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Cote d'Ivoire Phase 1 Female Questionnaire 2020

Region:

Department:

Sub-prefecture:

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. Enter your ID below.

Please record your ID

003b. Record the correct date and time.

The date must be between 2019-12-01 and 2021-03-01.

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}

Department: ${level2_unlinked}

Sub-prefecture: ${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

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

Please confirm that you have screened the respondent for COVID-19 before continuing.

[] Yes
[] No

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 me nomme _______________________________ et je travaille pour l?Ecole Nationale Supérieure de Statistique et d?Economie Appliquée (ENSEA) d?Abidjan. Nous menons une étude dans le domaine de la santé, plus spécifiquement sur la planification familiale en Côte d?Ivoire. A cet effet, je vais vous lire ce formulaire afin de vous exposer l?objectif principal de l?étude et vous donner des informations supplémentaires dans le but solliciter votre participation à cette étude.

Présentation et objet de l?étude

En collaboration avec le Ministère de la Santé et de l?Hygiène Publique de la Côte d?Ivoire et l?école de santé publique et de la santé reproductive de l?université de Johns Hopkins aux Etats-Unis, l?Ecole Nationale Supérieur de la Statistique et d?Economie Appliquée (ENSEA) réalise une étude dénommée PMA (Performance Monitoring for Action).

L?objectif principal de cette étude est de mettre en ?uvre un système de suivi des performances accomplies dans le domaine de la planification familiale et de la santé reproductive des femmes au sein de la population et des structures de santé en Côte d?Ivoire. En outre, les informations que nous collecterons serviront à éclairer les programmes de développement social en Côte d?Ivoire.

Pourquoi est-ce qu?on vous demande de participer??

Votre ménage a été sélectionné pour cette enquête. Nous vous demandons de participer à l?étude car vous êtes une jeune femme ayant entre 15 et 49 ans. Nous apprécierons beaucoup que vous fassiez partie de cette enquête. 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 resteront strictement confidentielles et ne seront montrées à personne d?autre que les membres de notre équipe.

Nous tenons à préciser que la participation à cette enquête est volontaire et il n'y a aucun avantage personnel direct pour votre participation dans cette étude. Néanmoins nous comptons vivement sur votre participation car votre point de vue est très important. Si vous ne souhaitez pas répondre à une question en particulier, faîtes-le moi savoir et je passerai à la question suivante. L?enquête prendra environ 1 heure et vous pourriez trouver cela lassant. Si c'est le cas, vous êtes libre d?arrêter l?entretien à n?importe quel moment.

Vous ne recevrez pas de motivation financière pour votre participation, mais en guise de remerciement un kit d?hygiène (composé de morceaux de savon et poudre à laver d?un montant de 1 000 FCFA) sera offert à votre ménage comme compensation pour le temps que les membres de votre ménage ont consacré pour répondre à nos différents questionnaires.

Protection de la confidentialité des données

Les données seront collectées sur des smartphones. Toutes les données seront envoyées par voie électronique sur le serveur «?cloud?» de l?étude PMA. L'utilisation et le partage des informations seront rigoureusement soumis à des principes de précautions pour garantir leur sécurité et confidentialité. Une fois la collecte terminée, les informations d'identification seront supprimées de la base de données.

Avant de continuer, avez-vous des questions sur cette enquête ?

Personne à contacter pour des compléments d?informations ou inquiétudes

Si vous avez des questions ou des inquiétudes par rapport à cette étude, vous pouvez joindre l?Investigatrice Principale nationale de l'étude Dr. Rosine Mosso-BOMISSO à Abidjan. Si cela s'avère nécessaire, vous pouvez aussi joindre le Comité national d'éthique à Abidjan qui a donné son approbation pour l'étude.

Que veut dire votre signature sur ce formulaire de consentement ?

Votre signature sur ce formulaire veut dire que :

? Vous avez été informé sur l?objectif, les procédures, les avantages et les risques de cette étude.
? Vous avez eu l?occasion de poser des questions avant de signer.
? Vous avez donné votre accord pour votre participation de votre propre volonté.

Est?ce que j'ai votre consentement pour commencer ?

008a. Provide a paper copy of the Consent Form to the respondent and read it.

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.

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, Employment, and Migration

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

101. In what month and year were you born?
Month:

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

Year:

Cannot be in the future.

102. How old were you at your last birthday?

Must be more than 14. Must agree with 101.

