7.1 7.2
7.3 7.4
7.5 7.6
7.7 7.8
7.9 7.10
7.11 7.12
7.13 7.14
7.15
ID CODE
10 11
12 13
14 15
16 17
18
Does this member have
difficulty seeing,
even if wearing
glasses? When did
this problem
begin? What was
the cause?
Does this member
have difficulty
hearing, even if
using a hearing
aid? When did
this problem
begin? What
was the
cause ? SEE
7.3 Does this
member have
difficulty walking or
climbing steps?
When did this
problem begin?
What was
the cause
? SEE 7.3
Does this member have
difficulty with
self-care such as
washing all over or
dressing? When did
this problem
begin? What
was the
cause? SEE
7.3 Does this
member have difficulty
remembering or
concentrating ?
When did this
problem begin?
What was
the cause
? SEE 7.3
SECTION 7: DISABILITIES
The next questions ask about difficulties you may have doing certain activities because of a HEALTH PROBLEM
1 2 3 4 1 2 3 4 5
1 2 3 4 1 2 3 4 5
1 2 3 4 5 1 2 3 4 5
1 2 3 4 5 1 2 3 4 5
1 2 3 4 5 1 2 3 4 5
8.1 8.2
8.3
8.4
SECTION 8: SOURCES OF HOUSEHOLD INCOME
Income source,
in order of
importa nce:
What are your households
income generating activities in
order of importance?
enter income activity codes
from table at right
For this activity,
please estimate the
proportion that it gives
to the households
total income? In which seasons does your
household receive this income?
Spring Summer
Fall Winter
All Seasons
For the main source of income the highest number in 8.2, what is the annual income?
Annual income Afs per
1 2
1 2
3 4
5 6
7 8
9 10
1 2 3 4 5 6 7 8 9 10 11 1
2 1
2 3
4 5
6 7
8 9
10 1 2 3 4 5 6 7 8 9 10 11
1 2
1 2
3 4
5 6
7 8
9 10
1 2 3 4 5 6 7 8 9 10 11 1
2 1
2 3
4 5
6 7
8 9
10 1 2 3 4 5 6 7 8 9 10 11
1 2
1 2
3 4
5 6
7 8
9 10
1 2 3 4 5 6 7 8 9 10 11 1
2 1
2 3
4 5
6 7
8 9
10 1 2 3 4 5 6 7 8 9 10 11
1 2
1 2
3 4
5 6
7 8
9 10
1 2 3 4 5 6 7 8 9 10 11 1
2 1
2 3
4 5
6 7
8 9
10 1 2 3 4 5 6 7 8 9 10 11
1 2
1 2
3 4
5 6
7 8
9 10
1 2 3 4 5 6 7 8 9 10 11 1
2 1
2 3
4 5
6 7
8 9
10 1 2 3 4 5 6 7 8 9 10 11
9.1 9.2
9.3 9.4
9.5 9.6
9.7
SECTION 9A: LABOUR FOR MEMBERS 6-15 YEARS OF AGE
List the members in the household who
are 6-15 years of age and put their ID
CODE from Roster, Question 1.1. If
there are more than 10 members of the
household from 6-15 years, list
begiining from the eldest.
Did this child do any
work for pay during the
past week, or did the child
help with a family
business or handicrafts
or assist with
agriculture or livestock
or collect things in the
street for household
use? What kind of work was this?
Where was this work mainly carried out?
In the past 7
days how
many days
did heshe
work? In the
past 7 days on
average how many
hours per day did
heshe work ?
In the past 7 days how
many hours in totaldid
heshe work on household
chores, or tending
children, cooking,
fetching water or
other household
chores?
NEXT MEMBER 6-15
NAME ID CODE
1 2
1 2
1 2
1 2
1 2
1 2 3 4 5 6 7 8 9 10 11 12 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1 2 3 4 5 6 7 8 9 10 11 12
1 2
1 2
1 2
1 2
1 2
1 2
1 2
1 2 3 4 5 6 7 8 9 10 11 12 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1 2 3 4 5 6 7 8 9 10 11 12
1 2
1 2
1 2
1 2
1 2
1 2
1 2
1 2 3 4 5 6 7 8 9 10 11 12 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1 2 3 4 5 6 7 8 9 10 11 12
1 2
1 2
1 2
1 2
1 2
1 2
1 2
1 2 3 4 5 6 7 8 9 10 11 12 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1 2 3 4 5 6 7 8 9 10 11 12
1 2
1 2
1 2
1 2
1 2
1 2
1 2
1 2 3 4 5 6 7 8 9 10 11 12 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1 2 3 4 5 6 7 8 9 10 11 12
1 2
1 2
9.8 9.9