APPENDIX I
(i)
Questionnaire - Form C-I
(ii)
Listing Record - Form C-3
FORM C I
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CONFIDENTIAL
COMMONWEALTH CARIBBEAN POPULATIOIV AND HOUSING CENSUS 199 7
JAMAICA
QUESTIONNAIRE
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Please give me the names of all the persons who usually live in this household. Please give me also the names of all other
persons who spent the night of April 7, here. Please give me the name of the head of household first.
i
1 . Surname
First Name
2. Surname
First Name
3. Surname
First Name
4. Surname
First Name
5. Surname
First Name
6. Surname
First Name
7. Surname
First Name
8. Surname
First Name
9. Surname
First Name
10. Surname
First Name
2.1. What type of Housing Unit is this? O Separate House-Detached
0 Semi-detached
0 Apartment Building
O Townhouse
0 Improvised Housing Unit
0 Part of Commercial Building
0 Other
0 Not Stated
2.2. What is the main type of material used in constructing the outer walls?
0 Concrete Incl. blocks
0 Stone
0 Brick
0 Nog
0 Wattle/Adobe
0 Wood
0 Wood and concrete
0 Wood and brick
0 Other
0 Not Stated
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2.3. What is the main type of material used in constructing the roof?
0 Metal Sheeting
0 Shingle - Wood
0 Shingle - Other
2.4. In what year was this unit built? O 1 9 9 0 - 1991
O 1985 - 1989
O 1 9 8 0 - 1984
0 Tile
0 Concrete
0 Other
0 Not Stated
0 1975 - 1979
0 1970 - 1974
0 Before 1970
0 Not Stated
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2.CHARACTERISTICS OF HOUSEHOLD
2.5. Does this household own, rent or lease this dwelling?
0 Owned
0 Leased
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0 Private rented
0 Government rented
2.6. What about this land is it owned or leased, etc.?
0 Owned
0 Rented
0 Squatted
0 Rent free
0 Squatted
0 Other
0 Not Stated
0 Not Stated
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PLEASE DO NOT WRITE IN THIS SHADED AREA
761125
22.
HOUSING UNIT NUMBER
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2.7. How many rooms does your household occupy?
IF NOT STATED RECORD "99"
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2.8. What is the main source of domestic water supply for the household?
0 Public piped into dwelling
0 Private catchment, not piped
0 Public piped into yard
0 Public Standpipe
0 Private piped into dwelling
0 Public Catchment
0 Spring or River
0 Other
0 Not Stated
2.9. (a) What type of toilet facilities does this household have?
0 Pit
0 WC Linked to Sewer
0 WC not linked to Sewer
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(b) Are these facilities shared? O Shared
0 Not Shared
0 Not Stated
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2.10. What does this household use most for lighting?
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--
0 Other
0 None (Go to Question 2.10)
0 Not Stated
O Electricity
0 Kerosene
O Other
0 Not Stated
2.1 1. What type of fuel does the household use most for cooking?
0 Gas
0 Electric
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0 Wood/Charcoal
0 Kerosene
0 Other
0 None
0 Not Stated
3. MISCELLANEOUS
2.12. Did anyone from this household go to live abroad during 1990? O Yes
0 No (Go to Question 2.15)
0 Not Stated
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2.13. How many persons?
IF NOT STATED RECORD "99"
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2.14. Could you give me the age and sex of each?
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2.15. Did anyone abroad come to live in this household in 1990?
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2.16. How many persons?
IF NOT STATED RECORD "99"
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IF NOT STATED RECORD "99"
O Yes
0 No (Go to Question 3.1 )
0 Not Stated
23.
PARISH
E.D. NUMBER
DWELLING NUMBER
I
BOOKNUMBER
1-
HOUSEHOLD NUMBER
HOUSING UNIT NUMBER
INDIVIDUAL NUMBER
I Name of Individual
3.1. What is your/
0 Head
0 Spouse/partner
1
3.2. Is
's relationship to the head of the household?
of head
0 Child of head/spouse
0 Grandchild of head/spouse
0 Spouse/partner of child 0 Parent of head/spouse
's date of birth?
