Survey Text
Afghanistan 2015
No questionnaire text is available for this sample.
Angola 2015
No questionnaire text is available for this sample.
Bangladesh 1994
Survey form
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text
429. CHECK 216:
CHILD ALIVE?
ALIVE (GO TO 430)
DEAD (GO TO 431)
Bangladesh 1997
No questionnaire text is available for this sample.
Bangladesh 2000
No questionnaire text is available for this sample.
Bangladesh 2004
Survey form
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text
225) FOR EACH LIVE BIRTH SINCE JANUARY 1995, ENTER 'B' IN THE MONTH OF BIRTH IN COLUMN 1 OF THE CALENDAR. FOR EACH BIRTH, ASK THE NUMBER OF MONTHS THE PREGNANCY LASTED AND RECORD 'P' IN EACH OF THE PRECEDING MONTHS ACCORDING TO THE DURATION OF PREGNANCY. (NOTE: THE NUMBER OF 'P's MUST BE ONE LESS THAN THE NUMBER OF MONTHS THAT THE PREGNANCY LASTED.) WRITE THE NAME OF THE CHILD TO THE LEFT OF THE 'B' CODE.
Bangladesh 2007
Survey form
view entire document:
text
215) In what month and year was (NAME) born? PROBE: What is his/her birthday?
MONTH____
YEAR____
Bangladesh 2011
No questionnaire text is available for this sample.
Bangladesh 2014
Survey form
view entire document:
text
225. (C) FOR EACH BIRTH SINCE JANUARY 2009, ENTER 'B' IN THE MONTH OF BIRTH IN THE CALENDAR. WRITE THE NAME OF THE CHILD TO THE LEFT OF THE 'B' CODE. FOR EACH BIRTH, ASK THE NUMBER OF MONTHS THE PREGNANCY LASTED AND RECORD 'P' IN EACH OF THE PRECEDING MONTHS ACCORDING TO THE DURATION OF PREGNANCY. (NOTE: THE NUMBER OF 'P's MUST BE ONE LESS THAN THE NUMBER OF MONTHS THAT THE PREGNANCY LASTED.)
Benin 2001
Survey form
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text
215) In what month and year was (NAME) born?
PROBE: What is his/her birthday?
MONTH: ___
YEAR: ___
Benin 2006
Survey form
view entire document:
text
215 In what month and year was (NAME) born?
PROBE: What is his/her birthday?
MONTH _________
YEAR _______
Benin 2011
No questionnaire text is available for this sample.
Benin 2017
No questionnaire text is available for this sample.
Burkina Faso 2003
Survey form
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text
215) In what month and year was (NAME) born?
PROBE: What is his/her birthday?
MONTH: ___
YEAR: ___
Burkina Faso 2010
Survey form
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text
215) IN WHAT MONTH AND YEAR WAS (NAME) BORN?
PROBE: WHEN IS HIS/HER BIRTHDAY?
MONTH____
YEAR_____
Burundi 2010
Survey form
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text
235) ASK THE DATE AND THE DURATION OF PREGNANCY FOR EACH EARLIER NON-LIVE BIRTH PREGNANCY BACK TO JANUARY 2005. (1)
C
ENTER 'T' IN THE CALENDAR IN THE MONTH THAT EACH PREGNANCY TERMINATED AND 'P' FOR THE REMAINING NUMBER OF COMPLETED MONTHS.
Burundi 2016
Survey form
view entire document:
text
215) In what month and year was (name) born? PROBE: What is his/her birthday?
MONTH___
YEAR_____
Cameroon 2004
Survey form
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text
215) In what month and year was (NAME) born?
PROBE: What is his/her birthday?
MONTH: ___
YEAR: ___
Cameroon 2011
Survey form
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text
215) IN WHAT MONTH AND YEAR WAS (NAME) BORN?
PROBE: WHEN IS HIS/HER BIRTHDAY?
MONTH____
YEAR_____
Cameroon 2018
No questionnaire text is available for this sample.
Congo (Democratic Republic) 2007
Survey form
view entire document:
text
215 In what month and year was (NAME) born?
PROBE: What is his/her birthday?
MONTH _________
YEAR _______
Congo Brazzaville 2005
No questionnaire text is available for this sample.
