Sierra Leone 2015 Population and Housing Census

Questionnaire number _ _

Total number of questionnaires used for this household _ _

_ _ _Total male
_ _ _Total female
_ _ _ Total

Date of Interview ____ December 2015

Section I: Identification

I1. Province _

I2. District ____ _

I3. Chiefdom/ward ____ _ _

I4. Section ____ _ _

I5. EA _ _

I6. Local council

[] 111 Kailahun District Council
[] 121 Kenema District Council
[] 122 Kenema City Council
[] 131 Kono District Council
[] 132 Koidu/New Sembehun City Council
[] 211 Bombali District Council
[] 212 Makeni City Council
[] 221 Kambia District Council
[] 231 Koinadugu District Council
[] 241 Port Loko District Council
[] 251 Tonkolili District Council
[] 311 Bo District Council
[] 312 Bo City Council
[] 321 Bonthe District Council
[] 322 Bonthe Municipality
[] 331 Moyamba District Council
[] 341 Pujehuh District Council
[] 411 Western Rural District Council
[] 422 Freetown City Council

I7. Urban/rural _

I8. EA type _

I9. Locality: ____ _ _ _

I10. Street address ____

I11. Structure type

[] 1 Single unit 1 storey
[] 2 Multiple unit 1 storey
[] 3 Single unit 2 storey
[] 4 Multiple unit 2 storey
[] 5 Single unit 3+ storey
[] 6 Multiple unit 3+ storey

I12. Structure number _ _ _

I13. Household number within the structure _ _

I14. Household number within the EA _ _ _

I15 Type of Residence

If 2, go to section III

[] 1. Occupied Housing Units
[] 2. Vacant Housing Units

Section II: Population Characteristics

All persons [Questions P01-P20]

[Section II was answered for all persons who selected living in occupied housing units in question I15]

P01. Serial number _ _

Name [Questions P02-P03]

What are the names of all persons who spent the census night in this household (Dec. 4/5, 2015)?

Record names of all persons, including young and old, starting with the household head

P02. First Name ____

P03. Surname ____

P04. Relationship

What is [the respondent's] relationship to the household head?

[] 01 Head
[] 02 Spouse
[] 03 Son/daughter
[] 04 Sister/brother
[] 05 Nephew/niece
[] 06 Parent
[] 07 Uncle/aunt
[] 08 In-law
[] 09 Grand parent
[] 10 Grand child
[] 11 Step son/daughter
[] 12 Other
[] 13 Not related

P05. Age

If less than 1 year record '000'
If greater or equal to 120 years record '120'

Age at last birthday (completed years) ____

P06. Sex

Is [the respondent] male or female?

[] 1. male
[] 2. female

P07. Religions

What is [the respondent's] religion? ____

Write the code of the religion _ _

[] 01 Catholic
[] 02 Anglican
[] 03 Methodist
[] 04 SDA
[] 05 Pentacostal
[] 06 Other Christian
[] 07 Islam
[] 08 Bahai
[] 09 Traditional
[] 10 Other
[] 11 No Religion

P08. Nationality

If Non- Sierra Leonean, Go to P10

Write the code of the nationality _ _ _ _

[] 6001 Sierra Leonean
[] 6002 Nigeria
[] 6003 Gambia
[] 6004 Guinea Republic
[] 6005 Ghana
[] 6006 Liberia
[] 6007 Cote d'Ivoire
[] 6008 Cape Verde
[] 6009 Senegal
[] 6010 Mali
[] 6011 Togo
[] 6012 Benin
[] 6013 Burkina Faso
[] 6014 Guinea Bissau
[] 6015 Niger
[] 6016 Zambia
[] 6017 Kenya
[] 6018 Other African Countries
[] 7001 United Kingdom
[] 7002 Other European Countries
[] 8001 United States of America
[] 8002 India
[] 8003 Lebanon
[] 8004 Pakistan
[] 9000 Other

P09. Ethnicity

Answered only if identified as Sierra Leonean national in P08.

