ANGUILLA
1780
ORGANISATION OF EASTERN CARIBBEAN STATES
POPULATION AND HOUSING CENSUS 2011
CENSUS DAY - MAY 11, 2011
CONFIDENTIAL WHEN COMPLETED
About the Census
Confidentiality is guaranteed
The Census takes place every ten (10) years and is the total
process of collecting, compiling and publishing demographic,
economic and social data pertaining to all persons in a
country at a specific time.
The Statistics Act guarantees the confidentiality of your
answers to the census questions.
Census Enumerator
The enumerator will assist you in the completion of this
questionnaire.
Participation is mandated
The Census is conducted under the Anguilla Statistics Act
R. S. A. c S60 and the Census Order and Regulations. You
are required by law to complete this questionnaire with
accurate information.
Thank you for your cooperation.
VERY IMPORTANT
INSTRUCTIONS ON HOW TO COMPLETE THIS QUESTIONNAIRE
1. Only use 2B pencils as provided. Do not use pen.
2. Place an X in the boxes.
3. Do not use check marks or shade outside the boxes.
4. Box entry answers must be written neatly inside the boxes
provided.
5. Do not make stray marks on the questionnaire.
6. If you need to make changes, completely erase the wrong
answer.
7. Where you are required to write in an answer in boxes, please
print carefully using BLOCK CAPITAL LETTERS, avoiding
contact with the edges of the box and leaving one space between
each word.
EXAMPLE:
Where were (was) ........... born?
0
A
B
C
D
E
F
G
H
I
J
K
L
M
N
1
O
2
P
3
Q
4
R
5
S
AN GU I L L A
6
T
7
8
9
U
V
W
X
Y
Z
SECTION A - HOUSEHOLD LOCATION
PHYSICAL ADDRESS OF HOUSEHOLD: __________________________________________________________
VILLAGE OF HOUSEHOLD:_____________________________________________________________________
District No:
0
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8
9
District Name:
0
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9
9
Household No:
Building No:
ED No:
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9
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Electoral District:
Page 1 of 10
Confidential when completed
1780
ENUMERATOR SAYS:
Good day/evening. My name is _____________________ and I am the census enumerator assigned to your area. I would appreciate it if
you would allow me to interview you to get some information about your household and its members.
Here is my identification card (Show card)
INTERVIEWER CALLS
1
SECTION B - RECORD OF VISITS
2
3
4
5
DATE (DD/MM/YY)
TIME STARTED (eg. 07:19)
TIME ENDED (eg. 23:11)
DURATION
RESULTS
Results Codes:
1. Fully Completed
2. Partially Completed - Call Back
3. Appointment Made
4. Dwelling Closed
5. Dwelling Vacant
6. No Contact
7. Refusal (complete appropriate form)
8. No Suitable Respondent Available eg: Child
9. Other - Specify _______________________
SECTION C - VERIFICATION OF QUESTIONNAIRE
ENUMERATOR:
ID No:
Date:
/
/ 2011
D D / MM / Y Y Y Y
Last Name:
First Name:
SUPERVISOR:
ID No.:
Date:
/
/ 2011
D D / M M /
Last Name:
Y Y Y Y
First Name:
EDITOR:
ID No.:
Date:
/
/ 2011
/
/ 2011
D D / M M /
Last Name:
Y Y Y Y
First Name:
CODER:
ID No.:
Last Name:
Date:
D D / M M / Y Y Y Y
First Name:
Page 2 of 10
Confidential when completed
Remember to mark all choice boxes like this
1780
x
SECTION 1 - LISTING OF HOUSEHOLD MEMBERS
ENUMERATOR ASKS:
H.1 Including
yourself, how many
persons usually live
here?
Males:
A.
B. Females:
0
1
2
3
4
5
6
7
8
9
0
0
1
1
2
2
3
3
4
4
5
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6
6
7
7
8
8
9
9
H.2 Including yourself,
how many persons who
usually live here were at
this residence on Census
Night - May 11, 2011?
0
1
2
3
4
5
6
(18:00hrs May 11th - 06:00hrs May 12th, 7
2011)
8
9
0
0
1
1
2
2
3
3
4
4
5
5
6
6
7
7
8
8
9
9
H.3 Including yourself,
how many persons who
usually live here were
abroad on Census Day May 11, 2011?
0
1
2
3
4
5
6
7
8
9
0
0
1
1
2
2
3
3
4
4
5
5
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8
9
9
ENUMERATOR SAYS:
Please tell me the names of all persons who usually live in this household and share at least one of the daily meals. Include those who
usually live in Anguilla for at least six (6) months of the year. Person number 1 is identified as the reference person/ head of the household.
(You may use initials if names are not available). Place an X in the box provided, if the person is under five years old.
Person No. SURNAME (LAST NAME)
CARTY
1
CHRISTIAN NAME (FIRST NAME)
MONROE
SURNAME
CHRISTIAN NAME
22
SURNAME
CHRISTIAN NAME
33
SURNAME
CHRISTIAN NAME
414
SURNAME
CHRISTIAN NAME
SURNAME
CHRISTIAN NAME
SURNAME
CHRISTIAN NAME
SURNAME
CHRISTIAN NAME
8
SURNAME
CHRISTIAN NAME
9
SURNAME
CHRISTIAN NAME
10
SURNAME
CHRISTIAN NAME
11
SURNAME
CHRISTIAN NAME
12
SURNAME
CHRISTIAN NAME
13
SURNAME
CHRISTIAN NAME
11
5
6
7
14
15
c
SURNAME
CHRISTIAN NAME
SURNAME
CHRISTIAN NAME
INITIAL SEX (M/F)
C
M=1 F=2
1
2
1
2
1
2
1
2
1
2
1
2
1
2
1
2
1
2
1
2
1
2
1
2
1
2
1
2
1
2
<5 years
old
Page 3 of 10
Confidential when completed
1780
Remember to mark all choice boxes like this
x
SECTION 2 - RELATIONSHIP OF HOUSEHOLD MEMBERS
ENUMERATOR: KINDLY FILL IN THE PERSON NUMBER OF THE PROVIDER OF THE HOUSEHOLD
QUESTIONNAIRE DATA
0
1
0
2
1
3
2
3
4
4
5
5
6
6
7
8
7
8
The listing of household members section focuses on the listed person and their relationship to the other household member(s). E.g., below there are
three persons in a household, only showing Persons 1 and 3, Person 1 is the head of household. Person 3 relationship to Person 1& 2 is the natural born
daughter to Person 1 and step-daughter to Person 2. If Person 2 was included, the relationship to person 1 would be wife.
1 Reference Person/Head Last Name
PERSON 1
of Household
Enter Name of person 1 here as in the CART Y
Household Listing on page 3
Last Name
62
PERSON 2
How is person 2 related to person CART Y
1 Husband/wife
3 Adopted son/daughter
1
2 Natural born son/daughter 4 Step son/daughter
11 Other relative (specify________________)
3
PERSON 3
How is person 3 related to persons
5 Brother/sister
6 Father/mother
12 Unrelated
First Name
MI
MONRO E
C
First Name
MI
L I NDA
T
7 Grandchild
8 Parent-in-law
9 Son-in-law/daughter-in-law
10 Partner
Last Name
First Name
MI
CART Y
SANDRA
D
1
1 Husband/wife
3 Adopted son/daughter
2 Natural born son/daughter 4 Step son/daughter
11 Other relative (specify________________)
5 Brother/sister
6 Father/mother
12 Unrelated
7 Grandchild
8 Parent-in-law
9 Son-in-law/daughter-in-law
10 Partner
2
1 Husband/wife
3 Adopted son/daughter
2 Natural born son/daughter 4 Step son/daughter
11 Other relative (specify________________)
5 Brother/sister
6 Father/mother
12 Unrelated
7 Grandchild
8 Parent-in-law
9 Son-in-law/daughter-in-law
10 Partner
If there are more than eight (8) persons in this household, fill out an additional Household questionnaire for the remaining person(s)
using the listing.
