PUBLIC/PARA-PUBLIC SECTOR

HOSPITAL A
HEALTH CENTER B
CSPS C
SMI D
DISPENSARY/MATERNITY POST E
COMMUNITY PHARMACEUTICAL DEPOT F
OTHER PUBLIC (SPECIFY) _____ G

PRIVATE MEDICAL SECTOR

PRIVATE DOCTOR'S OFFICE H
FAMILY PLANNING CLINIC I
PHARMACY J
NURSE'S OFFICE K
OTHER PRIVATE (SPECIFY) _____ L

OTHER SOURCE

STORE/MARKET M
BAR/NIGHTCLUB N
KIOSK O
HOTEL/ROOM FOR RENT P
INFORMAL RETAIL CIRCUIT Q
FRIENDS/RELATIVES R
OTHER (SPECIFY) _____ X
OTHER (SPECIFY) _____ Y

PUBLIC SECTOR

HOSPITAL A
HEALTH CENTER/MOTHER-INFANT CENTER B
FREE CLINIC C
MEDICAL POST D
OTHER PUBLIC (SPECIFY): ___ E

PRIVATE MEDICAL SECTOR

PRIVATE DOCTOR F
PRIVATE HOSPITAL/CLINIC G
FAMILY PLANNING CENTER H
PHARMACY/PHARMACY DEPOT I
OTHER PRIVATE MEDICAL (SPECIFY): ___ J

OTHER PRIVATE SECTOR

SHOP/MARKET K
INFORMAL COMMERCIAL DISTRIBUTION L
CHURCH M
ACQUAINTANCES/RELATIVES N
TRADITIONAL PRACTITIONER O

OTHER (SPECIFY): ___ X
DON'T KNOW Z

PUBLIC SECTOR

HOSPITAL A
FAMILY PLANNING CLINIC B
FREE CLINIC C
MEDICAL POST D
OTHER PUBLIC (SPECIFY) _____ E

PRIVATE MEDICAL SECTOR

PRIVATE DOCTOR F
PRIVATE CLINIC/HOSPITAL G
FAMILY PLANNING CLINIC H
PHARMACY/PHARMACEUTICAL DEPOT I
OTHER PRIVATE MEDICAL (SPECIFY) _____ J

OTHER PRIVATE SECTOR

SHOP/MARKET K
INFORMAL COMMERCIAL DISTRIBUTION L
CHURCH M
FRIENDS/RELATIVES N
TRADITIONAL PRACTITIONER O

OTHER (SPECIFY) _____ X
DOESN'T KNOW Z

PUBLIC SECTOR

GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
GOVT. DISPENSARY C

PRIVATE MEDICAL SECTOR

MISSION HOSP/CLINIC D
OTHER PVT. HOSP/CLINIC E
PHARMACY F
PRIVATE DOCTOR G

MOBILE CLINIC H
COMMUNITY BASED DISTRIBUTOR I
COMM. HEALTH WORKER J

OTHER SOURCE

SHOP K
HERBALIST/TRAD. PRACT. L
RELATIVE/FRIEND M

OTHER (SPECIFY) ______ X
DOES NOT KNOW Z

PUBLIC SECTOR

HOSPITAL A
HEALTH CENTER B
DISPENSARY C
LOCAL HEALTH POST D
OTHER PUBLIC (SPECIFY) __________ X

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL/CLINIC E
PHARMACY F
DOCTOR G
OTHER PRIVATE (SPECIFY) ______ Y

OTHER SOURCE

STORE I
RELIGIOUS CENTER J
RELATIVES K
FRIENDS L
HEALER M

OTHER (SPECIFY) ____________ Z

PUBLIC SECTOR

GOVT. HOSPITAL A
HEALTH CENTER B
FP CLINIC C
MOBILE CLINIC D
DISPENSARY E
OTHER PUBLIC SECTOR F

MEDICAL PRIVATE SECTOR

PRIVATE HOSPITAL/CLINIC G
PHARMACY/PMS H
PRIVATE DOCTOR I
MOBILE CLINIC J
OTHER MED. PRIVATE SECTOR K
OTHER SHOP L
RELATIVES/FRIENDS M
TRADITIONAL HEALER N
OTHER (SPECIFY) _______________ X
DOES NOT KNOW Z

