Community Survey 2016 Household Questionnaire

1. Statistics Act No. 6 of 1999 [confidentiality]
17 [1] Despite any other law, no return or other information collected by Statistics South Africa for the purposes of official or other statistics that relates to an individual or a household may be disclosed to any person.
17 [3b] Any person who is involved in the collection of, or who may use, that information or data, must first take an oath of confidentiality.
18 [1e] and18 [1g] An officer of Statistics South Africa who willfully discloses any data or information obtained in the course of such employment to a person not authorized to receive that information is guilty of an offence and liable on conviction to a fine not exceeding R10 000, or to imprisonment for a period not exceeding 6 months or to both.

[1.4] Enumeration area number _ _ _ _ _ _ _ _ _ _
[1.5] Map reference number identifier ________
[1.6] DU number _ _ _ _ _ _ _ _ _ _
[1.7] Province ________
[1.8] Local municipality ________
[1.9] Main place ________
[1.10] Sub-place ________
[1.11] Longitude and latitude coordinates ____

2. Particulars of dwelling unit

[2.1] Location of the dwelling ____
[2.2] Physical identification of the dwelling unit ________
[2.3] Total number of households in this dwelling unit _ _ _ _ _ _ _ _ _ _
[2.4] Household number for this household _ _ _ _ _ _ _ _ _ _

3. Person information

[3.1] Date of interview ____
[3.2] Name and surname of respondent ____
[3.3] Contact number of respondent _ _ _ _ _ _ _ _ _ _

[3.4] How many people were present in this household on the reference night [midnight 06 to 07 March 2016]?

A household is a group of persons who live together, and provide for themselves jointly with food or other essentials for living, or a single person who lives alone. All persons who were present in the household on reference night should be included.

_ _ _ _ _ _ _ _ _ _

[3.5] Please give me the name of every person who was present in this household on the reference night [midnight 06 to 07 March 2016].

Start with the head/acting head of the household. Do not forget to include babies, small children, older persons and visitors who were present on the reference night. Do not include paid domestic workers [those that receive a salary/wage], persons in special dwellings like boarding schools, retirement homes, hospitals, prisons, etc. ________

Now, I am going to ask you for some basic information about each person whose name you have provided.

[3.7] Household members

[3.7.1] Demographics

[3.7.1.1] Name ____

[3.7.1.2] Is the respondent male or female?

[] 1 Male
[] 2 Female

[3.7.1.3] What is the respondent's date of birth? ____

[3.7.1.4] What is the respondent's age in completed years? ____

[3.7.1.5] What is the respondent's relationship to the head or acting head of the household?

[] 1 Head/acting head
[] 2 Husband/wife/partner
[] 3 Son/daughter
[] 4 Adopted son/daughter
[] 5 Stepchild
[] 6 Brother/sister
[] 7 Parent [father/mother]
[] 8 Parent-in-law
[] 9 Grandchild/great grandchild
[] 10 Son-in-law/daughter-in-law
[] 11 Brother-in-law/sister-in-law
[] 12 Grandmother/grandfather
[] 13 Other relative [e.g. aunt/uncle]
[] 14 Non-related person

[3.7.1.6] What is the respondent's present marital status?

[] 1 Legally married [include customary, traditional, religious etc.]
[] 2 Living together like husband and wife/partners
[] 3 Divorced
[] 4 Separated, but still legally married
[] 5 Widowed
[] 6 Single, but have been living together with someone as husband/wife/partner before
[] 7 Single, and have never lived together as husband/wife/partner before

[3.7.1.7] What population group does the respondent belong to?

[] 1 Black African
[] 2 Coloured
[] 3 Indian/Asian
[] 4 White
[] 5 Other
[] 6 Refused

[3.7.1.8] Please specify "Other" population group ____

[3.7.1.9] Which language does the respondent speak most often in this household?

[] 1 Afrikaans
[] 2 English
[] 3 Isindebele
[] 4 Isixhosa
[] 5 Isizulu
[] 6 Sepedi
[] 7 Sesotho
[] 8 Setswana
[] 9 Sign language
[] 10 Siswati
[] 11 Tshivenda
[] 12 Xitsonga
[] 13 Khoi, Nama and San languages
[] 14 Other

[3.7.1.10] Please specify "Other" language ____

[3.7.1.11] How would you describe the respondent's main religious affiliation/belief?

[] 1 Christianity
[] 2 Islam
[] 3 Traditional African religion [e.g. Ancestral, Tribal, Animist etc.]
[] 4 Hinduism
[] 5 Buddhism
[] 6 Bahaism
[] 7 Judaism
[] 8 Atheism
[] 9 Agnosticism
[] 10 No religious affiliation/belief
[] 11 Other
[] 12 Do not know

[3.7.1.12] Which Christian denomination or church, if any, does the respondent identify with most closely?

[] 1 Catholic
[] 2 Anglican/Episcopalian
[] 3 Baptist
[] 4 Lutheran
[] 5 Methodist
[] 6 Presbyterian
[] 7 Pentecostal/Evangelistic [e.g. Assemblies of God, Born Again, Church of God in Christ, Rhema Church, Apostolic faith mission, Prophetic ministry]
[] 8 African independent church/African initiated church [e.g. Zion Christian church, Apostolic church, African Nazareth Baptist church/Shembe]
[] 9 Jehovah's Witness
[] 10 Seventh day Adventist
[] 11 Mormon [e.g. Church of Jesus Christ of latter day saints]
[] 12 Reformed Church [e.g. Dutch Reformed Church, Uniting Reformed Church, Christian Reformed Church]
[] 13 Just a Christian/Non-denominational
[] 14 Other
[] 15 Do not know

[3.7.2] Migration
Now, I am going to ask you some questions on migration. Migration is the movement of people from one area/place to another.

[3.7.2.2] In which province was the respondent born?

[] 1 Western Cape
[] 2 Eastern Cape
[] 3 Northern Cape
[] 4 Free State
[] 5 Kwazulu-Natal
[] 6 North West
[] 7 Gauteng
[] 8 Mpumalanga
[] 9 Limpopo
[] 10 Outside South Africa
[] 11 Do not know

[3.7.2.3] In which country was the respondent born?

[Note: No other countries were listed in the original form.]

[] 1 Andorra
[] 2 United Arab Emirates
[] 3 Afghanistan
[] 4 Antigua and Barbuda
[] 5 Anguilla
[] 6 Albania
[] 7 Armenia
[] 8 Angola
[] 9 Antarctica
[] 10 Argentina
[] 11 American Samoa
[] 12 Austria
[] 13 Australia
[] 14 Aruba
[] 15 Aland Islands
[] 16 Azerbaijan
[] 17 Bosnia and Herzegovina
[] 18 Barbados
[] 19 Bangladesh
[] 20 Belgium

[3.7.2.4] In which year did the respondent move to South Africa? ____

[3.7.2.5] What is the respondent's country of citizenship?

