Survey Text

Benin 2001 Guinea 2005 Mozambique 2011 Senegal 2012
Benin 2006 Lesotho 2004 Namibia 2006 Senegal 2014
Benin 2011 Lesotho 2009 Namibia 2013 Senegal 2015
Burkina Faso 2003 Lesotho 2014 Niger 2012 Senegal 2016
Burkina Faso 2010 Liberia 2007 Nigeria 2003 Senegal 2017
Cameroon 2011 Liberia 2013 Nigeria 2008 Uganda 2001
Congo (Democratic Republic) 2007 Madagascar 2003 Nigeria 2013 Uganda 2006
Cote d'Ivoire 2011 Madagascar 2008 Rwanda 2005 Uganda 2011
Eswatini (Swaziland) 2006 Malawi 2000 Rwanda 2010 Zambia 2007
Ghana 2003 Malawi 2004 Rwanda 2014 Zambia 2013
Ghana 2008 Malawi 2010 Senegal 2005 Zimbabwe 2005
Ghana 2014 Mozambique 2003 Senegal 2010 Zimbabwe 2010
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Benin 2001
Survey form view entire document:  text 
330) Where is this?
330A) Where did you learn to use the lactational amenorrhea method (LAM)? Any other place?
IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
RECORD ALL MENTIONED.

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

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Benin 2006
Survey form view entire document:  text 
330) Where is that?
330A) Where did you learn to use the lactational amenorrhea method (LAM)?
IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
RECORD ALL MENTIONED.

NAME OF PLACE ________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
FAMILY PLANNING CLINIC C
FIELDWORKER D
COMMUNITY CENTER E
STRAT AV HEALTH WORKER F
HEALTH WORKER/ COMMUNITY LIAISON G
VENDING MACHINE H
OTHER PUBLIC (SPECIFY) ________ I
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC J
RELIGIOUS HOSPITAL K
PHARMACY L
ABPF (BENIN FAMILY ADVOCACY ASSOCIATION) M
DOCTOR'S OFFICE N
HEALTH AGENT (NON-GOVERNMENTAL ORGANIZATION) O
OTHER PRIVATE MEDICAL (SPECIFY) ________ P
OTHER SOURCE
SHOP/MARKET Q
CHURCH/MOSQUE R
RELATIVES/FRIENDS S
BAR/SALOON T
OTHER (SPECIFY) ________ X

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Benin 2011
Survey form view entire document:  text 
325) Where is that? Any other place?
PROBE TO IDENTITY THE TYPE OF SOURCE. IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE(S))___________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
FAMILY PLANNING CLINIC C
FIELDWORKER D
SOCIAL CENTER E
STRAT AV HEALTH WORKER F
HEALTH WORKER/COMMUNITY LIAISON G
VENDING MACHINE H
OTHER PUBLIC SECTOR______(SPECIFY) I
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC J
RELIGIOUS HOSPITAL K
PRIVATE DOCTOR'S OFFICE L
PHARMACY M
BENINESE FAMILY PLANNING ASSOCIATION (ABPF) N
FIELDWORKER (NGO) O
OTHER PRIVATE MEDICAL _______(SPECIFY) P
OTHER SOURCE
SHOP/MARKET Q
CHURCH/MOSQUE R
FRIEND/RELATIVES S
BAR/REFRESHMENT AREA T
OTHER______ (SPECIFY) X

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Burkina Faso 2003
Survey form view entire document:  text 
330. Where is that?

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

NAME OF PLACE_______
PUBLIC SECTOR
HOSPITAL A
HEALTH CENTER B
DISPENSARY C
MEDICAL POST D
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC E
PRIVATE HEALTH CENTER F
PHARMACY/MEDICINE DISPENSARY G
PRIVATE DOCTOR H
PF/FISA CENTER I
OTHER SOURCE
DBC AGENT J
STORE K
KIOSK L
CHURCH M
RELATIVES/FRIENDS N
OTHER (SPECIFY) ______ X

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Burkina Faso 2010
Survey form view entire document:  text 
325) Where is that? (5)

Any other place?

PROBE TO IDENTIFY EACH TYPE OF SOURCE.

