1998 SSN98 educ ques ssn98 mpp
1
Attachment 3
VSEN98.MPP
SUSENAS
REPUBLIC OF INDONESIA
CENTRAL BUREAU OF STATISTICS
1998. NATIONAL SOCIO ECONOMIC SURVEY
LISTING OF EDUCATION, HOUSING AND SETTLEMENT
Confidential
IDENTIFICATION
1
2
3
4
5
6
7
8
9
10
11.
Province
Regency/Municipality *)
District
Village/ Kelurahan *)
Area
Enumeration area number
Segment group number
Segment number
Sample code number
Serial number of Sample household
Village classification
01
II. HOUSEHOLD CHARACTERISTICS
03
Number of household members aged 3 – 7 years
The name of household head
and participated in Kindergarten School
02
Number of household members
Urban
04
1
Rural
2
Least developed village
Developed village
1
2
Fill in by
Editor
Number of household member aged 5-39 years
and in schooling
III. ENUMERATING CHARACTERISTICS
Name and NIP/NMS of enumerator
05
Name and NIP/NMS of supervisor
06
Position of supervisor
Position of enumerator:
Staff of KS province 1 Mantis
Staff of KS province 1 Mantis
3
Staff of KS regency 2 Partner
Staff of KS regency 2 Partner
4
03
Date of enumeration
07
Date of supervision
04
Signature of enumerator
08
Signature of supervisor
*) Cross out inapplicable category
01
02
3
4
2
3
Serial
number
(1)
01
02
03
04
05
06
07
08
09
10
Name of
Household
Members
(write
down who
usually stay
and eating
in this
household;
adult,
children, or
baby)
(2)
IV. HOUSEHOLD MEMBERS CHARACTERISTICS
Relation
Sex:
Age
Only for
Only for
M
1
(year) household household
to the
F
2
head of
members
members
household
aged 3-7
aged 3-7
years
years
(3)
(4)
Code of column 3:
Relation to the head of household
The head of household 1 Parent/In-law
Wife/husband
2 Other relative
Children
3 House maid
Son/daughter in-law
4 Others
Grandchildren
5
(5)
6
7
8
9
Participa
ted in
Kindergar
ten school
/BA/RA
(code)
(6)
Mother tongue
Code
(Filled
In by
Editor)
Participa
ted in
Kindergar
ten school
(code)
(7)
Code of column 6:
Kindergarten school
Participated
Yes
No
(8)
1
2
(9)
Code of column 7:
School participated
In schooling
No schooling
BA= Bustanul Athfal
RA= Raidatul Athfal
The objection of question Mother Tongue, is to see the variation of culture/ethnic which linked to
variety of other population characteristics
Description:
Mother Tongue is the second language of respondent’s parent. In certain condition, respondent’s
language could be difference with his/her parent’s language. Foe example; when respondent was a young
that he/she doesn’t lived with her/his parent.
4
5
V. EDUCATION AND THE ACTIVITY OF HOUSEHOLD
MEMBERS AGED 5 – 39 YEARS
Name: ………………………..Serial number:
1. School participation: (Check Core Block V Q.14)
No schooling
1 (skip to Q. 5.a)
In school
2
Drop put
3
2. Educational record: (if Q.1 = 2, filling in 00 code on k.3)
Level of
Educ. 1 Year of Year of Did not
education
Dept.
start
finished pass a
Relig. 2 school school grade.
Dept.
Yes 1
Other 3
No 2
a. Pre school
(k.1)
(k.2)
(k.3)
(k.4)
Kindergarten
b. Primary school
c. Junior school
d. Senior high
e. University
3. If Q. 1 = 3, is the last education level completed?
Yes
1 (skip to Q.5.c) No 2 (skip to Q.5.b)
4. If Q. 1 = 2, do you want to continue your education to
high level?