Write the code of ethnic group _ _

[] 01 Krio
[] 02 Mende
[] 03 Temne
[] 04 Madingo
[] 05 Loko
[] 06 Sherbro
[] 07 Limba
[] 08 Kissi
[] 09 Kono
[] 10 Susu
[] 11 Fullah
[] 12 Krim
[] 13 Yalunka
[] 14 Koranko
[] 15 Vai
[] 16 English
[] 17 French
[] 18 Arabic
[] 19 Other
[] 20 None

Language [Questions P10-P11]

P10. Primary language

Write the code of the primary language spoken by [the respondent] _ _

[] 01 Krio
[] 02 Mende
[] 03 Temne
[] 04 Madingo
[] 05 Loko
[] 06 Sherbro
[] 07 Limba
[] 08 Kissi
[] 09 Kono
[] 10 Susu
[] 11 Fullah
[] 12 Krim
[] 13 Yalunka
[] 14 Koranko
[] 15 Vai
[] 16 English
[] 17 French
[] 18 Arabic
[] 19 Other
[] 20 None

P11. Secondary language

Write the code of the secondary language spoken by [the respondent] _ _

[] 01 Krio
[] 02 Mende
[] 03 Temne
[] 04 Madingo
[] 05 Loko
[] 06 Sherbro
[] 07 Limba
[] 08 Kissi
[] 09 Kono
[] 10 Susu
[] 11 Fullah
[] 12 Krim
[] 13 Yalunka
[] 14 Koranko
[] 15 Vai
[] 16 English
[] 17 French
[] 18 Arabic
[] 19 Other
[] 20 None

P12. Place of birth

Write the code of chiefdom of birth if born in Sierra Leone, or country if born outside Sierra Leone. _ _ _ _

[] 6001 Sierra Leonean
[] 6002 Nigeria
[] 6003 Gambia
[] 6004 Guinea Republic
[] 6005 Ghana
[] 6006 Liberia
[] 6007 Cote d'Ivoire
[] 6008 Cape Verde
[] 6009 Senegal
[] 6010 Mali
[] 6011 Togo
[] 6012 Benin
[] 6013 Burkina Faso
[] 6014 Guinea Bissau
[] 6015 Niger
[] 6016 Zambia
[] 6017 Kenya
[] 6018 Other African Countries
[] 7001 United Kingdom
[] 7002 Other European Countries
[] 8001 United States of America
[] 8002 India
[] 8003 Lebanon
[] 8004 Pakistan
[] 9000 Other

P13. Place of previous residence

Asked only if age is 5 years or more

Write the code of chiefdom of residence in December 2010, or the country if outside Sierra Leone. _ _ _ _

[] 6001 Sierra Leonean
[] 6002 Nigeria
[] 6003 Gambia
[] 6004 Guinea Republic
[] 6005 Ghana
[] 6006 Liberia
[] 6007 Cote d'Ivoire
[] 6008 Cape Verde
[] 6009 Senegal
[] 6010 Mali
[] 6011 Togo
[] 6012 Benin
[] 6013 Burkina Faso
[] 6014 Guinea Bissau
[] 6015 Niger
[] 6016 Zambia
[] 6017 Kenya
[] 6018 Other African Countries
[] 7001 United Kingdom
[] 7002 Other European Countries
[] 8001 United States of America
[] 8002 India
[] 8003 Lebanon
[] 8004 Pakistan
[] 9000 Other

P14. Orphanhood

Is [the respondent] mother and/or father alive?

[] 1. Both parents alive
[] 2. Only mother alive
[] 3. Only father alive
[] 4. Both parents dead
[] 5. Don't know

Disability [Questions P15-P19]

P15. Does [the respondent] suffer from any form of disability?

If 2 or 3 go to P20

[] 1. Yes
[] 2. No
[] 3. Don't Know

P16. Main type of disability

Answered only if the respondent answered yes to having a disability in P15.

[] 00 None
[] 01 Physical disability (Polio)
[] 02 Physical disability (Amputee)
[] 03 Blind or visually impaired
[] 04 Partially sighted
[] 05 Deaf
[] 06 Partially deaf
[] 07 Speech difficulties
[] 08 Mute/Dumb
[] 09 Mental difficulties
[] 10 Spinal injury/disability
[] 11 Psychiatric disability
[] 12 Epileptic
[] 13 Rheumatism
[] 14 Albinism
[] 15 Kyphoscoliosis (Hunch Back)
[] 16 Other

P17. Second type of disability

P18. Cause of main disability

Answered only if the respondent answered yes to having a disability in P15.