If there is only one household member skip to Section 2, H. 6.
1 Reference Person/Head Last Name
PERSON 1
of Household
Enter Name of person 1 here as in the
Household Listing on page 3
Last Name
62
PERSON 2
How is person 2 related to person
1 Husband/wife
3 Adopted son/daughter
1
2 Natural born son/daughter 4 Step son/daughter
11 Other relative (specify________________)
3
PERSON 3
How is person 3 related to persons
MI
First Name
5 Brother/sister
6 Father/mother
12 Unrelated
First Name
MI
7 Grandchild
8 Parent-in-law
9 Son-in-law/daughter-in-law
10 Partner
MI
First Name
Last Name
1
1 Husband/wife
3 Adopted son/daughter
2 Natural born son/daughter 4 Step son/daughter
11 Other relative (specify________________)
5 Brother/sister
6 Father/mother
12 Unrelated
7 Grandchild
8 Parent-in-law
9 Son-in-law/daughter-in-law
10 Partner
2
1 Husband/wife
3 Adopted son/daughter
2 Natural born son/daughter 4 Step son/daughter
11 Other relative (specify________________)
5 Brother/sister
6 Father/mother
12 Unrelated
7 Grandchild
8 Parent-in-law
9 Son-in-law/daughter-in-law
10 Partner
Page 4 of 10
Confidential when completed
1780
Remember to mark all choice boxes like this
x
SECTION 2 - RELATIONSHIP OF HOUSEHOLD MEMBERS
4
PERSON 4
How is person 4 related to persons
Last Name
First Name
MI
1
1 Husband/wife
3 Adopted son/daughter
2 Natural born son/daughter 4 Step son/daughter
11 Other relative (specify________________)
5 Brother/sister
6 Father/mother
12 Unrelated
7 Grandchild
8 Parent-in-law
9 Son-in-law/daughter-in-law
10 Partner
2
1 Husband/wife
3 Adopted son/daughter
2 Natural born son/daughter 4 Step son/daughter
11 Other relative (specify________________)
5 Brother/sister
6 Father/mother
12 Unrelated
7 Grandchild
8 Parent-in-law
9 Son-in-law/daughter-in-law
10 Partner
3
1 Husband/wife
3 Adopted son/daughter
2 Natural born son/daughter 4 Step son/daughter
11 Other relative (specify________________)
5 Brother/sister
6 Father/mother
12 Unrelated
7 Grandchild
8 Parent-in-law
9 Son-in-law/daughter-in-law
10 Partner
5
PERSON 5
How is person 5 related to persons
Last Name
First Name
MI
1
1 Husband/wife
3 Adopted son/daughter
2 Natural born son/daughter 4 Step son/daughter
11 Other relative (specify________________)
5 Brother/sister
6 Father/mother
12 Unrelated
7 Grandchild
8 Parent-in-law
9 Son-in-law/daughter-in-law
10 Partner
2
1 Husband/wife
3 Adopted son/daughter
2 Natural born son/daughter 4 Step son/daughter
11 Other relative (specify________________)
7 Grandchild
8 Parent-in-law
9 Son-in-law/daughter-in-law
10 Partner
3
1 Husband/wife
3 Adopted son/daughter
2 Natural born son/daughter 4 Step son/daughter
11 Other relative (specify________________)
5 Brother/sister
6 Father/mother
12 Unrelated
5 Brother/sister
6 Father/mother
12 Unrelated
7 Grandchild
8 Parent-in-law
9 Son-in-law/daughter-in-law
4
1 Husband/wife
3 Adopted son/daughter
2 Natural born son/daughter 4 Step son/daughter
11 Other relative (specify________________)
5 Brother/sister
6 Father/mother
12 Unrelated
7 Grandchild
8 Parent-in-law
6
PERSON 6
How is person 6related to persons
10 Partner
9 Son-in-law/daughter-in-law
10 Partner
First Name
Last Name
1:1
1 Husband/wife
3 Adopted son/daughter
2 Natural born son/daughter 4 Step son/daughter
11 Other relative (specify________________)
5 Brother/sister
6 Father/mother
12 Unrelated
7 Grandchild
8 Parent-in-law
2:
2
1 Husband/wife
3 Adopted son/daughter
2 Natural born son/daughter 4 Step son/daughter
11 Other relative (specify________________)
5 Brother/sister
6 Father/mother
12 Unrelated
7 Grandchild
8 Parent-in-law
3:3
1 Husband/wife
3 Adopted son/daughter
2 Natural born son/daughter 4 Step son/daughter
11 Other relative (specify________________)
7 Grandchild
8 Parent-in-law
4:
4
1 Husband/wife
3 Adopted son/daughter
2 Natural born son/daughter 4 Step son/daughter
11 Other relative (specify________________)
5:
5
1 Husband/wife
3 Adopted son/daughter
2 Natural born son/daughter 4 Step son/daughter
11 Other relative (specify________________)
5 Brother/sister
6 Father/mother
12 Unrelated
5 Brother/sister
6 Father/mother
12 Unrelated
5 Brother/sister
6 Father/mother
12 Unrelated
7 Grandchild
8 Parent-in-law
7 Grandchild
8 Parent-in-law
MI
9 Son-in-law/daughter-in-law
10 Partner
9 Son-in-law/daughter-in-law
10 Partner
9 Son-in-law/daughter-in-law
10 Partner
9 Son-in-law/daughter-in-law
10 Partner
9 Son-in-law/daughter-in-law
10 Partner
Page 5 of 10
Confidential when completed
Remember to mark all choice boxes like this
1780
x
SECTION 2 - RELATIONSHIP OF HOUSEHOLD MEMBERS
7
PERSON 7
How is person 7 related to persons
MI
First Name
Last Name
1
1 Husband/wife
3 Adopted son/daughter
2 Natural born son/daughter 4 Step son/daughter
11 Other relative (specify________________)
5 Brother/sister
6 Father/mother
12 Unrelated
7 Grandchild
8 Parent-in-law
9 Son-in-law/daughter-in-law
10 Partner
2
1 Husband/wife
3 Adopted son/daughter
2 Natural born son/daughter 4 Step son/daughter
11 Other relative (specify________________)
5 Brother/sister
6 Father/mother
12 Unrelated
7 Grandchild
8 Parent-in-law
9 Son-in-law/daughter-in-law
10 Partner
3
1 Husband/wife
3 Adopted son/daughter
2 Natural born son/daughter 4 Step son/daughter
11 Other relative (specify________________)
5 Brother/sister
6 Father/mother
12 Unrelated
7 Grandchild
8 Parent-in-law
9 Son-in-law/daughter-in-law
10 Partner
4
1 Husband/wife
3 Adopted son/daughter
2 Natural born son/daughter 4 Step son/daughter
11 Other relative (specify________________)
5 Brother/sister
6 Father/mother
12 Unrelated
7 Grandchild
8 Parent-in-law
9 Son-in-law/daughter-in-law
10 Partner
55
1 Husband/wife
3 Adopted son/daughter
2 Natural born son/daughter 4 Step son/daughter
11 Other relative (specify________________)
