DDI_IDN_2004_SUSENAS-JUL_v01_M_WB World Bank Indonesia, Poverty Team 2014-02-12 NADA Version 1 (December 22, 2012): Initial version of DDI documentation. Version 2 (February 12, 2014): Revision of DDI documentation. National Socio-Economic Survey 2004 July SUSENAS-JUL 2004 Survei Sosial Ekonomi Nasional 2004 IDN_2004_SUSENAS-JUL_v01_M Central Bureau of Statistics (BPS) of Indonesia Copyright © 2012, Central Board of Statistics (BPS) of Indonesia. All rights reserved. NADA Socio-Economic/Monitoring Survey [hh/sems] Since 1992, BPS through Susenas collecting core data and the module data every year. Susenas modules is divided into three major groups, that is module socio-cultural and educational, modules housing and health, module household consumption and household expenditure, implementation of each module is every three years. v01: basic raw data. Obtained from BPS Birth control Children Child health Consumption (Economics) Income Education Employment Family Fertility Health Heatlh services Housing Information technology Indonesia Literacy Living standards Mass media Breast milk Occupations Internet Married Recreation Energy Poverty Assets Social conditions Insurance Transport Victims of Crime Water supply Susenas is a survey designed to collect socio-demographic data in large area. The data collected were related to the fields of education, health / nutrition, housing / environmental, socio-cultural activities, consumption and household income, trips, and public opinion about the welfare of household. In 1992, Susenas data collection system has been updated, the information used to develop indicators of welfare (Welfare) contained in the module (information collected once every three years) drawn into the core (group information is collected each year). The questions are included in the core is intended to obtain the information and to monitor the things that may change each year. It is also useful for short-term planning, as well as questions that can be associated with a question module, such as expenditures. Questions in the modules required to analyze problems that do not need to be monitored every year or analyze issues like government intervention, such as poverty and malnutrition. Core module combined data can generate analysis to answer questions such as, whether the poor can get benefit from the appropriate educational program launched by the government (e.g., 9-year compulsory education program), who are able to take advantage of government subsidies in education, is there any kind -certain types of birth control that is more widely used by poor people than others, whether there is a link between working hours and fertility, then whether there is a link between sanitation and health status. Since 1993 the core Susenas sample size is enlarged to generate simple statistics for the district / city level. This new development gives a new dimension to the Susenas data analyst and in that time, several counties have started to develop the indicators / statistics on the welfare of each. Indonesia National coverage, representative to the district level Household Members (Individual) and Household Implementation of the 2004 Susenas includes 249.376 sample households spread across all geographic regions of Indonesia, with details of 67.072 sample household core-module and 182.304 households sample core (without module). Data from the sample core can presented at the national, provincial, and district / city. Data from sample core-module, can be presented at national and provincial levels. While the sample Consumption Module (Panel) of 10,200 households in the sample that is repetition Susenas 2003. Sample survey data [ssd] 1. Data Collected by corer questionnaire (VSEN2004.K) include: a. General Information of household members (art) i.e. name, relationship to head of household, sex, age, marital status; b. Information about mother deaths during pregnancy, childbirth and the postpartum period. c. Information races household heads (krt). d. Information about the state of health includes the health of the population, the costs incurred for the purposes of health household. e. Information household member education 5 years and above. f. Information of economic activity and employment household member 10 years and above. g. Fertility information for women never married and how to prevent pregnancy for married women. h. Housing information include the mastery of residence, the physical condition of residential buildings, residential buildings and facilities. i. Information of the average household consumption and the main source of household income. j. Household socio-economic information. k. Information rice field business 2 Data Collected by the Housing and Health Questionnaire Module (VSEN2004.MPK) a. More detailed information about the mastery of residence, the physical condition of buildings, facilities and equipment of residential buildings, and environmental conditions. b. More detailed information about the cost of healthcare, the youngest toddler and his biological mother, status / health conditions, risk behaviors, outpatient and inpatient care, as well as the health experience of respondents. - Sample Core 2004 susenas designed to estimate until the district / city level. The design of samples core Susenas 2004 was sample designs phased two for block census that are not formed sub-block census and sample design phased three for block census formed sub block census , both for urban and rural areas. Sample selection for urban and rural areas is done separately. Block census was not formed sub block census 1. The first phase, from the sample frame census blocks selected a number of census block by Probability Proportional to Size (PPS) - systemic linear sampling whereas size is the number of households from P4B census result. 2. The second phase, from a number of households of listing results in each census block selected and selected 16 household by systematic linear sampling Block census was formed sub block census 1. The first phase, from the sample frame of census blocks selected a number of census blocks in PPS method - systemic linear systematic whereas size is the number of household of listing results from P4B census result. 2. The second phase, from each selected census block was formed segment group (kelseg), then selected one segment group in PPS Sampling whereas size is the number of household of listing results from P4B census result in each sub block census. 3. The third phase, from number of households of listing results in each selected enumeration areas selected 16 households by systemic linear sampling Sample size module Housing and Health are designed for the presentation at the provincial level. This sample module is a subsample from the selected sample to estimate data at the district / city level, urban and rural areas. The subsample selected by systematic linear sampling from the list of selected block census in each district / city for urban and rural areas. Further selected block census (subsample) is the block census core-module, because in addition enumerated using the module questionnaire, also enumerated using core questionnaire. In other words, the block census which will be used to estimate at the provincial level (block census core-module)selected by systematic linear sampling from a list of selected census blocks in each district / city (block census core). Selected census blocks that are not core-module 2004 susenas is the core block census . Face-to-face Sub Directorate Services and Promotion Statistics Use of the dataset must be acknowledged using a citation which would include: - the Identification of the Primary Investigator - the title of the survey (including country, acronym and year of implementation) - the survey reference number - the source and date of download Example: Statistic Indonesia (BPS), National Socio-Economic Survey 2004, ref. IDN_2004_SUSENAS-JUL_v01_M. Data downloaded from www.microdatalib.worldbank.org in December 20, 2012 The user of the data acknowledges that the original collector of the data, the authorized distributor of the data, and the relevant funding agency bear no responsibility for use of the data or for interpretations or inferences based upon such uses. susenas04jul_ki Data contained in this file are questions from the National Social Economic Survey of 2004 - Main Information on Household and Household Members [VSEN2004.K] section Core Household Member (Individual): IV.A. Household Member Information IV.B. Death since January 2001 V.A. Health Information (all ages) V.B. Toddler Health (child age 0-59 months) V.C. Educational Information (for Household Member age five years up) V.D. Employment (for Household Member age 10 years up) V.E. Fertility and Family Planning (for women age 10 years and up with a status of married, divorced, divorce due to death of spouse) 1030250 111 susenas04jul_kr Data contained in this file are questions from the National Social Economic Survey of 2004 - Main Information on Household and Household Members [VSEN2004.K] section Core Household: VI. Housing VII.A. Household Expenditure - Expenditure for Food in the past one week [from Purchase, Self-Production and Present] VII.B. Household Expenditure - Non-Food Expenditure [from Purchase, Self-Production and Present] VIII. Household Socio-Economic Information IX. Rice Plant Business Information in 2003 252913 138 susenas04jul_blok4 Data contained in this file are questions from the National Social Economic Survey of 2004 - Information on Housing and Settlement and Health [VSEN2004.MPK]: IV. Household Member Information 267549 133 susenas04jul_blok8 Data contained in this file are questions from the National Social Economic Survey of 2004 - Information on Housing and Settlement and Health [VSEN2004.MPK]: VIII.A. Information from Selected Respondent - Health Status VIII.B. Information from Selected Respondent - Risky Behavior VIII.C. Information from Selected Respondent - Health Services VIII.D. Information from Selected Respondent - Medical History 66644 205 susenas04jul_blok56 Data contained in this file are questions from the National Social Economic Survey of 2004 - Information on Housing and Settlement and Health [VSEN2004.MPK]: V.A. Housing and Settlement - Residential Control V.B. Housing and Settlement - Building Physical Condition V.C. Housing and Settlement - Facility And Equipment V.D. Housing and Settlement - Surrounding Condition VI. Household Medical Cost 66755 253 susenas04jul_blok7 Data contained in this file are questions from the National Social Economic Survey of 2004 - Information on Housing and Settlement and Health [VSEN2004.MPK]: VII. The Youngest Toddler 21932 33 Province Province Province Province Province Province Write down the name province in the space provided and add the related code referred to in the box provided. 1030250 11 94 40.652 11 Nanggroe Aceh Darussalam 12 North Sumatera 13 West Sumatera 14 Riau 15 Jambi 16 South Sumatera 17 Bengkulu 18 Lampung 19 Bangka Belitung 21 Riau Island 31 DKI Jakarta 32 West Java 33 Central Java 34 DI Yogyakarta 35 East Java 36 Banten 51 Bali 52 West Nusa Tenggara 53 East Nusa Tenggara 61 West Kalimantan 62 Central Kalimantan 63 South Kalimantan 64 East Kalimantan 71 North Sulawesi 72 Central Sulawesi 73 South Sulawesi 74 Southeast Sulawesi 75 Gorontalo 76 West Sulawesi 81 Maluku 82 North Maluku 91 West Irian Jaya 94 Papua District/City District/City District/City District/City District/City District/City Cross out the unnecessary and the Write down the name of district/city in the space provided and add the related code referred to in the box provided. 1030250 1 79 23.592 Sub-district Sub-district Sub-district Sub-district Sub-district Sub-district Write down the name subdistrict in the space provided and add the related code referred to in the box provided. 1030250 4 740 64.645 Village/kelurahan Village/kelurahan Village/kelurahan Village/kelurahan Village/kelurahan Village/kelurahan Cross out the unnecessary and the Write down the name of village/kelurahan in the space provided and add the related code referred to in the box provided. 1030250 1 123 8.769 Village/kelurahan classification Village/kelurahan classification Village/kelurahan classification Village/kelurahan classification Village/kelurahan classification Village/kelurahan classification Circle the answered code, then write it down in the box provided. 1030250 1 2 1.597 1 Urban 2 Rural Sample code number Sample code number Sample code number Sample code number Sample code number Sample code number Write down the sample code number into the box provided. 1030250 1001 2582 1951.03 Household sample sequential number Household sample sequential number Household sample sequential number Household sample sequential number Household sample sequential number Household sample sequential number Write down the household sample sequential number into the box provided. 1030250 1 16 8.508 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Total household members (HM) Total household members (HM) Total household members (HM) Total household members (HM) Total household members (HM) 1030250 1 24 4.839 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 24 Serial number of household members Serial number of household members Serial number of household members Serial number of household members Serial number of household members 1030250 1 24 2.919 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Relation with the head of household Relation with the head of household Relation with the head of household Relation with the head of household Relation with the head of household Relation with the head of household Ask the relation of each household member to the head of household and enter the code accordingly into the boxes provided. 1030250 1 9 2.589 1 Head of household 2 Wife/husband 3 Child 4 In-law 5 Grandchild 6 Parent/in-law 7 Other family 8 Housemaid 9 Other 1. The head of household (krt) is a man in a group of household members who is responsible to provide the daily needs of the concerned households, or a person who is considerend/appointed to be the head of a household (for example a group of students live together in one room inside a census building; because they each are responsible for their own needs, one person is appointed as the household head). 2. Wife/husband, is the wife/husband of the head of household. 3. Children, includes biological children, stepchildren, and adopted children of the head of household. 4. Son/daughter in laws, are the husbands/wives of biological daughters/sons, step daughters/sons, or adopted daughters/sons. 5. Grandchildren, are the children of biological children, step children, or adopted children. 6. Parent in laws, are father/mother of the head of household or father/mother of the spouse of the head of household. 7. Other families, are those who have blood relation with head of the household or the spouse, such as siblings, aunties, uncles, grandparents. 8. Household helpers, are people who works as a helper and lives in the concerned household, receiving wage/salary in the form money or in-kind payment. 9. Other, are people who do not have familial relation to the head of household or the spouse, who live in the household for more than 6 months, such as visitors, friends or tenants who rent room plus food, including children of helpers who also live and eat in the employer's house. Gender Gender Gender Gender Gender Gender Write down the gender of each household member in the provided box, code 1 for “Male” and code 2 for “Female”. Do not guess people’s gender based on their names. To make sure, please ask if the person in question is a male or a female. 1030250 1 2 1.498 1 Male 2 Female Age (year) Age (year) Age (year) Age (year) Age (year) Age (year) Ask the respondent's age and enter the answer into the box. Age is measured in years rounded down or the age after the last birthday. Age calculation is based on Christian calendar. 1030250 98 27.453 Age is measured in years rounded down or the age after the last birthday. Age calculation is based on Christian calendar. Marital status Marital status Marital status Marital status Marital status Marital status Ask marital status of the respondent and enter the code into the box provided. 1030250 1 4 1.601 1 Not married 2 Married 3 Divorce 4 Divorce due to death 1. Married means having a wife (for male) or husband (for female) durint the census, whether living together or separately. In this case the people included in this status are those who are married legally (by the law of the tradition, religion, state, etc), and also those who live together and have been considered husband and wive by the local society. 2. Divorcee is a person who has been separated from wife/husband and has not remarried.In this case including a person who claims to be divorced although it is not legally confirmed yet. Perform “tour”* trip? (Oct 1 – Dec 31, 2003) Perform “tour”* trip? (Oct 1 – Dec 31, 2003) Perform “tour”* trip? (Oct 1 – Dec 31, 2003) Perform “tour”* trip? (Oct 1 – Dec 31, 2003) Perform “tour”* trip? (Oct 1 – Dec 31, 2003) Perform “tour”* trip? (Oct 1 – Dec 31, 2003) Fill in code 1 for “Yes” or code 2 for “No” into the provided boxes. 1030250 2 1.891 1 Yes 2 No “Tour” trip: trip to commercial tourist destinations, or stay in commercial accommodation, or trip distance = 100 Km (return). Travel frequency in the past 3 calendar months? Travel frequency in the past 3 calendar months? Travel frequency in the past 3 calendar months? Travel frequency in the past 3 calendar months? Travel frequency in the past 3 calendar months? Travel frequency in the past 3 calendar months? Fill in the travel frequency (times) for each household members who travel in the past 3 calendar months. Write down “00” if the related household member do not travel. 111888 918362 1 48 1.566 One time travel/journey is calculated since leaving home and return back to the initial place. Travel/journey that has not been completed (the person has not returned to the initial place), is not considered as traveling. Travelling household member: trip to commercial tourist destinations, or stay in commercial accommodation, and or trip distance = 100 Km (return), excluding commuter, school and work. Ever/ on pre-school education? Ever/ on pre-school education? Ever/ on pre-school education? Ever/ on pre-school education? Ever/ on pre-school education? Ever/ on pre-school education? Write down the appropriate code for family members aged 0-6 regarding their participation in pre-school education. Household member age 0-6 years 86839 943411 4 3.456 1 Yes, kindergarten/RA/RB 2 Yes, playgroup 3 Yes, daycare 4 No Sysmiss Yes, once , if they have attended pre-school education and at the moment has finished/completed/not active anymore. Yes, currently on, if at the moment the respondent is still actively attending a pre-school education. No, if the respondent never attended a pre-school education. Attended preschool education means enrolled in and actively attending education in kindergarten (TK)/Bustanul Athfal (BA), Raudatul Athfal (RA), play group, day-care center, Early Age Children Education (PAUD) and other institution. Information provider - Sequential no Information provider - Sequential no Information provider - Sequential no Information provider - Sequential no Information provider - Sequential no Information provider - Sequential no 1030250 24 2.919 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Biological mother sequential number Biological mother sequential number Biological mother sequential number Biological mother sequential number Biological mother sequential number Biological mother sequential number Biological mother number, ask whether the biological mother of this household member lives with him; if “Yes”, enter the number of the biological mother in accordance with the serial number in Column (1) BlockIV. If the answer is “No”, enter code 00. 1030249 1 15 0.989 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Sysmiss Is the household member present during interview? Is the household member present during interview? Is the household member present during interview? Is the household member present during interview? Is the household member present during interview? Is the household member present during interview? Enter code 1 if the answer is "Yes" or code 2 for "No" in the box provided. 1030250 1 2 1.305 1 Yes 2 No Health complaints - fever Health complaints - fever Health complaints - fever Health complaints - fever Health complaints - fever Any health complaint in the past one month? (read from a to h) a. fever If the answer is coded 2, skip to b5r8 Use code 1 if the respondent have health problems or code 2 if the answer is "No". 1030250 1 2 1.893 1 Yes 2 No 1. Health complaints is a condition where a person suffers from physical or mental illness, whether it is an acute disease, chronic disease (although there is no problem in the last one month), accident, criminal act or other things. 2. Fever is a condition which symptom is the increasing body temperature above 37.5 degrees Celcius, or if touched (especially with the back of the hand) it feels hot. Health complaints - cough Health complaints - cough Health complaints - cough Health complaints - cough Health complaints - cough Any health complaint in the past one month? (read from a to h) b. cough If the answer is coded 2, skip to b5r8 Use code 1 if the respondent have health problems or code 2 if the answer is "No". 1030249 1 1 2 1.872 1 Yes 2 No Sysmiss 1. Health complaints is a condition where a person suffers from physical or mental illness, whether it is an acute disease, chronic disease (although there is no problem in the last one month), accident, criminal act or other things. 2. Coughing is a sound produced by the sudden opening of vocal cords followed by the fast release of air, in order to let out the object that stimulates the central or lower part of respiratory tract; short or long; dry, phlegm or bloody expectoration; lasting for days, weeks, months or years. Health complaints - cold Health complaints - cold Health complaints - cold Health complaints - cold Health complaints - cold Any health complaint in the past one month? (read from a to h) c. cold If the answer is coded 2, skip to b5r8 Use code 1 if the respondent have health problems or code 2 if the answer is "No". 1030250 1 2 1.876 1 Yes 2 No 1. Health complaints is a condition where a person suffers from physical or mental illness, whether it is an acute disease, chronic disease (although there is no problem in the last one month), accident, criminal act or other things. 2. Colds is a condition with the following symptoms: mucus, nasal congestion, and might be followed by sneezing, or other symptoms. Health complaints - asthma/breathlessnes Health complaints - asthma/breathlessnes Health complaints - asthma/breathlessnes Health complaints - asthma/breathlessnes Health complaints - asthma/breathlessnes Any health complaint in the past one month? (read from a to h) d. asthma/breathlessnes If the answer is coded 2, skip to b5r8 Use code 1 if the respondent have health problems or code 2 if the answer is "No". 1030250 1 2 1.986 1 Yes 2 No 1. Health complaints is a condition where a person suffers from physical or mental illness, whether it is an acute disease, chronic disease (although there is no problem in the last one month), accident, criminal act or other things. 2. Asthma is an illness during which attack the patient suffers difficulty in breathing due to constriction in the lower respiratoty track, causing the breathing to make a shound while letting air out; local community calls the illness bengek or mengi. Health complaints - diarrhea Health complaints - diarrhea Health complaints - diarrhea Health complaints - diarrhea Health complaints - diarrhea Any health complaint in the past one month? (read from a to h) e. diarrhea If the answer is coded 2, skip to b5r8 Use code 1 if the respondent have health problems or code 2 if the answer is "No". 1030249 1 1 2 1.986 1 Yes 2 No Sysmiss 1. Health complaints is a condition where a person suffers from physical or mental illness, whether it is an acute disease, chronic disease (although there is no problem in the last one month), accident, criminal act or other things. 2. Diarrhea is an illness which symptomsare: runny or liquid faeces, sometimes mixed with blood or mucus; generally happens 3 times or more within 24 hours. Diarrhea might be accompanied with a throwing up, or decrement of consciousness. Local people call this illness as mencret or bocor. Health complaints - migraine Health complaints - migraine Health complaints - migraine Health complaints - migraine Health complaints - migraine Any health complaint in the past one month? (read from a to h) f. migraine If the answer is coded 2, skip to b5r8 Use code 1 if the respondent have health problems or code 2 if the answer is "No". 1030250 1 2 1.956 1 Yes 2 No 1. Health complaints is a condition where a person suffers from physical or mental illness, whether it is an acute disease, chronic disease (although there is no problem in the last one month), accident, criminal act or other things. 2. Migraine/Recurring headache is the feeling of pain, throbbing pain, jabbing pain, like being tied up, drilled or stabbed in the head, or other uncomfortable feelings in part or of the whole head. It lasts from a few hours to a few days, recurring for several times within 1 year (at least 2 times), with similar symptoms. Headache during fewer is not considered a recurring headache. Health complaints - toothache Health complaints - toothache Health complaints - toothache Health complaints - toothache Health complaints - toothache Any health complaint in the past one month? (read from a to h) g. toothache If the answer is coded 2, skip to b5r8 Use code 1 if the respondent have health problems or code 2 if the answer is "No". 1030249 1 1 2 1.982 1 Yes 2 No Sysmiss 1. Health complaints is a condition where a person suffers from physical or mental illness, whether it is an acute disease, chronic disease (although there is no problem in the last one month), accident, criminal act or other things. 2. Toothache is the feeling of pain in the teeth or gums, sometimes accompanied by swelling, but does not include sprue. Health complaints - other Health complaints - other Health complaints - other Health complaints - other Health complaints - other Any health complaint in the past one month? (read from a to h) h. other If the answer is coded 2, skip to b5r8 Use code 1 if the respondent have health problems or code 2 if the answer is "No". 1030250 1 2 1.938 1 Yes 2 No 1. Health complaints is a condition where a person suffers from physical or mental illness, whether it is an acute disease, chronic disease (although there is no problem in the last one month), accident, criminal act or other things. 2. Other problems are health problems such as measles, perforated tympanic membrane /CSOM, hepatitis/liver disease, seizures, paralyzed, senility, including other health problems caused by accidents/tragic events, natural disaster, lost of appetite, difficulty in defecating, headache caused by fever, non-recurring headache, problems with joints, problems in hearing, cataract, gastritis, stomachache, catching colds, unable to urinate, ulcer, sore eyes, and physical problems caused due to menstruation or pregnancy. If there is a complaint,did it disrupt job,school or daily activities? If there is a complaint,did it disrupt job,school or daily activities? If there is a complaint,did it disrupt job,school or daily activities? If there is a complaint,did it disrupt job,school or daily activities? If there is a complaint,did it disrupt job,school or daily activities? If there is a complaint,did it disrupt job,school or daily activities? If the answer is coded 2, skip to b5r5a Circle the appropriate code and fill in the provided box. 268390 761860 1 2 1.371 1 Yes 2 No Sysmiss Complaint of activities means that the respondent cannot do the normal activity (work, study, daily activities) as usual. Period of disruption: (days) Period of disruption: (days) Period of disruption: (days) Period of disruption: (days) Period of disruption: (days) Period of disruption:(days) Write down how long (days) the household members who have health problems are interrupted from their daily activities in the last one month.The duration of interruption shall not exceed 30 days because the time reference used is the last one month, although the actual health problems last for more than 30 days. 168903 861347 1 30 5.45 Period of disruption does not refer to the worst health problem, but also covers the total duration of all the health problems suffered by the household members in the last one month. If a person has more than one health problem, the length of interruption time caused by the illnesses should not be combined. Is it still disrupting now? Is it still disrupting now? Is it still disrupting now? Is it still disrupting now? Is it still disrupting now? Circle one of codes and record in the box available. Circles code 1 if householder "still has health disruption until the enumeration day" and circle code 2 if "No". 168903 861347 1 2 1.776 1 Yes 2 No Sysmiss Ever performed self-medication in the past 1 month? Ever performed self-medication in the past 1 month? Ever performed self-medication in the past 1 month? Ever performed self-medication in the past 1 month? Ever performed self-medication in the past 1 month? Ever performed self-medication in the past 1 month? If the answer is coded 2, skip to b5r6 Circle the appropriate code and fill in the provided box. 268390 761860 1 2 1.277 1 Yes 2 No Sysmiss Self medication is an effort to have a medication by deciding the kind of medicines by oneself (without any /prescription from a medical doctor/traditional medication/batra). Self medicine/treatment - traditional medicine Self medicine/treatment - traditional medicine Self medicine/treatment - traditional medicine Self medicine/treatment - traditional medicine Self medicine/treatment - traditional medicine Type of medicine/treatment method used: 1. traditional medicine Enter code 1 if the answer is “Yes” or code 2 for “No” in the box provided. 193978 836272 1 2 1.648 1 Yes 2 No Sysmiss Traditional Medicine is medicine concoction made of herbs/plants, animal, mineral, etc. which is generaly has already been used for generation whether to cure an illness ir to be taken as health supplement in a form of powder, finely chops, liquid, tablet, capsule, medical embrocation, liniment lotion, etc. Self medicine/treatment - modern medicine Self medicine/treatment - modern medicine Self medicine/treatment - modern medicine Self medicine/treatment - modern medicine Self medicine/treatment - modern medicine Type of medicine/treatment method used: 2. modern medicine Enter code 1 if the answer is “Yes” or code 2 for “No” in the box provided. 193978 836272 1 2 1.138 1 Yes 2 No Sysmiss Modern medicine is medicine used in a medical system, it can be in the form of tablet, caplet, capsule, syrup, powder, ointment, suppository (i.e. hemorrhoids medicine), inhaler (i.e. asthmatic medicine to be sprayed inside the mouth or to be inhaled); usually is ready made from pharmaceutical factories, with packaging and registration code number in the Ministry of Health starting with 1-3 letters followed by numbers. Self medicine/treatment - other Self medicine/treatment - other Self medicine/treatment - other Self medicine/treatment - other Self medicine/treatment - other Type of medicine/treatment method used: 3. other Enter code 1 if the answer is “Yes” or code 2 for “No” in the box provided. 193978 836272 1 2 1.896 1 Yes 2 No Sysmiss Others, such as food supplement/natural supplement (i.e: sunchlorella, squalen, omega 3, nuskin, imedeen, collagen, etc); tonic drinks (i.e: Kratingdaeng, Kaki Tiga, M-150, Adem Sari, Lasegar, etc) with registration code beginning with MD (local products) or ML (imported products); skin scrapping; massage. Ever become an outpatient in the past one month? Ever become an outpatient in the past one month? Ever become an outpatient in the past one month? Ever become an outpatient in the past one month? Ever become an outpatient in the past one month? Ever become an outpatient in the past one month? If the answer is coded 2, skip to b5r8 Circle the appropriate code and fill in the provided box. 268390 761860 1 2 1.624 1 Yes 2 No Sysmiss The followings are not included in medical treatment:consultation,medical check-up,health check (such as for Driver Liscense,new employee acceptance,promotion),screening (medical check-up to find illness,such as:Pap Smear Test for cervix cancer,mantoux tes for toddler to find TBC),normal pregnancy check-up,and immunization,because all are prevention efforts. Outpatient is an effort by household members who have health problems to check their health and get medication by going to modern or traditional health services without hospitalization,including housecall. Frequency of outpatient - state hospital Frequency of outpatient - state hospital Frequency of outpatient - state hospital Frequency of outpatient - state hospital Frequency of outpatient - state hospital How many times became outpatient in the past one month? a. state hospital Write down in the provided box the frequency of (how many times) the respondent visits health centers for medical treatment (without hospitalization). 100932 929318 30 0.119 1 2 3 4 5 6 7 8 10 11 12 14 15 20 21 22 24 25 30 Sysmiss State Hospital is a hospital owned by the central government (such as RSCM/RSUP Dr. Cipto Mangunkusumo); regional government (such as RSU Labuang Baji), National Army/TNI (such as RSPAD), or State-owned Enterprise/BUMN (such as RS Pertamina). Frequency of outpatient - private hospital Frequency of outpatient - private hospital Frequency of outpatient - private hospital Frequency of outpatient - private hospital Frequency of outpatient - private hospital How many times became outpatient in the past one month? b. private hospital Write down in the provided box the frequency of (how many times) the respondent visits health centers for medical treatment (without hospitalization). 100933 929317 25 0.046 1 2 3 4 5 6 7 8 9 10 11 12 13 14 20 25 Sysmiss Private Hospital is a private owned hospital such as RS St. Carolus, RS Medistra. Frequency of outpatient - doctor Frequency of outpatient - doctor Frequency of outpatient - doctor Frequency of outpatient - doctor Frequency of outpatient - doctor How many times became outpatient in the past one month? c. doctor Write down in the provided box the frequency of (how many times) the respondent visits health centers for medical treatment (without hospitalization). 100932 929318 30 0.355 1 2 3 4 5 6 7 8 9 10 11 12 13 20 28 30 Sysmiss Doctor is a health service center for outpatient (not hospitalized); usually managed by privates, companies, foundations, Army/TNI or various Departments/BUMN. Frequency of outpatient - health clinic Frequency of outpatient - health clinic Frequency of outpatient - health clinic Frequency of outpatient - health clinic Frequency of outpatient - health clinic How many times became outpatient in the past one month? d. health clinic Write down in the provided box the frequency of (how many times) the respondent visits health centers for medical treatment (without hospitalization). 100932 929318 30 0.71 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 20 21 22 30 Sysmiss Health clinic(Community Health Center) is a health service unit owned by the government responsible for providing health services to the community in sub-districts,part of sub-districts or kelurahan (such in DKI Jakarta). Puskesmas team can do mobile practices to certain places within its working territory in order to provide easier access of health services for the society. Frequency of outpatient - polyclinic Frequency of outpatient - polyclinic Frequency of outpatient - polyclinic Frequency of outpatient - polyclinic Frequency of outpatient - polyclinic How many times became outpatient in the past one month? e. polyclinic Write down in the provided box the frequency of (how many times) the respondent visits health centers for medical treatment (without hospitalization). 100932 929318 30 0.056 1 2 3 4 5 6 7 9 10 11 12 20 30 Sysmiss Frequency of outpatient - medical worker practice Frequency of outpatient - medical worker practice Frequency of outpatient - medical worker practice Frequency of outpatient - medical worker practice Frequency of outpatient - medical worker practice How many times became outpatient in the past one month? f. medical worker practice Write down in the provided box the frequency of (how many times) the respondent visits health centers for medical treatment (without hospitalization). 100932 929318 30 0.262 1 2 3 4 5 6 7 8 9 10 11 12 15 16 20 22 30 Sysmiss Medical worker practice are private/personal practices of physicians,whether general practitioners,dentists,or specialists.Location of practices can be carried out in Hospitals,puskesmas (community health center),supporting puskemas,or clinic that is commonly open outside the doctor's working hours. Frequency of outpatient - traditional treatment Frequency of outpatient - traditional treatment Frequency of outpatient - traditional treatment Frequency of outpatient - traditional treatment Frequency of outpatient - traditional treatment How many times became outpatient in the past one month? g. traditional treatment Write down in the provided box the frequency of (how many times) the respondent visits health centers for medical treatment (without hospitalization). 100933 929317 30 0.0303 1 2 3 4 5 6 7 8 9 10 11 12 15 20 30 Sysmiss Batra Practice (Traditional treatment) is an alternative health service by shaman/healer/sinshe,including accupuncture practice,finger therapy,paranormal,radiesthesia (usually using a pendulum). Frequency of outpatient - other Frequency of outpatient - other Frequency of outpatient - other Frequency of outpatient - other Frequency of outpatient - other How many times became outpatient in the past one month? h. other Write down in the provided box the frequency of (how many times) the respondent visits health centers for medical treatment (without hospitalization). 100932 929318 30 0.0895 1 2 3 4 5 6 7 8 9 10 11 12 14 15 20 21 22 23 25 30 Sysmiss Others, such as Polindes (Village Maternity Ward), Posyandu, or if a woman gave birth without any medical support. Ever become an inpatient in the past one year? Ever become an inpatient in the past one year? Ever become an inpatient in the past one year? Ever become an inpatient in the past one year? Ever become an inpatient in the past one year? Ever become an inpatient in the past one year? If the answer is no, skip to b5r10. Circle one of the codes and enter the number into the box provided. 1030250 1 2 1.99 1 Yes 2 No Inpatient is an effort to treat a disease by spending a night or more in a modern or traditional health service unit,including inpatient in maternity ward. Inpatient period - state hospital Inpatient period - state hospital Inpatient period - state hospital Inpatient period - state hospital Inpatient period - state hospital Inpatient period (in days) - a. state hospital Fill in the duration of inpatient that is already finished in the last one year , in the provided box, if the respondent has been inpatient more than once in the same place, add the duration of the inpatient days of the several visits for the last one year. 9963 1020287 360 3.812 State Hospital is a hospital owned by the central government (such as RSCM/RSUP Dr. Cipto Mangunkusumo); regional government (such as RSU Labuang Baji), National Army/TNI (such as RSPAD), or State-owned Enterprise/BUMN (such as RS Pertamina). Inpatient period - private hospital Inpatient period - private hospital Inpatient period - private hospital Inpatient period - private hospital Inpatient period - private hospital Inpatient period (in days) - b. private hospital Fill in the duration of inpatient that is already finished in the last one year , in the provided box, if the respondent has been inpatient more than once in the same place, add the duration of the inpatient days of the several visits for the last one year. 9963 1020287 222 1.935 Private Hospital is a private owned hospital such as RS St. Carolus, RS Medistra. Inpatient period - health clinic Inpatient period - health clinic Inpatient period - health clinic Inpatient period - health clinic Inpatient period - health clinic Inpatient period (in days) - c. health clinic Fill in the duration of inpatient that is already finished in the last one year , in the provided box, if the respondent has been inpatient more than once in the same place, add the duration of the inpatient days of the several visits for the last one year. 9963 1020287 311 0.714 Health clinic(Community Health Center) is a health service unit owned by the government responsible for providing health services to the community in sub-districts,part of sub-districts or kelurahan (such in DKI Jakarta). Puskesmas team can do mobile practices to certain places within its working territory in order to provide easier access of health services for the society. Inpatient period - medical worker practice Inpatient period - medical worker practice Inpatient period - medical worker practice Inpatient period - medical worker practice Inpatient period - medical worker practice Inpatient period (in days): d. medical worker practice Fill in the duration of inpatient that is already finished in the last one year , in the provided box, if the respondent has been inpatient more than once in the same place, add the duration of the inpatient days of the several visits for the last one year. 9963 1020287 222 0.277 1 2 3 4 5 6 7 8 10 15 16 17 20 30 90 100 200 222 Sysmiss Medical worker practice are private/personal practices of physicians,whether general practitioners,dentists,or specialists.Location of practices can be carried out in Hospitals,puskesmas (community health center),supporting puskemas,or clinic that is commonly open outside the doctor's working hours. Inpatient period - traditional treatment Inpatient period - traditional treatment Inpatient period - traditional treatment Inpatient period - traditional treatment Inpatient period - traditional treatment Inpatient period (in days): e. traditional treatment Fill in the duration of inpatient that is already finished in the last one year , in the provided box, if the respondent has been inpatient more than once in the same place, add the duration of the inpatient days of the several visits for the last one year. 9963 1020287 222 0.139 1 2 3 4 5 6 7 8 10 12 15 20 30 34 48 50 60 110 222 Sysmiss Batra Practice (Traditional treatment) is an alternative health service by shaman/healer/sinshe,including accupuncture practice,finger therapy,paranormal,radiesthesia (usually using a pendulum). Inpatient period - other Inpatient period - other Inpatient period - other Inpatient period - other Inpatient period - other Inpatient period (in days): f. other Fill in the duration of inpatient that is already finished in the last one year, in the provided box, if the respondent has been inpatient more than once in the same place, add the duration of the inpatient days of the several visits for the last one year. 9963 1020287 222 0.237 1 2 3 4 5 6 7 8 9 10 11 14 15 16 20 22 30 32 36 45 53 70 90 98 118 120 140 188 211 222 Sysmiss Health insurance for outpatient/inpatient needs - Askes Health insurance for outpatient/inpatient needs - Askes Health insurance for outpatient/inpatient needs - Askes Health insurance for outpatient/inpatient needs - Askes Health insurance for outpatient/inpatient needs - Askes Is there any health insurance/financing for outpatient/inpatient needs as follows: a. Askes Fill in code 1 for “Yes” or code 2 for “No” into the provided boxes. 1030250 1 2 1.934 1 Yes 2 No Health Insurance for Civil Servant/Veteran/Pensioneris healthcare insurance for Civil Servant,Veteran and Pensioner,proven by membership card that is managed by PT Askes (Persero). Health insurance for outpatient/inpatient needs - Askes/Jamsostek Health insurance for outpatient/inpatient needs - Askes/Jamsostek Health insurance for outpatient/inpatient needs - Askes/Jamsostek Health insurance for outpatient/inpatient needs - Askes/Jamsostek Health insurance for outpatient/inpatient needs - Askes/Jamsostek Is there any health insurance/financing for outpatient/inpatient needs as follows: b. Askes/Jamsostek Fill in code 1 for “Yes” or code 2 for “No” into the provided boxes. 1030250 1 2 1.979 1 Yes 2 No Jamsostek is healthcare insurance for employee of private company in formal sector,proven by membership card that is managed by PT Jamsostek. Health financing for outpatient/inpatient needs - Office/company Health financing for outpatient/inpatient needs - Office/company Health financing for outpatient/inpatient needs - Office/company Health financing for outpatient/inpatient needs - Office/company Health financing for outpatient/inpatient needs - Office/company Is there any health insurance/financing for outpatient/inpatient needs as follows: c. Office/company Fill in code 1 for “Yes” or code 2 for “No” into the provided boxes. 1030250 1 2 1.983 1 Yes 2 No Private health insurance is commercial medical insurance to replace the expenses of health services spent by the policy holders. The membership is proven by medical insurance card. Health insurance for outpatient/inpatient needs - JPKM (Public Health Service Assurance) Health insurance for outpatient/inpatient needs - JPKM (Public Health Service Assurance) Health insurance for outpatient/inpatient needs - JPKM (Public Health Service Assurance) Health insurance for outpatient/inpatient needs - JPKM (Public Health Service Assurance) Health insurance for outpatient/inpatient needs - JPKM (Public Health Service Assurance) Is there any health insurance/financing for outpatient/inpatient needs as follows: d. JPKM (Public Health Service Assurance) Fill in code 1 for “Yes” or code 2 for “No” into the provided boxes. 1030250 1 2 1.992 1 Yes 2 No Benefit/reimbursement by company is healthcare benefit that is proven by identity card as an employee of the company that will provide health benefit/reimbursement of the medical expenses. Health insurance for outpatient/inpatient needs - Commercial health insurance Health insurance for outpatient/inpatient needs - Commercial health insurance Health insurance for outpatient/inpatient needs - Commercial health insurance Health insurance for outpatient/inpatient needs - Commercial health insurance Health insurance for outpatient/inpatient needs - Commercial health insurance Is there any health insurance/financing for outpatient/inpatient needs as follows: e. Commercial health insurance Fill in code 1 for “Yes” or code 2 for “No” into the provided boxes. 1030250 1 2 1.996 1 Yes 2 No Health insurance/health card/poor insurance/poor card is a health security for poor people that is proven by a membership card of JPK-MM,health card,poor card,JPK Gakin card or SKTM (Letter of Poverty) or Jamkesmas card. Health financing for outpatient/inpatient needs - Dana sehat (health fund) Health financing for outpatient/inpatient needs - Dana sehat (health fund) Health financing for outpatient/inpatient needs - Dana sehat (health fund) Health financing for outpatient/inpatient needs - Dana sehat (health fund) Health financing for outpatient/inpatient needs - Dana sehat (health fund) Is there any health insurance/financing for outpatient/inpatient needs as follows: f. Dana sehat (health fund) Fill in code 1 for “Yes” or code 2 for “No” into the provided boxes. 1030250 1 2 1.899 1 Yes 2 No Health fund is membership of healthcare for a group/community that is proven by the membership card of health fund. Health insurance for outpatient/inpatient needs - Kartu sehat (health/poor card) Health insurance for outpatient/inpatient needs - Kartu sehat (health/poor card) Health insurance for outpatient/inpatient needs - Kartu sehat (health/poor card) Health insurance for outpatient/inpatient needs - Kartu sehat (health/poor card) Health insurance for outpatient/inpatient needs - Kartu sehat (health/poor card) Is there any health insurance/financing for outpatient/inpatient needs as follows: g. Kartu sehat (health/poor card) Fill in code 1 for “Yes” or code 2 for “No” into the provided boxes. 1030250 1 2 1.982 1 Yes 2 No Other health insurance are other healthcare and medical securities that can be proven by ownership of membership cards for the above healthcare services. Age of child : (months) Age of child : (months) Age of child : (months) Age of child : (months) Age of child : (months) Age of child : (months) If the toddler is 1 month old or more (b5r11a not equal to 00), continue to b5r12. Fill in the toddler's age in months, if the age is >= 1 month in the space provided and directly move it to the box provided Child age 0-59 months 99126 931124 59 29.825 Age of child : (days) Age of child : (days) Age of child : (days) Age of child : (days) Age of child : (days) If b5r11a = 00 Age of child : (days) Fill in the toddler's age in days, if the toddler is < 1 month old in the space provided and directly move it to the box provided. Child age 0-59 months 998 1029252 30 15.466 Has birth certificate (not birth statement), can I see it? Has birth certificate (not birth statement), can I see it? Has birth certificate (not birth statement), can I see it? Has birth certificate (not birth statement), can I see it? Has birth certificate (not birth statement), can I see it? Has birth certificate (not birth statement), can I see it? If the answer is coded 1 or 2, skip to b5r14. Fill in the answer code to the box. Child age 0-59 months 99126 931124 1 9 2.463 1 Yes, can be shown 2 No, cannot be shown 3 Do not have 9 Do not know Sysmiss Birth certificate is a letter of birth proof issued by Civil Registry Office, either in the country or overseas. 1. Yes, it can be shown if the birth certificate can be shown to the officer 2. Yes, but it can't be shown if the birth certificate can't be shown to the officer 3. Do not have - self explanatory Main reason of do not have/do not know Main reason of do not have/do not know Main reason of do not have/do not know Main reason of do not have/do not know Main reason of do not have/do not know If do not have/do not know (b5r12 = 3 or 9) If do not have/do not know (R.12 = 3 or 9), why? Do not read out the answer. Circle one of the codes and enter the number into the box provided. Child age 0-59 months 62691 967559 1 99 23.026 1 Expensive/no fund 2 Far traveling distance 3 Expensive and Far traveling distance 4 Do not know about birth certificate recording 5 Expensive and Do not know about birth certificate recording 6 Far traveling distance and Do not know about birth certificate recording 7 Expensive, Far traveling distance and Do not know about birth certificate recording 8 Do not know the processing procedure 9 Expensive and Do not know the processing procedure 10 Far traveling distance and Do not know the processing procedure 11 Expensive, Far traveling distance and Do not know the processing procedure 12 Do not know about birth certificate recording and Do not know the processing procedure 13 Expensive, Do not know about birth certificate recording and Do not know the processing procedure 14 Far traveling distance, Do not know about birth certificate recording and Do not know the processing procedure 15 Expensive, Far traveling distance, Do not know about birth certificate recording and Do not know the processing procedure 16 Do not see the need 17 Expensive and Do not see the need 18 Far traveling distance and Do not see the need 19 Expensive, Far traveling distance and Do not see the need 20 Do not know about birth certificate recording and Do not see the need 21 Expensive, Do not know about birth certificate recording and Do not see the need 22 Far traveling distance, Do not know about birth certificate recording and Do not see the need 23 Expensive, Far traveling distance, Do not know about birth certificate recording and Do not see the need 24 Do not know the processing procedure and Do not see the need 25 Expensive, Do not know the processing procedure and Do not see the need 26 Far traveling distance, Do not know the processing procedure and Do not see the need 27 Expensive, Far traveling distance, Do not know the processing procedure and Do not see the need 28 Do not know about birth certificate recording, Do not know the processing procedure and Do not see the need 29 Expensive, Do not know about birth certificate recording, Do not know the processing procedure and Do not see the need 30 Far traveling distance, Do not know about birth certificate recording, Do not know the processing procedure and Do not see the need 31 Expensive, Far traveling distance, Do not know about birth certificate recording, Do not know the processing procedure and Do not see the need 32 Other 33 Expensive and Other 34 Far traveling distance and Other 35 Expensive, Far traveling distance and Other 36 Do not know about birth certificate recording and Other 37 Expensive, Do not know about birth certificate recording and Other 38 Far traveling distance, Do not know about birth certificate recording and Other 39 Expensive, Far traveling distance, Do not know about birth certificate recording and Other 40 Do not know the processing procedure and Other 41 Expensive, Do not know the processing procedure and Other 42 Far traveling distance, Do not know the processing procedure and Other 43 Expensive, Far traveling distance, Do not know the processing procedure and Other 44 Do not know about birth certificate recording, Do not know the processing procedure and Other 45 Expensive, Do not know about birth certificate recording, Do not know the processing procedure and Other 46 Far traveling distance, Do not know about birth certificate recording, Do not know the processing procedure and Other 47 Expensive, Far traveling distance, Do not know about birth certificate recording, Do not know the processing procedure and Other 48 Do not see the need and Other 49 Expensive, Do not see the need and Other 50 Far traveling distance, Do not see the need and Other 51 Expensive, Far traveling distance, Do not see the need and Other 99 Do not know Who assisted the first birth process? Who assisted the first birth process? Who assisted the first birth process? Who assisted the first birth process? Who assisted the first birth process? Who assisted the first birth process? Fill in the box a for the helper for the first born . Child age 0-59 months 99126 931124 1 9 2.737 1 Doctor 2 Midwife 3 Other paramedic 4 Healer 5 Family 6 Other 9 Sysmiss The birth process is the process of birth of a fetus from the mother’s womb to the world,starting with birth symptoms (periodic stomach ache that gets more often,longer and stronger,contraction of womb,water-broke mixed with mucus and blood from vagina, water-broke of yellowish clear color from vagina,and the feeling of defecation before the baby is finally delivered),infant delivered,cutting the placenta cord and the release of placenta.In birth a process,a woman might be help by more than one type of helper(such as traditional midwife and a nurse). Birth is a process when the fetus is delivered at the age of more than 5 months (22 weeks);if the fetus’s age is less than 5 months,it is called an abortion. Who assisted the last birth process? Who assisted the last birth process? Who assisted the last birth process? Who assisted the last birth process? Who assisted the last birth process? Who assisted the last birth process? Fill in box b for the helper for the last born . Child age 0-59 months 99126 931124 1 9 2.549 1 Doctor 2 Midwife 3 Other paramedic 4 Healer 5 Family 6 Other 9 Sysmiss The birth process is the process of birth of a fetus from the mother’s womb to the world,starting with birth symptoms (periodic stomach ache that gets more often,longer and stronger,contraction of womb,water-broke mixed with mucus and blood from vagina, water-broke of yellowish clear color from vagina,and the feeling of defecation before the baby is finally delivered),infant delivered,cutting the placenta cord and the release of placenta.In birth a process,a woman might be help by more than one type of helper(such as traditional midwife and a nurse). Birth is a process when the fetus is delivered at the age of more than 5 months (22 weeks);if the fetus’s age is less than 5 months,it is called an abortion. Frequency immunization - BCG Frequency immunization - BCG Frequency immunization - BCG Frequency immunization - BCG Frequency immunization - BCG How many times the child received immunization? a. BCG Enter how many times a child has been given immunization according to the mother's answer, and enter the code into the boxes provided. If the answer is never, enter a zero and if she does not know, enter a nine. Child age 0-59 months 99126 931124 9 1.007 1 2 3 4 5 6 7 9 Sysmiss 1. Immunization or vaccination is inserting certain attenuated germs or toxins(vaccine) into human body by means of injecting or drinking(dropping into mouth) in order to increase body immunity against the disease. 2. BCG (Bacillus Calmette Guerin) is a vaccination to prevent Tuberculosis/TBC, given to a new born baby or a toddler by injection on the base of the upper arm. BCG injection is given one time. Frequency immunization - DPT Frequency immunization - DPT Frequency immunization - DPT Frequency immunization - DPT Frequency immunization - DPT How many times the child received immunization? b. DPT Enter how many times a child has been given immunization according to the mother's answer, and enter the code into the boxes provided. If the answer is never, enter a zero and if she does not know, enter a nine. Child age 0-59 months 99126 931124 9 1.782 1 2 3 4 5 6 7 9 Sysmiss 1. Immunization or vaccination is inserting certain attenuated germs or toxins(vaccine) into human body by means of injecting or drinking(dropping into mouth) in order to increase body immunity against the disease. 2. DPT (Diphteria ,Pertussis, Tetanus) is given to a baby aged 3 months or older, by injecting it on the thigh and should be repeated after 1 month and then again after 2 months. Thus, a complete DPT Immunization on toddlers are done 3 times (sometimes time lapse between injections can be more than one month). Frequency immunization - Polio Frequency immunization - Polio Frequency immunization - Polio Frequency immunization - Polio Frequency immunization - Polio How many times the child received immunization? c. Polio Enter how many times a child has been given immunization according to the mother's answer, and enter the code into the boxes provided. If the answer is never, enter a zero and if she does not know, enter a nine. Child age 0-59 months 99126 931124 9 1.93 1 2 3 4 5 6 7 9 Sysmiss 1. Immunization or vaccination is inserting certain attenuated germs or toxins(vaccine) into human body by means of injecting or drinking(dropping into mouth) in order to increase body immunity against the disease. 2. Polio is a vaccine to prevent polio virus, given to a baby at the age 3 months or older by giving 3 drops of liquid vaccine in a pink or white color directly into the baby's mouth; usually given together with DPT vaccination. A complete Polio immunization is given 3 times. In National Immunization Week (PIN), polio immunization are given specifically for all toddlers in Indonesia at the same week (in certain regions are at the same month or day) in accordance to the given schedule. Frequency immunization - Measles Frequency immunization - Measles Frequency immunization - Measles Frequency immunization - Measles Frequency immunization - Measles How many times the child received immunization? d. Measles Enter how many times a child has been given immunization according to the mother's answer, and enter the code into the boxes provided. If the answer is never, enter a zero and if she does not know, enter a nine. Child age 0-59 months 99126 931124 9 0.871 1 2 3 4 5 6 7 9 Sysmiss 1. Immunization or vaccination is inserting certain attenuated germs or toxins(vaccine) into human body by means of injecting or drinking(dropping into mouth) in order to increase body immunity against the disease. 2. Measles/morbilli is a vaccine to prevent measles/morbilli; (please state the symptoms and epidemic area of measles if the mother seems not understand), that is usually given one time to a baby aged between 9 to 12 months, by injecting on the thigh. Frequency immunization - Hepatitis B Frequency immunization - Hepatitis B Frequency immunization - Hepatitis B Frequency immunization - Hepatitis B Frequency immunization - Hepatitis B How many times the child received immunization? e. Hepatitis B Enter how many times a child has been given immunization according to the mother's answer, and enter the code into the boxes provided. If the answer is never, enter a zero and if she does not know, enter a nine. Child age 0-59 months 99126 931124 9 1.393 1 2 3 4 5 6 7 9 Sysmiss 1. Immunization or vaccination is inserting certain attenuated germs or toxins(vaccine) into human body by means of injecting or drinking(dropping into mouth) in order to increase body immunity against the disease. 2. Hepatitis B is an intramuscular injection (injection to the mucsle), usually on the thigh, given to baby to prevent Hepatitis B. This injection is given 3 times. The first injection given when the baby is 0 month old, the second is given at the age of 1 month, and the third is at the age of 6 months. Ever provided with breast milk? Ever provided with breast milk? Ever provided with breast milk? Ever provided with breast milk? Ever provided with breast milk? Ever provided with breast milk? If the entry is coded 2, skip to question other household member. Circle code 1 for “Yes” and code 2 for “No” and write down in the provided box. Child age 0-59 months 99126 931124 1 2 1.038 1 Yes 2 No Sysmiss Breastfeeding is if a mother’s nipple sucked by a baby secreting milk that is drunk by the baby,although only a little. A breastfeeding mother is not only the biological mother of the baby but she could be another woman. Breast milk(ASI) is the best natural food for baby,which composition meets the full requirement of a baby up to 6 months old.ASI contains elements that provides protection against various diseases and also enzyme that help baby’s digestive system. Breastfeeding with affection can also strengthen the bond between a mother and her baby. Period of provided with breast milk: Period of provided with breast milk: Period of provided with breast milk: Period of provided with breast milk: Period of provided with breast milk: If “yes” [b5r16a = 1] Period of provided with breast milk: Record the answer of duration in the box available in month by completing below. Child age 0-59 months 95329 934921 59 16.03 Period - Breast milk exclusive: Period - Breast milk exclusive: Period - Breast milk exclusive: Period - Breast milk exclusive: Period - Breast milk exclusive: If “yes” [b5r16a = 1] Period - Breast milk exclusive: Fill in days if age < 1 month and in months if age is >= 1 month Child age 0-59 months 95329 934921 57 3.753 If age less than 7 months, is only provided with breast milk only for the last 24 hours? If age less than 7 months, is only provided with breast milk only for the last 24 hours? If age less than 7 months, is only provided with breast milk only for the last 24 hours? If age less than 7 months, is only provided with breast milk only for the last 24 hours? If age less than 7 months, is only provided with breast milk only for the last 24 hours? Child age 0-59 months 7324 1022926 1 2 1.295 1 Yes 2 No Sysmiss Schooling participation: Schooling participation: Schooling participation: Schooling participation: Schooling participation: Schooling participation: 1. If the answer is coded 1, skip to b5r23, and 2. If the answer is coded 2, skip to b5r19 Circle one of the codes from 1 to 3 and enter the number into the box provided. For household member age five years up 931124 99126 1 3 2.533 1 No/never in school 2 Still in school 3 No longer in school Sysmiss A person is considered schooling if he is registered and active in attending a study process in formal education level,whether under supervision of Ministry of National Education/Depdiknas or other department/institution. 1. Not/not yet attending school - never or not yet been registered and never been active in attending school or at formal education level, including have completed/not completed kindergarten level but do not continue to elementary school. 2. Still attending school - are those who are registered and actively attending a formal education level, whether it is under supervision of Ministry of National Education, Ministry of Religion, other Government Institution, or Private Institution. 3. No longer in school - those who were once registered and actively attending a formal education, but at the time of census are not registered and active anymore, including those who are attending Package A program of SD (Elementary) equivalent, Package B program of SMP (Junior High) equivalent and Package C Program of SMA (Senior High) equivalent. When did you quit school? (Month) When did you quit school? (Month) When did you quit school? (Month) When did you quit school? (Month) When did you quit school? (Month) When did you quit school? (Month) Fill in the month for people who quit prior to 1993, write down completely in the empty space and provided box. If quit prior to 1993, enter 00 into the month boxes. For household member age five years up 592761 437489 12 1.447 1 2 3 4 5 6 7 8 9 10 11 12 Sysmiss When did you quit school? (Year) When did you quit school? (Year) When did you quit school? (Year) When did you quit school? (Year) When did you quit school? (Year) When did you quit school? (Year) Fill in the year for people who quit prior to 1993, write down completely in the empty space and provided box. If quit prior to 1993, enter 0000 into year boxes. For household member age five years up 592761 437489 2004 473.153 The highest education type and level currently studied/passed: The highest education type and level currently studied/passed: The highest education type and level currently studied/passed: The highest education type and level currently studied/passed: The highest education type and level currently studied/passed: The highest education type and level currently studied/passed: Circle one of code 1 to 14 and fill it in the provided box. For household member age five years up 834764 195486 1 11 2.82 1 Elementary school 2 M. Ibtidaiyah 3 Public/vocationaljunior high 4 M. Tsanawiyah 5 Senior High 6 M. Aliyah (Islamic school) 7 Vocational School 8 Diploma I/II 9 Diploma III 10 Diploma IV/S1 11 S2/S3 Sysmiss 1. SD/SDLB is an Elementary School of 5/6/7 years or equivalent(elementary special school,small elementary school,pamong elementary school). 2. Madrasah Ibtidaiyah(MI) is Islamic Elementary School of SD equivalent. 3. SMP/SMPLB is Secondary School or the equivalent MULO,3-year HBS,and Secondary Special School). 4. Madrasah Tsanawiyah(MTs) is Islamic Secondary School of SMP equivalent . 5. General High School(SMU)/Special High School(SMLB) is a High School(SMU),or the equivalent(Special High School,5-year HBS,AMS,and Employee Administration High Course(KPAA). 6. Madrasah Aliyah(MA) is an Islamic High School of SMU equivalent. 7. Vocational High School(SMK) is a vocational school of SMA equivalent. 8. Diploma 1/2 Program is D1/D2 program in a university that organizes diploma 1 and 2 program in formal education. 9. Diploma 3 Program/baccalaureate is a D3 program or baccalaureate degree in an academy or university that organizes diploma programs or issues baccalaureate degrees. 10. Diploma 4 Program/bachelor is an education program of Diploma 4 or Strata1 in a university. 