3.3. a. What is your/
0 Other Non-relative
0 Not Stated
MONTH
1
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O Female
O Male
maie or female?
0 Other relative of head/spouse
0 Domestic Employee
--
DAY
IYEAR I
Ib. Age at last birthday?
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FOR PERSONS 100 YEARS AND OVER RECORD "99"
3.4. To which race or ethnic group would you say
belong(s)?
YOU/
0 Negro/Black
0 East Indian
0 Chinese
0 White
3.5. To which religious group do you/does
0 Anglican
0 Baptist
0 Brethren
0 Church of God
Age:
0 Jehovah's Witness
0 Methodist
0 Moravian
0 Pentecostal
0 Mixed
0 Other (specify)
0 Not Stated
belong?
0 Rastafarian/Ethiopian Orthodox
0 Roman Catholic
0 Seventh Day Adventist
0 United Church
0 Disciples of Christ
0 None
0 Other (specify)
0 Not Stated
0 Under 16 years (Score Never Married and go to Question 3.7)
0 16 years or older
3.6. What is your/
married?
0 Widowed
3.7. Do you/does
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's legal marital status? For example are you/is he/she married, divorced, widowed or never
0 Never Married
0 Married
--------
0 Divorced
0 Legally Separated
0 Not Stated
suffer from any long standing illness, disability or infirmity?
O Yes
0 No (Go to Question 4.1 )
0 Not Stated
3.8. Does this limit your/
's activities compared with most people of the same age?
0 Yes
0 No (Go to Question 4.1 1
0 Not Stated
3.9. What type of disability or impairment do you/does
0 Sight only
0 Hearing only
0 Speech only
0 Physical Disability only
0 Multiple Disability
have?
0 Slowness at Learning or Understanding
0 Mental Retardation
0 Mental Illness
0 Other (specify)
0 Not Stated
3.10. In which of the following are you handicapped? O Self-care
0 Mobility
0 Communication
0 Schooling
0 Employment
0 None
0 Not Stated
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24.
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usually live in this household? By this I mean do you/does
4.1. Do you/does
most of the time?
o No
0 Yes (Go to Question 4.3)
4.2. Where do you/does
a) Elsewhere in this country
usually live?
0 St. Ann
0 Trelawny
0 St. James
0 Hanover
0 Westmoreland
0 U S.A.
0 Canada
0 U.K.
0 Caribbean C'wealth
0 Other C'wealth
0 Other
0 Not Stated
b) Abroad
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a St Elizabeth
0 Kingston
0 St Andrew
0 St. Thomas
0 Portland
0 St Mary
6> St
0 U S.A
0 Canada
0 U.K
0 Caribbean C'wealth
0 India
0 Other C'weaith
0 Centrai America
0 Cuba
0 Other
0 Not Stated
Ann
0 St
James
Hanover
0 Vdestmoreland
8 St
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come
4.4. In what year did you/did
to live in Jamaica?
(GOTO QUESTION 5.1)
19
IF NOT STATED RECORD "99"
FOR YEARS BEFORE 1900 SCORE "00"
4.6. In which parish did you/did
0 Kingston
0 St Andrew
0 St Thomas
0 Portland
0 St Mary
0 Manchester
0 Clarendon
Q Trelanny
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0 St. Elizabeth
0 Manchester
0 Clarendon
0 St. Catherine
0 Not Stated
born? By that I mean the ptaee in which your/his/her mother was residing at the time.
(GOTO QUESTION 4.5)
b) Abroad
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0 Not Stated
0 Kingston
0 St. Andrew
0 St. Thomas
0 Portland
0 St. Mary
4.3. Where were you/was
a) Elsewhere in this country
reside here all or
Catherine
a Mot Stated
ag
4.5. In what year did you/did
to live in this parish?
come
IF NOT STATED RECORD "93"
FOR YEARS BEFORE 1980 SCORE "00"
last live?
0 St Ann
0 Trelawny
0 St James
0 Hanover
0 Westmoreland
St. Elizabeth
0 Manchester
0 Clarendon
0 St. Catherine
0 Not Stated
INTERVIEWER:
(i) FOR CHILDREN UNDER 4 YEARS MARK "NO" AT QUESTION 5.1 AND GO TO QUESTION 8.1.
