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PMA Kenya Female Questionnaire 2019 - Baseline

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

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

Press OK to continue

[] OK

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

[] Yes
[] No

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

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

County:

District:

Division:

Location:

Enumeration Area:

Structure number:

Household number:

001a. Are you in the correct household?

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

Go to the right household.

[] Yes
[] No

002. Your name:

Is this your name?

[] Yes
[] No

002. Enter your name below.

Please record your name

003a. Current date and time.

Is this date and time correct?

[] Yes
[] No

003b. Record the correct date and time.

The date must be between 2019-09-01 and 2020-09-01.

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.

County: ${level1_unlinked}

District: ${level2_unlinked}

Division: ${level3_unlinked}

Location: ${level4_unlinked}

Enumeration Area: ${EA_unlinked}

Structure number: ${structure_unlinked}

Household number: ${household_unlinked}

004b. Is the above information correct?

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

[] Yes
[] No

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

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

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

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

Or

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

You must interview the right person.

[] Yes
[] No

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

[] Yes
[] No

007. How well acquainted are you with the respondent?

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

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 ____________________________________ and I am working for the International Center for Reproductive Health in Kenya, in collaboration with the Ministry of Health and the Kenya National Bureau of Statistics. We are conducting a local survey that asks women about various reproductive health issues. We would very much appreciate your participation in this survey. This information will help us inform the government to better plan health services. The survey usually takes between 15 and 20 minutes to complete. Whatever information you provide will be kept strictly confidential and will not be shown to anyone other than members of our survey team.
Participation in this survey is voluntary, and if we should come to any question you don't want to answer, just let me know and I will go on to the next question; or you can stop the interview at any time. However, we hope that you will participate in this survey since your views are important.
At this time, do you want to ask me anything about the survey?

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

[] Yes
[] No

009b. Respondent's signature

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

Checkbox

[] NA

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

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

010. Interviewer's name: ${your_name}

Mark your name as a witness to the consent process.

[] NA

010. Interviewer's name

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

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

011. Respondent's first name.

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

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

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

101. In what month and year were you born?

The age in the household roster is ${age}.
Month:

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

Year: ___

101. In what month and year were you born?


Cannot be in the future.

102. How old were you at your last birthday?

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

Age in the Household Roster:

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

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

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

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

The age in the roster agrees with the age in 102. Go to the next screen without changing the number on this screen.

#####

This screen must agree with the previous one. Enter the right number.

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
[] Post-Primary/Vocational
[] Secondary/'A' Level
[] College (Middle Level)
[] University
[] No response

103a. What is the highest [GRADE/ FORM / STANDARD / YEAR] you completed at that level?

Enter -99 for no response.

103b. Are you still attending school?

[] Yes
[] No
[] No response

103c. How old were you when you left school?

Must be between 0 and 19.

103d. 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

103e. Are you currently enrolled in any training program?

[] Yes
[] No
[] No response

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

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

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

412. 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

413. 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

104a. Have you ever had a partner / boyfriend?

[] Yes
[] No
[] No response

104b. How old were you the first time you had a boyfriend or partner?

Must be between 15 and 19.

104c. Do you currently have a boyfriend or partner?

[] Yes
[] No
[] No response

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

Enter -99 for no response.

106a. 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.

Date cannot be in the future.

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

Date of first living with husband/partner cannot be before respondent's birth. You entered: ${husband_cohabit_start_first_lab}

Respondent's birth: ${birthdate_lab}

Date of first living with husband/partner cannot be before respondent's birth. You entered: ${hcf_y_lab}

Respondent's birth: ${birthdate_lab}

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

Did you enter 106a correctly?

RETURN TO 106a TO CORRECT BEFORE CONTINUING

[] Yes
[] No

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

Select 'Do not know' for month and '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.

Date cannot be in the future.

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

Date of living with current / most recent husband/partner cannot be before respondent's birth. You entered: ${husband_cohabit_start_recent_lab}

Respondent's birth: ${birthdate_lab}

Date of living with current / most recent husband/partner cannot be before respondent's birth. You entered: ${hcs_y_lab}

Respondent's birth: ${birthdate_lab}

Date of living with current / most recent husband/partner cannot be before date respondent started living with first partner. You entered: ${husband_cohabit_start_recent_lab}

Date started living with first partner: ${husband_cohabit_start_first_lab}

Year of living with current / most recent husband/partner cannot be before year respondent started living with first partner. You entered: ${hcs_y_lab}

Year started living with first partner: ${hcf_y_lab}

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

Did you enter 107a correctly?

[] Yes
[] No

107c. RETURN TO 107A TO CORRECT BEFORE CONTINUING

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

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

109. 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.

110. 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.

111. 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.

112. 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.

MIG_1. Please tell me how many locations you have lived in for six (6) months or more after age 15 or after your first marriage (if you were younger than 15 years of age when you first got married).

Probe: Location means a community, village, or neighborhood.

Enter -99 for no response.

Respondent said she has lived in ${locations_lived} locations, is that correct?

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

[] Yes
[] No

I am now going to ask you some questions about the places you have lived starting with the place you lived before this place.

Residential history group

MIG_2a. What is the name of the place you lived before this place?

MIG_2. Is ${place_lived} located in Kenya or in another country?

[] Kenya
[] Another country
[] No response

MIG_3. In which county is ${place_lived}?

[] BUNGOMA
[] KERICHO
[] KIAMBU
[] KILIFI
[] KITUI
[] NAIROBI
[] NANDI
[] NYAMIRA
[] SIAYA
[] KAKAMEGA
[] WEST POKOT
[] MOMBASA
[] KWALE
[] TANA RIVER
[] LAMU
[] TAITA-TAVETA
[] GARISSA
[] WAJIR
[] MANDERA
[] MARSABIT
[] ISIOLO
[] MERU
[] THARAKA-NITHI
[] EMBU
[] MACHAKOS
[] MAKUENI
[] NYANDARUA
[] NYERI
[] KIRINYAGA
[] MURANG'A
[] TURKANA
[] SAMBURU
[] TRANS-NZOIA
[] UASIN GISHU
[] ELGEYO-MARAKWET
[] BARINGO
[] LAIKIPIA
[] NAKURU
[] NAROK
[] KAJIADO
[] BOMET
[] VIHIGA
[] BUSIA
[] KISUMU
[] HOMA BAY
[] MIGORI
[] KISII

MIG_4. Was ${place_lived} a city, a town, or a rural area?

[] City/town
[] Peri-urban
[] Rural
[] No response

MIG_5. How old were you when you moved to ${place_lived}?

Enter age in years.

Enter -99 for no response.

Years entered cannot exceed age.

MIG_6. For what reason did you move to ${place_lived}?

Select all that apply.

Cannot select 'no response' with other options.

[] Looking for a job
[] Seasonal work
[] Work (non-seasonal)
[] Want to change jobs
[] Family or village conflict
[] To attend school
[] Move after completed school
[] Join spouse after marriage
[] Co-reside with boy/girlfriend
[] Divorce/widowhood
[] Hospitalization/health problem
[] Better access to health service
[] Caring for sick relative
[] Followed spouse to job
[] Better land for farming
[] Better education for children
[] Other social reasons
[] Other
[] No response

MIG_7. Now I will ask you about the place you lived before ${place_lived}.

113. 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

114. 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

115. 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

116. 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

117. 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

118. 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

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. Mpesa or M-Shwari)?

[] 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

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

[] Yes
[] No
[] No response

201. How many times have you given birth?

Enter -99 for no response.

205. When was your FIRST birth?
Please record the date of the first 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'.

Month____
Year____

Date cannot be in the future.
You entered: ${first_birth_lab}
Today: ${today}

First birth cannot be before respondent was 10 years of age. You entered: ${first_birth_lab}
Respondent's birth date: ${birthdate_lab}

CALENDAR: Add a "birth" annotation next to the month ${first_birth_lab} in the contraceptive calendar paper aid and enter the duration of the pregnancy.

206. When was your MOST RECENT 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'.
Month____
Year____

Date cannot be in the future.

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

Date of most recent birth cannot be before respondent was 10 years of age. You entered: ${recent_birth_lab}

Respondent's birth date: ${birthdate_lab}

Date of most recent birth must be at least 6 months after the first birth. You entered: ${recent_birth_lab}

First birth: ${first_birth_lab}

Year of most recent birth cannot be before first birth. You entered: ${rb_y_lab}

Year of first birth: ${fb_y_lab}

CALENDAR: Add a "birth" annotation next to the month ${recent_birth_lab} in the contraceptive calendar paper aid and enter the duration of the pregnancy.

