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. Has your husband/partner ever had an operation to avoid having any more children?

YES 1
NO 2

03 PILL Women can take a pill every day or every week to avoid becoming pregnant.

YES 1
NO 2

04 IUD OR LOOP 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 CONDOM OR NIRODH Men can put a rubber sheath on their penis before sexual intercourse.

YES 1
NO 2

07 FEMALE CONDOM Women can place a sheath in their vagina before sexual intercourse.

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 climax.

YES 1
NO 2

10 EMERGENCY CONTRACEPTION Women can take pills up to three days after sexual intercourse to avoid becoming pregnant.

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

FEMALE STERILIZATION A
MALE STERILIZATION B
IUD/PPIUD C
INJECTABLES D
PULL E
CONDOM/NIRODH F
FEMALE CONDOM G
EMERGENCY CONTRACEPTION H
DIAPHRAGM I
FOAM/JELLY J
STANDARD DAYS METHOD K
LACTATIONAL AMENDMENT METHOD L
RHYTHM METHOD M
WITHDRAWAL N
OTHER MODERN METHOD X
OTHER TRADITIONAL METHOD Y

01 FEMALE STERILISATION 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 STERILISATION 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 stop them from 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 INJECTIONS Women can have an injection by a health provider which stops them from becoming pregnant for one or more months.

YES 1
NO 2

06 CONDOM Men can put a rubber sheath on their penis before sexual intercourse.

YES 1
NO 2

07 FEMALE CONDOM Women can place a sheath in their vagina before sexual intercourse.

YES 1
NO 2

08 DIAPHRAGM /FOAM/JELLY Women can place a sponge, suppository, diaphragm, jelly or cream in their vagina before intercourse.

YES 1
NO 2

09 RHYTHM OR 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.

YES 1
NO 2

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

YES 1
NO 2

11 EMERGENCY CONTRACEPTION Women can take pills up to three days after sexual intercourse to avoid becoming pregnant.

YES 1
NO 2

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

YES 1
NO 2