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[p. 1]

State of Palestine
Palestinian Central Bureau of Statistics
Population, Housing and Establishment
Census 2017

Census Data are Confidential in Accordance with the General Statistics Law No. (4) for Year 2000


Household and Housing Conditions Questionnaire

Governorate ____
Locality name ____
Locality code _ _ _ _ _ _
Enumeration area number _ _ _

[p. 2]

Population, Housing and Establishment Census 2017

Part one: Housing and housing conditions

Identification data

02. Building number in enumeration area _ _ _

02a. Is the building ...

[] 1. For habitation only
[] 2. For habitation and work
[] 3. For work only
[] 4. Closed
[] 5. Vacant
[] 6. Deserted
[] 7. Under preparation

03. Housing unit number in the building _ _ _

03a. Is the housing unit ...

[] 1. For habitation only
[] 2. For habitation and work
[] 3. For occupied by students or workers who have families in Palestine
[] 4. For work only
[] 5. Closed / vacant / deserted
[] 6. Under preparation

03b. Household number in the building _ _ _

04. Household number in enumeration area _ _ _

05. Occupancy type

[] 1. Private household
[] 2. Collective (institutional households)
[] 3. Hotel

06. Type of housing unit

[] 1. Villa
[] 2. House
[] 3. Apartment
[] 4. Independent room
[] 5. Tent
[] 6. Marginal / caravan / barracks
[] 7. Other

07. Tenure of the housing unit

[] 1. Owned
[] 2. Rented unfurnished
[] 3. Rented furnished
[] 4. Without payment
[] 5. For work
[] 6. Other

08. Housing unit area (meters squared) _ _ _

09. Number of housing unit rooms _ _

10. Number of bedrooms _ _

11. What is the main source of drinking water

[] 1. Public network connected to housing unit
[] 2. Protected well / protected spring
[] 3. Unprotected well / unprotected spring
[] 4. Rainwater
[] 5. Tanker- truck / cart
[] 6. Bottled water
[] 7. A public tap
[] 8. Other, specify ____

12. Main source of electricity (most used)

[] 1. Public network
[] 2. Private generator
[] 3. No electricity

13. What kind of toilet facility do members of your household usually use

[] 1. Flush to piped sewer system
[] 2. Flush to septic tank
[] 3. Flush to pit (latrine)
[] 4. Flush to open drain
[] 5. No facility / bush / field
[] 6. Other, specify ____


14. Methods of solid waste disposal

[] 1. Throwing it in the nearest container
[] 2. Burned
[] 3. Throwing randomly
[] 4. Other

Main source of energy used in

15. Cooking

[] 1. Gas
[] 2. Kerosene
[] 3. Electricity
[] 4. Wood
[] 5. Other


16. Heating
[] 0. No heating
[] 1. Gas
[] 2. Kerosene
[] 3. Electricity
[] 4. Wood
[] 5. Coal
[] 6. Diesel
[] 7. Other

Number of facilities and durable goods
[Questions 17 to 40]

_ 17. Kitchens

_ 18. Bathrooms

_ 19. Toilets

_ 20. Bathrooms and toilets

_ 21. Private car

_ 22. Gas / electric stove

_ 23. Refrigerator

_ 24. Freezer

_ 25. Vacuum cleaner

_ 26. Microwave

_ 27. Washing machine

_ 28. Dryer

_ 29. Dishwasher

_ 30. Filter

_ 31. LED, LCD TV

_ 32. TV

_ 33. Satellite / dish

_ 34. Electric fan

_ 35. Air conditioner

_ 36. Central air conditioning

_ 37. Central heating

_ 38. Solar boiler

_ 39. Phone line

_ 40. Home library

Information technology for household (number)
[Question 41 to 49]

_ 41. Palestinian internet line

_ 42. Israeli internet line

_ 43. Palestinian mobile phone line

_ 44. Israeli mobile phone line

_ 45. Computers

_ 46. Laptops

_ 47. Tablet / IPAD

_ 48. Smart mobile phones

_ 49. Number of household members using computer

Part two: Household members data

For all members of the household
[Questions 50 to 62 are asked of all persons]

50. Individual number _ _

51. Full name

____ First
____ Father
____ Grandfather
____ Family

52. Relation to the head of household

[] 1. Head of household
[] 2. Spouse
[] 3. Son / daughter
[] 4. Father / mother
[] 5. Brother / sister
[] 6. Grandfather / mother
[] 7. Grandson / daughter
[] 8. Son / daughter in law
[] 9. Other relatives
[] 10. Others