Usual residence

[3.7.2.7] Has the respondent been part of this household for at least four nights a week and has done so for the last six months or intends to be part of this household for at least four nights a week for the next six months?

[] 1 Yes
[] 2 No

[3.7.2.8] In which province does the respondent usually live?

[] 1 Western Cape
[] 2 Eastern Cape
[] 3 Northern Cape
[] 4 Free State
[] 5 Kwazulu-Natal
[] 6 North West
[] 7 Gauteng
[] 8 Mpumalanga
[] 9 Limpopo
[] 10 Outside South Africa
[] 11 Do not know

[3.7.2.9] In which local/metropolitan municipality does the respondent usually live?

[] 1 160 WC011: Matzikama [1]
[] 2 161 WC012: Cederberg [1]
[] 3 162 WC013: Bergrivier [1]
[] 4 163 WC014: Saldanha Bay [1]
[] 5 164 WC015: Swartland [1]
[] 6 165 WC022: Witzenberg [1]
[] 7 166 WC023: Drakenstein [1]
[] 8 167 WC024: Stellenbosch [1]
[] 9 168 WC025: Breede Valley [1]
[] 10 169 WC026: Langeberg [1]
[] 11 170 WC034: Swellendam [1]
[] 12 171 WC031: Theewaterskloof [1]
[] 13 172 WC032: Overstrand [1]
[] 14 173 WC033: Cape Agulhas [1]
[] 15 174 WC041: Kannaland [1]
[] 16 175 WC042: Hessequa [1]
[] 17 176 WC043: Mossel Bay [1]
[] 18 177 WC044: George [1]
[] 19 178 WC045: Oudtshoorn [1]
[] 20 179 WC047: Bitou [1]

[3.7.2.10] In which city/town/traditional area/village/township does the respondent usually live?

[] 1 160005: Kliprand [1]
[] 2 160008: Matzikama NU [1]
[] 3 160010: Rietpoort [1]
[] 4 160001: Bitterfontein [1]
[] 5 160009: Nuwerus [1]
[] 6 160006: Koekenaap [1]
[] 7 160007: Lutzville [1]
[] 8 160003: Ebenhaezer [1]
[] 9 160012: Vanrhynsdorp [1]
[] 10 160013: Vredendal [1]
[] 11 160011: Strandfontein [1]
[] 12 160004: Klawer [1]
[] 13 160002: Doringbaai [1]
[] 14 161002: Citrusdal [2]
[] 15 161006: Lamberts Bay [2]
[] 16 161001: Cederberg NU [2]
[] 17 161005: Graafwater [2]
[] 18 161003: Clanwilliam [2]
[] 19 161007: Leipoldtville [2]
[] 20 161004: Elands Bay [2]

[3.7.2.11] Has the respondent been staying in this place since October 2011?

[] 1 Yes
[] 2 No
[] 3 Born after October 2011, but never moved
[] 4 Born after October 2011 and moved

[3.7.2.12] In which year did the respondent move to this place? _ _ _ _ _ _ _ _ _ _

[3.7.2.13] In which month did the respondent move to this place?

[] 1 January
[] 2 February
[] 3 March
[] 4 April
[] 5 May
[] 6 June
[] 7 July
[] 8 August
[] 9 September
[] 10 October
[] 11 November
[] 12 December

Previous Residence

[3.7.2.15] In which province did the respondent live before moving to this place?

[] 1 Western Cape
[] 2 Eastern Cape
[] 3 Northern Cape
[] 4 Free State
[] 5 Kwazulu-Natal
[] 6 North West
[] 7 Gauteng
[] 8 Mpumalanga
[] 9 Limpopo
[] 10 Outside South Africa
[] 11 Do not know

[3.7.2.16] In which local/metropolitan municipality did the respondent live before moving to this place?

[3.7.2.17] In which city/town/traditional area/village/township did the respondent live before moving to this place?

[3.7.2.18] What was the main reason for the respondent to move to this place?

[] 1 Divorce/separation
[] 2 Education [e.g. studying, schooling, training]
[] 3 For better municipal services
[] 4 Health [e.g. poor/ill health]
[] 5 High levels of crime
[] 6 Job loss/retrenchment/contract ended
[] 7 Job transfer/take up new job opportunity
[] 8 Look for paid work
[] 9 Moving as a household to accompany a household member [for health, education, employment etc.]
[] 10 Moving to live with or be closer to spouse [marriage], family, friends, partner
[] 11 New dwelling for household
[] 12 Other business reasons [e.g. expansion of business]
[] 13 Political instability/religious conflict/persecution
[] 14 Retirement
[] 15 Start a business
[] 16 Other
[] 17 Do not know

[3.7.2.19] Please specify "Other" reason for moving from previous residence. ________

[3.7.3] General health and functioning
Now, I am going to ask you health-related questions.

[3.7.3.2] Does the respondent have difficulty seeing [even with glasses/contact lenses, if he/she wears them]?

[] 1 No difficulty
[] 2 Some difficulty
[] 3 A lot of difficulty
[] 4 Cannot do at all
[] 5 Do not know

[3.7.3.3] Does the respondent have difficulty hearing [even with a hearing aid, if he/she wears one]?

[] 1 No difficulty
[] 2 Some difficulty
[] 3 A lot of difficulty
[] 4 Cannot do at all
[] 5 Do not know

[3.7.3.4] Does the respondent have difficulty communicating in his/her usual language [i.e. understanding others or being understood by others]?

[] 1 No difficulty
[] 2 Some difficulty
[] 3 A lot of difficulty
[] 4 Cannot do at all
[] 5 Do not know

[3.7.3.5] Does the respondent have difficulty walking a kilometer [length of 10 soccer fields] or climbing a flight of steps?

[] 1 No difficulty
[] 2 Some difficulty
[] 3 A lot of difficulty
[] 4 Cannot do at all
[] 5 Do not know

[3.7.3.6] Does the respondent have difficulty remembering or concentrating?

[] 1 No difficulty
[] 2 Some difficulty
[] 3 A lot of difficulty
[] 4 Cannot do at all
[] 5 Do not know

[3.7.3.7] Does the respondent have difficulty with self-care such as washing, dressing or feeding him/herself?

[] 1 No difficulty
[] 2 Some difficulty
[] 3 A lot of difficulty
[] 4 Cannot do at all
[] 5 Do not know

Assistive devices/aids

[3.7.3.9] Does the respondent use eye glasses/spectacles/contact lenses?

[] 1 Yes
[] 2 No
[] 3 Do not know

[3.7.3.10] Does the respondent use a hearing aid?

[] 1 Yes
[] 2 No
[] 3 Do not know

[3.7.3.11] Does the respondent use a walking stick, walking frame or crutches?

[] 1 Yes
[] 2 No
[] 3 Do not know

[3.7.3.12] Does the respondent use a wheelchair?

