Survey Text

Afghanistan 2015 Eswatini (Swaziland) 2006 Malawi 2000 Rwanda 2014
Angola 2015 Ethiopia 2000 Malawi 2004 Senegal 1986
Bangladesh 1994 Ethiopia 2005 Malawi 2010 Senegal 1992
Bangladesh 1997 Ethiopia 2011 Malawi 2016 Senegal 1997
Bangladesh 2000 Ethiopia 2016 Mali 1987 Senegal 2005
Bangladesh 2004 Ethiopia 2019 Mali 1995 Senegal 2010
Bangladesh 2007 Ghana 1988 Mali 2001 Senegal 2012
Bangladesh 2011 Ghana 1993 Mali 2006 Senegal 2014
Bangladesh 2014 Ghana 1998 Mali 2012 Senegal 2015
Benin 1996 Ghana 2003 Mali 2018 Senegal 2016
Benin 2001 Ghana 2008 Morocco 1987 Senegal 2017
Benin 2006 Ghana 2014 Morocco 1992 South Africa 1998
Benin 2011 Guinea 1999 Morocco 2003 South Africa 2016
Benin 2017 Guinea 2005 Mozambique 1997 Sudan 1989
Burkina Faso 1993 Guinea 2012 Mozambique 2003 Tanzania 1991
Burkina Faso 1998 Guinea 2018 Mozambique 2011 Tanzania 1996
Burkina Faso 2003 India 1992 Myanmar 2015 Tanzania 1999
Burkina Faso 2010 India 1998 Namibia 1992 Tanzania 2004
Burundi 1987 India 2005 Namibia 2000 Tanzania 2010
Burundi 2010 India 2015 Namibia 2006 Tanzania 2015
Burundi 2016 Jordan 1990 Namibia 2013 Togo 1988
Cameroon 1991 Jordan 1997 Nepal 1996 Togo 1998
Cameroon 1998 Jordan 2002 Nepal 2001 Togo 2013
Cameroon 2004 Jordan 2007 Nepal 2006 Uganda 1988
Cameroon 2011 Jordan 2009 Nepal 2011 Uganda 1995
Cameroon 2018 Jordan 2012 Nepal 2016 Uganda 2001
Central African Republic 1995 Jordan 2017 Niger 1992 Uganda 2006
Chad 1996 Kenya 1989 Niger 1998 Uganda 2011
Chad 2014 Kenya 1993 Niger 2006 Uganda 2016
Congo (Democratic Republic) 2007 Kenya 1998 Niger 2012 Yemen 1991
Congo (Democratic Republic) 2013 Kenya 2003 Nigeria 1990 Yemen 2013
Congo Brazzaville 2005 Kenya 2008 Nigeria 1999 Zambia 1992
Congo Brazzaville 2011 Kenya 2014 Nigeria 2003 Zambia 1996
Cote d'Ivoire 1994 Lesotho 2004 Nigeria 2008 Zambia 2001
Cote d'Ivoire 1998 Lesotho 2009 Nigeria 2013 Zambia 2007
Cote d'Ivoire 2011 Lesotho 2014 Nigeria 2018 Zambia 2013
Egypt 1988 Liberia 1986 Pakistan 1991 Zambia 2018
Egypt 1992 Liberia 2007 Pakistan 2006 Zimbabwe 1988
Egypt 1995 Liberia 2013 Pakistan 2012 Zimbabwe 1994
Egypt 2000 Madagascar 1992 Pakistan 2017 Zimbabwe 1999
Egypt 2003 Madagascar 1997 Rwanda 1992 Zimbabwe 2005
Egypt 2005 Madagascar 2003 Rwanda 2000 Zimbabwe 2010
Egypt 2008 Madagascar 2008 Rwanda 2005 Zimbabwe 2015
Egypt 2014 Malawi 1992 Rwanda 2010
top
Afghanistan 2015
Survey form view entire document:  text 
310. CHECK 308/308A:

YEAR IS 1389 OR LATER: ENTER CODE FOR METHOD USED IN MONTH OF INTERVIEW IN THE CALENDAR AND IN EACH MONTH BACK TO THE DATE STARTED USING. (GO TO 311)

YEAR IS 1388 OR EARLIER: ENTER CODE FOR METHOD USIDE IN MONTH OF INTERVIEW IN THE CALENDAR AND EACH MONTH BACK TO HAMMAL 1389. (GO TO 322)


top
Angola 2015
Survey form view entire document:  text 
316) You first started using (CURRENT METHOD) in (DATE FROM 307 OR 308). 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
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
PHARMACY 22
HEALTH CENTER 23
OTHER: (SPECIFY)____26
OTHER SOURCE
MARKET/STORE 31
FRIEND/RELATIVE 32
OTHER: (SPECIFY)____96

top
Bangladesh 1994
Survey form view entire document:  text 
323. Where did you obtain (METHOD) the last time?
323A. Where did the sterilization take place?

NAME OF PLACE ___
PUBLIC SECTOR
HOSPITAL OR MEDICAL COLLEGE 11
FAMILY WELFARE CENTRE 12
THANA HEALTH COMPLEX 13
SATELLITE CLINIC 14
MEDICAL PRIVATE SECTOR
PRIVATE CLINIC OR DOCTOR 21
TRADITIONAL DOCTOR 22
PHARMACY 23
OTHER PRIVATE SECTOR
SHOP 31
FRIENDS OR RELATIVES 32
FIELDWORKER, FWA 41 (GO TO 325E)
OTHER (SPECIFY) 51
DOES NOT KNOW 98

top
Bangladesh 1997
Survey form view entire document:  text 
333. 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 12
THANA HEALTH COMPLEX 13
SATELLITE OR EPI CLINIC 14
MEDICAL PRIVATE SECTOR
PRIVATE CLINIC OR DOCTOR 21
TRADITIONAL DOCTOR 22
PHARMACY 23
OTHER PRIVATE SECTOR
SHOP 31
FRIENDS OR RELATIVES 32
FIELDWORKER, FWA 41
NGO CLINIC 42
OTHER (SPECIFY) 96
DOES NOT KNOW 98

top
Bangladesh 2000
Survey form view entire document:  text 
327. Where did you obtain (CURRENT METHOD) the last time?

NAME OF PLACE ___
PUBLIC SECTOR
HOSPITAL OR MEDICAL COLLEGE 11
FAMILY WELFARE CENTRE 12
THANA HEALTH COMPLEX 13
SATELLITE CLINIC OR EPI OUTREACH SITE 14
MATERNAL AND CHILD WELFARE CENTER (MCWC) 15
GOVERNMENT FIELD WORKER (FWA) 16
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

top
Bangladesh 2004
Survey form view entire document:  text 
327. Where did you obtain (CURRENT METHOD) the last time?

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

top
Bangladesh 2007
Survey form view entire document:  text 
321) Where did you obtain (CURRENT METHOD) 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
HOSPITAL/MEDICAL COLLEGE 11 (GO TO 324)
FAMILY WELFARE CENTRE 12 (GO TO 324)
UPAZILA HEALTH COMPLEX 13 (GO TO 324)
SATELLITE CLINIC/EPI OUTREACH 14 (GO TO 324)
MATERNAL AND CHILD WELFARE CENTRE (MCWC) 15 (GO TO 324)
GOVERNMENT FIELD WORKER (FWA) 16 (GO TO 324)
COMMUNITY CLINIC 17 (GO TO 324)
OTHER (SPECIFY)____ 18 (GO TO 324)
NGO SECTOR
NGO STATIC CLINIC 21 (GO TO 324)
NGO SATELLITE CLINIC 22 (GO TO 324)
NGO DEPOT HOLDER 23 (GO TO 324)
NGO FIELD WORKER (FWA) 24 (GO TO 324)
OTHER (SPECIFY)____ 26 (GO TO 324)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31 (GO TO 324)
QUALIFIED DOCTOR 32 (GO TO 324)
TRADITIONAL DOCTOR 33 (GO TO 324)
PHARMACY 34 (GO TO 324)
OTHER PRIVATE MEDICAL (SPECIFY)____ 36 (GO TO 324)
OTHER SOURCE
SHOP 41 (GO TO 324)
FRIEND/RELATIVE 42 (GO TO 324)
OTHER (SPECIFY)____ 96 (GO TO 324)

top
Bangladesh 2011
Survey form view entire document:  text 
323) 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 THE PLACE) _____________________
PUBLIC SECTOR
MEDICAL COLLEGE HOSPITAL A
SPECIALISED GOVT. HOSPITAL
HOSPITAL (SPECIFY) ________________ B
DISTRICT HOSPITAL C
MCWC D
UPAZILLA HEALTH COMPLEX E
H and FWC F
SAT. CLINIC/EPI OUTREACH G
COMMUNITY CLINIC H
GOVT. FIELD WORKER (FWA) I
OTHER PUBLIC SECTOR (SPECIFY) ______________ J
NGO SECTOR
NGO STATIC CLINIC K
NGO SATELLITE CLINIC L
NGO DEPO HOLDER M
NGO FIELD WORKER N
OTHER NGO SECTOR (SPECIFY) _____________ O
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC P
QUALIFIED DOCTOR'S CHAMBER Q
NON-QUALIFIED DOCTOR'S CHAMBER R
PHARMACY S
PRIVATE MEDICAL COLLEGE HOSPITAL (SPECIFY) ______________ T
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) _____________ U
OTHER SOURCE
GROCERY V
FRIENDS/RELATIVES W
OTHER (SPECIFY) _____________ X

top
Bangladesh 2014
Survey form view entire document:  text 
314. CHECK 304:
CIRCLE METHOD CODE:
IF MORE THAN ONE METHOD CODE CIRCLED IN 304,
CIRCLE CODE FOR HIGHEST METHOD IN LIST.

NO CODE CIRCLED 00 (GO TO 324)
FEMALE STERILIZATION 01 (GO TO 325A)
MALE STERILIZATION 02 (GO TO 325A)
IUD 03
INJECTABLES 04
IMPLANTS 05
PILL 06
CONDOM 07
LACTATIONAL AMEN. METHOD 11 (GO TO 324)
SAFE PERIOD 12 (GO TO 324)
WITHDRAWAL 13 (GO TO 324)
OTHER MODERN METHOD 96 (GO TO 324)

323. 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
HOSP./MEDICAL COLLEGE/SPE. MED. COL 11 (GO TO 325A)
DISTRICT HOSPITAL 12 (GO TO 325A)
MCWC 13 (GO TO 325A)
UPAZILLA HEALTH COMPLEX 14 (GO TO 325A)
UH AND FWC 15 (GO TO 325A)
SAT. CLINIC/EPI OUTREACH 17 (GO TO 325A)
COMMUNITY CLINIC 18 (GO TO 325A)
GOVT. FIELD WORKER (FWA) 19 (GO TO 325A)
OTHER PUBLIC SECTOR (SPECIFY) _____ 16 (GO TO 325A)
NGO SECTOR
NGO STATIC CLINIC 21 (GO TO 325A)
NGO SATELLITE CLINIC 22 (GO TO 325A)
NGO DEPO HOLDER 23 (GO TO 325A)
NGO FIELD WORKER 24 (GO TO 325A)
OTHER NGO SECTOR (SPECIFY) _____ 26 (GO TO 325A)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31 (GO TO 325A)
QUALIFIED DOCTOR'S CHAMBER 32 (GO TO 325A)
NON-QUALIFIED DOCTOR'S CHAMBER 33 (GO TO 325A)
PHARMACY/DRUG STORE 34 (GO TO 325A)
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) _____ 36 (GO TO 325A)
OTHER SOURCE
SHOP 41 (GO TO 325A)
FRIENDS/RELATIVES 42 (GO TO 325A)
OTHER (SPECIFY) _____ 96 (GO TO 325A)

top
Benin 1996
Survey form view entire document:  text 
328) Where did you obtain (CURRENT 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 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

top
Benin 2001
Survey form view entire document:  text 
328) Where did you obtain (CURRENT 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 (GO TO 331)
GOVERNMENT HEALTH CENTER 12 (GO TO 331)
FAMILY PLANNING CLINIC 13 (GO TO 331)
FIELDWORKER 14 (GO TO 331)
COMMUNITY CENTER 15 (GO TO 331)
STRAT AV HEALTH WORKER 16 (GO TO 331)
HEALTH WORKER/COMMUNITY LIAISON 17 (GO TO 331)
VENDING MACHINE 18 (GO TO 331)
OTHER PUBLIC (SPECIFY)______ 19 (GO TO 331)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21 (GO TO 331)
RELIGIOUS HOSPITAL 22 (GO TO 331)
PHARMACY 23 (GO TO 331)
ABPF (BENIN FAMILY ADVOCACY ASSOCIATION) 24 (GO TO 331)
DOCTOR'S OFFICE 25 (GO TO 331)
HEALTH AGENT (NGO) 26 (GO TO 331)
OTHER PRIVATE MEDICAL (SPECIFY)______ 27 (GO TO 331)
OTHER SOURCE
SHOP/MARKET 31 (GO TO 331)
CHURCH/MOSQUE 32 (GO TO 331)
RELATIVES/FRIENDS 33 (GO TO 331)
OTHER (SPECIFY)______ 96 (GO TO 331)

top
Benin 2006
Survey form view entire document:  text 
328) Where did you obtain (CURRENT METHOD) 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 (GO TO 331)
GOVERNMENT HEALTH CENTER 12 (GO TO 331)
FAMILY PLANNING CLINIC 13 (GO TO 331)
FIELDWORKER 14 (GO TO 331)
COMMUNITY CENTER 15 (GO TO 331)
STRAT AV HEALTH WORKER 16 (GO TO 331)
HEALTH WORKER/ COMMUNITY LIAISON 17 (GO TO 331)
VENDING MACHINE 18 (GO TO 331)
OTHER PUBLIC (SPECIFY) ________ 19 (GO TO 331)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21 (GO TO 331)
RELIGIOUS HOSPITAL 22 (GO TO 331)
PHARMACY 23 (GO TO 331)
ABPF (BENIN FAMILY ADVOCACY ASSOCIATION) 24 (GO TO 331)
DOCTOR'S OFFICE 25 (GO TO 331)
HEALTH AGENT (NON-GOVERNMENTAL ORGANIZATION) 26 (GO TO 331)
OTHER PRIVATE MEDICAL (SPECIFY) ________ 27 (GO TO 331)
OTHER SOURCE
SHOP/MARKET 31 (GO TO 331)
CHURCH/MOSQUE 32 (GO TO 331)
RELATIVES/FRIENDS 33 (GO TO 331)
BAR/SALOON 34 (GO TO 331)
OTHER (SPECIFY) ________ 96

top
Benin 2011
Survey form view entire document:  text 
323) Where did you obtain (CURRENT METHOD) 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
GOVERNMENT HOSPITAL 11 (GO TO 326)
GOVERNMENT HEALTH CENTER 12 (GO TO 326)
FAMILY PLANNING CLINIC 13 (GO TO 326)
FIELDWORKER 14 (GO TO 326)
SOCIAL CENTER 15 (GO TO 326)
STRAT AV HEALTH WORKER 16 (GO TO 326)
HEALTHWORKER/COMMUNITY LIAISON 17 (GO TO 326)
VENDING MACHINE 18 (GO TO 326)
OTHER PUBLIC SECTOR_______(SPECIFY) 19 (GO TO 326)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21 (GO TO 326)
RELIGIOUS HOSPITAL 22 (GO TO 326)
PRIVATE DOCTOR'S OFFICE 23 (GO TO 326)
PHARMACY 24 (GO TO 326)
BENINESE FAMILY PLANNING ASSOCIATION (ABPF) 25 (GO TO 326)
FIELDWORKER (NOG) 26 (GO TO 326)
OTHER PRIVATE MEDICAL_______ (SPECIFY) 26 (GO TO 326)
OTHER SOURCE
SHOP/MARKET 31 (GO TO 326)
CHURCH/MOSQUE 32 (GO TO 326)
FRIEND/RELATIVES 33 (GO TO 326)
BAR/REFRESHMENT AREA 34 (GO TO 326)
OTHER______ (SPECIFY) 96 (GO TO 326)

top
Benin 2017
Survey form view entire document:  text 
325) Where did you obtain (current method) 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
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
All skip to 327

top
Burkina Faso 1993
Survey form view entire document:  text 
318. CHECK 312:

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

USES ANOTHER METHOD: Where did you obtain (METHOD) the last time?

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 321)
OTHER (SPECIFY) _____ 41 (GO TO 321)
DOESN'T KNOW 98 (GO TO 321)

top
Burkina Faso 1998
Survey form view entire document:  text 
328. Where did you last obtain (METHOD)?

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

top
Burkina Faso 2003
Survey form view entire document:  text 
328. Where did you obtain (CURRENT METHOD) the last time?

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 11 (GO TO 331)
HEALTH CENTER 12 (GO TO 331)
DISPENSARY 13 (GO TO 331)
MEDICAL POST 14 (GO TO 331)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21 (GO TO 331)
PRIVATE HEALTH CENTER 22 (GO TO 331)
PHARMACY/MEDICINE DEPOT 23 (GO TO 331)
PRIVATE DOCTOR 24 (GO TO 331)
PF/FISA CENTER 25 (GO TO 331)
OTHER SOURCE
DBC AGENT 31 (GO TO 331)
STORE 32 (GO TO 331)
KIOSK 33 (GO TO 331)
CHURCH 34 (GO TO 331)
RELATIVES/FRIENDS 35 (GO TO 331)
OTHER (SPECIFY) _____ 96 (GO TO 331)

top
Burkina Faso 2010
Survey form view entire document:  text 
323. Where did you obtain (CURRENT METHOD) 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
GOVERNMENT HOSPITAL 11 (GO TO 326)
GOVERNMENT HEALTH CENTER 12 (GO TO 326)
FAMILY PLANNING CLINIC 13 (GO TO 326)
MOBILE CLINIC 14 (GO TO 326)
OTHER PUBLIC SECTOR (SPECIFY) ______16 (GO TO 326)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21 (GO TO 326)
PHARMACY 22 (GO TO 326)
PRIVATE DOCTOR 23 (GO TO 326)
MOBILE CLINIC 24 (GO TO 326)
OTHER PRIVATE MEDICAL (SPECIFY) ______ 26 (GO TO 326)
OTHER SOURCE
COMMUNITY/VILLAGE FIELDWORKER 31 (GO TO 326)
SHOP 32 (GO TO 326)
CHURCH 33 (GO TO 326)
FRIEND/RELATIVES 34 (GO TO 326)
OTHER (SPECIFY) _____ 96 (GO TO 326)

top
Burundi 1987
Survey form view entire document:  text 
317) Where did you obtain (advice on) (current method) the last time?

