Household Survey Questionnaire - ENDLINE

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Zambia Household Survey: Abortion Knowledge, Attitudes, and Practices
Place of Interview
Interviewer: Please fill out the following prior to traveling to interview location.
Province (circle one): Copperbelt | Lusaka
District (circle one): Kafue | Lusaka | Mufulira | Kitwe
Community (circle one): Chilanga | Chipata | Kawama | Mufulira
Census supervisory area (CSA): ___________
Standard enumeration area (SEA): ___________
Locality: _______________________________
Sampling serial number of household: ___ ___ ___
Day of Interview: ___ ___ November
Primary language of Interview (circle one): English | Bemba | Nyanja | Tonga
Interviewer’s Name: _________________________________
Interviewer’s Sex (circle one): Male | Female
Field Reviewed/Edited by: ________________________________
Page 1 of 16
Respondent Information (for adult who answers door)
Good morning/afternoon. My name is __________________ and I’m conducting a survey on behalf
of the Ministry of Health, University Teaching Hospital, and an NGO called Ipas. Would you or any
other adult in your household be willing to answer a few questions? [If yes, thank them and
continue. If no, thank them, stop the interview, and mark the box below.]
Respondent who answered the door refused to participate in the survey.
List of Household Members
Could you please tell me the name of all the adults aged 18-49, including yourself, that live in this
household and who slept here last night? [Where applicable, mention that this does not include
servants.]
RESPONDENT
NUMBER
NAME
AGE
SEX
(M/F)
SELECTED
FOR
INTERVIEW
(Y/N)
RESULT*
01
02
03
04
05
06
07
08
09
10
Interviewer: Please randomly select two adults in the household for the interviews. If the
household only has one or two adults please interview all adult household members.
* Code for result column:
1=Respondent refused to participate
3=Told to come back at another time
5=Tonga speaker only
2=Respondent agreed to participate
4=Not selected for interview
6=Made 3 unsuccessful attempts to contact
Page 2 of 16
Sampling serial number: ___ ___ ___
Household respondent number: ___ ___
Introduction [Read to randomly selected respondent]
Good morning/afternoon. My name is __________________ and I’m conducting a survey on behalf
of the Ministry of Health, University Teaching Hospital, and an NGO called Ipas. Would you be
willing to answer a few questions? [If yes, thank them and continue, marking their participation in
the “results” column on the previous page. If no, thank them and record their refusal on the previous
page.]
We are undertaking a survey among community members about an important reproductive health
problem that affects many women and teenage girls. The survey is about unwanted pregnancy and
means of preventing it. Unwanted pregnancy is a problem that affects women all over the world
and can seriously impair their health, well-being, and future fertility. The purpose of this survey is to
obtain information that can help improve our understanding of the problem and how to address it in
Zambia. Your views on these issues are important to us. Information gathered from you and other
volunteers will help us to get a better picture of the situation in Zambia and will form the basis for
planning to provide better reproductive health services. We would be very grateful for your
cooperation. We assure you that any information you provide will be kept strictly confidential and
your name will not be captured or used in any reports. Any identifying information is captured only
so that we can select the respondent for the questionnaire and to be sure that you understand what
we are asking you to do. No identifying information about you or your household members will be
used in any report or anaylsis of these data. Your participation is voluntary.
If you decide to participate in this interview, you will be among approximately 800 others
interviewed. We will ask you a series of questions. This interview will take between 30 minutes to
one hour to complete.
You will not benefit personally from your participation in this study. This research is designed to
benefit society by obtaining new knowledge.
You may feel uncomfortable answering questions about topics related to sexual health and rights. If
you do not want to answer a question, we can skip it.
We will protect your personal contact information and will not share it with anyone outside of the
study team. You will not be personally identified in any report or manuscript resulting from this
study.
There are no costs for participating in this study.
[GIVE THEM INFORMATION SHEET TO KEEP; HAVE THEM SIGN CONSENT FORM AT THIS POINT]
Do you have any questions before we begin?
Page 3 of 16
Signatures
If you don’t have any/any more questions and agree to participate in the study, I ask you to sign this
form stating that I, the interviewer, have informed you of your rights as a participant and that you
have agreed to participate. We thank you for your time.
I have read the information in this consent form (or it has been read to me). All my
questions about the study and my participation have been answered. I understand
what my involvement in the study means. I understand my participation is voluntary
and I can refuse to participate at any moment, for any reason, without penalty.
