DDI_IDN_2001_SUSENAS_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 2001 SUSENAS 2001 Survei Sosial Ekonomi Nasional 2001 IDN_2001_SUSENAS_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 Sector Part Chapter 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 In 2001 Susenas conducted in all geographic regions of Indonesia with a sample size of 20 896 households spread across urban and rural areas, 65 280 households carried out in the core-module census block using core-module list (VSEN2001.KM) and 155 616 households in the census block core only , using Core list (VSEN2001.K). With the consideration of security issues, the activities Susenas 2001 in Nanggroe Aceh Darussalam not carried out. Sample survey data [ssd] Data collected in 2001 SUSENAS include: - General information about the households members (art) that includes name, relationship to head of household, sex, age, marital status. - Information of children (aged 0-14 years) orphaned and possession of child's birth certificate (age 0-4 years). - Information child labor and allocation of time children aged 5 -14 years. - Information education of children (aged 3-6 years) pre-school, education household information 5 years and above. - Information of economic activities of children 10 years and above. - Information about health and nutrition include population health status, nutritional status women aged 15-49 years, posyandu services, costs incurred for the purposes of domestic health, health financing, health insurance, and smoking habits. - Information fertility for women never married and how to prevent pregnancy for married women. - Information about housing tenure includes the residence, the physical condition of residential buildings, facilities and equipment home and neighborhood conditions. - Information about average household consumption and the main source of household income. - Information on household rice stocks. Design of 2001 Susenas sample is a sample design two-phase for urban areas and sample design three-phase to rural areas. Sample selection for urban and rural areas is done separately. For urban areas, the first phase of the sample frame census blocks selected a number of census block linear systematic sampling. Then, from each selected census blocks selected 16 households by systemic linear sampling. For rural areas, the first phase of the sample frame number of sub-districts selected by probability proportional to size, with the number of household size in the district. The second phase, from each district elected, selected a number of census blocks in a systemic linear sampling. And final stage, from each selected census blocks selected 16 households by systemic linear sampling. For the presentation of data estimates at the provincial level, the implementing cost the enumeration obtained from state funds, sub district samples (for rural areas) / census block (for urban areas) is a subsample from sample of sub districts/ census block that are used to estimate the district / city level, which is selected from the list of districts / selected census blocks that are used to estimate the level of the sub districts / city in sampling systematic method 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 2001, ref. IDN_2001_SUSENAS_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. susenas01_ki Data contained in this file are questions from the National Social Economic Survey of 2001 - Main Information on Household and Household Members [VSEN2001.K] section Core Household Member (Individual): IV. Description of Household Member V.A. Education Description (for Household Member age five years up) V.B. Employment (for Household Member age 10 years up) V.C. Health Description (all ages) V.D. Health of Children under 5 years old (children age 0-59 months) 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) 889413 130 susenas01_kr Data contained in this file are questions from the National Social Economic Survey of 2001 - Main Information on Household and Household Members [VSEN2001.K] section Core Household: VI. Settlement and Housing VII.A. Household Expenditure - Spending for Food during last week VII.B. Household Expenditure - Spending Not for Food [from Purchase, Self-Production and Gift] 218568 65 susenas01_ind_km Data contained in this file are questions from the 2001 National Socio Economic Survey - Core Characteristics of Housdehold and Household Member as well as Health and Housing Module [VSEN2001.KM] section Household Member (Individual) Core - Module: IV. Household Members Characteristics V.A Education Characteristics (for Household Member aged 5 years and above) V.B. Manpower ( for Household Member aged 10 years old and above) V.C. Health Characteristics (for all ages) V.D. “Balita’s” Health (Children aged 0-59 months old) V.E. Smoking Habit (Household Member aged 10 year old and above) V.F. Fertility and Family Planning Ever Married Women age 10 years and up 277432 213 susenas01_rt_km Data contained in this file are questions from the 2001 National Socio Economic Survey - Core Characteristics of Household and Household Member as well as Health and Housing Module [VSEN2001.KM] section Household Core - Module: VI.A. Housing and Settlement - Housing Authority VI.B. Housing and Settlement - Physical Condition of Building VI.C. Housing and Settlement - Facility and Complement VI.D. Housing and Settlement - Environmental Condition VII.A. Household’s Expenditure - Food Expenditure during a previous week (based on purchasing, own-production, and grant) VII.B. Household’s Expenditure - Non-Food Expenditure (based on purchasing, own-production, and grant) VIII. Rice Stock Characteristics 69166 174 Myid Myid Myid Myid Myid 889413 Sysmiss Myidsec Myidsec Myidsec Myidsec Myidsec 889413 3 4 3.688 3 4 Number of household members Number of household members Number of household members Number of household members Number of household members 887968 1445 1 20 4.859 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 20 Sysmiss Number of children aged 0 - 4 years old Number of children aged 0 - 4 years old Number of children aged 0 - 4 years old Number of children aged 0 - 4 years old Number of children aged 0 - 4 years old 887968 1445 5 0.497 1 2 3 4 5 Sysmiss 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 889413 1 15 2.93 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 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. 889413 1 9 2.601 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. 889413 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. 889413 98 27.057 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. 889413 1 4 1.599 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. Had your biological father/ mother been died? Had your biological father/ mother been died? Had your biological father/ mother been died? Had your biological father/ mother been died? Had your biological father/ mother been died? Did you travel as a tourist? (October 1 – December 31, 2001) 280407 609006 1 9 3.897 1 Yes, biological father 2 Yes, biological mother 3 Yes, both of biological father and mother 4 No, biological father/mother are still alive 5 Do not know 9 Sysmiss Do you have a birth certificate (not identification papers)? May I see it? Do you have a birth certificate (not identification papers)? May I see it? Do you have a birth certificate (not identification papers)? May I see it? Do you have a birth certificate (not identification papers)? May I see it? Do you have a birth certificate (not identification papers)? May I see it? Frequency (times) 88101 801312 1 9 2.478 1 Yes, can be shown 2 Yes, cannot be shown 3 Do not have 4 Do not know 9 Sysmiss Why you don’t have? Why you don’t have? Why you don’t have? Why you don’t have? Why you don’t have? If C.8 = 3 or 9 Does he/she ever/still follow a pre-school education? 55559 833854 1 99 23.738 1 Expensive cost/ Do not have money 2 Long distance 3 Do not know that every birth should be registered 4 Do not know how to register 5 Other 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 56 57 58 59 60 61 62 63 99 Sysmiss Are you participating in pre-school? Are you participating in pre-school? Are you participating in pre-school? Are you participating in pre-school? Are you participating in pre-school? 76540 812873 1 4 3.419 1 Yes, TK 2 Yes, playgroup 3 Yes, "TPA" 4 No Sysmiss What the reasons? answer choices do not be read What the reasons? answer choices do not be read What the reasons? answer choices do not be read What the reasons? answer choices do not be read What the reasons? answer choices do not be read If “No” (C.10=4) 58433 830980 1 8 5.849 1 Ever in TK 2 Currently in Primary School 3 The child didn’t want to go to school 4 No money 5 Not needed 6 There is no facility in village/kelurahan 7 Do not there is pre-school level 8 Others Sysmiss Did you work at least 1 hour during a previous week? Did you work at least 1 hour during a previous week? Did you work at least 1 hour during a previous week? Did you work at least 1 hour during a previous week? Did you work at least 1 hour during a previous week? 192306 697107 1 2 1.951 1 Yes 2 No Sysmiss Work has been done with: Work has been done with: Work has been done with: Work has been done with: Work has been done with: If “Yes” [C.12=1] 9340 880073 1 14 2.43 1 Yourself 2 Your own house¬hold 3 Paid people 4 Unpaid people 5 6 7 8 9 10 11 12 13 14 Sysmiss Main job during a previous week Main job during a previous week Main job during a previous week Main job during a previous week Main job during a previous week 9340 880073 1 9 5.656 1 Periphery selling 2 Selling in permanent 3 Rolling in to pellets 4 Working in small/household industry sector 5 Working in medium/large industry sector 6 Working in farming sector 7 Working in transportation sector 8 Working service sector 9 Others Sysmiss Did you do some activities beside working but making money during a previous week , look at examples below? Did you do some activities beside working but making money during a previous week , look at examples below? Did you do some activities beside working but making money during a previous week , look at examples below? Did you do some activities beside working but making money during a previous week , look at examples below? Did you do some activities beside working but making money during a previous week , look at examples below? 192306 697107 1 2 1.984 1 Yes 2 No Sysmiss - Street singing/ bagging - Car cleaning when cars stop in the traffic light area - Traffic arranging Did you assist some household jobs (cooking, going to the market, washing clothes, taking water, baby sitting, others)? Did you assist some household jobs (cooking, going to the market, washing clothes, taking water, baby sitting, others)? Did you assist some household jobs (cooking, going to the market, washing clothes, taking water, baby sitting, others)? Did you assist some household jobs (cooking, going to the market, washing clothes, taking water, baby sitting, others)? Did you assist some household jobs (cooking, going to the market, washing clothes, taking water, baby sitting, others)? 192306 697107 1 2 1.693 1 Yes 2 No Sysmiss How many hours in average did you do those activities per-day? How many hours in average did you do those activities per-day? How many hours in average did you do those activities per-day? How many hours in average did you do those activities per-day? How many hours in average did you do those activities per-day? If “Yes” (C.16=1) 59131 830282 9 1.572 1 2 3 4 5 6 7 8 9 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. 889413 1 9 1.34 1 Yes 2 No 9 Serial Number of biological mother: Serial Number of biological mother: Serial Number of biological mother: Serial Number of biological mother: Serial Number of biological mother: 889413 13 0.978 1 2 3 4 5 6 7 8 9 10 11 12 13 Serial number of biological father: Serial number of biological father: Serial number of biological father: Serial number of biological father: Serial number of biological father: 889413 14 0.481 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Schooling participation: Schooling participation: Schooling participation: Schooling participation: Schooling participation: Schooling participation: 1. If the answer is coded 1, skip to k5r6, and 2. If the answer is coded 2, skip to k5r3a. Circle one of the codes from 1 to 3 and enter the number into the box provided. For household member age five years up 801312 88101 1 3 2.481 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 dropped out? (month) When did you dropped out? (month) When did you dropped out? (month) When did you dropped out? (month) When did you dropped out? (month) If k5r1 = 3 491182 398231 99 1.615 1 2 3 4 5 6 7 8 9 10 11 12 99 Sysmiss When did you dropped out? (year) When did you dropped out? (year) When did you dropped out? (year) When did you dropped out? (year) When did you dropped out? (year) If k5r1 = 3 491182 398231 9998 492.606 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 9998 Sysmiss Highest Level Ever Or Being Attended Highest Level Ever Or Being Attended Highest Level Ever Or Being Attended Highest Level Ever Or Being Attended Highest Level Ever Or Being Attended 695277 194136 1 11 2.683 1 Primary school 2 “Ibtidaiyah” (Islamic) 3 Junior high / Vocational 4 “Tsanawiyah” (Islamic) 5 Senior High School 6 "Aliyah” (islamic) 7 Vocational High School 8 Diploma I / II 9 Diploma III / Bachelor 10 Diploma IV / Graduate 11 Master / Ph.D. Sysmiss Number Of Days Not Attending School During The Previous Month Number Of Days Not Attending School During The Previous Month Number Of Days Not Attending School During The Previous Month Number Of Days Not Attending School During The Previous Month Number Of Days Not Attending School During The Previous Month To whom are in schooling (b5r1 = 2 and b5r3a = 01 to 07) 195712 693701 26 0.875 The highest level/grade ever or being attended The highest level/grade ever or being attended The highest level/grade ever or being attended The highest level/grade ever or being attended The highest level/grade ever or being attended The highest level/grade ever or being attended Circle one of code 1 to 14 and fill it in the provided box. For household member age five years up 695277 194136 1 8 5.581 1 Grade-1 2 Grade-2 3 Grade-3 4 Grade-4 5 Grade-5 6 Grade-6 7 Grade-7 8 Graduated 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. Highest certificate you have: Highest certificate you have: Highest certificate you have: Highest certificate you have: Highest certificate you have: Highest certificate you have: 695277 194136 1 9 2.341 1 None 2 Primary school 3 Junior high school / Junior Vocational 4 Senior high school 5 Vocational high school 6 Diploma I / II 7 Diploma III / bachelor 8 Diploma IV / graduate 9 Master / Ph.D. Sysmiss 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 801312 88101 1 3 1.305 1 Latin alphabets 2 Other alphabets 3 Latin and other alphabets 4 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 704768 184645 1 2 1.461 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 704768 184645 1 2 1.802 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 704768 184645 1 2 1.562 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 704768 184645 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 b5r21a1- 4 with code 1 (“Yes”) What activity used the most time in the past one week? If the answer is coded 1, skip to k5r9. 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 704768 184645 1 4 1.957 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 368005 521408 1 2 1.971 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 704768 184645 1 2 1.958 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 704768 184645 1 2 1.988 1 Yes 2 No 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 390925 498488 9 5.761 1 2 3 4 5 6 7 9 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 390925 498488 99 37.519 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 Sysmiss 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 390925 498488 990 264.729 11 12 13 14 15 20 50 101 102 111 112 120 131 132 141 142 151 152 153 154 155 160 171 172 173 174 181 182 191 192 201 202 210 221 222 223 231 232 241 242 243 251 252 261 262 263 264 265 266 269 271 272 273 281 289 291 292 293 300 311 312 313 314 315 319 321 322 323 331 332 333 341 342 343 351 352 353 359 361 369 371 372 401 402 403 410 451 452 453 454 455 501 502 503 504 505 511 512 513 514 515 519 521 522 523 524 525 526 531 532 533 534 535 539 541 542 543 544 545 549 551 552 601 602 603 611 612 621 622 631 632 633 634 635 639 641 642 651 659 660 671 672 701 702 703 711 712 713 721 722 723 724 725 729 731 732 741 742 743 749 751 752 753 801 802 803 809 851 852 853 900 911 912 919 921 922 923 924 930 950 951 956 959 960 980 990 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 390925 498488 11 999 664.048 11 21 31 91 111 112 113 114 121 122 123 124 131 132 133 139 141 211 212 221 222 223 229 231 232 233 234 239 241 242 243 249 251 252 253 254 255 311 312 321 329 331 332 339 341 342 349 391 399 411 412 421 431 441 442 443 449 451 461 462 491 492 493 494 498 499 511 599 611 612 613 614 615 619 621 631 632 639 711 712 721 729 731 791 799 811 821 829 831 911 921 922 991 992 993 999 Sysmiss 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 1,5, or 6 skip to Block k5r16 1. If the answer is coded 2,3, or 7 skip to Block V.C., and 2. If the answer is coded 4 skip to k5r16. Circle one of the code 1 to code 7 and enter the answer into the provided box. For working household member 390925 498488 1 7 3.746 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. - - - - - 889413 Sysmiss 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 Only for working household member (b5r24a1 = 1 or b5r25 = 1) The amount of net wage/salary (money and goods) generally received in a month from the main job - rupiah Continue to Block V.C Write down the income in the space provided and enter into the box provided. For working household member 91634 797779 100000000 476294.561 The wage/net salary - In cash: (Rp) The wage/net salary - In cash: (Rp) The wage/net salary - In cash: (Rp) The wage/net salary - In cash: (Rp) The wage/net salary - In cash: (Rp) How much the wage/net salary received in a month from main job? a. In cash: (Rp) 106139 783274 100000000 583624.965 The wage/net salary - In-goods: The wage/net salary - In-goods: The wage/net salary - In-goods: The wage/net salary - In-goods: The wage/net salary - In-goods: How much the wage/net salary received in a month from main job? b. In-goods: 106139 783274 100000000 62462.779 Health complaints - fever 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 p) a. fever If the answer is coded 2, skip to k5r24 Use code 1 if the respondent have health problems or code 2 if the answer is "No". 889413 1 2 1.909 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 p) b. cough If the answer is coded 2, skip to k5r24 Use code 1 if the respondent have health problems or code 2 if the answer is "No". 889413 1 2 1.894 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. 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 p) c. cold If the answer is coded 2, skip to k5r24 Use code 1 if the respondent have health problems or code 2 if the answer is "No". 889413 1 2 1.896 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 Health complaints - asthma Health complaints - asthma Health complaints - asthma Health complaints - asthma Any health complaint in the past one month? (read from a to p) d. asthma If the answer is coded 2, skip to k5r24 Use code 1 if the respondent have health problems or code 2 if the answer is "No". 889413 1 2 1.993 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 - breathlessness Health complaints - breathlessness Health complaints - breathlessness Health complaints - breathlessness Health complaints - breathlessness Any health complaint in the past one month? (read from a to p) e. breathlessness If the answer is coded 2, skip to k5r24 Use code 1 if the respondent have health problems or code 2 if the answer is "No". 889413 1 2 1.991 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. Breathlessness is a condition where panting of breath so must using extra energy (drawn into the chest wall when breathing)and fast (infants> 50 beats/min, 14 years> 40 beats / min, 5 + years> 30 times/min), possibly accompanied a bluish color to lips and nails, because of lack of oxygen. 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 p) f. diarrhea If the answer is coded 2, skip to k5r24 Use code 1 if the respondent have health problems or code 2 if the answer is "No". 889413 1 2 1.988 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. 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 - measles Health complaints - measles Health complaints - measles Health complaints - measles Health complaints - measles Any health complaint in the past one month? (read from a to p) g. measles If the answer is coded 2, skip to k5r24 Use code 1 if the respondent have health problems or code 2 if the answer is "No". 889413 1 2 1.999 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. Measles is a disease that is known by people with diffrent various local names, such as: tampek (Java), kerumut (Borneo), eder, gabagan (Java), etc., usually occurs in children, characterized by fever, red eyes, red spots on the skin, cough, cold, possibly accompanied by breathlessness and diarrhea. Health complaints - ear diseases Health complaints - ear diseases Health complaints - ear diseases Health complaints - ear diseases Health complaints - ear diseases Any health complaint in the past one month? (read from a to p) h. ear diseases If the answer is coded 2, skip to k5r24 Use code 1 if the respondent have health problems or code 2 if the answer is "No". 889413 1 2 1.999 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. Ear diseases/congek is a disease known to the public as congek, characterized by smelling discharge from the ear. Health complaints - liver Health complaints - liver Health complaints - liver Health complaints - liver Health complaints - liver Any health complaint in the past one month? (read from a to p) i. liver If the answer is coded 2, skip to k5r24 Use code 1 if the respondent have health problems or code 2 if the answer is "No". 889413 1 2 1.999 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. Liver is a disease characterized by skin and the whites of eyes looks yellow and colored urine like strong tea. 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 p) j. migraine If the answer is coded 2, skip to k5r24 Use code 1 if the respondent have health problems or code 2 if the answer is "No". 889413 1 2 1.963 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 - epilepsy Health complaints - epilepsy Health complaints - epilepsy Health complaints - epilepsy Health complaints - epilepsy Any health complaint in the past one month? (read from a to p) k. epilepsy If the answer is coded 2, skip to k5r24 Use code 1 if the respondent have health problems or code 2 if the answer is "No". 889413 1 2 1.998 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. Seizures are uncontrolled movements from the whole body or parts of the body, various causes such as epilepsy, febrile seizures (stip), encephalitis/meningitis. In epileptic seizures appear periodically (eg, every few months) with properties similar to seizures, seizures in epilepsy may be local (ie on the left cheek and eyelid), or whole body, people are not aware at the time of seizure, there is kind of epilepsy is not accompanied by seizures, unconsciousness stare just moments Health complaints - palsy Health complaints - palsy Health complaints - palsy Health complaints - palsy Health complaints - palsy Any health complaint in the past one month? (read from a to p) l. palsy If the answer is coded 2, skip to k5r24 Use code 1 if the respondent have health problems or code 2 if the answer is "No". 889413 1 2 1.998 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. Paralyzed is a weakness or inability to move a part of the body. It affects the left side, right side, lower part, right and left side or the whole body, the degree may be mild or medium (the strength is weakening), or severe (does not have any strength to move). The cause is various, example: stroke, polio, spine fracture, meningitis. Impotency is not considered as paralyzed. Health complaints - senile Health complaints - senile Health complaints - senile Health complaints - senile Health complaints - senile Any health complaint in the past one month? (read from a to p) m. senile If the answer is coded 2, skip to k5r24 Use code 1 if the respondent have health problems or code 2 if the answer is "No". 889413 1 2 1.997 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. Senility is a disease characterized by the loss or decline of intellectual ability so severe that impede social or occupational functioning; may occur in the elderly or older adults, either after exposure to the disease (eg, stroke), or for no apparent reason. Disruption occurs in memory, abstract thinking, the values, the ability to speak, recognize objects, doing a bit complex, the mimic, and accompanied by personality changes. Health complaints - accident Health complaints - accident Health complaints - accident Health complaints - accident Health complaints - accident Any health complaint in the past one month? (read from a to p) n. accident If the answer is coded 2, skip to k5r24 Use code 1 if the respondent have health problems or code 2 if the answer is "No". 889413 1 2 1.998 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. Accidents are not accidental events, omissions or failure of a system that cause injury (not including intentional / criminal), occurred in the home (eg slip, scalded, stabbed nails), on the road (eg falling from a horse, hit by a gig, grazed truck), at work (eg crushed building materials, an explosion), or other (eg falling from a tree, sprains while playing basketball). 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 p) o. toothache If the answer is coded 2, skip to k5r24 Use code 1 if the respondent have health problems or code 2 if the answer is "No". 889413 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. 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 p) p. other If the answer is coded 2, skip to k5r24 Use code 1 if the respondent have health problems or code 2 if the answer is "No". 