Survey Text

Angola 2015 Benin 2011 Egypt 2003 Egypt 2014
Bangladesh 2007 Benin 2017 Egypt 2005 Mali 2012
Bangladesh 2014 Burkina Faso 2010 Egypt 2008 Myanmar 2015
top
Angola 2015
Survey form view entire document:  text 
410) Where did you received antenatal care for this pregnancy?
Anywhere else?
PROBE TO IDENTIFY THE TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE)____
PUBLIC SECTOR
CENTRAL HOSPITAL A
HOSPITAL IN PROVINCE B
HOSPITAL IN RURAL AREA C
HEALTH CENTER/POST D
MATERNITY WARD E
MOBILE CLINIC F
OTHER PUBLIC SECTOR: (SPECIFY)____ G
PRIVATE MEDICAL SECTOR
PRIVATE CLINIC/HOSPITAL H
HEALTH CENTER I
OTHER PRIVATE MEDICAL SECTOR: (SPECIFY)____J
OTHER: (SPECIFY) ______ X

top
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

top
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

top
Benin 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
Benin 2017
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
Govt. Hospital C
Govt. Health Center D
Maternity E
Village unit F

Other public sector (specify) G
Private medical sector
Private hospital/clinic H
Religious hospital I
Other private medical (specify) J

Other (specify) X

top
Burkina Faso 2010
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.
[ASK ONLY FOR MOST RECENT BIRTH]

NAME OF PLACE(S) _______
HOME
RESPONDENT'S HOME A
OTHER HOME B
PUBLIC SECTOR
GOVERNMENT HOSPITAL C
MATERNITY CENTER D
GOVERNMENT HEALTH CENTER/FAMILY PLANNING CLINIC E
OTHER (SPECIFY) _____ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
OTHER PRIVATE MEDICAL (SPECIFY) ______ H
OTHER (SPECIFY) ______ X

top
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

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
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

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