Questionnaire for Clinic Kay Holder - Page 4

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29.

Would the people be willing for a male nurse co deliver babies?

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30.

Would che people accepe family planning and sex education from a heaith
worker of either sex?

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31.

Yes
No

Yes
No

Tf no, specify sex preference:

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Males can do famtly planning and sex education for both sexes
Females can do family planning and sex education for beth sexes

“Must have male workers for male patients and female workers for
female patients

32.

Number of people in clinic serving area

33.

Number of births per month in clinic serving area

34,

number of deliveries per month at clinic

35.

Number oz deaths per month in clinic serving area

36.

Whe records births and deachs?

Who determines cause of death?

38.

Is this information recorded on a death certificate?

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39.

Yes
Yo

Where are records of births and deaths kepc?

Select target paragraph3