11. S2/S3 is a postgraduate education program(master or doctorate),Strata 2 or Strata 3 in a university. Education provider: Education provider: Education provider: Education provider: Education provider: For household member age five years up 834764 195486 1 3 1.197 1 State 2 Private 3 Overseas Sysmiss Highest class/level studied/currently studied: Highest class/level studied/currently studied: Highest class/level studied/currently studied: Highest class/level studied/currently studied: Highest class/level studied/currently studied: Highest class/level studied/currently studied: Circle one of the following codes from 1 to 8 and enter the code into the box provided. For household member age five years up 834764 195486 8 5.744 1 Grade-1 2 Grade-2 3 Grade-3 4 Grade-4 5 Grade-5 6 Grade-6 7 Grade-7 8 Graduated Sysmiss Examples: Highest Level/Class Attended/Being Attended a.For household head/member who has graduated,use code 8 for the highest level/class has been/being attended. b.For household head/member who has a bachelor degree attending/has attended master/S2 program,use code 6. c.For household head/member who has a master degree attending/has attended S3 program,use code 7. d.For household head/member who has attended/is stillatending the highest level/class of S1 program,use code 5. Graduated means has completed the study marked with passing the final exams in the last class/level of an education in a public or private school and received a certificate/diploma. A household head/member who has not attended the last level of education program but has passed the final exams is considered graduate. Highest diploma obtained: Highest diploma obtained: Highest diploma obtained: Highest diploma obtained: Highest diploma obtained: Highest diploma obtained: Circle one of the codes from 1 to 15 and enter the answer into the box provided. For household member age five years up 834764 195486 1 9 2.449 1 No elementary diploma 2 Elementary/MI 3 Junior High/equal 4 Senior High/equal 5 Vocational junior high 6 Diploma I/II 7 Diploma III 8 Diploma IV/S1 9 S2/S3 Sysmiss No elementary school diploma means that the household/member does not possessed certificate for a certain educational level, but has to attended to Elementary School of 5/6/7 year study or equivalent(among others are basic level of SLB,Madrasah Ibtidaiyah,Pamong Elementary School,Smal Elementary School,Package A1-A100,Package a Equivalent) but did not/has not yet graduate.This include household/member who graduated 3-year elementary school or equivalent. Can read and write: Can read and write: Can read and write: Can read and write: Can read and write: Can read and write: Circle one of the code 1 to code 4 and enter the answer into the provided box. For household member age five years up 931124 99126 1 3 1.247 1 Latin alphabets 2 Other alphabets 3 Cannot Sysmiss Can read and write means able to read and write words/simple sentences in certain letters, e.g. "I must be honest." Activities in past one week - work Activities in past one week - work Activities in past one week - work Activities in past one week - work Activities in past one week - work Did you perform the following activity in the past one week? a. work Circle code 1 for "Yes" or code 2 for "No", and enter in the boxes provided. For household member age 10 years up 820829 209421 1 2 1.501 1 Yes 2 No Sysmiss Working is an activity of doing work with the intention to earn or help earning a living or profit,minimum for one hour in the last one week. Working for one hour as mentioned above should be done continuously and uninterrupted. Income includes wages/salary,including all the benefits and bonus for worker/employee and business income in the form of rents or profits,whether in cash or goods for businessmen. Activities in past one week - attending school Activities in past one week - attending school Activities in past one week - attending school Activities in past one week - attending school Activities in past one week - attending school Did you perform the following activity in the past one week? b. attending school Circle code 1 for "Yes" or code 2 for "No", and enter in the boxes provided. For household member age 10 years up 820829 209421 1 2 1.799 1 Yes 2 No Sysmiss Going to school is an activity at a formal school,whether in primary,secondary,or higher education.Students on leave are not included. Activities in past one week - handling household Activities in past one week - handling household Activities in past one week - handling household Activities in past one week - handling household Activities in past one week - handling household Did you perform the following activity in the past one week? c. handling household Circle code 1 for "Yes" or code 2 for "No", and enter in the boxes provided. For household member age 10 years up 820829 209421 1 2 1.589 1 Yes 2 No Sysmiss Handling household is an activities of managing the household or helping to manage the household without getting paid. Activities in past one week - other beside personal activity Activities in past one week - other beside personal activity Activities in past one week - other beside personal activity Activities in past one week - other beside personal activity Activities in past one week - other beside personal activity Did you perform the following activity in the past one week? d. other beside personal activity Circle code 1 for "Yes" or code 2 for "No", and enter in the boxes provided. For household member age 10 years up 820829 209421 1 1 1 1 Yes 2 No Sysmiss Other activities include: sports, course, picnic and social activities (organization, volunteering) Others are activities other than working,going to school and managing household. Included in this category are people who cannot do activities such as senior citizens,disabled and people who receive pension and do not work anymore. What activity used the most time in the past one week? What activity used the most time in the past one week? What activity used the most time in the past one week? What activity used the most time in the past one week? What activity used the most time in the past one week? If b5r24a1- 4 with code 1 (“Yes”) What activity used the most time in the past one week? If b5r24a1 is coded 1, skip to b5r26. B5r24a with code 1 (“Yes”) – ask what activity is the most time consuming in the last one week, circle one of the codes and enter the number into the box provided. For household member age 10 years up 820829 209421 1 4 2.003 1 Work 2 School 3 Handling Household 4 Other Sysmiss The most time consuming activity is an activity that uses up most time in comparison with other activities. Do you have work/business, but temporarily not working for the past one week? Do you have work/business, but temporarily not working for the past one week? Do you have work/business, but temporarily not working for the past one week? Do you have work/business, but temporarily not working for the past one week? Do you have work/business, but temporarily not working for the past one week? Do you have work/business, but temporarily not working for the past one week? Circle code 1 for “Yes” or code 2 for “No”, then enter the answer into the provided box. For household member age 10 years up 411279 618971 1 2 1.973 1 Yes 2 No Sysmiss Those who are categorized as have jobs but temporarily do not work are: 1.Professional workers who do not work because of sickness waiting for the next projects.Examples: Puppet master,masseur/se,shaman and singer. 2.Regular employees,government officials or employees of private companies who are ill,on leave,absent,on strike or temporarily laid off because the company stopped operating,for example a factory having machine malfunction,or lack of raw material,etc. 3.Farmer who works on farm land,stops working because of an illness or waiting for the next job such as harvest or rainy season to start planting paddy field. Those who are categorized as having jobs but temporarily do not work are people who work/have businesses but for the last one week stop working for a reason,such as sick,on leave,waiting for harvesting,or on a strike. Are you looking for work? Are you looking for work? Are you looking for work? Are you looking for work? Are you looking for work? For household member age 10 years up 820829 209421 1 2 1.928 1 Yes 2 No Sysmiss Are you preparing a business during the past one week? Are you preparing a business during the past one week? Are you preparing a business during the past one week? Are you preparing a business during the past one week? Are you preparing a business during the past one week? For household member age 10 years up 820829 209421 1 2 1.986 1 Yes 2 No Sysmiss Main reason of not looking for work/preparing business: Main reason of not looking for work/preparing business: Main reason of not looking for work/preparing business: Main reason of not looking for work/preparing business: Main reason of not looking for work/preparing business: If b5r26 = 2 and b5r27 = 2 For household member age 10 years up 756502 273748 1 5 3.186 1 Feel unable to obtain work 2 Have work, but not yet started 3 In school or handling household/family 4 Have work/business, feel sufficient 5 Other (disabled, old, and the like) Sysmiss If there is a job offer, will you accept it? If there is a job offer, will you accept it? If there is a job offer, will you accept it? If there is a job offer, will you accept it? If there is a job offer, will you accept it? If b5r26 = 2 and b5r27 = 2 For household member age 10 years up 756502 273748 1 2 1.756 1 2 Sysmiss Total work day: (days) Total work day: (days) Total work day: (days) Total work day: (days) Total work day: (days) Total work day: (days) Write down the total working days for the last one week according to the number of days spent for work and enter it in the box provided. For working household member 420473 609777 7 5.865 1 2 3 4 5 6 7 Sysmiss Working days means days spent by a person to carry out working activities at a minimum of one (1) hour continuously in the last one week. Total work hour from all jobs in the past one week: (hours) Total work hour from all jobs in the past one week: (hours) Total work hour from all jobs in the past one week: (hours) Total work hour from all jobs in the past one week: (hours) Total work hour from all jobs in the past one week: (hours) Total work hour from all jobs in the past one week: (hours) Write down the total working hours in the last one week and enter it in the box provided. For working household member 420473 609777 98 38.715 Total working hours is the time (in hour) spent to do all the working activities in the last one week. If respondent is temporary out of work, write down "00" Main business/job from workplace in the past one week: Main business/job from workplace in the past one week: Main business/job from workplace in the past one week: Main business/job from workplace in the past one week: Main business/job from workplace in the past one week: Main business/job from workplace in the past one week: Write down completely the main business/job from workplace in the empty space provided. For working household member 420473 609777 990 277.345 1 2 3 5 7 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 29 30 31 32 33 35 37 41 42 45 50 51 52 53 54 55 56 57 60 61 62 63 70 71 73 74 75 77 79 80 81 83 84 85 89 90 91 92 93 95 98 99 100 101 102 107 108 109 110 111 112 113 114 115 116 120 121 122 123 125 130 131 132 133 134 135 136 139 141 142 143 144 145 147 149 150 151 152 153 154 155 156 157 159 160 161 162 163 164 166 168 170 171 172 173 174 176 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 195 199 200 201 202 203 204 206 207 209 210 212 214 215 217 220 221 222 223 225 230 231 232 233 240 241 242 243 245 248 249 250 251 252 253 254 255 256 260 261 262 263 264 265 266 269 270 271 272 273 274 275 280 281 282 286 287 288 289 291 292 293 295 298 300 301 302 303 304 307 308 310 311 312 313 314 315 319 321 322 323 324 325 331 332 333 339 341 342 343 345 350 351 352 353 354 355 357 359 360 361 363 365 368 369 371 372 375 380 381 390 391 392 393 395 396 397 399 400 401 402 403 404 410 411 413 414 416 419 420 421 422 423 424 425 429 430 431 432 434 436 442 445 450 451 452 453 454 455 456 457 458 459 462 463 464 470 475 479 484 489 490 491 492 495 500 501 502 503 504 505 506 507 509 510 511 512 513 514 515 516 518 519 520 521 522 523 524 525 526 527 528 529 530 531 532 533 534 535 539 540 541 542 543 544 545 546 549 550 551 552 553 554 555 557 560 561 562 563 564 565 566 570 571 572 573 575 580 582 583 585 589 590 591 593 599 600 601 602 603 604 605 606 607 608 609 611 612 613 614 619 620 621 622 623 624 625 626 628 629 630 631 632 633 634 635 636 637 639 640 641 642 643 644 645 646 648 650 651 652 653 654 655 657 659 660 662 665 666 671 672 674 681 682 691 692 701 702 703 705 708 711 712 713 714 715 716 717 719 721 722 723 724 725 728 729 730 731 732 734 735 739 740 741 742 743 744 745 747 748 749 750 751 752 753 754 755 756 757 759 761 764 769 770 771 776 779 781 782 791 793 795 800 801 802 803 804 805 806 807 808 809 810 811 812 819 820 821 822 823 825 826 830 831 832 835 842 845 850 851 852 853 854 856 857 859 861 862 863 869 889 890 891 893 899 900 901 902 903 905 908 909 910 911 912 919 920 921 922 923 924 925 927 930 931 932 933 936 937 938 939 940 941 942 943 949 950 951 952 953 954 955 956 957 958 959 960 965 970 971 972 980 985 987 989 990 Sysmiss Business sector/type of work is the sector of activity of work/company/business where the household head/member works. How to determine the main work: 1.If a household head/member in the last one week only has only one work,than it is considered the main work. 2.If a household head/member in the last one week has more than one work,the main work is the one that consumes the most time. If the time spent to do those works are the same,than the work that produces the largest income is considered the main work. Type of work/position of the main job in the past one week: Type of work/position of the main job in the past one week: Type of work/position of the main job in the past one week: Type of work/position of the main job in the past one week: Type of work/position of the main job in the past one week: Write down completely type of work/position of the main job in the empty space provided. For working household member 420473 609777 1 999 606.649 Position/status of the main job in the past one week: Position/status of the main job in the past one week: Position/status of the main job in the past one week: Position/status of the main job in the past one week: Position/status of the main job in the past one week: Position/status of the main job in the past one week: 1. If the answer is coded 1,2,3,5,6, or 7 skip to Block V.E., and 2. If the answer is coded 4 skip to b5r34. Circle one of the code 1 to code 7 and enter the answer into the provided box. For working household member 420473 609777 1 7 3.51 1 Self-owned business/freelance 2 Self-owned business with non-permanent/non-paid worker 3 Self-owned business with permanent/paid worker 4 Worker/employee/staff 5 Freelancer in agricultural sector 6 Freelancer in non-agricultural sector 7 Non-paid worker Sysmiss Status/work position is the household head/member position at main job. 1. Self-owned business/freelance is a household head/member who works/owns business by taking economical risk, that may result in the lost of production cost that has been spent in doing the business, and does not employ any worker whether paid or unpaid. Included in this category are works that required special skill/talent. 2. Self-owned business with non-permanent/non-paid worker is a household head/member who works or owns a business on his own risk, and hires unpaid labor/employee/staff and or employs fee labor/employee/staff. 3. Self-owned business with permanent/paid worker is a household head/member who opens a business at his own risk and employs at lease one paid labor/employee/staff. 4. Worker/employee/staff is a household head/member whow works for other people or institutions/ office/company and regularly receives wages/salaries in the form of money or goods (in-kind) 5. Freelancer is a household head/member who works irregularly for other people/employer/institution, who has more than one employer in the last one month in a household business or non-household business based on a reward system by receiving wages or compensation both in the form of money or in-kind, whether paid daily or per project. 6. Non-paid worker is a household member who works to help household head/member/other people without getting paid, whether in the form of money or goods. The amount of net wage/salary (money and goods) generally received in a month from the main job - rupiah The amount of net wage/salary (money and goods) generally received in a month from the main job - rupiah The amount of net wage/salary (money and goods) generally received in a month from the main job - rupiah The amount of net wage/salary (money and goods) generally received in a month from the main job - rupiah The amount of net wage/salary (money and goods) generally received in a month from the main job - rupiah The amount of net wage/salary (money and goods) generally received in a month from the main job - rupiah Write down the income in the space provided and enter into the box provided. For working household member 118141 912109 10000 89200000 851711.687 First marriage at age: (Years) First marriage at age: (Years) First marriage at age: (Years) First marriage at age: (Years) First marriage at age: (Years) First marriage at age: (Years) Fill in respondent’s age at first marriage in the provided space and write it down in the box. The formula to calculate the respondent's age at first marriage is the same as the formula to count respondent's age. For women age 10 years and up - women who once married 278327 751923 10 60 19.732 Number of years in marriage: (years) Number of years in marriage: (years) Number of years in marriage: (years) Number of years in marriage: (years) Number of years in marriage: (years) Number of years in marriage: (years) Ask how long the respondent has been married. If there were more than one marriage, please add the number of years of the entire wedlocks made. Rounded it down. For those who got pregnant out of wedlock enter code "00". For women age 10 years and up - women who once married 278327 751923 86 19.595 Children are live birth - male Children are live birth - male Children are live birth - male Children are live birth - male Children are live birth - male Total child born from marriage: a. Member of household, live birth (M) Enter the number of male children born alive, in the corresponding column.If there are no biological children born alive, write down "00". For women age 10 years and up - women who once married 278327 751923 20 1.545 1 2 3 4 5 6 7 8 9 10 11 12 13 14 20 Sysmiss Biological children born alive means biological children who were born in a lively condition, showing signs of living although only for a brief period, such as heart beating, breathing and crying. Stillborn children (children born without showing signs of living) are not included in this survey. Children are live birth - female Children are live birth - female Children are live birth - female Children are live birth - female Children are live birth - female Total child born from marriage: a. Member of household, live birth (F) Enter the number of female children born alive, in the corresponding column.If there are no biological children born alive, write down "00". For women age 10 years and up - women who once married 278327 751923 20 1.444 1 2 3 4 5 6 7 8 9 10 11 12 13 14 16 17 20 Sysmiss Biological children born alive means biological children who were born in a lively condition, showing signs of living although only for a brief period, such as heart beating, breathing and crying. Stillborn children (children born without showing signs of living) are not included in this survey. Children are live birth - male + female Children are live birth - male + female Children are live birth - male + female Children are live birth - male + female Children are live birth - male + female Total child born from marriage: a. Member of household, live birth (M+F) Insert the total number in the male + female colums.If there are no biological children born alive, write down "00". For women age 10 years and up - women who once married 278327 751923 23 2.989 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 23 Sysmiss Biological children born alive means biological children who were born in a lively condition, showing signs of living although only for a brief period, such as heart beating, breathing and crying. Stillborn children (children born without showing signs of living) are not included in this survey. Children are still alive - male Children are still alive - male Children are still alive - male Children are still alive - male Children are still alive - male Total child born from marriage: b. Member of household, still alive (M) Enter the number of male children still alive, in the corresponding column.If there are no biological children still alive, write down "00". For women age 10 years and up - women who once married 278327 751923 20 1.398 1 2 3 4 5 6 7 8 9 10 11 12 20 Sysmiss Children are still alive - female Children are still alive - female Children are still alive - female Children are still alive - female Children are still alive - female Total child born from marriage: b. Member of household, still alive (F) Enter the number of female children still alive, in the corresponding column.If there are no biological children still alive, write down "00". For women age 10 years and up - women who once married 278327 751923 20 1.321 1 2 3 4 5 6 7 8 9 10 11 12 17 20 Sysmiss Children are still alive - male + female Children are still alive - male + female Children are still alive - male + female Children are still alive - male + female Children are still alive - male + female Total child born from marriage: b .Member of household, still alive (M+F) Insert the total number in the male + female colums.If there are no biological children still alive, write down "00". For women age 10 years and up - women who once married 278327 751923 20 2.718 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 18 20 Sysmiss Children are already deceased - male Children are already deceased - male Children are already deceased - male Children are already deceased - male Children are already deceased - male Total child born from marriage: c. Member of household, already deceased (M) Enter the number of male children already deceased, in the corresponding column.If there are no biological children already deceased, write down "00". For women age 10 years and up - women who once married 278327 751923 11 0.148 1 2 3 4 5 6 7 8 9 10 11 Sysmiss Children are already deceased - female Children are already deceased - female Children are already deceased - female Children are already deceased - female Children are already deceased - female Total child born from marriage: c. Member of household, already deceased (F) Enter the number of female children already deceased, in the corresponding column.If there are no biological children already deceased, write down "00". For women age 10 years and up - women who once married 278327 751923 12 0.123 1 2 3 4 5 6 7 8 9 10 11 12 Sysmiss Children are already deceased - male + female Children are already deceased - male + female Children are already deceased - male + female Children are already deceased - male + female Children are already deceased - male + female Total child born from marriage: c. Member of household, already deceased (M+F) Insert the total number in the male + female colums.If there are no biological children already deceased, write down "00". For women age 10 years and up - women who once married 278327 751923 13 0.271 1 2 3 4 5 6 7 8 9 10 11 12 13 Sysmiss Ever use/wear family planning tool/device/method? Ever use/wear family planning tool/device/method? Ever use/wear family planning tool/device/method? Ever use/wear family planning tool/device/method? Ever use/wear family planning tool/device/method? If the answer is coded 2 skip to other household member. For women age 10 years and up - women who once married 278327 751923 1 2 1.439 1 Yes 2 No Sysmiss The use/wearing of family planning device/method? The use/wearing of family planning device/method? The use/wearing of family planning device/method? The use/wearing of family planning device/method? The use/wearing of family planning device/method? The use/wearing of family planning device/method? If the answer is no longer use it or never use it , skip to other household member Circle the contraception/birth control (KB) code according to the respondent’s answer, enter it in the box provided. If using more than one type of contraception, please record only the type currently used. Generally,the reference time for various birth controls used is 30 days. For women age 10 years and up - Women with married status 147259 882991 1 2 1.273 1 Yes 2 No Sysmiss The selected family planning device/method: The selected family planning device/method: The selected family planning device/method: The selected family planning device/method: The selected family planning device/method: The selected family planning device/method: Continue to other household member. If respondent uses more than one type of contraception (to meet the concept of contraception usage), then write down the type with the smallest code number. For women age 10 years and up - Women with married status 107011 923239 1 9 4.528 1 Women/tubectomy 2 Men/vasectomy 3 IUD/spiral 4 Injection 5 Implant/norplant 6 Birth control pill 7 Condom/rubber 8 Intravag/tissue/women condom 9 Traditional method Sysmiss 1. MOW/Medis Operasi Wanita (woman medical surgery)/tubectomy (woman sterilization) is a surgery performed on female household head/member by having her fallopian tubes closed to prevent pregnancy. Please emphasize that the goal is to prevent future pregnancies. 2. MOP/Medis Operasi Pria (man medical surgery)/vasectomy (man sterilization) is a minor surgery performed on male household head/member to prevent his spouse from being pregnant. 3. AKDR/Alat Kontrasepsi Dalam Rahim (IUD/Intra Uterus Device) is a device made of soft plastic/copper,small in size,in the forms of spiral,T,fan,etc. installed inside the womb/uterus to prevent pregnancy. This device functions as pregnancy prevention for a long period of time. 4. KB Injection is one of ways to prevent pregnancy by injecting contraceptive substance periodically,e.g. once in one,three,or six months. 5. Susuk KB/norplant/implanon/alwalit (Contraceptive Skin Implant)-are six small metals to be implanted/injected under the skin of the upper arm to prevent pregnancy. A household head/member is considered using susuk KB if she had the implant less than five(5) years ago prior to the date of census. This includes under the skin injection(implant). 6. KB Pills are pills that are taken to prevent pregnancy. These pills should be taken regularly. 7. Condom/KB rubber is a device made of rubber,in a balloon-like shape,used by male household head/member while having sexual intercourse in order to prevent the spouse from getting pregnant. 8. Intravag/tissue/woman’s condom is a KB tissue positioned inside the vagina before having sexual intercourse. Reference time for this device is up to the last intercourse within 30 days before the interview. 9. Traditional method: a.Periodic abstinence/calendar method is based on the assumption that by not having sexual intercourse in a certain days of the month,which is during fertile period in monthly cycle,a woman could prevent pregnancy. b.Coitus interruptus is a method to prevent semen from entering vagina by interrupting intercourse before ejaculation. The refference time for this method is the last intercourse within 30 days. c.Other traditional methods such as breastfeeding for the purpose of birth control,abstinence,traditional herbs (jamu),and massage. Individual weight Individual weight Individual weight Individual weight Individual weight 1030250 4 1038 210.699 Province Province Province Province Province Province Write down the name province in the space provided and add the related code referred to in the box provided. 252913 11 94 40.469 11 Nanggroe Aceh Darussalam 12 North Sumatera 13 West Sumatera 14 Riau 15 Jambi 16 South Sumatera 17 Bengkulu 18 Lampung 19 Bangka Belitung 21 Riau Island 31 DKI Jakarta 32 West Java 33 Central Java 34 DI Yogyakarta 35 East Java 36 Banten 51 Bali 52 West Nusa Tenggara 53 East Nusa Tenggara 61 West Kalimantan 62 Central Kalimantan 63 South Kalimantan 64 East Kalimantan 71 North Sulawesi 72 Central Sulawesi 73 South Sulawesi 74 Southeast Sulawesi 75 Gorontalo 76 West Sulawesi 81 Maluku 82 North Maluku 91 West Irian Jaya 94 Papua District/City District/City District/City District/City District/City District/City Cross out the unnecessary and the Write down the name of district/city in the space provided and add the related code referred to in the box provided. 252913 1 79 23.399 Sub-district Sub-district Sub-district Sub-district Sub-district Sub-district Write down the name subdistrict in the space provided and add the related code referred to in the box provided. 252913 4 740 65.674 Village/kelurahan Village/kelurahan Village/kelurahan Village/kelurahan Village/kelurahan Village/kelurahan Cross out the unnecessary and the Write down the name of village/kelurahan in the space provided and add the related code referred to in the box provided. 252913 1 123 8.691 Village/kelurahan classification Village/kelurahan classification Village/kelurahan classification Village/kelurahan classification Village/kelurahan classification Village/kelurahan classification Circle the answered code, then write it down in the box provided. 252913 1 2 1.599 1 Urban 2 Rural Sample code number Sample code number Sample code number Sample code number Sample code number Sample code number Write down the sample code number into the box provided. 252913 1001 2582 1946.285 Household sample sequential number Household sample sequential number Household sample sequential number Household sample sequential number Household sample sequential number Household sample sequential number Write down the household sample sequential number into the box provided. 252913 1 16 8.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Race of the head of household Race of the head of household Race of the head of household Race of the head of household Race of the head of household 252913 1 31 8.853 Total household members (HM) Total household members (HM) Total household members (HM) Total household members (HM) Total household members (HM) 252913 1 24 4.074 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 24 Number of children aged 0-4 years Number of children aged 0-4 years Number of children aged 0-4 years Number of children aged 0-4 years Number of children aged 0-4 years 252913 5 0.392 1 2 3 4 5 Total HM who died since January 2001: Total HM who died since January 2001: Total HM who died since January 2001: Total HM who died since January 2001: Total HM who died since January 2001: 252913 4 0.0321 1 2 3 4 Building status: Building status: Building status: Building status: Building status: Building status: Circle one of codes 1 to 7 according to respondent’s answer, and fill it in the provided box. 252913 1 7 1.617 1 Own house 2 Lease 3 Rent 4 Free lease 5 Company house 6 Owned by parents/sibling/family 7 Other 1. Own housed residence,if during the census,the residence is legally owned by the household head or member. Residence obtained by credit through banks or under the status of buying lease,is considered personally owned. 2. Leased residence,if the residence is leased by the household head/member for a certain period based on an agrement between tenant and landlord,for example for 1 or 2 years lease. Payment method is usually totally in advance,or in installment that is mutually agreed upon. At the end of the lease,the tenant should leave the residence and if mutually agreen it is possible to renew the lease agreement. 3. Rented residence,if the residence is rented by the household head or one of the members with regular payment continuously without a certain time limit. 4. Rent-free residence,owned by other people,if the residence is provided by other people (not family/parents) and can be occupied/resided in without having to make any kind of payment. 5. Company’s housed Residence,is the residence is owned and provided by an institution/company where the household head/member works,whether by paying rents or not. 6. Parent/relative’s housed,if the residence is not personally owned but belongs to either parents/family/relatives and is free to live in,where the owner of the house does not live there and is not a member of the household. 7. Others,if the residence cannot be included in any of the above categories,such as group owned residence,custom house. Building condition: Building condition: Building condition: Building condition: Building condition: Building condition: 252913 1 3 2.882 1 New building, finished construction by 2003 2 Newly renovated/repaired in 2003 3 Old building Type of most roof material : Type of most roof material : Type of most roof material : Type of most roof material : Type of most roof material : Type of most roof material : Circle one of the codes of widest roof type of the physical building where the household of respondent resides,then write it down in the box provided. 252913 1 7 3.247 1 Concrete 2 Roof tile 3 Shingle 4 Iron sheet 5 Asbestos 6 Fiber/palm 7 Other Roof is the top cover of a building,so that household head/members live in under is protected from the sun heat,rain etc. For multi storeys building,the referred roof is the very top part of the building. 1. Concrete is roof made of a mixture of cement,corals and sand with water. 2. Roof tile is made of clay that is molded and then burned. Including here is concrete roof tile (tiles made of a mixture of cement and sand),fiber cement tile,and ceramic tile. 3. Shingle is roof layered with wooden tiles,usually made of ironwood,or ulin wood (ironwood from Borneo). 4. Iron sheeting is roof made of zinc. Zinc roof shape can be flat or wavy,including zinc roof called decrabond (zinc roof layered with epoxy and acrylic). 5. Asbestos is roof made of asbestos fiber and cement. Generally comes in wavy shapes. 6. Palm is roof made of palm tree fiber or other of the the same type,generally is black in color. 7. Others for all other roof types aside from the above,such as bamboo,plywood,leaves,etc. Type of most wall material : Type of most wall material : Type of most wall material : Type of most wall material : Type of most wall material : Type of most wall material : Circle one of the codes of the widest wall type in the physical building where the respondent lives,and then write it down in the provided box. 252913 1 4 1.619 1 Concrete 2 Wood 3 Bamboo 4 Other Wall is the outer side/border in a building or the separator to other building. If the building has more than one type of wall of the same floor size.the one considered the widest wall is the more costly wall(smallet code). 1. Concrete is wall made of red brick or hollow brick layers plasterd with cement. Including in this category is wall made of red brick layers and plastered, but using wooden beam installed in usually 1 – 1.5 meter distance. 2. Wood is wall made of wood. 3. Bamboo/fiber is wall made of bamboo or fiber. Including in this category is wall made of bamboo weave with size less than 1 m X 1 m.framed in wooden beam and plastered with cement and sand. 4. Others for other types not included in category 1-3. Type of most flooring material : Type of most flooring material : Type of most flooring material : Type of most flooring material : Type of most flooring material : Type of most flooring material : Circle one of the codes of the widest floor type of the physical building where the household members reside,and write it down to the provided box. 252913 1 2 1.131 1 Non soil 2 Soil Definition of floor in this survey is the bottom part/base of a room,whether earthen floor or tiled floor, such as ceramic, marble, wood, and cement. Floor area:(square meter) Floor area:(square meter) Floor area:(square meter) Floor area:(square meter) Floor area:(square meter) Floor area:(square meter) Fill in the floor size of the residence of the respondent’s household and write down in the provided box (in m 2 ). 252913 3 998 65.686 Floor size means the size of the floor occupied and used for daily needs(limited to the roof). Any part of the building that is not occupied or used for daily needs is not included in the floor size calculation such as rice storage, live stock farm,service area for drying clothes(cemented floor) and specific space for business(such as stall/store). The floor size of a multi storeys is the total of the entire floors occupied. Source of drinking water: Source of drinking water: Source of drinking water: Source of drinking water: Source of drinking water: Source of drinking water: 1. If b6r6a the answer is coded 1,2, or 4 skip to b6r8 2. If b6r6a the answer is coded 3,10, or 11 skip to b6r7 Please ask the main source of drinking water used by the respondent’s household. Circle one of the codes and write it down in the provided box. 252913 9 4.251 Other 1 Bottled water 2 Pipe 3 Pump 4 Protected/covered well 5 Unprotected/uncovered well 6 Protected spring 7 Unprotected/uncovered spring 8 River 9 Rainwater Please be cautious in determining drinking water source,because in several regions,some people channel river water or mountain spring water to houses using bamboo or plastic pipes. In this case,the drinking water source should still be written as river water or springs,instead of tap water. 1. Branded bottled water is bottled water produced and distributed by a company in various bottles(500 ml,1L,12 L,or 19 L) and in glass/cups packaging; e.g. water from the following brands: Aqua,Moya,2Tang,VIT. 2. Recycled bottled water is water produced through purification process and is not branded. 3. Pipe, retail payment is water produced through purification and sanitation process(PAM water),although it distributed by retail/mobile water sellers 4. Pipe with meter is water produced throuh purification and sanitation process before distributing it to consumers through water piping. This source of water is produced by PAM(Drinking Water Company) and PDAM(Regional Drinking Water Company) or BPAM(Drinking Water Management Agency),whether they managed by the government or private companies. 5. Terrestrial well/pump is ground water obtained by manual pump,electric pump,or windmill including artesis well(drilled well). 6. Protected/covered well is ground water that is dug up,which surrounding is enforced with wall of minimum 0.8 meters above ground and 3 meters under ground,with 1 meter cemented floor around the well. 7. Unprotected/uncovered well is ground water that is dug up,but the surrounding of the well is not protected with wall or 1 meter cemented floor.The method to get water from covered or uncovered water well is with a bucket,whether using pulley or not. 8. Protected spring is surface water source,where water already pooled naturally,protected from waste such as used water,waste from bathing or washing,etc. 9. Unprotected spring is surface water,where water already pooled naturally,but is unprotected from waste,such as used water,waste from bathing,washing,etc. 10. Other water sources are other source of drinking water,such as from dam/lake. Distance to the closest feces containment: Distance to the closest feces containment: Distance to the closest feces containment: Distance to the closest feces containment: Distance to the closest feces containment: If b6r7a = 3 to 7 (pump/well/spring) Distance to the closest feces containment: Ask the distance of pump/well/springs to the closest animal waste tank, septic tank or liquid waste whether located in the household or neighbor's surroundings. Circle the answer and write it down in the provided box. 173347 79566 1 3 1.969 1 <10 m 2 >= 10 m 3 Don’t know Sysmiss Method to obtain drinking water: Method to obtain drinking water: Method to obtain drinking water: Method to obtain drinking water: Method to obtain drinking water: Method to obtain drinking water: Circle one of the codes according to respondent’s answer and write it down in the provided box. 252913 1 3 2.551 1 Subscription 2 Retail buying 3 Not buy 1. Subscribe by buying water to drink on a subscription basis (tap of PAM / taps / BPAM), including also subscribe bottled water (aqua, etc.). 2. Buy retail when respondents were randomly buy water. 3. Not buying if drinking water is obtained with their own efforts for free. Explanation: Asking a neighbor to get water from the dam by paying for his effort is considered buying drinking water. The use of drinking water facilities: The use of drinking water facilities: The use of drinking water facilities: The use of drinking water facilities: The use of drinking water facilities: If b6r6a not equal to 3,5 to 12 The use of drinking water facilities: Circle one of the codes according to the answer and write it down in the provided box. 252913 1 4 1.907 1 Personal 2 Mutual 3 Public 4 None Included in drinking water facilities are drinking water installation managed by PAM/PDAM, or non PAM/PDAM,including water from drilled well and pump. The approach used is the amount of water used in the last one month. 1. Personal,if the water facility is only used by respondent's household. 2. Mutual,if the water facility is used by the respondent's household jointly with several certain households. 3. Public,if the water facility is used by every households,including the resident's household. 4. None,if the distance of drinking water facility to the respondent's household is > 2.5 Km or by taking water directly from river/lake/rain without purification process by machine,or by purchasing the water. Defecation facility use: Defecation facility use: Defecation facility use: Defecation facility use: Defecation facility use: Defecation facility use: If the answer is coded 4, skip to b6r10c Circle one of the codes accordingly, then fill in the answer in the provided box. 252913 1 4 1.919 1 Personal 2 Mutual 3 Public 4 None Defecation facility means the availability of latrine to be used by respondent’s household. 1. Personal,if the defecation facility is only used by the respondent's household. 2. Mutual,if the defecation facility is used by the respondent's household together with several certain households. 3. Public,if the defecation facility is used by evry households,including respondent's household. 4. None,if respondent's household does not have defecation facility Type of toilet: Type of toilet: Type of toilet: Type of toilet: Type of toilet: Type of toilet: Circle one of the codes accordingly, and fill it in the provided box, 192143 60770 1 4 1.678 1 Goose neck/leher angsa 2 Pit toilet/plengsengan 3 Squat toilet/cemplung 4 None Sysmiss Type of toilet is sitting/squatting latrine used in the toilet. 1. Goose neck/leher angsa is a closet under which seat there is a U shaped pipe(like a duck’s neck) to be filled with water to prevent the odor from going out. 2. Pit toilet/plengsengan is a closet/latrine under which seat there is a flat pipe installed in slightly inclined position towards the final disposal. 3. Squat toilet/cemplung a closet under which seat there is no pipe,so that the waste went directly to its final disposal place. Final disposal location: Final disposal location: Final disposal location: Final disposal location: Final disposal location: Final disposal location: Circle one of the codes accordingly, and fill it in the provided box. 252913 1 6 2.656 1 Tank/septic tank 2 Pool/field 3 River/lake/sea 4 Pit hole 5 Beach/open field/farm 6 Other Tanks are the waste final disposal place in the form of reservoirs,usually made of brick/stone or concrete whether or not having an absorption tub.Included in this category is housing complex that has integrated Liquid Waste Disposal System (SPAL),managed by the municipal government. 1. Septic tank are the waste final disposal place in the form of reservoirs,usually made of brick/stone or concrete whether or not having an absorption tub. 2. Pool/field,if the waste is disposed to the pond/paddy field. 3. River/lake/sea,if the waste is disposed to the river/lake/sea. 4. Pit hole,if the waste is disposed to the Underground hole(large hole in the ground) without separators/walls(not water tight). 5. Beach/open ground/garden,if the waste is disposed to the beach areas or fields,including disposed to the yards. Source of lighting: Source of lighting: Source of lighting: Source of lighting: Source of lighting: Source of lighting: Circle one of the codes for lighting source used in respondent’s household,then write it down in the provided box. 252913 1 5 1.527 1 PLN electricity 2 Non-PLN electricity 3 Paraffin lamp/petromak 4 Oil lamp/torch 5 Other 1. PLN Electricity is electricity source managed by PLN(National Electricity Company). 2. Non-PLN Electricity is electricity source managed by other institutions/parties aside from PLN. Including in this category are power source from accumulator/battery storage,generator,and solar power plant(that are not managed by PLN). 3. Petromak/aladin lamp such as multi-fuel lantern and gas lantern is categorized in code 3,while other oil lamps such as (sentir,pelita and other of the same type) are categorized in code 4. Carbide lamp,candle,castor oir lamp,and candlenut lamp are included in code 5. Food expenditure - Grains [rice, corn, wheat, flour, cornflour etc.] - in the past one week: (Rp) Food expenditure - Grains [rice, corn, wheat, flour, cornflour etc.] - in the past one week: (Rp) Food expenditure - Grains [rice, corn, wheat, flour, cornflour etc.] - in the past one week: (Rp) Food expenditure - Grains [rice, corn, wheat, flour, cornflour etc.] - in the past one week: (Rp) Food expenditure - Grains [rice, corn, wheat, flour, cornflour etc.] - in the past one week: (Rp) Expenditure for Grains [rice, corn, wheat, flour, cornflour etc.] from purchase, self-producation and present in the past one week: (Rp) Write down in Column (2) food expenditure from purchases, self produced, and gifts for rice in the past one week :(Rp) 252913 37500850 22672.459 Consumption/expenditure is the value of expenditures for household consumption in the last one week that comes from purchases, own productions or gifts. Food expenditure - Tubers [cassava, sweet potato, potato, yam, sago, etc.] - in the past one week: (Rp) Food expenditure - Tubers [cassava, sweet potato, potato, yam, sago, etc.] - in the past one week: (Rp) Food expenditure - Tubers [cassava, sweet potato, potato, yam, sago, etc.] - in the past one week: (Rp) Food expenditure - Tubers [cassava, sweet potato, potato, yam, sago, etc.] - in the past one week: (Rp) Food expenditure - Tubers [cassava, sweet potato, potato, yam, sago, etc.] - in the past one week: (Rp) Expenditure for Tubers [cassava, sweet potato, potato, yam, sago, etc.] from purchase, self-producation and present in the past one week: (Rp) Write down in Column (2) food expenditure from purchases, self produced, and gifts for rice in the past one week :(Rp) 252913 125000 2048.207 Yang termasuk umbi-umbian dalam yaitu ketela pohon,ketela rambat,kentang,gaplek,talas,sagu, dll. Consumption/expenditure is the value of expenditures for household consumption in the last one week that comes from purchases, own productions or gifts. Food expenditure - Fish [fresh fish, salted/preserved fish, prawn etc.] - in the past one week: (Rp) Food expenditure - Fish [fresh fish, salted/preserved fish, prawn etc.] - in the past one week: (Rp) Food expenditure - Fish [fresh fish, salted/preserved fish, prawn etc.] - in the past one week: (Rp) Food expenditure - Fish [fresh fish, salted/preserved fish, prawn etc.] - in the past one week: (Rp) Food expenditure - Fish [fresh fish, salted/preserved fish, prawn etc.] - in the past one week: (Rp) Expenditure for Fish [fresh fish, salted/preserved fish, prawn etc.] from purchase, self-producation and present in the past one week: (Rp) Write down in Column (2) food expenditure from purchases, self produced, and gifts for rice in the past one week :(Rp) 252913 400000 13414.626 Consumption/expenditure is the value of expenditures for household consumption in the last one week that comes from purchases, own productions or gifts. Food expenditure - Meat [beef, buffalo meat, mutton, lamb, pork, chicken, offal, liver, spleen, floss, jerky etc.] - in the past one week: (Rp) Food expenditure - Meat [beef, buffalo meat, mutton, lamb, pork, chicken, offal, liver, spleen, floss, jerky etc.] - in the past one week: (Rp) Food expenditure - Meat [beef, buffalo meat, mutton, lamb, pork, chicken, offal, liver, spleen, floss, jerky etc.] - in the past one week: (Rp) Food expenditure - Meat [beef, buffalo meat, mutton, lamb, pork, chicken, offal, liver, spleen, floss, jerky etc.] - in the past one week: (Rp) Food expenditure - Meat [beef, buffalo meat, mutton, lamb, pork, chicken, offal, liver, spleen, floss, jerky etc.] - in the past one week: (Rp) Expenditure for Meat [beef, buffalo meat, mutton, lamb, pork, chicken, offal, liver, spleen, floss, jerky etc.] from purchase, self-producation and present in the past one week: (Rp) Write down in Column (2) food expenditure from purchases, self produced, and gifts for rice in the past one week :(Rp) 252913 264000 5607.933 Yang termasuk daging yaitu daging sapi/kerbau/kambing/domba/babi/ayam,jeroan,hati,limpa,abon,dendeng,dll. Consumption/expenditure is the value of expenditures for household consumption in the last one week that comes from purchases, own productions or gifts. Food expenditure - Egg and milk (chicken egg, duck egg, quail egg, fresh milk, evaporated milk, milk powder etc.] - in the past one week: (Rp) Food expenditure - Egg and milk (chicken egg, duck egg, quail egg, fresh milk, evaporated milk, milk powder etc.] - in the past one week: (Rp) Food expenditure - Egg and milk (chicken egg, duck egg, quail egg, fresh milk, evaporated milk, milk powder etc.] - in the past one week: (Rp) Food expenditure - Egg and milk (chicken egg, duck egg, quail egg, fresh milk, evaporated milk, milk powder etc.] - in the past one week: (Rp) Food expenditure - Egg and milk (chicken egg, duck egg, quail egg, fresh milk, evaporated milk, milk powder etc.] - in the past one week: (Rp) Expenditure for Egg and milk (chicken egg, duck egg, quail egg, fresh milk, evaporated milk, milk powder etc.] from purchase, self-producation and present in the past one week: (Rp) Write down in Column (2) food expenditure from purchases, self produced, and gifts for rice in the past one week :(Rp) 252913 480000 6791.152 Consumption/expenditure is the value of expenditures for household consumption in the last one week that comes from purchases, own productions or gifts. Food expenditure - Vegetables [spinach, water spinach, cucumber, carrot, bean, snaps, onion, chili, tomato etc.] - in the past one week: (Rp) Food expenditure - Vegetables [spinach, water spinach, cucumber, carrot, bean, snaps, onion, chili, tomato etc.] - in the past one week: (Rp) Food expenditure - Vegetables [spinach, water spinach, cucumber, carrot, bean, snaps, onion, chili, tomato etc.] - in the past one week: (Rp) Food expenditure - Vegetables [spinach, water spinach, cucumber, carrot, bean, snaps, onion, chili, tomato etc.] - in the past one week: (Rp) Food expenditure - Vegetables [spinach, water spinach, cucumber, carrot, bean, snaps, onion, chili, tomato etc.] - in the past one week: (Rp) Expenditure for Vegetables [spinach, water spinach, cucumber, carrot, bean, snaps, onion, chili, tomato etc.] from purchase, self-producation and present in the past one week: (Rp) Write down in Column (2) food expenditure from purchases, self produced, and gifts for rice in the past one week :(Rp) 252913 210000 8189.3 Yang termasuk sayur-sayuran yaitu sayur bayam,kangkung,ketimun,wortel,kacang panjang,buncis,bawang,cabe,tomat,dll. Consumption/expenditure is the value of expenditures for household consumption in the last one week that comes from purchases, own productions or gifts. Food expenditure - Nuts [peanut, mung bean, soybean, red bean, cowpea, cashew nut, tofu, tempeh etc.] - in the past one week: (Rp) Food expenditure - Nuts [peanut, mung bean, soybean, red bean, cowpea, cashew nut, tofu, tempeh etc.] - in the past one week: (Rp) Food expenditure - Nuts [peanut, mung bean, soybean, red bean, cowpea, cashew nut, tofu, tempeh etc.] - in the past one week: (Rp) Food expenditure - Nuts [peanut, mung bean, soybean, red bean, cowpea, cashew nut, tofu, tempeh etc.] - in the past one week: (Rp) Food expenditure - Nuts [peanut, mung bean, soybean, red bean, cowpea, cashew nut, tofu, tempeh etc.] - in the past one week: (Rp) Expenditure for Nuts [peanut, mung bean, soybean, red bean, cowpea, cashew nut, tofu, tempeh etc.] from purchase, self-producation and present in the past one week: (Rp) Write down in Column (2) food expenditure from purchases, self produced, and gifts for rice in the past one week :(Rp) 252913 160000 3886.056 Yang termasuk kacang-kacangan yaitu kacang tanah/hijau/kedele/merah/ tunggak/mete,tahu,tempe,tauco,oncom,dll. Consumption/expenditure is the value of expenditures for household consumption in the last one week that comes from purchases, own productions or gifts. Food expenditure - Fruits [orange, mango, apple, durian, rambutan, salak, duku, pineapple, watermelon, banana, papaya etc.] - in the past one week: (Rp) Food expenditure - Fruits [orange, mango, apple, durian, rambutan, salak, duku, pineapple, watermelon, banana, papaya etc.] - in the past one week: (Rp) Food expenditure - Fruits [orange, mango, apple, durian, rambutan, salak, duku, pineapple, watermelon, banana, papaya etc.] - in the past one week: (Rp) Food expenditure - Fruits [orange, mango, apple, durian, rambutan, salak, duku, pineapple, watermelon, banana, papaya etc.] - in the past one week: (Rp) Food expenditure - Fruits [orange, mango, apple, durian, rambutan, salak, duku, pineapple, watermelon, banana, papaya etc.] - in the past one week: (Rp) Expenditure for Fruits [orange, mango, apple, durian, rambutan, salak, duku, pineapple, watermelon, banana, papaya etc.] from purchase, self-producation and present in the past one week: (Rp) Write down in Column (2) food expenditure from purchases, self produced, and gifts for rice in the past one week :(Rp) 252913 250000 4610.532 Yang termasuk buah-buahan yaitu jeruk,mangga,apel,durian,rambutan,salak,duku,nanas,semangka,pisang,pepaya,dll. Consumption/expenditure is the value of expenditures for household consumption in the last one week that comes from purchases, own productions or gifts. Food expenditure - Oil and fat [coconut oil, cooking oil, coconut, margarine etc.] - in the past one week: (Rp) Food expenditure - Oil and fat [coconut oil, cooking oil, coconut, margarine etc.] - in the past one week: (Rp) Food expenditure - Oil and fat [coconut oil, cooking oil, coconut, margarine etc.] - in the past one week: (Rp) Food expenditure - Oil and fat [coconut oil, cooking oil, coconut, margarine etc.] - in the past one week: (Rp) Food expenditure - Oil and fat [coconut oil, cooking oil, coconut, margarine etc.] - in the past one week: (Rp) Expenditure for Oil and fat [coconut oil, cooking oil, coconut, margarine etc.] from purchase, self-producation and present in the past one week: (Rp) Write down in Column (2) food expenditure from purchases, self produced, and gifts for rice in the past one week :(Rp) 252913 175000 5351.405 Yang termasuk minyak dan lemak yaitu minyak kelapa/goreng,kelapa,mentega,dll. Consumption/expenditure is the value of expenditures for household consumption in the last one week that comes from purchases, own productions or gifts. Food expenditure - Beverage supplements [sugar, brown sugar, tea, coffee, chocolate, syrup, etc.] - in the past one week: (Rp) Food expenditure - Beverage supplements [sugar, brown sugar, tea, coffee, chocolate, syrup, etc.] - in the past one week: (Rp) Food expenditure - Beverage supplements [sugar, brown sugar, tea, coffee, chocolate, syrup, etc.] - in the past one week: (Rp) Food expenditure - Beverage supplements [sugar, brown sugar, tea, coffee, chocolate, syrup, etc.] - in the past one week: (Rp) Food expenditure - Beverage supplements [sugar, brown sugar, tea, coffee, chocolate, syrup, etc.] - in the past one week: (Rp) Expenditure for Beverage supplements [sugar, brown sugar, tea, coffee, chocolate, syrup, etc.] from purchase, self-producation and present in the past one week: (Rp) Write down in Column (2) food expenditure from purchases, self produced, and gifts for rice in the past one week :(Rp) 252913 140000 6201.15 Yang termasuk bahan minuman yaitu gula pasir,gula merah,teh,kopi,coklat,sirup,dll. Consumption/expenditure is the value of expenditures for household consumption in the last one week that comes from purchases, own productions or gifts. Food expenditure - Spices [salt, hazelnut, coriander, pepper, fish paste, soybean sauce, MSG etc.] - in the past one week: (Rp) Food expenditure - Spices [salt, hazelnut, coriander, pepper, fish paste, soybean sauce, MSG etc.] - in the past one week: (Rp) Food expenditure - Spices [salt, hazelnut, coriander, pepper, fish paste, soybean sauce, MSG etc.] - in the past one week: (Rp) Food expenditure - Spices [salt, hazelnut, coriander, pepper, fish paste, soybean sauce, MSG etc.] - in the past one week: (Rp) Food expenditure - Spices [salt, hazelnut, coriander, pepper, fish paste, soybean sauce, MSG etc.] - in the past one week: (Rp) Expenditure for Spices [salt, hazelnut, coriander, pepper, fish paste, soybean sauce, MSG etc.] from purchase, self-producation and present in the past one week: (Rp)) Write down in Column (2) food expenditure from purchases, self produced, and gifts for rice in the past one week :(Rp) 252913 180000 3228.225 Yang termasuk bumbu-bumbuan yaitu garam,kemiri,ketumbar,merica,terasi,kecap,vetsin,dll. Consumption/expenditure is the value of expenditures for household consumption in the last one week that comes from purchases, own productions or gifts. Food expenditure - Other foodstuffs [cracker, noodle, vermicelli, macaroni etc.] - in the past one week: (Rp) Food expenditure - Other foodstuffs [cracker, noodle, vermicelli, macaroni etc.] - in the past one week: (Rp) Food expenditure - Other foodstuffs [cracker, noodle, vermicelli, macaroni etc.] - in the past one week: (Rp) Food expenditure - Other foodstuffs [cracker, noodle, vermicelli, macaroni etc.] - in the past one week: (Rp) Food expenditure - Other foodstuffs [cracker, noodle, vermicelli, macaroni etc.] - in the past one week: (Rp) Expenditure for Other foodstuffs [cracker, noodle, vermicelli, macaroni etc.] from purchase, self-producation and present in the past one week: (Rp) Write down in Column (2) food expenditure from purchases, self produced, and gifts for rice in the past one week :(Rp) 252913 450000 2911.115 Mie instant,mie basah,bihun,makaroni/mie kering termasuk jenis konsunsi rumah tangga lainnya Consumption/expenditure is the value of expenditures for household consumption in the last one week that comes from purchases, own productions or gifts. Food expenditure - Delicatessen [bread, biscuit, porridge, meatball, ice, lemonade, salad etc.] - in the past one week: (Rp) Food expenditure - Delicatessen [bread, biscuit, porridge, meatball, ice, lemonade, salad etc.] - in the past one week: (Rp) Food expenditure - Delicatessen [bread, biscuit, porridge, meatball, ice, lemonade, salad etc.] - in the past one week: (Rp) Food expenditure - Delicatessen [bread, biscuit, porridge, meatball, ice, lemonade, salad etc.] - in the past one week: (Rp) Food expenditure - Delicatessen [bread, biscuit, porridge, meatball, ice, lemonade, salad etc.] - in the past one week: (Rp) Expenditure for Delicatessen [bread, biscuit, porridge, meatball, ice, lemonade, salad etc.] from purchase, self-producation and present in the past one week: (Rp) Write down in Column (2) food expenditure from purchases, self produced, and gifts for rice in the past one week :(Rp) 252913 2250000 12742.581 Yang termasuk makanan jadi yaitu roti,biskuit,kue basah,bubur,bakso,gado-gado,nasi rames,dll. Consumption/expenditure is the value of expenditures for household consumption in the last one week that comes from purchases, own productions or gifts. Food expenditure - Alcoholic beverages [beer, wine, other]from purchase, self-producation and present in the past one week: (Rp) Food expenditure - Alcoholic beverages [beer, wine, other]from purchase, self-producation and present in the past one week: (Rp) Food expenditure - Alcoholic beverages [beer, wine, other]from purchase, self-producation and present in the past one week: (Rp) Food expenditure - Alcoholic beverages [beer, wine, other]from purchase, self-producation and present in the past one week: (Rp) Food expenditure - Alcoholic beverages [beer, wine, other]from purchase, self-producation and present in the past one week: (Rp) Expenditure for Alcoholic beverages [beer, wine, other]from purchase, self-producation and present in the past one week: (Rp) Write down in Column (2) food expenditure from purchases, self produced, and gifts for rice in the past one week :(Rp) 252913 1250000 317.507 Consumption/expenditure is the value of expenditures for household consumption in the last one week that comes from purchases, own productions or gifts. Food expenditure - Tobacco and betel [clove cigarette, white cigarette, cigar, tobacco, betel, areca nut etc.] - in the past one week: (Rp) Food expenditure - Tobacco and betel [clove cigarette, white cigarette, cigar, tobacco, betel, areca nut etc.] - in the past one week: (Rp) Food expenditure - Tobacco and betel [clove cigarette, white cigarette, cigar, tobacco, betel, areca nut etc.] - in the past one week: (Rp) Food expenditure - Tobacco and betel [clove cigarette, white cigarette, cigar, tobacco, betel, areca nut etc.] - in the past one week: (Rp) Food expenditure - Tobacco and betel [clove cigarette, white cigarette, cigar, tobacco, betel, areca nut etc.] - in the past one week: (Rp) Expenditure for Tobacco and betel [clove cigarette, white cigarette, cigar, tobacco, betel, areca nut etc.] from purchase, self-producation and present in the past one week: (Rp) Write down in Column (2) food expenditure from purchases, self produced, and gifts for rice in the past one week :(Rp) 252913 525000 16410.38 Consumption/expenditure is the value of expenditures for household consumption in the last one week that comes from purchases, own productions or gifts. Total Foodstuff [Details 1 to 15] Total Foodstuff [Details 1 to 15] Total Foodstuff [Details 1 to 15] Total Foodstuff [Details 1 to 15] Total Foodstuff [Details 1 to 15] Total Foodstuff [Details 1 to 15] Write down in Column (2) total expenditures [Details 1 to 15] 252913 5000 37729850 114382.628 Non-food expenditure - house lease, rent, rent expectation (owned, free lease, company house) etc. in the past month:(Rp) Non-food expenditure - house lease, rent, rent expectation (owned, free lease, company house) etc. in the past month:(Rp) Non-food expenditure - house lease, rent, rent expectation (owned, free lease, company house) etc. in the past month:(Rp) Non-food expenditure - house lease, rent, rent expectation (owned, free lease, company house) etc. in the past month:(Rp) Non-food expenditure - house lease, rent, rent expectation (owned, free lease, company house) etc. in the past month:(Rp) Non-food expenditure for house lease, rent, rent expectation (owned, free lease, company house) etc. from purchase, self-producation and present, in the past month:(Rp) Write down in Column (2) non-food expenditure from purchases, self produced, and gifts in one past month for house maintenance and minor repairs :(Rp) 252913 100 108333330 96889.826 Expenditure in the last one month should be the amount really spent in the last one month, not the average monthly amount of the last 12 months. Non-food expenditure - house lease, rent, rent expectation (owned, free lease, company house) etc. in the 12 months :(Rp) Non-food expenditure - house lease, rent, rent expectation (owned, free lease, company house) etc. in the 12 months :(Rp) Non-food expenditure - house lease, rent, rent expectation (owned, free lease, company house) etc. in the 12 months :(Rp) Non-food expenditure - house lease, rent, rent expectation (owned, free lease, company house) etc. in the 12 months :(Rp) Non-food expenditure - house lease, rent, rent expectation (owned, free lease, company house) etc. in the 12 months :(Rp) Non-food expenditure for house lease, rent, rent expectation (owned, free lease, company house) etc. from purchase, self-producation and present, in the 12 months :(Rp) Write down in Column (3) non-food expenditure from purchases, self produced, and gifts in past 12 months for house lease,rent,rent expectation :(Rp) 252913 100 600000000 1133956.747 The expenditure in the last 12 months should be the amount trully spent in the last 12 months that ends one day before the census date, 12 calendar months. Non-food expenditure - electricity bill, telephone bill, gas, kerosene, water, firewood etc. in the past month:(Rp) Non-food expenditure - electricity bill, telephone bill, gas, kerosene, water, firewood etc. in the past month:(Rp) Non-food expenditure - electricity bill, telephone bill, gas, kerosene, water, firewood etc. in the past month:(Rp) Non-food expenditure - electricity bill, telephone bill, gas, kerosene, water, firewood etc. in the past month:(Rp) Non-food expenditure - electricity bill, telephone bill, gas, kerosene, water, firewood etc. in the past month:(Rp) Non-food expenditure for electricity bill, telephone bill, gas, kerosene, water, firewood etc. from purchase, self-producation and present, in the past month:(Rp) Write down in Column (2) non-food expenditure from purchases, self produced, and gifts in one past month for house maintenance and minor repairs :(Rp) 252913 7680000 77035.933 Expenditure in the last one month should be the amount really spent in the last one month, not the average monthly amount of the last 12 months. Non-food expenditure - electricity bill, telephone bill, gas, kerosene, water, firewood etc. in the 12 months :(Rp) Non-food expenditure - electricity bill, telephone bill, gas, kerosene, water, firewood etc. in the 12 months :(Rp) Non-food expenditure - electricity bill, telephone bill, gas, kerosene, water, firewood etc. in the 12 months :(Rp) Non-food expenditure - electricity bill, telephone bill, gas, kerosene, water, firewood etc. in the 12 months :(Rp) Non-food expenditure - electricity bill, telephone bill, gas, kerosene, water, firewood etc. in the 12 months :(Rp) Non-food expenditure for electricity bill, telephone bill, gas, kerosene, water, firewood etc. from purchase, self-producation and present, in the 12 months :(Rp) Write down in Column (3) non-food expenditure from purchases, self produced, and gifts in past 12 months for house maintenance and minor repairs :(Rp) 252913 388125500 877187.005 The expenditure in the last 12 months should be the amount trully spent in the last 12 months that ends one day before the census date, 12 calendar months. Non-food expenditure - house maintenance and minor repair in the past month:(Rp) Non-food expenditure - house maintenance and minor repair in the past month:(Rp) Non-food expenditure - house maintenance and minor repair in the past month:(Rp) Non-food expenditure - house maintenance and minor repair in the past month:(Rp) Non-food expenditure - house maintenance and minor repair in the past month:(Rp) Non-food expenditure for house maintenance and minor repair from purchase, self-producation and present, in the past month:(Rp) Write down in Column (2) non-food expenditure from purchases, self produced, and gifts in one past month for electricity bill,telephone bill, gas, kerosene, water, firewood etc. :(Rp) 252913 50000000 6955.53 Expenditure in the last one month should be the amount really spent in the last one month, not the average monthly amount of the last 12 months. Non-food expenditure - house maintenance and minor repair in the 12 months :(Rp) Non-food expenditure - house maintenance and minor repair in the 12 months :(Rp) Non-food expenditure - house maintenance and minor repair in the 12 months :(Rp) Non-food expenditure - house maintenance and minor repair in the 12 months :(Rp) Non-food expenditure - house maintenance and minor repair in the 12 months :(Rp) Non-food expenditure for house maintenance and minor repair from purchase, self-producation and present, in the 12 months :(Rp) Write down in Column (3) non-food expenditure from purchases, self produced, and gifts in past 12 months for electricity bill,telephone bill, gas, kerosene, water, firewood etc. :(Rp) 252913 90000000 87751.143 The expenditure in the last 12 months should be the amount trully spent in the last 12 months that ends one day before the census date, 12 calendar months. Non-food expenditure - various