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Questionnaire R.f Question No Q35 Q35 Q36 Q37 Coding Sheet Reference MONTH YEAR Q36 Q37 (1) No of Boxes/ Characters 2 2 2 2 COding Instructions/Remarks Values -3-12 Enter month of operation. Values -3-92 Enter year of operation. Values -3-02 Was your operation less than 2 years ago? Yes .................. ....01 No .......................02 Values -3-19 1st method of preventing pregnancy. No sexual relationship. ...18 No method used at all. ....17 Pregnsnt ..................19 Withdrawal ................01 Sheath/condom. ............02 Safe period frhythm method, 03 Cap/diaphragm. ............04 Contraceptive sponge. .....05 Pill: mini pill ...........06 Pill: combined (inc multi physic )............o7 Pill: not sure if mini or combined .................08 IVD/coil/intra uterine device ................. Foams /gels /spray s/pessar. (Spermicides )...... .... Going without sexual intercourse to avoid pregnancy ............... .11 Injections ................12 Another method ............13 ( .09 es .10
Quastaonnaara Raf I Codang Shmat I No of I Questuan No R-f ●renca Boxesf Characters I I I Q37 Q37 (2) 2 Q37 Q37 (3) 2 Q38 Q38 2 Q39 Q39 ., Q39 ANY Q39 (1) 2 2 ,+.+. Coding Instructions/Rmmarks 2nd method. Code as Q37 (1 ) with rsnga -3-13. 3rd method. Coda an Q37 (1 ) w~th range -3-13. Arm you prmgmnt now? Yes ......................01 No, orunsure ........... ..O2 Using a method. Nomathod usad ............O2 Othmr ....................00 l-t method of pravant ing prmgnancy? Withdrawal ................01 Shmath/condom. ............02 Safe p-riod/rh~hm method. 03 Cap/diaphragm. ............04 Contracmptiva npongm. .....05 Pill: mini pill ...........O6 Pill: comhincd (lnc multi phas~c) ..,...... ...07 PL1l: not aurm Lf minL or comhmad . . ..... ..........08 IUO/coLl/intra utmrLne dev~ca ...................09 Fo=s/g*ls/apray m/pesaarlas (spsrnuc~das )........ ...10 In]mctionn ................12 Another mathod ............l3 Not9: no code 11, 167
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SWQ33 TO 7HOSE WHO HAvE NOT HAO A S
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sWQ41 If you (or your partner) used
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SWQ47 Please put a rtng around the
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&d7
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DWQI ~nldng of your (mast Mant) Man
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DwQi 1 Hava yOUever had a blby? NO=
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owa19 TO TWOSEwHO ARE NOT PREGNANT
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DWQ33NHS Was tie oporatinncati out
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0WQ43 Which of the tilbtig mdwd(s)
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DWQ50 WIIkh of the fallowingmdhod(s
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TO THOSE WliO 00 NOT USE A MEl1100
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Mwm Thinidngof yourpmsmt man?agg,dl
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(A) (s) (c) 1 I Child Firstbom Seco
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MWQ20N0 How many ctwdmndo youminkyo
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W241WH MWQ34PWH Oldyoumldhe hava th
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Mwau Wflcll of thd followingmethod(
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MWQ61 WIIich of ttw foibwingmethod(
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“PP]UOuf-641(b) SG CONTINUOUS HOU
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CONTINUOUS HOUSEHOLD SURVEY i Dotmm
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EOUSEEOLD TYPE A CODE (02-3) Valuas
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Y aa3 m 4 \N 4 \ z uco6 ,
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_— Employment Status ~ EHp —. Q
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— Quastlonnaare R= f Qumst~on No
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Questionnaire Ref Coding Sheet No o
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Questionnaire Ref Question No Q1 Q2
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Questionnaire Ref 1 Coding Sheet No
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Quaat,onnaxra Ref Codang Sheet No o
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Questionnaire Ref Question NO Q1l(A
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Questionnaire Ref Question No Q1l(A
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Quest ionnaire Re f Question No Q1l
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Questionnaire Ref Question No Q1l(A
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Questionnaire Ref Question No Q13 Q
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Questionnaire Ref Coding Sheet NO o
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Questionnaire Ref Coding Sheet Ques
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Questionnaire Ref Coding Sheet No O
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Questionnaire Ref Coding sheet No o
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Questionnaire Ref Question NO Marit
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Questionnaire Ref Question No Stand
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Questionnaire Ref Question No Posit
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All others Those persons not fallin
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Qumst.onna.re Raf — Qu88t&0rJ No
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Quastlonnaare Raf Queatxon No QID Q
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Quastlonnaara R-f Coding Shmt No of
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Quastaomaarm R-f Cod>hg Sheet No of
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Qumst .onna>r. R= f ..-* ! Codzng S
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— Qu9st~onnazre Ref Qumst,on NO Q