HOSPITAL/MATERNITY 01 (SKIP TO 322)
HEALTH CENTER/MOTHER-INFANT CENTER 02 (SKIP TO 322)
PUBLIC CLINIC 03 (SKIP TO 322)
AUTHORIZED CLINIC 04 (SKIP TO 322)
PRIVATE OFFICE 05 (SKIP TO 322)
PHARMACY 06 (SKIP TO 322)
TRADITIONAL HEALER 07 (SKIP TO 322)
ACQUAINTANCES 08 (SKIP TO 322)
OTHER (SPECIFY) _____ 09 (SKIP TO 322)
DK 98 (SKIP TO 322)

top
Burundi 2010
Survey form view entire document:  text 
323) Where did you obtain (CURRENT METHOD) the last time? (5)

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 (GO TO 326)
GOVT. HEALTH CENTER 12 (GO TO 326)
FAMILY PLANNING CLINIC 13 (GO TO 326)
MOBILE CLINIC 14 (GO TO 326)
FIELDWORKER 15 (GO TO 326)
OTHER PUBLIC SECTOR (SPECIFY)_____ 16 (GO TO 326)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21 (GO TO 326)
PHARMACY 22 (GO TO 326)
PRIVATE DOCTOR 23 (GO TO 326)
MOBILE CLINIC 24 (GO TO 326)
FIELDWORKER 25 (GO TO 326)
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)_____ 96 (GO TO 326)
OTHER SOURCE
SHOP 31 (GO TO 326)
CHURCH 32 (GO TO 326)
FRIEND/RELATIVE 33 (GO TO 326)
OTHER(SPECIFY)_____ 96 (GO TO 326)

top
Burundi 2016
Survey form view entire document:  text 
325) Where did you obtain (CURRENT METHOD) 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
OTHER________15
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

GO TO 327.


top
Cameroon 1991
Survey form view entire document:  text 
320) CHECK 312:

IF SHE/HE IS STERILIZED:
Where did the sterilization take place?/Where did your husband/spouse's sterilization take place?

IF USING ANOTHER METHOD:
Where did you obtain (method) the last time?

NAME OF PLACE: ___
PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH POST 12
PUBLIC HEALTH CENTER 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 323)
ACQUAINTANCES/RELATIVES 32 (GO TO 323)
OTHER (SPECIFY): ___ 41 (GO TO 323)
DK 98 (GO TO 323)

top
Cameroon 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/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

top
Cameroon 2004
Survey form view entire document:  text 
328) Where did you obtain (CURRENT METHOD) last time?

IF SOURCE IS A 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 (GO TO 331)
HEALTH CENTER 12 (GO TO 331)
OTHER PUBLIC (SPECIFY): ___ 16 (GO TO 331)
PRIVATE MEDICAL SECTOR
PRIVATE RELIGIOUS HOSPITAL 21 (GO TO 331)
SECULAR HOSPITAL/CLINIC 22 (GO TO 331)
HEALTH CENTER/RELIGIOUS CLINIC/MISSION 23 (GO TO 331)
DOCTOR'S OFFICE (SPECIFY): ___ 24 (GO TO 331)
PHARMACY 25 (GO TO 331)
OTHER PRIVATE MEDICAL (SPECIFY): ___ 26 (GO TO 331)
OTHER PRIVATE SECTOR
SHOP/MARKET 31 (GO TO 331)
BAR/NIGHTCLUB 32 (GO TO 331)
KIOSK 33 (GO TO 331)
INFORMAL COMMERCIAL DISTRIBUTION 34 (GO TO 331)
RELATIVES/FRIENDS 35 (GO TO 331)
OTHER (SPECIFY): ___ 96 (GO TO 331)

top
Cameroon 2011
Survey form view entire document:  text 
332) Where did you obtain (METHOD FROM 323) the last time?

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

IF YOU CANNOT DETERMINE IF THE HOSPITAL, HEALTH CENTER OR CLINIC IS PRIVATE OR PUBLIC, WRITE THE NAME OF THE PLACE.

NAME OF PLACE: ___
PUBLIC/PARA PUBLIC SECTOR
HOSPITAL 11 (GO TO 335)
HEALTH CENTER 12 (GO TO 335)
OTHER PUBLIC (SPECIFY): ___ 16 (GO TO 335)
PRIVATE MEDICAL SECTOR
PRIVATE RELIGIOUS HOSPITAL 21 (GO TO 335)
PRIVATE SECULAR HOSPITAL/CLINIC 22 (GO TO 335)
HEALTH CENTER/RELIGIOUS DISPENSARY/MISSION 23 (GO TO 335)
MEDICAL OFFICE (SPECIFY): ___ 24 (GO TO 335)
PHARMACY 25 (GO TO 335)
OTHER PRIVATE MEDICAL (SPECIFY): ___ 26 (GO TO 335)
OTHER PRIVATE SECTOR
SHOP/MARKET 31 (GO TO 335)
RELIGIOUS INSTITUTION 32 (GO TO 335)
FRIENDS/RELATIVES 33 (GO TO 335)
OTHER SOURCE (SPECIFY): ___ 96 (GO TO 335)

top
Cameroon 2018
Survey form view entire document:  text 
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.

PUBLIC MEDICAL SECTOR
GOVERNMENT HOSPITAL 11 (SKIP TO 327)
INTEGRATED HEALTH CENTER / DISPENSARY 12 (SKIP TO 327)
SUB-DIVISIONAL MEDICAL CENTER 13 (SKIP TO 327)
OTHER PUBLIC SECTOR (SPECIFY)________16 (SKIP TO 327)
PRIVATE MEDICAL SECTOR
CONFESSIONAL HOSPITAL / CLINIC 21 (SKIP TO 327)
PRIVATE LAY HOSPITAL / CLINIC 22 (SKIP TO 327)
CONFESSIONAL HEALTH CENTER / DISPENSARY 23 (SKIP TO 327)
PHARMACY 24 (SKIP TO 327)
DOCTOR'S OFFICE 25 (SKIP TO 327)
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)_________26 (SKIP TO 327)
OTHER SOURCE
SHOP / MARKET 31 (SKIP TO 327)
CHURCH 32 (SKIP TO 327)
FRIEND / RELATIVE 33 (SKIP TO 327)
OTHER (SPECIFY)___________96 (SKIP TO 327)

top
Central African Republic 1995
Survey form view entire document:  text 
327) Where did you obtain (CURRENT METHOD) 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 CENTER 12
HEALTH SUB-CENTER 13
HEALTH POST 14
FIELDWORKER 15
OTHER PUBLIC (SPECIFY)_____ 16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
PHARMACY 22
PRIVATE DOCTOR 23
HEALTH CENTER 24
FIELDWORKER 25
OTHER PRIVATE MEDICAL (SPECIFY)____ 26
OTHER SOURCE
SHOP 31
CHURCH 32
FRIEND/RELATIVE 33
OTHER (SPECIFY)____ 96

top
Chad 1996
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

PLEASE NOTE:
IF RESPONSE IS 'MILITARY HOSPITAL/GARRISON,' CIRCLE '12' FOR N'DJAMENA AND THE CODE '13' FOR OTHER CITIES.

PLEASE NOTE:
IF THE RESPONSE IS 'NURSE', PROBE TO DETERMINE IF A REAL NURSE (CODE '25' 'WORKPLACE HEALTH CENTER'), A HOSPITAL, OR A PUBLIC HEALTH CENTER.

NAME OF PLACE: ___
PUBLIC SECTOR
PUBLIC HOSPITAL/MATERNITY CLINIC 11
MILITARY HOSPITAL/GARRISON 12
HEALTH CENTER/DISPENSARY/GARRISON 13
WALK-IN CLINIC 14
HOSPITAL OR HEALTH CENTER PHARMACY 15
OTHER PUBLIC (SPECIFY): ___ 16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL 21
CLINIC/PRIVATE DOCTOR'S OFFICE 22
CHADIAN FAMILY WELFARE ASSOCIATION 23
PRIVATE HEALTH CENTER 24
WORKPLACE HEALTH CENTER 25
PHARMACY/PHARMACEUTICAL DEPOT 26
OTHER PRIVATE MEDICAL (SPECIFY): ___ 27
PUBLIC/PRIVATE SECTOR
VILLAGE PHARMACY/HEALTH CENTER 31
OTHER
SHOP/BAR/MARKET 41
FIRST AID WORKER 42
TRAVELING SALESMAN 43
FRIENDS/NEIGHBORS/RELATIVES 44
OTHER (SPECIFY): ___ 96
DK 98

top
Chad 2014
Survey form view entire document:  text 
323) Where did you obtain (CURRENT METHOD) 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
HOSPITAL/MATERNITY 11
MILITARY HOSPITAL/GARRISON 12
FREE CLINIC 13
POLYCLINIC 14
PHARMACY OF HOSPITAL/HEALTH CENTER 15
OTHER PUBLIC SECTOR (SPECIFY) 16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL 21
CLINIC/DOCTOR'S OFFICE 22
CHADIAN ASSOCIATION FOR FAMILY WELL-BEING 23
PRIVATE HEALTH CENTER 24
BUSINESS HEALTH CENTER 25
CARE OFFICE/INFIRMARY 26
PHARMACY/PHARMACY DEPOT 27
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) 28
PUBLIC/PRIVATE SECTOR
PHARMACY/VILLAGE HEALTH CENTER 31
Other
SHOP/BAR/MARKET 41
FIRST AID WORKER 42
TRAVELING VENDOR 43
FRIENDS/NEIGHBORS/RELATIVES 44
OTHER (SPECIFY) 96
DON'T KNOW 98

ALL SKIP TO 326


top
Congo (Democratic Republic) 2007
Survey form view entire document:  text 
328) Where did you obtain (CURRENT METHOD) 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 (GO TO 331)
CLINIC 12 (GO TO 331)
HEALTH OUTPOST/CENTER 13 (GO TO 331)
MATERNITY CENTER 14 (GO TO 331)
OTHER PUBLIC (SPECIFY) _____ 16 (GO TO 331)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/POLYCLINIC 21 (GO TO 331)
PHARMACY 22 (GO TO 331)
AMO-CONGO 23 (GO TO 331)
HEALTH CENTER 24 (GO TO 331)
MEDICAL OFFICE 25 (GO TO 331)
TRAVELING NURSE 26 (GO TO 331)
FIELDWORKER 27 (GO TO 331)
OTHER PRIVATE MEDICAL (SPECIFY) _____ 29 (GO TO 331)
OTHER SOURCE
SHOP 31 (GO TO 331)
CHURCH 32 (GO TO 331)
RELATIVES/FRIENDS 33 (GO TO 331)
OTHER (SPECIFY) _____ 96 (GO TO 331)

top
Congo (Democratic Republic) 2013
Survey form view entire document:  text 
323) Where did you obtain (CURRENT METHOD) 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
GOVERNMENT HOSPITAL 11
FAMILY PLANNING CLINIC 12
GOVERNMENT HEALTH CENTER 13
MATERNITY 14
FIELDWORKER 15
OTHER PUBLIC SECTOR (SPECIFY) 16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
PHARMACY 22
NGO 23
PRIVATE HEALTH CENTER 24
PRIVATE DOCTOR'S OFFICE 25
DOCTOR 26
MOBILE CLINIC 27
FIELDWORKER 28
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) 29
OTHER SOURCE
SHOP 31
RELIGIOUS INSTITUTION 32
FRIEND/RELATIVES 33
BAR/NIGHTCLUB 34
OTHER (SPECIFY) 96

top
Congo Brazzaville 2005
Survey form view entire document:  text 
328) Where did you obtain (CURRENT METHOD) last time?

PUBLIC SECTOR
HOSPITAL 11 (GO TO 401)
HEALTH CENTER/MOTHER-INFANT CENTER 12 (GO TO 401)
HEALTH POST 13 (GO TO 401)
PRIVATE MEDICAL SECTOR
CLINIC 21 (GO TO 401)
PRIVATE DOCTOR'S OFFICE 22 (GO TO 401)
NURSE'S OFFICE 23 (GO TO 401)
MEDICAL-SOCIAL CENTER 24 (GO TO 401)
CONGOLESE ASSOCIATION FOR FAMILY WELL-BEING 25 (GO TO 401)
PHARMACY 26 (GO TO 401)
OTHER PRIVATE SECTOR
TRADITIONAL THERAPIST 31 (GO TO 401)
SPIRITUAL MEDICAL CENTER 32 (GO TO 401)
TRAVELLING SALESMAN/UNOFFICIAL PHARMACY 33 (GO TO 401)
SHOP/MARKET 34 (GO TO 401)
BAR/NIGHTCLUB/HOTEL 35 (GO TO 401)
RELATIVES/FRIENDS 36 (GO TO 401)
OTHER PLACE 96 (GO TO 401)

top
Congo Brazzaville 2011
Survey form view entire document:  text 
315) You first started using (CURRENT METHOD) in (DATE FROM 308/308A). Where did you get it at that time?

315A) Where did you learn how to use the rhythm method?

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
HOSPITAL 11
INTEGRATED HEALTH CENTER 12
HEALTH POST 13
PRIVATE MEDICAL SECTOR
CLINIC 21
DOCTOR'S OFFICE 22
CONGOLESE ASSOCIATION FOR FAMILY WELL-BEING 24
PHARMACY 25
OTHER PRIVATE SECTOR
PEDDLER/TRAVELING PHARMACY 31
SHOP/MARKET 32
BAR/NIGHTCLUB/HOTEL 33
FRIENDS/RELATIVES 34
OTHER PLACE (SPECIFY) ____ 96

top
Cote d'Ivoire 1994
Survey form view entire document:  text 
321) CHECK 314:

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

USED ANOTHER METHOD: Where did you obtain (METHOD) the last time?

NAME OF PLACE___
PUBLIC SECTOR
HOSPITAL 11
HEALTH CENTER 12
CLINIC 13
MEDICAL POST 14
PRIVATE MEDICAL SECTOR
PRIVATE DOCTOR 21
PRIVATE HOSPITAL/CLINIC 22
PHARMACY 23
FAMILY PLANNING CENTER 24
OTHER PRIVATE SECTOR
SHOP 31
CHURCH 32 (GO TO 324)
ACQUAINTANCES/RELATIVES 33 (GO TO 324)
OTHER (SPECIFY)______ 41(GO TO 324)
DON'T KNOW 98 (GO TO 324)

top
Cote d'Ivoire 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
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

top
Cote d'Ivoire 2011
Survey form view entire document:  text 
323) Where did you obtain (CURRENT METHOD) 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
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
FAMILY PLANNING CLINIC 13
MOBILE CLINIC 14
HEALTH AGENT 15
OTHER_____ (SPECIFY) 16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21 (GO TO 326)
PHARMACY 22 (GO TO 326)
PRIVATE DOCTOR 23 (GO TO 326)
MOBILE CLINIC 24 (GO TO 326)
HEALTH AGENT 25 (GO TO 326)
OTHER PRIVATE MEDICAL_____ (SPECIFY) 26 (GO TO 326)
OTHER SOURCE
SHOP 31 (GO TO 326)
RELIGIOUS INSTITUTIONS 32 (GO TO 326)
FRIEND/RELATIVES 33 (GO TO 326)
OTHER__________ (SPECIFY) 96 (GO TO 326)

top
Egypt 1988
Survey form view entire document:  text 
352. Where did you (or your husband) obtain (CURRENT METHOD) the last time?

GOVERNMENT FP CLINIC 01
PRIVATE VOLUNTARY FP CLINIC 02
GOVERNMENT MCH CENTER 03
GOVERNMENT HOSPITAL 04
PRIVATE DOCTOR/CLINIC 05
PHARMACY 06 (TO 401)
OTHER (SPECIFY) __________ 08 (GO TO 401)
NOT SURE/DON'T KNOW 98 (GO TO 401)

top
Egypt 1992
Survey form view entire document:  text 
321. CHECK 318:
SHE/HE STERILIZED: ___Where did the sterilization take place?
USING IUD: ___ Where did you have the IUD inserted?
USING ANOTHER METHOD: ___ Where did you obtain (METHOD) the last time?

WRITE THE NAME AND THE 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

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 324)
OTHER 42
DON'T KNOW 98 (GO TO 326)

top
Egypt 1995
Survey form view entire document:  text 
319. CHECK 318:
SHE/HE STERILIZED: Where did the sterilization take place?
USING IUD: Where did you have the IUD inserted?
USING ANOTHER METHOD: Where did you obtain (METHOD) the last time?
WRITE THE NAME AND THE 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 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 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..) 36
FRIENDS/RELATIVES 41
OTHER (SPECIFY) __________ 96
DON'T KNOW 98 (GO TO 325)

top
Egypt 2000
Survey form view entire document:  text 
320) CHECK 316:

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)?

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

(NAME AND ADDRESS OF PLACE)________
OFFICE: CODE SOURCE____
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 (SPECIFY)_______X
DON'T KNOW Z

top
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

top
Egypt 2005
Survey form view entire document:  text 
321) CHECK 313/313A
IF MORE THAN ONE METHOD RECORDED IN 313/313A, CHECK AND ASK ABOUT METHOD HIGHEST ON THE LIST.

PILL (Where did you obtain the packet of pills you are using now (you used most recently)?)
__
INJECTION (Where did you go for your last injection?)
__
M CONDOM/ DIAPHRAGM/FOAM/ JELLY (From where did you obtain your most recent supply of (METHOD)?)
__

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
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

top
Egypt 2008
Survey form view entire document:  text 
321. CHECK 313/313A
IF MORE THAN ONE METHOD RECORDED IN 313/313A, CHECK AND ASK ABOUT METHOD HIGHEST ON THE LIST.

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

INJECTION___: Where did you go for your last injection?

M CONDOM/DIAPHRAGM/FOAM/JELLY/CREAM___: From where did you obtain your most recent supply of (METHOD)?

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

top
Egypt 2014
Survey form view entire document:  text 
315. You started using (CURRENT METHOD) in (DATE FROM 308A). Where did you get it at that time?

315A. Where did you have the IUD inserted when you started using it in (DATE FROM
308A)?

315B. Where did you have the implant inserted when you started using it in (DATE FROM 308A)?

315C. Did you obtain advice about how to use (CURRENT METHOD) when you started using it in (DATE FROM 308A)?

IF YES: from where did you get the advice?
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_________________________
MINISTRY OF HEALTH AND POPULATION
URBAN HOSP'L (GENERAL/DISTRICT) 11
URBAN HEALTH UNIT 12
HEALTH OFFICE 13
RURAL HOSP'L (CENTRAL) 14
RURAL HEALTH UNIT 15
MCH CENTER 16
MOBILE UNIT 17
OTHER GOVERNMENTAL
UNIVERSITY/TEACHING HOSPITAL 21
HEALTH INSURNACE ORGANIZATION 22
CURATIVE CARE ORGANIZATION 23
OTHER GOVERNMENTAL 26
NON-GOVERNMENTAL ORGANIZATION
EGYPT FAMILY PLANNING ASSOCIATION 31
CSI PROJECT 32
OTHER NON-GOVERNMENTAL 36
PRIVATE MEDICAL
PRIVATE HOSPITAL/CLINIC 41
PRIVATE DOCTOR 42
PHARMACY 43
OTHER PRIVATE MEDICAL
MOSQUE HEALTH UNIT 44
CHURCH HEALTH UNIT 45
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)______________46
OTHER NON-MEDICAL
VENDOR (SHOP, KIOSK, ETC) 61
FRIEND/RELATIVE 62
OTHER (SPECIFY)___________66
NO ONE 94
DON'T KNOW 98

top
Eswatini (Swaziland) 2006
Survey form view entire document:  text 
311) Which method are you using?
CIRCLE ALL MENTIONED. IF MORE THAN ONE METHOD MENTIONED, FOLLOW GO INSTRUCTION FOR HIGHEST METHOD ON LIST.
311A) CIRCLE 'A' FOR FEMALE STERILIZATION.

