Egypt Sub-national MICS

Household Information Panel: HH

HH1. Cluster number: _ _ _

HH2. Household number: _ _

HH3. Interviewer's name and number

HH4. Supervisor's name and number:

HH5. Day/month/year of interview

HH6. Area

HH7. Governorate:

My name is ____, we are implementing a survey for the ministry of health and population. The survey about the situation of children, families and households. I would like to talk to you about these subjects. The interview will take about 15 minutes. All the information we obtain will remain strictly confidential and anonymous. May I start now?

HH9. Result of household interview:

After the household questionnaire has been completed, fill in the following information:
HH10. Respondent to household questionnaire:

After the household questionnaire has been completed, fill in the following information:
HH11. Total number of household members: _ _

After the household questionnaire has been completed, fill in the following information:
HH12. Number of Ever-married women age 15-49 years: _ _

After all questionnaires for the household have been completed, fill in the following information:
HH13. Number of Ever-married women's questionnaires completed: _ _

After the household questionnaire has been completed, fill in the following information:
HH14. Number of children under age 5: _ _

After all questionnaires for the household have been completed, fill in the following information:
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

First, please tell me the name of each person who usually lives here, starting with the head of the household.
List the head of the household in line 01. List all household members (HL2), their relationship to the household head (HL3), and their sex (HL4)
Then ask: Are there any others who live here, even if they are not at home now?
If yes, complete listing for questions HL2-HL4. Then, ask questions starting with HL5 for each person at a time. Use an additional questionnaire if all rows in the list of household members have been used.

HL1. Line number: _ _

HL2. Name: ____

HL3. What is the relation-ship of (name) to the head of household?

Codes for HL3. Relationship to head of household

HL4. Is (name) Male or Female?

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

HL6. How old is (name)?

Record in completed years. If age is 95 or above '95':

Marital status
For household members age 12 and older
HL6B. What is (name's) current marital status?

For ever married women age 15-49
HL6B=1-4
HL7. Circle line no. if woman age 15-49 and ever-married: _ _

For children age 0-4
HL7B. Circle line no. If children age 0-4.

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. Record 00 for "No".

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. Record 00 for "No".

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

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 0-4
[] Put a sign in this square if you used another questionnaire

Probe for additional household members. Probe especially for any infants or small children not listed, and others who may not be members of the family (such as servants, friends) but who usually live in the household. Insert names of additional members in the household list and complete form accordingly.

Now for each ever-married woman age 15-49 years, write her name and line number and other identifying information in the information panel of a separate individual women's questionnaire.
For each child under age 5, write his/her name and line number and the line number of his/her mother or caretaker in the information panel of a separate under-5 questionnaire.
You should now have a separate questionnaire for each eligible woman and each child under five in the household.

Education: ED

ED1. Line number: _ _

ED2. Name and age
Copy from HL2 and HL6.
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 less than 1 grade at this level, enter 0.
ED5. During the school year 2013-2014, did (name) attend school or preschool at any time?
For household members age 5-24 years
ED6. During this school year (2013-2014), which level and grade is/was (name) attending?
For household members age 5-24 years. If level=0 skip to ED7
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, go to next person
Household Characteristics: HC

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

HC3. Main material of the dwelling floor.
Record observation.
HC4. Main material of the roof.
Record observation.
HC5. Main material of the exterior walls.
Record observation
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 mobile telephone?

[F] A video or DVD player?

[G] A personal home computer?

[H] A sewing machine?

[I] An electric fan?

[J] An air conditioner?

[K] Satellite dish or connection?

[L] A refrigerator?

[M] A freezer?

[N] A water heater?

[O] A dishwasher?

[P] An automatic washing machine?

[Q] Any other washing machine?

[R] A bed?

[S] A sofa?

[T] Hanging lamp (yellow with no cover)?

[U] A table?

[V] A tabila (very low round table)?

[W] A chair?

[X] Kolla/zeer (a container for reserving water)?

HC9. Does any member of your household own:

[A] A watch?

[B] A bicycle?

[C] A motorcycle or scooter?

[D] An animal-drawn cart?

[E] A car or truck?

HC10. Do you or someone living in this household own this dwelling or it is rented from someone?
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".
HC10A. Did you own this dwelling alone or with someone else?

HC11. Does any member of this household own any land that can be used for agriculture?

HC12. How many feddans or kirrates of agricultural land do members of this household own?
Write in feddan and kirrat as mentioned and don?t record the area in the shadowed space.

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] Poultry (chicken, ducks, turkey, ....)?

[F] Camels?

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

Water and Sanitation: WS

WS1. What is the main source of drinking water for 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 the places that households use to 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 your 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:

Return to the cover page and make sure that all information is entered, including the number of eligible women (HH12) and under-5s (HH14). Make arrangements for the administration of the remaining questionnaire(s) in this household.

Interviewer's Observations ________

Field Editor's Observations ________

Supervisor's Observations ________