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Angola 2015

Survey form view entire document: text

446) Where did the check take place?
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)____

HOME

YOUR HOME 11
OTHER HOME 12

PUBLIC SECTOR

CENTRAL HOSPITAL 21
HOSPITAL IN PROVINCE 22
HOSPITAL IN RURAL AREA 23
HEALTH CENTER/POST 24
MATERNITY WARD 25
OTHER PUBLIC SECTOR: (SPECIFY)____ 26

PRIVATE MEDICAL SECTOR

PRIVATE CLINIC/HOSPITAL 31
HEALTH CENTER 32
HEALTH POST 33
OTHER PRIVATE MEDICAL SECTOR: (SPECIFY)____36

OTHER: (SPECIFY)___96

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Bangladesh 2007

Survey form view entire document: text

435) Where did the first check take place?
PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE. 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

OWN HOME 01
OTHER HOME 02

PUBLIC SECTOR

GOVERNMENT HOSPITAL MEDICAL/COLLE 11
FAMILY WELFARE CENTER 12
UPAZILA HEALTH COMPLEX 13
SATELLITE CLINIC EPI OUTRICH SITE 14
MATERNAL AND CHILD WELFARE CENTER 15
COMMUNITY CLINIC 16
OTHER (SPECIFY)____ 17

NGO SECTOR

NGO STATIC CLINIC 21
NGO SATELLITE CLINIC 22
OTHER (SPECIFY)____ 26

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL/CLINIC 31
QUALIFIED DOCTOR 32
TRADITIONAL DOCTOR 33
PHARMACY 34
OTHER (SPECIFY)____ 36

OTHER (SPECIFY)____ 96

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Benin 2006

Survey form view entire document: text

432) Where did this first check take place?
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 11
OTHER HOME 12

PUBLIC SECTOR

GOVERNMENT HOSPITAL 21
GOVERNMENT HEALTH CENTER 22
STAND-ALONE MATERNITY WARD 23
VILLAGE UNIT 24
OTHER PUBLIC (SPECIFY) _________ 26

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL/CLINIC 31
RELIGIOUS HOSPITAL 32
OTHER PRIVATE MEDICAL (SPECIFY) __________ 36

OTHER (SPECIFY) ________ 96

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Benin 2017

Survey form view entire document: text

444) Where did this first check of (name) take place?
Probe to identity the type of source and circle the appropriate code.
If unable to determine if public or private sector, write the name of the place.
(Name of place(s))

Home

Her home 11
Other home 12

Public sector

Govt. Hospital 21
Govt. Health Center 22
Maternity 23
Village unit 24

Other public sector (specify) 26

Private medical sector

Private hospital/clinic 31
Religious hospital 32
Other private medical (specify) 36

Other (specify) 96

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Burundi 2016

Survey form view entire document: text

444) Where did this first check of (NAME) take place?

PROBE TO IDENTITY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE. IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE(S))_________________________

HOME

YOUR HOME 11
OTHER HOME 12

PUBLIC SECTOR

NATIONAL GOVERNMENT HOSPITAL 21
REGIONAL GOVERNMENT HOSPITAL 22
DISTRICT HOSPITAL 23
GOVERNMENT HEALTH CENTER 24
OTHER______________26

CERTIFIED MEDICAL SECTOR

CERTIFIED HOSPITAL 31
CERTIFIED HEALTH CENTER 32
OTHER PRIVATE MEDICAL___________J

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL/CLINIC 41
PRIVATE HEALTH CARE CENTER 42
OTHER PRIVATE MEDICAL___________46

OTHER__________96

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Cameroon 2018

Survey form view entire document: text

444. Where did the check take place?
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 11
OTHER HOME 12

PUBLIC MEDICAL SECTOR

GOVERNMENT HOSPITAL 21
INTEGRATED HEALTH CENTER / DISPENSARY 22
SUB-DIVISIONAL MEDICAL CENTER 23
OTHER PUBLIC SECTOR (SPECIFY)_________26

