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Uganda Phase 3 Female Questionnaire


Region


District


Sub-county


Enumeration Area:


Structure number:


Household number:


001a. Are you in the correct household?
EA: {EA_nice} Household head: ${HQ_ODK_display_name} Structure #: ${structure} Household #: ${household}

Go to the right household.

[] Yes
[] No


001a. Are you in the correct household?
EA: {EA_nice} Household head: ${HQ_ODK_display_name}

Go to the right household.

[] Yes
[] No


002a. Your name:

Is this your name?

[] Yes
[] No


002a. Enter your name below.

Please record your name


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

[] Yes
[] No


003b. Record the correct date and time.

The date must be between 2022-06-01 and 2022-12-31.


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


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

Is the above information correct?

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

[] Yes
[] No


Is the respondent present and available to be interviewed today?

[] Yes
[] No


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.


008a. Provide a paper copy of the Consent Form to the respondent and read it.
Then, ask: May I begin the interview now?

[] Yes
[] No


Interviewer?s name: {your_name}

Mark your name as a witness to the consent process.

[] NA


Interviewer?s name
Please record your name as a witness to the consent process. You previously entered "{your_name_text}."

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


Respondent?s first name: {firstname_raw_auto}
Did you want to update the respondent?s first name?

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

[] Yes
[] No


Respondent?s first name:


Was this woman interviewed in ANY previous survey?

Check your list of panel women

[] Yes
[] No


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

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


In what month and year were you born?

Month:

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

Year:

Cannot be this year or in the future.


How old were you at your last birthday?
Age in the Household Roster: {hq_age}

Must be more than 14. Must agree with 101.

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


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

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


Have you attended school in the past 12 months?

[] Yes
[] No
[] No response


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
[] ?O? Level
[] ?A? Level
[] Tertiary
[] University
[] No response


What is the highest [class / year] you completed at that level?

Enter -99 for no response.


XS_101. How old were you when you left school?

Must be between 0 and the respondent?s age.


What was the main reason you stopped attending school?

[] 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


Are you currently enrolled in any training program?

[] Yes
[] No
[] No response


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


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

[] Never attended
[] Primary
[] ?O? Level
[] ?A? Level
[] Tertiary
[] University
[] Do not know
[] No response


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

[] Yes
[] No
[] No response


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

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


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

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


Have you ever had a partner / boyfriend?

[] Yes
[] No
[] No response


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

Must be between 0 and the respondent?s age.


Do you currently have a boyfriend or partner?

[] Yes
[] No
[] No response


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

Select ?Do not know? for month and ?2030? for year to indicate ?No response?.

Month:

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

Year:

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


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

Enter -99 for no response.

Must be at least 1


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

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

Month:

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

Year:

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


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

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.

Select ?Do not know? for month to indicate ?No Response?.


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

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.

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


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

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


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

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

Years entered cannot exceed age.


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

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

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


In the last 12 months, for how many nights have you slept away from your community?
PROBE: Community is the area where you are currently living

Enter -99 for no response.


In the last 12 months, for how many nights has your husband/partner slept away from your community?
PROBE: Community is the area where you are currently living

Enter -99 for no response.


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

[] Yes
[] No
[] No response


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

[] Yes
[] No
[] No response


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

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


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


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


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

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


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

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


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

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


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

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


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

[] Yes
[] No
[] No response


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

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


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

Read each option aloud and select if yes.

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

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


Do you have a way of accessing the internet?

[] Yes
[] No
[] No response


How often do you access the internet?

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


What devices do you use to access the internet?

Read all options aloud and select all that apply

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

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


What other device do you use to access the internet?


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

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


Section 2 -- Reproduction, Pregnancy and Fertility Preferences


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


How many times have you given birth?

Enter -99 for no response.


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

[] Yes
[] No
[] No response


PL_202. When was that birth?

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

Month:

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

Year:

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


PL_INF_1b. How many months did it take for you to become pregnant?

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


XS_201. When was your FIRST birth?

Please record the date of the first live birth. Date should be found by calculating forward or backward from memorable events if needed.
Select ?Do not know? for month and ?2030? for year to indicate ?No Response?.
CALENDAR: If the birth was after {cc_start_date_lab} enter the birth and duration of pregnancy in the calendar.

Month:

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

Year:

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


XS_202. When was your MOST RECENT birth?

Please record the date of the first live birth. Date should be found by calculating forward or backward from memorable events if needed.
Select ?Do not know? for month and ?2030? for year to indicate ?No Response?.
CALENDAR: If the birth was after {cc_start_date_lab} enter the birth and duration of pregnancy in the calendar.

