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Jordan 2009
Jordan 2012
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Jordan 2009
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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 
314. CHECK 304:
CHECK METHOD CODE:
IF MORE THAN ONE METHOD CODE CIRCLED IN 304, CIRCLE CODE FOR HIGHEST METHOD IN LIST.

NO CODE CIRCLED 00 (GO TO 324)
FEMALE STERILIZATION 01 (GO TO 317A)
MALE STERILIZATION 02 (GO TO 326)
IUD 03
INJECTABLES 04
IMPLANTS 05
PILL 06
CONDOM 07
FEMALE CONDOM 08
DIAPHRAGM 09
FOAM/JELLY 10
LACTATIONAL AMEN. METHOD 11 (GO TO 315A)
RHYTHM METHOD 12 (GO TO 315A)
WITHDRAWAL 13 (GO TO 326)
OTHER MODERN METHOD 95 (GO TO 326)
OTHER TRADITIONAL METHOD (GO TO 326)