889413 1 2 1.92 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 k5r21a. Circle the appropriate code and fill in the provided box. 225051 664362 1 2 1.403 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. 134401 755012 1 30 5.629 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". 134401 755012 1 2 1.772 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 k5r22 Circle the appropriate code and fill in the provided box. 225051 664362 1 2 1.423 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. 129806 759607 1 2 1.683 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. 129806 759607 1 2 1.173 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. 129806 759607 1 2 1.902 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. Cost of self-medication incurred by the household:(Rp) Cost of self-medication incurred by the household:(Rp) Cost of self-medication incurred by the household:(Rp) Cost of self-medication incurred by the household:(Rp) Cost of self-medication incurred by the household:(Rp) If using traditional medicine (k5r21b1=1) Cost of self-medication incurred by the household:(Rp) 129806 759607 5000000 8493.853 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 k5r24 Circle the appropriate code and fill in the provided box. 225051 664362 1 2 1.623 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 (times) - State hospital Frequency (times) - State hospital Frequency (times) - State hospital Frequency (times) - State hospital Frequency (times) - State hospital Outpatient’s expenditure in detail for a previous month: frequency (times) 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). 84943 804470 15 0.0775 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Sysmiss Private Hospital is a private owned hospital such as RS St. Carolus, RS Medistra. Frequency (times) - Private hospital Frequency (times) - Private hospital Frequency (times) - Private hospital Frequency (times) - Private hospital Frequency (times) - Private hospital Outpatient’s expenditure in detail for a previous month: frequency (times) 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). 84943 804470 15 0.0507 1 2 3 4 5 6 7 8 9 10 11 12 15 Sysmiss Frequency (times) - Doctor practice Frequency (times) - Doctor practice Frequency (times) - Doctor practice Frequency (times) - Doctor practice Frequency (times) - Doctor practice Outpatient’s expenditure in detail for a previous month: frequency (times) c. Doctor practice Write down in the provided box the frequency of (how many times) the respondent visits health centers for medical treatment (without hospitalization). 84943 804470 15 0.387 1 2 3 4 5 6 7 8 9 10 11 12 13 15 Sysmiss Frequency (times) - Puskesmas Frequency (times) - Puskesmas Frequency (times) - Puskesmas Frequency (times) - Puskesmas Frequency (times) - Puskesmas Outpatient’s expenditure in detail for a previous month: frequency (times) d. Puskesmas Write down in the provided box the frequency of (how many times) the respondent visits health centers for medical treatment (without hospitalization). 84943 804470 15 0.42 1 2 3 4 5 6 7 8 9 10 11 12 14 15 Sysmiss Frequency (times) - Supporting Puskesmas Frequency (times) - Supporting Puskesmas Frequency (times) - Supporting Puskesmas Frequency (times) - Supporting Puskesmas Frequency (times) - Supporting Puskesmas Outpatient’s expenditure in detail for a previous month: frequency (times) e. Supporting Puskesmas Write down in the provided box the frequency of (how many times) the respondent visits health centers for medical treatment (without hospitalization). 84943 804470 15 0.166 1 2 3 4 5 6 7 8 9 10 12 15 Sysmiss Frequency (times) - Polyclinic Frequency (times) - Polyclinic Frequency (times) - Polyclinic Frequency (times) - Polyclinic Frequency (times) - Polyclinic Outpatient’s expenditure in detail for a previous month: frequency (times) f. Polyclinic Write down in the provided box the frequency of (how many times) the respondent visits health centers for medical treatment (without hospitalization). 84943 804470 12 0.0465 1 2 3 4 5 6 7 8 10 12 Sysmiss Frequency (times) - Paramedic practice Frequency (times) - Paramedic practice Frequency (times) - Paramedic practice Frequency (times) - Paramedic practice Frequency (times) - Paramedic practice Outpatient’s expenditure in detail for a previous month: frequency (times) g. Paramedic practice Write down in the provided box the frequency of (how many times) the respondent visits health centers for medical treatment (without hospitalization). 84943 804470 15 0.319 1 2 3 4 5 6 7 8 9 10 11 12 13 15 Sysmiss Frequency (times) - Traditional healing practice Frequency (times) - Traditional healing practice Frequency (times) - Traditional healing practice Frequency (times) - Traditional healing practice Frequency (times) - Traditional healing practice Outpatient’s expenditure in detail for a previous month: frequency (times) h. Traditional healing practice Write down in the provided box the frequency of (how many times) the respondent visits health centers for medical treatment (without hospitalization). 84943 804470 15 0.0327 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Sysmiss Frequency (times) - “Polindes” (Village Maternity Post) Frequency (times) - “Polindes” (Village Maternity Post) Frequency (times) - “Polindes” (Village Maternity Post) Frequency (times) - “Polindes” (Village Maternity Post) Frequency (times) - “Polindes” (Village Maternity Post) Outpatient’s expenditure in detail for a previous month: frequency (times) i. “Polindes” (Village Maternity Post) Write down in the provided box the frequency of (how many times) the respondent visits health centers for medical treatment (without hospitalization). 84943 804470 11 0.0787 1 2 3 4 5 6 8 9 10 11 Sysmiss Frequency (times) - “Posyandu” (Integrated Service Post) Frequency (times) - “Posyandu” (Integrated Service Post) Frequency (times) - “Posyandu” (Integrated Service Post) Frequency (times) - “Posyandu” (Integrated Service Post) Frequency (times) - “Posyandu” (Integrated Service Post) Outpatient’s expenditure in detail for a previous month: frequency (times) j. “Posyandu” (Integrated Service Post) Write down in the provided box the frequency of (how many times) the respondent visits health centers for medical treatment (without hospitalization). 84940 804473 15 0.0193 1 2 3 4 5 6 7 8 9 10 15 Sysmiss How Much Is The Cost? (Idr) How Much Is The Cost? (Idr) How Much Is The Cost? (Idr) How Much Is The Cost? (Idr) How Much Is The Cost? (Idr) Total cost for self-treatment paid by the household: (Rp) 82194 807219 7500222 20555.999 Have ever been/ are being treated in a previous year? Have ever been/ are being treated in a previous year? Have ever been/ are being treated in a previous year? Have ever been/ are being treated in a previous year? Have ever been/ are being treated in a previous year? If b5r26 = 2 and b5r27 = 2 Have ever been/ are being treated in a previous year? For household member age 10 years up 889413 1 2 1.991 1 Yes 2 No Treatment days - State hospital Treatment days - State hospital Treatment days - State hospital Treatment days - State hospital Treatment days - State hospital The detailed of being treated in a previous year: treatment 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. 7890 881523 260 3.786 Private Hospital is a private owned hospital such as RS St. Carolus, RS Medistra. Treatment days - Private hospital Treatment days - Private hospital Treatment days - Private hospital Treatment days - Private hospital Treatment days - Private hospital The detailed of being treated in a previous year: treatment 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. 7890 881523 221 2.267 Treatment days - Puskesmas Treatment days - Puskesmas Treatment days - Puskesmas Treatment days - Puskesmas Treatment days - Puskesmas The detailed of being treated in a previous year: treatment days c. Puskesmas 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. 7890 881523 125 0.365 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 17 20 21 24 30 31 125 Sysmiss Treatment days - Others Treatment days - Others Treatment days - Others Treatment days - Others Treatment days - Others The detailed of being treated in a previous year: treatment days g. Others 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. 7890 881523 210 0.401 How Much Is The Cost? (Idr) How Much Is The Cost? (Idr) How Much Is The Cost? (Idr) How Much Is The Cost? (Idr) How Much Is The Cost? (Idr) How Much Is The Cost? (Idr) 7560 881853 50000000 633161.825 Financing assurance/health insurance for outpatient/treatment - Astek/Jamsostek (Labor insurance) Financing assurance/health insurance for outpatient/treatment - Astek/Jamsostek (Labor insurance) Financing assurance/health insurance for outpatient/treatment - Astek/Jamsostek (Labor insurance) Financing assurance/health insurance for outpatient/treatment - Astek/Jamsostek (Labor insurance) Financing assurance/health insurance for outpatient/treatment - Astek/Jamsostek (Labor insurance) Is there a financing assurance/ health insurance for outpatient/treatment below? b. Astek/Jamsostek (Labor insurance) 889413 1 2 1.909 1 2 Financing assurance/health insurance for outpatient/treatment - Company/ office Financing assurance/health insurance for outpatient/treatment - Company/ office Financing assurance/health insurance for outpatient/treatment - Company/ office Financing assurance/health insurance for outpatient/treatment - Company/ office Financing assurance/health insurance for outpatient/treatment - Company/ office Is there a financing assurance/ health insurance for outpatient/treatment below? c. Company/ office 889413 1 2 1.979 1 2 Financing assurance/health insurance for outpatient/treatment - Other insurance Financing assurance/health insurance for outpatient/treatment - Other insurance Financing assurance/health insurance for outpatient/treatment - Other insurance Financing assurance/health insurance for outpatient/treatment - Other insurance Financing assurance/health insurance for outpatient/treatment - Other insurance Is there a financing assurance/ health insurance for outpatient/treatment below? d. Other insurance 889413 1 2 1.989 1 2 Financing assurance/health insurance for outpatient/treatment - Health fund Financing assurance/health insurance for outpatient/treatment - Health fund Financing assurance/health insurance for outpatient/treatment - Health fund Financing assurance/health insurance for outpatient/treatment - Health fund Financing assurance/health insurance for outpatient/treatment - Health fund Is there a financing assurance/ health insurance for outpatient/treatment below? e. Health fund 889413 1 2 1.992 1 2 Financing assurance/health insurance for outpatient/treatment - Health card Financing assurance/health insurance for outpatient/treatment - Health card Financing assurance/health insurance for outpatient/treatment - Health card Financing assurance/health insurance for outpatient/treatment - Health card Financing assurance/health insurance for outpatient/treatment - Health card Is there a financing assurance/ health insurance for outpatient/treatment below? f. Health card 889413 1 2 1.953 1 2 Financing assurance/health insurance for outpatient/treatment - JKPM Financing assurance/health insurance for outpatient/treatment - JKPM Financing assurance/health insurance for outpatient/treatment - JKPM Financing assurance/health insurance for outpatient/treatment - JKPM Financing assurance/health insurance for outpatient/treatment - JKPM Is there a financing assurance/ health insurance for outpatient/treatment below? g. JKPM 889413 1 2 1.972 1 2 Age: (month) Age: (month) Age: (month) Age: (month) Age: (month) Age: (month) 88101 801312 59 28.863 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 88101 801312 1 6 2.822 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 88101 801312 1 6 2.676 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. 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 or Block VI. Circle code 1 for “Yes” and code 2 for “No” and write down in the provided box. Child age 0-59 months 88101 801312 1 2 1.036 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” [k5r29a = 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 84928 804485 59 15.721 Had it been breastfed in this last 24 hours? Had it been breastfed in this last 24 hours? Had it been breastfed in this last 24 hours? Had it been breastfed in this last 24 hours? Had it been breastfed in this last 24 hours? Had it been breastfed in this last 24 hours? If the entry is coded 2, skip to question other household member or Block VI. Child age 0-59 months 10572 878841 1 2 1.055 1 Yes 2 No Sysmiss Had it been given other foods/drinks besides breast milk yesterday/last night? Had it been given other foods/drinks besides breast milk yesterday/last night? Had it been given other foods/drinks besides breast milk yesterday/last night? Had it been given other foods/drinks besides breast milk yesterday/last night? Had it been given other foods/drinks besides breast milk yesterday/last night? Had it been given other foods/drinks besides breast milk yesterday/last night? 262944 626469 1 2 1.957 1 2 Sysmiss 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 238725 650688 10 73 19.416 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 238725 650688 85 19.365 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 240521 648892 99 1.673 1 2 3 4 5 6 7 8 9 10 11 12 13 14 99 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 240521 648892 16 1.57 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 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 240521 648892 99 3.243 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 20 99 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 240521 648892 99 1.448 1 2 3 4 5 6 7 8 9 10 11 99 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 240521 648892 11 1.383 1 2 3 4 5 6 7 8 9 10 11 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 240521 648892 99 2.831 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 20 99 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 240521 648892 10 0.225 1 2 3 4 5 6 7 8 9 10 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 240521 648892 13 0.187 1 2 3 4 5 6 7 8 9 10 13 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 240521 648892 14 0.412 1 2 3 4 5 6 7 8 9 10 11 12 13 14 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 238725 650688 1 2 1.476 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 entry is coded 2, skip to question other household member or Block VI. 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 - status of married 118792 770621 1 2 1.3 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: If currently using (b5r28 = 1) 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 - status of married 83176 806237 1 9 4.537 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. Place to get your last family planning contraception: Place to get your last family planning contraception: Place to get your last family planning contraception: Place to get your last family planning contraception: Place to get your last family planning contraception: Place to get your last family planning contraception: 81463 807950 1 8 4.572 1 Government’s hospital 2 Private hospital 3 Doctor’s office 4 Public Health Center (Puskesmas) 5 Midwife practice 6 Polindes/BDD/Posyandu 7 Drug store 8 Other Sysmiss Money spent to get the last family planning service: (Rp) Money spent to get the last family planning service: (Rp) Money spent to get the last family planning service: (Rp) Money spent to get the last family planning service: (Rp) Money spent to get the last family planning service: (Rp) 81463 807950 9999999 15984.859 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. 889413 12 91 41.245 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 54 East Timor 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 Papua 91 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. 889413 1 78 22.706 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 71 72 73 74 75 76 77 78 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. 889413 1 2 1.613 1 Urban 2 Rural Kab Kab Kab Kab Kab 889413 1201 9171 4147.19 Myd_flag Myd_flag Myd_flag Myd_flag Myd_flag 889413 Sysmiss Typedok Typedok Typedok Typedok Typedok 889413 1 2 1.312 1 2 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. 889413 4 740 73.786 4 5 8 10 16 18 20 30 40 41 50 60 70 80 90 100 110 120 130 140 150 160 170 172 180 190 200 210 220 221 230 240 250 260 270 280 290 300 310 320 330 350 360 370 390 710 720 730 740 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. 889413 1 272 8.42 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 67 68 70 72 73 76 77 80 83 84 85 87 107 112 116 242 272 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. 889413 1 578 209.763 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 150 320 501 502 503 504 505 506 507 508 509 510 511 512 513 514 515 516 517 518 519 520 521 522 523 524 525 526 527 528 529 530 531 532 533 534 535 536 537 538 539 540 541 542 543 544 545 546 547 548 549 550 551 552 553 554 555 556 557 558 559 560 561 562 563 564 565 566 567 568 569 570 571 572 573 574 575 576 577 578 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. 889413 1 16 8.493 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Individual Inflation factor SUSENAS 2001 Individual Inflation factor SUSENAS 2001 Individual Inflation factor SUSENAS 2001 Individual Inflation factor SUSENAS 2001 Individual Inflation factor SUSENAS 2001 889413 4 1328 226.783 Myid Myid Myid Myid Myid 218568 Sysmiss Ethnicity of the household head: Ethnicity of the household head: Ethnicity of the household head: Ethnicity of the household head: Ethnicity of the household head: 218568 1 20 4.069 Number of household members: Number of household members: Number of household members: Number of household members: Number of household members: 218568 5 0.403 1 2 3 4 5 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. 218568 1 7 1.653 1 Own house 2 Lease 3 Rent 4 Company house 5 Free lease 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. 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. 218568 1 7 3.235 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. 218568 1 4 1.688 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. 218568 1 2 1.163 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 ). 218568 3 998 65.156 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. 218568 9 4.392 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. 149196 69372 1 3 2.006 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. 218568 1 4 3.359 1 Subscription 2 Directly to the agent 3 Through seller 4 Not buy 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. 218568 1 4 1.911 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 b6r9c Circle one of the codes accordingly, then fill in the answer in the provided box. 218568 1 4 2.059 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, 156987 61581 1 4 1.767 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. 218568 1 6 2.782 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. 218568 1 5 1.622 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) 218568 350000 19783.012 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) 218568 150000 1618.673 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) 218568 270000 10790.945 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) 218568 500000 4749.101 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) 218568 367500 5155.513 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) 218568 150000 6686.002 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) 218568 140000 3353.618 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) 218568 310000 3422.01 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) 218568 120000 3970.269 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) 218568 240000 5058.28 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) 218568 100000 2572.817 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) 218568 250000 2046.525 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) 218568 775000 9504.94 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) 218568 270000 233.61 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) 218568 350000 11935.06 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] 218568 3000 1368000 90880.375 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) 218568 100 10100000 87946.171 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) 218568 5000 124100000 1066225.255 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) 218568 42153000 24558.263 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) 218568 55133200 275188.816 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) 218568 8250000 16413.774 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) 218568 96000000 182017.92 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) 218568 70200000 33971.003 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) 218568 161000000 158955.912 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) 218568 5346750 24765.325 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) 218568 36000000 310653.34 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) 218568 144000000 25499.302 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) 218568 200000000 241612.79 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) 218568 11000000 3322.375 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) 218568 23130000 42257.039 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 - 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) 218568 50060000 17291.042 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) 218568 84000000 117638.304 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) Write down in Column (2) total non-food (details 17 to 24) from purchases, self produced, and gifts in one past month for house lease,rent,rent expectation :(Rp) 218568 1000 145330832 233767.255 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) 218568 15000 218200000 2394549.375 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 (2) average food expenditure a month (Details 16 x 30/7) 218568 12857 5862857 389487.31 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) The average non-food expenditure a month (Details 25 column 3 / 12) 218568 1250 18183332 199545.785 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 monthly household expenditure (Details 26 + Details 27). 218568 29269 20182438 589033.095 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. 218568 111 9502 1567.736 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. 218568 12 91 41.011 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. 218568 1 78 22.519 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. 218568 1 2 1.617 1 Urban 2 Rural Kab Kab Kab Kab Kab 218568 1201 9171 4123.616 Typedok Typedok Typedok Typedok Typedok 218568 1 2 1.316 1 2 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. 218568 4 740 74.326 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. 218568 272 8.318 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. 218568 1 578 207.817 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. 218568 1 16 8.498 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Household Inflation factor SUSENAS 2001 Household Inflation factor SUSENAS 2001 Household Inflation factor SUSENAS 2001 Household Inflation factor SUSENAS 2001 Household Inflation factor SUSENAS 2001 218568 4 1330 236.883 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: 218568 110 9900 2926.402 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. 277401 1 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 3 31 DKI Jakarta 32 West Java 33 Central Java 34 DI Yogyakarta 35 East Java 36 Banten 4 5 51 Bali 52 West Nusa Tenggara 53 East Nusa Tenggara 6 61 West Kalimantan 62 Central Kalimantan 63 South Kalimantan 64 East Kalimantan 7 71 North Sulawesi 72 Central Sulawesi 73 South Sulawesi 74 Southeast Sulawesi 75 Gorontalo 76 West Sulawesi 8 81 Maluku 82 North Maluku 9 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. 277402 1 10 11 12 13 14 15 16 17 18 19 2 20 21 22 23 24 25 26 27 28 29 3 31 32 33 34 35 36 4 5 51 53 6 61 64 7 71 72 73 74 75 76 77 78 8 9 91 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. 277432 000 1 1 1 2 1 6 10 100 110 118 120 130 135 140 150 160 170 171 176 180 190 191 2 1 20 200 201 203 210 220 230 240 250 260 270 280 281 284 290 3 1 3 6 3 8 30 300 310 320 330 350 360 370 390 4 9 40 5 6 5 9 50 6 1 6 4 60 7 3 7 7 7 8 70 710 711 712 713 720 722 724 730 740 741 761 8 1 8 4 80 90 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. 277400 0 1 0 2 0 3 0 4 0 5 0 7 0 8 001 002 1 10 101 11 12 13 14 15 16 17 18 19 2 20 209 21 22 23 24 25 26 27 28 29 3 30 301 31 32 33 34 35 36 38 39 4 43 44 49 5 52 54 6 60 605 607 63 7 72 8 9 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. 277361 1 Urban 2 Rural 3 5 6 8 9 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. 277401 1 10 11 12 13 14 15 16 17 18 19 2 20 21 22 23 24 25 26 27 28 29 3 30 31 32 33 34 35 36 37 38 39 4 40 41 42 43 44 45 46 47 48 5 50 501 502 503 504 505 506 507 508 509 51 510 511 512 513 514 515 516 517 518 519 52 520 521 522 523 524 525 526 527 528 529 53 530 531 532 533 534 535 536 537 538 539 54 540 541 542 543 544 545 546 547 548 549 550 551 552 553 554 555 556 557 558 559 560 561 562 563 564 565 566 567 568 569 570 571 572 573 574 575 576 6 7 8 9 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. 