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Burkina Faso 2017 Round 5 Female Questionnaire

READ THIS WARNING: This female questionnaire is not linked to a household questionnaire.

ONLY continue if there is no linked female questionnaire under the "Edit Saved Form" Menu.

Press OK to continue

[] OK

Did you check the Edit Saved forms menu for a linked female questionnaire?

[] Yes
[] No

Provide your signature to acknowledge that there is no linked female questionnaire.

Close and exit this form without saving. Look for a linked female questionnaire through the 'Edit Saved Forms' Menu.

Region:

Province:

Commune:

Enumeration Area:

Structure number:

Household number:

001a. Are you in the correct household?

EA: ${EA}
Structure #: ${structure}
Household #: ${household}

Go to the right household.

[] Yes
[] No

002. Your ID:

Is this your ID?

[] Yes
[] No

002. Enter your ID below.

Please record your ID

003a. Current date and time.

Is this date and time correct?

[] Yes
[] No

003b. Record the correct date and time.

The date must be between 2017-08-01 and 2018-08-01.

004a. The following info is from the household questionnaire. Please review to make sure you are interviewing the correct respondent.

004a. The following info is what you provided previously. Please review.

Region: ${level1_unlinked}

Province: ${level2_unlinked}

Commune: ${level3_unlinked}

Enumeration Area: ${EA_unlinked}

Structure number: ${structure_unlinked}

Household number: ${household_unlinked}

004b. Is the above information correct?

Go to the right household or update the Household Roster if needed.

[] Yes
[] No

005. CHECK: You should be attempting to interview ${firstname}. Is that correct?

If misspelled, select "yes" and update the name in question "011."

If this is the wrong person, you have two options:

(1) exit and ignore changes to this form. Open the correct form.

Or

(2) find and interview the person whose name appears above.

You must interview the right person.

[] Yes
[] No

006. Is the respondent present and available to be interviewed today?

[] Yes
[] No

007. How well acquainted are you with the respondent?

[] Very well acquainted
[] Well acquainted
[] Not well acquainted
[] Not acquainted

008. Has the respondent previously participated in PMA 2020 surveys?

[] Yes
[] No
[] Do not know
[] No response

INFORMED CONSENT

Find the woman between the age of 15-49 associated with this Female Respondent Questionnaire. The interview must have auditory privacy. Read the following greeting

Hello. My name is ____________________________________ and I am working for the Institut Supérieur des Sciences de la Population (ISSP). We are conducting a local survey that asks women about various reproductive health issues. We would very much appreciate your participation in this survey. This information will help us inform the government to better plan health services. The survey usually takes between 15 and 20 minutes to complete. Whatever information you provide will be kept strictly confidential and will not be shown to anyone other than members of our survey team.

Participation in this survey is voluntary, and if we should come to any question you don't want to answer, just let me know and I will go on to the next question; or you can stop the interview at any time. However, we hope that you will participate in this survey since your views are important.

At this time, do you want to ask me anything about the survey?

009a. Provide a paper copy of the Consent Form to the respondent and explain it. Then, ask: May I begin the interview now?

[] Yes
[] No

009b. Respondent's signature

WARNING: The respondent has not signed or checked the box, despite agreeing to be interviewed. To conduct the survey, the respondent must sign or touch the checkbox.

You may go back to obtain a signature or check the box or you should go back to question H to indicate the respondent does not want to be interviewed.

010. Interviewer's ID: ${your_name}

Mark your ID as a witness to the consent process.

[] NA

010. Interviewer's ID

Please record your ID as a witness to the consent process. You previously entered "${name_typed}."

That is not what you entered for your ID earlier in this survey.

011. Respondent's first name.

You may correct the spelling here if it is not correct, but you must be interviewing the person whose name appears below.

Section 1: Respondent's Background, Marital Status, Household characteristics

Now I would like to ask about your background and socioeconomic conditions.

101. In what month and year were you born?

The age in the household roster is ${age}

The date cannot be in the future

101. In what month and year were you born?

The date cannot be in the future

Month:

[] January
[] February
[] March
[] April
[] May
[] June
[] July
[] August
[] September
[] October
[] November
[] December
[] Do not know

Year:

102. How old were you at your last birthday?

Age must be less than 130.
Must agree with 101.

Age in the Household Roster:

WARNING: The age you entered for 102 is ${FQ_age}, which makes her ineligible for interview. She must be at least 15 years old and not more than 49 years old.

If that age is correct, update her age on this screen, hit the back key, and save changes to exit the interview. This form will be deleted automatically upon saving it.

If that age is not correct, go back to the previous screen and enter the correct age.

WARNING: The age you entered for 102 is ${FQ_age}. This does not agree with the household roster, but she is still eligible to be interviewed. If 102 is correct update the age on this screen to ${FQ_age}. Otherwise, return to the previous screen and enter the correct age.

103. What is the highest level of school you attended?

Only record formal schooling. Do not record bible or koranic school or short courses.

