Survey Text

Angola 2015 Ethiopia 2016 Nigeria 2018 Zambia 2018
Benin 2017 Guinea 2018 Senegal 2017 Zimbabwe 2015
Burundi 2016 Malawi 2016 Tanzania 2015
Congo (Democratic Republic) 2007 Nepal 2016 Uganda 2016
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Angola 2015
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730) From where did you obtain the condom last time?
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 11
HOSPITAL IN PROVINCE 12
HOSPITAL IN RURAL AREA 13
HEALTH CENTER 14
MATERNITY WARD 15
MOBILE CLINIC 16
OTHER: (SPECIFY)____ 17
PRIVATE MEDICAL SECTOR
PRIVATE CLINIC 21
HEALTH CENTER 22
PHARMACY 23
OTHER: (SPECIFY)____26
OTHER SOURCE
MARKET/STORE 31
CHURCH 32
FRIEND/RELATIVE 33
NGOs 34
OTHER: (SPECIFY)____96
DON'T KNOW 98

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Benin 2017
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730) From where did you obtain the condom the last time?
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)

Public sector
Govt. Hospital 11
Govt. Health Center 12
Mobile clinic 14
Fieldworker 15

Other public sector (specify) 16
Private medical sector
Private hospital/clinic 21
Pharmacy 22
Private doctor 23
Mobile clinic 24
Religious hospital 25
Other private medical (specify) 26
NGO
Family planning clinic 31
Other source
Shop 41
Church 42
Friend/relative 43

Other (specify) 96

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Burundi 2016
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730) From where did you obtain the condom the last time?

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)_______________
PUBLIC SECTOR
NATIONAL GOVERNMENT HOSPITAL 11
REGIONAL GOVERNMENT HOSPITAL 12
DISTRICT HOSPITAL 13
GOVERNMENT HEALTH CENTER 14
COMMUNITY FIELDWORKER 15
OTHER___________16
CERTIFIED MEDICAL SECTOR
CERTIFIED HOSPITAL 21
CERTIFIED HEALTH CENTER 22
OTHER PRIVATE MEDICAL___________26
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31
PRIVATE HEALTH CARE CENTER 32
PHARMACY 33
PRIVATE DOCTOR'S OFFICE 34
OTHER PRIVATE MEDICAL________36
OTHER SOURCE
SHOP 41
FRIENDS/RELATIVES 42
OTHER_________96

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Congo (Democratic Republic) 2007
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548) Where did you get the condom last time?

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) ______________
PUBLIC SECTOR
HOSPITAL 11
HEALTH CENTER 12
HEALTH OUTPOST 13
FAMILY PLANNING CLINIC 14
COMMUNITY WORKER 15
OTHER PUBLIC (SPECIFY) _____ 16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/DOCTOR 21
PHARMACY 22
AMO-CONGO 23
HEALTH AGENT 24
OTHER PRIVATE MEDICAL (SPECIFY) ____ 26
OTHER SOURCE
SHOP 31
BAR/NIGHTCLUB 32
KIOSK 33
TABLIER 34
FRIENDS/ACQUAINTANCES/RELATIVES 35
HOTEL/MOTEL 26
PARTNER HAD CONDOM 41
OTHER (SPECIFY) _____ 96
DON'T KNOW 98

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Ethiopia 2016
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730. From where did you obtain the condom the last time?

PROBE TO IDENTIFY TYPE OF SOURCE.

IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

NAME OF PLACE ___
PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
GOVERNMENT HEALTH POST 13
PUBLIC PHARMACY 14
OTHER PUBLIC SECTOR (SPECIFY) 16
NGO
HEALTH FACILITY 21
OTHER NGO MEDICAL SECTOR (SPECIFY) 26
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL 31
PRIVATE CLINIC 32
PRIVATE PHARMACY 33
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) 36
OTHER SOURCE
SHOP 41
BAR/HOTEL/GROCERY 42
FRIEND/RELATIVE 43
OTHER (SPECIFY) 96
DON'T KNOW 98

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Guinea 2018
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Malawi 2016
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730. From where did you obtain the condom the last time?

PROBE TO IDENTIFY TYPE OF SOURCE.

IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

NAME OF PLACE ___
PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
GOVERNMENT HEALTH POST/OUTREACH 13
MOBILE CLINIC 14
HSA 15
CBDA/DOOR TO DOOR 16
OTHER PUBLIC SECTOR (SPECIFY) 17
CHAM/MISSION
HOSPITAL 21
HEALTH CENTER 22
MOBILE CLINIC 23
CBDA/DOOR TO DOOR 24
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL OR CLINIC 31
PHARMACY 32
PRIVATE DOCTOR 33
MOBILE CLINIC 34
CBDA/DOOR TO DOOR 34
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) 36
BLM 41
MACRO 51
YOUTH DROP IN CENTRE 61
OTHER SOURCE
SHOP 71
CHURCH 72
FRIEND OR RELATIVE 73
CONDOMISED CAMPAIGNS 74
OTHER (SPECIFY) 96
DON'T KNOW 98

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Nepal 2016
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730. From where did you obtain the condom the last time? PROBE TO IDENTIFY TYPE OF SOURCE. IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

NAME OF PLACE ___
PUBLIC SECTOR
GOVERNMENT HOSPITAL/CLINIC 11
PRIMARY HEALTH CARE CENTER 12
HEALTH POST/SUB-HEALTH POST 13
PHC OUTREACH CLINIC 14
MOBILE CAMP 15
FCHV 16
OTHER PUBLIC FACILITIES (SPECIFY) __ 17
NON-GOVT. (NGO) SECTOR
FPAN 21
MARIE STOPES 22
OTHER NGO FACILITIES (SPECIFY) ___ 26
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/NURSING HOME 31
PRIVATE CLINIC 32
PHARMACY 33
SANGINI OUTLET 34
OTHER PRIVATE MEDICAL FACILITIES (SPECIFY) __ 36
OTHER SOURCE
SHOP 41
FRIEND/RELATIVE 42
OTHER (SPECIFY) ___ 96
DON'T KNOW 98

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Nigeria 2018
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730. From where did you obtain the condom the last time?

PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
FAMILY PLANNING CLINIC 13
MOBILE CLINIC 14
FIELDWORKER 15
OTHER PUBLIC SECTOR _____ 16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
PHARMACY 22
CHEMIST/PMS 23
PRIVATE DOCTOR 24
MOBILE CLINIC 25
FIELDWORKER 26
OTHER PRIVATE MEDICAL SECTOR _____ 27
OTHER SOURCE
SHOP 31
CHURCH 32
FRIEND/RELATIVE 33
NGO 34
OTHER _____ 96
DON'T KNOW 96

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Senegal 2017
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325) Where did you obtain (CURRENT METHOD) the last time?
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) _____
PUBLIC SECTOR
GOVERNMENT HOSPITAL 11 (GO TO 327)
GOVERNMENT HEALTH CENTER 12 (GO TO 327)
HEALTH POST 13 (GO TO 327)
GOVERNMENT FAMILY PLANNING CENTER 14 (GO TO 327)
RURAL MATERNITY 15 (GO TO 327)
HEALTH HUT 16 (GO TO 327)
COMMUNITY PHARMACY 17 (GO TO 327)
MOBILE CLINIC 18 (GO TO 327)
OTHER PUBLIC SECTOR (SPECIFY) ____ 19 (GO TO 327)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/OFFICE 21/22 (GO TO 327)
PHARMACY 23 (GO TO 327)
PRIVATE DOCTOR 24 (GO TO 327)
RELIGIOUS FREE CLINIC 25 (GO TO 327)
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) ____ 26 (GO TO 327)
OTHER SOURCE
SHOP 31 (GO TO 327)
CHURCH 32 (GO TO 327)
FRIENDS/RELATIVES 33 (GO TO 327)
BAR 34 (GO TO 327)
OTHER (SPECIFY) _____ 96 (GO TO 327)

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Tanzania 2015
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730) From where did you obtain the condom the last time? PROBE TO IDENTIFY TYPE OF SOURCE. IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE) _____
GOVERNMENT/PARASTATAL
ZON/REFERRAL/SPEC. HOSPITAL 11
REFERRAL REGIONAL HOSPITAL 12
REGIONAL HOSPITAL 13
DISTRICT HOSPITAL 14
HEALTH CENTRE 15
DISPENSARY 16
CLINIC 17
CHW 18
RELIGIOUS/VOLUNTARY
REFERRAL SPEC. HOSPITAL 21
DISTRICT HOSPITAL 22
HOSPITAL 23
HEALTH CENTRE 24
DISPENSARY 25
CLINIC 26
PRIVATE
SPECIALISED HOSPITAL 31
HOSPITAL 32
HEALTH CENTRE 33
DISPENSARY 34
CLINIC 35
OTHER
PHARMACY 41
ADDO 42
NGO 43
VCT CENTRE 44
SHOP/KIOSK 45
BAR 46
GUEST HOUSE/HOTEL 47
FRIEND/RELATIVE/NEIGHBOR 48
OTHER (SPECIFY) 96
DON'T KNOW 98

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Uganda 2016
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730) From where did you obtain the condom the last time?

PROBE TO IDENTIFY TYPE OF SOURCE.

IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

NAME OF PLACE _______

PUBLIC SECTOR
GOVERNMENT HOSPITAL11
GOVERNMENT HEALTH CENTER12
FAMILY PLANNING CLINIC 13
OUTREACH/MOBILE CLINIC 14
FIELDWORKER/VHT 15
OTHER PUBLIC SECTOR (SPECIFY) ______16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
PHARMACY/DRUG SHOP 22
PRIVATE DOCTOR 23
MOBILE CLINIC 24
COMMUNITY HEALTH WORKER 25
OTHER PRIVATE MEDICAL SECOR (SPECIFY) ____26
OTHER SOURCE
SHOP 31
CHURCH 32
FRIEND/RELATIVE 33
STREET VENDOR 34
LODGE 35
OTHER (SPECIFY) _____96

DONT'T KNOW 98

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Zambia 2018
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(730) From where did you obtain the condom the last time?
PROBE TO IDENTIFY TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE) ____________________


PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
GOVERNMENT HEALTH POST 13
MOBILE CLINIC/HOSPITAL 14
AGENT/FIELDWORKER 15
OTHER PUBLIC SECTOR (SPECIFY) ____________________ 16

PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
MISSION HOSPITAL/CLINIC 22
PHARMACY 23
PRIVATE DOCTOR 24
MOBILE HOSPITAL/CLINIC 25
COMMUNITY BASED AGENT/FIELDWORKER 26
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) ____________________ 27

OTHER SOURCE
SHOP 31
CHURCH 32
FRIEND/RELATIVE 33
OTHER (SPECIFY) ____________________ 96
DON'T KNOW 98

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Zimbabwe 2015
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729. You told me that a condom was used the last time you had sex. What is the brand name of the condom used at that time?

IF BRAND NOT KNOWN, ASK TO SEE THE PACKAGE.

PROTECTOR PLUS 01
PANTHER (PUBLIC SECTOR) 02
CAREX CHOICE ASSORTED 03
DUREX 04
VIBE 05
ECSTASY 06
CASANOVA 07
MOODS 08
OTHER (SPECIFY) 96
DON'T KNOW 98