In the last 4 weeks, how much did your household spend on housing, gas, electricity, water, telephone, and heating fuel?
In the last 4 weeks, how much did your household spend on education fees and supplies?
In the last 4 weeks, how much did your household spend on health care costs, excluding any insurance reimbursements?
In the last 4 weeks, how much did your household spend on voluntary insurance premiums or prepaid health plans?
In the last 4 weeks, how much did your household spend on all other goods and services?
In the last 4 weeks, how much did your household spend on care that required staying overnight in a hospital or health facility?
In the last 4 weeks, how much did your household spend on care by doctors, nurses, or trained midwives that did not require an overnight stay?
In your opinion, was [the health care provider's] equipment adequate for your treatment?
In your opinion, were [the health care provider's] drug supplies adequate for your treatment?
Thinking about your last visit, how long did it take you to get there?
Thinking about your last visit, how did you get there? [Interviewer; mark the one used for most of the travel distance.] - Private car or motorcycle - Public transport - Ambulance - Bicycle - Walked - Other
Thinking about your last visit, how much did you or your household pay for: [Health care provider's] fees
Thinking about your last visit, how much did you or your household pay for: Medicines
Thinking about your last visit, how much did you or your household pay for: Tests
Thinking about your last visit, how much did you or your household pay for: Transport
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