Survey Text

Afghanistan 2015 Ghana 2008 Nepal 2011 Senegal 2016
Congo (Democratic Republic) 2013 Ghana 2014 Nepal 2016 Senegal 2017
Congo Brazzaville 2011 Guinea 2012 Nigeria 2003 Tanzania 2004
Cote d'Ivoire 2011 Guinea 2018 Nigeria 2008 Tanzania 2010
Egypt 2005 Lesotho 2004 Nigeria 2013 Uganda 2006
Egypt 2008 Lesotho 2009 Nigeria 2018 Uganda 2011
Egypt 2014 Lesotho 2014 Rwanda 2010 Zambia 2007
Eswatini (Swaziland) 2006 Malawi 2004 Rwanda 2014 Zambia 2018
Ethiopia 2005 Malawi 2010 Senegal 2010 Zimbabwe 2005
Ethiopia 2011 Malawi 2016 Senegal 2012
Ethiopia 2019 Myanmar 2015 Senegal 2014
Ghana 2003 Nepal 2006 Senegal 2015
top
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

top
Congo (Democratic Republic) 2013
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

top
Congo Brazzaville 2011
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.

HOME
YOUR HOME A
OTHER HOME B
PUBLIC SECTOR
HOSPITAL C
INTEGRATED HEALTH CENTER D
HEALTH POST E
PRIVATE MEDICAL SECTOR
CLINIC F
DOCTOR'S OFFICE G
OTHER PLACE (SPECIFY) _____ X

top
Cote d'Ivoire 2011
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

top
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

top
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

top
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

top
Eswatini (Swaziland) 2006
Survey form view entire document:  text 
408) Where did you receive antenatal care for this pregnancy?
CIRCLE ALL MENTIONED.
IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.

(NAME OF PLACE)__________
HOME
YOUR HOME A
OTHER HOME B
PUBLIC SECTOR
GOVERNMENT HOSPITAL C
GOVERNMENT HEALTH CENTER D
PHU/CLINIC E
OTHER PUBLIC (SPECIFY)________F
PRIVATE SECTOR
PRIVATE. HOSPITAL/CLINIC G
OTHER PRIVATE (SPECIFY)______H
MISSION
HOSPITAL I
CLINIC J
OTHER MISSION (SPECIFY)_______K
NGO
FLAS L
OTHER NGO (SPECIFY)______M
OTHER (SPECIFY)_________X

top
Ethiopia 2005
Survey form view entire document:  text 
408. Where did you receive antenatal care for this pregnancy?
CIRCLE ALL MENTIONED. IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
[FOR LAST BIRTH ONLY]

NAME OF PLACE_______________
HOME
YOUR HOME A
OTHER HOME B
PUBLIC SECTOR
GOVERNMENT HOSPITAL C
GOVERNMENT HEALTH CENTER D
GOVERNMENT HEALTH POST E
OTHER PUBLIC (SPECIFY) ________F
NON-GOVERNMENT (NGO)
NGO HEALTH FACILITY G
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC H
OTHER PRIVATE MEDICAL (SPECIFY) ___________________ I
OTHER (SPECIFY) _____________ X

top
Ethiopia 2011
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

top
Ethiopia 2019
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
GOVERNMENT HOSPITAL C
GOVERNMENT HEALTH
CENTER D
GOVERNMENT HEALTH
POST E
OTHER PUBLIC SECTOR (SPECIFY) __ F


NGO
HEALTH FACILITY G
OTHER NGO HEALTH FACILITY (SPECIFY) ___ H


PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL I
PRIVATE CLINIC J
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) ___ K
OTHER (SPECIFY) ___ X

top
Ghana 2003
Survey form view entire document:  text 
407A. Where did you receive antenatal care for this pregnancy? Anywhere else?
[Most recent birth within the last five years]

