HOUSEHOLD MEMBERSHIP AND DEMOGRAPHIC INFORMATION

1 2 3 4 5 6 7 8 9 10 11
M

E
NAME DBI A S CSC P ED OCCUPATION WORKPLAC CLAS
RTH G E S U E S
M
E X C C
N
O
FOR 3 YEARS OLD AND ABOVE FOR 10 YEARS OLD AND ABOVE
M
Please give me the names of the persons who What is (NAME) Compute for the Is What What (NAME) Physiological What is the occupation of
E usually sleep and eat in your house and those who Date of Birth? Age of all the (NA Status? What is the highest Where is What kind of worker is (NAME)?
(NAME) in the past 6
are currently away from home starting with the members of ME) (NAME) Civil educational attainment completed by the Place
M months?
head of the household. Use the the household as mal Status? (NAME )? of work of
B format of last birthday. e or If engaged in 2 jobs, consider (NAME)?
E Write surname first. Mo/Da/Yea fem the one That occupies most of
r If <6 yrs, record ale?
age his/her time (in the past 6
R
Refer to the Manual of Instructions (MOI) for the in months months)
N definition of Household Membership.
If>6 yrs, record age If 50-50, get the one with
U in years and
months higher salary or Income.
M

M S Physiologi Formal Cl
DAY YEA YRS MO Civil Status Code Cod Occupation Cod Code
e cal Education as
R Code e e
O x Status Completed s
Place of
C Work of
o Code W
d or
e ke
r
0 1
0 2
0 3
0 4
0 5
0 6
0 7
0 8
0 9
1 0
1 1
1 2
1 3
1 4
1 5
Codes for #5 Code for #6 Code for #7 11 - Lactating, 7-12 months Code for #8 Codes for #8 High School College Codes Codes for # 10 Codes for #11
(Sex) (Civil Satus) (Physiological Satus) 12 - Lactating, over 1 (Highest Educational Attainment) Elementary 21 1st Year HS/Grade 7 51 1st for #9 (Place of work) (Class of Worker) 5 - Employer in own family
1 - Male 1 - Single year 00 - Non - pregnant/Non 99 - Male Member Year 99 Not Applicable (<3y0) 11 Grade I 22 2nd Year HS/Grade 8 52 2nd (Has 0 - At home 1 - Worked for private operated farm or business
6 - Worked with pay on own
2 - Female 2 - Married lactating female Year Work) 1 - Local, household
family operated farm or
3 - Widowed members If both pregnant and lactating, 77 Alternative Learning 12 Grade II 23 3rd Year HS/Grade 9 53 3rd Year Without away from 2- Worked for business
4 - Separated code System (ALS) 13 Grade III 24 4th Year HS/Grade 10 54 4th /5th work/business 00 home private 7- Worked without pay in own
5 - 01 - Pregnant, 1 month as pregnant Year No occupation 2- establishmen familv operated farm or
Common- 02 - Pregnant, 2 months For pregnant or lactating, ask 0 No Grade Completed 14 Grade IV 25 Grade 11 55 Graduate, specify 01 House keeper Abroa t business
Law/Live-in the 03 - Pregnant, 3 months weeks of pregnancy or months 01 Nurserv 15 Grade V 26 Grade 12 course 02 Student d9- 3- Worked 9 - NA (for housekeepers,
6 - Unknown of 04 - Pregnant, 4 months lactation 02 Kinder 16 Grade VI (if w/ VIl) 27 High School Graduate 03 Pensioner NA for pensioners, students,
05 - Pregnant, 5 months 03 Preparatory 17 Graduate Post Graduate With (for governm no occupation)
06 - Pregnant, 6 months 66 Master's work/business housekeeper ent/
08 - Pregnant, 8 months Graduate 11 With job or business s, governm
09 - Pregnant, 9 months Specify 12 With job or pensioners, ent
10 - Lactating, 0-6 months course business and students, no corpora
67 PhD Student occupation) tion
Graduate 99 Not applicable 4 - Self-employed w/o
Specify (<10y.0.) any employee
course
 2015 UPDATING FORM 1.6-HOUSEHOLD DIETARY DIVERSITY AND FOOD FREQUENCY
Ask the meal planner of all the foods and drinks served/prepared to the househoid members for the last 7 days (during the past week) for each food group12b. Do you make your water safer to drink?
(Note for enumerator: exclude foods eaten outside the home) Q#13
1. Ask the meal planner if they consume foods belonging under each food group listed below for the last 7 days.
"Mayroon ba kayong ginagawang paraan
"Ano-anong pagkain ang hinahanda e nakonsumo ng miyembro ng pamilya na kasali sa bawat grupo ng pagkain na nakalista sa ibaba noong nakarsan? Araw upang ang inyong tubig ay maging