53. Sex

[] 1. Male
[] 2. Female

54. Date of Birth

Day_ _
Month _ _
Year_ _ _ _

55. Age in complete years (for individuals less than a year put 00) _ _

56. Original nationality

(Palestinian who has another nationality enter Palestinian)

____ Nationality
____ Code

56a. Identification card ____

For Palestinian people

57. Residency of mother at date of birth

Locality name / governorate or country abroad

____ Name
____ Code

58. Current place of usual residence

Locality name / governorate or country abroad

____ Name
____ Code

59. Duration of usual residence in complete years ____

60. Previous place of usual residence (if any)

Locality name / governorate or country abroad

____ Name
____ Code

61. Reasons for changing previous place of residency

[] 1. Job / work
[] 2. Study
[] 3. Marriage
[] 4. Accompany
[] 5. Deportation
[] 6. Return
[] 7. The Wall
[] 8. Maintain the Jerusalem identity card
[] 9. Israeli measurements
[] 10. Other

62. Religion

[] 1. Muslim
[] 2. Christian
[] 3. Other

For Palestinians only
[Question 63 to 67 are asked of only Palestinians]

63. Refugee status

[] 1. Registered refugee
[] 2. Non registered refugee
[] 3. Non refugee

64a. Visual difficulty: As a result of a health condition, does [the respondent] suffer a difficulty in ...

[] 0. No difficulty
[] 1. Yes, some difficulty
[] 2. Yes, major difficulty
[] 3. Not at all

65a. Visual difficulty: Reason

[For persons who reported a visual difficulty]

[] 1. Congenital / genetic
[] 2. During pregnancy / delivery
[] 3. Illness
[] 4. Psychological / physical abuse
[] 5. Aging
[] 6. Work injury
[] 7. Traffic accident
[] 8. Other accident
[] 9. Israeli measurements
[] 10. War
[] 11. Stress
[] 12. Other

64b. Hearing difficulty: As a result of a health condition, does [the respondent] suffer a difficulty in ...

[] 0. No difficulty
[] 1. Yes, some difficulty
[] 2. Yes, major difficulty
[] 3. Not at all

65b. Hearing difficulty: Reason

[For persons who reported a hearing difficulty]

[] 1. Congenital / genetic
[] 2. During pregnancy / delivery
[] 3. Illness
[] 4. Psychological / physical abuse
[] 5. Aging
[] 6. Work injury
[] 7. Traffic accident
[] 8. Other accident
[] 9. Israeli measurements
[] 10. War
[] 11. Stress
[] 12. Other

64c. Moving and using hands difficulty: As a result of a health condition, does [the respondent] suffer a difficulty in ...

[] 0. No difficulty
[] 1. Yes, some difficulty
[] 2. Yes, major difficulty
[] 3. Not at all

65c. Moving and using hands difficulty: Reason

[For persons who reported a moving and using hands difficulty]

[] 1. Congenital / genetic
[] 2. During pregnancy / delivery
[] 3. Illness
[] 4. Psychological / physical abuse
[] 5. Aging
[] 6. Work injury
[] 7. Traffic accident
[] 8. Other accident
[] 9. Israeli measurements
[] 10. War
[] 11. Stress
[] 12. Other

64d. Remembering or concentrating difficulty: As a result of a health condition, does [the respondent] suffer a difficulty in ...

[] 0. No difficulty
[] 1. Yes, some difficulty
[] 2. Yes, major difficulty
[] 3. Not at all

65d. Remembering or concentrating difficulty: Reason

[For persons who reported a remembering or concentrating difficulty]

[] 1. Congenital / genetic
[] 2. During pregnancy / delivery
[] 3. Illness
[] 4. Psychological / physical abuse
[] 5. Aging
[] 6. Work injury
[] 7. Traffic accident
[] 8. Other accident
[] 9. Israeli measurements
[] 10. War
[] 11. Stress
[] 12. Other

64e. Communication difficulty: As a result of a health condition, does [the respondent] suffer a difficulty in ...

