PILL: Women can take a pill every day to delay or avoid pregnancy.

01 PUBLIC HOSPITAL/MATERNITY
02 HEALTH CENTER/MOTHER-INFANT CENTER
03 PUBLIC CLINIC
04 AUTHORIZED CLINIC
05 PRIVATE OFFICE
06 PHARMACY
07 TRADITIONAL HEALER
08 ACQUAINTANCES
09 OTHER (SPECIFY) _____
98 DK

IUD: Women can have a plastic or metal coil or device placed inside their uterus by a doctor.

01 PUBLIC HOSPITAL/MATERNITY
02 HEALTH CENTER/MOTHER-INFANT CENTER
03 PUBLIC CLINIC
04 AUTHORIZED CLINIC
05 PRIVATE OFFICE
06 PHARMACY
07 TRADITIONAL HEALER
08 ACQUAINTANCES
09 OTHER (SPECIFY) _____
98 DK

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

01 PUBLIC HOSPITAL/MATERNITY
02 HEALTH CENTER/MOTHER-INFANT CENTER
03 PUBLIC CLINIC
04 AUTHORIZED CLINIC
05 PRIVATE OFFICE
06 PHARMACY
07 TRADITIONAL HEALER
08 ACQUAINTANCES
09 OTHER (SPECIFY) _____
98 DK

DIAPHRAGM/FOAM/JELLY: Women can place a sponge, suppository, diaphragm, jelly, or cream inside themselves before intercourse to avoid pregnancy.

01 PUBLIC HOSPITAL/MATERNITY
02 HEALTH CENTER/MOTHER-INFANT CENTER
03 PUBLIC CLINIC
04 AUTHORIZED CLINIC
05 PRIVATE OFFICE
06 PHARMACY
07 TRADITIONAL HEALER
08 ACQUAINTANCES
09 OTHER (SPECIFY) _____
98 DK

CONDOM: Men use a condom to avoid getting the woman pregnant.

01 PUBLIC HOSPITAL/MATERNITY
02 HEALTH CENTER/MOTHER-INFANT CENTER
03 PUBLIC CLINIC
04 AUTHORIZED CLINIC
05 PRIVATE OFFICE
06 PHARMACY
07 TRADITIONAL HEALER
08 ACQUAINTANCES
09 OTHER (SPECIFY) _____
98 DK

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

01 PUBLIC HOSPITAL/MATERNITY
02 HEALTH CENTER/MOTHER-INFANT CENTER
03 PUBLIC CLINIC
04 AUTHORIZED CLINIC
05 PRIVATE OFFICE
06 PHARMACY
07 TRADITIONAL HEALER
08 ACQUAINTANCES
09 OTHER (SPECIFY) _____
98 DK

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

01 PUBLIC HOSPITAL/MATERNITY
02 HEALTH CENTER/MOTHER-INFANT CENTER
03 PUBLIC CLINIC
04 AUTHORIZED CLINIC
05 PRIVATE OFFICE
06 PHARMACY
07 TRADITIONAL HEALER
08 ACQUAINTANCES
09 OTHER (SPECIFY) _____
98 DK

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

01 PUBLIC HOSPITAL/MATERNITY
02 HEALTH CENTER/MOTHER-INFANT CENTER
03 PUBLIC CLINIC
04 AUTHORIZED CLINIC
05 PRIVATE OFFICE
06 PHARMACY
07 TRADITIONAL HEALER
08 ACQUAINTANCES
09 OTHER (SPECIFY) _____
98 DK

PERIODIC ABSTINENCE: Some couples can avoid pregnancy by not having sexual intercourse on the days of the month she is most likely to get pregnant.

01 PUBLIC HOSPITAL/MATERNITY
02 HEALTH CENTER/MOTHER-INFANT CENTER
03 PUBLIC CLINIC
04 AUTHORIZED CLINIC
05 PRIVATE OFFICE
06 PHARMACY
07 TRADITIONAL HEALER
08 ACQUAINTANCES
09 OTHER (SPECIFY) _____
98 DK

MEDICAL PLANTS (bark, roots, leaves) are used by some women to delay or space out pregnancies.

