Survey Text

Afghanistan 2015 Cameroon 2018 Mali 2012 Pakistan 2012
Bangladesh 2007 Egypt 2003 Mali 2018 Pakistan 2017
Bangladesh 2011 Egypt 2005 Mozambique 2003 Rwanda 2008
Bangladesh 2014 Egypt 2008 Mozambique 2011 Senegal 2017
Cameroon 2011 Egypt 2014 Pakistan 2006 Togo 2013
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Afghanistan 2015
Survey form view entire document:  text 
410. Where did you receive antenatal care for this pregnancy? Anywhere else?

PROBE TO IDENTIFY EACH TYPE OF SOURCE. IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

NAME OF PLACE(S)________________
HOME
YOUR HOME A
OTHER HOME B
PUBLIC SECTOR
GOVT. HOSPITAL C
CHC/POLYCLINIC D
BASIC HEALTH CENTER E
HEALTH SUB-CENTER F
HP/SHP G
CHW H
MOBILE CLINIC I
OTHER PUBLIC SECTOR________J
NGO SECTOR
MARIE STOPES K
RED CROSS L
AFGA M
OTHER NGO________N
PRIVATE MED. SECTOR
PVT. HOSPITAL/CLINIC O
PRIVATE DOCTOR P
OTHER PRIVATE MED. SECTOR________Q
OTHER SOURCE
CHARITY/FOUNDATIONS R
REFUGEE CAMP S
OTHER___________X

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Bangladesh 2007
Survey form view entire document:  text 
408) Where did you receive antenatal care for this pregnancy? Anywhere else? PROBE TO IDENTIFY TYPE(S) OF SOURCE(S) AND CIRCLE THE APPROPRIATE CODE(S). IF UN ABLE TO DETERMINE IF A HOSPITAL, HEALTH CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE(S))____
HOME
OWN HOME A
OTHER HOME B
PUBLIC SECTOR
HOSPITAL/MEDICAL COLLEGE C
FAMILY WELFARE CENTRE D
THANA HEALTH COMPLEX E
SAT. CLINIC/EPI OUTREACH F
MAT. AND CHILD WELFARE CENTER G
COMM. CLINIC H
OTHER (SPECIFY)____ I
NGO SECTOR
NGO STATIC CLINIC J
NGO SAT CLINIC K
OTHER (SPECIFY)____ L
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC M
QUAL. DOCTOR N
TRAD. DOCTOR O
PHARMACY P
OTHER (SPECIFY)____ X

Survey form view entire document:  text 
408) Where did you receive antenatal care for this pregnancy? Anywhere else? PROBE TO IDENTIFY TYPE(S) OF SOURCE(S) AND CIRCLE THE APPROPRIATE CODE(S). IF UN ABLE TO DETERMINE IF A HOSPITAL, HEALTH CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE(S))____
HOME
OWN HOME A
OTHER HOME B
PUBLIC SECTOR
HOSPITAL/MEDICAL COLLEGE C
FAMILY WELFARE CENTRE D
THANA HEALTH COMPLEX E
SAT. CLINIC/EPI OUTREACH F
MAT. AND CHILD WELFARE CENTER G
COMM. CLINIC H
OTHER (SPECIFY)____ I
NGO SECTOR
NGO STATIC CLINIC J
NGO SAT CLINIC K
OTHER (SPECIFY)____ L
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC M
QUAL. DOCTOR N
TRAD. DOCTOR O
PHARMACY P
OTHER (SPECIFY)____ X

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Bangladesh 2011
Survey form view entire document:  text 
410) Where did you receive antenatal care for this pregnancy? (ONLY FOR MOST RECENT BIRTH)
Anywhere else?
PROBE TO IDENTIFY EACH TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE(S))____
HOME
HOME A
PUBLIC SECTOR
HOSP./MEDICAL COLLEGE B
SPE. MEDICAL COL. (SPECIFY) __________ C
DIST. HOSP. D
MCWC E
UPAZILLA HEALTH COMPLEX F
H and FAMILY WELFARE CENTRE G
SAT. CLINIC/EPI OUTREACH H
COMM. CLINIC I
OTHER (SPECIFY) __________ J
NGO SECTOR
NGO STATIC CLINIC K
NGO SAT CLINIC (SPECIFY) L
OTHER (SPECIFY) _____________ M
PRIVATE MED. SECTOR
PVT. HOSPITAL/CLINIC N
QUAL. DOCTOR P
PHARMACY Q
PVT. MED COLL.
HOSP. (SPECIFY) ____________ R
OTHER (SPECIFY)____________X