[] 1 Congenital (from birth)
[] 2 Disease/illness
[] 3 Transport Accident
[] 4 Occupational injury
[] 5 Other accident
[] 6 War
[] 7 Natural ageing process
[] 8 Other

P19. Kind of treatment or rehabilitation received or still receiving

Answered only if the respondent answered yes to having a disability in P15.

[] 1 Surgical operation
[] 2 Medication
[] 3 Assistive devices
[] 4 Special education (mentally retarded)
[] 5 Braille training/Sign language training
[] 6 Skills training (vocational)
[] 7 Counseling
[] 8 Financial
[] 9 Other
[] 0 None

P20. Birth registration

Does [the respondent] have a birth certificate?

[] 1. Yes
[] 2. No
[] 3. Don't know

P21. Is [the respondent] fully immunized?

For persons 0-5 years:

[] 0. Never
[] 1. Yes Partially
[] 2. Yes Fully
[] 3. Don't know

3 years and above [Questions P22-P24]

P22. School attendance

Has [the respondent] ever attended school?

If 2 or 3 go to P25

[] 1. Yes
[] 2. No
[] 3. Don't know

P23. Current enrollment

Answered only if the respondent indicated that they had ever attended school in P22.

Is [the respondent] currently attending school?

[] 1. Yes
[] 2. No
[] 3. Don't know

P24. What is the highest level of education [the respondent] ever attended and grade completed?

Answered only if the respondent indicated that they had ever attended school in P22.

[] 0 Kindergarten

Grade completed:
[] 0
[] 1
[] 2
[] 3

[] 1 Primary

Grade completed:
[] 0
[] 1
[] 2
[] 3
[] 4
[] 5
[] 6

[] 2 JSS

Grade completed:
[] 0
[] 1
[] 2
[] 3

[] 3 SSS

Grade completed:
[] 0
[] 1
[] 2
[] 3
[] 4

[] 4 Vocational/tech/nursing/teacher

Grade completed:
[] 0
[] 1
[] 2
[] 3

[] 5 Higher (First degree)

Grade completed:
[] 0
[] 1
[] 2
[] 3
[] 4

[] 6 Tertiary (Post-graduate)

Grade completed:
[] 0
[] 1
[] 2

[] 7 Koranic

Grade completed: 81

[] 8 Other

Grade completed: 92

[] 9 Don't know

Grade completed: 98

10 years and above [Questions P25-P33]

P25. Literacy

Can [the respondent] read and write a text in any of the following languages?

[] 1. Yes, English
[] 2. Yes, French
[] 3. Yes, Arabic
[] 4. Yes, local language
[] 5. None
[] 6. Don't know

P26. Tobacco and alcohol intake

Does [the respondent] take/smoke tobacco and/or take alcohol?

[] 1. Tobacco only
[] 2. Alcohol only
[] 3. Both Tobacco and Alcohol
[] 4. None
[] 5. Don't Know

P27. Marital status

What is the marital status of [the respondent]?

[] 01 Never married
[] 02 Engaged
[] 03 Married monogamous
[] 04 Married polygamous
[] 05 Co-habitation (less than 5 years)
[] 06 Co-habitation (equal to more than 5 years)
[] 07 Separated
[] 08 Divorced
[] 09 Widowed
[] 10 Don't know

Economic activity [Questions P28-P31]

P28. Employment status

What was [the respondent's] main (or usual) employment status during the past 12 months?

If 9 to 14, go to P32

[] 01 Paid employee
[] 02 Self-employed without employees
[] 03 Self-employed with employees (employer)
[] 04 Unpaid family worker
[] 05 Paid apprentice
[] 06 Unpaid apprentice
[] 07 Worked before but currently looking for work
[] 08 Looking for work for the first time
[] 09 Household work
[] 10 Not working and not looking for work
[] 11 Full time student
[] 12 Retired/pensioner
[] 13 Others
[] 14 Don't know

P29. Employer

Answered only by respondents who indicated that they were employed, in an apprenticeship or looking for work in question P28.

Who did [the respondent] work for during the past 12 months?

