Population and Development Dynamics in Rural Communities (FPA/INT/287/INT) | ||||||||||||
Head of household questionnaire | ||||||||||||
Identification of the household | ||||||||||||
District: | District ID number | |||||||||||
Tana: | Tana ID number | |||||||||||
Union: | Union ID number | |||||||||||
Village: | Village ID number | |||||||||||
Country: | Household ID number | |||||||||||
Interviewer visits | |||||||||||
First visit (1) | Second visit (2) | Third visit (3) | |||||||||
Name interviewer: | Name interviewer: | Name interviewer: | |||||||||
Day | Day | Day | |||||||||
Month | Month | Month | |||||||||
Result* | Result | Result* | |||||||||
* Codes for interview result: | Total number of visits | ||||||||||
1. Completed 2. Household present, but no eligible respondent at home 3. Household absent 4. Questionnaire incomplete 5. Refused 6. Dwelling not found 7. Dwelling vacant/address not a dwelling/destroyed 8. Other | |||||||||||
Summary data of household (Module A): | |||||||||||
Person number of respondent of household questionnaire | |||||||||||
Number of persons in household | |||||||||||
Count of nuclear families in household (See A6) | |||||||||||
interviewer and coders: in case explicit coding instructions for “answer refused”, “don't know” or “not-stated” in the questionnaire are lacking, you must use the following coding convention: a. Answer refused=7, 97, 997, etc. b. Does not know answer= 8,98 or 998, etc, c. Answer not stated=9, 99 or 999, etc. | |||||||||||
Count of ELIGIBLE MALES (15–64) in household (Count A13a) | |||||||||||
Count of ELIGIBLE FEMALES (15–49) in household (Count A13b) | |||||||||||
Name: | Day: Month: Year: | ||||||||||
Field edited by: | on: | / / | |||||||||
Office edited by: | on: | / / | |||||||||
Computer data-entry by: | on: | / / |
Module A: Household roster ((acting) head of household) | |||||||||||||||||||
Interviewer: The questions A1–A13 must be completed for all members of the household that are now present in the household, including: | Pers. num. | A1 | A2 | A3 | A4 | A5 | |||||||||||||
Could you give me the NAMES of all persons who usually live in this household. Start with the name of the head of the household | What is the relationship (*) of (NAME) to the head of the household | Is (NAME male or female? | Does (NAME) usually live here in the household? | Did (NAME) sleep here last night? | |||||||||||||||
1 | Currently absent household members (e.g. children!) who went to live in an institution for an expected stay not more than one year; | ||||||||||||||||||
1 = Male | 1 = Yes | 1 = Yes | |||||||||||||||||
NAMES | 2 = Female | 2 = No | 2 = No | ||||||||||||||||
01 | 0 | 1 | |||||||||||||||||
02 | |||||||||||||||||||
2 | Maids and servants who usually eat, live and sleep here; Currently absent household members who are temporarily working away from the home, but who are expected to return within 6 months | ||||||||||||||||||
03 | |||||||||||||||||||
04 | |||||||||||||||||||
05 | |||||||||||||||||||
06 | |||||||||||||||||||
07 | |||||||||||||||||||
08 | |||||||||||||||||||
but exclude: | |||||||||||||||||||
09 | |||||||||||||||||||
1 | Temporary visitors | ||||||||||||||||||
2 | Friends | 10 | |||||||||||||||||
11 | |||||||||||||||||||
Enter ‘X’ In box to indicate that you have checked the above. | → | ||||||||||||||||||
12 | |||||||||||||||||||
13 | |||||||||||||||||||
14 | |||||||||||||||||||
15 | |||||||||||||||||||
Module A: Household roster ((acting) head of household) | ||||||||||||||||||||||||||
Only for persons of age 6–64 | ||||||||||||||||||||||||||
Pers. Num | A6 | A7 | A8 | A9 | A10 | |||||||||||||||||||||
Interviewer: | What is the age of (NAME)? | What is the date of birth of (NAME)? | Has (NAME) ever attended school? | What is the highest level of school attended (*) by (NAME)? | ||||||||||||||||||||||
If (Name) belongs to a nuclear family, register here the FAMILY RANK NUMBER(*) e.g. 1, 2,..etc.. | ||||||||||||||||||||||||||
↓ | + | |||||||||||||||||||||||||
What is the total number of years of schooling successfully completed? | ||||||||||||||||||||||||||
Interviewer: enter ‘95’ if person is 95 or older | ||||||||||||||||||||||||||
1 = Yes | ||||||||||||||||||||||||||
2 = No | ↓ | |||||||||||||||||||||||||
A10a level | A10b years | |||||||||||||||||||||||||
Year | Month | Go to A11 | ||||||||||||||||||||||||
01 | 1 | 9 | ||||||||||||||||||||||||
1 | 9 | |||||||||||||||||||||||||
03 | 1 | 9 | ||||||||||||||||||||||||
04 | 1 | 9 | ||||||||||||||||||||||||
05 | 1 | 9 | ||||||||||||||||||||||||
06 | 1 | 9 | ||||||||||||||||||||||||
07 | 1 | 9 | ||||||||||||||||||||||||
08 | 1 | 9 | ||||||||||||||||||||||||
09 | 1 | 9 | ||||||||||||||||||||||||
10 | 1 | 9 | ||||||||||||||||||||||||
11 | 1 | 9 | ||||||||||||||||||||||||
12 | 1 | 9 | ||||||||||||||||||||||||
13 | 1 | 9 | ||||||||||||||||||||||||
14 | 1 | 9 | ||||||||||||||||||||||||
15 | 1 | 9 | ||||||||||||||||||||||||
Module A: Household roster ((acting) head of household) | |||||||||
Pers. No. | Only for persons of age 6 – 64 | ||||||||
A11 | A12 | A13 Interviewer: | |||||||
What kind of work (*) does (NAME) do most of the time? | What is the current marital status of (NAME)? | Place a circle around the person numbers of household members that are eligible for a personal interview | |||||||
1. Never married | A13a ELIGIBLE MALE | A13b ELIGIBLE FEMALE | |||||||
2. Married | If married and age 15 or older, but below age 65. (married, 15–64) | If married and age 15 or older, but below age 50 (married, 15–49) | |||||||
3. Widowed | |||||||||
4. Divorced | |||||||||
5. Separated | |||||||||
01 | 01 | 01 | |||||||
02 | 02 | 02 | |||||||
03 | 03 | 03 | |||||||
04 | 04 | 04 | |||||||
05 | 05 | 05 | |||||||
06 | 06 | 06 | |||||||
07 | 07 | 07 | |||||||
08 | 08 | 08 | |||||||
09 | 09 | 09 | |||||||
10 | 10 | 10 | |||||||
11 | 11 | 11 | |||||||
12 | 12 | 12 | |||||||
13 | 13 | 13 | |||||||
14 | 14 | 14 | |||||||
15 | 15 | 15 | |||||||
Count number of ELIGIBLE males and females and enter the counts on coverpage | → | Males | Females | ||||||
End of module A, go to module B |