NEPAL LIVING STANDARDS SURVEY - web.worldbank.org
Transcript of NEPAL LIVING STANDARDS SURVEY - web.worldbank.org
NEPAL LIVING STANDARDSSURVEY
HOUSEHOLD QUESTIONNAIRE
WARD SERIAL NUMBER HOUSEHOLD
HEAD OF HOUSEHOLD _______________________________ ADDRESS ________________________
VILLAGE / MUNICIPALITY ______________________________ DISTRICT ________________________
CENTRAL BUREAU OF STATISTICS
2
TABLE OF CONTENTS
SURVEY INFORMATION................................................................................ 3
1. HOUSEHOLD INFORMATION
A: HOUSEHOLD ROSTER .................................................................... 4B: INFORMATION ON PARENTS.......................................................... 5C: ACTIVITIES ..................................................................................... 6D: UNEMPLOYMENT .......................................................................... 8
2. HOUSING
A: TYPE OF DWELLING....................................................................... 9B: HOUSING EXPENSES .................................................................... 10C: UTILITIES AND AMENITIES .......................................................... 11D: WATER AND FIREWOOD .............................................................. 13
3. ACCESS TO FACILITIES .............................................................................. 15
4. MIGRATION.................................................................................................... 16
5. FOOD EXPENSES AND HOME PRODUCTION ......................................... 17
6. NON-FOOD EXPENDITURES AND DURABLE GOODS
A: FREQUENT NON-FOOD EXPENDITURES ...................................... 22B: INFREQUENT NON-FOOD EXPENDITURES ................................... 23C: INVENTORY OF DURABLE GOODS............................................... 24
7. EDUCATION
A: LITERACY .................................................................................... 25B: PAST ENROLLMENT..................................................................... 26C: CURRENT ENROLLMENT ............................................................. 27
8. HEALTH
A: CHRONIC ILLNESSES ................................................................... 29B: ILLNESSES OR INJURIES............................................................... 30C: IMMUNIZATION............................................................................ 32
9. ANTHROPOMETRICS ................................................................................... 33
10. MARRIAGE AND MATERNITY HISTORY
A: MATERNITY HISTORY.................................................................. 34B: PRE- AND POST-NATAL CARE ..................................................... 37C: FAMILY PLANNING ...................................................................... 38
11. WAGE EMPLOYMENT
A: IN AGRICULTURE......................................................................... 39B: OUTSIDE AGRICULTURE .............................................................. 41
12. FARMING AND LIVESTOCK
A: LANDHOLDING ............................................................................ 43B: PRODUCTION AND DISTRIBUTION............................................... 49C: EXPENDITURE ON INPUTS ........................................................... 50D: EARNINGS FROM AGRICULTURE ................................................ 54E: LIVESTOCK................................................................................... 55
F: OWNERSHIP OF FARMING ASSETS.............................................. 57 G: EXTENSION SERVICES ................................................................. 58
13. NON-FARM ENTERPRISES/ACTIVITIES
A: GENERAL CHARACTERISTICS ..................................................... 59B: INCOME FROM ENTERPRISES ...................................................... 61
14. CREDIT AND SAVINGS
A: BORROWING ................................................................................ 62B: LENDING ...................................................................................... 64C: OTHER ASSETS............................................................................. 66
15. REMITTANCES AND TRANSFERS
A: INCOME SENT .............................................................................. 67B: INCOME RECEIVED ...................................................................... 68
16. OTHER INCOME ............................................................................................ 69
17. ADEQUACY OF CONSUMPTION ................................................................ 70
LIST OF CODES ............................................................................................. 72
3
SURVEY INFORMATION
INTERVIEW
DATE OF INTERVIEW:
INTERVIEWER _________________________ CODE:
DWELLING YES.... 1FOUND? NO..... 2 (èSUPERVISOR)
RELIGION HINDU.. 1 MUSLIM..... 3OF HEAD: BUDDHIST2 OTHER...... 4
LANGUAGE NEPALI. 1 TAMANG..... 4USED: MAITHILI2 NEWARI..... 5 BHOJPURI3 OTHER...... 6
ETHNICITY: USE ETHNICITY CODES PROVIDED AT THE BACK OF THE QUESTIONNAIRE
INTERPRETER: YES..... 1 NO..... 2
REMARKS:_________________________________________________________________
_________________________________________________________________________
SUPERVISOR: PLEASE FILL IF HOUSEHOLD TO BE REPLACED, ORIF THIS HOUSEHOLD IS A REPLACEMENT HOUSEHOLD:
THIS HOUSEHOLD REPLACESHOUSEHOLD NUMBER:
THIS HOUSEHOLD WILL BE REPLACEDBY HOUSEHOLD NUMBER:
REASON:
DWELLING NOT FOUND.....1OCCUPANT NOT AT HOME...2REFUSAL................3
DATA ENTRY OF QUESTIONNAIRE
DATE OF 1ST ROUND OF DATA ENTRY:
OPERATOR _________________________ CODE:
REMARKS: _________________________________________________________________
_________________________________________________________________________
DATE OF REVIEW BY SUPERVISOR:
SUPERVISOR ________________________ CODE:
REMARKS: _________________________________________________________________
_________________________________________________________________________
DATE CORRECTIONS MADE:
OPERATOR _________________________ CODE:
VERIFICATION BY SUPERVISOR:
SIGNATURE _________________________________
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SECTION 1. HOUSEHOLD INFORMATION PART A HOUSEHOLD ROSTER
IDENTIFICATION
CODE
2.
What isthe sex of..[NAME]..?
MALE .... 1FEMALE .. 2
3.
What is the relationship of..[NAME].. to the head ofhousehold?
HEAD ....................... 1WIFE OR HUSBAND ............ 2SON/DAUGHTER ............... 3GRANDCHILD ................. 4FATHER OR MOTHER ........... 5SISTER OR BROTHER .......... 6NIECE OR NEPHEW ............ 7SON/DAUGHTER-IN-LAW ........ 8BROTHER/SISTER-IN-LAW ...... 9FATHER/MOTHER-IN-LAW ...... 10OTHER FAMILY RELATIVE ..... 11SERVANT/SERVANT’S RELATIVE 12TENANT/TENANT’S RELATIVE .. 13OTHER PERSON NOT RELATED .. 14
4.
Where was..[NAME]..born?
Was it then anurban or ruralarea?
URBAN ......1RURAL ......2
5.
How old is..[NAME]..?
IF LESS THAN ONEYEAR, WRITE ZERO
6.
What is thepresent maritalstatus of..[NAME]..?
MARRIED ... 1DIVORCED .. 2(è9)SEPARATED . 3(è9)WIDOW/ WIDOWER .. 4(è9)NEVER MARRIED .. 5(è9)
7.
Is thespouse of..[NAME]..in the list?
YES ......1NO .......2
(è9)
8.
COPY THEID CODE OFTHE SPOUSE
9.
During the past12 months, howmany months did..[NAME].. livehere?
WRITE 12 IFALWAYS PRESENT,OR IF AWAY LESSTHAN A MONTH
10.
ACCORDING TOCRITERIA, IS..[NAME].. AMEMBER OFTHEHOUSEHOLD?
YES ....... 1NO ........ 2
DISTRICT U/R MONTHS
01
02
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05
06
07
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09
10
11
12
13
14
15
IF <10 YEARSTHEN è 9
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SECTION 1. HOUSEHOLD INFORMATION PART B. INFORMATION ON PARENTS OF HOUSEHOLD MEMBERS
IDENTUFICATION
CODE
1.
Is thefather of..[NAME]..in the list?
YES ...... 1NO ....... 2
(è3)DECEASED . 3
(è3)
2.
COPY THE IDCODE OF THEFATHER
3.
Is/was thefather of..[NAME]..literate?
YES .... 1NO ..... 2
(è5)
4.
What was thehighest levelof schoolingthat hecompleted?
NONE ........ 1LESS THAN PRIMARY .... 2PRIMARY ..... 3LOWERSECONDARY .. 4
SECONDARY ORMORE ....... 5
5.
What workdid/does he do?
WAGE EMPLOYMENTAGRICULTURE . 1WAGE EMPLOYMENTNOT IN AGR .. 2SELF-EMPLOYEDAGRICULTURE . 3SELF-EMPLOYEDNOT IN AGR. . 4OTHER ........ 5
6.
Where was..[NAME’S]..father born?
Was it then anurban or ruralarea?
URBAN ....1 RURAL ....2
7.
Is thenaturalmother of..[NAME]..in the list?
YES ...... 1NO ....... 2
(è9)DECEASED . 3
(è9)
8.
COPY THE IDCODE OF THEMOTHER
9.
Is/was themother of..[NAME]..literate?
YES .....1NO ......2
(è11)
10.
What was thehighest levelof schoolingthat shecompleted?
NONE .......1LESS THAN PRIMARY ...2PRIMARY ....3LOWERSECONDARY.4
SECONDARY ORMORE......5
11.
What workdid/does she do?
WAGE EMPLOYMENTAGRICULTURE..1WAGE EMPLOYMENTNOT IN AGR...2SELF-EMPLOYEDAGRICULTURE..3SELF-EMPLOYEDNOT IN AGR...4OTHER.........5
12.
Where was..[NAME’S]..mother born?
Was it then anurban or ruralarea?
URBAN .... 1 RURAL .... 2
DISTRICT U/R DISTRICT U/R
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02
03
04
05
06
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è 7 è NEXTPERSON
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SECTION 1. HOUSEHOLD INFORMATION PART C ACTIVITIES (FOR ALL HOUSEHOLD MEMBERS 10 YEARS AND OLDER)
DURING PAST 12 MONTHS DURING PAST 7 DAYS LOCATION SECTOR OF EMPLOYMENTACTIVITY
COD
ID
CODE
1.
During the past 12 months,what work did ..[NAME].. do?
2.
During thepast 12months,how manymonths did..[NAME]..do thiswork?
3.
How manydays permonth?
4.
How manyhours perday?
5.
Duringthe past7 days,how manydays did..[NAME].. do thiswork?
6.
How manyhours perday?
7.
Did.[NAME]. dothis workin thisVDC/NP?
YES ......1(è9)
NO .......2
8.
Where did..[NAME].. dothis work?
Was it an urbanor rural area?
URBAN...... 1 RURAL...... 2
9.
INTERVIEWER: PUT A “1” LEAVE THE
WAGE EMPLOYMENT
IN THE RELEVANT COLUMNOTHER COLUMNS BLANK
SELF EMPLOYMENT
E IN NOT IN IN NOT INOCCUPATION CODE MONTHS DAYS/MONTH HRS/DAY DAYS HRS/DAY DISTRICT U/R AGRICULTURE AGRICULTURE AGRICULTURE AGRICULTURE
A
B
C
D
E
F
G
H
I
J
K
L
M
N
O
P
Q
R
S
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SECTION 1. HOUSEHOLD INFORMATION PART C ACTIVITIES (FOR ALL HOUSEHOLD MEMBERS 10 YEARS AND OLDER)
DURING PAST 12 MONTHS DURING PAST 7 DAYS LOCATION SECTOR OF EMPLOYMENT
ACTIVITY
COD
ID
CODE
1.
During the past 12 months,what work did ..[NAME].. do?
2.
During thepast 12months,how manymonths did..[NAME]..do thiswork?
3.
How manydays permonth?
4.
How manyhours perday?
5.
Duringthe past7 days,how manydays did..[NAME].. do thiswork?
6.
How manyhours perday?
7.
Did.[NAME]. dothis workin thisVDC/NP?
YES ......1(è9)
NO .......2
8.
Where did..[NAME].. dothis work?
Was it an urbanor rural area?
URBAN...... 1 RURAL...... 2
9.
INTERVIEWER: PUT A “1” LEAVE THE
WAGE EMPLOYMENT
IN THE RELEVANT COLUMNOTHER COLUMNS BLANK
SELF EMPLOYMENT
E IN NOT IN IN NOT INOCCUPATION CODE MONTHS DAYS/MONTH HRS/DAY DAYS HRS/DAY DISTRICT U/R AGRICULTURE AGRICULTURE AGRICULTURE AGRICULTURE
T
U
V
W
X
Y
Z
1
2
3
4
5
6
7
8
9
0
(SECOND PAGE)
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SECTION 1. HOUSEHOLD INFORMATION PART D UNEMPLOYMENT (FOR ALL HOUSEHOLD MEMBERS 10 YEARS AND OLDER
IDENTUFICATION
CODE
1.
Were you availableforwork/additionalwork during thepast 7 days?
YES ......... 1NO .......... 2
(è3)
2.
Did you lookfor work?