[] 1 Yes
[] 2 No
[] 3 Do not know

[3.7.3.13] Does the respondent use any other assistive device/aid?

[] 1 Yes
[] 2 No
[] 3 Do not know

[3.7.3.14] Please specify "Other" assistive device/aid. _______

[3.7.4] Parental survival
Now, I am going to ask you questions on the survival status of parents.

[3.7.4.2] Is the respondent's own biological mother still alive?

[] 1 Yes
[] 2 No
[] 3 Do not know

[3.7.4.3] In which year did the respondent's biological mother pass away? ____

[3.7.4.4] Is the respondent's biological mother a member of this household?

[] 1 Yes
[] 2 No

[3.7.4.5] Who in this household is the respondent's biological mother? ____

[3.7.4.6] Is the respondent's own biological father still alive?

[] 1 Yes
[] 2 No
[] 3 Do not know

[3.7.4.7] In which year did the respondent's biological father pass away? ____

[3.7.4.8] Is the respondent's biological father a member of this household?

[] 1 Yes
[] 2 No

[3.7.4.9] Who in this household is the respondent's biological father? ____

[3.7.5] Education
Now, I am going to ask you questions on education.

[3.7.5.2] Is the respondent currently attending an educational institution?

For example, school, home school/home-based education, Early Childhood Development Centre [ECD] [e.g. day care, creche, pre-school, nursery school or preprimary school], distance or correspondence education. Only include courses of 6 months or longer.

[] 1 Yes
[] 2 No
[] 3 Do not know

[3.7.5.3] Which of the following educational institutions does the respondent attend?

[] 1 Pre-school [incl. ECD centre, e.g. day care, crèche, playgroup, nursery school, Grade RR or pre-primary school]
[] 2 Primary school [Grade R to 7]
[] 3 Secondary school [Grade 8 to 12]
[] 4 Technical vocational education and training [TVET], formerly known as Further education and training colleges [FET], including private colleges
[] 5 Other college [including private and public nursing college, agricultural college and police college]
[] 6 Higher educational institution [including university/university of technology and private higher educational institution]
[] 7 Community education and training college [including adult education and training learning centre [AET], formerly known as ABET]
[] 8 Home-based education/home schooling
[] 9 Other
[] 10 Do not know

[3.7.5.4] Is the institution that the respondent is attending public or private?

[] 1 Public [government]
[] 2 Private [independent]
[] 3 Do not know

[3.7.5.5] Which of the following mode(s) of transport does the respondent usually use to get to the educational institution that he/she attends?

1 Walking

[] Yes
[] No

2 Bicycle

[] Yes
[] No

3 Motorcycle/scooter

[] Yes
[] No

4 Minibus taxi/sedan taxi

[] Yes
[] No

5 Bakkie taxi

[] Yes
[] No

6 Metered taxi

[] Yes
[] No

7 Bus [public]

[] Yes
[] No

8 Train [Metrorail, Gautrain]

[] Yes
[] No

9 Vehicle provided by the institution

[] Yes
[] No

10 Vehicle provided the government and not paid for

[] Yes
[] No

11 Vehicle hired by a group of parents/students

[] Yes
[] No

12 Own car/private vehicle

[] Yes
[] No

13 Animal-drawn transport/use of animals, such as horseback

[] Yes
[] No

14 Other

[] Yes
[] No

[3.7.5.6] How long does it usually take the respondent to get to the educational institution he/she attends from his/her home?

[] 1 Less than 15 minutes
[] 2 15-30 minutes
[] 3 31-60 minutes
[] 4 More than 90 minutes
[] 5 More than 90 minutes
[] 6 Do not know

[3.7.5.7] What is the highest level of education that the respondent has successfully completed?

[] 98 No schooling
[] 0 Grade R/O
[] 1 Grade 1/Sub A/Class 1
[] 2 Grade 2/Sub B/Class 2
[] 3 Grade 3/Standard 1/ABET 1
[] 4 Grade 5/Standard 2
[] 5 Grade 5/Standard 3/ABET 2
[] 6 Grade 6/Standard 4
[] 7 Grade 7/Standard 5/ABET 3
[] 8 Grade 8/Standard 6/Form 1
[] 9 Grade 9/Standard 7/Form 2/ABET 4/Occupational certificate NQF level 1
[] 10 Grade 10/Standard 8/Form 3/NCV level 2/Occupational certificate NQF level 2
[] 11 Grade 11/Standard 9/Form 4/NCV level 3/Occupational certificate NQF level 3
[] 12 Grade 12/Standard 10/Form 5/Matric/NCV level 4/Occupational certificate NQF level 4
[] 13 NTC I/N1
[] 14 NTC II/N2
[] 15 NTC III/N3
[] 16 N4/NTC 4/Occupational certificate NQF level 5
[] 17 N5/NTC 5/Occupational certificate NQF level 5
[] 18 N6/NTC 6/Occupational certificate NQF level 5

[3.7.5.8] What type of institution did the respondent obtain this qualification?

[] 1 Higher education institution [University/University of technology]
[] 2 TVET [formerly FET]/Private colleges

[3.7.5.9] In which field of education [at university/university of technology] is the respondent's highest post-school qualification?

[] 1 Agriculture, agricultural operations and related science
[] 2 Architecture and the built environment
[] 3 Visual and performing arts
[] 4 Business, economics and management studies
[] 5 Communication, journalism and related studies
[] 6 Computer and information sciences
[] 7 Education
[] 8 Engineering
[] 9 Health professions and related clinical sciences
[] 10 Family ecology and consumer sciences
[] 11 Languages, linguistics and literature
[] 12 Law
[] 13 Life sciences
[] 14 Physical sciences
[] 15 Mathematics and statistics
[] 16 Military sciences
[] 17 Philosophy, religion and theology
[] 18 Psychology
[] 19 Public management and services
[] 20 Social sciences

[3.7.5.10] In which field of education [in TVET (formerly FET) or private colleges] is the respondent's highest post-school qualification?

[] 1 Management
[] 2 Marketing
[] 3 Information technology and computer science
[] 4 Finance, economics and accounting
[] 5 Office administration
[] 6 Electrical infrastructure construction
[] 7 Civil engineering and building construction
[] 8 Engineering
[] 9 Primary agriculture
[] 10 Hospitality
[] 11 Tourism
[] 12 Safety in society
[] 13 Mechatronics
[] 14 Education and development
[] 15 Other
[] 16 Do not know

[3.7.6] Employment
Now, I am going to ask you questions on economic activities.

[3.7.6.2] In the last week [Monday to Sunday], did the respondent work for a wage, salary, commission or any payment in kind [including paid domestic work], even if it was for only one hour?

[E.g. a permanent job, contract, casual or piece work for pay, work in exchange for food or housing].