277391 01 02 05 06 09 1 10 11 12 13 14 15 16 2 21 26 3 31 37 4 5 6 7 8 9 Banyaknya ART Banyaknya ART Banyaknya ART Banyaknya ART Banyaknya ART 275956 1 10 11 12 13 14 15 16 2 3 4 5 6 7 8 9 Banyaknya anak 0-4 tahun Banyaknya anak 0-4 tahun Banyaknya anak 0-4 tahun Banyaknya anak 0-4 tahun Banyaknya anak 0-4 tahun 275956 1 10 2 3 4 5 6 7 8 9 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 277401 1 10 11 12 13 14 2 3 4 5 6 7 8 9 Relation to the head of household Relation to the head of household Relation to the head of household Relation to the head of household Relation to the head of household 277401 1 2 3 4 5 6 7 8 9 Sex Sex Sex Sex Sex 277345 1 Male 2 Female Age(Year) Age(Year) Age(Year) Age(Year) Age(Year) 277401 31 99 27.182 Marital Status Marital Status Marital Status Marital Status Marital Status 277391 1 Not married 2 Married 3 Divorce 4 Widowed 5 6 8 Had your biological father/ mother been died? Had your biological father/ mother been died? Had your biological father/ mother been died? Had your biological father/ mother been died? Had your biological father/ mother been died? Did you travel as a tourist? (October 1 – December 31, 2001) 86044 1 Yes, biological father 2 Yes, biological mother 3 Yes, both of biological father and mother 4 No, biological father/mother are still alive 5 Do not know 6 7 8 9 Do you have a birth certificate (not identification papers)? May I see it? Do you have a birth certificate (not identification papers)? May I see it? Do you have a birth certificate (not identification papers)? May I see it? Do you have a birth certificate (not identification papers)? May I see it? Do you have a birth certificate (not identification papers)? May I see it? Frequency (times) 27187 1 Yes, can be shown 2 Yes, cannot be shown 3 Do not have 4 Do not know 9 Why you don’t have? Why you don’t have? Why you don’t have? Why you don’t have? Why you don’t have? If C.8 = 3 or 9 Does he/she ever/still follow a pre-school education? 15810 1 Expensive cost/ Do not have money 10 11 12 13 14 15 16 17 18 19 2 Long distance 20 21 22 23 24 25 26 27 28 29 3 Do not know that every birth should be registered 30 31 32 33 34 35 36 37 38 4 Do not know how to register 40 41 42 43 44 45 46 47 48 49 5 Other 50 51 52 56 57 6 7 8 9 99 Are you participating in pre-school? Are you participating in pre-school? Are you participating in pre-school? Are you participating in pre-school? Are you participating in pre-school? 23203 1 Yes, TK 2 Yes, playgroup 3 Yes, "TPA" 4 No What the reasons? answer choices do not be read What the reasons? answer choices do not be read What the reasons? answer choices do not be read What the reasons? answer choices do not be read What the reasons? answer choices do not be read If “No” (C.10=4) 17597 1 Ever in TK 2 Currently in Primary School 3 The child didn’t want to go to school 4 No money 5 Not needed 6 There is no facility in village/kelurahan 7 Do not there is pre-school level 8 Others Did you work at least 1 hour during a previous week? Did you work at least 1 hour during a previous week? Did you work at least 1 hour during a previous week? Did you work at least 1 hour during a previous week? Did you work at least 1 hour during a previous week? 58891 1 Yes 2 No 3 4 Work has been done with: Work has been done with: Work has been done with: Work has been done with: Work has been done with: If “Yes” [C.12=1] 2630 1 Yourself 10 11 12 2 Your own house¬hold 3 Paid people 4 Unpaid people 5 6 7 8 9 Main job during a previous week Main job during a previous week Main job during a previous week Main job during a previous week Main job during a previous week 2620 1 Periphery selling 2 Selling in permanent 3 Rolling in to pellets 4 Working in small/household industry sector 5 Working in medium/large industry sector 6 Working in farming sector 7 Working in transportation sector 8 Working service sector 9 Others Did you do some activities beside working but making money during a previous week , look at examples below? Did you do some activities beside working but making money during a previous week , look at examples below? Did you do some activities beside working but making money during a previous week , look at examples below? Did you do some activities beside working but making money during a previous week , look at examples below? Did you do some activities beside working but making money during a previous week , look at examples below? 58888 1 Yes 2 No 3 4 5 6 8 9 - Street singing/ bagging - Car cleaning when cars stop in the traffic light area - Traffic arranging Did you assist some household jobs (cooking, going to the market, washing clothes, taking water, baby sitting, others)? Did you assist some household jobs (cooking, going to the market, washing clothes, taking water, baby sitting, others)? Did you assist some household jobs (cooking, going to the market, washing clothes, taking water, baby sitting, others)? Did you assist some household jobs (cooking, going to the market, washing clothes, taking water, baby sitting, others)? Did you assist some household jobs (cooking, going to the market, washing clothes, taking water, baby sitting, others)? 58857 1 Yes 2 No How many hours in average did you do those activities per-day? How many hours in average did you do those activities per-day? How many hours in average did you do those activities per-day? How many hours in average did you do those activities per-day? How many hours in average did you do those activities per-day? If “Yes” (C.16=1) 17330 1 2 3 4 5 6 7 8 9 Size of circle arm/(LILA) (Cm) Size of circle arm/(LILA) (Cm) Size of circle arm/(LILA) (Cm) Size of circle arm/(LILA) (Cm) Size of circle arm/(LILA) (Cm) 277431 1 99.9 7.114 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. 277401 . 1 Yes 2 No Serial Number of biological mother: Serial Number of biological mother: Serial Number of biological mother: Serial Number of biological mother: Serial Number of biological mother: 277432 01 02 1 10 11 13 2 21 22 3 31 4 41 5 51 6 61 7 8 9 Serial number of biological father: Serial number of biological father: Serial number of biological father: Serial number of biological father: Serial number of biological father: 277432 1 10 11 12 2 3 4 5 6 7 8 9 Schooling participation: Schooling participation: Schooling participation: Schooling participation: Schooling participation: Schooling participation: 1. If the answer is coded 1, skip to b5r6, and 2. If the answer is coded 2, skip to b5r3a. Circle one of the codes from 1 to 3 and enter the number into the box provided. For household member age five years up 250301 1 No/never in school 2 Still in school 3 No longer in school 8 9 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 dropped out? (month) When did you dropped out? (month) When did you dropped out? (month) When did you dropped out? (month) When did you dropped out? (month) If b5r1 = 3 154808 06 1 10 11 12 14 2 25 3 33 4 48 5 6 7 8 9 99 When did you dropped out? (year) When did you dropped out? (year) When did you dropped out? (year) When did you dropped out? (year) When did you dropped out? (year) If b5r1 = 3 154790 0 0 1 19 199 2 200 6 1 6 2 7 1 999 Highest Level Ever Or Being Attended Highest Level Ever Or Being Attended Highest Level Ever Or Being Attended Highest Level Ever Or Being Attended Highest Level Ever Or Being Attended 217677 00 1 Primary school 10 Diploma IV / Graduate 11 Master / Ph.D. 2 “Ibtidaiyah” (Islamic) 3 Junior high / Vocational 4 “Tsanawiyah” (Islamic) 5 Senior High School 6 "Aliyah” (islamic) 7 Vocational High School 8 Diploma I / II 9 Diploma III / Bachelor 99 Ï Number Of Days Not Attending School During The Previous Month Number Of Days Not Attending School During The Previous Month Number Of Days Not Attending School During The Previous Month Number Of Days Not Attending School During The Previous Month Number Of Days Not Attending School During The Previous Month To whom are in schooling (b5r1 = 2 and b5r3a = 01 to 07) 277420 12 52 0.181 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 217656 1 Elementary school 10 Diploma IV/S1 11 S2/S3 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 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. Highest certificate you have: Highest certificate you have: Highest certificate you have: Highest certificate you have: Highest certificate you have: Highest certificate you have: 217726 1 None 2 Elementary/MI and its equivalent 3 Junior high/MTs/vocational and its equivalent 4 Senior high/MS and its equivalent 5 Vocational school 6 Diploma I/II 7 Diploma III/junior bachelor 8 Diploma IV/University 9 Master degree/doctoral degree Can read and write: Can read and write: Can read and write: Can read and write: Can read and write: Can read and write: If the answer is coded 2, skip to b5r22 Circle one of the code 1 to code 4 and enter the answer into the provided box. For household member age five years up 250290 1 Latin alphabets 2 Other alphabets 3 Latin and other alphabets 4 Cannot 5 6 8 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 220671 1 Yes 2 No 3 4 5 7 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 220667 1 Yes 2 No 3 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 220663 1 Yes 2 No 3 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 220663 1 Yes 2 No 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 b5r21a1- 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 220663 1 Work 2 School 3 Handling Household 4 Other 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 112743 1 Yes 2 No 5 8 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 220670 1 Yes 2 No 3 4 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 220637 1 Yes 2 No 4 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 124334 1 2 3 4 5 6 7 9 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 124344 1 10 11 12 13 14 15 16 17 18 19 2 20 21 22 23 24 25 26 27 28 29 3 30 31 32 33 34 35 36 37 38 39 4 40 41 42 43 44 45 46 47 48 49 5 50 51 52 53 54 55 56 57 58 59 6 60 61 62 63 64 65 66 67 68 69 7 70 71 72 73 74 75 76 77 78 79 8 80 81 82 83 84 85 86 87 88 89 9 90 91 92 93 94 95 96 97 98 99 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: For working household member 124327 101 102 11 111 112 12 120 13 131 132 14 141 142 15 151 152 153 154 155 160 161 171 172 173 174 181 182 191 192 2 20 201 202 210 211 221 222 223 231 232 241 242 243 247 251 252 261 262 263 264 265 266 269 271 272 273 281 289 291 292 293 300 305 311 312 313 314 315 319 321 322 323 331 332 333 341 342 343 351 352 353 357 359 361 369 371 372 401 402 403 410 411 421 431 451 452 453 454 455 50 501 502 503 504 505 511 512 513 514 515 519 521 522 523 524 525 526 531 532 533 534 535 539 541 542 543 544 545 549 551 552 561 562 565 601 602 603 604 611 612 621 622 631 632 633 634 635 639 641 642 651 659 660 671 672 675 701 702 703 705 711 712 713 721 722 723 724 725 729 731 741 742 743 749 751 752 753 801 802 803 809 851 852 853 9 8 900 911 912 919 921 922 923 924 930 950 951 956 959 960 980 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: For working household member 124340 0.0 012 019 044 1 1 1 2 1 4 1 9 11 111 112 113 114 121 122 123 124 131 132 133 139 141 2 9 2.0 2.3 2.4 21 211 212 218 221 222 223 229 231 232 233 234 239 241 242 243 249 251 252 253 254 255 3.0 3.1 304 31 311 312 321 329 331 332 339 341 342 349 391 399 4 9 4.1 4.4 411 412 421 431 441 442 443 451 461 462 491 492 493 494 498 499 511 516 521 524 528 529 544 599 611 612 613 614 615 619 621 631 632 634 639 711 712 721 729 731 791 799 811 821 829 831 91 911 919 921 922 991 992 993 999 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 2, 3, or 7 skip to Block V.C., and 2. If the answer is coded 1, 5, or 6 skip to b5r15. 3. If the answer is coded 4 skip to b5r16. Circle one of the code 1 to code 6 and enter the answer into the provided box. For working household member 124340 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 9 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. Not included in questionnaire Not included in questionnaire Not included in questionnaire Not included in questionnaire Not included in questionnaire 57 1 2 3 4 8 † 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 Only for working household member (b5r24a1 = 1 or b5r25 = 1) The amount of net wage/salary (money and goods) generally received in a month from the main job - rupiah Continue to Block V.C Write down the income in the space provided and enter into the box provided. For working household member 277394 38 99999999 62961.044 How much the wage/net salary received in a month from main job? a. In cash: (Rp) How much the wage/net salary received in a month from main job? a. In cash: (Rp) How much the wage/net salary received in a month from main job? a. In cash: (Rp) How much the wage/net salary received in a month from main job? a. In cash: (Rp) How much the wage/net salary received in a month from main job? a. In cash: (Rp) How much the wage/net salary received in a month from main job? a. In cash: (Rp) 277432 99999999 84233.446 How much the wage/net salary received in a month from main job? b. In-goods: How much the wage/net salary received in a month from main job? b. In-goods: How much the wage/net salary received in a month from main job? b. In-goods: How much the wage/net salary received in a month from main job? b. In-goods: How much the wage/net salary received in a month from main job? b. In-goods: How much the wage/net salary received in a month from main job? b. In-goods: 277421 11 99999999 8489.785 Health complaints - fever 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 p) a. fever If the answer is coded 2, skip to b5r24. Use code 1 if the respondent have health problems or code 2 if the answer is "No". 277357 No 1 Yes 2 3 7 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 p) b. cough If the answer is coded 2, skip to b5r24. Use code 1 if the respondent have health problems or code 2 if the answer is "No". 277416 No 1 Yes 2 5 6 7 9 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 p) c. cold If the answer is coded 2, skip to b5r24. Use code 1 if the respondent have health problems or code 2 if the answer is "No". 277412 No 1 Yes 2 3 6 7 8 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 Health complaints - asthma Health complaints - asthma Health complaints - asthma Health complaints - asthma Any health complaint in the past one month? (read from a to p) d. asthma If the answer is coded 2, skip to b5r24. Use code 1 if the respondent have health problems or code 2 if the answer is "No". 277416 No 1 Yes 2 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 - breathlessness Health complaints - breathlessness Health complaints - breathlessness Health complaints - breathlessness Health complaints - breathlessness Any health complaint in the past one month? (read from a to p) e. breathlessness If the answer is coded 2, skip to b5r24. Use code 1 if the respondent have health problems or code 2 if the answer is "No". 277416 No 1 Yes 2 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. 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 p) f. diarrhea If the answer is coded 2, skip to b5r24. Use code 1 if the respondent have health problems or code 2 if the answer is "No". 277401 No 1 Yes 2 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 - measles Health complaints - measles Health complaints - measles Health complaints - measles Health complaints - measles Any health complaint in the past one month? (read from a to p) g. measles If the answer is coded 2, skip to b5r24. Use code 1 if the respondent have health problems or code 2 if the answer is "No". 277416 No 1 Yes 2 4 9 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. Health complaints - ear diseases Health complaints - ear diseases Health complaints - ear diseases Health complaints - ear diseases Health complaints - ear diseases Any health complaint in the past one month? (read from a to p) h. ear diseases If the answer is coded 2, skip to b5r24. Use code 1 if the respondent have health problems or code 2 if the answer is "No". 277415 No 1 Yes 2 6 9 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. Health complaints - liver Health complaints - liver Health complaints - liver Health complaints - liver Health complaints - liver Any health complaint in the past one month? (read from a to p) i. liver If the answer is coded 2, skip to b5r24. Use code 1 if the respondent have health problems or code 2 if the answer is "No". 277416 No 1 Yes 2 ÿ 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. 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 p) j. migraine If the answer is coded 2, skip to b5r24. Use code 1 if the respondent have health problems or code 2 if the answer is "No". 277416 No 1 Yes 2 4 5 7 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 - epilepsy Health complaints - epilepsy Health complaints - epilepsy Health complaints - epilepsy Health complaints - epilepsy Any health complaint in the past one month? (read from a to p) k. epilepsy If the answer is coded 2, skip to b5r24. Use code 1 if the respondent have health problems or code 2 if the answer is "No". 277401 No 1 Yes 2 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. Health complaints - palsy Health complaints - palsy Health complaints - palsy Health complaints - palsy Health complaints - palsy Any health complaint in the past one month? (read from a to p) l. palsy If the answer is coded 2, skip to b5r24. Use code 1 if the respondent have health problems or code 2 if the answer is "No". 277401 No 1 Yes 2 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. Health complaints - senile Health complaints - senile Health complaints - senile Health complaints - senile Health complaints - senile Any health complaint in the past one month? (read from a to p) m. senile If the answer is coded 2, skip to b5r24. Use code 1 if the respondent have health problems or code 2 if the answer is "No". 277401 No 1 Yes 2 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. Health complaints - accident Health complaints - accident Health complaints - accident Health complaints - accident Health complaints - accident Any health complaint in the past one month? (read from a to p) n. accident If the answer is coded 2, skip to b5r24. Use code 1 if the respondent have health problems or code 2 if the answer is "No". 277402 No 1 Yes 2 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. 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 p) o. toothache If the answer is coded 2, skip to b5r24. Use code 1 if the respondent have health problems or code 2 if the answer is "No". 277406 No 1 Yes 2 4 5 6 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 p) p. other If the answer is coded 2, skip to b5r24. Use code 1 if the respondent have health problems or code 2 if the answer is "No". 277408 No 1 Yes 2 5 6 7 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 b5r21a Circle the appropriate code and fill in the provided box. 70106 1 Yes 2 No 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. 277431 1 30 0.797 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". 39591 1 Yes 2 No 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 b5r22 Circle the appropriate code and fill in the provided box. 70099 1 Yes 2 No 3 4 7 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. 38086 1 Yes 2 No 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. 38095 1 Yes 2 No 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. 38087 1 Yes 2 No 7 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. Who made it - Own-self Who made it - Own-self Who made it - Own-self Who made it - Own-self Who made it - Own-self If using traditional medicine (b5r21b1=1) Who made it? 1. Own-self 11032 1 Yes 2 No Who made it - Fabrics Who made it - Fabrics Who made it - Fabrics Who made it - Fabrics Who made it - Fabrics If using traditional medicine (b5r21b1=1) Who made it? 2. Fabrics 11032 1 Yes 2 No Who made it - “Jamu gendong “ periphery seller Who made it - “Jamu gendong “ periphery seller Who made it - “Jamu gendong “ periphery seller Who made it - “Jamu gendong “ periphery seller Who made it - “Jamu gendong “ periphery seller If using traditional medicine (b5r21b1=1) Who made it? 3. “Jamu gendong “ periphery seller 11055 1 Yes 2 No Who made it - Others Who made it - Others Who made it - Others Who made it - Others Who made it - Others If using traditional medicine (b5r21b1=1) Who made it? 4. Others 11024 1 Yes 2 No Household’s expenditure for the cost of self-treatment (Rp) Household’s expenditure for the cost of self-treatment (Rp) Household’s expenditure for the cost of self-treatment (Rp) Household’s expenditure for the cost of self-treatment (Rp) Household’s expenditure for the cost of self-treatment (Rp) Household’s expenditure for the cost of self-treatment (Rp) 277379 53 2500000 945.48 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 b5r24 Circle the appropriate code and fill in the provided box. 70075 1 Yes 2 No 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 (times) - State hospital Frequency (times) - State hospital Frequency (times) - State hospital Frequency (times) - State hospital Frequency (times) - State hospital Outpatient’s expenditure in detail for a previous month: frequency (times) 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). 277432 22 0.00997 1 2 3 4 5 6 7 8 10 11 12 13 14 15 21 22 Private Hospital is a private owned hospital such as RS St. Carolus, RS Medistra. Source of financing - State hospital Source of financing - State hospital Source of financing - State hospital Source of financing - State hospital Source of financing - State hospital Outpatient’s expenditure in detail for a previous month: source of financing a. State hospital Ask the amount of the total cost for the purpose of outpatient during the past one month 1294 1 Household 11 122 13 16 17 19 2 Health insurance/ labor insurance “Askes, Jamsostek, Jasa Raharja” 20 21 212 222 3 Health fund 31 32 33 4 Health card/ Lurah’s recommendation letter 5 “JPKM” (Social Health Guarantee) 6 Other parties 64 65 67 8 9 Doctor’s office is a health service center for outpatient (not hospitalized); usually managed by privates, companies, foundations, Army/TNI or various Departments/BUMN. Household’s expenses (in rupiah) - State hospital Household’s expenses (in rupiah) - State hospital Household’s expenses (in rupiah) - State hospital Household’s expenses (in rupiah) - State hospital Household’s expenses (in rupiah) - State hospital Outpatient’s expenditure in detail for a previous month: household’s expenses (in rupiah) a. State hospital Ask the total cost of health / paid by household is concerned, either partially or completely, for the purpose of outpatient during the last month. 277368 64 22222222 2962.389 1000 1500 1700 2000 2500 3000 3100 3400 3500 4000 4500 5000 5500 6000 6800 7000 7200 7500 7600 8000 8500 9000 10000 10500 11000 11500 12000 12100 12500 13000 14000 14500 15000 15500 16000 17000 17500 18000 19000 20000 20500 21000 22500 23000 24000 25000 25500 26000 27000 28000 29000 30000 31000 32000 33000 34500 35000 36000 37000 37500 38000 39800 40000 42000 43000 43500 45000 46000 47000 50000 51000 52000 53000 54000 55000 56000 58000 60000 61000 62000 63000 64000 65000 65300 65500 67000 70000 71000 75000 76000 78000 80000 86000 87000 90000 93000 98000 100000 105000 106000 110000 113000 115000 118000 120000 125000 126000 130000 132000 135000 135500 140000 142500 145000 150000 151000 152000 160000 168000 170000 175000 176000 180000 183500 190000 200000 210000 230000 240000 247500 250000 253500 280000 300000 320000 350000 363000 383000 400000 425000 450000 460000 470000 500000 543000 550000 600000 700000 720000 750000 780000 800000 900000 1000000 1100000 1140000 1200000 1300000 1340000 1500000 1652000 2000000 2100000 2400000 2500000 3000000 5000000 7000000 22122222 22222222 Sysmiss Public Health Center (Puskesmas) 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. Services satisfaction - State hospital Services satisfaction - State hospital Services satisfaction - State hospital Services satisfaction - State hospital Services satisfaction - State hospital Outpatient’s expenditure in detail for a previous month: services satisfaction a. State hospitalHow many times have you had an ongoing treatment in this last month: 05. Assisted Public Health Center (Puskesmas Pembantu) Ask the respondents about the level of satisfaction according to services provided and enter the relevant code in the box provided. 1233 1 Satisfied 2 Not really satisfied 3 Unsatisfied Frequency (times) - Private hospital Frequency (times) - Private hospital Frequency (times) - Private hospital Frequency (times) - Private hospital Frequency (times) - Private hospital Outpatient’s expenditure in detail for a previous month: frequency (times) 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). 277417 15 15 0.0055 1 2 3 4 5 6 7 8 9 10 11 12 13 15 Sysmiss Source of financing - Private hospital Source of financing - Private hospital Source of financing - Private hospital Source of financing - Private hospital Source of financing - Private hospital Outpatient’s expenditure in detail for a previous month: source of financing b. Private hospital Ask the amount of the total cost for the purpose of outpatient during the past one month 1049 0 1 011 021 1 Household 10 100 112 15 16 17 2 Health insurance/ labor insurance “Askes, Jamsostek, Jasa Raharja” 211 3 Health fund 322 4 Health card/ Lurah’s recommendation letter 421 5 “JPKM” (Social Health Guarantee) 6 Other parties 622 64 65 7 712 722 9 921 Household’s expenses (in rupiah) - Private hospital Household’s expenses (in rupiah) - Private hospital Household’s expenses (in rupiah) - Private hospital Household’s expenses (in rupiah) - Private hospital Household’s expenses (in rupiah) - Private hospital Outpatient’s expenditure in detail for a previous month: household’s expenses (in rupiah) b. Private hospital Ask the total cost of health / paid by household is concerned, either partially or completely, for the purpose of outpatient during the last month. 277344 88 7000000 512.775 Services satisfaction - Private hospital Services satisfaction - Private hospital Services satisfaction - Private hospital Services satisfaction - Private hospital Services satisfaction - Private hospital Outpatient’s expenditure in detail for a previous month: services satisfaction b. Private hospital Ask the respondents about the level of satisfaction according to services provided and enter the relevant code in the box provided. 954 1 Satisfied 2 Not really satisfied 3 Unsatisfied Frequency (times) - Doctor practice Frequency (times) - Doctor practice Frequency (times) - Doctor practice Frequency (times) - Doctor practice Frequency (times) - Doctor practice Outpatient’s expenditure in detail for a previous month: frequency (times) c. Doctor practice Write down in the provided box the frequency of (how many times) the respondent visits health centers for medical treatment (without hospitalization). 