5 Brother/sister
6 Father/mother
12 Unrelated
7 Grandchild
8 Parent-in-law
9 Son-in-law/daughter-in-law
10 Partner
6
1 Husband/wife
3 Adopted son/daughter
2 Natural born son/daughter 4 Step son/daughter
11 Other relative (specify________________)
5 Brother/sister
6 Father/mother
12 Unrelated
7 Grandchild
8 Parent-in-law
9 Son-in-law/daughter-in-law
10 Partner
8
PERSON 8
How is person 8 related to persons
First Name
Last Name
MI
1
1 Husband/wife
3 Adopted son/daughter
2 Natural born son/daughter 4 Step son/daughter
11 Other relative (specify________________)
5 Brother/sister
6 Father/mother
12 Unrelated
7 Grandchild
8 Parent-in-law
9 Son-in-law/daughter-in-law
10 Partner
2
1 Husband/wife
3 Adopted son/daughter
2 Natural born son/daughter 4 Step son/daughter
11 Other relative (specify________________)
7 Grandchild
8 Parent-in-law
9 Son-in-law/daughter-in-law
10 Partner
3
1 Husband/wife
3 Adopted son/daughter
2 Natural born son/daughter 4 Step son/daughter
11 Other relative (specify________________)
7 Grandchild
8 Parent-in-law
9 Son-in-law/daughter-in-law
10 Partner
7 Grandchild
8 Parent-in-law
9 Son-in-law/daughter-in-law
4
1 Husband/wife
3 Adopted son/daughter
2 Natural born son/daughter 4 Step son/daughter
11 Other relative (specify________________)
55
1 Husband/wife
3 Adopted son/daughter
2 Natural born son/daughter 4 Step son/daughter
11 Other relative (specify________________)
6
1 Husband/wife
3 Adopted son/daughter
2 Natural born son/daughter 4 Step son/daughter
11 Other relative (specify________________)
7
1 Husband/wife
3 Adopted son/daughter
2 Natural born son/daughter 4 Step son/daughter
11 Other relative (specify________________)
5 Brother/sister
6 Father/mother
12 Unrelated
5 Brother/sister
6 Father/mother
12 Unrelated
5 Brother/sister
6 Father/mother
12 Unrelated
5 Brother/sister
6 Father/mother
12 Unrelated
5 Brother/sister
6 Father/mother
12 Unrelated
5 Brother/sister
6 Father/mother
12 Unrelated
10 Partner
7 Grandchild
8 Parent-in-law
9 Son-in-law/daughter-in-law
10 Partner
7 Grandchild
8 Parent-in-law
9 Son-in-law/daughter-in-law
10 Partner
7 Grandchild
8 Parent-in-law
9 Son-in-law/daughter-in-law
10 Partner
FOR OFFICIAL USE ONLY:
H. 4 Number of families in this household
H. 5 Type of Household/ Family
1 One person household
2 Nuclear household
3 Extended household
4 Composite household
5 Other/unknown
Page 6 of 10
Confidential when completed
Remember to mark all choice boxes like this
1780
x
SECTION 3 - HOUSING I
ENUMERATOR SAYS:
I would like to ask you a few questions about the dwelling that your household occupies, may I start?
H. 6 What type of building does this household occupy?
1 Undivided private house
2 Part of a private house
3 Duplex house/apartment
4 Flat/apartment
5 Combined dwelling & business
6 Barracks
7 Other - specify_________________________
8 NS
1 Concrete or concrete blocks
2 Stone & Concrete
3 Wood only
4 Wood & Concrete
5 Brick
6 Makeshift - specify _____________________
7 Other - specify _________________________
8 NS
1 Yes
2 No
3 NS
H. 8 Are the contents of the dwelling insured?
1 Yes
2 No
3 NS
H.16 What is the MAIN outer roof material of this dwelling?
H. 9 Does this household own/rent/lease this dwelling?
1 Own with Mortgage
2 Own without Mortgage (Go to H.14)
3 Rent (Continue to H.11)
4 Rent free (Go to H.13)
5 Lease (Continue to H.14)
6 Other - specify _____________________ (Go to H.14)
7 NS
H.10 What is the monthly mortgage payment in XCD?
Monthly Mortgage Payment in XCD
$
,
(Go to H.14)
1 Weekly
2 Fortnightly
3 Monthly
4 Quarterly
5 Twice a year
6 Annually
7 NS
H.17 Is the roof MAINLY pitched or flat?
1 Pitched
3 NS
2 Flat
1 Before 1970
2 1970 - 79
3 1980 - 89
4 1990 - 95
5 1996 - 99
6 2000 - 01
7 2002
8 2003
9 2004
10 2005
11 2006
12 2007
13 2008
14 2009
15 2010
16 2011
17 DK
18 NS
H.19 What is the MAIN source of water?
H. 12 Is the dwelling rented, fully furnished, semi-furnished
or un-furnished?
1 Fully furnished
2 Semi-furnished
3 Un-furnished
4 NS
1 Cistern, piped into dwelling
2 Cistern, not piped into dwelling
3 Public, piped into dwelling
4 Public, piped into yard
5 Public standpipe
6 Public well/tank
7 Bottled water
8 Other - specify _________
9 NS
H. 20 What is the MAIN source of drinking water?
H.13 How much monthly rent is being paid in XCD?
Monthly Rent in XCD
1 Concrete
2 Sheet metal
3 Asphalt shingles
4 Wood shingles
5 Other shingles
6 Tiles
7 Makeshift/thatched - specify ____________________
8 Other - specify_________________
9 NS
H.18 In which year was this dwelling built/completed?
H. 11 What is the frequency of rent for this dwelling?
Category
1 Owned/freehold
2 Rented
3 Rent free
4 Leasehold
5 Other - specify _____________________
6 NS
H.15 What is the MAIN material of the outer walls of the dwelling?
H. 7 Is this dwelling insured?
Category
H.14 What is the land tenure status?
$
,
1 Cistern, piped into dwelling
2 Cistern, not piped into dwelling
3 Public, piped into dwelling
4 Public, piped into yard
5 Public standpipe
6 Public well/tank
7 Bottled water
8 Other - specify _________
9 NS
Page 7 of 10
Confidential when completed
Remember to mark all choice boxes like this
1780
x
SECTION 3 - HOUSING I CONTINUED
H.21 What is the MOST frequently used type of toilet
facility?
H.32 Does your household have any of the following household
appliances/items/services? (Indicate all that apply)
1 W.C. flush toilet inside dwelling
2 W.C. flush toilet outside dwelling
3 Pit latrine ventilated/elevated
4 Pit latrine not ventilated/elevated
5 Other - specify _________________
6 None (Go to H.23)
7 NS
H.22 Are these toilet facilities shared with another
household?
1 Yes (shared)
2 No (not shared)
3 NS
H.23 Are bathing facilities shared with another household?
