Survey Text

Afghanistan 2015 Ethiopia 2011 Jordan 2017 Nigeria 2008
Bangladesh 2007 India 2005 Myanmar 2015 Nigeria 2013
Bangladesh 2011 India 2015 Nepal 2001 Tanzania 2004
Congo (Democratic Republic) 2013 Jordan 2002 Nepal 2006 Togo 2013
Eswatini (Swaziland) 2006 Jordan 2007 Nepal 2011 Yemen 2013
Ethiopia 2005 Jordan 2012 Nigeria 2003
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Afghanistan 2015
Survey form view entire document:  text 
325. Where is that? Any other place?

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

NAME OF PLACE(S)________________
PUBLIC SECTOR
GOVT. HOSPITAL (NATIONAL, REGIONAL, PROVINCIAL OR DISTRICT) A
CHC/POLYCLINIC B
BASIC HEALTH CENTER C
HEALTH SUB-CENTER D
HEALTH POST/SUB-HEALTH POST E
COMMUNITY HEALTH WORKER F
MOBILE CLINIC G
OTHER PUBLIC SECTOR__________H
NON-GOVERNMENT SECTOR
MARIE STOPES I
RED CROSS SOCIETY J
AFGA K
OTHER NGO SECTOR_________L
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC M
PHARMACY N
PRIVATE DOCTOR O
FIELDWORKER P
OTHER PRIVATE MEDICAL SECTOR_____________Q
OTHER SOURCE
CHARITY FOUNDATION R
REFUGEE CAMP S
SHOP T
FRIEND/RELATIVE U
OTHER__________X

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Bangladesh 2007
Survey form view entire document:  text 
323) 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 THE NAME OF THE PLACE.

(NAME OF PLACE(S))____
PUBLIC SECTOR
HOSPITAL/MEDICAL COLLEGE A
FAMILY WELFARE CENTRE B
UPAZILA HEALTH COMPLEX C
SATELLITE CLINIC/EPI OUTREACH D
MATERNAL AND CHILD WELFARE CENTRE (MCWC) E
GOVERNMENT FIELD WORKER (FWA) F
COMMUNITY CLINIC G
OTHER (SPECIFY)____ H
NGO SECTOR
NGO STATIC CLINIC I
NGO SATELLITE CLINIC J
NGO DEPOT HOLDER K
NGO FIELD WORKER (FWA) L
OTHER (SPECIFY)____ M
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC N
QUALIFIED DOCTOR O
TRADITIONAL DOCTOR P
PHARMACY Q
OTHER PRIVATE MEDICAL (SPECIFY)____ R
OTHER SOURCE
SHOP S
FRIEND/RELATIVE T
OTHER (SPECIFY)____ X

Survey form view entire document:  text 
323) 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 THE NAME OF THE PLACE.

(NAME OF PLACE(S))____
PUBLIC SECTOR
HOSPITAL/MEDICAL COLLEGE A
FAMILY WELFARE CENTRE B
UPAZILA HEALTH COMPLEX C
SATELLITE CLINIC/EPI OUTREACH D
MATERNAL AND CHILD WELFARE CENTRE (MCWC) E
GOVERNMENT FIELD WORKER (FWA) F
COMMUNITY CLINIC G
OTHER (SPECIFY)____ H
NGO SECTOR
NGO STATIC CLINIC I
NGO SATELLITE CLINIC J
NGO DEPOT HOLDER K
NGO FIELD WORKER (FWA) L
OTHER (SPECIFY)____ M
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC N
QUALIFIED DOCTOR O
TRADITIONAL DOCTOR P
PHARMACY Q
OTHER PRIVATE MEDICAL (SPECIFY)____ R
OTHER SOURCE
SHOP S
FRIEND/RELATIVE T
OTHER (SPECIFY)____ X

Survey form view entire document:  text 
323) 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 THE NAME OF THE PLACE.

