2
Use No. 2 pencil only. (Do not use ink or ballpoint pen.)
O
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Erase cleanly any changes you make.
2
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Make n o stray marks o n this f o r m .
3
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4
Completely fill in the oval response.
Incorrect Ma r I<s
Correct Mark
3 . 3
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--
Address Of Househol
Bown / WiIlage / District
I
0
t
PLEASE DO NOT WRITE IN THIS A R E A
‘
j
I
7
i
3
8
8
8
9
9
9
m
5
II
1
lil
II
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U
I
m
I
1
I
n
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B
U
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II
BI
I
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1
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U
1
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U
E
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U
B
I
B
II
I
U
B
II
*Resuit Codes:
1 = Completed
2 = Partially completed, call back
3 = Dwelling vacant
4 = Address not a dwelling
5 = Address not found Q T non-existent
6 = No suitable respondent at iiorne
7 = Other
(Please specify)
I
1.1 (a) Has anybody from this household gone to live
abroad in the past year?
1
Yes
.No
2
(SKIP TO Q. 1.2)
(b) How many persons?
2
1
3
4
5
6
(c) Please give me the sex and age of each.
5.
1
2
6.
1
2
TEWVIEWER SAY:
ow fi wsukl lil<eto ask a few questions about the dwe9lilreg which your household occupies and
the faccilities that you have.
1
~
~
Ask this question
~ only if the~
answer is
not obvious. Else, mark the appropriate oval.
~
31.5 What
the outer walls?
~is the construction
~ material of~
W
1 1 Wood
2Concrete
3 .>Wood 8 Concrete
4 i Stone
*>
1.2 What type of dwelling does this household occupy?
1
Undivided private house
2
> Part of a private house
3
: FIat/apartment/concbmnium
4
5
6
7
8
%
I
i
Double house/duplex
Combined business 8 dwelling
Barracks
Other
1.3 Does this household own, rent or lease this dwelling?
1
2
3
4
I
7
8
I
I
~
1
Freehold
. Leasehold
3
4
5
Rented
6
Permission to work laiid
Sharecropping
Squatted
7
8
Otlw
Don't know/Not stateci
j
Before 1 9 6 0
1 9 6 0 - 1969
4
5+
1980 or later
Don't know
1 9 7 0 - 1979
1.8 What is the main source of your water supply?
(SKBP.-rOCB. 1.5)
1.4 What about the land is it freehold, leasehold, or
some other type of occupancy?
2
~
3
-----+
Other/Don't know
1.7 In which year was this dwelling built?
2
-
5
6
<
1.6 What is aks materia! used for roofing?
1
Owned
. Squatted
'
Rented-Private
Rented-Govt
Leased
Rent-free
Other
Don't know/Not stated
8
* Sheet metal (zinc. aluminum, galvanize)
1
2 .+y, Shingle (asphalt)
3
Shingle (wood)
4
Shingle (other)
5 \,3; Tile
6 'CL Concrete
7 3 Makeshift
8 --I Other/Don't know
, Townhouse
* j
5 (" Brick
6 i Adobe
75
Makeshift
1
2
4
3
4
5
6
7
Private, piped into dwelling
-Private catchment, not piped
Public, piped into dwelling
' Public, piped into yard
Public standpipe
Public well or tank
' Other
1.9 What type of t d e t facilities does this h o ~ s e h o l dhave?
1
2-
3
4
'
i
W.C. linked to sewer
W.C. Cesspit or septic tank
Pit-Latrine
Other
1.10 Are these toilet facilities shared with another person
not of this household OP another household?
1
2
<C2 Yes
'3No
1.116 How many bedrooms are there in
this dwelling unit? Bedrooms are
rooms used mainly for sleeping and
exclude makeshift and temporary
sleeping quarters. Count all
bedrooms including spares not
occupied.
-
-
4.1 1 What type of lighting does this household use most?
O Gas
O Kerosene
3 2 Electricity
4 U Other
II
2
1.12 What type of fuel does this household use most for
cooking?
~3
Coal
2 (-3
Wood
1
3
4
5
6
T Gas
'3Kerosene
(a) How many radios are owned or rented by
members of this household?
'
Electricity
C.3 Other
t"3
1.1 3 Is your kitchen indoors or outdoors?
1
2
(b) How many television sets m e owned or rented
by members sf this household?
C.
indoors
O Outdoors
1.14 Is the kitchen shared with another person not of this
household or another household?
