Survey Text

Burkina Faso 1993 Cameroon 1991 Nepal 1996 Togo 1998
Burkina Faso 1998 Jordan 1997 Sri Lanka 1987 Zambia 1996
Burkina Faso 2003 Mali 1987 Tanzania 1996
Burundi 1987 Morocco 1987 Togo 1988
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Burkina Faso 1993
Survey form view entire document:  text 
303. Have you ever used (METHOD)?
[THIS QUESTION IS ASKED ABOUT EACH METHOD IN 301 WITH '1' or '2' CIRCLED.]

01. PILL: Women can take a pill every day to avoid becoming pregnant.
YES 1
NO 2
02. IUD: Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2
03. INJECTABLES: Women can have an injection by a health provider that stops them from becoming pregnant for one or more months.
YES 1
NO 2
04. MOUSSE, FOAM OR GEL: Women can place a mousse, gel or foam inside their vagina before sexual intercourse.
YES 1
NO 2
05. CONDOM: Men can put a rubber or latex sheath on their penis before sexual intercourse. Have you ever used a condom with a partner?
YES 1
NO 2
06. FEMALE STERILIZATION: Women can have an operation to avoid having any more children. Have you ever had an operation to avoid having any more children?
YES 1
NO 2
07. MALE STERILIZATION: Men can have an operation to avoid having any more children. Has your husband/partner ever had an operation to avoid having any more children?
YES 1
NO 2
08. RHYTHM METHOD: Some couples avoid having sex during certain days of the month when the woman is most likely to get pregnant.
YES 1
NO 2
09. WITHDRAWAL: Men can be careful and pull out before ejaculation.
YES 1
NO 2
10. PROLONGED ABSTINENCE: Beyond the avoidance of sex traditionally observed after a birth, some couples avoid having sex for some months so the woman won't become pregnant.
YES 1
NO 2
11. CHARM/TALISMAN: Some women use amulets/charms to avoid getting pregnant.

YES 1
NO 2
12. OTHER METHOD(S) (SPECIFY) _____
YES 1
NO 2

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Burkina Faso 1998
Survey form view entire document:  text 
303. Have you ever used (METHOD)?
THIS QUESTION IS ASKED ABOUT EACH METHOD IN 301 WITH '1' OR '2' CIRCLED.

01. PILL: Women can take a pill every day to avoid becoming pregnant.
YES 1
NO 2
02. IUD: Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2
03. INJECTABLES: Women can have an injection by a health provider that stops them from becoming pregnant for one or more months.
YES 1
NO 2
04. MOUSSE, FOAM OR GEL: Women can place a mousse, gel or foam inside their vagina before sexual intercourse.
YES 1
NO 2
05. CONDOM: Men can put a rubber or latex sheath on their penis before sexual intercourse.
YES 1
NO 2
06. FEMALE STERILIZATION: Women can have an operation to avoid having any more children. Have you ever had an operation to avoid having any more children?
YES 1
NO 2
07. MALE STERILIZATION: Men can have an operation to avoid having any more children. Have you ever had a partner who has an operation to avoid having any more children?
YES 1
NO 2
08. RHYTHM METHOD: Every month that a woman is sexually active she can avoid pregnancy by not having sexual intercourse on the days of the month she is most likely to get pregnant.
YES 1
NO 2
09. WITHDRAWAL: Men can be careful and pull out before ejaculation.
YES 1
NO 2
10. OTHER METHOD(S) (SPECIFY) ______
YES 1
NO 2

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Burkina Faso 2003
Survey form view entire document:  text 
302. Have you ever used (METHOD)?
[THIS QUESTION IS ASKED ABOUT EACH METHOD IN 301 WITH '1' or '2' CIRCLED.]