[] 1 Yes
[] 2 No

[3.7.6.3] In the last week [Monday to Sunday], did the respondent run or do any kind of business, big or small, for himself/herself or with one or more partners, even if it was for only one hour?

E.g. Commercial farming, selling things, making things for sale, construction, repairing things, guarding cars, brewing beer, hairdressing, crèche business, taxi or other transport business, having a legal or medical practice, performing in public, having a public phone shop, etc.

[] 1 Yes
[] 2 No

[3.7.6.4] In the last week [Monday to Sunday], did the respondent help without being paid in any kind of business run by his/her household, even if it was for only an hour?

E.g. Commercial farming, help to sell things, makes things for sale or exchange, doing the accounts, cleaning up for the business, etc.

[] 1 Yes
[] 2 No

[3.7.6.5] In the last week [Monday to Sunday], even though the respondent did not do any work for pay, profit or did not help without pay in a household business, did the respondent have paid work or business that he/she would definitely return to?

E.g. a permanent job, contract, casual or piece work for pay, work in exchange for food or housing, paid domestic work.

[] 1 Yes
[] 2 No

[3.7.6.6] In the last four weeks, was the respondent looking for any kind of paid work or trying to start any kind of business?

[] 1 Yes
[] 2 No
[] 3 Do not know

[3.7.6.7] Would the respondent have liked to work/start a business in the last week [Monday to Sunday]?

[] 1 Yes
[] 2 No
[] 3 Do not know

[3.7.6.8] What was the main reason why the respondent did not want to work or start a business in the last week [Monday to Sunday]?

[] 1 Scholar/student
[] 2 Housewife/homemaker [family considerations/child care]
[] 3 Health reasons
[] 4 Retired or too old for work
[] 5 No desire to work
[] 6 Too young to work
[] 7 Pregnancy
[] 8 Disabled or unable to work
[] 9 Other
[] 10 Do not know

[3.7.6.9] What was the main reason why the respondent did not try to find work/start a business in the last four weeks?

[] 1 Awaiting the season for work
[] 2 Waiting to be recalled to former job
[] 3 Health reasons
[] 4 Pregnancy
[] 5 Disabled or unable to work
[] 6 Stay-at-home homemaker [housewife, househusband, family considerations, child care]
[] 7 Undergoing training to help find work
[] 8 No jobs available in the area
[] 9 Lack of money to pay for transport to look for work
[] 10 Unable to find work requiring his/her skills
[] 11 Lost hope of finding any kind of work
[] 12 No transport available
[] 13 Scholar/student
[] 14 Retired/too old to work
[] 15 Too young to work
[] 16 No identity document
[] 17 Volunteering
[] 18 Other
[] 19 Do not know

[3.7.6.10] If a suitable job had been offered or circumstances had allowed, would the respondent have been able to start work or a business in the last week [Monday to Sunday]?

[] 1 Yes
[] 2 No
[] 3 Do not know

[3.7.6.11] What was the main reason why the respondent was not available for work/starting a business in the last week [Monday to Sunday]?

[3.7.6.12] How soon can the respondent start work or a business?

[] 1 Within a week
[] 2 Within two weeks
[] 3 Within four weeks
[] 4 Later than four weeks from now
[] 5 No desire to work
[] 6 Do not know

[3.7.6.13] What kind of work does the respondent usually do in the main job/business that he/she had during the last week [Monday to Sunday]?

E.g. car sales person, office cleaner, vegetable farmer, primary school teacher, etc.

Occupation ________

[3.7.6.14] What is the respondent's main task or duty in this work/business?

E.g. selling fruits, repairing watches, keeping accounts, teaching children, feeding cattle etc.

Task ________

[3.7.6.15] What is the name of the establishment/institution/business/organization that the respondent works for (the one that pays his/her salary)? ____

[3.7.6.16] What are the main goods or services produced, or the main function at the respondent's place of work or business?

E.g. repairing cars, retail clothing, primary education, manufacturing household appliances. For domestic workers write private household.

Goods ____

[3.7.6.17] In which sector is the respondent's place of work or business?

[] 1 Formal sector
[] 2 Informal sector
[] 3 Private household
[] 4 Do not know

[3.7.6.18] Which of the following mode(s) of transport does the respondent usually use to get to his/her place of work?

1 Walking

[] Yes
[] No

2 Bicycle

[] Yes
[] No

3 Motorcycle/scooter

[] Yes
[] No

4 Minibus taxi/sedan taxi/bakkie taxi

[] Yes
[] No

5 Metered taxi

[] Yes
[] No

6 Bus (public)

[] Yes
[] No

7 Train (e.g. Metrorail, Gautrain)

[] Yes
[] No

8 Vehicle provided by employer/company vehicle

[] Yes
[] No

9 Lift club by group of people sharing a private vehicle

[] Yes
[] No

10 Own car/private vehicle

[] Yes
[] No

11 Animal-drawn transport

[] Yes
[] No

12 Other

[] Yes
[] No

[3.7.6.19] How long does it usually take the respondent to get to his/her place of work?

[] 1 Less than 15 minutes
[] 2 15-30 minutes
[] 3 31-60 minutes
[] 4 61-90 minutes
[] 5 More than 90 minutes
[] 6 Do not know

[3.7.7] Income and social grants
Now, I am going to ask you questions on income and social grants received in the past 12 months.

[3.7.7.2] In the past 12 months [01 March 2015 to 29 February 2016], which of the following source(s) of income did the respondent have?

1 Salaries and wages

[] Yes
[] No

2 Net profit from business or professional practice/activities of commercial farming

[] Yes
[] No

3 Income from subsistence farming

[] Yes
[] No

4 Income from letting of fixed property

[] Yes
[] No

5 Regular receipts from pension fund from previous employment and pension from annuity funds

[] Yes
[] No

6 Social grants [including old age grant]

[] Yes
[] No

7 Maintenance, spousal support and similar allowances from divorced spouse, family members, etc., living elsewhere

[] Yes
[] No

8 Regular allowance/remittances received from non-household members

[] Yes
[] No

9 Other income [e.g. royalties, interest, dividends on shares, income from share trading]

[] Yes
[] No

[3.7.7.3] Which income category describes the respondent's total income before deductions, including all sources of income?