Participant Name (Please print)
Participant Signature
Date
_________________________
_________________________
_______________
Thumbprint of participant (if participant cannot sign):
Interviewer Name (Please print)
Interviewer Signature
Date
_________________________
_________________________
___________________
Page 4 of 16
Section 1. Demographic and Household Information
101
Are you able to read and write?
(select only one answer)
Read only
Write only
 Both read and write
 Cannot read nor write (neither)
102
What is the highest level of schooling you have
completed?
(select only one answer)
 None
 Primary
 Secondary
Technical school
College
University
103
What is your current marital status?
(select only one answer)
Married
Separated/ Divorced
Widowed
Single/never married
What is the religion you follow?
(select only one answer)
Protestant
Catholic
Muslim
104
Traditional
None
Other (specify):
What do you do for a living?
(select only one answer)
105
106
110
What is the average monthly income of your
household?
(select only one answer)
Have you ever witnessed a street drama on a
health topic?
(select only one answer)
If yes, on which topics?
(allow multiple answers, read responses aloud)
111
Page 5 of 16
__________________________________
Farmer
Agricultural labor
Non-agricultural wage labor
Business
Salaried
Not working/student
Small trade/vendor
Other (specify):
___________________________________
 Less than 100,000 Kwacha
101,000-150,000 Kwacha
151,000-500,000 Kwacha
501,000-1,000,000 Kwacha
1,000,000 Kwacha and above
Does not know/No answer
No  Go to question 201
Yes
Does not know/No answer
Malaria
HIV/AIDS
STI prevention
Vaccinations
Tuberculosis
Family Planning
Abortion
Other (specify):
___________________________________
Does not know/No answer
Section 2. Legal Indications for Abortion in Zambia
201
Do you think abortion is legal in Zambia?
(select only one answer)
202
204
205
206
207
208
209
210
211
212
Yes
Does not know/ No answer  Go to
Where did you get this information on abortion?
(allow multiple answers, but do not read
responses)
203
No
To your knowledge, is abortion legal if the
pregnancy is a result of rape?
(select only one answer)
To your knowledge, is abortion legal if the
woman’s existing children would suffer from
physical or mental harm if the pregnancy were
continued?
(select only one answer)
To your knowledge, is abortion legal if the
woman’s life is endangered by the pregnancy?
(select only one answer)
To your knowledge, is abortion legal if the child
has a strong chance of a serious physical or
mental defect?
(select only one answer)
To your knowledge, is abortion legal if the
woman does not want another child?
(select only one answer)
To your knowledge, is abortion legal if the
woman cannot financially afford to support
another child?
(select only one answer)
To your knowledge, is abortion legal if the
pregnancy is a result of incest?
(select only one answer)
To your knowledge, is abortion legal for any
reason or whenever the woman decides?
(select only one answer)
To your knowledge, is abortion legal if the
young girl or woman wants to continue her
studies?
(select only one answer)
To your knowledge, is abortion legal if there is a
risk to the woman’s physical or mental health?
(select only one answer)
Page 6 of 16
question 203
The radio
Medical staff at a health facility
Neighbors/family/friends
Street drama/signs/posters/pamphlets
Church
Other (specify):
__________________________________
No
Yes
Does not know/ No answer
No
Yes
Does not know/ No answer
No
Yes
Does not know/ No answer
No
Yes
Does not know/ No answer
No
Yes
Does not know/ No answer
No
Yes
Does not know/ No answer
No
Yes
Does not know/ No answer
No
Yes
Does not know/ No answer
No
Yes
Does not know/ No answer
No
Yes
Does not know/ No answer
Now, I’d like to know your personal opinion. Under which of the following
situations do you personally feel that a woman should be allowed to have an
abortion?
213
214
215
216
217
218
219
220
221
222
Do you think a woman should be allowed to
have an abortion if the pregnancy is a result of
rape?
(select only one answer)
Do you think a woman should be allowed to
have an abortion if the woman’s existing
children would suffer from physical or mental
harm if the pregnancy were continued?
(select only one answer)
Do you think a woman should be allowed to
have an abortion if the woman’s life is
endangered by the pregnancy?
(select only one answer)
Do you think a woman should be allowed to
have an abortion if the child has a strong chance
of a serious physical or mental defect ?
