Survey Text

Afghanistan 2015 Egypt 2005 Kenya 2008 Rwanda 2005
Bangladesh 1994 Egypt 2008 Madagascar 1992 Senegal 1992
Bangladesh 1997 Egypt 2014 Madagascar 1997 Senegal 1997
Bangladesh 2000 Ethiopia 2000 Malawi 1992 Senegal 2005
Bangladesh 2004 Ethiopia 2016 Malawi 2004 Senegal 2010
Benin 1996 Ghana 1993 Mali 1995 Senegal 2017
Benin 2001 Ghana 1998 Mali 2006 South Africa 1998
Burkina Faso 1993 Ghana 2003 Morocco 1992 Tanzania 1991
Burkina Faso 1998 Ghana 2008 Morocco 2003 Tanzania 1996
Burundi 2010 Guinea 1999 Mozambique 1997 Tanzania 1999
Burundi 2016 Guinea 2005 Mozambique 2011 Tanzania 2015
Cameroon 1991 Guinea 2012 Namibia 1992 Togo 2013
Cameroon 1998 Guinea 2018 Nepal 1996 Uganda 1995
Cameroon 2018 India 1992 Niger 1992 Uganda 2016
Central African Republic 1995 India 1998 Niger 1998 Yemen 2013
Congo (Democratic Republic) 2007 Jordan 1990 Niger 2006 Zambia 1992
Cote d'Ivoire 1994 Jordan 1997 Nigeria 1990 Zambia 1996
Cote d'Ivoire 1998 Jordan 2002 Nigeria 1999 Zambia 2007
Egypt 1992 Jordan 2017 Nigeria 2008 Zambia 2018
Egypt 1995 Kenya 1993 Nigeria 2018 Zimbabwe 1994
Egypt 2000 Kenya 1998 Pakistan 1991 Zimbabwe 1999
Egypt 2003 Kenya 2003 Rwanda 2000 Zimbabwe 2015
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Afghanistan 2015
Survey form view entire document:  text 
315. You first started using (CURRENT METHOD) in (DATE FROM 308/308A). Where did you get it that 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 (NATIONAL, REGIONAL, PROVINCIAL OR DISTRICT) 11
CHC/POLYCLINIC 12
BASIC HEALTH CENTER 13
HEALTH SUB-CENTER 14
HEALTH POST/SUB-HEALTH POST 15
COMMUNITY HEALTH WORKER 16
MOBILE CLINIC 17
OTHER PUBLIC SECTOR__________18
NON-GOVERNMENT SECTOR
MARIE STOPES 21
RED CROSS SOCIETY 22
AFGA 23
OTHER NGO SECTOR_________26
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31
PHARMACY 32
PRIVATE DOCTOR 33
FIELDWORKER 34
OTHER PRIVATE MEDICAL SECTOR_____________36
OTHER SOURCE
CHARITY FOUNDATION 41
REFUGEE CAMP 42
SHOP 43
FRIEND/RELATIVE 44
OTHER__________96

315A. Where did you learn how to use the rhythm/lactational amenorrhea method?

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 (NATIONAL, REGIONAL, PROVINCIAL OR DISTRICT) 11
CHC/POLYCLINIC 12
BASIC HEALTH CENTER 13
HEALTH SUB-CENTER 14
HEALTH POST/SUB-HEALTH POST 15
COMMUNITY HEALTH WORKER 16
MOBILE CLINIC 17
OTHER PUBLIC SECTOR__________18
NON-GOVERNMENT SECTOR
MARIE STOPES 21
RED CROSS SOCIETY 22
AFGA 23
OTHER NGO SECTOR_________26
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31
PHARMACY 32
PRIVATE DOCTOR 33
FIELDWORKER 34
OTHER PRIVATE MEDICAL SECTOR_____________36
OTHER SOURCE
CHARITY FOUNDATION 41
REFUGEE CAMP 42
SHOP 43
FRIEND/RELATIVE 44
OTHER__________96

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Bangladesh 1994
Survey form view entire document:  text 
304. Do you know where a person could go to get (METHOD)?

01. PILL, MAYA: Women can take a pill every day.
YES 1
NO 2
02. IUD, COPPER T: Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2
03. INJECTIONS: Women can have an injection by a doctor or nurse which stops them from becoming pregnant for several months.
YES 1
NO 2
04. CONDOM, RAJA: Men can use a rubber sheath during sexual intercourse.
YES 1
NO 2
05. FEMALE STERILIZATION, TUBAL LIGATION, TL: Have you ever had an operation to avoid having any more children?
YES 1
NO 2
06. MALE STERILIZATION, VASECTOMY: Men can have an operation to avoid having any more children.
YES 1
NO 2
07. SAFE PERIOD, COUNTING DAYS, CALENDAR, RHYTHM METHOD: Do you know where a person can obtain advice on how to use the safe period?
YES 1
NO 2

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Bangladesh 1997
Survey form view entire document:  text 
332. Do you know where you can obtain a method of family planning?

YES 1
NO 2 (GO TO 334)

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Bangladesh 2000
Survey form view entire document:  text 
328. Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2 (GO TO 330)

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Bangladesh 2004
Survey form view entire document:  text 
329. Where is that?

IF WOMAN SAYS MORE THAN ONE PLACE, ASK FOR THE PLACE SHE WOULD MOST LIKELY USE.

NAME OF PLACE ___
PUBLIC SECTOR
HOSPITAL OR MEDICAL COLLEGE 11
FAMILY WELFARE CENTRE (FWC) 12
THANA HEALTH COMPLEX 13
SATELLITE CLINIC OR EPI OUTREACH SITE 14
MATERNAL AND CHILD WELFARE CENTER (MCWC) 15
GOVERNMENT FIELDWORKER 16
COMMUNITY CLINIC 17
NGO SECTOR
NGO STATIC CLINIC 21
NGO SATELLITE CLINIC 22
NGO DEPOT HOLDER 23
NGO FIELDWORKER 24
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL OR CLINIC 31
QUALIFIED DOCTOR 32
TRADITIONAL DOCTOR 33
PHARMACY 34
OTHER PRIVATE SECTOR
SHOP 41
FRIEND OR RELATIVES 42
OTHER (SPECIFY) 96
DON'T KNOW 98

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Benin 1996
Survey form view entire document:  text 
332) Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2 (GO TO 334)

333) Where is this?
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
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
FAMILY PLANNING CLINIC 13
FIELDWORKER 14
COMMUNITY CENTER 15
OTHER PUBLIC (SPECIFY) ______________ 16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
RELIGIOUS HOSPITAL 22
PHARMACY 23
ABPF (BENIN FAMILY ADVOCACY ASSOCIATION) 24
DOCTOR'S OFFICE 25
FIELDWORKER 26
OTHER PRIVATE MEDICAL (SPECIFY) _________________ 27
OTHER SOURCE
SHOP/MARKET 31
CHURCH 32
RELATIVES/FRIENDS 33
GAS STATION 34
OTHER (SPECIFY) _______________ 96

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Benin 2001
Survey form view entire document:  text 
329) Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2 (GO TO 331)

330) Where is this?
330A) Where did you learn to use the lactational amenorrhea method (LAM)? Any other 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.
RECORD ALL MENTIONED.

NAME OF PLACE _____
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
FAMILY PLANNING CLINIC C
FIELDWORKER D
COMMUNITY CENTER E
STRAT AV HEALTH WORKER F
HEALTH WORKER/COMMUNITY LIAISON G
VENDING MACHINE H
OTHER PUBLIC (SPECIFY) ______ I
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC J
RELIGIOUS HOSPITAL K
PHARMACY L
ABPF (BENIN FAMILY ADVOCACY ASSOCIATION) M
DOCTOR'S OFFICE N
HEALTH AGENT (NGO) O
OTHER PRIVATE MEDICAL (SPECIFY) ______ P
OTHER SOURCE
SHOP/MARKET Q
CHURCH/MOSQUE R
RELATIVES/FRIENDS S
OTHER (SPECIFY)_____ X

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Burkina Faso 1993
Survey form view entire document:  text 
333. Where is it?

NAME OF PLACE _______
PUBLIC SECTOR
HOSPITAL 11
MEDICAL CENTER 12
CSPS 13
SMI 14
DISPENSARY/MATERNITY POST 15
PRIMARY HEALTH POST 16
COMMUNITY PHARMACEUTICAL DEPOT 17
PRIVATE MEDICAL SECTOR
PRIVATE DOCTOR'S OFFICE 21
FAMILY PLANNING CLINIC 22
PHARMACY 23
NURSE'S OFFICE 24
OTHER PRIVATE SECTOR
RELATIVE/NEIGHBOR/FRIEND 32 (GO TO 336)
OTHER (SPECIFY) _____ 41 (GO TO 336)
DOESN'T KNOW 98 (GO TO 336)

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Burkina Faso 1998
Survey form view entire document:  text 
332. Do you know of a place where you can get contraception?

