Survey Text

Afghanistan 2015 Ethiopia 2011 Malawi 2016 Senegal 2005
Angola 2015 Ghana 2008 Mali 2006 Senegal 2010
Benin 2001 Ghana 2014 Mali 2012 Senegal 2014
Benin 2006 Guinea 2005 Mali 2018 Senegal 2015
Benin 2017 Guinea 2012 Myanmar 2015 Senegal 2016
Burkina Faso 2010 India 2005 Namibia 2006 Senegal 2017
Burundi 2010 India 2015 Namibia 2013 South Africa 2016
Burundi 2016 Jordan 2007 Nepal 2006 Togo 2013
Cameroon 2011 Jordan 2012 Nepal 2011 Uganda 1995
Cameroon 2018 Jordan 2017 Nepal 2016 Uganda 2006
Chad 2004 Kenya 2008 Niger 2006 Uganda 2011
Chad 2014 Kenya 2014 Niger 2012 Uganda 2016
Congo (Democratic Republic) 2007 Lesotho 2009 Nigeria 2008 Zambia 2007
Congo (Democratic Republic) 2013 Lesotho 2014 Nigeria 2013 Zambia 2013
Cote d'Ivoire 2011 Liberia 2007 Pakistan 2012 Zambia 2018
Egypt 2005 Liberia 2013 Pakistan 2017 Zimbabwe 2005
Egypt 2014 Madagascar 2003 Rwanda 2005 Zimbabwe 2015
Eswatini (Swaziland) 2006 Madagascar 2008 Rwanda 2010
Ethiopia 2005 Malawi 2010 Rwanda 2014
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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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Angola 2015
Survey form view entire document:  text 
1031) Do you know of any place where people can go to get an HIV test done?

YES 1
NO 2 (GO TO 1033)

1032) Where?
Any other place?
MULTIPLE CHOICES
PROBE TO IDENTIFY THE PLACE.
IF IT IS NOT POSSIBLE TO DETERMINE IF THE PLACE IS PUBLIC OR PRIVATE, RECORD THE NAME OF THE PLACE.

(NAME OF PLACE)____
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
REGIONAL HOSPITAL B
MUNICIPAL HOSPITAL C
CATV (Office for Advice and Voluntary Testing of HIV/AIDS) D
HEALTH CENTER E
PTV F
OTHER PUBLIC: (SPECIFY)____ G
PRIVATE SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR H
CATV I
PHARMACY J
OTHER PRIVATE: (SPECIFY)____ K
OTHER: (SPECIFY)____ X

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Benin 2001
Survey form view entire document:  text 
817F) Where can you go for this test?
RECORD ALL MENTIONED.

817FX) Where did you go for this test?

IF SOURCE IS HOSPITAL, HEALTH CENTER, 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
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
FAMILY PLANNING CLINIC C
MATERNITY D
MOBILE CLINIC E
FIELDWORKER F
OTHER (SPECIFY)_____ G
PRIVATE MEDICAL SECTOR
CLINIC H
PHARMACY I
PRIVATE DOCTOR J
FIELDWORKER K
OTHER PRIVATE MEDICAL (SPECIFY) ______ L
COMMUNITY SECTOR
HEALTH CENTER M
HEALTH WORKER N
ADBC/MATRON/MIDWIFE/NURSE'S AIDE O
PARA-PUBLIC SECTOR
INFORMATION AND ADVICE CENTER P
PNLS (NATIONAL PROGRAM AGAINST AIDS) Q
OTHER (SPECIFY)_____ R
OTHER SOURCE
SHOP/MARKET S
TRADITIONAL PRACTITIONER T
CHURCH U
RELATIVES/FRIENDS V
OTHER (SPECIFY) _____ X

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Benin 2006
Survey form view entire document:  text 
928 Where is that? (4)
Any other place?
PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE) __________
PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
STAND-ALONE VCT CENTER C
FAMILY PLANNING CLINIC D
MOBILE CLINIC E
FIELDWORKER F
OTHER PUBLIC (SPECIFY) _________ G
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR H
STAND-ALONE VCT CENTER 2I
PHARMACY J
MOBILE CLINIC K
FIELDWORKER L
OTHER PRIVATE MEDICAL (SPECIFY) __________ M
OTHER (SPECIFY) ___________ X

