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Minister of Economy and Development, Burkina Faso
Secretary General
National Institute of Statistics and Demography

Fourth General Population and Habitation Census, December 2006 (RGPH 2006)

Census Notebook

____ Notebook number
____ Number of notebooks
I. Identification

1. Region _ _
2. Province _ _
3. Commune/Neighborhood _ _
4. Village/Sector _ _ _
5. Type of Locality (1 = Urban; 2 = Rural) _
6. Control/Counting Zone Number _ _ _ _

II. Census Notebook Summary Table


Resident Status:


1. Present Residents (RP)

____ M
____ F
____ Total


2. Absent Residents (AP)
____ M
____ F
____ Total

Subtotal (1+2):
____ M
____ F
____ Total



3. Visitors (VIS)

____ M
____ F
____ Total



Total Counted (1+2+3):

____ M
____ F
____ Total



4. Emigrants (EM)

____ M
____ F
____ Total


Standard Household Questionnaire

____ Number of notebooks
____ Household questionnaire number

I. Household identification


M1. Region _ _
M2. Province _ _
M3. Commune/Neighborhood _ _
M4. Village/Sector _ _ _
M5. Type of Locality (1 = Urban; 2 = Rural) _
M6. Control/Counting Zone Number _ _ _ _
M7. Concession within the Counting Zone _ _
M8. Household within the concession _ _ _

III. Housing characteristics


H1. Housing zone

[] 1. Plotted zone
[] 2. Non-plotted zone



H2. Housing type

[] 1. Apartment building
[] 2. Villa
[] 3. Single family home
[] 4. Multiple family dwelling (not apartments)
[] 5. Hut
[] 0. Other



H3. Occupation status

[] 1. Owner
[] 2. Rent-to-own
[] 3. Rent
[] 4. Lodged for free
[] 0. Other



H4. Number of rooms occupied by household

Only count the living room and bedrooms, including those of dependents.
_ _



H5. Type of walls

[] 1. Hard material (materials such as cement, brick, etc.)
[] 2. Partly hard material (structure made with both hard material, such as cement, and something removable, such as earthen plaster, wood, etc.)
[] 3. Dried red earth
[] 4. Straw
[] 0. Other



H6. Type of roof

[] 1. Concrete
[] 2. Sheet metal
[] 3. Tiles
[] 4. Clay
[] 5. Thatch
[] 0. Other



H7. Type of floor

[] 1. Tile
[] 2. Cement
[] 3. Earth
[] 4. Sand
[] 0. Other



H8. Main light source

[] 1. Gridded electricity
[] 2. Personal electricity (group, solar panel, battery)
[] 3. Gas lamp
[] 4. Kerosene lamp
[] 5. Oil lamp
[] 6. Flashlight
[] 7. Candles
[] 8. Wood/Straw
[] 0. Other



H9. Principal source of cooking energy

[] 1. Electricity
[] 2. Natural gas
[] 3. Petrol
[] 4. Coal
[] 5. Wood (reinforced hearth)
[] 6. Wood (simple hearth)
[] 7. Not applicable
[] 0. Other



H10. Principal source of drinking water

[] 1. Running water
[] 2. Public tap
[] 3. Drilled pump
[] 4. Cased well
[] 5. Ordinary well
[] 6. River, marshland, dam
[] 0. Other



H11. Sanitary equipment

[] 1. Private flush toilet
[] 2. Shared flush toilet
[] 3. Ordinary latrine
[] 4. Ventilated pit latrine
[] 5. Outdoors
[] 0. Other



H12. Trash disposal method

[] 1. Private trash removal service
[] 2. Trash heap
[] 3. Ditches
[] 4. Dumpster
[] 5. Street
[] 0. Other



H13. Used water disposal method

[] 1. Courtyard
[] 2. Street
[] 3. Ditch
[] 4. Gutters
[] 5. Septic tank
[] 0. Other



H14. Household goods

According to the respondent's answer, write the number of appliances in the appropriate box. If there aren't any in the household, write 00.

In your household, how many working [appliance] do you have?