206a. Have you had any other births since [January 1, 2017]?

[] Yes
[] No
[] No response

206b. When was that birth?

CALENDAR: Enter the birth and duration of pregnancy in the calendar. Select 'Do not know' for month and '2030' for year to indicate 'No Response' Cannot be in future.

Month____
Year____

CALENDAR: Add a "birth" annotation next to the month ${other_birth_lab} in the contraceptive calendar paper aid and enter the duration of the pregnancy.

206c. Have you ever had a pregnancy that miscarried, was aborted, or ended in a stillbirth since [January 1, 2017]?

[] Yes
[] No
[] No response

206d. When did that pregnancy end?
CALENDAR: Enter the termination and duration of pregnancy in the calendar. Select 'Do not know' for month and '2030' for year to indicate 'No Response'.

Month____
Year____

210a. Are you pregnant now?

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

210b. How many months pregnant are you?

The most recent birth was: [RECENT BIRTH DATE]

#####

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.

Add a "pregnant" annotation next to the current date ${today_ym} in the contraceptive calendar paper aid.

Add a "pregnant" annotation next to the most recent ${months_pregnant} months, including in ${today_ym}, in the contraceptive calendar paper aid.

209. When did your last menstrual period start?
If you select days, weeks, months, or years, you will enter a number for X on the next screen. Enter 0 days for today, not 0 weeks/months/years.

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

You entered "Never menstruated" in 209 but the respondent 206 indicates she previously gave birth. Is that what she said?
If no, return to the previous screen and change the response.
Invalid. Go back
[] Yes
[] No

209. Enter [VALUE]
Enter 0 days for today, not 0 weeks/months/years.
Must be 0 days or larger. Must be 1 week/month/year or larger.

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

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

Invalid. Go back

[] Yes
[] No

You entered "Never menstruated" in 209 but 210a indicates that the respondent is pregnant currently. Is that what she said?
If no, return to the previous screen and change the response.
Invalid. Go back

[] Yes
[] No

209a. 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.
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

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 children at all?

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

Now I have some questions about the future.

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

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

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

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

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

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

212a. How long would you like to wait from now before the birth of a child?
If you select months or years, you will enter a number for X on the next screen.Select ?Years? if more than 36 months.Please check that you correctly entered the value for months/years.

[] _____months
[] _____years
[] Soon/now
[] Says she can't get pregnant
[] Other
[] Do not know
[] No response

212a. How long would you like to wait from now before the birth of another child?
If you select months or years, you will enter a number for X on the next screen.
Select ?Years? if more than 36 months.
Please check that you correctly entered the value for months/years.
[] _____months
[] _____years
[] Soon/now
[] Says she can't get pregnant
[] Other
[] Do not know
[] No response

212b. After the birth of the child you are expecting now, how long would you like to wait before the birth of another child?
If you select months or years, you will enter a number for X on the next screen. Select ?Years? if more than 36 months. Please check that you correctly entered the value for months/years.

[] _____months
[] _____years
[] Soon/now
[] Says she can't get pregnant
[] Other
[] Do not know
[] No response

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

Use years if more than 36 months.

214a. 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

214b. If you got pregnant now, how would you feel?

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

Section 3 ? Contraception

Now I would like to talk about family planning - the various ways or methods that a couple can use to delay or avoid a pregnancy.

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

301a. Have you ever heard of female sterilization?

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

[] Yes
[] No
[] No response

301b. Have you ever heard of male sterilization?

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

[] Yes
[] No
[] No response

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

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

[] Yes
[] No
[] No response

301d. Have you ever heard of the IUD?

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

[] Yes
[] No
[] No response

301e. Have you ever heard of injectables?

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

[] Yes
[] No
[] No response

301f. Have you 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

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

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

[] Yes
[] No
[] No response

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

[] Yes
[] No
[] No response

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

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

[] Yes
[] No
[] No response

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

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

[] Yes
[] No
[] No response

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

[] Yes
[] No
[] No response

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

[] Yes
[] No
[] No response

302b. Which method or methods are you using?
PROBE: Anything else?
Select all methods mentioned. SCROLL TO THE BOTTOM to see all choices.
You selected no response with another option.
[] Female sterilization
[] Male sterilization
[] Implant
[] IUD
[] Injectables
[] Pill
[] Emergency Contraception
[] Male condom
[] Female condom
[] Diaphragm
[] Foam/Jelly
[] Standard Days/Cycle beads
[] LAM
[] Rhythm method
[] Withdrawal
[] Other traditional methods
[] No response

Check here to acknowledge you considered all options.

[] NA

CALC_CM. CALCULATE: CURRENT METHOD

THIS WILL NOT APPEAR ON THE SCREEN

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

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

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

Show the image to the respondent.

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

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

[] Yes
[] No
[] No response

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

[] Yes
[] No
[] No response

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

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

[] Yes
[] No

IMP_301b. How many rods is your implant?

[] 1
[] 2
[] 6
[] Do not know
[] No response

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

[] Yes
[] No
[] No response

IMP_303. How long were you told?
If you select months or years, you will enter a number for X on the next screen. Please check that you correctly entered the value for months/years.

[] X months
[] X years
[] Do not know
[] No response

IMP_303. Enter the number of [IMPLANT DURATION] you were told:
If more than 12 months record in years

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

[] Yes
[] No
[] No response

303a. If you needed family planning, where would you go?

[] Govt. Hospital / polyclinic
[] Govt. Health Center
[] Govt. Dispensary
[] Other Public
[] Private Hospital/Clinic
[] Pharmacy/Chemist
[] Nursing/Maternity Home
[] Faith-based, church, mission hospital/clinic
[] Family options/FHOK clinic
[] Other private medical sector
[] Shop
[] Mobile clinic
[] Community-based distributor
[] Community health volunteer/CHV
[] Friend/relative
[] Other
[] Don't know
[] No Response

303b. 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
[] Don't know
[] No response

303c. 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

303d. 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

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

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

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

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

305c. 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.

305d. What method do you think you will use?

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

305e. Would your husband/partner be supportive of you using family planning?

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

307. Before you started using [MOST RECENT / CURRENT METHOD], had you discussed the decision to delay or avoid pregnancy with your husband/partner?

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

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

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

309a. Since what month and year have you been using [CURRENT METHOD] without stopping?
Calculate backwards from memorable events if needed. CALENDAR: Enter episode of contraceptive use in the calendar.
Year:

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

Cannot be in future.

Month:

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


Date cannot be in the future.

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

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

Respondent's birth date: ${birthdate_lab}

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

Most recent birth: ${recent_birth_lab}

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

Most recent birth: ${rb_y_lab}

Add an annotation for ${current_method_label} next to the current date ${today_ym} in the contraceptive calendar paper aid.

Add an annotation for ${current_method_label} from ${begin_using_full_lab} to the current date ${today_ym} in the contraceptive calendar paper aid.


310. Why did you stop using your [MOST RECENT METHOD]?

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

311a. You first started using [CURRENT/RECENT METHOD] on [DATE].

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

Scroll to bottom to see all choices.

[] Govt. Hospital / polyclinic
[] Govt. Health Center
[] Govt. Dispensary
[] Other Public
[] Private Hospital/Clinic
[] Pharmacy/Chemist
[] Nursing/Maternity Home
[] Faith-based, church, mission hospital/clinic
[] Family options/FHOK clinic
[] Other private medical sector
[] Shop
[] Mobile clinic
[] Community-based distributor
[] Community health volunteer/CHV
[] Friend/relative
[] Other
[] Don't know
[] No Response

311a. Where did you or your partner get [CURRENT METHOD] when you first started using it?

Scroll to bottom to see all choices.

[] Govt. Hospital / polyclinic
[] Govt. Health Center
[] Govt. Dispensary
[] Other Public
[] Private Hospital/Clinic
[] Pharmacy/Chemist
[] Nursing/Maternity Home
[] Faith-based, church, mission hospital/clinic
[] Family options/FHOK clinic
[] Other private medical sector
[] Shop
[] Mobile clinic
[] Community-based distributor
[] Community health volunteer/CHV
[] Friend/relative
[] Other
[] Don't know
[] No Response

Check here to acknowledge you considered all options.

[] NA

312a. When you obtained your [METHOD], 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

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

[] Yes
[] No
[] No response

IMP_304. Were you told where you could go to have the implant removed?
Provider: [PROVIDER]

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

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

[] Yes
[] No
[] No response

313a. At that time, were you told that you could switch to a different method in the future?

