Survey Text

Congo Brazzaville 2005 Guinea 2005 Jordan 2017 Niger 2012
Congo Brazzaville 2011 Jordan 2007 Myanmar 2015 Nigeria 2013
Egypt 2014 Jordan 2012 Niger 2006 Senegal 2017
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Congo Brazzaville 2005
Survey form view entire document:  text 
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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Congo Brazzaville 2011
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931) Where is that?
Any other place?

PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.

PUBLIC SECTOR
HOSPITAL A
INTEGRATED HEALTH CENTER B
NATIONAL LABORATORY C
VOLUNTARY ANONYMOUS TESTING CENTER D
PRIVATE MEDICAL SECTOR
CLINIC E
DOCTOR'S OFFICE F
LABORATORY G
OTHER PLACE (SPECIFY) _____ X

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Egypt 2014
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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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Guinea 2005
Survey form view entire document:  text 
830. Where is that?
Any other place?
RECORD ALL PLACES MENTIONED.

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

NAME OF PLACE _____
PUBLIC SECTOR
NATIONAL REFERENCE LAB A
CHU B [note: some type of public health facility, meaning unclear]
REGIONAL HOSPITAL C
HOSPITAL D [note: the original shows "hospital pref.", the "pref." portion may mean preferential or preferred; again, this is some type of public hospital]
CMC F [note: some type of public health facility, meaning unclear]
OTHER PUBLIC (SPECIFY) _____ G
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC H
PRIVATE LABORATORY I
OTHER PRIVATE MEDICAL (SPECIFY) _____ J
OTHER (SPECIFY) _____ X

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Jordan 2007
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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
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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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Niger 2006
Survey form view entire document:  text 
830. Where is this? Is there another place?
RECORD ALL PLACES MENTIONED.

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

PLACE NAME __________
PUBLIC SECTOR
HOSPITAL A
CEDAV (ANONYMOUS AND VOLUNTARY TESTING CENTER) B
OTHER PUBLIC (SPECIFY) __________ 16 G
PRIVATE MEDICAL SECTOR
HOSPITAL/CLINIC 21 H
PRIVATE LAB 22 I
OTHER PRIVATE MEDICAL (SPECIFY) __________ 26 J
OTHER (SPECIFY) __________ 96 X

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Niger 2012
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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
A NATIONAL HOSPITAL
B REGIONAL HOSPITAL
C HD C
D MATERNITY
E INTEGRATED HEALTH CENTER
F CARITAS DÉVELOPPEMENT F
G AMBULATORY TREATMENT CENTER
H SCHOOL BASED CLINIC
I OTHER PUBLIC SECTOR (SPECIFY)
PRIVATE MEDICAL SECTOR
J PRIVATE HOSPITAL/CLINIC
K PRIVATE LABORATORY
L SCHOOL BASED CLINIC
M CLINIC/ NIGERIEN ASSOCIATION FOR FAMILIAL WELL-BEING
N OTHER PRIVATE MEDICAL SECTOR (SPECIFY)
X OTHER (SPECIFY)

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Nigeria 2013
Survey form view entire document:  text 
931) Where is that? (4)

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
GOVT. HEALTH CENTER B
STAND-ALONE VCT CENTER C
FAMILY PLANNING CLINIC D
MOBILE CLINIC E
FIELDWORKER F
OTHER PUBLIC SECTOR (SPECIFY)______ G
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR H
STAND ALONE VCT CENTER I
PHARMACY J
MOBILE CLINIC K
FIELDWORKER L
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)______ M
OTHER (SPECIFY)____ X

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Senegal 2017
Survey form view entire document:  text 
1017) Where was the test done?

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 11
GOVERNMENT HEALTH CENTER 12
HEALTH POST 13
GOVERNMENT FAMILY PLANNING CENTER 14
RURAL MATERNITY 15
HEALTH HUT 16
COMMUNITY PHARMACY 17
VOLUNTARY TESTING CENTER 18
MOBILE CLINIC 19
OTHER PUBLIC SECTOR (SPECIFY) _____ 20
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/OFFICE 21
PHARMACY 22
PRIVATE DOCTOR 23
RELIGIOUS FREE CLINIC 24
PRIVATE LABORATORY 25
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) _____ 26
OTHER SOURCE
SHOP 31
CHURCH 32
FRIENDS/RELATIVES 33
BAR 34
OTHER (SPECIFY) _____ 96