Survey Text

Benin 2001 Ghana 2003 Madagascar 2003 Nigeria 2003
Benin 2006 Ghana 2008 Malawi 2000 Nigeria 2008
Burkina Faso 2003 Guinea 2005 Mali 2001 Nigeria 2013
Burkina Faso 2010 Guinea 2012 Mali 2006 Rwanda 2000
Burundi 2010 Jordan 1997 Morocco 2003 Rwanda 2005
Cameroon 2004 Jordan 2002 Mozambique 2003 Senegal 2005
Cameroon 2011 Jordan 2007 Namibia 2013 Tanzania 2004
Chad 2004 Jordan 2009 Nepal 2001 Tanzania 2010
Congo (Democratic Republic) 2007 Jordan 2012 Nepal 2011 Uganda 2001
Congo (Democratic Republic) 2013 Kenya 2003 Niger 2006 Zimbabwe 1988
Cote d'Ivoire 2011 Lesotho 2004 Nigeria 1990 Zimbabwe 1999
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Benin 2001
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 301, READING THE NAME AND DESCRIPTION OF EACH METHOD NOT MENTIONED SPONTANEOUSLY. CIRCLE CODE 1 IF METHOD IS RECOGNIZED, AND CODE 2 IF NOT RECOGNIZED. THEN, FOR EACH METHOD WITH CODE 1 CIRCLED IN 301, ASK 302.

301) Which ways or methods have you heard about?

FOR METHODS NOT MENTIONED SPONTANEOUSLY, ASK: Have you ever heard of (METHOD)?

01. FEMALE STERILIZATION Women can have 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.
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 sheath on their penis before sexual intercourse.
YES 1
NO 2
08. FEMALE CONDOM Women can place a sheath in their vagina before sexual intercourse.
YES 1
NO 2
09. DIAPHRAGM Women can place a thin flexible disk in their vagina before intercourse.
YES 1
NO 2
10. FOAM OR JELLY Women can place a suppository, jelly or cream in their vagina before intercourse.
YES 1
NO 2
11. LACTATIONAL AMENORRHEA METHOD (LAM) Up to 6 months after childbirth, a woman can use a method that requires that she breastfeeds frequently, day and night, and that her menstrual period has not returned.
YES 1
NO 2
12. RHYTHM OR PERIODIC ABSTINENCE Every month that a woman is sexual 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 Women can take pills up to three days after sexual intercourse to avoid becoming pregnant.
YES 1
NO 2
15. Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES (SPECIFY): _____________ 1
NO 2

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Benin 2006
Survey form view entire document:  text 
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 301, READING THE NAME AND DESCRIPTION OF EACH METHOD NOT MENTIONED SPONTANEOUSLY. CIRCLE CODE 1 IF METHOD IS RECOGNIZED, AND CODE 2 IF NOT RECOGNIZED. THEN, FOR EACH METHOD WITH CODE 1 CIRCLED IN 301, ASK 302.

301) Which ways or methods have you heard about?
FOR METHODS NOT MENTIONED SPONTANEOUSLY: Have you ever heard of (METHOD)?

01) FEMALE STERILIZATION: Women can have 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.
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 heath provider which 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 sheath on their penis before sexual intercourse.
YES 1
NO 2
08) FEMALE CONDOM: Women can place a sheath in their vagina before sexual intercourse.
YES 1
NO 2
09) DIAPHRAGM: Women can place a thin flexible disk in their vagina before sexual intercourse.
YES 1
NO 2
10) FOAM OR JELLY: Women can place jelly or cream in their vagina before sexual intercourse.
YES 1
NO 2
11) LACTATIONAL AMENORRHEA METHOD (LAM): Up to 6 months after childbirth, a woman can use a method that requires that she breastfeeds frequently, day and night, and that her menstrual period has not returned.
YES 1
NO 2
11A) CYCLE BEADS: A method which involves moving beads to count from the first day of your period (red bead).
YES 1
NO 2
12) 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
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) Have you heard of any other ways or methods that women or men can use to avoid pregnancy? LIST UP TO TWO DIFFERENT METHODS.
SPECIFY____
YES 1
NO 2

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Burkina Faso 2003
Survey form view entire document:  text 
SECTION 3: CONTRACEPTION

Now I would like to talk about family planning and 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 301, READING THE NAME AND DESCRIPTION OF EACH METHOD NOT MENTIONED SPONTANEOUSLY. CIRCLE CODE '1' IF METHOD IS RECOGNIZED AND CODE '2' IF NOT RECOGNIZED. THEN, FOR EACH METHOD WITH CODE '1' CIRCLED IN 301, ASK 302.

301. Which ways or methods have you heard about?
FOR METHODS NOT MENTIONED SPONTANEOUSLY, ASK: Have you ever heard of (METHOD)?

01. FEMALE STERILIZATION: Women can have an operation to avoid having any more children.
YES 1
NO 2 (GO TO NEXT METHOD)
02. MALE STERILIZATION: Men can have an operation to avoid having any more children.
YES 1
NO 2 (GO TO NEXT METHOD)
03. PILL: Women can take a pill every day to avoid becoming pregnant.
YES 1
NO 2 (GO TO NEXT METHOD)
04. IUD: Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2 (GO TO NEXT METHOD)
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 (GO TO NEXT METHOD)
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 (GO TO NEXT METHOD)
07. CONDOM: Men can put a rubber or latex sheath on their penis before sexual intercourse.
YES 1
NO 2 (GO TO NEXT METHOD)
08. FEMALE CONDOM: Women can place a latex sheath in their vagina before sexual intercourse.
YES 1
NO 2 (GO TO NEXT METHOD)
09. DIAPHRAGM: Women can place a diaphragm in their vagina before sexual intercourse.
YES 1
NO 2 (GO TO NEXT METHOD)
10. MOUSSE OR GEL: Women can insert a suppository, or put gel or cream inside their vagina before sexual intercourse.
YES 1
NO 2 (GO TO NEXT METHOD)
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 (GO TO NEXT METHOD)
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 (GO TO NEXT METHOD)
13. WITHDRAWAL: Men can be careful and pull out before climax.
YES 1
NO 2 (GO TO NEXT METHOD)
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 (GO TO NEXT METHOD)
15. Have you heard of any other ways or methods that women or men can use to avoid pregnancy? IF YES, LIST UP TO TWO OTHER METHODS.
YES 1
NO 2
(SPECIFY) _____

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Burkina Faso 2010
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.

301. Have you ever heard of (METHOD)?

01. FEMALE STERILIZATION: Women can have 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.
YES 1
NO 2
03. IUD: Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2
04. INJECTABLES: Women can have an injection by a heath provider that stops them from becoming pregnant for one or more months.
YES 1
NO 2
05. IMPLANTS: Women can have one or more 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
06. PILL: Women can take a pill every day to avoid becoming pregnant.
YES 1
NO 2
07. CONDOM: Men can put a rubber sheath on their penis before sexual intercourse.
YES 1
NO 2
08. FEMALE CONDOM: Women can place a sheath in their vagina before sexual intercourse.
YES 1
NO 2
09. LACTATIONAL AMENORRHEA METHOD (LAM)
YES 1
NO 2
10. RHYTHM METHOD: A Woman 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
11. WITHDRAWAL: Men can be careful and pull out before climax.
YES 1
NO 2
12. EMERGENCY CONTRACEPTION: As an emergency measure, within three days after they have unprotected sexual intercourse, women can take special pills to prevent pregnancy.
YES 1
NO 2
12A. DIAPHRAGM/CERVICAL CAP: Women can place a latex disk on their cervix before intercourse.
YES 1
NO 2
12B. FOAM/JELLY/SPERMICIDE: Women can place a suppository, jelly, or cream in their vagina before intercourse to kill men's sperm. This cream can also be used on the diaphragm.
YES 1
NO 2
13. Have you heard of any other ways or methods that women or men can use to avoid pregnancy? IF YES, LIST UP TO TWO OTHER METHODS.
YES 1
NO 2
(SPECIFY) _____

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Burundi 2010
Survey form view entire document:  text 
301) Now I would like to talk about family planning-the various ways or methods that a couple can use to delay or avoid pregnancy.
Have you ever heard (METHOD)? (1)

01) Female Sterilization. PROBE: A woman can have an operation to avoid having any more children.
YES 1
NO 2
02) Male Sterilization. PROBE: Men can have an operation to avoid having any more children.
YES 1
NO 2
03) IUD. PROBE: Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2
04) Injectables. PROBE: Women can have an injection by a health provider that stops them from becoming pregnant for one or more months.
YES 1
NO 2
05) Implants. PROBE: Women can have one or more 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
06) Pill. PROBE: Women can take a pill every day to avoid becoming pregnant.
YES 1
NO 2
07) Condom. PROBE: Men can put a rubber sheath on their penis before sexual intercourse.
YES 1
NO 2
08) Female Condom. PROBE: Women can place a sheath in their vagina before sexual intercourse.
YES 1
NO 2
09) (2) Lactational Amenorrhea Method (LAM) (2)
YES 1
NO 2
10) Rhythm Method. PROBE: To avoid pregnancy, women do not have sexual intercourse on the days of the month they think they can get pregnant.
YES 1
NO 2
11) Withdrawal. PROBE: Men can be careful and pull out before climax.
YES 1
NO 2
12) Emergency Contraception. PROBE: As an emergency measure, within three days after they have unprotected sexual intercourse, women can take special pills to prevent pregnancy. (3)
YES 1
NO 2
13) Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES(SPECIFY)________ 1
(SPECIFY)________
NO 2

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Cameroon 2004
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 301, READING THE NAME AND DESCRIPTION OF EACH METHOD NOT MENTIONED SPONTANEOUSLY. CIRCLE CODE 1 IF METHOD IS RECOGNIZED, AND CODE 2 IF NOT RECOGNIZED. THEN, FOR EACH METHOD WITH CODE 1 CIRCLED IN 301, ASK 302.

301) Which ways or methods have you heard about?

FOR METHODS NOT MENTIONED SPONTANEOUSLY, ASK: Have you ever heard of (METHOD)?