[] Yes
[] No
[] No response

314a. 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

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

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

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

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

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

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

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

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

316. Would you return to this provider?

Provider: ${provider_label}

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

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

Provider: [PROVIDER]

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

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

[] Yes
[] No
[] No response

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

[] Govt. Hospital / polyclinic
[] Govt. Health Center
[] Govt. Dispensary
[] Other Public
[] Private Hospital/Clinic
[] Pharmacy/Chemist
[] Nursing/Maternity Home
[] Faith-based, church, mission hospital/clinic
[] Family options/FHOK clinic
[] Other private medical sector
[] Shop
[] Mobile clinic
[] Community-based distributor
[] Community health volunteer/CHV
[] Friend/relative
[] Self
[] Other
[] Don't know
[] No Response

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

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

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

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

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

[] Yes
[] No
[] No response

320. How old were you when you first used a method to delay or avoid getting pregnant?
The respondent said she was [AGE] years old at her last birthday.
Enter the age in years. Cannot be younger than 9. Cannot be older than the current age of the respondent. Cannot be younger than 9. Cannot be after recent/current use.

Check: You entered that the respondent first used family planning at the age of ${age_at_first_use}. Is that what she said?

Go back and change 320 if that is not correct.

Go back and change 320.

[] Yes
[] No

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

Note: the respondent said that she gave birth ${birth_events} times in 201.

Enter -99 for no response.

Must be zero or larger, or -99.

WARNING: you entered that the respondent gave birth ${birth_events} times in 201, and you entered that the respondent had ${age_at_first_use_children} children alive at the time she first used a method to delay or avoid getting pregnant in 321. Is this what the respondent said?

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

[] Yes
[] No

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

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

[] Yes
[] No
[] No response

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

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

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

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

Can you tell me why you are not using a method to prevent pregnancy?
PROBE: Any other reason?
RECORD ALL REASONS MENTIONED
Cannot select "Not Married" if 104 is "Yes, currently married".
Scroll to bottom to see all choices.

Cannot select "Do not know" or "No response" with other options.
Cannot select "Not Married" if 104 is "Yes, currently married".

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

Check here to acknowledge you considered all options.

[] NA

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

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

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

[] Yes
[] No
[] No response

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

For any health services.

[] Yes
[] No
[] No response

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

For any health services.

[] Yes
[] No
[] No response

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

[] Yes
[] No
[] No response

326. In the last 12 months have you:

Heard about family planning on the radio?
[] Yes
[] No
[] No Response

Seen anything about family planning on the television?
[] Yes
[] No
[] No Response

Read about family planning in a newspaper or magazine?

[] Yes
[] No
[] No Response

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

[] Yes
[] No
[] No Response

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

[] Yes
[] No
[] No Response

327. 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:

327a. Adolescents who use family planning are promiscuous.

[] Most
[] Some
[] Few
[] No Response




327b. Family planning is only for women who are married.

[] Most
[] Some
[] Few
[] No Response



327c. Family planning is only for women who don't want any more children.

[] Most
[] Some
[] Few
[] No Response

327d. People who use family planning have a better quality of life.

[] Most
[] Some
[] Few
[] No Response

328. 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?

328a. Adolescents who use family planning are promiscuous.

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

328b. Family planning is only for women who are married.

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

328c. Family planning is only for women who don't want any more children.

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

328d. People who use family planning have a better quality of life.

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

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

329a. Complete secondary school / technical school / vocation school

[] Very important
[] Somewhat important
[] Not important
[] No Response

329b. Attend university / tertiary institution

[] Very important
[] Somewhat important
[] Not important
[] No Response

329c. Have a good job

[] Very important
[] Somewhat important
[] Not important
[] No Response

329d. Start a business

[] Very important
[] Somewhat important
[] Not important
[] No Response

329e. Find a partner

[] Very important
[] Somewhat important
[] Not important
[] No Response

329f. Get married

[] Very important
[] Somewhat important
[] Not important
[] No Response

329g. Have children

[] Very important
[] Somewhat important
[] Not important
[] No Response

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

330a. Complete secondary school / technical school / vocation school

[] Very important
[] Somewhat important
[] Not important
[] No Response

330b. Attend university / tertiary institution

[] Very important
[] Somewhat important
[] Not important
[] No Response

330c. Have a good job

[] Very important
[] Somewhat important
[] Not important
[] No Response

330d. Start a business

[] Very important
[] Somewhat important
[] Not important
[] No Response

330e. Find a partner

[] Very important
[] Somewhat important
[] Not important
[] No Response

330f. Get married

[] Very important
[] Somewhat important
[] Not important
[] No Response

330g. Have children

[] Very important
[] Somewhat important
[] Not important
[] No Response

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

[] Yes
[] No
[] No response

332. What type of health insurance do you have?

RECORD ALL MENTIONED

Cannot select "No response" with other options.

[] National Hospital Insurance Fund (NHIF)
[] Health insurance through employer
[] Mutual health organization/Community-based health insurance
[] Linda Mama
[] Other privately purchased commercial health insurance
[] Other
[] No response

LCL_302. Have you used your insurance to pay for family planning services in the past year?

[] Yes
[] No
[] No response

Section 4 ? Sexual Activity

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

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

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

Current age: ${age}

Number of live births: ${birth_events}

The respondent is pregnant

Enter the age in years.

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

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

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

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

WARNING: the respondent gave birth ${birth_events} times, but first had sex at the age of ${age_at_first_sex}, only ${years_since_first_sex} years ago. Is that correct?

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

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

[] Yes
[] No

You entered that the respondent was ${age_at_first_sex} years old the first time she had sexual intercourse. Is that what the she said?

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

Invalid. Go back

[] Yes
[] No

You entered that the respondent's age at first sex was ${age_at_first_sex}. Previously the respondent said she has given birth at an earlier age: ${age_first_birth}. Is that correct?

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

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

[] Yes
[] No

406. 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

407. 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

408. 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

409. 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

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

[] Yes
[] No
[] No response

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

[] Yes
[] No
[] No response

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

Respondent is ${months_pregnant} months pregnant.

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

#####

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

Enter 0 days for today.

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

Must agree with the pregnancy status.

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

402. Enter ${last_time_sex_lab}.

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

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

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

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

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

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

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

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

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

[] Yes
[] No
[] No response

404. What method did you or your partner use?

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

405. 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?

1 = Yes
0 = No
-99 = No Response


WGE_1a. I did not want to have sex at that time

[] Yes
[] No
[] No response

WGE_1b. I felt pressured by my husband / partner to have sex then

[] Yes
[] No
[] No response

WGE_1c. I did not consent (was forced) to have sex then

[] Yes
[] No
[] No response

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
[] Somewhat disagree
[] Neither agree nor disagree
[] Somewhat agree
[] Strongly agree
[] 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
[] Somewhat disagree
[] Neither agree nor disagree
[] Somewhat agree
[] Strongly agree
[] Do not know
[] No response

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

[] Strongly disagree
[] Somewhat disagree
[] Neither agree nor disagree
[] Somewhat agree
[] Strongly agree
[] Do not know
[] No response

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

[] Strongly disagree
[] Somewhat disagree
[] Neither agree nor disagree
[] Somewhat agree
[] Strongly agree
[] Do not know
[] No response

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

[] Strongly disagree
[] Somewhat disagree
[] Neither agree nor disagree
[] Somewhat agree
[] Strongly agree
[] 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
[] Somewhat disagree
[] Neither agree nor disagree
[] Somewhat agree
[] Strongly agree
[] 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
[] Somewhat disagree
[] Neither agree nor disagree
[] Somewhat agree
[] Strongly agree
[] 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
[] Somewhat disagree
[] Neither agree nor disagree
[] Somewhat agree
[] Strongly agree
[] Do not know
[] No response
[] 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_4a. I want to complete my education before I have a child.

[] Strongly disagree
[] Somewhat disagree
[] Neither agree nor disagree
[] Somewhat agree
[] Strongly agree
[] Do not know
[] No response

WGE_4b. I wanted to complete my education before I had a child.

[] Strongly disagree
[] Somewhat disagree
[] Neither agree nor disagree
[] Somewhat agree
[] Strongly agree
[] Do not know
[] No response

WGE_5. If I rest between pregnancies, I can take better care of my family.

[] Strongly disagree
[] Somewhat disagree
[] Neither agree nor disagree
[] Somewhat agree
[] Strongly agree
[] Do not know
[] No response

WGE_6a. I can decide when I want to start having children.

[] Strongly disagree
[] Somewhat disagree
[] Neither agree nor disagree
[] Somewhat agree
[] Strongly agree
[] Do not know
[] No response

WGE_6b. I could decide when I wanted to start having children.