Yes, to public
1
( to Q.6a) No 3 (to Q.5.c)
Yes, to vocational 2
5. a. Why haven’t you gone to school?
b. Why did you drop out?
c. Why don’t you continue to higher level?
a
b
c
1. Due to the age
2. Unintelligent/Refused/Unqualified
3. Work as a family worker
4. Work as non a family worker
5. Funding problem
6. Satisfied with current education
7. Dislike/Unmotivated/shy
8. Distance (too far)
9. Get Married
10. Sick/disability
11. On leave or applying to higher
Education
12. Help housework’s
6. a Courses participation
Has been attended
1
Ongoing
2
No 3 (go to Q.8.a)
6. b Type of course has been/being attending:
Yes
1
No
0
Has
On
Has
On
Been going
been going
Language
House-life
Computer
Services
Technique
Specific
Offices
Others
7. Average expenses per monthly for all types of
current courses. Rp. …………. (000 Rp)
8. In the morning, what usually eat and drink?
Rice/Noodle/Bread/ 1 Fruits
8
Cassava
Other
16
Egg/side dishes
2 None
00
Milk
3
9. If Q. 1 = 2 and Q. 2.b k3 = 00, do they have
supplement food (PMTAS) at school of week
ago?
Yes, how many times (in a week) ………
No
0
SPESIFIC FOR CHILDREN AGED 5–9 YEARS
10.a. Did you do an activity during previous week
as mention follows:
1. Working for living
2. In School
3. Housekeeper
4. Seeking a job
5. Others
b. From Q.10.a. activity of 1 to 5 coded 1,
which activity the most took your time
during previous week?
1 (skip to Q.13.a) 2 3 4
5
11. Did you working for living at least 1 hour
during previous week
(if Q.10.a = 1, circle code 1)
Yes 1 (skip to Q. 13.a) No 2
12. Did you have a job/business, but not working
temporary during previous week?
Yes
1
No
2 (skip to B.VI)
13.a. Number of work hours: ……………days
b. Number of work hours of daily total worked
during previous week:
Mon Tue Wen Thur Fri Sat Sun Total
….. … ….. ….. … … ….. hours
14. Type of main work during previous week:
(Write down completely)
Filled in
……………………………….
By editor
15. Main business field (work) during previous
week:
Agriculture
1
Services
4
Industry
2
Others
5
Trade
3
16. Status of main work during previous week:
Self-employed
Family worker
1
2
Workers
3
6
7
VI. EDUCATION EXPENSES OF HOUSEHOLD MEMBERS AGED 5 – 39 YEARS
(WHO ARE IN SCHOOLING)
Name:
Serial number:
9.a. Place of study outside school hours
Inside the house 1
Outside the house 2
1. Registered and active in the school:
b. Average duration study of outside school hours
Primary School
01 ‘Aliyah’
08
of daily in a week: ………. hours
‘Ibtidayah’
02 Vocational senior 09
10.Availability of compulsory book in current
A Packet
03 high school
quarter:
Vocational/
04 Diploma I/II
10
Have
1
Not have
2
Junior high school/
Dipl. III/bachelor 11
a. PMP
d. Science g. Physics
‘Tsanawiyah’
05 Dipl. IV/under grad 12
b. Indonesia
e. Social
h. Chemistry
B Packet
06 Master
13
Language
f. English
i. Biology
Senior high school 07 PhD
14
c. Mathematics language
(If Q.1 = 01 to 06, skip to Q.3)
2. If Q. 1 = 07 to 14, subject of education:
Household Members Education Expenses
……………………………………
During
Type of expenditure
The last
3. a. The nearest distance usually passed from
July-Dec.