01 PUBLIC HOSPITAL/MATERNITY
02 HEALTH CENTER/MOTHER-INFANT CENTER
03 PUBLIC CLINIC
04 AUTHORIZED CLINIC
05 PRIVATE OFFICE
06 PHARMACY
07 TRADITIONAL HEALER
08 ACQUAINTANCES
09 OTHER (SPECIFY) _____
98 DK

TALISMANS: (charm, cord with knot, etc) are used by some women to delay or space out pregnancies.

01 PUBLIC HOSPITAL/MATERNITY
02 HEALTH CENTER/MOTHER-INFANT CENTER
03 PUBLIC CLINIC
04 AUTHORIZED CLINIC
05 PRIVATE OFFICE
06 PHARMACY
07 TRADITIONAL HEALER
08 ACQUAINTANCES
09 OTHER (SPECIFY) _____
98 DK

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 ____________

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 period?

RESPONSE____

01 GOVERNMENT FP CLINIC
02 PRIVATE VOLUNTARY FP CLINIC
03 GOVERNMENT MCH CENTER
04 GOVERNMENT HOSPITAL
05 PRIVATE DOCTOR/CLINIC
06 PHARMACY
07 HOME DELIVERED
08 OTHER (SPECIFY)
13 NOWHERE
98 NOT SURE/DON'T KNOW

01 GOVERNMENT HOSPITAL
02 GOVERNMENT HEALTH CNTR
03 PPG CLINIC
04 PRIVATE MATERNITY HOME
05 FIELD WORKER
06 PRIVATE DOCTOR/CLINIC
07 GOVT MATERNITY HOME
08 PHARMACY/CHEM SELLER
09 CHRISTIAN COUNCIL
10 FRIENDS/RELATIVES
11 OTHER (SPECIFY)
12 NOWHERE
98 DOES NOT KNOW

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

LOCATION
OTHER ______

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

LOCATION
OTHER ______

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

LOCATION
OTHER ______

04) DIAPHRAGM/FOAM/JELLY 'Women can place a sponge, suppository, diaphragm, jelly or cream inside them before intercourse.'

LOCATION
OTHER ______

05) CONDOM 'Men can use a rubber sheath during sexual intercourse.'

LOCATION
OTHER ______

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

LOCATION
OTHER ______

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

LOCATION
OTHER ______

08) PERIODIC ABSTINENCE '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 periodic abstinence?

LOCATION
OTHER ______

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

1 PMI (protection maternelle et infantile - a program created in France to give free care to expecting/recent mothers)
2 FREE CLINIC
3 AMPPF (Malian Association of Family Protection and Promotion)
4 HEALTH CENTER
5 PHARMACY
6 OTHER (SPECIFY) ____
8 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.

1 PMI (protection maternelle et infantile - a program created in France to give free care to expecting/recent mothers)
2 FREE CLINIC
3 AMPPF (Malian Association of Family Protection and Promotion)
4 HEALTH CENTER
5 PHARMACY
6 OTHER (SPECIFY) ____
8 DOESN'T KNOW

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

1 PMI (protection maternelle et infantile - a program created in France to give free care to expecting/recent mothers)
2 FREE CLINIC
3 AMPPF (Malian Association of Family Protection and Promotion)
4 HEALTH CENTER
5 PHARMACY
6 OTHER (SPECIFY) ____
8 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.

1 PMI (protection maternelle et infantile - a program created in France to give free care to expecting/recent mothers)
2 FREE CLINIC
3 AMPPF (Malian Association of Family Protection and Promotion)
4 HEALTH CENTER
5 PHARMACY
6 OTHER (SPECIFY) ____
8 DOESN'T KNOW

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

1 PMI (protection maternelle et infantile - a program created in France to give free care to expecting/recent mothers)
2 FREE CLINIC
3 AMPPF (Malian Association of Family Protection and Promotion)
4 HEALTH CENTER
5 PHARMACY
6 OTHER (SPECIFY) ____
8 DOESN'T KNOW

FEMALE STERILIZATION Women can have an operation to avoid having any more children. Or is it possible to get sterilized?

1 PMI (protection maternelle et infantile - a program created in France to give free care to expecting/recent mothers)
2 FREE CLINIC
3 AMPPF (Malian Association of Family Protection and Promotion)
4 HEALTH CENTER
5 PHARMACY
6 OTHER (SPECIFY) ____
8 DOESN'T KNOW

MALE STERILIZATION Men can have an operation to avoid having any more children. Or is it possible to get sterilized?