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

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
[] Tertiary
[] No response

104. What is the highest YEAR you completed at that level?

Enter -99 for no response.

105. Are you still attending school?

[] Yes
[] No
[] No response

106. How old were you when you left school?

Must be between 0 and the respondent's age.

107. What was the main reason for stopping your education?

[] 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. 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

111. 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

112. Have you ever had a partner / boyfriend?

[] Yes
[] No
[] No response

113. 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

115. 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

116. 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.

117. 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 '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.

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

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

119. 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.

120. 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.

121. 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.

122. 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.

123. Aside from your own housework, have you done any work in the last seven days?

Work is not always paid and can include things like work on the family farm or in the family business, selling things at the market, or running a small business.

[] Yes
[] No
[] No response

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

Work is not always paid and can include things like work on the family farm or in the family business, selling things at the market, or running a small business.

[] Yes
[] No
[] No response

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

Receiving a regular salary only is CASH, receiving lodging and food only is IN-KIND, receiving food and money is CASH AND IN-KIND, not being paid - like work on the family farm - is NOT PAID

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

126. 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

127. 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

128. 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. Did you take part in any of these activities over the past 30 days?

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

COV_1. Before I spoke with you today, how much, if anything, had you heard or read about the recent Coronavirus (COVID-19) outbreak? 

Read all options 

[] A lot
[] Some
[] A little
[] Not at all
[] 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)?

[] Yes
[] No
[] No response

FIN_3. When it comes to managing your money and financial matters, what is your level of knowledge?

[] Not knowledgeable at all
[] Not very knowledgeable
[] Somewhat knowledgeable
[] Very knowledgeable
[] No response

FIN_4. Do you know where to go for financial information or advice?

[] Yes
[] No
[] No response

FIN_5. Do you have financial goals toward which you are working?

PROBE: These are specific financial goals you have setup for yourself.

[] Yes
[] No
[] 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.

203. 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 ${cc_start_date_lab} 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.

204. 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 ${cc_start_date_lab} 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.

205. Have you had any other births since January 2018?

[] Yes
[] No
[] No response

206. When was that birth?

Please record the date of the MOST RECENT live 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.

207. Have you ever had a pregnancy that miscarried, was aborted, or ended in a stillbirth since ${cc_start_date_lab}?

[] Yes
[] No
[] No response

208. 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

209. Are you pregnant now?

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

210. 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.

211. 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

211. 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.

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

Enter -88 for do not know,
Enter -99 for no response.

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.

214a. 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

214a. 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

214b. 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

215a. 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

215a. 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

215b. 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

215c. Enter the number of ${waitchild} you would like to wait:

Use years if more than 36 months.

216a. 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

216b. 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

COV_2. Have you changed your mind about wanting to get pregnant due to concerns about Coronavirus (COVID-19)?

[] Yes
[] No
[] 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 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 five days to prevent pregnancy.

[] Yes
[] No
[] No response

301h. Have you ever heard of male 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

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

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

[] Yes
[] No
[] No response

303. 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
[] LAM
[] Rhythm method
[] Withdrawal
[] Other traditional method
[] No response

Check here to acknowledge you considered all options.

[] NA

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

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

[] Yes
[] No
[] No response

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

[] Yes
[] No
[] No response

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

[] Government hospital
[] Government health center
[] Family planning clinic
[] Mobile clinic (public)
[] Other public
[] Private hospital / clinic
[] Pharmacy
[] Private doctor
[] Mobile clinic (private)
[] Health agent
[] Other private
[] Store
[] Religious organizations
[] Community event
[] Friend / parent
[] Community health agent
[] Street vendor
[] Other
[] Do not know
[] No response

306. Why would you choose this location?

[] 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

307. 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

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 the pharmacy or chemist if needed.

PROBE: This question is specifically about your feelings.

[] Agree
[] Disagree
[] No response

309. 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

310. 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. 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.

312. 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
[] LAM
[] Rhythm method
[] Withdrawal
[] Other traditional method
[] No response

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

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

314. 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

315. 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

316. 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.

317. 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.

[] Government hospital
[] Government health center
[] Family planning clinic
[] Mobile clinic (public)
[] Other public
[] Private hospital / clinic
[] Pharmacy
[] Private doctor
[] Mobile clinic (private)
[] Health agent
[] Other private
[] Store
[] Religious organizations
[] Community event
[] Friend / parent
[] Community health agent
[] Street vendor
[] Other
[] Do not know
[] No response

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

Scroll to bottom to see all choices.

