Survey Text

Afghanistan 2015 Ethiopia 2011 Malawi 2016 Senegal 2014
Angola 2015 Ethiopia 2016 Mali 2012 Senegal 2015
Bangladesh 2007 Ethiopia 2019 Mali 2018 Senegal 2016
Bangladesh 2011 Ghana 2008 Myanmar 2015 Senegal 2017
Bangladesh 2014 Ghana 2014 Namibia 2006 South Africa 2016
Benin 2011 Guinea 2012 Namibia 2013 Tanzania 2010
Benin 2017 Guinea 2018 Nepal 2006 Tanzania 2015
Burkina Faso 2010 India 2005 Nepal 2011 Togo 2013
Burundi 2010 India 2015 Nepal 2016 Uganda 2006
Burundi 2016 Jordan 2007 Niger 2012 Uganda 2011
Cameroon 2011 Jordan 2012 Nigeria 2008 Uganda 2016
Cameroon 2018 Jordan 2017 Nigeria 2013 Yemen 2013
Chad 2014 Kenya 2008 Nigeria 2018 Zambia 2007
Congo (Democratic Republic) 2013 Kenya 2014 Pakistan 2006 Zambia 2013
Congo Brazzaville 2011 Lesotho 2009 Pakistan 2012 Zambia 2018
Cote d'Ivoire 2011 Lesotho 2014 Pakistan 2017 Zimbabwe 2005
Egypt 2003 Liberia 2007 Rwanda 2010 Zimbabwe 2010
Egypt 2008 Liberia 2013 Rwanda 2014 Zimbabwe 2015
Egypt 2014 Madagascar 2008 Senegal 2010
Eswatini (Swaziland) 2006 Malawi 2010 Senegal 2012
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Afghanistan 2015
Survey form view entire document:  text 
445. Where did this first check of (NAME) take 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________________
HOME
YOUR HOME 11 (GO TO 438)
OTHER HOME 12 (GO TO 438)
PUBLIC SECTOR
GOVT. HOSPITAL 21
CHC/POLYCLINIC 22
BASIC HEALTH CENTER 23
HEALTH SUB-CENTER 24
HP/SHP 25
MOBILE CLINIC 26
OTHER PUBLIC SECTOR_______27
NGO
MARIE STOPES 31
RED CROSS 32
OTHER NGO_________36
PRIVATE MED. SECTOR
PVT. HOSPITAL/CLINIC 41
PVT. MATERNITY HOME 42
PVT. DOCTOR'S OFFICE 43
OTHER PRIVATE MED. SECTOR________46
OTHER SOURCE
CHARITY/FOUNDATIONS 51
REFUGEE CAMP 52
OTHER__________96

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Angola 2015
Survey form view entire document:  text 
450) Where did this check of (NAME) take place?
PROBE TO IDENTIFY THE TYPE OF SOURCE.
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
CENTRAL HOSPITAL 21 (GO TO 459)
HOSPITAL IN PROVINCE 22 (GO TO 459)
HOSPITAL IN RURAL AREA 23 (GO TO 459)
HEALTH CENTER/POST 24 (GO TO 459)
MATERNITY WARD 25 (GO TO 459)
OTHER PUBLIC SECTOR: (SPECIFY)____ 26 (GO TO 459)
PRIVATE MEDICAL SECTOR
PRIVATE CLINIC/HOSPITAL 31 (GO TO 459)
HEALTH CENTER 32 (GO TO 459)
HEALTH POST 33 (GO TO 459)
OTHER PRIVATE MEDICAL SECTOR: (SPECIFY)____36 (GO TO 459)
OTHER: (SPECIFY)___96 (GO TO 459)

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Bangladesh 2007
Survey form view entire document:  text 
440) Where did the first check take place?
PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE. IF UNABLE TO DETERMINE IF A HOSPITAL, HEALTH CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

NAME OF PLACE____
HOME
OWN HOME 01
OTHER HOME 02
PUBLIC SECTOR
GOVERNMENT HOSPITAL MEDICAL/COLLE 11
FAMILY WELFARE CENTER 12
UPAZILA HEALTH COMPLEX 13
SATELLITE CLINIC EPI OUTRICH SITE 14
MATERNAL AND CHILD WELFARE CENTER 15
COMMUNITY CLINIC 16
OTHER (SPECIFY)____ 17
NGO SECTOR
NGO STATIC CLINIC 21
NGO SATELLITE CLINIC 22
OTHER (SPECIFY)____ 26
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31
QUALIFIED DOCTOR 32
TRADITIONAL DOCTOR 33
PHARMACY 34
OTHER (SPECIFY)____ 36
OTHER (SPECIFY)____ 96

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Bangladesh 2011
Survey form view entire document:  text 
445) Where did this first check of (NAME) take place? (ONLY FOR MOST RECENT BIRTH)
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) _____________________
HOME
HOME 11
PUBLIC SECTOR
HOSP./MEDICAL COLLEGE 21
SPE. MEDICAL COL. (SPECIFY) __________ 22
DIST. HOSP. 23
MCWC 24
UPAZILLA HEALTH COMPLEX 25
H and FAMILY WELFARE CENTRE 27
SAT. CLINIC/EPI OUTREACH 28
COMM. CLINIC 29
OTHER (SPECIFY) __________ 26
NGO SECTOR
NGO STATIC CLINIC 31
NGO SAT CLINIC (SPECIFY) 32
OTHER (SPECIFY) _____________ 36
PRIVATE MED. SECTOR
PVT. HOSPITAL/CLINIC 41
QUALIFIED. DOC. CHAMBER 42
UNQUALIFIED DOC. CHAMBER 43
PHARMACY 44
PVT. MED COLL. HOSP. (SPECIFY) ____________ 45
OTHER (SPECIFY)____________96

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Bangladesh 2014
Survey form view entire document:  text 
445. Where did this first check of (NAME) take 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) __________
HOME
YOUR HOME 11
PUBLIC SECTOR
HOSP./MEDICAL COLLEGE/SPE. MED. COL 21
DIST. HOSP. 22
MCWC 23
UPAZILLA HEALTH COMPLEX 24
UH AND FAMILY WELFARE CENTRE 25
SAT. CLINIC/EPI OUTREACH 27
COMM. CLINIC 28
OTHER (SPECIFY) _____ 26
NGO SECTOR
NGO STATIC CLINIC 31
NGO SAT CLINIC 32
OTHER (SPECIFY) _____ 36
PRIVATE MED. SECTOR
PVT. HOSPITAL/CLINIC 41
QUALIFIED DOC. CHAMBER 42
UNQUALIFIED DOC. CHAMBER 43
PHARMACY 44
OTHER (SPECIFY) _____ 96

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Benin 2011
Survey form view entire document:  text 
445) Where did this first check of (name) take place?
PROBE TO IDENTITY 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(S))_________
HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
GOVERNMENT HOSPITAL 21
GOVERNMENT HEALTH CENTER 22
STAND-ALONE MATERNITY 23
VILLAGE UNIT 24
OTHER PUBLIC_________(SPECIFY) 26
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31
RELIGIOUS HOSPITAL 32
OTHER PRIVATE MEDICAL________ (SPECIFY) 36
OTHER________ (SPECIFY) 96

