[For Census Office use]
Village ____
Locality ____
Settlement ____
Household number ____
For all persons
[Questions D1-D10 were asked of all persons.]
D1. Name
All who stayed on census night.
_____
D2. Relationship
To head. Husband/wife or parent?
______
D3. Sex
M for males, F for females
______
D4. Date of birth
If date unknown estimate year
Day ____
Month ____
Year____
D5. Ethnic group
Chinese, European, Fijian, Indian, part European, Rotuman, Tongan, etc.
______
D6. Marital status
Never married, married, widowed, divorced or separated
______
D7. Real father
Alive or dead
______
D8. Real mother
Alive or dead
______
D9. Religion
Exact denomination or sect
______
D10. Place of birth
Where did mother live at time of person's birth.
State province, country if outside Fiji
______
Give full address: Town, Street, Ward, if urban area. Village, settlement or locality, if rural.
______
D11. Where living in 1991
[Question D11 was asked of persons 5 years of age and older.]
State province, country if outside Fiji
______
Give full address: Town, Street, Ward, if urban area. Village, settlement or locality, if rural.
______
D12. School attendance
[Question D12 was asked of all persons.]
Attending school/institution full time (AT), left school (LEFT), never been (NB)
______
D13. Educational attainment
[Question D13 was asked of persons who are attending or attended school.]
For (AT) or (LEFT), highest level attained if at school state Kindergarten, primary class, secondary form, university/tertiary year, e.g. class 3, form 5, Diploma 1, Degree 2, etc.
______
For (LEFT), specify main field of study if completed Degree/Diploma/Certificate, e.g. primary school teaching, motor mechanic, economics
______
For all persons born in 1981 or before
[Questions D14-D17 were asked of persons born in 1981 or before.]
D14. Type of activity last week
(a) Did person do any work for money? If yes or if temporarily absent from work write (M). If no work for money write (NO).
______
(b) How many days money work? Give number or 0 if none or if actively looking for work, write (UNEMP).
______
(c) Did person plant or collect shells, fish or provide for own use? Write (SUBS) otherwise write (NO).
______
(d) If doing (M), (UNEMP) or (SUBS) write (NA). For others, state Student, Not looking for work, Fulltime homemaker, retired, disabled, other - specify.
______
D15. Occupation
What is person's occupation? Describe the main task usually performed in least 2 words.
______
D16. Industry
State activities, services, product of your place of work. Who does the person work for? Section if large company or government department
______
If self-employed, what is person's trade or business?
D17. Employment status
How is person paid? Weekly wages, fortnightly/monthly salary, by sale or job done, unpaid
______
For all women born in 1981 or before
[Questions F1-F5 were asked of women born in 1981 or before.]
F1. How many of the children this woman has borne alive were here on census night? If none, 0.
Girls ______
F2. How many were elsewhere? If none, 0.
Girls ______
F3. How many have died? If none, 0.
Girls ______
F4. When was the last child born?
Month ______
Year ______
F5. Is the [last] child still alive?
Yes or No
______
Household Questions
Money activity in household
This year (1996) did anyone in this household excluding visitors and those doing so in a wage job earn money from the following activities?
Tick appropriate box for each item
M1. Producing cash crops
[] No
[] No
[] No
[]
M2. Raising livestock
[] No
[] No
[] No
M3. Catching/collecting
[] No
[] No
[] No
[] No
M4. Running
[] No
[] No
[] No
M5. Making
[] No
[] No
[] No
[] No
[] No
M6. Other business or activity? Specify______.
[] No
Disability
C1. Does any person in this household have any disability or health problem that is long term? (Lasting 6 months or more).
Please circle person numbers from D1:
[] P2
[] P3
[] P4
[] P5
[] P6
[] P7
[] P8
[] P9
[] P10
C2. Does this person as a result of this condition has difficulty with or cannot do?
Tick appropriate box
[] Communicating, mixing with others or socializing
[] Any other activity that people his/ her age usually do
[] No difficulty with any of these
C3. What is the nature of the disability?
Insert code in appropriate box.
[] 2. Intelligence
[] 3. Hearing
[] 4. Physical
[] 5. Age
[] 6. Other
(Put appropriate number in right hand box)
H1. Type of living quarters
Does this household live in
[] 2. A one family house attached to one or more houses
[] 3. A building with two or more apartments
[] 4. A building with two or more households which share a kitchen or toilet
[] 5. A dwelling attached to a shop or other non-residential building
[] 6. A lodging house
[] 7. A hotel
[] 8. More than one of the above, or other, specify ______
H2. Construction of outer walls
Are the walls of the building mainly constructed of
[] 2. Wood in good or reasonably sound condition
[] 3. Tin or corrugated iron
[] 4. Traditional bure materials
[] 5. Wood in poor condition
[] 6. Makeshift or improvised materials
[] 7. Other materials, specify
H3. Number of rooms
How many rooms (bedrooms, living or sitting rooms) are there for the use of this household?
______
H4. Main water supply
[] 2. From a communal standpipe
[] 3. Rooftank
[] 4. Well
[] 5. River or creek
[] 6. Other, specify
Does the household's water supply ever dry up?
[] 2. Sometimes
[] 3. Every year
H5. Electricity
Does this household have electricity?
[] 2. No
H5 A. If yes, by which supply
[] 2. FSC
[] 3. Vatukoula
[] 4. Village power plant
[] 5. PWD
[] 6. Own plant
[] 7. Other, specify ______
H6. Lighting
What does this household mainly use for lighting?
2. Pressure lamp
3. Wick lamp
4. Other, specify ____
H7. Cooking fuel
What fuel does this household mainly use for cooking?
[] 2. LPG
[] 3. Kerosene
[] 4. Wood stove
[] 5. Wood, open fire
[] 6. Other, specify _____
H8. Toilet facilities
Does this household have a
[] 2. Flush toilet shared with others
[] 3. Water sealed privy for its exclusive use
[] 4. Water sealed privy shared with others
[] 5. Pit latrine for its exclusive use
[] 6. Pit latrine shared with others
[] 7. None
[] 8. Other, specify _____
Does this household have a septic tank?
[] 2. No
H9. Tenure: The living quarters
Does this household
[] 2. Rent them from a Private Landlord
[] 3. Rent them from the Public Rental Board
[] 4. Occupy government or institutional housing
[] 5. Occupy this housing by leave of the employer
[] 6. Pay no rent or have an informal renting arrangement with the landowner
[] 7. Other, specify _____
H10. Tenure: The land
Is the land on which the living quarters is situated
[] 2. Leased from State
[] 3. Leased from NLTB
[] 4. Occupied without legal arrangement, state or freehold land
[] 5. Occupied Native Land with informal arrangement
[] 6. Occupied through traditional village tenure
[] 7. Other, specify _____
H11. Dwelling adequacy
From an examination of the photographs supplied, is the dwelling
[] 2. Well above average
[] 3. Average
[] 4. Well below average
[] 5. Inferior
[] 6. Other, specify _____
H12. How is household waste disposed?
Tick appropriate box.
[] 2. Buried
[] 3. Burnt
[] 4. Disposed into rivers/seas
[] 5. Disposed in backyard
[] 6. Other, specify _____
H13. Are any of the following items available for use by members of this household?
Tick appropriate box if yes.
[] 2. Carrier/ Truck
[] 3. Refrigerator
[] 4. Video/TV
[] 5. Washing machine
[] 6. Gas/ Electric stove
[] 7. Telephone
[] 8. Outboard motor
[] 9. Water pump