Questionnaire Text

Questionnaire form view entire document:  text  image
Since Independence Day 2000, has any member (stayed for at least 14 days) of the household died?

(If "yes", ask for sex, age, and usual place of residence.)

D1. Serial number _ _

Questionnaire instructions view entire document:  text  image
132. Columns D1, D2, D3 and D4: Deaths in the household

Q: Since Independence Day 2000, has any member of this household died?

In general people are not happy to talk about deaths, especially recent ones, so be careful when asking this question. We are interested in recording information about any deaths since last Independence Day, September 30th, 2000, of anyone who had, up until their death, been a member of this household. The relevant portion of the sample questionnaire is shown below:

If there was any such death, enter the details under columns D1 to D3. Start with the serial number in D1. The first death should be given the serial number 01, the second death 02, etc. Record also the relationship in D2 of the deceased to the head of the current household, the SEX of the deceased in column D3 and his AGE at death in column D4. If the person was under 1 year at death enter 00. Lastly, in D5 you will have to collect information on where the deceased was living most of the times or usually before dying, which might help you establish if the deceased was really a member of the household. The deceased should be regarded a usual member if he/she has stayed with the household for period longer than 14 days before death. Still deaths should not be considered to be deaths.

If there were more than three deaths in the household, write "continued" in the comments box and enter the particulars of these other deaths in Part D of the next questionnaire form, starting with serial number 04.

If there were no deaths, enter dashes in the spaces provided for answer codes in the first line only. Ensure that one death is not repeated in more than one household. The repetition of one death is common among relatives of the deceased who are not of the same household, and another confusion from those people who were staying in the same dwelling with the deceased but not being of the same household with the deceased. These situations could be avoided by finding out the usual residence of the deceased and whether the deceased had common provision for food with the household interviewed.

Example: The household has had one death since independence day last year, this death is assigned serial number 1, coded 06 in D2 to show that the deceased was Maungo's grandparent and coded 1 in D3 to show that the person was male. This person was aged 96 years and was living in Francsitown most of the time, at the time of death the deceased had moved to Tsootsha until his death two months later.

[Table in P.52 of the original document is not presented here]