{"id":1331,"date":"2017-10-24T13:46:39","date_gmt":"2017-10-24T12:46:39","guid":{"rendered":"https:\/\/phemadagascar.org\/portail\/telechargement-de-donnees-des-membres\/"},"modified":"2018-02-15T15:26:00","modified_gmt":"2018-02-15T15:26:00","slug":"saisie-dinfos-des-membres","status":"publish","type":"page","link":"https:\/\/phemadagascar.org\/fr\/portail\/saisie-dinfos-des-membres\/","title":{"rendered":"Saisie d&#8217;infos des membres"},"content":{"rendered":"<p>[et_pb_section bb_built=&#8221;1&#8243; fullwidth=&#8221;on&#8221; specialty=&#8221;off&#8221; next_background_color=&#8221;#000000&#8243;][et_pb_fullwidth_header title=&#8221;Saisie d&#8217;infos des membres&#8221; background_color=&#8221;#3399cc&#8221; text_orientation=&#8221;center&#8221; header_fullscreen=&#8221;off&#8221; header_scroll_down=&#8221;off&#8221; image_orientation=&#8221;center&#8221; background_layout=&#8221;dark&#8221; content_orientation=&#8221;center&#8221; title_font_size=&#8221;32px&#8221; custom_button_one=&#8221;off&#8221; button_one_icon_placement=&#8221;right&#8221; custom_button_two=&#8221;off&#8221; button_two_icon_placement=&#8221;right&#8221; _builder_version=&#8221;3.0.101&#8243; max_width_tablet=&#8221;50px&#8221; \/][\/et_pb_section][et_pb_section bb_built=&#8221;1&#8243; admin_label=&#8221;section&#8221; prev_background_color=&#8221;#000000&#8243;][et_pb_row admin_label=&#8221;row&#8221; background_position=&#8221;top_left&#8221; background_repeat=&#8221;repeat&#8221; background_size=&#8221;initial&#8221;][et_pb_column type=&#8221;4_4&#8243;][et_pb_tabs admin_label=&#8221;Update site information \/ add new site&#8221; active_tab_background_color=&#8221;#ffcc33&#8243; inactive_tab_background_color=&#8221;#ffe1a5&#8243; tab_text_color=&#8221;#006666&#8243; use_border_color=&#8221;on&#8221; border_color=&#8221;#999933&#8243; border_style=&#8221;solid&#8221; tab_font_size=&#8221;22&#8243; border_width=&#8221;3px&#8221; background_position=&#8221;top_left&#8221; background_repeat=&#8221;repeat&#8221; background_size=&#8221;initial&#8221; _builder_version=&#8221;3.0.62&#8243; border_color_all=&#8221;#999933&#8243; border_width_all=&#8221;3px&#8221; border_style_all=&#8221;solid&#8221;][et_pb_tab title=&#8221;Mettez \u00e0 jour les informations du site&#8221; tab_font_select=&#8221;default&#8221; tab_font=&#8221;||||&#8221; tab_line_height=&#8221;2em&#8221; tab_line_height_tablet=&#8221;2em&#8221; tab_line_height_phone=&#8221;2em&#8221; body_font_select=&#8221;default&#8221; body_font=&#8221;||||&#8221; body_line_height=&#8221;2em&#8221; body_line_height_tablet=&#8221;2em&#8221; body_line_height_phone=&#8221;2em&#8221; use_background_color_gradient=&#8221;off&#8221; background_color_gradient_start=&#8221;#2b87da&#8221; background_color_gradient_end=&#8221;#29c4a9&#8243; background_color_gradient_type=&#8221;linear&#8221; background_color_gradient_direction=&#8221;180deg&#8221; background_color_gradient_direction_radial=&#8221;center&#8221; background_color_gradient_start_position=&#8221;0%&#8221; background_color_gradient_end_position=&#8221;100%&#8221; parallax=&#8221;off&#8221; parallax_method=&#8221;on&#8221; background_size=&#8221;cover&#8221; background_position=&#8221;center&#8221; background_repeat=&#8221;no-repeat&#8221; background_blend=&#8221;normal&#8221; allow_player_pause=&#8221;off&#8221;]<div id=\"gv-view-1151-1\" class=\"gv-template-table\"><div class=\"gv-table-view gv-table-container gv-table-multiple-container gv-container gv-container-1151 gv-container-no-results\">\n<table class=\"gv-table-view\">\n\t<caption class=\"screen-reader-text\">Entr\u00e9es<\/caption>\n\t<thead>\n\t\t\t\t<tr>\n\t\t\t<th scope=\"col\" id=\"gv-field-8-6\" class=\"gv-field-8-6\" data-label=\"Site name:\"><span class=\"gv-field-label\">Site name:<\/span><\/th>\t\t<\/tr>\n\t<\/thead>\n\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t\t\t<td colspan=\"1\" class=\"gv-no-results gv-no-results-text\" role=\"status\">\n\t\t\t\t\t<p>Aucune entr\u00e9e ne correspond \u00e0 votre demande.<\/p>\n\t\t\t\t<\/td>\n\t\t\t\t\t\t\t<\/tr>\n\t\t\t\t<\/tbody>\n\t<tfoot>\n\t\t<tr>\n\t\t\t<th scope=\"col\" id=\"gv-field-8-6\" class=\"gv-field-8-6\" data-label=\"Site name:\"><span class=\"gv-field-label\">Site name:<\/span><\/th>\t\t<\/tr>\n\t\t\t<\/tfoot>\n<\/table>\n<\/div><!-- end .gv-table-container -->\n\t\t<style>\n\t\t\t.fancybox__container {\n\t\t\t\tz-index: 100000; \/** Divi is 99999 *\/\n\t\t\t}\n\n\t\t\t.admin-bar .fancybox__container {\n\t\t\t\tmargin-top: 32px;\n\t\t\t}\n\t\t<\/style>\n\t\t<script>\n\t\t\tif ( window.Fancybox ){\n\t\t\t\tvar gvFancyboxSettings = {\"animationEffect\":\"fade\",\"toolbar\":true,\"closeExisting\":true,\"arrows\":true,\"mainClass\":\"gv-lightbox\",\"buttons\":[\"thumbs\",\"close\"],\"i18n\":{\"en\":{\"CLOSE\":\"Fermer\",\"NEXT\":\"Suivant\",\"PREV\":\"Pr\\u00e9c\\u00e9dent\",\"ERROR\":\"Le contenu demand\\u00e9 ne peut pas \\u00eatre charg\\u00e9. Veuillez r\\u00e9essayer plus tard.