Questionnaire Text

Questionnaire form view entire document: text image

Part 1. Information on household members

The next questions are about difficulties a person faces when performing certain activities due to health reasons.

13. Does [the respondent] have any difficulty with:

(If yes: How difficult is it? difficult, very difficult or completely unable)

c) Walking on the ground? (even if there is someone to support or aid equipment used)

[] 1 Not difficult
[] 2 Difficult
[] 3 Very difficult
[] 4 Unable

Questionnaire instructions view entire document: text image

Part V: Instructions on how to question and record information on the census form

Part 1: Information about members of the household
Part 1 of the Census form consists of 41 questions, numbered sequentially from Question 1 to Question 41.

The respondent is the head of the household or a person knowledgeable about members of the household. For information on employment and birth history of women, DTV needs to interview DTDT face-to-face and collect information. In addition, for other information about members of the household, if the head of the household or the information provider is not knowledgeable, DTV also needs to interview DTDT face-to-face and record the information.

Question 13: Does [the respondent] have any difficulty when [...]?
This question is intended to gather information about difficulties a person may encounter in performing certain activities due to health problems/long term health problems, including difficulties due to the effects of old age, but does not include difficulties due to the children being young or not yet proficient in taking care of themselves (help from adults).

DTV asks about the conditions and level of difficulty of each person and in turn according to each ability, including vision, hearing, walking up the stairs, memory, self-care, and communication. Therein:

-Vision, even with glasses: DTV asked about the conditions and level of difficulty of DTDT when seeing. In case people have difficulty and have to wear glasses, DTV asks if they still have difficulty when wearing glasses and if so, the level of difficulty.

-Hearing, even with a hearing aid: DTV asks about the conditions and level of difficulty of DTDT when hearing. In case people have difficulty and have to use a hearing aid, DTV asks if they still have difficulty when using a hearing aid and, if so, the level of difficulty.