Survey Text

Benin 1996 Guinea 1999 Mozambique 1997 Tanzania 1999
Chad 1996 Kenya 1998 Nepal 1996 Uganda 1995
Cote d'Ivoire 1994 Madagascar 1997 Niger 1998 Zambia 1996
Cote d'Ivoire 1998 Mali 1995 Nigeria 1999 Zimbabwe 1994
Ghana 1998 Mali 2018 South Africa 1998
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Benin 1996
Survey form view entire document:  text 
517) Do you know of a place where you can get condoms?

YES 1
NO 2 (GO TO 519)

518) 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_________________
PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
FAMILY PLANNING CLINIC 13
FIELDWORKER 14
COMMUNITY CENTER 15
OTHER PUBLIC (SPECIFY) ____________ 16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
RELIGIOUS HOSPITAL 22
PHARMACY 23
ABPF (BENIN FAMILY ADVOCACY ASSOCIATION) 24
DOCTOR'S OFFICE 25
FIELDWORKER 26
OTHER PRIVATE MEDICAL (SPECIFY) _____________ 27
OTHER
SHOP/MARKET 31
CHURCH 32
FRIENDS/RELATIVES 33
GAS STATION 34
OTHER (SPECIFY) ___________ 96

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Chad 1996
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517. Do you know of a place where you can get condoms?

YES 1
NO 2 (GO TO 519)

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Cote d'Ivoire 1994
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919) Where did you or your husband/partner, get the condoms?

PUBLIC SECTOR
PUBLIC HOSPITAL 11
HEALTH CENTER/MOTHER-INFANT CENTER 12
PRIVATE MEDICAL SECTOR
CLINIC/PRIVATE NURSE 21
PHARMACY 22
OTHER PRIVATE SECTOR
SHOP/MINI-MART/SUPERMARKET 31
HOTEL/BAR/DANCE CLUB 32
FRIENDS/RELATIVES/PARTNERS 33
OTHER (SPECIFY)____ 41
DON'T KNOW 98

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Cote d'Ivoire 1998
Survey form view entire document:  text 
517) Do you know of a place where you can get condoms?

YES 1
NO 2 (GO TO 518A)

518) Where is that?

RECORD ALL MENTIONED

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

PUBLIC SECTOR
HOSPITAL 11
HEALTH CENTER/MOTHER-INFANT CENTER 12
FREE CLINIC 13
MEDICAL POST 14
OTHER PUBLIC (SPECIFY): ___ 16
PRIVATE MEDICAL SECTOR
PRIVATE DOCTOR 21
PRIVATE HOSPITAL/CLINIC 22
FAMILY PLANNING CENTER 23
PHARMACY/PHARMACY DEPOT 24
OTHER PRIVATE MEDICAL (SPECIFY): ___ 26
OTHER PRIVATE SECTOR
SHOP/MARKET 31
BAR/NIGHTCLUB 32
KIOSK 33
INFORMAL COMMERCIAL DISTRIBUTION 34
CHURCH 35
ACQUAINTANCES/RELATIVES 36
TRADITIONAL PRACTITIONER 37
OTHER (SPECIFY): ___ 96

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Ghana 1998
Survey form view entire document:  text 
518. Where is that? Anywhere else?

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
GVT. HOSPITAL/POLYCLINIC A
GVT. HEALTH CENTRE B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELD WORKER E
OTHER PUBLIC (SPECIFY) ____ F
PRIVATE SECTOR
HOSPITAL/CLINIC G
PHARMACY H
CHEMIST I
DRUG STORE J
MOBLIE CLINIC K
FIELD WORKER L
FP/PPAG CLINIC M
MATERNITY HOME N
OTHER PRIVATE (SPECIFY) ____O
OTHER SOURCE
CHURCH P
SHOP Q
FRIEND/RELATIVE R
OTHER (SPECIFY) _____ S

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Guinea 1999
Survey form view entire document:  text 
517. Do you know of a place where you can get condoms?

YES 1
NO 2 (GO TO 518A)

518. 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 _____
PUBLIC SECTOR
HOSPITAL 11
FAMILY PLANNING CLINIC 12
FREE CLINIC 13
MEDICAL POST 14
OTHER PUBLIC (SPECIFY) _____ 16
PRIVATE MEDICAL SECTOR
PRIVATE DOCTOR 21
PRIVATE CLINIC/HOSPITAL 22
FAMILY PLANNING CENTER 23
PHARMACY/PHARMACEUTICAL DEPOT 24
OTHER PRIVATE MEDICAL (SPECIFY) _____ 26
OTHER PRIVATE SECTOR
SHOP/MARKET 31
BAR/NIGHTCLUB 32
KIOSK 33
INFORMAL COMMERCIAL DISTRIBUTION 34
CHURCH 35
FRIENDS/RELATIVES 36
TRADITIONAL PRACTITIONER 37
OTHER (SPECIFY) _____ 96

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Kenya 1998
Survey form view entire document:  text 
517) Do you know of a place where you can get condoms?