YES 1
NO 2 (GO TO 334)

333. Where is it?

IF IT IS A HOSPITAL, MEDICAL CENTER OR CLINIC, WRITE THE NAME OF THE ESTABLISHMENT. PROBE TO DETERMINE THE PROPER TYPE OF SECTOR AND CIRCLE THE APPROPRIATE CODE.

NAME OF PLACE ______
PUBLIC/PARA-PUBLIC SECTOR
HOSPITAL 11
HEALTH CENTER 12
CSPS 13
SMI 14
DISPENSARY/MATERNITY POST 15
COMMUNITY PHARMACEUTICAL DEPOT 16
OTHER PUBLIC (SPECIFY) _____ 17
PRIVATE MEDICAL SECTOR
PRIVATE DOCTOR'S OFFICE 21
FAMILY PLANNING CLINIC 22
PHARMACY 23
NURSE'S OFFICE 24
OTHER PRIVATE (SPECIFY) _____ 27
OTHER SOURCE
STORE/MARKET 31
BAR/NIGHTCLUB 32
KIOSK 33
HOTEL/ROOM FOR RENT 34
INFORMAL RETAIL CIRCUIT 35
FRIENDS/RELATIVES 36
OTHER (SPECIFY) ______ 95
OTHER (SPECIFY) ______ 96

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Burundi 2010
Survey form view entire document:  text 
324) Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2 (GO TO 326)

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Burundi 2016
Survey form view entire document:  text 
326) Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2

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Cameroon 1991
Survey form view entire document:  text 
333) Do you know of a place where one can obtain a method of family planning?

YES 1
NO 2 (G TO 337)

334) Where is that?

NAME OF PLACE: ___
PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
GOVERNMENT HEALTH POST 13
MOBILE CLINIC 14
PRIVATE MEDICAL SECTOR
PRIVATE RELIGIOUS HOSPITAL 21
PRIVATE SECULAR HOSPITAL 22
HEALTH CENTER/RELIGIOUS CLINIC/MISSION 23
PHARMACY 24
OTHER PRIVATE SECTOR
CHURCH 31 (GO TO 337)
ACQUAINTANCES/RELATIVES 32 (GO TO 337)
OTHER (SPECIFY): ___ 41 (GO TO 337)

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Cameroon 1998
Survey form view entire document:  text 
332) Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2 (GO TO 334)

333) Where is that?

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/SEMIPUBLIC SECTOR
HOSPITAL 11
HEALTH CENTER 12
OTHER PUBLIC (SPECIFY): ___ 16
PRIVATE MEDICAL SECTOR
PRIVATE RELIGIOUS HOSPITAL 21
SECULAR HOSPITAL/CLINIC 22
HEALTH CENTER/RELIGIOUS CLINIC/MISSION 23
DOCTOR'S OFFICE 24
PHARMACY 25
OTHER PRIVATE MEDICAL (SPECIFY): ___ 26
OTHER PRIVATE SECTOR
SHOP/MARKET 31
BAR/NIGHTCLUB 32
KIOSK 33
INFORMAL COMMERCIAL DISTRIBUTION 34
RELATIVES/FRIENDS 35
OTHER (SPECIFY): ___ 96

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Cameroon 2018
Survey form view entire document:  text 
307. In what facility did the sterilization take place?
PROBE TO IDENTIFY THE TYPE OF SOURCE. IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
INTEGRATED HEALTH CENTER / DISPENSARY 12
SUB-DIVISIONAL MEDICAL CENTER 13
OTHER PUBLIC SECTOR (SPECIFY)_________ 16
PRIVATE MEDICAL SECTOR
CONFESSIONAL HOSPITAL / CLINIC 21
PRIVATE LAY HOSPITAL / CLINIC 22
CONFESSIONAL HEALTH CENTER / DISPENSARY 23
DOCTOR'S OFFICE 24
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)________ 26
OTHER (SPECIFY)________ 96
DON'T KNOW 98

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Central African Republic 1995
Survey form view entire document:  text 
331) Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2 (GO TO 333)

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Congo (Democratic Republic) 2007
Survey form view entire document:  text 
329) Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2 (GO TO 331)

330) Where is this?

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) __________

Another place?
RECORD ALL MENTIONED.

PUBLIC SECTOR
HOSPITAL A
CLINIC B
HEALTH OUTPOST/CENTER C
MATERNITY CENTER D
OTHER PUBLIC (SPECIFY) ____ E
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/POLYCLINIC G
PHARMACY H
AMO-CONGO I
HEALTH CENTER J
MEDICAL OFFICE K
PRIVATE DOCTOR L
TRAVELLING NURSE M
FIELDWORKER N
OTHER PRIVATE MEDICAL (SPECIFY) ____ 0
OTHER SOURCE
SHOP P
CHURCH Q
RELATIVES/FRIENDS R
OTHER (SPECIFY) ____ X

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Cote d'Ivoire 1994
Survey form view entire document:  text 
333) Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2 (GO TO 337)

334) Where is that?

NAME OF PLACE____
PUBLIC SECTOR
HOSPITAL A
HEALTH CENTER B
CLINIC C
MEDICAL POST D
PRIVATE MEDICAL SECTOR
PRIVATE DOCTOR E
PRIVATE HOSPITAL/CLINIC F
PHARMACY G
FAMILY PLANNING CENTER H
OTHER PUBLIC SECTOR
SHOP I
CHURCH J (GO TO 337)
ACQUAINTANCES/RELATIVES K (GO TO 337)
OTHER (SPECIFY)____ L (GO TO 337)
DON'T KNOW M (GO TO 337)

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Cote d'Ivoire 1998
Survey form view entire document:  text 
332) Do you know where you can obtain a method of family planning?

YES 1
NO 2 (GO TO 334)

333) Where is that?

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/MOTHER-INFANT CENTER 12
FREE CLINIC 13
MEDICAL POST 14
OTHER PUBLIC (SPECIFY): ___ 16
PRIVATE MEDICAL SECTOR
PRIVATE DOCTOR 21
PRIVATE HOSPITAL/CLINIC 22
FAMILY PLANNING CENTER 23
PHARMACY/PHARMACY DEPOT 24
OTHER PRIVATE MEDICAL (SPECIFY): ___ 26
OTHER PRIVATE SECTOR
SHOP/MARKET 31
BAR/NIGHTCLUB 32
KIOSK 33
INFORMAL COMMERCIAL DISTRIBUTION 34
CHURCH 35
ACQUAINTANCES/RELATIVES 36
TRADITIONAL PRACTITIONER 37
OTHER (SPECIFY): ___ 96

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Egypt 1992
Survey form view entire document:  text 
358. Where is that?
WRITE THE NAME AND ADDRESS OF THE SOURCE FROM WHICH THE RESPONDENT WOULD GET THE METHOD. PROSE IF NECESSARY TO IDENTIFY THE TYPE OF SOURCE AND THEN CIRCLE THE APPROPRIATE CODE.

(NAME AND ADDRESS OF PLACE) _______________________

MINISTRY OF HEALTH FACILITY

URBAN HOSPITAL 11
URBAN HEALTH UNIT 12
RURAL HOSPITAL 13
RURAL HEALTH UNIT 14
OTHER 15
OTHER GOVERNMENTAL FACILITY

TEACHING HOSPITAL 16
HEALTH INSURANCE ORGANIZATION 17
CURATIVE CARE ORGANIZATION 18
OTHER 19
PRIVATE VOLUNTARY ORGANIZATION

EGYPT FAMILY PLANNING ASSOCIATION 21
CSI PROJECT 22
OTHER 23
MEDICAL PRIVATE SECTOR

PRIVATE HOSPITAL/CLINIC 24
PRIVATE DOCTOR 25
PHARMACY 26
OTHER PRIVATE SECTOR

MOSQUE HEALTH UNIT 31
CHURCH HEALTH UNIT 32
OTHER VENDOR (SHOP, KIOSK, ETC.) 33
FRIENDS/RELATIVES 41 (GO TO 401)
OTHER 42 (GO TO 401)
DON'T KNOW 98 (GO TO 401)

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Egypt 1995
Survey form view entire document:  text 
357. Where is that? WRITE THE NAME AND ADDRESS OF THE SOURCE FROM WHICH THE RESPONDENT WOULD GET THE METHOD. PROBE IF NECESSARY TO IDENTIFY THE TYPE OF SOURCE AND THEN CIRCLE THE APPROPRIATE CODE.

