Questionnaire Text
Burkina Faso 2014
Questionnaire form
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
Burkina Faso 2015
Questionnaire form
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
Burkina Faso 2016a
Questionnaire form
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
Burkina Faso 2016b
Questionnaire form
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
Burkina Faso 2017
Questionnaire form
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
Burkina Faso 2018
Questionnaire form
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206. When was your MOST RECENT birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____
Year____
Burkina Faso 2020
Questionnaire form
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206. When was your MOST RECENT birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed.
Select 'Do not know' for month and '2030' for year to indicate 'No Response'.
CALENDAR: If the birth was after [JANUARY 2018] enter the birth and duration of pregnancy in the calendar.
Burkina Faso 2021
Questionnaire form
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XS_202. When was your MOST RECENT birth?
Please record the date of the first live birth. Date should be found by calculating forward or backward from memorable events if needed.
Select 'Do not know' for month and '2030' for year to indicate 'No Response'.
CALENDAR: If the birth was after {cc_start_date_lab} enter the birth and duration of pregnancy in the calendar.
Month:
[] January
[] February
[] March
[] April
[] May
[] June
[] July
[] August
[] September
[] October
[] November
[] December
[] Do not know
Year: ___
If entering '2030' for No Response, must select 'Do not know' for month.
Cannot be in future.
Burkina Faso 2022
Questionnaire form
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XS_202. When was your MOST RECENT birth?
Please record the date of the first live birth. Date should be found by calculating forward or backward from memorable events if needed.
Select 'Do not know' for month and '2030' for year to indicate 'No Response'.
CALENDAR: If the birth was after January 2019 enter the birth and duration of pregnancy in the calendar.
Month:
[] January
[] February
[] March
[] April
[] May
[] June
[] July
[] August
[] September
[] October
[] November
[] December
[] Do not know
Year:
If entering '2030' for No Response, must select 'Do not know' for month.
Cannot be in future.
Congo (Democratic Republic) 2013
Questionnaire form
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
Congo (Democratic Republic) 2014
Questionnaire form
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
Congo (Democratic Republic) 2015a
Questionnaire form
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
Congo (Democratic Republic) 2015b
Questionnaire form
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
Congo (Democratic Republic) 2015c
Questionnaire form
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
Congo (Democratic Republic) 2016a
Questionnaire form
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
Congo (Democratic Republic) 2016b
Questionnaire form
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
Congo (Democratic Republic) 2017a
Questionnaire form
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206. When was your MOST RECENT birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____
Year____
Congo (Democratic Republic) 2017b
Questionnaire form
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206. When was your MOST RECENT birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____
Year____
Congo (Democratic Republic) 2018a
Questionnaire form
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206. When was your MOST RECENT birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____
Year____
Congo (Democratic Republic) 2018b
Questionnaire form
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206. When was your MOST RECENT birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____
Year____
Congo (Democratic Republic) 2019a
Questionnaire form
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204. When was your MOST RECENT birth?
Please record the date of the first live birth. Date should be found by calculating forward or backward from memorable events if needed. Select 'Do not know' for month and '2030' for year to indicate 'No Response'.
CALENDAR: If the birth was after ${cc_start_date_lab} enter the birth and duration of pregnancy in the calendar.
Congo (Democratic Republic) 2019b
Questionnaire form
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204. When was your MOST RECENT birth?
Please record the date of the first live birth. Date should be found by calculating forward or backward from memorable events if needed. Select 'Do not know' for month and '2030' for year to indicate 'No Response'.
CALENDAR: If the birth was after ${cc_start_date_lab} enter the birth and duration of pregnancy in the calendar.
Congo (Democratic Republic) 2020
Questionnaire form
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204. When was your MOST RECENT birth?
Please record the date of the first live birth. Date should be found by calculating forward or backward from memorable events if needed. Select 'Do not know' for month and '2030' for year to indicate 'No Response'.
CALENDAR: If the birth was after ${cc_start_date_lab} enter the birth and duration of pregnancy in the calendar.
Congo (Democratic Republic) 2020
Questionnaire form
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204. When was your MOST RECENT birth?
Please record the date of the first live birth. Date should be found by calculating forward or backward from memorable events if needed. Select 'Do not know' for month and '2030' for year to indicate 'No Response'.
