Questionnaire Text
Burkina Faso 2014
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Burkina Faso 2015
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Burkina Faso 2016a
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Burkina Faso 2016b
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Burkina Faso 2017
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Burkina Faso 2018
Questionnaire form
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402. When was the last time you had sexual intercourse?
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. ____days ago
____weeks ago
____months ago
____years ago
Burkina Faso 2020
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Burkina Faso 2021
Questionnaire form
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407. 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
407. 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.
Burkina Faso 2022
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Congo (Democratic Republic) 2013
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Congo (Democratic Republic) 2014
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Congo (Democratic Republic) 2015a
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Congo (Democratic Republic) 2015b
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Congo (Democratic Republic) 2015c
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Congo (Democratic Republic) 2016a
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Congo (Democratic Republic) 2016b
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Congo (Democratic Republic) 2017a
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402. When was the last time you had sexual intercourse?
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. ____days ago
____weeks ago
____months ago
____years ago
Congo (Democratic Republic) 2017b
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402. When was the last time you had sexual intercourse?
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. ____days ago
____weeks ago
____months ago
____years ago
Congo (Democratic Republic) 2018a
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402. When was the last time you had sexual intercourse?
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. ____days ago
____weeks ago
____months ago
____years ago
Congo (Democratic Republic) 2018b
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402. When was the last time you had sexual intercourse?
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. ____days ago
____weeks ago
____months ago
____years ago
Congo (Democratic Republic) 2019a
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Congo (Democratic Republic) 2019b
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Congo (Democratic Republic) 2020
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Congo (Democratic Republic) 2020
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Congo (Democratic Republic) 2021
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Congo (Democratic Republic) 2021
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Cote d'Ivoire 2017
Questionnaire form
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402. When was the last time you had sexual intercourse?
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. ____days ago
____weeks ago
____months ago
____years ago
Cote d'Ivoire 2018
Questionnaire form
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402. When was the last time you had sexual intercourse?
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. ____days ago
____weeks ago
____months ago
____years ago
Cote d'Ivoire 2020
Questionnaire form
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408. When was the last time you had sexual intercourse?
Answer must be in days or weeks up to 4 weeks or 30 days
If less than 12 months ago, answer must be recorded in months, weeks, or days.
Enter 0 days for today.
You will enter a number for X on the next screen.
Must agree with the pregnancy status.
[] X days ago
[] X weeks ago
[] X months ago
[] X years ago
[] No response
408. Enter ${last_time_sex_lab}.
If today, enter zero days only, not zero weeks/months/years.
Must agree with the age of first sexual intercourse and the pregnancy status.
Days must be greater or equal to 0. Weeks/months/years must be greater than 0.
Cote d'Ivoire 2021
Questionnaire form
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407. 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
407. 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.
Ethiopia 2014a
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Ethiopia 2014b
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Ethiopia 2015
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Ethiopia 2016
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Ethiopia 2017
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Ethiopia 2018
Questionnaire form
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402. When was the last time you had sexual intercourse?
402. Enter [# days / weeks / months / years]. If today, enter zero days only, not zero weeks/months/years. Must agree with the age of first sexual intercourse and the pregnancy status.
Ethiopia 2019
Questionnaire form
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402. When was the last time you had sexual intercourse?
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. ____days ago
____weeks ago
____months ago
____years ago
Ethiopia 2020
Questionnaire form
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502. 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
502. 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.
Ghana 2013
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Ghana 2014a
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Ghana 2014b
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Ghana 2015
Questionnaire form
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402. When was the last time you had sexual intercourse?
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. ____days ago
____weeks ago
____months ago
____years ago
Ghana 2016
Questionnaire form
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402. When was the last time you had sexual intercourse?
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. ____days ago
____weeks ago
____months ago
____years ago
Ghana 2017
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
India 2016
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
India 2017a
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
India 2017b
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
India 2018
Questionnaire form
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402. When was the last time you had sexual intercourse?
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. ____days ago
____weeks ago
____months ago
____years ago
India 2020
Questionnaire form
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402. When was the last time you had sexual intercourse?
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. ____days ago
____weeks ago
____months ago
____years ago
India 2021
Questionnaire form
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text
407. 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
407. 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.
Indonesia 2015
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Indonesia 2016
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Kenya 2014a
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Kenya 2014b
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Kenya 2015a
Questionnaire form
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402. When was the last time you had sexual intercourse?
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. ____days ago
____weeks ago
____months ago
____years ago
Kenya 2015b
Questionnaire form
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402. When was the last time you had sexual intercourse?
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. ____days ago
____weeks ago
____months ago
____years ago
Kenya 2016
Questionnaire form
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402. When was the last time you had sexual intercourse?
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. ____days ago
____weeks ago
____months ago
____years ago
Kenya 2017
Questionnaire form
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402. When was the last time you had sexual intercourse?
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. ____days ago
____weeks ago
____months ago
____years ago
Kenya 2018
Questionnaire form
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402. When was the last time you had sexual intercourse?
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. ____days ago
____weeks ago
____months ago
____years ago
Kenya 2019
Questionnaire form
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402. When was the last time you had sexual intercourse?
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. ____days ago
____weeks ago
____months ago
____years ago
Kenya 2020
Questionnaire form
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402. When was the last time you had sexual intercourse?
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. ____days ago
____weeks ago
____months ago
____years ago
Kenya 2021
Questionnaire form
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text
407. 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
407. 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.
Niger 2015
Questionnaire form
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text
49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Niger 2016a
Questionnaire form
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text
49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Niger 2016b
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Niger 2017
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Niger 2018
Questionnaire form
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402. When was the last time you had sexual intercourse?
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. ____days ago
____weeks ago
____months ago
____years ago
Niger 2020
Questionnaire form
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text
408. When was the last time you had sexual intercourse?
If less than 12 months ago, answer must be recorded in months, weeks, or days.
Answer must be in days or weeks up to 4 weeks or 30 days
Enter 0 days for today.
You will enter a number for X on the next screen.
Must agree with the pregnancy status.
[] X days ago
[] X weeks ago
[] X months ago
[] X years ago
[] No response
408. Enter {last_time_sex_lab}.
If today, enter zero days only, not zero weeks/months/years.
Must agree with the age of first sexual intercourse and the pregnancy status.
Days must be greater or equal to 0. Weeks/months/years must be greater than 0.
Niger 2022
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Nigeria 2014a
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Nigeria 2014b
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Nigeria 2015a
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Nigeria 2015b
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Nigeria 2016
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Nigeria 2017a
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Nigeria 2017b
Questionnaire form
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402. When was the last time you had sexual intercourse?
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. ____days ago
____weeks ago
____months ago
____years ago
Nigeria 2018
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Nigeria 2019a
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Nigeria 2019b
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Nigeria 2020a
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Nigeria 2020b
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Nigeria 2021a
Questionnaire form
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407. 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
407. 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.
Nigeria 2021b
Questionnaire form
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407. 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
407. 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.
Uganda 2014
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Uganda 2015a
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Uganda 2015b
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Uganda 2016
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Uganda 2017
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Uganda 2018
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Uganda 2019
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Uganda 2020
Questionnaire form
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49. When was the last time you had sexual intercourse?
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.
DAYS AGO:____ WEEKS AGO:____ MONTHS AGO:____ YEARS AGO:____
Uganda 2021
Questionnaire form
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407. When was the last time you had sexual intercourse?
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
407. 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.