501) ENTER IN THE TABLE THE LINE NUMBER, NAME, AND SURVIVAL STATUS OF EACH BIRTH IN 2002 OR LATER. ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS. BEGIN WITH THE LAST BIRTH. (IF THERE ARE MORE THAN 3 BIRTHS, USE LAST 2 COLUMNS OF ADDITIONAL QUESTIONNAIRES).

502) LINE NUMBER FROM 212

441) LINE NUMBER FROM Q. 212

442) FROM Q. 212 AND Q. 216

455) LINE NUMBER FROM Q. 212

455) LINE NUMBER FROM QUESTION 212

502) BIRTH HISTORY NUMBER FROM 212 IN BIRTH HISTORY

441. ENTER THE LINE NUMBER, NAME, AND SURVIVAL STATUS FOR EACH BIRTH SINCE JANUARY 1987 IN THE TABLE. ASK THE QUESTIONS FOR ALL BIRTHS BEGINNING WITH THE LAST BIRTH. (IF THERE ARE MORE THAN 3 BIRTHS, USE LAST COLUMN OF ADDITIONAL QUESTIONNAIRES.)

LINE NUMBER FROM 212:

FROM 212 AND 216:

441. COMPLETE THE HEADING OF THE TABLE BY FOLLOWING THE SAME PROCEDURE AS FOR SECTION 4A. THERE IS AN IMPORTANT DIFFERENCE BETWEEN SECTIONS 4A AND 4B. SECTION 4A GATHERS INFORMATION ABOUT CHILDREN BOTH ALIVE AND DECEASED, WHEREAS SECTION 4B CONCERNS ONLY LIVING CHILDREN (442-477).

HOWEVER, YOU SHOULD COMPLETE THE HEADING OF THE TABLE IN SECTION 4B FOR ALL CHILDREN, LIVING OR DECEASED, BECAUSE THE QUESTIONS ABOUT THE TREATMENT OF CHILDREN'S DIARRHEA THAT ARE AT THE END OF THE SECTION (478-488) WILL BE ASKED OF ALL WOMEN.

LINE NUMBER FROM Q. 212

442) ENTER LINE NUMBER, NAME, AND SURVIVAL STATUS OF EACH BIRTH SINCE JANUARY 1991 IN THE TABLE.
ASK THE QUESTIONS FOR ALL THE BIRTHS. BEGIN WITH THE LAST BIRTH.
(IF THERE ARE MORE THAN 2 BIRTHS, USE ADDITIONAL QUESTIONNAIRE)

473) RECORD THE LINE, THE NAME AND SURVIVAL STATUS OF EACH CHILD BORN SINCE JANUARY 1991 ACCORDING TO THE REPRODUCTION TABLE.
ASK THE QUESTIONS ABOUT ALL THESE BIRTHS ENDING IN DEATH. IF 3 OR MORE, BEGIN WITH THE LAST (IF MORE THAN 3 BIRTHS, USE ANOTHER QUESTIONNAIRE).

LINE NUMBER FROM 212:

ACCORDING TO 212 AND 216:

LINE NUMBER FROM Q212 ___

602) LINE NUMBER FROM Q. 212

ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS. BEGIN WITH THE LAST BIRTH.

(IF THERE ARE MORE THAN 3 BIRTHS, USE ADDITIONAL FORMS).

ASK THE QUESTIONS ABOUT ALL OF THESE CHILDREN. BEGIN WITH THE YOUNGEST CHILD.
(IF THERE ARE MORE THAN 3 LIVING CHILDREN, USE ADDITIONAL QUESTIONNAIRES).

Now I would like to ask you some more questions about the health of all your children in the past five years. (We will talk about one child at a time.)

LINE NUMBER FROM Q. 212

FROM Q. 212 AND Q. 216

453. ENTER THE LINE NUMBER AND NAME OF LAST TWO BIRTHS SINCE JANUARY 1995 IN THE TABLE. ASK THE QUESTIONS ABOUT THESE TWO BIRTHS. BEGIN WITH THE LAST BIRTH. (IF THERE ARE MORE THAN 2 BIRTHS, RECORD ONLY LAST TWO BIRTHS.)

