Survey Text

Benin 2006 Lesotho 2009 Nigeria 2008 Zambia 2007
Egypt 2005 Liberia 2007 Pakistan 2006 Zambia 2013
Ethiopia 2005 Madagascar 2008 Rwanda 2005 Zimbabwe 2005
Ghana 2008 Mali 2006 Senegal 2005
Guinea 2005 Namibia 2006 Tanzania 2004
India 2005 Niger 2006 Uganda 2006
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Benin 2006
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499E) Where did you go to get the last injection?

PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
FAMILY PLANNING CLINIC 13
MATERNITY CENTER 14
COMMUNITY PHARMACY 15
STRAT AV HEALTH WORKER 16
HEALTH WORKER 17
OTHER PUBLIC (SPECIFY) ________ 18
PRIVATE MEDICAL SECTOR
HOSPITAL/CLINIC/OFFICE 21
PHARMACY 22
DENTIST 23
PRIVATE DOCTOR 24
HEALTH AGENT 25
OTHER PRIVATE MEDICAL (SPECIFY) ________ 26
OTHER SOURCE
AT HOME 31
OTHER (SPECIFY) ________ 96

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Egypt 2005
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1006) The last time you had an injection given to you by a health worker, where did you get the injection?

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

(NAME AND ADDRESS OF PLACE) ____________________________________________
HOME
YOUR HOME 1
OTHER HOME 2
MINISTRY OF HEALTH
URBAN HOSPITAL 3
URBAN HEALTH UNIT 4
HEALTH OFFICE 5
RURAL HOSPITAL 6
RURAL HEALTH UNIT 7
MCH CENTER 8
MOBILE UNIT 9
OTHER GOVERNMENTAL
UNIVERSITY HOSPITAL A
TEACHING HOSPITAL B
HEALTH INSURANCE ORG C
CURATIVE CARE ORGANIZATION . D
OTHER GOVERNMENTAL E
NON-GOVERNMENNTAL ORGANIZATIONS
EGYPTIAN FP ASSOC F
CSI PROJIECT G
OTHER NON-GOVERNMENTAL H
PRIVATE MEDICAL
PRIVATE HOSPITAL/ CLINIC I
PRIVATE DOCTOR J
DENTIST K
PHARMACY L
MOSQUE HEALTH UNIT M
CHURCH HEALTH UNIT N
OTHER NON-/MEDICAL (SPECIFY) __________ X

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Ethiopia 2005
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556. The last time you had an injection given to you by a health worker, where did you go to get the injection?
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 11
GOVERNMENT HEALTH CENTER 12
GOVERNMENT HEALTH POST 13
COMMUNITY HEALTH AGENT 14
OTHER PUBLIC (SPECIFY) ________16
NGO HEALTH FACILITY 21
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/DOCTOR 31
DENTAL CLINIC/OFFICE 32
PHARMACY 33
OFFICE OR HOME OF NURSE/HEALTH WORKER 34
OTHER PRIVATE MEDICAL (SPECIFY) ___________________ 36
OTHER PLACE
AT HOME 41
OTHER (SPECIFY) _____________ 96

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Ghana 2008
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1007. The last time you had an injection given to you by a health worker, where did you go to get the injection?

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

NAME ______
PUBLIC SECTOR
GOVT. HOSPITAL/POLYCLINIC 11
GOVT. HEALTH CENTER 12
GOVT. HEALTH POST/CHPS 13
STAND-ALONE VCT CENTER 14
FAMILY PLANNING CLINIC 15
MOBILE CLINIC 16
FIELDWORKER/OUTREACH/PEER EDUCATOR 17
OTHER PUBLIC (SPECIFY) _____ 18
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR 21
STAND-ALONE VCT CENTER 22
PHARMACY 23
CHEMICAL/DRUG STORE 24
FP/PPAG CLINIC 25
MATERNITY HOME 26
OTHER PRIVATE MEDICAL (SPECIFY) ____ 27
OTHER SOURCE
AT HOME 31
OTHER (SPECIFY) ____ 96

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Guinea 2005
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499D. Where did you go to get the last injection?