\",\"PLAY_START\":\"D\\u00e9marrer le diaporama\",\"PLAY_STOP\":\"Mettre le diaporama en pause\",\"FULL_SCREEN\":\"Plein \\u00e9cran\",\"THUMBS\":\"Vignettes\",\"DOWNLOAD\":\"T\\u00e9l\\u00e9charger\",\"SHARE\":\"Partager\",\"ZOOM\":\"Zoom\"}}};\n\n\t\t\t\t\/\/ Stamp the per-View theme marker onto the body-mounted\n\t\t\t\t\/\/ Fancybox container. The `gv-lightbox` hook is applied\n\t\t\t\t\/\/ unconditionally via the `mainClass` setting; the theme\n\t\t\t\t\/\/ classes are copied per-instance from the triggering element\n\t\t\t\t\/\/ so only lightboxes opened from a themed View inherit the\n\t\t\t\t\/\/ theme token scope.\n\t\t\t\tgvFancyboxSettings.on = Object.assign( {}, gvFancyboxSettings.on, {\n\t\t\t\t\tready: function ( fancybox ) {\n\t\t\t\t\t\tvar trigger = fancybox.options && fancybox.options.$trigger;\n\t\t\t\t\t\tvar themed  = trigger && trigger.closest ? trigger.closest( '.gv-themed' ) : null;\n\n\t\t\t\t\t\tif ( themed && fancybox.$container ) {\n\t\t\t\t\t\t\tfancybox.$container.classList.add( 'gv-themed' );\n\t\t\t\t\t\t\tthemed.classList.forEach( function ( cls ) {\n\t\t\t\t\t\t\t\tif ( 0 === cls.indexOf( 'gv-theme-' ) ) {\n\t\t\t\t\t\t\t\t\tfancybox.$container.classList.add( cls );\n\t\t\t\t\t\t\t\t}\n\t\t\t\t\t\t\t} );\n\t\t\t\t\t\t}\n\t\t\t\t\t}\n\t\t\t\t} );\n\n\t\t\t\tFancybox.bind(\".gravityview-fancybox\", gvFancyboxSettings);\n\t\t\t}\n\t\t<\/script>\n\t\t<input type=\"hidden\" class=\"gravityview-view-id\" value=\"1151\"><\/div>[\/et_pb_tab][et_pb_tab title=&#8221;Ajoutez un nouveau site&#8221; tab_font_select=&#8221;default&#8221; tab_font=&#8221;||||&#8221; tab_line_height=&#8221;2em&#8221; tab_line_height_tablet=&#8221;2em&#8221; tab_line_height_phone=&#8221;2em&#8221; body_font_select=&#8221;default&#8221; body_font=&#8221;||||&#8221; body_line_height=&#8221;2em&#8221; body_line_height_tablet=&#8221;2em&#8221; body_line_height_phone=&#8221;2em&#8221; use_background_color_gradient=&#8221;off&#8221; background_color_gradient_start=&#8221;#2b87da&#8221; background_color_gradient_end=&#8221;#29c4a9&#8243; background_color_gradient_type=&#8221;linear&#8221; background_color_gradient_direction=&#8221;180deg&#8221; background_color_gradient_direction_radial=&#8221;center&#8221; background_color_gradient_start_position=&#8221;0%&#8221; background_color_gradient_end_position=&#8221;100%&#8221; parallax=&#8221;off&#8221; parallax_method=&#8221;on&#8221; background_size=&#8221;cover&#8221; background_position=&#8221;center&#8221; background_repeat=&#8221;no-repeat&#8221; background_blend=&#8221;normal&#8221; allow_player_pause=&#8221;off&#8221;]<\/p>\n<h4><span style=\"font-weight: 400;\">Avant de remplir ce formulaire, veuillez v\u00e9rifier que le site SPE que vous ajoutez n&#8217;appara\u00eet pas d\u00e9j\u00e0 dans l&#8217;onglet adjacent!\u00a0<\/span><\/h4>\n<h5><em><span style=\"font-weight: 400;\"><span style=\"text-decoration: underline;\">Remarque :<\/span> ce formulaire doit seulement \u00eatre rempli par les organisations environnementales qui mettent en \u0153uvre actuellement ou travaillent activement au d\u00e9veloppement des partenariats SPE avec des organisations sanitaires dans ce site.<\/span><\/em><\/h5>\n<hr \/>\n<h4><script>\nvar 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class='gform-body gform_body'><ul id='gform_fields_8' class='gform_fields top_label form_sublabel_below description_above validation_below' data-column-layout='fill'><li id=\"field_8_1\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_hidden\"><label id='gfield_label_8_1' class='gfield_label gform-field-label' for='input_8_1'><span class='gform-field-label__text'>Nom de l&#039;organisation:<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_1' id='input_8_1' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_8_6\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"><label id='gfield_label_8_6' class='gfield_label gform-field-label' for='input_8_6'><span class='gform-field-label__text'>Nom de 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gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"><label id='gfield_label_8_46' class='gfield_label gform-field-label' for='input_8_46'><span class='gform-field-label__text'>R\u00e9gion dans laquelle se trouve ce site:<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_46' id='input_8_46' class='medium gfield_select'     aria-invalid=\"false\" ><option value='Alaotra-Mangoro' >Alaotra-Mangoro<\/option><option value='Amoron&#039;i Mania' >Amoron&#039;i