 0 0 Line Number of the Person Line number of the Respondent All children of age 6-15 years only 0 0 Child ID for Education Module All children of age 6-15 years only 0 0 Gender of the Child Sex All children of age 6-15 years only 0 0 0 0 1 Male 2 Female Age of the Child Age All children of age 6-15 years only 0 0 0 0 Ever Gone to School Has s/he ever attended school? All children of age 6-15 years only 0 0 0 0 1 Yes 2 No Why Not-1st Why did not s/he go to school? All children of age 6-15 years only who never attended school (ed301 = 2) 0 0 0 0 1 Child was sick 2 Had to help in HH chores 3 School too far 4 Teachers not good 5 Child not willing 6 Language problem 7 Can not afford 8 Girls shouldn't be educated 9 Others Why Not-2nd Why did not s/he go to school? All children of age 6-15 years only who never attended school (ed301 = 2) 0 0 0 0 1 Child was sick 2 Had to help in HH chores 3 School too far 4 Teachers not good 5 Child not willing 6 Language problem 7 Can not afford 8 Girls shouldn't be educated 9 Others Why Not-3rd Why did not s/he go to school? All children of age 6-15 years only who never attended school (ed301 = 2) 0 0 0 0 1 Child was sick 2 Had to help in HH chores 3 School too far 4 Teachers not good 5 Child not willing 6 Language problem 7 Can not afford 8 Girls shouldn't be educated 9 Others Currently in School Is s/he currently attending school? All children of age 6-15 years only who have ever attended school (ed301 = 1) 0 0 0 0 1 Yes 2 No Ever Studied at Pre-School Did the child attend preprimary school earlier? All children of age 6-15 years only who are currently attending school (ed303 = 1) 0 0 0 0 1 Yes 2 No Grade Currently In Which grade child is currently attending? All children of age 6-15 years only who are currently attending school (ed303 = 1) 0 0 0 0 0 Grade 0 1 Grade 1 2 Grade 2 3 Grade 3 4 Grade 4 5 Grade 5 6 Grade 6 7 Grade 7 8 Grade 8 9 Grade 9 10 Grade 10 11 Grade 11 Type of School Which school child is currently attending? All children of age 6-15 years only who are currently attending school (ed303 = 1) 0 0 0 0 1 Public 2 Private 3 Madarsa 4 Others Which Year in Grade 1 What year did s/he enter grade 1? All children of age 6-15 years only who are currently attending school (ed303 = 1) 0 0 0 0 98 DK Time Taken to Reach the School (in minutes) All children of age 6-15 years only who are currently attending school (ed303 = 1) 0 0 0 0 Child Attended School in Last Three Days Did s/he go to school during last three days (except holidays)? All children of age 6-15 years only who are currently attending school (ed303 = 1) 0 0 0 0 0 None 1 One 2 Two 3 Three Why did not Child Attend School-1st If the child did not attend any classes in last three school days ask why did this child did not go to school these days? Multiple response questions record up to three responses. ed309 = 0 0 0 0 0 1 Child was sick 2 Had to help in HH chores 3 School is too far 4 Teachers not good 5 Child not willing 6 Language problem 7 Others Why did not Child Attend School-2nd If the child did not attend any classes in last three school days ask why did this child did not go to school these days? Multiple response questions record up to three responses. ed309 = 0 0 0 0 0 1 Child was sick 2 Had to help in HH chores 3 School is too far 4 Teachers not good 5 Child not willing 6 Language problem 7 Others Why did not Child Attend School-3rd If the child did not attend any classes in last three school days ask why did this child did not go to school these days? Multiple response questions record up to three responses. ed309 = 0 0 0 0 0 1 Child was sick 2 Had to help in HH chores 3 School is too far 4 Teachers not good 5 Child not willing 6 Language problem 7 Others Type of School Prev Went to Which school did s/he attend in the past? ed309 = 1 0 0 0 0 1 Public 2 Private 3 Madarsa 4 Others Which Year Prev in Grade 1 What year did s/he enter grade1? If the child attended only preprimary school then write 97. ed309 = 1 0 0 0 0 97 Only pre-school 99 Missing Highest Grade Completed What grade did s/he complete? ed309 = 1 0 0 0 0 0 Grade 0 1 Grade 1 2 Grade 2 3 Grade 3 4 Grade 4 5 Grade 5 6 Grade 6 7 Grade 7 8 Grade 8 9 Grade 9 10 Grade 10 11 Grade 11 Ever Prep School Did the child attend preprimary school earlier? ed309 = 1 0 0 0 0 1 Yes 2 No Which Year Did S/He Dropped Out Which year did s/he drop out? ed309 = 1 0 0 0 0 99 Missing Main Reasons for Dropping Out-1st What are the main reasons for discontinuing? Multiple response question, record up to 3 responses. ed309 = 1 0 0 0 0 1 Completed desired schooling 2 Further schooling not available 3 Too expensive 4 Had to help at home/farm 5 School or teacher not good 6 All male teachers 7 Parents did not want 8 Had to repeat the grade /FAILED 9 Not willing to attend 10 Language problem 11 Got married 12 Scarcity of textbooks 13 Others Main Reasons for Dropping Out-2nd What are the main reasons for discontinuing? Multiple response question, record up to 3 responses. ed309 = 1 0 0 0 0 1 Completed desired schooling 2 Further schooling not available 3 Too expensive 4 Had to help at home/farm 5 School or teacher not good 6 All male teachers 7 Parents did not want 8 Had to repeat the grade /FAILED 9 Not willing to attend 10 Language problem 11 Got married 12 Scarcity of textbooks 13 Others Main Reasons for Dropping Out-3rd What are the main reasons for discontinuing? Multiple response question, record up to 3 responses. ed309 = 1 0 0 0 0 1 Completed desired schooling 2 Further schooling not available 3 Too expensive 4 Had to help at home/farm 5 School or teacher not good 6 All male teachers 7 Parents did not want 8 Had to repeat the grade /FAILED 9 Not willing to attend 10 Language problem 11 Got married 12 Scarcity of textbooks 13 Others Household weight 0 0 Urban/Rural Residence 0 0 1 Urban 2 Rural Ecological Zones 0 0 1 Terai 2 Hills 3 Mountain Ecological Development Region 0 0 1 Eastern Terai 2 Central Terai 3 Western Terai 4 M-Western Terai 5 F-Western Terai 6 E+C+W Mountains 7 F+MW Mountains 8 KTM Valley 9 E. Hills 10 C. Hills 11 W. Hills 12 M.W. Hills 13 F.W. Hills District District 0 0 1 Taplejung 2 Panchthar 3 Illam 4 Jhapa 5 Sankhuwasabha 6 Tehrathum 7 Bhojpur 8 Dhankuta 9 Morang 10 Sunsari 11 Solukhumbu 12 Khotang 13 Okhaldhunga 14 Udayapur 15 Saptari 16 Siraha 17 Dhanusha 18 Mahottari 19 Sarlahi 20 Sindhuli 21 Ramechap 22 Dolkha 23 Sindhupalchok 24 Kavre 25 Lalitpur 26 Bhaktapur 27 Kathmandu 28 Nuwakot 30 Dhading 31 Makwanpur 32 Rautahat 33 Bara 34 Parsa 35 Chitwan 36 Gorkha 37 Manang 38 Lamjung 39 Tanahu 40 Kaski 41 Syangja 42 Gulmi 43 Palpa 44 Nawalparasi 45 Rupandehi 46 Kapilbastu 47 Agrakhachi 49 Myagdi 50 Baglung 51 Parbat 52 Rukum 53 Rolpa 54 Pyuthan 55 Salyan 56 Dang 57 Jumla 60 Kalikot 62 Jajarkot 63 Dailekh 64 Surkhet 65 Banke 66 Bardiya 67 Bajhang 68 Bajura 69 Achham 70 Doti 71 Kailali 72 Darchula 73 Baitadi 74 Dadeldhura 75 Kanchanpur Cluster Number Cluster Number 0 0 Record ID 0 0 Line Number of the Person Line number of the Respondent 0 0 Individual ID Number 0 0 Number of members in the Household HH Member's Name All memeber of the hh selected 0 0 Household member's name Relationship Relationship 0 0 0 0 1 Head 2 Spouse 3 Son/daughter 4 Daughter-in-law 5 Parents 6 Grand child 7 Others relatives 8 Others non-relatives Gender Gender 0 0 0 0 1 Male 2 Female Age in Completed Years Age in completed yrs 0 0 0 0 Unit of Age - Months or Years 0 0 0 0 M Months Y Years Under Five Age under 5 0 0 0 0 1 Yes 2 No 15-49 Currently Married Woman 0 0 0 0 1 Yes 2 No Able to Read and Write For persons 6 years or older Can s/he read and write? If No, go to 211 Persons 6 years or older 0 0 0 0 1 Yes 2 No How Known For persons 6 years or older If yes how did s/he learn to read and write? Persons 6 years or older who can read and write (hl208 = 1) 0 0 0 0 1 Formal 2 Informal Highest Grade Completed For persons 6 years or older If s/he attended school highest level of grade completed Persons 6 years or older who can read and write (hl208 = 1) 0 0 0 0 0 Grade 0 1 Grade 1 2 Grade 2 3 Grade 3 4 Grade 4 5 Grade 5 6 Grade 6 7 Grade 7 8 Grade 8 9 Grade 9 10 Grade 10 11 Grade 11 12 Grade 12 13 Grade 13 14 Grade 14 15 Grade 15 16 Grade 16 Child between 6 to 15 Enumerator 0 0 0 0 1 Yes 2 No Birth Registered Has the child's birth been registered? Childred 5 years or under 0 0 0 0 1 Yes 2 No Reasons for No Registration Why was the birth not registered? Childred 5 years or under 0 0 0 0 1 DK 2 No time 3 No need 4 Too far 5 Others Household weight 0 0 Urban/Rural Residence 0 0 1 Urban 2 Rural Ecological Zones 0 0 1 Terai 2 Hills 3 Mountain Ecological Development Region 0 0 1 Eastern Terai 2 Central Terai 3 Western Terai 4 M-Western Terai 5 F-Western Terai 6 E+C+W Mountains 7 F+MW Mountains 8 KTM Valley 9 E. Hills 10 C. Hills 11 W. Hills 12 M.W. Hills 13 F.W. Hills District District 0 0 1 Taplejung 2 Panchthar 3 Illam 4 Jhapa 5 Sankhuwasabha 6 Tehrathum 7 Bhojpur 8 Dhankuta 9 Morang 10 Sunsari 11 Solukhumbu 12 Khotang 13 Okhaldhunga 14 Udayapur 15 Saptari 16 Siraha 17 Dhanusha 18 Mahottari 19 Sarlahi 20 Sindhuli 21 Ramechap 22 Dolkha 23 Sindhupalchok 