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Burkina Faso 2022 Phase 3 Female Questionnaire

Region:

Province:

Commune:

Village:

Enumeration Area:

Structure number:

Household number:

001a. Are you in the correct household?

EA: {EA_nice}
Household head: {HQ_ODK_display_name}
Structure #: {structure}
Household #: {household}

Go to the right household.

[] Yes
[] No

002a. Your ID:

Is this your ID?

[] Yes
[] No

002a. Enter your ID below.

Please record your ID

003a. Is this date and time correct?

{today_formatted}

[] Yes
[] No

003b. Record the correct date and time.

The date must be between 2021-11-01 and 2022-12-31.

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

Region: {level1_unlinked}

Province: {level2_unlinked}

Commune: {level3_unlinked}

Village: {level4_unlinked}

Enumeration Area: {EA_unlinked}

Structure number: {structure_unlinked}{hq_structure}

Household number: {household_unlinked}{hq_household}

004a. 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 '010.'

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

INFORMED CONSENT

Find the woman between the ages of 15-49 associated with this Female Questionnaire. The interview must have auditory privacy. Administer the consent procedures.

Bonjour. Je m?appelle ________________________________ et je travaille pour l?Institut Supérieur des Sciences de la Population (ISSP) de l?Université Joseph KI-ZERBO. Je vais à présent vous lire une déclaration expliquant l?enquête que nous menons.

Note d?information

L?Institut Supérieur des Sciences de la Population (ISSP) de l?Université Joseph KI-ZERBO en collaboration avec le ministère de la santé du Burkina Faso et l?école de santé publique et de la santé reproductive de l?université Johns Hopkins aux Etats-Unis mène une étude dénommée PMA (Performance Monitoring for Action). Cette étude a pour objectifs de mettre en ?uvre un système de suivi des performances accomplies dans le domaine de la planification familiale, y compris la contraception et l'avortement, et de la santé en général au sein de la population et des structures de santé au Burkina Faso. Les informations que nous recueillerons serviront aussi pour mener des recherches et informer les orientations programmatiques en matière de planification familiale au Burkina Faso.

Consentement

Nous vous demandons de participer à l?étude car vous avez participé à une enquête que nous avons menée l'année dernière et avez indiqué que vous seriez disposé à participer à une enquête de suivi. Bien que vous ayez accepté à l?époque d'être recontactée pour les prochaines enquêtes, vous avez toujours le droit de décider de ne pas participer à tout moment. Néanmoins, nous apprécierons beaucoup que vous fassiez partie de cette enquête, car les informations que nous collecterons aideront à informer le gouvernement afin de mieux planifier les services de santé. Toutes les informations que vous nous donnerez seront strictement confidentielles et ne seront montrées à personne d?autre que les membres de notre équipe.

La participation à cette enquête est volontaire, et s?il y a une question à laquelle vous ne souhaitez pas répondre, faîtes le moi savoir et je passerai à la suivante ; ou vous pouvez également interrompre l?interview à tout moment. La participation à l?étude ne présente aucun avantage direct pour vous. Vous ne serez pas rémunérée pour avoir répondu à ce questionnaire. Cependant, nous espérons que vous accepterez de participer à cette enquête car votre point de vue est important. Notre entretien devrait durer environ 1 heure. A la fin de l?enquête un cadeau symbolique constitué d?un paquet de sucre et de deux boules de savon sera remis à votre ménage comme compensation pour le temps que les membres de votre ménage ont consacré pour répondre à nos différents questionnaires.

Puis-je commencer ?

008a. Read the verbal consent text.

Then, ask:
May I begin the interview now?

[] Yes
[] No

008b. Respondent's signature

Please ask the respondent to sign or check the box in agreement of their participation.

Checkbox

[] NA

009. Interviewer's ID: {your_name}

Mark your ID as a witness to the consent process.

[] NA

010. Respondent's first name: {firstname_raw_auto}

Did you want to update the 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.

[] Yes
[] No

010. Respondent's first name:

011. Was this woman interviewed in ANY previous survey?

Check your list of panel women

[] Yes
[] No

Section 1 - Respondent's Background, Marital Status, Employment, and Migration

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 {hq_age}.

Month:

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

Year:

Cannot be this year or in the future.

102. How old were you at your last birthday?

Age in the Household Roster: {hq_age}

Must be more than 14. Must agree with 101.

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

102c. In general, would you say your health is very good, good, moderate, bad, or very bad?

[] Very good
[] Good
[] Moderate
[] Bad
[] Very bad
[] No response

103. Have you attended school in the past 12 months?

[] Yes
[] No
[] No response

104. 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

105. What is the highest [GRADE/ FORM / STANDARD / YEAR] you completed at that level?

Enter -99 for no response.

XS_101. How old were you when you left school?

Must be between 0 and the respondent's age.

107. What was the main reason you stopped attending school?

[] Finished education
[] Failed exams
[] Did not enjoy school
[] School was too far
[] Wanted to start working
[] Got married
[] Got pregnant
[] Parents did not want you to continue
[] Economic reasons
[] Menstruation / period
[] Illness
[] Other
[] No response

108. Are you currently enrolled in any training program?

[] Yes
[] No
[] No response

109. 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

110. What is the highest level of schooling your husband/partner attended?

[] Never attended
[] Primary
[] Secondary (first cycle)
[] Secondary (second cycle)
[] Tertiary
[] Do not know
[] No response

PL_101. Did you start living with your current husband / partner in past 12 months?