01. FEMALE STERILIZATION: Women can have an operation to avoid having any more children. Have you ever had an operation to avoid having any (more) children?
YES 1
NO 2
02. MALE STERILIZATION: Men can have an operation to avoid having any more children. Have you ever had a partner who had an operation to avoid having any (more) children?
YES 1
NO 2
03. PILL: Women can take a pill every day to avoid becoming pregnant.
YES 1
NO 2
04. IUD: Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2
05. INJECTABLES: Women can have an injection by a health provider that stops them from becoming pregnant for one or more months.
YES 1
NO 2
06. IMPLANTS: Women can have several small rods placed in their upper arm by a doctor or nurse which can prevent pregnancy for one or more years.
YES 1
NO 2
07. CONDOM: Men can put a rubber or latex sheath on their penis before sexual intercourse.
YES 1
NO 2
08. FEMALE CONDOM: Women can place a latex sheath in their vagina before sexual intercourse.
YES 1
NO 2
09. DIAPHRAGM: Women can place a diaphragm in their vagina before sexual intercourse.
YES 1
NO 2
10. MOUSSE OR GEL: Women can insert a suppository, or put gel or cream inside their vagina before sexual intercourse.
YES 1
NO 2
11. LACTATIONAL AMENORRHEA METHOD (LAM): Up until 6 months after giving birth, a woman can use a method that consists of nursing frequently, day and night, and that prevents her from getting her period again.
YES 1
NO 2
12. RHYTHM METHOD: Every month that a woman is sexually active she can avoid pregnancy by not having sexual intercourse on the days of the month she is most likely to get pregnant.
YES 1
NO 2
13. WITHDRAWAL: Men can be careful and pull out before climax.
YES 1
NO 2
14. EMERGENCY CONTRACEPTION: As an emergency measure after unprotected sexual intercourse, women can take special pills at any time within three days to prevent pregnancy.
YES 1
NO 2
15. OTHER METHOD(S) (SPECIFY) _____
YES 1
NO 2

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Burundi 1987
Survey form view entire document:  text 
303) Have you ever used (method)?

PILL: Women can take a pill every day to delay or avoid pregnancy.
YES 1
NO 2
IUD: Women can have a plastic or metal coil or device placed inside their uterus by a doctor.
YES 1
NO 2
INJECTIONS: Women can have an injection by a doctor or a nurse which stops them from becoming pregnant for several months.
YES 1
NO 2
DIAPHRAGM/FOAM/JELLY: Women can place a sponge, suppository, diaphragm, jelly, or cream inside themselves before intercourse to avoid pregnancy.
YES 1
NO 2
CONDOM: Men use a condom to avoid getting the woman pregnant.
YES 1
NO 2
FEMALE STERILIZATION: Women can have an operation to avoid having any more children
YES 1
NO 2
MALE STERILIZATION: Men can have an operation to avoid having any more children
YES 1
NO 2
WITHDRAWAL: Men can be careful and pull out before climax.
YES 1
NO 2
ABSTINENCE: Some couples, not including the post-natal period of abstinence, avoid sexual intercourse for months so that the woman doesn't get pregnant.
YES 1
NO 2
PERIODIC ABSTINENCE: Some couples can avoid pregnancy by not having sexual intercourse on the days of the month she is most likely to get pregnant.
YES 1
NO 2
MEDICAL PLANTS (bark, roots, leaves) are used by some women to delay or space out pregnancies.
YES 1
NO 2
TALISMANS: (charm, cord with knot, etc) are used by some women to delay or space out pregnancies.
YES 1
NO 2
OTHER METHODS: Have you heard of any other ways or methods, including traditional methods, that women or men can use to avoid pregnancy?
YES 1
NO 2

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Cameroon 1991
Survey form view entire document:  text 
303) Have you ever used (METHOD)?

01. Pill: Women can take a pill every day.
YES 1
NO 2
02. IUD: Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2
03. Injectables: Women can have an injection by a health provider which stops them from becoming pregnant for several months.
YES 1
NO 2
04. Diaphragm/foam/jelly: Women can place a sponge, suppository, diaphragm, jelly, or cream inside themselves before intercourse.
YES 1
NO 2
05. Condom (rubber): Men can put a rubber sheath on their penis during sexual intercourse.
YES 1
NO 2
06. Female Sterilization: Women can have an operation to avoid having any more children.

Have you had an operation to avoid having any more children?
YES 1
NO 2
07. Male Sterilization: Men can have an operation to avoid having any more children.