Mania<\/option><option value='Analamanga' >Analamanga<\/option><option value='Analanjirofo' >Analanjirofo<\/option><option value='Androy' >Androy<\/option><option value='Anosy' >Anosy<\/option><option value='Atsimo-Andrefana' >Atsimo-Andrefana<\/option><option value='Atsimo-Atsinanana' >Atsimo-Atsinanana<\/option><option value='Atsinanana' >Atsinanana<\/option><option value='Betsiboka' >Betsiboka<\/option><option value='Boeny' >Boeny<\/option><option value='Bongolava' >Bongolava<\/option><option value='Diana' >Diana<\/option><option value='Ihorombe' >Ihorombe<\/option><option value='Itasy' >Itasy<\/option><option value='Matsiatra Ambony' >Matsiatra Ambony<\/option><option value='Melaky' >Melaky<\/option><option value='Menabe' >Menabe<\/option><option value='Sava' >Sava<\/option><option value='Sofia' >Sofia<\/option><option value='Vakinankaratra' >Vakinankaratra<\/option><option value='Vatovavy-Fitovinany' >Vatovavy-Fitovinany<\/option><\/select><\/div><\/li><li id=\"field_8_41\" class=\"gfield gfield--type-list gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"><label id='gfield_label_8_41' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Noms de commune(s) et fokontany inclus dans ce site:<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><style type=\"text\/css\">\n\n\t\t\t\t\t\tbody .ginput_container_list table.gfield_list tbody tr td.gfield_list_icons {\n\t\t\t\t\t\t\tvertical-align: middle !important;\n\t\t\t\t\t\t}\n\n\t\t\t\t\t\tbody .ginput_container_list table.gfield_list tbody tr td.gfield_list_icons img {\n\t\t\t\t\t\t\tbackground-color: transparent !important;\n\t\t\t\t\t\t\tbackground-position: 0 0;\n\t\t\t\t\t\t\tbackground-size: 16px 16px !important;\n\t\t\t\t\t\t\tbackground-repeat: no-repeat;\n\t\t\t\t\t\t\tborder: none !important;\n\t\t\t\t\t\t\twidth: 16px !important;\n\t\t\t\t\t\t\theight: 16px !important;\n\t\t\t\t\t\t\topacity: 0.5;\n\t\t\t\t\t\t\ttransition: opacity .5s ease-out;\n\t\t\t\t\t\t    -moz-transition: opacity .5s ease-out;\n\t\t\t\t\t\t    -webkit-transition: opacity .5s ease-out;\n\t\t\t\t\t\t    -o-transition: opacity .5s ease-out;\n\t\t\t\t\t\t}\n\n\t\t\t\t\t\tbody .ginput_container_list table.gfield_list tbody tr td.gfield_list_icons a:hover img {\n\t\t\t\t\t\t\topacity: 1.0;\n\t\t\t\t\t\t}\n\n\t\t\t\t\t\t<\/style><div class='ginput_container ginput_container_list ginput_list'><table class='gfield_list gfield_list_container'><colgroup><col id='gfield_list_41_col_1' class='gfield_list_col_odd' \/><col id='gfield_list_41_col_2' class='gfield_list_col_even' \/><col id='gfield_list_41_col_3' class='gfield_list_col_odd' \/><\/colgroup><thead><tr><th scope=\"col\" id=\"gfield_list_8_41_header_1\">Nom de la commune:<\/th><th scope=\"col\" id=\"gfield_list_8_41_header_2\">Nom du fokontany:<\/th><td>&nbsp;<\/td><\/tr><\/thead><tbody><tr class='gfield_list_row_odd gfield_list_group'><td class='gfield_list_cell gfield_list_41_cell1' data-label='Nom de la commune:'><input aria-invalid='false' aria-required=\"true\"  aria-labelledby=\"gfield_list_8_41_header_1 gfield_label_8_41\" data-aria-label-template='Nom de la commune:, Ligne {0}' type='text' name='input_41[]' value=''   \/><\/td><td 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\/><\/a><\/td><\/tr><\/tbody><\/table><\/div><\/li><li id=\"field_8_5\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"><label id='gfield_label_8_5' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Type(s) d&#039;\u00e9cosyst\u00e8me(s) \u00e0 ce site:<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_8_5'><li class='gchoice gchoice_8_5_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_5.1' type='checkbox'  value='Marine'  id='choice_8_5_1'    aria-labelledby=\"label_8_5_1 gfield_label_8_5\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_8_5_1' id='label_8_5_1' class='gform-field-label gform-field-label--type-inline'>Marine<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_8_5_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_5.2' type='checkbox'  value='Terrestre'  id='choice_8_5_2'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_5_2' id='label_8_5_2' class='gform-field-label gform-field-label--type-inline'>Terrestre<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_8_5_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_5.3' type='checkbox'  value='Autre - sp\u00e9cifi\u00e9 ci-dessous'  id='choice_8_5_3'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_5_3' id='label_8_5_3' class='gform-field-label gform-field-label--type-inline'>Autre - sp\u00e9cifi\u00e9 ci-dessous<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_8_8\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"><label id='gfield_label_8_8' class='gfield_label