1
2
1.17 Now I would like some information on the ownership
or rental of such facilities as television sets, videos
and radios by members of the household.
Yes, shared
( c ) How many video recorders are owned or rented
by members of this household?
" ~ j
' Not shared
-
3.15 How many rooms does your household occupy? Do
not count bathrooms, porches, kitchens, etc.
1. 18 is there a telephone serwice in this home?
1
2
y
Yes
No
Whenever a dotted line (,
. . .) appears in a question, call the name of
2.1 Please fill in this person‘s assigned number.
#
:o’
10,
20
‘Q
1
2
3
4
5
2.5 To what ethnic, racial or national group do you think
. . . . . , belongs?
t .
2 i
7 ‘ 8 , 9
6
4
household?
1
Head
Spouse/partner
Child
Son /daughter-in-law
3
4
5
6
7
8
FOR PERSONS NOT SEEN ASK: I s . .
. . . . male or female?
f
i
Don’t know/Not stated
1
,
2
3
MONTH YEAR
16
If not known, ask:
Mow old w a s . .
. . . . on his/her
I
4:
5 ,
6
7
8 C
2.4 What i s , . . . . .‘s date of birth?
DAY
,”-
last birthday?
17 C
3.1 Does . . . . . . suffer from any long-standing
illness, disability or infirmity?
1 i.:
2
Yes
.i
5
Portuguese
6 ‘
Syrian/Lebanese
7 L‘White
8 I --‘Mixed
2.6 M a t i s . . . . . .‘s religion?
,
2
Afr~can/Negro/Black
Amerindian/Carib
East Indian
Chinese
Other (Please specify)
10
Male
‘ Feniale
1
~
9
Grandchild
Parent/parent-in-law
Other relative
Non-relative
2.3 INTERVIEWER: Mark the appropriate oval.
I
3
2.2 What i s . . . . . . . .’s relationship to the head of
2
the person to w h o m the information relates,
Presbytenan/
Cong rey at iona I
10 :* Roman Catholic
1 1 ( - Salvation Army
t 2 i”’ Seventh Day Adventist
13 I Hindu
14
Muslim
15 C-4 Rastafarian
Id
Anglican
Baptist (Spiritual)
Brethren
Church of God
Jehovah Witness
Methodist
Morawan
Pentecostal
%
i
’
%,
Other (Please specify)
None
3.3 In which of the following ways are . . . . . .Is
activities limited compared with most people your/
han one ova! may be marked)
No (SKIP TO Q. 4 . 4 1
3.2 What type of disability or impairment d o e s , . . . . .
hawe? (More than one owal may be marked)
Sight
1
2
3
4
5
7
:+
Hearing
.I
- ;
I
1
SDeech
Upper Iinib (arm)
Lower limb (legs)
8
9
I
Slowness at learning
or understanding
Mental retardation
Other (Please specify)
4
In this country
Abroad
Not stated
Don’t know
3
(SKIP TO
i
None
I
4.1 Where was . . . . . . born?
‘INTERVIEWER: Remember what is required is the
mother’s normal residence at the time of birth, and
riot the hospital or place where the birth took place.
1
2
3
7
4.3
In what country
was that?
Don’t know
a. 4.3)
(SKIP TO Q. 4.5)
4.2a In what part of the
country is that?
4.4 In what year d i d . . . . . . Bast corne to Dive in this
country?
Don’t know
19
4.5 in what country did
. . . . . . last liwe?
4.2b Mave you/has
country?
. . . . . . ever lived in another
1
Yes
(SKIP TO Cp. 4.5)
2 -. No/Don’t know (SKIP TO Q. 4.6)
LO
Q
i
120 34 4Q2 6 0 60 70 80 90
12
3 4 5 6>*7 8 9
4.6 ln what town,
village or district ie%
. . . . . .did
ke/she fast live?
.
here d o e s . . . . . Lasolally Dive?
(
9
At this address
(SKIP TO c9.5.9 1
2 C.)Elsewhere in this country
3 1 Abroad
SIK KIP TO Q. ci. 1 )
4 I Don't know
(SKIP TO
5.1)
Ii
o
(2Never moved
$SKIP $8 Q. 5.1%
a.
B n what para of th@
*
*
country is that?
come to live in this town,
i
. - .. attending any schoof or edkacationai
institution now. whether fu$!-tn'meor part-time?
