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Distribution Dates:
Date Survey Completed:
Number of Facilities in the Distribution Zone:
Number of Facilities Visited:
Of the facilities you visited this month, for how many were you able to enter all the distribution data directly on the tablet while you were at the facility?
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If you were not able to enter the distribution data directly on the tablet, what prevented you from doing so:
- Tablet was out of battery -- is "out of battery" how they phrase this problem, or should it be something like "The tablet needed to be recharged." ??
- Website wasn’t working -- entering data on the tablet is not be dependent on the website working – they will be in offline mode. Should this question be: "The distribution wasn't cached on the tablet." ??
- Not enough time to use the tablet
- The tablet was too hard to use
- Other problem with the tablet: ____________________
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If you were not able to enter the distribution data directly on the tablet, how did you collect the facility visit information:
- All on the paper DLS form
- Some on the tablet, and some on the paper DLS form
- Some on the tablet, and some on an extra piece of paper
- Other: ___________
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While on distribution, how often were you able to synchronize the distribution data that was entered on the tablet:
- Every day
- About every other day
- Once or twice
- I didn’t synchronize until synchronized when I got back to the provincial office
- I didn't enter any data on the tablet
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If you didn’t synchronize every day, why?
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Did the tablet ever run out of battery? "...out of charge?"
- Yes
- No
The facility visits took more time while using the tablet – see below.
- Yes
- No
How much longer did it take you to use the tablet versus writing the information on the paper DLS form: – this question presumse de facto that the tablet will take more time. This AND the preceding question should be presented as shown in blue below...
- About an hour more
- About 30 minutes more
- About 15 minute more
- About 10 minutes more
- About 5 minutes more
How does the tablet compare with the paper DLS form in terms of how much time in takes you to collect data for a facility?
- It takes 20-30 minutes less to collect the data with the tablet
- It takes 10-15 minutes less to collect the data with the tablet
- Using the tablet or the paper DLS form take roughly the same amount of time to collect the data
- It takes 10-15 minutes longer to collect the data with the tablet
- It takes 20-20 minutes longer to collect the data with the tablet
- Other: ______________________________
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The best things about using the tablet are:
1.
2.
3.
The most difficult things about using the tablet are:
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- Keep using the tablet
- Go back to writing the data on paper DLS form and then entering it on the computer later
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