Defaulter questionnaire

In your opinion state to what degree the following factors lead to patient to default:
i) Proximity to the health facility

Most likely

More likely

Less likely

Very unlikely

ii) health care workers shouting at patients

Most likely

More likely

Less likely

Very unlikely

Miraculous cure

Most likely

More likely

Less likely

Very unlikely

Patient use of concoctions believed to cure HIV infection

Most likely

More likely

Less likely

Very unlikely

Patients ability to read and write

Most likely

More likely

less likely

Very unlikely

Patients ability to pay for transport costs

Most likely

More likely

less likely

Very unlikely

Patients having ART side effects

Most likely

More likely

less likely

very unlikely

Being seen together with non HIV patients in the clinic

Most likely

More likely

Less likely

Very unlikely

How often do you conduct surveys?

Weekly

Monthly

Quarterly

Annually

Being seen together with non HIV patients in the clinic

Most likely

More likely

Less likely

Very unlikely