1
2
3
c:
cC
s.2 Ate
f
c
Yes
No
Don't know
9
2
(SKIP TO Q. 5.68
( S K P $0 Q. 5.6)
3
3*
1 i
hat t y p e OB sckoh~lor institution are yo%a/is/$se/she
attending?
2
3
4
C' Nursery/ Infant/ Kindergarten / Pre-schoo!
<
' Primary
C )Senior School or Secondary Dep?. of Primary School
High School
Comprehensive or Composite Schooi
fi C? Trade / \ I - ,iiona¡ School
3 CT Te
[nstituPe
8 i-' C
m i t y College/Sixth Forni Cclleijc'
5
9
8
11
6
7
,derslfy
I
C: Not stated
6 ' ., Sixth Standard
7
Seventh Standard
First Standard
- Second Standard
?hird Standard
Foiirsh Stand?-.(
Fr'
I
or higher
R
, ^
h n ' p knww
None
School leaving
Cambridge Schooi Ccrtificate
GCE 'O' levels or CXC
Number of subjects
I'
C' Junior Secondary
C? Senior Secondary. General Secondary,
cy
I
I
5.8 What is the highest certificate, diploma or degree
that you/he/she earned?
> Don't know
2 Cj Part-time
t
2
3
4
5
I
4
5
yau/is/he/she attending fu!l-tirne O P part-time?
Ci>Full-time
I
5.7 What grade/stendard did y ~ / h e / s k ereach?
5.7 I s . .
'
[
'
Don't know
9
(a
3
4, 5
6
5
8:
GCE 'A'
levels
09 O r more
CI: Not stated
Number of subjects
I 2' 3
'
4 or more
:
Higher School Ccrtificate
Diploma (post-graduate)
i
Degree
C 1 Other (Please specify)
Not stated
Not stated
IO
5.4 Please give the name and address of the schsal or
2'
5.9 ~~~~~~~~~~~:
Mark the appropriate ovai. (See Q. 2.4)
institution.
3
'
2
Under 15
(SKIP TO Q. 8.1)
15 years and over
5.18 H a s . . , . . . purasued any course of formal training
for at least 3 months?
1 lL Yes
2c,No
3
hat is yous/kisbher main mods of arave! to the
school or institution?
1
2
<.
Don't know
(SKBP TO Q. 6.11
(SKIP TO Q. 6.9)
5.1 T How was this training received?
1 C Correspondence course
2 c - On the job
3
Apprenticeship
4 C Institution
5 C Other (Pkase specify)
0Walk
oBcycie
3 O Private car OP vehide
4 Q Public vehicle (bus,etc.)
6 0Hired transport (taxi, maxi-taxi, winibus)
6 O Don't know/Not stated
7 C3 Other
6
CL' Don't
know
5-72 For what cpccupati~ndoes this training prepare
you/ hi881 / her?
tag/,/Post-Secondar
Exia
TQ Q. 5.8)
--
I
1
6.1 What is . . . . . .'s IegaO marital status - that is, are
you/is he/she married, divorced, legally separated,
widowed or never married?
1
Married
Widowed
Divorced
Legally separated
Never married
Not stateci
2
3
4
5
6
6.8 HOWmany livebirths has - . .
Yes
I
~.ever had?
(SKIP TO Q. 6.3)
6.9 How old w e r e you/was she when yoka/slae had the
fitst !iW@bQrn
Chiidl
6.2 Are you/is he/she living with your/his/her
husband/wife IWW?
1
I
\o
(SKIP TO Q. 6.6)
'
No
2
6.3 Are you/is he/she living with a partner now?
Yes
1
(SKIP TO Q. 6.6)
No
2
6.10 Wow old were you/was she at the birth 0%your/her
last Biweborn chiid?
6.4 INTERVIEWER: If Q. 6.3 is shaded 2 (No) and Q. 6.1
is shaded 2,3 or 4 then Skip to Q. 6.6.
6.5 Have you/has he/she ever lived together with a
partner in a common law relationship?
2:
Yes
1
No
(SKW TO Q.6.7)
6.6 How old were you/he/she when you/he/she were/was
first married or lived with a partner?
6.1 t HQWmany livebirths did y o u i s h e have in the last 42
Bur QnthS?