PRIVATE MEDICAL SECTOR

CONFESSIONAL HOSPITAL / CLINIC 31
PRIVATE LAY HOSPITAL / CLINIC 32
CONFESSIONAL HEALTH CENTER / DISPENSARY 33
DOCTOR'S OFFICE 34
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)_________36
OTHER (SPECIFY)_________96

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Egypt 2008

Survey form view entire document: text

558. Where did this first check take place? 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.
[LAST BIRTH ONLY]

(NAME OF PLACE) _________________

HOME

YOUR HOME 11
OTHER HOME 12

GOVERNMENT

URBAN HOSPITAL (GNRL/DSTRCT) 21
URBAN HEALTH UNIT 22
HEALTH OFFICE 23
RURAL HOSPITAL (COMPL'TARY) 24
RURAL HEALTH UNIT 25
MCH CENTER 26
OTHER GOV'T (SPECIFY) ________ 27

NONGOVERNMENTAL

EGYPTIAN FP ASSOC 31
CSI PROJECT 32
OTHER NGO (SPECIFY) ________ 36

PRIVATE MEDICAL

PVT. HOSPITAL/CLINIC 41
PVT. DOCTOR 42
OTHER PVT. MED.(SPECIFY) __________ 46

OTHER NON-MEDICAL (SPECIFY) _________ 96

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Eswatini (Swaziland) 2006

Survey form view entire document: text

444) Where did this first check take place?
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 11
OTHER HOME 12

PUBLIC SECTOR

GOVERNMENT HOSPITAL 21
GOVERNMENT HEALTH CENTER 22
PHU/CLINIC 23
OTHER PUBLIC (SPECIFY)______26

PRIVATE SECTOR

PRIVATE. HOSPITAL/CLINIC 31
OTHER PRIVATE (SPECIFY)_________36

MISSION

HOSPITAL 41
CLINIC 42
OTHER MISSION (SPECIFY)________46

NGO

FLAS 51
OTHER NGO (SPECIFY)_________56
OTHER (SPECIFY)_______96

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Ethiopia 2016

Survey form view entire document: text

444. Where did the check take place?

PROBE TO IDENTIFY THE TYPE OF SOURCE.

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

NAME OF PLACE ___

HOME

HER HOME 11
OTHER HOME 12

PUBLIC SECTOR

GOVERNMENT HOSPITAL 21
GOVERNMENT HEALTH STATION 22
GOVERNMENT HEALTH POST 23
OTHER PUBLIC SECTOR (SPECIFY) 26

NGO

HEALTH FACILITY 31
OTHER NGO MEDICAL HEALTH FACILITY (SPECIFY) 36

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL 41
PRIVATE CLINIC 42
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) 43

OTHER (SPECIFY) 96

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Ethiopia 2019

Survey form view entire document: text

444. Where did the check take place?

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 11
OTHER HOME 12

PUBLIC SECTOR

GOVERNMENT HOSPITAL 21
GOVERNMENT HEALTH CENTER 23
GOVERNMENT HEALTH POST 23
OTHER PUBLIC SECTOR (SPECIFY) ___ 26

NGO

HEALTH FACILITY 31
OTHER NGO HEALTH FACILITY 36

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL 41
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) ___ 46
OTHER (SPECIFY) ___ 96

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Ghana 2008

Survey form view entire document: text

447. Where did this first check take place?

PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
IF UNABLE TO DETERMINE IF A HOSPITAL, HEALTH CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.
[Most recent birth within the last five years]

(NAME OF PLACE) __________________

HOME

YOUR HOME 11
OTHER HOME 12

PUBLIC SECTOR

GOVT. HOPSITAL/POLYCLINIC 21
GOVT. HEALTH CENTER 22
GOVT. HEALTH POST/CHPS 23
OTHER PUBLIC (SPECIFY) ____ 26

PRIVATE MED. SECTOR

PVT. HOSPITAL/CLINIC 31
MOBILE CLINIC 32
FP/PPAG CLINIC 33
MATERNITY HOME 34
OTHER PRIVATED MED. (SPECIFY) _____ 36

OTHER (SPECIFY) ______ 96

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Guinea 2018

Survey form view entire document: text

444) Where did this first check of (NAME) take place?
PROBE TO IDENTITY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE(S))___