PUBLIC SECTOR

HOSPITAL A
HEALTH CENTER B
HEALTH POST/ PMI (Protection Maternelle et Infantile) C

PRIVATE MEDICAL SECTOR

PRIVATE CLINIC/HOSPITAL D
PHARMACY E
PRIVATE DOCTOR F
PRIVATE NURSE/CONFES G

OTHER SECTOR

ASBEF (Senegalese Association for Family Well-Being) H
CHURCH I
FRIEND/RELATIVE J
OTHER (SPECIFY) _____L

DOESN'T KNOW M

GOVERNMENT AND PARASTATAL

REGIONAL/CONSULTANT HOSPITAL A
DISTRICT HOSPITAL B
HEALTH CENTRE C
DISPENSARY/PARASTATAL FACILITY D
VILLAGE HEALTH POST/WORKER E

MEDICAL PRIVATE SECTOR

RELIGIOUS ORG. FACILITY F
PRIV. DOCTOR/CLINIC/HOSPITAL G
PHARMACY/MEDICAL STORE H
CBD WORKER I

OTHER PRIVATE SECTOR

SHOP J
CHURCH K
FRIENDS/RELATIVES/NEIGHBORS L

OTHER (SPECIFY) ___________ X

PUBLIC SECTOR

HOSPITAL A
MEDICAL-SOCIAL CENTER B
DISPENSARY/INFIRMARY C
M.C.H. D
HEALTH POST E
STATE PHARMACY F
OTHER PUBLIC (SPECIFY) __________ G

PRIVATE MEDICAL SECTOR

HOSPITAL/PRIVATE CLINIC H
PHARMACY I
TOGOLESE ASSOCIATION FOR FAMILIAL WELL-BEING J
DOCTOR'S OFFICE K
FIELDWORKER L
OTHER PRIVATE MEDICAL (SPECIFY) __________ M

OTHER PRIVATE SECTOR

SHOP/MARKET N
FRIEND(S)/RELATIVES O
TRADITIONAL PRACTITIONER P

OTHER (SPECIFY) __________ X
DON'T KNOW Z

PUBLIC SECTOR

GOVERNMENT HOSPITAL A (GO TO 810B)
GOVERNMENT HEALTH CENTER B (GO TO 810B)
DISPENSARY/HEALTH UNIT C (GO TO 810B)
GOVERNMENT MOBILE CLINIC D (GO TO 810B)
GOVERNMENT FIELD WORKER E (GO TO 810B)
OTHER PUBLIC (SPECIFY) _________ F (GO TO 810B)

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL/CLINIC G (GO TO 810B)
PHARMACY/DRUG STORE H (GO TO 810B)
PRIVATE DOCTOR I (GO TO 810B)
PRIVATE MOBILE CLINIC J (GO TO 810B)
PRIVATE FIELD WORKER K (GO TO 810B)
OTHER PRIVATE MEDICAL (SPECIFY) ________ L (GO TO 810B)

OTHER PRIVATE SECTOR

SHOP M (GO TO 810B)
CHURCH N (GO TO 810B)
FRIENDS/RELATIVES O (GO TO 810B)
TRADITIONAL HEALER P (GO TO 810B)

OTHER (SPECIFY) _________ X (GO TO 810B)
DOES NOT KNOW Z (GO TO 810B)

PUBLIC SECTOR

CENTRAL HOSPITAL A
PROVINCIAL HOSPITAL B
DISTRICT/RURAL HOSPITAL C
RURAL HEALTH CENTRE D
RURAL/MUNICIPAL CLINIC E
VILLAGE COMMUNITY WORKER F
OTHER PUBLIC SECTOR (SPECIFY) __________ G

MISSION HOSPITAL/CLINIC H

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL/CLINIC I
PHARMACY J
PRIVATE DOCTOR K
VILLAGE COMMUNITY WORKER L
OTHER MEDICAL PRIVATE SECTOR (SPECIFY) __________ M

OTHER PRIVATE SECTOR

SHOP N
RELATIVES/FRIENDS O
TRADITIONAL HEALER P

OTHER (SPECIFY) __________ X