Republic of Ghana
Ghana Statistical Service
(Household Population)
2010 Population and Housing Census
Quest. ID
Struc. No _ _ _ _
HH No _ _
Q. No _
[Instructions for filling in circles and boxes omitted.]
[Questions A01-A11 applies to both the household and "non-household" population.]
A01. Region name ____
A02. District name ____
A03. District type ____
A04. Sub-district ____
A05. Locality name ____
A06a. Detailed address of house/compound ________
A06b. NHIS/ECG/VRA/Other number ________
A06c. HH contact phone number 1 ____
A06d. HH contact phone number 2 ____
Geographical information and household
A07. Enumeration area code
Region _ _
District _ _
District Type _
Sub-district _ _
EA number _ _ _
A08. EA type _
A09. Locality code _ _ _
A10. Structure number of house/compound _ _ _ _
A11. Household number within house/compound _ _
A12. Type of residence
[For the household population only]
[] 1 Occupied housing unit
[] 2 Vacant housing unit [skip to section H]
If 2, go to section H
[] 2 Vacant housing unit [skip to section H]
If 2, go to section H
[For the non-household population only]
[] 03 Homeless household
[] 04 Schools, college, university, seminary, monastery, convent, school hostel
[] 05 Children's Home/SOS, orphanage, destitute home, old people's home
[] 06 Hospital, maternity home, divine healers or herbalist establishment, leper settlement, infirmary, prayer camp
[] 07 Prison, Borstal institution, police/immigration/military cells, industrial school, Remand home
[] 08 Service training institution including police training college, military academy and army camp
[] 09 Mining camp, road camp, farm camp, refugee camp, etc.
[] 10 Hotel, rest-house, transit quarters, hostel, bar night club, restaurant
[] 11 Transit post e.g. at railway station, in ship, in ferry, inside harbor, at airport, at international border stations
[] 12 Passengers at lorry parks and other transport terminals
[] 13 Location of outdoor sleepers (e.g. on floor near shops, in markets, lorry parks, on beaches, on verandah of houses, on pavements at office premises), and other locations of persons not in transit (e.g. mentally ill)
[] 04 Schools, college, university, seminary, monastery, convent, school hostel
[] 05 Children's Home/SOS, orphanage, destitute home, old people's home
[] 06 Hospital, maternity home, divine healers or herbalist establishment, leper settlement, infirmary, prayer camp
[] 07 Prison, Borstal institution, police/immigration/military cells, industrial school, Remand home
[] 08 Service training institution including police training college, military academy and army camp
[] 09 Mining camp, road camp, farm camp, refugee camp, etc.
[] 10 Hotel, rest-house, transit quarters, hostel, bar night club, restaurant
[] 11 Transit post e.g. at railway station, in ship, in ferry, inside harbor, at airport, at international border stations
[] 12 Passengers at lorry parks and other transport terminals
[] 13 Location of outdoor sleepers (e.g. on floor near shops, in markets, lorry parks, on beaches, on verandah of houses, on pavements at office premises), and other locations of persons not in transit (e.g. mentally ill)
Interview dates and number of visits
[Questions A13 to A15b apply to both household and non-household population.]
A13. Date started
Day _ _
Month _ _
Year 2010
Month _ _
Year 2010
A14. Date completed
Day _ _
Month _ _
Year 2010
Month _ _
Year 2010
A15a. Total number of visits ____
A15b. Form _ of _
A16a: Household roster.
[Question A16a applies to both the household and non-household population.]
A -- Usual member(s) present on census night; B -- Visitor(s) present on census night.
Person ID _ _
Full name ________
Relationship to head
Full name ________
Relationship to head
[] 01 Head
[] 02 Spouse (wife/husband)
[] 03 Child (son/daughter)
[] 04 Parent/parent in-law
[] 05 Son/daughter in-law
[] 06 Grandchild
[] 07 Brother/sister
[] 08 Step child
[] 09 Foster child
[] 10 Other relative
[] 11 Non-relative
[] 02 Spouse (wife/husband)
[] 03 Child (son/daughter)
[] 04 Parent/parent in-law
[] 05 Son/daughter in-law
[] 06 Grandchild
[] 07 Brother/sister
[] 08 Step child
[] 09 Foster child
[] 10 Other relative
[] 11 Non-relative
Sex
[] M
[] F
[] F
Status
[] A
[] B
[] B
A16b: Usual members absent on census night (Status C)
[Question A16b was asked of the household population only (non-household population excluded).]
A16b. How many of your USUAL household members were absent on census night?
_ _
If 00, go to section E.
[The remaining items in A16b were answered for households that reported having at least 1 usual member absent on census night.]