goods and services in the past month:(Rp) Non-food expenditure - various goods and services in the past month:(Rp) Non-food expenditure - various goods and services in the past month:(Rp) Non-food expenditure - various goods and services in the past month:(Rp) Non-food expenditure - various goods and services in the past month:(Rp) Non-food expenditure for various goods and services (soap, cosmetics, transportation, reading, ID card/driver license processing fee, recreation, telephone card, postal fee etc.) from purchase, self-producation and present, in the past month:(Rp) Write down in Column (2) non-food expenditure from purchases, self produced, and gifts in one past month for various goods and services :(Rp) 252913 50550000 43592.002 Expenditure in the last one month should be the amount really spent in the last one month, not the average monthly amount of the last 12 months. Non-food expenditure - various goods and services in the past 12 month:(Rp) Non-food expenditure - various goods and services in the past 12 month:(Rp) Non-food expenditure - various goods and services in the past 12 month:(Rp) Non-food expenditure - various goods and services in the past 12 month:(Rp) Non-food expenditure - various goods and services in the past 12 month:(Rp) Non-food expenditure fo various goods and services (soap, cosmetics, transportation, reading, ID card/driver license processing fee, recreation, telephone card, postal fee etc.) from purchase, self-producation and present, in the past 12 month:(Rp) Write down in Column (3) non-food expenditure from purchases, self produced, and gifts in past 12 months for various goods and services:(Rp) 252913 105000000 486479.677 The expenditure in the last 12 months should be the amount trully spent in the last 12 months that ends one day before the census date, 12 calendar months. Non-food expenditure - education cost in the past month:(Rp) Non-food expenditure - education cost in the past month:(Rp) Non-food expenditure - education cost in the past month:(Rp) Non-food expenditure - education cost in the past month:(Rp) Non-food expenditure - education cost in the past month:(Rp) Non-food expenditure for education cost (registration fee, monthly educational fee, re-registration fee, boy/girl scout, craft, course etc.) from purchase, self-producation and present, in the past month:(Rp) Write down in Column (2) non-food expenditure from purchases, self produced, and gifts in one past month for clothes,footwear and headgear :(Rp) 252913 8850000 26268.958 Expenditure in the last one month should be the amount really spent in the last one month, not the average monthly amount of the last 12 months. Non-food expenditure - education cost in the 12 months :(Rp) Non-food expenditure - education cost in the 12 months :(Rp) Non-food expenditure - education cost in the 12 months :(Rp) Non-food expenditure - education cost in the 12 months :(Rp) Non-food expenditure - education cost in the 12 months :(Rp) Non-food expenditure for education cost (registration fee, monthly educational fee, re-registration fee, boy/girl scout, craft, course etc.) from purchase, self-producation and present, in the 12 months :(Rp) Write down in Column (3) non-food expenditure from purchases, self produced, and gifts in past 12 months for clothes,footwear and headgear :(Rp) 252913 93730000 299362.359 The expenditure in the last 12 months should be the amount trully spent in the last 12 months that ends one day before the census date, 12 calendar months. Non-food expenditure - health cost in the past month:(Rp) Non-food expenditure - health cost in the past month:(Rp) Non-food expenditure - health cost in the past month:(Rp) Non-food expenditure - health cost in the past month:(Rp) Non-food expenditure - health cost in the past month:(Rp) Non-food expenditure for health cost (hospital, public clinic, doctor practice, healer, medicine etc.) from purchase, self-producation and present, in the past month:(Rp) Write down in Column (2) non-food expenditure from purchases, self produced, and gifts in one past month for durable goods :(Rp) 252913 48490000 27270.617 Expenditure in the last one month should be the amount really spent in the last one month, not the average monthly amount of the last 12 months. Non-food expenditure - health cost in the past 12 months :(Rp) Non-food expenditure - health cost in the past 12 months :(Rp) Non-food expenditure - health cost in the past 12 months :(Rp) Non-food expenditure - health cost in the past 12 months :(Rp) Non-food expenditure - health cost in the past 12 months :(Rp) Non-food expenditure for health cost (hospital, public clinic, doctor practice, healer, medicine etc.) from purchase, self-producation and present in the past 12 months :(Rp) Write down in Column (3) non-food expenditure from purchases, self produced, and gifts in past 12 months for durable goods :(Rp) 252913 280000750 185342.497 The expenditure in the last 12 months should be the amount trully spent in the last 12 months that ends one day before the census date, 12 calendar months. Non-food expenditure - clothes, footwear and headgear in the past month:(Rp) Non-food expenditure - clothes, footwear and headgear in the past month:(Rp) Non-food expenditure - clothes, footwear and headgear in the past month:(Rp) Non-food expenditure - clothes, footwear and headgear in the past month:(Rp) Non-food expenditure - clothes, footwear and headgear in the past month:(Rp) Non-food expenditure for clothes, footwear and headgear (clothes, apparel, shoes, hat, detergent etc.) from purchase, self-producation and present in the past month:(Rp) Write down in Column (2) non-food expenditure from purchases, self produced, and gifts in one past month for party and ceremony excluding food :(Rp) 252913 6000000 31074.578 The expenditure recorded in this detail is expenses for wedding party, birthday party, circumcision event, religious event, etc., excluding food (food consumption for party/event should be recorded in each of the visitors’ household food expenditure. Expenditure in the last one month should be the amount really spent in the last one month, not the average monthly amount of the last 12 months. Non-food expenditure - clothes, footwear and headgear in the past 12 months :(Rp) Non-food expenditure - clothes, footwear and headgear in the past 12 months :(Rp) Non-food expenditure - clothes, footwear and headgear in the past 12 months :(Rp) Non-food expenditure - clothes, footwear and headgear in the past 12 months :(Rp) Non-food expenditure - clothes, footwear and headgear in the past 12 months :(Rp) Non-food expenditure for clothes, footwear and headgear (clothes, apparel, shoes, hat, detergent etc.) from purchase, self-producation and present in the past 12 months :(Rp) Write down in Column (3) non-food expenditure from purchases, self produced, and gifts in past 12 months for party and ceremony excluding food :(Rp) 252913 100000000 391227.198 The expenditure recorded in this detail is expenses for wedding party, birthday party, circumcision event, religious event, etc., excluding food (food consumption for party/event should be recorded in each of the visitors' household food expenditure. The expenditure in the last 12 months should be the amount trully spent in the last 12 months that ends one day before the census date, 12 calendar months. Non-food expenditure - durable goods in the past month:(Rp) Non-food expenditure - durable goods in the past month:(Rp) Non-food expenditure - durable goods in the past month:(Rp) Non-food expenditure - durable goods in the past month:(Rp) Non-food expenditure - durable goods in the past month:(Rp) Non-food expenditure for durable goods (household equipment, tools, kitchen equipment, entertainment [electronics], sports equipment, genuine/imitation jewelry, vehicles, umbrella, watch, camera, telephone installation, power installation, electronic goods etc.) from purchase, self-producation and present in the past month:(Rp) Write down in Column (2) non-food expenditure from purchases, self produced, and gifts in one past month for house lease,rent,rent expectation :(Rp) 252913 71621000 26546.566 The expenditure recorded in this detail is expenses for wedding party, birthday party, circumcision event, religious event, etc., excluding food (food consumption for party/event should be recorded in each of the visitors’ household food expenditure. Expenditure in the last one month should be the amount really spent in the last one month, not the average monthly amount of the last 12 months. Non-food expenditure - durable goods in the past 12 months :(Rp) Non-food expenditure - durable goods in the past 12 months :(Rp) Non-food expenditure - durable goods in the past 12 months :(Rp) Non-food expenditure - durable goods in the past 12 months :(Rp) Non-food expenditure - durable goods in the past 12 months :(Rp) Non-food expenditure for durable goods (household equipment, tools, kitchen equipment, entertainment [electronics], sports equipment, genuine/imitation jewelry, vehicles, umbrella, watch, camera, telephone installation, power installation, electronic goods etc.) from purchase, self-producation and present in the past 12 months :(Rp) Write down in Column (3) non-food expenditure from purchases, self produced, and gifts in past 12 months for party and ceremony excluding food :(Rp) 252913 650000400 268933.63 The expenditure recorded in this detail is expenses for wedding party, birthday party, circumcision event, religious event, etc., excluding food (food consumption for party/event should be recorded in each of the visitors' household food expenditure. The expenditure in the last 12 months should be the amount trully spent in the last 12 months that ends one day before the census date, 12 calendar months. Non-food expenditure - tax (Land and building tax, vehicle tax) in the past month:(Rp) Non-food expenditure - tax (Land and building tax, vehicle tax) in the past month:(Rp) Non-food expenditure - tax (Land and building tax, vehicle tax) in the past month:(Rp) Non-food expenditure - tax (Land and building tax, vehicle tax) in the past month:(Rp) Non-food expenditure - tax (Land and building tax, vehicle tax) in the past month:(Rp) Non-food expenditure for tax (Land and building tax, vehicle tax) from purchase, self-producation and present in the past month:(Rp) Write down in Column (2) non-food expenditure from purchases, self produced, and gifts in one past month for house lease,rent,rent expectation :(Rp) 252913 4000000 4849.002 Rumah tangga yang tidak membayar PBB tidak perlu diperkirakan nilainya,tetapi bagi rumah tangga yang biasa membayar iuran PBB maka nilainya harus dicantumkan meskipun rumah tangga tersebut belum membayar. Isian PBB sebulan yang lalu dapat diperoleh dari PBB tahunan dibagi 12. Expenditure in the last one month should be the amount really spent in the last one month, not the average monthly amount of the last 12 months. Non-food expenditure - tax (Land and building tax, vehicle tax) in the past 12 months :(Rp) Non-food expenditure - tax (Land and building tax, vehicle tax) in the past 12 months :(Rp) Non-food expenditure - tax (Land and building tax, vehicle tax) in the past 12 months :(Rp) Non-food expenditure - tax (Land and building tax, vehicle tax) in the past 12 months :(Rp) Non-food expenditure - tax (Land and building tax, vehicle tax) in the past 12 months :(Rp) Non-food expenditure for tax (Land and building tax, vehicle tax) from purchase, self-producation and present in the past 12 months :(Rp) Write down in Column (3) non-food expenditure from purchases, self produced, and gifts in past 12 months for party and ceremony excluding food :(Rp) 252913 48000000 59825.842 Rumah tangga yang tidak membayar PBB tidak perlu diperkirakan nilainya,tetapi bagi rumah tangga yang biasa membayar iuran PBB maka nilainya harus dicantumkan meskipun rumah tangga tersebut belum membayar. Isian PBB sebulan yang lalu dapat diperoleh dari PBB tahunan dibagi 12. The expenditure in the last 12 months should be the amount trully spent in the last 12 months that ends one day before the census date, 12 calendar months. Non-food expenditure - health insurance in the past month:(Rp) Non-food expenditure - health insurance in the past month:(Rp) Non-food expenditure - health insurance in the past month:(Rp) Non-food expenditure - health insurance in the past month:(Rp) Non-food expenditure - health insurance in the past month:(Rp) Non-food expenditure health insurance from purchase, self-producation and present in the past month:(Rp) Write down in Column (2) non-food expenditure from purchases, self produced, and gifts in one past month for house lease,rent,rent expectation :(Rp) 252913 2083330 707.76 Contohnya pungutan RT/RW, biaya parkir, dan sebagainya. Expenditure in the last one month should be the amount really spent in the last one month, not the average monthly amount of the last 12 months. Non-food expenditure - health insurance in the past 12 months :(Rp) Non-food expenditure - health insurance in the past 12 months :(Rp) Non-food expenditure - health insurance in the past 12 months :(Rp) Non-food expenditure - health insurance in the past 12 months :(Rp) Non-food expenditure - health insurance in the past 12 months :(Rp) Non-food expenditure for fee/retribution from purchase, self-producation and present in the past 12 months :(Rp) Write down in Column (3) non-food expenditure from purchases, self produced, and gifts in past 12 months for party and ceremony excluding food :(Rp) 252913 25000000 8526.972 Contohnya pungutan RT/RW, biaya parkir, dan sebagainya. The expenditure in the last 12 months should be the amount trully spent in the last 12 months that ends one day before the census date, 12 calendar months. Non-food expenditure - other insurance in the past month:(Rp) Non-food expenditure - other insurance in the past month:(Rp) Non-food expenditure - other insurance in the past month:(Rp) Non-food expenditure - other insurance in the past month:(Rp) Non-food expenditure - other insurance in the past month:(Rp) Non-food expenditure for other insurance from purchase, self-producation and present in the past 12 months :(Rp) Write down in Column (2) non-food expenditure from purchases, self produced, and gifts in one past month for house lease,rent,rent expectation :(Rp) 252913 15000000 1097.71 Pengeluaran yang dicatat di sini adalah pengeluaran untuk asuransi kesehatan yang hanya bisa diklaim bila pemegang polis mengalami kejadian seperti yang ada dalam perjanjian asuransi tersebut. Bila tidak terjadi sesuatu(seperti dalam perjanjian asuransi) dalam jangka waktu yang telah ditentukan,maka asuransi tersebut tidak dapat di klaim dan akan hilang(sifatnya bukan tabungan). Expenditure in the last one month should be the amount really spent in the last one month, not the average monthly amount of the last 12 months. Non-food expenditure - other insurance in the past 12 months :(Rp) Non-food expenditure - other insurance in the past 12 months :(Rp) Non-food expenditure - other insurance in the past 12 months :(Rp) Non-food expenditure - other insurance in the past 12 months :(Rp) Non-food expenditure - other insurance in the past 12 months :(Rp) Non-food expenditure for other insurance from purchase, self-producation and present in the past 12 months :(Rp) Write down in Column (3) non-food expenditure from purchases, self produced, and gifts in past 12 months for party and ceremony excluding food :(Rp) 252913 50000000 11180.905 Pengeluaran yang dicatat di sini adalah pengeluaran untuk asuransi kesehatan yang hanya bisa diklaim bila pemegang polis mengalami kejadian seperti yang ada dalam perjanjian asuransi tersebut. Bila tidak terjadi sesuatu(seperti dalam perjanjian asuransi) dalam jangka waktu yang telah ditentukan,maka asuransi tersebut tidak dapat di klaim dan akan hilang(sifatnya bukan tabungan). The expenditure in the last 12 months should be the amount trully spent in the last 12 months that ends one day before the census date, 12 calendar months. Non-food expenditure - party and ceremony in the past month:(Rp) Non-food expenditure - party and ceremony in the past month:(Rp) Non-food expenditure - party and ceremony in the past month:(Rp) Non-food expenditure - party and ceremony in the past month:(Rp) Non-food expenditure - party and ceremony in the past month:(Rp) Non-food expenditure for party and ceremony (wedding, circumcision, birthday, religious holiday, traditional ceremony etc.) from purchase, self-producation and present in the past month:(Rp) Write down in Column (2) non-food expenditure from purchases, self produced, and gifts in one past month for house lease,rent,rent expectation :(Rp) 252913 80000000 19429.31 Pengeluaran yang dicatat di sini adalah pengeluaran untuk pesta perkawinan, ulang tahun, khitanan, upacara keagamaan, upacara adat,dan lainnya, tidak termasuk makanan untuk pesta atau untuk khitanan (konsumsi makanan untuk pesta akan tercatat dalam konsumsi makanan di rumah tangga masing-masing tamu yang datang ke pesta tersebut). Expenditure in the last one month should be the amount really spent in the last one month, not the average monthly amount of the last 12 months. Non-food expenditure - party and ceremony in the past 12 months :(Rp) Non-food expenditure - party and ceremony in the past 12 months :(Rp) Non-food expenditure - party and ceremony in the past 12 months :(Rp) Non-food expenditure - party and ceremony in the past 12 months :(Rp) Non-food expenditure - party and ceremony in the past 12 months :(Rp) Non-food expenditure for party and ceremony (wedding, circumcision, birthday, religious holiday, traditional ceremony etc.) from purchase, self-producation and present in the past 12 months :(Rp) Write down in Column (3) non-food expenditure from purchases, self produced, and gifts in past 12 months for party and ceremony excluding food :(Rp) 252913 95400000 146234.884 Pengeluaran yang dicatat di sini adalah pengeluaran untuk pesta perkawinan, ulang tahun, khitanan, upacara keagamaan, upacara adat,dan lainnya, tidak termasuk makanan untuk pesta atau untuk khitanan (konsumsi makanan untuk pesta akan tercatat dalam konsumsi makanan di rumah tangga masing-masing tamu yang datang ke pesta tersebut). The expenditure in the last 12 months should be the amount trully spent in the last 12 months that ends one day before the census date, 12 calendar months. Total non-food (details 17 to 24) in the past month:(Rp) Total non-food (details 17 to 24) in the past month:(Rp) Total non-food (details 17 to 24) in the past month:(Rp) Total non-food (details 17 to 24) in the past month:(Rp) Total non-food (details 17 to 24) in the past month:(Rp) Total non-food (details 17 to 24) in the past month:(Rp) Write down in Column (2) total non-food (details 17 to 24) from purchases, self produced, and gifts in one past month:(Rp) 252913 100 108486330 361717.792 Total non-food (details 17 to 24) in the past 12 months :(Rp) Total non-food (details 17 to 24) in the past 12 months :(Rp) Total non-food (details 17 to 24) in the past 12 months :(Rp) Total non-food (details 17 to 24) in the past 12 months :(Rp) Total non-food (details 17 to 24) in the past 12 months :(Rp) Total non-food (details 17 to 24) in the past 12 months :(Rp) Write down in Column (3) total non-food (details 17 to 24) from purchases, self produced, and gifts in the past 12 months:(Rp) 252913 49560 722340000 3956008.858 The average food expenditure a month (Details 16 x 30/7) The average food expenditure a month (Details 16 x 30/7) The average food expenditure a month (Details 16 x 30/7) The average food expenditure a month (Details 16 x 30/7) The average food expenditure a month (Details 16 x 30/7) The average food expenditure a month (Details 16 x 30/7) Write down in Column (3) average food expenditure a month (Details 16 x 30/7) 252913 21428 161699357 490210.835 The entry is the total sum of Detail 23 and 24, which is the average household expense per month. The entry is the total sum of Detail 23 and 24, which is the average household expense per month. The average non-food expenditure a month (Details 25 column 3 / 12) The average non-food expenditure a month (Details 25 column 3 / 12) The average non-food expenditure a month (Details 25 column 3 / 12) The average non-food expenditure a month (Details 25 column 3 / 12) The average non-food expenditure a month (Details 25 column 3 / 12) The average non-food expenditure a month (Details 25 column 3 / 12) Write down in Column (2) average non-food expenditure a month (Details 25 column 3 / 12) 252913 4130 60195000 329667.066 Isiannya adalah hasil pembagian Rincian 22 Kolom (3) dengan 12. The average household expenditure a month (Details 26 + Details 27) The average household expenditure a month (Details 26 + Details 27) The average household expenditure a month (Details 26 + Details 27) The average household expenditure a month (Details 26 + Details 27) The average household expenditure a month (Details 26 + Details 27) The average household expenditure a month (Details 26 + Details 27) Write down in Column (2) average household expenditure a month (Details 26 + Details 27) 252913 41666 162338940 819877.902 Main source of household income: Main source of household income: Main source of household income: Main source of household income: Main source of household income: Write down completely the main source of household income in the empty space provided. 252913 111 9902 2752.929 Average expenditure per capita Average expenditure per capita Average expenditure per capita Average expenditure per capita Average expenditure per capita 252913 12925 32467788 221419.283 Have health card? Have health card? Have health card? Have health card? Have health card? Have health card? If the answer is coded 2, skip to b8r3a. Enter code 1 if the answer is “Yes” or code 2 for “No” in the box provided. 252913 1 2 1.842 1 Yes 2 No Health card is a card issued by the Ministry of Health to assist poor people (poverty-stricken). This card can be used to get medical treatment in the Government’s health services facilities (Hospital and Puskesmas) without any charge. One family should have one health card in which listed the names of all family members, and each member of the family can use it. Ever use health card for medical treatment Ever use health card for medical treatment Ever use health card for medical treatment Ever use health card for medical treatment Ever use health card for medical treatment Ever use health card in public clinic, sub-health clinic, and state hospital during Jan – Dec 2003? 1. Medical treatment Write down in the provided box the frequency usage of health card/poor certificate. 40074 212839 1 2 1.284 1 Yes 2 No Sysmiss Charged with a fee for medical treatment Charged with a fee for medical treatment Charged with a fee for medical treatment Charged with a fee for medical treatment Charged with a fee for medical treatment If Column 2 = 0 Did you charged with a fee? 1. Medical treatment Enter code 1 if the answer is "Yes" or code 2 for "No" in the box provided. 28676 224237 1 2 1.778 1 Yes 2 No Ever use health card for pregnancy checking/ labor Ever use health card for pregnancy checking/ labor Ever use health card for pregnancy checking/ labor Ever use health card for pregnancy checking/ labor Ever use health card for pregnancy checking/ labor Ever use health card in public clinic, sub-health clinic, and state hospital during Jan - Dec 2003? 2. Pregnancy checking/ labor Write down in the provided box the frequency usage of health card/poor certificate. 40074 212839 1 2 1.886 1 Yes 2 No Sysmiss Charged with a fee for pregnancy checking/ labor Charged with a fee for pregnancy checking/ labor Charged with a fee for pregnancy checking/ labor Charged with a fee for pregnancy checking/ labor Charged with a fee for pregnancy checking/ labor If Column 2 = 0 Did you charged with a fee? 2. Pregnancy checking/ labor Enter code 1 if the answer is "Yes" or code 2 for "No" in the box provided. 4576 248337 1 2 1.681 1 Yes 2 No Ever use health card for family planning need Ever use health card for family planning need Ever use health card for family planning need Ever use health card for family planning need Ever use health card for family planning need Ever use health card in public clinic, sub-health clinic, and state hospital during Jan - Dec 2003? 3. For family planning need Write down in the provided box the frequency usage of health card/poor certificate. 40074 212839 1 2 1.848 1 Yes 2 No Sysmiss Charged with a fee for family planning need Charged with a fee for family planning need Charged with a fee for family planning need Charged with a fee for family planning need Charged with a fee for family planning need If Column 2 = 0 Did you charged with a fee? 3. For family planning need Enter code 1 if the answer is "Yes" or code 2 for "No" in the box provided. 6109 246804 1 2 1.63 1 Yes 2 No If household purchased cheap rice/rice for poor people for the past 3 months, the amount purchased: (Kg) If household purchased cheap rice/rice for poor people for the past 3 months, the amount purchased: (Kg) If household purchased cheap rice/rice for poor people for the past 3 months, the amount purchased: (Kg) If household purchased cheap rice/rice for poor people for the past 3 months, the amount purchased: (Kg) If household purchased cheap rice/rice for poor people for the past 3 months, the amount purchased: (Kg) If household purchased cheap rice/rice for poor people for the past 3 months, the amount purchased: (Kg) If not buying continue to b9r3. Fill in the amount of raskin in Kilogram bought the last time in the space provided and insert it into the boxes rounded down. 252913 910 6.944 How much per kg generally paid by the household? (Rp) How much per kg generally paid by the household? (Rp) How much per kg generally paid by the household? (Rp) How much per kg generally paid by the household? (Rp) How much per kg generally paid by the household? (Rp) How much per kg generally paid by the household? (Rp) Write down in the provided space the amount of money paid by the household the last time to get one Kg of raskin and insert the amount into the provided boxes. 85676 167237 500 9990 1158.944 Amount of credit received (in thousand Rp): Rp Amount of credit received (in thousand Rp): Rp Amount of credit received (in thousand Rp): Rp Amount of credit received (in thousand Rp): Rp Amount of credit received (in thousand Rp): Rp If received a business credit (= Rp 10 million) during Jan – Dec 2003, the amount of credit received (in thousand Rp): Rp If don't receive, skip to b8r4 252913 999998 202.951 1 2 3 5 6 8 10 15 20 21 22 25 30 40 45 50 60 72 75 90 100 106 120 125 126 130 140 150 155 160 175 180 200 225 233 245 250 260 300 320 330 350 375 390 400 450 460 480 490 500 525 550 560 600 650 660 700 750 775 800 815 850 900 1000 1010 1100 1150 1200 1250 1300 1400 1500 1600 1700 1750 1800 1875 1900 2000 2200 2250 2300 2400 2500 2525 2550 2600 2650 2750 2900 3000 3050 3100 3200 3250 3500 3600 3625 4000 4200 4250 4300 4500 4560 4600 4800 4970 5000 5200 5250 5300 5420 5500 5600 5800 6000 6500 7000 7500 7622 7750 8000 8400 8500 9000 9500 9790 10000 10101 10500 10800 11000 12000 12096 12300 12500 12600 13000 13500 14000 14003 14500 14700 15000 15500 15750 15840 16000 17000 17500 18000 19000 19500 20000 20001 21000 22000 22222 23000 24000 24500 24503 25000 26000 26500 27000 28000 30000 30002 31000 35000 36000 40000 42500 45000 49000 50000 55000 60000 65000 70000 75000 80000 85000 90000 98000 100000 100002 100015 120000 150000 150001 180000 200000 200001 200022 200030 210000 250000 250001 300000 340000 400000 500000 500018 500180 600000 700000 900000 999998 What is the interest rate per year which must be paid (for the largest credit)? (percent) What is the interest rate per year which must be paid (for the largest credit)? (percent) What is the interest rate per year which must be paid (for the largest credit)? (percent) What is the interest rate per year which must be paid (for the largest credit)? (percent) What is the interest rate per year which must be paid (for the largest credit)? (percent) What is the interest rate per year which must be paid (for the largest credit)? (percent) Write down in the provided space the interest rate per year which must be paid and insert into the provided boxes. 4889 248024 99 14.398 Source of credit (the largest credit): Source of credit (the largest credit): Source of credit (the largest credit): Source of credit (the largest credit): Source of credit (the largest credit): Source of credit (the largest credit): Circle one of the codes and enter the number into the box provided. 4889 248024 1 5 2.319 1 Government program 2 Bank 3 Cooperatives/Foundation 4 Individual 5 Other Sysmiss Ever received scholarship from social safety net (JPS) state scholarship Ever received scholarship from social safety net (JPS) state scholarship Ever received scholarship from social safety net (JPS) state scholarship Ever received scholarship from social safety net (JPS) state scholarship Ever received scholarship from social safety net (JPS) state scholarship If there is household member who still in school, ever received scholarship in Jan – Dec 2003 from the following source? 1. Social safety net (JPS) state scholarship Enter code 1 if the answer is "Yes" or code 2 for "No" in the box provided. 246841 6072 1 2 1.957 1 Yes 2 No Sysmiss Scholarships are educational fund supports provided to any student who excels. The available scholarship in college among others BBM-Bantuan Belajar Mahasiswa (Student Learning Support), PPA-Peningkatan Prestasi Akademik (Academic Achievement Improvement), PPE-Peningkatan Prestasi Ekstrakurikuler (Extracurricular Achievement Improvement), BKM-Bantuan Khusus Mahasiswa (Student Special Support). Ever received scholarship from Non-JPS state scholarship Ever received scholarship from Non-JPS state scholarship Ever received scholarship from Non-JPS state scholarship Ever received scholarship from Non-JPS state scholarship Ever received scholarship from Non-JPS state scholarship If there is household member who still in school, ever received scholarship in Jan – Dec 2003 from the following source? 2. Non-JPS state scholarship Enter code 1 if the answer is "Yes" or code 2 for "No" in the box provided. 246841 6072 1 2 1.992 1 Yes 2 No Sysmiss Scholarships are educational fund supports provided to any student who excels. The available scholarship in college among others BBM-Bantuan Belajar Mahasiswa (Student Learning Support), PPA-Peningkatan Prestasi Akademik (Academic Achievement Improvement), PPE-Peningkatan Prestasi Ekstrakurikuler (Extracurricular Achievement Improvement), BKM-Bantuan Khusus Mahasiswa (Student Special Support). Ever received scholarship from GN-OTA (national movement on foster parents) Ever received scholarship from GN-OTA (national movement on foster parents) Ever received scholarship from GN-OTA (national movement on foster parents) Ever received scholarship from GN-OTA (national movement on foster parents) Ever received scholarship from GN-OTA (national movement on foster parents) If there is household member who still in school, ever received scholarship in Jan – Dec 2003 from the following source? 3. GN-OTA (national movement on foster parents) Enter code 1 if the answer is "Yes" or code 2 for "No" in the box provided. 246841 6072 1 2 1.995 1 Yes 2 No Sysmiss Scholarships are educational fund supports provided to any student who excels. The available scholarship in college among others BBM-Bantuan Belajar Mahasiswa (Student Learning Support), PPA-Peningkatan Prestasi Akademik (Academic Achievement Improvement), PPE-Peningkatan Prestasi Ekstrakurikuler (Extracurricular Achievement Improvement), BKM-Bantuan Khusus Mahasiswa (Student Special Support). Ever received scholarship from private agency Ever received scholarship from private agency Ever received scholarship from private agency Ever received scholarship from private agency Ever received scholarship from private agency If there is household member who still in school, ever received scholarship in Jan – Dec 2003 from the following source? 4. Private agency Enter code 1 if the answer is "Yes" or code 2 for "No" in the box provided. 246841 6072 1 2 1.997 1 Yes 2 No Sysmiss Scholarships are educational fund supports provided to any student who excels. The available scholarship in college among others BBM-Bantuan Belajar Mahasiswa (Student Learning Support), PPA-Peningkatan Prestasi Akademik (Academic Achievement Improvement), PPE-Peningkatan Prestasi Ekstrakurikuler (Extracurricular Achievement Improvement), BKM-Bantuan Khusus Mahasiswa (Student Special Support). Ever received scholarship from school Ever received scholarship from school Ever received scholarship from school Ever received scholarship from school Ever received scholarship from school If there is household member who still in school, ever received scholarship in Jan – Dec 2003 from the following source? 5. School Enter code 1 if the answer is "Yes" or code 2 for "No" in the box provided. 246841 6072 1 2 1.983 1 Yes 2 No Sysmiss Scholarships are educational fund supports provided to any student who excels. The available scholarship in college among others BBM-Bantuan Belajar Mahasiswa (Student Learning Support), PPA-Peningkatan Prestasi Akademik (Academic Achievement Improvement), PPE-Peningkatan Prestasi Ekstrakurikuler (Extracurricular Achievement Improvement), BKM-Bantuan Khusus Mahasiswa (Student Special Support). Ever received scholarship from individual Ever received scholarship from individual Ever received scholarship from individual Ever received scholarship from individual Ever received scholarship from individual If there is household member who still in school, ever received scholarship in Jan – Dec 2003 from the following source? 6. Individual Enter code 1 if the answer is "Yes" or code 2 for "No" in the box provided. 246841 6072 1 2 1.999 1 Yes 2 No Sysmiss Scholarships are educational fund supports provided to any student who excels. The available scholarship in college among others BBM-Bantuan Belajar Mahasiswa (Student Learning Support), PPA-Peningkatan Prestasi Akademik (Academic Achievement Improvement), PPE-Peningkatan Prestasi Ekstrakurikuler (Extracurricular Achievement Improvement), BKM-Bantuan Khusus Mahasiswa (Student Special Support). Ever received scholarship from other Ever received scholarship from other Ever received scholarship from other Ever received scholarship from other Ever received scholarship from other If there is household member who still in school, ever received scholarship in Jan – Dec 2003 from the following source? 7. Other Enter code 1 if the answer is "Yes" or code 2 for "No" in the box provided. 246841 6072 1 2 1.996 1 Yes 2 No Sysmiss Scholarships are educational fund supports provided to any student who excels. The available scholarship in college among others BBM-Bantuan Belajar Mahasiswa (Student Learning Support), PPA-Peningkatan Prestasi Akademik (Academic Achievement Improvement), PPE-Peningkatan Prestasi Ekstrakurikuler (Extracurricular Achievement Improvement), BKM-Bantuan Khusus Mahasiswa (Student Special Support). Is the household use fuel/ energy - kerosene Is the household use fuel/ energy - kerosene Is the household use fuel/ energy - kerosene Is the household use fuel/ energy - kerosene Is the household use fuel/ energy - kerosene Household fuel/energy consumption for cooking, lighting and transportation, is the household use fuel/ energy in the past one month? a. Kerosene Enter code 1 if the answer is "Yes" or code 2 for "No" in the box provided. 252913 1 2 1.092 1 Yes 2 No Amount (lier)- Kerosene Amount (lier)- Kerosene Amount (lier)- Kerosene Amount (lier)- Kerosene Amount (lier)- Kerosene If column (2) =1 Household fuel/energy consumption for cooking, lighting and transportation, Amount (lier): a. Kerosene Fill in column (4) the number / quantity of use during a month ago (two digits after comma). 229737 23176 0.01 750 16.082 Value (Rp) - Kerosene Value (Rp) - Kerosene Value (Rp) - Kerosene Value (Rp) - Kerosene Value (Rp) - Kerosene If column (2) =1 Household fuel/energy consumption for cooking, lighting and transportation, Value (Rp): a. Kerosene Fill in column (5) value (in rupiah) usage for a month ago. 229737 23176 200 900000 20840.405 Is the household use fuel/ energy - gas (LPG) Is the household use fuel/ energy - gas (LPG) Is the household use fuel/ energy - gas (LPG) Is the household use fuel/ energy - gas (LPG) Is the household use fuel/ energy - gas (LPG) Household fuel/energy consumption for cooking, lighting and transportation, is the household use fuel/ energy in the past one month? b. Gas (LPG) Enter code 1 if the answer is "Yes" or code 2 for "No" in the box provided. 252913 1 2 1.891 1 Yes 2 No Amount (kg) - Gas (LPG) Amount (kg) - Gas (LPG) Amount (kg) - Gas (LPG) Amount (kg) - Gas (LPG) Amount (kg) - Gas (LPG) If column (2) =1 Household fuel/energy consumption for cooking, lighting and transportation, Amount (kg): b. Gas (LPG) Fill in column (4) the number / quantity of use during a month ago (two digits after comma). 27473 225440 0.02 380 13.802 Value (Rp) - Gas (LPG) Value (Rp) - Gas (LPG) Value (Rp) - Gas (LPG) Value (Rp) - Gas (LPG) Value (Rp) - Gas (LPG) If column (2) =1 Household fuel/energy consumption for cooking, lighting and transportation, Value (Rp): b. Gas (LPG) Fill in column (5) value (in rupiah) usage for a month ago. 27473 225440 1300 650000 37391.598 Is the household use fuel/ energy - gasoline Is the household use fuel/ energy - gasoline Is the household use fuel/ energy - gasoline Is the household use fuel/ energy - gasoline Is the household use fuel/ energy - gasoline Household fuel/energy consumption for cooking, lighting and transportation, is the household use fuel/ energy in the past one month? c. Gasoline Enter code 1 if the answer is "Yes" or code 2 for "No" in the box provided. 252913 1 2 1.76 1 Yes 2 No Amount (liter) - Gasoline Amount (liter) - Gasoline Amount (liter) - Gasoline Amount (liter) - Gasoline Amount (liter) - Gasoline If column (2) =1 Household fuel/energy consumption for cooking, lighting and transportation, Amount (liter): c. Gasoline Fill in column (4) the number / quantity of use during a month ago (two digits after comma). 60789 192124 0.01 660 30.523 Value (Rp) - Gasoline Value (Rp) - Gasoline Value (Rp) - Gasoline Value (Rp) - Gasoline Value (Rp) - Gasoline If column (2) =1 Household fuel/energy consumption for cooking, lighting and transportation, Value (Rp): c. Gasoline Fill in column (5) value (in rupiah) usage for a month ago. 60789 192124 350 999900 62072.217 Is the household use fuel/ energy - diesel fuel Is the household use fuel/ energy - diesel fuel Is the household use fuel/ energy - diesel fuel Is the household use fuel/ energy - diesel fuel Is the household use fuel/ energy - diesel fuel Household fuel/energy consumption for cooking, lighting and transportation, is the household use fuel/ energy in the past one month? d. Diesel fuel Enter code 1 if the answer is "Yes" or code 2 for "No" in the box provided. 252913 1 2 1.988 1 Yes 2 No Amount (liter) - Diesel fuel Amount (liter) - Diesel fuel Amount (liter) - Diesel fuel Amount (liter) - Diesel fuel Amount (liter) - Diesel fuel If column (2) =1 Household fuel/energy consumption for cooking, lighting and transportation, Amount (liter): d. Diesel fuel Fill in column (4) the number / quantity of use during a month ago (two digits after comma). 2921 249992 0.05 660 49.039 Value (Rp) - Diesel fuel Value (Rp) - Diesel fuel Value (Rp) - Diesel fuel Value (Rp) - Diesel fuel Value (Rp) - Diesel fuel If column (2) =1 Household fuel/energy consumption for cooking, lighting and transportation, Value (Rp): d. Diesel fuel Fill in column (5) value (in rupiah) usage for a month ago. 2921 249992 1500 999000 97058.511 Is the household use fuel/ energy - PLN electricity Is the household use fuel/ energy - PLN electricity Is the household use fuel/ energy - PLN electricity Is the household use fuel/ energy - PLN electricity Is the household use fuel/ energy - PLN electricity Household fuel/energy consumption for cooking, lighting and transportation, is the household use fuel/ energy in the past one month? e. PLN electricity Jika b.9.r.1=2 (tidak) maka tidak berlanjut(selesai) Enter code 1 if the answer is "Yes" or code 2 for "No" in the box provided. 252913 1 2 1.203 1 Yes 2 No Amount (kwh) - PLN electricity Amount (kwh) - PLN electricity Amount (kwh) - PLN electricity Amount (kwh) - PLN electricity Amount (kwh) - PLN electricity If column (2) =1 Household fuel/energy consumption for cooking, lighting and transportation, Amount (kwh): e. PLN electricity Fill in column (4) the number / quantity of use during a month ago (two digits after comma). 201615 51298 0.01 999.98 74.42 Value (Rp) - PLN electricity Value (Rp) - PLN electricity Value (Rp) - PLN electricity Value (Rp) - PLN electricity Value (Rp) - PLN electricity If column (2) =1 Household fuel/energy consumption for cooking, lighting and transportation, Value (Rp): e. PLN electricity Fill in column (5) value (in rupiah) usage for a month ago. 201615 51298 5 999995 38897.147 Is the household use fuel/ energy - Firewood Is the household use fuel/ energy - Firewood Is the household use fuel/ energy - Firewood Is the household use fuel/ energy - Firewood Is the household use fuel/ energy - Firewood Household fuel/energy consumption for cooking, lighting and transportation, is the household use fuel/ energy in the past one month? f. Firewood Enter code 1 if the answer is "Yes" or code 2 for "No" in the box provided. 252913 1 2 1.487 1 Yes 2 No Amount - Firewood Amount - Firewood Amount - Firewood Amount - Firewood Amount - Firewood If column (2) =1 Household fuel/energy consumption for cooking, lighting and transportation, Amount: f. Firewood Fill in column (4) the number / quantity of use during a month ago (two digits after comma). 129842 123071 0.01 99.98 34.534 Value (Rp): - Firewood Value (Rp): - Firewood Value (Rp): - Firewood Value (Rp): - Firewood Value (Rp): - Firewood If column (2) =1 Household fuel/energy consumption for cooking, lighting and transportation, Value (Rp): f. Firewood Fill in column (5) value (in rupiah) usage for a month ago. 129842 123071 100 900000 18155.556 Did you plant and harvest rice plant in 2003? Did you plant and harvest rice plant in 2003? Did you plant and harvest rice plant in 2003? Did you plant and harvest rice plant in 2003? Did you plant and harvest rice plant in 2003? Did you plant and harvest rice plant in 2003? If the answer is coded 2, finish Enter code 1 if the answer is "Yes" or code 2 for "No" in the box provided. 252913 1 2 1.756 1 Yes 2 No Harvest rice during Jan – Apr 2003 Harvest rice during Jan – Apr 2003 Harvest rice during Jan – Apr 2003 Harvest rice during Jan – Apr 2003 Harvest rice during Jan – Apr 2003 Did you harvest rice during Jan – Apr 2003? Circle one code according to the respondent's answer. 61657 191256 1 9 2.97 1 Self-harvest 2 Brooking 3 Cutting 9 No Planted area (m2), Jan – Apr 2003 Planted area (m2), Jan – Apr 2003 Planted area (m2), Jan – Apr 2003 Planted area (m2), Jan – Apr 2003 Planted area (m2), Jan – Apr 2003 Planted area (m2), Jan – Apr 2003 Fill in column January - April 2003 area of rice planting land (in m2). 47258 205655 900000 5039.829 Harvested area (m2), Jan – Apr 2003 Harvested area (m2), Jan – Apr 2003 Harvested area (m2), Jan – Apr 2003 Harvested area (m2), Jan – Apr 2003 Harvested area (m2), Jan – Apr 2003 Harvested area (m2), Jan – Apr 2003 Fill in column January - April 2003 area of land during the rice harvest (in m2). 47265 205648 900000 4742.628 Jan – Apr 2003 - As harvest wage/payment (bawon) Jan – Apr 2003 - As harvest wage/payment (bawon) Jan – Apr 2003 - As harvest wage/payment (bawon) Jan – Apr 2003 - As harvest wage/payment (bawon) Jan – Apr 2003 - As harvest wage/payment (bawon) Harvest (kg – GKP), Jan – Apr 2003 : 1. As harvest wage/payment (bawon) Fill in column January - April 2003 harvest as the wage / payment (bawon) in units of Kg-GPK (dry grain of harvest) 47257 205656 468750 218.776 Jan – Apr 2003 - Directly sold Jan – Apr 2003 - Directly sold Jan – Apr 2003 - Directly sold Jan – Apr 2003 - Directly sold Jan – Apr 2003 - Directly sold Harvest (kg – GKP), Jan – Apr 2003 : 2. Directly sold Fill in column January - April 2003 harvest sold directly in units of Kg-GPK (dry grain of harvest) 47257 205656 618000 427.828 Jan – Apr 2003 - Taken home Jan – Apr 2003 - Taken home Jan – Apr 2003 - Taken home Jan – Apr 2003 - Taken home Jan – Apr 2003 - Taken home Harvest (kg – GKP), Jan – Apr 2003 : 3. Taken home Fill in column January - April 2003 harvest of the taken home in units of Kg-GPK (dry grain of harvest). 47257 205656 980000 1868.878 Jan – Apr 2003 - Total harvest obtained Jan – Apr 2003 - Total harvest obtained Jan – Apr 2003 - Total harvest obtained Jan – Apr 2003 - Total harvest obtained Jan – Apr 2003 - Total harvest obtained Harvest (kg – GKP), Jan – Apr 2003 : 4. Total harvest obtained Fill in column January - April 2003 total harvest obtained in units of Kg-GPK (dry grain of harvest). 47257 205656 980000 2515.481 Selling price/kg of GKP, Jan – Apr 2003 Selling price/kg of GKP, Jan – Apr 2003 Selling price/kg of GKP, Jan – Apr 2003 Selling price/kg of GKP, Jan – Apr 2003 Selling price/kg of GKP, Jan – Apr 2003 If b9r2d2 is filled Selling price/kg of GKP, Jan – Apr 2003 Fill in column January - April 2003 selling price / kg of GKP in rupiah. 7743 245170 9115 1125.513 Area cut/brokered (m2), Jan – Apr 2003? Area cut/brokered (m2), Jan – Apr 2003? Area cut/brokered (m2), Jan – Apr 2003? Area cut/brokered (m2), Jan – Apr 2003? Area cut/brokered (m2), Jan – Apr 2003? If b9r2a has code 2 to 7 Area cut/brokered (m2), Jan – Apr 2003? Fill in column January - April 2003 land area of the cut / brokered (in m2). 2320 250593 75000 2379.7 Harvest rice during May – Aug 2003 Harvest rice during May – Aug 2003 Harvest rice during May – Aug 2003 Harvest rice during May – Aug 2003 Harvest rice during May – Aug 2003 Did you harvest rice during May – Aug 2003? Circle one code according to the respondent's answer. 61657 191256 9 5.624 1 Self-harvest 2 Brooking 3 Cutting 9 No Planted area (m2), May – Aug 2003 Planted area (m2), May – Aug 2003 Planted area (m2), May – Aug 2003 Planted area (m2), May – Aug 2003 Planted area (m2), May – Aug 2003 Planted area (m2), May – Aug 2003 Fill in column May - August 2003 area of rice planting land (in m2). 26748 226165 700000 4593.859 Harvested area (m2), May – Aug 2003 Harvested area (m2), May – Aug 2003 Harvested area (m2), May – Aug 2003 Harvested area (m2), May – Aug 2003 Harvested area (m2), May – Aug 2003 Harvested area (m2), May – Aug 2003 Fill in column May - August 2003 area of land during the rice harvest (in m2). 26741 226172 700000 4241.102 May – Aug 2003 - As harvest wage/payment (bawon) May – Aug 2003 - As harvest wage/payment (bawon) May – Aug 2003 - As harvest wage/payment (bawon) May – Aug 2003 - As harvest wage/payment (bawon) May – Aug 2003 - As harvest wage/payment (bawon) Harvest (kg – GKP), May – Aug 2003 : 1. As harvest wage/payment (bawon) Fill in column May - August 2003 harvest as the wage / payment (bawon) in units of Kg-GPK (dry grain of harvest) 26745 226168 400000 230.45 May – Aug 2003 - Directly sold May – Aug 2003 - Directly sold May – Aug 2003 - Directly sold May – Aug 2003 - Directly sold May – Aug 2003 - Directly sold Harvest (kg – GKP), May – Aug 2003 : 2. Directly sold Fill in column May - August 2003 harvest sold directly in units of Kg-GPK (dry grain of harvest) 26746 226167 876315 533.131 May – Aug 2003 - Taken home May – Aug 2003 - Taken home May – Aug 2003 - Taken home May – Aug 2003 - Taken home May – Aug 2003 - Taken home Harvest (kg – GKP), May – Aug 2003 : 3. Taken home Fill in column May - August 2003 harvest of the taken home in units of Kg-GPK (dry grain of harvest). 26741 226172 880000 1590.821 May – Aug 2003 - Total harvest obtained May – Aug 2003 - Total harvest obtained May – Aug 2003 - Total harvest obtained May – Aug 2003 - Total harvest obtained May – Aug 2003 - Total harvest obtained Harvest (kg – GKP), May – Aug 2003 : 4. Total harvest obtained Fill in column May - August 2003 total harvest obtained in units of Kg-GPK (dry grain of harvest). 26748 226165 880000 2322.62 Selling price/kg of GKP, May – Aug 2003 Selling price/kg of GKP, May – Aug 2003 Selling price/kg of GKP, May – Aug 2003 Selling price/kg of GKP, May – Aug 2003 Selling price/kg of GKP, May – Aug 2003 If b9r2d2 is filled Selling price/kg of GKP, May – Aug 2003 Fill in column May - August 2003 selling price / kg of GKP in rupiah. 4592 248321 9505 1173.415 Area cut/brokered (m2), May – Aug 2003? Area cut/brokered (m2), May – Aug 2003? Area cut/brokered (m2), May – Aug 2003? Area cut/brokered (m2), May – Aug 2003? Area cut/brokered (m2), May – Aug 2003? If b9r2a has code 2 to 7 Area cut/brokered (m2), May – Aug 2003? Fill in column May - August 2003 land area of the cut / brokered (in m2). 2651 250262 511501 2228.07 Harvest rice during Sept – Dec 2003? Harvest rice during Sept – Dec 2003? Harvest rice during Sept – Dec 2003? Harvest rice during Sept – Dec 2003? Harvest rice during Sept – Dec 2003? Did you harvest rice during Sept – Dec 2003? Circle one code according to the respondent's answer. 61656 191257 9 6.469 1 Self-harvest 2 Brooking 3 Cutting 9 No Planted area (m2), Sept – Dec 2003 Planted area (m2), Sept – Dec 2003 Planted area (m2), Sept – Dec 2003 Planted area (m2), Sept – Dec 2003 Planted area (m2), Sept – Dec 2003 Planted area (m2), Sept – Dec 2003 Fill in column September - December 2003 area of rice planting land (in m2). 20096 232817 500000 4425.485 Harvested area (m2), Sept – Dec 2003 Harvested area (m2), Sept – Dec 2003 Harvested area (m2), Sept – Dec 2003 Harvested area (m2), Sept – Dec 2003 Harvested area (m2), Sept – Dec 2003 Harvested area (m2), Sept – Dec 2003 Fill in column September - December 2003 area of land during the rice harvest (in m2). 20089 232824 500000 4078.564 Sept – Dec 2003 - As harvest wage/payment (bawon) Sept – Dec 2003 - As harvest wage/payment (bawon) Sept – Dec 2003 - As harvest wage/payment (bawon) Sept – Dec 2003 - As harvest wage/payment (bawon) Sept – Dec 2003 - As harvest wage/payment (bawon) Harvest (kg – GKP), Sept – Dec 2003 : 1. As harvest wage/payment (bawon) Fill in column September - December 2003, harvest as the wage / payment (bawon) in units of Kg-GPK (dry grain of harvest) 20089 232824 600000 302.967 Sept – Dec 2003 - Directly sold Sept – Dec 2003 - Directly sold Sept – Dec 2003 - Directly sold Sept – Dec 2003 - Directly sold Sept – Dec 2003 - Directly sold Harvest (kg – GKP), Sept – Dec 2003 : 2. Directly sold Fill in column September - December 2003, harvest sold directly in units of Kg-GPK (dry grain of harvest) 20089 232824 400000 505.177 Sept – Dec 2003 - Taken home Sept – Dec 2003 - Taken home Sept – Dec 2003 - Taken home Sept – Dec 2003 - Taken home Sept – Dec 2003 - Taken home Harvest (kg – GKP), Sept – Dec 2003 : 3. Taken home Fill in column September - December 2003, harvest of the taken home in units of Kg-GPK (dry grain of harvest). 20089 232824 980000 1521.936 Sept – Dec 2003 - Total harvest obtained Sept – Dec 2003 - Total harvest obtained Sept – Dec 2003 - Total harvest obtained Sept – Dec 2003 - Total harvest obtained Sept – Dec 2003 - Total harvest obtained Harvest (kg – GKP), Sept – Dec 2003 : 4. Total harvest obtained Fill in column September - December 2003, total harvest obtained in units of Kg-GPK (dry grain of harvest). 20089 232824 980000 2330.179 Selling price/kg of GKP, Sept – Dec 2003 Selling price/kg of GKP, Sept – Dec 2003 Selling price/kg of GKP, Sept – Dec 2003 Selling price/kg of GKP, Sept – Dec 2003 Selling price/kg of GKP, Sept – Dec 2003 If b9r2d2 is filled Selling price/kg of GKP, Sept – Dec 2003 Fill in column September - December 2003, selling price / kg of GKP in rupiah. 4185 248728 9500 1156.996 Area cut/brokered (m2), Sept – Dec 2003 Area cut/brokered (m2), Sept – Dec 2003 Area cut/brokered (m2), Sept – Dec 2003 Area cut/brokered (m2), Sept – Dec 2003 Area cut/brokered (m2), Sept – Dec 2003 If b9r2a has code 2 to 7 Area cut/brokered (m2), Sept – Dec 2003? Fill in column September - December 2003, land area of the cut / brokered (in m2). 2348 250565 75000 1316.116 Household weight Household weight Household weight Household weight Household weight 252913 1013 216.936 Province Province Province Province Province Province Write down the name province in the space provided and add the related code referred to in the box provided. 267549 11 94 39.213 11 Nanggroe Aceh Darussalam 12 North Sumatera 13 West Sumatera 14 Riau 15 Jambi 16 South Sumatera 17 Bengkulu 18 Lampung 19 Bangka Belitung 21 Riau Island 31 DKI Jakarta 32 West Java 33 Central Java 34 DI Yogyakarta 35 East Java 36 Banten 51 Bali 52 West Nusa Tenggara 53 East Nusa Tenggara 61 West Kalimantan 62 Central Kalimantan 63 South Kalimantan 64 East Kalimantan 71 North Sulawesi 72 Central Sulawesi 73 South Sulawesi 74 Southeast Sulawesi 75 Gorontalo 76 West Sulawesi 81 Maluku 82 North Maluku 91 West Irian Jaya 94 Papua District/City District/City District/City District/City District/City District/City Cross out the unnecessary and the Write down the name of district/city in the space provided and add the related code referred to in the box provided. 267549 1 79 23.297 Sub-district Sub-district Sub-district Sub-district Sub-district Sub-district Write down the name subdistrict in the space provided and add the related code referred to in the box provided. 267549 10 740 75.166 Village/kelurahan Village/kelurahan Village/kelurahan Village/kelurahan Village/kelurahan Village/kelurahan Cross out the unnecessary and the Write down the name of village/kelurahan in the space provided and add the related code referred to in the box provided. 267549 1 111 8.632 Village/kelurahan classification Village/kelurahan classification Village/kelurahan classification Village/kelurahan classification Village/kelurahan classification Village/kelurahan classification Circle the answered code, then write it down in the box provided. 267549 1 2 1.555 1 Urban 2 Rural Sample code number Sample code number Sample code number Sample code number Sample code number Sample code number Write down the sample code number into the box provided. 267549 1001 2542 1242.811 Household sample sequential number Household sample sequential number Household sample sequential number Household sample sequential number Household sample sequential number Household sample sequential number Write down the household sample sequential number into the box provided. 267549 16 8.502 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Serial number of household members Serial number of household members Serial number of household members Serial number of household members Serial number of household members Serial number of household members 267549 1 15 2.881 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Relationship with head of household (HH) Relationship with head of household (HH) Relationship with head of household (HH) Relationship with head of household (HH) Relationship with head of household (HH) Relationship with head of household (HH) Ask the relation of each household member to the head of household and enter the code accordingly into the boxes provided. The first household member should be the head of household, and therefore, Column (3) should be filled in with code 1. 267549 1 9 2.571 1 Head of household 2 Wife/husband 3 Child 4 In-law 5 Grandchild 6 Parent/in-law 7 Other family 8 Housemaid 9 Other 1. The head of household (krt) is a man in a group of household members who is responsible to provide the daily needs of the concerned households, or a person who is considerend/appointed to be the head of a household (for example a group of students live together in one room inside a census building; because they each are responsible for their own needs, one person is appointed as the household head). 2. Wife/husband, is the wife/husband of the head of household. 3. Children, includes biological children, stepchildren, and adopted children of the head of household. 4. Son/daughter in laws, are the husbands/wives of biological daughters/sons, step daughters/sons, or adopted daughters/sons. 5. Grandchildren, are the children of biological children, step children, or adopted children. 6. Parent in laws, are father/mother of the head of household or father/mother of the spouse of the head of household. 7. Other families, are those who have blood relation with head of the household or the spouse, such as siblings, aunties, uncles, grandparents. 8. Housemaid, are people who works as a helper and lives in the concerned household, receiving wage/salary in the form money or in-kind payment. 9. Other, are people who do not have familial relation to the head of household or the spouse, who live in the household for more than 6 months, such as visitors, friends or tenants who rent room plus food, including children of helpers who also live and eat in the employer's house. Gender Gender Gender Gender Gender Gender 267549 1 2 1.499 1 Male 2 Female Age (Year) Age (Year) Age (Year) Age (Year) Age (Year) Age (Year) 267549 99 27.742 Give check mark (v) for men and cross (x) for women Give check mark (v) for men and cross (x) for women Give check mark (v) for men and cross (x) for women Give check mark (v) for men and cross (x) for women Give check mark (v) for men and cross (x) for women Give check mark (v) for men and cross (x) for women Give check mark (v) for male household members aged 15 years and above and cross (x) for female household members aged 15 years and above 267549 - V X Respondent and respondent selection sequential number [See elucidation] Respondent and respondent selection sequential number [See elucidation] Respondent and respondent selection sequential number [See elucidation] Respondent and respondent selection sequential number [See elucidation] Respondent and respondent selection sequential number [See elucidation] Respondent and respondent selection sequential number [See elucidation] 186553 80996 1 9 2.187 1 2 3 4 5 6 7 8 9 Sysmiss 1. Write sequential number from 1 for eldest male to youngest then continued with eldest female to youngest 2. Circle the sequential number as selected respondent based on KISH Table with the following condition: (as it is written in the questionnaire VSEN2004.MPK) Biological father still alive? Biological father still alive? Biological father still alive? Biological father still alive? Biological father still alive? Biological father still alive? 267549 1 9 1.331 1 Yes 2 No 9 Do not know Biological mother still alive? Biological mother still alive? Biological mother still alive? Biological mother still alive? Biological mother still alive? Biological mother still alive? 267549 1 9 1.252 1 Yes 2 No 9 Do not know Receive dental examination/ care by doctor/ nurse in the past 6 months? Receive dental examination/ care by doctor/ nurse in the past 6 months? Receive dental examination/ care by doctor/ nurse in the past 6 months? Receive dental examination/ care by doctor/ nurse in the past 6 months? Receive dental examination/ care by doctor/ nurse in the past 6 months? Receive dental examination/ care by doctor/ nurse in the past 6 months? Fill code 1 if "Yes, for the treatment", code 2 if "Yes, for a check up / treatments", code 3 if "Yes, for the treatment and check-up", and code 4 if the "No" for each household member 1 year old up into the box provided. 263491 4058 4 3.781 1 Yes, for treatment 2 Yes, for checkup/care 3 Yes, for treatment & checkup 4 No Sysmiss Work at least 1 hour in the past week? Work at least 1 hour in the past week? Work at least 1 hour in the past week? Work at least 1 hour in the past week? Work at least 1 hour in the past week? Work at least 1 hour in the past week? 55336 212213 1 2 1.935 1 Yes 2 No Sysmiss Work is at (the main) business? Work is at (the main) business? Work is at (the main) business? Work is at (the main) business? Work is at (the main) business? If “Yes” (Col. 10 = 1) Work is at (the main) business? 3582 263967 1 4 1.999 1 Self-owned 2 Owned PT 3 Other paid people/ party 4 Other unpaid people/ party Sysmiss Main job in the past week: Main job in the past week: Main job in the past week: Main job in the past week: Main job in the past week: Main job in the past week: 3582 263967 1 9 6.494 1 Traveling trader 2 Permanent place trader 3 Scavenging 4 Work in household/small industry 5 Work in medium/large industry 6 Work in agriculture sector 7 Work in transportation sector 8 Work in service sector 9 Other Sysmiss Perform money generating activity such as busker or beg, clean car in traffic lights etc. in the past week? Perform money generating activity such as busker or beg, clean car in traffic lights etc. in the past week? Perform money generating activity such as busker or beg, clean car in traffic lights etc. in the past week? Perform money generating activity such as busker or beg, clean car in traffic lights etc. in the past week? Perform money generating activity such as busker or beg, clean car in traffic lights etc. in the past week? Perform money generating activity such as busker or beg, clean car in traffic lights etc. in the past week? 55336 212213 1 2 1.993 1 Yes 2 No Sysmiss Help household work (cook, shop, wash, nurse younger sibling/other household member etc.) in the past week? Help household work (cook, shop, wash, nurse younger sibling/other household member etc.) in the past week? Help household work (cook, shop, wash, nurse younger sibling/other household member etc.) in the past week? Help household work (cook, shop, wash, nurse younger sibling/other household member etc.) in the past week? Help household work (cook, shop, wash, nurse younger sibling/other household member etc.) in the past week? Help household work (cook, shop, wash, nurse younger sibling/other household member etc.) in the past week? 55336 212213 1 2 1.648 1 Yes 2 No Sysmiss Daily average hour for the activity? Daily average hour for the activity? Daily average hour for the activity? Daily average hour for the activity? Daily average hour for the activity? If “Yes” (Col. 14=1) Daily average hour for the activity? 19500 248049 1 8 1.441 1 2 3 4 5 6 7 8 Sysmiss Individual weight Individual weight Individual weight Individual weight Individual weight 267549 230 1580 811.337 - - - - - 266195 1354 1 79 23.271 Relation with the head of household Relation with the head of household Relation with the head of household Relation with the head of household Relation with the head of household Relation with the head of household Ask the relation of each household member to the head of household and enter the code accordingly into the boxes provided. 266195 1354 1 9 2.574 1 Head of household 2 Wife/husband 3 Child 4 In-law 5 Grandchild 6 Parent/in-law 7 Other family 8 Housemaid 9 Other Sysmiss 1. The head of household (krt) is a man in a group of household members who is responsible to provide the daily needs of the concerned households, or a person who is considerend/appointed to be the head of a household (for example a group of students live together in one room inside a census building; because they each are responsible for their own needs, one person is appointed as the household head). 2. Wife/husband, is the wife/husband of the head of household. 3. Children, includes biological children, stepchildren, and adopted children of the head of household. 4. Son/daughter in laws, are the husbands/wives of biological daughters/sons, step daughters/sons, or adopted daughters/sons. 5. Grandchildren, are the children of biological children, step children, or adopted children. 6. Parent in laws, are father/mother of the head of household or father/mother of the spouse of the head of household. 7. Other families, are those who have blood relation with head of the household or the spouse, such as siblings, aunties, uncles, grandparents. 8. Housemaid, are people who works as a helper and lives in the concerned household, receiving wage/salary in the form money or in-kind payment. 9. Other, are people who do not have familial relation to the head of household or the spouse, who live in the household for more than 6 months, such as visitors, friends or tenants who rent room plus food, including children of helpers who also live and eat in the employer's house. Gender Gender Gender Gender Gender Gender Write down the gender of each household member in the provided box, code 1 for “Male” and code 2 for “Female”. Do not guess people’s gender based on their names. To make sure, please ask if the person in question is a male or a female. 266195 1354 1 2 1.499 1 Male 2 Female Sysmiss Age (year) Age (year) Age (year) Age (year) Age (year) Age (year) Ask the respondent’s age and enter the answer into the box. 266195 1354 98 27.787 Age is measured in years rounded down or the age after the last birthday. Age calculation is based on Christian calendar. Marital status Marital status Marital status Marital status Marital status Marital status: Ask marital status of the respondent and enter the code into the box provided. 266195 1354 1 4 1.612 1 Not married 2 Married 3 Divorce 4 Divorce due to death Sysmiss 1. Married means having a wife (for male) or husband (for female) durint the census, whether living together or separately. In this case the people included in this status are those who are married legally (by the law of the tradition, religion, state, etc), and also those who live together and have been considered husband and wive by the local society. 2. Divorcee is a person who has been separated from wife/husband and has not remarried.In this case including a person who claims to be divorced although it is not legally confirmed yet. Household member sequential No. Household member sequential No. Household member sequential No. Household member sequential No. Household member sequential No. 266195 1354 15 2.877 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Sysmiss Perform “tour”* trip? (Oct 1 – Dec 31, 2003) Perform “tour”* trip? (Oct 1 – Dec 31, 2003) Perform “tour”* trip? (Oct 1 – Dec 31, 2003) Perform “tour”* trip? (Oct 1 – Dec 31, 2003) Perform “tour”* trip? (Oct 1 – Dec 31, 2003) 266195 1354 1 2 1.872 1 Yes 2 No Sysmiss Travel frequency in the past 3 calendar months? Travel frequency in the past 3 calendar months? Travel frequency in the past 3 calendar months? Travel frequency in the past 3 calendar months? Travel frequency in the past 3 calendar months? 265635 1914 41 0.196 Ever/ on pre-school education? Ever/ on pre-school education? Ever/ on pre-school education? Ever/ on pre-school education? Ever/ on pre-school education? 265432 2117 4 0.276 1 2 3 4 Sysmiss Information provider - Sequential no Information provider - Sequential no Information provider - Sequential no Information provider - Sequential no Information provider - Sequential no 266195 1354 1 18 4.76 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 18 Sysmiss Biological mother sequential number Biological mother sequential number Biological mother sequential number Biological mother sequential number Biological mother sequential number 266194 1355 13 0.973 1 2 3 4 5 6 7 8 9 10 11 12 13 Sysmiss Is the household member present during interview? Is the household member present during interview? Is the household member present during interview? Is the household member present during interview? Is the household member present during interview? Enter code 1 if the answer is "Yes" or code 2 for "No" in the box provided. 266195 1354 1 2 1.276 1 Yes 2 No Sysmiss Health complaints - fever Health complaints - fever Health complaints - fever Health complaints - fever Health complaints - fever Any health complaint in the past one month? (read from a to h) a. fever If the answer is coded 2, skip to b5r8 Use code 1 if the respondent have health problems or code 2 if the answer is "No". 266195 1354 1 2 1.883 1 Yes 2 No Sysmiss 1. Health complaints is a condition where a person suffers from physical or mental illness, whether it is an acute disease, chronic disease (although there is no problem in the last one month), accident, criminal act or other things. 2. Fever is a condition which symptom is the increasing body temperature above 37.5 degrees Celcius, or if touched (especially with the back of the hand) it feels hot. Health complaints - cough Health complaints - cough Health complaints - cough Health complaints - cough Health complaints - cough Any health complaint in the past one month? (read from a to h) b. cough If the answer is coded 2, skip to b5r8 Use code 1 if the respondent have health problems or code 2 if the answer is "No". 