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Benin 2017
Survey form view entire document:  text 
448) Where did this check of (name) take place.
Probe to identity 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(s))

Home
Her home 11
Other home 12
Public sector
Govt. Hospital 21
Govt. Health Center 22
Maternity 23
Village unit 24

Other public sector (specify) 26
Private medical sector
Private hospital/clinic 31
Religious hospital 32
Other private medical (specify) 36
Other (specify) 96
All skip to 457

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Burkina Faso 2010
Survey form view entire document:  text 
445. Where did this first check of (NAME) take place?
[ASK ONLY FOR MOST RECENT BIRTH]

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) ______
HOME
RESPONDENT'S HOME 11
OTHER HOME 12
PUBLIC SECTOR
GOVERNMENT HOSPITAL 21
MATERNITY CENTER 22
GOVERNMENT HEALTH CENTER/FAMILY PLANNING CLINIC 23
OTHER (SPECIFY) _____ 26
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31
OTHER PRIVATE MEDICAL (SPECIFY) _____ 36
OTHER (SPECIFY) ______ 96

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Burundi 2010
Survey form view entire document:  text 
445) Where did this first check of (NAME) take 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)) ______
HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
GOVERNMENT HOSPITAL 21
GOVERNMENT HEALTH CENTER 22
OTHER PUBLIC SECTOR (SPECIFY) _____ 26
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) ______ 36
OTHER (SPECIFY) ______ 96

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Burundi 2016
Survey form view entire document:  text 
456) Where did this first check of (NAME) take place?

PROBE TO IDENTITY 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(S))_____________
HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
NATIONAL GOVERNMENT HOSPITAL 21
REGIONAL GOVERNMENT HOSPITAL 22
DISTRICT HOSPITAL 23
GOVERNMENT HEALTH CENTER 24
OTHER___________26
CERTIFIED MEDICAL SECTOR
CERTIFIED HOSPITAL 31
CERTIFIED HEALTH CENTER 32
OTHER PRIVATE MEDICAL_________ J
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 41
PRIVATE HEALTH CARE CENTER 42
OTHER PRIVATE MEDICAL____________46
OTHER___________96

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Cameroon 2011
Survey form view entire document:  text 
445) Where did this first check of (NAME) take place? (2)

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

IF UNABLE TO IDENTIFY IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.
[Most recent birth within the last five years]

(NAME OF PLACE)________
HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
GOVT. HOSPITAL 21
GOVT. HEALTH CENTER 22
GOVT. HEALTH POST 23
OTHER PUBLIC (SPECIFY)_______ 26
PRIVATE MED. SECTOR
PVT. HOSPITAL/CLINIC 31
OTHER PRIVATE MED.(SPECIFY)______ 36
OTHER(SPECIFY)_______ 96

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Cameroon 2018
Survey form view entire document:  text 
448. Where did this check of (NAME) take place?
PROBE TO IDENTIFY THE TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

HOME
HER HOME 11 (SKIP TO 457)
OTHER HOME 12 (SKIP TO 457)
PUBLIC MEDICAL SECTOR
GOVERNMENT HOSPITAL 21 (SKIP TO 457)
INTEGRATED HEALTH CENTER / DISPENSARY 22 (SKIP TO 457)
SUB-DIVISIONAL MEDICAL CENTER 23 (SKIP TO 457)
OTHER PUBLIC SECTOR (SPECIFY)_________26 (SKIP TO 457)
PRIVATE MEDICAL SECTOR
CONFESSIONAL HOSPITAL / CLINIC 31 (SKIP TO 457)
PRIVATE LAY HOSPITAL / CLINIC 32 (SKIP TO 457)
CONFESSIONAL HEALTH CENTER / DISPENSARY 33 (SKIP TO 457)
DOCTOR'S OFFICE 34 (SKIP TO 457)
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)_________36 (SKIP TO 457)
OTHER (SPECIFY)__________96 (SKIP TO 457)

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Chad 2014
Survey form view entire document:  text 
445) Where did this first check of (NAME) take place?
PROBE TO IDENTITY 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(S))______________
HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
GOVERNMENT HOSPITAL 21
GOVERNMENT HEALTH CENTER 22
GOVERNMENT HEALTH POST 23
OTHER PUBLIC SECTOR (SPECIFY) 26
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31
OTHER PRIVATE MEDICAL 36
OTHER (SPECIFY) 96

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Congo (Democratic Republic) 2013
Survey form view entire document:  text 
445) Where did this first check of (NAME) take place?
PROBE TO IDENTITY 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(S)) ____
HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
GOVERNMENT HOSPITAL 21
GOVERNMENT HEALTH CENTER 22
GOVERNMENT HEALTH POST 23
OTHER PUBLIC SECTOR (SPECIFY) 26
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) 36
OTHER (SPECIFY) 96

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Congo Brazzaville 2011
Survey form view entire document:  text 
445) Where did this first check of (NAME) take 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))____________
HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
HOSPITAL 21
INTEGRATED HEALTH CENTER 22
HEALTH POST 23
PRIVATE MEDICAL SECTOR
CLINIC 31
DOCTOR'S OFFICE 32
OTHER PLACE (SPECIFY) _____ 96

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Cote d'Ivoire 2011
Survey form view entire document:  text 
445) Where did this first check of (NAME) take place? (2)

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

IF UNABLE TO IDENTIFY IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.
[Most recent birth within the last five years]

(NAME OF PLACE)________
HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
GOVT. HOSPITAL 21
GOVT. HEALTH CENTER 22
GOVT. HEALTH POST 23
OTHER PUBLIC (SPECIFY)_______ 26
PRIVATE MED. SECTOR
PVT. HOSPITAL/CLINIC 31
OTHER PRIVATE MED.(SPECIFY)______ 36
OTHER(SPECIFY)_______ 96

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Egypt 2003
Survey form view entire document:  text 
537. Where did this first check take place?

HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
GVT. HOSPITAL 21
GVT. HEALTH UNIT 22
MCH CENTER 23
PRIVATE SECTOR
PVT. HOSPITAL/CLINIC 31
OTHER________96

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Egypt 2008
Survey form view entire document:  text 
572. Where did this first check of (NAME) take place? IF SOURCE IS HOSPITAL, HEALTH UNIT, OR CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
[LAST BIRTH ONLY]

(NAME OF PLACE) _________________
HOME
YOUR HOME 11
OTHER HOME 12
GOVERNMENT
URBAN HOSPITAL (GNRL/DSTRCT) 21
URBAN H'LTH UNIT 22
HEALTH OFFICE 23
RURAL HOSPITAL (COMPL'TARY) 24
RURAL HEALTH UNIT 25
MCH CENTER 26
OTHER GOV'T (SPECIFY) ________ 27
NONGOVERNMENTAL
EGYPTIAN FP ASSOC 31
CSI PROJECT 32
OTHER NGO (SPECIFY) ________ 36
PRIVATE MEDICAL
PVT. HOSPITAL/CLINIC 41
PVT. DOCTOR 42
OTHER PVT. MED. (SPECIFY) __________ 46
OTHER NON-MEDICAL (SPECIFY) _________ 96

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Egypt 2014
Survey form view entire document:  text 
541. Where did this first check of (NAME) take place?
[ASK FOR MOST RECENT BIRTH ONLY]

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.

