What type of clinic is your program? (multiple choice: antenatal clinic, clinical research site, family planning, HIV care site, primary care clinic, other; more than one answer may be appropriate)
Is cervical cancer screening available to your patients (either on site or via referral)? (Yes, No)
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If cervical cancer screening is available on site:
Does your program screen HIV-infected women? (Yes, No)
Does your program screen HIV-uninfected women? (Yes, No)
Does your program maintain electronic records on women screened? (Yes, No)
Cervical cancer screening is done by: (multiple choice: clinical officer, nurse, lay health worker, physician, other; more than one answer may be appropriate)
The method(s) used for cervical cancer screening are: (multiple choice: Pap, VIA, HPV DNA, VILI; more than one answer may be appropriate)
Treatments available for premalignant lesions and cervical cancer: (multiple choice: cryotherapy, conization, loop electrocautery excisional procedure [LEEP], radical hysterectomy, radiation therapy, chemotherapy, other; more than one answer may be appropriate)
Patients are referred to our facility for cervical cancer screening (Yes, No)
Patients are referred from: (multiple choice: antenatal clinic, clinical research site, family planning, HIV care site, primary care clinic, other)
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If cervical cancer screening is available at referral site:
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