This research instrument, which was developed by the Manoff Group for the USAID-funded MotherCare Project, was used in formative research for the Indramayu Project. One component of research tested ways to improve the existing iron supplementation program for pregnant women in this Indonesian region. The results were used to develop messages for counseling women and a social marketing campaign, train health workers and others delivering iron tablets, and identify and develop delivery mechanisms/strategies for the improved iron supplementation program.