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Question Type
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a. 15-20 years
b. 20-25 years
c. 25-30 years
d. 30-35 years
e. 35-40 years
f. 40 and older
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Question
Question Type
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a. Primary
b. Secondary
c. Higher secondary
d. Graduate
e. Post graduate
f. Diploma holder
g. Others (please specify: _______________)
Other…
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a. Yes
b. No
c. Prefer not to answer
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a. Yes
b. No
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Question
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a. Yes [Go to Questions 6 to 8]
b. No [Skip to Question 9]
c. Prefer not to answer [Skip to Question 10]
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Question
Question Type
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a. Oral contraceptive pills (OCPs)
b. Copper IUD
c. Hormonal IUD
d. Injectable
e. Diaphragm/cervical cap
f. Contraceptive sponge (ie, Today sponge, etc.)
g. Male condom
h. Female condom
i. Emergency contraception (ie, i-Pill, Unwanted 72, Preventol, etc.)
j. Permanent sterilization (eg, tubal ligation, male vasectomy, etc)
k. Any other (please specify: ________)
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a. Easy to use
b. Low cost
c. Easily available
d. Effective at preventing pregnancy
e. Doctor’s advice
f. Any other
g. Prefer not to answer
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Question
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a. Completed my family
b. Spacing between children
c. Financial problems
d. Improvement of health
e. Career/professional engagements
f. Student, want to finish my studies first
g. Others (please specify: ________)
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Question
Question Type
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a. Don’t know about contraceptives
b. Concerns about side effects
c. Inaccessibility
d. Trying to conceive
e. Partner opposes the use of contraceptive
f. Other family member(s) oppose use of contraceptive
g. Not currently sexually active
i. Prefer not to answer
h. Any other reason (please specify: ________)
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Question
Question Type
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a. Don’t know about contraceptives
b. Concerns about side effects
c. Inaccessibility
d. Trying to conceive
e. Partner opposes the use of contraceptive
f. Other family member(s) oppose use of contraceptive
g. Not currently sexually active
i. Prefer not to answer
h. Any other reason (please specify: ________)
Other…
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Question
Question Type
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a. Oral pills
b. IUD (Copper/Hormonal)
c. PP IUD
d. Injectable
e. Emergency contraception (ie, i-Pill, Unwanted 72, Preventol, etc.)
f. Diaphragm/cervical cap
g. Contraceptive sponge (eg Today sponge, etc)
h. Male condom
i. Female condom
j. Permanent sterilization (tubal ligation, male vasectormy, etc.)
k. Other (please specify)
Other…
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Question
Question Type
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a. Television
b. Radio
c. Films
d. Newspaper
e. Magazine/book(s)
f. Doctor
g. Friends/relatives
h. Others (Please specify:---------------)
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Question
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a. Wife
b. Husband
c. Both of us
e. Prefer not to answer
d. Other family member(s)
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Question
Question Type
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a. Concerned following unprotected sex or other contraceptive failure
b. Extra protection in combination with another contraceptive method (ie, condom, diaphragm, spermicide)
c. Emergency contraception is the only contraceptive method I currently use
e. Prefer not to answer
Other reason(s) (please specify: ______________)
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1. Which age group are you in?
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2. What is your educational qualification?
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3. Are you working outside the family home?
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4. Do you have any children?
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5. Are you currently using any method of contraception?
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6. If YES, what is the method of contraception that you are using?
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7. Why did you choose this method?
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8. Why do you use contraceptives?
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9. If NO, what is the reason for not using contraception?
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9. If NO, what is the reason for not using contraception?
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10. Which modern methods of contraception do you know about? [Tick the appropriate ones]
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11. Where do you get the information about the contraception methods?
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12. In your family, who decides whether or not to use contraception and which method to use?
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13. If you have used emergency contraceptive pills, what is/are your reason(s) for doing so?
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