Democratic Republic of Congo Round 7 -Household Questionnaire
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Democratic Republic of Congo Round 7 -Household Questionnaire 001b. Enter your ID below. Please record your ID Day: 002b. Record the correct date and time. Month: Year: ◯ Kongo Central 003a. Province ◯ KINSHASA ◯ BARUMBU ◯ BAS_FLEUVE ◯ BINZA_METEO ◯ BINZA_OZONE ◯ BIYELA ◯ BOMA ◯ BUMBU ◯ CATARACTES ◯ KALAMU_I ◯ KALAMU_II ◯ KIKIMI ◯ KIMBANSEKE ◯ KINGABWA ◯ KINGASANI ◯ KINSHASA 003b. District ◯ KINTAMBO ◯ KISENSO ◯ LEMBA ◯ LIMETE ◯ LINGWALA ◯ LUKAYA ◯ MASINA_I ◯ MASINA_II ◯ MATADI ◯ MATETE ◯ MONT_NGAFULA_I ◯ MONT_NGAFULA_II ◯ NGABA ◯ NGIRINGIRI ◯ SELEMBAO ◯ BARUMBU 003b. Zone de Santé ◯ BAS_FLEUVE 1 ◯ BINZA_METEO ◯ BINZA_OZONE ◯ BIYELA ◯ BOMA ◯ BUMBU ◯ CATARACTES ◯ KALAMU_I ◯ KALAMU_II ◯ KIKIMI ◯ KIMBANSEKE ◯ KINGABWA ◯ KINGASANI ◯ KINSHASA ◯ KINTAMBO ◯ KISENSO ◯ LEMBA ◯ LIMETE ◯ LINGWALA ◯ LUKAYA ◯ MASINA_I ◯ MASINA_II ◯ MATADI ◯ MATETE ◯ MONT_NGAFULA_I ◯ MONT_NGAFULA_II ◯ NGABA ◯ NGIRINGIRI ◯ SELEMBAO ◯ 17_MAI ◯ ASSOSSA_NGIRI_NGIRI ◯ BAKI_VILLE ◯ BAMBOMA ◯ BANA ◯ BANGU ◯ BETON ◯ BINZA_PIGEON ◯ BITSHAKU_TSHAKU 003c. Aire de Santé ◯ BOBA ◯ BUMBA ◯ BUNZI ◯ CAMP_PERMANENT ◯ CNECI ◯ CONGO ◯ CONGO_1 ◯ DIANGIENDA_I ◯ DINGI_DINGI 2 ◯ ESSANGA ◯ HYGIENE_A ◯ IMBALI ◯ INGA ◯ KAPINGA ◯ KASAI_MASINA ◯ KASAI_BUMBU ◯ KAUKA_I ◯ KEMI ◯ KHAMI ◯ KHESA ◯ KIFUMA_NGIMBI ◯ KIKIMI ◯ KIMBANGU_A ◯ KIMBANZA ◯ KIMBATA___TUDI ◯ KIMBIANGA ◯ KIMBONDO1(_KINDELE) ◯ KIMUAKA ◯ KINGABWA ◯ KINKENGE ◯ KINSUKA_PECHEUR ◯ KINZAU_MVUE ◯ KIPASA ◯ KISANTU ◯ KISENSO_GARE ◯ KITOMESA ◯ KIVALA_TADI ◯ KIVEVE ◯ KIVUNDA ◯ KUMBI ◯ LOBIKO ◯ LOVO_BOMA ◯ LOVO_CATARACTES ◯ LT_MBAKI ◯ LT_MPAKA ◯ LUBAMBA ◯ LUBUDI_KUKA ◯ LUBUSI ◯ LUKUNGA ◯ LUNGI ◯ LUNIONZO ◯ LUOZI ◯ LUYI ◯ MAMA_YEMO ◯ MAMAN_YEMO ◯ MAPELA_1 3 ◯ MATADI ◯ MATEBA ◯ MAYULU ◯ MBANZA_NZUNGU ◯ MBATA_NLUNDU ◯ MB.KILENDA ◯ MFUMU_SUKA ◯ MITENDI ◯ MONGO ◯ MUANDA ◯ MUNGANGA ◯ MUSHIE_CPA ◯ MVULA_MATADI ◯ NDEMBO_LUKAYA ◯ NDEMBO_CATARCTES ◯ NGADI ◯ NGBAKA ◯ NGOMBA_KIKUSA ◯ NGOMBE_LUTENDELE ◯ NGOMUILA ◯ NKAMUNA ◯ NKANDU ◯ NKULU ◯ NSANGA ◯ NTAMPA ◯ PETI_PETI ◯ POSTE_24 ◯ Q_LONZO ◯ SADI ◯ SALONGO_KINGABWA ◯ SALONGO_MATADI ◯ SANS_FIL ◯ TELEVISION ◯ TROUPE ◯ TSANGA_NGOM ◯ TSHIANGU ◯ TSHUENGE ◯ TUZOLANA ◯ VIVI ◯ YANGALA ◯ YEMA_NTENE ◯ YOLO_NORD_II ◯ 17_MAI ◯ ASSOSSA_NGIRI_NGIRI 003c. Quartier ◯ BAKI_VILLE ◯ BAMBOMA 4 ◯ BANA ◯ BANGU ◯ BETON ◯ BINZA_PIGEON ◯ BITSHAKU_TSHAKU ◯ BOBA ◯ BUMBA ◯ BUNZI ◯ CAMP_PERMANENT ◯ CNECI ◯ CONGO ◯ CONGO_1 ◯ DIANGIENDA_I ◯ DINGI_DINGI ◯ ESSANGA ◯ HYGIENE_A ◯ IMBALI ◯ INGA ◯ KAPINGA ◯ KASAI_MASINA ◯ KASAI_BUMBU ◯ KAUKA_I ◯ KEMI ◯ KHAMI ◯ KHESA ◯ KIFUMA_NGIMBI ◯ KIKIMI ◯ KIMBANGU_A ◯ KIMBANZA ◯ KIMBATA___TUDI ◯ KIMBIANGA ◯ KIMBONDO1(_KINDELE) ◯ KIMUAKA ◯ KINGABWA ◯ KINKENGE ◯ KINSUKA_PECHEUR ◯ KINZAU_MVUE ◯ KIPASA ◯ KISANTU ◯ KISENSO_GARE ◯ KITOMESA ◯ KIVALA_TADI ◯ KIVEVE ◯ KIVUNDA ◯ KUMBI ◯ LOBIKO ◯ LOVO_BOMA 5 ◯ LOVO_CATARACTES ◯ LT_MBAKI ◯ LT_MPAKA ◯ LUBAMBA ◯ LUBUDI_KUKA ◯ LUBUSI ◯ LUKUNGA ◯ LUNGI ◯ LUNIONZO ◯ LUOZI ◯ LUYI ◯ MAMA_YEMO ◯ MAMAN_YEMO ◯ MAPELA_1 ◯ MATADI ◯ MATEBA ◯ MAYULU ◯ MBANZA_NZUNGU ◯ MBATA_NLUNDU ◯ MB.KILENDA ◯ MFUMU_SUKA ◯ MITENDI ◯ MONGO ◯ MUANDA ◯ MUNGANGA ◯ MUSHIE_CPA ◯ MVULA_MATADI ◯ NDEMBO_LUKAYA ◯ NDEMBO_CATARCTES ◯ NGADI ◯ NGBAKA ◯ NGOMBA_KIKUSA ◯ NGOMBE_LUTENDELE ◯ NGOMUILA ◯ NKAMUNA ◯ NKANDU ◯ NKULU ◯ NSANGA ◯ NTAMPA ◯ PETI_PETI ◯ POSTE_24 ◯ Q_LONZO ◯ SADI ◯ SALONGO_KINGABWA ◯ SALONGO_MATADI ◯ SANS_FIL ◯ TELEVISION 6 ◯ TROUPE ◯ TSANGA_NGOM ◯ TSHIANGU ◯ TSHUENGE ◯ TUZOLANA ◯ VIVI ◯ YANGALA ◯ YEMA_NTENE ◯ YOLO_NORD_II ◯ 17_MAI_A ◯ ASSOSSA_NGIRI_NGIRI_A ◯ BAMBOMA_A ◯ BANDUNDU ◯ BATALLON_3_TALANGAYI ◯ BATENDE_1 ◯ BETON_1 ◯ BLOC_1 ◯ BOBA_I ◯ BOKALA ◯ BOLAFA_PETI_PETI ◯ BUNZI_1 ◯ CBCO ◯ CNECI_I ◯ CONGO_A ◯ DIANGIENDA_I ◯ FOIRE_AGRICOLE ◯ KAI_MANSITU 003d. Village ◯ KANIOKA ◯ KAPINGA_1 ◯ KASAI_MASINA ◯ KASAI_BUMBU ◯ KAUKA_A ◯ KEMI_A ◯ KHAMI_1 ◯ KHESA_1 ◯ KIBULA ◯ KIFUMA_NGIMBI_1 ◯ KIKIMI_KIKIMI ◯ KIKIMI_LOBIKO ◯ KIMBANZA_1 ◯ KIMBATA_TUDI_1 ◯ KIMBIANGA_1 ◯ KIMPESE ◯ KIMPONKO ◯ KIMUAKA ◯ KIMVULA 7 ◯ KINDAMBA ◯ KINGABWA_A ◯ KINGABWA_SALONGO ◯ KINKENGE ◯ KINKONDO ◯ KINSIONA ◯ KINZAU_MVUE_A ◯ KINZAU_MVUE_B ◯ KINZAU_MVUE_C ◯ KIPASA__1 ◯ KISANTU_A ◯ KISENSO_GARE_A ◯ KITOMESA_1 ◯ KIVALA_TADI_1__1 ◯ KIVEVE_1 ◯ KIVUNDA_1 ◯ KUMBI_1 ◯ KUNDA_1 ◯ LAC_MOERO ◯ LIKONZI_LUTUNU ◯ LOVO_1 ◯ LUBUDI_KUKA_A ◯ LUBUSI_1 ◯ LUKI ◯ LUKUNGA ◯ LUNGI_1 ◯ LUVUEZO_1 ◯ MABANGA ◯ MADIMBA ◯ MASIKA_BASANKUSU ◯ MATEBA_A ◯ MATONGA_CONSACRE ◯ MAYULU_A ◯ MAZAL_AILE_DROITE ◯ MBAMBA_KILENDA ◯ MBANZA_KANU ◯ MBATA ◯ MBUKU_NDINGI ◯ MFUMU_SUKA_A ◯ MOLENDE ◯ MONDONGA ◯ MOTANGA ◯ MPOMPAGE ◯ MUANDA_MAMPUTU ◯ MUTEBA ◯ NDEMBO_1 ◯ NDJILI 8 ◯ NDUNU ◯ NGOMUILA_1 ◯ NIENGA_MBOTA ◯ NKAMUNA ◯ NKANZA ◯ NKONGO_DE_LA_PAIX ◯ NKULU_I ◯ NTOLASANI ◯ POSTE_24 ◯ PROMOBAT ◯ Q1 ◯ Q_SINZA ◯ SADI_1 ◯ SAMBI ◯ SANS_FIL ◯ SHABA ◯ SONA_BATA ◯ SONABATA_ASOSA ◯ THUTA ◯ TSANGA_NGOM_1 ◯ TSHIANGU_A ◯ TUZOLANA_1 ◯ USOKE ◯ WAMBA ◯ YANGALA ◯ YOLO_NORD_II_A ◯ 17_MAI_A ◯ ASSOSSA_NGIRI_NGIRI_A ◯ BAMBOMA_A ◯ BANDUNDU ◯ BATALLON_3_TALANGAYI ◯ BATENDE_1 ◯ BETON_1 ◯ BLOC_1 ◯ BOBA_I ◯ BOKALA 003d. Localité / rue ◯ BOLAFA_PETI_PETI ◯ BUNZI_1 ◯ CBCO ◯ CNECI_I ◯ CONGO_A ◯ DIANGIENDA_I ◯ FOIRE_AGRICOLE ◯ KAI_MANSITU ◯ KANIOKA ◯ KAPINGA_1 9 ◯ KASAI_MASINA ◯ KASAI_BUMBU ◯ KAUKA_A ◯ KEMI_A ◯ KHAMI_1 ◯ KHESA_1 ◯ KIBULA ◯ KIFUMA_NGIMBI_1 ◯ KIKIMI_KIKIMI ◯ KIKIMI_LOBIKO ◯ KIMBANZA_1 ◯ KIMBATA_TUDI_1 ◯ KIMBIANGA_1 ◯ KIMPESE ◯ KIMPONKO ◯ KIMUAKA ◯ KIMVULA ◯ KINDAMBA ◯ KINGABWA_A ◯ KINGABWA_SALONGO ◯ KINKENGE ◯ KINKONDO ◯ KINSIONA ◯ KINZAU_MVUE_A ◯ KINZAU_MVUE_B ◯ KINZAU_MVUE_C ◯ KIPASA__1 ◯ KISANTU_A ◯ KISENSO_GARE_A ◯ KITOMESA_1 ◯ KIVALA_TADI_1__1 ◯ KIVEVE_1 ◯ KIVUNDA_1 ◯ KUMBI_1 ◯ KUNDA_1 ◯ LAC_MOERO ◯ LIKONZI_LUTUNU ◯ LOVO_1 ◯ LUBUDI_KUKA_A ◯ LUBUSI_1 ◯ LUKI ◯ LUKUNGA ◯ LUNGI_1 ◯ LUVUEZO_1 ◯ MABANGA ◯ MADIMBA ◯ MASIKA_BASANKUSU 10 ◯ MATEBA_A ◯ MATONGA_CONSACRE ◯ MAYULU_A ◯ MAZAL_AILE_DROITE ◯ MBAMBA_KILENDA ◯ MBANZA_KANU ◯ MBATA ◯ MBUKU_NDINGI ◯ MFUMU_SUKA_A ◯ MOLENDE ◯ MONDONGA ◯ MOTANGA ◯ MPOMPAGE ◯ MUANDA_MAMPUTU ◯ MUTEBA ◯ NDEMBO_1 ◯ NDJILI ◯ NDUNU ◯ NGOMUILA_1 ◯ NIENGA_MBOTA ◯ NKAMUNA ◯ NKANZA ◯ NKONGO_DE_LA_PAIX ◯ NKULU_I ◯ NTOLASANI ◯ POSTE_24 ◯ PROMOBAT ◯ Q1 ◯ Q_SINZA ◯ SADI_1 ◯ SAMBI ◯ SANS_FIL ◯ SHABA ◯ SONA_BATA ◯ SONABATA_ASOSA ◯ THUTA ◯ TSANGA_NGOM_1 ◯ TSHIANGU_A ◯ TUZOLANA_1 ◯ USOKE ◯ WAMBA ◯ YANGALA ◯ YOLO_NORD_II_A ◯ 17_MAI_A 004. EA ◯ ASSOSSA_NGIRI_NGIRI_A ◯ NDEMBO_1 11 ◯ KIMBATA___TUDI_1 ◯ NDEMBO ◯ BUNZI ◯ KIMBANGU_A ◯ KIVEVE_1 ◯ NGOMUILA_1 ◯ LOVO ◯ MBANZA_NZUNGU ◯ MVULA_MATADI ◯ KINKENGE ◯ KIMUAKA ◯ YANGALA ◯ LOVO_1 ◯ LUBUSI_1 ◯ TSANGA_NGOM_1 ◯ KIFUMA_NGIMBI_1 ◯ KIVALA_TADI_1 ◯ NKANDU ◯ KIPASA_1 ◯ MB.KILENDA ◯ CAMP_PERMANENT ◯ BAKI_VILLE ◯ TROUPE ◯ KIVUNDA_1 ◯ YEMA_NTENE ◯ BETON ◯ POSTE_24 ◯ SADI_1 ◯ TUZOLANA ◯ KIMBIANGA ◯ MBATA_NLUNDU ◯ LUOZI ◯ BANA ◯ HYGIENE_A ◯ MONGO ◯ NGADI ◯ SALONGO ◯ KUMBI_1 ◯ MUANDA_MAMPUTU ◯ MUANDA_CBCO ◯ KIMBANZA ◯ LUNGI_1 ◯ NKAMUNA ◯ KITOMESA_1 ◯ LT_MPAKA ◯ KINZAU_MVUE_A ◯ KINZAU_MVUE_B 12 ◯ KINZAU_MVUE_C ◯ NTAMPA ◯ KHESA_1 ◯ KHAMI_1 ◯ BAMBOMA_A ◯ BANDUNDU ◯ BATALLON_3__TALANGAYI ◯ BATENDE_1 ◯ BOBA_I ◯ BOKALA ◯ BOLAFA_PETI_PETI ◯ CNECI_I ◯ CONGO_A ◯ DIANGIENDA_I ◯ FOIRE_AGRICOLE ◯ KANIOKA ◯ KAPINGA_1 ◯ KASAI_MASINA ◯ KASAI_BUMBU ◯ KAUKA_A ◯ KEMI_A ◯ KIKIMI_KIKIMI ◯ KIKIMI_LOBIKO ◯ KIMPESE ◯ KIMPONKO ◯ KIMVULA ◯ KINGABWA_A ◯ KINGABWA_SALONGO ◯ KISANTU_A ◯ KISENSO_GARE_A ◯ KUNDA_1 ◯ LAC_MOERO ◯ LIKONZI_LUTUNU ◯ LUBUDI_KUKA_A ◯ LUKUNGA ◯ MABANGA ◯ MADIMBA ◯ MASIKA_BASANKUSU ◯ MATEBA_A ◯ MAYULU_A ◯ MAZAL_AILE_DROITE ◯ MBANZA_KANU ◯ MFUMU_SUKA_A ◯ MOLENDE ◯ MONDONGA ◯ MOTANGA ◯ MPOMPAGE 13 ◯ MUTEBA ◯ NDUNU ◯ NKANZA ◯ NKONGO_DE_LA_PAIX ◯ NKULU_I ◯ PROMOBAT ◯ SAMBI ◯ SANS_FIL_A ◯ SONABATA_ASOSA ◯ TSHIANGU_A ◯ USOKE ◯ WAMBA ◯ YOLO_NORD_II_A 005. Please note the street or avenue number where the household is located The supervisor will