ANNEX 2
Questionnaires

Population and Development Dynamics in Rural Communities
(FPA/INT/287/INT)

Head of household questionnaire

Identification of the household

District:

District ID number

Tana:

Tana ID number

Union:

Union ID number

Village:

Village ID number

Country:

Household ID number

Interviewer visits
First visit (1)	Second visit (2)		Third visit (3)
Name interviewer:	Name interviewer:		Name interviewer:


Day	Day		Day

Month	Month		Month

*Result**	*Result*		*Result**


* Codes for interview result:			Total number of visits

1. Completed 2. Household present, but no eligible respondent at home 3. Household absent 4. Questionnaire incomplete 5. Refused 6. Dwelling not found 7. Dwelling vacant/address not a dwelling/destroyed 8. Other
		Summary data of household (Module A):

		Person number of respondent of household questionnaire

		Number of persons in household

		Count of nuclear families in household (See A6)
interviewer and coders: in case explicit coding instructions for “answer refused”, “don't know” or “not-stated” in the questionnaire are lacking, you must use the following coding convention: a. Answer refused=7, 97, 997, etc. b. Does not know answer= 8,98 or 998, etc, c. Answer not stated=9, 99 or 999, etc.
		Count of ELIGIBLE MALES (15–64) in household (Count A13a)

		Count of ELIGIBLE FEMALES (15–49) in household (Count A13b)

			Module A: Household roster ((acting) head of household)

*Interviewer:* *The questions A1–A13 must be completed for all members of the household that are now present in the household, including:*			*Pers. num.*	A1	A2			A3	A4	A5
				Could you give me the NAMES of all persons who usually live in this household. Start with the name of the head of the household	What is the relationship (*) of (NAME) to the head of the household			Is (NAME male or female?	Does (NAME) usually live here in the household?	Did (NAME) sleep here last night?
1	Currently absent household members (e.g. children!) who went to live in an institution for an expected stay not more than one year;
								1 = Male	1 = Yes	1 = Yes
				NAMES				2 = Female	2 = No	2 = No


			01			0	1

			02
2	Maids and servants who usually eat, live and sleep here; Currently absent household members who are temporarily working away from the home, but who are expected to return within 6 months
			03

			04

			05

			06

			07

			08
*but exclude:*
			09
1	Temporary visitors
2	Friends		10

			11
Enter ‘X’ In box to indicate that you have checked the above.		→
			12

			13

			14

			15

	Module A: Household roster ((acting) head of household)
							Only for persons of age 6–64
*Pers. Num*	A6	A7	A8				A9	A10
*Pers. Num*	Interviewer:	What is the age of (NAME)?	What is the date of birth of (NAME)?				Has (NAME) ever attended school?	What is the highest level of school attended (*) by (NAME)?

	If (Name) belongs to a nuclear family, register here the FAMILY RANK NUMBER() e.g. 1, 2,..etc..*
								↓	+
									What is the total number of years of schooling successfully completed?
		Interviewer: enter ‘95’ if person is 95 or older
							1 = Yes
							2 = No		↓
								A10a level	A10b years
			Year			Month	Go to A11	A10a level	A10b years

01				1	9

				1	9

03				1	9

04				1	9

05				1	9

06				1	9

07				1	9

08				1	9

09				1	9

10				1	9

11				1	9

12				1	9

13				1	9

14				1	9

15				1	9

Module A: Household roster ((acting) head of household)
*Pers. No.*	Only for persons of age 6 – 64
	A11	A12		A13 Interviewer:
	What kind of work (*) does (NAME) do most of the time?	What is the current marital status of (NAME)?		Place a circle around the person numbers of household members that are eligible for a personal interview
		1. Never married		A13a ELIGIBLE MALE	A13b ELIGIBLE FEMALE
		2. Married		If married and age 15 or older, but below age 65. (married, 15–64)	If married and age 15 or older, but below age 50 (married, 15–49)
		3. Widowed
		4. Divorced
		5. Separated

01				01	01

02				02	02

03				03	03

04				04	04

05				05	05

06				06	06

07				07	07

08				08	08

09				09	09

10				10	10

11				11	11

12				12	12

13				13	13

14				14	14

15				15	15

Count number of ELIGIBLE males and females and enter the counts on coverpage			→	Males	Females
End of module A, go to module B