Questionnaire Text

Questionnaire form view entire document:  text  image

21. What was the date of the birth of your last child born alive?
Date:
____ Month
19 _ _ Year

Questionnaire instructions view entire document:  text  image

Question 21. On what date was the last son or daughter born alive?

Ask this question; write the month and the year of the birth of the last child born alive. Emphasize that the question is about the last child born alive, even if this child died or is living elsewhere.

It is possible that the interviewee does not remember the date of birth, in these cases try to help her remember, asking her age at the birth of the child, or is the child is present, he/she can tell you if he/she is over 5 years old.

On what date did you have your last child who was born alive?

_____ Month
19___ Year