(NAME OF PLACE(S))____
PUBLIC SECTOR
HOSPITAL/MEDICAL COLLEGE A
FAMILY WELFARE CENTRE B
UPAZILA HEALTH COMPLEX C
SATELLITE CLINIC/EPI OUTREACH D
MATERNAL AND CHILD WELFARE CENTRE (MCWC) E
GOVERNMENT FIELD WORKER (FWA) F
COMMUNITY CLINIC G
OTHER (SPECIFY)____ H
NGO SECTOR
NGO STATIC CLINIC I
NGO SATELLITE CLINIC J
NGO DEPOT HOLDER K
NGO FIELD WORKER (FWA) L
OTHER (SPECIFY)____ M
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC N
QUALIFIED DOCTOR O
TRADITIONAL DOCTOR P
PHARMACY Q
OTHER PRIVATE MEDICAL (SPECIFY)____ R
OTHER SOURCE
SHOP S
FRIEND/RELATIVE T
OTHER (SPECIFY)____ X

Survey form view entire document:  text 
323) 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 THE NAME OF THE PLACE.

(NAME OF PLACE(S))____
PUBLIC SECTOR
HOSPITAL/MEDICAL COLLEGE A
FAMILY WELFARE CENTRE B
UPAZILA HEALTH COMPLEX C
SATELLITE CLINIC/EPI OUTREACH D
MATERNAL AND CHILD WELFARE CENTRE (MCWC) E
GOVERNMENT FIELD WORKER (FWA) F
COMMUNITY CLINIC G
OTHER (SPECIFY)____ H
NGO SECTOR
NGO STATIC CLINIC I
NGO SATELLITE CLINIC J
NGO DEPOT HOLDER K
NGO FIELD WORKER (FWA) L
OTHER (SPECIFY)____ M
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC N
QUALIFIED DOCTOR O
TRADITIONAL DOCTOR P
PHARMACY Q
OTHER PRIVATE MEDICAL (SPECIFY)____ R
OTHER SOURCE
SHOP S
FRIEND/RELATIVE T
OTHER (SPECIFY)____ X

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Bangladesh 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 325A)

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 THE PLACE(S)) _____________________
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

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 325A)

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 THE PLACE(S)) _____________________
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

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Congo (Democratic Republic) 2013
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
FAMILY PLANNING CLINIC B
GOVERNMENT HEALTH CENTER C
MATERNITY D
FIELDWORKER E
OTHER PUBLIC SECTOR (SPECIFY) F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
NGO I
PRIVATE HEALTH CENTER J
PRIVATE DOCTOR'S OFFICE K
DOCTOR L
MOBILE CLINIC M
FIELDWORKER N
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) O
OTHER SOURCE
SHOP P
RELIGIOUS INSTITUTION Q
FRIEND/RELATIVES R
BAR/NIGHTCLUB S
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

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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Ethiopia 2005
Survey form view entire document:  text 
332. 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
GOVERNMENT HEALTH POST C
GOVERNMENT HEALTH STATION/CLINIC D
CBD E
OTHER PUBLIC (SPECIFY) ________F
NON-GOVERNMENT (NGO)
NGO HEALTH FACILITY G
CBD/CBRHA H
OTHER NGO ______ I
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/DOCTOR J
PHARMACY K
OTHER PRIVATE MEDICAL (SPECIFY) ___________________ L
OTHER SOURCE
DRUG VENDOR M
SHOP N
FRIEND/RELATIVE O
OTHER (SPECIFY) _____________ X

Survey form view entire document:  text 
332. 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
GOVERNMENT HEALTH POST C
GOVERNMENT HEALTH STATION/CLINIC D
CBD E
OTHER PUBLIC (SPECIFY) ________F
NON-GOVERNMENT (NGO)
NGO HEALTH FACILITY G
CBD/CBRHA H
OTHER NGO ______ I
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/DOCTOR J
PHARMACY K
OTHER PRIVATE MEDICAL (SPECIFY) ___________________ L
OTHER SOURCE
DRUG VENDOR M
SHOP N
FRIEND/RELATIVE O
OTHER (SPECIFY) _____________ X

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

PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE(S). 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. HEALTH STATION/CLINIC C
GOVT. HEALTH POST/HEW D
OTHER PUBLIC (SPECIFY) _____ E
NGO
NGO HEALTH FACILITY F
VOLUNTARY COMMUNITY HEALTH WORKERS G
OTHER NGO (SPECIFY) _____ H
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL I
PRIVATE CLINIC J
PHARMACY K
OTHER PRIVATE MEDICAL (SPECIFY) _____ L
OTHER SOURCE
DRUG VENDOR/STORE M
SHOP N
FRIEND/RELATIVE O
OTHER (SPECIFY) ______ X

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

PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE(S). 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. HEALTH STATION/CLINIC C
GOVT. HEALTH POST/HEW D
OTHER PUBLIC (SPECIFY) _____ E
NGO
NGO HEALTH FACILITY F
VOLUNTARY COMMUNITY HEALTH WORKERS G
OTHER NGO (SPECIFY) _____ H
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL I
PRIVATE CLINIC J
PHARMACY K
OTHER PRIVATE MEDICAL (SPECIFY) _____ L
OTHER SOURCE
DRUG VENDOR/STORE M
SHOP N
FRIEND/RELATIVE O
OTHER (SPECIFY) ______ X

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India 2005
Survey form view entire document:  text 
355. Where is that?
Any other place?

