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HCFPUBOTH
(V762BF)
Known source for female condoms: Other public source
Codes and Frequencies
An 'X' indicates the category is available for that sample
| Code | Label |
benin
11
|
burkf
03
|
burkf
10
|
burun
10
|
chad
14
|
comor
12
|
condr
13
|
cotedi
11
|
eswat
06
|
ethio
11
|
gambia
13
|
ghana
03
|
ghana
14
|
guinea
12
|
kenya
03
|
Code | Label |
kenya
08
|
kenya
14
|
lesoth
04
|
lesoth
09
|
lesoth
14
|
madag
03
|
madag
08
|
malaw
00
|
malaw
10
|
mali
12
|
myan
15
|
namib
06
|
namib
13
|
niger
12
|
nigera
03
|
Code | Label |
nigera
08
|
nigera
13
|
rwand
10
|
seneg
10
|
seneg
12
|
seneg
14
|
seneg
15
|
seneg
16
|
sleone
08
|
sleone
13
|
togo
13
|
ugand
01
|
zambia
01
|
zambia
07
|
zambia
13
|
Code | Label |
zimbw
05
|
zimbw
10
|
zimbw
15
|
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 0 | No | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | 0 | No | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | 0 | No | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | 0 | No | X | X | X |
| 1 | Yes | · | X | X | X | · | X | X | X | X | X | X | X | X | · | · | 1 | Yes | X | X | X | X | X | · | · | · | X | X | X | X | X | X | · | 1 | Yes | X | · | X | X | X | X | X | X | · | X | X | X | X | X | X | 1 | Yes | X | X | X |
| 8 | Missing | · | X | X | X | X | X | X | X | X | X | X | X | X | X | X | 8 | Missing | X | X | X | · | · | X | X | X | X | · | · | X | X | X | X | 8 | Missing | X | X | X | · | · | · | · | · | X | X | X | X | X | X | X | 8 | Missing | X | · | · |
| 9 | NIU (not in universe) | · | · | · | · | · | · | · | · | · | · | · | · | · | · | X | 9 | NIU (not in universe) | · | X | · | · | · | · | · | · | · | · | · | · | · | · | · | 9 | NIU (not in universe) | · | · | · | · | · | · | · | · | · | · | · | · | · | · | · | 9 | NIU (not in universe) | · | · | · |
Can't find the category you are looking for? Try the Detailed codes
Description
HCFPUBOTH (V762BF) indicates whether the woman reported some other public facility as a source for female condoms.
See HCFPRIVOTH (other private medical sector) and HCFOTHER (other non-medical sector) for similar variables.
Comparability — Index
|
GENERAL |
Malawi |
Comparability
Along with universe differences, HCFPUBOTH (V762BF) has some contextual factors regarding question wording that should be noted by researchers. This survey context broadly applies to the "source for female condom" series. For discussion of this topic, see the comparability section of variable HCFDK.
The response category wording for HCFPUBOTH is largely comparable across samples, and this response is consistently organized under the "public sector" or "public medical sector" header.
The meaning of "other" depends on the sources for female condoms specified in a given sample. Researchers should be especially attentive to the survey text response categories under the "Public Sector" or "Public Medical Sector" headers. HCFPUBOTH does not include "other sources" that are organized under the private medical or "other source"/"other private source" sectors.
For most samples, the variable was a part of a question that asked the respondent to list all known sources for female condoms. Some countries (noted below) recorded only the first response, which may affect the comparability of those samples.
For "other" categorized under the private medical sector, see HCFPRIVOTH. For "other" categorized under "other source" or "other private source" (non-medical sector), see HCFOTHER.
Comparability - Standard DHS
HCFPUBOTH (V762BF) first appears in phase IV of the Standard DHS. It is removed in phase VI and replaced with "country specific public sector."
Comparability — Malawi [top]
For Malawi 2000, only the first response was recorded. Although the respondent may have known of some other public facility as a source for female condoms, only her first response was documented.
For Malawi 2010, interviewers were not provided with space on the survey form to record the meaning of "other" as stated by respondents.
Universe
- Benin 2011: All women age 15-49.
- Burkina Faso 2003: All women age 15-49.
- Burkina Faso 2010: All women age 15-49.
- Burundi 2010: All women age 15-49.
- Chad 2014: All women age 15-49.
- Comoros 2012: All women age 15-49.
- Congo (Democratic Republic) 2013: All women age 15-49.
- Cote d'Ivoire 2011: All women age 15-49.
- Eswatini (Swaziland) 2006: All women age 15-49.
- Ethiopia 2011: All women age 15-49.
- Gambia 2013: All women age 15-49.
- Ghana 2003: All women age 15-49.
- Ghana 2014: All women age 15-49.
- Guinea 2012: All women age 15-49.
- Kenya 2003: Women age 15-49 who know a source for female condoms.
- Kenya 2008: All women age 15-49.
- Kenya 2014: Women age 15-49 in households selected for the male interview.
- Lesotho 2004: All women age 15-49.
- Lesotho 2009: All women age 15-49.
- Lesotho 2014: All women age 15-49.
- Madagascar 2003: All women age 15-49.
- Madagascar 2008: All women age 15-49.
- Malawi 2000: All women age 15-49.
- Malawi 2010: All women age 15-49.
- Mali 2012: All women age 15-49.
- Myanmar 2015: All women age 15-49.
- Namibia 2006: All women age 15-49.
- Namibia 2013: All women age 15-64.
- Niger 2012: All women age 15-49.
- Nigeria 2003: All women age 15-49.
- Nigeria 2008: All women age 15-49.
- Nigeria 2013: All women age 15-49.
- Rwanda 2010: All women age 15-49.
- Senegal 2010: All women age 15-49.
- Senegal 2012: All women age 15-49.
- Senegal 2014: All women age 15-49.
- Senegal 2015: All women age 15-49.
- Senegal 2016: All women age 15-49.
- Sierra Leone 2008: All women age 15-49.
- Sierra Leone 2013: All women age 15-49.
- Togo 2013: All women age 15-49.