24 Kavre 25 Lalitpur 26 Bhaktapur 27 Kathmandu 28 Nuwakot 30 Dhading 31 Makwanpur 32 Rautahat 33 Bara 34 Parsa 35 Chitwan 36 Gorkha 37 Manang 38 Lamjung 39 Tanahu 40 Kaski 41 Syangja 42 Gulmi 43 Palpa 44 Nawalparasi 45 Rupandehi 46 Kapilbastu 47 Agrakhachi 49 Myagdi 50 Baglung 51 Parbat 52 Rukum 53 Rolpa 54 Pyuthan 55 Salyan 56 Dang 57 Jumla 60 Kalikot 62 Jajarkot 63 Dailekh 64 Surkhet 65 Banke 66 Bardiya 67 Bajhang 68 Bajura 69 Achham 70 Doti 71 Kailali 72 Darchula 73 Baitadi 74 Dadeldhura 75 Kanchanpur Cluster Number Cluster Number 0 0 Record ID 0 0 Interview day 0 0 Interview month 0 0 Interview year 0 0 Sex of the HH Head Gender of the household head All household head in the selected household 0 0 0 0 Sex of the Household head 1 Male 2 Female Religion of the HH Head Religion of HHH All household head 0 0 0 0 Religion of the household head 1 Hindu 2 Buddhist 3 Islam 4 Christian 5 Others Ethnic of the HH Head Caste Ethnicity of HHH All household head 0 0 0 0 Ethnicity of the household head 1 Brahmin 2 Chhetri 3 Newar 4 Gurung Ghale 5 Magar 6 Rai Limbu 7 Tamang Sherpa 8 Muslim 9 Tharu 10 Yadav 11 Others: Hills 12 Others: Terai 13 Others: Mountains Mother Tongue Mother Tongue All household head 0 0 0 0 Mother Tongue of the Household head 1 Nepali 2 Maithali 3 Bhojpuri 4 Abadhi 5 Newari 6 Tharu 7 Rai-Kirati 8 Magar-Gurung 9 Sherpa 10 Others: Pahadi 11 Others: Terai 12 Others: Himali Revisit Necessary Enumerator Revisit Necessary Enumerator 0 0 1 Yes 2 No Interview Completed Enumerator Interview Complete? Enumerator 0 0 1 Yes 2 No Reasons for Incomplete Interview Enumerator Reasons for no/or incomplete interview Enumerator 0 0 Reasons for not completing questionnaire 1 Refusal 2 No hh member 3 No competent person 4 Entire hh empty 5 Others Main Source of Drinking Water Circle appropriate code All household head from the selected household 0 0 0 0 Main source of drinking water 1 Piped in dwelling 2 Public tap 3 Private tubewell 4 Public tubewell 5 Private dugwell 6 Public dugwell 7 Pond-river-stream 8 Stone tap 9 Neighbors private ta 10 Neighbors tubewell 11 Others Sufficient Water from the Source Is water sufficient from that source? All household head from the selected household 0 0 0 0 1 Yes 2 No Months per Year Available from the Source For how many months water available from that source? ............months All household head from the selected household 0 0 0 0 Time Taken to Fetch Water from the Source-Trip All household head from the selected household 0 0 0 0 Time taken to fetch water All household head from the selected household 0 0 0 0 All household head from the selected household 0 0 0 0 All household head from the selected household 0 0 0 0 Trips Fetched Water Total All household head from the selected household 0 0 0 0 Methods used to Purify Water-1st What do you do to treat water? (upto 3 answers) upto 3 answers All household head from the selected household 0 0 0 0 Method used to purify water 1 Boil water 2 Use water purification tabs 3 Filter 4 Cover water storage vessel 5 Keep water source clean 6 Others Methods used to Purify Water-2nd What do you do to treat water? (upto 3 answers) upto 3 answers All household head from the selected household 0 0 0 0 1 Boil water 2 Use water purification tabs 3 Filter 4 Cover water storage vessel 5 Keep water source clean 6 Others Methods used to Purify Water-3rd What do you do to treat water? (upto 3 answers) upto 3 answers All household head from the selected household 0 0 0 0 1 Boil water 2 Use water purification tabs 3 Filter 4 Cover water storage vessel 5 Keep water source clean 6 Others Diarrhoea Did you noticed any following diseases in your community? All household head from the selected household 0 0 0 0 any disease seen in the community 1 Yes 2 No Dysentery Did you noticed any following diseases in your community? All household head from the selected household 0 0 0 0 any disease seen in the community 1 Yes 2 No Jaundice Did you noticed any following diseases in your community? All household head from the selected household 0 0 0 0 any disease seen in the community 1 Yes 2 No Typhoid Did you noticed any following diseases in your community? All household head from the selected household 0 0 0 0 any disease seen in the community 1 Yes 2 No Cholera Did you noticed any following diseases in your community? All household head from the selected household 0 0 0 0 any disease seen in the community 1 Yes 2 No Have own Toilet Facility Is this house has own toilet? All households 0 0 0 0 Toilet facility 1 Yes 2 No Kind of Toilet Facility What type of latrine has this house? 2. No (Go to 510) All households with toilet (sl501 = 1) 0 0 0 0 Types of Toilet 1 Flush toilet 2 Trad pit toilet 3 Ventd improved pit 4 Pan (without flush) 5 Others Children 5-14 in the HH Use Toilet Do all the children (Aged 5 to 14) use latrine? All households with toilet (sl501 = 1) 0 0 0 0 Children 5-14 using latrine 1 Yes all 2 Yes some 3 None 4 No chld 5-14 Adults in the House Use Toilet Do all the adult ( >15 yrs of age) use latrine? All households with toilet (sl501 = 1) 0 0 0 0 Adult in the household using latrine 1 Yes all 2 Yes some 3 None Reason for not Using Toilet Facility Why the latrine in not used? All households with toilet (sl501 = 1) 0 0 0 0 Reasons for not using Latrine 1 Smells 2 Flies-dirty 3 No-water 4 Filled-in 5 Others Toilet Far from House How far is the latrine from house? All households with toilet (sl501 = 1) 0 0 0 0 Distance between house and toilet 1 Vicinity of hh 2 <50 feet 3 51-100 feet 4 >100 ft Toilet far from Source of Water How far is the latrine from source of water? All households with toilet (sl501 = 1) 0 0 0 0 Distance from the source of water to toilet 1 Vicinity of hh 2 <50 feet 3 51-100 feet 4 >100 ft Working Condition of Toilet Is latrine in working condition? (See) All households with toilet (sl501 = 1) 0 0 0 0 Status of Toilet 1 Yes 2 No Toilet Clean Is latrine clean? All households with toilet (sl501 = 1) 0 0 0 0 cleanlyness of toilet 1 Yes 2 No Family Member usually goes for Defecation Where household member goes for defecation? All households without toilet (sl501 = 2) 0 0 0 0 Family member going for defacation 1 In own yard 2 Bush-forest 3 Just outside yard 4 Near water source 5 In the field 6 Others Reason for not Having Toilet Facility What is the cause for not constructive latrine? All households without toilet (sl501 = 2) 0 0 0 0 Reasons for not having toilet facility 1 No habit 2 Foul smell 3 No space 2 build 4 Imp not known 5 Can not afford 6 Others What done with Children-Infant Stool Where do you throw children's stool? All households 0 0 0 0 1 Outside house: indscrete 2 Throw in pit 3 Rachhan 4 In khet-bari 5 In latrine 6 No child 7 Others Place of Disposal of Household Waste Where do you throw the wastage of house? All households 0 0 0 0 1 Dung disposal pit 2 Garbage pit 3 Alongside road 4 Corner of courtyard 5 Indiscrete disposal 6 Municipality pick up area 7 Others Distance from Home of Disposal Site How far is the dustbin place from your house? All households 0 0 0 0 1 In vicinity of HH 2 <50 feet 3 50-100 feet 4 101-300 ft 5 >300 ft Everybody Wash Hands before Meals Do all the members wash hands before meal? All households 0 0 0 0 1 Yes, all 2 Yes, some 3 None Material used for Cleaning What do they use for cleaning hand? All households 0 0 0 0 Meterails using for cleaning 1 Water only 2 Ash+water 3 Soap+water 4 Soil+water 5 Others Everybody Wash Hands after Defecation Do all wash hands after defecation? All households 0 0 0 0 1 Yes, all 2 Yes, some 3 None Material used for Washing Hand What do they use for hand washing? All households 0 0 0 0 1 Water only 2 Ash+water 3 Soap+water 4 Soil+water 5 Others Adults Wash Hands before Preparing Food Do all adult member wash hand before preparing meal? All households 0 0 0 0 1 Yes, all 2 Yes, some 3 None Adults Wash Hands before Feeding the Child all adult member wash hand before feeding to young children? All households 0 0 0 0 1 Yes, all 2 Yes, some 3 None 4 No child Water Storage Vessel Covered Does the household cover the water vessel? (observe yourself ) All households 0 0 0 0 1 Yes 2 No 3 Not seen 4 None remaining Leftover Food Covered Does the household cover leftover food? All households 0 0 0 0 1 Yes 2 No 3 Not seen 4 None remaining Electricity in HH Do this household have following facilities? All households 0 0 0 0 Facility available in household 1 Yes 2 No Radio in HH Do this household have following facilities? All households 0 0 0 0 Facility available in household 1 Yes 2 No TV in HH Do this household have following facilities? All households 0 0 0 0 Facility available in household 1 Yes 2 No Phone in HH Do this household have following facilities? All households 0 0 0 0 Facility available in household 1 Yes 2 No Cycle in HH Do this household have following facilities? All households 0 0 0 0 Facility available in household 1 Yes 2 No Motorcycle in HH Do this household have following facilities? All households 0 0 0 0 Facility available in household 1 Yes 2 No Motor Car in HH Do this household have following facilities? All households 0 0 0 0 Facility available in household 1 Yes 2 No Fridge in HH Do this household have following facilities? All households 0 0 0 0 Facility available in household 1 Yes 2 No Type of Oven What do you use for cooking food? All households 0 0 0 0 1 Traditional 2 Smokeless 3 Gas-kerosene 4 Others No. of Rooms used for Sleeping How many rooms are used in this household for sleeping? ……….. All households 0 0 0 0 Sleeping room number We want to test the salt, which was used in your house. Can we see the salt, which was used in last evening? All households 0 0 0 0 0 Zero 1 Less than15 2 Greater than 15 Type of Salt Type of salt used All households 0 0 0 0 Type of salt 1 Aayo salt 2 Tata salt 3 Shakti salt 4 Bhanu salt 5 Brandless powder 6 Crushed salt 7 Crystal salt foda 8 Crystal salt tibet 9 Others Last time salt was bought Note if the iodine content is less than 15 PPM, as the following questions: When did you buy this salt?