Survey Text

Afghanistan 2015 Ethiopia 2000 Malawi 1992 Rwanda 2005
Angola 2015 Ethiopia 2005 Malawi 2000 Rwanda 2008
Bangladesh 1994 Ethiopia 2011 Malawi 2004 Rwanda 2010
Bangladesh 1997 Ethiopia 2016 Malawi 2010 Rwanda 2014
Bangladesh 2000 Ghana 1993 Malawi 2016 Senegal 1992
Bangladesh 2004 Ghana 1998 Mali 1995 Senegal 1997
Bangladesh 2007 Ghana 2003 Mali 2001 Senegal 2005
Bangladesh 2011 Ghana 2008 Mali 2006 Senegal 2010
Bangladesh 2014 Ghana 2014 Mali 2012 Senegal 2012
Benin 1996 Guinea 1999 Mali 2018 Senegal 2014
Benin 2001 Guinea 2005 Morocco 1992 Senegal 2015
Benin 2006 Guinea 2012 Morocco 2003 Senegal 2016
Benin 2011 Guinea 2018 Mozambique 1997 Senegal 2017
Benin 2017 India 1992 Mozambique 2003 South Africa 1998
Burkina Faso 1993 India 1998 Mozambique 2011 South Africa 2016
Burkina Faso 1998 India 2005 Myanmar 2015 Tanzania 1996
Burkina Faso 2003 India 2015 Namibia 2000 Tanzania 1999
Burkina Faso 2010 Jordan 1997 Namibia 2006 Tanzania 2004
Burundi 2010 Jordan 2002 Namibia 2013 Tanzania 2010
Burundi 2016 Jordan 2007 Nepal 1996 Tanzania 2015
Cameroon 1998 Jordan 2009 Nepal 2001 Uganda 1995
Cameroon 2004 Jordan 2012 Nepal 2006 Uganda 2001
Cameroon 2011 Jordan 2017 Nepal 2011 Uganda 2006
Chad 1996 Kenya 1993 Nepal 2016 Uganda 2011
Chad 2004 Kenya 1998 Niger 1992 Uganda 2016
Chad 2014 Kenya 2003 Niger 1998 Yemen 2013
Congo (Democratic Republic) 2007 Kenya 2008 Niger 2006 Zambia 1992
Congo (Democratic Republic) 2013 Kenya 2014 Niger 2012 Zambia 1996
Cote d'Ivoire 1998 Lesotho 2004 Nigeria 1999 Zambia 2001
Cote d'Ivoire 2011 Lesotho 2009 Nigeria 2003 Zambia 2007
Egypt 1992 Lesotho 2014 Nigeria 2008 Zambia 2013
Egypt 1995 Liberia 2007 Nigeria 2013 Zambia 2018
Egypt 2000 Liberia 2013 Nigeria 2018 Zimbabwe 1994
Egypt 2003 Madagascar 1992 Pakistan 2006 Zimbabwe 1999
Egypt 2005 Madagascar 1997 Pakistan 2012 Zimbabwe 2005
Egypt 2008 Madagascar 2003 Pakistan 2017 Zimbabwe 2010
Egypt 2014 Madagascar 2008 Rwanda 2000 Zimbabwe 2015
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Afghanistan 2015
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1. LINE NO. ____

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Angola 2015
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TOTAL PERSONS IN HOUSEHOLD_________
TOTAL NO. OF WOMEN AGES 15-49_________
TOTAL NO. OF MEN AGES 15-54_________
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE_________

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Bangladesh 1994
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TOTAL NUMBER OF VISITS

NAME
DATE

FIELD EDITED BY
OFFICE EDITED BY
KEYED BY
KEYED BY


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Bangladesh 1997
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LINE NUMBER OF RESPONDED TO HOUSEHOLD SCHEDULE

NAME
DATE


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Bangladesh 2000
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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:


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Bangladesh 2004
Survey form view entire document:  text 
INTERVIEWER VISITS

FIRST VISIT
DATE
INTERVIEWER'S NAME
RESULT

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

SECOND VISIT
DATE
INTERVIEWER'S NAME
RESULT

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

NEXT VISIT
DATE
TIME

THIRD VISIT
DATE
INTERVIEWER'S NAME
RESULT

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

FINAL VISIT
DAY
MONTH
YEAR
INTERVIEWER'S CODE
RESULT

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

TOTAL NUMBER OF VISITS:

TOTAL PERSONS IN HOUSEHOLD:

TOTAL ELIGIBLE WOMEN:

TOTAL ELIGIBLE MEN:

LINE NUMBER OF RESPONDENT TO HOUSEHOLD SCHEDULE:


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Bangladesh 2007
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TOTAL NUMBER OF VISITS____

TOTAL PERSONS IN HOUSEHOLD____
TOTAL ELIGIBLE WOMEN____
TOTAL ELIGIBLE MEN____
LINE NUMBER OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE____