[] Never attended
[] Primary
[] Secondary (first cycle)
[] Secondary (second cycle)
[] Tertiary
[] No response

104. Are you currently married or living together with a man as if married?

Probe: If no, ask whether the respondent is divorced, separated, or widowed.

[] Yes, currently married
[] Yes, living with a man
[] Not currently in union: Divorced / separated
[] Not currently in union: Widow
[] No, never in union
[] No response

105. Have you been married or lived with a man only once or more than once?

[] Only once
[] More than once
[] No response

106a. In what month and year did you start living with your FIRST husband / partner?

Select 'Do not know' for month and '2020' for year to indicate 'No Response'.

Month:

[] January
[] February
[] March
[] April
[] May
[] June
[] July
[] August
[] September
[] October
[] November
[] December
[] Do not know

Year:

If entering '2020' for No Response, must select 'Do not know' for month.

106b. CHECK: Based on the response you entered in 106a, the respondent was possibly 15 years old or younger at the time of her first marriage.

Did you enter 106a correctly?

[] Yes
[] No

107a. Now I would like to ask about when you started living with your CURRENT or MOST RECENT husband / partner. In what month and year was that?

Select 'Do not know' for month and '2020' for year to indicate 'No Response'.

Month:

[] January
[] February
[] March
[] April
[] May
[] June
[] July
[] August
[] September
[] October
[] November
[] December
[] Do not know

Year:

If entering '2020' for No Response, must select 'Do not know' for month.

107b. CHECK: Based on the response you entered in 107a, the respondent was possibly 15 years old or younger at the time of her current or most recent marriage.

Did you enter 107a correctly?

[] Yes
[] No

108. Does your husband / partner have other wives or does he live with other women as if married?

[] Yes
[] No
[] Do not know
[] No response

Section 2: Reproduction, Pregnancy and Fertility Preferences

Now I would like to ask about all the births you have had during your life.

200. Now I would like to ask about all the births you have had during your life. Have you ever given birth?

[] Yes
[] No
[] No response

201. How many times have you given birth?

Enter -99 for no response.

205. When was your FIRST birth?

Please record the date of the FIRST birth. The date should be found by calculating backwards from memorable events if needed.

Select 'Do not know' for month and '2020' for year to indicate 'No Response'.

Month:

[] January
[] February
[] March
[] April
[] May
[] June
[] July
[] August
[] September
[] October
[] November
[] December
[] Do not know

Year:

If entering '2020' for No Response, must select 'Do not know' for month.

Cannot be in future.

206. When was your MOST RECENT birth?

Select 'Do not know' for month and '2020' for year to indicate 'No Response'.

Month:

[] January
[] February
[] March
[] April
[] May
[] June
[] July
[] August
[] September
[] October
[] November
[] December
[] Do not know

Year:

If entering '2020' for No Response, must select 'Do not know' for month.

Cannot be in future.

210a. Are you pregnant now?

[] Yes
[] No
[] Unsure
[] No response

210b. How many months pregnant are you?

Please record the number of completed months. Enter -88 for do not know, -99 for No response.

Value must be at least 0 and not more than 10. A current pregnancy must start after the most recent birth.

209. When did your last menstrual period start?

If you select days, weeks, months, or years, you will enter a number for X on the next screen. Enter 0 days for today, not 0 weeks/months/years.

[] X days ago
[] X weeks ago
[] X months ago
[] X years ago
[] Menopausal / Hysterectomy
[] Before last birth
[] Never menstruated
[] No response

You entered "Never menstruated" in 209 but the respondent 206 indicates she previously gave birth. Is that what she said?

If no, return to the previous screen and change the response.

Invalid. Go back

[] Yes
[] No

209a. Enter ${menstrual_period_lab}

Enter 0 days for today, not 0 weeks/months/years.

Must be 0 days or larger. Must be 1 week/month/year or larger.

You entered that the respondent is ${months_pregnant} months pregnant, but she said her last menstrual period started ${menstrual_period_value} (${menstrual_period_lab}) ago. Is that what she said?

If no, return to the previous screen and change the response.

Invalid. Go back

[] Yes
[] No

You entered "Never menstruated" in 209 but 210a indicates that the respondent is pregnant currently. Is that what she said?

If no, return to the previous screen and change the response.

Invalid. Go back

[] Yes
[] No

213a. Now I would like to ask a question about your last birth.

213b. Now I would like to ask a question about your current pregnancy.

At the time you became pregnant, did you want to become pregnant then, did you want to wait until later, or did you not want to have any more children at all?

[] Then
[] Later
[] Not at all
[] No response

At the time you became pregnant, did you want to become pregnant then, did you want to wait until later, or did you not want to have any children at all?

[] Then
[] Later
[] Not at all
[] No response

Now I have some questions about the future.

211a. Would you like to have a child or would you prefer not to have any children?

[] Have a child
[] Prefer no children
[] Says she can't get pregnant
[] Undecided / Don't know
[] No response

211a. Would you like to have another child or would you prefer not to have any more children?

[] Have another child
[] No more
[] Says she can't get pregnant
[] Undecided / Don't know
[] No response

211b. After the child you are expecting now, would you like to have another child or would you prefer not to have any more children?