(ii) FOR PERSONS OVER 50 YEARS MARK "NO" AT QUESTION 5.1 AND PROCEED FROM QUESTION 5.2 IN RELATION
TO THE LAST INSTITUTION ATTENDED.
(iii) FOR PERSONS BETWEEN AGES 30 AND 50 YEARS SAY: "It is known that sorne people try to further their education
as they get older" BEFORE ASI(!NG QUESTION 5.1.
(iv) FOR ALL OTHER PERSONS i.e. 4-29 YEARS OLD PROCEED DIRECTLY TO QUESTiON 5.1.
5.1. Are you/is
currently attending an educational institution?
0 'tes
----
O No
0 Not Stated
5.2. What type of educational institution are you/is
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attend ing/d id you /did
0 None (Go IO Question 6 1)
0 Pnmary/Preparatory
0 Nursery/lnfant (Go to Question 5 5) 0 All Age/Elementary
0 New Secondary
0 Secondary High
5.4
0 Vocational
0 CommerciaI/SecretariaI
0 University (Go to Question 5.5)
0 Other Tertiary (specify)
last atteldLo to
0 Special School
0 Other
0 Not Stated
Question 5.4
25.
5.4. What is/was the highest class, grade or form that you are/were in/that
0 A and B class, Elementary
is/was in at that level?
0 Grade 5-8. Primary, All Age, Secondary
0 Grade 9- 12, Primary, All Age, Secondary
0 Forms 1-3, Secondary High
0 Forms 4-5, Secondary High
0 Standard 1-3. Elementary
0 Standard 4-6, Elementary
0 Grade 1-4, Primary, All Age, Secondary
0 Form 6, Secondary High
0 Grade 7-9, Secondary High
0 Grade 10-12, Secondary High
0 Not Stated
5.5. How many years of schooling have you/has
IF NOT STATED RECORD "99"
5.6. Are you/is
attending school full-time or part-time?
0 Full-time
0 Part-time
0 Not Stated
ANSWER QUESTION 5.6 ONLY IF QUESTION
5.1 WAS YES.
5.7. What is the highest examination that you have/that
has passed?
MARK NONE FOR ALL PERSONS CURRENTLY ATTENDING/LAST ATTENDED NURSERY/INFANT AND
PRIMARY/PREPARATORY SCHOOLS (SEE QUESTION 5.2)
0 None
0 CXC Basic, JSC or JSCE, 3rd JLCL, SSC, JC
0 GCE 'O' 1-3,CXC General 1-3, AEB 1-3
0 GCE 'O' 4+, CXC General 4+, AEB 4+, SC
0 GCE 'A' 1+, HSC
0 College Certificates and Diplomas
0 Other Certificates and Diplomas
0 Degrees and Professional Qualifications
0 Other
0 Not Stated
do most DURING THE'FIRST WEEK OF APRIL? For example did you/did
6.1. What did you/did
look for work, keep house or what?
0 Worked
0 With Job Not Working (Go to Question 6.3)
0 Seeking First Job (Go to Question 6 7)
0 Other, Seeking Work (Go to Question 6 4)
0 Did Not Seek Work but Wanted Work and Available
(Go to Question 6 4)
6.2. How many hours did you/did
FIRST WEEK OF APRIL?
6.3. Do you/does
0 Student
0 Home Duties
0 Retired
0 Disabled, unable to work
0 Other
0 Not Stated
work during the
IF NOT STATED RECORD "99"
work,
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6.4. What kind of work do you do/does
last do?
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GO TO QUESTION 6.7
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work for a wage, carry on your/his/her own business or what?
0 Paid Employee (Government)
0 Pad Employee (Private Enterprise)
0 Paid Employee (Private Home)
0 Unpaid Worker
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0 Own Business with paid employees
0 Own Business without paid employees
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0 Not Stated
do/did you last do/did
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6.5. What type of business is/was carried on at the work place?
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6.6. Would you consider your job/
0 Completely Tourism Related
0 Partially Tourism Related
's job as being Tourism Related?