FEMALE STERILIZATION A (GO TO 316)
MALE STERILIZATION B (GO TO 316)
PILL C
IUD D (GO TO 315)
INJECTABLES E (GO TO 315)
IMPLANTS F (GO TO 315)
CONDOM G
FEMALE CONDOM H
DIAPHRAGM I
FOAM/JELLY J
LACTATIONAL AMN. METHOD K (GO TO 319A)
RHYTHM METHOD L (GO TO 319A)
WITHDRAWAL M (GO TO 319A)
OTHER (SPECIFY)_________X (GO TO 319A)

top
Ethiopia 2000
Survey form view entire document:  text 
319A. Where did you obtain (CURRENT METHOD) when you started using it the last time?
319B. Where did you learn to use (CURRENT METHOD)?
319C. Where did the sterilization 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 AND/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 (GO TO 330)
OTHER (SPECIFY)______________________ 46 (GO TO 330)
DID NOT CONSULT SOURCE 95 (GO TO 330)
DON'T KNOW 98 (GO TO 330)

top
Ethiopia 2005
Survey form view entire document:  text 
330. Where did you obtain (CURRENT 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 (GO TO 333)
GOVERNMENT HEALTH CENTER 12 (GO TO 333)
GOVERNMENT HEALTH POST 13 (GO TO 333)
GOVERNMENT HEALTH STATION/CLINIC 14 (GO TO 333)
CBD 15 (GO TO 333)
OTHER PUBLIC (SPECIFY) ________16 (GO TO 333)
NON-GOVERNMENT (NGO)
NGO HEALTH FACILITY 21 (GO TO 333)
CBD/CBRHA 22 (GO TO 333)
OTHER NGO ______ 26 (GO TO 333)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/DOCTOR 31 (GO TO 333)
PHARMACY 32 (GO TO 333)
OTHER PRIVATE MEDICAL (SPECIFY) ___________________ 36 (GO TO 333)
OTHER SOURCE
DRUG VENDOR 41 (GO TO 333)
SHOP 42 (GO TO 333)
FRIEND/RELATIVE 43 (GO TO 333)
OTHER (SPECIFY) _____________ 96 (GO TO 333)

top
Ethiopia 2011
Survey form view entire document:  text 
323. 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
GOVT. HOSPITAL 11 (GO TO 326)
GOVT. HEALTH CENTER 12 (GO TO 326)
GOVT. HEALTH STATION/CLINIC 13 (GO TO 326)
GOVT. HEALTH POST/HEW 14 (GO TO 326)
OTHER PUBLIC (SPECIFY) _____ 15 (GO TO 326)
NGO
NGO HEALTH FACILITY 21 (GO TO 326)
VOLUNTARY COMMUNITY HEALTH WORKERS 22 (GO TO 326)
OTHER NGO (SPECIFY) _____ 26 (GO TO 326)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL 31 (GO TO 326)
PRIVATE CLINIC 32 (GO TO 326)
PHARMACY 33 (GO TO 326)
OTHER PRIVATE MEDICAL (SPECIFY) _____ 36 (GO TO 326)
OTHER SOURCE
DRUG VENDOR/STORE 41 (GO TO 326)
SHOP 42 (GO TO 326)
FRIEND/RELATIVE 43 (GO TO 326)
OTHER (SPECIFY) _____ 96 (GO TO 326)

top
Ethiopia 2016
Survey form view entire document:  text 
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 STATION/CENTER 12 (GO TO 327)
GOVERNMENT HEALTH POST 13 (GO TO 327)
PUBLIC PHARMACY 14 (GO TO 327)
OTHER PUBLIC SECTOR (SPECIFY) 16 (GO TO 327)
NGO
HEALTH FACILITY 21 (GO TO 327)
OTHER NGO HEALTH FACILITY (SPECIFY) 26 (GO TO 327)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL 31 (GO TO 327)
PRIVATE CLINIC 32 (GO TO 327)
PRIVATE PHARMACY 33 (GO TO 327)
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) 36 (GO TO 327)
OTHER SOURCE
SHOP 41 (GO TO 327)
FRIEND/RELATIVE 42 (GO TO 327)
OTHER (SPECIFY) 96 (GO TO 327)

top
Ethiopia 2019
Survey form view entire document:  text 
304.
A. Where did you obtain (METHOD FROM Q. 304) the last time?
IF MORE THAN ONE METHOD CIRCLED IN Q. 3O4, ASK ABOUT THE METHOD THAT IS HIGHEST IN LIST.

PROBE TO IDENTIFY THE TYPE OF COURSE.

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

(NAME OF PLACE) ____

B. Where did you learn to use (METHOD FROM Q. 304)?

PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
GOVERNMENT HEALTH POST 13
PUBLIC PHARMACY 14
OTHER PUBLIC SECTOR (SPECIFY) ___ 16


NGO
NGO HEALTH FACILITY 21
OTHER NGO (SPECIFY) ___26


PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL 31
PRIVATE CLINIC 32
PHARMACY 33
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) ___36


OTHER SOURCE
SHOP 41
FRIEND/RELATIVE 42
OTHER (SPECIFY) ___96

top
Ghana 1988
Survey form view entire document:  text 
315. Where did you obtain (METHOD) the last time?

GOVERNMENT HOSPITAL 01
GOVERNMENT HEALTH CENTER 02
PPAG CLINIC 03
PRIVATE MATERNITY HOME 04
FIELD WORKER 05
PRIVATE DOCTOR/CLINIC 06
GOVT MATERNITY HOME 07
PHARMACY/CHEMICAL SELLER 08
CHRISTIAN COUNCIL 08
FRIENDS/RELATIVES/SCHOOL 10 (SKIP TO 315F)
OTHER (SPECIFY) ______ 11 (SKIP TO 315F)
NOWHERE 12 (SKIP TO 315F)
DK 98 (SKIP TO 315F)

top
Ghana 1993
Survey form view entire document:  text 
318. CHECK 312:
SHE/HE STERILIZED ___ Where did the sterilization take place?
USING ANOTHER METHOD ___ Where did you obtain (METHOD) the last time?

(NAME OF SOURCE) _____________
PUBLIC SECTOR
GOVERNMENT HOSPITAL/POLYCLINIC 11
GOVERNMENT HEALTH CENTER 12
FAMILY PLANNING CLINIC 13
MOBILE CLINIC 14 (GO TO 321)
FIELD WORKER 15 (GO TO 321)
MEDICAL PRIVATE SECTOR
PRIVATE HOSPITAL 21
PHARMACY/CHEMIST/DRUG STORE 22
PRIVATE DOCTOR/CLINIC 23
MOBILE CLINIC 24 (GO TO 321)
FIELD WORKER 25 (GO TO 321)
PRIVATE FP/PPAG CLINIC 26
MATERNITY HOME 27
OTHER PRIVATE SECTOR
SHOP 31
CHURCH 32
FRIENDS/RELATIVES 33 (GO TO 321)
OTHER (SPECIFY) _____ 96 (GO TO 321)
DON'T KNOW 98 (GO TO 321)

top
Ghana 1998
Survey form view entire document:  text 
326. Where did you obtain (METHOD) the last time?
326A. Where did you learn how to use the Lactational Amenorrhea Method?

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
GVT. HOSPITAL/POLYCLINIC 11
GVT. HEALTH CENTRE 12
FAMILY PLANNING CLINIC 13
MOBILE CLINIC 14 (GO TO 327)
FIELD WORKER 15 (GO TO 327)
OTHER PUBLIC (SPECIFY) ____ 16 (GO TO 327)
PRIVATE SECTOR
HOSPITAL/CLINIC 21
PHARMACY 22
CHEMIST 23
DRUG STORE 24
MOBILE CLINIC 25 (GO TO 327)
FIELD WORKER 26 (GO TO 327)
FP/PPAG CLINIC 27
MATERNITY HOME 28
OTHER PRIVATE (SPECIFY) ____ 29
OTHER SOURCE
CHURCH 31
SHOP 32
FRIEND/RELATIVE 33 (GO TO 327)
OTHER (SPECIFY) ____ 36 (GO TO 327)

top
Ghana 2003
Survey form view entire document:  text 
328) Where did you obtain (CURRENT METHOD) the last time?

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

NAME OF PLACE: ________________
PUBLIC SECTOR
GOVT. HOSPITAL 11
GOVT. HEALTH CENTER 12
FAMILY PLANNING CLINIC 13
MOBILE CLINIC 14
FIELDWORKER 15
OTHER PUBLIC (SPECIFY): ___________ 16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
PHARMACY 22
PRIVATE DOCTOR 23
MOBILE CLINIC 24
FIELDWORKER 25
OTHER PRIVATE MEDICAL (SPECIFY): __________ 26
OTHER SOURCE
SHOP 31
CHURCH 32
FRIEND/RELATIVE 33
OTHER (SPECIFY): __________ 96

top
Ghana 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
GOVT. HOSPITAL/POLYCLINIC 11 (GO TO 335)
GOVT. HEALTH CENTER 12 (GO TO 335)
GOVT. HEALTH POST/CHPS 13 (GO TO 335)
FAMILY PLANNING CLINIC 14 (GO TO 335)
MOBILE CLINIC 15 (GO TO 335)
FIELDWORKER/OUTREACH/PEER EDUCATOR ______ 16 (GO TO 335)
OTHER PUBLIC (SPECIFY) _____ 17 (GO TO 335)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21 (GO TO 335)
PRIVATE DOCTOR 22 (GO TO 335)
PHARMACY 23 (GO TO 335)
CHEMICAL/DRUG STORE 24 (GO TO 335)
FP/PPAG CLINIC 25 (GO TO 335)
MATERNITY HOME 26 (GO TO 335)
OTHER PRIVATE MEDICAL (SPECIFY) ____ 27 (GO TO 335)
OTHER SOURCE
SHOP/MARKET 31 (GO TO 335)
CHURCH 32 (GO TO 335)
COMMUNITY VOLUNTEER 33 (GO TO 335)
FRIEND/RELATIVE 34 (GO TO 335)
OTHER (SPECIFY) ____ 96 (GO TO 335)
DON'T KNOW 98 (GO TO 335)

top
Ghana 2014
Survey form view entire document:  text 
323) 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
GOVT. HOSPITAL/POLYCLINIC 11 (GO TO 326)
GOVT. HEALTH CENTER/CLINIC 12 (GO TO 326)
GOVT. HEALTH POST/CHPS 13 (GO TO 326)
FAMILY PLANNING CLINIC 14 (GO TO 326)
MOBILE CLINIC 15 (GO TO 326)
FIELDWORKER/OUTREACH/PEER EDUCATOR 16 (GO TO 326)
OTHER PUBLIC (SPECIFY) _____ 17 (GO TO 326)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21 (GO TO 326)
PRIVATE DOCTOR 22 (GO TO 326)
PHARMACY 23 (GO TO 326)
CHEMICAL/DRUG STORE 24 (GO TO 326)
FP/PPAG CLINIC 25 (GO TO 326)
MATERNITY HOME 26 (GO TO 326)
OTHER PRIVATE MEDICAL (SPECIFY) _____ 27 (GO TO 326)
OTHER SOURCE
SHOP/MARKET 31 (GO TO 326)
CHURCH 32 (GO TO 326)
COMMUNITY VOLUNTEER 33 (GO TO 326)
FRIEND/RELATIVE 34 (GO TO 326)
OTHER (SPECIFY) _____ 96 (GO TO 326)

top
Guinea 1999
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
HOSPITAL 11
FAMILY PLANNING CLINIC 12
FREE CLINIC 13
MEDICAL POST 14
COMMUNITY AGENT/COMMUNITY BASED HEALTH AGENT 15
OTHER PUBLIC (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

top
Guinea 2005
Survey form view entire document:  text 
328. Where did you obtain (CURRENT METHOD) 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 (GO TO 331)
HEALTH CENTER 12 (GO TO 331)
MEDICAL POST 13 (GO TO 331)
FAMILY PLANNING CLINIC 14 (GO TO 331)
FIELDWORKER 15 (GO TO 331)
OTHER PUBLIC (SPECIFY) _____ 16 (GO TO 331)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21 (GO TO 331)
PHARMACY 22 (GO TO 331)
PRIVATE DOCTOR 23 (GO TO 331)
MOBILE CLINIC 24 (GO TO 331)
FIELDWORKER 25 (GO TO 331)
OTHER PRIVATE MEDICAL (SPECIFY) _____ 26 (GO TO 331)
OTHER SOURCE
SHOP 31 (GO TO 331)
BAR/NIGHTCLUB 32 (GO TO 331)
KIOSK 33 (GO TO 331)
WORKPLACE 34 (GO TO 331)
CHURCH 35 (GO TO 331)
FRIENDS/ACQUAINTANCES/RELATIVES 36 (GO TO 331)
OTHER (SPECIFY) _____ 96 (GO TO 331)

top
Guinea 2012
Survey form view entire document:  text 
323) Where did you obtain (CURRENT METHOD) 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
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
FAMILY PLANNING CLINIC/AGBEF [##TRANSLATOR NOTE: GUINEAN ASSOCIATION FOR FAMILIAL WELL-BEING] 13
MOBILE CLINIC 14
FIELDWORKER 15
OTHER (SPECIFY) 16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
PHARMACY 22
PRIVATE DOCTOR 23
MOBILE CLINIC 24
FIELDWORKER 25
OTHER PRIVATE MEDICAL (SPECIFY) 26
OTHER SOURCE
SHOP 31
BAR/NIGHTCLUB/HOTEL 32
FRIEND/RELATIVES 33
OTHER (SPECIFY) 96
(All GO TO 326)

top
Guinea 2018
Survey form view entire document:  text 
325) Where did you obtain (current method) 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 HOSPITAL 11
REGIONAL HOSPITAL 12
PREFECTURAL HOSPITAL/COMMUNAL MEDICAL CENTER 13
HEALTH CENTER 14
HEALTH POST/CENTER 15
OTHER PUBLIC SECTOR (SPECIFY) 16


PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
PHARMACY 22
PRIVATE DOCTOR 23
PRIVATE HEALTH CLINIC 24
FAMILY PLANNING CLINIC/GUINEAN ASSOCIATION FOR FAMILY WELL-BEING 25

OTHER PRIVATE MEDICAL (SPECIFY) 26


OTHER SOURCE
SHOP 31
RELIGIOUS INSTITUTE 32
FRIENDS/PARENTS 33
COMMUNITY FIELDWORKER 34


OTHER (SPECIFY) 96

top
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)

top
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)

top
India 2005
Survey form view entire document:  text 
352. Where did you obtain (CURRENT METHOD) the last time?

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

NAME OF PLACE __________
PUBLIC MEDICAL SECTOR
GOVT./MUNICIPAL HOSPITAL 11 (GO TO 356)
GOVT. DISPENSARY 12 (GO TO 356)
UHC/UHP/UFWC 13 (GO TO 356)
CHC/RURAL HOSPITAL/PHC 14 (GO TO 356)
SUB-CENTRE/ANM 15 (GO TO 356)
GOVT. MOBILE CLINIC 16 (GO TO 356)
CAMP 17 (GO TO 356)
ANGANWADI/ICDS CENTRE 18 (GO TO 356)
ASHA 19 (GO TO 356)
OTHER COMMUNITY-BASED WORKER 20 (GO TO 356)
OTHER PUBLIC MEDICAL SECTOR 21 (GO TO 356)
NGO OR TRUST HOSPITAL/CLINIC 31 (GO TO 356)
PRIVATE MEDICAL SECTOR
PVT. HOSPITAL 41 (GO TO 356)
PVT. DOCTOR/CLINIC 42 (GO TO 356)
PVT. MOBILE CLINIC 43 (GO TO 356)
VAIDYA/HAKIM/HOMEOPATH 44 (GO TO 356)
TRADITIONAL HEALER 45 (GO TO 356)
PHARMACY/DRUGSTORE 46 (GO TO 356)
DAI (TBA) 47 (GO TO 356)
OTHER PRIVATE MEDICAL SECTOR 48 (GO TO 356)
OTHER SOURCE
SHOP 51 (GO TO 356)
HUSBAND 52 (GO TO 356)
FRIEND/RELATIVE 53 (GO TO 356)
OTHER (SPECIFY) _________ 96 (GO TO 356)

top
India 2015
Survey form view entire document:  text 
350. Where did you obtain (CURRENT METHOD) the last time?

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)_____________
PUBLIC HEALTH SECTOR
GOVT./MUNICIPAL HOSPITAL 11 (GO TO 354)
VAIDYA/HAKIM HOMEOPATH (AYUSH) 12 (GO TO 354)
GOVT. DISPENSAR 13 (GO TO 354)
UHC/UHP/UFWC 14 (GO TO 354)
CHC/RURAL HOSPITAL/BLOCK PHC 15 (GO TO 354)
PHC/ADDITIONAL PHC 16 (GO TO 354)
GOVT. MOBILE CLINIC 18 (GO TO 354)
CAMP 19 (GO TO 354)
ANGANWADI/ICDS CENTRE 20 (GO TO 354)
ASHA 21 (GO TO 354)
OTHER COMMUNITY-BASED WORKER 22 (GO TO 354)
OTHER PUBLIC HEALTH SECTOR 23 (GO TO 354)
NGO OR TRUST HOSPITAL/CLINIC 31 (GO TO 354)
PRIVATE HEALTH SECTOR
PVT. HOSPITAL 41 (GO TO 354)
PVT. DOCTOR/CLINIC 42 (GO TO 354)
PVT. MOBILE CLINIC 43 (GO TO 354)
VAIDYA/HAKIM/HOMEOPATH (AYUSH)
TRADITIONAL HEALER 45 (GO TO 354)
PHARMACY/DRUGSTORE 46 (GO TO 354)
DAI (TBA) 47 (GO TO 354)
OTHER PRIVATE HEALTH SECTOR 48 (GO TO 354)
OTHER SOURCE
SHOP 51 (GO TO 354)
HUSBAND 52 (GO TO 354)
FRIEND/RELATIVE 53 (GO TO 354)
OTHER (SPECIFY)________96

top
Jordan 1990
Survey form view entire document:  text 
323) CHECK 315:
SHE/HE STERILIZED: Where did the sterilization take place?***

USING ANOTHER METHOD: Where did you obtain (METHOD) the last time?***

(NAME OF PLACE) __________
PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
FAMILY PLANNING CLINIC 13
MOBILE CLINIC 14 (GO TO 326)
FIELD WORKER 15 (GO TO 326)
MEDICAL PRIVATE SECTOR
PRIVATE HOSPITAL OR CLINIC 21
PHARMACY 22
PRIVATE DOCTOR 23
MOBILE CLINIC 24 (GO TO 326)
FIELD WORKER 25 (GO TO 326)
OTHER PRIVATE SECTOR
SHOP 31
CHURCH 32 (GO TO 326)
FRIENDS/RELATIVES 33 (GO TO 326)
OTHER (SPECIFY) ________ 41 (GO TO 326)
DON'T KNOW 98 (GO TO 326)

top
Jordan 1997
Survey form view entire document:  text 
428. 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 CENTER 12
GOVERNMENT MCH 13
UNIVERSITY HOSPITAL/CLINIC 14
ROYAL MEDICAL SERVICES (ARMED FORCES) 15
OTHER PUBLIC ____________ 16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
PRIVATE DOCTOR 22
PHARMACY 23
JORDANIAN ASSOCIATION OF FP AND PROTECTION (JAFPP) 24
UN RELIEF AGENCY HC 25
OTHER NGOs 26
OTHER P. MEDICAL ________ 27
OTHER SOURCE
FRIENDS/RELATIVES 31
OTHER___________36

top
Jordan 2002
Survey form view entire document:  text 
318. I would like to ask you some questions about the times you or your husband may have used a method to avoid getting pregnant during the last few years.

