MICS Household Questionnaire

[Macedonia (Roma)]
Household Information Panel: HH

HH1. Cluster number: _ _ _

HH2. Household number: _ _

HH3. Interviewer name and number

HH4. Supervisor's name and number:

HH5. Day/month/year of interviewing

HH6. Area

HH7. Region

We are from Ipsos Strategic Puls. We are working on a project related to family health and education. I would like to talk to you about these issues. The interview will last for about
30 minutes. All the information obtained will remain strictly confidential and your answers will only be analysed as group data by the project team, without any direct correlations to your personal data. Can we start now?

HH8. Name of the head of household: ____

HH9. Result from the household interview:

HH10. The respondent who answers the household questionnaire:

HH11. Total number of household members: _ _

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

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

HH14. Number of children aged 5 or less: _ _

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

HH15A. Number of children aged between 2-9 years: _ _

HH15B. Number of questionnaires for child disability (children 2-9) completed: _ _

HH16. Editor in the field (name and number)

HH17. Data entered by (name and number)

HH18. Record momentary time

Household List: HL

At 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 row 01. List all household members (HL2), their relationship to the household head (HL3), and their gender (HL4)
Then ask: Are there any other persons living here, even if they are not at home at the moment?
If yes, fill in the list for questions HL2-HL4. Then, ask all the questions starting with HL5 for each person individually.
Use an additional questionnaire if all rows in the household roster have been used.

HL1. Row number: _ _

HL2. Name: ____

HL3. What is the relation-ship of (name) to the head of household?
(See codes for relationship below the table)
Code for HL3. Relationship to the head of household

HL4. Is the (name) male or female?

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

HL6. How old is (name)?
Record in full years. If age is 95 or above '95'
HL7. Circle row number if woman is age 15-49
(For woman age 15-49)

HL7A. Circle line no.
If man is age 15-49 (for men age 15-49)

HL8. Who is the mother or primary caretaker of this child?
Record line no. of mother/caretaker (for children age 5-14.)
HL9. Who is this child's mother or primary guardian?
Record row number for mother/ guardian (For children under 5)
HL9A. Copy child?s mother or primary guardian raw number for each child between 2 and nine. Use the previous 2 columns - HL8 and HL9 don?t ask again
(For children age 2-9)
For children age 0-17 years [HL11 to HL14]

HL11. Is (name's) birth mother alive?

HL12. Does (name's) birth mother live in this household?
Record row number for the mother or 00 for no
HL13. Is (name's) natural father alive?

HL14. Does (name's) natural father live in this household?
Record row number for the father or 00 for "no"
[] tick here is additional questionnaire used.
Check for additional household members. Probe in particular for any newborns or small children not listed above and other persons who are not family members (like for ex. retainers, friends) but they happen to live in the household.
Insert the names of all the additional members in the household roster and complete the for each of them.
Now, for each woman aged between 15 and 49, write the name and the row number and other information in the data panel of the separate Individual Women's Questionnaire.
For each child under 5 years of age, write his/her name and row number AND the raw number of his/her mother or guardian in the data panel of the separate Under-5 Questionnaire.
And, for each child aged between 2 and 9, write his/her name and row number AND the raw number of his/her mother or guardian in the data panel of the separate Child Disability Questionnaire.
Now, you should have a separate questionnaire per each eligible woman, per each child under five, and per each child aged between 2 and 9 in the household.
If there are children aged from 0 to 5 within this household, inform the mother/guardian that these children will have to be measured after the interviewing process is complete.

Education: ED

For all the household members aged 5 and above, including the adult members as well [ED1 to ED4B]

ED1. Row number: _ _

ED2. Name and age
Copy from the Household List, HL2 and HL6
ED3. Has (name) ever attended school or pre-school education?

ED4A. What is the highest level of education (name) attended?
If level=0, skip to ED5
ED4B. What is the highest grade (name) completed at this level (ED4A)?
If less than 1, enter 00
For household members age 5-24 years [ED5 to ED8]

ED5. During the school year (2010-2011), has (name) attend school or preschool at any time?

ED6. During this/that school year, which level and grade does/did (name) attend?
If level=0, skip to ED7
ED7. During the previous school year, that is (2009-2010), did (name) attend school or preschool at any time?

ED8. During that previous school year, which level and grade did (name) attend?
If level=0, go to next person
Household characteristics: HC

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

HC1B. What is the head of the household's mother tongue?

HC1C. What ethnic group does the head of this household belong to?

HC2. How many rooms in this household do you use for sleeping?

HC3. Main material the dwelling floor is made from.
Record your own observation
HC4. Main material the dwelling roof is made of
Record your own observation
HC5. Main material the exterior walls are made from
Record your own observation
HC6. What type of fuel does your household mostly utilize for cooking?

HC7. Does cooking usually take place in the house, in a separate construction, or outdoors?
If 'In the house', check: does it take place in a separate room used as a kitchen?

