Survey Text

Burkina Faso 1993 Kenya 1993 Nepal 1996 Senegal 1992
Cameroon 1991 Madagascar 1992 Niger 1992 Senegal 1997
Ghana 1993 Malawi 1992 Nigeria 1990 Sudan 1989
India 1992 Morocco 1992 Pakistan 1991 Tanzania 1991
Jordan 1990 Namibia 1992 Rwanda 1992 Zambia 1992
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Burkina Faso 1993
Survey form view entire document:  text 
488. Where can you obtain the ORS packet? Anywhere else?
RECORD ALL RESPONSES.

PUBLIC SECTOR
HOSPITAL A
MEDICAL CENTER B
CSPS C
SMI D
DISPENSARY E
PSP F
COMMUNITY PHARMACEUTICAL DEPOT G
PRIVATE MEDICAL SECTOR
PRIVATE DOCTOR'S OFFICE H
PHARMACY I
NURSE'S OFFICE J
RELIGIOUS DISPENSARY K
OTHER PRIVATE SECTOR
TRADITIONAL HEALER L
RELATIVE/NEIGHBOR/FRIEND M
OTHER (SPECIFY) _____ N

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Cameroon 1991
Survey form view entire document:  text 
486 Where can you get the (LOCAL NAME) packet?
PROBE: Anything else?
RECORD ALL PLACES MENTIONED. **

PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
GOVERNMENT HEALTH POST C
MOBILE CLINIC D
COMMUNITY HEALTH WORKER E
MEDICAL PRIVATE SECTOR
PRIVATE HOSPITAL OR CLINIC F
PHARMACY G
PRIVATE DOCTOR H
MOBILE CLINIC I
COMMUNITY HEALTH WORKER J
OTHER PRIVATE SECTION
SHOP K
TRADITIONAL PRACTITIONER L
OTHER (SPECIFY) __________ M

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Ghana 1993
Survey form view entire document:  text 
486. Where can you get the ORS or PHERMEROL packet? PROBE: Anywhere else?
RECORD ALL PLACES MENTIONED.

PUBLIC SECTOR
GOVERNMENT HOSPITAL/CLINIC A
GOVERNMENT HEALTH CENTER B
GOVERNMENT HEALTH POST C
MOBILE CLINIC D
COMMUNITY HEALTH CENTER E
MEDICAL PRIVATE SECTOR
PRIVATE HOSPITAL F
PHARMACY/DRGST./CHEMIST G
PRIVATE DOCTOR/CLINIC H
MOBILE CLINIC I
COMMUNITY HEALTH WORKER J
OTHER PRIVATE SECTOR
SHOP K
TRADITIONAL PRACTITIONER L
OTHER (SPECIFY) _____ M

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India 1992
Survey form view entire document:  text 
486 Where can you get the (LOCAL NAME) packet?
PROBE: Anything else?
RECORD ALL PLACES MENTIONED. **

PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
GOVERNMENT HEALTH POST C
MOBILE CLINIC D
COMMUNITY HEALTH WORKER E
MEDICAL PRIVATE SECTOR
PRIVATE HOSPITAL OR CLINIC F
PHARMACY G
PRIVATE DOCTOR H
MOBILE CLINIC I
COMMUNITY HEALTH WORKER J
OTHER PRIVATE SECTION
SHOP K
TRADITIONAL PRACTITIONER L
OTHER (SPECIFY) __________ M

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Jordan 1990
Survey form view entire document:  text 
498) Where did you learn to prepare the recommended home fluid made from (RECOMMENDED INGREDIENTS) *** given to (NAME) when he/she had diarrhea?**

PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
GOVERNMENT HEALTH POST 13
MOBILE PUBLIC SECTOR 14
COMMUNITY HEALTH WORKER 15
MEDICAL PRIVATE SECTOR
PRIVATE HOSPITAL OR CLINIC 21
PHARMACY 22
PRIVATE DOCTOR 23
MOBILE CLINIC 24
COMMUNITY HEALTH WORKER 25
OTHER PRIVATE SECTOR
SHOP 31
TRADITIONAL PRACTITIONER 32
OTHER (SPECIFY) __________ 41

* Response codes to be developed according to local instructions for mixing ORS. If these include the use of a certain container, e.g. a soda bottle, this should be added as a response category.
** Coding categories for health facilities and providers to be developed locally and revised based on pretest, however, the large categories must be maintained.
*** Question to be developed locally according to the ingredients promoted for use in the recommended home fluid.


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Kenya 1993
Survey form view entire document:  text 
486. Where can you get Oralite/ORS sachets?
PROBE: Anywhere else?

RECORD ALL PLACES MENTIONED.

PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTRE B
GOVERNMENT DISPENSARY C
MEDICAL PRIVATE SECTOR
MISSION, CHURCH HOSPITAL OR CLINIC D
OTHER NON-GOVERNMENTAL SERVICE E
PRIVATE HOSPITAL/CLINIC F
PHARMACY G
PRIVATE DOCTOR H
MOBILE CLINIC I
COMMUNITY HEALTH WORKER J
OTHER PRIVATE SECTOR
SHOP K
HERBALIST L
RELATIVE/FRIEND M
OTHER (SPECIFY) ______ N

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Madagascar 1992
Survey form view entire document:  text 
485. Where can you obtain an ORS/ODIVA packet?
INSIST: Nowhere else?
RECORD ALL PLACES MENTIONED.

PUBLIC SECTOR
HOSPITAL 11
HEALTH CENTER 12
DISPENSARY 13
LOCAL HEALTH POST 14
PRIVATE MEDICAL SECTOR
PRIVATE DOCTOR 21
PRIVATE HOSPITAL/CLINIC 22
PHARMACY 23
OTHER LOCATION
STORE 31
TRADITIONAL HEALER 32
FAMILY/FRIENDS 33
OTHER (SPECIFY) ____ 41
DOESN'T KNOW 98

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Malawi 1992
Survey form view entire document:  text 
484. Where can you get the ORS packet?
PROBE: Anywhere else?
RECORD ALL PLACES MENTIONED.

PUBLIC SECTOR
GOVERNMENT HOSPITAL A
PRIMARY HEALTH CENTRE B
DISPENSARY C
OTHER FIXED FACILITY D
MOBILE CLINIC E
MEDICAL PRIVATE SECTOR
PRIVATE HOSPITAL F
PRIMARY HEALTH CENTRE G
DISPENSARY H
PRIVATE DOCTOR I
CHEMIST J
MOBILE CLINIC K
OTHER PRIVATE SECTOR
SHOP L
TRADITIONAL PRACTITIONER M
OTHER (SPECIFY) ____ N
DON'T KNOW O

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Morocco 1992
Survey form view entire document:  text 
596) Where can you get the (local name) packet?
PROBE: Anywhere else?

RECORD ALL PLACES MENTIONED.

PUBLIC SECTOR
PUBLIC HOSPITAL A
HEALTH CENTER B
FREE CLINIC C
MOBILE TEAM D
TRAVELING PERSONNEL E
PRIVATE SECTOR
CLINIC F
PHARMACY G
PRIVATE DOCTOR H
OTHER PRIVATE
MUSLIM SCHOLAR I
SHOP J
OTHER K

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Namibia 1992
Survey form view entire document:  text 
486 Where can you get the (LOCAL NAME) packet?
PROBE: Anything else?
RECORD ALL PLACES MENTIONED. **

PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
GOVERNMENT HEALTH POST C
MOBILE CLINIC D
COMMUNITY HEALTH WORKER E
MEDICAL PRIVATE SECTOR
PRIVATE HOSPITAL OR CLINIC F
PHARMACY G
PRIVATE DOCTOR H
MOBILE CLINIC I
COMMUNITY HEALTH WORKER J
OTHER PRIVATE SECTION
SHOP K
TRADITIONAL PRACTITIONER L
OTHER (SPECIFY) __________ M

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Nepal 1996
Survey form view entire document:  text 
472A. Where can you buy or obtain a packet of ORS like Jeevan Jal?
PROBE: Where else?
RECORD ALL MENTIONED.

PUBLIC SECTOR
HOSP./DISTRICT CLINIC A
PRY./HEALTH CENTRE B
HEALTH/SUB-HEALTH POST C
MOBILE CLINIC D
FIELD WORKER E
OTHER PUBLIC (SPECIFY)_________________________F
PRIVATE SECTOR
HOSPITAL G
CLINIC/NURSING HOME H
PHARMACY I
MOBILE CLINIC J
COMM. HEALTH WORKER K
OTHER PRIVATE (SPECIFY)________________________L
OTHER SOURCE
SHOP N
TRAD. PRACTITIONER O
OTHER (SPECIFY)_________________________________X

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Niger 1992
Survey form view entire document:  text 
488) Where can you get this packet?

PROBE: Anywhere else?

RECORD ALL PLACES MENTIONED.

PUBLIC SECTOR
HOSPITAL A
MEDICAL CENTER B
MOTHER AND CHILD CARE CENTER C
DISPENSARY D
PEOPLE'S PHARMACY E
MOBILE CLINIC F
FIRST AID WORKER G
PRIVATE MEDICAL SECTOR
CLINIC/HOSPITAL H
PRIVATE PHARMACY I
PRIVATE DOCTOR'S OFFICE J
PRIVATE DISPENSARY K
OTHER PRIVATE SECTOR
PHARMACEUTICAL WAREHOUSE L
NEIGHBOR/RELATIVE M
OTHER (SPECIFY): ___ N

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Nigeria 1990
Survey form view entire document:  text 
486. Where can you get the (LOCAL NAME) packet?
PROBE: Anywhere else?
(CIRCLE ALL PLACES MENTIONED)

VILLAGE HEALTH WORKER 1
HEALTH CLINIC/POST 1
HEALTH CENTER 1
HOSPITAL 1
PRIVATE DOCTOR 1
TRADITIONAL/SPIRITUAL HEALER 1
VILLAGE CHEMIST AT PATENT MEDICINE SHOP 1
PHARMACY 1
OTHER (SPECIFY) _______ 1
DON'T KNOW 1

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Pakistan 1991
Survey form view entire document:  text 
496. Where can you get the (LOCAL NAME) packet?

