Survey Text
Afghanistan 2015
No questionnaire text is available for this sample.
Angola 2015
No questionnaire text is available for this sample.
Bangladesh 1994
No questionnaire text is available for this sample.
Bangladesh 1997
No questionnaire text is available for this sample.
Bangladesh 2000
No questionnaire text is available for this sample.
Bangladesh 2004
No questionnaire text is available for this sample.
Bangladesh 2007
No questionnaire text is available for this sample.
Bangladesh 2011
No questionnaire text is available for this sample.
Bangladesh 2014
No questionnaire text is available for this sample.
Benin 2006
No questionnaire text is available for this sample.
Benin 2011
No questionnaire text is available for this sample.
Benin 2017
Survey form
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text
Instructions:
Only one code should appear in any box
Column 1 requires a code in every month.
Information to be coded for each column.
Column 1: Births, Pregnancies, Contraceptive Use
B Birth
P Pregnancies
T Terminations
0 No method
1 Female sterilization
2 Male sterilization
3 IUD
4 Injectables
5 Implants
6 Pill
7 Condom
8 Female condom
9 Emergency contraception
J Standard Days Method
K Lactational Amenorrhea Method
L Rhythm method
M Withdrawal
X Other modern method
Y Other traditional method
Column 2: Discontinuation of contraceptive use
0 Infrequent sex/husband away
1 Became pregnant while using
2 Wanted to become pregnant
3 Husband/partner disapproved
4 Wanted more effective method
5 Side effects/health concerns
6 Lack of access/too far
7 Costs too much
8 Inconvenient to use
F Up to God/Fatalist
A Difficult to get pregnant/menopausal
D Marital dissolution/separation
X Other (specify)
Z Don't know
Column 1 Column 2
2017 (1)
12 Dec 01
11 Nov 02
10 Oct 03
09 Sept 04
08 Aug 05
07 Jul 06
06 Jun 07
05 May 08
04 Apr 09
03 Mar 10
02 Feb 11
01 Jan 12
2016
12 Dec 13
11 Nov 14
10 Oct 15
09 Sept 16
08 Aug 17
07 Jul 18
06 Jun 19
05 May 20
04 Apr 21
03 Mar 22
02 Feb 23
01 Jan 24
2015
12 Dec 25
11 Nov 26
10 Oct 27
09 Sept 28
08 Aug 29
07 Jul 30
06 Jun 31
05 May 32
04 Apr 33
03 Mar 34
02 Feb 35
01 Jan 36
2014
12 Dec 37
11 Nov 38
10 Oct 39
09 Sept 40
08 Aug 41
07 Jul 42
06 Jun 43
05 May 44
04 Apr 45
03 Mar 46
02 Feb 47
01 Jan 48
2013
12 Dec 49
11 Nov 50
10 Oct 51
09 Sept 52
08 Aug 53
07 Jul 54
06 Jun 55
05 May 56
04 Apr 57
03 Mar 58
02 Feb 59
01 Jan 60
2012
12 Dec 61
11 Nov 62
10 Oct 63
09 Sept 64
08 Aug 65
07 Jul 66
06 Jun 67
05 May 68
04 Apr 69
03 Mar 70
02 Feb 71
01 Jan 72
Burkina Faso 2003
No questionnaire text is available for this sample.
Burkina Faso 2010
No questionnaire text is available for this sample.
Burundi 2010
Survey form
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text
CALENDAR
INSTRUCTIONS:
ONLY ONE CODE SHOULD APPEAR IN EACH BOX
COLUMN 1 REQUIRES A CODE IN EVERY MONTH.
INFORMATION TO BE CODED FOR EACH COLUMN.
