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[p. 1]


Republic of Honduras
Presidential Commission on the Modernization of the State

XVI Population Census and V Dwelling Census

The requested information is strictly confidential. Legislative decree number 86-2000, July 8, 2000.
_ Additional form. Fill out the geographical location, go to section D and continue with section F.
_ Form for another household. Full out the geographical, go to section C and continue with the interview.

A. Geographical Location

1. Department _ _
2. Municipality _ _
3. Area _
4. Zone _ _
5. Segment _ _ _
6. Sector _ _
7. Village _ _
8. City or town _ _ _
9. Neighborhood or subdivision _ _ _
10. Block _ _ _
11. Number of dwelling in route _ _ _
12. Number of household _ _

Section B. Information about the Dwelling

1. Type of dwelling:

Individual Dwelling

[] 01 Independent house
[] 02 Apartment
[] 03 Room in house or boarding house
[] 04 Retail space not build for habitation
[] 05 Temporary shelter
[] 06 Improvised house
[] 07 Other

Collective Dwelling

[] 08 Hotel, pension, or guest house
[] 09 Hospital, sanitarium, or clinic
[] 10 Orphanage or home for the elderly
[] 11 Barracks, battalion, or police station
[] 12 Prison or reformatory
[] 13 Other

(Continue to Section F if any of these answers are selected)

Construction materials of the dwelling:

2. What is the predominant material of the exterior walls of the dwelling?

[] 1 Brick
[] 2 Stone or quarry stone
[] 3 Cement block or concrete
[] 4 Adobe
[] 5 Wood
[] 6 Cane with earth (bahareque)
[] 7 Palm or cane
[] 8 Discarded materials
[] 9 Other

3. What is the predominant material of the roof?

[] 1 Clay tile
[] 2 Asbestos Sheeting
[] 3 Zinc Sheeting
[] 4 Concrete
[] 5 Straw, palm, or similar
[] 6 Discarded materials
[] 7 Other

4. Condition of Occupancy:

Occupied dwelling

[] 1 Dwelling with persons present
[] 2 Dwelling with persons absent
End the form here after three visits

Unoccupied dwelling

[] 3 For rent or sale
[] 4 Temporary use
[] 5 Being repaired
[] 6 Under construction
[] 7 Other

(End the form here if any of these answers are selected)

Only for individual dwellings that are occupied with persons present
[Questions 5- 12 were asked of individual, occupied dwellings.]

5. What is the predominant material of the floors of the dwelling?

[] 1 Dirt
[] 2 Cement slab
[] 3 Wood
[] 4 Cement brick
[] 5 Granite or stone tile
[] 6 Clay brick
[] 7 Ceramic
[] 8 Other

Basic services of the dwelling

6. Where does the water supply for the dwelling come from?

[] 1 Piped from a public or private system
[] 2 From a well with a rotating mechanism
[] 3 From a well with a pump
[] 4 From a fall, river, or spring
[] 5 From a lake or lagoon
[] 6 From a vendor or delivery system
[] 7 Other

7. Does the dwelling have a piped system for water service?

[] 1 Inside the dwelling
[] 2 Outside the dwelling, but inside the property
[] 3 None

8. What is the principal form of lighting used by the dwelling?

[] 1 Electricity from a public system
[] 2 Electricity from a private system
[] 3 Electricity with a private generator
[] 4 Flashlight or kerosene gas lamp
[] 5 Candle
[] 6 Pine fire
[] 7 Solar panel
[] 8 Other

Trash removal

9. What is the principal form of trash removal?

[] 1 Throw it in the street, river, ditch, lake, or sea
[] 2 It is picked up by a trash collector
[] 3 They take it to a deposit or collection site
[] 4 They burn it or bury it
[] 5 They pay individuals to dispose of it
[] 6 Other

Rooms in the dwelling:

10. Without counting bathrooms and corridors, how many total rooms are there in the dwelling?

Number of rooms: _ _

Households in dwelling

11. In this dwelling, does some person, group, or household buy and consume their food separately?

[] 1 Yes
[] 2 No (Continue to section C)

12. Including yours, how many groups or households are there in all?

Total number of households: _ _

Starting with the second household, use another form and mark the box for "Form for other household."

