Questionnaire Text

Burkina Faso 2016a Congo (Democratic Republic) 2017b India 2017b Nigeria 2016
Burkina Faso 2016b Congo (Democratic Republic) 2018a India 2018 Nigeria 2017a
Burkina Faso 2017 Congo (Democratic Republic) 2018b Indonesia 2016 Nigeria 2017b
Burkina Faso 2018 Cote d'Ivoire 2017 Kenya 2016 Nigeria 2018
Congo (Democratic Republic) 2015b Cote d'Ivoire 2018 Kenya 2017 Uganda 2017
Congo (Democratic Republic) 2015c Ethiopia 2017 Kenya 2018 Uganda 2018
Congo (Democratic Republic) 2016a Ethiopia 2018 Niger 2016b Uganda 2019
Congo (Democratic Republic) 2016b Ghana 2016 Niger 2017
Congo (Democratic Republic) 2017a India 2017a Niger 2018
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Burkina Faso 2016a
Questionnaire form view entire document:  text 
28. Which method did you use most recently? Probe: Anything else?
Select most effective method (highest method on list). Scroll to bottom to see all choices.
[] Implant
[] IUD
[] Injectables
[] Pill
[] Emergency Contraception
[] Male Condom
[] Female Condom
[] Diaphragm
[] Foam/Jelly
[] Std. Days/Cycle beads
[] LAM
[] Rhythm method
[] Withdrawal
[] Other traditional method
[] No response

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Burkina Faso 2016b
Questionnaire form view entire document:  text 
28. Which method did you use most recently? Probe: Anything else?
Select most effective method (highest method on list). Scroll to bottom to see all choices.
[] Implant
[] IUD
[] Injectables
[] Pill
[] Emergency Contraception
[] Male Condom
[] Female Condom
[] Diaphragm
[] Foam/Jelly
[] Std. Days/Cycle beads
[] LAM
[] Rhythm method
[] Withdrawal
[] Other traditional method
[] No response

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Burkina Faso 2017
Questionnaire form view entire document:  text 
28. Which method did you use most recently? Probe: Anything else?
Select most effective method (highest method on list). Scroll to bottom to see all choices.
[] Implant
[] IUD
[] Injectables
[] Pill
[] Emergency Contraception
[] Male Condom
[] Female Condom
[] Diaphragm
[] Foam/Jelly
[] Std. Days/Cycle beads
[] LAM
[] Rhythm method
[] Withdrawal
[] Other traditional method
[] No response

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Burkina Faso 2018
Questionnaire form view entire document:  text 
306b. Which method did you use most recently?

PROBE: Anything else?

Select most effective method (highest method in list). Scroll to bottom to see all choices.

[] 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

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Congo (Democratic Republic) 2015b
Questionnaire form view entire document:  text 
28. Which method did you use most recently? Probe: Anything else?
Select most effective method (highest method on list). Scroll to bottom to see all choices.
[] Implant
[] IUD
[] Injectables
[] Pill
[] Emergency Contraception
[] Male Condom
[] Female Condom
[] Diaphragm
[] Foam/Jelly
[] Std. Days/Cycle beads
[] LAM
[] Rhythm method
[] Withdrawal
[] Other traditional method
[] No response

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Congo (Democratic Republic) 2015c
Questionnaire form view entire document:  text 
28. Which method did you use most recently? Probe: Anything else?
Select most effective method (highest method on list). Scroll to bottom to see all choices.
[] Implant
[] IUD
[] Injectables
[] Pill
[] Emergency Contraception
[] Male Condom
[] Female Condom
[] Diaphragm
[] Foam/Jelly
[] Std. Days/Cycle beads
[] LAM
[] Rhythm method
[] Withdrawal
[] Other traditional method
[] No response

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Congo (Democratic Republic) 2016a
Questionnaire form view entire document:  text 
28. Which method did you use most recently? Probe: Anything else?
Select most effective method (highest method on list). Scroll to bottom to see all choices.
[] Implant
[] IUD
[] Injectables
[] Pill
[] Emergency Contraception
[] Male Condom
[] Female Condom
[] Diaphragm
[] Foam/Jelly
[] Std. Days/Cycle beads
[] LAM
[] Rhythm method
[] Withdrawal
[] Other traditional method
[] No response

