| Variables in Mother's Information Form (MIF) | ||||||||
| Question# | Question | Field name | Response nature | Response options | ||||
| 1 | PID Number | PID | ### | |||||
| 2 | Initials of the mother | mif_A | XX | |||||
| 3 | Field Worker code | mif_B | ## | |||||
| 4 | Date
of interview (According to English calender) |
mif_C | ##-XXX-## | dd-mmm-yy | ||||
| 5 | Age
of the pregnant mother (completed years) |
mif_1 | ## | |||||
| 6 | How many years are you in married life? | mif_2 | ## | 00 if less than 1 year; mention completed years | ||||
| 7 | Years of schooling of pregnant mother | mif_3 | ## | |||||
| 8 | Occupation of pregnant mother | mif_4 | # | 1=Housewife, 3=Agriculture, 4=Carpet worker, 5=Daily wage earner, 6=Business, 7=Government employee, 8= Services in private sector, 9=NA, 10=Foreign employment | ||||
| 10 | Any h/o previous illness that required hospital admission? | mif_5 | # | 1=Yes, 2=No | ||||
| 11 | If yes, specify | mif_5txt | TXT | TEXT
if mif_5=1 NA if mif_5ǂ1 |
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| 12 | Cigarette /other tobacco smoking? | mif_6 | # | 1=Yes, regularly, 2=No, 3=Yes, occasionally, 4=Previous smoker | ||||
| 14 | Consuming alcohol ? | mif_7 | # | 1=Yes, 2= No, 3= Yes, in past | ||||
| 15 | If yes, how often? | mif_7i | TXT | NA,
if mif_7= 2 or 3 Following options if mif_7=1: 1= Daily, 2= 2-4 times a week, 3=Once a week, 4=2-4 times a month, 5=once a month or less |
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| 16 | Did you or your spouse use any kind of contraception before pregnancy | mif_8 | # | 2=No, 3=Condom, 4=Three monthly injection (Depo), 5=Pills, 6=IUCD, 7=Implant (Norplant), 8=She or husband has gone through operation, 10=Calendar method, 11=Other | ||||
| 17 | Is this first pregnancy? | mif_9 | # | 1=Yes, 2=No | ||||
| 18 | Remarks | TXT | ||||||