1 Yes (shared)
2 No (not shared)
3 NS
H.24 Are your bathing facilities indoors or outdoors?
1 Indoors
2 Outdoors
3 NS
H.25 What type of lighting do you use MOST?
1 Electricity - ANGLEC
2 Electricity - Generator
3 Gas
4 Kerosene
5 Other - specify _________________
6 NS
H.26 What type of cooking fuel is used MOST?
1 Gas/LPG
2 Coal/Wood
3 Kerosene
4 Electricity
5 Other - specify _________________
6 NS
H.27 Is your kitchen indoors or outdoors?
1 Indoors
3 NS
2 Outdoors
H.28 Is your kitchen shared with another household?
1 Yes (shared)
2 No (not shared)
3 NS
H.29 How many bedrooms are there in this dwelling?
Bedrooms are rooms used mainly
for sleeping and exclude makeshift
and temporary sleeping areas.
Count includes spare bedrooms
not occupied.
0 1 2 3 4 5 6 7 8 9
0
1
2
3
4
5
6
7
8
9
0
1
2
3
4
5
6
7
8
9
H.30 How many rooms are there in this dwelling?
0 1 2 3 4 5 6 7 8 9
Include in your count of bedrooms,
living rooms etc. exclude bathroom,
porches, passageways etc.
0
1
2
3
4
5
6
7
8
9
0
1
2
3
4
5
6
7
8
9
H.31 What is the household's MAIN method of garbage
disposal?
1 Dumpster/bin/garbage collection
2 Dumping on land
3 Dumping in pond
4 Burning
5 Burying
6 Composting
7 Other - specify ___________________
8 NS
Stereo/Radio
1 Yes
2 No
3 NS
Qty:
Television CRT
1 Yes
2 No
3 NS
Qty:
Flat Panel/Screen TV
1 Yes
2 No
3 NS
Qty:
Landline Telephone
1 Yes
2 No
3 NS
Qty:
Cellular Telephone
1 Yes
2 No
3 NS
Qty:
Desktop Computer
1 Yes
2 No
3 NS
Qty:
Laptop Computer
1 Yes
2 No
3 NS
Qty:
Air-Conditioning Unit
1 Yes
2 No
3 NS
Qty:
Clothes Dryer
1 Yes
2 No
3 NS
Qty:
Dishwasher
1 Yes
2 No
3 NS
Qty:
DVD Player
1 Yes
2 No
3 NS
Qty:
Freezer
1 Yes
2 No
3 NS
Qty:
Generator
1 Yes
2 No
3 NS
Qty:
Game Console
1 Yes
2 No
3 NS
Qty:
Refrigerator
1 Yes
2 No
3 NS
Qty:
Microwave
1 Yes
2 No
3 NS
Qty:
Satellite Dish
1 Yes
2 No
3 NS
Qty:
Solar Panels
1 Yes
2 No
3 NS
Qty:
Stove
1 Yes
2 No
3 NS
Qty:
Washing Machine
1 Yes
2 No
3 NS
Qty:
Water Pump
1 Yes
2 No
3 NS
Qty:
Water Heater
1 Yes
2 No
3 NS
Qty:
Video Cassette Recorder
1 Yes
2 No
3 NS
Qty:
Cable Services
1 Yes
2 No
3 NS
Qty:
H.33 How many of each of the following types of motor vehicles
are kept and used privately by this household?
1 Saloon Car
Qty:
4 Pick-up truck
Qty:
2 Motorcycle
Qty:
5 SUV/Jeep
Qty:
6 Other
Qty:
3 Van/truck/lorry Qty:
Specify ______________
H.34 Does this household have access to an Internet
Connection?
1 Yes
2 No
3 NS
Page 8 of 10
Confidential when completed
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1780
x
SECTION 4 - MIGRATION
H.35 Has this household been living together since
2001, even at another location?
1 Yes
2 No
H.37 Since 2001, did any member of this household
move to live abroad permanently?
3 NS
1 Yes (Continue to H.38)
If "No", end Household questionnaire; go to P.45
H.36 How many people left Anguilla to live abroad and are
yet to return? 0 1 2 3 4 5 6 7 8 9
0
1
2
3
4
5
6
7
8
9
0
1
2
3
4
5
6
7
8
9
2 No
3 NS
If "No" or "NS" , end Household
questionnaire; go to P.45
Not stated = 99
If "00", end Household questionnaire; go to P.45
SECTION 4 - CHARACTERISTICS OF HOUSEHOLD MEMBER WHO MOVED PERMANENTLY
H.40 Highest
H.38 Sex H.39 Age at Educational Level H.41 What was .... occupation H.42 Year of move
Person
1 Male
Departure
at time of departure
reached when
(2001 - 2010).
No.
2 Female
moved
1 None
1
#1
2
0
1
2
3
4
5
6
7
8
9
0
0
1
1
2
2
3
3
4
4
5
5
6
6
7
7
8
8
9
9
2 Preschool
3 Primary
4 Secondary
5 College
6 University
Occupation:
7 Other
8 NS
0
1
2
3
4
5
6
7
8
9
0
0
0
0
1
1
1
1
2
2
2
2
3
3
3
3
4
4
4
4
5
5
5
5
6
6
6
6
7
7
7
7
8
8
8
8
9
9
9
9
1 None
1
#2
2
0
1
2
3
4
5
6
7
8
9
0
0
1
1
2
2
3
3
4
4
5
5
6
6
7
7
8
8
9
9
2 Preschool
3 Primary
4 Secondary
5 College
6 University
Occupation:
7 Other
8 NS
0
1
2
3
4
5
6
7
8
9
0
0
0
0
1
1
1
1
2
2
2
2
3
3
3
3
4
4
4
4
5
5
5
5
6
6
6
6
7
7
7
7
8
8
8
8
9
9
9
9
1 None
1
#3
2
0
1
2
3
4
5
6
7
8
9
0
0
1
1
2
2
3
3
4
4
5
5
6
6
7
7
8
8
9
9
2 Preschool
3 Primary
4 Secondary
5 College
6 University
Occupation:
7 Other
8 NS
0
1
2
3
4
5
6
7
8
9
0
0
0
0
1
1
1
1
2
2
2
2
3
3
3
3
4
4
4
4
5
5
5
5
6
6
6
6
7
7
7
7
8
8
8
8
9
9
9
9
1 None
1
#4
2
0
1
2
3
4
5
6
7
8
9
2 Preschool
0
0
1
1
2
2
3
3
4
4
5
5
6
6
7
7
8
8
9
9
3 Primary
4 Secondary
5 College
6 University
7 Other
8 NS
Occupation:
0
1
2
3
4
5
6
7
8
9
0
0
0
0
1
1
1
1
2
2
2
2
3
3
3
3
4
4
4
4
5
5
5
5
6
6
6
6
7
7
7
7
8
8
8
8
9
9
9
9
H.43 Country migrated to
1 U.S.A.
2 U.S.V.I
3 U.K.
4 Canada
5 St. Martin/St. Maarten
6 Other - specify ___________
7 NS
Country Code:
1 U.S.A.
2 U.S.V.I
3 U.K.
4 Canada
5 St. Martin/St. Maarten
6 Other - specify ___________
7 NS
Country Code:
1 U.S.A.
2 U.S.V.I
3 U.K.
4 Canada
5 St. Martin/St. Maarten
6 Other - specify ___________
7 NS
Country Code:
1 U.S.A.
2 U.S.V.I
3 U.K.
4 Canada
5 St. Martin/St. Maarten
6 Other - specify ___________
7 NS
Country Code:
H.44 Main Reason for Migration
1 Higher Income
2 Employment
3 Study
4 Medical
5 Marriage
6 Family Reasons
7 Crime Rate
8 Other - specify ___________
1 Higher Income
2 Employment
3 Study
4 Medical
5 Marriage
6 Family Reasons
7 Crime Rate
8 Other - specify ___________
1 Higher Income
2 Employment
3 Study
4 Medical
5 Marriage
6 Family Reasons
7 Crime Rate
8 Other - specify ___________
1 Higher Income
2 Employment
3 Study
4 Medical
5 Marriage
6 Family Reasons
7 Crime Rate
8 Other - specify ___________
ENUMERATOR: You have now completed the Household questionnaire. Please continue to the Individual questionnaire, which is to be completed for each person listed .