gform-field-label' for='input_8_8'><span class='gform-field-label__text'>Autre(s) \u00e9cosyst\u00e8me(s) \u00e0 ce site:<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_8' id='input_8_8' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_8_7\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"><label id='gfield_label_8_7' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Type(s) de gestion communautaire des ressources naturelles \u00e0 ce site:<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_8_7'><li class='gchoice gchoice_8_7_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.1' type='checkbox'  value='LMMA'  id='choice_8_7_1'    aria-labelledby=\"label_8_7_1 gfield_label_8_7\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_8_7_1' id='label_8_7_1' class='gform-field-label gform-field-label--type-inline'>LMMA<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_8_7_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.2' type='checkbox'  value='COBA'  id='choice_8_7_2'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_7_2' id='label_8_7_2' class='gform-field-label gform-field-label--type-inline'>COBA<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_8_7_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.3' type='checkbox'  value='Autre - sp\u00e9cifi\u00e9 ci-dessous'  id='choice_8_7_3'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_7_3' id='label_8_7_3' class='gform-field-label gform-field-label--type-inline'>Autre - sp\u00e9cifi\u00e9 ci-dessous<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_8_9\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"><label id='gfield_label_8_9' class='gfield_label gform-field-label' for='input_8_9'><span class='gform-field-label__text'>Autre gestion communautaire des ressources naturelles \u00e0 ce site:<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_9' id='input_8_9' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_8_42\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"><label id='gfield_label_8_42' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Complementary activities supported at this site (in addition to health and environmental initiatives):<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_8_42'><li class='gchoice gchoice_8_42_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.1' type='checkbox'  value='none'  id='choice_8_42_1'    aria-labelledby=\"label_8_42_1 gfield_label_8_42\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_8_42_1' id='label_8_42_1' class='gform-field-label gform-field-label--type-inline'>Aucun<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_8_42_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.2' type='checkbox'  value='alternative'  id='choice_8_42_2'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_42_2' id='label_8_42_2' class='gform-field-label gform-field-label--type-inline'>Activit\u00e9s alternatives g\u00e9n\u00e9ratrices de revenus<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_8_42_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.3' type='checkbox'  value='\u00c9pargne et pr\u00eats villageois'  id='choice_8_42_3'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_42_3' id='label_8_42_3' class='gform-field-label gform-field-label--type-inline'>\u00c9pargne et pr\u00eats villageois<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_8_42_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.4' type='checkbox'  value='Formation \u00e0 l&#039;alphab\u00e9tisation'  id='choice_8_42_4'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_42_4' id='label_8_42_4' class='gform-field-label gform-field-label--type-inline'>Formation \u00e0 l'alphab\u00e9tisation<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_8_42_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.5' type='checkbox'  value='Autre - sp\u00e9cifi\u00e9 ci-dessous'  id='choice_8_42_5'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_42_5' id='label_8_42_5' class='gform-field-label gform-field-label--type-inline'>Autre - sp\u00e9cifi\u00e9 ci-dessous<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_8_11\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"><label id='gfield_label_8_11' class='gfield_label gform-field-label' for='input_8_11'><span class='gform-field-label__text'>Activit\u00e9s compl\u00e9mentaires appuy\u00e9es \u00e0 ce site (en plus des initiatives en mati\u00e8re de sant\u00e9 et d&#039;environnement):<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_11' id='input_8_11' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_8_12\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"><label id='gfield_label_8_12' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Type(s) de sensibilisation communautaire