2006 Population and Household Census of the Kingdom of Lesotho
[pg.1]
Lekala La Lipalo
Maeru, Lesotho
Section A. Interview information
1. Name of household head ____
2. District ____
3. Principal Chief ____
4. Area Chief ____
5. Village Chief ____
6. Village name ____
7. HSA Name ____
District _ _
Ward _ _ _
Zone _
Urban/Rural _
Constituency _ _
EA Number _ _ _ _ _ _ _ _ _
Village Number _ _
Household Number _ _ _
Local Community County _ _ _
Questionnaire Number _
Important
Create a reference number by combining the EA code, village number, household number, and the questionnaire numbers. Write this number now on the top of all pages.
Number of visits (write day of visit)
____ 2
____ 3
____Final Visit
Total persons in household
_ _ Females
Final results code
[] 2 No household member at home
[] 3 Entire household absent for extended period of time
[] 4 Dwelling vacant
[] 5 Dwelling destroyed
[] 6 Other
[Interview information omitted.]
[pg.2]
Section B. List of household members
1. Who slept in this household Saturday night (April 8, 2006)?
Exclude those in Lesotho but away for more than six months except for members in institutions. Exclude those away continuously for more than three years, except those in institutions.
Name ____
Person number _ _
2. What is (the respondent's) relationship to head of household?
[] 1 Head
[] 2 Spouse
[] 3 Child
[] 4 Son/daughter- in- law
[] 5 Grandchild/great grand child
[] 6 Parent/ parent-in-law
[] 7 Other relative
[] 8 Domestic employee
[] 9 Other person not related
[] 10 Herd boy
3. Is (respondent) male or female?
[] 2 Female
4. How old was (the respondent) on his/her last birthday?
_ _ _ Age
Year _ _ _ _
6. What is (the respondent's) marital status?
[] 1 Never married
[] 2 Monogamously married
[] 3 Polygamously married
[] 4 Living together
[] 5 Separated
[] 6 Divorced
[] 7 Widowed
[] 9 Don't know
Enter age in completed years. Enter 88 for not applicable
_ _ Age
[pg.3]
8. Is (the respondent's) first or only spouse alive?
[] 1 Alive
[] 2 Not alive
[] 8 Not applicable
[] 9 Don't know
9. Is father of (the respondent) alive?
[] 2 No
[] 9 Don't know
10. Is mother of (the respondent) alive?
[] 2 No
[] 9 Don't know
11. What is (the respondent's) residential status?
[] 2 Visitor
[] 3 Member elsewhere in Lesotho
[] 4 Member in Republic of South Africa
[] 5 Outside Lesotho and Republic of South Africa
12. If (the respondent) is absent outside Lesotho, where is she/he staying?
[] 15 Republic of South Africa
[] 20 Swaziland
[] 25 Botswana
[] 30 Namibia
[] 35 Zimbabwe
[] 40 Zambia
[] 45 Mozambique
[] 50 Angola
[] 55 Tanzania
[] 60 Malawi
[] 65 Other Africa
[] 70 America
[] 75 Asia
[] 80 Europe
[] 85 Other
[] 88 Not applicable
[] 99 Don't know
13. If (the respondent) is outside Lesotho, how long is (the respondent) in the country?
Write 88- Not applicable for those in Lesotho. Enter 00 for less than one year. Enter 99 for "Don't know".
_ _ Total number of years lived outside for those away from more than a year.
14. What is (the respondent's) citizenship?
[] 15 Republic of South Africa
[] 20 Swaziland
[] 25 Botswana
[] 30 Namibia
[] 35 Zimbabwe
[] 40 Zambia
[] 45 Mozambique
[] 50 Angola
[] 55 Tanzania
[] 60 Malawi
[] 65 Other Africa, specify ____
[] 70 America
[] 75 Asia
[] 80 Europe
[] 90 Other, specify ____
[] 99 Don't know
[pg. 4]