[] 1. R1-R50 per week, R1-R200 per month, R1-R2 400 per annum
[] 2. R51-R125 per week, R201-R500 per month, R2 401-R6 000 per annum
[] 3. R126-R250 per week, R501-R1 000 per month, R6 001-R12 000 per annum
[] 4. R251-R375 per week, R1 001-R1 500 per month, R12 001-R18 000 per annum
[] 5. R376-R625 per week, R1 501-R2 500 per month, R18 001-R30 000 per annum
[] 6. R626-R875 per week, R2 501-R3 500 per month, R30 001-R42 000 per annum
[] 7. R876-R1 125 per week, R3 501-R4 500 per month, R42 001-R54 000 per annum
[] 8. R1 126-R1 500 per week, R4 501-R6 000 per month, R54 001-R72 000 per annum
[] 9. R1 501-R2 000 per week, R6 001-R8 000 per month, R72 001-R96 000 per annum
[] 10. R2 001-R2 750 per week, R8 001-R11 000 per month, R96 001-R132 000 per annum
[] 11. R2 751-R4 000 per week, R11 001-R16 000 per month, R132 001-R192 000 per annum
[] 12. R4 001-R7 500 per week, R16 001-R30 000 per month, R192 001-R360 000 per annum
[] 13. R7 501 or more per week, R30 001 or more per month, R360 001 or more per annum
[] 14. Do not know
[] 15. Refused

[3.7.8] Fertility
Now, I am going to ask you questions about your biological children.

[3.7.8.2] Has the respondent ever given birth to a live child, even if the child died soon after birth?

[] 1 Yes
[] 2 No
[] 3 Do not know

[3.7.8.3] How many of the respondent's children are still alive? _ _ _ _ _ _ _ _ _ _

[3.7.8.4] How many are boys? _ _ _ _ _ _ _ _ _ _

[3.7.8.5] How many are girls? _ _ _ _ _ _ _ _ _ _

[3.7.8.6] How many of the respondent's children are no longer alive? _ _ _ _ _ _ _ _ _ _

[3.7.8.7] How many are boys? _ _ _ _ _ _ _ _ _ _

[3.7.8.8] How many are girls? _ _ _ _ _ _ _ _ _ _

[3.7.8.9] How many children has the respondent ever given birth to that were born alive? _ _ _ _ _ _ _ _ _ _

[3.7.8.10] How many are boys? _ _ _ _ _ _ _ _ _ _

[3.7.8.11] How many are girls? _ _ _ _ _ _ _ _ _ _

[3.7.8.12] When was the respondent's last child born? ____

[3.7.8.13] Is the respondent's last child born male or female?

[] 1 Male
[] 2 Female
[] 3 Do not know

[3.7.8.14] Did the respondent breastfeed her last child?

[] 1 Yes
[] 2 No
[] 3 Do not know

[3.7.8.15] How long did the respondent breastfeed her last child?

[] 1 Less than 6 months
[] 2 6 to 12 months
[] 3 More than one year
[] 4 Do not know

[3.7.8.16] Is the respondent's last child born still alive?

[] 1 Yes
[] 2 No
[] 3 Do not know

[3.7.8.17] When did the respondent's last child born die? ____

4 Housing, household goods, services and crime and agricultural activities

Now, I am going to ask you some questions related to housing, household goods and services, crime and agricultural activities for this particular household.

[4.2] Who in this household will be responding to the household questions? ____

Problem/difficulty in the municipality

[4.4] What do you consider to be the main problem/difficulty facing this municipality presently?

[] 1 Lack of safe and reliable water supply
[] 2 Cost of water
[] 3 Lack of reliable electricity supply
[] 4 Cost of electricity
[] 5 Inadequate sanitation/sewerage/toilet services
[] 6 Inadequate refuse/waste removal
[] 7 Inadequate housing
[] 8 Inadequate roads
[] 9 Inadequate street lights
[] 10 Lack of/inadequate employment opportunities
[] 11 Lack of/inadequate educational facilities
[] 12 Violence and crime
[] 13 Drug abuse
[] 14 Alcohol abuse
[] 15 Gangsterism
[] 16 Lack of/inadequate perks and recreational area
[] 17 Lack of/inadequate healthcare services
[] 18 Lack of/inadequate public transport
[] 19 Corruption
[] 20 Other

[4.5] Given the problem/difficulty you have mentioned above, to what extent do you agree that the municipality is trying to solve the problem/difficulty?

[] 1 Strongly disagree
[] 2 Disagree
[] 3 Neither agree nor disagree
[] 4 Agree
[] 5 Strongly agree

Satisfaction with basic services

[4.7] How would you rate the overall quality of the water services that this household has access to or utilizes?

[] 1 Good
[] 2 Average
[] 3 Poor
[] 4 No access
[] 5 Do not use

[4.8] How would you rate the overall quality of the refuse removal services that this household has access to or utilizes?

[] 1 Good
[] 2 Average
[] 3 Poor
[] 4 No access
[] 5 Do not use

[4.9] How would you rate the overall quality of the electricity supply services [incl. maintenance, meter reading, billing, complaint handling, connection, installation] that this household has access to or utilizes?

[] 1 Good
[] 2 Average
[] 3 Poor
[] 4 No access
[] 5 Do not use

[4.10] How would you rate the overall quality of the toilet/sanitation services that this household has access to or utilizes?

[] 1 Good
[] 2 Average
[] 3 Poor
[] 4 No access
[] 5 Do not use

[4.11] How would you rate the overall quality of the local public hospital that this household has access to or utilizes?

[] 1 Good
[] 2 Average
[] 3 Poor
[] 4 No access
[] 5 Do not use

[4.12] How would you rate the overall quality of the local public clinic that this household has access to or utilizes?

[] 1 Good
[] 2 Average
[] 3 Poor
[] 4 No access
[] 5 Do not use

[4.13] How would you rate the overall quality of the local police services that this household has access to?

[] 1 Good
[] 2 Average
[] 3 Poor
[] 4 No access
[] 5 Do not use

[4.14] How would you rate the overall quality of the local public school that this household has access to or utilizes?

[] 1 Good
[] 2 Average
[] 3 Poor
[] 4 No access
[] 5 Do not use

Improving the standard of living of the household

[4.16] In your opinion, how important is education for maintaining or improving the standard of living for this household?

[] 1 Very important
[] 2 Important
[] 3 Not important at all

[4.17] In your opinion, how important is health for maintaining or improving the standard of living for this household?

[] 1 Very important
[] 2 Important
[] 3 Not important at all

[4.18] In your opinion, how important are living conditions [e.g. access to piped water in dwelling, access to a safe and reliable toilet facility, access to electricity, access to adequate housing] for maintaining or improving the standard of living for this household?

[] 1 Very important
[] 2 Important
[] 3 Not important at all

[4.19] In your opinion, how important is the ownership of household assets for maintaining or improving the standard of living for this household?

[] 1 Very important
[] 2 Important
[] 3 Not important at all

[4.20] In your opinion, how important is employment for maintaining or improving the standard of living for this household?

[] 1 Very important
[] 2 Important
[] 3 Not important at all

[4.21] In your opinion, how important is safety and security for maintaining or improving the standard of living for this household?

[] 1 Very important
[] 2 Important
[] 3 Not important at all

Dwelling unit

[4.23] Which of the following describes the main dwelling that this household currently lives in?