int\u00e9gr\u00e9e facilit\u00e9e \u00e0 ce site:<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_8_12'><li class='gchoice gchoice_8_12_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_12.1' type='checkbox'  value='aucun'  id='choice_8_12_1'    aria-labelledby=\"label_8_12_1 gfield_label_8_12\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_8_12_1' id='label_8_12_1' class='gform-field-label gform-field-label--type-inline'>Aucun<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_8_12_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_12.2' type='checkbox'  value='Discussions utilisant des cartes de r\u00e9cits SPE'  id='choice_8_12_2'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_12_2' id='label_8_12_2' class='gform-field-label gform-field-label--type-inline'>Discussions utilisant des cartes de r\u00e9cits SPE<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_8_12_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_12.3' type='checkbox'  value='Th\u00e9\u00e2tre interactif'  id='choice_8_12_3'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_12_3' id='label_8_12_3' class='gform-field-label gform-field-label--type-inline'>Th\u00e9\u00e2tre interactif<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_8_12_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_12.4' type='checkbox'  value='Pr\u00e9sentations communautaires'  id='choice_8_12_4'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_12_4' id='label_8_12_4' class='gform-field-label gform-field-label--type-inline'>Pr\u00e9sentations communautaires<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_8_12_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_12.5' type='checkbox'  value='Radio'  id='choice_8_12_5'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_12_5' id='label_8_12_5' class='gform-field-label gform-field-label--type-inline'>Radio<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_8_12_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_12.6' type='checkbox'  value='Autre - sp\u00e9cifi\u00e9 ci-dessous'  id='choice_8_12_6'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_12_6' id='label_8_12_6' class='gform-field-label gform-field-label--type-inline'>Autre - sp\u00e9cifi\u00e9 ci-dessous<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_8_13\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"><label id='gfield_label_8_13' class='gfield_label gform-field-label' for='input_8_13'><span class='gform-field-label__text'>Autre sensibilisation communautaire int\u00e9gr\u00e9e facilit\u00e9e \u00e0 ce site:<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_13' id='input_8_13' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_8_200\" class=\"gfield gfield--type-number field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"><label id='gfield_label_8_200' class='gfield_label gform-field-label' for='input_8_200'><span class='gform-field-label__text'>Total number of fixed health service delivery points at this site (e.g. CSBs and facility-based clinics):<\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_200' id='input_8_200' type='number' step='any'   value='' class='medium'      aria-invalid=\"false\"  \/><\/div><\/li><li id=\"field_8_201\" class=\"gfield gfield--type-number field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"><label id='gfield_label_8_201' class='gfield_label gform-field-label' for='input_8_201'><span class='gform-field-label__text'>Total number of community-based health service delivery points at this site (e.g. community health volunteers):<\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_201' id='input_8_201' type='number' step='any'   value='' class='medium'      aria-invalid=\"false\"  \/><\/div><\/li><li id=\"field_8_202\" class=\"gfield gfield--type-number field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"><label id='gfield_label_8_202' class='gfield_label gform-field-label' for='input_8_202'><span class='gform-field-label__text'>Total number of mobile health service delivery points at this site (e.g. number of villages served by mobile outreach teams \/ mobile service providers including MS ladies):<\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_202' id='input_8_202' type='number' step='any'   value='' class='medium'      aria-invalid=\"false\"  \/><\/div><\/li><li id=\"field_8_43\" class=\"gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"><label id='gfield_label_8_43' class='gfield_label gform-field-label' for='input_8_43'><span class='gform-field-label__text'>Premier partenaire sanitaire avec lequel vous collaborez \u00e0 ce site:<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_43' id='input_8_43' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Marie