[] 0. No difficulty
[] 1. Yes, some difficulty
[] 2. Yes, major difficulty
[] 3. Not at all

65e. Communication difficulty: Reason

[For persons who reported a communication difficulty]

[] 1. Congenital / genetic
[] 2. During pregnancy / delivery
[] 3. Illness
[] 4. Psychological / physical abuse
[] 5. Aging
[] 6. Work injury
[] 7. Traffic accident
[] 8. Other accident
[] 9. Israeli measurements
[] 10. War
[] 11. Stress
[] 12. Other

66. Health insurance

[] 0. No
[] 1. Governmental only
[] 2. UNRWA [United Nations Relief and Works Agency for Palestine Refugees in the Near East] only
[] 3. Private only
[] 4. Governmental and UNRWA
[] 5. Governmental and private
[] 6. UNRWA and private
[] 7. Israeli
[] 8. Others

67. Does [the respondent] suffer from any chronic disease, according to a medical diagnosis, and receives treatment continuously?

[] 1. Yes
[] 2. No

[p. 3]

Part two (cont.): Household members data

50. Individual number _ _

68. Enrollment in education

[For persons 3 years and over]

[] 0. Currently enrolled in kindergartens
[] 1. Currently enrolled
[] 2. Enrolled and left
[] 3. Enrolled and graduated
[] 4. Never enrolled

69. Number of schooling years successfully completed _ _

[For persons 5 years and over.]


For persons (10 years and over)
[Question 70 to 73 are asked of persons who were older than 10 years old]

Educational attainment and specialization
[Question 70 to 71]

70. Educational attainment

[] 1. Illiterate
[] 2. Can read and write
[] 3. Elementary
[] 4. Preparatory
[] 5. Secondary
[] 6. Intermediate diploma
[] 7. Bachelor
[] 8. Higher diploma
[] 9. Master
[] 10. PhD


71. Specialization:

[For persons who obtained secondary or above (who answer 5 -- 10 in question 70)]

____ Specialization
____ Code

72. Place the highest degree obtained

[] 1. Palestine
[] 2. Jordan
[] 3. Egypt
[] 4. Other Arab countries
[] 5. Russia
[] 6. Other non-Arab Asian countries
[] 7. Non-Arab African countries
[] 8. Eastern Europe
[] 9. Western Europe
[] 10. North America
[] 11. South America
[] 12. Australia
[] 13. Other


73. Technical / professional qualification obtained
[] 0. None
[] 1. Vocational training / short technical at place of work
[] 2. Vocational training less than 6 months
[] 3. Vocational training from 6 -- less than 12 months
[] 4. Vocational training 1--2 years (without experience)
[] 5. Joining a vocational / industrial school (without experience)
[] 6. Vocational training 1--2 years (with experience)
[] 7. Enrolling a vocational / industrial school (with experience)

Labor force status in the past week previous to the reference night (18--24/11/2017) (persons 7 years and over)
[Questions 74 to 82 asked to persons aged 7 years and older]

74. Type of labor force status

[] 1. Worker 1 -- 14 hours
[] 2. Worker 15 -- 34 hour
[] 3. Worker 35 -- 45 hours
[] 4. Worker 46 hours and more
[] 5. Sought work during the last 4 weeks (doesn't work but want to work -- worked before)
[] 6. Sought work during the last 4 weeks (doesn't work but want to work -- not worked before or doesn't work and not want to work)
[] 7. Studying/training
[] 8. Housekeeping
[] 9. Disability/aging/illness
[] 10. Having another source of income
[] 11. Retirement
[] 12. Other

[If answered response 6 through 12, go to question 83.]

75. For persons answered question 74 answers (1--2)

Are the individual willing and ready to work overtime?

[] 1. Yes
[] 2. No


For employed persons and unemployed ones who ever worked (who answers items (1--5) of question 74, and if the answers (6--12) go to question 83
[Questions 79 through 82 asked of persons aged 7 or older who were employed or unemployed as indicated in questions 74 responses 1 through 5.]


76. Main occupation current/previous (detailed type of employee work)

____ Occupation
____ Code

77. Main economic activity current/previous (detailed employer type of work)

____ Activity
____ Code

78. Sector

[] 1. National private inside establishment
[] 2. National private outside establishment
[] 3. Foreign private inside establishment
[] 4. Foreign private outside establishment
[] 5. National government
[] 6. Local authority
[] 7. Foreign government
[] 8. Non-profit organization
[] 9. Cooperative association
[] 10. UNRWA [United Nations Relief and Works Agency for Palestine Refugees in the Near East]
[] 11. International organization

79. Place of work

[] 1. At home
[] 2. In the same locality
[] 3. In the same governorate
[] 4. In other governorate
[] 5. In Israel
[] 6. In settlement
[] 7. Abroad


80. Main employment status

[] 1. Employer
[] 2. Self employed
[] 3. Regular wage employee
[] 4. Irregular wage employee
[] 5. Unpaid family member