Line No. _ _
Full name ____
Relationship to head
Relationship to head
[] 01 Head
[] 02 Spouse (wife/husband)
[] 03 Child (son/daughter)
[] 04 Parent/parent in-law
[] 05 Son/daughter in-law
[] 06 Grandchild
[] 07 Brother/sister
[] 08 Step child
[] 09 Foster child
[] 10 Other relative
[] 11 Non-relative
[] 02 Spouse (wife/husband)
[] 03 Child (son/daughter)
[] 04 Parent/parent in-law
[] 05 Son/daughter in-law
[] 06 Grandchild
[] 07 Brother/sister
[] 08 Step child
[] 09 Foster child
[] 10 Other relative
[] 11 Non-relative
Sex
[] M
[] F
[] F
Age
_ _
Destination town/village ________
Region/country code
[] 01 Western
[] 02 Central
[] 03 Greater Accra
[] 04 Volta
[] 05 Eastern
[] 06 Ashanti
[] 07 Brong Ahafo
[] 08 Northern
[] 09 Upper East
[] 10 Upper West
[] 11 Nigeria
[] 12 Liberia
[] 13 Sierra Leone
[] 14 Gambia
[] 15 Togo
[] 16 Burkina Faso
[] 17 Cote d'Ivoire
[] 18 Other ECOWAS states
[] 19 African, other than ECOWAS
[] 20 Europe
[] 21 Americas
[] 22 Asia
[] 23 Oceania
[] 02 Central
[] 03 Greater Accra
[] 04 Volta
[] 05 Eastern
[] 06 Ashanti
[] 07 Brong Ahafo
[] 08 Northern
[] 09 Upper East
[] 10 Upper West
[] 11 Nigeria
[] 12 Liberia
[] 13 Sierra Leone
[] 14 Gambia
[] 15 Togo
[] 16 Burkina Faso
[] 17 Cote d'Ivoire
[] 18 Other ECOWAS states
[] 19 African, other than ECOWAS
[] 20 Europe
[] 21 Americas
[] 22 Asia
[] 23 Oceania
Months absent_ _
Household members summary
[Questions A17-A19 applies to the household population only.]
[A -- Usual member(s) present on census night; B -- Visitor(s) present on census night; C -- Usual members absent on census night.]
A17. Status A
M _ _
F _ _
F _ _
A 18. Status B
M _ _
F _ _
F _ _
A19. Status C
M _ _
F _ _
F _ _
[Question A20 applies to both the household and non-household populations.]
A20. Status "A" + "B"
M _ _ _
F _ _ _
F _ _ _
Emigration outside the country
[Questions E01 to E02 were asked of all non-vacant households in the household population.]
Answer for all former household members 15 years and older who have been living continuously for 6 months or more outside Ghana (or intends to do so).
E01. Has any former member of this household been living continuously for 6 months or more outside Ghana?
[] Yes
[] No
[] No
If no, go to P00.
E02. Record the following information on former household members living outside Ghana.
[E02 was asked of all households who reported having at least one former household member 15+ years of age who has lived continuously outside of Ghana for 6 months or more, per question E01.]
Line No. _ _
Full Name ________
Relationship to head
Full Name ________
Relationship to head
[] 01 Head
[] 02 Spouse (wife/husband)
[] 03 Child (son/daughter)
[] 04 Parent/parent in-law
[] 05 Son/daughter in-law
[] 06 Grandchild
[] 07 Brother/sister
[] 08 Step child
[] 09 Foster child
[] 10 Other relative
[] 11 Non-relative
[] 02 Spouse (wife/husband)
[] 03 Child (son/daughter)
[] 04 Parent/parent in-law
[] 05 Son/daughter in-law
[] 06 Grandchild
[] 07 Brother/sister
[] 08 Step child
[] 09 Foster child
[] 10 Other relative
[] 11 Non-relative
Sex
[] M
[] F
[] F
Age _ _
Destination country name ____
Code _ _
Year of departure _ _ _ _
Destination country name ____
Code _ _
Year of departure _ _ _ _
Activity
[] 1 Employed
[] 2 Unemployed
[] 3 Student
[] 4 Other (specify) ____
[] 2 Unemployed
[] 3 Student
[] 4 Other (specify) ____
[Questions P00-P20 were asked for persons in both the household and non-household populations.]
[Questions P00 to P03 were asked for all persons in the household (usual members or visitors) who were present on census night (per the roster in A16a).]
P00. Name of member____
Please copy from the roster in A16a.
P01. Date of birth.
What is [the respondent's] date of birth? ____
Refer to historical calendar of events if date of birth is not known and estimate year of birth (see appendix 1 of Enumerator's Manual).
P02. Age.
How old is [respondent], in completed years? _ _
Fill in actual age if 00-98. If 99 or older, fill 99.