Month
house to school ………….. km
(000 Rp)
(Rp)
b. Duration of the trip ………..minute
4. Transportation facility for going to school
(1)
(2)
(3)
Motor vehicle possessed by household
1
11.Registration (enroll
Non-motor vehicle possessed by household 2
ment fee/tuition, reMotor vehicle of public transportation
3
entry fee)
Non motor vehicle of public transportation 4
12.Contributions
Other people’s vehicle (free)
5
a. School fee
Walking
6
b. P.T.A
5. Responsible for living & eating expenses:
c. Lab./Art
Parent
1 Other person
4
d. Others
Brother/sister of
2 Individually
5
13.Evaluation/
Same mother/father
Government
6
examination
Relative
3 Foundation/Inst.
7
14.Supporting material of
6. Responsible for school expenses:
subject study
Parent
1 Other person
4
15. School /sport uniform
Brother/sister of
2 Individually
5
16. Books, stationers, and
Same mother/father
Government
6
school supply (a+b)
Relative
3 Foundation/Inst.
7
a. Text book
Question 7 to 10, Only for Primary School, Junior
b. Stationary, etc
High School and Senior High School
17. Transportation
7.a. Did you have tutorial (study outside of school
(including pick-up and
hours) during the last quarter?
dropped expenses
Yes 1
No
2 (skip to Q. 10)
b. Did you study in a group?
18. Courses which relation
Yes 1
No
2
to the school/study
c. Did you study accompany by a Tutor?
Yes 1
No
2 (skip to Q. 9.a)
8. a. If Q.7 c. = 1, who tutored you?
19. Others
Household members 1 Relative
3
TOTAL
School friend
2 Other people
4
(11
+
12
+
13
+
14
+
15
+ 16 + 17 + 18 + 19)
b. Did you pay the Tutor:
Yes
1
No
2
8
9
VII. HOUSING AND SETTLEMENT
A. PHYSICAL CONSTRUCTION
9. Legal Status of land:
Property right
1
1.a. Type of physical construction:
Right to build
2
Single, not storied
1
Right to use
3
Single, storied
2
Duplex, not storied
3
10 Age of construction:
Duplex, storied
4
0 - 4 years
1
Multiplex, not storied
5
5 - 9 years
2
Multiplex, storied
6
10-14 years
3
b. If the construction storied (Q.1.a = 2, 4, 6),
type of building
Two storied regular house
1
House shop/house office
2
Apartment/flat
3
2. Land area: ……………..m2
3. Type of main foundation
Concrete
1
Wood/bamboo 4
Coral
2
Others
5
Brick
3
4. Main material of pillars/columns:
Concrete
1
Bamboo
4
Brick
2
Others
5
Wood
3
5. Type of main roof frame:
Concrete
1
Bamboo
3
Wood
2
Others
4
6. Building condition
Good
1
Damaged
3
Mediocre
2
Severely damaged 4
DWELLING OWNERSHIP
7. a. Dwelling ownership status:
Own property
1
Official house 5
Lease
2
Rent free
6
Rent
3
Other
7
Rent purchase
4
(If Q.7.a # 1, skip directly to Q. 11)
b If the dwelling is your own (Q.7.a = 1), how did
you come into possession?
Build on own account
1
Purchased from developer
2
(Perumnas, Real-estate, etc)
Purchased first hand from individual
3
Purchased second hand
4
Administrative allocation
5
(official house, etc)
Others(inheritance, gift, etc)
6
8. How did the land come into possession?
Purchase
1
Squatter
4
Inheritance
2
Other
5
Lease
3
Others
Don’t know
4
5
³ 15 years
Don’t know
5
C. UTILITY/EQUIPMENT’S
11. a. Number of rooms:
rooms
(If Q. 11.a = 01, directly go to Q 13.a)
b. Utilization of rooms/space
Private 1 Shared
2
None
4
3
1. Bed room
Dining room
2. Living room
Family room
12.a. IF having separate bed room (R.11.b.1 = 1),
number of bedrooms, ………..rooms
b. Number of bed rooms has:
1. Window
rooms
2. Ventilation
rooms
3. Air condition
rooms
4. Exhaust fan
rooms
13.a. Was the drinking water is clear, colorless,
odorless, tasteless, no bubbles?
Yes
1
No
2
b. Distance to the place to get drinking water:
In the yard
1
Outside the yard:
£9m
2
100-499 m
5
10-49 m
3
³ 500 m
6
50-99 m
4
14.a. Source of bathing water:
Pipe
1
Protected spring
Pump
2
Unprotected spring
Protected well 3
River
Unprotected 4
Rain water
Well
Other
b. Bathing facility:
Private
1
Shared
2
Public
None
5
6
7
8
9
3
4
10
11
15.a. Do you subscriber PLN electricity?