[] 01 Government
[] 02 Parastatal/quasi government
[] 03 Self employed
[] 04 International non-governmental organization
[] 05 Local non-governmental organization
[] 06 Family member
[] 07 Private enterprises
[] 08 Private household (paid domestic work)
[] 09 Embassy or International organization
[] 10 Others
[] 11 Don't know

P30. Occupation

Answered only by respondents who indicated that they were employed, in an apprenticeship or looking for work in question P28

What kind of work did [the respondent] do during the past 12 months?

[] 01 Legislators, senior officials and managers (members of parliament, civil servants, traditional chiefs and headmen, chief executive officers, managers, directors, etc.).
[] 02 Professionals (lecturers, teachers, SNR nurses, bankers, statisticians, engineers, lawyers, accountants, imams, pastors, journalists, librarians, medical doctor, building contractors)
[] 03 Technicians and associate professionals (technicians, plumbers, it specialists, JNR nurses, traditional healers, police officers, prison officers, traffic wardens, entertainers, tax officers)
[] 04 Clerks (secretaries, data processing operators, cashiers, custom service officers, other office clerks)
[] 05 Service workers, and shop and market sales workers (waitresses, restaurant attendants, travel attendants, house maid, soothsayers, fire force officers, models, traders, private security officers)
[] 06 Agricultural and fishery workers (farmers, fishermen, animal rearers, hunters, palm wine tappers, poultry workers etc.)
[] 07 Craft and related trade workers (stone breakers, sand miners, diamond and gold miners, other miners, wood carvers, painters, masoner, builders, structure cleaners, black smith, mechanics and fitters, electricians, printers, wood cutter, shoe makers, carpenters, welders, tailors, cookery sellers, seamstress, etc. )
[] 08 Plant and machine operators and assemblers (machine operators, tractor drivers, motor vehicle drivers, okada riders, printers, binders, potters, crewmen, power saw operators, boat drivers, ferry workers)
[] 09 Elementary workers (newspaper vendors. street sellers, hawkers, shoe cleaners, labourers, cleaners, caretakers, messengers, garbage collectors, porters)
[] 10 Armed forces (army, navy, OSD)

P31. Industry

Answered only by respondents who indicated that they were employed, in an apprenticeship or looking for work in question P28.

What industry did [the respondent] work in during the past 12 months?

[] 01 Crops production: (the production of rice, maize, cassava, potato, orange, coffee, rubber, cocoa, groundnut etc.)
[] 02 Animal production: (rearing of cow, goat, sheep, pig, chicken, duck, etc.)
[] 03 Forestry, logging and hunting: (timber, fire wood, charcoal, honey, wild life animals, etc.)
[] 04 Fishing and aquaculture: (fish pond, streams, rivers sea/ocean etc.)
[] 05 Mining and quarrying: (diamond mining, gold mining, sand mining, salt mining, stone breaking, etc.)
[] 06 Manufacturing: (soap making, bakery, carpentering, manufacturing of food product, sugar, beverages, tobacco, textile, printing, rubber and plastic production, yoghurt, butter scotch making, weaving, rice milling, repairs of machineries and equipment except motor vehicles and computers, welding, etc.)
[] 07 Electricity, gas, steam and air conditioning supply: (electricity power supply from hydro, sun, and wind, thermal plant e.g. EDSA / BKPS / Solar, gas supply e.g. Afrigas etc.)
[] 08 Water supply; sewerage, waste management and remediation activities: (water treatment and supply e.g. Guma Valley/SALWACO, Massada, Clean Salone, Toilet disposal, etc.)
[] 09 Construction: (construction of roads, bridges, rail ways, schools, air fields, etc.)
[] 10 Wholesale and retail trade; repair of motor vehicles and motorcycles: (selling in large quantity, selling in bits, mechanics, etc.)
[] 11 Transport and storage: (land, air, sea, E.g. taxi, podapoda, okada, boat/ferry, airplane, warehouse, etc.)
[] 12 Accommodation and food service activities: (Hotels, guest house cookery shops, bars, restaurant, hostels, and ice cream truck vendor's etc.)
[] 13 Information and communication: (mobile communication, print media, electronic media, social media, internet providers, etc.)
[] 14 Financial and Insurance activities: (bank, micro-finance, insurance, etc.)
[] 15 Real estate activities: (buying, renting and selling of houses and other properties etc.)
[] 16 Professional, scientific and technical activities: (legal services, examiners, bailiffs, accountants, researchers, consultancies, engineering, advertising, marketing, experimental work, auditing, etc.)
[] 17 Administration and support service activities: (security agencies, traveling agencies e.g. IPC travel, rental and leasing of household goods and services and motor vehicles, surveyors, and office support staffs, etc.)
[] 18 Public administration and defense; compulsory social security: (purely government e.g. local government, MDAs, armed forces, police.)
[] 19 Education: (kindergarten, primary, junior secondary, senior secondary, tertiary, university, etc.)
[] 20 Human health and social work activities: (primary health care, medical and dental activities, nursing care activities, mental care and substance abuse, care for elderly and disabled people, traditional healers.)
[] 21 Arts, entertainment and recreation: (designers, musicians, actors, actresses, concerts, gambling and betting, sport activities, etc.)
[] 22 Other service activities: (hairdressing, barbering, funeral and related activities, repairs of shoes, religious organizations, political organizations, personal service activities.)
[] 23 Activities of households as employers; production activities of households for own use: (gardeners, domestic workers, etc.)
[] 24 Activities of extraterritorial organizations and bodies: (International organizations like, UN, ECOWAS, Embassies, AU, IMF, World Bank, ADB, High Commissions, etc.)