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Congo (Democratic Republic) 2016b
Questionnaire form view entire document:  text 
28. Which method did you use most recently? Probe: Anything else?
Select most effective method (highest method on list). Scroll to bottom to see all choices.
[] Implant
[] IUD
[] Injectables
[] Pill
[] Emergency Contraception
[] Male Condom
[] Female Condom
[] Diaphragm
[] Foam/Jelly
[] Std. Days/Cycle beads
[] LAM
[] Rhythm method
[] Withdrawal
[] Other traditional method
[] No response

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Congo (Democratic Republic) 2017a
Questionnaire form view entire document:  text 
302b. Which method or methods are you using?
Probe: Anything else?
Select all methods mentioned. Be sure to scroll to bottom to see all choices.
[] Female sterilization
[] Male sterilization
[] Implant
[] IUD
[] Injectables
[] Injectables_1mo
[] Pill
[] Emergency Contraception
[] Male Condom
[] Female Condom
[] Diaphragm
[] Foam/Jelly
[] Std. Days/Cycle beads
[] LAM
[] N_tablet
[] Sayana Press
[] Other modern
[] Rhythm method
[] Withdrawal
[] Washing
[] Other traditional methods
No response -99

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Congo (Democratic Republic) 2017b
Questionnaire form view entire document:  text 
306b. Which method did you use most recently?
Probe: Anything else?
Select most effective method (highest method on list). Scroll to bottom to see all choices.
[] Implant
[] IUD
[] Injectables
[] Injectables_1mo
[] Pill
[] Emergency Contraception
[] Male Condom
[] Female Condom
[] Diaphragm
[] Foam/Jelly
[] Std. Days/Cycle beads
[] LAM
[] N_tablet
[] Sayana Press
[] Other modern
[] Rhythm method
[] Withdrawal
[] Washing
[] Other traditional methods
[] No response

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Congo (Democratic Republic) 2018a
Questionnaire form view entire document:  text 
306b. Which method did you use most recently?
PROBE: Anything else?
Select most effective method (highest method in list). Scroll to bottom to see all choices.
[] 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

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Congo (Democratic Republic) 2018b
Questionnaire form view entire document:  text 
306b. Which method did you use most recently?
PROBE: Anything else?
Select most effective method (highest method in list). Scroll to bottom to see all choices.
[] 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

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Cote d'Ivoire 2017
Questionnaire form view entire document:  text 
306b. Which method did you use most recently?
PROBE: Anything else?
Select most effective method (highest method in list). Scroll to bottom to see all choices.
[] Implant
[] IUD
[] Injectables
[] Pill
[] Emergency Contraception
[] Male condom
[] Female condom
[] Diaphragm
[] Foam/Jelly
[] LAM
[] Other modern method
[] Rhythm method
[] Withdrawal
[] Other traditional method
[] No response

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Cote d'Ivoire 2018
Questionnaire form view entire document:  text 
306b. Which method did you use most recently?
PROBE: Anything else? Select most effective method (highest method in list). Scroll to bottom to see all choices.
[] 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

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Ethiopia 2017
Questionnaire form view entire document:  text 
306b Which method did you use most recently? Probe: Anything else? Select most effective method (highest method on list). Scroll to bottom to see all choices.

[] Female sterilization
[] Male sterilization
[] Implant
[] IUD
[] Injectables
[] Pill
[] Emergency Contraception
[] Male Condom
[] Female Condom
[] Std. Days/Cycle beads
[] LAM
[] Rhythm method
[] Withdrawal
[] No response

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Ethiopia 2018
Questionnaire form view entire document:  text 
306b. Which method did you use most recently?

PROBE: Anything else? Select most effective method (highest method in list). Scroll to bottom to see all choices.