1 PMI (protection maternelle et infantile - a program created in France to give free care to expecting/recent mothers)
2 FREE CLINIC
3 AMPPF (Malian Association of Family Protection and Promotion)
4 HEALTH CENTER
5 PHARMACY
6 OTHER (SPECIFY) ____
8 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. Or is it possible to get advice on using the rhythm method?

1 PMI (protection maternelle et infantile - a program created in France to give free care to expecting/recent mothers)
2 FREE CLINIC
3 AMPPF (Malian Association of Family Protection and Promotion)
4 HEALTH CENTER
5 PHARMACY
6 OTHER (SPECIFY) ____
8 DOESN'T KNOW

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

1 PMI (protection maternelle et infantile - a program created in France to give free care to expecting/recent mothers)
2 FREE CLINIC
3 AMPPF (Malian Association of Family Protection and Promotion)
4 HEALTH CENTER
5 PHARMACY
6 OTHER (SPECIFY) ____
8 DOESN'T KNOW

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

1 PMI (protection maternelle et infantile - a program created in France to give free care to expecting/recent mothers)
2 FREE CLINIC
3 AMPPF (Malian Association of Family Protection and Promotion)
4 HEALTH CENTER
5 PHARMACY
6 OTHER (SPECIFY) ____
8 DOESN'T KNOW

OTHER METHOD (SPECIFY) ____

1 PMI (protection maternelle et infantile - a program created in France to give free care to expecting/recent mothers)
2 FREE CLINIC
3 AMPPF (Malian Association of Family Protection and Promotion)
4 HEALTH CENTER
5 PHARMACY
6 OTHER (SPECIFY) ____
8 DOESN'T KNOW

01) PILL
Women can take a pill every day to delay or avoid pregnancy.

PUBLIC HOSPITAL 01
MATERNITY 02
HEALTH CENTER/REFERENCE CENTER 03
FREE CLINIC 04
HOME OR TRAVELLING VISIT 05
MOBILE TEAM 06
MOROCCAN ASSOCIATION FOR FAMILY PLANNING 07
PRIVATE CLINIC 08
PHARMACY 09
PRIVATE DOCTOR OR MIDWIFE 10
TRADITIONAL BIRTH ATTENDANT 11
RELATIVES, FRIENDS, OR NEIGHBORS 12
NO ONE 13
OTHER 14
DON'T KNOW 98

02) IUD
Women can have a plastic or metal coil or device placed inside their uterus by a doctor (or a midwife).

PUBLIC HOSPITAL 01
MATERNITY 02
HEALTH CENTER/REFERENCE CENTER 03
FREE CLINIC 04
HOME OR TRAVELLING VISIT 05
MOBILE TEAM 06
MOROCCAN ASSOCIATION FOR FAMILY PLANNING 07
PRIVATE CLINIC 08
PHARMACY 09
PRIVATE DOCTOR OR MIDWIFE 10
TRADITIONAL BIRTH ATTENDANT 11
RELATIVES, FRIENDS, OR NEIGHBORS 12
NO ONE 13
OTHER 14
DON'T KNOW 98

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

PUBLIC HOSPITAL 01
MATERNITY 02
HEALTH CENTER/REFERENCE CENTER 03
FREE CLINIC 04
HOME OR TRAVELLING VISIT 05
MOBILE TEAM 06
MOROCCAN ASSOCIATION FOR FAMILY PLANNING 07
PRIVATE CLINIC 08
PHARMACY 09
PRIVATE DOCTOR OR MIDWIFE 10
TRADITIONAL BIRTH ATTENDANT 11
RELATIVES, FRIENDS, OR NEIGHBORS 12
NO ONE 13
OTHER 14
DON'T KNOW 98

04) OTHER SCIENTIFIC METHODS
Women can place a diaphragm, a sponge, suppository, jelly, or cream inside themselves before intercourse to avoid pregnancy.