P03. Nationality.
What is [the respondent's] nationality?
[] 01 Ghanaian by birth
[] 02 Dual Nationality
[] 03 Ghanaian by naturalization [skip questions P04 and P05]
[] 04 Nigerian [skip questions P04 and P05]
[] 05 Liberian [skip questions P04 and P05]
[] 06 Sierra Leonean [skip questions P04 and P05]
[] 07 Gambian [skip questions P04 and P05]
[] 08 Togolese [skip questions P04 and P05]
[] 09 Burkinabe [skip questions P04 and P05]
[] 10 Ivorian [skip questions P04 and P05]
[] 11 Other ECOWAS national [skip questions P04 and P05]
[] 12 African, other than ECOWAS [skip questions P04 and P05]
[] 13 European [skip questions P04 and P05]
[] 14 American (North, South/Caribbean) [skip questions P04 and P05]
[] 15 Asian [skip questions P04 and P05]
[] 16 Oceanian (incl. Australian and New Zealander) [skip questions P04 and P05]
[] 02 Dual Nationality
[] 03 Ghanaian by naturalization [skip questions P04 and P05]
[] 04 Nigerian [skip questions P04 and P05]
[] 05 Liberian [skip questions P04 and P05]
[] 06 Sierra Leonean [skip questions P04 and P05]
[] 07 Gambian [skip questions P04 and P05]
[] 08 Togolese [skip questions P04 and P05]
[] 09 Burkinabe [skip questions P04 and P05]
[] 10 Ivorian [skip questions P04 and P05]
[] 11 Other ECOWAS national [skip questions P04 and P05]
[] 12 African, other than ECOWAS [skip questions P04 and P05]
[] 13 European [skip questions P04 and P05]
[] 14 American (North, South/Caribbean) [skip questions P04 and P05]
[] 15 Asian [skip questions P04 and P05]
[] 16 Oceanian (incl. Australian and New Zealander) [skip questions P04 and P05]
[Questions P04 and P05 were asked of all persons who responded that they were Ghanaian by birth, or of dual nationality (responses of 01-02 for P03).]
P04. Ethnicity.
To which ethnic group does [respondent] belong? _ _
Refer to Appendix 3 for code list.
Birthplace
P05. Was [the respondent] born in this village/town?
[] Yes [skip question P06]
[] No
[] No
P06. In what region or country was [the respondent] born?
[For all persons who were not born in this village/town (response of "no" to P05).]
[After responding to question P06, skip to P08.]
[] 01 Western
[] 02 Central
[] 03 Greater Accra
[] 04 Volta
[] 05 Eastern
[] 06 Ashanti
[] 07 Brong Ahafo
[] 08 Northern
[] 09 Upper East
[] 10 Upper West
[] 11 Nigeria
[] 12 Liberia
[] 13 Sierra Leone
[] 14 Gambia
[] 15 Togo
[] 16 Burkina Faso
[] 17 Cote d'Ivoire
[] 18 Other ECOWAS states
[] 19 African, other than ECOWAS
[] 20 Europe
[] 21 Americas (North, South/Caribbean)
[] 22 Asia
[] 23 Oceania
[After responding to question P06, skip to P08.]
[] 01 Western
[] 02 Central
[] 03 Greater Accra
[] 04 Volta
[] 05 Eastern
[] 06 Ashanti
[] 07 Brong Ahafo
[] 08 Northern
[] 09 Upper East
[] 10 Upper West
[] 11 Nigeria
[] 12 Liberia
[] 13 Sierra Leone
[] 14 Gambia
[] 15 Togo
[] 16 Burkina Faso
[] 17 Cote d'Ivoire
[] 18 Other ECOWAS states
[] 19 African, other than ECOWAS
[] 20 Europe
[] 21 Americas (North, South/Caribbean)
[] 22 Asia
[] 23 Oceania
Go to P08.
P07. Living in this village/town.
[P07 was asked of persons who were born in their current village or town (per P05).]
Has [the respondent] been living in this village or town since birth?
[] Yes [skip question P08]
[] No
[] No
P08. Number of years lived in this village/town.
[P08 was asked of all persons who had not been living in their current village or town since birth (responded "no" to P05).]
For how long has [the respondent] been living in this village or town? _ _
P09. Religion.
[Question P09 was asked for all persons.]
What is [the respondent's] religious affiliation?
[] 1 No religion
[] 2 Catholic
[] 3 Protestant (Anglican, Lutheran, Presbyterian, Methodist, etc.)
[] 4 Pentecostal/Charismatic
[] 5 Other Christian
[] 6 Islam
[] 7 Ahmadi
[] 8 Traditionalist
[] 9 Other (Specify)____
[] 2 Catholic
[] 3 Protestant (Anglican, Lutheran, Presbyterian, Methodist, etc.)