HOME

HER HOME 11
OTHER HOME 12

PUBLIC SECTOR

NATIONAL HOSPITAL 21
REGIONAL HOSPITAL 22
PREFECTURAL HOSPITAL/COMMUNAL HEALTH CENTER 23
HEALTH CENTER 24
HEALTH POST 25
OTHER PUBLIC SECTOR (SPECIFY) 26

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL/CLINIC 31
FAMILY PLANNING CLINIC/GUINEAN ASSOCIATION FOR FAMILY WELL-BEING 32
PRIVATE MIDWIFE'S CLINIC 33

OTHER PRIVATE MEDICAL (SPECIFY) 36

OTHER (SPECIFY) 96

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India 2005

Survey form view entire document: text

447 Where did this first check take place? (2)
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 11
OTHER HOME 12

PUBLIC SECTOR

GOVT. HOSPITAL 21
GOVT. HEALTH CENTER 22
GOVT. HEALTH POST 23
OTHER PUBLIC (SPECIFY) __________ 26

PRIVATE MED. SECTOR

PVT. HOSPITAL/CLINIC 31
OTHER PRIVATE MED. (SPECIFY) ______ 36

OTHER (SPECIFY) _________ 96

top

India 2015

Survey form view entire document: text

469. Where did this first check take place?
[ASK FOR MOST RECENT BIRTH ONLY]

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

(NAME OF FACILITY/PLACE)______________

HOME

YOUR HOME 11
PARENTS' HOME 12
OTHER HOME 13
PUBLIC HEALTH SECTOR
GOVERNMENT/MUNICIPAL HOSPITAL 21
GOVERNMENT DISPENSARY 22
UHC/UHP/UFWC 23
CHC/RURAL HOSPITAL/BLOCK PHC 24
PHC/ADDITIONAL PHC 25
SUB-CENTRE 26
ANGANWADI/ICDS CENTRE 27
OTHER PUBLIC SECTOR HEALTH FACILITY 28

NGO/TRUST HOSP./CLINIC 31

PRIVATE HEALTH SECTOR

PRIVATE HOSPITAL/MATERNITY HOME/CLINIC 41
OTHER PRIVATE SECTOR HEALTH FACILITY 42

OTHER (SPECIFY) ______96

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Jordan 2007

Survey form view entire document: text

441) Where did this (first) check take place? (ASK ONLY FOR MOST RECENT BIRTH IN THE LAST FIVE YEARS)

PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.

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 11
OTHER HOME 12

PUBLIC MEDICAL SECTOR

GOVERNMENT HOSPITAL 21
GOVERNMENT HEALTH CENTER 22
GOVERNMENT MOTHER CHILD HEALTH CENTER 23
UNIVERSITY HOSPITAL 24
ROYAL MEDICAL SERVICES 25
OTHER PUBLIC (SPECIFY)_________ 26

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL/CLINIC 31
UNITED NATIONS RELIEF AND WORKS AGENCY HEALTH CENTER 32
OTHER PRIVATE MEDICAL (SPECIFY) __________ 36

OTHER (SPECIFY)__________ 96

top

Jordan 2017

Survey form view entire document: text

444) Where did the check take place?
PROBE TO IDENTIFY THE TYPE OF SOURSE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE) _____________

HOME

HER HOME 11
OTHER HOME 12

PUBLIC MED. SECTOR

GOVT. HOSPITAL 21
GOVT. HEALTH CENTER 22
GOVT. MCH 23
UNIVERSITY HOSPITAL 23
ROYAL MED. SERVICES 24
OTHER PUBLIC (SPECIFY) _____________ 26

PRIVATE MED. SECTOR

PVT. HOSPITAL/CLINIC 31
PRIVATE DOCTOR 32
UNRWA HEALTH CENTER 33
UNHCR OTHER NGO 34
OTHER PRIVATE (SPECIFY) ______________ 36

