Questionnaire Text

Burkina Faso 2017 Burkina Faso 2022 Congo (Democratic Republic) 2021 Kenya 2019
Burkina Faso 2018 Congo (Democratic Republic) 2020 Ethiopia 2019 Kenya 2021
Burkina Faso 2020 Congo (Democratic Republic) 2020 Kenya 2017 Niger 2022
Burkina Faso 2021 Congo (Democratic Republic) 2021 Kenya 2018 Uganda 2021
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Burkina Faso 2017
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IMP_305b. Where did you go or who attempted to remove your implant?

[] National Hospital Center
[] Health and Social Services Center (public)
[] Family planning clinic
[] Mobile clinic (public)
[] Regional Hospital Center
[] Medical Center with Surgery Unit (public)
[] Medical Center (public)
[] Fieldworker and community health volunteers (public)
[] Private hospital or clinic
[] Pharmacy
[] Private practice
[] Mobile clinic (private)
[] Maternity
[] Health Agent
[] Store/market/supermarket/mobile vendors
[] Religious organizations
[] Friend / parent
[] Self
[] Other
[] Don't know
[] No Response

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Burkina Faso 2018
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IMP_305b. Where did you go or who attempted to remove your implant?

[] National Hospital Center
[] Health and Social Services Center (public)
[] Family planning clinic
[] Mobile clinic (public)
[] Regional Hospital Center
[] Medical Center with Surgery Unit (public)
[] Medical Center (public)
[] Fieldworker and community health volunteers (public)
[] Private hospital or clinic
[] Pharmacy
[] Private practice
[] Mobile clinic (private)
[] Maternity
[] Health Agent
[] Store/market/supermarket/mobile vendors
[] Religious organizations
[] Friend / parent
[] Self
[] Other
[] Don't know
[] No Response

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Burkina Faso 2020
Questionnaire form view entire document:  text 
IMP_305b. Where did you go or who attempted to remove your implant?

[] National hospital center
[] Health and social services center (public)
[] Family planning clinic
[] Mobile clinic (public)
[] Regional hospital center
[] Medical center with surgery unit (public)
[] Medical center (public)
[] Fieldworker and community health volunteers (public)
[] Private hospital or clinic
[] Pharmacy
[] Private practice
[] Mobile clinic (private)
[] Maternity
[] Health agent
[] Store/market/supermarket/mobile vendors
[] Religious organizations
[] Community event
[] Friend / parent
[] Self
[] Other
[] Do not know
[] No response

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Burkina Faso 2021
Questionnaire form view entire document:  text 
IMP_306. Where did you go or who attempted to remove your implant?

[] National hospital center
[] Health and social services center (public)
[] Family planning clinic
[] Mobile clinic (public)
[] Regional hospital center
[] Medical center with surgery unit (public)
[] Medical center (public)
[] Fieldworker and community health volunteers (public)
[] Private hospital or clinic
[] Pharmacy
[] Private practice
[] Mobile clinic (private)
[] Maternity
[] Health agent
[] Store/market/supermarket/mobile vendors
[] Religious organizations
[] Community event
[] Friend / parent
[] Self
[] Other
[] Do not know
[] No response

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Burkina Faso 2022
Questionnaire form view entire document:  text 
IMP_306. Where did you go or who attempted to remove your implant?

[] National hospital center
[] Health and social services center (public)
[] Family planning clinic
[] Mobile clinic (public)
[] Regional hospital center
[] Medical center with surgery unit (public)
[] Medical center (public)
[] Fieldworker and community health volunteers (public)
[] Private hospital or clinic
[] Pharmacy
[] Private practice
[] Mobile clinic (private)
[] Maternity
[] Health agent
[] Store/market/supermarket/mobile vendors
[] Religious organizations
[] Community event
[] Friend / parent
[] Self
[] Other
[] Do not know
[] No response

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Congo (Democratic Republic) 2020
Questionnaire form view entire document:  text 
IMP_306. Where did you go or who attempted to remove your implant?

[] National hospital center
[] Health and social services center (public)
[] Family planning clinic
[] Mobile clinic (public)
[] Regional hospital center
[] Medical center with surgery unit (public)
[] Medical center (public)
[] Fieldworker and community health volunteers (public)
[] Private hospital or clinic
[] Pharmacy
[] Private practice
[] Mobile clinic (private)
[] Maternity
[] Health agent
[] Store/market/supermarket/mobile vendors
[] Religious organizations
[] Community event
[] Friend / parent
[] Self
[] Other
[] Do not know
[] No response

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Congo (Democratic Republic) 2020
Questionnaire form view entire document:  text 
IMP_306. Where did you go or who attempted to remove your implant?

[] National hospital center
[] Health and social services center (public)
[] Family planning clinic
[] Mobile clinic (public)
[] Regional hospital center
[] Medical center with surgery unit (public)
[] Medical center (public)
[] Fieldworker and community health volunteers (public)
[] Private hospital or clinic
[] Pharmacy
[] Private practice
[] Mobile clinic (private)
[] Maternity
[] Health agent
[] Store/market/supermarket/mobile vendors
[] Religious organizations
[] Community event
[] Friend / parent
[] Self
[] Other
[] Do not know
[] No response

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Congo (Democratic Republic) 2021
Questionnaire form view entire document:  text 
IMP_306. Where did you go or who attempted to remove your implant?