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

(NAME OF PLACE(S))__________
PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC SECTOR (SPECIFY)_____ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)_____ L
OTHER SOURCE
SHOP M
CHURCH N
FRIEND/RELATIVE O
OTHER (SPECIFY)______ X

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Cameroon 2011
Survey form view entire document:  text 
333) Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2 (GO TO 335)

334) What is this place?

Anywhere else?

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

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

NAME OF PLACE: ___
PUBLIC/PARA PUBLIC SECTOR
HOSPITAL A
HEALTH CENTER B
OTHER PUBLIC (SPECIFY): ___ C
PRIVATE MEDICAL SECTOR
PRIVATE RELIGIOUS HOSPITAL D
PRIVATE SECULAR HOSPITAL/CLINIC E
HEALTH CENTER/RELIGIOUS DISPENSARY/MISSION F
MEDICAL OFFICE (SPECIFY): ___ G
PHARMACY H
OTHER PRIVATE MEDICAL (SPECIFY): ___ I
OTHER PRIVATE SECTOR
SHOP/MARKET J
RELIGIOUS INSTITUTION K
FRIENDS/RELATIVES L
OTHER SOURCE (SPECIFY): ___ X

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

YES 1
NO 2 (GO TO 331)

330) Where is this?

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

(NAME OF PLACE) __________

Another place?
RECORD ALL MENTIONED.

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

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Cote d'Ivoire 2011
Survey form view entire document:  text 
324) Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2 (GO TO 326)

325) Where is that?
Any other place?
PROBE TO IDENTITY THE TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.
(NAME OF PLACE(S))_______________

PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
HEALTH WORKER E
OTHER______ (SPECIFY) F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
HEALTH AGENT K
OTHER PRIVATE MEDICAL_________ (SPECIFY) L
OTHER SOURCE
SHOP M
RELIGIOUS INSTITUTIONS N
FRIEND/RELATIVES O
OTHER__________ (SPECIFY) X

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Eswatini (Swaziland) 2006
Survey form view entire document:  text 
332) Where is that? Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE(S). IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE)__________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
PHU/CLINIC C
MOBILE CLINIC D
RHM/CBD E
OTHER PUBLIC (SPECIFY)_________F
PRIVATE SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
CBD K
OTHER PRIVATE (SPECIFY)______L
MISSION
HOSPITAL M
CLINIC N
OTHER MISSION (SPECIFY)_____O
NGO
FLAS P
OTHER NGO (SPECIFY)____Q
OTHER SOURCE
SHOP R
CHURCH S
FRIEND/RELATIVE T
OTHER (SPECIFY)______X

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Ghana 2003
Survey form view entire document:  text 
330) Where is that?

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

Any other place?

RECORD ALL PLACES MENTIONED.

NAME OF PLACE: _________
PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC (SPECIFY): ___________ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL (SPECIFY): __________ L
OTHER SOURCE
SHOP M
CHURCH N
FRIEND/RELATIVE O
OTHER (SPECIFY): __________ X

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Ghana 2008
Survey form view entire document:  text 
334 Where is that? (4)
Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE(S).
IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE) ____________
PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC (SPECIFY) ____________ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL (SPECIFY) __________ L
OTHER SOURCE
SHOP M
CHURCH N
FRIEND/RELATIVE O
OTHER (SPECIFY) __________ X

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Ghana 2014
Survey form view entire document:  text 
325) Where is that? (5)

Any other place?

PROBE TO IDENTIFY EACH TYPE OF SOURCE.

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

(NAME OF PLACE(S))__________
PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC SECTOR (SPECIFY)_____ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)_____ L
OTHER SOURCE
SHOP M
CHURCH N
FRIEND/RELATIVE O
OTHER (SPECIFY)______ X

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Guinea 2005
Survey form view entire document:  text 
334 Where is that? (4)
Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE(S).
IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE) ____________
PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC (SPECIFY) ____________ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL (SPECIFY) __________ L
OTHER SOURCE
SHOP M
CHURCH N
FRIEND/RELATIVE O
OTHER (SPECIFY) __________ X

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Lesotho 2004
Survey form view entire document:  text 
319 Where is that? Any other place?
RECORD ALL MENTIONED.

PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
OTHER PUBLIC ______(SPECIFY) D
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC E
PHARMACY F
PRIVATE DOCTOR G
OTHER PRIVATE MEDICAL _______ (SPECIFY) H
CHAL
CHAL HOSPITAL I
CHAL HEALTH CENTER J
CBD K
COMMUNITY HEALTH WORKER L
SUPPORT GROUPS M
OTHER SOURCE
SHOP N
CHURCH O
PEER EDUCATORS P
FRIENDS/RELATIVES Q
OTHER _____________(SPECIFY) X

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Lesotho 2009
Survey form view entire document:  text 
334 Where is that? Any other place?
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(S)) _____________
PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
OTHER PUBLIC SECTOR C
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC D
LPPA E
PHARMACY F
PRIVATE DOCTOR G
OTHER PRIVATE MEDICAL SECTOR H
CHAL
CHAL HOSPITAL I
CHAL HEALTH CENTER J
CHAL HEALTH POST K
CBD L
COMMUNITY HEALTH WORKER M
SUPPORT GROUPS N
OTHER SOURCE
SHOP O
CHURCH P
PEER EDUCATORS Q
FRIEND/RELATIVE R
OTHER X

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

YES 1
NO 2 (GO TO 326)

325) Where is that? Any other place?

PROBE TO IDENTIFY EACH TYPE OF SOURCE.

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

NAME OF PLACE(S) ____
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
GOVERNMENT HEALTH POST C
FAMILY PLANNING CLINIC D
OTHER PUBLIC SECTOR (SPECIFY) ____ E
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC F
PHARMACY G
PRIVATE DOCTOR H
LESOTHO PLANNED PARENTHOOD I
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) ____ J
CHAL
CHAL HOSPITAL K
CHAL HEALTH CENTER L
CHAL HEALTH POST M
RED CROSS HEALTH CENTER N
CBD O
VILLAGE HEALTH WORKER P
SUPPORT GROUPS Q
FACILITY OUTSIDE LESOTHO R
OTHER SOURCE
SHOP S
CHURCH T
PEER EDUCATORS U
FRIEND/RELATIVE V
OTHER (SPECIFY) ____ X

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Liberia 2007
Survey form view entire document:  text 
404 FROM 212 AND 216

NAME ____
LIVING (GO TO 405)
DEAD (GO TO 405)

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

YES 1
NO 2 (GO TO 326)

325) Where is that? Any other place?

PROBE TO IDENTIFY EACH TYPE OF SOURCE.

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

(NAME OF PLACE(S))____
PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
GOVT. CLINIC C
COMMUNITY HEALTH VOL/gCHV D
OTHER PUBLIC SECTOR (SPECIFY) E
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC F
PHARMACY G
PRIVATE DOCTOR H
PLANNED PARENTHOOD ASSN. LIB. I
MOBILE CLINIC J
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) K
OTHER SOURCE
SHOP L
CHURCH M
FRIENDS/RELATIVES N
OTHER (SPECIFY) X

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Madagascar 2003
Survey form view entire document:  text 
330. Where is that?

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] A
DISTRICT HOSPITAL I [NON-SURGICAL MEDICAL CAPABILITIES] B
BASIC HEALTH CENTER II [BASIC HEALTH CARE, PHYSICIAN-RUN] C
BASIC HEALTH CENTER I [BASIC HEALTH CARE, RUN BY PARA-MEDICAL OFFICER] D
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC E
PRIVATE HEALTH CENTER F
PHARMACY/MEDICINE DISPENSARY G
PRIVATE DOCTOR H
PF/FISA CENTER I
OTHER SOURCE
VBC AGENT J
STORE K
KIOSK L
CHURCH M
RELATIVES/FRIENDS N
OTHER (SPECIFY) ______ X

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Madagascar 2008
Survey form view entire document:  text 
333. Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2 (GO TO 335)

334. Where is that?
Any other place?

PROBE TO IDENTIFY 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) A
DISTRICT HOSPITAL I (non-surgical medical capabilities) B
BASIC HEALTH CENTER II (basic health care, physician-run) C
BASIC HEALTH CENTER I (basic health care, run by para-medical officer) D
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC E
PRIVATE MOBILE CLINIC F
PHARMACY G
PRIVATE DOCTOR H
FAMILY PLANNING CENTER I
OTHER SOURCE
FIELDWORKER J
STORE K
KIOSK L
CHURCH M
FRIEND/RELATIVE N
OTHER (SPECIFY) ______ X

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Malawi 2000
Survey form view entire document:  text 
329. Where is that? Any other place?

