Costa Rica 2018

Household Information Panel: HH

HH1. ID: _ _ _

HH2. Household number: _ _

HH3. Interviewer name and number:

HH4. Supervisor name and number:

HH5. Day/Month/Year of interview:

HH6. Area

HH7. Province

Before proceeding, check that the respondent is a knowledgeable member of the household and at least 18 years old before proceeding. You may only interview a child age 15-17 if there is no adult member of the household or all adult members are incapacitated. You may not interview a child under age 15.

HH11. Record the time.

HH12. Hello, my name is (your name). We are interviewers for the National Institute of Statistics and Censuses (INEC) and we are conducting a survey about the situation of households, women, children, and adolescents, so I would like to talk to you about these subjects. This interview will last approximately 20 minutes. Following this, I may ask to conduct additional interviews with you or other individual members of your household, in addition to if there are people under 5 years old then a person from CEN-CINAI will come to weigh and measure each of them. All the information we obtain will remain strictly confidential and anonymous. If you do not wish to answer any question or questions or wish to discontinue the interview, please let me know. Can I start now?

HH46. Result of household questionnaire interview:
Discuss any result not completed with supervisor.
HH47. Name and line number of the respondent to household questionnaire interview:

To be filled after the Household Questionnaire is completed
Total number

HH48. Household members: __ __


HH49. Women age 15-49: __ __

HH51. Children under age 5: __ __

HH52. Children age 5-17: __ __

To be filled after all the questionnaires are completed
Completed number

HH53. Women age 15-49: __ __

HH55. Children under age 5: __ __

HH56. Children age 5-17

Obligation and Confidentiality of Information

The National Institute of Statistics and Censuses is the governing technical body for national statistics and coordinator of the National Statistics System (SEN). This function was assigned to it in the National Statistics System Law (No. 7839 dated November 4, 1998), which was promulgated considering, among other things, the importance of having timely and updated statistical data on which to base establish economic and social policies.
This Law also establishes the obligation to provide the necessary data for the preparation of national statistics and their confidentiality:
Article 4: "The data obtained according to this Law will be strictly confidential... The data coming from private individuals or legal entities may not be supplied or published individually, but rather as part of global figures, except with the prior authorization of the person who provided the data. For this purpose, global figures will be considered those corresponding to three or more natural or legal persons. These data may not be supplied for tax purposes, or of any other nature..."
Article 5: "The SEN may request information regarding its activity, from all natural and legal persons residing in Costa Rica."

List Of Household Members: HL

First complete HL2-HL4 vertically for all household members, starting with the head of the household. Once HL2-HL4 are complete for all members, make sure to probe for additional members: Those that are not currently at home, any infants or small children and any others who may not be family (such as servants, friends) but who usually live in the household.
Then, ask questions HL5-HL20 for each member one at a time. Use an additional questionnaire if all the rows of the list of household members have been used. If additional questionnaires are used, indicate by ticking this box: ____. Then, starting with HL5, ask all the questions for each person.

HL1. Line number: _ _

HL2. First, please tell me the name of each person who usually lives here, starting with the head of the household.
Probe for additional household members.
HL3. What is the relationship of (name) to (name of the head of household)?

HL4. Is (name) male or female?

HL5. What is (name)'s date of birth?

HL6. How old is (name)?
If age is 95 or above, record "95".
HL8. Record line number if woman and age 15-49: _ _

HL10. Record line number if age 0-4: _ _

HL11. Age 0-17?

HL12. Is (name)"s natural mother alive?

HL13. Does (name)'s natural mother live in this household?

HL14. Record the line number of mother and go to HL16: _ _

HL15. Where does (name)'s natural mother live?

HL16. Is (name)'s natural father alive?

HL17. Does (name)'s natural father live in this household?

HL18. Record the line number of father and go to HL20: _ _

HL19. Where does (name)'s natural father live?

