Survey Text

Benin 2001 Kenya 2014 Senegal 2010 Zambia 2001
Benin 2006 Lesotho 2004 Senegal 2012 Zambia 2007
Benin 2011 Lesotho 2009 Senegal 2014 Zambia 2013
Cameroon 2004 Lesotho 2014 Senegal 2015 Zimbabwe 2005
Cameroon 2011 Malawi 2000 Senegal 2016 Zimbabwe 2010
Eswatini (Swaziland) 2006 Malawi 2004 Senegal 2017
Kenya 2003 Malawi 2010 Tanzania 2004
Kenya 2008 Senegal 2005 Togo 2013
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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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Cameroon 2004
Survey form view entire document:  text 
329) Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2 (GO TO 331)

330) Where is this? Another place?

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

NAME OF PLACE: ___
PUBLIC/SEMIPUBLIC SECTOR
HOSPITAL A
HEALTH CENTER B
OTHER PUBLIC (SPECIFY): ___ C
PRIVATE MEDICAL SECTOR
PRIVATE RELIGIOUS HOSPITAL D
SECULAR HOSPITAL/CLINIC E
HEALTH CENTER/RELIGIOUS CLINIC/MISSION F
DOCTOR'S OFFICE (SPECIFY): ___ G
PHARMACY H
OTHER PRIVATE MEDICAL (SPECIFY): ___ I
OTHER PRIVATE SECTOR
SHOP/MARKET J
BAR/NIGHTCLUB K
KIOSK L
INFORMAL COMMERCIAL DISTRIBUTION M
RELATIVES/FRIENDS N
OTHER (SPECIFY): ___ X

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

YES 1
NO 2 (GO TO 331)

330) Where is this? Another place?

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

NAME OF PLACE: ___
PUBLIC/SEMIPUBLIC SECTOR
HOSPITAL A
HEALTH CENTER B
OTHER PUBLIC (SPECIFY): ___ C
PRIVATE MEDICAL SECTOR
PRIVATE RELIGIOUS HOSPITAL D
SECULAR HOSPITAL/CLINIC E
HEALTH CENTER/RELIGIOUS CLINIC/MISSION F
DOCTOR'S OFFICE (SPECIFY): ___ G
PHARMACY H
OTHER PRIVATE MEDICAL (SPECIFY): ___ I
OTHER PRIVATE SECTOR
SHOP/MARKET J
BAR/NIGHTCLUB K
KIOSK L
INFORMAL COMMERCIAL DISTRIBUTION M
RELATIVES/FRIENDS N
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

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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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

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

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 'F'.

PUBLIC SECTOR
GOVERNMENT HOSPITAL B
GOVERNMENT HEALTH CENTRE C
GOVERNMENT DISPENSARY D
OTHER PUBLIC (SPECIFY) ________ E
PRIVATE MEDICAL SECTOR
MISSION, CHURCH HOSP./CLINIC F
FPAK HEALTH CENTRE/CLINIC G
PRIVATE HOSPITAL OR CLINIC H
PHARMACY/CHEMIST I
NURSING/MATERNITY HOME K
OTHER PRIV. MEDICAL (SPECIFY) _____ L
OTHER SOURCE
MOBILE CLINIC M
COMMUNITY-BASED DISTRIBUTOR N
SHOP O
FRIEND/RELATIVE P
OTHER (SPECIFY) _________ X

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Kenya 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(S)) ___________
PUBLIC SECTOR
GOVERNMENT HOSPITAL B
GOVT. HEALTH CENTER C
GOVERNMENT DISPENSARY D
OTHER PUBLIC (SPECIFY) ____________ E
PRIVATE MEDICAL SECTOR
FAITH-BASED, CHURCH, MISSION HOSPITAL/CLINIC F
FHOK/FPAK HEALTH CENTER/CLINIC G
PRIVATE HOSPITAL/CLINIC H
PHARMACY/CHEMIST I
NURSING/MATERNITY HOME J
OTHER PRIV. MEDICAL (SPECIFY) ________ K
OTHER SOURCE
MOBILE CLINIC L
COMMUNITY-BASED DISTRIBUTOR M
SHOP N
FRIEND/RELATIVE P
OTHER (SPECIFY) __________________ X

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Kenya 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) __________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
GOVERNMENT DISPENSARY C
OTHER PUBLIC SECTOR (SPECIFY) _______ D
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC E
PHARMACY/CHEMIST F
NURSING/MATERNITY HOME G
FAITH-BASED, CHURCH, MISSION HOSPITAL/CLINIC H
FAMILY OPTIONS/FHOK CLINIC I
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) ________ J
OTHER SOURCE
SHOP K
MOBILE CLINIC L
COMMUNITY-BASED DISTRIBUTOR M
COMMUNITY HEALTH WORKER/CHW 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

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

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

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

top
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

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

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

top
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

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

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

top
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(S) __________________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
CBDA/FIELDWORKER 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/FIELDWORKER N
OTHER PRIVATE MEDICAL (SPECIFY) __________ O
BLM P
OTHER SOURCE
SHOP Q
CHURCH R
FRIEND/RELATIVE S
OTHER (SPECIFY) _____ X