OTHER (SPECIFY) ____________ 96

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Kenya 2008

Survey form view entire document: text

447. Where did this first check take place?
PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.

IF UNABLE TO DETERMINE IF A HOSPITAL, HEALTH CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.
[Most recent birth within the last five years]

(NAME OF PLACE) __________________

HOME

YOUR HOME 11
OTHER HOME 12

PUBLIC SECTOR

GOVT. HOSPITAL 21
GOVT. HEALTH CENTER 22
GOVT. DISPENSARY 23
OTHER PUBLIC (SPECIFY) __________ 26

PRIVATE MED. SECTOR

MISSION HOSPITAL/CLINIC 31
PVT. HOSPITAL/CLINIC 33
NURSING/MATERNITY HOME 35
OTHER PRIVATE MED. (SPECIFY) ___________ 36

OTHER (SPECIFY) ___________ 96

top

Lesotho 2009

Survey form view entire document: text

447 Where did this first check take place?
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

YOUR HOME 11
OTHER HOME 12

PUBLIC SECTOR

GOVT. HOSPITAL 21
GOVT. HEALTH CENTER 22
GOVT. HEALTH POST 23
OTHER PUBLIC SECTOR 26

PRIVATE MEDICAL SECTOR

PVT. HOSPITAL/CLINIC 31
OTHER PVTIVATE MEDICAL SECTOR 36

CHAL

CHAL HOSPITAL 41
CHAL HEALTH CENTER 42
CHAL HEALTH POST 46

OTHER 96

top

Liberia 2007

Survey form view entire document: text

447 Where did this first check take place? (2)
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 11
OTHER HOME 12

PUBLIC SECTOR

GOVT. HOSPITAL 21
GOVT. HEALTH CENTER 22
GOVT. HEALTH POST 23
OTHER PUBLIC (SPECIFY) __________ 26

PRIVATE MED. SECTOR

PVT. HOSPITAL/CLINIC 31
OTHER PRIVATE MED. (SPECIFY) ______ 36

OTHER (SPECIFY) _________ 96

top

Madagascar 2008

Survey form view entire document: text

447. Where did this first check take place?
[ASK ONLY FOR MOST RECENT BIRTH]

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

NAME OF PLACE ______

HOME

RESPONDENT'S HOME 11
OTHER HOME 12

PUBLIC SECTOR

GOVERNMENT HOSPITAL 21
BASIC HEALTH CENTER II (basic health care, physician-run) 22
BASIC HEALTH CENTER I (basic health care, run by para-medical officer) 23
OTHER PUBLIC (SPECIFY) _____ 26

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL/CLINIC 31
OTHER PRIVATE MEDICAL (SPECIFY) ______ 36

OTHER (SPECIFY) ______ 96

top

Malawi 2010

Survey form view entire document: text

447. Where did this first check take place?
PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
IF UNABLE TO DETERMINE IF A HOSPITAL, HEALTH CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.
[FOR LAST BIRTH ONLY]

NAME OF PLACE_______________

HOME

YOUR HOME 11
OTHER HOME 12

PUBLIC SECTOR

GOVERNMENT HOSPITAL 21
GOVERNMENT HEALTH CENTER 22
GOVERNMENT HEALTH POST/OUTREACH 23
OTHER PUBLIC 26

CHAM/MISSION

HOSPITAL 31
HEALTH CENTER 32

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL/CLINIC 41
OTHER PRIVATE MEDICAL 46

BLM 51
OTHER 96

top

Malawi 2016

Survey form view entire document: text

444. Where did the check take place?

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 11
OTHER HOME 12

PUBLIC SECTOR

GOVERNMENT HOSPITAL 21
GOVERNMENT HEALTH CENTER 22
GOVERNMENT HEALTH POST/OUTREACH 23
OTHER PUBLIC SECTOR (SPECIFY) 26

CHAM/MISSION

HOSPITAL 31
HEALTH CENTER 32

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL OR CLINIC 41
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) 46

BLM 51
OTHER (SPECIFY) 96

top

Mali 2018

Survey form view entire document: text

444) Where did this first check of (NAME) take place?
PROBE TO IDENTITY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.
(NAME OF PLACE(S))