CALENDAR: If the birth was after ${cc_start_date_lab} enter the birth and duration of pregnancy in the calendar.
Congo (Democratic Republic) 2021
Questionnaire form
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XS_202. When was your MOST RECENT birth?
Please record the date of the first live birth. Date should be found by calculating forward or backward from memorable events if needed.
Select 'Do not know' for month and '2030' for year to indicate 'No Response'.
CALENDAR: If the birth was after January 2019 enter the birth and duration of pregnancy in the calendar.
Month:
[] January
[] February
[] March
[] April
[] May
[] June
[] July
[] August
[] September
[] October
[] November
[] December
[] Do not know
Year:
If entering '2030' for No Response, must select 'Do not know' for month.
Cannot be in future.
Congo (Democratic Republic) 2021
Questionnaire form
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XS_202. When was your MOST RECENT birth?
Please record the date of the first live birth. Date should be found by calculating forward or backward from memorable events if needed.
Select 'Do not know' for month and '2030' for year to indicate 'No Response'.
CALENDAR: If the birth was after January 2019 enter the birth and duration of pregnancy in the calendar.
Month:
[] January
[] February
[] March
[] April
[] May
[] June
[] July
[] August
[] September
[] October
[] November
[] December
[] Do not know
Year:
If entering '2030' for No Response, must select 'Do not know' for month.
Cannot be in future.
Cote d'Ivoire 2017
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Cote d'Ivoire 2018
Questionnaire form
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206. When was your MOST RECENT birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____
Year____
Cote d'Ivoire 2020
Questionnaire form
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206. When was your MOST RECENT birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____
Year____
Cote d'Ivoire 2021
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206. When was your MOST RECENT birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____
Year____
Ethiopia 2014a
Questionnaire form
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
Ethiopia 2014b
Questionnaire form
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
Ethiopia 2015
Questionnaire form
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
Ethiopia 2016
Questionnaire form
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
Ethiopia 2017
Questionnaire form
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
Ethiopia 2018
Questionnaire form
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206. When was your MOST RECENT birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____
Year____
Ethiopia 2019
Questionnaire form
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FFQ021. When was your MOST RECENT birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed.
Select 'Do not know' for month and '2030' for year to indicate 'No Response'.
Use visual aid to record dates of most recent birth
Ghana 2013
Questionnaire form
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
Ghana 2014a
Questionnaire form
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
Ghana 2014b
Questionnaire form
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
Ghana 2015
Questionnaire form
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206. When was your MOST RECENT birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____
Year____
Ghana 2016
Questionnaire form
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206. When was your MOST RECENT birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____
Year____
Ghana 2017
Questionnaire form
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206. When was your MOST RECENT birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____
Year____
India 2016
Questionnaire form
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
India 2017a
Questionnaire form
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
India 2017b
Questionnaire form
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
India 2018
Questionnaire form
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206. When was your MOST RECENT birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____
Year____
India 2020
Questionnaire form
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206. When was your MOST RECENT birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____
Year____
India 2021
Questionnaire form
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206. When was your MOST RECENT birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____
Year____
Indonesia 2015
Questionnaire form
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
Indonesia 2016
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
Kenya 2014a
Questionnaire form
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
Kenya 2014b
Questionnaire form
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
Kenya 2015a
Questionnaire form
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206. When was your MOST RECENT birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____
Year____
Kenya 2015b
Questionnaire form
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206. When was your MOST RECENT birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____
Year____
Kenya 2016
Questionnaire form
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206. When was your MOST RECENT birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____
Year____
Kenya 2017
Questionnaire form
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206. When was your MOST RECENT birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____
Year____
Kenya 2018
Questionnaire form
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206. When was your MOST RECENT birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____
Year____
Kenya 2019
Questionnaire form
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206. When was your MOST RECENT birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Select 'Do not know' for month and '2030' for year to indicate 'No Response'.Month____
Year____
Kenya 2020
Questionnaire form
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206. When was your MOST RECENT birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Select 'Do not know' for month and '2030' for year to indicate 'No Response'.Month____
Year____
Kenya 2021
Questionnaire form
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206. When was your MOST RECENT birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____
Year____
Niger 2015
Questionnaire form
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
Niger 2016a
Questionnaire form
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
Niger 2016b
Questionnaire form
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
Niger 2017
Questionnaire form
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
Niger 2018
Questionnaire form
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206. When was your MOST RECENT birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____
Year____
Niger 2020
Questionnaire form
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204. When was your MOST RECENT birth?
