Questionnaire Text

Questionnaire form view entire document:  text  image
Section IV. Population information


18. Have you given birth to any children who were born alive?

[] 1 Yes
[] 6 No - Go on to the next person

Questionnaire instructions view entire document:  text  image

Only for women 14 years old and older.

The questions 18 and on refer to fertility. They will be asked only of women who are fourteen years old and older.

Question 18: Have you had a son (or daughter) born alive?

If she responds yes, continue asking questions 19 and on.

If she answers no, end the interview and continue with the next person.

Question 19: How many sons and daughters do you have that were born alive?

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In the box, write, with legible numbers, the number of sons/daughters that the woman had and those that are alive at this time. Mark the circle "none" if she does not have children who are alive.