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MARUPI Individual '& Community Health Assessment Questionnaire

This questionnaire is intended for MARUPI stakeholders in order to assess the health of every individuals of their community. The objective of this assessment is to get a clear and reliable vison of both social and health needs of this population. The collected data will serve to priories future investments thus the funding of international bodies to best respond to the Mano River Union population needs as taken care by MARUPI.
Those questionnaires will be concatenated and analysed by MARUPI with the help of StratAdviser Ltd, a third party which is already providing advices to the WAHO regarding epidemiological data analysis and public health issues.
In parallel to the public health use of those questionnaire, each will benefit from a specific analysis by a doctor in order to propose a personal assessment with its related medical recommendation to the benefit of the individual who accepted to respond.

mandatory answer

Question 1

Thank you to enter here your pseudonym

mandatory answer

Question 2

Church's Name

mandatory answer

Question 3

Forename / Surname of the interviewer

mandatory answer

Question 4

Date of the day YYY/MM/DD

Social Identity

mandatory answer

Question 5

Forename / Surname / Usual name

mandatory answer

Question 6

MARUPI ID Number

Question 7

Age (approx)




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