Survey Text

Afghanistan 2015 India 2005 Namibia 2000 Senegal 2017
Angola 2015 Jordan 2012 Nepal 2016 South Africa 2016
Burundi 2016 Jordan 2017 Nigeria 2018 Uganda 2016
Ethiopia 2016 Myanmar 2015 Pakistan 2017
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Afghanistan 2015
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.
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. Male Condom. PROBE: Men can put a rubber sheath on their penis 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
13. Have you heard of any other ways or methods that women can use to avoid pregnancy?
YES 1 (SPECIFY)_______________
NO 2

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Angola 2015
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 pregnancy. Which ways or methods have you heard about?
For methods not mentioned spontaneously, ask: Have you heard of (read: METHOD)?

01 Female Sterilization. (Tubal ligation). PROBE: Women can have an operation to avoid having any more children.
YES 1
NO 2
02 Male Sterilization. (Vasectomy).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 to avoid pregnancy
YES 1
NO 2
04 Injectables. PROBE: Women can have an injection by a doctor or nurse which stops them from becoming pregnant for several 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 pill everyday to avoid pregnancy.
YES 1
NO 2
07 Condom. PROBE: Men can put a rubber sheath on their penis during sexual intercourse.
YES 1
NO 2
08 Female Condom. PROBE: Women can place a sheath on their vagina before sexual intercourse.
YES 1
NO 2
09 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
10 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, she uses a condom or does not have sexual intercourse.
YES 1
NO 2
11 Lactational Amenorrhea Method (LAM). PROBE: 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 Periodic Abstinence. PROBE: Every month that a women 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
13 Withdrawal. PROBE: Men can be careful and pull out before climax ejaculating outside of the vagina.
YES 1
NO 2
14 Other Methods. ROBE: 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?
YES 1 (SPECIFY) ______
NO 2

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Burundi 2016
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) IUD: Women can have a loop or coil placed inside them by a doctor or a nurse which can prevent pregnancy for one or more years.

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) 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

10) STANDARD DAYS METHOD: A woman uses a string of colored beads to know the days she can get pregnant. On the days she can get pregnant, she uses a condom or does not have intercourse.

YES 1
NO 2

11) LACTATIONAL AMENORRHEA METHOD (LAM): Up to six months after child birth, before the menstrual period has returned, women use a method requiring frequent breastfeeding day and night.

YES 1
NO 2

12) 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

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

YES 1
NO 2

14) 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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Ethiopia 2016
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. IUD: Women can have a loop or coil placed inside them by a doctor or a nurse which can prevent pregnancy for one or more years.
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. 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. 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
10. STANDARD DAYS METHOD: A woman uses a string of colored beads to know the days she can get pregnant. On the days she can get pregnant, she uses a condom or does not have sexual intercourse.
YES 1
NO 2
11. LACTATIONAL AMENORRHEA METHOD (LAM): Up to six months after childbirth, before the menstrual period has returned, women use a method requiring frequent breastfeeding day and night.
YES 1
NO 2
12. 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
13. WITHDRAWAL: Men can be careful and pull out before climax.
YES 1
NO 2
14. Have you heard of any other ways or method that women or men can use to avoid pregnancy?
YES, MODERN METHOD (SPECIFY) 1
YES, TRADITIONAL METHOD (SPECIFY) 2
NO 3

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India 2005
Survey form view entire document:  text 
SECTION 3B. 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.

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

CIRCLE CODE '1' IN 318 FOR EACH METHOD MENTIONED SPONTANEOUSLY.
THEN PROCEED DOWN COLUMN 318 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
PERFORM THE CHECK AT THE BOTTOM OF THE COLUMN. IF 316 IS YES
OR NOT ASKED, ASK 320 FOR EACH METHOD WITH CODE '1' CIRCLED IN 318.

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 or every week to avoid becoming pregnant.
YES 1
NO 2 (GO TO NEXT METHOD)
04 IUD OR LOOP 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 CONDOM OR NIRODH Men can put a rubber sheath on their penis before sexual intercourse.
YES 1
NO 2 (GO TO NEXT METHOD)
07 FEMALE CONDOM Women can place a sheath in their vagina before sexual intercourse.
YES 1
NO 2 (GO TO NEXT METHOD)
08 RHYTHM METHOD Every month that a woman is sexually active she can avoid pregnancy by not having sexual intercourse on the days of the month she is most likely to get pregnant.
YES 1
NO 2 (GO TO NEXT METHOD)
09 WITHDRAWAL Men can be careful and pull out before climax.
YES 1
NO 2 (GO TO NEXT METHOD)
10 EMERGENCY CONTRACEPTION Women can take pills up to three days after sexual intercourse
YES 1
NO 2 (GO TO NEXT METHOD)
11 Have you heard of any other ways or methods that women or men can use to avoid pregnancy? LIST UP TO TWO OTHER METHODS.
(SPECIFY) _______
YES 1
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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Jordan 2017
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.