PUBLIC HOSPITAL 01
MATERNITY 02
HEALTH CENTER/REFERENCE CENTER 03
FREE CLINIC 04
HOME OR TRAVELLING VISIT 05
MOBILE TEAM 06
MOROCCAN ASSOCIATION FOR FAMILY PLANNING 07
PRIVATE CLINIC 08
PHARMACY 09
PRIVATE DOCTOR OR MIDWIFE 10
TRADITIONAL BIRTH ATTENDANT 11
RELATIVES, FRIENDS, OR NEIGHBORS 12
NO ONE 13
OTHER 14
DON'T KNOW 98

05) CONDOM
Men use a condom to avoid getting the woman pregnant.

PUBLIC HOSPITAL 01
MATERNITY 02
HEALTH CENTER/REFERENCE CENTER 03
FREE CLINIC 04
HOME OR TRAVELLING VISIT 05
MOBILE TEAM 06
MOROCCAN ASSOCIATION FOR FAMILY PLANNING 07
PRIVATE CLINIC 08
PHARMACY 09
PRIVATE DOCTOR OR MIDWIFE 10
TRADITIONAL BIRTH ATTENDANT 11
RELATIVES, FRIENDS, OR NEIGHBORS 12
NO ONE 13
OTHER 14
DON'T KNOW 98

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

PUBLIC HOSPITAL 01
MATERNITY 02
HEALTH CENTER/REFERENCE CENTER 03
FREE CLINIC 04
HOME OR TRAVELLING VISIT 05
MOBILE TEAM 06
MOROCCAN ASSOCIATION FOR FAMILY PLANNING 07
PRIVATE CLINIC 08
PHARMACY 09
PRIVATE DOCTOR OR MIDWIFE 10
TRADITIONAL BIRTH ATTENDANT 11
RELATIVES, FRIENDS, OR NEIGHBORS 12
NO ONE 13
OTHER 14
DON'T KNOW 98

07) VASECTOMY
Men can have an operation to avoid having any more children

PUBLIC HOSPITAL 01
MATERNITY 02
HEALTH CENTER/REFERENCE CENTER 03
FREE CLINIC 04
HOME OR TRAVELLING VISIT 05
MOBILE TEAM 06
MOROCCAN ASSOCIATION FOR FAMILY PLANNING 07
PRIVATE CLINIC 08
PHARMACY 09
PRIVATE DOCTOR OR MIDWIFE 10
TRADITIONAL BIRTH ATTENDANT 11
RELATIVES, FRIENDS, OR NEIGHBORS 12
NO ONE 13
OTHER 14
DON'T KNOW 98

08) PERIODIC ABSTINENCE
Some couples can avoid pregnancy by not having sexual intercourse on the days of the month she is most likely to get pregnant.

PUBLIC HOSPITAL 01
MATERNITY 02
HEALTH CENTER/REFERENCE CENTER 03
FREE CLINIC 04
HOME OR TRAVELLING VISIT 05
MOBILE TEAM 06
MOROCCAN ASSOCIATION FOR FAMILY PLANNING 07
PRIVATE CLINIC 08
PHARMACY 09
PRIVATE DOCTOR OR MIDWIFE 10
TRADITIONAL BIRTH ATTENDANT 11
RELATIVES, FRIENDS, OR NEIGHBORS 12
NO ONE 13
OTHER 14
DON'T KNOW 98

09) VAGINAL DOUCHING
After sexual intercourse, some women wash themselves with water or something else to avoid getting pregnant.

PUBLIC HOSPITAL 01
MATERNITY 02
HEALTH CENTER/REFERENCE CENTER 03
FREE CLINIC 04
HOME OR TRAVELLING VISIT 05
MOBILE TEAM 06
MOROCCAN ASSOCIATION FOR FAMILY PLANNING 07
PRIVATE CLINIC 08
PHARMACY 09
PRIVATE DOCTOR OR MIDWIFE 10
TRADITIONAL BIRTH ATTENDANT 11
RELATIVES, FRIENDS, OR NEIGHBORS 12
NO ONE 13
OTHER 14
DON'T KNOW 98

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

HOSPITAL, CLINIC, PRIVATE DOCTOR'S OFFICE 1
PUBLIC HOSPITAL 2
HEALTH CENTER 3
PMI 4
PHARMACY 5
OTHER (SPECIFY) _____ 6
DOESN'T KNOW 8

02. IUD: Women can have a loop or a coil placed inside them by a doctor or a nurse to avoid becoming pregnant.

HOSPITAL, CLINIC, PRIVATE DOCTOR'S OFFICE 1
PUBLIC HOSPITAL 2
HEALTH CENTER 3
PMI 4
PHARMACY 5
OTHER (SPECIFY) _____ 6
DOESN'T KNOW 8

03. INJECTIONS: Women can have an injection by a doctor, mid-wife or nurse to avoid becoming pregnant during many months.

