[This document consists of Appendix III and IV, which contain two different versions of the questionnaire for rural and urban area.]
Appendix III
1984 Ethiopian Population and Housing Census Questionnaire -Rural
____ 1. Region
____ 2. Awraja
____ 3. Wereda
____ 4. Town
____ 5. Kefyegna
____ 6. Supervisory area
____ 7. Settlement area
____ 8. Enumeration area
9. Type of resident
[] 2 Hotel or hostel resident
[] 3 Other collective quarter
[] 4 Homeless
[] 5 Nomadic
10. Housing unit serial no. ____
Housing unit
11. Number _ _ _ _
12. Sub No. _ _ _
13. Household Serial No. _ _ _
Block 2. Particulars of household members
Ask for every member of the household
14. Number of household member ____
15. Names of usual household members and visitors.
____
[] 2 Resident absent
[] 3 Visitor
17. Relationship to head of household
[] 1 Spouse
[] 2 Son/daughter of head and spouse
[] 3 Son/daughter of head
[] 4 Son/daughter of spouse
[] 5 Mother or father of head/spouse
[] 6 Brother or sister of head/spouse
[] 7 Other relatives
[] 8 Non relative
[] 2 Female
_ _
[Question 20 through 28 were asked of resident household members]
[] 2 Protestant
[] 3 Catholic
[] 4 Islam
[] 5 Other religion
[] 6 Idolatry
[] 7 Pagan
____
____
Place of birth
Was [person] born in an urban or rural area?
23. Town ____
24. Wereda ___
25. District ____
26. Region ____
27. What is the number of years [person] has continuously lived in this wereda?
Disability status
28. Is [person] disabled? If yes, state type of disability.
5 years of age and over
[Questions 29-30 were asked of resident household members age 5+.]
Educational status
29. Write grade enrolled for those now attending, 24 if attended in the past, 25 if never attended.
_ _
Ask for members age 10 years and over.
[Questions 31-36 were asked for household members age 10+.]
[] 2 Married
[] 3 Divorced
[] 4 Widowed
[] 5 Separated
32. Was [person] engaged in productive work during most of the last 12 months?
[] 2 No
33. If did not work, reason for not working.
[Question 33 was asked for household members age 10+ who reported not being engaged in productive work during the last 12 months.]
____
For those who have been engaged in productive work during most of the last 12 months, unemployed with work experience.
[Questions 34-36 were asked of resident household members age 10+ who were engaged in productive work during most of the last 12 months, or were unemployed with work experience.]
35. Major product or service of establishment
Ask for women aged 10 years and over
[Questions 37-40 were asked for resident female aged 10+.]
What is the total number of children ever born to [person]?
_ _ Females
_ _ Females
_ _ Females
40. What is the number of live births born by [person] in the last 12 months?
_ _ Still living
Block 3. Information on deaths
41. Particulars of deaths in the households in the last 12 months.
Age _ _
Age _ _
Age _ _
Age _ _
Age _ _
Block 4. Detailed information on housing unit
42. What is the major material used for the construction of the housing unit?
[] 1 Wood and mud wall and thatch roof
[] 2 Wood and mud wall and wood and mud roof
[] 3 Wood and mud wall and corrugated iron roof
[] 4 Stone wall and thatch roof
[] 5 Stone wall and corrugated iron roof
[] 6 Stone wall and wood, mud and thatch roof
[] 7 Stone wall and wood, stone, mud and thatch roof
[] 8 Other ____
43. What is the number of rooms in the housing unit?
_ _
44. Status of kitchen in the housing unit
[] 2 Has a room mainly as a kitchen
[] 3 Used as a kitchen the room where members spend the night
[] 4 Used as a kitchen the room where livestock spend the night
45. Do domestic animals spend the night in the room(s) where members spend the night?
[] 2 No
Supervisor ____
Appendix IV
1984 Ethiopian Population and Housing Census Questionnaire - Urban
[In the enumeration form for Urban area, Block 1-3 consisting of questions 1-41 are identical to the Rural Enumeration form, except for question 32 on productive work. As such, the texts for questions 1-31 and 33-41 are omitted here.]