[] 4 Pentecostal/Charismatic
[] 5 Other Christian
[] 6 Islam
[] 7 Ahmadi
[] 8 Traditionalist
[] 9 Other (Specify)____
Marital status: Answer for persons 12 years and older.
P10. What is [the respondent's] current marital status?
[] 1 Never married
[] 2 Informal/consensual union/living together
[] 3 Married
[] 4 Separated
[] 5 Divorced
[] 6 Widowed
[] 2 Informal/consensual union/living together
[] 3 Married
[] 4 Separated
[] 5 Divorced
[] 6 Widowed
Literacy: answer for persons 11 years and older
P11. In what language can [the respondent] read and write?
[] 1 None (not literate)
[] 2 English only
[] 03 Ghanaian language only
[] 04 English and Ghanaian language
[] 05 English and French
[] 06 English, French and Ghanaian language
[] 07 Other (Specify) ____
[] 2 English only
[] 03 Ghanaian language only
[] 04 English and Ghanaian language
[] 05 English and French
[] 06 English, French and Ghanaian language
[] 07 Other (Specify) ____
Full time education: answer for persons 3 years and older
[P12a, P12b and P12c were asked for persons 3 years of age and older.]
P12a. Has [the respondent] ever attended school or is [the respondent] attending school now?
[] Never [skip questions P12a and P12b]
[] Past
[] Now
[] Past
[] Now
P12b. What is the highest level of schooling [the respondent] is attending now/attended in the past?
[P12b was asked for persons who had attended school in the past or were attending school now (responded "past" or "now" to P12a).]
[] 01 Nursery
[] 02 Kindergarten
[] 03 Primary
[] 04 JSS/JHS
[] 05 Middle
[] 06 SSS/SHS
[] 07 Secondary
[] 08 Voc/technical/commercial
[] 09 Post middle/secondary certificate (teacher training/college of education, agric, nursing etc.)
[] 10 Post secondary diploma (university diploma, HND, teacher training/college of education diploma, etc)
[] 11 Bachelor degree
[] 12 Post graduate (Cert., Diploma, Masters, PHD, etc.)
[] 01 Nursery
[] 02 Kindergarten
[] 03 Primary
[] 04 JSS/JHS
[] 05 Middle
[] 06 SSS/SHS
[] 07 Secondary
[] 08 Voc/technical/commercial
[] 09 Post middle/secondary certificate (teacher training/college of education, agric, nursing etc.)
[] 10 Post secondary diploma (university diploma, HND, teacher training/college of education diploma, etc)
[] 11 Bachelor degree
[] 12 Post graduate (Cert., Diploma, Masters, PHD, etc.)
P12c. Highest educational grade completed for those currently attending school or attended in the past.
[P12c was asked for persons who had attended school in the past or were attending school now (responded "past" or "now" to P12a).]
What is the highest grade (form/class/level) [the respondent] has completed at that level of schooling? _
If 0 -8, record actual grade. If 9 or more, code 9.
What is the highest grade (form/class/level) [the respondent] has completed at that level of schooling? _
If 0 -8, record actual grade. If 9 or more, code 9.
Economic activity -- P13-P17: Should be related to the past 7 days preceding census night
[P13 to P17 were asked of all persons age 5 years or older.]
P13a. During the 7 days before census night, did [the respondent] engage in any activity for pay (cash or kind) or profit or family gain for at least one hour?
(This includes helping in the family business/farm, trading, street vending, etc.)
[] Yes [skip questions P13b and P13c]
[] No
[] No
P13b. How was [the respondent] mainly engaged?
[P13b was asked of persons who were 5 years of age and were not engaged in any activity for pay in the 7 days prior to the census (per question P13a).]
[] 1 Did not work but had job to go back to (go to P14)
[] 2 Worked before, seeking work and available for work (go to P14)
[] 3 Seeking work for the first time and available to work (go to P18)
[] 4 Did voluntary work without pay (go to P14)
[] 5 Did not work and not seeking work
[] 1 Did not work but had job to go back to (go to P14)
[] 2 Worked before, seeking work and available for work (go to P14)
[] 3 Seeking work for the first time and available to work (go to P18)
[] 4 Did voluntary work without pay (go to P14)
[] 5 Did not work and not seeking work
P13c. Why did [the respondent] not seek work?
[P13b was asked of persons who were 5 years of age and were not engaged in any activity for pay in the 7 days prior to the census (per question P13a) and was not seeking work (per P13b).]
[After responding to P13c, skip P14-P17]
[] 1 Did home duties (household chores/full time homemaker)
[] 2 In full time education/student
[] 3 Pensioner/retired
[] 4 Disabled/too sick to work
[] 5 Too old/too young
[] 6 Other
Go to P18.