COLUMN 1: BIRTHS, PREGNANCIES, CONTRACEPTIVE USE
B BIRTH
P PREGNANCIES
T TERMINATIONS
0 NO METHOD
1 FEMALE STERILIZATION
2 MALE STERILIZATION
3 IUD
4 INJECTABLES
5 IMPLANTS
6 PILL
7 CONDOM
8 FEMALE CONDOM
9 DIAPHRAGM
J FOAM OR JELLY
K LACTATIONAL AMENORRHEA METHOD
L RHYTHM METHOD
M WITHDRAWAL
X OTHER MODERN METHOD
Y OTHER TRADITIONAL METHOD
COLUMN 2: DISCONTINUATION OF CONTRACEPTIVE USE
0 INFREQUENT SEX/HUSBAND AWAY
1 BECAME PREGNANT WHILE USING
2 WANTED TO BECOME PREGNANT
3 HUSBAND/PARTNER DISAPPROVED
4 WANTED MORE EFFECTIVE METHOD
5 SIDE EFFECTS/HEALTH CONCERNS
6 LACK OF ACCESS/TOO FAR
7 COSTS TOO MUCH
8 INCONVENIENT TO USE
F UP TO GOD/FATALIST
A DIFFICULT TO GET PREGNANT/MENOPAUSAL
D MARITAL DISSOLUTION/SEPARATION
X OTHER (SPECIFY) _____
Z DON'T KNOW
2011:
04 APR 01 ____ ____
03 MAR 02 ____ ____
02 FEB 03 ____ ____
01 JAN 04 ____ ____
2010:
12 DEC 05 ____ ____
11 NOV 06 ____ ____
10 OCT 07 ____ ____
09 SEPT 08 ____ ____
08 AUG 09 ____ ____
07 JUL 10 ____ ____
06 JUN 11 ____ ____
05 MAY 12 ____ ____
04 APR 13____ ____
03 MAR 14____ ____
02 FEB 15____ ____
01 JAN 16____ ____
2009:
12 DEC 17____ ____
11 NOV 18 ____ ____
10 OCT 19 ____ ____
09 SEPT 20 ____ ____
08 AUG 21 ____ ____
07 JUL 22 ____ ____
06 JUN 23 ____ ____
05 MAY 24 ____ ____
04 APR 25____ ____
03 MAR 26____ ____
02 FEB 27____ ____
01 JAN 28____ ____
2008:
12 DEC 29 ____ ____
11 NOV 30 ____ ____
10 OCT 31 ____ ____
09 SEPT 32 ____ ____
08 AUG 33 ____ ____
07 JUL 34 ____ ____
06 JUN 35 ____ ____
05 MAY 36 ____ ____
04 APR 37____ ____
03 MAR 38____ ____
02 FEB 39____ ____
01 JAN 40____ ____
2007:
12 DEC 41 ____ ____
11 NOV 42 ____ ____
10 OCT 43 ____ ____
09 SEPT 44 ____ ____
08 AUG 45 ____ ____
07 JUL 46 ____ ____
06 JUN 47 ____ ____
05 MAY 48 ____ ____
04 APR 49____ ____
03 MAR 50____ ____
02 FEB 51____ ____
01 JAN 52____ ____
2006:
12 DEC 53 ____ ____
11 NOV 54 ____ ____
10 OCT 55 ____ ____
09 SEPT 56 ____ ____
08 AUG 57 ____ ____
07 JUL 58 ____ ____
06 JUN 59 ____ ____
05 MAY 60 ____ ____
04 APR 61____ ____
03 MAR 62____ ____
02 FEB 63____ ____
01 JAN 64____ ____
2005:
12 DEC 65 ____ ____
11 NOV 66 ____ ____
10 OCT 67 ____ ____
09 SEPT 68 ____ ____
08 AUG 69 ____ ____
07 JUL 70 ____ ____
06 JUN 71 ____ ____
05 MAY 72 ____ ____
04 APR 73____ ____
03 MAR 74____ ____
02 FEB 75____ ____
01 JAN 76____ ____
Burundi 2016
No questionnaire text is available for this sample.
Egypt 1992
Survey form
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text
701. ENTER THE LINE NUMBER AND NAME OF EACH BIRTH SINCE JANUARY 1987 IN THE TABLE. BEGIN WITH THE LAST BIRTH. RECORD TWINS OR TRIPLETS IN SEPARATE COLUMNS. ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS. BEGIN WITH THE LAST BIRTH. (IF THERE ARE MORE THAN 3 BIRTHS, USE ADDITIONAL FORMS).
LINE NUMBER FROM Q212 ___
NAME
ALIVE
DEAD
Egypt 1995
No questionnaire text is available for this sample.
Egypt 2000
No questionnaire text is available for this sample.
Egypt 2003
No questionnaire text is available for this sample.