01. FEMALE STERILIZATION Women can have 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.
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 sheath on their penis before sexual intercourse.
YES 1
NO 2
08. FEMALE CONDOM Women can place a sheath in their vagina before sexual intercourse.
YES 1
NO 2
09. DIAPHRAGM Women can place a thin flexible disk in their vagina before intercourse.
YES 1
NO 2
10. FOAM OR JELLY Women can place a suppository, jelly or cream in their vagina before intercourse.
YES 1
NO 2
11. LACTATIONAL AMENORRHEA METHOD (LAM) Up to 6 months after childbirth, a woman can use a method that requires that she breastfeeds frequently, day and night, and that her menstrual period has not returned.
YES 1
NO 2
12. RHYTHM OR PERIODIC ABSTINENCE Every month that a woman is sexual 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 Women can take pills up to three days after sexual intercourse to avoid becoming pregnant.
YES 1
NO 2
15. Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES (SPECIFY): _____________ 1
NO 2

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Cameroon 2011
Survey form view entire document:  text 
SECTION 3. CONTRACEPTION

301) 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.

Have you ever heard of (METHOD)?

01. FEMALE STERILIZATION Women can have 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.
YES 1
NO 2
03. PILL Women can take a pill every day.
YES 1
NO 2
04. IUD/STERILET Women can have a sterilet that a doctor, midwife, or nurse places inside their vagina.
YES 1
NO 2
05. INJECTABLES 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. 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 sheath on their penis before sexual intercourse.
YES 1
NO 2
08. FEMALE CONDOM Women can place a sheath in their vagina before sexual intercourse.
YES 1
NO 2
09. DIAPHRAGM Women can place a diaphragm in their vagina before intercourse.
YES 1
NO 2
10. FOAM OR GEL Women can place a suppository, gel, or cream in their vagina before intercourse.
YES 1
NO 2
11. LACTATIONAL AMENORRHEA METHOD (LAM) Up to 6 months after childbirth, a woman can use a method that requires that she breastfeeds frequently, day and night, and that her menstrual period has not returned.
YES 1
NO 2
12. RHYTHM/PERIODIC ABSTINENCE/BILLINGS OVULATION METHOD (Cervical mucus) 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. MORNING AFTER PILL Women can take pills at any time up to 5 days after sexual intercourse to avoid becoming pregnant.
YES 1
NO 2

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Chad 2004
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 301A FOR EACH METHOD MENTIONED SPONTANEOUSLY. THEN PROCEED DOWN COLUMN 301A, READING THE NAME AND DESCRIPTION OF EACH METHOD NOT MENTIONED SPONTANEOUSLY. CIRCLE CODE 1 IF METHOD IS RECOGNIZED, AND CODE 2 IF NOT RECOGNIZED. THEN, FOR EACH METHOD WITH CODE 1 CIRCLED IN 301A, ASK 302.

301a) Which ways or methods have you heard about? For methods not mentioned spontaneously, ask: Have you ever heard of (method)?

YES 1
NO 2

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Congo (Democratic Republic) 2007
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 CONTINUE DOWN COLUMN 301, READING THE NAME AND DESCRIPTION OF EACH METHOD NOT MENTIONED SPONTANEOUSLY. CIRCLE CODE '1' IF METHOD IS RECOGNIZED, AND CODE 2 IF NOT RECOGNIZED. THEN, FOR EACH METHOD WITH CODE 1 CIRCLED IN 301, ASK 302.

301) Which ways or methods have you heard about? FOR METHODS NOT MENTIONED SPONTANEOUSLY, ASK: Have you heard of (METHOD)?

01) FEMALE STERILIZATION: Women can have an operation to avoid having any more children.
YES 1
NO 2 (GO TO 02)
02) MALE STERILIZATION: Men can have an operation to avoid having any more children.
YES 1
NO 2 (GO TO 03)
03) PILL: women can take a pill every day to avoid becoming pregnant.
YES 1
NO 2 (GO TO 04)
04) IUD: Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2 (GO TO 05)
05) INJECTABLES: Women can have an injection by a heath provider which stops them from becoming pregnant for one or more months.
YES 1
NO 2 (GO TO 06)
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 (GO TO 07)
07) CONDOM: Men can put a rubber sheath on their penis before sexual intercourse.
YES 1
NO 2 (GO TO 08)
08) FEMALE CONDOM: Women can place a sheath in their vagina before sexual intercourse.
YES 1
NO 2 (GO TO 09)
09) DIAPHRAGM: Women can place a thin flexible disk in their vagina before intercourse.
YES 1
NO 2 (GO TO 10)
10) SUPPOSITORY, FOAM OR JELLY: Women can place a suppository, jelly or cream in their vagina before intercourse.
YES 1
NO 2 (GO TO 12)
12) 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 (GO TO 13)
13) WITHDRAWAL: Men can be careful and pull out before climax.
YES 1
NO 2 (GO TO 14)
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 (GO TO 15)
15) Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES 1 (SPECIFY) _____
NO 2

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Congo (Democratic Republic) 2013
Survey form view entire document:  text 
SECTION 3. CONTRACEPTION

301) 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.

Have you ever heard of (Method)?

01) FEMALE STERILIZATION
PROBE: Women can have an operation to avoid having any more children
Have you ever heard of (method)?
YES 1
NO 2
02) MALE STERILIZATION
PROBE: Men can have an operation to avoid having any more children
Have you ever heard of (method)?
YES 1
NO 2
03) IUD
PROBE: Women can have a loop or coil placed inside them by a doctor or a nurse.
Have you ever heard of (method)?
YES 1
NO 2
04) INJECTABLES
PROBE: Women can have an injection by a heath provider that stops them from becoming pregnant for one or more months.
Have you ever heard of (method)?
YES 1
NO 2
05) IMPLANTS
PROBE: Women can have one or more small rods placed in their upper arm by a doctor or nurse which can prevent pregnancy for one or more years.
Have you ever heard of (method)?
YES 1
NO 2
06) PILL
PROBE: Women can take a pill every day to avoid becoming pregnant
Have you ever heard of (method)?
YES 1
NO 2
07) CONDOM
PROBE: Men can put a rubber sheath on their penis before sexual intercourse.
Have you ever heard of (method)?
YES 1
NO 2
08) FEMALE CONDOM
PROBE: Women can place a sheath in their vagina before sexual intercourse.
Have you ever heard of (method)?
YES 1
NO 2
08A) BEADS (CYCLE BEADS OR FIXED DAY METHOD)
PROBE: A woman uses a string of colors beads to know which days she could get pregnant. On the days she could get pregnant, she uses a condom or does not have sexual intercourse.
Have you ever heard of (method)?
YES 1
NO 2
09) SUPPOSITORY, FOAM, JELLY
PROBE: Women can insert a suppository, put foam or cream in their vagina before sexual intercourse.
Have you ever heard of (method)?
YES 1
NO 2
10) RHYTHM METHOD
PROBE: To avoid pregnancy, women do not have sexual intercourse on days of the month they think they can get pregnant.
Have you ever heard of (method)?
YES 1
NO 2
11) WITHDRAWAL
PROBE: Men can be careful and pull out before climax.
Have you ever heard of (method)?
YES 1
NO 2
12) EMERGENCY CONTRACEPTION
PROBE: As an emergency measure, within three days after they have unprotected sexual intercourse, women can take special pills to prevent pregnancy.
Have you ever heard of (method)?
YES 1
NO 2
13) Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES 1
(SPECIFY)
(SPECIFY)
NO 2

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Cote d'Ivoire 2011
Survey form view entire document:  text 
Section 3. Contraception

301) 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.
What methods have you heard of?
Have you ever heard of (METHOD)?

01) Female Sterilization
PROBE: Women can have an operation to avoid having any more children
YES 1
NO 2
02) Male Sterilization
PROBE: Men can have an operation to avoid having any more children
YES 1
NO 2
03) IUD
PROBE: Women can have a loop or coil placed inside their uterus by a doctor or a nurse.
YES 1
NO 2
04) Injectables
Probe: Women can have an injection by a heath provider that stops them from becoming pregnant for one or more months.
YES 1
NO 2
05) Implants
PROBE: Women can have one or more 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
06) Pill
PROBE: Women can take a pill every day to avoid becoming pregnant
YES 1
NO 2
07) Condom
PROBE: Men can put a rubber sheath on their penis before sexual intercourse.
YES 1
NO 2
08) Female condom
PROBE: Women can place a sheath in their vagina before sexual intercourse.
YES 1
NO 2
09) Lactational amenorrhea method (LAM)
YES 1
NO 2
10) Rhythm Method
PROBE: To avoid pregnancy, women do not have sexual intercourse on the days of the month they think they can get pregnant.
YES 1
NO 2
11) Withdrawal
PROBE: Men can be careful and pull out before climax.
YES 1
NO 2
12) Emergency contraception
PROBE: As an emergency measure, within three days after they have unprotected sexual intercourse, women can take special pills to prevent pregnancy.
YES 1
NO 2
12a) Diaphragm
Women can place a latex disk on their cervix before intercourse.
YES 1
NO 2
12b) Foam/jelly/spermicide
Women can place a suppository, jelly, or cream in their vagina before intercourse to kill men's sperm. This cream can also be used on the diaphragm.
YES 1
NO 2
13) Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES 1
__________(SPECIFY)
__________(SPECIFY)
NO 2

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Ghana 2003
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 301, READING THE NAME AND DESCRIPTION OF EACH METHOD NOT MENTIONED SPONTANEOUSLY. CIRCLE CODE 1 IF METHOD IS RECOGNIZED, AND CODE 2 IF NOT RECOGNIZED. THEN, FOR EACH METHOD WITH CODE 1 CIRCLED IN 301, ASK 302.

301) Which ways or methods have you heard about?

FOR METHODS NOT MENTIONED SPONTANEOUSLY, ASK: Have you ever heard of (METHOD)?