[After responding to P13c, skip P14-P17]
[] 1 Did home duties (household chores/full time homemaker)
[] 2 In full time education/student
[] 3 Pensioner/retired
[] 4 Disabled/too sick to work
[] 5 Too old/too young
[] 6 Other
Go to P18.
[Questions P14-P17 were asked of persons age 5 or older who were engaged in an activity for pay in the 7 days prior to the census (per question P13a) or had worked before and were seeking work or had been engaged in voluntary work without pay in the 7 days prior to the census (per question P13b).]
P14. Occupation
If yes in P13a; ask: what kind of work did [the respondent] mainly do?
If P13b=1, ask: what kind of work did [the respondent] do before the break period?
If P13b=2 or 4, ask: what kind of work did [the respondent] do previously?
Detailed description of occupation ________
Occupation code _ _ _ _
If P13b=1, ask: what kind of work did [the respondent] do before the break period?
If P13b=2 or 4, ask: what kind of work did [the respondent] do previously?
Detailed description of occupation ________
Occupation code _ _ _ _
P15. Name and physical location.
What is the name and physical location of the establishment where [the respondent] currently works/previously worked?
Name and location of establishment ________
Name and location of establishment ________
P15a. Industry.
What is the main product or service of the establishment where [the respondent] works/worked?
Main product or service ________
Main product or service ________
P16. Employment status.
What was [the respondent's] employment status in that establishment/industry?
[] 1 Employee
[] 2 Self-employed without employees
[] 3 Self-employed with employees
[] 4 Casual worker
[] 5 Contributing family worker
[] 6 Apprentice
[] 7 Domestic employee (househelp)
[] 8 Other
[] 2 Self-employed without employees
[] 3 Self-employed with employees
[] 4 Casual worker
[] 5 Contributing family worker
[] 6 Apprentice
[] 7 Domestic employee (househelp)
[] 8 Other
P17. Employment sector.
In what sector was [the respondent] mainly working?
[] 1 Public (government)
[] 2 Private formal
[] 3 Private informal
[] 4 Semi-public, parastatal
[] 5 NGO (local and international)
[] 6 International organization
[] 2 Private formal
[] 3 Private informal
[] 4 Semi-public, parastatal
[] 5 NGO (local and international)
[] 6 International organization
P18. Disability (answer for all persons).
[P18 was asked of all persons.]
Does [the respondent] have any serious disability that limits his/her full participation in life activities (such as mobility, work, social life, etc.?
Does [the respondent] have any serious disability that limits his/her full participation in life activities (such as mobility, work, social life, etc.?
a. Sight
[] Yes
[] No
[] No
b. Hearing
[] Yes
[] No
[] No
c. Speech
[] Yes
[] No
[] No
d. Physical
[] Yes
[] No
[] No
e. Intellect
[] Yes
[] No
[] No
f. Emotional
[] Yes
[] No
[] No
g. Other
[] Yes
[] No
[] No
If "yes" in g (other), specify: ________
Information communication technology (ICT): answer for persons aged 12 years and older
P19a. Does [the respondent] own a mobile phone?
[] Yes
[] No
[] No
P19b. Does [the respondent] use internet facility (at home, internet café, on phone, other mobile device?
[] Yes
[] No
[] No
Fertility: children ever born and children surviving
[P20a and P20b were asked for females age 12 years or older.]
P20a. Children ever born
How many children has [the respondent] ever born alive?
Male _ _
Female _ _
Female _ _
P20b. Children surviving
How many children ever born alive to [the respondent] are still surviving (living with you or elsewhere)?
Male _ _
Female _ _
Female _ _
Number of children born alive in the past 12 months
[P20c was asked of females age 12-54.]
P20c. Children born in the past 12 months.
How many children has [the respondent] born alive in the past 12 months?
Male _ _
Female _ _
Female _ _
M: Mortality
[Questions M01-M02 were asked for the household population only (excludes the non-household population).]
M01. Has any member of this household died in the past 12 months?
[] Yes
[] No [skip questions M02A-M02E]
[] No [skip questions M02A-M02E]
[M02A- M02E were asked of households that reported having at least one household member dead in the past 12 months (per M01).]
M02. Record the following information for each member who died during the past 12 months.
M02A. Name of deceased____
M02B. Sex of deceased
[] Male
[] Female
[] Female
M02C. Age at death _ _
M02D. Was the death due to accident, violence, homicide or suicide?
[] Yes
[] No
[] No
M02E. For only females 12-54 years old. Did the death occur whilst pregnant, during delivery, or within 6 weeks after the end of a pregnancy or child birth?
