Questionnaire Text

Questionnaire form view entire document:  text  image

E. Marriage and fertility
Ask of all ever-married women. Ask questions person by person.
[Questions E1-E11]


[Questions E6-E11 were asked of women who have ever married and who have ever had a live birth, as per question E1.]


E9. Date of last live birth

In what month and year was your last child born?

Fill in month and year of marriage in the Western or Islamic/Javanese calendars or other ____.

Month:
Western_ _
Islam/Java/____
Other ____

Year:
Western_ _
Islam/Java/____
Other ____

Questionnaire instructions view entire document:  text  image

E. Information on mother's fertility
Ask these questions to women who have ever been married, that is, currently married, widowed or divorced

This part of the questionnaire contains questions about marriage (how many times married), number of children, and some questions about family planning.


Column (6) through (11): The questions for these columns are special ones that are asked about the last baby born (born alive) and only asked to women who have ever given birth (column (2) not 0).


Column (6) through (9) Month and year of birth of last child

"What was the month and year of the birth of your last child?"

Fill in the answer from the respondent using the Christian calendar or the Islamic.