REPUBLIC OF SENEGAL DEMOGRAPHIC AND HEALTH SURVEY (EDS)
HOUSEHOLD QUESTIONNAIRE - 1986
HOUSEHOLD QUESTIONNAIRE - 1986
VILLAGE____
DEPARTMENT____
NEIGHBORHOOD/REGION____
ARRONDISSEMENT/COMMUNE____
SUB-DISTRICT____
PARCELLE NUMBER____
CONCESSION NUMBER (a group of houses on a plot, usually centered around the huts of a man and his wives) ____
FIRST VISIT (REPEAT FOR SECOND AND THIRD INTERVIEWERS)
DATE____
INTERVIEWER NAME___
RESULT
1 COMPLETED
2 NOT AT HOME OR NOT A COMPETENT RESPONDENT
3 POSTPONED
4 REFUSED
5 EMPTY DWELLING
6 NO DWELLING AT GIVEN ADDRESS
7 ADDRESS NOT RECEIVED OR INACCURATE ADDRESS
8 OTHER (SPECIFY) ____
2 NOT AT HOME OR NOT A COMPETENT RESPONDENT
3 POSTPONED
4 REFUSED
5 EMPTY DWELLING
6 NO DWELLING AT GIVEN ADDRESS
7 ADDRESS NOT RECEIVED OR INACCURATE ADDRESS
8 OTHER (SPECIFY) ____
FINAL VISIT
MONTH _____
YEAR ____
INTERVIEWER CODE ____
RESPONDENT CODE ____
FIELD EDITOR
NAME__
DATE__
OFFICE EDITOR__
KEYED BY___
Now I would like information on the people who usually live in your household or who are currently visiting your household.
001. HOUSEHOLD ORDER NUMBER:
ORDER NO. _____
ORDER NO. _____
003. FIRST AND LAST NAMES OF USUAL RESIDENTS AND GUESTS:
NAME _____
004. RELATIONSHIPS IN HOUSEHOLD:
RELATION _____
SEX ____
AGE _____
STATUS _____
______
009. SELECTION OF ELIGIBLE WOMEN:
_____