Congo Brazzaville 2011
No questionnaire text is available for this sample.
Egypt 1992
Survey form
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text
233) ASK FOR DATES AND DURATIONS OF ANY OTHER PREGNANCIES BACK TO JANUARY 1985.* ENTER "T" IN COLUMN 1 OF CALENDAR IN MONTH PREGNANCY TERMINATED, AND "P" IN EACH PRECEDING MONTH PREGNANT.
Egypt 1995
Survey form
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text
232) CHECK 231:
LAST PREGNANCY ENDED SINCE JANUARY 1989*
LAST PREGNANCY ENDED BEFORE JANUARY 1989* (GO TO 236)
Egypt 2000
Survey form
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text
211) NOW I WOULD LIKE TO RECORD THE NAMES OF ALL YOUR BIRTHS, WHETHER STILL ALIVE OR NOT, STARTING WITH THE FIRST ONE YOU HAD.
Egypt 2003
Survey form
view entire document:
text
230. Unfortunately many women have pregnancies that do not end in a live birth. Sometimes a baby is still born, that is, the baby is born who does not breathe or show any life. Other times women have a miscarriage or abortion early during a pregnancy. It is very important in our study to know about such pregnancies so health programs can be developed for women.
USING THE INFORMATION IN THE CALENDAR, PROBE TO DETERMINE IF THE WOMAN HAD ANY STILL BIRTHS, MISCARRIAGES, OR ABORTIONS BACK TO JANUARY 1998. IF THE WOMAN REPORTS A PREGNANCY THAT DID NOT END IN A LIVE BIRTH, ASK ABOUT THE MONTH AND YEAR IN WHICH
THE PREGNANCY ENDED. RECORD THE APPROPRIATE CODE FOR THE PREGNANCY OUTCOME ON THAT DATE IN COLUMN 2 IN THE CALENDAR: ("B" FOR STILL BIRTH, "M" FOR MISCARRIAGE AND "A" FOR ABORTION). THEN ASK ABOUT THE NUMBER OF MONTHS THE PREGNANCY LASTED AND RECORD "P" IN EACH OF THE PRECEDING MONTHS ACCORDING TO THE DURATION OF THE PREGNANCY. (NOTE: SINCE THE OUTCOME OF THE PREGNANCY IS RECORDED IN THE MONTH THAT PREGNANCY ENDED, THE NUMBER OF P'S MUST BE ONE LESS THAN THE NUMBER OF MONTHS THAT THE PREGNANCY LASTED.)
ILLUSTRATIVE QUESTIONS:
TO IDENTIFY NON-LIVE BIRTH PREGNANCIES, ASK:
INTERVAL BETWEEN CURRENT PREGNANCY AND PRIOR BIRTH (LAST BIRTH): Did you have any pregnancy that ended in a still birth after the birth of (NAME OF LAST BIRTH) and before your current pregnancy? Or any pregnancy that ended in a miscarriage or abortion?
INTERVAL BETWEEN LAST BIRTH AND PRIOR BIRTH: Did you have any pregnancy that ended in a still birth between (NAME OF NEXT TO LAST BIRTH) and (NAME OF PRIOR BIRTH)? Or any pregnancy that ended in a miscarriage or abortion?
INTERVAL BETWEEN NEXT-TO-LAST BIRTH AND PRIOR BIRTH: Did you have any pregnancy that ended in a still birth between (NAME OF NEXT TO LAST BIRTH) and (NAME OF PRIOR BIRTH)? Or any pregnancy that ended in a miscarriage or abortion?
WOMEN WITH NO LIVE BIRTHS BUT WITH CURRENT PREGNANCY: Before your current pregnancy, did you ever have any other pregnancy that ended in a still birth? Or any other pregnancy that ended in a miscarriage or abortion?
WOMEN WITH NO LIVE BIRTHS AND NOT CURRENTLY PREGNANT: Have you ever had a still birth? IF YES: When did the last still birth occur? Have you ever had a miscarriage or abortion? IF YES: When did the last miscarriage or abortion occur?
FOR EACH PREGNANCY TERMINATION, ASK: How many months pregnant were you when the pregnancy ended?
Egypt 2005
Survey form
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text
219 IF ALIVE:
RECORD HOUSEHOLD NUMBER OF CHILD (RECORD '00' IF CHILD MOT LISTED IN HOUSEHOLD).