[] 1 Formal dwelling/house or brick/concrete block structure on a separate stand or yard or on a farm
[] 2 Traditional dwelling/hut/structure made of traditional material
[] 3 Flat or apartment in a block of flats
[] 4 Cluster house in complex
[] 5 Townhouse [semi-detached house in a complex]
[] 6 Semi-detached house
[] 7 Formal dwelling/house/flat/room in backyard
[] 8 Informal dwelling/shack in backyard
[] 9 Informal dwelling/shack not in backyard [e.g. in an informal/squatter settlement or on a farm]
[] 10 Room/flatlet on a property or larger dwelling/servants quarters/granny flat/cottage
[] 11 Caravan/tent
[] 12 Other

[4.24] What is the tenure status of the main dwelling that this household currently occupies?

[] 1 Rented from private individual
[] 2 Rented from other [incl. municipality and social housing institutions]
[] 3 Owned, but not yet paid off
[] 4 Owned and fully paid off
[] 5 Occupied rent-free
[] 6 Other
[] 7 Do not know

[4.25] What is the total amount in rands paid by this household for rent in the past month? ____

[4.26] What is the estimated value of rent the household would pay if it had to pay rent? [imputed rent] ____

[4.27] Does the total rent [or free rental] include water, electricity, etc?

[] 1 Yes
[] 2 No
[] 3 Do not know

[4.28] Does this household possess a title deed for this dwelling?

[] 1 Yes
[] 2 No
[] 3 Do not know

[4.29] Is the main dwelling that the household currently lives in an RDP or government subsidized dwelling?

[] 1 Yes
[] 2 No
[] 3 Do not know

[4.30] How would this household rate the overall quality of the RDP or government subsidized dwelling provided by the government?

[] 1 Good
[] 2 Average
[] 3 Poor
[] 4 Do not know

Water

[4.32] What is the household's main source of water for drinking?

[] 1 Piped [tap] water inside the dwelling/house
[] 2 Piped [tap] water inside yard
[] 3 Piped water on community stand
[] 4 Borehole in the yard
[] 5 Rain-water tank in yard
[] 6 Neighbor's tap
[] 7 Public/communal tap
[] 8 Water-carrier/tanker
[] 9 Borehole outside the yard
[] 10 Flowing water/stream/river
[] 11 Well
[] 12 Spring
[] 13 Other

[4.33] How far is the main source of water for drinking from the dwelling or yard?

[] 1 Less than 200 meters
[] 2 201-500 meters
[] 3 501 metres-1 kilometer
[] 4 More than 1 kilometer
[] 5 Do not know

[4.34] Does this household have access to a safe drinking water supply service?

[] 1 Yes
[] 2 No
[] 3 Do not know

[4.35] Is the household's main source of drinking water supplied by...?

[] 1 A municipality
[] 2 Other water scheme [e.g. community water supply]
[] 3 A water vendor
[] 4 Own service [e.g. private borehole, own source on a farm, etc.]
[] 5 Flowing water/stream/river/spring/rain water
[] 6 Do not know

[4.36] In the past 3 months, has this household's municipal water supply been interrupted, even though the household paid their bill or bought sufficient pre-paid units?

[] 1 Yes
[] 2 No
[] 3 Do not know

[4.37] How long did this/these interruption(s) in municipal water supply last?

[] 1 Less than 2 days in total over a three month period
[] 2 2 to 7 days in total over a three month period
[] 3 8 to 14 days in total over a three month period
[] 4 More than a 14 days in total over a three month period
[] 5 Do not know

[4.38] Thinking about this/these interruption(s) in the municipal water supply, was any specific interruption longer than two consecutive days?

[] 1 Yes
[] 2 No
[] 3 Do not know

[4.39] What alternative water source did the household use during water supply interruption?

[] 1 Borehole
[] 2 Spring
[] 3 Well
[] 4 Rain water tank
[] 5 Dam/pool/stagnant water
[] 6 River/stream
[] 7 Water vendor
[] 8 Water tanker
[] 9 Other
[] 10 None
[] 11 Do not know

Sanitation

[4.41] What is the main type of toilet facility used by this household?

[] 1 Flush toilet connected to a public sewerage system
[] 2 Flush toilet connected to a septic tank or conservancy tank
[] 3 Chemical toilet
[] 4 Pit latrine/toilet with ventilation pipe
[] 5 Pit latrine/toilet without ventilation pipe
[] 6 Ecological toilet [e.g. urine diversion, enviroloo, etc.]
[] 7 Bucket toilet [collected by municipality]
[] 8 Bucket toilet [emptied by household]
[] 9 Other
[] 10 None

[4.42] Is the main toilet facility which the household has access to in the dwelling, in the yard, or outside the yard?

[] 1 In the dwelling house
[] 2 In the yard
[] 3 Outside the yard

[4.43] Is the main toilet facility shared with other households?

[] 1 Yes
[] 2 No
[] 3 Do not know

[4.44] Who maintains the sanitation facility used by this household?

[] 1 The household or households [in the case of multiple households in one dwelling]
[] 2 The community
[] 3 The municipality
[] 4 Do not know

Electricity

[4.46] How does this household presently access electricity?

[] 1 In-house conventional meter
[] 2 In-house prepaid meter
[] 3 Connected to other source which household pays for [e.g. connected to neighbor's line and paying neighbor, paying landlord]
[] 4 Connected to other source which household is not paying for [e.g. connected to neighbor's line and not paying neighbor]
[] 5 Generator
[] 6 Solar home system
[] 7 Battery
[] 8 Other
[] 9 No access to electricity

[4.47] Is this household's electricity supplied by...?

[] 1 Municipality-Prepaid
[] 2 Municipality-Receive bill from municipality
[] 3 Eskom-Pre-paid
[] 4 Eskom-Receive bill from Eskom
[] 5 Other supplier [e.g. metering services such as Impact Meters]
[] 6 Do not know

[4.48] In the past three months, has this household's electricity been cut or interrupted without prior notification, even though the household paid the bill or bought pre-paid electricity?

[] 1 Yes
[] 2 No
[] 3 Do not know

[4.49] In the past 3 months, did any of these electricity interruptions last for more than 12 hours?

[] 1 Yes
[] 2 No
[] 3 Do not know

Saving energy in the household

[4.51] Which of the following energy saving methods does this household often use to save energy?

1 Switching off your lights when you leave the house

[] Yes
[] No

2 Using energy-saving light bulbs

[] Yes
[] No

3 Switching off all your lights, except security lights in the home when not in use

[] Yes
[] No

4 Switching off appliances [TV, radio, hi-fi] at the wall [not remote control] when not in use

[] Yes
[] No

5 Switching off geyser at certain times

[] Yes
[] No

6 Boiling only as much water with a pot or kettle that is needed

[] Yes
[] No

7 Using stove plates and oven as little as possible

[] Yes
[] No

8 Using warm clothing or blankets instead of an electric heater

[] Yes
[] No

9 Closing windows and doors when heater is on

[] Yes
[] No

10 Allowing clothes to drip-dry instead of ironing

[] Yes
[] No

11 Installing a solar water heater instead of an electric geyser

[] Yes
[] No

12 Insulating household's geyser and hot pipes

[] Yes
[] No

Energy source

[4.53] What is this household's main source of energy for cooking?