Has your husband /partner had an operation to avoid having any more children?
YES 1
NO 2
08. Rhythm method/periodic abstinence: Every month that a woman is sexually active she can avoid pregnancy by not having sexual intercourse on the days of the month she is most likely to get pregnant; it is called the Ogino method.
YES 1
NO 2
09. Abstinence: Outside of the cessation of sexual relations traditionally observed after giving birth, some couples avoid having sexual intercourse for months so that the woman doesn't become pregnant.
YES 1
NO 2
10. Withdrawal: Men can be careful and pull out before climax.
YES 1
NO 2
11. Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES (SPECIFY) 1
SPECIFY METHOD ONE: ___
SPECIFY METHOD TWO: ___
SPECIFY METHOD THREE: ___
NO 3

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Jordan 1997
Survey form view entire document:  text 
403. Have you ever used (METHOD)?

01) PILL: Women can take a pill every day.

YES 1
NO 2

02) IUD: Women can have a loop or coil placed inside them by a doctor or a nurse

YES 1
NO 2

03) INJECTIONS: Women can have an injection by a doctor or nurse which stops them from becoming pregnant for several months.

YES 1
NO 2

04) IMPLANTS: Women can have several small rods placed in their upper arm by a doctor or nurse which can prevent pregnancy for several years.

YES 1
NO 2

05) DIAPHRAGM, FOAM, JELLY: Women can place a sponge, suppository, diaphragm, jelly, or cream inside themselves before intercourse.

YES 1
NO 2

06) CONDOM: Men can put a rubber sheath on their penis during sexual intercourse.

YES 1
NO 2

07) FEMALE STERILIZATION: Have you ever had an operation to avoid having any more children?

YES 1
NO 2

08) MALE STERILIZATION: Have you ever had a husband who had an operation to avoid having children?

YES 1
NO 2

09) RHYTHM, PERIODIC ABSTINENCE: Every month that a woman is sexually active she can avoid having sexual intercourse on the days of the month that she is most likely to get pregnant.

10) WITHDRAWAL: Men can be careful and pull out before climax.

11) PROLONGED BREASTFEEDING: Women can breastfeed for longer period to avoid getting pregnant.

12) Have you heard of any other methods that women or men can use to avoid pregnancy?

SPECIFY___________

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Mali 1987
Survey form view entire document:  text 
303. Have ever used (METHOD)?

PILL Women can take a pill every day to avoid becoming pregnant.
YES 1
NO 2
IUD Women can have a loop or a coil in plastic or metal placed inside their uterus by a doctor or a nurse to avoid becoming pregnant.
YES 1
NO 2
INJECTIONS Women can have an injection by a health provider to avoid becoming pregnant during one or more months.
YES 1
NO 2
CREAM, JELLY, SPONGE Some women put a diaphragm, a sponge, effervescent pills, jelly or cream before having sexual intercourse to avoid getting pregnant.
YES 1
NO 2
CONDOM Men can put a rubber sheath on their penis before sexual intercourse.
YES 1
NO 2
FEMALE STERILIZATION Women can have an operation to avoid having any more children. Are you sterilized?
YES 1
NO 2
MALE STERILIZATION Men can have an operation to avoid having any more children.
Have you ever had a partner who had an operation to avoid having any more children?
YES 1
NO 2
PERIODIC ABSTINENCE Every month that a woman is sexually active she can avoid pregnancy by not having intercourse on the days of the month she is most likely to get pregnant.
YES 1
NO 2
WITHDRAWAL Men can be careful to pull out before climax.
YES 1
NO 2
ABSTINENCE Some couples, in addition to post natal abstinence, avoid having sexual intercourse so that the woman does not get pregnant.
YES 1
NO 2
MEDICINAL PLANTS (stem, root, leaves) are products that can be used to delay pregnancy.
YES 1
NO 2
AMULET (cord with a knot) are things couples can use to delay pregnancy.
YES 1
NO 2
OTHER METHOD (SPECIFY) ____
YES 1
NO 2

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Morocco 1987
Survey form view entire document:  text 
403) Have you or your husband ever used (METHOD)?