[] National hospital
[] Family planning clinic
[] Health center/Poste de sante
[] Maternity
[] Community health volunteer
[] Regional hospital
[] Private hospital/clinic
[] pharmacy
[] NGO
[] Private health center
[] Private practice
[] Private doctor
[] Mobile nurse
[] Community health worker (ASC)
[] Community-based medical student
[] Boutique
[] Religious institution
[] Friend / Relative
[] Bar / Night club
[] Ligablo / Kiosk
[] Chayeur
[] Self
[] Other
[] Don't know
[] No Response

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Congo (Democratic Republic) 2021
Questionnaire form view entire document:  text 
IMP_306. Where did you go or who attempted to remove your implant?

[] National hospital
[] Family planning clinic
[] Health center/Poste de sante
[] Maternity
[] Community health volunteer
[] Regional hospital
[] Private hospital/clinic
[] pharmacy
[] NGO
[] Private health center
[] Private practice
[] Private doctor
[] Mobile nurse
[] Community health worker (ASC)
[] Community-based medical student
[] Boutique
[] Religious institution
[] Friend / Relative
[] Bar / Night club
[] Ligablo / Kiosk
[] Chayeur
[] Self
[] Other
[] Don't know
[] No Response

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Ethiopia 2019
Questionnaire form view entire document:  text 
FFQ211b. Where did you go to try to have your implant removed?

[] GOVT HOSPITAL
[] GOVT HEALTH CENTER
[] GOVT. HEALTH POST/HEW
[] Health development army
[] Public Pharmacy
[] OTHER PUBLIC
[] NGO HEALTH FACILITY
[] OTHER NGO
[] PRIVATE HOSPITAL
[] PRIVATE CLINIC
[] Private PHARMACY
[] OTHER PRIVATE MEDICAL
[] DRUG VENDORS/STORE
[] Shop
[] OTHER
[] DO not KNOW
[] NO RESPONSE

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Kenya 2017
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IMP_305b. Where did you go or who attempted to remove your implant?

[] Govt. Hospital / polyclinic
[] Govt. Health Center
[] Govt. Dispensary
[] Other Public
[] Private Hospital/Clinic
[] Pharmacy/Chemist
[] Nursing/Maternity Home
[] Faith-based, church, mission hospital/clinic
[] Family options/FHOK clinic
[] Other private medical sector
[] Shop
[] Mobile clinic
[] Community-based distributor
[] Community health volunteer/CHV
[] Friend/relative
[] Self
[] Other
[] Don't know
[] No Response

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Kenya 2018
Questionnaire form view entire document:  text 
IMP_305b. Where did you go or who attempted to remove your implant?

[] Govt. Hospital / polyclinic
[] Govt. Health Center
[] Govt. Dispensary
[] Other Public
[] Private Hospital/Clinic
[] Pharmacy/Chemist
[] Nursing/Maternity Home
[] Faith-based, church, mission hospital/clinic
[] Family options/FHOK clinic
[] Other private medical sector
[] Shop
[] Mobile clinic
[] Community-based distributor
[] Community health volunteer/CHV
[] Friend/relative
[] Self
[] Other
[] Don't know
[] No Response

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Kenya 2019
Questionnaire form view entire document:  text 
IMP_305b. Where did you go or who attempted to remove your implant?

[] Govt. Hospital / polyclinic
[] Govt. Health Center
[] Govt. Dispensary
[] Other Public
[] Private Hospital/Clinic
[] Pharmacy/Chemist
[] Nursing/Maternity Home
[] Faith-based, church, mission hospital/clinic
[] Family options/FHOK clinic
[] Other private medical sector
[] Shop
[] Mobile clinic
[] Community-based distributor
[] Community health volunteer/CHV
[] Friend/relative
[] Self
[] Other
[] Don't know
[] No Response

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Kenya 2021
Questionnaire form view entire document:  text 
IMP_306. Where did you go or who attempted to remove your implant?

[] Govt. Hospital / polyclinic
[] Govt. Health Center
[] Govt. Dispensary
[] Other Public
[] Private Hospital/Clinic
[] Pharmacy/Chemist
[] Nursing/Maternity Home
[] Faith-based, church, mission hospital/clinic
[] Family options/FHOK clinic
[] Other private medical sector
[] Shop
[] Mobile clinic
[] Community-based distributor
[] Community health volunteer/CHV
[] Community event
[] Friend/relative
[] Self
[] Other
[] Don't know
[] No Response

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Niger 2022
Questionnaire form view entire document:  text 
IMP_306. Where did you go or who attempted to remove your implant?

[] Pharmacy - public
[] Maternity Central
[] Center of Madonna and Child
[] Maternity CHR
[] Maternity HD
[] Health Center
[] Community-based distribution site
[] Case de santé
[] Mobile clinic
[] Private hospital or clinic
[] Pharmacy - private
[] Mobile clinic (private)
[] Center ANBEF
[] Kiosk Routier
[] Polyclinic or Private clinic
[] Boutique
[] Religious organizations
[] Community event
[] Friend / parent
[] Walking pharmacy
[] Self
[] Other
[] Do not know
[] No response

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Uganda 2021
Questionnaire form view entire document:  text 
IMP_306. Where did you go or who attempted to remove your implant?

[] Govt. Hospital
[] Govt. Health Center
[] Public Family Planning Clinic
[] Public Outreach
[] Public Fieldwork/VHT
[] Other Public
[] Private Hospital/Clinic
[] Pharmacy
[] Private Doctor
[] Private Outreach
[] Private Fieldwork/VHT
[] Other Private
[] Shop
[] Church
[] Friend/relative
[] Self
[] Other
[] Do not know
[] No Response