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If No, why?

If yes, comment

-Are contraceptives only used by married women (please notify)

-Change in type of contraceptive

Yes                                                                        No

If yes, please comment

-Stop using contraceptives

Yes                                                                        No

If yes, why?

-Use during nursing period

Yes                                                                        No

If No, why?

-Availability of consultant for the FP techniques

Yes                                                                        No

If No, why?

-Reproductive health awareness

Yes                                                                        No

If No, why?

-Availability of counseling

Yes                                                                        No

If No, why?

-Quality of counseling

Good                                                                     Bad                                  

C/Data collection tools

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