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Afghanistan 2015

Survey form view entire document: text

945. Where did you go? 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

CHARITY/FOUNDATIONS U
REFUGEE CAMP V
SHOP W

OTHER___________X

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Benin 2017

Survey form view entire document: text

1050. Where did you go?
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
FAMILY PLANNING CLINIC D
MOBILE HTC SERVICES E
OTHER PUBLIC SECTOR (SPECIFY)____________F

PRIVATE MEDICAL SECTOR

PRIVATE/HOSPITAL/CLINIC PRIVATE DOCTOR G
STAND-ALONE HTC CENTER H
PHARMACY I
MOBILE HTC SERVICES J
OTHER PRIVATE MEDICAL SECTOR (SPECIFY)_____________K

OTHER SOURCE

SHOP L

OTHER (SPECIFY)________________X

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Burkina Faso 2010

Survey form view entire document: text

945) Where did you go? (4)
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
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 SOURCE

SHOP N
OTHER (SPECIFY)____ X

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Burundi 2010

Survey form view entire document: text

945) Where did you go? (4)
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
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 SOURCE

SHOP N
OTHER (SPECIFY)____ X

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Burundi 2016

Survey form view entire document: text

1050) Where did you go? 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

NATIONAL GOVERNMENT HOSPITAL A
REGIONAL GOVERNMENT HOSPITAL B
DISTRICT HOSPITAL C
GOVERNMENT HEALTH CENTER D
INDEPENDENT TESTING CENTER E
MOBILE TESTING SERVICE F
OTHER____________G

CERTIFIED MEDICAL SECTOR

CERTIFIED HOSPITAL H
CERTIFIED HEALTH CENTER I
OTHER PRIVATE MEDICAL__________J

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL/CLINIC/DOCTOR K
PRIVATE HEALTH CARE CENTER L
INDEPENDENT TESTING CENTER M
PHARMACY N
MOBILE TESTING SERVICE O
OTHER PRIVATE MEDICAL__________P

OTHER SOURCE

SHOP Q

OTHER_____________X

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Cameroon 2011

Survey form view entire document: text

945) Where did you go? (4)
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
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 SOURCE

SHOP N
OTHER (SPECIFY)____ X

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Cameroon 2018

Survey form view entire document: text

1050. Where did you go? 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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Congo (Democratic Republic) 2013

Survey form view entire document: text

945) Where did you go? 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(S)) ____

RECORD ALL MENTIONED.

PUBLIC SECTOR

GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
STAND-ALONG VCT CENTER C
FAMILY PLANNING CLINIC D
MOBILE VCT CLINIC E
FIELDWORKER F
TRAVELING TREATMENT CENTER G
OTHER PUBLIC SECTOR (SPECIFY) H

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL/MEDICAL POLYCLINIC I
MOBILE VCT CLINIC J
TRAVELING TREATMENT CENTER K
YOUTH CENTER L
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) M

OTHER (SPECIFY) X

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Cote d'Ivoire 2011

Survey form view entire document: text

945) Where did you go? (4)
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
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 SOURCE

SHOP N
OTHER (SPECIFY)____ X

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Eswatini (Swaziland) 2006

Survey form view entire document: text

1011) Where did you go?
Any other place?
RECORD ALL SOURCES MENTIONED.
PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE(S).
WRITE THE NAME OF THE PLACE.

(NAME OF PLACE)__________

PUBLIC SECTOR

GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
PHU/CLINIC C
MOBILE CLINIC D
RHM E
OTHER PUBLIC (SPECIFY) _______F

PRIVATE SECTOR

PRIVATE. HOSPITAL/CLINIC G
PHARMACY H
PRIVATE. DOCTOR I
MOBILE CLINIC J
OTHER PRIVATE (SPECIFY) ________

MISSION

HOSPITAL L
CLINIC M
OTHER MISSION (SPECIFY) _________N

NGO O
TASC P

OTHER SOURCE

SHOP Q
TRADITIONAL HEALER R

OTHER (SPECIFY) _______X
(ALL GO TO 1013)

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India 2015

Survey form view entire document: text

1055. Where did you go?
Any other place?

RECORD ALL PLACES MENTIONED. IF UNABLE TO DETERMINE IF 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
VAIDYA/HAKIM/HOMEOPATH (AYUSH) B
GOVERNMENT HEALTH CENTRE C
STAND-ALONE ICTC D
FAMILY PLANNING CLINIC E
MOBILE CLINIC F
FIELDWORKER G
SCHOOL BASED CLINIC H
OTHER PUBLIC SECTOR (SPECIFY) ________I