LINE NUMBER FROM QUESTION 212:

FROM QUESTIONS 212 AND 216:

501 ENTER IN THE TABLE THE LINE NUMBER, NAME, AND SURVIVAL STATUS OF EACH BIRTH IN 2001 (1) OR LATER.
ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS. BEGIN WITH THE LAST BIRTH.
(IF THERE ARE MORE THAN 3 BIRTHS, USE LAST 2 COLUMNS OF ADDITIONAL QUESTIONNAIRES).

Now I would like to ask you some more questions about the health of all your children born in the past five years. (We will talk about one child at a time.)

ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS. BEGIN WITH THE LAST BIRTH.

(IF THERE ARE MORE THAN 3 BIRTHS, USE LAST 2 COLUMNS OF ADDITIONAL QUESTIONNAIRES).

501) ENTER IN THE TABLE THE BIRTH HISTORY NUMBER, NAME, AND SURVIVAL STATUS OF EACH BIRTH IN 2009 OR LATER. ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS. BEGIN WITH THE LAST BIRTH. (IF THERE ARE MORE THAN 3 BIRTHS, USE LAST 2 COLUMNS OF ADDITIONAL QUESTIONNAIRE(S)).

501 ENTER IN THE TABLE THE LINE NUMBER, NAME, AND SURVIVAL STATUS OF EACH BIRTH IN 2001 (1) OR LATER.
ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS. BEGIN WITH THE LAST BIRTH.
(IF THERE ARE MORE THAN 3 BIRTHS, USE LAST 2 COLUMNS OF ADDITIONAL QUESTIONNAIRES).

LINE NUMBER FROM Q. 212

LINE NUMBER FROM Q. 212

WRITE THE NAME AND THE SURVIVAL STATE OF EACH BIRTH SINCE MARCH 1982 IN TABLE 4, BEGINNING WITH THE LAST BIRTH. THE FIRST LINE OF TABLE 4 SHOULD BE EXACTLY THE SAME AS THAT OF TABLE 3. ONLY ASK QUESTIONS OF LIVING CHILDREN.

(REPEAT FOR 4 BIRTHS)

501 ENTER IN THE TABLE THE LINE NUMBER, NAME, AND SURVIVAL STATUS OF EACH BIRTH IN 2001 (1) OR LATER.
ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS. BEGIN WITH THE LAST BIRTH.
(IF THERE ARE MORE THAN 3 BIRTHS, USE LAST 2 COLUMNS OF ADDITIONAL QUESTIONNAIRES).

441. LINE NUMBER FROM 212:

455. LINE NUMBER FROM QUESTION 212:

502. LINE NUMBER FROM Q. 212

LINE NUMBER FROM Q. 212

501 ENTER IN THE TABLE THE LINE NUMBER, NAME, AND SURVIVAL STATUS OF EACH BIRTH IN 2001 (1) OR LATER.
ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS. BEGIN WITH THE LAST BIRTH.
(IF THERE ARE MORE THAN 3 BIRTHS, USE LAST 2 COLUMNS OF ADDITIONAL QUESTIONNAIRES).

439. ENTER THE NAME, LINE NUMBER, AND SURVIVAL STATUS OF EACH BIRTH SINCE BAISAKH 2049 IN THE TABLE. ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS. BEGIN WITH THE LAST BIRTH. (IF THERE ARE MORE THAN 2 BIRTHS, USE ADDITIONAL QUESTIONNAIRES).

501. ENTER IN THE TABLE THE LINE NUMBER, NAME, AND SURVIVAL STATUS OF EACH BIRTH IN 2057 OR LATER. ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS. BEGIN WITH THE LAST BIRTH.
(IF THERE ARE MORE THAN 3 BIRTHS, USE LAST 2 COLUMNS OF ADDITIONAL QUESTIONNAIRES).

FROM QUESTION 212 AND QUESTION 216:

As part of this survey, we are asking people all over the country to take an anemia test. Anemia is a serious health problem that usually results from poor nutrition, infection, or chronic disease. This survey will assist the government to develop programs to prevent and treat anemia.

