Household Number
Member's Serial Number
Relation to household head
Sex
Age  in years
Marital Status
Highest level of education achieved
Overall, how would you rate your health during the past 4 weeks?
In the last 12 months, has a medical professional taken your blood pressure?
Is this person covered by any form of government or private health insurance? (1
Is this person covered by any form of government or private health insurance? (2
Since when has this person been covered by this insurance? (longest if more than
Stratum
Urban or rural
CensusUnitID
DwellingID
RegNo
UrbanOrRural
YarNo
QuartNo
UID
Food_consumption
Health_consumption
Total _Consumption
Total _Consumption_EqAdScale_08
Sample weight
Day of first visit
Month of first visit
Time of first visit
interviewed? (first visit)
If 'No', why not? (first visit)
Day of second visit
Month of second visit
Time of second visit
interviewed? (second visit)
If 'No', why not? (second visit)
Day of third visit
Month of third visit
Time of third visit
interviewed? (third visit)
If 'No', why not? (third visit)
Time Interview started
Time Interview finished
Interviewer: has the same (IHS) household been found?
Completeness of questionnaire, Section B, Expected number of completed sections
Completeness of questionnaire, Section B, Number of completed sections
Completeness of questionnaire, Section B, Complete?
Completeness of questionnaire, Section C, Expected number of completed sections
Completeness of questionnaire, Section C, Number of completed sections
Completeness of questionnaire, Section C, Complete?
Completeness of questionnaire, Section D, Expected number of completed sections
Completeness of questionnaire, Section D, Number of completed sections
Completeness of questionnaire, Section D, Complete?
Completeness of questionnaire, Section E, Expected number of completed sections
Completeness of questionnaire, Section E, Number of completed sections
Completeness of questionnaire, Section E, Complete?
Completeness of questionnaire, Section F, Expected number of completed sections
Completeness of questionnaire, Section F, Number of completed sections
Completeness of questionnaire, Section F, Complete?
Completeness of questionnaire, Section G, Expected number of completed sections
Completeness of questionnaire, Section G, Number of completed sections
Completeness of questionnaire, Section G, Complete?
Completeness of questionnaire, Section H, Expected number of completed sections
Completeness of questionnaire, Section H, Number of completed sections
Completeness of questionnaire, Section H, Complete?
Respondents S/N
What type of facility is that?
If someone in this family gets sick and needed to see a doctor, would they norma
Why not?
How many days per week is a doctor usually present at that facility?
How would you normally travel to this facility?
How long does it take to travel there in this way? (hours)
How long does it take to travel there in this way? (minutes)
Overall, how satisfied are you with the quality of services provided by this fac
How much do you trust this facility to give you and your household the health ca
In general, how affordable are the services provided by this facility?
Compared with three years ago, would you say that the quality of services offere
If you have a consultation with a doctor at this facility, would you normally ex
In the last 12 months, has anyone in your household been given advice and/or hel
In the last 12 months, has anyone in your household been given information by an
If you went for an ambulatory (outpatient) consultation at a general hospital, w
Would you say that, overall, the quality of health services available in Georgia
Do you know about the state programme for medical insurance for the population b
Do you know what benefits this insurance provides?
what this program provides (includes)?(first answer)
what this program provides (includes)?(second answer)
what this program provides (includes)?(third answer)
what this program provides (includes)?(fourth answer)
what this program provides (includes)?(fifth answer)
Are you or any member of your household beneficiary of universal health care pro
During the last 12 months did you or any member of your household have problems
If there had been any problem/misunderstanding, name it(first problem)
If there had been any problem/misunderstanding, name it(second problem)
If there had been any problem/misunderstanding, name it(third problem)
Whom did you address regarding the above problem/problems?
In addition to the Universal Health Care Program, do you know what kind of servi
Has anyone in your household given birth in the last two years (24 months)?
If yes, which family member(s) were pregnant? (first Person)
If yes, which family member(s) were pregnant? (second Person)
If yes, which family member(s) were pregnant? (third Person)
How many pre-natal appointments did you have during this last pregnancy? (first
How many pre-natal appointments did you have during this last pregnancy? (second
How many pre-natal appointments did you have during this last pregnancy? (third
How many times was your blood pressure taken by a medical practitioner during yo
(If yes) At which facilities was your blood pressure measured during this pregna
Did you have a urine test during your pregnancy? (first Person)
Did you have a urine test during your pregnancy? (second Person)
Did you have a urine test during your pregnancy? (third Person)
Were there any occasions within the last year when someone within the household
If yes, which family member was ill? (first episode)
If yes, which family member was ill? (second episode)
If yes, which family member was ill? (third episode)
What was the illness? (first episode)
What was the illness? (second episode)
What was the illness? (third episode)
Did a doctor or health professional say that they should be hospitalised? (first
Did a doctor or health professional say that they should be hospitalised? (secon
Did a doctor or health professional say that they should be hospitalised? (third
Why were they NOT hospitalised? (first episode)
Why were they NOT hospitalised? (second episode)
Why were they NOT hospitalised? (third episode)
Quintiles of Adult Equivalent HH Consumption