Survey form view entire document:  text 
410) Where did you receive antenatal care for this pregnancy? (ONLY FOR MOST RECENT BIRTH)
Anywhere else?
PROBE TO IDENTIFY EACH TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE(S))____
HOME
HOME A
PUBLIC SECTOR
HOSP./MEDICAL COLLEGE B
SPE. MEDICAL COL. (SPECIFY) __________ C
DIST. HOSP. D
MCWC E
UPAZILLA HEALTH COMPLEX F
H and FAMILY WELFARE CENTRE G
SAT. CLINIC/EPI OUTREACH H
COMM. CLINIC I
OTHER (SPECIFY) __________ J
NGO SECTOR
NGO STATIC CLINIC K
NGO SAT CLINIC (SPECIFY) L
OTHER (SPECIFY) _____________ M
PRIVATE MED. SECTOR
PVT. HOSPITAL/CLINIC N
QUAL. DOCTOR P
PHARMACY Q
PVT. MED COLL.
HOSP. (SPECIFY) ____________ R
OTHER (SPECIFY)____________X

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Bangladesh 2014
Survey form view entire document:  text 
410. Where did you receive antenatal care for this pregnancy?
Anywhere else?
PROBE TO IDENTIFY EACH TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE(S)) ____________
HOME
HOME A
PUBLIC SECTOR
HOSP./MEDICAL COLLEGE/SPE. MED. COL B
DIST. HOSP. C
MCWC D
UPAZILLA HEALTH COMPLEX E
UH AND FAMILY WELFARE CENTRE F
SAT. CLINIC/EPI OUTREACH G
COMM. CLINIC H
OTHER PUBLIC SECTOR (SPECIFY) _____ I
NGO SECTOR
NGO STATIC CLINIC J
NGO SAT CLINIC K
OTHER (SPECIFY) _____ L
PRIVATE MED. SECTOR
PVT. HOSPITAL/CLINIC M
QUAL. DOCTOR N
TRAD. DOCTOR O
PHARMACY P
OTHER (SPECIFY) _____ X

Survey form view entire document:  text 
410. Where did you receive antenatal care for this pregnancy?
Anywhere else?
PROBE TO IDENTIFY EACH TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE(S)) ____________
HOME
HOME A
PUBLIC SECTOR
HOSP./MEDICAL COLLEGE/SPE. MED. COL B
DIST. HOSP. C
MCWC D
UPAZILLA HEALTH COMPLEX E
UH AND FAMILY WELFARE CENTRE F
SAT. CLINIC/EPI OUTREACH G
COMM. CLINIC H
OTHER PUBLIC SECTOR (SPECIFY) _____ I
NGO SECTOR
NGO STATIC CLINIC J
NGO SAT CLINIC K
OTHER (SPECIFY) _____ L
PRIVATE MED. SECTOR
PVT. HOSPITAL/CLINIC M
QUAL. DOCTOR N
TRAD. DOCTOR O
PHARMACY P
OTHER (SPECIFY) _____ X

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Cameroon 2011
Survey form view entire document:  text 
408) Where did you receive prenatal care for this pregnancy?

Anywhere else?

PROBE FOR THE TYPE OF PLACE AND CIRCLE THE APPROPRIATE CODE(S).

IF YOU CAN NOT DETERMINE IF THE HOSPITAL, HEALTH CENTER OR CLINIC IS PUBLIC OR PRIVATE, WRITE THE NAME OF THE PLACE.

