Dominican Republic 2014

Household Information Panel: HH

HH1. Primary Sampling Unit (UPM): _ _ _ _

HH1A. Registry household line number: _ _ _

HH2. Sample household line number: _ _

HH2A. Household selection code:

HH6. Area

HH7. Province: _ _

HH7A. Municipality: _ _

HH7B. Municipal District: _ _

HH7C. Section: _ _

HH7D. Neighborhood: _ _ _

HH7E. Block: _ _ _

HH7F. Area: _ _ _

HH7G. Segment: _ _ _

HH7H. Street

HH7I. Reference: ____

Number of visits for the interview [1-3]

HH3. Interviewer name and number

HH4. Supervisor name and number:

HH5. Day/month/year of interview

HH9. Result of household interview: _ _

Codes for result of household interview

HH11. Total number of household members: _ _

HH12. Number of women age 15-49 years: _ _

HH13. Number of women's questionnaires completed: _ _

HH14. Number of children under age 5: _ _

HH15. Number of under-5 questionnaires completed: _ _

HH16. Field editor's name and number:

HH17. Main data entry clerk's name and number:

HH18 Record the time

List of Household Members: HL

HL6. When was (name) born?

Note the day and the month with two digits and the year with four digits

For people 16 years and older
Circle the line number of every household member aged 16 or older

For people 16 years and older
HL6B. Does (name) have an identity card?

For women aged 15 to 49 years
HL7. 1. Check HL5 and then:
2. Circle the line number of every woman in this household of 15 to 49 years of age
3. Then, after proceeding with the interview, take a questionnaire "2" for each one
4. Write the name and line number of each woman in question "WM3" on its correspondent questionnaire "2"
5. Then continue with the interview

For children under 5 years
HL7B. 1. Check HL5 and then:
2. Circle the line number of every girl under five years of age in this household
3. Then, after proceeding with the interview, take a questionnaire "3" for each one
4. Write the name and line number of each woman in question "UF3" on its correspondent questionnaire "3"
5. Then continue with the interview

For children 0-17 years
Circle the line number of every person in this household of 0 to 17 years of age

HL11. Is (name)'s natural mother alive?
For children age 0-17 years
HL12. Does (name)'s natural mother live in this household? _ _
If "Yes", record line no. of mother and go to HL13. If "No", record 00.

HL12A. Where does (name)'s natural mother live?

HL13. Is (name)'s natural father alive

HL14. Does (name)'s natural father live in this household? _ _
If "Yes", record line no. of father and go to HL15. If "No", record 00.

HL14A. Where does (name)'s natural father live?

For children 0-14 years
Circle the line number of every person in this household of 0 to 14 years of age

HL15. Record line no. of mother from HL12 if indicated.
If HL12 is blank or '00' ask: who is the primary caretaker of (name)?
For children age 0-14
Go to the household members relation in question HL12 and write the line number that corresponds to the mother or to the person responsible.
Education: ED

ED1. Line number: _ _

ED2. Does (name) know how to read and write?

ED3. Has (name) ever attended school or pre-school?
For household members age 5 and above
ED4A. What is the highest level school (name) has ever attended?
For household members age 5 and above. If level=0, skip to ED5
ED4B. What is the highest grade (name) completed at this level?
For household members age 5 and above. If the first grade at this level is not completed, enter "00".
ED5. During the current school year, that is 2013-2014, did (name) attend school or preschool at any time?
For household members age 5-24 years
ED6. During this/that school year, which level and grade is/was (name) attending?
For household members age 5-24 years. If level=0 skip to ED7
ED6A. Which grade is/was name attending?
If DK register "98"
ED7. During the previous school year, that is 2012-2013, did (name) attend school or preschool at any time?
For household members age 5-24 years
ED8. During that previous school year, which level and grade did (name) attend?
For household members age 5-24 years
If level=0 skip to ED7
ED8A. Which grade is/was name attending?
If DK register "98"
Access To Information And Communication Technologies: TIC

Circle the line number of all individuals over 5 years of age.

TIC1. Does (name) have a personal computer?
A computer is available because: 1. they bought it 2. it was a gift 3. it was provided at work
TIC2. Did (name) use any computer, at any place, in the past 12 months?
The computer can be a desktop computer, a laptop, or a tablet
TIC3. Does (name) have a cellphone even if it's not their property?