YES.......... 1(èNEXT PERSON)NO........... 2
3.
Why were you not available/did you not look for work?
ALREADY HAVE ENOUGH WORK . 1STUDENT .................. 2 HOUSEWIFE ............... 3 TOO OLD/ RETIRED ........ 4 SICK .................... 5 HANDICAPPED ............. 6 ON VACATION ............. 7 AWAITING REPLY FROM EMPLOYER OR AGENCY ..... 8 WAITING TO START NEW JOB ................ 9 THERE IS NO WORK ....... 10 DON’T KNOW HOW TO LOOK ............... 11 OTHER REASONS .......... 12
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SECTION 2. HOUSING PART A TYPE OF DWELLING
1. Is this dwelling unit occupied by your household only?
YES .................. 1NO .................. 2
2. How many rooms does your household occupy?
TOTAL
KITCHEN
TOILET/BATHROOM
BEDROOMS
LIVING/DINING ROOMS
BUSINESS
MIXED USE
OTHER
3. IS THERE A KITCHEN GARDEN?
YES .................. 1NO ................... 2
4. MAIN CONSTRUCTION MATERIAL OF OUTSIDE WALLS:
CEMENT BONDED BRICKS/STONES1MUD BONDED BRICKS/STONES .. 2WOOD/BRANCHES ............. 3CONCRETE .................. 4UNBAKED BRICKS ............ 5OTHER PERMANENT MATERIAL .. 6NO OUTSIDE WALLS .......... 7
5. MAIN FLOORING MATERIAL:
EARTH ...................... 1WOOD ....................... 2STONE-BRICK ................ 3CEMENT/TILE ................ 4OTHER ...................... 5
6. MAIN MATERIAL ROOF IS MADE OF:
STRAW, THATCH .............. 1EARTH/MUD .................. 2WOOD, PLANKS ............... 3GALVANIZED IRON ............ 4CONCRETE, CEMENT ........... 5
TILES/SLATE ................ 6OTHER ...................... 7
7. THE WINDOWS ARE FITTED (CHECK THE FIRST THAT APPLIES)
NO WINDOWS/ NO COVERING .... 1SHUTTERS ................... 2SCREENS/GLASS .............. 3OTHER ...................... 4
8. HOW BIG IS THE HOUSING PLOT?SQ. FT.
9. HOW BIG IS THE INSIDE OF THE DWELLING? SQ. FT.
INTERVIEWER: PLEASE PROVIDE THE FOLLOWING INFORMATION ON THERESPONDENT HOUSEHOLD’S DWELLING UNIT (Q. 3-9)
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SECTION 2. HOUSING PART B HOUSING EXPENSES
1. Is this dwelling yours?
YES .................. 1NO ................... 2 (è6)
2. If you wanted to buy a dwelling just like this today, how muchmoney would you have to pay?
RUPEESINCLUDE VALUE OF HOUSING PLOT
3. If someone wanted to rent this dwelling today, how much moneywould they have to pay each month?
RUPEES
4. Did you rent out part of this dwelling unit?
YES .................. 1NO ................... 2 (èPART C)
5. How much do you receive as rent per month?
RUPEES
6. What is your present occupancy status?
RENTER ............... 1 (è8)PROVIDED FREE OF CHARGE BY RELATIVES, LANDLORD OR EMPLOYER ....... 2SQUATTING ............ 3OTHER ................ 4
7. If someone wanted to rent this dwelling today, how much moneywould they have to pay each month?
RUPEES
8. From whom are you renting?
PRIVATE INDIVIDUAL ... 1RELATIVE ............. 2EMPLOYER ............. 3OTHER ................ 4
9. What is the rent per month? (cash plus value of in-kind payments)
RUPEES
10. Does the rent include:ELECTRICITY
YES ... 1NO .... 2
WATER
TELEPHONE
è PART C
è PART C
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SECTION 2. HOUSING PART C UTILITIES AND AMENITIES
1. Where does your drinking water come from?
PIPED WATER SUPPLY .... 1COVERED WELL/HAND PUMP 2 (è3)OPEN WELL ............. 3 (è3)OTHER WATER SOURCE .... 4 (è3)
2. Do you have water piped into your house?
YES ................... 1NO .................... 2
3. How much did you pay for water over the last 12 months?(EXCLUDE WATER USED FOR IRRIGATION)
IF NOTHING, WRITE ZERO RUPEES
4. Are you connected to a sanitary system for liquid wastes?
YES, UNDERGROUND DRAINS ...... 1YES, OPEN DRAINS ............. 2YES, SOAK PIT ................ 3NO ........................... 4
5. How does your household dispose of its garbage?
COLLECTED BY GARBAGE TRUCK ...1PRIVATE COLLECTOR ............2DUMPED .......................3 (è7)BURNED/BURIED ................4 (è7)DUMPED AND USED FOR FERTILIZER 5 (è7)OTHER ........................6
6. How much do you pay for garbage disposal over the last 12 months?
IF NOTHING, WRITE ZERO RUPEES
7. What type of toilet is used by your household?
HOUSEHOLD FLUSH (CONNECTEDTO MUNICIPAL SEWER) ..........1HOUSEHOLD FLUSH (CONNECTEDTO SEPTIC TANK) ..............2HOUSEHOLD NON-FLUSH ..........3COMMUNAL LATRINE .............4NO TOILET ....................5
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SECTION 2. HOUSING PART C UTILITIES AND AMENITIES (CONT.)
8. What is the main source of lighting for your dwelling?
ELECTRICITY .......... 1GAS, OIL, KEROSENE ... 2 (è11)GENERATOR ............ 3 (è11)BIO-GAS .............. 4 (è11)OTHER ................ 5 (è11)(SPECIFY ___________ )
9. Do you have a joint or individual electric meter?
JOINT ................ 1INDIVIDUAL ........... 2NO METER ............. 3
10. How much did you spend on electricity over the past 12 months?
IF NOTHING, WRITE ZERORUPEES
11. Do you have a telephone in your dwelling unit?
YES ................. 1NO .................. 2 (è13)
12. How much did you pay for your telephone over the last 12 months?
RUPEES
13. What kind of fuel is most often used by your household forcooking?
WOOD .......................1COW DUNG ...................2LEAVES/RUBBISH/STRAW/THATCH 3COAL/CHARCOAL ..............4GAS CYLINDER ...............5ELECTRICITY ................6KEROSENE ...................7BIO-GAS ....................8OTHER ......................9
MAIN FUEL SECONDARY FUEL
14. What type of stove does your household mainly use for cooking?
OPEN FIREPLACE ....... 1MUD .................. 2SMOKELESS CHULLAH .... 3KEROSENE/GAS ......... 4OTHER ................ 5
13
SECTION 2. HOUSING PART D WATER AND FIREWOOD
1. Have you fetched water at any time over the past 12 months?
YES ....1NO .....2 (è7)
2.
Did you fetchwater during thismonth?
YES ....... 1NO ........ 2(èNEXT MONTH)
3.
Was there awater shortageduring thisperiod?
YES .....1NO ......2
4,
How many timesa day did themembers of yourhousehold go tocollect waterduring thismonth?
5.
How long did ittake to collectwater each time?
(ROUND TRIP)MONTH CD NUMBER HOURS MIN
KARTIK 01
MAGH 02
BAISAKH 03
6. Who in the household is mainly responsible for fetching water?
ID CODE ID CODE ID CODE ID CODE
14
SECTION 2. HOUSING PART D WATER AND FIREWOOD (CONT.)
7. Did you use any firewood over the past 12 months?
YES ....1NO .....2 (è19)
8. Did you collect any firewood in the past 12 months?
9. On average, how many bharis/carts of firewood do you collect each month?
BHARI.1CART ...2 NO: UNIT:
10. How long does it take to collect one bhari of firewood?
TIME TAKEN ROUND TRIP HRS MIN
11. Who in the household is mainly responsible for collecting firewood?
ID CODE ID CODE ID CODE ID CODE
12. Where did you collect the firewood?
OWN LAND ............... 1 (è14)
COMMUNITY MANAGED FOREST2GOVERNMENT FOREST ...... 3 (è14)
OTHER .................. 4 (è14)
13. How much did you pay for each bhari?
IF NOTHING WRITE ZERO RUPEES
14. Did you purchase any firewood in the past 12 months?
YES.... 1NO..... 2 (è19)
15. On average, how many bharis/carts of firewood do you purchase each month?
BHARI 1CART... 2 NO: UNIT:
16. How much did you pay per unit?
RUPEES
17. How long does it take to purchase firewood each month?
TIME TAKEN IN TOTAL HRS MINIF NOTHING WRITE ZERO
18. Who in the household is mainly responsible for purchasing firewood?
ID CODE ID CODE ID CODE ID CODE
19. Did you collect fodder for your livestock over the past 12 months?
YES.... 1NO..... 2 (èNEXT SECTION)
20. Where did you collect the fodder?
OWN LAND................1COMMUNITY MANAGED FOREST2GOVERNMENT FOREST.......3OTHER...................4
15
SECTION 3 ACCESS TO FACILITIES
1.
How long does it take to get from yourhouse to the closest ..[FACILITY}?
2.
MODE OF TRANSPORT:
FOOT (WITHOUT LOAD) ..... 1 BICYCLE ................. 2 MOTORCYCLE .............. 3 CAR/BUS ................. 4 MIXED (FOOT+VEHICLE) .... 5 PRESENT NEXT TO HH ...... 6 NOT APPLICABLE .......... 7
(èNEXT FACILITY)
3.
TIME TAKEN:
(ONE WAY)
CODE DAYS HOURS MINUTES
Primary School 101
Health Post 102
Bus stop 103
Paved Road 104
Dirt Road, vehicle passable 105
Dirt Road, vehicle impassable 106
Local shop/shops 107
Haath bazaar 108
Market center 109
Krishi Center 110
Sajha (cooperative) 111
Commercial bank branch office 112
16
SECTION 4 MIGRATION (Household head)
ASK OF THE HOUSEHOLD HEAD:
1. Have you ever migrated for reasons of work or land availability?
YES .. 1NO ... 2 (èNEXT SECTION)
2. Where did you migrate from?
DISTRICT CODE
URBAN......1 U/RRURAL......2
3. How old were you when you migrated?
YEARS
4. What did you primarily do there (i.e. before migrating)?
OCCUPATION: CODE
INDUSTRY: CODE
5. Where did you migrate to?
DISTRICT CODE
URBAN......1 U/RRURAL......2
6. How long did you stay there? IF STILL LIVING THERE WRITE “99” YEARS
7. What did you do there primarily (i.e. after migrating)?
OCCUPATION: CODE
INDUSTRY: CODE
IF ACTIVITY LISTED IN SECTION 1 PART CTHEN WRITE ACTIVITY CODE HERE
8. How long did it take you to find this job?
MONTHS
17
SECTION 5 FOOD EXPENSES AND HOME PRODUCTION
FOOD PURCHASES HOME PRODUCTION IN-KIND1.
Have you consumed ..[FOOD].. during the past 12months?
PUT A CHECK (ü) IN THE APPROPRIATE BOX FOR EACHFOOD ITEM. IF THE ANSWER TO Q. 1 IS YES, ASKQ. 2-8.
2.
How manymonths inthe past 12months didyou purchase..[FOOD].. ?
IF NONEWRITE ZEROAND è5
3.
In a typicalmonth duringwhich youpurchased..[FOOD]. howmuch did youpurchase?
4.
How muchwould younormally haveto spend intotal to buythisquantity?
5.
How manymonths in thepast 12months didyou consume..[FOOD]..that you grewor producedyourself?
IF NONE WRITEZERO AND è8
6.
In a typicalmonth duringwhich you ate..[FOOD].., howmuch did yourhouseholdconsume of..[FOOD]..?
7.
How much wouldyour householdhave to spendin the marketto buy thisquantity of..[FOOD]..(i.e. theamountconsumed in atypicalmonth)?
8.
What is thetotal value ofthe ..[FOOD]..consumed thatyou received in-kind over thepast 12 months(wages for work,etc.)?
IF NONE WRITEZERO
NO YES CODE MONTHS QUANTITY UNIT RUPEES MONTHS QUANTITY UNIT RUPEES RUPEES
1. GRAINS AND CEREALS: 010
Fine rice 011
Coarse rice 012
Beaten, flattened rice 013
Maize 014
Maize flour 015
Wheat flour 016
Millet 017
Other grains/cereals 018
2. PULSES AND LENTILS: 020
Black Pulse 021
Masoor 022
Rahar 023
Gram 024
Other pulses 025
Other beans 026
18
SECTION 5 FOOD EXPENSES AND HOME PRODUCTION (CONT.)