- Uganda 2001: All women age 15-49.
- Zambia 2001: All women age 15-49.
- Zambia 2007: All women age 15-49.
- Zambia 2013: All women age 15-49.
- Zimbabwe 2005: All women age 15-49.
- Zimbabwe 2010: All women age 15-49.
- Zimbabwe 2015: All women age 15-49.
Survey Text
Benin 2011
Survey form
view entire document:
text
633) (4)
Where is that? (3)
Where is that? (3)
Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.
(NAME OF PLACE(S))_________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC SECTOR (SPECIFY)______ F
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC SECTOR (SPECIFY)______ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)______ L
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)______ L
OTHER SOURCE
SHOP M
CHURCH N
FRIENDS/RELATIVES O
CHURCH N
FRIENDS/RELATIVES O
OTHER (SPECIFY)______ X
Burkina Faso 2003
Survey form
view entire document:
text
528) 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.
Any other place?
RECORD ALL SOURCES MENTIONED.
NAME OF PLACE: _____________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC (SPECIFY): __________ F
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC (SPECIFY): __________ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL (SPECIFY): ___________ L
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL (SPECIFY): ___________ L
OTHER SOURCE
SHOP M
CHURCH N
FRIENDS/RELATIVES O
OTHER (SPECIFY): ___________ X
CHURCH N
FRIENDS/RELATIVES O
OTHER (SPECIFY): ___________ X
Burkina Faso 2010
Survey form
view entire document:
text
633) (4)
Where is that? (3)
Where is that? (3)
Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.
(NAME OF PLACE(S))_________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC SECTOR (SPECIFY)______ F
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC SECTOR (SPECIFY)______ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)______ L
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)______ L
OTHER SOURCE
SHOP M
CHURCH N
FRIENDS/RELATIVES O
CHURCH N
FRIENDS/RELATIVES O
OTHER (SPECIFY)______ X
Burundi 2010
Survey form
view entire document:
text
632) Do you know of a place where a person can get female condoms?
YES 1
NO 2 (GO TO 701)
NO 2 (GO TO 701)
633) Where is that?
Any other 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)) _______
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC (SPECIFY) ______ F
GOVERNMENT HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC (SPECIFY) ______ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) ______ L
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) ______ L
OTHER SOURCE
SHOP M
CHURCH N
FRIEND/RELATIVE O
CHURCH N
FRIEND/RELATIVE O
OTHER (SPECIFY) ______ X
Chad 2014
Survey form
view entire document:
text
634) Where is that?
Any other place?
PROBE TO IDENTITY THE TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.
Any other 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))__________
PUBLIC SECTOR
HOSPITAL/MATERNITY A
MILITARY HOSPITAL/GARRISON B
HEALTH CENTER/FREE CLINIC C
POLYCLINIC D
PHARMACY OF HOSPITAL/HEALTH CENTER E
OTHER PUBLIC SECTOR (SPECIFY) F
MILITARY HOSPITAL/GARRISON B
HEALTH CENTER/FREE CLINIC C
POLYCLINIC D
PHARMACY OF HOSPITAL/HEALTH CENTER E
OTHER PUBLIC SECTOR (SPECIFY) F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL G
CLINIC/DOCTOR'S OFFICE H
CHADIAN ASSOCIATION FOR FAMILY WELL-BEING I
PRIVATE HEALTH CENTER J
BUSINESS HEALTH CENTER K
CARE OFFICE/INFIRMARY L
PHARMACY/PHARMACY DEPOT M
CHADIAN SOCIAL MARKETING ASSOCIATION N
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) O
CLINIC/DOCTOR'S OFFICE H
CHADIAN ASSOCIATION FOR FAMILY WELL-BEING I
PRIVATE HEALTH CENTER J
BUSINESS HEALTH CENTER K
CARE OFFICE/INFIRMARY L
PHARMACY/PHARMACY DEPOT M
CHADIAN SOCIAL MARKETING ASSOCIATION N
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) O
PUBLIC/PRIVATE SECTOR
PHARMACY/VILLAGE HEALTH CENTER P
OTHER
RELIGIOUS INSTITUTION Q
SHOP/BAR/MARKET R
FIRST AID WORKER S
TRAVELING VENDOR T
FRIENDS/NEIGHBORS/RELATIVES U
OTHER (SPECIFY) X
SHOP/BAR/MARKET R
FIRST AID WORKER S
TRAVELING VENDOR T
FRIENDS/NEIGHBORS/RELATIVES U
OTHER (SPECIFY) X
Comoros 2012
Survey form
view entire document:
text
633) Where is that? Any other 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))_________________
PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
SURGICAL MEDICAL CENTER C
URBAN MEDICAL CENTER D
FIELDWORKER E
COMMUNITY HEALTH CENTER F
HEALTH HUT G
COMORIAN ASSOCIATION FOR FAMILY WELL-BEING (ASCOBEF) H
NATIONAL PHARMACY (PNAC) I [##TRANSLATOR NOTE: NATIONAL, PUBLIC PHARMACY, FINANCIALLY AUTONOMOUS, BUT NON-PROFIT]
OTHER PUBLIC SECTOR (SPECIFY) J
GOVT. HEALTH CENTER B
SURGICAL MEDICAL CENTER C
URBAN MEDICAL CENTER D
FIELDWORKER E
COMMUNITY HEALTH CENTER F
HEALTH HUT G
COMORIAN ASSOCIATION FOR FAMILY WELL-BEING (ASCOBEF) H
NATIONAL PHARMACY (PNAC) I [##TRANSLATOR NOTE: NATIONAL, PUBLIC PHARMACY, FINANCIALLY AUTONOMOUS, BUT NON-PROFIT]
OTHER PUBLIC SECTOR (SPECIFY) J
PRIVATE MEDICAL SECTOR
PRIVATE CLINIC K
PRIVATE PHARMACY L
PRIVATE DOCTOR M
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) N
PRIVATE PHARMACY L
PRIVATE DOCTOR M
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) N
OTHER SOURCE
SHOP O
FRIENDS/RELATIVES P
FRIENDS/RELATIVES P
OTHER (SPECIFY) X
Congo (Democratic Republic) 2013
Survey form
view entire document:
text
632) Do you know of a place where a person can get female condoms?