15. Where was (the respondent) born?
[] 12 Different village/ town same district
[] 1 Butha- Buthe
[] 2 Leribe
[] 3 Berea
[] 4 Maseru
[] 5 Mafeteng
[] 6 Mohale's Hoek
[] 7 Quthing
[] 8 Qacha's Nek
[] 9 Mokhotlong
[] 10 Thaha-Tseka
[] 13 Republic of South Africa
[] 14 Other countries, specify ____
[] 99 Don't know
16. Where was (the respondent) living in April 1996?
[] 12 Different village/ town same district
[] 1 Butha- Buthe
[] 2 Leribe
[] 3 Berea
[] 4 Maseru
[] 5 Mafeteng
[] 6 Mohale's Hoek
[] 7 Quthing
[] 8 Qacha's nek
[] 9 Mokhotlong
[] 10 Thaha-Tseka
[] 13 Republic of South Africa
[] 14 Other countries, specify ____
[] 88 For persons aged less than 10
[] 99 Don't know
17. For how long has (the respondent) lived in this village/town?
_ _ Number of years
[pg.5]
Section C. For all persons - Disability
18. Is (the respondent) disabled?
[] 1 Amputation of fingers
[] 2 Amputation of arms
[] 3 Amputation of hands
[] 4 Amputation of toes
[] 5 Amputation of foot/leg
[] 6 Lame/ paralyzed limb
[] 7 Blind (total/ partial)
[] 8 Deaf (total/ partial)
[] 9 Speech problem
[] 10 Mental illness
[] 11 Mental retardation
[] 12 Not disabled [Skip to Question 21.]
[] 13 Other, specify ____
[] 99 Don't know [Skip to Question 21.]
19. For how long has (the respondent) been disabled?
_ _ _ Years
20. What was the cause of disability?
[] 2 Illness
[] 3 Traffic accidents
[] 4 Domestic accident
[] 5 Mine accident
[] 6 Other work/farming accident
[] 7 Fight/ assault
[] 8 Playing/sport
[] 9 Animal accident
[] 10 Witchcraft
[] 11 Unknown
[] 12 Domestic violence
[] 13 Other, specify ____
Section D. Education
[For all persons aged 2 years and over.]
21. Has (the respondent) ever attended school?
[] 2 Still attending
[] 3 Left school
[] NA not applicable
22. What is (the respondent's) highest level of education completed?
[] 1 Standard 1
[] 2 Standard 2
[] 3 Standard 3
[] 4 Standard 4
[] 5 Standard 5
[] 6 Standard 6
[] 7 Standard 7
[] 11 Form 1
[] 12 Form 2
[] 13 Form 3
[] 14 Form 4
[] 15 Form 5
[] 20 Diploma/ Certificate after primary
[] 21 Vocational training after primary
[] 22 Diploma/ Certificate after secondary
[] 23 Vocational after secondary
[] 24 Diploma/ Certificate after High School
[] 25 Vocational after High School
[] 26 Graduate
[] 27 Post Graduate
[] 28 Non formal education
[] 29 None
[] 30 Other, Specify ____
[] 88 Not applicable
[] 99 Don't know
23. Does (the respondent) know how to read and write?
[] 2 Yes, with difficulty
[] 3 Not at all
[] 4 Blind
[] 5 No card with required language
[] 6 Pre school
[] 8 Not applicable
[] 9 Don't know
[pg. 6]
Section E. Economic status
[For persons aged 10 years and above.]
24. What was (the respondent's) employment status during the previous week?
[] 20 Own account worker/ farmer
[] 31 Regular wage/ salary earner
[] 32 Causal worker
[] 40 Unpaid family worker
[] 50 Job seeking
[] 55 Job seeking for first time
[] 60 Homemaker/ housewife
[] 70 Retired
[] 80 Student
[] 90 Disabled
[] 95 Other, specify ____
[] 99 Don't know
25. If job seeking (code 50 in Question 24), what was (the respondent's) employment status 12 months ago (April 2005)?
[] 20 Own account worker/ farmer
[] 31 Regular wage/ salary earner
[] 32 Causal worker
[] 40 Unpaid family worker
[] 50 Job seeking
[] 55 Job seeking for first time
[] 60 Homemaker/ housewife
[] 70 Retired
[] 80 Student
[] 90 Disabled
[] 95 Other, specify ____
[] 99 Don't know
26. If employed last week, who was (the respondent's) employer?
[] 1 Government
[] 2 Parastatal
[] 3 Private, including self employed
[] 4 Republic of South Africa
[] 5 Other, specify ____
[] 8 Not applicable
27. What was (the respondent's) last type of work done?
Remember to ask only those who were job seeking for less than 5 years.
