Questionnaire Text

Questionnaire form view entire document: text image

For all persons
[Questions 1-10 were asked of all persons.]

7. Is the person's own mother still alive?

If "Yes" and mother is in this house, enter mother's person number in the boxes. Enter "00" if mother is not in this house.

[] 1 Yes
[] 2 No
Mother's person number _ _

Questionnaire instructions view entire document: text image

Questions on Personal Characteristics
Questions 1 to 7 provide information on personal characteristics such as age, sex, marital status and religion. They help us to plan for the needs of communities.

Question 7: Survival of own mother.
This question is used to find out how long people live. The information needed is about the natural mother, not the adopted mother. The Mother's Person number is needed so we can work out the mother's age. This information is important to find out health and social needs.

Q7. Is the person's mother still alive?
(If "Yes" and mother in this house, enter mother's person number in the boxes. Enter "00" if mother not in this household)

Yes
No
Mother's Person number _ _

Who to ask: Ask the head of the household or the person responding.

Get this information for: Every person in each household.

How to ask:
"Is your/his/her own mother still alive?" Remember, this question is about the person's own biological or natural mother, not their adopted mother. You must ask if the person's own mother is alive, and whether or not the mother is in the same household.
If the answer is "yes", ask "Is your/his/her own mother living in this household?"

How to record:
Write the code 1 "Yes" (alive) or 2 "No" (not alive) in the first box.

-If the response is Yes (Code 1), and the mother lives in the household, fill in the mother's person number in the two boxes below.
-If the mother is alive but does not live in the household, enter 00 in the two boxes.
-If the response is "No" (Code 2, not alive), do not write in the mothers person number in the two boxes provided.