HOME
YOUR HOME 11
OTHER HOME 12
GOVERNMENT
URBAN HOSPITAL (GENERAL/DISCTRICT) 21
URBAN HEALTH UNIT 22
HEALTH OFFICE 23
RURAL HOSPITAL (CENTRAL) 24
RURAL HEALTH UNIT 25
MCH CENTER 26
OTHER GOVERNMENT (SPECIFY)_________27
NONGOVERNMENT
EGYPTIAN FP ASSOCIATION 31
CSI PROJECT 32
OTHER NGO (SPECIFY)___________36
PRIVATE MEDICAL
PRIVATE HOSPITAL/CLINIC 41
PRIVATE DOCTOR 42
OTHER PRIVATE MEDICAL (SPECIFY)________46
OTHER NON-MEDICAL (SPECIFY)_____________96

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Eswatini (Swaziland) 2006
Survey form view entire document:  text 
448) Where did this first check of (NAME) take 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.

(NAME OF PLACE)_____________
HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
GOVERNMENT HOSPITAL 21
GOVERNMENT HEALTH CENTER 22
PHU/CLINIC 23
OTHER PUBLIC (SPECIFY)__________26
PRIVATE MED. SECTOR
PRIVATE. HOSPITAL/CLINIC 31
OTHER PRIVATE (SPECIFY)_______36
MISSION
HOSPITAL 41
CLINIC 42
OTHER MISSION (SPECIFY)_______46
NGO
FLAS 51
OTHER NGO (SPECIFY)________56
OTHER (SPECIFY)_______96

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Ethiopia 2011
Survey form view entire document:  text 
445. Where did this first check of (NAME) take place?
[ASK ONLY FOR MOST RECENT BIRTH]

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(S) ________
HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
GOVT. HOSPITAL 21
GOVT. HEALTH CENTER 22
GOVT. HEALTH STAT/CLINIC 23
GOVT. HEALTH POST 24
OTHER PUBLIC (SPECIFY) ______ 26
NGO
HEALTH FACILITY 31
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL 41
PRIVATE CLINIC 42
OTHER PRIVATE MEDICAL (SPECIFY) _____ 43
OTHER (SPECIFY) _____ 96

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Ethiopia 2016
Survey form view entire document:  text 
448. Where did this check of (NAME) take 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 ___
HOME
HER HOME 11 (GO TO 457)
OTHER HOME 12 (GO TO 457)
PUBLIC SECTOR
GOVERNMENT HOSPITAL 21 (GO TO 457)
GOVERNMENT HEALTH CENTER 22 (GO TO 457)
GOVERNMENT HEALTH POST 23 (GO TO 457)
OTHER PUBLIC SECTOR (SPECIFY) 26 (GO TO 457)
NGO
HEALTH FACILITY 31 (GO TO 457)
OTHER NGO HEALTH FACILITY (SPECIFY) 36 (GO TO 457)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL 41 (GO TO 457)
PRIVATE CLINIC 42 (GO TO 457)
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) 46 (GO TO 457)
OTHER (SPECIFY) 96 (GO TO 457)

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Ethiopia 2019
Survey form view entire document:  text 
448. Where did this check of (NAME) take 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) ___

HOME
HER HOME 11
OTHER HOME 12


PUBLIC SECTOR
GOVERNMENT HOSPITAL 21
GOVERNMENT HEALTH CENTER 23
GOVERNMENT HEALTH POST 23
OTHER PUBLIC SECTOR (SPECIFY) ___ 26


NGO
HEALTH FACILITY 31
OTHER NGO HEALTH FACILITY 36


PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL 41
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) ___ 46
OTHER (SPECIFY) ___ 96

ALL SKIP TO 457.


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Ghana 2008
Survey form view entire document:  text 
452. Where did this first check of (NAME) take place?

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

IF UNABLE TO DETERMINE IF A HOSPITAL, HEALTH CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.
[Most recent birth within the last five years]

(NAME OF PLACE) __________________
HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
GOVT. HOPSITAL/POLYCLINIC 21
GOVT. HEALTH CENTER 22
GOVT. HEALTH POST/CHPS 23
OTHER PUBLIC (SPECIFY) ____ 26
PRIVATE MED. SECTOR
PVT. HOSPITAL/CLINIC 31
MOBILE CLINIC 32
FP/PPAG CLINIC 33
MATERNITY HOME 34
OTHER PRIVATED MED. (SPECIFY) _____ 36
OTHER (SPECIFY) ______ 96

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Ghana 2014
Survey form view entire document:  text 
445) Where did this first check of (NAME) take place?
[ASK FOR MOST RECENT BIRTH ONLY]

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) _____
HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
GOVT. HOSPITAL 21
GOVT. HEALTH CENTER/CLINIC 22
GOVT. HEALTH POST/CHPS 23
MOBILE CLINIC 24
OTHER PUBLIC SECTOR (SPECIFY) _____ 26
PRIVATE MEDICAL SECTOR
PVT. HOSPITAL/CLINIC 31
FP/PPAG CLINIC 32
MOBILE CLINIC 33
MATERNITY HOME 34
OTHER PRIVATE MED. SECTOR (SPECIFY) _____ 36
OTHER (SPECIFY) _____ 96

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Guinea 2012
Survey form view entire document:  text 
445) Where did this first check of (NAME) take place? (2)

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

IF UNABLE TO IDENTIFY IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.
[Most recent birth within the last five years]

(NAME OF PLACE)________
HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
GOVT. HOSPITAL 21
GOVT. HEALTH CENTER 22
GOVT. HEALTH POST 23
OTHER PUBLIC (SPECIFY)_______ 26
PRIVATE MED. SECTOR
PVT. HOSPITAL/CLINIC 31
OTHER PRIVATE MED.(SPECIFY)______ 36
OTHER(SPECIFY)_______ 96

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Guinea 2018
Survey form view entire document:  text 
448) Where did this check of (NAME) take place.

PROBE TO IDENTITY 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(S))___

HOME
HER HOME 11 (GO TO 457)
OTHER HOME 12 (GO TO 457)


PUBLIC SECTOR
NATIONAL HOSPITAL 21 (GO TO 457)
REGIONAL HOSPITAL 22 (GO TO 457)
PREFECTURAL HOSPITAL/COMMUNAL HEALTH CENTER 23 (GO TO 457)
HEALTH CENTER 24 (GO TO 457)
HEALTH POST 25 (GO TO 457)
OTHER PUBLIC SECTOR (SPECIFY) 26 (GO TO 457)


PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31 (GO TO 457)
FAMILY PLANNING CLINIC/GUINEAN ASSOCIATION FOR FAMILY WELL-BEING 32 (GO TO 457)
PRIVATE MIDWIFE'S CLINIC 33 (GO TO 457)


OTHER PRIVATE MEDICAL (SPECIFY) 36 (GO TO 457)

OTHER (SPECIFY) 96 (GO TO 457)

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India 2005
Survey form view entire document:  text 
452 Where did this first check of (NAME) take place? (2)
PROBE TO IDENTIFY TYPE(S) OF SOURCE(S) AND CIRCLE THE APPROPRIATE CODE(S).
IF UNABLE TO DETERMINE IF A HOSPITAL, HEALTH CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE(S)) ___________
HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
GOVT. HOSPITAL 21
GOVT. HEALTH CENTER 22
GOVT. HEALTH POST 23
OTHER PUBLIC (SPECIFY) __________ 26
PRIVATE MED. SECTOR
PVT. HOSPITAL/CLINIC 31
OTHER PRIVATE MED. (SPECIFY) ______ 36
OTHER (SPECIFY) _________ 96

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India 2015
Survey form view entire document:  text 
473. Where did this first check of (NAME) take place?
[ASK FOR MOST RECENT BIRTH ONLY]

IF UNABLE TO DETERMINE IF A HOSPITAL, HEALTH CENTRE, OR CLINIC IS PUBLIC OR PRIVATE HEALTH SECTOR, WRITE THE NAME OF THE PLACE.