TIC4. Does the cellphone that (name) uses the most is their own, or was it provided at work or by an institution?
Regardless of the answer, skip to question TIC6
TIC5. Did (name) use a cellphone, even if it wasn't their property, in the past 12 months?

TIC6. Did (name) use the Internet at their home, office, or any other location in the past 12 months?

TIC7. Which device(s) did (name) use to acces the Internet in the past 12 months?
Register every option mentioned by the respondent
Selection of One Child For Child Labour/Child Discipline: SL

SL1. Check HL6 in the list of household members and write the total number of children age 1-17 years.
SL2. Check the number of children age 1-17 years in SL1:
SL2A. List each of the children age 1-17 years below in the order they appear in the List of household members. Do not include other household members outside of the age range 1-17 years. Record the line number, name, sex, and age for each child.

SL3. Rank number: _

SL4. Line number from HL1: _ _

SL5. Name from HL2: ____

SL6. Sex from HL4

SL7. Age from HL6: _ _

SL8. Check the last digit of the household number (HH2) from the cover page. This is the number of the row you should go to in the table below.
Check the total number of children age 1-17 years in SL1 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 circle the number that appears in the box. This is the rank number (SL3) of the selected child.
SL9. Record the rank number (SL3), line number (SL4), name (SL5) and age (SL7) of the selected child.
Child Labor: CL

CL1. Check selected child's age from SL9:
CL2. Now I would like to ask about any work children in this household may do.
Since last (day of the week), did (name) do any of the following activities, even for only one hour?

A. Did (name) do any work or help on his/her own or the household's plot/farm/food garden or looked after animals? For example, growing farm produce, harvesting, or feeding, grazing, milking animals?

B. Did (name) help in family business or relative's business with or without pay, or run his/her own business?

C. Did (name) produce or sell articles, handicrafts, clothes, food or agricultural products?

D. Since last (day of the week), did (name) engage in any other activity in return for income in cash or in kind, even for only one hour?
If "No", Probe: Please include any activity (name) performed as a regular or casual employee, self-employed or employer; or as an unpaid family worker helping out in household business or farm.

CL3. Check CL2, A to D
CL4. Since last (day of the week) about how many hours did (name) engage in this activity/these activities, in total?
If less than one hour, record "00"
CL5. Does the activity/do these activities require carrying heavy loads?

CL6. Does the activity/do these activities require working with dangerous tools (knives etc.) or operating heavy machinery?

CL7. How would you describe the work environment of (name)?

[A] Is (name) exposed to dust, fumes or gas?

[B] Is (name) exposed to extreme cold, heat or humidity?

[C] Is (name) exposed to loud noise or vibration?

[D] Is (name) required to work at heights?

[E] Is (name) required to work with chemicals (pesticides, glues, etc.) or explosives?

[F] Is (name) exposed to other things, processes or conditions bad for (name)'s health or safety?

CL8. Since last (day of the week), did (name) fetch water or collect firewood for household use?

CL9. In total, how many hours did (name) spend on fetching water or collecting firewood for household use, since last (day of the week)?
If less than one hour, record "00"
CL10. Since last (day of the week), did (name) do any of the following for this household?

[A] Shopping for household?

[B] Repair any household equipment?

[C] Cooking or cleaning utensils or the house?

[D] Washing clothes?

[E] Caring for children?

[F] Caring for the old or sick?

[G] Other household tasks?

CL11 Check CL10, A to G
CL12. Since last (day of the week), about how many hours did (name) engage in this activity/these activities, in total?
If less than one hour, record "00"
Child Discipline: CD

CD1. Check selected child's age from SL9
CD2. Write the line number and name of the child from SL9.

CD3. Adults use certain ways to teach children the right behaviour or to address a behaviour problem. I will read various methods that are used. Please tell me if you or anyone else in your household has used this method with (name) in the past month.

[A] Took away privileges, forbade something (name) liked or did not allow him/her to leave the house.

[B] Explained why (name)'s behaviour was wrong.

[C] Shook him/her.

[D] Shouted, yelled at or screamed at him/her.

[E] Gave him/her something else to do.

[F] Spanked, hit or slapped him/her on the bottom with bare hand.

[G] Hit him/her on the bottom or elsewhere on the body with something like a belt, hairbrush, stick or other hard object.

