Dominican Republic
Technical Secretariat of the Office of the President
National Office of Statistics
Eighth National Population and Housing Census 2002
The information requested is strictly confidential pursuant to Law 5096 of 6 March
1959.
No. of file (copy the file number here) _ _ _ _ _ _ _
No. of dwelling interviewed _ _
No. of household within the dwelling _
Street, highway or road ____
House/building No. ____
Floor ____
Apartment No. ____
Complete the form by filling the oval boxes, using only the pencil provided. Write in capital letters, without accents; do not cross out, make corrections with the eraser provided; use this type of letters and numbers.
[Example of how to fill out the bubbles omitted]
Section II - Characteristics of the dwelling
If the dwelling is occupied with persons present, answer questions 1 through 6 on the basis of observation and then continue with the other questions.
If the dwelling is unoccupied, or occupied with persons abfsent, answer questions 1 and 3 on the basis of observation and then move to the next dwelling.
Data on the dwelling
1. Type of dwelling
[] 2 Apartment
[] 3 Room in a bunkhouse or in rear of premises
[] 4 Room in barracón
[] 5 Premises not intended for habitation
[] 6 Dwelling under construction
[] 7 Housing shared as business
[] 8 Other type of private dwelling
[] 10 Military quarters
[] 11 Prison
[] 12 Hospital or health center
[] 13 Religious institution or boarding school
[] 14 Other
2. This dwelling is reached by:
[] 2 Unpaved street/road
[] 3 Alley or road
[] 4 Staircase
[] 5 Other
[] 2 Occupied with absent residents
[] 3 Unoccupied
If the dwelling is occupied with persons absent, return later
[Questions 4-6] only for dwellings that are occupied with persons present
Main construction material of:
[] 2 Wood
[] 3 Palm planks
[] 4 Wood planks (tejamanil)
[] 5 Palm leaves (yagua)
[] 6 Other
[] 2 Zinc
[] 3 Asbestos cement
[] 4 Palm leaves (yagua)
[] 5 Cane
[] 6 Other
[] 2 Tile
[] 3 Cement
[] 4 Dirt
[] 5 Wood
[] 6 Other
Rooms of the dwelling
7. How many rooms does this dwelling have altogether, excluding bathrooms, kitchen, corridors and garage?
8. Does this dwelling have a kitchen?
[] 2 Yes, outside the dwelling
[] 3 No
9. Which of the following sources of pollution exist close to the dwelling? Read each alternative and mark those for which the answer is yes.
[] b Accumulation of garbage
[] c Irrigation canal containing garbage or polluted water
[] d Noise from vehicles or engines
[] e Pigsty or farm
[] f Factory smoke/gases
[] g Factory or workshop noises
[] h Waste material from factory, workshop, clinic etc.
[] i Noise and smoke from electric power plant
[] j Gas bottling plant
[] k Gasoline station
[] l Loud music from bars, take-aways (colmados), or neighbors
[] m No pollution
Section III - Identification of households in the dwelling
Read the following to the person being enumerated: A household can be formed by a person living alone, or by several persons living under the same roof who share the same meals, or, if not eating together, share common expenses.
10. How many households or groups of persons who eat their meals separately are there in this dwelling, counting your own?
If the answer is just one, skip to question 11. If there is more than one census household in the dwelling:
(b) For each additional household, start a new form and fill out Section I, Identification. Leave Sections II and III blank, and continue the interview from Section IV, Household Characteristics.
Section IV - Household characteristics - Possession of the dwelling
Tenancy of the dwelling
11. This dwelling (or the part of it that is occupied by this household) is:
[] 1 Rented
[] 2 Owned by the household, paying mortgage
[] 3 Owned by the household, paid off
[] 4 Given or lent
[] 5 Other
Bedrooms
12. How many bedrooms does this dwelling have?
Fuel for cooking
13. What fuel is mainly used for cooking in this household?
[] 2 Coal
[] 3 Firewood
[] 4 Electricity
[] 5 Other
[] 6 Household does not cook
Lighting
14. What type of lighting is used in this household?
[] 2 Energy from own generator
[] 3 Propane gas lamp
[] 4 Kerosene gas lamp
[] 5 Other
Water source
15. Where does the water for washing, cleaning, bathing, etc., used in this household come from?
[] 2 Water conduit in the yard of the house
[] 3 Public tap
[] 4 Spring, river, stream
[] 5 Well
[] 6 Rainfall
[] 7 Tanker truck
[] 8 Other
Sanitary facility
16. What type of sanitary facility does the household have?
[] 2 Latrine
[] 3 None
17. Does this household share its sanitary facility with other households?
[] 2 No
Waste removal
18. How does this household eliminate its waste material?
[] 2 Collected by private sanitation service
[] 3 Burned
[] 4 Thrown in yard or lot
[] 5 Put in garbage dump
[] 6 Thrown in river or canal
[] 7 Other
Household goods and services
19. Which of the following articles or services does this household have?
[] a. Refrigerator
[] b. Stove
[] c. Washing machine
[] d. Television
[] e. Air conditioning
[] f. Radio/music equipment
[] g. Private automobile
[] h. Cistern or water tank
[] i. Computer
[] j. Converter
[] k. Generator
[] l. Landline or cellphone
[] m. Internet
Section V - List of persons who live in the household
Make sure of listing all persons living in this household, including children, newborn babies and old people.