…….months All households with iodine content less than 15 PPM (si601 = 1) 0 0 0 0 condition of salt Reasons for using Brand of Salt Why did you use this salt? All households with iodine content less than 15 PPM (si601 = 1) 0 0 0 0 reason for using this salt 1 Available here 2 Cheaper than others 3 Like brand 4 Others Household weight 0 0 Urban/Rural Residence 0 0 1 Urban 2 Rural Ecological Zones 0 0 1 Terai 2 Hills 3 Mountain Ecological Development Region 0 0 1 Eastern Terai 2 Central Terai 3 Western Terai 4 M-Western Terai 5 F-Western Terai 6 E+C+W Mountains 7 F+MW Mountains 8 KTM Valley 9 E. Hills 10 C. Hills 11 W. Hills 12 M.W. Hills 13 F.W. Hills District District 0 0 1 Taplejung 2 Panchthar 3 Illam 4 Jhapa 5 Sankhuwasabha 6 Tehrathum 7 Bhojpur 8 Dhankuta 9 Morang 10 Sunsari 11 Solukhumbu 12 Khotang 13 Okhaldhunga 14 Udayapur 15 Saptari 16 Siraha 17 Dhanusha 18 Mahottari 19 Sarlahi 20 Sindhuli 21 Ramechap 22 Dolkha 23 Sindhupalchok 24 Kavre 25 Lalitpur 26 Bhaktapur 27 Kathmandu 28 Nuwakot 30 Dhading 31 Makwanpur 32 Rautahat 33 Bara 34 Parsa 35 Chitwan 36 Gorkha 37 Manang 38 Lamjung 39 Tanahu 40 Kaski 41 Syangja 42 Gulmi 43 Palpa 44 Nawalparasi 45 Rupandehi 46 Kapilbastu 47 Agrakhachi 49 Myagdi 50 Baglung 51 Parbat 52 Rukum 53 Rolpa 54 Pyuthan 55 Salyan 56 Dang 57 Jumla 60 Kalikot 62 Jajarkot 63 Dailekh 64 Surkhet 65 Banke 66 Bardiya 67 Bajhang 68 Bajura 69 Achham 70 Doti 71 Kailali 72 Darchula 73 Baitadi 74 Dadeldhura 75 Kanchanpur Cluster Number Cluster Number 0 0 Record ID 0 0 Line Number of the Person Line number of the Respondent 0 0 Woman ID 0 0 Child ID for IMM Module 0 0 Gender of the Child 0 0 0 0 1 Male 2 Female Day of Birth 0 0 44 Nothing 98 Date missing Month of Birth 0 0 44 Nothing 98 Date missing Year of Birth 0 0 44 Nothing 98 Date missing Card Available Mother or caretaker Is there a vaccination card for (name)? All children of age 12-23 months 0 0 0 0 Child received vaccination 1 Yes 2 No BCG Mother or caretaker Is there are vaccination card for (name)? All children of age 12-23 months 0 0 0 0 Child received vaccination 1 Yes 2 No Date - BCG Mother or caretaker Date of Immunisation All children of age 12-23 months 0 0 0 0 Child received vaccination 44 Nothing 98 Date missing Month - BCG Mother or caretaker Date of Immunisation All children of age 12-23 months 0 0 0 0 Child received vaccination 44 Nothing 98 Date missing Year - BCG Mother or caretaker Date of Immunisation All children of age 12-23 months 0 0 0 0 Child received vaccination 44 Nothing 98 Date missing DPT-1 Mother or caretaker Is there are vaccination card for (name)? All children of age 12-23 months 0 0 0 0 Child received vaccination 1 Yes 2 No Date - DPT1 Mother or caretaker Date of Immunisation All children of age 12-23 months 0 0 0 0 Child received vaccination 44 Nothing 98 Date missing Month- DPT1 Mother or caretaker Date of Immunisation All children of age 12-23 months 0 0 0 0 Child received vaccination 44 Nothing 98 Date missing Year - DPT1 Mother or caretaker Date of Immunisation All children of age 12-23 months 0 0 0 0 Child received vaccination 44 Nothing 98 Date missing DPT2 Mother or caretaker Is there are vaccination card for (name)? All children of age 12-23 months 0 0 0 0 Child received vaccination 1 Yes 2 No Date - DPT2 Mother or caretaker Date of Immunisation All children of age 12-23 months 0 0 0 0 Child received vaccination 44 Nothing 98 Date missing Month - DPT2 Mother or caretaker Date of Immunisation All children of age 12-23 months 0 0 0 0 Child received vaccination 44 Nothing 98 Date missing Year - DPT2 Mother or caretaker Date of Immunisation All children of age 12-23 months 0 0 0 0 Child received vaccination 44 Nothing 98 Date missing DPT-3 Mother or caretaker Is there are vaccination card for (name)? All children of age 12-23 months 0 0 0 0 Child received vaccination 1 Yes 2 No Date - DPT3 Mother or caretaker Date of Immunisation All children of age 12-23 months 0 0 0 0 Child received vaccination 44 Nothing 98 Date missing Month - DPT3 Mother or caretaker Date of Immunisation All children of age 12-23 months 0 0 0 0 Child received vaccination 44 Nothing 98 Date missing Year - DPT3 Mother or caretaker Date of Immunisation All children of age 12-23 months 0 0 0 0 Child received vaccination 44 Nothing 98 Date missing Polio-1 Mother or caretaker Is there are vaccination card for (name)? All children of age 12-23 months 0 0 0 0 Child received vaccination 1 Yes 2 No Date - OPV1 Mother or caretaker Date of Immunisation All children of age 12-23 months 0 0 0 0 Child received vaccination 44 Nothing 98 Date missing Month - OPV1 Mother or caretaker Date of Immunisation All children of age 12-23 months 0 0 0 0 Child received vaccination 44 Nothing 98 Date missing Year - OPV1 Mother or caretaker Date of Immunisation All children of age 12-23 months 0 0 0 0 Child received vaccination 44 Nothing 98 Date missing Polio-2 Mother or caretaker Is there are vaccination card for (name)? All children of age 12-23 months 0 0 0 0 Child received vaccination 1 Yes 2 No Date - OPV2 Mother or caretaker Date of Immunisation All children of age 12-23 months 0 0 0 0 Child received vaccination 44 Nothing 98 Date missing Month - OPV2 Mother or caretaker Date of Immunisation All children of age 12-23 months 0 0 0 0 Child received vaccination 44 Nothing 98 Date missing Year - OPV2 Mother or caretaker Date of Immunisation All children of age 12-23 months 0 0 0 0 Child received vaccination 44 Nothing 98 Date missing Polio-3 Mother or caretaker Is there are vaccination card for (name)? All children of age 12-23 months 0 0 0 0 Child received vaccination 1 Yes 2 No Date - OPV3 Mother or caretaker Date of Immunisation All children of age 12-23 months 0 0 0 0 Child received vaccination 44 Nothing 98 Date missing Month - OPV3 Mother or caretaker Date of Immunisation All children of age 12-23 months 0 0 0 0 Child received vaccination 44 Nothing 98 Date missing Year - OPV3 Mother or caretaker Date of Immunisation All children of age 12-23 months 0 0 0 0 Child received vaccination 44 Nothing 98 Date missing Measles Mother or caretaker Is there are vaccination card for (name)? All children of age 12-23 months 0 0 0 0 Child received vaccination 1 Yes 2 No Date - Measles Mother or caretaker Date of Immunisation All children of age 12-23 months 0 0 0 0 Child received vaccination 44 Nothing 98 Date missing Month - Measles Mother or caretaker Date of Immunisation All children of age 12-23 months 0 0 0 0 Child received vaccination 44 Nothing 98 Date missing Year - Measles Mother or caretaker Date of Immunisation All children of age 12-23 months 0 0 0 0 Child received vaccination 44 Nothing 98 Date missing Any Date not Mentioned in Card Mother or caretaker Has (name) received any vaccination whose dates are not recorded in the card? All children of age 12-23 months 0 0 0 0 Child received vaccination 1 Yes 2 No Ever given BCG Mother or caretaker Probing questions to use when no vaccination card is available Has (name) received BCG vaccination against tuberculosis, that is, an injection in the shoulder that caused a scar? All children of age 12-23 months 0 0 0 0 Child received vaccination 1 Yes 2 No Ever given DPT Mother or caretaker Probing questions to use when no vaccination card is available Has (name) ever been given ”vaccination injections” that is an injection in the thigh or buttocks to prevent him/her from getting tetanus, whooping cough, and diphtheria? Note DPT is given at the time of polio drops. All children of age 12-23 months 0 0 0 0 Child received vaccination 1 Yes 2 No Number of Times DPT Mother or caretaker Probing questions to use when no vaccination card is available How many times? All children of age 12-23 months 0 0 0 0 Child received vaccination Ever given Polio Drops Mother or caretaker Probing questions to use when no vaccination card is available Has (name) been given any “polio drops” to protect him/her from getting polio diseases? All children of age 12-23 months 0 0 0 0 Child received vaccination 1 Yes 2 No Number of Times-Polio Mother or caretaker Probing questions to use when no vaccination card is available How many times? All children of age 12-23 