Please record the date of the first live birth. Date should be found by calculating forward or backward from memorable events if needed.
Select 'Do not know' for month and '2030' for year to indicate 'No Response'.
CALENDAR: If the birth was after {cc_start_date_lab} enter the birth and duration of pregnancy in the calendar.
Month:
[] January
[] February
[] March
[] April
[] May
[] June
[] July
[] August
[] September
[] October
[] November
[] December
[] Do not know
Year:
If entering '2030' for No Response, must select 'Do not know' for month.
Cannot be in future. Date of most recent birth cannot be before respondent was 10 years of age. Date of most recent birth must be at least 6 months after the first birth. Year of most recent birth cannot be before first birth.
Niger 2022
Questionnaire form
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XS_202. When was your MOST RECENT birth?
Please record the date of the first live birth. Date should be found by calculating forward or backward from memorable events if needed.
Select 'Do not know' for month and '2030' for year to indicate 'No Response'.
CALENDAR: If the birth was after January 2018 enter the birth and duration of pregnancy in the calendar.
Month:
[] January
[] February
[] March
[] April
[] May
[] June
[] July
[] August
[] September
[] October
[] November
[] December
[] Do not know
Year:
If entering '2030' for No Response, must select 'Do not know' for month.
Cannot be in future.
Nigeria 2014a
Questionnaire form
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
Nigeria 2014b
Questionnaire form
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
Nigeria 2015a
Questionnaire form
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
Nigeria 2015b
Questionnaire form
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
Nigeria 2016
Questionnaire form
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
Nigeria 2017a
Questionnaire form
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
Nigeria 2017b
Questionnaire form
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206. When was your MOST RECENT birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____
Year____
Nigeria 2018
Questionnaire form
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
Nigeria 2019a
Questionnaire form
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206. When was your MOST RECENT birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed.
Select 'Do not know' for month and '2030' for year to indicate 'No Response'.
Nigeria 2019b
Questionnaire form
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206. When was your MOST RECENT birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed.
Select 'Do not know' for month and '2030' for year to indicate 'No Response'.
Nigeria 2020a
Questionnaire form
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206. When was your MOST RECENT birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed.
Select 'Do not know' for month and '2030' for year to indicate 'No Response'.
Nigeria 2020b
Questionnaire form
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206. When was your MOST RECENT birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed.
Select 'Do not know' for month and '2030' for year to indicate 'No Response'.
Nigeria 2021a
Questionnaire form
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206. When was your MOST RECENT birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____
Year____
Nigeria 2021b
Questionnaire form
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206. When was your MOST RECENT birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____
Year____
Uganda 2014
Questionnaire form
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
Uganda 2015a
Questionnaire form
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
Uganda 2015b
Questionnaire form
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
Uganda 2016
Questionnaire form
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9. When was your MOST RECENT live birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
Uganda 2017
Questionnaire form
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206. When was your MOST RECENT birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____ Year____
Uganda 2018
Questionnaire form
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206. When was your MOST RECENT birth?
Select 'Do not know' for month and '2020' for year to indicate 'No Response'. Month:
[] January
[] February
[] March
[] April
[] May
[] June
[] July
[] August
[] September
[] October
[] November
[] December
[] Do not know
Year: ____
Uganda 2019
Questionnaire form
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206. When was your MOST RECENT birth?
Select 'Do not know' for month and '2020' for year to indicate 'No Response'. Month:
[] January
[] February
[] March
[] April
[] May
[] June
[] July
[] August
[] September
[] October
[] November
[] December
[] Do not know
Year: ____
Uganda 2020
Questionnaire form
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206. When was your MOST RECENT birth?
Select 'Do not know' for month and '2020' for year to indicate 'No Response'. Month:
[] January
[] February
[] March
[] April
[] May
[] June
[] July
[] August
[] September
[] October
[] November
[] December
[] Do not know
Year: ____
Uganda 2021
Questionnaire form
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206. When was your MOST RECENT birth?
Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.Month____
Year____