FOOD PURCHASES HOME PRODUCTION IN-KIND1.
Have you consumed ..[FOOD].. during the past 12months?
PUT A CHECK (ü) IN THE APPROPRIATE BOX FOR EACHFOOD ITEM. IF THE ANSWER TO Q. 1 IS YES, ASKQ. 2-8.
2.
How manymonths inthe past 12months didyou purchase..[FOOD].. ?
IF NONEWRITE ZEROAND è5
3.
In a typicalmonth duringwhich youpurchased..[FOOD]. howmuch did youpurchase?
4.
How muchwould younormally haveto spend intotal to buythisquantity?
5.
How manymonths in thepast 12months didyou consume..[FOOD]..that you grewor producedyourself?
IF NONE WRITEZERO AND è8
6.
In a typicalmonth duringwhich you ate..[FOOD].., howmuch did yourhouseholdconsume of..[FOOD]..?
7.
How much wouldyour householdhave to spendin the marketto buy thisquantity of..[FOOD]..(i.e. theamountconsumed in atypicalmonth)?
8.
What is thetotal value ofthe ..[FOOD]..consumed thatyou received in-kind over thepast 12 months(wages for work,etc.)?
IF NONE WRITEZERO
NO YES CODE MONTHS QUANTITY UNIT RUPEES MONTHS QUANTITY UNIT RUPEES RUPEES
3. EGGS AND MILK PRODUCTS 030
Eggs 031
Milk 032
Condensed milk 033
Baby milk/powder milk 034
Curd 035
Other milk products 036
4. COOKING OILS 040
Ghee 041
Vegetable oil 042
Mustard oil 043
Other oil 044
5. VEGETABLES: 050
Potatoes/pindaaloo 051
Onions 052
Cauliflower/cabbage 053
Tomatoes 054
Green leafy vegetables 055
Other vegetables 056
19
SECTION 5 FOOD EXPENSES AND HOME PRODUCTION (CONT.)
FOOD PURCHASES HOME PRODUCTION IN-KIND1.
Have you consumed ..[FOOD].. during the past 12months?
PUT A CHECK (ü) IN THE APPROPRIATE BOX FOR EACHFOOD ITEM. IF THE ANSWER TO Q. 1 IS YES, ASKQ. 2-8.
2.
How manymonths inthe past 12months didyou purchase..[FOOD].. ?
IF NONEWRITE ZEROAND è5
3.
In a typicalmonth duringwhich youpurchased..[FOOD]. howmuch did youpurchase?
4.
How muchwould younormally haveto spend intotal to buythisquantity?
5.
How manymonths in thepast 12months didyou consume..[FOOD]..that you grewor producedyourself?
IF NONE WRITEZERO AND è8
6.
In a typicalmonth duringwhich you ate..[FOOD].., howmuch did yourhouseholdconsume of..[FOOD]..?
7.
How much wouldyour householdhave to spendin the marketto buy thisquantity of..[FOOD]..(i.e. theamountconsumed in atypicalmonth)?
8.
What is thetotal value ofthe ..[FOOD]..consumed thatyou received in-kind over thepast 12 months(wages for work,etc.)?
IF NONE WRITEZERO
NO YES CODE MONTHS QUANTITY UNIT RUPEES MONTHS QUANTITY UNIT RUPEES RUPEES
6. FRUITS AND NUTS: 060
Bananas 061
Citrus fruits (oranges, etc.) 062
Mangoes 063
Apples 064
Pineapple 065
Papaya 066
Other fruits 067
Dried fruits 068
7. FISH AND MEAT: 070
Fish 071
Mutton 072
Buff. 073
Chicken 074
Other meats (boar, duck, etc.) 075
20
SECTION 5 FOOD EXPENSES AND HOME PRODUCTION (CONT.)
FOOD PURCHASES HOME PRODUCTION IN-KIND1.
Have you consumed ..[FOOD].. during the past 12months?
PUT A CHECK (ü) IN THE APPROPRIATE BOX FOR EACHFOOD ITEM. IF THE ANSWER TO Q. 1 IS YES, ASKQ. 2-8.
2.
How manymonths inthe past 12months didyou purchase..[FOOD].. ?
IF NONEWRITE ZEROAND è5
3.
In a typicalmonth duringwhich youpurchased..[FOOD]. howmuch did youpurchase?
4.
How muchwould younormally haveto spend intotal to buythisquantity?
5.
How manymonths in thepast 12months didyou consume..[FOOD]..that you grewor producedyourself?
IF NONE WRITEZERO AND è8
6.
In a typicalmonth duringwhich you ate..[FOOD].., howmuch did yourhouseholdconsume of..[FOOD]..?
7.
How much wouldyour householdhave to spendin the marketto buy thisquantity of..[FOOD]..(i.e. theamountconsumed in atypicalmonth)?
8.
What is thetotal value ofthe ..[FOOD]..consumed thatyou received in-kind over thepast 12 months(wages for work,etc.)?
IF NONE WRITEZERO
NO YES CODE MONTHS QUANTITY UNIT RUPEES MONTHS QUANTITY UNIT RUPEES RUPEES
8. SPICES AND CONDIMENTS: 080
Salt 081
Cumin seed/black pepper 082
Turmeric 083
Ginger and garlic 084
Chilies 085
Other spices and condiments 086
9. SWEETS AND CONFECTIONERY: 090
Sugar 091
Gur 092
Sweets (mithai) 093
Sugar candy, chocolate, etc. 094
10. NON-ALCOHOLIC BEVERAGES 100
Tea (dried leaves) 101
Coffee (ground, instant) 102
Carbonated drinks, fruit juices 103
Other non-alcoholic drinks 104
21
SECTION 5 FOOD EXPENSES AND HOME PRODUCTION (CONT.)
FOOD PURCHASES HOME PRODUCTION IN-KIND1.
Have you consumed ..[FOOD].. during the past 12months?
PUT A CHECK (ü) IN THE APPROPRIATE BOX FOR EACHFOOD ITEM. IF THE ANSWER TO Q. 1 IS YES, ASKQ. 2-8.
2.
How manymonths inthe past 12months didyou purchase..[FOOD].. ?
IF NONEWRITE ZEROAND è5
3.
In a typicalmonth duringwhich youpurchased..[FOOD]. howmuch did youpurchase?
4.
How muchwould younormally haveto spend intotal to buythisquantity?
5.
How manymonths in thepast 12months didyou consume..[FOOD]..that you grewor producedyourself?
IF NONE WRITEZERO AND è8
6.
In a typicalmonth duringwhich you ate..[FOOD].., howmuch did yourhouseholdconsume of..[FOOD]..?
7.
How much wouldyour householdhave to spendin the marketto buy thisquantity of..[FOOD]..(i.e. theamountconsumed in atypicalmonth)?
8.
What is thetotal value ofthe ..[FOOD]..consumed thatyou received in-kind over thepast 12 months(wages for work,etc.)?
IF NONE WRITEZERO
NO YES CODE MONTHS QUANTITY UNIT RUPEES MONTHS QUANTITY UNIT RUPEES RUPEES
11. ALCOHOLIC BEVERAGES: 110
Wine 111
Gin, whiskey 112
Beer/jandh 113
Other alcoholic drinks 114
12. TOBACCO & TOBACCO PRODUCTS: 120
Cigarettes 121
Bidis 122
Tobacco 123
Other (jarda, khaini, betel
nut)
124
13. MISC. FOOD PRODUCTS: 130
Meals taken outside home 131
Misc. other food expenditures 132
ASK RESPONDENT TO ESTIMATE AVERAGE MONTHLYEXPENDITURE ON FOOD, VALUE OF HOME PRODUCEDFOOD, AND FOOD RECEIVED IN KIND .... 140
22
SECTION 6. NON-FOOD EXPENDITURES AND INVENTORY OF DURABLE GOODS PART A FREQUENT NON-FOOD EXPENDITURES
1.
Were any of the following items purchased orreceived in-kind over the past 12 months?
PUT A CHECK (ü) IN THE APPROPRIATE BOX FOR ALLITEMS. IF THE ANSWER IS YES, ASK Q 2-3.
What is the money value ofthe amount purchased orreceived in-kind by yourhousehold during the past:
AMOUNT IN RUPEES
2. 3.
NO YES CD 30 DAYS 12 MONTHS21. FUELS: 210
Wood (bundlewood, logwood, sawdust) 211
Kerosene oil 212
Coal, charcoal 213
Cylinder gas 214
Matches, candles, flint, lighters,lanterns, etc.
215
22. APPAREL AND PERSONALCARE ITEMS:
220
Ready-made clothing and apparel 221
Cloth, wool, yarn, and thread formaking clothes and sweaters
222
Tailoring expenses 223
Footwear (shoes, slippers,chappals, etc.)
224
Toilet soap 225
Toothpaste, tooth powder,toothbrush, etc.)
226
Other personal care items (shampoo,combs, cosmetics, etc.)
227
Dry cleaning and washing expenses 228
Personal services (haircuts,shaving, shoeshine, etc.)
229
1.
Were any of the following items purchased orreceived in-kind over the past 12 months?
PUT A CHECK (ü) IN THE APPROPRIATE BOX FOR ALLITEMS. IF THE ANSWER IS YES, ASK Q 2-3.
What is the money value ofthe amount purchased orreceived in-kind by yourhousehold during the past:
AMOUNT IN RUPEES
2. 3.
NO YES CD 30 DAYS 12 MONTHS23. OTHER FREQUENT EXPENSES: 230
Public transportation (buses,taxis, rickshaws, train tickets)
231
Petrol, diesel, motor oil forpersonal vehicle only
232
Entertainment (cinema, radio tax,cassette rentals, etc.)
233
Newspapers, books, stationerysupplies
234
Pocket money to children 235
Educational and professionalservices
236
Modern medicines and healthservices (doctor fees, hospitalcharges etc.)
237
Traditional medicines and healthservices
238
Wages paid to servants, malie,chowkidars, etc.
239
Light bulbs, shades, batteries,etc.
241
Household cleaning articles (soap,bleach, washing powder, etc.)
242
TOTAL: (210 + 220 + 230)250
ASK RESPONDENT TO ESTIMATE AVE. MONTHLY & ANNUAL260 EXPENDITURE ON FREQUENTLY PURCHASED NON-FOODITEMS
23
SECTION 6. NON-FOOD EXPENDITURES AND INVENTORY OF DURABLE GOODS PART B INFREQUENT NON-FOOD EXPENDITURES
1.
Were any of the following items purchased orreceived in-kind over the past 12 months?
PUT A CHECK (ü) IN THE APPROPRIATE BOX FOR ALLITEMS. IF THE ANSWER IS YES, ASK Q 2.
2.
What is the money value ofthe amount purchased orreceived in-kind by yourhousehold during the past12 months:
AMOUNT IN RUPEESNO YES CD 12 MONTHS
31. INFREQ. EXPENSES: 310
Legal expenses and insurance (car,life, etc.)
311
Income taxes, land taxes, housingand property taxes
312
Repair and other expenses forpersonal vehicle(registrationfines)
313
Postal expenses, telegrams, fax,telephone
314
Excursion, holiday, (includingtravel and lodging)
315
Toys, sports goods 316
Repair and maintenance of the house 317
Repair and servicing of householdeffects
318
Home improvements and additions 319
32. MISC. EXPENSES: 320
Marriages, births, and otherceremonies
321
Dowry & bride price given 322
Dowry & bride price received 323
Funeral and death related expenses 324
Expenditure on religious ceremonies 325
Charity, donations, etc. 326
Cash losses 327
Gifts and transfers 328
1.
Were any of the following items purchased orreceived in-kind over the past 12 months?
PUT A CHECK (ü) IN THE APPROPRIATE BOX FOR ALLITEMS. IF THE ANSWER IS YES, ASK Q 2.
2.
What is the money value ofthe amount purchased orreceived in-kind by yourhousehold during the past:
AMOUNT IN RUPEESNO YES CD 12 MONTHS
41. DURABLE GOODS: 410
Crockery, cutlery and kitchenutensils (household use)
411
Kitchen appliances (refrigerator,cooking range, blenders, etc.)
412
Pillows, mattresses, blankets, etc. 413
Jewelry 414
Furniture and fixtures 415
Electric fans 416
Heaters (electric, gas, kerosene) 417
Sewing machine 418
Iron (electric or other) 419
Television/VCR 421
Washing machine 422
Cassette recorder or player, radio,etc.
423
Camera, camcorder, etc. 424
Bicycle 425
Motorcycle 426
Motor car or other such vehicle 427
Other durable goods 428
24
SECTION 6. NON-FOOD EXPENDITURES AND INVENTORY OF DURABLE GOODS PART C INVENTORY OF DURABLE GOODS
1.