Type of work ____
28. What was (the respondent's) main product/ service/ activity of place of work?
[] 2 Fishing
[] 3 Mining/ quarrying
[] 4 Manufacturing/processing
[] 5 Electricity
[] 6 Construction
[] 7 Wholesale and retail, repair of motor vehicles and personal and household goods
[] 8 Hotels and restaurants
[] 9 Transport, storage, and communication
[] 10 Financial intermediation
[] 11 Real estate, renting, and business activities
[] 12 Public administration, defense, comp. social service
[] 13 Education
[] 14 Health and social work
[] 15 Other community, social, and personal services
[] 16 Private household
[] 17 Extra territorial organizations bodies
[] 88 Not applicable
[pg.7]
[] 11 Same village
[] 12 Different village/ town same district
Other districts/country
[] 2 Leribe
[] 3 Berea
[] 4 Maseru
[] 5 Mafeteng
[] 6 Mohale's Hoek
[] 7 Quthing
[] 8 Qacha's Nek
[] 9 Mokhotlong
[] 10 Thaha-Tseka
[] 13 Republic of South Africa
[] 14 Other countries
[] 99 Don't know
30. Location of employment in urban areas
[] 2 Hlotse
[] 3 Maputsoe
[] 4 Teyateyaneng
[] 5 Maseru
[] 6 Semonkong
[] 7 Mafeteng
[] 8 Mohale's Hoek
[] 9 Moyeni
[] 10 Qacha's Nek
[] 11 Mokhotlong
[] 12 Thaha-Tseka
[] 13 Republic of South Africa
[] 14 Other countries, specify ____
[] 99 Don't know
31. Has (the respondent) ever worked in Republic of South Africa in the past 10 years (since 1996)?
[] 2 Worked in past
[] 3 Presently working in Republic of South Africa
[] 8 Not applicable
[] 9 Don't know
32. If (the respondent) ever worked in Republic of South Africa in the past 10 years, how long has she/he worked?
_ _ Years
[pg. 8]
Section F. Women aged 12 to 49 years (Fertility)
For each woman 12-49 years, enter woman line number from the list of household member.
33. How many pregnancies have you had?
_ _ Pregnancies
34. Have you ever given a live birth?
_ _ Live births
35. Have you ever given a live birth in the last 12 months?
_ _ Live births in last 12 months
36. When did you give your last live birth?
Month _ _
Year _ _ _ _
37. What was the sex of the last live birth?
[] Male
[] Female
38. Is the last child still alive?
[] No
39. How many sons live with you?
40. How many daughters live with you?
41. How many sons are alive but do not live with you?
42. How many daughters are alive but do not live with you?
44. How many daughters have died?
Section G. Women 12 to 49 years (Maternal mortality)
_ _ Number of sisters (alive and dead)
46. How many sisters (of the same mother) died after reaching the age of 15?
47. How many of these dead sisters died due to pregnancy?
48. How many of these dead sisters died during childbirth?
49. How many of these dead sisters died during six weeks after end of pregnancy?
Section H. Housing characteristics and household possessions
50. What is the title of the land?
[] 2 Title deed
[] 3 Form C
[] 4 No title
[] 9 Don't know
51a. From whom did you acquire your land?
[] 1 Government agency
[] 2 Allocated by chief
[] 3 Bought from somebody
[] 4 Inherited/gift
[] 5 Other, specify____
[] 9 Don't know
51b. From which government agency did you acquire your land?