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Quastionnamm R-f Qumstxon No Q5(A)
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Q5(A) FRENCH Q5(C) FRENCH Q5(c) (L)
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Qu9staonnaara R-f Q5(A) GREEK Q5(C)
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(p49stn7nnaara Rmf Quostzon No Q5(A
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Quast~omaare Raf Q5(A) SPANISH Q5(C
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Quast~onnaar9 Ref Qumstmn No Q5(F)
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Qucstaonnalre R= f Qu9stxon No Q5(F
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Q.@stzonnaara R-f Qwstaon No Q5(F)
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i, , ‘! Quast>onna2re R-f Codxng
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QuastlonnaLra R@f Questaon No Q5(L)
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Quast~onnaLra Rof Q5(Fs) Q5(M) Q5(M
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Qu.staonnaxrm Ref Q5(N) Q5(N) Q5(N)
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Quast>onnaLre R-f Q5(0) Q5(0) Q5(0)
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,.. --- Quastuannmra Raf Cod>ng Sha
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QumstaonnaLra Rmf QuastLon No Q6(A)
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Q6(A) (ii) Q6(A) (11) Q6(A) (U) Q6(
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— Quastxonnaarm Ref Cod~ng sheet
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Questaonnur, R9f Questaon No Qlc Q2
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Q.astuxmaxre Ref Questaon No Q4(A)
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. . . + . Quastzonna~r= R-f Codang
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Q6 Q6 Q7[A) Q7A Q7(B) Q7B cHECK C C
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Quastuanna.ra R-f Q13 Q14 Q15 Quast
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Quastzonnaara R-f Questmn No Q18 Q1
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Qu*stmnnaLr* R-f Cod~iig Shoat No o
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Q19(B) Q19B Q19(B) (i.) Q19(C) Q19C
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— Qu8stx0nrIUr9 Raf Quwstaon No Q
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Quest ~onnalrm Rmf — QumstLOn No
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Questiomaire Ref Coding Sheet Quest
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Questionnaire Ref 1 Coding sheet No
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Page 172 and 173: Questionnaire Ref Question No Q3B P
Page 175: Quastaonnalre Re f —. Quest~on No
Page 178 and 179: Questionnaire Re f Question No Q2(A
Page 180 and 181: Q.estaonnaire Ref Question No Q4(C)
Page 182 and 183: Questionnaire Ref Question No Codin
Page 184 and 185: Questionnaire Ref Question No Q1O Q
Page 186 and 187: CHILD HEALTH TSE FOLLOWING QUESTION
Page 188 and 189: Questionnaire Ref Question No QIO(A
Page 190 and 191: Quest ionnaire Re f Question No Q12
Page 193 and 194: Quast>onnalr. Ref —. Quastlon No
Page 195 and 196: Questlonna~r9 R-f Q1(A) Qumstaon No
Page 197 and 198: Q2(C) Q3 Q3 Q3A Q3B Q3C -i Cadang S
Page 199 and 200: Questaonnaxrm Ref Qu-st>on No Q4A Q
Page 201 and 202: Qu8staonnaxrm Raf Qumstmn No Q8A Q8
Page 203 and 204: cHSCK F CHECK G Q13 Q13A Q13A CHX F
Page 205 and 206: Questxonnalra Raf Q14C Quest.on No
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Page 209: — Questuannaxre Ref Coding Shaat
Page 213 and 214: Q.est.m.n~.r= Rmf Quastaon No Q3 Q4
Page 215 and 216: Quastionnaara Ref Questzon No Q1O R
Page 217 and 218: Questaonnalrm Raf Coding Shoot No o
Page 219: Q29 Q30 Q31 Q32 Q33 Q34 Ref ●r*nc
Page 223 and 224: Q43 Q43 Q43 Q43 Q44 Q44 Q43 (1) Q43
Page 225 and 226: Qu9sta0nnaar* Raf Qu*staon No Q46 Q
Page 227 and 228: Q51 Q51 Q51 Q52 Q53 Q51 (2) Q51 (3)
Page 229: Q56 Q56 Q57 Q58 Q58 Q58 Q58 Codang
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Page 234 and 235: Questionnaire Ref Question No Q9 Q1
Page 236 and 237: Questionnaire Ref Question No (215
Page 238 and 239: Questionnaire Ref Question No Q25 (
Page 241 and 242: Questaonnaira Raf Questmn No Q3 Q4
Page 243 and 244: Questlonna~re Ref Codxng Shaat No o
Page 245 and 246: m 23 .+
Page 247 and 248: Q32 Q33 Q34 Q35 Q35 Q36 cw- Q33 INH
Page 249 and 250: Q39 (1ST WETHOD) Q39 (2wD-4TH NETHO
Page 251 and 252: Quastaonnaara Ref Qua=tion No Q44 Q
Page 253 and 254: Quastaonaaara Ref Cod>ng Shomt Quas
Page 255 and 256: Quastmmaara Raf mdxng Shaat No of Q
Page 257 and 258: — Qu9staonnaare R-f QUOStLOll No
Page 259: — Qumstxonnaarm Ref Quastlon No P
Page 262 and 263: Q5 LIVYR Q6 Q6 Q7 Q7N0 Q8 I I Mont
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Questionnaire Re f Coding Sheet No
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Questionnaire Ref Coding Sheet NO o
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Q50 Q50 (1) I I 2 2 Coding Instruct
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— Quastxonnalre Ref Qummtxon No P
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Questionnaire Ref Question No Q5(A)
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Questionnaire Ref Question No Q5(E)
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Questionnaire Ref Question No Q6(C)
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Questionnaire Ref Question No Q6(I)
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Q3(I)(L1) Q3(I) (iii) !23(1 )(111)
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Q3(B) Quastxm No Q3(B) (i) Q3(C) Q3
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Qu9stJonnaarm Raf Quastxon No Q3(G)
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) Questaonnura Ref — Quoatxen No
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Questionnaire Raf Question No Q4(A)
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Questionnaire Ref I Coding Sheet I
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Questionnaire Ref Question No Q1(A)
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