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Basic Information

 

Name:

Distribution Month:

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?

  • All the facilities
  • Most of the facilities
  • About half of the facilities
  • Less than half
  • None

 

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: ____________________

 

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: ___________

 

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 synchronized when I got back to the provincial office
  • I didn't enter any data on the tablet

 

If you didn’t synchronize every day, why?

  • No internet access
  • Tried to synchronize but it didn’t work
  • I forgot
  • Other: ___________

 

How often did you charge the tablet?

  • Always while driving
  • Every day
  • Every other day
  • Less than every other day

 

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: ______________________________

 

The best things about using the tablet are:

1.

2.

3.

 

The most difficult things about using the tablet are:

1.

2.

3.

 

 

Now that I’ve tried using the tablet, my preference would be to:

  • 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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