Ministry of the Economy, Industry, and Commerce
National Office of Statistics and Data
Central Survey Bureau
Republic of Mali
One People-One Goal-One Faith
Fourth General Population and Housing Survey
Law No. 98-020 from March 1998
Household and Housing questionnaire
April 1-14, 2009
Confidential: The information in this document are confidential and cannot be used in judicial proceedings, tax audits, and economic suppression.
Questionnaire No.: _____
Number of questionnaires used for this household: ____
Circle: ______
District: ______
Commune: _______
Village or location: ______
Hamlet or regrouping location: ______
Neighborhood for urban communes: ______
SE: ______
Plot: ______
Household in the SE: _______
[] 2 Nomad
[] 3 Collective
[] 1 Barracks
[] 2 Convent/monastery
[] 3 Hotel
[] 4 Prison
[] 5 Boarding school/orphanage
[] 6 Center for handicapped people
[] 7 Hospital
[] 8 Muslim religious school
[] 9 Other (specify)
First and last name of head of household:___________
II. Summary table
[Give the number of males, females, and total members in the household]
0) Residence status
1) Residents present (RP)
____Female
____Total
2) Residents absent (RA):
____Female
____Total
3) Subtotal 1 (RP +RA):
____Female
____Total
4) Visitors (V):
____Female
____Total
5) Subtotal 2 (RP + V):
____Female
____Total
6) Total list (RP + RA + V):
____Female
____Total
7) Emigrants:
____Female
____Total
Administrative usage
Survey agent: _______
Name: _______
Date Signature: _______
Supervisor [##translator note: in other surveys, this term was translated as supervisor, a word repeated later in this section]
Name: _______
Date Signature: _______
Editor
Name: _______
Date Signature: _______
Supervisor
Name: _______
Date Signature: _______
Checked by
Name: _______
Date Signature: _______
Coded by Name
Date Signature: _______
Keyed by
Name: _______
Date Signature: _______
Keyed editor
Name: _______
Date Signature: _______
Observations: _______________________________________________
III. Information on individuals
P0) Type of registration: _______
P1) Order number: _______
P2) First and last name: _______
Head of household
Unmarried children of head of household whose mother does not live in the household
Spouse(s) of head of household followed by her unmarried child(ren) from youngest to oldest
Other relatives of head of household or of his spouse(s)
Persons not related to the head of household
[] 1 Male
[] 2 Female
P4) Relationship to head of household
What is the relationship of [Name] to the head of the household?
[] 01 Head of household
[] 02 Spouse of head of household
[] 03 Son or daughter of head of household
[] 04 Brother or sister of head of household
[] 05 Father or mother of head of household
[] 06 Grandchild
[] 07 Nephew/niece
[] 08 Uncle/Aunt
[] 09 Daughter-in-law/Son-in-law
[] 10 Other relative of head of household
[] 11 Servant
[] 12 Not related to head of household
[] 1 Resident present
[] 2 Resident absent
[] 3 Visitor
P6) Religion
What is [Name]?s religion?
[] 01 Muslim
[] 02 Christian
[] 03 Animist
[] 04 Other religion
[] 05 No religion
P7) Birth registration
Does [Name] have a birth certificate or a suppletory judgment?
[] 1 Yes
[] 2 No
[] 3 Don't know
Month: _ _
Year: _ _ _ _
[] 1 Day
[] 2 Month
[] 3 Year
_ _
P10) Location of birth
Where was [Name] born?
____
P11) Nationality
What is [Name]?s nationality?
____
P12) Handicap
Does [Name] have any kind of handicap?
[] 00 None
[] 01 Physical handicap
[] 02 Hearing handicap
[] 03 Visual handicap
[] 04 Mental handicap
[] 05 Multiple handicaps
P13) Previous residence
Did [Name] ever live elsewhere for more than 6 months?
____
P14) Length of residence/stay
For how many years has [Name] continuously lived here?
P15) Usual residence
Ask only visitors: Where does [Name] usually live?
____
P16) Father
Is [Name]?s natural father alive?
[] 1 Yes
[] 2 No
[] 3 Don't know
P17) Mother
Is [Name]?s natural mother alive?
[] 1 Yes
[] 2 No
[] 3 Don't know
Population age three or older
[Questions P18-P23 were asked for persons age 3+.]
P18) School attendance
Has [Name] ever attended school or is he/she currently attending school?
[] 0 No, never attended
[] 1 Yes, attended in past
[] 2 Yes, attending currently
P19) Level
What is [Name]?s education level?