[] Strongly disagree
[] Somewhat disagree
[] Neither agree nor disagree
[] Somewhat agree
[] Strongly agree
[] Do not know
[] No response

WGE_7. I feel confident discussing with my husband/partner when to start having children.

[] Strongly disagree
[] Somewhat disagree
[] Neither agree nor disagree
[] Somewhat agree
[] Strongly agree
[] Do not know
[] No response

WGE_8. I can decide when to have another child.

[] Strongly disagree
[] Somewhat disagree
[] Neither agree nor disagree
[] Somewhat agree
[] Strongly agree
[] Do not know
[] No response

WGE_9a. I will be able to negotiate with my husband/partner when to stop having children.

[] Strongly disagree
[] Somewhat disagree
[] Neither agree nor disagree
[] Somewhat agree
[] Strongly agree
[] Do not know
[] No response

WGE_9b. I can negotiate with my husband/partner when to stop having children.

[] Strongly disagree
[] Somewhat disagree
[] Neither agree nor disagree
[] Somewhat agree
[] Strongly agree
[] 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_10. If I refuse sex with my husband/partner, he may stop supporting me.

[] Strongly disagree
[] Somewhat disagree
[] Neither agree nor disagree
[] Somewhat agree
[] Strongly agree
[] Do not know
[] No response

WGE_11. If I refuse sex with my husband/partner, he may force me to have sex.

[] Strongly disagree
[] Somewhat disagree
[] Neither agree nor disagree
[] Somewhat agree
[] Strongly agree
[] Do not know
[] No response

WGE_12. If I refuse sex with my husband/partner, he may physically hurt me.

[] Strongly disagree
[] Somewhat disagree
[] Neither agree nor disagree
[] Somewhat agree
[] Strongly agree
[] Do not know
[] No response

WGE_13. If I show my husband/partner that I want to have sex, he may consider me promiscuous.

[] Strongly disagree
[] Somewhat disagree
[] Neither agree nor disagree
[] Somewhat agree
[] Strongly agree
[] Do not know
[] No response

WGE_14. I am confident I can tell my husband/partner when I want to have sex.

[] Strongly disagree
[] Somewhat disagree
[] Neither agree nor disagree
[] Somewhat agree
[] Strongly agree
[] Do not know
[] No response

WGE_15. I am able to decide when to have sex.

[] Strongly disagree
[] Somewhat disagree
[] Neither agree nor disagree
[] Somewhat agree
[] Strongly agree
[] Do not know
[] No response

WGE_16. If I do not want to have sex, I can tell my husband/partner.

[] Strongly disagree
[] Somewhat disagree
[] Neither agree nor disagree
[] Somewhat agree
[] Strongly agree
[] Do not know
[] No response

WGE_17. If I do not want to have sex, I am capable of avoiding it with my husband/partner.

[] Strongly disagree
[] Somewhat disagree
[] Neither agree nor disagree
[] Somewhat agree
[] Strongly agree
[] Do not know
[] No response

Follow-up Consent

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

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

[] Yes
[] No
[] No response

FLW_802. Do you own a phone?

[] Yes
[] No
[] No response

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

Enter an 10-digit number without the country code. Do not include spaces or dashes.
Enter 0 for no response.

Invalid number of digits.

FLW_804. Can you repeat the number again?

Enter an 10-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
[] Kiswahili
[] 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

CONTRACEPTIVE CALENDAR: please enter answers from visual aid paper

ENTER VALUE FROM COL. 1

Enter Value December 2019

[] B. Births
[] P. Pregnancies
[] T. Terminations
[] 0. No method used
[] 1. Female Sterilization
[] 2. Male Sterilization
[] 3. Implant
[] 4. IUD
[] 5. Injectables
[] 7. Pill
[] 8. Emergency Contraception
[] 9. Male Condom
[] 10. Female Condom
[] 11. Diaphragm
[] 12. Foam / Jelly
[] 13. Std Days / Cycle beads
[] 14. LAM
[] 30. Rhythm method
[] 31. Withdrawal
[] 39. Other traditional methods

Enter Value November 2019

[] B. Births
[] P. Pregnancies
[] T. Terminations
[] 0. No method used
[] 1. Female Sterilization
[] 2. Male Sterilization
[] 3. Implant
[] 4. IUD
[] 5. Injectables
[] 7. Pill
[] 8. Emergency Contraception
[] 9. Male Condom
[] 10. Female Condom
[] 11. Diaphragm
[] 12. Foam / Jelly
[] 13. Std Days / Cycle beads
[] 14. LAM
[] 30. Rhythm method
[] 31. Withdrawal
[] 39. Other traditional methods

Enter Value October 2019

[] B. Births
[] P. Pregnancies
[] T. Terminations
[] 0. No method used
[] 1. Female Sterilization
[] 2. Male Sterilization
[] 3. Implant
[] 4. IUD
[] 5. Injectables
[] 7. Pill
[] 8. Emergency Contraception
[] 9. Male Condom
[] 10. Female Condom
[] 11. Diaphragm
[] 12. Foam / Jelly
[] 13. Std Days / Cycle beads
[] 14. LAM
[] 30. Rhythm method
[] 31. Withdrawal
[] 39. Other traditional methods

Enter Value September 2019

[] B. Births
[] P. Pregnancies
[] T. Terminations
[] 0. No method used
[] 1. Female Sterilization
[] 2. Male Sterilization
[] 3. Implant
[] 4. IUD
[] 5. Injectables
[] 7. Pill
[] 8. Emergency Contraception
[] 9. Male Condom
[] 10. Female Condom
[] 11. Diaphragm
[] 12. Foam / Jelly
[] 13. Std Days / Cycle beads
[] 14. LAM
[] 30. Rhythm method
[] 31. Withdrawal
[] 39. Other traditional methods

Enter Value August 2019

[] B. Births
[] P. Pregnancies
[] T. Terminations
[] 0. No method used
[] 1. Female Sterilization
[] 2. Male Sterilization
[] 3. Implant
[] 4. IUD
[] 5. Injectables
[] 7. Pill
[] 8. Emergency Contraception
[] 9. Male Condom
[] 10. Female Condom
[] 11. Diaphragm
[] 12. Foam / Jelly
[] 13. Std Days / Cycle beads
[] 14. LAM
[] 30. Rhythm method
[] 31. Withdrawal
[] 39. Other traditional methods

Enter Value July 2019

[] B. Births
[] P. Pregnancies
[] T. Terminations
[] 0. No method used
[] 1. Female Sterilization
[] 2. Male Sterilization
[] 3. Implant
[] 4. IUD
[] 5. Injectables
[] 7. Pill
[] 8. Emergency Contraception
[] 9. Male Condom
[] 10. Female Condom
[] 11. Diaphragm
[] 12. Foam / Jelly
[] 13. Std Days / Cycle beads
[] 14. LAM
[] 30. Rhythm method
[] 31. Withdrawal
[] 39. Other traditional methods

Enter Value June 2019

[] B. Births
[] P. Pregnancies
[] T. Terminations
[] 0. No method used
[] 1. Female Sterilization
[] 2. Male Sterilization
[] 3. Implant
[] 4. IUD
[] 5. Injectables
[] 7. Pill
[] 8. Emergency Contraception
[] 9. Male Condom
[] 10. Female Condom
[] 11. Diaphragm
[] 12. Foam / Jelly
[] 13. Std Days / Cycle beads
[] 14. LAM
[] 30. Rhythm method
[] 31. Withdrawal
[] 39. Other traditional methods

Enter Value May 2019

[] B. Births
[] P. Pregnancies
[] T. Terminations
[] 0. No method used
[] 1. Female Sterilization
[] 2. Male Sterilization
[] 3. Implant
[] 4. IUD
[] 5. Injectables
[] 7. Pill
[] 8. Emergency Contraception
[] 9. Male Condom
[] 10. Female Condom
[] 11. Diaphragm
[] 12. Foam / Jelly
[] 13. Std Days / Cycle beads
[] 14. LAM
[] 30. Rhythm method
[] 31. Withdrawal
[] 39. Other traditional methods

Enter Value April 2019

[] B. Births
[] P. Pregnancies
[] T. Terminations
[] 0. No method used
[] 1. Female Sterilization
[] 2. Male Sterilization
[] 3. Implant
[] 4. IUD
[] 5. Injectables
[] 7. Pill
[] 8. Emergency Contraception
[] 9. Male Condom
[] 10. Female Condom
[] 11. Diaphragm
[] 12. Foam / Jelly
[] 13. Std Days / Cycle beads
[] 14. LAM
[] 30. Rhythm method
[] 31. Withdrawal
[] 39. Other traditional methods