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

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Ghana 2016
Questionnaire form view entire document:  text 
306b. Which method did you use most recently? Probe: Anything else?
Select most effective method (highest method on list).
Scroll to bottom to see all choices.
[] Implant
[] IUD
[] Injectables -- 3 month
[] Injectables -- 1 month
[] Pill
[] Emergency Contraception
[] Male Condom
[] Female Condom
[] Diaphragm
[] Foam/Jelly
[] Std. Days/Cycle beads
[] LAM
[] N_tablet
[] Rhythm method
[] Withdrawal
[] Washing
[] Other traditional methods
[] No response

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India 2017a
Questionnaire form view entire document:  text 
306b. Which method did you use most recently? Probe: Anything else? Select most effective method (highest method on list). Scroll to bottom to see all choices.

[] Implant
[] IUD/PPIUD
[] Injectables
[] Pill
[] Emergency Contraception
[] Male Condom/Nirodh
[] Female Condom
[] Std. Days/Cycle beads
[] LAM
[] Rhythm method
[] Withdrawal
[] Other traditional methods
[] No response

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India 2017b
Questionnaire form view entire document:  text 
28. Which method did you use most recently? Probe: Anything else?
Select most effective method (highest method on list). Scroll to bottom to see all choices.
[] Implant
[] IUD
[] Injectables
[] Pill
[] Emergency Contraception
[] Male Condom
[] Female Condom
[] Diaphragm
[] Foam/Jelly
[] Std. Days/Cycle beads
[] LAM
[] Rhythm method
[] Withdrawal
[] Other traditional method
[] No response

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India 2018
Questionnaire form view entire document:  text 
306b. Which method did you use most recently?

PROBE: Anything else?

Select most effective method (highest method in list). Scroll to bottom to see all choices.

[] Implant
[] IUD / PPIUD
[] Injectables
[] Pill
[] Emergency Contraception
[] Male condom / nirodh
[] Female condom
[] Standard Days/Cycle beads
[] LAM
[] Rhythm method
[] Withdrawal
[] Other modern method
[] No response

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Indonesia 2016
Questionnaire form view entire document:  text 
306b. Which method did you use most recently? Probe: Anything else? Select most effective method (highest method on list). Scroll to bottom to see all choices.

[] Implant
[] IUD
[] Injectables - 1 month
[] Injectables - 3 months
[] Pill
[] Emergency Contraception
[] Male Condom
[] Female Condom
[] Intravag/Diaphragm
[] Std Days/Cycle Beads
[] LAM
[] Rhythm method
[] Withdrawal
[] Other traditional method
[] No response

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Kenya 2016
Questionnaire form view entire document:  text 
28. Which method did you use most recently? Probe: Anything else?
Select most effective method (highest method on list). Scroll to bottom to see all choices.
[] Implant
[] IUD
[] Injectables
[] Pill
[] Emergency Contraception
[] Male Condom
[] Female Condom
[] Diaphragm
[] Foam/Jelly
[] Std. Days/Cycle beads
[] LAM
[] Rhythm method
[] Withdrawal
[] Other traditional method
[] No response

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Kenya 2017
Questionnaire form view entire document:  text 
306b. Which method did you use most recently?

PROBE: Anything else?

Select most effective method (highest method in list). Scroll to bottom to see all choices.

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

top
Kenya 2018
Questionnaire form view entire document:  text 
306b. Which method did you use most recently?

PROBE: Anything else?

Select most effective method (highest method in list). Scroll to bottom to see all choices.

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

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Niger 2016b
Questionnaire form view entire document:  text 
28. Which method did you use most recently? Probe: Anything else?
Select most effective method (highest method on list). Scroll to bottom to see all choices.
[] Implant
[] IUD
[] Injectables
[] Pill
[] Emergency Contraception
[] Male Condom
[] Female Condom
[] Diaphragm
[] Foam/Jelly
[] Std. Days/Cycle beads
[] LAM
[] Rhythm method
[] Withdrawal
[] Other traditional method
[] No response

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Niger 2017
Questionnaire form view entire document:  text 
28. Which method did you use most recently? Probe: Anything else?
Select most effective method (highest method on list). Scroll to bottom to see all choices.
[] Implant
[] IUD
[] Injectables
[] Pill
[] Emergency Contraception
[] Male Condom
[] Female Condom
[] Diaphragm
[] Foam/Jelly
[] Std. Days/Cycle beads
[] LAM
[] Rhythm method
[] Withdrawal
[] Other traditional method
[] No response

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Niger 2018
Questionnaire form view entire document:  text 
306b. Which method did you use most recently?