USE CALENDAR TO PROBE FOR EARLIER PERIODS OF PREGNANCY AS REFERENCE POINTS.

IN COLUMN 1, ENTER METHOD USE CODE OR '0' FOR NONUSE IN EACH BLANK MONTH.

ILLUSTRATIVE QUESTIONS:
When was the last time you used a method? Which method was that?
When did you start using that method? How long after the birth of (NAME)?
How long did you use the method then?

IN COLUMN 2, ENTER METHOD SOURCE CODE IN FIRST MONTH OF EACH USE.

ILLUSTRATIVE QUESTIONS:
Where did you obtain the method when you started using it?
Where did you get advice on how to use the method [for LAM, rhythm, or withdrawal]?

IN COLUMN 3, ENTER CODES FOR DISCONTINUATION NEXT TO LAST MONTH OF USE. NUMBER OF CODES IN COLUMN 3 MUST BE SAME AS NUMBER OF INTERRUPTIONS OF METHOD USE IN COLUMN 1.

ASK WHY SHE STOPPED USING THE METHOD, IF A PREGNANCY FOLLOWED, ASK WHETHER SHE BECAME PREGNANT UNINTENTIONALLY WHILE USING THE METHOD OR DELIBERATELY STOPPED TO GET PREGNANT.

ILLUSTRATIVE QUESTIONS:
Why did you stop using the (METHOD)?
Did you become pregnant while using (METHOD), or did you stop to get pregnant, or did you stop for some other reason?

IF DELIBERATELY STOPPED TO BECOME PREGNANT, ASK:
How many months did it take you to get pregnant after you stopped using (METHOD)?

AND ENTER '0' IN EACH SUCH MONTH IN COLUMN 1


top
Jordan 2007
Survey form view entire document:  text 
331) CHECK 311/311A:

CIRCLE METHOD CODE:

IF MORE THAN ONE METHOD CODE CIRCLED IN 311/311A, CIRCLE CODE FOR HIGHEST METHOD IN LIST.

FEMALE STERILIZATION 01 (GO TO 335)
MALE STERILIZATION 02 (GO TO 335)
PILL 03
IUD 04
INJECTABLES 05
IMPLANTS 06
CONDOM 07
FEMALE CONDOM 08
DIAPHRAGM 09
FOAM/JELLY 10
LACTATIONAL AMEN. METHOD 11 (GO TO 335)
PERIODIC ABSTINENCE 12 (GO TO 335)
WITHDRAWAL 13 (GO TO 335)
OTHER METHOD 96 (GO TO 335)

top
Jordan 2009
Survey form view entire document:  text 
322) Where did you obtain (CURRENT METHOD) the last time?

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

PUBLIC MEDICAL SECTOR
GOVERNMENT HOSPITAL 11 (SKIP TO 401)
GOVERNMENT HEALTH CENTER 12 (SKIP TO 401)
GOVERNMENT MCH 13 (SKIP TO 401)
UNIVERSITY HOSPITAL /CLINIC 14 (SKIP TO 401)
ROYAL MEDICAL SERVICES 15 (SKIP TO 401)
OTHER PUBLIC (SPECIFY)________ 16 (SKIP TO 401)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21 (SKIP TO 401)
PRIVATE DOCTOR 22 (SKIP TO 401)
PHARMACY 23 (SKIP TO 401)
JORDANIAN AS. OF FP AND PROTECTION (JAFPP) 24 (SKIP TO 401)
UNRWA CLINIC 25 (SKIP TO 401)
OTHER NON-GOVERNMENT ORGANIZATION 26 (SKIP TO 401)
OTHER PRIVATE MEDICAL (SPECIFY) _________ 27 (SKIP TO 401)
OTHER SOURCE
FRIEND/RELATIVE 33 (SKIP TO 401)
OTHER (SPECIFY) ___________ 96 (SKIP TO 401)

IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE) ____________

top
Jordan 2012
Survey form view entire document:  text 
323. 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 MEDICAL SECTOR
GOVT. HOSPITAL 11 (GO TO 326)
GOVT. HEALTH CENTER 12 (GO TO 326)
GOVT. MCH 13 (GO TO 326)
UNIVERSITY HOSPITAL/CLINIC 14 (GO TO 326)
ROYAL MEDICAL SERVICES 15 (GO TO 326)
OTHER PUBLIC (SPECIFY) _____ 16 (GO TO 326)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21 (GO TO 326)
PRIVATE DOCTOR 22 (GO TO 326)
PHARMACY 23 (GO TO 326)
JORDANIAN AS. OF FP AND PROTECTION (JAFPP) 24 (GO TO 326)
UNRWA CLINIC 25 (GO TO 326)
OTHER NON-GOV ORGANIZATION 26 (GO TO 326)
OTHER PRIVATE MEDICAL (SPECIFY) _____ 27 (GO TO 326)
OTHER SOURCE
FRIEND/RELATIVE 33 (GO TO 326)
OTHER (SPECIFY) _____ 96 (GO TO 326)

top
Jordan 2017
Survey form view entire document:  text 
324) CHECK 304:

CIRCLE METHOD CODE:

IF MORE THAN ONE METHOD CODE CIRCLED IN 304, CIRCLE CODE FOR HIGHEST METHOD IN LIST.

FEMALE STERILIZATION 01 (SKIP TO 327)
MALE STERILIZATION 02 (SKIP TO 327)
IUD 03
INJECTABLES 04
IMPLANTS 05
PILL 06
CONDOM 07
FEMALE CONDOM 08
EMERGENCY CONCEPTION 09
LACTATIONAL AMENORRHEA METHOD 10 (SKIP TO 327)
RHYTHM METHOD 11 (SKIP TO 323)
WITHDRAWAL 12 (SKIP TO 323)
OTHER MODERN METHOD 95
OTHER TRADITIONAL METHOD 96 (SKIP TO 327)

top
Kenya 1989
Survey form view entire document:  text 
315. Where did you obtain (METHOD) the last time?
315A. Where did the sterilization take place?
315B. Where did you obtain instructions for this method?

HOSPITAL 01
HEALTH CENTER/CLINIC 02
MOBILE CLINIC 03
FIELD EDUCATOR 04
PHARMACY/SHOP 05 (TO 315D)
PRIVATE DOCTOR 06 (TO 315D)
TRADITIONAL HEALER 07 (TO 315D)
HUSBAND/PARTNER OBTAINS METHOD 08 (TO 315D)
FRIENDS/RELATIVES 09 (TO 315H)
OTHER (SPECIFY) ________ 10 (TO 315H)

top
Kenya 1993
Survey form view entire document:  text 
318. CHECK 312:

SHE/HE STERILISED __
Where did the sterilization take place?

USING ANOTHER METHOD __
Where did you obtain (METHOD) the last time?

(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 321)
OTHER (SPECIFY) ________ 71 (GO TO 321)
DOES NOT KNOW 98 (GO TO 321)

top
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

top
Kenya 2003
Survey form view entire document:  text 
328. Where did you obtain (CURRENT METHOD) the last time?

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) _________

IF NURSING/MATERNITY HOME, ASK IF IT IS RUN BY A CHURCH OR MISSION. IF SO, CIRCLE CODE '21'.

PUBLIC SECTOR

GOVERNMENT HOSPITAL 11 (GO TO 331)
GOVERNMENT HEALTH CENTRE 12 (GO TO 331)
GOVERNMENT DISPENSARY 13 (GO TO 331)
OTHER PUBLIC (SPECIFY) _______ 16 (GO TO 331)
PRIVATE MEDICAL SECTOR
MISSION, CHURCH HOSP./CLINIC 21 (GO TO 331)
FPAK HEALTH CENTRE/CLINIC 22 (GO TO 331)
PRIVATE HOSPITAL OR CLINIC 23 (GO TO 331)
PHARMACY/CHEMIST 24 (GO TO 331)
NURSING/MATERNITY HOME 26 (GO TO 331)
OTHER SOURCE
MOBILE CLINIC 31 (GO TO 331)
COMMUNITY-BASED DISTRIBUTOR 41 (GO TO 331)
SHOP 51 (GO TO 331)
FRIEND/RELATIVE 61 (GO TO 331)
OTHER (SPECIFY) ________ 96 (GO TO 331)

top
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

top
Kenya 2014
Survey form view entire document:  text 
315) You first started using (CURRENT METHOD) in (DATE FROM 308/308A). Where did you get it at that time?

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
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
GOVERNMENT DISPENSARY 13
OTHER PUBLIC SECTOR (SPECIFY) ___________ 16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
PHARMACY/CHEMIST 22
NURSING/MATERNITY HOME 23
FAITH-BASED, CHURCH, MISSION HOSPITAL/CLINIC 24
FAMILY OPTIONS/FHOK CLINIC 25
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) _______ 26
OTHER SOURCE
SHOP 31
MOBILE CLINIC 32
COMMUNITY-BASED DISTRIBUTOR 33
COMMUNITY HEALTH WORKER/CHW 34
FRIEND/RELATIVE 35
OTHER (SPECIFY) __________ 96

top
Lesotho 2004
Survey form view entire document:  text 
317 Where did you obtain (CURRENT 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
GOVT. HOSPITAL 11 (GO TO 320)
GOVT. HEALTH CENTER 12 (GO TO 320)
FAMILY PLANNING CLINIC 13 (GO TO 320)
OTHER PUBLIC ________(SPECIFY) 16 (GO TO 320)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21 (GO TO 320)
PHARMACY 22 (GO TO 320)
PRIVATE DOCTOR 23 (GO TO 320)
OTHER PRIVATE MEDICAL __________(SPECIFY) 26 (GO TO 320)
CHAL
CHAL HOSPITAL 31 (GO TO 320)
CHAL HEALTH CENTER 32 (GO TO 320)
CBD 41
COMMUNITY HEALTH WORKER 42 (GO TO 320)
SUPPORT GROUPS 43 (GO TO 320)
OTHER SOURCE
SHOP 51 (GO TO 320)
CHURCH 52 (GO TO 320)
PEER EDUCATORS 53 (GO TO 320)
FRIEND/RELATIVE 54 (GO TO 320)
OTHER __________(SPECIFY) 96 (GO TO 320)

top
Lesotho 2009
Survey form view entire document:  text 
332 Where did you obtain (CURRENT METHOD) the last time?
PROBE TO IDENTIFY THE TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE MEDICAL SECTOR, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE) ____________
PUBLIC SECTOR
GOVT. HOSPITAL 11 (GO TO 335)
GOVT. HEALTH CENTER 12 (GO TO 335)
OTHER PUBLIC SECTOR 13 (GO TO 335)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21 (GO TO 335)
LPPA 22 (GO TO 335)
PHARMACY 23 (GO TO 335)
PRIVATE DOCTOR 24 (GO TO 335)
OTHER PRIVATE MEDICAL SECTOR 25 (GO TO 335)
CHAL
CHAL HOSPITAL 31 (GO TO 335)
CHAL HEALTH CENTER 32 (GO TO 335)
CHAL HEALTH POST 33 (GO TO 335)
CBD 41 (GO TO 335)
COMMUNITY HEALTH WORKER 42 (GO TO 335)
SUPPORT GROUPS 43 (GO TO 335)
OTHER SOURCE
SHOP 51 (GO TO 335)
CHURCH 52 (GO TO 335)
PEER EDUCATORS 53 (GO TO 335)
FRIEND/RELATIVE 54 (GO TO 335)
OTHER 96 (GO TO 335)

top
Lesotho 2014
Survey form view entire document:  text 
323) 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 326)
GOVERNMENT HEALTH CENTER 12 (GO TO 326)
GOVERNMENT HEALTH POST 13 (GO TO 326)
FAMILY PLANNING CLINIC 14 (GO TO 326)
OTHER PUBLIC SECTOR (SPECIFY) ____ 16 (GO TO 326)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21(GO TO 326)
PHARMACY 22 (GO TO 326)
PRIVATE DOCTOR 23 (GO TO 326)
LESOTHO PLANNED PARENTHOOD 24 (GO TO 326)
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) ____ 26 (GO TO 326)
CHAL
CHAL HOSPITAL 31 (GO TO 326)
CHAL HEALTH CENTER 32 (GO TO 326)
CHAL HEALTH POST 33 (GO TO 326)
RED CROSS HEALTH CENTER 41 (GO TO 326)
CBD 51
VILLAGE HEALTH WORKER 52 (GO TO 326)
SUPPORT GROUPS 53 (GO TO 326)
FACILITY OUTSIDE LESOTHO 61 (GO TO 326)
OTHER SOURCE
SHOP 71 (GO TO 326)
CHURCH 72 (GO TO 326)
PEER EDUCATORS 73 (GO TO 326)
FRIEND/RELATIVE 74 (GO TO 326)
OTHER (SPECIFY) ____ 96 (GO TO 326)

top
Liberia 1986
Survey form view entire document:  text 
315) Where did you get (METHOD) from, the last time?
IF RHYTHM OR SAFE PERIOD, ASK: Where did you get advice about this method?

GOVERNMENT HOSPITAL OR HEALTH CLINIC 1 (GO TO 401)
CHURCH HOSPITAL OR CLINIC 2 (GO TO 401)
FPAL CLINIC 3 (GO TO 401)
PRIVATE DOCTOR/CLINIC 4 (GO TO 401)
PHARMACY/SHOP 5 (GO TO 401)
FIELD WORKER 6 (GO TO 401)
OTHER (SPECIFY) ________ 7(GO TO 401)
DON'T KNOW 8 (GO TO 401)

top
Liberia 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)

top
Liberia 2013
Survey form view entire document:  text 
323) 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
GOVT. HOSPITAL 11
GOVT. HEALTH CENTER 12
GOVT. CLINIC 13
COMMUNITY HEALTH VOL/gCHV 14
OTHER PUBLIC SECTOR (SPECIFY) 16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
PHARMACY 22
PRIVATE DOCTOR 23
PLANNED PARENTHOOD ASSN. LIB. 24
MOBILE CLINIC 25
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) 26
OTHER SOURCE
SHOP 31
CHURCH 32
FRIENDS/RELATIVES 33
OTHER (SPECIFY) 96

top
Madagascar 1992
Survey form view entire document:  text 
318. CHECK 312:

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

USES ANOTHER METHOD
Where did you obtain (METHOD) the last time?

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 321)
FRIENDS/RELATIVES 33 (GO TO 321)
OTHER (SPECIFY) _____ 41 (GO TO 321)
DOESN'T KNOW 98 (GO TO 321)

top
Madagascar 1997
Survey form view entire document:  text 
328. Where did you last obtain (METHOD)?

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 11
HEALTH CENTER 12
DISPENSARY 13
MEDICAL POST 14
OTHER PUBLIC (SPECIFY) ______ 16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
PHARMACY 22
DOCTOR 23
PF/FISA CENTER 24
OTHER PRIVATE (SPECIFY) ______ 26
OTHER SOURCE
STORE 31
RELIGIOUS CENTER 32
RELATIVES 33
FRIENDS 34
OTHER (SPECIFY) ______ 36

top
Madagascar 2003
Survey form view entire document:  text 
328. Where did you obtain (CURRENT METHOD) the last time?

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
DISTRICT HOSPITAL II [FACILITY EQUIPPED FOR SURGERIES] 11 (GO TO 331)
DISTRICT HOSPITAL I [NON-SURGICAL MEDICAL CAPABILITIES] 12 (GO TO 331)
BASIC HEALTH CENTER II [BASIC HEALTH CARE, PHYSICIAN-RUN] 13 (GO TO 331)
BASIC HEALTH CENTER I [BASIC HEALTH CARE, RUN BY PARA-MEDICAL OFFICER] 14 (GO TO 331)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21 (GO TO 331)
PRIVATE HEALTH CENTER 22 (GO TO 331)
PHARMACY/MEDICINE DISPENSARY 23 (GO TO 331)
PRIVATE DOCTOR 24 (GO TO 331)
PF/FISA CENTER 25 (GO TO 331)
OTHER SOURCE
VBC AGENT 31 (GO TO 331)
STORE 32 (GO TO 331)
KIOSK 33 (GO TO 331)
CHURCH 34 (GO TO 331)
RELATIVES/FRIENDS 35 (GO TO 331)
OTHER (SPECIFY) ______ 96 (GO TO 331)

top
Madagascar 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 A PUBLIC OR PRIVATE INSTITUTION, WRITE THE NAME OF THE PLACE.

NAME OF PLACE ______
PUBLIC SECTOR
DISTRICT HOSPITAL II (facility equipped for surgeries) 11 (GO TO 335)
DISTRICT HOSPITAL I (non-surgical medical capabilities) 12 (GO TO 335)
BASIC HEALTH CENTER II (basic health care, physician-run) 13 (GO TO 335)
BASIC HEALTH CENTER I (basic health care, run by para-medical officer) 14 (GO TO 335)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21 (GO TO 335)
PRIVATE MOBILE CLINIC 22 (GO TO 335)
PHARMACY 23 (GO TO 335)
PRIVATE DOCTOR 24 (GO TO 335)
FAMILY PLANNING CENTER 25 (GO TO 335)
OTHER SOURCE
FIELDWORKER 31 (GO TO 335)
STORE 32 (GO TO 335)
KIOSK 33 (GO TO 335)
CHURCH 34 (GO TO 335)
FRIEND/RELATIVE 35 (GO TO 335)
OTHER (SPECIFY) _____ 96 (GO TO 335)

top
Malawi 1992
Survey form view entire document:  text 
318. CHECK 312:

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

USING ANOTHER METHOD: Where did you obtain (METHOD) the last time?