Does your household own any of thefollowing items?
PUT A CHECK (ü) IN THE APPROPRIATE BOX FORALL ITEMS. IF THE ANSWER IS YES, ASK Q. 2-6
2.
How many..[ITEM].. doesyour householdown?
3.
How many years agodid you acquire..[ITEM]..?
IF MORE THAN ONEITEM OWNED, ASK
ABOUT MOST RECENTLYACQUIRED ITEM
4.
Did you purchase it,receive it as a gift orpayment for services, orreceive it as dowry orinheritance?
PURCHASE ............. 1GIFT/PAYMENT ......... 2DOWRY/INHERITANCE .... 3
5.
How much was itworth when youacquired it?
6.
if you wanted to sellthis ..[ITEM].. today,how much money wouldyou receive for it?
IF MORE THAN ONE ITEMOWNED, ASK ABOUT TOTAL
VALUE OF ALL ITEMS
ITEM NO YES CODE No: YEARS RUPEES RUPEES
Radio / cassette player 501
Camera/camcorder 502
Bicycle 503
Motorcycle / scooter 504
Motor car etc. 505
Refrigerator or freezer 506
Washing machine 507
Fans 508
Heaters 509
Television / VCR 510
Pressure lamps / petromax 511
Telephone sets / cordless 512
Sewing machine 513
Furniture and rugs 514
Kitchen utensils 515
Jewelry (incl. watches) 516
25
SECTION 7. EDUCATION PART A LITERACY (ALL PERSONS 5 YEARS AND OLDER)
IDENTIFICATION
CODE
1.
WRITE ID CODEFROM HOUSEHOLDROSTER OFPERSONPROVIDING THISINFORMATION
2.
Can you read aletter?
YES....... 1NO........ 2
(è5)
3.
Can youwrite a letter?
YES ....... 1NO ........ 2
(è5)
4.
Where did you learn toread and write?
FORMAL SCHOOLING....1TAUGHT AT HOME......2GOVT LITERACY COURSE3NGO LITERACY COURSE.4OTHER...............5
5.
INTERVIEWER:
ASK EACH PERSON ABOUT THEIREDUCATIONAL BACKGROUND, ANDCODE THEIR EDUCATIONALBACKGROUND AS FOLLOWS:
NEVER ATTENDED SCHOOL...........1ATTENDED SCHOOL IN THE PAST........ 2 (èPART B)CURRENTLY ATTENDING SCHOOL...........3 (èPART C)
6.
Why didn’t you ever attend school?
SCHOOL NOT PRESENT.............. 1TOO EXPENSIVE................... 2TOO FAR AWAY.................... 3HAD TO HELP AT HOME............. 4HAD TO HELP WITH FARM WORK ..... 5HAD TO HELP WITH FAMILY BUSINESS 6SCHOOL OR TEACHER NOT GOOD...... 7TEACHER ABSENT TOO OFTEN........ 8ALL MALE TEACHERS............... 9EDUCATION NOT USEFUL........... 10PARENTS DID NOT WANT........... 11NOT WILLING TO ATTEND.......... 12OTHER REASONS.................. 13
ID CODE PRIMARY REASON SECONDARY REASON
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
è NEXT PERSON
26
SECTION 7. EDUCATION PART B PAST ENROLLMENT (ALL PERSONS 5 YEARS AND OLDER)
INTERVIEWER: ASK ONLY OF THOSE PERSONS WHO HAVE ATTENDED SCHOOL IN THE PAST
IDENTIFICATION
CODE
1.
What type of schooldid you lastattend?
PUBLIC .......... 1PRIVATE ENGLISHMEDIUM .......... 2PRIVATE COMMUNITY/PROPOSED SCHOOL 3TECHNICAL SCHOOL 4OTHER ........... 5
2.
What was thehighest classthat youcompleted?
EDUCATION
3.
How many yearsdid it take youto completeprimary school?
IF PRIMARYSCHOOL NOT
COMPLETED WRITENUMBER OF YEARSSCHOOL ATTENDED
AND è5
4.
How many yearsdid it take youto pass your SLCexamination?
IF SLC LEVEL NOT COMPLETEDWRITE NUMBER OFYEARS SCHOOL
ATTENDED
5.
Why did you leave school?
COMPLETED DESIRED SCHOOLING ....... 1 FURTHER SCHOOLING NOT AVAILABLE ... 2 TOO EXPENSIVE ..................... 3 TOO FAR AWAY ...................... 4 HAD TO HELP AT HOME ............... 5 HAD TO HELP WITH FARM WORK ....... 6 HAD TO HELP WITH FAMILY BUSINESS .. 7 SCHOOL OR TEACHER NOT GOOD ........ 8 TEACHER ABSENT TOO OFTEN .......... 9 ALL MALE TEACHERS ................ 10 PARENTS DID NOT WANT ............. 11 NOT WILLING TO ATTEND FURTHER .... 12 MOVED AWAY ....................... 13 POOR ACADEMIC PROGRESS ........... 14 OTHER REASONS .................... 15
CODE PRIMARY REASON SECONDARY REASON
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
è NEXT PERSON
27
SECTION 7. EDUCATION PART C CURRENT ENROLLMENT (ALL PERSONS 5 YEARS AND OLDER)
INTERVIEWER: ASK ONLY OF THOSE PERSONS CURRENTLY ATTENDING SCHOOL
IDENTIFICATION
CODE
1.
What type of schoolare you currentlyattending?
PUBLIC .......... 1PRIVATE ENGLISHMEDIUM .......... 2PRIVATE COMMUNITY/PROPOSED SCHOOL 3TECHNICAL SCHOOL 4OTHER ........... 5
2.
What class areyou currentlyattending?
EDUCATION
3.
How many yearsdid it take youto completeprimary school?
IF PRIMARYSCHOOL NOTCOMPLETED
WRITE NUMBEROF YEARS SCHOOLATTENDED AND è5
4.
How many yearsdid it take youto pass your SLCexamination?
IF SLC LEVEL NOT COMPLETEDWRITE NUMBER OFYEARS SCHOOL
ATTENDED
5.
Do you liveaway from hometo study?
YES .... 1 (è8)NO ..... 2
6.
How do you goto school?
WALK ...... 1BUS ....... 2BIKE ...... 3OTHER ..... 4
7.
How much time doyou spendcommuting everyday?
8.
Where do you liveto attend school?
WRITE DISTRICT CODEAND WHETHER IT ISURBAN OR RURAL
URBAN ..... 1 RURAL ..... 2
CODE HRS MIN DISTRICT U/R
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
è 9
28
SECTION 7. EDUCATION PART C CURRENT ENROLLMENT (ALL PERSONS 5 YEARS AND OLDER)(CONT.)
IDENTIFICATION
9.
How much has your household spent during the past 12 months for your schooling?
IF NOTHING WAS SPENT, WRITE ZERO.
IF THE RESPONDENT CAN ONLY GIVE A TOTAL AMOUNT OF EXPENSES AND NOT THE BREAKDOWN PER TYPE, WRITE DK(DON’T KNOW) IN COLUMNS A TO G, AND THE TOTAL AMOUNT IN COLUMN H.
10.
Did you receivea scholarshipto help pay foryoureducationalexpenses?
YES......... 1NO.......... 2(èNEXT PERSON)
11.
How much did youreceive over thepast 12 months?
CODE
A.
Admission,Registrationand Tuition
B.
Examina-tion fees
C.
Transpor-tation feesand costs
D.
Textbooks,writing supp.stationeryetc
E.
Privatetutoring
F.
Boardingfees
G.
Otherfees andexpenses
H.
TOTAL
Rs. Rs. Rs. Rs. Rs. Rs. Rs. Rs. RUPEES
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
29
SECTION 8. HEALTH PART A CHRONIC ILLNESSES (ALL HOUSEHOLD MEMBERS)
I D E N T I F I C A T I O N
C O D E
1.
WRITE IDCODE FROMHOUSEHOLDROSTER OFPERSONPROVIDINGINFORMATION
2.
Do you sufferfrom a chronicillness?
YES ........ 1NO ......... 2(èNEXT PERSON)
3.
What chronicillness do youprimarilysuffer from?
HEART CONDITIONS .1ASTHMA ......2EPILEPSY ....3CANCER ......4DIABETES ....5CIRRHOSIS OF THE LIVER ..6OCCUPATIONAL ILLNESSES ..7OTHER .......8
4.
How many years agodid the illnessstart?
5.
How much haveyou spent in thepast 12 monthson the treatmentof this illness?
INCLUDE COST OFMEDICINES AND
CONSULTATIONS ASWELL AS TRAVEL
COSTS
6.
How many daysdid you have tostop doing yourusual activitydue to thisillness duringthe past 12months?
ID CODE YEARS RUPEES DAYS
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
30
SECTION 8. HEALTH PART B ILLNESSES OR INJURIES (ALL HOUSEHOLD MEMBERS)
FIRST CONSULTATION
IDENTIFICATION
CODE
1.
When was thelast time thatyou were ill?
IF MORE THAN ONE MONTH THENèNEXT PERSON
IF RESPONDENTCANNOT REMEMBERWRITE “99” INTHE MONTHSCOLUMN ANDèNEXT PERSON
2.
What type ofillness orinjury?
DIARRHEA ..... 1DYSENTERY .... 2RESPIRATORY PROBLEMS .... 3MALARIA ...... 4OTHER FEVER .. 5SKIN DISEASE . 6TB ........... 7MEASLES ...... 8JAUNDICE ..... 9PARASITES ... 10INJURY ...... 11OTHER ...... 12
3.
Was anyoneconsulted (e.g.a doctor nurseor otherhealer) for theillness orinjury?
YES ........ 1NO ......... 2
(è13)
4.
Who was consultedfirst?
DOCTOR ......... 1PARAMEDIC (HA,SAHW AHW, ANM) . 2NON-PARAMEDIC VHW CHV, MCHW) 3TRADITIONAL HEALER ........ 4HOMEOPATH ...... 5OTHER .......... 6
5.
Where didyou go forthisconsultation?
SHP ........1HP .........2PHC ........3HOSPITAL ...4MOBILE CLINIC ....5PHARMACY ...6HOME VISIT .7OTHER PUBLIC ....8OTHER PRIVATE ...9
6.
What was thecost of thisconsultation, includinganymedicinesprovided?
7.
How much didyou spend ontravel costs?
IF NOTHINGWRITE ZERO
8.
Did you go for asecondconsultation?
YES ......... 1NO .......... 2
(è13)
MONTHS DAYS RUPEES RUPEES
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
31
SECTION 8. HEALTH PART B ILLNESSES OR INJURIES (ALL HOUSEHOLD MEMBERS) CONT.
SECOND CONSULTATION FOR CHILDREN UNDER 5 YRS WITH DIARRHEA
I D E N T I F I C A T I O N
C O D E
9.
Who was consultedsecond?
DOCTOR ......... 1PARAMEDIC (HA,SAHW AHW, ANM) . 2NON-PARAMEDIC VHW CHV, MCHW) 3TRADITIONAL HEALER ........ 4HOMEOPATH ...... 5OTHER .......... 6
10.
Where did yougo for thisconsultation?
SHP........ 1HP......... 2PHC........ 3HOSPITAL... 4MOBILE CLINIC.... 5PHARMACY... 6HOME VISIT. 7OTHER PUBLIC.... 8OTHER PRIVATE... 9
11.
What was thecost of thisconsultation,including anymedicinesprovided?
12.
How much didyou spend ontravel costs?
IF NOTHINGWRITE ZERO
13.
How much intotal wasspent overthis illnessor injuryover the past30 days?
14.
Did you have tostop doing yourusual activitiesbecause of thisillness orinjury?
YES ........... 1NO ............ 2(èNEXT PERSON)
15.
How manydays didyou have tostop doingyour usualactivities?
16.
Did you give..[NAME]..anything totreat thediarrhea?
YES ....... 1 NO ........ 2(èNEXT PERSON)
17.
What did you give.[NAME]. to treatthe diarrhea?
ORS (PACKETOR HOME-MADE) . 1ALLOPATHIC MEDICINE .... 2 (èNEXT PERSON)TRADITIONAL MEDICINE .... 3 (èNEXT PERSON)OTHER ......... 4 (èNEXT PERSON)
18.
Where did youobtain the ORS?
SHP ............ 1HP ............. 2PHC ............ 3MOBILE CLINIC/ IMMUNIZ. CAMP . 4PHARMACY ....... 5MADE AT HOME ... 6OTHER PUBLIC ... 7OTHER PRIVATE .. 8
RUPEES RUPEES RUPEES DAYS
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
32
SECTION 8. HEALTH PART C IMMUNIZATIONS (CHILDREN 5 YEARS AND UNDER)
I D E N T I F I C A T I O N
C O D E
1.