Yes
1
No
2 (skip to Q.16.a)
b. If Yes (Q.15.a = 1), how much the capacity?
450 w
1
3200 w
4
900 w
2
> 2200 w
5
1300 w
3
16.a. Do you have kitchen?
Yes
1
No
2 (skip to Q.18)
b. If Yes (Q.16.a = 1), where is the location?
Separate room
1
Together with other rooms
2
Outside of the building
3
17.a.Gasoline material for cooking:
Electricity
1
Firewood
4
Gas/LPG
2
Charcoal/coal 5
Kerosene
3
Others
6
18. Goods possessed by this household:
(Filling in 1 code if yes, 0 code if Not)
a. Buffet/long cupboard
f. Refrigerator
b. Stove
g. Telephone
c. Bicycle/boat
h. motorcycle/
d. Radio/tape
motorboat
e. TV
i. Car/motor ship
19. Did this household used: (during previous
month):
a. Air freshener
f. Cloth stain remover
b. Hair spray/
g. Shoe polish
deodorant spray
h. Car battery
c. Liquid disinfectant
i. Iron/wood/ wall
d. Floor cleaner
paint
e. Window/car/wood
j. Insecticide
cleaner
D. ENVIRONMENT CONDITION
20. House/dwelling location:
Side of road/alley/corridor
1
Other
2
(If Q. 20 = 2, directly to Q.24)
21. If the house is in the side of alley/corridor
(q.20=1) the wide of road/lane/isle: …………m
22. Type of pavement:
Asphalt
1 Wood/bamboo
4
Cement
2 Dirt/sand
5
Gravel/hardened 3 Other
6
23. Road/alley/corridor conditions:
Good
1
Damaged
3
Mediocre
2
Several damaged 4
24. Do you have a yard?
Yes
1
No
2 (skip to Q.26.a)
25. a. If Yes (Q.24=1), do you have a plants?
Yes
1
No
2 (skip to Q.26.a)
26.
27.
28.
29.
30.
b. If Yes (Q. 25.a.=1), What kind of plants?
Vegetables
1
Traditional
8
Fruits
2
herbs plants
Ornamental
3
Others
16
plants
a. Do you raise livestock/poultry?
Yes
1
No
2 (skip to Q.27)
b. Place of raising livestock/poultry:
Inside the house 1 In the yard
3
Under the house 2 In other place
4
No cage
5
Where do you dispose your bath, kitchen, and
wash wastewater?
Covered hole in yard
1
Uncovered hole in yard
2
In yard without the hole
3
Outside yard
4
How do you dispose your bath, kitchen, and
wash wastewater?
Through covered channel
1
Through uncovered channel
2
Without channel
3
What is the gutter condition around the house?
Water is stuck
1
Fast
3
Water flows very 2
No gutter
4
slowly
How do you dispose your trash?
Carried away by 1
Thrown into river 5
Workers
Thrown anywhere 6
Dumped
2
Other
7
Turned into
3
fertilizer
Burned
4
31. Does any of the household member feel
offended by:
a. Factory smoke/odor/noise
b. Garage smoke/odor/noise
c. Continues sound of neighbor
d. Noise of motor vehicle
e. Unpleasant garbage or water odor
12
13
32. Access to housing and settlement facility
Type facility
Distance from home
(Km)
(1)
a. Public road
b. Public transportation
c. Hospital
d. Puskesmas
e. Market/shopping area
f. Bank
g. Post office
h. Worship place
i. Cinema/amusement/recreation park
j. Police station
k. Fire extinguisher station
l. Public hydrant/Fire hydrant
m. Public telephone
n. Primary School
o. Junior High School
p. Senior High School
q. Public cemetery
(2)
Transportation used:
Motor vehicle
1
Non motor vehicle 2
Walking
3
(3)
Time spent
(minute
(4)
VIII. N O T E
14
Attachment 3
VSEN98.MPP
SUSENAS
REPUBLIC OF INDONESIA
CENTRAL BUREAU OF STATISTICS
1998. NATIONAL SOCIO ECONOMIC SURVEY
LISTING OF EDUCATION, HOUSING AND SETTLEMENT
Confidential
IDENTIFICATION
1
2
3
4
5
6
7
8
9
10
11.
