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Vietnam Population and AIDS Indicator Survey 2005 ... - Measure DHS

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Introduction <strong>and</strong> consent<br />

Section 1. respondent’s background<br />

Informed consent<br />

Hello. My name is _______________________________ <strong>and</strong> I am working with the Department of<br />

<strong>Population</strong> <strong>and</strong> Labour Statistics <strong>and</strong> the National Institute of Hygiene <strong>and</strong> Epidemiology. We are<br />

conducting a national health survey. We would very much appreciate your participation in this survey.<br />

I would like to ask you about some important health issues. This information will help the government<br />

to plan health services. The survey usually takes around 20 minutes to complete.<br />

Whatever information you provide will be kept strictly confidential <strong>and</strong> will not be shown to other<br />

persons.<br />

Participation in this survey is voluntary <strong>and</strong> you can choose not to answer any individual question or<br />

all of the questions. However, we hope that you will participate in this survey since your views are<br />

important.<br />

At this time, do you want to ask me anything about the survey<br />

May I begin the interview now<br />

Signature of interviewer: _________________________________ Date: ____________________<br />

respondent agrees to be 1 espondent does not agree to be interviewed 2<br />

end interviewed<br />

no Questions <strong>and</strong> filters Coding categories skip<br />

101 Record the time hour..............................................................<br />

minutes .......................................................<br />

102 In what month <strong>and</strong> year were you<br />

born<br />

month ..........................................................<br />

don’t know month.......................................... 98<br />

year .................................................. 1 9<br />

don’t know year......................................... 9998<br />

103 How old were you at your last<br />

birthday<br />

Compare <strong>and</strong> correct 102 <strong>and</strong>/or<br />

103 if inconsistent<br />

Age in completed years.....................<br />

104 Have you ever attended school yes ............................................................................. 1<br />

no ............................................................................... 2 107<br />

105 What is the highest level of school<br />

you attended: primary, lower<br />

secondary, upper secondary or<br />

higher<br />

106 What is the highest<br />

(grade/form/year) you completed<br />

primary................................................................... 1<br />

lower secondary.............................................. 2<br />

upper secondary ............................................... 3<br />

higher...................................................................... 4<br />

Grade………………………………………..<br />

grades = 0,1,2,...,12 (Level 1-3)<br />

years = 0,1,2,3,4,5 + ( Level 4)<br />

don't know = 98<br />

1<br />

138 | Appendix D

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