NAME AND ADDRESS OF PLACE ___________________

MINISTRY OF HEALTH FACILITY (MOH)
URBAN HOSPITAL 11
URBAN HEALTH UNIT 12
RURAL HOSPITAL 13
RURAL HEALTH UNIT 14
OTHER MOH UNIT 15
OTHER GOVERNMENTAL FACILITY
TEACHING HOSPITAL 16
HEALTH INSURANCE ORGANIZATION 17
CURATIVE CARE ORGANIZATION 18
OTHER GOVERNMENTAL 19
PRIVATE VOLUNTARY ORGANIZATION (PVO)
EGYPT FAMILY PLANNING ASSOCIATION 21
CSI PROJECT 22
OTHER PVO 23
MEDICAL PRIVATE MEDICAL
PRIVATE HOSPITAL/ CLINIC 24
PRIVATE DOCTOR 25
PHARMACY 26
OTHER PRIVATE SECTOR
MOSQUE HEALTH UNIT 31
CHURCH HEALTH UNIT 32
OTHER VENDOR (SHOP, KIOSK, ETC.,) 36
FRIENDS/RELATIVES 41
OTHER (SPECIFY) __________ 96
DON'T KNOW 98

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Egypt 2000
Survey form view entire document:  text 
413) Where is that?
WRITE THE NAME OF THE ADDRESS OF THE SOURCE FROM WHICH THE RESPONDENT WOULD GET THE METHOD. PROBE IF NECESSARY TO IDENTIFY THE TYPE OF SOURCE AND THEN CIRCLE THE APPROPRIATE CODE.

(NAME AND ADDRESS OF PLACE)____________
MINISTRY OF HEALTH FACILITY (MOH)
URBAN HOSPITAL 1
URBAN HEALTH UNIT 2
RURAL HOSPITAL 3
RURAL HEALTH UNIT 4
MOBILE UNIT 5
MCH CENTER 6
OTHER MOH UNITS 7
OTHER GOVERNMENTAL FACILITY
TEACHING HOSPITAL 8
HEALTH INSURANCE ORGANIZATION 9
CURATIVE CARE ORGANIZATION A
OTHER GOVERNMENTAL B
NON-GOVERNMENTAL ORRGANIZATIONS (NGO's)
EGYPT FAMILY PLANNING ASSOCIATION C
CSI PROJECT D
OTHER NGO's E
MEDICAL PRIVATE SECTOR
PRIVATE HOSPITAL/CLINIC F
PRIVATE DOCTOR G
PHARMACY H
OTHER PRIVATE SECTOR
PRIVATE HOSPITAL/CLINIC F
PRIVATE DOCTOR G
PHARMACY H
OTHER PRIVATE SECTOR
MOSQUE HEALTH UNIT I
CHURCH HEALTH UNIT J
OTHER VENDOR (SHOP, KIOSK, ETC.,) K
FRIENDS/RELATIVES L
OTHER (SPECIFY)______X
DON'T KNOW Z

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Egypt 2003
Survey form view entire document:  text 
316. CHECK 313:

USING PILL: Where did you obtain the packet of pills you are using now (you used most recently)?

USING INJECTABLES: Where did you go for your last injection?

USING CONDOM, DIAPHRAGM, FOAM, OR JELLY: From where did you obtain your most recent supply of (METHOD)?

USING IUD: Where did you have the IUD inserted?

USING IMPLANT: Where did you have the implant inserted?

SHE/HE STERILIZED: Where did the sterilization take place?

USING PERIODIC ABSTINENCE, WITHDRAWAL, PROLONGED BREASTFEEDING OR OTHER: Did you get advice from anyone about how to use (METHOD) at the time you began this current period of use?

WRITE THE NAME AND ADDRESS OF THE SOURCE FROM WHICH THE RESPONDENT OBTAINED THE METHOD. PROBE IF NECESSARY TO IDENTIFY THE TYPE OF SOURCE AND THEN CIRCLE THE APPROPRIATE CODE.

NAME AND ADDRESS OF PLACE________________
MINISTRY OF HEALTH FACILITY (MOH)
URBAN HOSPITAL 1
URBAN HEALTH UNIT 2
RURAL HOSPITAL 3
RURAL HEALTH UNIT 4
MCH CENTER 5
MOBILE UNIT 6
OTHER MOH UNITS 7
OTHER GOVERNMENTAL FACILITY
TEACHING HOSPITAL 8
HEALTH INSURANCE ORGANIZATION 9
CURATIVE CARE ORGANIZATION A
OTHER GOVERNMENTAL B
NON-GOVERNMENTAL ORGANIZATIONS (NGO's)
EGYPT FAMILY PLANNING ASSOCIATION C
CSI PROJECT D
OTHER NON-GOVERNMENTAL E
MEDICAL PRIVATE SECTOR
PRIVATE HOSPITAL/CLINIC F
PRIVATE DOCTOR G
PHARMACY H
OTHER PRIVATE SECTOR
MOSQUE HEALTH UNIT I
CHURCH HEALTH UNIT J
OTHER VENDOR (SHOP,KIOSK, ETC.,) K
FRIENDS/RELATIVES L
OTHER___________X
NO ONE Y

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Egypt 2005
Survey form view entire document:  text 
333 Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2 (GO TO 335)

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Egypt 2008
Survey form view entire document:  text 
349. Where is that? IF SOURCE IS HOSPITAL, HEALTH UNIT, OR CLINIC, WRITE THE NAME AND THE ADDRESS OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.

________________________ (NAME AND ADDRESS OF PLACE)

FOR OFFICE USE:

SOURCE CODE___________________
MINISTRY OF HEALTH AND POPULATION
URBAN HOSP'L (GENERAL/DISTRICT) 1
URBAN HEALTH UNIT 2
HEALTH OFFICE 3
RURAL HOSP'L (COMPLEMENTARY) 4
RURAL HEALTH UNIT 5
MCH CENTER 6
MOBILE UNIT 7
OTHER GOVERNMENTAL
UNIVERSITY HOSPITAL 8
TEACHING HOSPITAL 9
HEALTH INSURANCE ORG A
CURATIVE CARE ORGANIZATION B
OTHER GOVERNMENTAL C
NON-GOVERNMENTAL ORGANIZATION
EGYPT FAMILY PLANNING ASSOC D
CSI PROJECT E
OTHER NON-GOVERNMENTAL F
PRIVATE MEDICAL
PRIVATE HOSPITAL/ CLINIC G
PRIVATE DOCTOR H
PHARMACY I
OTHER PRIVATE
MOSQUE HEALTH UNIT J
CHURCH HEALTH UNIT K
OTHER NON-MEDICAL
OTHER VENDOR (SHOP, KIOSK, ETC.,) L
FRIEND/RELATIVE M
OTHER (SPECIFY)___________ X
DON'T KNOW Z

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Egypt 2014
Survey form view entire document:  text 
324) Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2 (GO TO 326)

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Ethiopia 2000
Survey form view entire document:  text 
329. Where is that?
IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, WRITE THE NAME AND/OR LOCATION OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.

NAME AND/OR LOCATION OF PLACE____

GOVERNMENT
HOSPITAL 11
HEALTH CENTER 12
HEALTH STATION/CLINIC 13
HEALTH POST 14
COMMUNITY-BASED OUTLET 15
OTHER GOVERNMENT (SPECIFY)__________16
NONGOVERNMENTAL (NGO)
HEALTH FACILITY 21
COMMUNITY-BASED OUTLETS 22
OTHER NGO (SPECIFY) ___________________26
PRIVATE MEDICAL
PRIVATE HOSPITAL 31
PRIVATE DOCTOR/CLINIC 32
PHARMACY 33
OTHER PRIVATE MEDICAL (SPECIFY)__________________ 36
OTHER SOURCE
DRUG VENDOR 41
SHOP 42
FRIEND/RELATIVE 43
OTHER (SPECIFY)______________________ 46

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Ethiopia 2016
Survey form view entire document:  text 
316. You first started using (CURRENT METHOD) in (DATE FROM 308 OR 309). Where did you get it at that 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
GOVERNMENT HEALTH STATION/CENTER 12
GOVERNMENT HEALTH POST 13
PUBLIC PHARMACY 14
OTHER PUBLIC SECTOR (SPECIFY) 16
NGO
HEALTH FACILITY 21
OTHER NGO HEALTH FACILITY (SPECIFY) 26
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL 31
PRIVATE CLINIC 32
PRIVATE PHARMACY 33
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) 36
OTHER SOURCE
SHOP 41
FRIEND/RELATIVE 42
OTHER (SPECIFY) 96