YES 1
NO 2 (GO TO 519)

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Madagascar 1997
Survey form view entire document:  text 
517. Do you know of a place where you can get condoms?

YES 1
NO 2 (GO TO 519)

518. 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
OTHER PUBLIC (SPECIFY) __________ X
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC E
PHARMACY F
DOCTOR G
PF/FISA CENTER H
OTHER PRIVATE (SPECIFY) ______ Y
OTHER SOURCE
STORE I
RELIGIOUS CENTER J
RELATIVES K
FRIENDS L
OTHER (SPECIFY) ____________ Z

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Mali 1995
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518. Where is this?

IF IT IS HOSPITAL, HEALTH CENTER OR A CLINIC, CIRCLE THE NAME OF THE PLACE. PROBE TO DETERMINE THE TYPE OF SERVICE AND CIRCLE THE APPROPRIATE CODE.

NAME OF PLACE__
PUBLIC SECTOR
HOSPITAL 11
HEALTH CENTER/FREE CLINIC/CLINIC/MATERNITY 12
HEALTH AGENT 13
PRIVATE SECTOR
CLINIC 21
PRIVATE DOCTOR 22
PHARMACY 23
FIELD WORKER 24
COMMUNITY
HEALTH CENTER 31
HEALTH CARE WORKER 32
FAMILY PLANNING FIELDWORKER/DOULA/BIRTHER/HEALTH AID 33
PARA-PUBLIC
INPS/CMIE (NATIONAL INSTITUTE OF SOCIAL FUNDS/INTER-ENTREPRISE MEDIAL CENTER) 41
MUTEC (EDUCATION AND CULTURE WORKERS MUTUAL) 42
NON GOVERNMENTAL
NGO/AMPPF (Malian Association of Family Protection and Promotion) 51
OTHER PRIVATE SECTOR
SHOP/MARKET 61
HEALER/TRADITIONAL PRACTITIONER/MARABOUT (a kind of spiritual healer/witch doctor) 62
FRIEND(S)/RELATIVE(S) 63
OTHER (SPECIFY)__96
DOESN'T KNOW 98

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Mali 2018
Survey form view entire document:  text 
730) From where did you obtain the condom the last time?

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

PUBLIC SECTOR
NATIONAL HOSPITAL 11
REGIONAL HOSPITAL 12
REFERENCE HEALTH CENTER 13
COMMUNITY HEALTH CENTER 14
DISPENSARY/MATERNITY 15
OTHER PUBLIC SECTOR (SPECIFY) 16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
DOCTOR'S OFFICE 22
PRIVATE HEALTH CLINIC 23
PHARMACY 24
HEALTH POSTS 25
FAMILY PLANNING CLINIC 26
OTHER PRIVATE MEDICAL (SPECIFY) 28
OTHER SOURCE
SHOP 31
BAR/NIGHTCLUB 32
BOOTH 36
TRAVELING PEDDLER 34
FRIENDS/RELATIVES 35
OTHER (SPECIFY) 96
DON'T KNOW 98

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Mozambique 1997
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518. 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_____
PUBLIC SECTOR
CENTRAL HOSPITAL A
PROVINCIAL/GENERAL HOSPITAL B
RURAL HOSPITAL C
HEALTH CENTER D
HEALTH POST E
MOBILE CLINIC F
OTHER (SPECIFY) _____ G
PRIVATE MEDICAL SECTOR
PRIVATE CLINIC H
PRIVATE PHARMACY I
PRIVATE DOCTOR J
OTHER PRIVATE MEDICAL (SPECIFY) _____ K
OTHER SOURCE
SHOP L
TRADITIONAL HEALER M
MEDICAL STAFF IN THE NEIGHBORHOOD N
OTHER (SPECIFY) ______ X

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Nepal 1996
Survey form view entire document:  text 
714. Do you know of a place where you can get condoms?

YES 1
NO 2 (SKIP TO 716)

715. Where is that?

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

(NAME OF PLACE) ______________________

PUBLIC SECTOR
HOSPITAL/DISTRICT CLINIC 11
PRIMARY HEALTH CENTRE 12
FAMILY PLANNING CLINIC 13
HEALTH POST 14
SUB-HEALTH POST 15
MOBILE CLINIC 17
OTHER PUBLIC (SPECIFY)___________________16
PRIVATE SECTOR
HOSPITAL 21
CLINIC/NURSING HOME 22
PHARMACY 23
CHW 24
FPAN 25
OTHER PRIVATE (SPECIFY)__________________26
OTHER SOURCE
FCHV 31
SHOP 32
FRIEND/RELATIVE 33
OTHER (SPECIFY)___________________________36

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Niger 1998
Survey form view entire document:  text 
517) Do you know of a place where you could get condoms?

YES 1
NO 2 (GO TO 519)

518) Where is this?