YES 1
NO 2 (GO TO 701)
NO 2 (GO TO 701)
633) Where is that? Any other 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)) ____
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
FAMILY PLANNING CLINIC B
GOVERNMENT HEALTH CENTER C
FAMILY PLANNING CLINIC D
COMMUNITY LIAISON E
OTHER PUBLIC SECTOR (SPECIFY) F
FAMILY PLANNING CLINIC B
GOVERNMENT HEALTH CENTER C
FAMILY PLANNING CLINIC D
COMMUNITY LIAISON E
OTHER PUBLIC SECTOR (SPECIFY) F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
NGO I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) L
PHARMACY H
NGO I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) L
OTHER SOURCE
SHOP M
BAR/NIGHTCLUB N
KIOSK O
TABLIER P
FRIEND/ACQUAINTANCE/RELATIVES Q
BAR/NIGHTCLUB N
KIOSK O
TABLIER P
FRIEND/ACQUAINTANCE/RELATIVES Q
OTHER (SPECIFY) X
Cote d'Ivoire 2011
Survey form
view entire document:
text
633) (4)
Where is that? (3)
Where is that? (3)
Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.
(NAME OF PLACE(S))_________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC SECTOR (SPECIFY)______ F
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC SECTOR (SPECIFY)______ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)______ L
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)______ L
OTHER SOURCE
SHOP M
CHURCH N
FRIENDS/RELATIVES O
CHURCH N
FRIENDS/RELATIVES O
OTHER (SPECIFY)______ X
Eswatini (Swaziland) 2006
Survey form
view entire document:
text
646) Where is that? Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE(S). IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.
PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE(S). IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.
(NAME OF PLACE(S))___________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
PHU/CLINIC C
MOBILE CLINIC D
RHM/CBD E
OTHER PUBLIC (SPECIFY)_________F
GOVERNMENT HEALTH CENTER B
PHU/CLINIC C
MOBILE CLINIC D
RHM/CBD E
OTHER PUBLIC (SPECIFY)_________F
PRIVATE SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
CBD K
OTHER PRIVATE (SPECIFY)_______L
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
CBD K
OTHER PRIVATE (SPECIFY)_______L
MISSION
HOSPITAL M
OTHER MISSION (SPECIFY)________O
OTHER MISSION (SPECIFY)________O
NGO
FLAS P
OTHER NGO (SPECIFY)__________Q
OTHER NGO (SPECIFY)__________Q
OTHER SOURCE
SHOP R
CHURCH S
FRIENDS/RELATIVES T
OTHER (SPECIFY)_______X
CHURCH S
FRIENDS/RELATIVES T
OTHER (SPECIFY)_______X
Ethiopia 2011
Survey form
view entire document:
text
633. Where is that? Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE. IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR WRITE THE NAME OF THE PLACE.
NAME OF PLACE(S) _______
PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
GOVT. HEALTH STATION/CLINIC C
GOVT. HEALTH POST/HEW D
OTHER PUBLIC (SPECIFY) _____ E
GOVT. HEALTH CENTER B
GOVT. HEALTH STATION/CLINIC C
GOVT. HEALTH POST/HEW D
OTHER PUBLIC (SPECIFY) _____ E
NGO
NGO HEALTH FACILITY F
VOLUNTARY COMMUNITY HEALTH WORKERS G
OTHER NGO (SPECIFY) _____ H
VOLUNTARY COMMUNITY HEALTH WORKERS G
OTHER NGO (SPECIFY) _____ H
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL I
PRIVATE CLINIC J
PHARMACY K
ANTI-AIDS CLUB/ASSOCIATION L
OTHER PRIVATE MEDICAL (SPECIFY) _____ M
PRIVATE CLINIC J
PHARMACY K
ANTI-AIDS CLUB/ASSOCIATION L
OTHER PRIVATE MEDICAL (SPECIFY) _____ M
OTHER SOURCE
DRUG VENDOR/STORE N
SHOP/BAR/HOTEL/GROCERY O
FRIEND/RELATIVE P
SHOP/BAR/HOTEL/GROCERY O
FRIEND/RELATIVE P
OTHER (SPECIFY) ______ X
Gambia 2013
Survey form
view entire document:
text
633) Where is that? Any other place? PROBE TO IDENTIFY EACH TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE NAME OF THE PLACE.
(NAME OF PLACE(S)) _________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
FAMILY PLANNING CLINIC C
FIELDWORKER E
OTHER PUBLIC SECTOR (SPECIFY) __________ F
GOVERNMENT HEALTH CENTER B
FAMILY PLANNING CLINIC C
FIELDWORKER E
OTHER PUBLIC SECTOR (SPECIFY) __________ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
FIELDWORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) ________ L
PHARMACY H
PRIVATE DOCTOR I
FIELDWORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) ________ L
NGO MEDICAL SECTOR
NGO HOSPITAL/CLINIC M
NGO MOBILE CLINIC N
OTHER NGO MEDICAL SECTOR (SPECIFY) _________ O
NGO MOBILE CLINIC N
OTHER NGO MEDICAL SECTOR (SPECIFY) _________ O
OTHER SOURCE
SHOP P
FRIENDS/RELATIVES R
FRIENDS/RELATIVES R
OTHER (SPECIFY) ________ X
Survey form
view entire document:
text
633) Where is that? Any other place? PROBE TO IDENTIFY EACH TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE NAME OF THE PLACE.