266194 1355 1 2 1.856 1 Yes 2 No Sysmiss 1. Health complaints is a condition where a person suffers from physical or mental illness, whether it is an acute disease, chronic disease (although there is no problem in the last one month), accident, criminal act or other things. 2. Coughing is a sound produced by the sudden opening of vocal cords followed by the fast release of air, in order to let out the object that stimulates the central or lower part of respiratory tract; short or long; dry, phlegm or bloody expectoration; lasting for days, weeks, months or years. Health complaints - cold Health complaints - cold Health complaints - cold Health complaints - cold Health complaints - cold Any health complaint in the past one month? (read from a to h) c. cold If the answer is coded 2, skip to b5r8 Use code 1 if the respondent have health problems or code 2 if the answer is "No". 266195 1354 1 2 1.857 1 Yes 2 No Sysmiss 1. Health complaints is a condition where a person suffers from physical or mental illness, whether it is an acute disease, chronic disease (although there is no problem in the last one month), accident, criminal act or other things. 2. Colds is a condition with the following symptoms: mucus, nasal congestion, and might be followed by sneezing, or other symptoms. Health complaints - asthma/breathlessnes Health complaints - asthma/breathlessnes Health complaints - asthma/breathlessnes Health complaints - asthma/breathlessnes Health complaints - asthma/breathlessnes Any health complaint in the past one month? (read from a to h) d. asthma/breathlessnes If the answer is coded 2, skip to b5r8 Use code 1 if the respondent have health problems or code 2 if the answer is "No". 266195 1354 1 2 1.984 1 Yes 2 No Sysmiss 1. Health complaints is a condition where a person suffers from physical or mental illness, whether it is an acute disease, chronic disease (although there is no problem in the last one month), accident, criminal act or other things. 2. Asthma is an illness during which attack the patient suffers difficulty in breathing due to constriction in the lower respiratoty track, causing the breathing to make a shound while letting air out; local community calls the illness bengek or mengi. Health complaints - diarrhea Health complaints - diarrhea Health complaints - diarrhea Health complaints - diarrhea Health complaints - diarrhea Any health complaint in the past one month? (read from a to h) e. diarrhea If the answer is coded 2, skip to b5r8 Use code 1 if the respondent have health problems or code 2 if the answer is "No". 266194 1355 1 2 1.984 1 Yes 2 No Sysmiss 1. Health complaints is a condition where a person suffers from physical or mental illness, whether it is an acute disease, chronic disease (although there is no problem in the last one month), accident, criminal act or other things. 2. Diarrhea is an illness which symptomsare: runny or liquid faeces, sometimes mixed with blood or mucus; generally happens 3 times or more within 24 hours. Diarrhea might be accompanied with a throwing up, or decrement of consciousness. Local people call this illness as mencret or bocor. Health complaints - migraine Health complaints - migraine Health complaints - migraine Health complaints - migraine Health complaints - migraine Any health complaint in the past one month? (read from a to h) f. migraine If the answer is coded 2, skip to b5r8 Use code 1 if the respondent have health problems or code 2 if the answer is "No". 266195 1354 1 2 1.948 1 Yes 2 No Sysmiss 1. Health complaints is a condition where a person suffers from physical or mental illness, whether it is an acute disease, chronic disease (although there is no problem in the last one month), accident, criminal act or other things. 2. Migraine/Recurring headache is the feeling of pain, throbbing pain, jabbing pain, like being tied up, drilled or stabbed in the head, or other uncomfortable feelings in part or of the whole head. It lasts from a few hours to a few days, recurring for several times within 1 year (at least 2 times), with similar symptoms. Headache during fewer is not considered a recurring headache. Health complaints - toothache Health complaints - toothache Health complaints - toothache Health complaints - toothache Health complaints - toothache Any health complaint in the past one month? (read from a to h) g. toothache If the answer is coded 2, skip to b5r8 Use code 1 if the respondent have health problems or code 2 if the answer is "No". 266194 1355 1 2 1.979 1 Yes 2 No Sysmiss 1. Health complaints is a condition where a person suffers from physical or mental illness, whether it is an acute disease, chronic disease (although there is no problem in the last one month), accident, criminal act or other things. 2. Toothache is the feeling of pain in the teeth or gums, sometimes accompanied by swelling, but does not include sprue. Health complaints - other Health complaints - other Health complaints - other Health complaints - other Health complaints - other Any health complaint in the past one month? (read from a to h) h. other If the answer is coded 2, skip to b5r8 Use code 1 if the respondent have health problems or code 2 if the answer is "No". 266195 1354 1 2 1.922 1 Yes 2 No Sysmiss 1. Health complaints is a condition where a person suffers from physical or mental illness, whether it is an acute disease, chronic disease (although there is no problem in the last one month), accident, criminal act or other things. 2. Other problems are health problems such as measles, perforated tympanic membrane /CSOM, hepatitis/liver disease, seizures, paralyzed, senility, including other health problems caused by accidents/tragic events, natural disaster, lost of appetite, difficulty in defecating, headache caused by fever, non-recurring headache, problems with joints, problems in hearing, cataract, gastritis, stomachache, catching colds, unable to urinate, ulcer, sore eyes, and physical problems caused due to menstruation or pregnancy. If there is a complaint,did it disrupt job,school or daily activities? If there is a complaint,did it disrupt job,school or daily activities? If there is a complaint,did it disrupt job,school or daily activities? If there is a complaint,did it disrupt job,school or daily activities? If there is a complaint,did it disrupt job,school or daily activities? If there is a complaint,did it disrupt job,school or daily activities? If the answer is coded 2, skip to b5r5a Circle the appropriate code and fill in the provided box. 265776 1773 2 0.416 1 Yes 2 No Sysmiss Complaint of activities means that the respondent cannot do the normal activity (work, study, daily activities) as usual. Period of disruption: (days) Period of disruption: (days) Period of disruption: (days) Period of disruption: (days) Period of disruption: (days) Period of disruption:(days) Write down how long (days) the household members who have health problems are interrupted from their daily activities in the last one month.The duration of interruption shall not exceed 30 days because the time reference used is the last one month, although the actual health problems last for more than 30 days. 265607 1942 30 0.976 Period of disruption does not refer to the worst health problem, but also covers the total duration of all the health problems suffered by the household members in the last one month. If a person has more than one health problem, the length of interruption time caused by the illnesses should not be combined. Is it still disrupting now? Is it still disrupting now? Is it still disrupting now? Is it still disrupting now? Is it still disrupting now? Circle one of codes and record in the box available. Circles code 1 if householder "still has health disruption until the enumeration day" and circle code 2 if "No". 265608 1941 2 0.32 1 Yes 2 No Sysmiss Ever performed self-medication in the past 1 month? Ever performed self-medication in the past 1 month? Ever performed self-medication in the past 1 month? Ever performed self-medication in the past 1 month? Ever performed self-medication in the past 1 month? Ever performed self-medication in the past 1 month? If the answer is coded 2, skip to b5r6 Circle the appropriate code and fill in the provided box. 265776 1773 2 0.386 1 Yes 2 No Sysmiss Self medication is an effort to have a medication by deciding the kind of medicines by oneself (without any /prescription from a medical doctor/traditional medication/batra). Self medicine/treatment - traditional medicine Self medicine/treatment - traditional medicine Self medicine/treatment - traditional medicine Self medicine/treatment - traditional medicine Self medicine/treatment - traditional medicine Type of medicine/treatment method used: 1. traditional medicine Enter code 1 if the answer is “Yes” or code 2 for “No” in the box provided. 265698 1851 2 0.352 1 Yes 2 No Sysmiss Traditional Medicine is medicine concoction made of herbs/plants, animal, mineral, etc. which is generaly has already been used for generation whether to cure an illness ir to be taken as health supplement in a form of powder, finely chops, liquid, tablet, capsule, medical embrocation, liniment lotion, etc. Self medicine/treatment - modern medicine Self medicine/treatment - modern medicine Self medicine/treatment - modern medicine Self medicine/treatment - modern medicine Self medicine/treatment - modern medicine Type of medicine/treatment method used: 2. modern medicine Enter code 1 if the answer is “Yes” or code 2 for “No” in the box provided. 265698 1851 2 0.237 1 Yes 2 No Sysmiss Modern medicine is medicine used in a medical system, it can be in the form of tablet, caplet, capsule, syrup, powder, ointment, suppository (i.e. hemorrhoids medicine), inhaler (i.e. asthmatic medicine to be sprayed inside the mouth or to be inhaled); usually is ready made from pharmaceutical factories, with packaging and registration code number in the Ministry of Health starting with 1-3 letters followed by numbers. Self medicine/treatment - other Self medicine/treatment - other Self medicine/treatment - other Self medicine/treatment - other Self medicine/treatment - other Type of medicine/treatment method used: 3. other Enter code 1 if the answer is “Yes” or code 2 for “No” in the box provided. 265697 1852 2 0.4 1 Yes 2 No Sysmiss Others, such as food supplement/natural supplement (i.e: sunchlorella, squalen, omega 3, nuskin, imedeen, collagen, etc); tonic drinks (i.e: Kratingdaeng, Kaki Tiga, M-150, Adem Sari, Lasegar, etc) with registration code beginning with MD (local products) or ML (imported products); skin scrapping; massage. Ever become an outpatient in the past one month? Ever become an outpatient in the past one month? Ever become an outpatient in the past one month? Ever become an outpatient in the past one month? Ever become an outpatient in the past one month? Ever become an outpatient in the past one month? If the answer is coded 2, skip to b5r8 Circle the appropriate code and fill in the provided box. 265776 1773 2 0.48 1 Yes 2 No Sysmiss The followings are not included in medical treatment:consultation,medical check-up,health check (such as for Driver Liscense,new employee acceptance,promotion),screening (medical check-up to find illness,such as:Pap Smear Test for cervix cancer,mantoux tes for toddler to find TBC),normal pregnancy check-up,and immunization,because all are prevention efforts. Outpatient is an effort by household members who have health problems to check their health and get medication by going to modern or traditional health services without hospitalization,including housecall. Frequency of outpatient - state hospital Frequency of outpatient - state hospital Frequency of outpatient - state hospital Frequency of outpatient - state hospital Frequency of outpatient - state hospital How many times became outpatient in the past one month? a. state hospital Write down in the provided box the frequency of (how many times) the respondent visits health centers for medical treatment (without hospitalization). 265523 2026 30 0.0124 1 2 3 4 5 6 7 8 10 11 12 20 21 22 30 Sysmiss State Hospital is a hospital owned by the central government (such as RSCM/RSUP Dr. Cipto Mangunkusumo); regional government (such as RSU Labuang Baji), National Army/TNI (such as RSPAD), or State-owned Enterprise/BUMN (such as RS Pertamina). Frequency of outpatient - private hospital Frequency of outpatient - private hospital Frequency of outpatient - private hospital Frequency of outpatient - private hospital Frequency of outpatient - private hospital How many times became outpatient in the past one month? b. private hospital Write down in the provided box the frequency of (how many times) the respondent visits health centers for medical treatment (without hospitalization). 265523 2026 14 0.00587 1 2 3 4 5 6 7 8 10 14 Sysmiss Private Hospital is a private owned hospital such as RS St. Carolus, RS Medistra. Frequency of outpatient - doctor Frequency of outpatient - doctor Frequency of outpatient - doctor Frequency of outpatient - doctor Frequency of outpatient - doctor How many times became outpatient in the past one month? c. doctor Write down in the provided box the frequency of (how many times) the respondent visits health centers for medical treatment (without hospitalization). 265523 2026 20 0.043 1 2 3 4 5 6 7 8 9 10 11 12 13 20 Sysmiss Doctor is a health service center for outpatient (not hospitalized); usually managed by privates, companies, foundations, Army/TNI or various Departments/BUMN. Frequency of outpatient - health clinic Frequency of outpatient - health clinic Frequency of outpatient - health clinic Frequency of outpatient - health clinic Frequency of outpatient - health clinic How many times became outpatient in the past one month? d. health clinic Write down in the provided box the frequency of (how many times) the respondent visits health centers for medical treatment (without hospitalization). 265523 2026 30 0.0706 1 2 3 4 5 6 7 8 9 10 11 12 20 21 30 Sysmiss Health clinic(Community Health Center) is a health service unit owned by the government responsible for providing health services to the community in sub-districts,part of sub-districts or kelurahan (such in DKI Jakarta). Puskesmas team can do mobile practices to certain places within its working territory in order to provide easier access of health services for the society. Frequency of outpatient - polyclinic Frequency of outpatient - polyclinic Frequency of outpatient - polyclinic Frequency of outpatient - polyclinic Frequency of outpatient - polyclinic How many times became outpatient in the past one month? e. polyclinic Write down in the provided box the frequency of (how many times) the respondent visits health centers for medical treatment (without hospitalization). 265522 2027 10 0.0064 1 2 3 4 5 7 10 Sysmiss Frequency of outpatient - medical worker practice Frequency of outpatient - medical worker practice Frequency of outpatient - medical worker practice Frequency of outpatient - medical worker practice Frequency of outpatient - medical worker practice How many times became outpatient in the past one month? f. medical worker practice Write down in the provided box the frequency of (how many times) the respondent visits health centers for medical treatment (without hospitalization). 265523 2026 30 0.036 1 2 3 4 5 6 7 8 10 12 20 30 Sysmiss Medical worker practice are private/personal practices of physicians,whether general practitioners,dentists,or specialists.Location of practices can be carried out in Hospitals,puskesmas (community health center),supporting puskemas,or clinic that is commonly open outside the doctor's working hours. Frequency of outpatient - traditional treatment Frequency of outpatient - traditional treatment Frequency of outpatient - traditional treatment Frequency of outpatient - traditional treatment Frequency of outpatient - traditional treatment How many times became outpatient in the past one month? g. traditional treatment Write down in the provided box the frequency of (how many times) the respondent visits health centers for medical treatment (without hospitalization). 265523 2026 12 0.0038 1 2 3 4 5 6 7 8 9 10 12 Sysmiss Batra Practice (Traditional treatment) is an alternative health service by shaman/healer/sinshe,including accupuncture practice,finger therapy,paranormal,radiesthesia (usually using a pendulum). Frequency of outpatient - other Frequency of outpatient - other Frequency of outpatient - other Frequency of outpatient - other Frequency of outpatient - other How many times became outpatient in the past one month? h. other Write down in the provided box the frequency of (how many times) the respondent visits health centers for medical treatment (without hospitalization). 265523 2026 30 0.00955 1 2 3 4 5 6 7 8 9 10 11 12 20 21 22 25 30 Sysmiss Others, such as Polindes (Village Maternity Ward), Posyandu, or if a woman gave birth without any medical support. Ever become an inpatient in the past one year? Ever become an inpatient in the past one year? Ever become an inpatient in the past one year? Ever become an inpatient in the past one year? Ever become an inpatient in the past one year? Ever become an inpatient in the past one year? If the answer is no, skip to b5r10. Circle one of the codes and enter the number into the box provided. 266195 1354 1 2 1.988 1 Yes 2 No Sysmiss Inpatient is an effort to treat a disease by spending a night or more in a modern or traditional health service unit,including inpatient in maternity ward. Inpatient period - state hospital Inpatient period - state hospital Inpatient period - state hospital Inpatient period - state hospital Inpatient period - state hospital Inpatient period (in days) - a. state hospital Fill in the duration of inpatient that is already finished in the last one year , in the provided box, if the respondent has been inpatient more than once in the same place, add the duration of the inpatient days of the several visits for the last one year. 265422 2127 212 0.0392 State Hospital is a hospital owned by the central government (such as RSCM/RSUP Dr. Cipto Mangunkusumo); regional government (such as RSU Labuang Baji), National Army/TNI (such as RSPAD), or State-owned Enterprise/BUMN (such as RS Pertamina). Inpatient period - private hospital Inpatient period - private hospital Inpatient period - private hospital Inpatient period - private hospital Inpatient period - private hospital Inpatient period (in days) - b. private hospital Fill in the duration of inpatient that is already finished in the last one year , in the provided box, if the respondent has been inpatient more than once in the same place, add the duration of the inpatient days of the several visits for the last one year. 265422 2127 222 0.0253 Private Hospital is a private owned hospital such as RS St. Carolus, RS Medistra. Inpatient period - health clinic Inpatient period - health clinic Inpatient period - health clinic Inpatient period - health clinic Inpatient period - health clinic Inpatient period (in days) - c. health clinic Fill in the duration of inpatient that is already finished in the last one year , in the provided box, if the respondent has been inpatient more than once in the same place, add the duration of the inpatient days of the several visits for the last one year. 265422 2127 300 0.00726 Health clinic(Community Health Center) is a health service unit owned by the government responsible for providing health services to the community in sub-districts,part of sub-districts or kelurahan (such in DKI Jakarta). Puskesmas team can do mobile practices to certain places within its working territory in order to provide easier access of health services for the society. Inpatient period - medical worker practice Inpatient period - medical worker practice Inpatient period - medical worker practice Inpatient period - medical worker practice Inpatient period - medical worker practice Inpatient period (in days): d. medical worker practice Fill in the duration of inpatient that is already finished in the last one year , in the provided box, if the respondent has been inpatient more than once in the same place, add the duration of the inpatient days of the several visits for the last one year. 265422 2127 222 0.00358 1 2 3 4 5 6 7 8 10 15 20 100 222 Sysmiss Medical worker practice are private/personal practices of physicians,whether general practitioners,dentists,or specialists.Location of practices can be carried out in Hospitals,puskesmas (community health center),supporting puskemas,or clinic that is commonly open outside the doctor's working hours. Inpatient period - traditional treatment Inpatient period - traditional treatment Inpatient period - traditional treatment Inpatient period - traditional treatment Inpatient period - traditional treatment Inpatient period (in days): e. traditional treatment Fill in the duration of inpatient that is already finished in the last one year , in the provided box, if the respondent has been inpatient more than once in the same place, add the duration of the inpatient days of the several visits for the last one year. 265422 2127 222 0.00192 1 2 3 4 5 6 8 10 15 20 30 48 222 Sysmiss Batra Practice (Traditional treatment) is an alternative health service by shaman/healer/sinshe,including accupuncture practice,finger therapy,paranormal,radiesthesia (usually using a pendulum). Inpatient period - other Inpatient period - other Inpatient period - other Inpatient period - other Inpatient period - other Inpatient period (in days): f. other Fill in the duration of inpatient that is already finished in the last one year, in the provided box, if the respondent has been inpatient more than once in the same place, add the duration of the inpatient days of the several visits for the last one year. 265422 2127 222 0.00232 1 2 3 4 5 6 7 9 14 16 22 30 98 222 Sysmiss Health insurance for outpatient/inpatient needs - Askes Health insurance for outpatient/inpatient needs - Askes Health insurance for outpatient/inpatient needs - Askes Health insurance for outpatient/inpatient needs - Askes Health insurance for outpatient/inpatient needs - Askes Is there any health insurance/financing for outpatient/inpatient needs as follows: a. Askes Fill in code 1 for “Yes” or code 2 for “No” into the provided boxes. 266195 1354 1 2 1.936 1 Yes 2 No Sysmiss Health Insurance for Civil Servant/Veteran/Pensioneris healthcare insurance for Civil Servant,Veteran and Pensioner,proven by membership card that is managed by PT Askes (Persero). Health insurance for outpatient/inpatient needs - Askes/Jamsostek Health insurance for outpatient/inpatient needs - Askes/Jamsostek Health insurance for outpatient/inpatient needs - Askes/Jamsostek Health insurance for outpatient/inpatient needs - Askes/Jamsostek Health insurance for outpatient/inpatient needs - Askes/Jamsostek Is there any health insurance/financing for outpatient/inpatient needs as follows: b. Askes/Jamsostek Fill in code 1 for “Yes” or code 2 for “No” into the provided boxes. 266195 1354 1 2 1.974 1 Yes 2 No Sysmiss Jamsostek is healthcare insurance for employee of private company in formal sector,proven by membership card that is managed by PT Jamsostek. Health financing for outpatient/inpatient needs - Office/company Health financing for outpatient/inpatient needs - Office/company Health financing for outpatient/inpatient needs - Office/company Health financing for outpatient/inpatient needs - Office/company Health financing for outpatient/inpatient needs - Office/company Is there any health insurance/financing for outpatient/inpatient needs as follows: c. Office/company Fill in code 1 for “Yes” or code 2 for “No” into the provided boxes. 266195 1354 1 2 1.977 1 Yes 2 No Sysmiss Private health insurance is commercial medical insurance to replace the expenses of health services spent by the policy holders. The membership is proven by medical insurance card. Health insurance for outpatient/inpatient needs - JPKM (Public Health Service Assurance) Health insurance for outpatient/inpatient needs - JPKM (Public Health Service Assurance) Health insurance for outpatient/inpatient needs - JPKM (Public Health Service Assurance) Health insurance for outpatient/inpatient needs - JPKM (Public Health Service Assurance) Health insurance for outpatient/inpatient needs - JPKM (Public Health Service Assurance) Is there any health insurance/financing for outpatient/inpatient needs as follows: d. JPKM (Public Health Service Assurance) Fill in code 1 for “Yes” or code 2 for “No” into the provided boxes. 266195 1354 1 2 1.992 1 Yes 2 No Sysmiss Benefit/reimbursement by company is healthcare benefit that is proven by identity card as an employee of the company that will provide health benefit/reimbursement of the medical expenses. Health insurance for outpatient/inpatient needs - Commercial health insurance Health insurance for outpatient/inpatient needs - Commercial health insurance Health insurance for outpatient/inpatient needs - Commercial health insurance Health insurance for outpatient/inpatient needs - Commercial health insurance Health insurance for outpatient/inpatient needs - Commercial health insurance Is there any health insurance/financing for outpatient/inpatient needs as follows: e. Commercial health insurance Fill in code 1 for “Yes” or code 2 for “No” into the provided boxes. 266195 1354 1 2 1.996 1 Yes 2 No Sysmiss Health insurance/health card/poor insurance/poor card is a health security for poor people that is proven by a membership card of JPK-MM,health card,poor card,JPK Gakin card or SKTM (Letter of Poverty) or Jamkesmas card. Health financing for outpatient/inpatient needs - Dana sehat (health fund) Health financing for outpatient/inpatient needs - Dana sehat (health fund) Health financing for outpatient/inpatient needs - Dana sehat (health fund) Health financing for outpatient/inpatient needs - Dana sehat (health fund) Health financing for outpatient/inpatient needs - Dana sehat (health fund) Is there any health insurance/financing for outpatient/inpatient needs as follows: f. Dana sehat (health fund) Fill in code 1 for “Yes” or code 2 for “No” into the provided boxes. 266195 1354 1 2 1.907 1 Yes 2 No Sysmiss Health fund is membership of healthcare for a group/community that is proven by the membership card of health fund. Health insurance for outpatient/inpatient needs - Kartu sehat (health/poor card) Health insurance for outpatient/inpatient needs - Kartu sehat (health/poor card) Health insurance for outpatient/inpatient needs - Kartu sehat (health/poor card) Health insurance for outpatient/inpatient needs - Kartu sehat (health/poor card) Health insurance for outpatient/inpatient needs - Kartu sehat (health/poor card) Is there any health insurance/financing for outpatient/inpatient needs as follows: g. Kartu sehat (health/poor card) Fill in code 1 for “Yes” or code 2 for “No” into the provided boxes. 266195 1354 1 2 1.977 1 Yes 2 No Sysmiss Other health insurance are other healthcare and medical securities that can be proven by ownership of membership cards for the above healthcare services. Age of child : (months) Age of child : (months) Age of child : (months) Age of child : (months) Age of child : (months) Age of child : (months) If the toddler is 1 month old or more (b5r11a not equal to 00), continue to b5r12. Fill in the toddler's age in months, if the age is >= 1 month in the space provided and directly move it to the box provided Child age 0-59 months 265438 2111 59 2.844 Age of child : (days) Age of child : (days) Age of child : (days) Age of child : (days) Age of child : (days) If b5r11a = 00 Age of child : (days) Fill in the toddler's age in days, if the toddler is < 1 month old in the space provided and directly move it to the box provided. Child age 0-59 months 265399 2150 30 0.0144 Has birth certificate (not birth statement), can I see it? Has birth certificate (not birth statement), can I see it? Has birth certificate (not birth statement), can I see it? Has birth certificate (not birth statement), can I see it? Has birth certificate (not birth statement), can I see it? Has birth certificate (not birth statement), can I see it? If the answer is coded 1 or 2, skip to b5r14. Fill in the answer code to the box. Child age 0-59 months 265438 2111 9 0.233 1 Yes, can be shown 2 No, cannot be shown 3 Do not have 9 Do not know Sysmiss Birth certificate is a letter of birth proof issued by Civil Registry Office, either in the country or overseas. 1. Yes, it can be shown if the birth certificate can be shown to the officer 2. Yes, but it can't be shown if the birth certificate can't be shown to the officer 3. Do not have - self explanatory Main reason of do not have/do not know Main reason of do not have/do not know Main reason of do not have/do not know Main reason of do not have/do not know Main reason of do not have/do not know If do not have/do not know (b5r12 = 3 or 9) If do not have/do not know (R.12 = 3 or 9), why? Do not read out the answer. Circle one of the codes and enter the number into the box provided. Child age 0-59 months 265404 2145 99 1.33 1 Expensive/no fund 2 Far traveling distance 3 Expensive and Far traveling distance 4 Do not know about birth certificate recording 5 Expensive and Do not know about birth certificate recording 6 Far traveling distance and Do not know about birth certificate recording 7 Expensive, Far traveling distance and Do not know about birth certificate recording 8 Do not know the processing procedure 9 Expensive and Do not know the processing procedure 10 Far traveling distance and Do not know the processing procedure 11 Expensive, Far traveling distance and Do not know the processing procedure 12 Do not know about birth certificate recording and Do not know the processing procedure 13 Expensive, Do not know about birth certificate recording and Do not know the processing procedure 14 Far traveling distance, Do not know about birth certificate recording and Do not know the processing procedure 15 Expensive, Far traveling distance, Do not know about birth certificate recording and Do not know the processing procedure 16 Do not see the need 17 Expensive and Do not see the need 18 Far traveling distance and Do not see the need 19 Expensive, Far traveling distance and Do not see the need 20 Do not know about birth certificate recording and Do not see the need 21 Expensive, Do not know about birth certificate recording and Do not see the need 22 Far traveling distance, Do not know about birth certificate recording and Do not see the need 23 Expensive, Far traveling distance, Do not know about birth certificate recording and Do not see the need 24 Do not know the processing procedure and Do not see the need 25 Expensive, Do not know the processing procedure and Do not see the need 26 Far traveling distance, Do not know the processing procedure and Do not see the need 27 Expensive, Far traveling distance, Do not know the processing procedure and Do not see the need 28 Do not know about birth certificate recording, Do not know the processing procedure and Do not see the need 29 Expensive, Do not know about birth certificate recording, Do not know the processing procedure and Do not see the need 30 Far traveling distance, Do not know about birth certificate recording, Do not know the processing procedure and Do not see the need 31 Expensive, Far traveling distance, Do not know about birth certificate recording, Do not know the processing procedure and Do not see the need 32 Other 33 Expensive and Other 34 Far traveling distance and Other 35 Expensive, Far traveling distance and Other 36 Do not know about birth certificate recording and Other 37 Expensive, Do not know about birth certificate recording and Other 38 Far traveling distance, Do not know about birth certificate recording and Other 39 Expensive, Far traveling distance, Do not know about birth certificate recording and Other 40 Do not know the processing procedure and Other 41 Expensive, Do not know the processing procedure and Other 42 Far traveling distance, Do not know the processing procedure and Other 43 Expensive, Far traveling distance, Do not know the processing procedure and Other 44 Do not know about birth certificate recording, Do not know the processing procedure and Other 45 Expensive, Do not know about birth certificate recording, Do not know the processing procedure and Other 46 Far traveling distance, Do not know about birth certificate recording, Do not know the processing procedure and Other 47 Expensive, Far traveling distance, Do not know about birth certificate recording, Do not know the processing procedure and Other 48 Do not see the need and Other 49 Expensive, Do not see the need and Other 50 Far traveling distance, Do not see the need and Other 51 Expensive, Far traveling distance, Do not see the need and Other 99 Do not know Who assisted the first birth process? Who assisted the first birth process? Who assisted the first birth process? Who assisted the first birth process? Who assisted the first birth process? Who assisted the first birth process? Fill in the box a for the helper for the first born . Child age 0-59 months 265438 2111 9 0.257 1 Doctor 2 Midwife 3 Other paramedic 4 Healer 5 Family 6 Other 9 Sysmiss The birth process is the process of birth of a fetus from the mother’s womb to the world,starting with birth symptoms (periodic stomach ache that gets more often,longer and stronger,contraction of womb,water-broke mixed with mucus and blood from vagina, water-broke of yellowish clear color from vagina,and the feeling of defecation before the baby is finally delivered),infant delivered,cutting the placenta cord and the release of placenta.In birth a process,a woman might be help by more than one type of helper(such as traditional midwife and a nurse). Birth is a process when the fetus is delivered at the age of more than 5 months (22 weeks);if the fetus’s age is less than 5 months,it is called an abortion. Who assisted the last birth process? Who assisted the last birth process? Who assisted the last birth process? Who assisted the last birth process? Who assisted the last birth process? Who assisted the last birth process? Fill in box b for the helper for the last born . Child age 0-59 months 265438 2111 9 0.241 1 Doctor 2 Midwife 3 Other paramedic 4 Healer 5 Family 6 Other 9 Sysmiss The birth process is the process of birth of a fetus from the mother’s womb to the world,starting with birth symptoms (periodic stomach ache that gets more often,longer and stronger,contraction of womb,water-broke mixed with mucus and blood from vagina, water-broke of yellowish clear color from vagina,and the feeling of defecation before the baby is finally delivered),infant delivered,cutting the placenta cord and the release of placenta.In birth a process,a woman might be help by more than one type of helper(such as traditional midwife and a nurse). Birth is a process when the fetus is delivered at the age of more than 5 months (22 weeks);if the fetus’s age is less than 5 months,it is called an abortion. Frequency immunization - BCG Frequency immunization - BCG Frequency immunization - BCG Frequency immunization - BCG Frequency immunization - BCG How many times the child received immunization? a. BCG Enter how many times a child has been given immunization according to the mother's answer, and enter the code into the boxes provided. If the answer is never, enter a zero and if she does not know, enter a nine. Child age 0-59 months 265438 2111 9 0.0985 1 2 3 4 5 6 7 9 Sysmiss 1. Immunization or vaccination is inserting certain attenuated germs or toxins(vaccine) into human body by means of injecting or drinking(dropping into mouth) in order to increase body immunity against the disease. 2. BCG (Bacillus Calmette Guerin) is a vaccination to prevent Tuberculosis/TBC, given to a new born baby or a toddler by injection on the base of the upper arm. BCG injection is given one time. Frequency immunization - DPT Frequency immunization - DPT Frequency immunization - DPT Frequency immunization - DPT Frequency immunization - DPT How many times the child received immunization? b. DPT Enter how many times a child has been given immunization according to the mother's answer, and enter the code into the boxes provided. If the answer is never, enter a zero and if she does not know, enter a nine. Child age 0-59 months 265438 2111 9 0.178 1 2 3 4 5 6 7 9 Sysmiss 1. Immunization or vaccination is inserting certain attenuated germs or toxins(vaccine) into human body by means of injecting or drinking(dropping into mouth) in order to increase body immunity against the disease. 2. DPT (Diphteria ,Pertussis, Tetanus) is given to a baby aged 3 months or older, by injecting it on the thigh and should be repeated after 1 month and then again after 2 months. Thus, a complete DPT Immunization on toddlers are done 3 times (sometimes time lapse between injections can be more than one month). Frequency immunization - Polio Frequency immunization - Polio Frequency immunization - Polio Frequency immunization - Polio Frequency immunization - Polio How many times the child received immunization? c. Polio Enter how many times a child has been given immunization according to the mother's answer, and enter the code into the boxes provided. If the answer is never, enter a zero and if she does not know, enter a nine. Child age 0-59 months 265438 2111 9 0.192 1 2 3 4 5 6 7 9 Sysmiss 1. Immunization or vaccination is inserting certain attenuated germs or toxins(vaccine) into human body by means of injecting or drinking(dropping into mouth) in order to increase body immunity against the disease. 2. Polio is a vaccine to prevent polio virus, given to a baby at the age 3 months or older by giving 3 drops of liquid vaccine in a pink or white color directly into the baby's mouth; usually given together with DPT vaccination. A complete Polio immunization is given 3 times. In National Immunization Week (PIN), polio immunization are given specifically for all toddlers in Indonesia at the same week (in certain regions are at the same month or day) in accordance to the given schedule. Frequency immunization - Measles Frequency immunization - Measles Frequency immunization - Measles Frequency immunization - Measles Frequency immunization - Measles How many times the child received immunization? d. Measles Enter how many times a child has been given immunization according to the mother's answer, and enter the code into the boxes provided. If the answer is never, enter a zero and if she does not know, enter a nine. Child age 0-59 months 265438 2111 9 0.0842 1 2 3 4 5 6 7 9 Sysmiss 1. Immunization or vaccination is inserting certain attenuated germs or toxins(vaccine) into human body by means of injecting or drinking(dropping into mouth) in order to increase body immunity against the disease. 2. Measles/morbilli is a vaccine to prevent measles/morbilli; (please state the symptoms and epidemic area of measles if the mother seems not understand), that is usually given one time to a baby aged between 9 to 12 months, by injecting on the thigh. Frequency immunization - Hepatitis B Frequency immunization - Hepatitis B Frequency immunization - Hepatitis B Frequency immunization - Hepatitis B Frequency immunization - Hepatitis B How many times the child received immunization? e. Hepatitis B Enter how many times a child has been given immunization according to the mother's answer, and enter the code into the boxes provided. If the answer is never, enter a zero and if she does not know, enter a nine. Child age 0-59 months 265438 2111 9 0.136 1 2 3 4 5 6 9 Sysmiss 1. Immunization or vaccination is inserting certain attenuated germs or toxins(vaccine) into human body by means of injecting or drinking(dropping into mouth) in order to increase body immunity against the disease. 2. Hepatitis B is an intramuscular injection (injection to the mucsle), usually on the thigh, given to baby to prevent Hepatitis B. This injection is given 3 times. The first injection given when the baby is 0 month old, the second is given at the age of 1 month, and the third is at the age of 6 months. Ever provided with breast milk? Ever provided with breast milk? Ever provided with breast milk? Ever provided with breast milk? Ever provided with breast milk? Ever provided with breast milk? If the entry is coded 2, skip to question other household member. Circle code 1 for “Yes” and code 2 for “No” and write down in the provided box. Child age 0-59 months 265438 2111 2 0.1 1 Yes 2 No Sysmiss Breastfeeding is if a mother’s nipple sucked by a baby secreting milk that is drunk by the baby,although only a little. A breastfeeding mother is not only the biological mother of the baby but she could be another woman. Breast milk(ASI) is the best natural food for baby,which composition meets the full requirement of a baby up to 6 months old.ASI contains elements that provides protection against various diseases and also enzyme that help baby’s digestive system. Breastfeeding with affection can also strengthen the bond between a mother and her baby. Period of provided with breast milk: Period of provided with breast milk: Period of provided with breast milk: Period of provided with breast milk: Period of provided with breast milk: If “yes” [b5r16a = 1] Period of provided with breast milk: Record the answer of duration in the box available in month by completing below. Child age 0-59 months 265435 2114 59 1.483 Period - Breast milk exclusive: Period - Breast milk exclusive: Period - Breast milk exclusive: Period - Breast milk exclusive: Period - Breast milk exclusive: If “yes” [b5r16a = 1] Period - Breast milk exclusive: Fill in days if age < 1 month and in months if age is >= 1 month Child age 0-59 months 265435 2114 48 0.332 If age less than 7 months, is only provided with breast milk only for the last 24 hours? If age less than 7 months, is only provided with breast milk only for the last 24 hours? If age less than 7 months, is only provided with breast milk only for the last 24 hours? If age less than 7 months, is only provided with breast milk only for the last 24 hours? If age less than 7 months, is only provided with breast milk only for the last 24 hours? Child age 0-59 months 265401 2148 2 0.0103 1 Yes 2 No Sysmiss Schooling participation: Schooling participation: Schooling participation: Schooling participation: Schooling participation: Schooling participation: 1. If the answer is coded 1, skip to b5r23, and 2. If the answer is coded 2, skip to b5r19 Circle one of the codes from 1 to 3 and enter the number into the box provided. For household member age five years up 266156 1393 3 2.301 1 No/never in school 2 Still in school 3 No longer in school Sysmiss A person is considered schooling if he is registered and active in attending a study process in formal education level,whether under supervision of Ministry of National Education/Depdiknas or other department/institution. 1. Not/not yet attending school - never or not yet been registered and never been active in attending school or at formal education level, including have completed/not completed kindergarten level but do not continue to elementary school. 2. Still attending school - are those who are registered and actively attending a formal education level, whether it is under supervision of Ministry of National Education, Ministry of Religion, other Government Institution, or Private Institution. 3. No longer in school - those who were once registered and actively attending a formal education, but at the time of census are not registered and active anymore, including those who are attending Package A program of SD (Elementary) equivalent, Package B program of SMP (Junior High) equivalent and Package C Program of SMA (Senior High) equivalent. When did you quit school? (Month) When did you quit school? (Month) When did you quit school? (Month) When did you quit school? (Month) When did you quit school? (Month) When did you quit school? (Month) Fill in the month for people who quit prior to 1993, write down completely in the empty space and provided box. If quit prior to 1993, enter 00 into the month boxes. For household member age five years up 265858 1691 12 0.869 1 2 3 4 5 6 7 8 9 10 11 12 Sysmiss When did you quit school? (Year) When did you quit school? (Year) When did you quit school? (Year) When did you quit school? (Year) When did you quit school? (Year) When did you quit school? (Year) Fill in the year for people who quit prior to 1993, write down completely in the empty space and provided box. If quit prior to 1993, enter 0000 into year boxes. For household member age five years up 265858 1691 2004 284.133 The highest education type and level currently studied/passed: The highest education type and level currently studied/passed: The highest education type and level currently studied/passed: The highest education type and level currently studied/passed: The highest education type and level currently studied/passed: The highest education type and level currently studied/passed: Circle one of code 1 to 14 and fill it in the provided box. For household member age five years up 266122 1427 11 2.33 1 Elementary school 2 M. Ibtidaiyah 3 Public/vocationaljunior high 4 M. Tsanawiyah 5 Senior High 6 M. Aliyah (Islamic school) 7 Vocational School 8 Diploma I/II 9 Diploma III 10 Diploma IV/S1 11 S2/S3 Sysmiss 1. SD/SDLB is an Elementary School of 5/6/7 years or equivalent(elementary special school,small elementary school,pamong elementary school). 2. Madrasah Ibtidaiyah(MI) is Islamic Elementary School of SD equivalent. 3. SMP/SMPLB is Secondary School or the equivalent MULO,3-year HBS,and Secondary Special School). 4. Madrasah Tsanawiyah(MTs) is Islamic Secondary School of SMP equivalent . 5. General High School(SMU)/Special High School(SMLB) is a High School(SMU),or the equivalent(Special High School,5-year HBS,AMS,and Employee Administration High Course(KPAA). 6. Madrasah Aliyah(MA) is an Islamic High School of SMU equivalent. 7. Vocational High School(SMK) is a vocational school of SMA equivalent. 8. Diploma 1/2 Program is D1/D2 program in a university that organizes diploma 1 and 2 program in formal education. 9. Diploma 3 Program/baccalaureate is a D3 program or baccalaureate degree in an academy or university that organizes diploma programs or issues baccalaureate degrees. 10. Diploma 4 Program/bachelor is an education program of Diploma 4 or Strata1 in a university. 11. S2/S3 is a postgraduate education program(master or doctorate),Strata 2 or Strata 3 in a university. Education provider: Education provider: Education provider: Education provider: Education provider: For household member age five years up 266122 1427 3 0.991 1 State 2 Private 3 Overseas Sysmiss Highest class/level studied/currently studied: Highest class/level studied/currently studied: Highest class/level studied/currently studied: Highest class/level studied/currently studied: Highest class/level studied/currently studied: Highest class/level studied/currently studied: Circle one of the following codes from 1 to 8 and enter the code into the box provided. For household member age five years up 266122 1427 8 4.676 1 Grade-1 2 Grade-2 3 Grade-3 4 Grade-4 5 Grade-5 6 Grade-6 7 Grade-7 8 Graduated Sysmiss Examples: Highest Level/Class Attended/Being Attended a.For household head/member who has graduated,use code 8 for the highest level/class has been/being attended. b.For household head/member who has a bachelor degree attending/has attended master/S2 program,use code 6. c.For household head/member who has a master degree attending/has attended S3 program,use code 7. d.For household head/member who has attended/is stillatending the highest level/class of S1 program,use code 5. Graduated means has completed the study marked with passing the final exams in the last class/level of an education in a public or private school and received a certificate/diploma. A household head/member who has not attended the last level of education program but has passed the final exams is considered graduate. Highest diploma obtained: Highest diploma obtained: Highest diploma obtained: Highest diploma obtained: Highest diploma obtained: Highest diploma obtained: Circle one of the codes from 1 to 15 and enter the answer into the box provided. For household member age five years up 266122 1427 9 2.01 1 No elementary diploma 2 Elementary/MI 3 Junior High/equal 4 Senior High/equal 5 Vocational junior high 6 Diploma I/II 7 Diploma III 8 Diploma IV/S1 9 S2/S3 Sysmiss No elementary school diploma means that the household/member does not possessed certificate for a certain educational level, but has to attended to Elementary School of 5/6/7 year study or equivalent(among others are basic level of SLB,Madrasah Ibtidaiyah,Pamong Elementary School,Smal Elementary School,Package A1-A100,Package a Equivalent) but did not/has not yet graduate.This include household/member who graduated 3-year elementary school or equivalent. Can read and write: Can read and write: Can read and write: Can read and write: Can read and write: Can read and write: Circle one of the code 1 to code 4 and enter the answer into the provided box. For household member age five years up 266156 1393 3 1.125 1 Latin alphabets 2 Other alphabets 3 Cannot Sysmiss Can read and write means able to read and write words/simple sentences in certain letters, e.g. "I must be honest." Activities in past one week - work Activities in past one week - work Activities in past one week - work Activities in past one week - work Activities in past one week - work Did you perform the following activity in the past one week? a. work Circle code 1 for "Yes" or code 2 for "No", and enter in the boxes provided. For household member age 10 years up 266110 1439 2 1.193 1 Yes 2 No Sysmiss Working is an activity of doing work with the intention to earn or help earning a living or profit,minimum for one hour in the last one week. Working for one hour as mentioned above should be done continuously and uninterrupted. Income includes wages/salary,including all the benefits and bonus for worker/employee and business income in the form of rents or profits,whether in cash or goods for businessmen. Activities in past one week - attending school Activities in past one week - attending school Activities in past one week - attending school Activities in past one week - attending school Activities in past one week - attending school Did you perform the following activity in the past one week? b. attending school Circle code 1 for "Yes" or code 2 for "No", and enter in the boxes provided. For household member age 10 years up 266110 1439 2 1.447 1 Yes 2 No Sysmiss Going to school is an activity at a formal school,whether in primary,secondary,or higher education.Students on leave are not included. Activities in past one week - handling household Activities in past one week - handling household Activities in past one week - handling household Activities in past one week - handling household Activities in past one week - handling household Did you perform the following activity in the past one week? c. handling household Circle code 1 for "Yes" or code 2 for "No", and enter in the boxes provided. For household member age 10 years up 266110 1439 2 1.258 1 Yes 2 No Sysmiss Handling household is an activities of managing the household or helping to manage the household without getting paid. Activities in past one week - other beside personal activity Activities in past one week - other beside personal activity Activities in past one week - other beside personal activity Activities in past one week - other beside personal activity Activities in past one week - other beside personal activity Did you perform the following activity in the past one week? d. other beside personal activity Circle code 1 for "Yes" or code 2 for "No", and enter in the boxes provided. For household member age 10 years up 266110 1439 1 0.801 1 Yes 2 No Sysmiss Other activities include: sports, course, picnic and social activities (organization, volunteering) Others are activities other than working,going to school and managing household. Included in this category are people who cannot do activities such as senior citizens,disabled and people who receive pension and do not work anymore. What activity used the most time in the past one week? What activity used the most time in the past one week? What activity used the most time in the past one week? What activity used the most time in the past one week? What activity used the most time in the past one week? If b5r24a1- 4 with code 1 (“Yes”) What activity used the most time in the past one week? If b5r24a1 is coded 1, skip to b5r26. B5r24a with code 1 (“Yes”) – ask what activity is the most time consuming in the last one week, circle one of the codes and enter the number into the box provided. For household member age 10 years up 266110 1439 4 1.599 1 Work 2 School 3 Handling Household 4 Other Sysmiss The most time consuming activity is an activity that uses up most time in comparison with other activities. Do you have work/business, but temporarily not working for the past one week? Do you have work/business, but temporarily not working for the past one week? Do you have work/business, but temporarily not working for the past one week? Do you have work/business, but temporarily not working for the past one week? Do you have work/business, but temporarily not working for the past one week? Do you have work/business, but temporarily not working for the past one week? Circle code 1 for “Yes” or code 2 for “No”, then enter the answer into the provided box. For household member age 10 years up 265756 1793 2 0.77 1 Yes 2 No Sysmiss Those who are categorized as have jobs but temporarily do not work are: 1.Professional workers who do not work because of sickness waiting for the next projects.Examples: Puppet master,masseur/se,shaman and singer. 2.Regular employees,government officials or employees of private companies who are ill,on leave,absent,on strike or temporarily laid off because the company stopped operating,for example a factory having machine malfunction,or lack of raw material,etc. 3.Farmer who works on farm land,stops working because of an illness or waiting for the next job such as harvest or rainy season to start planting paddy field. Those who are categorized as having jobs but temporarily do not work are people who work/have businesses but for the last one week stop working for a reason,such as sick,on leave,waiting for harvesting,or on a strike. Are you looking for work? Are you looking for work? Are you looking for work? Are you looking for work? Are you looking for work? For household member age 10 years up 266110 1439 2 1.544 1 Yes 2 No Sysmiss Are you preparing a business during the past one week? Are you preparing a business during the past one week? Are you preparing a business during the past one week? Are you preparing a business during the past one week? Are you preparing a business during the past one week? For household member age 10 years up 266110 1439 2 1.592 1 Yes 2 No Sysmiss Main reason of not looking for work/preparing business: Main reason of not looking for work/preparing business: Main reason of not looking for work/preparing business: Main reason of not looking for work/preparing business: Main reason of not looking for work/preparing business: If b5r26 = 2 and b5r27 = 2 For household member age 10 years up 266056 1493 5 2.368 1 Feel unable to obtain work 2 Have work, but not yet started 3 In school or handling household/family 4 Have work/business, feel sufficient 5 Other (disabled, old, and the like) Sysmiss If there is a job offer, will you accept it? If there is a job offer, will you accept it? If there is a job offer, will you accept it? If there is a job offer, will you accept it? If there is a job offer, will you accept it? If b5r26 = 2 and b5r27 = 2 For household member age 10 years up 266056 1493 2 1.286 1 2 Sysmiss Total work day: (days) Total work day: (days) Total work day: (days) Total work day: (days) Total work day: (days) Total work day: (days) Write down the total working days for the last one week according to the number of days spent for work and enter it in the box provided. For working household member 265756 1793 7 2.463 1 2 3 4 5 6 7 Sysmiss Working days means days spent by a person to carry out working activities at a minimum of one (1) hour continuously in the last one week. Total work hour from all jobs in the past one week: (hours) Total work hour from all jobs in the past one week: (hours) Total work hour from all jobs in the past one week: (hours) Total work hour from all jobs in the past one week: (hours) Total work hour from all jobs in the past one week: (hours) Total work hour from all jobs in the past one week: (hours) Write down the total working hours in the last one week and enter it in the box provided. For working household member 265756 1793 98 16.21 Total working hours is the time (in hour) spent to do all the working activities in the last one week. If respondent is temporary out of work, write down "00" Main business/job from workplace in the past one week: Main business/job from workplace in the past one week: Main business/job from workplace in the past one week: Main business/job from workplace in the past one week: Main business/job from workplace in the past one week: Main business/job from workplace in the past one week: Write down completely the main business/job from workplace in the empty space provided. For working household member 265756 1793 972 122.971 1 5 7 9 10 11 12 13 14 15 19 20 21 22 23 30 41 42 50 51 52 54 55 56 61 70 73 75 81 84 85 90 98 100 101 102 108 110 111 112 113 114 120 122 123 131 132 133 134 141 142 144 145 150 151 152 153 154 155 157 160 162 163 164 166 170 171 172 173 174 176 180 181 182 183 184 187 188 189 190 191 192 200 201 202 204 209 210 212 215 221 222 223 231 232 233 241 242 243 248 250 251 252 253 256 260 261 262 263 264 265 266 269 271 272 273 275 281 282 289 291 292 293 300 302 303 310 311 312 313 314 315 319 321 322 323 325 331 332 333 341 342 343 345 350 351 352 353 354 359 360 361 363 365 368 369 371 372 390 391 399 401 402 403 404 410 413 416 421 422 423 424 425 429 430 432 434 436 445 450 451 452 453 454 455 456 459 462 463 470 475 484 490 491 492 500 501 502 503 504 505 507 509 510 511 512 513 514 515 516 518 519 520 521 522 523 524 525 526 527 528 529 530 531 532 533 534 535 539 540 541 542 543 544 545 549 550 551 552 553 554 557 561 563 564 566 570 571 572 575 582 589 600 601 602 603 604 605 606 607 608 611 612 621 622 623 624 625 626 629 630 631 632 633 634 635 636 639 641 642 643 645 648 650 651 654 655 659 660 662 671 672 674 682 701 702 703 711 712 713 714 715 716 717 721 722 723 724 725 729 731 732 735 739 741 742 743 744 747 749 750 751 752 753 755 756 757 769 771 781 791 795 800 801 802 803 804 806 807 809 810 812 820 825 830 831 835 842 850 851 852 853 854 856 859 893 900 901 902 905 909 911 912 919 921 922 923 924 925 927 930 931 932 936 940 941 949 950 951 952 956 957 958 959 960 965 970 971 972 Sysmiss Business sector/type of work is the sector of activity of work/company/business where the household head/member works. How to determine the main work: 1.If a household head/member in the last one week only has only one work,than it is considered the main work. 2.If a household head/member in the last one week has more than one work,the main work is the one that consumes the most time. If the time spent to do those works are the same,than the work that produces the largest income is considered the main work. Type of work/position of the main job in the past one week: Type of work/position of the main job in the past one week: Type of work/position of the main job in the past one week: Type of work/position of the main job in the past one week: Type of work/position of the main job in the past one week: Write down completely type of work/position of the main job in the empty space provided. For working household member 265756 1793 999 258.26 Position/status of the main job in the past one week: Position/status of the main job in the past one week: Position/status of the main job in the past one week: Position/status of the main job in the past one week: Position/status of the main job in the past one week: Position/status of the main job in the past one week: 1. If the answer is coded 1,2,3,5,6, or 7 skip to Block V.E., and 2. If the answer is coded 4 skip to b5r34. Circle one of the code 1 to code 7 and enter the answer into the provided box. For working household member 265756 1793 7 1.505 1 Self-owned business/freelance 2 Self-owned business with non-permanent/non-paid worker 3 Self-owned business with permanent/paid worker 4 Worker/employee/staff 5 Freelancer in agricultural sector 6 Freelancer in non-agricultural sector 7 Non-paid worker Sysmiss Status/work position is the household head/member position at main job. 1. Self-owned business/freelance is a household head/member who works/owns business by taking economical risk, that may result in the lost of production cost that has been spent in doing the business, and does not employ any worker whether paid or unpaid. Included in this category are works that required special skill/talent. 2. Self-owned business with non-permanent/non-paid worker is a household head/member who works or owns a business on his own risk, and hires unpaid labor/employee/staff and or employs fee labor/employee/staff. 3. Self-owned business with permanent/paid worker is a household head/member who opens a business at his own risk and employs at lease one paid labor/employee/staff. 4. Worker/employee/staff is a household head/member whow works for other people or institutions/ office/company and regularly receives wages/salaries in the form of money or goods (in-kind) 5. Freelancer is a household head/member who works irregularly for other people/employer/institution, who has more than one employer in the last one month in a household business or non-household business based on a reward system by receiving wages or compensation both in the form of money or in-kind, whether paid daily or per project. 6. Non-paid worker is a household member who works to help household head/member/other people without getting paid, whether in the form of money or goods. The amount of net wage/salary (money and goods) generally received in a month from the main job - rupiah The amount of net wage/salary (money and goods) generally received in a month from the main job - rupiah The amount of net wage/salary (money and goods) generally received in a month from the main job - rupiah The amount of net wage/salary (money and goods) generally received in a month from the main job - rupiah The amount of net wage/salary (money and goods) generally received in a month from the main job - rupiah The amount of net wage/salary (money and goods) generally received in a month from the main job - rupiah Write down the income in the space provided and enter into the box provided. For working household member 256078 11471 999500 48342.812 First marriage at age: (Years) First marriage at age: (Years) First marriage at age: (Years) First marriage at age: (Years) First marriage at age: (Years) First marriage at age: (Years) Fill in respondent’s age at first marriage in the provided space and write it down in the box. The formula to calculate the respondent's age at first marriage is the same as the formula to count respondent's age. For women age 10 years and up - women who once married 265577 1972 60 5.379 Number of years in marriage: (years) Number of years in marriage: (years) Number of years in marriage: (years) Number of years in marriage: (years) Number of years in marriage: (years) Number of years in marriage: (years) Ask how long the respondent has been married. If there were more than one marriage, please add the number of years of the entire wedlocks made. Rounded it down. For those who got pregnant out of wedlock enter code "00". For women age 10 years and up - women who once married 265577 1972 82 5.476 Ever use/wear family planning tool/device/method? Ever use/wear family planning tool/device/method? Ever use/wear family planning tool/device/method? Ever use/wear family planning tool/device/method? Ever use/wear family planning tool/device/method? If the answer is coded 2 skip to other household member. For women age 10 years and up - women who once married 265577 1972 2 0.391 1 Yes 2 No Sysmiss The use/wearing of family planning device/method? The use/wearing of family planning device/method? The use/wearing of family planning device/method? The use/wearing of family planning device/method? The use/wearing of family planning device/method? The use/wearing of family planning device/method? If the answer is no longer use it or never use it , skip to other household member Circle the contraception/birth control (KB) code according to the respondent’s answer, enter it in the box provided. If using more than one type of contraception, please record only the type currently used. Generally,the reference time for various birth controls used is 30 days. For women age 10 years and up - Women with married status 265507 2042 2 0.192 1 Yes 2 No Sysmiss The selected family planning device/method: The selected family planning device/method: The selected family planning device/method: The selected family planning device/method: The selected family planning device/method: The selected family planning device/method: Continue to other household member. If respondent uses more than one type of contraception (to meet the concept of contraception usage), then write down the type with the smallest code number. For women age 10 years and up - Women with married status 265474 2075 9 0.487 1 Women/tubectomy 2 Men/vasectomy 3 IUD/spiral 4 Injection 5 Implant/norplant 6 Birth control pill 7 Condom/rubber 8 Intravag/tissue/women condom 9 Traditional method Sysmiss 1. MOW/Medis Operasi Wanita (woman medical surgery)/tubectomy (woman sterilization) is a surgery performed on female household head/member by having her fallopian tubes closed to prevent pregnancy. Please emphasize that the goal is to prevent future pregnancies. 2. MOP/Medis Operasi Pria (man medical surgery)/vasectomy (man sterilization) is a minor surgery performed on male household head/member to prevent his spouse from being pregnant. 3. AKDR/Alat Kontrasepsi Dalam Rahim (IUD/Intra Uterus Device) is a device made of soft plastic/copper,small in size,in the forms of spiral,T,fan,etc. installed inside the womb/uterus to prevent pregnancy. This device functions as pregnancy prevention for a long period of time. 4. KB Injection is one of ways to prevent pregnancy by injecting contraceptive substance periodically,e.g. once in one,three,or six months. 5. Susuk KB/norplant/implanon/alwalit (Contraceptive Skin Implant)-are six small metals to be implanted/injected under the skin of the upper arm to prevent pregnancy. A household head/member is considered using susuk KB if she had the implant less than five(5) years ago prior to the date of census. This includes under the skin injection(implant). 6. KB Pills are pills that are taken to prevent pregnancy. These pills should be taken regularly. 7. Condom/KB rubber is a device made of rubber,in a balloon-like shape,used by male household head/member while having sexual intercourse in order to prevent the spouse from getting pregnant. 8. Intravag/tissue/woman’s condom is a KB tissue positioned inside the vagina before having sexual intercourse. Reference time for this device is up to the last intercourse within 30 days before the interview. 9. Traditional method: a.Periodic abstinence/calendar method is based on the assumption that by not having sexual intercourse in a certain days of the month,which is during fertile period in monthly cycle,a woman could prevent pregnancy. b.Coitus interruptus is a method to prevent semen from entering vagina by interrupting intercourse before ejaculation. The refference time for this method is the last intercourse within 30 days. c.Other traditional methods such as breastfeeding for the purpose of birth control,abstinence,traditional herbs (jamu),and massage. Household member sequential No. Household member sequential No. Household member sequential No. Household member sequential No. Household member sequential No. 266195 1354 1 15 2.877 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Sysmiss Relation with the head of household Relation with the head of household Relation with the head of household Relation with the head of household Relation with the head of household Relation with the head of household Ask the relation of each household member to the head of household and enter the code accordingly into the boxes provided. 