HOSPITAL, CLINIC, PRIVATE DOCTOR'S OFFICE 1
PUBLIC HOSPITAL 2
HEALTH CENTER 3
PMI 4
PHARMACY 5
OTHER (SPECIFY) _____ 6
DOESN'T KNOW 8

04. OTHER SCIENTIFIC METHODS FOR THE WOMAN: Some women insert a diaphragm, a sponge, effervescent pills, jelly or cream before having sexual intercourse.

HOSPITAL, CLINIC, PRIVATE DOCTOR'S OFFICE 1
PUBLIC HOSPITAL 2
HEALTH CENTER 3
PMI 4
PHARMACY 5
OTHER (SPECIFY) _____ 6
DOESN'T KNOW 8

05. CONDOM: Men can put a rubber sheath on their penis before sexual intercourse so that their wife does not get pregnant.

HOSPITAL, CLINIC, PRIVATE DOCTOR'S OFFICE 1
PUBLIC HOSPITAL 2
HEALTH CENTER 3
PMI 4
PHARMACY 5
OTHER (SPECIFY) _____ 6
DOESN'T KNOW 8

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

HOSPITAL, CLINIC, PRIVATE DOCTOR'S OFFICE 1
PUBLIC HOSPITAL 2
HEALTH CENTER 3
PMI 4
PHARMACY 5
OTHER (SPECIFY) _____ 6
DOESN'T KNOW 8

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

HOSPITAL, CLINIC, PRIVATE DOCTOR'S OFFICE 1
PUBLIC HOSPITAL 2
HEALTH CENTER 3
PMI 4
PHARMACY 5
OTHER (SPECIFY) _____ 6
DOESN'T KNOW 8

08. 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. Where would you go to obtain advice about the using the rhythm method?

HOSPITAL, CLINIC, PRIVATE DOCTOR'S OFFICE 1
PUBLIC HOSPITAL 2
HEALTH CENTER 3
PMI 4
PHARMACY 5
OTHER (SPECIFY) _____ 6
DOESN'T KNOW 8

11. MEDICINAL PLANTS (bark, roots, leaves)

HOSPITAL, CLINIC, PRIVATE DOCTOR'S OFFICE 1
PUBLIC HOSPITAL 2
HEALTH CENTER 3
PMI 4
PHARMACY 5
OTHER (SPECIFY) _____ 6
DOESN'T KNOW 8

12. GRIS-GRIS (amulet cord, node, fass, galane)

HOSPITAL, CLINIC, PRIVATE DOCTOR'S OFFICE 1
PUBLIC HOSPITAL 2
HEALTH CENTER 3
PMI 4
PHARMACY 5
OTHER (SPECIFY) _____ 6
DOESN'T KNOW 8

13. OTHER METHOD (SPECIFY) _____

HOSPITAL, CLINIC, PRIVATE DOCTOR'S OFFICE 1
PUBLIC HOSPITAL 2
HEALTH CENTER 3
PMI 4
PHARMACY 5
OTHER (SPECIFY) _____ 6
DOESN'T KNOW 8

01 PILL Women can take a pill every day.

YES 1
NO 2

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

YES 1
NO 2

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

YES 1
NO 2

04 JELLY/DIAPAGM/ FOAM Women can place a sponge, suppository, jelly, or cream in their vagina before sexual intercourse.

_______
OTHER _____

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

_______
OTHER _____

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

_______
OTHER _____

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

_______
OTHER _____

08 PERIODIC ABSTINENCE Couples can avoid having sexual intercourse on certain days of the month when the woman is most likely to become pregnant.

Where would you go to obtain advice on periodic abstinence?