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 321)
MEDICAL PRIVATE SECTOR
PRIVATE HOSPITAL 21
PRIVATE HEALTH CENTRE 22
DISPENSARY/MATERNITY CLINIC 23
MOBILE CLINIC 24 (GO TO 321)
PRIVATE DOCTOR 25
OTHER PRIVATE SECTOR
SHOP/PHARMACY 31
CHURCH 32 (GO TO 321)
FRIENDS/RELATIVES 33 (GO TO 321)
OTHER (SPECIFY) ____ 41 (GO TO 321)
DON'T KNOW 98 (GO TO 321)

top
Malawi 2000
Survey form view entire document:  text 
327. Where did you obtain (CURRENT 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 (GO TO 330)
GOVERNMENT HEALTH CENTER 12 (GO TO 330)
FAMILY PLANNING CLINIC 13 (GO TO 330)
MOBILE CLINIC 14 (GO TO 330)
CBDA/FIELD WORKER 15 (GO TO 330)
OTHER PUBLIC (SPECIFY) ____ 16 (GO TO 330)
MISSION
HOSPITAL 21 (GO TO 330)
HEALTH CENTER 22 (GO TO 330)
MOBILE CLINIC 23 (GO TO 330)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31 (GO TO 330)
PHARMACY 32 (GO TO 330)
PRIVATE DOCTOR 33 (GO TO 330)
MOBILE CLINIC 34 (GO TO 330)
CBDA/FIELD WORKER 35 (GO TO 330)
OTHER PRIVATE MEDICAL (SPECIFY) _____ 36 (GO TO 330)
BLM 41 (GO TO 330)
OTHER SOURCE
SHOP 51 (GO TO 330)
CHURCH 52 (GO TO 330)
FRIEND/RELATIVE 53 (GO TO 330)
OTHER (SPECIFY) _____ 96 (GO TO 330)

top
Malawi 2004
Survey form view entire document:  text 
328. Where did you obtain (CURRENT 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 (GO TO 331)
GOVERNMENT HEALTH CENTER 12 (GO TO 331)
FAMILY PLANNING CLINIC 13 (GO TO 331)
MOBILE CLINIC 14 (GO TO 331)
CBDA/FIELDWORKER 15 (GO TO 331)
OTHER PUBLIC (SPECIFY) ______ 16 (GO TO 331)

MISSION
HOSPITAL 21 (GO TO 331)
HEALTH CENTER 22 (GO TO 331)
MOBILE CLINIC 23 (GO TO 331)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31 (GO TO 331)
PHARMACY 32 (GO TO 331)
PRIVATE DOCTOR 33 (GO TO 331)
MOBILE CLINIC 34 (GO TO 331)
CBDA/FIELDWORKER 35 (GO TO 331)
OTHER PRIVATE MEDICAL (SPECIFY) __________ 36 (GO TO 331)
BLM 41 (GO TO 331)
OTHER SOURCE
SHOP 51 (GO TO 331)
FRIEND/RELATIVE 53 (GO TO 331)
OTHER (SPECIFY) _____ 96 (GO TO 331)

top
Malawi 2010
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 (GO TO 335)
GOVERNMENT HEALTH CENTER 12 (GO TO 335)
GOVERNMENT HEALTH POST/OUTREACH 13 (GO TO 335)
MOBILE CLINIC 14 (GO TO 335)
HSA 15 (GO TO 335)
CBDA/DOOR TO DOOR 16 (GO TO 335)
OTHER PUBLIC 17 (GO TO 335)
CHAM/MISSION
HOSPITAL 21 (GO TO 335)
HEALTH CENTER 22 (GO TO 335)
MOBILE CLINIC 23 (GO TO 335)
DOOR TO DOOR 24 (GO TO 335)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR 31 (GO TO 335)
PHARMACY 32 (GO TO 335)
MOBILE CLINIC 33 (GO TO 335)
CBDA/DOOR TO DOOR 34 (GO TO 335)
OTHER PRIVATE MEDICAL 36 (GO TO 335)
BLM 41 (GO TO 335)
MACRO 51 (GO TO 335)
YOUTH DROP IN CENTRE 61 (GO TO 335)
OTHER SOURCE
SHOP 71 (GO TO 335)
CHURCH 72 (GO TO 335)
FRIEND/RELATIVE 73 (GO TO 335)
OTHER 96 (GO TO 335)

top
Malawi 2016
Survey form view entire document:  text 
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)
GOVERNMENT HEALTH POST/OUTREACH 13 (GO TO 327)
MOBILE CLINIC 14 (GO TO 327)
HSA 15 (GO TO 327)
CBDA/DOOR TO DOOR 16 (GO TO 327)
OTHER PUBLIC SECTOR (SPECIFY) 17 (GO TO 327)
CHAM/MISSION
HOSPITAL 21 (GO TO 327)
HEALTH CENTER 22 (GO TO 327)
MOBILE CLINIC 23 (GO TO 327)
CBDA/DOOR TO DOOR 24 (GO TO 327)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL OR CLINIC 31 (GO TO 327)
PHARMACY 32 (GO TO 327)
PRIVATE DOCTOR 33 (GO TO 327)
MOBILE CLINIC 34 (GO TO 327)
CBDA/DOOR TO DOOR 34 (GO TO 327)
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) 36 (GO TO 327)
BLM 41 (GO TO 327)
MACRO 51 (GO TO 327)
YOUTH DROP IN CENTRE 61 (GO TO 327)
OTHER SOURCE
SHOP 71 (GO TO 327)
CHURCH 72 (GO TO 327)
FRIEND OR RELATIVE 73 (GO TO 327)
OTHER (SPECIFY) 96 (GO TO 327)

top
Mali 1987
Survey form view entire document:  text 
315. Where did you (your partner) get (advice for) (CURRENT METHOD) the last time?

1 PMI (protection maternelle et infantile - a program created in France to give free care to expecting/recent mothers)
2 FREE CLINIC (GO TO 321)
3 AMPPF (Malian Association of Family Protection and Promotion) (GO TO 321)
4 HEALTH CENTER (GO TO 321)
5 PHARMACY (GO TO 321)
6 OTHER (SPECIFY) _____ (GO TO 321)
8 DOESN'T KNOW (GO TO 321)

top
Mali 1995
Survey form view entire document:  text 
328. Where did you get (CURRENT METHOD) the last time?

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

top
Mali 2001
Survey form view entire document:  text 
328) Where did you obtain (CURRENT METHOD) the last time?

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

NAME OF PLACE: ________________
PUBLIC SECTOR
GOVT. HOSPITAL 11
GOVT. HEALTH CENTER 12
FAMILY PLANNING CLINIC 13
MOBILE CLINIC 14
FIELDWORKER 15
OTHER PUBLIC (SPECIFY): ___________ 16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
PHARMACY 22
PRIVATE DOCTOR 23
MOBILE CLINIC 24
FIELDWORKER 25
OTHER PRIVATE MEDICAL (SPECIFY): __________ 26
OTHER SOURCE
SHOP 31
CHURCH 32
FRIEND/RELATIVE 33
OTHER (SPECIFY): __________ 96

top
Mali 2006
Survey form view entire document:  text 
328. Where did you get (THE CURRENT METHOD) the last time?

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
NATIONAL HOSPITAL 11 (GO TO 331)
REGIONAL HOSPITAL 12 (GO TO 331)
CSREF (heath referral center)13 (GO TO 331)
PMI (protection maternelle et infantile - a program created in France to give free care to expecting/recent mothers) /MATERNITY 14 (GO TO 331)
CSCOM (Centre de Santé Communitaire) Community Health Center 15 (GO TO 331)
OTHER PUBLIC (SPECIFY)__18 (GO TO 331)
PRIVATE SECTOR
PRIVATE HOSPITAL/CLINIC 21 (GO TO 331)
DOCTOR'S OFFICE 23 (GO TO 331)
HEALTH WARD 24 (GO TO 331)
PHARMACY 25 (GO TO 331)
MOBILE CLINIC 26 (GO TO 331)
OTHER PRIVATE (SPECIFY)__28 (GO TO 331)
OTHER SOURCE
SHOP 31 (GO TO 331)
BAR/NIGHTCLUB 32 (GO TO 331)
KIOSK 33 (GO TO 331)
AMBULENT SALESPERSON 34 (GO TO 331)
ADBC (AGENTS DE DISTRIBUTION À BASE COMMUNAUTAIRE) - MOBILE COMMUNITY HEALTH DISTRIBUTION) 35 (GO TO 331)
FRIEND/ACQUAINTANCE/RELATIVE 36 (GO TO 331)
OTHER (SPECIFY)__96 (GO TO 331)

top
Mali 2012
Survey form view entire document:  text 
323) Where did you obtain (current method) 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 HOSPITAL 11 (GO TO 326)
REGIONAL HOSPITAL 12 (GO TO 326)
REFERRAL HEALTH CENTER (CSREF) 13 (GO TO 326)
FREE CLINIC/MATERNITY 14 (GO TO 326)
COMMUNITY HEALTH CENTER (CSCOM) 15 (GO TO 326)
OTHER PUBLIC (SPECIFY) ________ 16 (GO TO 326)
PRIVATE SECTOR
PRIVATE CLINIC/OFFICE 21 (GO TO 326)
PRIVATE HEALTH CARE OFFICE 22 (GO TO 326)
TREATMENT ROOM 23 (GO TO 326)
PHARMACY 24 (GO TO 326)
COMMUNITY BASED AGENT 25 (GO TO 326)
OTHER PRIVATE (SPECIFY) ________ 26 (GO TO 326)
OTHER SOURCE
SHOP 31 (GO TO 326)
BAR/NIGHTCLUB 32 (GO TO 326)
KIOSK 33 (GO TO 326)
TRAVELING VENDOR 34 (GO TO 326)
FRIEND/ACQUAINTANCE/RELATIVES 35 (GO TO 326)
OTHER (SPECIFY) _________ 96 (GO TO 326)

top
Mali 2018
Survey form view entire document:  text 
325) Where did you obtain (current method) 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 HOSPITAL 11
REGIONAL HOSPITAL 12
REFERENCE HEALTH CENTER 13
COMMUNITY HEALTH CENTER 14
DISPENSARY/MATERNITY 15
OTHER PUBLIC SECTOR (SPECIFY) 16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
DOCTOR'S OFFICE 22
PRIVATE HEALTH CLINIC 23
PHARMACY 24
HEALTH POSTS 25
FAMILY PLANNING CLINIC 26
OTHER PRIVATE MEDICAL (SPECIFY) 28
OTHER SOURCE
SHOP 31
BAR/NIGHTCLUB 32
BOOTH 36
TRAVELING PEDDLER 34
FRIENDS/RELATIVES 35
OTHER (SPECIFY) 96

top
Morocco 1987
Survey form view entire document:  text 
425) Was there anything in particular that you didn't like about the service you received at these establishments?

NOTHING 01
LONG WAIT 02
UNWELCOME/BAD SERVICE 03
COSTS TOO HIGH 04
FAR AND DIFFICULTY TO ACCESS 05
DIDN'T GET DESIRED METHOD OR INFORMATION 06
TOO MANY ADMINISTRATIVE ASPECTS 07
PERSONNEL NOT COMPETENT 08
DIDN'T LIKE BEING HELPED BY A MAN 09
NOT HYGIENIC 10
OTHER (SPECIFY): ____ 11

top
Morocco 1992
Survey form view entire document:  text 
423) CHECK 415:
WAS STERILIZED: In what facility did the sterilization take place?
CURRENTLY USING ANOTHER METHOD: Where did you obtain (METHOD) last time?

(NAME OF PLACE)____
PUBLIC SECTOR
PUBLIC HOSPITAL 11
MATERNITY CENTER 12
HEALTH CENTER 13
FREE CLINIC 14
HOME VISIT 15 (GO TO 426)
MOBILE TEAM 16 (GO TO 426)
PRIVATE SECTOR
FAMILY PLANNING ASSOCIATION 21 [##TRANSLATOR NOTE: THIS IS AN OFFICIAL ORGANIZATION, AMPF (ASSOCIATION MAROCAINE DE PLANIFICATION FAMILIALE)]
CLINIC 22
PHARMACY 23
DOCTOR/MIDWIFE 24
OTHER PRIVATE
FEMALE RELATIVE/FRIEND 31 (GO TO 426)
QABLA 32 (GO TO 426) [##TRANSLATOR NOTE: THIS IS AN INDIVIDUAL/INSTITUTION RELATED TO THE ISLAMIC FAITH]
OTHER (SPECIFY) 41 (GO TO 426)
OTHER 98 (GO TO 426)
31-98 ( GO TO 426)

top
Morocco 2003
Survey form view entire document:  text 
328) Where did you obtain (CURRENT 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
MATERNITY 12
HEALTH CENTER 13
DISPENSARY 14
HOME VISIT 15
MOBILE UNIT 16
OTHER PUBLIC (SPECIFY) 16
PRIVATE MEDICAL SECTOR
PRIVATE CLINIC 21
PHARMACY 22
DOCTOR/MID-WIFE 23
MOROCCAN ASSOCIATION FOR FAMILY PLANNING 24
OTHER PRIVATE MEDICAL (SPECIFY) 26
OTHER SOURCE
RELATIVE/FRIEND 31
MIDWIFE 32
OTHER (SPECIFY) 96 _________

top
Mozambique 1997
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
CENTRAL HOSPITAL 11
PROVINCIAL/GENERAL HOSPITAL 12
RURAL HOSPITAL 13
HEALTH CENTER 14
MOBILE CLINIC 15
OTHER (SPECIFY) _____ 16
PRIVATE MEDICAL SECTOR
PRIVATE CLINIC 21
PRIVATE DOCTOR 23
PRIVATE NURSE 24
OTHER PRIVATE MEDICAL (SPECIFY) _____ 26
OTHER SOURCE
SHOP 31
CHURCH 32
FRIEND/RELATIVE 33
MEDICAL STAFF IN THE NEIGHBORHOOD 35
OTHER (SPECIFY) _____ 36

top
Mozambique 2003
Survey form view entire document:  text 
328. Where did you obtain (CURRENT METHOD) the last time?

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

NAME OF PLACE______
PUBLIC SECTOR
CENTRAL HOSPITAL 11 (GO TO 331)
PROVINCIAL/GENERAL HOSPITAL 12 (GO TO 331)
RURAL HOSPITAL 13 (GO TO 331)
HEALTH CENTER 14 (GO TO 331)
MOBILE CLINIC 15 (GO TO 331)
OTHER (SPECIFY) ____ 16 (GO TO 331)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL 21 (GO TO 331)
PRIVATE CLINIC 22 (GO TO 331)
PRIVATE DOCTOR 23 (GO TO 331)
PRIVATE NURSE 24 (GO TO 331)
PHARMACY 25 (GO TO 331)
OTHER PRIVATE MEDICAL (SPECIFY) ____ 26 (GO TO 331)
OTHER SOURCE
SHOP 31 (GO TO 331)
CHURCH 32 (GO TO 331)
FRIEND/RELATIVE 33 (GO TO 331)
MEDICAL STAFF IN THE NEIGHBORHOOD 34 (GO TO 331)
PARTNER 35 (GO TO 331)
STAND/BOOTH INFORMATION 36 (GO TO 331)
STORE 37 (GO TO 331)
TRADITIONAL HEALER 38 (GO TO 331)
BAR/DISCOTHEQUE 39 (GO TO 331)
ADOLESCENTE SPECIAL SERVICES 40 (GO TO 331)
OTHER (SPECIFY) ____96 (GO TO 331)

top
Mozambique 2011
Survey form view entire document:  text 
323. 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
CENTRAL HOSPITAL 11 (GO TO 326)
PROVINCIAL/GENERAL HOSPITAL 12 (GO TO 326)
RURAL HOSPITAL 13 (GO TO 326)
HEALTH CENTER/POST 14 (GO TO 326)
MOBILE CLINIC 15 (GO TO 326)
PHARMACY 16 (GO TO 326)
OTHER (SPECIFY)____ 17 (GO TO 326)
PRIVATE MEDICAL SECTOR
PRIVATE CLINIC 21 (GO TO 326)
PRIVATE DOCTOR 22 (GO TO 326)
PRIVATE NURSE 23 (GO TO 326)
PHARMACY 24 (GO TO 326)
SHOP 25 (GO TO 326)
GAS STATION 26 (GO TO 326)
BAR/DISCOTHEQUE 27 (GO TO 326)
INFORMATION STAND/BOOTH 28 (GO TO 326)
OTHER (SPECIFY)____29 (GO TO 326)
OTHER SOURCE
SCHOOL 31 (GO TO 326)
MARKET/STORE 32 (GO TO 326)
CHURCH 33 (GO TO 326)
FRIEND/RELATIVE 34 (GO TO 326)
TRADITIONAL HEALER 35 (GO TO 326)
ADOLESCENT SPECIAL SERVICES 36 (GO TO 326)
OTHER (SPECIFY)____96 (GO TO 326)

top
Myanmar 2015
Survey form view entire document:  text 
315) You first started using (CURRENT METHOD) in (DATE FROM 308/308A). Where did you get it at that time?
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 11
GOVT. HEALTH CENTER (RHC) 12
GOVT. HEALTH POST (SUB-CENTER) 13
VILLAGE HEALTH WORKER 14
MOBILE CLINIC 15
UHC/MCH CENTER 16
OTHER PUBLIC SECTOR____(SPECIFY) 17
NON-GOVERNMENT SECTOR
MARIE STOPES 21
MYANMAR RED CROSS SOCIETY 22
PSI/M (SUN) 23
MMA 24
OTHER NGO SECTOR___(SPECIFY) 26
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31
PHARMACY 32
PRIVATE DOCTOR 33
MOBILE CLINIC 34
FIELDWORKER 35
OTHER PRIVATE MEDICAL SECTOR____(SPECIFY) 36
OTHER SOURCE
SHOP 41
FRIEND/RELATIVE 42
OTHER___(SPECIFY) 96

top
Namibia 1992
Survey form view entire document:  text 
318) CHECK 312:
SHE/HE STERILIZED__: Where did the sterilization take place?
USING ANOTHER METHOD___: Where did you obtain (method) the last time?

