QNO Questionnaire ID CNAME Clinic name CID Clinic ID DATE Interview date DD / MM / YY T0 Interview time HH : MM AM / PM INTNAME Name of interviewer INTID Interviewer ID SUPID Field supervisor ID DATAID Data entry specialist ID Basic socio-demographic information [Section developed by PRIME.] T1 [Record start time] HH : MM AM / PM A1 years AGE How old are you? A2 Male 0 SEX [Interviewee sex] Female A3 1 Third sex (NE) 2 Can’t read or write (ET) 0 Less than primary school 1 What is the highest level of education you Primary school EDU A4 2 have completed? Secondary school 3 College/University 4 Paid or self-employment 1 EMP Voluntary employment 2 What is your employment status? A5 Unemployed 3 Student 4
Questionnaire ID QNO Clinic name CNAME Clinic ID CID Interview date DD / MM / YY DATE Interview time HH : MM AM / PM T0 Name of interviewer INTNAME Interviewer ID INTID Field supervisor ID SUPID Data entry specialist ID DATAID Basic socio-demographic information [Section developed by PRIME.] A1 [Record start time] HH : MM AM / PM T1 A2 How old are you? years AGE A3 [Interviewee sex] Male 0 SEX Female 1 Third sex (NE) 2 A4 What is the highest level of education you have completed? Can’t read or write (ET) 0 EDU Less than primary school 1 Primary school 2 Secondary school 3 College/University 4 A5 What is your employment status? Paid or self-employment 1 EMP Voluntary employment 2 Unemployed 3 Student 4