ICAN SOCIAL SUPPORT PROGRAM – BASELINE DATA COLLECTION

LANGI TOOLS

SURVEY FOR PROGRAM BENEFICIARIES

Study Title: Optimizing Approaches to Implementing Self-Injection of DMPA-SC

Version: 1 Dated 25 October, 2022

General information
No. Question response
1 Date of data collection: d/m/y
2 Respondent ID
3 Data collector
4 Location Mayuge……….0
Oyam………….1

A. Demographics [drawn from ICAN cohort study Demographics section]

I would like to start by asking you some questions about yourself and your background.
Socdem What year were you born? ___ ___ ___ ___ Free response
_yob
Socdem What are the main languages you English 1 Check all that
_langua speak at home? Ipaco kan, kit leb Langi 2 apply
ge adii ame ikobo? Luganda 3
Lusoga 4 Mia angee leb
Other: -97 ame ikobo
No response -99 ducu
Socdem What is your religion? Yin ibatija idini Catholic/Atoli 1 Select One
_relig mene? Pentecostal/ Pentakori 2 Mia angee
Protestant/Ogeri 3 acelono
Muslim/Acilam 4
None/ Akampiri 5
Other (specify)/Pe ocoo
kan:_____ -97
No response/Iromo ling alinga
-99
Socdem In the past one month, Have you No work for pay 1 Atio tic ape Check All that
_work done any work for pay? Idwe acel oculo apply
angec, ibin ito ticoro ame cul onwong Work that provides Mia angee
tye iye? compensation other than cash ducu
2 Atio tic ame oculo
igin apat icente
Work for pay 3 Atio tic ame
oculo icente
No response/ Iromo dang ling
alinga -99
Socdem Can you please estimate your Number/Wel cente:_____ Select One
_income income from the work you did for pay Don’t know/ Pe angeo -98 Yer acel keken
during the last one month? Ikom tic No response/Iromo ling alinga
ducu ame itio idwe acel okato angec, -99
wel cente ducu ame itio romo ciling
adii?

Select “income amount” response

option before inputting a number
Socdem What is the highest level of Never went to school or less Select One
_edu education you have completed? Yin than primary/ Pe akwano nyo Yer acel keken
ibin ikwano ite gik ikilaci adii pe atunu i puramari 0
Primary school/ Acel perepere

1
 1
Secondary school/ Cinia
2
Higher than secondary/
Iyongee Cinia 3
Don’t know/ Pe angeo -98
No response/Irommo ling
alinga -99
Now, I would like to understand a bit more about your household and where you live. Mia angee
koporo anok ikom jami me turi kede kan ame ibedo iyee
SES – Uganda Truncated DHS Module from Equity Tool
Socdem Does your household have…. Electricity/ Mac elengtwic Check All
_assets Read out all types and select all that 1
apply. Television/Telebijon 3 Kob ducu
Paco turi tye kede kit kodi jami magi? Cassette/CD/DVD player/ Gi
Jami me Gwoko Tum 4
yii oot Sofa set/ Kom ayom me bedo
5
Cupboard/ Kabad 6
None of the above/ Pe kan -
97
No response/ Iromo ling alinga
-99
Socdem Does any member of your household No/Pe 0 Select One
_phone own a mobile phone? Tye ngatoro Yes/Ee 1 Yer acel keken
abedo turi ame tye kede cim cing? No response/ Iromo ling alinga
Jami me -99
kubo lok
Socdem Does any member of your household No/ Pe 0 Select One
_bank have a bank account, mobile money Yes/ Ee 1 Yer acel keken
account, or account with an agent? No response/ Iromo ling alinga
Kite me Tye ngatoro abedo turi ame kano -99
kano cente I Bengk, icimere, agenti me
cente bengki moro keken?
Socdem What is the main material of the floor Earth/sand/ Lobo nono/ kwoyo Select One
_floor of your household? Dii oodi ogero 1 Yer acel keken
kede ngo? Cement/ Cementi 2
Kop me Tiles/ Tail 3
dii oot Marble/ Marbule 4
Other/ Gin okene -97
No response/ Iromo ling alinga
-99
Socdem What is the main material of the Cement/ Cementi 1 Select One
_wall exterior walls in your household? Kor Bricks/ Lobo owango 2 Yer acel keken
Kop me oodi ioko mere ogero kede ngo? Other/ En okene -97
kor oot No response/ Iromo ling alinga
-99
Socdem What is the main material of the roof Thatch/palm leaf/ Lum 1 Select One
_roof in your household? Wii oodi ogero Iron sheets/ Obati 2 Yer acel keken
kede ngo? Other/ En okene -97
Kop me No response/ Iromo ling alinga
wii oot -99
Socdem What does your household mainly Wood/Yen 1 Select One
_fuel use for cooking? Paco turi itedo kede Gas/ Gac/ Yamo 2 Yer acel keken
ngo? Electricity/ Elengtwic 3
Keno Charcoal/ Makar 4
me tedo Other/ En okene -97
No response/ Iromo ling alinga
-99
Now I would like to ask some questions about your relationships and sexual activity in order to gain

2
a better understanding of some important life issues. Let me assure you again that your answers
are completely confidential and will not be told to anyone. If we should come to any question that
you don't want to answer, just let me know and we will go to the next question. Aman atye kede
apeny akwako kit ame ibedo kede cwari kede kop me wii tana pi nyango kopogo apirgi tek akwako
kwoo adano. Kop ducu ame ikoba an abino gwoko acalo imung. Ka atunu kan ame pet ye imito dok
iye, mia ange wek owot ien okene. Ageno ni inyang aber.
Socdem Do you currently have a husband, Yes, currently married/Ee, Check all
_relstat partner, or boyfriend? Itye kede cwari anyomere oko 1 Kobe en ame
nyo ngatoro ame ibedo kede acalo Yes, partner/boyfriend/Ee, atye tye ateni
adwong oot? kede agal wanga 2
Nyom Not currently in union/ Aman
ape icoo:
divorced/separated/widow/Cw
ari okweri/Ikwero cwari/Ibedo
dako too/Ipokere icwara oko
3
No, never in union/Pe, pe abin
abedo kede icoo 4
No response/Iromo ling alinga
-99
Socdem How old is your partner? Mwaka a Age/ Mwaka:_____ Number/Nama
_partag cwari tye adii? No response/Iromo ling alinga
e [if socdem_relstat==1 | ==2] -99

Mwaka
Socdem How old were you the first time you Age/Mwaka:_____ Number/
_ageliv started living with a partner? Icako No response/ Iromo ling alinga Nama
nwongo cwari ame itye imwaka adii -99
Mwaka [if socdem_relstat==1 | ==2]
me
nyom
Socdem What is the highest level of Never went to school/ or less Select One
_parted education your partner completed? than primary/ Pe okwano nyo Yer acel keken
u Cwari okwano te gik ikilaci adii? pe otunu I puramari
[if socdem_relstat==1 | ==2] 0
Kwan Primary school/ Ogik I
puramari 1
Secondary school/Ogik icinia
2
Higher than secondary/ Okato
cinia oko 3
Don’t know/ Pe angeo -98
No response/ Iromo ling alinga
-99
Socdem Would you say that the money that More/ Kato 1 Select One
_partinc you earn in a typical month is more Less/ Nok (tidi) 2
ome than what your main partner earns, Same/Rorom 3 Yer acel keken
less than what he earns, or about the Don’t know/ Pe angeo -98
Yii cao same? Iromo miyowa ngeyo ka cee No response/ Iromo ling alinga
cente ame yin itio iyi dwee acel kato, -99
tidi, nyo rom ime acwari?
[if socdem_relstat==1 | ==2]
Socdem Who makes a decision about how Her alone/ Dako kene 1 Yer acel keken
_decide the money they earn is spent? Iyii Her and partner/ Icoo kede
money ootwu, ngaa ame tye kede twero me dako karacel 2
tic kede cente ame wun utio Partner alone/ Icoo nyo dako
Twero keken 3
ikom lim Don’t know/ Pe angeo -98
No response/ Iromo ling alinga
-99

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B. Contraceptive Knowledge [New questions developed to capture areas we expect mentors to
provide information to beneficiaries]

The next set of questions is about different types of contraceptives and how they may impact a woman’s
body. Apeny ame tye ping kan tye ikom yika apapat me juko yaco ked keta me yika acel acel yelo kede dako
acel ace lame tio kede
For each of the statements, please indicate your level of agreement or disagreement. Pi tyen kop acel acel,
miwa onge rwom me moka/yee ni iye.
Variable Question/Apeny Response/Agam
Ck_1 A if a woman who uses Strongly agree/ Tye ateni atek
family planning, she may Agree/ Tye ateni idyere dyere
never again be able to get Neither agree nor disagree/Pe aye dang pe akwero (room bedo
pregnant again – even if she ateni room dang bedo goba)
wants to. Yen me lagoro Disagree/Akwero
nywal mwato dako atwal Strongly disagree/ Akwero atek
CK_2 Some women experience Strongly agree/ Tye ateni atek
changes to menstruation Agree/ Tye ateni idyere dyere
when using family planning, Neither agree nor disagree/Romo bedo ateni ento room dang
and some women do not. bedo goba
Yika me lagoro nywal yelo Disagree/ Akwero
mon okene ento dang pe Strongly disagree/ Akwero atek
yelo mon okene
CK_3 Every woman’s body reacts Strongly agree/ Tye ateni atek
differently to using Agree/ Tye ateni idyere dyere
contraception. Yika me Neither agree nor disagree/ Romo bedo ateni ento romo dang
lagoro nywal gamo nyo bedo goba
kwero dako acel acel pien Disagree/Akwero
kom mon ducu pe rom Strongly disagree/ Akwero atek
CK_4 What methods to delay or Female sterilization/Mwato dako..............................................1
avoid pregnancy – that is, Male sterilization/Mwato icoo....................................................2
keep it from happening in Implant/ Keto yat ibad mon.......................................................3
the first place – have you IUD/IUCD/Coil/ Rwako yat i aura..............................................4
heard of? (mark all Injectables/Tucere i pico...........................................................5
mentioned) Pill/Yat amwonya......................................................................6
Emergency contraception.........................................................7
Ingeo yika/yore ducu me Male condom/Roc bol (opera) pi coo........................................8
genyo yaco ame oryeo ping Female condom/Opira a mon...................................................9
kan? Kobe en ame ingeo Diaphragm..............................................................................10
ducu Foam/Jelly/Yat amwonya/awiira.............................................11
Standard days/Cycle beads/Libo kare me butu......................12
Lactation amenorrhea method (LAM) Weko dako ikare me dot13
Rhythm method......................................................................14
Withdrawal/ Miyo kwir oony oko.............................................15
None mentioned/ Pet ye kan..................................................17
Other (specify)/ En okene:_____...........................................-97
No response -99
The last two questions in this section are about where one might get contraceptive products.
Ck_5 Where have you learned about Radio/Radio 1
contraceptive methods? [select Television/Telebijon 2
all that apply] Newspaper or magazine Papara/buk akwana 3
Online media: internet website or advertisement or social media
Yin ibin iwinyo kop ikom yika campaign/Cim cing/ Nyonyo me wii yamo 4
apapat me gengo yaco ikwene? Provider at a health facility (public sector)/Atic a gamente 6
[Tuc kan ame iwinyo iye ducu] Provider at a health facility or drug
shop (private sector)/ Atic me dakatal ame cato wil 7
village health team member/CHW/Atic me dakatal me kin
paco(VHT)
Outreaches in the community/ Rabo ngec ikin paco 8

