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Papua New Guinea

Office use only
Household number _ _ _
Cont _
V/H _
Total persons _ _
House type _ _

____ Province
____ District/ town
____ Census division
____ Census unit number
____ Census unit name
____ Section
____ Lot number
____ Building number
____ Type of house
____ Further identification

Residents
[Questions 1A- 3 were asked of household residents.]

Start a new page for each household.

List in this order: Head, wife of head, never married children of head (by age), others. Do not forget babies and old people.

Person number _ _ (list 01- 07)

1A. What are the names of the people who are living here?

____

2.Write down the relationship of each person to the head of the household/family.

Wife, son, daughter, adopted son, etc.: ____

3. Ask for each person: Did you stay here last night?

If stayed in this house, write 'In'
If stayed anywhere else, write 'Out'
If 'OutÂ’ in Question 3, end of questions for this person

Visitors last night
[Questions 1B- 3 were asked of all visitors to the household.]

Village interview: exclude those from other villages.

Person number _ _ (list 08- 10)

1B. Did you have any visitors who stayed here last night?

Write down names

____

2. Write down the relationship of each person to the head of the household/family.

Wife, son, daughter, adopted son, etc.: ____

3. Ask for each person: Did you stay here last night?

If stayed in this house, write 'In'
If stayed anywhere else, write 'Out'

If 'OutÂ’ in Question 3, end of questions for this person

[Questions 4-14 were asked of all persons who stayed in the residence last night.]

4. What is your date of birth?

Ask for birth record care. If date of birth, unknown, estimate age in years

____ Day
____ Month
____ Year
____ Age in years

5. Sex

Write 'M' (male) or 'F' (female) ____

6. What is your citizenship?

Write name of country, e.g. Papua New Guinea, Australia, New Zealand, United Kingdom ____

7. Are you married now?

Write 'M' (married), 'NM' (never married) or 'O' (others) ____

8. How long have you lived in (this town, R.N.V. district)?

If less than one year, give months. If born here, write B/H.

____ Number of months
____ Number of years

9. Where were you usually living in 1975 at the time of independence?

If not born, write N/B. If [not] in Papua New Guinea, write country.

____ Province
____ District (Sub-province or C.G.)

10. In which province and district (sub-province) were you born?

For example: EHP, Lufe, NIP, Kavieng. If born outside Papua New Guinea, write country of birth.

____ Province
____ District (Sub- Province) or CG

11. What is the highest grade you finished at school?

Write number of grades finished or 'NIL'____

12. Do you go to community or high school now?

[] Yes
[] No

13. Except for school, have you done any training or course that took more than 3 months?

Give full name of course. If none, write 'No'.____

14A. Is your own mother still alive?

Note: natural mother, not foster or step mother.

[] Yes
[] No

14B. If yes in Q14A, is she on the form (S) for this household?

Write her person number or 'No'.____

For all females 15 years of age and older (born in 1965 or before)
[Questions 15-16 were asked of females age 15+.]

15A. How many children have you given birth to?

Include live births only.

____ Number of boys
____ Number of girls

15B. Have any of your children died?

____ Number of boys
____ Number of girls

15C. Do any (of your children) live somewhere else?

____ Number of boys
____ Number of girls

15D. How many (of your children) live here with you?

____ Number of boys
____ Number of girls

16A. What is the date of birth of your last born child?

____ Day
____ Month
____ Year

16B. Is this (last born) child still alive?

[] Yes
[] No

For all persons 10 years of age and older (born in 1970 or before).
[Questions 17-19 were asked of all persons age 10+.]

17A. In your house, what language do you speak most?

[] 1 Pidgin
[] 2 Motu
[] 3 English
[] 4 Enga
[] 5 Melpa
[] 6 Kuman
[] 7 Total/ Kuanua
[] 8 Huli
[] 9 Mendi
[] 10 Kate
[] 11 Yabem
[] 12 Others and Tokples (vernaculars)

17B. When buying at the market, what language do you speak most?

[] 1 Pidgin
[] 2 Motu
[] 3 English
[] 4 Enga
[] 5 Melpa
[] 6 Kuman
[] 7 Total/ Kuanua
[] 8 Huli
[] 9 Mendi
[] 10 Kate
[] 11 Yabem
[] 12 Others and Tokples (vernaculars)

18. Do you belong to a church?

Write name of church or 'No'. ____

19. Last week, what did you do most of the time?

[] 01 Worked at a wage job
[] 02 On leave or temporarily absent from work
[] 03 Big or small-scale business (including unpaid helper), e.g. PMV betal nut seller
[] 04 Farming or fishing for food and money
If code 01, 02, 03 or 04, ask Questions 20- 22.
[] 05 Farming or fishing, subsistence only
[] 06 Full time student (including student on holiday)
[] 07 Working in the house (e.g. housewife)
[] 08 Too old or too young to work or handicapped
[] 09 Other activities and looking for work
[] 10 Other activities and not looking for work

[Questions 20-22 were asked of persons who answered 01-04 on Question 19.]

20. What kind of work do you do?

Describe in a few words, e.g. shop assistant, taxi driver, coffee grower, wood carver, ship builder, fishing.________

21. Who do you work for?

Write name or company or government department, e.g. Steamships, DPI, Dept. of Works and Supply. If self-employed, write "Self".____

22. What does (name of company/department) make or do where you work?

Describe in few words, e.g. makes copra, sells hardware, transport pool. If self-employed, write type of business.________

23. Does anyone in this household (not for a wage job):

[] Grow coffee?
[] Grow tea?
[] Grow cocoa?
[] Grow rubber?
[] Grow spices?
[] Ginger
[] Chillies
[] Pepper
[] Cardamom
[] Vanilla
[] Raise pigs?
[] Raise cattle?

24. In the last 12 months did this household get any money from ____ (not from a wage job)?

[] Selling things they made?
[] Bilums
[] Necklaces
[] Beads
[] Grass skirts
[] Pots
[] Baskets
[] Carvings
[] Tables
[] Rugs
[] Selling coconuts or copra?
[] Selling food crops?
[] Selling fish?
[] Running a store?
[] Running a P.M.V.?
[] Running a boat canoe?
[] Any other activity (describe)? ____

Urban areas only

25. Do you rent or own this house? (Tick box)

[] Rent
[] Own

If rented who do you rent it from?
[] 1 Housing commission
[] 2 Semi-government (e.g. PNGBC, Elcom)
[] 3 Other government (Prov/local government, D.U.M.)
[] 4. Others (private, e.g. BP's)

Totals

____ Number of males
____ Number of females
____Total persons