Enter Value March 2019

[] B. Births
[] P. Pregnancies
[] T. Terminations
[] 0. No method used
[] 1. Female Sterilization
[] 2. Male Sterilization
[] 3. Implant
[] 4. IUD
[] 5. Injectables
[] 7. Pill
[] 8. Emergency Contraception
[] 9. Male Condom
[] 10. Female Condom
[] 11. Diaphragm
[] 12. Foam / Jelly
[] 13. Std Days / Cycle beads
[] 14. LAM
[] 30. Rhythm method
[] 31. Withdrawal
[] 39. Other traditional methods

Enter Value February 2019

[] B. Births
[] P. Pregnancies
[] T. Terminations
[] 0. No method used
[] 1. Female Sterilization
[] 2. Male Sterilization
[] 3. Implant
[] 4. IUD
[] 5. Injectables
[] 7. Pill
[] 8. Emergency Contraception
[] 9. Male Condom
[] 10. Female Condom
[] 11. Diaphragm
[] 12. Foam / Jelly
[] 13. Std Days / Cycle beads
[] 14. LAM
[] 30. Rhythm method
[] 31. Withdrawal
[] 39. Other traditional methods

Enter Value January 2019

[] B. Births
[] P. Pregnancies
[] T. Terminations
[] 0. No method used
[] 1. Female Sterilization
[] 2. Male Sterilization
[] 3. Implant
[] 4. IUD
[] 5. Injectables
[] 7. Pill
[] 8. Emergency Contraception
[] 9. Male Condom
[] 10. Female Condom
[] 11. Diaphragm
[] 12. Foam / Jelly
[] 13. Std Days / Cycle beads
[] 14. LAM
[] 30. Rhythm method
[] 31. Withdrawal
[] 39. Other traditional methods

Please verify your inputs for 2019. Are they correct?

Please correct any mistakes.

[] Yes
[] No

ENTER VALUE FROM COL. 1

Enter Value December 2018

[] B. Births
[] P. Pregnancies
[] T. Terminations
[] 0. No method used
[] 1. Female Sterilization
[] 2. Male Sterilization
[] 3. Implant
[] 4. IUD
[] 5. Injectables
[] 7. Pill
[] 8. Emergency Contraception
[] 9. Male Condom
[] 10. Female Condom
[] 11. Diaphragm
[] 12. Foam / Jelly
[] 13. Std Days / Cycle beads
[] 14. LAM
[] 30. Rhythm method
[] 31. Withdrawal
[] 39. Other traditional methods

Enter Value November 2018

[] B. Births
[] P. Pregnancies
[] T. Terminations
[] 0. No method used
[] 1. Female Sterilization
[] 2. Male Sterilization
[] 3. Implant
[] 4. IUD
[] 5. Injectables
[] 7. Pill
[] 8. Emergency Contraception
[] 9. Male Condom
[] 10. Female Condom
[] 11. Diaphragm
[] 12. Foam / Jelly
[] 13. Std Days / Cycle beads
[] 14. LAM
[] 30. Rhythm method
[] 31. Withdrawal
[] 39. Other traditional methods

Enter Value October 2018

[] B. Births
[] P. Pregnancies
[] T. Terminations
[] 0. No method used
[] 1. Female Sterilization
[] 2. Male Sterilization
[] 3. Implant
[] 4. IUD
[] 5. Injectables
[] 7. Pill
[] 8. Emergency Contraception
[] 9. Male Condom
[] 10. Female Condom
[] 11. Diaphragm
[] 12. Foam / Jelly
[] 13. Std Days / Cycle beads
[] 14. LAM
[] 30. Rhythm method
[] 31. Withdrawal
[] 39. Other traditional methods

Enter Value September 2018

[] B. Births
[] P. Pregnancies
[] T. Terminations
[] 0. No method used
[] 1. Female Sterilization
[] 2. Male Sterilization
[] 3. Implant
[] 4. IUD
[] 5. Injectables
[] 7. Pill
[] 8. Emergency Contraception
[] 9. Male Condom
[] 10. Female Condom
[] 11. Diaphragm
[] 12. Foam / Jelly
[] 13. Std Days / Cycle beads
[] 14. LAM
[] 30. Rhythm method
[] 31. Withdrawal
[] 39. Other traditional methods

Enter Value August 2018

[] B. Births
[] P. Pregnancies
[] T. Terminations
[] 0. No method used
[] 1. Female Sterilization
[] 2. Male Sterilization
[] 3. Implant
[] 4. IUD
[] 5. Injectables
[] 7. Pill
[] 8. Emergency Contraception
[] 9. Male Condom
[] 10. Female Condom
[] 11. Diaphragm
[] 12. Foam / Jelly
[] 13. Std Days / Cycle beads
[] 14. LAM
[] 30. Rhythm method
[] 31. Withdrawal
[] 39. Other traditional methods

Enter Value July 2018

[] B. Births
[] P. Pregnancies
[] T. Terminations
[] 0. No method used
[] 1. Female Sterilization
[] 2. Male Sterilization
[] 3. Implant
[] 4. IUD
[] 5. Injectables
[] 7. Pill
[] 8. Emergency Contraception
[] 9. Male Condom
[] 10. Female Condom
[] 11. Diaphragm
[] 12. Foam / Jelly
[] 13. Std Days / Cycle beads
[] 14. LAM
[] 30. Rhythm method
[] 31. Withdrawal
[] 39. Other traditional methods

Enter Value June 2018

[] B. Births
[] P. Pregnancies
[] T. Terminations
[] 0. No method used
[] 1. Female Sterilization
[] 2. Male Sterilization
[] 3. Implant
[] 4. IUD
[] 5. Injectables
[] 7. Pill
[] 8. Emergency Contraception
[] 9. Male Condom
[] 10. Female Condom
[] 11. Diaphragm
[] 12. Foam / Jelly
[] 13. Std Days / Cycle beads
[] 14. LAM
[] 30. Rhythm method
[] 31. Withdrawal
[] 39. Other traditional methods

Enter Value May 2018

[] B. Births
[] P. Pregnancies
[] T. Terminations
[] 0. No method used
[] 1. Female Sterilization
[] 2. Male Sterilization
[] 3. Implant
[] 4. IUD
[] 5. Injectables
[] 7. Pill
[] 8. Emergency Contraception
[] 9. Male Condom
[] 10. Female Condom
[] 11. Diaphragm
[] 12. Foam / Jelly
[] 13. Std Days / Cycle beads
[] 14. LAM
[] 30. Rhythm method
[] 31. Withdrawal
[] 39. Other traditional methods

Enter Value April 2018

[] B. Births
[] P. Pregnancies
[] T. Terminations
[] 0. No method used
[] 1. Female Sterilization
[] 2. Male Sterilization
[] 3. Implant
[] 4. IUD
[] 5. Injectables
[] 7. Pill
[] 8. Emergency Contraception
[] 9. Male Condom
[] 10. Female Condom
[] 11. Diaphragm
[] 12. Foam / Jelly
[] 13. Std Days / Cycle beads
[] 14. LAM
[] 30. Rhythm method
[] 31. Withdrawal
[] 39. Other traditional methods

Enter Value March 2018

[] B. Births
[] P. Pregnancies
[] T. Terminations
[] 0. No method used
[] 1. Female Sterilization
[] 2. Male Sterilization
[] 3. Implant
[] 4. IUD
[] 5. Injectables
[] 7. Pill
[] 8. Emergency Contraception
[] 9. Male Condom
[] 10. Female Condom
[] 11. Diaphragm
[] 12. Foam / Jelly
[] 13. Std Days / Cycle beads
[] 14. LAM
[] 30. Rhythm method
[] 31. Withdrawal
[] 39. Other traditional methods

Enter Value February 2018

[] B. Births
[] P. Pregnancies
[] T. Terminations
[] 0. No method used
[] 1. Female Sterilization
[] 2. Male Sterilization
[] 3. Implant
[] 4. IUD
[] 5. Injectables
[] 7. Pill
[] 8. Emergency Contraception
[] 9. Male Condom
[] 10. Female Condom
[] 11. Diaphragm
[] 12. Foam / Jelly
[] 13. Std Days / Cycle beads
[] 14. LAM
[] 30. Rhythm method
[] 31. Withdrawal
[] 39. Other traditional methods

Enter Value January 2018

[] B. Births
[] P. Pregnancies
[] T. Terminations
[] 0. No method used
[] 1. Female Sterilization
[] 2. Male Sterilization
[] 3. Implant
[] 4. IUD
[] 5. Injectables
[] 7. Pill
[] 8. Emergency Contraception
[] 9. Male Condom
[] 10. Female Condom
[] 11. Diaphragm
[] 12. Foam / Jelly
[] 13. Std Days / Cycle beads
[] 14. LAM
[] 30. Rhythm method
[] 31. Withdrawal
[] 39. Other traditional methods

Please verify your inputs for 2018. Are they correct?