277404 28 15 0.0375 1 2 3 4 5 6 7 9 10 11 12 15 Sysmiss Source of financing - Doctor practice Source of financing - Doctor practice Source of financing - Doctor practice Source of financing - Doctor practice Source of financing - Doctor practice Outpatient’s expenditure in detail for a previous month: source of financing c. Doctor practice Ask the amount of the total cost for the purpose of outpatient during the past one month 7583 000 1 Household 10 101 11 115 123 13 15 16 17 2 Health insurance/ labor insurance “Askes, Jamsostek, Jasa Raharja” 20 250 3 Health fund 32 33 4 Health card/ Lurah’s recommendation letter 43 5 “JPKM” (Social Health Guarantee) 500 6 Other parties 63 64 65 67 69 8 9 Household’s expenses (in rupiah) - Doctor practice Household’s expenses (in rupiah) - Doctor practice Household’s expenses (in rupiah) - Doctor practice Household’s expenses (in rupiah) - Doctor practice Household’s expenses (in rupiah) - Doctor practice Outpatient’s expenditure in detail for a previous month: household’s expenses (in rupiah) c. Doctor practice Ask the total cost of health / paid by household is concerned, either partially or completely, for the purpose of outpatient during the last month. 277369 63 3000000 1458.361 Services satisfaction - Doctor practice Services satisfaction - Doctor practice Services satisfaction - Doctor practice Services satisfaction - Doctor practice Services satisfaction - Doctor practice Outpatient’s expenditure in detail for a previous month: services satisfaction c. Doctor practice Ask the respondents about the level of satisfaction according to services provided and enter the relevant code in the box provided. 7516 1 Satisfied 2 Not really satisfied 3 Unsatisfied Frequency (times) - Puskesmas Frequency (times) - Puskesmas Frequency (times) - Puskesmas Frequency (times) - Puskesmas Frequency (times) - Puskesmas Outpatient’s expenditure in detail for a previous month: frequency (times) d. Puskesmas Write down in the provided box the frequency of (how many times) the respondent visits health centers for medical treatment (without hospitalization). 277402 30 15 0.0352 1 2 3 4 5 6 7 8 9 10 11 12 15 Sysmiss Source of financing - Puskesmas Source of financing - Puskesmas Source of financing - Puskesmas Source of financing - Puskesmas Source of financing - Puskesmas Outpatient’s expenditure in detail for a previous month: source of financing d. Puskesmas Ask the amount of the total cost for the purpose of outpatient during the past one month 7016 000 1 Household 10 102 11 12 13 15 16 17 19 2 Health insurance/ labor insurance “Askes, Jamsostek, Jasa Raharja” 20 3 Health fund 32 33 4 Health card/ Lurah’s recommendation letter 46 5 “JPKM” (Social Health Guarantee) 6 Other parties 64 65 68 7 72 8 80 9 Household’s expenses (in rupiah) - Puskesmas Household’s expenses (in rupiah) - Puskesmas Household’s expenses (in rupiah) - Puskesmas Household’s expenses (in rupiah) - Puskesmas Household’s expenses (in rupiah) - Puskesmas Outpatient’s expenditure in detail for a previous month: household’s expenses (in rupiah) d. Puskesmas Ask the total cost of health / paid by household is concerned, either partially or completely, for the purpose of outpatient during the last month. 277367 65 1000000 182.06 Services satisfaction - Puskesmas Services satisfaction - Puskesmas Services satisfaction - Puskesmas Services satisfaction - Puskesmas Services satisfaction - Puskesmas Outpatient’s expenditure in detail for a previous month: services satisfaction d. Puskesmas Ask the respondents about the level of satisfaction according to services provided and enter the relevant code in the box provided. 6953 1 Satisfied 2 Not really satisfied 3 Unsatisfied Frequency (times) - Supporting Puskesmas Frequency (times) - Supporting Puskesmas Frequency (times) - Supporting Puskesmas Frequency (times) - Supporting Puskesmas Frequency (times) - Supporting Puskesmas Outpatient’s expenditure in detail for a previous month: frequency (times) e. Supporting Puskesmas Write down in the provided box the frequency of (how many times) the respondent visits health centers for medical treatment (without hospitalization). 277401 31 15 0.0159 1 2 3 4 5 6 7 8 9 10 12 15 Sysmiss Source of financing - Supporting Puskesmas Source of financing - Supporting Puskesmas Source of financing - Supporting Puskesmas Source of financing - Supporting Puskesmas Source of financing - Supporting Puskesmas Outpatient’s expenditure in detail for a previous month: source of financing e. Supporting Puskesmas Ask the amount of the total cost for the purpose of outpatient during the past one month 3273 1 Household 101 11 12 16 17 2 Health insurance/ labor insurance “Askes, Jamsostek, Jasa Raharja” 3 Health fund 31 32 33 4 Health card/ Lurah’s recommendation letter 5 “JPKM” (Social Health Guarantee) 6 Other parties 64 65 8 9 Household’s expenses (in rupiah) - Supporting Puskesmas Household’s expenses (in rupiah) - Supporting Puskesmas Household’s expenses (in rupiah) - Supporting Puskesmas Household’s expenses (in rupiah) - Supporting Puskesmas Household’s expenses (in rupiah) - Supporting Puskesmas Outpatient’s expenditure in detail for a previous month: household’s expenses (in rupiah) e. Supporting Puskesmas Ask the total cost of health / paid by household is concerned, either partially or completely, for the purpose of outpatient during the last month. 277362 70 570000 78.283 Services satisfaction - Supporting Puskesmas Services satisfaction - Supporting Puskesmas Services satisfaction - Supporting Puskesmas Services satisfaction - Supporting Puskesmas Services satisfaction - Supporting Puskesmas Outpatient’s expenditure in detail for a previous month: services satisfaction e. Supporting Puskesmas Ask the respondents about the level of satisfaction according to services provided and enter the relevant code in the box provided. 3206 1 Satisfied 2 Not really satisfied 3 Unsatisfied Frequency (times) - Polyclinic Frequency (times) - Polyclinic Frequency (times) - Polyclinic Frequency (times) - Polyclinic Frequency (times) - Polyclinic Outpatient’s expenditure in detail for a previous month: frequency (times) f. Polyclinic Write down in the provided box the frequency of (how many times) the respondent visits health centers for medical treatment (without hospitalization). 277401 31 10 0.00535 1 2 3 4 5 6 7 8 10 Sysmiss Source of financing - Polyclinic Source of financing - Polyclinic Source of financing - Polyclinic Source of financing - Polyclinic Source of financing - Polyclinic Outpatient’s expenditure in detail for a previous month: source of financing f. Polyclinic Ask the amount of the total cost for the purpose of outpatient during the past one month 1200 1 Household 16 17 2 Health insurance/ labor insurance “Askes, Jamsostek, Jasa Raharja” 3 Health fund 32 4 Health card/ Lurah’s recommendation letter 5 “JPKM” (Social Health Guarantee) 500 6 Other parties 62 64 7 8 9 Household’s expenses (in rupiah) - Polyclinic Household’s expenses (in rupiah) - Polyclinic Household’s expenses (in rupiah) - Polyclinic Household’s expenses (in rupiah) - Polyclinic Household’s expenses (in rupiah) - Polyclinic Outpatient’s expenditure in detail for a previous month: household’s expenses (in rupiah) f. Polyclinic Ask the total cost of health / paid by household is concerned, either partially or completely, for the purpose of outpatient during the last month. 277360 72 1200000 86.675 Services satisfaction - Polyclinic Services satisfaction - Polyclinic Services satisfaction - Polyclinic Services satisfaction - Polyclinic Services satisfaction - Polyclinic Outpatient’s expenditure in detail for a previous month: services satisfaction f. Polyclinic Ask the respondents about the level of satisfaction according to services provided and enter the relevant code in the box provided. 1127 1 Satisfied 2 Not really satisfied 3 Unsatisfied Frequency (times) - Paramedic practice Frequency (times) - Paramedic practice Frequency (times) - Paramedic practice Frequency (times) - Paramedic practice Frequency (times) - Paramedic practice Outpatient’s expenditure in detail for a previous month: frequency (times) g. Paramedic practice Write down in the provided box the frequency of (how many times) the respondent visits health centers for medical treatment (without hospitalization). 277402 30 15 0.0351 1 2 3 4 5 6 7 8 9 10 12 15 Sysmiss Source of financing - Paramedic practice Source of financing - Paramedic practice Source of financing - Paramedic practice Source of financing - Paramedic practice Source of financing - Paramedic practice Outpatient’s expenditure in detail for a previous month: source of financing g. Paramedic practice Ask the amount of the total cost for the purpose of outpatient during the past one month 7203 000 1 Household 11 16 17 2 Health insurance/ labor insurance “Askes, Jamsostek, Jasa Raharja” 3 Health fund 32 4 Health card/ Lurah’s recommendation letter 5 “JPKM” (Social Health Guarantee) 6 Other parties 63 64 65 8 81 9 Household’s expenses (in rupiah) - Paramedic practice Household’s expenses (in rupiah) - Paramedic practice Household’s expenses (in rupiah) - Paramedic practice Household’s expenses (in rupiah) - Paramedic practice Household’s expenses (in rupiah) - Paramedic practice Outpatient’s expenditure in detail for a previous month: household’s expenses (in rupiah) g. Paramedic practice Ask the total cost of health / paid by household is concerned, either partially or completely, for the purpose of outpatient during the last month. 277365 67 1500000 470.45 Services satisfaction - Paramedic practice Services satisfaction - Paramedic practice Services satisfaction - Paramedic practice Services satisfaction - Paramedic practice Services satisfaction - Paramedic practice Outpatient’s expenditure in detail for a previous month: services satisfaction g. Paramedic practice Ask the respondents about the level of satisfaction according to services provided and enter the relevant code in the box provided. 7134 1 Satisfied 2 Not really satisfied 3 Unsatisfied Frequency (times) - Traditional healing practice Frequency (times) - Traditional healing practice Frequency (times) - Traditional healing practice Frequency (times) - Traditional healing practice Frequency (times) - Traditional healing practice Outpatient’s expenditure in detail for a previous month: frequency (times) h. Traditional healing practice Write down in the provided box the frequency of (how many times) the respondent visits health centers for medical treatment (without hospitalization). 277400 32 15 0.00557 1 2 3 4 5 6 7 8 10 11 12 13 14 15 Sysmiss Source of financing - Traditional healing practice Source of financing - Traditional healing practice Source of financing - Traditional healing practice Source of financing - Traditional healing practice Source of financing - Traditional healing practice Outpatient’s expenditure in detail for a previous month: source of financing h. Traditional healing practice Ask the amount of the total cost for the purpose of outpatient during the past one month 832 1 Household 10 13 15 16 2 Health insurance/ labor insurance “Askes, Jamsostek, Jasa Raharja” 3 Health fund 4 Health card/ Lurah’s recommendation letter 5 “JPKM” (Social Health Guarantee) 6 Other parties 64 65 8 Household’s expenses (in rupiah) - Traditional healing practice Household’s expenses (in rupiah) - Traditional healing practice Household’s expenses (in rupiah) - Traditional healing practice Household’s expenses (in rupiah) - Traditional healing practice Household’s expenses (in rupiah) - Traditional healing practice Outpatient’s expenditure in detail for a previous month: household’s expenses (in rupiah) h. Traditional healing practice Ask the total cost of health / paid by household is concerned, either partially or completely, for the purpose of outpatient during the last month. 277363 69 5000000 136.223 Services satisfaction - Traditional healing practice Services satisfaction - Traditional healing practice Services satisfaction - Traditional healing practice Services satisfaction - Traditional healing practice Services satisfaction - Traditional healing practice Outpatient’s expenditure in detail for a previous month: services satisfaction h. Traditional healing practice Ask the respondents about the level of satisfaction according to services provided and enter the relevant code in the box provided. 763 1 Satisfied 2 Not really satisfied 3 Unsatisfied Frequency (times) - “Polindes” (Village Maternity Post) Frequency (times) - “Polindes” (Village Maternity Post) Frequency (times) - “Polindes” (Village Maternity Post) Frequency (times) - “Polindes” (Village Maternity Post) Frequency (times) - “Polindes” (Village Maternity Post) Outpatient’s expenditure in detail for a previous month: frequency (times) i. “Polindes” (Village Maternity Post) Write down in the provided box the frequency of (how many times) the respondent visits health centers for medical treatment (without hospitalization). 277400 32 11 0.00521 1 2 3 4 5 6 8 10 11 Sysmiss Source of financing - “Polindes” (Village Maternity Post) Source of financing - “Polindes” (Village Maternity Post) Source of financing - “Polindes” (Village Maternity Post) Source of financing - “Polindes” (Village Maternity Post) Source of financing - “Polindes” (Village Maternity Post) Outpatient’s expenditure in detail for a previous month: source of financing i. “Polindes” (Village Maternity Post) Ask the amount of the total cost for the purpose of outpatient during the past one month 1080 1 Household 10 16 17 2 Health insurance/ labor insurance “Askes, Jamsostek, Jasa Raharja” 3 Health fund 32 33 4 Health card/ Lurah’s recommendation letter 5 “JPKM” (Social Health Guarantee) 6 Other parties 64 65 8 Household’s expenses (in rupiah) - “Polindes” (Village Maternity Post) Household’s expenses (in rupiah) - “Polindes” (Village Maternity Post) Household’s expenses (in rupiah) - “Polindes” (Village Maternity Post) Household’s expenses (in rupiah) - “Polindes” (Village Maternity Post) Household’s expenses (in rupiah) - “Polindes” (Village Maternity Post) Outpatient’s expenditure in detail for a previous month: household’s expenses (in rupiah) i. “Polindes” (Village Maternity Post) Ask the total cost of health / paid by household is concerned, either partially or completely, for the purpose of outpatient during the last month. 277362 70 100000 29.069 Services satisfaction - “Polindes” (Village Maternity Post) Services satisfaction - “Polindes” (Village Maternity Post) Services satisfaction - “Polindes” (Village Maternity Post) Services satisfaction - “Polindes” (Village Maternity Post) Services satisfaction - “Polindes” (Village Maternity Post) Outpatient’s expenditure in detail for a previous month: services satisfaction i. “Polindes” (Village Maternity Post) Ask the respondents about the level of satisfaction according to services provided and enter the relevant code in the box provided. 1011 1 Satisfied 2 Not really satisfied 3 Unsatisfied Frequency (times) - “Posyandu” (Integrated Service Post) Frequency (times) - “Posyandu” (Integrated Service Post) Frequency (times) - “Posyandu” (Integrated Service Post) Frequency (times) - “Posyandu” (Integrated Service Post) Frequency (times) - “Posyandu” (Integrated Service Post) Outpatient’s expenditure in detail for a previous month: frequency (times) j. “Posyandu” (Integrated Service Post) Write down in the provided box the frequency of (how many times) the respondent visits health centers for medical treatment (without hospitalization). 277403 29 5 0.00149 1 2 3 4 5 Sysmiss Source of financing - “Posyandu” (Integrated Service Post) Source of financing - “Posyandu” (Integrated Service Post) Source of financing - “Posyandu” (Integrated Service Post) Source of financing - “Posyandu” (Integrated Service Post) Source of financing - “Posyandu” (Integrated Service Post) Outpatient’s expenditure in detail for a previous month: source of financing j. “Posyandu” (Integrated Service Post) Ask the amount of the total cost for the purpose of outpatient during the past one month 425 000 1 Household 16 17 2 Health insurance/ labor insurance “Askes, Jamsostek, Jasa Raharja” 3 Health fund 32 33 4 Health card/ Lurah’s recommendation letter 5 “JPKM” (Social Health Guarantee) 6 Other parties 64 8 9 Household’s expenses (in rupiah) - “Posyandu” (Integrated Service Post) Household’s expenses (in rupiah) - “Posyandu” (Integrated Service Post) Household’s expenses (in rupiah) - “Posyandu” (Integrated Service Post) Household’s expenses (in rupiah) - “Posyandu” (Integrated Service Post) Household’s expenses (in rupiah) - “Posyandu” (Integrated Service Post) Outpatient’s expenditure in detail for a previous month: household’s expenses (in rupiah) j. “Posyandu” (Integrated Service Post) Ask the total cost of health / paid by household is concerned, either partially or completely, for the purpose of outpatient during the last month. 277363 69 45000 2.84 Services satisfaction - “Posyandu” (Integrated Service Post) Services satisfaction - “Posyandu” (Integrated Service Post) Services satisfaction - “Posyandu” (Integrated Service Post) Services satisfaction - “Posyandu” (Integrated Service Post) Services satisfaction - “Posyandu” (Integrated Service Post) Outpatient’s expenditure in detail for a previous month: services satisfaction j. “Posyandu” (Integrated Service Post) Ask the respondents about the level of satisfaction according to services provided and enter the relevant code in the box provided. 353 1 Satisfied 2 Not really satisfied 3 Unsatisfied Have ever been/ are being treated in a previous year? Have ever been/ are being treated in a previous year? Have ever been/ are being treated in a previous year? Have ever been/ are being treated in a previous year? Have ever been/ are being treated in a previous year? If b5r26 = 2 and b5r27 = 2 Have ever been/ are being treated in a previous year? If the answer is coded 2 skip to b5r26. For household member age 10 years up 277401 1 Yes 2 No Treatment days - State hospital Treatment days - State hospital Treatment days - State hospital Treatment days - State hospital Treatment days - State hospital The detailed of being treated in a previous year: treatment 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. 277402 30 210 0.0333 Private Hospital is a private owned hospital such as RS St. Carolus, RS Medistra. Source of financing - State hospital Source of financing - State hospital Source of financing - State hospital Source of financing - State hospital Source of financing - State hospital The detailed of being treated in a previous year: source of financing a. State hospital Ask the amount of the total cost for the purposes of inpatient (hospitalization) during the last 12 months. 1213 001 1 Household 10 Health insurance and Health fund 11 Household, Health insurance and Health fund 12 Other insurance and Health fund 13 Household, Other insurance and Health fund 14 Health insurance, Other insurance and Health fund 15 Household, Health insurance, Other insurance and Health fund 16 Health card / Lurah’s recommendation letter 17 Household and Health card 18 Health insurance and Health card 19 Household, Health insurance and Health card 2 Health insurance / labor insurance “Askes, Jamsostek, Jasa Raharja” 20 Other insurance and Health card 21 Household, Other insurance and Health card 22 Health insurance, Other insurance and Health card 23 Household, Health insurance, Other insurance and Health card 24 Health fund and Health card 25 Household, Health fund and Health card 26 Health insurance, Health fund and Health card 27 Household, Health insurance, Health fund and Health card 28 Other insurance, Health fund and Health card 29 Household, Other insurance, Health fund and Health card 3 Household and Health insurance 30 Health insurance, Other insurance, Health fund and Health card 31 Household, Health insurance, Other insurance, Health fund and Health card 32 “JPKM” (Social Health Guarantee) 33 4 Other insurance / company / office 5 Household and Other insurance 6 Health insurance and Other insurance 62 63 64 Other parties 65 66 67 69 7 Household, Health insurance and Other insurance 70 8 Health fund 81 9 Household and Health fund Public Health Center (Puskesmas) 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. Household’s expenses (in rupiah) - State hospital Household’s expenses (in rupiah) - State hospital Household’s expenses (in rupiah) - State hospital Household’s expenses (in rupiah) - State hospital Household’s expenses (in rupiah) - State hospital The detailed of being treated in a previous year: household’s expenses (in rupiah) 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. 277364 68 27500000 3997.606 250 500 1300 2500 5000 7000 10000 12000 12500 15000 18750 20000 25000 30000 32000 32500 34000 40000 45000 47000 50000 51000 55000 56000 60000 62000 64000 65000 67000 70000 72800 73000 75000 78000 80000 85000 87000 87500 88000 90000 95000 96000 99000 100000 107500 109000 110000 113000 115000 120000 123000 125000 130000 131100 132000 135000 140000 145000 150000 154000 156000 160000 165000 170000 175000 180000 181000 188000 190000 200000 204000 204500 205000 220000 225000 225600 230000 236000 240000 243000 250000 252000 255000 260000 265000 270000 272000 275000 285000 288000 295000 297000 300000 305000 308000 315000 320000 323000 325000 326000 331000 340000 342500 350000 360000 367000 370000 372000 375000 380000 385200 395000 400000 419000 425000 430000 440000 443000 450000 460000 464000 469000 470000 475000 476000 480000 482400 499000 500000 504000 511000 520000 547000 550000 552200 560000 580000 588000 600000 605000 620000 625000 626500 630000 635000 650000 660000 675000 684000 700000 720000 723000 735000 740000 750000 768000 775000 800000 846000 850000 869000 900000 920000 932000 950000 980000 985000 1000000 1000200 1020000 1045000 1050000 1095000 1100000 1110000 1126000 1150000 1170000 1195000 1200000 1230000 1250000 1275000 1300000 1330000 1336000 1350000 1400000 1437000 1450000 1500000 1515000 1560000 1575000 1650000 1700000 1750000 1780000 1800000 1870750 1900000 1910000 1954000 1985000 2000000 2100000 2134000 2150000 2200000 2250000 2300000 2400000 2500000 2800000 2870000 3000000 3200000 3300000 3400000 3500000 3600000 3800000 3880000 4000000 4200000 4250000 4300000 4500000 4750000 5000000 5060000 5200000 5250000 5300000 5350000 6000000 6600000 7000000 7750000 8000000 8100000 8700000 9000000 11000000 13000000 15000000 20000000 25000000 27500000 Sysmiss Services satisfaction - State hospital Services satisfaction - State hospital Services satisfaction - State hospital Services satisfaction - State hospital Services satisfaction - State hospital The detailed of being treated in a previous year: services satisfaction a. State hospital 1115 1 Satisfied 2 Not really satisfied 3 Unsatisfied Treatment days - Private hospital Treatment days - Private hospital Treatment days - Private hospital Treatment days - Private hospital Treatment days - Private hospital The detailed of being treated in a previous year: treatment 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. 277401 31 74 0.0242 Source of financing - Private hospital Source of financing - Private hospital Source of financing - Private hospital Source of financing - Private hospital Source of financing - Private hospital The detailed of being treated in a previous year: source of financing b. Private hospital Ask the amount of the total cost for the purposes of inpatient (hospitalization) during the last 12 months. 1086 1 Household 10 Health insurance and Health fund 11 Household, Health insurance and Health fund 12 Other insurance and Health fund 13 Household, Other insurance and Health fund 14 Health insurance, Other insurance and Health fund 15 Household, Health insurance, Other insurance and Health fund 16 Health card / Lurah’s recommendation letter 17 Household and Health card 18 Health insurance and Health card 19 Household, Health insurance and Health card 2 Health insurance / labor insurance “Askes, Jamsostek, Jasa Raharja” 20 Other insurance and Health card 21 Household, Other insurance and Health card 22 Health insurance, Other insurance and Health card 23 Household, Health insurance, Other insurance and Health card 24 Health fund and Health card 25 Household, Health fund and Health card 26 Health insurance, Health fund and Health card 27 Household, Health insurance, Health fund and Health card 28 Other insurance, Health fund and Health card 29 Household, Other insurance, Health fund and Health card 3 Household and Health insurance 30 Health insurance, Other insurance, Health fund and Health card 31 Household, Health insurance, Other insurance, Health fund and Health card 32 “JPKM” (Social Health Guarantee) 33 Other parties 4 Other insurance / company / office 5 Household and Other insurance 53 6 Health insurance and Other insurance 64 65 67 7 Household, Health insurance and Other insurance 8 Health fund 81 9 Household and Health fund Household’s expenses (in rupiah) - Private hospital Household’s expenses (in rupiah) - Private hospital Household’s expenses (in rupiah) - Private hospital Household’s expenses (in rupiah) - Private hospital Household’s expenses (in rupiah) - Private hospital The detailed of being treated in a previous year: household’s expenses (in rupiah) b. Private hospital 277364 68 45000000 5223.747 Services satisfaction - Private hospital Services satisfaction - Private hospital Services satisfaction - Private hospital Services satisfaction - Private hospital Services satisfaction - Private hospital The detailed of being treated in a previous year: services satisfaction b. Private hospital 987 1 Satisfied 2 Not really satisfied 3 Unsatisfied Treatment days - Puskesmas Treatment days - Puskesmas Treatment days - Puskesmas Treatment days - Puskesmas Treatment days - Puskesmas The detailed of being treated in a previous year: treatment days c. Puskesmas 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. 277430 2 15 0.00329 1 2 3 4 5 6 7 8 9 10 12 14 15 Sysmiss Source of financing - Puskesmas Source of financing - Puskesmas Source of financing - Puskesmas Source of financing - Puskesmas Source of financing - Puskesmas The detailed of being treated in a previous year: source of financing c. Puskesmas Ask the amount of the total cost for the purposes of inpatient (hospitalization) during the last 12 months. 