HOME

HER HOME 11
OTHER HOME 12

PUBLIC SECTOR

NATIONAL HOSPITAL 21
REGIONAL HOSPITAL 22
REFERENCE HEALTH CENTER 23
COMMUNITY HEALTH CENTER 24
DISPENSARY/MATERNITY 25
OTHER PUBLIC SECTOR (SPECIFY) 26

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL/CLINIC 31
DOCTOR'S OFFICE 32
PRIVATE HEALTH CLINIC 36
HEALTH POSTS 34
OTHER PRIVATE MEDICAL (SPECIFY) 36

OTHER (SPECIFY) 96

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Namibia 2006

Survey form view entire document: text

447. Where did this first check take place?
PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE. IF UNABLE TO DETERMINE IF A HOSPITAL, HEALTH CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE THE NAME OF THE PLACE.
[LAST BIRTH ONLY]

(NAME OF PLACE) _____

LAST BIRTH ONLY:
HOME

YOUR HOME 11
OTHER HOME 12

PUBLIC SECTOR

GOVT. HOSPITAL 21
GOVT. HEALTH CENTER/CLINIC 22
OTHER PUBLIC (SPECIFY) ____ 26

PRIVATE MED. SECTOR

PVT. HOSPITAL/CLINIC 31
OTHER PRIVATED MED. (SPECIFY) ____ 36
OTHER (SPECIFY) ____ 96

top

Nepal 2006

Survey form view entire document: text

436. Where did this first check take place?
PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
IF UNABLE TO DETERMINE IF A HOSPITAL, HEALTH CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE NAME OF THE PLACE.

NAME OF PLACE ____

HOME

YOUR HOME 11
OTHER HOME 12

GOVT. SECTOR

GOVT. HOSPITAL 21
PHC CENTER 22
HEALTH POST 23
SUB-HEALTH 24
PHC OUTREACH 25
OTHER GOVT. (SPECIFY) ___ 26

NON-GOVT. SECTOR

UMN/RED CROSS 31
OTHER GOVT. (SPECIFY) __ 36

PRIVATE MED. SECTOR

PVT. HOSPITAL/CLINIC 41
OTHER PRIVATE MED (SPECIFY) ___ 46

OTHER (SPECIFY) ___ 96

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Nepal 2016

Survey form view entire document: text

452. Where did this first check take place? PROBE TO IDENTIFY THE TYPE OF SOURCE. IF UNABLE TO DETERMINE IF PUBLIC OR PRIAVE SECTOR. WRITE THE NAME OF THE PLACE.

NAME OF PLACE __

HOME

HER HOME 11
OTHER HOME 12

PUBLIC SECTOR

GOVT. HOSPITAL/CLINIC 21
PHC CENTER 22
HEALTH POST/SUB-HEALTH POST 23
PHC OUTREACH CLINIC 24
OTHER PUBLIC FACILITIES (SPECIFY) ___ 26

NON-GOVT. (NGO)

FPAN 31
MARIE STOPES 32
OTHER NGO FACILITIES (SPECIFY) ___ 36

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL/NURSING HOME 41
PRIVATE CLINIC 42
OTHER PRIVATE MEDICAL FACILITIES (SPECIFY) ___ 46

OTHER (SPECIFY) ___ 96

top

Nigeria 2008

Survey form view entire document: text

447. Where did this first check take place?
PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
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 11
OTHER HOME 12

PUBLIC SECTOR

GOVERNMENT HOSPITAL 21
GOVERNMENT HEALTH CENTER 22
GOVERNMENT HEALTH POST/DISPENSARY 23
OTHER PUBLIC (SPECIFY) ____________ 26

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL/CLINIC 31
OTHER PRIVATE MED. (SPECIFY) _____________ 36