4

Ck_6 What places do you know of
where people could go to get
family planning services or
contraceptive methods?
Kwene ame yin ingeo ame jo
romo wot iye pi nwongo kong
me lagoro nywal nyo gengo
yaco?
CK_7 FOR THOSE USING ANY
METHOD/PI JO AME TYE
ATIC KEDE YIKA MORO
KEKEN:
Where did you get the method
that you are currently using?
Kony ame aman tye itic kede
no, inwongo ikwene?
Friend/Awot 10
Relatives/Wat
Husband/partner/Cwara, cega apaina 11
Mentor/Amii tam oywek
12
Other (specify)/Okene: _______________ -97
Don’t know/Pe angeo -98
No response/Iromo ling alinga
-99
Doesn’t know of any place/ Pe angeo kanoro keken 0
Traditional healer/ Dano me yen tee kwaro 1
Government health facility/Oot yat a gamente 2
Private health center/Oot yat acat wil 3
Pharmacy/ Citoa me oot yat
drug shop/clinic/Oot yat me kin paco 4
Community outreach worker/Arab kop me lagoro nywal 5
No response/Iromo ling alinga -99
Government health facility/Oot yat a gamente
Private health facility/Oot yat acat wil
VHT/CHW/Otic ame opwonyo ikin paco
Pharmacy/Citoa me oot yat
Drug shop/clinic/Oot yat me kin paco
Outreach/mobile clinic/Kony pi two ame owoto awota ikin paco
Traditional healer/Yen me tee kwaro
Others: Specify/En okene: Mia angee
No response/Iromo ling alinga

G. PREFERENCE-ALIGNED FERTILITY MANAGEMENT

PAFM 1. Do you currently want to be using any method to avoid pregnancy – that is, to do something
to keep it from happening? Tye nyo imito tic kede yika moro me gengo yac?
No/Pe 0
Yes/Ee 1
Don’t know/Pe angeo -98
No response/Iromo ling alinga -99

PAFM 2. Are you currently using any method to avoid pregnancy? Aman tye itic iyika moro me
gengo yac?
No/Pe 0
Yes/Ee 1 [specify method(s):_______________]
Sometimes/Icel icel 2 [specify method(s):_______________]
No response/Iromo ling alinga -99

PAFM 3. [If sometimes to Q2, ask for each episodic method reported]: You said that you sometimes
use [METHOD REPORTED] to prevent pregnancy. During the times when you want to use this
method to prevent pregnancy, are there times you want to use this but are not able to? Yin ikobo ni
ikare okene yin itio kede yika {man} me gengo yac. Tye kare ame ka imito keto itic inwongo
agengoro?
No/Pe 0
Yes/Ee 1
No response/Iromo ling alinga -99

PAFM 4. [For each method reported in Q2, ask]: Do you want to be using this method right now? Pi
yika ame iyero no imito dong cako keto itic aman?
No/Pe 0
Yes/Ee 1
Don’t know/Pe angeo -98
No response/ Iromo ling alinga -99

5
C. SOCIAL SUPPORT [adapted from published measure 1]
People sometimes look to others for assistance, information or other types of support related to
contraception. How often is each of the following kinds of support available to you if you need it?
Choose one number from each line. Dano acel acel nwongo tam, ngec nyo kony apapat ikom kop me
gengo yac ibot jo okene. Yin ka imito nwongo kit kony ibot jo magi, inwongo ikare ikare?
SS1 Someone you can count on to listen to you when you need to talk None of the time
about contraception/ Dano moro tye ame yee winyo kopi ikare A little of the time
ducu ame yin tye imito kop kede me gengo yac. Some of the time
Most of the time
All of the time
SS2 Someone to give you information to help you understand None of the time
contraception. Dano moro tye ame mii ngec me nyango kop me A little of the time
juko yac. Some of the time
Most of the time
All of the time
SS3 Someone to give you good advice about a problem you are having None of the time/
related to contraception Dano moro tye ame mii tam ikom peko Pe atwali ikare ducu
ame oddi ikop me juko yac. A little of the time/
Icel icel
Some of the
time/Ikare okene
Most of the time/Pol
akare
All of the time/Ikare
ducu
SS4 Someone to confide in or talk to about yourself or your problems None of the time/
related to contraception Dano moro tye ame kano imungi nyo Pe atwali ikare ducu
pekoni akwako kop me juko yac. A little of the time/
Icel icel
Some of the
time/Ikare okene
Most of the time/Pol
akare
All of the time/Ikare
ducu
SS5 Someone whose advice you really want about contraception. None of the time/
Dano moro tye ame yin igeno tamere akwako kop me juko yac Pe atwali ikare ducu
A little of the time/
Icel icel
Some of the
time/Ikare okene
Most of the time/Pol
akare
All of the time/Ikare

1
https://www.rand.org/health-care/surveys_tools/mos/social-support/survey-instrument.html

6
 ducu
SS6 Someone to share your most private worries and fears with about None of the time/
contraception. Dano moro tye ame yin ileo jami awango cunyi nyo Pe atwali ikare ducu
ame mii lworo akwako kop me juko yac A little of the time/
Icel icel
Some of the
time/Ikare okene
Most of the time/Pol
akare
All of the time/Ikare
ducu
SS7 Someone to turn to for suggestions about how to deal with a None of the time/
personal problem about contraception. Dano moro tye ame yin Pe atwali ikare ducu
ilaro bote me miyi tam ikite me tyeko peko ikop me juko yac A little of the time/
Icel icel
Some of the
time/Ikare okene
Most of the time/Pol
akare
All of the time/Ikare
ducu
SS8 Someone who understands your problems about contraception None of the time/
Dano moro tye ame yin ilaro bote ame ngeo pekoni ikop me juko Pe atwali ikare ducu
yac A little of the time/
Icel icel
Some of the
time/Ikare okene
Most of the time/Pol
akare
All of the time/Ikare
ducu
SS9 Someone who supports and makes you feel like you can navigate None of the time/
the challenges you face regarding contraception or its use. Dano Pe atwali ikare ducu
moro tye ame konyi kede mio ibedo agonya acunyi tek me tyeko A little of the time/
peko me juko yac Icel icel
Some of the
time/Ikare okene
Most of the time/Pol
akare
All of the time/Ikare
ducu
SS10 Someone who can accompany you when you want to access any None of the time/
family planning services you need at a given moment. Dano moro Pe atwali ikare ducu
tye ame woto karacel kedi kan ame ka imito nwongo kony me A little of the time/
lagoro nywal icawa moro keken. Icel icel
Some of the
time/Ikare okene
Most of the time/Pol
akare
All of the time/Ikare
ducu

D. CONTRACEPTIVE SELF-EFFICACY [recently published scale validated in Kenya and

Nigeria2]

On a scale of 0 to 10, where 0 means cannot do at all and 10 means highly certain I can do, how certain are
you that you can… Man cawa me miyo makici ame cakere I 0 (not) nyo ping nono naka I 10 (apar). Imiyo
2
https://www.sciencedirect.com/science/article/pii/S2590151620300241#:~:text=Contraceptive%20self
%2Defficacy%20(CSE),measured%20in%20low%2Dresource%20settings

7
 makici alubere kede kop ame oryeo ping kan I kop akwaki yin kede cwari nyo apai ni, otic me dakatal,
kede yin keni ka imito tic kede yika me lagoro nywal nyo gengo yac. Ka koporo pe rwate nyo pet ye
ateni yin imio 0. Ka obedo kop ateni ikokome imio 10. Kat ye ateni kitoro kitoro, yin iyero ka myero imi
makici 1,2,3,4,5,6,7,8,9. Iniang?
Variabl Husband/partner communication subscale
e name
Cse1 1. Discuss family size with your husband/partner. Inyamo tam ikom wel otino 1…10
ame myero inywal wun icwari/apaini.
Cse2 2. Discuss IF you would like to get pregnant with your husband/partner. 1…10
Inyamo tam ka myero iyac wun icwari/apaini.
Discuss WHEN you would like to get pregnant with your husband/partner.
Inyamo tam wun icwari/apaini kare amyero iyac iye.
Cse3 3. Discuss specific family planning methods with your husband/partner. 1…10
Inyamo tam wun icwari/apaini kit yore mene amyero yin itii kede me lagoro
nywal.
Cse4 4. Reach an agreement with your husband/partner about use of family 1…10
planning that takes my desires. Imoko wun icwari/apaini yore mene aber ame
yin imaro me lagoro nywal.

Provider communication subscale

Cse5 1. Bring up the topic of family planning with a health care provider. Ikelo kop
me alara akwako lagoro nywal bot atic me yot kom
Cse6 2. Ask a provider to clarify something they have told me about family planning 1…10
if I’m not sure I understand. Apenyo atic me yotkom wek mia anyang aber kop
ame en okoba akwako lagoro nywal

Choosing and managing a method subscale

Cse7 1. Choose a family planning method that will work well for you. Ayero yika me 1…10
lagoro nywal ame angeo name aber pira.
Cse8 2. Obtain the method of family planning you want, if you choose to use one. 1…10
Anwongo yika me lagoro nywal ame amito teki ayero en yika no.
Cse9 3. Obtain a different method of family planning if the one you want is not 1…10
available. Anwongo yika me lagoro nywal ame amito teki name an ayero pe
tye
Cse10 4. Find solutions to bothersome side effects from using a contraceptive 1…10
method or switching methods if needed because of bothersome side effects.
Anwongo yore ducu ame mite me tyeko peko ame yika me lagoro nywal tye
akelo ikoma. Aco ka pe, akwanyo yore okene ame pe yela.
Cse11 5. Use a family planning method according to instructions to prevent 1…10
pregnancy. Atio kede yika me lagoro nywal alubere kede cik ducu pi gengo
yac.
Cse12 6. Stop using family planning and get pregnant if/when you want to. Wek tic 1…10
kede yika me lagoro nywal teki imito yac

E. Contraceptive Agency [ICAN Scale Item Pool]

Now, I would like to ask some questions about your preferences about avoiding pregnancy

All of these questions are about you and your personal circumstances We want to know about your
own choices and needs related to family planning or contraception. Some people choose to use a
method to avoid pregnancy and some people choose to NOT use a method. By “method to avoid
pregnancy” I am referring to a range of options a person might use or do, including condoms,
withdrawal, standard days method, injectables, devices you put in your body, pills, or other ways.
We are interested in your thoughts, and it does not matter if you have chosen to use a method to
avoid pregnancy or not—I respect your decision either way. And if you are doing something to avoid

8
 pregnancy, I respect any method you have chosen to use.

