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PDF, 1536K - Measure DHS

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NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP<br />

489A<br />

Why did you not seek medical treatment?<br />

Any other reasons?<br />

RECORD ALL MENTIONED<br />

DON’T KNOW WHERE TO GO....................................A<br />

DID NOT GET PERMISSION TO GO........................... B<br />

NO MONEY FOR TREATMENT .................................. C<br />

NO HEALTH FACILITY NEARBY................................ D<br />

NO TRANSPORT..........................................................E<br />

DID NOT WANT TO GO ALONE..................................F<br />

CONCERN THAT THERE MAY NOT BE A<br />

FEMALE HEALTH PROVIDER............................... G<br />

OTHER REASONS __________________________ X<br />

(SPECIFY)

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