[] Yes
[] No
[] No
C: Information communication technology (ICT)
[C01 and C02 were asked of all households (excludes the non-household population).]
C01. Does the household have a fixed telephone line at home?
[] Yes
[] No
[] No
C02. Does the household or any member of the household own a desktop or laptop computer?
[] Yes
[] No
[] No
G: Agricultural Activity
[G01a - G01d were asked of all households (excludes the non-household population).]
G01. Does any member of your household cultivate crops or tree plant, rear livestock or breed fish for sale or family gain?
a. Crop farming
[] Yes
[] No
[] No
b. Tree growing
[] Yes
[] No
[] No
c. Livestock rearing
[] Yes
[] No
[] No
d. Fish farming
[] Yes
[] No
[] No
If a, b, c and d = No, go to Section H (i.e. no household member engaged in agricultural activity)
G02. How many household members cultivate crops or tree plant, rear livestock or breed fish for sale or family gain?
Male _ _
Female _ _
Female _ _
G03. Crop farming and/or tree planting
[G03 was asked of households who reported cultivating crops or tree plants (per G01a and G01b).]
G03a. Type of crop and tree planting ____
G03a. Type of crop and tree planting ____
G03b. Crop code_ _ _ _ _ _
G03c. Farm size_ _
G03d. Measurement unit
G03c. Farm size_ _
G03d. Measurement unit
[] 1 Acre
[] 2 Hectare
[] 3 Pole
[] 4 Rope
[] 5 Plot
[] 2 Hectare
[] 3 Pole
[] 4 Rope
[] 5 Plot
G03d. Type of cropping
[] 1 Mixed Cropping
[] 2 Inter Cropping
[] 3 Mono Cropping
[] 2 Inter Cropping
[] 3 Mono Cropping
G04: Livestock and/or fisheries (if yes in G01c or G01d), ask:
What type(s) and number of livestock/fishery is your household currently rearing? (See appendix 5 for livestock/fisheries codes)
G04A. Types of livestock/fisheries ____
G04B. Livestock/fishery code _ _
G04C. Number _ _ _ _ _ _
G04B. Livestock/fishery code _ _
G04C. Number _ _ _ _ _ _
H: Housing conditions (household population only)
[For vacant housing unit fill only H01, H02, and H04]
H01: Type of dwelling.
In what type of dwelling does the household live?
[] 01 Separate house
[] 02 Semi-detached house
[] 03 Flat/apartment
[] 04 Compound house (rooms)
[] 05 Huts/buildings (same compound)
[] 06 Huts/buildings (different compounds)
[] 07 Tent
[] 08 Improvised home (kiosk, container)
[] 09 Living quarters attached to office/shop
[] 10 Uncompleted building
[] 11 Other (specify) ____
[] 02 Semi-detached house
[] 03 Flat/apartment
[] 04 Compound house (rooms)
[] 05 Huts/buildings (same compound)
[] 06 Huts/buildings (different compounds)
[] 07 Tent
[] 08 Improvised home (kiosk, container)
[] 09 Living quarters attached to office/shop
[] 10 Uncompleted building
[] 11 Other (specify) ____
H02: Outer Wall
What is the main material or the outer walls of this dwelling?
[] 1 Mud bricks/earth
[] 2 Wood
[] 3 Metal sheet/slate/asbestos
[] 4 Stone
[] 5 Burnt bricks
[] 6 Cement blocks/concrete
[] 7 Land-crete [laterite, land, and concrete]
[] 8 Bamboo
[] 9 Palm leaves/thatch (grass)/raffia
[] 10 Other (specify) ____
[] 2 Wood
[] 3 Metal sheet/slate/asbestos
[] 4 Stone
[] 5 Burnt bricks
[] 6 Cement blocks/concrete
[] 7 Land-crete [laterite, land, and concrete]
[] 8 Bamboo
[] 9 Palm leaves/thatch (grass)/raffia
[] 10 Other (specify) ____
H03: Floor
What is the main material of the floor of this dwelling?
[] 1 Earth/mud
[] 2 Cement/concrete
[] 3 Stone
[] 4 Burnt bricks
[] 5 Wood
[] 6 Vinyl tiles
[] 7 Ceramic/porcelain/granite/marble tiles
[] 8 Terrazzo/terrazzo tiles
[] 9 Other (specify) ____
[] 2 Cement/concrete
[] 3 Stone
[] 4 Burnt bricks
[] 5 Wood
[] 6 Vinyl tiles
[] 7 Ceramic/porcelain/granite/marble tiles
[] 8 Terrazzo/terrazzo tiles
[] 9 Other (specify) ____
H04: Roof
What is the main material used for the roof?