[] 1 Electricity from mains
[] 2 Other source of electricity [e.g. generator, etc.]
[] 3 Gas
[] 4 Paraffin
[] 5 Wood
[] 6 Coal
[] 8 Animal dung
[] 9 Solar
[] 10 Other
[] 11 None

[4.54] What is this household's main source of energy for lighting?

[] 1 Electricity from mains
[] 2 Other source of electricity [e.g. generator, etc]
[] 3 Gas
[] 4 Paraffin
[] 7 Candles
[] 9 Solar
[] 10 Other
[] 11 None

[4.55] What is this household's main source of energy for water heating?

[] 1 Electricity from mains
[] 2 Other source of electricity [e.g. generator, etc.]
[] 3 Gas
[] 4 Paraffin
[] 5 Wood
[] 6 Coal
[] 8 Animal dung
[] 9 Solar
[] 10 Other
[] 11 None

[4.56] What is this household's main source of energy for space heating?

[] 1 Electricity from mains
[] 2 Other source of electricity [e.g. generator, etc.]
[] 3 Gas
[] 4 Paraffin
[] 5 Wood
[] 6 Coal
[] 8 Animal dung
[] 9 Solar
[] 10 Other
[] 11 None

Expenditure on energy sources

[4.58] Does the household use the following energy sources?

1 Electricity

[] Yes
[] No

2 Paraffin

[] Yes
[] No

3 Gas

[] Yes
[] No

4 Candles

[] Yes
[] No

5 Coal

[] Yes
[] No

6 Firewood

[] Yes
[] No

7 Solar system

[] Yes
[] No

8 Car batteries

[] Yes
[] No

9 Other batteries

[] Yes
[] No

10 Generator [petrol/diesel]

[] Yes
[] No

11 Other

[] Yes
[] No

On average, how much does this household spend each month on the following energy sources?

[4.60] Electricity _ _ _ _ _ _ _ _ _ _

[4.61] Paraffin _ _ _ _ _ _ _ _ _ _

[4.62] Gas _ _ _ _ _ _ _ _ _ _

[4.63] Candles _ _ _ _ _ _ _ _ _ _

[4.64] Coal _ _ _ _ _ _ _ _ _ _

[4.65] Firewood _ _ _ _ _ _ _ _ _ _

[4.66] Solar system _ _ _ _ _ _ _ _ _ _

[4.67] Car batteries _ _ _ _ _ _ _ _ _ _

[4.68] Other batteries _ _ _ _ _ _ _ _ _ _

[4.69] Generator [petrol/diesel] _ _ _ _ _ _ _ _ _ _

[4.70] Other _ _ _ _ _ _ _ _ _ _

Refuse disposal

[4.72] How is the refuse or rubbish of this household mainly collected or removed?

[] 1 Removed by local authority/private company/community members at least once a week
[] 2 Removed by local authority/private company/community members less often than once a week
[] 3 Communal refuse dump
[] 4 Communal container/central collection point
[] 5 Own refuse dump
[] 6 Dump or leave rubbish anywhere [no rubbish disposal]
[] 7 Other

Household goods

[4.74] Does this household own any of the following in working order?

1 Refrigerator/freezer

[] Yes
[] No

2 Electric/gas stove

[] Yes
[] No

3 Vacuum cleaner / floor polisher

[] Yes
[] No

4 Washing machine

[] Yes
[] No

5 Tablet/Phablet

[] Yes
[] No

6 Personal computer/desktop/laptop

[] Yes
[] No

7 Satellite decoder [e.g. MNet/DSTV/StarSat, Open View HD]

[] Yes
[] No

8 Motor vehicle

[] Yes
[] No

9 Television

[] Yes
[] No

10 Radio

[] Yes
[] No

11 DVD Player/Blu-ray player

[] Yes
[] No

12 Home theatre system

[] Yes
[] No

13 Landline

[] Yes
[] No

14 Cellphone

[] Yes
[] No

15 Microwave oven

[] Yes
[] No

16 Geyser [providing hot water]

[] Yes
[] No

17 Air conditioner [excluding fans]

[] Yes
[] No

18 Internet services

[] Yes
[] No

Internet services

[4.76] Do members of this household use the following internet service(s)?

1 Internet connection in the dwelling

[] Yes
[] No

2 Internet connection from a library/community hall/Thusong centre

[] Yes
[] No

3 Internet for students at a school/university/college

[] Yes
[] No

4 Internet connection at a place of work

[] Yes
[] No

5 Internet cafe 2km or less from the dwelling

[] Yes
[] No

6 Internet cafe more than 2km from the dwelling

[] Yes
[] No

7 Any place via a cellphone

[] Yes
[] No

8 Any place via other mobile access service

[] Yes
[] No

9 Other

[] Yes
[] No

Postal/mail services

[4.78] How does this household receive most of its mail/post?

[] 1 Delivered to the dwelling
[] 2 Delivered to a post box/private bag owned by the household
[] 3 Through a friend/neighbor/relative
[] 4 Through a shop/school
[] 5 Through a workplace
[] 6 Through a tribal/traditional/local authority office
[] 7 By email
[] 8 Do not receive mail
[] 9 Other

Perceptions of safety

[4.80] If you had to walk alone in your area during the day, how safe would you feel?

[] 1 Very safe
[] 2 Fairly safe
[] 3 A bit unsafe
[] 4 Very unsafe

[4.81] If you had to walk alone in your area when it is dark, how safe would you feel?

[] 1 Very safe
[] 2 Fairly safe
[] 3 A bit unsafe
[] 4 Very unsafe

Crime experienced by the household

[4.83] In the past 12 months, has the household or any member of this household been a victim of crime in South Africa?

[] 1 Yes
[] 2 No
[] 3 Do not know

[4.84] In the past 12 months, did the household or any member of this household been a victim of the following crime(s) in South Africa?

1 Murder [unlawful and intentional killing of another human being]

[] Yes
[] No

2 Home robbery [unlawfully taking property from a person with the use of force or threat in a residential dwelling]

[] Yes
[] No

3 Housebreaking/burglary at a residential premises [gaining unauthorized access to a dwelling with the intent to commit theft or when actually committing theft-there is no contact between victim(s) and perpetrator(s)]

[] Yes
[] No

4 Robbery [taking something from a person by use of force or threat of force, excluding home robbery and motor vehicle hijacking]

[] Yes
[] No

5 Theft of livestock, poultry and other animals

[] Yes
[] No

6 Theft of a motor vehicle and/or motorcycle

[] Yes
[] No

7 Other crime

[] Yes
[] No

[4.85] Please specify "Other" crime experienced. ________

Agricultural activities and food security

Now, I am going to ask you questions on the agricultural activities that this household is involved in and questions related to food security.

