Region:

Department:

Sub-prefecture:

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.

002a. Your ID:

Is this your ID?

002a. Enter your ID below.

Please record your ID

003a. Is this date and time correct?
{today_formatted}

003b. Record the correct date and time.

The date must be between 2022-08-01 and 2022-12-31.

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

004a. Is the above information correct?

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

Is the respondent present and available to be interviewed today?

How well acquainted are you with the respondent?

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.

Hello, my name is {your_name} and I work for the Ecole Nationale Supérieure de Statistique et d?Economie Appliquée (ENSEA) in Abidjan. We are conducting a study in the field of health, specifically on family planning in Côte d?Ivoire. To this end, I am going to read you this form in order to explain the main objective of the study and to give you additional information in order to solicit your participation in this study.
Presentation and purpose of the study
In collaboration with the Ministry of Health and Public Hygiene and Universal Health Coverage of Côte d?Ivoire and the Johns Hopkins University School of Public and Reproductive Health in the United States, the Ecole Nationale Supérieure de la Statistique et d?Economie Appliquée (ENSEA) is conducting a study called PMA (Performance Monitoring for Action).
The main objective of this study is to implement a follow-up system for performance in the area of family planning and women?s reproductive health among the population and health facilities in Côte d?Ivoire. In addition, the information we collect will be used to inform social development programs in Côte d?Ivoire.
Why are you being asked to participate?
We are asking you to participate in the study because you participated in a survey we conducted last year and indicated that you would be willing to participate in a follow-up survey. Although you agreed at the time to be contacted again for future surveys, you still have the right to decide not to participate at any time. Nonetheless, we would very much appreciate it if you were part of this survey, as the information we collect will help inform the government to better plan health services. Any information you give us will be kept strictly confidential and will not be shown to anyone other than our team members.
Participation in this survey is voluntary, and if there is a question you do not wish to answer, please let me know and I will move on to the next one; you may also stop the interview at any time. However, we hope you will agree to participate in this survey because your views are important. Our interview should last approximately 45 minutes to 1 hour and 45 minutes.
We also want to remind you that there is no direct benefit to you for participating in the study. You will not be compensated for completing this survey. But as a thank you, a hygiene kit (consisting of soap and washing powder) will be offered to your household as compensation for the time your household members spent answering our various questionnaires.
Data privacy protection Data will be collected on smartphones. All data will be sent electronically to the PMA study cloud server. The use and sharing of the information will be subject to strict precautionary principles to ensure its security and confidentiality. Once collection is complete, identifying information will be deleted from the database.
Before continuing, do you have any questions about this survey?
Contact person for additional information or concerns If you have any questions or concerns about this study, you can contact the National Principal Investigator of the study, Dr. Rosine Mosso-BOMISSO in Abidjan. If necessary, you can also contact the National Ethics Committee in Abidjan, which has given its approval for the study.

Hello, my name is {your_name} and I work for the Ecole Nationale Supérieure de Statistique et d?Economie Appliquée (ENSEA) in Abidjan. We are conducting a study in the field of health, specifically on family planning in Côte d?Ivoire. To this end, I am going to read you this form in order to explain the main objective of the study and to give you additional information in order to solicit your participation in this study.
Presentation and purpose of the study
In collaboration with the Ministry of Health and Public Hygiene and Universal Health Coverage of Côte d?Ivoire and the Johns Hopkins University School of Public and Reproductive Health in the United States, the Ecole Nationale Supérieure de la Statistique et d?Economie Appliquée (ENSEA) is conducting a study called PMA (Performance Monitoring for Action).
The main objective of this study is to implement a follow-up system for performance in the area of family planning and women?s reproductive health among the population and health facilities in Côte d?Ivoire. In addition, the information we collect will be used to inform social development programs in Côte d?Ivoire.
Why are you being asked to participate?
Your household has been selected for this survey. We are asking you to participate in the study because you are a young woman between the ages of 15 and 49. We would appreciate it very much if you would be part of this survey. The information we collect will help inform the government so that they can better plan health services. All the information you give us will be kept strictly confidential and will not be shown to anyone other than our team members.
We would like to make it clear that participation in this survey is voluntary and there is no direct personal benefit for your participation in this study. Nevertheless, we rely heavily on your participation as your views are very important. If you do not wish to answer a particular question, please let me know and I will move on to the next question. The survey will take about 45 minutes to 1 hour and 45 minutes and you may find it tedious. If so, you are free to stop the interview at any time.
You will not receive any financial incentive for your participation, but as a thank you a hygiene kit (consisting of soap and washing powder) will be offered to your household as compensation for the time your household members have spent answering our various questionnaires.
Data privacy protection Data will be collected on smartphones. All data will be sent electronically to the PMA study cloud server. The use and sharing of the information will be subject to strict precautionary principles to ensure its security and confidentiality. Once collection is complete, identifying information will be deleted from the database.
Before continuing, do you have any questions about this survey?
Contact person for additional information or concerns If you have any questions or concerns about this study, you can contact the National Principal Investigator of the study, Dr. Rosine Mosso-BOMISSO in Abidjan. If necessary, you can also contact the National Ethics Committee in Abidjan, which has given its approval for the study.