[] Yes
[] No
[] No response

XS_102a. How much were you involved in the decision to get married - very much, not very much or not at all?

[] Very much
[] Not very much
[] Not at all
[] No response

XS_102b. How much do you think you will be involved in the decision to get married - very much, not very much or not at all?

[] Very much
[] Not very much
[] Not at all
[] No response

113. Have you ever had a partner / boyfriend?

[] Yes
[] No
[] No response

XS_102. How old were you the first time you had a boyfriend or partner?

Must be between 0 and the respondent's age.

114. Do you currently have a boyfriend or partner?

[] Yes
[] No
[] No response

INF_1. In what month and year did you begin this relationship?

Select 'Do not know' for month and '2030' for year to indicate 'No response'.
Month:

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

Year:

Year should be between 1980 and today. Use 2030 for 'no response'

Year should be between 1980 and today. Use 2030 for 'no response'

XS_103. How many times have you been married or lived with a man as if married?

Enter -99 for no response.

Must be at least 1

XS_104. In what month and year did you start living with your FIRST husband / partner?

Select 'Do not know' for month and '2030' 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 '2030' for No Response, must select 'Do not know' for month.

Cannot be in future.

115. Now I would like to ask about when you started living with your CURRENT husband / partner. In what month was that?

Select 'Do not know' for month to indicate 'No Response'.
Month:

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

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

Select 'Do not know' for month and '2030' 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 '2030' for No Response, must select 'Do not know' for month.

Cannot be in future.

LCL_101. Does your husband / partner have other wives or does he live with other women as if married?

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

XS_105. How long have you been living continuously in [NAME OF CURRENT PLACE OF RESIDENCE]?

Enter answer in years.

Enter 0 if less than 1 year.
Enter -95 for always.
Enter -96 for visitor.
Enter -99 for no response.

Years entered cannot exceed age.

XS_106. How long have you been living continuously in this particular house / structure?

Enter answer in years.

Enter 0 if less than 1 year.
Enter -95 for always.
Enter -96 for visitor.
Enter -99 for no response.

Years entered cannot exceed age. Must be consistent with previous answer.

116. In the last 12 months, for how many nights have you slept away from your community?

PROBE: Community is the area where you are currently living

Enter -99 for no response.

117. In the last 12 months, for how many nights has your husband/partner slept away from your community?

PROBE: Community is the area where you are currently living

Enter -99 for no response.

118. As you know, some women take up jobs for which they are paid in cash or kind. Others sell things, have a small business or work on the family farm or in the family business. Aside from your own housework, have you done any work in the last seven days?

[] Yes
[] No
[] No response

119. Aside from your own housework, have you done any work in the last 12 months?

[] Yes
[] No
[] No response

120. Are you paid in cash or kind for this work or are you not paid at all?

[] Cash
[] Cash and kind
[] In-kind
[] Not paid
[] No response

121. Who usually makes decisions about making large household purchases: you, your husband/partner, you and your husband/partner jointly, or someone else?

[] Respondent
[] Husband/partner
[] Respondent and husband/partner
[] Someone else
[] No response

122. Who usually makes decisions about making household purchases for daily needs: you, your husband/partner, you and your husband/partner jointly, or someone else?

[] Respondent
[] Husband/partner
[] Respondent and husband/partner
[] Someone else
[] No response

123. Who usually makes decisions about getting medical treatment for yourself: you, your husband/partner, you and your husband/partner jointly, or someone else?

[] Respondent
[] Husband/partner
[] Respondent and husband/partner
[] Someone else
[] No response

EMP_1. Who usually makes decisions about buying clothes for yourself: you, your husband/partner, you and your husband/partner jointly, or someone else?

[] Respondent
[] Husband/partner
[] Respondent and husband/partner
[] Someone else
[] No response

EMP_2. Who usually makes decisions about how your earnings will be used: you, your husband/partner, you and your husband/partner jointly, or someone else?

[] Respondent
[] Husband/partner
[] Respondent and husband/partner
[] Someone else
[] No response

EMP_3. Who usually makes decisions about how your husband/partner's earnings will be used: you, your husband/partner, you and your husband/partner jointly, or someone else?

[] Respondent
[] Husband/partner
[] Respondent and husband/partner
[] Someone else
[] No response

EMP_4. Do you own any land, either jointly or by yourself?

PROBE: This does not include land owned only by your husband.

[] Yes
[] No
[] No response

EMP_5. Would you say that the money that you earn is more than what your husband/partner earns, less than what he earns, or about the same?

[] More
[] Less
[] Same
[] No response

EMP_6. In the last 30 days, did you take part in any of these activities?

Read each option aloud and select if yes.