Month:

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

Year:

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


XS_203. Have you had any other births since {cc_start_date_lab}?

[] Yes
[] No
[] No response


XS_204. When was that birth?

Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed.
Select ?Do not know? for month and ?2030? for year to indicate ?No Response?.
CALENDAR: Enter the birth and duration of pregnancy in the calendar.

Month:

[] 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.


INF_1c. How many months did it take for you to become pregnant?

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


XS_205. Have you ever had a pregnancy that miscarried, was aborted, or ended in a stillbirth since {cc_start_date_lab}?

[] Yes
[] No
[] No response


XS_206. When did that pregnancy end?

Select ?Do not know? for month and ?2030? for year to indicate ?No Response?.
CALENDAR: Enter the termination and duration of pregnancy in the calendar.

Month:

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

Year:

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


PL_203. Have you had a pregnancy that miscarried, was aborted, or ended in a stillbirth since {p1_survey_date_lab}?

[] Yes
[] No
[] No response


PL_204. When did that pregnancy end?

Select ?Do not know? for month and ?2030? for year to indicate ?No Response?.
CALENDAR: Enter the termination and duration of pregnancy in the calendar.

Month:

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

Year:

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


Are you pregnant now?

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


How many months pregnant are you?

Please record the number of completed months. Enter -88 for do not know, -99 for No response.
CALENDAR: Enter number of months pregnant in the calendar.

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


When did your last menstrual period start?

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

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


You entered "Never menstruated" in 205 but the respondent 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


Enter {menstrual_period_lab}

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

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


You entered that the respondent is {months_pregnant} months pregnant, but she said her last menstrual period started {menstrual_period_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 205 but 203 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


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

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


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

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


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

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

206a. Now I would like to ask a question about your last birth.
At the time you became pregnant, did you want to become pregnant then, did you want to wait until later, or did you not want to have any more children at all?

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

206b. Now I would like to ask a question about your current pregnancy.
At the time you became pregnant, did you want to become pregnant then, did you want to wait until later, or did you not want to have any more children at all?

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


INF_4b. Did you want to become pregnant earlier?

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


INF_4c. How many months did it take for you to become pregnant?

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


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

Read response options and select one

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


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

Read response options and select one

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


Now I have some questions about the future.


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

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


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

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


208b. After the child you are expecting now, would you like to have another child or would you prefer not to have any more children?

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


209a. How long would you like to wait from now before the birth of a child?

If you select months or years, you will enter a number for X on the next screen.
Select "Years" if more than 36 months.
Please check that you correctly entered the value for months/years.

[] X months
[] X years
[] Soon/now
[] Says she can?t get pregnant
[] Other
[] Do not know
[] No response


209a. How long would you like to wait from now before the birth of another child?

If you select months or years, you will enter a number for X on the next screen.
Select "Years" if more than 36 months.
Please check that you correctly entered the value for months/years.

[] X months
[] X years
[] Soon/now
[] Says she can?t get pregnant
[] Other
[] Do not know
[] No response


209b. After the birth of the child you are expecting now, how long would you like to wait before the birth of another child?

If you select months or years, you will enter a number for X on the next screen.
Select "Years" if more than 36 months.
Please check that you correctly entered the value for months/years.

[] X months
[] X years
[] Soon/now
[] Says she can?t get pregnant
[] Other
[] Do not know
[] No response


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

Use years if more than 36 months.


INF_5. Are you currently trying to become pregnant?

[] Yes
[] No
[] No response


INF_6. How long have you been trying to become pregnant?
Probe: ?Do not know? or ?No response", probe to confirm if trying for more than 1 year.

If you select months or years, you will enter a number for X on the next screen.
Select "Years" if more than 36 months.
Please check that you correctly entered the value for months/years.

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

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


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

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


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

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


INF_6b. How long does it typically take for a woman to become pregnant from when they begin trying?

If you select months or years, you will enter a number for X on the next screen.
Select "Years" if more than 36 months.
Please check that you correctly entered the value for months/years.

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

INF_6b. Enter the number of {preg_time_typical_lab} that it typically takes for a woman to become pregnant?


INF_6c. If you were trying to become pregnant, after how long would you start worrying that you could not become pregnant?

If you select months or years, you will enter a number for X on the next screen.
Select "Years" if more than 36 months.
Please check that you correctly entered the value for months/years.

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

INF_6c. Enter the number of {preg_time_worry_lab} after which you would start worrying that you could not become pregnant?


INF_6d. How long after you started trying to become pregnant would you wait before seeking help?

