Data Cart

Your data extract

0 variables
0 samples
View Cart
A planned IPUMS system update is scheduled for Monday, December 9. The maintenance window is 10am to 1pm CST. Within that window, each site will have a brief outage of 10 or fewer minutes. This notice will be removed as soon as the update is complete.


DEMOGRAPHIC AND HEALTH SURVEY - BANGLADESH 1999-2000 - HOUSEHOLD QUESTIONNAIRE (ENGLISH)

BANGLADESH

IDENTIFICATION

DIVISION:
DISTRICT:
THANA:
UNION OR WARD:
VILLAGE OR MOHALLA OR BLOCK:
CLUSTER NUMBER:
HOUSEHOLD NUMBER:
REGION:

DHAKA/CHITTAGONG OR SMALL CITY OR TOWN OR VILLAGE?

DHAKA OR CHITTAGONG 1
SMALL CITY 2
TOWN 3
VILLAGE 4

NAME OF THE HOUSEHOLD HEAD :
IS THIS HOUSEHOLD SELECTED FOR THE MEN'S SURVEY?

YES 1
NO 2

INTERVIEWER VISITS

FIRST VISIT (REPEAT FOR SECOND AND THIRD VISITS)
DATE
INTERVIEWER'S NAME
RESULT*

1 COMPLETED
2 NO HOUSEHOLD MEMBER AT HOME OR NO COMPETENT RESPONDENT AT HOME AT TIME OF VISIT
3 ENTIRE HOUSEHOLD ABSENT FOR EXTENDED PERIOD OF TIME
4 POSTPONED
5 REFUSED
6 DWELLING VACANT OR ADDRESS NOT A DWELLING
7 DWELLING DESTROYED
8 DWELLING NOT FOUND
9 OTHER (SPECIFY)

NEXT VISIT
DATE
TIME

FINAL VISIT
DAY
MONTH
YEAR
INTERVIEWER'S CODE
RESULT*

TOTAL NUMBER OF VISITS:

TOTAL PERSONS IN HOUSEHOLD:
TOTAL ELIGIBLE WOMEN:
TOTAL ELIGIBLE MEN:
LINE NUMBER OF RESPONDENT TO HOUSEHOLD SCHEDULE:

SUPERVISOR
NAME
DATE

FIELD EDITOR
NAME
DATE

OFFICE EDITOR

KEYED BY

HOUSEHOLD SCHEDULE

Now we would like some information about the people who usually live in your household or who are staying with you now.

1. LINE NUMBER

___

2. USUAL RESIDENTS AND VISITORS: Please give me the names of all the persons who usually live in your household and guest of the household who stayed here last night, starting with the head of the household.

___

Just to make sure that I have the complete listing:

1. Are there any other persons such as small children or infants that we have not listed?

YES (ENTER EACH IN TABLE)
NO

2. In addition, are there any other people who may not be members of your family, such as domestic servants, lodgers or friends who usually live here?

YES (ENTER EACH IN TABLE)
NO

3. Are there any guests or temporary visitors staying here, or anyone else who slept here last night, who have not been listed?

YES (ENTER EACH IN TABLE)
NO

3. RELATIONSHIP TO HEAD OF HOUSEHOLD: What is the relationship of (NAME) to the head of the household?

01 HEAD
02 WIFE OR HUSBAND
03 SON OR DAUGHTER
04 SON-IN-LAW OR DAUGHTER-IN-LAW
05 GRANDCHILD
06 PARENT
07 PARENT-IN-LAW
09 BROTHER OR SISTER
10 OTHER RELATIVE
11 ADOPTED OR FOSTER OR STEPCHILD
12 NOT RELATED
98 DON'T KNOW

4. SEX: Is (NAME) a male or female?

MALE 1
FEMALE 2

5. RESIDENCE: Does (NAME) usually live her?

YES 1
NO 2

6. Did (NAME) sleep here last night?

YES 1
NO 2

7. AGE: How old is (NAME)

IN YEARS ___

MARITAL STATUS FOR ALL AGED 10 OR ABOVE

8. What is the current marital status of (NAME)?

CURRENTLY MARRIED 1
FORMERLY MARRIED (DIVORCED OR WIDOWED OR SEPARATED OR DESERTED) 2
NEVER MARRIED 3

FOR ALL WOMEN AGED 10-49

9. WOMAN ELIGIBILITY: CIRCLE LINE NUMBER OF ALL EVER MARRIED WOMEN FROM QUESTION 8 CODES 1 AND 2.

FOR ALL MEN AGED 15-59

10. MAN'S ELIGIBILITY: IF HOUSEHOLD CHOSEN FOR MEN'S SURVEY, CIRCLE LINE NUMBER OF ALL CURRENTLY MARRIED MEN FROM QUESTION 8 CODE 1.

