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Urban Poverty & Climate Change in Dar es Salaam, Tanzania:

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93<br />

Annex 1 (a)<br />

URBAN POVERTY AND CLIMATIC CHANGE IN DAR ES SALAAM CITY<br />

HOUSEHOLD QUESTIONNAIRE<br />

IRA-UDSM<br />

A: LOCATION<br />

Name of the Street: .............................................. Mtaa ……………………….<br />

Ward .................................. District............................................................ Name of River<br />

System:<br />

………………….. …………………………………………….<br />

Date/Month/Year of Interview.................................................. Name of Ten Cell Leader<br />

………………………………………………….. Mtaa Door Number ……………………….<br />

B: INFORMATION ABOUT RESPONDENT<br />

1. Name ........................................................... 2. Sex: Male/Female [ ]<br />

3. Age .............................<br />

4 Marital status of the r<strong>es</strong>pondent: [1] S<strong>in</strong>gle [2] Married [3] Divorced [4] Widow<br />

[5] Separated [6] Widower [ ]<br />

5 Is the household Male or Female Headed 1. Male Headed ( ) 2. Female Headed ( )<br />

6 Relation to the head of household 1. I am the head ( ) 2. Husband 3. Wife ( ) 4.<br />

Mother ( ) 5. Father ( ) 6. Other relations: Expla<strong>in</strong><br />

……………………......................................................<br />

7 Employment status: 1. Employed [ ] 2. Self-employed [ ] 3. Dependant [ ] 4.<br />

Retired Officer [ ]<br />

8 Occupation of R<strong>es</strong>pondent. Type of Ma<strong>in</strong> and M<strong>in</strong>or occupation of the head of<br />

household<br />

Major ............................................. earn<strong>in</strong>gs per month ............................................<br />

M<strong>in</strong>or ............................................... earn<strong>in</strong>g per month .........................................<br />

9 Total number of people <strong>in</strong> the households........................... Give their details <strong>in</strong> Table<br />

1. In Appendic<strong>es</strong> 1.<br />

C:RESIDENCE TYPE AND OCCUPANTS<br />

8. Plot No. ……………………………Has the plot been surveyed 1.Y<strong>es</strong> 2.No<br />

9. Density: High ( ) Medium ( ) Low ( )<br />

10. Geography of the area: 1. Dry hilly area [ ] 2. Low marshy wetland area [ ] 3. Low<br />

dry Sandy area [ ] 4. Low muddy clay soil area [ ] 5. Other, d<strong>es</strong>cribe<br />

.....................................................................................................................................<br />

11. Ownership: Are you the house owner or tenant 1. Owner ( ) 2. Tenant ( ) If owner<br />

of house, how did you acquire the land and how much did you pay to who? Give explanation<br />

below:

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