Survey Text

Afghanistan 2015 India 2005 Madagascar 2008 Uganda 2006
Angola 2015 Jordan 2012 Pakistan 2017 Zambia 2001
Burundi 2016 Jordan 2017 Senegal 2017
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Afghanistan 2015
Survey form view entire document:  text 
304. Which method are you using? CIRCLE ALL MENTIONED.

IF MORE THAN ONE METHOD MENTIONED, FOLLOW SKIP INSTRUCTION FOR HIGHEST METHOD IN LIST.

FEMALE STERILIZATION A (GO TO 307)
MALE STERILIZATION B (GO TO 307)
IUD C (GO TO 308A)
INJECTABLES D (GO TO 308A)
IMPLANTS E (GO TO 308A)
PILL F
MALE CONDOM G (GO TO 306)
LACTATIONAL AMEN. METHOD K (GO TO 308A)
RHYTHM METHOD L (GO TO 308A)
WITHDRAWAL M (GO TO 308A)
OTHER MODERN METHOD X (GO TO 308A)
OTHER TRADITIONAL METHOD Y (GO TO 308A)

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Angola 2015
Survey form view entire document:  text 
304) Which method are you using?
RECORD ALL ANSWERS. IF MORE THAN ONE METHOD MENTIONED, FOLLOW GO INSTRUCTION FOR HIGHEST METHOD IN LIST.

FEMALE STERILIZATION A (GO TO 306)
MALE STERILIZATION B (GO TO 306)
IUD C (GO TO 308)
INJECTABLES D (GO TO 308)
IMPLANTS E (GO TO 308)
PILL F
CONDOM G (GO TO 308)
FEMALE CONDOM H (GO TO 308)
EMERGENCY CONTRACEPTION I (GO TO 308)
STANDARD DAYS METHOD J (GO TO 308)
LACTATIONAL AMEN. METHOD K (GO TO 308)
PERIODIC ABSTINENCE L (GO TO 308)
WITHDRAWAL M (GO TO 308)
OTHER MODERN METHOD X (GO TO 308)
OTHER TRADITIONAL METHODS Y(GO TO 308)

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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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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 
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)

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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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Madagascar 2008
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. 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 that stops them from becoming pregnant for up to 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. LACTATIONAL AMENORRHEA METHOD (LAM): For up to six months after giving birth, a woman can use this method which requires breastfeeding often, day and night, so that her menstrual cycle does not return.
YES 1
NO 2 (GO TO NEXT METHOD)
10. 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)
11. WITHDRAWAL: Men can be careful and pull out before climax.
YES 1
NO 2 (GO TO NEXT METHOD)
12. 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)
13. NECKLACE METHOD: A method involving moving a ring on a necklace each day from one pearl to the next, counting from the first day of her period. Using this necklace, the woman can know the days of the month where she is more likely to become pregnant.
YES 1
NO 2 (GO TO NEXT METHOD)
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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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 
304) Which method are you using?

CIRCLE ALL MENTIONED.
IF MORE THAN ONE METHOD MENTIONED, FOLLOW SKIP INSTRUCTION FOR HIGHEST METHOD IN LIST.

FEMALE STERILIZATION A (GO TO 307)
MALE STERILIZATION B (GO TO 307)
IUD C (GO TO 309)
INJECTABLES D (GO TO 309)
IMPLANTS E (GO TO 309)
PILL F
CONDOM G (GO TO 306)
FEMALE CONDOM H (GO TO 306)
EMERGENCY CONTRACEPTION I (GO TO 309)
STANDARD DAYS METHOD J (GO TO 309)
LACTATIONAL AMEN. METHOD K (GO TO 309)
RHYTHM METHOD L (GO TO 309)
WITHDRAWAL M (GO TO 309)
OTHER MODERN METHOD X (GO TO 309)
OTHER TRADITIONAL METHOD Y (GO TO 309)

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Uganda 2006
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? (1)
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 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 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)

The LAM method should be deleted in countries that do not have a LAM program.

09 LACTATIONAL AMENORRHEA METHOD (LAM) (2)
YES 1
NO 2 (GO TO NEXT METHOD)
10 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)
11 WITHDRAWAL Men can be careful and pull out before climax.
YES 1
NO 2 (GO TO NEXT METHOD)
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 (GO TO NEXT METHOD)
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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Zambia 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 FOAM TABLETS, DIAPHRAGM OR JELLY Women can place a suppository, a diaphragm, jelly, or cream in their vagina before intercourse.
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, and that her menstrual period has not returned.
YES 1
NO 2
11 RHYTHM OR NATURAL FAMILY PLANNING 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 EMERGENCY CONTRACEPTION Women can take pills up to three days after sexual intercourse to avoid becoming pregnant.
YES 1
NO 2
14 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