(NAME OF PLACE)________
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER/ GOVERNMENT CLINIC12
PHC CLINIC (MOBILE) 13 (GO TO 321)
FIELD WORKER 14 (GO TO 321)
PRIVATE DOCTOR 21
PRIVATE HOSPITAL OR CLINIC 22
PHARMACY 23
SHOP 31
FRIENDS/RELATIVES 32
OTHER (SPECIFY)______41
DK 98 (GO TO 321)

top
Namibia 2000
Survey form view entire document:  text 
322) Where did you obtain (CURRENT 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
GOVT. HOSPITAL 11
GOVT. HEALTH CENTRE/CLINIC 12
PHC CLINIC (MOBILE) 13
COMMUNITY HEALTH WORKER 14
OTHER PUBLIC (SPECIFY)____ 16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
PHARMACY 22
PRIVATE DOCTOR 23
OTHER PRIVATE MEDICAL (SPECIFY)____ 26
OTHER SOURCE
SHOP 31
CHURCH/SCHOOL 32
FRIEND/RELATIVE 33
TRADITIONAL BIRTH ATTENDANT 34
TRADITIONAL HEALER 35
OTHER (SPECIFY) _____ 96
(ALL GO TO 401)

top
Namibia 2006
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
GOVT. HOSPITAL 11
GOVT. HEALTH CENTER/CLINIC 12
PHC CLINIC (MOBILE) 13
COMMUNITY HEALTH WORKER 14
OTHER PUBLIC (SPECIFY)____ 16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
PHARMACY 22
PRIVATE DOCTOR 23
OTHER PRIVATE MEDICAL (SPECIFY)____ 26
OTHER SOURCE
SHOP 31
CHURCH 32
FRIEND/RELATIVE 33
TRAD. BIRTH ATTENDANT 34
TRAD. HEALER 35
OTHER (SPECIFY) _____ 96
(ALL GO TO 335)

top
Namibia 2013
Survey form view entire document:  text 
323) 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
GOVT HOSPITAL 11 (GO TO 326)
GOVT HEALTH CENTER 12 (GO TO 326)
GVT PRIMARY HEALTH CARE CLINIC 13 (GO TO 326)
OUTREACH POINT 14 (GO TO 326)
FIELDWORKER/COMMUNITY HEALTH CARE PROVIDER 15 (GO TO 326)
OTHER PUBLIC SECTOR (SPECIFY __________) 16 (GO TO 326)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL 21 (GO TO 326)
PRIVATE CLINIC 22 (GO TO 326)
PHARMACY 23 (GO TO 326)
PRIVATE DOCTOR 24 (GO TO 326)
OTHER PRIVATE MEDICAL SECTOR (SPECIFY __________) 26 (GO TO 326)
OTHER SOURCE
SHOP 31 (GO TO 326)
CHURCH 32 (GO TO 326)
FRIEND/RELATIVE 33 (GO TO 326)
SCHOOL 34 (GO TO 326)
OTHER (SPECIFY __________) 96 (GO TO 326)

top
Nepal 1996
Survey form view entire document:  text 
323. Where did you obtain (METHOD) the last time?

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 (SPECIFY)___________________16
PRIVATE SECTOR
HOSPITAL 21
CLINIC/NURSING HOME 22
PHARMACY 23
CHW 24
FPAN 25
OTHER PRIVATE (SPECIFY)___________________26
OTHER SOURCE
FCHV 31
SHOP 32
FRIEND/RELATIVE 33
OTHER (SPECIFY)____________________________36

top
Nepal 2001
Survey form view entire document:  text 
327. Where did you obtain (CURRENT METHOD) the last time?

IF SOURCE IS HOSPITAL, HEALTH CARE 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 SECTOR
GOVT. HOSPITAL/CLINIC 11
PRIMARY HEALTH CARE CENTER/HEALTH CENTER 12
HEALTH POST 13
SUB-HEALTH POST 14
PHC OUTREACH CLINIC 15
FCHV 17
CONDOM BOX 18
OTHER GOVT. (SPECIFY) ____________ 16
NON-GOVT. (NGO) SECTOR
FP ASSN. OF NEPAL 21
MARIE STOPES 22
ADRA 23
NEPAL RED CROSS 24
OTHER NGO (SPECIFY) ___________ 26
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/NURSING HOME 31
PHARMACY 32
OTHER PRIVATE (SPECIFY) _______ 36
OTHER SOURCE
SHOP 41
FRIEND/RELATIVE 42

OTHER (SPECIFY) ______________ 96

top
Nepal 2006
Survey form view entire document:  text 
344. 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
GOVT. HOSPITAL/CLINIC 11
PHYC CENTER 12
HEALTH POST 13
SUB-HEALTH POST 14
PHC OUTREACH 15
MOBILE CLINIC 17
FCHV 18
CONDOM BOX 19
OTHER GOVT. (SPECIFY) ___ 16
NON-GOVT. (NGO) SECTOR
FPAN 21
MARIE STOPES 22
ADRA 23
NEPAL RED CROSS 24
UMN 25
OTHER NGO. (SPECIFY) ___ 26
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/NURSING HOME 31
PHARMACY 32
PRIVATE DOCTOR 33
OTHER PRIVATE MEDICAL (SPECIFY) ___ 36
OTHER SOURCE
SHOP 41
FRIEND/RELATIVE 42
OTHER (SPECIFY) ___ 96

top
Nepal 2011
Survey form view entire document:  text 
315) You first started using (CURRENT METHOD) in (DATE FROM 308/308A). Where did you get it at that time?

PUBLIC SECTOR
GOVT. HOSPITAL/CLINIC 11
PHC CENTER 12
HEALTH POST 13
SUB-HEALTH POST 14
PHC OUTREACH 15
MOBILE CLINIC 17
FCHV 18
CONDOM BOX 19
OTHER GOVT. (SPECIFY) ___________ 16
NON-GOVT. (NGO) SECTOR
FPAN 21
MARIE STOPES 22
ADRA 23
NEPAL RED CROSS 24
UMN 25
OTHER NGO. (SPECIFY) __________ 26
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/NURSING HOME 31
PHARMACY 32
SANGINI OUTLET 33
OTHER PRIVATE MEDICAL (SPECIFY) ___________ 36
OTHER SOURCE
SHOP 41
FRIEND/RELATIVE 42
OTHER (SPECIFY) ___________ 96

top
Nepal 2016
Survey form view entire document:  text 
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/CLINIC 11 (GO TO 327)
PRIMARY HEALTH CARE CENTER 12 (GO TO 327)
HEALTH POST/SUB-HEALTH POST 13 (GO TO 327)
PHC OUTREACH CLINIC 14 (GO TO 327)
MOBILE CAMP 15 (GO TO 327)
FCHV 16 (GO TO 327)
SATELLITE CLINIC 17 (GO TO 327)
OTHER PUBLIC FACILITIES (SPECIFY) ___ 18 (GO TO 327)
NON-GOVT. (NGO) SECTOR
FPAN 21 (GO TO 327)
MARIE STOPES 22 (GO TO 327)
OTHER NGO FACILITIES (SPECIFY) ___ 26 (GO TO 327)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/NURSING HOME 31 (GO TO 327)
PRIVATE CLINIC 32 (GO TO 327)
PHARMACY 33 (GO TO 327)
SANGINI OUTLET 34 (GO TO 327)
OTHER PRIVATE MEDICAL FACILITIES (SPECIFY) ___ 36 (GO TO 327)
OTHER SOURCE
SHOP 41 (GO TO 327)
FRIEND/RELATIVE 42 (GO TO 327)
OTHER (SPECIFY) ___ 96 (GO TO 327)

top
Niger 1992
Survey form view entire document:  text 
318) CHECK 312:

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

USES ANOTHER METHOD: Where did you obtain (METHOD) the last time?

NAME OF PLACE: ___
PUBLIC SECTOR
HOSPITAL 11
MEDICAL CENTER 12
FAMILY HEALTH CENTER 13
MOTHER AND CHILD CARE CENTER 14
DISPENSARY 15
MATERNITY WARD 16
PEOPLE'S PHARMACY 17
PRIVATE MEDICAL SECTOR
PRIVATE DOCTOR'S OFFICE 21
CLINIC/HOSPITAL 22
PHARMACY 23
OTHER PRIVATE SECTOR
RELATIVE 31 (GO TO 321)
NEIGHBOR 32 (GO TO 321)
OTHER (SPECIFY): ___ 41(GO TO 321)
DON'T KNOW 98 (GO TO 321)

top
Niger 1998
Survey form view entire document:  text 
328) Where did you get (CURRENT METHOD) the last time?

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
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

top
Niger 2006
Survey form view entire document:  text 
328. Where did you get (the current method) the last time?

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 THE ESTABLISHMENT __________
PUBLIC SECTOR
NATIONAL HOSPITAL 11 (GO TO 331)
INTEGRATED HEALTH CENTER 12 (GO TO 331)
MATERNITY 13 (GO TO 331)
HEALTH HUT 14 (GO TO 331)
COMMUNITY HEALTH CARE WORKER 15 (GO TO 331)
OTHER PUBLIC (SPECIFY) __________ 16 (GO TO 331)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21 (GO TO 331)
DOCTOR 23 (GO TO 331)
PHARMACY 24 (GO TO 331)
WALKING SALESMAN 25 (GO TO 331)
OTHER PRIVATE (SPECIFY) __________ 26 (GO TO 331)
OTHER SOURCE
SHOP 31 (GO TO 331)
BAR/NIGHTCLUB 32 (GO TO 331)
KIOSK 33 (GO TO 331)
VENDOR 34 (GO TO 331)
FRIEND/ACQUAINTANCE/RELATIVE 35 (GO TO 331)
HOTEL/MOTEL 36 (GO TO 331)
OTHER (SPECIFY) __________ 96 (GO TO 331)

top
Niger 2012
Survey form view entire document:  text 
323) Where did you obtain (CURRENT METHOD) 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
PHARMACY 11
MATERNITY REFERENCE CENTER 12
MATERNITY IN REGIONAL HOSPITAL 13
MATERNITY IN HD 14
INTEGRATED HEALTH CENTER 15
HEALTH HUT 16
MOBILE CLINIC 17
OTHER PUBLIC (SPECIFY) 18
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
PHARMACY 22
MOBILE CLINIC 24
NIGERIEN ASSOCIATION FOR FAMILIAL WELL-BEING 25
ROAD KIOSK 26
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) 28
OTHER SOURCE
SHOP 31
RELIGIOUS INSTITUTION 32
FRIENDS/RELATIVES 33
TRAVELLING PHARMACY/PEDDLER 34
COMMUNITY LIAISON 35
OTHER (SPECIFY) 96

ALL SKIP TO 326


top
Nigeria 1990
Survey form view entire document:  text 
319. CHECK 311 AND MARK BOX:

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

USING ANOTHER METHOD: Where did you obtain (METHOD) the last time?

(NAME OF PLACE) __________
HOSPITAL 01
HEALTH CENTER, MATERNITY CENTER, FAMILY PLANNING CLINIC, OR HEALTH CLINIC POST 02
DOCTOR 03 (GO TO 321)
PLANNED PARENTHOOD FED. CLINIC 04 (GO TO 322)
PRIVATE CLINIC 05 (GO TO 322)
PHARMACY 06 (GO TO 322)
PATENT MEDICINE SHOP 07 (GO TO 322)
MARKET 08 (GO TO 322)
HUSBAND'S PLACE OF WORK 09 (GO TO 324)
YOUR PLACE OF WORK 10 (GO TO 324)
CHURCH 11 (GO TO 324)
FRIENDS/RELATIVES 12 (GO TO 324)
OTHER (SPECIFY) _______________ 13 (GO TO 324)
DON'T KNOW 98 (GO TO 324)

top
Nigeria 1999
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 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/PATENT MEDICINE STORE 22
PRIVATE DOCTOR 23
MOBILE CLINIC 24
COMMUNITY HEALTH WORKER 25
OTHER PRIVATE MEDICAL (SPECIFY) ______ 26
OTHER SOURCE
SHOP 31
CHURCH 32
FRIEND/RELATIVE 33
NON-GOVERNMENT ORGANISATION 34
OTHER (SPECIFY) __________________ 36

top
Nigeria 2003
Survey form view entire document:  text 
328. Where did you obtain (CURRENT 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 (GO TO 331)
GOVERNMENT HEALTH CENTER 12 (GO TO 331)
FAMILY PLANNING CLINIC 13 (GO TO 331)
MOBILE CLINIC 14 (GO TO 331)
COMMUNITY HEALTH WORKER 15 (GO TO 331)
OTHER PUBLIC (SPECIFY) ______ 16 (GO TO 331)

PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21 (GO TO 331)
PHARMACY/PATENT MEDICINE STORE 22 (GO TO 331)
PRIVATE DOCTOR 23 (GO TO 331)
MOBILE CLINIC 24 (GO TO 331)
COMMUNITY HEALTH WORKER 25 (GO TO 331)
OTHER PRIVATE MEDICAL (SPECIFY) ______ 26 (GO TO 331)
OTHER SOURCE
SHOP 31 (GO TO 331)
CHURCH 32 (GO TO 331)
FRIEND/RELATIVE 33 (GO TO 331)
NGO 34 (GO TO 331)
OTHER (SPECIFY) _______________ 96 (GO TO 331)

top
Nigeria 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 (GO TO 335)
GOVERNMENT HEALTH CENTER 12 (GO TO 335)
FAMILY PLANNING CLINIC 13 (GO TO 335)
MOBILE CLINIC 14 (GO TO 335)
FIELDWORKER 15 (GO TO 335)
OTHER PUBLIC (SPECIFY) ______ 16 (GO TO 335)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21 (GO TO 335)
PHARMACY 22 (GO TO 335)
CHEMIST/PMS 23 (GO TO 335)
PRIVATE DOCTOR 24 (GO TO 335)
MOBILE CLINIC 25 (GO TO 335)
FIELDWORKER 26 (GO TO 335)
OTHER PRIVATE MEDICAL (SPECIFY) ______ 27 (GO TO 335)
OTHER SOURCE
SHOP 31 (GO TO 335)
CHURCH 32 (GO TO 335)
FRIEND/RELATIVE 33 (GO TO 335)
NGO 34 (GO TO 335)
OTHER (SPECIFY) _______________ 96 (GO TO 335)

top
Nigeria 2013
Survey form view entire document:  text 
323) 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
GOVT. HOSPITAL 11
GOVT. HEALTH CENTER 12
FAMILY PLANNING CLINIC 13
MOBILE CLINIC 14
FIELDWORKER 15
OTHER PUBLIC SECTOR (SPECIFY)_______
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
PHARMACY 22
CHEMIST/PMS STORE 23
PRIVATE DOCTOR 24
MOBILE CLINIC 25
FIELDWORKER 27
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)______ 26
OTHER SOURCE
SHOP 31
CHURCH 32
FRIEND/RELATIVE 33
NGO 34
OTHER (SPECIFY)______ 96

top
Nigeria 2018
Survey form view entire document:  text 
325. Where did you obtain (CURRENT METHOD) the last time?

PROBE TO INDENTIFY THE TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.
__________

PUBLIC SECTOR
GOVERNMENT HOSPITAL 11 (GO TO 327)
GOVERNMENT HEALTH CENTER 12 (GO TO 327)
FAMILY PLANNING CLINIC 13 (GO TO 327)

top
Pakistan 1991
Survey form view entire document:  text 
331. CHECK 322:

SHE/HE STERILIZED: Where did the sterilization take place?
USING ANOTHER METHOD: Where did you obtain (METHOD) the last time?

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 334)
FIELD WORKER 07 (GO TO 334)
PRIVATE DOCTOR 08
HAKIM/HOMOEOPATH 09
DRUGSTORE 10
SHOP (OTHER THAN DRUGSTORE) 11
TRADITIONAL BIRTH ATTENDANT 12
FRIENDS/RELATIVES 13 (GO TO 334)
OTHER (SPECIFY) _________ 14
DON'T KNOW 98 (GO TO 334)

top
Pakistan 2006
Survey form view entire document:  text 
317) Where did you obtain (CURRENT METHOD) the last time?
IF STERILIZED: Where did the sterilization take place?
IF SOURCE IS HOSPITAL, HEALTH CENTER, OR FWC, WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.

________(NAME OF PLACE)

ONLY FOR MODERN METHOD

PUBLIC SECTOR
GOVT. HOSPITAL/RHSC 11
RURAL HEALTH CENTRE, MCH 12
FAMILY WELFARE CENTRE 13
MOBILE SERVICE CAMP 14
LADY HEALTH WORKER 15
LH VISITOR 16
BASIC HEALTH UNIT 17
MALE MOBILIZER 18
OTHER PUBLIC (SPECIFY) ____ 19
PRIVATE/NGO MEDICAL SECTOR
PRIVATE/NGO HOSPITAL/CLINIC 21
PHARMACY, CHEMISTS 22
PRIVATE DOCTOR 23
HOMEOPATH 24
DISPENSER/COMPOUNDER 25
OTHER PRVATE MEDICAL (SPECIFY) __ 26
OTHER SOURCE
SHOP (NOT PHARMACY/CHEMIST) 31
FRIEND/RELATIVE 32
HAKIM 32
DAI, TRAD, BIRTH ATTENDANT 34
PUSHCART 35
OTHER (SPECIFY) ___ 96
DON'T KNOW 98

top
Pakistan 2012
Survey form view entire document:  text 
332) 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 NAME OF THE PLACE ____

PUBLIC SECTOR
GOVT. HOSPITAL/RHSC 11 (GO TO 335)
RURAL HEALTH CENTRE, MCH 12 (GO TO 335)
MCH 13 (GO TO 335)
FAMILY WELFARE CENTRE/FWW 14 (GO TO 335)
MOBILE SERVICE CAMP 15 (GO TO 335)
LADY HEALTH WORKER 16 (GO TO 335)
LH VISITOR 17 (GO TO 335)
BASIC HEALTH UNIT 18 (GO TO 335)
MALE MOBILIZER 19 (GO TO 335)
FWA 20 (GO TO 335)
OTHER PUBLIC (SPECIFY)___ 21 (GO TO 335)
PRIVATE/NGO MEDICAL SECTOR
PRIVATE/NGO HOSPITAL/CLINIC 22 (GO TO 335)
PHARMACY, CHEMISTS 23 (GO TO 335)
PRIVATE DOCTOR 24 (GO TO 335)
HOMEOPATH 25 (GO TO 335)
DISPENSER/COMPOUNDER 26 (GO TO 335)
OTHER PRIVATE MEDICAL (SPECIFY)___ (GO TO 335)
OTHER SOURCE
SHOP (NOT PHARMACY/CHEMIST) 31 (GO TO 335)
FRIEND/RELATIVE 32 (GO TO 335)
HAKIM 33 (GO TO 335)
DAI, TRAD, BIRTH ATTENDANT 34 (GO TO 335)
OTHER (SPECIFY)____96 (GO TO 335)
DON'T KNOW 98 (GO TO 335)

top
Pakistan 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
FAMILY HEALTH CLINIC/RHSC 11
FAMILY WELFARE CENTRE/FWW 12
MOBILE SERVICE CAMP/UNIT 13
MALE MOBILIZER 14
GOVERNMENT HOSPITAL 15
RURAL HEALTH CENTER 16
BASIC HEALTH UNIT 17
MCH CENTER 18
DISPENSORY 19
LADY HEALTH WORKER 20
LADY HEALTH VISITOR 21
COMMUNITY MIDWIFE 22
OTHER PUBLIC SECTOR (SPECIFY) __________ 26
PRIVATE/NGO MEDICAL SECTOR
PRIVATE/NGO HOSPITAL/CLINIC 31
PRIVATE DOCTOR 32
PHARMACY/MEDICAL STORE 33
HOMEOPATH 34
DISPENSER/COMPOUNDER 35
OTHER PRIVATE SECTOR (SPECIFY) _________ 36
OTHER SOURCE
SHOP (NOT PHARMACY/CHEMIST) 41
FRIEND/RELATIVE 42
HAKIM 43
DAI, TRADITIONAL BIRTH ATTENDANT 44
OTHER (SPECIFY) ______ 96

top
Rwanda 1992
Survey form view entire document:  text 
318 CHECK 312:
SHE/HE STERILIZED
Where did the sterilization take place?*

