Questionnaire Text

Questionnaire form view entire document:  text  image
B. For all persons in the household

Do you have any difficulty with the following activities?

Q17. Cause of main difficulty

(For persons with any difficulty from Q11 to Q16)

[] 1. Since birth
[] 2. War
[] 3. Accident
[] 4. UXO
[] 5. Disease
[] 6. Other
Questionnaire instructions view entire document:  text  image
Question Q17: The main cause of the disabilities
The purpose of this question is to gather information about the main causes of difficulties in the physical movement of household members.
 
The main cause of the disabilities: identified in this questionnaire include:

1) Congenital causes (congenital): refers to a person who is born with difficulty or disability by birth.
 
2) Caused by war: refers to difficulty or disability caused by the effects of war that cause a person to lose any part of the body or cause any part of the body to be dysfunctional or abnormal.
 
3) Caused by accident: refers to difficulty or disability caused by various accidents in many cases, such as accidents on land, water, accidents from physical work, playing sports, physical harm, electric shock, fire, hot water, or other causes.
 
4) Caused by Unexploded Ordnance: refers to difficulty or disability caused by explosives, massive bullets, and explosives left over from war causing the loss of any part of the body or making the operation of any part of the body difficult or abnormal.
 
5) The cause of the disease: refers to difficulty or disability caused by various diseases that affect people's health, making the operation of any part of the body difficult or not normal.
 
6) Other causes: refers to difficulty or disability caused by other causes not specified above, such as food poisoning symptoms, drug addiction, and others that make the operation of any part of the body difficult or abnormal.

 
The surveyor must write down the answers given by the interviewee and highlight in black the box of the causes code that causes difficulty or disability as specified in the questionnaire.
 
Note: If there are several disabilities, the surveyor is advised to ask the interviewee more about which disability causes the most difficulty (in questions 11-16) and then ask the reason for such difficulty.