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 a coil placed inside them by a doctor or a nurse which can prevent pregnancy for one or more.
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) 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
10) Lactational Amenorrhea Method (LAM).
PROBE: Up to six months after childbirth, before the menstrual period has returned, women use a method requiring frequent breastfeeding day and night.
YES 1
NO 2
11) 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
12) Withdrawal.
PROBE: Men can be careful and pull out before climax.
YES 1
NO 2

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

YES, MODERN METHOD (SPECIFY) ______________________ A
YES, TRADITIONAL METHOD (SPECIFY) _____________________ B
NO Y

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Myanmar 2015
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)?

METHOD 1 Female Sterilization. PROBE: Women can have an operation to avoid having any more children.
YES 1
NO 2
METHOD 2 Male sterilization. PROBE: Men can have an operation to avoid having any more children.
YES 1
NO 2
METHOD 3 IUD. PROBE: Women can have a loop or coil placed inside them by a doctor or nurse.
YES 1
NO 2
METHOD 4 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
METHOD 5 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
METHOD 6 Pill. PROBE: Women can take a pill every day to avoid becoming pregnant.
YES 1
NO 2
METHOD 7 Condom. PROBE: Men can put a rubber sheath on their penis before sexual intercourse.
YES 1
NO 2
METHOD 8 Female condom. PROBE: Women can place a sheath in their vagina before sexual intercourse.
YES 1
NO 2
METHOD 9 Lactational Amenorrhea Method (LAM).
YES 1
NO 2
METHOD 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
METHOD 11 Withdrawal. PROBE: Men can be careful and pull out before climax.
YES 1
NO 2
METHOD 12 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
METHOD 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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Namibia 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 RECOGNISED, AND CODE 2 IF NOT RECOGNISED. 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 STERILISATION Women can have an operation to avoid having any more children.
YES 1
NO 2
02 MALE STERILISATION Men can have an operation to avoid having any more children.
YES 1
NO 2
03 PILL Women can take a pill every day to stop them from becoming pregnant.
YES 1
NO 2
04 IUD Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2
05 INJECTIONS Women can have an injection by a health provider which stops them from becoming pregnant for one or more months.
YES 1
NO 2
06 CONDOM Men can put a rubber sheath on their penis before sexual intercourse.
YES 1
NO 2
07 FEMALE CONDOM Women can place a sheath in their vagina before sexual intercourse.
YES 1
NO 2
08 DIAPHRAGM /FOAM/JELLY Women can place a sponge, suppository, diaphragm, jelly or cream in their vagina before intercourse.
YES 1
NO 2
09 RHYTHM OR PERIODIC ABSTINENCE Every month that a woman is sexually active she can avoid pregnancy by not having sexual intercourse on the days of the month she is most likely to get pregnant.
YES 1
NO 2
10 WITHDRAWAL Men can be careful and pull out before climax.
YES 1
NO 2
11 EMERGENCY CONTRACEPTION Women can take pills up to three days after sexual intercourse to avoid becoming pregnant.
YES 1
NO 2
12 Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES 1
(SPECIFY) ____
(SPECIFY) ____
NO 2

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Nepal 2016
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.
YES 1
NO 2
02. Male Sterilization. PROBE: Men can have an operation to avoid having any more children.
YES 1
NO 2
03. IUCD. PROBE: Women can have a loop or coil placed inside them by a doctor or a nurse which can prevent pregnancy for one or more years.
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 three to five 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
09. Emergency Contraception. PROBE: As an emergency measure within five days after they have unprotected sexual intercourse, women can take special pills to prevent pregnancy (like I-Pill, E-CON)
YES 1
NO 2
11. Lactational Amenorrhea Method (LAM). PROBE: Up to six months after childbirth, before the menstrual period has returned, women use a method requiring frequent breastfeeding day and night.
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. Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES, MODERN METHOD (SPECIFY) ____ A
YES, TRADITIONAL METHOD (SPECIFY) ____ B
NO Y

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Nigeria 2018
Survey form view entire document:  text 
SECTION 3. CONTRACEPTION

