National Institute of Statistics
Republic of Mozambique

Is this a follow-up bulletin?

If yes, complete with the number of the 1st bulletin of this household _ _ _ _ _ _ _

Bulletin No. / Total no. of bulletins _ / _

Statistical authority and confidentiality (Law 7/96 of June 5)

Article 6. Statistical authority - The principle of statistical authority consists of the power conferred on the National Institute of Statistics to carry out surveys with mandatory responses within the deadlines, as well as taking steps to production of statistics.

Article 14. Statistical confidentiality - All statistical information of an individual nature, collected by the bodies producing official statistics, within the scope of the National Statistics System, is strictly confidential in nature.

Section A: Geographical location of housing

A1. Area of residence

A2. Province _ _

A3. District _ _

A4. Post administrative _ _

A5. Location/town _ _

A6. Neighborhood _ _

A7. Area of enumeration _ _ _

A8. Population/community unit/block _ _

A9. Zone/block _ _

House No. _ _ _

No. of households in this house_ _ _

No. of this household family _

Parish/ community unit/block ____

Name of head of household ____

____ Street/ avenue

____ N

____ Floor

____ Flat

Description for cases without ________

Section B: List of household members

B1. People to register:

Person no. _ _

Name of persons in household ____

B2. If it's not a follow-up bulletin:

Indicate the total number of people residing in the household _ _

Specify how many by gender: _ _

(To be completed at the end of the interview)

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Section C: Questions about the population

Person no. _ _

P1. Person's name ____

P2. What is the family relationship with the head of the household?

P3. Please indicate sex

P4. How old are you? _ _ _

P5. Please respond if at zero o'clock on the 1st day of August 2017, in this household, you were:

P6. Tell me if you are:

P7. Where were you born?

P7a. How many years have you lived in this district?

P8. What is your nationality?

P9. Do you have a disability/difficulty?

P10. What were the causes of the main disability/difficulty?

P10a. How old were you when you contracted this disability/difficulty?

P11. What is your religion?

P12. Is your birth mother alive?

P13. Is your biological father alive?

Only for people 0 to 17 years
[Questions P14 and P15 were asked of people aged 0 to 17.]

P14. Have you already been registered?

P15. Why were you not registered?

Only for people 1 year old or more
[Question P16 was asked of people aged 1 year old or more.]

P16. Where were you living on August 1, 2016?

Only for persons 5 years or more
[Questions P17 through P21b were asked of people aged 5 years or older]

P17. Where were you living 5 years ago (2012)?

P18. Can you read and write (in any language)?

P19. Can you speak Portuguese?

P20. What language did you learn to speak in?

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P21a. What language do you speak most at home?

P21b. In addition to the previous ones, what other language do you use to communicate anywhere?

Only for persons 3 years or older
[Questions P22 through P27 were asked of people aged 3 years or older.]

P22. Please respond if:

P23. Please select the level of education you are attending or, if you are no longer studying, the highest level you attended:

P24. What is the highest level of education you have completed?

P25. If you have completed a higher education course (bachelor, degree, master, Ph.D.), please indicate the name of the course:

P26. Please respond if in the last 3 months you used: Computer/laptop/tablet

P26a. Please respond if you used the internet in the last 3 months:

P26b. What was the means of accessing the internet?

P26c. How many times have you used the internet in the last 3 months?

P27. Do you have a cell phone (no matter how many)?

For people 7 years or more
[Questions 28 through 37 were asked of people aged 7 years or older]

P28. Do you have a bank account?

P29. Do you have bank credit in a regulated financial institution?

P30. Do you use Mpesa, Mkesh (or something similar)?

P31. Did you work on the 24th to the 30th of July?

P32. You did not work the week of July 24 to 30 because:

P33. If you were a housewife/husband, please respond if in the week of July 24th to 30th:

P34. What was your main task (main occupation) that week (24 to 30) or the last time you worked?

P35. Describe the main economic activity in your workplace.

P36. Please respond if you are a worker of:

P37. How many hours did you work per day in the week of July 24th to 30th? _ _

For people 12 years or more
[Question P38 was asked of persons aged 12 years old or more.]

P38. What is your marital status?

For women 10 to 50 years
[Questions P39 through P42 were asked of women aged 10 to 50 years]

P39. How many children born alive did you have?

P40. How many living children do you currently have?

P41. How many live-born children have you had in the past 12 months?

P42. Of the children born alive in the last 12 months, how many are alive?

Move on to the next person

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Section D: Housing features and conditions

Enumerator: Complete the housing questions bulletin. If there is more than one household in the dwelling, complete questions D1 to D13 for the first household only.

D1. Type of housing

Enumerator: If you checked 21 to 27, end the interview.

[The remaining enumeration form questions were only asked of private households (responses 11 to 18 in question D1)]

D2. This house is:

D3. Why is the house unoccupied?

Enumerator: If you checked 1, 2, 4 or 5, ask questions D6 through D13 and end the interview.

D4. The house is:

D5. If the house is your own, please respond if:

[The remaining housing questions were asked only for occupied houses (response of 1 on question D2) and unoccupied houses not under construction (responses other than 3 on question D3)]

D6. The house is built with:

D7. The house is covered with:

D8. The floor of the house is:

D9. How many rooms does the house have? _ _

D9a. Of these rooms, how many do you use to sleep? _ _

D10. What is the main source of water you use to drink in this household?

D11. The house has:

D12. Please respond the main form of waste treatment used in this household:

D13. Please select the main form of energy used in this household:

[The remaining enumeration form questions were asked only if the house was reported occupied in D2]

Section E: Durable assets and access to information and communication technologies

E1. The household has:

[p.5]

Section F: Agricultural and fisheries activity

F1. Does the household have fields?

F2. Where is the main field located?

F3. How many of these animals does the household have?

F4. Where are most of these animals located?

F5. How many fruit trees does the household have:

F6. Does the household have aquaculture tanks?

F7. Does the household practice artisanal fishing?

Section G: Mortality

G1. In this household, has anyone died in the last 12 months (August 1, 2016 to July 31, 2017)?

Deceased Person 1

Only for women 10 to 50 years old
[Questions about deaths during pregnancy or childbirth were asked only of women aged 10 to 50 years old.]

[The section G questions above were repeated five times for five deceased persons.]

[p.6]

General instructions

For each household, use the bulletins corresponding to the number of members residing in the household.

Who should fill out the bulletin?

All adult people. Information on minors and absent persons will be provided by the head of the household or by another adult member.

Sections D to G

Information to register

Information not to register:

How to fill out bulletin?

Equivalence table for questions P23 and P24 (level of education you attend or attended and the highest level you completed)

[The lists below form a table in the original enumeration form]

2017 Census

Old system 1976-1982

Colonial system - before independence

Notes ________

Date of census

Control date

Identification