OTHER (SPECIFY) _____________ 96

top

Nigeria 2018

Survey form view entire document: text

444. Where did the check take place?

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 11
OTHER HOME 12

PUBLIC SECTOR

GOVERNMENT HOSPITAL 21
GOVERNMENT HEALTH CENTER 22
GOVERNMENT HEALH POST 23
OTHER PUBLIC CENTER ______ 26

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL/CLINIC 31
OTHER PRIVATE MEDICAL SECTOR _____ 36
OTHER _____ 96

top

Pakistan 2006

Survey form view entire document: text

467) Where did this first check take place?
IF SOURCE IS A HOSPITAL, HEALTH CENTER, OR CLINIC, RECORD THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE

HOME

YOUR HOME 11
OTHER HOME 12

PUBLIC SECTOR

GOVT. HOSPITAL 21
RHC/MCH 22
BHU/FWC 23
OTHER PUBLIC (SPECIFY) ___ 26

PRIVATE MED. SECTOR

PVT. HOSPITAL/CLINIC 31
OTHER PRIVATE MED. (SPECIFY)__ 36

OTHER (SPECIFY) ___ 96

top

Pakistan 2017

Survey form view entire document: text

444) Where did the check take place?
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 11
OTHER HOME 12

PUBLIC SECTOR

GOVERNMENT HOSPITAL 21
RHC/MC 22
BHU 23
CMW 24
OTHER PUBLIC SECTOR (SPECIFY) ______ 26

PRIVATE MEDICAL CENTER

PRIVATE HOSPITAL/CLINIC 31

OTHER PRIVATE MEDICAL CENTER (SPECIFY) ________ 36

OTHER (SPECIFY) _______ 96

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Senegal 2017

Survey form view entire document: text

444) Where did the exam take place?

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)) _____

HOME

HER HOME 11
OTHER HOME 12

PUBLIC SECTOR

GOVERNMENT HOSPITAL 21
GOVERNMENT HEALTH CENTER/MATERNITY 22
GOVERNMENT HEALTH POST 23
OTHER PUBLIC SECTOR (SPECIFY) _____ 26

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL/CLINIC 31
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) _____ 36

OTHER (SPECIFY) ____ 96

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South Africa 2016

Survey form view entire document: text

444) Where did the check take place?
PROBE TO IDENTIFY THE TYPE OF SOURCE. IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, RECORD 96 AND WRITE THE NAME OF THE PLACE.

HOME

HER HOME 11
OTHER HOME 12

PUBLIC SECTOR

GOVERNMENT HOSPITAL 21
GOVERNMENT CLINIC/COMMUNITY HEALTH CENTRE 22
MOBILE CLINIC 23
OTHER PUBLIC SECTOR (SPECIFY) ________ 26

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL/DOCTOR 31
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) ________ 36

OTHER (SPECIFY) ____ 96

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Tanzania 2010

Survey form view entire document: text

447. Where did this first check take place?
PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
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 11
OTHER HOME 12

GOV.PARASTATAL

REFERAL/SPEC. 21
HOSPITAL REGIONAL HOSP. 22
DISTRICT HOSP. 23
HEALTH CENT. 24
DISPENSARY 25
VILLAGE HEALTH POST 26
CBD WORKER 27

RELIGIOUS/VOLUNTARY

REFERRAL/SPEC. HOSPITAL 31
DISTRICT HOSP 32
HEALTH CENT 33
DISPENSARY 34

PRIVATE

SPECIALISED HOSPITAL 41
HEALTH CENT 42
DISPENSARY 43

OTHER (SPECIFY) __________ 96

top

Tanzania 2015

Survey form view entire document: text

444) Where did the check take place? 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 11
OTHER HOME 12
TBA PREMISES 13

GOVERNMENT/PARASTATAL

ZONAL/REFERRAL/SPEC. HOSP. 21
REFERRAL REGIONAL HOSP. 22
REGIONAL HOSPITAL 23
DISTRICT HOSPITAL 24
HEALTH CENTRE 25
DISPENSARY 26
CLINIC 27

RELIGIOUS/VOLUNTARY

REFERRAL/SPEC. HOSPITAL 31
DISTRICT HOSPITAL 32
HOSPITAL 33
HEALTH CENTRE 34
DISPENSARY 35
CLINIC 36

PRIVATE

SPECIALISED HOSPITAL 41
HOSPITAL 42
HEALTH CENTRE 43
DISPENSARY 44
CLINIC 45

OTHER (SPECIFY) 96

top

Uganda 2006

Survey form view entire document: text

447. Where did this first check take place?

PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
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___