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(S) __________________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
CBDA/FIELDWORKER 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/FIELDWORKER N
OTHER PRIVATE MEDICAL (SPECIFY) __________ O
BLM P
OTHER SOURCE
SHOP Q
CHURCH R
FRIEND/RELATIVE S
OTHER (SPECIFY) _____ X

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(S) __________________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
CBDA/FIELDWORKER 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/FIELDWORKER 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 2010
Survey form view entire document:  text 
334. Where is that? Any other place?
PROBE TO IDENTIFY THE 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
GOVERNMENT HEALTH POST/OUTREACH C
MOBILE CLINIC D
HSA E
CBDA/DOOR TO DOOR F
OTHER PUBLIC G
CHAM/MISSION
HOSPITAL H
HEALTH CENTER I
MOBILE CLINIC J
DOOR TO DOOR K
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR L
PHARMACY M
MOBILE CLINIC N
CBDA/DOOR TO DOOR O
OTHER PRIVATE MEDICAL P
BLM Q
MACRO R
YOUTH DROP IN CENTRE S
OTHER SOURCE
SHOP T
CHURCH U
FRIEND/RELATIVE V
OTHER X

Survey form view entire document:  text 
334. Where is that? Any other place?
PROBE TO IDENTIFY THE 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
GOVERNMENT HEALTH POST/OUTREACH C
MOBILE CLINIC D
HSA E
CBDA/DOOR TO DOOR F
OTHER PUBLIC G
CHAM/MISSION
HOSPITAL H
HEALTH CENTER I
MOBILE CLINIC J
DOOR TO DOOR K
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR L
PHARMACY M
MOBILE CLINIC N
CBDA/DOOR TO DOOR O
OTHER PRIVATE MEDICAL P
BLM Q
MACRO R
YOUTH DROP IN CENTRE S
OTHER SOURCE
SHOP T
CHURCH U
FRIEND/RELATIVE V
OTHER 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?
Any other place?

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

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

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

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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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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

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

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

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

YES 1
NO 2 (GO TO 331)

330. Where is 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
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
HEALTH POST C
OTHER PUBLIC (SPECIFY) ______ D

PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/SURGERY E
MISSION HOSPITAL/CLINIC F
PHARMACY G
PRIVATE DOCTOR H
WORK PLACE I
OTHER PRIVATE MEDICAL (SPECIFY) ______ K
OTHER SOURCE
SHOP L
COMMUNITY-BASED AGENT M
FRIEND/RELATIVE N
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? Any other place?
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 A
GOVT. HEALTH CENTER/POST B
MOBILE HOSPITAL/CLINIC C
FAMILY PLANNING CLINIC D
COMMUNITY BASED AGENT/FIELDWORKER E
OTHER PUBLIC SECTOR F (SPECIFY) __________________________
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
MISSION HOSPITAL/CLINIC H
PHARMACY I
PRIVATE DOCTOR J
COMMUNITY BASED AGENT/FIELD WORKER K
MOBILE HOSPITAL/CLINIC L
OTHER PRIVATE MEDICAL SECTOR M (SPECIFY) ____________________
OTHER SOURCE
SHOP N
CHURCH O
FRIENDS/RELATIVES P
OTHER X (SPECIFY) _________________________

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Zimbabwe 2005
Survey form view entire document:  text 
331) 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.

PUBLIC SECTOR
GOVERNMENT HOSPITAL/CLINIC A
RURAL/MUNICIPAL CLINIC B
RURAL HEALTH CENTER C
ZNFPC CLINIC D
MOH MOBILE CLINIC E
ZNFPC CBD/DEPOT HOLDER F
OTHER PUBLIC (SPECIFY) __________ G
MISSION FACILITY H
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC I
PHARMACY J
PRIVATE DOCTOR K
CBD L
OTHER PRIVATE DOCTOR (SPECIFY) __________ M
RETAIL OUTLET
GENERAL DEALER N
SUPERMARKET O
TUCK SHOP P
SERVICE STATION Q
OTHER RETAIL (SPECIFY) __________ R
OTHER PRIVATE SOURCE
CHURCH S
FRIEND/RELATIVE T
OTHER (SPECIFY) __________ X

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Zimbabwe 2010
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 SCETOR, WRITE THE NAME OF THE PLACE.

NAME OF PLACE(S)

PUBLIC SECTOR
GOVERNMENT HOSPITAL/CLINIC A
RURAL/MUNICIPAL CLINIC B
RURAL HEALTH CENTRE C
ZNFCP CLINIC D
MOH MOBILE CLINIC E
ZNFPC CBD/DEPOT HOLDER F
OTHER PUBLIC SECTOR (SPECIFY) G
MISSION HOSPITAL/CLINIC H
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC I
PHARMACY J
PRIVATE DOCTOR K
CBD L
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) M
RETAIL OUTLET
GENERAL DEALER N
SUPERMARKET O
TUCK SHOP P
SERVICE STATION Q
OTHER RETAIL (SPECIFY) R
OTHER PRIVATE SOURCE
CHURCH S
FRIENDS/RELATIVE T
OTHER (SPECIFY) X