[] Government hospital
[] Government health center
[] Family planning clinic
[] Mobile clinic (public)
[] Other public
[] Private hospital / clinic
[] Pharmacy
[] Private doctor
[] Mobile clinic (private)
[] Health agent
[] Other private
[] Store
[] Religious organizations
[] Community event
[] Friend / parent
[] Community health agent
[] Street vendor
[] Other
[] Do not know
[] No response

Check here to acknowledge you considered all options.

[] NA

318. 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

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

[] Yes
[] No
[] No response

320. 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

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

[] Yes
[] No
[] No response

322. 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

323. 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

324a. 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

324b. Who made the final decision to use rhythm?

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

324b. Who made the final decision to use LAM?

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

325. Would you return to this provider?

Provider: ${provider_label}

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

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

Provider: ${provider_label}

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

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

[] Yes
[] No
[] No response

328. 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.

329. 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.

330. 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

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

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

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

331. 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

Check here to acknowledge you considered all options.

[] NA

COV_3. Can you tell me if any of the following Coronavirus (COVID-19) related reasons contribute to why you are not using a method to prevent pregnancy?

Read each option aloud and select if yes.

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

Cannot select "Not Married" if 109 is "Yes, currently married".

[] Healthcare facility or doctor's office closed, appointment not possible, services not available
[] Desired product(s) not available
[] Unable to access services because of government restrictions on movement
[] Fear of being infected with COVID-19 at healthcare facilities
[] Other
[] None of the above
[] No response

332. 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

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

[] Yes
[] No
[] No response

334. 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

334. 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

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

[] Yes
[] No
[] No response

336. In the last 12 months have you:
336a. Heard about family planning on the radio?

[] Yes
[] No
[] No response

336. In the last 12 months have you:
336b. Seen anything about family planning on the television?

[] Yes
[] No
[] No response

336. In the last 12 months have you:
336c. Read about family planning in a newspaper or magazine?

[] Yes
[] No
[] No response

336. In the last 12 months have you:
336d. Received a voice or text message about family planning on a mobile phone?

[] Yes
[] No
[] No response

336. In the last 12 months have you:
336e. Seen anything on social media about family planning that is Facebook, Viber, Twitter, WhatsApp or others?

[] Yes
[] No
[] No response

337. 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:
337a. Adolescents who use family planning are promiscuous.

[] Most
[] Some
[] Few
[] No response

337. 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:
337b. Family planning is only for women who are married.

[] Most
[] Some
[] Few
[] No response

337. 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:
337c. Family planning is only for women who don't want any more children.

[] Most
[] Some
[] Few
[] No response

337. 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:
337d. People who use family planning have a better quality of life.

[] Most
[] Some
[] Few
[] No response

338. Now, we would now like to know about your personal opinions about these issues. Do you strongly agree, agree, disagree, strongly disagree with the following statements?
338a. Adolescents who use family planning are promiscuous.

[] Strongly agree
[] Agree
[] Disagree
[] Strongly disagree
[] No response

338. Now, we would now like to know about your personal opinions about these issues. Do you strongly agree, agree, disagree, strongly disagree with the following statements?
338b. Family planning is only for women who are married.

[] Strongly agree
[] Agree
[] Disagree
[] Strongly disagree
[] No response

338. Now, we would now like to know about your personal opinions about these issues. Do you strongly agree, agree, disagree, strongly disagree with the following statements?
338c. Family planning is only for women who don't want any more children.

[] Strongly agree
[] Agree
[] Disagree
[] Strongly disagree
[] No response

338. Now, we would now like to know about your personal opinions about these issues. Do you strongly agree, agree, disagree, strongly disagree with the following statements?
338d. People who use family planning have a better quality of life.