414 1 Household 10 Health insurance and Health fund 11 Household, Health insurance and Health fund 12 Other insurance and Health fund 13 Household, Other insurance and Health fund 14 Health insurance, Other insurance and Health fund 15 Household, Health insurance, Other insurance and Health fund 16 Health card / Lurah’s recommendation letter 17 Household and Health card 18 Health insurance and Health card 19 Household, Health insurance and Health card 2 Health insurance / labor insurance “Askes, Jamsostek, Jasa Raharja” 20 Other insurance and Health card 21 Household, Other insurance and Health card 22 Health insurance, Other insurance and Health card 23 Household, Health insurance, Other insurance and Health card 24 Health fund and Health card 25 Household, Health fund and Health card 26 Health insurance, Health fund and Health card 27 Household, Health insurance, Health fund and Health card 28 Other insurance, Health fund and Health card 29 Household, Other insurance, Health fund and Health card 3 Household and Health insurance 30 Health insurance, Other insurance, Health fund and Health card 31 Household, Health insurance, Other insurance, Health fund and Health card 32 “JPKM” (Social Health Guarantee) 33 Other parties 4 Other insurance / company / office 5 Household and Other insurance 6 Health insurance and Other insurance 64 65 7 Household, Health insurance and Other insurance 8 Health fund 9 Household and Health fund Household’s expenses (in rupiah) - Puskesmas Household’s expenses (in rupiah) - Puskesmas Household’s expenses (in rupiah) - Puskesmas Household’s expenses (in rupiah) - Puskesmas Household’s expenses (in rupiah) - Puskesmas The detailed of being treated in a previous year: household’s expenses (in rupiah) c. Puskesmas 277364 68 4500000 168.48 Services satisfaction - Puskesmas Services satisfaction - Puskesmas Services satisfaction - Puskesmas Services satisfaction - Puskesmas Services satisfaction - Puskesmas The detailed of being treated in a previous year: services satisfaction c. Puskesmas 315 1 Satisfied 2 Not really satisfied 3 Unsatisfied Treatment days - Maternity hospital/ midwives practice Treatment days - Maternity hospital/ midwives practice Treatment days - Maternity hospital/ midwives practice Treatment days - Maternity hospital/ midwives practice Treatment days - Maternity hospital/ midwives practice The detailed of being treated in a previous year: treatment days d. Maternity hospital/ midwives 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. 277399 33 18 0.00366 1 2 3 4 5 6 7 8 10 16 18 Sysmiss Source of financing - Maternity hospital/ midwives practice Source of financing - Maternity hospital/ midwives practice Source of financing - Maternity hospital/ midwives practice Source of financing - Maternity hospital/ midwives practice Source of financing - Maternity hospital/ midwives practice The detailed of being treated in a previous year: source of financing d. Maternity hospital/ midwives practice Ask the amount of the total cost for the purposes of inpatient (hospitalization) during the last 12 months. 498 1 Household 10 Health insurance and Health fund 11 Household, Health insurance and Health fund 12 Other insurance and Health fund 13 Household, Other insurance and Health fund 14 Health insurance, Other insurance and Health fund 15 Household, Health insurance, Other insurance and Health fund 16 Health card / Lurah’s recommendation letter 17 Household and Health card 18 Health insurance and Health card 19 Household, Health insurance and Health card 2 Health insurance / labor insurance “Askes, Jamsostek, Jasa Raharja” 20 Other insurance and Health card 21 Household, Other insurance and Health card 22 Health insurance, Other insurance and Health card 23 Household, Health insurance, Other insurance and Health card 24 Health fund and Health card 25 Household, Health fund and Health card 26 Health insurance, Health fund and Health card 27 Household, Health insurance, Health fund and Health card 28 Other insurance, Health fund and Health card 29 Household, Other insurance, Health fund and Health card 3 Household and Health insurance 30 Health insurance, Other insurance, Health fund and Health card 31 Household, Health insurance, Other insurance, Health fund and Health card 32 “JPKM” (Social Health Guarantee) 33 Other parties 4 Other insurance / company / office 5 Household and Other insurance 6 Health insurance and Other insurance 64 65 69 7 Household, Health insurance and Other insurance 8 Health fund 9 Household and Health fund Household’s expenses (in rupiah) - Maternity hospital/ midwives practice Household’s expenses (in rupiah) - Maternity hospital/ midwives practice Household’s expenses (in rupiah) - Maternity hospital/ midwives practice Household’s expenses (in rupiah) - Maternity hospital/ midwives practice Household’s expenses (in rupiah) - Maternity hospital/ midwives practice The detailed of being treated in a previous year: household’s expenses (in rupiah) d. Maternity hospital/ midwives practice 277363 69 3400000 434.524 Services satisfaction - Maternity hospital/ midwives practice Services satisfaction - Maternity hospital/ midwives practice Services satisfaction - Maternity hospital/ midwives practice Services satisfaction - Maternity hospital/ midwives practice Services satisfaction - Maternity hospital/ midwives practice The detailed of being treated in a previous year: services satisfaction d. Maternity hospital/ midwives practice 397 1 Satisfied 2 Not really satisfied 3 Unsatisfied Treatment days - “Polindes” (Village Maternity Post) Treatment days - “Polindes” (Village Maternity Post) Treatment days - “Polindes” (Village Maternity Post) Treatment days - “Polindes” (Village Maternity Post) Treatment days - “Polindes” (Village Maternity Post) The detailed of being treated in a previous year: treatment days e. “Polindes” (Village Maternity Post) 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. 277401 31 20 0.000447 1 2 3 4 6 15 20 Sysmiss Source of financing - “Polindes” (Village Maternity Post) Source of financing - “Polindes” (Village Maternity Post) Source of financing - “Polindes” (Village Maternity Post) Source of financing - “Polindes” (Village Maternity Post) Source of financing - “Polindes” (Village Maternity Post) The detailed of being treated in a previous year: source of financing e. “Polindes” (Village Maternity Post) Ask the amount of the total cost for the purposes of inpatient (hospitalization) during the last 12 months. 150 1 Household 10 Health insurance and Health fund 11 Household, Health insurance and Health fund 12 Other insurance and Health fund 13 Household, Other insurance and Health fund 14 Health insurance, Other insurance and Health fund 15 Household, Health insurance, Other insurance and Health fund 16 Health card / Lurah’s recommendation letter 17 Household and Health card 18 Health insurance and Health card 19 Household, Health insurance and Health card 2 Health insurance / labor insurance “Askes, Jamsostek, Jasa Raharja” 20 Other insurance and Health card 21 Household, Other insurance and Health card 22 Health insurance, Other insurance and Health card 23 Household, Health insurance, Other insurance and Health card 24 Health fund and Health card 25 Household, Health fund and Health card 26 Health insurance, Health fund and Health card 27 Household, Health insurance, Health fund and Health card 28 Other insurance, Health fund and Health card 29 Household, Other insurance, Health fund and Health card 3 Household and Health insurance 30 Health insurance, Other insurance, Health fund and Health card 31 Household, Health insurance, Other insurance, Health fund and Health card 32 “JPKM” (Social Health Guarantee) 33 Other parties 4 Other insurance / company / office 5 Household and Other insurance 6 Health insurance and Other insurance 7 Household, Health insurance and Other insurance 8 Health fund 9 Household and Health fund Household’s expenses (in rupiah) - “Polindes” (Village Maternity Post) Household’s expenses (in rupiah) - “Polindes” (Village Maternity Post) Household’s expenses (in rupiah) - “Polindes” (Village Maternity Post) Household’s expenses (in rupiah) - “Polindes” (Village Maternity Post) Household’s expenses (in rupiah) - “Polindes” (Village Maternity Post) The detailed of being treated in a previous year: household’s expenses (in rupiah) e. “Polindes” (Village Maternity Post) 277364 68 200000 9.839 Services satisfaction - “Polindes” (Village Maternity Post) Services satisfaction - “Polindes” (Village Maternity Post) Services satisfaction - “Polindes” (Village Maternity Post) Services satisfaction - “Polindes” (Village Maternity Post) Services satisfaction - “Polindes” (Village Maternity Post) The detailed of being treated in a previous year: services satisfaction e. “Polindes” (Village Maternity Post) 50 1 Satisfied 2 Not really satisfied 3 Unsatisfied Treatment days - Traditional treatment Treatment days - Traditional treatment Treatment days - Traditional treatment Treatment days - Traditional treatment Treatment days - Traditional treatment The detailed of being treated in a previous year: treatment days f. 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. 277401 31 120 0.00218 1 2 3 4 5 6 7 12 15 30 65 80 120 Sysmiss Source of financing - Traditional treatment Source of financing - Traditional treatment Source of financing - Traditional treatment Source of financing - Traditional treatment Source of financing - Traditional treatment The detailed of being treated in a previous year: source of financing f. Traditional treatment Ask the amount of the total cost for the purposes of inpatient (hospitalization) during the last 12 months. 134 1 Household 10 Health insurance and Health fund 11 Household, Health insurance and Health fund 12 Other insurance and Health fund 13 Household, Other insurance and Health fund 14 Health insurance, Other insurance and Health fund 15 Household, Health insurance, Other insurance and Health fund 16 Health card / Lurah’s recommendation letter 17 Household and Health card 18 Health insurance and Health card 19 Household, Health insurance and Health card 2 Health insurance / labor insurance “Askes, Jamsostek, Jasa Raharja” 20 Other insurance and Health card 21 Household, Other insurance and Health card 22 Health insurance, Other insurance and Health card 23 Household, Health insurance, Other insurance and Health card 24 Health fund and Health card 25 Household, Health fund and Health card 26 Health insurance, Health fund and Health card 27 Household, Health insurance, Health fund and Health card 28 Other insurance, Health fund and Health card 29 Household, Other insurance, Health fund and Health card 3 Household and Health insurance 30 Health insurance, Other insurance, Health fund and Health card 31 Household, Health insurance, Other insurance, Health fund and Health card 32 “JPKM” (Social Health Guarantee) 33 Other parties 4 Other insurance / company / office 5 Household and Other insurance 6 Health insurance and Other insurance 65 7 Household, Health insurance and Other insurance 8 Health fund 9 Household and Health fund Household’s expenses (in rupiah) - Traditional treatment Household’s expenses (in rupiah) - Traditional treatment Household’s expenses (in rupiah) - Traditional treatment Household’s expenses (in rupiah) - Traditional treatment Household’s expenses (in rupiah) - Traditional treatment The detailed of being treated in a previous year: household’s expenses (in rupiah) f. Traditional treatment 277367 65 3500000 82.578 Services satisfaction - Traditional treatment Services satisfaction - Traditional treatment Services satisfaction - Traditional treatment Services satisfaction - Traditional treatment Services satisfaction - Traditional treatment The detailed of being treated in a previous year: services satisfaction f. Traditional treatment 37 1 Satisfied 2 Not really satisfied 3 Unsatisfied Treatment days - Others Treatment days - Others Treatment days - Others Treatment days - Others Treatment days - Others The detailed of being treated in a previous year: treatment days g. Others 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. 277401 31 -122 56 0.000988 Source of financing - Others Source of financing - Others Source of financing - Others Source of financing - Others Source of financing - Others The detailed of being treated in a previous year: source of financing g. Others Ask the amount of the total cost for the purposes of inpatient (hospitalization) during the last 12 months. 160 1 Household 10 Health insurance and Health fund 11 Household, Health insurance and Health fund 12 Other insurance and Health fund 121 13 Household, Other insurance and Health fund 14 Health insurance, Other insurance and Health fund 15 Household, Health insurance, Other insurance and Health fund 16 Health card / Lurah’s recommendation letter 17 Household and Health card 18 Health insurance and Health card 19 Household, Health insurance and Health card 2 Health insurance / labor insurance “Askes, Jamsostek, Jasa Raharja” 20 Other insurance and Health card 21 Household, Other insurance and Health card 22 Health insurance, Other insurance and Health card 23 Household, Health insurance, Other insurance and Health card 24 Health fund and Health card 25 Household, Health fund and Health card 26 Health insurance, Health fund and Health card 27 Household, Health insurance, Health fund and Health card 28 Other insurance, Health fund and Health card 29 Household, Other insurance, Health fund and Health card 3 Household and Health insurance 30 Health insurance, Other insurance, Health fund and Health card 31 Household, Health insurance, Other insurance, Health fund and Health card 32 “JPKM” (Social Health Guarantee) 33 Other parties 4 Other insurance / company / office 5 Household and Other insurance 6 Health insurance and Other insurance 64 7 Household, Health insurance and Other insurance 8 Health fund 81 9 Household and Health fund Household’s expenses (in rupiah) - Others Household’s expenses (in rupiah) - Others Household’s expenses (in rupiah) - Others Household’s expenses (in rupiah) - Others Household’s expenses (in rupiah) - Others The detailed of being treated in a previous year: household’s expenses (in rupiah) g. Others 277371 61 3500000 66.081 Services satisfaction - Others Services satisfaction - Others Services satisfaction - Others Services satisfaction - Others Services satisfaction - Others The detailed of being treated in a previous year: services satisfactiong. Others 66 1 Satisfied 2 Not really satisfied 3 Unsatisfied Financing assurance/health insurance for outpatient/treatment - Askes (Healt insurance) Financing assurance/health insurance for outpatient/treatment - Askes (Healt insurance) Financing assurance/health insurance for outpatient/treatment - Askes (Healt insurance) Financing assurance/health insurance for outpatient/treatment - Askes (Healt insurance) Financing assurance/health insurance for outpatient/treatment - Askes (Healt insurance) Is there a financing assurance/ health insurance for outpatient/treatment below? a. Askes (Healt insurance) 277401 1 2 6 Financing assurance/health insurance for outpatient/treatment - Astek/Jamsostek (Labor insurance) Financing assurance/health insurance for outpatient/treatment - Astek/Jamsostek (Labor insurance) Financing assurance/health insurance for outpatient/treatment - Astek/Jamsostek (Labor insurance) Financing assurance/health insurance for outpatient/treatment - Astek/Jamsostek (Labor insurance) Financing assurance/health insurance for outpatient/treatment - Astek/Jamsostek (Labor insurance) Is there a financing assurance/ health insurance for outpatient/treatment below? b. Astek/Jamsostek (Labor insurance) 277340 1 2 Financing assurance/health insurance for outpatient/treatment - Company/ office Financing assurance/health insurance for outpatient/treatment - Company/ office Financing assurance/health insurance for outpatient/treatment - Company/ office Financing assurance/health insurance for outpatient/treatment - Company/ office Financing assurance/health insurance for outpatient/treatment - Company/ office Is there a financing assurance/ health insurance for outpatient/treatment below? c. Company/ office 277402 1 2 Financing assurance/health insurance for outpatient/treatment - Other insurance Financing assurance/health insurance for outpatient/treatment - Other insurance Financing assurance/health insurance for outpatient/treatment - Other insurance Financing assurance/health insurance for outpatient/treatment - Other insurance Financing assurance/health insurance for outpatient/treatment - Other insurance Is there a financing assurance/ health insurance for outpatient/treatment below? d. Other insurance 277432 1 2 Financing assurance/health insurance for outpatient/treatment - Health fund Financing assurance/health insurance for outpatient/treatment - Health fund Financing assurance/health insurance for outpatient/treatment - Health fund Financing assurance/health insurance for outpatient/treatment - Health fund Financing assurance/health insurance for outpatient/treatment - Health fund Is there a financing assurance/ health insurance for outpatient/treatment below? e. Health fund 277402 1 2 Financing assurance/health insurance for outpatient/treatment - Health card Financing assurance/health insurance for outpatient/treatment - Health card Financing assurance/health insurance for outpatient/treatment - Health card Financing assurance/health insurance for outpatient/treatment - Health card Financing assurance/health insurance for outpatient/treatment - Health card Is there a financing assurance/ health insurance for outpatient/treatment below? f. Health card 277400 1 2 Financing assurance/health insurance for outpatient/treatment - JKPM Financing assurance/health insurance for outpatient/treatment - JKPM Financing assurance/health insurance for outpatient/treatment - JKPM Financing assurance/health insurance for outpatient/treatment - JKPM Financing assurance/health insurance for outpatient/treatment - JKPM Is there a financing assurance/ health insurance for outpatient/treatment below? g. JKPM 277401 1 2 ¶ Frequency of visits - State hospital Frequency of visits - State hospital Frequency of visits - State hospital Frequency of visits - State hospital Frequency of visits - State hospital Frequency of health consultation/ check up, pregnancy check up, healthy baby check up in a previous month? 1. State hospital 277432 8 0.00718 1 2 3 4 5 8 Frequency of visits - Private hospital Frequency of visits - Private hospital Frequency of visits - Private hospital Frequency of visits - Private hospital Frequency of visits - Private hospital Frequency of health consultation/ check up, pregnancy check up, healthy baby check up in a previous month? 2. Private hospital 277401 31 5 0.00652 1 2 3 4 5 Sysmiss Frequency of visits - Doctor practice Frequency of visits - Doctor practice Frequency of visits - Doctor practice Frequency of visits - Doctor practice Frequency of visits - Doctor practice Frequency of health consultation/ check up, pregnancy check up, healthy baby check up in a previous month? 3. Doctor practice 277401 31 6 0.0092 1 2 3 4 5 6 Sysmiss Frequency of visits - Puskesmas/Supporting Puskesmas Frequency of visits - Puskesmas/Supporting Puskesmas Frequency of visits - Puskesmas/Supporting Puskesmas Frequency of visits - Puskesmas/Supporting Puskesmas Frequency of visits - Puskesmas/Supporting Puskesmas Frequency of health consultation/ check up, pregnancy check up, healthy baby check up in a previous month? 4. Puskesmas/Supporting Puskesmas 277401 31 8 0.0117 1 2 3 4 5 8 Sysmiss Frequency of visits - Policlinic/ Laboratory Frequency of visits - Policlinic/ Laboratory Frequency of visits - Policlinic/ Laboratory Frequency of visits - Policlinic/ Laboratory Frequency of visits - Policlinic/ Laboratory Frequency of health consultation/ check up, pregnancy check up, healthy baby check up in a previous month? 5. Policlinic/ Laboratory 277401 31 8 0.00606 1 2 3 4 6 8 Sysmiss Frequency of visits - Paramedic practice Frequency of visits - Paramedic practice Frequency of visits - Paramedic practice Frequency of visits - Paramedic practice Frequency of visits - Paramedic practice Frequency of health consultation/ check up, pregnancy check up, healthy baby check up in a previous month? 6. Paramedic practice 277401 31 8 0.00744 1 2 3 4 5 6 7 8 Sysmiss Frequency of visits - “Batra” practice Frequency of visits - “Batra” practice Frequency of visits - “Batra” practice Frequency of visits - “Batra” practice Frequency of visits - “Batra” practice Frequency of health consultation/ check up, pregnancy check up, healthy baby check up in a previous month? 7. “Batra” practice 277399 33 4 0.00519 1 2 3 4 Sysmiss Frequency of visits - “Polindes”/”Posyandu” Frequency of visits - “Polindes”/”Posyandu” Frequency of visits - “Polindes”/”Posyandu” Frequency of visits - “Polindes”/”Posyandu” Frequency of visits - “Polindes”/”Posyandu” Frequency of health consultation/ check up, pregnancy check up, healthy baby check up in a previous month? 8. “Polindes”/”Posyandu” 277399 33 8 0.0147 1 2 3 4 6 7 8 Sysmiss How much the consultation cost being expended by household: (Rp) How much the consultation cost being expended by household: (Rp) How much the consultation cost being expended by household: (Rp) How much the consultation cost being expended by household: (Rp) How much the consultation cost being expended by household: (Rp) If one of b5r27a1 up to 8 not equal to 0 How much the consultation cost being expended by household: (Rp) 277431 1 3000000 437.148 Age: (month) Age: (month) Age: (month) Age: (month) Age: (month) Age: (month) 277400 32 59 2.787 Who did assist the birth process - first Who did assist the birth process - first Who did assist the birth process - first Who did assist the birth process - first Who did assist the birth process - first Who did assist the birth process? (a.first)EverWho did assist the birth process? (a.first) 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 27134 1 Doctor 2 Midwives 3 Other paramedics 4 Traditional healer 5 Relatives/ family 6 Other 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. Who did assist the birth process - last Who did assist the birth process - last Who did assist the birth process - last Who did assist the birth process - last Who did assist the birth process - last If “yes” [b5r16a = 1] Who did assist the birth process? (b.Last)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 27191 1 Doctor 2 Midwives 3 Other paramedics 4 Traditional healer 5 Relatives/ family 6 Other 7 8 Had he/she been took to the “Posyandu” during a previous year? Had he/she been took to the “Posyandu” during a previous year? Had he/she been took to the “Posyandu” during a previous year? Had he/she been took to the “Posyandu” during a previous year? Had he/she been took to the “Posyandu” during a previous year? Had he/she been took to the “Posyandu” during a previous year? 27136 1 Yes, less than 1 month ago 2 Yes, between 1-2 months ago 3 Yes, more than 2 months ago 4 No 5 The last visit services: The last visit services: The last visit services: The last visit services: The last visit services: The last visit services: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 19179 1 Weighting 10 11 12 13 14 15 16 17 18 19 2 Immunization 20 21 22 23 24 25 26 27 28 29 3 PMT/Vitamin/”Oralit” 30 31 4 Curing 5 Consultation 51 54 6 No service 7 8 9 Had been given mother's milk ("ASI")? Had been given mother's milk ("ASI")? Had been given mother's milk ("ASI")? Had been given mother's milk ("ASI")? Had been given mother's milk ("ASI")? Had been given mother's milk ("ASI")? If the answer is coded 2 skip to other household members 27134 1 Yes 2 No 3 5 7 Duration: (month) Duration: (month) Duration: (month) Duration: (month) Duration: (month) If b5r32a = 1 Duration: (month) 277346 86 59 1.447 Had been given mother’s milk in the last 24 hours Had been given mother’s milk in the last 24 hours Had been given mother’s milk in the last 24 hours Had been given mother’s milk in the last 24 hours Had been given mother’s milk in the last 24 hours Had been given mother’s milk in the last 24 hours 5345 1 Yes 2 No Foods/drink - baby formula Foods/drink - baby formula Foods/drink - baby formula Foods/drink - baby formula Foods/drink - baby formula Did yesterday/last night the children been given these foods/drink below: a. Baby formula 5370 1 Yes 2 No 3 4 6 8 9 Foods/drink - water/tea/cooked rice water Foods/drink - water/tea/cooked rice water Foods/drink - water/tea/cooked rice water Foods/drink - water/tea/cooked rice water Foods/drink - water/tea/cooked rice water Did yesterday/last night the children been given these foods/drink below: b. Water/tea/cooked rice water 5344 1 Yes 2 No Foods/drink - fruits Foods/drink - fruits Foods/drink - fruits Foods/drink - fruits Foods/drink - fruits Did yesterday/last night the children been given these foods/drink below: c. Fruits 5344 1 Yes 2 No Foods/drink - baby biscuits Foods/drink - baby biscuits Foods/drink - baby biscuits Foods/drink - baby biscuits Foods/drink - baby biscuits Did yesterday/last night the children been given these foods/drink below: d. Baby biscuits 5344 1 Yes 2 No Foods/drink - rice powder porridge Foods/drink - rice powder porridge Foods/drink - rice powder porridge Foods/drink - rice powder porridge Foods/drink - rice powder porridge Did yesterday/last night the children been given these foods/drink below: e. Rice powder porridge 5344 1 Yes 2 No Foods/drink - milk porridge Foods/drink - milk porridge Foods/drink - milk porridge Foods/drink - milk porridge Foods/drink - milk porridge Did yesterday/last night the children been given these foods/drink below: f. Milk porridge 5344 1 Yes 2 No Foods/drink - steam rice/Rice+vegetable porridge Foods/drink - steam rice/Rice+vegetable porridge Foods/drink - steam rice/Rice+vegetable porridge Foods/drink - steam rice/Rice+vegetable porridge Foods/drink - steam rice/Rice+vegetable porridge Did yesterday/last night the children been given these foods/drink below: g. Steam rice/Rice+vegetable porridge 5344 1 Yes 2 No Foods/drink - steam rice/Rice+vegetable+meat porridge Foods/drink - steam rice/Rice+vegetable+meat porridge Foods/drink - steam rice/Rice+vegetable+meat porridge Foods/drink - steam rice/Rice+vegetable+meat porridge Foods/drink - steam rice/Rice+vegetable+meat porridge Did yesterday/last night the children been given these foods/drink below: h. Steam rice/Rice+vegetable+meat porridge 5344 1 Yes 2 No Foods/drink - others Foods/drink - others Foods/drink - others Foods/drink - others Foods/drink - others Did yesterday/last night the children been given these foods/drink below: i. Others 5344 1 Yes 2 No Did you smoke during a previous month? Did you smoke during a previous month? Did you smoke during a previous month? Did you smoke during a previous month? Did you smoke during a previous month? Did you smoke during a previous month? The use/wearing of family planning device/method? If the answer is coded 1 skip to b5r37 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 - status of married 220647 1 Yes 2 No Had you ever smoke before? Had you ever smoke before? Had you ever smoke before? Had you ever smoke before? Had you ever smoke before? If currently using (b5r28 = 1) Had you ever smoke before?The selected family planning device/method: 1. If the answer is coded 2 skip to b5r39 2. If the answer is coded 2 skip to Block V.F or other household members 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 - status of married 160860 1 Yes 2 No 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. How many stick of cigarette did you consume in the last 24 hours? (sticks) How many stick of cigarette did you consume in the last 24 hours? (sticks) How many stick of cigarette did you consume in the last 24 hours? (sticks) How many stick of cigarette did you consume in the last 24 hours? (sticks) How many stick of cigarette did you consume in the last 24 hours? (sticks) If b5r35 = 1 How many stick of cigarette did you consume in the last 24 hours? (sticks)Place to get your last family planning contraception: 277419 13 99 2.495 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 50 51 53 55 60 61 62 63 64 66 72 73 81 84 98 99 Sysmiss Is it common to smoke in the house when other household member in the house too? Is it common to smoke in the house when other household member in the house too? Is it common to smoke in the house when other household member in the house too? Is it common to smoke in the house when other household member in the house too? Is it common to smoke in the house when other household member in the house too? Is it common to smoke in the house when other household member in the house too? 59824 1 Yes 2 No 4 How old were you when you started to smoke? How old were you when you started to smoke? How old were you when you started to smoke? How old were you when you started to smoke? How old were you when you started to smoke? How old were you when you started to smoke? 