USING ANOTHER METHOD
Where did you obtain (METHOD) the last time?*

(NAME OF PLACE) __________
PUBLIC SECTOR
GOVT. HOSPITAL 11
GOVT. HEALTH CENTER 12
FAMILY PLANNING CLINIC 13
MOBILE CLINIC 14 (GO TO 321)
FIELD WORKER 15 (GO TO 321)
MEDICAL PRIVATE SECTOR
PRIVATE HOSPITAL OR CLINIC 21
PHARMACY 22
PRIVATE DOCTOR 23
MOBILE CLINIC 24 (GO TO 321)
FIELD WORKER 25 (GO TO 321)
OTHER PRIVATE SECTOR
SHOP 31
CHURCH 32 (GO TO 321)
FRIENDS/RELATIVES 33 (GO TO 321)
OTHER (SPECIFY) ___________ 41 (GO TO 321)
DK 98 (GO TO 321)

top
Rwanda 2000
Survey form view entire document:  text 
327. Where did you obtain (CURRENT 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/GOVERNMENT-APPROVED HOSPITAL 11 (GO TO 330)
GOVERNMENT HEALTH CENTER 12 (GO TO 330)
FAMILY PLANNING CLINIC 13 (GO TO 330)
DBC AGENT 15 (GO TO 330)
OTHER PUBLIC (SPECIFY)_____ 16 (GO TO 330)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21 (GO TO 330)
PHARMACY 22 (GO TO 330)
PRIVATE DOCTOR 23 (GO TO 330)
ARBEF (RWANDAN ASSOCIATION FOR FAMILY WELFARE) CLINIC 24 (GO TO 330)
INFIRMARY 25 (GO TO 330)
OTHER PRIVATE MEDICAL (SPECIFY)_____ 26 (GO TO 330)
OTHER SOURCE
SHOP/KIOSK 31 (GO TO 330)
CHURCH 32 (GO TO 330)
RELATIVES/ FRIEND 33 (GO TO 330)
OTHER (SPECIFY)_____ 96 (GO TO 330)

top
Rwanda 2005
Survey form view entire document:  text 
328. Where did you obtain (CURRENT 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 HOSPITAL 12
NURSE 13
OTHER PUBLIC (SPECIFY)_____ 16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
PHARMACY 22
PRIVATE DOCTOR 23
ARBEF CLINIC 24
FIELDWORKER 25
OTHER PRIVATE MEDICAL (SPECIFY) ____ 26
OTHER SOURCE
SHOP 31
CHURCH 32
PARENTS/FRIEND 33
OTHER (SPECIFY) _____ 96

top
Rwanda 2010
Survey form view entire document:  text 
323) 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
REFERAL HOSPITAL 11 (GO TO 326)
DISTRICT HOSPITAL 12 (GO TO 326)
HEALTH CENTER 13 (GO TO 326)
HEALTH POST 14 (GO TO 326)
OUTREACH 15 (GO TO 326)
COMMUNITY HEALTH WORKER 16 (GO TO 326)
OTHER PUBLIC HEALTH FACILITY (SPECIFY) 17 (GO TO 326)
PRIVATE MEDICAL SECTOR
POLYCLINIC 21 (GO TO 326)
CLINIC 22 (GO TO 326)
DISPENSARY 23 (GO TO 326)
PHARMACY 24 (GO TO 326)
FAMLIY PLANNING CLINIC 25 (GO TO 326)
OTHER PRIVATE HEALTH FACILITY (SPECIFY) 26 (GO TO 326)
OTHER SOURCES
KIOSK 31 (GO TO 326)
CHURCH 32 (GO TO 326)
FRIEND/RELATIVE 33 (GO TO 326)
OTHER (SPECIFY) 96 (GO TO 326)
DON'T KNOW 98 (GO TO 326)

top
Rwanda 2014
Survey form view entire document:  text 
323) 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/AGREE SECTOR
REFERRAL HOSPITAL 11 (GO TO 326)
PROVINCIAL/DISTRICT HOSPITAL 12 (GO TO 326)
HEALTH CENTER 13 (GO TO 326)
HEALTH POST 14 (GO TO 326)
OUTREACH 15 (GO TO 326)
COMMUNITY HEALTH WORKER 16 (GO TO 326)
OTHER PUBLIC HEALTH FACILITY (SPECIFY) ____ 17 (GO TO 326)
PRIVATE MEDICAL SECTOR
POLYCLINIC 21 (GO TO 326)
CLINIC 22 (GO TO 326)
DISPENSARY 23 (GO TO 326)
PHARMACY 24 (GO TO 326)
FAMILY PLANNING CLINIC 25 (GO TO 326)
OTHER PRIVATE HEALTH FACILITY (SPECIFY) ____ 26 (GO TO 326)
OTHER SOURCES
KIOSK/SHOP/BAR 31 (GO TO 326)
CHURCH 32 (GO TO 326)
FRIEND/RELATIVE 33 (GO TO 326)
YOUTH CENTER 34 (GO TO 326)
OTHER (SPECIFY) ____ 96 (GO TO 326)
DON'T KNOW 98

top
Senegal 1986
Survey form view entire document:  text 
315. Where did you (or your partner) get (advice for) (CURRENT METHOD) the last time?

HOSPITAL, CLINIC, PRIVATE DOCTOR'S OFFICE 1 (GO TO 321)
PUBLIC HOSPITAL 2 (GO TO 321)
HEALTH CENTER 3 (GO TO 321)
PMI 4 (GO TO 321)
PHARMACY 4 (GO TO 321)
OTHER (SPECIFY) ____ 6 (GO TO 321)
DOESN'T KNOW 8 (GO TO 321)

top
Senegal 1992
Survey form view entire document:  text 
318. CHECK 312:

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

USES ANOTHER METHOD: Where did you get (METHOD) the last time?

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 PRVATE SECTOR
BOUTIQUE/MARKET 31
CHURCH 32 (GO TO 321)
FRIEND/RELATIVE 33 (GO TO 321)
AUXILIARY 41 (GO TO 321)
OTHER (SPECIFY) _____51 (GO TO 321)
DOESN'T KNOW 98 (GO TO 321)

top
Senegal 1997
Survey form view entire document:  text 
318. CHECK 312:

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

USES ANOTHER METHOD: Where did you get (METHOD) the last time?

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 (GO TO 321)
CHURCH 33 (GO TO 321)
FRIEND/RELATIVE 34 (GO TO 321)
AUXILIARY 41 (GO TO 321)
OTHER (SPECIFY) _____51 (GO TO 321)
DOESN'T KNOW 98 (GO TO 321)

top
Senegal 2005
Survey form view entire document:  text 
327) CHECK 311/311A:

CIRCLE METHOD CODE:

FEMALE STERILIZATION 01 (GO TO 331)
MALE STERILIZATION 02 (GO TO 331)
PILL 03
IUD 04
INJECTABLES 05
IMPLANTS 06
CONDOM 07
FEMALE CONDOM 08
DIAPHRAGM 09
FOAM/JELLY 10
LACTATIONAL AMEN. METHOD 11 (GO TO 331)
PERIODIC ABSTINENCE 12 (GO TO 331)
WITHDRAWAL 13 (GO TO 331)
OTHER METHOD 96 (GO TO 331)

top
Senegal 2010
Survey form view entire document:  text 
323. Where did you obtain (CURRENT METHOD) 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
GOVERNMENT HOSPITAL 11 (GO TO 326)
GOVERNMENT HEALTH CENTER 12 (GO TO 326)
HEALTH POST 13 (GO TO 326)
GOVERNMENT FAMILY PLANNING CLINIC 14 (GO TO 326)
HEALTH HUT/RURAL MATERNITY 15 (GO TO 326)
BASIC HEALTH CARE CENTER 16 (GO TO 326)
COMMUNITY PHARMACY 17 (GO TO 326)
MOBILE CLINIC 18 (GO TO 326)
OTHER PUBLIC (SPECIFY) _____ 19 (GO TO 326)
PRIVATE MEDICAL SECTOR
HOSPITAL/CLINIC/OFFICE 21 (GO TO 326)
PRIVATE HOSPITAL/CLINIC/OFFICE 22 (GO TO 326)
PHARMACY 23 (GO TO 326)
PRIVATE DOCTOR 24 (GO TO 326)
RELIGIOUS DISPENSARY 25 (GO TO 326)
OTHER PRIVATE MEDICAL (SPECIFY) _____ 26 (GO TO 326)
OTHER SOURCE
SHOP 31 (GO TO 326)
CHURCH 32 (GO TO 326)
RELATIVES/FRIENDS 33 (GO TO 326)
BAR 34 (GO TO 326)
OTHER (SPECIFY) _____ 96 (GO TO 326)

top
Senegal 2012
Survey form view entire document:  text 
323) Where did you obtain (CURRENT METHOD) 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
GOVT. HOSPITAL 11 (GO TO 326)
GOVT. HEALTH CENTER 12 (GO TO 326)
HEALTH POST 13 (GO TO 326)
GOVT. FAMILY PLANNING CENTER 14 (GO TO 326)
RURAL MATERNITY 15 (GO TO 326)
HEALTH HUT 16 (GO TO 326)
COMMUNITY PHARMACY 17 (GO TO 326)
MOBILE CLINIC 18 (GO TO 326)
OTHER PUBLIC SECTOR (SPECIFY) ________ 19 (GO TO 326)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/OFFICE 21/22 (GO TO 326)
PHARMACY 23 (GO TO 326)
PRIVATE DOCTOR 24 (GO TO 326)
RELIGIOUS FREE CLINIC 25 (GO TO 326)
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) _______ 26 (GO TO 326)
OTHER SOURCE
SHOP 31 (GO TO 326)
CHURCH 32 (GO TO 326)
FRIENDS/RELATIVES 33 (GO TO 326)
BAR 34 (GO TO 326)
OTHER (SPECIFY)________ 96 (GO TO 326)

top
Senegal 2014
Survey form view entire document:  text 
323) Where did you obtain (CURRENT METHOD) 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
GOVT. HOSPITAL 11 (GO TO 326)
GOVT. HEALTH CENTER 12 (GO TO 326)
HEALTH POST 13 (GO TO 326)
GOVT. FAMILY PLANNING CENTER 14 (GO TO 326)
RURAL MATERNITY 15 (GO TO 326)
HEALTH HUT 16 (GO TO 326)
COMMUNITY PHARMACY 17 (GO TO 326)
MOBILE CLINIC 18 (GO TO 326)
OTHER PUBLIC SECTOR (SPECIFY) 19 (GO TO 326)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/OFFICE 21/22 (GO TO 326)
PHARMACY 23 (GO TO 326)
PRIVATE DOCTOR 24 (GO TO 326)
RELIGIOUS FREE CLINIC 25 (GO TO 326)
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) 26 (GO TO 326)
OTHER SOURCE
SHOP 31 (GO TO 326)
CHURCH 32 (GO TO 326)
FRIENDS/RELATIVES 33 (GO TO 326)
BAR 34 (GO TO 326)
OTHER (SPECIFY) 96 (GO TO 326)

top
Senegal 2015
Survey form view entire document:  text 
323) Where did you obtain (CURRENT METHOD) 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
GOVT. HOSPITAL 11 (GO TO 326)
GOVT. HEALTH CENTER 12 (GO TO 326)
HEALTH POST 13 (GO TO 326)
GOVT. FAMILY PLANNING CENTER 14 (GO TO 326)
RURAL MATERNITY 15 (GO TO 326)
HEALTH HUT 16 (GO TO 326)
COMMUNITY PHARMACY 17 (GO TO 326)
MOBILE CLINIC 18 (GO TO 326)
OTHER PUBLIC SECTOR (SPECIFY) _____19 (GO TO 326)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/OFFICE 21/22 (GO TO 326)
PHARMACY 23 (GO TO 326)
PRIVATE DOCTOR 24 (GO TO 326)
RELIGIOUS FREE CLINIC 25 (GO TO 326)
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) _____26 (GO TO 326)
OTHER SOURCE
SHOP 31 (GO TO 326)
CHURCH 32 (GO TO 326)
FRIENDS/RELATIVES 33 (GO TO 326)
BAR 34 (GO TO 326)
OTHER (SPECIFY) ____ 96 (GO TO 326)

top
Senegal 2016
Survey form view entire document:  text 
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)

top
Senegal 2017
Survey form view entire document:  text 
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)

top
South Africa 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 IDENTIFYTHE TYPE OF SOURCE AND CIRCLE THE APPROPRIATECODE.

(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 (GO TO 330A)
CHURCH 32 (GO TO 330A)
FRIEND/RELATIVE 33 (GO TO 330A)
OTHER (SPECIFY) __________________ 96 (GO TO 330A)

top
South Africa 2016
Survey form view entire document:  text 
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, RECORD 96 AND WRITE THE NAME OF THE PLACE.

PUBLIC SECTOR
GOVERNMENT HOSPITAL 11 (GO TO 329)
GOVERNMENT HEALTH CLINIC/COMMUNITY HEALTH CENTRE 12 (GO TO 329)
MOBILE CLINIC 13 (GO TO 329)
CHW 14 (GO TO 329)
OTHER PUBLIC SECTOR (SPECIFY) ________ 16 (GO TO 329)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21 (GO TO 329)
CHEMIST/PHARMACY 22 (GO TO 329)
PRIVATE DOCTOR 23 (GO TO 329)
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) ________ 26 (GO TO 329)
OTHER SOURCE
WORKPLACE/WORKPLACE CLINIC 31 (GO TO 329)
COMMUNITY CENTER, LIBRARY OR OTHER PUBLIC PLACE 32 (GO TO 329)
SHOP 33 (GO TO 329)
CHURCH 34 (GO TO 329)
FRIEND/RELATIVE 35 (GO TO 329)
OTHER (SPECIFY) ________ (GO TO 329)

top
Sudan 1989
Survey form view entire document:  text 
315 Where did you obtain (METHGO) the Last time?
315A Where did the sterilization take place?
515B Where did you obtain instructions for this method?

GOVERNMENT HOSPITAL 01
GOVERNMENT HEALTH CENTRE 02
FAMILY PLANNING CLINIC 03
DISPENSARY 04
OTH, GOVT. HLTH FAC 05
PHARMACY 06
MOBILE CLINIC 07
PRIVATE DOCTOR 08
PRIVATE HOSPITAL 09
FRIENDS AND RELATIVES 10
OTHERS (SPECIFY) 11 (GO TO 319)
DOHT KNOW 98 (GO TO 319)

top
Tanzania 1991
Survey form view entire document:  text 
318. CHECK 312:
SHE/HE STERILIZED __
Where did the sterilization take place?

USING ANOTHER METHOD __
Where did you obtain (METHOD) the last time?

(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 321)
MEDICAL PRIVATE SECTOR
RELIGIOUS ORG. FACILITY 21
PRIV. DOCTOR/CLINIC/HOSPITAL 22
PHARMACY/MEDICAL STORE 23
UMATI CBD WORKER 24 (GO TO 321)
OTHER PRIVATE SECTOR
SHOP 31
NEIGHBORS/RELATIVES 32 (GO TO 321)
OTHER (SPECIFY) _________________ 41 (GO TO 321)
DK 98 (GO TO 321)

top
Tanzania 1996
Survey form view entire document:  text 
326. Where did you obtain (METHOD) the last time?
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/KIOSK 31
CHURCH 32
FRIENDS/RELATIVES/NEIGHBORS 33
HEALTH EDUCATOR/BAR GIRLS 34
OTHER (SPECIFY) _________________ 96
DOES NOT KNOW 98

top
Tanzania 1999
Survey form view entire document:  text 
327. Where did you obtain (CURRENT 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_____
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

top
Tanzania 2004
Survey form view entire document:  text 
328. Where did you obtain (CURRENT METHOD) the last time?
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/PARASTATAL
REFERAL/SPEC. HOSPITAL 11 (GO TO 331)
REGIONAL HOSPITAL 12(GO TO 331)
DISTRICT HOSPITAL 13(GO TO 331)
HEALTH CENTRE 14(GO TO 331)
DISPENSARY 15(GO TO 331)
VILLAGE HEALTH POST (WO 16 (GO TO 331)
CBD WORKER 17(GO TO 331)
RELIGIOUS/VOLUNTARY
REFERAL/SPEC. HOSPITAL 21 (GO TO 331)
DISTRICT HOSPITAL 22(GO TO 331)
GOVT. HEALTH CENTRE 23 (GO TO 331)
DISPENSARY 24 (GO TO 331)
PRIVATE
DISTRICT HOSPITAL 31 (GO TO 331)
HEALTH CENTRE 32 (GO TO 331)
DISPENSARY 33 (GO TO 331)
OTHER
PHARMACY 41 (GO TO 331)
NGO 42 (GO TO 331)
VCT CENTRE 43 (GO TO 331)
SHOP/KIOSK 44(GO TO 331)
BAR 45 (GO TO 331)
GUEST HOUSE/HOTEL 46 (GO TO 331)
FRIEND/RELATIVE/NEIGHBOUR 47 (GO TO 331)
OTHER (SPECIFY) _______________________ 96 (GO TO 331)

top
Tanzania 2010
Survey form view entire document:  text 
323. Where did you obtain (CURRENT METHOD) the last time?
PROBE TO IDENTIFY THE TYPE OF SOURCE. IF UNABLE TO DETERMINE IF IS PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE) _________
GOVERNMENT/PARASTATAL
REFERRAL/SPEC. HOSPITAL 11 (GO TO 326)
REGIONAL HOSPITAL 12 (GO TO 326)
DISTRICT HOSPITAL 13 (GO TO 326)
HEALTH CENTRE 14 (GO TO 326)
DISPENSARY 15 (GO TO 326)
VILLAGE HEALTH POST 16 (GO TO 326)
CBD WORKER 17 (GO TO 326)
RELIGIOUS/VOLUNTARY
REFERAL/SPEC. HOSPITAL 21 (GO TO 326)
DISTRICT HOSPITAL 22 (GO TO 326)
HEALTH CENTRE 23 (GO TO 326)
DISPENSARY 24 (GO TO 326)
PRIVATE
HOSPITAL 31 (GO TO 326)
HEALTH CENTRE 32 (GO TO 326)
DISPENSARY 33 (GO TO 326)
OTHER
PHARMACY 41 (GO TO 326)
NGO 42 (GO TO 326)
VCT CENTRE 43 (GO TO 326)
SHOP/KIOSK 44 (GO TO 326)
BAR 45 (GO TO 326)
GUESTHOUSE/HOTEL 46 (GO TO 326)
FRIEND/RELATIVE/NEIGHBOUR 47 (GO TO 326)
OTHER (SPECIFY) __________ 96 (GO TO 326)

top
Tanzania 2015
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) _____
GOVERNMENT/PARASTATAL
NATIONAL/ZONAL/SPEC. HOSPITAL 11
REGIONAL REFERRAL HOSPITAL 12
REGIONAL HOSPITAL 13
DISTRICT HOSPITAL 14
HEALTH CENTRE 15
DISPENSARY 16
CLINIC 17
CHW 18
RELIGIOUS/VOLUNTARY
REFERRAL SPECIALISED HOSPITAL 21
DISTRICT HOSPITAL 22
HOSPITAL 23
HEALTH CENTRE 24
DISPENSARY 25
CLINIC 26
PRIVATE MEDICAL SECTOR
SPECIALISED HOSPITAL 31
HOSPITAL 32
HEALTH CENTRE 33
DISPENSARY 34
CLINIC 35
OTHER
PHARMACY 41
ACCREDITED DRUG DISPENSING OUTLET (ADDO) 42
NGO 43
VCT CENTRE 44
SHOP/KIOSK 45
BAR 46
GUEST HOUSE/HOTEL 47
FRIEND/RELATIVE/NEIGHBOUR 48
OTHER (SPECIFY) 96

top
Togo 1988
Survey form view entire document:  text 
315) Where did you (your partner) obtain (CURRENT METHOD) the last time?