(NAME OF FACILITY/PLACE)___________
HOME
YOUR HOME 11
PARENTS' HOME 12
OTHER HOME 13
PUBLIC HEALTH SECTOR
GOVERNMENT/MUNICIPAL HOSPITAL 21
GOVERNMENT DISPENSARY 22
UHC/UHP/UFWC 23
CHC/RURAL HOSPITAL/BLOCK PHC 24
PHC/ADDITIONAL PHC 25
SUB-CENTRE 26
ANGANWADI/ICDS CENTRE 27
OTHER PUBLIC SECTOR HEALTH FACILITY 28
NGO/TRUST HOSPITAL/CLINIC 31
PRIVATE HEALTH SECTOR
PRIVATE HOSPITAL/MATERNITY HOME/CLINIC 41
OTHER PRIVATE SECTOR HEALTH FACILITY 42
OTHER (SPECIFY) ______96

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Jordan 2007
Survey form view entire document:  text 
446) Where did this first check of (NAME) take place? (ASK ONLY FOR MOST RECENT BIRTH IN THE LAST FIVE YEARS)

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

IF UNABLE TO DETERMINE IF A HOSPITAL, HEALTH CENTER, OR CLINIC IS PUBLIC OR PRIVATE, WRITE THE NAME OF THE PLACE.
(NAME OF PLACE)____________

HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC MEDICAL SECTOR
GOVERNMENT HOSPITAL 21
GOVERNMENT HEALTH CENTER 22
GOVERNMENT MOTHER CHILD HEALTH CENTER 23
UNIVERSITY HOSPITAL 24
ROYAL MEDICAL SERVICES 25
OTHER PUBLIC (SPECIFY)_________ 26
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31
UNITED NATIONS RELIEF AND WORKS AGENCY HEALTH CENTER 32
OTHER PRIVATE MEDICAL (SPECIFY) __________ 36
OTHER (SPECIFY)__________ 96

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Jordan 2012
Survey form view entire document:  text 
445. Where did this first check of (NAME) take place?
PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
IF UNABLE TO DETERMINE IF A HOSPITAL, HEALTH CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE) ____________
HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC MEDICAL SECTOR
GOVT. HOSPITAL 21
GOVT. HEALTH CENTER 22
GOVT. MCH 23
UNIVERSITY HOSPITAL 24
ROYAL MEDICAL SERVICES 25
OTHER PUBLIC (SPECIFY) _____ 26
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31
UNRWA HEALTH CENTER 32
OTHER PRIVATE MEDICAL (SPECIFY) _____ 36
OTHER (SPECIFY) _____ 96

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Jordan 2017
Survey form view entire document:  text 
448) Where did this check of (NAME) take place?

PROBE TO IDENTIFY THAT TYPE OF SOURCE.

IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PALCE.

(NAME OF PLACE) ________________________________________
HOME
HER HOME 11 (SKIP TO 457)
OTHER HOME 12 (SKIP TO 457)
PUBLIC MED. SECTOR
GOVT. HOSPITAL 21 (SKIP TO 457)
GOVT. HEALTH CENTER 22
GOVT. MCH 23 (SKIP TO 457)
UNIVERSITY HOSPITAL 23
ROYAL MED. SERVICES 24 (SKIP TO 457)
OTHER PUBLIC (SPECIFY) _____________ 26 (SKIP TO 457)
PRIVATE MED. SECTOR
PVT. HOSPITAL/CLINIC 31
PRIVATE DOCTOR 32 (SKIP TO 457)
UNRWA HEALTH CENTER 33
UNHCR OTHER NGO 34
OTHER PRIVATE (SPECIFY) ______________ 36 (SKIP TO 457)
OTHER (SPECIFY) ____________ 96 (SKIP TO 457)

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Kenya 2008
Survey form view entire document:  text 
452. Where did this first check take place?

PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
IF UNABLE TO DETERMINE IF A HOSPITAL, HEALTH CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.
[Most recent birth within the last five years]

(NAME OF PLACE) __________________
HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
GOVT. HOSPITAL 21
GOVT. HEALTH CENTER 22
GOVT. DISPENSARY 23
OTHER PUBLIC (SPECIFY) __________ 26
PRIVATE MED. SECTOR
FAITH-BASED, CHURCH HOSP/CLINIC 31
PVT. HOSPITAL/CLINIC 33
NURSING/MATERNITY HOME 35
OTHER PRIVATE MED. (SPECIFY) ___________ 36
OTHER (SPECIFY) ___________ 96

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Kenya 2014
Survey form view entire document:  text 
445) Where did this first check of (NAME) take 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)

[MOST RECENT BIRTH ONLY]

(NAME OF PLACE) ____
HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
GOVERNMENT HOSPITAL 21
GOVERNMENT HEALTH CENTER 22
GOVERNMENT DISPENSARY 23
OTHER PUBLIC (SPECIFY) _____ 26
PRIVATE MED. SECTOR
MISSION HOSPITAL/CLINIC 31
PVT. HOSPITAL/CLINIC 32
NURSING/MATERNITY HOME 33
OTHER PRIVATE MED. (SPECIFY) _____ 36
OTHER (SPECIFY) ______ 96

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Lesotho 2009
Survey form view entire document:  text 
452 Where did this first check of (NAME) take 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) _________
HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
GOVT. HOSPITAL 21
GOVT. HEALTH CENTER 22
GOVT. HEALTH POST 23
OTHER PUBLIC SECTOR 26
PRIVATE MEDICAL SECTOR
PVT. HOSPITAL/CLINIC 31
OTHER PVTIVATE MEDICAL SECTOR 36
CHAL
CHAL HOSPITAL 41
CHAL HEALTH CENTER 42
CHAL HEALTH POST 46
OTHER 96

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Lesotho 2014
Survey form view entire document:  text 
445) Where did this first check of (NAME) take place?
[FOR MOST RECENT BIRTH ONLY]