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

[] Agricultural work
[] Raising poultry / livestock
[] Producing ghee / cheese / butter
[] Collecting fuel / wood-cutting
[] Preparing food
[] Sewing / embroidery / crocheting
[] Producing straw products / carpets / textile / ropes
[] Offering services for others in a house, shop, or hotel
[] Independent paid work
[] Buying / selling goods in the market / the street / at home
[] Helping in construction work
[] Learning a skill
[] None of the above
[] No response

FIN_1. Do you currently have any savings for the future, such as a bank account, savings group, or cash?

[] Yes
[] No
[] No response

FIN_2. Do you currently have any mobile money accounts (e.g. Orange Money, MobiCash, Coris Money)?

[] Yes
[] No
[] No response

124. Do you have a way of accessing the internet?

[] Yes
[] No
[] No response

125. How often do you access the internet?

[] Daily
[] A few times per week
[] A few times per month
[] Less than once per month
[] Not at all
[] No response

126. What devices do you use to access the internet?

Read all options aloud and select all that apply

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

[] Mobile phone
[] Laptop or desktop computer
[] Tablet
[] Other
[] No response

127. When you use the internet, how often are you able to use it privately?

[] Always
[] Sometimes
[] Rarely
[] Never
[] No response

Section 2 - Reproduction, Pregnancy and Fertility Preferences

201. 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

202. How many times have you given birth?

Enter -99 for no response.

PL_201. Have you had any births since [Phase 1 survey interview date]?

[] Yes
[] No
[] No response

PL_202. When was that birth?

Select 'Do not know' for month and '2030' for year to indicate 'No Response'.

CALENDAR: Enter the birth and duration of pregnancy in the calendar.

Month:

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

Year:

If entering '2030' for No Response, must select 'Do not know' for month.

Cannot be in future.

XS_201. When was your FIRST birth?

Please record the date of the first live birth. Date should be found by calculating forward or backward from memorable events if needed.

Select 'Do not know' for month and '2030' for year to indicate 'No Response'.

CALENDAR: If the birth was after January 2019 enter the birth and duration of pregnancy in the calendar.

Month:

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

Year:

If entering '2030' for No Response, must select 'Do not know' for month.

Cannot be in future.

XS_202. When was your MOST RECENT birth?

Please record the date of the first live birth. Date should be found by calculating forward or backward from memorable events if needed.

Select 'Do not know' for month and '2030' for year to indicate 'No Response'.

CALENDAR: If the birth was after January 2019 enter the birth and duration of pregnancy in the calendar.

Month:

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

Year:

If entering '2030' for No Response, must select 'Do not know' for month.

Cannot be in future.

XS_203. Have you had any other births since January 2019?

[] Yes
[] No
[] No response

XS_204. When was that birth?

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

Select 'Do not know' for month and '2030' for year to indicate 'No Response'.

CALENDAR: Enter the birth and duration of pregnancy in the calendar.

Month:

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

Year:

If entering '2030' for No Response, must select 'Do not know' for month.

Cannot be in future.

XS_205. Have you ever had a pregnancy that miscarried, was aborted, or ended in a stillbirth since January 2019?

[] Yes
[] No
[] No response

XS_206. When did that pregnancy end?

Select 'Do not know' for month and '2030' for year to indicate 'No Response'.

CALENDAR: Enter the termination and duration of pregnancy in the calendar.

Month:

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

Year:

If entering '2030' for No Response, must select 'Do not know' for month.

Cannot be in future

PL_203. Have you had a pregnancy that miscarried, was aborted, or ended in a stillbirth since [Phase 1 survey interview date]?

[] Yes
[] No
[] No response

PL_204. When did that pregnancy end?

Select 'Do not know' for month and '2030' for year to indicate 'No Response'.

CALENDAR: Enter the termination and duration of pregnancy in the calendar.

Month:

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

Year:

If entering '2030' for No Response, must select 'Do not know' for month.

Cannot be in future

203. Are you pregnant now?

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

204. How many months pregnant are you?

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

CALENDAR: Enter number of months pregnant in the calendar.

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

205. 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

205. 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.

INF_2. Have you had a procedure to remove the uterus?

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

INF_3. From one menstrual period to the next, are there certain days when a woman is more likely to become pregnant?

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

INF_4. Is this just before her period begins, during her period, right after her period has ended, halfway between two periods?

[] Just before her period begins
[] During her period
[] Right after her period has ended
[] Halfway between two periods
[] All days are equal
[] Do not know
[] No response

206a. Now I would like to ask a question about your last birth.
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

206b. 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 children at all?

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

207a. Before you became pregnant with your last birth, which best describes your situation?

Read response options and select one

[] You and your partner had agreed for you to get pregnant
[] You and your partner had discussed having children together but had not agreed for you to get pregnant
[] You and your partner had never discussed having children together
[] No response

207b. Before you became pregnant with your current pregnancy, which best describes your situation?

Read response options and select one

[] You and your partner had agreed for you to get pregnant
[] You and your partner had discussed having children together but had not agreed for you to get pregnant
[] You and your partner had never discussed having children together
[] No response

Now I have some questions about the future.

208a. 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 / Do not know
[] No response

208a. 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 / Do not know
[] No response

208b. 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 / Do not know
[] No response

209a. 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
[] Do not know
[] No response

209a. 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
[] Do not know
[] No response

209b. 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
[] Do not know
[] No response

209c. Enter the number of {waitchild} you would like to wait:

Use years if more than 36 months.