Finally, when I ask you questions about methods to avoid pregnancy, I mean doing something to
make sure pregnancy does not happen at all – not about removing or washing away the pregnancy
after it has happened. .

Aman amito penyi kede apeny me gengo yac ento ame lubere kede mita ni. . Apeny magi ducu tye
ame kwaki kede kit ame yin ibedo kede ikin jo. Jo okene kwanyo yika oroni me gengo yac, ento
okene pe tio kede yika moro keken. Yika me gengo yac pol pat. Tye iye tic kede roc bol, pico, miyo
kwir icoo oony oko, libo kare me nywal keken, rwako yen ite del kom, mwonyo yat, tic kede yat
awira kede en okene apapat. Wan omito ngeyo tami yin. Pe dang oparo ka itio kede yika me gengo
yac nyo pe. Abiworo tami pien tami aye pire tek. Ka dang tye itic iyika moro keken, an amio woro
itami no.

Me agiki, ka apenyo pi kop me gengo nywal, man nwongo pat ioonyo yic iyonge yac. Gengo yac
obedo timo jami ducu ame mio pe iyac icawa ame pe imito atin. Oonyo yic obedo neko atin. Wan
omito ngeyo cunyi kede mita ni apiri keni. Inyang aber?

Note to enumerators: Ask participants to first respond with a “yes” or no” then follow-up to ask them
“yes or strongly yes” or “no or strongly no”.

Domain 1
1. Do you feel certain about No, I do not feel No/Pe Select One/
whether you want to do certain about what I Yer acel keken
anything to avoid want to do. Pe ba. Strongly No/ Pe
pregnancy? Tye iwinyo Pet tye awinyo ka atwali
icunyi keni ka imoko tami kom amoko tama
me ikom gin amyero
atim. Yes/Ee

timo jami ducu amite me
gengo yac?
Strongly Yes/Ateni
atek 1
Yes, I do feel certain
about what I want to
do? Eyo, tye awinyo
icunya ni myero atim
ginoro

No response/ Ape
kede agam

2. Do you know different ways No, I do not know No/Pe Select

to avoid pregnancy? Ingo different ways/Pe One/Yer acel
yika apapat me gengo yac? angeo Strongly No/Pe keken
angeo atwali

Yes, I do know
different ways/Eyo Yes/Ee
angeo yika apapat Strongly Yes/Ateni
No response/Ape atek 1
kede agam

3. At this point in your life, do No, I do not know Select One/Yer acel Select
you know what you want to what I want to know/ keken One/Yer acel
know about avoiding Pe ba. Pe amito

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 pregnancy? Aman dong ngeyo gin amyero No/Pe keken
ikom mwakani nie, tye imito angee.
ngeyo ngo ame myero Strongly No/Pe
ingee pi gengo yac? angeo atwali

Yes, I do know what I

want to know/ Eyo,
angeo gin amyero Yes/Ee
angee Strongly Yes/Ateni
No response/Aling atek 1
alinga

4. If you want to use a method No, I do not know Select One/Yer acel Select
to avoid pregnancy, do you where/ Pe ba, pe keken One/Yer acel
know where to get it? Ka angeo kakare keken
imito kwanyo yika moro No/Pe
ame imito pi gengo yac, Strongly No/Pe
ingeo kan amyero iwot angeo atwali
inwong iyee?
Yes, I do know
where/Eyo, angeo
kakare

No response Yes/Ee
-99 Strongly Yes/Ateni
atek 1

5. Do you know who to talk to No, I do not know Select One/Yer acel Select
if you need information or who to talk to. Pe ba. keken One/Yer acel
support related to avoiding Pe angeo dano keken
pregnancy? Ingeo dano amyero alok kede. No/Pe
amyero iwot bote ka imito Strongly No/Pe
nwongo ngec nyo kony angeo atwali
akwako gengo yac?

Yes, I do know who

to talk to. Eyo. Angeo
dano amyero alok Yes/Ee
kede
Strongly Yes/Ateni
No response/Aling atek 1
alinga

6. Could you get a method to No, I could not get a Select One/Yer acel Select
avoid pregnancy if you method. Pe ba. Pe keken One/Yer acel
need it? Iromo nwongo yika abin anwongo. keken
ame ikwanyo me gengo yac No/Pe
ka imito? Strongly No/Pe
Yes, I could get a angeo atwali
method. Eyo. Aromo
nwongo

10
 No response/ Aling Yes/Ee
alinga
Strongly Yes/Ateni
atek 1

7. Could you talk to a No, I could not talk to Select One/Yer acel Select
healthcare provider about a healthcare keken One/Yer acel
methods to avoid provider. Nwongo keken
pregnancy if you wanted dano no obin ploa No/Pe
to? Iromo lok kede atic me oko Strongly No/Pe
yot kom pi yika me gengo angeo atwali
yac ka imito?

Yes, I could talk to a

healthcare provider. Yes/Ee
Eyo. Aromo lok kede
dano no Strongly Yes/Ateni
atek 1
No response

8. Do you believe it is your No, I do not believe it Select One/Yer acel Select
right to decide whether to is my right. Pe ba. keken One/Yer acel
use (or not) a method to Atamo nip e obedo keken
avoid pregnancy? Ingeo ni twero na No/Pe
obedo twero ni me tic kede Strongly No/Pe
yika me gengo yac nyo pe angeo atwali
me tic kede? Yes, I do believe it is
my right/ Pe ba.
Atamo ni obedo
twero na
Yes/Ee
No response/Aling
alinga Strongly Yes/Ateni
atek 1

9. Do you believe married No, I do not believe Select One/Yer acel Select
women should be able to married women keken One/Yer acel
use a method to avoid should be able to keken
pregnancy when they want use a method when No/Pe
to? Itamo ni oroni they want to. Pe ba. Strongly No/Pe
onyomere myero bed Atamo ni oroni angeo atwali
agonya teki omito tic kede onyomere pe myero
yika me gengo yac ka cee tii kede yika me
omito? gengo yac kadi
mitagi tye iye
Yes/Ee

Strongly Yes/Ateni
Yes, I do believe
atek 1
married women
should be able to
use a method when
they want to. Eyo.

11
 Atamo ni oroni
onyomere myero tii
kede yika me gengo
yac kadi mitagi tye
iye

No response/Aling
alinga

10. Do you believe unmarried No, I do not believe Select One/Yer acel Select
women should be able to unmarried women keken One/Yer acel
use a method to avoid should be able to keken
pregnancy when they want use a method when No/Pe
to? Itamo ni oroni cog-gi pe they want to. Pe ba. Strongly No/Pe
myero bed agonya teki Atamo ni mon ape angeo atwali
omito tic kede yika me onyomere pe myero
gengo yac ka cee omito? tii kede yika me
gengo yac kadi
mitagi tye iye
Yes/Ee

Strongly Yes/Ateni
Yes, I do believe
atek 1
unmarried women
should be able to
use a method when
they want to. Eyo.
Atamo ni oroni pe
onyomere myero tii
kede yika me gengo
yac kadi mitagi tye
iye

No response/Aling
alinga

11. Do you believe you have No, I do not believe I Select One/Yer acel Select
the right to refuse a have the right to keken One/Yer acel
healthcare provider who refuse a healthcare keken
tries to make you use a provider. Pe ba. No/Pe
method to avoid Atamo ni an ape Strongly No/Pe
pregnancy? Itamo ni itye kede twero me angeo atwali
kede twero me kwero kop kwero me gengo atic
atic me yot kom ame mito me yot kom
diyi adia me tic kede yika
me gengo yac?
Yes, I do believe I Yes/Ee
have the right to
Strongly Yes/Ateni
refuse a healthcare
atek 1
provider. Eyo. Atamo
ni atye kede twero
me kwero kop atic
me yot kom.

No response/Aling
alinga

12. Should women be able to No, women should Select One/Yer acel Select

12
 use methods to avoid not be able to use keken One/Yer acel
pregnancy without their methods without keken
partners knowing if that’s their partners No/Pe
what they want? Itamo ni knowing Strongly No/Pe
mon myero bed agonya me angeo atwali
tic kede yika me gengo yac
abongo ngec a cog-gi nyo Yes, women should
apaigi ka man obedo be able to use
mitagi? methods without
their partners Yes/Ee
knowing
Strongly Yes/Ateni
No response Aling atek 1
alinga /

13. Do you believe the No, the government Select One/Yer acel Select
government should provide should not provide keken One/Yer acel
methods to avoid methods for free keken
pregnancy for free? Itamo No/Pe
ni gamente myero mii yika Strongly No/Pe
me gengo yaco bed abongo Yes, the government angeo atwali
culo cente moro keken? should provide
methods for free

No response/ Aling
alinga Yes/Ee

Strongly Yes/Ateni
atek 1

14. Is it ever ok for a healthcare No, it is never ok for Select One/Yer acel Select
provider to refuse to take a healthcare provider keken One/Yer acel
out a method to avoid to refuse to take out keken
pregnancy, say an IUD or a method No/Pe
implant, that a person Strongly No/Pe
wants taken out? Itamo ni angeo atwali
pore me atic me oot yat Yes, it is ok for a
ikwero kwanyo yat ikom healthcare provider
dano ame amito ni kwany to refuse to take out
oko yotono me gengo yac a method
ikome? Yes/Ee
No response/ Aling
alinga Strongly Yes/Ateni
atek 1

15. Should people have the No, people should Select One/Yer acel Select
right to be told about the not have the right to keken One/Yer acel
available methods for be told about the keken
avoiding pregnancy? Pore available methods. No/Pe
me jo ibedo kede twero me Pe, jo pe myero bed Strongly No/Pe
bedo kede ngec ikom yika kede twero me angeo atwali
apapat me gengo yac? nwongo ngec ibot
otic me oot yet

13
 akwako yore apapat
ame tye
Yes/Ee

Strongly Yes/Ateni
Yes, people should atek 1
have the right to be
told about the
available methods.
Eyo, jo myero bed
kede twero me yero
yore apapat ame tye.

No response/ Aling
alinga

16. Should people have the No, people should Select One/Yer acel Select
right to choose from not have the right to keken One/Yer acel
different methods to avoid choose from different keken
pregnancy if they want to methods. Pe, jo pe No/Pe
use one? Pore me jo ibedo myero bed kede Strongly No/Pe
kede twero me twero me yero yore angeo atwali
kwanyo/yero ikom yika apapat ame tye.
apapat me gengo yac teki
gin amito tic kede?
Yes, people should
have the right to Yes/Ee
choose from different
Strongly Yes/Ateni
methods. Eyo, jo
atek 1
myero bed kede
twero me yero yore
apapat ame tye.