266195 1354 1 9 2.574 1 Head of household 2 Wife/husband 3 Child 4 In-law 5 Grandchild 6 Parent/in-law 7 Other family 8 Housemaid 9 Other Sysmiss 1. The head of household (krt) is a man in a group of household members who is responsible to provide the daily needs of the concerned households, or a person who is considerend/appointed to be the head of a household (for example a group of students live together in one room inside a census building; because they each are responsible for their own needs, one person is appointed as the household head). 2. Wife/husband, is the wife/husband of the head of household. 3. Children, includes biological children, stepchildren, and adopted children of the head of household. 4. Son/daughter in laws, are the husbands/wives of biological daughters/sons, step daughters/sons, or adopted daughters/sons. 5. Grandchildren, are the children of biological children, step children, or adopted children. 6. Parent in laws, are father/mother of the head of household or father/mother of the spouse of the head of household. 7. Other families, are those who have blood relation with head of the household or the spouse, such as siblings, aunties, uncles, grandparents. 8. Household helpers, are people who works as a helper and lives in the concerned household, receiving wage/salary in the form money or in-kind payment. 9. Other, are people who do not have familial relation to the head of household or the spouse, who live in the household for more than 6 months, such as visitors, friends or tenants who rent room plus food, including children of helpers who also live and eat in the employer's house. Gender Gender Gender Gender Gender Gender Write down the gender of each household member in the provided box, code 1 for “Male” and code 2 for “Female”. Do not guess people’s gender based on their names. To make sure, please ask if the person in question is a male or a female. 266195 1354 1 2 1.499 1 Male 2 Female Sysmiss Age (year) Age (year) Age (year) Age (year) Age (year) Age (year) Ask the respondent's age and enter the answer into the box. Age is measured in years rounded down or the age after the last birthday. Age calculation is based on Christian calendar. 266195 1354 98 27.787 Age is measured in years rounded down or the age after the last birthday. Age calculation is based on Christian calendar. Marital status Marital status Marital status Marital status Marital status Marital status Ask marital status of the respondent and enter the code into the box provided. 266195 1354 1 4 1.612 1 Not married 2 Married 3 Divorce 4 Divorce due to death Sysmiss 1. Married means having a wife (for male) or husband (for female) durint the census, whether living together or separately. In this case the people included in this status are those who are married legally (by the law of the tradition, religion, state, etc), and also those who live together and have been considered husband and wive by the local society. 2. Divorcee is a person who has been separated from wife/husband and has not remarried.In this case including a person who claims to be divorced although it is not legally confirmed yet. Perform “tour”* trip? (Oct 1 – Dec 31, 2003) Perform “tour”* trip? (Oct 1 – Dec 31, 2003) Perform “tour”* trip? (Oct 1 – Dec 31, 2003) Perform “tour”* trip? (Oct 1 – Dec 31, 2003) Perform “tour”* trip? (Oct 1 – Dec 31, 2003) Perform “tour”* trip? (Oct 1 – Dec 31, 2003) Fill in code 1 for “Yes” or code 2 for “No” into the provided boxes. 266195 1354 1 2 1.872 1 Yes 2 No Sysmiss “Tour” trip: trip to commercial tourist destinations, or stay in commercial accommodation, or trip distance = 100 Km (return). Travel frequency in the past 3 calendar months? Travel frequency in the past 3 calendar months? Travel frequency in the past 3 calendar months? Travel frequency in the past 3 calendar months? Travel frequency in the past 3 calendar months? Travel frequency in the past 3 calendar months? Fill in the travel frequency (times) for each household members who travel in the past 3 calendar months. Write down “00” if the related household member do not travel. 265635 1914 41 0.196 One time travel/journey is calculated since leaving home and return back to the initial place. Travel/journey that has not been completed (the person has not returned to the initial place), is not considered as traveling. Travelling household member: trip to commercial tourist destinations, or stay in commercial accommodation, and or trip distance = 100 Km (return), excluding commuter, school and work. Ever/ on pre-school education? Ever/ on pre-school education? Ever/ on pre-school education? Ever/ on pre-school education? Ever/ on pre-school education? Ever/ on pre-school education? Write down the appropriate code for family members aged 0-6 regarding their participation in pre-school education. Household member age 0-6 years 265432 2117 4 0.278 1 Yes, kindergarten/RA/RB 2 Yes, playgroup 3 Yes, daycare 4 No Sysmiss Yes, once , if they have attended pre-school education and at the moment has finished/completed/not active anymore. Yes, currently on, if at the moment the respondent is still actively attending a pre-school education. No, if the respondent never attended a pre-school education. Attended preschool education means enrolled in and actively attending education in kindergarten (TK)/Bustanul Athfal (BA), Raudatul Athfal (RA), play group, day-care center, Early Age Children Education (PAUD) and other institution. District Id District Id District Id District Id District Id 266195 1354 1101 9472 3946.766 Participant education: Participant education: Participant education: Participant education: Participant education: 265399 2150 5 3.297 1 2 3 4 5 Sysmiss Kr Kr Kr Kr Kr 265399 2150 5 1.703 1 2 3 4 5 Sysmiss Has birth certificate (not birth statement), can I see it? Has birth certificate (not birth statement), can I see it? Has birth certificate (not birth statement), can I see it? Has birth certificate (not birth statement), can I see it? Has birth certificate (not birth statement), can I see it? 265399 2150 2 1.117 1 2 Sysmiss How many times became outpatient in the past one month? How many times became outpatient in the past one month? How many times became outpatient in the past one month? How many times became outpatient in the past one month? How many times became outpatient in the past one month? 265399 2150 30 0.187 Main business/job from workplace in the past one week: Main business/job from workplace in the past one week: Main business/job from workplace in the past one week: Main business/job from workplace in the past one week: Main business/job from workplace in the past one week: 112317 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 18 Position/status of the main job in the past one week: Position/status of the main job in the past one week: Position/status of the main job in the past one week: Position/status of the main job in the past one week: Position/status of the main job in the past one week: 112317 01 02 03 04 05 06 07 08 09 10 11 When did you quit school? When did you quit school? When did you quit school? When did you quit school? When did you quit school? 265399 2150 Sysmiss Province Province Province Province Province Province Write down the name province in the space provided and add the related code referred to in the box provided. 21932 11 94 39.657 11 Nanggroe Aceh Darussalam 12 North Sumatera 13 West Sumatera 14 Riau 15 Jambi 16 South Sumatera 17 Bengkulu 18 Lampung 19 Bangka Belitung 21 Riau Island 31 DKI Jakarta 32 West Java 33 Central Java 34 DI Yogyakarta 35 East Java 36 Banten 51 Bali 52 West Nusa Tenggara 53 East Nusa Tenggara 61 West Kalimantan 62 Central Kalimantan 63 South Kalimantan 64 East Kalimantan 71 North Sulawesi 72 Central Sulawesi 73 South Sulawesi 74 Southeast Sulawesi 75 Gorontalo 76 West Sulawesi 81 Maluku 82 North Maluku 91 West Irian Jaya 94 Papua District/City District/City District/City District/City District/City District/City Cross out the unnecessary and the Write down the name of district/city in the space provided and add the related code referred to in the box provided. 21932 1 79 22.717 Sub-district Sub-district Sub-district Sub-district Sub-district Sub-district Write down the name subdistrict in the space provided and add the related code referred to in the box provided. 21932 10 730 73.851 Village/kelurahan Village/kelurahan Village/kelurahan Village/kelurahan Village/kelurahan Village/kelurahan Cross out the unnecessary and the Write down the name of village/kelurahan in the space provided and add the related code referred to in the box provided. 21932 1 111 8.701 Village/kelurahan classification Village/kelurahan classification Village/kelurahan classification Village/kelurahan classification Village/kelurahan classification Village/kelurahan classification Circle the answered code, then write it down in the box provided. 21932 1 2 1.564 1 Urban 2 Rural Sample code number Sample code number Sample code number Sample code number Sample code number Sample code number Write down the sample code number into the box provided. 21932 1001 2542 1236.405 Household sample sequential number Household sample sequential number Household sample sequential number Household sample sequential number Household sample sequential number Household sample sequential number Write down the household sample sequential number into the box provided. 21932 16 8.491 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Total household members (HM) Total household members (HM) Total household members (HM) Total household members (HM) Total household members (HM) Total household members (HM) 21932 2 15 4.795 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Total toddlers Total toddlers Total toddlers Total toddlers Total toddlers Total toddlers 21932 1 5 1.17 1 2 3 4 5 Name and NIP of Census Taker: Name and NIP of Census Taker: Name and NIP of Census Taker: Name and NIP of Census Taker: Name and NIP of Census Taker: Name and NIP of Census Taker: 21932 99999 28469.674 Census Taker Position: Census Taker Position: Census Taker Position: Census Taker Position: Census Taker Position: Census Taker Position: 21932 1 4 3.42 1 Provincial BPS Staff 2 District/City BPS Staff 3 Statistics Clerk 4 Partner Name and NIP of Supervisor/Checker: Name and NIP of Supervisor/Checker: Name and NIP of Supervisor/Checker: Name and NIP of Supervisor/Checker: Name and NIP of Supervisor/Checker: Name and NIP of Supervisor/Checker: 21932 99999 14494.529 Supervisor/Checker Position: Supervisor/Checker Position: Supervisor/Checker Position: Supervisor/Checker Position: Supervisor/Checker Position: Supervisor/Checker Position: 21932 1 4 2.115 1 Provincial BPS Staff 2 District/City BPS Staff 3 Statistics Clerk 4 Partner Household member sequential No. (youngest toddler): Household member sequential No. (youngest toddler): Household member sequential No. (youngest toddler): Household member sequential No. (youngest toddler): Household member sequential No. (youngest toddler): Household member sequential No. (youngest toddler): 21932 2 14 4.562 2 3 4 5 6 7 8 9 10 11 12 13 14 Age (youngest toddler): (months) Age (youngest toddler): (months) Age (youngest toddler): (months) Age (youngest toddler): (months) Age (youngest toddler): (months) Age (youngest toddler): (months) 21932 59 27.346 Is (name of youngest toddler) received high dosage of vitamin A for the past year? (as showed in example)? Is (name of youngest toddler) received high dosage of vitamin A for the past year? (as showed in example)? Is (name of youngest toddler) received high dosage of vitamin A for the past year? (as showed in example)? Is (name of youngest toddler) received high dosage of vitamin A for the past year? (as showed in example)? Is (name of youngest toddler) received high dosage of vitamin A for the past year? (as showed in example)? Is (name of youngest toddler) received high dosage of vitamin A for the past year? (as showed in example)? 21932 1 9 1.867 1 Yes 2 No 9 Do not know How many times? How many times? How many times? How many times? How many times? If yes (m7r1 = 1) How many times? 13872 8060 1 9 2.266 1 1 time 2 2 times 3 More than 2 times 9 Do not know Sysmiss Is the toddler weighed in the past month? Is the toddler weighed in the past month? Is the toddler weighed in the past month? Is the toddler weighed in the past month? Is the toddler weighed in the past month? Is the toddler weighed in the past month? 21932 1 9 1.641 1 Yes 2 No 9 Do not know The weight from the last weighed: (kg) The weight from the last weighed: (kg) The weight from the last weighed: (kg) The weight from the last weighed: (kg) The weight from the last weighed: (kg) If yes (m7r3 = 1) The weight from the last weighed: (kg) 11045 10887 15 400 100.849 How many times (the youngest toddler) is examined (not for treatment) by medical worker in the past one year? (times) How many times (the youngest toddler) is examined (not for treatment) by medical worker in the past one year? (times) How many times (the youngest toddler) is examined (not for treatment) by medical worker in the past one year? (times) How many times (the youngest toddler) is examined (not for treatment) by medical worker in the past one year? (times) How many times (the youngest toddler) is examined (not for treatment) by medical worker in the past one year? (times) How many times (the youngest toddler) is examined (not for treatment) by medical worker in the past one year? (times) 21932 24 2.443 Was (the youngest toddler) examined by medical worker until age 1 month? Was (the youngest toddler) examined by medical worker until age 1 month? Was (the youngest toddler) examined by medical worker until age 1 month? Was (the youngest toddler) examined by medical worker until age 1 month? Was (the youngest toddler) examined by medical worker until age 1 month? Was (the youngest toddler) examined by medical worker until age 1 month? 21932 1 9 1.865 1 Yes 2 No 9 Do not know How many times the toddler was examined - Age 0-7 days: (times) How many times the toddler was examined - Age 0-7 days: (times) How many times the toddler was examined - Age 0-7 days: (times) How many times the toddler was examined - Age 0-7 days: (times) How many times the toddler was examined - Age 0-7 days: (times) If yes (m7r6 = 1) How many times the toddler was examined? a. Age 0-7 days: (times) 10724 11208 3 1.17 1 2 3 Sysmiss How many times the toddler was examined - Age 8-28 days: (times) How many times the toddler was examined - Age 8-28 days: (times) How many times the toddler was examined - Age 8-28 days: (times) How many times the toddler was examined - Age 8-28 days: (times) How many times the toddler was examined - Age 8-28 days: (times) How many times the toddler was examined? b. Age 8-28 days: (times) 10724 11208 9 1.454 1 2 3 4 5 6 7 8 9 Sysmiss Is the toddler's biological mother live in the household? Is the toddler's biological mother live in the household? Is the toddler's biological mother live in the household? Is the toddler's biological mother live in the household? Is the toddler's biological mother live in the household? Is the toddler's biological mother live in the household? 21932 1 2 1.032 1 Yes 2 No Household member sequential No. (biological mother of the youngest toddler): Household member sequential No. (biological mother of the youngest toddler): Household member sequential No. (biological mother of the youngest toddler): Household member sequential No. (biological mother of the youngest toddler): Household member sequential No. (biological mother of the youngest toddler): Household member sequential No. (biological mother of the youngest toddler): 21236 696 1 13 2.223 1 2 3 4 5 6 7 8 9 10 11 12 13 Sysmiss When the mother was pregnant with (name of the youngest toddler), did she check the pregnancy to health worker? When the mother was pregnant with (name of the youngest toddler), did she check the pregnancy to health worker? When the mother was pregnant with (name of the youngest toddler), did she check the pregnancy to health worker? When the mother was pregnant with (name of the youngest toddler), did she check the pregnancy to health worker? When the mother was pregnant with (name of the youngest toddler), did she check the pregnancy to health worker? When the mother was pregnant with (name of the youngest toddler), did she check the pregnancy to health worker? 21236 696 1 9 1.189 1 Yes 2 No 9 Do not know Sysmiss The mother check the pregnancy, when pregnancy age 0-3 months: (times) The mother check the pregnancy, when pregnancy age 0-3 months: (times) The mother check the pregnancy, when pregnancy age 0-3 months: (times) The mother check the pregnancy, when pregnancy age 0-3 months: (times) The mother check the pregnancy, when pregnancy age 0-3 months: (times) If yes, how many times did the mother check the pregnancy? a. When pregnancy age 0-3 months: (times) 18972 2960 9 1.559 1 2 3 4 5 6 7 8 9 Sysmiss The mother check the pregnancy, when pregnancy age 4-6 months: (times) The mother check the pregnancy, when pregnancy age 4-6 months: (times) The mother check the pregnancy, when pregnancy age 4-6 months: (times) The mother check the pregnancy, when pregnancy age 4-6 months: (times) The mother check the pregnancy, when pregnancy age 4-6 months: (times) If yes, how many times did the mother check the pregnancy? b. When pregnancy age 4-6 months: (times) 18972 2960 9 2.013 1 2 3 4 5 6 7 8 9 Sysmiss The mother check the pregnancy, when pregnancy age 7 month & up: (times) The mother check the pregnancy, when pregnancy age 7 month & up: (times) The mother check the pregnancy, when pregnancy age 7 month & up: (times) The mother check the pregnancy, when pregnancy age 7 month & up: (times) The mother check the pregnancy, when pregnancy age 7 month & up: (times) If yes, how many times did the mother check the pregnancy? c. When pregnancy age 7 month & up: (times) 18972 2960 9 2.629 1 2 3 4 5 6 7 8 9 Sysmiss The mother check the pregnancy, total checking (R.10.a to R.10.c): (times) The mother check the pregnancy, total checking (R.10.a to R.10.c): (times) The mother check the pregnancy, total checking (R.10.a to R.10.c): (times) The mother check the pregnancy, total checking (R.10.a to R.10.c): (times) The mother check the pregnancy, total checking (R.10.a to R.10.c): (times) If yes, how many times did the mother check the pregnancy? d. Total checking (R.10.a to R.10.c): (times 18972 2960 24 6.194 When pregnant with (name of the youngest toddler), was the mother ever consume iron/blood booster pill (as showed in example)? When pregnant with (name of the youngest toddler), was the mother ever consume iron/blood booster pill (as showed in example)? When pregnant with (name of the youngest toddler), was the mother ever consume iron/blood booster pill (as showed in example)? When pregnant with (name of the youngest toddler), was the mother ever consume iron/blood booster pill (as showed in example)? When pregnant with (name of the youngest toddler), was the mother ever consume iron/blood booster pill (as showed in example)? When pregnant with (name of the youngest toddler), was the mother ever consume iron/blood booster pill (as showed in example)? 21236 696 1 9 1.921 1 Yes 2 No 9 Do not know Sysmiss How many iron pills were consumed? How many iron pills were consumed? How many iron pills were consumed? How many iron pills were consumed? How many iron pills were consumed? If yes (m7r11 = 1) How many iron pills were consumed? 14376 7556 1 9 3.611 1 < 90 pills 2 90 pills or more 9 Do not know Sysmiss Individual weight Individual weight Individual weight Individual weight Individual weight 21932 244 3308 956.552 Province Province Province Province Province Province Write down the name province in the space provided and add the related code referred to in the box provided. 66644 11 94 38.995 11 Nanggroe Aceh Darussalam 12 North Sumatera 13 West Sumatera 14 Riau 15 Jambi 16 South Sumatera 17 Bengkulu 18 Lampung 19 Bangka Belitung 21 Riau Island 31 DKI Jakarta 32 West Java 33 Central Java 34 DI Yogyakarta 35 East Java 36 Banten 51 Bali 52 West Nusa Tenggara 53 East Nusa Tenggara 61 West Kalimantan 62 Central Kalimantan 63 South Kalimantan 64 East Kalimantan 71 North Sulawesi 72 Central Sulawesi 73 South Sulawesi 74 Southeast Sulawesi 75 Gorontalo 76 West Sulawesi 81 Maluku 82 North Maluku 91 West Irian Jaya 94 Papua District/City District/City District/City District/City District/City District/City Cross out the unnecessary and the Write down the name of district/city in the space provided and add the related code referred to in the box provided. 66644 1 79 23.119 Sub-district Sub-district Sub-district Sub-district Sub-district Sub-district Write down the name subdistrict in the space provided and add the related code referred to in the box provided. 66644 10 740 76.06 Village/kelurahan Village/kelurahan Village/kelurahan Village/kelurahan Village/kelurahan Village/kelurahan Cross out the unnecessary and the Write down the name of village/kelurahan in the space provided and add the related code referred to in the box provided. 66644 1 111 8.517 Village/kelurahan classification Village/kelurahan classification Village/kelurahan classification Village/kelurahan classification Village/kelurahan classification Village/kelurahan classification Circle the answered code, then write it down in the box provided. 66644 1 2 1.554 1 Urban 2 Rural Sample code number Sample code number Sample code number Sample code number Sample code number Sample code number Write down the sample code number into the box provided. 66644 1001 2542 1244.592 Household sample sequential number Household sample sequential number Household sample sequential number Household sample sequential number Household sample sequential number Household sample sequential number Write down the household sample sequential number into the box provided. 66644 16 8.499 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Serial number of household members Serial number of household members Serial number of household members Serial number of household members Serial number of household members Serial number of household members 66644 1 13 1.886 1 2 3 4 5 6 7 8 9 10 11 12 13 Marital status: Marital status: Marital status: Marital status: Marital status: Marital status (in line with VSEN2004.K, Block IV.A, Column 6): 66644 4 1.975 1 Not married 2 Married 3 Divorce 4 Divorce due to death 1. Married means having a wife (for male) or husband (for female) durint the census, whether living together or separately. In this case the people included in this status are those who are married legally (by the law of the tradition, religion, state, etc), and also those who live together and have been considered husband and wive by the local society. 2. Divorcee is a person who has been separated from wife/husband and has not remarried.In this case including a person who claims to be divorced although it is not legally confirmed yet. Highest certificate/diploma obtained: Highest certificate/diploma obtained: Highest certificate/diploma obtained: Highest certificate/diploma obtained: Highest certificate/diploma obtained: Highest certificate/diploma obtained (in line with VSEN2004.K, Block V.C, Detail 22) 66644 9 2.623 1 Do not have 2 Elementary school/equal 3 Junior high/equal 4 Senior high/equal 5 Vocational school 6 Diploma 1 or 2 7 Diploma 3/Bachelor Degree 8 Diploma 4/S1 9 S2/S3 In general, how is the current health condition of (name) (physical and mental)? In general, how is the current health condition of (name) (physical and mental)? In general, how is the current health condition of (name) (physical and mental)? In general, how is the current health condition of (name) (physical and mental)? In general, how is the current health condition of (name) (physical and mental)? In general, how is the current health condition of (name) (physical and mental)? 66644 1 5 1.901 1 Very good 2 Good 3 Fair 4 Bad 5 Very bad How severe is (name) having trouble walking in and out of house in the past one month? How severe is (name) having trouble walking in and out of house in the past one month? How severe is (name) having trouble walking in and out of house in the past one month? How severe is (name) having trouble walking in and out of house in the past one month? How severe is (name) having trouble walking in and out of house in the past one month? How severe is (name) having trouble walking in and out of house in the past one month? 66644 1 5 1.159 1 No problem 2 A little problem 3 Frequent problem 4 Very sever 5 Cannot walk/move How severe is (name) having trouble to take care of oneself (bathing, dressed) of house in the past 1 month? How severe is (name) having trouble to take care of oneself (bathing, dressed) of house in the past 1 month? How severe is (name) having trouble to take care of oneself (bathing, dressed) of house in the past 1 month? How severe is (name) having trouble to take care of oneself (bathing, dressed) of house in the past 1 month? How severe is (name) having trouble to take care of oneself (bathing, dressed) of house in the past 1 month? How severe is (name) having trouble to take care of oneself (bathing, dressed) of house in the past 1 month? 66644 1 5 1.095 1 No problem 2 A little problem 3 Frequent problem 4 Very sever 5 Cannot walk/move How severe is (name) feel pain or not feeling well in the past one month? How severe is (name) feel pain or not feeling well in the past one month? How severe is (name) feel pain or not feeling well in the past one month? How severe is (name) feel pain or not feeling well in the past one month? How severe is (name) feel pain or not feeling well in the past one month? How severe is (name) feel pain or not feeling well in the past one month? 66644 1 5 1.501 1 No sickness 2 Slight 3 Medium 4 Bad 5 Severe/very severe How severe is (name) having trouble to concentrate or remembering in the past 1 month? How severe is (name) having trouble to concentrate or remembering in the past 1 month? How severe is (name) having trouble to concentrate or remembering in the past 1 month? How severe is (name) having trouble to concentrate or remembering in the past 1 month? How severe is (name) having trouble to concentrate or remembering in the past 1 month? How severe is (name) having trouble to concentrate or remembering in the past 1 month? 66644 1 5 1.218 1 No problem 2 A little problem 3 Frequent problem 4 Very severe 5 Cannot do it How large is the obstacle faced by (name) in communicating or involving oneself in public activities in the past one month? How large is the obstacle faced by (name) in communicating or involving oneself in public activities in the past one month? How large is the obstacle faced by (name) in communicating or involving oneself in public activities in the past one month? How large is the obstacle faced by (name) in communicating or involving oneself in public activities in the past one month? How large is the obstacle faced by (name) in communicating or involving oneself in public activities in the past one month? How large is the obstacle faced by (name) in communicating or involving oneself in public activities in the past one month? 66644 1 5 1.274 1 No 2 Few 3 Sometimes 4 Numerous 5 A lot of How severe is (name) having trouble sleeping (cannot sleep, wake often during the night or wake up too early) in the past one month? How severe is (name) having trouble sleeping (cannot sleep, wake often during the night or wake up too early) in the past one month? How severe is (name) having trouble sleeping (cannot sleep, wake often during the night or wake up too early) in the past one month? How severe is (name) having trouble sleeping (cannot sleep, wake often during the night or wake up too early) in the past one month? How severe is (name) having trouble sleeping (cannot sleep, wake often during the night or wake up too early) in the past one month? How severe is (name) having trouble sleeping (cannot sleep, wake often during the night or wake up too early) in the past one month? 66644 1 5 1.324 1 No problem 2 Slight 3 Medium 4 Bad 5 Severe/very severe How severe is (name) feeling excessive anxiety or worried for no reason in the past one month? How severe is (name) feeling excessive anxiety or worried for no reason in the past one month? How severe is (name) feeling excessive anxiety or worried for no reason in the past one month? How severe is (name) feeling excessive anxiety or worried for no reason in the past one month? How severe is (name) feeling excessive anxiety or worried for no reason in the past one month? How severe is (name) feeling excessive anxiety or worried for no reason in the past one month? 66644 1 5 1.234 1 No problem 2 Slight 3 Medium 4 Bad 5 Severe/very severe Is (name) wear eyeglasses or contact lenses? Is (name) wear eyeglasses or contact lenses? Is (name) wear eyeglasses or contact lenses? Is (name) wear eyeglasses or contact lenses? Is (name) wear eyeglasses or contact lenses? Is (name) wear eyeglasses or contact lenses? 66644 1 5 1.89 1 Yes 2 No 3 4 5 How difficult (name) read or see object at arm’s length (around 30 cm) in the past one month? How difficult (name) read or see object at arm’s length (around 30 cm) in the past one month? How difficult (name) read or see object at arm’s length (around 30 cm) in the past one month? How difficult (name) read or see object at arm’s length (around 30 cm) in the past one month? How difficult (name) read or see object at arm’s length (around 30 cm) in the past one month? How difficult (name) read or see object at arm’s length (around 30 cm) in the past one month? 66644 1 5 1.371 1 No problem 2 Little problem 3 Frequent problem 4 Severe 5 Cannot see Is (name) smoke in the past one month? Is (name) smoke in the past one month? Is (name) smoke in the past one month? Is (name) smoke in the past one month? Is (name) smoke in the past one month? Is (name) smoke in the past one month? 1. If the answer is coded 2 or 3 skip to m8br14. 2. If the answer is coded 4, skip to m8br15. 66644 1 4 3.004 1 Yes, everyday 2 Yes, sometimes 3 No, used to 4 No, never How many cigarettes smoked every day? (cigarettes) How many cigarettes smoked every day? (cigarettes) How many cigarettes smoked every day? (cigarettes) How many cigarettes smoked every day? (cigarettes) How many cigarettes smoked every day? (cigarettes) If yes (m8br11 = 1) How many cigarettes smoked every day? (cigarettes) 18552 48092 1 99 11.065 At what age (name) started to smoke every day? (years old) At what age (name) started to smoke every day? (years old) At what age (name) started to smoke every day? (years old) At what age (name) started to smoke every day? (years old) At what age (name) started to smoke every day? (years old) At what age (name) started to smoke every day? (years old) 18552 48092 7 70 19.607 At what age (name) smoke for the first time? (years old) At what age (name) smoke for the first time? (years old) At what age (name) smoke for the first time? (years old) At what age (name) smoke for the first time? (years old) At what age (name) smoke for the first time? (years old) At what age (name) smoke for the first time? (years old) 25275 41369 5 74 17.443 Any other household member who smoke in the past one month? Any other household member who smoke in the past one month? Any other household member who smoke in the past one month? Any other household member who smoke in the past one month? Any other household member who smoke in the past one month? Any other household member who smoke in the past one month? If R.11 = 3 or 4, and R.15 = 2, go to R.17 66644 1 2 1.544 1 Yes 2 No Is (name)/household member smoke inside the house with other household members? Is (name)/household member smoke inside the house with other household members? Is (name)/household member smoke inside the house with other household members? Is (name)/household member smoke inside the house with other household members? Is (name)/household member smoke inside the house with other household members? Is (name)/household member smoke inside the house with other household members? 45607 21037 1 2 1.164 1 Yes 2 No Sysmiss How many days in one week (name) consume fruits? (days) How many days in one week (name) consume fruits? (days) How many days in one week (name) consume fruits? (days) How many days in one week (name) consume fruits? (days) How many days in one week (name) consume fruits? (days) How many days in one week (name) consume fruits? (days) If 0 day, go to m8br18a. 66644 7 2.204 1 2 3 4 5 6 7 How many portion in average every day? (portion) How many portion in average every day? (portion) How many portion in average every day? (portion) How many portion in average every day? (portion) How many portion in average every day? (portion) If m8br17a not equal to 0 How many portion in average every day? (portion) [Show consumption card to respondent] 50917 15727 0.5 9.9 1.652 How many days in one week (name) consume vegetables (soup, stir-fried, salad)? (days) How many days in one week (name) consume vegetables (soup, stir-fried, salad)? (days) How many days in one week (name) consume vegetables (soup, stir-fried, salad)? (days) How many days in one week (name) consume vegetables (soup, stir-fried, salad)? (days) How many days in one week (name) consume vegetables (soup, stir-fried, salad)? (days) How many days in one week (name) consume vegetables (soup, stir-fried, salad)? (days) If 0 day, go to m8br19a. 66644 7 5.045 1 2 3 4 5 6 7 How many portion in average every day? (portion) How many portion in average every day? (portion) How many portion in average every day? (portion) How many portion in average every day? (portion) How many portion in average every day? (portion) If m8br18a not equal to 0 How many portion in average every day? (portion) [Show consumption card to respondent] 64367 2277 0.5 9.9 2.028 How many days (one) perform heavy activities (showed physical activity card) for no less than 10 minutes without stopping for the past one week? (days) How many days (one) perform heavy activities (showed physical activity card) for no less than 10 minutes without stopping for the past one week? (days) How many days (one) perform heavy activities (showed physical activity card) for no less than 10 minutes without stopping for the past one week? (days) How many days (one) perform heavy activities (showed physical activity card) for no less than 10 minutes without stopping for the past one week? (days) How many days (one) perform heavy activities (showed physical activity card) for no less than 10 minutes without stopping for the past one week? (days) How many days (one) perform heavy activities (showed physical activity card) for no less than 10 minutes without stopping for the past one week? (days) If 0 day, go to m8br20a. 66644 7 1.695 1 2 3 4 5 6 7 How long in average (name) performed the heavy activities on those days? (minutes) How long in average (name) performed the heavy activities on those days? (minutes) How long in average (name) performed the heavy activities on those days? (minutes) How long in average (name) performed the heavy activities on those days? (minutes) How long in average (name) performed the heavy activities on those days? (minutes) How long in average (name) performed the heavy activities on those days? (minutes) 24383 42261 10 360 106.326 How many days (one) perform moderate activities (showed physical activity card) for no less than 10 minutes without stopping for the past one week? (days) How many days (one) perform moderate activities (showed physical activity card) for no less than 10 minutes without stopping for the past one week? (days) How many days (one) perform moderate activities (showed physical activity card) for no less than 10 minutes without stopping for the past one week? (days) How many days (one) perform moderate activities (showed physical activity card) for no less than 10 minutes without stopping for the past one week? (days) How many days (one) perform moderate activities (showed physical activity card) for no less than 10 minutes without stopping for the past one week? (days) How many days (one) perform moderate activities (showed physical activity card) for no less than 10 minutes without stopping for the past one week? (days) If 0 day, go to m8br21a. 66644 7 3.906 1 2 3 4 5 6 7 How long in average (name) performed the moderate activities on those days? (minutes) How long in average (name) performed the moderate activities on those days? (minutes) How long in average (name) performed the moderate activities on those days? (minutes) How long in average (name) performed the moderate activities on those days? (minutes) How long in average (name) performed the moderate activities on those days? (minutes) How long in average (name) performed the moderate activities on those days? (minutes) 51621 15023 10 360 72.498 How many days (one) walk for no less than 10 minutes without stopping for the past one week? (days) How many days (one) walk for no less than 10 minutes without stopping for the past one week? (days) How many days (one) walk for no less than 10 minutes without stopping for the past one week? (days) How many days (one) walk for no less than 10 minutes without stopping for the past one week? (days) How many days (one) walk for no less than 10 minutes without stopping for the past one week? (days) How many days (one) walk for no less than 10 minutes without stopping for the past one week? (days) If 0 day, go to m8br22a. 66644 7 3.321 1 2 3 4 5 6 7 How long in average (name) walk on those days? (minutes) How long in average (name) walk on those days? (minutes) How long in average (name) walk on those days? (minutes) How long in average (name) walk on those days? (minutes) How long in average (name) walk on those days? (minutes) How long in average (name) walk on those days? (minutes) 44790 21854 10 360 33.816 Is (name)/child (name) age no more than 12 years ever received outpatient service in the past one year? Is (name)/child (name) age no more than 12 years ever received outpatient service in the past one year? Is (name)/child (name) age no more than 12 years ever received outpatient service in the past one year? Is (name)/child (name) age no more than 12 years ever received outpatient service in the past one year? Is (name)/child (name) age no more than 12 years ever received outpatient service in the past one year? Is (name)/child (name) age no more than 12 years ever received outpatient service in the past one year? If the answer is coded 2, skip to m8cr23a. 66644 1 2 1.71 1 Yes 2 No To where (name)/child (name) age no more than 12 years was taken for the last outpatient service? To where (name)/child (name) age no more than 12 years was taken for the last outpatient service? To where (name)/child (name) age no more than 12 years was taken for the last outpatient service? To where (name)/child (name) age no more than 12 years was taken for the last outpatient service? To where (name)/child (name) age no more than 12 years was taken for the last outpatient service? If yes (m8cr22a = 1) To where (name)/child (name) age no more than 12 years was taken for the last outpatient service? 19294 47350 1 8 4.084 1 State hospital 2 Private hospital 3 Doctor practice 4 Public clinic 5 Polyclinic 6 Health worker practice 7 Traditional medicine 8 Other Sysmiss How long it took to each the outpatient service facility? How long it took to each the outpatient service facility? How long it took to each the outpatient service facility? How long it took to each the outpatient service facility? How long it took to each the outpatient service facility? How long it took to each the outpatient service facility? 19294 47350 1 4 1.459 1 = 29 minutes 2 30-59 minutes 3 60-119 minutes 4 = 120 minutes Sysmiss Who performed examination? Who performed examination? Who performed examination? Who performed examination? Who performed examination? Who performed examination? 19294 47350 1 7 2.634 1 Doctor 2 Dentist 3 Nurse 4 Midwife 5 Other paramedic 6 Shaman/traditional healer/sensei 7 Other Sysmiss In the last medical visit, was (name) satisfied with the provided services? In the last medical visit, was (name) satisfied with the provided services? In the last medical visit, was (name) satisfied with the provided services? In the last medical visit, was (name) satisfied with the provided services? In the last medical visit, was (name) satisfied with the provided services? In the last medical visit, was (name) satisfied with the provided services? 19294 47350 1 5 2.298 1 Very satisfied 2 Satisfied 3 Sufficiently satisfied 4 Less than satisfied 5 Not satisfied Sysmiss How long was the waiting time to obtain service in the place? How long was the waiting time to obtain service in the place? How long was the waiting time to obtain service in the place? How long was the waiting time to obtain service in the place? How long was the waiting time to obtain service in the place? How long was the waiting time to obtain service in the place? 19294 47350 1 4 1.409 1 = 29 minutes 2 30-59 minutes 3 60-119 minutes 4 = 120 minutes Sysmiss During the visit to the last treatment place, how was the explanation on disease, medical treatment and action? During the visit to the last treatment place, how was the explanation on disease, medical treatment and action? During the visit to the last treatment place, how was the explanation on disease, medical treatment and action? During the visit to the last treatment place, how was the explanation on disease, medical treatment and action? During the visit to the last treatment place, how was the explanation on disease, medical treatment and action? During the visit to the last treatment place, how was the explanation on disease, medical treatment and action? 19294 47350 1 5 2.342 1 Very clear 2 Clear 3 Sufficiently clear 4 Unclear 5 Very unclear Sysmiss Is (name)/child (name) age no more than 12 years ever received inpatient service in the past five years? Is (name)/child (name) age no more than 12 years ever received inpatient service in the past five years? Is (name)/child (name) age no more than 12 years ever received inpatient service in the past five years? Is (name)/child (name) age no more than 12 years ever received inpatient service in the past five years? Is (name)/child (name) age no more than 12 years ever received inpatient service in the past five years? Is (name)/child (name) age no more than 12 years ever received inpatient service in the past five years? If the answer is coded 2, skip to m8cr24. 66644 1 2 1.96 1 Yes 2 No To where (name)/child (name) age no more than 12 years was taken for the last inpatient service? To where (name)/child (name) age no more than 12 years was taken for the last inpatient service? To where (name)/child (name) age no more than 12 years was taken for the last inpatient service? To where (name)/child (name) age no more than 12 years was taken for the last inpatient service? To where (name)/child (name) age no more than 12 years was taken for the last inpatient service? If yes (m8cr23a = 1) To where (name)/child (name) age no more than 12 years was taken for the last inpatient service? 2657 63987 1 8 2.395 1 State hospital 2 Private hospital 3 Doctor practice 4 Public clinic 5 Polyclinic 6 Health worker practice 7 Traditional medicine 8 Other Sysmiss How long it took to each the inpatient service facility? How long it took to each the inpatient service facility? How long it took to each the inpatient service facility? How long it took to each the inpatient service facility? How long it took to each the inpatient service facility? How long it took to each the inpatient service facility? 2657 63987 1 4 1.918 1 = 29 minutes 2 30-59 minutes 3 60-119 minutes 4 = 120 minutes Sysmiss How long (name)/child (name) stayed as inpatient? How long (name)/child (name) stayed as inpatient? How long (name)/child (name) stayed as inpatient? How long (name)/child (name) stayed as inpatient? How long (name)/child (name) stayed as inpatient? How long (name)/child (name) stayed as inpatient? 2657 63987 1 4 2.102 1 1-2 days 2 3-5 days 3 6-14 days 4 6 15 days or more Sysmiss In the last inpatient service, was (name) satisfied with the provided services? In the last inpatient service, was (name) satisfied with the provided services? In the last inpatient service, was (name) satisfied with the provided services? In the last inpatient service, was (name) satisfied with the provided services? In the last inpatient service, was (name) satisfied with the provided services? In the last inpatient service, was (name) satisfied with the provided services? 2657 63987 1 5 2.409 1 Very satisfied 2 Satisfied 3 Sufficiently satisfied 4 Less than satisfied 5 Not satisfied Sysmiss How long was the waiting time to obtain service in the place? How long was the waiting time to obtain service in the place? How long was the waiting time to obtain service in the place? How long was the waiting time to obtain service in the place? How long was the waiting time to obtain service in the place? How long was the waiting time to obtain service in the place? 2657 63987 1 4 1.484 1 = 29 minutes 2 30-59 minutes 3 60-119 minutes 4 = 120 minutes Sysmiss During the inpatient service, how was the explanation on disease, medical treatment and action? During the inpatient service, how was the explanation on disease, medical treatment and action? During the inpatient service, how was the explanation on disease, medical treatment and action? During the inpatient service, how was the explanation on disease, medical treatment and action? During the inpatient service, how was the explanation on disease, medical treatment and action? During the inpatient service, how was the explanation on disease, medical treatment and action? 2657 63987 1 5 2.329 1 Very clear 2 Clear 3 Sufficiently clear 4 Unclear 5 Very unclear Sysmiss Is (name) ever diagnosed with joint disease (rheumatic/ arthritis) by medical worker? Is (name) ever diagnosed with joint disease (rheumatic/ arthritis) by medical worker? Is (name) ever diagnosed with joint disease (rheumatic/ arthritis) by medical worker? Is (name) ever diagnosed with joint disease (rheumatic/ arthritis) by medical worker? Is (name) ever diagnosed with joint disease (rheumatic/ arthritis) by medical worker? Is (name) ever diagnosed with joint disease (rheumatic/ arthritis) by medical worker? 66644 1 9 2.251 1 Yes 2 No 9 Do not know I will now ask about health issues that may be experienced by (name) and the treatment. Questions will be asked repeatedly to obtain detailed information I will now ask about health issues that may be experienced by (name) and the treatment. Questions will be asked repeatedly to obtain detailed information I will now ask about health issues that may be experienced by (name) and the treatment. Questions will be asked repeatedly to obtain detailed information I will now ask about health issues that may be experienced by (name) and the treatment. Questions will be asked repeatedly to obtain detailed information I will now ask about health issues that may be experienced by (name) and the treatment. Questions will be asked repeatedly to obtain detailed information I will now ask about health issues that may be experienced by (name) and the treatment. Questions will be asked repeatedly to obtain detailed information 66644 1 9 2.098 1 Yes 2 No 9 Do not know Is (name) ever treated for joint disease (rheumatic/arthritis)? Is (name) ever treated for joint disease (rheumatic/arthritis)? Is (name) ever treated for joint disease (rheumatic/arthritis)? Is (name) ever treated for joint disease (rheumatic/arthritis)? Is (name) ever treated for joint disease (rheumatic/arthritis)? Is (name) ever treated for joint disease (rheumatic/arthritis)? 66644 1 9 2.111 1 Yes 2 No 9 Do not know Pain, sore, numb or swelling not because of accident or wound, around arm joints, hand, leg and foot which occur for more than one month? Pain, sore, numb or swelling not because of accident or wound, around arm joints, hand, leg and foot which occur for more than one month? Pain, sore, numb or swelling not because of accident or wound, around arm joints, hand, leg and foot which occur for more than one month? Pain, sore, numb or swelling not because of accident or wound, around arm joints, hand, leg and foot which occur for more than one month? Pain, sore, numb or swelling not because of accident or wound, around arm joints, hand, leg and foot which occur for more than one month? Is (name) suffered the following in the past one year? a. Pain, sore, numb or swelling not because of accident or wound, around arm joints, hand, leg and foot which occur for more than one month? 66644 1 2 1.891 1 Yes 2 No Numbness on joints when awake from sleep, or after sit for a long time? Numbness on joints when awake from sleep, or after sit for a long time? Numbness on joints when awake from sleep, or after sit for a long time? Numbness on joints when awake from sleep, or after sit for a long time? Numbness on joints when awake from sleep, or after sit for a long time? If the answer is coded 2, skip to m8dr28a. Is (name) suffered the following in the past one year? b. Numbness on joints when awake from sleep, or after sit for a long time? 66644 1 2 1.813 1 Yes 2 No How long the numbness last? How long the numbness last? How long the numbness last? How long the numbness last? How long the numbness last? If yes (m8dr27b = 1) Is (name) suffered the following in the past one year? c. How long the numbness last? 12431 54213 1 2 1.138 1 <= 30 minutes 2 > 30 minutes Sysmiss Is the numbness disappear after (name) move the joints? Is the numbness disappear after (name) move the joints? Is the numbness disappear after (name) move the joints? Is the numbness disappear after (name) move the joints? Is the numbness disappear after (name) move the joints? Is (name) suffered the following in the past one year? d. Is the numbness disappear after (name) move the joints? 12431 54213 1 2 1.116 1 Yes 2 No Sysmiss Is (name) ever suffered back pain (along the back spine) for the past one month? Is (name) ever suffered back pain (along the back spine) for the past one month? Is (name) ever suffered back pain (along the back spine) for the past one month? Is (name) ever suffered back pain (along the back spine) for the past one month? Is (name) ever suffered back pain (along the back spine) for the past one month? If yes (R.27.b = 1) Is (name) ever suffered back pain (along the back spine) for the past one month? 66644 1 2 1.891 1 Yes 2 No How many days did (name) suffer from the back pain? (days) How many days did (name) suffer from the back pain? (days) How many days did (name) suffer from the back pain? (days) How many days did (name) suffer from the back pain? (days) How many days did (name) suffer from the back pain? (days) How many days did (name) suffer from the back pain? (days) 7279 59365 1 31 4.461 Is (name) ever diagnosed with heart disease by medical worker? Is (name) ever diagnosed with heart disease by medical worker? Is (name) ever diagnosed with heart disease by medical worker? Is (name) ever diagnosed with heart disease by medical worker? Is (name) ever diagnosed with heart disease by medical worker? Is (name) ever diagnosed with heart disease by medical worker? 66644 1 9 2.321 1 Yes 2 No 9 Do not know Is (name) ever treated for heart disease? Is (name) ever treated for heart disease? Is (name) ever treated for heart disease? Is (name) ever treated for heart disease? Is (name) ever treated for heart disease? Is (name) ever treated for heart disease? 66644 1 9 2.194 1 Yes 2 No 9 Do not know Is (name) ever treated or cared for the disease in the past two weeks? Is (name) ever treated or cared for the disease in the past two weeks? Is (name) ever treated or cared for the disease in the past two weeks? Is (name) ever treated or cared for the disease in the past two weeks? Is (name) ever treated or cared for the disease in the past two weeks? Is (name) ever treated or cared for the disease in the past two weeks? 66644 1 9 2.146 1 Yes 2 No 9 Do not know Stuffed feeling or chest pain when (name) walked rapidly or climbing? Stuffed feeling or chest pain when (name) walked rapidly or climbing? Stuffed feeling or chest pain when (name) walked rapidly or climbing? Stuffed feeling or chest pain when (name) walked rapidly or climbing? Stuffed feeling or chest pain when (name) walked rapidly or climbing? Is (name) ever experienced the following in the past one year: a. Stuffed feeling or chest pain when (name) walked rapidly or climbing? 66644 1 3 2.067 1 Yes 2 No 3 Never walked rapidly or climbing Stuffed feeling or chest pain when (name) walked normally on flat path? Stuffed feeling or chest pain when (name) walked normally on flat path? Stuffed feeling or chest pain when (name) walked normally on flat path? Stuffed feeling or chest pain when (name) walked normally on flat path? Stuffed feeling or chest pain when (name) walked normally on flat path? Is (name) ever experienced the following in the past one year: b. Stuffed feeling or chest pain when (name) walked normally on flat path? If m8dr32a = 2 or 3 and m8dr32b = 2, go to m8dr33a. 66644 1 2 1.958 1 Yes 2 No What (name) did when experienced the stuffed feeling or chest pain when walking? What (name) did when experienced the stuffed feeling or chest pain when walking? What (name) did when experienced the stuffed feeling or chest pain when walking? What (name) did when experienced the stuffed feeling or chest pain when walking? What (name) did when experienced the stuffed feeling or chest pain when walking? Is (name) ever experienced the following in the past one year: c. What (name) did when experienced the stuffed feeling or chest pain when walking? 6370 60274 1 9 1.221 1 Stop or slowed down the walk 2 Continue walking after put medicine below tongue 3 Continue walking 9 Sysmiss What happened with the stuffed feeling or chest pain, when (name) stopped walking? What happened with the stuffed feeling or chest pain, when (name) stopped walking? What happened with the stuffed feeling or chest pain, when (name) stopped walking? What happened with the stuffed feeling or chest pain, when (name) stopped walking? What happened with the stuffed feeling or chest pain, when (name) stopped walking? Is (name) ever experienced the following in the past one year: d. What happened with the stuffed feeling or chest pain, when (name) stopped walking? 6370 60274 1 9 1.098 1 Subside 2 Not subside 9 Sysmiss Please show on which section the stuffed feeling or chest pain occurred? Please show on which section the stuffed feeling or chest pain occurred? Please show on which section the stuffed feeling or chest pain occurred? Please show on which section the stuffed feeling or chest pain occurred? Please show on which section the stuffed feeling or chest pain occurred? Is (name) ever experienced the following in the past one year: e. Please show on which section the stuffed feeling or chest pain occurred? 6370 60274 1 15 2.644 1 Upper or middle part of chest 2 Lower part of chest 3 Left arm 4 Other 5 6 7 8 9 10 11 12 13 14 15 Sysmiss Is (name) ever suffered from injury due to traffic accident in the past one year? Is (name) ever suffered from injury due to traffic accident in the past one year? Is (name) ever suffered from injury due to traffic accident in the past one year? Is (name) ever suffered from injury due to traffic accident in the past one year? Is (name) ever suffered from injury due to traffic accident in the past one year? Is (name) ever suffered from injury due to traffic accident in the past one year? If the answer is coded 2, skip to m8dr34a. 66644 1 2 1.989 1 Yes 2 No When was (the last) accident occur? (months ago) When was (the last) accident occur? (months ago) When was (the last) accident occur? (months ago) When was (the last) accident occur? (months ago) When was (the last) accident occur? (months ago) When was (the last) accident occur? (months ago) 727 65917 1 12 5.319 1 2 3 4 5 6 7 8 9 10 11 12 Sysmiss Was (name) received medical aid at the time? Was (name) received medical aid at the time? Was (name) received medical aid at the time? Was (name) received medical aid at the time? Was (name) received medical aid at the time? Was (name) received medical aid at the time? If the answer is coded 2, skip to m8dr34a. 727 65917 1 2 1.367 1 Yes 2 No Sysmiss Where (name) received (the first) medical aid? Where (name) received (the first) medical aid? Where (name) received (the first) medical aid? Where (name) received (the first) medical aid? Where (name) received (the first) medical aid? Where (name) received (the first) medical aid? 460 66184 1 8 3.587 1 State hospital 2 Private hospital 3 Doctor practice 4 Public clinic 5 Polyclinic 6 Health worker practice 7 Traditional medicine 8 Other Sysmiss How long was the time between accident and (the first) medical aid? How long was the time between accident and (the first) medical aid? How long was the time between accident and (the first) medical aid? How long was the time between accident and (the first) medical aid? How long was the time between accident and (the first) medical aid? How long was the time between accident and (the first) medical aid? 460 66184 1 3 1.459 1 < 1 hour 2 1-24 hours 3 > 24 hours Sysmiss Is (name) ever suffered from poisoning, drowning, violence, burnt etc. which caused injury and disrupt daily activities in the past one year? Is (name) ever suffered from poisoning, drowning, violence, burnt etc. which caused injury and disrupt daily activities in the past one year? Is (name) ever suffered from poisoning, drowning, violence, burnt etc. which caused injury and disrupt daily activities in the past one year? Is (name) ever suffered from poisoning, drowning, violence, burnt etc. which caused injury and disrupt daily activities in the past one year? Is (name) ever suffered from poisoning, drowning, violence, burnt etc. which caused injury and disrupt daily activities in the past one year? Is (name) ever suffered from poisoning, drowning, violence, burnt etc. which caused injury and disrupt daily activities in the past one year? If the answer is coded 2, skip to m8dr35a. 66644 1 2 1.995 1 Yes 2 No When was (the last) event occur? (months ago) When was (the last) event occur? (months ago) When was (the last) event occur? (months ago) When was (the last) event occur? (months ago) When was (the last) event occur? (months ago) When was (the last) event occur? (months ago) 311 66333 1 12 4.913 1 2 3 4 5 6 7 8 9 10 11 12 Sysmiss Was (name) received medical aid at the time? Was (name) received medical aid at the time? Was (name) received medical aid at the time? Was (name) received medical aid at the time? Was (name) received medical aid at the time? Was (name) received medical aid at the time? If the answer is coded 2, skip to m8dr35a. 311 66333 1 2 1.498 1 Yes 2 No Sysmiss Where (name) received (the first) medical aid? Where (name) received (the first) medical aid? Where (name) received (the first) medical aid? Where (name) received (the first) medical aid? Where (name) received (the first) medical aid? Where (name) received (the first) medical aid? 156 66488 1 8 3.987 1 State hospital 2 Private hospital 3 Doctor practice 4 Public clinic 5 Polyclinic 6 Health worker practice 7 Traditional medicine 8 Other Sysmiss How long was the time between event and (the first) medical aid? How long was the time between event and (the first) medical aid? How long was the time between event and (the first) medical aid? How long was the time between event and (the first) medical aid? How long was the time between event and (the first) medical aid? How long was the time between event and (the first) medical aid? 156 66488 1 3 1.538 1 < 1 hour 2 1-24 hours 3 > 24 hours Sysmiss Coughing for 3 weeks or more? Coughing for 3 weeks or more? Coughing for 3 weeks or more? Coughing for 3 weeks or more? Coughing for 3 weeks or more? Is (name) ever experienced the following in the past one year: a. Coughing for 3 weeks or more? 66644 1 2 1.935 1 Yes 2 No Coughing with considerable sweating when sleeping at night? Coughing with considerable sweating when sleeping at night? Coughing with considerable sweating when sleeping at night? Coughing with considerable sweating when sleeping at night? Coughing with considerable sweating when sleeping at night? Is (name) ever experienced the following in the past one year: b. Coughing with considerable sweating when sleeping at night? 66644 1 2 1.954 1 Yes 2 No Coughing up blood or bloody sputum/phlegm? Coughing up blood or bloody sputum/phlegm? Coughing up blood or bloody sputum/phlegm? Coughing up blood or bloody sputum/phlegm? Coughing up blood or bloody sputum/phlegm? Is (name) ever experienced the following in the past one year: c. Coughing up blood or bloody sputum/phlegm? 66644 1 2 1.995 1 Yes 2 No Underwent TBC/lung disease test, with sputum testing in laboratory or lung x-ray? Underwent TBC/lung disease test, with sputum testing in laboratory or lung x-ray? Underwent TBC/lung disease test, with sputum testing in laboratory or lung x-ray? Underwent TBC/lung disease test, with sputum testing in laboratory or lung x-ray? Underwent TBC/lung disease test, with sputum testing in laboratory or lung x-ray? Is (name) ever experienced the following in the past one year: d. Underwent TBC/lung disease test, with sputum testing in laboratory or lung x-ray? If the answer is coded 2, skip to m8dr35f. 66644 1 2 1.993 1 Yes 2 No what was the result? what was the result? what was the result? what was the result? what was the result? If yes (m8dr35d = 1) Is (name) ever experienced the following in the past one year: e. If yes (R.35.d = 1), what was the result? 448 66196 1 9 2.853 1 Positive 2 Negative 9 Do not know Sysmiss Ever receive TBC medicine (cause red-colored urine)? Ever receive TBC medicine (cause red-colored urine)? Ever receive TBC medicine (cause red-colored urine)? Ever receive TBC medicine (cause red-colored urine)? Ever receive TBC medicine (cause red-colored urine)? Is (name) ever experienced the following in the past one year: f. Ever receive TBC medicine (cause red-colored urine)? 66644 1 2 1.996 1 Yes 2 No Relationship with head of household (HH) Relationship with head of household (HH) Relationship with head of household (HH) Relationship with head of household (HH) Relationship with head of household (HH) Relationship with head of household (HH) 66644 1 9 1.948 1 Head of household 2 Wife/husband 3 Child 4 In-law 5 Grandchild 6 Parent/in-law 7 Other family 8 Housemaid 9 Other Gender Gender Gender Gender Gender Gender 66644 1 2 1.493 1 Male 2 Female Age (Year) Age (Year) Age (Year) Age (Year) Age (Year) Age (Year) 66644 15 99 38.129 Give check mark (v) for men and cross (x) for women Give check mark (v) for men and cross (x) for women Give check mark (v) for men and cross (x) for women Give check mark (v) for men and cross (x) for women Give check mark (v) for men and cross (x) for women Give check mark (v) for men and cross (x) for women 66644 V X Respondent and respondent selection sequential number [See elucidation] Respondent and respondent selection sequential number [See elucidation] Respondent and respondent selection sequential number [See elucidation] Respondent and respondent selection sequential number [See elucidation] Respondent and respondent selection sequential number [See elucidation] Respondent and respondent selection sequential number [See elucidation] 66644 1 8 1.836 1 2 3 4 5 6 7 8 Biological father still alive? Biological father still alive? Biological father still alive? Biological father still alive? Biological father still alive? Biological father still alive? 66644 1 9 1.478 1 Yes 2 No 9 Do not know Biological mother still alive? Biological mother still alive? Biological mother still alive? Biological mother still alive? Biological mother still alive? Biological mother still alive? 66644 1 9 1.373 1 Yes 2 No 9 Do not know Receive dental examination/ care by doctor/ nurse in the past 6 months? Receive dental examination/ care by doctor/ nurse in the past 6 months? Receive dental examination/ care by doctor/ nurse in the past 6 months? Receive dental examination/ care by doctor/ nurse in the past 6 months? Receive dental examination/ care by doctor/ nurse in the past 6 months? Receive dental examination/ care by doctor/ nurse in the past 6 months? 66644 1 4 3.781 1 Yes, for treatment 2 Yes, for checkup/care 3 Yes, for treatment & checkup 4 No Work at least 1 hour in the past week? Work at least 1 hour in the past week? Work at least 1 hour in the past week? Work at least 1 hour in the past week? Work at least 1 hour in the past week? Work at least 1 hour in the past week? 66644 1 Yes 2 No Sysmiss Work is at (the main) business? Work is at (the main) business? Work is at (the main) business? Work is at (the main) business? Work is at (the main) business? If “Yes” (Col. 10 = 1) Work is at (the main) business? 66644 1 Self-owned 2 Owned PT 3 Other paid people/ party 4 Other unpaid people/ party Sysmiss Main job in the past week: Main job in the past week: Main job in the past week: Main job in the past week: Main job in the past week: Main job in the past week: 66644 1 Traveling trader 2 Permanent place trader 3 Scavenging 4 Work in household/small industry 5 Work in medium/large industry 6 Work in agriculture sector 7 Work in transportation sector 8 Work in service sector 9 Other Sysmiss Perform money generating activity such as busker or beg, clean car in traffic lights etc. in the past week? Perform money generating activity such as busker or beg, clean car in traffic lights etc. in the past week? Perform money generating activity such as busker or beg, clean car in traffic lights etc. in the past week? Perform money generating activity such as busker or beg, clean car in traffic lights etc. in the past week? Perform money generating activity such as busker or beg, clean car in traffic lights etc. in the past week? Perform money generating activity such as busker or beg, clean car in traffic lights etc. in the past week? 66644 1 Yes 2 No Sysmiss Help household work (cook, shop, wash, nurse younger sibling/other household member etc.) in the past week? Help household work (cook, shop, wash, nurse younger sibling/other household member etc.) in the past week? Help household work (cook, shop, wash, nurse younger sibling/other household member etc.) in the past week? Help household work (cook, shop, wash, nurse younger sibling/other household member etc.) in the past week? Help household work (cook, shop, wash, nurse younger sibling/other household member etc.) in the past week? Help household work (cook, shop, wash, nurse younger sibling/other household member etc.) in the past week? 66644 1 Yes 2 No Sysmiss Daily average hour for the activity? Daily average hour for the activity? Daily average hour for the activity? Daily average hour for the activity? Daily average hour for the activity? If “Yes” (Col. 14=1) Daily average hour for the activity? 66644 Sysmiss - - - - - 66419 225 1 79 23.072 Biological mother sequential number Biological mother sequential number Biological mother sequential number Biological mother sequential number Biological mother sequential number 66418 226 13 0.355 1 2 3 4 5 6 7 8 9 10 13 Sysmiss Is the household member present during interview? Is the household member present during interview? Is the household member present during interview? Is the household member present during interview? Is the household member present during interview? Enter code 1 if the answer is "Yes" or code 2 for "No" in the box provided. 66419 225 1 2 1.162 1 Yes 2 No Sysmiss Health complaints - fever Health complaints - fever Health complaints - fever Health complaints - fever Health complaints - fever Any health complaint in the past one month? (read from a to h) a. fever If the answer is coded 2, skip to b5r8 Use code 1 if the respondent have health problems or code 2 if the answer is "No". 66419 225 1 2 1.907 1 Yes 2 No Sysmiss 1. Health complaints is a condition where a person suffers from physical or mental illness, whether it is an acute disease, chronic disease (although there is no problem in the last one month), accident, criminal act or other things. 2. Fever is a condition which symptom is the increasing body temperature above 37.5 degrees Celcius, or if touched (especially with the back of the hand) it feels hot. Health complaints - cough Health complaints - cough Health complaints - cough Health complaints - cough Health complaints - cough Any health complaint in the past one month? (read from a to h) b. cough If the answer is coded 2, skip to b5r8 Use code 1 if the respondent have health problems or code 2 if the answer is "No". 