IF UNABLE TO DETERMINE IF A HOSPITAL, HEALTH CENTRE, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL SECTOR, WRITE THE NAME OF THE PLACE(S).
RECORD ALL PLACES MENTIONED.

NAME OF PLACE(S) ________
PUBLIC MEDICAL SECTOR
GOVT./MUNICIPAL HOSPITAL A
GOVT. DISPENSARY B
UHC/UHP/UFWC C
CHC/RURAL HOSPITAL/PHC D
SUB-CENTRE/ANM E
GOVT. MOBILE CLINIC F
CAMP G
ANGANWADI/ICDS CENTRE H
ASHA I
OTHER COMMUNITY-BASED WORKER J
OTHER PUBLIC MEDICAL SECTOR K
NGO OR TRUST HOSPITAL/CLINIC L
PRIVATE MEDICAL SECTOR
PVT. HOSPITAL M
PVT. DOCTOR/CLINIC N
PVT. MOBILE CLINIC O
VAIDYA/HAKIM/HOMEOPATH P
TRADITIONAL HEALER Q
PHARMACY/DRUGSTORE R
DAI (TBA) S
OTHER PRIVATE MEDICAL SECTOR T
OTHER SOURCE
SHOP U
FRIEND/RELATIVE V
OTHER (SPECIFY) _______ X

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

YES 1
NO 2 (GO TO 354)

353. Where is that? Any other place?

RECORD ALL PLACES MENTIONED.

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

(NAME OF FACILITY/PLACE(S))______________
PUBLIC HEALTH SECTOR
GOVT./MUNICIPAL HOSPITAL A
VAIDYA/HAKIM HOMEOPATH (AYUSH) B
GOVT. DISPENSARY C
UHC/UHP/UFWC D
CHC/RURAL HOSPITAL/BLOCK PHC E
PHC/ADDITIONAL PHC F
SUB-CENTRE/ANM G
GOVT. MOBILE CLINIC H
CAMP I
ANGANWADI/ICDS CENTRE J
ASHA K
OTHER COMMUNITY-BASED WORKER L
OTHER PUBLIC HEALTH SECTOR M
NGO OR TRUST HOSPITAL/CLINIC N
PRIVATE HEALTH SECTOR
PVT. HOSPITAL O
PVT. DOCTOR/CLINIC P
PVT. MOBILE CLINIC Q
VAIDYA/HAKIM/HOMEOPATH (AYUSH) R
TRADITIONAL HEALER S
PHARMACY/DRUGSTORE T
DAI (TBA) U
OTHER SOURCE
SHOP W
FRIEND/RELATIVE X
OTHER(SPECIFY)_________Y

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

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

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

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

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Jordan 2007
Survey form view entire document:  text 
334) Where is that?

Any other place?

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

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

(NAME OF PLACE(S))________________________
PUBLIC MEDICAL SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
GOVERNMENT MOTHER AND CHILD HEALTH CENTER C
UNIVERSITY HOSPITAL/CLINIC D
ROYAL MEDICAL SERVICES E
OTHER PUBLIC (SPECIFY)______________ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PRIVATE DOCTOR H
PHARMACY I
JORDANIAN ASSOCIATION OF FAMILY PLANNING AND PROTECTION (JAFPP) J
UNITED NATIONS RELIEF AND WORKS AGENCY CLINIC K
OTHER NON- GOVERNMENT ORGANIZATION L
OTHER PRIVATE MEDICAL (SPECIFY) __________ M
OTHER SOURCE
FRIEND/ RELATIVE N
OTHER (SPECIFY)____________ X

Survey form view entire document:  text 
334) Where is that?

Any other place?