No response/ Aling
alinga

17. Do you have the right to No, I do not have the Select One/Yer acel Select
decide what to do related to right to decide what keken One/Yer acel
avoiding pregnancy even if to do. Pe ba, an ape keken
people in your community itwero me yero ngo No/Pe
want you to do something amyero atim Strongly No/Pe
else? Yin itye kede twero angeo atwali
me moko ngo ame imito
timo akwako kop me gengo
yac kadi jo ikin paco boti
mito ni yin itim gin okene? Yes, I do have the
right to decide what Yes/Ee
to do. Eyo, an atye
itwero me yero ngo Strongly Yes/Ateni
amyero atim atek 1

No response/ Aling
alinga

18. Do you have the right to No, I do not have the Select One/Yer acel Select
decide what to do related to right to decide what keken One/Yer acel
avoiding pregnancy even if to do. Pe ba, an kom keken

14
 elders want you do so ape itwero me yero No/Pe
something else? Yin itye ngo amyero atim
kede twero me moko ngo Strongly No/Pe
ame imito timo akwako kop angeo atwali
me gengo yac kadi jo otego Yes, I do have the
ikin paco boti mito ni yin right to decide what
itim gin okene? to do

No response/ Aling Yes/Ee

alinga Strongly Yes/Ateni
atek 1

19. Do you believe that No, I do not believe Select One/Yer acel Select
women’s choices about women’s choices are keken One/Yer acel
avoiding pregnancy are unfairly limited. Pe keken
unfairly limited because of ba, an atamo oroni No/Pe
community views of amon kom pe oturu Strongly No/Pe
women? Itamo ni mita a oron. angeo atwali
mon pi yero yika moro
keken me gengo yac tye
anonok totwal pien tam Yes, I believe
amon wadgi me kin paco women’s choices are
diogo oko? unfairly limited. Eyo, Yes/Ee
an atamo oroni amon
Strongly Yes/Ateni
kom oturu atek.
atek 1
No response/ Aling
alinga

20. Do you believe that
unmarried women’s choices
for avoiding pregnancy are
unfairly limited?
Itamo ni mita a oroni cog-gi
pe me yero yika moro
keken me gengo yac tye
anonok totwal ame diogi
atek arac?
No, I do not believe Select One/Yer acel Select
unmarried women’s keken One/Yer acel
choices are unfairly keken
limited. Pe ba, an No/Pe
atamo oroni amon Strongly No/Pe
acog-gi pe kom pe
angeo atwali
nok oron.
Yes, I do believe
unmarried women’s Yes/Ee
choices are unfairly
Strongly Yes/Ateni
limited. Eyo, an
atek 1
atamo oroni amon
acog-gi pe kom oturu
atek.

No response/ Aling
alinga

21. Do you think women are No, I do not think Select One/Yer acel Select
often unable to discuss women are unable to keken One/Yer acel
what they want related to discuss what they keken
avoiding pregnancy with want. Pe ba, an No/Pe
their partners? Itamo ni pol atamo ni oroni tye Strongly No/Pe
kare mon tye ame pe leo itwero me leyo tam

15
 tam karacel kede ikom gin ame gin angeo atwali
cog-gi/apaigi ikom kop me amito
gengo yac?

Yes, I do think
women are unable to Yes/Ee
discuss what they Strongly Yes/Ateni
want. Eyo, an atamo atek 1
ni oroni pe tye itwero
me leyo tam ikom gin
ame gin amito

No response/ Aling
alinga

22. Do you believe that women No, I do not believe Select One/Yer acel Select
have fewer chances to be that women have keken One/Yer acel
successful in life? Itamo ni fewer chances. Pe keken
mon tye kede twero/gum ba, an atamo ni oroni No/Pe
anonok me kelo dongo twero-gi dwong. Strongly No/Pe
ikom kwoo-gi angeo atwali

Yes, I do believe that

women have fewer
changes. Eyo, an
kom atamo ni mon Yes/Ee
twero-gi nok.
Strongly Yes/Ateni
No response/ Aling atek 1
alinga

23. Do you believe that we No, I do not believe Select One/Yer acel Select
would have fewer problems we would have fewer keken One/Yer acel
if we treated people more problems. Pe ba, an keken
equally? Itamo ni ka atamo ni peko kom No/Pe
onwongo jo ducu tero onwongo pe ajwik. Strongly No/Pe
owategi arorom aroma, angeo atwali
onwongo peko abedo
ononok? Yes, I do believe we
would have fewer
problems. Eyo, an
atamo ni peko kom Yes/Ee
onwongo ajwik.
Strongly Yes/Ateni
No response/ Aling atek 1
alinga

24. Is it your decision who you No, it is not my Select One/Yer acel Select
tell or do not tell about if decision who I tell. keken One/Yer acel
you are doing something to Pe ba, pe obedo keken
avoid pregnancy? Yin aye twero na me moko No/Pe
imoko nga amyero imii tamo. Strongly No/Pe
ngec nyo pe imii ngec ka angeo atwali
imito timo ginoro pi gengo
yac? Yes, it is my decision

16
 who I tell. Eyo an
aye atio kede twero
na me moko tamo Yes/Ee

No response/ Aling Strongly Yes/Ateni

alinga atek 1

25. Do you decide for yourself No, I do not decide Select One/Yer acel Select
whose opinions you listen for myself. Pe ba, pe keken One/Yer acel
to about avoiding an aye ayero pira keken
pregnancy? Yin aye iyero kena No/Pe
kodi ngaa-gi amyero Strongly No/Pe
inwong tam ibotgi nyo pe angeo atwali
ibotgi pi kop me gengo yac Yes, I do decide for
myself. Eyo, an aye
ayero pira kena

No response /Aling Yes/Ee

alinga
Strongly Yes/Ateni
atek 1

26. Could you get a method to No, I could not get a Select One/Yer acel Select
avoid pregnancy without method without keken One/Yer acel
people in your community people knowing. Pe keken
knowing if you wanted to? ba, an pe atwero No/Pe
Yin aye iyero yika oroni me yero pira kena Strongly No/Pe
gengo yac abongo jo ikin abongo ngec-gi angeo atwali
paco bedo ingec iye ka
imito?
Yes, I could get a
method without
people knowing. Yes/Ee
Eyo, an atwero yero
Strongly Yes/Ateni
pira kena abongo
atek 1
ngec-gi

No response/ Aling
alinga

27. Do you worry about what No, I do not worry Select One/Yer acel Select
others will think if you what others will keken One/Yer acel
choose to use a method to think. Pe ba, an kom keken
avoid pregnancy? Ceeni pe aparo kit ajo tamo No/Pe
iparo ngo ame jo okene kede Strongly No/Pe
atamo ikomi teki ikwanyo angeo atwali
yika oroni me gengo yac?

Yes, I do worry what

others will think. Eyo,

17
 an kom aparo kit ajo Yes/Ee
tamo kede
Strongly Yes/Ateni
No response/ Aling atek 1
alinga

28. Now I would like to ask you No, I do not worry Select One/Yer acel Select
the opposite, do you worry what others will keken One/Yer acel
about what others will think think. Pe ba, an kom keken
if you choose NOT to use a pe aparo kit ajo tamo No/Pe
method to avoid kede Strongly No/Pe
pregnancy? Wek dok angeo atwali
apenyi oluktuke me apeny
aceli. Ceeni iparo ngo ame
jo okene atamo ikomi teki
pe ikwanyo yika oroni me Yes, I do worry what
gengo yac? others will think. Eyo, Yes/Ee
an kom aparo kit ajo
tamo kede Strongly Yes/Ateni
atek 1
No response/ Aling
alinga

29. Could you use methods to No, I could not use Select One/Yer acel Select
avoid pregnancy without methods without my keken One/Yer acel
your partner knowing if you partner knowing. Pe keken
want to? Ceeni iyero iromo ba, pe aromo yero No/Pe
yero yika me gengo yac yika moro keken Strongly No/Pe
abongo ngec ibot abongo ngec a angeo atwali
cwari/apaini? cwara.

Yes/Ee
Yes, I could use
methods without my Strongly Yes/Ateni
partner knowing. atek 1
Eyo, aromo yero yika
moro keken abongo
ngec a cwara

No response/ Aling
alinga

30. If someone pressured you No, I could not Select One/Yer acel Select
to use a method to avoid refuse. Pe ba, pe keken One/Yer acel
pregnancy, could you atwero kwero keken
refuse if you did not want to No/Pe
use it? Ka dano moro odii Strongly No/Pe
tetek me kwanyo yika moro angeo atwali
me gengo yac, ceeni itwero
kwero ka pe imito? Yes, I could refuse.
Eyo, atwero kwero

No response/ Aling
alinga Yes/Ee

Strongly Yes/Ateni

18
 atek 1

31. Are you confident that you No, I am not Select One/Yer acel Select
can make a choice about confident. Pe ba, ape keken One/Yer acel
whether or not to use a itekcuny. keken
method to avoid No/Pe
pregnancy? Cunyi tye atek Strongly No/Pe
ni iromo kwanyo yika nyo angeo atwali
pe iromo kwanyo yika me
gengo yac? Yes, I am confident.
Eyo, atye itekcuny.

No response Aling
alinga / Yes/Ee

Strongly Yes/Ateni
atek 1

32. If a family member did not No, I would not be Select One/Yer acel Select
support your choice, would able to. Pe ba, pe keken One/Yer acel
you still be able to do what atwero mede itama. keken
is best for you related to No/Pe
avoiding pregnancy? Ka Strongly No/Pe
dano moro acel ipaco i yii angeo atwali
oodi kwer yika me yac ame
yin iyero, pwod iromo wot Yes, I would be able
anyim itami? to. Eyo, pwod atwero
mede itama.

No response/ Aling Yes/Ee

alinga Strongly Yes/Ateni
atek 1

33. Are you confident you can No, I am not Select One/Yer acel Select
do what is best for you confident. Pe ba, ape keken One/Yer acel
related to avoiding itekcuny keken
pregnancy? Cunyi tye atek No/Pe
ni iromo timo gin aber atek Strongly No/Pe
piri ikop me gengo yac? angeo atwali

Yes, yes I am
confident. Eyo, atye
itekcuny

No response/ Aling Yes/Ee

alinga Strongly Yes/Ateni
atek 1

34. Imagine that you wanted to No, I would not be Select One/Yer acel Select
use a method to avoid able to use one. Pe keken One/Yer acel
pregnancy… ba, pe dong aromo keken

19
 Would you be able to use mede itamano No/Pe
one? Go kong ni itye imito
tic kede yika moro acel me Strongly No/Pe
gengo yac, itamo ni pwod angeo atwali
iromo wot anyim kede tami
no? Yes, I would be able
to use one. Eyo,
pwod aromo mede
itamano Yes/Ee

No response/ Aling Strongly Yes/Ateni

alinga atek 1

35. Now I would like to ask you No, I would not be Select One/Yer acel Select
the opposite, imagine that able to NOT use keken One/Yer acel
you did not want to use a one. Pe ba, pe keken
method to avoid aromo mede itamano No/Pe
pregnancy… Strongly No/Pe
angeo atwali

Would you be able to not Yes, I would be able

use one? Wek amii to NOT use one.
oluktuke me apeny man. Eyo, pwod aromo
Go kong ni pe tye imito tic mede itamano Yes/Ee
kede yika moro me gengo
No response /Aling Strongly Yes/Ateni
yac, itamo ni pwod iromo
alinga atek 1
wot anyim kede tami no me
pe tic kede yika moro
keken?

