Questionnaire Text

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Form B: household questionnaire - part 5: death in the household


Deaths in the household in the last 12 months

Total number of deaths _ _

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133. Filling in of Form B Household Questionnaire Part 5: Death in Household

This is the last part of the household questionnaire (Form B). This section is considered as part of household questionnaire with very sensitive questions. You should be polite and patient when asking these questions. You should explain to the respondents about this information which is very necessary for studying the mortality rate (per 1000 population), maternal mortality rate and for the calculation of the population growth rate. You should take special care to see that correct information is ascertained; you may have to ask probing questions patiently to achieve this.


133.1 Deaths in household in the last 12 months: Total Number of Deaths

Columns (1) to (6) are for recording death of any member of the household in the last 12 months

This relates to the death of any member of the household during the last 12 months in the same household. Before recording any death you should know that the death of the person took place when he/she was living in the household. For example, if a woman who was formerly a member of the household during the census had died as a member of another household (which she joined after marriage), her death should not be recorded in the census household.

133.2 If a member of the census household died at hospital irrespective of the period of stay in the hospital, such death should be recorded as in the census household. If a member of the census household was traveling to some place for getting health care and died in that place, it should be recorded as in the census household. For example, Nara who is a member of household (A) in Kandal fell ill and went to Phnom Penh to receive treatment and stayed in the household of (B) in Phnom Penh. If he died in Phnom Penh, his death should be recorded in household (A) and not in household (B). To determine to which household a member belongs in such cases, six months or more may be treated as the period the person should have stayed in the household to treat him/her as belonging to that household.

133.3 For recording death in the household in the last 12 months, nine columns are provided. One line should be used for recording one death. The first
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column is for the serial number. In Column 2 you should write the full name of the deceased. In case of infant death where the infant is not given a name, write "INFANT (Kouy Kim Deth's infant)". In Column 3 you should fill in the sex of the deceased. In Column 4 the relationship to the head of household should be filled in. In Column 5 the age at death in completed years of the deceased at the time of death should be recorded. In Column 6 give the appropriate code for the cause of death of the person. The list of causes of death given on the questionnaire contains one group of codes for illness and another for accidents. The codes from 01 to 11 relate to illness and codes from 12 to 15 for accidents. If there are two or more causes, give the code for one cause only after probing which was the most important cause. If with all efforts (i.e. discussing with other members, etc.) you are not able to ascertain the actual cause of death of any person, enter Code 16 (Not Known).