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Benin 2017
Survey form view entire document:  text 
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
Govt. Hospital A
Govt. Health Center B
Stand-Alone HTC Center C
Family planning clinic D
Mobile HTC Services E

Other public sector (specify) F
Private medical sector
Private hospital/clinic G
Stand-Alone HTC Center H
Pharmacy I
Mobile HTC Services J

Other private medical (specify) K

Other (specify) X

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Burkina Faso 2010
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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Burundi 2010
Survey form view entire document:  text 
929) Where was the test done? (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 11
GOVT. HEALTH CENTER 12
STAND-ALONE VCT CENTER 13
FAMILY PLANNING CLINIC 14
MOBILE CLINIC 15
FIELDWORKER 16
SCHOOL BASED CLINIC 17
OTHER PUBLIC SECTOR (SPECIFY)______ 18
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR 21
STAND ALONE VCT CENTER 22
PHARMACY 23
MOBILE CLINIC 24
FIELDWORKER 25
SCHOOL BASED CLINIC 26
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)______ 27
OTHER SOURCE
HOME 31
CORRECTIONAL FACILITY 32
OTHER (SPECIFY)____ 96

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Burundi 2016
Survey form view entire document:  text 
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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Cameroon 2011
Survey form view entire document:  text 
1235) Where is that?

Anywhere else?

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

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

NAME OF PLACE: ___
PUBLIC SECTOR
HOSPITAL A
HEALTH CENTER/INTEGRATED HEALTH CENTER/DISPENSARY/
MOTHER AND CHILD CARE CENTER B
HEALTH WORKER C
HIV PREVENTION AND VOLUNTARY TESTING CENTER D
MOBILE CLINIC E
OTHER PUBLIC (SPECIFY): ___ F
PRIVATE MEDICAL SECTOR
PRIVATE RELIGIOUS HOSPITAL G
PRIVATE SECULAR HOSPITAL/CLINIC H
HEALTH CENTER/RELIGIOUS DISPENSARY/MISSION I
MEDICAL OFFICE J
PHARMACY K
HEALTH WORKER L
HIV PREVENTION AND VOLUNTARY TESTING CENTER M
MOBILE CLINIC N
OTHER PRIVATE MEDICAL (SPECIFY): ___ O
OTHER SOURCE (SPECIFY): ___ X

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Cameroon 2018
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.

PUBLIC SECTOR
GOVERNMENT HOSPITAL A
SUB-DIVISIONAL MEDICAL CENTER / INTEGRATED HEALTH CENTER / DISPENSARY B
HEALTH / COMMUNITY WORKER C
STAND-ALONE HTC CENTER D
MOBILE HTC SERVICES / CNLS E
OTHER PUBLIC SECTOR (SPECIFY)_________F
PRIVATE MEDICAL SECTOR
CONFESSIONAL HOSPITAL / CLINIC G
PRIVATE LAY HOSPITAL / CLINIC H
CONFESSIONAL HEALTH CENTER / DISPENSARY I
DOCTOR'S OFFICE J
PHARMACY K
STAND-ALONE HTC CENTER L
MOBILE HTC SERVICES M
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)________N
OTHER SOURCE
HOME O
WORKPLACE P
CORRECTIONAL FACILITY Q
SCHOOL / CULTURAL CENTER R
OTHER (SPECIFY)__________X

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Chad 2004
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
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 (Democratic Republic) 2007
Survey form view entire document:  text 
830) Where is that?
Any other place?
RECORD ALL PLACES MENTIONED.