_______
OTHER _____

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

_______
OTHER _____

01 GOVERNMENT HOSPITAL
02 GOVERNMENT HEALTH CNTR
03 FAMILY PLANNING CLINIC
04 DISPENSARY
05 OTH, GOVT. HLTH FAC.
06 PHARMACY
07 MOBILE CLINIC
08 PRIVATE DOCTOR
09 PRIVATE HOSPITAL
10 FRIENDS AND RELATIVES
11 OTHERS (SPECIFY)
98 DON'T KNOW

01. PILL

MATERNAL AND CHILD HEALTH CENTER (PMI) 01
DISPENSARY 02
TOGOLESE ASSOCIATION FOR FAMILIAL WELL-BEING 03
HOSPITAL 04
HEALTH CENTER 05
PHARMACY 06
PRIVATE CLINIC 07
MARKET 08
RELIGIOUS MISSION 09
SCHOOL 10
OTHER (SPECIFY) __________ 11
DON'T KNOW 98

02. IUD

MATERNAL AND CHILD HEALTH CENTER (PMI) 01
DISPENSARY 02
TOGOLESE ASSOCIATION FOR FAMILIAL WELL-BEING 03
HOSPITAL 04
HEALTH CENTER 05
PHARMACY 06
PRIVATE CLINIC 07
MARKET 08
RELIGIOUS MISSION 09
SCHOOL 10
OTHER (SPECIFY) __________ 11
DON'T KNOW 98

03. INJECTIONS

MATERNAL AND CHILD HEALTH CENTER (PMI) 01
DISPENSARY 02
TOGOLESE ASSOCIATION FOR FAMILIAL WELL-BEING 03
HOSPITAL 04
HEALTH CENTER 05
PHARMACY 06
PRIVATE CLINIC 07
MARKET 08
RELIGIOUS MISSION 09
SCHOOL 10
OTHER (SPECIFY) __________ 11
DON'T KNOW 98

04. CREAM/JELLY/PILL/SPERMICIDE

MATERNAL AND CHILD HEALTH CENTER (PMI) 01
DISPENSARY 02
TOGOLESE ASSOCIATION FOR FAMILIAL WELL-BEING 03
HOSPITAL 04
HEALTH CENTER 05
PHARMACY 06
PRIVATE CLINIC 07
MARKET 08
RELIGIOUS MISSION 09
SCHOOL 10
OTHER (SPECIFY) __________ 11
DON'T KNOW 98

05. CONDOM

MATERNAL AND CHILD HEALTH CENTER (PMI) 01
DISPENSARY 02
TOGOLESE ASSOCIATION FOR FAMILIAL WELL-BEING 03
HOSPITAL 04
HEALTH CENTER 05
PHARMACY 06
PRIVATE CLINIC 07
MARKET 08
RELIGIOUS MISSION 09
SCHOOL 10
OTHER (SPECIFY) __________ 11
DON'T KNOW 98

6) FEMALE STERILIZATION: Where can you get this operation?

MATERNAL AND CHILD HEALTH CENTER (PMI) 01
DISPENSARY 02
TOGOLESE ASSOCIATION FOR FAMILIAL WELL-BEING 03
HOSPITAL 04
HEALTH CENTER 05
PHARMACY 06
PRIVATE CLINIC 07
MARKET 08
RELIGIOUS MISSION 09
SCHOOL 10
OTHER (SPECIFY) __________ 11
DON'T KNOW 98

07. MALE STERILIZATION: Where can one get this operation?

MATERNAL AND CHILD HEALTH CENTER (PMI) 01
DISPENSARY 02
TOGOLESE ASSOCIATION FOR FAMILIAL WELL-BEING 03
HOSPITAL 04
HEALTH CENTER 05
PHARMACY 06
PRIVATE CLINIC 07
MARKET 08
RELIGIOUS MISSION 09
SCHOOL 10
OTHER (SPECIFY) __________ 11
DON'T KNOW 98

08. PERIODIC ABSTINENCE (OGINO): Where would you go to get advice on OGINO?

MATERNAL AND CHILD HEALTH CENTER (PMI) 01
DISPENSARY 02
TOGOLESE ASSOCIATION FOR FAMILIAL WELL-BEING 03
HOSPITAL 04
HEALTH CENTER 05
PHARMACY 06
PRIVATE CLINIC 07
MARKET 08
RELIGIOUS MISSION 09
SCHOOL 10
OTHER (SPECIFY) __________ 11
DON'T KNOW 98