277431 1 81 4.356 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 277400 32 57 5.196 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 277399 33 84 5.26 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 277400 32 99 0.452 1 2 3 4 5 6 7 8 9 10 11 12 13 15 18 19 20 25 34 35 36 45 58 99 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 277432 16 0.422 1 2 3 4 5 6 7 8 9 10 11 12 13 15 16 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 277431 1 99 0.874 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 20 27 49 99 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 277402 30 99 0.388 1 2 3 4 5 6 7 8 9 10 12 13 44 99 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 277403 29 10 0.369 1 2 3 4 5 6 7 8 9 10 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 277402 30 99 0.757 1 2 3 4 5 6 7 8 9 10 11 12 13 14 99 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 277432 24 0.0637 1 2 3 4 5 6 7 8 9 10 16 24 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 277401 31 13 0.0531 1 2 3 4 5 6 7 8 9 10 12 13 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 277400 32 22 0.116 1 2 3 4 5 6 7 8 9 10 11 12 13 14 22 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. Fill in code 1 for “Yes” or code 2 for “No” according to the respondent’s answer into the provided boxes. For women age 10 years and up - women who once married 74874 1 Yes 2 No r 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 coded 2 skip to other household members or Block VI 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 - status of married 39310 1 Yes 2 No 5 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: If currently using (b5r28 = 1) The selected family planning device/method: Continue to other household member or Block VI. 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 - status of married 27808 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 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. Place to get your last family planning contraception: Place to get your last family planning contraception: Place to get your last family planning contraception: Place to get your last family planning contraception: Place to get your last family planning contraception: Place to get your last family planning contraception: Circle one code as appropriate and enter the answer into the box provided. 27238 1 Government’s hospital 10 11 14 15 16 2 Private hospital 22 3 Doctor’s office 4 Public Health Center (Puskesmas) 5 Midwife practice 6 Polindes/BDD/Posyandu 7 Drug store 8 Other 9 Money spent to get the last family planning service: (Rp) Money spent to get the last family planning service: (Rp) Money spent to get the last family planning service: (Rp) Money spent to get the last family planning service: (Rp) Money spent to get the last family planning service: (Rp) 277379 53 9999999 1750.139 Date Date Date Date Date 91 00 17 18 20 21 24 Month Month Month Month Month 32 13 19 26 40 5 7 Year Year Year Year Year 31 1 2 6 Date Date Date Date Date 31 1 2 3 4 Month Month Month Month Month 31 2 3 4 9 b3k10 b3k10 b3k10 b3k10 b3k10 31 0 0 0 4 1 0 1 1 1 2 2 0 4 2 Individual Inflation factor SUSENAS 2001 Individual Inflation factor SUSENAS 2001 Individual Inflation factor SUSENAS 2001 Individual Inflation factor SUSENAS 2001 Individual Inflation factor SUSENAS 2001 277430 2 1387 719.571 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. 69166 1 11 Nanggroe Aceh Darussalam 12 North Sumatera 13 West Sumatera 14 Riau 15 Jambi 16 South Sumatera 17 Bengkulu 18 Lampung 19 Bangka Belitung 2 21 Riau Island 31 DKI Jakarta 32 West Java 33 Central Java 34 DI Yogyakarta 35 East Java 36 Banten 4 5 51 Bali 52 West Nusa Tenggara 53 East Nusa Tenggara 6 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. 69164 1 10 11 12 13 14 15 16 17 18 19 2 20 21 22 23 24 25 26 27 28 29 3 31 32 35 36 4 5 52 53 6 61 7 71 72 73 74 75 76 77 78 8 9 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. 69166 10 100 110 120 130 140 150 160 170 180 190 20 200 210 220 221 230 240 241 250 260 270 280 290 30 300 310 320 330 350 360 370 390 4 1 40 50 6 1 6 3 6 4 60 70 710 720 725 730 735 740 743 751 762 80 90 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. 69166 0 1 0 2 0 3 0 4 0 5 0 7 0 8 0 9 1 10 11 12 13 14 15 16 17 18 19 2 20 209 21 22 23 24 25 26 27 28 29 3 30 31 32 33 34 35 36 38 39 4 43 44 49 5 52 54 6 60 63 7 72 8 803 9 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. 69150 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. 69166 1 10 11 12 13 14 15 16 17 18 19 2 20 21 22 23 24 25 26 27 28 29 3 30 31 32 33 34 35 36 37 38 39 4 40 41 42 43 44 45 46 47 48 5 501 502 503 504 505 506 507 508 509 51 510 511 512 513 514 515 516 517 518 519 52 520 521 522 523 524 525 526 527 528 529 53 530 531 532 533 534 535 536 537 538 539 54 540 541 542 543 544 545 546 547 548 549 550 551 552 553 554 555 556 557 558 559 560 561 562 563 564 565 566 567 568 569 570 571 572 573 574 575 576 6 7 8 9 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. 69162 02 09 1 10 11 12 13 14 15 16 2 24 3 30 4 5 6 7 8 9 Number of household members: Number of household members: Number of household members: Number of household members: Number of household members: Number of household members: 69166 1 10 11 12 13 14 15 16 2 3 4 5 6 7 8 9 Number of household members 0-4 years Number of household members 0-4 years Number of household members 0-4 years Number of household members 0-4 years Number of household members 0-4 years Number of household members 0-4 years 69166 1 2 3 4 5 6 7 8 Status of house building authority: Status of house building authority: Status of house building authority: Status of house building authority: Status of house building authority: Status of house building authority: 1. If the answer is coded 1, skip to b6r4a 2. If the answer is coded 1, skip to b6r2a 3. If the answer is coded 1, skip to b6r2b 4. If b6r1 = 4 to 7 , directly to b6r3 Circle one of codes 1 to 7 according to respondent’s answer, and fill it in the provided box. 69166 1 Own property 2 Lease 3 Rent 4 Official house 5 Free rent 6 Parent’s house 7 Others 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. Value of leasing per year: (Rp) Value of leasing per year: (Rp) Value of leasing per year: (Rp) Value of leasing per year: (Rp) Value of leasing per year: (Rp) If leasing (b6r1=2) Value of leasing per year: (Rp) Continue to b6r3 69166 60020000 63869.118 Value of leasing per year: (Rp) Value of leasing per year: (Rp) Value of leasing per year: (Rp) Value of leasing per year: (Rp) Value of leasing per year: (Rp) If leasing (b6r1=2) Value of leasing per year: (Rp) 69166 3e+81 4.33739e+76 Did you have own house? Did you have own house? Did you have own house? Did you have own house? Did you have own house? If housing authority status not own property (b6r1 not equal to 1) Did you have own house?Type of most wall material : If the answer is coded 2 skip to b6r5 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. 15614 1 Yes 2 No 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. How to get the building? How to get the building? How to get the building? How to get the building? How to get the building? If own property (b6r1 = 1) or have own house (b6r3 = 1) How to get the building? 1. If the answer is coded 1,6 or 7 skip to b6r4d 2. If the answer is coded 2,3,4 or 5, skip to b6r4b 55474 1 Self build 2 Buying from developers(Perumnas, real estate, etc.) 3 Buying new from individuals 4 Buying not news 5 Buying from cooperatives 6 Administration allocations (official house, etc) 7 Others (inheritance, grant, etc) How the paying of procedure? How the paying of procedure? How the paying of procedure? How the paying of procedure? How the paying of procedure? If b6r4a = 2,3,4 or 5 How the paying of procedure? If the answer is coded 2 or 3, skip to b6r4d 5603 1 “KPR” credit (Bank, cooperative) 2 Non-“KPR” credits 3 Cashs How long the credit return duration? How long the credit return duration? How long the credit return duration? How long the credit return duration? How long the credit return duration? If “KPR” credit (b6r4b = 1) How long the credit return duration? 1731 1 < = 5 year 2 <= 10 year 3 <= 20 year 4 > 20 year 7 How to get the land? How to get the land? How to get the land? How to get the land? How to get the land? How to get the land? 55460 1 Buying house and house 2 Buying the land 3 Inheritance/ grant 4 Leasing 5 Staying with 6 Others Law status of the land: Law status of the land: Law status of the land: Law status of the land: Law status of the land: Law status of the land: 1. If the answer is coded 1 skip to b6r4f 2. If b6r4e not equal to 1, continue to Block VI.B 55458 1 Property rights 2 Building purpose rights 3 Using rights 4 Others 5 Do not What the law evidence? What the law evidence? What the law evidence? What the law evidence? What the law evidence? If “property rights” (b6r4e = 1) What the law evidence? Continue to Block VI.B 45563 1 2 3 4 What is your plan in 5 years later? What is your plan in 5 years later? What is your plan in 5 years later? What is your plan in 5 years later? What is your plan in 5 years later? If have not had own house (b6r3=2) What is your plan in 5 years later? Fill in the floor size of the residence of the respondent’s household and write down in the provided box (in m 2 ). 13701 1 Owning house by “KPR” credit (BTN, Private Bank, Cooperative) 2 Owning house in cash 3 Leasing/ renting house 4 Others 5 No plan Type physical building: Type physical building: Type physical building: Type physical building: Type physical building: Type physical building:Source of drinking water: If b6r6a the answer is coded 1 or 3 skip to b6r6c 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. 69157 1 Single non-stages 2 Single stages 3 Double non-stages 4 Double stages 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. Building type: Building type: Building type: Building type: Building type: If b6r7a = 3 to 7 (pump/well/spring) Building type:Distance to the closest feces containment: If the answer is coded 3 skip to b6r6c3 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. 3661 1 Common stages house 2 Shop house/office house 3 Flat/apartment 5 Area: 1. Parcel of land:(m2) Area: 1. Parcel of land:(m2) Area: 1. Parcel of land:(m2) Area: 1. Parcel of land:(m2) Area: 1. Parcel of land:(m2) Area: 1. Parcel of land:(m2) 69166 9998 269.025 Area: 2. Building site:(m2) Area: 2. Building site:(m2) Area: 2. Building site:(m2) Area: 2. Building site:(m2) Area: 2. Building site:(m2) Area: 2. Building site:(m2) 69166 999 70.89 Area: 3. Dwelling floor:(m2) Area: 3. Dwelling floor:(m2) Area: 3. Dwelling floor:(m2) Area: 3. Dwelling floor:(m2) Area: 3. Dwelling floor:(m2) Area: 3. Dwelling floor:(m2) 69166 999 68.752 Type of the widest roof: Type of the widest roof: Type of the widest roof: Type of the widest roof: Type of the widest roof: Type of the widest roof:Method to obtain drinking water: Circle one of the codes according to respondent’s answer and write it down in the provided box. 69166 1 Concrete 2 Corrugated tile 3 Shingle roof 4 Iron sheeting 5 Asbestos 6 Palm fiber 7 Others 9 Type of the widest ceiling: Type of the widest ceiling: Type of the widest ceiling: Type of the widest ceiling: Type of the widest ceiling: If b6r6a not equal to 3,5 to 12 Type of the widest ceiling:The use of drinking water facilities: Circle one of the codes according to the answer and write it down in the provided box. 69166 1 Asbestos 2 Non-asbestos 3 None 4 5 8 Type of the widest wall Type of the widest wall Type of the widest wall Type of the widest wall Type of the widest wall Type of the widest wall Circle one of the codes for lighting source used in respondent's household,then write it down in the provided box. 69166 1 Brick 2 Wood 3 Bamboo 4 Others 5 Type of the widest floor: Type of the widest floor: Type of the widest floor: Type of the widest floor: Type of the widest floor: Type of the widest floor:Source of lighting: Circle one of the codes for lighting source used in respondent’s household,then write it down in the provided box. 69166 1 Not ground 2 ground 3 Building condition: Building condition: Building condition: Building condition: Building condition: Building condition: 69165 1 Good 2 Moderate 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) 69166 -1218 71 4.435 Room utilized: 1. Bed room Room utilized: 1. Bed room Room utilized: 1. Bed room Room utilized: 1. Bed room Room utilized: 1. Bed room Room utilized: 1. Bed room Circle one code as appropriate and enter the answer into the box provided. 69149 1 Separately 2 Mixing up 3 None Number of room: 1. Bed room Number of room: 1. Bed room Number of room: 1. Bed room Number of room: 1. Bed room Number of room: 1. Bed room If Col.2 = 1 Number of room: 1. Bed room Ask the number of rooms that is in the house and enter the answer into the box provided in column 3 65608 1 2 3 4 5 6 7 8 9 Venitilized mostly: 1. Bed room Venitilized mostly: 1. Bed room Venitilized mostly: 1. Bed room Venitilized mostly: 1. Bed room Venitilized mostly: 1. Bed room If Col. 2 = 1 or 2 Venitilized mostly: 1. Bed room Fill in code 1 for “Yes” or code 2 for “No” according to the respondent’s answer into the provided boxes. 68826 1 Yes 2 No Enough of nature light: 1. Bed room Enough of nature light: 1. Bed room Enough of nature light: 1. Bed room Enough of nature light: 1. Bed room Enough of nature light: 1. Bed room If Col. 2 = 1 or 2 Enough of nature light: 1. Bed room Fill in code 1 for “Yes” or code 2 for “No” according to the respondent’s answer into the provided boxes. 68824 1 Yes 2 No 3 4 Room utilized: 2. Family room Room utilized: 2. Family room Room utilized: 2. Family room Room utilized: 2. Family room Room utilized: 2. Family room Room utilized: 2. Family room Circle one code as appropriate and enter the answer into the box provided. 69166 1 Separately 2 Mixing up 3 None Number of room: 2. Family room Number of room: 2. Family room Number of room: 2. Family room Number of room: 2. Family room Number of room: 2. Family room If Col.2 = 1 Number of room: 2. Family room Ask the number of rooms that is in the house and enter the answer into the box provided in column 3 17089 1 2 3 Venitilized mostly: 2. Family room Venitilized mostly: 2. Family room Venitilized mostly: 2. Family room Venitilized mostly: 2. Family room Venitilized mostly: 2. Family room If Col. 2 = 1 or 2 Venitilized mostly: 2. Family room Fill in code 1 for “Yes” or code 2 for “No” according to the respondent’s answer into the provided boxes. 52576 1 Yes 2 No 3 ¶ Enough of nature light: 2. Family room Enough of nature light: 2. Family room Enough of nature light: 2. Family room Enough of nature light: 2. Family room Enough of nature light: 2. Family room If Col. 2 = 1 or 2 Enough of nature light: 2. Family room Fill in code 1 for “Yes” or code 2 for “No” according to the respondent’s answer into the provided boxes. 52563 1 Yes 2 No Room utilized: 3. Guest room Room utilized: 3. Guest room Room utilized: 3. Guest room Room utilized: 3. Guest room Room utilized: 3. Guest room Room utilized: 3. Guest room Circle one code as appropriate and enter the answer into the box provided. 69156 1 Separately 2 Mixing up 3 None Number of room: 3. Guest room Number of room: 3. Guest room Number of room: 3. Guest room Number of room: 3. Guest room Number of room: 3. Guest room If Col.2 = 1 Number of room: 3. Guest room Ask the number of rooms that is in the house and enter the answer into the box provided in column 3 34881 1 2 3 Venitilized mostly: 3. Guest room Venitilized mostly: 3. Guest room Venitilized mostly: 3. Guest room Venitilized mostly: 3. Guest room Venitilized mostly: 3. Guest room If Col. 2 = 1 or 2 Venitilized mostly: 3. Guest room Fill in code 1 for “Yes” or code 2 for “No” according to the respondent’s answer into the provided boxes. 64024 1 Yes 2 No 3 Enough of nature light: 3. Guest room Enough of nature light: 3. Guest room Enough of nature light: 3. Guest room Enough of nature light: 3. Guest room Enough of nature light: 3. Guest room If Col. 2 = 1 or 2 Enough of nature light: 3. Guest room Fill in code 1 for “Yes” or code 2 for “No” according to the respondent’s answer into the provided boxes. 64019 1 Yes 2 No Room utilized: 4. Dinner room Room utilized: 4. Dinner room Room utilized: 4. Dinner room Room utilized: 4. Dinner room Room utilized: 4. Dinner room Room utilized: 4. Dinner room Circle one code as appropriate and enter the answer into the box provided. 69165 1 Separately 2 Mixing up 3 None Number of room: 4. Dinner room Number of room: 4. Dinner room Number of room: 4. Dinner room Number of room: 4. Dinner room Number of room: 4. Dinner room If Col.2 = 1 Number of room: 4. Dinner room Ask the number of rooms that is in the house and enter the answer into the box provided in column 3 15664 1 2 3 Venitilized mostly: 4. Dinner room Venitilized mostly: 4. Dinner room Venitilized mostly: 4. Dinner room Venitilized mostly: 4. Dinner room Venitilized mostly: 4. Dinner room If Col. 2 = 1 or 2 Venitilized mostly: 4. Dinner room Fill in code 1 for “Yes” or code 2 for “No” according to the respondent’s answer into the provided boxes. 52425 1 Yes 2 No 3 Enough of nature light: 4. Dinner room Enough of nature light: 4. Dinner room Enough of nature light: 4. Dinner room Enough of nature light: 4. Dinner room Enough of nature light: 4. Dinner room If Col. 2 = 1 or 2 Enough of nature light: 4. Dinner room Fill in code 1 for “Yes” or code 2 for “No” according to the respondent’s answer into the provided boxes. 52415 1 Yes 2 No Room utilized: 5. Kitchen room Room utilized: 5. Kitchen room Room utilized: 5. Kitchen room Room utilized: 5. Kitchen room Room utilized: 5. Kitchen room Room utilized: 5. Kitchen room Circle one code as appropriate and enter the answer into the box provided. 69162 1 Separately 2 Mixing up 3 None Number of room: 5. Kitchen room Number of room: 5. Kitchen room Number of room: 5. Kitchen room Number of room: 5. Kitchen room Number of room: 5. Kitchen room If Col.2 = 1 Number of room: 5. Kitchen room Ask the number of rooms that is in the house and enter the answer into the box provided in column 3 45778 1 2 3 Venitilized mostly: 5. Kitchen room Venitilized mostly: 5. Kitchen room Venitilized mostly: 5. Kitchen room Venitilized mostly: 5. Kitchen room Venitilized mostly: 5. Kitchen room If Col. 2 = 1 or 2 Venitilized mostly: 5. Kitchen room Fill in code 1 for “Yes” or code 2 for “No” according to the respondent’s answer into the provided boxes. 66393 1 Yes 2 No Enough of nature light: 5. Kitchen room Enough of nature light: 5. Kitchen room Enough of nature light: 5. Kitchen room Enough of nature light: 5. Kitchen room Enough of nature light: 5. Kitchen room If Col. 2 = 1 or 2 Enough of nature light: 5. Kitchen room Fill in code 1 for “Yes” or code 2 for “No” according to the respondent’s answer into the provided boxes. 66389 1 Yes 2 No Bathing facility: Bathing facility: Bathing facility: Bathing facility: Bathing facility: Bathing facility: Circle one code as appropriate and enter the answer into the box provided. 69166 1 Private 2 Shared 3 Public 4 Others Toilet facility: Toilet facility: Toilet facility: Toilet facility: Toilet facility: Toilet facility: If the answer is coded 4 skip to b6r14c Circle one code as appropriate and enter the answer into the box provided. 69166 1 Private 2 Shared 3 Public 4 Others Type of toilet: Type of toilet: Type of toilet: Type of toilet: Type of toilet: Type of toilet: Circle one code as appropriate and enter the answer into the box provided. 50984 1 Squatter 2 Throne 3 Dry latrine 4 No toilet Final disposal: Final disposal: Final disposal: Final disposal: Final disposal: Final disposal: Circle one code as appropriate and enter the answer into the box provided. 69166 1 Septic tank 2 Pond/field rice 3 River/lake/sea 4 Hole 5 Shore/open field/garden 6 Others Source of drinking water: Source of drinking water: Source of drinking water: Source of drinking water: Source of drinking water: Source of drinking water: Circle one code as appropriate and enter the answer into the box provided. 69163 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 Nearest distance to the septic tank: Nearest distance to the septic tank: Nearest distance to the septic tank: Nearest distance to the septic tank: Nearest distance to the septic tank: If b6r15a. = 3 to 7 (pump/well/spring) Nearest distance to the septic tank: Circle one code as appropriate and enter the answer into the box provided. 46694 1 = 10 m 2 > 10 m 3 Don’t know 4 5 Obtaining drinking water method: Obtaining drinking water method: Obtaining drinking water method: Obtaining drinking water method: Obtaining drinking water method: Obtaining drinking water method: Circle one code as appropriate and enter the answer into the box provided. 69166 1 Subscribing 2 Direct purchasing 3 Purchasing from water man 4 Do not purchase 5 9 Drinking water facility: Drinking water facility: Drinking water facility: Drinking water facility: Drinking water facility: Drinking water facility: Circle one code as appropriate and enter the answer into the box provided. 69161 1 Private 2 Shared 3 Public 4 None Does the drinking water clear/ pure, no color, no taste, no bubble and no fragrant? Does the drinking water clear/ pure, no color, no taste, no bubble and no fragrant? Does the drinking water clear/ pure, no color, no taste, no bubble and no fragrant? Does the drinking water clear/ pure, no color, no taste, no bubble and no fragrant? Does the drinking water clear/ pure, no color, no taste, no bubble and no fragrant? Does the drinking water clear/ pure, no color, no taste, no bubble and no fragrant? Fill in code 1 for “Yes” or code 2 for “No” according to the respondent’s answer into the provided boxes. 69166 1 Yes 2 No 4 Source of light: Source of light: Source of light: Source of light: Source of light: Source of light: Circle one code as appropriate and enter the answer into the box provided. 69166 1 PLN electricity 2 Electricity non PLN 3 Pump lantern 4 Oil lamp 5 Others Cooking fuel: Cooking fuel: Cooking fuel: Cooking fuel: Cooking fuel: Cooking fuel: Circle one code as appropriate and enter the answer into the box provided. 69166 1 Electricity 2 Gas/ Liquid gas 3 Kerosene 4 Wood 5 Coal 6 Others 7 Not cooking Household’s show case Household’s show case Household’s show case Household’s show case Household’s show case Household’s home appliances: a. Show case Fill in code 1 for “Yes” or code 2 for “No” according to the respondent’s answer into the provided boxes. 69166 1 Yes 2 No 4 Household’s stove Household’s stove Household’s stove Household’s stove Household’s stove Household’s home appliances: b. Stove Fill in code 1 for “Yes” or code 2 for “No” according to the respondent’s answer into the provided boxes. 69166 1 Yes 2 No 3 4 7 Household’s radio/tape/video Household’s radio/tape/video Household’s radio/tape/video Household’s radio/tape/video Household’s radio/tape/video Household’s home appliances: c. Radio/tape/video Fill in code 1 for “Yes” or code 2 for “No” according to the respondent’s answer into the provided boxes. 69166 1 Yes 2 No Household’s television Household’s television Household’s television Household’s television Household’s television Household’s home appliances: d. Television Fill in code 1 for “Yes” or code 2 for “No” according to the respondent’s answer into the provided boxes. 69166 1 Yes 2 No Household’s refrigerator Household’s refrigerator Household’s refrigerator Household’s refrigerator Household’s refrigerator Household’s home appliances: e. Refrigerator Fill in code 1 for “Yes” or code 2 for “No” according to the respondent’s answer into the provided boxes. 69166 1 Yes 2 No Household’s telephone Household’s telephone Household’s telephone Household’s telephone Household’s telephone Household’s home appliances: f. Telephone Fill in code 1 for “Yes” or code 2 for “No” according to the respondent’s answer into the provided boxes. 