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Ghana 1993
Survey form view entire document:  text 
331. Where is that?
(IF MORE THAN ONE ASK FOR THE NEAREST)

NAME OF SOURCE _______________________
PUBLIC SECTOR
GOVERNMENT HOSPITAL/POLYCLINIC 11
GOVERNMENT HEALTH CENTER 12
FAMILY PLANNING CLINIC 13
MOBILE CLINIC 14 (GO TO 334)
FIELD WORKER 15 (GO TO 324)
MEDICAL PRIVATE SECTOR
PRIVATE HOSPITAL 21
PHARMACY/CHEMIST/DRUG STORE 22
PRIVATE DOCTOR/CLINIC 23
MOBILE CLINIC 24 (GO TO 334)
FIELD WORKER 25 (GO TO 334)
PRIVATE FP/PPAG CLINIC 26
MATERNITY HOME 27
OTHER PRIVATE SECTOR
SHOP 31
CHURCH 32
FRIENDS/RELATIVES 33 (GO TO 334)
OTHER (SPECIFY) _____ 96 (GO TO 334)

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Ghana 1998
Survey form view entire document:  text 
332. Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2 (GO TO 334)

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Ghana 2003
Survey form view entire document:  text 
329) Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2 (GO TO 331)

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Ghana 2008
Survey form view entire document:  text 
334. Where is that? Any other place?

PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE(S). 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
GOVT. HOSPITAL/POLYCLINIC A
GOVT. HEALTH CENTER B
GOVT. HEALTH POST/CHIPS C
FAMILY PLANNING CLINIC D
MOBILE CLINIC E
FIELDWORKER/OUTREACH/PEER EDUCATOR ______ F
OTHER PUBLIC (SPECIFY) _____ G
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC H
PRIVATE DOCTOR I
PHARMACY J
CHEMICAL/DRUG STORE K
FP/PPAG CLINIC L
MATERNITY HOME M
OTHER PRIVATE MEDICAL (SPECIFY) ____ N
OTHER SOURCE
SHOP/MARKET O
CHURCH P
COMMUNITY VOLUNTEER Q
FRIEND/RELATIVE R
OTHER (SPECIFY) ____ X

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Guinea 1999
Survey form view entire document:  text 
332. Do you know where you can obtain a method of family planning?

YES 1
NO 2 (GO TO 334)

333. Where is that?

IF SOURCE IS HOSPITAL, HEATH 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
FAMILY PLANNING CLINIC 12
FREE CLINIC 13
MEDICAL POST 14
COMMUNITY AGENT/COMMUNITY BASED HEALTH AGENT 15
OTHER PUBLIC MEDICAL (SPECIFY) ______ 16
PRIVATE MEDICAL SECTOR
PRIVATE DOCTOR 21
PRIVATE CLINIC 22
FAMILY PLANNING CENTER 23
PHARMACY/PHARMACEUTICAL DEPOT 24
OTHER PRIVATE MEDICAL (SPECIFY) _____ 26
OTHER PRIVATE SECTOR
SHOP/MARKET 31
BAR/NIGHTCLUB 32
KIOSK 33
INFORMAL COMMERCIAL DISTRIBUTION 34
CHURCH 35
FRIENDS/RELATIVES 36
TRADITIONAL PRACTITIONER 37
OTHER (SPECIFY) _____ 96

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Guinea 2005
Survey form view entire document:  text 
329. Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2 (GO TO 331)

330. Where is this?
Another place?
RECORD ALL PLACES 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 _____
PUBLIC SECTOR
HOSPITAL A
HEALTH CENTER B
MEDICAL POST C
FAMILY PLANNING CLINIC D
FIELDWORKER E
OTHER PUBLIC (SPECIFY) _____ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
FIELDWORKER K
OTHER PRIVATE MEDICAL (SPECIFY) _____ L
OTHER SOURCE
SHOP M
BAR/NIGHTCLUB N
KIOSK O
WORKPLACE P
CHURCH Q
FRIENDS/ACQUAINTANCES/RELATIVES R
OTHER (SPECIFY) _____ X

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Guinea 2012
Survey form view entire document:  text 
324) Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2 (GO TO 326)

325) Where is that?
Any other place?
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
A GOVERNMENT HOSPITAL
B GOVERNMENT HEALTH CENTER
C FAMILY PLANNING CLINIC/AGBEF [##TRANSLATOR NOTE: GUINEAN ASSOCIATION FOR FAMILIAL WELL-BEING]
D FIELDWORKER
E OTHER (SPECIFY)
PRIVATE MEDICAL SECTOR
F PRIVATE HOSPITAL/CLINIC
G PHARMACY
H PRIVATE DOCTOR
I FIELDWORKER
J OTHER PRIVATE MEDICAL (SPECIFY)
OTHER SOURCE
K SHOP
L BAR/NIGHTCLUB/HOTEL
M FRIEND/RELATIVES
X OTHER (SPECIFY)

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Guinea 2018
Survey form view entire document:  text 
326) Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2

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India 1992
Survey form view entire document:  text 
320. Where did you obtain the pills the last time?

NAME OF HOSPITAL IF CODE 11 OR 21 ________
PUBLIC SECTOR
GOVT./MUNICIPAL HOSPITAL 11 (GO TO 352)
PRIMARY HEALTH CENTRE 12 (GO TO 352)
SUB-CENTRE 13 (GO TO 352)
FAMILY PLANNING CLINIC 14 (GO TO 352)
MOBILE CLINIC 15 (GO TO 352)
GOVERNMENT PARAMEDIC 16 (GO TO 352)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL OR CLINIC 21 (GO TO 352)
PHARMACY/DRUGSTORE 22 (GO TO 352)
PRIVATE DOCTOR 23 (GO TO 352)
MOBILE CLINIC 24 (GO TO 352)
FIELD WORKER 25 (GO TO 352)
OTHER PRIVATE SECTOR
SHOP 31 (GO TO 352)
FRIENDS/RELATIVES 32 (GO TO 352)
OTHER (SPECIFY) _____ 41 (GO TO 352)

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India 1998
Survey form view entire document:  text 
329. Where did you obtain the pills/condoms the last time?

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

NAME OF HOSPITAL OR CLINIC________
PUBLIC MEDICAL SECTOR
GOVT./MUNICIPAL HOSPITAL 11 (GO TO 331)
GOVT. DISPENSARY 12 (GO TO 331)
UHC/UHP/UFWC 13 (GO TO 331)
CHC/RURAL HOSPITAL/PHC 14 (GO TO 331)
SUB-CENTRE 15 (GO TO 331)
GOVT. MOBILE CLINIC 16 (GO TO 331)
GOVT. PARAMEDIC 17 (GO TO 331)
CAMP 18 (GO TO 331)
OTHER PUBLIC SECTOR HEALTH FACILITY 19 (GO TO 331)
NGO OR TRUST HOSPITAL/CLINIC 21 (GO TO 331)
NGO WORKER 22 (GO TO 331)
PRIVATE MEDICAL SECTOR
PVT. HOSPITAL/CLINIC 31 (GO TO 331)
PVT. DOCTOR 32 (GO TO 331)
PVT. MOBILE CLINIC 33 (GO TO 331)
PVT. PARAMEDIC 34 (GO TO 331)
VAIDYA/HAKIM/HOMEOPATH 35 (GO TO 331)
TRADITIONAL HEALER 36 (GO TO 331)
PHARMACY/DRUGSTORE 37 (GO TO 331)
DAI (TBA) 38 (GO TO 331)
OTHER PRIVATE SECTOR HEALTH FACILITY 39 (GO TO 331)
OTHER SOURCE
SHOP 41 (GO TO 331)
HUSBAND 42
FRIEND/OTHER RELATIVE 43
OTHER (SPECIFY) ________ 96 (GO TO 331)

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Jordan 1990
Survey form view entire document:  text 
345) Where is that?*

(NAME OF PLACE) ________
PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
FAMILY PLANNING CLINIC 13
MOBILE CLINIC 14 (GO TO 348)
FIELD WORKER 15 (GO TO 348)
MEDICAL PRIVATE SECTOR
PRIVATE HOSPITAL OR CLINIC 21
PHARMACY 22
PRIVATE DOCTOR 23
MOBILE CLINIC 24 (GO TO 348)
FIELD WORKER 25 (GO TO 348)
OTHER PRIVATE SECTOR
SHOP 31
CHURCH 32 (GO TO 348)
FRIENDS/RELATIVES 33 (GO TO 348)
OTHER (SPECIFY) _______ 41 (GO TO 348)
DON'T KNOW 98 (GO TO 348)

*Coding categories to be developed locally and revised based on the pretest, however, the large categories must be maintained.