IF SOURCE IS HOSPITAL, HEALTH CENTER 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
HOSPITAL A
HEALTH CENTER/OUTPOST B
ANONYMOUS VOLUNTEER SCREENING CENTER C
FAMILY PLANNING CLINIC D
MOBILE VOLUNTEER SCREENING CENTER E
TRAVELING TREATMENT CENTER F
OTHER PUBLIC (SPECIFY) _____ G
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/POLYCLINIC H
MOBILE VOLUNTEER SCREENING CENTER I
TRAVELING TREATMENT CENTER J
YOUTH SUPERVISING CENTER K
OTHER PRIVATE MEDICAL (SPECIFY) _____ L
OTHER (SPECIFY) _____ X

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Congo (Democratic Republic) 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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Cote d'Ivoire 2011
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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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

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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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Ghana 2008
Survey form view entire document:  text 
928 Where is that? (4)
Any other place?
PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE) __________
PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
STAND-ALONE VCT CENTER C
FAMILY PLANNING CLINIC D
MOBILE CLINIC E
FIELDWORKER F
OTHER PUBLIC (SPECIFY) _________ G
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR H
STAND-ALONE VCT CENTER 2I
PHARMACY J
MOBILE CLINIC K
FIELDWORKER L
OTHER PRIVATE MEDICAL (SPECIFY) __________ M
OTHER (SPECIFY) ___________ X

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Ghana 2014
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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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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Guinea 2012
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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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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Kenya 2008
Survey form view entire document:  text 
928 Where is that? (4)
Any other place?
PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE) __________
PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
STAND-ALONE VCT CENTER C
FAMILY PLANNING CLINIC D
MOBILE CLINIC E
FIELDWORKER F
OTHER PUBLIC (SPECIFY) _________ G
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR H
STAND-ALONE VCT CENTER 2I
PHARMACY J
MOBILE CLINIC K
FIELDWORKER L
OTHER PRIVATE MEDICAL (SPECIFY) __________ M
OTHER (SPECIFY) ___________ X

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Kenya 2014
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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Lesotho 2009
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 MEDICAL SECTOR, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE(S)) ________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVT. HEALTH CENTER B
OTHER PUBLIC SECTOR C
PRIVATE MEDICAL SECTOR
PVT HOSPITAL/CLINIC D
LPPA E
PHARMACY F
PVT DOCTOR G
OTHER PRIVATE MEDICAL SECTOR H
CHAL
CHAL HOSPITAL I
CHAL HEALTH CENTER J
COMMUNITY HEALTH WORKER/SUPPORT GROUPS K
OTHER X

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Lesotho 2014
Survey form view entire document:  text 
930) Do you know of a place where people can go to get tested for HIV?

YES 1
NO 2 (GO TO 931A)

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 ____
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
GOVERNMENT HEALTH POST C
FAMILY PLANNING CLINIC D
OTHER PUBLIC SECTOR (SPECIFY) ____ E
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC F
PHARMACY G
PRIVATE DOCTOR H
LESOTHO PLANNED PARENTHOOD I
PSI/NEW START CENTER J
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) ____ K
CHAL
CHAL HOSPITAL L
CHAL HEALTH CENTER M
CHAL HEALTH POST N
RED CROSS HEALTH CENTER O
VILLAGE HEALTH WORKER P
SUPPORT GROUPS Q
FACILITY OUTSIDE OF LESOTHO R
OTHER (SPECIFY) ____ X

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Liberia 2007
Survey form view entire document:  text 
928 Where is that? (4)
Any other place?
PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE) __________
PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
STAND-ALONE VCT CENTER C
FAMILY PLANNING CLINIC D
MOBILE CLINIC E
FIELDWORKER F
OTHER PUBLIC (SPECIFY) _________ G
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR H
STAND-ALONE VCT CENTER 2I
PHARMACY J
MOBILE CLINIC K
FIELDWORKER L
OTHER PRIVATE MEDICAL (SPECIFY) __________ M
OTHER (SPECIFY) ___________ X

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Liberia 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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Madagascar 2003
Survey form view entire document:  text 
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
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 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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Malawi 2010
Survey form view entire document:  text 
1333. 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
GOVERNMENT HEALTH POST/OUTREACH C
HSA D
DOOR TO DOOR E
OTHER PUBLIC F
CHAM/MISSION
HOSPITAL G
HEALTH CENTER H
MOBILE CLINIC I
DOOR TO DOOR J

PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR K
PRIVATE COMPANY HOSPITAL/CLINIC L
OTHER PRIVATE MEDICAL M
BLM N
MACRO O
OTHER X

THANK THE RESPONDENT FOR HER COOPERATION AND REASSURE HER ABOUT THE CONFIDENTIALITY OF HER ANSWERS.