[] Have another child
[] No more
[] Says she can't get pregnant
[] Undecided / Don't know
[] No response

212a. How long would you like to wait from now before the birth of a child?

If you select months or years, you will enter a number for X on the next screen.

Select "Years" if more than 36 months.

Please check that you correctly entered the value for months/years.

[] X months
[] X years
[] Soon/now
[] Says she can't get pregnant
[] Other
[] Don't know
[] No response

212a. How long would you like to wait from now before the birth of another child?

If you select months or years, you will enter a number for X on the next screen.

Select "Years" if more than 36 months.

Please check that you correctly entered the value for months/years.

[] X months
[] X years
[] Soon/now
[] Says she can't get pregnant
[] Other
[] Don't know
[] No response

212b. After the birth of the child you are expecting now, how long would you like to wait before the birth of another child?

If you select months or years, you will enter a number for X on the next screen.

Select "Years" if more than 36 months.

Please check that you correctly entered the value for months/years.

[] X months
[] X years
[] Soon/now
[] Says she can't get pregnant
[] Other
[] Don't know
[] No response

212c. Enter the number of ${waitchild} you would like to wait:

Use years if more than 36 months.

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.

An image will appear on the screen for some methods. If the respondent says that she has not heard of the method or if she hesitates to answer, read the probe aloud and show her the image, if available.

301a. Have you ever heard of female sterilization?

PROBE: Women can have an operation to avoid having any more children.

[] Yes
[] No
[] No response

301b. Have you ever heard of male sterilization?

PROBE: Men can have an operation to avoid having any more children.

[] Yes
[] No
[] No response

301c. Have you ever heard of the contraceptive implant?

PROBE: Women can have one or several small rods placed in her upper arm by a doctor or nurse, which can prevent pregnancy for one or more years.

[] Yes
[] No
[] No response

301d. Have you ever heard of the IUD?

PROBE: Women can have a loop or coil placed inside them by a doctor or a nurse.

[] Yes
[] No
[] No response

301e. Have you ever heard of injectables?

PROBE: Women can have an injection by a health provider that stops them from becoming pregnant for one or more months.

[] Yes
[] No
[] No response

301f. Have you ever heard of the (birth control) pill?

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

[] Yes
[] No
[] No response

301g. Have you ever heard of emergency contraception?

PROBE: As an emergency measure after unprotected sexual intercourse women can take special pills at any time within three to five days to prevent pregnancy.

[] Yes
[] No
[] No response

301h. Have you ever heard of condoms?

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

[] Yes
[] No
[] No response

301i. Have you ever heard of female condoms?

PROBE: Women can put a sheath in their vagina before sexual intercourse.

[] Yes
[] No
[] No response

301j. Have you ever heard of the diaphragm?

PROBE: Women can place a thin flexible disk in their vagina before sexual intercourse.

[] Yes
[] No
[] No response

301k. Have you ever heard of foam or jelly as a contraceptive method?

PROBE: Women can place a suppository, jelly, or cream in their vagina before sexual intercourse to prevent pregnancy.

[] Yes
[] No
[] No response

301l. Have you ever heard of the standard days method or Cycle Beads?

PROBE: A Woman can use a string of colored beads to know the days she can get pregnant. On the days she can get pregnant, she and her partner use a condom or do not have sexual intercourse.

[] Yes
[] No
[] No response

301m. Have you ever heard of the Lactational Amenorrhea Method or LAM?

[] Yes
[] No
[] No response

301n. Have you ever heard of the rhythm method?

PROBE: Women can avoid pregnancy by not having sexual intercourse on the days of the month they think they can get pregnant.

[] Yes
[] No
[] No response

301o. Have you ever heard of the withdrawal method?

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

[] Yes
[] No
[] No response

301p. Have you ever heard of any other ways or methods that women or men can use to avoid pregnancy?

[] Yes
[] No
[] No response

302a. Are you or your partner currently doing something or using any method to delay or avoid getting pregnant?

[] Yes
[] No
[] No response

302b. Which method or methods are you using?

PROBE: Anything else?

Select all methods mentioned. SCROLL TO THE BOTTOM to see all choices.

You selected no response with another option.

[] Female sterilization
[] Male sterilization
[] Implant
[] IUD
[] Injectables
[] Pill
[] Emergency Contraception
[] Male condom
[] Female condom
[] Diaphragm
[] Foam/Jelly
[] Standard Days/Cycle beads
[] LAM
[] Rhythm method
[] Withdrawal
[] Other traditional method
[] No response

CALC_CM. CALCULATE: CURRENT METHOD

THIS WILL NOT APPEAR ON THE SCREEN

ODK will identify the most effective method currently being used by the respondent by selecting the highest method in the choice list

[] Female sterilization
[] Male sterilization
[] Implant
[] IUD
[] Injectables
[] Pill
[] Emergency Contraception
[] Male condom
[] Female condom
[] Diaphragm
[] Foam/Jelly
[] Standard Days/Cycle beads
[] LAM
[] Rhythm method
[] Withdrawal
[] Other traditional method
[] No response

LCL_301. PROBE: Was the injection administered via syringe or small needle?