[p. 2]

Section C. Household information

Rooms in the house

1. How many rooms are used by this household for sleeping? _ _

2. Does this household have a room for cooking?

[] 1 Yes
[] 2 No (Continue to question 4)

3. Is the room that is used for cooking only used by this household?

[] 1 Yes
[] 2 No

Energy for cooking

4. What is the principal source of energy used for cooking?

[] 1 Wood
[] 2 Gas (kerosene)
[] 3 Natural gas
[] 4 Electricity
[] 5 Other
[] 6 Do not cook

Sanitary service

5. Does this household have?:

[] 1 Toilet connected to a public sewer system
[] 2 Toilet connected to a septic tank
[] 3 Toilet that drains into a river, ditch, lagoon, sea, or lake
[] 4 Latrine with a simple well
[] 5 None (Continue to question 7)

6. The sanitary service, is it for the exclusive use of the household?

[] 1 Yes
[] 2 No

Comfort and equipment

7. Does this household own an automobile for the exclusive use of the household?

[] 1 One
[] 2 More than one
[] 3 No

8. Does this household have any of the following appliances or equipment?

A. Refrigerator

[] 1 Yes
[] 2 No

B. Electric washer (clothes)

[] 1 Yes
[] 2 No

C. Radio, radio/tape recorder, or stereo equipment

[] 1 Yes
[] 2 No

D. Sewing machine

[] 1 Yes
[] 2 No

E. Television

[] 1 Yes
[] 2 No

F. Air conditioner

[] 1 Yes
[] 2 No

G. Computer

[] 1 Yes
[] 2 No

H. Telephone

[] 1 Yes
[] 2 No

Ownership of the dwelling

9. The dwelling occupied by this household is:

[] 1 Owned by occupants
[] 2 Owned, mortgaged and paying monthly
[] 3 Rented
[] 4 Loaned or given without payment

Disability

10. In this household, does any person have?

A. Total blindness

[] 1 Yes
[] 2 No

B. Total deafness

[] 1 Yes
[] 2 No

C. Total muteness

[] 1 Yes
[] 2 No

D. Loss or incapacity of a leg or arm

[] 1 Yes
[] 2 No

E. Mental deficiencies

[] 1 Yes
[] 2 No

Section D. Household composition

1. Including the newborns, girls, boys, elderly (female and male), and domestic employees (male and female), how many people usually make up this household in total?

_ _Total
_ _ Men
_ _ Women

2. What is the name and last name of each of the person that are usually part of this household? [The original document includes a table below.]

[Column headings:]
(A) Order number
(B) First and last name

Begin with the head of household (male or female) and continue in the following order:

a. Head of household (male or female)
b. Spouse or partner
c. Son, daughter, stepson, or stepdaughter
d. Son-in-law or daughter-in-law
e. Grandson or granddaughter
f. Father, mother, or parents-in-law
g. Brother, sister, brother-in-law, or sister-in-law
h. Nephew or niece
i. Other relative
j. Domestic servants (male and female) and their family members
k. Other non-relative
If there are more than 10 persons, use another form and mark the box for additional form.

Note: Be sure to include the newborns, girls, boys, elderly (female and male), and domestic employees (male and female), who live in the household and are temporarily absent.

Section E. International migration and mortality

International migration

1. After hurricane Mitch (October 1998), has a person from this household gone to live in another country?

[] 1 Yes (Continue to question 2)
[] 2 No (Continue to question 3)

2. Of the people who left after Mitch, how many live in:

A. United States?
Men _ _
Women _ _
B. Canada?
Men _ _
Women _ _
C. Mexico?
Men _ _
Women _ _
D. Central America?
Men _ _
Women _ _
E. Other countries?
Men _ _
Women _ _

Mortality

3. Including newborns and the elderly, did any person that belonged to this household die between January 1 and December 31 in 2000?

[] 1 Yes
[] 2 No (Continue to section F)

4. For the persons who died between January 1 and December 31, 2000, give the following information:

Order number ____
Name ____
2. Sex
[] 1 Male
[] 2 Female
3. Date of death
Day _ _
Month _ _
4. Age at death _ _ _

If the person who died is a woman between 14 and 49 years old, did she die:

5A. During a pregnancy

1 [] Yes
2 [] No

5B. During childbirth

1 [] Yes
2 [] No

5C. In the two months following childbirth

1 [] Yes
2 [] No

[p. 3]

Section F. Characteristics of the persons

Order number of the person _ _
Name _____

For all persons
[Questions 1- 5 were asked of all persons.]

1. What relationship does the person have to the head of household?

[] 01 Head of household (male or female)
[] 02 Spouse or partner
[] 03 Son, daughter, stepson, or stepdaughter
[] 04 Son-in-law or daughter-in-law
[] 05 Grandson or granddaughter
[] 06 Father, mother, or parents-in-law
[] 07 Brother, sister, brother-in-law, or sister-in-law
[] 08 Nephew or niece
[] 09 Other relatives
[] 10 Domestic servants and their families
[] 11 Other non-relatives
[] 12 Live in a collective dwelling

2. Sex

[] 1 Male
[] 2 Female

3. How old is the person in completed years?

Less, than one year, write 000
_ _ _

4. Where was [the person] born?

A. In this municipality
[] 1 Yes (Continue to question 5)
[] 2 No
B. In another municipality in the country
1. Municipality ____ _ _
2. Department ____ _ _
C. In another country
3. Country ____
4. Year of arrival in Honduras _ _ _ _

5. What population group does [the person] belong to?

[] 1 Garífuna
[] 2 Black English
[] 3 Tolupán
[] 4 Pech (Paya)
[] 5 Misquito
[] 6 Lenca
[] 7 Tawahka (Sumo)
[] 8 Chortí
[] 9 Other

For persons 5 years old or more
[Questions 6-11 were asked of persons aged 5 years or older.]

