republic of ivory coast ministry of the ... - ireda
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REPUBLIC OF IVORY COAST MINISTRY OF THE ECONOMY AND FINANCE STATISTICS DEPARTMENT
P E R MAN E N THO USE H 0 L D SUR V E Y
HOUSEHOLD QUESTIONNAIRE
WORLD BANK LIVING STANDARDS MEASUREMENT STUDY
STRICTLY CONFIDENTIAL
REPUBLIC !)F IVORY COl''iT IUNISTRY OF THE ECONClty ~MD FINANCE STA'!ISTICS DEPARTIIENT
PERH/\NENT HOUSEHDlD SiJRVEY
HOUSEHOlD RUESTIONNAIRE
WORLD BANr. LIVING ST~NDRR~S IIEASURE"EHT STUDY
STP.ICTLV CnNFIDENTIAL
L!::=S =U=R=V=E=Y=_ =~=N=F=O:::_.' "_:::::::~]
ClUSTERI _______________________________________ c=J HOUSEHOLD c=J ROSTERI c=J HEAD OF 1I0USEHOlDI _________________________________________________________________________________________ _
SUPERYISION OF PRINTOUTS, ROUND ONE =:=:::=:===========œ:====a:-=:I=i SUPERYISORI _______________________________________________ D DATEI
~DDRESSI __________________________________________________________________________________________ _ REIIARKSI _______________________________________________________________________________________ _
- FIRST ROUI/Il OF SURYEV :::::::U::=====ac::::I================1 SECOND ROUND OF SURVEY .. n .. :==::a:n:=m:I~=====aaœ::::s=II:ZB:_=_II:IZZIcs:::::=_smztll:aq
INTERVIEIIERI ______________________________________________ D DATEII .... _--'-___ 1'---'1 PROp~n~1 IL-_"--~----' YES •• 1 D NO ... 2 nSUPERV1S0RI D IHTERYIEItERI______________________________________________ D DATEI IL---_L--_L--~
NAIIE OF NEI HEADI ______________________________________________________________________________ _ REIIARKSI _______________________________________________________________________________________ _
~A~nJc OF HEADI ________________________________________________________________ _
LANSUASE OF FRENCH •••• 1 (ENDI D SPECIFY THE INTER-- YES •• 1 D (NTERYIEII OTHER ..... 2 LAt/SUAGEI ______________________ PRETER? HO ... 2 YERlflCATlON OF QUESTlONItAIRE, ROUND TIIO c:=Ima::t:::u:=:::::a~_::m:s=_:CC:::==-= __ a::I:II
RE"ARKSI _______________________________________________________________________________________ _ SUPERVISORI ______________________________________________ D DATEII L. _--'-_-'-_ ....
REIIARKSI ______________________________________________________________________________________ _
VERIFICATION Of THE QUESTIONNAIRE, ROUND OllE __ :Z::::O:Z=-==--_====c:::::I:::CZ::c:::I====-i
SUPERYISORI _______________________________________________ D DATEI
------------------------------------------------------------------ rollf~n~~ 1 EII ~~~:: ~ D DATA ENTRY, ROUND TIIO Il ... ::a=====::mm:a~::mc:a:::::::::rs: __ ICII:: ______ a:::.._.,..
REIIARKSI _______________________________________________________________________________________ _
------------------------------------------------------------------ RE-INTERYIEW? ~~~::! D OPERATDRI _________________________________________________ D DATEI L..._'-----''------'
REIIARKSI _______________________________________________________________________________________ _
r DATa ENTRY. ROUND ONE :::ur
OPERA TOR. _________________________________________________ D DATEI ~IL-_-L-_~_-J SUPERVISION OF PRINTOUTS, ROUIID TND aa ...... ::-==== ___ === __ :llZlC _____ ......
SUPERYISORI_______________________________________________ D DATEI IL---_L---_L---~ ~ : REfiARKSI _______________________________________________________________________________________ _ REIIARKSI _______________________________________________________________________________________ _
---------------------------------- .... ------------------------------------------------------------
DA
E------::==----=========="===::=~===:==:========-]
SU""ARY OF SIlI?VEY RESUlTS
.... =: =:.==co:=::======::::=::====-
INTERVIEWER - - - - - SUPERVISOR
F 1 R S T VIS 1 T SECOND .V 1 S 1 T INTERVIEWER OPERA TOR
---------- =========#:Z:::ZZl::2:c=====a:IIII:r:z
SECIIDN D A T E RESUlT D A T E RESUlT 'AT ISFACT~rY' Ëb' ~ SATI~FApORY ••• 1 !BRIEUID ~!i~ICE .. 1 o BE COli ET • CORR CT ONS .... 2 ~O"PLETE •••••••• ~ COIIPLETE •••••••• 1 TO BE REDONE .... 3 NOTS~~~Rlc f~~.:::::: J ARTlAl •• tA •• f . PARIIAL. •••••••• 2
DAY 1I0NTH YEAR NOT APPLI BL •• 3 DAY 1I0NTH YEAR
FlRST RQUND 1
2
r-- ----l
4
~
6
- _. 7
-B
SECOND ROUND 9
10
Il
12
13
14
I~
OB
Co B SE R V=;' ! O. , -===-:=====]
AND [OIlKENTS
EIIARKS BY THE INTERVIEWER ON THE FIRST ROUND================t E"ARKS BY THE HHERVIEMER ON THE SECOND ROUND================w
EItARKS DY THE SUPERVISOR OH THE FIRST ROUND==================; EIIARKS BY THE SUPERYISOR ON THE SECOND ROUND=========================iI
SECTION 1. PART A. HOUSEHOLD pqSTER
PERSON INTERVIENED: PREFERABLV THE HEAD OF HOUSEHOLD. IF HE/SHE IS NOT AVAILABLE, FIND A "PRINCIPAL RESPONDENT" TO ANSNER THE QUESTIONS IN HIS/HER PLACE. THE FERSON SELECTED MUST BE A MEMBER OF THE HOUSEHOLD WHO IS ABLE TO BIVE INFORMATION ON THE OTHER HOUSEHOLD MEMBERS.
~==INTERVIEWER=========================================================n D r------, Il 8 1 Il " RESPONDENT: ___________________________________ ID CODE: 1 1 Il ~ L ______ J Il ~======================================================================~
1-3. 1 would like to make a complete list of aIl the people who normally live and eat their meals together in this dwelling.
*
* First, 1 would like to have the names of aIl the members of your immedlate family, including the head of the household, his wlfe or wives (or her husband) and his/her children in order of age, who normally live and eat their meals together in this dwelling.
ALWAYS NRITE DOWN THE HEAD OF THE HOUSEHOLD FIRST 1 FOLLOWED ev HI SI HER SPOUSE AND THEIR CHILDREN IN ORDER OF AGE. I~ THERE 15 MORE THAN ONE NIFE 1 START NITH THE FIRST WIFE! FOLLOWED BY HER CHILDREN IN OROER OF AbE, THEN THE SECOND NIFE ANu HER CHILDREN IN OROER OF ABE, AND SO ON.
NRITE DOWN THE NAME , SEX AND RELATIONSHIP TO THE HEAD OF HOUSEHOLD FOR EACH PERSON.
Please give me the names of any other persons related to the head of the fiousehold or to his/her wife/husband, together Hith their families, who normally live and eat their meals here.
WRITE DOWN THE NAME , SEX AND RELATIONSHIP TO THE HEAD OF HOUSEHOLD.
f Flease give me the names of any other persans nat related to the head of household or ta his/her wife/husband but who normally live and eat their meals here. For instance, tenants or servants or other persons who are not relatives.
NRITE THE NAME, SEX AND RELATIONSHIP TO THE HEAD OF HOUSEHOLD.
Are there any other persans not now present but who normally live and eat their meals here? For example
l any person studying somewhere
else or who is on vacati~n or who is v sitlng other people.
WRITE THE NAME, SEX AND RELATIONSHIP TO THE HEAD OF HOUSHOLD.
4 Are there any other persans who slept here last night but who do not normally live here?
WRITE THE NAME, SEX AND RELATIONSHIP TO THE HEAD OF HOUSEHOLD.
FOR EACH PERSON LISTED IN QUESTION 1, ASK THE QUESTIONS 4-13 AND CLASSIFV THE PERSON ACCORDINBLY IN 9.14. COMPLETE THE ENTIRE LINE BEFORE GOING ON TO THE NEXT PERSON LISTED. lA
4-13. Now 1 would like ta have sorne information about each of the persans you mentioned.
IF THE RESPONDENT HAS ANY DIFFICULTY WITH HIS AGE OR DATE OF BIRTH (QUESTION 6), USE THE CALENDAR OF EVENTS TO MAKE AN ESTIMATE.
------------------------------------------------------ ----_., 14. CLASSIFY EACH PERSON ACCORDING TO THE FOLLOWING CRlTERIA. :
----------------------------------------------------------_: LOOK AT THE ANSWER TO QUESTION 13.
1 ALL PERSONS FOR WHOM THE ANSWER IS 9 MONTHS OR LESS ARE CLASSED AS HOUSEHOLD MEMBERS EXCEPT:
-- SERVANTS AND THEIR RELATIVES (SEE QUESTION 3) -- TENANTS AND THEIR RELATIVES (QUESTION 3) -- DECEASED PERSONS
1 IF THE ANSWER IS MORE THAN 9 MONTHS, ONLY THE FOLLOWING ARE HOUSEHOLD HEHBERS:
THE HEAD OF HOUSEHOLD INFANTS LESS THAN 3 MONTHS OLD (EXCLUDING CHILDREN OF SERVANTS AND TENANTS)
f ALL OTHER PERSaNS FOR WHOM THE ANSWER IS MORE THAN·9 MONTHS ARE NOT HOUSEHOLD MEMBERS.
ENTER CODE 1 FOR EACH HOUSEHOLD MEMBER AND CODE 2 FOR ALL OTHER PERSaNS. GO ON TO THE NEXT PERSON LISTED •
. -----------------, 1 1
: COLUMNS A AND B : 1 1 1 1 -----------------
COLUMN A. ON THE LEFT SIDE OF THE FORM j PUT A CROSS IN COLUMN A NEXT TO THE NAMES OF ALL PERSONS WITH COOt 1 IN QUESTION 14.
COLUMN B. ENTER THE AGE IN COMPLETEO VEARS (SEE QUESTION 6) OF ALL PERS ONS NITH CODE 1 IN QUESTION 14. THAT IS, FOR AGE 4 YEARS 8 MONTHS, ENTER 4. FOR AGE 9 MONTHS, ENTER O.
,-----------------------------------. 1 1
! FILLING-IN THE HOUSEHOLO CARO ! 1 1
WRITE THE NAMES OF ALL PERSONS WITH CODE 1 IN QUESTION 14 ON THE HOUSEHOLD CARD.
From no" on, 1 "ould like you to talk about these persons "hen 1 ask you questions about the members of your household.
READ OUT THE NAMES AND GIVE THE CARD TO THE RESPONDENT.
~ PART B lA
5 E t T ION 1. PAR T A. HOU 5 E H 0 L D ROS TER
P R R T B
• TO BE CD"PLETED FOR RLL HOUSEHOLD
"E"BERS
BRIDIB 9 E C T 1 0" 1. PAR T B. 1 Il FOR" A T 1 0" 0 Il PAR E If T S 0 F HOU 5 E H 0 l D "E" BER S ~~----,---.
1 3 4 "7 B 9 10 Il 12 13 14 15 16
1:1 1 1 1 1 1 1 1111 1 Il 1 1 Il
1:11 III 1 1 1111 III 1 III·
1:: 1 1 1 1 1 1 1 1 Il 1 1 1 1 1 1 1 1
1:: 1 1 1 1 1 1 1 1 Il 1 1 1 1 1 1 1 lIB
:----------------------:
;_:~:~~~~-~~--~~~:~~~--; NON 1 would like to ask you some questions about your dHelling. Sy dHelling 1 mean aIl the rooms and aIl the separate buildings used by the members of your household.
1----------------------------, 1 1
: PART A: TYPE OF DWElllNG : 1 1
1 ______ ----------------------,
Which buildings and rooms does your household occuPY?
1. HAIN TYPE OF DWElLING
SINGlE-FAMIl Y HOME •••.•..••••• 1 SEYERAl HUTS OR HOUSES ••••••.• 2 (.31 APARTMENT t ROOM l EFFICIENCY •.• 3 (.5) MORE THAN ONE A~ARTMENT •.•••.• 4 (.61
2. 1 S THE HOUSE PART OF A COMPOUND?
YES .•.•• 1 NO ..... 2 nal
3. HOW MANY BUILDINGS ALTOGETHER ARE THERE IN THE COMPOUND t INClUDING THOSE OCCUPIED BY THIS HOUSEHOlD AND THOSE OCCUPIED BY OTHER HOUSEHOLDS?
4. HON MANY BUILDINGS DOES THIS HoUSEHOlD OCCUPV?
5. IS THE APARTMENT PART OF A COURTYARD OR COMPOUND?
YESo •••• 1 NO ...... 2 (.8)
6. HON MANY OUTSIDE DOORS ARE THERE AlTOGETHER IN THE COURTYARD DR COMPOUND! INCLUDING THOSE FOR THIS HOUSEHOlD AND THOSE FOR OTHER HuUSEHOLDS?
7. HON MANY OUTSIDE DOORS ARE FOR THIS HOUSEHOLD?
8. HOH man Y rooms does the household occupYt including bedrooms and living rooms?
DO NOT COUNT BATHROOHS t TOIlETS OR KITCHENS.
9. Is the dHelling occupied by your household also used for a family business or trade?
YES ••••• I NO ...... 2 nPART B)
10. HOH much of the dwelling is used for business?
LESS THAN ONE QUARTER ••.. 1 A QUARTER TO A HALF ••.••. 2 tlORE THAN HALF .•••••••••• 3
.------------. ! • PART B l ,------------,
j--------j • 1 • 1 --------
:--------: 1 1 1 1 1 1 1 1 --------
1--------1 1 • 1 1 --------.--------, i i 1 1 1 ________ •
:--------: 1 •
:_------_:
:--------: 1 1 1 1 1 1
• 1 --------
:--------: 1 • 1 1
• 1 1 1 --------
:--------: 1 1
: : :--------: 1 1 1 1 1 1 1 1 --------
:--------: 1 1 1 1
• 1 1 1 --------
2A
.----------------------------. SECTI ON 2. 1 PART B: HOUSING EXPENSES 1
1. Does this dwelling belong to a member Di your household?
YESo •••• 1 NO •.••.• 2
2. Is this dwelling rented in ex change for goods, services or lIoney?
YES ••••• 1 NO •••••• 2 (.71
3. From "ho~ is the dwelling rented? 15 it from a relative, a private employer Di a member of the household, a publIC agency (e.g. SOGEFIHAI, SICOGI Dr a private indlvidual Dr Dr agency?
RELATIVE •••••••••••••••••••••••• 1 PRIVATE EMPLOYER •••••••••••••••• 2 5IC061 ••••••••••.••••••••••••••• 3 SOGEFIHA/OTHER PUBLIC AGENCY •••• 4 PRIVATE INDIVIDUAL/AGENCY ••••••• 5 DON"T KNOW •••••••••••••••••••••• 6
4. HOH much money does your household pay in rent for this dwelling?
:--------: 1 1 1 1 --------
:--------: 1 1
:_------_: .--------. 1 1
1
--------;
AMOUNT: ,----------------------------. ~ :
IF NO MONEY PAYMENT, ENTER ZERO. :_--------------------------_: TIME UNIT:
~. Does your hou5ehold also supply goods Dr services in ex change for this dwelling?
YESo •••• 1 NO ...... 2 (HI
6. What is the approximate value of these goods and services
,--------, : : : : ,--------, :--------:
1 1 1 1 --------
provided by your household? AMOUNT: ,----------------------------.
• 1 1 1 1 1 1 1 1 1
TIME UNIT:
7. Is part or ail of the rent paid by someone who i5 not a ~ember oi your household? For example by relative a private employer, a government agency 11ike SOGEFIHAI
1 SICOSI or other publIC agency, or a private individua or agency?
YES ..... 1 NO .••••• 2 (.121
B. Who pays ail or part of the rent?
RELATIVE ••••.•••••••••.•••••.••. 1 (.12) PRIVATE EMPLOyER ................ 2 (H2) SltOGI •••••••••••••••••••.•••••• 3 (.121 SOGEFIHA/OTHER PUBLIC ASENCY •••• 4 (.121 PRIVATE INDIVIDUAL/AGENCY ••••••• 5 (.121 DON'T KNOW ••••••••••••••••••••.• 6 (.121
lIME UNIT: DAY ••••••• 3 WEEK •••••• 4
MONTH ..... 5 GlUARTER ••• 6
SEI'1ESTER •• 7 YEAR •••••• B
,--------. . . 1 1 1 1 1 1 1 1
:--------: 1 . 1 1 --------
:--------: 1 1 , . 1 1 1 • --------
2B1
9. Do vou make mortgage payments on this d"elling?
YES ..... 1 NO ...... 2 <.12)
10. Ho" much Mag yOUf last payment?
:--------:-, ,
AMOUNT: .----------------------------, , , , , , 1 • 1
,----------------------______ 1
11. HOM often do you ~ake these payments?
NO. OF TII1ES:
TII1E UNIT:
12. What is the gource of drinking Mater for your household?
INDOOR FAUCET •••••.•••••••••••••••••••••• 1 NATER YENDOR ••••••••••••••••••••••••••••• 2 (.14) OUTSIDE FAUCET ••••••••••••••••••••••••••• 3 NELL WITH PUI1P •••.•.••••••••••••••••••••• 4 (.16) NELL WITHOUT PUI1P •••••••••••••••••••••••• 5 (.16) RIYER, LAKE, SPRING, MARSH •••••••.••••••• 6 nl7) RAIN WATER ••••••••••••••••••••••••••••••• 7 (.18) WATER TRUCK •••••••••••••••••••.•.•••••••• B (.14) OTHER (SPECIFY: ________________________ ).9 (.17)
13. Have you a joint or individual meter?
JOINT •••••••• 1 INDIVIDUAL. •• 2
14. HON much Has your household's last Hater bill?
:--------: , . . . , . , ,
:--------: 1 1 1 1 1 1 1 1 --------.--------. , . : : 1 1 1 1 --------
,--------, i : 1 • ,--------,
AI'IOUNT: .----------------------------,
15. What amount of time Mag covered by that bill?
NUI1BER:
TIME UNIT
U20)
~ : :_--------------------------_:
:--------: , 1
: : :--------; 1 1 , 1
--------1 1
16. Ig this [SUPPLY SOURCE IN 121 used by your household only or shared Hith others? :--------: , ,
l , , 1 , ,
THIS HOUSEHOLD ONLY ••••• 1 --------SHARED ••.••••••••••••••• 2
17. HOM man y meters is this [SUPPLY SOURCE IN 12] from your dMell i ng?
l'1ETERS: :--------------------: , 1
:_------------------_: 2B2
lB. What is your household's main source of Hater for laundry and bathlng?
OUTSIDE FAUCET •.•.•••.•.••.•.•••.•••.•.. 1 NELL WITH PUMP .•••.•..•.•.••••••.•••.••• 2 NELL WITHOUT PUMP •.•••••••.•.•.•.•••••.• 3 RIVER, LAKE, SPRING, MARSH .•••.•.•.•••.• 4 (~20) RAIN WATER ••.•••••.•.•.•••••••••..•••••• 5 (~20' NATER TRUCK •.••••......•..••..••.•••.••• 6 (~20) OTHER (SPECIFY: _______________________ '.7
19. 15 this [SOURCE OF WATER FOR LAUNDRY AND BATHINGl used only by your household or by other households also?