(select only one answer)
Do you think a woman should be allowed to
have an abortion if the woman does not want
another child?
(select only one answer)
Do you think a woman should be allowed to
have an abortion if the woman cannot
financially afford to support another child?
(select only one answer)
Do you think a woman should be allowed to
have an abortion if the pregnancy is a result of
incest?
(select only one answer)
Do you think a woman should be allowed to
have an abortion for any reason or whenever
the woman decides?
(select only one answer)
Do you think a woman should be allowed to
have an abortion if the young girl or woman
wants to continue her studies?
(select only one answer)
Do you think a woman should be allowed to
have an abortion if there is a risk to the
woman’s physical or mental health?
(select only one answer)
No
Yes
Does not know/ No answer
No
Yes
Does not know/ No answer
No
Yes
Does not know/ No answer
No
Yes
Does not know/ No answer
No
Yes
Does not know/ No answer
No
Yes
Does not know/ No answer
No
Yes
Does not know/ No answer
No
Yes
Does not know/ No answer
No
Yes
Does not know/ No answer
No
Yes
Does not know/ No answer
Section 3. Attitudes and Beliefs
301
In the past year, have you heard of safe
abortion services being provided at
______________________________________?
(INSERT NAME OF NEAREST STUDY FACILITY:
RONALD ROSS, CHIPATA CLINIC, CHILANGA
CLINIC, OR KAWAMA CLINIC)
(select only one answer)
Page 7 of 16
No
Yes
Does not know
No answer
Other (specify):
___________________________________
302
Do you know any women from your community
who became seriously ill from abortion related
complications or who died from trying to
terminate a pregnancy?
(select only one answer)
No
Yes
Does not know
No answer
In the next few questions, I am going to ask your opinion. I will read out some
statements. Please let me know whether you disagree with the statement, are
neutral or unsure, or agree with the statement.
Disagree
303
304
305
306
307
308
309
310
311
312
313
314
315
In your opinion, abortion services are normally
only available at urban clinics.
(select only one answer)
In your opinion, abortions usually cost more
than any other health treatment.
(select only one answer)
In your opinion, in your community abortions
among unmarried women are usually treated as
bad or sinful.
(select only one answer)
In your opinion, in your community abortions
among married women are usually treated as
bad or sinful. (select only one answer)
In your opinion, in your community it is not
acceptable to talk about any abortion-related
issues.
(select only one answer)
In your opinion, in your community people who
want to terminate a pregnancy prefer to go to a
traditional healer rather than a medical doctor,
nurse, or midwife.
(select only one answer)
In your opinion, abortion is immoral.
(select only one answer)
In your opinion, a woman has the right to
decide whether or not she wants to terminate a
pregnancy.
(select only one answer)
In your opinion, women should have access to
safe abortion services.
(select only one answer)
In your opinion, women dying from pregnancyrelated causes are a large problem in Zambia.
(select only one answer)
In your opinion, men and women should have
access to contraceptives to plan and space
births and prevent unplanned pregnancies.
(select only one answer)
In your opinion, adolescents should have access
to contraceptives to prevent unplanned
pregnancies.
(select only one answer)
In your opinion, quacks are more trustworthy to
keep your situation secret than doctors, nurses,
or midwives.
(select only one answer)
Page 8 of 16
Neutral/
Unsure
Agree
Disagree
316
317
318
319
In your opinion, a woman who has an unsafe
abortion can never become pregnant again
afterwards.
(select only one answer)
In your opinion, a woman who has a safe
abortion can never become pregnant again
afterwards.
(select only one answer)
In your opinion, a woman cannot work
immediately after having an abortion. (select
only one answer)
In your opinion, a woman can die from a
botched abortion done in unsafe conditions by
quacks. (select only one answer)
[For female respondents: ]
In your opinion, if you wanted to terminate a
pregnancy, your partner would support you.
(select only one answer)
320
[For male respondents: ]
In your opinion, if your partner wanted to
terminate a pregnancy, you would support her.
(select only one answer)
[For female respondents: ]
In your opinion, if you wanted to terminate a
pregnancy, your family would support you.
(select only one answer)
321
[For male respondents: ]
In your opinion, if your partner and you wanted
to have an abortion your family would support
you.
(select only one answer)
[For female respondents: ]
In your opinion, if you wanted to have an
abortion, you would have to do so without
telling anyone.