Province
Regency/Municipality *)
District
Village/ Kelurahan *)
Area
Enumeration area number
Segment group number
Segment number
Sample code number
Serial number of Sample household
Village classification
01
II. HOUSEHOLD CHARACTERISTICS
03
Number of household members aged 3 – 7 years
The name of household head
and participated in Kindergarten School
02
Number of household members
Urban
04
1
Rural
2
Least developed village
Developed village
1
2
Fill in by
Editor
Number of household member aged 5-39 years
and in schooling
III. ENUMERATING CHARACTERISTICS
Name and NIP/NMS of enumerator
05
Name and NIP/NMS of supervisor
06
Position of supervisor
Position of enumerator:
Staff of KS province 1 Mantis
Staff of KS province 1 Mantis
3
Staff of KS regency 2 Partner
Staff of KS regency 2 Partner
4
03
Date of enumeration
07
Date of supervision
04
Signature of enumerator
08
Signature of supervisor
*) Cross out inapplicable category
01
02
3
4
2
3
Serial
number
(1)
01
02
03
04
05
06
07
08
09
10
Name of
Household
Members
(write
down who
usually stay
and eating
in this
household;
adult,
children, or
baby)
(2)
IV. HOUSEHOLD MEMBERS CHARACTERISTICS
Relation
Sex:
Age
Only for
Only for
M
1
(year) household household
to the
F
2
head of
members
members
household
aged 3-7
aged 3-7
years
years
(3)
(4)
Code of column 3:
Relation to the head of household
The head of household 1 Parent/In-law
Wife/husband
2 Other relative
Children
3 House maid
Son/daughter in-law
4 Others
Grandchildren
5
(5)
6
7
8
9
Participa
ted in
Kindergar
ten school
/BA/RA
(code)
(6)
Mother tongue
Code
(Filled
In by
Editor)
Participa
ted in
Kindergar
ten school
(code)
(7)
Code of column 6:
Kindergarten school
Participated
Yes
No
(8)
1
2
(9)
Code of column 7:
School participated
In schooling
No schooling
BA= Bustanul Athfal
RA= Raidatul Athfal
The objection of question Mother Tongue, is to see the variation of culture/ethnic which linked to
variety of other population characteristics
Description:
Mother Tongue is the second language of respondent’s parent. In certain condition, respondent’s
language could be difference with his/her parent’s language. Foe example; when respondent was a young
that he/she doesn’t lived with her/his parent.
4
5
V. EDUCATION AND THE ACTIVITY OF HOUSEHOLD
MEMBERS AGED 5 – 39 YEARS
Name: ………………………..Serial number:
1. School participation: (Check Core Block V Q.14)
No schooling
1 (skip to Q. 5.a)
In school
2
Drop put
3
2. Educational record: (if Q.1 = 2, filling in 00 code on k.3)
Level of
Educ. 1 Year of Year of Did not
education
Dept.
start
finished pass a
Relig. 2 school school grade.
Dept.
Yes 1
Other 3
No 2
a. Pre school
(k.1)
(k.2)
(k.3)
(k.4)
Kindergarten
b. Primary school
c. Junior school
d. Senior high
e. University
3. If Q. 1 = 3, is the last education level completed?
Yes
1 (skip to Q.5.c) No 2 (skip to Q.5.b)
4. If Q. 1 = 2, do you want to continue your education to
high level?
