Government of the Nation
National Statistics Institute
Republic of Honduras
Census, Secretary of the Office of the President
National Statistics Institute
7th Population census and 6th Dwelling Census
Requested information is confidential.
Additional ballot Fill out the geographic location, skip section D, and continue in section F
Legislative Directive 86-2000, 8/7/2000.
Ballot for another home Fill out the geographic location, skip section D, and continue in section F.
Section A. Geographic location
2. Municipality _ _
3. Area _
4. Zone _ _
5. Sector _ _
6. Segment _ _ _
7. Village _ _
8. City or town _ _ _
9. Neighborhood/borough _ _ _
10. Block _ _ _
11. Street address _ _ _
12. House number _ _
Section B. Dwelling information
[] 02 Apartment
[] 03 Inn or Hotel
[] 04 Location not made for living
[] 05 Ranch
[] 06 Improvised home
[] 07 Another type of private home
[] 09 Hospital, institution, or clinic
[] 10 Orphanage or asylum center
[] 11 Barracks, battalion or police post
[] 12 Prison or reformatory
[] 13 Another type of collective housing
2. What is the predominant material in the exterior walls of the dwelling?
[] 2 Cracked or quarry stone
[] 3 Cement or concrete block
[] 4 Adobe
[] 5 Wood
[] 6 Bahareque
[] 7 Stick or cane
[] 8 Waste material
[] 9 Other
3. What is the predominant material in the interior walls of the dwelling?
[] 2 Asbestos sheets
[] 3 Zinc sheets
[] 4 Concrete
[] 5 Wood
[] 6 Palm leaves, straw, similar
[] 7 Waste material
[] 8 Aluzinc sheet
[] Other
4. Occupancy status of the dwelling
[] 2 With people absent -- After three visits, finalize the form here.
[] 4 For temporary use
[] 5 In repair
[] 6 Under construction
[] 7 Other
Only for occupied private dwellings with people present
[Questions 5-12 are asked of occupied private homes with people present]
5. What is the predominant material in the floor of the dwelling?
[] 2 Cement slab
[] 3 Wood
[] 4 Cement brick
[] 5 Terrazzo or granite bricks
[] 6 Mud bricks
[] 7 Tile
[] 8 Other
Basic services of the dwelling
6. How does the dwelling obtain water?
[] 2 Pipes outside the dwelling but within another building, lot, or property
[] 3 Pipes outside the building, lot, or property
[] 4 Receives water by other means
7. Where does the water that is used in the dwelling come from?
[] 2 Private system
[] 3 Winch well
[] 4 Well with a pump
[] 5 Creek, river, or stream
[] 6 Lake or lagoon
[] 7 Street salesman
[] 8 Other
8. What is the main type of lighting used?
[] 2 Private electricity
[] 3 Electric generator
[] 4 Oil or gas lamp (kerosine)
[] 5 Candle
[] 6 Ocote [firewood]
[] 7 Solar panel
[] 8 Other
9. Waste elimination: How is trash eliminated, mainly?
[] 2 Private home collection
[] 3 Deposited in containers
[] 4 Buried
[] 5 Prepared as fertilizer
[] 6 Burned
[] 7 Thrown in the street, river, ravine, lake, sea
[] 8 Paid to have others take it
[] 9 Other
10. Not counting bathrooms or hallways, how many rooms does the dwelling have?
11. Is there a person or group of people in the dwelling that buys or consumes separate foods?
[] 2 No (If no, move on to section C)
12. Including their own, how many groups or households are there in total?
Starting with a second house, use another form and check the box "form for other household"
Summary
Remember to fill in this summary once the interview is concluded.