(select only one answer)
322
[For male respondents: ]
In your opinion, if your partner and you wanted
to have an abortion, you would have to do so
without telling anyone.
(select only one answer)
[For female respondents: ]
In your opinion, if you wanted to have an
abortion, your friends and relatives would
isolate or reject you.
323
[For male respondents: ]
In your opinion, if your partner and you wanted
to have an abortion, your friends and relatives
would isolate or reject you.
(select only one answer)
Page 9 of 16
Neutral/
Unsure
Agree
Disagree
[For female respondents: ]
In your opinion, if you wanted to terminate a
pregnancy, doctors and health care providers
would treat you rudely.
(select only one answer)
324
325
326
327
328
329
330
331
332
333
334
335
336
[For male respondents: ]
In your opinion, if your partner and you wanted
to terminate a pregnancy, doctors and health
care providers would treat you rudely.
(select only one answer)
In your opinion, you can confidently talk to a
health care provider about issues related to
abortion.
(select only one answer)
In your opinion, you can easily talk about issues
related to abortion with yourfriends or
neighbors.
(select only one answer)
In your opinion, you can confidently talk to your
partner about any issues related to abortion.
(select only one answer)
In your opinion, a woman who has an abortion
probably has sex with lots of different men.
(select only one answer)
In your opinion, doctors and midwives who
perform abortions in a clinic are committing a
crime.
(select only one answer)
In your opinion, you would feel ashamed if a
member of my family had an abortion.
(select only one answer)
In your opinion, a woman should keep her
abortion a secret from other people.
(select only one answer)
In your opinion, traditional healers who help
women abort a pregnancy are helping women.
(select only one answer)
In your opinion, if a man wants to marry a
woman who has had an abortion, you would
advise against it.
(select only one answer)
In your opinion, a woman who has an abortion
can make other people fall ill or get sick.
(select only one answer)
In your opinion, if a woman has an abortion, she
should be reported to the police.
(select only one answer)
In your opinion, you would try to disgrace a
woman in your community if you found out
she’d had an abortion.
(select only one answer)
Page 10 of 16
Neutral/
Unsure
Agree
Disagree
337
338
339
340
341
342
343
344
345
346
347
348
In your opinion, the health of a woman who had
an abortion is never as good as it was before the
abortion.
(select only one answer)
In your opinion, a woman who has had an
abortion should be counseled by religious
leaders so that she doesn’t do it again.
(select only one answer)
In your opinion, it is a good idea for a woman
who has an abortion to not talk about her
experience.
(select only one answer)
In your opinion, you would not allow your
children to go near a woman who has had an
abortion.
(select only one answer)
In your opinion, a woman who has an abortion
is a bad mother.
(select only one answer)
In your opinion, a man who supports a woman
in getting an abortion is committing a crime.
(select only one answer)
In your opinion, it is a good idea for the
government to allow abortions to be legal.
(select only one answer)
In your opinion, you would continue to be
friends with someone if you found out that they
had an abortion.
(select only one answer)
In your opinion, a woman who has had an
abortion might influence other women to get
abortions.
(select only one answer)
In your opinion, it is okay for a woman to feel
relieved after having an abortion.
(select only one answer)
In your opinion, a man should not marry a
woman who has had an abortion because she
may not be able to bear children.
(select only one answer)
In your opinion, a woman who has an abortion
should be treated the same as everyone else.
(select only one answer)
Page 11 of 16
Neutral/
Unsure
Agree
Section 4. Knowledge of Abortion Practices
Where do married women in this community
go to have an abortion?
Traditional healer (Ng’anga)
Teaching/tertiary hospital (UTH)
Public Hospital
(allow multiple answers, but do not read
responses)
Public Health Center
Private clinic
NGO clinic (MSI)
401
Friends/family
Induces by herself
Traditional birth attendant
Pharmacy/drug seller
Other (specify):
Where do unmarried girls or women in this
community go to have an abortion?
(allow multiple answers, but do not read
responses)
402
If you, your partner, or someone you know
needed to have an abortion, where would you
go?
(allow multiple answers, but do not read
responses)
403
Why would you choose this facility/provider?