_ _ Radio
_ _ Television
_ _ Landline telephone
_ _ Cellular phone
_ _ Refrigerator
_ _ Computer
_ _ Internet connection



H15. Household goods (means of transportation)

According to the respondent's answer, write the number of appliances in the appropriate box. If there aren't any in the household, write 00.

In your household, how many working [means of transportation] do you have?

_ _ Bicycle
_ _ Motorbike
_ _ Car
_ _ Pirogue (small, flat-bottomed boat)
_ _ Cart
_ _ Camel
_ _ Horse
_ _ Donkey



IV. Household Summary Table

Sex:

R1. Male

____ RP (Present residents) (1)
____ RA (Absent residents) (2)
____ RP + RA (3) = (1) + (2)
____ VIS (Visitors) (4)
____ Total counted (5) = (3) + (4)
____ EM (Emigrants) (6)


R2. Female

____ RP (Present residents) (1)
____ RA (Absent residents) (2)
____ RP + RA (3) = (1) + (2)
____ VIS (Visitors) (4)
____ Total counted (5) = (3) + (4)
____ EM (Emigrants) (6)


Total

____ RP (Present residents) (1)
____ RA (Absent residents) (2)
____ RP + RA (3) = (1) + (2)
____ VIS (Visitors) (4)
____ Total counted (5) = (3) + (4)
____ EM (Emigrants) (6)


IV. Deaths in the last 12 months

D1. Has anyone in your household died within the last 12 months?

[] 1. Yes
[] 2. No

D2. If yes, how many?
____
[Repeat the remainder of section IV for each deceased member of the household in the provided table.]

D3. Order Number
____

D4. Full name
____

D5. Sex:

[] 1. Male
[] 2. Female

D6. Date of birth:

Month _ _
Year _ _ _ _

D7. Date of death:

Month _ _
Year _ _ _ _

D8. Age at time of death (in full years) _ _

If the deceased person is a woman between the ages of 10 and 55 years, at the time of her death was she:

D9. Pregnant?
[] 1. Yes
[] 2. No
D10. In the process of delivering a baby?
[] 1. Yes
[] 2. No

D11. In the two months following the end of a pregnancy or childbirth? (If Yes, record the exact number of days.)
[] 1. Yes _ _
[] 2. No

V. Emigration

E1. Is there anyone in your household who has emigrated within the last five years?

[] 1Yes
[] 2 No

E2. If Yes, how many?
____


E3. Order Number
____

E4. Full Name
____

E5. Age
_ _

E6. Sex

[] 1. Male
[] 2. Female

E7. Departure Date:

Month _ _
Year _ _ _ _

E8. Destination
____


Minister of Agriculture, Hydraulics and Fishing Resources
Secretary General
Director General of Agricultural Statistics and Forecasts
(DGPSA)

Minister of the Economy and Development
Secretary General
National Institute of Statistics and Demography (INSD)

General Agricultural Census (Phase One)
A. Identification

A1. Region _ _
A2. Province _ _
A3. Commune/Neighborhood _ _
A4. Village/Sector _ _ _
A5. Type of Locality (1 = Urban; 2 = Rural) _
A6. Control/Counting Zone Number _ _ _ _
A7. Concession within the Counting Zone _ _ _
A8. Household within the concession _ _

B. Household Summary Table

B1. Full name of the head of household ____

B2. Sex of the head of household:

[] 1 Male
[] 2 Female

B3. Head of household's date of birth:

Month _ _
Year _ _ _ _

B4. Age of the head of household _ _

B5. Size of household (RP + RA):

_ _ B5.1. Males
_ _ B5.2. Females

B6. Does any member of the household participate in the following activities?
(Yes = 1 No = 2)

_ B6.1. Rainfed agriculture
_ B6.2. Horticulture
_ B6.3. Fruit farming
_ B6.4. Forestry
_ B6.5. Fishing
_ B6.6. Raising livestock
_ B6.7. In possession of agricultural equipment

B7. Associated agricultural activity _ _

C. Agricultural information of the household

1. Practiced rain-fed agriculture?
(Yes = 1; No = 2)

Species:

Millet
Rainy season (Yes = 1; No = 2):_
Dry season (Yes = 1; No = 2):_
Corn
Rainy season (Yes = 1; No = 2):_
Dry season (Yes = 1; No = 2):_
Soy
Rainy season (Yes = 1; No = 2):_
Dry season (Yes = 1; No = 2):_
Rice
Rainy season (Yes = 1; No = 2):_
Dry season (Yes = 1; No = 2):_
Fonio [small grain]
Rainy season (Yes = 1; No = 2):_
Dry season (Yes = 1; No = 2):_
Cotton
Rainy season (Yes = 1; No = 2):_
Dry season (Yes = 1; No = 2):_
Peanut
Rainy season (Yes = 1; No = 2):_
Dry season (Yes = 1; No = 2):_
Sesame
Rainy season (Yes = 1; No = 2):_
Dry season (Yes = 1; No = 2):_
Black-eyed peas
Rainy season (Yes = 1; No = 2):_
Dry season (Yes = 1; No = 2):_
Bambara beans
Rainy season (Yes = 1; No = 2):_
Dry season (Yes = 1; No = 2):_
Yams
Rainy season (Yes = 1; No = 2):_
Dry season (Yes = 1; No = 2):_
Potato _
Rainy season (Yes = 1; No = 2):_
Dry season (Yes = 1; No = 2):_
Cassava root
Rainy season (Yes = 1; No = 2):_
Dry season (Yes = 1; No = 2):_
White sorghum
Rainy season (Yes = 1; No = 2):_
Dry season (Yes = 1; No = 2):_
Red sorghum
Rainy season (Yes = 1; No = 2):_
Dry season (Yes = 1; No = 2):_
Purple nut grass
Rainy season (Yes = 1; No = 2):_
Dry season (Yes = 1; No = 2):_
Fabirama
Rainy season (Yes = 1; No = 2):_
Dry season (Yes = 1; No = 2):_

2. Practiced horticulture?
(Yes = 1; No = 2)
_

Species:

Decorative flowers
Rainy season (Yes = 1; No = 2) _
Dry season (Yes = 1; No = 2) _
Onion
Rainy season (Yes = 1; No = 2) _
Dry season (Yes = 1; No = 2) _
Local eggplant
Rainy season (Yes = 1; No = 2) _
Dry season (Yes = 1; No = 2) _
Okra
Rainy season (Yes = 1; No = 2) _
Dry season (Yes = 1; No = 2) _
Capsicum
Rainy season (Yes = 1; No = 2) _
Dry season (Yes = 1; No = 2) _
Strawberry
Rainy season (Yes = 1; No = 2) _
Dry season (Yes = 1; No = 2) _
Tobacco
Rainy season (Yes = 1; No = 2) _
Dry season (Yes = 1; No = 2) _
Melon
Rainy season (Yes = 1; No = 2) _
Dry season (Yes = 1; No = 2) _
Watermelon
Rainy season (Yes = 1; No = 2) _
Dry season (Yes = 1; No = 2) _
Other market gardening crops
Rainy season (Yes = 1; No = 2) _
Dry season (Yes = 1; No = 2) _

3. Practiced fruit farming?
(Yes = 1; No = 2)
_

Species; number of feet:
Mango _ _ _ _
Banana _ _ _ _
Papaya _ _ _ _
Guava _ _ _ _
Cashew _ _ _ _
Dates _ _ _ _
Pineapple _ _ _ _
Citrus _ _ _ _

4. Practiced forestry?
(Yes = 1; No = 2)
_

Product name practiced (Yes = 1; No = 2):
Shea nuts _
Néré seed pods _
Tamarind _
Lumber _
Tree nursery _