01. FEMALE STERILIZATION Women can have 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.
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 sheath on their penis before sexual intercourse.
YES 1
NO 2
08. FEMALE CONDOM Women can place a sheath in their vagina before sexual intercourse.
YES 1
NO 2
09. DIAPHRAGM Women can place a thin flexible disk in their vagina before intercourse.
YES 1
NO 2
10. FOAM OR JELLY Women can place a suppository, jelly or cream in their vagina before intercourse.
YES 1
NO 2
11. LACTATIONAL AMENORRHEA METHOD (LAM) Up to 6 months after childbirth, a woman can use a method that requires that she breastfeeds frequently, day and night, and that her menstrual period has not returned.
YES 1
NO 2
12. RHYTHM OR PERIODIC ABSTINENCE Every month that a woman is sexual 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 Women can take pills up to three days after sexual intercourse to avoid becoming pregnant.
YES 1
NO 2
15. Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES (SPECIFY): _____________ 1
NO 2

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Ghana 2008
Survey form view entire document:  text 
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.

301. Which ways or methods have you heard about?

FOR METHODS NOT MENTIONED SPONTANEOUSLY, ASK: Have you ever heard of (METHOD)?

CIRCLE CODE IN 301 FOR EACH METHOD MENTIONED SPONTANEOUSLY. THEN PROCEED DOWN COLUMN 301, READING THE NAME AND DESCRIPTION OF EACH METHOD NOT MENTIONED SPONTANEOUSLY.

CIRCLE CODE IF METHOD IS RECOGNIZED, AND CODE IF NOT RECOGNIZED.
THEN, FOR EACH METHOD WITH CODE CIRCLED IN 301, ASK 302.

01) FEMALE STERILIZATION Women can have 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.
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) MALE CONDOM Men can put a rubber sheath on their penis before sexual intercourse.
YES 1
NO 2
08) FEMALE CONDOM Women can place a sheath in their vagina before sexual intercourse.
YES 1
NO 2
09) DIAPHRAGM Women can place a thin flexible disk in their vagina before sexual intercourse.
YES 1
NO 2
10) FOAM OR JELLY Women can place a suppository, jelly, or cream in their vagina before sexual intercourse.
YES 1
NO 2
11 RHYTHM (CALENDAR) 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
12) WITHDRAWAL Men can be careful and pull out before climax.
YES 1
NO 2
13) LACTATIONAL AMENORRHEA METHOD (LAM)
YES 1
NO 2
14) EMERGENCY CONTRACEPTION As an emergency measure after unprotected sexual intercourse, women can take special pills at any time within five days to prevent pregnancy.
YES 1
NO 2
15) Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
(SPECIFY) METHOD 1 ___
YES 1
NO 2
(SPECIFY) METHOD 2 __
YES 1
NO 2

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Guinea 2005
Survey form view entire document:  text 
SECTION 3. FAMILY PLANNING

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

301. Which ways or methods have you heard about?
FOR METHODS NOT MENTIONED SPONTANEOUSLY, ASK: Have you ever heard of (METHOD)?

01. FEMALE STERILIZATION: Women can have an operation to avoid having any more children.
YES 1
NO 2 (GO TO NEXT METHOD)
02. MALE STERILIZATION: Men can have an operation to avoid having any more children.
YES 1
NO 2 (GO TO NEXT METHOD)
03. PILL: Women can take a pill every day to avoid becoming pregnant.
YES 1
NO 2 (GO TO NEXT METHOD)
04. IUD: Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2 (GO TO NEXT METHOD)
05. INJECTABLES: Women can have an injection by a health provider which stops them from becoming pregnant for several months.
YES 1
NO 2 (GO TO NEXT METHOD)
06. 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 (GO TO NEXT METHOD)
07. CONDOM: Men can put a rubber sheath on their penis before sexual intercourse.
YES 1
NO 2 (GO TO NEXT METHOD)
08. FEMALE CONDOM: Women can place a sheath in their vagina before sexual intercourse.
YES 1
NO 2 (GO TO NEXT METHOD)
09. DIAPHRAGM: Women can place a thin flexible disk in their vagina before intercourse.
YES 1
NO 2 (GO TO NEXT METHOD)
10. SUPPOSITORY, FOAM OR JELLY: Women can place a suppository, jelly, or cream in their vagina before intercourse.
YES 1
NO 2 (GO TO NEXT METHOD)
11. LACTATIONAL AMENORRHEA METHOD (LAM): Up to 6 months after childbirth, and when her menstrual period has not returned, a woman can use a method that requires that she breastfeeds frequently, day and night, without giving him any other food.
YES 1
NO 2 (GO TO NEXT METHOD)
12. 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 (GO TO NEXT METHOD)
13. WITHDRAWAL: Men can be careful and pull out before climax.
YES 1
NO 2 (GO TO NEXT METHOD)
14. EMERGENCY CONTRACEPTION: Women can take pills up to three days after sexual intercourse to avoid becoming pregnant.
YES 1
NO 2 (GO TO NEXT METHOD)
15. Have you heard of any other ways or methods that women or men can use to avoid pregnancy? IF YES, LIST UP TO TWO OTHER METHODS.
YES 1
NO 2
(SPECIFY) _____

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Guinea 2012
Survey form view entire document:  text 
301) 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.

Have you ever heard of (METHOD)?

01) FEMALE STERILIZATION
PROBE: Women can have an operation to avoid having any more children
YES 1
NO 2
02) MALE STERILIZATION
PROBE: Men can have an operation to avoid having any more children
YES 1
NO 2
03) IUD
PROBE: Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2
04) INJECTABLES
PROBE: Women can have an injection by a heath provider that stops them from becoming pregnant for one or more months.
YES 1
NO 2
05) IMPLANTS
PROBE: Women can have one or more 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
06) PILL
PROBE: Women can take a pill every day to avoid becoming pregnant.
YES 1
NO 2
07) CONDOM
PROBE: Men can put a rubber sheath on their penis before sexual intercourse.
YES 1
NO 2
08) FEMALE CONDOM
PROBE: Women can place a sheath in their vagina before sexual intercourse.
YES 1
NO 2
09) LACTATIONAL AMENORRHEA METHOD (LAM)
Up to 6 months after childbirth, and when her menstrual period has not returned, a woman can use a method that requires that she breastfeeds whenever the child asks, day and night, without giving him any other food.
YES 1
NO 2
10) DIAPHRAGM
Women can place a latex disk on their cervix before intercourse.
YES 1
NO 2
11) TABLET/FOAM/JELLY
Women can place a tablet, foam or jelly in their vagina before intercourse.
YES 1
NO 2
12) RHYTHM METHOD
PROBE: To avoid pregnancy, women do not have sexual intercourse on the days of the month they think they can get pregnant.
YES 1
NO 2
13) WITHDRAWAL
PROBE: Men can be careful and pull out before climax.
YES 1
NO 2
14) EMERGENCY CONTRACEPTION
PROBE: As an emergency measure, within three days after they have unprotected sexual intercourse, women can take special pills to prevent pregnancy.
YES 1
NO 2
15) Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES 1
(SPECIFY)__________
(SPECIFY)__________
NO 2

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Jordan 1997
Survey form view entire document:  text 
SECTION 4. 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 401 FOR EACH METHOD MENTIONED SPONTANEOUSLY.
THEN PROCEED DOWN TO COLUMN 402, 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 401 OR 402, ASK 403.

401. Which ways have you heard about?
402. Have you ever heard of (METHOD)?

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

SPONTANEOUS YES 1
PROBED YES 2
NO 3

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

SPONTANEOUS YES 1
PROBED YES 2
NO 3

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

SPONTANEOUS YES 1
PROBED YES 2
NO 3

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.

SPONTANEOUS YES 1
PROBED YES 2
NO 3

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

SPONTANEOUS YES 1
PROBED YES 2
NO 3

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

SPONTANEOUS YES 1
PROBED YES 2
NO 3

07) FEMALE STERILIZATION: Women can have an operation to avoid having any more children.

SPONTANEOUS YES 1
PROBED YES 2
NO 3

08) MALE STERILIZATION: Men can have an operation to avoid having any more children.

SPONTANEOUS YES 1
PROBED YES 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 that she is most likely to get pregnant.

SPONTANEOUS YES 1
PROBED YES 2
NO 3

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

SPONTANEOUS YES 1
PROBED YES 2
NO 3

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

SPONTANEOUS YES 1
PROBED YES 2
NO 3

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

SPECIFY___________

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Jordan 2002
Survey form view entire document:  text 
301. Which ways or methods have you heard about?
FOR METHODS NOT MENTIONED SPONTANEOUSLY, ASK: Have you ever heard of (METHOD)?

YES 1
NO 2 (GO TO NEXT METHOD)

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Jordan 2007
Survey form view entire document:  text 
SECTION 3: CONTRACEPTION

301) 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.

Which ways or methods have you heard about?
FOR METHODS NOT MENTIONED SPONTANEOUSLY, ASK:
Have you ever heard of (METHOD)?

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

01 FEMALE STERILIZATION: Women can have 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.
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 midwife.
YES 1
NO 2
05 INJECTABLES: Women can have an injection by a health provider that stops them from becoming pregnant usually for 3 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 usually for 3 years.
YES 1
NO 2
07 CONDOM: Men can put a rubber sheath on their penis before sexual intercourse.
YES 1
NO 2
08 FEMALE CONDOM: Women can place a plastic sheath in their vagina before sexual intercourse.
YES 1
NO 2
09 LACTATIONAL AMENORRHEA METHOD (LAM)
YES 1
NO 2
10 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
11 WITHDRAWAL: Men can be careful and pull out before climax.
YES 1
NO 2
12 EMERGENCY CONTRACEPTION: As an emergency measure after unprotected sexual intercourse, women can take special pills at any time within five days to prevent pregnancy.
YES 1
NO 2
13: Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES 1
(SPECIFY)_______
(SPECIFY)________
NO 2

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Jordan 2009
Survey form view entire document:  text 
SECTION 3. CONTRACEPTION

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

Which ways or methods have you heard about? FOR METHODS NOT MENTIONED SPONTANEOUSLY, ASK: Have you ever heard of (METHOD)?

