National Institute of Statistics
III General Population and Housing Census: The Republic of Mozambique
Section A: Geographic Location of the Dwelling
____ _ _ 2. District
____ _ _ 3. Administrative Post
Name ____
6. Neighborhood ____ _ _
7. Enumeration Area No. _ _ _
8. Communal Unit _ _
Name ____
9. Block No. _ _ _
12. House No. _ _ _
13. No. of households in this dwelling _
14. No. of this household _
7. Enumeration Area No. _ _ _
10. Name of Village/ Settlement ____ _ _
11. Name of Zone/ Neighborhood ____ _ _
12. House No. _ _ _
13. No. of households in this dwelling _
14. No. of this household _
No.: ____
Floor: ____
Apt: ____
Description: ________
Section B: To be filled out after Interview
1. Name of Head of Household
_ _ 2 Female
_ _ 3 Total
[] 2
[] 3
[] 4
4. Declaration: I declare that the information in this Form is true and accurate.
Name (legible): _______
Signature: ________
Date: _ _-08-2007
Name (legible): ________
Signature: ________
Date: _ _-08-2007
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 III General Population and Housing Census and I need to ask you some statistical data.
Section C: Persons' Names
Enumerator: Write the first and last names of the people in the space below. As you list them, start with the head of household followed by his/ her spouse and finally the rest of the members. Do not forget about the BABIES.
1. Please tell me the names of all the people who regularly live in this dwelling, whether or not they present:
...
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, 2007 in this dwelling:
...
9. ________________ R V
Section D: Questions about the Population
Enumerator: Ask questions to all of the people listed in Section C.
Name: ________
2. What is (the person)'s relationship to the head of the household?
[] 2 Female
4. What is (the person)'s age?
_ _write the age in completed years
5. Say whether at 12:00a.m. of August 1, 1997 in this household, (the person) was a/an:
[] 2 Absent resident
[] 3 Visitor
[Question 6 through 36 were asked to the residents]
6. What is (the person)'s race/origin?
[] 2 Mixed
[] 3 White
[] 4 Indian
[] 5 Pakistani
[] 6 Other
7. Where was (the person) born?
________ _ _ District
________ _ _ City/Village
________ _ _ Foreigner
8. What is (the person)'s nationality?
[] Foreigner - Indicate which one
9. Does [the person] have any disability?
Yes:
[] 3 Deaf
[] 4 Amputated/ Atrophied arms(s)
[] 5 Amputated/ Atrophied legs(s)
[] 6 Paralysis
[] 7 Mental
[] 8 Other
10. What has caused the disability?
[] 2 Disease
[] 3 Landmines/ War
[] 4 Military Service
[] 5 Labor accident
[] 6 Car accident
[] 7 Other
11. What is (the person)'s religion/belief?
[] 2 Anglican
[] 3 Islamism
[] 4 Zion
[] 5 Christian/ Pentecostal
[] 6 No religion (atheist, animist, agnostic, etc)
[] 7 Other ____ _ _ _ _
12. Is (the person)'s biological mother alive?
[] 2 No
[] 3 Does not know
[] 2 No
[] 3 Do not know
For people aged 1-17 only.
14. Has [the person] been registered in the Civil Registry?
[] 2 No
15. Why hasn't [the person] been registered in the Civil Registry?
[] 2 It is not important
[] 3 Lack of information
[] 4 It is complicated
[] 5 It is expensive
[] 6 Other
16. Where was (the person) living 1 year ago, in August 2006?
________ _ _ District
________ _ _ City/Village
________ _ _ Foreigner
17. Where was (the person) living 5 years ago, in 2002?
________ _ _ District
________ _ _ City/Village
________ _ _ Foreigner
18. Say whether (in any language) the person:
[] 2 Can read only
[] 3 Cannot read nor write
19. Does (the person) know how to speak Portuguese?
[] 2 No
20. In what language did (the person) learn to speak?
21a. What language is most frequently used at home?
[] 2 Has attended school
[] 3 Has never attended school - Go to question 26
23. What level of education does (the person) attend or, if no longer studying, the highest level they have attended.
[] 2 Primary School (1st ? 5th grade)
[] 3 Primary School (6th ? 7th grade)
[] 4 General Secondary School ? 1st Cycle (8th ? 10th grade)
[] 5 General Secondary School ? 2nd Cycle (11th ? 12th grade)
[] 6 Elementary Technical School
[] 7 Basic Technical School
[] 8 Upper Technical School
[] 9 Primary Teacher Training Course
[] 10 Higher Education
24. Has [the person] completed the level indicated in the previous question?
[] 2 No- Go to question 26
25. If [the person] has completed Higher Education, please indicate the highest level.
[] 2 Licensure
[] 3 Mater's
[] 4 Doctor's
For people aged 7+ only
26. What activity did (the person) do in the last week of July, this year?
[] 2 Did not work, but had a job- Go to question 28
[] 3 Helped a relative- Go to question 28
[] 4 Looked for a new job- Go to question 28
[] 5 Domestic - Go to question 27
[] 6 Looked for a job for the first time- Go to question 32
[] 7 Served the FADM- Go to question 32
[] 8 Studied only- Go to question 32
[] 9 Retired/reserve- Go to question 32
[] 10 Was unable to work
[] 11 Other ____
27. If domestic, say whether on the week of July 25-31 this year, [the person]:
[Note: The word machamba refers to small plots of land used for agricultural practices].
