Survey Text

Afghanistan 2015 Ethiopia 2011 Myanmar 2015 Uganda 2006
Benin 2011 India 2005 Nepal 2006 Uganda 2011
Egypt 2005 India 2015 Nepal 2011 Yemen 2013
Egypt 2014 Jordan 2007 Nepal 2016
Eswatini (Swaziland) 2006 Jordan 2012 Tanzania 2010
Ethiopia 2005 Jordan 2017 Togo 2013
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Afghanistan 2015
Survey form view entire document:  text 
931. Where is that? Any other place?

PROBE TO IDENTIFY EACH TYPE OF SOURCE. IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

NAME OF PLACE(S)_______________
PUBLIC SECTOR
GOVT. HOSPITAL (NATIONAL, REGIONAL, PROVINCIAL OR DISTRICT) A
CHC/POLYCLINIC B
BASIC HEALTH CENTER C
HEALTH SUB-CENTER D
HEALTH POST/SUB-HEALTH POST E
STAND-ALONE VCT CENTER F
FAMILY PLANNING CLINIC G
MOBILE CLINIC H
COMMUNITY HEALTH WORKER I
OTHER PUBLIC SECTOR______J
NON-GOVERNMENT SECTOR
MARIE STOPES K
RED CROSS SOCIETY L
AFGA M
OTHER NGO SECTOR________N
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR O
STAND-ALONE VCT CENTER P
PHARMACY Q
MOBILE CLINIC R
FIELDWORKER S
OTHER PRIVATE MEDICAL SECTOR_______T
OTHER SOURCE
HOME U
CHARITY/FOUNDATIONS V
REFUGEE CAMP W
OTHER___________X

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Benin 2011
Survey form view entire document:  text 
931) Where is that?
Any other place?
PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE. IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE

(NAME OF PLACE)_______
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
STAND-ALONE VCT CENTER C
FAMILY PLANNING CLINIC D
FIELDWORKER E
STRAT AV HEALTH WORKER F
HEALTH WORKER/COMMUNITY LIAISON G
SCHOOL CLINIC H
OTHER PUBLIC SECTOR______ (SPECIFY) I
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/DOCTOR J
RELIGIOUS HOSPITAL K
INDEPENDENT VCT CENTER L
PRIVATE DOCTOR'S OFFICE M
PHARMACY N
BENINESE FAMILY PLANNING ASSOCIATION (ABPF) O
FIELDWORKER (NOG) P
SCHOOL CLINIC Q
OTHER PRIVATE MEDICAL SECTOR_________ (SPECIFY) R
OTHER______ (SPECIFY) X

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Egypt 2005
Survey form view entire document:  text 
1120) Where is that?

IF SOURCE IS HOSPITAL, HEALTH UNIT, OR CLINIC, WRITE THE NAME OF THE PLACE.
PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.

Any other place?
RECORD ALL SOURCES MENTIONED.

(NAME OF PLACE) _______________________
GOVERNMENT
GOVERNMENT HOSPITAL A
GOVT. HEALTH UNIT B
VCT CENTER C
FAMILY PLANNING CLINIC D
MOBILE CLINIC E
OTHER GOVT (SPECIFY) __________ F
NON GOVERNMENTAL (SPECIFY) ___________ G
PRIVATE MEDICAL
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR H
PHARMACY I
OTHER PRIVATE MEDICAL (SPECIFY) _________ J
OTHER NON-MEDICAL (SPECIFY) __________ X

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Egypt 2014
Survey form view entire document:  text 
1011. Do you know of place where people can go to get tested for the virus that causes AIDS?

YES 1
NO 2
DON'T KNOW 8

1012. Where is that?

IF SOURCE IS HOSPITAL, HEALTH UNIT, OR CLINIC, WRITE THE NAME AND ADDRESS OF THE PLACE. PROBE

GOVERNMENT
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH UNIT B
VCT CENTER C
FAMILY PLANNING CLINIC D
MOBILE CLINIC E
STANDALONE GOVERNMENT LABORATORY F
OTHER GOVERNMENT (SPECIFY)_____________G
NON GOVERNMENTAL (SPECIFY)______________H
PRIVATE MEDICAL
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR I
PHARMACY J
STANDALONE PRIVATE LABORATORY K
OTHER PRIVATE MEDICAL (SPECIFY)______________L
OTHER NON-MEDICAL (SPECIFY)_________________X

