Survey Text

Afghanistan 2015 Ghana 2008 Nigeria 2008 Uganda 2006
Benin 2001 Ghana 2014 Nigeria 2013 Uganda 2011
Benin 2006 Guinea 2012 Rwanda 2000 Uganda 2016
Benin 2011 India 2015 Rwanda 2010 Zambia 2007
Burundi 2010 Madagascar 2003 Rwanda 2014 Zambia 2013
Cameroon 2011 Malawi 2010 Senegal 2005
Cameroon 2018 Myanmar 2015 Tanzania 2010
Cote d'Ivoire 2011 Namibia 2006 Uganda 1995
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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 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 
830) Where is that? Any other place?
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.
RECORD ALL MENTIONED.

NAME OF PLACE _________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
FAMILY PLANNING CLINIC C
SCREENING CENTER D
STRAT AV HEALTH WORKER/MOBILE CLINIC E
HEALTH WORKER F
OTHER PUBLIC (SPECIFY) ________ G
PRIVATE MEDICAL SECTOR
HOSPITAL/CLINIC/OFFICE H
PHARMACY I
PRIVATE DOCTOR J
HEALTH AGENT K
OTHER PRIVATE MEDICAL (SPECIFY) ________ L
OTHER (SPECIFY) ________ X

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Benin 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

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

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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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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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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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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Ghana 2008
Survey form view entire document:  text 
928. Where is that? Any other place?
PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
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
GOVT. HOSPITAL/POLYCLINIC A
GOVT. HEALTH CENTER B
GOVT. HEALTH POST/CHPS C
STAND-ALONE VCT CENTER D
FAMILY PLANNING CLINIC E
MOBILE CLINIC F
FIELDWORKER/OUTREACH/PEER EDUCATOR G
OTHER PUBLIC (SPECIFY) _____
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR H
STAND-ALONE VCT CENTER J
PHARMACY K
CHEMICAL/DRUG STORE L
FP/PPAG CLINIC M
MATERNITY HOME N
OTHER PRIVATE MEDICAL (SPECIFY) ____ O
OTHER SOURCE
SHOP/MARKET P
CHURCH Q
FRIEND/RELATIVE R
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 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 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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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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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.


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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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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Nigeria 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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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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Rwanda 2000
Survey form view entire document:  text 
817F. Where can you go for this test?
817FX. Where did you go for this test?

IF SOURCE IS A HOSPITAL, HEALTH CENTER, OR CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO DETERMINE THE TYPE OF SOURCE AND CRICLE THE APPROPRIATE CODE.

RECORD ALL MENTIONED

NAME OF PLACE____
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC (SPECIFY)_____F
PRIVATE MEDICAL SECTOR
PRIVATE CLINIC/HOSPITAL G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL (SPECIFY)_____ L
OTHER SOURCE
SHOP M
CHURCH N
RELATIVES/FRIENDS O
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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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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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? 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 B
STAND-ALONE VCT CENTER C
FAMILY PLANNING CLINIC D
MOBILE CLINIC E
COMMUNITY/FIELDWORKER F
OTHER PUBLIC (SPECIFY) ______ G

PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR H
MISSION HOSPITA/CLINIC I
STAND-ALONE VCT CENTER J
MOBILE CLINIC K
COMMUNITY/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? Any other place?

PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE(S). IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

NAME OF PLACE(S) _____
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT CENTER/POST B
STAND-ALONE VCT CENTRE C
FAMILY PLANNING CLINIC D
MOBILE HOSPITAL/CLINIC E
COMMUNITY BASED AGENT/FIELDWORKER F
OTHER PUBLIC SECTOR (SPECIFY) __________________G
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR H
MISSION HOSPITAL/CLINIC I
STAND-ALONE VCT CENTRE J
MOBILE HOSPITAL/CLINIC K
COMMUNITY BASED AGENT/FIELDWORKER L
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) _____________________ M
OTHER SOURCE
PRISON N
OTHER (SPECIFY) _________________________X