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National Institute of Statistics
II General of Population and Housing Census

Section A: Geographic Location of the Dwelling

Province _________
District _________
Administrative Post__________

Locality/Village _______
Neighborhood _______
Enumeration Area No. ____
Block No. ____
Name of City/Village _______
House No. _____
No. of dwellings in this household ____
No. of this household _____
Locality _______
Enumeration Area No. ____
Name of Village/Settlement _______
Name of Zone/Neighborhood _______
House No. _____
No. of dwellers in this house ____
No. of this household ____
A14. Home address:
Enumerator: Write the home address that can be used by the National Institute of Statistics (INE) to locate and identify the household.
Street: ________
No.:____ Floor:____ Apt:____
Description: ________

Section B: To be filled out after interview
Name of Head of Household ____
No. of people enumerated (Resident Population only): ____
No. of Male ____
No. of Female ____
Total ____
No. of visits:
[] 1
[] 2
[] 3
[] 4

DECLARATION: I declare that the information in this Form is true and accurate.

Enumerator No. _ _ _
Name (legible): ________
Signature: ________
Date: _ _ - _ _ - 1997

Controller No.: _ _
Name (legible): ________
Date: _ _ - _ _ - 1997

Section C: Persons? Names

INTRODUCTION: Good morning, I am (name). I work for the census and here is my identification (show your badge/I.D). We are conducting our II General Population and Housing Census and I need to ask you some statistical data.
Enumerator:Write the first and last names on the people in the space below. This form allows space for 9 names. If there are more than 9 people in the dwelling, please fill out the continuation form.

1. Please tell me the names of all the people who regularly live in this dwelling, either or not present:
1. _________________R V
9. ________________ R V
2. In addition to these, please tell me the names of the people who spent the night of July 31 ? Aug 1, 1997 in this dwelling:
1. _________________R V
9. ________________ R V

Section D: Questions about the Population

1. Person Number

No. (From section C): _ _
Name (first and last): ________

2. What is (the person)?s relationship to the head of the household?
[] Head
[] Spouse
[] Son/daughter
[] Parent
[] Son/daughter-in-law
[] Grandchild
[] Other relative
[] Non- related Person

3. Sex

[] 1 Male
[] 2 Female

4. What is (the person)?s age?

Age in completed years: _ _

5. Say whether at 12:00a.m. of August 1, 1997 in this household, the person was a/an:

[] Permanent resident
[] Absent resident
[] Visitor

[Questions 6 through 31 were asked of usual residents of the household.]

6. What is (the person)?s race/origin?
[] Black
[] Mixed
[] White
[] Indian
[] Pakistani
[] Other

7. Where was (the person) born?

Province ________ _ _
District ________ _ _
City/Village ________ _ _
Foreigner ________ _ _

8. What is (the person)?s nationality?

[] Mozambican
[] Foreigner

Indicate which one: ________

9. Does (the person) have any disability?

[] No
[] Mental
[] Physical
[] Mental and Physical

10. What is (the person)?s religion/belief?

Religion/ Belief: ________

11. Where was (the person) living on August 1, 1996?

For people aged 1+ only.
Province ________
District ________
City/Village ________
Foreigner ________


12. Where was (the person) living when the war was over (October, 1992)?

Province _______
District ________
City/Village ________
Foreigner ________

13. Mother alive?

[] Yes
[] No
[] Does not know

14. Say whether the person: (in any language)

[] Can read and write
[] Can read only
[] Cannot read nor write

15. Does (the person) know how to speak Portuguese?

[] Yes
[] No

16. In what language did (the person) learn to speak?

Language _______

17a. What language is most used at home?

Language: ________

17b. Besides the ones mentioned, what other language does (the person) use in communication?

Language: ________

18. Say whether (the person):

[] Is attending an educational establishment
[] Attended an educational establishment
[] Has never attended an educational establishment ? Go to #2

19. What level of educational does (the person) attend or has attended (even if incomplete)?

[] Literacy
[] Primary School (1st ? 5th grade)
[] Primary School (6th ? 7th grade)
[] General Secondary School ? 1st Cycle (8th ? 10th grade)
[] General Secondary School ? 2nd Cycle (11th ? 12th grade)
[] Elementary Technical School
[] Basic Technical School
[] Upper Technical School
[] Primary Teacher Training Course
[] Higher Education

20a. Has (the person) completed the level indicated in the previous question?

[] Yes ? Go to #2
[] No

20b. If not, indicate the highest level and year/grade completed.