Egypt 2005
No questionnaire text is available for this sample.
Egypt 2008
No questionnaire text is available for this sample.
Egypt 2014
No questionnaire text is available for this sample.
Eswatini (Swaziland) 2006
No questionnaire text is available for this sample.
Ethiopia 2005
No questionnaire text is available for this sample.
Ethiopia 2011
No questionnaire text is available for this sample.
Ethiopia 2016
No questionnaire text is available for this sample.
Ghana 2003
No questionnaire text is available for this sample.
Ghana 2008
No questionnaire text is available for this sample.
Ghana 2014
No questionnaire text is available for this sample.
Guinea 2005
No questionnaire text is available for this sample.
Guinea 2018
Survey form
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text
2018 (1)
12 Dec 01
11 Nov 02
10 Oct 03
09 Sept 04
08 Aug 05
07 Jul 06
06 Jun 07
05 May 08
04 Apr 09
03 Mar 10
02 Feb 11
01 Jan 12
2017
12 Dec 13
11 Nov 14
10 Oct 15
09 Sept 16
08 Aug 17
07 Jul 18
06 Jun 19
05 May 20
04 Apr 21
03 Mar 22
02 Feb 23
01 Jan 24
2016
12 Dec 25
11 Nov 26
10 Oct 27
09 Sept 28
08 Aug 29
07 Jul 30
06 Jun 31
05 May 32
04 Apr 33
03 Mar 34
02 Feb 35
01 Jan 36
2015
12 Dec 37
11 Nov 38
10 Oct 39
09 Sept 40
08 Aug 41
07 Jul 42
06 Jun 43
05 May 44
04 Apr 45
03 Mar 46
02 Feb 47
01 Jan 48
2014
12 Dec 49
11 Nov 50
10 Oct 51
09 Sept 52
08 Aug 53
07 Jul 54
06 Jun 55
05 May 56
04 Apr 57
03 Mar 58
02 Feb 59
01 Jan 60
2013
12 Dec 61
11 Nov 62
10 Oct 63
09 Sept 64
08 Aug 65
07 Jul 66
06 Jun 67
05 May 68
04 Apr 69
03 Mar 70
02 Feb 71
01 Jan 72
(1) We assume that the collection year is 2018. For collection starting in 2019, all references to calendar year must be increased by one year: for example, 20112 must be changed to 2013, 2013 to 2014, 2014 to 2015, and so on for all years in the questionnaire.
(2) Codes can be added for other methods, like those based on knowledge of fertility.
India 2005
No questionnaire text is available for this sample.
India 2015
No questionnaire text is available for this sample.
Jordan 1990
No questionnaire text is available for this sample.
Jordan 1997
No questionnaire text is available for this sample.
Jordan 2002
No questionnaire text is available for this sample.
Jordan 2007
Survey form
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text
COLUMN 2: DISCONTINUATION OF CONTRACEPTIVE USE
0 INFREQUENT SEX/HUSBAND AWAY
1 BECAME PREGNANT WHILE USING
2 WANTED TO BECOME PREGNANT
3 HUSBAND DISAPPROVED
4 WANTED MORE EFFECTIVE METHOD
5 HEALTH CONCERNS
6 SIDE EFFECTS
7 LACK OF ACCESS/ TOO FAR
8 COSTS TOO MUCH
9 INCONVENIENT TO USE
F FATALISTIC
A DIFFICULT TO GET PREGNANT/ MENOPAUSAL
D WIDOW/ DIVORCE/ SEPARATION
R RAMADAN
X OTHER (SPECIFY)_________________
Z DON'T KNOW
2007
12 DEC 01_ _
11 NOV 02_ _
10 OCT 03_ _
09 SEP 04_ _
08 AUG 05_ _
07 JUL 06_ _
06 JUN 07_ _
05 MAY 08_ _
04 APR 09_ _
03 MAR 10_ _
02 FEB 11_ _
01 JAN 12_ _
2006
12 DEC 13_ _