MATERNAL AND CHILD HEALTH CENTER (PMI) 01
DISPENSARY 02
TOGOLESE ASSOCIATION FOR FAMILIAL WELL-BEING 03
HOSPITAL 04
HEALTH CENTER 05
PHARMACY 06
PRIVATE CLINIC 07
MARKET 08
RELIGIOUS MISSION 09
SCHOOL 10
OTHER (SPECIFY) __________ 11
DON'T KNOW 98

top
Togo 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
HOSPITAL 11
MEDICAL-SOCIAL CENTER 12
DISPENSARY/INFIRMARY 13
M.C.H. 14
HEALTH POST 15
PHARMACY 16
OTHER PUBLIC (SPECIFY) __________ 17
PRIVATE MEDICAL SECTOR
HOSPITAL/PRIVATE CLINIC 21
PHARMACY 22
TOGOLESE ASSOCIATION FOR FAMILIAL WELL-BEING 23
DOCTOR'S OFFICE 24
FIELDWORKER 25
OTHER PRIVATE MEDICAL (SPECIFY) __________ 26
OTHER PRIVATE SECTOR
MARKET/SHOP 31
CHURCH 32
FRIENDS/RELATIVES 33
GAS STATION 34
OTHER (SPECIFY) ____________ 96

top
Togo 2013
Survey form view entire document:  text 
323) Where did you obtain (CURRENT METHOD) 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
GOVERNMENT HOSPITAL 11-- (SKIP TO 326)
HEALTH CENTER 12-- (SKIP TO 326)
DISPENSARY13-- (SKIP TO 326)
MOTHER-INFANT PROTECTION 14-- (SKIP TO 326)
HEALTH HUT 15-- (SKIP TO 326)
MOBILE CLINIC 16-- (SKIP TO 326)
OTHER PUBLIC SECTOR_________ (SPECIFY) 17-- (SKIP TO 326)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21-- (SKIP TO 326)
PHARMACY 22 -- (SKIP TO 326)
PRIVATE DOCTOR'S OFFICE 23-- (SKIP TO 326)
NGO/ASSOCIATION 23-- (SKIP TO 326)
OTHER PRIVATE MEDICAL SECTOR______ (SPECIFY) 24-- (SKIP TO 326)
OTHER SOURCE
SHOP 31-- (SKIP TO 326)
RELIGIOUS INSTITUTION 32-- (SKIP TO 326)
FRIENDS/RELATIVES 33-- (SKIP TO 326)
OTHER (SPECIFY) 96-- (SKIP TO 326)

top
Uganda 1988
Survey form view entire document:  text 
315) Where did you obtain (METHOD) the last time?

315A) Where did the sterilization take place?

315B) Where did you obtain instructions for this method?

GOVERNMENT HOSPITAL 01 (GO TO 319)
GOVERNMENT HEALTH CENTER 02 (GO TO 319)
FPAU CLINIC 03 (GO TO 319)
MOBILE CLINIC 04 (GO TO 319)
FIELD WORKER 05 (GO TO 319)
PRIVATE DOCTOR 06 (GO TO 319)
PRIVATE HOSPITAL OR CLINIC 07 (GO TO 319)
PHARMACY/SHOP 08 (GO TO 319)
CHURCH 09 (GO TO 319)
FRIENDS/RELATIVES 10 (GO TO 319)
TRADITIONAL HEALER 11 (GO TO 319)
OTHER (SPECIFY) __________ 12 (GO TO 319)
OTHER (SPECIFY) __________ 12 (GO TO 319)
NOWHERE 13 (GO TO 319)
DON'T KNOW 98 (GO TO 319)

top
Uganda 1995
Survey form view entire document:  text 
329) Where did you obtain (METHOD) the last time?

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 MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
PHARMACY/DRUG STORE 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

top
Uganda 2001
Survey form view entire document:  text 
328 Where did you obtain (current 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 (GO TO 331)
GOVERNMENT HEALTH CENTER 12 (GO TO 331)
FAMILY PLANNING CLINIC OUTREACH 14 (GO TO 331)
GOVERNMENT COMMUNITY BASED DISTRIBUTOR 15 (GO TO 331)
OTHER PUBLIC (SPECIFY) __________ 16 (GO TO 331)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21 (GO TO 331)
PHARMACY/DRUG SHOP 22 (GO TO 331)
PRIVATE DOCTOR/NURSE/MIDWIFE 23 (GO TO 331)
OUTREACH 24 (GO TO 331)
NGO COMMUNITY BASED DISTRIBUTOR 25 (GO TO 331)
OTHER PRIVATE MEDICAL (SPECIFY) __________ 26 (GO TO 331)
OTHER SOURCE
SHOP 31 (GO TO 331)
RELIGIOUS INSTITUTION 32 (GO TO 331)
FRIEND/RELATIVE 33
OTHER (SPECIFY) __________ 96

top
Uganda 2006
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
GOVERNMENT HEALTH CENTER 12
FAMILY PLANNING CLINIC 13
OUTREACH 14
GOVERNMENT COMMUNITY BASED DISTRIBUTOR 15
OTHER PUBLIC (SPECIFY) 16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
PHARMACY/DRUG SHOP 22
PRIVATE DOCTOR/NURSE/MIDWIFE 23
OUTREACH 24
NGO COMMUNITY BASED DISTRIBUTOR 25
OTHER PRIVATE MEDICAL (SPECIFY) 26
OTHER SOURCE
SHOP 31
RELIGIOUS INSTITUTION 32
FRIEND/RELATIVE 33
OTHER (SPECIFY) 96

top
Uganda 2011
Survey form view entire document:  text 
323) 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
GOVT HOSPITAL 11 (GO TO 326)
GOVT HEALTH CENTER 12 (GO TO 326)
FAMILY PLANNING CLINIC 13 (GO TO 326)
OUT REACH 14 (GO TO 326)
FIELDWORKER/VHT 15 (GO TO 326)
OTHER PUBLIC SECTOR (SPECIFY) _______________ 16 (GO TO 326)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21 (GO TO 326)
PHARMACY 22 (GO TO 326)
PRIVATE DOCTOR 23 (GO TO 326)
OUT REACH 24 (GO TO 326)
FIELDWORKER/VHT 25 (GO TO 326)
OTHER PRIVATE MEDICAL SECTOR 26 (SPECIFY) _____________ (GO TO 326)
OTHER SOURCE
SHOP 31 (GO TO 326)
CHURCH 32 (GO TO 326)
FRIEND/RELATIVE 33 (GO TO 326)
OTHER (SPECIFY) _____________________ 96 (GO TO 326)

top
Uganda 2016
Survey form view entire document:  text 
325) Where did you obtain (CURRENT METHOD) the last time?
PROBE TO IDENTIFY THE TYPE OF SOURCE.

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

NAME OF PLACE ________

PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
FAMILY PLANNING CLINIC 13
MOBILE CLINIC 14
OTHER PUBLIC SECTOR (SPECIFY) _____ 16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINI 21
PRIVATE DOCTOR'S OFFICE 22
MOBILE CLINIC 23
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) _____26
OTHERT SOURCE
SHOP 31
CHURCH 32
FRIEND/RELATIVE 33
OTHER (SPECIFY) ______ 96

top
Yemen 1991
Survey form view entire document:  text 
817C) Where did you obtain the (METHOD)?

PUBLIC HOSPITAL 1
PUBLIC FP CLINIC 2
PRIVATE VOLUNTARY FP CLINIC 3
MCH CENTRE 4
PRIVATE DOCTOR/CLINIC 5
FIELD WORKER 6
MOBILE CLINIC 7
PHARMACY 8
OTHER 9 (GO TO 819)
DON'T KNOW 10 (GO TO 819)

top
Yemen 2013
Survey form view entire document:  text 
322) CHECK 304: CIRCLE METHOD CODE: IF MORE THAN ONE METHOD CODE CIRCLED IN 304, CIRCLE CODE FOR HIGHEST METHOD IN LIST.

FEMALE STERILIZATION 01 (GO TO 326)
MALE STERILIZATION 02 (GO TO 326)
IUD 03
INJECTABLES 04
IMPLANTS 05
PILL 06
CONDOM 07
FEMALE CONDOM 08
DIAPHRAGM 09
LACTATIONAL AMEN. METHOD 10 (GO TO 326)
RHYTHM METHOD 11 (GO TO 326)
WITHDRAWAL 12 (GO TO 326)
OTHER MODERN METHOD 95 (GO TO 326)
OTHER TRADITIONAL METHOD 96 (GO TO 326)

top
Zambia 1992
Survey form view entire document:  text 
318. CHECK 312:

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

USING ANOTHER METHOD: Where did you obtain (METHOD) the last time?

RECORD MINES HOSPITAL OR CLINIC AS PRIVATE ('21')

(NAME OF PLACE) __________
PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
FIELD WORKER 13 (GO TO 321)
MEDICAL PRIVATE SECTOR
PRIVATE HOSPITAL OR CLINIC 21
MISSION HOSPITAL OR CLINIC 22
PHARMACY 23
PRIVATE DOCTOR 24
MOBILE CLINIC 25 (GO TO 321)
FIELD WORKER 26 (GO TO 321)
OTHER PRIVATE SECTOR
SHOP 31
FRIENDS/RELATIVES 32 (GO TO 321)
OTHER (SPECIFY) _________________ 41 (GO TO 321)
DON'T KNOW 98 (GO TO 321)

top
Zambia 1996
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 CENTER 12
FIELDWORKER 13 (GO TO 328C)
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 (GO TO 328C)
OTHER PRIVATE MEDICAL (SPECIFY) ____________ 27
OTHER SOURCE
SHOP 31 (GO TO 328C)
FRIENDS/RELATIVES 33 (GO TO 328C)
OTHER (SPECIFY) _________________ 36 (GO TO 328C)
DON'T KNOW 98 (GO TO 328C)

top
Zambia 2001
Survey form view entire document:  text 
328. Where did you obtain (CURRENT 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.
328A. Where did you learn to use Lactational Amenorrhea Method?

(NAME OF PLACE) _____________
PUBLIC SECTOR
GOVT. HOSPITAL 11 (GO TO 331)
GOVT. HEALTH CENTER 12 (GO TO 331)
HEALTH POST 13 (GO TO 331)
OTHER PUBLIC (SPECIFY) ______ 16 (GO TO 331)

PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/SURGERY 21 (GO TO 331)
MISSION HOSPITAL/CLINIC 22 (GO TO 331)
PHARMACY 23 (GO TO 331)
PRIVATE DOCTOR 24 (GO TO 331)
WORK PLACE 25 (GO TO 331)
OTHER PRIVATE MEDICAL (SPECIFY) ______ 26 (GO TO 331)
OTHER SOURCE
SHOP 31 (GO TO 331)
COMMUNITY-BASED AGENT 32 (GO TO 331)
FRIEND/RELATIVE 33 (GO TO 331)
OTHER (SPECIFY) _______________ 96 (GO TO 331)

top
Zambia 2007
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
GOVT. HOSPITAL 11 (GO TO 335)
GOVT. HEALTH CENTER 12 (GO TO 335)
HEALTH POST 13 (GO TO 335)
OTHER PUBLIC (SPECIFY) ______ 16 (GO TO 335)

PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/SURGERY 21 (GO TO 335)
MISSION HOSPITAL/CLINIC 22 (GO TO 335)
PHARMACY 23 (GO TO 335)
PRIVATE DOCTOR 24 (GO TO 335)
WORK PLACE 25 (GO TO 335)
OTHER PRIVATE MEDICAL (SPECIFY) ______ 26 (GO TO 335)
OTHER SOURCE
SHOP 31 (GO TO 335)
CHURCH 32 (GO TO 335)
FRIEND/RELATIVE 33 (GO TO 335)
OTHER (SPECIFY) _______________ 96 (GO TO 335)

top
Zambia 2013
Survey form view entire document:  text 
323) 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 PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

NAME OF PLACE ___________________
PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVT. HEALTH CENTER/POST 12
MOBILE HOSPITAL/CLINIC 13
FAMILY PLANNING CLINIC 14
COMMUNITY BASED AGENT/FIELDWORKER 15
OTHER PUBLIC SECTOR 16 (SPECIFY) _____________________
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
MISSION HOSPITAL/CLINIC 22
PHARMACY 23
PRIVATE DOCTOR 24
COMMUNITY BASED AGENT/FIELDWORKER 25
MOBILE HOSPITAL/CLINIC 26
OTHER PRIVATE MEDICAL SECTORS 27 (SPECIFY) _____________________
OTHER SOURCE

SHOP 31
CHURCH 32
FRIENDS/RELATIVES 33
OTHER 96 (SPECIFY) __________________________

top
Zambia 2018
Survey form view entire document:  text 
(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 (SKIP TO 327)
GOVERNMENT HEALTH CENTER 12 (SKIP TO 327)
GOVERNMENT HEALTH POST 13 (SKIP TO 327)
MOBILE CLINIC/HOSPITAL 14 (SKIP TO 327)
COMMUNITY BASED AGENT/FIELDWORKER 15 (SKIP TO 327)
OTHER PUBLIC SECTOR (SPECIFY) ________________ 16 (SKIP TO 327)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21 (SKIP TO 327)
MISSION HOSPITAL/CLINIC 22 (SKIP TO 327)
PHARMACY 23 (SKIP TO 327)
PRIVATE DOCTOR 24 (SKIP TO 327)
MOBILE HOSPITAL/CLINIC 25 (SKIP TO 327)
COMMUNITY BASED AGENT/FIELDWORKER 26 (SKIP TO 327)
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) ______ 27 (SKIP TO 327)
OTHER SOURCES
SHOP 31 (SKIP TO 327)
CHURCH 32 (SKIP TO 327)
FRIEND/RELATIVE 33 (SKIP TO 327)
OTHER (SPECIFY) _________________________ 96 (SKIP TO 327)

top
Zimbabwe 1988
Survey form view entire document:  text 
320) Where did you last visit to obtain (METHOD)?

320A) Where did the sterilization take place?

320B) Where did you obtain instructions for using the safe period?

MOH HOSPITAL/CLINIC 01
ZNFPC CLINIC 02
MUNICIPALITY/LOCAL GOVERNMENT 03
COMMERCE/INDUSTRY 04
MISSION/CHURCH 05
PRIVATE DOCTOR/PHARMACY 06
RURAL COUNCIL CLINIC 07
FRIEND/RELATIVE 08 (GO TO 322)
TRADITIONAL HEALER 09 (GO TO 322)
OTHER (SPECIFY) __________ 10 (GO TO 322)
DON'T KNOW 98 (GO TO 322)

top
Zimbabwe 1994
Survey form view entire document:  text 
339) Where did you obtain (METHOD) the last time?

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

top
Zimbabwe 1999
Survey form view entire document:  text 
328L) Where did you obtain (CURRENT 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/CLINIC 11 (SKIP TO 334)
RURAL/MUNICIPAL CLINIC 12 (SKIP TO 334)
RURAL HEALTH CENTER 13 (SKIP TO 334)
ZNFPC (FIXED) CLINIC 14 (SKIP TO 334)
ZNFPC MOBILE CLINIC 15 (SKIP TO 334)
MOH MOBLIE CLINIC 16 (SKIP TO 334)
ZNFPC CBD 17 (SKIP TO 334)
MOH CBD 18 (SKIP TO 334)
OTHER PUBLIC (SPECIFY) __________ 19 (SKIP TO 334)
MISSION FACILITY 21 (SKIP TO 334)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31 (SKIP TO 334)
PHARMACY 32 (SKIP TO 334)
PRIVATE DOCTOR 33 (SKIP TO 334)
CBD 34 (SKIP TO 334)
OTHER PRIVATE MEDICAL (SPECIFY) __________ 36 (SKIP TO 334)
OTHER SOURCE
SHOP 41 (SKIP TO 334)
CHURCH 42 (SKIP TO 334)
FRIENDS/RELATIVES 43 (SKIP TO 334)
OTHER (SPECIFY) __________ 96

top
Zimbabwe 2005
Survey form view entire document:  text 
329) Where did you (or your partner) obtain (CURRENT 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/CLINIC 11
RURAL/MUNICIPAL CLINIC 12
RURAL HEALTH CENTER 13
ZNFPC CLINIC 14
MOH MOBILE CLINIC 16
ZNFPC CBD/DEPOT HOLDER 17
OTHER PUBLIC (SPECIFY) __________ 18
MISSION FACILITY 21
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31
PHARMACY 32
PRIVATE DOCTOR 33
CBD 34
OTHER PRIVATE DOCTOR (SPECIFY) __________ 36
RETAIL OUTLET
GENERAL DEALER 41
SUPERMARKET 42
TUCK SHOP 43
SERVICE STATION 44
OTHER RETAIL (SPECIFY) __________ 46
OTHER PRIVATE SOURCE
CHURCH 51
FRIEND/RELATIVE 52
OTHER (SPECIFY) __________ 96

top
Zimbabwe 2010
Survey form view entire document:  text 
323) 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/CLINIC 11 (GO TO 326)
RURAL/MUNICIPAL CLINIC 12 (GO TO 326)
RURAL HEALTH CENTRE 13 (GO TO 326)
ZNFCP CLINIC 14 (GO TO 326)
MOH MOBILE CLINIC 15 (GO TO 326)
ZNFPC CBD/DEPOT HOLDER 16 (GO TO 326)
OTHER PUBLIC SECTOR (SPECIFY) 17 (GO TO 326)
MISSION HOSPITAL/CLINIC 21 (GO TO 326)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31 (GO TO 326)
PHARMACY 32 (GO TO 326)
PRIVATE DOCTOR 33 (GO TO 326)
CBD 34 (GO TO 326)
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) 36 (GO TO 326)
RETAIL OUTLET
GENERAL DEALER 41 (GO TO 326)
SUPERMARKET 42 (GO TO 326)
TUCK SHOP 43 (GO TO 326)
SERVICE STATION 44 (GO TO 326)
OTHER RETAIL (SPECIFY) 46 (GO TO 326)
OTHER PRIVATE SOURCE
CHURCH 51 (GO TO 326)
FRIENDS/RELATIVE 52 (GO TO 326)
OTHER (SPECIFY) 96 (GO TO 326)

top
Zimbabwe 2015
Survey form view entire document:  text 
323. Were you ever told by a health or family planning worker about other methods of family planning that you could use?

YES 1
NO 2