6. Where did [the person] live in 1996 (five years ago)?

A. In this village, town, or city
[] 1 Yes (Continue with question 7)
[] 2 No
B. In another part of the country
1. Village, town, or city ____ _ _ _
2. Municipality ____ _ _
3. Department ____ _ _
C. In another country
4. Country ____ _ _ _

7. Does [the person] know how to read and write?

[] 1 Yes
[] 2 No

8. Is [the person] currently studying in an educational center like a university, private or public school, or pre-school?

[] 1 Yes
[] 2 No

9. What is the last grade, course, or year that [the person] passed?

1. None
[] Grade 0
2. Literacy courses
[] Grade 1
[] Grade 2
[] Grade 3
3. Pre-school
[] Grade 1
[] Grade 2
[] Grade 3
(If the answer is any of the above, continue to Question 12)
4. Primary
[] Grade 1
[] Grade 2
[] Grade 3
[] Grade 4
[] Grade 5
[] Grade 6
[] Grade 7
[] Grade 8
[] Grade 9
5. Secondary, Common Cycle
[] Grade 1
[] Grade 2
[] Grade 3
6. Secondary school, Diversified Cycle
[] Grade 1
[] Grade 2
[] Grade 3
[] Grade 4
7. Post-Secondary Non-Tertiary
[] Grade 1
[] Grade 2
[] Grade 3
[] Grade 4
8. Undergraduate Studies
[] Grade 1
[] Grade 2
[] Grade 3
[] Grade 4
[] Grade 5
[] Grade 6
[] Grade 7
[] Grade 8
9. Graduate Studies
[] Grade 1
[] Grade 2
[] Grade 3
[] Grade 4
[] Grade 5

10. What was [the person's] field, training, or specialty during the past year? ____ _ _ _

11. Did [the person] complete this field, training, or specialty?

[] 1 Yes
[] 2 No

For persons 7 years old or more
[Questions 12-16 were asked of persons aged 7 years or older]

12. Did the person work last week?

[] 1 Yes (Continue to question 14)
[] 2 No

13. Last week, did the person:

[Part] A:

[] 01 Worked on agricultural or forestry crops or raised animals that belong to [him or her] or a relative
[] 02 Worked on or assisted in a business or shop that belongs to [him or her] or a relative
[] 03 Prepared food or produced articles for sale
[] 04 Had work, but did not work because of vacations, leave, illness, etc.
[] 05 Looked for work, having worked previously

[Part] B:

[] 06 Looked for work, not having worked previously
[] 07 Lived off retirement or pension
[] 08 Lived off of rental income
[] 09 Only studied
[] 10 Only did housework
[] 11 Is permanently incapacitated to work
[] 12 Other

(For answers 6-12, continue to question 17)

14. What is the name of the principal occupation, job or post that [the person] does or did in this job? For example: corn farmer, furniture carpenter, bus driver, etc.

____ _ _ _ _

15. In this job, [the person] works as or worked as:

[] 1 Private employee or worker
[] 2 Public employee or worker
[] 3 Owner with employees
[] 4 Self-employed
[] 5 Unpaid family worker
[] 6 Domestic employee
[] 7 Other

16. What is the principal activity of the business, institution, or place where the person last worked or works? For example: corn farming, furniture factory, passenger transportation, etc.

____ _ _ _ _

For persons 12 years old or more
[Question 17 was asked of persons aged 12 years or older]

17. What is your current marital status?

[] 1 Consensual union
[] 2 Married
[] 3 Separated
[] 4 Divorced
[] 5 Widowed
[] 6 Single

For women 12 years old or more
[Questions 18-22 were asked of only females aged 12 years or older]

18. Have you had any children (live-birth)?

[] 1 Yes
[] 2 No (end the interview here for this person)

19. What is the total number of live children that you have given birth to? _ _

20. How many of your daughters or sons are currently alive? _ _

21. On what date was your last son or daughter born alive?

Day _ _
Month _ _
Year _ _ _ _

22. Is your last son or daughter who was born alive still living?

[] 1 Yes
[] 2 No