Thank you.
Page 9 of 10
Confidential when completed
1780
SECTION 5 - COMMENTS
Page 10 of 10
Confidential when completed
Remember to mark all choice boxes like this
35288
x
INDIVIDUAL QUESTIONNAIRE
Household No.:
Building No.:
ED No.:
Person No.:
0
0
0
0
1
1
1
1
2
2
2
2
3
3
3
3
4
4
4
4
5
5
5
5
6
6
6
6
7
7
7
7
8
8
8
8
9
9
9
9
ENUMERATOR: When asking questions, replace dotted line with " you or your" unless the respondent is answering on behalf of a minor or
incapacitated person.
0
0
0
0
0
0
0
0
0
0
1
1
1
1
1
1
1
1
1
1
2
2
2
2
2
2
2
2
2
2
3
3
3
3
3
3
3
3
3
3
4
4
4
4
4
4
4
4
4
4
5
5
5
5
5
5
5
5
5
5
6
6
6
6
6
6
6
6
6
6
7
7
7
7
7
7
7
7
7
7
8
8
8
8
8
8
8
8
8
8
9
9
9
9
9
9
9
9
9
9
SECTION 6 CHARACTERISTICS - FOR ALL PERSONS
P.45 Write person's assigned number taken from page 3
of household questionnaire.
P.50 What is ... ('s) first language (mother tongue)?
1 English
2 Spanish
3 French
4 Chinese
5 Italian
6 German
7 Dutch
8 Other - specify__________________
1 English
2 Spanish
3 French
4 Chinese
(Indicate all that apply)
5 Italian
6 German
7 Dutch
8 Other - specify__________________
P.46 What is .... ('s) relationship to the reference
person/household head? (Use Section 2 of Household Questionnaire) P.51 Which language(s) can ....carry on a conversation?
1 Head
2 Spouse/partner
3 Son/daughter
4 Son/daughter-in-law
5 Grandchild
6 Parent/parent-in-law
7 Other relative
8 Non-relative
P.47 Are(is) .... male or female?
1 Male
P.52 What is(are) ....('s) country(ries) of citizenship? (Indicate all that apply)
2 Female
1 BOTC (Anguilla) (Go to P.53)
P.48 a. What is .... date of birth?
BOTC - British Overseas Territory Citizen
Year
Month
Day
0
1
2
3
4
5
6
7
8
9
0
0
1
1
2
2
3
3
4
4
5
5
6
6
7
7
8
8
9
9
0
1
2
3
4
5
6
7
8
9
0
0
1
1
2
2
3
3
4
4
5
5
6
6
7
7
8
8
9
9
2 United States
0
1
2
3
4
5
6
7
8
9
0
0
0
0
1
1
1
1
2
2
2
2
3
3
3
3
4
4
4
4
5
5
5
5
6
6
6
6
7
7
7
7
8
8
8
8
9
9
9
9
b. If not known, how old were (was) .... on last
birthday?
Age
0 1 2 3 4 5 6 7 8 9
0
1
2
3
4
5
6
7
8
9
0
1
2
3
4
5
6
7
8
9
0
1
2
3
4
5
6
7
8
9
Estimated
P.49 To which ethnic/racial group do(es) .... belong?
1
2
3
4
5
African/Negro/Black
Amerindian/Carib
East Indian/Indian
Caucasian/White
Chinese/Oriental
6 Hispanic
7 Syrian/Lebanese
8 Mixed
9 Other - specify_______________
10 NS
3 Jamaica
7 Dominican Republic
8 Guyana
9 Other Caribbean - specify____________
4 St. Kitts & Nevis
10 Other European - specify____________
5 United Kingdom
11 Other - specify______________
6 St. Martin/St. Maarten
12 NS
Answer next question if checked
"BOTC (Anguilla)", otherwise go to
P.54.
P.53 How did.... acquire BOTC (Anguilla) status?
1 Birth
2 Descent
3 Marriage/determination
4 Adoption
5 Naturalisation/registration
6 Grant of status
P.54 What is ....('s) religion/denomination?
1 Anglican
2 Baptist
3 Baha'i
4 Brethren
5 Christianity
6 Church of God
7 Evangelical
8 Hindu
9 Jehovah Witness
10 Jewish
21 NS
11 Methodist
12 Muslim/Islam
13 Pentecostal
14 Presbyterian
15 Rastafarian
16 Roman Catholic
17 Salvation Army
18 Seventh Day Adventist
19 None
20 Other - specify _________________
Page 1 of 9
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35288
x
SECTION 7 HEALTH - FOR ALL PERSONS
P.55 Do(es) .... suffer from any long-standing illness(es) that is either physical or mental? Indicate also whether diagnosed by a
doctor, the origins and age at which the illness began. (Indicate all that apply)
Illness, or infirmity
Rate responses as follows
Indicate origin
1.Yes
2.Yes(not diagnosed) 1.Illness 2.Accident
3.No
4.NS
1. Sickle cell
2. Arthritis/rheumatism
3. Asthma
4. Diabetes
5. Hypertension
6. Heart Disease
7. Stroke
8. Kidney Disease
9. Cancer
10.HIV
11.AIDS
12.Lupus
13.Mental Illness
14.Allergies
15.Epilepsy
16.Complete blindness
17.Drug dependency
18.Alcohol dependency
19.Back/spine problem
20.Other res/lung problem
21.Other- specify__________
22.Not stated
1
2
3
1
2
1
2
1
23.No condition
1 No Condition
3.Birth
4.Old age
5.Other
6.DK
Age at which it
began
7.NS
4
1
2
3
4
5______________
6
7
3
4
1
2
3
4
5______________
6
7
3
4
1
2
3
4
5______________
6
7
2
3
4
1
2
3
4
5______________
6
7
1
2
3
4
1
2
3
4
5______________
6
7
1
2
3
4
1
2
3
4
5______________
6
7
1
2
3
4
1
2
3
4
5______________
6
7
1
2
3
4
1
2
3
4
5______________
6
7
1
2
3
4
1
2
3
4
5______________
6
7
1
2
3
4
1
2
3
4
5______________
6
7
1
2
3
4
1
2
3
4
5______________
6
7
1
2
3
4
1
2
3
4
5______________
6
7
1
2
3
4
1
2
3
4
5______________
6
7
1
2
3
4
1
2
3
4
5______________
6
7
1
2
3
4
1
2
3
4
5______________
6
7
1
2
3
4
1
2
3
4
5______________
6
7
1
2
3
4
1
2
3
4
5______________
6
7
1
2
3
4
1
2
3
4
5______________
6
7
1
2
3
4
1
2
3
4
5______________
6
7
1
2
3
4
1
2
3
4
5______________
6
7
1
2
3
4
1
2
3
4
5______________
6
7
NS = 999
DK = 998
1 Not stated
P.56 When was the last time that .... used a medical facility
(hospital, doctor, clinic, etc.)?