If you select months or years, you will enter a number for X on the next screen.
Select "Years" if more than 36 months.
Please check that you correctly entered the value for months/years.

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

INF_6d. Enter the number of {preg_time_seek_lab} that you would wait before seeking help to get pregnant?


Section 3 -- Contraception

Now I would like to talk about family planning - the various ways or methods that a couple can use to delay or avoid a pregnancy.
An image will appear on the screen for some methods. If the respondent says that she has not heard of the method or if she hesitates to answer, read the probe aloud and show her the image, if available.


301a. Have you ever heard of female sterilization?
PROBE: Women can have an operation to avoid having any more children.

[] Yes
[] No
[] No response


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

[] Yes
[] No
[] No response


301c. Have you ever heard of the contraceptive implant?
PROBE: Women can have one or several small rods placed in her upper arm by a doctor or nurse, which can prevent pregnancy for one or more years.

[] Yes
[] No
[] No response


301d. Have you ever heard of the IUD?
PROBE: Women can have a loop or coil placed inside them by a doctor or a nurse.

[] Yes
[] No
[] No response


301e. Have you ever heard of injectables?
PROBE: Women can have an injection by a health provider that stops them from becoming pregnant for one or more months.

[] Yes
[] No
[] No response


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

[] Yes
[] No
[] No response


301g. From whom did you hear about it?

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


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

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


CIFF_1. Did you hear about the type of injectable that you can inject yourself (self-injection) through social or digital media?

[] Yes
[] No
[] No response


CIFF_2. Do you know where you can go to obtain the type of injectable that you can inject yourself?

[] Yes
[] No
[] No response


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

[] Yes
[] No
[] No response


301i. Have you ever heard of emergency contraception?
PROBE: As an emergency measure after unprotected sexual intercourse women can take special pills at any time within five days to prevent pregnancy.

[] Yes
[] No
[] No response


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

[] Yes
[] No
[] No response


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

[] Yes
[] No
[] No response


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

[] Yes
[] No
[] No response


301m. Have you ever heard of foam or jelly as a contraceptive method?
PROBE: Women can place a suppository, jelly, or cream in their vagina before sexual intercourse to prevent pregnancy.

[] Yes
[] No
[] No response


301n. Have you ever heard of the standard days method or Cycle Beads?
PROBE: A Woman can use a string of colored beads to know the days she can get pregnant. On the days she can get pregnant, she and her partner use a condom or do not have sexual intercourse.

[] Yes
[] No
[] No response


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

[] Yes
[] No
[] No response


301p. Have you ever heard of the rhythm method?
PROBE: Women can avoid pregnancy by not having sexual intercourse on the days of the month they think they can get pregnant.

[] Yes
[] No
[] No response


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

[] Yes
[] No
[] No response


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

[] Yes
[] No
[] No response


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

[] Yes
[] No
[] No response


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

[] Yes
[] No
[] No response


Which method or methods are you using?
PROBE: Anything else?

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

You selected no response with another option.

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

Check here to acknowledge you considered all options.

[] NA


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

Show the image to the respondent.

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


LCL_302. Who administered the injection?

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


CIFF_3. Would you consider using a type of injectable that you can inject yourself in the future?

[] Yes
[] No
[] No response


CIFF_4. Have you ever injected yourself with a contraceptive method?

[] Yes
[] No
[] No response


CIFF_5. Why did you stop using this self-administered injectable?

Multiple response options are possible

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

[] 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
[] 13. Fear of Pain
[] 14. Missing reinjection period
[] 15. Lack of privacy
[] 16. Need refresher training/don?t remember how to self-inject
[] 96. Other
[] Do not know
[] No response


CIFF_6. Do you feel your contraceptive method is private to use?

[] Yes
[] No
[] No response


CIFF_7. Do you feel confident in using your current contraceptive method?

[] Yes
[] No
[] No response


CIFF_8. Did you feel it was easy to obtain your current method?

[] Yes
[] No
[] No response


CIFF_9. Do you feel in control of your fertility choices?

[] Yes
[] No
[] No response


304a. Do you like your {current_method_label}?

[] Yes
[] No
[] No response


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

[] Yes
[] No
[] No response


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

[] Yes
[] No
[] No response


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

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


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

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


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

[] Yes
[] No
[] No response


If you needed family planning, where would you go?

[] Govt. Hospital
[] Govt. Health Center
[] Public Family Planning Clinic
[] Public Outreach
[] Public Fieldwork/VHT
[] Other Public
[] Private Hospital/Clinic
[] Pharmacy
[] Private Doctor
[] Private Outreach
[] Private Fieldwork/VHT
[] Other Private
[] Shop
[] Church
[] Friend/relative
[] Other
[] Do not know
[] No Response


Why would you choose this location?