5. Practiced fishing?
(Yes = 1; No = 2)
_

Fish/shrimp _
Frog _

6. Practiced raising livestock?
(Yes = 1; No = 2)
_

Species:
(Type of livestock-raising:
1 = Traditional: Animals are free range and pasture in the vicinity;
2 =Migrating: Animals leave the area during certain times of the year to search for pastures;
3 = Intensive: Animals stay fenced in and are fed there as well.)
Cows
Number _ _ _
Type _
Sheep/Goats
Number _ _ _
Type _
Donkeys
Number _ _ _
Type _
Horses
Number _ _ _
Type _
Camels
Number _ _ _
Type _
Pigs
Number _ _ _
Type _
Chickens
Number _ _ _
Type _
Guinea fowl
Number _ _ _
Type _
Ducks
Number _ _ _
Type _
Turkeys
Number _ _ _
Type _
Pigeons
Number _ _ _
Type _
Other
Number _ _ _
Type _

7.1. Owned work animals?
(Yes = 1; No = 2)

Number of work animals:
_ _ Cows
_ _ Donkeys
_ _ Horses
_ _ Camels

7.2. Owned agricultural equipment?
(Yes = 1; No = 2)

Number of working pieces of equipment:
_ _ _ _ Plows
_ _ _ _ Tractors
_ _ _ _ Motor-pumps
_ _ _ _ Carts
_ _ _ _ Beehives

8. Rural Residents Organizations:
Is any member of your household associated with a Rural Residents Organization?
(Yes = 1; No = 2)

Census agent

____ Name
____ Date
____ Signature

Supervisor

____ Name
____ Date
____ Signature

Coded by:

____ Name
____ Date

Keyed by:

____ Name
____ Date
____ Observations

Confidential


Summary Table
To be filled out throughout the counting of the population

[The followings are the column headings for the summary table.]

____ Concession number

____ Household number

____ Name of Head of Household

I. Resident Population:

Present Resident

____ M
____ F
____ Total

Absent Resident

____ M
____ F
____ Total

Total (RP + RA)

____ M
____ F
____ Total

Visitor

____ M
____ F
____ Total

Total Counted

____ M
____ F
____ Total

Emigrant

____ M
____ F
____ Total

____ Total [Total applies to each column starting at Present Resident]

II. Individual Characteristics
Entire Population


P01. Order Number _ _
P02. Full name ____
Record all persons in the household beginning with the head of household.


P03. Sex

Circle the corresponding code.

[] 1 Male
[] 2 Female



P04. Relationship to head of household

What is [the person's] relationship to the head of household? Circle the corresponding code.

[] 1 Head of household
[] 2 Spouse
[] 3 Son/daughter
[] 4 Brother/sister
[] 5 Father/mother
[] 6 Grandson/granddaughter
[] 7 Nephew/niece
[] 8 Uncle/aunt
[] 9 Other relative
[] 0 No relation



P05. Resident status

Circle the corresponding code.

[] 1 = RP (present resident)
[] 2 = RA (absent resident)
[] 3 = VIS (visitors)



Date of Birth or Age

P06. Date of birth

What is [the person's] date of birth?

Write the month and year of birth.

Month _ _
Year _ _ _ _


P07. Age

If the date of birth is unknown.

What is [the person's] age in full years?
_ _


P08. Birth Certificate

Does [the person] have a birth certificate?

[] 1 = Yes
[] 2 = No
[] 3 = Don't know



P09. Place of birth

In which commune and province was [the person] born?

Write the name of the commune and province if the person was born in Burkina Faso, or the name of the country if they were born outside of Burkina Faso.
____



P10. Place of residence one year ago

In which commune and province of the country did [the person] live a year ago?

Write the name of the commune and province if the person lived in Burkina Faso, or the name of the country if they lived outside of Burkina Faso.
____



P11. Residence abroad

Did [the person] live in another country between 1996 and 2006?

Circle the corresponding code.

[] 0 = No
[] 1 = CI (Yes, Ivory Coast)
[] 2 = AP (Yes, other country)



P12. Time since arrival or return

How long has it been since [the person] returned or came for the first time to Burkina Faso? (in whole years)
_ _



P13. Motive for arrival or return

Why did [the person] return or come for the first time to Burkina Faso?

Circle the corresponding code.

[] 1 Socio-political crisis
[] 2 Deportation
[] 3 Educational purposes
[] 4 Voluntary return
[] 5 Other



P14. Nature of handicap

Does [the person] suffer from any form of handicap?

Circle the corresponding code.