01) PILL
Women can take a pill every day to delay or avoid pregnancy.
YES 1
NO 2
02) IUD
Women can have a plastic or metal coil or device placed inside their uterus by a doctor (or a midwife).
YES 1
NO 2
03) INJECTIONS
Women can have an injection by a doctor or a midwife which stops them from becoming pregnant for several months.
YES 1
NO 2
04) OTHER SCIENTIFIC METHODS
Women can place a diaphragm, a sponge, suppository, jelly, or cream inside themselves before intercourse to avoid pregnancy.
YES 1
NO 2
05) CONDOM
Men use a condom to avoid getting the woman pregnant.
YES 1
NO 2
06) FEMALE STERILIZATION
Women can have an operation to avoid having any more children
YES 1
NO 2
07) VASECTOMY
Men can have an operation to avoid having any more children
YES 1
NO 2
08) PERIODIC ABSTINENCE
Some couples can avoid pregnancy by not having sexual intercourse on the days of the month she is most likely to get pregnant.
YES 1
NO 2
09) VAGINAL DOUCHING
After sexual intercourse, some women wash themselves with water or something else to avoid getting pregnant.
YES 1
NO 2
10) WITHDRAWAL
Men can be careful and pull out before climax
YES 1
NO 2
11) PROLONGED ABSTINENCE
Some couples, not including the post-natal period of abstinence, avoid sexual intercourse for months so that the woman doesn't get pregnant.
YES 1
NO 2
12) OTHER METHODS
Have you heard of any other ways or methods, including traditional methods, that women or men can use to avoid pregnancy? (SPECIFY): ____
YES 1
NO 2

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Nepal 1996
Survey form view entire document:  text 
SECTION 3. CONTRACEPTION

Now I would like to talk about family planning -- the various ways or methods that a couple can use to delay or avoid a pregnancy.

CIRCLE CODE 1 IN 301 FOR EACH METHOD MENTIONED SPONTANEOUSLY. THEN PROCEED DOWN COLUMN 302, READING THE NAME AND DESCRIPTION OF EACH METHOD NOT MENTIONED SPONTANEOUSLY. CIRCLE CODE 2 IF METHOD IS RECOGNIZED, AND CODE 3 IF NOT RECOGNIZED. THEN, FOR EACH METHOD WITH CODE 1 OR 2 CIRCLED IN 301 OR 302, ASK 303.

301. Which ways or methods have you heard about?

01 PILL Women can take a pill every day.
YES/SPONT 1
NO (GO TO 302 01)
02. IUD Women can have a loop or coil placed inside them by a doctor or a nurse.
YES/SPONT 1
NO (GO TO 302 02)
03 INJECTIONS Women can have an injection by a doctor, nurse or pharmacist, which stops them from becoming pregnant for several months.
YES/SPONT 1
NO (GO TO 302 03)
04 NORPLANT Women can have several small rods placed in their upper arms by a doctor or nurse which can prevent pregnancy for several years.
YES/SPONT 1
NO (GO TO 302 04)
05 DIAPHRAGM, FOAM, JELLY Women can place a sponged, suppository, diaphragm, jelly, or cream inside themselves before intercourse.
YES/SPONT 1
NO (GO TO 302 05)
06 CONDOM Men can put a rubber sheath on their penis during sexual intercourse.
YES/SPONT 1
NO (GO TO 302 06)
07 FEMALE STERILIZATION Women can have an operation to avoid having any more children.
YES/SPONT 1
NO (GO TO 302 07)
08 MALE STERILIZATION Men can have an operation to avoid having any more children.
YES/SPONT 1
NO (GO TO 302 08)
09 RHYTHEM, PERIODIC ABSTINENCE Every month that a woman is sexually active she can avoid having sexual intercourse on the days of the month she is most likely to get pregnant.
YES/SPONT 1
NO (GO TO 302 09)
10 WITHDRAWAL Men can be careful and pull out before climax.
YES/SPONT 1
NO (GO TO 302 10)
11 Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES/SPONT 1
(SPECIFY)