LINE NUMBER _________ (NEXT BIRTH)
Egypt 2008
Survey form
view entire document:
text
215. In what month and year was (NAME) born?
PROBE: What is his/her birthday?
In what season was (NAME) born?
MONTH __________
YEAR __________
OR SEASON _______
Egypt 2014
No questionnaire text is available for this sample.
Eswatini (Swaziland) 2006
No questionnaire text is available for this sample.
Ethiopia 2005
Survey form
view entire document:
text
215 In what month and year was (NAME) born?
PROBE: What is his/her birthday?
MONTH _________
YEAR _______
Ethiopia 2011
Survey form
view entire document:
text
215) IN WHAT MONTH AND YEAR WAS (NAME) BORN?
PROBE: WHEN IS HIS/HER BIRTHDAY?
MONTH____
YEAR_____
Ethiopia 2016
Survey form
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text
215. On what day, month, and year was (NAME) born?
DAY ___
MONTH ___
YEAR ___
Ghana 2003
Survey form
view entire document:
text
215) In what month and year was (NAME) born?
PROBE: What is his/her birthday?
MONTH: ___
YEAR: ___
Ghana 2008
Survey form
view entire document:
text
215 In what month and year was (NAME) born?
PROBE: What is his/her birthday?
MONTH _________
YEAR _______
Ghana 2014
Survey form
view entire document:
text
235) ASK THE DATE AND THE DURATION OF PREGNANCY FOR EACH EARLIER NON-LIVE BIRTH PREGNANCY BACK TO JANUARY 2009.
ENTER 'T' IN THE CALENDAR IN THE MONTH THAT EACH PREGNANCY TERMINATED AND 'P' FOR THE REMAINING NUMBER OF COMPLETED MONTHS.
Guinea 2005
Survey form
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text
234 ASK THE DATE AND THE DURATION OF PREGNANCY FOR EACH EARLIER NON-LIVE BIRTH PREGNANCY BACK TO JANUARY 2001. (1)
ENTER 'T' IN THE CALENDAR IN THE MONTH THAT EACH PREGNANCY TERMINATED AND 'P' FOR THE REMAINING NUMBER OF COMPLETED MONTHS.
Guinea 2012
Survey form
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text
215) IN WHAT MONTH AND YEAR WAS (NAME) BORN?
PROBE: WHEN IS HIS/HER BIRTHDAY?
MONTH____
YEAR_____
Guinea 2018
No questionnaire text is available for this sample.
India 2005
Survey form
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text
234 ASK THE DATE AND THE DURATION OF PREGNANCY FOR EACH EARLIER NON-LIVE BIRTH PREGNANCY BACK TO JANUARY 2001. (1)
ENTER 'T' IN THE CALENDAR IN THE MONTH THAT EACH PREGNANCY TERMINATED AND 'P' FOR THE REMAINING NUMBER OF COMPLETED MONTHS.
India 2015
No questionnaire text is available for this sample.
Jordan 1990
Survey form
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text
224) AT THE BOTTOM OF THE CALENDAR, ENTER THE NAME AND BIRTH DATE OF THE LAST CHILD BORN PRIOR TO JANUARY 1985*, IF APPLICABLE.
*For fieldwork beginning in 1991, 1992, or 1993, the year should be changed to 1986, 1987, or 1988, respectively.
Jordan 1997
Survey form
view entire document:
text
315. In what month and year was (NAME) born?
PROBE: What is his/her birthday?
MONTH_____
YEAR_____
Jordan 2002
No questionnaire text is available for this sample.
Jordan 2007
Survey form
view entire document:
text
225) FOR EACH BIRTH SINCE JANUARY 2002, ENTER 'B' IN THE MONTH OF BIRTH IN COLUMN 1 OF THE CALENDAR. WRITE THE NAME OF THE CHILD TO THE LEFT OF THE 'B' CODE. FOR EACH BIRTH, ASK THE NUMBER OF MONTHS THE PREGNANCY LASTED AND RECORD 'P' IN EACH OF THE PRECEDING MONTHS ACCORDING TO THE DURATION OF PREGNANCY. (NOTE: THE NUMBER OF 'P'S MUST BE ONE LESS THAN THE NUMBER OF MONTHS THAT THE PREGNANCY LASTED.)