66418 226 1 2 1.857 1 Yes 2 No Sysmiss 1. Health complaints is a condition where a person suffers from physical or mental illness, whether it is an acute disease, chronic disease (although there is no problem in the last one month), accident, criminal act or other things. 2. Coughing is a sound produced by the sudden opening of vocal cords followed by the fast release of air, in order to let out the object that stimulates the central or lower part of respiratory tract; short or long; dry, phlegm or bloody expectoration; lasting for days, weeks, months or years. Health complaints - cold Health complaints - cold Health complaints - cold Health complaints - cold Health complaints - cold Any health complaint in the past one month? (read from a to h) c. cold If the answer is coded 2, skip to b5r8 Use code 1 if the respondent have health problems or code 2 if the answer is "No". 66419 225 1 2 1.869 1 Yes 2 No Sysmiss 1. Health complaints is a condition where a person suffers from physical or mental illness, whether it is an acute disease, chronic disease (although there is no problem in the last one month), accident, criminal act or other things. 2. Colds is a condition with the following symptoms: mucus, nasal congestion, and might be followed by sneezing, or other symptoms. Health complaints - asthma/breathlessnes Health complaints - asthma/breathlessnes Health complaints - asthma/breathlessnes Health complaints - asthma/breathlessnes Health complaints - asthma/breathlessnes Any health complaint in the past one month? (read from a to h) d. asthma/breathlessnes If the answer is coded 2, skip to b5r8 Use code 1 if the respondent have health problems or code 2 if the answer is "No". 66419 225 1 2 1.975 1 Yes 2 No Sysmiss 1. Health complaints is a condition where a person suffers from physical or mental illness, whether it is an acute disease, chronic disease (although there is no problem in the last one month), accident, criminal act or other things. 2. Asthma is an illness during which attack the patient suffers difficulty in breathing due to constriction in the lower respiratoty track, causing the breathing to make a shound while letting air out; local community calls the illness bengek or mengi. Health complaints - diarrhea Health complaints - diarrhea Health complaints - diarrhea Health complaints - diarrhea Health complaints - diarrhea Any health complaint in the past one month? (read from a to h) e. diarrhea If the answer is coded 2, skip to b5r8 Use code 1 if the respondent have health problems or code 2 if the answer is "No". 66418 226 1 2 1.985 1 Yes 2 No Sysmiss 1. Health complaints is a condition where a person suffers from physical or mental illness, whether it is an acute disease, chronic disease (although there is no problem in the last one month), accident, criminal act or other things. 2. Diarrhea is an illness which symptomsare: runny or liquid faeces, sometimes mixed with blood or mucus; generally happens 3 times or more within 24 hours. Diarrhea might be accompanied with a throwing up, or decrement of consciousness. Local people call this illness as mencret or bocor. Health complaints - migraine Health complaints - migraine Health complaints - migraine Health complaints - migraine Health complaints - migraine Any health complaint in the past one month? (read from a to h) f. migraine If the answer is coded 2, skip to b5r8 Use code 1 if the respondent have health problems or code 2 if the answer is "No". 66419 225 1 2 1.926 1 Yes 2 No Sysmiss 1. Health complaints is a condition where a person suffers from physical or mental illness, whether it is an acute disease, chronic disease (although there is no problem in the last one month), accident, criminal act or other things. 2. Migraine/Recurring headache is the feeling of pain, throbbing pain, jabbing pain, like being tied up, drilled or stabbed in the head, or other uncomfortable feelings in part or of the whole head. It lasts from a few hours to a few days, recurring for several times within 1 year (at least 2 times), with similar symptoms. Headache during fewer is not considered a recurring headache. Health complaints - toothache Health complaints - toothache Health complaints - toothache Health complaints - toothache Health complaints - toothache Any health complaint in the past one month? (read from a to h) g. toothache If the answer is coded 2, skip to b5r8 Use code 1 if the respondent have health problems or code 2 if the answer is "No". 66418 226 1 2 1.974 1 Yes 2 No Sysmiss 1. Health complaints is a condition where a person suffers from physical or mental illness, whether it is an acute disease, chronic disease (although there is no problem in the last one month), accident, criminal act or other things. 2. Toothache is the feeling of pain in the teeth or gums, sometimes accompanied by swelling, but does not include sprue. Health complaints - other Health complaints - other Health complaints - other Health complaints - other Health complaints - other Any health complaint in the past one month? (read from a to h) h. other If the answer is coded 2, skip to b5r8 Use code 1 if the respondent have health problems or code 2 if the answer is "No". 66419 225 1 2 1.89 1 Yes 2 No Sysmiss 1. Health complaints is a condition where a person suffers from physical or mental illness, whether it is an acute disease, chronic disease (although there is no problem in the last one month), accident, criminal act or other things. 2. Other problems are health problems such as measles, perforated tympanic membrane /CSOM, hepatitis/liver disease, seizures, paralyzed, senility, including other health problems caused by accidents/tragic events, natural disaster, lost of appetite, difficulty in defecating, headache caused by fever, non-recurring headache, problems with joints, problems in hearing, cataract, gastritis, stomachache, catching colds, unable to urinate, ulcer, sore eyes, and physical problems caused due to menstruation or pregnancy. If there is a complaint,did it disrupt job,school or daily activities? If there is a complaint,did it disrupt job,school or daily activities? If there is a complaint,did it disrupt job,school or daily activities? If there is a complaint,did it disrupt job,school or daily activities? If there is a complaint,did it disrupt job,school or daily activities? If there is a complaint,did it disrupt job,school or daily activities? If the answer is coded 2, skip to b5r5a Circle the appropriate code and fill in the provided box. 66260 384 2 0.462 1 Yes 2 No Sysmiss Complaint of activities means that the respondent cannot do the normal activity (work, study, daily activities) as usual. Period of disruption: (days) Period of disruption: (days) Period of disruption: (days) Period of disruption: (days) Period of disruption: (days) Period of disruption:(days) Write down how long (days) the household members who have health problems are interrupted from their daily activities in the last one month.The duration of interruption shall not exceed 30 days because the time reference used is the last one month, although the actual health problems last for more than 30 days. 66195 449 30 1.116 Period of disruption does not refer to the worst health problem, but also covers the total duration of all the health problems suffered by the household members in the last one month. If a person has more than one health problem, the length of interruption time caused by the illnesses should not be combined. Is it still disrupting now? Is it still disrupting now? Is it still disrupting now? Is it still disrupting now? Is it still disrupting now? Circle one of codes and record in the box available. Circles code 1 if householder "still has health disruption until the enumeration day" and circle code 2 if "No". 66196 448 2 0.317 1 Yes 2 No Sysmiss Ever performed self-medication in the past 1 month? Ever performed self-medication in the past 1 month? Ever performed self-medication in the past 1 month? Ever performed self-medication in the past 1 month? Ever performed self-medication in the past 1 month? Ever performed self-medication in the past 1 month? If the answer is coded 2, skip to b5r6 Circle the appropriate code and fill in the provided box. 66260 384 2 0.407 1 Yes 2 No Sysmiss Self medication is an effort to have a medication by deciding the kind of medicines by oneself (without any /prescription from a medical doctor/traditional medication/batra). Self medicine/treatment - traditional medicine Self medicine/treatment - traditional medicine Self medicine/treatment - traditional medicine Self medicine/treatment - traditional medicine Self medicine/treatment - traditional medicine Type of medicine/treatment method used: 1. traditional medicine Enter code 1 if the answer is “Yes” or code 2 for “No” in the box provided. 66236 408 2 0.392 1 Yes 2 No Sysmiss Traditional Medicine is medicine concoction made of herbs/plants, animal, mineral, etc. which is generaly has already been used for generation whether to cure an illness ir to be taken as health supplement in a form of powder, finely chops, liquid, tablet, capsule, medical embrocation, liniment lotion, etc. Self medicine/treatment - modern medicine Self medicine/treatment - modern medicine Self medicine/treatment - modern medicine Self medicine/treatment - modern medicine Self medicine/treatment - modern medicine Type of medicine/treatment method used: 2. modern medicine Enter code 1 if the answer is “Yes” or code 2 for “No” in the box provided. 66236 408 2 0.27 1 Yes 2 No Sysmiss Modern medicine is medicine used in a medical system, it can be in the form of tablet, caplet, capsule, syrup, powder, ointment, suppository (i.e. hemorrhoids medicine), inhaler (i.e. asthmatic medicine to be sprayed inside the mouth or to be inhaled); usually is ready made from pharmaceutical factories, with packaging and registration code number in the Ministry of Health starting with 1-3 letters followed by numbers. Self medicine/treatment - other Self medicine/treatment - other Self medicine/treatment - other Self medicine/treatment - other Self medicine/treatment - other Type of medicine/treatment method used: 3. other Enter code 1 if the answer is “Yes” or code 2 for “No” in the box provided. 66235 409 2 0.449 1 Yes 2 No Sysmiss Others, such as food supplement/natural supplement (i.e: sunchlorella, squalen, omega 3, nuskin, imedeen, collagen, etc); tonic drinks (i.e: Kratingdaeng, Kaki Tiga, M-150, Adem Sari, Lasegar, etc) with registration code beginning with MD (local products) or ML (imported products); skin scrapping; massage. Ever become an outpatient in the past one month? Ever become an outpatient in the past one month? Ever become an outpatient in the past one month? Ever become an outpatient in the past one month? Ever become an outpatient in the past one month? Ever become an outpatient in the past one month? If the answer is coded 2, skip to b5r8 Circle the appropriate code and fill in the provided box. 66260 384 2 0.528 1 Yes 2 No Sysmiss The followings are not included in medical treatment:consultation,medical check-up,health check (such as for Driver Liscense,new employee acceptance,promotion),screening (medical check-up to find illness,such as:Pap Smear Test for cervix cancer,mantoux tes for toddler to find TBC),normal pregnancy check-up,and immunization,because all are prevention efforts. Outpatient is an effort by household members who have health problems to check their health and get medication by going to modern or traditional health services without hospitalization,including housecall. Frequency of outpatient - state hospital Frequency of outpatient - state hospital Frequency of outpatient - state hospital Frequency of outpatient - state hospital Frequency of outpatient - state hospital How many times became outpatient in the past one month? a. state hospital Write down in the provided box the frequency of (how many times) the respondent visits health centers for medical treatment (without hospitalization). 66156 488 30 0.0142 1 2 3 4 5 6 7 8 11 21 30 Sysmiss State Hospital is a hospital owned by the central government (such as RSCM/RSUP Dr. Cipto Mangunkusumo); regional government (such as RSU Labuang Baji), National Army/TNI (such as RSPAD), or State-owned Enterprise/BUMN (such as RS Pertamina). Frequency of outpatient - private hospital Frequency of outpatient - private hospital Frequency of outpatient - private hospital Frequency of outpatient - private hospital Frequency of outpatient - private hospital How many times became outpatient in the past one month? b. private hospital Write down in the provided box the frequency of (how many times) the respondent visits health centers for medical treatment (without hospitalization). 66156 488 8 0.00623 1 2 3 4 5 6 8 Sysmiss Private Hospital is a private owned hospital such as RS St. Carolus, RS Medistra. Frequency of outpatient - doctor Frequency of outpatient - doctor Frequency of outpatient - doctor Frequency of outpatient - doctor Frequency of outpatient - doctor How many times became outpatient in the past one month? c. doctor Write down in the provided box the frequency of (how many times) the respondent visits health centers for medical treatment (without hospitalization). 66156 488 20 0.047 1 2 3 4 5 6 7 8 10 11 12 20 Sysmiss Doctor is a health service center for outpatient (not hospitalized); usually managed by privates, companies, foundations, Army/TNI or various Departments/BUMN. Frequency of outpatient - health clinic Frequency of outpatient - health clinic Frequency of outpatient - health clinic Frequency of outpatient - health clinic Frequency of outpatient - health clinic How many times became outpatient in the past one month? d. health clinic Write down in the provided box the frequency of (how many times) the respondent visits health centers for medical treatment (without hospitalization). 66156 488 20 0.0686 1 2 3 4 5 6 7 8 10 12 20 Sysmiss Health clinic(Community Health Center) is a health service unit owned by the government responsible for providing health services to the community in sub-districts,part of sub-districts or kelurahan (such in DKI Jakarta). Puskesmas team can do mobile practices to certain places within its working territory in order to provide easier access of health services for the society. Frequency of outpatient - polyclinic Frequency of outpatient - polyclinic Frequency of outpatient - polyclinic Frequency of outpatient - polyclinic Frequency of outpatient - polyclinic How many times became outpatient in the past one month? e. polyclinic Write down in the provided box the frequency of (how many times) the respondent visits health centers for medical treatment (without hospitalization). 66155 489 10 0.00642 1 2 3 4 10 Sysmiss Frequency of outpatient - medical worker practice Frequency of outpatient - medical worker practice Frequency of outpatient - medical worker practice Frequency of outpatient - medical worker practice Frequency of outpatient - medical worker practice How many times became outpatient in the past one month? f. medical worker practice Write down in the provided box the frequency of (how many times) the respondent visits health centers for medical treatment (without hospitalization). 66156 488 30 0.0396 1 2 3 4 5 6 7 8 10 12 20 30 Sysmiss Medical worker practice are private/personal practices of physicians,whether general practitioners,dentists,or specialists.Location of practices can be carried out in Hospitals,puskesmas (community health center),supporting puskemas,or clinic that is commonly open outside the doctor's working hours. Frequency of outpatient - traditional treatment Frequency of outpatient - traditional treatment Frequency of outpatient - traditional treatment Frequency of outpatient - traditional treatment Frequency of outpatient - traditional treatment How many times became outpatient in the past one month? g. traditional treatment Write down in the provided box the frequency of (how many times) the respondent visits health centers for medical treatment (without hospitalization). 66156 488 12 0.00452 1 2 3 4 5 6 8 9 12 Sysmiss Batra Practice (Traditional treatment) is an alternative health service by shaman/healer/sinshe,including accupuncture practice,finger therapy,paranormal,radiesthesia (usually using a pendulum). Frequency of outpatient - other Frequency of outpatient - other Frequency of outpatient - other Frequency of outpatient - other Frequency of outpatient - other How many times became outpatient in the past one month? h. other Write down in the provided box the frequency of (how many times) the respondent visits health centers for medical treatment (without hospitalization). 66156 488 30 0.0116 1 2 3 4 5 6 7 8 10 11 12 21 22 25 30 Sysmiss Others, such as Polindes (Village Maternity Ward), Posyandu, or if a woman gave birth without any medical support. Ever become an inpatient in the past one year? Ever become an inpatient in the past one year? Ever become an inpatient in the past one year? Ever become an inpatient in the past one year? Ever become an inpatient in the past one year? Ever become an inpatient in the past one year? If the answer is no, skip to b5r10. Circle one of the codes and enter the number into the box provided. 66419 225 1 2 1.985 1 Yes 2 No Sysmiss Inpatient is an effort to treat a disease by spending a night or more in a modern or traditional health service unit,including inpatient in maternity ward. Inpatient period - state hospital Inpatient period - state hospital Inpatient period - state hospital Inpatient period - state hospital Inpatient period - state hospital Inpatient period (in days) - a. state hospital Fill in the duration of inpatient that is already finished in the last one year , in the provided box, if the respondent has been inpatient more than once in the same place, add the duration of the inpatient days of the several visits for the last one year. 66123 521 106 0.0486 State Hospital is a hospital owned by the central government (such as RSCM/RSUP Dr. Cipto Mangunkusumo); regional government (such as RSU Labuang Baji), National Army/TNI (such as RSPAD), or State-owned Enterprise/BUMN (such as RS Pertamina). Inpatient period - private hospital Inpatient period - private hospital Inpatient period - private hospital Inpatient period - private hospital Inpatient period - private hospital Inpatient period (in days) - b. private hospital Fill in the duration of inpatient that is already finished in the last one year , in the provided box, if the respondent has been inpatient more than once in the same place, add the duration of the inpatient days of the several visits for the last one year. 66123 521 90 0.0295 Private Hospital is a private owned hospital such as RS St. Carolus, RS Medistra. Inpatient period - health clinic Inpatient period - health clinic Inpatient period - health clinic Inpatient period - health clinic Inpatient period - health clinic Inpatient period (in days) - c. health clinic Fill in the duration of inpatient that is already finished in the last one year , in the provided box, if the respondent has been inpatient more than once in the same place, add the duration of the inpatient days of the several visits for the last one year. 66123 521 16 0.00561 Health clinic(Community Health Center) is a health service unit owned by the government responsible for providing health services to the community in sub-districts,part of sub-districts or kelurahan (such in DKI Jakarta). Puskesmas team can do mobile practices to certain places within its working territory in order to provide easier access of health services for the society. Inpatient period - medical worker practice Inpatient period - medical worker practice Inpatient period - medical worker practice Inpatient period - medical worker practice Inpatient period - medical worker practice Inpatient period (in days): d. medical worker practice Fill in the duration of inpatient that is already finished in the last one year , in the provided box, if the respondent has been inpatient more than once in the same place, add the duration of the inpatient days of the several visits for the last one year. 66123 521 20 0.00371 1 2 3 4 5 6 7 8 15 20 Sysmiss Medical worker practice are private/personal practices of physicians,whether general practitioners,dentists,or specialists.Location of practices can be carried out in Hospitals,puskesmas (community health center),supporting puskemas,or clinic that is commonly open outside the doctor's working hours. Inpatient period - traditional treatment Inpatient period - traditional treatment Inpatient period - traditional treatment Inpatient period - traditional treatment Inpatient period - traditional treatment Inpatient period (in days): e. traditional treatment Fill in the duration of inpatient that is already finished in the last one year , in the provided box, if the respondent has been inpatient more than once in the same place, add the duration of the inpatient days of the several visits for the last one year. 66123 521 30 0.00234 1 2 3 4 5 6 15 20 30 Sysmiss Batra Practice (Traditional treatment) is an alternative health service by shaman/healer/sinshe,including accupuncture practice,finger therapy,paranormal,radiesthesia (usually using a pendulum). Inpatient period - other Inpatient period - other Inpatient period - other Inpatient period - other Inpatient period - other Inpatient period (in days): f. other Fill in the duration of inpatient that is already finished in the last one year, in the provided box, if the respondent has been inpatient more than once in the same place, add the duration of the inpatient days of the several visits for the last one year. 66123 521 30 0.00219 1 2 3 4 5 6 7 16 22 30 Sysmiss Health insurance for outpatient/inpatient needs - Askes Health insurance for outpatient/inpatient needs - Askes Health insurance for outpatient/inpatient needs - Askes Health insurance for outpatient/inpatient needs - Askes Health insurance for outpatient/inpatient needs - Askes Is there any health insurance/financing for outpatient/inpatient needs as follows: a. Askes Fill in code 1 for “Yes” or code 2 for “No” into the provided boxes. 66419 225 1 2 1.932 1 Yes 2 No Sysmiss Health Insurance for Civil Servant/Veteran/Pensioneris healthcare insurance for Civil Servant,Veteran and Pensioner,proven by membership card that is managed by PT Askes (Persero). Health insurance for outpatient/inpatient needs - Askes/Jamsostek Health insurance for outpatient/inpatient needs - Askes/Jamsostek Health insurance for outpatient/inpatient needs - Askes/Jamsostek Health insurance for outpatient/inpatient needs - Askes/Jamsostek Health insurance for outpatient/inpatient needs - Askes/Jamsostek Is there any health insurance/financing for outpatient/inpatient needs as follows: b. Askes/Jamsostek Fill in code 1 for “Yes” or code 2 for “No” into the provided boxes. 66419 225 1 2 1.969 1 Yes 2 No Sysmiss Jamsostek is healthcare insurance for employee of private company in formal sector,proven by membership card that is managed by PT Jamsostek. Health financing for outpatient/inpatient needs - Office/company Health financing for outpatient/inpatient needs - Office/company Health financing for outpatient/inpatient needs - Office/company Health financing for outpatient/inpatient needs - Office/company Health financing for outpatient/inpatient needs - Office/company Is there any health insurance/financing for outpatient/inpatient needs as follows: c. Office/company Fill in code 1 for “Yes” or code 2 for “No” into the provided boxes. 66419 225 1 2 1.976 1 Yes 2 No Sysmiss Private health insurance is commercial medical insurance to replace the expenses of health services spent by the policy holders. The membership is proven by medical insurance card. Health insurance for outpatient/inpatient needs - JPKM (Public Health Service Assurance) Health insurance for outpatient/inpatient needs - JPKM (Public Health Service Assurance) Health insurance for outpatient/inpatient needs - JPKM (Public Health Service Assurance) Health insurance for outpatient/inpatient needs - JPKM (Public Health Service Assurance) Health insurance for outpatient/inpatient needs - JPKM (Public Health Service Assurance) Is there any health insurance/financing for outpatient/inpatient needs as follows: d. JPKM (Public Health Service Assurance) Fill in code 1 for “Yes” or code 2 for “No” into the provided boxes. 66419 225 1 2 1.992 1 Yes 2 No Sysmiss Benefit/reimbursement by company is healthcare benefit that is proven by identity card as an employee of the company that will provide health benefit/reimbursement of the medical expenses. Health insurance for outpatient/inpatient needs - Commercial health insurance Health insurance for outpatient/inpatient needs - Commercial health insurance Health insurance for outpatient/inpatient needs - Commercial health insurance Health insurance for outpatient/inpatient needs - Commercial health insurance Health insurance for outpatient/inpatient needs - Commercial health insurance Is there any health insurance/financing for outpatient/inpatient needs as follows: e. Commercial health insurance Fill in code 1 for “Yes” or code 2 for “No” into the provided boxes. 66419 225 1 2 1.996 1 Yes 2 No Sysmiss Health insurance/health card/poor insurance/poor card is a health security for poor people that is proven by a membership card of JPK-MM,health card,poor card,JPK Gakin card or SKTM (Letter of Poverty) or Jamkesmas card. Health financing for outpatient/inpatient needs - Dana sehat (health fund) Health financing for outpatient/inpatient needs - Dana sehat (health fund) Health financing for outpatient/inpatient needs - Dana sehat (health fund) Health financing for outpatient/inpatient needs - Dana sehat (health fund) Health financing for outpatient/inpatient needs - Dana sehat (health fund) Is there any health insurance/financing for outpatient/inpatient needs as follows: f. Dana sehat (health fund) Fill in code 1 for “Yes” or code 2 for “No” into the provided boxes. 66419 225 1 2 1.906 1 Yes 2 No Sysmiss Health fund is membership of healthcare for a group/community that is proven by the membership card of health fund. Health insurance for outpatient/inpatient needs - Kartu sehat (health/poor card) Health insurance for outpatient/inpatient needs - Kartu sehat (health/poor card) Health insurance for outpatient/inpatient needs - Kartu sehat (health/poor card) Health insurance for outpatient/inpatient needs - Kartu sehat (health/poor card) Health insurance for outpatient/inpatient needs - Kartu sehat (health/poor card) Is there any health insurance/financing for outpatient/inpatient needs as follows: g. Kartu sehat (health/poor card) Fill in code 1 for “Yes” or code 2 for “No” into the provided boxes. 66419 225 1 2 1.977 1 Yes 2 No Sysmiss Other health insurance are other healthcare and medical securities that can be proven by ownership of membership cards for the above healthcare services. Age of child : (months) Age of child : (months) Age of child : (months) Age of child : (months) Age of child : (months) Age of child : (months) If the toddler is 1 month old or more (b5r11a not equal to 00), continue to b5r12. Fill in the toddler's age in months, if the age is >= 1 month in the space provided and directly move it to the box provided Child age 0-59 months 66116 528 48 0.00395 Age of child : (days) Age of child : (days) Age of child : (days) Age of child : (days) Age of child : (days) If b5r11a = 00 Age of child : (days) Fill in the toddler's age in days, if the toddler is < 1 month old in the space provided and directly move it to the box provided. Child age 0-59 months 66116 528 Has birth certificate (not birth statement), can I see it? Has birth certificate (not birth statement), can I see it? Has birth certificate (not birth statement), can I see it? Has birth certificate (not birth statement), can I see it? Has birth certificate (not birth statement), can I see it? Has birth certificate (not birth statement), can I see it? If the answer is coded 1 or 2, skip to b5r14. Fill in the answer code to the box. Child age 0-59 months 66116 528 3 0.000302 1 Yes, can be shown 2 No, cannot be shown 3 Do not have 9 Do not know Sysmiss Birth certificate is a letter of birth proof issued by Civil Registry Office, either in the country or overseas. 1. Yes, it can be shown if the birth certificate can be shown to the officer 2. Yes, but it can't be shown if the birth certificate can't be shown to the officer 3. Do not have - self explanatory Main reason of do not have/do not know Main reason of do not have/do not know Main reason of do not have/do not know Main reason of do not have/do not know Main reason of do not have/do not know If do not have/do not know (b5r12 = 3 or 9) If do not have/do not know (R.12 = 3 or 9), why? Do not read out the answer. Circle one of the codes and enter the number into the box provided. Child age 0-59 months 66116 528 99 0.00191 1 Expensive/no fund 2 Far traveling distance 3 Expensive and Far traveling distance 4 Do not know about birth certificate recording 5 Expensive and Do not know about birth certificate recording 6 Far traveling distance and Do not know about birth certificate recording 7 Expensive, Far traveling distance and Do not know about birth certificate recording 8 Do not know the processing procedure 9 Expensive and Do not know the processing procedure 10 Far traveling distance and Do not know the processing procedure 11 Expensive, Far traveling distance and Do not know the processing procedure 12 Do not know about birth certificate recording and Do not know the processing procedure 13 Expensive, Do not know about birth certificate recording and Do not know the processing procedure 14 Far traveling distance, Do not know about birth certificate recording and Do not know the processing procedure 15 Expensive, Far traveling distance, Do not know about birth certificate recording and Do not know the processing procedure 16 Do not see the need 17 Expensive and Do not see the need 18 Far traveling distance and Do not see the need 19 Expensive, Far traveling distance and Do not see the need 20 Do not know about birth certificate recording and Do not see the need 21 Expensive, Do not know about birth certificate recording and Do not see the need 22 Far traveling distance, Do not know about birth certificate recording and Do not see the need 23 Expensive, Far traveling distance, Do not know about birth certificate recording and Do not see the need 24 Do not know the processing procedure and Do not see the need 25 Expensive, Do not know the processing procedure and Do not see the need 26 Far traveling distance, Do not know the processing procedure and Do not see the need 27 Expensive, Far traveling distance, Do not know the processing procedure and Do not see the need 28 Do not know about birth certificate recording, Do not know the processing procedure and Do not see the need 29 Expensive, Do not know about birth certificate recording, Do not know the processing procedure and Do not see the need 30 Far traveling distance, Do not know about birth certificate recording, Do not know the processing procedure and Do not see the need 31 Expensive, Far traveling distance, Do not know about birth certificate recording, Do not know the processing procedure and Do not see the need 32 Other 33 Expensive and Other 34 Far traveling distance and Other 35 Expensive, Far traveling distance and Other 36 Do not know about birth certificate recording and Other 37 Expensive, Do not know about birth certificate recording and Other 38 Far traveling distance, Do not know about birth certificate recording and Other 39 Expensive, Far traveling distance, Do not know about birth certificate recording and Other 40 Do not know the processing procedure and Other 41 Expensive, Do not know the processing procedure and Other 42 Far traveling distance, Do not know the processing procedure and Other 43 Expensive, Far traveling distance, Do not know the processing procedure and Other 44 Do not know about birth certificate recording, Do not know the processing procedure and Other 45 Expensive, Do not know about birth certificate recording, Do not know the processing procedure and Other 46 Far traveling distance, Do not know about birth certificate recording, Do not know the processing procedure and Other 47 Expensive, Far traveling distance, Do not know about birth certificate recording, Do not know the processing procedure and Other 48 Do not see the need and Other 49 Expensive, Do not see the need and Other 50 Far traveling distance, Do not see the need and Other 51 Expensive, Far traveling distance, Do not see the need and Other 99 Do not know Who assisted the first birth process? Who assisted the first birth process? Who assisted the first birth process? Who assisted the first birth process? Who assisted the first birth process? Who assisted the first birth process? Fill in the box a for the helper for the first born . Child age 0-59 months 66116 528 4 0.000363 1 Doctor 2 Midwife 3 Other paramedic 4 Healer 5 Family 6 Other Sysmiss The birth process is the process of birth of a fetus from the mother’s womb to the world,starting with birth symptoms (periodic stomach ache that gets more often,longer and stronger,contraction of womb,water-broke mixed with mucus and blood from vagina, water-broke of yellowish clear color from vagina,and the feeling of defecation before the baby is finally delivered),infant delivered,cutting the placenta cord and the release of placenta.In birth a process,a woman might be help by more than one type of helper(such as traditional midwife and a nurse). Birth is a process when the fetus is delivered at the age of more than 5 months (22 weeks);if the fetus’s age is less than 5 months,it is called an abortion. Who assisted the last birth process? Who assisted the last birth process? Who assisted the last birth process? Who assisted the last birth process? Who assisted the last birth process? Who assisted the last birth process? Fill in box b for the helper for the last born . Child age 0-59 months 66116 528 5 0.000408 1 Doctor 2 Midwife 3 Other paramedic 4 Healer 5 Family 6 Other Sysmiss The birth process is the process of birth of a fetus from the mother’s womb to the world,starting with birth symptoms (periodic stomach ache that gets more often,longer and stronger,contraction of womb,water-broke mixed with mucus and blood from vagina, water-broke of yellowish clear color from vagina,and the feeling of defecation before the baby is finally delivered),infant delivered,cutting the placenta cord and the release of placenta.In birth a process,a woman might be help by more than one type of helper(such as traditional midwife and a nurse). Birth is a process when the fetus is delivered at the age of more than 5 months (22 weeks);if the fetus’s age is less than 5 months,it is called an abortion. Frequency immunization - BCG Frequency immunization - BCG Frequency immunization - BCG Frequency immunization - BCG Frequency immunization - BCG How many times the child received immunization? a. BCG Enter how many times a child has been given immunization according to the mother's answer, and enter the code into the boxes provided. If the answer is never, enter a zero and if she does not know, enter a nine. Child age 0-59 months 66116 528 3 0.000136 1 3 Sysmiss 1. Immunization or vaccination is inserting certain attenuated germs or toxins(vaccine) into human body by means of injecting or drinking(dropping into mouth) in order to increase body immunity against the disease. 2. BCG (Bacillus Calmette Guerin) is a vaccination to prevent Tuberculosis/TBC, given to a new born baby or a toddler by injection on the base of the upper arm. BCG injection is given one time. Frequency immunization - DPT Frequency immunization - DPT Frequency immunization - DPT Frequency immunization - DPT Frequency immunization - DPT How many times the child received immunization? b. DPT Enter how many times a child has been given immunization according to the mother's answer, and enter the code into the boxes provided. If the answer is never, enter a zero and if she does not know, enter a nine. Child age 0-59 months 66116 528 3 0.000242 1 2 3 Sysmiss 1. Immunization or vaccination is inserting certain attenuated germs or toxins(vaccine) into human body by means of injecting or drinking(dropping into mouth) in order to increase body immunity against the disease. 2. DPT (Diphteria ,Pertussis, Tetanus) is given to a baby aged 3 months or older, by injecting it on the thigh and should be repeated after 1 month and then again after 2 months. Thus, a complete DPT Immunization on toddlers are done 3 times (sometimes time lapse between injections can be more than one month). Frequency immunization - Polio Frequency immunization - Polio Frequency immunization - Polio Frequency immunization - Polio Frequency immunization - Polio How many times the child received immunization? c. Polio Enter how many times a child has been given immunization according to the mother's answer, and enter the code into the boxes provided. If the answer is never, enter a zero and if she does not know, enter a nine. Child age 0-59 months 66116 528 3 0.000212 1 2 3 Sysmiss 1. Immunization or vaccination is inserting certain attenuated germs or toxins(vaccine) into human body by means of injecting or drinking(dropping into mouth) in order to increase body immunity against the disease. 2. Polio is a vaccine to prevent polio virus, given to a baby at the age 3 months or older by giving 3 drops of liquid vaccine in a pink or white color directly into the baby's mouth; usually given together with DPT vaccination. A complete Polio immunization is given 3 times. In National Immunization Week (PIN), polio immunization are given specifically for all toddlers in Indonesia at the same week (in certain regions are at the same month or day) in accordance to the given schedule. Frequency immunization - Measles Frequency immunization - Measles Frequency immunization - Measles Frequency immunization - Measles Frequency immunization - Measles How many times the child received immunization? d. Measles Enter how many times a child has been given immunization according to the mother's answer, and enter the code into the boxes provided. If the answer is never, enter a zero and if she does not know, enter a nine. Child age 0-59 months 66116 528 3 0.000151 1 3 Sysmiss 1. Immunization or vaccination is inserting certain attenuated germs or toxins(vaccine) into human body by means of injecting or drinking(dropping into mouth) in order to increase body immunity against the disease. 2. Measles/morbilli is a vaccine to prevent measles/morbilli; (please state the symptoms and epidemic area of measles if the mother seems not understand), that is usually given one time to a baby aged between 9 to 12 months, by injecting on the thigh. Frequency immunization - Hepatitis B Frequency immunization - Hepatitis B Frequency immunization - Hepatitis B Frequency immunization - Hepatitis B Frequency immunization - Hepatitis B How many times the child received immunization? e. Hepatitis B Enter how many times a child has been given immunization according to the mother's answer, and enter the code into the boxes provided. If the answer is never, enter a zero and if she does not know, enter a nine. Child age 0-59 months 66116 528 3 0.000106 1 2 3 Sysmiss 1. Immunization or vaccination is inserting certain attenuated germs or toxins(vaccine) into human body by means of injecting or drinking(dropping into mouth) in order to increase body immunity against the disease. 2. Hepatitis B is an intramuscular injection (injection to the mucsle), usually on the thigh, given to baby to prevent Hepatitis B. This injection is given 3 times. The first injection given when the baby is 0 month old, the second is given at the age of 1 month, and the third is at the age of 6 months. Ever provided with breast milk? Ever provided with breast milk? Ever provided with breast milk? Ever provided with breast milk? Ever provided with breast milk? Ever provided with breast milk? If the entry is coded 2, skip to question other household member. Circle code 1 for “Yes” and code 2 for “No” and write down in the provided box. Child age 0-59 months 66116 528 2 0.000136 1 Yes 2 No Sysmiss Breastfeeding is if a mother’s nipple sucked by a baby secreting milk that is drunk by the baby,although only a little. A breastfeeding mother is not only the biological mother of the baby but she could be another woman. Breast milk(ASI) is the best natural food for baby,which composition meets the full requirement of a baby up to 6 months old.ASI contains elements that provides protection against various diseases and also enzyme that help baby’s digestive system. Breastfeeding with affection can also strengthen the bond between a mother and her baby. Period of provided with breast milk: Period of provided with breast milk: Period of provided with breast milk: Period of provided with breast milk: Period of provided with breast milk: If “yes” [b5r16a = 1] Period of provided with breast milk: Record the answer of duration in the box available in month by completing below. Child age 0-59 months 66116 528 24 0.00203 Period - Breast milk exclusive: Period - Breast milk exclusive: Period - Breast milk exclusive: Period - Breast milk exclusive: Period - Breast milk exclusive: If “yes” [b5r16a = 1] Period - Breast milk exclusive: Fill in days if age < 1 month and in months if age is >= 1 month Child age 0-59 months 66116 528 4 0.000227 If age less than 7 months, is only provided with breast milk only for the last 24 hours? If age less than 7 months, is only provided with breast milk only for the last 24 hours? If age less than 7 months, is only provided with breast milk only for the last 24 hours? If age less than 7 months, is only provided with breast milk only for the last 24 hours? If age less than 7 months, is only provided with breast milk only for the last 24 hours? Child age 0-59 months 66116 528 1 Yes 2 No Sysmiss Schooling participation: Schooling participation: Schooling participation: Schooling participation: Schooling participation: Schooling participation: 1. If the answer is coded 1, skip to b5r23, and 2. If the answer is coded 2, skip to b5r19 Circle one of the codes from 1 to 3 and enter the number into the box provided. For household member age five years up 66419 225 3 2.745 1 No/never in school 2 Still in school 3 No longer in school Sysmiss A person is considered schooling if he is registered and active in attending a study process in formal education level,whether under supervision of Ministry of National Education/Depdiknas or other department/institution. 1. Not/not yet attending school - never or not yet been registered and never been active in attending school or at formal education level, including have completed/not completed kindergarten level but do not continue to elementary school. 2. Still attending school - are those who are registered and actively attending a formal education level, whether it is under supervision of Ministry of National Education, Ministry of Religion, other Government Institution, or Private Institution. 3. No longer in school - those who were once registered and actively attending a formal education, but at the time of census are not registered and active anymore, including those who are attending Package A program of SD (Elementary) equivalent, Package B program of SMP (Junior High) equivalent and Package C Program of SMA (Senior High) equivalent. When did you quit school? (Month) When did you quit school? (Month) When did you quit school? (Month) When did you quit school? (Month) When did you quit school? (Month) When did you quit school? (Month) Fill in the month for people who quit prior to 1993, write down completely in the empty space and provided box. If quit prior to 1993, enter 00 into the month boxes. For household member age five years up 66294 350 12 0.999 1 2 3 4 5 6 7 8 9 10 11 12 Sysmiss When did you quit school? (Year) When did you quit school? (Year) When did you quit school? (Year) When did you quit school? (Year) When did you quit school? (Year) When did you quit school? (Year) Fill in the year for people who quit prior to 1993, write down completely in the empty space and provided box. If quit prior to 1993, enter 0000 into year boxes. For household member age five years up 66294 350 2004 323.938 The highest education type and level currently studied/passed: The highest education type and level currently studied/passed: The highest education type and level currently studied/passed: The highest education type and level currently studied/passed: The highest education type and level currently studied/passed: The highest education type and level currently studied/passed: Circle one of code 1 to 14 and fill it in the provided box. For household member age five years up 66407 237 11 2.871 1 Elementary school 2 M. Ibtidaiyah 3 Public/vocationaljunior high 4 M. Tsanawiyah 5 Senior High 6 M. Aliyah (Islamic school) 7 Vocational School 8 Diploma I/II 9 Diploma III 10 Diploma IV/S1 11 S2/S3 Sysmiss 1. SD/SDLB is an Elementary School of 5/6/7 years or equivalent(elementary special school,small elementary school,pamong elementary school). 2. Madrasah Ibtidaiyah(MI) is Islamic Elementary School of SD equivalent. 3. SMP/SMPLB is Secondary School or the equivalent MULO,3-year HBS,and Secondary Special School). 4. Madrasah Tsanawiyah(MTs) is Islamic Secondary School of SMP equivalent . 5. General High School(SMU)/Special High School(SMLB) is a High School(SMU),or the equivalent(Special High School,5-year HBS,AMS,and Employee Administration High Course(KPAA). 6. Madrasah Aliyah(MA) is an Islamic High School of SMU equivalent. 7. Vocational High School(SMK) is a vocational school of SMA equivalent. 8. Diploma 1/2 Program is D1/D2 program in a university that organizes diploma 1 and 2 program in formal education. 9. Diploma 3 Program/baccalaureate is a D3 program or baccalaureate degree in an academy or university that organizes diploma programs or issues baccalaureate degrees. 10. Diploma 4 Program/bachelor is an education program of Diploma 4 or Strata1 in a university. 11. S2/S3 is a postgraduate education program(master or doctorate),Strata 2 or Strata 3 in a university. Education provider: Education provider: Education provider: Education provider: Education provider: For household member age five years up 66407 237 3 1.118 1 State 2 Private 3 Overseas Sysmiss Highest class/level studied/currently studied: Highest class/level studied/currently studied: Highest class/level studied/currently studied: Highest class/level studied/currently studied: Highest class/level studied/currently studied: Highest class/level studied/currently studied: Circle one of the following codes from 1 to 8 and enter the code into the box provided. For household member age five years up 66407 237 8 5.931 1 Grade-1 2 Grade-2 3 Grade-3 4 Grade-4 5 Grade-5 6 Grade-6 7 Grade-7 8 Graduated Sysmiss Examples: Highest Level/Class Attended/Being Attended a.For household head/member who has graduated,use code 8 for the highest level/class has been/being attended. b.For household head/member who has a bachelor degree attending/has attended master/S2 program,use code 6. c.For household head/member who has a master degree attending/has attended S3 program,use code 7. d.For household head/member who has attended/is stillatending the highest level/class of S1 program,use code 5. Graduated means has completed the study marked with passing the final exams in the last class/level of an education in a public or private school and received a certificate/diploma. A household head/member who has not attended the last level of education program but has passed the final exams is considered graduate. Highest diploma obtained: Highest diploma obtained: Highest diploma obtained: Highest diploma obtained: Highest diploma obtained: Highest diploma obtained: Circle one of the codes from 1 to 15 and enter the answer into the box provided. For household member age five years up 66407 237 9 2.523 1 No elementary diploma 2 Elementary/MI 3 Junior High/equal 4 Senior High/equal 5 Vocational junior high 6 Diploma I/II 7 Diploma III 8 Diploma IV/S1 9 S2/S3 Sysmiss No elementary school diploma means that the household/member does not possessed certificate for a certain educational level, but has to attended to Elementary School of 5/6/7 year study or equivalent(among others are basic level of SLB,Madrasah Ibtidaiyah,Pamong Elementary School,Smal Elementary School,Package A1-A100,Package a Equivalent) but did not/has not yet graduate.This include household/member who graduated 3-year elementary school or equivalent. Can read and write: Can read and write: Can read and write: Can read and write: Can read and write: Can read and write: Circle one of the code 1 to code 4 and enter the answer into the provided box. For household member age five years up 66419 225 3 1.216 1 Latin alphabets 2 Other alphabets 3 Cannot Sysmiss Can read and write means able to read and write words/simple sentences in certain letters, e.g. "I must be honest." Activities in past one week - work Activities in past one week - work Activities in past one week - work Activities in past one week - work Activities in past one week - work Did you perform the following activity in the past one week? a. work Circle code 1 for "Yes" or code 2 for "No", and enter in the boxes provided. For household member age 10 years up 66419 225 2 1.383 1 Yes 2 No Sysmiss Working is an activity of doing work with the intention to earn or help earning a living or profit,minimum for one hour in the last one week. Working for one hour as mentioned above should be done continuously and uninterrupted. Income includes wages/salary,including all the benefits and bonus for worker/employee and business income in the form of rents or profits,whether in cash or goods for businessmen. Activities in past one week - attending school Activities in past one week - attending school Activities in past one week - attending school Activities in past one week - attending school Activities in past one week - attending school Did you perform the following activity in the past one week? b. attending school Circle code 1 for "Yes" or code 2 for "No", and enter in the boxes provided. For household member age 10 years up 66419 225 2 1.935 1 Yes 2 No Sysmiss Going to school is an activity at a formal school,whether in primary,secondary,or higher education.Students on leave are not included. Activities in past one week - handling household Activities in past one week - handling household Activities in past one week - handling household Activities in past one week - handling household Activities in past one week - handling household Did you perform the following activity in the past one week? c. handling household Circle code 1 for "Yes" or code 2 for "No", and enter in the boxes provided. For household member age 10 years up 66419 225 2 1.51 1 Yes 2 No Sysmiss Handling household is an activities of managing the household or helping to manage the household without getting paid. Activities in past one week - other beside personal activity Activities in past one week - other beside personal activity Activities in past one week - other beside personal activity Activities in past one week - other beside personal activity Activities in past one week - other beside personal activity Did you perform the following activity in the past one week? d. other beside personal activity Circle code 1 for "Yes" or code 2 for "No", and enter in the boxes provided. For household member age 10 years up 66419 225 1 1 1 Yes 2 No Sysmiss Other activities include: sports, course, picnic and social activities (organization, volunteering) Others are activities other than working,going to school and managing household. Included in this category are people who cannot do activities such as senior citizens,disabled and people who receive pension and do not work anymore. What activity used the most time in the past one week? What activity used the most time in the past one week? What activity used the most time in the past one week? What activity used the most time in the past one week? What activity used the most time in the past one week? If b5r24a1- 4 with code 1 (“Yes”) What activity used the most time in the past one week? If b5r24a1 is coded 1, skip to b5r26. B5r24a with code 1 (“Yes”) – ask what activity is the most time consuming in the last one week, circle one of the codes and enter the number into the box provided. For household member age 10 years up 66419 225 4 1.917 1 Work 2 School 3 Handling Household 4 Other Sysmiss The most time consuming activity is an activity that uses up most time in comparison with other activities. Do you have work/business, but temporarily not working for the past one week? Do you have work/business, but temporarily not working for the past one week? Do you have work/business, but temporarily not working for the past one week? Do you have work/business, but temporarily not working for the past one week? Do you have work/business, but temporarily not working for the past one week? Do you have work/business, but temporarily not working for the past one week? Circle code 1 for “Yes” or code 2 for “No”, then enter the answer into the provided box. For household member age 10 years up 66277 367 2 0.747 1 Yes 2 No Sysmiss Those who are categorized as have jobs but temporarily do not work are: 1.Professional workers who do not work because of sickness waiting for the next projects.Examples: Puppet master,masseur/se,shaman and singer. 2.Regular employees,government officials or employees of private companies who are ill,on leave,absent,on strike or temporarily laid off because the company stopped operating,for example a factory having machine malfunction,or lack of raw material,etc. 3.Farmer who works on farm land,stops working because of an illness or waiting for the next job such as harvest or rainy season to start planting paddy field. Those who are categorized as having jobs but temporarily do not work are people who work/have businesses but for the last one week stop working for a reason,such as sick,on leave,waiting for harvesting,or on a strike. Are you looking for work? Are you looking for work? Are you looking for work? Are you looking for work? Are you looking for work? For household member age 10 years up 66419 225 2 1.93 1 Yes 2 No Sysmiss Are you preparing a business during the past one week? Are you preparing a business during the past one week? Are you preparing a business during the past one week? Are you preparing a business during the past one week? Are you preparing a business during the past one week? For household member age 10 years up 66419 225 2 1.985 1 Yes 2 No Sysmiss Main reason of not looking for work/preparing business: Main reason of not looking for work/preparing business: Main reason of not looking for work/preparing business: Main reason of not looking for work/preparing business: Main reason of not looking for work/preparing business: If b5r26 = 2 and b5r27 = 2 For household member age 10 years up 66397 247 5 3.019 1 Feel unable to obtain work 2 Have work, but not yet started 3 In school or handling household/family 4 Have work/business, feel sufficient 5 Other (disabled, old, and the like) Sysmiss If there is a job offer, will you accept it? If there is a job offer, will you accept it? If there is a job offer, will you accept it? If there is a job offer, will you accept it? If there is a job offer, will you accept it? If b5r26 = 2 and b5r27 = 2 For household member age 10 years up 66397 247 2 1.575 1 2 Sysmiss Total work day: (days) Total work day: (days) Total work day: (days) Total work day: (days) Total work day: (days) Total work day: (days) Write down the total working days for the last one week according to the number of days spent for work and enter it in the box provided. For working household member 66259 385 7 3.709 1 2 3 4 5 6 7 Sysmiss Working days means days spent by a person to carry out working activities at a minimum of one (1) hour continuously in the last one week. Total work hour from all jobs in the past one week: (hours) Total work hour from all jobs in the past one week: (hours) Total work hour from all jobs in the past one week: (hours) Total work hour from all jobs in the past one week: (hours) Total work hour from all jobs in the past one week: (hours) Total work hour from all jobs in the past one week: (hours) Write down the total working hours in the last one week and enter it in the box provided. For working household member 66259 385 98 24.455 Total working hours is the time (in hour) spent to do all the working activities in the last one week. If respondent is temporary out of work, write down "00" Main business/job from workplace in the past one week: Main business/job from workplace in the past one week: Main business/job from workplace in the past one week: Main business/job from workplace in the past one week: Main business/job from workplace in the past one week: Main business/job from workplace in the past one week: Write down completely the main business/job from workplace in the empty space provided. For working household member 66259 385 970 182.849 1 7 9 11 12 13 14 15 19 20 21 30 50 55 56 90 100 101 102 110 111 112 113 122 123 131 132 133 141 142 151 152 153 154 155 160 164 171 172 173 174 180 181 182 189 191 192 200 201 202 204 210 221 222 223 231 232 241 242 243 250 251 252 253 256 260 261 262 263 264 265 266 269 271 272 273 275 281 282 289 291 292 293 300 302 303 310 311 313 314 315 319 321 322 323 331 332 333 341 342 343 351 353 359 361 369 371 372 401 402 410 423 425 430 434 450 451 452 453 454 455 456 470 475 501 502 503 504 505 510 511 512 513 514 515 519 520 521 522 523 524 525 526 527 528 530 532 533 535 539 542 543 549 551 552 554 557 561 564 600 601 602 603 604 605 607 611 612 621 622 623 624 625 626 630 631 632 633 634 635 636 639 641 642 650 651 655 659 660 662 671 672 701 702 703 711 712 713 715 716 717 721 723 724 725 729 731 735 739 741 742 743 744 749 750 751 752 753 755 756 757 769 771 800 801 802 803 804 806 809 810 820 842 850 851 852 853 854 856 893 900 901 909 911 912 919 921 922 923 924 927 930 931 936 950 951 960 970 Sysmiss Business sector/type of work is the sector of activity of work/company/business where the household head/member works. How to determine the main work: 1.If a household head/member in the last one week only has only one work,than it is considered the main work. 2.If a household head/member in the last one week has more than one work,the main work is the one that consumes the most time. If the time spent to do those works are the same,than the work that produces the largest income is considered the main work. Type of work/position of the main job in the past one week: Type of work/position of the main job in the past one week: Type of work/position of the main job in the past one week: Type of work/position of the main job in the past one week: Type of work/position of the main job in the past one week: Write down completely type of work/position of the main job in the empty space provided. For working household member 66259 385 999 390.194 Position/status of the main job in the past one week: Position/status of the main job in the past one week: Position/status of the main job in the past one week: Position/status of the main job in the past one week: Position/status of the main job in the past one week: Position/status of the main job in the past one week: 1. If the answer is coded 1,2,3,5,6, or 7 skip to Block V.E., and 2. If the answer is coded 4 skip to b5r34. Circle one of the code 1 to code 7 and enter the answer into the provided box. For working household member 66259 385 7 2.127 1 Self-owned business/freelance 2 Self-owned business with non-permanent/non-paid worker 3 Self-owned business with permanent/paid worker 4 Worker/employee/staff 5 Freelancer in agricultural sector 6 Freelancer in non-agricultural sector 7 Non-paid worker Sysmiss Status/work position is the household head/member position at main job. 1. Self-owned business/freelance is a household head/member who works/owns business by taking economical risk, that may result in the lost of production cost that has been spent in doing the business, and does not employ any worker whether paid or unpaid. Included in this category are works that required special skill/talent. 2. Self-owned business with non-permanent/non-paid worker is a household head/member who works or owns a business on his own risk, and hires unpaid labor/employee/staff and or employs fee labor/employee/staff. 3. Self-owned business with permanent/paid worker is a household head/member who opens a business at his own risk and employs at lease one paid labor/employee/staff. 4. Worker/employee/staff is a household head/member whow works for other people or institutions/ office/company and regularly receives wages/salaries in the form of money or goods (in-kind) 5. Freelancer is a household head/member who works irregularly for other people/employer/institution, who has more than one employer in the last one month in a household business or non-household business based on a reward system by receiving wages or compensation both in the form of money or in-kind, whether paid daily or per project. 6. Non-paid worker is a household member who works to help household head/member/other people without getting paid, whether in the form of money or goods. The amount of net wage/salary (money and goods) generally received in a month from the main job - rupiah The amount of net wage/salary (money and goods) generally received in a month from the main job - rupiah The amount of net wage/salary (money and goods) generally received in a month from the main job - rupiah The amount of net wage/salary (money and goods) generally received in a month from the main job - rupiah The amount of net wage/salary (money and goods) generally received in a month from the main job - rupiah The amount of net wage/salary (money and goods) generally received in a month from the main job - rupiah Write down the income in the space provided and enter into the box provided. For working household member 62589 4055 998350 73098.036 First marriage at age: (Years) First marriage at age: (Years) First marriage at age: (Years) First marriage at age: (Years) First marriage at age: (Years) First marriage at age: (Years) Fill in respondent’s age at first marriage in the provided space and write it down in the box. The formula to calculate the respondent's age at first marriage is the same as the formula to count respondent's age. For women age 10 years and up - women who once married 66185 459 60 8.055 Number of years in marriage: (years) Number of years in marriage: (years) Number of years in marriage: (years) Number of years in marriage: (years) Number of years in marriage: (years) Number of years in marriage: (years) Ask how long the respondent has been married. If there were more than one marriage, please add the number of years of the entire wedlocks made. Rounded it down. For those who got pregnant out of wedlock enter code "00". For women age 10 years and up - women who once married 66185 459 81 7.975 Ever use/wear family planning tool/device/method? Ever use/wear family planning tool/device/method? Ever use/wear family planning tool/device/method? Ever use/wear family planning tool/device/method? Ever use/wear family planning tool/device/method? If the answer is coded 2 skip to other household member. For women age 10 years and up - women who once married 66185 459 2 0.593 1 Yes 2 No Sysmiss The use/wearing of family planning device/method? The use/wearing of family planning device/method? The use/wearing of family planning device/method? The use/wearing of family planning device/method? The use/wearing of family planning device/method? The use/wearing of family planning device/method? If the answer is no longer use it or never use it , skip to other household member Circle the contraception/birth control (KB) code according to the respondent’s answer, enter it in the box provided. If using more than one type of contraception, please record only the type currently used. Generally,the reference time for various birth controls used is 30 days. For women age 10 years and up - Women with married status 66152 492 2 0.272 1 Yes 2 No Sysmiss The selected family planning device/method: The selected family planning device/method: The selected family planning device/method: The selected family planning device/method: The selected family planning device/method: The selected family planning device/method: Continue to other household member. If respondent uses more than one type of contraception (to meet the concept of contraception usage), then write down the type with the smallest code number. For women age 10 years and up - Women with married status 66146 498 9 0.725 1 Women/tubectomy 2 Men/vasectomy 3 IUD/spiral 4 Injection 5 Implant/norplant 6 Birth control pill 7 Condom/rubber 8 Intravag/tissue/women condom 9 Traditional method Sysmiss 1. MOW/Medis Operasi Wanita (woman medical surgery)/tubectomy (woman sterilization) is a surgery performed on female household head/member by having her fallopian tubes closed to prevent pregnancy. Please emphasize that the goal is to prevent future pregnancies. 2. MOP/Medis Operasi Pria (man medical surgery)/vasectomy (man sterilization) is a minor surgery performed on male household head/member to prevent his spouse from being pregnant. 3. AKDR/Alat Kontrasepsi Dalam Rahim (IUD/Intra Uterus Device) is a device made of soft plastic/copper,small in size,in the forms of spiral,T,fan,etc. installed inside the womb/uterus to prevent pregnancy. This device functions as pregnancy prevention for a long period of time. 4. KB Injection is one of ways to prevent pregnancy by injecting contraceptive substance periodically,e.g. once in one,three,or six months. 5. Susuk KB/norplant/implanon/alwalit (Contraceptive Skin Implant)-are six small metals to be implanted/injected under the skin of the upper arm to prevent pregnancy. A household head/member is considered using susuk KB if she had the implant less than five(5) years ago prior to the date of census. This includes under the skin injection(implant). 6. KB Pills are pills that are taken to prevent pregnancy. These pills should be taken regularly. 7. Condom/KB rubber is a device made of rubber,in a balloon-like shape,used by male household head/member while having sexual intercourse in order to prevent the spouse from getting pregnant. 8. Intravag/tissue/woman’s condom is a KB tissue positioned inside the vagina before having sexual intercourse. Reference time for this device is up to the last intercourse within 30 days before the interview. 9. Traditional method: a.Periodic abstinence/calendar method is based on the assumption that by not having sexual intercourse in a certain days of the month,which is during fertile period in monthly cycle,a woman could prevent pregnancy. b.Coitus interruptus is a method to prevent semen from entering vagina by interrupting intercourse before ejaculation. The refference time for this method is the last intercourse within 30 days. c.Other traditional methods such as breastfeeding for the purpose of birth control,abstinence,traditional herbs (jamu),and massage. Serial number of household members Serial number of household members Serial number of household members Serial number of household members Serial number of household members 66419 225 1 13 1.884 1 2 3 4 5 6 7 8 9 10 11 12 13 Sysmiss Relation with the head of household Relation with the head of household Relation with the head of household Relation with the head of household Relation with the head of household Relation with the head of household Ask the relation of each household member to the head of household and enter the code accordingly into the boxes provided. 66419 225 1 9 1.951 1 Head of household 2 Wife/husband 3 Child 4 In-law 5 Grandchild 6 Parent/in-law 7 Other family 8 Housemaid 9 Other Sysmiss 1. The head of household (krt) is a man in a group of household members who is responsible to provide the daily needs of the concerned households, or a person who is considerend/appointed to be the head of a household (for example a group of students live together in one room inside a census building; because they each are responsible for their own needs, one person is appointed as the household head). 2. Wife/husband, is the wife/husband of the head of household. 