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Jordan 1997
Survey form view entire document:  text 
432. Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2 (GO TO 434)

433. Where is that? 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
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
GOVERNMENT MCH 13
ROYAL MEDICAL SERVICES (ARMED FORCES) 14
OTHER PUBLC__________ 15
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
PRIVATE DOCTOR 22
JORDANIAN ASSOCIATION OF FP AND PROTECTION (JAFPP) 23
UN RELIEF AGENCY HC 24
OTHER NGOs 25
OTHER P. MEDICAL___________ 26
OTHER SOURCE
FRIENDS/RELATIVES 31
OTHER___________ 36

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Jordan 2002
Survey form view entire document:  text 
330. Where is that? Any other place? RECORD ALL PLACES MENTIONED.

NAME OF PLACE_______
PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT HEALTH CENTER B
GOVT. MCH C
UNIVERSITY HOSPITAL/CLINIC D
ROYAL MEDICAL SERVICES (ARMED FORCES) E
MOBILE CLINIC F
OTHER PUBLIC_______ G
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC H
PRIVATE DOCTOR I
PHARMACY J
JORDANIAN AS. OF FP AND PROTECTION (JAFPP) K
UNRWA HEALTH CENTER L
OTHER NON GOV. ORGANIZATION M
OTHER PRIVATE MEDICAL_______N
OTHER SOURCE
FRIEND/RELATIVE O
OTHER_________X

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Jordan 2017
Survey form view entire document:  text 
326A) Where is that?

Any other place?

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 MEDICAL SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
GOVERNMENT MCH C
UNIVERSITY HOSPITAL/CLINIC D
ROYAL MEDICAL SERVICES E
OTHER PUBLIC F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PRIVATE DOCTOR H
PHARMACY I
JORDNIAN AS OF FP AND PROTECTION (JAFPP) J
INSTITUTE FOR FAMILY HEALTH (IFH) K
INTERNATIONAL RESCUE COMMITTEE (IRC) L
UNRWA CLINIC M
UNHCR/OTHER NGO N
OTHER PRIVATE O
OTHER SOURCE
FRIEND/RELATIVE P
OTHER X

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Kenya 1993
Survey form view entire document:  text 
331. Where is that?

(NAME OF PLACE) __________
PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTRE 12
GOVERNMENT DISPENSARY 13
MEDICAL PRIVATE SECTOR
MISSION, CHURCH HOSP./CLINIC 21
FPAK HEALTH CENTRE/CLINIC 22
OTHER NON-GOVERNMENTAL SERVICE 23
PRIVATE HOSPITAL OR CLINIC 24
PHARMACY 25
PRIVATE DOCTOR 26
MOBILE CLINIC 31
COMMUNITY-BASED DISTRIBUTOR/COMMUNITY HEALTH WORKER 41
SHOP 51
FRIENDS/RELATIVES 61 (GO TO 333A)
OTHER (SPECIFY) ________ 71 (GO TO 333A)

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Kenya 1998
Survey form view entire document:  text 
328. Where did you obtain (METHOD) the 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
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTRE 12
GOVERNMENT DISPENSARY 13
MEDICAL PRIVATE SECTOR
MISSION, CHURCH HOSPITAL/CLINIC 21
FPAK HEALTH CENTRE/CLINIC 22
OTHER NON-GOVERNMENTAL SERVICE 23
PRIVATE HOSPITAL OR CLINIC 24
PHARMACY 25
PRIVATE DOCTOR 26
MOBILE CLINIC 31
COMMUNITY BASED DISTRIBUTOR 41
SHOP 51
FRIENDS/RELATIVES 61
OTHER (SPECIFY) _____ 96

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Kenya 2003
Survey form view entire document:  text 
311) Which method are you using?
IF MORE THAN ONE METHOD MENTIONED, FOLLOW SKIP INSTRUCTION FOR HIGHEST METHOD ON LIST.
311A) CIRCLE 'A' FOR FEMALE STERILIZATION.

FEMALE STERILIZATION A (GO TO 313)
MALE STERILIZATION B (GO TO 313)
PILL C
IUD D (GO TO 316A)
INJECTABLES E (GO TO 316A)
IMPLANTS F (GO TO 316A)
CONDOM G (GO TO 316A)
FEMALE CONDOM H (GO TO 316A)
DIAPHRAGM I (GO TO 316A)
FOAM/JELLY J (GO TO 316A)
LACTATIONAL AMENORRHEA METHOD K (GO TO 316A)
PERIODIC ABSTINENCE L (GO TO 316A)
WITHDRAWAL M (GO TO 316A)
OTHER (SPECIFY) __________ X (GO TO 316A)

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Kenya 2008
Survey form view entire document:  text 
332. Where did you obtain (CURRENT METHOD) the last time?

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) ___________
PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVT. HEALTH CENTER 12
GOVERNMENT DISPENSARY 13
OTHER PUBLIC (SPECIFY) _______ 16
PRIVATE MEDICAL SECTOR
FAITH-BASED, CHURCH, MISSION HOSPITAL/CLINIC 21
FHOK/FPAK HEALTH CENTER/CLINIC 22
PRIVATE HOSPITAL/CLINIC 23
PHARMACY/CHEMIST 24
NURSING/MATERNITY HOME 25
OTHER PRIV. MEDICAL (SPECIFY) ___________ 26
OTHER SOURCE:
MOBILE CLINIC 31
COMMUNITY-BASED DISTRIBUTOR 41
SHOP 51
OTHER (SPECIFY) _______________________ 96

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Madagascar 1992
Survey form view entire document:  text 
330. Do you know of a place where one can get contraception?

YES 1
NO 2 (GO TO 333)

331. Where is it?

NAME OF PLACE___________
PUBLIC SECTOR
HOSPITAL 11
HEALTH CENTER 12
DISPENSARY 13
MEDICAL POST 14
PRIVATE MEDICAL SECTOR
PRIVATE DOCTOR 21
PRIVATE HOSPITAL/CLINIC 22
PHARMACY 23
SP/FISA CENTER 24
OTHER PRIVATE SECTOR
SHOP 31
CHURCH 32 (GO TO 334)
FRIENDS/RELATIVES 33 (GO TO 334)
OTHER (SPECIFY) _____ 41 (GO TO 334)
DOESN'T KNOW 98 (GO TO 334)

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Madagascar 1997
Survey form view entire document:  text 
332. Do you know of a place where you can get contraception?

YES 1
NO 2 (GO TO 334)

333. Where is it?

IF IT IS A PUBLIC HOSPITAL OR A PRIVATE HOSPITAL OR CLINIC, WRITE THE NAME OF THE ESTABLISHMENT. PROBE TO DETERMINE THE PROPER TYPE OF SECTOR AND CIRCLE THE APPROPRIATE CODE.

NAME OF PLACE __________
PUBLIC SECTOR
HOSPITAL A
HEALTH CENTER B
DISPENSARY C
MEDICAL POST D
OTHER PUBLIC (SPECIFY) ______ X
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC E
PHARMACY F
DOCTOR G
PF/FISA CENTER H
OTHER PRIVATE (SPECIFY) ______ Y
OTHER SOURCE
STORE I
RELIGIOUS CENTER J
RELATIVES K
FRIENDS L
OTHER (SPECIFY) _______ Z

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Malawi 1992
Survey form view entire document:  text 
331. Where is that?
NOTE: PRIVATE SECTOR INCLUDES MISSION FACILITIES

NAME OF PLACE____
PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
PRIMARY HEALTH CENTRE 12
DISPENSARY/MATERNITY CLINIC 13
MOBILE CLINIC 14 (GO TO 334)
MEDICAL PRIVATE SECTOR
PRIVATE HOSPITAL 21
PRIVATE HEALTH CENTRE 22
DISPENSARY/MATERNITY CLINIC 23
MOBILE CLINIC 24 (GO TO 334)
PRIVATE DOCTOR 25
OTHER PRIVATE SECTOR
SHOP/PHARMACY 31
CHURCH 32 (GO TO 334)
FRIENDS/RELATIVES 33 (GO TO 334)
OTHER (SPECIFY) ____ 41 (GO TO 334)

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Malawi 2004
Survey form view entire document:  text 
311) Which method are you using?
IF MORE THAN ONE METHOD MENTIONED, FOLLOW SKIP INSTRUCTION FOR HIGHEST METHOD ON LIST.
311A) CIRCLE 'A' FOR FEMALE STERILIZATION.

