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Burundi 2016

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1032) 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

NATIONAL GOVERNMENT HOSPITAL A
REGIONAL GOVERNMENT HOSPITAL B
DISTRICT HOSPITAL C
GOVERNMENT HEALTH CENTER D
INDEPENDENT TESTING CENTER E
MOBILE TESTING SERVICE F
SCHOOL CLINIC G
OTHER_____________H

CERTIFIED MEDICAL SECTOR

CERTIFIED HOSPITAL I
CERTIFIED HEALTH CENTER J
OTHER PRIVATE MEDICAL___________K

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL/CLINIC/DOCTOR L
PRIVATE HEALTH CARE CENTER M
SCHOOL CLINIC N
INDEPENDENT TESTING CENTER O
PHARMACY P
MOBILE TESTING SERVICE Q
OTHER PRIVATE MEDICAL__________ R

OTHER___________X

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Chad 2004

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816l) Where can you go for this test?
ANYWHERE ELSE?
RECORD ALL MENTIONED

PUBLIC SECTOR

TESTING CENTER A [##TRANSLATOR NOTE: THIS IS AN OFFICIAL LOCATION NAME]
HOSPITAL/MATERNITY B
MILITARY HOSPITAL/GARRISON C
HEALTH CENTER/FREE CLINIC/GARRISON D
NATIONAL PROGRAM FIGHTING AIDS (PNLS) E [##TRANSLATOR NOTE: THIS IS AN OFFICIAL LOCATION NAME]
POLYCLINIC F
HOSPITAL/HEALTH CENTER PHARMACY G
OTHER PUBLIC H

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL I
CLINIC/OFFICE J
CHADIAN ASSOCIATION FOR FAMILY WELL-BEING K
PRIVATE HEALTH CENTER L
COMPANY HEALTH CENTER M
CARE OFFICE/NURSE N
PHARMACY/PHARMACY DEPOT O
OTHER PRIVATE MEDICAL P

PUBLIC/PRIVATE SECTOR

VILLAGE PHARMACY/HEALTH CENTER Q

OTHER PLACE X

Survey form view entire document: text

816l) Where can you go for this test?
ANYWHERE ELSE?
RECORD ALL MENTIONED

PUBLIC SECTOR

TESTING CENTER A [##TRANSLATOR NOTE: THIS IS AN OFFICIAL LOCATION NAME]
HOSPITAL/MATERNITY B
MILITARY HOSPITAL/GARRISON C
HEALTH CENTER/FREE CLINIC/GARRISON D
NATIONAL PROGRAM FIGHTING AIDS (PNLS) E [##TRANSLATOR NOTE: THIS IS AN OFFICIAL LOCATION NAME]
POLYCLINIC F
HOSPITAL/HEALTH CENTER PHARMACY G
OTHER PUBLIC H

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL I
CLINIC/OFFICE J
CHADIAN ASSOCIATION FOR FAMILY WELL-BEING K
PRIVATE HEALTH CENTER L
COMPANY HEALTH CENTER M
CARE OFFICE/NURSE N
PHARMACY/PHARMACY DEPOT O
OTHER PRIVATE MEDICAL P

PUBLIC/PRIVATE SECTOR

VILLAGE PHARMACY/HEALTH CENTER Q

OTHER PLACE X

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Chad 2014

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931) Where is that?
PROBE TO IDENTIFY THE TYPE OF SOURCE.

IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE
ANY OTHER PLACE?
RECORD ALL MENTIONED

NAME OF PLACE(S)___________

PUBLIC SECTOR

VOLUNTARY TESTING CENTER A
HOSPITAL/MATERNITY B
MILITARY HOSPITAL/GARRISON C
HEALTH CENTER/FREE CLINIC D
SECTOR-SPECIFIC PROGRAM FOR THE FIGHT AGAINST AIDS E
POLYCLINIC F
PHARMACY OF HOSPITAL/HEALTH CENTER G
AL NADJMA CENTER [##TRANSLATOR NOTE: HIV/AIDS TESTING CENTER] H
OTHER PUBLIC SECTOR (SPECIFY) I

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL J
CLINIC/DOCTOR'S OFFICE K
CHADIAN ASSOCIATION FOR FAMILY WELL-BEING L
PRIVATE HEALTH CENTER M
BUSINESS HEALTH CENTER N
CARE OFFICE/INFIRMARY O
PHARMACY/PHARMACY DEPOT P
CHADIAN SOCIAL MARKETING ASSOCIATION Q
DIOCESAN CENTER FOR MEDICAL ACTION (CEDIAM) R
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) S

PUBLIC/PRIVATE SECTOR

PHARMACY/VILLAGE HEALTH CENTER T
COMMUNITY VOLUNTEER TESTING CENTER U
OTHER (SPECIFY) X

Survey form view entire document: text

931) Where is that?
PROBE TO IDENTIFY THE TYPE OF SOURCE.

IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE
ANY OTHER PLACE?
RECORD ALL MENTIONED

NAME OF PLACE(S)___________

PUBLIC SECTOR

VOLUNTARY TESTING CENTER A
HOSPITAL/MATERNITY B
MILITARY HOSPITAL/GARRISON C
HEALTH CENTER/FREE CLINIC D
SECTOR-SPECIFIC PROGRAM FOR THE FIGHT AGAINST AIDS E
POLYCLINIC F
PHARMACY OF HOSPITAL/HEALTH CENTER G
AL NADJMA CENTER [##TRANSLATOR NOTE: HIV/AIDS TESTING CENTER] H
OTHER PUBLIC SECTOR (SPECIFY) I

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL J
CLINIC/DOCTOR'S OFFICE K
CHADIAN ASSOCIATION FOR FAMILY WELL-BEING L
PRIVATE HEALTH CENTER M
BUSINESS HEALTH CENTER N
CARE OFFICE/INFIRMARY O
PHARMACY/PHARMACY DEPOT P
CHADIAN SOCIAL MARKETING ASSOCIATION Q
DIOCESAN CENTER FOR MEDICAL ACTION (CEDIAM) R
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) S

PUBLIC/PRIVATE SECTOR

PHARMACY/VILLAGE HEALTH CENTER T
COMMUNITY VOLUNTEER TESTING CENTER U
OTHER (SPECIFY) X

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Congo Brazzaville 2005

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830) Where is that? Any other place?
RECORD ALL PLACES MENTIONED.

PUBLIC SECTOR

HOSPITAL A
HEALTH CENTER/MOTHER-INFANT CENTER B
NATIONAL LABORATORY C
ANONYMOUS VOLUNTEER SCREENING CENTER D

PRIVATE MEDICAL SECTOR

CLINIC E
PRIVATE DOCTOR'S OFFICE F
LABORATORY G
MEDICAL-SOCIAL CENTER H
CONGOLESE ASSOCIATION FOR FAMILY WELL-BEING I

OTHER PLACE X

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Madagascar 2003

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816F. Where can you go for this test?
816FX. Where did you go for this test?
RECORD ALL MENTIONED.

IF IT'S A HOSPITAL, HEALTH CENTER OR CLINIC, WRITE THE NAME OF THE ESTABLISHMENT. PROBE TO DETERMINE THE PROPER TYPE OF SECTOR AND CIRCLE THE APPROPRIATE CODE.

NAME OF PLACE_________

PUBLIC SECTOR

DISTRICT HOSPITAL II [FACILITY EQUIPPED FOR SURGERIES] A
DISTRICT HOSPITAL I [NON-SURGICAL MEDICAL CAPABILITIES] B
BASIC HEALTH CENTER II [BASIC HEALTH CARE, PHYSICIAN-RUN] C
BASIC HEALTH CENTER I [BASIC HEALTH CARE, RUN BY PARA-MEDICAL OFFICER] D
OTHER PUBLIC (SPECIFY) _____ E

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL/CLINIC F
PRIVATE HEALTH CENTER G
PHARMACY/MEDICINE DISPERSAL CENTER H
PRIVATE DOCTOR I
PIF/FISA CENTER J
OTHER PRIVATE MEDICAL (SPECIFY) ____ K

OTHER LOCATION

VBC AGENT L
STORE M
KIOSK N
TRADITIONAL HEALER O

OTHER (SPECIFY) _____ X

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Madagascar 2008

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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 A HOSPITAL, HEALTH CENTER, OR CLINIC IS A PUBLIC OR PRIVATE INSTITUTION, WRITE THE NAME OF THE PLACE.

NAME OF PLACE(S) _____

PUBLIC SECTOR

DISTRICT HOSPITAL II (facility equipped for surgeries) A
DISTRICT HOSPITAL I (non-surgical medical capabilities) B
BASIC HEALTH CENTER II (basic health care, physician-run) C
BASIC HEALTH CENTER I (basic health care, run by para-medical officer) D
OTHER PUBLIC PLACE (SPECIFY) ______ E

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL/CLINIC F
PRIVATE HEALTH CENTER G
PHARMACY/MEDICINE DISPERSAL CENTER H
PRIVATE DOCTOR I
PF/FISA CENTER J
OTHER PRIVATE MEDICAL (SPECIFY) _____ K

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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