Column 2
Please tell me the names of the persons that live most of the time in this household, trying to keep to this order: head of household (entered on the first line), spouse or companion of the head of household, children, stepchildren, son/daughter-in-law, parents and parents in law, grandchildren, other family relatives (brothers/sisters, brothers/sisters-in-law, aunts/uncles, etc.), domestic worker, other non-relatives
Column 3
Note the relationship or link with the head of household
Column 4
Age (put 00 if the person is younger than one year old)
____
If there are more than six persons in the household, continue on other form, repeating the data from Section I, Identification. List other persons in section V and continue as from section VIL
20. Is there any newborn baby or child that has not been listed?
[] 2 No
21. Apart from the persons listed, is there any household member who lives in this dwelling most of the time, but is absent because of vacation, work, business, illness, etc.?
[] 2 No
_ _ _ Females
_ _ _ Total
Total number of persons of 18 years and older: _ _ _
Section VI - International emigration and remittances
23. Are any persons who used to live in this household currently living outside the country?
[] 2 No (Skip to question 25)
24. How many men and how many women are currently living outside the country?
_ _ Females
25. Do any of the members of this household receive money regularly from abroad?
[] 2 No (Skip to question 27)
26. On average, how much money is received from abroad each month? Enter the amount in Dominican pesos
Section VII - Personal characteristics
Person No. : ______
Name: ______
27. What is the person's relationship to the head of household?
[] 2 Spouse/companion
[] 3 Son/daughter
[] 4 Stepchild/foster child
[] 5 Son/daughter-in-law
[] 6 Grandchild
[] 7 Father/mother
[] 8 Father/mother-in-law
[] 9 Other relation
[] 10 Domestic worker
[] 11 Other non-relation
28. Is [the respondent] male or female?
[] 2 Female
29. On what date was [the respondent] born?
____ Month
____ Year
30. How old is [the respondent]? _ _
31. Where was [the respondent] born?
[] 2 In another municipality
[] 3 Abroad
____
If born abroad, indicate year of arrival in the Dominican Republic (Skip to question 34)
_ _ _ _
32. In which country was [the respondent]'s mother born?
[] 2 Abroad ____
33. In which country was [the respondent]'s father born?
[] 2 Abroad ____
34. Is [the respondent]'s mother alive?
[] 2 No
[] 3 Unknown
35. Does [the respondent] have any of the following disabilities? Read each option and mark cases where the answer is yes.
[] b Blind in both eyes
[] c Deaf
[] d Mute
[] e Loss or permanent limitation in arm movement
[] f Loss or permanent limitation in leg movement
[] g Mental retardation or deficiency
[] h Other disability
[] I No disability (Skip to question 37)
36. What is the cause of these disabilities?
[] 2 Illness
[] 3 Violence or abuse
[] 4 Motorcycle accident
[] 5 Other motor vehicle accident
[] 6 Other accident (excluding workplace)
[] 7 Workplace accident
[] 8 Old age
[] 9 Other cause
[] 10 Unknown
For persons of 3 years old and more
[Questions 37-44 were asked of persons age 3+.]
37. Can [the respondent] read and write?
[] 2 No
38. Does/did [the respondent] attend a school, college or university, whether public or private?
[] 2 Attending a private school (Go to question 40)
[] 3 Never attended school (Go to question 45)
[] 4 Not currently attending but attended in the past
39. What was the main reason why [the respondent] stopped studying? Read all options and mark just one.
[] 2 Has/had to work
[] 3 Got married or went to live with partner
[] 4 Looking after/looked after younger brothers and sisters
[] 5 There is/was no school in the locality
[] 6 School is/was far away
[] 7 Does not/did not have economic means
[] 8 Does not/did not have birth certificate
[] 9 Appropriate grades are/were not available
[] 10 Lack of places
[] 11 Completed studies
[] 12 Left when pregnant
[] 13 Other reason
40. If [the respondent] is currently attending school (question 38, answer 1 or 2): What course is he/she attending and at what level? If the answer was that [the respondent] is not currently attending school, but attended in the past (question 38, answer 4): What was the last year of study that [the respondent] completed, and at what level?
41. Did [the respondent] complete this level?
[] 2 No
42. (a) What basic field is/did [the respondent] studying/study?
(b) What specialty, masters or doctorate does/did [the respondent] take? Skip to question 45
____
See question 30. If [the respondent] is more than 30 years old, skip to question 45, otherwise:
43. Did [the respondent] attend school or college during the last school year?
[] 2 No
44. Is [the respondent] repeating the course he/she is currently attending?
[] 2 No
[] 3 Not attending school
For persons of 5 years old and more
[Question 45 was asked for persons age 5+.]