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Eswatini (Swaziland) 2006
Survey form view entire document:  text 
930) Where is that?
Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE(S). IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER VCT CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE)__________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
STAND-ALONE VCT CENTER C
PHU/CLINIC D
MOBILE CLINIC E
OTHER PUBLIC (SPECIFY) ________F
PRIVATE SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR G
STAND-ALONE VCT CENTER H
MOBILE CLINIC I
OTHER PRIVATE (SPECIFY) _________J
MISSION
HOSPITAL K
CLINIC L
OTHER (SPECIFY) ________M
NGO
FLAS N
TASC O
OTHER NGO P
(SPECIFY)_________X

Survey form view entire document:  text 
930) Where is that?
Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE(S). IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER VCT CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE)__________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
STAND-ALONE VCT CENTER C
PHU/CLINIC D
MOBILE CLINIC E
OTHER PUBLIC (SPECIFY) ________F
PRIVATE SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR G
STAND-ALONE VCT CENTER H
MOBILE CLINIC I
OTHER PRIVATE (SPECIFY) _________J
MISSION
HOSPITAL K
CLINIC L
OTHER (SPECIFY) ________M
NGO
FLAS N
TASC O
OTHER NGO P
(SPECIFY)_________X

Survey form view entire document:  text 
930) Where is that?
Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE(S). IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER VCT CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE)__________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
STAND-ALONE VCT CENTER C
PHU/CLINIC D
MOBILE CLINIC E
OTHER PUBLIC (SPECIFY) ________F
PRIVATE SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR G
STAND-ALONE VCT CENTER H
MOBILE CLINIC I
OTHER PRIVATE (SPECIFY) _________J
MISSION
HOSPITAL K
CLINIC L
OTHER (SPECIFY) ________M
NGO
FLAS N
TASC O
OTHER NGO P
(SPECIFY)_________X

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Ethiopia 2005
Survey form view entire document:  text 
912. Where is that? Any other place?
IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, WRITE THE NAME OF THE SOURCE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
RECORD ALL SOURCES MENTIONED.

NAME OF THE PLACE_____________________________________
PUBLIC SECTOR
GOVERNMENT HOSPITAL/CLINIC A
GOVERNMENT HEALTH CENTER B
VCT CENTER C
GOVERNMENT HEALTH POST D
FAMILY PLANNING CLINIC E
STAND ALONE VCT CENTER F
OTHER PUBLIC (SPECIFY) ________G
NGO HEALTH FACILITY H
STAND ALONE VCT CENTER I
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/DOCTOR J
STAND ALONE VCT CENTER K
OTHER PRIVATE MEDICAL (SPECIFY) ___________________ L
OTHER (SPECIFY) _____________ M

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Ethiopia 2011
Survey form view entire document:  text 
931. Where is that? Any other place?

PROBE TO IDENTIFY EACH TYPE OF SOURCE. IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR WRITE THE NAME OF THE PLACE.

NAME OF THE PLACE(S) _______
PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
GOVT. HEALTH STATION/CLINIC C
STAND-ALONE VCT CENTER D
OTHER PUBLIC (SPECIFY) ______ E
NGO
NGO HEALTH FACILITY F
STAND-ALONE VCT CENTER G
MOBILE H
OTHER NGO (SPECIFY) ______ I
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL J
PRIVATE CLINIC K
OTHER PRIVATE MEDICAL (SPECIFY) ______ L
OTHER (SPECIFY) ______ X

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India 2005
Survey form view entire document:  text 
921. Where is that? Any other place?

IF UNABLE TO DETERMINE IF A HOSPITAL, HEALTH CENTRE, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL SECTOR, WRITE THE NAME OF THE PLACE.
RECORD ALL PLACES MENTIONED.

NAME OF PLACE(S) ______
PUBLIC MEDICAL SECTOR
GOVT./MUNICIPAL HOSPITAL A
GOVT. DISPENSARY B
UHC/UHP/UFWC C
CHC/RURAL HOSP./PHC D
SUB-CENTRE E
GOVT. MOBILE CLINIC F
VCT CLINIC
STI CLINIC H
OTHER PUBLIC MEDICAL SECTOR (SPECIFY) ______ I
NGO OR TRUST HOSPITAL/CLINIC J
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR K
VCT CLINIC L
STI CLINIC M
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) ______ N
OTHER (SPECIFY) ______ X

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India 2015
Survey form view entire document:  text 
1038. Where is that? Any other place?