Jordan 2009
Survey form
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text
215) In what month and year was (NAME) born?
PROBE: What is his/her birthday?
MONTH __
YEAR ____
Jordan 2012
No questionnaire text is available for this sample.
Jordan 2017
No questionnaire text is available for this sample.
Kenya 1998
Survey form
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text
211) Now I would like to record the names of all your births, whether still alive or not, starting with the first one you had. RECORD NAMES OF ALL THE BIRTHS IN 212. RECORD TWINS AND TRIPLETS ON SEPARATE LINES.
212) What name was given to your (first/next) baby?
NAME __________
Kenya 2003
Survey form
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text
234. ASK THE DATE AND THE DURATION OF PREGNANCY FOR EACH EARLIER PREGNANCY THAT DID NOT END IN A LIVE BIRTH BACK TO JANUARY 1998.
ENTER 'T' IN COLUMN 1 OF CALENDAR IN THE MONTH THAT EACH PREGNANCY TERMINATED AND 'P' FOR THE REMAINING NUMBER OF COMPLETED MONTHS.
Kenya 2008
Survey form
view entire document:
text
219 IF ALIVE:
RECORD HOUSEHOLD NUMBER OF CHILD (RECORD '00' IF CHILD MOT LISTED IN HOUSEHOLD).
LINE NUMBER _________ (NEXT BIRTH)
Kenya 2014
Survey form
view entire document:
text
219) IF ALIVE: RECORD HOUSEHOLD LINE NUMBER OF CHILD (RECORD '00' IF CHILD NOT LISTED IN HOUSEHOLD)
HOUSEHOLD LINE NUMBER ______ (GO TO NEXT BIRTH)
Lesotho 2009
No questionnaire text is available for this sample.
Lesotho 2014
Survey form
view entire document:
text
216) Is (NAME) still alive?
YES 1
NO 2 (GO TO 220)
Liberia 2013
No questionnaire text is available for this sample.
Madagascar 2003
Survey form
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text
215) In what month and year was (NAME) born?
PROBE: What is his/her birthday?
MONTH: ___
YEAR: ___
Madagascar 2008
Survey form
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text
234 ASK THE DATE AND THE DURATION OF PREGNANCY FOR EACH EARLIER NON-LIVE BIRTH PREGNANCY BACK TO JANUARY 2001. (1)
ENTER 'T' IN THE CALENDAR IN THE MONTH THAT EACH PREGNANCY TERMINATED AND 'P' FOR THE REMAINING NUMBER OF COMPLETED MONTHS.
Malawi 2000
Survey form
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text
234. ASK THE DATE AND THE DURATION OF PREGNANCY FOR EACH EARLIER NON-LIVE BIRTH PREGNANCY BACK TO JANUARY 1995.
ENTER 'T' IN THE CALENDAR IN THE MONTH THAT EACH PREGNANCY TERMINATED AND 'P' FOR THE REMAINING NUMBER OF COMPLETED MONTHS.
234A. Did you have any pregnancies that terminated before 1995 which did not result in a live birth?
YES 1
NO 2 (GO TO 236)
Malawi 2004
Survey form
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text
234) ASK THE DATE AND THE DURATION OF PREGNANCY FOR EACH EARLIER NON-LIVE BIRTH PREGNANCY BACK TO JANUARY 1995. ENTER 'T' IN COLUMN 1 OF CALENDAR IN THE MONTH THAT EACH PREGNANCY TERMINATED AND 'P' FOR THE REMAINING NUMBER OF COMPLETED MONTHS.
Malawi 2010
Survey form
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text
234 ASK THE DATE AND THE DURATION OF PREGNANCY FOR EACH EARLIER NON-LIVE BIRTH PREGNANCY BACK TO JANUARY 2001. (1)
ENTER 'T' IN THE CALENDAR IN THE MONTH THAT EACH PREGNANCY TERMINATED AND 'P' FOR THE REMAINING NUMBER OF COMPLETED MONTHS.