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

1) FEMALE STERILIZATION. Women can have an operation to avoid having any more children.
YES 1
NO 2
2) MALE STERILIZATION. Men can have an operation to avoid having any more children.
YES 1
NO 2
3) PILL. Women can take a pill every day to avoid becoming pregnant.
YES 1
NO 2
4) IUD. Women can have a loop or coil placed inside them by a doctor or a midwife.
YES 1
NO 2
5) INJECTABLES. Women can have an injection by a health provider that stops them from becoming pregnant usually for 3 months.
YES 1
NO 2
6) IMPLANTS. Women can have several small rods placed in their upper arm by a doctor or nurse which can prevent pregnancy usually for 3 years.
YES 1
NO 2
7) CONDOM. Men can put a rubber sheath on their penis before sexual intercourse.
YES 1
NO 2
8) FEMALE CONDOM. Women can place a sheath in their vagina before sexual intercourse.
YES 1
NO 2
9) LACTATIONAL AMENORRHEA METHOD (LAM)
YES 1
NO 2
10) 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
11) WITHDRAWL. Man can be careful and pull out before climax
YES 1
NO 2
12) EMERGENCY CONTRACEPTION. As an emergency measure after unprotected sexual intercourse, women can take special pills at any time within five days to prevent pregnancy.
YES 1
NO 2
13) Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES 1 (SPECIFY) ________
NO 2

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Jordan 2012
Survey form view entire document:  text 
301. 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.
Have you ever heard of (METHOD)?

01. Female Sterilization. PROBE: Women can have an operation to avoid having any more children.
YES 1
NO 2 (GO TO 02)
02. Male Sterilization. PROBE: Men can have an operation to avoid having any more children.
YES 1
NO 2 (GO TO 03)
03. IUD. PROBE: Women can have a loop or coil placed inside them by a doctor or a midwife.
YES 1
NO 2 (GO TO 04)
04. Injectables. PROBE: Women can have an injection by a health provider that stops them from becoming pregnant usually for 3 months.
YES 1
NO 2 (GO TO 05)
05. Implants. PROBE: Women can have one or more small rods placed in their upper arm by a doctor which can prevent pregnancy usually for 3 years
YES 1
NO 2 (GO TO 06)
06. Pill. PROBE: Women can take a pill every day to avoid becoming pregnant.
YES 1
NO 2 (GO TO 07)
07. Condom. PROBE: Men can put a rubber sheath on their penis before sexual intercourse.
YES 1
NO 2 (GO TO 08)
08. Female Condom. PROBE: Women can place a sheath in their vagina before sexual intercourse.
YES 1
NO 2 (GO TO 09)
09. Lactational Amenorrhea Method (LAM)
YES 1
NO 2 (GO TO 10)
10. Rhythm Method. PROBE: To avoid pregnancy, women do not have sexual intercourse on the days of the month they think they can get pregnant.
YES 1
NO 2 (GO TO 11)
11. Withdrawal. PROBE: Men can be careful and pull out before climax.
YES 1
NO 2 (GO TO 12)
12. Emergency Contraception. PROBE: As an emergency measure, within three days after they have unprotected sexual intercourse, women can take special pills to prevent pregnancy.
YES 1
NO 2 (GO TO 13)
13. Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES 1 (SPECIFY) ______
NO 2

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Kenya 2003
Survey form view entire document:  text 
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 301, READING THE NAME AND DESCRIPTION OF EACH METHOD NOT MENTIONED SPONTANEOUSLY.

CIRCLE CODE 1 IF SHE HAS HEARD OF THE METHOD AND CODE 2 IF SHE HAS NOT HEARD OF IT. THEN, FOR EACH METHOD WITH CODE 1 CIRCLED IN 301, ASK 302.

301. Which ways or methods have you heard about?

FOR METHODS NOT MENTIONED SPONTANEOUSLY, ASK:
Have you ever heard of (METHOD)?

METHOD 01) FEMALE STERILISATION Women can have an operation to avoid having any more children.
YES 1
NO 2
METHOD 02) MALE STERILISATION Men can have an operation to avoid having any more children.
YES 1
NO 2
METHOD 03) PILL Women can take a pill every day to stop them from becoming pregnant.
YES 1
NO 2
METHOD 04) IUD Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2
METHOD 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
METHOD 06) IMPLANTS, NORPLANT 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
METHOD 07) CONDOM Men can put a rubber sheath on their penis before sexual intercourse.
YES 1
NO 2
METHOD 08) FEMALE CONDOM Women can place a sheath in their vagina before sexual intercourse.
YES 1
NO 2
METHOD 09) RHYTHM OR NATURAL METHODS 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
METHOD 10) WITHDRAWAL Men can be careful and pull out before climax.
YES 1
NO 2
METHOD 11) EMERGENCY CONTRACEPTION Women can take pills up to three days after sexual intercourse to avoid becoming pregnant.
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
(SPECIFY) ____
(SPECIFY) ____
NO 2

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Lesotho 2004
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 301, READING THE NAME AND DESCRIPTION OF EACH METHOD NOT MENTIONED SPONTANEOUSLY. CIRCLE CODE 1 IF METHOD IS RECOGNIZED, AND CODE 2 IF NOT RECOGNIZED. THEN, FOR EACH METHOD WITH CODE 1 CIRCLED IN 301, ASK 302.

301) Which ways or methods have you heard about?

FOR METHODS NOT MENTIONED SPONTANEOUSLY, ASK: Have you ever heard of (METHOD)?

01. FEMALE STERILIZATION Women can have 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.
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 sheath on their penis before sexual intercourse.
YES 1
NO 2
08. FEMALE CONDOM Women can place a sheath in their vagina before sexual intercourse.
YES 1
NO 2
09. DIAPHRAGM Women can place a thin flexible disk in their vagina before intercourse.
YES 1
NO 2
10. FOAM OR JELLY Women can place a suppository, jelly or cream in their vagina before intercourse.
YES 1
NO 2
11. LACTATIONAL AMENORRHEA METHOD (LAM) Up to 6 months after childbirth, a woman can use a method that requires that she breastfeeds frequently, day and night, and that her menstrual period has not returned.
YES 1
NO 2
12. RHYTHM OR PERIODIC ABSTINENCE Every month that a woman is sexual 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 Women can take pills up to three days after sexual intercourse to avoid becoming pregnant.
YES 1
NO 2
15. Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES (SPECIFY): _____________ 1
NO 2

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Madagascar 2003
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 301, 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, ASK 302.

301. Which ways or methods have you heard about?
FOR METHODS NOT MENTIONED SPONTANEOUSLY, ASK: Have you ever heard of (METHOD)?

01. FEMALE STERILIZATION Women can have an operation to avoid having any more children.
YES, SPONTANEOUSLY 1
YES, DESCRIPTION 2
NO 3 (GO TO NEXT METHOD)
02. MALE STERILIZATION Men can have an operation to avoid having any more children.
YES, SPONTANEOUSLY 1
YES, DESCRIPTION 2
NO 3 (GO TO NEXT METHOD)
03. PILL Women can take a pill every day to avoid becoming pregnant.
YES, SPONTANEOUSLY 1
YES, DESCRIPTION 2
NO 3 (GO TO NEXT METHOD)
04. IUD Women can have a loop or coil placed inside them by a doctor or a nurse to avoid pregnancy for a year or longer.
YES, SPONTANEOUSLY 1
YES, DESCRIPTION 2
NO 3 (GO TO NEXT METHOD)
05. INJECTIONS Women can have an injection by a health provider that stops them from becoming pregnant for one or more months.
YES, SPONTANEOUSLY 1
YES, DESCRIPTION 2
NO 3 (GO TO NEXT METHOD)
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, SPONTANEOUSLY 1
YES, DESCRIPTION 2
NO 3 (GO TO NEXT METHOD)
07. CONDOM Men can put a rubber or latex sheath on their penis before sexual intercourse.
YES, SPONTANEOUSLY 1
YES, DESCRIPTION 2
NO 3 (GO TO NEXT METHOD)
08. FEMALE CONDOM Women can place a latex sheath in their vagina before sexual intercourse.
YES, SPONTANEOUSLY 1
YES, DESCRIPTION 2
NO 3 (GO TO NEXT METHOD)
09. DIAPHRAGM Women can place a diaphragm in their vagina before sexual intercourse.
YES, SPONTANEOUSLY 1
YES, DESCRIPTION 2
NO 3 (GO TO NEXT METHOD)
10. MOUSSE OR GEL Women can insert a suppository, or put gel or cream inside their vagina before sexual intercourse.
YES, SPONTANEOUSLY 1
YES, DESCRIPTION 2
NO 3 (GO TO NEXT METHOD)
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, SPONTANEOUSLY 1
YES, DESCRIPTION 2
NO 3 (GO TO NEXT METHOD)
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, SPONTANEOUSLY 1
YES, DESCRIPTION 2
NO 3 (GO TO NEXT METHOD)
13. WITHDRAWAL Men can be careful and pull out before climax.
YES, SPONTANEOUSLY 1
YES, DESCRIPTION 2
NO 3 (GO TO NEXT METHOD)
14. EMERGENCY CONTRACEPTION After sexual intercourse, women can take special pills at any time within three days to prevent pregnancy.
YES, SPONTANEOUSLY 1
YES, DESCRIPTION 2
NO 3 (GO TO NEXT METHOD)
15. Have you heard of any other ways or methods that women or men can use to avoid pregnancy? LIST UP TO TWO METHODS.
SPECIFY ____
YES 1
NO 2

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Malawi 2000
Survey form view entire document:  text 
301. Which ways or methods have you heard about?
FOR METHODS NOT MENTIONED SPONTANEOUSLY, ASK: Have you ever heard of (METHOD)?