THIS HOUSEHOLD ONLY •••.• 1 SHARED •••••••••••••••••• 2
20. HON does your household dispose of most of its garbage?
COLLECTED BY A GARBAGE TRUCK ••.••• 1 DUMPED ••••••.•.•••••••••••.•••.••• 2 BURNED ••.•••.•.•••••••••••••.•.•.. 3 BURIED ••••••.•.•••••••••.•••.•••.• 4
21. What type of toilet is available for your household?
FLUSH TO 1 LET ••.•.••••••••••••••••• 1 PIT LATRINE ••••••••••••••••••••••• 2 NO TOILET •••••••••••••••••••••••• 3 (~24) OTHER (SPECIFY: ).4
22. 15 this toilet used only by your household, or do other hou5eholds use it?
THIS HOUSEHOLD ONLY ••••• 1 SHARED •••••••••••••••••• 2
23. 15 the toilet inside or outside the dHelling?
INSIDE ••••••••.• 1 OUTSIDE ••••••••• 2
24. What is the main source of lighting for your dHelling?
ELECTRICITY •••••.•.•.••.•.•••••••••.•••••• 1 GAS •••••••••••••••••.••••.•••••••••••.•••• 2 (~28) CANDLES, FLASHLIGHTS, GAS OR OIL LAMPS •••• 3 (~28) NONE •••••••.•••••••••••••••••••.•••.•••••• 4 (~2B)
25. Have Vou a joint or individual meter?
JOINT •••••••• 1 INDIVIDUAL. .• 2
26. HON much Has the last electric bill for your household?
:--------:
:--------: 1 1 1 1 1 1 1 1 --------
.--------. 1 • 1 • · . 1 1 1 1
:--------: 1 •
: i
:--------1
--------1 . 1 1
.--------. · . • 1 · . : 1
.--------. 1 •
• 1 1 1 1 1 1 1 --------
.--------. : : • 1 1 • --------
AI10UNT: (IF NOTHING, WRITE ZERO)
~----------------------------:
:_--------------------------_: 27. Ho" many months consumption Has covered by this bill?
TlME UNIT:
MONTHS:
DAY ••.•••. 3 MONTH ••••• 5 SEMESTER •• 7 WEEK •••.•• 4 QUARTER ••• 6 YEAR •••••• 8
:------------: 1 1 1 • • 1 • 1
2B3
28. What kind of fuel is most oflen used by your household to prepare meals?
WOOD •••••••••.•••.••.•..••...•.••.•••.• 1 CHARCOAL ••.••••••.••.•••.•••.•.•.•••••• 2 GAS •••••••••••••••.•.•.•.•.•.•.•••••.•• 3 ElECTRICITY •••.•.•.•.•••.••.••••••.•.•. 4 OTHER (SPECIFY: 1.5
n SECTION 31 n SECTION 31 n SECTION 31 n SECTION 31
29. Ho" does the household usually get its Hood? By •••••
coll ect i ng/gather i ng ••••.• 1 purchase? ••••••.•.•••.••• 2 (~ SECTION 31
30. HON far must you go to fetch Hood?
:--------: 1 1 1 1 1
:--------: 1 :
KILOI1ETERS: :----------------:
31. HOH long does it take to get there?
HOURS:
MINUTES:
32. Ho" often must Hood be fetched?
lIME UNIT:
TIMES:
lIME UNIT:
,---------------. 1 1
! ~ SECTION 3 ! ,---------______ 1
DAY ••••••. 3 MONTH ••••• 5 SEMESTER •• 7 WEEK ...... 4 QUARTER ... b HAR ...... B
1 1
---------------_:
:------------:
------------1 1 1 1
:------------: 1 1 1 1
:_----- ______ 1
,--------. 1 1 l ,
i ________ :
;--------: 1 1 1 1 --------
2B4
SECTION 3. EDUCATION
TO BE COKPlETED FOR Rll HOUSEHOlD
K E K 8 ERS 5 y E ARS D R D l DER.
9fU D3A 1 SECTION 3. EDUCATION PAR T A. S C H 0 0 LIN 6
t 2 3 4 ~ [, 7 8 9 10 Il 12 13 14 I~ 16 17
1
How
!=ral Wh.t If' th. i!dIt- HOIf ~i,hllt Nu th! '!r.h. ~Oll ~r':h. Durln, th. rRtttl:·· III h., ICln ••• (lIME]. 1 UIAd l.n1 hil~" l.n1 . 1~1. I.~t ',Ih~ gll dlya, rh. Y'· 1 gr r h.',h. on, n· 1 0' Iln.d? IC Dol Il .nd- in ln 1 VI It Olf I.nl ' ln Id ivi:J. of ,rttnd- ecep Itl1l? al hl' athnd- lnl to r.- hDH hOllrs h 1 lehool or Ath
nid .,.1 li do lork- liprln- Id or Ih. hld traln- .d ••• IC Dol turn to IIhU. hUlh. Idu- nCllv.d at thl , r ",lt- .d t ct- h hl' fny ing? I···········~ al ,chool? rthnd- a "f,nt r~~fnin, la. n"l- .t- tin .. In ,hip? ,b.- Khnl- prtlent a nd ng l.?
1
p".. tir? cal- IP- • ttlnd- CODES • caler C: : : i: : : : : : : 3 7 a~Kool7 clallll? durln, h. cal,- ~rtn- inR a profll- PROBATO RE •••••• Pub- pitt 2 tir' iet? le ool?
rl~EE lion,. BAC~AœtAT ••• 5 lie ••• 1 tontha? tn~n- , E ........ 6 YES ••• I l"g JERl·····1 Prh-
ORi 'OR"S It. NO •••• 2 YE8 •• 1 fKU- YES ••• 1
Ul 62 U3 ~4 l~üi.~ .. 9 Ir ••• 2 YE8 ••• 1 r--
1 YE8.1 YES.1 YEB.l YES.1 WilEii YES ••• 1 YE9 ••• 1 YES ••• 1 NO •••• 2 IH& NEI~I H&
US U6 U7 us OTHER ••••••••• 10 Priv- 'H.' 'H6' nl& PASE _r lIEn 1ttI.32 KO .. 2 NO •• 2 "~ •• 2 I SE
-MO··r2 dt MEil 't T PASE ct , t6,
"1eR' ct 0' f.Hg- 110 •••• 2 1(tJ"'6~ PASE'
" Ir;D YEARS BRADE YEMS laul •• 3 CH HOORS ----
8fUD3A2 SEC T ION 3. PAR T A (E N D 1
lB 19 20 21 22 23
1 How lUth hll yaur houllhold Ip.nt during th. pllt 12 IOnthl on ••. [fMlfE'Sl ••• !duution far ••. 'id ... IRtrt '" l~' HII Iny Ibt far How IR' ItAlIE). VI UI 0 l 1 alhtr
I~·· f:t: lIME) havi 1 ,thOI ~rlhip plnf:' ; !l' IF *lTHIMe 1MB SPENT, IfRITE ZERO. Ichol- or t 1 palt ietlf 1 la 90 lf
J Inhip 12 ICtIlhl? no a
frol Ith:.1 rOi
fg~ing IHblr of h.,. !ia.1 p~5IItN!~flJ'\lDBJI tolRl~~œrh IIRITE HP •••
1 ~our Il.,..?
~ ~::th!~ :f"-o d, A paid Iny T alhtr ~ A. B. C. O. E. F. B. Ichao. dl\v " CDftlriblTanl Unifr." lnd Books lnd TranlgcrUtian Caf.ltrh, Taition and Dlh.,? ':fIn
"1
iD ~nft l' l'or 1 Ich:rl lo It 00 bOlrd Ind r'9i1trltion (Clubs, .lt.l •• [MAttE)? C .11 i.t Dftl? t alh"? lupp .. ? lodging? f"l? ~ 1 YES ... l YES ... 1 PERSOM
NO •••• 2 NO .... 2 AIIKItT APIOlIMT AItOtMT MOUNT AtIIUNT AItOtIIT AIIOUlfT U21l MooNT K" litS 1 "1"
1:: 1 1 1 1 1 ·1 1 1 1 1 1 III
:: ::::::::::::::::::::: .::::::: :.: :::::::::: :~:::::: :::::: ::: :: ::::::::::::: :::::::::: ::: ::::::::::::::::::::::::::: :::::::::::::::::::::::: ::. :: ::::: :::::::::::::::: ::: :: ::::::::.:::::::::::: :::: :: ::.:.::::::::: :::::.::: ::::::::.:::::: .:::: .:':.::: :::: :::: ::: :::::: :::::::: :::::::: ::: !:::::: ::
1:1 1 1 1 1 1 1 1 1 1 1 III
1:; 1 1 1 1 1 1 1 1 1 1 1 III
/::1 1 1 1 1 1 1 1 1 1 1 1 1 1
3/\2
6RIDlB
1. ODes any lelber of your household have children und!!r 30 years of age not living her!! in this household?
YES ..... I
NO ...... 2 1. SECTION 41 D FOR EACH CHllD LISTED IN QUESTION 2, ASK QUESTIONS 4-11.
2 3 4 ~ 6 7 8 '1
~ Nhat are their nales? Sex? HOIf old ODes the COPY THE Does the COPY THE Has 15 ... father of FATHER'S natural tlDTHER'S •• [NAtlEl ••• 0 l~ST Al~ THE CHI~DREN UNDER NAtlEl ... •• [NAtlE) •• ID CODE. lother of ID CODE. attended E 3 YEAR CF AGE HO DO NOT nOIf? li ve in .. (HAtlE] .. school? R LIVE IN THIS HOUSEHOlD. , ... ~ tbis ~~Yl! ln household? 15
~ ousehold? CO"P~ETE THE LI ST BEFORE 60lN TO 4-10. YESo .1 YES •• I YES .... I
C H NO ... 2 NO ... 2 MO .. r ·2 1 U71 It'li UNIT
~ ID ID CHllDI YEARS CODE CODE
Il 1 1
Il 1 1
Il [ 1
Il 1
5 Il 1
6 Il 1
Il ~-Ir
S Il 1 1 1
Il -r 1 1
Ito Il 1 1 1
10 11
Is .. [NAKEl Khat is the hi~hest ••• attend- grade cOlplete by ing school ... [NAtlE) ... ? no.?
CODES: ~~iEd~~~~l YES .... I 3E ~~ I~E ,IR Ul U U U5 HO ..... 2 U6 U7 US
GRADE
3B I·SECTION 4 1
SECTION 4. HE~lTH
TO BE ASKED OF EACH HOUSEHOlD
" E " BER. FOR CHI l D R E N, A 5 K THE gUE S T J 0 N 5 0 F , HEl R PAR E N T S.
~109/8R1C4l31-B-B' SEC T 1 0 Il •• H E A l T H
1 2 3 4 5 6 7 B 9 10 Il 12 13 14 15 lb 17 19 l H." Ir. h.d For how For "r. HII 1 1110 .11 IhlTl did thl Il this mIr' HOtthr HOtt Ilny Ho, IUch Dtd you lfoeI .any Ha. IUch H"I~DU IfoeIllch IJ thl g"t
fn' Iny i ftlll Ilnr dlyl •• nI 'l' doctar, Conlu~ttd conlultation • publ ic •• , this ti3" dld ye h .. 1 ta nighll hIY3Yau Iho Id
t,t'1!r IDIIt l,
or rJur~ dur ftl dar nt hl nunl firlt talet p ICl7 or blet yaa iDII,ut ta- di yau h .. 1 a ply :frr fn durinl pal Dr to bllr ~avi XCII àilr n, t 1 1hl P ,t pli Ch.nldlt, prlvall ta la ta ion 'H CDIIluit this pll'- 1hl P It .iIl rc ttdJ~ n- ad • Y
T Cil .. Ih .. Ih "'1 tlllr,
H~'~"""I .. lIb- thi can- h.,,7 thil r fD1' '1' r olpi- ,"b? l'fi ro ur:- rel ... ;'lh:rRf;, 1 "b For dit ~u rau un,blt :l~,ifl, Dr lil~Hnt luU,Uon
'nlfeis hr conlu - ~ ~II' or fil~"1 ~lIlpll, o Clrry l, t~:::~~ 1 tonl artlr nltlll 18 f!!lr: .er:tf:; t IVI Iga hld Hm hil on Jrr hllnh nlll ur n, thl hrlpilal r "9 1 pllt 'ofr. ,a n ... e~I~~lon- Ig~'n!1t e::~1 lr·i';nt .IY?
'h:Jln ..... ? ( " fon- =t:!~th. T ~hrlh .. , ln
or ë~r vlU:J ,C ~1i5 Ile 11 g~ U,t Il rt onl inJury? lcaUlt 0 CDIIlulttd or 0 ~n
~ t:ja~y I~~r- this m- Ir. Ihlo 4 Il 1 r"~ IVI ni)' or 1ntll or 1":::1 !Ir '~"1Iê11 IJ blCfurl rola 1-
'·'"10.1 ~n:k fi1!ny in ury? nJurl dur- yf h 1 0111 ftl t 1 P IST •• Illy I1n"17 l,n, C' , " ..... TtE Slcl f.IR- YES ••• 1
,,~"l ...... SOlI' III ,U61' PUBLIC. 1 YES •• 1
~S"'l (SptêiJ,; •• ~B .. t ("~) U'I Usi °1~nyr .... 9 PRft tIRS I"IN Us "Yu,i lAya DAYS A ... 2 K1I TIllES AItOUIIT MIMS MOOIIT MOOfIT M1MT
1:1 1 Î 1 1 1 1 III 1 1 1 1 1 1 1 1· 1 1
1:1 1 1 1 1 1 III 1 1 1 1 1 1 1 1 1 1
1:: 1 1 1 1 1 1 1 III 1 1 1 1 1 1 1 1 1 1
1:: 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 4
SECTTON 5. ECONOnIC AC~:~~~~:J
TO BE ASKED OF All HOUSEHOlD
"E"BERS AGEl) 1 YEARS OR OlDER
r ART AI TI" EUS E
6RID5A 1 2 3 • 5 6 7 B 9 10 Il 12 13
'f~ Ouring tbl put And Ouring thl put And During thl put 7 And AllONS THE Hnl Jou Il.rI you ln looking for .ort, during th. put l1li, did ~ru nDt look for
!~o 7 dl"1 havi dur- 7 d'YII hlVl ~ur- d.y., h,vl you in AlfSMERS TO look looung 1 d'YI, h,vl Vou ........... IfDft da ni ~I Slrt 1 lou lfO t! fpr t~1 JOu 110 hd i~ • ICI rrrhd ,n • thl h ~H~~ i for p.id or .ort d.,.? 1 1 9
~~ onl 0 11 irld or grf ln ra111 lndu.tf1' n·t 110ft Il •• '91 ngr. ft Ir of nit bl onalng 0 nit bUI n Il, '"tl - ·VES· IODE during 'Ir"'r, .. Il Q mlONS JDlSf houllbald, yours f or pri .. or JfY il- IOn- D? thl put 1 IIlf- Ap'pli- ••• und ••• und ••• ••• • •• fi' IIIf - la - .... 1 1 ~HE~ ~rfl or 'xr~lt, tD1I- your hOUllhold, IOn- .ion br) , na to th.? 1 dlys? ':f~oy.d I~ ta fI.ily int,r- fPpll •d 'gplied "f~ Rlit6 .•...•.•••••.••. MA~' ln 1'" a Ir, 1 th.? or havi rou th.? ~OUrll a, af • If of OIlDCI? conntc- ftdil- n i 0 Ir ~,~::::::::::::: 'if' th. rfilld 1 yt- oUllhold? or for '"J tionl? rh.? plrlon? witing Hthed.
1 ov,lnl,nt Of .od? Ix .. plla 'f ln Und 0 ? ? \1" tlAt6"········· Ion othlr i nd'iln ln nr- .ort? T •••••••••• t
p,non auhid, chin or fi .h.r- 1 ;0 ~iftI::::::8 your houlthold? lin Il'fofA In~ER ... 1 YES ... I ~~Ji~ D,.~hlr
Il .cUv ty ,.Y~hr', 11) .... 2
·kit~::I! n YJIA .. I, YES ••• I 9ELF-t YES •• 1 YE9 ••• 1 n41 YES.l YES ••• 1 n61 YES.t YES ••• 1 n81 YES.t E!!PLOYED.2
It'l'ra, 0 JIU •••• 2 JIU •••• 2 YESo •• 1 YES ••• 1 YES ••• 1 YES ••• I YES ... 1 ~ D JIO ••• 2 NO •••• 2 NO .. 2 MO •••• 2 fII •• 2 MO •••• 2 NO •• 2 lU' nl1) ~ .... 3
H3 , ........... Ij E NO •••• 2 fII •••• 2 NO .... 2 NO .... 2 fII .... 2 o ........... 1
~I Il Il Il Il 1 1 1 1 1 1 1 1 1 1
~I Il Il 111111111111 Il
_1 Il Il Il Il 1 1 1 1 1 1 1 1 1 1 ~I
. ~I Il! 1 ! 1 Il ! 1 ! ! ! ! ! 1 1 1 SA
IRID5BI 8 E C 1 1 0 MS. PAR T B. "A 1 N J 0 8 DUR 1 NOl HEP A S 1 7 D A Y S
1 2 3 4 5 6 7 0 9 10 Il 12
1 1 wuld lit. ta I,t vou lot. ~ulltion, IIhll Und of trad., indullry, Did For ho. During For ho. ls thh H!nt Jona havi Havi 1fD" IUch Ion..,? ln thll HavI l'bout th. _ort you hlVi don. uring or blilinll' il il connlct.d Jour Ilny the" ::1, "ort {OU bH doln; yOIl . IIOrt
ln .. n 1::. th. put 7 daI'i PIII .. dtlcrib. your vith? Ithtr d,y. daYI, 11I10n- hi. IfOrt1 nCllV-
Ilin jOb, thl ~, th. IOrt on ""ich you or ~our during hait furin! Il? :1.F Ilote oft.n? ~"~r~ an~ 1 .pltlt 10.t ti.. ur n, th. put 7 d~'l tot tr th. Ilny - h. P It ot r 1 '~r if IOU.:'{~ not ,~d for il. , do or p'ilt 7 hour3 12 1rcliv. ~1!1 on
rr. In dl you a ln Il lfO k Irt ~fli ou p'ir 'V IOnth.
l thly ~id ~ou dld ~ou IOft'V oall 7 doin; do t~iI do t il do t il far 1 farr or ay.? A th. wurt? wurt? wcrt? tM. in 1 11.1-1 "" IICIr.? nif' , Und of li angin;
IfDr.? (Jf 40 D ,aur Yf9A1t
,1 If IlEEKS OR hau "'old? 'P 1 C IIORE'tO) CI
YES .... 1 0 YES ... I YES ... I YES ... I W~Mt2 D
ICODE ICODE
HOURS
YRB./1tII8.IRB. I~" ~i~;ïfT E NO •••• 2 PER 110 .... 2 10 .... 2 DI DESCRIPTION TYPE DAYS DAY IlEEKS 'H., AfIOIMT
1 TIIE UNIT. "INUlE ... 1 HOUR ... 2 DAY ... 3 IIEEK ... 4 "otITH ... 5 QUARTER ... " BE"E8TER ... 7 YEM ... e 1
9RID:5B2 SECTIOII 5. PART B. "AIN JOB DURIIIB THE PAST 7 DAYS ICONT.I
13 14 15 16 17 18 19 20 21
, For whOI did Il lour ~OIIfr~ÎI Hol 19n~ Hott oH'n do A~, t~X" HIVI you DDt. thi. How lUeh do th.l. you IfDrk? Hp oytr, don lt 19:'l~ For
1 ni y ne,ivtd ply""t bonu"l eOIIIi IIi ons , Ifnl9tr or r .. l1in~ il lIh you to ftducl'd or will you lnclud, tips, 1I10001neli Ind
1 ~n~F, d {:ftor ~Il' • '0 th.n '11191., rOll hl nc,lv, Iny bonu .. s ,r~taiti fi IlOUnt n , Id to ru. htr'? hiet 1 dlh 1~"nt bonuf" n:lh'fras, dif hl:" (011 .. ronl,
o. you one, 1 l"
IfOrk Klhl I~s, Illolt" In~:~ Ir .,.-far ~our ln 1 ar ~r,tuiriIl7 wor. ,rataIUI' i lb'_n- or lbi.
