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FEDERAL REPUBLIC OF NIGERIA
NATIONAL POPULATION COMMISSION
1999 NIGERIA DEMOGRAPHIC AND HEALTH SURVEY
HOUSEHOLD SCHEDULE

IDENTIFICATION

STATE NAME ___
LOCAL GOVT. AREA ___
LOCALITY NAME ___
ENUMERATION AREA ___

URBAN/RURAL:

Urban = 1
Rural = 2

BUILDING NUMBER ___
HOUSEHOLD NAME/NUMBER ___

LARGE TOWN/MEDIUM TOWN/SMALL TOWN/VILLAGE:

Large Town = 1
Medium Town = 2
Small Town = 3
Village = 4

INTERVIEWER'S 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
7 DWELLING DESTROYED
8 OTHER (SPECIFY) ___________

NEXT VISIT (FOR INTERVIEWERS 1 AND 2)
DATE __________
TIME ___________

FINAL VISIT
DAY ____
MONTH ____
YEAR ____
NAME ____
RESULT _____

TOTAL NO. OF VISITS __

TOTAL IN HOUSEHOLD __

TOTAL ELIGIBLE WOMEN__

TOTAL ELIGIBLE MEN __

LINE NO. OF RESPONDENTS TO HOUSEHOLD SCHEDULE __

SUPERVISOR
NAME ________ ___
DATE ________

FIELD EDITOR
NAME ________ ___
DATE ________

OFFICE EDITOR____

KEYED BY____

HOUSEHOLD SCHEDULE

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

(1) LINE NO. (1) (01-14)

LINE NUMBER____

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

NAME___________

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

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
08 = BROTHER OR SISTER
09 = BROTHER OR SISTER-IN-LAW
10 = OTHER RELATIVE
11 = ADOPTED/FOSTER/STEPCHILD
12 = NOT RELATED
98 = DON’T KNOW

(4) RESIDENCE: Does (NAME) usually live here?

YES 1
NO 2

(5) RESIDENCE: Did (NAME) stay here last night?

YES 1
NO 2

(6) SEX: Is (NAME) male or female?

MALE 1
FEMALE 2

(7) AGE: How old is (NAME) as of last birthday?

IN YEARS __

EDUCATION IF AGE 6 YEARS OR OLDER:

(8) Can (NAME) read and write in any language with understanding?

YES 1
NO 2

(9) Has (NAME) ever been to school?

YES 1
NO 2

(10) IF ATTENDED SCHOOL: Which is the highest level of school (NAME) attended? What is the highest grade (NAME) completed at that level?**

LEVEL ___
1 = PRIMARY
2 = SECONDARY
3 = HIGHER
8 = DON’T KNOW
GRADE ___
00 = LESS THAN 1 YEAR COMPLETED
01 = 1 YEAR COMPLETED
02 = 2 YEARS COMPLETED
03 = 3 YEARS COMPLETED
04 = 4 YEARS COMPLETED
05 = 5 YEARS COMPLETED
06 = 6 YEARS COMPLETED
98 = DON’T KNOW

(11) Is (NAME) still in school? (For Age less than 25 Years)

YES 1
NO 2

PARENTAL SURVIVORSHIP AND RESIDENCE FOR PERSONS LESS THAN 15 YEARS OLD:
Q.12 THROUGH Q.15: These questions refer to the biological parents of the child. Record 00 if parent not member of household.

(12) Is (NAME)’s natural mother alive?

YES 1
NO 2
DON'T KNOW 8

(13) (IF ALIVE) Does (NAME)’s natural mother live in this household?
IF YES: What is her name?
RECORD MOTHER’S LINE NUMBER

LINE NUMBER____

(14) Is (NAME)’s natural father alive?

YES 1
NO 2
DON'T KNOW 8

(15) (IF ALIVE) Does (NAME)’s natural father live in this household?
IF YES: What is his name?
RECORD FATHER’S LINE NUMBER

LINE NUMBER____

(16) ELIGIBILITY: CIRCLE LINE NUMBER OF ALL WOMEN AGED 10-49.

(17) ELIGIBILITY: CIRCLE LINE NUMBER OF ALL MEN AGED 15-64.

TICK HERE IF CONTINUATION SHEET USED __

Tick here if Household has more than 14 persons __

Just to make sure that I have a 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 that have not been listed?

YES (ENTER EACH IN TABLE)
NO

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

PIPED WATER
PIPED INTO RESIDENCE/YARD/PLOT 11 (GO TO 20)
PUBLIC TAP 12
WELL WATER
WELL IN RESIDENCE/YARD/PLOT 21 (GO TO 20)
PUBLIC WELL 22
SURFACE WATER
SPRING 31
RIVER/STREAM 32
POND/LAKE 33
DAM 34
RAINWATER 41 (GO TO 20)
TANKER (TRUCK) 51 (GO TO 20)
TANKER VENDOR 52 (GO TO 20)
BOTTLED WATER 61
BOREHOLE 71
OTHER (SPECIFY) __________ 96 (GO TO 20)

19. How long does it take you to go there, get water, and come back?

MINUTES _____
ON PREMISES 996

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

FLUSH TOILET (W.C)
OWN WATER CLOSET 11
SHARED FLUSH TOILET (W.C) 12
PIT TOILET/LATRINE
TRADITIONAL PIT TOILET 21
VENTILATED IMPROVED PIT (VIP) LATRINE 22
BUCKET TOILET 23
NO FACILITY/BUSH/FIELD/RIVER 31
OTHER (SPECIFY) ___________ 96

21. Does your household have:

Electricity?
A radio?
A television?
A telephone?
A refrigerator?
A Gas Cooker?
An Electric Iron?
An Electric Fan?