GOVERNMENT HOSPITAL 1
RHC/BHU/GOVERNMENT CLINIC 1
PRIVATE HOSPITAL/CLINIC 1
PRIVATE DOCTOR 1
FAMILY WELFARE WORKER 1
LADY HEALTH VISITOR 1
HAKIM/HOMEOPATH 1
DRUGSTORE 1
SHOP (OTHER THAN DRUGSTORE) 1
OTHER (SPECIFY) _____ 1
DON'T KNOW 1

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Rwanda 1992
Survey form view entire document:  text 
477) Where can you get this packet?
PROBE: Anywhere else?
RECORD ALL PLACES MENTIONED.

ABAKANGURAMBAGA 1
DISPENSARY 1
HEALTH CENTER 1
HOSPITAL 1
PRIVATE DOCTOR 1
TRADITIONAL HEALER 1
PHARMACY 1
SHOP 1
OTHER (SPECIFY)____ 1
DON'T KNOW 1

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Senegal 1992
Survey form view entire document:  text 
486. Where can you get (LOCAL NAME) packet?
PROBE: Anywhere else?
CIRCLE THE CODE CORRESPONDING TO ALL RESPONSES GIVEN.

PUBLIC SECTOR
HOSPITAL A
HEALTH CENTER/PMI B
HEALTH POST/FREE CLINIC C
COMMUNITY HEALTH CARE WORKER D
PRIVATE MEDICAL SECTOR
CLINIC/PRIVATE HOSPITAL E
PHARMACY F
PRIVATE DOCTOR G
PRIVATE NURSE/CONFES H
OTHER PRIVATE SECTOR
SHOP/BOUTIQUE I
TRADITIONAL HEALER J
OTHER (SPECIFY) _____K

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Senegal 1997
Survey form view entire document:  text 
483B. What place do you know of?

NAME OF PLACE _____
PUBLIC SECTOR
HOSPITAL 11
HEALTH CENTER/PMI (Protection Maternelle et Infantile) 12
HEALTH POST/FREE CLINIC 13
PRIVATE MEDICAL SECTOR
PRIVATE CLINIC/HOSPITAL 21
PHARMACY 22
PRIVATE DOCTOR 23
PRIVATE NURSE/CONFES 24
OTHER SECTOR
ASBEF (Senegalese Association for Family Well-Being) 31
TRADITIONAL HEALER 32
CHURCH 33
FRIEND/RELATIVE 34
AUXILIARY 41
OTHER (SPECIFY) _____51

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Sudan 1989
Survey form view entire document:  text 
452 Where can you get the ORS packets?
PROSE: Anywhere else?
CIRCLE ALL PLACES MENTIONED.

GOVERNMENT HOSPITAL 1
GOVERNMENT HEALTH CENTER 1
DISPENSARY 1
DRESSING STATION 1
PRIMARY HEALTH FACILITY 1
MOBILE CLINIC 1
PRIVATE DOCTOR 1
PRIVATE CLINIC 1
PHARMACY 1
SHOP 1
TRADITIONAL DOCTOR 1
OTHER (SPECIFY) _______ 1
DK 1

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Tanzania 1991
Survey form view entire document:  text 
491. Where can you get (LOCAL NAME) packet?
PROBE: Anywhere else?
CIRCLE ALL PLACES MENTIONED.

GOVERNMENT AND PARASTATAL
HOSPITAL A
HEALTH CENTRE B
DISPENSARY C
PARASTATAL HOSP/CLINIC D
VILLAGE HEALTH POST/WORKER E
MEDICAL PRIVATE SECTOR
RELIGIOUS ORG. HOSP/CLINIC F
PRIVATE DOCTOR/HOSP/CLINIC G
PHARMACY/MEDICAL STORE H
OTHER PRIVATE SECTOR
SHOP I
TRADITIONAL PRACTIONER J
NEIGHBORS/RELATIVES K
OTHER (SPECIFY) _________________ L

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Zambia 1992
Survey form view entire document:  text 
486. Where can you get Madzi a Moyo packet?
PROBE: Anywhere else?
RECORD ALL PLACES MENTIONED.

PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
COMMUNITY HEALTH WORKER C
MEDICAL PRIVATE SECTOR
PRIVATE HOSPITAL/CLINIC D
MISSION HOSPITAL/CLINIC E
PHARMACY F
PRIVATE DOCTOR G
OTHER PRIVATE SECTOR
SHOP H
TRADITIONAL PRACTIONER I
OTHER (SPECIFY) _________________ J