Show the image to the respondent.

[] Syringe
[] Small needle (Sayana Press)
[] No Response

302c. Does your husband/partner know that you are using ${current_method_label}?

[] Yes
[] No
[] No response

302c. Does your husband/partner know that you are using family planning?

[] Yes
[] No
[] No response

IMP_301a. CHECK. In question 302b, the respondent mentioned that she had been using implants. Is that correct?

If she says she is not currently using implants, please verify her answer and go back to 302b and select the correct method.

[] Yes
[] No

IMP_301b. How many rods is your implant?

[] 1
[] 2
[] 6
[] Don't know
[] No response

IMP_302. At the visit when the implant was inserted, were you
told for how long the implant would protect you from pregnancy?

[] Yes
[] No
[] No response

IMP_303. How long were you told ?

If you select months or years, you will enter a number for X on the next screen.

Please check that you correctly entered the value for months/years.

[] X months
[] X years
[] Don't know
[] No response

IMP_303. Enter the number of ${implant_duration_lab} you were told:

If more than 12 months record in years

303. Did the provider tell you or your partner that this method was permanent?

[] Yes
[] No
[] No response

305a. You said that you are not currently using a contraceptive method. Do you think you will use a contraceptive method to delay or avoid getting pregnant at any time in the future?

[] Yes
[] No
[] No response

305b. Do you think you will use a contraceptive method to delay or avoid getting pregnant at any time in the future?

[] Yes
[] No
[] No response

306a. In the last 12 months, have you ever done something or used a method to delay or avoid getting pregnant?

[] Yes
[] No
[] No response

306b. Which method did you use most recently?

PROBE: Anything else?

Select most effective method (highest method in list). Scroll to bottom to see all choices.

[] Male sterilization
[] Implant
[] IUD
[] Injectables
[] Pill
[] Emergency Contraception
[] Male condom
[] Female condom
[] Diaphragm
[] Foam/Jelly
[] Standard Days/Cycle beads
[] LAM
[] Rhythm method
[] Withdrawal
[] Other traditional method
[] No response

LCL_302. PROBE: Was the injection administered via syringe or small needle?

Show the image to the respondent.

[] Syringe
[] Small needle (Sayana Press)
[] No Response

307. Before you started using ${current_recent_label}, had you discussed the decision to delay or avoid pregnancy with your husband/partner?

[] Yes
[] No
[] Do not know
[] No response

308. Would you say that using contraception is mainly your decision, mainly your husband/partner's decision or did you both decide together?

[] Mainly respondent
[] Mainly husband/partner
[] Joint decision
[] Other
[] No response

308a. The last time you received your ${current_recent_label}, how much did you have to pay out of pocket, including any fees paid for the method, supplies or services, and transportation?

Enter all prices in CFA. Zero is a possible answer. Enter -88 if respondent does not know, -99 for no response.

309a. Since what month and year have you been using ${current_recent_label} without stopping?

Calculate backwards from memorable events if needed.

Month:

[] January
[] February
[] March
[] April
[] May
[] June
[] July
[] August
[] September
[] October
[] November
[] December
[] Do not know

Year:

If entering '2020' for No Response, must select 'Do not know' for month.

Cannot be in future.

Date cannot be in the future.

You entered: ${begin_using_full_lab}
Today: ${today}

Date of starting ${current_recent_label} without stopping cannot be before most recent birth. You entered: ${bus_y_lab}

Most recent birth: ${rb_y_lab}

309b. When did you stop using ${current_recent_label}?

Please record the date.
The date should be found by calculating backwards from memorable events if needed.

Select 'Do not know' for month and '2020' for year to indicate No Response.

Month:

[] January
[] February
[] March
[] April
[] May
[] June
[] July
[] August
[] September
[] October
[] November
[] December
[] Do not know

Year:

If entering '2020' for No Response, must select 'Do not know' for month.

Cannot be in future.

Date cannot be in the future.

You entered: ${stop_using_full_lab}
Today: ${today}

Date of stopping ${current_recent_label} must be within the last 12 months. Otherwise, the answer to 306a should be no. You entered: ${stop_using_full_lab}

Today: ${today}

Date of stopping ${current_recent_label} must be within the last 12 months. Otherwise, the answer to 306a should be no. You entered: ${spu_y_lab}

Today: ${today}

309c. In what month and year had you started using ${current_recent_label} before stopping?

Calculate backwards from memorable events if needed.

Select 'Do not know' for month and '2020' for year to indicate No Response.

Month:

[] January
[] February
[] March
[] April
[] May
[] June
[] July
[] August
[] September
[] October
[] November
[] December
[] Do not know

Year:

If entering '2020' for No Response, must select 'Do not know' for month.

Cannot be in future.

Date cannot be in the future.

