01 PILL Women can take a pill every day.

RESPONSE ____________

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

RESPONSE ____________

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

RESPONSE ____________

05 FOAM/JELLY Women can place a sponge, suppository, jelly or cream inside the before intercourse.

RESPONSE ____________

06 CONDOM Men can use a rubber sheath during sexual intercourse.

RESPONSE ____________

07 FEMALE STERILIZATION Women can deliberately choose to have an operation to avoid having any more children.

RESPONSE ____________

08 MALE STERILIZATION Men can deliberately choose to have an operation to avoid having any more children.

RESPONSE ____________

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

RESPONSE ____________

10 SAFE PERIOD Couples can avoid having sexual intercourse on certain days of the month when the woman is more likely to become pregnant.
Where would you go to obtain advice on safe peried?

RESPONSE ____________

11 PROLONGED BREASTFEEDING Women can prolong the time that they breastfeed their babies to delay the next pregnancy.

RESPONSE ____________

02 NOT EFFECTIVE
04 HUSBAND DISAPPROVES
05 OTH RELAT DISAPPROVE
06 RELIGIOUS PROHIBITIONS
07 SIDE EFFECTS FOR WOMAN
08 SIDE EFFECTS FOR CHILD
09 METHOD PERMANENT
11 DIFFICULT TO OBTAIN
12 COSTS TOO MUCH
13 INCONVENIENT TO USE
18 OTHER (SPECIFY)
96 NO PROBLEM
98 NOT SURE/DON'T KNOW

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

01 NOTHING
02 ACCESSIBILITY/AVAILABILITY
03 COST
04 SECONDARY EFFECTS
05 INEFFECTIVE METHOD
06 HUSBAND OPPOSED
07 OTHER (SPECIFY) _____
98 DOESN'T KNOW

IUD Women can have a loop or a coil in plastic or metal placed inside their uterus by a doctor or a nurse to avoid becoming pregnant.

01 NOTHING
02 ACCESSIBILITY/AVAILABILITY
03 COST
04 SECONDARY EFFECTS
05 INEFFECTIVE METHOD
06 HUSBAND OPPOSED
07 OTHER (SPECIFY) _____
98 DOESN'T KNOW

INJECTIONS Women can have an injection by a health provider to avoid becoming pregnant during one or more months.

01 NOTHING
02 ACCESSIBILITY/AVAILABILITY
03 COST
04 SECONDARY EFFECTS
05 INEFFECTIVE METHOD
06 HUSBAND OPPOSED
07 OTHER (SPECIFY) _____
98 DOESN'T KNOW

CREAM, JELLY, SPONGE Some women put a diaphragm, a sponge, effervescent pills, jelly or cream before having sexual intercourse to avoid getting pregnant.

01 NOTHING
02 ACCESSIBILITY/AVAILABILITY
03 COST
04 SECONDARY EFFECTS
05 INEFFECTIVE METHOD
06 HUSBAND OPPOSED
07 OTHER (SPECIFY) _____
98 DOESN'T KNOW

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

01 NOTHING
02 ACCESSIBILITY/AVAILABILITY
03 COST
04 SECONDARY EFFECTS
05 INEFFECTIVE METHOD
06 HUSBAND OPPOSED
07 OTHER (SPECIFY) _____
98 DOESN'T KNOW

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

01 NOTHING
02 ACCESSIBILITY/AVAILABILITY
03 COST
04 SECONDARY EFFECTS
05 INEFFECTIVE METHOD
06 HUSBAND OPPOSED
07 OTHER (SPECIFY) _____
98 DOESN'T KNOW

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

01 NOTHING
02 ACCESSIBILITY/AVAILABILITY
03 COST
04 SECONDARY EFFECTS
05 INEFFECTIVE METHOD
06 HUSBAND OPPOSED
07 OTHER (SPECIFY) _____
98 DOESN'T KNOW

PERIODIC ABSTINENCE Every month that a woman is sexually active she can avoid pregnancy by not having intercourse on the days of the month she is most likely to get pregnant.

01 NOTHING
02 ACCESSIBILITY/AVAILABILITY
03 COST
04 SECONDARY EFFECTS
05 INEFFECTIVE METHOD
06 HUSBAND OPPOSED
07 OTHER (SPECIFY) _____
98 DOESN'T KNOW

MEDICINAL PLANTS (stem, root, leaves) are products that can use to delay pregnancy.

01 NOTHING
02 ACCESSIBILITY/AVAILABILITY
03 COST
04 SECONDARY EFFECTS
05 INEFFECTIVE METHOD
06 HUSBAND OPPOSED
07 OTHER (SPECIFY) _____
98 DOESN'T KNOW

AMULET (cord with a knot) are things couples can use to delay pregnancy.

01 NOTHING
02 ACCESSIBILITY/AVAILABILITY
03 COST
04 SECONDARY EFFECTS
05 INEFFECTIVE METHOD
06 HUSBAND OPPOSED
07 OTHER (SPECIFY) _____
98 DOESN'T KNOW

OTHER METHOD (SPECIFY) _____

01 NOTHING
02 ACCESSIBILITY/AVAILABILITY
03 COST
04 SECONDARY EFFECTS
05 INEFFECTIVE METHOD
06 HUSBAND OPPOSED
07 OTHER (SPECIFY) _____
98 DOESN'T KNOW

02 NOT EFFECTIVE
03 HUSBAND DISAPPROVES
04 HEALTH CONCERNS
05 ACCESS/AVAILABILITY
06 COSTS TOO MUCH
07 INCONVENIENT TO USE
09 METHOD PERMANENT
11 OTHER (SPECIFY) __________
12 NONE
98 DON'T KNOW

01. PILL Women can take a pill by mouth every day.

PROBLEM FROM LIST ___
OTHER __________

02. LOOP Women can have a loop or IUD inserted in their wombs by a doctor or a nurse.

PROBLEM FROM LIST ___
OTHER __________

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

PROBLEM FROM LIST ___
OTHER __________

04. DIAPHRAGM Women can place a diaphragm or pessary inside them before intercourse.

PROBLEM FROM LIST ___
OTHER __________

05. CONDOM OR DUREX Men can use a rubber during sexual intercourse.

PROBLEM FROM LIST ___
OTHER __________

06. FEMALE STERILIZATION Women can have an operation to avoid having any more children.

PROBLEM FROM LIST ___
OTHER __________

07. MALE STERILIZATION Men can have an operation to avoid having any more children.

PROBLEM FROM LIST ___
OTHER __________

08. SAFE PERIOD Couples can avoid having sexual intercourse on certain days of the month when the woman is more likely to become pregnant.

PROBLEM FROM LIST ___
OTHER __________

09. WITHDRAWAL Men can be careful and pull out before ejaculation.

PROBLEM FROM LIST ___
OTHER __________

10. FOAM/JELLY/FOAMING TABLETS Women can insert foam or jelly or foaming tablets inside them before intercourse.

PROBLEM FROM LIST ___
OTHER __________

11. ANY OTHER METHODS? Have you heard of any other ways or methods that women or men can use to avoid pregnancy? (SPECIFY) __________

PROBLEM FROM LIST ___
OTHER __________