NGO OR TRUST HOSPITAL/CLINIC J

PRIVATE HEALTH SECTOR

PRIVATE HOSPITAL/CLINIC PRIVATE DOCTOR K
VAIDYA/HAKIM/HOMEOPATH (AYUSH) L
STAND-ALONE ICTC M
PHARMACY N
MOBILE CLINIC O
FIELDWORKER P
SCHOOL BASED CLINIC Q
OTHER PRIVATE HEALTH SECTOR (SPECIFY) _______R

OTHER SOURCE

HOME S
CORRECTIONAL FACILITY T

OTHER (SPECIFY) ___________X

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Liberia 2007

Survey form view entire document: text

950 Where did you go? (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 SOURCE

SHOP N
OTHER (SPECIFY) ___________ X

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Liberia 2013

Survey form view entire document: text

945) Where did you go? (4)
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
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 SOURCE

SHOP N
OTHER (SPECIFY)____ X

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Mali 2018

Survey form view entire document: text

1050) Where did you go?

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

NATIONAL HOSPITAL A
REGIONAL HOSPITAL B
REFERENCE HEALTH CENTER C
COMMUNITY HEALTH CENTER D
DISPENSARY/MATERNITY E
STAND-ALONE HTC CENTER F
MOBILE HTC SERVICES G
OTHER PUBLIC SECTOR (SPECIFY) H

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR I
STAND-ALONE HTC CENTER J
PHARMACY K
MOBILE HTC SERVICES L
OTHER PRIVATE MEDICAL (SPECIFY) M

OTHER SOURCE

SHOP N

OTHER (SPECIFY) X

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Myanmar 2015

Survey form view entire document: text

945) Where did you go? 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 (RHC) B
GOVT. HEALTH POST (SUB-CENTER) C
STAND-ALONE VCT CENTER D
FAMILY PLANNING CLINIC E
MOBILE CLINIC F
FIELDWORKER G
OTHER PUBLIC SECTOR___(SPECIFY) H

NGO

MARIE STOPES I
MYANMAR RED CROSS SOCIETY J
PSI/M (SUN) K
MMA L
OTHER NGO SECTOR___(SPECIFY) M

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR N
STAND-ALONE VCT CENTER O
PHARMACY P
MOBILE CLINIC Q
FIELDWORKER R
OTHER PRIVATE MEDICAL SECTOR___(SPECIFY) S

OTHER SOURCE

SHOP T
OTHER____(SPECIFY) X

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Namibia 2013

Survey form view entire document: text

945) Where did you go? (4)
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
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 SOURCE

SHOP N
OTHER (SPECIFY)____ X

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Nigeria 1999

Survey form view entire document: text

801I. Where did you seek advice or treatment?
ANY OTHER PLACE OR PERSON.
RECORD ALL MENTIONED.

PUBLIC SECTOR

GOVT. HOSPITAL A
HEALTH CENTER B
FP CLINIC C
MOBILE CLINIC D
DISPENSARY E
OTHER PUBLIC SECTOR F

MEDICAL PRIVATE SECTOR

PRIVATE HOSPITAL/CLINIC G
PHARMACY/PMS H
PRIVATE DOCTOR I
MOBILE CLINIC J
OTHER MED. PRIVATE SECTOR K
OTHER SHOP L
RELATIVES/FRIENDS M
TRADITIONAL HEALER N
OTHER (SPECIFY) _______________ X
DOES NOT KNOW Z

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Nigeria 2008

Survey form view entire document: text

950 Where did you go? (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 SOURCE

SHOP N
OTHER (SPECIFY) ___________ X

top

Nigeria 2013

Survey form view entire document: text

945) Where did you go? (4)
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
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 SOURCE

SHOP N
OTHER (SPECIFY)____ X

top

Nigeria 2018

Survey form view entire document: text

1050. Where did you go?

Any other place?

PROBE TO IDENTIFY THE TYPE OF SOURCE.