(NAME OF PLACE(S)) _________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
FAMILY PLANNING CLINIC C
FIELDWORKER E
OTHER PUBLIC SECTOR (SPECIFY) __________ F
GOVERNMENT HEALTH CENTER B
FAMILY PLANNING CLINIC C
FIELDWORKER E
OTHER PUBLIC SECTOR (SPECIFY) __________ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
FIELDWORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) ________ L
PHARMACY H
PRIVATE DOCTOR I
FIELDWORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) ________ L
NGO MEDICAL SECTOR
NGO HOSPITAL/CLINIC M
NGO MOBILE CLINIC N
OTHER NGO MEDICAL SECTOR (SPECIFY) _________ O
NGO MOBILE CLINIC N
OTHER NGO MEDICAL SECTOR (SPECIFY) _________ O
OTHER SOURCE
SHOP P
FRIENDS/RELATIVES R
FRIENDS/RELATIVES R
OTHER (SPECIFY) ________ X
Ghana 2003
Survey form
view entire document:
text
528) 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.
Any other place?
RECORD ALL SOURCES MENTIONED.
NAME OF PLACE: _____________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC (SPECIFY): __________ F
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC (SPECIFY): __________ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL (SPECIFY): ___________ L
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL (SPECIFY): ___________ L
OTHER SOURCE
SHOP M
CHURCH N
FRIENDS/RELATIVES O
OTHER (SPECIFY): ___________ X
CHURCH N
FRIENDS/RELATIVES O
OTHER (SPECIFY): ___________ X
Ghana 2014
Survey form
view entire document:
text
633) (4)
Where is that? (3)
Where is that? (3)
Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.
(NAME OF PLACE(S))_________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC SECTOR (SPECIFY)______ F
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC SECTOR (SPECIFY)______ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)______ L
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)______ L
OTHER SOURCE
SHOP M
CHURCH N
FRIENDS/RELATIVES O
CHURCH N
FRIENDS/RELATIVES O
OTHER (SPECIFY)______ X
Guinea 2012
Survey form
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633) (4)
Where is that? (3)
Where is that? (3)
Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.
(NAME OF PLACE(S))_________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC SECTOR (SPECIFY)______ F
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC SECTOR (SPECIFY)______ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)______ L
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)______ L
OTHER SOURCE
SHOP M
CHURCH N
FRIENDS/RELATIVES O
CHURCH N
FRIENDS/RELATIVES O
OTHER (SPECIFY)______ X
Kenya 2003
Survey form
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528) Where is that? Any other 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.
RECORD ALL SOURCES MENTIONED.
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 SOURCES MENTIONED.
NAME OF PLACE________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC (SPECIFY) ______ F
GOVERNMENT HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC (SPECIFY) ______ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL (SPECIFY) _______ L
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL (SPECIFY) _______ L
OTHER SOURCE
SHOP M
CHURCH N
FRIENDS/RELATIVES O
CHURCH N
FRIENDS/RELATIVES O
OTHER (SPECIFY) _______ X
Kenya 2008
Survey form
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645 Where is that? (5)
Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE(S).
IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.
Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE(S).
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
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC (SPECIFY) ____________ F
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC (SPECIFY) ____________ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL (SPECIFY) __________ L
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL (SPECIFY) __________ L
OTHER SOURCE
SHOP M
CHURCH N
FRIEND/RELATIVE O
OTHER (SPECIFY) __________ X
CHURCH N
FRIEND/RELATIVE O
OTHER (SPECIFY) __________ X
Kenya 2014
Survey form
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633) (4)
Where is that? (3)
Where is that? (3)
Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.
(NAME OF PLACE(S))_________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC SECTOR (SPECIFY)______ F
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC SECTOR (SPECIFY)______ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)______ L
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)______ L
OTHER SOURCE
SHOP M
CHURCH N
FRIENDS/RELATIVES O
CHURCH N
FRIENDS/RELATIVES O
OTHER (SPECIFY)______ X
Lesotho 2004
Survey form
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528) 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.
Any other place?
RECORD ALL SOURCES MENTIONED.
NAME OF PLACE: _____________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC (SPECIFY): __________ F
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC (SPECIFY): __________ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL (SPECIFY): ___________ L
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL (SPECIFY): ___________ L
OTHER SOURCE
SHOP M
CHURCH N
FRIENDS/RELATIVES O
OTHER (SPECIFY): ___________ X
CHURCH N
FRIENDS/RELATIVES O
OTHER (SPECIFY): ___________ X
Lesotho 2009
Survey form
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645Where is that? Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.
PROBE TO IDENTIFY EACH 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(S)) __________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVT. HEALTH CENTER B
OTHER PUBLIC SECTOR C
GOVT. HEALTH CENTER B
OTHER PUBLIC SECTOR C
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC D
LPPA E
PHARMACY F
PRIVATE DOCTOR G
OTHER MEDICAL SECTOR H
LPPA E
PHARMACY F
PRIVATE DOCTOR G
OTHER MEDICAL SECTOR H
CHAL
CHAL HOSPITAL I
CHAL HEALTH CENTER J
CHAL HEALTH POST K
CHAL HEALTH CENTER J
CHAL HEALTH POST K
CBD L
COMMUNITY HEALTH WORKER/
SUPPORT GROUPS M
COMMUNITY HEALTH WORKER/
SUPPORT GROUPS M
OTHER SOURCE
SHOP N
CHURCH O
FRIENDS/RELATIVES P
PEER EDUCATORS Q
OTHER X
CHURCH O
FRIENDS/RELATIVES P
PEER EDUCATORS Q
OTHER X
Lesotho 2014
Survey form
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632) Do you know of a place where a person can get female condoms?
YES 1
NO 2 (GO TO 701)
NO 2 (GO TO 701)
633) Where is that? Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.