Block 2. Particulars of household members
32. How many days has [the person] done productive work during last 7 days? ____
Block 4. Detailed information on housing unit
[Question 42 through 63 were asked of urban households]
42. What is the type of housing unit?
[] 2 Improvised
[] 3 Mobile
[] 4 Other (Specify) ____
43. What is the type of building in which the housing unit is found?
[] 1 Non-storeyed 2 units attached
[] 2 Non-storeyed 3-5 units
[] 3 Non-storeyed 6 or more units
[] 4 One or more storeyed detached
[] 5 One or more storeyed, 2-3 units attached
[] 6 One or more storeyed, 4-6 units attached
[] 7 One or more storeyed, 7-10 units attached
[] 8 One or more storeyed, 11 or more units attached
44. What is the purpose of the housing unit?
[] 2 Residential and establishment
45. What is the major material used for the construction of wall of housing unit?
[] 1 Stone and cement
[] 2 Stone and mud
[] 3 Blockets
[] 4 Wood and mud
[] 5 Bamboo and mud / Reed and mud
[] 6 Concrete or cement
[] 7 Corrugated iron
[] 8 Other (Specify) ____
46. What is the major material used for the construction of roof of the housing unit?
[] 2 Concrete or cement
[] 3 Wood and mud
[] 4 Thatch
[] 5 Reed/Bamboo, thatch and mud
[] 6 Asbestos
[] 7 Other (Specify) ____
47. What is the major material used for the construction of floor of the housing unit?
[] 1 Wood tiles
[] 2 Cement/Concrete finish
[] 3 Plastic tile
[] 4 Cement or clay tile
[] 5 Marble tile
[] 6 Stone
[] 7 Bamboo/Reed
[] 8 Other (Specify) ____
48. Does the major part of the housing unit have a ceiling?
[] 2 No
49. If yes in 48, what is the major material used for the construction of the ceiling?
[] 2 Hard fabrics
[] 3 Chip board
[] 4 Wooden
[] 5 Cement or concrete
[] 6 Clipboard
[] 7 Other (Specify) ____
50. What is the number of rooms in the housing unit?
Enter the number of room in the space provided _ _
51. What is the type of tenure of the housing unit?
[] 2 Rented from Kebele or City Residents Association
[] 3 Rented from public housing agency
[] 4 Paying difference in rent
[] 5 Rent free
52. If rented, what is the monthly amount of rent in BIRR?
Enter the amount of rent in the space provided _ _ _ _
53. What type of kitchen does the housing unit have?
[] 2 Modern kitchen, private
[] 3 Modern kitchen, shared
[] 4 Traditional kitchen, private
[] 5 Traditional kitchen, shared
54. What type of fuel is usually used for cooking in the housing unit?
[] 2 Gas
[] 3 Electricity and gas
[] 4 Electricity, firewood and charcoal
[] 5 Gas, firewood and charcoal
[] 6 Firewood and charcoal
[] 7 Firewood
[] 8 Other (Specify) ____
55. Where does the housing unit get drinking water?
[] 2 Tap in compound, private
[] 3 Tap in compound, shared
[] 4 Outside compound, public tap
[] 5 Tap outside compound, shared
[] 6 Protected well or spring
[] 7 Unprotected well or spring
[] 8 River or lake/pond
56. What type of bathing facility does the housing unit have?
[] 2 Bath tub, private
[] 3 Bath tub, shared
[] 4 Shower, private
[] 5 Shower, shared
[] 6 Bath tub and shower, private
[] 7 Bath tub and shower, shared
57. What type of toilet facility does the housing unit have?
[] 2 Flush toilet, private
[] 3 Flush toilet, shared
[] 4 Pit, private
[] 5 Pit, shared
58. What type of lighting has the housing unit?
[] 2 Electricity (Meter, shared)
[] 3 Masho (storm lantern)
[] 4 Lantern
[] 5 Kerosene lamp
[] 6 Other (Specify) ____
59. Is there a radio in this housing unit?
[] 2 No
60. Is there a telephone in this housing unit?
[] 2 No
61. Is there a television in this housing unit?
[] 2 No
62. What is the total number of households in the housing unit?
____
63. What is the total number of household members of households in the housing unit?
_ _ Females
_ _ Total
[Box 64 for enumerator and supervisor to sign and date is omitted here.]