Level: ________
Year/grade: _ _


21. What activity has (the person) performed in the past week?

[] Worked- Go to #2
[] Did not work, but has a job- Go to #23
[] Helped a relative- Go to #23
[] Looked for a new job- Go to #23
[] Domestic- Go to #22
[] Looked for a job for the first time- Go to #27
[] Served the FADM- Go to #27
[] Studied only- Go to #27
[] Retired/ reserve- Go to #27
[] Was unable to work- Go to #27
[] Other- Go to #27

22. If domestic, say whether in the past week (the person):

[] Has been to the machamba
[] Has produced or sold goods
[] Has looked after the house/children only- Go to #27

23. What was (the person)?s main occupation/duty in the past week or the last time he/she worked?

Occupation: ________

24. What kind of activity is executed in the place where (the person) currently works at?

Activity executed: ________

25. Say whether (the person) is a (worker of):

[] the Public Administration/ Government Agency
[] the Private Sector
[] a Government-owned Corporation
[] the Cooperative sector
[] Self-employed worker
[] Family worker with no pay
[] Member of a Cooperative
[] Boss/ Employer

26. How many hours a day did (the person) work in the past week?

Hours/week ____


27. What is (the person)?s marital status?

[] Single
[] Married
[] Living together as married partners
[] Divorced/Separated
[] Widowed


28. How many children born alive has (the person) had?

____ Male
____ Female

29. How many of (the person)?s children are alive?

____ Male
____ Female

30. How many children born alive has (the person) had in the past 12 months?

____ Male
____ Female

31. From those children born alive in the past 12 months, how many are alive?

____ Male
____ Female

Enumerator: Please turn to the following page and carry on interviewing the next person in the dwelling/ living quarter. If this is the last person, go to Section E- Housing.

Section E: Characteristics and Condition of the Dwelling
Enumerator: Fill in the next question about the dwelling unit. If there is more than one household in the dwelling unit, fill in questions 1-10 for the first household only.

1. Type of dwelling:

[] House
[] Flat/apartment
[] Hut
[] Precarious Dwelling (shack, tin, cardboard)
[] Wooden and Zinc house
[] Other: ________

[] Hospital
[] Hotel/ boarding house
[] Barracks/ military camp
[] Convent/ seminary
[] School/ boarding school/ student residence
Other: ________

[] Homeless people
Enumerator:If you have NOT selected anything under ?Private?, please finish the interview and go on to the last page of this form.

[Questions 2 and 4 were asked of private households.]

2. The house you live in is:

[] Rented
[] Owned
[] Borrowed
[] Other
[] Vacant

[Questions 2 and 3 were asked of private households.]

3. The walls of the house are made of:
[] Cement blocks
[] Bricks
[] Wood/ zinc
[] Adobe blocks
[] Reed/ sticks/ bamboo/ palm tree
[] Weaved sticks (mud and wattle)
[] Tin/ cardboard/ paper/ canvas/ bark
[] Other materials

4. The house is roofed with:
[] Concrete Slab (cement)
[] Tiles
[] Asbestos plates
[] Zinc plates
[] Grass/ culms/ palm tree leaves
[] Other materials
Enumerator: If you selected ?Vacant? for question 2, finish the interview and turn to the last page of the form.

[Questions 5 through 10 were asked of private households in occupied dwellings.]

5. The house floor is made of: (excluding kitchen and bathrooms)

[] Wood or parquet
[] Marble/ granite
[] Cement
[] Mosaic/ ceramic
[] Adobe
[] Nothing (dirt floor)
[] Others

6a. How many rooms is the house divided into? (Excluding kitchen and bathrooms)
No. of Rooms: ____

6b. From those, how many are used for persons to sleep?
No. of Rooms: ___

7. What is the main source of water used to drink in this household?
[] Piped water inside the dwelling
[] Piped water outside the dwelling
[] Water from fountain
[] Water from well
[] Water from borehole
[] River/ lake water
[] Other

8. The house has:
[] Flush toilet
[] Toilet without flush
[] Latrine
[] No toilet/ latrine

9. Does the house have electricity?
[] Yes
[] No

10. Does the household have a radio?
[] Yes
[] No

Section F: Agricultural Activity
[Note: The word machamba refers to small plots of land used for the agricultural practices].

1. Does this household have a machamba?

[] Yes
[] No ? go to #5

2. How many machambas does this household have?
No. ____

3. How many machambas were sowed in the last agricultural campaign (1996/1997)?
No. ____

4. How many members of the household have a machamba?
No. ____

5. Does this household have cashew trees?
[] Yes
[] No

6. How many animals do all members of the household have?
[] 1 Cows/Oxen
[] 2 Goats
[] 3 Pigs
[] 4 Birds

Section G: Mortality
Enumerator: Get information about the deceased in the household. Do not forget about the children.

1. Has anybody passed away in this household in the past 12 months?

[] Yes
[] No - Finish the interview and turn to the last page of this form.

2. Please specify the sex and age of those who passed away.

1. Sex ____
2. Age (in years) _____

Enumerator: Finish the interview and turn to the last page of the Enumeration Form.

There is information in Sections A and B (questions from A1 to B4) from the first page of the Enumeration Form
The names of all the members of the household have been Witten in Section C, on the first page of the Enumeration Form
You have collected most part of the information about the household and the Dwelling.
The information is clear and legible
You have signed the Enumeration Form
You have issued the census cards and stuck a tag on it.
You thank the people surveyed for their cooperation and go on to the next household.
Notes: __________________________________________________________