[] 00 Not applicable (less than 3 years)
[] 01 None
[] 02 Instruction in the Koran (not trained)
[] 03 Literate (not trained)
[] 04 Preschool
[] 05 Fundamental 1st cycle
[] 06 Fundamental 2nd cycle
[] 07 Madras 1st cycle
[] 08 Madras 2nd cycle
[] 09 Secondary
[] 10 Technical and Professional
[] 11 Teaching school
[] 12 University
[] 13 Post University
P20) Class
What is the highest class in this level of school [Name] has attended?
P21) Diploma
What is the highest diploma [Name] earned?
[] 00 Nothing, Koran instruction, literate, person not applicable
[] 01 Certificate of primary studies
[] 02 Fundamental studies diploma (DEF) [##translator note: entrance exam for secondary school admission
[] 03 CAP [##translator note: Level V diploma, stands for Certificate of Professional Aptitude]
[] 04 Preschool and special educator teacher training
[] 05 Technician?s certificate (BT)
[] 06 Superior Technician?s certificate (BTS)/University Technology Diploma (DUT) (BAC + 2, 3)
[] 07 Teaching training (IFM)
[] 08 High school diploma
[] 09 2-year college degree (DEUG)
[] 10 Bachelor?s degree
[] 11 Master?s degree
[] 12 Post university diploma (Master, DEA, DESS, PHD, etc)
Language
P22) What is [Name]?s native language?
[] 00 Person not applicable
[] 01 Bambara
[] 02 Malinke
[] 03 Peul/Foulfoulbe
[] 04 Sonrai/Djerma
[] 05 Maraka/Soninke
[] 06 Kassonke
[] 07 Senoufo
[] 08 Dogon
[] 09 Maure
[] 10 Tamacheq
[] 11 Bobo
[] 12 Dafing
[] 13 Minianka
[] 14 Haoussa
[] 15 Samogo
[] 16 Bozo
[] 17 Arab
[] 18 Other Malian languages
[] 19 Other African languages
[] 20 Other foreign languages
P23) Spoken
What language does [Name] speak fluently?
[] 00 Person not applicable
[] 01 Bambara
[] 02 Malinke
[] 03 Peul/Foulfoulbe
[] 04 Sonrai/Djerma
[] 05 Maraka/Soninke
[] 06 Kassonke
[] 07 Senoufo
[] 08 Dogon
[] 09 Maure
[] 10 Tamacheq
[] 11 Bobo
[] 12 Dafing
[] 13 Minianka
[] 14 Haoussa
[] 15 Samogo
[] 16 Bozo
[] 17 Arab
[] 18 Other Malian languages
[] 19 Other African languages
[] 20 Other foreign languages
Population age six or older
[Questions P24-P28 were asked for persons age 6+.]
P24) Occupation situation
What did [Name] do for work most of the time in the last 4 weeks?
[] 0 Person not applicable
[] 1 Occupied
[] 2 Unemployed
[] 3 Looking for first job
[] 4 Seasonal inactivity
[] 5 Occupied at home
[] 6 Student
[] 7 Person of independent means
[] 8 Retired, elderly
[] 9 Hasn?t worked
P25) Main economic activity
For those who worked during the reference month: What type of work did [Name] mainly do? For those who did not work but who have worked: What was the last main job that [Name] had?
____
P26) Position in main occupation
What is (or what was) the position that [Name] had in this occupation?
[] 00 Person not applicable
[] 01 Independent worker
[] 02 Employer/Boss
[] 03 Salaried/Permanent employee
[] 04 Salaried/Temporary employee
[] 05 Apprentice
[] 06 Family helper
[] 07 Others
Agricultural sector
[] 08 Independent
[] 09 Primary associated [partnered] household
[] 10 Secondary associated [partnered] household
P27) Branch of economic activity
What does the business or establishment that [Name] works or worked for mainly do?
P28) Agriculture
For workers in the agricultural sector: What is the main type of agricultural work that [Name] does?
[] 01 Growing of dry grains
[] 02 Rice farming
[] 03 Industrial farming
[] 04 Vegetable farming
[] 05 Fruit tree farming
[] 06 Livestock farming
[] 07 Fishing
[] 08 Silviculture/forestry
[] 09 Harvesting
[] 10 Hunting
[] 11 Other agricultural activities
Population age twelve or older
[Questions P29-P30 were asked for persons age 12+.]
