Questionnaire Text

Questionnaire form view entire document:  text  image
Section D: Questions about the Population
Enumerator: Ask questions to all of the people listed in Section C.

[Question 6 through 36 were asked to the residents]

9. Does [the person] have any disability?

[] 1 No- Go to question 11
Yes:
[] 2 Blind
[] 3 Deaf
[] 4 Amputated/ Atrophied arms(s)
[] 5 Amputated/ Atrophied legs(s)
[] 6 Paralysis
[] 7 Mental
[] 8 Other
Questionnaire instructions view entire document:  text  image
P9. Does (the person) have any disability?

This is a very delicate question. Some people do not like to talk about their or their relatives' disabilities, especially if it concerns the minors. For that reason you should try and be gentle when asking that question.

Consider as a disability any of the following: blindness, deafness, amputated/atrophied arm(s) or leg(s), paralysis, mental and others.

If the respondent does not have any disability, write an X in box number 1 and go to P11. If they have any physical disability, write an X in the box that corresponds to the kind of disability.

This question admits more than one response. This means that if the respondent has an amputated arm and is blind, you should mark an X in the boxes that correspond to numbers 2 and 5.