008a. Read the verbal consent text.
Then, ask: May I begin the interview now?

008b. Respondent?s signature

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

Checkbox

Interviewer?s ID: {your_name}

Mark your ID as a witness to the consent process.

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.

Respondent?s first name:

Was this woman interviewed in ANY previous survey?

Check your list of panel women

Section 1 ? Respondent?s Background, Marital Status, Employment, and Migration

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

In what month and year were you born?
The age in the household roster is {hq_age}.

In what month and year were you born?

Month:

Year:

Cannot be this year or in the future.

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.

Previous Birthday: {p1_fq_birthdate}

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

Have you attended school in the past 12 months?

What is the highest level of school you attended?

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

What is the highest 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.

What was the main reason you stopped attending school?

Are you currently enrolled in any training program?

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.

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

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

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

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?

Have you ever had a partner / boyfriend?

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

Must be between 0 and the respondent?s age.

Do you currently have a boyfriend or partner?

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:

Year:

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:

Year:

If entering ?2030? for No Response, must select ?Do not know? for month.
Cannot be in future.

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:

Year:

If entering ?2030? for No Response, must select ?Do not know? for month.
Cannot be in future.

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:

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?

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.

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.

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.

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?

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

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

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

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

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

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

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?

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?

EMP_4. Do you own any land, either jointly or by yourself?
PROBE: This does not include land owned only by your husband.

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?

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.

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

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

Do you have a way of accessing the internet?

How often do you access the internet?

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.

What other device do you use to access the internet?

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

Section 2 ? Reproduction, Pregnancy and Fertility Preferences

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

How many times have you given birth?

Enter -99 for no response.

PL_201. Have you had any births since {p1_survey_date_lab}?

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:

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 {cc_start_date_lab} enter the birth and duration of pregnancy in the calendar.

Month:

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 {cc_start_date_lab} enter the birth and duration of pregnancy in the calendar.

Month:

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 {cc_start_date_lab}?

XS_204. 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:

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 {cc_start_date_lab}?

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:

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 {p1_survey_date_lab}?

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:

Year:

If entering ?2030? for No Response, must select ?Do not know? for month.
Cannot be in future

Are you pregnant now?

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.

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.

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?

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

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

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?

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?

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

Read response options and select one

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

Read response options and select one

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?

208a. Would you like to have another child or would you prefer not to have any more children?

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?

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.

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.

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.

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?

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.

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?

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

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.

301b. Have you ever heard of male sterilization?
PROBE: Men can have an operation to avoid having any more children.

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.

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.

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.

301f. Have you heard that there is a type of injectable that you can inject yourself?

301g. From whom did you hear about it?

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

301h. Have you ever heard of the (birth control) pill?
PROBE: Women can take a pill every day to avoid becoming pregnant.

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.

301j. Have you ever heard of male condoms?
PROBE: Men can put a rubber sheath on their penis before sexual intercourse.

301k. Have you ever heard of female condoms?
PROBE: Women can put a sheath in their vagina before sexual intercourse.

301l. Have you ever heard of the diaphragm?
PROBE: Women can place a thin flexible disk in their vagina before sexual intercourse.

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.

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.

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

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.

301q. Have you ever heard of the withdrawal method?
PROBE: Men can be careful and pull out before climax.

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

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

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?

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.

Check here to acknowledge you considered all options.

304a. Do you like your {current_method_label}?

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

Show the image to the respondent.

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

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

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?

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?

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

If you needed family planning, where would you go?

Why would you choose this location?

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

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.

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.

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?

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

When do you think you will start using a method?

Enter {fp_start_lab}:

Use years if more than 36 months.

What method do you think you will use?

Who would you prefer to have administer the injectable?

Read all options

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

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

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

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

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.