Malawi 2016
Survey form
view entire document:
text
225. FOR EACH BIRTH IN 2010-2015. ENTER 'B' IN THE MONTH OF BIRTH IN THE CALENDAR. WRITE THE NAME OF THE CHILD TO THE LEFT OF THE 'B' CODE. FOR EACH BIRTH, ASK THE NUMBER OF COMPLETED MONTHS THE PREGNANCY LASTED AND RECORD 'P' IN EACH OF THE PRECEDING MONTHS ACCORDING TO THE DURATION OF PREGNANCY. (NOTE: THE NUMBER OF 'P's MUST BE ONE LESS THAN THE NUMBER OF MONTHS THAT THE PREGNANCY LASTED. )
Mali 2001
Survey form
view entire document:
text
211) Now I would like to record the names of all your births, whether still alive or not, starting with the first one you had.
RECORD NAMES OF ALL BIRTHS IN 212. RECORD TWINS AND TRIPLETS ON SEPARATE LINES.
Mali 2006
Survey form
view entire document:
text
215 In what month and year was (NAME) born?
PROBE: What is his/her birthday?
MONTH _________
YEAR _______
Mali 2012
No questionnaire text is available for this sample.
Mali 2018
No questionnaire text is available for this sample.
Morocco 1992
Survey form
view entire document:
text
334) ASK THE DATES AND DURATION OF THE OTHER PREGNANCIES OF THIS TYPE UP TO JANUARY 1986. RECORD "F" IN COLUMN 1 OF CALENDAR FOR THE MONTH WHEN THE PREGNANCY ENDED, AND "G" FOR THE MONTHS OF PREGNANCY.
Morocco 2003
No questionnaire text is available for this sample.
Mozambique 2003
Survey form
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text
215. In what month and year was (NAME) born?
MONTH____
YEAR____
Mozambique 2011
Survey form
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text
219) IF ALIVE:
RECORD HOUSEHOLD LINE NUMBER OF CHILD
RECORD '00' IF CHILD NOT LISTED IN HOUSEHOLD
HOUSEHOLD LINE NUMBER_____ (GO TO 221)
Myanmar 2015
Survey form
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text
234) Since January 2010, have you had any other pregnancies that did not result in a live birth?
YES 1
NO 2 (SKIP TO 236)
Namibia 2006
Survey form
view entire document:
text
215 In what month and year was (NAME) born?
PROBE: What is his/her birthday?
MONTH _________
YEAR _______
Namibia 2013
Survey form
view entire document:
text
215) IN WHAT MONTH AND YEAR WAS (NAME) BORN?
PROBE: WHEN IS HIS/HER BIRTHDAY?
MONTH____
YEAR_____
Nepal 2001
No questionnaire text is available for this sample.
Nepal 2006
Survey form
view entire document:
text
221. In what month and year was name born?
MONTH ___
YEAR ____
Nepal 2011
No questionnaire text is available for this sample.
Nepal 2016
No questionnaire text is available for this sample.
Niger 2006
Survey form
view entire document:
text
215 In what month and year was (NAME) born?
PROBE: What is his/her birthday?
MONTH _________
YEAR _______
Niger 2012
Survey form
view entire document:
text
215) IN WHAT MONTH AND YEAR WAS (NAME) BORN?
PROBE: WHEN IS HIS/HER BIRTHDAY?
MONTH____
YEAR_____
Nigeria 2008
Survey form
view entire document:
text
219 IF ALIVE:
RECORD HOUSEHOLD NUMBER OF CHILD (RECORD '00' IF CHILD MOT LISTED IN HOUSEHOLD).
LINE NUMBER _________ (NEXT BIRTH)
Nigeria 2013
No questionnaire text is available for this sample.
Nigeria 2018
No questionnaire text is available for this sample.
Pakistan 2006
No questionnaire text is available for this sample.
Pakistan 2012
No questionnaire text is available for this sample.
Pakistan 2017
Survey form
view entire document:
text
225) FOR EACH BIRTH IN 2012-2018, ENTER 'B' IN THE MONTH OF BIRTH IN THE CALENDAR. WRITE THE NAME OF THE CHILD TO THE LEFT OF THE 'B' CODE. FOR EACH BIRTH, ASK THE NUMBER OF COMPLETED MONTHS THE PREGNANCY LASTED AND RECORD 'P' IN EACH OF THE PRECEDING MONTHS ACCORDING TO THE DURATION OF PREGNANCY. (NOTE: THE NUMBER OF 'P'S MUST BE ONE LESS THAN THE NUMBER OF MONTHS THAT THE PREGNANCY LASTED.)