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Malawi 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
GOVERNMENT HEALTH CENTER B
GOVERNMENT HEALTH POST/OUTREACH C
HSA D
DOOR TO DOOR E
OTHER PUBLIC SECTOR (SPECIFY) F
CHAM/MISSION
HOSPITAL G
HEALTH CENTER H
MOBILE CLINIC I
DOOR TO DOOR J
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR K
PHARMACY L
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) M
BLM N
MACRO O
OTHER SOURCE
HOME P
WORKPLACE Q
CORRECTIONAL FACILITY R
OTHER (SPECIFY) X

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Mali 2006
Survey form view entire document:  text 
830. Where is this?
Is there another place?

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.

RECORD ALL PLACES MENTIONED.

PLACE NAME___
PUBLIC SECTOR
NATIONAL REF LAB A
NATIONAL HOSPITAL B
REGIONAL HOSPITAL C
CSREF (heath referral center) D
CSCOM (Centre de Santé Communitaire) Community Health Center F
OTHER PUBLIC (SPECIFY) __G
PRIVATE MEDICAL SECTOR
CESAC (AIDS treatment center in Mali) H
VCT I
OTHER PRIVATE MEDICAL (SPECIFY) __J
OTHER (SPECIFY) __X

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Mali 2012
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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Mali 2018
Survey form view entire document:  text 
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
GOVT. HOSPITAL 11
GOVT. HEALTH CENTER 12
STAND-ALONE HTC CENTER 13
MOBILE HTC SERVICES 14
OTHER PUBLIC SECTOR (SPECIFY) 16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/DOCTOR 21
STAND-ALONE HTC CENTER 22
MOBILE HTC SERVICES 23
OTHER PRIVATE MEDICAL (SPECIFY) 26
OTHER (SPECIFY) 96

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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

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

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Namibia 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 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
GVT. PRIMARY HEALTH CARE CLINIC D
OUTREACH POINT E
MOBILE CLINIC F
SCHOOL BASED CLINIC G
OTHER PUBLIC SECTOR (SPECIFY __________) H
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLNIC/PRIVATE DOCTOR I
STAND-ALONE VCT CENTER J
PHARMACY K
MOBILE CLNIC L
FIELDWORKER M
SCHOOL BASED CLINIC N
OTHER PRIVATE MEDICAL SECTOR (SPECIFY __________) O
OTHER SOURCE
HOME P
CORRECTIONAL FACILITY Q
OTHER (SPECIFY __________) X

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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

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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

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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

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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
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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Nigeria 2008
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) ___________________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
STAND-ALONE VCT CENTER C
FAMILY PLANNING CLINIC D
MOBILE CLINIC E
FIELDWORKER F
OTHER PUBLIC (SPECIFY) ______ G
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR H
STAND-ALONE VCT CENTER I
PHARMACY J
CHEMIST/PMS K
MOBILE CLINIC L
FIELDWORKER M
OTHER PRIVATE MEDICAL (SPECIFY) ______ N
OTHER (SPECIFY) _______________ X

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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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Pakistan 2012
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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Pakistan 2017
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
GOVERNMENT HEALTH CENTER B
STAND-ALONE HTC CENTER C
OTHER PUBLIC SECTOR (SPECIFY) _________ D
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR E
STAND-ALONE HTC CENTER F
PHARMACY G
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) _______ H
OTHER (SPECIFY) _______ X

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Rwanda 2005
Survey form view entire document:  text 
928 Where is that? (4)
Any other place?
PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE) __________
PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
STAND-ALONE VCT CENTER C
FAMILY PLANNING CLINIC D
MOBILE CLINIC E
FIELDWORKER F
OTHER PUBLIC (SPECIFY) _________ G
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR H
STAND-ALONE VCT CENTER 2I
PHARMACY J
MOBILE CLINIC K
FIELDWORKER L
OTHER PRIVATE MEDICAL (SPECIFY) __________ M
OTHER (SPECIFY) ___________ X