months 0 0 0 0 Child received vaccination Polio given in Last NID Mother or caretaker Probing questions to use when no vaccination card is available Has s/he ever been given polio drops in last National Immunisation Day? All children of age 12-23 months 0 0 0 0 Child received vaccination 1 Yes 2 No Measles given Mother or caretaker Probing questions to use when no vaccination card is available Has (name) ever been given “vaccination injections,” that is, a shot in the arm after nine months of age to prevent him/her from getting measles? All children of age 12-23 months 0 0 0 0 Child received vaccination 1 Yes 2 No Child weight 0 0 Urban/Rural Residence 0 0 1 Urban 2 Rural Ecological Zones 0 0 1 Terai 2 Hills 3 Mountain Ecological Development Region 0 0 1 Eastern Terai 2 Central Terai 3 Western Terai 4 M-Western Terai 5 F-Western Terai 6 E+C+W Mountains 7 F+MW Mountains 8 KTM Valley 9 E. Hills 10 C. Hills 11 W. Hills 12 M.W. Hills 13 F.W. Hills District District 0 0 1 Taplejung 2 Panchthar 3 Illam 4 Jhapa 5 Sankhuwasabha 6 Tehrathum 7 Bhojpur 8 Dhankuta 9 Morang 10 Sunsari 11 Solukhumbu 12 Khotang 13 Okhaldhunga 14 Udayapur 15 Saptari 16 Siraha 17 Dhanusha 18 Mahottari 19 Sarlahi 20 Sindhuli 21 Ramechap 22 Dolkha 23 Sindhupalchok 24 Kavre 25 Lalitpur 26 Bhaktapur 27 Kathmandu 28 Nuwakot 30 Dhading 31 Makwanpur 32 Rautahat 33 Bara 34 Parsa 35 Chitwan 36 Gorkha 37 Manang 38 Lamjung 39 Tanahu 40 Kaski 41 Syangja 42 Gulmi 43 Palpa 44 Nawalparasi 45 Rupandehi 46 Kapilbastu 47 Agrakhachi 49 Myagdi 50 Baglung 51 Parbat 52 Rukum 53 Rolpa 54 Pyuthan 55 Salyan 56 Dang 57 Jumla 60 Kalikot 62 Jajarkot 63 Dailekh 64 Surkhet 65 Banke 66 Bardiya 67 Bajhang 68 Bajura 69 Achham 70 Doti 71 Kailali 72 Darchula 73 Baitadi 74 Dadeldhura 75 Kanchanpur Cluster Number Cluster Number 0 0 Record ID 0 0 Line Number of the Person Line number of the Respondent 0 0 Woman ID 0 0 Child ID 0 0 Gender of the Child Children aged 6 months to 5 years of age 0 0 0 0 1 Male 2 Female Age of the Child Children aged 6 months to 5 years of age 0 0 Unit for Age of the Child Children aged 6 months to 5 years of age 0 0 M Months Y Years Aware of National Vit A Program Mother or caretaker Are you aware of the National Vitamin 'A' program? Children aged 6 months to 5 years of age 0 0 0 0 Vitamin A received by the children of age 6 months to 5 years of age 1 Yes 2 No Knowledge of Vit A Program in Family Mother or caretaker Are any other members of your family aware of this programme? Children aged 6 months to 5 years of age 0 0 0 0 Vitamin A received by the children of age 6 months to 5 years of age 1 Yes 2 No 3 DK Given Vitmain A During Last Distribution Mother or caretaker Did s/he receive Vitamin A capsule during last Oct/Nov - April/May? Children aged 6 months to 5 years of age 0 0 0 0 Vitamin A received by the children of age 6 months to 5 years of age 1 Yes 2 No Capsule Given in the Hand Mother or caretaker Can you tell me the activities done during the distribution of vitamin A? Record all that applies. Children aged 6 months to 5 years of age 0 0 0 0 Vitamin A received by the children of age 6 months to 5 years of age 1 Yes 2 No 3 Don't know Capsule Cut by Scissors or Other Equipment Mother or caretaker Can you tell me the activities done during the distribution of vitamin A? Record all that applies. Children aged 6 months to 5 years of age 0 0 0 0 Vitamin A received by the children of age 6 months to 5 years of age 1 Yes 2 No 3 Don't know Name of the Child Written Mother or caretaker Can you tell me the activities done during the distribution of vitamin A? Record all that applies. Children aged 6 months to 5 years of age 0 0 0 0 Vitamin A received by the children of age 6 months to 5 years of age 1 Yes 2 No 3 Don't know Capsule Squeezed in the Mouth Mother or caretaker Can you tell me the activities done during the distribution of vitamin A? Record all that applies. Children aged 6 months to 5 years of age 0 0 0 0 Vitamin A received by the children of age 6 months to 5 years of age 1 Yes 2 No 3 Don't know Child weight 0 0 Urban/Rural Residence 0 0 1 Urban 2 Rural Ecological Zones 0 0 1 Terai 2 Hills 3 Mountain Ecological Development Region 0 0 1 Eastern Terai 2 Central Terai 3 Western Terai 4 M-Western Terai 5 F-Western Terai 6 E+C+W Mountains 7 F+MW Mountains 8 KTM Valley 9 E. Hills 10 C. Hills 11 W. Hills 12 M.W. Hills 13 F.W. Hills District District 0 0 1 Taplejung 2 Panchthar 3 Illam 4 Jhapa 5 Sankhuwasabha 6 Tehrathum 7 Bhojpur 8 Dhankuta 9 Morang 10 Sunsari 11 Solukhumbu 12 Khotang 13 Okhaldhunga 14 Udayapur 15 Saptari 16 Siraha 17 Dhanusha 18 Mahottari 19 Sarlahi 20 Sindhuli 21 Ramechap 22 Dolkha 23 Sindhupalchok 24 Kavre 25 Lalitpur 26 Bhaktapur 27 Kathmandu 28 Nuwakot 30 Dhading 31 Makwanpur 32 Rautahat 33 Bara 34 Parsa 35 Chitwan 36 Gorkha 37 Manang 38 Lamjung 39 Tanahu 40 Kaski 41 Syangja 42 Gulmi 43 Palpa 44 Nawalparasi 45 Rupandehi 46 Kapilbastu 47 Agrakhachi 49 Myagdi 50 Baglung 51 Parbat 52 Rukum 53 Rolpa 54 Pyuthan 55 Salyan 56 Dang 57 Jumla 60 Kalikot 62 Jajarkot 63 Dailekh 64 Surkhet 65 Banke 66 Bardiya 67 Bajhang 68 Bajura 69 Achham 70 Doti 71 Kailali 72 Darchula 73 Baitadi 74 Dadeldhura 75 Kanchanpur Cluster Number Cluster Number 0 0 Record ID 0 0 Line Number of the Person Line Number of the Respondent 0 0 Woman ID 0 0 Interview Complete Interview complete? If yes, fill from Q117 onwards. 0 0 1 Yes 2 No Reason for No Interview Reasons for no or incomplete interview 0 0 1 Refusal 2 Not at home 3 Have no time 4 Ask again to come 5 Others 6 Went to mother's home Age in Completed Years How old are you? Write completed years. Marrried women aged 15-49 years 0 0 0 0 Age at Marriage At what age were you first married? Write completed years. Marrried women aged 15-49 years 0 0 0 0 Number of Sons Given Birth to How many sons have you given birth to? Write 00 if none and skip to Q205. Marrried women aged 15-49 years 0 0 0 0 Sons Surviving How many of them are alive? Write 00 if none. Married women aged 15-49 who have born sons 0 0 0 0 Number of Daughters Given Birth to How many of them are alive? Write 00 if none and skip to Q207. Marrried women aged 15-49 years 0 0 0 0 Daughters Surviving How many of them are alive? Write 00 if none. Married women aged 15-49 who have born daughters 0 0 0 0 Pregnancy Status Are your currently pregnant? No -> Skip to instructions just before Q208. Marrried women aged 15-49 years 0 0 0 0 1 Yes 2 No Months into Pregnancy How many months into pregnancy? _________ months Pregnant women aged 15-49 0 0 0 0 Age at first Pregnancy If she has never been pregnant ask Q210. If she has given at least one birth or is currently pregnant, then ask Q208. At what age did you get pregnant for the first time? Write completed years. Pregnant women aged 15-49 years 0 0 0 0 Desire for More Children Do you want to have any more children (apart from current pregnancy)? No -> Skip to Q211. Pregnant women aged 15-49 years 0 0 0 0 1 Yes 2 No 3 DK How Many More How many children would you like to have? Pregnant women aged 15-49 years 0 0 0 0 Ever Been to School Have you ever attended school? No -> Ask Q213. Pregnant women aged 15-49 years 0 0 0 0 1 Yes 2 No Highest Grade Completed What is the highest grade you have completed? Ask Q 214 if grade 5 or above. Pregnant women aged 15-49 years 0 0 0 0 1 Grade 1 2 Grade 2 3 Grade 3 4 Grade 4 5 Grade 5 6 Grade 6 7 Grade 7 8 Grade 8 9 Grade 9 10 Grade 10 11 Grade 11 12 Grade 12 13 Grade 13 14 Grade 14 15 Grade 15 16 Grade 16 96 Informal education Able to Read and Write Can you read and write? No -> Ask Q215 Pregnant women aged 15-49 years 0 0 0 0 1 Read only 2 Read/write 3 No read/write Times Read Papers/Magazine in a Week How often do you read a newspaper or a magazine in a week? ___ Times Q212 >= 5 0 0 0 0 Times Listen to Radio in a Day How often do you listen to radio in a day? ___ Times Pregnant women aged 15-49 years 0 0 0 0 Times See TV in a Week How often do you watch television in a week? ___ Times Pregnant women aged 15-49 years 0 0 0 0 Knowledge of FP There are different ways of delaying, postponing and stopping getting pregnant, and these are called family planning methods. Are you aware of any of these methods? No -> Skip to Q323 Married women of aged 15-49 0 0 0 0 1 Yes 2 No FP Methods Heard of 1st What are the methods are you aware of? fp301 = 1 0 0 0 0 1 Pills 2 Condom 3 Depo-provera 4 IUD 5 Norplant 6 Female sterilization 7 Vasectomy 8 Foaming tabs-foams 9 No sex with unsafe person FP Methods Heard of 2nd What are the methods are you aware of? fp301 = 1 0 0 0 0 1 Pills 2 Condom 3 Depo-provera 4 IUD 5 Norplant 6 Female sterilization 7 Vasectomy 8 Foaming tabs-foams 9 No sex with unsafe person FP Methods Heard of 3rd What are the methods are you aware of? fp301 = 1 0 0 0 0 1 Pills 2 Condom 3 Depo-provera 4 IUD 5 Norplant 6 Female sterilization 7 Vasectomy 8 Foaming tabs-foams 9 No sex with unsafe person FP Methods Heard of 4th What are the methods are you aware of? fp301 = 1 0 0 0 0 1 Pills 2 Condom 3 Depo-provera 4 IUD 5 Norplant 6 Female sterilization 7 Vasectomy 8 Foaming tabs-foams 9 No sex with unsafe person FP Methods Heard of 