[] 2 Has produced or sold goods
[] 3 Has looked after the house/children only- Go to 32
28. What was [the person]'s main occupation/duty this week or the last time he/she worked? ____
29. What kind of activity is performed at the place where [the person] currently works? ____
30. Say whether [the person] is a (worker of):
[] 2 The Local Autarchies
[] 3 A Government-owned Corporation
[] 4 The Private Sector
[] 5 The Cooperative sector
[] 6 A Non-profit Institution
[] 7 Domestic worker in a Private House
[] 8 Self-employed worker with Employees
[] 9 Self-employed worker without Employees
[] 10 Home worker without pay
[] 11 International Organizations/ Embassies
[] 12 The General Population and Housing Census
31. How many hours a day did [the person] work in the last week of July (25-31), this year? _ _
32. What is [the person]'s marital status?
[] 2 Married
[] 3 Living together as married partners
[] 4 Divorced/Separated
[] 5 Widowed
33. How many children born alive has [the person] had?
_ _ 2 No. of Female
34. How many of [the person]'s children are alive?
_ _ 2 No. of Female
35. How many children born alive has [the person] had in the past 12 months?
_ _ 2 No. of Female
36. From those children born alive in the past 12 months, how many are alive?
_ _ 2 No. of Female
Section E: Characteristics and Condition of the Dwelling
Enumerator: Fill out the Enumeration Form using the question about the dwelling. If there is more than one household within the dwelling, fill out questions 1-11 only, for the first household.
[] 12 Flat/apartment
[] 13 Hut
[] 14 Precarious Dwelling (shack, tin, cardboard)
[] 15 Mixed dwelling
[] 16 Basic dwelling (train house)
[] 17 Part of a commercial building
[] 18 Other: ________
[] 22 Hotel/ Boarding house
[] 23 Barracks/ Military camp
[] 24 Boarding School/ Seminary/ Student residence
[] 25 Prison unit
[] 26 Other: ________
[] 2 Vacant
3. Why is the dwelling vacant?
[] 2 It is for rent
[] 3 It is under construction- Finish the interview
[] 4 It is for occasional use
[] 5 Other
[Questions 4 through 6 were asked those in private dwellings]
[] 2 Rented
[] 3 Lent/borrowed temporarily
[] 4 Other
5. The walls of the dwelling are made of:
[] 2 Bricks
[] 3 Wood/ zinc
[] 4 Adobe blocks
[] 5 Reed/ sticks/ bamboo/ palm tree leaves
[] 6 Weaved sticks (mud and wattle)
[] 7 Tin/cardboard/ paper/ canvas/ bark
[] 8 Other
6. The dwelling is roofed with:
[] 2 Tiles
[] 3 Asbestos plates
[] 4 Zinc plates
[] 5 Grass/ culms/ palm tree leaves
[] 6 Other
[Question 7 through 11, section F and G were asked those in private occupied dwellings]
7. The house floor is made of: (excluding kitchen and bathrooms)
[] 2 Marble/ granite
[] 3 Cement
[] 4 Mosaic/ ceramic
[] 5 Adobe (dirt floor)
[] 6 Nothing
[] 7 Other
[] Others
8a. How many rooms is the dwelling divided into? (excluding kitchen and bathrooms)_ _
8b. From those, how many are used for persons to sleep? _ _
9. What is the main source of water used to drink by this household?
[] 2 Piped water outside the dwelling
[] 3 Water from fountain
[] 4 Water from well/ covered borehole with hand pump
[] 5 Water from well/ covered borehole without hand pump
[] 6 River/ Lake water
[] 7 Rain water
[] 8 Bottled water
[] 9 Other
[] 2 Improved latrine
[] 3 Traditional improved latrine
[] 4 Non-improved latrine
[] 5 Does not have flush toilet/latrine
11. What is the main source of energy used for lighting in this dwelling?
[] 2 Generator/ Solar panel
[] 3 Gas
[] 4 Oil/ Paraffin/ Kerosene
[] 5 Candles
[] 6 Storage Battery
[] 7 Firewood
[] 8 Other
Section F: Durable Goods and Access to Information and Communication Technologies.
1. Does the household have? (admits more than one answer)
[] 2 TV
[] 3 Telephone (landline)
[] 4 Computer
[] 5 Car
[] 6 Motorcycle
[] 7 Bicycle
[] 8 None of the above
2. In the past 12 months, how many members of this household used: Regardless of the place of use (e.g. at work, internet café, home, etc.)
[] 2 Internet: _ _ members
3. How many people in this household have a cellular phone?
Section G: Agriculture and Fishing Activity
1. Does any member of this household practice agricultural activity on their own initiative?
[] 2 No
2. Does this household have an aquaculture tank?
[] 2 No
3. Does any member of this household practice artisanal fishing?
[] 2 No
4. Does this household have cashew trees?
[] 2 No
5. Does this household have coconut trees?
[] 2 No
6. How many of the following animals does this household raise?
_ _ _ _ Goats
_ _ _ _ Sheep
_ _ _ _ Pigs
_ _ _ _ Chickens
_ _ _ _ Ducks
Section H: Mortality
Enumerator: Get information about the deceased in the household. Do not forget about the deceased children.
1. In this household, has anybody passed away in the past 12 months? (from August 1, 2006 to July 31, 2007)
[] 2 No (To make sure, ask whether in that period any newborn or infant has passed away)
[] 1 Male
[] 2 Female
[] 1 Yes
[] 2 No
[] 1 Yes
[] 2 No
[] 1 Yes
[] 2 No
Enumerator: Before you move on to the next household, make sure that:
2. The names of all the members of the household are listed in Section C, on the first page of the Enumeration Form
3. You have collected all the information regarding the Household and the Dwelling.
4. The information is clear and legible
5. You have signed the Enumeration Form
6. You have stuck a tag for Enumerated Dwelling or Non-enumerated Dwelling