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

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

(NAME OF PLACE(S))________________________
PUBLIC MEDICAL SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
GOVERNMENT MOTHER AND CHILD HEALTH CENTER C
UNIVERSITY HOSPITAL/CLINIC D
ROYAL MEDICAL SERVICES E
OTHER PUBLIC (SPECIFY)______________ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PRIVATE DOCTOR H
PHARMACY I
JORDANIAN ASSOCIATION OF FAMILY PLANNING AND PROTECTION (JAFPP) J
UNITED NATIONS RELIEF AND WORKS AGENCY CLINIC K
OTHER NON- GOVERNMENT ORGANIZATION L
OTHER PRIVATE MEDICAL (SPECIFY) __________ M
OTHER SOURCE
FRIEND/ RELATIVE N
OTHER (SPECIFY)____________ X

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Jordan 2012
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 MEDICAL SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
GOVT. MCH C
UNIVERSITY HOSPITAL/CLINIC D
ROYAL MEDICAL SERVICES E
OTHER PUBLIC (SPECIFY) _____ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PRIVATE DOCTOR H
PHARMACY I
JORDANIAN AS. OF FP AND PROTECTION (JAFPP) J
UNRWA CLINIC K
OTHER NON-GOV ORGANIZATION L
OTHER PRIVATE MEDICAL (SPECIFY) _____ M
OTHER SOURCE
FRIEND/RELATIVE N
OTHER (SPECIFY) _____ X

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 MEDICAL SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
GOVT. MCH C
UNIVERSITY HOSPITAL/CLINIC D
ROYAL MEDICAL SERVICES E
OTHER PUBLIC (SPECIFY) _____ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PRIVATE DOCTOR H
PHARMACY I
JORDANIAN AS. OF FP AND PROTECTION (JAFPP) J
UNRWA CLINIC K
OTHER NON-GOV ORGANIZATION L
OTHER PRIVATE MEDICAL (SPECIFY) _____ M
OTHER SOURCE
FRIEND/RELATIVE N
OTHER (SPECIFY) _____ X

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

Any other place?

PROBE TO IDENTIFY EACH TYPE OF SOURCE.

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

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

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

Any other place?

PROBE TO IDENTIFY EACH TYPE OF SOURCE.

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

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

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

Any other place?

PROBE TO IDENTIFY EACH TYPE OF SOURCE.

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

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

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

Any other place?

PROBE TO IDENTIFY EACH TYPE OF SOURCE.

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

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

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Myanmar 2015
Survey form view entire document:  text 
325) Where is that? Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE.
IF UNABLE TO DETERMINE WHETHER PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.___(NAME OF PLACE(S))

PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER (RHC) B
GOVT. HEALTH POST (SUB-CENTER) C
VILLAGE HEALTH WORKER D
MOBILE CLINIC E
UHC/MCH CENTER F
OTHER PUBLIC SECTOR___(SPECIFY) G
NON-GOVERNMENT SECTOR
MARIE STOPES H
MYANMAR RED CROSS SOCIETY I
PSI/M (SUN) J
MMA K
OTHER NGO SECTOR___(SPECIFY) L
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC M
PHARMACY N
PRIVATE DOCTOR O
MOBILE CLINIC P
FIELDWORKER Q
OTHER PRIVATE MEDICAL SECTOR___(SPECIFY) R
OTHER SOURCE
SHOP S
FRIEND/RELATIVE T
OTHER___(SPECIFY) X

Survey form view entire document:  text 
325) Where is that? Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE.
IF UNABLE TO DETERMINE WHETHER PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.___(NAME OF PLACE(S))

PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER (RHC) B
GOVT. HEALTH POST (SUB-CENTER) C
VILLAGE HEALTH WORKER D
MOBILE CLINIC E
UHC/MCH CENTER F
OTHER PUBLIC SECTOR___(SPECIFY) G
NON-GOVERNMENT SECTOR
MARIE STOPES H
MYANMAR RED CROSS SOCIETY I
PSI/M (SUN) J
MMA K
OTHER NGO SECTOR___(SPECIFY) L
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC M
PHARMACY N
PRIVATE DOCTOR O
MOBILE CLINIC P
FIELDWORKER Q
OTHER PRIVATE MEDICAL SECTOR___(SPECIFY) R
OTHER SOURCE
SHOP S
FRIEND/RELATIVE T
OTHER___(SPECIFY) X

Survey form view entire document:  text 
325) Where is that? Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE.
IF UNABLE TO DETERMINE WHETHER PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.___(NAME OF PLACE(S))

PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER (RHC) B
GOVT. HEALTH POST (SUB-CENTER) C
VILLAGE HEALTH WORKER D
MOBILE CLINIC E
UHC/MCH CENTER F
OTHER PUBLIC SECTOR___(SPECIFY) G
NON-GOVERNMENT SECTOR
MARIE STOPES H
MYANMAR RED CROSS SOCIETY I
PSI/M (SUN) J
MMA K
OTHER NGO SECTOR___(SPECIFY) L
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC M
PHARMACY N
PRIVATE DOCTOR O
MOBILE CLINIC P
FIELDWORKER Q
OTHER PRIVATE MEDICAL SECTOR___(SPECIFY) R
OTHER SOURCE
SHOP S
FRIEND/RELATIVE T
OTHER___(SPECIFY) X

Survey form view entire document:  text 
325) Where is that? Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE.
IF UNABLE TO DETERMINE WHETHER PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.___(NAME OF PLACE(S))

PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER (RHC) B
GOVT. HEALTH POST (SUB-CENTER) C
VILLAGE HEALTH WORKER D
MOBILE CLINIC E
UHC/MCH CENTER F
OTHER PUBLIC SECTOR___(SPECIFY) G
NON-GOVERNMENT SECTOR
MARIE STOPES H
MYANMAR RED CROSS SOCIETY I
PSI/M (SUN) J
MMA K
OTHER NGO SECTOR___(SPECIFY) L
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC M
PHARMACY N
PRIVATE DOCTOR O
MOBILE CLINIC P
FIELDWORKER Q
OTHER PRIVATE MEDICAL SECTOR___(SPECIFY) R
OTHER SOURCE
SHOP S
FRIEND/RELATIVE T
OTHER___(SPECIFY) X

Survey form view entire document:  text 
325) Where is that? Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE.
IF UNABLE TO DETERMINE WHETHER PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.___(NAME OF PLACE(S))

PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER (RHC) B
GOVT. HEALTH POST (SUB-CENTER) C
VILLAGE HEALTH WORKER D
MOBILE CLINIC E
UHC/MCH CENTER F
OTHER PUBLIC SECTOR___(SPECIFY) G
NON-GOVERNMENT SECTOR
MARIE STOPES H
MYANMAR RED CROSS SOCIETY I
PSI/M (SUN) J
MMA K
OTHER NGO SECTOR___(SPECIFY) L
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC M
PHARMACY N
PRIVATE DOCTOR O
MOBILE CLINIC P
FIELDWORKER Q
OTHER PRIVATE MEDICAL SECTOR___(SPECIFY) R
OTHER SOURCE
SHOP S
FRIEND/RELATIVE T
OTHER___(SPECIFY) X

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Nepal 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 PLACES MENTIONED.

GOVERNMENT SECTOR
GOVT. HOSPITAL/CLINIC A
PRIMARY HEALTH CARE CENTER/HEALTH CENTER B
HEALTH POST C
SUB-HEALTH POST D
PHC OUTREACH CLINIC E
FCHV F
CONDOM BOX G
OTHER GOVT. (SPECIFY) ____________ H
NON-GOVT. (NGO) SECTOR
FP ASSN. OF NEPAL I
MARIE STOPES J
ADRA K
NEPAL RED CROSS L
OTHER NGO (SPECIFY) ___________ M
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/NURSING HOME N
PHARMACY O
OTHER PRIVATE (SPECIFY) _______ P
OTHER SOURCE
SHOP Q
FRIEND/RELATIVE R

OTHER (SPECIFY) ______________ X

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 PLACES MENTIONED.

GOVERNMENT SECTOR
GOVT. HOSPITAL/CLINIC A
PRIMARY HEALTH CARE CENTER/HEALTH CENTER B
HEALTH POST C
SUB-HEALTH POST D
PHC OUTREACH CLINIC E
FCHV F
CONDOM BOX G
OTHER GOVT. (SPECIFY) ____________ H
NON-GOVT. (NGO) SECTOR
FP ASSN. OF NEPAL I
MARIE STOPES J
ADRA K
NEPAL RED CROSS L
OTHER NGO (SPECIFY) ___________ M
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/NURSING HOME N
PHARMACY O
OTHER PRIVATE (SPECIFY) _______ P
OTHER SOURCE
SHOP Q
FRIEND/RELATIVE R

OTHER (SPECIFY) ______________ X

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 PLACES MENTIONED.