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 ____
HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
GOVERNMENT HOSPITAL 21
GOVERNMENT HEALTH CENTER 22
GOVERNMENT HEALTH POST 23
OTHER PUBLIC (SPECIFY) ____ 26
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31
OTHER PRIVATE MEDICAL (SPECIFY) ____ 36
CHAL
CHAL HOSPITAL 41
CHAL HEALTH CENTRE 42
CHAL HEALTH POST 43
RED CROSS HEALTH CENTER 51
FACILITY OUTSIDE LESOTHO 61
OTHER (SPECIFY) ____ 96

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Liberia 2007
Survey form view entire document:  text 
452 Where did this first check of (NAME) take place? (2)
PROBE TO IDENTIFY TYPE(S) OF SOURCE(S) AND CIRCLE THE APPROPRIATE CODE(S).
IF UNABLE TO DETERMINE IF A HOSPITAL, HEALTH CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE(S)) ___________
HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
GOVT. HOSPITAL 21
GOVT. HEALTH CENTER 22
GOVT. HEALTH POST 23
OTHER PUBLIC (SPECIFY) __________ 26
PRIVATE MED. SECTOR
PVT. HOSPITAL/CLINIC 31
OTHER PRIVATE MED. (SPECIFY) ______ 36
OTHER (SPECIFY) _________ 96

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Liberia 2013
Survey form view entire document:  text 
445. Where did this first check of (NAME) take place? (2)
PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
IF UNABLE TO TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE)______________
HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
GOVT. HOSPITAL 21
GOVT. HEALTH CENTER 22
GOVT. HEALTH POST 23
OTHER PUBLIC (SPECIFY)________26
PRIVATE MED. SECTOR
PVT. HOSPITAL/CLINIC 31
OTHER PRIVATE MED. (SPECIFY)________36
OTHER (SPECIFY)_________96

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Madagascar 2008
Survey form view entire document:  text 
452. Where did the first check of (NAME) take place?
[ASK ONLY FOR MOST RECENT BIRTH]

PROBE TO IDENTIFY THE 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 _______
HOME
RESPONDENT'S HOME 11
OTHER HOME 12
PUBLIC SECTOR
GOVERNMENT HOSPITAL 21
BASIC HEALTH CENTER II (basic health care, physician-run) 22
BASIC HEALTH CENTER I (basic health care, run by para-medical officer) 23
OTHER PUBLIC (SPECIFY) ______ 26
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31
OTHER PRIVATE MEDICAL (SPECIFY) ______ 36
OTHER (SPECIFY) _______ 96

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Malawi 2010
Survey form view entire document:  text 
452. Where did this first check for (NAME) take place?
PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
IF UNABLE TO DETERMINE IF A HOSPITAL, HEALTH CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.
[FOR LAST BIRTH ONLY]

NAME OF PLACE_______________
HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
GOVERNMENT HOSPITAL 21
GOVERNMENT HEALTH CENTER 22
GOVERNMENT HEALTH POST/OUTREACH 23
OTHER PUBLIC 26
CHAM/MISSION
HOSPITAL 31
HEALTH CENTER 32
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 41
OTHER PRIVATE MEDICAL 46
BLM 51
OTHER 96

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Malawi 2016
Survey form view entire document:  text 
448. Where did this check of (NAME) take 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 ___
HOME
HER HOME 11 (GO TO 457)
OTHER HOME 12 (GO TO 457)
PUBLIC SECTOR
GOVERNMENT HOSPITAL 21 (GO TO 457)
GOVERNMENT HEALTH CENTER 22 (GO TO 457)
GOVERNMENT HEALTH POST/OUTREACH 23 (GO TO 457)
OTHER PUBLIC SECTOR (SPECIFY) 26 (GO TO 457)
CHAM/MISSION
HOSPITAL 31 (GO TO 457)
HEALTH CENTER 32 (GO TO 457)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL OR CLINIC 41 (GO TO 457)
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) 46 (GO TO 457)
BLM 51 (GO TO 457)
OTHER (SPECIFY) 96 (GO TO 457)

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Mali 2012
Survey form view entire document:  text 
445) Where did this first check of (NAME) take place?
PROBE TO IDENTITY 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(S))_______________
HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
NATIONAL HOSPITAL 21
REGIONAL HOSPITAL 22
REFERRAL HEALTH CENTER (CSREF) 23
FREE CLINIC/MATERNITY 24
COMMUNITY HEALTH CENTER (CSCOM) 25
OTHER PUBLIC SECTOR__________ (SPECIFY) 26
PRIVATE SECTOR
PRIVATE CLINIC/OFFICE 31
PRIVATE HEALTH CARE OFFICE 32
TREATMENT ROOM 33
PHARMACY 34
COMMUNITY BASED AGENT 35
OTHER PRIVATE MEDICAL SECTOR__________ (SPECIFY) 36
Other___________ (SPECIFY) 96

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Mali 2018
Survey form view entire document:  text 
448) Where did this check of (NAME) take place.

PROBE TO IDENTITY 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(S))

HOME
HER HOME 11
OTHER HOME 12
PUBLIC SECTOR
NATIONAL HOSPITAL 21
REGIONAL HOSPITAL 22
REFERENCE HEALTH CENTER 23
COMMUNITY HEALTH CENTER 24
DISPENSARY/MATERNITY 25
OTHER PUBLIC SECTOR (SPECIFY) 26
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31
DOCTOR'S OFFICE 32
PRIVATE HEALTH CLINIC 36
HEALTH POSTS 34
OTHER PRIVATE MEDICAL (SPECIFY) 36
OTHER (SPECIFY) 96

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Myanmar 2015
Survey form view entire document:  text 
445) Where did this first check of (NAME) take palce?
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)

HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
GOVT. HOSPITAL 21
GOVT. HEALTH CENTER (RHC) 22
GOVT. HEALTH POST SUB-CENTER 23
MOBILE CLINIC 24
UHC/MCH CENTER 25
OTHER PUBLIC SECTOR___(SPECIFY) 26
NGO
MARIE STOPES 31
MYANMAR RED CROSS 32
PSI/M (SUN) 33
MMA 34
OTHER NGO SECTOR___(SPECIFY) 36
PRIVATE MED. SECTOR
PVT. HOSPITAL/CLINIC 41
PVT. MATERNITY HOME 42
MMCWA MATERNITY HOME 43
OTHER PRIVATE MED. SECTOR___(SPECIFY) 46
OTHER___(SPECIFY) 96

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Namibia 2006
Survey form view entire document:  text 
452. Where did this first check of (NAME) take place?
PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE. IF UNABLE TO DETERMINE IF A HOSPITAL, HEALTH CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE THE NAME OF THE PLACE.
[LAST BIRTH ONLY]

(NAME OF PLACE) ____
LAST BIRTH ONLY:
HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
GOVT. HOSPITAL 21
GOVT. HEALTH CENTER/CLINIC 22
OTHER PUBLIC (SPECIFY) ____ 26
PRIVATE MED. SECTOR
PVT. HOSPITAL/CLINIC 31
OTHER PRIVATED MED. (SPECIFY) ____ 36
OTHER (SPECIFY) ____ 96

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Namibia 2013
Survey form view entire document:  text 
445) Where did this frist check of (NAME) take place?
PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRLCE THE APPROPRIATE CODE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVEATE SECTOR, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE) __________
HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
GOVT HOSPITAL 21
GOVT HEALTH CENTER 22
GVT HEALTH CARE CLINIC 23
OUTREACH POINT 24
OTHER PUBLIC (SPECIFY __________) 26
PRIVATE MED. SECTOR
PVT HOSPITAL 31
PVT CLINIC 32
OTHER PRIVATE MED. (SPECIFY __________) 36
OTHER (SPECIFY __________) 96

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Nepal 2006
Survey form view entire document:  text 
441. Where did this first check of (NAME) take place?
PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
IF UNABLE TO DETERMINE IF A HOSPITAL, HEALTH CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE NAME OF THE PLACE.