Stopes Madagascar (MSM)' >Marie Stopes Madagascar (MSM)<\/option><option value='USAID Mikolo' >USAID Mikolo<\/option><option value='Mahefa Miaraka' >Mahefa Miaraka<\/option><option value='Minist\u00e8re de la Sant\u00e9 Publique' >Minist\u00e8re de la Sant\u00e9 Publique<\/option><option value='Autre' >Autre<\/option><\/select><\/div><\/li><li id=\"field_8_21\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"><label id='gfield_label_8_21' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Type(s) de services offerts par ce partenaire sanitaire \u00e0 ce site:<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_8_21'><li class='gchoice gchoice_8_21_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_21.1' type='checkbox'  value='short-acting'  id='choice_8_21_1'    aria-labelledby=\"label_8_21_1 gfield_label_8_21\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_8_21_1' id='label_8_21_1' class='gform-field-label gform-field-label--type-inline'>Planification familiale - m\u00e9thodes de contraception \u00e0 courte action (pilules, injections)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_8_21_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_21.2' type='checkbox'  value='long-acting'  id='choice_8_21_2'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_21_2' id='label_8_21_2' class='gform-field-label gform-field-label--type-inline'>Planification familiale - m\u00e9thodes de contraception \u00e0 longue dur\u00e9e d'action \/ permanentes (implants, DIU, ligature, vasectomie)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_8_21_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_21.3' type='checkbox'  value='Sant\u00e9 sexuelle (par ex. d\u00e9pistage et traitement des IST \/ VIH)'  id='choice_8_21_3'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_21_3' id='label_8_21_3' class='gform-field-label gform-field-label--type-inline'>Sant\u00e9 sexuelle (par ex. d\u00e9pistage et traitement des IST \/ VIH)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_8_21_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_21.4' type='checkbox'  value='maternalhealth'  id='choice_8_21_4'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_21_4' id='label_8_21_4' class='gform-field-label gform-field-label--type-inline'>Sant\u00e9 maternelle<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_8_21_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_21.5' type='checkbox'  value='childhealth'  id='choice_8_21_5'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_21_5' id='label_8_21_5' class='gform-field-label gform-field-label--type-inline'>Sant\u00e9 de l'enfant (PCIMEC)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_8_21_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_21.6' type='checkbox'  value='WASHpromotion'  id='choice_8_21_6'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_21_6' id='label_8_21_6' class='gform-field-label gform-field-label--type-inline'>Promotion WASH<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_8_21_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_21.7' type='checkbox'  value='Pr\u00e9vention du paludisme'  id='choice_8_21_7'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_21_7' id='label_8_21_7' class='gform-field-label gform-field-label--type-inline'>Pr\u00e9vention du paludisme<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_8_21_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_21.8' type='checkbox'  value='nutrition'  id='choice_8_21_8'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_21_8' id='label_8_21_8' class='gform-field-label gform-field-label--type-inline'>\u00c9ducation sur la nutrition<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_8_21_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_21.9' type='checkbox'  value='Autre - sp\u00e9cifi\u00e9 ci-dessous'  id='choice_8_21_9'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_21_9' id='label_8_21_9' class='gform-field-label gform-field-label--type-inline'>Autre - sp\u00e9cifi\u00e9 ci-dessous<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_8_19\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"><label id='gfield_label_8_19' class='gfield_label gform-field-label' for='input_8_19'><span class='gform-field-label__text'>Autre services offerts par ce partenaire sanitaire \u00e0 ce site:<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_19' id='input_8_19' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_8_15\" class=\"gfield gfield--type-date gfield--input-type-datedropdown gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"><label id='gfield_label_8_15' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Date approximative de d\u00e9but de ce partenariat \u00e0 ce