Where do most community members get medicines when they are sick? Is this type What is the distance How many Number of male Number of female Type of school building in [TYPE] schools in the community MARK ALL THAT APPLY

1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 4 Type of service provider Health post house of community health worker Public Clinic may be Basic or Comprehens ive Health Center District or Provincial Hospital Private doctors office or private hospital Female CHW Male CHW Female doctor Female nurse Female midwife Male doctor Male nurse Female doctor Female nurse Female midwife Male doctor Male nurse Female doctor Female nurse Female midwife Male doctor Male nurse Yes NO Dont Know Yes NO Dont Know Private pharmacy Female doctor Male doctor 4.6 Are the following types of staff present in the nearest _________? 4.7 Where do most community members get medicines when they are sick? 1 2 1 2 3 4 1 2 3 4 1 2 1 2 3 4 1 2 3 4 1 2 1 2 3 4 1 2 3 4 1 2 1 2 3 4 1 2 3 4 1 2 1 2 3 4 1 2 3 4 1 2 1 2 3 4 1 2 3 4 1 2 1 2 3 4 1 2 3 4 1 2 1 2 3 4 1 2 3 4 8 12 1 2 1 2 3 4 1 2 3 4 SECTION 5: EDUCATION

5.1 Is this type

of school present in the community?

5.2 What is the distance

one way to the nearest [TYPE] school? IF NOT ANY AVAILABLE, MARK 99 next type of school

5.3 How many

public government [TYPE] schools are there in the community: 5.4 How many privateN GO [TYPE] schools are there in the community ?

5.5 Number of male

teachers in all [TYPE] schools in the community:

5.6 Number of female

teachers in all [TYPE]sc hools in the community: Primary, girls Primary, boys Primary, boys and Girls Middle school, girls Middle school, boys Middle school, boys and Girls High school girls High school boys Madrassa TYPE of school 1 2 3 4 1 2 3 9 12 Primary, girls Primary, boys Primary, boys and Girls Middle school, girls Middle school, boys High school girls High school boys Madrassa TYPE of school 5.7 Type of school building in [TYPE] schools in the community MARK ALL THAT APPLY Separate, with roof and wall Tent Privates house In Masjid, or public building Open or semi-open air Separate, with roof and wall Tent Privates house In Masjid, or public building Open or semi-open air Separate, with roof and wall Tent Privates house In Masjid, or public building Open or semi-open air Separate, with roof and wall Tent Privates house In Masjid, or public building Open or semi-open air Separate, with roof and wall Tent Privates house In Masjid, or public building Open or semi-open air Separate, with roof and wall Tent Privates house In Masjid, or public building Open or semi-open air Separate, with roof and wall Tent Privates house In Masjid, or public building Open or semi-open air Separate, with roof and wall Tent Privates house In Masjid, or public building Open or semi-open air In your opinion, will people in the community contribute a small sum of money each month to support the schooling of children in the community?

5.8 5.9If the shura were formally asked by