[] 0 Person not applicable
[] 1 Single
[] 2 Married monogamous
[] 3 Married polygamous
[] 4 Widowed
[] 5 Divorced/separated
[] 6 De facto union/Civil partnership
P30) Literacy
Does (name know how to read and write?
[] 0 Person not applicable
[] 1 Can read and write French only
[] 2 Can read and write a national language only
[] 3 Can read and write only other language
[] 4 Can read and write French and a national language
[] 5 Cannot read or write
Women age 12-49 years
[Questions P31-P33 were asked for women age 12-49.]
P31) Total live births
This question should be asked only to women age 12-49: How many live births has [Name] had?
F _ _
P32) Surviving children
This question should be asked only to women age 12-49. Among the live births mentioned in P31 how many are still alive?
F _ _
P33) Births in the last 12 months
How many of [Name]?s children were born alive in the last 12 months?
F _ _
IV. Deaths in last 12 months (not including collective households)
D1. Were there any deaths in this household in the last 12 months (circle the number corresponding to the response).
[] 2 No
If yes, get the name of each of the deceased in the household in D3, circle their sex in D4, record their date of birth in D5, their date of death in D6, and their age at death in D7. For the women deceased between ages 12 and 49, ask questions D8 to D10.
All deceased persons
Type of registration
D2) 01, 02, 03, etc.
D3) First and last name _____
[] 2 Female
Year: _ _ _ _
Year: _ _ _ _
If the deceased person is a woman age 12 to 49, the death was related to:
[] 2 No
[] 2 No
[] 2 No
V. Questions about emigration (not including communal households)
E1. In the last 5 years, have there been any members of your household who moved abroad and currently live there (emigrated)?
[] 2 No
If yes, get the number of emigrants in the household in E2, record each person?s name in E4, record their age in E5, Circle the code corresponding to the emigrant?s sex in E6, record the month and year of departure in E7, record all the letters of the destination country in E8.
E3) Number in list
01, 02, 03, etc.
E4) Names: _____
[] 2 Female
Year _ _ _ _
[] 02 Social reasons
[] 03 Professional reasons
[] 04 Political reasons
[] 05 Scholarly reasons
[] 06 Health reasons
VI. Questions about the dwelling (including ordinary and collective households)
Circle the code that applies or record the appropriate code in the space provided. If there is a plot occupied by a single household, use the characteristics of the main building (without including the number of rooms)
[] 2 Mobile
[] 2 Villa
[] 3 Simple individual house
[] 4 Concession with several dwellings
[] 5 Hut
[] 6 Tent
[] 7 Precarious dwelling/shack
[] 8 Others
[] 2 Semi Hard
[] 3 Mudbrick
[] 4 Wood/straw
[] 5 Other, specify
[] 2 Sheet metal with ceiling
[] 3 Tile
[] 4 Concrete
[] 5 Mudbrick
[] 6 Thatch
[] 7 Other, specify
[] 2 Tile
[] 3 Beaten earth
[] 4 Other, specify
[] 2 Rural electrification/multifunction platform
[] 3 Generator
[] 4 Gas
[] 6 Petroleum lamp
[] 7 Gas lamp
[] 8 Flashlight (batteries)
[] 9 Other, specify
[] 2 Bore hole
[] 3 Improved well
[] 4 Traditional well
[] 5 Public tap
[] 6 Surface water
[] 7 Other, specify
H8) Main source of energy for cooking
[] 2 Gas
[] 3 Petroleum
[] 4 Wood
[] 5 Wood charcoal
[] 6 Animal dung
[] 7 Solar oven
[] 8 Other, specify
[] 2 Outdoor private with flush
[] 3 Communal to several household with flush
[] 4 Private latrine
[] 5 Communal latrine
[] 6 Nature/field
[] 7 Other, specify
[] 2 Owner without property title
[] 3 Co-owner
[] 4 Renter
[] 5 Hire purchase
[] 6 Lodged for free
[] 7 Others, specify
H11) Number of occupied rooms: _____
H12) Existence of improved stove
[] 2 No
[] 2 Truck/collection
[] 3 Communal trash can
[] 4 GIE [Groupement d?Intérêt Economique: NGO initiative facilitating lower cost collaborative waste removal activity]
[] 5 Trash pile
[] 6 Ditch
[] 7 Street
[] 8 Nature/field
[] 9 Others
H14) Used water evacuation method
[] 2 Street
[] 3 Soak pit
[] 4 Truck/collection
[] 5 Septic tank
[] 6 Sewer system
[] 7 Nature/field
[] 8 Others, specify