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Bangladesh 2011
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TOTAL NUMBER OF VISITS____

TOTAL PERSONS IN HOUSEHOLD__
TOTAL WOMEN 12 TO 49 YR.
TOTAL MEN 15 TO 54 YR.
TOTAL ADULTS 35 OR MORE YEARS__
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE__


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Bangladesh 2014
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INTERVIEWER VISITS

FIRST VISIT

DATE_______________
INTERVIEWER'S NAME_____________________
RESULT*________________

SECOND VISIT

DATE_______________
INTERVIEWER'S NAME_____________________
RESULT*________________

THIRD VISIT

DATE_______________
INTERVIEWER'S NAME_____________________
RESULT*________________

NEXT VISIT:

DATE_____________
TIME______________

FINAL VISIT

DAY __ __
MONTH __ __
YEAR __ __ __ __
INT. NO. __ __
RESULT*___

TOTAL NUMBER OF VISITS

TOTAL PERSONS IN HOUSEHOLD __ __
TOTAL ELIGIBLE WOMEN __ __
TOTAL ELIGIBLE MEN __ __
LINE NO. RESPONDENT TO HOUSEHOLD QUESTIONNAIRE __ __

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Benin 1996
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LINE NUMBER OF RESPONDENT FOR HOUSEHOLD QUESTIONNAIRE ____

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Benin 2001
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NAME AND LINE NUMBER OF RESPONDENT____

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Benin 2006
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LINE NUMBER OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE ________

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Benin 2011
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NAME AND NUMBER OF RESPONDENT_________

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Benin 2017
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INTERVIEWER VISITS

FIRST VISIT

DATE_______________
INTERVIEWER'S NAME_____________________
RESULT*________________

SECOND VISIT

DATE_______________
INTERVIEWER'S NAME_____________________
RESULT*________________

THIRD VISIT

DATE_______________
INTERVIEWER'S NAME_____________________
RESULT*________________

NEXT VISIT:

DATE_____________
TIME______________

FINAL VISIT

DAY __ __
MONTH __ __
YEAR __ __ __ __
INT. NO. __ __
RESULT*___

TOTAL NUMBER OF VISITS

TOTAL PERSONS IN HOUSEHOLD __ __
TOTAL ELIGIBLE WOMEN __ __
TOTAL ELIGIBLE MEN __ __
LINE NO. RESPONDENT TO HOUSEHOLD QUESTIONNAIRE __ __

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Burkina Faso 1993
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NAME OF PERSON INTERVIEWED ______

LINE NUMBER OF RESPONDENT FROM HOUSEHOLD QUESTIONNAIRE _____


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Burkina Faso 1998
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LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE _____

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Burkina Faso 2003
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LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE _____

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Burkina Faso 2010
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LINE NUMBER OF RESPONDENT TO HOUSEHOLD QUESTIONS_____

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Burundi 2010
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LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE_____

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Burundi 2016
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TOTAL PERSONS IN HOUSEHOLD
TOTAL ELIGIBLE WOMEN
TOTAL ELIGIBLE MEN
LINE NUMBER OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE

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Cameroon 1998
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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 (the number of persons listed by the respondent)

LINE NO. ___

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Cameroon 2004
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Now we would like some information about the people who usually live in your household or who are staying with you now.

1) LINE NO. (THE NUMBER OF PERSONS LISTEN BY THE RESPONDENT)

___

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Cameroon 2011
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TOTAL PERSONS IN HOUSEHOLD ____
TOTAL ELIGIBLE WOMEN ____
TOTAL ELIGIBLE MEN ____
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE ____

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Chad 1996
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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 (the number of persons listed by the respondent)

LINE NO. ___

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Chad 2004
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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 no.

________

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Chad 2014
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CHECK COVER OF HOUSEHOLD QUESTIONNAIRE: HOUSEHOLD WAS SELECTED FOR THE MEN'S SURVEY AND THE HIV TEST?

YES 1
NO 2

INTERVIEWER VISITS
1 2 3
DATE

INTERVIEWER'S NAME
RESULT*

FINAL VISIT
DAY__ __
MONTH__ __
YEAR 201__
INT. NUMBER
CODE RESULT

NEXT VISIT
DATE____
TIME____


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Congo (Democratic Republic) 2007
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TOTAL PERSONS IN HOUSEHOLD _____
TOTAL ELIGIBLE WOMEN _______
TOTAL ELIGIBLE MEN ________
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE __________

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Congo (Democratic Republic) 2013
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TOTAL PERSONS IN HOUSEHOLD ____

TOTAL ELIGIBLE WOMEN ____

TOTAL ELIGIBLE MEN ____

LINE NUMBER OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE ____


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Cote d'Ivoire 1998
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TOTAL PERSONS IN HOUSEHOLD: ___
TOTAL ELIGIBLE WOMEN: ___
TOTAL ELIGIBLE MEN: ___
LINE NUMBER OF RESPONDENT FOR HOUSEHOLD QUESTIONNAIRE: ___