NAME OF PLACE (S) ____
PUBLIC SECTOR
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
GOVERNMENT HEALTH POST C
FAMILY PLANNING CLINIC D
OTHER PUBLIC SECTOR (SPECIFY) ____ E
GOVERNMENT HEALTH CENTER B
GOVERNMENT HEALTH POST C
FAMILY PLANNING CLINIC D
OTHER PUBLIC SECTOR (SPECIFY) ____ E
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC F
PRIVATE DOCTOR H
LESOTHO PLANNED PARENTHOOD I
PSI/NEW START CENTER J
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) ____ K
PRIVATE DOCTOR H
LESOTHO PLANNED PARENTHOOD I
PSI/NEW START CENTER J
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) ____ K
CHAL
CHAL HOSPITAL L
CHAL HEALTH CENTER M
CHAL HEALTH POST N
CHAL HEALTH CENTER M
CHAL HEALTH POST N
RED CROSS HEALTH CENTER O
CBD P
VILLAGE HEALTH WORKER Q
SUPPORT GROUPS R
FACILITY OUTSIDE OF LESOTHO S
OTHER SOURCE
CBD P
VILLAGE HEALTH WORKER Q
SUPPORT GROUPS R
FACILITY OUTSIDE OF LESOTHO S
OTHER SOURCE
SHOP T
CHURCH U
PEER EDUCATORS V
FRIEND/RELATIVE W
CHURCH U
PEER EDUCATORS V
FRIEND/RELATIVE W
OTHER (SPECIFY) ____ X
Madagascar 2003
Survey form
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528) 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.
Any other place?
RECORD ALL SOURCES MENTIONED.
NAME OF PLACE: _____________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC (SPECIFY): __________ F
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC (SPECIFY): __________ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL (SPECIFY): ___________ L
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL (SPECIFY): ___________ L
OTHER SOURCE
SHOP M
CHURCH N
FRIENDS/RELATIVES O
OTHER (SPECIFY): ___________ X
CHURCH N
FRIENDS/RELATIVES O
OTHER (SPECIFY): ___________ X
Madagascar 2008
Survey form
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644. Do you know of a place where a person can get female condoms?
YES 1
NO 2 (GO TO 701)
NO 2 (GO TO 701)
645. Where is that?
Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE(S). 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
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
PF CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC PLACE (SPECIFY) ______ F
GOVERNMENT HEALTH CENTER B
PF CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC PLACE (SPECIFY) ______ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
HEALTH WORKER K
OTHER PRIVATE MEDICAL (SPECIFY) _______ L
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
HEALTH WORKER K
OTHER PRIVATE MEDICAL (SPECIFY) _______ L
OTHER LOCATION
STORE M
RELIGIOUS INSTITUTION N
FRIENDS/RELATIVES O
RELIGIOUS INSTITUTION N
FRIENDS/RELATIVES O
OTHER (SPECIFY) _______ X
Malawi 2000
Survey form
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528. Where is that?
RECORD FIRST RESPONSE ONLY.
RECORD FIRST RESPONSE ONLY.
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
FIELD WORKER 15
OTHER PUBLIC (SPECIFY) _____ 16
GOVERNMENT HEALTH CENTER 12
FAMILY PLANNING CLINIC 13
MOBILE CLINIC 14
FIELD WORKER 15
OTHER PUBLIC (SPECIFY) _____ 16
MISSION
HOSPITAL 21
HEALTH CENTER 22
MOBILE CLINIC 23
HEALTH CENTER 22
MOBILE CLINIC 23
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31
PHARMACY 32
PRIVATE DOCTOR 33
MOBILE CLINIC 34
FIELD WORKER 35
OTHER PRIVATE MEDICAL (SPECIFY) ____ 36
PHARMACY 32
PRIVATE DOCTOR 33
MOBILE CLINIC 34
FIELD WORKER 35
OTHER PRIVATE MEDICAL (SPECIFY) ____ 36
BLM 41
OTHER SOURCE
SHOP 51
CHURCH 52
FRIEND/RELATIVE 53
CHURCH 52
FRIEND/RELATIVE 53
OTHER (SPECIFY) _____ 96
Malawi 2010
Survey form
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645. Where is that? Anywhere else?
PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE
CODE(S). IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.
PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE
CODE(S). IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.
NAME OF PLACE(S)____________________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
GOVERNMENT HEALTH POST/OUTREACH C
MOBILE CLINIC D
HSA E
CBDA/DOOR TO DOOR F
OTHER PUBLIC G
GOVERNMENT HEALTH CENTER B
GOVERNMENT HEALTH POST/OUTREACH C
MOBILE CLINIC D
HSA E
CBDA/DOOR TO DOOR F
OTHER PUBLIC G
CHAM/MISSION
HOSPITAL H
HEALTH CENTER I
MOBILE CLINIC J
DOOR TO DOOR K
HEALTH CENTER I
MOBILE CLINIC J
DOOR TO DOOR K
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR L
PHARMACY M
MOBILE CLINIC N
CBDA/DOOR TO DOOR O
OTHER PRIVATE MEDICAL P
PHARMACY M
MOBILE CLINIC N
CBDA/DOOR TO DOOR O
OTHER PRIVATE MEDICAL P
BLM Q
MACRO R
YOUTH DROP IN CENTRE S
MACRO R
YOUTH DROP IN CENTRE S
OTHER SOURCE
SHOP T
CHURCH U
FRIEND/RELATIVE V
CHURCH U
FRIEND/RELATIVE V
OTHER X
Mali 2012
Survey form
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633) (4)
Where is that? (3)
Where is that? (3)
Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.
(NAME OF PLACE(S))_________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC SECTOR (SPECIFY)______ F
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC SECTOR (SPECIFY)______ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)______ L
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)______ L
OTHER SOURCE
SHOP M
CHURCH N
FRIENDS/RELATIVES O
CHURCH N
FRIENDS/RELATIVES O
OTHER (SPECIFY)______ X
Myanmar 2015
Survey form
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632) Do you know of a place where a person can get female condoms?
YES 1
NO 2 (SKIP TO 701)
NO 2 (SKIP TO 701)
Namibia 2006
Survey form
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text
645 Where is that?
Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE(S).
IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE
THE NAME OF THE PLACE.
Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE(S).
IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE
THE NAME OF THE PLACE.