FEMALE STERILIZATION A (GO TO 313)
MALE STERILIZATION B (GO TO 313)
PILL C
IUD D (GO TO 316A)
INJECTABLES E (GO TO 316A)
IMPLANTS F (GO TO 316A)
CONDOM G (GO TO 316A)
FEMALE CONDOM H (GO TO 316A)
DIAPHRAGM I (GO TO 316A)
FOAM/JELLY J (GO TO 316A)
LACTATIONAL AMENORRHEA METHOD K (GO TO 316A)
PERIODIC ABSTINENCE L (GO TO 316A)
WITHDRAWAL M (GO TO 316A)
OTHER (SPECIFY) __________ X (GO TO 316A)

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Mali 1995
Survey form view entire document:  text 
333. Where is this?

IF THE SOURCE IS A HOSPITAL, A HEALTH CENTER OR A CLINIC, WRITE THE NAME OF THE ESTABLISHMENT. PROBE TO DETERMINE THE SECTOR AND CIRCLE THE APPROPRIATE CODE.

NAME OF ESTABLISHMENT__
PUBLIC SECTOR
HOSPITAL 11
HEALTH CENTER/FREE CLINIC/CLINIC/MATERNITY 12
HEALTH CARE CLINIC 13
PRIVATE SECTOR
CLINIC 21
PRIVATE DOCTOR 22
PHARMACY 23
FIELD WORKER 24
COMMUNITY
HEALTH CENTER 31
HEALTH CARE WORKER 32
FAMILY PLANNING FIELDWORKER/DOULA/BIRTHER/HEALTH AID 33
PARA PUBLIC
INPS/CMIE (NATIONAL INSTITUTE OF SOCIAL FUNDS/INTER-ENTREPRISE MEDIAL CENTER) 41
MUTEC (EDUCATION AND CULTURE WORKERS MUTUAL) 42
NON GOVERNMENTAL
NGO/AMPPF (Malian Association of Family Protection and Promotion) 51
OTHER PRIVATE SECTOR
SHOP/MARKET 61
HEALER/TRADITIONAL PRACTITIONER/MARABOUT (a kind of spiritual healer/witch doctor) 62
FRIEND(S)/RELATIVE(S) 63
OTHER (SPECIFY)__96
DOESN'T KNOW 98

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Mali 2006
Survey form view entire document:  text 
333 Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2 (GO TO 335)

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Morocco 1992
Survey form view entire document:  text 
445) Where is that?

(NAME OF PLACE)____
PUBLIC SECTOR
PUBLIC HOSPITAL 11
MATERNITY CENTER 12
HEALTH CENTER 13
FREE CLINIC 14
HOME VISIT 15 (GO TO 448)
MOBILE TEAM 16 (GO TO 448)
PRIVATE SECTOR
FAMILY PLANNING ASSOCIATION 21
CLINIC 22
PHARMACY 23
DOCTOR/MIDWIFE 24
OTHER PRIVATE
FEMALE RELATIVE/FRIEND 31 (GO TO 448)
QABLA 32 (GO TO 448)
OTHER (SPECIFY) 41 (GO TO 448)
OTHER 98 (GO TO 448)

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Morocco 2003
Survey form view entire document:  text 
329) Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2 (GO TO 331)

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Mozambique 1997
Survey form view entire document:  text 
332. Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2 (GO TO 334)

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Mozambique 2011
Survey form view entire document:  text 
325. Where is that? Any other place?

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

RECORD ALL PLACES MENTIONED.

(NAME OF PLACE(S))_________
PUBLIC SECTOR
CENTRAL HOSPITAL A
PROVINCIAL/GENERAL HOSPITAL B
RURAL HOSPITAL C
HEALTH CENTER/POST D
MOBILE CLINIC E
PHARMACY F
OTHER (SPECIFY)____G
PRIVATE MEDICAL SECTOR
PRIVATE CLINIC H
PRIVATE DOCTOR I
PRIVATE NURSE J
PRIVATE PHARMACY K
SHOP L
GAS STATION M
BAR/DISCOTHEQUE N
INFORMATION STAND/BOOTH O
OTHER (SPECIFY)___ P
OTHER SOURCE
SCHOOL Q
MARKET/STORE R
CHURCH S
FRIEND/RELATIVE T
TRADITIONAL HEALER U
ADOLESCENT SPECIAL SERVICES V
OTHER (SPECIFY)____X

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Namibia 1992
Survey form view entire document:  text 
331) Where is that?

(NAME OF PLACE)_______
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER/GOVERNMENT CLINIC 12
PHC CLINIC (MOBILE) 13
FIELD WORKER 14 (GO TO 334)
PRIVATE DOCTOR 21
PRIVATE HOSPITAL OR CLINIC 22
PHARMACY 23
SHOP 31
FRIENDS/RELATIVES 32
OTHER (SPECIFY)________41 (GO TO 334)

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Nepal 1996
Survey form view entire document:  text 
327. Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2 (SKIP TO 329)

328. Where is that?
IF SOURCE IS HOSPITAL, HEALTH CENTRE, 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/DISTRICT CLINIC 11
PRIMARY/HEALTH CENTRE 12
FAMILY PLANNING CLINIC 13
HEALTH POST 14
SUB-HEALTH POST 15
MOBILE CLINIC 17
OTHER PUBLIC_____________________16
PRIVATE SECTOR
HOSPITAL 21
CLINIC/NURSING HOME 22
PHARMACY 23
CHW 24
FPAN 25
OTHER PRIVATE____________________26
OTHER SOURCE
FCHV 31
SHOP 32
FRIEND/RELATIVE 33
OTHER (SPECIFY)_____________________________36

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Niger 1992
Survey form view entire document:  text 
330 Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2 (GO TO 334)

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Niger 1998
Survey form view entire document:  text 
332) Do you know a place where you can get a method of contraception?

YES 1
NO 2 (GO TO 334)

333) Where is that?

IF THE SOURCES IS A HOSPITAL, A HEALTH CENTER OR A CLINIC, WRITE THE NAME OF THE ESTABLISHMENT. PROBE TO DETERMINE THE SECTOR AND CIRCLE THE APPROPRIATE CODE.

NAME OF ESTABLISHMENT: ___
PUBLIC SECTOR
HOSPITAL 11
INTEGRATED HEALTH CENTER 12
MATERNITY WARD 13
HEALTH HUT 14
CONSULTATION AT A FAIR 15
OTHER PUBLIC (SPECIFY): ___ 16
PRIVATE MEDICAL SECTOR
PRIVATE CLINIC 21
PHARMACY 22
PRIVATE DOCTOR'S OFFICE 23
HEALTHCARE WORKER 25
OTHER PRIVATE MEDICAL (SPECIFY): ___ 26
OTHER SOURCE
"PHARMACY ON THE GROUND" (LOCATED IN A LOCAL MARKET) 31
TRADITIONAL PRACTITIONERS 32
FRIENDS/RELATIVES 33
OTHER (SPECIFY): ___ 36

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Niger 2006
Survey form view entire document:  text 
336 In the last 12 months, have you visited a health facility for care for yourself (or your children)?

YES 1
NO 2 (GO TO 401)

337 Did any staff member at the health facility speak to you about family planning methods?

YES 1
NO 2

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Nigeria 1990
Survey form view entire document:  text 
304. Do you know where a person could go to get (METHOD)?

