Literal question
523) Where did you ask for advice or seek treatment?
Anywhere else?
PROBE TO IDENTIFY THE TYPE OF EACH SOURCE AND CIRCLE THE APPROPRIATE CODE(S).
IF UNABLE TO DETERMINE IF THE HOSPITAL, HEALTH CENTER, OR CLINIC IS PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.
NAME OF PLACE: ___
PUBLIC SECTOR
HOSPITAL A
HEALTH CENTER/INTEGRATED HEALTH CENTER/DISPENSARY/
MOTHER AND CHILD CARE CENTER B
HEALTH WORKER C
OTHER PUBLIC (SPECIFY): ___ D
PRIVATE MEDICAL SECTOR
PRIVATE RELIGIOUS HOSPITAL E
PRIVATE SECULAR HOSPITAL/CLINIC F
HEALTH CENTER/RELIGIOUS DISPENSARY/MISSION G
MEDICAL OFFICE H
PHARMACY I
OTHER PRIVATE MEDICAL (SPECIFY): ___ J
OTHER PLACE
INFORMAL MEDICATION VENDOR K
TRADITIONAL HEALER L
NONPROFIT HEALTH COOPERATIVE M
SHOP N
COMMUNITY HEALTH POST O
OTHER SOURCE (SPECIFY): ___ X
*****
523) Where did you ask for advice or seek treatment?
Anywhere else?
PROBE TO IDENTIFY THE TYPE OF EACH SOURCE AND CIRCLE THE APPROPRIATE CODE(S).
IF UNABLE TO DETERMINE IF THE HOSPITAL, HEALTH CENTER, OR CLINIC IS PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.
NAME OF PLACE: ___
PUBLIC SECTOR
HOSPITAL A
HEALTH CENTER/INTEGRATED HEALTH CENTER/DISPENSARY/
MOTHER AND CHILD CARE CENTER B
HEALTH WORKER C
OTHER PUBLIC (SPECIFY): ___ D
PRIVATE MEDICAL SECTOR
PRIVATE RELIGIOUS HOSPITAL E
PRIVATE SECULAR HOSPITAL/CLINIC F
HEALTH CENTER/RELIGIOUS DISPENSARY/MISSION G
MEDICAL OFFICE H
PHARMACY I
OTHER PRIVATE MEDICAL (SPECIFY): ___ J
OTHER PLACE
INFORMAL MEDICATION VENDOR K
TRADITIONAL HEALER L
NONPROFIT HEALTH COOPERATIVE M
SHOP N
COMMUNITY HEALTH POST O
OTHER SOURCE (SPECIFY): ___ X