[] Strongly agree
[] Agree
[] Disagree
[] Strongly disagree
[] No response

339. How important is it for you to achieve the following in the next two years:
339a. Complete secondary school / technical school / vocation school

[] Very important
[] Somewhat important
[] Not important
[] No response

339. How important is it for you to achieve the following in the next two years:
339b. Attend university / tertiary institution

[] Very important
[] Somewhat important
[] Not important
[] No response

339. How important is it for you to achieve the following in the next two years:
339c. Have a good job

[] Very important
[] Somewhat important
[] Not important
[] No response

339. How important is it for you to achieve the following in the next two years:
339d. Start a business

[] Very important
[] Somewhat important
[] Not important
[] No response

339. How important is it for you to achieve the following in the next two years:
339e. Find a partner

[] Very important
[] Somewhat important
[] Not important
[] No response

339. How important is it for you to achieve the following in the next two years:
339f. Get married

[] Very important
[] Somewhat important
[] Not important
[] No response

339. How important is it for you to achieve the following in the next two years:
339g. Have children

[] Very important
[] Somewhat important
[] Not important
[] No response

340. How important is it to your parents / guardian that you achieve the following in the next two years:
340a. Complete secondary school / technical school / vocation school

[] Very important
[] Somewhat important
[] Not important
[] No response

340. How important is it to your parents / guardian that you achieve the following in the next two years:
340b. Attend university / tertiary institution

[] Very important
[] Somewhat important
[] Not important
[] No response

340. How important is it to your parents / guardian that you achieve the following in the next two years:
340c. Have a good job

[] Very important
[] Somewhat important
[] Not important
[] No response

340. How important is it to your parents / guardian that you achieve the following in the next two years:
340d. Start a business

[] Very important
[] Somewhat important
[] Not important
[] No response

340. How important is it to your parents / guardian that you achieve the following in the next two years:
340e. Find a partner

[] Very important
[] Somewhat important
[] Not important
[] No response

340. How important is it to your parents / guardian that you achieve the following in the next two years:
340f. Get married

[] Very important
[] Somewhat important
[] Not important
[] No response

340. How important is it to your parents / guardian that you achieve the following in the next two years:
340g. Have children

[] Very important
[] Somewhat important
[] Not important
[] No response

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

[] Yes
[] No
[] No response

342. What type of health insurance do you have?

RECORD ALL MENTIONED

Cannot select "No response" with other options.

[] Universal health coverage
[] MUGEFCI
[] HEALTH IVORY
[] Company health insurance
[] Organization / community-based health insurance
[] Other Private Health Insurance
[] Other
[] No answer

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. How much do you think you will be involved in the decision to have sex for the first time ? very much, not very much or not at all?

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

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

[] Yes
[] No
[] No response

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

[] Yes
[] No
[] No response

408. 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

408. 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.

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

[] Yes
[] No
[] No response

410. 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
[] LAM
[] Rhythm method
[] Withdrawal
[] Other traditional method
[] No response

411. Whose choice was it to use that method?

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

WGE_1. At the last time you had sex, did any of the following happen?
WGE_1a. I did not want to have sex at that time

[] Yes
[] No
[] No response

WGE_1. At the last time you had sex, did any of the following happen?
WGE_1b. I felt pressured by my husband / partner to have sex then

[] Yes
[] No
[] No response

WGE_1. At the last time you had sex, did any of the following happen?
WGE_1c. I did not consent (was forced) to have sex then

[] Yes
[] No
[] No response

WGE_1. At the last time you had sex, did any of the following happen?
WGE_1d. I felt at risk of physical violence if I declined to have sex at that time

[] Yes
[] No
[] 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)
[] 2
[] 3
[] 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)
[] 2
[] 3
[] 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)
[] 2
[] 3
[] 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)
[] 2
[] 3
[] 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)
[] 2
[] 3
[] 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)
[] 2
[] 3
[] 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)
[] 2
[] 3
[] 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)
[] 2
[] 3
[] 4
[] Strongly agree (5)
[] Do not know
[] No response

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

[] Strongly disagree (1)
[] 2
[] 3
[] 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)
[] 2
[] 3
[] 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)
[] 2
[] 3
[] 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)
[] 2
[] 3
[] 4
[] Strongly agree (5)
[] Do not know
[] No response

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

[] Strongly disagree (1)
[] 2
[] 3
[] 4
[] Strongly agree (5)
[] Do not know
[] No response

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

[] Strongly disagree (1)
[] 2
[] 3
[] 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)
[] 2
[] 3
[] 4
[] Strongly agree (5)
[] Do not know
[] No response

WGE_9. I can decide when to have another child.