36. If something or someone No, I could not find a Select One/Yer acel Select
stood in your way, could way to do what I keken One/Yer acel
you find a way to do what want. Pe ba, pe dong keken
you want related to aromo nwongo yore No/Pe
avoiding pregnancy? Ka okene Strongly No/Pe
agengoro nyo ngatoro riye angeo atwali
oko inyim yika ni me gengo
yac, iromo nwongo yore
okene me wot itami ni
anyim wek lewic make? Yes, I could find a
way to do what I Yes/Ee
want. . Eyo, aromo
nwongo yore okene Strongly Yes/Ateni
atek 1
No response/ Aling
alinga

Domain 2
Now I will ask some questions about whether you are currently able to do what you want related to
preventing or not preventing pregnancy. This could be using a method to avoid pregnancy or not
using a method—whatever your preference is right now. Please think about what you desire right
now and answer these questions according to that.

37. Are you free to do what you No, I am not free to Select One/Yer acel Select
want related to avoiding do what I want. Pe One/Yer acel

20
 pregnancy? Itye agonya me ba, pe atye agonya keken keken
timo ginoro keken ka imito me timo gin ame yia
gengo yac? mito No/Pe

Strongly No/Pe
angeo atwali
Yes, I am free to do
what I want. . Eyo,
atye agonya me timo
gin ame yia mito
Yes/Ee
No response/ Aling
alinga Strongly Yes/Ateni
atek 1

38. Is someone in your life No, nobody is Select One/Yer acel Select
making you do something making me do keken One/Yer acel
you don’t want to do related something I don’t keken
to avoiding pregnancy? Tye want to do. Pe ba, No/Pe
dano moro ame aman ngatoro pe ame miya Strongly No/Pe
wiwira me miyi timo jami atimo gin ame yia angeo atwali
ame yii pe mito ikop me pe mito
gengo yac?

Yes, someone is
making me do Yes/Ee
something I don’t
Strongly Yes/Ateni
want to do. . Eyo,
atek 1
ngatoro tye ame
oron atimo gin ame
yia pe mito

No response/ Aling
alinga

39. Does lack of money make it No, lack of money Select One/Yer acel Select
difficult for you to do what does not make it keken One/Yer acel
you want related to difficult. Pe ba, can keken
avoiding pregnancy? Ceeni cente pe genga kom No/Pe
can cente gengi timo jami Strongly No/Pe
ame yii mito pi gengo yac? angeo atwali

Yes, lack of money

does make it difficult.
Pe ba, can cente pe
genga kom Yes/Ee

No response/ Aling Strongly Yes/Ateni

alinga atek 1

40. Do you feel confident about No, I do not feel Select One/Yer acel Select
what you are doing or not confident. Pe ba, keken One/Yer acel
doing to avoid pregnancy? cunya kom pe tek keken
Itye ame cunyi tek ikom gin No/Pe
ame tye itimo pi gengo nyo

21
 pe gengo yac? Strongly No/Pe
angeo atwali

Yes, I do feel
confident. . Eyo,
cunya kom tek
Yes/Ee
No response/ Aling
alinga Strongly Yes/Ateni
atek 1

41. Is someone in your life No, nobody in my life Select One/Yer acel Select
stopping you from doing is stopping me from keken One/Yer acel
something you want related doing something I keken
to avoiding pregnancy? Tye want. Pe ba, ngatoro No/Pe
dano moro ame aman kom pe Strongly No/Pe
wiwira me gengi timo jami angeo atwali
ame yii mito ikop me gengo Yes, somebody in my
yac? life is stopping me
from doing
something I want.
Eyo, dano moro kom
Yes/Ee
tye
Strongly Yes/Ateni
No response/ Aling
atek 1
alinga

42. Can you control who in your No, I cannot control Select One/Yer acel Select
family knows whether you who in my family keken One/Yer acel
are doing something to knows. Pe ba, an keken
avoid pregnancy? Tye kom pe atwero No/Pe
kitoro ame yin aye iyero gengo ngatoro keken Strongly No/Pe
dano oroni ipaco turi me me bedo ingec itura angeo atwali
bedo ingec ka tye itimo
ginoro me gengo yac?

Yes, I can control Yes/Ee

who in my family
knows. Eyo, an kom Strongly Yes/Ateni
atwero gengo atek 1
ngatoro keken me
bedo ingec itura

No response/ Aling
alinga

F. SELF-EFFICACY TO SELF-INJECT [PATH scale – not yet validated; also fielded in ICAN
quant cohort]

Now, I’d like to speak with you about the family planning injection that you can inject by yourself
without the help of a healthcare provider. This injection is commonly called Sayana Press and you
can get it from a healthcare provider and inject yourself every three months.

22
Now I am going to read some statements about administering the injection to yourself. For each
statement, tell me if you strongly agree, agree, neutral, disagree or strongly disagree.

Aman dong amito leyo tam kedi ikop me lagoro nywal nibeo ipico ame yin itucere kede keni keni
abongo kony ibot atic me oot yat. Yat man olwongo ni Sayana Press dok nwongere bot otic me oot
yat kun itucere kede iyonge dwete adek adek.

Abino kwano boti nyig kop acel acel alubere kede kite me ticc iyat man ikomi. Pi nyig kop acel acel,
yin ibino tito ka iyee odoco, ka iyee, ka pe iromo kwero kede ka pe dang iromo yee, ka ikwero nyo
ka ikwero odoco. Inyang aber?

I feel confident that I could administer the Strongly disagree/Akwer Select

injection on my own after being trained. Iyonge odoco One/ Yer
nwongo pwonyere, atye ame cunya tek ni aromo Disagree/Akwero acel
Selfef_ Neutral/Pe akwero, pe
tucere kena keken
1 ayee
Agree/Ayee (acwako)
Strongly agree/ Ayee
atek
No response/ Pe akop
99
Selfef_ I feel confident that I know how to activate the Strongly disagree/Akwer Select
2 device. Atye icuny atek ni aromo miyo nyonyo odoco One/ Yer
me Sayana Press bedo ame tye atera me cako Disagree/Akwero acel
tic Neutral/Pe akwero, pe keken
ayee
Agree/Ayee (acwako)
Strongly agree/ Ayee
atek
No response/ Pe akop
99
Selfef_ I feel confident that I know how to create a skin Strongly disagree/Akwer Select
3 tent at the injection site. Atye icuny atek ni odoco One/ Yer
angeo copo kan ame ojolo jo iye pi kop me Disagree/Akwero acel
tucere. Neutral/Pe akwero, pe keken
ayee
Agree/Ayee (acwako)
Strongly agree/ Ayee
atek
No response/ Pe akop
99
Selfef_ I feel confident that I can inject the contraceptive Strongly disagree/Akwer Select
4 into my body. Cunya tye atek ni aromo tucere odoco One/ Yer
kena iyen me gengo yac. Disagree/Akwero acel
Neutral/Pe akwero, pe keken
ayee
Agree/Ayee (acwako)
Strongly agree/ Ayee
atek
No response/ Pe akop
99
Selfef_ I feel confident in pressing the reservoir slowly to Strongly disagree/Akwer Select
5 expel the liquid. Cunya tye atek ni aromo coro odoco One/ Yer
yat ame tye ipur pico momot naka donyo oko Disagree/Akwero acel
mot. Neutral/Pe akwero, pe keken
ayee
Agree/Ayee (acwako)
Strongly agree/ Ayee
atek
No response/ Pe akop

23
 99
Selfef_ I feel confident in calculating my re-injection Strongly disagree/Akwer Select
6 date. Cunya tye atek ni angeo tiyo cura me odoco One/ Yer
nyutu awene nyo nino me tucerena me tyelo Disagree/Akwero acel
okene ducu. Neutral/Pe akwero, pe keken
ayee
Agree/Ayee (acwako)
Strongly agree/ Ayee
atek
No response/ Pe akop
99
Selfef_ I feel confident that I can do all the steps Strongly disagree/Akwer Select
7 correctly and will be protected from pregnancy. odoco One/ Yer
Cunya tye atek ni ango lubu yore ducu amite Disagree/Akwero acel
kakare dang ni abino gengo yac kit ame yia Neutral/Pe akwero, pe keken
mito. ayee
Agree/Ayee (acwako)
Strongly agree/ Ayee
atek
No response/ Pe akop
99
Selfef_ I can manage to administer the injection to Strongly disagree/Akwer Select
8 myself even if I have to try several times until I odoco One/ Yer
succeed. Disagree/Akwero acel
Neutral/Pe akwero, pe keken
Atwero tucere kena kadi atem tyelo apol naka ayee
wan atyeko acil Agree/Ayee (acwako)
Strongly agree/ Ayee
atek
No response/ Pe akop
99
Selfef_ I can manage to administer the injection to Strongly disagree/Akwer Select
9 myself even if I do not receive a great deal of odoco One/ Yer
support from others. Atwero tucere kena kadi pe Disagree/Akwero acel
anwong kony me neyo tucere ibot jo okene Neutral/Pe akwero, pe keken
ayee
Agree/Ayee (acwako)
Strongly agree/ Ayee
atek
No response/ Pe akop
99
Selfef_ I can manage to administer the injection to Strongly disagree/Akwer Select
10 myself even if I feel very scared at first. Akadi odoco One/ Yer
tucere me nama acel kena room myelo koma, Disagree/Akwero acel
pwod pe genga tucere aber. Neutral/Pe akwero, pe keken
ayee
Agree/Ayee (acwako)
Strongly agree/ Ayee
atek
No response/ Pe akop
99
Interest Would you consider using a type of injectable Strongly disagree/Akwer Select
SI that you can inject yourself in the future? Iromo odoco One/ Yer
tucere keni kede yat okene ikare me anyim. Disagree/Akwero acel
Neutral/Pe akwero, pe keken
ayee
Agree/Ayee (acwako)
Strongly agree/ Ayee
atek
No response/ Pe akop