[4.88] Did this household produce any kind of food or other agricultural products [e.g. livestock, crops, poultry, food gardening, forestry, fish, etc.] whether sold or consumed, between 01 January 2015 and 31 December 2015?

[] 1 Yes
[] 2 No

[4.89] Where does the household mainly operate its agricultural activities?

[] 1 Farm land [including commercial farm land and small holdings]
[] 2 Communal/tribal land
[] 3 Backyard/fields attached to the household
[] 4 School/church/other organization garden/land
[] 5 Other

[4.90] What is the main purpose of the household's involvement in agriculture activities?

[] 1 As a main source of food for the household
[] 2 As a main source of income/earning a living
[] 3 As an extra source of income
[] 4 As an extra source of food for the household
[] 5 As a leisure activity/hobby [e.g. gardening]
[] 6 Other

Type of Agricultural activities

[4.92] Which of the following agricultural activities was the household involved in?

1 Livestock production [e.g. cattle, goats, sheep, pigs]

[] Yes
[] No

2 Poultry production [e.g. chicken, ducks, geese, guinea fowl, ostrich]

[] Yes
[] No

3 Grains and food crops [e.g. maize, wheat, beans, sorghum, millet, groundnuts]

[] Yes
[] No

4 Industrial crops [e.g. tea, coffee, cotton, tobacco]

[] Yes
[] No

5 Fruit production

[] Yes
[] No

6 Vegetable production

[] Yes
[] No

7 Other

[] Yes
[] No

Type of farming practice for crop production

[4.94] What type of farming practice is used by this household for crop production?

[] 1 Irrigation
[] 2 Dry land
[] 3 Both irrigation and dry land

Livestock/Poultry

[4.96] Did this household own/look after any livestock or poultry as on 07 March 2016?

[] 1 Yes
[] 2 No

How many of the following livestock/poultry does this household own or look after as on 07 March 2016?

[4.98] Cattle _ _ _ _ _ _ _ _ _ _

[4.99] Sheep _ _ _ _ _ _ _ _ _ _

[4.100] Goats _ _ _ _ _ _ _ _ _ _

[4.101] Pigs _ _ _ _ _ _ _ _ _ _

[4.102] Chickens _ _ _ _ _ _ _ _ _ _

[4.103] Other poultry [e.g. ducks, turkeys, ostriches, geese] _ _ _ _ _ _ _ _ _ _

Food security

[4.105] In the past 12 months, did this household run out of money to buy food?

[] 1 Yes
[] 2 No
[] 3 Do not know

[4.106] Has this happened for 5 or more days in the past 30 days?

[] 1 Yes
[] 2 No
[] 3 Do not know

[4.107] In the past 12 months, did this household skip any meal(s) because there was not enough food for the household?

[] 1 Yes
[] 2 No
[] 3 Do not know

[4.108] Has this happened for 5 or more days in the past 30 days?

[] 1 Yes
[] 2 No
[] 3 Do not know

5. Emigration and mortality

Emigration

Now, I am going to ask you question on any person(s) that were part of this household at any time since March 2006 and have left South Africa to reside in another country and are still residing outside South Africa.

5.3 Are there any person(s) who were part of this household at any time since March 2006 who have left South Africa to reside in another country and are still residing outside South Africa?

[] 1 Yes
[] 2 No
[] 3 Do not know

5.4 How many persons were part of this household at any time since March 2006 who have left South Africa to reside in another country and are still residing outside South Africa? ________

5.5 Please give me the name of the person(s) who were part of this household at any time since March 2006 who have left South Africa to reside in another country and are still residing outside South Africa? _______

[5.6] Emigrants

[5.6.1] Is the respondent male or female?

[] 1 Male
[] 2 Female

[5.6.2] What is the respondent's current age in completed years? ____

[5.6.3] In which country is the respondent currently residing?

[5.6.4] In which year did the respondent leave South Africa? ____

Mortality

Now, I am going to ask you questions on any member of the household who has passed away in the past 12 months [between 07 March 2015 and 06 March 2016].

5.9 In the past 12 months [between 07 March 2015 and 06 March 2016], has any member of this household passed away?

[] 1 Yes
[] 2 No
[] 3 Do not know

[5.10] How many members of this household have passed away in the last 12 months [between 07 March 2015 and 06 March 2016]? ____

[5.11] Please give the names of the person(s) in this household who have passed away in the past 12 months. ________

[5.12] Mortality

[5.12.1] Was the respondent male or female?

[] 1 Male
[] 2 Female

[5.12.2] What was the respondent's age in completed years at the time of death? ____

[5.12.3] In which year did the respondent pass away? ____

[5.12.4] In which month did the respondent pass away?

[] 1 January
[] 2 February
[] 3 March
[] 4 April
[] 5 May
[] 6 June
[] 7 July
[] 8 August
[] 9 September
[] 10 October
[] 11 November
[] 12 December

[5.12.5] Did the respondent die while pregnant or die while giving birth or die within 6 weeks after delivery?

[] 1 Yes
[] 2 No
[] 3 Do not know

6. Result codes and comments

[6.1] Visit number 1

[6.1.1] Result code

[] 11 Completed
[] 12 Partly completed
[] 21 Non-contact
[] 22 Refusal
[] 23 Other non-response
[] 31 Unoccupied dwelling
[] 32 Vacant dwelling
[] 33 Demolished dwelling
[] 34 New dwelling under construction
[] 35 Status change
[] 36 Classification error

[6.1.2] What was the main reason for the refusal?

[] 1 Too busy
[] 2 Not interested
[] 3 Respondent fatigue
[] 4 Anti-government attitudes
[] 5 Censuses not mandatory
[] 6 Privacy/confidentiality concerns
[] 7 Won't open door to strangers/security concerns
[] 8 Fear of negative consequence
[] 9 Other

[6.1.3] Please specify "Other" reason for refusal. ________

[6.1.4] Date of next visit ____

[6.1.5] Any comments _______

[6.2] Visit number 2

[6.2.1] Result code

[6.2.2] What was the main reason for the refusal?

[] 1 Too busy
[] 2 Not interested
[] 3 Respondent fatigue
[] 4 Anti-government attitudes
[] 5 Censuses not mandatory
] 6 Privacy/confidentiality concerns
[] 7 Won't open door to strangers/security concerns
[] 8 Fear of negative consequence
[] 9 Other

[6.2.3] Please specify "Other" reason for refusal. ________

[6.2.4] Date of next visit ____

[6.2.5] Any comments _______

[6.3] Visit number 3

[6.3.1] Result code

[6.3.2] What was the main reason for the refusal?

[6.3.3] Please specify "Other" reason for refusal. ________

[6.3.4] Date of next visit ____

[6.3.5] Any comments _______

6.4 Final result code

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