01) FEMALE STERILIZATION: Women can have an operation to avoid having any more children.
YES 1
NO 2 (GO TO NEXT METHOD)
02) MALE STERILIZATION: Men can have an operation to avoid having any more children.
YES 1
NO 2 (GO TO NEXT METHOD)
03) PILL: Women can take a pill every day to avoid becoming pregnant.
YES 1
NO 2 (GO TO NEXT METHOD)
04) IUD: Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2 (GO TO NEXT METHOD)
05) INJECTIONS: Women can have an injection by a health provider which stops them from becoming pregnant for three months.
YES 1
NO 2 (GO TO NEXT METHOD)
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 (GO TO NEXT METHOD)
07) CONDOM: Men can put a rubber sheath on their penis before sexual intercourse.
YES 1
NO 2 (GO TO NEXT METHOD)
08) FEMALE CONDOM: Women can place a sheath in their vagina before sexual intercourse.
YES 1
NO 2 (GO TO NEXT METHOD)
09) DIAPHRAGM: Women can place a thin flexible disk in their vagina before intercourse.
YES 1
NO 2 (GO TO NEXT METHOD)
10) FOAM OR JELLY: Women can place a suppository, jelly, or cream in their vagina before intercourse.
YES 1
NO 2 (GO TO NEXT METHOD)
11) LACTATIONAL AMENORRHEA METHOD (LAM): Up to 6 months after childbirth, a woman can use a method that requires that she breastfeeds frequently, day and night, and that her menstrual period has not returned.
YES 1
NO 2 (GO TO NEXT METHOD)
12) RHYTHM, BILLINGS OR OTHER NATURAL METHODS: 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 (GO TO NEXT METHOD)
13) WITHDRAWAL: Men can be careful and pull out before climax.
YES 1
NO 2 (GO TO NEXT METHOD)
14) EMERGENCY CONTRACEPTION: Women can take pills up to three days after sexual intercourse to avoid becoming pregnant.
YES 1
NO 2 (GO TO NEXT METHOD)
15) Have you heard of any other ways or methods that women or men can use to avoid pregnancy? LIST UP TO TWO DIFFERENT METHODS.
SPECIFY____
YES 1
NO 2

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Mali 2001
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 301, READING THE NAME AND DESCRIPTION OF EACH METHOD NOT MENTIONED SPONTANEOUSLY. CIRCLE CODE 1 IF METHOD IS RECOGNIZED, AND CODE 2 IF NOT RECOGNIZED. THEN, FOR EACH METHOD WITH CODE 1 CIRCLED IN 301, ASK 302.

301) Which ways or methods have you heard about?

FOR METHODS NOT MENTIONED SPONTANEOUSLY, ASK: Have you ever heard of (METHOD)?

01. FEMALE STERILIZATION Women can have 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.
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 sheath on their penis before sexual intercourse.
YES 1
NO 2
08. FEMALE CONDOM Women can place a sheath in their vagina before sexual intercourse.
YES 1
NO 2
09. DIAPHRAGM Women can place a thin flexible disk in their vagina before intercourse.
YES 1
NO 2
10. FOAM OR JELLY Women can place a suppository, jelly or cream in their vagina before intercourse.
YES 1
NO 2
11. LACTATIONAL AMENORRHEA METHOD (LAM) Up to 6 months after childbirth, a woman can use a method that requires that she breastfeeds frequently, day and night, and that her menstrual period has not returned.
YES 1
NO 2
12. RHYTHM OR PERIODIC ABSTINENCE Every month that a woman is sexual 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 Women can take pills up to three days after sexual intercourse to avoid becoming pregnant.
YES 1
NO 2
15. Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES (SPECIFY): _____________ 1
NO 2

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Mali 2006
Survey form view entire document:  text 
301. Which methods have you heard about? FOR THE METHODS SPONTANEOUSLY MENTIONED, ASK: Have ever heard about (METHOD)?

01. FEMALE STERILIZATION Women can have 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.
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 a coil placed inside them by a doctor or a nurse to avoid becoming pregnant.
YES 1
NO 2
05. INJECTIONS Women can have an injection by a health provider to avoid becoming pregnant during 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 sheath on their penis before sexual intercourse.
YES 1
NO 2
08. FEMALE CONDOM Women can place a sheath in their vagina before intercourse.
YES 1
NO 2
09. DIAPHRAGM Women can place a diaphragm in their vagina before sexual intercourse.
YES 1
NO 2
10. COMPRESS, FOAM, JELLY Women can insert a compress, JELLY or lotion in their vagina before intercourse.
YES 1
NO 2
11. LACTATIONAL AMENORRHEA METHOD (LAM) Up to 6 months after a birth and before her period returns, a woman can use a method consisting of nursing her baby each time that he/she wants, day and night, without ever giving him/her any other food.
YES 1
NO 2
12. RHYTHM METHOD 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
13. WITHDRAWAL Men can be careful to pull out before climax.
YES 1
NO 2
14. DAY AFTER PILL Women can take pills days following intercourse until the third day after to avoid getting pregnant.
YES 1
NO 2
15. Have you heard of other ways or methods that women or men can use to avoid pregnancy?
YES 1(SPECIFY)__
(SPECIFY)__
NO 2

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Morocco 2003
Survey form view entire document:  text 
301) FOR METHODS NOT MENTIONED SPONTANEOUSLY, ASK (METHOD)
Have you ever heard of (METHOD)?

302) Have you ever used (METHOD)

01) FEMALE STERILIZATION
Women can have an operation to avoid having any more children
YES 1
NO 2
302) 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.
YES 1
NO 2
302) Did your husband have this 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
302) EVER USED PILL
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
302) EVER USED IUD
YES 1
NO 2
05) INJECTABLES
Women can have an injection by a nurse/midwife that stops them from becoming pregnant for one or more months.
YES 1
NO 2
302) EVER USED INJECTABLES
YES 1
NO 2
06) IMPLANTS
Women can have several small rods placed in their left arm by a doctor, which can prevent pregnancy for 5 years.
YES 1
NO 2
302) EVER USED IMPLANTS
YES 1
NO 2
07) CONDOM
Men can put a rubber sheath on their penis before sexual intercourse so that women do not fell pregnant
YES 1
NO 2
302) EVER USED CONDOM
YES 1
NO 2
08) DIAPHRAGM
Women can place a sheath in their vagina (female condom) or a thin flexible disk in their vagina before intercourse to prevent pregnancy.
YES 1
NO 2
302) EVER USED DIAPHRAGM
YES 1
NO 2
09) FOAM OR JELLY
Women can place a suppository, jelly, or cream in their vagina before intercourse to prevent pregnancy.
YES 1
NO 2
302) EVER USED FOAM OR JELLY
YES 1
NO 2
10) LACTATIONAL AMENORRHEA METHOD (LAM)
Up to 6 months after childbirth, a woman can use a method that requires that she breastfeeds frequently, day and night, so that her menstrual period does not return.
YES 1
NO 2
302) EVER USED LAM
YES 1
NO 2
11) RHYTHM OR PERIODIC ABSTINENCE
Only during few days a month can a woman fell pregnant after sexual intercourse. 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
302) EVER USED RHYTHM
YES 1
NO 2
12) WITHDRAWAL
Men can be careful and pull out before climax.
YES 1
NO 2
302) EVER USED WITHDRAWAL
YES 1
NO 2
13) OTHER
Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES (SPECIFY) ______ 1
NO 2
302) Have you ever used (OTHER METHOD)
YES 1
NO 2

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Mozambique 2003
Survey form view entire document:  text 
Now I would like to talk about family planning - the various ways or methods that a couple can use to delay or avoid pregnancy.

301. Which ways or methods have you heard about?
CIRCLE CODE '1' IN 301 FOR EACH METHOD MENTIONED SPONTANEOUSLY.
FOR METHODS NOT MENTIONED SPONTANEOUSLY, ASK: Have you heard of (METHOD)?

THEN CIRCLE CODE '1' FOR EACH KNOWN METHOD OTHERWISE CIRCLE CODE '2' AND CONTINUE WITH NEXT METHOD NOT MENTIONED SPONTANEOUSLY.
FOR EACH RECOGNIZED METHOD, ASK QUESTION 302.

01) FEMALE STERILIZATION. (Tubal ligation). Women can have an operation to avoid having any more children.
YES 1
NO 2 (GO TO NEXT METHOD)
02) MALE STERILIZATION. (Vasectomy). Men can have an operation to avoid having any more children.
YES 1
NO 2 (GO TO NEXT METHOD)
03) PILL. Women can take pill every day to avoid pregnancy
YES 1
NO 2 (GO TO NEXT METHOD)
04) IUD. Women can have a loop or coil placed inside them by a doctor or a nurse to avoid pregnancy
YES 1
NO 2 (GO TO NEXT METHOD)
05) INJECTABLES. Women can have an injection by a doctor or nurse which stops them from becoming pregnant for several months.
YES 1
NO 2 (GO TO NEXT METHOD)
06) CONDOM. Men can put a rubber sheath on their penis during sexual intercourse.
YES 1
NO 2 (GO TO NEXT METHOD)
07) DIAPHRAGM. Women can place a diaphragm inside themselves before intercourse.
YES 1
NO 2 (GO TO NEXT METHOD)
08) FOAM, JELLY OR SPONGE. Women can place a sponge, suppository, jelly or cream inside themselves before intercourse.
YES 1
NO 2 (GO TO NEXT METHOD)
09) LACTATIONAL AMENORRHEA METHOD (LAM). Up to 6 months after childbirth, a woman can use a method that requires that she breastfeeds frequently, day and night, and that her menstrual period has not returned.
YES 1
NO 2 (GO TO NEXT METHOD)
10) 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 1
NO 2 (GO TO NEXT METHOD)
11) WITHDRAWAL. Men can be careful and pull out before climax, ejaculating outside of the vagina.
YES 1
NO 2 (GO TO NEXT METHOD)
12) OTHER METHODS. Couples can use other methods or ways to avoid pregnancy. Have you heard of any other ways or methods that women or men can use to avoid pregnancy? LIST UP TO TWO METHODS.
(SPECIFY) ____
YES 1
NO 2

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Namibia 2013
Survey form view entire document:  text 
SECTION 3. CONTRACEPTION

301) 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.

Have you ever heard of (METHOD)?

