Questionnaire Text

Burkina Faso 2020 Congo (Democratic Republic) 2021 India 2022 Nigeria 2020b
Burkina Faso 2021 Congo (Democratic Republic) 2021 Kenya 2020 Nigeria 2021a
Burkina Faso 2022 Cote d'Ivoire 2020 Kenya 2021 Nigeria 2021b
Congo (Democratic Republic) 2019a Cote d'Ivoire 2021 Niger 2020 Uganda 2020
Congo (Democratic Republic) 2019b Cote d'Ivoire 2022 Niger 2022 Uganda 2021
Congo (Democratic Republic) 2020 India 2020 Niger 2023 Uganda 2022
Congo (Democratic Republic) 2020 India 2021 Nigeria 2020a
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Burkina Faso 2020
Questionnaire form view entire document:  text 
206b. When was that birth?

CALENDAR: Enter the birth and duration of pregnancy in the calendar.

Select 'Do not know' for month and '2030' for year to indicate 'No Response'.


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Burkina Faso 2021
Questionnaire form view entire document:  text 
XS_204. When was that 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: 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.


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Burkina Faso 2022
Questionnaire form view entire document:  text 
XS_204. When was that 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: 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.


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Congo (Democratic Republic) 2019a
Questionnaire form view entire document:  text 
206. When was that birth?

CALENDAR: Enter the birth and duration of pregnancy in the calendar.

Select 'Do not know' for month and '2030' for year to indicate 'No Response'.


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Congo (Democratic Republic) 2019b
Questionnaire form view entire document:  text 
206. When was that birth?

CALENDAR: Enter the birth and duration of pregnancy in the calendar.

Select 'Do not know' for month and '2030' for year to indicate 'No Response'.


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Congo (Democratic Republic) 2020
Questionnaire form view entire document:  text 
206. When was that birth?

CALENDAR: Enter the birth and duration of pregnancy in the calendar.

Select 'Do not know' for month and '2030' for year to indicate 'No Response'.


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Congo (Democratic Republic) 2020
Questionnaire form view entire document:  text 
206. When was that birth?

CALENDAR: Enter the birth and duration of pregnancy in the calendar.

Select 'Do not know' for month and '2030' for year to indicate 'No Response'.


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Congo (Democratic Republic) 2021
Questionnaire form view entire document:  text 
XS_204. When was that 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: 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.


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Congo (Democratic Republic) 2021
Questionnaire form view entire document:  text 
XS_204. When was that 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: 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.


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Cote d'Ivoire 2020
Questionnaire form view entire document:  text 
206. When was that 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: 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.


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Cote d'Ivoire 2021
Questionnaire form view entire document:  text 
XS_204. When was that 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: 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.


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Cote d'Ivoire 2022
Questionnaire form view entire document:  text 
XS_204. When was that 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: 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.


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India 2020
Questionnaire form view entire document:  text 
206. When was that 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: 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.


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India 2021
Questionnaire form view entire document:  text 
XS_204. When was that 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: 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.


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India 2022
Questionnaire form view entire document:  text 
XS_203. Have you had any other births since {cc_start_date_lab}?

[] Yes
[] No
[] No response

XS_204. When was that 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: 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.


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Kenya 2020
Questionnaire form view entire document:  text 
XS_204. When was that 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: 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.


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Kenya 2021
Questionnaire form view entire document:  text 
XS_204. When was that 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: 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.


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Niger 2020
Questionnaire form view entire document:  text 
206. When was that 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: 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.


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Niger 2022
Questionnaire form view entire document:  text 
XS_204. When was that 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: 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.


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Niger 2023
Questionnaire form view entire document:  text 
XS_204. When was that 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: 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.


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Nigeria 2020a
Questionnaire form view entire document:  text 
XS_204. When was that 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: 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.


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Nigeria 2020b
Questionnaire form view entire document:  text 
XS_204. When was that 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: 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.


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Nigeria 2021a
Questionnaire form view entire document:  text 
XS_204. When was that 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: 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.


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Nigeria 2021b
Questionnaire form view entire document:  text 
XS_204. When was that 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: 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.


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Uganda 2020
Questionnaire form view entire document:  text 
206. When was that 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: 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.


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Uganda 2021
Questionnaire form view entire document:  text 
XS_204. When was that 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: 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.


top
Uganda 2022
Questionnaire form view entire document:  text 
XS_204. When was that 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: 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.