ELECTRICITY
YES 1
NO 2
RADIO
YES 1
NO 2
TELEVISION
YES 1
NO 2
TELEPHONE
YES 1
NO 2
REFRIGERATOR
YES 1
NO 2
GAS COOKER
YES 1
NO 2
ELECTRIC IRON
YES 1
NO 2
ELECTRIC FAN
YES 1
NO 2

22. How many rooms are in your household?

ROOMS ______________

22B. How many rooms are used for sleeping in your household?

ROOMS ______________

23. MAIN MATERIAL OF THE FLOOR.
RECORD OBSERVATION.

NATURAL FLOOR
EARTH/SAND 11
DUNG 12
RUDIMENTARY FLOOR
WOOD PLANKS 21
PALM/BAMBOO 22
FINISHED FLOOR
PARQUET OR POLISHED WOOD 31
VINYL OR ASPHALT STRIPS 32
CERAMIC TILES 33
CEMENT 34
TERRAZZO/MARBLE 35
CARPET 36
OTHER (SPECIFY) ___________ 96

24. Does any member of your household own:

A bicycle?
A motorcycle?
A car?
A Donkey/Horse/Camel?
A Canoe/Boat/Ship?

BICYCLE
YES 1
NO 2
MOTORCYCLE
YES 1
NO 2
CAR
YES 1
NO 2
DONKEY/HORSE/CAMEL
YES 1
NO 2
CANOE/BOAT/SHIP
YES 1
NO 2

25. What type of salt is usually used for cooking in your household?
(ASK TO SEE SALT PACKAGE).

LOCAL SALT 01
PACKAGED SALT (IODIZED) 02
PACKAGED SALT (NOT IODIZED) 03
SALT FOR ANIMALS 04
LOOSE SALT 05
OTHER (SPECIFY) __________ 06

26. How do you hold this accommodation?

RENT 01
OWNER OCCUPIER 02
NOT OWNER, BUT RENT FREE 03
HOUSED BY EMPLOYER 04
OTHER (SPECIFY) ______________ 96

27. If you rent it or if it is rent-free, who owns the accommodation?

PRIVATE INDIVIDUAL 01
PUBLIC OWNERSHIP 02
EMPLOYER 03
PRIVATE MORTGAGE COMPANY 04
OTHER (SPECIFY) _____________ 96

28. MAIN MATERIAL USED FOR OUTER WALLS.
RECORD OBSERVATION

CEMENT BLOCKS 01
CONCRETE 02
BAKED BRICKS 03
UNBAKED BRICK, MUD OR EARTH 04
TERRAZZO/MARBLE/HEWN STONE 05
PLANK/WOOD/BAMBOO MATERIAL 06
THATCH/MAT/LEAVES/STRAW 07
CORRUGATED IRON SHEETS/ZINC 08
OTHER (SPECIFY) ____________ 96

29. MAIN MATERIAL USED FOR ROOF.
RECORD OBSERVATION

HARD CONCRETE (CEMENT) 01
CORRUGATED METAL SHEET/ASBESTOS TILES 02
WOODEN TILES/PLANKS 03
EARTH/MUD 04
THATCH/MAT/LEAVES 05
OTHER (SPECIFY) ____________ 96

30. MAIN SOURCE OF LIGHT

ELECTRICITY 01
PRESSURE LAMP 02
KEROSINE LAMPS WITH GLASS SHADES 03
KEROSINE/OIL LAMPS WITHOUT GLASS SHADES 04
OTHER (SPECIFY) ____________ 96

31. TYPE OF KITCHEN FACILITY

SEPARATE ROOM IN THE BUILDING FOR EXCLUSIVE USE OF HOUSEHOLD 01
SEPARATE ROOM IN THE BUILDING FOR USE OF THIS AND OTHER HOUSEHOLDS 02
ENCLOSURE WITHOUT ROOF 03
OPEN SPACE WITHIN/AROUND BUILDING 04
OTHER (SPECIFY) ____________ 96

32. TYPE OF BATHING FACILITY

SEPARATE ROOM IN THE BUILDING FOR EXCLUSIVE USE OF HOUSEHOLD 01
SEPARATE ROOM IN THE BUILDING FOR ALL OCCUPANTS 02
ENCLOSURE IN THE BUILDING BUT WITHOUT ROOF 03
PUBLIC BATHROOM/STREAM/RIVER 04
OTHER (SPECIFY) ____________ 96