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The United Republic of Tanzania
2002 Population and Housing Census

Region ____
District ____
Ward / shebia ____
Village / street ____
Form number ____

A. IdentificationRegion _ _
District _ _
Ward / sheabia _ _ _
EA _ _ _
Household number _ _ _

B. All persons
01. Number

02: Household members
Please give me the names of the persons who spent the census night in your household, starting with the name of the head of household. ________
03. Relationship to head of householdWhat is the head relationship of [respondent] to the head of the household?

[] 1 Head
[] 2 Spouse
[] 3 Son / daughter
[] 4 Parent
[] 5 Grandchild
[] 6 Relative
[] 7 Not related

04. SexIs [respondent] male or female?

[] 1 Male
[] 2 Female

05. AgeHow old is [respondent]?

Write age in completed years.
If under one year, write "00".
More than 97 years, write "97".
_ _

06. DisabilityDoes [respondent] have any disability

[] 1 No
[] Yes _ _
What type of disability? (see codes).

07. Citizenship[Respondent] is a citizen of which country?

Write the code of the country.
_ _

08. Marital statusIs [respondent] currently never married, married/living together/divorced/separated or widowed?

[] 1 Never married
[] 2 Married
[] 3 Living together
[] 4 Divorced
[] 5 Separated
[] 6 Widowed
[] 9 Not stated

09. Survival of parent
Is [respondent's] father alive?

[] 1 Yes
[] 2 No
[] 8 Don't know

Is [respondent's] mother alive?

[] 1 Yes
[] 2 No
[] 8 Don't know

10. Place of birthWhere was [respondent] born?

Write codes for the region (if [respondent] is born in the country), or the code for the country (if [respondent] is born outside Tanzania)
_ _

11. Place of residenceWhere does [respondent] usually live?

Write codes for the region (if [respondent] is living in the country), or the code for the country (if [respondent] is living outside Tanzania)
_ _ _

12. Place of residence in 2001

Where was [respondent] living in 2001?
Write codes for the region (if [respondent] lived in the country), or the code for the country (if [respondent] lived outside Tanzania)
For children aged "00" in question 05, write code "998".
_ _ _

C. EducationFor those 5 years and more
[Questions 13-15.]
13. LiteracyCan [respondent] read and write in Kiswahili, in English, both in English and Kiswahili, or in any other language?

[] 1 Kiswahili
[] 2 English
[] 3 Both English and Kiswahili
[] 4 Other language
[] 5 None

14. EducationIs [respondent] currently attending, has partly attended, completed, or never attended school?

[] 1 Now attending
[] 2 Partly attended
[] 3 Completed
[] 4 Never attended

If the answer is "Never attended", skip to question 16.
15. Education attainment attendingWhat is the highest level of education has [respondent] completed, partly attended, or attending?

[Question 15 is asked of persons age 5 and older who attended school, as per question 14]
Write the appropriate code.
_ _

D. Economic activityFor persons age 5 and older
[Questions 16-20.]
16. Economic activityWhat did [respondent] do in the last 12 months?

Write the appropriate code.
_ _

17. What did [respondent] do in the last seven days?

Write the appropriate code. For codes greater than 06, skip to question 21.
_ _

18. Employment statusWas [respondent] an employer, employee, own account worker- non agriculture, own account worker- agriculture, contributing family worker, an apprentice?

Write the appropriate code.
_ _

19. OccupationWhat type of work did [respondent] do for the last seven days?

Write the appropriate code.
_ _

20. IndustryWhat is the main activity at [respondent's] place of work for the last seven days?

Write the appropriate code?
_ _

E. Female respondents age 12 and older[Questions 21-24.]
Children ever born
21. How many male/female children were born alive to [respondent] and are now living with her in this household?

If she is not staying with any of her children, write "00".
Male _ _
Female _ _

22. How many male/female children were born alive to [respondent] and are now living elsewhere?

If she has no child living elsewhere, write "00"
Male _ _
Female _ _

23. How many male/female children were born alive to [respondent] and are now dead?

If none of her children has died, write "00".
Male _ _
Female _ _

24. How many male/female children were born alive to [respondent] in the last 12 months?

If no child was born alive in the last 12 months, write "0". Don't ask females age 50 and and older.
Male _ _
Female _ _

F. Deaths in the householdOccurrence of death

Person 1
25. Was there any death that occurred in this household during the last 12 months?

[] 1 Yes
[] 2 No

If the answer is "No", skip to question 32.
[Questions 26-31 were asked of households that had at least one death during the last 12 months, as per question 25.]
26. Was the deceased a male or a female?

[] 1 Male
[] 2 Female

27. How old was that person at the time of death?

Write age in completed years.
If younger than 1 year, write "00"
More older than 97 years, write "97"
_ _

Person 2
28. Was the deceased a male or a female?

[] 1 Male
[] 2 Female

29. How old was that person at the time of death?

Write age in completed years.
If below 1 year, write "00"
More than 97 years, write "97"
_ _

Person 3
30. Was the deceased a male or a female?

[] 1 Male
[] 2 Female

31. How old was that person at the time of death?

Write age in completed years.
If below 1 year, write "00"
More than 97 years, write "97"
_ _

G. Housing conditions
32. What building materials were used for roofing the main building?

[] 1 Iron sheets
[] 2 Tiles
[] 3 Concrete
[] 4 Asbestos
[] 5 Grass
[] 6 Grass and mud
[] 7 Other

33. What building materials were used for the walls of the main building?

[] 1 Stones
[] 2 Cement bricks
[] 3 Sundried bricks
[] 4 Baked bricks
[] 5 Poles and mud
[] 6 Timber
[] 7 Grass
[] 8 Other

34. What building materials were used for the floor of the main building?

[] 1 Cement
[] 2 Mud
[] 3 Timber
[] 4 Tiles
[] 5 Other

35. How many rooms in your household are used for sleeping?

Write the number of rooms used for sleeping.
_ _

36. What is the main source of energy for cooking in this household?

[] 1 Electricity
[] 2 Kerosene / paraffin
[] 3 Gas
[] 4 Firewood
[] 5 Charcoal
[] 6 Not applicable
[] 7 Other

37. What is the main source of energy for lighting in this household?

[] 1 Electricity
[] 2 Lantern
[] 3 Pressure lamp
[] 4 Fire wood
[] 5 Candle
[] 6 Oil lamp
[] 7 Solar
[] 8 Other

38. What is the main source of drinking water for household?

[] 01 Piped water
[] 02 Protected well
[] 03 Unprotected well
[] 04 Protected spring
[] 05 Unprotected spring
[] 06 River/stream
[] 07 Pond
[] 08 Lake
[] 09 Rain water
[] 10 Water vendors
[] 98 Others

39. What kind of toilet facility does your household use?

[] 1 Flush toilet
[] 2 Traditional pit toilet
[] 3 Ventilated improved pit latrine (VIP)
[] 4 No facility
[] 6 Other type

40. Does your household own ____?Circle the appropriate answer for each item.
A radio
[] 1 Yes
[] 2 No

A telephone
[] 1 Yes
[] 2 No

A bicycle
[] 1 Yes
[] 2 No

A hoe
[] 1 Yes
[] 2 No

Wheel barrow
[] 1 Yes
[] 2 No

A charcoal/electric iron
[] 1 Yes
[] 2 No

Electricity
[] 1 Yes
[] 2 No

H. Total number

Male _ _ _
Female _ _ _
Total _ _ _ _