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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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Angola 2015

Survey form view entire document: text

1045) Where did you seek advice or treatment?
Anywhere else?
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

CENTRAL HOSPITAL A
HOSPITAL IN PROVINCE B
HOSPITAL IN RURAL AREA C
MATERNITY WARD D
GATV E
HEALTH CENTER/POST F
MOBILE CLINIC G
OTHER: (SPECIFY)____ H

PRIVATE MEDICAL SECTOR

PRIVATE CLINIC/HOSPITAL/DOCTOR I
GATV J
PHARMACY K
OTHER PRIVATE SECTOR: (SPECIFY) ______ L

OTHER SOURCE

TRADITIONAL HEALER M
FRIEND/RELATIVE N
OTHER: (SPECIFY)____X

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Benin 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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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

1249) Where did you go?

Anywhere else?

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

IF UNABLE TO DETERMINE IF THE HOSPITAL, HEALTH CENTER, CTV 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 (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) 2007

Survey form view entire document: text

860) Where did you go?
Any other place?
CIRCLE ALL MENTIONED.

PUBLIC SECTOR

HOSPITAL A
HEALTH CENTER/OUTPOST B
ANONYMOUS VOLUNTEER SCREEN CENTER C
CENTER FOR SEXUALLY TRANSMITTED INFECTIONS D
FAMILY PLANNING CLINIC E
COMMUNITY AGENT F
MATERNITY CENTER G
OTHER PUBLIC (SPECIFY) _____ H

PRIVATE MEDICAL SECTOR

PRIVATE CLINIC/HOSPITAL/DOCTOR I
MATERNITY J
PHARMACY K
ANONYMOUS VOLUNTEER SCREENING CENTER L
HEALTH AGENT M
OTHER PRIVATE MEDICAL (SPECIFY) _____ N

OTHER SOURCE

TRADITIONAL PRACTITIONER Q
SHOP R

OTHER (SPECIFY) _____ X

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Congo (Democratic Republic) 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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Cote d'Ivoire 2011

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)_________

PUBLIC SECTOR

GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
INDEPENDENT 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______ (SPECIFY) M

OTHER SOURCE

SHOP N
OTHER___________ (SPECIFY) X

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Ethiopia 2005

Survey form view entire document: text

925. Where did you go? Any other place?
RECORD ALL SOURCES MENTIONED

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

NON-GOVERNMENT (NGO) HEALTH FACILITY H
STANDALONE VCT CENTER I

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL/ CLINIC/DOCTOR J
STAND ALONE VCT CENTER K
PHARMACY L
OTHER PRIVATE MEDICAL (SPECIFY) ___________________ M

OTHER SOURCE

DRUG VENDOR N
SHOP O
TRADITIONAL HEALER P
OTHER (SPECIFY) _____________ X

Survey form view entire document: text

925. Where did you go? Any other place?
RECORD ALL SOURCES MENTIONED

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

NON-GOVERNMENT (NGO) HEALTH FACILITY H
STANDALONE VCT CENTER I

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL/ CLINIC/DOCTOR J
STAND ALONE VCT CENTER K
PHARMACY L
OTHER PRIVATE MEDICAL (SPECIFY) ___________________ M

OTHER SOURCE

DRUG VENDOR N
SHOP O
TRADITIONAL HEALER P
OTHER (SPECIFY) _____________ X

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Ghana 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

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Ghana 2014

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

Guinea 2005

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

Guinea 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

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

top

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

top

Mali 2012

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)__________

PUBLIC SECTOR

NATIONAL HOSPITAL A
REGIONAL HOSPITAL B
REFERRAL HEALTH CENTER (CSREF) C
FREE CLINIC/MATERNITY D
COMMUNITY HEALTH CENTER (CSCOM) E
PUBLIC VOLUNTEER TESTING CENTER F
SCHOOL BASED CLINIC G
OTHER PUBLIC H_______ (SPECIFY)

PRIVATE SECTOR

PRIVATE CLINIC/HOSPITAL I
PRIVATE HEALTH CARE PRACTICE J
TREATMENT ROOM K
INDEPENDENT VOLUNTEER TESTING CENTER L
PHARMACY M
COMMUNITY BASED AGENT N
SCHOOL BASED CLINIC O
OTHER PRIVATE_____ (SPECIFY) P

OTHER SOURCE

HOME (RESPONDENT'S HOME) Q
MILITARY CAMP R
SHOP S

OTHER_______ (SPECIFY) X

top

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

top

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

top

Namibia 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
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) ____ L
OTHER SOURCE

SHOP M
OTHER (SPECIFY) _____ X

top

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

top

Niger 2006

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 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

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Pakistan 2017

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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
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) ________ J

OTHER SOURCE

SHOP K

OTHER (SPECIFY) _________ X

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Rwanda 2005

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866. Where did you go?
Any other place?
RECORD ALL SOURCES MENTIONED.

PUBLIC SECTOR

GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
AGENT DBC C
VCT CENTER D
YOUTH CENTER E
OTHER PUBLIC (SPECIFY) _____ F

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL/CLINIC G
PRIVATE DOCTOR H
PHARMACY I
ARBEF CLINIC J
INFIRMARY L
YOUTH CENTER M
OTHER PRIVATE MEDICAL (SPECIFY) ____ Y

OTHER SOURCE

SHOP N
OTHER (SPECIFY) ____ X

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Senegal 2017

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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
HEALTH POST C
GOVERNMENT FAMILY PLANNING CENTER D
RURAL MATERNITY E
HEALTH HUT F
COMMUNITY PHARMACY G
VOLUNTARY TESTING CENTER H
MOBILE HTC SEVICES 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 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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Togo 2013

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

YES 1
NO 2- (SKIP TO 946)

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))_________

PUBLIC SECTOR

GOVERNMENT HOSPITAL A
STAND-ALONE VCT CENTER B
HEALTH CENTER C
DISPENSARY D
MOTHER-INFANT PROTECTION E
MOBILE CLINIC F
SCHOOL BASED CLINIC G
OTHER PUBLIC SECTOR________ (SPECIFY) H

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL/CLINIC I
PRIVATE DOCTOR'S OFFICE J
PHARMACY K
SCHOOL BASED CLINIC L
NGO/ASSOCIATION M
OTHER PRIVATE MEDICAL SECTOR______ (SPECIFY) N

OTHER_____ (SPECIFY) X

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Uganda 2006

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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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Uganda 2011

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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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Uganda 2016

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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

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Zambia 2007

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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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Zambia 2013

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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 946)

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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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	Congo (Democratic Republic) 2013	Mali 2018	Rwanda 2005
Angola 2015	Cote d'Ivoire 2011	Myanmar 2015	Senegal 2017
Benin 2011	Ethiopia 2005	Namibia 2006	Togo 2013
Benin 2017	Ghana 2008	Namibia 2013	Uganda 2006
Burkina Faso 2010	Ghana 2014	Niger 2006	Uganda 2011
Burundi 2010	Guinea 2005	Nigeria 2008	Uganda 2016
Burundi 2016	Guinea 2012	Nigeria 2013	Zambia 2007
Cameroon 2011	Liberia 2007	Nigeria 2018	Zambia 2013
Cameroon 2018	Liberia 2013	Pakistan 2012	Zambia 2018
Congo (Democratic Republic) 2007	Mali 2012	Pakistan 2017

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