Healthcare template

Maternal health needs assessment

Identify current conditions, priorities and gaps related to maternal health information and support needs.

3 minute estimate5 fully editable questionsNo account needed to preview

Full question preview

What this template asks

1

How would you rate the current situation for maternal health information and support needs?

Required

Creates a consistent numeric measure that can be compared across respondents. It is required in this starting template, but you can change that in the builder.

2

Which challenges currently apply?

Required

Allows more than one applicable factor without forcing a false single choice. It is required in this starting template, but you can change that in the builder.

Limited resourcesLimited informationAccess barriersCapacity or skillsNo major challenge
3

Is adequate support currently available?

Required

Provides a structured answer that is straightforward to compare and segment. It is required in this starting template, but you can change that in the builder.

4

Which priority should be addressed first?

Required

Provides a structured answer that is straightforward to compare and segment. It is required in this starting template, but you can change that in the builder.

Immediate basic needAccessQualityCapacityLong-term sustainability
5

Please explain the most important need or recommendation.

Captures context, examples, and ideas that fixed options may miss. It is optional so respondents can continue when it does not apply.

Sample-size considerations

Follow the study protocol and applicable ethics requirements. Clinical or sensitive health studies normally require specialist review beyond a general survey template.

Best practices

Minimise health identifiersExplain confidentiality and limitsProvide an urgent-care route outside the survey

Common mistakes

Using a survey as emergency clinical supportCollecting diagnoses without safeguardsMaking medical claims from an unrepresentative sample

Frequently asked questions

Can I edit the maternal health needs assessment template?

Yes. Every question, answer option, required setting, section, theme, and eligible logic rule can be changed in Surveyor before you publish.

Can I preview the questionnaire before signing up?

Yes. The respondent preview is available without an account. An account is required only when you want to create and save an editable survey in a protected workspace.

Last reviewed 2 August 2026

Maternal health needs assessment template | Surveyor