[] 2 UDS/ Mabote Project
[] 3 LSPP
[] 4 MCC
52. Number and types of housing units
_ _ Heisi
_ _ Polata
_ _ Malaene
_ _ Optaka
_ _ Apartment houses
_ _ Bungalow
_ _ Temporary structure
_ _ Heisi
_ _ Polata
_ _ Malaene
_ _ Optaka
_ _ Apartment houses
_ _ Bungalow
_ _ Temporary structure
[] 2 Heisi
[] 3 Polata
[] 4 Malaene
[] 5 Optaka
[] 6 Apartment houses
[] 7 Bungalow
[] 8 Temporary structure / mok'huk'hu
55. Main material of construction of walls of the main type of house
[] 2 Cement bricks
[] 3 Mud bricks
[] 4 Stick and mud
[] 5 Corrugated iron
[] 6 Stone
[] 7 Other, specify ____
56. Main material of the floor of the main type of house
[] 2 Tiles
[] 3 Mud and dung
[] 4 Wood
[] 5 Cement
[] 6 Vinyl/ linoleum
[] 7 Carpet
[] 8 Other, specify ____
57. Main material of the roof of the main type of house
[] 2 Roof tiles
[] 3 Corrugated iron
[] 4 Other, specify ____
[] 1 Electricity (generator)
[] 2 Electricity (solar)
[] 3 Gas
[] 4 Paraffin
[] 5 Coal
[] 6 Wood
[] 7 Dung
[] 8 Crop waste
[] 9 Other, specify ____
[] 1 Electricity (generator)
[] 2 Electricity (solar)
[] 3 Gas
[] 4 Paraffin
[] 5 Coal
[] 6 Wood
[] 7 Dung
[] 8 Crop waste
[] 9 Other, specify ____
[] 1 Electricity (generator)
[] 2 Electricity (solar)
[] 4 Electricity (battery)
[] 5 Gas
[] 6 Paraffin
[] 7 Candle
[] 8 Other, specify ____
[] 2 Sewage system
[] 3 Septic tank
[] 4 Soak away
[] 5 Pit latrine
[] 6 VIP
62. What is the source of drinking water for the household?
[] 2 Piped water community supply
[] 3 Catchment tank
[] 4 Public well
[] 5 Private well
[] 6 Spring covered
[] 7 Spring not covered
[] 8 River
[] 9 Private borehole
[] 10 Public borehole
[] 11 Other, specify ____
63. How long does it take to get water?
State time in minutes. I.e. to go, get water and come back walking.
[] 1 00-14 Minutes
[] 2 15-29 Minutes
[] 3 30-44 Minutes
[] 4 45-49 Minutes
[] 5 50-59 Minutes
[] 6 60-119 Minutes
[] 7 120 plus minutes
64. Possession of one of the following by one of the household members.
[] 2 No
[] 2 No
[] 2 No
D. Possession of cellular phone
[] 2 No
[] 2 No
[] 2 No
[] 2 No
[] 2 No
[] 2 No
[] 2 No
65. Do you own one of the following?
Cattle _ _ _ _
Sheep _ _ _ _
Goat's _ _ __ _
Horses _ _
Donkeys _ _
Pigs _ _
Unimproved poultry _ _ _ _
Improved poultry _ _ _ _
Rabbits _ _
Mules _ _
66. How does this household dispose of its refuse/ rubbish?
[] 2 Irregular collected
[] 3 Common refuse dump
[] 4 Own refuse dump
[] 5 Roadside dumping
[] 6 Other, specify ____
Section I. Deaths of household members during past 12 months (Since April 2005)
67. Did death occur in the household since April 2005?
[] 2 No [If no, go to next household.]
[] 2 Female
_ _ Age
70. What was the cause of death?
[] 2 Sejeso
[] 3 Headache
[] 4 Diarrhea
[] 5 Heart diseases
[] 6 High blood
[] 7 Stress
[] 8 Stroke
[] 9 Diabetes
[] 10 Accidents
[] 11 Borurusi
[] 12 HIV/AIDS
[] 13 Other, specify ____