site:<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div id='input_8_15' class='ginput_container ginput_complex gform-grid-row'><div class=\"clear-multi\"><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_8_15_2_container'><label for='input_8_15_2' id='input_8_15_2_label' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Date<\/label><select name='input_15[]' id='input_8_15_2'   aria-required='true'   aria-labelledby=\"input_8_15_2_label gfield_label_8_15\" ><option value=''>Date<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_8_15_1_container'><label for='input_8_15_1' id='input_8_15_1_label' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Mois<\/label><select name='input_15[]' id='input_8_15_1'   aria-required='true'  ><option value=''>Mois<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_8_15_3_container'><label for='input_8_15_3' id='input_8_15_3_label' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Ann\u00e9e<\/label><select name='input_15[]' id='input_8_15_3'   aria-required='true'  ><option value=''>Ann\u00e9e<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/div><\/li><li id=\"field_8_16\" class=\"gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"><label id='gfield_label_8_16' class='gfield_label gform-field-label' for='input_8_16'><span class='gform-field-label__text'>\u00c9tat actuel de ce partenariat \u00e0 ce site:<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_16' id='input_8_16' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Actif (MoU sign\u00e9)' >Active (MoU signed)<\/option><option value='Actif (MoU en d\u00e9veloppement)' >Actif (MoU en d\u00e9veloppement)<\/option><option value='Actif (pas de MoU)' >Actif (pas de MoU)<\/option><option value='En d\u00e9veloppement (pas encore actif)' >En d\u00e9veloppement (pas encore actif)<\/option><option value='En pause \/ sommeil (pr\u00e9c\u00e9demment actif)' >En pause \/ sommeil (pr\u00e9c\u00e9demment actif)<\/option><\/select><\/div><\/li><li id=\"field_8_20\" class=\"gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"><label id='gfield_label_8_20' class='gfield_label gform-field-label' for='input_8_20'><span class='gform-field-label__text'>Deuxi\u00e8me partenaire sanitaire avec lequel vous collaborez \u00e0 ce site:<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_20' id='input_8_20' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Non applicable (seulement un partenaire sanitaire)' >Non applicable (seulement un partenaire sanitaire)<\/option><option value='USAID Mikolo' >USAID Mikolo<\/option><option value='Mahefa Miaraka' >Mahefa Miaraka<\/option><option value='Minist\u00e8re de la Sant\u00e9 Publique' >Minist\u00e8re de la Sant\u00e9 Publique<\/option><option value='Marie Stopes Madagascar (MSM)' >Marie Stopes Madagascar (MSM)<\/option><option value='Autre' >Autre<\/option><\/select><\/div><\/li><li id=\"field_8_44\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"><label id='gfield_label_8_44' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Type(s) de services offerts par ce partenaire sanitaire \u00e0 ce site:<\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_8_44'><li class='gchoice gchoice_8_44_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.1' type='checkbox'  value='short-acting'  id='choice_8_44_1'    aria-labelledby=\"label_8_44_1 gfield_label_8_44\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_8_44_1' id='label_8_44_1' class='gform-field-label gform-field-label--type-inline'>Planification familiale - m\u00e9thodes de contraception \u00e0 courte action (pilules, injections)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_8_44_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.2' type='checkbox'  value='long-acting'  id='choice_8_44_2'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_44_2' id='label_8_44_2' class='gform-field-label gform-field-label--type-inline'>Planification familiale - m\u00e9thodes de contraception \u00e0 longue dur\u00e9e d'action \/ permanentes (implants, DIU, ligature, vasectomie)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_8_44_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.3' type='checkbox'  value='Sexual health (e.g. STI\/HIV testing and treatment)'  id='choice_8_44_3'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_44_3' id='label_8_44_3' class='gform-field-label gform-field-label--type-inline'>Sant\u00e9 sexuelle (par ex. d\u00e9pistage et traitement des IST \/ VIH)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_8_44_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.4' type='checkbox'  value='maternalhealth'  id='choice_8_44_4'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_44_4' id='label_8_44_4' class='gform-field-label