I
I
,
REPUBLIC OF NAMll
CONFIDENTIAL
1991 POPULATION AND HOU
FORM A
SECTION A
I
elderly perso-ts
stmi. country
SECTION B
TYPE OF
HOUSING UNIT
n
:
?
;
e
1
I
,
1 Detached house
2 Semn detached1
lownhouse
3 Apartment 'flat
4 Guest flat
5 Part commerc~al,
industrnal
6 M o b ~ l ehome
(caravan tent)
7 Stngle quarters
8 Kraal/hut
9 Improvbsed hou
slng unit (shack)
El ( 0
HOUSING CONDITIONS
TENURE
Is hous~nqu n ~ t
1 Rented
2 Owner
occup~ed
3 Rent free
(not owner
occup,ed)
Other spectfy
8 2 (1)
NUMBER
OF ROOMS
How many rooms
arc there #n :h#s
holrslng un,l,
(exclude bath
rooms totlets
kntchens stoeps
and verandahs)
8 3 (11
- TO BE ASKED OF EACH HOUSEHOLD
WHAT IS THE MAIN MATERIAL
USED FOR
-
Outer walls
Roof
Cook~ng
1 Corrugated-won 1 E l e c t r ~ c ~ t y
2 Gas
sheets
3 Parafton
bricks'
sheets
4 F~rcwoodl
Face-br1cks
charcoal
3 Corrugated lron 3 Brick t ~ l e r
Other spec~fy
sheets
4 Slate
4 Prefab
5 Wood covered
w ~ t hmelthold
5 Wooden p o l o
6 Thatch grass
st#cks6 grass
7 S I ~ c k smud
6 Stlcks mud
and cow-dung
and cow-dung
Other spec~fy
Other spectfy
1 Cement blocks/
Cement bucks
8 4 (1)
B5 (1)
WATER SUPPLY
WHAT IS THE MAIN TYPE OF FUEL
USED FOR
8 6 (1)
L~ghttng
1 Electr~c~ty
2 Gas
3 Paraff~nlamp
4 Candle
Other specify
87 (I)
Heating
0 None
1 Electrlc~ty
2 Gas
3 Paraff~n
4 Ftrewoodl
charcoal
Other SPeclfy
68 (0
-
What 1s the main
source of water
supply 101 this
household?
1 Piped water
~ndoors
2 p,ped water
tn yard
3 Public ptpe
4 Well
5 Borehole
6 Rover canal
or lake
Other s p e c l f ~
B9 (1)
-
TOILET
FACILITY
Wnat type o f toalet
facility does tots
household use7
1 Water closet
(used erclu
slvely by house
hold)
2 Water closet
(used b y other
households)
3 Pit (long drop)
4 Bucket pall
5 Bush
Other spec~fy
E l 0 (1)
OV
RADIO
Does this how
hold owr, a rac
0
1
No
Yes
El1 I1
IDENTIFICATION:
REPUBLIC OF NAMIBIA
District .........................................................................................
Enumeration Area
JLATION AND HOUSING CENSUS
......................................................................
Locality (Town/Village)
............................................................
(a1 What k ~ n dof actwlty is
(b) What are the main prod
dut~esat thns job?
06
07
Home-maker
Income reclpnent
................................
(a) ................................
(b)
(
WATER SUPPLY
I
What 1s the maln
source of water
S ~ P P ~(or
Y this
household7
1 Piped Water
~ndoors
2 P~pedwater
~nyard
3 Publtc p~pe
4 Well
~ n a type
t
of toile'
faciltty does t h ~ s
household use'
I Water closet
(used exclu
s~velyby house
hold)
2 Water closet
(used by other
households)
OWNERSHIP OF
RADIO
TELEVISION
Does this household owr, a fadlo?
Does l h ~ shouse.
hold own a TV?
0
I
C
1
No
Yes
No
Yes
I
PURCHASE OF
NEWSPAPER
B9 (1)
BIO ( 1 )
1
CONTROL SECTION
1
Date
Number of Q
~
~
~ Enumerat~on
~ started
m Household/
used In Household or
Instglut~on ................................................. l n s t ~ t ~ t ~ o n
0
1
Number of Persons Enumerated
an Household or lnst~tul~on
2
None
One only
More than one
813 (1)
~
Has Questic
~
checked?
~
1
Date Enumeration complered
..................
on Household/lnst~tut~on
Total
..................
Male
......................
remale
812 ( 0
TO BE C(
TO BE COMPLETED BY ENUMERATOR
How many m w s papers does this
buy
~na week"
5 Bush
or lake
I)
TOILET
FACILITY
................................
....................
Name of Enumerator:
Date check(
.........................
Name of Ch
...............
I
Signature:
I
I
IDENTIFICATION:
District
m
........................................................................................................................
Enumeration Area .........................................................................................
Locality (Town/Village)
Inn
...............................................................................
Household number
........................................................................
Type of Residence ............................
CensusHouseNo .................
Household cornposit~on..............
15 YEARS AND OVER
ALL FEMALES ACED 15 YEARS AND OVER
STATUS I N
EMPLOYMENT
MARITAL STATUS
CHILDREN EVER BORN ALIVE
In thts lob dgd
work as
1 Employer
iwtth p a ~ d
employees)
2 Own-account
worker
(w~thoutp a ~ d
employees)
3 Employee.
Government
What I S . . . .'a manta
status'
1 Never married,
2 Marrjed. legally or
customar~ly
3 Marr~ed.
consensually.
4 Separated.
5 D~vorced
6 W~dowed
ERSONS AGED 10 YEARS AND OVER
IN
NAME AND ADDRESS
OF WORKPLACE
INDUSTRY
What 1s the name and
. 's workplace?
address o f
(a) What k ~ n dof act,v~tyIS
c a r r ~ dout at . . 's
workplace?
(b) What are the maln products
produced or servtce offered
at
's workplace?
How many
children
have been
born alwe
by
,
HOWmany o f these
ch~ldren
A'e
Are
l~v~ng l~v~ng
in lhls
elsehouse.
where'
....................................................
Date Enumerat~onstarted
Ye.
..........................
No
Date checked
..................
...................
................................................
......................
Address of House: ..............................
d$Lz,
[17
FEMALES AGED 15-49
CHILDREN BORN DURING
LAST 12 MONTHS
How many
chddren have
been born
dove by
durlng the
past I 2
months?
Of the
ch~ldrenborn
a l ~ v eto
tn part 12
months, how
many are
dead7