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Cote d'Ivoire 2011
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TOTAL PERSONS IN HOUSEHOLD ____
TOTAL ELIGIBLE WOMEN ____
TOTAL ELIGIBLE MEN ____
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE ____

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Egypt 1992
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TOTAL IN HOUSEHOLD _____
TOTAL ELIGIBLE WOMEN _______
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE __________

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Egypt 1995
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TRANSLATOR USED

YES 1
NO 2

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Egypt 2000
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NEXT VISIT:
DATE_____
TIME______

FINAL VISIT
DAY___
MONTH_____
YEAR 2000
TEAM_____
INTERVIEWER______
SUPERVISOR______
RESULT______

TOTAL VISITS_____

TOTAL IN HOUSEHOLD______
TOTAL ELIGIBLE WOMEN______
LINE NO. OF RESPONDENT FROM HOUSEHOLD SCHEDULE_______

WOMAN/CHILD/ADOLESCENT REFERRED FOR SEVERE ANEMIA
ADDRESS CHECKED (BY NAME:______)
REINTERVIEW:

YES 1
NO 2

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Egypt 2003

No questionnaire text is available for this sample.


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Egypt 2005
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TOTAL PERSONS IN HOUSEHOLD __ __

TOTAL ELIGIBLE WOMEN __ __

LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE __ __


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Egypt 2008
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TOTAL PERSONS IN HOUSEHOLD __
TOTAL ELIGIBLE WOMEN __
TOTAL ELIGIBLE RESPONDENTS HEPATITIS C TESTING SUBSAMPLE __
LINE NO. RESPONDENT TO HOUSEHOLD QUESTIONNAIRE __

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Egypt 2014
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LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE____

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Ethiopia 2000
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TOTAL PERSONS IN HOUSEHOLD ___
TOTAL ELIGIBLE WOMEN ___
LINE NO. OF RESP. TO HOUSEHOLD QUEST. ___

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Ethiopia 2005
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TOTAL PERSONS IN HOUSEHOLD _____
TOTAL ELIGIBLE WOMEN _______
TOTAL ELIGIBLE MEN ________
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE __________

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Ethiopia 2011
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TOTAL PERSONS IN HOUSEHOLD ____
TOTAL ELIGIBLE WOMEN ____
TOTAL ELIGIBLE MEN ____
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE ____

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Ethiopia 2016
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TOTAL PERSONS IN HOUSEHOLD

TOTAL ELIGIBLE WOMEN

TOTAL ELIGIBLE MEN

LINE NUMBER OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE


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Ghana 1993
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LINE NO. OF RESP. TO HOUSEHOLD SCHEDULE ____

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Ghana 1998
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TOTAL IN HOUSEHOLD ____

TOTAL ELIGIBLE WOMEN ____

LINE NO. OF RESP. TO HOUSEHOLD SCHEDULE ____


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Ghana 2003
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LINE NO. OF RESP TO HH QUESTION

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Ghana 2008
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TOTAL PERSONS IN HOUSEHOLD _____
TOTAL ELIGIBLE WOMEN _______
TOTAL ELIGIBLE MEN ________
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE __________

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Ghana 2014
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TOTAL PERSONS IN HOUSEHOLD ____
TOTAL ELIGIBLE WOMEN ____
TOTAL ELIGIBLE MEN ____
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE ____

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Guinea 1999
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LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE _____

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Guinea 2005
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LINE NO. OF RESPONDENTS TO HOUSEHOLD QUESTIONNAIRE _____

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Guinea 2012
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TOTAL PERSONS IN HOUSEHOLD ____
TOTAL ELIGIBLE WOMEN ____
TOTAL ELIGIBLE MEN ____
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE ____

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Guinea 2018
Survey form view entire document:  text 
TOTAL NO. OF VISITS

TOTAL PERSONS IN HOUSEHOLD
TOTAL ELIGIBLE WOMEN
TOTAL ELIGIBLE MEN
TOTAL ELIGIBLE CHILDREN
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE


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India 1992
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TOTAL IN HOUSEHOLD ______
TOTAL ELIGIBLE WOMEN ______
LINE NO. OF RESPONDENT TO HOUSEHOLD SCHEDULE _____

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India 1998
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TOTAL PERSONS IN HOUSEHOLD ________
TOTAL ELIGIBLE WOMEN _______
LINE NO. OF RESPONDENT TO HOUSEHOLD SCHEDULE _____

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India 2005
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LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE _____

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India 2015
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TOTAL PERSONS IN HOUSEHOLD___
TOTAL ELIGIBLE WOMEN___
TOTAL ELIGIBLE MEN___
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE___

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Jordan 1997
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TOTAL IN HOUSEHOLD
TOTAL ELIGIBLE WOMEN
TOTAL NUMBER OF RESPONDENT TO HOUSEHOLD SCHEDULE