[] 1 Mud/mud bricks/earth
[] 2 Wood
[] 3 Metal sheet
[] 4 Slate/asbestos
[] 5 Cement/concrete
[] 6 Roofing tiles
[] 7 Bamboo
[] 8 Thatch/palm leaves or raffia
[] 9 Other (specify) ____
[] 2 Wood
[] 3 Metal sheet
[] 4 Slate/asbestos
[] 5 Cement/concrete
[] 6 Roofing tiles
[] 7 Bamboo
[] 8 Thatch/palm leaves or raffia
[] 9 Other (specify) ____
H05: Tenure/holding arrangement
What is the present holding/tenancy arrangement of this dwelling?
[] 1 Owner occupied
[] 2 Renting
[] 3 Rent-free
[] 4 Perching
[] 5 Squatting
[] 6 Other (specify) ____
[] 2 Renting
[] 3 Rent-free
[] 4 Perching
[] 5 Squatting
[] 6 Other (specify) ____
H06: Ownership type
Who owns the dwelling?
[] 1 Owned by household member
[] 2 Being purchased (e.g. mortgage)
[] 3 Relative not household member
[] 4 Other private individual
[] 5 Private employer
[] 6 Other private agency
[] 7 Public/government ownership
[] 8 Other (specify) ____
[] 2 Being purchased (e.g. mortgage)
[] 3 Relative not household member
[] 4 Other private individual
[] 5 Private employer
[] 6 Other private agency
[] 7 Public/government ownership
[] 8 Other (specify) ____
H07: Rooms
H07a. How many rooms does this household occupy? _ _
(Count living, dining, bedrooms but not bathrooms, toilet and kitchen)
H07b. How many of the rooms are used or sleeping? _ _
If more than 1, go to H08.
H07c. Does the household share this sleeping room with other households?
[H07c was asked of households that reported having only one room used for sleeping in H07b.]
[] Yes
[] No [skip question H07d]
[] Yes
[] No [skip question H07d]
H07d. How many households, including your household, share this sleeping room? _ _
[H07d was asked of households that had only one sleeping room and reported sharing that sleeping room with other households (per questions H07b and H07c).]
[H08- H12 and H13a were asked of all non-vacant households.]
H08. Lighting.
What is the main source of lighting for your dwelling?
[] 01 Electricity (mains)
[] 02 Electricity (private generator)
[] 03 Kerosene lamp
[] 04 Gas lamp
[] 05 Solar energy
[] 06 Candle
[] 07 Flashlight/torch
[] 08 Firewood
[] 09 Crop residue
[] 10 Other (specify) ____
[] 02 Electricity (private generator)
[] 03 Kerosene lamp
[] 04 Gas lamp
[] 05 Solar energy
[] 06 Candle
[] 07 Flashlight/torch
[] 08 Firewood
[] 09 Crop residue
[] 10 Other (specify) ____
H09: Water supply
H09a. What is the main source of drinking water for the household?
[] 01 Pipe-borne inside dwelling
[] 02 Pipe-borne outside dwelling
[] 03 Public tap/standpipe
[] 04 Borehole/pump/tube well
[] 05 Protected well
[] 06 Rain water
[] 07 Protected spring
[] 08 Bottled water
[] 09 Sachet water
[] 10 Tanker supply/vendor provided
[] 11 Unprotected well
[] 12 Unprotected spring
[] 13 River/stream
[] 14 Dugout/pond/lake/dam/canal
[] 15 Other (specify) ____
[] 02 Pipe-borne outside dwelling
[] 03 Public tap/standpipe
[] 04 Borehole/pump/tube well
[] 05 Protected well
[] 06 Rain water
[] 07 Protected spring
[] 08 Bottled water
[] 09 Sachet water
[] 10 Tanker supply/vendor provided
[] 11 Unprotected well
[] 12 Unprotected spring
[] 13 River/stream
[] 14 Dugout/pond/lake/dam/canal
[] 15 Other (specify) ____
H09b. What is the main source of water used by your household for other domestic purposes such as cooking and washing?
[] 01 Pipe-borne inside dwelling
[] 02 Pipe-borne outside dwelling
[] 03 Public tap/standpipe
[] 04 Borehole/pump/tube well
[] 05 Protected well
[] 06 Rain water
[] 07 Protected spring
[] 08 Tanker supply/vendor provided
[] 09 Unprotected well
[] 10 Unprotected spring
[] 11 River/stream
[] 12 Dugout/pond/lake/dam/canal
[] 13 Other (specify) ____
[] 02 Pipe-borne outside dwelling
[] 03 Public tap/standpipe
[] 04 Borehole/pump/tube well
[] 05 Protected well
[] 06 Rain water
[] 07 Protected spring
[] 08 Tanker supply/vendor provided
[] 09 Unprotected well
[] 10 Unprotected spring
[] 11 River/stream
[] 12 Dugout/pond/lake/dam/canal
[] 13 Other (specify) ____
H10: Cooking fuel
What is the main source of cooking fuel for this household?