RECORD ALL PLACES MENTIONED. IF UNABLE TO DETERMINE IF A HOSPITAL, HEALTH CENTRE, OR CLINIC IS PUBLIC OR PRIVATE HEALTH SECTOR, WRITE THE NAME OF THE PLACE.

(NAME OF FACILITY/PLACE(S))_______________
PUBLIC HEALTH SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTRE B
STAND-ALONE ICTC C
FAMILY PLANNING CLINIC D
MOBILE CLINIC E
FIELDWORKER F
SCHOOL BASED CLINIC G
OTHER PUBLIC SECTOR (SPECIFY)________H
NGO OR TRUST HOSPITAL/CLINIC I
PRIVATE HEALTH SECTOR
PRIVATE HOSPITAL/CLINIC PRIVATE DOCTOR J
STAND-ALONE ICTC K
PHARMACY L
MOBILE CLINIC M
FIELDWORKER N
SCHOOL BASED CLINIC O
OTHER PRIVATE HEALTH SECTOR (SPECIFY) _______P
OTHER SOURCE
HOME Q
CORRECTIONAL FACILITY R
OTHER (SPECIFY) ________X

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Jordan 2007
Survey form view entire document:  text 
911) Where is that ?

Any other place?

PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE(S).

IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER, VOLUNTARY COUNSELING AND TESTING CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE(S)) _______________________
PUBLIC MEDICAL SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
GOVERNMENT MOTHER AND CHILD HEALTH CENTER C
UNIVERSITY HOSPITAL D
ROYAL MEDICAL SERVICES E
TESTING AND COUNSELING CENTER F
OTHER PUBLIC (SPECIFY)_____________ G
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC H
PRIVATE DOCTOR I
JORDANIAN ASSOCIATION OF FAMILY PLANNING AND PROTECTION (JAFPP) J
PRIVATE LABORATORY K
OTHER NON GOVERNMENT ORGANIZATION L
OTHER PRIVATE MEDICAL (SPECIFY)________ M
OTHER (SPECIFY)________________ X

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Jordan 2012
Survey form view entire document:  text 
911. Where is that?
Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE(S). IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER, VCT CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE(S)) _______________
PUBLIC MEDICAL SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
GOVT. MCH C
UNIVERSITY HOSPITAL D
ROYAL MEDICAL SERVICES E
TESTING AND COUNCELING CENTER F
OTHER PUBLIC (SPECIFY) _____ G
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC H
PRIVATE DOCTOR I
JORDANIAN AS. OF FP AND PROTECTION (JAFPP) J
PRIVATE LABORATORY K
OTHER NON GOV. ORGANIZATION L
OTHER PRIVATE MEDICAL (SPECIFY) _____ M
OTHER (SPECIFY) _____ X

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Jordan 2017
Survey form view entire document:  text 
1032) Where is that? Any other place?
PROBE TO IDENTIFY THE TYPE OF SOURSE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE) ______________________________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
GOVERNMENT MCH C
UNIVERSITY HOSPITAL D
ROYAL MEDICAL SERVICES E
TESTING AND COUNCELING CENTER F
OTHER PUBLIC SECTOR (SPECIFY) ______________G
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC H
PRIVATE DOCTOR I
JORDANIAN AS. OF FP AND PROTECTION (JAFPP) J
PRIVATE LABORATORY K
OTHER NON GOV. ORGANIZATION L
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) ___________________ M
OTHER (SPECIFY) ___________________ X

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Myanmar 2015
Survey form view entire document:  text 
929) Where was the test done? PROBE TO IDENTIFY THE TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.____(NAME OF PLACE)

PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVT. HEALTH CENTER (RHC) 12
GOVT. HEALTH POST (SUB-CENTER) 13
STAND-ALONE VCT CENTER 14
FAMILY PLANNING CLINIC 15
MOBILE CLINIC 16
FIELDWORKER 17
SCHOOL BASED CLINIC 18
OTHER PUBLIC SECTOR____(SPECIFY) 19
NGO
MARIE STOPES 21
MYANMAR RED CROSS SOCIETY 22
PSI/M (SUN) 23
MMA 24
OTHER NGO SECTOR___(SPECIFY) 26
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR 31
STAND-ALONE VCT CENTER 32
PHARMACY 33
MOBILE CLINIC 34
DIAGNOSTIC LABORATORY 35
OTHER PRIVATE MEDICAL SECTOR____(SPECIFY) 36
OTHER SOURCE
HOME 41
CORRECTIONAL FACILITY 42
OTHER___(SPECIFY) 96

Survey form view entire document:  text 
929) Where was the test done? PROBE TO IDENTIFY THE TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.____(NAME OF PLACE)

PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVT. HEALTH CENTER (RHC) 12
GOVT. HEALTH POST (SUB-CENTER) 13
STAND-ALONE VCT CENTER 14
FAMILY PLANNING CLINIC 15
MOBILE CLINIC 16
FIELDWORKER 17
SCHOOL BASED CLINIC 18
OTHER PUBLIC SECTOR____(SPECIFY) 19
NGO
MARIE STOPES 21
MYANMAR RED CROSS SOCIETY 22
PSI/M (SUN) 23
MMA 24
OTHER NGO SECTOR___(SPECIFY) 26
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR 31
STAND-ALONE VCT CENTER 32
PHARMACY 33
MOBILE CLINIC 34
DIAGNOSTIC LABORATORY 35
OTHER PRIVATE MEDICAL SECTOR____(SPECIFY) 36
OTHER SOURCE
HOME 41
CORRECTIONAL FACILITY 42
OTHER___(SPECIFY) 96

Survey form view entire document:  text 
929) Where was the test done? PROBE TO IDENTIFY THE TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.____(NAME OF PLACE)

PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVT. HEALTH CENTER (RHC) 12
GOVT. HEALTH POST (SUB-CENTER) 13
STAND-ALONE VCT CENTER 14
FAMILY PLANNING CLINIC 15
MOBILE CLINIC 16
FIELDWORKER 17
SCHOOL BASED CLINIC 18
OTHER PUBLIC SECTOR____(SPECIFY) 19
NGO
MARIE STOPES 21
MYANMAR RED CROSS SOCIETY 22
PSI/M (SUN) 23
MMA 24
OTHER NGO SECTOR___(SPECIFY) 26
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR 31
STAND-ALONE VCT CENTER 32
PHARMACY 33
MOBILE CLINIC 34
DIAGNOSTIC LABORATORY 35
OTHER PRIVATE MEDICAL SECTOR____(SPECIFY) 36
OTHER SOURCE
HOME 41
CORRECTIONAL FACILITY 42
OTHER___(SPECIFY) 96

Survey form view entire document:  text 
929) Where was the test done? PROBE TO IDENTIFY THE TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.____(NAME OF PLACE)

PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVT. HEALTH CENTER (RHC) 12
GOVT. HEALTH POST (SUB-CENTER) 13
STAND-ALONE VCT CENTER 14
FAMILY PLANNING CLINIC 15
MOBILE CLINIC 16
FIELDWORKER 17
SCHOOL BASED CLINIC 18
OTHER PUBLIC SECTOR____(SPECIFY) 19
NGO
MARIE STOPES 21
MYANMAR RED CROSS SOCIETY 22
PSI/M (SUN) 23
MMA 24
OTHER NGO SECTOR___(SPECIFY) 26
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR 31
STAND-ALONE VCT CENTER 32
PHARMACY 33
MOBILE CLINIC 34
DIAGNOSTIC LABORATORY 35
OTHER PRIVATE MEDICAL SECTOR____(SPECIFY) 36
OTHER SOURCE
HOME 41
CORRECTIONAL FACILITY 42
OTHER___(SPECIFY) 96

Survey form view entire document:  text 
929) Where was the test done? PROBE TO IDENTIFY THE TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.____(NAME OF PLACE)

PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVT. HEALTH CENTER (RHC) 12
GOVT. HEALTH POST (SUB-CENTER) 13
STAND-ALONE VCT CENTER 14
FAMILY PLANNING CLINIC 15
MOBILE CLINIC 16
FIELDWORKER 17
SCHOOL BASED CLINIC 18
OTHER PUBLIC SECTOR____(SPECIFY) 19
NGO
MARIE STOPES 21
MYANMAR RED CROSS SOCIETY 22
PSI/M (SUN) 23
MMA 24
OTHER NGO SECTOR___(SPECIFY) 26
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR 31
STAND-ALONE VCT CENTER 32
PHARMACY 33
MOBILE CLINIC 34
DIAGNOSTIC LABORATORY 35
OTHER PRIVATE MEDICAL SECTOR____(SPECIFY) 36
OTHER SOURCE
HOME 41
CORRECTIONAL FACILITY 42
OTHER___(SPECIFY) 96

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Nepal 2006
Survey form view entire document:  text 
910. Where is that? Any other place? PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE(S). IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER VCT CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

NAME OF PLACE __
GOVT. SECTOR
GOVERNMENT HOSPITAL A
VCT CENTER B
OTHER GOVT. (SPECIFY) ___ C
NON-GOVT. SECTOR
FPAN D
AMDA E
INF F
NEPAL RED CROSS G
OTHER NON-GOVT. (SPECIFY) ___ H
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR I
OTHER PRIVATE MEDICAL (SPECIFY) ___ J
OTHER (SPECIFY) ___ X

Survey form view entire document:  text 
910. Where is that? Any other place? PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE(S). IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER VCT CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

NAME OF PLACE __
GOVT. SECTOR
GOVERNMENT HOSPITAL A
VCT CENTER B
OTHER GOVT. (SPECIFY) ___ C
NON-GOVT. SECTOR
FPAN D
AMDA E
INF F
NEPAL RED CROSS G
OTHER NON-GOVT. (SPECIFY) ___ H
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR I
OTHER PRIVATE MEDICAL (SPECIFY) ___ J
OTHER (SPECIFY) ___ X

Survey form view entire document:  text 
910. Where is that? Any other place? PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE(S). IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER VCT CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

NAME OF PLACE __
GOVT. SECTOR
GOVERNMENT HOSPITAL A
VCT CENTER B
OTHER GOVT. (SPECIFY) ___ C
NON-GOVT. SECTOR
FPAN D
AMDA E
INF F
NEPAL RED CROSS G
OTHER NON-GOVT. (SPECIFY) ___ H
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR I
OTHER PRIVATE MEDICAL (SPECIFY) ___ J
OTHER (SPECIFY) ___ X

Survey form view entire document:  text 
910. Where is that? Any other place? PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE(S). IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER VCT CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

NAME OF PLACE __
GOVT. SECTOR
GOVERNMENT HOSPITAL A
VCT CENTER B
OTHER GOVT. (SPECIFY) ___ C
NON-GOVT. SECTOR
FPAN D
AMDA E
INF F
NEPAL RED CROSS G
OTHER NON-GOVT. (SPECIFY) ___ H
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR I
OTHER PRIVATE MEDICAL (SPECIFY) ___ J
OTHER (SPECIFY) ___ X

Survey form view entire document:  text 
910. Where is that? Any other place? PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE(S). IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER VCT CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

NAME OF PLACE __
GOVT. SECTOR
GOVERNMENT HOSPITAL A
VCT CENTER B
OTHER GOVT. (SPECIFY) ___ C
NON-GOVT. SECTOR
FPAN D
AMDA E
INF F
NEPAL RED CROSS G
OTHER NON-GOVT. (SPECIFY) ___ H
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR I
OTHER PRIVATE MEDICAL (SPECIFY) ___ J
OTHER (SPECIFY) ___ X

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Nepal 2011
Survey form view entire document:  text 
916) Where is that?
Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE. IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE (S)) _____________________
GOVT. SECTOR
GOVERNMENT HOSPITAL A
VCT CENTER B
OTHER GOVT. (SPECIFY) ___________ C
NON-GOVT. SECTOR
FPAN D
AMDA E
INF F
NEPAL RED CROSS G
OTHER GOVT. (SPECIFY) _________ H
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/NURSING HOME I
OTHER PRIVATE MEDICAL (SPECIFY) _____________ J
OTHER (SPECIFY) ___________ X