HC8. Is there in your household:

A. Electricity?

B. Radio?

C. Television - classical (CRT)?

D. Plasma/LCD TV?

E. Landline telephone?

F. Refrigerator?

G. Washing machine?

H. Cooker?

I. Water boiler?

J. Air-conditioning?

K. Dish-washer?

L. Microwave-oven?

M. Dryer?

N. Sitting set/sofa?

O. Sleeping bed?

P. Dining table?

HC9. Does any member in your household own:

A. A watch?

B. A mobile phone?

C. A bicycle?

D. A motorcycle or a scooter?

E. A cart pulled by animals?

F. A car or a truck?

G. A motor boat?

H. Computer/PC

I. Laptop

J. Caravan

HC10. Are you or someone else living in this household an owner of this dwelling?
If the answer is "No", then ask: Do you rent this dwelling from someone who does not live in this household? If the answer is "Rented from someone else", circle "2". For other responses, circle "6".
HC11. Does any member of this household own any land that can be utilized for agricultural purposes?

HC12. How many hectares of agricultural land do the members of this household possess?
If less than 1, record "00". If 95 or more, record '95'. If don't know, 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?

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

Child Labour: CL

To be filled in for those children in the household aged 5-17. For those household members that are below 5 or above 17 years of age, leave rows as blank.
Now I would like to ask you about each work that the children in this household may be doing.

CL1. Row number: _ _

CL2. Name and age
copy from Household roster, HL2 and HL6
CL3. During the last week, did (name) do any kind of work for a person who is not a member of this household?
If yes: For pay in cash or in kind?
CL4. Since last (day of the week), how many hours did he/she work for the person who is not a member of this household?
If more than one job, include all hours for all the jobs executed.
CL5. During the last week, did (name) bring any water or collect firewood for household's use?

CL6. Since last (day of the week), about how many working hours did he/she spend to bring water or collect firewood for household use?

CL7. During the last week, did (name) perform any paid or unpaid work on a family farm or in a family business or by selling goods in the street?
Include also the work from a business run by the child, alone or with one or more partners.
CL8. Since last (day of the week), working hours did he/she spend for his/her family or himself/herself?

CL9. During the last week, did (name) help with household chores such as shopping, cleaning, washing the clothes, cooking; or taking care for children, older or sick people?

CL10. Since last (day of the week), how many working hours did he/she spend on these chores?

Child Discipline: CD

Table 1: Children Aged Between 2-14 Years Are Eligible for the Child Discipline Questions
Record each of the children aged 2-14 years below according to the order they appear in the Household List. Do not include other household members who are outside the age range of 2-14 years.
Indicate the row number, name, the sex, and age for each child.
Then insert the total number of children aged between 2-14 in the appropriate box below (CD6).
If there are no children age 2-14 years in the household, go to next module.
If there is only one child in the household age 2-14 years, skip to table 2 and go to CD8; write down'1' and continue with CD9.

CD1. Rank Number: _

CD2. Row number from HL1: _ _

CD3. Name from HL2: ____

CD4. Sex from HL4

CD5. Age from HL6: _ _

CD6. Total children age 2-14 years: _ _

Table 2: Random Selection of a Child for the Child Discipline Questions
Use Table 2 to select one child between the ages of 2 and 14 years, if there is more than one child in the household belonging to this age group.
Check the last digit of the household number (HH2) from the front page. This is the number of the row you should move to in the table given below.
Check the total number of the eligible children (2-14) in CD6 above. This is the number of the column you should move to.
Find the box where the row and the column cross along and circle the number that appears in the box. This is the rank number of the child (CD1) that is going to be the subject of the questions you will be asking.


CD7.
Total number of the eligible children in the household (CD6) [Column 1 to 8+]
Last digit of household number (HH2) [Row 0 to 9]

CD8. Record the rank number of the selected child: _

CD9. Write the name and row number for the child selected for this module from CD3 and CD2, according to the rank number in CD8.
CD10. Adults use certain ways to teach children the proper behaviour or to approach a behavioural problem. I will read you some methods that are used and I want you to tell me if you or any other person in your household has ever used this method with (name) in the past month.

CD11. Took privileges, or have forbade something (name) wanted to do or grounded him/her not to leave the house.

CD12. Explained why (name)'s behaviour was incorrect.

CD13. Shook him/her with hands.

CD14. Shouted, or yelled at him/her.

CD15. Gave him/her something else to do.

CD16. Spanked, or slapped him/her on the bottom.

CD17. Hit him/her on the bottom or somewhere else on the body with something like a belt, a hairbrush, a stick or another hard object.

CD18. Called him/her stupid, lazy, or with similar adjectives.

CD19. Hit or slapped him/her on the face, head or ears.

CD20. Hit or slapped him/her on the hand, arm, or leg.

CD21. Beat him/her up, that is hit him/her over and over as hard as one could.

CD22. Do you believe that for the purpose of properly bringing up, rising, or educating a child, one needs to physically punish the child?

HH19. Record the momentary time

HH20. Thank the respondent for his/her cooperation and check the Household List:

Return to the cover page and confirm that all information about the number of eligible women (HH12), all children under 5 (HH14), and all children aged between 2 and 9 (HH15A) is properly entered.
Make all the necessary steps for all the individual questionnaires to be filled in correctly for this household.
Interviewer's observations ________

Field editor's observations ________

Supervisor's observations ________