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Questionnaire Ref Coding Sheet I No of<br />

Question No<br />

Reference<br />

Boxes/<br />

Characters<br />

I<br />

I<br />

Q52<br />

(1ST METHOD)<br />

Q52<br />

(2ND-4TH t4STHODS )<br />

Q53<br />

Q54<br />

Q52<br />

QS2 (2)<br />

Q52 (3)<br />

Q52 (4)<br />

2<br />

2<br />

Q53 2<br />

Q54 N!2TH 2<br />

I<br />

Coding Instructions/Remmrks<br />

Values -3-18<br />

Methods usually used at<br />

present.<br />

No sexual relationship. ...18<br />

No method used ............17<br />

Withdrawal ................Ol<br />

Sheath/condom. ............02<br />

Safe period/rhythm method. 03<br />

Cap/diaphragm .............O4<br />

Contraceptive sponge. .....05<br />

Pill: mini pill<br />

(progesteromz only) .......06<br />

Pill: combined pill<br />

(including multi-phasic<br />

pill )....................07<br />

Pill: not sure if mini or<br />

combined .................08<br />

IUD /coil/ intra-uterine<br />

device ..................09<br />

Foams /gels /spray sjpessaries<br />

(spermicides ),... ........10<br />

Going without sexual<br />

intercourse to avoid<br />

pregnancy ................ll<br />

Injections ................l2<br />

Another method. ...........13<br />

Values -3-13<br />

Code as for 1st method<br />

(codes 17-18 do not apply)<br />

Values -3-03<br />

Only use one method. ......01<br />

Use more than one method<br />

at a time ................02<br />

Sometimes use one,<br />

sometimes another. .......03<br />

Values -3-13<br />

Enter number of method used<br />

most often.<br />

f<br />

..a

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