Basic Information

Name:

Distribution Month:

Distribution Dates:

Date Survey Completed:

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
I wasn't able to open the internet/web-browser
The TP-LINK/router didn't work
I was able to get to the website, but then I didn't see my distribution
I was able to get to the website and see the distribution, but then was unable to enter data
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? Yes

No

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 about 30 minutes or more less to collect the data with the tablet
It takes about 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 about 15 minutes longer to collect the data with the tablet
It takes 30 minutes or more 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