Questionnaire Text

Questionnaire form view entire document: text image

For women age 14 or older
[Questions 19-25 were asked of women age 14 or older]

25. If the woman's last child died within the last five years, was a death certificate obtained from MINSA?

[] 1 Yes
[] 2 No

Questionnaire instructions view entire document: text image

Questions only for women who are age 14 or older
This series of questions will only be asked of women age 14 or older. For the case of all of the females younger than 14 and all males of any age, you will annul the questions from 19 to 25 by making a diagonal line through each of the boxes.

Question 25: If the woman's last child died within the last five years, was a death certificate obtained from MINSA?
You should note "Yes" only if MINSA provided the certificate at the moment of death of the last live-born child.

Be aware that this question is closely linked to questions number 22 and 23.