01) FEMALE STERLIZATION: Women can have an operation to avoid having any more children.
YES 1
NO 2
02) MALE STERLIZATION: Men can have an operation to avoid having any more children.
YES 1
NO 2
03) IUD: Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2
04) 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
05) IMPLANTS: Women can have one or more 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
06) PILL: Women can take a pill every day to avoid becoming pregnant.
YES 1
NO 2
07) CONTRACEPTIVE PATCH (EVRA): Women can have a transdermal patch applied to their skin that releases synthetic estrogen and progestin hormones to prevent pregnancy.
YES 1
NO 2
08) CONDOM: Men can put a rubber sheath on their penis before sexual intercourse.
YES 1
NO 2
09) FEMALE CONDOM: Women can place a sheath in their vagina before sexual intercourse.
YES 1
NO 2
10) LACTATIONAL AMENORRHEA METHOD (LAM):
YES 1
NO 2
11) RHYTHM METHOD: To avoid pregnancy, women do not have sexual intercourse on the days of the month they think they can get pregnant.
YES 1
NO 2
12) WITHDRAWL: Men can be careful and pull out before climax or ejaculation.
YES 1
NO 2
13) EMERGENCY CONTRACEPTION: As an emergency measure, within three days after they have unprotected sexual intercourse, women can take special pills to prevent.
YES 1
NO 2
14) Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
SPECIFY __________
YES 1
NO 2

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Nepal 2001
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 3O1 FOR EACH METHOD MENTIONED SPONTANEOUSLY. THEN PROCEED DOWN COLUMN 301, READING THE NAME AND DESCRIPTION OF EACH METHOD NOT MENTIONED SPONTANEOUSLY. CIRCLE CODE 1 IF METHOD IS RECOGNIZED, AND CODE 2 IF NOT RECOGNIZED. THEN, FOR EACH METHOD WITH CODE 1 CIRCLED IN 301, ASK 302.

301. Which ways or methods have you heard about?
FOR METHODS NOT MENTIONED SPONTANEOULY, ASK: Have you ever heard of (MEHOD)?

01 FEMALE STERILIZATION Women can have an operation to avoid having any more children (also known as tubal ligation).
YES 1
NO 2
02 MALE STERILIZATION Men can have an operation to avoid having any more children (also known as a vasectomy).
YES 1
NO 2
03 PILL Women can take a pill every day to avoid becoming pregnant (ex. Nilocon).
YES 1
NO 2
04 IUD Women can have a loop or coil placed inside them by a doctor or a nurse (ex. Copper-T, Loop).
YES 1
NO 2
05 INJECTABLES Women can have an injection by a health provider which stops them from becoming pregnant for one or more months (ex. Sangini/Depo Provera).
YES 1
NO 2
06 IMPLANTS Women can have several small rods placed in their upper arm by a doctor or nurse which can help prevent pregnancy for one or more years (also known as NORPLANT).
YES 1
NO 2
07 CONDOM Men can put a rubber sheath on their penis before sexual intercourse (ex. Daal).
YES 1
NO 2
08 FOAM OR JELLY Women can place a suppository, foaming tablets, jelly, or cream in their vagina before intercourse (ex. Kamal).
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 Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES 1
SPECIFY ______________
SPECIFY_______________
NO 2

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Nepal 2011
Survey form view entire document:  text 
SECTION 3. CONTRACEPTION

301) Now I would like to talk about family planning--the various ways or methods that a couple can use to delay or avoid a pregancy. Have you ever heard of (METHOD)?

01) Female Sterilization. PROBE: Women can have an operation to avoid having any more children.
YES 1
NO 2
02) Male Sterilization. PROBE: Men can have an operation to avoid having any more children.
YES 1
NO 2
03) IUD PROBE: Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2
04) Injectables. PROBE: Women can have an injection by a health provider that stops them from becoming pregnant for one or more months.
YES 1
NO 2
05) Implants. PROBE: Women can have on or more 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
06) Pill. PROBE: Women can take pill every day to avoid becoming pregnant.
YES 1
NO 2
07) Condom. PROBE: Med can put a rubber sheath on their penis before sexual intercourse.
YES 1
NO 2
08) Rhythm Method. PROBE: 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. PROBE: Men can be careful and pull out before climax.
YES 1
NO 2
10) Emergency Contraception. PROBE: As an emergency measure, within three/five days after they have unprotected sexual intercourse, women can take special pills to prevent pregnancy.
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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Niger 2006
Survey form view entire document:  text 
301. Which methods have you heard about?
FOR METHODS NOT MENTIONED SPONTANEOUSLY, ASK: Have ever heard about (METHOD)?

01. FEMALE STERILIZATION: Women can have an operation to avoid having any more children.
YES 1
NO 2 (GO TO NEXT METHOD)
02. MALE STERILIZATION: Men can have an operation to avoid having any more children.
YES 1
NO 2 (GO TO NEXT METHOD)
03. PILL: Women can take a pill every day to avoid becoming pregnant.
YES 1
NO 2 (GO TO NEXT METHOD)
04. IUD: Women can have a loop or a coil placed inside them by a doctor or a nurse to avoid becoming pregnant.
YES 1
NO 2 (GO TO NEXT METHOD)
05. INJECTIONS: Women can have an injection by a health provider to avoid becoming pregnant during one or more months.
YES 1
NO 2 (GO TO NEXT METHOD)
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 (GO TO NEXT METHOD)
07. CONDOM: Men can put a rubber sheath on their penis before sexual intercourse.
YES 1
NO 2 (GO TO NEXT METHOD)
08. FEMALE CONDOM: Women can place a sheath in their vagina before intercourse.
YES 1
NO 2 (GO TO NEXT METHOD)
09. DIAPHRAGM: Women can place a diaphragm in their vagina before sexual intercourse.
YES 1
NO 2 (GO TO NEXT METHOD)
10. COMPRESS, FOAM OR JELLY: Women can insert a compress, jelly or lotion in their vagina before intercourse.
YES 1
NO 2 (GO TO NEXT METHOD)
11. LACTATIONAL AMENORRHEA METHOD (LAM): Up to 6 months after a birth and before her period returns, a woman can use a method consisting of nursing her baby each time that he/she wants, day and night, without ever giving him/her any other food.
YES 1
NO 2 (GO TO NEXT METHOD)
12. RHYTHM METHOD: 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 (GO TO NEXT METHOD)
13. WITHDRAWAL: Men can be careful to pull out before climax.
YES 1
NO 2 (GO TO NEXT METHOD)
14. DAY AFTER PILL: Women can take pills days following intercourse until the third day after to avoid getting pregnant.
YES 1
NO 2 (GO TO NEXT METHOD)
15. Have you heard of other ways or methods that women or men can use to avoid pregnancy?
YES (SPECIFY) __________ 1
NO 2

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Nigeria 1990
Survey form view entire document:  text 
301. 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. Which ways or methods have you heard about?

CIRCLE CODE 1 IN 302 FOR EACH METHOD MENTIONED SPONTANEOUSLY.
THEN PROCEED DOWN THE COLUMN, 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 302, ASK 303-304 BEFORE PROCEEDING TO THE NEXT METHOD.

302. Have you ever heard of (METHOD)?
READ DESCRIPTION OF EACH METHOD.

METHOD 01 PILL Women can take a pill every day.
YES/SPONT 1
YES/PROBED 2
NO 3 (GO TO NEXT METHOD)
METHOD 02 IUD Women can have a loop or coil placed inside them by a doctor or a nurse.
YES/SPONT 1
YES/PROBED 2
NO 3(GO TO NEXT METHOD)
METHOD 03 INJECTIONS Women can have an injection by a doctor or nurse which stops them from becoming pregnant for several months.
YES/SPONT 1
YES/PROBED 2
NO 3(GO TO NEXT METHOD)
METHOD 04 FOAMING TABLETS Women can place a foaming tablet or pill inside them before intercourse.
YES/SPONT 1
YES/PROBED 2
NO 3 (GO TO NEXT METHOD)
METHOD 05 DIAPHRAGM, FOAM, JELLY Women can place a sponge, diaphragm, jelly or cream inside them before intercourse.
YES/SPONT 1
YES/PROBED 2
NO 3 (GO TO NEXT METHOD)
METHOD 06 DUREX OR CONDOM Men can use a rubber sheath during sexual intercourse.
YES/SPONT 1
YES/PROBED 2
NO 3 (GO TO NEXT METHOD)
METHOD 07 FEMALE STERILIZATION Women can have an operation to avoid having any more children.
YES/SPONT 1
YES/PROBED 2
NO 3 (GO TO NEXT METHOD)
METHOD 08 MALE STERILIZATION Men can have an operation to avoid having any more children.
YES/SPONT 1
YES/PROBED 2
NO 3 (GO TO NEXT METHOD)
METHOD 09 RHYTHM Couples can avoid having sexual intercourse on certain days of the month when the woman is more likely to become pregnant.
YES/SPONT 1
YES/PROBED 2
NO 3 (GO TO NEXT METHOD)
METHOD 10 WITHDRAWAL Men can be careful and pull out before climax.
YES/SPONT 1
YES/PROBED 2
NO 3 (GO TO NEXT METHOD)
METHOD 11 Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES/SPONT 1 (SPECIFY) ____
NO 3 (GO TO NEXT METHOD)

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Nigeria 2003
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 301, READING THE NAME AND DESCRIPTION OF EACH METHOD NOT MENTIONED SPONTANEOUSLY. CIRCLE CODE 1 IF METHOD IS RECOGNIZED, AND CODE 2 IF NOT RECOGNIZED. THEN, FOR EACH METHOD WITH CODE 1 CIRCLED IN 301, ASK 302.

301) Which ways or methods have you heard about?

FOR METHODS NOT MENTIONED SPONTANEOUSLY, ASK: Have you ever heard of (METHOD)?