5th What are the methods are you aware of? fp301 = 1 0 0 0 0 1 Pills 2 Condom 3 Depo-provera 4 IUD 5 Norplant 6 Female sterilization 7 Vasectomy 8 Foaming tabs-foams 9 No sex with unsafe person FP Methods Heard of 6th What are the methods are you aware of? fp301 = 1 0 0 0 0 1 Pills 2 Condom 3 Depo-provera 4 IUD 5 Norplant 6 Female sterilization 7 Vasectomy 8 Foaming tabs-foams 9 No sex with unsafe person FP Methods Heard of 7th What are the methods are you aware of? fp301 = 1 0 0 0 0 1 Pills 2 Condom 3 Depo-provera 4 IUD 5 Norplant 6 Female sterilization 7 Vasectomy 8 Foaming tabs-foams 9 No sex with unsafe person FP Methods Heard of 8th What are the methods are you aware of? fp301 = 1 0 0 0 0 1 Pills 2 Condom 3 Depo-provera 4 IUD 5 Norplant 6 Female sterilization 7 Vasectomy 8 Foaming tabs-foams 9 No sex with unsafe person FP Methods Heard of 9th What are the methods are you aware of? fp301 = 1 0 0 0 0 1 Pills 2 Condom 3 Depo-provera 4 IUD 5 Norplant 6 Female sterilization 7 Vasectomy 8 Foaming tabs-foams 9 No sex with unsafe person Source of Knowledge of FP 1st What is the source of your knowledge? Up to 3 multi responses fp301 = 1 0 0 0 0 1 Newspaper 2 Poster-pamphlets 3 Signboards 4 Radio 5 TV 6 Health workers 7 TBA 8 FCHV 10 Husband 11 Freinds 12 Neighbours 13 Others 9 NGO FP worker Source of Knowledge of FP 2nd What is the source of your knowledge? Up to 3 multi responses fp301 = 1 0 0 0 0 1 Newspaper 2 Poster-pamphlets 3 Signboards 4 Radio 5 TV 6 Health workers 7 TBA 8 FCHV 9 NGO FP worker 10 Husband 11 Freinds 12 Neighbours 13 Others Source of Knowledge of FP 3rd What is the source of your knowledge? Up to 3 multi responses fp301 = 1 0 0 0 0 1 Newspaper 2 Poster-pamphlets 3 Signboards 4 Radio 5 TV 6 Health workers 7 TBA 8 FCHV 9 NGO FP worker 10 Husband 11 Freinds 12 Neighbours 13 Others Ever Used FP Have you ever used anything or tried in any way to delay or avoid getting pregnant? 2. No -> Skip to filter box before Q305. fp301 = 1 0 0 0 0 1 Yes 2 No Method Ever Used 1 What had you done? Up to 3 responses fp303 = 1 0 0 0 0 1 Pills 2 Condom 3 Depo-provera 4 IUD 5 Norplant 6 Female sterilization 7 Vasectomy 8 Foaming tabs-foams 9 No sex with unsafe person Method Ever Used 2 What had you done? Up to 3 responses fp303 = 1 0 0 0 0 1 Pills 2 Condom 3 Depo-provera 4 IUD 5 Norplant 6 Female sterilization 7 Vasectomy 8 Foaming tabs-foams 9 No sex with unsafe person Method Ever Used 3 What had you done? Up to 3 responses fp303 = 1 0 0 0 0 1 Pills 2 Condom 3 Depo-provera 4 IUD 5 Norplant 6 Female sterilization 7 Vasectomy 8 Foaming tabs-foams 9 No sex with unsafe person Current Use of FP Are you or your husband currently doing some thing or using any method to delay or avoid your getting pregnant? 2. No -> Ask Q319. Married women not currently pregnant (dm207 = 2) 0 0 0 0 1 Yes 2 No Method Currently Using What method are you/your husband currently using? fp305 = 1 0 0 0 0 1 Pills 2 Condom 3 Depo-provera 4 Iud 5 Norplant 6 Female sterilization 7 Vasectomy 8 Foaming tabs-foams 9 No sex in unsafe per Signed Consent form for STE If no method is used/ ever used, ask from Q319. If sterilisation is used, ask Q307 and if no ther methods are used, then ask Q312. Did you/your spouse sign a consent form at the time of sterilisation? fp306 = 6 0 0 0 0 1 Yes 2 No Number of Sons at the Time of STE How many sons did you have at the time of sterilisation? fp306 = 6 0 0 0 0 Number of Daughters at the Time of STE How many daughters did you have at the time of sterilisation? fp306 = 6 0 0 0 0 Any Regret having STE Do you regret that you/your husband had the operation not to have any children? 2. No -> Skip to Q312. fp306 = 6 0 0 0 0 1 Yes 2 No Reason for Regret Why do you regret the operation? fp310 = 1 0 0 0 0 1 2 Spouse wants child 3 Side effects 4 Death of children 5 Others How Long Currently Using FP Methods How long have you been using the last method of family planning? __ Months fp305 = 1 0 0 0 0 Any Side Effects of FP Did you experience any side-effects? 2. No -> Ask Q318. fp303 = 1 0 0 0 0 1 Yes 2 No Side Effects of FP 1 If yes, what was it? Up to 3 multi-responses fp313 = 1 0 0 0 0 1 Weakness 2 Nausea 3 Vomiting 4 Cramps 5 Amenorrhea-delayed periods 6 Back pain 7 Others Side Effects of FP 2 If yes, what was it? Up to 3 multi-responses fp313 = 1 0 0 0 0 1 Weakness 2 Nausea 3 Vomiting 4 Cramps 5 Amenorrhea-delayed periods 6 Back pain 7 Others Side Effects of FP 3 If yes, what was it? Up to 3 multi-responses fp313 = 1 0 0 0 0 1 Weakness 2 Nausea 3 Vomiting 4 Cramps 5 Amenorrhea-delayed periods 6 Back pain 7 Others Consult With HW for Treat of Side Effects Did you go anywhere or contact any health/FP worker for the treatment of side effect? 2. No -> Ask Q318. fp313 = 1 0 0 0 0 1 Yes 2 No Where Consult for Treatment Where did you go or whom did you contact for treatment? fp315 = 1 0 0 0 0 1 Hospital-HC-PHCC 2 HP-SHP 3 Private clinic-NH 4 Faith healers 5 VHW-MCHW 6 FCHV-TBA 7 FP Services of NGO 8 Others Improve After Treatment Was their treatment/advice helpful? fp315 = 1 0 0 0 0 1 Yes 2 No Nearest Center FP Service Where is the nearest place you can get family planning service? Ask Q320. [dm207 = 1 & fp303 = 1] OR [dm207 = 2 & fp305 = 1] 0 0 0 0 1 Hospital 2 Health Center-PHCC 3 HP-SHP 4 Village clinic 5 Pharmacy 6 Private Clinic-Nursing Home 7 Others Reson for not Using FP Methods What is the main reason for not using any contraception to avoid getting pregnant? dm207 = 1 & fp303 = 2 0 0 0 0 11 Not having sex 12 Infrequent sex 13 Menopausal hysterect 14 Sub-fecund-infecund 21 Respondent opposed 22 Husband opposed 23 Others opposed 24 Religious prohibitio 31 Knows no method 32 Knows no source 41 Health concerns 42 Fear of side effects 43 Lack of access-too f 44 Time not suitable 45 Costs too much 46 Inconvenient to use 47 Interferes with body 48 Pregnant 49 Wants more child 96 Others Desire of Using FP Methods in Future Do you plan to use family planning method in future? Skip to Q322 3. DK -> Skip to Q322]]> All married women of aged 15-49 0 0 0 0 1 Yes 2 No 3 DK Which FP Methods Wants to Use Which method do you plan to use? fp320 = 1 0 0 0 0 1 Pills 2 Condom 3 Depo-provera 4 Iud 5 Norplant 6 Female sterilization 7 Vasectomy 8 Foaming tabs-foams 9 No sex in unsafe per Discussion of FP Methods With Spouse Have you and your husband ever discussed the number of children you should have? All married women of aged 15-49 0 0 0 0 1 Yes 2 No Discussion about No. of Children Have you and your husband ever discussed the use of family planning methods? All married women of aged 15-49 0 0 0 0 1 Yes 2 No Ever Heard Ghati Heri Had Nilau All married women of aged 15-49 0 0 0 0 1 Yes 2 No Wants to Hear By Radio-TV 1 What sort of information about family planning or health would you be interested to hear/see on radio/TV? All married women of aged 15-49 0 0 0 0 1 FP methods 2 Side effects 3 STD 4 HIV-AIDS 5 Safe motherhood 6 Diarrhea 7 ARI 8 Immunization 9 Nutrition 10 Sanitation 11 Other Wants to Hear By Radio-TV 2 What sort of information about family planning or health would you be interested to hear/see on radio/TV? All married women of aged 15-49 0 0 0 0 1 FP methods 2 Side effects 3 STD 4 HIV-AIDS 5 Safe motherhood 6 Diarrhea 7 ARI 8 Immunization 9 Nutrition 10 Sanitation 11 Other Wants to Hear By Radio-TV 3 What sort of information about family planning or health would you be interested to hear/see on radio/TV? All married women of aged 15-49 0 0 0 0 1 FP methods 2 Side effects 3 STD 4 HIV-AIDS 5 Safe motherhood 6 Diarrhea 7 ARI 8 Immunization 9 Nutrition 10 Sanitation 11 Other Suitable Time to Broadcast in Radio-TV What should be the best time to broadcast these messages? All married women of aged 15-49 0 0 0 0 1 M 6-9 2 M 9-12 3 D 12-3 4 D 3-6 5 E 6-9 6 N 9-12 ANC Services in This/Last Pregnancy Did you go anywhere for antenatal care during your this/last pregnancy? 2. No -> Start asking Q420. Married women aged 15-49 who are currently pregnant or have children under 5 years of age 0 0 0 0 1 Yes 2 No Where for ANC Where did you go? ac401 = 1 0 0 0 0 1 Village Clinic 2 SHP-HP 3 Health Center-PHCC 4 Hospital 5 Private Clinic 6 Others Who Examined in ANC Who did you see? ac401 = 1 0 0 0 0 1 Doctor 2 Nurse-ANM 3 Health Assistant 4 AHW 5 MCH 6 VHW 7 Others Discussion about Place of Delivery Did the health care provider discussed about: ac401 = 1 0 0 0 0 1 Yes 2 No Discussion about Breastfeeding Did the health care provider discussed about: ac401 = 1 0 0 0 0 1 Yes 2 No Discussion about TT Did the health care provider discussed about: ac401 = 1 0 0 0 0 1 Yes 2 No Discussion about Nutrition Did the health care provider discussed about: ac401 = 1 0 0 0 0 1 Yes 2 No Discussion about Sanitation Did the health care provider discussed about: ac401 = 1 0 0 0 0 1 Yes 2 No Discussion about Iron-Folic Acid Did the health care provider discussed about: ac401 = 1 0 0 0 0 1 Yes 2 No Discussion about Danger Sign in Pregnancy Did the health care provider discussed about: ac401 = 1 0 0 0 0 1 Yes 2 No Discussion about Danger Sign in Delivery Did the health care provider discussed about: ac401 = 1 0 0 0 0 1 Yes 2 No Did the health care provider discussed about: ac401 = 1 0 0 0 0 1 Yes 2 No Discussion about FP Methods Did the health care provider discussed about: ac401 = 1 0 0 0 0 1 Yes 2 No Time Taken to Reach Institution How long did it take you to get there from your home? __ Minutes 00 if less than one hour ac401 = 1 0 0 0 0 How Many Times Received ANC During this/last pregnancy how many times did you receive antenatal care? __ Times ac401 = 1 0 0 0 0 Months Pregnant in First ANC How many months pregnant were you when you first received antenatal care during your this/last pregnancy? __ Months ac401 = 1 0 0 0 0 TT Shots during Pregnancy Were you given TT shots during your this/last pregnancy? 