27.03.2017 Views

Malawi 2015-16

FR319

FR319

SHOW MORE
SHOW LESS

Create successful ePaper yourself

Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.

CHILD FUNCTIONING AND DISABILITY (AGE 10-17)<br />

CHILD 3 CHILD 4<br />

303 LINE NUMBER FROM COLUMN 1.<br />

LINE LINE<br />

NUMBER ..................... NUMBER .....................<br />

NAME FROM COLUMN 2. NAME NAME<br />

304 CHILD SEX FROM COLUMN 4.<br />

MALE . . . . . . . . . . . . . . . . . . . . . 1 MALE . . . . . . . . . . . . . . . . . . . . . 1<br />

FEMALE . . . . . . . . . . . . . . . . . . 2 FEMALE . . . . . . . . . . . . . . . . . . 2<br />

305 CHILD AGE FROM COLUMN 7.<br />

AGE AGE<br />

306 Does (NAME) wear glasses or contact YES . . . . . . . . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . . . . . . . 1<br />

lenses?<br />

NO . . . . . . . . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . . . . . . . . 2<br />

(SKIP TO 309) (SKIP TO 309)<br />

307 Does (NAME) have difficulty seeing even YES . . . . . . . . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . . . . . . . 1<br />

if he/she is wearing glasses or contact NO . . . . . . . . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . . . . . . . . 2<br />

lenses?<br />

(SKIP TO 311) (SKIP TO 311)<br />

DON'T KNOW . . . . . . . . . . . . . 8 DON'T KNOW . . . . . . . . . . . . . 8<br />

308 Would you say that (NAME) has some SOME DIFFICULTY . . . . . . . . . . 1 SOME DIFFICULTY . . . . . . . . . . 1<br />

difficulty seeing, a lot of difficultly, or can A LOT OF DIFFICULTY . . . . . . . 2 A LOT OF DIFFICULTY . . . . . . . 2<br />

he/she not see at all?<br />

CAN'T SEE AT ALL . . . . . . . . . . 3 CAN'T SEE AT ALL . . . . . . . . . . 3<br />

DON'T KNOW . . . . . . . . . . . . . 8 DON'T KNOW . . . . . . . . . . . . . 8<br />

(SKIP TO 311) (SKIP TO 311)<br />

309 Does (NAME) have difficulty seeing? YES . . . . . . . . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . . . . . . . 1<br />

NO . . . . . . . . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . . . . . . . . 2<br />

(SKIP TO 311) (SKIP TO 311)<br />

DON'T KNOW . . . . . . . . . . . . . 8 DON'T KNOW . . . . . . . . . . . . . 8<br />

310 Would you say that (NAME) has some SOME DIFFICULTY . . . . . . . . . . 1 SOME DIFFICULTY . . . . . . . . . . 1<br />

difficulty seeing, a lot of difficultly, or can A LOT OF DIFFICULTY . . . . . . . 2 A LOT OF DIFFICULTY . . . . . . . 2<br />

he/she not see at all?<br />

CAN'T SEE AT ALL . . . . . . . . . . 3 CAN'T SEE AT ALL . . . . . . . . . . 3<br />

DON'T KNOW . . . . . . . . . . . . . 8 DON'T KNOW . . . . . . . . . . . . . 8<br />

311 Does (NAME) use a hearing aid?<br />

YES . . . . . . . . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . . . . . . . 1<br />

NO . . . . . . . . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . . . . . . . . 2<br />

(SKIP TO 314) (SKIP TO 314)<br />

DON'T KNOW . . . . . . . . . . . . . 8 DON'T KNOW . . . . . . . . . . . . . 8<br />

312 Does (NAME) have difficulty hearing even YES . . . . . . . . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . . . . . . . 1<br />

if he/she is using a hearing aid?<br />

NO . . . . . . . . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . . . . . . . . 2<br />

(SKIP TO 3<strong>16</strong>) (SKIP TO 3<strong>16</strong>)<br />

DON'T KNOW . . . . . . . . . . . . . 8 DON'T KNOW . . . . . . . . . . . . . 8<br />

313 Would you say that (NAME) has some SOME DIFFICULTY . . . . . . . . . . 1 SOME DIFFICULTY . . . . . . . . . . 1<br />

difficulty hearing, a lot of difficultly, or can A LOT OF DIFFICULTY . . . . . . . 2 A LOT OF DIFFICULTY . . . . . . . 2<br />

he/she not hear at all?<br />

CAN'T HEAR AT ALL . . . . . . . 3 CAN'T HEAR AT ALL . . . . . . . 3<br />

DON'T KNOW . . . . . . . . . . . . . 8 DON'T KNOW . . . . . . . . . . . . . 8<br />

(SKIP TO 3<strong>16</strong>) (SKIP TO 3<strong>16</strong>)<br />

314 Does (NAME) have difficulty hearing ? YES . . . . . . . . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . . . . . . . 1<br />

NO . . . . . . . . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . . . . . . . . 2<br />

(SKIP TO 3<strong>16</strong>) (SKIP TO 3<strong>16</strong>)<br />

DON'T KNOW . . . . . . . . . . . . . 8 DON'T KNOW . . . . . . . . . . . . . 8<br />

315 Would you say that (NAME) has some SOME DIFFICULTY . . . . . . . . . . 1 SOME DIFFICULTY . . . . . . . . . . 1<br />

difficulty hearing, a lot of difficultly, or can A LOT OF DIFFICULTY . . . . . . . 2 A LOT OF DIFFICULTY . . . . . . . 2<br />

he/she not hear at all?<br />

CAN'T HEAR AT ALL . . . . . . . 3 CAN'T HEAR AT ALL . . . . . . . 3<br />

DON'T KNOW . . . . . . . . . . . . . 8 DON'T KNOW . . . . . . . . . . . . . 8<br />

Appendix F<br />

• 529

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!