PROBE: Anything else? Select most effective method (highest method in list). Scroll to bottom to see all choices.

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

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Nigeria 2016
Questionnaire form view entire document:  text 
28. Which method did you use most recently? Probe: Anything else?
Select most effective method (highest method on list). Scroll to bottom to see all choices.
[] Implant
[] IUD
[] Injectables
[] Pill
[] Emergency Contraception
[] Male Condom
[] Female Condom
[] Diaphragm
[] Foam/Jelly
[] Std. Days/Cycle beads
[] LAM
[] Rhythm method
[] Withdrawal
[] Other traditional method
[] No response

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Nigeria 2017a
Questionnaire form view entire document:  text 
28. Which method did you use most recently? Probe: Anything else?
Select most effective method (highest method on list). Scroll to bottom to see all choices.
[] Implant
[] IUD
[] Injectables
[] Pill
[] Emergency Contraception
[] Male Condom
[] Female Condom
[] Diaphragm
[] Foam/Jelly
[] Std. Days/Cycle beads
[] LAM
[] Rhythm method
[] Withdrawal
[] Other traditional method
[] No response

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Nigeria 2017b
Questionnaire form view entire document:  text 
306b. Which method did you use most recently?

PROBE: Anything else?

Select most effective method (highest method in list). Scroll to bottom to see all choices.

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

top
Nigeria 2018
Questionnaire form view entire document:  text 
306b. Which method did you use most recently?
Probe: Anything else?
Select most effective method (highest method on list). Scroll to bottom to see all choices.
[] Implant
[] IUD
[] Injectables
[] Injectables_1mo
[] Pill
[] Emergency Contraception
[] Male Condom
[] Female Condom
[] Diaphragm
[] Foam/Jelly
[] Std. Days/Cycle beads
[] LAM
[] N_tablet
[] Sayana Press
[] Other modern
[] Rhythm method
[] Withdrawal
[] Washing
[] Other traditional methods
[] No response

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Uganda 2017
Questionnaire form view entire document:  text 
28. Which method did you use most recently? Probe: Anything else?
Select most effective method (highest method on list). Scroll to bottom to see all choices.
[] Implant
[] IUD
[] Injectables
[] Pill
[] Emergency Contraception
[] Male Condom
[] Female Condom
[] Diaphragm
[] Foam/Jelly
[] Std. Days/Cycle beads
[] LAM
[] Rhythm method
[] Withdrawal
[] Other traditional method
[] No response

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Uganda 2018
Questionnaire form view entire document:  text 
306. b. Which method did you use most recently?
PROBE: Anything else?
Select most effective method (highest method in list). Scroll to bottom to see all choices.
[] Implant
[] IUD
[] Injectables
[] Pill
[] Emergency Contraception
[] Male condom
[] Female condom
[] Diaphragm
[] Foam/Jelly
[] Standard Days/Cycle beads
[] LAM
[] Rhythm method
[] Withdrawal
[] No response

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Uganda 2019
Questionnaire form view entire document:  text 
CS2. Which method did you use just before ${current_method_label}?

Do not include the current episode of use. Only select the current method if the woman used it continuously, stopped and restarted during the two-year period]

[] 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
[] Monthly Chinese Pill
[] No response

CS2. Which method did you use most recently?
Do not include the current episode of use. Only select the current method if the woman used it continuously, stopped and restarted during the two-year period]
Cannot select 'no response' with other options.

[] 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
[] Monthly Chinese Pill
[] No response