Literal question
441. Where did you get the condom the last time?
PROBE TO IDENTIFY TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.
(NAME OF PLACE) ______________
PUBLIC SECTOR
GOVT. HOSPITAL/POLYCLINIC 11
GOVT. HEALTH CENTER 12
GOVT. HEALTH POST/CHPS 13
FAMILY PLANNING CLINIC 14
MOBILE CLINIC 15
FIELDWORKER/OUTREACH/PEER EDUCATOR 16
OTHER PUBLIC (SPECIFY) ____ 17
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 20
PRIVATE DOCTOR 21
PHARMACY 22
CHEMICAL/DRUG STORE 23
FP/PPAG CLINIC 24
MATERNITY HOME 25
OTHER PRIVATE MEDICAL (SPECIFY) _____ 26
OTHER SOURCE
SHOP/MARKET 31
CHURCH 32
COMMUNITY VOLUNTEER 33
FRIEND/RELATIVE 34
OTHER (SPECIFY) _____ 96
DON'T KNOW 98