Please correct any mistakes.

[] Yes
[] No

ENTER VALUE FROM COL. 1

Enter Value December 2017

[] B. Births
[] P. Pregnancies
[] T. Terminations
[] 0. No method used
[] 1. Female Sterilization
[] 2. Male Sterilization
[] 3. Implant
[] 4. IUD
[] 5. Injectables
[] 7. Pill
[] 8. Emergency Contraception
[] 9. Male Condom
[] 10. Female Condom
[] 11. Diaphragm
[] 12. Foam / Jelly
[] 13. Std Days / Cycle beads
[] 14. LAM
[] 30. Rhythm method
[] 31. Withdrawal
[] 39. Other traditional methods

Enter Value November 2017

[] B. Births
[] P. Pregnancies
[] T. Terminations
[] 0. No method used
[] 1. Female Sterilization
[] 2. Male Sterilization
[] 3. Implant
[] 4. IUD
[] 5. Injectables
[] 7. Pill
[] 8. Emergency Contraception
[] 9. Male Condom
[] 10. Female Condom
[] 11. Diaphragm
[] 12. Foam / Jelly
[] 13. Std Days / Cycle beads
[] 14. LAM
[] 30. Rhythm method
[] 31. Withdrawal
[] 39. Other traditional methods

Enter Value October 2017

[] B. Births
[] P. Pregnancies
[] T. Terminations
[] 0. No method used
[] 1. Female Sterilization
[] 2. Male Sterilization
[] 3. Implant
[] 4. IUD
[] 5. Injectables
[] 7. Pill
[] 8. Emergency Contraception
[] 9. Male Condom
[] 10. Female Condom
[] 11. Diaphragm
[] 12. Foam / Jelly
[] 13. Std Days / Cycle beads
[] 14. LAM
[] 30. Rhythm method
[] 31. Withdrawal
[] 39. Other traditional methods

Enter Value September 2017

[] B. Births
[] P. Pregnancies
[] T. Terminations
[] 0. No method used
[] 1. Female Sterilization
[] 2. Male Sterilization
[] 3. Implant
[] 4. IUD
[] 5. Injectables
[] 7. Pill
[] 8. Emergency Contraception
[] 9. Male Condom
[] 10. Female Condom
[] 11. Diaphragm
[] 12. Foam / Jelly
[] 13. Std Days / Cycle beads
[] 14. LAM
[] 30. Rhythm method
[] 31. Withdrawal
[] 39. Other traditional methods

Enter Value August 2017

[] B. Births
[] P. Pregnancies
[] T. Terminations
[] 0. No method used
[] 1. Female Sterilization
[] 2. Male Sterilization
[] 3. Implant
[] 4. IUD
[] 5. Injectables
[] 7. Pill
[] 8. Emergency Contraception
[] 9. Male Condom
[] 10. Female Condom
[] 11. Diaphragm
[] 12. Foam / Jelly
[] 13. Std Days / Cycle beads
[] 14. LAM
[] 30. Rhythm method
[] 31. Withdrawal
[] 39. Other traditional methods

Enter Value July 2017

[] B. Births
[] P. Pregnancies
[] T. Terminations
[] 0. No method used
[] 1. Female Sterilization
[] 2. Male Sterilization
[] 3. Implant
[] 4. IUD
[] 5. Injectables
[] 7. Pill
[] 8. Emergency Contraception
[] 9. Male Condom
[] 10. Female Condom
[] 11. Diaphragm
[] 12. Foam / Jelly
[] 13. Std Days / Cycle beads
[] 14. LAM
[] 30. Rhythm method
[] 31. Withdrawal
[] 39. Other traditional methods

Enter Value June 2017

[] B. Births
[] P. Pregnancies
[] T. Terminations
[] 0. No method used
[] 1. Female Sterilization
[] 2. Male Sterilization
[] 3. Implant
[] 4. IUD
[] 5. Injectables
[] 7. Pill
[] 8. Emergency Contraception
[] 9. Male Condom
[] 10. Female Condom
[] 11. Diaphragm
[] 12. Foam / Jelly
[] 13. Std Days / Cycle beads
[] 14. LAM
[] 30. Rhythm method
[] 31. Withdrawal
[] 39. Other traditional methods

Enter Value May 2017

[] B. Births
[] P. Pregnancies
[] T. Terminations
[] 0. No method used
[] 1. Female Sterilization
[] 2. Male Sterilization
[] 3. Implant
[] 4. IUD
[] 5. Injectables
[] 7. Pill
[] 8. Emergency Contraception
[] 9. Male Condom
[] 10. Female Condom
[] 11. Diaphragm
[] 12. Foam / Jelly
[] 13. Std Days / Cycle beads
[] 14. LAM
[] 30. Rhythm method
[] 31. Withdrawal
[] 39. Other traditional methods

Enter Value April 2017

[] B. Births
[] P. Pregnancies
[] T. Terminations
[] 0. No method used
[] 1. Female Sterilization
[] 2. Male Sterilization
[] 3. Implant
[] 4. IUD
[] 5. Injectables
[] 7. Pill
[] 8. Emergency Contraception
[] 9. Male Condom
[] 10. Female Condom
[] 11. Diaphragm
[] 12. Foam / Jelly
[] 13. Std Days / Cycle beads
[] 14. LAM
[] 30. Rhythm method
[] 31. Withdrawal
[] 39. Other traditional methods

Enter Value March 2017

[] B. Births
[] P. Pregnancies
[] T. Terminations
[] 0. No method used
[] 1. Female Sterilization
[] 2. Male Sterilization
[] 3. Implant
[] 4. IUD
[] 5. Injectables
[] 7. Pill
[] 8. Emergency Contraception
[] 9. Male Condom
[] 10. Female Condom
[] 11. Diaphragm
[] 12. Foam / Jelly
[] 13. Std Days / Cycle beads
[] 14. LAM
[] 30. Rhythm method
[] 31. Withdrawal
[] 39. Other traditional methods

Enter Value February 2017

[] B. Births
[] P. Pregnancies
[] T. Terminations
[] 0. No method used
[] 1. Female Sterilization
[] 2. Male Sterilization
[] 3. Implant
[] 4. IUD
[] 5. Injectables
[] 7. Pill
[] 8. Emergency Contraception
[] 9. Male Condom
[] 10. Female Condom
[] 11. Diaphragm
[] 12. Foam / Jelly
[] 13. Std Days / Cycle beads
[] 14. LAM
[] 30. Rhythm method
[] 31. Withdrawal
[] 39. Other traditional methods

Enter Value January 2017

[] B. Births
[] P. Pregnancies
[] T. Terminations
[] 0. No method used
[] 1. Female Sterilization
[] 2. Male Sterilization
[] 3. Implant
[] 4. IUD
[] 5. Injectables
[] 7. Pill
[] 8. Emergency Contraception
[] 9. Male Condom
[] 10. Female Condom
[] 11. Diaphragm
[] 12. Foam / Jelly
[] 13. Std Days / Cycle beads
[] 14. LAM
[] 30. Rhythm method
[] 31. Withdrawal
[] 39. Other traditional methods

Please verify your inputs for 2017. Are they correct?

Please correct any mistakes.