HOME
YOUR HOME A
TBA'S HOME B
OTHER HOME C
PUBLIC SECTOR
GOVT. HOSPITAL/CLINIC D
GOVT. HEALTH CENTER E
GOVT. HEALTH POST F
MOBILE CLINIC G
OTHER PUBLIC (SPECIFY) ____H
PRIVATE MEDICAL SECTOR
PVT. HOSPITAL/CLINIC I
MOBILE CLINIC J
MATERNITY HOME K
OTHER PVT. MEDICAL (SPECIFY)____ L
OTHER (SPECIFY)____ X

top
Ghana 2008
Survey form view entire document:  text 
408. Where did you receive antenatal care for this pregnancy? Anywhere else?
[Most recent birth within the last five years]

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
GOVT. HOSPITAL POLYCLINIC C
GOVT. HEALTH CENTER D
GOVT. HEALTH POST/CHPS E
MOBILE CLINIC F
OTHER PUBLIC (SPECIFY) ____ G
PRIVATE MED. SECTOR
PVT. HOSPITAL/CLINIC H
FF/PPAG CLINIC I
MOBILE CLINIC J
MATERNITY HOME K
OTHER PRIVATE MED. (SPECIFY) _____ L
OTHER (SPECIFY) _____ X

top
Ghana 2014
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

top
Guinea 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

top
Guinea 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
PREFECTURAL HOSPITAL/COMMUNAL MEDICAL CENTER E
HEALTH CENTER F
HEALTH POST G
OTHER PUBLIC SECTOR (SPECIFY) H


PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC I
FAMILY PLANNING CLINIC/GUINEAN ASSOCIATION FOR FAMILY WELL-BEING J
PRIVATE MIDWIFE'S OFFICE K
OTHER PRIVATE MEDICAL (SPECIFY) L


OTHER (SPECIFY) X

top
Lesotho 2004
Survey form view entire document:  text 
407A Where did you receive antenatal care for this pregnancy? Anywhere else?

PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
GOVT. HEALTH POST C
OTHER PUBLIC _________(SPECIFY) D
PRIVATE MEDICAL SECTOR
PVT. HOSPITAL/CLINIC E
OTHER PVT. MEDICAL _______(SPECIFY) F
CHAL
CHAL HOSPITAL G
CHAL HEALTH CENTER H
OTHER _________(SPECIFY) X

top
Lesotho 2009
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).
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE(S)) ___________
PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
GOVT. HEALTH POST C
OTHER PUBLIC SECTOR D
PRIVATE MEDICAL SECTOR
PVT. HOSPITAL/CLINIC E
PRIVATE MED. SECTOR F
CHAL
CHAL HOSPITAL G
CHAL HEALTH CENTER H
CHAL HEALTH POST I
OTHER X

top
Lesotho 2014
Survey form view entire document:  text 
410) Where did you receive antenatal care for this pregnancy? Anywhere else?
[FOR MOST RECENT BIRTH ONLY]

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) ____
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
GOVERNMENT HEALTH POST C
OTHER PUBLIC SECTOR (SPECIFY) ____ D
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC E
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) ____ F
CHAL
CHAL HOSPITAL G
CHAL HEALTH CENTER H
CHAL HEALTH POST I
REDCROSS HEALTH CENTER J
FACILITY OUTSIDE LESOTHO K
OTHER (SPECIFY) ____ X

top
Malawi 2004
Survey form view entire document:  text 
407A. Where did you receive antenatal care for this pregnancy? Anywhere else?
[FOR LAST BIRTH ONLY]

HOME
YOUR HOME A
OTHER HOME B
PUBLIC SECTOR
GOVERNMENT HOSPITAL C
GOVERNMENT HEALTH CENTER D
GOVERNMENT HEALTH POST E
MOBILE CLINIC F
OTHER PUBLIC (SPECIFY) _____ G
MISSION
HOSPITAL H
HEALTH CENTER I
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC J
MOBILE CLINIC K
OTHER PRIVATE MEDICAL (SPECIFY) __________ L
TRADITIONAL BIRTH ATTENDANT M
OTHER (SPECIFY) ________ X

