Plurinational State of Bolivia
2012 National Census of Population and Housing
Under Decree Law No. 14100 of the National Statistics Information System, the information provided is confidential
[p. 1]
Chapter A. Geographical location of the dwelling
1.1 Copy the geographical location information that appears on the cover sheet
City / community _ _
Census tract _ _ _
Sector _ _ _
Segment _ _
Block _ _ _ _
____ Population hub / locality
____ Neighborhood / tract / N.U.
____ Street, avenue, path, or road
____ Door number
____ Floor
____ Apartment number
____ Building name
If there are more than 8 people, use 2 or more forms:
b) In 2.2, note down 2, 3, etc., as appropriate, and continue with Chapter F.
2.1 Dwelling sequence number _ _
2.2 Census form number in this dwelling _ _ _
3. How many people spent the night before Census Day in this dwelling?
_ _ _ Total people
_ _ _ Male
_ _ _ Female
Chapter B. Main characteristics of the dwelling
Private
[] 2 Apartment
[] 3 Individual room(s)
[] 4 Improvised dwelling
[] 5 Premises not intended as a dwelling
[] 8 Person living on the street [Go to Chapter F]
Occupied dwellings
[] 2 Occupied with people temporarily absent
[] 4 Under construction or repair
[] 5 Abandoned
3. What is the main construction material used in the exterior walls of this dwelling?
[] 2 Adobe, rammed earth
[] 3 Tabique, quinche
[] 4 Stone
[] 5 Wood
[] 6 Reed, palm, log
[] 7 Other
4. Do the interior walls of this dwelling have plaster?
[] 2 No
5. What is the main material used in the roofs of this dwelling?
[] 2 Clay roof tile, cement roof tile, fiber cement
[] 3 Reinforced concrete slab
[] 4 Straw, palm, reed, mud
[] 5 Other
6 What is the main material used in the floors of this dwelling?
[] 2 Wooden board
[] 3 Tongue-and-groove wood
[] 4 Parquet
[] 5 Ceramic
[] 6 Cement
[] 7 Mosaic, floor tile
[] 8 Brick
[] 9 Other
7. Does the water used in this dwelling come primarily from...?
[] 2 Public wash basin
[] 3 Water truck
[] 4 Well or waterwheel with pump
[] 5 Well or waterwheel with no pump
[] 6 Rainwater, river, spring, stream
[] 7 Lake, pond, wetland
8. Is the water used in this dwelling distributed by...?
[] 2 Pipes outside the dwelling but on the lot or grounds
[] 3 Pipes outside the dwelling not on the lot or grounds
[] 4 Not distributed through pipes
[The bottom of each page consists of an instructional graphic for writing in and marking the boxes. These graphics have been omitted.]
[p. 2]
9. Does it have a toilet, bathroom, or latrine?
[] 2 Yes, shared
[] 3 No, dwelling does not have [Go to question 11]
10. Does the toilet, bathroom, or latrine drain into...?
[] 2 A septic tank
[] 3 A cesspit
[] 4 The street
[] 5 The creek or river
[] 6 A lake, pond, or wetland
11. Do they have electricity that comes from...?
[] 2 Own generator
[] 3 Solar panel
[] 4 Other
[] 5 None
12. What is the main fuel or power used for cooking?
[] 2 Bottled gas
[] 3 Electricity
[] 4 Solar energy
[] 5 Wood
[] 6 Guano, dung, or manure
[] 7 Other
[] 8 No cooking
13. Is there a dedicated room for cooking?
[] 2 No
14. How many rooms does your household occupy, not counting bathrooms or kitchens? _ _
15. Of the total number of rooms, how many are used only for sleeping? _ _
16. What is the main way you dispose of trash?
[] 2 Use the public trash collection service (garbage truck)
[] 3 Throw it into a vacant lot or the street
[] 4 Throw it in a river
[] 5 Burn it
[] 6 Bury it
[] 7 Other
[] 2 No
[] 2 No
[] 2 No
[] 2 No
[] 2 No
[] 2 No
[] 2 No
[] 2 No
[] 2 No
[] 2 No
19. Is the dwelling that this household occupies...?
[] 2 Rented
[] 3 Under a contract of antichresis
[] 4 Under a contract of antichresis and rent
[] 5 Granted in exchange for services
[] 6 Lent by relatives or friends
[] 7 Other
Chapter C. International emigration
20. Is there anyone who lived with you in this home in 2001 or later who now lives in another country?
In the table below, record the information for each of the people who now live in another country.
Number _
The person is:
[] 2 Male
Year of departure _ _ _ _
Age at departure _ _ _
Country where person now lives ____
[p. 3]
Chapter D. Mortality
21. From January to December of last year, did anyone who lived with you in this home die?
In the table below, record the information for each of the people who died. Don't forget children, newborns, and old people.
Number _
Age at death (Write 0 if under 1 year old) _ _ _
The person was:
[] 2 Male
If it was a woman at least 15 years old, did she die of causes related to...
[] 2 Childbirth
[] 3 Postpartum (up to 2 months after childbirth)
[] 4 Other cause
Chapter E. People with a permanent difficulty
22. Does anyone in this household have a permanent difficulty with any of the following?
Hearing, even if they use a hearing aid?
Speaking, communicating, or conversing?
Walking or climbing stairs?
[] 2 No [Go to question 23]
In the table below, record the information for each person with a permanent difficulty.
Number _
Person's name ____
Age _ _ _
The person is:
[] 2 Male
The permanent difficulty is with...
[] 2 Hearing, even with a hearing aid
[] 3 Speech, communicating, or conversing
[] 4 Walking or climbing stairs
[] 5 Remembering or concentrating
[p. 4]
Chapter F. The person's main characteristics
Person number _ _ _ _
Person's name ____
23. What is your familial or other relationship with the head of household?
[] 2 Spouse, domestic partner, or cohabiting partner
[] 3 Daughter or son
[] 4 Daughter-in-law or son-in-law
[] 5 Granddaughter or grandson
[] 6 Sibling, brother-in-law, or sister-in-law
[] 7 Parent, mother-in-law, or father-in-law
[] 8 Other relative
[] 9 Domestic worker
[] 10 Other nonrelative
[] 11 Person in a collective dwelling
[] 2 Male
25. How old were you on your last birthday? _ _ _ [If under age 1, write 0]
26. Was your birth recorded in the civil registry or office of vital records?
[] 2 No
27. Do you have a national identity card or document?
[] 2 No
28. When you have health problems, do you rely on...
[] 2 No
[] 2 No
[] 2 No
[] 2 No
[] 2 No
[] 2 No
[] 2 No
29. If you are Bolivian, are you part of an Afro-Bolivian or original peasant indigenous nation or people?
Which nation or people? ____
Afroboliviano, Araona, Aymara, Ayoreo, Baure, Canichana, Cavineño, Cayubaba, Chácobo, Chipaya, Chiquitano, Esse Ejja, Guaraní, Guarasugwe, Guarayo, Itonama, Joaquiniano, Kallawaya, Leco, Machinerí, Maropa, Mojeño, Moré, Mosetén, Movima, Murato, Pacahuara, Quechua, Sirionó, Tacana, Tapiete, Tsimane/Chiman, Urus, Weenayek, Yaminagua, Yampara, Yuki, Yuracaré, Yuracaré - Mojeño
[] 3 I am not Bolivian
30. What is the first language you learned to speak as a child?
[] 2 Does not speak [Go to question 32]
31. What language do you speak?
1 ____
2 ____
3 ____
4 ____
5 ____
[] 2 Elsewhere in this country
____ Municipality
____ Department
Year of arrival in Bolivia _ _ _ _
33. Where do you usually live?
[] 2 Elsewhere in this country
____ Municipality
____ Department
34. Where did you leave 5 years ago?
[] 2 Elsewhere in this country
____ Municipality
____ Department
F2. Only for people at least 4 years old
[] 2 No
[p. 5]
36. Do you currently attend a school?
[] 2 Yes, a private school
[] 3 Yes, a charter school
[] 4 Not attending school
37. What was the highest educational level that you passed? [If 1-14, go to question 39]
[] 4 Basic (1 to 5 years)
[] 7 Primary (1 to 8 years)
[] 9 Primary (1 to 6 years)
[] 11 Technical university education
[] 15 Teacher's College
38. To access that level, what level and year of schooling did you pass?
[] 4 Basic (1 to 5 years)
[] 7 Primary (1 to 8 years)
[] 9 Primary (1 to 6 years)
F3. Only for people at least 7 years old
39. Did you work in the last week?
[] 2 No
40. In the last week, did you...?
[] 2 Serve or assist in agricultural growing or in raising livestock [Go to question 42]
[] 3 Serve or assist in a family business or your own business [Go to question 42]
[] 4 Perform any activity for income [Go to question 42]
[] 5 Not work
41. During the past week, were you... ?
[] 2 Seeking work for the first time [Go to question 45]
[] 3 A student [Go to question 45]
[] 4 A homemaker [Go to question 45]
[] 5 Retired, a pensioner, or an annuitant [Go to question 45]
[] 6 Other [Go to question 45]
42. What was your principal occupation, job, or trade in the last week? ____
43. In that occupation, did you work as...?
[] 2 A freelance worker
[] 3 An employer or partner
[] 4 An unpaid apprentice or family worker
[] 5 A domestic worker
[] 6 A member of a production / service co-op
44. What is the principal thing produced or sold by the place you work, or what is its principal economic activity? ____
F4. Only for people at least 15 years old
45. What is your civil or marital status?
[] 2 Married
[] 3 Domestic partner or cohabiting partner
[] 4 Separated
[] 5 Divorced
[] 6 Widowed
F5. Only for women at least 15 years old
46. In total, how many live births have you had, including children who are now dead or absent?
47. Of the live births, how many of your children are now alive?
48. In what month and year was your most recent live birth?
Year _ _ _ _
49a. Is this latest child still alive?
[] 2 No
49b. Where did your most recent childbirth occur?
[] 2 In a home
[] 3 Somewhere else
[p. 6]
General instructions for filling out the census form
To fill out the census form, bear in mind these instructions:
When the multiple-choice options are not followed by a question mark:
Ask the question, wait for the answer, and fill in the appropriate circle based on the information obtained.
[Figure omitted]
When the multiple-choice options are followed by a question mark:
Ask the question and read the multiple-choice options slowly until you obtain a positive response; then fill in the appropriate circle or bubble based on the information obtained.
[Figure omitted]
If the question has an arrow or bracket after one or more multiple-choice options:
This tells you which question or chapter of the census form you should go to next.
[Figure omitted]
Open-ended questions:
Open-ended questions have no preset answer. The answer should be written in capital block letters. Each box corresponds to one letter. For example: Juana states that she is a retail merchant and that this is her main occupation.
[Figure omitted]
Writing:
All information requested on the census form should be written in black pencil. When filling in circles or bubbles or writing numbers and letters into the individual boxes, mark and write clearly, being careful about spelling, and use capital letters, as shown in the figures below.
[Figure omitted]
Boxes for writing numbers:
Answering these questions requires writing quantities in numerical format. If the answer is only one or two digits long, the first boxes should not be left blank. One number must be written in each box. Never write two numbers in the same box.
[Figure omitted]