3. Children, includes biological children, stepchildren, and adopted children of the head of household. 4. Son/daughter in laws, are the husbands/wives of biological daughters/sons, step daughters/sons, or adopted daughters/sons. 5. Grandchildren, are the children of biological children, step children, or adopted children. 6. Parent in laws, are father/mother of the head of household or father/mother of the spouse of the head of household. 7. Other families, are those who have blood relation with head of the household or the spouse, such as siblings, aunties, uncles, grandparents. 8. Household helpers, are people who works as a helper and lives in the concerned household, receiving wage/salary in the form money or in-kind payment. 9. Other, are people who do not have familial relation to the head of household or the spouse, who live in the household for more than 6 months, such as visitors, friends or tenants who rent room plus food, including children of helpers who also live and eat in the employer's house. Gender Gender Gender Gender Gender Gender Write down the gender of each household member in the provided box, code 1 for “Male” and code 2 for “Female”. Do not guess people’s gender based on their names. To make sure, please ask if the person in question is a male or a female. 66419 225 1 2 1.493 1 Male 2 Female Sysmiss Age (year) Age (year) Age (year) Age (year) Age (year) Age (year) Ask the respondent's age and enter the answer into the box. Age is measured in years rounded down or the age after the last birthday. Age calculation is based on Christian calendar. 66419 225 2 98 38.138 Age is measured in years rounded down or the age after the last birthday. Age calculation is based on Christian calendar. Marital status Marital status Marital status Marital status Marital status Marital status Ask marital status of the respondent and enter the code into the box provided. 66419 225 1 4 1.998 1 Not married 2 Married 3 Divorce 4 Divorce due to death Sysmiss 1. Married means having a wife (for male) or husband (for female) durint the census, whether living together or separately. In this case the people included in this status are those who are married legally (by the law of the tradition, religion, state, etc), and also those who live together and have been considered husband and wive by the local society. 2. Divorcee is a person who has been separated from wife/husband and has not remarried.In this case including a person who claims to be divorced although it is not legally confirmed yet. Perform “tour”* trip? (Oct 1 – Dec 31, 2003) Perform “tour”* trip? (Oct 1 – Dec 31, 2003) Perform “tour”* trip? (Oct 1 – Dec 31, 2003) Perform “tour”* trip? (Oct 1 – Dec 31, 2003) Perform “tour”* trip? (Oct 1 – Dec 31, 2003) Perform “tour”* trip? (Oct 1 – Dec 31, 2003) Fill in code 1 for “Yes” or code 2 for “No” into the provided boxes. 66419 225 1 2 1.857 1 Yes 2 No Sysmiss “Tour” trip: trip to commercial tourist destinations, or stay in commercial accommodation, or trip distance = 100 Km (return). Travel frequency in the past 3 calendar months? Travel frequency in the past 3 calendar months? Travel frequency in the past 3 calendar months? Travel frequency in the past 3 calendar months? Travel frequency in the past 3 calendar months? Travel frequency in the past 3 calendar months? Fill in the travel frequency (times) for each household members who travel in the past 3 calendar months. Write down “00” if the related household member do not travel. 66227 417 41 0.233 One time travel/journey is calculated since leaving home and return back to the initial place. Travel/journey that has not been completed (the person has not returned to the initial place), is not considered as traveling. Travelling household member: trip to commercial tourist destinations, or stay in commercial accommodation, and or trip distance = 100 Km (return), excluding commuter, school and work. Ever/ on pre-school education? Ever/ on pre-school education? Ever/ on pre-school education? Ever/ on pre-school education? Ever/ on pre-school education? Ever/ on pre-school education? Write down the appropriate code for family members aged 0-6 regarding their participation in pre-school education. Household member age 0-6 years 66116 528 4 0.000635 1 Yes, kindergarten/RA/RB 2 Yes, playgroup 3 Yes, daycare 4 No Sysmiss Yes, once , if they have attended pre-school education and at the moment has finished/completed/not active anymore. Yes, currently on, if at the moment the respondent is still actively attending a pre-school education. No, if the respondent never attended a pre-school education. Attended preschool education means enrolled in and actively attending education in kindergarten (TK)/Bustanul Athfal (BA), Raudatul Athfal (RA), play group, day-care center, Early Age Children Education (PAUD) and other institution. District Id District Id District Id District Id District Id 66419 225 1101 9472 3924.175 Participant education: Participant education: Participant education: Participant education: Participant education: 66116 528 5 4.397 1 2 3 4 5 Sysmiss HH HH HH HH HH 66116 528 5 1.942 1 2 3 4 5 Sysmiss Has birth certificate (not birth statement), can I see it? Has birth certificate (not birth statement), can I see it? Has birth certificate (not birth statement), can I see it? Has birth certificate (not birth statement), can I see it? Has birth certificate (not birth statement), can I see it? 66116 528 2 1.296 1 2 Sysmiss How many times became outpatient in the past one month? How many times became outpatient in the past one month? How many times became outpatient in the past one month? How many times became outpatient in the past one month? How many times became outpatient in the past one month? 66116 528 30 0.198 Main business/job from workplace in the past one week: Main business/job from workplace in the past one week: Main business/job from workplace in the past one week: Main business/job from workplace in the past one week: Main business/job from workplace in the past one week: 42193 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 18 Position/status of the main job in the past one week: Position/status of the main job in the past one week: Position/status of the main job in the past one week: Position/status of the main job in the past one week: Position/status of the main job in the past one week: 42193 01 02 03 04 05 06 07 08 09 10 11 When did you quit school? When did you quit school? When did you quit school? When did you quit school? When did you quit school? 66116 528 Sysmiss Individual weight Individual weight Individual weight Individual weight Individual weight 66644 745 4004 2292.613 Village/kelurahan classification Village/kelurahan classification Village/kelurahan classification Village/kelurahan classification Village/kelurahan classification 66644 1 2 1.554 1 Urban 2 Rural Number Number Number Number Number 66644 1 1 1 1 How long the numbness last? How long the numbness last? How long the numbness last? How long the numbness last? How long the numbness last? 12431 54213 1 1 1 1 Sysmiss How many cigarettes smoked every day? (cigarettes) How many cigarettes smoked every day? (cigarettes) How many cigarettes smoked every day? (cigarettes) How many cigarettes smoked every day? (cigarettes) How many cigarettes smoked every day? (cigarettes) 18552 48092 1 6 2.826 1 <4 2 5-9 3 10-14 4 15-19 5 20-24 6 >= 25 Sysmiss At what age (name) started to smoke every day? (years old) At what age (name) started to smoke every day? (years old) At what age (name) started to smoke every day? (years old) At what age (name) started to smoke every day? (years old) At what age (name) started to smoke every day? (years old) 18552 48092 1 6 3.587 1 5-9 2 10-14 3 15-19 4 20-24 5 25-29 6 >=30 Sysmiss At what age (name) smoke for the first time? (years old) At what age (name) smoke for the first time? (years old) At what age (name) smoke for the first time? (years old) At what age (name) smoke for the first time? (years old) At what age (name) smoke for the first time? (years old) 25275 41369 1 6 3.142 1 5-9 2 10-14 3 15-19 4 20-24 5 25-29 6 >=30 Sysmiss Province Province Province Province Province Province Write down the name province in the space provided and add the related code referred to in the box provided. 66755 11 94 38.995 11 Nanggroe Aceh Darussalam 12 North Sumatera 13 West Sumatera 14 Riau 15 Jambi 16 South Sumatera 17 Bengkulu 18 Lampung 19 Bangka Belitung 21 Riau Island 31 DKI Jakarta 32 West Java 33 Central Java 34 DI Yogyakarta 35 East Java 36 Banten 51 Bali 52 West Nusa Tenggara 53 East Nusa Tenggara 61 West Kalimantan 62 Central Kalimantan 63 South Kalimantan 64 East Kalimantan 71 North Sulawesi 72 Central Sulawesi 73 South Sulawesi 74 Southeast Sulawesi 75 Gorontalo 76 West Sulawesi 81 Maluku 82 North Maluku 91 West Irian Jaya 94 Papua District/City District/City District/City District/City District/City District/City Cross out the unnecessary and the Write down the name of district/city in the space provided and add the related code referred to in the box provided. 66755 1 79 23.118 Sub-district Sub-district Sub-district Sub-district Sub-district Sub-district Write down the name subdistrict in the space provided and add the related code referred to in the box provided. 66755 10 740 76.046 Village/kelurahan Village/kelurahan Village/kelurahan Village/kelurahan Village/kelurahan Village/kelurahan Cross out the unnecessary and the Write down the name of village/kelurahan in the space provided and add the related code referred to in the box provided. 66755 1 111 8.517 Village/kelurahan classification Village/kelurahan classification Village/kelurahan classification Village/kelurahan classification Village/kelurahan classification Village/kelurahan classification Circle the answered code, then write it down in the box provided. 66755 1 2 1.554 1 Urban 2 Rural Sample code number Sample code number Sample code number Sample code number Sample code number Sample code number Write down the sample code number into the box provided. 66755 1001 2542 1244.585 Household sample sequential number Household sample sequential number Household sample sequential number Household sample sequential number Household sample sequential number Household sample sequential number Write down the household sample sequential number into the box provided. 66755 16 8.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Total household members (HM) Total household members (HM) Total household members (HM) Total household members (HM) Total household members (HM) Total household members (HM) 66755 1 15 4.007 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Total toddlers Total toddlers Total toddlers Total toddlers Total toddlers Total toddlers 66755 5 0.384 1 2 3 4 5 Name and NIP of Census Taker: Name and NIP of Census Taker: Name and NIP of Census Taker: Name and NIP of Census Taker: Name and NIP of Census Taker: Name and NIP of Census Taker: 66755 99999 29259.84 Census Taker Position: Census Taker Position: Census Taker Position: Census Taker Position: Census Taker Position: Census Taker Position: 66755 1 4 3.424 1 2 3 4 Name and NIP of Supervisor/Checker: Name and NIP of Supervisor/Checker: Name and NIP of Supervisor/Checker: Name and NIP of Supervisor/Checker: Name and NIP of Supervisor/Checker: Name and NIP of Supervisor/Checker: 66755 99999 14543.47 Supervisor/Checker Position: Supervisor/Checker Position: Supervisor/Checker Position: Supervisor/Checker Position: Supervisor/Checker Position: 66755 1 4 2.115 1 2 3 4 Residential building control status Residential building control status Residential building control status Residential building control status Residential building control status Residential building control status (in line with VSEN2004.K, Block VI.R.1) If m5r1 = 4 to 7, go to m5r4. 66755 1 7 1.699 1 Owned 2 Lease 3 Rent 4 Rent free 5 Official house 6 Owned by other people/child/family 7 Other Lease amount per year: (Rp) Lease amount per year: (Rp) Lease amount per year: (Rp) Lease amount per year: (Rp) Lease amount per year: (Rp) If lease (m5r1=2) Lease amount per year: (Rp) 3030 63725 15000 99999999 1822459.571 Rent amount per month: (Rp) Rent amount per month: (Rp) Rent amount per month: (Rp) Rent amount per month: (Rp) Rent amount per month: (Rp) If rent (m5r1=3) Rent amount per month: (Rp) 2562 64193 5000 833000 128845.911 How was the building obtained? How was the building obtained? How was the building obtained? How was the building obtained? How was the building obtained? If owned (m5r1=1) How was the building obtained? 52776 13979 1 7 5.111 1 Purchased from developer (national housing, real estate) 2 Purchased from cooperatives/Foundation 3 Purchased new from individual 4 Purchase not new 5 Self-construction 6 Administrative allocation (official house etc.) 7 Other (heritage,grant, etc.) Sysmiss What was the payment method? What was the payment method? What was the payment method? What was the payment method? What was the payment method? If m5r3a = 1, 2, 3 or 4 What was the payment method? 6576 60179 1 4 1.441 1 Cash 2 Public housing loan (KPR) 3 Non-public housing loan 4 Other Sysmiss How long is the credit period? (years) How long is the credit period? (years) How long is the credit period? (years) How long is the credit period? (years) How long is the credit period? (years) If using KPR (m5r3b = 2) How long is the credit period? (years) 1289 65466 1 99 12.908 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 20 21 22 25 32 42 52 99 Sysmiss Method of purchasing land: Method of purchasing land: Method of purchasing land: Method of purchasing land: Method of purchasing land: Method of purchasing land: 52776 13979 1 9 2.638 1 Purchase along with house 2 Purchase just land 3 Heritage/grant 4 Rent 5 On other people land 6 Other 9 Sysmiss Land legal evidence Land legal evidence Land legal evidence Land legal evidence Land legal evidence Land legal evidence 52776 13979 1 9 2.847 1 Certificate from National Land Agency (BPN) 2 Sell deed 3 Girik(uncertified) 4 Other 5 No evidence 9 Sysmiss The land legal status: The land legal status: The land legal status: The land legal status: The land legal status: If certificate (m5r3e.=1) The land legal status: 14858 51897 1 3 1.078 1 Owner rights 2 Building User Rights 3 Use rights Sysmiss Is the residential building constructed by yourself or by constructed by mutual aid? Is the residential building constructed by yourself or by constructed by mutual aid? Is the residential building constructed by yourself or by constructed by mutual aid? Is the residential building constructed by yourself or by constructed by mutual aid? Is the residential building constructed by yourself or by constructed by mutual aid? If m5r3a = 5 Is the residential building constructed by yourself or by constructed by mutual aid? 36658 30097 1 2 1.681 1 Yes 2 No Sysmiss How long have you live in the house/residence? How long have you live in the house/residence? How long have you live in the house/residence? How long have you live in the house/residence? How long have you live in the house/residence? How long have you live in the house/residence? 66755 1 4 3.5 1 < 1 year 2 1-3 years 3 4-5 years 4 > 5 years Do you have your own house? Do you have your own house? Do you have your own house? Do you have your own house? Do you have your own house? If the residential place status is not personally owned (m5r1 not equal to 1) Do you have your own house? 13979 52776 1 2 1.861 1 ya 2 tidak Sysmiss Is there any plan for the next 3 years? Is there any plan for the next 3 years? Is there any plan for the next 3 years? Is there any plan for the next 3 years? Is there any plan for the next 3 years? If have no house (m5r5=2) Is there any plan for the next 3 years? 12038 54717 1 6 5.132 1 Purchase house through KPR housing loan 2 Purchase house through non-KPR housing loan 3 Purchase house by cash 4 Build their own house 5 Lease/rent 6 No plan Sysmiss Kind of building: Kind of building: Kind of building: Kind of building: Kind of building: Kind of building: 66755 1 3 1.139 1 Regular house 2 House on stilts 3 Floating house Type of building: Type of building: Type of building: Type of building: Type of building: Type of building: 66719 36 1 6 1.295 1 Single one floor 2 Single multiple floors 3 Coupled one floor 4 Coupled multiple floors 5 Many coupled one floor 6 Many coupled multiple floors/cheap flat Sysmiss Building function Building function Building function Building function Building function Building function 66719 36 1 2 1.058 1 Regular residence 2 Mixed residence Sysmiss Plot area: (square meters) Plot area: (square meters) Plot area: (square meters) Plot area: (square meters) Plot area: (square meters) Plot area: (square meters) 66719 36 2 999 210.337 Building area: (square meters) Building area: (square meters) Building area: (square meters) Building area: (square meters) Building area: (square meters) If m5r7 = 1 Building area: (square meters) 57510 9245 3 999 73.593 Type of ceiling (mostly used) Type of ceiling (mostly used) Type of ceiling (mostly used) Type of ceiling (mostly used) Type of ceiling (mostly used) Type of ceiling (mostly used) 66755 1 6 4.127 1 Gypsum 2 Plywood 3 Asbestos 4 Plait/bamboo 5 Other 6 None Building condition Building condition Building condition Building condition Building condition Building condition 66755 1 4 1.577 1 Good 2 Fair 3 Damaged 4 Heavily damaged Number of room: (rooms) Number of room: (rooms) Number of room: (rooms) Number of room: (rooms) Number of room: (rooms) Number of room: (rooms) 66755 1 99 4.286 Total - bedroom Total - bedroom Total - bedroom Total - bedroom Total - bedroom Room condition according to function - Total: 1. Bedroom 66755 9 2.152 1 2 3 4 5 6 7 8 9 Mostly ventilated - bedroom Mostly ventilated - bedroom Mostly ventilated - bedroom Mostly ventilated - bedroom Mostly ventilated - bedroom Room condition according to function - Mostly ventilated: 1. Bedroom 64610 2145 1 2 1.106 1 Yes 2 No Sysmiss Sufficient natural light - bedroom Sufficient natural light - bedroom Sufficient natural light - bedroom Sufficient natural light - bedroom Sufficient natural light - bedroom Room condition according to function - Sufficient natural light: 1. Bedroom 64610 2145 1 2 1.099 1 Yes 2 No Sysmiss Total - living room Total - living room Total - living room Total - living room Total - living room Room condition according to function - Total: 2. Living room 66755 4 0.298 1 2 3 4 Mostly ventilated - living room Mostly ventilated - living room Mostly ventilated - living room Mostly ventilated - living room Mostly ventilated - living room Room condition according to function - Mostly ventilated: 2. Living room 19419 47336 1 2 1.083 1 Yes 2 No Sysmiss Sufficient natural light - living room Sufficient natural light - living room Sufficient natural light - living room Sufficient natural light - living room Sufficient natural light - living room Room condition according to function - Sufficient natural light: 2. Living room 19419 47336 1 2 1.078 1 Yes 2 No Sysmiss Total - parlor Total - parlor Total - parlor Total - parlor Total - parlor Room condition according to function - Total: 3. Parlor 66755 3 0.671 1 2 3 Mostly ventilated - parlor Mostly ventilated - parlor Mostly ventilated - parlor Mostly ventilated - parlor Mostly ventilated - parlor Room condition according to function - Mostly ventilated: 3. Parlor 44430 22325 1 2 1.046 1 Yes 2 No Sysmiss Sufficient natural light - parlor Sufficient natural light - parlor Sufficient natural light - parlor Sufficient natural light - parlor Sufficient natural light - parlor Room condition according to function - Sufficient natural light: 3. Parlor 44430 22325 1 2 1.036 1 Yes 2 No Sysmiss Total - dining room Total - dining room Total - dining room Total - dining room Total - dining room Room condition according to function - Total: 4. Dining room 66755 3 0.245 1 2 3 Mostly ventilated - dining room Mostly ventilated - dining room Mostly ventilated - dining room Mostly ventilated - dining room Mostly ventilated - dining room Room condition according to function - Mostly ventilated: 4. Dining room 16088 50667 1 2 1.113 1 Yes 2 No Sysmiss Sufficient natural light - dining room Sufficient natural light - dining room Sufficient natural light - dining room Sufficient natural light - dining room Sufficient natural light - dining room Room condition according to function - Sufficient natural light: 4. Dining room 16088 50667 1 2 1.096 1 Yes 2 No Sysmiss Total - mixed-use room Total - mixed-use room Total - mixed-use room Total - mixed-use room Total - mixed-use room Room condition according to function - Total: 5. Mixed-use room 66755 8 0.675 1 2 3 4 8 Mostly ventilated - mixed-use room Mostly ventilated - mixed-use room Mostly ventilated - mixed-use room Mostly ventilated - mixed-use room Mostly ventilated - mixed-use room Room condition according to function - Mostly ventilated: 5. Mixed-use room 43561 23194 1 2 1.105 1 Yes 2 No Sysmiss Sufficient natural light - mixed-use room Sufficient natural light - mixed-use room Sufficient natural light - mixed-use room Sufficient natural light - mixed-use room Sufficient natural light - mixed-use room Room condition according to function - Sufficient natural light: 5. Mixed-use room 43561 23194 1 2 1.094 1 Yes 2 No Sysmiss Total - kitchen Total - kitchen Total - kitchen Total - kitchen Total - kitchen Room condition according to function - Total: 6. Kitchen 66755 7 0.925 1 2 3 4 5 7 Mostly ventilated - kitchen Mostly ventilated - kitchen Mostly ventilated - kitchen Mostly ventilated - kitchen Mostly ventilated - kitchen Room condition according to function - Mostly ventilated: 6. Kitchen 61535 5220 1 2 1.118 1 Yes 2 No Sysmiss Sufficient natural light - kitchen Sufficient natural light - kitchen Sufficient natural light - kitchen Sufficient natural light - kitchen Sufficient natural light - kitchen Room condition according to function - Sufficient natural light: 6. Kitchen 61535 5220 1 2 1.094 1 Yes 2 No Sysmiss Has bathroom? Has bathroom? Has bathroom? Has bathroom? Has bathroom? Has bathroom? 66755 1 2 1.351 1 Yes 2 No Total time required to obtain drinking/clean water Total time required to obtain drinking/clean water Total time required to obtain drinking/clean water Total time required to obtain drinking/clean water Total time required to obtain drinking/clean water Total time required to obtain drinking/clean water 66755 1 5 1.388 1 < 5 minutes 2 5-29 minutes 3 30-59 minutes 4 60-89 minutes 5 >= 90 minutes Drinking water - clear/limpid Drinking water - clear/limpid Drinking water - clear/limpid Drinking water - clear/limpid Drinking water - clear/limpid Drinking water quality: a. Clear/limpid Enter code 1 if the answer is "Yes" or code 2 for "No" in the box provided. 66755 1 2 1.034 1 Yes 2 No Drinking water - colored/not clear Drinking water - colored/not clear Drinking water - colored/not clear Drinking water - colored/not clear Drinking water - colored/not clear Drinking water quality: b. Colored/not clear Enter code 1 if the answer is "Yes" or code 2 for "No" in the box provided. 66755 1 2 1.96 1 Yes 2 No Drinking water - bad taste Drinking water - bad taste Drinking water - bad taste Drinking water - bad taste Drinking water - bad taste Drinking water quality: c. Bad taste Enter code 1 if the answer is "Yes" or code 2 for "No" in the box provided. 66755 1 2 1.977 1 Yes 2 No Drinking water - foamy Drinking water - foamy Drinking water - foamy Drinking water - foamy Drinking water - foamy Drinking water quality: d. Foamy Enter code 1 if the answer is "Yes" or code 2 for "No" in the box provided. 66755 1 2 1.993 1 Yes 2 No Drinking water - bad odor Drinking water - bad odor Drinking water - bad odor Drinking water - bad odor Drinking water - bad odor Drinking water quality: e. Bad odor Enter code 1 if the answer is "Yes" or code 2 for "No" in the box provided. 66755 1 2 1.987 1 Yes 2 No Is water available in the household, no less than 20 liters per household member per day for bath, wash, drink and cooking? Is water available in the household, no less than 20 liters per household member per day for bath, wash, drink and cooking? Is water available in the household, no less than 20 liters per household member per day for bath, wash, drink and cooking? Is water available in the household, no less than 20 liters per household member per day for bath, wash, drink and cooking? Is water available in the household, no less than 20 liters per household member per day for bath, wash, drink and cooking? Is water available in the household, no less than 20 liters per household member per day for bath, wash, drink and cooking? 66755 1 2 1.143 1 Yes 2 No Is the household use wood as fuel in the past month? Is the household use wood as fuel in the past month? Is the household use wood as fuel in the past month? Is the household use wood as fuel in the past month? Is the household use wood as fuel in the past month? Is the household use wood as fuel in the past month? 66755 1 2 1.534 1 Yes 2 No Since when the household use wood as fuel? (Month) Since when the household use wood as fuel? (Month) Since when the household use wood as fuel? (Month) Since when the household use wood as fuel? (Month) Since when the household use wood as fuel? (Month) Since when the household use wood as fuel? (Month) 31109 35646 1 12 3.663 1 2 3 4 5 6 7 8 9 10 11 12 Sysmiss Since when the household use wood as fuel? (Year) Since when the household use wood as fuel? (Year) Since when the household use wood as fuel? (Year) Since when the household use wood as fuel? (Year) Since when the household use wood as fuel? (Year) Since when the household use wood as fuel? (Year) 31109 35646 1917 2004 1980.99 Method to obtain wood for fuel: Method to obtain wood for fuel: Method to obtain wood for fuel: Method to obtain wood for fuel: Method to obtain wood for fuel: Method to obtain wood for fuel: 31109 35646 1 15 2.487 1 Buy 2 Go looking 3 Buy and go looking 4 Given 5 Buy and given 6 Go looking and given 7 Buy, go looking and given 8 Other 9 Buy and other 10 Go looking and other 11 Buy, go looking and other 12 Given and other 13 Buy, given and other 14 Go looking, given and other 15 Buy, go looking, given and other Sysmiss Is the household planning to replace wood with other type of fuel? Is the household planning to replace wood with other type of fuel? Is the household planning to replace wood with other type of fuel? Is the household planning to replace wood with other type of fuel? Is the household planning to replace wood with other type of fuel? Is the household planning to replace wood with other type of fuel? 31109 35646 1 2 1.72 1 Yes 2 No Sysmiss Type of replacement fuel: Type of replacement fuel: Type of replacement fuel: Type of replacement fuel: Type of replacement fuel: If m516a = 1 Type of replacement fuel: 8712 58043 1 5 2.752 1 Electricity 2 Gas/LPG 3 Kerosene 4 Wood/shell charcoal 5 Other Sysmiss Source of lighting: Source of lighting: Source of lighting: Source of lighting: Source of lighting: Source of lighting (in line with VSEN2004.K, Block VI R.11): 66755 1 2 1.189 1 PLN Electricity 2 Other than PLN How much is the installed capacity? How much is the installed capacity? How much is the installed capacity? How much is the installed capacity? How much is the installed capacity? If source of lighting is from PLN electricity (m5r17a = 1) How much is the installed capacity? 54161 12594 1 6 1.887 1 450 watt 2 900 watt 3 1,300 watt 4 2,200 watt 5 > 2,200 watt 6 Without indicator Sysmiss Owned - gas stove Owned - gas stove Owned - gas stove Owned - gas stove Owned - gas stove Goods owned by the household: a. Gas stove 66755 1 2 1.852 1 Yes 2 No Owned - radio/tape Owned - radio/tape Owned - radio/tape Owned - radio/tape Owned - radio/tape Goods owned by the household: b. Radio/tape 66755 1 2 1.32 1 Yes 2 No Owned - television/video Owned - television/video Owned - television/video Owned - television/video Owned - television/video Goods owned by the household: c. Television/video 66755 1 2 1.367 1 Yes 2 No Owned - refrigerator Owned - refrigerator Owned - refrigerator Owned - refrigerator Owned - refrigerator Goods owned by the household: d. Refrigerator 66755 1 2 1.801 1 Yes 2 No Owned - telephone/cellphone Owned - telephone/cellphone Owned - telephone/cellphone Owned - telephone/cellphone Owned - telephone/cellphone Goods owned by the household: e. Telephone/cellphone 66755 1 2 1.845 1 Yes 2 No Owned - computer Owned - computer Owned - computer Owned - computer Owned - computer Goods owned by the household: f. Computer 66755 1 2 1.969 1 Yes 2 No Owned - motorcycle/outboard motor boat Owned - motorcycle/outboard motor boat Owned - motorcycle/outboard motor boat Owned - motorcycle/outboard motor boat Owned - motorcycle/outboard motor boat Goods owned by the household: g. Motorcycle/outboard motor boat 66755 1 2 1.718 1 Yes 2 No Owned - car/motorboat Owned - car/motorboat Owned - car/motorboat Owned - car/motorboat Owned - car/motorboat Goods owned by the household: h. Car/motorboat 66755 1 2 1.953 1 Yes 2 No Owned - parabolic antennae Owned - parabolic antennae Owned - parabolic antennae Owned - parabolic antennae Owned - parabolic antennae Goods owned by the household: i. Parabolic antennae 66755 1 2 1.948 1 Yes 2 No Location of house/residential building Location of house/residential building Location of house/residential building Location of house/residential building Location of house/residential building Location of house/residential building 66755 1 3 2.087 1 New residential area 2 Old residential area 3 Other Is the house located on riverbank/on river/lake/ocean? Is the house located on riverbank/on river/lake/ocean? Is the house located on riverbank/on river/lake/ocean? Is the house located on riverbank/on river/lake/ocean? Is the house located on riverbank/on river/lake/ocean? Is the house located on riverbank/on river/lake/ocean? 66755 1 2 1.918 1 Yes 2 No Is the house located on the edge of forest/in forest? Is the house located on the edge of forest/in forest? Is the house located on the edge of forest/in forest? Is the house located on the edge of forest/in forest? Is the house located on the edge of forest/in forest? Is the house located on the edge of forest/in forest? 66755 1 2 1.929 1 Yes 2 No Is the house located on disaster-prone area? Is the house located on disaster-prone area? Is the house located on disaster-prone area? Is the house located on disaster-prone area? Is the house located on disaster-prone area? Is the house located on disaster-prone area? 66755 1 2 1.915 1 Yes 2 No Type of disaster that occurred the most: Type of disaster that occurred the most: Type of disaster that occurred the most: Type of disaster that occurred the most: Type of disaster that occurred the most: If m5r20c = 1 Type of disaster that occurred the most: 5670 61085 1 7 1.962 1 Flood 2 Landslide 3 Fire 4 Earthquake 5 Tornado/tsunami 6 Volcano eruption 7 Other Sysmiss Is the house located on roadside/in alley/lane? Is the house located on roadside/in alley/lane? Is the house located on roadside/in alley/lane? Is the house located on roadside/in alley/lane? Is the house located on roadside/in alley/lane? Is the house located on roadside/in alley/lane? 66755 1 2 1.215 1 Yes 2 No Width of road/alley/lane: (meter) Width of road/alley/lane: (meter) Width of road/alley/lane: (meter) Width of road/alley/lane: (meter) Width of road/alley/lane: (meter) Width of road/alley/lane: (meter) 52391 14364 9 3.39 1 2 3 4 5 6 7 8 9 Sysmiss Type of ground surface of road/alley/lane Type of ground surface of road/alley/lane Type of ground surface of road/alley/lane Type of ground surface of road/alley/lane Type of ground surface of road/alley/lane Type of ground surface of road/alley/lane 52391 14364 1 6 2.649 1 Asphalt 2 Cement/conblock 3 Gravel/hardened 4 Wood/bamboo 5 Soil/sand 6 Other Sysmiss Any electric street lamp in your neighborhood? Any electric street lamp in your neighborhood? Any electric street lamp in your neighborhood? Any electric street lamp in your neighborhood? Any electric street lamp in your neighborhood? Any electric street lamp in your neighborhood? 66755 1 2 1.485 1 Yes 2 No Container/tank for wastewater from bath/kitchen/wash: Container/tank for wastewater from bath/kitchen/wash: Container/tank for wastewater from bath/kitchen/wash: Container/tank for wastewater from bath/kitchen/wash: Container/tank for wastewater from bath/kitchen/wash: Container/tank for wastewater from bath/kitchen/wash: 66755 1 4 2.99 1 Closed container in yard 2 Open container in yard 3 Container outside of yard 4 No container/directly to sewer/river Channel for wastewater from bath/kitchen/wash: Channel for wastewater from bath/kitchen/wash: Channel for wastewater from bath/kitchen/wash: Channel for wastewater from bath/kitchen/wash: Channel for wastewater from bath/kitchen/wash: Channel for wastewater from bath/kitchen/wash: 66755 1 3 1.846 1 With open channel 2 With closed channel/pipe 3 No channel Condition of drain/canal around the house: Condition of drain/canal around the house: Condition of drain/canal around the house: Condition of drain/canal around the house: Condition of drain/canal around the house: Condition of drain/canal around the house: 66755 1 4 2.154 1 Flowing 2 Flowing very slowly 3 Clogged 4 No drain Garbage disposal method Garbage disposal method Garbage disposal method Garbage disposal method Garbage disposal method Garbage disposal method 66755 1 7 3.688 1 Collected by garbage man 2 Dumped 3 Converted to compost 4 Burnt 5 Throw to river/drain 6 Carelessly discarded 7 Other Used - air freshener (spray) Used - air freshener (spray) Used - air freshener (spray) Used - air freshener (spray) Used - air freshener (spray) The household use the following in the past month: a. Air freshener (spray) 66755 1 2 1.869 1 Yes 2 No Used - hair/deodorant spray Used - hair/deodorant spray Used - hair/deodorant spray Used - hair/deodorant spray Used - hair/deodorant spray The household use the following in the past month: b. Hair/deodorant spray 66755 1 2 1.805 1 Yes 2 No Used - floor cleaner Used - floor cleaner Used - floor cleaner Used - floor cleaner Used - floor cleaner The household use the following in the past month: c. Floor cleaner 66755 1 2 1.779 1 Yes 2 No Used - mirror/wood/metal polisher Used - mirror/wood/metal polisher Used - mirror/wood/metal polisher Used - mirror/wood/metal polisher Used - mirror/wood/metal polisher The household use the following in the past month: d. Mirror/wood/metal polisher 66755 1 2 1.919 1 Yes 2 No Used - cloth stain remover Used - cloth stain remover Used - cloth stain remover Used - cloth stain remover Used - cloth stain remover The household use the following in the past month: e. Cloth stain remover 66755 1 2 1.589 1 Yes 2 No Used - battery Used - battery Used - battery Used - battery Used - battery The household use the following in the past month: f. Battery 66755 1 2 1.885 1 Yes 2 No Used - paint Used - paint Used - paint Used - paint Used - paint The household use the following in the past month: g. Paint 66755 1 2 1.939 1 Yes 2 No Used - bug spray/pesticide Used - bug spray/pesticide Used - bug spray/pesticide Used - bug spray/pesticide Used - bug spray/pesticide The household use the following in the past month: h. Bug spray/pesticide 66755 1 2 1.613 1 Yes 2 No Type of pollution - smoke/odor/noise from factory Type of pollution - smoke/odor/noise from factory Type of pollution - smoke/odor/noise from factory Type of pollution - smoke/odor/noise from factory Type of pollution - smoke/odor/noise from factory Any household member feel disturbed by the type of following pollution? a. Smoke/odor/noise from factory Any household member feel disturbed by the type of following pollution? a. Smoke/odor/noise from factory 66755 1 2 1.964 1 Yes 2 No Type of pollution - smoke/odor/noise from workshop Type of pollution - smoke/odor/noise from workshop Type of pollution - smoke/odor/noise from workshop Type of pollution - smoke/odor/noise from workshop Type of pollution - smoke/odor/noise from workshop Any household member feel disturbed by the type of following pollution? b. Smoke/odor/noise from workshop 66755 1 2 1.981 1 Yes 2 No Type of pollution - continuous noise from neighbor Type of pollution - continuous noise from neighbor Type of pollution - continuous noise from neighbor Type of pollution - continuous noise from neighbor Type of pollution - continuous noise from neighbor Any household member feel disturbed by the type of following pollution? c. Continuous noise from neighbor 66755 1 2 1.966 1 Yes 2 No Type of pollution - noise from motor vehicles Type of pollution - noise from motor vehicles Type of pollution - noise from motor vehicles Type of pollution - noise from motor vehicles Type of pollution - noise from motor vehicles Any household member feel disturbed by the type of following pollution? d. Noise from motor vehicles 66755 1 2 1.914 1 Yes 2 No Type of pollution - smell from garbage Type of pollution - smell from garbage Type of pollution - smell from garbage Type of pollution - smell from garbage Type of pollution - smell from garbage Any household member feel disturbed by the type of following pollution? e. Smell from garbage 66755 1 2 1.958 1 Yes 2 No Type of pollution - smell from drain/sewer/river Type of pollution - smell from drain/sewer/river Type of pollution - smell from drain/sewer/river Type of pollution - smell from drain/sewer/river Type of pollution - smell from drain/sewer/river Any household member feel disturbed by the type of following pollution? f. Smell from drain/sewer/river 66755 1 2 1.949 1 Yes 2 No FS in sub-district - transport route FS in sub-district - transport route FS in sub-district - transport route FS in sub-district - transport route FS in sub-district - transport route Access to public facilities (FS): FS in sub-district a. Transport route 66755 1 2 1.127 1 Yes 2 No Shortest distance from home (km)- transport route Shortest distance from home (km)- transport route Shortest distance from home (km)- transport route Shortest distance from home (km)- transport route Shortest distance from home (km)- transport route Access to public facilities (FS): Shortest distance from home (km) a. Transport route 66755 99 4.341 Available Public Transportation - transport route Available Public Transportation - transport route Available Public Transportation - transport route Available Public Transportation - transport route Available Public Transportation - transport route Access to public facilities (FS): Available Public Transportation a. Transport route 66755 1 3 1.479 1 Motorized public transportation 2 Non-motorized public transportation 3 No public transportation FS in sub-district - public clinic FS in sub-district - public clinic FS in sub-district - public clinic FS in sub-district - public clinic FS in sub-district - public clinic Access to public facilities (FS): FS in sub-district b. Public clinic 66755 1 2 1.025 1 Yes 2 No Shortest distance from home (km)- public clinic Shortest distance from home (km)- public clinic Shortest distance from home (km)- public clinic Shortest distance from home (km)- public clinic Shortest distance from home (km)- public clinic Access to public facilities (FS): Shortest distance from home (km) b. Public clinic 66755 99 3.669 Available Public Transportation - public clinic Available Public Transportation - public clinic Available Public Transportation - public clinic Available Public Transportation - public clinic Available Public Transportation - public clinic Access to public facilities (FS): Available Public Transportation b. Public clinic 66755 1 3 1.428 1 Motorized public transportation 2 Non-motorized public transportation 3 No public transportation FS in sub-district - post office FS in sub-district - post office FS in sub-district - post office FS in sub-district - post office FS in sub-district - post office Access to public facilities (FS): FS in sub-district c. Post office 66755 1 2 1.227 1 Yes 2 No Shortest distance from home (km)- post office Shortest distance from home (km)- post office Shortest distance from home (km)- post office Shortest distance from home (km)- post office Shortest distance from home (km)- post office Access to public facilities (FS): Shortest distance from home (km) c. Post office 66755 99 8.182 Available Public Transportation - post office Available Public Transportation - post office Available Public Transportation - post office Available Public Transportation - post office Available Public Transportation - post office Access to public facilities (FS): Available Public Transportation c. Post office 66755 1 3 1.286 1 Motorized public transportation 2 Non-motorized public transportation 3 No public transportation FS in sub-district - police station FS in sub-district - police station FS in sub-district - police station FS in sub-district - police station FS in sub-district - police station Access to public facilities (FS): FS in sub-district d. Police station 66755 1 2 1.099 1 Yes 2 No Shortest distance from home (km)- police station Shortest distance from home (km)- police station Shortest distance from home (km)- police station Shortest distance from home (km)- police station Shortest distance from home (km)- police station Access to public facilities (FS): Shortest distance from home (km) d. Police station 66755 99 6.181 Available Public Transportation - police station Available Public Transportation - police station Available Public Transportation - police station Available Public Transportation - police station Available Public Transportation - police station Access to public facilities (FS): Available Public Transportation d. Police station 66755 1 3 1.295 1 Motorized public transportation 2 Non-motorized public transportation 3 No public transportation FS in sub-district - traditional market FS in sub-district - traditional market FS in sub-district - traditional market FS in sub-district - traditional market FS in sub-district - traditional market Access to public facilities (FS): FS in sub-district e. Traditional market 66755 1 2 1.137 1 Yes 2 No Shortest distance from home (km)- traditional market Shortest distance from home (km)- traditional market Shortest distance from home (km)- traditional market Shortest distance from home (km)- traditional market Shortest distance from home (km)- traditional market Access to public facilities (FS): Shortest distance from home (km) e. Traditional market 66755 99 5.046 Available Public Transportation - traditional market Available Public Transportation - traditional market Available Public Transportation - traditional market Available Public Transportation - traditional market Available Public Transportation - traditional market Access to public facilities (FS): Available Public Transportation e. Traditional market 66755 1 3 1.451 1 Motorized public transportation 2 Non-motorized public transportation 3 No public transportation FS in sub-district - public telephone/kiosk FS in sub-district - public telephone/kiosk FS in sub-district - public telephone/kiosk FS in sub-district - public telephone/kiosk FS in sub-district - public telephone/kiosk Access to public facilities (FS): FS in sub-district f. Public telephone/kiosk 66755 1 2 1.081 1 Yes 2 No Shortest distance from home (km)- public telephone/kiosk Shortest distance from home (km)- public telephone/kiosk Shortest distance from home (km)- public telephone/kiosk Shortest distance from home (km)- public telephone/kiosk Shortest distance from home (km)- public telephone/kiosk Access to public facilities (FS): Shortest distance from home (km) f. Public telephone/kiosk 66755 99 4.631 Available Public Transportation - public telephone/kiosk Available Public Transportation - public telephone/kiosk Available Public Transportation - public telephone/kiosk Available Public Transportation - public telephone/kiosk Available Public Transportation - public telephone/kiosk Access to public facilities (FS): Available Public Transportation f. Public telephone/kiosk 66755 1 3 1.624 1 Motorized public transportation 2 Non-motorized public transportation 3 No public transportation FS in sub-district - elementary school/equal FS in sub-district - elementary school/equal FS in sub-district - elementary school/equal FS in sub-district - elementary school/equal FS in sub-district - elementary school/equal Access to public facilities (FS): FS in sub-district g. Elementary school/equal 66755 1 2 1.007 1 Yes 2 No Shortest distance from home (km)- elementary school/equal Shortest distance from home (km)- elementary school/equal Shortest distance from home (km)- elementary school/equal Shortest distance from home (km)- elementary school/equal Shortest distance from home (km)- elementary school/equal Access to public facilities (FS): Shortest distance from home (km) g. Elementary school/equal 66755 99 1.059 Available Public Transportation - elementary school/equal Available Public Transportation - elementary school/equal Available Public Transportation - elementary school/equal Available Public Transportation - elementary school/equal Available Public Transportation - elementary school/equal Access to public facilities (FS): Available Public Transportation g. Elementary school/equal 66755 1 3 1.863 1 Motorized public transportation 2 Non-motorized public transportation 3 No public transportation FS in sub-district - junior high/ equal FS in sub-district - junior high/ equal FS in sub-district - junior high/ equal FS in sub-district - junior high/ equal FS in sub-district - junior high/ equal Access to public facilities (FS): FS in sub-district h. Junior high/ equal 66755 1 2 1.039 1 Yes 2 No Shortest distance from home (km)- junior high/ equal Shortest distance from home (km)- junior high/ equal Shortest distance from home (km)- junior high/ equal Shortest distance from home (km)- junior high/ equal Shortest distance from home (km)- junior high/ equal Access to public facilities (FS): Shortest distance from home (km) h. Junior high/ equal 66755 99 3.586 Available Public Transportation - junior high/ equal Available Public Transportation - junior high/ equal Available Public Transportation - junior high/ equal Available Public Transportation - junior high/ equal Available Public Transportation - junior high/ equal Access to public facilities (FS): Available Public Transportation h. Junior high/ equal 66755 1 3 1.481 1 Motorized public transportation 2 Non-motorized public transportation 3 No public transportation FS in sub-district - senior high/ equal FS in sub-district - senior high/ equal FS in sub-district - senior high/ equal FS in sub-district - senior high/ equal FS in sub-district - senior high/ equal Access to public facilities (FS): FS in sub-district i. Senior high/ equal 66755 1 2 1.144 1 Yes 2 No Shortest distance from home (km)- senior high/ equal Shortest distance from home (km)- senior high/ equal Shortest distance from home (km)- senior high/ equal Shortest distance from home (km)- senior high/ equal Shortest distance from home (km)- senior high/ equal Access to public facilities (FS): Shortest distance from home (km) i. Senior high/ equal 66755 99 6.685 Available Public Transportation - senior high/ equal Available Public Transportation - senior high/ equal Available Public Transportation - senior high/ equal Available Public Transportation - senior high/ equal Available Public Transportation - senior high/ equal Access to public facilities (FS): Available Public Transportation i. Senior high/ equal 66755 1 3 1.378 1 Motorized public transportation 2 Non-motorized public transportation 3 No public transportation FS in sub-district - place of worship FS in sub-district - place of worship FS in sub-district - place of worship FS in sub-district - place of worship FS in sub-district - place of worship Access to public facilities (FS): FS in sub-district j. Place of worship 66755 1 2 1.008 1 Yes 2 No Shortest distance from home (km)- place of worship Shortest distance from home (km)- place of worship Shortest distance from home (km)- place of worship Shortest distance from home (km)- place of worship Shortest distance from home (km)- place of worship Access to public facilities (FS): Shortest distance from home (km) j. Place of worship 66755 99 0.865 Available Public Transportation - place of worship Available Public Transportation - place of worship Available Public Transportation - place of worship Available Public Transportation - place of worship Available Public Transportation - place of worship Access to public facilities (FS): Available Public Transportation j. Place of worship 66755 1 3 1.992 1 Motorized public transportation 2 Non-motorized public transportation 3 No public transportation FS in sub-district - sub-district office FS in sub-district - sub-district office FS in sub-district - sub-district office FS in sub-district - sub-district office FS in sub-district - sub-district office Access to public facilities (FS): FS in sub-district k. Sub-district office 66755 1 2 1.043 1 Yes 2 No Shortest distance from home (km)- sub-district office Shortest distance from home (km)- sub-district office Shortest distance from home (km)- sub-district office Shortest distance from home (km)- sub-district office Shortest distance from home (km)- sub-district office Access to public facilities (FS): Shortest distance from home (km) k. Sub-district office 66755 99 6.61 Available Public Transportation - sub-district office Available Public Transportation - sub-district office Available Public Transportation - sub-district office Available Public Transportation - sub-district office Available Public Transportation - sub-district office Access to public facilities (FS): Available Public Transportation k. Sub-district office 66755 1 3 1.288 1 Motorized public transportation 2 Non-motorized public transportation 3 No public transportation FS in sub-district - place of work for HM/spouse FS in sub-district - place of work for HM/spouse FS in sub-district - place of work for HM/spouse FS in sub-district - place of work for HM/spouse FS in sub-district - place of work for HM/spouse Access to public facilities (FS): FS in sub-district l. Place of work for HM/spouse 66755 1 Yes 2 No Sysmiss Shortest distance from home (km)- place of work for HM/spouse Shortest distance from home (km)- place of work for HM/spouse Shortest distance from home (km)- place of work for HM/spouse Shortest distance from home (km)- place of work for HM/spouse Shortest distance from home (km)- place of work for HM/spouse Access to public facilities (FS): Shortest distance from home (km) l. Place of work for HM/spouse 66755 99 4.201 Available Public Transportation - place of work for HM/spouse Available Public Transportation - place of work for HM/spouse Available Public Transportation - place of work for HM/spouse Available Public Transportation - place of work for HM/spouse Available Public Transportation - place of work for HM/spouse Access to public facilities (FS): Available Public Transportation l. Place of work for HM/spouse 66755 1 9 2.261 1 Motorized public transportation 2 Non-motorized public transportation 3 No public transportation 9 Expenditure - inpatient service by health facility: (Rp) Expenditure - inpatient service by health facility: (Rp) Expenditure - inpatient service by health facility: (Rp) Expenditure - inpatient service by health facility: (Rp) Expenditure - inpatient service by health facility: (Rp) Cost incurred by household (excluding payment from insurance or other party) for the past month for: a. Inpatient service by health facility: (Rp) 66755 40000000 15695.062 Expenditure - outpatient service by health facility/worker: (Rp) Expenditure - outpatient service by health facility/worker: (Rp) Expenditure - outpatient service by health facility/worker: (Rp) Expenditure - outpatient service by health facility/worker: (Rp) Expenditure - outpatient service by health facility/worker: (Rp) Cost incurred by household (excluding payment from insurance or other party) for the past month for: b. Outpatient service by health facility/worker: (Rp) 66755 35000000 16088.901 Expenditure - traditional medication (in- & outpatient): (Rp) Expenditure - traditional medication (in- & outpatient): (Rp) Expenditure - traditional medication (in- & outpatient): (Rp) Expenditure - traditional medication (in- & outpatient): (Rp) Expenditure - traditional medication (in- & outpatient): (Rp) Cost incurred by household (excluding payment from insurance or other party) for the past month for: c. Traditional medication (in- & outpatient): (Rp) 66755 5000000 2283.274 Expenditure - self-treatment: (Rp) Expenditure - self-treatment: (Rp) Expenditure - self-treatment: (Rp) Expenditure - self-treatment: (Rp) Expenditure - self-treatment: (Rp) Cost incurred by household (excluding payment from insurance or other party) for the past month for: d. Self-treatment: (Rp) 66755 650000000 15561.03 Expenditure - other health products and services Expenditure - other health products and services Expenditure - other health products and services Expenditure - other health products and services Expenditure - other health products and services Cost incurred by household (excluding payment from insurance or other party) for the past month for: e. Other health products and services (beside R.1a-R.1d) (consultation, pregnancy test, circumcision, eyeglasses, false teeth etc.): (Rp) 66755 6000000 2230.479 How many household member received inpatient service in the past one year? How many household member received inpatient service in the past one year? How many household member received inpatient service in the past one year? How many household member received inpatient service in the past one year? How many household member received inpatient service in the past one year? How many household member received inpatient service in the past one year? [Total for every household member, if no, use “00”] (times) 66755 99 0.0812 Cost incurred by household to pay for inpatient service in the past one year? Cost incurred by household to pay for inpatient service in the past one year? Cost incurred by household to pay for inpatient service in the past one year? Cost incurred by household to pay for inpatient service in the past one year? Cost incurred by household to pay for inpatient service in the past one year? Cost incurred by household to pay for inpatient service in the past one year? (Excluding payment from insurance or other party): (Rp) 3519 63236 999999999 2341133.434 Source of fund to finance household health needs - Household income Source of fund to finance household health needs - Household income Source of fund to finance household health needs - Household income Source of fund to finance household health needs - Household income Source of fund to finance household health needs - Household income Source of fund to finance household health needs for the past one year: a. Household income 66755 1 2 1.134 1 Yes 2 No Source of fund to finance household health needs - Savings Source of fund to finance household health needs - Savings Source of fund to finance household health needs - Savings Source of fund to finance household health needs - Savings Source of fund to finance household health needs - Savings Source of fund to finance household health needs for the past one year: b. Savings 66755 1 2 1.858 1 Yes 2 No Source of fund to finance household health needs - Sell assets/goods Source of fund to finance household health needs - Sell assets/goods Source of fund to finance household health needs - Sell assets/goods Source of fund to finance household health needs - Sell assets/goods Source of fund to finance household health needs - Sell assets/goods Source of fund to finance household health needs for the past one year: c. Sell assets/goods 66755 1 2 1.954 1 Yes 2 No Source of fund to finance household health needs - Borrow/pawn goods Source of fund to finance household health needs - Borrow/pawn goods Source of fund to finance household health needs - Borrow/pawn goods Source of fund to finance household health needs - Borrow/pawn goods Source of fund to finance household health needs - Borrow/pawn goods Source of fund to finance household health needs for the past one year: d. Borrow/pawn goods 66755 1 2 1.945 1 Yes 2 No Source of fund to finance household health needs - Assistance from family member or friend Source of fund to finance household health needs - Assistance from family member or friend Source of fund to finance household health needs - Assistance from family member or friend Source of fund to finance household health needs - Assistance from family member or friend Source of fund to finance household health needs - Assistance from family member or friend Source of fund to finance household health needs for the past one year: e. Assistance from family member or friend 66755 1 2 1.885 1 Yes 2 No Source of fund to finance household health needs - Insurance or company/office claim Source of fund to finance household health needs - Insurance or company/office claim Source of fund to finance household health needs - Insurance or company/office claim Source of fund to finance household health needs - Insurance or company/office claim Source of fund to finance household health needs - Insurance or company/office claim Source of fund to finance household health needs for the past one year: f. Insurance or company/office claim 66755 1 2 1.947 1 Yes 2 No Source of fund to finance household health needs - JPKM, health card, poverty statement letter and health fund Source of fund to finance household health needs - JPKM, health card, poverty statement letter and health fund Source of fund to finance household health needs - JPKM, health card, poverty statement letter and health fund Source of fund to finance household health needs - JPKM, health card, poverty statement letter and health fund Source of fund to finance household health needs - JPKM, health card, poverty statement letter and health fund Source of fund to finance household health needs for the past one year: g. JPKM, health card, poverty statement letter and health fund 66755 1 2 1.932 1 Yes 2 No Source of fund to finance household health needs - Other Source of fund to finance household health needs - Other Source of fund to finance household health needs - Other Source of fund to finance household health needs - Other Source of fund to finance household health needs - Other Source of fund to finance household health needs for the past one year: h. Other 66755 1 2 1.933 1 Yes 2 No Household weight Household weight Household weight Household weight Household weight 66755 159 1616 821.898 Individual weight Individual weight Individual weight Individual weight Individual weight 66755 230 1580 820.765 Race of the head of household Race of the head of household Race of the head of household Race of the head of household Race of the head of household 66563 192 31 8.673 Number of children aged 0-4 years Number of children aged 0-4 years Number of children aged 0-4 years Number of children aged 0-4 years Number of children aged 0-4 years 66565 190 10 0.391 1 2 3 4 5 6 7 8 9 10 Sysmiss Total HM who died since January 2001: Total HM who died since January 2001: Total HM who died since January 2001: Total HM who died since January 2001: Total HM who died since January 2001: 66565 190 4 0.0368 1 2 3 4 Sysmiss Name and NIP of Census Taker: Name and NIP of Census Taker: Name and NIP of Census Taker: Name and NIP of Census Taker: Name and NIP of Census Taker: 66565 190 99999 13252.921 Census Taker Position: Census Taker Position: Census Taker Position: Census Taker Position: Census Taker Position: 66565 190 99999 19.637 1 Provincial BPS Staff 2 District/City BPS Staff 3 Statistics Clerk 4 Partner Census date: Census date: Census date: Census date: Census date: 66563 192 1 31 15.884 Census date: Census date: Census date: Census date: Census date: 66565 190 1 31 11.95 Census month: Census month: Census month: Census month: Census month: 66565 190 1 30 1.979 Census year: Census year: Census year: Census year: Census year: 66565 190 1 2004 2000.571 Name and NIP of Supervisor/Checker: Name and NIP of Supervisor/Checker: Name and NIP of Supervisor/Checker: Name and NIP of Supervisor/Checker: Name and NIP of Supervisor/Checker: 66565 190 99999 12189.648 Supervisor/Checker Position: Supervisor/Checker Position: Supervisor/Checker Position: Supervisor/Checker Position: Supervisor/Checker Position: 66565 190 1 16869 22.08 1 Provincial BPS Staff 2 District/City BPS Staff 3 Statistics Clerk 4 Partner Supervising/checking date: Supervising/checking date: Supervising/checking date: Supervising/checking date: Supervising/checking date: 66563 192 1 31 12.933 Supervising/checking date: Supervising/checking date: Supervising/checking date: Supervising/checking date: Supervising/checking date: 66565 190 1 31 14.754 Supervising/checking month: Supervising/checking month: Supervising/checking month: Supervising/checking month: Supervising/checking month: 66565 190 1 30 2.726 Supervising/checking year: Supervising/checking year: Supervising/checking year: Supervising/checking year: Supervising/checking year: 66565 190 1 2004 2000.573 - - - - - 66565 190 1 2004 4.443 Building status: Building status: Building status: Building status: Building status: Building status: Circle one of codes 1 to 7 according to respondent’s answer, and fill it in the provided box. 66565 190 1 7 1.68 1 Own house 2 Lease 3 Rent 4 Free lease 5 Company house 6 Owned by parents/sibling/family 7 Other Sysmiss 1. Own housed residence,if during the census,the residence is legally owned by the household head or member. Residence obtained by credit through banks or under the status of buying lease,is considered personally owned. 2. Leased residence,if the residence is leased by the household head/member for a certain period based on an agrement between tenant and landlord,for example for 1 or 2 years lease. Payment method is usually totally in advance,or in installment that is mutually agreed upon. At the end of the lease,the tenant should leave the residence and if mutually agreen it is possible to renew the lease agreement. 3. Rented residence,if the residence is rented by the household head or one of the members with regular payment continuously without a certain time limit. 4. Rent-free residence,owned by other people,if the residence is provided by other people (not family/parents) and can be occupied/resided in without having to make any kind of payment. 5. Company’s housed Residence,is the residence is owned and provided by an institution/company where the household head/member works,whether by paying rents or not. 6. Parent/relative’s housed,if the residence is not personally owned but belongs to either parents/family/relatives and is free to live in,where the owner of the house does not live there and is not a member of the household. 7. Others,if the residence cannot be included in any of the above categories,such as group owned residence,custom house. Building condition: Building condition: Building condition: Building condition: Building condition: Building condition: 66565 190 1 3 2.879 1 New building, finished construction by 2003 2 Newly renovated/repaired in 2003 3 Old building Sysmiss Type of most roof material : Type of most roof material : Type of most roof material : Type of most roof material : Type of most roof material : Type of most roof material : Circle one of the codes of widest roof type of the physical building where the household of respondent resides,then write it down in the box provided. 66565 190 1 7 3.051 1 Concrete 2 Roof tile 3 Shingle 4 Iron sheet 5 Asbestos 6 Fiber/palm 7 Other Sysmiss Roof is the top cover of a building,so that household head/members live in under is protected from the sun heat,rain etc. For multi storeys building,the referred roof is the very top part of the building. 1. Concrete is roof made of a mixture of cement,corals and sand with water. 2. Roof tile is made of clay that is molded and then burned. Including here is concrete roof tile (tiles made of a mixture of cement and sand),fiber cement tile,and ceramic tile. 3. Shingle is roof layered with wooden tiles,usually made of ironwood,or ulin wood (ironwood from Borneo). 4. Iron sheeting is roof made of zinc. Zinc roof shape can be flat or wavy,including zinc roof called decrabond (zinc roof layered with epoxy and acrylic). 5. Asbestos is roof made of asbestos fiber and cement. Generally comes in wavy shapes. 6. Palm is roof made of palm tree fiber or other of the the same type,generally is black in color. 7. Others for all other roof types aside from the above,such as bamboo,plywood,leaves,etc. Type of most wall material : Type of most wall material : Type of most wall material : Type of most wall material : Type of most wall material : Type of most wall material : Circle one of the codes of the widest wall type in the physical building where the respondent lives,and then write it down in the provided box. 66565 190 1 4 1.558 1 Concrete 2 Wood 3 Bamboo 4 Other Sysmiss Wall is the outer side/border in a building or the separator to other building. If the building has more than one type of wall of the same floor size.the one considered the widest wall is the more costly wall(smallet code). 1. Concrete is wall made of red brick or hollow brick layers plasterd with cement. Including in this category is wall made of red brick layers and plastered, but using wooden beam installed in usually 1 – 1.5 meter distance. 2. Wood is wall made of wood. 3. Bamboo/fiber is wall made of bamboo or fiber. Including in this category is wall made of bamboo weave with size less than 1 m X 1 m.framed in wooden beam and plastered with cement and sand. 4. Others for other types not included in category 1-3. Type of most flooring material : Type of most flooring material : Type of most flooring material : Type of most flooring material : Type of most flooring material : Type of most flooring material : Circle one of the codes of the widest floor type of the physical building where the household members reside,and write it down to the provided box. 66565 190 1 2 1.135 1 Non soil 2 Soil Sysmiss Definition of floor in this survey is the bottom part/base of a room,whether earthen floor or tiled floor, such as ceramic, marble, wood, and cement. Floor area:(square meter) Floor area:(square meter) Floor area:(square meter) Floor area:(square meter) Floor area:(square meter) Floor area:(square meter) Fill in the floor size of the residence of the respondent’s household and write down in the provided box (in m 2 ). 66565 190 3 998 67.515 Floor size means the size of the floor occupied and used for daily needs(limited to the roof). Any part of the building that is not occupied or used for daily needs is not included in the floor size calculation such as rice storage, live stock farm,service area for drying clothes(cemented floor) and specific space for business(such as stall/store). The floor size of a multi storeys is the total of the entire floors occupied. Source of drinking water: Source of drinking water: Source of drinking water: Source of drinking water: Source of drinking water: Source of drinking water: 1. If b6r6a the answer is coded 1,2, or 4 skip to b6r8 2. If b6r6a the answer is coded 3,10, or 11 skip to b6r7 Please ask the main source of drinking water used by the respondent’s household. Circle one of the codes and write it down in the provided box. 66565 190 9 4.137 Other 1 Bottled water 2 Pipe 3 Pump 4 Protected/covered well 5 Unprotected/uncovered well 6 Protected spring 7 Unprotected/uncovered spring 8 River 9 Rainwater Sysmiss Please be cautious in determining drinking water source,because in several regions,some people channel river water or mountain spring water to houses using bamboo or plastic pipes. In this case,the drinking water source should still be written as river water or springs,instead of tap water. 1. Branded bottled water is bottled water produced and distributed by a company in various bottles(500 ml,1L,12 L,or 19 L) and in glass/cups packaging; e.g. water from the following brands: Aqua,Moya,2Tang,VIT. 2. Recycled bottled water is water produced through purification process and is not branded. 3. Pipe, retail payment is water produced through purification and sanitation process(PAM water),although it distributed by retail/mobile water sellers 4. Pipe with meter is water produced throuh purification and sanitation process before distributing it to consumers through water piping. This source of water is produced by PAM(Drinking Water Company) and PDAM(Regional Drinking Water Company) or BPAM(Drinking Water Management Agency),whether they managed by the government or private companies. 