uni or tlll IfIIr.? Ir.y ......... 1
A .tat....,td YE9 ... 1 1.22 ~JlI cCllplny •••••• 2 111 •••• 2 YES .... YES .... 1 A prh,t,
c Iny or
HRSI "III TIllES 1 l.\" yES .... 1 110 .... 2 110 .... 2
I~" ,:ft:'ri ..... 3 ~ ., ..... 2 (·~iltlT AfIMIT
SB2
0010:193 SEC T 1 0 Il :1. PAR T B. "A 1 Il JOB DUR 1 Il 8 THE PAS' 7 D A Y SIC 0 Il T. 1
22 23 24 2S 26 27 28 29 30 31
, HIVI yOIl IItIlt il th. '1llut of HIVI you Ifhal il th. '111 u. of Hlv. you ""al if tht Vilut of Il your Ilhat il th. vllu. of Hlv. yau IIhlt ir tht vIlu, of rK'IVid th". goodl? rKlivld thit IUblidl y? rKtlvrd thi, C othl n;? trln'fart this trlnlpart? rKlhld this a IItr fan of
E In" Il ar ,ill Of' ,il to th 1 or will plyltnt? Il ,au you ,au wor. fn, you T rKthr rKtivt netiv, or ,ub- rKth, 1 r:1..n r l , lInl ,I,..nt li di nit? r1y..nt F thit or th 1 or thit or thit l 1tOf'. in mk in work in .ork le th. forl t forl forlof Inya If" A of faodol of frn dothin;? for.? 1 crap. or lub-
Inil.h? .idiztd 0 haulin9? Il
IU2~1 1
YES •• ' YES ••• YES •• ' YES .. ' YES •• ' NO ... 2
IliA" NO ... 2 'nëi NO"'i (r!2'ÎT Il.\" "24' n26' 1 lUlE 1 TIllE .. 30 1 TItE MIOOMT MOONT UIUT MooNT UNIT AttIIUNT UNIT P ) MOUNT
1:1 1 Il 1 Il 1 Il 1 Il 1 Il
1: 1 1 Il 1 Il 1 Il 1 Il 1 Il
1:: 1 1 Il 1 Il 1 Il 1 Il 1 Il
1:1 1 Il 1 Il 1 Il 1 Il 1 Il SB3
BftID:lB4 SEC T ION 5. PAR T B. "r. 1 N JOB DUR 1 N B THE PAS' 7 D A Y SIE ND)
32 33 34 35 36 37 3B 39 40 41 42 43
t 11011 'llIy Il thtr. Il yDUr lfIt.n you HIV. you ~:i'Jau liII you ëtjIr.d
HIV.Y? HIV. you urd Jf fOU lanttd to Hn.yeu
U~:thn • union rlrtn.- tU~tid h.t or rtc.iv. ne.;v too l, Iqu - III th ... tOOII, don. any U th. r. on wl 1 you wi 1 yau • o rH or wli .. nll IUpp r .. tqr~.tnt or 3thtr Tt;k Il IIDrk It h. P u. 'ar thll ~~kyOU nCliv. rIC.h. ~trt- or IU~- 1~,lv. or 0 h.r • illI thlt IIdn, h. 1 plie' IIbtr. tr. work g~Ud'YI p.ld ~iz.d .Ittri ... Df ~. gng to you, how lilt you do thh {OU do GbiICt lign • lid ftnlion iul 10d.1 (our atm in IUt would you d'yl?
F lork? 1Ii~ o h. cantrad in thil Illv. in n t~h tlrt in IIcurlty hil wark? r'f'iv. frai th.
~ lor ? 1 ln lIbich IIOrt? tbil IIOrt thh t,nf' li Il .?
n~.l yaur IDr.? work? n hil .in lUI IIl1ry lark?
1 w'r' III r.,)? If~i-f • ?
Il
C nJUrtf 0
~ YES •• I YES •• I YES •• I YES •• I YES •• I YES •• I YES •• I YES •• I YES .. t uPRRrD? PERSONB 110 ... 2 1«) ... 2 NO ... 2 1fO ... 2 110 ... 2 MO ... 2 NO ... 2 ND ... 2 NO ... 2 U43) Aft(IUMT
5B4
BRID!lCI SEC T ION 5. PAR T C. SEC 0 " DAR Y J 0 9 0 URI" B THE PAS T 7 D A Y 5
1 2 3 4 5 6 7 8 9 10 Il 12 1 D Pl 'III dllerib, th, work to IItIith Ilhat Und of trld., indaltrl or For ho. On For hOII Il thil Ho. Ion? hav, HIVI Ho_ lUth lOn.y? ln this HIY' Itot! lUth dU r: or E you d,vottd IOtt li. dtlr your bUli ntll il i t tonnKttd .i h? I.ny thtl! lanr work bttn do n9 you .ork lin 1=. ~p 'F: ~ •• , 'r. 1 I.in Jeb dur ln; thl pllt 7 dlyl. dlY' dlYlf ~n 1 Irllon- this work rKiVl- rou ln t 1 htr wor
J !RIlt did th. work eonlht of? during .bou urinl 1 ? .d or Ho. oUln? nr~tnr- I"l r~t1,d n9JI,=t i~ th. hOII n' p It .ill .n or- ot r • or. Da 1 Ind Rllt 7 rny
1:':'h' r:~.1~ rr. in lervle .. ?
i ~nl ou ~r3i3 'nthl lonlY gllt 7 ° t~il {OU do ~~ t~r.- for 1 flrl or Iyl?
work? hil .or.? thit ln 1 lIal-work? work? tn.1I b,-
1 (i 40 on,! n,
1 If K5 OR h:U'rOld " E t7) YES ... ' ItPMT D 1 YES •••• 1
'ES ... 1 YES ... 1 W~AAt2 1 CODE 1 CODE
HOURS
'Rs.IIHI9.I.s. I~n lIOï;ï1 lun PER tIJ .... 2 NO •••• 2 lU T Dt DESCRIPTION TYPE DAYS DAY IIEEKS (HOt MDUIfT t MIOUMT
1 TIllE UMITSI "1IIJTE ... 1 HOUR ... 2 DAY ... J IlEEK ... 4 II{)IfTH ... 5 QUARTER ... 6 SEMSTER ... 7 YEM ... S 1
BRID5C2 SEC T 1 0 If 5. P ft RTe. SEC 0 If D ft R Y JOB DUR 1 If B THE P ft 5 T 7 D ft Y S (E If D ,
13 14 15 1ft 17 18 19 20
~ lfIIo'1id you An t .. " Do you IIblt il th, v.lu, H.VI you UI,d 1 f rI .. nhd ta H.VI ru don, Ho. lueh did TOU ra work or? f~:~rld .ho of th'l' goodl Ind tDOII, ,~ulr III th'f' tooll, .~ 0 hlr "lP ~r rn l v. or riclivi Ifni Cil? Hn {lU P Il Iq~ ~.'" or • • urinq • t 1 D hlr k,
It rD, thl r .. un.u· or 0 hlr .. • hll thlt b.- th. ~lSt 7 t ncl ud ng JIY"~ i n
J ~n~~Nfr p.y .. nt tion in Idlri. 1 of lone to TOU, hOlt dlyl. h. for, goodl Ind youn- 1)0adi or your own in thil lUe wou d you IlrViCI,1 Clt" for IIr.,ic"? work? r'fli v, for th,
t Thl BovlrnHnt
th 1 work? Il I?
T or th. 1 Ir.y ........ 1 0 If ft Iht. Dllnttl
cOIp.ny ••••• 2 YES ... I YE9 ... 1 YES ... I ItPMT D 1 YE5 .... 1 i A prl .. l. 110 •••• 2 NOUi7i NO .. r 2
co",.ny or
I~" (U, NO ••••• 2
tntlrpri Il •• 3 (tPART DI I~I"E MOUIIT AIIOUIfT AIIOIIIT UMIT
5C2
61nD:!D SEC T ION :1. PAR T D. S E Il R CHF 0 R Il DOl T ION Il LE" PLO Y " E N T
1 2 3 4 5 , Kavl IDU ln loatilli for .dn .ork during th. pllt lib, hu.n't yau laok,d fDr Durin, th. Ifhd Und af .ork Irt you
E look. for 7 dIY', h y, you ....... '11 ra 110ft dl1ring th. pllt Cllt dIY', looUng for?
" addition.l 7 day.? lY'Iou 1 p'iid IIOrt looh for
Blrin, th. IMIII MASOI., othrr .ark F pllt d.y.?
Ippft.d , .. und !.[und
'Pi!ild ippli.d uiid ta nphet
1 'Iily ln tr- your prll.nt 1 • PART E 1 C ~OCI? eOlln.c- .. dilr- in oth.r IJD NOT liANT TD "rvIC ....... 1 work?
A tion.? ill? p,rlon? .,.i~in9 Hthadl a&nH lfORK ALRJA y ........ 2 1 ? A D"I UPU ROll AN ELY •••• U .......... 3 0 AIlAIDr REPU lItI AN ln th ••••
" YES ... I E OYIlENTAI NeY ....... 4 S.lf-1fA1TIN6 TO ST T A Ilpl oy.d? •••• Privat, ~rieu~-C 1«) .... 2 THIIIITfa'·~Arlf··· .. ··:I ~,nr? .. • .. ·1 ar.l "1 ... 1
1 YES ... I Il.g.- 1Ion-.,rieu -lfO iii ICtO ...... ····6 .lrntr? ..... 2 SKtor? ..... 2 tur. ? ...... 2
YES ... I YES ... I YES ... I YES ... I YES ... I YES ... I ~
ODIn K HOIt 110 .... 2
1fO .... 2 lU) tiR!»:tAMMê' ••••••••••••. & "PART El EITHER? ....... 3 EITHER? ....... 3 EITHER? ....... 3 MO .... 2 MO .... 2 NO .... 2 MO .... 2 MO .... 2 DT R ..............
1:: 1 1 1 Il 1 1 1 1 1 1 1 1
~ 1111···11······11············· ........ ··1···1······· ·······1···1·1 04 >~:»)~:> ~:») »):: :/:::>:: ::»> >~:» ~:)::>:: ::>~««<:r>::::>::::»:::: ::»>::::>:: ::::::»>~:>:.:::. ~:>::»::»> ~«:~:>::::>::::::
. ; •• : ••••• :::.: ••• : ••• : ••• : ••••••••••••• -•••••••••••••• -•••••••••••••• : ••••••••••••••••••••••••••• : ••••••••••••••••••••••.••••••••••••• : ••••••.•• : ••• : ••••••••••••••••••••••• : •••.•••••••••••••••••••••.•••• : ••••• : ............................................... -: ..... : ••. : •••••••••••• : .• : ••
1:1 1 1 1 1 1 Il 1 1 1 1 1 ............................................................................................................................................
II····· ... ···1· ·····1· ·····ffi· ···1···· ·1· .... ·1····· ·1··· ................... _ ......... ·1··· .......... ·1··· .......... ·1····· ........ ·1
1:: 1 Il 1 1 1 1 1 1 1 1 1 1
illl·····I··II····I······················I······1········11··············1 lb ::::»»> ~:») >~{:) ::::::::::::: »::> <:;:» ).:::;> :::::»»»)):::«<:<::: >:»>:::::>: »::::::::::.:}::::} :::::-::::~:::::::::::» ~:»>::::::::>:::
~ •••••••• : •••••••••••••••••••••••••••• : •••••••••••••• : •••••••••• : ••••••••••• : •••• :: •••• : •••••••••••••••• : ••••••••••••••••••••••••.•••••••••••• : •••••••••••••••••••••••• : •••••••••••••••.•••••••••••• : •••••••••••••••••••••••••••••• : ••••••••••••••••••••••••••••••
1: 1 1 1 1 1 1 1 1 1 1 1 1 1 sn
BRID5E1 SEC T ION 5. P Il RTE. "II 1 N JOB 0 URI N 6 THE PliS T 1 2 "0 N T H 5
1 2 3 4 5 6 7 8 9 10 Il 12
~ ~0It 1 ICn:ld lib la hl Il Ibn:t your Ilin !lOrI! Ilhat l'nd of tndl, Il this IIOrk th,. Did For hOI Il this t,:rin9 Ifo. Ho. la~ ~IVI Han- H!MI IUch ton.y? ln thil aring 1 pllt 12 tGn hl hat il, thl !Cork ta indui ry, or bUlinll1 il Il'' Il laur lai n Jour lanr .ork hnl Ilny {au bl oing Vou IOrll Wlrt
E .hich fOU d.vottd th. 10ll ti ... during thl pllt i t connechd li th? ar IICon Iry job ath.r .... IIllanll ... h, houri 1 hit lorll? rtClh- How oft,"? IDa an Il 12 tGn h. '.inCl ..... ). ""at did thh lork durtne) the pitt 7 or during ? hOlt I.ny diV did .d r ndtptnd-T con.ht of? dlyl? loth.r the pllt diV' 1 vau .u nt lIOrlltr , do or 12 ",ek did IIOrk? VOU r.11~ art thlV lonthl vau IIOrk? rtClhl ! YE~ SAKE liS daine) did ~ou lon.y war on
AINtIPAl ••••••• 1 th. 1111 do t il for r flrl or Il 't PART Ft Und of IIOrt? thi. n 1 tu.i-T lork? !CarU n ... 1-
~ YES SAItE AS l:"9~, HCONDARY ••••••• 2 N ft PARTI FI IIF 40 hoallflol d7
OR IIORE C NO DIFFERENT t 71 VIS ••• I 0 hAl •........... 3 YES •• I YES •• 1 YES .. 1 'tPART Ft D
1 CODE 1 CODE 1 DAYS HOURS
YRB IKOB Iws Il.\" E ND ... 2 MO ... 2 ~UK 'i~ "Y. 121 Ijr~~H DESCRIPTION TYPE IfEEKS AfIOUIIT
1:1 Il Il 1 1 1 1 111111 Il 1
1:: 1 1 1 1 1 1 1 1 1 1 1111 1 Il 1
1:: 1 1 1 1 1 1 1 1 1 1111 1 Il 1
1: 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 ISE 1
1 TillE UNIT. "INUTE ... l HOUR ... 2 0IlY ••• 3 lIEU.... KOMTH ... 5 IlUARTER ... 6 SEMBTER ... 7 YEAR ... B
6RID5E2 SEC T 1 0 Il 5. PAR TE." AIN JOB DUR 1 N B THE PAS T 1 2 "0 N , H SIC 0 Il T. )
13 14 15 16 11 lB 19 20 21
'11h01 di d you - Il rour He. hr Ho. long Ho. oH.n Do Ar. talll HlYlyou DotS thil Ho. IUch do thtl. .art for? '19 oy.r, frDl thil dotl it (OU ID .In.dy nflivtd Dr payent tonUll1 f CDlli Il i onl,
E IInlglr or dw.lling ta .. you tD hlr? For ftduclid .1 l, yDU Includl iPI, 1 low.ncti Ind JI dl{litr il thl '0 thlrl l"l,h, rOI hl nCllvl.ny bonUlll, ,r Itui U.. IIDunt T ri 1 1 lD pllu rOI hlrl? hic 1 dlI' ply"nt bonultl CDlllIll on" o? ! ~~I'O~~E~~ you? ithlr. yDu onc. 1 WII , you Cfailllon" tii" dld ~bll :~i~71 nCtivl t ~'I .110.- .1 ounel'
.art for ~DUr .n r or or .ark ira ultit. gr.tui titi?
A or this
1 Thl Bovlrnltnt work?
a or thl Iny?1 YES ... l YES .... I
A .htl-otmtd 1.22 JlIlI ~ cOIp.ny? ..... 2 1IJ .... 2 110 ••••• 2 YES ... l YES ... I
',inl. 1IJ .... 2 110 .... 2 E C .nyor
HRS 1 "IN TIllES I~An ~Ul,1Œ1T 1 TIllE Iftllrpri 117 .. 3 k" AIIOUIfT UNIT
1:1 1 1 11111 1 1 1 Il
1:1 1 1 11111 1 1 1 Il
1:: 1 1 1 III Il 1 1 1 Il ::: •••••••••••••••••••••••••• -•• :: ••• :.: •••• ::::: •• : •• ::::: •• :.: ••••••••••• ::.: •• : •• : •••• ::.: •• :.:.:.:.: •• ::: ••• :: ••• : •• :.: •••••• : ••• : •• : ••••••• :: ••••••••••• :: ••••••••• : ••••••••••• ' •••••••••••• : •••••••••••• : : •••••••••
'16' ............................ , .................. , .................... , ........ , ........ , .... ) .. , ........ , .................. , ...................... , ...................... , ............................ , ........ ,
1:1 1 1 III Il 1 1 1 1 1 SE2
6RID5E3 SECT 1 D N 5. PART E. Il AIN J 0 8 DUR 1 N 6 , HEP AS' 1 2 Il 0 N T H S (C 0 N T. )
22 23 24 25 26 27 28 29 JO JI
t HIV., '03 Mblt il th. Vllu. of HIV. vou Whlt il th. val u, of HIY. Y03 "hat il the Yllu, of th, II your IIhlt il thR YI~Uf of HaVI yo~ If~at JI th. Yllu, Dt ~~:In th." lJood.? rfClhyd thil .ubsidy? rRclin clothinlJ? nnlfart this ransport. rK'ivI t il orl of payltn ?
ar _il Dr Il to th 1 or _ 1
.. 1011 you you, .or' frH vou T K.iv. rK.h, rKlV. or rK.ivr 1 r:Tht, rlYHnt rlYHnt IUblidiz- ra,"n or this or this Id? or thil 1 .or' in .or' in .or' in ~'olCtr eth. forl th. forl th. forl A of flHld. of frll of fon? 1 cr9P1 or ar lub- ' clDthing?
Inillll? sidiz.d .. houling?
~ YES •• I YES •• 1 YES .. I YES •• I YES •• I 1.32 nul ~ ·'.ni ~'26i NO"si ~'3oi I~A"
MDii, Iljn 1~1I1, 1 TIllE U2 1 nifE U3 Il AItOUNT UNI AIIOUNT UNIT A!!OUNT UNIT AIIOIJJIT P ) AItIItlNT
1:1 1 Il 1 Il 1 Il 1 Il 1 Il
1:1 1 Il 1 1·1 1 Il 1 Il 1 Il
1::1 1 Il 1 Il III 1 Il 1 Il :: -••••••••••••••••• -•••••••••••••••••••••••••••••••••••••••••••••• -••••••••••••••••••.•••••••••••••••••••••••••••••••••••••••••••••• -•••••••••••••••••••••••••••••••••••••••••••••••••••••••• : •••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• -......... : ••••••••••••••••••••••••••••••••••••••••••••••••••••••• : ••••••••••
1:: 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 SEJ
BRID5E4 9 E C T 1 0 If :1. PAR T E. "A 1 M J 0 9 DUR 1 "B THE P A 9 T 1 2 "0" T H S (E" D 1
32 33 34 35 3b 37 38 39 40 41 42
1 HoeI IIny Il thl,. JI your Nhln ~u HaVI Vou HaVI you Nill Vou Ar. lOU HaVI Hav. you Ulld If TOU lIanttd to IIll thnl D P"~I 1 union ruunlr- .tut hld or had or nni'i Inti lld
1:li'r' tooh, too .~ "uipltflt Dr latlrhh
E 1 Ithlr It thl ftion lIart, .ilI vou lIill. you a tD frH Iquif"nt, th.t .long to vou, hOlf IUch If "r.t at th. ~ICI ar thi. did Vou r.uiVl rK.IVI r,tlrl- ar tub- Dr lIil lugP 1.1 or lIDul~ you nc.h. ra. th. ! P "j 00II,,,
,n
f'IK! .ign a ~:l1dfY' riek Mn .idlZtd 1°U Dt Ir .. 11.