gform-field-label--type-inline'>Sant\u00e9 maternelle<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_8_44_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.5' type='checkbox'  value='childhealth'  id='choice_8_44_5'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_44_5' id='label_8_44_5' class='gform-field-label gform-field-label--type-inline'>Sant\u00e9 de l'enfant (PCIMEC)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_8_44_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.6' type='checkbox'  value='WASHpromotion'  id='choice_8_44_6'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_44_6' id='label_8_44_6' class='gform-field-label gform-field-label--type-inline'>Promotion WASH<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_8_44_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.7' type='checkbox'  value='Pr\u00e9vention du paludisme'  id='choice_8_44_7'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_44_7' id='label_8_44_7' class='gform-field-label gform-field-label--type-inline'>Pr\u00e9vention du paludisme<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_8_44_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.8' type='checkbox'  value='nutrition'  id='choice_8_44_8'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_44_8' id='label_8_44_8' class='gform-field-label gform-field-label--type-inline'>\u00c9ducation sur la nutrition<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_8_44_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.9' type='checkbox'  value='Autre - sp\u00e9cifi\u00e9 ci-dessous'  id='choice_8_44_9'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_44_9' id='label_8_44_9' class='gform-field-label gform-field-label--type-inline'>Autre - sp\u00e9cifi\u00e9 ci-dessous<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_8_22\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"><label id='gfield_label_8_22' class='gfield_label gform-field-label' for='input_8_22'><span class='gform-field-label__text'>Autre services offerts par ce partenaire sanitaire \u00e0 ce site:<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_22' id='input_8_22' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_8_23\" class=\"gfield gfield--type-date gfield--input-type-datedropdown field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"><label id='gfield_label_8_23' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Date approximative de d\u00e9but de ce partenariat \u00e0 ce site:<\/span><\/label><div id='input_8_23' class='ginput_container ginput_complex gform-grid-row'><div class=\"clear-multi\"><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_8_23_2_container'><label for='input_8_23_2' id='input_8_23_2_label' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Date<\/label><select name='input_23[]' id='input_8_23_2'   aria-required='false'   aria-labelledby=\"input_8_23_2_label gfield_label_8_23\" ><option value=''>Date<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_8_23_1_container'><label for='input_8_23_1' id='input_8_23_1_label' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Mois<\/label><select name='input_23[]' id='input_8_23_1'   aria-required='false'  ><option value=''>Mois<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_8_23_3_container'><label for='input_8_23_3' id='input_8_23_3_label' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Ann\u00e9e<\/label><select name='input_23[]' id='input_8_23_3'   aria-required='false'  ><option value=''>Ann\u00e9e<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/div><\/li><li id=\"field_8_24\" class=\"gfield gfield--type-select field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"><label id='gfield_label_8_24' class='gfield_label gform-field-label' for='input_8_24'><span class='gform-field-label__text'>\u00c9tat actuel de ce partenariat \u00e0 ce site:<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_24' id='input_8_24' class='medium gfield_select'     aria-invalid=\"false\" ><option value='Non applicable (seulement un partenaire sanitaire)' >Non applicable (seulement un partenaire sanitaire)<\/option><option value='Actif (MoU sign\u00e9)' >Actif (MoU sign\u00e9)<\/option><option value='Actif (MoU en d\u00e9veloppement)' >Actif (MoU en d\u00e9veloppement)<\/option><option value='Actif (pas de MoU)' >Actif (pas de MoU)<\/option><option value='En d\u00e9veloppement (pas encore actif)' >En d\u00e9veloppement (pas encore actif)<\/option><option value='En pause \/ sommeil (pr\u00e9c\u00e9demment actif)' >En pause \/ sommeil (pr\u00e9c\u00e9demment actif)<\/option><\/select><\/div><\/li><li id=\"field_8_198\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible 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