2. Then ask how many days in the past week the food item has been malini at ligtas inumin?
"Ilang araw sa sa nakaraang linggo hinanda o kinain ang pagkain?" Q#13
3. If there were two or more food items served under one food group ask what is the food that was served the MOST during the past week?
"Alin sa mga nabanggit na pagkain sa bawat grupo ang pinakamadalas na kainin noong nakaraang linggo?"
4. Ask what is the source of the food ilom that was sorved the MOST? 12c. How do you make your water safer to drink?”
"Saan nanggaling o binili ang pagkain na madalas ihanda o nakonsumo?"
“Paano nyo ginagawang maging malinis ang inyong
CONSUM ACTUAL NO. OF SERVE THE tubig at ligtas tong inumin?”
PTION DAYS FOOD MOST
CODE FOOD GROUP EXAMPLES CODE CONSUMED IN (FOOD
0- No THE PAST WEEK ITEM)
1- Yes
1 CEREALS AND Rice, bread, noodles, biscuits, cookies or any rice and cereal products 13. What is the main source of water of the household used
PRODUCTS like biko, suman (malagkit), puto, noodles/pasta, porridge (arrozcaldo, for cooking and handwashing?
champorado) and others
2 VITAMIN A RICH carrots, squash, sweet potatoes that are yellow or orange inside “Ano ang inyong pangunahing pinagkukunan
VEGETABLES AND ng tubig na ginagamit niniyong pangluto ng
TUBERS pagkain at panghugas ng kamay?”
3 WHITE TUBERS AND white potatoes, potato, cassava, yacon, tugi or foods made from roots
ROOTS like French fries, pitsi-pitsi, bibingka, camote cue etc. Cooking “pangluto”
4 DARK LEAFY GREEN dark green, leafy vegetables, such ascamote tops, kangkong, Washing hands “panghugas ng kamay”
VEGETABLES, INCLUDING malunggay, cassava leaves etc., including wild ones likepako and
WILD ONES others 14a. What type of toilet facility do the household members Q#15
5 OTHER VEGETABLES Eggplant, sitao, ampalaya and other wild vegetables like rattan shoot, usually use?
INCLUDING WILD bamboo shoots and others
VEGETABLE “Anong uri ng palikuran ang kadalasang
6 VITAMIN A RICH FRUITS ripe mangoes, papayas, guava, melon, passion fruit, dragon fruit and ginagamit ng mga miyembro ng inyong
others
pamilya?”
7 OTHER FRUITS, like banana, guyabano, Star apple, chico, atisand wild fruits like sapinit
INCLUDING WILD FRUITS (wild raspberry), bangkoro, bignay and others 14b. Does the house share the toilet facility with other
8 MEAT, FRESH AND fresh like beef, pork, lamb, goat, rabbit, chicken, duck, or other birds,
household?
PROCESSED wild game, boar, snake, turtle; processed meat like hotdog, tocino,
longanisa and others “Maliban sa inyong pamilya, may iba pa bang
9 ORGAN MEATS (IRON- liver, kidney, heart or other organ meats or blood-based foods like pamilya o tao na gumagamit ng palikuran na
RICH) dinuguan, isaw (chicken/pork), bopis, sisig and others
10 EGGS Any eggs, fresh and salted
ito?”
11 FISH AND SHELLFISH Fresh, dried, processed, like sardines, tuyo, tinapa, alamang and 15. How do you usually dispose your garbage?
others
12 LEGUMES, NUTS AND beans, peas, lentils, nuts, seeds or foods made from these like pork “Paano kayo kadaksan nagtatapon ng inyong basura?”
SEEDS and beans, guisantes de lata, tokwa, tofu and others
13 MILK AND MILK milk (fresh, canned milk, powder) and products like cheese, yogurt, ice Multiple Responses. Check all that applies
PRODUCTS cream, leche flan and others 0– No 1– Yes
14 OILS AND FATS oil, fats or butter added to food or used for cooking
15 SWEETS sugar, candies, honey, sweetened soda, sugary foods like chocolates 16. Does the household practice garbage segregation?
0 - No
and others
“Pinaghihiwalay nyo baa ng nabubulok at di- 1 - Yes
16 SPICES, CONDIMENTS, Pepper, salt, knorr seasoning condiments like vetsin, soy sauce, hot
nabubulok na basura?”
BEVERAGES sauce, coffee, tea, alcoholic beverages like Tanduay, Emperador, San
Miguel product, locally made like basi, tuba, lambanog, vino kulafu
and others

HOUSEHOLD MEMBERSHIP AND DEMOGRAPHIC INFORMATION

II. WATER AND SANITATION

12a. What is the source of drinking water of

the household
"Ano ang pangunahing pinagkukunan
ninyo ng tubig na inyong iniinum?"