1 Less than a month ago
2 1 to 6 months
3 7 months to a year
4 More than a year ago
5 Never (Go to P.58)
6 NS
P.57 What is the main medical facility that .... have (has)
used in the 12 months?
1 Hospital in Anguilla
2 Private doctor in Anguilla
3 Doctor overseas
4 Public Health Centre, Anguilla
5 Drug store for medical services
6 Clinic/hospital, St. Martin
7 Clinic/hospital overseas not in St.Martin
8 Other - specify ___________
9 NS
P.58 Are (is) .... covered by health/life insurance (include S.S.)?
1 Yes
2 No
(Go to P.60)
3 DK
4 NS
P.59 Which insurance plan(s) do(es) .... have? (Indicate all that apply)
1 Social Security
7 Life only
2 Group Health
8 Endowment only
3 Individual Health
9 National Health Fund
4 Life with Health
10 Other - specify ___________
5 Group Life
11 NS
6 Endowment with Health
Page 2 of 9
Confidential when completed
35288
Remember to mark all choice boxes like this
x
SECTION 8 DISABILITY - FOR ALL PERSONS
P.60 Do(es) .... suffer from any long-standing impairment(s)/disability(ies) that is (are) either physical or mental? Indicate also
whether diagnosed by a doctor, the origins and age at which the disability began. (Indicate all that apply)
Disability
1.Partial or total loss of sight
even with glasses/contacts
2.Partial or total loss of
hearing
3.Incomplete use of leg, feet
4.Incomplete use of
arms/fingers
5.Slow development/learning
difficulties
6.Partial or total loss of
speech
7.Behavioural problems/
mental impairment
8.Other - specify
Rate responses as follows
Indicate origin
1.Yes
2.Yes(not diagnosed) 1.Illness 2.Accident
3.No
4.NS
3.Birth
4.Old age
5.Other
6.DK
7.NS
1
2
3
4
1
2
3
4
5______________
6
7
1
2
3
4
1
2
3
4
5______________
6
7
1
2
3
4
1
2
3
4
5______________
6
7
1
2
3
4
1
2
3
4
5______________
6
7
1
2
3
4
1
2
3
4
5______________
6
7
1
2
3
4
1
2
3
4
5______________
6
7
1
2
3
4
1
2
3
4
5______________
6
7
1
2
3
4
1
2
3
4
5______________
6
7
9.Not stated
1 Not stated
10.No condition
1 No condition
Age at which it
began
NS = 999
DK = 998
If no difficulty for all the options, go to Section 9
P.61 Due to a physical, mental or emotional condition lasting
6 months or more, do(es) .... have any difficulty doing any of
the following activities?
Rate responses as follows:
1. No - no difficulty
3. Yes - a lot of difficulty
2. Yes - some difficulty 4. Cannot do at all
P.62 Do(es) .... require any of the following aids?
(Indicate all that apply)
1 Wheelchair
8 Prosthesis/artificial body part
2 Walker
7 Hearing aid
3 Crutches
9 Orthopedic shoes
4 Brailler
10 Other - specify ___________
5 Adapted car
11 None
6 Cane
12 NS
1. Seeing, even if wearing glasses
1
2
3
4
2. Hearing, even if using a hearing aid
1
2
3
4
3. Walking or climbing steps
1
2
3
4
4. Body movement (reaching, couching,kneeling)
1
2
3
4
5. Gripping/holding (using fingers to grip/hold)
1
2
3
4
1 Yes, financial assistance
6. Self care (washing all over or dressing, feeding)
1
2
3
4
2 Yes, assistance in kind
7. Remembering or concentrating
1
2
3
4
8. Communicating
1
2
3
4
9. Behavioural (psychological, emotional problem)
1
2
3
4
P.63 Do(es) .... receive assistance due to the disability?
3 Yes, both financial and assistance in kind
4 No assistance
5 NS
Page 3 of 9
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35288
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SECTION 9 BIRTH PLACE AND RESIDENCE - FOR ALL PERSONS
P.64 Where were (was) .... born?
1 Anguilla (Go to P.67)
2 Overseas
3 DK
4 NS
ED
Country
2 No
0
1
2
3
4
5
6
7
8
9
0
1
2
3
4
5
6
7
8
9
NS = 99
DK = 98
If 00 skip to P.70
P.68 How long were (was) .... living at the previous address?
P.65 Did .... come to Anguilla before the age of one?
1 Yes
P.67 How many times have (has) .... moved house within
Anguilla in the last year?
(Go to P.67)
3 NS
(Go to P.67)
P.66 On coming to Anguilla, where did .... reside?
0
1
2
3
4
5
6
7
8
9
0
1
2
3
4
5
6
7
8
9
0
1
2
3
4
5
6
7
8
9
NS = 999
Months DK = 998
P.69 How long have (has) .... been living at this present address?
ED
0
1
2
3
4
5
6
7
8
9
0
1
2
3
4
5
6
7
8
9
NS = 99
Months DK = 98
SECTION 10 INTERNATIONAL MIGRATION - FOR ALL PERSONS
P.70 Other than for educational or health purposes, have
(has)... ever lived abroad for 1 year or more continuously?
1 Yes
2 No (Go to P.76)
3 NS
P.71 Which country did .... reside in?
1 St. Martin
7 China
2 St. Maarten
8 United States
3 Dominican Republic
9 Canada
4 US Virgin Islands
10 United Kingdom
P.73 What is ..... ('s) MAIN reason for coming/returning to
Anguilla?
1 Home
6 Start a business
2 Family here
7 Completed studies
3 Involuntary Return/Deported
8 Work
4 Retired
9 Other - specify ___________
5 Build a house
10 NS
P.74 In what village did .... live before leaving Anguilla?
ED
11 Other - specify ____________ P.75 What is ... ('s) status in Anguilla?
1 BOTC (Anguilla) by descent, adoption, naturalisation
6 Other Caribbean - specify ______________
2 Belonger by other condition
12 NS
3 Temporary resident permit
5 B.V.I
P.72 In what year did .... come/return to live in Anguilla?
4 Permanent resident permit
5 Work permit
6 Other - specify ________________
Year
7 NS
SECTION 11 INTERNET USAGE - FOR ALL PERSONS
P.76 Have (has) ... used the Internet from any location in the
last 3 months?
1 Yes
2 No (Go to P.78)
3 NS
P.77 Where did ... use the internet in the last 3 months?
(Indicate all that apply)
1 At home
2 At work
3 At school/ place of education
4 Internet café/ community or commercial access facility
5 At the home of a family, friend or neighbour
6 Via a mobile cellular phone
7 Via other mobile access device
9 NS
Page 4 of 9
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35288
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SECTION 12 EDUCATION - FOR ALL PERSONS
P.78 Are (is) .... currently attending an educational
institution/day care?