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

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


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


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


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


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


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.


What method do you think you will use?

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


CIFF_10. Would you consider using a type of injectable that you can inject yourself in the future?

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


Who would you prefer to have administer the injectable?

Read all options

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


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

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


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

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


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

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


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

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


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

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

In the last 12 months has your husband/partner:

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

1 = Yes 0 = No -99 = No Response

[] 1
[] 0
[] -99

In the last 12 months has your husband/partner:

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

1 = Yes 0 = No -99 = No Response

[] 1
[] 0
[] -99

In the last 12 months has your husband/partner:

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

1 = Yes 0 = No -99 = No Response

[] 1
[] 0
[] -99

In the last 12 months has your husband/partner:

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

1 = Yes 0 = No -99 = No Response

[] 1
[] 0
[] -99

In the last 12 months has your husband/partner:

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

1 = Yes 0 = No -99 = No Response

[] 1
[] 0
[] -99


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

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

Month:

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

Year:

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


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

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

Month:

[] 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.


You first started using {current_method_label} on ${start_date_lab}.
Where did you or your partner get it at that time?

Scroll to bottom to see all choices.

[] Govt. Hospital
[] Govt. Health Center
[] Public Family Planning Clinic
[] Public Outreach
[] Public Fieldwork/VHT
[] Other Public
[] Private Hospital/Clinic
[] Pharmacy
[] Private Doctor
[] Private Outreach
[] Private Fieldwork/VHT
[] Other Private
[] Shop
[] Church
[] Friend/relative
[] Other
[] Do not know
[] No Response


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

Scroll to bottom to see all choices.

[] Govt. Hospital
[] Govt. Health Center
[] Public Family Planning Clinic
[] Public Outreach
[] Public Fieldwork/VHT
[] Other Public
[] Private Hospital/Clinic
[] Pharmacy
[] Private Doctor
[] Private Outreach
[] Private Fieldwork/VHT
[] Other Private
[] Shop
[] Church
[] Friend/relative
[] Other
[] Do not know
[] No Response

Check here to acknowledge you considered all options.

[] NA


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

[] Yes
[] No
[] No response


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

[] Yes
[] No
[] No response


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

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

[] Yes
[] No


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

[] Yes
[] No
[] No response


IMP_303. How long were you told?

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

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

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

If more than 12 months record in years


IMP_304. Were you told where you could go to have the implant removed?
Provider: {provider_label}

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


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

[] Yes
[] No
[] No response


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

[] Yes
[] No
[] No response


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


Why didn?t you obtain the method you wanted?

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


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

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


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

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


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

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


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

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


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

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


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

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


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

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


Which method did you feel pressured to use?

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


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

[] Yes
[] No
[] No response


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

[] Yes
[] No
[] No response


Which method were you using?

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


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

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


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

[] Yes
[] No
[] No response


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

[] Govt. Hospital
[] Govt. Health Center
[] Public Family Planning Clinic
[] Public Outreach
[] Public Fieldwork/VHT
[] Other Public
[] Private Hospital/Clinic
[] Pharmacy
[] Private Doctor
[] Private Outreach
[] Private Fieldwork/VHT
[] Other Private
[] Shop
[] Church
[] Friend/relative
[] Self
[] Other
[] Do not know
[] No Response


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

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

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


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

[] Yes
[] No
[] No response


XS_301. How old were you when you first used a method to delay or avoid getting pregnant?
The respondent said she was {age} years old at her last birthday.

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

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


How many living children did you have at that time, if any?
Note: the respondent said that she gave birth {birth_events} times in 202.

Enter -99 for no response.

Must be zero or larger, or -99.


Have you used emergency contraception at any time in the last 12 months?
PROBE: As an emergency measure after unprotected sexual intercourse women can take special pills at any time within five days to prevent pregnancy.

[] Yes
[] No
[] No response


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


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


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


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


Can you tell me why you are not using a method to prevent pregnancy?
PROBE: Any other reason?

RECORD ALL REASONS MENTIONED
Cannot select "Not Married" if 109 is "Yes, currently married".
Scroll to bottom to see all choices.

Cannot select "Do not know" or "No response" with other options.
Cannot select "Not Married" if 109 is "Yes, currently married".

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

Check here to acknowledge you considered all options.

[] NA


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


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

[] Yes
[] No
[] No response


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


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


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

[] Yes
[] No
[] No response

In the last 12 months have you:

342a. Heard about family planning on the radio?

