Interviewer instructions
This section collects information relating to the use of various contraceptive methods, which a couple can use to avoid or delay pregnancy. A respondent may consider the topic of contraception and family planning a personal matter, and she may feel embarrassed to talk about it. To overcome her embarrassment, you must show that you do not feel embarrassed or uncomfortable in any way. Ask these questions as if they were no different from any other questions in the questionnaire. If she is hesitant to answer any of these questions, reassure her that everything she says will be treated confidentially and that the same questions are being asked of women all over the country.
For women who respondent in Q402a that she and her partner are using a method, Q403 ask the women about the method they are currently using to avoid or delay pregnancy. If more than one method is selected, record the highest method on the list and ask the subsequent questions about that method.
If respondent is using female sterilization or her husband or partner has been sterilized, select codes 1 or 2, and skip to Q403d. If using emergency contraception, select code 'EMERGENCY CONTRACEPTION', and skip to 403d. As emergency method is a one-off method, the users are considered non-users in the subsequent questions.
Example: If she says she used rhythm method and condom, and also used emergency contraception just to be safe, select 'CONDOM' as the highest method. Then move to Q403a.
Example: If she says she used rhythm method, and also used emergency contraception in the just to be safe, you will select 'RHYTHM METHOD' as the highest method. Then move to Q403a.
Example: If she says she used emergency contraception in the past 4 weeks and not using any other method, select EMERGENCY CONTRACEPTION as the highest method. Then move to Q403a.
These questions are some of the most important in the questionnaire. Depending on the method a respondent mentions, you may need to probe to determine that the method is being used currently. Current users of pills should be taking pills daily. Some methods provide ongoing protection without daily or regular action by the woman. Contraceptive injections may have been administered two to six months earlier and still provide protection, while implants provide protection for up to five years, or until removed. An IUD, once inserted, protects against pregnancy until it is removed or expelled.
Note: If a woman says the current method she is using is abstinence or staying away from her husband/partner, choose the option other traditional.
Description of Contraceptive Methods
The respondent may not always understand what you are talking about when you describe a particular method. In such cases, repeat the description. If she still does not understand, you may need to explain the method in different words or in slightly greater detail.
In order to complete the contraceptive table accurately and completely, it is important that you have some knowledge of contraceptive methods yourself and that you are familiar with the names that people use to refer to each method. The following provides additional information on selected methods that are included in the contraceptive table that may be useful in completing the table:
FEMALE STERILIZATION: There are several types of operations a woman can have that will make her sterile, including a “tube tie” or the removal of the uterus (i.e., a hysterectomy) or ovaries. Operations to remove the womb or uterus may be performed for reasons other than to provide contraceptive protection, e.g., because the woman experienced a problem during delivery, the woman had recurrent spells of heavy bleeding, or cancer was found. Only when the operation was performed to enable the woman to stop having children should you record it as a sterilization.
MALE STERILIZATION: This is a comparatively minor operation done on men for contraceptive purposes. It is also called vasectomy.
IUD: Women can have a plastic, T-shaped device placed inside them by a doctor or a nurse. There are two types of IUDs: hormone IUDs and copper IUDs. Both types are effective in preventing pregnancy. The IUD is a reversible form of contraception and can be used for up to 5-10 years (depending on type) before needing to be replaced.
IMPLANTS: Also called Norplant, these are small rods surgically implanted in a woman's upper arm. They usually protect a woman against pregnancy for five or more years.
INJECTABLES: An injection of hormone that is released slowly into the bloodstream can be given regularly to women to prevent pregnancy. The most common type of injectable contraceptive is given every three months. This is known as depomedroxyprogesterone acetate (DMPA), Depo Provera, Depo, or Megestron®. Another injectable contraceptive, NET EN (also called Noristerat®) is given every two months.
PILL: Women can take a pill every day to avoid becoming pregnant.
LACTATIONAL AMENORRHEA METHOD (LAM): Women can postpone the return of menstruation after a birth (and therefore remain unlikely to become pregnant) by breastfeeding frequently. A specially taught method that makes use of this principle is the lactational amenorrhea method (known as LAM). This method requires:
• Breastfeed frequently (without feeding the child anything else except small quantities of water)
• No return of menstruation
• The infant is less than six months old
This method can be used for up to six months after a birth as long as menstruation has not returned. The method also teaches women that if menstruation returns, the child becomes six months old, or the mother starts feeding her child anything other than breast milk or small quantities of plain water, they should begin using another method of contraception if they want to avoid becoming pregnant.
CONDOM: Men can put a thin, rubber sheath on their penis before sexual intercourse.
FEMALE CONDOM: A thin, transparent rubber can be placed in the vagina before sex to avoid pregnancy.
EMERGENCY CONTRACEPTION: Women can take pills up to [three/five] days after having sex to avoid getting pregnant. These pills are also called “morning-after pills.”
RHYTHM METHOD: This is also called the safe period, periodic abstinence, or the calendar method. This method is based on the principle that by not having sexual relations on certain days of her monthly cycle, a woman can avoid becoming pregnant. Note that this is not the same as prolonged abstinence where the couple stops having sexual relations for months at a time to avoid pregnancy without regard to the woman's monthly cycle. Nor is it the same as Standard Days Method, which requires the use of colored beads or a similar tool. To ensure that the respondent understands, stress the phrase “on the days of the month she is most likely to get pregnant.” Also, if a woman does not feel like having sex on particular days of her cycle, that does not mean that she is using the rhythm method.
WITHDRAWAL: Men can be careful and pull out before climax.
OTHER MODERN METHOD(S). Women may mention methods that are not described in the table. These may include modern methods such as spermicides including foam, cream, jelly, foaming tablets, or suppositories that are used to kill sperm or make sperm unable to move toward the egg. They may also mention the diaphragm or cervical cap. Diaphragms and cervical caps are soft rubber cups that can be placed in the vagina to cover the cervix to block sperm from entering the uterus and tubes where sperm could meet an egg. Diaphragms and cervical caps should be used with spermicidal jelly or cream.
OTHER TRADITINOAL METHOD(S): Women may also mention traditional or folk methods such as prolonged abstinence, breastfeeding, herbs, pain killer or taking water, syrup or lemon.
Q403a asks when the woman started using the current method. You will record this in the calendar under column 2.