In the last 12 months has your husband/partner:

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

1 = Yes 0 = No -99 = No Response

In the last 12 months has your husband/partner:

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

1 = Yes 0 = No -99 = No Response

In the last 12 months has your husband/partner:

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

1 = Yes 0 = No -99 = No Response

In the last 12 months has your husband/partner:

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

1 = Yes 0 = No -99 = No Response

In the last 12 months has your husband/partner:

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

1 = Yes 0 = No -99 = No Response

In the last 12 months has your husband/partner:

318f. Hurt you physically because you did not get pregnant?

1 = Yes 0 = No -99 = No Response

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.

Since what month and year have you been using family planning without stopping?

Calculate backwards from memorable events if needed.
CALENDAR: Enter episode of contraceptive use in the calendar.

Month:

Year:

If entering ?2030? for No Response, must select ?Do not know? for month.
Cannot be in future.

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.

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

Scroll to bottom to see all choices.

Check here to acknowledge you considered all options.

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?

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

IMP_301. CHECK. In question 304, the respondent mentioned that she had been using implants. Is that correct?

If she says she is not currently using implants, please verify her answer and go back to 304 and select the correct method.

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

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.

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}

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?

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

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

Why didn?t you obtain the method you wanted?

327a. During that visit, who made the final decision about what method you got?

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

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

Would you return to this provider?
Provider: {provider_label}

Would you refer your relative or friend to this provider / facility?
Provider: {provider_label}

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

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

Which method did you feel pressured to use?

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?

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?

Which method were you using?

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

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

IMP_306. Where did you go or who attempted to remove your implant?

IMP_307. Why were you not able to have your implant removed?

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

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

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

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.

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.

You said that you do not want a child soon 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".

Check here to acknowledge you considered all options.

You said that you do not want any 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".

Check here to acknowledge you considered all options.

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".

Check here to acknowledge you considered all options.

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

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

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

For any health services.

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

For any health services.

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

In the last 12 months have you:

342a. Heard about family planning on the radio?

1 = Yes 0 = No -99 = No Response

In the last 12 months have you:

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

1 = Yes 0 = No -99 = No Response

In the last 12 months have you:

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

1 = Yes 0 = No -99 = No Response

In the last 12 months have you:

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

1 = Yes 0 = No -99 = No Response

In the last 12 months have you:

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

1 = Yes 0 = No -99 = No Response

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:

343a. Adolescents who use family planning are promiscuous.

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

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:

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

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

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:

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

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

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:

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

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

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:

343e. Family planning is only for women who don?t want any more children.

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

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:

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

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

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?

344a. Adolescents who use family planning are promiscuous.

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

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?

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

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

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?

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

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

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?

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

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

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?

344e. Family planning is only for women who don?t want any more children.

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

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?

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

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

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

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

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

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

345b. Attend university / tertiary institution

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

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

345c. Find a husband/partner

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

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

345d. Have children

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

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

What type of health insurance do you have?
RECORD ALL MENTIONED

Cannot select "No response" with other options.

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.

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.

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?

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?

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.

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

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

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.

Enter {last_time_sex_lab}.

If today, enter zero days only, not zero weeks/months/years.
Must agree with the age of first sexual intercourse and the pregnancy status.

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

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

What method did you or your partner use?

Whose choice was it to use that method?

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 ?

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?

INF_10. Who have you sought help from?

Select all that apply

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

INF_11. What type of care did you receive?

Select all that apply

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

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.

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?

INF_14. And regarding your partner:

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

1 = Yes 0 = No -99 = 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

1 = Yes 0 = No -99 = 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

1 = Yes 0 = No -99 = 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

1 = Yes 0 = No -99 = 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.

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

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

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

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

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

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

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

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

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

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.

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

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

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

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

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

WGE_9. I can decide when to have another child.

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

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

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.

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

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

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

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

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

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

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

Section 7 ? Violence Against Women and Girls

CHECK FOR THE PRESENCE OF OTHERS. DO NOT CONTINUE UNTIL YOU CAN ENSURE COMPLETE PRIVACY.
We know that relationships can sometimes have conflict and difficulty. These next questions ask about conflicts you may have had in relationships. Remember, you can skip any question you do not want to answer.

VIO_1a. Were you able to obtain complete privacy?

VIO_1. In the last 12 months, has your husband/partner:

Insulted you, yelled at you, screamed or made humiliating remarks?

1 = Yes 0 = No -99 = No Response

VIO_1. In the last 12 months, has your husband/partner:

Slapped, hit or physically hurt you?

