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1994
ROMANIA GGGGG GG GGMinistry of Labor and Social Protection Center Code Month Form NumberNational Commission for Statistics
Strictly confidentialOnly for research purposes
The Integrated Household SurveyQuestionnaire 2
Interviewer SupervisorName _______________________ Name __________________
Signature __________________ Signature ________________
Interview result |__| 1 accepted 2 household found, refused interview 3 household left from locality all month
t:\lsms\lsms\_dis\romania\docs\rm94hhq2.pdf
12. List of Food Goods-Balances Page 32
Purchases from: Other Inputs Sales Other
Public Sector Private Sector
1Code
AFood Good
BU.M.
2Stock atbeginningof month
3Quan
4Amountpaidlei
5Quan
6Amountpaidlei
7Ownproduction
8In-kindpaymentfor work,receivedas gift,barter
9Quan
10Amountpaidlei
11Given asgift, seeds,given forprocessingfor work
12Used forfodder
13Humanconsumption
14Stock atend ofmonth
101 Wheat, rye kg
102 Maize kg
103 Flour kg
104 Maize flour kg
105 Bread kg
106 Bakery prods kg
107 Biscuits kg
108 Bakery specials kg
109 Pasta kg
110 Rice kg
111 Semolina kg
112 Other bakery kg
113 Vegs. kg
114 Potatoes kg
115 Carrots, beets kg
116 Oth roots kg
117 Tomatoes kg
118 Eggplants kg
119 Onion kg
12
12. List of Food Goods-Balances (cont'd.) Page 33
Purchases from: Other Inputs Sales Other
Public Sector Private Sector
1Code
AFood Good
BU.M.
2Stock atbeginningof month
3Quan
4Amountpaidlei
5Quan
6Amountpaidlei
7Ownproduction
8In-kindpaymentfor work,receivedas gift,barter
9Quan
10Amountpaidlei
11Given asgift, seeds,given forprocessingfor work
12Used forfodder
13Humanconsumption
14Stock atend ofmonth
120 Garlic kg
121 Peppers kg
122 Green beans kg
123 Cabbagecauliflowr
kg
124 Greens kg
125 Other veg kg
126 Pickles, sourcabbage
kg
127 Tomato paste kg
128 Tinned vegs kg
129 Melons kg
130 Nuts kg
131 Apples kg
132 Pears kg
133 Cherries kg
134 Apricots kg
135 Plums kg
136 Grapes kg
137 Strwberry kg
138 Frsh fruit kg
12
12. List of Food Goods-Balances (cont'd.) Page 34
Purchases from: Other Inputs Sales Other
Public Sector Private Sector
1Code
AFood Good
BU.M.
2Stock atbeginningof month
3Quan
4Amountpaidlei
5Quan
6Amountpaidlei
7Ownproduction
8In-kindpaymentfor work,receivedas gift,barter
9Quantity
10Amountpaidlei
11Given asgift, seeds,given forprocessingfor work
12Used forfodder
13Humanconsumption
14Stock atend ofmonth
139 Citrus kg
140 Dried fruit kg
141 Oil liter
142 Margarine kg
143 Fruitcompote
kg
144 Jam kg
145 Fruit syrup kg
146 Sugar kg
147 Chocolat kg
148 Halva kg
149 Oth sweets kg
150 Coffee kg
151 Cocoa kg
152 Wine liter
153 Wine prod liter
154 Beer liter
155 Brandy liter
156 Alcohol liter
157 Soft drinks liter
12
12. List of Food Goods-Balances (cont'd.) Page 35
Purchases from: Other Inputs Sales Other
Public Sector Private Sector
1Code
AFood Good
BU.M.
2Stock atbeginningof month
3Quan
4Amountpaidlei
5Quan
6Amountpaidlei
7Ownproduction
8In-kindpaymentfor work,receivedas gift,barter
9Quantity
10Amountpaidlei
11Given asgift, seeds,given forprocessingfor work
12Used forfodder
13Humanconsumption
14Stock atend ofmonth
158 Beef kg
159 Pork kg
160 Mutton kg
161 Poultry kg
162 Oth meat kg
163 Meat by-products
kg
164 Salami kg
165 Oth by-products
kg
166 Tinned meat kg
167 Lard kg
168 Grease kg
169 Fresh fish kg
170 Smk fish kg
171 Can fish kg
172 Cow milk liter
173 Shp milk liter
174 Powderedmilk
kg
175 Butter-milk liter
176 Cheese kg
12
12. List of Food Goods-Balances (cont'd.) Page 36
Purchases from: Other Inputs Sales Other
Public Sector Private Sector
1Code
AFoodGood
BU.M.
2Stock atbeginningof month
3Quan
4Amountpaidlei
5Quantity
6Amountpaidlei
7Ownproduction
8In-kindpaymentfor work,receivedas gift,barter
9Quantity
10Amountpaidlei
11Given asgift, seeds,given forprocessingfor work
12Used forfodder
13Humanconsumption
14Stock atend ofmonth
177 Sheepcheese
kg
178 Creamcheese
kg
179 Pressedcheese
kg
180 Othercheese
kg
181 Butter kg
182 Eggs piece
183 Honey kg
184 Salt lei
185 Oth food lei
186 Total agricfoodprods
lei
187 Hay,fodder,othercereals
lei
188 Unwashedwool
kg
189 Washedwool
kg
190 Total
12
13. Non-food Goods Page 37
Total Purchases from Public, PrivateSectors and the Population
Total Purchases from Public, PrivateSectors and the Population
1Code
ANon-Food Good
BUnit of Measure
2Quantity
3Amount paidlei
1Code
ANon-Food Good
BUnit of Measure
2Quantity
3Amount paid
Textiles Ready-made Clothes for Children
201 Cotton, cotton-like textiles m.l. 217 Cotton, cotton-like
202 Wool, wool-like textiles m.l. 218 Wool, wool-like
203 Silk , silk-like textiles m.l. 219 Silk, silk-like
204 Other kinds of fibers m.l. 220 Other fibers
Ready-made Clothes for Men 221 Leather and furs
205 Cotton, cotton-like Knitwear for:
206 Wool, wool-like 222 Men
207 Silk, silk-like 223 Women
208 Other fibers 224 Children
209 Natural leather and furs Socks and stockings for:
210 Synthetic leather and furs 225 Men pairs
Ready-made Clothes for Women 226 Women pairs
211 Cotton, cotton-like 227 Children pairs
212 Wool, wool-like Men's Footwear
213 Silk, silk-like 228 Natural leather pairs
214 Other fibers 229 Synthetic leather pairs
215 Natural leather and fur 230 Rubber and plastic pairs
216 Synthetic leather and fur
13
13. Non-food Goods (cont'd) Page 38
Total Purchases from Public, PrivateSectors and the Population
Total Purchases from Public, PrivateSectors and the Population
1Code
ANon-Food Good
BUnit ofMeasure
2Quantity
3Amount paidlei
1Code
ANon-Food Good
BUnit ofMeasure
2Quantity
3Amount paid
Women's Footwear Articole de uz gospadaresc
231 Natural leather pairs 246 Textiles, othermanufactures
232 Synthetic leather pairs 247 Towels, tablecloths
233 Rubber and plastics pairs 248 Blankets
Children's Footwear 249 Carpets
234 Natural leather pairs 250 Rugs
235 Synthetic Leather pairs Aparate de uz casnic
236 Rubber and plastics pairs 251 Refrigerator piece
Haberdashery Articles, Smallware Articles, Leather Goods 252 Freezer piece
237 Haberdashery articles 253 Simple washing machine piece
238 Other haberdashery small articles 254 Automatic washingmachine
piece
239 Leather goods 255 Sewing machine piece
Furniture for: 256 Vacuum cleaner piece
240 Living room 257 Gas stoves, gas cylinders piece
241 Bedrooms 258 Electric cookers
242 Kitchen 259 Other cooking stoves
243 Sofas and armchairs 260 Other electric laborsaving devices
244 Bookcases 261 Lighting goods
245 Other furniture, accessories 262 Accessories for electricgoods
13
13. Non-food Goods (cont'd) Page 39
Total Purchases from Public, PrivateSectors and the Population
Total Purchases from Public, PrivateSectors and the Population
1Code
ANon-Food Good
BUnit of Measure
2Quantity
3Amount paidlei
1Code
ANon-Food Good
BUnit ofMeasure
2Quantity
3Amount paid
Housekeeping Articles Made of 277 Music instruments piece
263 Metal 278 Audio, video tapes
264 Plastics 279 Spare parts
265 China, ceramics Sports, Tourism, Cultural Articles
266 Glass, crystal 280 Goods for sport, tourism,culture
267 Other materials 281 Photo and video cameras
Chemical Products 282 Other cultural,entertainment
268 Lacquers, paints kg 283 Toys and games
269 Other chemical goods Clocks, Watches, Jewelery
Books, Newspapers, Magazines 284 Clocks, watches
270 School books 285 Jewelry-precious metals,stones
271 Fiction, technical, medicalbooks
286 Jewelry-other materials
272 Newspapers, magazines Motorcars, Motorcycles, Accessories, and Spare Parts
Stationery 287 Cars piece
273 School supplies 288 Motorcycles piece
274 Other stationery goods 289 Bicycles piece
Audio-visual goods and musical instruments 290 Auto-moto accessories,spare parts
275 Radio sets, cassette players piece 291 Bicycle accessories,spare parts
276 TV sets and VCR piece
13
13. Non-food Goods (cont'd) Page 40
Total Purchases from Public, PrivateSectors and the Population
Total Purchases from Public, PrivateSectors and the Population
1Code
ANon-Food Good
BUnit of Measure
2Quantity
3Amount paidlei
1Code
ANon-Food Good
BUnit of Measure
2Quantity
3Amount paid
Toilet Articles 308 Gas cylinder
292 Perfumes, cosmetics Construction Materials, Agricultural Inventory
293 Hygienic articles 309 Building materials
294 Human medicines 310 Tools for farm,handicraft
295 Optical goods 311 Flowers
296 Technical medical articles 312 Funeral objects
297 Soap kg 313 Other non-foodgoods
298 Toilet soap kg
299 Detergents kg 314 Total (sum ofarticles 201 to 313)
Tobacco and Accessories for Smoking
300 Cigarettes, tobacco
301 Accessories for smoking
Fuels
302 Firewood kg
303 Coal kg
304 Petroleum liter
305 Gasoline liter
306 Diesel oil, oil for cars liter
307 Oil for heating liter
13
14. Expenditures for Payment of Services Page 41
1Code
AType of Service
2Amount Paid (lei)
1Code
AType of Service
2Amount Paid(lei)
Payment for Clothes Manufacture 415 Repair and maintenance of motor vehicles
401 Men 416 Maintenance of electronic goods
402 Women 417 Payment for new building construction
403 Children 418 Repair and maintenance of dwellings
419 Other industrial service
404 Clothes repair Health and Personal Care Services
Payment for Shoe Manufacturing 420 Medical tests, consultations, treatments
405 Men 421 Dental
406 Women 422 Hair cut, cosmetics and hygiene for men
407 Children 423 Hair, cosmetics and hygiene for women
Cultural and Entertainment Services
408 Shoe repairs 424 Hotel accomodations
Industrial Services 425 Tourism, entertainment, sport
409 Manufacture and repair of leather goods 426 Cinema, theater, museums, etc
410 Manufacture and repair of jewelry Educational Services
411 Manufacture and repair of furniture, domestic goods 427 School and out-of-school education
412 Manufacture and repair of medical/optical goods 428 School accomodation
429 Driving lessons
413 Clock and watch repair
414 Photo works
14
14. Expenditures for Payment of Services (cont'd.) Page 42
1Code
AType of Service
2Amount Paid (lei)
1Code
AType of Service
2Amount Paid(lei)
Rent and Dwelling Services Payments for Nourishment
430 Rent 446 Canteen
431 Water supply, garbage 447 Restaurants
432 Electricity 448 Bars, snack-bars, etc.
433 Heating 449 Confectioners, pastry stores
434 Natural gas
435 Other communal services 450 Rent services
Mail, Telephone, Radio-TV 451 Payment for housekeeping services
436 Mail 452 Dry-cleaning, laundry
437 Telephone 453 Interest
438 Radio-TV subscription 454 Payment for people who worked for household production
Transport Services 455 Payments for kindergarten and nurseries
439 Town transport 456 Other services
440 Interurban transport
441 Taxi 457 Total (sum of 401 to 456)
442 Railway
443 Air
444 Sea
445 Other sorts of transportation
14
A. Type of Savings
1 Cash in the household2 Cash in foreign currency3 CEC deposit4 Bank deposit5 Certificate of deposit6 Local saving group7 Amount lent to relative
B. Currency C. Loans
1 Lei2 US dollar3 Deutschmark4 Ruble5 Forint6 French franc7 Swiss franc8 Pound9 Italian lira10 Other
1 Bank2 Local savingsgroup3 Friends/family4 Employer5 Other
D. Reason for Loan
1 Business necessity2 Agricultural equipment3 Current expenses4 Ceremonies and funerals5 Special purchases6 Medical expenses7 House8 Other
15. Savings and Loans Page 43
A. Savings in the Reference Month1Type of Savings(Code from BoxA)
2Currency(Code from BoxB)
3Amount atBeginning ofMonth
4Pay Ins/LoansGranted
5InterestReceived
6Withdrawls/LoansReturned
7Amount at End of Month
B. Loans in the Reference Month1Type of Loan(Code from BoxC)
2Currency (Codefrom Box B)
3Amount at theBeginning of theMonth
4Loans Received
5Interest Paid
6LoansReturned
7Amountat End ofMonth
8Reason for Loan(Code from Box D)
15
Page 44
A List of Diseases
01020304050607
08091011
12131415161718
1920212223242526272829303132
Rheumatic cardiopathyHigh blood pressureIschemic cardiopathyCardio/pulmonary/cerebralCergral, vascular diseaseArterioclerosisPiles
Graves-Basedow diseaseTyroidan adenomaGlucosuriaFatness
Rheumatic polyarthritisYouthful polyarthritisArthrosisAnchylosing spondylitisSpondilosis, discopathiesCommon lumbar pain of adultsVertegral lumbar sciatica
Gastric ulcerDuodenal ulcerPostoperative ulcerHypertrophic gastritisBlunt gastritisInguinal heriaEventratonColitisAbcessFistulaAlcoholic hepatopathyChronic hepatitisLiver cirrhosisChronic cholecystis
33343536373839404142434445464748
4950
5152535455
5657
585960
6162
Salpingitis,ovaritisHydrosalpinxPyosalpinxAcute parametritisChronic parametritisAcute endometritisChronic endometritisAcute metritisChronic metritisVulva-vaginitisProlaps vaginal wallUterine prolapseUterine-vag prolapsePerineum breakUterine polypusUterine
Cervical ectropionVaginal atrophy
Iron deficiencyAnaemiaHemolytic anaemiaSiderosis anaemiaSecondary anaemia
Chronic bronchitisBronchitic asthma
CataractCongenital cataractRefraction vices
Nephrotic syndromeChronic glomeruli
6364
65666768697071
727374757677
787980818283848586878889
Interstitial nephropathyKidney calculus
Spina bifidaMicrocephalyHydrocephalyPalate fissurePolycystic kidneyCongenital l...Foot deformation
PsoriasisStomach tumorsPulmonary tumorsBreast, uterus tumorsBlood tumorsSkin tumors
OtitisStomach diseaseParasitesVeneral diseaseProfessional diseaseCirculatoryWork accidentRicketsSyphilisAIDSFluOther
Attention: Ask these questions only to household members Page 45who during the reference month have a permanent disabilityor have suffered illness or accident.
16. Health
What was the diseaseor injury
1Line no.
2Person code
3Did you haveany diseaseor injuryduring thereferencemonth?1 yes2 no L 20
4Code(Page44)
AName(Page 44)
5How manydays wereyou sick?(number)
6How manydays didyou missschool orworkbecause ofthe diseaseor injury
7Are youstill sick orinjured?
1 yes2 no
8Who was firstconsulted aboutthe disease orinjury?L 10
1 Nobody2 Private doctor3 Dispensary4 Public clinic5 Hospital6 Emergency room7 Dentist8 Traditionalmedicine9 Ambulance service10 Other
9Why didn't youseek medicalservice?L 17
1 Not very sick2 Distance too long3 Waiting period toolong4 Poor quality ofservice5 Highe cost6 Other
10How long didit take totravel to theconsultation
minutes
11Type oftransportused
1 Own car L 132 Publictransport3 Taxi4 On foot
L 135 Other
12Cost oftrans-port
lei
01
02
03
04
05
06
07
08
09
10
11
12
16/1
Page 46
B Type of Handicap (Column 21)
01 Limb amputation
02 Limb paralysis
03 Limb ankylosis
04 Column ankylosis
05 Physical deformations
06 Unilateral cecity
07 Incomplete bilateral cecity
08 Complete bilateral cecity
09 Deafness, dumbness
10 Serious dumbness
11 Epilepsy
12 Mental retardation
13 Schizophrenic psychosis
14 Mental disorder
16. Health (cont'd.) Page 47
ALineno.
BPersoncode
13How long didyou wait forconsultation(minutes)
14Cost ofconsultation(99 = paid by state oremployer)
lei
15Who wasconsultedsecond(samecodes ascolumn 8)
16Cost ofsecondconsultation(99 = paid by state oremployer)
lei
17Cost oftests (99 =paid bystate oremployer)lei
18 *Cost oftreatment(99 = paid by state oremployer)
lei
19 **Cost ofdrugspurchased(99 = paid by state oremployer)lei
20Do yousuffer froma handicap1 yes2 no L 22
21Type ofhandicap(codes onpage 46)
22Number ofdaysaffectedbysicknessin the lastyear
23Did youreceiveassistanceor care inthehouseholdin the lastyear1 yes2 no L
nextperson
24Who tookcare ofyou?1 parents/relatives2 husband/ wife3 children4 nurse5 other
01
02
03
04
05
06
07
08
09
10
11
12
* Incuding the cost for hospital care** Including the cost for classes, prothestetics, etc.
16/2
17. Anthropometrics Page 48
For children under 5
1Child code
2Heightcm
3Weightkg (2 decimals)
Date of Measurement(height, weight) at the dispensary
5Where was the childborn?
1 Hospital2 Health unit3 Home4 Other
6Weight at birthkg (2 decimals)
7Currentlybeingbreastfed?
1 yes2 no L 9
8How many timesfed yesterday?
L next line
9How many monthswas the childbreastfed?
Day Month
17
Surname and first name:
1. At what age did you have your first period?|__|__|
2. Have you ever been pregnant?1 yes2 no L 8 |__|
3. At what age where you pregnant for the firsttime? |__|__|
4. Did you ever have a miscarriage?1 yes L how many? |__|2 no |__|__|
5. Did you ever have an abortion?1 yes L how many? |__|2 no |__|__|
6. Did you have any children? |__|1 yes L how many?2 no L 8 |__|__|
7. At what age did you have your first child? |__|__|
8. Would you like to have any more children?1 yes2 no L 11 |__|
9. How many children would you like to have?|__|__|
10. How many years would you like to be betweenbirths? |__|__|
11 Do you use any birth control means?1 yes2 no |__|
Reason forDeath
1 Respiratoryinfection
2 Diarrheaanddehydration
3 Accident
4 Hepatitis
5 Geneticdisease
6Tuberculosis
7 Cancer
8 Meningitis
9 Otherinfectiousdisease
10 Dystrophy
11 Other
Person Code |__|__|
Birth date Deceased
1Child
2Firstname
3Sex 1 M2 F
4Month
5Year
6If alive,recordpersoncode. If notinhouseholdrecord 99
7Date of death
8 Reason
Month Year
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18. Fertility Page 49 Center Code Month Form Number
To be filled in for all women 14 years and older GGGGG GG GG
18
19. Incomes - balance Page 50
1LineNo.