Has..[NAME]..ever beenimmunized?
YES .........1NO ..........2(èNEXT CHILD)DO NOT KNOW .3(èNEXT CHILD)
2.
Do you have animmunizationcard for..[NAME]..?
ASK TO SEE CARDSFOR ALL CHILDRENFOR WHOM CARDSARE AVAILABLE
YES, CARDAVAILABLE... 1
NO, OR CARD NOTAVAILABLE... 2
(è4)
3.
CHECK FROM CARD WHETHER IMMUNIZATION HAS TAKEN PLACE
YES ........... 1 NO ............ 2
4.
How manydoses ofvaccine has..[NAME]..received?
(1 TO 8)
5.
Where was themost recentimmunizationgiven?
SHP .......... 1HP ........... 2OUTREACH CLINIC ...... 3HOSPITAL ..... 4OTHER HEALTH FACILITY .... 5
BCG DPT1 DPT2 DPT3 POLIO 1 POLIO 2 POLIO 3 MEASLES
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
è 5
33
SECTION 9 ANTHROPOMETRICS (ALL CHILDREN 3 YEARS AND UNDER)
IDENTIFICATION
CODE
1.
When was..[NAME]..born?
ASK TO SEEBIRTHREGISTRATION OROTHERCERTIFICATE OFBIRTH. IF NOTAVAILABLE, ASKTO SEEIMMUNIZATIONCARD
2.
ISINFORMATIONPROVIDED FROMBIRTHCERTIFICATEOR OTHEROFFICIALPAPER?
YES ....... 1NO ........ 2
3.
This means that..[NAME].. is___ yearsand/or___ months old.
Is thiscorrect?
PROBE ANDRECORD CORRECTAGE IN MONTHS
4.
WAS..[NAME]..MEASURED?
Yes ... 1 (è6)No .... 2
5.
WHY NOT?
NOT HOMEDURING ENTIRESURVEY PERIOD 1TOO ILL...... 2HANDICAPPED/ DEFORMED.... 3NOT WILLING.. 4OTHER........ 5
6.
HEIGHT
FRAC CMS. TION
7.
WEIGHT
FRAC KILOS TION
8.
Was ..[NAME]..breastfed?
Yes ......... 1No .......... 2 (èNEXTCHILD)
9.
Up until what agewas ..[NAME]..exclusivelybreastfed?
IF CURRENTLYSTILL EXCLUSIVELY
BREASTFED WRITE “99”
DAY MTH YR AGE IN MONTHS MONTHS
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
è 8
34
SECTION 10. MARRIAGE AND MATERNITY HISTORY PARTA
MATERNITY HISTORY (ALL EVER MARRIED WOMEN WHO HAVE GIVEN BIRTH)
NAME OF WOMAN WRITE WOMAN’S ID CODE FROM ROSTER WRITE ID CODE OF RESPONDENT
1 B I R T H
O R D E R
1.
When was ..[ORDER]..child born?
IF NOT KNOWN,ESTIMATE USINGSUPPLEMENTARYCALENDAR
2.
What is the child’s name?
3.
What is thesex of..[NAME]..?
MALE..... 1FEMALE... 2
4.
Is ..[NAME]..still alive?
YES ..... 1NO ...... 2
(è7)
5.
Does..[NAME]..currently livewith you?
YES...... 1NO...... 2
(è8)
6.
COPY ID CODE OFCHILD FROMHOUSEHOLD ROSTER
7
How long did the..[NAME].. live?
8.
What was the highestlevel of schoolingthat ..[NAME]..completed?
MONTH YEAR ID CODE YEARS MONTHS DAYS EDUCATION CODE
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
è NEXT CHILD
35
SECTION 10. MARRIAGE AND MATERNITY HISTORY PARTA
MATERNITY HISTORY (ALL EVER MARRIED WOMEN WHO HAVE GIVEN BIRTH)
NAME OF WOMAN WRITE WOMAN’S ID CODE FROM ROSTER WRITE ID CODE OF RESPONDENT
2 B I R T H
O R D E R
1.
When was ..[ORDER]..child born?
IF NOT KNOWN,ESTIMATE USINGSUPPLEMENTARYCALENDAR
2.
What is the child’s name?
3.
What is thesex of..[NAME]..?
MALE..... 1FEMALE... 2
4.
Is ..[NAME]..still alive?
YES ..... 1NO ...... 2
(è7)
5.
Does..[NAME]..currently livewith you?
YES...... 1NO...... 2
(è8)
6.
COPY ID CODE OFCHILD FROMHOUSEHOLD ROSTER
7
How long did the..[NAME].. live?
8.
What was the highestlevel of schoolingthat ..[NAME]..completed?
MONTH YEAR ID CODE YEARS MONTHS DAYS EDUCATION CODE
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
è NEXT CHILD
36
SECTION 10. MARRIAGE AND MATERNITY HISTORY PARTA
MATERNITY HISTORY (ALL EVER MARRIED WOMEN WHO HAVE GIVEN BIRTH)
NAME OF WOMAN WRITE WOMAN’S ID CODE FROM ROSTER WRITE ID CODE OF RESPONDENT
3 B I R T H
O R D E R
1.
When was ..[ORDER]..child born?
IF NOT KNOWN,ESTIMATE USINGSUPPLEMENTARYCALENDAR
2.
What is the child’s name?
3.
What is thesex of..[NAME]..?
MALE .....1FEMALE ...2
4.
Is ..[NAME]..still alive?
YES...... 1NO....... 2
(è7)
5.
Does..[NAME]..currently livewith you?
YES ......1NO ......2
(è8)
6.
COPY ID CODE OFCHILD FROMHOUSEHOLD ROSTER
7
How long did the..[NAME].. live?
8.
What was the highestlevel of schoolingthat ..[NAME]..completed?
MONTH YEAR ID CODE YEARS MONTHS DAYS EDUCATION CODE
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
è NEXT CHILD
37
SECTION 10. MARRIAGE AND MATERNITY HISTORY PART B PRE AND POST-NATAL CARE (ALL WOMEN WITH A CHILD 3 YRS OR YOUNGER)
PRE-NATAL CARE POST-NATAL CARE
I D E N T I F I C A T I O N
C O D E
1.
While you werepregnant withyour lastchild, did yougo forprenatalconsultationsto a healthcare facility?
YES....... 1NO........ 2
(è6)
2.
Where didyou firstreceive thiscare?
SHP ...... 1HP ....... 2PHC ...... 3HOSPITAL . 4MATERNITY HOSPITAL 5OTHER .... 6
3.
At whatmonth ofpregnancydid you gofor yourfirstvisit?
4.
During thispregnancy, wereyou given aninjection in thearm to preventthe baby fromgetting tetanus,that isconvulsions afterbirth?
YES ........ 1NO ......... 2 (è6)
5.
How manytimes did youreceive thisinjection?
ONCE.....1TWICE....2MORE THANTWICE...3
6.
Who assistedyou with thisbirth?
FAMILY MEMBEROR RELATIVE 1NEIGHBORS .. 2TBA ........ 3ANM ........ 4MCH WORKER . 5OTHER ...... 6
7.
Where did yougive birth?
HOME....... 1SHP........ 2HP......... 3PHC........ 4HOSPITAL... 5MATERNITY HOSPITAL.. 6OTHER...... 7
8.
After the birth,did you visit ahealth carefacility withinsix weeks ofdelivery for apost-natalcheckup?
YES ........ 1NO ......... 2(èNEXT WOMAN)
9.
Where did you gofor this visit?
SHP ........ 1HP ......... 2PHC ........ 3HOSPITAL ... 4MATERNITY HOSPITAL .. 5OTHER ...... 6
MONTH
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
38
SECTION 10. MARRIAGE AND MATERNITY HISTORY PARTC
FAMILY PLANNING (ALL MEN AND WOMEN AGED 15-49 YRS)
I D E N T I F I C A T I O N
C O D E
1.
How old wereyou when youfirst gotmarried?
IF UNMARRIEDLEAVE BLANK
2.
Do you knowof anymethod topreventpregnancy orspacebirths?
YES...... 1NO....... 2
(è9)
3.
How did youlearn aboutsuch methods?
FAMILY/RELATIVE/FRIEND ..... 1RADIO/TV .... 2HEALTH WORKER............ 3OTHER ....... 4
4.
Have you(or yourspouse)ever usedany ofthesemethods?
YES ... 1NO .... 2
(è8)
5.
Are youcurrentlyusing anyof thesemethods?
YES ....1NO .....2
(è8)
6.
Which method do youcurrently use?
CONDOM ........ 1OTHER TEMPORARY2PERMANENT ..... 3TRADITIONAL ... 4 (è9)
7.
Where do you/did you getthis method?
PUBLIC HEALTHFACILITY ...1
PRIVATE HEALTHFACILITY ...2
PHARMACY ....3VSI CAMP ....4OTHER .......5NOT APPLIC. .6
8.
Why not?
NOT AVAILABLE . 1TOO EXPENSIVE . 2SPOUSE AWAY ... 3WANT MORECHILDREN .... 4
RELIGIOUSREASONS ..... 5
BAD/FEARED SIDE-EFFECTS . 6NOT MARRIED ... 7OTHER ......... 8
9.
During the lastsix months, didany healthworker visityour home totalk aboutfamilyplanning?
YES........1NO.........2
10.
How many childrenwould you like tohave?
How many boys?
How many girls?
IF RESPONDENTREPLIES
“UPTO GOD OR KARMA”CODE AS “99”
YEARS BOYS GIRLS TOTAL
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
è 9
39
SECTION 11. WAGE EMPLOYMENT PART A IN AGRICULTURE (ALL PERSONS 10 YEARS AND OLDER)
JOB DESCRIPTION PAID BY DAY
ACTIVITY
CODE
ID
CODE
1.
JOB (COPY FROM 1.C)
2.
Were youpaid on apiece ratebasis?
YES .... 1(è7)
NO ..... 2
3.
Were youpaid on adaily basis?
YES ..... 1NO ...... 2
(è7)
4.
How much did youget in cash perday for thisjob?
5.
What did you get inkind?
PADDY/RICE ....... 1WHEAT ............ 2MAIZE ............ 3MEALS ............ 4CLOTHING ......... 5OTHER ............ 6
LEAVE BLANK IF NO IN-KIND
PAYMENT RECEIVED
6.
What was the value of what youreceived in kind?
RECORD VALUE OF DAILY IN-KINDPAYMENTS AND VALUE OF IN-KIND
PAYMENTS FOR WHOLE PERIODWORKED
OCCUPATION CODE Rs. PER DAY FIRST SECOND PER DAY WHOLE PERIOD
è NEXT ACTIVITY
40
SECTION 11. WAGE EMPLOYMENT PART A IN AGRICULTURE (CONT.) (ALL PERSONS 10 YEARS AND OLDER)
PAID ON A LONGER BASIS
ACTIVITY
CODE
7.
How much didyou get incash for thisjob over thepast 12months?
8.
What did you get in kind?
PADDY/RICE ........1WHEAT .............2MAIZE .............3MEALS .............4CLOTHING ..........5OTHER .............6
LEAVE BLANK IF NO IN-KINDPAYMENT RECEIVED
9.
What was the value of what youreceived in kind?
RECORD VALUE OF DAILY IN-KINDPAYMENTS AND VALUE OF IN-KIND
PAYMENTS FOR WHOLE PERIOD
10.
Did you at anytime take a loanfrom youremployer?
YES ........... 1NO ............ 2
IF LOANOUTSTANDING DURING
PAST 12 MONTHSCOVER THIS INSECTION 14
11.
Did any othermember of yourhousehold also workfor the sameemployer?
YES ........... 1NO ............ 2
12.
Did you share-cropany land with youremployer?
YES ........... 1NO ............ 2
13.
Did you tend anylivestock for youremployer?
YES ........... 1NO ............ 2
Rs. FIRST SECOND PER DAY WHOLE PERIOD
41
SECTION 11. WAGE EMPLOYMENT PART B OUTSIDE AGRICULTURE (ALL PERSONS 10 AND OLDER)
JOB DESCRIPTION PAID BY DAY
ACTIVITY
CODE
ID
CODE
1.
JOB (COPY FROM 1.C)
2.
INDUSTRIAL SECTOR
3.
Were youpaid on aPiece-ratebasis?
YES .... 1...(è14)NO ..... 2
4.
Were youpaid on adailybasis?
YES.....1NO......2
(è8)
5.