NAME OF PLACE: ___
HOME
YOUR HOME A
OTHER HOME B
PUBLIC/PARA PUBLIC SECTOR
HOSPITAL C
HEALTH CENTER D
OTHER PUBLIC (SPECIFY): ___ E
PRIVATE MEDICAL SECTOR
PRIVATE RELIGIOUS HOSPITAL F
PRIVATE SECULAR HOSPITAL/CLINIC G
HEALTH CENTER/RELIGIOUS DISPENSARY/MISSION H
MEDICAL OFFICE I
OTHER PRIVATE MEDICAL (SPECIFY): ___ J
OTHER: ___ X

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Cameroon 2018
Survey form view entire document:  text 
410. Where did you receive antenatal care for this pregnancy? Anywhere else?
PROBE TO IDENTIFY THE TYPE OF SOURCE. IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

HOME
HER HOME A
OTHER HOME B
PUBLIC SECTOR
GOVERNMENT HOSPITAL C
SUB-DIVISIONAL MEDICAL CENTER / INTERGRATED HEALTH CENTER / DISPENSARY D
OTHER PUBLIC SECTOR (SPECIFY)________E
PRIVATE MEDICAL SECTOR
CONFESSIONAL HOSPITAL / CLINIC F
PRIVATE LAY HOSPITAL / CLINIC G
CONFESSIONAL HEALTH CENTER / DISPENSARY H
DOCTOR'S OFFICE I
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)_________J
OTHER (SPECIFY)_________X

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Egypt 2003
Survey form view entire document:  text 
508. Where did you receive the antenatal care? RECORD ALL PLACED.

PUBLIC SECTOR
GVT. HOSPITAL A
GVT. HEALTH UNIT B
MCH CENTER C
PRIVATE SECTOR
PVT. HOSPITAL/CLINIC D
PVT. DOCTOR E
OTHER___________X

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Egypt 2005
Survey form view entire document:  text 
508) Where did you receive antenatal care for this pregnancy?
CIRCLE ALL MENTIONED.

IF SOURCE IS HOSPITAL, HEALTH UNIT, OR CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.

(NAME OF PLACE(S)) ________________
HOME
YOUR HOME A
OTHER HOME B
GOVERNMENT
URBAN HOSPITAL C
URBAN HEALITH UNIT D
HEALTH OFFICE E
RURAL HOSPITAL F
RURAL HEALITH UNIT G
MCH CENTER H
OTHER GOV'T (SPECIFY) _________ I
NONGOVERNMENTAL
EGYPTIAN FP ASSOC J
CSI PROJECT K
OTHER NGO (SPECIFY) __________ L
PRIVATE MEDICAL
PVT. HOSPITAL/CLINIC M
PVT. DOCTOR N
OTHER PVT. MED. (SPECIFY) _________ P
OTHER NON-MEDICAL (SPECIFY) __________ X

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Egypt 2008
Survey form view entire document:  text 
508. Where did you receive antenatal care for this pregnancy? CIRCLE ALL MENTIONED. IF SOURCE IS HOSPITAL, HEALTH UNIT, OR CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.

(NAME OF PLACE(S)) _________________
HOME
YOUR HOME A
OTHER HOME B
GOVERNMENT
URBAN HOSPITAL (GNRL/DSTRCT) C
URBAN H'LTH UNIT D
HEALTH OFFICE E
RURAL HOSPITAL (COMPL'TARY) F
RURAL HEALTH UNIT G
MCH CENTER H
OTHER GOV'T (SPECIFY) ________ I
NONGOVERNMENTAL
EGYPTIAN FP ASSOC J
CSI PROJECT K
OTHER NGO (SPECIFY) ________ L
PRIVATE MEDICAL
PVT.HOSPITAL/CLINIC M
PVT.DOCTOR N
OTHER PVT.MED.(SPECIFY) __________ P
OTHER NON-MEDICAL (SPECIFY) _________ X

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Egypt 2014
Survey form view entire document:  text 
510. Where did you receive antenatal care for this pregnancy? Anywhere else?