VOU 0 thi. rer do ï~n~t~~ 11'11 r·nri9n Iid cri Ic.hl Iltlrilll of lIor •. fi hl ~rWI ln Uh n ~l' i~r' n lOci Il rgyr olln ~n lIarr? I~~ry lIor . lIork
lIarr? lieur II II IfOrk :y11 blnlh
A lin lUI III in thh
1 III" Ip'ci- 1I0rk? ri ,)? hecl?
0 If
C 1 • PART F 1 0 YES ••• I
~ YES •• 1 YE9 •• 1 YE9 •• 1 YE9 •• 1 YES •• I YES •• I YES •• 1 YES •• I
PERSONS 1lO ... 2 110 ... 2 NO ••• 2 110 ... 2 1«1 ... 2 MO ... 2 1«1 ... 2 MO. 112 ttf~ARt2F) AtroUlfT
SE4
SRID5F SEC T 1 0" 5. PAR TF. E" PLO Y " E "T HIS TOR Y
1 1 2
~ Mb.t did IOU do IDIt Df PIII •• dtlcrib. th. llin lork ~au did btfon ~ou " th. UI. .fon Ihrt- Ihrhd your I.in job during t , palt 12 lont •• Ting thil IICrk? Thil h, Itbat did th.t IIOrk conlilt of? 11er. you doing Dth.r F lork, ,tudyinh or "ri ~ you un'lploYI
T 1 0 N
O'II"ORK ...... 1 C 9CH lo·t6······) CU' 0 UllEltPl y • • .. • • ( , D E
DESCRIPTION 1 CODE
3 4
Nhlt kind of bu.in .. s, trad., indultry, or ln this lort profession 1111 il conn.chd lIith? .,n you .n
ind~,nd.nt 1I0rt.f or • hfily IOrker on 1 art or in a bUlintll b.long-inq to Jf1r hDUltho ?
YES •••• I
1fO ••••• 2
TYPE 1 CODE
:5
For ho. long did yau do thll lIork?
YEARS 1 ",*THB
6
Ourln9 thl Pllt 12 IOnthl, IIIYI yDU don. InJ Dther IIOrk n .ddlUon to your Iain tiployltllt?
n'Mri, '/:PART'i,
1:1 1 1 1 1 1 1 1 Iii
1:1 1 . 1 1 1 1 1 1 Iii
1:: 1 1 1 1 1 1 1 1 1 il 1::1 1 1 ·1 1 1 1 liB SF
ImID561 BEC 1 ION 5. P ft R 1 B. BEC 0 M D fi R Y J 0 9 DUR 1 M B 1 HEP A S T 1 2 Il 0 N T H S
• 2 3 4 5 6 7 B 9 10 II
, 1f1Ml, 1 IOIIlt li kt to ialk .bout ~our Itcandlry ""at klnd of tndl, Il thh ItIIrk tht For hOll Il tM. During HOII H1ItI lonX havi Hav. Ho. IUch .onty? ln this tOrt Job durlng h. Pllt. eunth., t It h, th. work indultry, or balintl. i. IIH il lour Iii n Ilnr work th .. 1 lin y Xou b" 1:.h- ..,. ~ ln în ""lch yau .ptnt ICIlt tift If tir yaur llin i t conn.cttd .1 th? ar 11e0l! Iry job ft •• Itl~onll w"h ho:ln oin, thls &. ofhn? indH dtnt Il ob (sinet ••••• ,. Ilhat dld th 1 IfDrk con.ht ~uri n9 tht pllt 7 during 11011 Ilny • Iy tOrt :tIr ml J :'~tr 1 of? IYI? n,pllt d"r • did ~ou
1 w" did IIOI"k. 1DIJ r: •• rl or lonth. yCXI leliv. n 1 bu.ln ...
t ~!ilc!m· ::ser .. 1 did ~ou _art?
m" .lonlln. to do t il gr. ~:rr DU t-work? D d?
A YES BAffE AS
work1
SEC~KIIARY ••••••••• 2 Il '.1 liEn PASO I~ 40
,.IISml, IIORE C 1(°6ol1~~?~~! ..... 3 • 6' 8 YES •• I YES •• '
1 CODE 1 CODE 1 DAYS lURS
YRS.llIJs.IR9. nn'~Ù, E HO ••• 2 ~lfK ER 110 ... 2 UnIE DESCRIPTION TYPE IiEKS AY ,un MOUNT UMll
1 TIllE UlnTl "INUlE ... ' HOlIR ... 2 DAY ... 3 lIEU.... IIOHTH ... 5 RUARTER ... 6 SEIIE9TER .... 7 YEAR ... B 1
81110562 5 E C T ION 5. PAR T 6. 5 ECO Il 0 Il R Y J 0 8 0 URI Il 6 THE PliS T 1 2 "0 Il T H SIE Il 0 1
12 13 14 15 16 17 18 19
11fII~ 11d ,au Ar' tanl Do 'ou Ilhat il th, ni u. of Hni vau ulld If Jou want.d to wor or? a rlldy alla th"l gaadl and Ifrviu.? too l, Iqui - III th". taols,
dtductH r.Ctiv' tif! 1 .uppl fil Iquipltnt or N frai th. rllUnlra- or a h.r uttrhll that T pl,.nt lion in lattrilh of b.lon; tf yau, how , ~nJolBE~~ 1°U l0od. or vau, own in thi. lUth wou d Vou
'Cltn Iniu.? .or ? nt,i VI frOi th.
~ for hh Ill.? 110ft?
HIY' 'DU don. Hew If th hUI 'ou ',,' ved 3th., wor' Dr .1 1 you ne,1 v. or urtn, the thh oth,r workJ intludlng
pli 2 pay.nt 1 ft th, Orl of tonlh.? good. Ind IInl Cil?
1 Th. ~oY.,.nlr.t or t • 'rly •• 1
A .tll,-olll'le eOlplny? ••••• 2 YES ... 1 YES ••• I YES ... I
1 A,rh'to 10 .... 2 1CO ... ,2 N~nê;2 iCI Irtyar lU 1 tnte:prI1l7 ••• 3
MOUNT 1~1~' AtIOUMT
YES •••• 1 I.PART H 1
"~r··2 UP HI
IlJA" MOUNT
o
SG2
BRID~ SEC , ION 5. PAR T H. 0 THE R ACT 1 Y 1 T 1 E S
1 2 :1 4 5 6 7 B
1 During thl llit 7 dlyl, For hOI For hOI HIVI you HIVI IOV For ho. Ilny For hOI Durin! th.
1 hlVi you worlttd in your IIny lany bltn li thout loah or diH.nnt Ilny IlIb ~t 2 ho .. , for 1"!IIII., dlyl houri paid .art lor. ptriodl Itr' al togtth.r thl, hlVI , tl'Ininx thl hou,l, ~.Y, you IIch on ont or durin! tht yoy li thout lin yr you lait r.id r'rri 9 11111 or your an, dly? Ion pli 2 p'.ld .ar. .ithou r,id l'Ploylln
1 :: ~'llir~lCil~h~Uing thi~ attllionl lonthl? ilurtny thl rgrJc dur n~ ~KIUI3 of urtny thl pli 2 1 ~"t 1 ~I ln a
~ food or cath", fJ h- ru~ini pli 2 IDnthl? lant 1 t • i n9 Iittr or woOd or th. P st IDnthl Ilinee ... I? Igricultural
A caoting? 7 dlll Ilint •••• )1 Stllon? T Ilin 1 , ...... ,?
YES .... I YES .... I 1.51 YE9 ... 1 YES ... I
~ 111 ..... 2 U4' 110 ..... 2
IroNtU·2 110'1'2 D UNEl ~ E PERSO'U PERSON' PERSOII
DAY9 HOURS PERIODS IIEEKS
p 1······························(············1 .. ············1··············1··········(······1··················1························1·················· ····1························1 Fœ ••••••••• • •••••••• • •••• :· •• ·.: ••••••• • ••••••• :.: .............. : ••••••••••••••• -•••• : •••• : •••••••••••• :: •••••••••••••••••• : •••••••••••••••••••••••••• : •••••••••••••••••••••••• -••.•••••••••••••••••••••••
1: 1 1 1 1 1 1 1 1 1 SB
SECTION 6. "I6RATIOH
TO BE ASKED OF All HOUSEHOlO
ft E " BER S ABE D 1 5 Y E ARS 0 R 0 l DER.
BRID" SECTION " . "IBRATION 1 1 2 3 4 S " 7 8 9 10
1 i~isli; rfv, you Al th. tin Hn old lIby t1d ~o. Ion; IIhy did FrOi .hich Depart.ent or "ri th. Hr. lanf vld country .,re you co.ing frol? p ICI .hen t III o (our Itr' you you "VI IYI ym fr:~i;: ~our al , anylh,rl bir h& wu wh,n you your lhld ~ Jou Itrl ! ~~ftCI_O~ ,III? your irth- l,ft phu •• ~PRE ENT ivlng IVI Y3u plac, ••• rur of birth1 P~ E OF P AC Of iEPARTruNT IF IN b'fyr' chang' i ~!J __ l lice of R SIDEMCEl? REBI- VORY OAST COi ng hlr, your plac,
irth DENCE)? COUlfTRY IF AsRDAI>. of for th, rtlidtnc,? fi nt ft city •••• t ti .. ta IIOI,p'_ IIORK OF ft town •••• 2
ft city •••• 2 li v, R~SPOKD- ft IIr2' ft t01ln .... 2 101'- IN OR TIllE lM fi~/~ vill YI .. 3
I~ ft hr;, Ih,n ISlrER YEARS ft lIal YES .... t Yill fY'" 3 fh.? Ff-I Y.t F ILY.1 vil hg' .. 4 PERSON
~ YES ••• 1 n , Alu J" "UNTRS Jlro':J vil hg' .. 4 "lIAt--j &dEISYEAR ft ca.p .... s
~ MO ... !2 "nït2 ft ClIp .... S still ..
rorur Othtrr .. ·6 OTtlER ••• YEARsIIIOS.
OTHER ••• 4 Othtr? .... 6 ,. , PE SOtn YEARS DEPARTlfENT TIllES
1:: 1 1 1 1 1 III 1 1 1 1 1
1: 1 1 1 1 1 III 1 1 1 1 1
1:: 1 1 1 1 1 III 1 1 1 1 1
1:: 1 1 1 1 1 1 1 1 1 1 1 1 1 6
SRI01A rs E C T ( 0 N 1. RES P 0 N DEN 1 S FOR ROU N D j=m RESPONDENT: THE PERSON BE ST lNFORKEO OF THE ACTlVlTlES OF THE HOUSEHOlO KE"BERS
1 lUIRE OF III( RESI'ONDENI • _______________________________________________________________ --_--___ --__ 1, o_c_o_oE_I_o __ -,,1
1. Durin; the put 12 lonths, has Iny lelber of your household worted 15 an independent hrler or hilly Norker on a hrl belonging tCl the hOU5ehoid Dr rahed anilals belongin; to the household, luch i5 poultry, cattle, s~eep, pig. or other anlllls?
VERIFY IIITH SECTION 5.
YES ..... I
NO ...... 2 ft 31 D 2. IIho Ir the Pfr,"n Nho tno •• 10st about .11 the agriculturil and liyestock
auh hes b the lelbers of your househo d?
1 NARE._______________________________________________ ID CtIDE. D 3. D~rlna thl Pllt 12 lonth'l hu Iny Irlber Of rour houllhold Norkld for
hillelf other th an on a f ri or rU s nQ anill.? For eXllple hu anyone oPlrate~ his/her Olln business, tnde of indllstry, engIQ'~ ln ln independent ptofeSSlon, or worked 15 an i ndependent fi sherlin or afU san?
VERIFY lUTH SECTION 5.
YES ..... I
NO ...... 2 ft B NEil PASEI D 4 5
0 Ilhat diHerent tradu, business!!!, industries, serYÎul Dr profellions, were owne~ or IIna~ed by Il!lbers of yOUf hll y during the put 12
IIho il the plrlyn who knowft lut about th, explnses and incole of ... [NAKE OF BUS NESS, ENTE PR E, ETC .... ?
~ lonthl (slnce •••• I.
1 O~~ICE ~ "AKE A COriPlETE LIST BEFORE 601N& TO 5. 1 ID CODE MAKE
1 L ____ ~~ J-C 1 1
1 1
IT ~ __ -_-----_----_------_-~~'=~r~-_---_-____ ~J 6. ARE THERE "ORE THAN 3 BUSltiESSES, ENTERPRISES, ETC?
YES ••••• I (t 1 NEIT PA6EI
110 ...... 2 (t B NEIT PA6EI D 7A
6RI078
7. Along th!!s!! tradl!5, industri!!s, and business!!s, IIhich ar!! th!! lost ilportant for the hous!!hold?
IIRITE THE OROER fCUII8ER OF THE THREE IIOST IIIPORTANT.
D D D a. IIho Ihops for the food for your household?
1 MME._______________________________________________ ID CODE. Dl 9. IIhotln YOur houslhold knolll lIost about the other expenses, incoll! and savings
of hl t .. ben of your hou'l!hol d?
IIIAME.------------------____________________________ • ID CODE. 0 1
10. TD CHDOSE A 1f0ilAN AT RANDOII TO ANSIfER THE QUESTIONS ON FERTILITY IN THE SECOND ROUND OF THE SURYEYI
READ THE FIRST L1NE OF THE STICKER BELOIf UNTIL yoU COIΠTO THE ID CODE.Of A IfOIlAle BELOlf6IH6 TO THE HOUSEHOLD AND A6EO 15 OR OLDER IN THE HaUSEHDLD RDSTER. CROSS OUT EACH REJECTED ID CODE ON THE STiCKER. If THERE IS NO VALlD ID ~ii~LINIJ~ FIRST LlfCE, 60 TO THE SECOND. IIHEN A YALID ID CODE IS fOUND,
STiCKER
IIRITE THE !CAKE AND ID CODE OF THE IIOIIAH SELECTED:
1 MAME. ---------------------------------------------- ID CODE. 0 1
1. SECTION a
7B
GRIOS
\SECTIDM 8. CHARACTERISTICS OF HOUSINS
KOIl 1 lIould lite to teasure the perileter of your dMelling, including ail the diHerent buildings or aparbents occupied by your housl!ho d.
~~~~P ~E~E~~ I~~~ ~~~~~~of~, Ak~A~tl~E B~~~O ~~~, AE~~~Rl~~NI~D ~~~ T fo~~r THE DI"ENSIIlNS OH THE SKETCH.
DO KOT IIEASURE TERRAtES OR BAltONIES.
[IIPERYISDR'
ARE A 1 2
"
2 HOII WAS THE AREA "EASURED?
INSIOE .......... 1
OUTSIDE ••••••••• 2
KAIN CONSTRUCTION KATERIAL OF OUTSIDE WAlLS:
IfUD,"UD BRICK •••••••••••••• I i~~1~6i(Uvtê::::::::::::: :i GAlYANIZËD IRON •••••••••••• 4 KOODEN PlANKS .............. 5 STOKE/BRICK ................ 6 CE"ENT ••••••••••••••••••••• 7
OTHER ...................... 8
(SPECIFY:
"AIN FlOORING "ATERIAL:
EARTH ...................... I KODO (PLYWDOD' ............. 2 STONE/BRICK •••••••••••••••• 3 cl"INT ..................... 4 T ll.l. ..................... 5 B 1( uu ••••••••••••••••• , ••• 6
OTHER ...................... 7
(SPECIFYI ,
KAIN IIATERIAL ROOF 15 IIADE OF:
STR,", THATtH, GRASS ••••••• I EAR H IIUD .................. 2 1100 DA PLAKKSu. ............. 3 6ALY NUEO IKuN ............ 4 CANVASt .... • .. • L' t ........... 5 CONtRE t, CtlltN ........... 6
OTHER •••••••••••••••••••••• 7
(SPEtIFYI
6 THE IIINOOIiS ARE FIlTED IIITH (CHECK THE FIRST THAT IIPPLlES'
SLASS •••••••••••• 1 SCREENS
1 ...... · .. 2
SHUTTER ......... 3 CURTAI" 1." ...... 4 NO COYE 1(" ...... 5 KO IUKOOIfS ....... 6
END OF ROUND ONE
o o
o
o
D
8
[
=======::======:::1 ROUND TiiO
::U::::::::::::::::II:==:::==
EIPLAIN ABAIN tHE OBJECTIVES OF THE SURVEY AND
THE CONFIDENTlAllTY OF THE DATA.
READ TIIE LIST OF IIDUSEHOlD "EIIBERS.
rr==============================================================================n a 5 E C T ION 9. A G R 0 - PAS TOR A lAC T l VIT 1 ES" ~==============================================================================9
rr==SUPERVISOR==================================================================ù ft r-----,R B 1 III n RESPONDENT: ______________________________________________ ID CODE: 1 lU
U L-----JU ~====c=========================================================================9
rr==INTERVIEWER=================================================================0 1 r-----,U 8 IS THIS THE PERSON ACTUAllY YES ... 1 1 lU 1 INTERVIEWED? NO •••• 2 1 lB B L-----JD ~================~=============================================================9
r---------------------------------------, 1 1 1 PAR T A. l AND 1 1 1 L _______________________________________ J
•• During the last 12 months (since ••• 1 has any member of your household "orked fields or a garden belonging to the household?
yES .....•
No" 1 "ould like to ask Vou some questions about aIl of the land that is for the exclusive use of your household for growing crops or for pasture.
2. Ho" many hectares altogether have the members of your household used during the past 12 months. (Since ••• 1 including the area of aIl parcels of ail the members of your household?
HECTARES:
3. Ho" many hectares of fallo" land are available for use by the members of your household?
HECTARES: 9Al
4. Ho" many hectares of the land available to your household are part of a land development scheme?
HECTARES:
5. HOH many hectares belong to a cooperative? (including GVC>
HECTARES:
6. Do the members of your household have the right to sell aIl or part of this land if they Hish?
YES •.••• 1
NO •••••• 2 (HO)
7. Have they sold any land during {he past 12 months? (Sinee .•. 1
YES ..... 1
NO ...... 2 n lOI
a. HOH many hectares did they 5!11?
HECTARES:
q. HOH much did they receive from the sale?