1 = Yes 0 = No -99 = No Response

[] 1
[] 0
[] -99

In the last 12 months have you:

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

1 = Yes 0 = No -99 = No Response

[] 1
[] 0
[] -99

In the last 12 months have you:

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

1 = Yes 0 = No -99 = No Response

[] 1
[] 0
[] -99

In the last 12 months have you:

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

1 = Yes 0 = No -99 = No Response

[] 1
[] 0
[] -99

In the last 12 months have you:

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

1 = Yes 0 = No -99 = No Response

[] 1
[] 0
[] -99

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

343a. Adolescents who use family planning are promiscuous.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

344a. Adolescents who use family planning are promiscuous.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

345b. Attend university / tertiary institution

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

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

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

345c. Find a husband/partner

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

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

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

345d. Have children

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

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


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

[] Yes
[] No
[] No response


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

Cannot select "No response" with other options.

[] Health insurance through employer
[] Community-based health insurance
[] Other
[] No response


HIV Testing


CIFF_11. I don?t want to know your result, but have you ever been tested for HIV?

[] Yes
[] No
[] No response


CIFF_12. When was your most recent HIV test?

Choose Period here

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

Record the value of X here


CIFF_13. Who administered your most recent HIV test?

[] Self
[] Health care provider
[] Other
[] No response


Section 4 -- Sexual Activity

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


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


How old were you when you first had sexual intercourse?

Enter the age in years.

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

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


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

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


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


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


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

[] Yes
[] No
[] No response


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

[] Yes
[] No
[] No response


When was the last time you had sexual intercourse?

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

If less than 12 months ago, answer must be recorded in months, weeks, or days.
Enter 0 days for today.
You will enter a number for X on the next screen.

Must agree with the pregnancy status.

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

Enter {last_time_sex_lab}.

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

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


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

[] Yes
[] No
[] No response


What method did you or your partner use?

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


Whose choice was it to use that method?

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


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

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

Must be a number or -88, -99


INF_8. In the past 12 months, how many months did you not have any sex ?

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

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


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

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


INF_10. Who have you sought help from?

Select all that apply

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

[] Govt. Hospital
[] Govt. Health Center
[] Public Family Planning Clinic
[] Public Outreach
[] Public Fieldwork/VHT
[] Other Public
[] Private Hospital/Clinic
[] Pharmacy
[] Private Doctor
[] Private Outreach
[] Private Fieldwork/VHT
[] Other Private
[] Shop
[] Church
[] Friend/relative
[] Infertility clinic (public)
[] Infertility clinic (private)
[] Traditional healer/Herbalists
[] Religious leaders
[] Other
[] Do not know
[] No response


INF_11. What type of care did you receive?

Select all that apply

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

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


INF_12. When did you most recently seek help?

If you select months or years, you will enter a number for X on the next screen.
Select "Years" if more than 36 months.
Please check that you correctly entered the value for months/years.

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

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


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

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


INF_14. And regarding your partner:

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


Section 5 -- Women and Girls Empowerment Section

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


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

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


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

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


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

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


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

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


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

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


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

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


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

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


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

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


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

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


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


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

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


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

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


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

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


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

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


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

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


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

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


WGE_9. I can decide when to have another child.

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


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

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


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

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


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


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

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


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

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


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

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


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

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


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

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


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

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


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

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


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

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


Follow-up Consent


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


Do you have access to a phone?

[] Yes
[] No
[] No response


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

[] Yes
[] No
[] No response


803b. What is your primary phone number?

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

Invalid number of digits.


803c. Can you repeat the number again?

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

Number entered must match previously entered number.


803d. Is this your personal phone number?

A personal phone is not shared with other people.

[] Yes
[] No
[] No response


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

[] Yes
[] No
[] No response


804b. What is your secondary phone number?

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

Invalid number of digits.


804c. Can you repeat the number again?

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

Number entered must match previously entered number.


804d. Is this your personal phone number?

A personal phone is not shared with other people.

[] Yes
[] No
[] No response


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

[] Yes
[] No
[] No response


What is the name you go by in your household?


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

[] Yes
[] No
[] No response


What is the name you go by in your community?


Thank the respondent for her time.

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


Thank you.

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


Location and Questionnaire result


Location

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


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

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


In what language was this interview conducted?

[] English
[] Ateso
[] Luganda
[] Lugbara
[] Luo
[] Lusoga
[] Ngakarimojong
[] Runyankole-Rukiga
[] Runyoro-Rutoro
[] Other


Questionnaire Result

Record the result of the questionnaire.

Check answer to 006 and consent.

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