For the anemia testing, we will need a few drops of blood from a finger. The equipment used to take the blood is clean and completely safe. It has never been used before and will be thrown away after each test. The blood will be tested for anemia immediately, and the result will be told to you right away. The result will be kept strictly confidential and will not be shared with anyone other than members of our survey team.

Do you have any questions?

You can say yes to the test, or you can say no. It is up to you to decide. Will you take the anemia test?

253. CIRCLE THE APPROPRIATE CODE AND SIGN YOUR NAME.

(SIGN) ____________

LINE NUMBER FROM Q.212

FROM Q.212 AND Q.216

441. LINE NUMBER FROM Q212

442. FROM Q212 AND Q216

501 ENTER IN THE TABLE THE LINE NUMBER, NAME, AND SURVIVAL STATUS OF EACH BIRTH IN 2001 (1) OR LATER.
ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS. BEGIN WITH THE LAST BIRTH.
(IF THERE ARE MORE THAN 3 BIRTHS, USE LAST 2 COLUMNS OF ADDITIONAL QUESTIONNAIRES).

502) BIRTH HISTORY NUMBER FROM 212 IN BIRTH HISTORY

Now I would like to ask you some more questions about the health of all your children in the past five years. (We will talk about one child at a time.)

LINE NUMBER FROM Q. 212

FROM Q. 212 AND Q. 216

501 ENTER IN THE TABLE THE LINE NUMBER, NAME, AND SURVIVAL STATUS OF EACH BIRTH IN 2001 (1) OR LATER.
ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS. BEGIN WITH THE LAST BIRTH.
(IF THERE ARE MORE THAN 3 BIRTHS, USE LAST 2 COLUMNS OF ADDITIONAL QUESTIONNAIRES).

ASK THE QUESTIONS ONLY FOR LIVING CHILDREN.

LINE NUMBER FROM Q. 212

LINE NUMBER FROM Q. 212

401) INTERVIEWER: CHECK 214:

INTERVIEWER: ENTER THE LINE NUMBER, THE NAME, AND THE SURVIVAL STATUS OF EACH BIRTH SINCE JANUARY 1983 IN TABLE 3, STARTING WITH THE LAST BIRTH.

LINE NUMBER FROM QUESTION 212

443) ENTER LINE NUMBER, NAME, AND SURVIVAL STATUS OF EACH BIRTH SINCE JANUARY 1991 IN THE TABLE. ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS. BEGIN WITH THE LAST BIRTH. (IF THERE ARE MORE THAN 2 BIRTHS USE ADDITIONAL FORMS.)

501) ENTER IN THE TABLE THE BIRTH HISTORY NUMBER, NAME, AND SURVIVAL STATUS OF EACH BIRTH IN 2008 OR LATER. ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS. BEGIN WITH THE LAST BIRTH. (IF THERE ARE MORE THAN 3 BIRTHS, USE LAST 2 COLUMNS OF ADDITIONAL QUESTIONNAIRES). NOW, I WOULD LIKE TO ASK YOU SOME QUESTIONS ABOUT YOUR CHILDREN WHO BORN SINCE 2008 OR LATER, WE WILL TALK ABOUT EACH SEPARATELY

502) BIRTH HISTORY NUMBER FROM 212 IN BIRTH HISTORY

LINE NUMBER FROM Q. 212

454. ENTER IN THE TABLE THE LINE NUMBER, NAME, AND SURVIVAL STATUS OF EACH BIRTH IN 1996 OR LATER. (IF THERE ARE MORE THAN 2 BIRTHS, USE LAST COLUMN OF ADDITIONAL QUESTIONNAIRES).

455. LINE NUMBER FROM 212

502. LINE NUMBER FROM 212

RECORD TWINS IN SEPARATE COLUMNS.

ASK QUESTIONS ABOUT ALL BIRTHS SINCE JANUARY 1983.

NAME __________

(IF THERE ARE MORE THAN 3 BIRTHS, USE LAST 2 COLUMNS OF ADDITIONAL QUESTIONNAIRES).