Yes, to public
1
( to Q.6a) No 3 (to Q.5.c)
Yes, to vocational 2
5. a. Why haven’t you gone to school?
b. Why did you drop out?
c. Why don’t you continue to higher level?
a
b
c
1. Due to the age
2. Unintelligent/Refused/Unqualified
3. Work as a family worker
4. Work as non a family worker
5. Funding problem
6. Satisfied with current education
7. Dislike/Unmotivated/shy
8. Distance (too far)
9. Get Married
10. Sick/disability
11. On leave or applying to higher
Education
12. Help housework’s
6. a Courses participation
Has been attended
1
Ongoing
2
No 3 (go to Q.8.a)
6. b Type of course has been/being attending:
Yes
1
No
0
Has
On
Has
On
Been going
been going
Language
House-life
Computer
Services
Technique
Specific
Offices
Others
7. Average expenses per monthly for all types of
current courses. Rp. …………. (000 Rp)
8. In the morning, what usually eat and drink?
Rice/Noodle/Bread/ 1 Fruits
8
Cassava
Other
16
Egg/side dishes
2 None
00
Milk
3
9. If Q. 1 = 2 and Q. 2.b k3 = 00, do they have
supplement food (PMTAS) at school of week
ago?
Yes, how many times (in a week) ………
No
0
SPESIFIC FOR CHILDREN AGED 5–9 YEARS
10.a. Did you do an activity during previous week
as mention follows:
1. Working for living
2. In School
3. Housekeeper
4. Seeking a job
5. Others
b. From Q.10.a. activity of 1 to 5 coded 1,
which activity the most took your time
during previous week?
1 (skip to Q.13.a) 2 3 4
5
11. Did you working for living at least 1 hour
during previous week
(if Q.10.a = 1, circle code 1)
Yes 1 (skip to Q. 13.a) No 2
12. Did you have a job/business, but not working
temporary during previous week?
Yes
1
No
2 (skip to B.VI)
13.a. Number of work hours: ……………days
b. Number of work hours of daily total worked
during previous week:
Mon Tue Wen Thur Fri Sat Sun Total
….. … ….. ….. … … ….. hours
14. Type of main work during previous week:
(Write down completely)
Filled in
……………………………….
By editor
15. Main business field (work) during previous
week:
Agriculture
1
Services
4
Industry
2
Others
5
Trade
3
16. Status of main work during previous week:
Self-employed
Family worker
1
2
Workers
3
6
7
VI. EDUCATION EXPENSES OF HOUSEHOLD MEMBERS AGED 5 – 39 YEARS
(WHO ARE IN SCHOOLING)
Name:
Serial number:
9.a. Place of study outside school hours
Inside the house 1
Outside the house 2
1. Registered and active in the school:
b. Average duration study of outside school hours
Primary School
01 ‘Aliyah’
08
of daily in a week: ………. hours
‘Ibtidayah’
02 Vocational senior 09
10.Availability of compulsory book in current
A Packet
03 high school
quarter:
Vocational/
04 Diploma I/II
10
Have
1
Not have
2
Junior high school/
Dipl. III/bachelor 11
a. PMP
d. Science g. Physics
‘Tsanawiyah’
05 Dipl. IV/under grad 12
b. Indonesia
e. Social
h. Chemistry
B Packet
06 Master
13
Language
f. English
i. Biology
Senior high school 07 PhD
14
c. Mathematics language
(If Q.1 = 01 to 06, skip to Q.3)
2. If Q. 1 = 07 to 14, subject of education:
Household Members Education Expenses
……………………………………
During
Type of expenditure
The last
3. a. The nearest distance usually passed from
July-Dec.
Month
house to school ………….. km
(000 Rp)
(Rp)
b. Duration of the trip ………..minute
4. Transportation facility for going to school
(1)
(2)
(3)
Motor vehicle possessed by household
1
11.Registration (enroll
Non-motor vehicle possessed by household 2
ment fee/tuition, reMotor vehicle of public transportation
3
entry fee)
Non motor vehicle of public transportation 4
12.Contributions
Other people’s vehicle (free)