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

NAME OF PLACE_______
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
CBDA/FIELD WORKER E
OTHER PUBLIC (SPECIFY) ____ F
MISSION
HOSPITAL G
HEALTH CENTER H
MOBILE CLINIC I
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC J
PHARMACY K
PRIVATE DOCTOR L
MOBILE CLINIC M
CBDA/FIELD WORKER N
OTHER PRIVATE MEDICAL (SPECIFY) _____ O
BLM P
OTHER SOURCE
SHOP Q
CHURCH R
FRIEND/RELATIVE S
OTHER (SPECIFY) _____ X

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Malawi 2004
Survey form view entire document:  text 
330) Where is that? Any other place?
IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.

RECORD ALL PLACES MENTIONED.

NAME OF PLACE_________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC (SPECIFY) ______ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL (SPECIFY) ______ L
OTHER SOURCE
SHOP M
CHURCH N
FRIEND/RELATIVE O
OTHER (SPECIFY) ______ X

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Malawi 2010
Survey form view entire document:  text 
334 Where is that? (4)
Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE(S).
IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE) ____________
PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC (SPECIFY) ____________ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL (SPECIFY) __________ L
OTHER SOURCE
SHOP M
CHURCH N
FRIEND/RELATIVE O
OTHER (SPECIFY) __________ X

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Mozambique 2003
Survey form view entire document:  text 
330. Where is that?
Any other place?
RECORD ALL PLACES MENTIONED.

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 A
PROVINCIAL/GENERAL HOSPITAL B
RURAL HOSPITAL C
HEALTH CENTER D
MOBILE CLINIC E
OTHER (SPECIFY) ____ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL G
PRIVATE CLINIC H
PRIVATE DOCTOR I
PRIVATE NURSE J
PRIVATE PHARMACY K
OTHER PRIVATE MEDICAL (SPECIFY) ___ L
OTHER SOURCE
SHOP M
CHURCH N
FRIENDS/RELATIVES O
OTHER (SPECIFY) ______ X

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

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

RECORD ALL PLACES MENTIONED.

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

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

YES 1
NO 2 (GO TO 335)

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

(NAME OF PLACE(S)) ____________
PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER/CLINIC B
PHC CLINIC (MOBILE) C
COMMUNITY HEALTH WORKER D
OTHER PUBLIC (SPECIFY)____ E
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC F
PHARMACY G
PRIVATE DOCTOR H
OTHER PRIVATE MEDICAL (SPECIFY)____ I
OTHER SOURCE
SHOP J
CHURCH K
FRIEND/RELATIVE L
TRAD. BIRTH ATTENDANT M
TRAD. HEALER N
OTHER (SPECIFY) _____ X

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Namibia 2013
Survey form view entire document:  text 
325) Where is that? (5)

Any other place?

PROBE TO IDENTIFY EACH TYPE OF SOURCE.

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

(NAME OF PLACE(S))__________
PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC SECTOR (SPECIFY)_____ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)_____ L
OTHER SOURCE
SHOP M
CHURCH N
FRIEND/RELATIVE O
OTHER (SPECIFY)______ X

top
Niger 2012
Survey form view entire document:  text 
325) Where is that?

Any other place?

PROBE TO IDENTITY THE TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.
(NAME OF PLACE(S))____________

PUBLIC SECTOR
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

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Nigeria 2003
Survey form view entire document:  text 
330. Where is that? Any other place?
IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
RECORD ALL PLACES MENTIONED

(NAME OF PLACE) _____________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
COMMUNITY HEALTH WORKER E
OTHER PUBLIC (SPECIFY) ______ F

PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY/PATENT MEDICINE STORE H
PRIVATE DOCTOR I
MOBILE CLINIC J
COMMUNITY HEALTH WORKER K
OTHER PRIVATE MEDICAL (SPECIFY) ______ L
OTHER SOURCE
SHOP M
CHURCH N
FRIEND/RELATIVE O
NGO P
OTHER (SPECIFY) _______________ X

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Nigeria 2008
Survey form view entire document:  text 
334 Where is that? (4)
Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE(S).
IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE) ____________
PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC (SPECIFY) ____________ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL (SPECIFY) __________ L
OTHER SOURCE
SHOP M
CHURCH N
FRIEND/RELATIVE O
OTHER (SPECIFY) __________ X

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Nigeria 2013
Survey form view entire document:  text 
325) Where is that? (5)

Any other place?