GOVERNMENT SECTOR
GOVT. HOSPITAL/CLINIC A
PRIMARY HEALTH CARE CENTER/HEALTH CENTER B
HEALTH POST C
SUB-HEALTH POST D
PHC OUTREACH CLINIC E
FCHV F
CONDOM BOX G
OTHER GOVT. (SPECIFY) ____________ H
NON-GOVT. (NGO) SECTOR
FP ASSN. OF NEPAL I
MARIE STOPES J
ADRA K
NEPAL RED CROSS L
OTHER NGO (SPECIFY) ___________ M
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/NURSING HOME N
PHARMACY O
OTHER PRIVATE (SPECIFY) _______ P
OTHER SOURCE
SHOP Q
FRIEND/RELATIVE R

OTHER (SPECIFY) ______________ X

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 PLACES MENTIONED.

GOVERNMENT SECTOR
GOVT. HOSPITAL/CLINIC A
PRIMARY HEALTH CARE CENTER/HEALTH CENTER B
HEALTH POST C
SUB-HEALTH POST D
PHC OUTREACH CLINIC E
FCHV F
CONDOM BOX G
OTHER GOVT. (SPECIFY) ____________ H
NON-GOVT. (NGO) SECTOR
FP ASSN. OF NEPAL I
MARIE STOPES J
ADRA K
NEPAL RED CROSS L
OTHER NGO (SPECIFY) ___________ M
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/NURSING HOME N
PHARMACY O
OTHER PRIVATE (SPECIFY) _______ P
OTHER SOURCE
SHOP Q
FRIEND/RELATIVE R

OTHER (SPECIFY) ______________ X

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 PLACES MENTIONED.

GOVERNMENT SECTOR
GOVT. HOSPITAL/CLINIC A
PRIMARY HEALTH CARE CENTER/HEALTH CENTER B
HEALTH POST C
SUB-HEALTH POST D
PHC OUTREACH CLINIC E
FCHV F
CONDOM BOX G
OTHER GOVT. (SPECIFY) ____________ H
NON-GOVT. (NGO) SECTOR
FP ASSN. OF NEPAL I
MARIE STOPES J
ADRA K
NEPAL RED CROSS L
OTHER NGO (SPECIFY) ___________ M
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/NURSING HOME N
PHARMACY O
OTHER PRIVATE (SPECIFY) _______ P
OTHER SOURCE
SHOP Q
FRIEND/RELATIVE R

OTHER (SPECIFY) ______________ X

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

YES 1
NO 2 (GO TO 347)

346. 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/CLINIC A
PHC CENTER B
HEALTH POST C
SUB-HEALTH POST D
PHC OUTREACH E
MOBILE CLINIC F
FCHV G
CONDOM BOX H
OTHER GOVT. (SPECIFY) ___ I
NON-GOVT. (NGO) SECTOR
FPAN J
MARIE STOPES K
ADRA L
NEPAL RED CROSS M
UMN N
OTHER NGO. (SPECIFY) ___ O
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/NURSING HOME P
PHARMACY Q
PRIVATE DOCTOR R
OTHER PRIVATE MEDICAL (SPECIFY) __ S
OTHER SOURCE
SHOP T
FRIEND/RELATIVE U
OTHER (SPECIFY) __ X

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

YES 1
NO 2 (GO TO 347)

346. 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/CLINIC A
PHC CENTER B
HEALTH POST C
SUB-HEALTH POST D
PHC OUTREACH E
MOBILE CLINIC F
FCHV G
CONDOM BOX H
OTHER GOVT. (SPECIFY) ___ I
NON-GOVT. (NGO) SECTOR
FPAN J
MARIE STOPES K
ADRA L
NEPAL RED CROSS M
UMN N
OTHER NGO. (SPECIFY) ___ O
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/NURSING HOME P
PHARMACY Q
PRIVATE DOCTOR R
OTHER PRIVATE MEDICAL (SPECIFY) __ S
OTHER SOURCE
SHOP T
FRIEND/RELATIVE U
OTHER (SPECIFY) __ X

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

YES 1
NO 2 (GO TO 347)

346. 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/CLINIC A
PHC CENTER B
HEALTH POST C
SUB-HEALTH POST D
PHC OUTREACH E
MOBILE CLINIC F
FCHV G
CONDOM BOX H
OTHER GOVT. (SPECIFY) ___ I
NON-GOVT. (NGO) SECTOR
FPAN J
MARIE STOPES K
ADRA L
NEPAL RED CROSS M
UMN N
OTHER NGO. (SPECIFY) ___ O
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/NURSING HOME P
PHARMACY Q
PRIVATE DOCTOR R
OTHER PRIVATE MEDICAL (SPECIFY) __ S
OTHER SOURCE
SHOP T
FRIEND/RELATIVE U
OTHER (SPECIFY) __ X