Information communication technology [Questions P32-P33]

P32. Does [the respondent] have access to internet facility?

If 2 or 3 go to P34

[] 1. Yes
[] 2. No
[] 3. Don't know

P33. Has [the respondent] used internet in the past one week?

Answered only if the respondent indicated having access to an internet facility in question P32

[] 1. Yes, at home
[] 2. Yes, at office
[] 3. Yes, internet cafe
[] 4. Yes, other
[] 5. No

Females aged 10 years and over [Questions P34-P37]

Children ever born

How many children have been born alive to [the respondent] who are:

If no child, write '00'

P34. Total births

_ _ P34M. Total male births
_ _ P34F. Total female births

P35. Children living in household

_ _ P35M. Male children living in household
_ _ P35F. Female children living in household

P36. Children living elsewhere

_ _ P36M. Male children living elsewhere
_ _ P36F. Female children living elsewhere

P37. Children dead

_ _ P37M. Male children dead
_ _ P37F. Female children dead

Females 10-54 years [Questions P38-P40]

Recent births (last 12 months)

P38. How many live births did [the respondent] have in the last 12 months?

If no live birth, write '0' and go to Section III

_ _ P38M. Male live births
_ _ P38F. Female live births

P39. Did [the respondent] give birth in a hospital or a clinic?

Only if live births occurred per question P38

[] 1. Yes
[] 2. No
[] 3. Don't know

P40. How many of the live births did [the respondent] have during the past 12 months that are still alive?

Only if live births occurred per question P38

If no child is alive, write '0'

_ _ P40M. Male child(ren) alive
_ _ P40F. Female child(ren) alive

Section III: Housing facilities

(For vacant housing unit, complete only H01, H06 and H07)

[Questions H01, H06, and H07 were asked of all people. The rest of the questions in section III were recorded only for respondent's whose indicated type of residence was occupied housing units in question I15]

H01. Type of dwelling unit

[] 01. Separate house
[] 02. Semi-detached house
[] 03. Flat / Apartment
[] 04. Compound house (rooms)
[] 05. Huts/Buildings (same compound)
[] 06. Huts/Buildings (different compound)
[] 07. Tent
[] 08. Improvised home (kiosk, container, board, pan-body)
[] 09. Uncompleted building
[] 10. Other ____

H02. Tenure status

How was this dwelling acquired?

Owner:

[] 01 Purchased
[] 02 Constructed
[] 03 Inherited

Employer Provided:

[] 04 Government
[] 05 Private
[] 06 Parastatal/Quasi-Govt.

Renting:

[] 07 Government
[] 08 Housing Cooperation
[] 09 Private
[] 10 Parastatal/Quasi-Govt.

Other:

[] 11 Squatter
[] 12 Other

H03. What are the current repair needs of the dwelling unit?

[] 1. No repairs
[] 2. Minor repairs
[] 3. Major repairs/rehabilitation
[] 4. Reconstruction

H04. How many rooms does the household occupy? _ _

H05. How many beds with mosquito net?