45. Where was [the respondent] living in October of 1997?
[] 2 In another municipality
[] p Town/city
If [the respondent] was living abroad, write the name of the country.
____
For persons of 10 years old and more
46. Last week (i.e. the last seven days) did [the respondent] have any job or work for payment or reward, even though he/she may have been absent from work owing to vacations, illness or some other reason?
[] 2 No
47. Did [the respondent] undertake any activity for payment or gain last week, such as selling food or clothing, sewing, guarding automobiles, selling tickets, etc., for at least one hour?
[] 2 No
48. Last week, did [the respondent] help, without payment or gain, in the business, farm or economic activity of a family member?
[] 2 No
49. Has [the respondent] previously worked for payment or gain?
[] 2 No (Skip to question 55)
50. What was the main occupation or task undertaken by [the respondent] during the last week, (or in his/her last job)?
51. In that job, [the respondent] is/ was:
[] 2 Employer or boss
[] 3 Unpaid family worker
[] 4 Self-employed (Skip to question 54)
[] 5 Member of a production cooperative (Skip to question 54)
[] 6 Other (Skip to question 54)
52. For what type of firm, business, or institution did [the respondent] work last week (or in his/her last job or trade)? Read all options and select just one.
[] 2 Other private enterprise or business
[] 3 Non-governmental non-profit organization
[] 4 For a particular individual
[] 5 Public institution or enterprise (Skip to question 54)
[] 6 A family house (Skip to question 54)
[] 7 Other (Skip to question 54)
53. How many persons work/worked in that firm, business or institution?
54. What does the firm, business or institution in which [the respondent] works (or last worked) do?
If the answer to questions 46 or 47 or 48 was "yes", skip to question 59.
55. Last week, did [the respondent] seek work for payment or gain, or try to establish his/her own business or enterprise?
[] 2 No
56. What was [the respondent]'s main activity last week? Read all options and select just one:
[] 2 Studies
[] 3 Living from investments
[] 4 Retired or receiving pension
[] 5 Disabled/elderly
[] 6 No activity
[] 7 Other
57. At the present time, would [the respondent] be willing to work if offered a job?
[] 2 No (Skip to question 59)
58. Why did [the respondent] not seek work last week? Read all options and select just one
[] 2 Believes it is very difficult to find work
[] 3 Other people are looking for work
[] 4 Is waiting for a reply to a job application
[] 5 Has to study
[] 6 Has to look after the home/children
[] 7 Lives from investment income or is retired
[] 8 Does not need or want to work
[] 9 Is disabled or elderly
[] 10 Partner does not allow him/her to work
[] 11 Other
59. How much did [the respondent] receive last month in terms of wages, rent, pension, retirement pension, interest, or any other income?
For persons of 15 years old and more
[Questions 60-63 were asked for persons age 15+.]
60. At the present time [the respondent] is...
[] 1 Married
[] 2 Cohabiting
[] 3 Widow/widower
[] 4 Divorced
[] 5 Separated from legal or religious marriage
[] 6 Separated from cohabitation
[] 7 Single
61. How many sisters from the same mother has [the respondent] had that have reached 12 years old? If any, indicate the number; if not, fill the oval box and skip to question 64.
[] None
62. Of these of sisters, how many have died? If any, indicate the number; if none fill the oval box.
[] None
63. Of sisters who have died, how many died during pregnancy, childbirth, or risk period? If any, indicate the number, if not fill the oval box.
[] None
For women of 15 years old and more
[Questions 64-67 were asked for women age 15+.]
64. In total, how many live-born children has [the respondent] had, including those that died a few hours or days after birth? If any, indicate the number; if not, fill the oval box, and skip to the next person.
_ _ Daughters
[] None
65. Of these sons and daughters, how many are currently living? If none fill the oval box.
_ _ Daughters
[] None
66. What is the date of birth of [the respondent]'s last live-born son or daughter?
Year _ _ _ _
67. Is this last son or daughter of [the respondent], currently living?
[] 2 No
[] 3 Unknown
Section VIII - Identification of agricultural producers
A.- Do any of the men or women members of this household have land plots that are sown, uncultivated, at rest, fallow (whether owned, rented, or under sharecropping, etc.) or which they have harvested over the last 12 years?
[] 2 No (Skip to question B)
Sex (Put V for male or F for female) ____
____Harvested
____Uncultivated, at rest, or fallow
B. - Do any of the men or women of this household have animals for household consumption or sale?
[] 2 No
Sex (Put V for male or F for female) ____
____ Ducks, turkeys, geese
____ Hens, chickens, cockerels
____ Beehives
____ Pigs
____ Kids, goats, sheep, rabbits
Name of census enumerator: ____
Name of supervisor: ____
Observations: ________