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

PUBLIC SECTOR

GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
STAND-ALONE HTS CENTER C
FAMILY PLANNINGCLINIC D
MOBILE HTS CENTER E
OTHER PUBLIC SECTOR _____ F

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR G
STAND-ALONE HTS CENTER H
PHARMACY I
CHEMIST/PMS STORE J
MOBILE HTS SERVICES K
OTHER PRIVATE MEDICAL SECTOR ______ L

OTHER SOURCE

SHOP M
OTHER ______ X

top

Pakistan 2012

Survey form view entire document: text

945) Where did you go? (4)
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
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 SOURCE

SHOP N
OTHER (SPECIFY)____ X

top

Uganda 1995

Survey form view entire document: text

810) Where did you seek advice or treatment? Any other place or person?

RECORD ALL MENTIONED

PUBLIC SECTOR

GOVERNMENT HOSPITAL A (GO TO 810B)
GOVERNMENT HEALTH CENTER B (GO TO 810B)
DISPENSARY/HEALTH UNIT C (GO TO 810B)
GOVERNMENT MOBILE CLINIC D (GO TO 810B)
GOVERNMENT FIELD WORKER E (GO TO 810B)
OTHER PUBLIC (SPECIFY) _________ F (GO TO 810B)

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL/CLINIC G (GO TO 810B)
PHARMACY/DRUG STORE H (GO TO 810B)
PRIVATE DOCTOR I (GO TO 810B)
PRIVATE MOBILE CLINIC J (GO TO 810B)
PRIVATE FIELD WORKER K (GO TO 810B)
OTHER PRIVATE MEDICAL (SPECIFY) ________ L (GO TO 810B)

OTHER PRIVATE SECTOR

SHOP M (GO TO 810B)
CHURCH N (GO TO 810B)
FRIENDS/RELATIVES O (GO TO 810B)
TRADITIONAL HEALER P (GO TO 810B)

OTHER (SPECIFY) _________ X (GO TO 810B)
DOES NOT KNOW Z (GO TO 810B)

top

Uganda 2006

Survey form view entire document: text

950) Where did you go? 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 CENTER 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 SOURCE

SHOP P
OTHER (SPECIFY) Q

top

Uganda 2011

Survey form view entire document: text

945) Where did you go?
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 SOURCE

SHOP P
OTHER (SPECIFY) _____________ X

top

Uganda 2016

Survey form view entire document: text

1050) Where did you go? Any other place?

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

(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 SOURCE

SHOP L

OTHER (SPECIFY) ______X

top

Zambia 1996

Survey form view entire document: text

801G. Where did you seek advice or treatment?
Any other place or person?
RECORD ALL MENTIONED.

PUBLIC SECTOR

GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
OTHER PUBLIC SECTOR C

MEDICAL PRIVATE SECTOR

PRIVATE HOSPITAL/CLINIC D
MISSION HOSPITAL/CLINIC E
PHARMACY F
PRIVATE DOCTOR G
MOBILE CLINIC H
OTHER MED. PRIVATE SECTOR I

OTHER

SHOP J
RELATIVES/FRIENDS K
TRADITIONAL HEALER L

OTHER (SPECIFY) ______ X
DOES NOT KNOW Z

top

Zambia 2007

Survey form view entire document: text

950 Where did you go? (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 SOURCE

SHOP N
OTHER (SPECIFY) ___________ X

top

Zambia 2013

Survey form view entire document: text

944) The last time you had (PROBLEM FROM 940/941/942), did you seek any kind of advice or treatment?

YES 1
NO 2 (GO TO 945A)

945) Where did you go? 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 HEALTH 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 SHOP N

OTHER (SPECIFY) _________________X

top

Zambia 2018

Survey form view entire document: text

(1050) Where did you go?
Any other places?
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 SOURCE

SHOP M
OTHER (SPECIFY) _______________

Afghanistan 2015	Cote d'Ivoire 2011	Nigeria 1999	Uganda 2016
Benin 2017	Eswatini (Swaziland) 2006	Nigeria 2008	Zambia 1996
Burkina Faso 2010	India 2015	Nigeria 2013	Zambia 2007
Burundi 2010	Liberia 2007	Nigeria 2018	Zambia 2013
Burundi 2016	Liberia 2013	Pakistan 2012	Zambia 2018
Cameroon 2011	Mali 2018	Uganda 1995
Cameroon 2018	Myanmar 2015	Uganda 2006
Congo (Democratic Republic) 2013	Namibia 2013	Uganda 2011

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