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Liberia 2008 Population and Housing Census

If institution, write name ________
County _ _
District _ _
Township / Clan _ _

Structure No. _ _ _

EA _ _ _

Household No. _ _ _

Locality _ _ _

Population type _ _ _

Locality name ________
Street address ________

Household size:
Males _ _
Female _ _
Total _ _

Section 1: Population

All persons

P01. Name

  • What is the name of the head of this household?
  • Names of persons who usually live here?
  • Any babies, old people or PWD you did not list?
  • Names of persons temporarily return within 2 months.
  • Names of persons staying here with no usual place of residence elsewhere.
  • Names of persons not usually residents but who have been staying here more than 2 months.

P02. Relationship

What is [the respondent's] relationship to the head of the household?

P03. Sex

What is [the respondent's] sex?
[] 1 M
[] 2 F

P04. Age (completed years)

How old is [the respondent]?
(Record age in completed years, if under 1 record '00'. For 98 and over record '98')

P05. Religion

What is [the respondent's] religion?

P06. Marital Status

What is [the respondent's] marital status?

P07. Ethnic affiliation

What is [the respondent's] ethnic affiliation?

P08. Place of birth

Where was [the respondent's] born?
(Record county code or country if outside Liberia)

P09. Citizenship

What is [the respondent's] citizenship?

P10. Length of residence

How long has [the respondent] been living in Liberia in completed years?

P11-12. Displacement / Resettlement-- 10 years and over

P11. Has [the respondent] been displaced by war ever since 1990?

[] 1 Yes
[] 2 No
[] 3 DK

P12. Has [the respondent] been resettled?

[] 1 Yes
[] 2 No
[] 3 DK

P13-14. Parental survivorship -- 10 to 24 years

P13. Is [the respondent's] mother alive?

[] 1 Yes
[] 2 No
[] 3 DK

P14. Is [the respondent's] father alive?

[] 1 Yes
[] 2 No
[] 3 DK

P15-17. Disability

P15. Does [the respondent] have any form of disability?

[] 1 Yes
[] 2 No -- Skip to P18

P16. Type of disability?
____

P17. What is the cause of [the respondent's] disability?
____

Persons 5 years and over

P18. Literacy

Can [the respondent] read and write in any language?
[] 1 Yes
[] 2 No

P19. School attendance

Has [the respondent] ever attended school?
If never skip to P21

P20. Highest level attended

What is the highest level that [the respondent] attained?

Persons 6 years and over

P21. Economic Activity

What was [the respondent] doing mainly, during past one year (12 months)?

P22. Occupation

What type of work did [the respondent] do?

P23. Industry

What kind of business or industry did [the respondent's] work in?

P24. Work status

What work status did [the respondent's] have at the work place?

Females aged 12 years and over

P25-26. Total children ever born
If none record '0'

P25. M _ _

P26. F _ _

P27-32. How many children have been born alive to [the respondent] who are?

P27-28. Living in this household
(Record as given -- '0' no child)
P27. M _ _

P28. F _ _

P29-30. Living elsewhere
(Record as given -- '0' no child)
P29. M _ _

P30. F _ _

P31-32. Dead
(Record as given -- '0' no child)
P31. M _ _

P32. F _ _

Females aged 12-49 years

P33-38. No. of births (last 12 months)

P33-35. Sex
[] 1 M
[] 2 F

P36-38. Is the child alive?
[] 1 Yes
[] 2 No

Section 2: Housing facilities

H01. What type of housing unit does this household occupy?

[] 1 Conventional permanent
[] 2 Conventional semi-permanent
[] 3 Temporary
[] 4 Other (specify)

H02. How was this dwelling acquired?

Owner
[] 1 Purchased
[] 2 Constructed
[] 3 Inherited
Provided / Rented
[] 4 Government
[] 5 NHC
[] 6 Private company
[] 7 Private individual
[] 8 Squatter
[] 9 Other (specify)

H03. How many rooms does the household occupy?