24
 99

H. Self-Injection use [Adapted from cohort study; only asked of women using DMPA-SC]

Now, I’d like to know more specifically about your experiences with the family planning injection that
is administered by a small needle injected into thigh or stomach. This injection is called Sayana
Press…
1. Did you know that you could No/Pe Sele
choose to administer the Yes/Ee ct
injection to yourselfHave you No response/Aling alinga One/
heard there is a type of Yer
injectable that you can inject acel
yourself? Ibin ingeo ni keke
onwongo iromo tucere keni n
kede yat man?
2. Have you ever administered No, only provider Sele
the injection to yourselfused administered/Pe, ber ka otic me ct
sayana press? Anaka ni kong oot yate en omio jo One/
ibin itucere iyat man keni? Yes/Ee Yer
No response/ Aling alinga acel
keke
n
3. If yes, who administered the self
injection partner/husband
other family/friend
mentor
doctor/nurse/midwife
pharmacist/drug shop employee
community health worker
another user I know
4. Have you ever taken home No/Pe Sele
units of the injection to Yes/Ee ct
administer yourself? Ceeni No response/Aling alinga One/
kong ibin iwoto kede yat man Yer
paco turi me tucere kede acel
keni? keke
n
5. What made you interested in Ease of use/ Tic kede yot Chec If ever
administering the Sayana Few side effects/ Racere nok k All/ SIed
Press injection to yourself? Ease of access/Nwongo yot Yer
Ngo ame obin okeli keo me Liked that it could be self- en
tucere keni iyat man? administered/Itucere kede keni ame
Wanted more effective tye
Probe for additional reasons method/Nwong yika aber akato ateni
after initial response and man ducu
record all reasons mentioned. Wanted longer acting method/
Ber ka yato rii kong nakanaka
Cannot select “Don’t know” or Sayana Press cost less than
“No response” with other other methods/Welere yot loo en
options. okene
Other desired method was
unavailable/Yika aber okene
nwongo tek
Smaller needle/ Pico atino
Provider recommended/Atic
okene mite
Able to use without my partner’s

25
 knowledge/ Atio kede kena
Other/En Okene
Don't know/Pe angeo
No response/Iromo ling alinga
99
6. How many times have you Number/Nyukta:_____ Num
injected Sayana Press for No response/Aliling ber/
yourself? Tyelo adii ame Nyuk
itucere kede Sayana Press ta
keni?
7. Have you ever experienced No/Pe Sele q8
any side effects after injecting Yes/Ee ct 8
Sayana Press yourself? Ibin No response/Aliling One/
iwinyo baloro ikomi iyenge Yer q8
tucere keni kede Sayana acel 8
Press? keke
n
8. What side effects did you Changes in bleeding/ Alokaloka Chec
experience? Bale ango ame icwer aremo k
ibin inwongo? Pain/bruising/swelling at All/Y
injection site that would not go er en
away/ Arem/Macere/Kwot ikan ame
ame otucu ame rii icang tye
Headache, nausea, ateni
dizziness/Abar wic/ngokere/lem kadi
cuny pol
Weight gain/loss/ Cwee/Jonyo
Bloating/ Jero (kwoto)
Fatigue/Oolo
Other (specify) Okene
(Kobi):_____
No response/Aliling
9. How bothersome are these Very bothersome/Yelo jo atek If
side effects? Rac ayat man Somewhat bothersome/ Yelo jo experien
yeli ningo? kitoro kitoro cing
Not at all bothersome/Mom yelo side
jo itik effects/
Don’t know/Pe angeo Ka tye
No response/ Aling alinga inwongo
ayeli
10. Why have you never injected Fear
yourself with Sayana Press? Prefer provider administration
Didn’t know could SI
Lack of access to supplies for SI
Other Don’t Know
No response
11. Would you consider using a No
type of injectable that you can Yes
inject yourself in the future? No response

12. Would you consider using a No

self-injectable contraceptive Yes
method if trained? No response

Perceived Norms about SI (only for women who have heard of SI)

Now I will ask you questions about what you think others in your community think and do with self-
injection. These questions are not about your own beliefs but about what you understand about
people in your community.

26
For each situation, I will ask you how many people in your community you think believe a certain way.
Please tell me if you think the situation reflects all of the people in your community, most of them,
about half of them, some of them, or none of them. Instructions for women who have ever heard of SI.
Its OK if you don’t know the answer, just take your best guess.

1. How many people All............................................................................................. Select

in your Most.......................................................................................... One
community About half.................................................................................
believe it is Some........................................................................................
acceptable for None.........................................................................................
women to No response -99
administer the
Sayana Press
injection to
themselves?
2 How many people All............................................................................................. Select
in your Most.......................................................................................... One
community would About half.................................................................................
say negative Some........................................................................................
things about None.........................................................................................
women who No response -99
administer the
Sayana Press
injection to
themselves?
Now I would like to know what people in your community actually do. Please tell me if you think the
situation reflects all of the people in your community, most of them, about half of them, some of
them, or none of them.
3 How many All............................................................................................. Select
married women in Most.......................................................................................... One
your community About half.................................................................................
administer the Some........................................................................................
Sayana Press None.........................................................................................
injection to No response -99
themselves?
4 How many All............................................................................................. Select
unmarried women Most.......................................................................................... One
in your About half.................................................................................
community Some........................................................................................
administer the None.........................................................................................
Sayana Press No response -99
injection to
themselves?
How many All............................................................................................. Select
adolescent girls in Most.......................................................................................... One
your community About half.................................................................................
administer the Some........................................................................................
Sayana Press None.........................................................................................
injection to No response..........................................................................-99
themselves?

27
IN-DEPTH INTERVIEW GUIDE FOR PROGRAM BENEFICIARIES- BASELINE

Study Title: Optimizing Approaches too Implementing Self-Injection of DMPA-SC

Version: 1 Dated 25 October, 2022

Session ID: [_____]_[___ ___ ]_[__]_[_____] Date (DD/MM/YY): ____ /____ / ____

Name of Interviewer: ___________________________________________________________

Before the Interview

1. INTRODUCE YOURSELF AND THE STUDY

2. MAKE SURE THE PARTICIPANT IS ELIGIBLE

A. IS THE PARTICIPANT A WOMAN?  YES  NO
B. IS SHE 15-45 YEARS OF AGE?  YES  NO
C. IS SHE PARTICIPATING IN THE SOCIAL SUPPORT PROGRAM?  YES  NO

3. OBTAIN INFORMED CONSENT [READ CONSENT SCRIPT]

A. DID YOU ANSWER ANY QUESTIONS ASKED BY THE PARTICIPANT? 
YES  NO  N/A
B. DID THE PARTICIPANT CONSENT OR ASSENT TO PARTICIPATE?  YES 
NOSTOP INTERVIEW
C. OPTIONAL: DID THE PARTICIPANT ACCEPT A COPY OF THE CONSENT FORM?  YES 
NO
4. OBTAIN PERMISSION TO AUDIO RECORD
A. DID THE PARTICIPANT GIVE YOU PERMISSION TO BE RECORDED?
 YESTURN ON RECORDER

 NOTHANK THEM AND END SESSION

5. TURN ON THE TAPE RECORDER(S) AND SAY:

“Thank you for giving me permission to record, this is interviewer XXX and Session ID XXX”

DOMAIN 1: PROGRAM INTRODUCTION

[THE PURPOSE OF THIS SECTION IS TO LEARN HOW PARTICIPANTS WERE INTRODUCED TO

THE PROGRAM AND WHY THEY WERE MOTIVATED TO JOIN]

Thank you again for your willingness to participate in this study and to help our research team learn
more about the [NAME] program. I am going to start by asking you some questions about your
experiences with and expectations for the program.

1. First, how did you first learn about the [NAME] program?
Me acel yin icako ngeo nying purugrami ningo?
2. When you first met your mentor/heard your mentor speak in a group, how did she
describe the program?
Ikare ame iwinyo ngat apwonyo wu oloko,ibin inyang ni purugrami obedo ngo?

28
 a. Describe in your own words what you think the program offers. Mia ange apiri
keni ber a yika man
b. What made you gain interest in what she had to say? Ngo omedo kero ni
iyonge kopere
c. What did you think the benefits of mentorship might be? Itamo apri ni ber a
miyo tam kit man tye. Mia angee-gi.
d. What kinds of challenges, if any, did you anticipate? Itamo ni kit peko ango
ame romo yaa i miyo tam
i. What could make it hard for you to meet with the mentor when you
were scheduled to? How would you go about this? Agengoro tye
ame twero balo rwate ni kede a mii tam ka yika me rwate man tye?
Iromo tyeko kodi peki magi ningo
3. What do you ultimately hope to get out of this program? [PROBE: Help deciding which method
to use, connections to the formal health system, help learning how to SI] Ngo ame yin itamo ni
iromo nwongo aber ame aya I purugrami akwako yot kom kede kwan
4. How would you prefer to keep meeting with the mentor? Where would you prefer to meet
up with her? yore ango ame yin itwero kwanyo me bedo rwate kede apwony adakoni,
iyore ango?
5. How do you anticipate your interaction(s) with the mentor would go?
For example, if you were trying to make a decision on which method to use or to switch
to, and you went to the mentor, can you take me through how this discussion would
go……?
Yin iromo myeko ni ngo aber ame apwony wu romo timo? Mii tami.
6. From your experience or what you have observed or heard from others, when would the
mentor be of most help to you? Alubere kede ngo ineno nyo iwinyo,itamo ni apwonyi romo
bedo apire tek boti
a. On average, how many times would you want to meet up with the mentor for
instance in a month? Please explain. Etamo ni eromo wrate kede ami tam idi
eyi dwea cel, koba cong

FOR PARTICIPANTS WHO MENTION SUPPORT FOR SI ABOVE

7. What made you decide to use the self-injectable contraception?

Ngo omio yin icwako tic kede yat lagoro nywal ame ocobo jo acoba ibad dano?
a. What, if anything, has stopped you from using this method on your own?ongo
omio iweko tic kede yika me lagoro nywal apiri keni
b. What do you expect this program will offer you in terms of support for using
SI that you have not been able to get from elsewhere? Itamo ni yika man
twero konyi eyore ango
8. Have you already arranged a time to meet with your mentor?
Iyiko kare moro me rwate kede apwony ?
a. IF YES: How did you set up the first meeting with your mentor? Ka yiko,
etimu ongo me miyo cokere no bedo aber
b. What, if anything, has she done so far to follow up with you afterwards?
Eyunge cokere, apwony otimo ngo me lubu gin ame omoko E.g., has she
called you or met you at a place of your convenience?
c. IF NO: How are you planning on connecting with your mentor now that you
have joined the program? ka alubboro obeda pee, tami tea ni ngo iye me yiko

DOMAIN 2: CONTRACEPTIVE AUTONOMY

[THE PURPOSE OF THIS SECTION IS TO LEARN TO WHAT EXTENT PARTICIPANTS FEEL THEY
HAVE AUTONOMY TO MAKE AND ACT ON CONTRACEPTIVE DECISIONS]

9. Where do you typically get information about contraception? Kwene ame inwongo ngec me
lagoro nywal iye?
a. Why this person/place? Pingo inwongo ibot dano/kabedo man?
b. What information do you commonly get from this person/place (mention)? Kit
ngec ngoame inwongo ibot dano/kabedo man?