Survey form view entire document:  text 
916) Where is that?
Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE. IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE (S)) _____________________
GOVT. SECTOR
GOVERNMENT HOSPITAL A
VCT CENTER B
OTHER GOVT. (SPECIFY) ___________ C
NON-GOVT. SECTOR
FPAN D
AMDA E
INF F
NEPAL RED CROSS G
OTHER GOVT. (SPECIFY) _________ H
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/NURSING HOME I
OTHER PRIVATE MEDICAL (SPECIFY) _____________ J
OTHER (SPECIFY) ___________ X

Survey form view entire document:  text 
916) Where is that?
Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE. IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE (S)) _____________________
GOVT. SECTOR
GOVERNMENT HOSPITAL A
VCT CENTER B
OTHER GOVT. (SPECIFY) ___________ C
NON-GOVT. SECTOR
FPAN D
AMDA E
INF F
NEPAL RED CROSS G
OTHER GOVT. (SPECIFY) _________ H
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/NURSING HOME I
OTHER PRIVATE MEDICAL (SPECIFY) _____________ J
OTHER (SPECIFY) ___________ X

Survey form view entire document:  text 
916) Where is that?
Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE. IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE (S)) _____________________
GOVT. SECTOR
GOVERNMENT HOSPITAL A
VCT CENTER B
OTHER GOVT. (SPECIFY) ___________ C
NON-GOVT. SECTOR
FPAN D
AMDA E
INF F
NEPAL RED CROSS G
OTHER GOVT. (SPECIFY) _________ H
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/NURSING HOME I
OTHER PRIVATE MEDICAL (SPECIFY) _____________ J
OTHER (SPECIFY) ___________ X

Survey form view entire document:  text 
916) Where is that?
Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE. IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE (S)) _____________________
GOVT. SECTOR
GOVERNMENT HOSPITAL A
VCT CENTER B
OTHER GOVT. (SPECIFY) ___________ C
NON-GOVT. SECTOR
FPAN D
AMDA E
INF F
NEPAL RED CROSS G
OTHER GOVT. (SPECIFY) _________ H
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/NURSING HOME I
OTHER PRIVATE MEDICAL (SPECIFY) _____________ J
OTHER (SPECIFY) ___________ X

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Nepal 2016
Survey form view entire document:  text 
1032. Where is that? Any other place? PROBE TO IDENTIFY THE TYPE OF SOURCE. IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

NAME OF PLACE __
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
PRIMARY HEALTH CARE CENTER B
OTHER PUBLIC FACILITIES (SPECIFY) ___ D
NON-GOVT. (NGO) SECTOR
FPAN E
MARIE STOPES F
OTHER NGO FACILITIES (SPECIFY) ___ G
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR H
PRIVATE CLINIC I
STAND-ALONE HTC/VCT CENTER J
PHARMACY K
MOBILE HTC/VCT SERVICES L
OTHER PRIVATE MEDICAL FACILITIES (SPECIFY) ___ M
OTHER (SPECIFY) ___ X

Survey form view entire document:  text 
1032. Where is that? Any other place? PROBE TO IDENTIFY THE TYPE OF SOURCE. IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

NAME OF PLACE __
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
PRIMARY HEALTH CARE CENTER B
OTHER PUBLIC FACILITIES (SPECIFY) ___ D
NON-GOVT. (NGO) SECTOR
FPAN E
MARIE STOPES F
OTHER NGO FACILITIES (SPECIFY) ___ G
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR H
PRIVATE CLINIC I
STAND-ALONE HTC/VCT CENTER J
PHARMACY K
MOBILE HTC/VCT SERVICES L
OTHER PRIVATE MEDICAL FACILITIES (SPECIFY) ___ M
OTHER (SPECIFY) ___ X

Survey form view entire document:  text 
1032. Where is that? Any other place? PROBE TO IDENTIFY THE TYPE OF SOURCE. IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

NAME OF PLACE __
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
PRIMARY HEALTH CARE CENTER B
OTHER PUBLIC FACILITIES (SPECIFY) ___ D
NON-GOVT. (NGO) SECTOR
FPAN E
MARIE STOPES F
OTHER NGO FACILITIES (SPECIFY) ___ G
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR H
PRIVATE CLINIC I
STAND-ALONE HTC/VCT CENTER J
PHARMACY K
MOBILE HTC/VCT SERVICES L
OTHER PRIVATE MEDICAL FACILITIES (SPECIFY) ___ M
OTHER (SPECIFY) ___ X

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Tanzania 2010
Survey form view entire document:  text 
928. Where is that? Any other place?
PROBE TO IDENTIFY THE TYPE OF SOURCE. IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE. WRITE THE NAME OF THE PLACE.