01. FEMALE STERILIZATION Women can have 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.
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 sheath on their penis before sexual intercourse.
YES 1
NO 2
08. FEMALE CONDOM Women can place a sheath in their vagina before sexual intercourse.
YES 1
NO 2
09. DIAPHRAGM Women can place a thin flexible disk in their vagina before intercourse.
YES 1
NO 2
10. FOAM OR JELLY Women can place a suppository, jelly or cream in their vagina before intercourse.
YES 1
NO 2
11. LACTATIONAL AMENORRHEA METHOD (LAM) Up to 6 months after childbirth, a woman can use a method that requires that she breastfeeds frequently, day and night, and that her menstrual period has not returned.
YES 1
NO 2
12. RHYTHM OR PERIODIC ABSTINENCE Every month that a woman is sexual 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 Women can take pills up to three days after sexual intercourse to avoid becoming pregnant.
YES 1
NO 2
15. Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES (SPECIFY): _____________ 1
NO 2

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Nigeria 2008
Survey form view entire document:  text 
301. 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. Which ways or methods have you heard about?
FOR METHODS NOT MENTIONED SPONTANEOUSLY, ASK: Have you ever heard of (METHOD)?
CIRCLE CODE 1 IN 301 FOR EACH METHOD MENTIONED SPONTANEOUSLY.
THEN PROCEED DOWN COLUMN 301, READING THE NAME AND DESCRIPTION OF
EACH METHOD NOT MENTIONED SPONTANEOUSLY. CIRCLE CODE 1 IF METHOD
IS RECOGNIZED, AND CODE 2 IF NOT RECOGNIZED. THEN, FOR EACH METHOD
WITH CODE 1 CIRCLED IN 301, ASK 302.

01 FEMALE STERILIZATION Women can have an operation to avoid having any more children.
YES 1
NO 2 (GO TO NEXT METHOD)
02 MALE STERILIZATION Men can have an operation to avoid having any more children.
YES 1
NO 2 (GO TO NEXT METHOD)
03 PILL Women can take a pill every day to avoid becoming pregnant.
YES 1
NO 2 (GO TO NEXT METHOD)
04 IUD Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2 (GO TO NEXT METHOD)
05 INJECTABLES Women can have an injection by a health provider which stops them from becoming pregnant for one or more months.
YES 1
NO 2 (GO TO NEXT METHOD)
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 (GO TO NEXT METHOD)
07 MALE CONDOM Men can put a rubber sheath on their penis before sexual intercourse.
YES 1
NO 2 (GO TO NEXT METHOD)
08 FEMALE CONDOM Women can place a sheath in their vagina before sexual intercourse.
YES 1
NO 2 (GO TO NEXT METHOD)
09 DIAPHRAGM Women can place a thin flexible disk in their vagina before intercourse.
YES 1
NO 2 (GO TO NEXT METHOD)
10 FOAM OR JELLY Women can place a suppository, jelly, or cream in their vagina before intercourse.
YES 1
NO 2 (GO TO NEXT METHOD)
11 LACTATIONAL AMENORRHEA METHOD (LAM) Up to 6 months after childbirth, a woman can use a method that requires that she breastfeeds frequently, day and night, and that her menstrual period has not returned.
YES 1
NO 2 (GO TO NEXT METHOD)
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 (GO TO NEXT METHOD)
13 WITHDRAWAL Men can be careful and pull out before climax.
YES 1
NO 2 (GO TO NEXT METHOD)
14 EMERGENCY CONTRACEPTION As an emergency measure after unprotected sexual intercourse, women can take special pills at any time within five days to prevent pregnancy.
YES 1
NO 2 (GO TO NEXT METHOD)
15 Have you heard of any other ways or traditional methods that women or men can use to avoid pregnancy? LIST UP TO TWO METHODS.
SPECIFY___
YES 1
NO 2

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Nigeria 2013
Survey form view entire document:  text 
301) 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. Have you ever heard of (METHOD?)

01) Female Sterilization. PROBE: Women can have an operation to avoid having any more children?
YES 1
NO 2
02) Male Sterilization. PROBE: Men can have an operation to avoid having any more children.
YES 1
NO 2
03) IUD. PROBE: Women can have a loop or coil placed inside tem by a doctor or a nurse.
YES 1
NO 2
04) Injectables. PROBE: Women can have an injection by a health provider that stops them from becoming pregnant for one or more months.
YES 1
NO 2
05) Implants. PROBE: Women can have one or more 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
06) Pill. PROBE: Women can take a pill every day to avoid becoming pregnant.
YES 1
NO 2
07) Condom. PROBE: Men can put a rubber on their penis before sexual intercourse.
YES 1
NO 2
08) Female Condom. PROBE: Women can place a sheath in their vagina before sexual intercourses.
YES 1
NO 2
09) Diaphragm. Women can place thin flexible disks in their vagina before intercourse.
YES 1
NO 2
10) Foam or Jelly: Women can place a suppository jelly, or cream in their vagina before intercourse.
YES 1
NO 2
11) Standard Days Method. PROBE: A Woman uses a string of colored beads to know the days she can get pregnant. On the days she can get pregnant, they use a condom or do not have sexual intercourse.
YES 1
NO 2
12) Lactational Amenorrhea Method (LAM)
YES 1
NO 2
13) Rhythm Method. PROBE: To avoid pregnancy, women do not have sexual intercourse on the days of the month they think they can get pregnant.
YES 1
NO 2
14) Withdrawal. PROBE: Men can be careful and pull out before climax.
YES 1
NO 2
15) Emergency Contraception. PROBE: As an emergency measure, within three days after they have unprotected sexual intercourse, women can take special pills to prevent.
YES 1
NO 2
16) Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES 1 (SPECIFY) ________
NO 2

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Rwanda 2000
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 301, READING THE NAME AND DESCRIPTION OF EACH METHOD NOT MENTIONED SPONTANEOUSLY. CIRCLE CODE 1 IF METHOD IS
RECOGNIZED, AND CODE 2 IF NOT RECOGNIZED. THEN, FOR EACH METHOD WITH CODE 1 CIRCLED IN 301, ASK 302.

301. Which ways or methods have you heard about?
FOR METHODS NOT MENTIONED SPONTANEOUSLY, ASK:
Have you ever heard of (METHOD)?

01) FEMALE STERILIZATION: Women can have 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.
YES 1
NO 2
03) PILL: Women can take a pill every day.
YES 1
NO 2
04) IUD: Women can have an IUD placed inside them by a doctor or a nurse.
YES 1
NO 2
05) INJECTABLES: 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) 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 sheath on their penis before sexual intercourse.
YES 1
NO 2
08) FEMALE CONDOM: Women can place a 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) FOAM OR JELLY: Women can place a suppository, jelly, or cream in their vagina before sexual intercourse.
YES 1
NO 2
11) LACTATIONAL AMENORRHEA METHOD (LAM): Up to 6 months after childbirth, a woman can use a method that requires that she breastfeeds frequently, day and night, and that her menstrual period has not returned.
YES 1
NO 2
12) RHYTHM/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
13) WITHDRAWAL: Men can be careful and pull out before climax.
YES 1
NO 2
14) MORNING AFTER PILL: Women can take pills up to three days after sexual intercourse to avoid becoming pregnant.
YES 1
NO 2
15) Have you heard of any other ways or methods that women or men can use to avoid pregnancy? LIST UP TO TWO METHODS.
SPECIFY___
YES 1
NO 2

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Rwanda 2005
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 301, READING THE NAME AND DESCRIPTION OF EACH METHOD NOT MENTIONED SPONTANEOUSLY.
CIRCLE CODE 1 IF METHOD IS RECOGNIZED, AND CODE 2 IF NOT RECOGNIZED. THEN, FOR EACH METHOD WITH CODE 1 CIRCLED IN 301, ASK 302.

301. Which ways or methods have you heard about?
FOR METHODS NOT MENTIONED SPONTANEOUSLY, ASK:
Have you ever heard of (METHOD)?

01 FEMALE STERILIZATION Women can have an operation to avoid having any more children.
YES 1
NO 2 (GO TO NEXT METHOD)
02 MALE STERILIZATION Men can have an operation to avoid having any more children.
YES 1
NO 2 (GO TO NEXT METHOD)
03 PILL Women can take a pill every day to avoid becoming pregnant.
YES 1
NO 2 (GO TO NEXT METHOD)
04 IUD Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2 (GO TO NEXT METHOD)
05 INJECTABLES Women can have an injection by a health provider which stops them from becoming pregnant for one or more months.
YES 1
NO 2 (GO TO NEXT METHOD)
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 (GO TO NEXT METHOD)
07 CONDOM Men can put a rubber sheath on their penis before sexual intercourse.
YES 1
NO 2 (GO TO NEXT METHOD)
08 FEMALE CONDOM Women can place a sheath in their vagina before sexual intercourse.
YES 1
NO 2 (GO TO NEXT METHOD)
09 DIAPHRAGM Women can place a thin flexible disk in their vagina before intercourse.
YES 1
NO 2 (GO TO NEXT METHOD)
10 FOAM OR JELLY Women can place a suppository, jelly, or cream in their vagina before intercourse.
YES 1
NO 2 (GO TO NEXT METHOD)
11 LACTATIONAL AMENORRHEA METHOD (LAM) Up to 6 months after childbirth, a woman can use a method that requires that she breastfeeds frequently, day and night, and that her menstrual period has not returned.
YES 1
NO 2 (GO TO NEXT METHOD)
12 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 (GO TO NEXT METHOD)
12A BEADS /STANDARD DAYS METHOD (SDM) The woman know days of the month when she can get pregnant by using beads or calendar
YES 1
NO 2 (GO TO NEXT METHOD)
13 WITHDRAWAL Men can be careful and pull out before climax.
YES 1
NO 2 (GO TO NEXT METHOD)
14 EMERGENCY CONTRACEPTION Women can take pills up to three days after sexual intercourse to avoid becoming pregnant.
YES 1
NO 2 (GO TO NEXT METHOD)
15 Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES 1
(SPECIFY)______
(SPECIFY) ______
NO 2

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Senegal 2005
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 301, READING THE NAME AND DESCRIPTION OF EACH METHOD NOT MENTIONED SPONTANEOUSLY. CIRCLE CODE 1 IF METHOD IS RECOGNIZED, AND CODE 2 IF NOT RECOGNIZED. THEN, FOR EACH METHOD WITH CODE 1 CIRCLED IN 301, ASK 302.

301) Which ways or methods have you heard about?

FOR METHODS NOT MENTIONED SPONTANEOUSLY, ASK: Have you ever heard of (METHOD)?

