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Tanzania HIV/AIDS and Malaria Indicator Survey ... - Measure DHS

Tanzania HIV/AIDS and Malaria Indicator Survey ... - Measure DHS

Tanzania HIV/AIDS and Malaria Indicator Survey ... - Measure DHS

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SECTION 1 - RESPONDENT'S BACKGROUNDINFORMED CONSENTHello. My name is ______________<strong>and</strong> I am working with the National Bureau of Statistics.We are conducting a national survey that asks women <strong>and</strong> men about various health issues. We would very much appreciate yourparticipation in this survey. This information will help the government to plan health services. The survey usually takesabout 30 minutes to complete.Whatever information you provide will be kept strictly confidential <strong>and</strong> will not be shown to other persons.Participation in this survey is voluntary, <strong>and</strong> if we should come to any question you don't want to answer, just let me know <strong>and</strong>I will go on to the next question; or you can stop the interview at any time. However, we hope that you will participate in this surveysince your views are important.At this time, do you want to ask me anything about the survey?May I begin the interview now?Signature of interviewer:Date:RESPONDENT AGREES TO BE INTERVIEWED . . . 1 RESPONDENT DOES NOT AGREE TO BE INTERVIEWED . 2 ENDNO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP101 RECORD THE TIME.HOUR . . . . . . . . . . . . . . . . . . . .MINUTES. . . . . . . . . . . . . . . . .MORNING . . . . . . . . . . . . . . . . . . 1AFTERNOON . . . . . . . . . . . . . . . . . . 2EVENING/NIGHT . . . . . . . . . . . . . . . . 3102 In what month <strong>and</strong> year were you born?MONTH . . . . . . . . . . . . . . . . . .DON'T KNOW MONTH . . . . . . . . . . . . 98YEAR . . . . . . . . . . . .DON'T KNOW YEAR . . . . . . . . . . . . 9998103 How old are you?COMPARE AND CORRECT 102 AND/OR 103 IF INCONSISTENT.AGE IN COMPLETED YEARS104 Have you ever attended school? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 107105 What is the highest st<strong>and</strong>ard or form you completed? PRE-PRIMARY . . . . . . . . . . . . . . . . 00STANDARD 1 . . . . . . . . . . . . . . . . . . . 01STANDARD 2 . . . . . . . . . . . . . . . . . . . 02STANDARD 3 . . . . . . . . . . . . . . . . . . . 03STANDARD 4 . . . . . . . . . . . . . . . . . . . 04STANDARD 5 . . . . . . . . . . . . . . . . . . . 05STANDARD 6 . . . . . . . . . . . . . . . . . . . 06STANDARD 7 . . . . . . . . . . . . . . . . . . . 07STANDARD 8 . . . . . . . . . . . . . . . . . . . 08TRAINING AFTER PRIMARY . . . . . . . 09PRE-FORM 1 . . . . . . . . . . . . . . . . . . . 10FORM 1 . . . . . . . . . . . . . . . . . . . . . . . 11FORM 2 . . . . . . . . . . . . . . . . . . . . . . . 12FORM 3 . . . . . . . . . . . . . . . . . . . . . . . 13FORM 4 . . . . . . . . . . . . . . . . . . . . . . . 14FORM 5 . . . . . . . . . . . . . . . . . . . . . . . 15FORM 6 . . . . . . . . . . . . . . . . . . . . . . . 16TRAINING AFTER SECONDARY. . . . . 17UNIVERSITY . . . . . . . . . . . . . . . . . . . 18OTHER _____________________ 96107 Do you read a newspaper or magazine almost every day, at least ALMOST EVERY DAY . . . . . . . . . . . . . . 1once a week, less than once a week or not at all? AT LEAST ONCE A WEEK . . . . . . . . . . 2LESS THAN ONCE A WEEK . . . . . . . 3NOT AT ALL . . . . . . . . . . . . . . . . . . . . 4CANNOT READ . . . . . . . . . . . . . . . . . . 8246 | Appendix D

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