AIncome
2Amountreceived lei
1Lineno.
AIncome
2Amount receivedlei
01 Gross revenues and other wage rights 23 •Share interests, share sales
02 Benefits and bonuses from the net profit 24 •Other self-employment activities
03 Payments from social security funds for temporary work incapacity 25 Cash incomes from agricultural associations
04 Payments from social security funds for maternity leave and childcare INCOMES FROM SELLING
05 Unemployment benefits 26 •Food products
06 Social aids for unemployment 27 •Animals and products
07 Children's allowances 28 •Houses and other buildings
08 Scholarships 29 •Land
SOCIAL SECURITY PENSIONS FOR: 30 Amounts received from absent household members and from otherpersons
09 •Old age and number of years worked 31 Other incomes
10 •Losing work capacity 32 Cash income total (rows 1 through 31)
11 •Agricultural farmers 33 In-kind payments
12 •Successors 34 Cash and in-kind income total (rows 32 and 33)
13 IOVR pensions 35 Advances received and loans returned by other persons
14 Social aid (pension) 36 Amounts withdrawn from banks, savings, etc.
15 Special aids for handicapped LOANS TAKEN FROM:
PAYMENTS FOR: 37 •State units, cooperatives and mixed units
16 •War veterans and war widows 38 •Private units and population
17 •Persons persecuted for political reasons 39 Goods and services bought by installments
18 Aids in the social assistance system 40 Total amounts entered (rows 34 through 39)
INCOMES FROM: 41 Amount of money at the beginning of the month
19 •Handicraft 42 Total balance (rows 40 and 41)
20 •Trade 43 Savings at banks at the beginning of the month
21 •Transport
22 •Lending lands, agricultural tools, buildings
19
20. Expenses and Other Payments - Balance Page 51
1LineNo.
AExpenses
2Amount paid lei
1Lineno.
AExpenses
2Amount paidlei
501 Food Goods (Sec 12, line 186, col 4 + col 6) 517 Dues (trade unions, parties)
502 Nonfood Goods (Sec 13, line 314, col 3) 518 Taxes
503 Fodder (Sec 12, line 187, cols 4 + 6; Sec 10, line 14, col 7) 519 Amounts sent to relatives and other persons
504 Houses and other buildings 520 Other expenses
505 Lands 521 Total expenses (rows 501 through 520)
506 Animals and poultry 522 Advances and loans granted
507 Seeds 523 Deposits at banks, savings associations, etc.
508 Shares, property certificates
509 Service payments (Sec 14, line 457, col 2) 524 State units, cooperatives and mixed units
CONTRIBUTIONS FOR: 525 Private units and population
510 •Supplementary pension
511 •Unemployment benefit 526 Installments for houses and other purchases
TAXES FOR: 527 Total outputs (rows 521 through 526)
512 •Wages 528 Amount of money at the end of the month
513 •Agricultural incomes, land 529 Total balance (lines 527 + 528)
514 •Buildings, cars 530 Savings left in banks, savings associations at the end of the month(Sec 19, line 43 + Sec 20, line 523 - Sec 19, line 36)
515 •Self-employed and non-agricultural activities
516 Goods and persons insurances
20
21. Public Benefits Page 52
Gratuities and Price Reductions in the Reference Month 1 - free of charge; 2 - price reduction
1Person code
2Railway
3Subway
4Bus, trolley,tramway
5Prothesis, hearingaids, etc.
6Canteen
7Radio, TVsubscription
8Telephone
9Medicines
21