5
a. School fee
Walking
6
b. P.T.A
5. Responsible for living & eating expenses:
c. Lab./Art
Parent
1 Other person
4
d. Others
Brother/sister of
2 Individually
5
13.Evaluation/
Same mother/father
Government
6
examination
Relative
3 Foundation/Inst.
7
14.Supporting material of
6. Responsible for school expenses:
subject study
Parent
1 Other person
4
15. School /sport uniform
Brother/sister of
2 Individually
5
16. Books, stationers, and
Same mother/father
Government
6
school supply (a+b)
Relative
3 Foundation/Inst.
7
a. Text book
Question 7 to 10, Only for Primary School, Junior
b. Stationary, etc
High School and Senior High School
17. Transportation
7.a. Did you have tutorial (study outside of school
(including pick-up and
hours) during the last quarter?
dropped expenses
Yes 1
No
2 (skip to Q. 10)
b. Did you study in a group?
18. Courses which relation
Yes 1
No
2
to the school/study
c. Did you study accompany by a Tutor?
Yes 1
No
2 (skip to Q. 9.a)
8. a. If Q.7 c. = 1, who tutored you?
19. Others
Household members 1 Relative
3
TOTAL
School friend
2 Other people
4
(11
+
12
+
13
+
14
+
15
+ 16 + 17 + 18 + 19)
b. Did you pay the Tutor:
Yes
1
No
2
8
9
VII. HOUSING AND SETTLEMENT
A. PHYSICAL CONSTRUCTION
9. Legal Status of land:
Property right
1
1.a. Type of physical construction:
Right to build
2
Single, not storied
1
Right to use
3
Single, storied
2
Duplex, not storied
3
10 Age of construction:
Duplex, storied
4
0 - 4 years
1
Multiplex, not storied
5
5 - 9 years
2
Multiplex, storied
6
10-14 years
3
b. If the construction storied (Q.1.a = 2, 4, 6),
type of building
Two storied regular house
1
House shop/house office
2
Apartment/flat
3
2. Land area: ……………..m2
3. Type of main foundation
Concrete
1
Wood/bamboo 4
Coral
2
Others
5
Brick
3
4. Main material of pillars/columns:
Concrete
1
Bamboo
4
Brick
2
Others
5
Wood
3
5. Type of main roof frame:
Concrete
1
Bamboo
3
Wood
2
Others
4
6. Building condition
Good
1
Damaged
3
Mediocre
2
Severely damaged 4
DWELLING OWNERSHIP
7. a. Dwelling ownership status:
Own property
1
Official house 5
Lease
2
Rent free
6
Rent
3
Other
7
Rent purchase
4
(If Q.7.a # 1, skip directly to Q. 11)
b If the dwelling is your own (Q.7.a = 1), how did
you come into possession?
Build on own account
1
Purchased from developer
2
(Perumnas, Real-estate, etc)
Purchased first hand from individual
3
Purchased second hand
4
Administrative allocation
5
(official house, etc)
Others(inheritance, gift, etc)
6
8. How did the land come into possession?
Purchase
1
Squatter
4
Inheritance
2
Other
5
Lease
3
Others
Don’t know
4
5
³ 15 years
Don’t know
5
C. UTILITY/EQUIPMENT’S
11. a. Number of rooms:
rooms
(If Q. 11.a = 01, directly go to Q 13.a)
b. Utilization of rooms/space
Private 1 Shared
2
None
4
3
1. Bed room
Dining room
2. Living room
Family room
12.a. IF having separate bed room (R.11.b.1 = 1),
number of bedrooms, ………..rooms
b. Number of bed rooms has:
1. Window
rooms
2. Ventilation
rooms
3. Air condition
rooms
4. Exhaust fan
rooms
13.a. Was the drinking water is clear, colorless,
odorless, tasteless, no bubbles?
Yes
1
No
2
b. Distance to the place to get drinking water:
In the yard
1
Outside the yard:
£9m
2
100-499 m
5
10-49 m
3
³ 500 m
6
50-99 m
4
14.a. Source of bathing water:
Pipe
1
Protected spring
Pump
2
Unprotected spring
Protected well 3
River
Unprotected 4
Rain water
Well
Other
b. Bathing facility:
Private
1
Shared
2
Public
None
5
6
7
8
9
3
4
10
11
15.a. Do you subscriber PLN electricity?
