NATIONAL COUNCIL FOR POPULATION AND DEVELOPMENT
CENTRAL BUREAU OF STATISTICS
KENYA DEMOGRAPHIC AND HEALTH SURVEY 2
HOUSEHOLD SCHEDULE
PROVINCE __________
DISTRICT __________
LOCATION/TOWN __________
SUBLOCATION/WARD __________
NASSEP CLUSTER NUMBER
KDHS CLUSTER NUMBER
HOUSEHOLD NUMBER
NAIROBI/MOMBASA 1, SMALL CITY 2, TOWN 3, RURAL 4
SMALL CITY 2
TOWN 3
RURAL 4
NAME OF HOUSEHOLD HEAD _______________
HOUSEHOLD SELECTED FOR MALE SURVEY?
NO 2
INTERVIEWER VISIT 1
DATE _________
INTERVIEWER'S NAME __________
RESULT* __________
NEXT VISIT:
DATE _______
TIME ________
INTERVIEWER VISIT 2
DATE _________
INTERVIEWER'S NAME __________
RESULT* __________
NEXT VISIT:
DATE _______
TIME ________
INTERVIEWER VISIT 3
DATE _________
INTERVIEWER'S NAME __________
RESULT* __________
FINAL VISIT
DAY __
MONTH __
YEAR __
NAME ___
RESULT __
LINE NO. OF RESP. TO HOUSEHOLD SCHEDULE __
2 NO HOUSEHOLD MEMBER AT HOME OR NO COMPETENT RESPONDENT AT HOME AT TIME OF VISIT
3 ENTIRE HOUSEHOLD ABSENT FOR EXTENDED PERIOD
4 POSTPONED
5 REFUSED
6 DWELLING VACANT OR ADDRESS NOT A DWELLING
7 DWELLING DESTROYED
8 DWELLING NOT FOUND
9 OTHER (SPECIFY) _________
LANGUAGE OF QUESTIONNAIRE: ENGLISH 10
FIELD EDITED BY
NAME __________
DATE __________
OFFICE EDITED BY
NAME ____________
DATE ____________
KEYED BY
NAME _____________ ____
DATE _____________
Now we would like some information about the people who usually live in your household or who are staying with you now.
LINE NO.
USUAL RESIDENTS AND VISITORS:
Please give me the names of the persons who usually live in your household and guests of the household who stayed here last night, starting with the head of the household. (2)
RELATIONSHIP TO HEAD OF HOUSEHOLD*
What is the relationship of (NAME) to the head of the household? (3)
*CODES FOR Q.3
RELATIONSHIP TO HEAD OF HOUSEHOLD:
01 = HEAD
02 = WIFE/HUSBAND
03 = SON OR DAUGHTER
04 = SON-IN-LAW OR DAUGHTER-IN-LAW
05 = GRANDCHILD
06 = PARENT
07 = PARENT-IN-LAW
08 = BROTHER OR SISTER
09 = OTHER RELATIVE
10 = ADOPTED/FOSTER CHILD
11 = NOT RELATED
98 = DOES NOT KNOW
RESIDENCE: Does (NAME) usually live here? (4)
NO 2
RESIDENCE: Did (NAME) stay here last night? (5)
NO 2
SEX : Is (NAME) male or female? (6)
F 2
Has (NAME) ever attended school? (8)
NO 2
IF ATTENDED SCHOOL
What is the highest level of school (NAME) attended? What is the highest standard or form (NAME) completed at that level?** (9)
FORM ____
**CODES FOR LEVEL OF EDUCATION:
0 = NURSERY
1 = PRIMARY
2 = SECONDARY
3 = UNIVERSITY
8 = DK
CODES FOR STANDARD/FORM/YEAR:
00 = LESS THAN 1 YEAR COMPLETED
98 = DON'T KNOW
Is (NAME) still in school?(10)
NO 2
PARENTAL SURVIVORSHIP AND RESIDENCE FOR PERSONS LESS THAN 15 YEARS OLD***
***THESE QUESTIONS REFER TO THE BIOLOGICAL PARENTS OF THE CHILD. RECORD '00' IF PARENT NOT MEMBER OF HOUSEHOLD.
Is (NAME)'s natural mother alive? (11)
NO 2
DK 8
IF ALIVE
Does (NAME)'s natural mother live in this household?
IF YES: What is her name?
RECORD MOTHER'S LINE NUMBER. (12)
Is (NAME)'s natural father alive? (13)
NO 2
DK 8
IF ALIVE
Does (NAME)'s natural father live in this household?
IF YES: What is his name?
RECORD FATHER'S LINE NUMBER. (14)
ELIGIBILITY WOMEN
CIRCLE LINE NUMBER OF ALL WOMEN AGED 15-49. (15)
HUSBAND LINE NUMBER
WRITE LINE NUMBER OF THE HUSBAND OF EACH ELIGIBLE WOMAN.
WRITE 00 IF NOT MARRIED OR IF HUSBAND NOT IN HOUSEHOLD. (16)
ELIGIBILITY MEN
CIRCLE LINE NUMBER OF ALL MEN AGED 20-54
(IF HOUSEHOLD FALLS IN MALE SAMPLE) (17)
TICK HERE IF CONTINUATION SHEET USED __
TOTAL NUMBER OF ELIGIBLE WOMEN __
TOTAL NUMBER OF ELIGIBLE MEN__
Just to make sure that I have a complete listing:
1) Are there any other persons such as small children or infants that we have not listed?
NO __
2) In addition, are there any other people who may not be members of your family, such as domestic servants, lodgers or friends who usually live here?
NO __
3) Do you have any guests or temporary visitors staying here, or anyone else who slept here last night?
NO __
18. What is the source of water your household uses for handwashing and dishwashing for most of the year?
PUBLIC TAP 12
WELL WITHOUT PUMP 22
RIVER/STREAM 32
OTHER _______ 51
19. How long does it take to go there, get water, and come back?
ON PREMISES 996
20. Does your household get drinking water from this same source?
NO 2
21. What is the source of drinking water for members of your household?
PUBLIC TAP 12
WELL WITHOUT PUMP 22
RIVER/STREAM 32
OTHER _______ 51
22. What kind of toilet facility does your household have?
SHARED FLUSH TOILET 12
VENTILATED IMPROVED PIT TOILET 22
OTHER ____ 41
23. Does your household have:
Electricity?
A radio?
A television?
A refrigerator?
NO 2
NO 2
NO 2
NO 2
24. How many rooms in your household are used for sleeping?
25. MAIN MATERIAL OF THE FLOOR.
RECORD OBSERVATION.
RUDIMENTARY FLOOR
VINYL/LINOLEUM/ASPHALT STRIPS 32
CERAMIC TILES 33
CEMENT 34
26. MAIN MATERIAL OF THE WALL.
RECORD OBSERVATION.
RUDIMENTARY WALLS
CEMENT/STONE BLOCKS 32
27. MAIN MATERIAL OF THE ROOF.
RECORD OBSERVATION.
RUDIMENTARY ROOF
28. Does any member of your household own:
A bicycle?
Land?
Cattle, goats or sheep?
Cash crops such as tea, coffee, cotton?
NO 2
NO 2
NO 2
NO 2