EDUCATION IF AGE 5 YEARS OR OLDER

11. Has (NAME) ever attended school?

YES 1
NO 2 (GO TO 14)

12. What is the highest level of school (NAME) has attended? What is the highest class (NAME) has completed at that level?

LEVEL
1 PRIMARY
2 SECONDARY
3 COLLEGE OR UNIVERSITY
8 DON'T KNOW
CLASS
00 LESS THAN 1 YEAR COMPLETED
98 DON'T KNOW

IF AGED LESS THAN 25 YEARS

13. Is (NAME) currently attending school?

YES 1
NO 2

EMPLOYMENT IF AGE 5 YEARS OR OLDER

14. Is (NAME) currently working?

YES 1
NO 2 (GO TO NEXT LINE)

15. Does (NAME) receive wages or income in cash or kind?

CASH 1
KIND 2
BOTH 3
NONE 4

18. What is the main source of water your household uses for dishwashing?

PIPED WATER
PIPED INSIDE DWELLING 11
PIPED OUTSIDE DWELLING 12
WELL WATER
TUBE WELL OR DEEP TUBE WELL 21
SURFACE WELL OR OTHER WELL 22
SURFACE WATER
POND OR TANK OR LAKE 31
RIVER OR STREAM 32
RAINWATER 41
OTHER (SPECIFY) 96

19. What is the main source of drinking water for members of your household?

PIPED WATER
PIPED INSIDE DWELLING 11
PIPED OUTSIDE DWELLING 12
WELL WATER
TUBE WELL OR DEEP TUBE WELL 21
SURFACE WELL OR OTHER WELL 22
SURFACE WATER
POND OR TANK OR LAKE 31
RIVER OR STREAM 32
RAINWATER 41
OTHER (SPECIFY) 96

19A. Do you boil drinking water?

YES 1
NO 2

20. What kind of toilet facility does your household have?

SEPTIC TANK OR MODERN TOILET 11
PIT TOILET OR LATRINE
WATER SEALED OR SLAB LATRINE 21
PIT LATRINE 22
OPEN LATRINE 23
HANGING LATRINE 24
NO FACILITY OR BUSH OR FIELD 31 (GO TO 22)
OTHER (SPECIFY) 96

21. Do you share this facility with other households?

YES 1
NO 2

22. Does your household (or any member of your household) have:

Electricity?
YES 1
NO 2
Almirah (wardrobe)?
YES 1
NO 2
A table or chair?
YES 1
NO 2
A bench?
YES 1
NO 2
A watch or clock?
YES 1
NO 2
A cot or bed?
YES 1
NO 2
A radio that is working?
YES 1
NO 2
A television that is working?
YES 1
NO 2
A bicycle?
YES 1
NO 2
A motorcycle?
YES 1
NO 2
A sewing machine?
YES 1
NO 2
A telephone?
YES 1
NO 2

24. MAIN MATERIAL OF THE ROOF.

RECORD OBSERVATION.

NATURAL ROOF
KATCHA (BAMBOO OR THATCH) 11
RUDIMENTARY ROOF
TIN 21
FINISHED ROOF (PUKKA)
CEMENT OR CONCRETE OR TILED 31
OTHER (SPECIFY) 96

25. MAIN MATERIAL OF THE WALLS.

RECORD OBSERVATION.

NATURAL WALLS
JUTE OR BAMBOO OR MUD (KATCHA) 11
RUDIMENTARY WALLS
WOOD 21
FINISHED WALLS
BRICK OR CEMENT 31
TIN 32
OTHER (SPECIFY) 96

26. MAIN MATERIAL OF THE FLOOR.

RECORD OBSERVATION.

NATURAL FLOOR
EARTH OR BAMBOO (KATCHA) 11
RUDIMENTARY FLOOR
WOOD 21
FINISHED FLOOR (PUKKA)
CEMENT OR CONCRETE 31
OTHER (SPECIFY) 96

27. Does your household own any homestead?

IF 'NO', PROBE: Does your household own homestead any other places?

YES 1
NO 2

27A. Does your household own any land (other than the homestead land)?

YES 1
NO 2 (GO TO 29)

28. How much land does your household own (other than the homestead land)?

AMOUNT ___
ACRES ___
DECIMALS ___
SPECIFY UNIT ___
NONE 0000

29. In terms of household food consumption, how do you classify your household: deficit in whole year; somewhat deficit; neither deficit nor surplus; surplus.

DEFICIT IN WHOLE YEAR 1
SOMETIMES DEFICIT 2
NEITHER DEFICIT NOT SURPLUS 3
SURPLUS 4

30. Does your family have a vulnerable group feeding (VGF) card?

YES 1
NO 2

31. Do you have any male or female member in this household who are receiving old age pension or widow or destitute benefit?

YES 1
NO 2