NAME OF PLACE ____
HOME
YOUR HOME 11
OTHER HOME 12
GOVT. SECTOR
GOVT. HOSPITAL 21
PHC CENTER 22
HEALTH POST 23
SUB-HEALTH 24
PHC OUTREACH 25
OTHER GOVT. (SPECIFY) ___ 26
NON-GOVT. SECTOR
UMN/RED CROSS 31
OTHER GOVT. (SPECIFY) __ 36
PRIVATE MED. SECTOR
PVT. HOSPITAL/CLINIC 41
OTHER PRIVATE MED (SPECIFY) ___ 46
OTHER (SPECIFY) ___ 96

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Nepal 2011
Survey form view entire document:  text 
447) Did you ever breastfeed (NAME)?

YES 1 (SKIP TO 449)
NO 2

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Nepal 2016
Survey form view entire document:  text 
448. Where did this check of (NAME) take place? PROBE TO IDENTIFY THE TYPE OF SOURCE. IF UNABLE TO DETEMRINE IF PUBLIC OR PRIVATE SECOR, WRITE THE NAME OF THE PLACE.

NAME OF PLACE __
HOME
HER HOME 11 (SKIP TO 457)
OTHER HOME 12 (SKIP TO 457)
PUBLIC SECTOR
GOVT. HOSPITAL/CLINIC 21 (SKIP TO 457)
PHC CENTER 22 (SKIP TO 457)
HEALTH POST/SUB-HEALTH POST 23 (SKIP TO 457)
PHC OUT REACH CLINIC 24 (SKIP TO 457)
OTHER PUBLIC FACILITIES (SPECIFY) ___ 26 (SKIP TO 457)
NON-GOVT. (NGO)
FPAN 31 (SKIP TO 457)
MARIE STOPES 32 (SKIP TO 457)
OTHER NGO FACILITIES (SPECIFY) ___ 36 (SKIP TO 457)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/NURSING HOME 41 (SKIP TO 457)
PRIVATE CLINIC 42 (SKIP TO 457)
OTHER PRIVATE MEDICAL FACILITIES ___ 46 (SKIP TO 457)
OTHER (SPECIFY) ___ 96 (SKIP TO 457)

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Niger 2012
Survey form view entire document:  text 
445) Where did this first check of (NAME) take 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)) _____________

HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
CENTRAL MATERNITY 21
MATERNITY IN REGIONAL HOSPITAL 22
MATERNITY IN HD 23
INTEGRATED HEALTH CENTER 24
HEALTH HUT 25
OTHER PUBLIC SECTOR (SPECIFY) 26
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31
RELIGIOUS INSTITUTION 32
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) 36
OTHER (SPECIFY) 96

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Nigeria 2008
Survey form view entire document:  text 
452. Where did this first check of (NAME) take place?
PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
IF UNABLE TO DETERMINE IF A HOSPITAL, HEALTH CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE) _______________
HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
GOVERNMENT HOSPITAL 21
GOVERNMENT HEALTH CENTER 22
GOVERNMENT HEALTH POST/DISPENSARY 23
OTHER PUBLIC (SPECIFY) ____________ 26
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31
OTHER PRIVATE MED. (SPECIFY) _____________ 36
OTHER (SPECIFY) _____________ 96

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Nigeria 2013
Survey form view entire document:  text 
445) Where did this first check of (NAME) take place? (2)

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

IF UNABLE TO IDENTIFY IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.
[Most recent birth within the last five years]

(NAME OF PLACE)________
HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
GOVT. HOSPITAL 21
GOVT. HEALTH CENTER 22
GOVT. HEALTH POST 23
OTHER PUBLIC (SPECIFY)_______ 26
PRIVATE MED. SECTOR
PVT. HOSPITAL/CLINIC 31
OTHER PRIVATE MED.(SPECIFY)______ 36
OTHER(SPECIFY)_______ 96

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Nigeria 2018
Survey form view entire document:  text 
448. Where did this check of (NAME) take place?

PROBE TO IDENTIFY THE TYPE OF SOURCE.

IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE ________

HOME
HER HOME 11 (GO TO 457)
OTHER HOME 12 (GO TO 457)
PUBLIC SECTOR
GOVERNMENT HOSPITAL 21 (GO TO 457)
GOVERNMENT HEALTH CENTER 22 (GO TO 457)
GOVERNMENT HEALTH POST 23 (GO TO 457)
OTHER PUBLIC CENTER _____ 26 (GO TO 457)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31 (GO TO 457)
OTHER PRIVATE MEDICAL SECTOR _____ 36 (GO TO 457)
OTHER _____ 96 (GO TO 457)

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Pakistan 2006
Survey form view entire document:  text 
471) Where did the first check of (NAME) take place?
IF SOURCE IS A HOSPITAL, HEALTH CENTER, OR CLINIC, RECORD THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE

HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
GOVT. HOSPITAL 21
RHC/MCH 22
BHU/FWC 23
OTHER PUBLIC (SPECIFY) ___ 26
PRIVATE MED. SECTOR
PVT. HOSPITAL/CLINIC 31
OTHER PRIVATE MED. (SPECIFY)__ 36
OTHER (SPECIFY) ___ 96

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Pakistan 2012
Survey form view entire document:  text 
439) Where did this first check of (NAME) take 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. ___
[ONLY ASKED FOR MOST RECENT PREGNANCY]

HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
GOVT. HOSPITAL 21
RHC/MCH 22
BHU/FWC 23
OTHER PUBLIC (SPECIFY)___ 26
PRIVATE MED. SECTOR
PVT. HOSPITAL/CLINIC 31
OTHER PRIVATE MED. (SPECIFY) __ 36
OTHER (SPECIFY) ___ 96

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Pakistan 2017
Survey form view entire document:  text 
448) Where did this check of (NAME) take 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 ________

HOME
HER HOME 11 (GO TO 457)
OTHER HOME 12 (GO TO 457)
PUBLIC SECTOR
GOVERNMENT HOSPITAL 21 (GO TO 457)
RHC/MC 22 (GO TO 457)
BHU 23 (GO TO 457)
CMW 24 (GO TO 457)
OTHER PUBLIC SECTOR (SPECIFY) ______ 26 (GO TO 457)
PRIVATE MEDICAL CENTER
PRIVATE HOSPITAL/CLINIC 31 (GO TO 457)
OTHER PRIVATE MEDICAL CENTER (SPECIFY) ________ 36 (GO TO 457)
OTHER (SPECIFY) _______ 96 (GO TO 457)

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Rwanda 2010
Survey form view entire document:  text 
445) Where did this first check of (NAME) take place?
[ASK FOR MOST RECENT BIRTH ONLY]