(NAME OF PLACE(S))___________
PUBLIC SECTOR
GVT. HOSPITAL A
GOVT. HEALTH CENTER/CLINIC B
PHC CLINIC (MOBILE) C
COMM. HEALTH WORKER D
OTHER PUBLIC (SPECIFY) ____ E
GOVT. HEALTH CENTER/CLINIC B
PHC CLINIC (MOBILE) C
COMM. HEALTH WORKER D
OTHER PUBLIC (SPECIFY) ____ E
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC F
PHARMACY G
PRIVATE DOCTOR H
OTHER PRIVATE MEDICAL (SPECIFY) ____ I
PHARMACY G
PRIVATE DOCTOR H
OTHER PRIVATE MEDICAL (SPECIFY) ____ I
OTHER SOURCE
SHOP J
CHURCH/SCHOOL K
FRIENDS/RELATIVES L
TRAD. BIRTH ATTENDANT M
TRAD. HEALER N
OTHER _____ X
CHURCH/SCHOOL K
FRIENDS/RELATIVES L
TRAD. BIRTH ATTENDANT M
TRAD. HEALER N
OTHER _____ X
Namibia 2013
Survey form
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632) Do you know of a place where a person can get female condoms?
YES 1
NO 2 (GO TO 701A)
NO 2 (GO TO 701A)
633) Where is that? Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE HTE NAME OF THE PLACE.
(NAME OF PLACE(S)) __________
PUBLIC SECTOR
GOVT HOSPITAL A
GOVT HEALTH CENTER B
GVT PRIMARY HEALTH CARE CLINIC C
OUTREACH POINT D
MOBILE CLINIC E
FIELDWORKER/COMMUNITY HEALTH CARE PROVIDER F
OTHER PUBLIC SECTOR (SPECIFY __________) G
GOVT HEALTH CENTER B
GVT PRIMARY HEALTH CARE CLINIC C
OUTREACH POINT D
MOBILE CLINIC E
FIELDWORKER/COMMUNITY HEALTH CARE PROVIDER F
OTHER PUBLIC SECTOR (SPECIFY __________) G
PRIVATE MEDICAL CENTER
PRIVATE HOSPITAL H
PRIVATE CLINIC I
PHARMACY J
PRIVATE DOCTOR K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY __________) L
PRIVATE CLINIC I
PHARMACY J
PRIVATE DOCTOR K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY __________) L
OTHER SOURCE
SHOP M
FRIEND/RELATIVE N
SCHOOL O
FRIEND/RELATIVE N
SCHOOL O
OTHER (SPECIFY __________) X
Niger 2012
Survey form
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text
633) (4)
Where is that? (3)
Where is that? (3)
Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.
(NAME OF PLACE(S))_________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC SECTOR (SPECIFY)______ F
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC SECTOR (SPECIFY)______ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)______ L
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)______ L
OTHER SOURCE
SHOP M
CHURCH N
FRIENDS/RELATIVES O
CHURCH N
FRIENDS/RELATIVES O
OTHER (SPECIFY)______ X
Nigeria 2003
Survey form
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text
528) 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.
Any other place?
RECORD ALL SOURCES MENTIONED.
NAME OF PLACE: _____________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC (SPECIFY): __________ F
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC (SPECIFY): __________ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL (SPECIFY): ___________ L
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL (SPECIFY): ___________ L
OTHER SOURCE
SHOP M
CHURCH N
FRIENDS/RELATIVES O
OTHER (SPECIFY): ___________ X
CHURCH N
FRIENDS/RELATIVES O
OTHER (SPECIFY): ___________ X
Nigeria 2008
Survey form
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text
645 Where is that? (5)
Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE(S).
IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.
Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE(S).
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
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC (SPECIFY) ____________ F
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC (SPECIFY) ____________ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL (SPECIFY) __________ L
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL (SPECIFY) __________ L
OTHER SOURCE
SHOP M
CHURCH N
FRIEND/RELATIVE O
OTHER (SPECIFY) __________ X
CHURCH N
FRIEND/RELATIVE O
OTHER (SPECIFY) __________ X
Nigeria 2013
Survey form
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text
633) (4)
Where is that? (3)
Where is that? (3)
Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.
(NAME OF PLACE(S))_________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC SECTOR (SPECIFY)______ F
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC SECTOR (SPECIFY)______ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)______ L
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)______ L
OTHER SOURCE
SHOP M
CHURCH N
FRIENDS/RELATIVES O
CHURCH N
FRIENDS/RELATIVES O
OTHER (SPECIFY)______ X
Rwanda 2010
Survey form
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633) Where is that? Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.
NAME OF PLACE(S)
PUBLIC SECTOR
REFERAL HOSPITAL A
DISTRICT HOSPITAL B
HEALTH CENTER C
HEALTH POST D
OUTREACH E
COMMUNITY HEALTH WORKER F
OTHER PUBLIC HEALTH FACILITY (SPECIFY) G
DISTRICT HOSPITAL B
HEALTH CENTER C
HEALTH POST D
OUTREACH E
COMMUNITY HEALTH WORKER F
OTHER PUBLIC HEALTH FACILITY (SPECIFY) G
PRIVATE MEDICAL SECTOR
POLYCLINIC H
CLINIC I
DISPENSARY J
PHARMACY K
FAMILY PLANNING CLINIC L
OTHER PRIVATE MEDICAL FACILITY (SPECIFY) M
CLINIC I
DISPENSARY J
PHARMACY K
FAMILY PLANNING CLINIC L
OTHER PRIVATE MEDICAL FACILITY (SPECIFY) M
OTHER SOURCE
KIOSK N
TRADITIONAL BIRTH ATTENDANT O
FRIEND/RELATIVE P
TRADITIONAL BIRTH ATTENDANT O
FRIEND/RELATIVE P
OTHER (SPECIFY) X
Senegal 2010
Survey form
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632. Do you know of a place where a person can get female condoms?
