Questionnaire Text

Questionnaire form view entire document:  text  image
II. Recapitulation
Q.1. Number of household members ____
Q.2. Number of household members age 5 or older ____
Q.3. Number of household members age 10 or older ____
Q.4. Number of births (Code 1 at Q.9 and Q.20 Block X) _____
Q.5. Number of infant mortalities (Code 2 at Q.11 and Q.22 Block X) ____
Q.6. Total number of mortalities (from block XII B) _____
Questionnaire instructions view entire document:  text  image

Point 10: Serial number of the selected household

b. Block II: Summary
These items should be filled in after the interview using Form S is complete.

Point 1: Total number of household members
This should be the same as the last serial number used to record a member of the household in column (1), block IV of form S.

Point 2: Total number of household members age 5 or older
Count the number of household members in column (5), block IV of form S age 5 or older]

[pg. 39]

[Point 3:] Count the number of household members in column (5) Block IV age 10 or older

Point 4: Total number of births
Sum all the births to members of the household who were recorded as code "1" for Q.9 and Q.20 in block X.

Point 5: Record the number of dead babies who were born after 30 June, 1984. Fill in the sum of all baby deaths experienced in the household, that is, by summing the number of 2s in Q.11 and Q.22 Block X, for which Q.9 and Q.20 have code 1.

Point 6: Total number of deaths
Fill in the total number of deaths from 30 June, 1984 up to the date of the enumeration; this is the total number of members of the household who died as recorded in Q.1 block XII.B.


C. Block XII. B: Deaths after 30 June 1984
All deaths that occurred after 30 June, 1984 (Idul Fitri) up to the day of the enumeration are recorded in this block. Note that deaths are not limited to just deaths of babies and children, but include deaths of adults as well.