2. No -> Go to Q410. ac401 = 1 0 0 0 0 1 Yes 2 No Times TT Shots If yes, how many times during this/last pregnancy? __ Times If less than two times, ask Q410, otherwise start with Q412. ac408 = 1 0 0 0 0 TT Shots in Prev Pregnancy Were you given any TT shots during previous pregnancy? 2. No -> Ask Q412. ac409 < 2 0 0 0 0 1 Yes 2 No Times in Prev Pregnancy If yes how many times? __ Times ac410 = 1 0 0 0 0 Received Iron Folic Acid Did you receive or buy Iron or Iron/Folic Acid combination tablets during this/last pregnancy? 2. No -> Go to Q414. ac401 = 1 0 0 0 0 1 Yes 2 No Days Took Iron Folic Acid How many days did you take them during your this/last pregnancy? __ Days ac412 = 1 0 0 0 0 211 >=7 months Experienced Any Problems during Pregnancy Did you experience any complications/problem during this/last pregnancy? 2. No -> Skip to Q421. ac401 = 1 0 0 0 0 1 Yes 2 No What was the Problem 1 If yes, what was the problem? ac414 = 1 0 0 0 0 1 High blood pressure 2 Odema of facer-hand 3 Aneamia 4 High fever 5 Convulsions 6 Vaginal bleeding 7 Vaginal discharge 8 Severe abdominal pain 9 Others What was the Problem 2 If yes, what was the problem? ac414 = 1 0 0 0 0 1 High blood pressure 2 Odema of facer-hand 3 Aneamia 4 High fever 5 Convulsions 6 Vaginal bleeding 7 Vaginal discharge 8 Severe abdominal pain 9 Others What was the Problem 3 If yes, what was the problem? ac414 = 1 0 0 0 0 1 High blood pressure 2 Odema of facer-hand 3 Aneamia 4 High fever 5 Convulsions 6 Vaginal bleeding 7 Vaginal discharge 8 Severe abdominal pain 9 Others Sought Help for the Problem Did you seek help for this problem? 2. No -> Skip to Q421. ac414 = 1 0 0 0 0 1 Yes 2 No Where Did You Seek Help Where did you seek help for the problem? ac416 = 1 0 0 0 0 1 Shp-hp 2 Health center-phcc 3 Hospital 4 Private clinic-nursi 5 Others Satisfied with the Services Were you satisfied with the services? 1. Yes -> Skip to Q421. ac418 = 1 0 0 0 0 1 Yes 2 No Problem with the Services 1 What was the problem with the services? Up to 3 multi responses ac418 = 2 0 0 0 0 1 No improvement 2 No trained person 3 No medicine 4 No equipment 5 Bad attitude of HW 6 Had to pay 7 No prompt service 8 Others Problem with the Services 2 What was the problem with the services? Up to 3 multi responses ac418 = 2 0 0 0 0 1 No improvement 2 No trained person 3 No medicine 4 No equipment 5 Bad attitude of HW 6 Had to pay 7 No prompt service 8 Others Problem with the Services 3 What was the problem with the services? ac418 = 2 0 0 0 0 1 No improvement 2 No trained person 3 No medicine 4 No equipment 5 Bad attitude of HW 6 Had to pay 7 No prompt service 8 Others Why No ANC Services 1 Why did you not go for ANC service? Up to 3 multi resposes ac401 = 2 0 0 0 0 1 Did not feel any nee 2 Poor quality service 3 Bad attitude of HW 4 Too far away 5 No time to visit 6 Family did not allow 7 Have to pay 8 Not aware 9 Dk 10 Others Why No ANC Services 2 Why did you not go for ANC service? Up to 3 multi resposes ac401 = 2 0 0 0 0 1 Did not feel any nee 2 Poor quality service 3 Bad attitude of HW 4 Too far away 5 No time to visit 6 Family did not allow 7 Have to pay 8 Not aware 9 Dk 10 Others Why No ANC Services 3 Why did you not go for ANC service? Up to 3 multi resposes ac401 = 2 0 0 0 0 1 Did not feel any nee 2 Poor quality service 3 Bad attitude of HW 4 Too far away 5 No time to visit 6 Family did not allow 7 Have to pay 8 Not aware 9 DK 10 Others Smoked Tobacco during Pregnancy Did you smoke (tobacco) while you were pregnant? Married women aged 15-49 who are currently pregnant or have children under 5 years of age 0 0 0 0 1 Yes 2 No Drank Alchohol in Pregnacy Did you drink alcohol/beer during pregnancy? 2. No -> Skip to Q424. Married women aged 15-49 who are currently pregnant or have children under 5 years of age 0 0 0 0 1 Yes 2 No How often Drank ac422 = 1 0 0 0 0 1 Daily 2 Once in week 3 > Once in a week 4 Occasinally 5 Others Suffer from Night Blindness Did you suffer from night blindness during your this/last pregnancy? Married women aged 15-49 who are currently pregnant or have children under 5 years of age 0 0 0 0 1 Yes 2 No Food Intake Did your food intake decrease or increase during this/last pregnancy? Married women aged 15-49 who are currently pregnant or have children under 5 years of age 0 0 0 0 1 Increased 2 Decreased 3 Same Symptoms Leading to Emergency Care 1st What signs and symptoms during pregnancy will lead you to seek emergency care? Mark all responses. Married women aged 15-49 who are currently pregnant or have children under 5 years of age 0 0 0 0 1 High blood pressure 2 Odema of facer-hand 3 Aneamia 4 High fever 5 Convulsions 6 Vaginal bleeding 7 Vaginal discharge 8 Severe abdominal pain 9 Not in correct posn 10 Others Symptoms Leading to Emergency Care 2nd What signs and symptoms during pregnancy will lead you to seek emergency care? Mark all responses. Married women aged 15-49 who are currently pregnant or have children under 5 years of age 0 0 0 0 1 High blood pressure 2 Odema of facer-hand 3 Aneamia 4 High fever 5 Convulsions 6 Vaginal bleeding 7 Vaginal discharge 8 Severe abdominal pain 9 Not in correct posn 10 Others Symptoms Leading to Emergency Care 3rd What signs and symptoms during pregnancy will lead you to seek emergency care? Mark all responses. Married women aged 15-49 who are currently pregnant or have children under 5 years of age 0 0 0 0 1 High blood pressure 2 Odema of facer-hand 3 Aneamia 4 High fever 5 Convulsions 6 Vaginal bleeding 7 Vaginal discharge 8 Severe abdominal pain 9 Not in correct posn 10 Others Symptoms Leading to Emergency Care 4th What signs and symptoms during pregnancy will lead you to seek emergency care? Mark all responses. Married women aged 15-49 who are currently pregnant or have children under 5 years of age 0 0 0 0 1 High blood pressure 2 Odema of facer-hand 3 Aneamia 4 High fever 5 Convulsions 6 Vaginal bleeding 7 Vaginal discharge 8 Severe abdominal pain 9 Not in correct posn 10 Others Symptoms Leading to Emergency Care 5th What signs and symptoms during pregnancy will lead you to seek emergency care? Mark all responses. Married women aged 15-49 who are currently pregnant or have children under 5 years of age 0 0 0 0 1 High blood pressure 2 Odema of facer-hand 3 Aneamia 4 High fever 5 Convulsions 6 Vaginal bleeding 7 Vaginal discharge 8 Severe abdominal pain 9 Not in correct posn 10 Others Symptoms Leading to Emergency Care 6th What signs and symptoms during pregnancy will lead you to seek emergency care? Mark all responses. Married women aged 15-49 who are currently pregnant or have children under 5 years of age 0 0 0 0 1 High blood pressure 2 Odema of facer-hand 3 Aneamia 4 High fever 5 Convulsions 6 Vaginal bleeding 7 Vaginal discharge 8 Severe abdominal pain 9 Not in correct posn 10 Others Symptoms Leading to Emergency Care 7th What signs and symptoms during pregnancy will lead you to seek emergency care? Mark all responses. Married women aged 15-49 who are currently pregnant or have children under 5 years of age 0 0 0 0 1 High blood pressure 2 Odema of facer-hand 3 Aneamia 4 High fever 5 Convulsions 6 Vaginal bleeding 7 Vaginal discharge 8 Severe abdominal pain 9 Not in correct posn 10 Others Symptoms Leading to Emergency Care 8th What signs and symptoms during pregnancy will lead you to seek emergency care? Mark all responses. Married women aged 15-49 who are currently pregnant or have children under 5 years of age 0 0 0 0 1 High blood pressure 2 Odema of facer-hand 3 Aneamia 4 High fever 5 Convulsions 6 Vaginal bleeding 7 Vaginal discharge 8 Severe abdominal pain 9 Not in correct posn 10 Others Symptoms Leading to Emergency Care 9th What signs and symptoms during pregnancy will lead you to seek emergency care? Mark all responses. Married women aged 15-49 who are currently pregnant or have children under 5 years of age 0 0 0 0 1 High blood pressure 2 Odema of facer-hand 3 Aneamia 4 High fever 5 Convulsions 6 Vaginal bleeding 7 Vaginal discharge 8 Severe abdominal pain 9 Not in correct posn 10 Others Place of Delivery Where did you deliver your last child? Married women aged 15-49 who have had at least one delivery 0 0 0 0 1 Home 2 Cowshed 3 Hospital-PHCC-HC 4 HP-SHP 5 Private Clinic-Nursi 6 Others Who Assisted Who assisted you in delivery? 