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Jordan 2002
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IDENTIFICATION

GROUP NO:__

QUESTIONNAIRE NO:___

GOVERNORATE:____

DISTRICT:____

SUBDISTRICT:____

LOCALITY:____

STRATUM:____

URBAN/RURAL:

URBAN 1
RURAL 2

BLOCK NO:_____

BUILDING NO:_____

HOUSING UNIT NO:_____

CLUSTER NO:_____

HOUSEHOLD NO:____

TELEPHONE NO (IF AVAILABLE):____________


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Jordan 2007
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LINE NUMBER OF RESPONDENT HOUSEHOLD QUESTIONNAIRE___

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Jordan 2009
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TOTAL PERSONS IN HOUSEHOLD ___
TOTAL ELIGIBLE WOMEN___
TOTAL ELIGIBLE MEN___
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONAIRE

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Jordan 2012
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TOTAL PERSONS IN HOUSEHOLD ____
TOTAL ELIGIBLE WOMEN ____
LINE NO. OF RESPONDENT HOUSEHOLD QUESTIONNAIRE ____

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Jordan 2017
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TOTAL PERSONS IN HOUSEHOLD ____
TOTAL ELIGIBLE WOMEN ____
TOTAL ELIGIBLE MEN ____
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE

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Kenya 1993
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LINE NO. OF RESP. TO HOUSEHOLD SCHEDULE __

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Kenya 1998
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LINE NO. OF RESP. TO HOUSEHOLD SCHEDULE __

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Kenya 2003
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TOTAL NUMBER OF VISITS____

TOTAL PERSONS IN HOUSEHOLD ___

TOTAL ELIGIBLE WOMEN ___

LINE NUMBER OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE___


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Kenya 2008
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TOTAL PERSONS IN HOUSEHOLD _____
TOTAL ELIGIBLE WOMEN _______
TOTAL ELIGIBLE MEN ________
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE __________

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Kenya 2014
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TOTAL PERSONS IN HOUSEHOLD ____
TOTAL ELIGIBLE WOMEN ____
TOTAL ELIGIBLE MEN ____
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE ____

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Lesotho 2004
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LINE NUMBER OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE _____

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Lesotho 2009
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LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE _____

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Lesotho 2014
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TOTAL PERSONS IN HOUSEHOLD___
TOTAL ELIGIBLE WOMEN___
TOTAL ELIGIBLE MEN___
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE____

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Liberia 2007
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HOUSEHOLD SCHEDULE

1) LINE NO.


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Liberia 2013
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1. LINE NUMBER

LINE NO. ____

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Madagascar 1992
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1) LINE NO.

_____

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Madagascar 1997
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TOTAL PERSONS IN HOUSEHOLD _____
TOTAL ELIGIBLE WOMEN _____
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE _____

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Madagascar 2003
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TOTAL PERSONS IN HOUSEHOLD _____
TOTAL ELIGIBLE WOMEN _____
TOTAL ELIGIBLE MEN _____
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE _____

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Madagascar 2008
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TOTAL PERSONS IN HOUSEHOLD _____
TOTAL ELIGIBLE WOMEN _______
TOTAL ELIGIBLE MEN ________
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE __________

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Malawi 1992
Survey form view entire document:  text 
NEXT VISIT:
DATE ___
TIME ___

FINAL VISIT
DAY ___
MONTH____
YEAR ____
NAME ___
RESULT___

TOTAL NUMBER OF VISITS ____

TOTAL IN HOUSEHOLD ___

TOTAL NUMBER-ELIGIBLE WOMEN ___

TOTAL NUMBER-ELIGIBLE MEN ___

LINE NUMBER OF HOUSEHOLD RESPONDENT ___

FIELD EDITED BY
NAME ____
DATE ____

OFFICE EDITED BY
NAME ____
DATE ____

KEYED BY
NAME ____
DATE ____

KEYED BY ___


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Malawi 2000
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TOTAL NUMBER OF VISITS____

TOTAL PERSONS IN HOUSEHOLD ___

TOTAL ELIGIBLE WOMEN ___

LINE NUMBER OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE___


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Malawi 2004
Survey form view entire document:  text 
INTERVIEWER VISITS:

FIRST VISIT (REPEAT FOR SECOND AND THIRD VISITS)
DATE___
INTERVIEWER NAME___
RESULTS

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) __________

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Malawi 2010
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TOTAL PERSONS IN HOUSEHOLD _____
TOTAL ELIGIBLE WOMEN _______
TOTAL ELIGIBLE MEN ________
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE __________

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Malawi 2016
Survey form view entire document:  text 
INTERVIEWER VISITS

FIRST VISIT

DATE_______________
INTERVIEWER'S NAME_____________________
RESULT*________________

SECOND VISIT

DATE_______________
INTERVIEWER'S NAME_____________________
RESULT*________________

THIRD VISIT

DATE_______________
INTERVIEWER'S NAME_____________________
RESULT*________________

NEXT VISIT:

DATE_____________
TIME______________

FINAL VISIT

DAY __ __
MONTH __ __
YEAR __ __ __ __
INT. NO. __ __
RESULT*___

TOTAL NUMBER OF VISITS

TOTAL PERSONS IN HOUSEHOLD __ __
TOTAL ELIGIBLE WOMEN __ __
TOTAL ELIGIBLE MEN __ __
LINE NO. RESPONDENT TO HOUSEHOLD QUESTIONNAIRE __ __

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Mali 1995
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RESPONDENT'S LINE NUMBER__

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Mali 2001
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RESPONDENT'S LINE NUMBER_____

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Mali 2006
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TOTAL PERSONS IN HOUSEHOLD _____
TOTAL ELIGIBLE WOMEN _______
TOTAL ELIGIBLE MEN ________
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE __________

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Mali 2012
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TOTAL PERSONS IN HOUSEHOLD___
TOTAL ELIGIBLE WOMEN___
TOTAL ELIGIBLE MEN___
LINE NO. OF RESP. TO HOUSEHOLD INTERVIEW___

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Mali 2018
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LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE

_______

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Morocco 1992
Survey form view entire document:  text 
INTERVIEWER VISITS:

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

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

NEXT VISIT: (FOR INTERVIEWERS 1 AND 2)
DATE
TIME

FINAL VISIT
DAY
MONTH
YEAR
INT. NUMBER
RESULT

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

TOTAL NUMBER OF VISITS

TOTAL PERSONS IN HOUSEHOLD___
TOTAL ELIGIBLE WOMEN___
TOTAL ELIGIBLE MEN___
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE

SUPERVISOR
NAME

FIELD EDITOR
NAME

OFFICE EDITOR

KEYED BY


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Morocco 2003
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TOTAL NUMBER OF VISITS____

TOTAL PERSONS IN HOUSEHOLD ___

TOTAL ELIGIBLE WOMEN ___

LINE NUMBER OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE___


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Mozambique 1997
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LINE NO. OF RESPONDENT______

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Mozambique 2003
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TOTAL IN HOUSEHOLD_____
TOTAL NUMBER OF WOMEN 15-49_____
TOTAL NUMBER OF MEN 15-64_____
LINE NUMBER OF RESPONDENT______

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Mozambique 2011
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LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE_________

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Myanmar 2015
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TOTAL PERSONS IN HOUSEHOLD _____
TOTAL ELIGIBLE WOMEN _____
TOTAL ELIGIBLE MEN _____
LINE NUMBER OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE _____

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Namibia 2000
Survey form view entire document:  text 
LINE NO. OF RESP. TO HOUSEHOLD QUEST. ____

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Namibia 2006
Survey form view entire document:  text 
TOTAL PERSONS IN HOUSEHOLD___
TOTAL WOMEN 15-49___
TOTAL MEN 15-49___
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE ___

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Namibia 2013
Survey form view entire document:  text 
TOTAL PERSONS IN HOUSEHOLD ____
TOTAL ELIGIBLE WOMEN ____
TOTAL ELIGIBLE MEN ____
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE ____

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Nepal 1996
Survey form view entire document:  text 
TOTAL IN HOUSEHOLD
TOTAL ELIGIBLE WOMEN
LINE NUMBER OF RESPONDENT IN HOUSEHOLD SCHEDULE

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Nepal 2001
Survey form view entire document:  text 
INTERVIEWER VISITS

FIRST VISIT (REPEAT FOR SECOND AND THIRD VISITS)

DAY __
MONTH __
YEAR ____

INTERVIEWER'S NAME __________
INT. CODE __

RESULT

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

TOTAL PERSONS IN HOUSEHOLD __

TOTAL WOMEN ELIGIBLE __

TOTAL ELIGIBLE MEN __

LINE NO. OF RESP. TO HOUSEHOLD QUEST.

SUPERVISOR

NAME ______
DATE _______

FIELD EDITOR

NAME _______
DATE ________

OFFICE EDITOR __

KEYED BY __


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Nepal 2006
Survey form view entire document:  text 
IDENTIFICATION

NAME AND CODE OF DISTRICT

WARD NUMBER

CLUSTER NUMBER

HOUSEHOLD NUMBER

CITY/TOWN RURAL

CITY 1
TOWN 2
RURAL 3

NAME OF HOUSEHOLD HEAD

NAME OF RESPONDENT

HOUSEHOLD SELECTED FOR MALE SURVEY

YES 1
NO 2

ALTITUDE


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Nepal 2011
Survey form view entire document:  text 
INTERVIEWER VISITS