You entered: ${ante_start_using_full_lab}
Today: ${today}

Date of starting ${current_recent_label} cannot be before 10 years of age. You entered: ${ante_start_using_full_lab}

Respondent's birth date: ${birthdate_lab}

Date of having stopped using ${current_recent_label} cannot be before start of usage. You entered: ${ante_start_using_full_lab}

Date of stopping use: ${stop_using_full_lab}

Year of having stopped using ${current_recent_label} cannot be before start of usage. You entered: ${sus_y_lab}

Year of stopping use: ${spu_y_lab}

309d. CHECK: Just to make sure I have this correct, you used ${current_recent_label} continuously between ${ante_start_using_full_lab} and ${stop_using_full_lab} without stopping, is that correct?

[] Yes
[] No

GO BACK TO THE PREVIOUS SCREEN AND PROBE TO DETERMINE THE PERIOD OF MOST RECENT CONTINUOUS USE.

Suggested probes:
- When was the last time you used [METHOD]?
- How long had you been using [METHOD] without stopping

310. Why did you stop using ${current_recent_label}?

Cannot select 'no response' or 'do not know' with other options.

[] Infrequent sex / husband away
[] Became pregnant while using
[] Wanted to become pregnant
[] Husband / partner disapproved
[] Wanted a more effective method
[] No method available
[] Health concerns
[] Fear of side effects
[] Lack of access / too far
[] Costs too much
[] Inconvenient to use
[] Fatalistic
[] Difficult to get pregnant / menopausal
[] Interferes with body's processes
[] Other
[] Don't know
[] No response

311a. You first started using ${current_recent_label} on ${start_date_lab}.

Where did you or your partner get it at that time?

Scroll to bottom to see all choices.

[] National Hospital Center
[] Health and Social Services Center (public)
[] Family planning clinic
[] Mobile clinic (public)
[] Regional Hospital Center
[] Medical Center with Surgery Unit (public)
[] Medical Center (public)
[] Fieldworker and community health volunteers (public)
[] Private hospital or clinic
[] Pharmacy
[] Private practice
[] Mobile clinic (private)
[] Maternity
[] Health Agent
[] Store/market/supermarket/mobile vendors
[] Religious organizations
[] Community event
[] Other
[] Don't know
[] No Response

312a. When you obtained your [CURRENT/MOST RECENT METHOD], were you told by the provider about side effects or problems you might have with a method to delay or avoid getting pregnant?

[] Yes
[] No
[] No response

312b. Were you told what to do if you experienced side effects or problems?

[] Yes
[] No
[] No response

IMP_304. Were you told where you could go to have the implant removed?

Provider: [PROVIDER]

[] Yes
[] No
[] Do not know
[] No response

313. At that time, were you told by the family planning provider about methods of family planning other than the [CURRENT/MOST RECENT METHOD] that you could use?

[] Yes
[] No
[] No response

314a. During that visit, did you obtain the method you wanted to delay or avoid getting pregnant?

[] Yes
[] No
[] No response

314c. Why didn't you obtain the method you wanted?

[] Method out of stock that day
[] Method not available at all
[] Provider not trained to provide the method
[] Provider recommended a different method
[] Not eligible for method
[] Decided not to adopt a method
[] Too costly
[] Other
[] No response

315a. During that visit, who made the final decision about what method you got?

[] You alone
[] Provider
[] Partner
[] You and provider
[] You and partner
[] Other
[] Do not know
[] No response

315b. Who made the final decision to use rhythm?

[] You alone
[] Provider
[] Partner
[] You and provider
[] You and partner
[] Other
[] Do not know
[] No response

315b. Who made the final decision to use LAM?

[] You alone
[] Provider
[] Partner
[] You and provider
[] You and partner
[] Other
[] Do not know
[] No response

316. Would you return to this provider?

Provider: [PROVIDER]

[] Yes
[] No
[] Do not know
[] No response

317. Would you refer your relative or friend to this provider / facility?

Provider: [PROVIDER]

[] Yes
[] No
[] Do not know
[] No response

IMP_304b. When you stopped using the implant in [MONTH/YEAR], where did you go to have your implant removed?

Scroll to bottom to see all choices.

[] National Hospital Center
[] Health and Social Services Center (public)
[] Family planning clinic
[] Mobile clinic (public)
[] Regional Hospital Center
[] Medical Center with Surgery Unit (public)
[] Medical Center (public)
[] Fieldworker and community health volunteers (public)
[] Private hospital or clinic
[] Pharmacy
[] Private practice
[] Mobile clinic (private)
[] Maternity
[] Health Agent
[] Store/market/supermarket/mobile vendors
[] Religious organizations
[] Friend / parent
[] Self
[] Other
[] Don't know
[] No Response

IMP_305a. In the past 12 months, have you tried to have your current implant removed?

[] Yes
[] No
[] No response

IMP_305b. Where did you go or who attempted to remove your implant?

[] National Hospital Center
[] Health and Social Services Center (public)
[] Family planning clinic
[] Mobile clinic (public)
[] Regional Hospital Center
[] Medical Center with Surgery Unit (public)
[] Medical Center (public)
[] Fieldworker and community health volunteers (public)
[] Private hospital or clinic
[] Pharmacy
[] Private practice
[] Mobile clinic (private)
[] Maternity
[] Health Agent
[] Store/market/supermarket/mobile vendors
[] Religious organizations
[] Friend / parent
[] Self
[] Other
[] Don't know
[] No Response

IMP_306. Why were you not able to have your implant removed?