PROBE TO IDENTIFY EACH TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

HOME
YOUR HOME A
OTHER B
GOVERNMENT
URBAN HOSPITAL (GENERAL/DISTRICT) C
URBAN HEALTH UNIT D
RURAL HOSPITAL (CENTRAL) F
RURAL HEALTH UNIT G
MCH CENTER H
OTHER GOVERNMENT (SPECIFY)_________I
NONGOVERNMENTAL
EGYPTIAN FP ASSOCIATION J
CSI PROJECT K
OTHER NGO (SPECIFY)_________L
PRIVATE MEDICAL
PRIVATE HOSPITAL/CLINIC M
PRIVATE DOCTOR N
OTHER PRIVATE MEDICAL _________P
OTHER NON-MEDICAL X

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Mali 2012
Survey form view entire document:  text 
410) Where did you receive this antenatal care for this pregnancy?
Anywhere else?
PROBE TO IDENTITY THE TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE(S))_____________
HOME
YOUR HOME A
OTHER HOME B
PUBLIC SECTOR
NATIONAL HOSPITAL C
REGIONAL HOSPITAL D
REFERRAL HEALTH CENTER (CSREF) E
FREE CLINIC/MATERNITY F
COMMUNITY HEALTH CENTER (CSCOM) G
OTHER PUBLIC_______ (SPECIFY) H
PRIVATE SECTOR
PRIVATE CLINIC/OFFICE I
PRIVATE HEALTH CARE OFFICE J
TREATMENT ROOM K
PHARMACY L
OTHER PRIVATE______ (SPECIFY) M
OTHER_______ (SPECIFY) X

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Mali 2018
Survey form view entire document:  text 
410) Where did you receive this antenatal care for this pregnancy?
Anywhere else?
PROBE TO IDENTITY THE TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.
(NAME OF PLACE(S))

HOME
HER HOME A
OTHER HOME B
PUBLIC SECTOR
NATIONAL HOSPITAL C
REGIONAL HOSPITAL D
REFERENCE HEALTH CENTER E
COMMUNITY HEALTH CENTER F
DISPENSARY/MATERNITY G
OTHER PUBLIC SECTOR (SPECIFY) H
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC I
DOCTOR'S OFFICE J
PRIVATE HEALTH CLINIC K
HEALTH POSTS L
OTHER PRIVATE MEDICAL (SPECIFY) M
OTHER (SPECIFY) X

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Mozambique 2003
Survey form view entire document:  text 
407A. Where did you have your antenatal care appointment(s)? Anywhere else?
RECORD ALL PLACES MENTIONED.
[ASK ONLY FOR MOST RECENT BIRTH]

IF SOURCE IS HOSPITAL, WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.

NAME OF PLACE______
PUBLIC SECTOR
CENTRAL HOSPITAL A
PROVINCIAL/GENERAL HOSPITAL B
RURAL HOSPITAL C
HEALTH CENTER D
MOBILE CLINIC E
OTHER (SPECIFY) ____ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL G
PRIVATE CLINIC H
PRIVATE DOCTOR'S OFFICE I
PRIVATE NURSE J
OTHER PRIVATE MEDICAL (SPECIFY) _____ L
OTHER (SPECIFY) ______ X

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Mozambique 2011
Survey form view entire document:  text 
410. Where did you receive antenatal care for this pregnancy? Anywhere else?

PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE)_____
HOME
YOUR HOME A
OTHER HOME B
PUBLIC SECTOR
CENTRAL HOSPITAL C
PROVINCIAL/GENERAL HOSPITAL D
RURAL HOSPITAL E
HEALTH CENTER/POST F
MOBILE CLINIC G
OTHER (SPECIFY)____ H
PRIVATE MEDICAL SECTOR
PRIVATE CLINIC I
PRIVATE DOCTOR'S OFFICE J
PRIVATE NURSE K
PHARMACY L
OTHER (SPECIFY) ______ X

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Pakistan 2006
Survey form view entire document:  text 
408) Where did you receive antenatal care for this pregnancy? Anywhere else?
FOR ANY HOSPITAL, HEALTH CENTRE, OR CLINIC, WRITE THE NAME OF THE PLACE.
PROBE TO IDENTIFY TYPE(S) OF SOURCE(S) AND RECORD ALL MENTIONED.
[ONLY ASKED FOR MOST RECENT PREGNANCY]

HOME
YOUR HOME A
OTHER HOME B
PUBLIC SECTOR
GOVT. HOSPITAL C
RHC/MCH D
BHU/FWC E
OTHER PUBLIC (SPECIFY) ___ F
PRIVATE MED. SECTOR
PVT. HOSPITAL/CLINIC H
PVT. DOCTOR I
HOMEOPATH J
DISPENSER/COMPOUNDER K
OTHER PRIVATE MED. (SPECIFY) ___ L
HAKIM M
OTHER (SPECIFY) ___ X

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Pakistan 2012
Survey form view entire document:  text 
410) Where did you receive antenatal care for this pregnancy? (2)
Anywhere else?