METHOD 01 PILL Women can take a pill every day.
YES 1
NO 2
METHOD 02 IUD Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2
METHOD 03 INJECTIONS Women can have an injection by a doctor or nurse which stops them from becoming pregnant for several months.
YES 1
NO 2
METHOD 04 FOAMING TABLETS Women can place a foaming tablet or pill inside them before intercourse.
YES 1
NO 2
METHOD 05 DIAPHRAGM, FOAM, JELLY Women can place a sponge, diaphragm, jelly or cream inside them before intercourse.
YES 1
NO 2
METHOD 06 DUREX OR CONDOM Men can use a rubber sheath during sexual intercourse.
YES 1
NO 2
METHOD 07 FEMALE STERILIZATION Women can have an operation to avoid having any more children.
YES 1
NO 2
METHOD 08 MALE STERILIZATION Men can have an operation to avoid having any more children.
YES 1
NO 2
METHOD 09 RHYTHM Couples can avoid having sexual intercourse on certain days of the month when the woman is more likely to become pregnant: Do you know where a person can obtain advice on how to use the rhythm method?
YES 1
NO 2

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Nigeria 1999
Survey form view entire document:  text 
333. Where is that?
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
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
FAMILY PLANNING CLINIC 13
MOBILE CLINIC 14
COMMUNITY HEALTH WORKER 15
OTHER PUBLIC (SPECIFY) ______ 16

PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
PHARMACY/PMS 22
PRIVATE DOCTOR 23
MOBILE CLINIC 24
COMMUNITY HEALTH WORKER 25
OTHER PRIVATE MEDICAL (SPECIFY) ______ 26
OTHER SOURCE
SHOP 31
CHURCH 32
FRIENDS/RELATIVES 33
NGO 34
OTHER (SPECIFY) __________________ 36

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Nigeria 2008
Survey form view entire document:  text 
334. Where is that? Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE(S). 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
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC (SPECIFY) ______ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
CHEMIST/PMS I
PRIVATE DOCTOR J
MOBILE CLINIC K
FIELDWORKER L
OTHER PRIVATE MEDICAL (SPECIFY) ______ M
OTHER SOURCE
SHOP N
CHURCH O
FRIEND/RELATIVE P
NGO Q
OTHER (SPECIFY) _______________ X

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Nigeria 2018
Survey form view entire document:  text 
326. Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2

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Pakistan 1991
Survey form view entire document:  text 
344. What source is that?

NAME OF HOSPITAL, CLINIC OR CENTER, IF CODE 01-05 __________
GOVERNMENT/HOSPITAL/RHSC 01
RHC/BHU/GOVERNMENT CLINIC 02
FAMILY WELFARE CENTER 03
NGO CENTER 04
PRIVATE HOSPITAL OR CLINIC 05
MOBILE CLINIC/EXTENSION TEAM 06 (GO TO 347)
FIELD WORKER 07 (GO TO 347)
PRIVATE DOCTOR 08
HAKIM/HOMOEOPATH 09
DRUGSTORE 10
SHOP (OTHER THAN DRUGSTORE) 11
TRADITIONAL BIRTH ATTENDANT 12
FRIENDS/RELATIVES 13 (GO TO 347)
OTHER (SPECIFY) _____ 14 (GO TO 347)

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Rwanda 2000
Survey form view entire document:  text 
329. Where is that?

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
GOVERNMENT HOSPITAL/GOVERNMENT-APPROVED HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
FAMILY PLANNING CLINIC 13
DBC AGENT 15
OTHER PUBLIC (SPECIFY)_____ 16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
PHARMACY 22
PRIVATE DOCTOR 23
ARBEF (RWANDAN ASSOCIATION FOR FAMILY WELFARE) CLINIC 24
INFIRMARY 25
OTHER PRIVATE MEDICAL (SPECIFY)_____ 26
OTHER SOURCE
SHOP/KIOSK 31
CHURCH 32
RELATIVES/FRIENDS 33
OTHER (SPECIFY)_____ 96

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Rwanda 2005
Survey form view entire document:  text 
329. Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2 (GO TO 331)

330. Where is that?
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) ______

RECORD ALL PLACES MENTIONED.

PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH HOSPITAL B
AGENT DBC C
OTHER PUBLIC (SPECIFY)_____ D
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC E
PHARMACY F
PRIVATE DOCTOR G
ARBEF CLINIC H
INFIRMARY I
OTHER PRIVATE MEDICAL (SPECIFY) ____ J
OTHER SOURCE
SHOP K
CHURCH L
PARENTS/FRIEND M
OTHER (SPECIFY) _____ X

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Senegal 1992
Survey form view entire document:  text 
331. What places do you know of?

NAME OF PLACE_____
PUBLIC SECTOR
HOSPITAL 11
HEALTH CENTER/PMI 12
HEALTH POST/FREE CLINIC 13
PRIVATE MEDICAL SECTOR
CLINIC/PRIVATE HOSPITAL 21
PHARMACY 22
PRIVATE DOCTOR 23
OTHER PRIVATE SECTOR
MARKET/SHOP 31
CHURCH 32 (GO TO 334)
FRIEND/RELATIVE 33 (GO TO 334)
AUXILIARY 41 (GO TO 334)
OTHER (SPECIFY) _____51 (GO TO 334)

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Senegal 1997
Survey form view entire document:  text 
330. Do you know of a place where you could get a family planning method?

YES 1
NO 2 (GO TO 334)

331. What place do you know of?

NAME OF PLACE_____
PUBLIC SECTOR
HOSPITAL 11
HEALTH CENTER/PMI (Protection Maternelle et Infantile) 12
HEALTH POST/FREE CLINIC 13
PRIVATE MEDICAL SECTOR
PRIVATE CLINIC/HOSPITAL 21
PHARMACY 22
PRIVATE DOCTOR 23
PRIVATE NURSE/CONFES 24
OTHER SECTOR
ASBEF (Senegalese Association for Family Well-Being) 31
TRADITIONAL HEALER 32
CHURCH 33 (GO TO 334)
FRIEND/RELATIVE 34 (GO TO 334)
AUXILIARY 41 (GO TO 334)
OTHER (SPECIFY) _____51 (GO TO 334)

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Senegal 2005
Survey form view entire document:  text 
329. Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2 (GO TO 331)

330. Where is this place?
Anywhere else?
RECORD ALL MENTIONED.

IF THE SOURCE IS A HOSPITAL, A HEALTH CENTER OR A CLINIC, WRITE THE NAME OF THE ESTABLISHMENT. PROBE TO DETERMINE THE TYPE OF SECTOR AND CIRCLE THE APPROPRIATE CODE.

NAME OF ESTABLISHMENT ______
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
HEALTH POST C
GOVERNMENT FAMILY PLANNING CENTER D
RURALE MATERNITY E
HEALTH HUT F
COMMUNITY PHARMACY G
STRAT. AVANCÉE/EQU. MOBILE H
OTHER PUBLIC (SPECIFY) _____I
PRIVATE MEDICAL SECTOR
HOSPITAL/CLINIC/OFFICE J
PRIVATE HOSPITAL/CLINIC/OFFICE K
PHARMACY L
PRIVATE DOCTOR M
RELIGIOUS FREE CLINIC N
HEALTH CARE WORKER O
OTHER PRIVATE (SPECIFY) _____P
OTHER SOURCE
SHOP Q
CHURCH R
RELATIVES/FRIENDS S
BAR T
OTHER (SPECIFY) _____X

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Senegal 2010
Survey form view entire document:  text 
324. Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2 (GO TO 326)

325. Where is that?
Any other place?

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
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
HEALTH POST C
GOVERNMENT FAMILY PLANNING CLINIC D
HEALTH HUT/RURAL MATERNITY E
BASIC HEALTH CARE CENTER F
COMMUNITY PHARMACY G
MOBILE CLINIC H
OTHER PUBLIC (SPECIFY) _____ I
PRIVATE MEDICAL SECTOR
HOSPITAL/CLINIC/OFFICE J
PHARMACY K
PRIVATE DOCTOR L
RELIGIOUS DISPENSARY M
OTHER PRIVATE MEDICAL (SPECIFY) _____ N
OTHER SOURCE
SHOP O
CHURCH P
RELATIVES/FRIENDS Q
BAR R
OTHER (SPECIFY) _____ X

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Senegal 2017
Survey form view entire document:  text 
316) You first started using (CURRENT METHOD) in (DATE FROM 309). Where did you get it at that 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
GOVERNMENT HEALTH CENTER 12
HEALTH POST 13
GOVERNMENT FAMILY PLANNING CENTER 14
RURAL MATERNITY 15
HEALTH HUT 16
COMMUNITY PHARMACY 17
MOBILE CLINIC 18
OTHER PUBLIC SECTOR (SPECIFY) ____ 19
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/OFFICE 21/22
PHARMACY 23
PRIVATE DOCTOR 24
RELIGIOUS FREE CLINIC 25
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) ____ 26
OTHER SOURCE
SHOP 31
CHURCH 32
FRIENDS/RELATIVES 33
BAR 34
OTHER (SPECIFY) _____ 96

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South Africa 1998
Survey form view entire document:  text 
332 Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2 (GO TO 335)

333 Where is that?
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
GOVERNMENT HOSPITAL 11
DAY HOSPITAL/CLINIC/COMMUNITY HEALTH CENTRE 12
FAMILY PLANNING CLINIC 13
OTHER PUBLIC (SPECIFY) __________________16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
PRIVATE DOCTOR 23
OTHER PRIVATE MEDICAL (SPECIFY) ___________ 26
OTHER SOURCE
SHOP 31
CHURCH 32
FRIEND/RELATIVE 33
OTHER (SPECIFY) __________________ 96

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Tanzania 1991
Survey form view entire document:  text 
331.Where is that?

