Palestinian Family Survey 2010 Final Report - Palestinian Central ...

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PCBS: Palestinian Family Survey, 2010questionnaire for ElderlyState of Palestine PFS 2010Palestinian AuthorityPalestinian Central Bureau of StatisticsPalestinian Family Survey, 2010Elderly Questionnaire (60 years and over)Information collected through this questionnaire is considered as confidential and shall be used for statistical purposes ONLY in accordancewith the General Statistics Law-2000.This questionnaire targets persons aged 60 years or above and who are usual resident with the household.IDH00 - Questionnaire’s serial No. in sample IDH04 - Household number:IDH01 - GovernorateIIDH05 - Building’s address:IDH02 - LocalityIDH06 - Name of head of household:IDH03 - Cluster number:EIR01: Visits record:Visits Day Month Interview Start Time Interview End TimeFirst Visit __ :__ __ :__Second Visit __ :__ __ :__Third Visit __ :__ __ :__EIR02: Total visits11. Fully Completed2 2. Partially completedEIR03: Interview result:3 3. Refused4 4. Information Not available55. Other (specify)_____________EIR04: Line number of person responding to thequestionnaireName of the person:EIR04A: Line number of eligible person Name of the person:EIR11 Interviewer’s Name: EIR12Interviewer’s number:Notes:EIR13 Supervisor’s Name: EIR14Supervisor’s number:EIR15 Editor’s Name: EIR16Editor’s number:EIR17 Data entry clerk’s Name: EIR18Data entry clerk’s number :EIR19 Encoder’s Name EIR20Encoder’s number:EIR21: Date of data entry:273
PCBS: Palestinian Family Survey, 2010No Questions Coding categories Skip To101E Line number of respondent / eligible person102E Sex of respondent Male 1Female 2103E For fieldworker: according to1. Capable to answer and completeinstructions, the respondent is…the interview 1 E1082. NOT Capable to answer andcomplete the interview 2104EFor fieldworker: Ask about the personwho takes care of the elderly andcomplete the interview. In case he/sheis Not present, complete the interviewwith the other eligible person andwrite down the line number of therespondent. (If Not resident withhousehold, put 98The carer completed the interview (write his/her line number in the household)98: Not resident with the householdAnother person completed the interview (writehis/her line number in the household)98: Not resident with the household108E Do you have children alive? 1. Yes 12. No 2 E111E109 How many male children are stillalive?Male children still aliveE110E111E112E113How many female children are stillalive?How many married male children?How many married female children?Do you live alone or with othermembers of the household? (If withhousehold member, ask in your houseor his –the member’s - house)Female children still aliveMarried male childrenMarried female children1. Alone1 E1132. With other member in2respondent’s home3. With other member in his/her3homeLook at E111: Live with another 4. A. Husband/wife1 2member of the household:5. B. Son/daughter1 2In your house In his/her house 6. C. Son’s wife/daughter’s husband 1 2Who lives with With whom do 7. D. Grandson/granddaughter 1 2you?you live? 8. E. Husband of granddaughter/1 2Inspect:Inspect:wife of grand son9. F. Brother / sisterIs there another Is there another1 210. G. Other relative 1 2person?person? 11. H. Other person - Not a relative 1 2(Write down all 1.Yes 2. No 12. I. Move from one person topersons)1 2anotherAre the current housing conditionssuitable and comfortable for you?E114 Why the housing conditions are notsuitable or comfortable?Are there other reasons?1. Yes 2. NoE115E116Are you able to move around theneighborhood easily and safely?Why are you not able to move easilyand safely?1. Yes 2. No13. X. Other 1 2Suitable and comfortable 1 E115Not suitable and comfortable 2A. NOT enough space 1 2B. Crowded 1 2C. Loneliness 1 2D. No caring 1 2E. Bad treatment 1 2F. No privacy 1 2G. Noise because of children 1 2H. Hardship/danger 1 2I. Other/specify: 1 2Yes 1 E201No 2A. Bad health 1 2B. Afraid of Israeli conditions 1 2C. Rowdiness 1 2D. Family does not allow him/her tomove alone 1 2E. Other/specify: 1 2274
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Palestinian Family Survey 2010 Final Report - Palestinian Central ...

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