10. No One -> Skip to Q430. Married women aged 15-49 who have had at least one delivery 0 0 0 0 1 Doctor 2 Nurse-ANM 3 HA-AHW 4 Trained TBA 5 Untrained TBA 6 VHW 7 MCHW 8 FCHV 9 Relatives-Friends 10 None 11 Others When Assisted When did they assist you? dc428 <> 10 0 0 0 0 1 During labor 2 To deliver the baby 3 To deliver the place 4 When problem occurre 5 Others HDK Used 2. No -> Skip to Q432. dc427 = 1, 2, 6 0 0 0 0 1 Yes 2 No Where HDK obtained Where did you get it? dc430 = 1 0 0 0 0 1 VHW 2 FCHV 3 MCHW 4 Trained TBA 5 Untrained TBA 6 Pharmacy shop 7 Village shop 8 Depot holder 9 Others Instrument to Cut the Umbilical Cord What was used to cut the umbilical cord? dc427 = 1, 2, 6 0 0 0 0 1 New blade 2 Old blade boiled 3 Old blade not bolied 4 Other instruments boiled 5 Other instruments not boiled Instrument to Treat the Cord What was used to treat the cord? dc427 = 1, 2, 6 0 0 0 0 1 Nothing 2 Antiseptic 3 Ash 4 Oil-ghee 5 Cowdung 6 Besar-harro-barro 7 Others Size of Baby at Birth How big was the child at the time of delivery? Married women aged 15-49 who have had at least one delivery 0 0 0 0 1 Very large 2 Large 3 Average 4 Small 5 Very small Received Postpartum Check Up Did you receive postpartum check-up within 24 hours of delivery? Married women aged 15-49 who have had at least one delivery 0 0 0 0 1 Yes 2 No Prolonged Labor Around the time of birth did you have any of the following complications/problems? Married women aged 15-49 who have had at least one delivery 0 0 0 0 1 Yes 2 No Excessive Bleeding Around the time of birth did you have any of the following complications/problems? Married women aged 15-49 who have had at least one delivery 0 0 0 0 1 Yes 2 No Foul Smelling Vaginal Discharge Around the time of birth did you have any of the following complications/problems? Married women aged 15-49 who have had at least one delivery 0 0 0 0 1 Yes 2 No Convulsions Around the time of birth did you have any of the following complications/problems? Married women aged 15-49 who have had at least one delivery 0 0 0 0 1 Yes 2 No Where Contacted for Problem If 'no' in all categories of Q436 skip to Module 500. If 'yes' in any of the categories, ask: Where was she referred to for this/these problems? If 'nowhere', skip to Module 500 any of dc4361 - dc4364 = 1 0 0 0 0 0 No where 1 Trained TBA 2 Untrained TBA 3 FCHV 4 HP-SHP 5 HC-PHCC-Hospital 6 Private Clinic-Nursing Home 7 Pharmacy 8 Faith healers 9 Others 10 Home service by med practitioner Mode of Transport Used to Reach What mode of transport was used to reach the service centre? any of dc4361 - dc4364 = 1 0 0 0 0 1 Doko 2 Bullock cart 3 Tractor-truck 4 Stretcher 5 Bus-taxi 6 Others Knowledge of STD Have you ever heard of illness called STD? 2. No -> Ask Q503. Currently married women aged 15-49 0 0 0 0 1 Yes 2 No Source of Information STD 1 From which source of information have you learned about STD? ha501 = 1 0 0 0 0 1 Radio 2 Television 3 Newspaper-magazines 4 Pamphlets-posters 5 Health workers 6 FCHV 7 TBA 8 Husband 9 Schools-teachers 10 Community meetings 11 Friends-relatives 12 Workplace 13 Others Source of Information STD 2 From which source of information have you learned about STD? ha501 = 1 0 0 0 0 1 Radio 2 Television 3 Newspaper-magazines 4 Pamphlets-posters 5 Health workers 6 FCHV 7 TBA 8 Husband 9 Schools-teachers 10 Community meetings 11 Friends-relatives 12 Workplace 13 Others Source of Information STD 3 From which source of information have you learned about STD? ha501 = 1 0 0 0 0 1 Radio 2 Television 3 Newspaper-magazines 4 Pamphlets-posters 5 Health workers 6 FCHV 7 TBA 8 Husband 9 Schools-teachers 10 Community meetings 11 Friends-relatives 12 Workplace 13 Others Knowledge of AIDS Have you ever heard of illness called AIDS? 2. No -> Ask from Module 600. Currently married women aged 15-49 0 0 0 0 1 Yes 2 No Source of Information AIDS 1 From which sources of information have you learned most about AIDS? ha503 = 1 0 0 0 0 1 Radio 2 Television 3 Newspaper-magazines 4 Pamphlets-posters 5 Health workers 6 FCHV 7 TBA 8 Husband 9 Schools-teachers 10 Community meetings 11 Friends-relatives 12 Workplace 13 Others Source of Information AIDS 2 From which sources of information have you learned most about AIDS? ha503 = 1 0 0 0 0 1 Radio 2 Television 3 Newspaper-magazines 4 Pamphlets-posters 5 Health workers 6 FCHV 7 TBA 8 Husband 9 Schools-teachers 10 Community meetings 11 Friends-relatives 12 Workplace 13 Others Source of Information AIDS 3 From which sources of information have you learned most about AIDS? ha503 = 1 0 0 0 0 1 Radio 2 Television 3 Newspaper-magazines 4 Pamphlets-posters 5 Health workers 6 FCHV 7 TBA 8 Husband 9 Schools-teachers 10 Community meetings 11 Friends-relatives 12 Workplace 13 Others Things to Avoid Getting AIDS Is there anything a person can do to avoid getting AIDS or the virus that causes AIDS? 2. No -> Ask Q507. ha503 = 1 0 0 0 0 1 Yes 2 No What Can They Do 1st What can a person do? Any other ways? Probe and record all mentioned. ha505 = 1 0 0 0 0 1 Safe sex 2 Abstain from sex 3 Use condoms 4 Only one sex partner 5 Avoid sex with prost 6 Avoid sex with homos 7 Avoid blood transfus 8 Avoid injections 9 Avoid kissing 10 Avoid mosquito bites 11 Treat from traditional healers 12 Other What Can They Do 2nd What can a person do? Any other ways? Probe and record all mentioned. ha505 = 1 0 0 0 0 1 Safe sex 2 Abstain from sex 3 Use condoms 4 Only one sex partner 5 Avoid sex with prost 6 Avoid sex with homos 7 Avoid blood transfus 8 Avoid injections 9 Avoid kissing 10 Avoid mosquito bites 11 Treat from traditional healers 12 Other What Can They Do 3rd What can a person do? Any other ways? Probe and record all mentioned. ha505 = 1 0 0 0 0 1 Safe sex 2 Abstain from sex 3 Use condoms 4 Only one sex partner 5 Avoid sex with prost 6 Avoid sex with homos 7 Avoid blood transfus 8 Avoid injections 9 Avoid kissing 10 Avoid mosquito bites 11 Treat from traditional healers 12 Other What Can They Do 4th What can a person do? Any other ways? Probe and record all mentioned. ha505 = 1 0 0 0 0 1 Safe sex 2 Abstain from sex 3 Use condoms 4 Only one sex partner 5 Avoid sex with prost 6 Avoid sex with homos 7 Avoid blood transfus 8 Avoid injections 9 Avoid kissing 10 Avoid mosquito bites 11 Treat from traditional healers 12 Other What Can They Do 5th What can a person do? Any other ways? Probe and record all mentioned. ha505 = 1 0 0 0 0 1 Safe sex 2 Abstain from sex 3 Use condoms 4 Only one sex partner 5 Avoid sex with prost 6 Avoid sex with homos 7 Avoid blood transfus 8 Avoid injections 9 Avoid kissing 10 Avoid mosquito bites 11 Treat from traditional healers 12 Other What Can They Do 6th What can a person do? Any other ways? Probe and record all mentioned. ha505 = 1 0 0 0 0 1 Safe sex 2 Abstain from sex 3 Use condoms 4 Only one sex partner 5 Avoid sex with prost 6 Avoid sex with homos 7 Avoid blood transfus 8 Avoid injections 9 Avoid kissing 10 Avoid mosquito bites 11 Treat from traditional healers 12 Other What Can They Do 7th What can a person do? Any other ways? Probe and record all mentioned. ha505 = 1 0 0 0 0 1 Safe sex 2 Abstain from sex 3 Use condoms 4 Only one sex partner 5 Avoid sex with prost 6 Avoid sex with homos 7 Avoid blood transfus 8 Avoid injections 9 Avoid kissing 10 Avoid mosquito bites 11 Treat from traditional healers 12 Other What Can They Do 8th What can a person do? Any other ways? Probe and record all mentioned. ha505 = 1 0 0 0 0 1 Safe sex 2 Abstain from sex 3 Use condoms 4 Only one sex partner 5 Avoid sex with prost 6 Avoid sex with homos 7 Avoid blood transfus 8 Avoid injections 9 Avoid kissing 10 Avoid mosquito bites 11 Treat from traditional healers 12 Other What Can They Do 9th What can a person do? Any other ways? Probe and record all mentioned. ha505 = 1 0 0 0 0 1 Safe sex 2 Abstain from sex 3 Use condoms 4 Only one sex partner 5 Avoid sex with prost 6 Avoid sex with homos 7 Avoid blood transfus 8 Avoid injections 9 Avoid kissing 10 Avoid mosquito bites 11 Treat from traditional healers 12 Other What Can They Do 10th What can a person do? Any other ways? Probe and record all mentioned. ha505 = 1 0 0 0 0 1 Safe sex 2 Abstain from sex 3 Use condoms 4 Only one sex partner 5 Avoid sex with prost 6 Avoid sex with homos 7 Avoid blood transfus 8 Avoid injections 9 Avoid kissing 10 Avoid mosquito bites 11 Treat from traditional healers 12 Other What Can They Do 11th What can a person do? Any other ways? Probe and record all mentioned. ha505 = 1 0 0 0 0 1 Safe sex 2 Abstain from sex 3 Use condoms 4 Only one sex partner 5 Avoid sex with prost 6 Avoid sex with homos 7 Avoid blood transfus 8 Avoid injections 9 Avoid kissing 10 Avoid mosquito bites 11 Treat from traditional healers 12 Other What Can They Do 12th What can a person do? Any other ways? Probe and record all mentioned. ha505 = 1 0 0 0 0 1 Safe sex 2 Abstain from sex 3 Use condoms 4 Only one sex partner 5 Avoid sex with prost 6 Avoid sex with homos 7 Avoid blood transfus 8 Avoid injections 9 Avoid kissing 10 Avoid mosquito bites 11 Treat from traditional healers 12 Other Possibility of Healthy Person to Have AIDS Is it possible for a healthy-looking person to have the AIDS virus? ha503 = 1 0 0 0 0 1 Yes 2 No 3 DK Your Chance of Getting AIDS Do you think your chances of getting AIDS are small, moderate, great or that you have no risk at all? ha503 = 1 0 0 0 0 1 Small 2 Moderate 3 Great-high 4 No risk at all 5 Has aids 6 Dont know 7 Other Knowledge of HIV Testing Place Do you know the place where you could get (blood) tested for HIV? 2. No -> Skip to 600. ha503 = 1 0 0 0 0 1 Yes 2 No Ever Been Tested You do not need to tell me the results, have you ever been tested for HIV? ha509 = 1 0 0 0 0 1 Yes 2 No Whether Breastfed Last Child Did you ever breastfeed your last child? 