(NAME OF PLACE) __________
GOVERNMENT AND PARASTATAL
CONSULTANT HOSPITAL 11
REGIONAL HOSPITAL 12
DISTRICT HOSPITAL 13
HEALTH CENTRE 14
DISPENSARY 15
PARASTATAL HEALTH FACILITY 16
VILLAGE HEALTH POST/WORKER 17 (GO TO 334)
MEDICAL PRIVATE SECTOR
RELIGIOUS ORG. FACILITY 21
PRIV. DOCTOR/CLINIC/HOSPITAL 22
PHARMACY/MEDICAL STORE 23
UMATI CBD WORKER 24 (GO TO 334)
OTHER PRIVATE SECTOR
SHOP 31
NEIGHBORS/RELATIVES 32 (GO TO 334)
OTHER (SPECIFY) _________________ 41 (GO TO 334)

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Tanzania 1996
Survey form view entire document:  text 
331. Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2 (GO TO 333)

332. Where is that?
IF SOURCE IS HOSPITAL, HEALTH CENTRE, OR CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.

(NAME OF PLACE) ________________
GOVERNMENT AND PARASTATAL
REGIONAL/CONSULTANT HOSPITAL 11
DISTRICT HOSPITAL 12
HEALTH CENTRE 13
DISPENSARY/PARASTATAL FACILITY 14
VILLAGE HEALTH POST/WORKER 15
MEDICAL PRIVATE SECTOR
RELIGIOUS ORG. FACILITY 21
PRIV. DOCTOR/CLINIC/HOSPITAL 22
PHARMACY/MEDICAL STORE 23
CBD WORKER 24
OTHER PRIVATE SECTOR
SHOP 31
CHURCH 32
FRIENDS/RELATIVES/NEIGHBORS 33
OTHER (SPECIFY) _________________ 96

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Tanzania 1999
Survey form view entire document:  text 
328. Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2 (GO TO 330)

329. Where is that?

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_____
GOVERNMENT/PUBLIC SECTOR
REGIONAL/CONSULTANT HOSP 11
DISTRICT HOSPITAL 12
GOVT. HEALTH CENTER 13
DISPENSARY/PARASTATAL FACILITY 14
VILLAGE HEALTH POST/WORKER 15
PRIVATE MEDICAL SECTOR
RELIGIOUS ORGANIZATION FACILITY/MISSION HOSP 21
PRIVATE DOCTOR/CLINIC/HOSP 22
PHARMACY/MEDICAL STORE 23
CBD WORKER 24
OTHER PRIVATE SECTOR
SHOP/KIOSK 31
CHURCH 32
FRIEND/RELATIVE/NEIGHBOR 33
HEALTH EDUCATION/BAR GIRLS 34
OTHER (SPECIFY)_______________96
DON'T KNOW 98

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Tanzania 2015
Survey form view entire document:  text 
326. Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2

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Togo 2013
Survey form view entire document:  text 
324) Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2 (GO TO 326)

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Uganda 1995
Survey form view entire document:  text 
333) Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2 (GO TO 335)

334) Where is that?

IF SOURCE IS HOSPITAL, HEALTH CENTRE, OR CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE. MISSION/CHURCH FACILITIES ARE CONSIDERED "PRIVATE".

(NAME OF PLACE) ____________________

PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTRE 12
GOVERNMENT DISPENSARY/HEALTH UNIT 13
GOVERNMENT MOBILE CLINIC 14
GOVERNMENT FIELD WORKER 15
OTHER PUBLIC (SPECIFY) ___________ 16
PRIVATE/NGO MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
PHARMACY/CHEMISTS 22
PRIVATE DOCTOR 23
PRIVATE MOBILE CLINIC 24
PRIVATE FIELD WORKER 25
OTHER PRIVATE MEDICAL ______________ 26
OTHER PRIVATE SECTOR
SHOP 31
CHURCH 32
FRIENDS/RELATIVES 33
OTHER (SPECIFY) ___________ 96

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Uganda 2016
Survey form view entire document:  text 
326) Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2

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Yemen 2013
Survey form view entire document:  text 
325) Where is that? Any other place? 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
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
PRIMARY HEALTH CENTER C
FAMILY PLANNING CLINIC D
MOBILE CLINIC E
PRIVATE MEDICAL SECTOR
PR. HOSPITAL/CLINIC/DOCTOR F
PHARMACY G
NON GOVERNMENT ORGANIZATIONS
PR. HOSPITAL/CLINIC/DOCTOR H
OTHER (SPECIFY)____ X

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Zambia 1992
Survey form view entire document:  text 
330. Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2 (GO TO 334)

331. Where is that?

(NAME OF PLACE) __________
PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
FIELD WORKER 13 (GO TO 334)
MEDICAL PRIVATE SECTOR
PRIVATE HOSPITAL OR CLINIC 21
MISSION HOSPITAL OR CLINIC 22
PHARMACY 23
PRIVATE DOCTOR 24
MOBILE CLINIC 25 (GO TO 334)
FIELD WORKER 26 (GO TO 334)
OTHER PRIVATE SECTOR
SHOP 31
FRIENDS/RELATIVES 32 (GO TO 334)
OTHER (SPECIFY) _________________ 41 (GO TO 332)
DON'T KNOW 98 (GO TO 330)

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Zambia 1996
Survey form view entire document:  text 
332. Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2 (GO TO 334)

333. Where is that?
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
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
FIELDWORKER 15
OTHER PUBLIC (SPECIFY) ___________ 16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
MISSION HOSPITAL/CLINIC 22
PHARMACY 23
PRIVATE DOCTOR 24
MOBILE CLINIC 25
FIELDWORKER 26
OTHER PRIVATE MEDICAL (SPECIFY) ____________ 27
OTHER SOURCE
SHOP 31
FRIENDS/RELATIVES 32
OTHER (SPECIFY) _________________ 36

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Zambia 2007
Survey form view entire document:  text 
333. Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2 (GO TO 335)

334. Where is that? Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE(S). IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE(S)) ________________
PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC (SPECIFY) ______ F

PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
MISSION HOSPITAL/CLINIC H
PHARMACY I
PRIVATE DOCTOR J
COMMUNITY WORKPLACE K
WORKPLACE L
MOBILE CLINIC M
FIELDWORKER N
OTHER PRIVATE MEDICAL (SPECIFY) ______ O
OTHER SOURCE
SHOP P
CHURCH Q
FRIEND/RELATIVE R
OTHER (SPECIFY) _______________ X

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Zambia 2018
Survey form view entire document:  text 
(326) Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2

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Zimbabwe 1994
Survey form view entire document:  text 
344) Where is that?

IF SOURCE IS HOSPITAL, HEALTH CENTRE, 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
GOVERNMENT HOSPITAL/CLINIC 11
RURAL/MUNICIPAL CLINIC 12
RURAL HEALTH CENTRE 13
ZNFPC MOBILE CLINIC 14
MINISTRY OF HEALTH MOBILE CLINIC 15
ZNFPC CBD 16
MINISTRY OF HEALTH CBD 17
OTHER PUBLIC (SPECIFY) __________ 18
MISSION FACILITY 19
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
PHARMACY 22
PRIVATE DOCTOR 23
CBD 25
OTHER PRIVATE MEDICAL (SPECIFY) __________ 26
OTHER PRIVATE SECTOR
SHOP 31
CHURCH 32
FRIENDS/RELATIVES 33
OTHER (SPECIFY) __________ 96

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Zimbabwe 1999
Survey form view entire document:  text 
333) Where is that?

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
GOVERNMENT HOSPITAL/CLINIC 11
RURAL/MUNICIPAL CLINIC 12
RURAL HEALTH CENTER 13
ZNFPC (FIXED) CLINIC 14
ZNFPC MOBILE CLINIC 15
MOH MOBLIE CLINIC 16
ZNFPC CBD 17
MOH CBD 18
OTHER PUBLIC (SPECIFY) __________ 19
MISSION FACILITY 21
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31
PHARMACY 32
PRIVATE DOCTOR 33
CBD 34
OTHER PRIVATE MEDICAL (SPECIFY) __________ 36
OTHER SOURCE
SHOP 41
CHURCH 42
FRIENDS/RELATIVES 43
OTHER (SPECIFY) __________ 96

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Zimbabwe 2015
Survey form view entire document:  text 
326. Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2