Province _ _
District _ _
Division _ _
Sub-Location _ _
E.A. Number _ _
E.A. Type _
E.A. Status _
Household No. _ _ _
Household type _
Constituency _ _ _
Structure No.: S _ _ _ _
Ward _ _

_ _ _ _ Males
_ _ _ _ Females
_ _ _ _ Total household population

Spoilt []

A: Information regarding all persons
[Questions P-00 to P-23 were asked of all persons in conventional households or refugee camps].

Name
P-00. What are the names of each person who spent the night of 24th/25th August, 2009 in this household? (Record two names of each person, young and old, starting with the head of the household).

[An illustration of how to write the names is omitted.]

Line number
[Illustration is given showing the enumerator how to number the lines to indicate which person each answer refers to.]

Relationship
P-10. What is [the person's] relationship to the head of this household?

Sex
P-11. What is [the person's] sex?

Age
P-12. How old is [person]? _ _

Line number of mother
P-13. Please insert line number of [name's] biological mother. _ _

Usual member of household
P-14. Is [person] a usual member of this household?

Tribe/nationality
P-15. What is [person's] tribe or nationality? _ _ _

Religion
P-16. What is [person's] religion?

Marital status
P-17. What is [person's] marital status?

Birth place
P-18. Where was [person] born? _ _ _

Previous residence
P-19. Where was [person] living in August 2008? _ _ _

Duration of residence
P-20, P-21. When did [person] move to the current district?

Orphanhood


P-22. Is [person's] father alive?

P-23. Is [person's] mother alive?

B: Information regarding females aged 12 years and above
[Questions P-24 to P-36 were asked of females age 12+ only.]

Particulars of all live births
P-24, P-25. How many children have you ever born alive?

P-26, P-27. How many children have you born alive who usually live in this household?

P-28, P-29. How many children have you born alive who usually live elsewhere?

P-30, P-31. How many children have you born alive who died?

Particulars of last live births

P-32, P-33. When was your last child born?

[p. 2]

P-34. Was this last birth notified?

P-35. Was this child male or female?

P-36. Is this child still alive?

C: Information regarding persons with disability
[Questions P-37 and P-38 were asked of all individuals.]

P-37. What type of disability does [person] have?

P-38. Because of the disability, does [person] have difficulties engaging in any economic activity?

D: Information regarding persons aged 3 years and above
[Questions P-39 to P-41 were asked of all individuals age 3+.]

P-39. What is the school/learning institution status of [person]?

P-40. What is the highest standard/form/level reached by [person]? _ _

P-41. What is the highest standard/form/level completed by [person]? _ _

E: Labour force particulars
Economic activity
[Question 42 was asked of all individuals age 5+.]

P-42. What was [person] mainly doing during the last 7 days preceding the census night? _ _

For those who worked or held a job (including those on leave/sick leave).
[P-43 and P-44 were asked of all individuals age 5+ who worked or held a job in the 7 days preceding the census night.]

P-43. Who was [person's] main employer? _ _

P-44. How many hours did [person] work in the last 7 days preceding the census night? _ _

F: Information regarding ICT
(To be asked of persons aged 3 years and above)
[Questions P-45 to P-51 were asked of all individuals age 3+.]

Was [person] able to get a service from the following items within the last one month?

P-50. How often does [person] use internet (e.g. email, chatting, etc.)?

P-51. Where did [person] mainly use the internet?

G: Annual live births

[Questions H-10 and H-11 were asked of all households.]

H-10. How many live births occurred in this household between 24/08/2008 and 24/08/2009 (last 12 months)? _ _

H: Information about deaths in the household

H-11. How many deaths occurred in this household between 24/08/2008 and 24/08/2009 (last 12 months)? _ _

[Questions H-12 to H-16 were asked of all households that reported at least one death in H-11].

H-12. Name of the household member who died. ____

H-13. Was this death notified?

H-14. Age: How old was [person] at his/her death? _ _

H-15. Sex

Remarks ________

H-16. Did the death occur?

I: Information regarding livestock
[Questions H-17 to H-29 were asked of all households.]

H-17. How many of each of the following livestock are currently owned by this household?

J: Housing conditions and amenities -- to be asked of the household head or any other responsible person

Dwelling units
H-18. How many dwelling units does this household occupy? _ _

Habitable
H-19. How many habitable rooms do these units contain? _ _

Tenure status of main dwelling unit
H-20. If owner occupied, state whether

Dominant construction material of main dwelling unit
H-21. Roof

H-22. Wall

H-23. Floor

H-24. Main source of water

H-25. Main type of human waste disposal.

H-26. Main type of cooking fuel.

H-27. Main type of lighting fuel.

K: Ownership of household assets
H-28. Did the household own any of the following items?

L: Emigrants
Emigrants in the last 15 years (since 1995)

H-29. How many members of this household have migrated to another country since 1995? _ _