1 Yes, full-time ( go to P.80)
2 Yes, part-time ( go to P.80)
3 No
4 NS
P.79 For persons under sixteen (16) years of age, what is
the MAIN reason..... is not currently attending school?
1 Too young (End questionnaire)
8 No space in school
9 Pregnant/young mother
2 Financial problems
10
Baby sitting
3 Transportation problems
11 Apprenticeship
4 Working
12 Expelled
5 Illness
13 Not interested
6 Home schooling
14 Suspended
7 Physical/mentally challenged
Except for "Too young",
15 Not applicable (if person is > 15 years) all other responses go
to P.83
16 Other - specify ________________________
P.80 What type of educational institution are (is) ....attending?
1 Day care in a home (End questionnaire)
2 Day care not in a home (End questionnaire)
3 Pre-school
4 Primary
5 Secondary/high school
6 Community college
7 Sixth form
8 Technical/vocational school
9 UWI Extra Mural
10 US University/College
11 UWI/UK or equivalent university
12 Adult Education
13 Other - specify ________________________
14 NS
P.81 What is the name of the institution?
1 Albena Lake Hodge Comprehensive
2 Valley Primary
3 Orealia Kelly (Stoney Ground) Primary
4 Adrian T. Hazell (Road ) Primary
5 Morris Vanterpool (East End) Primary
6 Vivien Vanterpool (Island Harbour) Primary
7 Alwyn Allison (West End) Primary
8 Teacher Gloria Omolulu Institute
9 Central Christian School
10 Island Harbour Christian Pre-school
11 Maranatha Methodist Pre-school
12 St. Mary's Pre-school
13 Liz Pre-school
14 Bethel Pre-school
15 Ebenezer Pre-school
16 Prophecy Pre-school
17 Church of God (Holiness) Pre-school
18 Other - specify _________________________
19 NS
P.82 What is .......... ('s) MAIN mode of transport to school?
1 Hitches a ride
2 Walks
3 Cycles
4 School bus
5 Drives own vehicle or with a friend
6 Taxi
7 Other - specify ______________
8 NS
P.83 What is the highest level of education that ..... have
(has) completed?
1 Preschool (Go to P.85)
2 Primary - Years K - 2 (Go to P.85)
3 Primary - Years 3 - 6 (Go to P.85)
4 Some secondary (Go to P.85)
5 Completed Secondary School
6 Post secondary 6B
7 Post secondary 6A
8 Seventh Standard
9 UWI Extra Mural/College
10 US University/College
11 University W.I./UK or equivalents
12 Other - specify _______________________
13 None (Go to P.85)
14 NS
P.84 What is the highest level of certificate/examination
that.... have (has) passed?
1 School leaving (Standard six or seven school leaving exam)
2 GCE O'Levels/CXC/Cambridge
0
1
2
3
4
5
6
7
8
9
0
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2
3
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6
7
8
9
0
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5
6
7
8
9
0
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0
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0
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9
3 High school diploma/certificate
4 GCE A'Levels
5 CAPE
6 Undergraduate diploma
7 Other diploma/certificate
8 Associate degree
9 Professional certificate
10 Trade certificate
11 Bachelors degree (BA, BSc, LLB, etc.)
12 Postgraduate certificate
13 Postgraduate degree (MA, MSc, MEd, MBA, PhD, etc.)
14 Professional degree ( MD, DDS, etc.)
15 Other - specify _____________________
16 None
17 NS
P.85 What is .... ('s) age group?
1 Under 13 years
2 13 - 14 years
Use P.48
(End questionnaire)
(Go to P.97)
3 15 years and over
Page 5 of 9
Confidential when completed
35288
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x
SECTION 13 PROFESSIONAL, TECHNICAL AND VOCATIONAL TRAINING
P.86 Are (is) or have (has) .... been (being) trained for a specific occupation or profession? (Training can be on the job or formal)
1 Completed training
2 Being trained
3 Attempted training but did not complete (drop out)
4 No specific training
5 NS
If " No specific training" OR "NS" go to P.94
P.87 What is the MAIN occupation/profession for which .... received training?
P.88 Is ....('s) present job related to the most recent training?
1 Yes
2 No
3 No job
4 NS
P.89 a. Were (was).... ever trained formally?
1 Yes
2 No
Occupation
3 NS
b. Are (is)... being trained?
1 Yes
2 No
3 NS
P.90 In what year did.... complete the most recent training?
1 2011
7 1990 - 1999
2 2010
8 Before 1990
3 2009
9 Did not complete training
4 2008
10 Still being trained
5 2004 - 07
11 NS
6 2000 - 03
P.91 For the highest level of training, what type of qualification/certificate was received?
1
2
3
4
5
None
Certificate with examination
Certificate without examination
Diploma
Advanced Diploma
7
8
9
10
11
Bachelor Degree (BA, BSc, LLB, etc.)
Postgraduate certificate
Postgraduate degree (MA, MSc, MEd, MBA, etc.)
Professional qualification (MD, DDS, etc)
NS
6 Associate Degree
P.92 For ....('s) highest level of training, what was the main method/type of training used?
1 On the job
8 Technical college
2 Apprenticeship
9 University (On campus)
3 Correspondence Course
10 Distance learning
4 Secondary school
11 Virtual/Internet
5 Vocational trade school
12 Private self study
6 Commercial/secretarial school
13 Other - specify __________________
7 Business/computer school
14 NS
P.93 What was the total time for the training? (Not elapsed time)
1 Under 3 months
5 2 to less than 3 years
2 3 to 5 months
6 3 years and over
3 6 to 11 months
7 NS
4 1 to less than 2 years
Page 6 of 9
Confidential when completed
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35288
x
SECTION 14 MARITAL OR UNION STATUS - FOR PERSONS 15 YEARS AND OVER
P.94 What is ... ('s) present marital/union status?
1 Legally married (Go to P.96)
2 Common law union
3 Visiting partner
4 Not in a union & married (Go to P.96)
5 Not in a union & legally separated (Go to P.96)
6 Not in a union & widowed (Go to P.96)
7 Not in a union & divorced (Go to P.96)
8 Not in a union & single (Go to P.97)
9 Other - specify__________________
10 NS
Response 1 through 3 apply to those in union. 4
through 8 are for those not presently in a union.
P.95 Have (has) .... ever been married?
1 Yes
2 No (Go to P.97)
3 NS
P.96 How old were (was) .... when first married or living in a
union?
0
1
2
3
4
5
6
7
8
9
0
0
1
1
2
2
3
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SECTION 15 FERTILITY - FOR ALL PERSONS 13 YEARS AND OVER
P.97 How many live children have (has) .... ever
had/fathered?
Number of children ( If " 00" Go to P.105)
Number of males
Number of females
P.98 How old were (was) .... when the first child was born?
P.101 How many live births did.... have during the past 12
months?
1 None (Go to P.105)
2 One
3 Twin/multiple births
4 Two separate births
5 Three or more separate births
6 NS
P.102 What were the sexes & number of these babies?
1 2 3 4 5 6
Age when 1st baby born
Males
1
2
3
4
5
6
1 2 3 4 5 6
P.99 How old were (was) .... when the last child was born?
