Questionnaire Text

Questionnaire form view entire document:  text  image
Localization
M1. Region / lome-municipality _
M2. Prefecture / arrondissement _ _
M3. Sub-prefecture (if applicable) _
M4. Canton / neighborhood of lome _ _
M5. Number of zone of enumeration _ _
M6. Environment of residence

[] 1 Urban
[] 2 Rural

M7. Village/ town_ _
M8. Hamlet (if applicable) _ _
M9. Neighborhood (if applicable) _ _
M10. Farm (if applicable) _ _
M11. Number of the compound (if applicable) _ _ _
M12. Number of the household_ _ _

Questionnaire instructions view entire document:  text  image
A - Location

You will record clearly and in block capital letters the information of the geographic location of the household and sometimes, the corresponding codes in the white boxes situated to the right (see the appended list of these codes). The variables of location are:

M6. Place of residence: Circle the appropriate code and record it in the corresponding box. If your ZD is located in an urban zone, record code 1 or code 2 if the ZD is in a rural zone.