2. No -> Go to Module 700. Married women 15-49 with at least one child aged under 5 0 0 0 0 1 Yes 2 No Time after Birth Child Breastfed How long after birth did you put child to breast? __ Hours If less than one hour, write 00. bf601 = 1 0 0 0 0 Fed Colustrum Did you feed colostrum to the child? bf601 = 1 0 0 0 0 1 Yes 2 No Number of Months Breastfeeding For how many months have you been breastfeeding this child? __ Months Write 88 for still breastfeeding. If stopped breastfeeding, skip to Q606. bf601 = 1 0 0 0 0 88 Continuous feeding How long intends to Breastfeed If still breastfeeding how long do you intend to breastfeed him/her? __ Months bf604 = 88 0 0 0 0 97 Up to accessible Time Water Given to Child At what age did you give water to drink for your child? __ Months Write 88 if the child was not given water. bf601 = 1 0 0 0 0 88 Not given yet Child Fed Anything from Bottle Yesterday Was the child fed anything from the feeding bottle yesterday or last night? Write 88 if water not given yet. bf601 = 1 0 0 0 0 1 Yes 2 No When Food Supplements Given When (at what age) did you start giving other food to the child? (Age) __ Months Write 88 if no food given yet. bf601 = 1 0 0 0 0 0 Less than a month 88 Solid food not given yet Reason for not Breastfeeding If not currently breastfeeding, why did you stop breastfeeding the child? bf601 = 1 0 0 0 0 1 Mother ill-weak 2 Child ill-weak 3 Nipple-breast proble 4 Not enough milk 5 Mother working 6 Child refused 7 Weaning age-age to s 8 Became pregnant 9 Using contraception Symptoms Leading to Emergrency Care 1st Mother or caretaker When the child is sick what symptoms will lead you to seek cure at health institutions or a medical personnel? Record all answers. Married women 15-49 with at least one child aged 5 years and below 0 0 0 0 1 When the child cannot eat or drink 2 Chest in-drawing 3 When the fever is high 4 When the child is lethargic or unconscious 5 Difficulty in breathing or rapid breathing 6 When there is blood in the stool 7 Vomits everything s/he eats or drinks 8 When the frequency of diarrhoea is high 9 When the child is excessively thirsty Symptoms Leading to Emergrency Care 2nd Mother or caretaker When the child is sick what symptoms will lead you to seek cure at health institutions or a medical personnel? Record all answers. Married women 15-49 with at least one child aged 5 years and below 0 0 0 0 1 When the child cannot eat or drink 2 Chest in-drawing 3 When the fever is high 4 When the child is lethargic or unconscious 5 Difficulty in breathing or rapid breathing 6 When there is blood in the stool 7 Vomits everything s/he eats or drinks 8 When the frequency of diarrhoea is high 9 When the child is excessively thirsty Symptoms Leading to Emergrency Care 3rd Mother or caretaker When the child is sick what symptoms will lead you to seek cure at health institutions or a medical personnel? Record all answers. Married women 15-49 with at least one child aged 5 years and below 0 0 0 0 1 When the child cannot eat or drink 2 Chest in-drawing 3 When the fever is high 4 When the child is lethargic or unconscious 5 Difficulty in breathing or rapid breathing 6 When there is blood in the stool 7 Vomits everything s/he eats or drinks 8 When the frequency of diarrhoea is high 9 When the child is excessively thirsty Symptoms Leading to Emergrency Care 4th Mother or caretaker When the child is sick what symptoms will lead you to seek cure at health institutions or a medical personnel? Record all answers. Married women 15-49 with at least one child aged 5 years and below 0 0 0 0 1 When the child cannot eat or drink 2 Chest in-drawing 3 When the fever is high 4 When the child is lethargic or unconscious 5 Difficulty in breathing or rapid breathing 6 When there is blood in the stool 7 Vomits everything s/he eats or drinks 8 When the frequency of diarrhoea is high 9 When the child is excessively thirsty Symptoms Leading to Emergrency Care 5th Mother or caretaker When the child is sick what symptoms will lead you to seek cure at health institutions or a medical personnel? Record all answers. Married women 15-49 with at least one child aged 5 years and below 0 0 0 0 1 When the child cannot eat or drink 2 Chest in-drawing 3 When the fever is high 4 When the child is lethargic or unconscious 5 Difficulty in breathing or rapid breathing 6 When there is blood in the stool 7 Vomits everything s/he eats or drinks 8 When the frequency of diarrhoea is high 9 When the child is excessively thirsty Symptoms Leading to Emergrency Care 6th Mother or caretaker When the child is sick what symptoms will lead you to seek cure at health institutions or a medical personnel? Record all answers. Married women 15-49 with at least one child aged 5 years and below 0 0 0 0 1 When the child cannot eat or drink 2 Chest in-drawing 3 When the fever is high 4 When the child is lethargic or unconscious 5 Difficulty in breathing or rapid breathing 6 When there is blood in the stool 7 Vomits everything s/he eats or drinks 8 When the frequency of diarrhoea is high 9 When the child is excessively thirsty Symptoms Leading to Emergrency Care 7th Mother or caretaker When the child is sick what symptoms will lead you to seek cure at health institutions or a medical personnel? Record all answers. Married women 15-49 with at least one child aged 5 years and below 0 0 0 0 1 When the child cannot eat or drink 2 Chest in-drawing 3 When the fever is high 4 When the child is lethargic or unconscious 5 Difficulty in breathing or rapid breathing 6 When there is blood in the stool 7 Vomits everything s/he eats or drinks 8 When the frequency of diarrhoea is high 9 When the child is excessively thirsty Symptoms Leading to Emergrency Care 8th Mother or caretaker When the child is sick what symptoms will lead you to seek cure at health institutions or a medical personnel? Record all answers. Married women 15-49 with at least one child aged 5 years and below 0 0 0 0 1 When the child cannot eat or drink 2 Chest in-drawing 3 When the fever is high 4 When the child is lethargic or unconscious 5 Difficulty in breathing or rapid breathing 6 When there is blood in the stool 7 Vomits everything s/he eats or drinks 8 When the frequency of diarrhoea is high 9 When the child is excessively thirsty Symptoms Leading to Emergrency Care 9th Mother or caretaker When the child is sick what symptoms will lead you to seek cure at health institutions or a medical personnel? Record all answers. Married women 15-49 with at least one child aged 5 years and below 0 0 0 0 1 When the child cannot eat or drink 2 Chest in-drawing 3 When the fever is high 4 When the child is lethargic or unconscious 5 Difficulty in breathing or rapid breathing 6 When there is blood in the stool 7 Vomits everything s/he eats or drinks 8 When the frequency of diarrhoea is high 9 When the child is excessively thirsty Aware of National Vit A Program Are you aware of the National Vitamin 'A' programme? Married women 15-49 with at least one child aged 6 months to 5 years 0 0 0 0 1 Yes 2 No Knowledge of Vit A Program in Family Are any other members of your family aware of this programme? Married women 15-49 with at least one child aged 6 months to 5 years 0 0 0 0 1 Yes 2 No 3 DK Whether the IMM Card was Given Mother or caretaker If no vaccination card, then ask, was she given any vaccination card during vaccination of the child? All married women aged 15-49 with children aged 12-23 months 0 0 0 0 1 Yes 2 No Told to Keep Card Safely, Bring Next Time Mother or caretaker Was she asked to keep the card safely and bring it back the next time she brings the child for immunisation? All married women aged 15-49 with children aged 12-23 months 0 0 0 0 1 Yes 2 No Mother or caretaker During immunisation were you informed about the vaccine and what it protects against? All married women aged 15-49 with children aged 12-23 months 0 0 0 0 1 Yes 2 No Informed Number of Shots to be Completed Mother or caretaker During immunisation were you informed about the number of doses to be completed? All married women aged 15-49 with children aged 12-23 months 0 0 0 0 1 Yes 2 No Whether Inform the Side Effects of IMM Mother or caretaker During immunisation were you informed about the side-effects of immunisation including fever /swelling at the site of immunisation? All married women aged 15-49 with children aged 12-23 months 0 0 0 0 1 Yes 2 No Gender of the Child for BF Module Gender of the Children 0 0 0 0 1 Male 2 Female Child Age for BF Module Age of the children 0 0 0 0 Child Age Unit for BF Module Unit of the children age 0 0 M Months Y Years Woman weight 0 0