HL20. Copy the line number of mother from HL14. If blank, ask: Who is the primary caretaker of (name)?
If "No one" for a child age 15-17, record "90".
Codes for HL3. Relationship to head of household

Education 1: ED

ED1. Line number: _ _

ED2. Name and age
Copy names and ages of all members of the household from HL2 and HL6 to below and to next page of the module.
ED3. Age 3 or above?

ED4. Has (name) ever attended any education setting, including a program such as interactive, transition or high school, school, college or university?

ED5. What is the highest grade or year that (name) has attended?

ED6. Did (name) ever complete that (grade/year)?

ED7. Age 3-24?

ED8. Check ED4: Have you ever attended an educational center?
Education 2: ED

ED1. Line number _ _

ED2. Name and age

ED9. During the 2018 school year, has (name) ever attended an educational setting, including a program such as interactive, transition or high school, school, college, or university?

ED10. During the 2018 school year, what level and grade/year is (name) attending?

ED11. Is (he/she) attending a public school?
If "Yes", record "1". If "No", probe to code who controls and manages the school.
ED12. In the current school year (2018), has (name) received any school tuition support?
If "Yes", probe to ensure that support was not received from family, other relatives, friends or neighbours.
ED13. Who provided the tuition support?
Record all mentioned.
ED14. For the 2018 school year, has (name) received any material support or cash to buy shoes, exercise books, notebooks, school uniforms or other school supplies?
If "Yes", probe to ensure that support was not received from family, other relatives, friends or neighbours.
ED15. During the 2017 school year, did (name) ever attend an educational setting, including a program such as interactive transition or high school, school, college, or university?

ED16. During the 2017 school year, which level and grade or year did (name) attend?

Household Characteristics: HC

HC1A. What is the religion of (name of the head of the household from HL2)?

HC1B. What is the mother tongue of (name of the head of the household from HL2)?

HC2. (Name of the head of the household from HL2) is considered?

HC3. How many rooms do members of this household usually use for sleeping?

HC4. Main material of the dwelling floor.
Record observation. If observation is not possible, ask the respondent to determine the material of the dwelling floor.
HC5. Main material of the roof.
Record observation.

HC6. Main material of the exterior walls.
Record observation.
HC7. Does your household have:

A. A fixed telephone line?

B. A radio?

C. Bed?

D. Armchair?

E. Dining table?

F. Wardrobe or closet?

HC8. Does your household have electricity?

HC9. Does your household have:

A. A television?

B. A refrigerator?

C. Rice cooker?

D. Microwave?

E. Air conditioning?

F. Washing machine?

G Clothes dryer?.

H. Whole house hot water system?

HC10. Does any member of your household own:

A. A wristwatch?

B. A bicycle?

C. A motorcycle?

D. An animal-drawn cart?

E. Car?

F. A boat with a motor?

G. Boat without motor?

HC11. Does any member of your household have a computer or a tablet?

HC12. Does any member of your household have a mobile telephone?

HC13. Does your household have access to internet at home?

HC14. Do you or someone living in this household own this dwelling?
If "No", then ask: Do you rent this dwelling from someone not living in this household? If "Rented from someone else", record "2". For other responses, record "6" and specify.
Social Transfers: ST

ST1. I would like to ask you about various external economic assistance programmes provided to households. By external assistance I mean support that comes from the government or from non-governmental organizations such as religious, charitable, or community-based organizations. This excludes support from family, other relatives, friends or neighbours.

ST2. Are you aware of (name of programme)?

ST3. Has your household or anyone in your household received assistance through (name of programme)?

ST4. When was the last time your household or anyone in your household received assistance through (name of programme)?
If less than one month, record "1" and record "00" in Months. If less than 12 months, record "1" and record in Months. If 1 year/12 months or more, record "2" and record in Years.

Water and sanitation: WS

WS1. What is the main source of drinking water used by members of your household?
If unclear, probe to identify the place from which members of this household most often collect drinking water (collection point).
WS2. What is the main source of water used by members of your household for other purposes such as cooking and handwashing?
If unclear, probe to identify the place from which members of this household most often collect water for other purposes.
WS3. Where is that water source located?

WS4. How long does it take for members of your household to go there, get water, and come back?