Females
1
2
3
4
5
6
Age when had last baby born
P.103 Did any of these babies die?
P.100 Was .... ('s) last child born in Anguilla?
1 Yes
1 Yes, in Anguilla
2 No (Go to P.105)
2 No, overseas
3 NS
3 NS
Questions P.101 to P.104 apply only to females under 50 years
of age. If male or female and > 50 years go to question P.105.
P.104 How many died?
Within the first month of life
After 1st month and before 1 year
1
2
1
3
2
3
4
4
Page 7 of 9
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35288
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SECTION 16 ECONOMIC ACTIVITY - FOR ALL PERSONS 15 YEARS AND OVER
P.105 Have (has) .... ever worked or had a job?
1 Yes
2 No (Go to P.110)
P.113 What kind of work do(es)... do in your (his/her) MAIN job?
3 NS
Give a brief description of main duties.
P.106 Where is .... ('s) usual workplace?
1 Own home
2 Government
3 No Fixed Workplace
4 Private Sector- specify ____________
5 Other - specify ________________
P.114 What was .... ('s) MAIN occupation?
6 NS
P.107 What category worker are (is) ... in your (his/her) MAIN job?
1 Paid employee, government
2 Paid employee, statutory body
3 Paid employee, private establishment/business
4 Paid employee, private home
5 Apprentice/learner
6 Volunteer worker
7 Self-employed with paid employees
8 Self-employed without employees
9 Unpaid worker/employee
10 Contributing family member/worker
11 NS
P.108 How do(es) .... usually travel to work?
Occupation code
P.115 What kind of business did .... work at eg: hotel,
restaurant, supermarket, gas station?
Industry code
P.116 Was the work that .... did during the week May 4 -11,
2011 for an employer, self or family business?
1 Paid employee-government (Go to P.119)
2 Paid employee-private (Go to P.119)
3 Paid employee-statutory body (Go to P.119)
1 Hitches a ride
6 Taxi
2 Walks
7 Motor bike
3 Cycles
8 Other - specify _____________
6 Own business without paid help (self-employed)
4 Business transportation
9 NS
7 NS
4 Unpaid worker
(Go to P.121)
5 Own business with paid help (self-employed)
5 Drives own vehicle or with a friend
(Indicate all that apply)
P.117 How many people work for ....?
P.109 How many minutes does it take to get to work?
Minutes
P.110 What did .... do MOST during the week May 4 - 11, 2011?
1 Worked (Go to P.112)
2 Had a job but did not work
3 Looked for work, was available and wanted work
4 Home duties
5 Attended school
6 Retired
7 Disabled and unable to work (Go to P.121)
8 Nothing
9 Other - specify________________
10 NS
P.111 Did .... do any work at all for pay or profit during the week
May 4 - 11, 2011 for any length of time, including helping in a
family business, fishing or work for profit at home?
1 Yes
2 No (Go to P.121)
3 NS
P.112 How many hours did .... work during the week May 4 - 11,
2011 at MAIN job?
P.118 What kind of accounts do(es) ... keep for this
activity/business?
1 Complete set of records/accounts
2 Informal records of order, sales, purchases
3 Simplified written accounts
4 No records are kept
5 NS
P.119 How often do(es)... get paid?
1 Daily
2 Weekly
3 Fortnightly
4 Monthly
5 Annually
6 Other - specify _______________
7 NS
P.120 What was ....('s) monthly gross pay or self
employment income ie: before deductions, from all sources
during the last pay period?
Monthly income in XCD
$
,
Category
Number of hours worked
Page 8 of 9
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35288
x
SECTION 16 ECONOMIC ACTIVITY (CONTINUED)- FOR ALL PERSONS 15 YEARS AND OVER
P.121 What did .... do MOST during the past 12 months?
1 Worked for pay or profit
6 Retired
2 Had a job but did not work
7 Disabled and unable to work
3 Looked for work (Go to P.123)
8 Nothing (Go to P.122)
P.126 How much money did .... receive in the past 12
months from family or friends living abroad in XCD?
Remittances in 12 months in XCD
4 Home duties
5 Attended school
10 NS
Except for "Looked for Work"
OR "Nothing", all other
responses go to P.124
P.122 Did .... do any of the following activities to try to find
work during the past 12 months? (Indicate all that apply)
1 No/nothing
2 Applied for jobs/wrote letters
3 Checked work places for vacancies
4 Sought assistance from friends for work
5 Registered with Labour Office
6 Other - specify _______________
If answer to P.122 is "No/nothing" then go to
7 NS
P.123 otherwise go to P.124
3
4
5
6
7
,
P.128 Do(es).... have any other job(s) besides your (his/her)
MAIN job? If yes, how many?
1
2
3
1 Yes
2 No (Go to P.136)
3 NS
4
5
6
P.129 What are ... ('s) MAIN reason for other job(s)?
1 Meet expenses
2 Earn extra money
5 NS
3 Gain new experience
4 Other - specify _______________
3 Other - specify __________________
4 NS
Number of hours worked
P.132 What was .... ('s) other occupation?
Occupation code
P.133 What kind of business did .... work at other job eg:
hotel, restaurant, supermarket, gas station?
Industry code
8
9
10
11
P.134 How often do(es)... get paid for other job(s)?
12
Number of Months
Work includes fishing, cooking,
sewing etc for sale.
P.125 What were ....('s) other sources of income in the past
12 months? (Indicate all that apply)
1 Pension (Anguilla)
7 Rental income (Anguilla)
2 Pension (Overseas)
8 Rental income (Overseas)
3 Investments/dividends (Anguilla)
9 Savings/interest
4 Investments/dividends (Overseas)
10 Disability benefits
5 Friends/family (Anguilla)
11 Unemployment benefits
6 Friends/family (Overseas)
12 Social Security
14 Other - specify_______________
13 Other Public Assistance
15 NS
$
P.131 How many hours do(es) .... work at the other job(s)?
P.124 How many months did.... work at all for pay or profit
during the past 12 months?
2
Remittances out 12 months in XCD
1 Own home
2 Government
1 Own illness, disability, pregnancy
2 Personal or family responsibilities
3 In school or training
4 Retired or elderly
5 Waiting to start a job already found
6 Made arrangements to start self-employment
7 Awaiting recall to former job
8 Awaiting busy season
9 Waiting for replies from employers
10 Believe no suitable work available
11 Discouraged
12 Other - specify________________
13 NS
1
,
P.130 Where is (are) .... ('s) other workplace(s)?
P.123 Why did .... not seek work in the past 12 months?
0
$
P.127 How much money did .... send in the past 12 months
9 Other - specify_______________ to family or friends living abroad in XCD?
Answer next question if checked "Friends/family
(Overseas)" in question P.125 otherwise go to
question P.127.
1 Daily
2 Weekly
3 Fortnightly
4 Monthly
5 Annually
6 Other - specify _______________
7 NS
P.135 On average, how many hours do(es) .... spend each
week on housework eg: cleaning, laundry, care of family?
Weekly hours of unpaid work
P.136 In the past 12 months have (has) .... been a victim of a
crime?
1 Yes
2 No
3 NS
If "No" End Questionnaire
P.137 Was the crime reported to the police?
1 Yes
2 No
3 NS
Thank you for your assistance in completing the questionnaire.
Page 9 of 9