0 Not Tourism Related
0 Don't Know
0 Not Stated
6.7. What did you/did
do most DURING THE PAST 12 MONTHS? For example did you/did he/did she work, look
for work, keep house or what?
0 Worked or had a job
0 Looked for work
\
0 Student
0 Home duties
GO TO QUESTION 7.1
0 Retired
0 Disahled unable to h o r k
0 Other
0 Not Stated
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26.
6.8. HOW many months did you/did
0 less than 3 months
0 3 to under 6 months
work?
0 6 to under 9 months
0 9 to under 12 months
0 12 months
0 Not Stated
ANSWER QUESTION 6.9 ONLY IF THE PERSON HAD A JOB DURING THE PAST WEEK (SEE
QUESTION 6.1) AND IS NOT AN UNPAID WORKER (SEE QUESTION 6.3).
earn from your/his/her job?
6.9. How much do you/does
a) Weekly
0 less than $1 O0
$100-199
0 $200-299
O $300-399
b) Monthly
0 less than $400
O $400-799
O $800-1.199
O $1,200- 1,599
0 $400-499
0 $500-749
0 $750-999
o$1 ,ooo+
o
0 $1,600- 1,999
O $3,000-3,999
0 $4.000+
7.1. 0 Married (Go to Question 7.2)
0 Never Married (Go to Question 7.3)
0 Widowed. Divorced, Separated (Go to Question 7 4)
0 Not Stated
7.2. Are you/is
currently living with your/her husband?
0 Yes (Go to Question 7.5)
0 No (Go to Question 7.4)
0 Not Stated
ever lived with someone as a
AND (Go to Question 7.6)
currently living with someone as
0 Yes
0 No (Go to Queston 7 6)
0 Not Stated
6
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7.9. How old were you/was
when you had
your/she had her last liveborn child?
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7.10. Did you/did
past 12 months?
O One
0 Two separate births
0 Twins
0 Three or more
0 Not Stated
7.12. Of what sex was the child/were the children?
0 Not Stated
Male
O1
0 2
3+
Female
O1
0 2
O 3+
o
7.7. How many liveborn children have you/has
ever had?
aoaa)e,m~Cz)mcfi>
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aDaa>cD~c5cs,a@cs,
0 Not Stated
IF '00" GO TO QUESTION 8.1
0 Yes (Go to Question 8.1)
0 No
0 Not Stated
7.14. How many have died?
0 Not Stated
E
spknd Census Night?
0 In this household
0 Another household in Jamaica (Go to Question 8.2)
0 Abroad
0 Not Stated
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0 Kingston
0 St. Andrew
O St. Thomas
0 Portland
0 SiMary
aDcI)a>a)~~ctDa>cDoD
cp)€D~c3)~Q>aDa>casoc,
IF NOT STATED RECORD '99"
8.2. In which parish was this?
m
have any livebirths in the
7.13. Is the baby/are the babies still alive?
0 Under 65 years old
0 65 years old and over (Go to Question 8.1)
8.1. Where did you/did
m
0 Not Stated
7.1 1. How many livebirths were there?
0 Not Stated
7.6. Mark appropriate answer.
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7.8. How old were yau/was
when you had
yourjshe had her first liveborn child?
0 Yes
0 No (Go to Question 8 1)
0 Not Stated
and your/her husband/
7.5. How long have you/has
common-law partner been married/living together?
9
0 $40,000-59,999
0 $60,000-99,999
0 $100.000+
cp)a3~mGDa;>cs>cDca,GD
0 Yes
0 Never had a husband or common-law partner
9
0 $20,000-39,999
0 Not Stated
7.3. Have you/has
common-law partner?
0 Not Stated
0 less than $5,000
O $5,000-9,999
O $10,000-19.999
O $2.000-2,999
MARK THE APPROPRIATE ANSWER (see Question 3.6)
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O NOT STATED
cl Annually
0 St. Ann
0 Trelawny
0 St. James
0 Hanover
0 Westmoreland
0 St. Elizabeth
0 Manchester
0 Clarendon
0 St. Catherine
0 Not Stated