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___
HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC/AGREE SECTOR
REFERAL HOSPITAL 21
DISTRICT HOSPITAL 22
HEALTH CENTER 23
HEALTH POST 24
OTHER PUBLIC FACILITY (SPECIFY) 26
PRIVATE MEDICAL SECTOR
POLYCLINIC 31
CLINIC 32
DISPENSARY 33
OTHER PRIVATE MEDICAL FACILITY 36
OTHER (SPECIFY) 96

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Rwanda 2014
Survey form view entire document:  text 
445) Where did this first check of (NAME) take 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)
HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC/AGREE SECTOR
REF. HOSPITAL 21
PROV./DIST. HOSPITAL 22
HEALTH CENTER 23
HEALTH POST 24
OTHER PUBLIC FACILITY (SPECIFY) ____ 26
PRIVATE MEDICAL SECTOR
POLYCLINIC 31
CLINIC 32
DISPENSARY 33
OTHER PRIVATE MEDICAL FACILITY (SPECIFY) ____ 36
OTHER (SPECIFY) ____ 96

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Senegal 2010
Survey form view entire document:  text 
445) Where did this first check of (NAME) take place? (2)

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

IF UNABLE TO IDENTIFY IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.
[Most recent birth within the last five years]

(NAME OF PLACE)________
HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
GOVT. HOSPITAL 21
GOVT. HEALTH CENTER 22
GOVT. HEALTH POST 23
OTHER PUBLIC (SPECIFY)_______ 26
PRIVATE MED. SECTOR
PVT. HOSPITAL/CLINIC 31
OTHER PRIVATE MED.(SPECIFY)______ 36
OTHER(SPECIFY)_______ 96

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Senegal 2012
Survey form view entire document:  text 
445) Where did this first check of (NAME) take place? (2)

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

IF UNABLE TO IDENTIFY IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.
[Most recent birth within the last five years]

(NAME OF PLACE)________
HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
GOVT. HOSPITAL 21
GOVT. HEALTH CENTER 22
GOVT. HEALTH POST 23
OTHER PUBLIC (SPECIFY)_______ 26
PRIVATE MED. SECTOR
PVT. HOSPITAL/CLINIC 31
OTHER PRIVATE MED.(SPECIFY)______ 36
OTHER(SPECIFY)_______ 96

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Senegal 2014
Survey form view entire document:  text 
456. Where did this first check of (NAME) take 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)_________________
HOME
HER HOME 11
OTHER HOME 12
PUBLIC SECTOR
GOVERNMENT HOSPITAL 21
GOVERNMENT HEALTH CENTER 22
GOVERNMENT HEALTH POST 23
OTHER PUBLIC SECTOR (SPECIFY)____________26
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)_______________36
OTHER (SPECIFY)___________96

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Senegal 2015
Survey form view entire document:  text 
445) Where did this first check of (NAME) take place?
PROBE TO IDENTITY 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(S)) _____
HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
GOVT. HOSPITAL 21
GOVT. HEALTH CENTER/MATERNITY 22
GOVT. HEALTH POST 23
OTHER PUBLIC SECTOR (SPECIFY) _____ 26
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) ____ 36
OTHER (SPECIFY) _____ 96

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Senegal 2016
Survey form view entire document:  text 
456) Where did this first check of (NAME) take 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(S)) _____
HOME
HER HOME 11 (GO TO 457)
OTHER HOME 12 (GO TO 457)
PUBLIC SECTOR
GOVERNMENT HOSPITAL 21 (GO TO 457)
GOVERNMENT HEALTH CENTER/MATERNITY 22 (GO TO 457)
GOVERNMENT HEALTH POST 23 (GO TO 457)
OTHER PUBLIC SECTOR (SPECIFY) _____ 28 (GO TO 457)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31 (GO TO 457)
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) _____ 36 (GO TO 457)
OTHER (SPECIFY) ____ 96 (GO TO 457)

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Senegal 2017
Survey form view entire document:  text 
448) Where did this check of (NAME) take 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)) _____
HOME
HER HOME 11 (GO TO 457)
OTHER HOME 12 (GO TO 457)
PUBLIC SECTOR
GOVERNMENT HOSPITAL 21 (GO TO 457)
GOVERNMENT HEALTH CENTER/MATERNITY 22 (GO TO 457)
GOVERNMENT HEALTH POST 23 (GO TO 457)
OTHER PUBLIC SECTOR (SPECIFY) _____ 26 (GO TO 457)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31 (GO TO 457)
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) _____ 36 (GO TO 457)
OTHER (SPECIFY) ____ 96 (GO TO 457)

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South Africa 2016
Survey form view entire document:  text 
456) Where did this first check of (NAME) take place?
PROBE TO IDENTIFY THE TYPE OF SOURCE. IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, RECORD 96 AND WRITE THE NAME OF THE PLACE.

HOME
HER HOME 11
OTHER HOME 12
PUBLIC SECTOR
GOVERNMENT HOSPITAL 21
GOVERNMENT CLINIC/COMMUNITY HEALTH CENTRE 22
MOBILE CLINIC 23
OTHER PUBLIC SECTOR (SPECIFY) ________ 26
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/DOCTOR 31
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) ________ 36
OTHER (SPECIFY) ____ 96

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Tanzania 2010
Survey form view entire document:  text 
452. Where did this first check of (NAME) take place?
PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
IF UNABLE TO DETERMINE IF A HOSPITAL, HEALTH CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE) _________
HOME
YOUR HOME 11
OTHER HOME 12
GOV.PARASTATAL
REFERAL/SPEC. HOSPITAL 21
REGIONAL HOSP 22
DISTRICT HOSP 23
HEALTH CENT 24
DISPENSARY 25
VILLAGE HEALTH POST 26
CBD WORKER 27
RELIGIOUS/VOLUNTARY
REFERRAL/SPEC.HOSPITAL 31
DISTRICT HOSP 32
HEALTH CENT 33
DISPENSARY 34
PRIVATE
SPECIALISED HOSPITAL 41
HEALTH CENT 42
DISPENSARY 43
OTHER (SPECIFY) __________ 96

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Tanzania 2015
Survey form view entire document:  text 
448) Where did this check of (NAME) take 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)_____
HOME
HER HOME 11
OTHER HOME 12
TBA PREMISES 13
GOVERNMENT/PARASTATAL
ZONAL/REFERRAL/SPEC. HOSPITAL 21
REFERRAL REGIONAL HOSPITAL 22
REGIONAL HOSPITAL 23
DISTRICT HOSPITAL 24
HEALTH CENTRE 25
DISPENSARY 26
CLINIC 27
RELIGIOUS/VOLUNTARY
REFERRAL/SPEC. HOSPITAL 31
DISTRICT HOSPITAL 32
HOSPITAL 33
HEALTH CENTRE 34
DISPENSARY 35
CLINIC 36
PRIVATE
SPECIALISED HOSPITAL 41
HOSPITAL 42
HEALTH CENTRE 43
DISPENSARY 44
CLINIC 45
OTHER (SPECIFY) 96

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Togo 2013
Survey form view entire document:  text 
442) In the two months after (NAME) was born, did any health care provider or a traditional birth attendant check on his/her health?