11. MEDICAL PLANTS

MATERNAL AND CHILD HEALTH CENTER (PMI) 01
DISPENSARY 02
TOGOLESE ASSOCIATION FOR FAMILIAL WELL-BEING 03
HOSPITAL 04
HEALTH CENTER 05
PHARMACY 06
PRIVATE CLINIC 07
MARKET 08
RELIGIOUS MISSION 09
SCHOOL 10
OTHER (SPECIFY) __________ 11
DON'T KNOW 98

12. TALISMANS

MATERNAL AND CHILD HEALTH CENTER (PMI) 01
DISPENSARY 02
TOGOLESE ASSOCIATION FOR FAMILIAL WELL-BEING 03
HOSPITAL 04
HEALTH CENTER 05
PHARMACY 06
PRIVATE CLINIC 07
MARKET 08
RELIGIOUS MISSION 09
SCHOOL 10
OTHER (SPECIFY) __________ 11
DON'T KNOW 98

13) OTHER METHODS

MATERNAL AND CHILD HEALTH CENTER (PMI) 01
DISPENSARY 02
TOGOLESE ASSOCIATION FOR FAMILIAL WELL-BEING 03
HOSPITAL 04
HEALTH CENTER 05
PHARMACY 06
PRIVATE CLINIC 07
MARKET 08
RELIGIOUS MISSION 09
SCHOOL 10
OTHER (SPECIFY) __________ 11
DON'T KNOW 98

01 HOSPITAL/MATERNITY
02 CLINIC
03 DISPENSARY
04 MOBILE UNIT
05 FAMILY PLANNING CLINIC
06 MEDICAL-SOCIAL CENTER
07 PRIVATE DOCTOR'S OFFICE/CLINIC
08 PHARMACY
09 FRIENDS/NEIGHBORS/KABLA ARBI [##TRANSLATOR NOTE: TRANSLATION UNAVAILABLE]
10 OTHER
98 DON'T KNOW

01 PILL Women can take a pill every day.

OTHER ____________

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

OTHER ____________

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

OTHER ____________

04 DIAPHRAGM/FOAM/JELLY Women can place jelly, cream, tablets, or a diaphragm around the neck of the womb before intercourse.

OTHER ____________

05 CONDOM Men can wear a rubber sheath during sexual intercourse.

OTHER ____________

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

OTHER ____________

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

OTHER ____________

08 PERIODIC ABSTINENCE 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 periodic abstinence?

OTHER ____________

10 ANY OTHER METHODS? Have you ever heard of any other ways or methods that women or men can use to avoid pregnancy?

OTHER ____________

01 GOVERNMENT HOSPITAL
02 GOVERNMENT HEALTH CENTER
03 FPAU CLINIC
04 MOBILE CLINIC
05 FIELD WORKER
06 PRIVATE DOCTOR
07 PRIVATE HOSPITAL OR CLINIC
08 PHARMACY/SHOP
09 CHURCH
10 FRIENDS/RELATIVES
11 TRADITIONAL HEALER
12 OTHER (SPECIFY)
13 NOWHERE
98 DON'T KNOW

01 MOH HOSPITAL/CLINIC
02 ZXFPC CLINIC
03 MUNICIPALITY/LOCAL GOVERNMENT CLINIC
04 COMMERCE/INDUSTRY
05 MISSION/CHURCH
06 PRIVATE DOCTOR/PHARMACY
07 RURAL COUNCIL CLINIC
08 FRIEND/RELATIVE
09 TRADITIONAL HEALER
10 OTHER (SPECIFY) __________
11 NOWHERE
98 DON'T KNOW

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

PLACE FROM LIST ___
OTHER __________

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

PLACE FROM LIST ___
OTHER __________

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

PLACE FROM LIST ___
OTHER __________

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

PLACE FROM LIST ___
OTHER __________

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

PLACE FROM LIST ___
OTHER __________

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

PLACE FROM LIST ___
OTHER __________

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

PLACE 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: Where would you go to obtain instructions for using the safe period?

PLACE FROM LIST ___
OTHER __________

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

PLACE 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?

PLACE FROM LIST ___
OTHER (SPECIFY) __________