HOME

YOUR HOME 11
TBA'S HOME 12
OTHER HOME 13

PUBLIC SECTOR

GOVERNMENT HOSPITAL 21
GOVERNMENT HEALTH CENTER 22
GOVERNMENT HEALTH POST 23
OTHER PUBLIC (SPECIFY) 26

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL/CLINIC 31
OTHER PRIVATE MEDICAL (SPECIFY) 36

OTHER (SPECIFY) 96

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Uganda 2016

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444) Where did the check take place?

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 11
OTHER HOME 12

PUBLIC SECTOR

GOVERNMEN HOSPITAL 21
GOVERNMENT HEALTH CENTER 22
OTHER PUBLIC SECTOR (SPECIFY) _______26

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL CLINIC 31
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) ________36

OTHER (SPECIFY)_______96

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Zambia 2007

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447. Where did this first check take place?
PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
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 11
OTHER HOME 12

PUBLIC SECTOR

GOVT. HOSPITAL 21
GOVT. HEALTH CENTER 22
GOVT. HEALTH POST 23
OTHER PUBLIC (SPECIFY) ____________ 26

PRIVATE MED. SECTOR

PVT. HOSPITAL/CLINIC 31
MISSION HOSPITAL/CLINIC 32
OTHER PRIVATE MED. (SPECIFY) _____________ 36

OTHER (SPECIFY) _____________ 96

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Zambia 2018

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(444) Where did the check take place?
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 11
OTHER HOME 12

PUBLIC SECTOR

GOVERNMENT HOSPITAL 21
GOVERNMENT HEALTH CENTER 22
GOVERNMENT HEALTH POST 23
OTHER PUBLIC SECTOR (SPECIFY) ____________________ 26

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Zimbabwe 2005

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448) Where did this first check of (NAME) take place?

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 11
OTHER HOME 12

PUBLIC SECTOR

CENTRAL HOSPITAL 21
PROVINCIAL HOSPITAL 22
DISTRICT/RURAL HOSPITAL 23
RURAL/MUNICIPAL CLINIC 24
RURAL HEALTH CENTER 25
OTHER PUBLIC (SPECIFY) __________ 26

MISSION FACILITY 31

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL/CLINIC 41
OTHER PRIVATE (SPECIFY) __________ 42

OTHER (SPECIFY) __________ 96

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Zimbabwe 2015

Survey form view entire document: text

452. Where did this first check take place?

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 11 (GO TO 449)
OTHER HOME 12 (GO TO 449)

PUBLIC SECTOR

CENTRAL HOSPITAL 21
PROVINCIAL HOSPITAL 22
DISTRICT HOSPITAL 23
RURAL HOSPITAL 24
URBAN MUNICIPAL CLINIC 25
RURAL HEALTH CENTRE 26
OTHER PUBLIC SECTOR (SPECIFY) 27

MISSION HOSPITAL/CLINIC 31

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL/CLINIC 41
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) 46

OTHER (SPECIFY) 96

Angola 2015	Ghana 2008	Malawi 2010	Senegal 2017
Bangladesh 2007	Guinea 2018	Malawi 2016	South Africa 2016
Benin 2006	India 2005	Mali 2018	Tanzania 2010
Benin 2017	India 2015	Namibia 2006	Tanzania 2015
Burundi 2016	Jordan 2007	Nepal 2006	Uganda 2006
Cameroon 2018	Jordan 2017	Nepal 2016	Uganda 2016
Egypt 2008	Kenya 2008	Nigeria 2008	Zambia 2007
Eswatini (Swaziland) 2006	Lesotho 2009	Nigeria 2018	Zambia 2018
Ethiopia 2016	Liberia 2007	Pakistan 2006	Zimbabwe 2005
Ethiopia 2019	Madagascar 2008	Pakistan 2017	Zimbabwe 2015

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