PUBLIC SECTOR
HOSPITAL 11
HEALTH CENTER 12
MEDICAL POST 13
OTHER PUBLIC (SPECIFY) _____ 16
PRIVATE MEDICAL SECTOR
PRIVATE/HOSPITAL/CLINIC/DOCTOR 21
DENTIST 22
PHARMACY 23
PRIVATE DOCTOR'S OFFICE/HOME OF NURSE/HEALTH AGENT 24
OTHER PRIVATE MEDICAL (SPECIFY) _____ 26
OTHER LOCATION
AT HOME 31
OTHER (SPECIFY) _____ 96

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India 2005
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1007 The last time you had an injection given to you by a health worker, where did you go to get the injection? (2)
PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
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 11
GOVT. HEALTH CENTER 12
OTHER PUBLIC (SPECIFY) ________ 16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR 21
DENTAL CLINIC/OFFICE 22
PHARMACY 23
OFFICE OR HOME OF NURSE/HEALTH WORKER 24
OTHER PRIVATE MEDICAL (SPECIFY) ________ 26
OTHER PLACE
AT HOME 31
OTHER (SPECIFY) _______ 96

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Lesotho 2009
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1007 The last time you had an injection given to you by a doctor or a nurse, a dentist or any other health worker, where did you go to get the injection?
PROBE TO IDENTIFY EACH 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
GOVERNMENT HOSPITAL 11
GOVT. HEALTH CENTER 12
OTHER PUBLIC SECTOR 13
PRIVATE MEDICAL SECTOR
PVT HOSPITAL/CLINIC 21
LPPA 22
PHARMACY 23
PVT DOCTOR 24
OTHER PRIVATE MEDICAL SECTOR 26
CHAL
CHAL HOSPITAL 31
CHAL HEALTH CENTER 32
COMMUNITY HEALTH WORKER/SUPPORT GROUPS 41
OTHER SOURCE
SHOP 51
CHURCH 52
FRIENDS/RELATIVES 53
TRADITIONAL HEALER 54
OTHER 96

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Liberia 2007
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1107) The last time you had an injection given to you by a health worker, where did you go to get the injection?

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

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

(NAME OF PLACE) ______________________

PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
GOVERNMENT HEALTH CLINIC 13
OTHER PUBLIC (SPECIFY) ___________ 16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/DOCTOR 21
DENTAL CLINIC/OFFICE 22
PHARMACY 23
OFFICE OR HOME OF NURSE/HEALTH WORKER 24
MOBILE CLINIC 25
OTHER PRIVATE MEDICAL (SPECIFY) _______________ 26
OTHER PLACE
AT HOME 31
OTHER (SPECIFY) _________________ 96

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Madagascar 2008
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1007. The last time you had an injection given to you by a health worker, where did you go to get the injection?

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

NAME OF PLACE(S) ______
PUBLIC SECTOR
DISTRICT HOSPITAL II (facility equipped for surgeries) 11
DISTRICT HOSPITAL I (non-surgical medical capabilities) 12
BASIC HEALTH CENTER II (basic health care, physician-run) 13
BASIC HEALTH CENTER I (basic health care, run by para-medical officer) 14
OTHER PUBLIC PLACE (SPECIFY) ______ 16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
PRIVATE HEALTH CENTER 22
PHARMACY/MEDICINE DISPERSAL CENTER 23
PRIVATE DOCTOR 24
DENTAL OFFICE 25
OTHER PRIVATE MEDICAL (SPECIFY) _____ 26
OTHER SOURCE
AT HOME 31
OTHER (SPECIFY) ______ 96

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Mali 2006
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499D. The last time you had an injection, where did you go to get it?