AHOUNT:
10. For hOH much could you sell land exactly like that used by your household during the past 12 months?
AHOUNT: 9A2
Il. Have the members of your household the right to cede or transfer ail or part of the land they are using'
YES ••••• 1
NO ...... 2 nlSI
12. Have any members of your household.ceded or transferred land to someone Hho is not a member of the household in the past 12 months' ISince ••• )
YES ..... 1
13. HOH manv hectares did they cede or transfer?
HECTARES:
14. HOH much have the members of your household received for the right of use of this land? (INCLUOING THE VALUE OF GOOOSI
At10UNT:
15. Have the members of your household bought land during the pa st 12 months'
YES ..... 1
NO ...... 2 1. IBI
16. HOH man y hectares did they buy?
HECTARES:
17. HOH much did the y pay for the land?
At10UNT:
lB. Have the members of your household paid for rights of use of land during the past 12 months? ISince ••• )
YES ••••• 1
NO ...... 2 1. 211 9A3
19. On how many hectares have they paid for rights of use 7
HECTARES:
20. HOH much did they pay?
AMOUNT:
21. Have the members of your household received land as a gift, inheritance, dowry or grant from the government during the past 12 months? (Since .•• )
YESo •••• 1
NO ...... 2 (~ 231
22. HOH many hectares did they receive in this way?
HECTARES:
23. Have the members of your household given land to anyone who is not a member of the household as a gift, dowry or another reason in the past 12 months? (Since •.• 1
YESo •.•• 1
NO ...... 2 (~ PART BI
24. How many hectares did they give in this Hay?
HECTARES:
9A4
SECTION 9. PAR T B. C R 0 P S J 1 2 3 4 5 6 7 9 9 10 Il
Hlli the I!fberf ~f your house- ~?~. ~fny hect!~~~ Hi" lin Y hechres HO.luch T[ J Ho. luch .15 the Did you Ho. luch .ould Dtd yO? ,'ve HOIi luch .auld Dtd rou aro• Khich ather ho rf~n hl y ollinH cropt o ••• [ J ••• ••• lIiS 10 d hirvelt of of • i' kee~ pirt the ule qUln- ~Irt 0 hf hlr- r .... qum- f he tr Vs in cropl? dur n l,nt lont 11 IIlrf hltvllbd Ire nOl yet in d~rtn~ the put [ ... sold or? of he Ut[ r s~ed lit ff... J. Uy îf ... he ~lIe "'Id ( 1 tl ••• dr nH hl put produt ion? 1 10 ths? crop' for cos n t e ln re urn or ... ~ol~ Il teille ilç
~~JR~p~~~'IIBx TH~LDIf. l 10 ths? seeil? urke? Ufr, or iS 1 n the lU e . 15 ... [ l ....
inct •••• 1 9 or for ,. ~&J 1 ~I!rtlant~s Ind
~ IF KDTH~NS& WRITE et shel ZERO AN . YES .... 1 ASK QUE~TlIN b~OR YES ... 1 YES ... 1
~h~KfiR~O S 2-iL 10 •••• 2 t(~H0I2 ~fMilt'2 F~iDlsT IFiD~t(D HECTARES HECTARES QUANTITY IUNIT A"OUNT 1 UNIT nel AIIOUNT APIOUNT C PI
YES-:_ND I~ 2 _1_ 2-1-1-I-dSl.I-I-I-I--I.sam==I-I-I-1 fZIZI~=~!II:IIIJCsllIDI:I:z:z::I", ~~~~~~~~: : : 1 IRÎii::::: IRuhbor
Plinhini or blnlnll
IFrult Ir ...
IWood ICOI. nul
I-YE_S--:.-J(o---ll~daa::mawal_ 1_1_1_1_1;;;'1=1_.1_1 __ 1_1_1 I-YE_S·-:_-KO---lI~I __ I_I_I_I_I_I_I_I __ I= SdISIII_I~
I-YE_S--:_-NO---lI~. __ I_"I_I_I_I_I_I","dSlMSMl __ I_IIdMSAiSdiHI_I..J 1~ll:::::: :~ l ~it::::i~
!ITER .... ·II ~
CH .... .
It::::: ....... HlyE· .... ·16 ALL ....... 7
YES-:_ND 1"--1_1_1_1_1_1_1 ... _1_ ... _1_1._1_1_1 !BiEs,
YES~_NO 1~1a-... "lm __ I_I_I_I~I=I_I ___ 1"2 2-1-1-1 I[~~~~~~~~~I Oll PAL" ......... .
YES-:_KO 1lH--1SMM2id-l-I-I-mLHI-I-I-I-I-I-I-I-I t--Y_ES_:_-IID--tII __ I~-:::.I_I_I2IB_I_I_I_I_SdSd2HI_m_I_.I_1-1 t--YE_S--:.-NO--tIIIii. __ I~ldSfiid2IBl_I_I_I __ I_I_I_I_"_I_I~
9~~!A!A~~~:: :: ::: 1 CO~ Mut ........ ..
~~Ili"::::: ::::: U TOBA c6.~ ....... "1 PIlE PfL ••.••••• SUSA CAN ........ 1
~ ............ .. ~~iAyA·· .... · .. ·11 KA [~~!~!~~~::: ~'~~Il .. A6AêRûft;· 21
~,M ~'~~A::::::U ....................
9B1
SEC T 1 0 Il 9.
- ----- ------- - --_._----- -1 2 3 4 5 6 7 8 9 10 11
HlVe the .elbert of your house- Ka" uny hectares Kali .any hectares HOIl luch ... C J Hall luch IIIS the Did you HOIl hold rr"n th! ollollfnR crops of ... [ ~ ... of ... [ J ... ••• 1115 sold harvest of ';' [ J kee~ cart the d~rin he put 12 lont s? .ere huveste Ire not yet in during the put ... sold for. of h i ty ( inc ... ) frina th~ put production? 12 lonths? crop' for ln
~~JROpfi'R'~ I~x T~~lOIF. la ths. seeH?
( inn .... 1
~ IF K01"IN6, KRITE
~~ ~~~II~~F~R~OR ZERO ND ---H,
YES ... I 60 N6 TO 2-11. NDUêl2 HECTARES HECTARES QUANTITY IUNIT AKDUNT IUNIT
luch would Did you ,ive Hall luch Ifoul~ Did you groll Ifhich other sile qUlnt- part of he har- the fale ~uln i- other croir n crops? of seed cost vest 0 .. ( ] .. ty a ••• J the Slll! e he larket? ln return for ... cf~t in the It the sale I~
a~or, or 15 a tarle . as ... C J .... ~i t or for ,. ~M , erelonies and feUshes?
YES .... 1 YES ... I
N~H0i2 N01r2
f~~EISTlf~~E2ND AKOUNT UN ~ AKOUNT C PI
~ __ &-._&&-~~~;f;;;;;;;;;;;;;;;;;;;;f;;;;;;;;;n;t;;;;;t;;;;;;;;;;;;;;;t;;;;;t;;;=t;;.;;;;;;;;;;;;;;;t;;;;;;;~;;;;;;;;;;;;;;;;;t.;;;;=t=;t.;;;;;;t
r·ro __ , ______ ~ ______ ~ ________ ~~~~~~~~~~~~~~~~~_L~~~~~~~ __ ~ __ ~~~~~~~~~~~~~~~~~ Slfeet potato
Haiz!
Rite
Ki llet/Sorghul/foni 0l--__ n
Yegetabhs (tOllto!!s, Iggpllnt, okrl, 1----0' anIon, pi.ento, etc.
~~US: KILOSRA"" .1
~Kt"" .. i H·· .. ····l A§~n:::::
S9IfL"" ... 6 • JArt:::::::~ Il~~f(:::: I~ lJT~~ •••• "1 ~~~it''''' r8~ .. :::::I:s HIYE······16 All ....... 7
~~~91 COCOA ............. I COFFIE ............ 2 RUSS R ............ ~ COCO UT .......... . OIL AL" •••••••••• BAHANA •••••••••••• 6 FRUIT TREES."" .. 7 If 000 .............. 8 COLA NUT .......... 9
~IITrr""" ••• "11 J ;~~~i(t::::::: 5UBARCAME ••••••••
CASSAVA •••••••••• 16
Other crops?
Specify:
n'~t:~btÀtb::::: li ~1~l!m-lmnl-lmnlfll!lllllllmnmnm~I-I-I-I-1 ;;~IZE'l·::~;;~;;;::
~ 6.U' ...... ~~ I VE !lt:t ••••••• 23
• PAR T C OTHER CROPS ...... 24
9B2
t
1 INTERYIEWER: HAS THIS HDUSEHDLD PLANTED TREE CROPS sueH AS eOFFEE, CDeOA,
RUBBER, Oll PAL", BAHANAS, FRUIT TREES, TREES FOR MOOD, DR COLA NUT?
YES ••••• 1
NO ...... 2 0 PART 0) D 2 3
~IST ~lh TH~ TREE CROPs ~RRIC" Ilhat iroiorti on o{ xour ••• ( y TH DUS HOlO lUTH TH 1 CODES. ... p an invs i5 ° young 0
product?
--4 S
] Nhlt iro~orUon of Yiur ••• [ ) Khat ~roportion 15 near ... p an inq5 15 in ull the I! d of i ts product-production? ive life?
!cODE IBIYE THE PROPORTlOM AS A FRACTJON OF THE NUIIBER OF PlANTINSS, FOR EXAIIPLE 1/3, 3/4, ETC. IF NONE, "RITE 0/0. IF All, IIRITE 1 1. 1
i i
r- / / / 1 1 1
1 1 1
1 1 / 1
1 1 1 1 1 1
III~ 1 1 1
1 1 / 1
1 1 1 1
. 1 1 1 1 1 1
• PAR T 0
: ..
CODES:
CoeOAt ............ • CO~FE •••••••••••• i RU BERt .......... . CD ONU •••••••••••
~Il PAl" .......... 5 ANANAS1t ......... 6 RUIT TH Es ....... 1
1000 .............. 8 COLA NUT .......... 9
9C
5 [ CliON 9. {P-AR-T---ii:---rA-ïnr--nrpü-f-s-~~~~]
1. Has your household bought seeds or plants during the past 12 .onths'
YES •••• I 0 . NO ..... 2 on
--------------- - ------ -----2 3 4
For IIhich crops? HOIl luch lias spent for seeds or Have Vou already
\I~T THE CROPS IflTH roun~ plants for ... [ ] ... harvested the n t e past 12 lonths? fields for IIhich
H IR CODES. Vou bQu~ht these LIST All CROPS BEFORE
seeds/p ants?-601N6 TO 3-6. r--- YES ... ~
CODE AIIOUNT HO ••••
1
~ 2
3
4
7. HII vour hounhold und ftrtllizer during the pl5t 12 lonths?
YES .... 1 ND ..... 2 (U31 D
8 9 10
For IIhich crops? HOIl luch lias spent for Have Vou alreadv ferplizer fyr ... [ J ... harvested t~e
LIST THE CROPS IIITH ln he 115t 2 lonths? fieldl on Il ich THEIR CODES. Jau Ufed
IF MOTHING. NRITE ZERO erU izer? LIST All CROPS BEFORE 60lN6 TO 9-12. r--- YES ... 1
CODE AIIOUNT NO .... 2
lAI
2
3
IA4
Il. Has your household used organie lanure during the put 12 lonths?
YES .... 1 D Ho ..... 2 U1BI
-14 15 16
For IIhi ch crops? HOIl luch lias syent for organic Have you alreadv tanure for ... J ... during harvested the
LIST THE CRoPS IIITH the put 12 lonths? fields on IIhich ~HEIR CODES. vou u5ed the
aanure? ~I~T All CROPS BEFORE IF NOTHIN6, IIRITE ZERO. o NS TO 15-17. r--- YES .. 1
CODE AltOUNT KO ... 2 - -----1
2
3
v4
- ------ -------5 fi
HOIl did vou obtain the seeds or Oid Vou oblain plants? the seeds or
planls on credit? PRIYATEl Y ••• 1 ClOT ........ 6 SoDEPA~" •••• 2 BNDA •••••••• 1 YESo .1 SAT"AC ..... 3 COOPERA TI YE. B NO ... 2 50GB ........ 4 SAPHo ....... 5
OTHER PUBLIC A6EKCY ..... 9 -------
11 12
HOIl did Vou oblain the ferti 1 Ïler? Did Vou get the fertl p ter on credi ?
PRrA!E~ Y ... l CI~T ........ 6 50 EP l .... ~ BN A .... I ... 7 YESo .1 SA "ACl ..... COOPERAT YE.8 NO ••• 2 S06B ........ 4 OlHER PUBLIC SAPH ........ 5 AIiENCY ..... 9
---
17
IIhere did vou obtain the lanure?
PR'YA1ELY ... 1 CIDT ........ 6 SODEP lll •••• 2 BNDA ........ 7 IAT~Acr .. ". ~ COOPERA TI VE. 8
OS ........ OTHER PUB LI C SAPH ........ 5 AGENCY ..... 9
---
- ------
CROP CODES:
CoeOA ••••••••••••• 1 COFFEE ............ 2 RUBBERt ........... 3 COCOHU ........... 4 Oll PAL" .......... 5
BA~AHAtl~' :. ....... 6 FR If litE:, ....... 7 1100 .............. 8 COLA NUT .......... 9
COnON ........... ll PEAHUT ••••••••••• 12 TOBACCO •••••••••• 13 PINEAPPtE •••••••• 14 SUSARCAHE •••••••• 15
CASSAYA ••••••••• '16 YAII .............. 1 TARO •• :. .......... 18 SVEET rOTATO ..... 19 "AIZE ............ 20
RICE·t .. :.·I .. · .. ·21 Il llE FuN 0
SOR6HUIl ••••••••• 22 YE6ETABlES ••••••• 23 OTHER CROPS ...... 24 ALTOSETHER ••••••• 25
=:====:===::::::========
9Dl
SEC T ION Il. l~_~ R T D.
lB. Has you household used insecticides during the past 12 .onths'
19
On IIllich crops?
LIST THE CROPS lUTH THEIR CODES.
~I~l All CROPS BEFORE o NG rD 3-6.
.---
YES .... I D NO ..... 2 (.241
----CODE
-
20
HOIl Iuch iii insecticide in the put
IF NOTHIN6,
-
s spent on s for ... [
12 lonths?
MRITE ZERO.
AKOUNT
l ...
21 22
Have you already Hall did you obtain the harvested the i nsecti CI des? fields on IIhich the insecticides PRIVATELY ... I lIere used? SODEPAU .... 2
SATIIACI ••••• 3 YES ... I 50GB ........ 4 NO .... 2 SAPH ........ 5
ClOT ........ 6 SNDA •••••••• 7 CODPERATIVE. B OIHER PUBUC
MENCY ..... 9
2J
Did you obtain the Insecticides on credi t?
YESo .1 NO ••• 2
:~I -------- -------- 2 ---t------------- ---------
- IA3
IA4
24. Has your household hld Il.penllS for trlnsporUng crops during the put 12 .onths?
YES .... 1 D NO ..... 2 U2BI
2~ 26 27
for IIhlch crops? HOIl luch 1111 spent for Hall did lOU arrange for the
LIST THE CROPS lUTH transport ~f ... [ 1 ... in transpar ?
THEIR CODES. the put 1 lanths?
PRIYATELY ... 1 CIDT ........ 6 SODEPA~" •••• 2 BNDA· T · .. ·7
LIST All CROPS SEfORE SATIIAC ..... 3 COOPER TlYE.8 GOING TO 26-27. r-- S06B ........ 4 0lHER PUBLIC
CODE AKOUHT SAPH ........ 5 6ENtY ..... 9
1
2
f-- 03
----- 4 --2B. Has your houseflold bought sach, tlline or containers for i ts crops during the past 12 .onths?
YES .... 1 D NO ..... 2 0341
" -------29 30 31 32 33
For Mhich crops? HOIl luch lias s~ent for sacks l Have you already HOIl did ~ou obtain the sacks, Did you ohtain hine or conta ners for ... harvested the hine an containers? the sads, tlli ne
LIST THE CROPS IIITH ( l ... in the put 12 lonths? crops for IIhich and contal ners on .. THEIR CODES. you haught these PRIVATELY ... 1 CIDT ........ 6 credi t?
1 tels? SO~EPALII •••• 2 BNDA •••••••• 7 LIST ALL CROPS BEf ORE SA IIACI ..... 3 COOPERATIVE. B GOING TO 10-33. ~ V~S ... l S06B ........ 4 OTHER PUBLIC YES ... I
CODE AIIOUNT N .... 2 SAPH ........ 5 A6ENCY ••••• 9 NO .... 2 _. -lAI
11\2
03
4
[ .~! 1 NEXl PA6E
• NEill ~
tROP CODES:
COCOA ••••••••••••• 1 CDFFEE ............ 2 RUBBER ............ 3 COCOHUT ••••••••••• 4 Oll PALII .......... 5
BAHANAt·:. '1' ...... 6 FRUIT RtE:; ....... 7 MOOD •••••••••••••• 8 COLA NUT .......... 9
COTTOH ........... 11 PEANUT· .. •• .... ··12 TOBACCO .......... 3 PINEAPPLE •••••••• 14 SUGARCAKE.. .. • ... 5
CASSAVA •••••••••• 16 VAII .............. 17 TARO ............. 18 SIIEET POTATO ..... 19 IIAIIE ............ 20
~lfht'FÔNiD .... ·21 SORIiHUII ......... 22
VEIiETABLES ••••••• 23 OTHER CROPS •••••• 24 Al TOGETHER ••••••• 25
9D2
SEC T 1 0 H 9. ~-D.-FARli- 1 N PUT S (C-~-ii-T:-ï-------]
34. Has your household had exp entes for starage in the put 12 lonths?
yES .... l D No ..... 2 U3B'
35 36 37
For IIhich crops? Hall lueh IIIS spent for star age of ... [ J... duri ng the past
HOIl did yau arrange for star Ige?
LIn T~E CRoPS lUTH 12 lonths? TH RODES.
PRIV'lELY "1 CIDT ........ 6
~lliT All ~ROP, BEFORE ~Oil A\n •••• fi~llRATlvt:' A AC ..... o KG TO 6-3. r-- S~s ........ l PU lIC CODE AKOUNT SP ........ GENCy ..... 9
1 1-
2
3
4
3B. Hu your household hd expenlel for labor durin; the put 12 lonths?
yES .... l NO ..... 2 040' D
39. HOIl lueh 1111 Ipent for p.id lib or durln; the put 12 Ion th.? (Sinee .... '
AKOUNTII L.. ________ -1
40. HIS VQur houlthold hld othrr groducUon expen!ll!s durlnQ the put '2 lonths, such as for r,nttnQ antlàl., equlPltnt or I.ch net y, for llintenanee lnd rtpair of bu Idlngs or tachines, trrlgl iOn charges, fue olt, ehctrleity, other fuel, etc?
yES .... l NO ..... 2 U421 D
41. HOIl luch lias spent for III these other fan inputs during the put 12 lonths?
AnOUXTI 1 1
42. During ~he put 12 lonths, have l!!Iber. of your houuhold hten part in Iny euh.nge of unplld labor?
yES .... l D No ..... 2 (.441
43. HOIl uny lan hours of labor hll the haunhold rl!ceived in thls lIay in the last 12 lonthl?
If AN HOURS, 1 1
~~WEs: COCOA ••••••••••••• 1 CDFFEE ............ 2 R~BBERt ........... 3 C COMU ........... 4 o l PAl" .......... 5
BAHAMAS ........... 6 FRUIT TREES ....... 7 WOOD •••••••••••••• 8 COLA KUT" ........ 9
C~TTON···········ll P ANiT ............ f T BA Cu.
È ...... ..