INF_5. Are you currently trying to become pregnant?

[] Yes
[] No
[] No response

INF_6. How long have you been trying to become pregnant?

Probe: 'Do not know' or 'No response', probe to confirm if trying for more than 1 year.

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
[] Do not know
[] No response

INF_6a. Enter the number of {preg_trying_lab} you have been trying to get pregnant:

210a. When you found out you were pregnant, how did you feel?

[] Very happy
[] Sort of happy
[] Mixed happy and unhappy
[] Sort of unhappy
[] Very unhappy
[] No response

210b. If you got pregnant now, how would you feel?

[] Very happy
[] Sort of happy
[] Mixed happy and unhappy
[] Sort of unhappy
[] Very unhappy
[] No response

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 heard that there is a type of injectable that you can inject yourself?

[] Yes
[] No
[] No response

301g. From whom did you hear about it?

[] Provider
[] Community health worker
[] Pharmacist
[] Friend
[] Husband/partner
[] Other family member
[] Radio/TV
[] Books/Magazine
[] Advertisement/Flyer
[] Other
[] No response

301g2. Would your partner be supportive of you using an injection at home?

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

301h. 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

301i. 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 five days to prevent pregnancy.

[] Yes
[] No
[] No response

301j. Have you ever heard of male condoms?

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

[] Yes
[] No
[] No response

301k. Have you ever heard of female condoms?

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

[] Yes
[] No
[] No response

301l. 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

301m. 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

301n. 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

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

[] Yes
[] No
[] No response

301p. 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

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

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

[] Yes
[] No
[] No response

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

[] Yes
[] No
[] No response

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

[] Yes
[] No
[] No response

303. Just to check, are you or your partner doing any of the following to avoid pregnancy: deliberately avoiding sex on certain days, using a condom, using withdrawal or using emergency contraception?

[] Yes
[] No
[] No response

304. 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

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

LCL_302. Who administered the injection?

[] Self
[] Partner/husband
[] Other family/friend
[] Doctor/nurse/midwife
[] Pharmacist/Drug shop employee
[] CHW
[] Another user I know
[] No response

304a. Do you like your {current_method_label}?

[] Yes
[] No
[] No response

305. Does your husband/partner know that you are using {current_method_label}?

[] Yes
[] No
[] No response

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

[] Yes
[] No
[] No response

305a. Did you talk with your husband/partner about using your {current_method_label} before you started using, after you started using, or you have not talked about it?

[] Before using
[] After using
[] Has not talked to him
[] No response

305a. Did you talk with your husband/partner about using your family planning method before you started using, after you started using, or you have not talked about it?

[] Before using
[] After using
[] Has not talked to him
[] No response

LCL_303. Did the provider tell you or your partner that this method was permanent?

[] Yes
[] No
[] No response

306. If you needed family planning, where would you go?

[] 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

307. Why would you choose this location?

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

[] Close to home
[] Discreet location
[] Know confidentiality will be respected
[] Have the method that I want
[] Providers have a good reputation
[] Recommend by friend/relative
[] Method available for low cost/free
[] Other
[] Do not know
[] No response

308. Please tell me if you agree or disagree with the following statement: I would feel too shy or embarrassed to get family planning at a clinic, health center or physician's office if needed.

PROBE: This question is specifically about your feelings.

[] Agree
[] Disagree
[] No response

309. Please tell me if you agree or disagree with the following statement: I would feel too shy or embarrassed to get family planning at the pharmacy or chemist if needed.

PROBE: This question is specifically about your feelings.

[] Agree
[] Disagree
[] No response

310. 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
[] Do not know
[] No response

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

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

312. When do you think you will start using a method?

[] X months
[] X years
[] Soon/now
[] After the birth of this child
[] Do not know
[] No response

Enter {fp_start_lab}:

Use years if more than 36 months.

313. What method do you think you will use?

[] 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

314. Who would you prefer to have administer the injectable?

Read all options

[] Health professional
[] Self
[] Partner/friend/family
[] Do not know
[] No response

315. Would your husband/partner be supportive of you using family planning?

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

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

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

316. Before you started using family planning, had you discussed the decision to delay or avoid pregnancy with your husband/partner?

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

317. 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

Now I'm going to ask you a few sensitive questions about your relationship with your husband/partner. You do not have to answer these questions if you do not want to. We can pause at any time. If you do not feel comfortable answering any of the questions, let me know and I will either move onto the next statement or skip this section entirely.

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

318. In the last 12 months has your husband/partner:

1 = Yes
0 = No
-99 = No Response

318a. Made you feel bad or treated you badly for wanting to use a FP method to delay or prevent pregnancy?

[] 1
[] 0
[] -99

318. In the last 12 months has your husband/partner:

1 = Yes
0 = No
-99 = No Response

318b. Tried to force or pressure you to become pregnant?

[] 1
[] 0
[] -99

318. In the last 12 months has your husband/partner:

1 = Yes
0 = No
-99 = No Response

318c. Said he would leave you if you did not get pregnant?

[] 1
[] 0
[] -99

318. In the last 12 months has your husband/partner:

1 = Yes
0 = No
-99 = No Response

318d. Told you he would have a baby with someone else if you did not get pregnant?