VISIT 1

DATE __________
INTERVIEWER'S NAME _____________
RESULT ___________

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

NEXT VISIT:
DATE _________
TIME _________

VISIT 2

DATE __________
INTERVIEWER'S NAME _____________
RESULT ___________

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

NEXT VISIT:
DATE _________
TIME _________

VISIT 3

DATE __________
INTERVIEWER'S NAME _____________
RESULT ___________

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

NEXT VISIT:
DATE _________
TIME _________

FINAL VISIT

DAY ___________
MONTH __________
YEAR __________
INT. NUMBER __________
RESULT _________

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

TOTAL NUMBER OF VISITS __________

TOTAL PERSONS IN HOUSEHOLD _________

TOTAL ELIGIBLE WOMEN ________

TOTAL ELIGIBLE MEN ________

LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE ________

SUPERVISOR

NAME __________

DATE __________

OFFICE EDITOR __________

KEYED BY __________


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Nepal 2016
Survey form view entire document:  text 
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.
AFTER LISTING THE NAMES AND RECORDING THE RELATIONSHIP
AND SEX FOR EACH PERSON, ASK QUESTIONS 2A-2C
TO BE SURE THAT THE LISTING IS COMPLETE.
THEN ASK APPROPRIATE QUESTIONS IN COLUMNS 5-20 FOR EACH PERSON.

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Niger 1992
Survey form view entire document:  text 
NAME OF RESPONDENT ___
LINE NUMBER OF INTERVIEW FOR HOUSEHOLD QUESTIONNAIRE ___
STRATA NUMBER ___
CLUSTER NUMBER ___
STRUCTURE NUMBER ___
RESIDENCE NUMBER ___
CENSUS ZONE NUMBER ___

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Niger 1998
Survey form view entire document:  text 
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 (the number of persons listed by the respondent)

LINE NO. ___

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Niger 2006
Survey form view entire document:  text 
TOTAL PERSONS IN HOUSEHOLD ___

TOTAL ELIGIBLE WOMEN ___

TOTAL ELIGIBLE MEN ___

LINE NUMBER OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE ___


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Niger 2012
Survey form view entire document:  text 
1. LINE NUMBER

LINE NO. ____

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Nigeria 1999
Survey form view entire document:  text 
LINE NO. OF RESPONDENTS TO HOUSEHOLD SCHEDULE __

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Nigeria 2003
Survey form view entire document:  text 
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE __

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Nigeria 2008
Survey form view entire document:  text 
TOTAL PERSONS IN HOUSEHOLD _____
TOTAL ELIGIBLE WOMEN _______
TOTAL ELIGIBLE MEN ________
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE __________

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Nigeria 2013
Survey form view entire document:  text 
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE______

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Nigeria 2018
Survey form view entire document:  text 
NIGERIA NATIONAL POPULATION COMMISSION

IDENTIFICATION

STATE ____
LOCAL GOVT. AREA______
LOCALITY _____
ENUMERATION AREA_____
NAME OF HOUSEHOLD HEAD_____
CLUSTER NUMBER_____
HOUSEHOLD NUMBER_____

HOUSEHOLD SELECTED FOR MAN'S SURVEY?

YES 1
NO 2

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Pakistan 2006
Survey form view entire document:  text 
TOTAL PERSONS IN HOUSEHOLD __

DEATHS UNDER 5/SBs FROM Q. 38 __

FEMALE DEATHS AGE 12-49 FROM Q. 39 __

LINE NO. OF RESPONDENT __

LANGUAGE OF QUESTIONNAIRE: URDU


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Pakistan 2012
Survey form view entire document:  text 
TOTAL PERSONS IN HOUSEHOLD ____
TOTAL ELIGIBLE WOMEN ____
TOTAL ELIGIBLE MEN ____
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE ____

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Pakistan 2017
Survey form view entire document:  text 
INTERVIEWER VISITS

FIRST VISIT
DATE _______
INTERVIWER'S NAME _______
RESULT* ______

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

NEXT VISIT DATE _____
TIME ______

SECOND VISIT
DATE _______
INTERVIWER'S NAME _______
RESULT* ______

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

NEXT VISIT DATE _____
TIME ______

THIRD VISIT
DATE _______
INTERVIWER'S NAME _______
RESULT* ______

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

NEXT VISIT DATE _____
TIME ______

FINAL VISIT
DAY _____
MONTH ______
YEAR _____
INT. NO. _______
RESULT* _______

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

TOTAL NUMBER OF VISITS _________

TOTAL PERSONS IN HOUSEHOLD _____
TOTAL ELIGIBLE WOMEN ______
TOTAL ELIGIBLE MEN _______
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE _______


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Rwanda 2000
Survey form view entire document:  text 
LINE NUMBER OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE___

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Rwanda 2005
Survey form view entire document:  text 
TOTAL PERSONS IN HOUSEHOLD _____
TOTAL ELIGIBLE WOMEN _______
TOTAL ELIGIBLE MEN ________
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE __________