PINE PPl ...... .. SU6ARCANE •••••••• 15
CASSAYA .......... 16 yAn
Ô• .. • .. • ...... 17
TAR ............. 8 SIEEl POTATO ..... 19 "AIlE ............ 20
~1~~u.FONiO ..... 21 SORSHUn ......... 22
YE6ETABlES ••••••• 23 OTHER CRDPS ...... 24 Al TOSETIŒR ••••••• 25
:=:::==:=:=:=::=====:
9D3
SEC T ION Il. [!! R l D. FAR" 1 N P U j-s -(C~j:-ï-~
44. Durtng the put 12 ,onths, has your household lIorked land as sharecroppers?
YES •••• 1 D ND ••••• 2 '.481
~~ 46 47
Ilhat crops lIere grolln? HOIl liny hechre! of ... [ ] .. Ilhat proportion of the harvest of
~AnR T~6D~I?PS IIITH lIere lIorked by sharecropping? ... [ l ... did you or IIi Il you
Qi ve ta the 1 andollner?
LIST ALl CROPS BEFORE CODES: 1/4 J/3
/3 14 !01N6 TO 46-47. - 1/2 Other (Speci fyl
CODE HECTARES
1 . 2
3
4
48. Durlng th. put 12 lonthl, hu your housthold alilld land ta sharecroppers?
YES .... 1 D NO ..... 2 n~21
49 ~O ~1
Ilhat trops IIlrI Grolfn? Hall 'rni hectlr .. of •• [ l ... Khat proporUon of the hlfvllt 1111 IIlrf e sed a IhlrtcrogPtri 91 ven ta the Iharlcroppen? PU THE C~OPS lUTH dur n9 he put 12 .ont I?
H R CODE. CODESc 1/4 2/3
LIST All CROPS BEFORE 1/3 3/4 SOlN6 TO 50-51. r--- 112 OTHER (Specifyl
CODE IIECT~RES
lAI
2
3
4
52. Are Vou storing sOie of your cropl, At the present Ule for consu.ption by your household?
YES .... 1 D NO ..... 2 0551
53 ~4
IIhlch cropl? Far hOIl long lit Il the qUlntlty nOIf 1 ored uUsfy
~In THE ~ROPS lUTH your hausehold', needs? Il R COD S.
LIST A\~ CROPS BEFORE 601N6 54. r---
CODE liEUS
1
,v2
3
':4
CROP CODESI
~~~tr""""'''~ RUBBER:: : : : :: : : : : : 3 COCONUT ........... 4 Oll PAL" .......... S
BANANA'1&l1' •••••• 6 FRUIT Ktt:i ....... 7 IIDOD. t •• t .......... 8 COLA !lU .......... 9
COTTON ••••••••••• Il P~ANUT ........... 12 T BACCO., ........ 1l P KEAPPLt ........ 14 SU6ARC~NE •••••••• 15
~~~S~~~:::::::::: ft TAR"t'"1t1t ...... 18 SIIEE ru ft 0 ..... 19 "AIlE •••••••••••• 20
~lf~,T FilNloN" •. 21 SORH" ........
YE6E AYlh1 •••••• ~~ arHER tROP:! ...... 24 Al TD6ETHER ••••••• 25
============:::===::::::
9D4
5 E C T ION '1. [fiT D. FAR" 1 N PUT S ( -Ë-N D 1 -1
55. HIS your household had lny contact Mith an agricultural elttension 1gent during the put 12 lonths?
YES .... I D NO ..... 2 (.PART El
56 57 SB
FOf Mhi ch crops? Hait I.ny Uln in the ~ast 12 Ilhat lias the reason for the last lonths Mtf! these afen 5 consul tati on about ... [ ) ... ? lin TH~ ~~OPS IIITH consulted about ... ] ... ?
T~ ReD • SEEOS. '~r' S' •••• 1 INSE~TI DE ..... 2
lIST All CROPS BEFORE FERT LI ERS ...... 3 GOING TO 57-5B. r- PRESERYA TI ON ••••• 4
CODE OTHER ISpeci fyl .. 5
. 1 -
2
3
4 --CRIlP CODES:
COCOA ••••••••••••• 1 COFFEE ............ 2 RUBBER ............ 3 COCONUT ••••••••••• 4 Oll PALK .......... 5
BANAHAS ........... 6 FRUIT TREES ....... 7 11005 •••••••••••••• 8 COLA IfUT .......... 9
COTTON ••••••••••• 11 PEANUT ••••••••••• 12 TOBAiCO.Ê •••••••• 13 PINE PPl ........ 14 SU&A CANE ........ 15
CASSAYA •••••••••• 16 YAn .............. 17 TftRo··,\·tAi· .. • .. 1B SVEET rD O ..... 19 "AIZE •••••••••••• 20
RICEËY' " .. 1·····,21 "ll tON ON SOR6HU"Ë" ...... 22
YE6ETABL S ....... 23 OTHER CROPS •••••• 24 AL T06ETHER ••••••• 25
==============:====:=
9D5
NOIl 1 1I0uid IHe ta ask Vou sale questions about the processing by your household of their trOPS ta lah produch for Sile?
1. Has any Iylber of your household, during the past 12 lonths, processed any of his/her crops for sale? For exalp e, by laking pall
l Deanut or ceconut ail, or pail 1I1ne, Dr attiékê Dr any other preduct frai
trops grolln by your househo d?
D YES ••••• 1
NO •••••• 2 0 PART FI
- --- r------------- -----------2
During the put 12 lonths, hu any Iliber of your household lad!! the follo"ing produtts frai his/her crops for sale?
PUT A CROSS IN THE APPRDPRIA1E ~OX FiR EACH PRDDUCT. AS RUE TlON 2 F~R ALL PRODUCls BEFORE 6 INB TO 3-7.
Peanut 1 pill or totonut ai 1 ?
Pail wine?
"illet, corn or cassan Hour?
~
3 4
For hall lan~ During these lonths in t e lonths~ hall uny ~ast 12 lonths ti les id thel iVe lelbers of seU ••• [ •• ?
,our houlehold ade T~ l .• for sa e.
TIllES 1 TIllE
"ONTaS UNIT
5 6 7
And hall luth loney Did they have ta spend Hall luch did ther dl d they usuall y I1Rey for production s~end in the pas receive eath Ule? a ••• [ l... For 1 lonths?
eUIPle, ta buy tools, tontalners, transport, labor, etc.
• NEU YES ... 1 PRODUCT
NO .... 2 1. NEXl AIIOUNT PRODUCTI AKOUNT
---------------r-----~r_--------'r_----T----_r--------'--_,------------~----------__, Bari and tapioca?
~-----~~----~~--------~--~ prled 'rullo or vegetabl es?
_____________ A-____ ~~ ________ ,~ __ ~ ____ ~_________~~_
ether products la de frai yeur. trOps? Specl fy:
~
----~------------~------------,
1 TillE UN Il: DAY ... 3 MEU ... 4 1I0NT" ... 5 QUARTER ... 6 SEllES TER ... 7 YERR ... 8 9E
SECTION 9.
Has any lelber of your household riÏsed livl!stod or poultry during the past 12 aonth5. (Sinte ••••• ?
YES ....... I
1(0 ........ 2 n PART J) D IF TKE ANSIIER TO 2 15 YES, ASK QUESTIONS 3-4.
2
Durlni the put 12 lonthl, hll ur liber of your hou,ehol d ra sed ... ( l ... ?
P~T ~ ~RO,~ IN THE APRPIA 01.
ASK QUESTIONS 2 FOR AL~ ANf"ALS BEFORE 60 NS 0 3-14.
CattleJ. lncludlng COIl5?
Chidens?
1
3
Are an, luber of ~our oUllhoid railln; il the J •• ~resent ile?
YES ... I
110 .... 2 1.6)
4 5 6
HOIl liny If ther lIanted ta Ourtn, the •• ( l .. 5el1 a 1 thes! pli 2 do you ... ( l ... today, lonlhs, hav! havI hOIl luch lonly lelbers of nOM? -nid t~e1 receive ~oïr hOïse-a oget e ? o d 50 d
rny'}' ... ?
I(UnBER YES •• 1
AT THIS NO ... 2 TIllE AIIOUNT n9'
7
HOIl IIn1 ... ( ... hue they soId?
NUPIBER SOLO
B 9 10 11 12 13 14
HOIl luch Have Any HOIl lan1 HOIl luch dld the~ 11011 IIn1 Hall IInI Hall IIn1 al together have leabers of .. ( . pala~ toge her f r ... ( ... wirr ea en' ... ( l" the, recei ved ~our house- did they al t e "i( l .. ure barn IIIrr 101 or fro sales of old bought buy? they bough durini or n~!ived bl he Ito ,n
l Viven
... ( l ... any ... , l th!! past 12 lonth ? • 'b'f of ~~r~g~t~~~ pa5t t&ê d~~ln~2 3~rl~~ tlhe ~grr OUle; ;:crUli~3r lontCs ~~~thS~ pasf ~ ur ni e
pu ~ (sinee ... )? lonthl. lonthl. YES ... 1
HUIIDER NUIIBER NO .... 2 NUIIDER BORN OR N~R'~D ~iSIAcll~~Uo AIIOUNT U12' BOUSHT AIIOUNT RECEIYED
Oucts, turkeISt gu-I nea t 0111, P geons 1----11{) ïiiiim1iïïiüiiiïtiiiiliiiiiiiiiiiiUiïlimiïiiiïïïUliiïiïïiïiiïïïtïiiiïïiïiïiiüiDtiiiimiiïiœtïiüiiiHllïiiiiïüïiiiiiiiiiiiiifiiiiiiiiiiiiïtiiiiiiiiiiii1lniiiiiiiiiiiil or othl!r pou (ry?
Rlbbits?
Othl!r anilals? Speclfy:
I·NiXT
1 A I"AL
9F
SECTION 9.
1 PAR T 6. ANI" A L PRO DUC T S ]
During the p.st 12 lonths (since ..... 1 have any lelbers of your housenold sold .nl ~roducts obhlned frol their .nhals? For eXaiple, .i1k yoghurt, eg95 or .hned ski ns?
YES ••••• I
KO ...... 2 n PART HI D
Durini the p.st 12 lonths, HOll lueh has your household haYe her sold .ny ... J ... J ... rece!ved frol the SIle of J ..... ) frol the r .nillls? in the pllt 12 lonths?
(Sinte •••••• 1
PUT A CROSS IN THE
~ ~ NEU PRODUCT 1 APPROPR~~TE ~OJ BELOIIS ASK 2 F AL RODUCT BEFORE SOINS TU 3.
AlfOUNT
1 "ml 1 YEN 4-NO II~
Yoghurt, dêguê, thelsl?
1 Egg.? 1 YEN 4-NO II~I
Ir""d .klns? 1 YEN
4-NO II~I Other Inllal products?
5--Speti fy: DIIIIIIIIRHOlDllllIDlnnl1
ŒIJ I·PART iJ
~RT H. "UTUI'IL 1'110 FOR LIIJESTOCK ]
Have the lelbers of your hou$ehpld taken oart in an exehange of unpaid 1 abor for raising !vestod ln the past 12 lanths (sinee ...... I?
yES .... I
NO ..... 2 U3' D 2 HOIl lany undays of labor has your houlehold reeeived in tM! lIay in the
1 ast 12 lonths?
IfANDAYSI
HIS a luber pf YO\lr housl!~old hld Iny tonhtt lIith ln aClent of SDDEPRA Dr any other Ihestod extension .;eney durin; the past 12 lanths (sinte ... I?
YES .... 1
NO ..... 2 1. PART Il D HOIl IIny leetlngs hlve you h.d in the put 12 lanths?
NUIIBER OF KEETlM6S:
[------------- -;-l ~~~~~ __ l~_~_O C K EXP END 1 TU R E~
IF THE ANSIIER TO 2 IS YES, ASK 2-31.
1 2 3
ln the put 12 lonths (sinee ..... 1 HOIl 'Uih lone~ hne rll the lel- Khere did they obt.tn thls has a lelber of ~our household bers 0 your ouseho d S~l!nt on ••• [ I ... ? spent loney on t e follollin~ i tels ... [ ] ... in the pas 12
PRIYATE IfARKET ......... l in order ta raise livestock. lonths?
~ (Sinee ..... 1 1lI,!=1!~::''':':::: :1
PUT A ~R~SS IN THE 8J~~ J~lflë i~~~~l:::: APPROP 1 TE OX~ ASK 1 FOR All ITEH5 B FORE
1 • NEil EIPENDITURE 1 SOINS TU 2-3. AlfDUNT
YES-:~ __ I_I rreed. I.ct'dl', ni t?
e'!"I."y .. nlt .. ?
1 YES-I _ 4-NO
1 YEN
InllOtul aU ons, ledicines .nd th!liCiI t--;:;m·m~D;-iüi __ mi __ iUiin.;;;t __ ;m ______ iftiI produtts? RDDmnlllllDIIIIIIIIII IRlBRI .... RfiiiRiMIHIIII
Transport of anilals, feed, or supplies?
[COI;' ssi ons on the sale of aniuls?
----COlpensation for d'lage YES-.~ 1 1 caused by aniuls? B &--______ 4-NO nlmIRIII.RIH.llftllmRIRD nmIlHRIRIHRIMIIII~
uaCkaQ'~~f7n, iii an i uI and pou 1 try 1-----I09;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;t;;;;;;;;;;;;;;;;.;;;;;;;;;;;;;;;;;;;I produtts_? ___ --L ____ .L..~III ___ m_R_I_I._n_ID_D_'I_II_D_n.;...l_m_n_I_'~I_IHI_D_._n~n ___ IDI~I_nn~iHi..;:....I_RiillU~-..
Other expenses for r.ising livestatk and poul try?
Speti fy:
YES-. 110
1 1 4-NO 1.IIIIIHIIIRIDlnnnnnmnml.DDHIDIR.DIRI.iHIRlIR.R. ~,. _____ ~ ____________________ ~ __________________ -d
• PAR T
9G 9H 91
SEC T 1 0 If 9.
Hall uny of the follolling tools are ollnl!d by nlbl!rs of your household'
1 Hoesl D 3 "achetn: D :5 Shoveh: D 2 Axes: D 4 Ptdsl D IIheel- D barrollSl
SEC T 1 0 If 9. 1 PAR T k. FAR ft 1 If 6 E QUI P " E If T
1
Durlns th. 'lit 12 IOnthl (stne .... , has Any Iflber of rour household olfned I ......... ?
~~JR~p~f~n inl~KE
A~R;STlON 1 FOR All ~ 1 NT BIFORE o 0 2- 1.
SpraYir and/or fogQfr?
Veh~cle for fan use.
Draft bullod?
Othrr fQu,pllnt or Ip ilthts?
(2] I 1
! 1 V
IF THE ANSIIER TO 1 IS YES, ASk QUESTIONS 2-11.
2 3 4 :5
Dots Iny r~.~~~J IIblt ~rtfe ffuld HII Any I!lber of they e a luber of ~our do the these ... ( J ... ~oïr ~ouse-ousehold l!!Ibers for? o d ought Olm 1 of your
b'(he Rak ... ~ J .. hH~e-nOIl. hy olfn lont .? a D-gether?
YES ... I YES .... I
N~Bj'2 tftIftBER KO .. ê,,2
OIiNED AIIDUNT (. 1
IIRITE THE IlU"BER FOR EACH JODL IN THE BOl.
f!PART-k-]
6 7
HOIl uny HOIl luch did they ... ( J .. ,ar al toge her have they or these bought ... ( J ... ? al together?
W~BER 6HT AIIOUNT
-
B 9 10
Has Any Hall unJ HOIl lueh f{d thgy lelber of [ ...... recetve 1 oget er ~our hoyse- hav~ the for the ~ale of old 50 1a lei ers of III of t ese
Ir lhl Rail' ~or hOï3e- ... [ J ... ?
af ~;:fhlr? lont 1.
YES ... I
If~Hli2 ,~r~R AIiOUNT
1. END 0 f SEC T 1 0 If
Il
HOll luch lonu dtd ~our hOUrhO Irn by ellt ng
1i;.In~ th~'lllt la th.
I~Q~I~kNTI AIIOUNT
9.1
9K
NOll 1 1I0uid likf SOif InforllUon Ibout th, tndes, bU!jinesses, industrleSA
grsfeSSiOntl service5 Ind other self-ell!lov.ed ICtivitin of the te.bers of your household. Let us begln Mi h ... ( "AilE OF ENTERpR SE J ... , Ilnaged or aMned by... ( "liE F BEST - NFORIIEO PERSON]... IS HE/SHE AVAILABLE TO ANSIIER QUESTIONS?
COIIPLETE THE IIHOLE SECTION FOR EACH ENTERPRISE
BEFORE BOUI6 TO THE liEn.
1 PAR T AIl" FOR Il A T 1 0 Il
UPERYISOR= 1
~ Il A Il E OF THE ENTERPRISE
T
1 ~ E
IF THE RESPOIIDENT 15 NOT AYAILABLE, ASK ABOUT
THE SECOND AND THEN THE THIRD ENTERPRISE.
2
Il A Il E o F THE BE5T-INFORIIED
PERSON
1 COD E
IIAKE NEil APPOINTIIENT5 TO SEE ALL THE
RESPONDENTS NOT AYAllABlE.
3 INTERYIEilER
15 THIS THE PERSON ACTUALlY INTERYIEilED?
YES ... 1
1 COD E 110 .... 2
~1,1 ________ ~~ ________ ~li~ ~ ElL-L--=--=--=--=--=--=--_-_-_-=--~~ _-_-_-_-_-_-_-_-~---r-~---'ii a--~
I~JI========~~========~~II~ ~
IOAI
-4 5
HOM loni Do ~ou or the har hl le. ers 3f your en erpr~St hïulehol olln (etc. t etn i 1 of thi 5 ~~C:~lSt- enterpr 1 se?
YES .. 1 071
YEARS! IIOS. NO ... 2
EJ-l 1 [il 1 1
[~II 1
16
ODes the enterpr i 53 occu~y Hxed preliser or oe5 i love frequent y?
FUED ........ t ITI NERANT .... 2
---r-.-----6 7 8
"hit Durini the past 12 lonths ~urin~ the ~u iercenhQe (sine • ï ..... I' hOM IIny n t is en er s ollned by perso~5 a to,et~er hue anyone 1 n Cl5h
you and the Marke or he pe in thi5 Und, to lIork lelbers of enter~r,!ie inclufini Inc1udiva I!lb ~our lOurs l , ~ouseho d elbers househo ? oU5ehold? nd others, paid or not?
YES ... 1
PERCENTASE PERSONS NO .... 2
17 19 19
------r-------~------_r_--------I
10 11 12 13 14 15
t 12 lonths HOM unr workers Is there prue paid lCere pa d during a union or in the put 12 in this
here? lonths? enter-ers of your prise?
0161
IF FEIfER THANl 6 PERSONS .~
YES .. 1
NO ... 2
Does thi s Does i t. ahe Qlles it pay ODes this ,nter- Khen the IIPloYt'e!j of thi s enterprue thel pull Its prise pay the enter~rill shtted !fork, ghe Us sick luve? .. ployees legal Itnil!!1 did t ey rlgn f çontract el~loJees retirélent wilge ra e (5"161? spec Ua y 1 aUng paad eave? pensions? MaQI!' fnd Morking
colldlt1ons?