(allow multiple answers, but do not read
responses)
404
Page 12 of 16
____________________________________
Does not know/No answer
Traditional healer (Ng’anga)
Teaching/tertiary hospital (UTH)
Public Hospital
Public Health Center
Private clinic
NGO clinic (MSI)
Friends/family
Induces by herself
Traditional birth attendant
Pharmacy/drug seller
Other (specify):
___________________________________
Does not know/No answer
Traditional healer (Ng’anga)
Teaching/tertiary hospital (UTH)
Public Hospital
Public Health Center
Private clinic
NGO clinic (MSI)
Friends/family
Induces by herself
Traditional birth attendant
Pharmacy/drug seller
Other (specify):
___________________________________
Does not know/No answer
Cost
Distance
Female provider
Privacy
Partner’s consent not required
Provider skill
Equipped facility
Not required to adopt family planning
method
Other (specify):
________________ ____________________
Does not know/No answer
To your knowledge, where is the nearest
location where you or someone you know
could access services or help in getting a safe
abortion?
Traditional healer (Ng’anga)
Teaching/tertiary hospital (UTH)
Public Hospital
Public Health Center
Private clinic
(select only one answer)
NGO clinic (MSI)
405
Friends/family
Induces by herself
Traditional birth attendant
Pharmacy/drug seller
Other (specify):
406
407
If safe abortion services were to become
available at a clinic or hospital near your
community/compound, would you or your
partner go there?
(select only one answer)
If a woman wants to have an abortion, do you
know of any medication or substance she can
take?
(select only one answer)
What medication, method or substance do you
know of for starting an abortion?
(allow multiple answers, but do not read
responses. probe for answers on list.)
____________________________________
Does not know/No answer
No
Yes
Does not know/No answer
No  Go to question 410
Yes
Does not know/No answer
If respondent answers one of the following 4
choices, ask question 409:
Misoprostol/Cytotec
Medabon
Chinese abortion pill
Other tablets/ tablets inserted vaginally
______________________________________
If respondent answers one of the following
choices, go to question 410:
Chloroquine tablets
Boiled roots (Lunsonga, muzwezi,
408
(If respondent answered 1, 2, 3 or 4 to the
previous question, ask:)
409
You mentioned pills or tablets. How did you
first come to know about this method?
(allow multiple answers, but do not read
responses)
Page 13 of 16
mubonobono, mululwe, mulozameno,
munsokansoka, itembusha, mbulumbulu,
matolisa, mkoswe)
Ashes (mulota, ifisikisa, chidulo)
Painkillers/antibiotics (Cafenol, Panadol,
ampicillin, aspirin, Anadin)
Beverages (soda, coke, etc.)
Physical removal (sharp stick or sharp
root)
Crushed bottles (drink ground glass)
Washing powder (Dynamo, Boom, etc.)
Other (specify):
____________________________________
Does not know/No answer
Friend/Family member/Partner
Health care provider
Traditional healer (Ng’anga)
Radio
Pamphlet
Street drama
Signs/posters
Other (specify):
____________________________________
Does not know/No answer
Section 5. Health-Seeking Behaviors
501
In the last 12 months, have you received any
information about contraceptives or family
planning?
(select only one answer)
From whom did you get this information?
No  Go to question 503
Yes
Does not know/No answer
Friend/Family member/Partner
Health care provider
(allow multiple answers, but do not read
responses)
Traditional healer (Ng’anga)
Radio
Pamphlet
502
Street drama
Signs/posters
Pharmacy/drug seller
Other (specify):
503
In the last 12 months, have you received any
information about abortion?
(select only one answer)
From whom did you get this information?
(allow multiple answers, but do not read
responses)
504
505
In the past year, have you heard about
abortions being performed by tablets or pills at
______________________________________?
(INSERT NAME OF NEAREST STUDY FACILITY:
RONALD ROSS, CHIPATA CLINIC, CHILANGA
CLINIC, OR KAWAMA CLINIC)
Where did you hear about this?
___________________________________
Does not know/No answer
No  Go to question 505
Yes
Does not know/No answer
Friend/Family member/Partner
Health care provider
Traditional healer (Ng’anga)
Radio
Pamphlet
Street drama
Signs/posters
Pharmacy/drug seller
Other (specify):
____________________________________
Does not know/No answer
No  Go to question 507
Yes
Does not know/No answer
Friend/Family member/Partner
Health care provider
(allow multiple answers, but do not read
responses)
Traditional healer (Ng’anga)
Radio
Pamphlet
506
Street drama
Signs/posters
Pharmacy/drug seller
Other (specify):
Where do you go to treat general ailments for
your family?
