Zambia Demographic and Health Survey 2001-2002 - Measure DHS

September 28, 20012001 ZAMBIA DEMOGRAPHIC AND HEALTH SURVEYQUESTIONNAIRE FOR INDIVIDUAL WOMENCENTRAL BOARD OF HEALTH/CENTRAL STATISTICAL OFFICEIDENTIFICATIONLOCALITY NAMENAME OF HOUSEHOLD HEADCLUSTER NUMBER .................................................................HOUSEHOLD NUMBER ..............................................................PROVINCE ........................................................................URBAN/RURAL (URBAN=1, RURAL=2) .................................................LUSAKA/OTHER CITY/TOWN/VILLAGE .................................................(LUSAKA=1, OTHER CITY=2, TOWN=3, VILLAGE=4)NAME AND LINE NUMBER OF WOMANWOMAN SELECTED FOR Qs. 720A - 720L? (YES = 1, NO = 2) ...............................+)))0)))0))),*!!!*!!!*!!!*/)))3)))3)))1*!!!*!!!*!!!*.)))2)))3)))1!!!*!!!*/)))1*!!!*/)))1*!!!*+)))3)))1*!!!*!!!*.)))3)))1* !!*.)))-INTERVIEWER VISITS1 2 3 FINAL VISITDATEINTERVIEWER’S NAMERESULT*+))0)),DAY *!!*!!*/))3))1MONTH *!!*!!*+))0))3))3))1YEAR *!!*!!*!!*!!*.))2))3))3))1NAME *!!*!!*.))3))1RESULT *!!*.))-NEXT VISIT:DATETIMETOTAL NO.OF VISITS+)),*!!*.))-*RESULT CODES:1 COMPLETED2 NOT AT HOME3 POSTPONED4 REFUSED5 PARTLY COMPLETED6 INCAPACITATED7 OTHER__________________________(SPECIFY)LANGUAGE OF QUESTIONNAIRE** ENGLISH ..............LANGUAGE OF INTERVIEW** .....................................RESPONDENT’S LOCAL LANGUAGE** ..............................TRANSLATOR USED (1=NOT AT ALL; 2=SOMETIME; 3=ALL THE TIME) ....+)))0))),*!0!* 1!*/)))3)))1*!!!*!!!*/)))3)))1*!!!*!!!*.)))3)))1*!!!*.)))-** LANGUAGE CODES: 01 ENGLISH 03 KAONDE 05 LUNDA 07 NYANJA 09 OTHER02 BEMBA 04 LOZI 06 LUVALE 08 TONGA1