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Rwanda 2010
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/AGREE SECTOR
REFERAL HOSPITAL A
DISTRICT HOSPITAL B
HEALTH CENTER C
HEALTH POST D
OUTREACH E
COMMUNITY HEALTH WORKER F
OTHER PUBLIC HEALTH FACILITY (SPECIFY) G
PRIVATE MEDICAL SECTOR
POLYCLINIC H
CLINIC I
DISPENSARY J
PHARMACY K
FAMILY PLANNING CLINIC L
OTHER PRIVATE MEDICAL FACILITY (SPECIFY) M
OTHER SOURCE
KIOSK N
TRADITIONAL BIRTH ATTENDANT O
FRIEND/RELATIVE P
CORRECTIONAL FACILITY Q
OTHER (SPECIFY) X

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Rwanda 2014
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/AGREE SECTOR
REFERRAL HOSPITAL A
PROVINCIAL/DISTRICT HOSPITAL B
HEALTH CENTER C
HEALTH POST D
OUTREACH E
COMMUNITY HEALTH WORKER F
OTHER PUBLIC HEALTH FACILITY (SPECIFY) ____ G
PRIVATE MEDICAL SECTOR
POLYCLINIC H
CLINIC I
DISPENSARY J
PHARMACY K
FAMILY PLANNING CLINIC L
OTHER PRIVATE HEALTH FACILITY (SPECIFY) ____ M
OTHER SOURCES
KIOSK/SHOP/BAR N
TRADITIONAL HEALER O
FRIEND/RELATIVE P
YOUTH CENTER Q
CORRECTIONAL FACILITY R
OTHER (SPECIFY) ____ X

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Senegal 2005
Survey form view entire document:  text 
830. Where is this?
Is there another place?
RECORD ALL PLACES MENTIONED.

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

NAME OF PLACE _____
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
PLANNING FAMILY CENTER C
TESTING CENTER D
STRAT. AVANCÉE/EQU. MOBLI E
HEALTH CARE WORKER F
OTHER PUBLIC (SPECIFY) _____G
PRIVATE MEDICAL SECTOR
HOSPITAL/CLINIC/OFFICE H
PHARMACY I
PRIVATE DOCTOR J
HEALTH CARE WORKER K
OTHER PRIVATE (SPECIFY) _____L
OTHER (SPECIFY) _____X

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Senegal 2010
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 2014
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 (GO 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
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
HEALTH POST C
GOVT. FAMILY PLANNING CENTER D
RURAL MATERNITY E
HEALTH HUT F
COMMUNITY PHARMACY G
MOBILE CLINIC H
OTHER PUBLIC SECTOR (SPECIFY) I
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/OFFICE J
PHARMACY K
PRIVATE DOCTOR L
RELIGIOUS FREE CLINIC M
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) N
OTHER SOURCE
SHOP O
CHURCH P
FRIENDS/RELATIVES Q
BAR R
OTHER (SPECIFY) X

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Senegal 2015
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
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
HEALTH POST C
GOVT. FAMILY PLANNING CENTER D
RURAL MATERNITY E
HEALTH HUT F
COMMUNITY PHARMACY G
VOLUNTARY TESTING CENTER H
MOBILE CLINIC I
OTHER PUBLIC SECTOR (SPECIFY) _____ J
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/OFFICE K
PHARMACY L
PRIVATE DOCTOR M
PRIVATE LABORATORY N
RELIGIOUS FREE CLINIC P
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) _____ N
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) _____ O
OTHER SOURCE
SHOP P
CHURCH Q
FRIENDS/RELATIVES R
BAR S
OTHER (SPECIFY) _____ X

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Senegal 2016
Survey form view entire document:  text 
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
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
HEALTH POST C
GOVERNMENT FAMILY PLANNING CENTER D
RURAL MATERNITY E
HEALTH HUT F
COMMUNITY PHARMACY G
VOLUNTARY TESTING CENTER H
MOBILE CLINIC I
OTHER PUBLIC SECTOR (SPECIFY) _____ J
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/OFFICE K
PHARMACY L
PRIVATE DOCTOR M
RELIGIOUS FREE CLINIC N
PRIVATE LABORATORY O
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) _____ P
OTHER SOURCE
SHOP Q
CHURCH R
FRIENDS/RELATIVES S
BAR T
OTHER (SPECIFY) _____ X

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Senegal 2017

No questionnaire text is available for this sample.