1 = Yes 0 = No -99 = No Response

VIO_1. In the last 12 months, has your husband/partner:

Threatened with a weapon or attempted to strangle or kill you?

1 = Yes 0 = No -99 = No Response

VIO_1. In the last 12 months, has your husband/partner:

Pressured or insisted on having sex when you did not want to (without physical force)?

1 = Yes 0 = No -99 = No Response

VIO_1. In the last 12 months, has your husband/partner:

Physically forced you to have sex when you did not want to?

1 = Yes 0 = No -99 = No Response

VIO_2a. How many times has this happened in the last 12 months?

Insulted you, yelled at you, screamed or made humiliating remarks?

VIO_2b. How many times has this happened in the last 12 months?

Slapped, hit or physically hurt you?

VIO_2c. How many times has this happened in the last 12 months?

Threatened with a weapon or attempted to strangle or kill you?

VIO_2d. How many times has this happened in the last 12 months?

Pressured or insisted on having sex when you did not want to (without physical force)?

VIO_2e. How many times has this happened in the last 12 months?

Physically forced you to have sex when you did not want to?

VIO_4. In the last 12 months, has a member of your household that is not your spouse or partner:

VIO_4a. Insulted you, yelled at you, screamed or made humiliating remarks?

1 = Yes 0 = No -99 = No Response

VIO_4. In the last 12 months, has a member of your household that is not your spouse or partner:

VIO_4b. Slapped, hit or physically hurt you?

1 = Yes 0 = No -99 = No Response

VIO_4. In the last 12 months, has a member of your household that is not your spouse or partner:

VIO_4c. Threatened with a weapon or attempted to strangle or kill you?

1 = Yes 0 = No -99 = No Response

VIO_4. In the last 12 months, has a member of your household that is not your spouse or partner:

VIO_4d. Pressured or insisted on having sex when you did not want to (without physical force)?

1 = Yes 0 = No -99 = No Response

VIO_4. In the last 12 months, has a member of your household that is not your spouse or partner:

VIO_4e. Physically forced you to have sex when you did not want to?

1 = Yes 0 = No -99 = No Response

VIO_5a. How many times has this happened in the last 12 months?

Insulted you, yelled at you, screamed or made humiliating remarks?

VIO_5b. How many times has this happened in the last 12 months?

Slapped, hit or physically hurt you?

VIO_5c. How many times has this happened in the last 12 months?

Threatened with a weapon or attempted to strangle or kill you?

VIO_5d. How many times has this happened in the last 12 months?

Pressured or insisted on having sex when you did not want to (without physical force)?

VIO_5e. How many times has this happened in the last 12 months?

Physically forced you to have sex when you did not want to?

VIO_7. Thinking about the experiences of relationship conflict we have just discussed, have you tried to seek help in the last 12 months?

VIO_8. From whom have you sought help?
Probe: Anyone else?

Record all mentioned.

Thank you for sharing your personal experiences with me. I know it may have been difficult for you to talk about your experiences with me. If you would like to talk further about these experiences, I can refer you to a place that can provide you with help.

VIO_9. Did you have to interrupt the interview during this section because some adult was trying to listen, came into the room, or interfered in any other way?

VIO_9a. Husband / partner?

VIO_9. Did you have to interrupt the interview during this section because some adult was trying to listen, came into the room, or interfered in any other way?

VIO_9b. Other male adult?

VIO_9. Did you have to interrupt the interview during this section because some adult was trying to listen, came into the room, or interfered in any other way?

VIO_9c. Female adult?

Follow-up Consent

Thank you for the time you have kindly granted us.
Would you be willing to participate in another survey one year from now?

Do you have access to a phone?

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

803b. What is your primary phone number?

Enter a 9 or 10-digit number without the country code. Do not include spaces or dashes.

Invalid number of digits.

803c. Can you repeat the number again?

Enter a 9 or 10-digit number without the country code. Do not include spaces or dashes.

Number entered must match previously entered number.

803d. Is this your personal phone number?

A personal phone is not shared with other people.

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

804b. What is your secondary phone number?

Enter a 9 or 10-digit number without the country code. Do not include spaces or dashes.

Invalid number of digits.

804c. Can you repeat the number again?

Enter a 9 or 10-digit number without the country code. Do not include spaces or dashes.

Number entered must match previously entered number.

804d. Is this your personal phone number?

A personal phone is not shared with other people.

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

What is the name you go by in your household?

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

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

Location

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

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

In what language was this interview conducted?

Questionnaire Result

Record the result of the questionnaire.

Check answer to 006 and consent.