Wage employee question 80 answers (3--4)
[Question 81 and 82 were asked to respondents who answered they were wage earning employees in question 80]

81. What is the nature of individual contract (current/previous job)

[] 1. Written contract for a limited period
[] 2. Written contract for unlimited period
[] 3. Verbal agreement
[] 4. No

82. Does the employer contribute to

a. Pension fund
[] 1. Yes
[] 2. No

b. Paid annual leave
[] 1. Yes
[] 2. No

c. Paid sick leave
[] 1. Yes
[] 2. No

d. Paid maternity leave (only for women)
[] 1. Yes
[] 2. No


Marital status
[Question 83 and 84 are asked of persons who were over 14 years old]

83. Marital status

[] 1. Never married
[] 2. Legally engaged
[] 3. Married
[] 4. Divorced
[] 5. Widow
[] 6. Separated

84. Age at first marriage in completed years _ _

For married or ever married women
[Questions 85 through 93 asked of married or ever married women.]

85. Duration of marriage in completed years _ _

Births during marriage (for women 14 years and over)
[Question 86 through 89 asked of married or ever married women aged 14 years and older.]

Number of alive births

____ 86. Males
____ 87. Females

Number of surviving births

____ 88. Males
____ 89. Females

Births during the last 12 months (for women 14--54 years)
[Questions 90 through 93 asked of married or ever married women aged 14 to 54 years.]


Number of alive birth

____ 90. Males
____ 91. Females

Number of surviving births

____ 92. Males
____ 93. Females

Form No. (25/1 PHC)

Part three: Summary of household members

_ _ 94. Total
_ _ 95. Number of males
_ _ 96. Number of females

Part four: Agriculture

97. Is any of household members engaged in any form of own-account agriculture production during the agriculture year 2016/2017?

[] 1.Yes
[] 2. No

1. Does your household have cultivated land with protected temporary crops during agriculture year 2016/2017?

[] 1. Less than 0.2 dunum
[] 2. 0.2 dunum small than 0.5 dunum
[] 3. 0.5 dunum and more
[] 4. Nil [None]

2.a. Does your household have cultivated land with open temporary crops during the agriculture year 2016/2017?

[] 1. Less than 0.5 dunum
[] 2. 0.5 dunum small then 0.1 dunum
[] 3. 1.0 dunum and more
[] 4. Nil [None]

2.b. Does your household have permanent crops (horticulture trees) as on 01/12/2017?

[] 1. Less than 0.5 dunum
[] 2. 0.5 dunum small then 0.1 dunum
[] 3. 1.0 dunum and more
[] 4. Nil [None]

3. Does your household have one cattle / camel as on 01/12/2017?

[] 1. Yes
[] 2. No

4. Does your household have sheep and/or goats as on 01/12/2017?

[] 1. 1 -- 4 heads
[] 2. 5 heads and more
[] 3. Nil [None]

5. Does your household have poultry as on 01/12/2017?

[] 1. 1 -- 49
[] 2. 50 and more
[] 3. Nil [None]

6. Does your household have one beehives as on 01/12/2017?

[] 1. 1 -- 2 beehives
[] 2. 3 and more beehives
[] 3. Nil [None]

Part five: Death in household during the past 12 months
[Question 98 to 109]

98. God forbids ... did any death happened to one of the family members during the past 12 months (01/12/2016 -- 30/11/2017)

[If yes, record details in questions 99 through 109]

[] No


99. Serial number

100. Full name of the deceased member

____ First
____ Father
____ Family




101. Relation to the head of household (see codes 2-10 of question 52) _ _

102. Sex

[] 1. Male
[] 2. Female

103. Age at the time of death_ _

(Persons less than one year please put 00)

104. A death certificate was obtained

[] 1. Yes
[] 2. No

For women aged (14 -- 54) years at the time of death
[Questions 105 to 109 are asked of women age 14 to 54 who died]


105. Marital status

[] 1. Never married
[] 2. Legally engaged
[] 3. Married
[] 4. Divorced
[] 5. Widowed
[] 6. Separated


For married or ever married women, at the time of death, was she:
[Questions 106 to 109 are asked of ever married women age 14 to 54 who died]

106. Pregnant?

[] 1. Yes
[] 2. No


107. Giving birth?

[] 1. Yes
[] 2. No


108. Within 42 days of the end of a pregnancy or childbirth?

[] 1. Yes
[] 2. No


109. Because of accident (a traffic accident or a fall or fire etc ...)
[] 1. Yes
[] 2. No