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Rwanda 2008
Survey form view entire document:  text 
TOTAL PERSONS IN HOUSEHOLD ______
TOTAL ELIGIBLE WOMEN _________
TOTAL ELIGIBLE MEN __________
LINE NO. OF RESP. TO HOUSEHOLD QUEST. ___________

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Rwanda 2010
Survey form view entire document:  text 
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE

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Rwanda 2014
Survey form view entire document:  text 
INTERVIEWER VISITS

FIRST VISIT

DATE_______________
INTERVIEWER'S NAME_____________________
RESULT*________________

SECOND VISIT

DATE_______________
INTERVIEWER'S NAME_____________________
RESULT*________________

THIRD VISIT

DATE_______________
INTERVIEWER'S NAME_____________________
RESULT*________________

NEXT VISIT:

DATE_____________
TIME______________

FINAL VISIT

DAY __ __
MONTH __ __
YEAR __ __ __ __
INT. NO. __ __
RESULT*___

TOTAL NUMBER OF VISITS

TOTAL PERSONS IN HOUSEHOLD __ __
TOTAL ELIGIBLE WOMEN __ __
TOTAL ELIGIBLE MEN __ __
LINE NO. RESPONDENT TO HOUSEHOLD QUESTIONNAIRE __ __

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Senegal 1992
Survey form view entire document:  text 
NAME/LINE NUMBER OF RESPONDENT ON THE HOUSEHOLD SHEET:

______

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Senegal 1997
Survey form view entire document:  text 
NAME/LINE NUMBER OF RESPONDENT ON THE HOUSEHOLD SHEET _____

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Senegal 2005
Survey form view entire document:  text 
RESPONDENT'S LINE NUMBER FOR THE HOUSEHOLD QUESTIONNAIRE_____

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Senegal 2010
Survey form view entire document:  text 
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE _____

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Senegal 2012
Survey form view entire document:  text 
LINE NO. OF RESPONDENT TO HOUSEHOLD QUEST____

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Senegal 2014
Survey form view entire document:  text 
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE________

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Senegal 2015
Survey form view entire document:  text 
TOTAL PERSONS IN HOUSEHOLD _____
TOTAL ELIGIBLE WOMEN _____
TOTAL ELIGIBLE MEN ______
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE _________

SUPERVISOR _____

NAME ______
DATE ______

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Senegal 2016
Survey form view entire document:  text 
TOTAL PERSONS IN HOUSEHOLD ____
TOTAL ELIGIBLE WOMEN ___
TOTAL ELIGIBLE MEN ___
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE ___

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Senegal 2017
Survey form view entire document:  text 
TOTAL PERSONS IN HOUSEHOLD ____
TOTAL ELIGIBLE WOMEN ___
TOTAL ELIGIBLE MEN ___
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE ___

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South Africa 1998
Survey form view entire document:  text 
INTERVIEWER VISITS
FIRST VISIT
DATE
INTERVIEWER'S NAME
RESULT*

SECOND VISIT
DATE
INTERVIEWER'S NAME
RESULT*

THIRD VISIT
DATE
INTERVIEWER'S NAME
RESULT*

NEXT VISIT
DATE
TIME

FINAL VISIT
DAY
MONTH
YEAR
NAME RESULT

TOTAL NO. OF VISITS

TOTAL IN HOUSEHOLD
TOTAL ADULTS 15 YEARS AND OVER
TOTAL WOMEN 15-49 YEARS
LINE NO. OF RESP. TO HOUSEHOLD SCHEDULE


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South Africa 2016
Survey form view entire document:  text 
LINE NUMBER OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE ____

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Tanzania 1996
Survey form view entire document:  text 
LINE NO. OF RESP. TO HOUSEHOLD __

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Tanzania 1999
Survey form view entire document:  text 
LINE NO. OF RESP. TO HOUSEHOLD SCHEDULE ___

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Tanzania 2004
Survey form view entire document:  text 
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE

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Tanzania 2010
Survey form view entire document:  text 
TOTAL PERSONS IN HOUSEHOLD

TOTAL ELIGIBLE WOMEN 15-49

TOTAL ELIGIBLE MEN 15-49

LINE NUMBER OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE


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Tanzania 2015
Survey form view entire document:  text 
INTERVIEWER VISITS

FIRST VISIT

DATE_______________
INTERVIEWER'S NAME_____________________
RESULT*________________

SECOND VISIT

DATE_______________
INTERVIEWER'S NAME_____________________
RESULT*________________

THIRD VISIT

DATE_______________
INTERVIEWER'S NAME_____________________
RESULT*________________

NEXT VISIT:

DATE_____________
TIME______________

FINAL VISIT

DAY __ __
MONTH __ __
YEAR __ __ __ __
INT. NO. __ __
RESULT*___

TOTAL NUMBER OF VISITS

TOTAL PERSONS IN HOUSEHOLD __ __
TOTAL ELIGIBLE WOMEN __ __
TOTAL ELIGIBLE MEN __ __
LINE NO. RESPONDENT TO HOUSEHOLD QUESTIONNAIRE __ __