Cannot select 'no response' or 'do not know' with other options.

[] Facility not open
[] Qualified provider not available
[] Provider attempted but could not remove the implant
[] Provider refused
[] Cost of removal services
[] Travel cost
[] Provider counseled against removal
[] Told to return another day
[] Referred elsewhwere
[] Other
[] Don't know
[] No response

IMP_306b. Why were you not able to have your implant removed?

SW_1a. Right before you started using [CURRENT / RECENT METHOD] in [MONTH/YEAR], were you doing something or using any method to delay or avoid getting pregnant?

[] Yes
[] No
[] No response

SW_1b. Which method were you using?

[] Male sterilization
[] Implant
[] IUD
[] Injectables
[] Pill
[] Emergency Contraception
[] Male condom
[] Female condom
[] Diaphragm
[] Foam/Jelly
[] Standard Days/Cycle beads
[] LAM
[] Rhythm method
[] Withdrawal
[] Other traditional method
[] No response

PP_1. Since the birth of your child in [DATE OF MOST RECENT BIRTH], have you ever done something or used any method to delay or avoid getting pregnant?

[] Yes
[] No
[] No response

PP_2. How long after the birth in [DATE OF MOST RECENT BIRTH] did you start doing something or start using a method?

Enter 0 days for today.
You will enter a number for X on the next screen.

[] X days after
[] X weeks after
[] X months after
[] X years after
[] No response

PP_2. Enter ${pp_method_lab}.

If today, enter zero days only, not zero weeks/months/years.

Days must be greater or equal to 0. Weeks/months/years must be greater than 0.

Date of having started use ${pp_method_lab} cannot be in the future. You entered: ${pp_method_value}, ${pp_method_units}.

Most recent birth date: ${rec_birth_date}
Today: ${today}

PP_3. What was the method?

[] Female sterilization
[] Male sterilization
[] Implant
[] IUD
[] Injectables
[] Pill
[] Emergency Contraception
[] Male condom
[] Female condom
[] Diaphragm
[] Foam/Jelly
[] Standard Days/Cycle beads
[] LAM
[] Rhythm method
[] Withdrawal
[] Other traditional method
[] No response

The respondent answered 'female sterilization', but she did not say that is her current method. Go back and update the current method.

LCL_PP1. PROBE: Was the injection administered via syringe or small needle?

Show the image to the respondent.

[] Syringe
[] Small needle (Sayana Press)
[] No Response

319. Have you ever done anything or tried in any way to delay or avoid getting pregnant?

[] Yes
[] No
[] No response

320. How old were you when you first used a method to delay or avoid getting pregnant?

The respondent said she was ${age} years old at her last birthday.

Enter the age in years.
Enter -88 if the respondent does not know.
Enter -99 if there is no response.
Cannot be younger than 9.

Cannot be older than the current age of the respondent. Cannot be younger than 9. Cannot be after recent/current use.

Check: You entered that the respondent first used family planning at the age of [AGE OF FIRST USE]. Is that what she said?

Go back and change 320 if that is not correct.

Go back and change 320.

[] Yes
[] No

321. How many living children did you have at that time, if any?

Note: the respondent said that she gave birth [NUMBER OF BIRTH EVENTS] times in 201.

Enter -99 for no response.

Must be zero or larger, or -99.

WARNING: you entered that the respondent gave birth [NUMBER OF BIRTH EVENTS] times in 201, and you entered that the respondent had [NUMBER OF CHILDREN] children alive at the time she first used a method to delay or avoid getting pregnant in 321. Is this what the respondent said?

It may be that the answers to 201 and 321 are correct. This screen is a warning for verification.

[] Yes
[] No

322. Which method did you first use to delay or avoid getting pregnant?

Do not read the method choices. Scroll to bottom to see all choices.

You said you are currently pregnant.

[] Female sterilization
[] Male sterilization
[] Implant
[] IUD
[] Injectables
[] Pill
[] Emergency Contraception
[] Male condom
[] Female condom
[] Diaphragm
[] Foam/Jelly
[] Standard Days/Cycle beads
[] LAM
[] Rhythm method
[] Withdrawal
[] Other traditional method
[] No response

Check here to acknowledge you considered all options.

[] NA

The respondent said she first used female sterilization, but she did not say that is her current method. Go back to 302a and 302b and update the selection for current method.

LCL_322a. PROBE: Was the injection administered via syringe or small needle?

Show the image to the respondent.

[] Syringe
[] Small needle (Sayana Press)
[] No Response

322a. Have you used emergency contraception at any time in the last 12 months?

PROBE: As an emergency measure after unprotected sexual intercourse women can take special pills at any time within three to five days to prevent pregnancy.

[] Yes
[] No
[] No response

323a. You said that you do not want a child soon and that you are not using a method to avoid pregnancy.