29
 i. how do you feel about the information you get from this
person/place? PROBE: how reliable do you feel it is to you? Igeno
ngec man?
c. Where else would you like to get information from if it were more easily
available in the community? Tye kan/dano okene ame onwongo iromo
nwongo ngec iye ka onwongo tye ikin paco?
d. If a friend or family member came to you with questions about contraception,
how confident do you feel that you could answer them? Ka awoti nyo dano
moro me yii oodi paco turi obino boti te penyi kede apeny akwako gengo yac,
igame ikit tek cuny arom kwene?
i. Why? Pingo?
10. Who do you typically talk to, if anyone, when you have to make a decision about
contraception? Tye dano moro ame yin igeno ame inwongo tam ibote ka imito moko tami ikom
gengo yac?
a. Why this person/these people? Pingo dano man nyo jo magi?
b. Can you tell me about the last time you had a conversation about
contraception with this person/these people? Iromo miya ngeyo awene ame
ileo tam kede dano man nyo jo magi ikop me gengo yac?
i. How did you feel afterwards? Ibin iwinyo ningo iyongee rwate man?
ii. Was there anything about the conversation you wish had gone
differently? Tye ginoro ame itamo ni obedo iyore ape myero bed
kede?
11. Is there anyone else you would like to talk about contraception with?
Tye dok ngatoro okene ame yin itwero lok kede akwako lagoro nywal?

a. IF YES: Who? Kat ye, obedo nga?

b. Why this person? Pingo dano man
12. Can you take me through how you made your current decision regarding contraception. Iromo
koba imalo malo ngo ame omio iyero kit yika man me lagoro nywal?
a. Probe: what was happening at the time, who or what was consulted and why,
what else influenced the decision?
13. When making decisions about contraception, do you feel you need to keep these decisions
private from anyone in your life? Ka imoko tami me tic kede yore me lagoro nywal, itamoni
myero igwok kopi acalo imung ame pe ileo kede dano apire tek ikwooni?
a. IF YES: Who? Ka dano no tye, obedo nyaa?
b. Why this person? Pingo dano no?
c. What, if anything, have you done in the past to manage this situation? Tye
ginoro ikare okato angec ame itimo me neno ni tami ni owoto aber?
d. How might your mentor be able to help you access the contraceptive services
you desire in this situation? Tye kitoro ame apwonyi romo konyi kede me
nwongo kony me lagoro nywal alubere kede mitani me wot aber?
14. Once you have made a decision about contraception, do you need anyone else’s
permission to act on it? Ka dong imoko tami me tic kede yika me lagoro nywal, dok
inwongo twero ibot dano okene aperu iketo mokani ni itic?
a. who is that person? Ngaa no?
b. Why do/why don’t you need their permission to act on your decision? Pingo
pe imito tam a dano no nyo jo magi me keto tami itic?
15. When you make a decision on your own about contraception (e.g., whether to use or not),
what makes it easy for you to act on that decision? Please explain. Is there anything else? Ka
yin imoko tami keni ikop me lagoro nywal aporere me tic kede nyo pe, ngo amio tic kede bedo
ayot. Gony tere atutut. Gin okene nyo dok odong?
a. What makes it difficult for you to act on that decision? Please explain. Is there
anything else? Ngo ame omio keto moka ni no itic bedo atek?
b. What would make it easier for you to act on your own contraceptive decisions
that currently is not available to you? Ngo ame omio keto moka ni no itic
bedo ayot akadi yika me lago nywal ame iyero no pwod pe?
i. How do you feel about someone in your community supporting you to
act on your decision? Ka dano moro onwongo romo nwongere ikin
paco ame twero miyi kony ikop me lagoro nywal, itamo ningo iye?

30
 16. Comparing making to acting on your own decision about contraception, which of the two is
easier for you to do on your own and which one is harder? Please explain? Ka imoko tami
akwako lagororo nywal kun inwongo kony ibot dano kede en ame itio iye apiri, ikin aryo ni,
mene ayot kede mene atek. Kob atut iye?
17. Everyone has different feelings about whether they want others in their community to know
they are using contraception. How comfortable do you/would you feel seeking contraceptive
services at a health facility where you may see other people you know? Why do you think you
feel this way? Pol ajo tye kede tam apapat akwako yore me lagoro nywal akwako ka jo ikin
paco-gi dang myero bed ingec iye. Apeny tye kit man: Yin iwinyo icunyi keni ningo ka iwoto me
nwongo kony me lagoro nywal eka ite cop ikom jo me kin paco ame yin ingeo kunu? Mia ange
ngo omio iwinyo icunyi kito?
a. IF UNCOMFORTABLE: Has this feeling ever affected your ability to access
the contraceptive services you desire? Ka iwinyo ni myero inwong kony
imung imung, rwate kede jo ikin paco I oot yat balo kit ame amyero inwong
kede kony me gengo yac/lagoro nywal?
i. IF YES: In what way? Ka balo, balo iyore ango?
ii. What, if anything, have you done about this? Tye kit ginoro ame itimo
iye me yiko dwogo kakare?
iii. How might your mentor be able to help you access the contraceptive
services you desire in this situation? Tye kitoro ame apwonyi romo
konyi kede me wek inwony yika me gengo nywal akun jo ame yin
ingeo pete bedo ingec iye?

IF PARTICIPANT HAS NEVER USED CONTRACEPTION, SKIP TO QUESTION [X]

DOMAIN 3: CONTRACEPTIVE EXPERIENCE

[THE PURPOSE OF THIS SECTION IS TO LEARN TO WHAT PARTICIPANTS’ EXPERIENCES

HAVE BEEN LIKE ACCESSING AND USING CONTRACEPTION]

FOR PARTICIPANTS WHO HAVE EVER USED CONTRACEPTION

18. You mentioned that you are currently using contraception/have used contraception in the
past. Which method have you used most recently?
Ikoboni Amani ni itye itic kede yat lagoro nywal, dang rik con itio kede. Apeny, Yore mene ame
yin itio kede acegi ni me agiki? Pingo?

a. Why did you choose this method? Pi ngo eyero yika man
b. How confident did you feel about this decision right after you made it? Tek
cuny aromkwene a me I bin ebedo kede eyungea tam mi nono
i. Why? Pi ngo
c. What did/do you like about this method? Emaro ngo eyika ni
d. What didn’t/don’t you like about this method? Ngo emaro/ pe emaro eyika
man
e. How confident did/do you feel that you were/are able to use this method
correctly? Cunyi dong tea atek a me I tamo ni etwero tic kede yika man
i. Why? Pi ngo
19. Have you ever experienced any side effects while using this method? Side effects are
ways that using the method may affect your body other than preventing pregnancy.
Anakani inongo rac atic iyat lagoro nywali apat kede gengo yac ka tye amanono mene?

a. IF YES: What were/are they?ka ee, obedo gini ngo/ ngo nono
b. What, if anything, have you done to manage these side effects? Ebin etimo
ngo eyungea tic kede yat man me gengo nywal
c. How might your mentor help you with this? Apwony oromo konyi ni ngo
20. Now, please think back to the last time you accessed [method]. Where did you get it?
[PROBE: pharmacy, health facility, VHT]
Amani, poyo ceng ame inwong ngec me lagoro nywali, kwene ayin inwongo iye? (ot yat, ot
cato yen, dakatal, onyo ibot otic me yotkom me kin calo)

31
 a. Did you receive any support from the [pharmacist, provider, VHT] at that
time? What support did they give you? Enwo kony nyoro ebot jo etitu ni
b. What other support would you have liked from that person? Kony aber ango
emaro ebot dano no
c. What else could they have done that might have made you feel more
confident using the method? Ngo okene aber a me mwero onungo otim me
konyi
21. What challenges, if any, have you faced going to a health facility for contraceptive
counseling or service provision?
Peko ango ame yin ibedo kede ikare ame iwoto iyi dakatal akwako pwonyere me lagoro
nywal?
a. How have you managed these challenges? en peki ni otum ni ngo
b. How might your mentor help you with this in the future? Apwonyi twero konyi
epeki ni ni ngo eya anyim

FOR PARTICIPANTS WHO HAVE NEVER USED CONTRACEPTION

22. You mentioned that you don’t currently use contraception. What are your reasons for this?
Yin ikobo ni yin pe imito tic kede yen me lagoro nywal, pii tyen kop ango?
a. With the decision of not using anything to prevent pregnancy, is there any
information or support that you would like regarding family planning?
PROBE: child spacing, family size, healthy timing and spacing of
pregnancies? Tam moro okene tye ame kwoko lagoro nywal ame emito ngyo
b. If you were to start using contraception, are you interested in any particular
method? etic kede yika mene ame yin emaro
i. IF YES: Which one? Ka ee, Mene ni
ii. What concerns, if any, do you have about using this method? Yore
ango ame etamo ni etwero tic kede yika man aber
iii. What would you need to do or learn to feel confident using this
method correctly? Etamo ni etwero tic kede yika ni ni ngo eyore aber
23. Do you have any other comments to add as we conclude the interview?
Nyo tye dok tamoro okene anyen ame itwero medo ikom apeny man?

Thank you for participating in this study. We appreciate your time.

Apwoyo miya cawa ni kede leyo tam karecel kedi
TURN OFF RECORDER

32
IN-DEPTH INTERVIEW GUIDE (BASELINE): COMPARISON GROUP - LANGI

Study Title: OPTIMIZING APPROACHES TO IMPLEMENTING SELF-INJECTION OF DMPA-SC

Version: 1 DATED 08 November, 2022

Session ID: [_____]_[___ ___ ]_[__]_[_____] Date (DD/MM/YY): ____ /____ / ____
Name of Interviewer: ___________________________________________________________

Before the Interview

6. INTRODUCE YOURSELF AND THE STUDY

7. MAKE SURE THE PARTICIPANT IS ELIGIBLE

A. IS THE PARTICIPANT A WOMAN?  YES  NO
B. IS SHE BETWEEN 15-45 YEARS OF AGE?  YES  NO
C. IS SHE PARTICIPATING IN THE SOCIAL SUPPORT PROGRAM?  YES  NO

8. OBTAIN INFORMED CONSENT [READ CONSENT SCRIPT]

D. DID YOU ANSWER ANY QUESTIONS THEY HAD?  YES  NO  N/A
E. DID THEY CONSENT OR ASSENT TO PARTICIPATE?  YES  NOSTOP
INTERVIEW
F. OPTIONAL: DID THEY ACCEPT A COPY OF THE CONSENT FORM?  YES  NO
9. OBTAIN PERMISSION TO AUDIO RECORD
B. DID THEY GIVE YOU PERMISSION TO BE RECORDED?
 YESTURN ON RECORDER

 NOTHANK THEM AND CONCLUDE SESSION

10. TURN ON THE TAPE RECORDER(S) AND SAY:

“Thank you for giving me permission to record, this is interviewer XXX and Session ID XXX”

DOMAIN 1: SUPPORT FOR CONTRACEPTIVE DECISION-MAKING & USE

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[THE PURPOSE OF THIS SECTION IS TO LEARN HOW PARTICIPANTS MAKE DECISIONS
ABOUT CONTRACEPTION, THE SUPPORT THEY ALREADY HAVE AND ANY ADDITIONAL
SUPPORT THEY DESIRE.]

