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Third General Census of Population and Housing (2002)
Household Questionnaire Senegal

[p. 1]

Confidential: The information contained in this document is confidential, and cannot be used in any case for the purpose of legal prosecution, for fiscal control or for economic repression. Any refusal to answer or any false declaration will be punished according to law No 66-59 of June 30, 1966 related to obligations and confidentiality in statistical matter.

Questionnaire number: ________

Number of questionnaires filled: ________

Section A: Household Identification Characteristics

Write the answers to questions A01 to A09 in plain words. Do not write anything in the shaded boxes designed for the coding of these questions.

A01. Region ________

A02. Department _______

A03. Area of residence_______

[] 1 Urban
[] 2 Rural

A04. District________

A05. Township (for urban areas)________
Rural Community (for rural areas)________

A06. Municipality ________

A07. Census track number ________

A08. Village / neighborhood ________

A09. Urban quarter or hamlet (rural) ________

A10. Compound number ________

A11. Household number _________

Summary table:

[Two summary tables were included. One counted the number of females and males by RP, RA and visitors, the other recording census enumerator, controller, supervisor, coding agent, and data entry agent.]

[p. 2]

Section B: Individual Characteristics

Total Population

B1. Sequential number________

B2. First name and last name_________

Record the household members (present or absent) as well as any person who spent the night in the household, starting with the household head.

B3. Relationship to the head of household

Circle the code corresponding to the relationship with the household head.

[] 1 Head of household
[] 2 Spouse (husband or wife)
[] 3 Son / daughter
[] 4 Father / mother
[] 5 Grandfather / grandmother
[] 6 Brother / sister
[] 7 Grandson / granddaughter
[] 8 Other kinship
[] 9 No kin relationship

B4. Gender

Circle the appropriate code:

[] 1 Male
[] 2 Female

B5. Date of birth

If the person does not know her month and / or her year of birth, leave blank the appropriate boxes, and skip to the next question.

Month: _ _
Year: _ _ _ _

B6. Age________

Record the age as declared or the estimated age in completed number of years.
Write "98" for persons aged 98 years and above.

B7. Place of birth: ________

Write the name of the commune (urban) or the rural community if the place of birth is located in Senegal, and the name of the country of birth for persons born in foreign countries.

B8. Residence status

Circle:

[] 1 Usual residents in the household who spent the previous night in the household.
[] 2 Usual residents in the household who did not spend the preceding night in the household.
[] 3 Visitors.

B9. Place of residence five years ago

For all individuals age 5 and older.

For the residents, present and absent, write the name of the commune or the rural community of residence if this is a place in Senegal, and the name of the country of residence for persons who were living abroad._________________

For the visitors, write the name of the commune or the rural community where they are coming from if this is a place in Senegal, and the name of the country of residence where they are coming from for persons who are living abroad.____________

[p. 3]

B10. Ethnicity or nationality

For Senegalese, write the name of the ethnic group__________________
For foreigners, write the nationality________________

B11. Languages spoken

Write in sequential order, the name of the first language and that of the second language spoken by the respondent._________________________________

B12. Religion

Circle the following:

Muslims / brotherhood:
[] 1 Kadre
[] 2 Layenne
[] 3 Mouride
[] 4 Tidiane
[] 5 Other Muslim
Christians:
[] 6 Catholic
[] 7 Protestant
[] 8 Other Christian
Others:
[] 9 Other religion / no religion

B13. Disability / Handicap

Record all the disability or handicaps shown by the respondent, by writing "1" in the appropriate box.

[] None
[] Blind
[] Deaf
[] Mute
[] Disability in lower limbs
[] Disability in upper limbs
[] Mental deficiency
[] Albinos
[] Leper with mutilations
[] Other cases

For individuals 3 years of age and older
[Questions B14-B15 are asked only to those 3 years and older]

B14. School attendance

Record the various types of schools attended, by writing the number "1" in the appropriate boxes

[] None
[] French school
[] Franco-Arabic school
[] Arabic school
[] Koranic school
[] Other school

[If B14=FR, FA, or AUT go to B15; otherwise, go to B16]

B15. Level of education

Write the code corresponding to the highest grade completed, or to the current grade.