_ _ _ Men
_ _ _ Women
[p.2]
Section C. Data about the household
1.How many rooms does the household use for sleeping? _ _
2. Does the home have a room for cooking?
[] 2 No (If no, move to question 4)
3. Is the room used for cooking only used by this household?
[] 2 No
4. What is the main source of energy for cooking?
[] 2 Kerosene gas
[] 3 Propane gas (chimbo)
[] 4 Electricity
[] 5 Other
[] 6 No cooking
5. What kind of sanitation is used?
[] 2 Toilet connected to a septic tank
[] 3 Toilet that empties into a river, ravine, lagoon, sea, or lake
[] 4 Latrine with simple pit
[] 5 Latrine with hydraulic closure
[] 6 Other
[] 7 Doesn't have sanitation [Go to question 7]
6. Is the sanitation service used only by members of the household?
[] 2 No
7. Does the household have its own car?
[] 2 More than one car
[] 3 No car
8. Does the home have any of the following apparatus, equipment, or services?
[] No
[] No
[] No
[] No
[] No
[] No
[] No
[] No
[] No
[] No
[] No
[] No
[] No
9. Tenancy: The dwelling that this household occupies is:
[] 2 Owned, paying mortgage
[] 3 Rented
[] 4 Loaned without payment
[] 5 Loaned for work
Section D. Household composition
1. Including infants, children, elderly, domestic workers who sleep within the grounds, how many people in total live in this home?
_ _ Men
_ _ Women
2. What is the first and last name of each person who lives in the home?
2. Partner
3. Child or stepchild
4. Son/daughter-in-law
5. Grandchild
6. Mother or father
7. Mother or father-in-law
8. Brother or sister
9. Brother or sister-in-law
10. Niece or nephew
11. Other relative
12. Domestic employee
13. Other, non-relative
____ First and last name
____ Relationship to head of household
____ Age in years
If there are more than 9 people, use the other ballot and check the box additional ballot.
Note: Be sure to include in the list any newborns, children, elderly, domestic employees, and other people that live in the home and who might be temporarily absent. If there are more than 9 people, use another ballot, and check the box that says additional ballot.
Section E. International migration and mortality
1. In the past 10 years (beginning in 2003), does any person belonging to this household currently live in another country?
Order number ____
Gender
[] 2 Female
____ Age when they left
____ Current country of residence
[p.3]
2. Including children and the elderly. From January 1 - December 31 2012, Has anyone belonging to the household died?
____ Order number
____ First and last name of the deceased
The person was:
[] 2 Female
[] 2 No
[] 2 During birth
[] 3 During the two months of postpartum
[] 4 Due to other cause
Section F. Person characteristics
Person order number _ _
First and last name: ________
For all people
[Questions 1-8 are asked of all persons]
1.What relation does [the respondent] have with the head of the household?
[] 02 Spouse or partner
[] 03 Child or stepchild
[] 04 Son/daughter-in-law
[] 05 Grandchild
[] 06 Mother or father
[] 07 Mother or father-in-law
[] 08 Brother or sister
[] 09 Brother or sister-in-law
[] 10 Niece or nephew
[] 11 Other relative
[] 12 Domestic employee and their relatives
[] 13 Other, non-relative
[] 14. Residents of a collective dwelling
[] 2 Female
3. How old is [the respondent]? _ _ _
4. Is [the respondent] registered in the National Registry?
[] 2 No
5. How does [the respondent] self-identify?
[] 2 Afro-Honduran
[] 3 Black
[] 4 Mixed
[] 5 White
[] 6 Other. Specify ____
For 4, 5, 6, go to question 7.
6. To which community does [the respondent] belong?
[] 2 Lenca
[] 3 Miskito
[] 4 Nahua
[] 5 Pech
[] 6 Tolupán
[] 7 Tawahka
[] 8 Garifuna
[] 9 Black, English speaking
[] 10 Other. Specify ____
7. Does [the respondent] have a permanent disability regarding:
Cause of disability
[] 2 Disease
[] 3 Accident
[] 4 Age
Cause of disability
[] 2 Disease
[] 3 Accident
[] 4 Age
Cause of disability
[] 2 Disease
[] 3 Accident
[] 4 Age
Cause of disability
[] 2 Disease
[] 3 Accident
[] 4 Age
Cause of disability
[] 2 Disease
[] 3 Accident
[] 4 Age
Cause of disability
[] 2 Disease
[] 3 Accident
[] 4 Age
Cause of disability
[] 2 Disease
[] 3 Accident
[] 4 Age
Cause of disability
[] 2 Disease
[] 3 Accident
[] 4 Age
8. Where was [the respondent] born?
[] 2 In a different municipality of the country?
INE use _ _ _
Department ____
INE use _ _ _
INE use _ _ _
Year arrived in Honduras _ _ _ _
For people 3 years old and older
[Questions 9-13 are asked of persons aged 3 or more years old]
9. Does [the respondent] know how to read and write?
[] 2 No
10. Is [the respondent] currently studying in a preschool, elementary school, high school, or university?
[] 2 No
11. What was the last grade, course, or year that [the respondent] finished in this
[] 1
[] 2
[] 3
[] 1
[] 2
[] 3
[] 4
[] 5
[] 6
[] 7
[] 8
[] 9
[] 2
[] 3
[] 2
[] 3
[] 4
[] 2
[] 3
[] 2
[] 3
[] 4
[] 2
[] 3
[] 4
[] 5
[] 6
[] 7
[] 8
[] 2
[] 3
[] 4
[] 5
[] 6
12. Did [the respondent] finish their major field?
[] 2 No
13. What was the name of the career or major in the last year that was completed? ____
[p.5]
For people 5 years old and older
[Questions 14-21 are asked of persons aged 5 or more years old]
14. Where did [the respondent] live 5 years ago?
[] 2 In another part of the country
INE use _ _ _
Municipality ____
INE use _ _
Department ____
INE use _ _
INE use _ _ _
15. Did [the respondent] work at least one hour during the past week?
[] 1 Yes (Go to question 17)
[] 2 No
16. During last week [the respondent]:
[] 2 Did you attend or help in any of your own or family businesses or workshops?
[] 3 Did you prepare food or make items for sale?
[] 4 Did you have a job, but didn't work because you were on vacation, sick leave, etc.?
[] 5 Did you look for a job and have you worked before?
[] 7 Did you live off your retirement or pension?
[] 8 Did you live off your income?
[] 9 Did you justify?
[] 10 Did you only do household chores?
[] 11 Are you permanently unable to work?
[] 12 Other ____
If selected any option from B, go to question 22.
17. What is the name of the main occupation, trade or position [the respondent] holds or held in this work?
[Main occupation, trade, or position] ____
INE use _ _ _ _
18. In that job, does or did [the respondent] work as:
[] 2 Public employee or worker
[] 3 Employer with employees
[] 4 Independent worker
[] 5 Unpaid family worker
[] 6 Domestic employee
[] 7 Unpaid worker
[] 8 Other. Specify ____
19. How many hours did [the respondent] work the past week or during the last week the person worked?
20. What activity do they do or what does the company, institution or place where [the respondent] work or worked the last time do?
[Activity] ________
INE use _ _ _ _
21. In which municipality is the company, institutions or place where [the respondent] work or worked the last time located?
[] 2 In another municipality in the country
INE use _ _
Department ____
INE use _ _
For persons 12 years old or more
[Questions 22-24 are asked of persons aged 12 or more years old]
22. What is [the respondent] current marital status?
[] 2 Married
[] 3 Separated
[] 4 Divorced
[] 5 Widowed
[] 6 Single
23. Does [the respondent] have an email account?
[] 2 No
24. Has [the respondent] got a cellphone?
[] 2 No
[If you are a man and you are 18 years of age or older, go to question 30.]
For women 12 years old or more
[Questions 25-29 are asked of women aged 12 or more years old]
25. Has [the respondent] had any son or daughter born alive?
[] 2 No (Go to question 30)
26. How many sons and daughters born alive have [the respondent] had in total?
27. How many sons and daughters are currently alive?
28. On what date was your last son or daughter born alive?
Month _ _
Year _ _ _ _
29. Is your last son or daughter born alive currently living?
[] 2 No
For persons 18 years old or more
[Question 30 is asked of persons aged 18 or more years old]
30. Has [the respondent] got an identity card?
[] 2 No