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South Africa 2016
Survey form view entire document:  text 
1032) Where is that? Any other place?
PROBE TO IDENTIFY THE TYPE OF SOURCE. IF UNABLE TO IDENTIFY IF PUBLIC OR PRIVATE SECTOR, RECORD 'X' AND WRITE THE NAME OF THE PLACE(S).

PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT CLINIC/COMMUNITY HEALTH CENTRE B
MOBILE/TEMPORARY HCT SERVICES C
OTHER PUBLIC SECTOR (SPECIFY) _________ D
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR E
NEW START CENTRE F
CHEMIST/PHARMACY G
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) _________ H
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 (GO TO 932)

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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Uganda 1995
Survey form view entire document:  text 
835) Where could you go?

PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
DISPENSARY/HEALTH UNIT C
MOBILE CLINIC D
FIELD WORKER E
OTHER PUBLIC (SPECIFY) __________ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY/DRUG STORE H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELD WORKER K
OTHER PRIVATE MEDICAL (SPECIFY) ________ L
OTHER PRIVATE SECTOR
SHOP M
CHURCH N
FRIENDS/RELATIVES O
OTHER (SPECIFY) _________ X
DOES NOT KNOW Z

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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
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
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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Uganda 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 PRIBATE SECTOR, WRITE THE NAME OF THE PALCE.

(NAME OF PLACE) ___________

PUBLIC SETOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE VCT SERICES D
COMMUNITY HEALTH WORKER/VH E
OTHER PUBLIC SECTOR (SPECIFY)_______F
PRIVATE MEDICAL SECTOR
PRIVATE GISOURAK/CLINIC/PRIVATE DOCTOR G
PHARMACY/DRUG SHOP H
MEBILE VCT SERVICES I
COMMUNITY HEALTH WORKER J
OTHER PRIVAT MEDICAL SECTOR (SPECIFY) _____K
OTHER (SPECIFY) ______X

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Zambia 2007
Survey form view entire document:  text 
928 Where is that? (4)
Any other place?
PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE) __________
PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
STAND-ALONE VCT CENTER C
FAMILY PLANNING CLINIC D
MOBILE CLINIC E
FIELDWORKER F
OTHER PUBLIC (SPECIFY) _________ G
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR H
STAND-ALONE VCT CENTER 2I
PHARMACY J
MOBILE CLINIC K
FIELDWORKER L
OTHER PRIVATE MEDICAL (SPECIFY) __________ M
OTHER (SPECIFY) ___________ X

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Zambia 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 (GO TO 932)

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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Zambia 2018
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
GOVERNMENT HEALTH CENTER B
GOVERNMENT HEALTH POST C
STAND-ALONE HTC CENTER D
MOBILE HTC SERVICES E
OTHER PUBLIC SECTOR (SPECIFY) __________________________ F

PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/ PRIVATE DOCTOR G
MISSION HOSPITAL/CLINIC H
STAND-ALONE HTC CENTER I
PHARMACY J
MOBILE HTC SERVICES K
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) _________________ L
OTHER (SPECIFY) __________________ X

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Zimbabwe 2005
Survey form view entire document:  text 
928 Where is that? (4)
Any other place?
PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE) __________
PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
STAND-ALONE VCT CENTER C
FAMILY PLANNING CLINIC D
MOBILE CLINIC E
FIELDWORKER F
OTHER PUBLIC (SPECIFY) _________ G
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR H
STAND-ALONE VCT CENTER 2I
PHARMACY J
MOBILE CLINIC K
FIELDWORKER L
OTHER PRIVATE MEDICAL (SPECIFY) __________ M
OTHER (SPECIFY) ___________ X

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Zimbabwe 2015
Survey form view entire document:  text 
1031. Do you know of a place where people can go to get an HIV test?

YES 1
NO 2 (GO TO 1033)