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Uganda 1995
Survey form view entire document:  text 
TOTAL IN HOUSEHOLD

TOTAL WOMEN 15 - 49

MEN 15 - 54

LINE NUMBER OF REPONDENT OF HOUSEHOLD SCHEDULE

LANGUAGE OF QUESTIONNAIRE: ENGLISH


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Uganda 2001
Survey form view entire document:  text 
FINAL VISIT

DAY __________
MONTH __________
YEAR _____
NAME __________
RESULT __________

TOTAL NUMBER OF VISITS ___
TOTAL PERSONS IN HOUSEHOLD ___
TOTAL ELIGIBLE WOMEN ___
TOTAL ELIGIBLE MEN ___
LINE NUMBER OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE ___

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Uganda 2006
Survey form view entire document:  text 
TOTAL PERSONS IN HOUSEHOLD _____
TOTAL ELIGIBLE WOMEN _______
TOTAL ELIGIBLE MEN ________
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE __________

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Uganda 2011
Survey form view entire document:  text 
TOTAL PERSONS IN HOUSEHOLD ____
TOTAL ELIGIBLE WOMEN ____
TOTAL ELIGIBLE MEN ____
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE ____

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Uganda 2016
Survey form view entire document:  text 
TOTAL PERSONS IN HOUSEHOLD ___
TOTAL ELIGIBLE WOMEN ___
TOTAL ELIGIBLE MEN ___
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE ___

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Yemen 2013
Survey form view entire document:  text 
TOTAL PERSONS IN HOUSEHOLD____
TOTAL ELIGIBLE EVER MARRIED WOMEN IN AGE 15-49____
TOTAL ELIGIBLE NEVER MARRIED WOMEN IN AGE 15-49____
TOTAL CHILDREN 0-5____
LINE NUMBER OF RESPONDENT IN HH____

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Zambia 1992
Survey form view entire document:  text 
LINE NO. OF RESP. TO HOUSEHOLD SCHEDULE __

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Zambia 1996
Survey form view entire document:  text 
LINE NUMBER OF RESP. TO HOUSEHOLD SCHEDULE _

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Zambia 2001
Survey form view entire document:  text 
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTION __

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Zambia 2007
Survey form view entire document:  text 
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE __

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Zambia 2013
Survey form view entire document:  text 
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE________

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Zambia 2018
Survey form view entire document:  text 
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE _____

LANGUAGE OF QUESTIONNAIRE: ENGLISH 01

01 ENGLISH
02 BEMBA
03 KAONDE
04 LOZI
05 LUNDA
06 LUVALE
07 NYANJA
08 TONGA

LANGUAGE OF INTERVIEW**:

01 ENGLISH
02 BEMBA
03 KAONDE
04 LOZI
05 LUNDA
06 LUVALE
07 NYANJA
08 TONGA

NATIVE LANGUAGE OF RESPONDENT**:

01 ENGLISH
02 BEMBA
03 KAONDE
04 LOZI
05 LUNDA
06 LUVALE
07 NYANJA
08 TONGA

TRANSLATOR USED

YES = 1
NO = 2

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Zimbabwe 1994
Survey form view entire document:  text 
LINE NUMBER OF HOUSEHOLD RESPONDENT ___

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Zimbabwe 1999
Survey form view entire document:  text 
TOTAL NUMBER OF VISITS____

TOTAL PERSONS IN HOUSEHOLD ___

TOTAL ELIGIBLE WOMEN ___

LINE NUMBER OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE___


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Zimbabwe 2005
Survey form view entire document:  text 
TOTAL PERSONS IN HOUSEHOLD _____
TOTAL ELIGIBLE WOMEN _______
TOTAL ELIGIBLE MEN ________
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE __________

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Zimbabwe 2010
Survey form view entire document:  text 
TOTAL PERSONS IN HOUSEHOLD ____
TOTAL ELIGIBLE WOMEN ____
TOTAL ELIGIBLE MEN ____
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE ____

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Zimbabwe 2015
Survey form view entire document:  text 
INTERVIEWER VISITS

FIRST VISIT

DATE_______________
INTERVIEWER'S NAME_____________________
RESULT*________________

SECOND VISIT

DATE_______________
INTERVIEWER'S NAME_____________________
RESULT*________________

THIRD VISIT

DATE_______________
INTERVIEWER'S NAME_____________________
RESULT*________________

NEXT VISIT:

DATE_____________
TIME______________

FINAL VISIT

DAY __ __
MONTH __ __
YEAR __ __ __ __
INT. NO. __ __
RESULT*___

TOTAL NUMBER OF VISITS

TOTAL PERSONS IN HOUSEHOLD __ __
TOTAL ELIGIBLE WOMEN __ __
TOTAL ELIGIBLE MEN __ __
LINE NO. RESPONDENT TO HOUSEHOLD QUESTIONNAIRE __ __