give you the street or avenue name. 005. Structure number Please record the structure number from the household listing form. 006. Household number Please record the household number from the household listing form. 007. CHECK: Have you already sent a form for this structure and household? ◯ Yes DO NOT DUPLICATE ANY FORM UNLESS YOU ARE CORRECTING ◯ No A MISTAKE IN AN EARLIER FORM. ☐ There are new household members on this form ☐ I am correcting a mistake made on a previous form 008. CHECK: Why are you resending this form? ☐ The previous form disappeared Choose all that apply. from my phone without being sent ☐ I submitted the previous form and my supervisor told me that it was not received ☐ Other reason(s) 009a. Is a member of the household and competent respondent ◯ Yes present and available to be interviewed today? ◯ No ◯ Yes 009b. Did this household participate in a previous PMA2020 ◯ No survey? ◯ Do not know ◯ No response INFORMED CONSENT Find a competent member of the household. Read the greeting on the following screen. Hello. My name is ________________________________ and I am working for the School of Public Health of Kinshasa in collaboration with the Ministry of Health. We are conducting a 14 local survey about various health issues. We would very much appreciate your participation in this survey. This information will help us inform the government to better plan health services. Whatever information you provide will be kept strictly confidential and will not be shown to anyone other than members of our survey team. Participation in this survey is voluntary, and if we should come to any question you don't want to answer, just let me know and I will go on to the next question; or you can stop the interview at any time. However, we hope that you will participate in this survey since your views are important. I am going to ask you questions about your family and other household members. We would then