302. Have you ever heard of (METHOD)?

01 PILL Women can take a pill every day.
YES/PROBED 2
NO 3
02. IUD Women can have a loop or coil placed inside them by a doctor or a nurse.
YES/PROBED 2
NO 3
03 INJECTIONS Women can have an injection by a doctor, nurse or pharmacist, which stops them from becoming pregnant for several months.
YES/PROBED 2
NO 3
04 NORPLANT Women can have several small rods placed in their upper arms by a doctor or nurse which can prevent pregnancy for several years.
YES/PROBED 2
NO 3
05 DIAPHRAGM, FOAM, JELLY Women can place a sponged, suppository, diaphragm, jelly, or cream inside themselves before intercourse.
YES/PROBED 2
NO 3
06 CONDOM Men can put a rubber sheath on their penis during sexual intercourse.
YES/PROBED 2
NO 3
07 FEMALE STERILIZATION Women can have an operation to avoid having any more children.
YES/PROBED 2
NO 3
08 MALE STERILIZATION Men can have an operation to avoid having any more children.
YES/PROBED 2
NO 3
09 RHYTHM, PERIODIC ABSTINENCE. Every month that a woman is sexually active she can avoid having sexual intercourse on the days of the month she is most likely to get pregnant.
YES/PROBED 2
NO 3
10 WITHDRAWAL Men can be careful and pull out before climax.
YES/PROBED 2
NO 3
11 Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
NO 3

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Sri Lanka 1987
Survey form view entire document:  text 
315) Some women abstain from sexual relations completely for more than one or two months for the following reasons: 1: To avoid pregnancy. 2: Because the eldest child is of marriage age. 3: Because the husband is away. 4: A women has just had a baby or is breastfeeding. 5: Illness. 6: Religious reasons. Have you ever abstained for any of these reasons?

YES 1
NO 2 (GO TO 323)

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Tanzania 1996
Survey form view entire document:  text 
303. Have you ever used (METHOD)?

METHOD 01 PILL Women can take a pill every day.
YES 1
NO 2
METHOD 02 IUD Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2
METHOD 03 INJECTIONS Women can have an injection by a doctor or nurse which stops them from becoming pregnant for several months.
YES 1
NO 2
METHOD 04 IMPLANTS Women can have several small rods placed in their upper arm by a doctor or nurse which can prevent pregnancy for several years.
YES 1
NO 2
METHOD 05 DIAPHRAGM, FOAM, JELLY Women can place a sponge, suppository, diaphragm, jelly, or cream inside themselves before intercourse.
YES 1
NO 2
METHOD 06 CONDOM, RUBBER, RAINCOAT, DUREX A man can wear a rubber bag in his penis during sex to prevent pregnancy. The rubber bag is also used to prevent passing diseases such as AIDS and for cleanliness.
YES 1
NO 2
METHOD 07 FEMALE STERILIZATION Women can have an operation to avoid having any more children.
Have you ever had an operation to avoid having any more children?
YES 1
NO 2
METHOD 08 MALE STERILIZATION Men can have an operation to avoid having any more children.
Have you ever had a partner who had an operation to avoid having children?
YES 1
NO 2
METHOD 09 CALENDAR/SAFE PERIOD Couples can have sexual intercourse only during the safe period of the monthly cycle that is the times during monthly cycle when women is least likely to get pregnant.
YES 1
NO 2
METHOD 10 MUCUS METHOD A woman can observe daily the state of the mucus and avoid sexual intercourse at the time when the mucus is colorless and extremely elastic.
YES 1
NO 2
METHOD 11 WITHDRAWAL Men can be careful and pull out before climax.
YES 1
NO 2
METHOD 12 Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES 1
NO 2

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Togo 1988
Survey form view entire document:  text 
303) Have you ever used (METHOD)?