[] 00 None
[] 01 Pre-school / kindergarten
[] 02, 03, 04, 05, 06, 07 Primary
[] 08, 09, 10, 11 Secondary, first cycle
[] 12, 13, 14 Secondary, second cycle
[] 15, 16, 17, 18, 19 University / higher education

[p. 4]

For individuals 6 years of age and older
[B16-B19 were asked of individuals 6 years and older]

B16. Literacy

Record all the languages that the respondent knows to read and write, by writing the number "1" in the appropriate boxes.

[] None
[] French
[] Arabic
[] Wolof
[] Pulaar
[] Sereer
[] Mandinka
[] Diola
[] Soninke
[] Other language

B17. Employment status in the last 12 months

Circle the appropriate code:

[] 1 Employed
[] 2 Jobless
[] 3 Student / pupil
[] 4 Housewife
[] 5 Retired, pensioned
[] 6 Elderly
[] 7 Accident / illness
[] 8 Beggar
[] 9 Other cases

B18. Occupation practiced:_________

Record the most frequent occupation in the past 12 months.

B19. Work status

Circle: the appropriate code

[] 1 Employer
[] 2 Self employed
[] 3 Salaried
[] 4 Trainee
[] 5 Family aid
[] 6 Apprentice
[] 7 Other cases

[For individual 12 years of age or older]

B20. Marital status

Circle the appropriate code:

[] 0 Married, monogamous
[] 1 Polygamous first wife
[] 2 Polygamous, second wife / polygamous 2 wives
[] 3 Polygamous, third wife / Polygamous 3+ wives
[] 4 Single
[] 5 Widowed
[] 6 Divorced
[] 7 Other cases

Women aged 12 years and more
[Questions B21-B22 were asked of women aged 12 years and more]

B21. Number of children ever born

Record the number of children ever born, broken down by sex

Males: ______
Females: _____

B22. Number of children surviving

Record the number of children still alive, broken down by sex

Males: _____
Females: _____

[For all women aged 12-54 years]

B23. Births in past 12 months

Record the number of births during the past 12 months, broken down by sex.

Males: _____
Females: _____

[p. 6]

Section C: Deaths that occurred in the household in the past 12 months.

C01. Sequential number_____

C02. Record the first name(s) and the last name of all the household members who died in the past 12 months________________

C03. Gender (sex)

Circle the code corresponding to the sex of the deceased person:

[] 1 Male
[] 2 Female

C04. Age at death

Record the age of the deceased person at the time of death.________

For persons aged 98 years and above, write "98"

C05. Vital registration

Circle the code corresponding to the registration or to the lack of registration at the Vital Registration Office

[] Yes: Registered
[] No: Not registered
[] DKN: Does not know whether registered or not

C06. Maternal death

This question applies only to deaths of women that occurred between age 12 and age 54 years

Did the death [of this woman] occur while she was pregnant, or delivering, or within 40 days following delivery?
[] YES: Yes (maternal)
[] NO: No (not maternal)
[] DKN: Does not know whether maternal or not

Section D: Outmigration that occurred in the household in the past five years.

D01. Sequential number ________

D02. Record the first name(s) and the last name of all the household members who left Senegal for a foreign country during the past 5 years, and who are still living there._________

D03. Gender (sex)

Circle the code corresponding to the sex of the migrant:

[] 1 Male
[] 2 Female

D04. Age at departure

Record the age of the migrant at time of departure ____

For persons aged 98 years and above, write "98"

D05. Relationship with the household head

Circle the code corresponding to the relationship with the household head:

[] 1 Spouse (husband or wife)
[] 2 Son / daughter
[] 3 Father / mother
[] 4 Grand-father / grand-mother
[] 5 Brother / sister
[] 6 Grand-son / grand-daughter
[] 7 Other kinship
[] 8 No kin relationship

D06. Country of destination_______

Record the country of destination

D07. Reasons for out-migrating

Circle the code corresponding to the main reason for outmigrating:

[] TRA: Work
[] ET/AP: Studies / Training
[] MAR: Marriage
[] SAN: Health reasons
[] FAM: Family reasons
[] AUT: Other reasons
[] NSP: Unknown

[p. 7]

Section E: Housing Characteristics

E01. Type of dwelling unit

[] 1 Hut
[] 2 Shack
[] 3 House, no floor
[] 4 House, with floors
[] 5 Flat in apartment building
[] 6 Other

E02. Number of living rooms_____

E03. Ownership status

[] 1 Landlord
[] 2 Co-tenant
[] 3 Tenant
[] 4 Paid by employer
[] 5 Free family lodging
[] 6 Other

E04. Type of toilet facility

[] 1 Water closet, connected to sewage
[] 2 Water closet, septic tank
[] 3 Cesspool, Latrine
[] 4 Public toilet facility
[] 5 In the wild
[] 6 Other cases

E05. Source of water

[] 1 Well inside house
[] 2 Well outside house
[] 3 Tap, inside house
[] 4 Tap, outside house
[] 5 Deep well, pump
[] 6 Water truck / water dealer
[] 7 Spring, river
[] 8 Other case

E06. Main type of lighting

[] 1 Electricity
[] 2 Solar energy
[] 3 Generator
[] 4 Gas lamp
[] 5 Kerosene lantern
[] 6 Petrol lamp
[] 7 Candle
[] 8 Wood
[] 9 Other case

E07. Main type of fuel for cooking

[] 1 Wood
[] 2 Coal / charcoal
[] 3 Gas
[] 4 Electricity
[] 5 Other

[Circle the code corresponding to the main dwelling unit]

E08. Type of wall

[] 1 Cement
[] 2 Wood
[] 3 Adobe bricks
[] 4 Straw, thatch
[] 5 Other

E09. Type of roof

[] 1 Cement, concrete
[] 2 Tiles, slates
[] 3 Zinc sheets, iron sheets
[] 4 Straw, thatch
[] 5 Other

E10. Type of floor

[] 1 Ceramic tiles
[] 2 Cement
[] 3 Earth, adobe
[] 4 Sand
[] 5 Other

[Record all the amenities, means of transportation, means of production that the household owns by recording the number "1" in the appropriate boxes.]

E11. Household amenities

[] Radio
[] Television
[] VCR / DVD player
[] Refrigerator / freezer
[] Telephone
[] Gas cooker / oven
[] Improved stove
[] Air conditioned
[] Sewing machine
[] None

E12. Household means of transportation

[] Car
[] Motorcycle / motor bicycle
[] Bicycle
[] Cart / barouche
[] Pirogue / traditional boat
[] None

E13. Household means of production

[] Hoe / plough / sower
[] Carts / barouche
[] Draft animals (horses, oxen)
[] Tractor
[] Car / truck
[] Motorcycle / moto
[] Pirogue / traditional boat
[] Refrigerator / deep freezer
[] Sewing machine
[] Music instrument
[] Stools, canvas cover
[] Telephone / fax machine
[] Photocopy machine
[] Computer
[] Mill / shelling machine
[] Photo camera / camcorder
[] Land patch / building
[] None

E14. Main mode of disposal for household garbage

[] 1 Garbage truck
[] 2 Garbage cart
[] 3 Garbage dump, authorized
[] 4 Garbage dump, illegal (wild)
[] 5 Buried
[] 6 Burned
[] 7 Other

E15. Main mode of disposal for sewage water

[] 1 Sewage network
[] 2 Covered canal
[] 3 Open canal
[] 4 Grate / swallowing inlet
[] 5 In the sea, in large river
[] 6 In small river
[] 7 Hole dug [in soil]
[] 8 In the street / in the wild
[] 9 Other

Section F: Poverty

F01. Lack of resources for food

During the past 12 months, did it happen that your household missed a meal by lack of resources?

Circle the appropriate code:
[] 1 Yes
[] 2 No

F02. Lack of resources for health care

During the past 12 months, did it happen that a member of your household could not receive health care by lack of resources?

Circle the appropriate code:
[] 1 Yes
[] 2 No

Observations: