REPUBLIC OF NICARAGUA, CENTRAL AMERICA MINISTRY OF ECONOMIC AFFAIRS AND DEVELOPMENT (MEDE) NATIONAL INSTITUTE OF STATISTICS AND CENSUSES (INEC)

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REPUBLIC OF NICARAGUA, CENTRAL AMERICA MINISTRY OF ECONOMIC AFFAIRS AND DEVELOPMENT (MEDE) NATIONAL INSTITUTE OF STATISTICS AND CENSUSES (INEC) NATIONAL CENSUSES 1995 SEVENTH POPULATION CENSUS AND THIRD HOUSING CENSUS I. GEOGRAPHIC LOCATION AND POSITION OF THE DWELLING 1. Department: 2. Municipality: 3. Locality: 4. Supervision area: 5. Segment: 6. Number of dwelling within the segment: 7. Neighbourhood or hamlet: 8. Exact address: II. DATA ON THE DWELLING Type of dwelling 1. Private or collective dwellings House Farm Room in a cuartería Ranch or hut Improvised dwelling (stone, waste material, etc) Apartment or room in house or building Workplace used as dwelling (store, garages, etc) Hotels, boarding houses, and guesthouse Prison and correctional facilities Hospitals and sanatoriums Asylums, orphanages Convents and boarding schools type of collective dwelling (If a collective dwelling alternative is selected, skip to SECTION III) Occupation Status 2. This dwelling is: Occupied with inhabitants present Occupied with inhabitants absent Unoccupied dwelling: For sale or rent For seasonal use Under construction Form _ of _

Unoccupied for some other reason (End of interview) Name of census enumerator Date of interview (day, month, year) Name of supervisor Date of revision (day, month, year) CHARACTERISTICS OF THE DWELLING Material used in outside walls 3. What is the predominant material used in the walls of the dwelling? Clay brick or block cement or concrete block Adobe or taquezzal Quarry stone Barul, cane or palm leaves Wood Wood/concrete (mini-skirting) Plycem or nicalit panel Stone or waste material Roofing material 4. What is the predominant material used for roofing? Zinc Clay or cement tiles Plycem or nicalit panel Straw, palm leaves and similar Rubble or waste material Flooring material 5. What is the predominant material used for flooring? Wood, tambo Floor tiles Clay brick Cement brick, mosaic or terrazo Dirt Number of rooms 6. How many rooms does this dwelling have altogether? (Do not include bathrooms, kitchen, corridors, garages) Total:

Of this total number of rooms, how many are always used for sleeping in, even though they may have other uses during the day? Total: Kitchen 7. Does this dwelling have a room only for cooking? (go to question 8) Is the cooking room also used for sleeping in? Water service 8. How is the dwelling supplied with water? Piped inside the dwelling Piped outside the dwelling but inside the property River, spring or stream Public standpipe Public or private well Sanitary facility 9. What type of sanitary facility does this dwelling have? Lavatory or latrine Toilet: Connected to sewerage system Connected to sump or septic tank Discharged into river or stream ne Lighting service 10. What type of lighting does this dwelling have? Electric Gas (kerosene) Type of possession 11. This dwelling is: Owned with property deeds Owned without property deeds Rented

Domestic workshop or industry 12. In this dwelling: A. Is some product or article made for sale? (e.g. furniture, clothing, hammocks, ceramic objects, tortilla, bread, necatamales, other) B. Is a product or article sold there that is not manufactured or made there? (e.g. basic cereals, carbonated drinks, clothing, shoes, other) C. Is a service provided there? (e.g. radio, TV, refrigerator repairs; medical services, beauty parlours, hairdressers, other) Health 13A How far away is the nearest health post? ne Blocks Km 13B How long does it take to reach? Hours Minutes 13C What means of transport is used to get there? On foot Animal Vehicle III. LIST OF PERSONS WHO INHABIT THE DWELLING 1. How many persons live most of the time in this dwelling? Total Men Women 2. What are the names and surnames of each of the persons who live most of the time in this dwelling? Start with the head of household (do not forget to include children, newborn babies and old people).. of person Names and surnames Sex Age

Remember: Include newborn babies, old people and family members who live most of the time in this dwelling but are absent because of vacation, work, business or illness; also include domestic employees who sleep in the dwelling. Transcribe the name and number for each of these persons in Section V (Persons in the Dwelling). IV. MORTALITY 1. From January 1993 until the day before the start of the census, has anyone that used to live with you died? (how many) (go to section V). of person Names and surnames of deceased persons Date of death (day, month, year) Sex (male, female) Age at death (years, months, days) 2. Was a death certificate obtained from MINSA in respect of the deceased person(s)? Person. 1 (/) Person. 2 (/) Person. 3 (/).. V. PERSONS IN THE DWELLING Person. of the list (Write name and surnames) FOR ALL PERSONS 1. What is the person s relationship to the head of household? Head Spouse, companion Son/daughter, stepson/stepdaughter Son/daughter-in-law Grandchild or great grandchild Parents or parents in law relative Domestic employee Unrelated Sex 2. This person is Male Female Age 3. How many years old is the person? (If less than one year old put 00, if over 98 put 98) Years

Indicate date of birth Day, Month, Year Place of birth 4. In what municipality was the person born? Here, in this municipality Elsewhere in Nicaragua? Municipality: Department: In another country? Country: Year of arrival in Nicaragua: Mother tongue 5. Which language does the person speak from childhood at home? Spanish Miskito Sumo or Sumu English Religion 6. What is the person s religion? Catholic Evangelical Morava Episcopalian ne Previous place of residence 7. In what municipality was the person living five years ago (in 1990) Here, in this municipality Elsewhere in Nicaragua? Municipality: Department: In another country? Country: Literacy 8. This person:

Can read and write Can read only Cannot read or write School attendance 9. Is the person currently attending school at primary, secondary or higher level? Schooling 10. What is the highest school year or grade completed? Level Grade or Year ne Literacy Preschool Primary Secondary Basic technical Secondary technical Higher technical University Diploma obtained 11. In the case of persons who have completed studies ranging from basic technical to university, ask: What did you study? Specify Did you obtain a diploma? Did you leave without a diploma? FOR PERSONS OF 10 YEARS OLD AND MORE Marital status 12. What is this person s current marital status? Under 12 years of age Cohabiting Married Separated Divorced Widow/widower Single Activity status 13. Last week this person:

Worked Did not work because he/she was: On holiday/leave Sick/receiving subsidy Did not work because he/ she was waiting: To continue agricultural work For replies from an employer For a new job Looked for work having worked before Looked for work for the first time Lives from a pension, is retired or has private means Is a housewife Is a student Is permanently disabled 14. Last week this person worked in: Selling from a fixed or mobile sales point Washing, ironing, sewing clothes taken in from outside Making and selling bread, tortilla, pastries, handicraft or other items Assistance or apprentice Agricultural tasks (cultivating and harvesting, livestock breeding, milking cows and other similar tasks activity activity Main occupation 15. What did/does the person do in their main job? Status in job 16. In this occupation the person works or worked as Employee/manual worker Day labourer Self-employed Boss or entrepreneur Unpaid worker Member of production cooperatives Branch of activity 17. Indicate the products made, cultivated, sold, or the services provided by the place where this person works or used to work Hours worked 18. How many hours does/ did the person work last week?

Number of hours ONLY FOR WOMEN OF 14 YEARS OLD OR MORE 19. Has the person had any live-born child? 20. How many live-born children has the person had in total? Total Male children Female children 21. Of these children, how many are still living? Total Male children Female children 22. What is the date of birth of the person s last live-born child? Day, Month, Year 23. Is the person s last live-born child still alive? Alive Deceased 24. If the person s last child was born in the last five years, was a birth certificate obtained from MINSA? 25. If the person s last child died within the last five years, was a death certificate obtained from MINSA?