01. PILL: Women can take a pill every day to delay or avoid pregnancy.
YES 1
NO 2
02. IUD: Women can have a plastic device placed inside their uterus by a midwife or a doctor to prevent getting pregnant.
YES 1
NO 2
03. INJECTIONS: Women can have an injection by a doctor or a nurse which stops them from becoming pregnant for several months.
YES 1
NO 2
04. CREAM/JELLY/PILL/SPERMICIDE: Women can place a diaphragm, an effervescent pill, jelly, or crème inside themselves before intercourse to avoid pregnancy.
YES 1
NO 2
05. CONDOM: Men use a condom to avoid getting the woman pregnant.
YES 1
NO 2
6) FEMALE STERILIZATION: Have you ever had an operation to have no more children?
YES 1
NO 2
07. MALE STERILIZATION: Has your husband or partner ever had an operation to have no more children?
YES 1
NO 2
08. PERIODIC ABSTINENCE (OGINO): Some couples can avoid pregnancy by not having sexual intercourse on the days of the month she is most likely to get pregnant.
YES 1
NO 2
09. WITHDRAWAL: Some men practice withdrawal, that is that they can be careful and pull out before climax.
YES 1
NO 2
10. ABSTINENCE: Some couples, not including the post-natal period of abstinence, avoid sexual intercourse for months so that the woman doesn't get pregnant.
YES 1
NO 2
11. MEDICAL PLANTS (bark, roots, leaves) are used by some women to delay or space out pregnancies.
YES 1
NO 2
12. TALISMANS: (ring, belt) are used by some women to delay or space out pregnancies.
YES 1
NO 2
13) OTHER METHODS: Have you heard of any other ways or methods, including traditional methods, that women or men can use to avoid pregnancy? (specify)
YES 1
NO 2

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Togo 1998
Survey form view entire document:  text 
303. Have you ever used (METHOD)?

01. PILL Women can take a pill every day.
YES 1
NO 2
02. IUD Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2
03. INJECTABLES Women can have an injection by a doctor or nurse which stops them from becoming pregnant for several months.
YES 1
NO 2
04. IMPLANTS Women can have several small rods placed in their upper arm by a doctor or nurse which can prevent pregnancy for several years.
YES 1
NO 2
05. DIAPHRAGM, FOAM, JELLY Women can place a sponge, suppository, diaphragm, jelly, or cream inside themselves before intercourse.
YES 1
NO 2
06. CONDOM Men can put a rubber sheath on their penis during sexual intercourse.
YES 1
NO 2
07. FEMALE STERILIZATION Women can have an operation to avoid having any more children: Have you ever had an operation to avoid having any more children?
YES 1
NO 2
08. MALE STERILIZATION Men can have an operation to avoid having any more children: Have you ever had a partner who had an operation to avoid having children?
YES 1
NO 2
09. RHYTHM, PERIODIC ABSTINENCE Every moth that a woman is sexually active she can avoid having sexual intercourse on the days of the month she is most likely to get pregnant.
YES 1
NO 2
10. WITHDRAWAL Men can be careful and pull out before climax.
YES 1
NO 2
11. Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES 1
NO 2

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Zambia 1996
Survey form view entire document:  text 
303. Have you ever used (METHOD)?

METHOD 01 PILL Women can take a pill every day.
YES 1
NO 2
METHOD 02 IUCD Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2
METHOD 03 INJECTIONS Women can have an injection by a doctor or nurse which stops them from becoming pregnant for several months.
YES 1
NO 2
METHOD 04 IMPLANTS Women can have several small rods placed in their upper arm by a doctor or nurse which can prevent pregnancy for several years.
YES 1
NO 2
METHOD 05 FOAMING TABLETS/JELLY Women can place a sponge, suppository, diaphragm, jelly, or cream inside themselves before intercourse.
YES 1
NO 2
METHOD 06 CONDOM Men can put a rubber sheath on their penis during sexual intercourse.
YES 1
NO 2
METHOD 07 FEMALE STERILIZATION Women can have an operation to avoid having any more children: Have you ever had an operation to avoid having any more children?
YES 1
NO 2
METHOD 08 MALE STERILIZATION Men can have an operation to avoid having any more children: Have you ever had a partner who had an operation to avoid having children?
YES 1
NO 2
METHOD 09 NATURAL FAMILY PLANNING Couples can avoid having sexual intercourse on the days of the month when the woman is more likely to become pregnant.
YES 1
NO 2
METHOD 10 WITHDRAWAL Men can be careful and pull out before climax.
YES 1
NO 2
METHOD 11 Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES 1
NO 2