[] 1
[] 0
[] -99

318. In the last 12 months has your husband/partner:

1 = Yes
0 = No
-99 = No Response

318e. Taken away your family planning or kept you from going to the clinic to get family planning?

[] 1
[] 0
[] -99

319. Since what month and year have you been using {current_method_label} without stopping?

Calculate backwards from memorable events if needed.

CALENDAR: Enter episode of contraceptive use in the calendar.

Month:

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

Year:

If entering '2030' for No Response, must select 'Do not know' for month.

Cannot be in future.

320. You first started using {current_method_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

320. Where did you or your partner get {current_method_label} when you first started using it?

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

321. When you obtained your {current_method_label}, were you told by the provider about side effects or problems you might have with a method to delay or avoid pregnancy?

[] Yes
[] No
[] No response

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

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

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

If more than 12 months record in years

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

Provider: {provider_label}

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

323. At that time, were you told by the family planning provider about methods of family planning other than the {current_method_label} that you could use?

[] Yes
[] No
[] No response

324. At that time, were you told that you could switch to a different method in the future?

[] Yes
[] No
[] No response

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

[] Yes
[] No
[] Did not have a preference
[] No response

326. 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
[] Do not know
[] No response

327a. 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

327b. Who made the final decision to use rhythm?

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

327b. Who made the final decision to use LAM?

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

328. Would you return to this provider?

Provider: {provider_label}

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

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

Provider: {provider_label}

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

330. When you started using {current_method_label}, did you feel pressured by your provider to accept a specific method?

[] Yes
[] No
[] Did not have a preference before speaking with the provider
[] No response

330. When you started using family planning, did you feel pressured by your provider to accept a specific method?

[] Yes
[] No
[] Did not have a preference before speaking with the provider
[] No response

331. Which method did you feel pressured to use?

[] 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

332. Right before you started using {current_method_label} in {begin_using_full_lab}, were you doing something else or using a different method to delay or avoid getting pregnant?

[] Yes
[] No
[] No response

332. Right before you started using family planning in {begin_using_full_lab}, were you doing something else or using a different method to delay or avoid getting pregnant?

[] Yes
[] No
[] No response

333. 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

LCL_304. PROBE: Was the injection administered via syringe or small needle?

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

IMP_305. In the past 12 months, have you tried to have your current implant removed?

[] Yes
[] No
[] No response

IMP_306. 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
[] Community event
[] Friend / parent
[] Self
[] Other
[] Do not know
[] No response

IMP_307. 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
[] Do not know
[] No response

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

[] Yes
[] No
[] No response

XS_301. 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.

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

Note: the respondent said that she gave birth {birth_events} times in 202.

Enter -99 for no response.

Must be zero or larger, or -99.

336. 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 five days to prevent pregnancy.

[] Yes
[] No
[] No response

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

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

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

337. 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 109 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 109 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
[] Do not know
[] No response

338. 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

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

[] Yes
[] No
[] No response

340. 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

340. 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

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

[] Yes
[] No
[] No response

342. In the last 12 months have you:

1 = Yes
0 = No
-99 = No Response

342a. Heard about family planning on the radio?

[] 1
[] 0
[] -99

342. In the last 12 months have you:

1 = Yes
0 = No
-99 = No Response

342b. Seen anything about family planning on the television?

[] 1
[] 0
[] -99

342. In the last 12 months have you:

1 = Yes
0 = No
-99 = No Response

342c. Read about family planning in a newspaper or magazine?

[] 1
[] 0
[] -99

342. In the last 12 months have you:

1 = Yes
0 = No
-99 = No Response

342d. Received a voice or text message about family planning on a mobile phone?

[] 1
[] 0
[] -99

342. In the last 12 months have you:

1 = Yes
0 = No
-99 = No Response

342e. Seen anything on social media about family planning that is Facebook, Viber, Twitter, WhatsApp or others?

[] 1
[] 0
[] -99

343. People have different opinions about family planning. In your community, would you say most people, some people or few people have the following opinions about family planning:

1 = Most
2 = Some
3 = Few
-99 = No Response

343a. Adolescents who use family planning are promiscuous.

[] 1
[] 2
[] 3
[] -99

343. People have different opinions about family planning. In your community, would you say most people, some people or few people have the following opinions about family planning:

1 = Most
2 = Some
3 = Few
-99 = No Response

343b. Using family planning preserves a woman's health

[] 1
[] 2
[] 3
[] -99

343. People have different opinions about family planning. In your community, would you say most people, some people or few people have the following opinions about family planning:

1 = Most
2 = Some
3 = Few
-99 = No Response

343c. Family planning is only for women who are married.

[] 1
[] 2
[] 3
[] -99

343. People have different opinions about family planning. In your community, would you say most people, some people or few people have the following opinions about family planning:

1 = Most
2 = Some
3 = Few
-99 = No Response

343d. Women who use family planning can better support their children's schooling

[] 1
[] 2
[] 3
[] -99

343. People have different opinions about family planning. In your community, would you say most people, some people or few people have the following opinions about family planning:

1 = Most
2 = Some
3 = Few
-99 = No Response

343e. Family planning is only for women who don't want any more children.

