Republic of Benin
Ministry of Statistical Planning and Foreign Aid Coordination
National Institute for Statistics and Economic Analysis
National Census Committee
Central Census Bureau
Second population and habitation census
Prescribed by decree number 90-149 of 04/07/1990 and is obligatory for all persons present on the territory of the Republic of Benin
Household questionnaire document paragraph 2 number 1
Confidential
The individual information obtained through this questionnaire is covered by data privacy [statistical privacy is used]. Results can only be anonymously published in accordance with article 9 of ordinance 73-72 of October 16th 1973.
Localization
Department _
Sub-prefecture/Urban district _ _
Rural/Urban township _ _
Village/Neighborhood _ _
Locality or hamlet ____
Census zone _ _ _
Order number of building(s) _ _ _
Order number of household _ _ _
Type of household _
Name of respondent ____
Sub-prefecture/Urban district _ _
Rural/Urban township _ _
Village/Neighborhood _ _
Locality or hamlet ____
Census zone _ _ _
Order number of building(s) _ _ _
Order number of household _ _ _
Type of household _
Name of respondent ____
Census agent's seal
____ Last and first names
____ Date of household visit
____ Observations
____ Signature
____ Date of household visit
____ Observations
____ Signature
Team leader's seal
____ Last and first names
____ Census sector
____ Control date
____ Observations
____ Signature
____ Census sector
____ Control date
____ Observations
____ Signature
Is there at least one household member who independently runs an agricultural exploitation?
Circle the number according to the answer
[] 1 Yes
[] 2 No
If Yes, specify the department, the sub-prefecture, the urban district, the township, and the village/neighborhood of the exploitation.
[] 1 Yes
[] 2 No
If Yes, specify the department, the sub-prefecture, the urban district, the township, and the village/neighborhood of the exploitation.
Department _
Sub-prefecture or urban district _ _
Township _ _
Village _ _
Sub-prefecture or urban district _ _
Township _ _
Village _ _
Summary table
_ _ _ Size [It probably refers to household size i.e. number of its members]
Sex
_ _Total males
_ _Total females
_ _Total females
Total residents
[] Present
_ _Males
_ _Female
_ _Female
[] Absent
_ _Males
_ _Female
_ _Female
[] Present plus absent
_ _Males
_ _Female
_ _Female
Total visitors
_ _Males
_ _Female
_ _Female
____ Household form number
____ Number of forms used for the household
[next page, no page number]
For all persons
[Questions in columns 1 to 9 asked of all persons.]
(1) Order number_ _
(2) Last and first names____
Register the household members in the following order:
[] Head of household
[] Head of household's unmarried children whose mother is not in the household, from the youngest to the oldest
[] Head of household's wives followed by their unmarried children
[] Head of household's married children followed by their spouses and living children
[] Head of household's other relatives with their potential spouses and children
[] Servants and potentially their families
[] Visitors
[] Head of household's unmarried children whose mother is not in the household, from the youngest to the oldest
[] Head of household's wives followed by their unmarried children
[] Head of household's married children followed by their spouses and living children
[] Head of household's other relatives with their potential spouses and children
[] Servants and potentially their families
[] Visitors
(3) Relationship to the head of household
[] 0 CM: Head of household
[] 1 EP: spouse of head of household
[] 2 ENF: child of head of household
[] 3 PAR: father and mother of head of household
[] 4 BPAR: parents-in-law of head of household
[] 5 AP: other relatives of head of household
[] 6 PENF: grandson, granddaughter of head of household
[] 7 SP: no family relation
[] 9 ND: undeclared
[] 1 EP: spouse of head of household
[] 2 ENF: child of head of household
[] 3 PAR: father and mother of head of household
[] 4 BPAR: parents-in-law of head of household
[] 5 AP: other relatives of head of household
[] 6 PENF: grandson, granddaughter of head of household
[] 7 SP: no family relation
[] 9 ND: undeclared
[] Male
[] Female
[] Female
(5) Date of birth _ _ _ _
Write in the grid the numbers corresponding to the declared month and year
Example: August 13th, 1950 written as 0850
Example: August 13th, 1950 written as 0850
(6) Age _ _
Write in the declared or estimated age in fully lived years
(7) Place of birth ____
Sub-prefecture or urban district for persons born in Benin
Country for all others
Country for all others
(8) Nationality ____
Mark down the nationality (country)
(9) Ethnicity ____
Mark down Fon, Mina, Goun, Dendi, Bariba, etc.
(10) Religion
[] 1 TRA: Traditional
[] 2 CAT: Catholic
[] 3 PRO: Protestant
[] 4 ISL: Islamic
[] 5 AC: Other Christian
[] 6 AR: Other religion
[] 7 AUC: None
[] 9 ND: undeclared
[] 2 CAT: Catholic
[] 3 PRO: Protestant
[] 4 ISL: Islamic
[] 5 AC: Other Christian
[] 6 AR: Other religion
[] 7 AUC: None
[] 9 ND: undeclared
(11) Residency status
[] 1 RP: present resident
[] 2 RA: absent resident
[] 3 VISIT: visitor
[] 9 ND: undeclared
[] 2 RA: absent resident
[] 3 VISIT: visitor
[] 9 ND: undeclared
Residents only
[Question in columns 12 - 13 asked only of residents.]
(12) Duration of residency _ _
[Continue fill in duration of residency in number of years start from 00 to 50 years and above]
00 for less than one year
01 for one year
02 for 2 years
(...)
50 for 50 years and above
88 for visitors
98 for since birth
99 for undeclared
00 for less than one year
01 for one year
02 for 2 years
(...)
50 for 50 years and above
88 for visitors
98 for since birth
99 for undeclared
(13) Location of previous residence ____
For present residents or absent residents write down the sub-prefecture or urban district. The country for locations outside of Benin. For visitors mark down 8 8 8
Persons of 3 years or more of age
[Questions in columns 14 - 16 asked of persons 3 years or more.]
(14) Literacy
[] 1 NLE: cannot read or write
[] 2 SEF: can read and write in French
[] 3 ALN: literate in the national language
[] 4 SLN: can read in the national language
[] 5 AFLN: literate in French and in the national language
[] 6 AUT: literate in other foreign language
[] 8 SO: not applicable (children younger than 3)
[] 9 ND: undeclared
[] 2 SEF: can read and write in French
[] 3 ALN: literate in the national language
[] 4 SLN: can read in the national language
[] 5 AFLN: literate in French and in the national language
[] 6 AUT: literate in other foreign language
[] 8 SO: not applicable (children younger than 3)
[] 9 ND: undeclared
(15) Pre-school and school attendance
[] 1 FA: currently attending
[] 2 AF: has attended
[] 3 JF: never attended
[] 8 SO: not applicable
[] 9 ND: undeclared
[] 2 AF: has attended
[] 3 JF: never attended
[] 8 SO: not applicable
[] 9 ND: undeclared
(16) Last school grade level attended _ _
Current grade level for those attending. Or last graded level for those who no longer attend. For children younger than 3, simply mark down 88 in the grid.
Persons of 10 years or more of age
[Questions in columns 17 - 21 were asked of persons age 10 or older.]
(17) Marital status
[] 0 Single (C)
[] 1 Monogamous marriage (M1)
[] 2 Polygamous marriage with 2 wives (M2)
[] 3 Polygamous marriage with 3 or more wives (M3)
[] 4 Divorced (D)
[] 5 Widowed (V)
[] 6 Separated (S)
[] 7 Free union (UL) [unmarried couple]
[] 9 Undeclared (ND)
[] 8 Not applicable (SO) [persons younger than 10]
[] 1 Monogamous marriage (M1)
[] 2 Polygamous marriage with 2 wives (M2)
[] 3 Polygamous marriage with 3 or more wives (M3)
[] 4 Divorced (D)
[] 5 Widowed (V)
[] 6 Separated (S)
[] 7 Free union (UL) [unmarried couple]
[] 9 Undeclared (ND)
[] 8 Not applicable (SO) [persons younger than 10]
(18) Occupation
[] 1 OCC: employed
[] 2 CT: seeking first employment
[] 3 CHO: unemployed
[] 4 MEN: housewife
[] 5 ETU: school children and students
[] 6 RET: retired
[] 7 REN: rentier
[] 8 SO: Not applicable for persons younger than 10
[] 9 ND: Undeclared
[] 2 CT: seeking first employment
[] 3 CHO: unemployed
[] 4 MEN: housewife
[] 5 ETU: school children and students
[] 6 RET: retired
[] 7 REN: rentier
[] 8 SO: Not applicable for persons younger than 10
[] 9 ND: Undeclared
(19) Profession____
Ask the question according to the instruction manual. For persons younger than 10, this column is not applicable, write in 8 8 8 in the grid.
(20) Status within the profession
[] 0 EMP: employer
[] 1 IND: independent
[] 2 SAP: permanent salaried employee
[] 3 SAT: temporary salaried employee
[] 4 COOP: cooperative member
[] 5 AF: familial aid
[] 6 APP: apprentice
[] 7 AUT: other
[] 8 SO: Not applicable
[] 9 ND: Undeclared
[] 1 IND: independent
[] 2 SAP: permanent salaried employee
[] 3 SAT: temporary salaried employee
[] 4 COOP: cooperative member
[] 5 AF: familial aid
[] 6 APP: apprentice
[] 7 AUT: other
[] 8 SO: Not applicable
[] 9 ND: Undeclared
(21) Branch of activity ____
Mark down the type of the activity of the establishment in which the interviewee works or the work that the interviewee does interpedently. This column is not applicable for persons younger than 10. For these persons, write in 8 8 8 in the grid.
Female residents of 12 or more of age
[Questions in columns 22-25 were asked on female residents age 12 or older.]
Born alive children [columns 22-23]
Report the number declared by gender, in the grid. If not applicable, mark down 88 in the grid.
(22) _ _ Male
(23) _ _ Female
(22) _ _ Male
(23) _ _ Female
Living children [columns 24-25]
Report the number declared by gender, in the grid. If not applicable, mark down 88 in the grid.
(24) _ _ Male
(25) _ _ Female
(24) _ _ Male
(25) _ _ Female
[No page number in next page]
Events occurred in the household in the last 12 months
Births: has there been any births in the household since ____ [date to fill out]
(Circle the applicable number)
[] 1 Yes
[] 2 No
If yes, how many? _ _
[] 1 Yes
[] 2 No
If yes, how many? _ _
Fill out the table blow.
[The set of questions below apply to each child.]
Order Number _ [given 1-5]
Child's last and first names ____
_ _ Mothers' line number
Sex
[] Male
[] Female
[] Female
Date of birth
Month _ _
Year _ _ _ _
Year _ _ _ _
Is the child still alive?
[] 1Yes
[] 2 No
[] 2 No
Deaths: has there been any deaths in the household since _ _ _ _ [date to fill out]
(Circle the applicable number)
[] 1 Yes
[] 2 No
[] 1 Yes
[] 2 No
_ _ If yes, how many?
Fill out the table below.
Order Number [given 1-5]
____ Last and first names
Sex
[] Male
[] Female
[] Female
Date of death
Month_ _
Year_ _ _ _
Year_ _ _ _
Date of birth_ _ _ _
Month _ _
Year_ _ _ _
Year_ _ _ _
Age at death in days, months, or years
Days_ _
Months_ _
Years_ _ _ _
Months_ _
Years_ _ _ _
Death circumstances
[] 1 Death during pregnancy (DCG)
[] 2 Death after giving birth (DSC)
[] 3 Other circumstances (AC)
[] 2 Death after giving birth (DSC)
[] 3 Other circumstances (AC)
Household dwelling unit characteristics
Unit's construction type
[] 1 Isolated house
[] 2 Compartmentalized house
[] 3 Villa
[] 4 Building (multiple story house)
[] 5 Isolated case (traditional dwelling)
[] 6 Concession
[] 7 Other
[] 2 Compartmentalized house
[] 3 Villa
[] 4 Building (multiple story house)
[] 5 Isolated case (traditional dwelling)
[] 6 Concession
[] 7 Other
Usage type
[] 1 Residency
[] 2 Mixed
[] 2 Mixed
Occupation status
[] 1 Owner
[] 2 Renter
[] 3 Family property
[] 4 Other
[] 5 Undeclared
[] 2 Renter
[] 3 Family property
[] 4 Other
[] 5 Undeclared
Total number of occupied rooms _ _
Report the total number of rooms occupied by the household in the dwelling unit. (Write down the number in the grid)
Nature of the roof (primary construction)
[] 1 Sheet metal
[] 2 Tile
[] 3 Clay
[] 4 Straw
[] 5 Other
[] 2 Tile
[] 3 Clay
[] 4 Straw
[] 5 Other
Nature of the walls (primary construction)
[] 1 Brick or stone
[] 2 Clay
[] 3 Bamboo
[] 4 Semi-hard
[] 5 Other
[] 2 Clay
[] 3 Bamboo
[] 4 Semi-hard
[] 5 Other
Nature of the floor (primary construction)
[] 1 Cement
[] 2 Clay
[] 3 Wood
[] 4 Other
[] 2 Clay
[] 3 Wood
[] 4 Other
Lighting mode
[] 1 Electricity (SBEE)
[] 2 Gas (lamps)
[] 3 Oil
[] 4 Other
[] 2 Gas (lamps)
[] 3 Oil
[] 4 Other
Water provisioning
[] 1 Running water (SBEE)
[] 2 Fountain
[] 3 Village pump
[] 4 Cistern
[] 5 Wells
[] 6 River
[] 7 Other
[] 2 Fountain
[] 3 Village pump
[] 4 Cistern
[] 5 Wells
[] 6 River
[] 7 Other
Household's sanitation mode
[] 1 Septic tank
[] 2 Public latrine
[] 3 In nature
[] 4 W.C. with water flush
[] 5 Other
[] 2 Public latrine
[] 3 In nature
[] 4 W.C. with water flush
[] 5 Other
Used water evacuation (at the level of the household)
[] 1 Sewer system
[] 2 Septic tank
[] 3 In nature
[] 4 Other
[] 2 Septic tank
[] 3 In nature
[] 4 Other
Household waste evacuation
[] 1 Public or private garbage dump
[] 2 Burial
[] 3 Nature
[] 4 Burning
[] 5 Other
[] 2 Burial
[] 3 Nature
[] 4 Burning
[] 5 Other
Household's most used cooking energy method
[] 1 Wood
[] 2 Coal
[] 3 Electricity
[] 4 Gas
[] 5 Oil
[] 6 Other
[] 2 Coal
[] 3 Electricity
[] 4 Gas
[] 5 Oil
[] 6 Other