PROBE TO IDENTIFY EACH TYPE OF SOURCE.

IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.
[Most recent birth within the last five years]

(NAME OF PLACE(S))_______
HOME
YOUR HOME A
OTHER HOME B
PUBLIC SECTOR
GOVT. HOSPITAL C
GOVT. HEALTH CENTER D
GOVT. HEALTH POST E
OTHER PUBLIC SECTOR (SPECIFY)_____ F
PRIVATE MED. SECTOR
PVT. HOSPITAL/CLINIC G
OTHER PRIVATE MED. SECTOR (SPECIFY)______ H
OTHER (SPECIFY)______ X

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Pakistan 2017
Survey form view entire document:  text 
410) Where did you receive antenatal care for this pregnancy? Anywhere else? PROBE TO IDENTIFY THE TYPE OF SOURCE. IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

NAME OF PLACE ______

HOME
HER HOME A
OTHER HOME B
PUBLIC SECTOR
GOVT. HOSPITAL C
RHC/MCH D
BHU E
CMW F
OTHER PUBLIC SECTOR (SPECIFY) ______ G
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC H
PVT. DOCTOR I
HOMEOPATH J
DISPENSER/COMPOUNDER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) _______ L
HAKIM M
OTHER (SPECIFY) _______ X

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Rwanda 2008
Survey form view entire document:  text 
408) Where did you receive antenatal care for this pregnancy?
Anywhere else?

PROBE TO IDENTIFY TYPE(S) OF SOURCE(S) AND CIRCLE THE APPROPRITATE CODE(S).

IF UNABLE TO DETERMINE IF A HOSPITAL, HEALTH CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

HOME
YOUR HOME A
OTHER HOME B
PUBLIC SECTOR
GOV. HOSPITAL C
HEALTH CENTER D
OTHER PUBLIC E (SPECIFY) ___________
PRIV. MEDICAL SECTOR
PRIVATE HOSP./CLINIC F
PRIV. DOCTOR G
ARBEF CLINIC H
NURSE I
OTHER MEDICAL PRIVATE J (SPECIFY) _________
OTHER X (SPECIFY) _____________

(NAME OF PLACE(S)) ____________________

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Senegal 2017
Survey form view entire document:  text 
410) Where did you receive this antenatal care for this pregnancy?
Anywhere else?

PROBE TO IDENTIFY THE TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE(S)) _____
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
GOVERNMENT HEALTH POST C
HEALTH HUT D
MOBILE CLINIC E
FIELDWORKER F
OTHER PUBLIC SECTOR (SPECIFY) _____ G
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC H
PHARMACY I
PRIVATE DOCTOR'S OFFICE J
MOBILE CLINIC K
FIELDWORKER L
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) _____ M
OTHER SOURCE
SHOP N
TRADITIONAL PRACTITIONER O
MARKET P
COMMUNITY AGENT Q
OTHER (SPECIFY) ____ X

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Togo 2013
Survey form view entire document:  text 
410) Where did you receive this antenatal care for this pregnancy?
Anywhere else?
PROBE TO IDENTITY THE TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.
(NAME OF PLACE(S))________

HOME
YOUR HOME A
OTHER HOME B
PUBLIC SECTOR
GOVERNMENT HOSPITAL C
HEALTH CENTER D
DISPENSARY E
MOTHER-INFANT PROTECTION F
HEALTH HUT G
MOBILE CLINIC H
OTHER PUBLIC SECTOR (SPECIFY_________) I
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC J
PRIVATE DOCTOR'S OFFICE K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)________ M
OTHER (SPECIFY)_______ X