CHECK 220AC FOR EACH PREGNANCY THAT DID NOT END IN A LIVE BIRTH. CHECK 220AD. IF YES (CODE '1' CIRCLED), ENTER 'A' FOR ABORTION OR 'C' (IF CODE '2' CIRCLED) FOR MISCARRIAGE OR 'S' FOR STILLBIRTH, IN CALENDAR IN THE MONTH THAT THE PREGNANCY TERMINATED AND 'P' FOR THE REMAINING NUMBER OF COMPLETED MONTHS OF PREGNANCY.
IF THERE ARE MORE THAN FOUR PREGNANCIES THAT DID NOT END IN A LIVE BIRTH, USE AN ADDITIONAL QUESTIONAIRRE STARTING ON THE SECOND LINE.
Rwanda 2000
Survey form
view entire document:
text
215) In what month and year was (NAME) born?
PROBE: What is his/her birthday?
MONTH: ___
YEAR: ___
Rwanda 2005
Survey form
view entire document:
text
211 Now I would like to record the names of all your births, whether still alive or not, starting with the first one you had.
RECORD NAMES OF ALL THE BIRTHS IN 212. RECORD TWINS AND TRIPLETS ON SEPARATE LINES.
(IF THERE ARE MORE THAN 12 BIRTHS, USE AN ADDITIONAL QUESTIONNAIRE, STARTING WITH THE SECOND ROW).
Rwanda 2010
Survey form
view entire document:
text
211) NOW I WOULD LIKE TO RECORD THE NAMES OF ALL YOUR BIRTHS, WHETHER STILL ALIVE OR NOT, STARTING WITH THE FIRST ONE YOU HAD.
RECORD NAMES OF ALL THE BIRTHS IN 212. RECORD TWINS AND TRIPLETS ON SEPARATE ROWS. (IF THERE ARE MORE THAN 12 BIRTHS, USE ADDITIONAL QUESTIONNAIRE, STARTING WITH THE SECOND ROW).
Rwanda 2014
Survey form
view entire document:
text
225. FOR EACH BIRTH IN 2010-2015. ENTER 'B' IN THE MONTH OF BIRTH IN THE CALENDAR. WRITE THE NAME OF THE CHILD TO THE LEFT OF THE 'B' CODE. FOR EACH BIRTH, ASK THE NUMBER OF COMPLETED MONTHS THE PREGNANCY LASTED AND RECORD 'P' IN EACH OF THE PRECEDING MONTHS ACCORDING TO THE DURATION OF PREGNANCY. (NOTE: THE NUMBER OF 'P's MUST BE ONE LESS THAN THE NUMBER OF MONTHS THAT THE PREGNANCY LASTED. )
Senegal 2005
No questionnaire text is available for this sample.
Senegal 2010
Survey form
view entire document:
text
235) ASK THE DATE AND THE DURATION OF PREGNANCY FOR EACH EARLIER NON-LIVE BIRTH PREGNANCY BACK TO JANUARY 2005. (1)
C
ENTER 'T' IN THE CALENDAR IN THE MONTH THAT EACH PREGNANCY TERMINATED AND 'P' FOR THE REMAINING NUMBER OF COMPLETED MONTHS.
Senegal 2012
Survey form
view entire document:
text
211) NOW I WOULD LIKE TO RECORD THE NAMES OF ALL YOUR BIRTHS, WHETHER STILL ALIVE OR NOT, STARTING WITH THE FIRST ONE YOU HAD.
RECORD NAMES OF ALL THE BIRTHS IN 212. RECORD TWINS AND TRIPLETS ON SEPARATE ROWS. (IF THERE ARE MORE THAN 12 BIRTHS, USE ADDITIONAL QUESTIONNAIRE, STARTING WITH THE SECOND ROW).
Senegal 2014
No questionnaire text is available for this sample.
Senegal 2015
No questionnaire text is available for this sample.
Senegal 2016
No questionnaire text is available for this sample.
Senegal 2017
No questionnaire text is available for this sample.
South Africa 2016
No questionnaire text is available for this sample.
Tanzania 2004
Survey form
view entire document:
text
215) In what month and year was (NAME) born?
PROBE: What is his/her birthday?
MONTH___
YEAR___
Tanzania 2010
Survey form
view entire document:
text
215) IN WHAT MONTH AND YEAR WAS (NAME) BORN?
PROBE: WHEN IS HIS/HER BIRTHDAY?
MONTH____
YEAR_____
Tanzania 2015
Survey form
view entire document:
text
225) FOR EACH BIRTH IN 2010-2016, ENTER 'B' IN THE MONTH OF BIRTH IN THE CALENDAR. WRITE THE NAME OF THE CHILD TO THE LEFT OF THE 'B' CODE. FOR EACH BIRTH, ASK THE NUMBER OF COMPLETED MONTHS THE PREGNANCY LASTED AND RECORD 'P' IN EACH OF THE PRECEDING MONTHS ACCORDING TO THE DURATION OF PREGNANCY. (NOTE: THE NUMBER OF 'P's MUST BE ONE LESS THAN THE NUMBER OF MONTHS THAT THE PREGNANCY LASTED.)
Togo 2013
No questionnaire text is available for this sample.
Uganda 2001
Survey form
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text
236 FILL IN THE MONTH AND YEAR OF TERMINATION OF THE LAST NON-LIVE BIRTH PREGNANCY PRIOR TO JANUARY 1995.
MONTH __________
YEAR _____
Uganda 2006
Survey form
view entire document:
text
215 In what month and year was (NAME) born?
PROBE: What is his/her birthday?
MONTH _________
YEAR _______
Uganda 2011
Survey form
view entire document:
text
215) IN WHAT MONTH AND YEAR WAS (NAME) BORN?
PROBE: WHEN IS HIS/HER BIRTHDAY?
MONTH____
YEAR_____
Uganda 2016
No questionnaire text is available for this sample.
Yemen 2013
Survey form
view entire document:
text
235) ASK THE DATE AND THE DURATION OF PREGNANCY FOR EACH EARLIER NON-LIVE BIRTH PREGNANCY BACK TO JANUARY 2008
ENTER 'T' IN THE CALENDAR IN THE MONTH THAT EACH PREGNANCY TERMINATED AND 'P' FOR THE REMAINING NUMBER OF COMPLETED MONTHS FOR EACH PREGNANCY THAT MISCARRIED, WAS ABORTED, OR END IN STILLBIRTH.
Zambia 2001
Survey form
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text
215) In what month and year was (NAME) born?
PROBE: What is his/her birthday?
MONTH: ___
YEAR: ___
Zambia 2007
Survey form
view entire document:
text
215 In what month and year was (NAME) born?
PROBE: What is his/her birthday?
MONTH _________
YEAR _______
Zambia 2013
No questionnaire text is available for this sample.
Zambia 2018
No questionnaire text is available for this sample.
Zimbabwe 1994
Survey form
view entire document:
text
215) In what month and year was (NAME) born?
PROBE: What is his/her birthday? Or: In what season was he/she born?
MONTH ______
YEAR _____
Zimbabwe 1999
Survey form
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text
215) In what month and year was (NAME) born?
PROBE: What is his/her birthday?
MONTH___
YEAR___
Zimbabwe 2005
Survey form
view entire document:
text
215 In what month and year was (NAME) born?
PROBE: What is his/her birthday?
MONTH _________
YEAR _______
Zimbabwe 2010
Survey form
view entire document:
text
215) IN WHAT MONTH AND YEAR WAS (NAME) BORN?
PROBE: WHEN IS HIS/HER BIRTHDAY?
MONTH____
YEAR_____
Zimbabwe 2015
Survey form
view entire document:
text
236. FOR EACH PREGNANCY THAT DID NOT END IN A LIVE BIRTH IN 2010-2015 OR LATER, ENTER 'T' IN THE CALENDAR IN THE MONTH THAT THE PREGNANCY TERMINATED AND 'P' FOR THE REMAINING NUMBER OF COMPLETED MONTHS OF PREGNANCY.
IF THERE ARE MORE THAN FOUR PREGNANCIES THAT DID NOT END IN A LIVE BIRTH, USE AN ADDITIONAL QUESTIONNAIRE STARTING ON THE SECOND LINE.