5. Terrestrial well/pump is ground water obtained by manual pump,electric pump,or windmill including artesis well(drilled well). 6. Protected/covered well is ground water that is dug up,which surrounding is enforced with wall of minimum 0.8 meters above ground and 3 meters under ground,with 1 meter cemented floor around the well. 7. Unprotected/uncovered well is ground water that is dug up,but the surrounding of the well is not protected with wall or 1 meter cemented floor.The method to get water from covered or uncovered water well is with a bucket,whether using pulley or not. 8. Protected spring is surface water source,where water already pooled naturally,protected from waste such as used water,waste from bathing or washing,etc. 9. Unprotected spring is surface water,where water already pooled naturally,but is unprotected from waste,such as used water,waste from bathing,washing,etc. 10. Other water sources are other source of drinking water,such as from dam/lake. Distance to the closest feces containment: Distance to the closest feces containment: Distance to the closest feces containment: Distance to the closest feces containment: Distance to the closest feces containment: If b6r7a = 3 to 7 (pump/well/spring) Distance to the closest feces containment: Ask the distance of pump/well/springs to the closest animal waste tank, septic tank or liquid waste whether located in the household or neighbor's surroundings. Circle the answer and write it down in the provided box. 66464 291 3 1.336 1 <10 m 2 >= 10 m 3 Don’t know Sysmiss Method to obtain drinking water: Method to obtain drinking water: Method to obtain drinking water: Method to obtain drinking water: Method to obtain drinking water: Method to obtain drinking water: Circle one of the codes according to respondent’s answer and write it down in the provided box. 66565 190 1 3 2.558 1 Subscription 2 Retail buying 3 Not buy Sysmiss 1. Subscribe by buying water to drink on a subscription basis (tap of PAM / taps / BPAM), including also subscribe bottled water (aqua, etc.). 2. Buy retail when respondents were randomly buy water. 3. Not buying if drinking water is obtained with their own efforts for free. Explanation: Asking a neighbor to get water from the dam by paying for his effort is considered buying drinking water. The use of drinking water facilities: The use of drinking water facilities: The use of drinking water facilities: The use of drinking water facilities: The use of drinking water facilities: If b6r6a not equal to 3,5 to 12 The use of drinking water facilities: Circle one of the codes according to the answer and write it down in the provided box. 66565 190 1 4 1.88 1 Personal 2 Mutual 3 Public 4 None Sysmiss Included in drinking water facilities are drinking water installation managed by PAM/PDAM, or non PAM/PDAM,including water from drilled well and pump. The approach used is the amount of water used in the last one month. 1. Personal,if the water facility is only used by respondent's household. 2. Mutual,if the water facility is used by the respondent's household jointly with several certain households. 3. Public,if the water facility is used by every households,including the resident's household. 4. None,if the distance of drinking water facility to the respondent's household is > 2.5 Km or by taking water directly from river/lake/rain without purification process by machine,or by purchasing the water. Defecation facility use: Defecation facility use: Defecation facility use: Defecation facility use: Defecation facility use: Defecation facility use: If the answer is coded 4, skip to b6r10c Circle one of the codes accordingly, then fill in the answer in the provided box. 66565 190 1 4 1.914 1 Personal 2 Mutual 3 Public 4 None Sysmiss Defecation facility means the availability of latrine to be used by respondent’s household. 1. Personal,if the defecation facility is only used by the respondent's household. 2. Mutual,if the defecation facility is used by the respondent's household together with several certain households. 3. Public,if the defecation facility is used by evry households,including respondent's household. 4. None,if respondent's household does not have defecation facility Type of toilet: Type of toilet: Type of toilet: Type of toilet: Type of toilet: Type of toilet: Circle one of the codes accordingly, and fill it in the provided box, 66564 191 4 1.243 1 Goose neck/leher angsa 2 Pit toilet/plengsengan 3 Squat toilet/cemplung 4 None Sysmiss Type of toilet is sitting/squatting latrine used in the toilet. 1. Goose neck/leher angsa is a closet under which seat there is a U shaped pipe(like a duck’s neck) to be filled with water to prevent the odor from going out. 2. Pit toilet/plengsengan is a closet/latrine under which seat there is a flat pipe installed in slightly inclined position towards the final disposal. 3. Squat toilet/cemplung a closet under which seat there is no pipe,so that the waste went directly to its final disposal place. Final disposal location: Final disposal location: Final disposal location: Final disposal location: Final disposal location: Final disposal location: Circle one of the codes accordingly, and fill it in the provided box. 66565 190 1 6 2.567 1 Tank/septic tank 2 Pool/field 3 River/lake/sea 4 Pit hole 5 Beach/open field/farm 6 Other Sysmiss Tanks are the waste final disposal place in the form of reservoirs,usually made of brick/stone or concrete whether or not having an absorption tub.Included in this category is housing complex that has integrated Liquid Waste Disposal System (SPAL),managed by the municipal government. 1. Septic tank are the waste final disposal place in the form of reservoirs,usually made of brick/stone or concrete whether or not having an absorption tub. 2. Pool/field,if the waste is disposed to the pond/paddy field. 3. River/lake/sea,if the waste is disposed to the river/lake/sea. 4. Pit hole,if the waste is disposed to the Underground hole(large hole in the ground) without separators/walls(not water tight). 5. Beach/open ground/garden,if the waste is disposed to the beach areas or fields,including disposed to the yards. Source of lighting: Source of lighting: Source of lighting: Source of lighting: Source of lighting: Source of lighting: Circle one of the codes for lighting source used in respondent’s household,then write it down in the provided box. 66565 190 1 5 1.448 1 PLN electricity 2 Non-PLN electricity 3 Paraffin lamp/petromak 4 Oil lamp/torch 5 Other Sysmiss 1. PLN Electricity is electricity source managed by PLN(National Electricity Company). 2. Non-PLN Electricity is electricity source managed by other institutions/parties aside from PLN. Including in this category are power source from accumulator/battery storage,generator,and solar power plant(that are not managed by PLN). 3. Petromak/aladin lamp such as multi-fuel lantern and gas lantern is categorized in code 3,while other oil lamps such as (sentir,pelita and other of the same type) are categorized in code 4. Carbide lamp,candle,castor oir lamp,and candlenut lamp are included in code 5. Food expenditure - Grains [rice, corn, wheat, flour, cornflour etc.] - in the past one week: (Rp) Food expenditure - Grains [rice, corn, wheat, flour, cornflour etc.] - in the past one week: (Rp) Food expenditure - Grains [rice, corn, wheat, flour, cornflour etc.] - in the past one week: (Rp) Food expenditure - Grains [rice, corn, wheat, flour, cornflour etc.] - in the past one week: (Rp) Food expenditure - Grains [rice, corn, wheat, flour, cornflour etc.] - in the past one week: (Rp) Expenditure for Grains [rice, corn, wheat, flour, cornflour etc.] from purchase, self-producation and present in the past one week: (Rp) Write down in Column (2) food expenditure from purchases, self produced, and gifts for rice in the past one week :(Rp) 66564 191 875000 21700.836 Consumption/expenditure is the value of expenditures for household consumption in the last one week that comes from purchases, own productions or gifts. Food expenditure - Tubers [cassava, sweet potato, potato, yam, sago, etc.] - in the past one week: (Rp) Food expenditure - Tubers [cassava, sweet potato, potato, yam, sago, etc.] - in the past one week: (Rp) Food expenditure - Tubers [cassava, sweet potato, potato, yam, sago, etc.] - in the past one week: (Rp) Food expenditure - Tubers [cassava, sweet potato, potato, yam, sago, etc.] - in the past one week: (Rp) Food expenditure - Tubers [cassava, sweet potato, potato, yam, sago, etc.] - in the past one week: (Rp) Expenditure for Tubers [cassava, sweet potato, potato, yam, sago, etc.] from purchase, self-producation and present in the past one week: (Rp) Write down in Column (2) food expenditure from purchases, self produced, and gifts for rice in the past one week :(Rp) 66565 190 100000 1815.754 Yang termasuk umbi-umbian dalam yaitu ketela pohon,ketela rambat,kentang,gaplek,talas,sagu, dll. Consumption/expenditure is the value of expenditures for household consumption in the last one week that comes from purchases, own productions or gifts. Food expenditure - Fish [fresh fish, salted/preserved fish, prawn etc.] - in the past one week: (Rp) Food expenditure - Fish [fresh fish, salted/preserved fish, prawn etc.] - in the past one week: (Rp) Food expenditure - Fish [fresh fish, salted/preserved fish, prawn etc.] - in the past one week: (Rp) Food expenditure - Fish [fresh fish, salted/preserved fish, prawn etc.] - in the past one week: (Rp) Food expenditure - Fish [fresh fish, salted/preserved fish, prawn etc.] - in the past one week: (Rp) Expenditure for Fish [fresh fish, salted/preserved fish, prawn etc.] from purchase, self-producation and present in the past one week: (Rp) Write down in Column (2) food expenditure from purchases, self produced, and gifts for rice in the past one week :(Rp) 66565 190 300000 12120.691 200 250 300 350 400 450 500 525 600 650 700 750 800 850 875 900 950 1000 1050 1100 1150 1200 1250 1275 1300 1350 1400 1450 1500 1550 1600 1650 1700 1725 1750 1800 1850 1900 1915 1950 1960 2000 2100 2150 2200 2250 2275 2300 2350 2400 2450 2500 2550 2600 2650 2700 2750 2800 2850 2900 2950 3000 3010 3050 3100 3150 3200 3250 3300 3325 3350 3400 3415 3450 3500 3550 3600 3610 3650 3700 3750 3800 3850 3900 3950 4000 4050 4075 4100 4150 4200 4225 4250 4300 4350 4400 4450 4500 4525 4550 4600 4650 4700 4750 4800 4810 4850 4900 4950 5000 5100 5150 5200 5250 5300 5350 5400 5450 5500 5550 5600 5650 5700 5725 5750 5800 5850 5900 5975 6000 6100 6150 6195 6200 6250 6300 6350 6375 6400 6425 6450 6500 6550 6600 6650 6700 6750 6800 6850 6900 6950 6975 7000 7100 7150 7200 7240 7250 7300 7350 7400 7450 7500 7525 7550 7600 7650 7700 7720 7750 7800 7825 7850 7900 7950 7975 8000 8100 8125 8150 8200 8225 8250 8300 8350 8400 8450 8500 8550 8600 8650 8700 8750 8800 8850 8900 9000 9100 9200 9250 9270 9300 9350 9400 9450 9500 9550 9575 9600 9700 9750 9800 9850 9950 10000 10100 10125 10150 10200 10250 10300 10350 10400 10500 10600 10650 10700 10750 10800 10850 10900 11000 11100 11150 11195 11200 11250 11300 11350 11400 11500 11550 11600 11650 11700 11750 11800 11825 11900 12000 12100 12185 12200 12250 12300 12400 12450 12500 12550 12600 12650 12675 12700 12750 12800 12900 12950 13000 13100 13150 13200 13250 13300 13350 13400 13500 13600 13650 13700 13750 13800 13850 13900 14000 14080 14100 14150 14200 14225 14250 14300 14350 14400 14480 14500 14600 14625 14650 14700 14750 14800 14850 14900 14925 15000 15100 15150 15200 15250 15300 15375 15400 15500 15600 15700 15750 15800 15900 16000 16100 16200 16225 16250 16300 16400 16500 16600 16625 16700 16750 16800 16850 16900 17000 17100 17150 17200 17250 17300 17350 17400 17500 17600 17650 17700 17750 17800 17850 17875 17900 18000 18100 18200 18250 18275 18300 18400 18450 18500 18600 18625 18700 18750 18760 18800 18900 18950 19000 19200 19250 19300 19350 19375 19400 19500 19600 19700 19750 19800 19850 19975 20000 20100 20200 20300 20400 20500 20590 20600 20700 20750 20800 20900 21000 21150 21200 21230 21250 21300 21400 21425 21500 21600 21700 21750 21800 21850 21875 22000 22200 22250 22300 22400 22500 22600 22700 22750 23000 23150 23200 23250 23400 23420 23500 23600 23700 23750 23800 24000 24100 24200 24300 24400 24500 24600 24700 24750 24800 24875 25000 25200 25300 25400 25500 25600 25700 25750 25800 26000 26200 26250 26300 26350 26450 26500 26600 26700 26750 26800 26865 27000 27200 27250 27400 27500 27600 27620 27650 27700 27750 27800 27850 28000 28100 28300 28400 28500 28600 28700 28750 28800 28900 28950 29000 29100 29225 29300 29400 29500 29600 29650 29700 29750 29850 30000 30125 30300 30500 30725 30800 30850 30950 31000 31200 31250 31500 31600 31750 32000 32150 32200 32310 32500 32600 32700 32720 32750 32800 33000 33250 33500 33600 33750 33800 34000 34200 34400 34450 34500 34600 34900 35000 35100 35150 35200 35250 35500 35750 35800 35900 36000 36500 36700 36750 36800 37000 37250 37500 37650 37750 37900 38000 38150 38400 38500 38600 38700 38900 39000 39200 39500 39700 39750 39800 40000 40200 40250 40500 41000 41300 41500 41700 41750 41800 42000 42250 42300 42500 42600 43000 43500 43750 44000 44325 44500 45000 45500 46000 46300 46500 47000 47500 48000 48500 48700 49000 49500 50000 50500 51000 52000 52500 53000 53200 53500 54000 54500 55000 55500 56000 56250 57000 57500 58000 58500 58600 59000 59500 59750 60000 60500 62000 62500 63000 63200 63500 64000 65000 65500 66000 66500 67000 67500 68000 69000 70000 70500 71200 72000 72750 73000 73500 73700 74000 75000 76000 77000 77300 78000 79000 80000 82000 83000 84000 84200 85000 86000 86500 87500 88000 89000 90000 91000 94500 95500 96800 97500 98000 100000 105000 110000 112000 112500 115000 116000 117000 119000 120000 122500 124000 125000 135000 140000 150000 155000 156000 175000 210000 231000 240500 245000 300000 Sysmiss Consumption/expenditure is the value of expenditures for household consumption in the last one week that comes from purchases, own productions or gifts. Food expenditure - Meat [beef, buffalo meat, mutton, lamb, pork, chicken, offal, liver, spleen, floss, jerky etc.] - in the past one week: (Rp) Food expenditure - Meat [beef, buffalo meat, mutton, lamb, pork, chicken, offal, liver, spleen, floss, jerky etc.] - in the past one week: (Rp) Food expenditure - Meat [beef, buffalo meat, mutton, lamb, pork, chicken, offal, liver, spleen, floss, jerky etc.] - in the past one week: (Rp) Food expenditure - Meat [beef, buffalo meat, mutton, lamb, pork, chicken, offal, liver, spleen, floss, jerky etc.] - in the past one week: (Rp) Food expenditure - Meat [beef, buffalo meat, mutton, lamb, pork, chicken, offal, liver, spleen, floss, jerky etc.] - in the past one week: (Rp) Expenditure for Meat [beef, buffalo meat, mutton, lamb, pork, chicken, offal, liver, spleen, floss, jerky etc.] from purchase, self-producation and present in the past one week: (Rp) Write down in Column (2) food expenditure from purchases, self produced, and gifts for rice in the past one week :(Rp) 66565 190 250000 5678.079 Yang termasuk daging yaitu daging sapi/kerbau/kambing/domba/babi/ayam,jeroan,hati,limpa,abon,dendeng,dll. Consumption/expenditure is the value of expenditures for household consumption in the last one week that comes from purchases, own productions or gifts. Food expenditure - Egg and milk (chicken egg, duck egg, quail egg, fresh milk, evaporated milk, milk powder etc.] - in the past one week: (Rp) Food expenditure - Egg and milk (chicken egg, duck egg, quail egg, fresh milk, evaporated milk, milk powder etc.] - in the past one week: (Rp) Food expenditure - Egg and milk (chicken egg, duck egg, quail egg, fresh milk, evaporated milk, milk powder etc.] - in the past one week: (Rp) Food expenditure - Egg and milk (chicken egg, duck egg, quail egg, fresh milk, evaporated milk, milk powder etc.] - in the past one week: (Rp) Food expenditure - Egg and milk (chicken egg, duck egg, quail egg, fresh milk, evaporated milk, milk powder etc.] - in the past one week: (Rp) Expenditure for Egg and milk (chicken egg, duck egg, quail egg, fresh milk, evaporated milk, milk powder etc.] from purchase, self-producation and present in the past one week: (Rp) Write down in Column (2) food expenditure from purchases, self produced, and gifts for rice in the past one week :(Rp) 66565 190 366000 6796.285 300 400 450 500 550 600 625 650 700 750 800 850 900 950 975 1000 1050 1100 1150 1200 1225 1250 1300 1350 1375 1400 1425 1450 1500 1525 1550 1575 1600 1625 1650 1675 1700 1725 1750 1800 1810 1825 1850 1870 1875 1900 1920 1950 2000 2050 2100 2125 2150 2200 2210 2225 2250 2300 2350 2375 2400 2410 2425 2430 2450 2475 2500 2550 2570 2575 2600 2650 2675 2700 2710 2750 2770 2775 2800 2810 2850 2875 2900 2950 2975 3000 3050 3100 3150 3200 3250 3300 3315 3320 3325 3350 3360 3400 3425 3450 3475 3500 3550 3600 3625 3650 3700 3735 3750 3800 3840 3850 3895 3900 3925 3950 4000 4050 4100 4125 4150 4200 4250 4300 4320 4350 4375 4400 4450 4500 4550 4600 4625 4650 4700 4720 4725 4750 4800 4820 4850 4860 4875 4900 4925 4950 5000 5050 5100 5150 5175 5200 5225 5250 5300 5350 5400 5450 5500 5550 5575 5600 5625 5650 5700 5750 5760 5800 5850 5900 5950 6000 6050 6100 6150 6200 6225 6250 6300 6325 6350 6375 6400 6450 6500 6550 6600 6625 6650 6700 6750 6780 6800 6850 6875 6900 6950 7000 7050 7100 7150 7200 7225 7250 7300 7350 7400 7450 7500 7550 7600 7650 7700 7750 7800 7850 7900 7950 8000 8050 8100 8150 8200 8225 8250 8300 8350 8400 8450 8475 8500 8550 8575 8600 8650 8700 8750 8800 8850 8900 8915 8950 8975 9000 9050 9100 9145 9150 9200 9250 9300 9350 9375 9400 9450 9500 9525 9600 9625 9650 9700 9750 9800 9850 9875 9900 9975 10000 10050 10100 10125 10150 10200 10250 10300 10325 10400 10500 10600 10625 10700 10750 10800 10850 10900 10950 11000 11100 11150 11200 11250 11300 11350 11400 11450 11500 11550 11600 11650 11660 11700 11750 11800 11850 11875 11900 11925 11950 12000 12050 12100 12150 12200 12250 12300 12350 12375 12400 12450 12500 12550 12570 12600 12650 12700 12745 12750 12775 12780 12800 12850 12900 12925 13000 13050 13100 13150 13200 13250 13300 13350 13400 13450 13500 13600 13650 13700 13750 13800 13850 13900 13925 13950 14000 14100 14150 14200 14250 14300 14375 14400 14500 14550 14600 14625 14645 14700 14750 14800 14850 14900 14950 15000 15100 15150 15200 15250 15300 15400 15450 15500 15600 15700 15750 15800 15900 16000 16100 16150 16200 16250 16300 16325 16350 16400 16500 16600 16650 16700 16725 16750 16800 16825 16850 16900 16950 17000 17100 17200 17250 17300 17400 17450 17500 17525 17600 17650 17700 17725 17750 17800 17850 17900 17950 18000 18100 18150 18200 18250 18300 18350 18375 18400 18450 18500 18575 18600 18650 18700 18750 18800 18900 19000 19100 19200 19250 19300 19350 19400 19450 19500 19550 19600 19650 19700 19750 19800 19850 19900 20000 20100 20150 20175 20200 20250 20300 20400 20450 20500 20600 20625 20700 20750 20800 20900 21000 21100 21200 21250 21300 21400 21450 21500 21600 21700 21750 21800 21900 22000 22100 22200 22250 22300 22375 22400 22500 22600 22650 22700 22750 22800 22900 23000 23100 23200 23250 23300 23400 23500 23550 23600 23610 23700 23750 23800 23850 23900 24000 24100 24150 24200 24250 24300 24400 24500 24555 24600 24700 24750 24800 24850 25000 25100 25200 25250 25350 25500 25600 25700 25750 25800 25850 25900 25950 26000 26250 26300 26500 26550 26600 26700 26800 26900 27000 27100 27150 27200 27250 27300 27375 27400 27500 27600 27700 27800 28000 28100 28300 28375 28400 28500 28750 28800 29000 29100 29200 29250 29400 29425 29500 29600 29750 29850 30000 30100 30200 30250 30300 30400 30500 30700 30950 31000 31100 31400 31500 31600 31700 31750 31800 31900 32000 32100 32200 32250 32400 32500 32525 32550 32700 32750 32900 33000 33500 33600 33750 33800 33950 34000 34300 34400 34500 34535 34750 34900 35000 35100 35200 35300 35400 35500 35600 35700 35750 35800 36000 36250 36400 36500 36600 36800 36875 36900 36975 37000 37200 37300 37500 37600 37750 37900 38000 38150 38400 38500 38600 38650 38700 38750 38800 38875 39000 39125 39250 39400 39500 39600 39650 39700 39750 40000 40250 40500 40600 40950 41000 41100 41500 42000 42200 42300 42500 42600 42700 42750 42900 43000 43200 43500 43600 43700 43750 43800 44000 45000 45200 45500 45800 46000 46200 46350 46500 46670 46700 46750 47000 47100 47500 47600 47750 47800 47950 48000 48250 48500 49000 49500 49950 50000 50150 50400 50600 50700 50750 51000 51200 51500 52000 52450 52500 52800 52900 53000 53450 53700 54000 54300 54500 54600 54750 54800 54900 55000 55500 55950 56000 56200 56500 56750 57000 57200 57500 57750 58000 58150 58400 58600 58900 59000 59200 59400 59500 59600 60000 60250 60750 61000 61200 61250 61500 61600 62000 62500 62800 63000 64000 64300 64500 65000 65100 65200 65500 65700 66000 66500 66600 67000 67500 68000 70000 70500 71000 71250 71375 71750 72000 72800 73000 73100 74000 74300 74500 75000 75500 76000 76800 78000 80000 80500 81000 81500 82000 82250 83000 84000 84500 84600 85000 85200 86000 87500 88000 90000 90875 91000 91250 91500 92000 92400 93000 95000 95200 96000 96500 97000 98000 98500 98900 100000 100500 102000 104000 104500 105000 106000 106150 110000 110500 111000 113000 114000 116500 119500 120000 124000 125000 126000 126200 126500 127000 128000 130000 133000 135000 139000 140000 141000 142000 143000 144000 144375 145000 150000 150750 160000 161000 165500 166000 170000 180000 182000 188000 200000 226000 230000 232000 240125 250000 350000 366000 Sysmiss Consumption/expenditure is the value of expenditures for household consumption in the last one week that comes from purchases, own productions or gifts. Food expenditure - Vegetables [spinach, water spinach, cucumber, carrot, bean, snaps, onion, chili, tomato etc.] - in the past one week: (Rp) Food expenditure - Vegetables [spinach, water spinach, cucumber, carrot, bean, snaps, onion, chili, tomato etc.] - in the past one week: (Rp) Food expenditure - Vegetables [spinach, water spinach, cucumber, carrot, bean, snaps, onion, chili, tomato etc.] - in the past one week: (Rp) Food expenditure - Vegetables [spinach, water spinach, cucumber, carrot, bean, snaps, onion, chili, tomato etc.] - in the past one week: (Rp) Food expenditure - Vegetables [spinach, water spinach, cucumber, carrot, bean, snaps, onion, chili, tomato etc.] - in the past one week: (Rp) Expenditure for Vegetables [spinach, water spinach, cucumber, carrot, bean, snaps, onion, chili, tomato etc.] from purchase, self-producation and present in the past one week: (Rp) Write down in Column (2) food expenditure from purchases, self produced, and gifts for rice in the past one week :(Rp) 66565 190 140000 8306.327 Yang termasuk sayur-sayuran yaitu sayur bayam,kangkung,ketimun,wortel,kacang panjang,buncis,bawang,cabe,tomat,dll. Consumption/expenditure is the value of expenditures for household consumption in the last one week that comes from purchases, own productions or gifts. Food expenditure - Nuts [peanut, mung bean, soybean, red bean, cowpea, cashew nut, tofu, tempeh etc.] - in the past one week: (Rp) Food expenditure - Nuts [peanut, mung bean, soybean, red bean, cowpea, cashew nut, tofu, tempeh etc.] - in the past one week: (Rp) Food expenditure - Nuts [peanut, mung bean, soybean, red bean, cowpea, cashew nut, tofu, tempeh etc.] - in the past one week: (Rp) Food expenditure - Nuts [peanut, mung bean, soybean, red bean, cowpea, cashew nut, tofu, tempeh etc.] - in the past one week: (Rp) Food expenditure - Nuts [peanut, mung bean, soybean, red bean, cowpea, cashew nut, tofu, tempeh etc.] - in the past one week: (Rp) Expenditure for Nuts [peanut, mung bean, soybean, red bean, cowpea, cashew nut, tofu, tempeh etc.] from purchase, self-producation and present in the past one week: (Rp) Write down in Column (2) food expenditure from purchases, self produced, and gifts for rice in the past one week :(Rp) 66565 190 105000 4077.156 Yang termasuk kacang-kacangan yaitu kacang tanah/hijau/kedele/merah/ tunggak/mete,tahu,tempe,tauco,oncom,dll. Consumption/expenditure is the value of expenditures for household consumption in the last one week that comes from purchases, own productions or gifts. Food expenditure - Fruits [orange, mango, apple, durian, rambutan, salak, duku, pineapple, watermelon, banana, papaya etc.] - in the past one week: (Rp) Food expenditure - Fruits [orange, mango, apple, durian, rambutan, salak, duku, pineapple, watermelon, banana, papaya etc.] - in the past one week: (Rp) Food expenditure - Fruits [orange, mango, apple, durian, rambutan, salak, duku, pineapple, watermelon, banana, papaya etc.] - in the past one week: (Rp) Food expenditure - Fruits [orange, mango, apple, durian, rambutan, salak, duku, pineapple, watermelon, banana, papaya etc.] - in the past one week: (Rp) Food expenditure - Fruits [orange, mango, apple, durian, rambutan, salak, duku, pineapple, watermelon, banana, papaya etc.] - in the past one week: (Rp) Expenditure for Fruits [orange, mango, apple, durian, rambutan, salak, duku, pineapple, watermelon, banana, papaya etc.] from purchase, self-producation and present in the past one week: (Rp) Write down in Column (2) food expenditure from purchases, self produced, and gifts for rice in the past one week :(Rp) 66565 190 250000 5081.141 Yang termasuk buah-buahan yaitu jeruk,mangga,apel,durian,rambutan,salak,duku,nanas,semangka,pisang,pepaya,dll. Consumption/expenditure is the value of expenditures for household consumption in the last one week that comes from purchases, own productions or gifts. Food expenditure - Oil and fat [coconut oil, cooking oil, coconut, margarine etc.] - in the past one week: (Rp) Food expenditure - Oil and fat [coconut oil, cooking oil, coconut, margarine etc.] - in the past one week: (Rp) Food expenditure - Oil and fat [coconut oil, cooking oil, coconut, margarine etc.] - in the past one week: (Rp) Food expenditure - Oil and fat [coconut oil, cooking oil, coconut, margarine etc.] - in the past one week: (Rp) Food expenditure - Oil and fat [coconut oil, cooking oil, coconut, margarine etc.] - in the past one week: (Rp) Expenditure for Oil and fat [coconut oil, cooking oil, coconut, margarine etc.] from purchase, self-producation and present in the past one week: (Rp) Write down in Column (2) food expenditure from purchases, self produced, and gifts for rice in the past one week :(Rp) 66565 190 175000 5188.579 Yang termasuk minyak dan lemak yaitu minyak kelapa/goreng,kelapa,mentega,dll. Consumption/expenditure is the value of expenditures for household consumption in the last one week that comes from purchases, own productions or gifts. Food expenditure - Beverage supplements [sugar, brown sugar, tea, coffee, chocolate, syrup, etc.] - in the past one week: (Rp) Food expenditure - Beverage supplements [sugar, brown sugar, tea, coffee, chocolate, syrup, etc.] - in the past one week: (Rp) Food expenditure - Beverage supplements [sugar, brown sugar, tea, coffee, chocolate, syrup, etc.] - in the past one week: (Rp) Food expenditure - Beverage supplements [sugar, brown sugar, tea, coffee, chocolate, syrup, etc.] - in the past one week: (Rp) Food expenditure - Beverage supplements [sugar, brown sugar, tea, coffee, chocolate, syrup, etc.] - in the past one week: (Rp) Expenditure for Beverage supplements [sugar, brown sugar, tea, coffee, chocolate, syrup, etc.] from purchase, self-producation and present in the past one week: (Rp) Write down in Column (2) food expenditure from purchases, self produced, and gifts for rice in the past one week :(Rp) 66565 190 100000 5886.208 Yang termasuk bahan minuman yaitu gula pasir,gula merah,teh,kopi,coklat,sirup,dll. Consumption/expenditure is the value of expenditures for household consumption in the last one week that comes from purchases, own productions or gifts. Food expenditure - Spices [salt, hazelnut, coriander, pepper, fish paste, soybean sauce, MSG etc.] - in the past one week: (Rp) Food expenditure - Spices [salt, hazelnut, coriander, pepper, fish paste, soybean sauce, MSG etc.] - in the past one week: (Rp) Food expenditure - Spices [salt, hazelnut, coriander, pepper, fish paste, soybean sauce, MSG etc.] - in the past one week: (Rp) Food expenditure - Spices [salt, hazelnut, coriander, pepper, fish paste, soybean sauce, MSG etc.] - in the past one week: (Rp) Food expenditure - Spices [salt, hazelnut, coriander, pepper, fish paste, soybean sauce, MSG etc.] - in the past one week: (Rp) Expenditure for Spices [salt, hazelnut, coriander, pepper, fish paste, soybean sauce, MSG etc.] from purchase, self-producation and present in the past one week: (Rp)) Write down in Column (2) food expenditure from purchases, self produced, and gifts for rice in the past one week :(Rp) 66565 190 180000 3163.939 Yang termasuk bumbu-bumbuan yaitu garam,kemiri,ketumbar,merica,terasi,kecap,vetsin,dll. Consumption/expenditure is the value of expenditures for household consumption in the last one week that comes from purchases, own productions or gifts. Food expenditure - Other foodstuffs [cracker, noodle, vermicelli, macaroni etc.] - in the past one week: (Rp) Food expenditure - Other foodstuffs [cracker, noodle, vermicelli, macaroni etc.] - in the past one week: (Rp) Food expenditure - Other foodstuffs [cracker, noodle, vermicelli, macaroni etc.] - in the past one week: (Rp) Food expenditure - Other foodstuffs [cracker, noodle, vermicelli, macaroni etc.] - in the past one week: (Rp) Food expenditure - Other foodstuffs [cracker, noodle, vermicelli, macaroni etc.] - in the past one week: (Rp) Expenditure for Other foodstuffs [cracker, noodle, vermicelli, macaroni etc.] from purchase, self-producation and present in the past one week: (Rp) Write down in Column (2) food expenditure from purchases, self produced, and gifts for rice in the past one week :(Rp) 66565 190 450000 2966.214 Mie instant,mie basah,bihun,makaroni/mie kering termasuk jenis konsunsi rumah tangga lainnya Consumption/expenditure is the value of expenditures for household consumption in the last one week that comes from purchases, own productions or gifts. Food expenditure - Delicatessen [bread, biscuit, porridge, meatball, ice, lemonade, salad etc.] - in the past one week: (Rp) Food expenditure - Delicatessen [bread, biscuit, porridge, meatball, ice, lemonade, salad etc.] - in the past one week: (Rp) Food expenditure - Delicatessen [bread, biscuit, porridge, meatball, ice, lemonade, salad etc.] - in the past one week: (Rp) Food expenditure - Delicatessen [bread, biscuit, porridge, meatball, ice, lemonade, salad etc.] - in the past one week: (Rp) Food expenditure - Delicatessen [bread, biscuit, porridge, meatball, ice, lemonade, salad etc.] - in the past one week: (Rp) Expenditure for Delicatessen [bread, biscuit, porridge, meatball, ice, lemonade, salad etc.] from purchase, self-producation and present in the past one week: (Rp) Write down in Column (2) food expenditure from purchases, self produced, and gifts for rice in the past one week :(Rp) 66563 192 935000 15273.458 Yang termasuk makanan jadi yaitu roti,biskuit,kue basah,bubur,bakso,gado-gado,nasi rames,dll. Consumption/expenditure is the value of expenditures for household consumption in the last one week that comes from purchases, own productions or gifts. Food expenditure - Alcoholic beverages [beer, wine, other]from purchase, self-producation and present in the past one week: (Rp) Food expenditure - Alcoholic beverages [beer, wine, other]from purchase, self-producation and present in the past one week: (Rp) Food expenditure - Alcoholic beverages [beer, wine, other]from purchase, self-producation and present in the past one week: (Rp) Food expenditure - Alcoholic beverages [beer, wine, other]from purchase, self-producation and present in the past one week: (Rp) Food expenditure - Alcoholic beverages [beer, wine, other]from purchase, self-producation and present in the past one week: (Rp) Expenditure for Alcoholic beverages [beer, wine, other]from purchase, self-producation and present in the past one week: (Rp) Write down in Column (2) food expenditure from purchases, self produced, and gifts for rice in the past one week :(Rp) 66565 190 400000 274.635 Consumption/expenditure is the value of expenditures for household consumption in the last one week that comes from purchases, own productions or gifts. Food expenditure - Tobacco and betel [clove cigarette, white cigarette, cigar, tobacco, betel, areca nut etc.] - in the past one week: (Rp) Food expenditure - Tobacco and betel [clove cigarette, white cigarette, cigar, tobacco, betel, areca nut etc.] - in the past one week: (Rp) Food expenditure - Tobacco and betel [clove cigarette, white cigarette, cigar, tobacco, betel, areca nut etc.] - in the past one week: (Rp) Food expenditure - Tobacco and betel [clove cigarette, white cigarette, cigar, tobacco, betel, areca nut etc.] - in the past one week: (Rp) Food expenditure - Tobacco and betel [clove cigarette, white cigarette, cigar, tobacco, betel, areca nut etc.] - in the past one week: (Rp) Expenditure for Tobacco and betel [clove cigarette, white cigarette, cigar, tobacco, betel, areca nut etc.] from purchase, self-producation and present in the past one week: (Rp) Write down in Column (2) food expenditure from purchases, self produced, and gifts for rice in the past one week :(Rp) 66565 190 343000 16195.643 Consumption/expenditure is the value of expenditures for household consumption in the last one week that comes from purchases, own productions or gifts. Total Foodstuff [Details 1 to 15] Total Foodstuff [Details 1 to 15] Total Foodstuff [Details 1 to 15] Total Foodstuff [Details 1 to 15] Total Foodstuff [Details 1 to 15] Total Foodstuff [Details 1 to 15] Write down in Column (2) total expenditures [Details 1 to 15] 66553 202 6600 999500 114368.073 Non-food expenditure - house lease, rent, rent expectation (owned, free lease, company house) etc. in the past month:(Rp) Non-food expenditure - house lease, rent, rent expectation (owned, free lease, company house) etc. in the past month:(Rp) Non-food expenditure - house lease, rent, rent expectation (owned, free lease, company house) etc. in the past month:(Rp) Non-food expenditure - house lease, rent, rent expectation (owned, free lease, company house) etc. in the past month:(Rp) Non-food expenditure - house lease, rent, rent expectation (owned, free lease, company house) etc. in the past month:(Rp) Non-food expenditure for house lease, rent, rent expectation (owned, free lease, company house) etc. from purchase, self-producation and present, in the past month:(Rp) Write down in Column (2) non-food expenditure from purchases, self produced, and gifts in one past month for house maintenance and minor repairs :(Rp) 66087 668 100 900000 92265.021 Expenditure in the last one month should be the amount really spent in the last one month, not the average monthly amount of the last 12 months. Non-food expenditure - house lease, rent, rent expectation (owned, free lease, company house) etc. in the 12 months :(Rp) Non-food expenditure - house lease, rent, rent expectation (owned, free lease, company house) etc. in the 12 months :(Rp) Non-food expenditure - house lease, rent, rent expectation (owned, free lease, company house) etc. in the 12 months :(Rp) Non-food expenditure - house lease, rent, rent expectation (owned, free lease, company house) etc. in the 12 months :(Rp) Non-food expenditure - house lease, rent, rent expectation (owned, free lease, company house) etc. in the 12 months :(Rp) Non-food expenditure for house lease, rent, rent expectation (owned, free lease, company house) etc. from purchase, self-producation and present, in the 12 months :(Rp) Write down in Column (3) non-food expenditure from purchases, self produced, and gifts in past 12 months for house lease,rent,rent expectation :(Rp) 43549 23206 100 999960 460162.999 The expenditure in the last 12 months should be the amount trully spent in the last 12 months that ends one day before the census date, 12 calendar months. Non-food expenditure - electricity bill, telephone bill, gas, kerosene, water, firewood etc. in the past month:(Rp) Non-food expenditure - electricity bill, telephone bill, gas, kerosene, water, firewood etc. in the past month:(Rp) Non-food expenditure - electricity bill, telephone bill, gas, kerosene, water, firewood etc. in the past month:(Rp) Non-food expenditure - electricity bill, telephone bill, gas, kerosene, water, firewood etc. in the past month:(Rp) Non-food expenditure - electricity bill, telephone bill, gas, kerosene, water, firewood etc. in the past month:(Rp) Non-food expenditure for electricity bill, telephone bill, gas, kerosene, water, firewood etc. from purchase, self-producation and present, in the past month:(Rp) Write down in Column (2) non-food expenditure from purchases, self produced, and gifts in one past month for house maintenance and minor repairs :(Rp) 66483 272 995000 80361.03 Expenditure in the last one month should be the amount really spent in the last one month, not the average monthly amount of the last 12 months. Non-food expenditure - electricity bill, telephone bill, gas, kerosene, water, firewood etc. in the 12 months :(Rp) Non-food expenditure - electricity bill, telephone bill, gas, kerosene, water, firewood etc. in the 12 months :(Rp) Non-food expenditure - electricity bill, telephone bill, gas, kerosene, water, firewood etc. in the 12 months :(Rp) Non-food expenditure - electricity bill, telephone bill, gas, kerosene, water, firewood etc. in the 12 months :(Rp) Non-food expenditure - electricity bill, telephone bill, gas, kerosene, water, firewood etc. in the 12 months :(Rp) Non-food expenditure for electricity bill, telephone bill, gas, kerosene, water, firewood etc. from purchase, self-producation and present, in the 12 months :(Rp) Write down in Column (3) non-food expenditure from purchases, self produced, and gifts in past 12 months for house maintenance and minor repairs :(Rp) 48254 18501 999600 508435.804 The expenditure in the last 12 months should be the amount trully spent in the last 12 months that ends one day before the census date, 12 calendar months. Non-food expenditure - house maintenance and minor repair in the past month:(Rp) Non-food expenditure - house maintenance and minor repair in the past month:(Rp) Non-food expenditure - house maintenance and minor repair in the past month:(Rp) Non-food expenditure - house maintenance and minor repair in the past month:(Rp) Non-food expenditure - house maintenance and minor repair in the past month:(Rp) Non-food expenditure for house maintenance and minor repair from purchase, self-producation and present, in the past month:(Rp) Write down in Column (2) non-food expenditure from purchases, self produced, and gifts in one past month for electricity bill,telephone bill, gas, kerosene, water, firewood etc. :(Rp) 66463 292 974500 3159.207 Expenditure in the last one month should be the amount really spent in the last one month, not the average monthly amount of the last 12 months. Non-food expenditure - house maintenance and minor repair in the 12 months :(Rp) Non-food expenditure - house maintenance and minor repair in the 12 months :(Rp) Non-food expenditure - house maintenance and minor repair in the 12 months :(Rp) Non-food expenditure - house maintenance and minor repair in the 12 months :(Rp) Non-food expenditure - house maintenance and minor repair in the 12 months :(Rp) Non-food expenditure for house maintenance and minor repair from purchase, self-producation and present, in the 12 months :(Rp) Write down in Column (3) non-food expenditure from purchases, self produced, and gifts in past 12 months for electricity bill,telephone bill, gas, kerosene, water, firewood etc. :(Rp) 65390 1365 999500 38857.383 The expenditure in the last 12 months should be the amount trully spent in the last 12 months that ends one day before the census date, 12 calendar months. Non-food expenditure - various goods and services in the past month:(Rp) Non-food expenditure - various goods and services in the past month:(Rp) Non-food expenditure - various goods and services in the past month:(Rp) Non-food expenditure - various goods and services in the past month:(Rp) Non-food expenditure - various goods and services in the past month:(Rp) Non-food expenditure for various goods and services (soap, cosmetics, transportation, reading, ID card/driver license processing fee, recreation, telephone card, postal fee etc.) from purchase, self-producation and present, in the past month:(Rp) Write down in Column (2) non-food expenditure from purchases, self produced, and gifts in one past month for various goods and services :(Rp) 66461 294 986000 47819.159 Expenditure in the last one month should be the amount really spent in the last one month, not the average monthly amount of the last 12 months. Non-food expenditure - various goods and services in the past 12 month:(Rp) Non-food expenditure - various goods and services in the past 12 month:(Rp) Non-food expenditure - various goods and services in the past 12 month:(Rp) Non-food expenditure - various goods and services in the past 12 month:(Rp) Non-food expenditure - various goods and services in the past 12 month:(Rp) Non-food expenditure fo various goods and services (soap, cosmetics, transportation, reading, ID card/driver license processing fee, recreation, telephone card, postal fee etc.) from purchase, self-producation and present, in the past 12 month:(Rp) Write down in Column (3) non-food expenditure from purchases, self produced, and gifts in past 12 months for various goods and services:(Rp) 56778 9977 999600 257702.446 The expenditure in the last 12 months should be the amount trully spent in the last 12 months that ends one day before the census date, 12 calendar months. Non-food expenditure - education cost in the past month:(Rp) Non-food expenditure - education cost in the past month:(Rp) Non-food expenditure - education cost in the past month:(Rp) Non-food expenditure - education cost in the past month:(Rp) Non-food expenditure - education cost in the past month:(Rp) Non-food expenditure for education cost (registration fee, monthly educational fee, re-registration fee, boy/girl scout, craft, course etc.) from purchase, self-producation and present, in the past month:(Rp) Write down in Column (2) non-food expenditure from purchases, self produced, and gifts in one past month for clothes,footwear and headgear :(Rp) 66376 379 960000 25128.293 Expenditure in the last one month should be the amount really spent in the last one month, not the average monthly amount of the last 12 months. Non-food expenditure - education cost in the 12 months :(Rp) Non-food expenditure - education cost in the 12 months :(Rp) Non-food expenditure - education cost in the 12 months :(Rp) Non-food expenditure - education cost in the 12 months :(Rp) Non-food expenditure - education cost in the 12 months :(Rp) Non-food expenditure for education cost (registration fee, monthly educational fee, re-registration fee, boy/girl scout, craft, course etc.) from purchase, self-producation and present, in the 12 months :(Rp) Write down in Column (3) non-food expenditure from purchases, self produced, and gifts in past 12 months for clothes,footwear and headgear :(Rp) 61051 5704 999600 141990.339 The expenditure in the last 12 months should be the amount trully spent in the last 12 months that ends one day before the census date, 12 calendar months. Non-food expenditure - health cost in the past month:(Rp) Non-food expenditure - health cost in the past month:(Rp) Non-food expenditure - health cost in the past month:(Rp) Non-food expenditure - health cost in the past month:(Rp) Non-food expenditure - health cost in the past month:(Rp) Non-food expenditure for health cost (hospital, public clinic, doctor practice, healer, medicine etc.) from purchase, self-producation and present, in the past month:(Rp) Write down in Column (2) non-food expenditure from purchases, self produced, and gifts in one past month for durable goods :(Rp) 66248 507 995000 23808.741 Expenditure in the last one month should be the amount really spent in the last one month, not the average monthly amount of the last 12 months. Non-food expenditure - health cost in the past 12 months :(Rp) Non-food expenditure - health cost in the past 12 months :(Rp) Non-food expenditure - health cost in the past 12 months :(Rp) Non-food expenditure - health cost in the past 12 months :(Rp) Non-food expenditure - health cost in the past 12 months :(Rp) Non-food expenditure for health cost (hospital, public clinic, doctor practice, healer, medicine etc.) from purchase, self-producation and present in the past 12 months :(Rp) Write down in Column (3) non-food expenditure from purchases, self produced, and gifts in past 12 months for durable goods :(Rp) 64137 2618 997000 125638.791 The expenditure in the last 12 months should be the amount trully spent in the last 12 months that ends one day before the census date, 12 calendar months. Non-food expenditure - clothes, footwear and headgear in the past month:(Rp) Non-food expenditure - clothes, footwear and headgear in the past month:(Rp) Non-food expenditure - clothes, footwear and headgear in the past month:(Rp) Non-food expenditure - clothes, footwear and headgear in the past month:(Rp) Non-food expenditure - clothes, footwear and headgear in the past month:(Rp) Non-food expenditure for clothes, footwear and headgear (clothes, apparel, shoes, hat, detergent etc.) from purchase, self-producation and present in the past month:(Rp) Write down in Column (2) non-food expenditure from purchases, self produced, and gifts in one past month for party and ceremony excluding food :(Rp) 66487 268 993300 28575.546 The expenditure recorded in this detail is expenses for wedding party, birthday party, circumcision event, religious event, etc., excluding food (food consumption for party/event should be recorded in each of the visitors’ household food expenditure. Expenditure in the last one month should be the amount really spent in the last one month, not the average monthly amount of the last 12 months. Non-food expenditure - clothes, footwear and headgear in the past 12 months :(Rp) Non-food expenditure - clothes, footwear and headgear in the past 12 months :(Rp) Non-food expenditure - clothes, footwear and headgear in the past 12 months :(Rp) Non-food expenditure - clothes, footwear and headgear in the past 12 months :(Rp) Non-food expenditure - clothes, footwear and headgear in the past 12 months :(Rp) Non-food expenditure for clothes, footwear and headgear (clothes, apparel, shoes, hat, detergent etc.) from purchase, self-producation and present in the past 12 months :(Rp) Write down in Column (3) non-food expenditure from purchases, self produced, and gifts in past 12 months for party and ceremony excluding food :(Rp) 62009 4746 998500 320475.93 The expenditure recorded in this detail is expenses for wedding party, birthday party, circumcision event, religious event, etc., excluding food (food consumption for party/event should be recorded in each of the visitors' household food expenditure. The expenditure in the last 12 months should be the amount trully spent in the last 12 months that ends one day before the census date, 12 calendar months. Non-food expenditure - durable goods in the past month:(Rp) Non-food expenditure - durable goods in the past month:(Rp) Non-food expenditure - durable goods in the past month:(Rp) Non-food expenditure - durable goods in the past month:(Rp) Non-food expenditure - durable goods in the past month:(Rp) Non-food expenditure for durable goods (household equipment, tools, kitchen equipment, entertainment [electronics], sports equipment, genuine/imitation jewelry, vehicles, umbrella, watch, camera, telephone installation, power installation, electronic goods etc.) from purchase, self-producation and present in the past month:(Rp) Write down in Column (2) non-food expenditure from purchases, self produced, and gifts in one past month for house lease,rent,rent expectation :(Rp) 66263 492 997000 12224.254 The expenditure recorded in this detail is expenses for wedding party, birthday party, circumcision event, religious event, etc., excluding food (food consumption for party/event should be recorded in each of the visitors’ household food expenditure. Expenditure in the last one month should be the amount really spent in the last one month, not the average monthly amount of the last 12 months. Non-food expenditure - durable goods in the past 12 months :(Rp) Non-food expenditure - durable goods in the past 12 months :(Rp) Non-food expenditure - durable goods in the past 12 months :(Rp) Non-food expenditure - durable goods in the past 12 months :(Rp) Non-food expenditure - durable goods in the past 12 months :(Rp) Non-food expenditure for durable goods (household equipment, tools, kitchen equipment, entertainment [electronics], sports equipment, genuine/imitation jewelry, vehicles, umbrella, watch, camera, telephone installation, power installation, electronic goods etc.) from purchase, self-producation and present in the past 12 months :(Rp) Write down in Column (3) non-food expenditure from purchases, self produced, and gifts in past 12 months for party and ceremony excluding food :(Rp) 63199 3556 999100 103984.177 The expenditure recorded in this detail is expenses for wedding party, birthday party, circumcision event, religious event, etc., excluding food (food consumption for party/event should be recorded in each of the visitors' household food expenditure. The expenditure in the last 12 months should be the amount trully spent in the last 12 months that ends one day before the census date, 12 calendar months. Non-food expenditure - tax (Land and building tax, vehicle tax) in the past month:(Rp) Non-food expenditure - tax (Land and building tax, vehicle tax) in the past month:(Rp) Non-food expenditure - tax (Land and building tax, vehicle tax) in the past month:(Rp) Non-food expenditure - tax (Land and building tax, vehicle tax) in the past month:(Rp) Non-food expenditure - tax (Land and building tax, vehicle tax) in the past month:(Rp) Non-food expenditure for tax (Land and building tax, vehicle tax) from purchase, self-producation and present in the past month:(Rp) Write down in Column (2) non-food expenditure from purchases, self produced, and gifts in one past month for house lease,rent,rent expectation :(Rp) 66551 204 991665 5420.774 Rumah tangga yang tidak membayar PBB tidak perlu diperkirakan nilainya,tetapi bagi rumah tangga yang biasa membayar iuran PBB maka nilainya harus dicantumkan meskipun rumah tangga tersebut belum membayar. Isian PBB sebulan yang lalu dapat diperoleh dari PBB tahunan dibagi 12. Expenditure in the last one month should be the amount really spent in the last one month, not the average monthly amount of the last 12 months. Non-food expenditure - tax (Land and building tax, vehicle tax) in the past 12 months :(Rp) Non-food expenditure - tax (Land and building tax, vehicle tax) in the past 12 months :(Rp) Non-food expenditure - tax (Land and building tax, vehicle tax) in the past 12 months :(Rp) Non-food expenditure - tax (Land and building tax, vehicle tax) in the past 12 months :(Rp) Non-food expenditure - tax (Land and building tax, vehicle tax) in the past 12 months :(Rp) Non-food expenditure for tax (Land and building tax, vehicle tax) from purchase, self-producation and present in the past 12 months :(Rp) Write down in Column (3) non-food expenditure from purchases, self produced, and gifts in past 12 months for party and ceremony excluding food :(Rp) 66066 689 998500 53632.071 Rumah tangga yang tidak membayar PBB tidak perlu diperkirakan nilainya,tetapi bagi rumah tangga yang biasa membayar iuran PBB maka nilainya harus dicantumkan meskipun rumah tangga tersebut belum membayar. Isian PBB sebulan yang lalu dapat diperoleh dari PBB tahunan dibagi 12. The expenditure in the last 12 months should be the amount trully spent in the last 12 months that ends one day before the census date, 12 calendar months. Non-food expenditure - health insurance in the past month:(Rp) Non-food expenditure - health insurance in the past month:(Rp) Non-food expenditure - health insurance in the past month:(Rp) Non-food expenditure - health insurance in the past month:(Rp) Non-food expenditure - health insurance in the past month:(Rp) Non-food expenditure health insurance from purchase, self-producation and present in the past month:(Rp) Write down in Column (2) non-food expenditure from purchases, self produced, and gifts in one past month for house lease,rent,rent expectation :(Rp) 66559 196 833330 684.333 Contohnya pungutan RT/RW, biaya parkir, dan sebagainya. Expenditure in the last one month should be the amount really spent in the last one month, not the average monthly amount of the last 12 months. Non-food expenditure - health insurance in the past 12 months :(Rp) Non-food expenditure - health insurance in the past 12 months :(Rp) Non-food expenditure - health insurance in the past 12 months :(Rp) Non-food expenditure - health insurance in the past 12 months :(Rp) Non-food expenditure - health insurance in the past 12 months :(Rp) Non-food expenditure for fee/retribution from purchase, self-producation and present in the past 12 months :(Rp) Write down in Column (3) non-food expenditure from purchases, self produced, and gifts in past 12 months for party and ceremony excluding food :(Rp) 66418 337 972000 4104.097 Contohnya pungutan RT/RW, biaya parkir, dan sebagainya. The expenditure in the last 12 months should be the amount trully spent in the last 12 months that ends one day before the census date, 12 calendar months. Non-food expenditure - other insurance in the past month:(Rp) Non-food expenditure - other insurance in the past month:(Rp) Non-food expenditure - other insurance in the past month:(Rp) Non-food expenditure - other insurance in the past month:(Rp) Non-food expenditure - other insurance in the past month:(Rp) Non-food expenditure for other insurance from purchase, self-producation and present in the past 12 months :(Rp) Write down in Column (2) non-food expenditure from purchases, self produced, and gifts in one past month for house lease,rent,rent expectation :(Rp) 66560 195 608200 924.003 Pengeluaran yang dicatat di sini adalah pengeluaran untuk asuransi kesehatan yang hanya bisa diklaim bila pemegang polis mengalami kejadian seperti yang ada dalam perjanjian asuransi tersebut. Bila tidak terjadi sesuatu(seperti dalam perjanjian asuransi) dalam jangka waktu yang telah ditentukan,maka asuransi tersebut tidak dapat di klaim dan akan hilang(sifatnya bukan tabungan). Expenditure in the last one month should be the amount really spent in the last one month, not the average monthly amount of the last 12 months. Non-food expenditure - other insurance in the past 12 months :(Rp) Non-food expenditure - other insurance in the past 12 months :(Rp) Non-food expenditure - other insurance in the past 12 months :(Rp) Non-food expenditure - other insurance in the past 12 months :(Rp) Non-food expenditure - other insurance in the past 12 months :(Rp) Non-food expenditure for other insurance from purchase, self-producation and present in the past 12 months :(Rp) Write down in Column (3) non-food expenditure from purchases, self produced, and gifts in past 12 months for party and ceremony excluding food :(Rp) 66474 281 980000 8045.502 Pengeluaran yang dicatat di sini adalah pengeluaran untuk asuransi kesehatan yang hanya bisa diklaim bila pemegang polis mengalami kejadian seperti yang ada dalam perjanjian asuransi tersebut. Bila tidak terjadi sesuatu(seperti dalam perjanjian asuransi) dalam jangka waktu yang telah ditentukan,maka asuransi tersebut tidak dapat di klaim dan akan hilang(sifatnya bukan tabungan). The expenditure in the last 12 months should be the amount trully spent in the last 12 months that ends one day before the census date, 12 calendar months. Non-food expenditure - party and ceremony in the past month:(Rp) Non-food expenditure - party and ceremony in the past month:(Rp) Non-food expenditure - party and ceremony in the past month:(Rp) Non-food expenditure - party and ceremony in the past month:(Rp) Non-food expenditure - party and ceremony in the past month:(Rp) Non-food expenditure for party and ceremony (wedding, circumcision, birthday, religious holiday, traditional ceremony etc.) from purchase, self-producation and present in the past month:(Rp) Write down in Column (2) non-food expenditure from purchases, self produced, and gifts in one past month for house lease,rent,rent expectation :(Rp) 66446 309 983850 13881.695 Pengeluaran yang dicatat di sini adalah pengeluaran untuk pesta perkawinan, ulang tahun, khitanan, upacara keagamaan, upacara adat,dan lainnya, tidak termasuk makanan untuk pesta atau untuk khitanan (konsumsi makanan untuk pesta akan tercatat dalam konsumsi makanan di rumah tangga masing-masing tamu yang datang ke pesta tersebut). Expenditure in the last one month should be the amount really spent in the last one month, not the average monthly amount of the last 12 months. Non-food expenditure - party and ceremony in the past 12 months :(Rp) Non-food expenditure - party and ceremony in the past 12 months :(Rp) Non-food expenditure - party and ceremony in the past 12 months :(Rp) Non-food expenditure - party and ceremony in the past 12 months :(Rp) Non-food expenditure - party and ceremony in the past 12 months :(Rp) Non-food expenditure for party and ceremony (wedding, circumcision, birthday, religious holiday, traditional ceremony etc.) from purchase, self-producation and present in the past 12 months :(Rp) Write down in Column (3) non-food expenditure from purchases, self produced, and gifts in past 12 months for party and ceremony excluding food :(Rp) 64895 1860 995000 84254.697 Pengeluaran yang dicatat di sini adalah pengeluaran untuk pesta perkawinan, ulang tahun, khitanan, upacara keagamaan, upacara adat,dan lainnya, tidak termasuk makanan untuk pesta atau untuk khitanan (konsumsi makanan untuk pesta akan tercatat dalam konsumsi makanan di rumah tangga masing-masing tamu yang datang ke pesta tersebut). The expenditure in the last 12 months should be the amount trully spent in the last 12 months that ends one day before the census date, 12 calendar months. Total non-food (details 17 to 24) in the past month:(Rp) Total non-food (details 17 to 24) in the past month:(Rp) Total non-food (details 17 to 24) in the past month:(Rp) Total non-food (details 17 to 24) in the past month:(Rp) Total non-food (details 17 to 24) in the past month:(Rp) Total non-food (details 17 to 24) in the past month:(Rp) Write down in Column (2) total non-food (details 17 to 24) from purchases, self produced, and gifts in one past month:(Rp) 62152 4603 100 999835 270862.786 Total non-food (details 17 to 24) in the past 12 months :(Rp) Total non-food (details 17 to 24) in the past 12 months :(Rp) Total non-food (details 17 to 24) in the past 12 months :(Rp) Total non-food (details 17 to 24) in the past 12 months :(Rp) Total non-food (details 17 to 24) in the past 12 months :(Rp) Total non-food (details 17 to 24) in the past 12 months :(Rp) Write down in Column (3) total non-food (details 17 to 24) from purchases, self produced, and gifts in the past 12 months:(Rp) 5415 61340 49560 999600 752498.672 The average food expenditure a month (Details 16 x 30/7) The average food expenditure a month (Details 16 x 30/7) The average food expenditure a month (Details 16 x 30/7) The average food expenditure a month (Details 16 x 30/7) The average food expenditure a month (Details 16 x 30/7) The average food expenditure a month (Details 16 x 30/7) Write down in Column (3) average food expenditure a month (Details 16 x 30/7) 63349 3406 28285 999857 447735.793 The entry is the total sum of Detail 23 and 24, which is the average household expense per month. The entry is the total sum of Detail 23 and 24, which is the average household expense per month. The average non-food expenditure a month (Details 25 column 3 / 12) The average non-food expenditure a month (Details 25 column 3 / 12) The average non-food expenditure a month (Details 25 column 3 / 12) The average non-food expenditure a month (Details 25 column 3 / 12) The average non-food expenditure a month (Details 25 column 3 / 12) The average non-food expenditure a month (Details 25 column 3 / 12) Write down in Column (2) average non-food expenditure a month (Details 25 column 3 / 12) 62777 3978 4130 999916 274104.174 Isiannya adalah hasil pembagian Rincian 22 Kolom (3) dengan 12. The average household expenditure a month (Details 26 + Details 27) The average household expenditure a month (Details 26 + Details 27) The average household expenditure a month (Details 26 + Details 27) The average household expenditure a month (Details 26 + Details 27) The average household expenditure a month (Details 26 + Details 27) The average household expenditure a month (Details 26 + Details 27) Write down in Column (2) average household expenditure a month (Details 26 + Details 27) 49683 17072 55708 999987 579779.152 Main source of household income: Main source of household income: Main source of household income: Main source of household income: Main source of household income: Write down completely the main source of household income in the empty space provided. 66565 190 111 9502 2855.199 Average expenditure per capita Average expenditure per capita Average expenditure per capita Average expenditure per capita Average expenditure per capita 65913 842 22167 998273 221814.385 - - - - - 66261 494 Sysmiss Is the household use fuel/ energy - kerosene Is the household use fuel/ energy - kerosene Is the household use fuel/ energy - kerosene Is the household use fuel/ energy - kerosene Is the household use fuel/ energy - kerosene Household fuel/energy consumption for cooking, lighting and transportation, is the household use fuel/ energy in the past one month? a. Kerosene Enter code 1 if the answer is "Yes" or code 2 for "No" in the box provided. 66565 190 1 2 1.115 1 Yes 2 No Sysmiss Amount (lier)- Kerosene Amount (lier)- Kerosene Amount (lier)- Kerosene Amount (lier)- Kerosene Amount (lier)- Kerosene If column (2) =1 Household fuel/energy consumption for cooking, lighting and transportation, Amount (lier): a. Kerosene Fill in column (4) the number / quantity of use during a month ago (two digits after comma). 66439 316 750 14.715 Value (Rp) - Kerosene Value (Rp) - Kerosene Value (Rp) - Kerosene Value (Rp) - Kerosene Value (Rp) - Kerosene If column (2) =1 Household fuel/energy consumption for cooking, lighting and transportation, Value (Rp): a. Kerosene Fill in column (5) value (in rupiah) usage for a month ago. 66439 316 900000 18746.259 Is the household use fuel/ energy - gas (LPG) Is the household use fuel/ energy - gas (LPG) Is the household use fuel/ energy - gas (LPG) Is the household use fuel/ energy - gas (LPG) Is the household use fuel/ energy - gas (LPG) Household fuel/energy consumption for cooking, lighting and transportation, is the household use fuel/ energy in the past one month? b. Gas (LPG) Enter code 1 if the answer is "Yes" or code 2 for "No" in the box provided. 66565 190 1 2 1.881 1 Yes 2 No Sysmiss Amount (kg) - Gas (LPG) Amount (kg) - Gas (LPG) Amount (kg) - Gas (LPG) Amount (kg) - Gas (LPG) Amount (kg) - Gas (LPG) If column (2) =1 Household fuel/energy consumption for cooking, lighting and transportation, Amount (kg): b. Gas (LPG) Fill in column (4) the number / quantity of use during a month ago (two digits after comma). 66330 425 380 1.657 Value (Rp) - Gas (LPG) Value (Rp) - Gas (LPG) Value (Rp) - Gas (LPG) Value (Rp) - Gas (LPG) Value (Rp) - Gas (LPG) If column (2) =1 Household fuel/energy consumption for cooking, lighting and transportation, Value (Rp): b. Gas (LPG) Fill in column (5) value (in rupiah) usage for a month ago. 66330 425 638000 4436.767 Is the household use fuel/ energy - gasoline Is the household use fuel/ energy - gasoline Is the household use fuel/ energy - gasoline Is the household use fuel/ energy - gasoline Is the household use fuel/ energy - gasoline Household fuel/energy consumption for cooking, lighting and transportation, is the household use fuel/ energy in the past one month? c. Gasoline Enter code 1 if the answer is "Yes" or code 2 for "No" in the box provided. 66565 190 1 2 1.733 1 Yes 2 No Sysmiss Amount (liter) - Gasoline Amount (liter) - Gasoline Amount (liter) - Gasoline Amount (liter) - Gasoline Amount (liter) - Gasoline If column (2) =1 Household fuel/energy consumption for cooking, lighting and transportation, Amount (liter): c. Gasoline Fill in column (4) the number / quantity of use during a month ago (two digits after comma). 66400 355 660 8.621 Value (Rp) - Gasoline Value (Rp) - Gasoline Value (Rp) - Gasoline Value (Rp) - Gasoline Value (Rp) - Gasoline If column (2) =1 Household fuel/energy consumption for cooking, lighting and transportation, Value (Rp): c. Gasoline Fill in column (5) value (in rupiah) usage for a month ago. 66400 355 999900 17316.857 Is the household use fuel/ energy - diesel fuel Is the household use fuel/ energy - diesel fuel Is the household use fuel/ energy - diesel fuel Is the household use fuel/ energy - diesel fuel Is the household use fuel/ energy - diesel fuel Household fuel/energy consumption for cooking, lighting and transportation, is the household use fuel/ energy in the past one month? d. Diesel fuel Enter code 1 if the answer is "Yes" or code 2 for "No" in the box provided. 66565 190 1 2 1.989 1 Yes 2 No Sysmiss Amount (liter) - Diesel fuel Amount (liter) - Diesel fuel Amount (liter) - Diesel fuel Amount (liter) - Diesel fuel Amount (liter) - Diesel fuel If column (2) =1 Household fuel/energy consumption for cooking, lighting and transportation, Amount (liter): d. Diesel fuel Fill in column (4) the number / quantity of use during a month ago (two digits after comma). 66263 492 660 0.545 Value (Rp) - Diesel fuel Value (Rp) - Diesel fuel Value (Rp) - Diesel fuel Value (Rp) - Diesel fuel Value (Rp) - Diesel fuel If column (2) =1 Household fuel/energy consumption for cooking, lighting and transportation, Value (Rp): d. Diesel fuel Fill in column (5) value (in rupiah) usage for a month ago. 66263 492 999000 1051.695 Is the household use fuel/ energy - PLN electricity Is the household use fuel/ energy - PLN electricity Is the household use fuel/ energy - PLN electricity Is the household use fuel/ energy - PLN electricity Is the household use fuel/ energy - PLN electricity Household fuel/energy consumption for cooking, lighting and transportation, is the household use fuel/ energy in the past one month? e. PLN electricity Jika b.9.r.1=2 (tidak) maka tidak berlanjut(selesai) Enter code 1 if the answer is "Yes" or code 2 for "No" in the box provided. 66565 190 1 2 1.172 1 Yes 2 No Sysmiss Amount (kwh) - PLN electricity Amount (kwh) - PLN electricity Amount (kwh) - PLN electricity Amount (kwh) - PLN electricity Amount (kwh) - PLN electricity If column (2) =1 Household fuel/energy consumption for cooking, lighting and transportation, Amount (kwh): e. PLN electricity Fill in column (4) the number / quantity of use during a month ago (two digits after comma). 66565 190 1000 63.44 Value (Rp) - PLN electricity Value (Rp) - PLN electricity Value (Rp) - PLN electricity Value (Rp) - PLN electricity Value (Rp) - PLN electricity If column (2) =1 Household fuel/energy consumption for cooking, lighting and transportation, Value (Rp): e. PLN electricity Fill in column (5) value (in rupiah) usage for a month ago. 66565 190 999995 33380.83 Is the household use fuel/ energy - Firewood Is the household use fuel/ energy - Firewood Is the household use fuel/ energy - Firewood Is the household use fuel/ energy - Firewood Is the household use fuel/ energy - Firewood Household fuel/energy consumption for cooking, lighting and transportation, is the household use fuel/ energy in the past one month? f. Firewood Enter code 1 if the answer is "Yes" or code 2 for "No" in the box provided. 66565 190 1 2 1.517 1 Yes 2 No Sysmiss Amount - Firewood Amount - Firewood Amount - Firewood Amount - Firewood Amount - Firewood If column (2) =1 Household fuel/energy consumption for cooking, lighting and transportation, Amount: f. Firewood Fill in column (4) the number / quantity of use during a month ago (two digits after comma). 66265 490 100 17.801 Value (Rp): - Firewood Value (Rp): - Firewood Value (Rp): - Firewood Value (Rp): - Firewood Value (Rp): - Firewood If column (2) =1 Household fuel/energy consumption for cooking, lighting and transportation, Value (Rp): f. Firewood Fill in column (5) value (in rupiah) usage for a month ago. 66265 490 750000 9339.692