323a. You said that you do not want another child soon and that you are not using a method to avoid pregnancy.

323a. You said that you do not want any children and that you are not using a method to avoid pregnancy.

323a. You said that you do not want any more children and that you are not using a method to avoid pregnancy.

Can you tell me why you are not using a method to prevent pregnancy?

PROBE: Any other reason?

RECORD ALL REASONS MENTIONED

Cannot select "Not Married" if 104 is "Yes, currently married".

Scroll to bottom to see all choices.

Cannot select "Do not know" or "No response" with other options.

Cannot select "Not Married" if 104 is "Yes, currently married".

[] Not married
[] Infrequent sex / Not having sex
[] Menopausal / Hysterectomy
[] Subfecund / Infecund
[] Not menstruated since last birth
[] Breastfeeding
[] Husband away for multiple days
[] Up to God / fatalistic
[] Respondent opposed
[] Husband / partner opposed
[] Others opposed
[] Religious prohibition
[] Knows no method
[] Knows no source
[] Fear of side effects
[] Health concerns
[] Lack of access / too far
[] Costs too much
[] Preferred method not available
[] No method available
[] Inconvenient to use
[] Interferes with body's processes
[] Other
[] Don't know
[] No response

323b. Would you say that not using contraception is mainly your decision, mainly your husband/partner's decision or did you both decide together?

[] Mainly respondent
[] Mainly husband/partner
[] Joint decision
[] Other
[] No response

324. In the last 12 months, were you visited by a community health worker who talked to you about family planning?

[] Yes
[] No
[] No response

325a. In the last 12 months, have you visited a health facility or camp for care for yourself?

For any health services.

[] Yes
[] No
[] No response

325a. In the last 12 months, have you visited a health facility or camp for care for yourself or your children?

For any health services.

[] Yes
[] No
[] No response

325b. Did any staff member at the health facility speak to you about family planning methods?

[] Yes
[] No
[] No response

In the last few months have you:

326a. Heard about family planning on the radio?

[] Yes
[] No
[] No response

326b. Seen anything about family planning on the television?

[] Yes
[] No
[] No response

326c. Read about family planning in a newspaper or magazine?

[] Yes
[] No
[] No response

326d. Received a voice or text message about family planning on a mobile phone?

[] Yes
[] No
[] No response

Section 4: Sexual Activity

CHECK FOR THE PRESENCE OF OTHERS. BEFORE CONTINUING, MAKE EVERY EFFORT TO ENSURE PRIVACY.

Now I would like to ask some questions about sexual activity in order to gain a better understanding of some important life issues. Let me assure you again that your answers are completely confidential and will not be told to anyone. If we should come to any question that you don't want to answer, just let me know and we will go to the next question.

401a. How old were you when you first had sexual intercourse?

Enter the age in years.

Enter -77 if she has never had sex.
Enter -99 for no response.
Enter -88 for do not know.

Answer must agree with the current age and date of first birth.

WARNING: you entered -77, but the respondent is currently pregnant or has given birth before. Go back and fix.

The timing of the number of births should agree with 401a

WARNING: the respondent gave birth [NUMBER OF BIRTH EVENTS] times, but first had sex at the age of [AGE AT FIRST SEX], only [YEARS SINCE FIRST SEX] years ago. Is that correct?

The timing of the number of births should agree with 401a.

You must reconcile 401a with the respondent's pregnancy history.

[] Yes
[] No

You entered that the respondent was [AGE AT FIRST SEX] years old the first time she had sexual intercourse. Is that what the she said?

Go back and change 401a if it is not correct.

Invalid. Go back

[] Yes
[] No

You entered that the respondent's age at first sex was [AGE AT FIRST SEX]. Previously the respondent said she has given birth at an earlier age: [AGE AT FIRST BIRTH]. Is that correct?

Go back and change "age at first sex" if it is not correct

You must reconcile 401a with the respondent's pregnancy history.

[] Yes
[] No

402. When was the last time you had sexual intercourse?

Answer must be in days or weeks up to 4 weeks or 30 days

If less than 12 months ago, answer must be recorded in months, weeks, or days.

Enter 0 days for today.

You will enter a number for X on the next screen.

Must agree with the pregnancy status.

[] X days ago
[] X weeks ago
[] X months ago
[] X years ago
[] No response

402. Enter ${last_time_sex_lab}.

If today, enter zero days only, not zero weeks/months/years.

Must agree with the age of first sexual intercourse and the pregnancy status.

Days must be greater or equal to 0. Weeks/months/years must be greater than 0.

The respondent is pregnant. The time since last sex must not be earlier than one month prior to the start of pregnancy.

If number of months pregnant is unknown, then the time since last sex must be less than 11 months.

Months pregnant: ${months_pregnant}
Last time sex units: ${last_time_sex}
Last time sex value: ${last_time_sex_value}

The respondent cannot enter a time since last sex that would be before her age at first sex.