[] 01 None, no cooking
[] 02 Wood
[] 03 Gas
[] 04 Electricity
[] 05 Kerosene
[] 06 Charcoal
[] 07 Crop residue
[] 08 Saw dust
[] 09 Animal waste
[] 10 Other (specify) ____
[] 02 Wood
[] 03 Gas
[] 04 Electricity
[] 05 Kerosene
[] 06 Charcoal
[] 07 Crop residue
[] 08 Saw dust
[] 09 Animal waste
[] 10 Other (specify) ____
H11: Cooking space (kitchen)
What type of cooking space does this household use?
[] 1 No cooking
[] 2 Separate room for exclusive use of household
[] 3 Separate room shared with other household(s)
[] 4 Enclosure without roof
[] 5 Structure with roof but without walls
[] 6 Bedroom/hall/living room
[] 7 Veranda
[] 8 Open space in compound
[] 9 Other (specify) ____
[] 2 Separate room for exclusive use of household
[] 3 Separate room shared with other household(s)
[] 4 Enclosure without roof
[] 5 Structure with roof but without walls
[] 6 Bedroom/hall/living room
[] 7 Veranda
[] 8 Open space in compound
[] 9 Other (specify) ____
H12: Bathing facilities
What type of bathing facility is used by this household?
[] 1 Own bathroom for exclusive use
[] 2 Shared separate bathroom in same house
[] 3 Private open cubicle
[] 4 Shared open cubicle
[] 5 Public bath house
[] 6 Bathroom in another house
[] 7 Open space around house
[] 8 In a river, pond, lake or dam
[] 9 Other (specify) ____
[] 2 Shared separate bathroom in same house
[] 3 Private open cubicle
[] 4 Shared open cubicle
[] 5 Public bath house
[] 6 Bathroom in another house
[] 7 Open space around house
[] 8 In a river, pond, lake or dam
[] 9 Other (specify) ____
H13a: Toilet facilities
What type of toilet facility is usually used by the household?
[] 1 No facility (e.g. bush/beach/field) (go to H14)
[] 2 W.C.
[] 3 Pit latrine
[] 4 KVIP
[] 5 Bucket/pan
[] 6 Public toilet (e.g. WC, KVIP, Pit, Pan) (go to H14)
[] 7 Other (specify) ____
[] 2 W.C.
[] 3 Pit latrine
[] 4 KVIP
[] 5 Bucket/pan
[] 6 Public toilet (e.g. WC, KVIP, Pit, Pan) (go to H14)
[] 7 Other (specify) ____
H13b: Toilet facilities -- Continued
[H13b was asked of households that had their own toilet facility (any response other than "no facility" or "public toilet" in question H13a).]
Do you share this toilet facility with other households?
Do you share this toilet facility with other households?
[] 1 Yes, with other household(s) in same house
[] 2 Yes, with other household(s) in different house
[] 3 Yes, with other household(s) and located in different house (go to H14)
[] 4 No
[] 2 Yes, with other household(s) in different house
[] 3 Yes, with other household(s) and located in different house (go to H14)
[] 4 No
H13c: Toilet facilities -- Continued
[H13c was asked of households that had a toilet facility and responded that their toilet facility was shared with other household(s) in the same house or a different house ("1" or "2" to H13b).]
How many households including your household use this toilet facility?
_ _
How many households including your household use this toilet facility?
_ _
[H14 and H15 were asked of all non-vacant households.]
H14: Solid waste disposal
How does the household dispose of rubbish (refuse)?
[] 1 Collected
[] 2 Burned by household
[] 3 Public dump (container)
[] 4 Public dump (open space)
[] 5 Dumped indiscriminately
[] 6 Buried by household
[] 7 Other (specify) ____
[] 2 Burned by household
[] 3 Public dump (container)
[] 4 Public dump (open space)
[] 5 Dumped indiscriminately
[] 6 Buried by household
[] 7 Other (specify) ____
H15: Liquid waste disposal
How does your household dispose of liquid waste?
[] 1 Through the sewage system
[] 2 Through drainage system into a gutter
[] 3 Through drainage into a pit (soak away)
[] 4 Thrown onto the street/outside
[] 5 Thrown into gutter
[] 6 Thrown onto compound
[] 7 Other (specify) ____
[] 2 Through drainage system into a gutter
[] 3 Through drainage into a pit (soak away)
[] 4 Thrown onto the street/outside
[] 5 Thrown into gutter
[] 6 Thrown onto compound
[] 7 Other (specify) ____