301. Now I would like to talk about family planning- the various methods that a couple can use to delay or avoid pregnancy. Have you 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 nurse which can prevent pregnancy for a while.
YES 1
NO 2
04. Injectable.
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 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. 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
10. Standard Days Method.
PROBE: A woman used a string of colored beads to know the days she can get pregnant. On the days she can get pregnant, she uses a condom or does not have sexual intercourse.
YES 1
NO 2
11. Lactational Amenorrhea Method (LAM).
PROBE: Up to six months after childbirth, before the menstrual period has returned, women use a method requiring frequent breastfeeding day and night.
YES 1
NO 2
12. Rhythm Method
PROBE: To avoid pregnancy, women do not have sexual intercourse on the days of the month they thing they can get pregnant.
YES 1
NO 2
13. Withdrawal.
PROBE: Men can be careful and pull out before climax.
YES 1
NO 2

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Pakistan 2017
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 pregnancy. Have you ever heard of (METHOD)?

METHOD 1: FEMALE STERILIZATION. Woman can have an operation to avoid having any more children.
YES 1
NO 2
METHOD 2: MALE STERILIZATION. Man can have an operation to avoid having any more children.
YES 1
NO 2
METHOD 3: IUD. Women can have a loop or coil placed inside them by a doctor or a nurse which can prevent pregnancy up to ten years.
YES 1
NO 2
METHOD 4: 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
METHOD 5: IMPLANTS. Women can have one or more small rods placed in their upper arm by a doctor, nurse, or LHV which can prevent pregnancy up to five years.
YES 1
NO 2
METHOD 6: PILL. Women can take a pill every day to avoid becoming pregnant.
YES 1
NO 2
METHOD 7: CONDOM. Men can put a rubber sheath on their penis before sexual intercourse.
YES 1
NO 2
METHOD 8: 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
METHOD 9: STANDARD DAYS METHOD. A woman uses a string of colored beads to know the days she can get pregnant. On the days she can get pregnant, she uses a condom or does not have sexual intercourse.
YES 1
NO 2
METHOD 10: LACTATIONAL AMENORRHEA METHOD (LAM). Up to six months after childbirth, before the menstrual period has returned, women use a method requiring frequent breastfeeding day and night.
YES 1
NO 2
METHOD 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
METHOD 12: WITHDRAWAL. Men can be careful and pull out before climax.
YES 1
NO 2
METHOD 13: Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES, MODERN METHOD (SPECIFY) ____________ A
YES, TRADITIONAL METHOD (SPECIFY) __________ B
NO Y

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Senegal 2017
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
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 which can prevent pregnancy for one or more months.
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) 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
10) Standard Days Method
PROBE: A women uses a string of colored beads to know the days she can get pregnant. On the days she can get pregnant, she uses a condom or does not have sexual intercourse.
YES 1
NO 2
11) Lactational amenorrhea method (LAM)
PROBE: Up to six months after giving birth, before the menstrual period has returned, women use a method which requires her to breastfeed frequently day and night.
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) Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES, MODERN METHOD (SPECIFY) ______ A
YES, TRADITIONAL METHOD (SPECIFY) _____ B
NO Y

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South Africa 2016
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? MARK ALL METHODS DECLARED BY THE RESPONDENT.

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

01 Female Sterilization/Tubal Ligation/Tubes Cut/Tubes Binded.
PROBE: Women can have an operation to avoid having any more children.
YES 1
NO 2
02 Male Sterilization/Vasectomy/Tubes Cut/Tubes Binded.
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 which can prevent pregnancy for one or more years.
YES 1
NO 2
04 Injectables/Depo.
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 Male 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 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
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 Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES, MODERN METHOD (SPECIFY) ____ A
YES, TRADITIONAL METHOD (SPECIFY) ______ B
NO Y

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Uganda 2016
Survey form view entire document:  text 
SECTION 3. CONTRACEPTION
301) Now I would like to talk about family planning - the various ways of methods that a couple can use to delay or avoid a pregnancy. Have you ever heard of (METHODS)?

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 which can prevent pregnancy for one or more years.
YES 1
NO 2
04) Injectables.
PROBE: Women can have an injection by a health provider that stops them form 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.
YES 1
NO 2
08) Female Condom.
PROBE: Women can place a sheath in their vagina before sexual intercourse.
YES 1
NO2
09) 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
10) Standard Days Method/Moon Beads
PROBE: A woman used a string of colored beads to know the days she can get pregnant. On the days she can get pregnant, she uses a condom or does not have sexual intercourse.
YES 1
NO 2
11) Lactational Amenorrhea Method (LAM)
PROBE: Up to six months after childbirth, before the menstrual period has returned, women use a method requiring frequent breastfeeding day and night.
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) Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES, MEDERN METHOD (SPECIFY) ______A
YES, TRADITIONAL METHOD (SPECIFY) _______B
NO Y