YES 1
NO 2 (GO TO 701)
NO 2 (GO TO 701)
633. Where is that?
Any other 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) ______
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
HEALTH POST C
GOVERNMENT FAMILY PLANNING CLINIC D
RURAL MATERNITY CENTER E
BASIC HEALTH CARE CENTER F
COMMUNITY PHARMACY G
MOBILE CLINIC H
OTHER PUBLIC (SPECIFY) _____ I
GOVERNMENT HEALTH CENTER B
HEALTH POST C
GOVERNMENT FAMILY PLANNING CLINIC D
RURAL MATERNITY CENTER E
BASIC HEALTH CARE CENTER F
COMMUNITY PHARMACY G
MOBILE CLINIC H
OTHER PUBLIC (SPECIFY) _____ I
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/OFFICE J
PHARMACY K
PRIVATE DOCTOR L
RELIGIOUS DISPENSARY M
OTHER PRIVATE MEDICAL (SPECIFY) _____ N
PHARMACY K
PRIVATE DOCTOR L
RELIGIOUS DISPENSARY M
OTHER PRIVATE MEDICAL (SPECIFY) _____ N
OTHER SOURCE
SHOP O
CHURCH P
FRIEND/RELATIVES Q
BAR R
CHURCH P
FRIEND/RELATIVES Q
BAR R
OTHER (SPECIFY) _____ X
Senegal 2012
Survey form
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632) Do you know of a place where a person can get female condoms?
YES 1
NO 2 (GO TO 701)
NO 2 (GO TO 701)
633) Where is that?
Any other 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)) ____________
PUBLIC SECTOR
A GOVT. HOSPITAL
B GOVT. HEALTH CENTER
C HEALTH POST
D GOVT. FAMILY PLANNING CENTER
E RURAL MATERNITY
F HEALTH HUT
G COMMUNITY PHARMACY
H MOBILE CLINIC
I OTHER PUBLIC SECTOR (SPECIFY)
B GOVT. HEALTH CENTER
C HEALTH POST
D GOVT. FAMILY PLANNING CENTER
E RURAL MATERNITY
F HEALTH HUT
G COMMUNITY PHARMACY
H MOBILE CLINIC
I OTHER PUBLIC SECTOR (SPECIFY)
PRIVATE MEDICAL SECTOR
J PRIVATE HOSPITAL/CLINIC/OFFICE
K PHARMACY
L PRIVATE DOCTOR
M RELIGIOUS FREE CLINIC
N OTHER PRIVATE MEDICAL SECTOR (SPECIFY)
K PHARMACY
L PRIVATE DOCTOR
M RELIGIOUS FREE CLINIC
N OTHER PRIVATE MEDICAL SECTOR (SPECIFY)
OTHER SOURCE
O SHOP
P CHURCH
Q FRIENDS/RELATIVES
R BAR
P CHURCH
Q FRIENDS/RELATIVES
R BAR
X OTHER (SPECIFY)
Senegal 2014
Survey form
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632) Do you know of a place where a person can get female condoms?
YES 1
NO 2 (GO TO 701)
NO 2 (GO TO 701)
633) Where is that?
Any other 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)_____________
PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
HEALTH POST C
GOVT. FAMILY PLANNING CENTER D
RURAL MATERNITY E
HEALTH HUT F
COMMUNITY PHARMACY G
MOBILE CLINIC H
OTHER PUBLIC SECTOR (SPECIFY) I
GOVT. HEALTH CENTER B
HEALTH POST C
GOVT. FAMILY PLANNING CENTER D
RURAL MATERNITY E
HEALTH HUT F
COMMUNITY PHARMACY G
MOBILE CLINIC H
OTHER PUBLIC SECTOR (SPECIFY) I
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/OFFICE J
PHARMACY K
PRIVATE DOCTOR L
RELIGIOUS FREE CLINIC M
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) N
PHARMACY K
PRIVATE DOCTOR L
RELIGIOUS FREE CLINIC M
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) N
OTHER SOURCE
SHOP O
CHURCH P
FRIENDS/RELATIVES Q
BAR R
CHURCH P
FRIENDS/RELATIVES Q
BAR R
OTHER (SPECIFY) X
Senegal 2015
Survey form
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633) Where is that?
Any other place?
PROBE TO IDENTITY THE TYPE OF SOURCE. IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.
Any other 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)) ______
PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
HEALTH POST C
GOVT. FAMILY PLANNING CENTER D
RURAL MATERNITY E
HEALTH HUT F
COMMUNITY PHARMACY G
MOBILE CLINIC H
OTHER PUBLIC SECTOR (SPECIFY) ____ I
GOVT. HEALTH CENTER B
HEALTH POST C
GOVT. FAMILY PLANNING CENTER D
RURAL MATERNITY E
HEALTH HUT F
COMMUNITY PHARMACY G
MOBILE CLINIC H
OTHER PUBLIC SECTOR (SPECIFY) ____ I
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/OFFICE J
PHARMACY K
PRIVATE DOCTOR L
RELIGIOUS FREE CLINIC M
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) _____ N
PHARMACY K
PRIVATE DOCTOR L
RELIGIOUS FREE CLINIC M
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) _____ N
OTHER SOURCE
SHOP O
CHURCH P
FRIENDS/RELATIVES Q
BAR R
OTHER (SPECIFY) _____ X
CHURCH P
FRIENDS/RELATIVES Q
BAR R
OTHER (SPECIFY) _____ X
Senegal 2016
Survey form
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316) You first started using (CURRENT METHOD) in (DATE FROM 309). Where did you get it at that time?
PROBE TO IDENTIFY THE TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE 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) _______
PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
HEALTH POST 13
GOVERNMENT FAMILY PLANNING CENTER 14
RURAL MATERNITY 15
HEALTH HUT 16
COMMUNITY PHARMACY 17
MOBILE CLINIC 18
OTHER PUBLIC SECTOR (SPECIFY) ____ 19
GOVERNMENT HEALTH CENTER 12
HEALTH POST 13
GOVERNMENT FAMILY PLANNING CENTER 14
RURAL MATERNITY 15
HEALTH HUT 16
COMMUNITY PHARMACY 17
MOBILE CLINIC 18
OTHER PUBLIC SECTOR (SPECIFY) ____ 19
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/OFFICE 21/22
PHARMACY 23
PRIVATE DOCTOR 24
RELIGIOUS FREE CLINIC 25
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) ____ 26
PHARMACY 23
PRIVATE DOCTOR 24
RELIGIOUS FREE CLINIC 25
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) ____ 26
OTHER SOURCE
SHOP 31
CHURCH 32
FRIENDS/RELATIVES 33
BAR 34
OTHER (SPECIFY) _____ 96
CHURCH 32
FRIENDS/RELATIVES 33
BAR 34
OTHER (SPECIFY) _____ 96
Sierra Leone 2008
Survey form
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644) Do you know of a place where a person can get female condoms?