[] Yes
[] No

Look for COL. 2 on the visual aid paper

ENTER VALUE FROM COL. 2

Enter Value December 2019

[] 1. Infrequent sex / husband away
[] 2. Became pregnant while using
[] 3. Wanted to become pregnant
[] 4. Husband / partner disapproved
[] 5. Wanted more effective method
[] 6. Side effects / health concerns
[] 7. Lack of access / too far
[] 8. Costs too much
[] 9. Inconvenient to use
[] 10. Up to god / fatalistic
[] 11. Difficult to get pregnant / menopausal
[] 12. Marital dissolution / separation
[] 96. Other

Enter Value November 2019

[] 1. Infrequent sex / husband away
[] 2. Became pregnant while using
[] 3. Wanted to become pregnant
[] 4. Husband / partner disapproved
[] 5. Wanted more effective method
[] 6. Side effects / health concerns
[] 7. Lack of access / too far
[] 8. Costs too much
[] 9. Inconvenient to use
[] 10. Up to god / fatalistic
[] 11. Difficult to get pregnant / menopausal
[] 12. Marital dissolution / separation
[] 96. Other

Enter Value October 2019

[] 1. Infrequent sex / husband away
[] 2. Became pregnant while using
[] 3. Wanted to become pregnant
[] 4. Husband / partner disapproved
[] 5. Wanted more effective method
[] 6. Side effects / health concerns
[] 7. Lack of access / too far
[] 8. Costs too much
[] 9. Inconvenient to use
[] 10. Up to god / fatalistic
[] 11. Difficult to get pregnant / menopausal
[] 12. Marital dissolution / separation
[] 96. Other

Enter Value September 2019

[] 1. Infrequent sex / husband away
[] 2. Became pregnant while using
[] 3. Wanted to become pregnant
[] 4. Husband / partner disapproved
[] 5. Wanted more effective method
[] 6. Side effects / health concerns
[] 7. Lack of access / too far
[] 8. Costs too much
[] 9. Inconvenient to use
[] 10. Up to god / fatalistic
[] 11. Difficult to get pregnant / menopausal
[] 12. Marital dissolution / separation
[] 96. Other

Enter Value August 2019

[] 1. Infrequent sex / husband away
[] 2. Became pregnant while using
[] 3. Wanted to become pregnant
[] 4. Husband / partner disapproved
[] 5. Wanted more effective method
[] 6. Side effects / health concerns
[] 7. Lack of access / too far
[] 8. Costs too much
[] 9. Inconvenient to use
[] 10. Up to god / fatalistic
[] 11. Difficult to get pregnant / menopausal
[] 12. Marital dissolution / separation
[] 96. Other

Enter Value July 2019

[] 1. Infrequent sex / husband away
[] 2. Became pregnant while using
[] 3. Wanted to become pregnant
[] 4. Husband / partner disapproved
[] 5. Wanted more effective method
[] 6. Side effects / health concerns
[] 7. Lack of access / too far
[] 8. Costs too much
[] 9. Inconvenient to use
[] 10. Up to god / fatalistic
[] 11. Difficult to get pregnant / menopausal
[] 12. Marital dissolution / separation
[] 96. Other

Enter Value June 2019

[] 1. Infrequent sex / husband away
[] 2. Became pregnant while using
[] 3. Wanted to become pregnant
[] 4. Husband / partner disapproved
[] 5. Wanted more effective method
[] 6. Side effects / health concerns
[] 7. Lack of access / too far
[] 8. Costs too much
[] 9. Inconvenient to use
[] 10. Up to god / fatalistic
[] 11. Difficult to get pregnant / menopausal
[] 12. Marital dissolution / separation
[] 96. Other

Enter Value May 2019

[] 1. Infrequent sex / husband away
[] 2. Became pregnant while using
[] 3. Wanted to become pregnant
[] 4. Husband / partner disapproved
[] 5. Wanted more effective method
[] 6. Side effects / health concerns
[] 7. Lack of access / too far
[] 8. Costs too much
[] 9. Inconvenient to use
[] 10. Up to god / fatalistic
[] 11. Difficult to get pregnant / menopausal
[] 12. Marital dissolution / separation
[] 96. Other

Enter Value April 2019

[] 1. Infrequent sex / husband away
[] 2. Became pregnant while using
[] 3. Wanted to become pregnant
[] 4. Husband / partner disapproved
[] 5. Wanted more effective method
[] 6. Side effects / health concerns
[] 7. Lack of access / too far
[] 8. Costs too much
[] 9. Inconvenient to use
[] 10. Up to god / fatalistic
[] 11. Difficult to get pregnant / menopausal
[] 12. Marital dissolution / separation
[] 96. Other

Enter Value March 2019

[] 1. Infrequent sex / husband away
[] 2. Became pregnant while using
[] 3. Wanted to become pregnant
[] 4. Husband / partner disapproved
[] 5. Wanted more effective method
[] 6. Side effects / health concerns
[] 7. Lack of access / too far
[] 8. Costs too much
[] 9. Inconvenient to use
[] 10. Up to god / fatalistic
[] 11. Difficult to get pregnant / menopausal
[] 12. Marital dissolution / separation
[] 96. Other

Enter Value February 2019

[] 1. Infrequent sex / husband away
[] 2. Became pregnant while using
[] 3. Wanted to become pregnant
[] 4. Husband / partner disapproved
[] 5. Wanted more effective method
[] 6. Side effects / health concerns
[] 7. Lack of access / too far
[] 8. Costs too much
[] 9. Inconvenient to use
[] 10. Up to god / fatalistic
[] 11. Difficult to get pregnant / menopausal
[] 12. Marital dissolution / separation
[] 96. Other

Enter Value January 2019

[] 1. Infrequent sex / husband away
[] 2. Became pregnant while using
[] 3. Wanted to become pregnant
[] 4. Husband / partner disapproved
[] 5. Wanted more effective method
[] 6. Side effects / health concerns
[] 7. Lack of access / too far
[] 8. Costs too much
[] 9. Inconvenient to use
[] 10. Up to god / fatalistic
[] 11. Difficult to get pregnant / menopausal
[] 12. Marital dissolution / separation
[] 96. Other

ENTER VALUE FROM COL. 2

Enter Value December 2018

[] 1. Infrequent sex / husband away
[] 2. Became pregnant while using
[] 3. Wanted to become pregnant
[] 4. Husband / partner disapproved
[] 5. Wanted more effective method
[] 6. Side effects / health concerns
[] 7. Lack of access / too far
[] 8. Costs too much
[] 9. Inconvenient to use
[] 10. Up to god / fatalistic
[] 11. Difficult to get pregnant / menopausal
[] 12. Marital dissolution / separation
[] 96. Other

Enter Value November 2018

[] 1. Infrequent sex / husband away
[] 2. Became pregnant while using
[] 3. Wanted to become pregnant
[] 4. Husband / partner disapproved
[] 5. Wanted more effective method
[] 6. Side effects / health concerns
[] 7. Lack of access / too far
[] 8. Costs too much
[] 9. Inconvenient to use
[] 10. Up to god / fatalistic
[] 11. Difficult to get pregnant / menopausal
[] 12. Marital dissolution / separation
[] 96. Other

Enter Value October 2018

[] 1. Infrequent sex / husband away
[] 2. Became pregnant while using
[] 3. Wanted to become pregnant
[] 4. Husband / partner disapproved
[] 5. Wanted more effective method
[] 6. Side effects / health concerns
[] 7. Lack of access / too far
[] 8. Costs too much
[] 9. Inconvenient to use
[] 10. Up to god / fatalistic
[] 11. Difficult to get pregnant / menopausal
[] 12. Marital dissolution / separation
[] 96. Other

Enter Value September 2018

[] 1. Infrequent sex / husband away
[] 2. Became pregnant while using
[] 3. Wanted to become pregnant
[] 4. Husband / partner disapproved
[] 5. Wanted more effective method
[] 6. Side effects / health concerns
[] 7. Lack of access / too far
[] 8. Costs too much
[] 9. Inconvenient to use
[] 10. Up to god / fatalistic
[] 11. Difficult to get pregnant / menopausal
[] 12. Marital dissolution / separation
[] 96. Other

Enter Value August 2018

[] 1. Infrequent sex / husband away
[] 2. Became pregnant while using
[] 3. Wanted to become pregnant
[] 4. Husband / partner disapproved
[] 5. Wanted more effective method
[] 6. Side effects / health concerns
[] 7. Lack of access / too far
[] 8. Costs too much
[] 9. Inconvenient to use
[] 10. Up to god / fatalistic
[] 11. Difficult to get pregnant / menopausal
[] 12. Marital dissolution / separation
[] 96. Other

Enter Value July 2018

[] 1. Infrequent sex / husband away
[] 2. Became pregnant while using
[] 3. Wanted to become pregnant
[] 4. Husband / partner disapproved
[] 5. Wanted more effective method
[] 6. Side effects / health concerns
[] 7. Lack of access / too far
[] 8. Costs too much
[] 9. Inconvenient to use
[] 10. Up to god / fatalistic
[] 11. Difficult to get pregnant / menopausal
[] 12. Marital dissolution / separation
[] 96. Other

Enter Value June 2018

[] 1. Infrequent sex / husband away
[] 2. Became pregnant while using
[] 3. Wanted to become pregnant
[] 4. Husband / partner disapproved
[] 5. Wanted more effective method
[] 6. Side effects / health concerns
[] 7. Lack of access / too far
[] 8. Costs too much
[] 9. Inconvenient to use
[] 10. Up to god / fatalistic
[] 11. Difficult to get pregnant / menopausal
[] 12. Marital dissolution / separation
[] 96. Other