11 NOV 14_ _
10 OCT 15_ _
09 SEP 16_ _
08 AUG 17_ _
07 JUL 18_ _
06 JUN 19_ _
05 MAY 20_ _
04 APR 21_ _
03 MAR 22_ _
02 FEB 23_ _
01 JAN 24_ _
2005
12 DEC 25_ _
11 NOV 26_ _
10 OCT 27_ _
09 SEP 28_ _
08 AUG 29_ _
07 JUL 30_ _
06 JUN 31_ _
05 MAY 32_ _
04 APR 33_ _
03 MAR 34_ _
02 FEB 35_ _
01 JAN 36_ _
2004
12 DEC 37_ _
11 NOV 38_ _
10 OCT 39_ _
09 SEP 40_ _
08 AUG 41_ _
07 JUL 42_ _
06 JUN 43_ _
05 MAY 44_ _
04 APR 45_ _
03 MAR 46_ _
02 FEB 47_ _
01 JAN 48_ _
2003
12 DEC 49_ _
11 NOV 50_ _
10 OCT 51_ _
09 SEP 52_ _
08 AUG 53_ _
07 JUL 54_ _
06 JUN 55_ _
05 MAY 56_ _
04 APR 57_ _
03 MAR 58_ _
02 FEB 59_ _
01 JAN 60_ _
2002
12 DEC 61_ _
11 NOV 62_ _
10 OCT 63_ _
09 SEP 64_ _
08 AUG 65_ _
07 JUL 66_ _
06 JUN 67_ _
05 MAY 68_ _
04 APR 69_ _
03 MAR 71_ _
02 FEB 71_ _
01 JAN 72_ _
Jordan 2009
Survey form
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text
CALENDAR
INSTRUCTIONS: ONLY ONE CODE SHOULD APPEAR IN ANY BOX. IN COLUMN 1, ALL MONTHS SHOULD BE FILLED IN.
INFORMATION TO BE CODED FOR EACH COLUMN.
COLUMN 1: BIRTHS, PREGNANCIES, CONTRACEPTIVES USE
BIRTHS B
PREGNANCIES P
TERMINATIONS T
NO METHOD 0
FEMALE STERILIZATION 1
MALE STERILIZATION 2
PILL 3
IUD 4
INJECTABLES 5
IMPLANTS 6
CONDOM 7
FAMLE CONDOM 8
DIAPHRAGM 9
FOAM OR JELLY J
LACTATIONAL AMENORRHEA METHOD K
PERIODIC ASTINENCE L
WITHDRAWL M
OTHER(SPECIFY) ________________ X
NOTE: In case of multiple birth which ended with live and non-live birth outcomes record BIRTH to the calendar
COLUMN 2: DISCONTINUATION OF CONTRACEPTIVE USE
INFREQUENT SEX/HUSBAND AWAY 0
BECAME PREGNANT WHILE USING 1
WANTED TO BECOME PREGNANT 2
HUSBAND DISAPPROVED 3
WANTED MORE EFFECTIVE METHOD 4
HEALTH CONCERNS 5
SIDE EFFECTS 6
LACK OF ACCESS/TOO FAR 7
COSTS TOO MUCH 8
INCONVIENT TO USE 9
FATALISTIC F
DIFFICULT TO GET PREGNANT/MENOPAUSAL A
WIDOW/DIVORCE/SEPARATION D
RAMADAN R
OTHER(SPECIFY) _____________ X
DON'T KNOW Z
2009
12 DEC 01 __
11 NOV 02 __
10 OCT 03 __
09 SEP 04 __
08 AUG 05 __
07 JUL 06 __
06 JUN 07 __
05 MAY 08 __
04 APR 09 __
03 MAR 10 __
02 FEB 11 __
01 JAN 12 __
2008
12 DEC 13 __
11 NOV 14 __
10 OCT 15 __
09 SEP 16 __
08 AUG 17 __
07 JUL 18 __
06 JUN 19 __
05 MAY 20 __
04 APR 21 __
03 MAR 22 __
02 FEB 23 __
01 JAN 24 __
2007
12 DEC 25 __
11 NOV 26 __
10 OCT 27 __
09 SEP 28 __
08 AUG 29 __
07 JUL 30 __
06 JUN 31 __
05 MAY 32 __
04 APR 33 __
03 MAR 34 __
02 FEB 35 __
01 JAN 36 __
2006
12 DEC 37 __
11 NOV 38 __
10 OCT 39 __
09 SEP 40 __
08 AUG 41 __
07 JUL 42 __
06 JUN 43 __
05 MAY 44 __
04 APR 45 __
03 MAR 46 __
02 FEB 47 __
01 JAN 48 __
2005
12 DEC 49 __
11 NOV 50 __
10 OCT 51 __
09 SEP 52 __
08 AUG 53 __
07 JUL 54 __
06 JUN 55 __
05 MAY 56 __
04 APR 57 __
03 MAR 58 __
02 FEB 59 __
01 JAN 60 __
2004
12 DEC 61 __
11 NOV 62 __
10 OCT 63 __
09 SEP 64 __
08 AUG 65 __
07 JUL 66 __
06 JUN 67 __
05 MAY 68 __
04 APR 69 __
03 MAR 70 __
02 FEB 71 __
01 JAN 72 __
Jordan 2012
No questionnaire text is available for this sample.