1
2
3
Nofle (SKGPT
One
Two separatc births
**;
5
Three or more
6.12 What is/are the sexles) of this child/these children?
umber of
umber of
6.7 INTERVIEWER: Mark the appropriate ova!.
(See 0 s . 2.3, 2.4.5.7, 5.2, 5.3)
1
,
2
'
3
Male
Female - 65 years & over
1 Female under 65 years attending school
(SKBP TO
Q. 7.9)
7.1 What did . . . . . . do most durinq the past 12
months - for example, did ysu/he/shework, look for
a job, keep house or carry on 5881198 other activity?
1
2
3
,
4
5
6
7
8
9
10
4
'
(SKIP TO O. 7.4)
(SKIP TO Q. 7.4)
Worked
Had a job but did not work
Looked for work
Wanted work and available
Home duties
Attended school
Retired
Disabled, unable to work
Other (Please specify)
9)
Qj
I
2
No
Don't know
4
t5'
Q>
4
i-$>
3
ivo (SKIP TO O. 7.1)
~
1
Worked
2
, Had a lob biit did not work
3 . Looked for work
4 I
Wanted work and available
5
(SKIP TO Q. 7.8)
(SKIP TO QB. 7.8)
(SKIP TO Q. 7.7)
l
'
Not stated
W Q T ~
did a/ou/he/she
look for or want?
(SKIPTO Q. 7.7)
i
7.3 Have you/he/she ewer worked or had a job?
1
2
Yes
No
($KIP TO
B.7.5)
:I
7.5 What did
do most during the past week for example, did y o u / h e / s h e work, look for a job,
keep house or carry ooi some other activity?
8
9
3
c,j)
lm
10
Yes (SKIP TO O. 7.4)
,<z)
2'
7.6 ?/Uhat sort of
1
(2)
'bes
::
7
7.2 Did you/he/she do any work at all in t h e past 12
months? Include work at home, for example, piece
w o r k , smocking, etc.
i-7
6.13 0 6 these, have any of the babies died?
s
Not stated
Cj
7.7 Did you/he/she do any work at ai! last week for any
length of time, inclu
business/farm, street vending or work at home?
1
Yes
2 c-3No
~~~~~
TO o. 7.9)
7.8 How many hours did you/he/she work last week?
3.14 Did you/he/she carry on your/his/her own business,
work f ~ ar wage or salary or as an unpaid worker in
a family business?
(SKIP TO B.7.16)
(SKIP TO Q. 7.16)
(SKIP TO Q. 4. "1)
1 1-3 Paid employee - Governnient
2 -_ Paid employee - Private
3
Unpaid worker
>
4
O w n business with paid help
(Employer)
5 -'I O w n business without pclidhelp
(Own Account)
6 -? Don't know/Not stated
Never worked
(SKIP TO Q. 7.16)
(SKIP TO Q. 7.78)
WORK
7.15 00 you/doeS he/She mQVeall your/his/her goods
every night; e.g., fruits, nuts, lottery tickets,
clothing/s hoes, etc.?
1
1
Completely dependent
2 . Partially dependent
3
Not dependent at all
4 C, Don't know/Not stated
7.7 'I What type of business is/was carried ow at
Pfease specify
in detek
i . .-
-
i
i
Yes (Informal trader)
d.as .
. . . . .'s
2
:NO
last pay/iticorne period?
1
Weekly
2 \ ) Fortnightly
3 ( v 1 Monthly
4 < ,j Quarterly
5 f ? Annually
6 ( J Other (Please specify)
I
7
\None
8 i 1 Not stated
. . . . . .'s gross pay/income during the last
pay period, that is before income tax or other
deductions? (PRESENT FLASH CARD)
7.17 What was
7.12 What is the name and address of your/his/her
present
WWQrkplac@?
i-
No present workplace (SKBP TO Q. 7.18)
7.18 DQ you/does he/she receive any money from family
and/or friends abroad?
7.13 How do
1
2
3
4
5
6
7
8
t
2
3
~ O U / ~ Qhe/s&e
~ S
trave! to work?
i Work at home
Walk
.I--Bicycle
9Private car or velicle
-11 Public vehlcle (bus, etc
- Hired transport (taxi, minibus. maxi taxi, etc.)
" Other
' Don't know/Not stated
I
1
C?AP this address
O Elsewhere in this country
C.)Abroad
gEND ~~~~~W~~~~
1
2
.- Yes
<: No
(SKIP TO Q. 8.7)
7.19 Approximately how rnucta money did you/he/she
receive last yeas (1990) from family and/or friends
abroad? (PRESENT FLASH CARD)
Don't know