YES ... 1 YES ... 1 YES ... 1 YES ... 1 YES .... 1
ND .... 2 ND .... 2 HO •••• 2 NO .... 2 ND ••••• 2 .~---~---
__ L _______ h-_______ ~ ______________ __J -rT--r=r=..L---[ ~ ______ [1 1 ]_~,_~------"
-r-l-- _1 -J ~ ------,--1 --L--_ _II
-20 21 22 23 24 25
For hall lan~ Has this Since Iy last visU, hall Sinee Illirt visit, Ilhat was the value of Since Iy last visit, Ilhat lias the HIS your enter~ri se lIie Hall luch dl1 xour Inter-lonths dur i R the enterprise luch has the enterprl se hrs thi en erprise these ~aYlents since have anr of this nlue of the lore Sller or enr Si es prise Ilh r 1 the sale p'ut 12 lont s ~een 9perat- recei ved frOI the SI e of i so recel ved Iy las visit? enterpr se' 5 ~roducts products slnce Il ut Yisit thln of 100dS or serviCes Isinee ...... ) 1115 InQ Slnce i ts products, goods or plylent! ln the fOrl or services b en conSUled or !lsed in the ICO lII!ets before d~r nI thl Illt Wt!ets the enter~rise in Ir 115t servICes? of 900ds or services? consu.ed or ysed br b~ ~our house- that Yi5it? 1 lia in o~entlon, operation. v sit? your househo d i ns ead h 1 since Iy inelu in; t e YI ue Df
of being sold? lut visit? IID~~ SINCEË"'~ plYlenls ln Und? IIF 12 1105., YES ... 1 FE R INC ...
1 • PART 9 1 • 19 YES ... 1 YES ... 1 1 • PART 1 ND .... 2 9
1I0NTHS 1.251 AHOUNT NO .... 2 U221 AIIDUNT ND •••• 2 1.241 A"OUNT AIIOUNT
lOA2
SEC T ION 1 0 • [~~~=~~--Ë-i-p-EN-ii-ï~T-ü-R-Ë-5-]
r---------tL~IRST ENTERPRISE .-1---- --l,-------r~~[ON~TERPRln----------l
l 2 3 4
Dyring the ~nt '2 lonths, The Int tile you Hait oHen do Do your d1d 3 ur en erpn se Caid for ••• [ J. you piy for household (~ri et industrt, profes- 011 luch did you ... [ ] ... ? or other non, etc.,) ta e any spend? business-exyendi tures for the es be-fa 101lin9?
~,c~~~~rfiT~H~N VALUE 10n,ing
;~~R~pfi'R'~ IRx !HE ~~9 ~euse
1 KIN. t lS •• l.?
YES •• l
COIIPLETE 1 FOR All NO ... 2
~~~~fi ,~F~~t A"OUNT TI"ES 1 ~~n h~f~~IT.
1 1
YES-. Transport? "
_ .-NO
E 1
YES-. Fuel? ___ ..1." ___ .&--_______ ~_~_-'--_~ ._ 4-NO
YES-. - -----r--r-l---l 1-_------'---.--No---&~iulDllDllmm}UüîilBBij..-J
§] 1. NEXT PAGE
-,...-------r----1 2 3 4
During the ~ast 12 looths, The 1 ast ti Il! you Hall often do Do your did your en erprise (trade, ~aid for .. [ 1 .. pay for household i ndustry t p'rofessi on, etc. 011 luch did vou ... [ ] ... ? or other lah expenai tures for the spend? business-follolling? es be-
lonying .. I,[LU~IN6 THE VALUE a he
~~~R~P~'~'~ IR X !HE o PA "ENTS IN hhl'ld use
1 KIND. th1s
"t[ l? y S •• I NO ... 2
COKPlETE 1 FOR AlL
TI~~. ~~~, f&E~~4~EFORE GOINS A"OUNT h'U~IT.
L-___ --'-~-__ -_. __ -_--I-IL....~~ 1. NEil PA6~
,--------L THIRO ENTERPRISE -,1-------..
1 2 3 4
Duri ng the 1 ast 12 lonths, Thr lad ti le you HOIl often do Do your did your enterprise (trade ~a d for ... [ 1. xou havr hOU51hoid industry, p,rofession, etc", 011 luth did vou xpendi ureg or other lake expenai tures for the spend? for ... [ 1 .. business-folloMing? ? es be-
lan,ing INCtUDIH6 THE VALUE o he
P~T CRO~S IN ~HE ~F AYKENTS IN ~~~sr~fld A PROPR ATE B X.
1 IN •
otE' 17 y .. 1
fl~~~:~~F~R~O~O~~~ NO ... 2
A"OUNT lI"ES 1 ~~n h'U~IT. _.
~_~5_f_or_ .... IL--YE_S-_: __ NO---lI~ij ...... n,;;...l ...... m~l ...... n ...... m~ilid~.a.;;I-~...;...L.I-~ ___ IL..IIIIIIIII_---,1
Purchase of equi glent, blltldlng5 land, vehlcles t lath nery7
YEN 1... 1 1 1 1 4-NO .DnmnnmlnnllRllllnnml ....... J
RentaI of egui p- YES-. L 1 1 1 1 r:~~: ~~M~I~~!' 4-NO • • dnlniRlIDIIRIIIBIIIIHIIIBIHRIIIIII tathlnery7
IEI'd'lCIIYl
~I::::! ~ 11! 1 1 1-1 4-NO DHIDnmnnnt I11IIIliliiii1IIIIIIII --- --
1. KEIT PAGE lOB
SEC' 1 0 Il 10 ..... [ _P _A_R_'_C_. __ C_A_P_I _, A L A N-D--I'N~E"T-ORY~]
r------tl FlRST ENTERPRISE
Do" your tnhrprhl Itr.d. industry, Ifh.t ~ri~e eould you lell proftilion, etc. 1 olln th! follollln; this ... ( 1 ... for tod.y? Hus?
PUT Il CROSS IN 'HE APPROPRIAlE BOl. ..
CO"PLETE IIt1ESTlOM 1 FOR ALL ITEftS BEF ORE 601N& TO 2.
Buildln;s .nd IInd1
V.hieles '.utos, trucks, ~t~l~ 's, scoot ri,
TooU~ eq~lpllnt, Ile Iry
~thlr durlble Qoodl or runnlng lour
Intnprile , te.l?
1• IIEIl 1 nE"
YEs-l l-
I-NO _lIB_Inn YEs-l
l-tiO inm __ onn
YES-l 17
1-1(0 IIHOdlllll __
YES-l
1-1(0 In_IRH • NEll ENTERPRISE
I--~ SECOND EHTERPRISE 1------, _.--.----._-----------~--.------------~ 1
Do!s lour Interprile (tridi, indus rI' profession, etc.) olln the fol olllng HIlIS at this tile?
PUT Il CROSS III THE APPROPRIIITE BOl.
Buildings Ind land?
vehieles (autos, trucks, ~IU~ 's, seootlrs,
ToolrA tqulpunt, Ilch ery?
Othtr dur.blt ~îodl for runnln; your t tr~riSl (ete.1
YEs-l
1-110
YEs-l
1-110
YEs-1
l-NO
YEs-l
l-IID
Ilhat priee tould vou stll ail these ... ( 1 ... for today?
15
IlnIRlmIUU_
lii.nllnllDlllllm
17
IOI_I.IIB
lB Im_UnDlO.
,. tiEll ENTERPRISE
TlftE UNIT: DAY ... 3 IfEEk ... 4 ftOIlT" ... 5 IIUARTER ... 6 SE"ESTER ... 7 YEAR .. O
THIRD EIITERPRISE
Do.s lour enterprhe (trlde, Indus ry, professionJ Itc.1 oltn the follolling 1hlS at tnis tile?
PUT Il CROSS III THE IIPPROPRIATE BOl.
tO"PLETE IIUEST ION 1 FOR AU ITEftS BEFORE &01116 TO 2.
Whrt priee eDl,lld vou 1111 .1 thtst ... ( J ... for tod.y?
Il"OUNT ~.----------_.-------~-------------~ ------------.--.---r-----------~
60Dds not yet sold? t---,...--t1 4---------t
Idings Ind land?
vehicJes (.utos, trucks, YEs-l ~l~,~ 's, scoohrs, 11-1~a;~_iiiiïiiiiiiiïiliiiiiiiiiil
l-ND I_Bi YES-Tooh) Iqulpunt,
.. chinl!ry? J----.---f1 7--------t
-NO
Other dur.bll! goodl for YES-runnln~ your enterprin t---,...--tlB---------I (etc.l.
-NO
1 • EIIU OF SECTION 1
IOC
( 5 E C T 1 0 Il 1 1. E 1 PEN DIT U RES ANDIN YEN TOR Y 0 F DUR A BLE 6-0 ii 0 =~ 1
r~::::::: -------------------------------------------------------- ID CDDE,
rI MTERY 1 EliER
IS THIS THE PERSON ACTUAllY INTERYIEltED? YES ••• 1 NO •••• 2
1 PAR T A. DAllY EXPEIISES
Sinu .Y IJSl visit hlv, thl .elb,rs of Ho; luch hll lour hausehold
rour househo d spin! anytMn; on thl follalfinQ Ipent far •• t J ••• since teu? IY lIst visit. .
PIT A CROSS IN THE RDPRIATE 801. ASK 1 eSTlON l FOR ALL ITEftS
B FORE 60 NB TO 2.
Food Ind bevlflQel eORluled INly frai hall?
CtQlrIUII, toblteo, coh nuts?
COllercid or hall-Ilde loap?
DI D
ot~r Dlrlllnd Clr, Ind hlal th pr ue t 1 (toothp IStl!, IhllpOO, t--;.:;;-1 f;~1 0~4 ;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;1 .te 7 nhiillHUlRHDmlRDIBIDD
Hall Illntenlnïl irodueh (broo", dehrQents, to le paper, etc.)? dii.lm.lllnmnnIIWnnIDI
Charcoll? 1-----11-106----------1
IIWmmnnmUlllnnmlDl1
1 Wood'? I_IES-' 1'- 1 _ _ 4-No[dihummIDDDHIIIRIHlnn
108 mmnmlmmnnllRlHRIIO
le ... IIOI "d IOtor .111
• PART 8
1 FOR CALCUlATlONS
lIA
SEC T ION 1 1 • 1 PAR T B. A N NUA lEI P ~~_S_J -----
IF THE ANSIIER To QUESTION 1 IS YES, ASk 2·4.
1
HaVI the lelblrs of JOïr houlehold . n,nt lonly ffr the 0 IOllini
el. durlnQ he put 12 Ion hs
~ ftpiRill j"XTHE CO P ElII ~ AlL lHE hEflS B~ ORE 60lN6 o 2-4.
Shon for adul tf? Heather, phsl cl
Ch 11 dun " rholr? (luthlr, p ut cl
Ooltltle Dr ilporttd pagnes~
Fabr!c for Idult clothlng?
Frbrle for chlldrln'I c othll?
Adul t cl ithinO? 'It! hl rltllll{ prjllll, undlrc 0 hll, 1 e.
Ch11dren'l ClothinQ? (Iulh, Ihlr l, etf.I
~
2 3 4
Sinet I~ lut HOIl luch did th!!y ~Oll luch did viii 1 IVI! he sp!!nd? Dunhold 1!!lbRrs lub!! s of the f~end on TI J ... household spent the las 2 lonry on lonths? ... J ... ?
YES .....
HD ..... 2 '.41 AHOUHT AflOUNT
Purchlle of Clrs, bleyclll, or other tunl 0 t-7-im1t.liiiiiiiiiiiiiiit.iiiiiiiiiiiiiiiiiiiiifiiiiiiiiiiiiiiiHiinml tranlport?
Public transport, hxh, etc. ?
~ote repairs{ ollnting, Insurance, I! c7
BOOhf
nohbooh and other schoo supplies?
0lhlr Ichool ,xpelll" ( utt\on, ItcolltodaUon, 1 c.l.
"'dlçlnll (lOd,rn and tradl 10nall?
"Idlul ItrVI,II, IUl;h Il dpdor or !l'fl Ir! Inll other Itdici expenlll?
Ki tc:hln TQ\I',,"nt (CU". fort.~ p .tl!~, lIuclplnl, etc.l. &-__ -Ul ____ --'-____ _
Have the lelbers yf rour househo loney for the fol 011 ng i telS du
'Id spent ring
the put 12 lonths?
PUT A CROSS IN THE APPRoPRIATE BOX. CO"PLETE 1 FOR All THE ITEKS BEFORE 60lN6 TO 2-4
0 !
_. IF THE ANS 11ER TD QUESTION 1 IS YES, ASK 2-4.
2 3 4
51 nCf Iy Jart HOlf luch dl d they HOlf lueh did the v Il havf h' spend? hou!lehold lelbers le.b'~1 a th, rcln~ on TI J ... hOUle Dld spent t ,pas 2 lonry on lont !l1 ... J ... ?
YES ... I
NO .... 2 U41 A"OUHT AIIOUNT
r----------------'~------~r--------~----------~----------_,
--------.....--
Il ... 1 ry. ..Ich .. l
Enlerhinlent1 (novels, nellspapers, cinen, sports, recards, tapes, toys, etc.
TaUI Hncluding PDCII?
Rei.burselent of loans and
lnterest to bank5 or other enden?
lIeddi ng5 and dD.ri es?
~~I-I--I IOlher nup"",l
_ Specify:
Havi thf Iylbrrs of your househo d 05 loney during the past 12 lonths?
------------- -----
YES-.
HID ------
HIVI thrK 10lt rOlf ~uch di d thly HCHf Irch ~ld thrY lonry s t~ Iy Olt. 1~1t n t 1 pli ~n.lvlaL2U4) 1 .0ntU~
A"OUtfT UNT
14:1 IDlDIDlIIIIII .nOID •• na_ RRlRhH.Rih.M ----------------- ... _------- --------------
llB
1 • PART
--------------INSTRUCT IONS:
~~~ ,n~HFM~Rwl~6 TU~E~n~N~ELON, Do the lelber, of your household have (TYPE OF 600DI?
PUT A CRO~ IN THE APPROPRIATf BOX FOR EACH J~~"ilHlm T~T~~SauTIIT~h, A,~A~~hTI~~"l.
Do the Hlbers of your houllhold hue ••••••
ilE" CODE YES NO
Sewing IIthines? 201
6u dovlS? 202
Refrigeratars? 203
Air condi li anerl? 204
Fans? 20~
Radlol? 206
Radlo/casseUn playen? 207
Phanoqnphs? 208
Stereo equiplent? 209
TV lib? 210
Bicyclll? 211
"obylett .. ? 212
Car!!, other vehi cl es? 213
r------- -1 2 3 4
Plea5e describe ail the .. [ J ... ln Ilhat How luch did vou If JOU IIanted to ollned by telbers of your househol d. year did ~~
r--
0 R
~ R
SEC T ION 1 1. [p ART D. E x -PENSË S FOR RE" 1 T TAN C E S~]
1. During the put 12 lonlhs has Iny lelber of your household sent loney or 1I00ds tQ persans ICho rre not lelbers of your household? For exuple, chilliren Cr relatives living e sellhere, or ta other persans.
YES ..... I
NO ...... 2 n SECTION 12) D NDII 1 1C0uid like ta ask you sale Questions about the persans ta whol the luben of your household send assistance.
PUT QUESTIONS 3-7 FOR All PERSONS LISTED IN 2.
2 3 4
Ilhat Ir! th! nales of ail th! Ilhat is the relationship. of Mhere does he/she ~ersons ta 11h01 leabers of your ... If AilE] ... to the heail of the live? 15 it in ..... ? ou,ehol~ hav't snt ISf~ s;lnce household? unng e pas Ion 5.
HU,B~HD/IfIFE ••••••••••••• ~ CH l .................... READ TO THE
~~Sl_,~l MAllES BEFORE 60lN6 FAr! UR "111!!' .. · .... j RES PONDENT : S! TE DR B T ........ N C DR H H ••••••••• ft ~ity ............. 1
IF TIIE RESPDNOENT DOES NOT VISH S /~AU6HTE~-iN-lAw •••••• 6 A olln ... '1'" ..... 2 T~ 61YE HAllES, NUIIBER THE BRDTHERIS 1 STi~-IN-LAV •••• 7 ft larye vi lage .... 3 P RSONS. PARENTS-I N-l ê'll" ....... B ft s.a 1 vil age .... 4
DT"E~ RELAJIYI F THE ft ca.p ............. S HEA DR S OU E .......... 9
OTIIER PERSON, NOT RELATED ........... 0 .... 10
NAKE
5
In Ilhat re~ion is this place.
SOUTH .......... 1 SDUfH NEST ..... ~ CEN ER .... ft .... N~SJ CENTE •••• ~ Il 5 ........... EAST ........... 6 HORIH •••••••••• 7 IIAL .... F ...... O BUR~INA- ASO ••• 9 lUI EA ........ IO HANATRii:A"ll OTHER F ••
FRAHCE ........ l OTHER COUNTRY. 14
6 7
Hall luch loney have 15 part of .eabers of the this hgl,lSehOld seot 19 fS5~stance'd t If ~~rsont~n e fiS Ion s, g ~erepal ncludiny the value le.bers of
of contr butions in ~oïr house-hnd? o d?
YES .... 1
NO ..... 2
Il. NEIT 1 PERSON
AKOUNT
16 Il L __ [ L" ,--,---J, 11----11 -----,-, r=r-' 1 1
fal--------] "---l T""" 1 ---=r=J El Il 1 1 Il ~
.SECTION 12 110
lS-Ëc-Tl-ii-II-12-~iiD---eiPEN-srs A Il D H-ii:~:T-p-R 0 D U ~_ T 1 0 N . J [PART-A. F 0 0 DEI PEN SEO
1
Durin~ thf ~lSt 12 lo~th~, have the le.~e s a our house 01 bought any of he f01l0MIng foods?
PUT A fiROU IN THE APPROP lA BOX. CDIIPLETE UUESTIDN • FUR ALL FOODS BEFORE 60lN6 TO 2-6.
Rice?
"fhe Icob, grain or 1 our)?
cp
------------.-"Blet, fonio, sorghui (grain or flnur)?
r~ rttiêt61-
ICi!isavaJ -;;.; or in a lori other tnan attiêké?
1 YES-t 4-NO
1 !EH _ 4-HO
- -------IF THE ANSKER TO A 1 JS YES, ASK 2-6.
2 3 4
Hfve the .elb~rf HOlf luch did they Duri~i hOM lany o your house a d spend? Ion in the ~ast bought ••• ( ) .. 12 lonths did he any sinee Iy last lelbers of your visit? househol d bU~ . .. [ ) ....
YES •• ' NO ... 2 1.41 AIIOUNT IIUNTHS
~-~-?------~------_~~lhL----------~--------.~.-------, ~eanuh Irolshd, rail l:r butterl?
Other seeds Inocfdo, coconut nérê oulêOU t, t----u pUI~kin, Iresh/drieol?
Fi sh Ind she 11 fi sh?
1 --. CONTINUED 1
--5 6
Dur l ni these Hall Irch did they Ion h , hOM often usual y s~end did they usuall~ each hie. buy 1 ......... 1.
~r ] FOOD 1 TIllE --
TIllES UNIT AltOUNT -'--------
rUPERYISOR.- -
::S::::NI 1 -0---------------------------------------------------1 r:INTERYIEKER
15 THIS THE PERSON ACTUALLY INTERVIENED?
[--
DAlt. ...... 3 ifE " ...... 4
UNIT UF TIllE: IIUNTH.,. ... 5 QUARTE" ••• 6 SEIIESTER •• 7 YEAR ...... 8
-----
YES ... I NO .... 2 D
12Al
Durina th, put 12 lonth" hue th!! 1!!lb", of your household purchased the folloNing foods?
PUT A CROSS IN THE AP~RO[RIATE BOX. CO PL TE QUESTION 1 FO A L FOODS DEFORE 60lffS TO 2-6.
Gale (anitals or birdll?
Chlckln, duck pigeon turklV, or ot~et paul lry?
~, luttonl ClOlt, park, l~r dOlest clted l!!It?
" Chlden eggl?
Pall ail and shea butter?