[] 1
[] 2
[] 3
[] -99

343. People have different opinions about family planning. In your community, would you say most people, some people or few people have the following opinions about family planning:

1 = Most
2 = Some
3 = Few
-99 = No Response

343f. People who use family planning have a better quality of life.

[] 1
[] 2
[] 3
[] -99

344. Now, we would like to know about your personal opinions about these issues. Do you strongly agree, agree, disagree, strongly disagree with the following statements?

4 = Strongly agree
3 = Agree
2 = Disagree
1 = Strongly disagree
-99 = No response

344a. Adolescents who use family planning are promiscuous.

[] 4
[] 3
[] 2
[] 1
[] -99

344. Now, we would like to know about your personal opinions about these issues. Do you strongly agree, agree, disagree, strongly disagree with the following statements?

4 = Strongly agree
3 = Agree
2 = Disagree
1 = Strongly disagree
-99 = No response

344b. Using family planning preserves a woman's health

[] 4
[] 3
[] 2
[] 1
[] -99

344. Now, we would like to know about your personal opinions about these issues. Do you strongly agree, agree, disagree, strongly disagree with the following statements?

4 = Strongly agree
3 = Agree
2 = Disagree
1 = Strongly disagree
-99 = No response

344c. Family planning is only for women who are married.

[] 4
[] 3
[] 2
[] 1
[] -99

344. Now, we would like to know about your personal opinions about these issues. Do you strongly agree, agree, disagree, strongly disagree with the following statements?

4 = Strongly agree
3 = Agree
2 = Disagree
1 = Strongly disagree
-99 = No response

344d. Women who use family planning can better support their children's schooling

[] 4
[] 3
[] 2
[] 1
[] -99

344. Now, we would like to know about your personal opinions about these issues. Do you strongly agree, agree, disagree, strongly disagree with the following statements?

4 = Strongly agree
3 = Agree
2 = Disagree
1 = Strongly disagree
-99 = No response

344e. Family planning is only for women who don't want any more children.

[] 4
[] 3
[] 2
[] 1
[] -99

344. Now, we would like to know about your personal opinions about these issues. Do you strongly agree, agree, disagree, strongly disagree with the following statements?

4 = Strongly agree
3 = Agree
2 = Disagree
1 = Strongly disagree
-99 = No response

344f. People who use family planning have a better quality of life.

[] 4
[] 3
[] 2
[] 1
[] -99

345. How important is it for you to achieve the following in the next two years:

1 = Very important
2 = Somewhat important
3 = Not important
-99 = No Response

345a. Complete secondary school / technical school / vocation school

[] 1
[] 2
[] 3
[] -99

345. How important is it for you to achieve the following in the next two years:

1 = Very important
2 = Somewhat important
3 = Not important
-99 = No Response

345b. Attend university / tertiary institution

[] 1
[] 2
[] 3
[] -99

345. How important is it for you to achieve the following in the next two years:

1 = Very important
2 = Somewhat important
3 = Not important
-99 = No Response

345c. Find a husband/partner

[] 1
[] 2
[] 3
[] -99

345. How important is it for you to achieve the following in the next two years:

1 = Very important
2 = Somewhat important
3 = Not important
-99 = No Response

345d. Have children

[] 1
[] 2
[] 3
[] -99

346. Do you have any health insurance or are you a member of a mutual health organization?

[] Yes
[] No
[] No response

347. What type of health insurance do you have?

RECORD ALL MENTIONED

Cannot select "No response" with other options.

[] National/District Health Insurance (NHIS)
[] Health insurance through employer
[] Mutual health organization/Community-based health insurance
[] Other privately purchased commercial health insurance
[] Other
[] 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.

401. 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.

402. Looking back to the first time you had sexual intercourse, do you think you would have preferred to: have waited longer before having sex with anyone, not have waited so long, or was it the right time?

[] Waited longer
[] Not have waited so long
[] It was the right time
[] No response

403. The first time you had sexual intercourse, would you say you and your partner were both equally willing to have sexual intercourse was one of you more willing than the other?

[] Equally willing
[] Respondent more willing
[] Partner more willing
[] No response

404. Which of these applied to you at the first time you had sex?

Read each option aloud and select if yes.

Cannot select "None of the above" or "No response" with other options.

[] I was curious
[] I was carried away
[] I was under the influence of a substance
[] I was doing what was expected of me
[] I was forced against my will
[] None of the above
[] No response

405. Did you and your partner want to avoid a pregnancy the first time you had sexual intercourse?

[] Yes
[] No
[] No response

406. Did you or your partner do something or use any method to delay or avoid getting pregnant?

[] Yes
[] No
[] No response

407. 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

407. 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.

408. The last time you had sex did you or your partner use any method to avoid or prevent a pregnancy?

[] Yes
[] No
[] No response

409. What method did you or your partner use?

[] 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

410. Whose choice was it to use that method?

[] Respondent
[] Respondent and partner
[] Partner
[] Someone else
[] No response

INF_7. How many times do you have sex in a typical month?

Use -88 for 'do not know' and -99 for 'no response'

Must be a number or -88, -99

INF_8. In the past 12 months, how many months did you not have any sex with your husband/partner?