507
(allow multiple answers, but do not read
responses)
Page 14 of 16
___________________________________
Does not know/No answer
Government health facility
Private health facility
NGO hospital/clinic
Pharmacy/Drug seller
Traditional Healer (Ng’anga)
Other (specify):
___________________________________
Does not know/No answer
Where do you mostly go to consult/treat for
more personal health issues such as antenatal
care?
508
Government health facility
Private health facility
NGO hospital/clinic
Pharmacy/Drugstore
(allow multiple answers, but do not read
responses)
Traditional Healer (Ng’anga)
Other (specify):
___________________________________
Does not know/No answer
Interviewer: If respondent is male, thank the respondent and end the survey.
Only continue to the rest of the survey questions if the respondent is female.
Section 6. Female Respondents Only
601
602
Have you ever have had an unexpected delay in
your period?
(select only one answer)
Did you do anything to bring on your period?
(select only one answer)
No  Go to question 605
Yes
Does not know/No answer
No  Go to question
605
Yes
Does not know/No answer
From whom did you seek help in bringing on
your period?
No one/self
Family
Friend
603
(allow multiple answers, but do not read
responses)
Pharmacist
Health care provider
Traditional healer
Other (specify):
What did you use or do to bring on your period?
(allow multiple answers, but do not read
responses)
604
605
Have you ever fallen pregnant when you were
not hoping or expecting to become pregnant?
(select only one answer)
Page 15 of 16
___________________________________
Does not know/No answer
Misoprostol/Cytotec
Medabon
Chinese abortion pill
Other tablets/ tablets inserted vaginally
Chloroquine tablets
Boiled roots (Lunsonga, muzwezi,
mubonobono, mululwe, mulozameno,
munsokansoka, itembusha, mbulumbulu,
matolisa, mkoswe)
Ashes (mulota, ifisikisa, chidulo)
Painkillers/antibiotics (Cafenol, Panadol,
ampicillin, aspirin, Anadin)
Beverages (soda, coke, etc.)
Physical removal (sharp stick or sharp
root)
Crushed bottles (drink ground glass)
Washing powder (Dynamo, Boom, etc.)
Other (specify):
____________________________________
Does not know/No answer
No  Thank the respondent and end
survey
Yes
Does not know/No answer
606
Did you do anything to terminate the
pregnancy?
(select only one answer)
No  Thank the respondent and end
survey
Yes
Does not know/No answer
Interviewer: If respondent answered “No” to the previous question, thank the
respondent and end the survey. Only continue to the rest of the survey
questions if the respondent reports a previous abortion experience.
From whom did you seek help in terminating
the pregnancy?
No one/self
Family
Friend
607
(allow multiple answers, but do not read
responses)
Pharmacist
Health care provider
Traditional healer
Does not know/No answer
What did you use or do terminate the
pregnancy?
Misoprostol/Cytotec
Medabon
Chinese abortion pill
(allow multiple answers, but do not read
responses. probe for answers in list.)
Other tablets/ tablets inserted vaginally
Chloroquine tablets
Boiled roots (Lunsonga, muzwezi,
608
609
610
611
Did this action enable you to terminate the
pregnancy completely?
(select only one answer)
Did you seek care at a health facility at any point
after trying to terminate your pregnancy?
(select only one answer)
Did you experience any health complications
after trying to terminate this pregnancy?
(select only one answer)
mubonobono, mululwe, mulozameno,
munsokansoka, itembusha, mbulumbulu,
matolisa, mkoswe)
Ashes (mulota, ifisikisa, chidulo)
Painkillers/antibiotics (Cafenol, Panadol,
ampicillin, aspirin, Anadin)
Beverages (soda, coke, etc.)
Physical removal (sharp stick or sharp
root)
Crushed bottles (drink ground glass)
Washing powder (Dynamo, Boom, etc.)
Other (specify):
____________________________________
Does not know/No answer
Yes
No, it was incomplete
No, nothing happened
Does not know/No answer
No
Yes
Does not know/No answer
No  Thank the respondent and end
survey
Yes
Does not know/No answer
If yes, can you please tell us about your health complications?
612
Interviewer: Thank the respondent and end the survey.
Page 16 of 16
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