[] Strongly disagree (1)
[] 2
[] 3
[] 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)
[] 2
[] 3
[] 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)
[] 2
[] 3
[] 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)
[] 2
[] 3
[] 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)
[] 2
[] 3
[] 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)
[] 2
[] 3
[] 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)
[] 2
[] 3
[] 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)
[] 2
[] 3
[] 4
[] Strongly agree (5)
[] Do not know
[] No response

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

[] Strongly disagree (1)
[] 2
[] 3
[] 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)
[] 2
[] 3
[] 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)
[] 2
[] 3
[] 4
[] Strongly agree (5)
[] Do not know
[] No response

Section 6 ? COVID-19 (Coronavirus)

We understand that Coronavirus (COVID-19) has impacted many people's lives. We are interested in learning more about how you are being affected.

COV_4. How concerned are you about getting infected yourself?

Read all options

[] Very concerned
[] Concerned
[] A little concerned
[] Not concerned
[] I was infected with Coronavirus (COVID-19)
[] No response

COV_5. You previously mentioned that you spent some time away from your current community this year, did you leave your current community to avoid Coronavirus (COVID-19)?

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

COV_6. During the Coronavirus (COVID-19) restrictions, how much of a loss of income did your household experience?

Read all options

[] None
[] Complete
[] Partial
[] No response

COV_7. During the Coronavirus (COVID-19) restrictions, how much of a loss of income did you experience?

Read all options

[] Large
[] Moderate
[] Small
[] Has no income
[] No response

COV_8. Are you worried about the impact of Coronavirus (COVID-19) on your household's finances in the future?

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

COV_9. During the Coronavirus (COVID-19) restrictions, did you or any household member go a whole day and night without eating anything because there was not enough food?

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

COV_10. During the Coronavirus (COVID-19) restrictions, how often did this happen?

[] Rarely (1-2 times)
[] Sometimes (3-10 times)
[] Often (more than 10 times)
[] Do not know
[] No response

COV_11. Was this more common during the Coronavirus (COVID-19) restrictions compared to before the restrictions began?

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

COV_12. During the Coronavirus (COVID-19) restrictions, who usually made 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

COV_13. Are you currently economically reliant on your husband/partner for basic needs?

[] Yes
[] No
[] No response

COV_14. Are you more economically reliant on your husband/partner now than before the Coronavirus (COVID-19) restrictions began?

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

COV_15. During the Coronavirus (COVID-19) restrictions, did you want to visit a health facility for any of the following services?

Read each option aloud and select if yes.

You selected no response with another option.

[] Family planning services
[] Abortion / post-abortion services
[] ANC
[] Delivery
[] PNC
[] Child's health
[] Immunization
[] Pick up of regular medications
[] HIV
[] Emergency services
[] General health services
[] Other
[] Did not want to access a health facility
[] No response

COV_16. Did you experience any of the following difficulties in accessing healthcare services during the Coronavirus (COVID-19) restrictions?

Read each option aloud and select if yes.

You selected no response with another option.

[] Healthcare facility or doctor's office closed, appointment not possible, services not available
[] Desired product(s) not available
[] Partner does not approve
[] No transportation to access healthcare services
[] Unable to access services because of government restrictions on movement
[] Unable to afford healthcare services
[] Fear of being infected with COVID-19 at healthcare facilities
[] Other
[] Did not attempt to access healthcare services or did not experience difficulties accessing care
[] No response

COV_17. Did you successfully access the health services you needed?

[] Yes
[] No
[] No response

COV_18. Did you stop or interrupt your contraceptive use at any time due to Coronavirus (COVID-19) restrictions?

[] Yes
[] No
[] No response

COV_19. During the Coronavirus (COVID-19) restrictions, did you use emergency contraception?

[] Yes
[] No
[] 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 own a phone?

[] Yes
[] No
[] No response

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 0 for no response.

804. Can you repeat the number again?

Enter an 8-digit number without the country code. Do not include spaces or dashes.
Enter 0 for no response.

Number entered must match previously entered number.

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
[] Abbey
[] Abron
[] Adjoukrou
[] Agni
[] Arabic
[] Attie
[] Avikam
[] Bakoué
[] Baoule
[] Bete
[] Dida
[] Dioula
[] Djimini
[] Ebrié
[] Eholié
[] Elomoin
[] Fantin
[] Gnaboua
[] Godié
[] Gouro
[] Guere
[] Koulango
[] Kouzié
[] Kôyaka
[] Kroumen
[] Lobi
[] Mahou
[] Moré
[] N'zima
[] Senoufo
[] Suamlin
[] Wobe
[] Yacouba
[] Other

098. Questionnaire Result

Record the result of the questionnaire.

Check answer to 006 and consent.

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