PROBE TO IDENTIFY EACH TYPE OF SOURCE.

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

(NAME OF PLACE(S))__________
PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC SECTOR (SPECIFY)_____ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)_____ L
OTHER SOURCE
SHOP M
CHURCH N
FRIEND/RELATIVE O
OTHER (SPECIFY)______ X

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Rwanda 2005
Survey form view entire document:  text 
330. Where is that?
IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.

(NAME OF PLACE) ______

RECORD ALL PLACES MENTIONED.

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

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Rwanda 2010
Survey form view entire document:  text 
325) Where is that? Any other place?

PROBE TO IDENTIFY THE TYPE OF SOURCE

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

NAME OF PLACE(S)
PUBLIC SECTOR
REFERAL HOSPITAL A
DISTRICT HOSPITAL B
HEALTH CENTER C
HEALTH POST D
OUTREACH E
COMMUNITY HEALTH WORKER F
OTHER PUBLIC HEALTH FACILITY (SPECIFY) G
PRIVATE MEDICAL SECTOR
POLYCLINIC H
CLINIC I
DISPENSARY J
PHARMACY K
FAMLIY PLANNING CLINIC L
OTHER PRIVATE HEALTH FACILITY (SPECIFY) M
OTHER SOURCES
KIOSK N
CHURCH O
FRIEND/RELATIVE P
OTHER (SPECIFY) X

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Rwanda 2014
Survey form view entire document:  text 
325) Where is that? Any other place?

PROBE TO IDENTIFY EACH TYPE OF SOURCE.

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

(NAME OF PLACE(S))_____
PUBLIC/AGREE SECTOR
REFERRAL HOSPITAL A
PROVINCIAL/DISTRICT HOSPITAL B
HEALTH CENTER C
HEALTH POST D
OUTREACH E
COMMUNITY HEALTH WORKER F
OTHER PUBLIC HEALTH FACILITY (SPECIFY) ____ G
PRIVATE MEDICAL SECTOR
POLYCLINIC H
CLINIC I
DISPENSARY J
PHARMACY K
FAMILY PLANNING CLINIC L
OTHER PRIVATE HEALTH FACILITY (SPECIFY) ____ M
OTHER SOURCES
KIOSK/SHOP/BAR N
CHURCH O
FRIEND/RELATIVE P
YOUTH CENTER Q
OTHER (SPECIFY) ____ X

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Senegal 2005
Survey form view entire document:  text 
330. Where is this place?
Anywhere else?
RECORD ALL MENTIONED.

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

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

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Senegal 2010
Survey form view entire document:  text 
325) Where is that? (5)

Any other place?

PROBE TO IDENTIFY EACH TYPE OF SOURCE.

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

(NAME OF PLACE(S))__________
PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC SECTOR (SPECIFY)_____ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)_____ L
OTHER SOURCE
SHOP M
CHURCH N
FRIEND/RELATIVE O
OTHER (SPECIFY)______ X

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Senegal 2012
Survey form view entire document:  text 
325) Where is that? (5)

Any other place?

PROBE TO IDENTIFY EACH TYPE OF SOURCE.

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

(NAME OF PLACE(S))__________
PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC SECTOR (SPECIFY)_____ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)_____ L
OTHER SOURCE
SHOP M
CHURCH N
FRIEND/RELATIVE O
OTHER (SPECIFY)______ X

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

YES 1
NO 2 (GO TO 326)

325) Where is that?
Any other place?
PROBE TO IDENTITY THE TYPE OF SOURCE. IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

NAME OF PLACE(S)_______________
PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
HEALTH POST C
GOVT. FAMILY PLANNING CENTER D
RURAL MATERNITY E
HEALTH HUT F
COMMUNITY PHARMACY G
MOBILE CLINIC H
OTHER PUBLIC SECTOR (SPECIFY) I
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/OFFICE J
PHARMACY K
PRIVATE DOCTOR L
RELIGIOUS FREE CLINIC M
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) N
OTHER SOURCE
SHOP O
CHURCH P
FRIENDS/RELATIVES Q
BAR R
OTHER (SPECIFY) X