WS5. Who usually goes to this source to collect the water for your household?
Record the name of the person and copy the line number of this person from the list of household members module.

WS6. Since last (day of the week), how many times has this person collected water?

WS7. In the last month, has there been any time when your household did not have sufficient quantities of drinking water?

WS11. What kind of toilet facility do members of your household usually use?
If "Flush" or "Pour flush", probe: Where does it flush to?
If not possible to determine, ask permission to observe the facility.
WS12. Has your (answer from WS11) ever been emptied?

WS13. Where was the contents emptied last time?
Probe: Was it removed by a service provider?
WS14. Where is this toilet facility located?

WS15. Do you share this facility with others who are not members of your household?

WS16. Do you share this facility only with members of other households that you know, or is the facility open to the use of the general public?

WS17. How many households in total use this toilet facility, including your own household?

Handwashing: HW

HW1. We would like to learn about where members of this household wash their hands. Can you please show me where members of your household most often wash their hands?
Record result and observation.
HW2. Observe presence of water at the place for handwashing.
Verify by checking the tap/pump, bucket, water container or similar objects for presence of water.
HW3. Is there soap or detergent on site for handwashing?

HW4. Where do you and household members usually wash their hands?

HW5. Do you have any soap or detergent in your house for washing hands?

HW6. Can you please show it to me?

HW7. Record your observation.
Record all that apply.
HH13. Record the time.

HH14. Language of the Questionnaire.

HH15. Language of the Interview.

HH16. Native language of the Respondent.

HH17. Was a translator used for any parts of this questionnaire?

HH18. Check HL6 in the "List of household members" and indicate the total number of children age 5-17 years:
HH19. Write down in the table below each of the children between the ages of 5-17 in the order in which they appear in the list of household members. Do not include other household members outside of the age range 5-17 years. Record the line number, name, sex, and age for each child.

HH20. Rank number: _

HH21. Line number from HL1: _ _

HH22. Name from HL2: ____

HH23. Sex from HL4

HH24. Age from HL6: _ _

HH25. Check the last digit of the household number (HH2) from the household information panel. This is the number of the row you should go to in the table below.
Check the total number of children age 5-17 years in HH18 above. This is the number of the column you should go to in the table below.
Find the box where the row and the column meet and record the number that appears in the box. This is the rank number (HH20) of the selected child.

HH26. Record the rank number (HH20), line number (HH21), name (HH22) and age (HH24) of the selected child.

HH27. (When HH18=1 or when there is a single child age 5-17 in the household): Record the rank number as "1"and record the line number (HL1), the name (HL2) and age (HL6) of this child from the list of household members.

HH28. Issue a questionnaire for children age 5-17 to be administered to the mother/caretaker of this child.

HH29. Check HL8 in the list of household members: Are there any women age 15-49?
HH30. Issue a separate questionnaire for individual women for each woman age 15-49 years.

HH31. Check HL6 and HL8 in the list of household members: Are there any girls age 15-17?
HH32. Check HL20 in the list of household members: Is consent required for interviewing at least one girl age 15-17?
HH33. As part of the survey we are also interviewing women age 15-49. We ask each person we interview for permission. A female interviewer conducts these interviews.
For girls age 15-17 we must also get permission from an adult to interview them. As mentioned before, all the information we obtain will remain strictly confidential and anonymous.
May we interview (name(s) of female member(s) age 15-17) later?

HH40. Check HL10 in the "List of household members": Are there any children age 0-4?
HH41. Issue a separate questionnaire for children under five for each child age 0-4 years.

HH45. Now return to the household information panel and,
Record "01" in question HH46 (Result of the Household Questionnaire interview). Record the name and the line number (from the list of household members) of the respondent to the household questionnaire interview in HH47. Fill the questions HH48 ? HH52. Thank the respondent for his/her cooperation and then proceed with the administration of the remaining individual questionnaire(s) in this household.
Once all the questionnaire(s) have been completed, thank the respondent for his/her cooperation and move to the next household you have been assigned by your supervisor.