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." ??
• I wasn't able to open the internet/web-browser
• The TP-LINK/router didn't work
  
• 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 while out on a distribution
• 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