Use -88 for 'do not know' and -99 for 'no response'

Must be a number: -88, -99, or 0-12

INF_9. Have you ever sought help because you were having trouble getting pregnant?

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

INF_10. Who have you sought help from?

Select all that apply

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

[] 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
[] Friend / parent
[] Infertilty clinic (public)
[] Infertility clinic (private)
[] Traditional healer/Herbalists
[] Religious leaders
[] Other
[] Do not know
[] No response

INF_11. What type of care did you receive?

Select all that apply

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

[] In vitro fertilization (IVF) or intrauterine insemination (IUI)
[] Treatment to increase ovulation
[] STI treatment
[] Surgery
[] Injections
[] Pills
[] Medicinal drink
[] Home remedy
[] Herbs
[] Ritual
[] Prayer
[] Other
[] Do not know
[] No response

INF_12. When did you most recently seek help?

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
[] Do not know
[] No response

INF_12a. Enter the number of {preg_help_lab} ago you most recently sought help:

INF_13. Some people wonder if they can have children. In your case, what is the sentence that best describes your current situation?

[] You think you can have children
[] You have difficulties having children
[] You are sure you can't have children (anymore) yourself
[] You do not know if you can have children
[] You can have children but the doctor has recommended you do not
[] Do not know
[] No response

INF_14. And regarding your partner:

[] You think your partner can have children
[] Your partner has difficulties having children
[] You are sure your partner can't have children (anymore)
[] You do not know if he can have children
[] Do not know
[] No response

Section 5 - Women and Girls Empowerment Section

Now I'm going to ask you a series of statements about family planning and contraception. Please indicate how much you think these statements could apply to you by indicating how strongly you agree or disagree with the statement. Some will seem similar but we would like you to consider each one as different.
We can pause at any time. If you do not feel comfortable answering any of the statements, let me know and I will move onto the next statement.

501. If I use family planning, my husband/partner may seek another sexual partner.

[] Strongly disagree (1)
[] Disagree (2)
[] Neither agree nor disagree (3)
[] Agree (4)
[] Strongly agree (5)
[] Do not know
[] No response

502. If I use family planning, I may have trouble getting pregnant the next time I want to.

[] Strongly disagree (1)
[] Disagree (2)
[] Neither agree nor disagree (3)
[] Agree (4)
[] Strongly agree (5)
[] Do not know
[] No response

503a. There could be conflict in my relationship/marriage if I use family planning.

[] Strongly disagree (1)
[] Disagree (2)
[] Neither agree nor disagree (3)
[] Agree (4)
[] Strongly agree (5)
[] Do not know
[] No response

503b. There will be conflict in my relationship/marriage if I use family planning.

[] Strongly disagree (1)
[] Disagree (2)
[] Neither agree nor disagree (3)
[] Agree (4)
[] Strongly agree (5)
[] Do not know
[] No response

504. If I use family planning, my children may not be born normal.

[] Strongly disagree (1)
[] Disagree (2)
[] Neither agree nor disagree (3)
[] Agree (4)
[] Strongly agree (5)
[] Do not know
[] No response

505. If I use family planning, my body may experience side effects that will disrupt my relations with my husband/partner.

[] Strongly disagree (1)
[] Disagree (2)
[] Neither agree nor disagree (3)
[] Agree (4)
[] Strongly agree (5)
[] Do not know
[] No response

WGE_2. I can decide to switch from one family planning method to another if I want to.

[] Strongly disagree (1)
[] Disagree (2)
[] Neither agree nor disagree (3)
[] Agree (4)
[] Strongly agree (5)
[] Do not know
[] No response

WGE_3. I feel confident telling my provider what is important for me when selecting a family planning method.

[] Strongly disagree (1)
[] Disagree (2)
[] Neither agree nor disagree (3)
[] Agree (4)
[] Strongly agree (5)
[] Do not know
[] No response

WGE_4. I feel confident discussing family planning with my husband/partner.

[] Strongly disagree (1)
[] Disagree (2)
[] Neither agree nor disagree (3)
[] Agree (4)
[] Strongly agree (5)
[] Do not know
[] No response

Now I'm going to ask you a series of statements about pregnancy and childbearing. Please indicate how much you think these statements could apply to you by indicating how strongly you agree or disagree with the statement. Some will seem similar but we would like you to consider each one as different. We can pause at any time. If you do not feel comfortable answering any of the statements, let me know and I will move onto the next statement.

WGE_5a. I want to complete my education before I have a child.

[] Strongly disagree (1)
[] Disagree (2)
[] Neither agree nor disagree (3)
[] Agree (4)
[] Strongly agree (5)
[] Do not know
[] No response

WGE_5b. I wanted to complete my education before I had a child.

[] Strongly disagree (1)
[] Disagree (2)
[] Neither agree nor disagree (3)
[] Agree (4)
[] Strongly agree (5)
[] Do not know
[] No response

WGE_6. If I rest between pregnancies, I can take better care of my family.

[] Strongly disagree (1)
[] Disagree (2)
[] Neither agree nor disagree (3)
[] Agree (4)
[] Strongly agree (5)
[] Do not know
[] No response

WGE_7a. I can decide when I want to start having children.