HlVe the I"bers HON luch did they of your household spend? bt;)ught anr ,,[ J Slnce IV ut visit?
YES .. 1
ND ••• 2 041 A"OUNT
Durina haN uny During these lantht in the put lonths, haN oHen J2 lonths did the did ther usually the lelbers of your buy... J ... ? hausehold bu~ ...( J" •.
KONTHS T1HES
~--------------~.----~~----------------.--------~--------
Reflned oil (pl.nut oil, DINOR oil, etc.l?
Buttlr, IIrglrine?
Suoar, undies, honey, sugarClne?
IS'ltl ____________ I~ ____ ~ __ • __________ ~ __________ ~~ ________ ~~ ______ .
HON luch did they usuallr spend euh ile?
~--------------,_-----~r_--------_r-------------~-----------,_----._----r_-------
~ DAY ••••••• 1 MEEK ...... 4
TI"E UNIT: "ONTH ..... 5 QUARTER, •• 6 SEHESTEn •• 7 YEAR •••••• 8
• PART B
12A2
1. During the past 12 lonths. have the lubers of your household !!ahn foods groMn or r al sed bV the househol d'
YES ..... 1 D NO ...... 2 (t SECTION IJI
--IF THE ANSNER TO 2 IS YES, ASK J-5.
2
During the put 12 lonths, hiVe the "'Ibers of your household eilen ... [ 1 ... that lias hOle-produted?
PUT A CROSS IN THE CD APPROPRIATE.
,~~~~U~~1~~~S6~1~~R All
"rhe (tob, Qrlln or f ourl?
"illet, fonlo, 50rghui (grains or HourI?
Crsuva (rall l shrch, f our or driedl?
L_,
1 1
V
J 4 5
During hOIl HOIl uny Ules during HOIl luch 1I0ul d it unI lonths these looths did they cost to buy the in he ~a5t !!It hOle-produced alouot they eat 12 10~t 5 ... [ 1 ... ? euh day? have ouse-hold Iglbers ealen Oll!-produced ... 1 1 .. ?
KONTHS TlftES 1 TI"i UNI AIIOUNT
----t CONTINUED
During the past 12 lonths, h lelbers of Vour household ea ••• [ ) ••• that lias hou-pr
PUT A CROSS IN THE APPROPRIATE BOX.
ave the ten oduced?
0]
1
IF THE ANSIER TO 2 15 YES, ASK 3-5.
3 4 5
Durini hOIl HOll IInX Ules during HOIl luch KOU! d it "or onths these 1 nths di d cost to buy the in he ~ast theX !!It hou- .Iount they ut 12 lont s pro uced ... 1 1 .. ? euh diV? hAYe the lelbers of the houre-hold ea en hOI!-
~~~fuced1 •• ?
IIONTHS 1 TlII~ TIllES UNI AKotINT
, __ ----.11-, _YE_S--:_-NO-lfIIHlumnnI_I __ I_1 Beef ~ luttan t i°lt • pork]YES-t Il 1 1 1 1 other dOlestlc ted leat? --4--NO-l ülmnlDllIIIIIIIIIllDDRlllliHii.H~·
[Ë99----------~-- F-1::~ ________ ~m.....m.I~~-1 Pail o~l and shea YES-t I---I-~-~ ~ buller. _-~~_I_lnn __
-~~~ Fruit (oranges, tangoes, YES-t "'dari' .. , P'P'Y", ,le.l? - 121 1 1 1 1 4-NO mllUIOn 1111_m n.mm nnnnlIIIIImI ------- ---------:=:J--Sugarcane? YES-t
~~I-I-I
1 YEN 4-NO
E DAY ••••• ~3 NEEK ...... 4 TlKE UNIT: KONTH ..... 5 . gUARTER ... 6
SEftESTER •• 7 yEAR ...... 8
---------
ItSECTION 131
12B
(SECTION IL FERTILIff] I~-SUPERYISOR'===~~~~='="=~~==I
~~r~C~~D~H~_~~~~~ __________________________________________________ ID CODE: L~
r=INTERVIElfER
VAS THIS VOftAN PRESENT DURIN& THE INTERVIEII? YES ... I NO •••• 2 D
1 1C0uid lih to ut you sOie questions about your pregnancies and ail the children you have given birth ta.
1. Have you ever been pregnant? Even though the pregnancy h5ted only a hll lCeeks or .onths?
YES ••• I D No •••• 2 '.22, NEil PAGEl
2. Have you evtr given btrth ta a chtld? Even though the child lived only a short the, for eu.ple a lell linutes or hours?
YES ••• I D No .... 2 'UB, HEIl PAGEl
No .. 1 lCould lite to have. cOlplete li5t of .11 the children you have given birth ta, during your lIfe, shrtinq lCith th! fint.
ASK QUESTIONS 3-10 FOR EACH CHILO BORN TO THE RESPONOENT, IN OROER OF BIRTH.
3 4 5 6
° Ilhat i 5 hi I/her nale? ln Ilhat I~~~h and lias it a boy ls he/she sU Il year Nas lS or a qirl? living?
R child barn?
0
E BOy .... ·• 1 YES ... I
R NAKE KONTH 1 YEAR &IRL .... 2 NO .... 2 '.91
1: 1 1
7 B 9
Js he/she CHILD'S ID Hall .anr Ignthg or livina in your CODE. rens d d e/5 e house old? ive?
'SEE THE ~U~EHOLD R SERI
YES ... 1
NO .... 2 '.101 .~ KONTHS 1 YEARS
1 1 1 1 "1
10
"fve you 1iven birth t1 a her chi dren, even i they 1 i ved onl y a very short tin?
YES ... I U31
NO .... 2 'Ult NEil PAS 1
1
1:: 1 1 1 ~ 1 1 ~ ~ I::b 1
+p 1 + ~
~I 1 1 H 1 1 l ~I 1 t 1 1 1
J_J 1 13
11. COUNT All THE CHIlDREN WH05E NAMES ARE llSTED IN THE TABLE.
1 Hould li~E to be sure 1 have understood correctly. You have given
birth to (TOTAL) children. 15 this correct? _______________ _
YES (. WRITE THE NUMBER HERE) --------.
NO C. 60 BACK TO QUESTIONS 3-10 AND CORRECT ANY ERRORS AND ADD ANY CHIlDREN OMITTED)
NRITE HERE THE NA ME OF THE LAST BORN CHILD:
12. White you Here pregnant with (NAME OF lAST BORN) did you go for prenatal consultations at the PMI or the maternity clinic?
YESo •••• 1 NO ...... 2 (H4t
13. HON many times? TIMES:
14. Did Vou give birth to CNAME OF LAST BORN) in a maternity?
YES ..... 1 (H6) NO •••••• 2
15. Who assisted you at the birth?
16.
DOCTOR ••••.• 1 MIDNIFE. •••• 2 MATRON •••••• 3 TRADITIONAL MIDWIFE ••••••••• 4 RELATIVE OR OTHER ••••••.•.•• S
Did you breast-feed (NAME OF LAST BORN)
YES ••••• 1
., • •• !
NO ••••.• 2 (.18)
17. HON many months did you breast-feed the child? That is, hOH old Kas he/she "hen completely weaned?
MONTHS:
IF SHE 15 STIll BREAST-FEEDING THE CHllD, PUT CHILD'S AGE.
13
18. Have you had any pregnancies that were interrupted before term, through a miscarriage, even though the pregnancy lasted only a few "eeks or months, or have you had a stillborn child?
YES ..... 1 NO ...... 2 n201
19. Ho .. many such pregnancies hav~ you had in your life?
NUMBER:
20. Are you pregnant nOH?
YES ••.•. 1 NO ...... 2 (.221
21. How many months?
HONTHS.
22. Are you married no", have you been married, or have you already lived with someone?
YES •••.• 1 NO ••••.• 2 (.SECTION 141
23. How old .. ere you .. hen you and your first husband or boyfriend started living together? ______________ _
AGE:
24. What month and year Has it?
MONTH:
YEAR:
'1 1
13
1 would lite vou ta tell le about other incole received by lelbers of rour household during the past 12 lonths. That is ta say, incole received by these persans:
~D THE tlAnËSOF-ffiË HOUSEHDliïëARDToruËRËSPOtlDENT] ------ ----------[PT R T A. "1 S CEL l A N E 0 U SIN c -iiïiT]
During the past 12 lonths, holS any leaber of YQur liousehold r'teived incole in colSh or in Und frai the foIlolllng sources?
PUT A CROSS IN THE APPROPRIATE [TI BOX.
I!Mr!!li! Il!~ All lIEns 1
Hilt~onal Social MeHare Fund <CN SI?
Other pension or retirelent funds?
Other unelploylent insurince?
Other lediul or 1 i fe insurance?
Di vidends on investlt!nts?
Inhrest on savings or other accounts?
-Incole frai loan regaYlentr ta leabers 0 your ouseho d?
Incole frol a tontine?
Schohrships or other eduution grants?
YEs-I
J-NO
YES-'
J-HO
YES-I
J-NO
YES-'
J-NO
;ES-'
J-NO
YES-'
J-NO
YEs-I
l-KO
YEs-1
I-NO
Khat 15 the value of ail incole receiYed by the lelbers of your household in cash or in Und frOI ... [ J ... during the past 12 .onths?
AnOUNT
01
mllllOlllnlnlllll1 --
-----403
111I1_mOIIII
404
IllOnnOUllIlIlll1 --
405 --11101111111111001111 ------
406
10IOHIDIU_11 --
407 ~ ~ 40B 10 __
409 IIIIIIIIIIIIIII_'
~:::::::::::===::=~== _____ = __________ -ID CDOCI
rINTERYIEiER- = = - - - -[5 THIS THE PERSON ACTUA~LY [:TERVIEMED? YES ... 1 NO .... 2
-----. CONTINUED
1
During the past 12 lonths, has any lelber of your liousehold ryçeived incole in cash or in kind frai the fa 10lling sources?
PUT A CROSS IN THE APPRDPRIATE BOX.
ASK UUESTION 1 FOR All ITEnS BEFORE SOINS TO 2.
f;-----co j
Khat i s the val ue of ail incole reçeived by the le.bers of your hou sehold in cash or in Und fro .... [ J ••• durinll the put 12 lonths?
AIIOUNT
DOlfry or inheritance? 1 YEs-I-.J1 1 ~. _______ 1:;J ÎÜIIIBB __
lOU-ery -lfinningS'-? --Iv~ ~ 1
n;;JIiolll_-IncOle frollease of land, equip- 1 ~ lent or buildings? ~~-J
ION BEHAlF OF THE HOUSEHOlD OR .--- ill~=1II1DD1 ~~ ITS FARIIS AND BUS_IN_ES_SE_SI_. -11---_ ~--NN_OO -&.L. nnnllllii
YEs-1 ~ ION BEHALF OF THE HOUSEHOlD DR 414 OF ilS FARIIS AND BUSINESSESI. 1-"0 n'HlmnRIBII. Inco.e frai the sale of land?
Incole frol the sale of vehicles YEs-1 Icars, trucks, bicycles, etc •• ?
415 ION BEHAlF OF THE HDUSEHOlD OR OF
J-NO IllIIm __ on ilS FARIIS AND BUSINESSESI.
Incole frol the sale of bUild:-1 j Il 1
:;:3~MAlr or TME HmlS!MOlD OR IES- -Ka uïliïïiïïïa.i OF ilS FARns AND BUSIHESSES.. _ __ _
Dther incole Dr grlnts? I----T'--IM 1 7------1
-HO
Dl 0]
14A
r---
0 R 0 E R
1. During the past 12 lonths, has any lU ber of your hOU51!hoid received loney or 1I00ds frol persons Nho are not lelbers of rour household? For eXaiple, assistahce sent br relatives Norking e sellhere, Dr by childrl'n of househola lelbers, by frieniJs Dr by nei ghbours.
YES ..... 1
ND ...... 2 0 SECTION 15) D Nolt 1 lIould IHe to ask yau sale questions about all the persons Nha have sent assi stance in loney or goods to your household.
FOR ALL PERSONS LlSTED UNDER 2, PUT QUESTIONS 3-7.
2 --r--
3
!Chat are the nales of Il 1 the Ilhat is the relationship. of ~ersong IIho rent IOGe~ D~ Y30ds ~ .. (N~Kfh" to the hea~ of the ~rrg; t~~ gasloy~ .gnlgs~ Duse 0 .
IIIFE/HUSBAND .................. 1 ~HtL~"bR •• ~t.U'" ••••••••••• 2 A H R ft H .............. 3 SI T(R OR B OlHER ............. 3
!CRITE DO!CM ALL THE NAIIES DEFORE NIEC OR NEPHEN ............... 6DINS TD 3-7. SON/DAU&HTER-ON-LAII ••••••••••• 6
DROTHERISISTER- IN-LAII ••••••••• 7 IF THE RESPONDENT ODES NOT liANT ~~~nT~Ël~T\~~S • OF' tHE' HEAD' OR 8 TO GIVE HAllES, NU"BER THE PERSDNS. HIr~H~R SPDUS~·t·············9 OrH ERSQ.N, 0 A
RELATIVE •••••••••••••••••••• 10
HAllE
4
IIhere does he/she ~!~~! .. ~~.!~ in
READ THE ANSII~RS TO THE RESPON ENT
A city ............. 1 A tOIIO ............. 2 A lar,e village .... 3 A sla 1 village .... 4 A ca.p ............. S
5
ln is
~mJ CEN liES NES EAS NOR "AL DUR SUI SHA OlH FRA DTH
Ilhat region thi s place?
TH •••••••••• 1 TH IIEST ..... 2 TRE. ........ 3 T CENTRE .... 4 T ........... 5 T ........... 6 TH •••••••••• 7 J ••••••••••• 8 KINA-FASD ••• 9 NEA •••••••• 10 NA .. •1 • .. ··11 ER AFnICA. '12 NCE ........ 3 • COUNTRY ••• 14
HON .uch loney have household f.e.bf~~ r:~~~~ern [g: a~r Y2 lonths, incfuding the val ue of aIl paylents in kind?
AIIOUNT
Js part of this f5s~St-~~~ii ~Oto ethe sender?
YES .... 1
NO ••••• 2
IbNEU 1 Il PERSON
][ r---r-- 1
~ __ ~ []'~_ -_ --I..._--L---1
--Jl1 ~ __ ~J'~I_-_-_=C, __ l 1 I~
L-I.---_----lILA--..1 __ ~ J ___ l ___ L_J 5 l J---r-- 1 1 1 ~_--..II_ 1 J I--T-]
Il r-. -j--r= 1 :=J E Il 1 1 1 1 ~
Il 1 1 1 1 J ItSECTION 15
14B
ISECTION 15. CREDIT AND SAVINm
1 PAR T A. "OHEY AND BOODS LENT AND BORRONED ---)
1 would IHe ta ast you sale Questions about Iny loans by lubers of your household ta other péople th.( have not yet been repaid.
1. Has Iny lelber of' your household lent loney or goods ta individu.h( farls or businesses th.} h.ve not been repaid? For I!~aaple, loans (1 friends! ~eighbours, re ativës or business partners that hue not yet been repald?
YES •••• I D t«I ..... 2 n JI
2. HOM IlIch altoQether h (lwed by thes, persons ta lelbers of your household at Ihe present the?
TOTAl AIIOUNTI
J. Have Iny lelberl of your household borrolled loney or goods frol a hnt, a bu,iness, a cODperltive, a aovernlent agency, a loneylender i relative, a friend or iny olher individual or institution, {hat they have not rIlllaid? Includina lo.nl of clpi tal or goods for businesses or fUIS belonging to the fiousehold?
YES .... I
NO ..... 2 (t PART CI D 4. HOM luch altaaether h olled by 1,lbers Df the hausehold ta these persons
or insU tutions at the present tue?
1. PART B
15A
1 lIould lih ta ask you sOie questions about the loans contrilcted by .!!Ibers of your household tha( have not yet been repaid.
1 2 3
To IIhich banh, business fins CREDITOR HOIl lany coope~ aU ves { fovernaent agend es CODES loanl Dr Dt er ins jutions do Vou or have been the l!!Iber of ~our hlil y Olll! ~~~ïCI~ contract-It'ney or goods. ed frol
p~~~~Tr 1 this
Ta IIhich inrivlduals (Ione~lendersl person or friends, re ah ves, etc.1 Des vou 6~~~f···2 agency? househo dalle loney or goods?
C~~fRÀ:3 NUIIDER AlL lOANS
TlVE .... 4 FROIt EACH IF THE RESPONDENT D~ES NOT MISH OTHER ••• 5 SOURCE. TO 6IYE HAltES, NUIIB R THE PERSONS.
4
HOM luch lelbers househol frai ••• under th the{ bar IIha is value?
AllO
-------r----- r---S 6 7 9 10
have the ln Ilhat Nas a rate Ilhat Have the HOIl Did the of the lonth and of in- lias household luch household d borrolled year did the terest the lelbers had did le.bers [ J... househol d specif i ed annual to gay, or they h~ve to i5 loan? If lelbers for this rate lIill pay pay or glve rOlled goods, borroll thi 5 loan? of additlonal IIi Il 50aethi ng their loney loney Dr int- loney or they as colla-
these goads erest'? goads in add- haYe to brai
UNT
frai IUon to pay? for tbis ... [ ) .. ? repaving the loan?
10an? YESo .1
YES ••• I N~HOI2 AIIOUNT
YES .. 1
NO ... 2 1I0NTH 1 YEAR N~~ êl 2
____ ---J~ __ ..L-.._..L-___ -L. ________ _
11 12 13 14 15
Do the ael- HOIl luch do they IIhen lIill If the 10an II1r"1l bers of ~our pay and hOIl oHen? ther have hld t~ be th 1 lon~y househol in shed gay- rep.li barrolled _ Ilke regular in~ oH t e tO~I~ Ilhat repaYlents de t? alou lilouid to .. [ 1? hln to be
kO FIXE~ pa ? FARIt·US'·1
DATE = ONï '~i~f. .. ~.2 KNOll ~~~i~::::~
YES ... I
N~Jl!12 AIIOUNT 1 ~In fffin liON TH l YEAR AKOUNT ~------ '---
J----03 1 ~ ITf-~-~--I±f b 1 III 1 1
J----03· 1 I~____ 3±;-I§-f±l 1 1 III 1 1 §] ~üNiT;-OAY.'~.3 IIEEK ... 4 IIONTH ... S QUARTER ... 6 SEIIESTER ... 7 YEAR ... 8
Ip ART C. S A YIN B S
1. DOI!5 lny Inlblr of yaur houlehold have loney in sale Und of savinos account, such as in a Post Office Savings Acccount (PHI, a bant or coopenU VI! or other Slvings insU tution, or other Slvinqs in cash I!lsellherl! than ln thl!se insU tuUons?
YES .... I
NO ..... 2 'tEND) D 2. Does any Il!Ibl!r of your household haVI! any of thl! followlng accaunts?
A. Post Office Savings Account 'PTT 1 ?------------------------.
B. Bank snings account?-----------t
C. Housin; savingl fund?-----------.
D. Rural savings fund (CREPI ?------.
E. BNDA fund?----------------------• .----1 F. Cahsl! autonole d' .. orU sSllent?
6. POltal checking account?--------t r-----,
H. Other blnt Iccounts?------------t t----t
1. Bondl?--------------------------t
J. Stock! lin cOlpanies or bank!I?-t
J. Nhat is th, ~otat valul! of ,1 t the abpvl! ,ccopnts fnd of other savings outsldl! hl!u insU tu ions belonglng to al the I"abers of your household?
TOTAL AIIOUNTI IENO OF SECOND ROUND]
I5B ISe
