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Characteristics of Households - Childinfo.org

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QUESTIONNAIRE FOR MEN AGE 15–29 YEARSREPUBLIC OF SERBIAMODULE ME — MAN’S INFORMATION PANELThis questionnaire is to be administered to all men age 15 through 29 (see Household Listing Form, column HL7A). A separate questionnaire should be used for eacheligible man.ME1. Cluster number:ME3. Man’s name:ME5. Interviewer name and number:ME2. Household number:ME4. Man’s line number:ME6. Day/month/year <strong>of</strong> interview:Number: (Day) (Month) (Year)Repeat greeting if not already read to this man:We are from Statistical Office <strong>of</strong> the Republic <strong>of</strong> Serbia. We are working ona project concerned with family health and education. I would like to talkto you about these subjects. The interview will take about 15 minutes.All the information we obtain will remain strictly confidential and youranswers will never be shared with anyone other than our project team.May I start now?Yes, permission is given Go to ME10 to record the time and then begin the interview.No, permission is not given Complete ME7. Discuss this result with your supervisor.If greeting at the beginning <strong>of</strong> the household questionnaire has already beenread to this man, then read the following:Now I would like to talk to you more about your health and other topics.This interview will take about 15 minutes. Again, all the information weobtain will remain strictly confidential and your answers will never beshared with anyone other than our project team.ME7. Result <strong>of</strong> man’s interview Completed 01Not at home 02Refused 03Partly completed 04Incapacitated 05Other (specify) 96ME8. Field edited by:NameID codeME9. Data entry clerk:NameID codeME10. Record the time. Hour and minutes :MODULE MB — MAN’S BACKGROUNDMB1. In what month and year were you born?MB2. How old are you?Probe: How old were you at your last birthday?Compare and correct MB1 and/or MB2 if inconsistent.Date <strong>of</strong> birthMonthDK month 98YearDK year 9998Age (in completed years)MB3. Have you ever attended school or preschool? Yes 1No 2 2 MB7MB4. What is the highest level <strong>of</strong> school you attended or nowattend?Preschool 0Primary 1Secondary 2Higher 30 MB7338MULTIPLE INDICATOR CLUSTER SURVEY 2010

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