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

YES 1
NO 2 (GO TO 347)

346. 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/CLINIC A
PHC CENTER B
HEALTH POST C
SUB-HEALTH POST D
PHC OUTREACH E
MOBILE CLINIC F
FCHV G
CONDOM BOX H
OTHER GOVT. (SPECIFY) ___ I
NON-GOVT. (NGO) SECTOR
FPAN J
MARIE STOPES K
ADRA L
NEPAL RED CROSS M
UMN N
OTHER NGO. (SPECIFY) ___ O
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/NURSING HOME P
PHARMACY Q
PRIVATE DOCTOR R
OTHER PRIVATE MEDICAL (SPECIFY) __ S
OTHER SOURCE
SHOP T
FRIEND/RELATIVE U
OTHER (SPECIFY) __ X

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

YES 1
NO 2 (GO TO 347)

346. 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/CLINIC A
PHC CENTER B
HEALTH POST C
SUB-HEALTH POST D
PHC OUTREACH E
MOBILE CLINIC F
FCHV G
CONDOM BOX H
OTHER GOVT. (SPECIFY) ___ I
NON-GOVT. (NGO) SECTOR
FPAN J
MARIE STOPES K
ADRA L
NEPAL RED CROSS M
UMN N
OTHER NGO. (SPECIFY) ___ O
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/NURSING HOME P
PHARMACY Q
PRIVATE DOCTOR R
OTHER PRIVATE MEDICAL (SPECIFY) __ S
OTHER SOURCE
SHOP T
FRIEND/RELATIVE U
OTHER (SPECIFY) __ X

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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

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

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

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

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

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

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

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

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Nigeria 2013
Survey form view entire document:  text 
325) Where is that? Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE. IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE. (NAME OF PLACE(S))_________.

PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC SECTOR (SPECIFY)_______ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
CHEMIST/PMS STORE I
PRIVATE DOCTOR J
MOBILE CLINIC K
FIELDWORKER L
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)______ M
OTHER SOURCE
SHOP N
CHURCH O
FRIEND/RELATIVE P
NGO Q
OTHER (SPECIFY)______ X

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Tanzania 2004
Survey form view entire document:  text 
329. Do you know of a place where a person can obtain a method of family planning?

YES 1
NO 2 (GO TO 331)

330. Where is that? Any other place?
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.
RECORD ALL PLACES MENTIONED.

(NAME OF PLACE) _________
GOVERNMENT/PARASTATAL
REFERRAL/SPEC.HOSPITAL A
REGIONALHOSPITAL B
DISTRICTHOSPITAL C
HEALTHCENTRE D
DISPENSARY E
VILLAGEHEALTHPOST F
CBDWORKER G
RELIGIOUS/VOLUNTARY
REFERAL/SPEC.HOSPITAL H
DISTRICTHOSPITAL I
GOVT.HEALTHCENTRE J
DISPENSARY K
PRIVATE
DISTRICTHOSPITAL L
HEALTHCENTRE M
DISPENSARY N
OTHER
PHARMACY O
NGO P
VCTCENTRE Q
SHOP/KIOSK R
BAR S
GUESTHOUSE/HOTEL T
FRIEND/RELATIVE/NEIGHBOUR U
OTHER (SPECIFY) _______ X

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

YES 1
NO 2- (SKIP 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
HEALTH CENTER B
DISPENSARY C
MOTHER-INFANT PROTECTION D
HEALTH HUT E
MOBILE CLINIC F
OTHER PUBLIC SECTOR______ (SPECIFY) G
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC H
PHARMACY I
PRIVATE DOCTOR'S OFFICE J
NGO/ASSOCIATION K
OTHER PRIVATE MEDICAL SECTOR________ (SPECIFY) L
OTHER SOURCE
SHOP M
RELIGIOUS INSTITUTION N
FRIENDS/RELATIVES O
OTHER________ (SPECIFY) X

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Yemen 2013
Survey form view entire document:  text 
103) How old were you on your last birthday? COMPARE AND CORRECT 102 AND/OR 103 IF INCONSISTENT.

AGE IN COMPLETED YEARS