top
Malawi 2010
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 UNABLE 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
YOUR HOME A
OTHER HOME B
PUBLIC SECTOR
GOVT. HOSPITAL C
GOVT. HEALTH CENTER D
GOVT. HEALTH POST E
OTHER PUBLIC (SPECIFY) __________ F
PRIVATE MED. SECTOR
PVT. HOSPITAL/CLINIC G
OTHER PRIVATE MED. (SPECIFY) ______ H
OTHER (SPECIFY) _________ X

top
Malawi 2016
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
GOVERNMENT HOSPITAL C
GOVERNMENT HEALTH CENTER D
GOVERNMENT HEALTH POST E
MOBILE CLINIC F
OTHER PUBLIC SECTOR (SPECIFY) G
CHAM/MISSION
HOSPITAL H
HEALTH CENTER I
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL OR CLINIC J
MOBILE CLINIC K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) L
BLM M
OTHER (SPECIFY) X

top
Myanmar 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
HOME A
OTHER B
PUBLIC SECTOR
GOVT. HOSPITAL C
GOVT. HEALTH CENTER (RHC) D
GOVT. HEALTH POST SUB-CENTER E
MOBILE CLINIC F
UHC/MCH CENTER G
OTHER PUBLIC SECTORY___(SPECIFY) H
NGO
MARIE STOPES I
MYANMAR RED CROSS J
PSI/M (SUN) K
MMA L
OTHER NGO SECTOR___(SPECIFY) M
PRIVATE MED. SECTOR
PVT. HOSPITAL/CLINIC N
OTHER PRIVATE MED. SECTOR___(SPECIFY) O
OTHER___(SPECIFY) X

top
Nepal 2006
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 UNABLE 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
YOUR HOME A
OTHER HOME B
GOVT. SECTOR
GOVT. HOSPITAL C
PHC CENTER D
HEALTH POST E
SUB-HEALTH F
PHC OUTREACH G
OTHER GOVT. (SPECIFY) ___ H
NON-GOVT. (NGO)
UMN/RED CROSS HOSPITAL I
OTHER NGO (SPECIFY) __ J
PRIVATE MED. SECTOR PVT. HOSPITAL/CLINIC/NURSING HOME K
OTHER PRIVATE MED (SPECIFY) __ L
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 UNABLE 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
YOUR HOME A
OTHER HOME B
GOVT. SECTOR
GOVT. HOSPITAL C
PHC CENTER D
HEALTH POST E
SUB-HEALTH F
PHC OUTREACH G
OTHER GOVT. (SPECIFY) ___ H
NON-GOVT. (NGO)
UMN/RED CROSS HOSPITAL I
OTHER NGO (SPECIFY) __ J
PRIVATE MED. SECTOR PVT. HOSPITAL/CLINIC/NURSING HOME K
OTHER PRIVATE MED (SPECIFY) __ L
OTHER (SPECIFY) __ X

top
Nepal 2011
Survey form view entire document:  text 
410) Where did you receive antenatal care for this pregnancy?
Anywhere else?
PROBE TO IDENTIFY TYPE(S) OF SOURCE(S).
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
GOVT. SECTOR
GOVT. HOSPITAL C
PHC CENTER D
HEALTH POST E
SUB-HEALTH POST F
PHC OUTREACH G
OTHER GOVT. (SPECIFY) ___________ H
NON-GOVT. (NGO) SECTOR
FPAN I
MARIE STOPES J
ADRA K
UMN L
OTHER NGO. (SPECIFY) __________ M
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/NURSING HOME N
OTHER PRIVATE MEDICAL (SPECIFY) ___________ O
OTHER (SPECIFY) __________ X