69166 1 Yes 2 No Household’s bycicle/boat Household’s bycicle/boat Household’s bycicle/boat Household’s bycicle/boat Household’s bycicle/boat Household’s home appliances: g. Bycicle/boat Fill in code 1 for “Yes” or code 2 for “No” according to the respondent’s answer into the provided boxes. 69166 1 Yes 2 No Household’s motor cycle/boat motor Household’s motor cycle/boat motor Household’s motor cycle/boat motor Household’s motor cycle/boat motor Household’s motor cycle/boat motor Household’s home appliances: h. Motor cycle/boat motor Fill in code 1 for “Yes” or code 2 for “No” according to the respondent’s answer into the provided boxes. 69166 1 Yes 2 No Household’s car/motor boat Household’s car/motor boat Household’s car/motor boat Household’s car/motor boat Household’s car/motor boat Household’s home appliances: i. Car/motor boat Fill in code 1 for “Yes” or code 2 for “No” according to the respondent’s answer into the provided boxes. 69166 1 Yes 2 No House location/building of the house: House location/building of the house: House location/building of the house: House location/building of the house: House location/building of the house: House location/building of the house: Circle one code as appropriate and enter the answer into the box provided. 69166 1 New dwelling 2 Old dwelling 3 Others Is the house Near to the seashore/river bank/side of the lake? Is the house Near to the seashore/river bank/side of the lake? Is the house Near to the seashore/river bank/side of the lake? Is the house Near to the seashore/river bank/side of the lake? Is the house Near to the seashore/river bank/side of the lake? Is the house Near to the seashore/river bank/side of the lake? Fill in code 1 for “Yes” or code 2 for “No” according to the respondent’s answer into the provided boxes. 69166 1 Yes 2 No Is the house located in flooded area/disaster area? Is the house located in flooded area/disaster area? Is the house located in flooded area/disaster area? Is the house located in flooded area/disaster area? Is the house located in flooded area/disaster area? Is the house located in flooded area/disaster area? Fill in code 1 for “Yes” or code 2 for “No” according to the respondent’s answer into the provided boxes. 69166 1 Yes 2 No 3 Is the house located in the side of road/alley/aisle? Is the house located in the side of road/alley/aisle? Is the house located in the side of road/alley/aisle? Is the house located in the side of road/alley/aisle? Is the house located in the side of road/alley/aisle? Is the house located in the side of road/alley/aisle? If the answer is coded 2 skip to b6r25 Fill in code 1 for “Yes” or code 2 for “No” according to the respondent’s answer into the provided boxes. 69166 1 Yes 2 No Wide of road/alley/ aisle: (m) Wide of road/alley/ aisle: (m) Wide of road/alley/ aisle: (m) Wide of road/alley/ aisle: (m) Wide of road/alley/ aisle: (m) Wide of road/alley/ aisle: (m) 69166 9 2.642 1 2 3 4 5 6 7 8 9 Type of road/alley/ aisle surface: Type of road/alley/ aisle surface: Type of road/alley/ aisle surface: Type of road/alley/ aisle surface: Type of road/alley/ aisle surface: Type of road/alley/ aisle surface: Circle one code as appropriate and enter the answer into the box provided. 51739 1 Aspalth 2 Cement/”conblok” 3 Hardened gravel 4 Wood/bamboo 5 Ground/sand 6 Others Location for wasted water reservoir from bathing/kitchen/washing : Location for wasted water reservoir from bathing/kitchen/washing : Location for wasted water reservoir from bathing/kitchen/washing : Location for wasted water reservoir from bathing/kitchen/washing : Location for wasted water reservoir from bathing/kitchen/washing : Location for wasted water reservoir from bathing/kitchen/washing : Circle one code as appropriate and enter the answer into the box provided. 69166 1 Closed reservoir in the yard 2 Open reservoir in the yard 3 Out-yard reservoir 4 Without reservoir/Directly to the drain/River 5 6 9 Drainage system for waste from bathing/kitchen/washing : Drainage system for waste from bathing/kitchen/washing : Drainage system for waste from bathing/kitchen/washing : Drainage system for waste from bathing/kitchen/washing : Drainage system for waste from bathing/kitchen/washing : Drainage system for waste from bathing/kitchen/washing : Circle one code as appropriate and enter the answer into the box provided. 69165 1 Closed drainage 2 Open drainage 3 No drainage 5 6 9 Water drain condition around the neighborhood: Water drain condition around the neighborhood: Water drain condition around the neighborhood: Water drain condition around the neighborhood: Water drain condition around the neighborhood: Water drain condition around the neighborhood: Circle one code as appropriate and enter the answer into the box provided. 69166 1 Smooth 2 Flows slowly 3 Not flowing 4 No drain Garbage disposal method: Garbage disposal method: Garbage disposal method: Garbage disposal method: Garbage disposal method: Garbage disposal method: Circle one code as appropriate and enter the answer into the box provided. 69165 1 Picked up by garbage men 2 Pilled up 3 Turned into compost 4 Burned 5 Throw away to the river 6 Throw away to anywhere 7 Others Household using - room perfume (spray) Household using - room perfume (spray) Household using - room perfume (spray) Household using - room perfume (spray) Household using - room perfume (spray) During a previous month, this household using: a. Room perfume (spray) Fill in the code 1 if yes and code 2 if not,and enter the answer into the box provided 69165 1 Yes 2 No 4 Household using - hair spray/deodorant spray Household using - hair spray/deodorant spray Household using - hair spray/deodorant spray Household using - hair spray/deodorant spray Household using - hair spray/deodorant spray During a previous month, this household using: b. Hair spray/deodorant spray Fill in the code 1 if yes and code 2 if not,and enter the answer into the box provided 69166 1 Yes 2 No 4 6 7 Household using - floor cleaner Household using - floor cleaner Household using - floor cleaner Household using - floor cleaner Household using - floor cleaner During a previous month, this household using: c. Floor cleaner Fill in the code 1 if yes and code 2 if not,and enter the answer into the box provided 69166 1 Yes 2 No Household using - glass/wood/metal polish Household using - glass/wood/metal polish Household using - glass/wood/metal polish Household using - glass/wood/metal polish Household using - glass/wood/metal polish During a previous month, this household using: d. Glass/wood/metal polish Fill in the code 1 if yes and code 2 if not,and enter the answer into the box provided 69166 1 Yes 2 No Household using - clothes bleaching solution Household using - clothes bleaching solution Household using - clothes bleaching solution Household using - clothes bleaching solution Household using - clothes bleaching solution During a previous month, this household using: e. Clothes bleaching solution Fill in the code 1 if yes and code 2 if not,and enter the answer into the box provided 69166 1 Yes 2 No Household using - storage battery Household using - storage battery Household using - storage battery Household using - storage battery Household using - storage battery During a previous month, this household using: f. Storage battery Fill in the code 1 if yes and code 2 if not,and enter the answer into the box provided 69166 1 Yes 2 No Household using - paint Household using - paint Household using - paint Household using - paint Household using - paint During a previous month, this household using: g. Paint Fill in the code 1 if yes and code 2 if not,and enter the answer into the box provided 69166 1 Yes 2 No Household using - insects poison/insect eradicator Household using - insects poison/insect eradicator Household using - insects poison/insect eradicator Household using - insects poison/insect eradicator Household using - insects poison/insect eradicator During a previous month, this household using: h. Insects poison/insect eradicator Fill in the code 1 if yes and code 2 if not,and enter the answer into the box provided 69166 1 Yes 2 No Types of pollution - Smoke/smell/ fabric sound Types of pollution - Smoke/smell/ fabric sound Types of pollution - Smoke/smell/ fabric sound Types of pollution - Smoke/smell/ fabric sound Types of pollution - Smoke/smell/ fabric sound Is there any household member disrupted by types of pollution below: a. Smoke/smell/ fabric sound Fill in the code 1 if yes and code 2 if not,and enter the answer into the box provided 69166 1 Yes 2 No Types of pollution - Smoke/smell/ repair shop sound Types of pollution - Smoke/smell/ repair shop sound Types of pollution - Smoke/smell/ repair shop sound Types of pollution - Smoke/smell/ repair shop sound Types of pollution - Smoke/smell/ repair shop sound Is there any household member disrupted by types of pollution below: b. Smoke/smell/ repair shop sound Fill in the code 1 if yes and code 2 if not,and enter the answer into the box provided 69166 1 Yes 2 No Types of pollution - Sounds from neighbor continuously Types of pollution - Sounds from neighbor continuously Types of pollution - Sounds from neighbor continuously Types of pollution - Sounds from neighbor continuously Types of pollution - Sounds from neighbor continuously Is there any household member disrupted by types of pollution below: c. Sounds from neighbor continuously Fill in the code 1 if yes and code 2 if not,and enter the answer into the box provided 69166 1 Yes 2 No Types of pollution - Sounds from motor vehicle Types of pollution - Sounds from motor vehicle Types of pollution - Sounds from motor vehicle Types of pollution - Sounds from motor vehicle Types of pollution - Sounds from motor vehicle Is there any household member disrupted by types of pollution below: d. Sounds from motor vehicle Fill in the code 1 if yes and code 2 if not,and enter the answer into the box provided 69166 1 Yes 2 No Types of pollution - Waste smell/ not flowing water Types of pollution - Waste smell/ not flowing water Types of pollution - Waste smell/ not flowing water Types of pollution - Waste smell/ not flowing water Types of pollution - Waste smell/ not flowing water Is there any household member disrupted by types of pollution below: e. Waste smell/ not flowing water Fill in the code 1 if yes and code 2 if not,and enter the answer into the box provided 69166 1 Yes 2 No Is there any member of community in your neighborhood being the victim of narcotics? Is there any member of community in your neighborhood being the victim of narcotics? Is there any member of community in your neighborhood being the victim of narcotics? Is there any member of community in your neighborhood being the victim of narcotics? Is there any member of community in your neighborhood being the victim of narcotics? Is there any member of community in your neighborhood being the victim of narcotics? If the answer is coded 2 or 3, skip to b6r32. Circle one code as appropriate and enter the answer into the box provided. 69166 1 Yes 2 No 3 Don’t know If “Yes”, How was the progress during a previous year? If “Yes”, How was the progress during a previous year? If “Yes”, How was the progress during a previous year? If “Yes”, How was the progress during a previous year? If “Yes”, How was the progress during a previous year? If “Yes”, How was the progress during a previous year? Circle one code as appropriate and enter the answer into the box provided. 1416 1 Increasing 2 Same 3 Decreasing 4 Do not know Availability of public facility - Designated route transportation Availability of public facility - Designated route transportation Availability of public facility - Designated route transportation Availability of public facility - Designated route transportation Availability of public facility - Designated route transportation Accessibility to public facilities (fasum), availability of public facility a.Designated route transportation 69166 1 2 3 Distance from house - Designated route transportation Distance from house - Designated route transportation Distance from house - Designated route transportation Distance from house - Designated route transportation Distance from house - Designated route transportation Accessibility to public facilities (fasum), distance from house a.Designated route transportation Fill in the closest distance (in km) from home to public facility in column (3). 69166 99 5.475 Usable public transports - Designated route transportation Usable public transports - Designated route transportation Usable public transports - Designated route transportation Usable public transports - Designated route transportation Usable public transports - Designated route transportation Accessibility to public facilities (fasum), usable public transports a.Designated route transportation Fill in the code 1 when using motorize public transportation, code 2 when using non-motorize public transportation, code 3 when no public transportion into the column (4) . 69152 1 Motorize public transportation 2 Non-motorize public transportation 3 No public transportation Availability of public facility - ”Puskesmas”/policlinic Availability of public facility - ”Puskesmas”/policlinic Availability of public facility - ”Puskesmas”/policlinic Availability of public facility - ”Puskesmas”/policlinic Availability of public facility - ”Puskesmas”/policlinic Accessibility to public facilities (fasum), availability of public facility b.”Puskesmas”/policlinic 69166 1 2 3 6 Distance from house - ”Puskesmas”/policlinic Distance from house - ”Puskesmas”/policlinic Distance from house - ”Puskesmas”/policlinic Distance from house - ”Puskesmas”/policlinic Distance from house - ”Puskesmas”/policlinic Accessibility to public facilities (fasum), distance from house b.”Puskesmas”/policlinic Fill in the closest distance (in km) from home to public facility in column (3). 69166 99 4.549 Usable public transports - ”Puskesmas”/policlinic Usable public transports - ”Puskesmas”/policlinic Usable public transports - ”Puskesmas”/policlinic Usable public transports - ”Puskesmas”/policlinic Usable public transports - ”Puskesmas”/policlinic Accessibility to public facilities (fasum), usable public transports b.”Puskesmas”/policlinic Fill in the code 1 when using motorize public transportation, code 2 when using non-motorize public transportation, code 3 when no public transportion into the column (4) . 69152 1 Motorize public transportation 2 Non-motorize public transportation 3 No public transportation Availability of public facility - Post office Availability of public facility - Post office Availability of public facility - Post office Availability of public facility - Post office Availability of public facility - Post office Accessibility to public facilities (fasum), availability of public facility c.Post office 69165 1 2 4 5 6 8 Distance from house - Post office Distance from house - Post office Distance from house - Post office Distance from house - Post office Distance from house - Post office Accessibility to public facilities (fasum), distance from house c.Post office Fill in the closest distance (in km) from home to public facility in column (3). 69166 99 9.705 Usable public transports - Post office Usable public transports - Post office Usable public transports - Post office Usable public transports - Post office Usable public transports - Post office Accessibility to public facilities (fasum), usable public transports c.Post office Fill in the code 1 when using motorize public transportation, code 2 when using non-motorize public transportation, code 3 when no public transportion into the column (4) . 69154 1 Motorize public transportation 2 Non-motorize public transportation 3 No public transportation Availability of public facility - Police post Availability of public facility - Police post Availability of public facility - Police post Availability of public facility - Police post Availability of public facility - Police post Accessibility to public facilities (fasum), availability of public facility d.Police post 69165 1 2 4 5 6 8 9 Distance from house - Police post Distance from house - Police post Distance from house - Police post Distance from house - Police post Distance from house - Police post Accessibility to public facilities (fasum), distance from house d.Police post Fill in the closest distance (in km) from home to public facility in column (3). 69165 1 99 7.954 Usable public transports - Police post Usable public transports - Police post Usable public transports - Police post Usable public transports - Police post Usable public transports - Police post Accessibility to public facilities (fasum), usable public transports d.Police post Fill in the code 1 when using motorize public transportation, code 2 when using non-motorize public transportation, code 3 when no public transportion into the column (4) . 69154 1 Motorize public transportation 2 Non-motorize public transportation 3 No public transportation Availability of public facility - Traditional market Availability of public facility - Traditional market Availability of public facility - Traditional market Availability of public facility - Traditional market Availability of public facility - Traditional market Accessibility to public facilities (fasum), availability of public facility e.Traditional market 69166 1 2 3 4 5 6 9 Distance from house - Traditional market Distance from house - Traditional market Distance from house - Traditional market Distance from house - Traditional market Distance from house - Traditional market Accessibility to public facilities (fasum), distance from house e.Traditional market Fill in the closest distance (in km) from home to public facility in column (3). 69166 99 6.251 Usable public transports - Traditional market Usable public transports - Traditional market Usable public transports - Traditional market Usable public transports - Traditional market Usable public transports - Traditional market Accessibility to public facilities (fasum), usable public transports e.Traditional market Fill in the code 1 when using motorize public transportation, code 2 when using non-motorize public transportation, code 3 when no public transportion into the column (4) . 69152 1 Motorize public transportation 2 Non-motorize public transportation 3 No public transportation 9 Availability of public facility - Public phone Availability of public facility - Public phone Availability of public facility - Public phone Availability of public facility - Public phone Availability of public facility - Public phone Accessibility to public facilities (fasum), availability of public facility f.Public phone 69166 1 2 5 8 Distance from house - Public phone Distance from house - Public phone Distance from house - Public phone Distance from house - Public phone Distance from house - Public phone Accessibility to public facilities (fasum), distance from house f.Public phone Fill in the closest distance (in km) from home to public facility in column (3). 69166 99 8.773 Usable public transports - Public phone Usable public transports - Public phone Usable public transports - Public phone Usable public transports - Public phone Usable public transports - Public phone Accessibility to public facilities (fasum), usable public transports f.Public phone Fill in the code 1 when using motorize public transportation, code 2 when using non-motorize public transportation, code 3 when no public transportion into the column (4) . 69155 1 Motorize public transportation 2 Non-motorize public transportation 3 No public transportation 9 Availability of public facility - Junior High School Availability of public facility - Junior High School Availability of public facility - Junior High School Availability of public facility - Junior High School Availability of public facility - Junior High School Accessibility to public facilities (fasum), availability of public facility g.Junior High School 69166 1 2 5 8 9 Distance from house - Junior High School Distance from house - Junior High School Distance from house - Junior High School Distance from house - Junior High School Distance from house - Junior High School Accessibility to public facilities (fasum), distance from house g.Junior High School Fill in the closest distance (in km) from home to public facility in column (3). 69166 99 4.761 Usable public transports - Junior High School Usable public transports - Junior High School Usable public transports - Junior High School Usable public transports - Junior High School Usable public transports - Junior High School Accessibility to public facilities (fasum), usable public transports g.Junior High School Fill in the code 1 when using motorize public transportation, code 2 when using non-motorize public transportation, code 3 when no public transportion into the column (4) . 69152 1 Motorize public transportation 2 Non-motorize public transportation 3 No public transportation Availability of public facility - Senior High School Availability of public facility - Senior High School Availability of public facility - Senior High School Availability of public facility - Senior High School Availability of public facility - Senior High School Accessibility to public facilities (fasum), availability of public facility h.Senior High School 69166 1 2 3 4 Distance from house - Senior High School Distance from house - Senior High School Distance from house - Senior High School Distance from house - Senior High School Distance from house - Senior High School Accessibility to public facilities (fasum), distance from house h.Senior High School Fill in the closest distance (in km) from home to public facility in column (3). 69166 99 8.793 Usable public transports - Senior High School Usable public transports - Senior High School Usable public transports - Senior High School Usable public transports - Senior High School Usable public transports - Senior High School Accessibility to public facilities (fasum), usable public transports h.Senior High School Fill in the code 1 when using motorize public transportation, code 2 when using non-motorize public transportation, code 3 when no public transportion into the column (4) . 69153 1 Motorize public transportation 2 Non-motorize public transportation 3 No public transportation 9 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) Food expenditure - Grains [rice, corn, wheat, flour, cornflour etc.] - 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) 69165 1 350000 19197.112 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) 69165 1 55000 1334.322 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) 69166 270000 9503.048 150 200 250 300 350 400 425 450 500 525 550 600 625 650 700 750 800 850 870 900 950 975 1000 1025 1050 1100 1125 1150 1200 1225 1250 1255 1300 1325 1350 1375 1400 1425 1450 1500 1550 1575 1600 1650 1700 1750 1755 1780 1800 1850 1900 1940 1950 1970 2000 2010 2025 2050 2100 2125 2150 2170 2200 2225 2235 2240 2250 2300 2350 2400 2425 2450 2460 2500 2550 2560 2600 2620 2625 2650 2700 2725 2750 2800 2850 2900 2950 2975 3000 3050 3100 3150 3170 3175 3200 3250 3300 3350 3400 3425 3450 3500 3525 3550 3600 3650 3675 3700 3750 3800 3850 3900 3950 4000 4095 4100 4125 4150 4175 4200 4250 4300 4350 4375 4400 4450 4500 4525 4550 4575 4600 4650 4700 4725 4750 4800 4825 4850 4900 4950 5000 5050 5085 5100 5125 5150 5200 5225 5250 5300 5350 5400 5425 5450 5475 5500 5550 5600 5650 5700 5750 5800 5815 5850 5900 5950 6000 6100 6125 6150 6200 6240 6250 6300 6350 6400 6450 6460 6500 6550 6600 6650 6700 6725 6750 6800 6845 6850 6900 6925 6950 7000 7100 7125 7150 7200 7225 7250 7300 7350 7400 7450 7500 7550 7600 7650 7700 7750 7800 7825 7850 7900 8000 8050 8100 8125 8150 8200 8250 8300 8350 8400 8440 8450 8475 8500 8600 8650 8700 8750 8800 8850 8900 9000 9100 9125 9150 9200 9250 9300 9350 9400 9450 9500 9540 9600 9645 9650 9700 9750 9800 9850 9900 9950 10000 10100 10150 10200 10225 10250 10300 10350 10400 10450 10500 10600 10700 10750 10760 10800 10850 10900 11000 11100 11200 11250 11300 11350 11375 11400 11450 11475 11500 11550 11600 11635 11650 11700 11750 11800 11850 11900 11915 12000 12100 12150 12200 12250 12300 12350 12400 12450 12500 12600 12650 12700 12750 12775 12800 12850 12900 12950 13000 13100 13150 13200 13250 13275 13300 13400 13500 13600 13650 13700 13750 13800 13850 13900 13950 14000 14050 14100 14150 14200 14250 14300 14375 14400 14450 14500 14575 14600 14650 14700 14750 14800 14850 14900 15000 15050 15150 15200 15225 15250 15300 15325 15350 15400 15450 15475 15500 15550 15600 15650 15700 15750 15800 15850 15900 16000 16100 16150 16200 16250 16300 16350 16400 16450 16500 16600 16700 16750 16800 16850 16875 16900 16950 17000 17100 17200 17250 17300 17350 17500 17550 17600 17650 17700 17750 17800 17850 17900 17925 17950 18000 18150 18200 18250 18300 18400 18500 18600 18650 18700 18725 18750 18800 18900 18950 19000 19125 19150 19200 19250 19300 19500 19600 19650 19700 19750 19800 19850 19900 19950 20000 20100 20150 20175 20250 20275 20300 20400 20500 20600 20700 20750 20800 20900 20950 21000 21200 21250 21300 21400 21500 21600 21650 21660 21700 21750 21800 21900 22000 22150 22250 22300 22350 22400 22500 22550 22600 22680 22700 22750 22800 22850 23000 23200 23250 23300 23400 23500 23600 23700 23750 23800 23850 23900 24000 24100 24125 24200 24300 24350 24400 24450 24500 24600 24700 24750 24800 24900 25000 25100 25125 25200 25300 25400 25500 25535 25550 25600 25700 25750 25800 25900 26000 26150 26250 26300 26400 26450 26500 26550 26800 27000 27050 27100 27200 27250 27300 27500 27550 27600 27750 27800 27850 27900 28000 28100 28200 28300 28400 28500 28550 28600 28700 28750 28800 28900 29000 29300 29350 29400 29500 29600 29700 29750 29800 30000 30025 30100 30450 30500 30600 30700 31000 31200 31500 31700 31750 31900 32000 32200 32500 32600 32700 32750 32900 33000 33250 33500 33700 33900 34000 34500 34700 34900 35000 35150 35200 35250 35400 35500 35600 35700 36000 36250 36300 36500 36700 36750 36800 37000 37200 37300 37500 37600 37700 37750 37800 37900 38000 38170 38250 38500 38800 38900 39000 39500 39750 40000 40100 40350 40500 40650 41000 41250 41500 42000 42125 42200 42500 42800 43000 43500 44000 44100 44200 44500 45000 45500 45800 45900 46000 46200 46500 47000 47250 47500 47900 48000 48500 49000 49250 49500 49600 49700 50000 50500 51000 51500 51600 52000 52500 53000 53500 54000 55000 55500 55800 56000 56400 56500 57000 57500 58000 58500 58750 59000 59500 60000 60600 61000 61500 62500 62750 63000 64000 64500 64750 65000 65500 66000 66500 68000 68600 69500 70000 71000 72000 72500 74500 