_ _ How many beds have impregnated net?
_ _ How many beds have regular net?
_ _ How many beds have no net?

Major material of construction [Questions H06-H08]

H06. Roof

[] 1. Concrete
[] 2. Asbestos
[] 3. Zinc
[] 4. Thatch
[] 5. Tarpaulin
[] 6. Tiles
[] 7. Other ____

H07. Wall

[] 01. Stone
[] 02. Cement blocks
[] 03. Clay bricks
[] 04. Sandcrete
[] 05. Zinc
[] 06. Timber
[] 07. Mud bricks
[] 08. Poles/reed
[] 09. Tarpaulin
[] 10. Burned bricks
[] 11. Mud and wattle
[] 12. Other ____

H08. Floor

[] 1. Stone
[] 2. Tiles
[] 3. Cement
[] 4. Wood
[] 5. Mud
[] 6. Other ____

H09. How do you dispose of rubbish?

[] 1. Collected
[] 2. Dumped anywhere
[] 3. Burnt
[] 4. Buried
[] 5. Deposited in bin
[] 6. Other ____

H10. What is your principal source of fuel supply for cooking?

[] 01. Electricity
[] 02. Gas
[] 03. Kerosene
[] 04. Charcoal
[] 05. Wood
[] 06. Crop residue
[] 07. Saw dust
[] 08. Solar
[] 09. Animal waste
[] 10. Other ____

H11. What is your principal source for lighting?

[] 1. NPA/BKPS
[] 2. Gas
[] 3. Kerosene
[] 4. Generator
[] 5. Battery/rechargeable lite
[] 6. Candle
[] 7. Wood
[] 8. Solar
[] 9. Other ___

What is your principal source of water supply for [Questions H12-H13]

H12. Drinking

[] 01. Piped indoors
[] 02. Piped in compound
[] 03. Public tap
[] 04. Protected ordinary well
[] 05. Unprotected ordinary well
[] 06. Mechanical well
[] 07. River / riverbed/ stream
[] 08. Neighbor's tap
[] 09. Sacket / bottled water
[] 10. Water vendor / bowser
[] 11. Other ____

H13. Household use

[] 01. Piped indoors
[] 02. Piped in compound
[] 03. Public Tap
[] 04. Protected ordinary well
[] 05. Unprotected ordinary well
[] 06. Mechanical well
[] 07. River / riverbed / stream
[] 08. Neighbor's tap
[] 09. Sacket / bottled water
[] 10. Water vendor / bowser
[] 11. Other ____

What kind of facilities do you have for [Questions H14-H15]

H14. Toilet

Communal:

[] 11 VIP
[] 12 Flushed inside
[] 13 Flushed outside
[] 14 Pit
[] 15 Bucket
[] 16 Bush/river bed
[] 17 Other

Private:

[] 21 VIP
[] 22 Flushed inside
[] 23 Flushed outside
[] 24 Pit
[] 25 Bucket
[] 26 Other

H15. Bathing

[] 1. Inside
[] 2. Outside; built
[] 3. Outside; makeshift
[] 4. Other ____
[] 5. None

H16. What is the household main source of information?

[] 1. Radio
[] 2. Television
[] 3. Print media
[] 4. Post mail
[] 5. Hand mail
[] 6. Social media
[] 7. Word of mouth
[] 8. Church / mosque
[] 9. Other ____

What is the distance from this household to the nearest? [Questions H17-H19]

H17. Health facility

[] 1. Within compound
[] 2. Less than 0.5 mile
[] 3. 0.5 mile but less than 1 mile
[] 4. 1 to less than 5 miles
[] 5. Five miles or more
[] 6. Don't know

H18. Primary school

[] 1. Within compound
[] 2. Less than 0.5 mile
[] 3. 0.5 mile but less than 1 mile
[] 4. 1 to less than 5 miles
[] 5. Five miles or more
[] 6. Don't know

H19. Source of water

[] 1. Within compound
[] 2. Less than 0.5 mile
[] 3. 0.5 mile but less than 1 mile
[] 4. 1 to less than 5 miles
[] 5. Five miles or more
[] 6. Don't know

Section IV: Ownership of durables

Does the household own any of the following?

(Record only items in working condition)

01 Electric iron: