Questionnaire Text

Questionnaire form view entire document:  text  image

26) Births

Have there been any births in this household during the period from ______ to _______
Mark an x in the proper box

Yes [ ] No [ ]

If yes, specify the sex of the child, the order number and the age of the mother.

Order number of mother ____
Sex of child __
Age of mother _ _

Questionnaire instructions view entire document:  text  image

Column 26: Births:

Ask if there were any births in this household from April 9, 1975 to April 8, 1976 (make an effort to respect this period), whether the child is currently present or absent, living or deceased. Only consider live births (children who cried after birth).

Mark a cross in the square corresponding to the correct answer (if a cross was inadvertently marked in the wrong square, black out this square completely and mark the cross in the square corresponding to the correct response.)

If NO: go to the next question.

If YES: mark in the corresponding columns the order number of the mother, the sex of the child (M for male, F for female) and the age of the mother in years passed.


The other number of the mother is the number marked in column 1 of the questionnaire and the age of the mother is the age marked in column 9.

[Example omitted]

N.B. A birth should only be marked on the household sheet where the mother was living during the event.

Meanwhile, if the mother and her baby no longer live in the household where the birth took place at the time of the survey, they will not be surveyed in this household, but in the household where they currently live.