Items:

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

Response Options:
Yes
No

 2. Are you or your partner sterilized? (Probe: Who is sterilized, you or your partner?)

Response Options:
Yes, respondent sterilized only
Yes, partner sterilized only
Yes, both sterilized
No, neither sterilized

 3. 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?

Response Options:
Yes
No

 4. Which method are you using? [RECORD ALL MENTIONED]

Response Options:
Female sterilization
Male sterilization
IUD
Injectables
Implants
Pill
Condom
Female condom
Emergency contraception
Standard days method
Lactational amenorrhea method
Rhythm method
Withdrawal
Other modern method
Other traditional method

 5. What is the brand name of the pills you are using?
 6. What is the brand name of the condoms you are using? (For 5-6: If participants don’t know the brand, ask to see the package.)

Response Options:
Brand A
Brand B
Brand C
Other (Additionally, specify in text)
Don’t know

 7. In what facility did the sterilization take place? (Probe to identify the type of source)

Response Options:
Public sector:
Government hospital
Government health center
Family planning clinic
Mobile clinic
Other public sector (Additionally, specify in text)
Private medical sector:
Private hospital
Private clinic
Private doctor’s office
Mobile clinic
Other private medical sector (Additionally, specify in text)
Other (Additionally, specify in text) Don’t know
NGO medical sector
NGO hospital
NGO clinic
Other NGO medical sector (specify)
Other (specify)
Don’t know
If unable to determine if public, private, or NGO sector, record ‘96’ and write the name of the place

 8. In what month and year was the sterilization performed?
 9. Since what month and year have you been using (current method) without stopping? (Probe for 9: For how long have you been using (current method) now without stopping?)

Response Options:
2-digit numeric value(_month)
4-digit numeric value(_year)