[H] Called him/her dumb, lazy, or another name like that.

[I] Hit or slapped him/her on the face, head or ears.

[J] Hit or slapped him/her on the hand, arm, or leg.

[K] Beat him/her up, that is hit him/her over and over as hard as one could.

CD4. Do you believe that in order to bring up, raise, or educate a child properly, the child needs to be physically punished?

Household Characteristics: HC

HC1A. What is the religion of the head of this household?

HC1B. What is the mother tongue/native language of the head of this household?

HC2. How many rooms in this household are used for sleeping?

HC3. Main material of the dwelling floor.
Record observation. If the interview takes place outside of the household and you cannot see the flooring inside, please ask for the information.
HC4. Main material of the roof.
Record observation. If the interview takes place outside of the household and you cannot see the roof, please ask for the information.
HC5. Main material of the exterior walls.
Record observation. If the interview takes place outside of the household and you cannot see the walls, please ask for the information.
HC6. What type of fuel does your household mainly use for cooking?

HC7. Is the cooking usually done in the house, in a separate building, or outdoors?
If 'In the house', probe: is it done in a separate room used as a kitchen?

HC8. Does your household have:

[A] Electricity?

[B] A radio?

[C] A television?

[D] A non-mobile telephone?

[E] A refrigerator?

[F] Stove?

[G] Washing machine?

[H] Electric inverter?

[I] Water pump?

[J] Electric iron?

[K] Internet?

[L] Air conditioner?

[M] Microwave oven?

[N] Desktop computer?

[O] Matresses?

[P] Sofa?

[Q] Chairs and table?

[R] Drawers?

HC9. Does any member of your household own:

[A] A watch?

[B] A mobile telephone?

[C] A bicycle?

[D] A motorcycle or scooter?

[E] An animal-drawn cart?

[F] A car or van?

[G] A boat with a motor?

[H] Laptop

[I] Tableta?

[J] Jeep?

[K] Truck?

HC10. 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", circle "2". For other responses, circle "6".
HC11. Does any member of this household own any land that can be used for agriculture?

HC12. How many hectares of agricultural land do members of this household own?
If less than one, record "00". If 95 or more, record '95'. If unknown, record '98'.

HC13. Does this household own any livestock, herds, other farm animals, or poultry?

HC14. How many of the following animals does this household have?
If none, record '00'. If 95 or more, record '95'. If unknown, record '98'.

[A] Cattle, milk cows, or bulls?

[B] Horses, donkeys, or mules?

[C] Goats?

[D] Sheep?

[E] Chickens?

[F] Pigs?

[G] Turkeys?

[H] Ducks?

[I] Guinea pigs?

[J] Goats?

HC15. Does any member of this household have a bank account?

Water and Sanitation: WS

WS1. What is the main source of drinking water used by members of your household?

WS2. What is the main source of water used by your household for other purposes such as cooking and handwashing?

WS3. Where is that water source located?

WS4. How long does it take to go there, get water, and come back?

WS5. Who usually goes to this source to collect the water for your household?
Probe: is this person under age 15? What sex?

WS6. Do you do anything to the water to make it safer to drink?

WS7. What do you usually do to make the water safer to drink?
Probe: Anything else?
Record all items mentioned
WS8. 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.
WS9. Do you share this facility with others who are not members of your household?

WS10. 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?

WS11. 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?

HW2 Observe presence of water at the place for handwashing. Verify by checking the tap/pump, or basin, bucket, water container or similar objects for presence of water
HW3A. Is soap, detergent or ash/mud/sand present at the place for handwashing?

HW3B Record you observation
Circle all that apply
HW4 Do you have any soap or detergent or ash/mud/sand in your house for washing hands?

HW5A. Can you please show it to me?

HW5B Record your observation
Circle all that apply
HH19. Record the time
HH20. Thank the respondent for his/her cooperation and check the list of household members:Check HH8. If the household is selected for questionnaire for individual men:

Return to the cover page and make sure that the result of the household interview (HH9), the name and line number of the respondent to the household questionnaire (HH10), and the number of eligible women (HH12), men (HH13A), and under-5s (HH14) are entered. Make arrangements for the administration of the remaining questionnaire(s) in this household.

Interviewer's Observations ________

Field Editor's Observations ________

Supervisor's Observations ________