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

NAME OF PLACE: ___
PUBLIC SECTOR
HOSPITAL 11
INTEGRATED HEALTH CENTER 12
MATERNITY WARD 13
HEALTH CHECK 14
CONSULTATION AT A FAIR 15
OTHER PUBLIC (SPECIFY): ___ 16
PRIVATE SECTOR
PRIVATE CLINIC 21
PHARMACY 22
PRIVATE DOCTOR'S OFFICE 23
HEALTHCARE WORKER 24
OTHER PRIVATE (SPECIFY): ___ 26
OTHER SOURCE
FIELD PHARMACY 31
TRADITIONAL HEALERS 32
FRIENDS/FAMILY 33
OTHER (SPECIFY): ___ 36

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Nigeria 1999
Survey form view entire document:  text 
518. 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) __________________
PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
FAMILY PLANNING CLINIC 13
MOBILE CLINIC 14
COMMUNITY HEALTH WORKER 15
OTHER PUBLIC (SPECIFY) ______ 16

PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
PHARMACY/PMS 22
PRIVATE DOCTOR 23
MOBILE CLINIC 24
COMMUNITY HEALTH WORKER 25
OTHER PRIVATE MEDICAL (SPECIFY) ______ 26
OTHER SOURCE
SHOP 31
CHURCH 32
FRIENDS/RELATIVES 33
NGO 34
OTHER (SPECIFY) _______________ 36

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South Africa 1998
Survey form view entire document:  text 
517 Do you know of a place where you can get condoms?

YES 1
NO 2 (GO TO 519)

518 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) __________________________
PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
DAY HOSP/CLINIC COMMUNITY HEALTH CENTER 12
FAMILY PLANNING CLINIC 13
MOBILE CLINIC 14
COMMUNITY HEALTH WORKER 15
OTHER PUBLIC (SPECIFY) ___________________ 16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
PHARMACY 22
PRIVATE DOCTOR 23
OTHER PRIVATE
MEDICAL (SPECIFY) ________________ 26
OTHER SOURCE
SHOP 31
CHURCH 32
FRIENDS/RELATIVES 33
OTHER (SPECIFY) ______________ 36

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Tanzania 1999
Survey form view entire document:  text 
524. Do you know of a place where one can get condoms?

YES 1
NO 2 (GO TO 526)

525. 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______
GOVERNMENT/PUBLIC SECTOR
REGIONAL/CONSULTANT HOSP 11
DISTRICT HOSPITAL 12
GOVT. HEALTH CENTER 13
DISPENSARY/PARASTATAL FACILITY 14
VILLAGE HEALTH POST/WORKER 15
PRIVATE MEDICAL SECTOR
RELIGIOUS ORGANIZATION FACILITY/MISSION HOSP 21
PRIVATE DOCTOR/CLINIC/HOSP 22
PHARMACY/MEDICAL STORE 23
CBD WORKER 24
OTHER PRIVATE SECTOR
SHOP/KIOSK 31
CHURCH 32
FRIEND/RELATIVE/NEIGHBOR 33
HEALTH EDUCATION/BAR GIRLS 34
OTHER (SPECIFY)_______________96
DON'T KNOW 98

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Uganda 1995
Survey form view entire document:  text 
529) Do you know where you can get condoms?

YES 1
NO 2 (GO TO 532)

530) Where is that?

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

(NAME OF PLACE) __________________

PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
DISPENSARY/HEALTH UNIT 13
MOBILE CLINIC 14
FIELD WORKER 15
OTHER PUBLIC (SPECIFY) ___________ 16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
PHARMACY/DRUG STORE 22
PRIVATE DOCTOR 23
MOBILE CLINIC 24
FIELD WORKER 25
OTHER PRIVATE MEDICAL (SPECIFY) __________ 26
OTHER PRIVATE SECTOR
SHOP 31
CHURCH 32
FRIENDS/RELATIVES 33
OTHER (SPECIFY) __________ 96

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Zambia 1996
Survey form view entire document:  text 
517. Do you know of a place where you can get condoms?

YES 1
NO 2 (GO TO 519)

517. 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) ________________
PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
COMMUNITY HEALTH WORKER 13
OTHER PUBLIC (SPECIFY) ___________ 14
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
MISSION HOSPITAL/CLINIC 22
PHARMACY 23
PRIVATE DOCTOR 24
MOBILE CLINIC 25
OTHER PRIVATE MEDICAL (SPECIFY) ____________ 26
OTHER SOURCE
SHOP 31
FRIENDS/RELATIVES 33
OTHER (SPECIFY) _________________ 36

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Zimbabwe 1994
Survey form view entire document:  text 
518) 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 __________
PUBLIC SECTOR
GOVERNMENT HOSPITAL/CLINIC 10
RURAL/MUNICIPAL CLINIC 11
ZNFPC CLINIC 12
RURAL HEALTH CENTRE 13
ZNFPC MOBILE CLINIC 14
MOH MOBILE CLINIC 15
ZNFPC CBD 16
MOH CBD 17
OTHER PUBLIC (SPECIFY) __________ 18
MISSION FACILITY 19
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
PHARMACY 22
PRIVATE DOCTOR 23
CBD 25
OTHER PRIVATE MEDICAL (SPECIFY) __________ 26
OTHER PRIVATE SECTOR
SHOP 31
CHURCH 32
FRIENDS/RELATIVES 33
OTHER (SPECIFY) __________ 96