(NAME OF PLACE) ___________
GOVERNMENT/PARASTATAL
REFERAL/SPEC. HOSPITAL A
REGIONAL HOSPITAL B
DISTRICT HOSPITAL C
HEALTH CENTRE D
DISPENSARY E
VILLAGE HEALTH POST F
CBD WORKER G
RELIGIOUS/VOLUNTARY
REFERAL/SPEC. HOSPITAL H
DISTRICT HOSPITAL I
GOVT. HEALTH CENTRE J
DISPENSARY K
PRIVATE
HOSPITAL L
HEALTH CENTRE M
DISPENSARY N
OTHER
PRIVATE PHARMACY O
NGO P
VCT CENTRE Q
OTHER (SPECIFY) ________________________ X

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Togo 2013
Survey form view entire document:  text 
930) Do you know of a place where people can go to get tested for the AIDS virus?

YES 1
NO 2- (SKIP TO 932)

931) Where is that?
Any other place?

PROBE TO IDENTIFY THE TYPE OF SOURCE.

IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE
(NAME OF PLACE)_______

PUBLIC SECTOR
GOVERNMENT HOSPITAL A
STAND-ALONE VCT CENTER B
HEALTH CENTER C
DISPENSARY D
MOTHER-INFANT PROTECTION E
MOBILE CLINIC F
SCHOOL BASED CLINIC G
OTHER PUBLIC SECTOR_______ (SPECIFY) H
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC I
PRIVATE DOCTOR'S OFFICE J
PHARMACY K
SCHOOL BASED CLINIC L
NGO/ASSOCIATION M
OTHER PRIVATE MEDICAL SECTOR________ (SPECIFY) N
OTHER__________ (SPECIFY) X

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Uganda 2006
Survey form view entire document:  text 
928) Where is that? Any other place?

PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE(S).

IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER, VCT CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

NAME OF PLACE(S)_____
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
STAND-ALONE VCT CENTER C
FAMILY PLANNING CLINIC D
OUTREACH E
GOVERNMENT COMMUNITY BASED WORKER F
OTHER PUBLIC (SPECIFY) G
PRIVATE/NGO MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC H
STAND-ALONE VCT CLINIC I
PHARMACY/DRUG SHOP J
PRIVATE DOCTOR/NURSE/MIDWIFE K
OUTREACH L
TASO M
AIDS INFORMATION CENTER N
OTHER PRIVATE/NGO MEDICAL (SPECIFY) O
OTHER (SPECIFY) 96

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Uganda 2011
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931) Where is that?
Any other place?

PROBE TO IDENTIFY EACH TYPE OF SOURCE.

IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE(S)) ______________________

PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVT. HEALTH CENTER B
STAND-ALONE VCT CENTER C
FAMILY PLANNING CLINIC D
OUT REACH E
VILLAGE HEALTH TEAM F
OTHER PUBLIC (SPECIFY) ___________ G
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC H
STAND-ALONE VCT CENTER I
PHARMACY/DRUG SHOP J
PRIVATE DOCTOR/NURSE/MIDWIFE K
OUT REACH L
TASO M
AIDS INFORMATION CENTRE N
OTHER PRIVATE/NGO MEDICAL (SPECIFY) ______________ O
OTHER (SPECIFY) _____________ X

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Yemen 2013
Survey form view entire document:  text 
931) Where is that? Any other place? PROBE TO IDENTIFY EACH TYPE OF SOURCE. IF UNABLE TO DETERMINE IF THE SECTOR, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE(S))____
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
PRIMARY HEALTH CENTER C
FAMILY PLANNING CLINIC D
MOBILE CLINIC E
PRIVATE SECTOR
(PRIVATE HOSPITAL/CLINIC/DISPENSARY/DOCTOR'S OFFICE) F
NON GOVERNMENT ORGANIZATIONS
(HOSPITAL/CLINIC/DISPENSARY/PRIVATE DOCTOR'S OFFICE, MOBILE CLINIC) G
OTHER (SPECIFY) ____ X