YES 1
NO 2 (GO TO 701)
NO 2 (GO TO 701)
645) Where is that? Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE(S).
IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.
(NAME OF PLACE(S))_________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC (SPECIFY)_______F
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC (SPECIFY)_______F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVARE MEDICAL (SPECIFY)_______L
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVARE MEDICAL (SPECIFY)_______L
OTHER SOURCE
SHOP M
CHURCH N
FRIENDS/RELATIVES O
CHURCH N
FRIENDS/RELATIVES O
OTHER (SPECIFY)_________X
Sierra Leone 2013
Survey form
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632) Do you know of a place where a person can get female condoms?
YES 1
NO 2 (GO TO 701)
NO 2 (GO TO 701)
633) Where is that? Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE. IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.
NAME OF PLACE __________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
OUTREACH WORKER E
OTHER PUBLIC SECTOR (SPECIFY __________) F
GOVERNMENT HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
OUTREACH WORKER E
OTHER PUBLIC SECTOR (SPECIFY __________) F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
OUTREACH WORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY __________) L
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
OUTREACH WORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY __________) L
OTHER SOURCE
SHOP M
CHURCH N
FRIENDS/RELATIVES O
CHURCH N
FRIENDS/RELATIVES O
OTHER (SPECIFY __________) X
Togo 2013
Survey form
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632) (4) Do you know of a place where a person can get female condoms?
YES 1
NO 2 (GO TO 701)
NO 2 (GO TO 701)
633) (4)
Where is that? (3)
Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.
(NAME OF PLACE(S))_________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC SECTOR (SPECIFY)______ F
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC SECTOR (SPECIFY)______ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)______ L
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)______ L
OTHER SOURCE
SHOP M
CHURCH N
FRIENDS/RELATIVES O
CHURCH N
FRIENDS/RELATIVES O
OTHER (SPECIFY)______ X
Uganda 2001
Survey form
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528) 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.
Any other place?
RECORD ALL SOURCES MENTIONED.
NAME OF PLACE: _____________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC (SPECIFY): __________ F
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC (SPECIFY): __________ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL (SPECIFY): ___________ L
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL (SPECIFY): ___________ L
OTHER SOURCE
SHOP M
CHURCH N
FRIENDS/RELATIVES O
OTHER (SPECIFY): ___________ X
CHURCH N
FRIENDS/RELATIVES O
OTHER (SPECIFY): ___________ X
Zambia 2001
Survey form
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528. Do you know of a place where a person can get female condoms?
YES 1
NO 2 (GO TO 530)
NO 2 (GO TO 530)
529. Where is that? Any other 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. RECORD ALL SOURCES MENTIONED.
(NAME OF PLACE) ____________
PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
GOVT. HEALTH POST C
OTHER PUBLIC (SPECIFY) ______ D
GOVT. HEALTH CENTER B
GOVT. HEALTH POST C
OTHER PUBLIC (SPECIFY) ______ D
PRIVATE MEDICAL SECTOR
PVT. HOSPITAL/SURGERY E
MISSION HOSPITAL/CLINIC F
PHARMACY G
PRIVATE DOCTOR H
OTHER PRIVATE MEDICAL (SPECIFY) ______ I
MISSION HOSPITAL/CLINIC F
PHARMACY G
PRIVATE DOCTOR H
OTHER PRIVATE MEDICAL (SPECIFY) ______ I
OTHER SOURCE
SHOP J
COMMUNITY-BASED AGENT/HEALTH WORKER K
FRIEND/RELATIVE L
SCHOOL M
BAR, HOTEL N
COMMUNITY-BASED AGENT/HEALTH WORKER K
FRIEND/RELATIVE L
SCHOOL M
BAR, HOTEL N
OTHER (SPECIFY) _______________ X
Zambia 2007
Survey form
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645 Where is that? (5)
Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE(S).
IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.
Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE(S).
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
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC (SPECIFY) ____________ F
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC (SPECIFY) ____________ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL (SPECIFY) __________ L
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL (SPECIFY) __________ L
OTHER SOURCE
SHOP M
CHURCH N
FRIEND/RELATIVE O
OTHER (SPECIFY) __________ X
CHURCH N
FRIEND/RELATIVE O
OTHER (SPECIFY) __________ X
Zambia 2013
Survey form
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text
632) (4) Do you know of a place where a person can get female condoms?
YES 1
NO 2 (GO TO 701)
NO 2 (GO TO 701)
633) (4)
Where is that? (3)
Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.
(NAME OF PLACE(S))_________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC SECTOR (SPECIFY)______ F
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC SECTOR (SPECIFY)______ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)______ L
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)______ L
OTHER SOURCE
SHOP M
CHURCH N
FRIENDS/RELATIVES O
CHURCH N
FRIENDS/RELATIVES O
OTHER (SPECIFY)______ X
Zimbabwe 2005
Survey form
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text
645 Where is that? (5)
Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE(S).
IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.
Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE(S).
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
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC (SPECIFY) ____________ F
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC (SPECIFY) ____________ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL (SPECIFY) __________ L
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL (SPECIFY) __________ L
OTHER SOURCE
SHOP M
CHURCH N
FRIEND/RELATIVE O
OTHER (SPECIFY) __________ X
CHURCH N
FRIEND/RELATIVE O
OTHER (SPECIFY) __________ X
Zimbabwe 2010
Survey form
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text
633) (4)
Where is that? (3)
Where is that? (3)
Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.
(NAME OF PLACE(S))_________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC SECTOR (SPECIFY)______ F
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC SECTOR (SPECIFY)______ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)______ L
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)______ L
OTHER SOURCE
SHOP M
CHURCH N
FRIENDS/RELATIVES O
CHURCH N
FRIENDS/RELATIVES O
OTHER (SPECIFY)______ X