YES 1
NO 2- (SKIP TO 446)
DON'T KNOW 8- (SKIP TO 446)

445) Where did this first check of (NAME) take place?
PROBE TO IDENTITY 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(S))_________

HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
GOVERNMENT HOSPITAL 21
HEALTH CENTER 22
DISPENSARY 23
MOTHER-INFANT PROTECTION 24
HEALTH HUT 25
MOBILE CLINIC 26
OTHER PUBLIC SECTOR (SPECIFY) 27
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31
PRIVATE DOCTOR'S OFFICE 32
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) 36
OTHER (SPECIFY) 96

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Uganda 2006
Survey form view entire document:  text 
452. Where did this first check of (NAME) take place?

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

NAME OF PLACE___
HOME
YOUR HOME 11
TBA'S HOME 12
OTHER HOME 13
PUBLIC SECTOR
GOVERNMENT HOSPITAL 21
GOVERNMENT HEALTH CENTER 22
GOVERNMENT HEALTH POST 23
OTHER PUBLIC (SPECIFY) 26
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31
OTHER PRIVATE MEDICAL (SPECIFY) 36
OTHER (SPECIFY) 96

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Uganda 2011
Survey form view entire document:  text 
445) Where did this first check of (NAME) take place?
[FOR LAST BIRTH ONLY]

PROBE TO IDENTIFY THE TYPE OF SOURCE

IF UNABLE TO DETERMINEIF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE) ______________________

HOME
YOUR HOME 11
TBA'S HOME 12
OTHER HOME 13
PUBLIC SECTOR
GOVT HOSPITAL 21
GOVT HEALTH CENTER 22
OTHER PUBLIC (SPECIFY) _____________ 26
PRIVATE MED. SECTOR
PVT HOSPITAL/ CLINIC 31
OTHER PRIVATE MED. (SPECIFY) ____________ 36
OTHER (SPECIFY) _____________ 96

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Uganda 2016
Survey form view entire document:  text 
448)Where did this check of (NAME) take 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 ______
HOME
HER HOME 11 (GO TO 457)
OTHER HOME 12 (GO TO 457)
PUBLIC SECTOR
GOVERNMEN HOSPITAL 21 (GO TO 457)
GOVERNMENT HEALTH CENTER 22 (GO TO 457)
OTHER PUBLIC SECTOR (SPECIFY) _______26 (GO TO 457)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL CLINIC 31 (GO TO 457)
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) ________36 (GO TO 457)
OTHER (SPECIFY)_______96 (GO TO 457)

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Yemen 2013
Survey form view entire document:  text 
445) Where did this first check of (NAME) take place? PROBE TO IDENTIFY THE TYPE OF SOURCE. IF UNABLE TO DETERMINE THE SECTOR WRITE THE NAME OF PLACE.

(NAME OF PLACE)____
YOUR HOME A
OTHER HOME B
GOVT. HOSPITAL C
GOVT. H. CENTER D
PRIM. H. CENTER E
FP. CLINIC F
MOBILE CLINIC G
PRIVATE SECTOR
(HOSP./CLINIC/DISPENSARY/DOCT. OFFICE) H
NG ORGANIZATIONS
(HOSPITAL/CLINIC/DISPENSARY DOCT. OFFICE) I
OTHER (SPECIFY) ____ X

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Zambia 2007
Survey form view entire document:  text 
452. Where did this first check of (NAME) take place?
PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
IF UNABLE TO DETERMINE IF A HOSPITAL, HEALTH CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE) _______________
HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
GOVT. HOSPITAL 21
GOVT. HEALTH CENTER 22
GOVT. HEALTH POST 23
OTHER PUBLIC (SPECIFY) ____________ 26
PRIVATE MED. SECTOR
PVT. HOSPITAL/CLINIC 31
MISSION HOSPITAL/CLINIC 32
OTHER PRIVATE MED. (SPECIFY) _____________ 36
OTHER (SPECIFY) _____________ 96

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Zambia 2013
Survey form view entire document:  text 
445) Where did this first check of (NAME) take 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 _______________________
HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
GOVERNMENT HOSPITAL 21
GOVERNMENT HEALTH CENTER/POST 22
MOBILE HOSPITAL/CLINIC 23
OTHER PUBLIC SECTOR (SPECIFY) _______________________ 26
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31
MISSION HOSPITAL/CLINIC 32
OTHER PRIVATE SECTOR (SPECIFY)_______________________ 36
OTHER (SPECIFY) ________________________ 96

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Zambia 2018
Survey form view entire document:  text 
(448) Where did this check of (NAME) take 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) _____________________

HOME
HER HOME 11 (SKIP TO 457)
OTHER HOME 12 (SKIP TO 457)
PUBLIC SECTOR
GOVERNMENT HOSPITAL 21 (SKIP TO 457)
GOVERNMENT HEALTH CENTER 22 (SKIP TO 457)
GOVERNMENT HEALTH POST 23 (SKIP TO 457)
OTHER PUBLIC SECTOR (SPECIFY) _______________ 26 (SKIP TO 457)

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Zimbabwe 2005
Survey form view entire document:  text 
452) Where did this first check of (NAME) take 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.

NAME OF PLACE __________
HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
CENTRAL HOSPITAL 21
PROVINCIAL HOSPITAL 22
DISTRICT/RURAL HOSPITAL 23
RURAL/MUNICIPAL CLINIC 24
RURAL HEALTH CENTER 25
OTHER PUBLIC (SPECIFY) __________ 26
MISSION FACILITY 31
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 41
OTHER PRIVATE (SPECIFY) __________ 42
OTHER (SPECIFY) __________ 96

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Zimbabwe 2010
Survey form view entire document:  text 
445) Where did this first check of (NAME) take 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___
HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
CENTRAL HOSPITAL 21
PROVINCIAL HOSPITAL 22
DISTRICT HOSPITAL 23
RURAL HOSPITAL 24
URBAN MUNICIPAL CLINIC 25
RURAL HEALTH CENTRE 26
OTHER PUBLIC SECTOR (SPECIFY) 27
MISSION HOSPITAL/CLINIC 31
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 41
OTHER PRIVATE MEDICAL SECTOR 46
OTHER (SPECIFY) 96

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Zimbabwe 2015
Survey form view entire document:  text 
448. Where did this check of (NAME) take 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 ___
HOME
HER HOME 11 (GO TO 457)
OTHER HOME 12 (GO TO 457)
PUBLIC SECTOR
CENTRAL HOSPITAL 21 (GO TO 457)
PROVINCIAL HOSPITAL 22 (GO TO 457)
DISTRICT HOSPITAL 23 (GO TO 457)
RURAL HOSPITAL 24 (GO TO 457)
URBAN MUNICIPAL CLINIC 25 (GO TO 457)
RURAL HEALTH CENTRE 26 (GO TO 457)
OTHER PUBLIC SECTOR (SPECIFY) 27 (GO TO 457)
MISSION HOSPITAL/CLINIC 31 (GO TO 457)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 41 (GO TO 457)
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) 46 (GO TO 457)
OTHER (SPECIFY) 96 (GO TO 457)