75000 76000 76500 77000 78000 80000 81300 81750 82000 84000 85000 87000 87500 90000 91000 95000 98000 100000 105000 115000 120000 125500 140000 210000 240000 250000 270000 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) 69166 500000 4933.491 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) 69166 367500 5225.696 100 200 300 350 375 400 450 500 550 600 650 700 750 800 825 850 900 950 1000 1020 1050 1100 1125 1150 1200 1250 1300 1350 1400 1450 1500 1525 1550 1575 1600 1620 1625 1650 1700 1725 1750 1800 1840 1850 1875 1900 1925 1950 2000 2015 2050 2100 2125 2150 2200 2250 2275 2285 2300 2350 2400 2450 2475 2480 2500 2540 2550 2600 2625 2650 2655 2700 2720 2750 2790 2800 2850 2900 2910 2950 3000 3025 3050 3065 3100 3125 3150 3200 3220 3225 3250 3275 3300 3350 3375 3400 3450 3500 3550 3575 3600 3625 3650 3700 3750 3800 3840 3850 3875 3900 3950 3975 4000 4015 4050 4100 4125 4150 4200 4225 4250 4270 4275 4300 4320 4350 4375 4400 4450 4475 4480 4500 4525 4550 4600 4625 4650 4675 4700 4725 4750 4800 4850 4875 4900 4950 4975 5000 5050 5100 5150 5200 5250 5300 5350 5400 5450 5475 5500 5550 5600 5625 5650 5700 5750 5800 5850 5875 5900 5950 6000 6050 6075 6100 6125 6150 6200 6250 6300 6350 6375 6400 6450 6500 6580 6600 6625 6650 6675 6700 6750 6800 6850 6875 6900 6950 7000 7050 7075 7100 7150 7175 7200 7250 7300 7350 7375 7400 7450 7500 7550 7600 7625 7650 7700 7750 7800 7850 7875 7900 7950 8000 8050 8100 8125 8150 8200 8250 8300 8350 8375 8400 8450 8500 8550 8600 8650 8700 8750 8800 8850 8860 8900 8950 8975 9000 9100 9150 9175 9200 9250 9300 9350 9375 9400 9450 9500 9550 9600 9650 9700 9750 9760 9800 9850 9900 9925 9950 10000 10050 10100 10125 10150 10175 10200 10250 10300 10325 10350 10400 10425 10450 10500 10600 10625 10670 10700 10725 10750 10800 10850 10875 10900 10950 11000 11100 11150 11200 11250 11300 11350 11400 11450 11485 11500 11550 11600 11650 11700 11750 11800 11850 11900 11950 12000 12100 12175 12200 12250 12300 12400 12450 12500 12550 12600 12625 12670 12700 12750 12800 12850 12900 12975 13000 13050 13100 13200 13250 13300 13350 13400 13425 13467 13500 13600 13650 13675 13700 13725 13750 13770 13800 13900 14000 14030 14100 14200 14250 14300 14350 14400 14500 14550 14600 14650 14700 14750 14800 14850 14875 14900 14950 15000 15050 15100 15150 15200 15250 15300 15350 15375 15400 15450 15500 15550 15600 15650 15700 15750 15800 15850 15875 15900 15950 16000 16050 16100 16200 16250 16300 16350 16375 16400 16450 16500 16600 16625 16650 16700 16750 16767 16800 16875 16900 17000 17100 17200 17250 17300 17375 17400 17500 17550 17600 17650 17675 17700 17750 17800 17850 17900 17950 18000 18100 18200 18250 18300 18350 18375 18400 18500 18550 18600 18700 18750 18800 18850 18875 18900 18920 19000 19050 19100 19200 19250 19300 19400 19450 19500 19600 19650 19700 19750 19800 19875 19900 19925 19950 20000 20100 20125 20200 20225 20250 20300 20350 20400 20450 20500 20600 20650 20700 20750 20800 20900 20950 20975 21000 21100 21200 21250 21270 21300 21400 21500 21600 21650 21700 21750 21800 21900 22000 22100 22150 22200 22250 22300 22400 22500 22600 22650 22700 22800 22900 23000 23100 23150 23200 23250 23333 23400 23500 23600 23625 23650 23700 23800 23900 24000 24150 24200 24400 24500 24600 24675 24700 24750 24800 24900 25000 25100 25200 25250 25300 25400 25450 25490 25500 25600 25620 25650 25700 25750 25800 25900 26000 26100 26200 26250 26300 26400 26500 26600 26700 26750 26800 26850 26875 26900 27000 27150 27200 27250 27300 27350 27400 27500 27575 27600 27700 27750 27800 27900 27950 28000 28100 28150 28250 28300 28350 28500 28550 28600 28800 29000 29050 29100 29200 29250 29300 29350 29400 29450 29500 29600 29700 29750 29790 29800 29900 30000 30100 30200 30225 30400 30500 30800 30950 31000 31100 31200 31250 31400 31500 31700 31750 31800 32000 32200 32300 32400 32500 32600 32700 32800 32900 33000 33400 33500 33600 33650 33700 33800 34000 34200 34250 34300 34400 34500 34550 34600 34650 34750 34800 34840 34900 35000 35200 35250 35400 35500 35700 35750 35800 36000 36150 36300 36500 36700 36750 36800 36855 36900 37000 37200 37400 37500 37600 37700 37800 38000 38200 38250 38400 38500 38800 39000 39200 39500 39600 39650 39700 39750 39800 40000 40100 40500 40550 40575 41000 41250 41450 41500 41800 41900 42000 42200 42250 42300 42400 42500 42700 43000 43200 43500 43600 43700 43750 44000 44100 44300 44500 44750 44800 45000 45300 45350 45550 45700 45800 46000 46500 46700 47000 47500 47600 47750 47800 48000 48500 49000 49500 49800 50000 50500 50600 50700 51000 51800 52000 52300 52500 52700 52750 53000 53500 53900 54000 54750 55000 55125 55250 55500 56000 56200 56250 56400 56500 57000 57500 57750 58000 58200 59000 59100 59400 59800 60000 60500 60900 61000 61500 62000 62400 62500 62600 63000 63250 63350 63600 63700 64000 64100 64850 65000 65500 65550 65950 66000 66400 67000 67500 68000 68500 68550 69000 69375 69500 70000 70750 71000 71500 72000 73000 74500 74900 75000 75400 75500 75600 75750 76000 76500 77000 78000 78500 78750 79400 80000 80500 81000 82000 82500 82600 83300 84500 85000 85750 86000 87000 87500 88000 90000 91000 92500 93375 96800 97200 100000 100100 100800 101667 102000 103000 107900 110000 115000 117500 118000 120000 123167 124500 125000 126000 132000 140000 150000 150400 155000 156000 163000 166000 171000 182000 193500 196000 200000 202000 222000 238000 367500 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) 69166 150000 6724.586 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) 69166 140000 3510.848 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) 69165 1 310000 3538.137 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) 69166 100000 3805.27 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) 69165 1 150000 4719.783 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) 69166 100000 2418.29 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) 69165 1 200000 1898.554 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) 69165 1 775000 11494.996 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) 69165 1 138200 189.711 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) 69166 250000 12541.459 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] Jumlah Pengeluaran untuk makanan selama seminggu yang lalu (Rincian 1 s.d 14) Write down in Column (2) total expenditures for b7r1a-b7r14. 69166 1368000 91036.894 Rincian ini merupakan jumlah dari Rincian 1 s.d. 14. 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) 69166 10100000 103528.33 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) 69165 1 124100000 1249155.836 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) 69165 1 5291700 29309.018 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) 69165 1 48000000 333170.717 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) 69166 8250000 19176.608 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) 69166 36600000 214926.986 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) 69165 1 70200000 35940.774 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) 69166 70200000 173919.808 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) 69166 1600000 22848.447 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) 69166 15000000 324498.964 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) 69166 80000000 20333.27 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) 69166 147350000 227900.701 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) 69165 1 11000000 4043.645 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) 69166 11011500 50666.562 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 - 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) 69165 1 48150000 17906.125 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) 69166 80000000 126533.956 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) - past month Total non-food (details 17 to 24) - past month Total non-food (details 17 to 24) - past month Total non-food (details 17 to 24) - past month Total non-food (details 17 to 24) - past month Total non-food (details 17 to 24) Write down in Column (2) total non-food (details 17 to 24) from purchases, self produced, and gifts in one past month for house lease,rent,rent expectation :(Rp) 69164 2 80685167 253047.959 Total non-food (details 17 to 24) - past 12 months Total non-food (details 17 to 24) - past 12 months Total non-food (details 17 to 24) - past 12 months Total non-food (details 17 to 24) - past 12 months Total non-food (details 17 to 24) - past 12 months Total non-food (details 17 to 24) - past 12 months 69165 1 197783000 2699992.16 Average monthly expenditure for food (Details 16 x 30 / 12) Average monthly expenditure for food (Details 16 x 30 / 12) Average monthly expenditure for food (Details 16 x 30 / 12) Average monthly expenditure for food (Details 16 x 30 / 12) Average monthly expenditure for food (Details 16 x 30 / 12) Average monthly expenditure for food (Details 16 x 30 / 12) Write down in Column (2) Average monthly expenditure for food (Details 16 x 30 / 12) 69166 5862857 390131.374 The entry is the total sum of Detail 23 and 24, which is the average household expense per month. Average monthly expenditure for non-food (Details 25 column 3 / 12) Average monthly expenditure for non-food (Details 25 column 3 / 12) Average monthly expenditure for non-food (Details 25 column 3 / 12) Average monthly expenditure for non-food (Details 25 column 3 / 12) Average monthly expenditure for non-food (Details 25 column 3 / 12) Average monthly expenditure for non-food (Details 25 column 3 / 12) Write down in Column (2) Average monthly expenditure for non-food (Details 25 column 3 / 12). 69166 16481917 225001.361 Average monthly household expenditure (Details 26 + Details 27) Average monthly household expenditure (Details 26 + Details 27) Average monthly household expenditure (Details 26 + Details 27) Average monthly household expenditure (Details 26 + Details 27) Average monthly household expenditure (Details 26 + Details 27) Average monthly household expenditure (Details 26 + Details 27) Write down in Column (2) Average monthly household expenditure (Details 26 + Details 27). 69166 18330131 615146.756 The contents is the sum of details 23 and 24, which is an average expenditure of households in a month. 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: Main source of household income: Fill job field/income receiver code and job status according to household main source of income in the box. The first three digits for job field/income receiver code and one last digit for job status code. 69166 0011 0845 1000 1001 1002 1011 1012 1021 1022 1031 1032 1041 1042 1052 1091 1092 1102 111 1111 1112 1115 112 1121 1122 1131 1132 1141 1142 1151 1152 1191 1192 1201 1202 1211 1212 122 1221 1222 1231 1232 1241 1242 1251 1252 1261 1262 1301 1302 1311 1312 1321 1322 1331 1332 1341 1342 1351 1352 1391 1392 141 1411 1412 1421 1422 1432 1442 1451 1452 1491 1492 1501 1502 151 1511 1512 152 1521 1522 1531 1532 1541 1542 1551 1552 1591 1592 1601 1602 1611 1612 1691 1692 1711 1712 1721 1722 1731 1732 1741 1742 1811 1812 1821 1822 1911 1912 1921 1922 2001 2002 201 2011 2012 2021 2022 2031 2032 2041 2042 2051 2052 2091 2092 2101 2102 2111 2112 2121 2122 2131 2132 2141 2142 2151 2152 2191 2192 2201 2202 2211 2212 2221 2222 2231 2232 2241 2242 2251 2252 2261 2262 2291 2301 2302 2311 2312 2321 2322 2331 2332 2341 2342 2351 2391 2392 2411 2412 2421 2422 2431 2491 2501 2502 2511 2512 2521 2522 2531 2532 2541 2542 2551 2591 2601 2611 2612 2621 2622 2631 2632 2641 2642 2651 2652 2661 2691 2692 2711 2712 2721 2722 2731 2732 2811 2891 2892 2901 2911 2912 2921 2922 2931 2932 3111 3121 3131 3141 3151 3211 3212 3221 3231 3232 3311 3321 3411 3412 3421 3431 3511 3512 3531 3591 3611 3612 3691 3692 3750 4011 4012 4021 4101 4311 4511 4512 4521 4522 4531 4541 4551 4652 501 5011 5012 502 5021 5022 5031 5032 5041 5042 5051 5111 5121 5122 5131 5132 5141 5142 5151 5191 5192 5211 5212 5221 5222 5231 5232 5241 5242 5251 5252 5261 5262 5311 5312 5321 5322 5331 5341 5342 5351 5352 5391 5392 5422 5431 5511 5512 5521 5522 6011 6021 6022 6111 6112 6121 6211 6221 6311 6312 6321 6331 6332 6341 6342 6351 6352 6391 6392 6410 6411 6421 6422 6425 6511 6591 6592 6601 6602 6619 6711 6721 7011 7012 7021 7022 7111 7112 7121 7122 7131 7132 7211 7212 7231 7251 7252 7291 7292 7311 7312 7411 7412 7415 7421 7422 7431 7432 7491 7492 7511 7512 7521 7522 7531 8011 8021 8031 8091 8092 8510 8511 8512 8521 8522 8531 8532 8566 9001 9002 9111 9121 9191 9211 9212 9221 9241 9242 9301 9302 9501 9502 9711 Has this household been planting paddy and got the harvest since January 01, 2000 until this enumerating day? Has this household been planting paddy and got the harvest since January 01, 2000 until this enumerating day? Has this household been planting paddy and got the harvest since January 01, 2000 until this enumerating day? Has this household been planting paddy and got the harvest since January 01, 2000 until this enumerating day? Has this household been planting paddy and got the harvest since January 01, 2000 until this enumerating day? Has this household been planting paddy and got the harvest since January 01, 2000 until this enumerating day? Circle code 1 if "Yes", "code 2 if" No "then move into the box provided. 69166 1 Yes 2 No 3 Households considered to produced rice if one or more household members aged 10 years and over do penaman / maintenance at his own risk with the goal of most / all the results for their own consumption or for sale. How much kilogram of dry paddy (GKP) had been produced in the last harvest from one planting period? How much kilogram of dry paddy (GKP) had been produced in the last harvest from one planting period? How much kilogram of dry paddy (GKP) had been produced in the last harvest from one planting period? How much kilogram of dry paddy (GKP) had been produced in the last harvest from one planting period? How much kilogram of dry paddy (GKP) had been produced in the last harvest from one planting period? How much kilogram of dry paddy (GKP) had been produced in the last harvest from one planting period? The amount of dry paddy that is recorded in this question is the amount of gross harvest of dry paddy, which is the amount of dry paddy produced before deduction of wages in the form of grain (bawonan). Ask how much dry paddy (kg) were produced. If you are still using the local unit, converted into units of kilograms, according to the region. For example: 1 ketiding rice in West Sumatra = 20 kg 69165 1 99999 318.978 Last harvest intended is harvesting before the end of the planting. The amount of dry paddy that is recorded is the amount of dry paddy the last harvested in the growing season (MT). How much kilogram of dry paddy (GKP) had been sold from production based on b8r1b? How much kilogram of dry paddy (GKP) had been sold from production based on b8r1b? How much kilogram of dry paddy (GKP) had been sold from production based on b8r1b? How much kilogram of dry paddy (GKP) had been sold from production based on b8r1b? How much kilogram of dry paddy (GKP) had been sold from production based on b8r1b? How much kilogram of dry paddy (GKP) had been sold from production based on b8r1b? Ask how much the sale of production of grain produced in the last harvest in units of Kg. If the production is sold in the form of milled rice (GKG) or in the form of rice, convert to a form of dry grain harvest (GKP). 69166 -1200 99999 140.784 GKG (Rice dry milling) is paddy that contains of water content. maximum of 14 percent GKP (dry paddy harvest) is obtained when harvesting rice paddy. Stock of dry paddy mill (producer) dry paddy mill (GKG) (Kg) - Stock at the enumerating day Stock of dry paddy mill (producer) dry paddy mill (GKG) (Kg) - Stock at the enumerating day Stock of dry paddy mill (producer) dry paddy mill (GKG) (Kg) - Stock at the enumerating day Stock of dry paddy mill (producer) dry paddy mill (GKG) (Kg) - Stock at the enumerating day Stock of dry paddy mill (producer) dry paddy mill (GKG) (Kg) - Stock at the enumerating day Stock of dry paddy mill in agricultural paddy household (producer): dry paddy mill (GKG) (Kg) a. Stock at the enumerating day Ask how many the dry paddy mill stock by producer households per December 31, 2000 with the approach of calculating backward / reverse (back cast) and fill into the box in column (3). 69166 99999 91.705 Stock in when enumeration is the number paddy / rice owned / controlled by the household at the time of enumeration. Stock of dry paddy mill (producer) rice (kg) - Stock at the enumerating day Stock of dry paddy mill (producer) rice (kg) - Stock at the enumerating day Stock of dry paddy mill (producer) rice (kg) - Stock at the enumerating day Stock of dry paddy mill (producer) rice (kg) - Stock at the enumerating day Stock of dry paddy mill (producer) rice (kg) - Stock at the enumerating day Stock of dry paddy mill in agricultural paddy household (producer): rice (kg) a. Stock at the enumerating day Ask how many the rice stock by producer households per December 31, 2000 with the approach of calculating backward / reverse (back cast) and fill into the box in column (3). 69166 99999 19.114 Stock of dry paddy mill (producer) dry paddy mill (GKG) (Kg)- Production since January 01, 2001 until enumerating day Stock of dry paddy mill (producer) dry paddy mill (GKG) (Kg)- Production since January 01, 2001 until enumerating day Stock of dry paddy mill (producer) dry paddy mill (GKG) (Kg)- Production since January 01, 2001 until enumerating day Stock of dry paddy mill (producer) dry paddy mill (GKG) (Kg)- Production since January 01, 2001 until enumerating day Stock of dry paddy mill (producer) dry paddy mill (GKG) (Kg)- Production since January 01, 2001 until enumerating day Stock of dry paddy mill in agricultural paddy household (producer): dry paddy mill (GKG) (Kg) b. Production since January 01, 2001 until enumerating day Ask how many production of dry paddy milled since January 1, 2001 by producer household and fill into the box in column (2). 69166 99999 169.965 Production since January 1, 2001 until the during enumeration is a production output or recieved by household during in January 1 up to the enumeration. Stock of dry paddy mill (producer) dry paddy mill (GKG) (Kg) - Selling/ extended to other party since January 01, 2001 until enumerating day Stock of dry paddy mill (producer) dry paddy mill (GKG) (Kg) - Selling/ extended to other party since January 01, 2001 until enumerating day Stock of dry paddy mill (producer) dry paddy mill (GKG) (Kg) - Selling/ extended to other party since January 01, 2001 until enumerating day Stock of dry paddy mill (producer) dry paddy mill (GKG) (Kg) - Selling/ extended to other party since January 01, 2001 until enumerating day Stock of dry paddy mill (producer) dry paddy mill (GKG) (Kg) - Selling/ extended to other party since January 01, 2001 until enumerating day Stock of dry paddy mill in agricultural paddy household (producer): dry paddy mill (GKG) (Kg) c. Selling/ extended to other party since January 01, 2001 until enumerating day Ask how many dry paddy owned by household being sold during the period of January 1, 2001 until the time of enumeration and then fill in the box in column (3). 69166 99999 67.996 Sales / given to other parties since January 1, 2001 up to during enumeration is the amount paddy held by households that sold during the period January 1, 2001 until during enumeration. If a household than as farmers also do sale and purchase activities of the paddy, then paddy are recorded in these details is paddy owned of household not including sale of paddy and trading businesses. Stock of dry paddy mill (producer) rice (kg) - Selling/ extended to other party since January 01, 2001 until enumerating day Stock of dry paddy mill (producer) rice (kg) - Selling/ extended to other party since January 01, 2001 until enumerating day Stock of dry paddy mill (producer) rice (kg) - Selling/ extended to other party since January 01, 2001 until enumerating day Stock of dry paddy mill (producer) rice (kg) - Selling/ extended to other party since January 01, 2001 until enumerating day Stock of dry paddy mill (producer) rice (kg) - Selling/ extended to other party since January 01, 2001 until enumerating day Stock of dry paddy mill in agricultural paddy household (producer): rice (kg) c. Selling/ extended to other party since January 01, 2001 until enumerating day Ask how many rice paddy owned by household being sold during the period of January 1, 2001 until the time of enumeration and then fill in the box in column (3). 69166 99999 12.628 Stock of dry paddy mill (producer) dry paddy mill (GKG) (Kg) - Purchasing/ extending from other party since January 01, 2001 until enumerating day Stock of dry paddy mill (producer) dry paddy mill (GKG) (Kg) - Purchasing/ extending from other party since January 01, 2001 until enumerating day Stock of dry paddy mill (producer) dry paddy mill (GKG) (Kg) - Purchasing/ extending from other party since January 01, 2001 until enumerating day Stock of dry paddy mill (producer) dry paddy mill (GKG) (Kg) - Purchasing/ extending from other party since January 01, 2001 until enumerating day Stock of dry paddy mill (producer) dry paddy mill (GKG) (Kg) - Purchasing/ extending from other party since January 01, 2001 until enumerating day Stock of dry paddy mill in agricultural paddy household (producer): dry paddy mill (GKG) (Kg) d. Purchasing/ extending from other party since January 01, 2001 until enumerating day Ask how many dry paddy owned by household purchased from other parties during the period of January 1, 2001 until the time of enumeration and then fill in the box in column (3). 69165 1 99999 3.95 Purchase / giving of other parties since January 1, 2001 up to during enumeration is the amount paddy purchased by households or other party given to households during January 1, 2001 up to during enumeration. Stock of dry paddy mill (producer) rice (kg) - Purchasing/ extending from other party since January 01, 2001 until enumerating day Stock of dry paddy mill (producer) rice (kg) - Purchasing/ extending from other party since January 01, 2001 until enumerating day Stock of dry paddy mill (producer) rice (kg) - Purchasing/ extending from other party since January 01, 2001 until enumerating day Stock of dry paddy mill (producer) rice (kg) - Purchasing/ extending from other party since January 01, 2001 until enumerating day Stock of dry paddy mill (producer) rice (kg) - Purchasing/ extending from other party since January 01, 2001 until enumerating day Stock of dry paddy mill in agricultural paddy household (producer): rice (kg) d. Purchasing/ extending from other party since January 01, 2001 until enumerating day Ask how many rice paddy owned by household purchased from other parties during the period of January 1, 2001 until the time of enumeration and then fill in the box in column (3). 69166 99999 5.957 Stock of dry paddy mill (producer) rice (kg) - Average rice consumption per-day Stock of dry paddy mill (producer) rice (kg) - Average rice consumption per-day Stock of dry paddy mill (producer) rice (kg) - Average rice consumption per-day Stock of dry paddy mill (producer) rice (kg) - Average rice consumption per-day Stock of dry paddy mill (producer) rice (kg) - Average rice consumption per-day Stock of dry paddy mill in agricultural paddy household (producer): rice (kg) e. Average rice consumption per-day Ask how much rice paddy is consumed by the household per day during January 1, 2001 up to the time of enumeration and then fill in the box in column (3). 69166 20 0.34 Stock and rice procurement (consumer) Total (kg) - Rice stock at the enumerating day Stock and rice procurement (consumer) Total (kg) - Rice stock at the enumerating day Stock and rice procurement (consumer) Total (kg) - Rice stock at the enumerating day Stock and rice procurement (consumer) Total (kg) - Rice stock at the enumerating day Stock and rice procurement (consumer) Total (kg) - Rice stock at the enumerating day Stock and rice procurement in non-agricultural paddy household (consumer): Total (kg) a. Rice stock at the enumerating day Ask the stock of rice paddy non-farmer households (consumers) during enumeration and then fill in the box in column (2). 69166 999 9.052 Stock and rice procurement (consumer) Total (kg) - Average rice consumption per-day Stock and rice procurement (consumer) Total (kg) - Average rice consumption per-day Stock and rice procurement (consumer) Total (kg) - Average rice consumption per-day Stock and rice procurement (consumer) Total (kg) - Average rice consumption per-day Stock and rice procurement (consumer) Total (kg) - Average rice consumption per-day Stock and rice procurement in non-agricultural paddy household (consumer): Total (kg) b. Average rice consumption per-day Ask the average consumption of rice paddy non-farmer households (consumers) per day and then fill in the box in column (2). 69166 25 0.874 Stock and rice procurement (consumer) Total (kg) - Pattern/ manner of purchasing/ getting rice: Stock and rice procurement (consumer) Total (kg) - Pattern/ manner of purchasing/ getting rice: Stock and rice procurement (consumer) Total (kg) - Pattern/ manner of purchasing/ getting rice: Stock and rice procurement (consumer) Total (kg) - Pattern/ manner of purchasing/ getting rice: Stock and rice procurement (consumer) Total (kg) - Pattern/ manner of purchasing/ getting rice: Stock and rice procurement in non-agricultural paddy household (consumer): Total (kg) c. Pattern/ manner of purchasing/ getting rice: Circle one code as appropriate and enter the answer into the box provided. 52778 . 1 Daily 2 Weekly 3 Every two week 4 Monthly 5 Randomly Average quantity of rice that been purchased based on pattern/manner of purchasing Average quantity of rice that been purchased based on pattern/manner of purchasing Average quantity of rice that been purchased based on pattern/manner of purchasing Average quantity of rice that been purchased based on pattern/manner of purchasing Average quantity of rice that been purchased based on pattern/manner of purchasing Average quantity of rice that been purchased based on pattern/manner of purchasing 69166 999.9 10.52 Household Inflation factor SUSENAS 2001 Household Inflation factor SUSENAS 2001 Household Inflation factor SUSENAS 2001 Household Inflation factor SUSENAS 2001 Household Inflation factor SUSENAS 2001 Household Inflation factor SUSENAS 2001 69166 1365 742.595