[] 0 No handicap
[] 1 Handicap of upper extremities
[] 2 Handicap of lower extremities
[] 3 Mental retardation
[] 4 Blind
[] 5 Deaf/Mute
[] 6 Other



P15. Religion

What religion is [the person]?

Circle the corresponding code.

[] 1 Animist
[] 2 Muslim
[] 3 Catholic
[] 4 Protestant
[] 5 Other
[] 6 Not religious



P16. Nationality

What nationality is [the person]?

Specify the country.
____



Residents three years of age and older
[Question P.17-P.20 are asked of residents who are three years of age and older]


P17. Scholarly attendance

Does [the person] currently attend school, or has [the person] ever attended school in the past?

Circle the corresponding code.

[] 0 No, never attended
[] 1 Yes, attended in the past
[] 2 Yes, currently attends



P18. Level of education

What is the last grade level completed or in the process of being completed?

Circle the corresponding code.

[] 0 = None
[] 1 = Kindergarten
[] 2 = 1st grade
[] 3 = 2nd grade
[] 4 = 3rd grade
[] 5 = 4th grade
[] 6 = 5th grade
[] 7 = 6th grade
[] 8 = Middle school
[] 9 = High school
[] 10 = Higher



P19. Literacy ____

Can [the person] read and write a language fluently?

Specify the main foreign language spoken and written on the first line and the main local language spoken and written on the second line.
____
____



P20. Spoken language

What is the main language spoken by [the person]?
____



Participation in economic activity
[For persons five years of age and older]


P21. Occupational situation

Has [the person] worked at least three out of the last seven days (OCC) or was working and lost his/her job (CHO)?

If yes, circle code 1 or 2. If no, circle the corresponding code.

[] 1. Employed (OCC)
[] 2. Unemployed and looking (CHO)
[] 3. Looking for first job (QUE)
[] 4. Retired (RET)
[] 5. Housewife (FOY)
[] 6. Student (ETU)
[] 7. Shareholder (REN)
[] 8. Other inactive persons (AUT)



[Questions P.22-P.24 were asked only of economically active residents (code 1 or 2 circled in P21)]


P22. Principal occupation

What is the occupation that took the majority of [the person's] time over those three days?

For those who were employed and lost their jobs (CHO): What was [the person's] occupation?

Write clearly in the column.
____



P23. Situation within principal occupation:

What is/was [the person's] situation within this occupation?

Circle the corresponding code.

[] 1 Employer, Boss (EMP)
[] 2 Independent (IND)
[] 3 Salaried (SAL)
[] 4 Apprentice (APP)
[] 5 Family helper (AIF)
[] 6 Other (AUT)



P24. Type of economic activity:

What is the primary activity of the company for which [the person] works/worked?
____



P25. Marital status

For residents 12 years of age or older

Does [the person] live with one (or more) women (or a man)?

Circle the corresponding code.

[] 0 Single
[] 1 Married and monogamous
[] 2 Married to two women
[] 3 Married to three women
[] 4 Married to four or more women
[] 5 Widowed (man or woman)
[] 6 Divorced or separated (man or woman)
[] 7 Civil union



Survival of children
[Question P.26-P.28 were asked of female residents age 10 years or older]


P26. Live births:

How many live births total has [the person] had?

Write the given number, divided by sex.

_ _ Male
_ _ Female



P27. Living children:

Of those births listed above, how many of the children are still alive?

Write the given number, divided by sex.

_ _ Male
_ _ Female



P28. Births within the last 12 months (since December 2005):

How many of [the person's] children were born alive during the last 12 months?

Write the given number, divided by sex.

_ _ Male
_ _ Female



Survival and residence of biological parents
[Question P.29-P.30 were asked of residents from 0 to 30 years of age]


P29-P30. Survival of father/ mother

Do [the person's] biological father and mother live in the household?

Write the corresponding code for the given response in the appropriate provided box.

[] 1 Lives in the household
[] 2 Does not live in the household but lives in Burkina Faso
[] 3 Lives somewhere outside of Burkina Faso
[] 4 Deceased
[] 5 Don't know