Jordan 2017
No questionnaire text is available for this sample.
Kenya 1998
Survey form
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text
FIRST VISIT
DATE
INTERVIEWER'S NAME
RESULT***
NEXT VISIT:
DATE
TIME
SECOND VISIT
DATE
INTERVIEWER'S NAME
RESULT***
NEXT VISIT:
DATE
TIME
THIRD VISIT
DATE
INTERVIEWER'S NAME
RESULT***
FINAL VISIT
DAY
MONTH
YEAR
NAME
RESULT
Kenya 2003
No questionnaire text is available for this sample.
Kenya 2008
No questionnaire text is available for this sample.
Kenya 2014
No questionnaire text is available for this sample.
Lesotho 2009
No questionnaire text is available for this sample.
Lesotho 2014
No questionnaire text is available for this sample.
Liberia 2013
No questionnaire text is available for this sample.
Madagascar 2003
No questionnaire text is available for this sample.
Madagascar 2008
No questionnaire text is available for this sample.
Malawi 2000
No questionnaire text is available for this sample.
Malawi 2004
No questionnaire text is available for this sample.
Malawi 2010
No questionnaire text is available for this sample.
Malawi 2016
No questionnaire text is available for this sample.
Mali 2001
Survey form
view entire document:
text
CALENDAR
INSTRUCTIONS: ONLY ONE CODE PER BOX.
BIRTHS AND PREGNANCIES:
N BIRTH
G PREGNANCY
F END OF PREGNANCY
2001:
12 DEC 01____
11 NOV 02____
10 OCT 03____
09 SEPT 04____
08 AUG 05____
07 JUL 06____
06 JUN 07____
05 MAY 08____
04 APR 09____
03 MAR 10____
02 FEB 11____
01 JAN 12____
2000:
12 DEC 13____
11 NOV 14____
10 OCT 15____
09 SEPT 16____
08 AUG 17____
07 JUL 18____
06 JUN 19____
05 MAY 20____
04 APR 21____
03 MAR 22____
02 FEB 23____
01 JAN 24____
1999:
12 DEC 25____
11 NOV 26____
10 OCT 27____
09 SEPT 28____
08 AUG 29____
07 JUL 30____
06 JUN 31____
05 MAY 32____
04 APR 33 ____
03 MAR 34____
02 FEB 35____
01 JAN 36____
1998:
12 DEC 37____
11 NOV 38____
10 OCT 39____
09 SEPT 40____
08 AUG 41____
07 JUL 42____
06 JUN 43____
05 MAY 44____
04 APR 45____
03 MAR 46____
02 FEB 47____
01 JAN 48____
1997:
12 DEC 49____
11 NOV 50____
10 OCT 51____
09 SEPT 52____
08 AUG 53____
07 JUL 54____
06 JUN 55____
05 MAY 56____
04 APR 57____
03 MAR 58____
02 FEB 59____
01 JAN 60____
1996:
12 DEC 61____
11 NOV 62____
10 OCT 63____
09 SEPT 64____
08 AUG 65____
07 JUL 66____
06 JUN 67____
05 MAY 68____
04 APR 69____
03 MAR 70____
02 FEB 71____
01 JAN 72____
Mali 2006
No questionnaire text is available for this sample.
Mali 2012
No questionnaire text is available for this sample.
Mali 2018
No questionnaire text is available for this sample.
Morocco 1992
No questionnaire text is available for this sample.
Morocco 2003
No questionnaire text is available for this sample.