PUBLIC SECTOR
HOSPITAL 11
HEALTH CENTER 12
HEALTH POST 13
OTHER PUBLIC (SPECIFY)__16
PRIVATE SECTOR MEDICAL
PRIVATE HOSPITAL/CLINIC/DOCTOR 21
DENTIST 22
PHARMACY 23
PRIVATE OFFICE/NURSE'S HOME/HEALTH WORKER 24
OTHER PRIVATE MEDICAL (SPECIFY) __26
OTHER PLACE
HOME 31
OTHER (SPECIFY) __ 96

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Namibia 2006
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1015. The last time you had an injection given to you by a health worker, where did you go to get the injection?
PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
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 11
GOVT. HEALTH CENTER/CLINIC 12
PHC (MOBILE) 13
OTHER PUBLIC (SPECIFY) 16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR 21
DENTAL CLINIC/OFFICE 22
PHARMACY 23
OFFICE OR HOME OF NURSE/HEALTH WORKER 24
OTHER PRIVATE MEDICAL (SPECIFY) ____ 26
OTHER PLACE
AT HOME 31
OTHER (SPECIFY) ____ 36

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Niger 2006
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499D. The last time you had an injection, where did you go to get it?

PUBLIC SECTOR
HOSPITAL 11
HEALTH CENTER 12
HEALTH HUT 13
OTHER PUBLIC (SPECIFY) ___ 16
PRIVATE SECTOR MEDICAL
PRIVATE HOSPITAL/CLINIC/DOCTOR 21
DENTIST 22
PHARMACY 23
PRIVATE OFFICE/NURSE'S HOME/HEALTH WORKER 24
OTHER PRIVATE MEDICAL (SPECIFY) ___ 26
OTHER PLACE
HOME 31
OTHER (SPECIFY) __________ 96

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Nigeria 2008
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1007 The last time you had an injection given to you by a health worker, where did you go to get the injection? (2)
PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
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 11
GOVT. HEALTH CENTER 12
OTHER PUBLIC (SPECIFY) ________ 16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR 21
DENTAL CLINIC/OFFICE 22
PHARMACY 23
OFFICE OR HOME OF NURSE/HEALTH WORKER 24
OTHER PRIVATE MEDICAL (SPECIFY) ________ 26
OTHER PLACE
AT HOME 31
OTHER (SPECIFY) _______ 96

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Pakistan 2006
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913) The last time you had an injection from where did you obtain the syringe?
IF SOURCE IS HOSPITAL, HEALTH CENTER OR CLINIC, WRITE THE NAME OF THE SOURCE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE. IF SYRINGE WAS PURCHASED FROM A CHEMIST CODE '23'

PUBLIC SECTOR
GOVT. HOSPITAL/RHSC 11
RHC/MCH 12
BHU/FWC 13
MOBILE SERVICE CAMP 14
LADY HEALTH WORKER/HEALTH HOUSE 15
OTHER PUBLIC (SPECIFY) ___ 16
PRIVATE MED. SECTOR
PRIVATE HOSPITAL/CLINIC/DOCTOR 21
DENTAL CLINIC/OFFICE 22
CHEMIST 23
OFFICE OR HOME OR NURSE/HEALTH WORKER 24
DISPENSER/COMPOUNDER 25
OTHER PRIVATE MEDICAL (SPECIFY) ___ 26
OTHER PLACE AT HOME 31
OTHER (SPECIFY) ___ 96

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Rwanda 2005
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499D. THE LAST TIME YOU HAD AN INJECTION, WHERE DID YOU GET IT FROM?
IF IT IS A HOSPITAL, A HEALTH CENTER OR A PRIVATE CLINIC, WRITE NAME OF THE FACILITY. INSIST TO DETERMINE TYPE OF SECTOR AND ENCIRCLE THE SUITABLE CODE.

(NAME OF THE FACILITY) _______
PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
AGENT DBC 13
OTHER PUBLIC (SPECIFY) _____ 16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
DENTIST 22
PHARMACY 23
PRIVATE DOCTOR/NURSE 24
ARBEF CLINIC 25
OTHER PRIVATE MEDICAL (SPECIFY) ____ 26
OTHER SOURCE
HOME 31
OTHER (SPECIFY) ____ 96

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Senegal 2005
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499D. The last time you had an injection, where did you go to get it?

PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
GOVERNMENT HEALTH POST 13
HEALTH HUT/ RURAL MATERNITY 14
COMMUNITY PHARMACY 15
STRAT. AVANCÉE/EQU. MOBILE 16
HEALTH CARE WORKER 17
OTHER PUBLIC (SPECIFY) _____18
PRIVATE MEDICAL SECTOR
HOSPITAL/CLINIC/OFFICE 21
PHARMACY 22
DENTIST 23
PRIVATE DOCTOR 24
HEALTH CARE WORKER 25
OTHER PRIVATE (SPECIFY) _____26
OTHER PLACE
AT HOME 31
OTHER (SPECIFY) _____96

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Tanzania 2004
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499D. The last time you had an injection from a health professional, where did you go for the injection to be given?

GOVERNMENT/PARASTATAL
REFERAL/SPEC. HOSPITAL 11
REGIONAL HOSPITAL 12
DISTRICT HOSPITAL 13
HEALTH CENTRE 14
DISPENSARY 15
VILLAGE HEALTH POST (WO 16
CBD WORKER 17
RELIGIOUS/VOLUNTARY
REFERAL/SPEC. HOSPITAL 21
DISTRICT HOSPITAL 22
GOVT. HEALTH CENTRE 23
DISPENSARY 24
PRIVATE
DISTRICT HOSPITAL 31
HEALTH CENTRE 32
DISPENSARY 33
OTHER
PHARMACY 41
NGO 42
VCT CENTRE 43
OTHER (SPECIFY) ______________________ 96

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Uganda 2006
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1007 The last time you had an injection given to you by a health worker, where did you go to get the injection? (2)
PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
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 11
GOVT. HEALTH CENTER 12
OTHER PUBLIC (SPECIFY) ________ 16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR 21
DENTAL CLINIC/OFFICE 22
PHARMACY 23
OFFICE OR HOME OF NURSE/HEALTH WORKER 24
OTHER PRIVATE MEDICAL (SPECIFY) ________ 26
OTHER PLACE
AT HOME 31
OTHER (SPECIFY) _______ 96

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Zambia 2007
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1007. The last time you had an injection given to you by a trained health worker where did you go to get the injection?
PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
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 11
GOVT. HEALTH CENTER 12
OTHER PUBLIC (SPECIFY) ______ 16

PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR 20
MISSION HOSPITAL/CLINIC 21
DENTAL CLINIC/OFFICE 22
PHARMACY 23
OFFICE OR HOME OF NURSE/HEALTH WORKER 24
OTHER PRIVATE MEDICAL (SPECIFY) ______ 26
OTHER PLACE
AT HOME 31
OTHER (SPECIFY) ______ 96

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Zambia 2013
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1002A) The last time you had an injection given to you by a trained health worker where did you go to get the injection?

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 11
GOVERNMENT HEALTH CENTER/POST 12
MOBILE HOSPITAL/CLINIC 13
OTHER PUBLIC SECTOR (SPECIFY) ______________ 16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR 21
MISSION HOSPITAL/CLINIC 22
DENTAL CLINIC/OFFICE 23
MOBILE HOSPITAL/CLINIC 24
PHARMACY 25
OFFICE OR HOME OF NURSE/HEALTH WORKER 26
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) ________________27
OTHER SOURCE AT HOME 31
OTHER (SPECIFY) __________________ 96

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Zimbabwe 2005
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1020) The last time you had an injection given to you by a health worker, where did you go to get the injection?

PUBLIC SECTOR
CENTRAL HOSPITAL 11
PROVINCIAL HOSPITAL 12
DISTRICT/RURAL HOSPITAL 13
RURAL HEALTH CENTER 14
MUNICIPAL CLINIC 15
OTHER PUBLIC (SPECIFY) __________ 16
MISSION FACILITY 21
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31
NEW START CENTER 32
OTHER PRIVATE VCT CENTER (SPECIFY) __________ 33
OTHER PRIVATE DOCTOR (SPECIFY) __________ 34
OTHER (SPECIFY) __________ 96