Enter Value May 2018

[] 1. Infrequent sex / husband away
[] 2. Became pregnant while using
[] 3. Wanted to become pregnant
[] 4. Husband / partner disapproved
[] 5. Wanted more effective method
[] 6. Side effects / health concerns
[] 7. Lack of access / too far
[] 8. Costs too much
[] 9. Inconvenient to use
[] 10. Up to god / fatalistic
[] 11. Difficult to get pregnant / menopausal
[] 12. Marital dissolution / separation
[] 96. Other

Enter Value April 2018

[] 1. Infrequent sex / husband away
[] 2. Became pregnant while using
[] 3. Wanted to become pregnant
[] 4. Husband / partner disapproved
[] 5. Wanted more effective method
[] 6. Side effects / health concerns
[] 7. Lack of access / too far
[] 8. Costs too much
[] 9. Inconvenient to use
[] 10. Up to god / fatalistic
[] 11. Difficult to get pregnant / menopausal
[] 12. Marital dissolution / separation
[] 96. Other

Enter Value March 2018

[] 1. Infrequent sex / husband away
[] 2. Became pregnant while using
[] 3. Wanted to become pregnant
[] 4. Husband / partner disapproved
[] 5. Wanted more effective method
[] 6. Side effects / health concerns
[] 7. Lack of access / too far
[] 8. Costs too much
[] 9. Inconvenient to use
[] 10. Up to god / fatalistic
[] 11. Difficult to get pregnant / menopausal
[] 12. Marital dissolution / separation
[] 96. Other

Enter Value February 2018

[] 1. Infrequent sex / husband away
[] 2. Became pregnant while using
[] 3. Wanted to become pregnant
[] 4. Husband / partner disapproved
[] 5. Wanted more effective method
[] 6. Side effects / health concerns
[] 7. Lack of access / too far
[] 8. Costs too much
[] 9. Inconvenient to use
[] 10. Up to god / fatalistic
[] 11. Difficult to get pregnant / menopausal
[] 12. Marital dissolution / separation
[] 96. Other

Enter Value January 2018

[] 1. Infrequent sex / husband away
[] 2. Became pregnant while using
[] 3. Wanted to become pregnant
[] 4. Husband / partner disapproved
[] 5. Wanted more effective method
[] 6. Side effects / health concerns
[] 7. Lack of access / too far
[] 8. Costs too much
[] 9. Inconvenient to use
[] 10. Up to god / fatalistic
[] 11. Difficult to get pregnant / menopausal
[] 12. Marital dissolution / separation
[] 96. Other

ENTER VALUE FROM COL. 2

Enter Value December 2017

[] 1. Infrequent sex / husband away
[] 2. Became pregnant while using
[] 3. Wanted to become pregnant
[] 4. Husband / partner disapproved
[] 5. Wanted more effective method
[] 6. Side effects / health concerns
[] 7. Lack of access / too far
[] 8. Costs too much
[] 9. Inconvenient to use
[] 10. Up to god / fatalistic
[] 11. Difficult to get pregnant / menopausal
[] 12. Marital dissolution / separation
[] 96. Other

Enter Value November 2017

[] 1. Infrequent sex / husband away
[] 2. Became pregnant while using
[] 3. Wanted to become pregnant
[] 4. Husband / partner disapproved
[] 5. Wanted more effective method
[] 6. Side effects / health concerns
[] 7. Lack of access / too far
[] 8. Costs too much
[] 9. Inconvenient to use
[] 10. Up to god / fatalistic
[] 11. Difficult to get pregnant / menopausal
[] 12. Marital dissolution / separation
[] 96. Other

Enter Value October 2017

[] 1. Infrequent sex / husband away
[] 2. Became pregnant while using
[] 3. Wanted to become pregnant
[] 4. Husband / partner disapproved
[] 5. Wanted more effective method
[] 6. Side effects / health concerns
[] 7. Lack of access / too far
[] 8. Costs too much
[] 9. Inconvenient to use
[] 10. Up to god / fatalistic
[] 11. Difficult to get pregnant / menopausal
[] 12. Marital dissolution / separation
[] 96. Other

Enter Value September 2017

[] 1. Infrequent sex / husband away
[] 2. Became pregnant while using
[] 3. Wanted to become pregnant
[] 4. Husband / partner disapproved
[] 5. Wanted more effective method
[] 6. Side effects / health concerns
[] 7. Lack of access / too far
[] 8. Costs too much
[] 9. Inconvenient to use
[] 10. Up to god / fatalistic
[] 11. Difficult to get pregnant / menopausal
[] 12. Marital dissolution / separation
[] 96. Other

Enter Value August 2017

[] 1. Infrequent sex / husband away
[] 2. Became pregnant while using
[] 3. Wanted to become pregnant
[] 4. Husband / partner disapproved
[] 5. Wanted more effective method
[] 6. Side effects / health concerns
[] 7. Lack of access / too far
[] 8. Costs too much
[] 9. Inconvenient to use
[] 10. Up to god / fatalistic
[] 11. Difficult to get pregnant / menopausal
[] 12. Marital dissolution / separation
[] 96. Other

Enter Value July 2017

[] 1. Infrequent sex / husband away
[] 2. Became pregnant while using
[] 3. Wanted to become pregnant
[] 4. Husband / partner disapproved
[] 5. Wanted more effective method
[] 6. Side effects / health concerns
[] 7. Lack of access / too far
[] 8. Costs too much
[] 9. Inconvenient to use
[] 10. Up to god / fatalistic
[] 11. Difficult to get pregnant / menopausal
[] 12. Marital dissolution / separation
[] 96. Other

Enter Value June 2017

[] 1. Infrequent sex / husband away
[] 2. Became pregnant while using
[] 3. Wanted to become pregnant
[] 4. Husband / partner disapproved
[] 5. Wanted more effective method
[] 6. Side effects / health concerns
[] 7. Lack of access / too far
[] 8. Costs too much
[] 9. Inconvenient to use
[] 10. Up to god / fatalistic
[] 11. Difficult to get pregnant / menopausal
[] 12. Marital dissolution / separation
[] 96. Other

Enter Value May 2017

[] 1. Infrequent sex / husband away
[] 2. Became pregnant while using
[] 3. Wanted to become pregnant
[] 4. Husband / partner disapproved
[] 5. Wanted more effective method
[] 6. Side effects / health concerns
[] 7. Lack of access / too far
[] 8. Costs too much
[] 9. Inconvenient to use
[] 10. Up to god / fatalistic
[] 11. Difficult to get pregnant / menopausal
[] 12. Marital dissolution / separation
[] 96. Other

Enter Value April 2017

[] 1. Infrequent sex / husband away
[] 2. Became pregnant while using
[] 3. Wanted to become pregnant
[] 4. Husband / partner disapproved
[] 5. Wanted more effective method
[] 6. Side effects / health concerns
[] 7. Lack of access / too far
[] 8. Costs too much
[] 9. Inconvenient to use
[] 10. Up to god / fatalistic
[] 11. Difficult to get pregnant / menopausal
[] 12. Marital dissolution / separation
[] 96. Other

Enter Value March 2017

[] 1. Infrequent sex / husband away
[] 2. Became pregnant while using
[] 3. Wanted to become pregnant
[] 4. Husband / partner disapproved
[] 5. Wanted more effective method
[] 6. Side effects / health concerns
[] 7. Lack of access / too far
[] 8. Costs too much
[] 9. Inconvenient to use
[] 10. Up to god / fatalistic
[] 11. Difficult to get pregnant / menopausal
[] 12. Marital dissolution / separation
[] 96. Other

Enter Value February 2017

[] 1. Infrequent sex / husband away
[] 2. Became pregnant while using
[] 3. Wanted to become pregnant
[] 4. Husband / partner disapproved
[] 5. Wanted more effective method
[] 6. Side effects / health concerns
[] 7. Lack of access / too far
[] 8. Costs too much
[] 9. Inconvenient to use
[] 10. Up to god / fatalistic
[] 11. Difficult to get pregnant / menopausal
[] 12. Marital dissolution / separation
[] 96. Other

Enter Value January 2017

[] 1. Infrequent sex / husband away
[] 2. Became pregnant while using
[] 3. Wanted to become pregnant
[] 4. Husband / partner disapproved
[] 5. Wanted more effective method
[] 6. Side effects / health concerns
[] 7. Lack of access / too far
[] 8. Costs too much
[] 9. Inconvenient to use
[] 10. Up to god / fatalistic
[] 11. Difficult to get pregnant / menopausal
[] 12. Marital dissolution / separation
[] 96. Other

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