Survey Text

Eswatini (Swaziland) 2006
Ethiopia 2011
Myanmar 2015
Nigeria 2003
Nigeria 2008
Nigeria 2013
Tanzania 2004
Tanzania 2010
Togo 2013
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Eswatini (Swaziland) 2006
Survey form view entire document:  text 
646) 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
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
OTHER MISSION (SPECIFY)________O
NGO
FLAS P
OTHER NGO (SPECIFY)__________Q
OTHER SOURCE
SHOP R
CHURCH S
FRIENDS/RELATIVES T
OTHER (SPECIFY)_______X

Survey form view entire document:  text 
646) 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
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
OTHER MISSION (SPECIFY)________O
NGO
FLAS P
OTHER NGO (SPECIFY)__________Q
OTHER SOURCE
SHOP R
CHURCH S
FRIENDS/RELATIVES T
OTHER (SPECIFY)_______X

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Ethiopia 2011
Survey form view entire document:  text 
633. 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. 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
ANTI-AIDS CLUB/ASSOCIATION L
OTHER PRIVATE MEDICAL (SPECIFY) _____ M
OTHER SOURCE
DRUG VENDOR/STORE N
SHOP/BAR/HOTEL/GROCERY O
FRIEND/RELATIVE P
OTHER (SPECIFY) ______ X

Survey form view entire document:  text 
633. 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. 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
ANTI-AIDS CLUB/ASSOCIATION L
OTHER PRIVATE MEDICAL (SPECIFY) _____ M
OTHER SOURCE
DRUG VENDOR/STORE N
SHOP/BAR/HOTEL/GROCERY O
FRIEND/RELATIVE P
OTHER (SPECIFY) ______ X

Survey form view entire document:  text 
633. 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. 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
ANTI-AIDS CLUB/ASSOCIATION L
OTHER PRIVATE MEDICAL (SPECIFY) _____ M
OTHER SOURCE
DRUG VENDOR/STORE N
SHOP/BAR/HOTEL/GROCERY O
FRIEND/RELATIVE P
OTHER (SPECIFY) ______ X

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Myanmar 2015
Survey form view entire document:  text 
632) Do you know of a place where a person can get female condoms?

YES 1
NO 2 (SKIP TO 701)

Survey form view entire document:  text 
632) Do you know of a place where a person can get female condoms?

YES 1
NO 2 (SKIP TO 701)

Survey form view entire document:  text 
632) Do you know of a place where a person can get female condoms?

YES 1
NO 2 (SKIP TO 701)

Survey form view entire document:  text 
632) Do you know of a place where a person can get female condoms?

YES 1
NO 2 (SKIP TO 701)

Survey form view entire document:  text 
632) Do you know of a place where a person can get female condoms?

YES 1
NO 2 (SKIP TO 701)

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Nigeria 2003
Survey form view entire document:  text 
528. 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 SOURCES 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
FRIENDS/RELATIVES O
NGO P
OTHER (SPECIFY) _______________ X

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Nigeria 2008
Survey form view entire document:  text 
645. 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
FRIENDS/RELATIVES P
NGO Q
OTHER (SPECIFY) _______________ X

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Nigeria 2013
Survey form view entire document:  text 
633) 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
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 I
PRIVATE DOCTOR J
MOBILE CLINIC K
FIELDWORKER L
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)______ M
OTHER SOURCE
SHOP N
CHURCH O
FRIENDS/RELATIVES P
NGO Q
OTHER (SPECIFY)________

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Tanzania 2004

No questionnaire text is available for this sample.


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Tanzania 2010
Survey form view entire document:  text 
642. 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)) ___________
GOVERNMENT/PARASTATAL
REFERAL/SPEC. HOSPITAL A
REGIONAL HOSPITAL B
DISTRICT HOSPITAL C
HEALTH CENTRE D
DISPENSARY E
VILLAGE HEALTH POST (WORKER) F
CBD WORKER G
RELIGIOUS/VOLUNTARY
REFERAL/SPEC. HOSPITAL H
DISTRICT HOSPITAL I
GOVT. HEALTH CENTRE J
DISPENSARY K
PRIVATE
DISTRICT HOSPITAL L
HEALTH CENTRE M
DISPENSARY N
OTHER
PHARMACY O
NGO P
VCT CENTRE Q
SHOP/KIOSK R
BAR S
GUEST HOUSE/HOTEL T
FRIEND/RELATIVE/NEIGHBOUR U
OTHER (SPECIFY) ___________ X
DON'T KNOW Z

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Togo 2013
Survey form view entire document:  text 
632) Do you know of a place where a person can get female condoms?

YES 1
NO 2- (SKIP TO 701)

633) 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