01. FEMALE STERILIZATION Women can have 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.
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 sheath on their penis before sexual intercourse.
YES 1
NO 2
08. FEMALE CONDOM Women can place a sheath in their vagina before sexual intercourse.
YES 1
NO 2
09. DIAPHRAGM Women can place a thin flexible disk in their vagina before intercourse.
YES 1
NO 2
10. FOAM OR JELLY Women can place a suppository, jelly or cream in their vagina before intercourse.
YES 1
NO 2
11. LACTATIONAL AMENORRHEA METHOD (LAM) Up to 6 months after childbirth, a woman can use a method that requires that she breastfeeds frequently, day and night, and that her menstrual period has not returned.
YES 1
NO 2
12. RHYTHM OR PERIODIC ABSTINENCE Every month that a woman is sexual 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 Women can take pills up to three days after sexual intercourse to avoid becoming pregnant.
YES 1
NO 2
15. Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES (SPECIFY): _____________ 1
NO 2

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Tanzania 2004
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 301, READING THE NAME AND DESCRIPTION OF EACH METHOD NOT MENTIONED SPONTANEOUSLY. CIRCLE CODE 1 IF METHOD IS RECOGNIZED, AND CODE 2 IF NOT RECOGNIZED. THEN, FOR EACH METHOD WITH CODE 1 CIRCLED IN 301, ASK 302.

301. Which ways or methods have you heard about?
FOR METHODS NOT MENTIONED SPONTANEOUSLY, ASK: Have you ever heard of (METHOD)?

01 FEMALE STERILIZATION Women can have 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.
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 three 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 sheath on their penis before sexual intercourse.
YES 1
NO 2
08 FEMALE CONDOM Women can place a sheath in their vagina before sexual intercourse.
YES 1
NO 2
09 DIAPHRAGM Women can place a thin flexible disk in their vagina before intercourse.
YES 1
NO 2
10 FOAM OR JELLY Women can place a suppository, jelly, or cream in their vagina before sexual intercourse.
YES 1
NO 2
11 LACTATIONAL AMENORRHEA METHOD (LAM) Up to 6 months after childbirth, a woman can use a method that requires that she breastfeeds frequently, day and night, and that her menstrual period has not returned.
YES 1
NO 2
12 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
13 WITHDRAWAL Men can be careful and pull out before climax.
YES 1
NO 2
14 EMERGENCY CONTRACEPTION Women can take pills up to three days after sexual intercourse to avoid becoming pregnant and must take the pills every day for 5 days.
YES 1
NO 2
15 Have you heard of any other ways or methods that women or men can use to avoid pregnancy? LIST UP TO TWO METHODS.
SPECIFY____
YES 1
NO 2

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Tanzania 2010
Survey form view entire document:  text 
SECTION 3. CONTRACEPTION

301. 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. Have you ever heard of (METHOD)?
PROCEED DOWN COLUMN 301, READING THE NAME AND DESCRIPTION OF EACH METHOD. CIRCLE CODE 1 IF METHOD IS RECOGNIZED, AND CODE 2 IF NOT RECOGNIZED.

01 Female Sterilization. PROBE: Women can have an operation to avoid having any more children.
YES 1
NO 2
02 Male Sterilization. PROBE : Men can have an operation to avoid having any more children.
YES 1
NO 2
03 Injectables. PROBE: 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 Implants. PROBE: 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
05 IUD. PROBE: Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2
06 PILL. PROBE: Women can take a pill every day to avoid becoming pregnant.
YES 1
NO 2
07 Condom. PROBE: Men can put a rubber sheath on their penis before sexual Intercourse.
YES 1
NO 2
08 Female Condom. PROBE: Women can place a sheath in their vagina before sexual intercourse.
YES 1
NO 2
09 Diaphragm. PROBE: Women can place a sheath in their vagina before sexual intercourse.
YES 1
NO 2
10 Foam or Jelly. PROBE: Women can place a suppository, jelly or cream in their vagina before sexual intercourse.
YES 1
NO 2
11 Lactational Amenorrhea Method (LAM)
YES 1
NO 2
12 Rhythm Method. PROBE: 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. PROBE: Men can be careful and pull out before climax.
YES 1
NO 2
14 Emergency Contraception. PROBE: As an emergency measure after unprotected sexual intercourse, women can take special pills at any time within five days to prevent pregnancy.
YES 1
NO 2
15 Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES (SPECIFY) _________ 1
NO 2

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Uganda 2001
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 301,
reading the name and description of each method not mentioned spontaneously. Circle code 1 if method is recognized, and code 2 if not recognized. Then, for each method with code 1 circled in 301, ask 302.

301 Which ways or methods have you heard about?
FOR METHODS NOT MENTIONED SPONTANEOUSLY, ASK: Have you ever heard of (method)?

01 FEMALE STERILIZATION: Women can have 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
YES 1
NO 2
03 PILL: Women can take a pill every day to avoid becoming pregnant.
YES 1
NO 2
04 IUD/COIL: 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 which 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 sheath on their penis before sexual intercourse.
YES 1
NO 2
08 FEMALE CONDOM: Women can place a sheath in their vagina before sexual intercourse.
YES 1
NO 2
09 DIAPHRAGM: Women can place a thin flexible disk in their vagina before intercourse.
YES 1
NO 2
10 FOAM OR JELLY: Women can place a suppository, jelly, or cream in their vagina before intercourse.
YES 1
NO 2
11 LACTATIONAL AMENORRHEA METHOD (LAM): Up to 6 months after childbirth, a woman can use a method that requires that she breastfeeds frequently, day and night, and that her menstrual period has not returned.
YES 1
NO 2
12 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
13 WITHDRAWAL: Men can be careful and pull out before climax.
YES 1
NO 2
14 EMERGENCY CONTRACEPTION (NORLEVO) Women can take pills up to three days after sexual intercourse to avoid becoming pregnant.
YES 1
NO 2
15 Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES 1 (SPECIFY) __________
NO 2

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Zimbabwe 1988
Survey form view entire document:  text 
301) Now I would like to talk about a different topic. There are various ways or methods that a couple can use to delay or avoid a pregnancy. Which of these ways or methods have you heard about?

INTERVIEWER: CIRCLE CODE '1' IN 302 FOR EACH METHOD MENTIONED SPONTANEOUSLY. THEN PROCEED DOWN THE COLUMN, 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 302, ASK 303 - 305 BEFORE PROCEEDING TO THE NEXT METHOD.

302) Have you ever heard of (METHOD)?

READ DESCRIPTION.

01. PILL Women can take a pill by mouth every day.
YES/SPONTANEOUS 1
YES/PROBED 2
NO 3 (GO TO 02)
02. LOOP Women can have a loop or IUD inserted in their wombs by a doctor or a nurse.
YES/SPONTANEOUS 1
YES/PROBED 2
NO 3 (GO TO 03)
03. INJECTIONS Women can have an injection by a doctor or nurse which stops them from becoming pregnant for several months.
YES/SPONTANEOUS 1
YES/PROBED 2
NO 3 (GO TO 04)
04. DIAPHRAGM Women can place a diaphragm or pessary inside them before intercourse.
YES/SPONTANEOUS 1
YES/PROBED 2
NO 3 (GO TO 05)
05. CONDOM OR DUREX Men can use a rubber during sexual intercourse.
YES/SPONTANEOUS 1
YES/PROBED 2
NO 3 (GO TO 06)
06. FEMALE STERILIZATION Women can have an operation to avoid having any more children.
YES/SPONTANEOUS 1
YES/PROBED 2
NO 3 (GO TO 07)
07. MALE STERILIZATION Men can have an operation to avoid having any more children.
YES/SPONTANEOUS 1
YES/PROBED 2
NO 3 (GO TO 08)
08. SAFE PERIOD Couples can avoid having sexual intercourse on certain days of the month when the woman is more likely to become pregnant.
YES/SPONTANEOUS 1
YES/PROBED 2
NO 3 (GO TO 09)
09. WITHDRAWAL Men can be careful and pull out before ejaculation.
YES/SPONTANEOUS 1
YES/PROBED 2
NO 3 (GO TO 10)
10. FOAM/JELLY/FOAMING TABLETS Women can insert foam or jelly or foaming tablets inside them before intercourse.
YES/SPONTANEOUS 1
YES/PROBED 2
NO 3 (GO TO 11)
11. ANY OTHER METHODS? Have you heard of any other ways or methods that women or men can use to avoid pregnancy? (SPECIFY) __________
YES/SPONTANEOUS 1
NO 3 (GO TO 306)

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Zimbabwe 1999
Survey form view entire document:  text 
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 301, READING THE NAME AND DESCRIPTION OF EACH METHOD NOT MENTIONED SPONTANEOUSLY. CIRCLE CODE 1 IF METHOD IS RECOGNIZED, AND CODE 2 IF NOT RECOGNIZED. THEN, FOR EACH METHOD WITH CODE 1 CIRCLED IN 301, ASK 302.

301) Which ways or methods have you heard about?
FOR METHODS NOT MENTIONED SPONTANEOUSLY, ASK: Have you ever heard of (METHOD)?

01) FEMALE STERILIZATION: Women can have 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.
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 sheath on their penis before sexual intercourse.
YES 1
NO 2
08) FEMALE CONDOM: Women can place a sheath in their vagina before sexual intercourse.
YES 1
NO 2
09) DIAPHRAGM: Women can place a thin flexible disk in their vagina before intercourse.
YES 1
NO 2
10) FOAM OR JELLY: Women can place a suppository, jelly, or cream in their vagina before intercourse.
YES 1
NO 2
11) LACTATIONAL AMENORRHEA METHOD (LAM): Up to 6 months after childbirth, a woman can use a method that requires that she breastfeeds frequently, day and night, and that her menstrual period has not returned.
YES 1
NO 2
12) 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
13) WITHDRAWAL: Men can be careful and pull out before climax.
YES 1
NO 2
14) EMERGENCY CONTRACEPTION: Women can take pills up to three days after sexual intercourse to avoid becoming pregnant.
YES 1
NO 2
15) Have you heard of any other ways or methods that women or men can use to avoid pregnancy? LIST UP TO TWO METHODS.
SPECIFY____
YES 1
NO 2