_ _

H04-06. Main construction materials of dwelling units

H04. Outer walls

[] 1 Stone, concrete
[] 2 Cement blocks
[] 3 Clay bricks
[] 4 Zinc or iron
[] 5 Wood or board
[] 6 Mud bricks
[] 7 Mud (sticks)
[] 8 Reed, bamboo, grass or mat
[] 9 Other (specify)

H05. Roof

[] 1 Concrete
[] 2 Tiles
[] 3 Asbestos
[] 4 Zinc or iron
[] 5 Bamboo, leaves or thatch
[] 6 Other (specify)

H06. Floor

[] 1 Cement
[] 2 Tiles, marble
[] 3 Wood
[] 4 Mud
[] 5 Other

H07. What is your main source of water supply for drinking?

[] 1 Pipe or pump indoors
[] 2 Pipe or pump outdoors
[] 3 Public tap
[] 4 Closed well or closed spring
[] 5 Open well or spring
[] 6 River, lake or stream
[] 7 Water vendors
[] 8 Other (specify)

H08. What is your main source of fuel for lighting?

[] 1 Electricity -- Own generator
[] 2 Electricity -- Power supplier
[] 3 Kerosene
[] 4 Candle
[] 5 Palm oil lamp
[] 6 Wood
[] 7 Other (specify)

H09. What is your main source of fuel supply for cooking?

[] 1 Electricity
[] 2 Gas
[] 3 Kerosene
[] 4 Charcoal
[] 5 Wood
[] 6 Other (specify)

H10. What type of human waste disposal is used by household members??

[] 1 Flush toilet for HU only
[] 2 Flush shared with other HU
[] 3 Covered pit latrine outside building
[] 4 Open ditch
[] 5 Bush
[] 6 Other (specify)

H11-13. What is the distance from home to the nearestÂ…

H11. Health facility?

[] 1 On premises
[] 2 Less than 0.5 miles
[] 3 From 0.5 miles to 1 mile
[] 4 From 1 mile to 5 miles
[] 5 5 miles and above

H12. Primary school?

[] 1 On premises
[] 2 Less than 0.5 miles
[] 3 From 0.5 miles to 1 mile
[] 4 From 1 mile to 5 miles
[] 5 5 miles and above

H13. Source of water?

[] 1 On premises
[] 2 Less than 0.5 miles
[] 3 From 0.5 miles to 1 mile
[] 4 From 1 mile to 5 miles
[] 5 5 miles and above

Section 3: Ownership of amenities

Q1-6 Does your household own any of the following items?
(Include items only if they are in working conditions)

Q1. Radio
[] 1 Yes
[] 2 No

Q2. Television
[] 1 Yes
[] 2 No

Q3. Cellphone
[] 1 Yes
[] 2 No

Q4. Motorcycle
[] 1 Yes
[] 2 No

Q5. Vehicle
[] 1 Yes
[] 2 No

Q6. Refrigerator
[] 1 Yes
[] 2 No

Section 4: Agriculture

A1. Does any member of the household do agricultural or livestock farming?

[] 1 Yes -- ask A2-A13
[] 2 No -- go to D1

A2. Rice

[] 1 Yes
[] 2 No

A3. Cassava

[] 1 Yes
[] 2 No

A4. Plantain

[] 1 Yes
[] 2 No

A5. Rubber

[] 1 Yes
[] 2 No

A6. Palm oil

[] 1 Yes
[] 2 No

A7. Coffee

[] 1 Yes
[] 2 No

A8. Cocoa

[] 1 Yes
[] 2 No

A9. Coconut

[] 1 Yes
[] 2 No

A10. Sugarcane

[] 1 Yes
[] 2 No

A11. Livestock

[] 1 Yes
[] 2 No

A12. Poultry

[] 1 Yes
[] 2 No

A13. Fishery

[] 1 Yes
[] 2 No

Section 5: Deaths in the household

D1. How many deaths occurred in this household in the last 12 months (1 April 2007 -- March 2008)

_

D2. Name of the deceased

D3. Sex

[] 1 M
[] 2 F

D4. If female 10-49, was [the respondent's] death during pregnancy or within 42 days after child birth?

[] 1 Yes
[] 2 No

D5. Age at death
Completed years

_ _