Survey form view entire document:  text 
410) Where did you receive antenatal care for this pregnancy?
Anywhere else?
PROBE TO IDENTIFY TYPE(S) OF SOURCE(S).
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
GOVT. SECTOR
GOVT. HOSPITAL C
PHC CENTER D
HEALTH POST E
SUB-HEALTH POST F
PHC OUTREACH G
OTHER GOVT. (SPECIFY) ___________ H
NON-GOVT. (NGO) SECTOR
FPAN I
MARIE STOPES J
ADRA K
UMN L
OTHER NGO. (SPECIFY) __________ M
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/NURSING HOME N
OTHER PRIVATE MEDICAL (SPECIFY) ___________ O
OTHER (SPECIFY) __________ X

top
Nepal 2016
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/CLINIC C
PHC CENTER D
HEALTH POST/SUB-HEALTH POST E
PHC OUTREACH CLINIC F
OTHER PUBLIC FACILITIES (SPECIFY) ____ G
NON-GOVT. (NGO)
FPAN H
MARIE STOPES I
OTHER NGO FACILIITES (SPECIFY) ____ J
PRIVATE MEDICAL SECTOR
PVT. HOSPITAL/NURSING HOME K
PRIVATE CLINIC L
OTHER PRIVATE MEDICAL FACILITIES (SPECIFY) ___ M
OTHER (SPECIFY) ___ X

top
Nigeria 2003
Survey form view entire document:  text 
407A. Where did you receive antenatal care for this pregnancy? Anywhere else?

HOME
YOUR HOME A
OTHER HOME B
PUBLIC SECTOR
GOVERNMENT HOSPITAL C
GOVERNMENT HEALTH CENTRE D
GOVERNMENT HEALTH POST E
MOBILE CLINIC F
OTHER PUBLIC (SPECIFY) ____________ G
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL H
MOBILE CLINIC I
OTHER PRIVATE MEDICAL (SPECIFY) _____________ J
OTHER X

top
Nigeria 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 APPROPRIATE CODE(S). IF UNABLE TO DETERMINE IF A 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
GOVERNMENT HOSPITAL C
GOVERNMENT HEALTH CENTER D
GOVERNMENT HEALTH POST/DISPENSARY E
OTHER PUBLIC (SPECIFY) ____________ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
OTHER PRIVATE MED. (SPECIFY) _____________ H
OTHER (SPECIFY) _____________ X

top
Nigeria 2013
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
GOVT. HEALTH CENTER D
GOVT. HEALTH POST/DISPENSARY E
OTHER PUBLIC SECTOR (SPECIFY)________F
PRIVATE MED. SECTOR
PVT. HOSPITAL/CLINIC G
OTHER PRIVATE MED. SECTOR (SPECIFY)______ H
OTHER (SPECIFY)_____ X

top
Nigeria 2018
Survey form view entire document:  text 
410. Where did you receive antenatal care for this pregnancy?

HOME
HER HOME A
OTHER HOME B
PUBLIC SECTOR
GOVERNMENT HOSPITAL C
GOVERNMENT HEALTH CENTER D
GOVERNMENT HEALTH POST E
OTHER PUBLIC SECTOR ________ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL G
OTHER PRIVATE MEDICAL SECTOR ______ H

OTHER _____ X

top
Rwanda 2010
Survey form view entire document:  text 
410) Where did you receive antenatal care for this pregnancy? Anywhere else?
[ASK FOR MOST RECENT BIRTH ONLY]

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

NAME OF PLACE(S)
HOME
YOUR HOME A
OTHER HOME B
PUBLIC/AGREE SECTOR
REFERAL HOSPITAL C
DISTRICT HOSPITAL D
HEALTH CENTER E
HEALTH POST F
OTHER PUBLIC SECTOR (SPECIFY) G
PRIVATE MEDICAL SECTOR
POLYCLINIC H
CLINIC I
DISPENSARY J
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) K
OTHER (SPECIFY) X

top
Rwanda 2014
Survey form view entire document:  text 
410) Where did you receive antenatal care for this pregnancy? Anywhere else?

PROBE TO IDENTIFY TYPE(S) OF SOURCE(S).