Yes
1
No
2 (skip to Q.16.a)
b. If Yes (Q.15.a = 1), how much the capacity?
450 w
1
3200 w
4
900 w
2
> 2200 w
5
1300 w
3
16.a. Do you have kitchen?
Yes
1
No
2 (skip to Q.18)
b. If Yes (Q.16.a = 1), where is the location?
Separate room
1
Together with other rooms
2
Outside of the building
3
17.a.Gasoline material for cooking:
Electricity
1
Firewood
4
Gas/LPG
2
Charcoal/coal 5
Kerosene
3
Others
6
18. Goods possessed by this household:
(Filling in 1 code if yes, 0 code if Not)
a. Buffet/long cupboard
f. Refrigerator
b. Stove
g. Telephone
c. Bicycle/boat
h. motorcycle/
d. Radio/tape
motorboat
e. TV
i. Car/motor ship
19. Did this household used: (during previous
month):
a. Air freshener
f. Cloth stain remover
b. Hair spray/
g. Shoe polish
deodorant spray
h. Car battery
c. Liquid disinfectant
i. Iron/wood/ wall
d. Floor cleaner
paint
e. Window/car/wood
j. Insecticide
cleaner
D. ENVIRONMENT CONDITION
20. House/dwelling location:
Side of road/alley/corridor
1
Other
2
(If Q. 20 = 2, directly to Q.24)
21. If the house is in the side of alley/corridor
(q.20=1) the wide of road/lane/isle: …………m
22. Type of pavement:
Asphalt
1 Wood/bamboo
4
Cement
2 Dirt/sand
5
Gravel/hardened 3 Other
6
23. Road/alley/corridor conditions:
Good
1
Damaged
3
Mediocre
2
Several damaged 4
24. Do you have a yard?
Yes
1
No
2 (skip to Q.26.a)
25. a. If Yes (Q.24=1), do you have a plants?
Yes
1
No
2 (skip to Q.26.a)
26.
27.
28.
29.
30.
b. If Yes (Q. 25.a.=1), What kind of plants?
Vegetables
1
Traditional
8
Fruits
2
herbs plants
Ornamental
3
Others
16
plants
a. Do you raise livestock/poultry?
Yes
1
No
2 (skip to Q.27)
b. Place of raising livestock/poultry:
Inside the house 1 In the yard
3
Under the house 2 In other place
4
No cage
5
Where do you dispose your bath, kitchen, and
wash wastewater?
Covered hole in yard
1
Uncovered hole in yard
2
In yard without the hole
3
Outside yard
4
How do you dispose your bath, kitchen, and
wash wastewater?
Through covered channel
1
Through uncovered channel
2
Without channel
3
What is the gutter condition around the house?
Water is stuck
1
Fast
3
Water flows very 2
No gutter
4
slowly
How do you dispose your trash?
Carried away by 1
Thrown into river 5
Workers
Thrown anywhere 6
Dumped
2
Other
7
Turned into
3
fertilizer
Burned
4
31. Does any of the household member feel
offended by:
a. Factory smoke/odor/noise
b. Garage smoke/odor/noise
c. Continues sound of neighbor
d. Noise of motor vehicle
e. Unpleasant garbage or water odor
12
13
32. Access to housing and settlement facility
Type facility
Distance from home
(Km)
(1)
a. Public road
b. Public transportation
c. Hospital
d. Puskesmas
e. Market/shopping area
f. Bank
g. Post office
h. Worship place
i. Cinema/amusement/recreation park
j. Police station
k. Fire extinguisher station
l. Public hydrant/Fire hydrant
m. Public telephone
n. Primary School
o. Junior High School
p. Senior High School
q. Public cemetery
(2)
Transportation used:
Motor vehicle
1
Non motor vehicle 2
Walking
3
(3)
Time spent
(minute
(4)
VIII. N O T E
14