How much didyou get incash per dayfor this job?
6.
What did you get inkind?
PADDY/RICE ........1WHEAT .............2MAIZE .............3MEALS .............4CLOTHING ..........5OTHER .............6
LEAVE BLANK IF NO IN-KIND PAYMENT RECEIVED
7.
What was the value ofwhat you received inkind?
RECORD VALUE OF DAILY IN-KIND PAYMENTS AND VALUEOF IN-KIND PAYMENTS FOR
WHOLE PERIOD WORKED
OCCUPATION CODE INDUSTRY CODE Rs. PER DAY FIRST SECOND Rs. PER DAY TOTAL (Rs)
è NEXT ACTIVITY
42
SECTION 11. WAGE EMPLOYMENT PART B OUTSIDE AGRICULTURE (CONT.) (ALL PERSONS 10 AND OLDER)
PAID ON A LONGER BASIS PIECE-RATE
ACTIV
8.
How much did you get for this job?
9.
Are taxesalreadydeducted?
10.
Do youcontribute toan EmployeeProvident Fund
11.
Will youreceive apensionwhen youretire?
12.
Do youreceivesubsidizedmedical care?
13.
How manypeople workfor youremployer?
14.
During thepast 12months, howmuch did you
I PER MONTH PAST 12 MONTHS (10%)? receiveTY
CODE
TAKE-HOME PAYPER MONTH
TRANSPORTPER MONTH
BONUSES,TIPS,
ALLOWANCES(INCLUDE.DASAIN)
OVER PAST12 MONTHS
CLOTHINGOVER PAST12 MONTHS
ANY OTHERPAYMENTSOVER PAST12 MONTHS
YES ....... 1NO ........ 2
YES........1NO.........2
YES ....... 1NO ........ 2
YES ....... 1NO ........ 2
1 ......... 12-9 ....... 210 OR MORE 3
from piece-rate work?(cash + in-kindpayments)
RUPEES PER MONTH RUPEES PER YEAR RUPEES
èNEXTACTIVITY
43
SECTION 12. FARMING LIVESTOCK PART A1 LANDHOLDING - LAND OWNED
ID CODE OF 1. Does your household own any YES....1RESPONDENT: agricultural land? NO.....2 (èPART A2)
PLOT
NUMBER
2.
MAKE A LIST OF ALL THEPLOTS/GARDENS THAT THEHOUSEHOLD OWNS:
3.
What is the total area ofthis ..[PLOT]..?
ROPANI ........ 1BIGHA ......... 2BIJAN (RICE) . 3BIJAN (MAIZE) 4
4.
Where is thisplot located?
DISTRICT
5.
What type ofland is the..[PLOT]..?
PAKHO/BARI ... 1KHET ......... 2UNCULTIVABLE . 3
6.
Is the .[PLOT].irrigated orrainfed?
IRRIGATED.... 1RAINFED...... 2
(è10)
7.
Is theirrigation onthe .[PLOT].seasonal or yearround?
SEASONAL ... 1YEAR ROUND .. 2
8.
What is the modeof irrigation onthe .[PLOT].?
TUBEWELL..... 1CANAL........ 2POND/TANK.... 3OTHER NATURAL SOURCES..... 4MIXED........ 5
9.
Who manages theirrigation systemthat is availableon the .[PLOT].?
SELF-MANAGED ..... 1AGENCY MANAGED ... 2COMMUNITY MANAGED 3
AREA UNIT CODE
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
44
SECTION 12. FARMING AND LIVESTOCK PART A1 LANDHOLDING - LAND OWNED (CONT)
DRY SEASON
PLOT
NUMBER
10.
Did you inheritthe .[PLOT].?
YES ....... 1NO ........ 2
11.
Is the..[PLOT]..registeredwith theGovernment?
YES .....1NO ..... 2
12.
What is thequality of..[PLOT]..?
AWAL.......... 1DWAIM......... 2SIM........... 3CHAHAR........ 4NOT APPL...... 5
13.
If you wanted tobuy a plotexactly likethis, how muchwould it costyou?
14.
Over the past DRYSEASON what did you dowith the .[PLOT].?
CROPPED YOURSELF 1(è16)SHARECROPPED OUT 2FIXED RENT OUT .. 3MORTGAGED OUT ... 4(è17)LEFT FALLOW ..... 5(è17)OTHER ........... 6
15.
For the plots which youdid not crop yourself,what net rent did youreceive from thetenant?
NET RENT (Rs)
16.
For the plots which you croppedyourself, what crops did you grow?
CROP CODE
RUPEES CASH IN-KIND 1 2 3 4
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
è 17
45
SECTION 12. FARMING AND LIVESTOCK PART A1 LANDHOLDING - LAND OWNED (CONT)
WET SEASON
PLOT
NUMBER
17.
Over the past WET SEASON what didyou do with the .[PLOT].?
CROPPED YOURSELF .......1(è19)SHARECROPPED OUT .......2FIXED RENT OUT .........3MORTGAGED OUT ..........4
(èNEXT PLOT)LEFT FALLOW ............5
(èNEXT PLOT)OTHER ..................6
18.
For the plots which youdid not crop yourself,what net rent did youreceive from the tenant?
NET RENT (Rs)
19.
For the plots which you croppedyourself, what crops did yougrow?
CROP CODECASH IN-KIND 1 2 3 4
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
è NEXT PLOT
46
SECTION 12 FARMING AND LIVESTOCK PART A2 LANDHOLDING - LAND SHARECROPPED/RENTED/MORTGAGED -IN
1. Over the past AGRICULTURE YEAR did your household cultivate land owned YES ..... 1 by someone else (or that was mortgaged in)? NO ...... 2 (èPART A3)
PLOT
NUMBER
2.
MAKE A LIST OF ALL THEPLOTS/GARDENS THAT THEHOUSEHOLD CULTIVATEDTHROUGH SHARECROPPING-IN, RENTING-IN ORMORTGAGING-IN:
3.
What is thecontractualarrangement onthis .[PLOT].?
SHARECROPPED 1RENTED-IN ... 2MORTGAGED-IN 3
4.
How much “rent”did you pay forthis plot to thelandlord?
INCLUDE ONLYCASH PAYMENTS
IF NOTHINGWRITE ZERO
5.
What is the total area ofthis ..[PLOT]..?
ROPANI .......... 1BIGHA ........... 2BIJAN (RICE) ... 3BIJAN (MAIZE) ... 4
6.
What type ofland is the..[PLOT]..?
PAKHO/BARI...1KHET.........2UNCULTIVABLE.3
7.
Is the .[PLOT].irrigated orrainfed?
IRRIGATED ... 1RAINFED ..... 2
(è11)
8.
Is theirrigation onthe .[PLOT].seasonal oryear round?
SEASONAL ... 1YEAR ROUND .. 2
9.
What is the mode ofirrigation on the.[PLOT].?
TUBEWELL ..... 1CANAL ........ 2POND/TANK .... 3OTHER NATURAL SOURCES ..... 4MIXED ........ 5
RUPEES AREA UNIT
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
47
SECTION 12 FARMING AND LIVESTOCK PART A2 LANDHOLDING - LAND SHARECROPPED/RENTED/MORTGAGED -IN
DRY SEASON WET SEASON
PLOT
NUMBER
10.
Who manages theirrigation system that isavailable on the.[PLOT].?
SELF-MANAGED ..... 1AGENCY MANAGED ... 2COMMUNITY MANAGED 3
11.
What crops did you cultivateover the past DRY SEASON?
CROP CODE
12.
What crops did you cultivateover the past WET SEASON?
CROP CODE1 2 3 4 1 2 3 4
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
48
SECTION 12 FARMING AND LIVESTOCK PART A3 LANDHOLDING - INCREASE-DECREASE IN HOLDINGS
1. Did your household sell any land over the past 12 months?
YES.......1NO........2 (è4)
2. How much land did your household sell?
AREA: UNIT:
ROPANI ........ 1 BIGHAS ........ 2 BIJAN ......... 3
3. How much did your household receive from the sales?
WRITE ZERO IF FREE RUPEES:
4. Did your household buy any land over the past 12 months?
YES.......1NO........2 (èPART B)
IF NO LAND OPERATED è PART E
5. How much land did your household buy?
AREA: UNIT:
ROPANI ........ 1 BIGHAS ........ 2 BIJAN ......... 3
6. How much did your household pay for this land?
WRITE ZERO IF FREE RUPEES:
49
SECTION 12 FARMING AND LIVESTOCK PART B PRODUCTION AND USES
1.
In the past AGRICULTURE YEAR, whatcrops did you grow?
LIST ALL CROPS GROWN BY HOUSEHOLDFIRST BEFORE ASKING Q. 2 - 4.
2.
Did youuse animprovedvariety ofseed?
YES ..... 1NO ...... 2
3.
Please provide the following information related to quantity of..[CROP].. produced by your household, as well as the varioususes to which it was put:
UNITS: USE CODES LISTED AT END OF THE QUESTIONNAIRE
4.
What was the total quantity sold?
What was the price that you received per unit?
What was the total value of sales?
IF CROP NOT SOLD, WRITE ZERO IN TOAL SALES COLUMN AND LEAVE THE OTHERS BLANK
CROPCODE
A.
UNIT
B.
TOTALQUANTITYHARVESTED
C.
QUANTITY GIVENTO LANDLORD
D.
QUANTITY SOLD(OR EXPECT TO
SELL)
A.
UNIT
B.
TOTALQUANTITY SOLD
C.
PRICE PERUNIT
D.
TOTAL SALES
99 TOTAL CROP SALES (RUPEES)
50
SECTION 12 FARMING AND LIVESTOCK PART C1 EXPENDITURES ON SEEDS AND YOUNG PLANTS
1. Did you purchase or receive any seeds or young plants over the past AGRICULTURE YEAR?
YES ....1NO......2 (èPART C2)
EXPENDITURES ON SEEDS AND YOUNG PLANTS2.
For which crops?
WRITE NAME AND CODE OF CROP:
3.
Where did you obtain them?
AIC/COOPERATIVE .... 1OTHER FARMERS ...... 2PRIVATE DEALER ..... 3FROM INDIA ......... 4LANDLORD ........... 5OTHER .............. 6
4.
How much did you spend onbuying them?
IF NOTHING WRITE ZERO
CODE RUPEES
98 TRANSPORTATION COSTS:
99 TOTAL EXPENDITURE ON SEEDS AND PLANTS:
51
SECTION 12 FARMING AND LIVESTOCK PART C2 EXPENDITURES ON FERTILIZERS AND INSECTICIDES
1. Did you purchase any chemical fertilizers or insecticides over the past AGRICULTURE YEAR (or receive them from the landlord)?
YES ....1NO......2 (èPART C3)
EXPENDITURES ON FERTILIZER AND INSECTICIDES2.
TYPE OF FERTILIZER ORINSECTICIDE:
3.
CROPS ON WHICH USED:
CROP CODE
4.
QUANTITY RECEIVEDFROM LANDLORD
5.
AMOUNT PURCHASED
CODE A B C QUANTITY (KG) QUANTITY (KG) EXPENDITURE (Rs)
UREA 01
COMPLEX 02
DAP 03
OTHER FERTILIZER 04
INSECT/PEST-ICIDES 05
06 TOTAL TRANSPORTATION COSTS:
99 TOTAL EXPENDITURE ON FERTILIZER AND INSECTICIDES:
6. Where did you obtain the fertilizer?
AIC/COOPERATIVE......... 1OTHER FARMERS........... 2PRIVATE DEALER.......... 3FROM INDIA.............. 4OBTAINED FROM LANDLORD.. 5OTHER................... 6
7. Did you obtain any of the fertilizer on credit?
YES.........1NO..........2 (è9)
8. ............ Who was the source of credit for the fertilizer?
ADB/N ..................1FRIENDS/FAMILY ..........2COOPERATIVES ............3
9. Were you able to obtain all the fertilizer you needed over the pastAGRICULTURE YEAR?
YES ........ 1 (èPART C3)NO ......... 2
10. Why were you unable to get all the fertilizer you needed in the pastAGRICULTURE YEAR?
NOT AVAILABLE FOR PURCHASE ..1NOT ENOUGH MONEY ............2OTHER ......................3
52
SECTION 12 FARMING AND LIVESTOCK PART C3 EXPENDITURES ON HIRING LABOR
1. Did you hire any casual farm workers over the past AGRICULTURE YEAR?
YES ....1NO......2 (è9)
PAID ON A DAILY BASIS2.
WORKERS HIRED ON A DAILY BASIS
USE SEPARATE ROWS FORWORKERS HIRED ON A PIECE-RATE BASIS AND TIME BASIS
3.
Did you hire theseworkers on apiece-rate basis?
YES .......1 (è8)NO ........ 2
4.
For how manydays in totaldid you hirethis type ofworkers overthe pastAGRICULTUREYEAR?
5.
How much didyou pay incash per dayto eachworker?
6.
What was thevalue of whatyou gave inkind to eachworker? (meals,etc.)
7. INTERVIEWER:
ADD THE AMOUNTS REPORTEDIN Q. 5 AND 6
(Q. 5 + Q. 6)
8. INTERVIEWER:
MULTIPLY MAN-DAYS REPORTEDIN Q. 4. BY THE AMOUNT IN
Q. 7
(Q. 4. x Q. 7)
DESCRIPTION CODE TOTAL MAN-DAYS RUPEES PER DAY RUPEES PER DAY EXPENDITURE PER WORKER TOTAL EXPENDITURE
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
EXCHANGE LABOR 16
9. TOTAL EXPENDITURE ON HIRING CASUAL WORKERS SUB-TOTAL - CASUAL WORKERS: (IF NOTHING WRITE ZERO)
53
SECTION 12 FARMING AND LIVESTOCK PART C3 EXPENDITURES ON HIRING LABOR (CONT.)
10. Did you hire any permanent farm workers over the past AGRICULTURE YEAR? YES..... 1 NO ..... 2 (è13)
11. How many permanent workers did you hire?NUMBER
12. How much did you pay the permanent workers over the past AGRICULTURE YEAR? SUB-TOTAL - PERMANENT WORKERS
13. TOTAL EXPENDITURE ON HIRING FARM LABOR TOTAL EXPENDITURE ON HIRED LABOR (ADD SUB-TOTAL FOR CASUAL AND PERMANENT WORKERS)
54
SECTION 12 FARMING AND LIVESTOCK PART D EARNINGS FROM AGRICULTURE
REVENUES EXPENDITURES
REVENUE SOURCE:TOTAL REVENUE OVERAGRICULTURE YEAR EXPENDITURE ITEM:
TOTAL EXPENDITUREOVER AGRICULTUREYEAR
1. TOTAL CROP SALES (COPY FROM PART
B)
9. TOTAL EXPENDITURE ON SEEDS ETC. (COPY FROM PARTC1)
2. Sale of crop by-products (straw, husk, etc.) 10. TOTAL EXPENDITURE ON FERTILIZER (COPY FROM PARTC2)
11. TOTAL EXPENDITURE ON HIRED LABOR (COPY FROM PARTC3)
12. Irrigation charges/maintenance of water course. etc.
13. Transportation of crops to market
14. Sacks, twine, or other containers
15. Storage facilities
16. Improvements on land or buildings
17. Repair and maintenance of equipment
INCOME FROM RENTING OUT: EXPENDITURE ON RENTING IN:
3. Draft animals 18. Draft animals
4. Tractor 19. Tractor
5. Thresher 20. Thresher
6. Other machinery 21. Other machinery
7. Other income 22. Other expenditures
8. TOTAL REVENUES 23. TOTAL EXPENDITURES
55
SECTION 12. FARMING AND LIVESTOCK PART E1 LIVESTOCK OWNERSHIP
1. Has your household owned any livestock over the past 12 months?
YES ... 1NO ..... 2 (èPART F)
2.
Did you own any ..[ANIMALS]..over the past 12 months?
PUT A CHECK (ü) IN THE APPROPRIATEBOX FOR ANIMAL. IF THE ANSWER TOQ. 2 IS YES, ASK Q. 3-6.
3.
How many do you own now?
For how much could youbuy them all today?
4.
How many did you have 12months ago?
For how much could youhave bought them allthen?
5.
How many did you sellover the past 12 months?
How much did you sellthem for?
6.
How many did you buy overthe past 12 months?
How much did you pay forthem?
ANIMALS NO YES CODE NUMBER Rs. NUMBER Rs. NUMBER Rs. NUMBER Rs.
Cows 01
Buffaloes 02
Goats 03
Sheep 04
Yaks 05
Pigs 06
Donkeys, mules,
and horses
07
Poultry 08
Other livestock 09
TOTAL 10
56
SECTION 12. FARMING AND LIVESTOCK PART E2 EARNINGS FROM LIVESTOCK
REVENUES EXPENDITURES
REVENUE SOURCETOTAL REVENUE OVERPAST 12 MONTHS EXPENDITURE ITEM:
TOTAL EXPENDITUREOVER
PAST 12 MONTHS
1. Milk 9 Fodder
2. Ghee 10 Transportation of animal feed
3. Eggs 11. Veterinary services,inoculations, etc.
4. Dahi
5. Meat
6. Animal hides
7. Other income 12. Other expenditures
8. TOTAL REVENUES 13. TOTAL EXPENDITURES
14. During the past 12 months, did you hire any labor fortending livestock?
YES ............ 1NO ............. 2
57
SECTION 12 FARMING AND LIVESTOCK PART F OWNERSHIP OF FARMING ASSETS
1.
Do you own a ..[EQUIPMENT]..?
PUT A CHECK (ü) IN THE APPROPRIATE BOXFOR ALL EQUIPMENT. IF THE ANSWER TO Q.2IS YES, ASK Q. 2-7.
2.
How many..[EQUIPMENT].. does yourhouseholdpresently own?
3.
For how muchcould you sellthem all today?
4.
How many..[EQUIPMENT]..did your householdsell over the past12 months?
IF NONE WRITE ZERO AND è6
5.
How much did youreceive from thesale?
6.
How many..[EQUIPMENT]..did your householdbuy over the past12 months?
IF NONE WRITE ZERO AND èNEXT
7.
How much did youpay for this?
NO YES CODE NUMBER RUPEES NUMBER RUPEES NUMBER RUPEES
Tractor 01
Plough 02
Cart 03
Trolley 04
Thresher 05
Water Pump 06
Generator/Diesel Engine 07
Grain Storage Bin 08
Other Machinery 09
TOTAL 10
58
SECTION 12 FARMING AND LIVESTOCK PART G EXTENSION SERVICES
1. Have you spoken to a JT or JTA during the past 12 months?
YES .... 1NO ..... 2 (è5)
2. Which crops did you discuss with the agent during your last consultation?
CROP 1 CODE
CROP 2 CODE
CROP 3 CODE
3. Was the information provided by the agent during your last consultationhelpful?
YES, VERY HELPFUL ...1YES, FAIRLY HELPFUL .2NO, NOT HELPFUL .....3
4. What did the agent recommend during your last consultation?
IMPROVED SEEDS ........ 1 FIRSTFERTILIZER APPLICATION 2 RECOMMENDATIONINSECTICIDE USE ....... 3CHANGES IN CULTIVATION PRACTICES ........... 4OTHER ................ 5 SECOND
RECOMMENDATION
5. Have you spoken to a veterinary extension officer over the past 12 months?
YES .... 1NO ..... 2 (è7)
6. What services did the agent provide?
ANIMAL BREED .......... 1 FIRSTANIMAL FOOD ........... 2 SERVICEVACCINATION ........... 3MEDICINE .............. 4OTHER ................ 5 SECOND
SERVICE
7. Have you planted any trees on your land over the past 12 months?
YES .... 1NO ..... 2(èNEXT SECTION)
8. How many trees have you planted over the past 12 months?
NUMBER
59
SECTION 13 NON FARM ENTERPRISES/ACTIVITIES PART A GENERAL CHARACTERISTICS
INTERVIEWER: CHECK SECTION 1 PART C TO SEE IF ANY SELF-EMPLOYMENT ACTIVITIES OUTSIDE AGRICULTURE REPORTED
Yes .....1No ......2 (èNEXT SECTION)
ENTERPRISE
CODE
1.
What kind of enterprise did/do you operate?
CROSS CHECK SELF-EMPLOYMENT ACTIVITIES REPORTED IN SECTION 1 PART C
WRITE DESCRIPTION IN FULL
2.
Which people in thehousehold work in thisenterprise/activity?
WRITE ID CODES FROMROSTER
3.
WRITE IDCODE OFPERSONINTERVIEWED
4.
For how longhas theenterprise beenoperating?
TOTAL TIME ISSUM OF YEARSAND MONTHS.
5.
Where do youoperate theenterprise?
HOME .........1OTHER FIXEDLOCATION ....2
OTHER VARIABLELOCATION ....3
6.
In the past12 months,how manymonths didtheenterpriseoperate?
7.
Who owns thebusiness?
HOUSEHOLD ONLY........ 1
(è9)SHARED WITH OTHER OWNERS 2
8.
What shareof theprofits iskept byyourhousehold?
DESCRIPTION INDUSTRY CD A B C D E ID CODE YEARS MONTHS MONTHS PERCENT
01
02
03
04
05
06
07
08
60
SECTION 13 NON FARM ENTERPRISES/ACTIVITIES PART A GENERAL CHARACTERISTICS
ENTERPRISE
CODE
9.
Who are your customers?
OTHER HOUSEHOLDS ORINDIVIDUALS ............... 1SMALL ENTERPRISES .......... 2LARGE PRIVATE ENTERPRISES .. 3GOVT. OR OTHER PUBLIC FIRM . 4LOCAL TRADERS OR RETAILERS . 5EXPORTERS OR FOREIGNPURCHASERS ................ 6CONTRACTOR ................. 7TOURISTS ................... 8NGO/INTERNAT. ORGANIZATION . 9OTHER ..................... 10
10.
Is theenterpriseregisteredwith thegovernment?
YES .... 1NO ..... 2
11.
What was your mainsource of money forsetting up thebusiness?
DIDN’T NEED ANY MONEY 1OWN SAVINGS.......... 2RELATIVES/FRIENDS.... 3AGRI. DEV. BANK...... 4COMMERCIAL BANK...... 5GRAMEEN-TYPE BANK.... 6OTHER FINANCIAL INSTITUTION......... 7LOCAL GROUP (DHUKUTI) 8NGO OR RELIEF AGENCY. 9SALE OF ASSETS...... 10OTHER............... 11
12.
Have you tried toborrow money tooperate or expandyour business inthe past 12months?
YES,SUCCESSFULLY..1YES, BUTUNSUCCESSFULLY 2NO..............3
(è14)
13.
Whom did you borrow, ortry to borrow, from?
RELATIVES/FRIENDS .... 1AGRI. DEV. BANK ..... 2COMMERCIAL BANK ...... 3GRAMEEN-TYPE BANK .... 4OTHER FINANCIAL INSTITUTION ......... 5LOCAL GROUP (DHUKUTI) 6NGO OR RELIEF AGENCY...7
OTHER..................8
14.
Did youhireanyoneover thepast 12months?
YES .....1NO ......2
(è16)
15.
How manyworkers doyounormallyhire,during amonth whentheenterpriseisoperating?
16.
What problems, if any,do you have in runningyour business?
NO MAJOR PROBLEM .... 1CAPITAL OR CREDITPROBLEMS ........... 2
LACK OF TECHNICAL KNOW-HOW ........... 3PROBLEMS WITH SUPPLY OF POWER OR WATER .. 4PROBLEMS WITH EQUIPMENT OR SPARE PARTS ..... 5LACK OF ADEQUATE LABOR6GOVERNMENT REGULATIONS7LACK OF RAW MATERIALS 8LACK OF CUSTOMERS ... 9TRANSPORT PROBLEMS . 10OTHER .............. 11
PRIMARY SECONDARY PRIMARY SECONDARY
01
02
03
04
05
06
07
08
61
SECTION 13. NON-FARM ENTERPRISES/ACTIVITIES PART B INCOME FROM ENTERPRISES
EXPENDITURES OVER PAST 12 MONTHS
ENTERPRISE
CODE
1.
ENTERPRISE/ACTIVITY
(COPY FROM PART A)
2.
GROSS REVENUESOVER THE PAST12 MONTHS
3.
EXPENDITURES ON WAGES
BOTH CASHAND IN-KIND
4.
EXPENDITUREON FUEL,KEROSENE,ELECTRICITY, ETC.
5.
EXPENDITURE ONRAW MATERIALS
RUPEES
6.
OTHEROPERATINGEXPENSES
7.
NET REVENUES
8.
EXPENDITURE ON
CAPITALGOODS OVERPAST 12MONTHS
9.
SALE OFASSETS
OVER PAST12 MONTHS
10.
If someonewanted tobuy thisenterprisetoday, howmuch wouldhe have topay?
11.
And ayear ago?
