Questionnaire Text

Burkina Faso 2017 Cote d'Ivoire 2018 Indonesia 2016 Nigeria 2017b
Burkina Faso 2018 Ethiopia 2018 Kenya 2017 Nigeria 2018
Congo (Democratic Republic) 2018a India 2018 Kenya 2018 Uganda 2018
Congo (Democratic Republic) 2018b Indonesia 2015 Niger 2018
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Burkina Faso 2017
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308a. The last time you received your ${current_recent_label}, how much did you have to pay out of pocket, including any fees paid for the method, supplies or services, and transportation?

Enter all prices in CFA. Zero is a possible answer. Enter -88 if respondent does not know, -99 for no response.


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Burkina Faso 2018
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308a. The last time you received your ${current_recent_label}, how much did you have to pay out of pocket, including any fees paid for the method, supplies or services, and transportation?

Enter all prices in CFA. Zero is a possible answer. Enter -88 if respondent does not know, -99 for no response.


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Congo (Democratic Republic) 2018a
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308a. The last time you received your ${current_recent_label}, how much did you have to pay out of pocket, including any fees paid for the method, supplies or services, and transportation?

Enter all prices in FRANCS CONGOLAIS. Zero is a possible answer. Enter -88 if respondent does not know, -99 for no response.


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Congo (Democratic Republic) 2018b
Questionnaire form view entire document:  text 
308a. The last time you received your ${current_recent_label}, how much did you have to pay out of pocket, including any fees paid for the method, supplies or services, and transportation?

Enter all prices in FRANCS CONGOLAIS. Zero is a possible answer. Enter -88 if respondent does not know, -99 for no response.


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Cote d'Ivoire 2018
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308a. The last time you received your [CURREN METHOD /MOST RECENT METHOD], how much did you have to pay out of pocket, including any fees paid for the method, supplies or services, and transportation?
Enter all prices in FCFA. Zero is a possible answer.

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Ethiopia 2018
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308a. The last time you received your [CURREN METHOD /MOST RECENT METHOD], how much did you have to pay out of pocket, including any fees paid for the method, supplies or services, and transportation?

Enter all prices in Ethiopian Birr.


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India 2018
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308a. The last time you received your {current_recent_label}, how much did you have to pay out of pocket, including any fees paid for the method, supplies or services, and transportation?

Enter all prices in rupees. Enter -88 if respondent does not know, -99 for no response.


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Indonesia 2015
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34. How much did you pay? Enter all prices in [local currency]. Enter -88 if respondent does not know, -99 for no response.
Fee: _______

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Indonesia 2016
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ID_ INS4 How much did you pay?

Enter Amount: ____

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Kenya 2017
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308a. The last time you received your {current_recent_label}, how much did you have to pay out of pocket, including any fees paid for the method, supplies or services, and transportation?

Enter all prices in Kenyan Shillings. Enter -88 if respondent does not know, -99 for no response.


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Kenya 2018
Questionnaire form view entire document:  text 
308a. The last time you received your {current_recent_label}, how much did you have to pay out of pocket, including any fees paid for the method, supplies or services, and transportation?

Enter all prices in Kenyan Shillings. Enter -88 if respondent does not know, -99 for no response.


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Niger 2018
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308a. The last time you received your [CURREN METHOD /MOST RECENT METHOD], how much did you have to pay out of pocket, including any fees paid for the method, supplies or services, and transportation?

Enter all prices in FCFA.


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Nigeria 2017b
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308a. The last time you received your {current_recent_label}, how much did you have to pay out of pocket, including any fees paid for the method, supplies or services, and transportation?

Enter all prices in Naira. Zero is a possible answer. Enter -88 if respondent does not know, -99 for no response.


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Nigeria 2018
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308a. The last time you received your {current_recent_label}, how much did you have to pay out of pocket, including any fees paid for the method, supplies or services, and transportation?

Enter all prices in Naira. Zero is a possible answer. Enter -88 if respondent does not know, -99 for no response.


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Uganda 2018
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308. a. The last time you received your [CURRENT METHOD /MOST RECENT METHOD], how much did you have to pay out of pocket, including any fees paid for the method, supplies or services, and transportation?
Enter all prices in Ugandan shillings. Zero is a possible answer. Enter -88 if respondent does not know, -99 for no response.