Mozambique 2003
No questionnaire text is available for this sample.
Mozambique 2011
No questionnaire text is available for this sample.
Myanmar 2015
No questionnaire text is available for this sample.
Namibia 2006
No questionnaire text is available for this sample.
Namibia 2013
No questionnaire text is available for this sample.
Nepal 2006
No questionnaire text is available for this sample.
Nepal 2011
No questionnaire text is available for this sample.
Nepal 2016
No questionnaire text is available for this sample.
Niger 2006
No questionnaire text is available for this sample.
Niger 2012
No questionnaire text is available for this sample.
Nigeria 2008
No questionnaire text is available for this sample.
Nigeria 2013
No questionnaire text is available for this sample.
Nigeria 2018
Survey form
view entire document:
text
Pakistan 2012
No questionnaire text is available for this sample.
Pakistan 2017
No questionnaire text is available for this sample.
Rwanda 2000
No questionnaire text is available for this sample.
Rwanda 2005
No questionnaire text is available for this sample.
Rwanda 2010
No questionnaire text is available for this sample.
Rwanda 2014
No questionnaire text is available for this sample.
Senegal 2005
No questionnaire text is available for this sample.
Senegal 2010
No questionnaire text is available for this sample.
Senegal 2012
No questionnaire text is available for this sample.
Senegal 2014
No questionnaire text is available for this sample.
Senegal 2015
No questionnaire text is available for this sample.
Senegal 2016
No questionnaire text is available for this sample.
Senegal 2017
No questionnaire text is available for this sample.
South Africa 2016
No questionnaire text is available for this sample.
Tanzania 2004
No questionnaire text is available for this sample.
Tanzania 2010
No questionnaire text is available for this sample.
Tanzania 2015
No questionnaire text is available for this sample.
Uganda 2001
No questionnaire text is available for this sample.
Uganda 2006
No questionnaire text is available for this sample.
Uganda 2011
No questionnaire text is available for this sample.
Uganda 2016
No questionnaire text is available for this sample.
Yemen 2013
No questionnaire text is available for this sample.
Zambia 2007
No questionnaire text is available for this sample.
Zambia 2013
No questionnaire text is available for this sample.
Zambia 2018
Survey form
view entire document:
text
INSTRUCTIONS:
ONLY ONE CODE SHOULD APPEAR IN ANY BOX.
COLUMN 1 REQUIRES A CODE IN EVERY MONTH.
CODES FOR EACH COLUMN:
COLUMN 1: BIRTHS, PREGNANCIES, CONTRACEPTIVE USE (2)
B BIRTHS
P PREGNANCIES
T TERMINATIONS
0 NO METHOD
1 FEMALE STERILIZATION
2 MALE STERILIZATION
3 IUD
4 INJECTABLES
5 IMPLANTS
6 PILLS
7 CONDOM
8 FEMALE CONDOM
9 EMERGENCY CONTRACEPTION
J STANDARD DAYS METHOD
K LACTATIONAL AMENORRHEA METHOD
L RHYTHM METHOD
M WITHDRAWAL
X OTHER MODERN METHOD
Y OTHER TRADITIONAL METHOD
COLUMN 2: DISCONTINUATION OF CONTRACEPTIVE USE
0 INFREQUENT SEX/HUSBAND AWAY
1 BECAME PREGNANT WHILE USING
2 WANTED TO BECOME PREGNANT
3 HUSBAND/PARTNER DISAPPROVED
4 WANTED MORE EFFECTIVE METHOD
5 SIDE EFFECTS/HEALTH CONCERNS
6 LACK OF ACCESS/TOO FAR
7 COSTS TOO MUCH
8 INCONVENIENT TO USE
F UP TO GOD/FATALISTIC
A DIFFICULT TO GET PREGNANT/MENOPAUSAL
D MARITAL DISSOLUTION/SEPARATION
X OTHER (SPECIFY) ____________________
Z DON'T KNOW
Zimbabwe 1994
No questionnaire text is available for this sample.
Zimbabwe 1999
No questionnaire text is available for this sample.
Zimbabwe 2005
No questionnaire text is available for this sample.
Zimbabwe 2010
No questionnaire text is available for this sample.
Zimbabwe 2015
No questionnaire text is available for this sample.