Thank you again for your willingness to participate in this study and to help our research team learn
more about the kinds of support women desire when they are making decisions related to
contraception. First, I am going to ask you about how you make decisions related to contraception.

1. Where do you typically get information about contraception? Inwongo ngec ikwene nyo
ibot nga ikom kop me juko yaco?
a. Why this person/place? Pingo inwongo I kakanoro no nyo ibot dano no?
b. What information do you commonly get from this person/place (mention)? Kit
ngec ango ame yin inwongo I kano nyo ibot dano no?
i. how do you feel about the information you get from this
person/place? Ka inwongo ngecono iwinyo icunyu keni keni ningo?
PROBE: how reliable do you feel it is to you?
c. Where else would you like to get information from if it were more easily
available in the community? Ka kono ka onwongo ngec tye acok kedi kun
dang nwongo room bedo ayot, yin itamo ni onwongo myero igam kodi
ngecono ikwene nyo ibot nga-gi?
d. If a friend or family member came to you with questions about contraception,
how confident do you feel that you could answer them?
Ka kono awoti moro nyo dano moro me yii ootwu (paco tungwu) penyi ikom
kop man, iromo gamo apenyere ikit tekcuny arom kwnene
i. Why? Pingo?

2. Who do you typically talk to, if anyone, when you have to make a decision about
contraception? Yin ileo tam kede nga icawa ame imiti moko tami pi juko yaco?
a. Why this person/these people? Pingo dano no nyo jono?
b. Can you tell me about the last time you had a conversation about
contraception with this person/these people? Mia ange awene ame ibin ileo
tam kede dano no nyo jono akwako kop me juko yaco?
i. How did you feel afterwards? Ibin iwinyo ningo iyonge leyo tam man?
ii. Was there anything about the conversation you wish had gone
differently? Tye tamoro ame iparo ni onwongo myero kato nyo pe
kato ikare ame ibin ileo tam kede dano naca?

3. Is there anyone else you would like to talk about contraception with? Tye dano moro
okene ame itamo ni myero ilee tam me juko yaco kede?
a. IF YES: Who? Ka tye: Obedo nga?
b. Why this person? Pingo dano no?

4. Once you have made a decision about contraception, do you need anyone else’s
permission to act on it? Teki dong imoko tami oko me juko yac, tye dok dano moro ame
myero inwong twero ibote aperu iketo tami itic?
a. who is that person? Dano mene no?
b. Why do/why don’t you need their permission to act on your decision? Pingo
imito/pe imito twero ame yaa ibot dano no ikom tam ame imoko?

5. When you make a decision on your own about contraception (e.g., whether to use or
not), what makes it easy for you to act on that decision? Please explain. Is there
anything else? Ka yin dong imoko tami oko me yac nyo pe me yac, ngo ame mio ibunyo
keto tami no itic oyotoyot?
a. What makes it difficult for you to act on that decision? Please explain. Is there
anything else? Ka yin dong imoko tami oko me yac nyo pe me yac, ngo ame
gengi ibunyo keto tami no itic oyotoyot?
b. What would make it easier for you to act on your own contraceptive decisions
that currently is not available to you? Ngo ame mio ibunyo keto tami itic
oyotoyot ikom kop me juko yaco okene apat ame yin aye ingeo keni?

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 i. How do you feel about someone in your community supporting you to
act on your decision? Iwinyo icunyi ningo ka dano moro ikin pace tye
amito konyi ikom tami me juko yaco?

6. Comparing making to acting on your own decision about contraception, which of the two
is easier for you to do on your own and which one is harder? Please explain? Mene ame
inwongo yot kede mene ame tek ikin kop aryo magi: moko tami apiri keni nyo leyo tam
kede dano okene ikom kop me juko yaco?

7. Everyone has different feelings about whether they want others in their community to
know they are using contraception. Jo okene paro ento en okene pe paro ka jo ikin paco
ongeo ni gin tye atic kede cura nyo diro me juko yaco. How comfortable do you/would
you feel seeking contraceptive services at a health facility where you may see other
people you know? Yin iwinyo ningo apiri keni ka iwoto ikaka nwongo kony (i dakatal) pi
kop me juko yaco eka dok ite nwongo jo okene ame yin ingeo kunu?
a. Why do you think you feel this way? Pingo iwinyo icunyi keni kit ame ikoba
kede no?
b. IF UNCOMFORTABLE: Has this feeling ever affected your ability to access
the contraceptive services you desire? Tye yore moro ame kit ame iwinyo
kede icunyi no obin otemo yengo kit ame inwongo kede kony me juko yaco
ame nwongo yin ikato dong kede oko?
i. IF YES: In what way? Ka oyengo yore me nwongo kony man:
Oyengo iyore mene?
ii. What, if anything, have you done about this? Itemo timo ginoro iye?
iii. Is there any other support that might help you access the
contraceptive services you desire in this situation? Tye kit konyoro
okene apat ame imito ame romo konyi nwongo kony ikom kop me
juko yaco?

IF PARTICIPANT HAS NEVER USED CONTRACEPTION, SKIP TO QUESTION [X]

FOR PARTICIPANTS WHO HAVE EVER USED CONTRACEPTION

8. You mentioned that you are currently using contraception/have used contraception in the
past. Yin ikobo ni aman tye itic kede yika acel me gengo yaco/dang itio kede yika man
ikare okato. Which method have you used most recently? Yika mene ame itio kede
acocoki?
a. Why did you choose this method? Ngo omio ikwanyo kit yika man?
b. How confident did you feel about this decision right after you made it? Ibin
iwinyo icunyi ningo iyonge kwanyo yika man?
i. Why? Pingo?
c. What did/do you like about this method? Ngo ame imaro ikom yika man ame
tye itic kede nie?
d. What didn’t/don’t you like about this method? Ngo ame pe imaro ikom yika
man ame tye itic kede nie?
e. How confident did/do you feel that you were/are able to use this method
correctly? Tek cuny arom kwene ame mio yin itamo ni iromo tic kede
yore/yika man kakare?
i. Why? Pingo?

9. Have you ever experienced any side effects while using this method? Side effects are
ways that using the method may affect your body other than preventing pregnancy. Tye
kitoro ame ka itio kede yika man me gengo yaco kelo peko ikomi akun dang pe gengo
yac?
a. IF YES: What were/are they? Ka tye: Mia angee-gi

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 b. What, if anything, have you done to manage these side effects? Ibin itimo
ngo iye me konyi coro peko man?
c. Is there any other support that might help you with this? Tye kit konyoro apat
ame romo miyi coro peko man?

10. Now, please think back to the last time you accessed [method]. Where did you get it?
[PROBE: pharmacy, health facility, VHT] Tam kun idok cen ite tito kwene ame obin omii
icako tic kede yore/yika man me juko yaco?
a. Did you receive any support from the [pharmacist, provider, VHT] at that
time? Ibin inwongo konyoro ibot aticoro keken me oot yat ikare naca?
i. What support did they give you? Kit kony ango ame en dano/jo naca
obin omii?
b. What other support would you have liked from that person? Tye kit konyoro
apat ame onwongo imito ibot dano naca?
c. What else could they have done that might have made you feel more
confident using the method? Tye kit konyoro apat ame jo naca onwongo
myero mii boti me medo tek cunyi (kero) me tic kede yika me juko yaco ikare
naca?

11. What challenges, if any, have you faced going to a health facility for contraceptive
counseling or service provision? Kit peki ango ame ibedo nwongo akwako wot ioot yat pi
nwongo kony me gengo yaco?
a. How have you managed these challenges? Icoro kit peki magi ducu iyoo
ango?
b. What other support might help you with this in the future? Tye kit kony ango
ame iromo tic kede me coro peki magi ikare me anyim?

12. IF SELF-INJECTION NOT ALREADY MENTIONED: Sayana Press is an injectable

family planning method that someone can buy from a pharmacy or get from a health
facility and inject themselves every three months. Have you heard of this method of
contraception before? Tye yat pico moro ame olwongo ni Sayana Press ame nwongere i
oot cato yen me yot kom (pharmacy) kede iwudi atino me oot yat. Dano rome wilo te
tucere kede kenekene me gengo yaco iyonge dwete adek adek. Anaka riki ibin iwinyo kit
yoo man me gengo yaco?
a. Are you at all interested in using this method? Itye kede miti/kero me tic kede
kit yoo me gengo yaco man?
i. IF YES: What, if anything, has stopped you from using this method
on your own? Ka itye kede miti: Ngo ame obin ogengi me tic kede
yore/yika man?
ii. What kind of support do you think you would need to be able to use
Sayana Press with confidence? Kit kony ango ame imito me wek icak
tic kede yika man me Sayana Press itek cuny?

FOR PARTICIPANTS WHO HAVE NEVER USED CONTRACEPTION

13. You mentioned that you don’t currently use contraception. What are your reasons for
this?
a. With the decision of not using anything to prevent pregnancy, is there any
information or support that you would like regarding family planning?
PROBE: child spacing, family size, healthy timing and spacing of
pregnancies? Alubere kede moka ni me pe tic kede yika moro keken me
gengo yaco, tye kit konyoro ame imito pi lagoro nywal?
b. If you were to start using contraception, are you interested in any particular
method? Ka kono icak tic kede yika me gengo yaco, mita ni romo bedo ikom
yika moro?
i. IF YES: Which one? Ka mita ni tye: Tye ikom yika mene?
ii. What concerns, if any, do you have about using this method? Ngo
ame imito ni tim ikom yika man wek bed aber pi tic kede?

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 iii. What would you need to do or learn to feel confident using this
method correctly? Tye kit konyoro apat ame ka inwongo medo tek
cunyi (kero) me tic kede yika man me juko yaco kakare?

14. Do you have any other comments to add as we conclude the interview?
Onyo itye kede koporo ame iromo medo ame peru ocego leyo tam tin?

Thank you for participating in this study. We appreciate your time. Apwoyo leyo tam keda tin iyore
ducu amwonya. Apwoyo dang jalo kare me tici pi leyo tam tin. Jojok Amalo.

TURN OFF RECORDER

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