[] Strongly disagree (1)
[] Disagree (2)
[] Neither agree nor disagree (3)
[] Agree (4)
[] Strongly agree (5)
[] Do not know
[] No response

WGE_7b. I could decide when I wanted to start having children.

[] Strongly disagree (1)
[] Disagree (2)
[] Neither agree nor disagree (3)
[] Agree (4)
[] Strongly agree (5)
[] Do not know
[] No response

WGE_8. I feel confident discussing with my husband/partner when to start having children.

[] Strongly disagree (1)
[] Disagree (2)
[] Neither agree nor disagree (3)
[] Agree (4)
[] Strongly agree (5)
[] Do not know
[] No response

WGE_9. I can decide when to have another child.

[] Strongly disagree (1)
[] Disagree (2)
[] Neither agree nor disagree (3)
[] Agree (4)
[] Strongly agree (5)
[] Do not know
[] No response

WGE_10a. I will be able to negotiate with my husband/partner when to stop having children.

[] Strongly disagree (1)
[] Disagree (2)
[] Neither agree nor disagree (3)
[] Agree (4)
[] Strongly agree (5)
[] Do not know
[] No response

WGE_10b. I can negotiate with my husband/partner when to stop having children.

[] Strongly disagree (1)
[] Disagree (2)
[] Neither agree nor disagree (3)
[] Agree (4)
[] Strongly agree (5)
[] Do not know
[] No response

Now I'm going to ask you a series of statements about sexual activity. Please indicate how much you think these statements could apply to you by indicating how strongly you agree or disagree with the statement. If you are not now living with a husband/partner, you can refer to your situation with your last husband/partner. Some will seem similar but we would like you to consider each one as different. We can pause at any time. If you do not feel comfortable answering any of the statements, let me know and I will move onto the next statement.

WGE_11. If I refuse sex with my husband/partner, he may stop supporting me.

[] Strongly disagree (1)
[] Disagree (2)
[] Neither agree nor disagree (3)
[] Agree (4)
[] Strongly agree (5)
[] Do not know
[] No response

WGE_12. If I refuse sex with my husband/partner, he may force me to have sex.

[] Strongly disagree (1)
[] Disagree (2)
[] Neither agree nor disagree (3)
[] Agree (4)
[] Strongly agree (5)
[] Do not know
[] No response

WGE_13. If I refuse sex with my husband/partner, he may physically hurt me.

[] Strongly disagree (1)
[] Disagree (2)
[] Neither agree nor disagree (3)
[] Agree (4)
[] Strongly agree (5)
[] Do not know
[] No response

WGE_14. If I show my husband/partner that I want to have sex, he may consider me promiscuous.

[] Strongly disagree (1)
[] Disagree (2)
[] Neither agree nor disagree (3)
[] Agree (4)
[] Strongly agree (5)
[] Do not know
[] No response

WGE_15. I am confident I can tell my husband/partner when I want to have sex.

[] Strongly disagree (1)
[] Disagree (2)
[] Neither agree nor disagree (3)
[] Agree (4)
[] Strongly agree (5)
[] Do not know
[] No response

WGE_16. I am able to decide when to have sex.

[] Strongly disagree (1)
[] Disagree (2)
[] Neither agree nor disagree (3)
[] Agree (4)
[] Strongly agree (5)
[] Do not know
[] No response

WGE_17. If I do not want to have sex, I can tell my husband/partner.

[] Strongly disagree (1)
[] Disagree (2)
[] Neither agree nor disagree (3)
[] Agree (4)
[] Strongly agree (5)
[] Do not know
[] No response

WGE_18. If I do not want to have sex, I am capable of avoiding it with my husband/partner.

[] Strongly disagree (1)
[] Disagree (2)
[] Neither agree nor disagree (3)
[] Agree (4)
[] Strongly agree (5)
[] Do not know
[] No response

Follow-up Consent

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

Would you be willing to participate in another survey one year from now?

[] Yes
[] No
[] No response

802. Do you have access to a phone?

[] Yes
[] No
[] No response

803a. Can I have your primary phone number in case we would like to follow up with you in the future?

[] Yes
[] No
[] No response

803b. What is your primary phone number?

Enter an 8-digit number without the country code. Do not include spaces or dashes.

803d. Is this your personal phone number?

A personal phone is not shared with other people.

[] Yes
[] No
[] No response

804a. Can I have your secondary phone number in case we would like to follow up with you in the future?

[] Yes
[] No
[] No response

804b. What is your secondary phone number?

Enter an 8-digit number without the country code. Do not include spaces or dashes.

804d. Is this your personal phone number?

A personal phone is not shared with other people.

[] Yes
[] No
[] No response

805. Is {firstname} the name you go by in your household?

[] Yes
[] No
[] No response

806. What is the name you go by in your household?

807. Is {firstname} the name you go by in your community?

[] Yes
[] No
[] No response

808. What is the name you go by in your community?

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

098. Questionnaire Result

Record the result of the questionnaire.

Check answer to 006 and consent.

[] Completed
[] Not at home
[] Postponed
[] Refused
[] Partly completed
[] Incapacitated
[] Deceased
[] Moved out of study area