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/AGREE SECTOR
REF. HOSPITAL C
PROV/DIST. HOSPITAL D
HEALTH CENTER E
HEALTH POST F
OTHER PUBLIC FACILITY (SPECIFY) ____ G
PRIVATE MEDICAL SECTOR
POLYCLINIC H
CLINIC I
DISPENSARY J
OTHER PRIVATE MEDICAL FACILITY (SPECIFY) ____ K
OTHER (SPECIFY) ____ X

top
Senegal 2010
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

top
Senegal 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

top
Senegal 2014
Survey form view entire document:  text 
410. (2) 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
GOVERNMENT HOSPITAL C
GOVERNMENT HEALTH CENTER D
GOVERNMENT HEALTH POST E
OTHER PUBLIC SECTOR (SPECIFY)_____________F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)_____________H
OTHER (SPECIFY)____________X

top
Senegal 2015
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)) _____
PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
GOVT. HEALTH POST C
HEALTH HUT D
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

top
Senegal 2016
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

top
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

top
Tanzania 2004
Survey form view entire document:  text 
407A. Where did you receive antenatal care for this pregnancy? Anywhere else?

HOME A
GOV. PARASTATAL
REFERAL/SPEC. HOSPITAL B
REGIONAL HOSP. C
DISTRICT HOSP D
HEALTH CENT E
DISPENSARY F
VILLAGE HEALTH POST G
CBD WORKER H
RELIGIOUS/VOLUNTARY
REFERAL/SPEC. HOSPITAL I
DISTRICT HOSP J
HEALTH CENT K
DISPENSARY L
PRIVATE
SPECIALISED HOSPITAL M
HEALTH CENT N
DISPENSARY O
OTHER (SPECIFY) __________ X

top
Tanzania 2010
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). IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE(S)) ______
HOME A
GOV. PARASTATAL
REFERAL/SPEC. HOSPITAL B
REGIONAL HOSP. C
DISTRICT HOSP D
HEALTH CENT E
DISPENSARY F
VILLAGE HEALTH POST G
CBD WORKER H
RELIGIOUS/VOLUNTARY
REFERAL/SPEC. HOSPITAL I
DISTRICT HOSP J
HEALTH CENT K
DISPENSARY L
PRIVATE
SPECIALISED HOSPITAL M
HEALTH CENT N
DISPENSARY O
OTHER (SPECIFY) __________ X

top
Uganda 2006
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 UNABLE 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
YOUR HOME A
OTHER HOME B
PUBLIC SECTOR
GOVT. HOSPITAL C
GOVT. HEALTH CENTER D
GOVT. HEALTH POST E
OTHER PUBLIC (SPECIFY) __________ F
PRIVATE MED. SECTOR
PVT. HOSPITAL/CLINIC G
OTHER PRIVATE MED. (SPECIFY) ______ H
OTHER (SPECIFY) _________ X

top
Uganda 2011
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

top
Zambia 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 UNABLE TO DETERMINE IF A HOSPITAL, HEALTH CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.
[LAST BIRTH ONLY]

(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 (SPECIFY) ____________ F
PRIVATE MED. SECTOR
PVT. HOSPITAL/SURGERY G
MISSION HOSPITAL/CLINIC H
WORK PLACE I
OTHER PRIVATE MED. (SPECIFY) _____________ J
OTHER (SPECIFY) _____________ X

top
Zambia 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.
NAME OF PLACE _____________________

HOME
HER HOME A
OTHER HOME B
PUBLIC SECTOR
GOVERNMENT HOSPITAL C
GOVERNMENT HEALTH CENTER D
GOVERNMENT HEALTH POST E
MOBILE HOSPITAL/CLINIC F
OTHER PUBLIC SECTOR (SPECIFY) ____________________ J

top
Zimbabwe 2005
Survey form view entire document:  text 
408) Where did you receive antenatal care for this pregnancy? Anywhere else?

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

RECORD ALL MENTIONED.

NAME OF PLACE(S) __________
HOME
YOUR HOME A
OTHER HOME B
PUBLIC SECTOR
CENTRAL HOSPITAL C
PROVINCIAL HOSPITAL D
DISTRICT/RURAL HOSPITAL E
RURAL/MUNICIPAL CLINIC F
RURAL HEALTH CENTER G
OTHER PUBLIC (SPECIFY) __________ H
MISSION FACILITY I
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC J
OTHER PRIVATE MEDICAL K
OTHER (SPECIFY) __________ X