Age at first sex: ${age_at_first_sex}
Current age: ${age}
Last time sex units: ${last_time_sex}
Last time sex value: ${last_time_sex_value}

LCL_305a. If you could go back to the time you did not have any children and could choose exactly the number of children to have in your whole life, how many would that be?

If you select X children, you will enter a number for X on the following screen. If none, select X children, then enter 0.

[] X children
[] It's God's will (not respondent's decision)
[] Other
[] Do not know
[] No response

Enter ${children_des_lab}:

LCL_305b. If you could choose exactly the number of children to have in your whole life, how many would that be?

If you select X children, you will enter a number for X on the following screen. If none, select X children, then enter 0.

[] X children
[] It's God's will (not respondent's decision)
[] Other
[] Do not know
[] No response

Enter [NUMBER OF CHILDREN]:

Section 6: Menstrual Hygiene

Now I'm going to ask you about menstrual hygiene management.
This includes the use of absorbent materials; access to a private, clean, safe space; washing as required; and a place to dispose used materials.

602a. Where do you most often change your used pads, cloths, or other sanitary materials?

[] Flush/pour flush toilet
[] Ventilated improved pit latrine
[] Pit latrine with slab
[] Pit latrine without slab / open pit
[] Bucket toilet
[] Composting toilet
[] Hanging toilet /Hanging latrine
[] Sleeping area/bedroom
[] Backyard
[] No facility / bush / field
[] Other
[] No response

Place: ${main_mhm_label}

602b. While managing your menstrual hygiene, was this place:

Read each option aloud and select if yes.

Cannot select 'no response' or 'none of the above' with other options.

[] Clean?
[] Private?
[] Safe?
[] Able to be locked?
[] Supplied with water?
[] Supplied with soap?
[] None of the above
[] No response

603. During your last menstrual period, what did you use to collect or absorb your menstrual blood?

PROBE: Anything else?

Do not read options aloud. Select all that apply.

Cannot select 'no response' or 'no materials used' with other options.

[] Disposable sanitary pad (commercial)
[] Reusable sanitary pad
[] New cloth
[] Old cloth
[] Cotton wool
[] Diaper
[] Tampons
[] Toilet paper
[] Underwear alone
[] Bucket
[] Other
[] No materials used
[] No response

604a. Did you wash and reuse pads, cloths, or other sanitary materials during your last menstrual period?

[] Yes
[] No
[] No response

604b. During your last menstrual period, were the sanitary materials that you washed and reused completely dried before each reuse?

[] Yes
[] No
[] No response

605. You mentioned that you used ${mhm_materials_joined} during your last menstrual period. Where did you dispose of these materials after use?

PROBE: Anywhere else?

Do not read options aloud. Select all that apply.

[] Flush toilet
[] Latrine
[] Waste bin/trash bag
[] Burning
[] Bush/field
[] Other
[] No response

606a. Aside from your own housework, have you done any work in the last month?

[] Yes
[] No
[] No response

606b. Due to your last menstrual period, were there any work days in the last month that you did not attend?

[] Yes
[] No
[] No response

607a. Did you attend school at any time in the past 12 months?

[] Yes
[] No
[] No response

607b. Due to your menstrual period, were there any school days in the past 12 months that you did not attend?

[] Yes
[] No
[] No response

LCL_608. How old were you at the time you experienced your first menstruation?

Enter the age in years. Enter '-88' for 'do not know' or '-99' for 'no response'.

Follow-up Consent

FLW_801. Thank you for the time you have kindly granted us.

Would you be willing to participate in another survey on this or any other topic either by phone or in person at some point in the future?

[] Yes
[] No
[] No response

FLW_802. Do you own a phone?

[] Yes
[] No
[] No response

FLW_803. Can I have your primary phone number in case we would like to follow up with you in the future?

Enter an 8-digit number without the country code. Do not include spaces or dashes.
Enter -99 for no response.

FLW_804. To confirm, here is the number you gave me: ${flw_number_typed}. Is that correct?

If not, return to 803 and correct it.

You must answer yes.

[] Yes
[] No

Thank the respondent for her time.

The respondent is finished, but there are still more questions for you to complete outside the home.

Thank you.

There are still more questions for you to complete outside the home.

Location and Questionnaire result

095. Location

Take a GPS point near the entrance to the household. Record location when the accuracy is smaller than 6 m.

096. How many times have you visited this household to interview this female respondent?

[] 1st time
[] 2nd time
[] 3rd time

097. In what language was this interview conducted?

[] English
[] French
[] Moore
[] Goumantchema
[] Fulfulde
[] Dioula
[] Autre

Presence of others during the interview (people present and listening, people present but not listening, or not present).

a. Children under 10 years

[] Present, listening
[] Present, not listening
[] Not present

b. Husband

[] Present, listening
[] Present, not listening
[] Not present

c. Other men

[] Present, listening
[] Present, not listening
[] Not present

d. Other women

[] Present, listening
[] Present, not listening
[] Not present

098. Questionnaire result

Record the result of the female respondent survey

Check answer to 006 and consent.

[] Completed
[] Not at home
[] Postponed
[] Refused
[] Partly completed
[] Incapacitated