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Senegal 2015
Survey form view entire document:  text 
325) Where is that?
Any other place?
PROBE TO IDENTITY THE TYPE OF SOURCE. IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE(S)) _____
PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
HEALTH POST C
GOVT. FAMILY PLANNING CENTER D
RURAL MATERNITY E
HEALTH HUT F
COMMUNITY PHARMACY G
MOBILE CLINIC H
OTHER PUBLIC SECTOR (SPECIFY) _____ I
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/OFFICE J
PHARMACY K
PRIVATE DOCTOR L
RELIGIOUS FREE CLINIC M
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) _____N
OTHER SOURCE
SHOP O
CHURCH P
FRIENDS/RELATIVES Q
BAR R
OTHER (SPECIFY) _____X

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Senegal 2016
Survey form view entire document:  text 
327) Where is that?
Any other place?
PROBE TO IDENTIFY THE TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

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

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Senegal 2017
Survey form view entire document:  text 
327) Where is that?
Any other place?

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

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

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Uganda 2001
Survey form view entire document:  text 
330 Where is that?
IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.

NAME OF PLACE __________

ANY OTHER PLACE?
RECORD ALL MENTIONED.

PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
FAMILY PLANNING CLINIC C
OUTREACH D
GOVERNMENT COMMUNITY BASED DISTRIBUTOR E
OTHER PUBLIC (SPECIFY) __________ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY/DRUG SHOP H
PRIVATE DOCTOR/NURSE/MIDWIFE I
OUTREACH J
NGO COMMUNITY BASED DISTRIBUTOR K
OTHER PRIVATE MEDICAL (SPECIFY) __________ L
OTHER SOURCE
SHOP M
RELIGIOUS INSTITUTION N
FRIEND/RELATIVE O
OTHER (SPECIFY) __________ X

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

YES 1
NO 2 (GO TO 335)

334) Where is that? Any other place?

PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE(S).

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

NAME OF PLACE(S)______
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
FAMILY PLANNING CLINIC C
OUTREACH D
GOVERNMENT COMMUNITY BASED DISTRIBUTOR E
OTHER PUBLIC (SPECIFY) F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY/DRUG SHOP H
PRIVATE DOCTOR/NURSE/MIDWIFE I
OUTREACH J
NGO COMMUNITY BASED DISTRIBUTOR K
OTHER PRIVATE MEDICAL (SPECIFY) L
OTHER SOURCE
SHOP M
RELIGIOUS INSTITUTION N
FRIEND/RELATIVE O
OTHER (SPECIFY) X

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Uganda 2011
Survey form view entire document:  text 
324) Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2 (GO TO 326)

325) Where is that?
Any other place?

PROBE TO IDENTIFY EACH TYPE OF SOURCE.

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

(NAME OF PLACE(S)) ________________________

PUBLIC SECTOR
GOVT HOSPITAL A
GOVT HEALTH CENTER B
FAMILY PLANNING CLINIC C
OUT REACH D
FIELDWORKER/VHT E
OTHER PUBLIC SECTOR (SPECIFY) _______________ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
OUT REACH J
FIELDWORKER/VHT K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) ____________ L
OTHER SOURCE
SHOP M
CHURCH N
FRIEND/RELATIVE O
OTHER (SPECIFY) _______________ X

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

YES 1
NO 2 (GO TO 335)

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

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

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

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

YES 1
NO 2 (GO TO 326)

325) Where is that? (5)

Any other place?

PROBE TO IDENTIFY EACH TYPE OF SOURCE.

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

(NAME OF PLACE(S))__________
PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC SECTOR (SPECIFY)_____ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)_____ L
OTHER SOURCE
SHOP M
CHURCH N
FRIEND/RELATIVE O
OTHER (SPECIFY)______ X

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Zimbabwe 2005
Survey form view entire document:  text 
334 Where is that? (4)
Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE(S).
IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE) ____________
PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC (SPECIFY) ____________ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL (SPECIFY) __________ L
OTHER SOURCE
SHOP M
CHURCH N
FRIEND/RELATIVE O
OTHER (SPECIFY) __________ X

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Zimbabwe 2010
Survey form view entire document:  text 
325) Where is that? (5)

Any other place?

PROBE TO IDENTIFY EACH TYPE OF SOURCE.

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

(NAME OF PLACE(S))__________
PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC SECTOR (SPECIFY)_____ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)_____ L
OTHER SOURCE
SHOP M
CHURCH N
FRIEND/RELATIVE O
OTHER (SPECIFY)______ X