RUPEES RUPEES RUPEES CASH IN-KIND
RUPEES RUPEES RUPEES RUPEES RUPEES
01
02
03
04
05
06
07
08
62
SECTION 14. CREDIT AND SAVINGS PART A BORROWING AND OUTSTANDING LOANS
1. Do you or any member of your household have loans outstanding, or have you contracted anyloans over the past 12 months that you have already repaid (include both cash and in-kindloans)?
YES....... 1NO........ 2 (èPART B)
LOAN
NUMBER
2.
ASK THE RESPONDENT TOFIRST MENTION ALL THELOANS
3.
Who was theprimaryborrower inthehousehold?
4.
When did you getthe loan?
5.
From whom did youobtain the loan?
RELATIVES/FRIENDS.....1AGRI. DEV. BANK ......2COMMERCIAL BANK.......3GRAMEEN-TYPE BANK.....4OTHER FINANCIAL INSTITUTION..........5LOCAL GROUP (DHUKUTI).6NGO OR RELIEF AGENCY..7LANDLORD/EMPLOYER.....8SHOPKEEPER............9MONEY LENDER.........10OTHER.................11
6.
How farfrom yourhome wasthelender’soffice orplace?
WRITETRAVEL TIME
ONE WAY
IF LESSTHAN ONE
HOUR, WRITEZERO
7.
For what purpose did you obtainthe loan?
BUSINESS OR FARM USE:
PURCHASE OF INPUTS ............. 1PURCHASE OF EQUIPMENT .......... 2PURCHASE OF LAND ............... 3PURCHASE OF ANIMALS ............ 4BUILDING IMPROVEMENTS .......... 5OTHER BUSINESS OR FARM USE ..... 6
PERSONAL USE:
HOUSEHOLD CONSUMPTION NEEDS .... 7PURCHASE/IMPROVEMENT OF DWELLING 8MARRIAGE/FAMILY EVENTS ......... 9CONSUMER DURABLES ............. 10OTHER PERSONAL USE ............ 11
FOR BUSINESS LOANS WRITE ENTERPRISE CODE
OTHERWISE LEAVE SECOND COLUMNBLANK
8.
How much intotal didyou borrow?
INCLUDE ONLYTHE
PRINCIPAL
9.
How much is/wasto be repaid?
OR
What is/was theinterest rate onthe loan?
DESCRIPTION OF LOAN ID CODE MONTH YEAR DAYS HRS USE OF LOAN ENTERPRISE CODE RUPEES RUPEES PERCENT
01
02
03
04
05
06
07
08
09
10
63
SECTION 14. CREDIT AND SAVINGS PART A BORROWING AND OUTSTANDING LOANS (CONT.)
LOAN
NUMBER
10.
Other than theinterest rate, didthe loan carry anyadditionalpayments (forexample cashpayments, laborcontributions orin-kind payments)?
YES.......1NO........2 (è12)
11.
How much were theseadditional payments?
12.
Did/do youhave to repaythe loan by aparticulartime?
YES ... 1NO .... 2 (è14)
13.
When are you(were you)scheduled tofinish repayingthe loan?
14.
Have youfinishedrepayingthe loan?
YES .....1NO ......2
15.
How muchin totalhave yourepaid?
16.
What collateral did youuse to secure the loan?
AGRICULTURAL LAND ... 1BUILDINGS OROTHER PROPERTY ...... 2GOLD/SILVER ......... 3PROPERTY DOCUMENTS .. 4PERSONAL GUARANTEE .. 5PAST BORROWING RECORD6OTHER ............... 7NO COLLATERAL ....... 8
17.
How many weeksdid it take toobtain the loan,counting fromthe time youformallyrequested orapplied for theloan to the timeyou received themoney?
LABOR: CASH ANDDAYS IN-KIND (Rs) MONTH YEAR RUPEES PRIMARY SECONDARY WEEKS
01
02
03
04
05
06
07
08
09
10
64
SECTION 14. CREDIT AND SAVINGS PART B LENDING AND OUTSTANDING LOANS
1. Does any person outside your household have loans owed to you or any member of yourhousehold? Have any loans been repaid to members of your household over the past 12 months?
YES....... 1NO........ 2 (èPART C)
LOAN
NUMBER
2.
ASK THE RESPONDENT TOFIRST MENTION ALL THELOANS
3.
Who was theprimarylender inthehousehold?
4.
When was theloan made?
5.
What is therelationship of theborrower to the primarylender?
EMPLOYEE OR TENANT FARMER........1BUSINESS CUSTOMER ....2OTHER BUSINESS ASSOCIATE............3FRIEND/NEIGHBOR.......4RELATIVE..............5OTHER.................6
6.
How farfrom yourhome is theborrowerlocated?
WRITETRAVEL TIMEONE WAY
IF LESSTHAN ONE
HOUR, WRITEZERO
7.
What was the primary purposefor which you lent the money?
BUSINESS OR FARM USE:
PURCHASE OF INPUTS ........ 1PURCHASE OF EQUIPMENT ..... 2PURCHASE OF LAND .......... 3PURCHASE OF ANIMALS ....... 4BUILDING IMPROVEMENTS ..... 5OTHER BUSINESS OR FARM USE 6
PERSONAL USE:
HOUSEHOLD CONSUMPTION NEEDS7PURCHASE/IMPROVEMENT OF DWELLING ............. 8MARRIAGE/FAMILY EVENTS ... 9CONSUMER DURABLES ....... 10OTHER PERSONAL USE ...... 11
8.
How much intotal didyou lend?
INCLUDE ONLYTHE
PRINCIPAL
9.
How much is/was tobe repaid?
OR
What is/was theinterest rate onthe loan?
DESCRIPTION OF LOAN ID CODE MONTH YEAR DAYS HRS USE OF LOAN RUPEES RUPEES PERCENT
01
02
03
04
05
06
07
08
09
10
65
SECTION 14. CREDIT AND SAVINGS PART B LENDING AND OUTSTANDING LOANS (CONT.)
LOAN
NUMBER
10.
Other than theinterest rate, didthe loan carry anyadditionalpayments (forexample cashpayments, laborcontributions orin-kind payments)?
YES.......1NO........2 (è12)
11.
How much were theseadditional payments?
12.
Did/does theborrower haveto repay theloan by aparticulartime?
YES ... 1NO .... 2(è14)
13.
When is/was theborrower scheduledto finish repayingthe loan?
14.
Has theborrowerfinishedrepayingthe loan?
YES..... 1NO...... 2
15.
How muchin totalhas beenrepaid onthe loan?
16.
What collateral did youlend against?
AGRICULTURAL LAND ...1BUILDINGS OROTHER PROPERTY ......2GOLD/SILVER .........3PROPERTY DOCUMENTS ..4PERSONAL GUARANTEE ..5PAST BORROWING RECORD6OTHER ...............7NO COLLATERAL .......8
LABOR: CASH ANDDAYS IN-KIND (Rs) MONTH YEAR RUPEES PRIMARY SECONDARY
01
02
03
04
05
06
07
08
09
10
66
SECTION 14. CREDIT AND SAVINGS PART C OTHER ASSETS
1. Does your household own any land or property (do not include property inwhich the household lives, or land or property already reported in Section12 or 13)?
YES .. 1NO ... 2 (è9)
2. How much money would it cost to buy property like that owned by yourhousehold?
..... RUPEES
3. How much money would it have cost a year ago to buy the property that yourhousehold now owns?
..... RUPEES
4. Did your household purchase any property over the past 12 months?
YES .. 1NO ... 2 (è6)
5. How much did your household spend in purchasing this property?
..... RUPEES
6. Did your household sell any such property over the past 12 months?
YES .. 1NO ... 2 (è8)
7. How much did your household receive from selling this property?
..... RUPEES
8. How much did your household receive in total over the past 12 months fromrenting this property to others?
IF NOTHING WRITE ZERO RUPEES
9. Does your household own any other real assets (other than financial assetsor those assets already been reported in Section 12 or 13)?
YES ..1NO ...2 (èNEXT SECTION)
10. How much money would it cost to buy assets like those owned by yourhousehold?
RUPEES
11. How much money would it have cost a year ago to buy the assets that yourhousehold now owns?
RUPEES
12. Did your household purchase any such assets over the past 12 months?
YES ..1NO ...2 (è14)
13. How much did your household spend in purchasing these assets?
RUPEES
14. Did your household sell any such assets over the past 12 months?
YES ..1NO ...2 (è16)
15. How much did your household receive from selling these assets?
RUPEES
16. How much did your household receive in total over the past 12 months fromrenting these assets to others?
IF NOTHING WRITE ZERO RUPEES
67
SECTION 15 REMITTANCES AND TRANSFERS PART A REMITTANCES AND TRANSFER INCOME SENT
1. During the past 12 months, did you, or any member of your household send money or other payments (for example, food or clothing) to someone who is not a member of yourhousehold?
YES ... 1NO .... 2 (èPART B)
LINE
NUMBER
ID CODEOFRESPONDENT
2.
What are the names ofthe people to whommembers of yourhousehold have sentmoney or goods duringthe past 12 months?
LIST ALL NAMES BEFOREGOING TO Q. 3-8.
IF THE RESPONDENT DOESNOT WISH TO GIVE NAMES,
LEAVE BLANK
3.
Who in yourhousehold isprimarilyresponsiblefor sendingthisassistance?
WRITE IDCODE FROM SECTION
1A
4.
What is therelationshipof the..[RECIPIENT..to the donor?
USERELATIONSHIPCODES FROMSECTION 1 A
5.
What is thesex of the.[RECIPIENT].?
MALE ......1FEMALE ....2
6.
Where does the..[RECIPIENT].. currentlylive?
is it an urbanor rural area?
URBAN ....... 1RURAL........ 2
7.
What is the.[RECIPIENT].’sprimary occupation?
8.
Which industrialsector does.[RECIPIENT]. workin?
9.
How much intotal did yousend to.[RECIPIENT]overthe past 12months?
RUPEES
ID CODE ID CODE DISTRICT U/R OCCUPATION CODE INDUSTRY CODE CASH IN-KIND
01
02
03
04
05
06
07
08
09
10
68
SECTION 15 REMITTANCES AND TRANSFERS PART B REMITTANCES AND TRANSFER INCOME RECEIVED
1. During the past 12 months, have you received any money or payments in kind, or gifts from any person who is not a member of your household?
YES ... 1NO .... 2 (èNEXT SECTION)
LINE
NUMBER
ID CODEOFRESPONDENT
2.
What are the names ofall the people who sentyou money or goodsduring the past 12months?
LIST ALL NAMES BEFOREGOING TO Q. 3-8.
IF THE RESPONDENT DOESNOT WISH TO GIVE NAMES,LEAVE BLANK
3.
Who in yourhousehold isthe primaryrecipient oftheassistance?
WRITE IDCODE FROM
SECTION 1A
4.
What is therelationshipof the..[DONOR]..to therecipient?
USERELATIONSHIPCODES FROMSECTION 1A
5.
What is thesex of the..[DONOR]..?
MALE ......1FEMALE ....2
6.
Where does the..[DONOR]..currently live?
is it an urbanor rural area?
URBAN ....... 1RURAL........ 2
7.
What is the.[DONOR].’s primaryoccupation?
8.
Which industrialsector does.[DONOR]. work in?
9.
How much in totaldid you receivefrom. ..[DONOR]..over the past 12months?
RUPEES
ID CODE ID CODE DISTRICT U/R OCCUPATION CODE INDUSTRY CODE CASH IN-KIND
01
02
03
04
05
06
07
08
09
10
69
SECTION 16 OTHER INCOME
1.
TYPE OF ASSET OR SOURCE OF INCOME:
2.
What is the currentvalue of the.[ITEM]. that thehousehold owns?
3.
And a year ago?
4.
How much has thehousehold received from..[ITEM].. in the past12 months? (interest,dividends, profit,payments, etc.)
ITEM CODE RUPEES RUPEES RUPEES
Savings account 101
Fixed deposit 102
Treasury bills, etc. 103
Stocks, shares, etc. 104
Employee Provident fund 105
Pension 106
Commission fee, royalties,
etc.
107
70
SECTION 17 ADEQUACY OF CONSUMPTION
ID CODE OF RESPONDENT
Now, I would like to ask your opinion of your family’sstandard of living
It was less than adequate for your family’s needs ... 1It was just adequate for your family’s needs ........ 2It was more than adequate for your family’s needs .. 3Not applicable ...................................... 4
“Adequate” means no more nor less than what the respondent considers to be the minimum consumption needs of the family.
1. Concerning your family’s food consumption over the pastone month, which of the following is true?
2. Concerning your family’s housing, which of the followingis true?
3. Concerning your family’s clothing, which of thefollowing is true?
4. Concerning the health care your family gets, which ofthe following is true?
5. Concerning your children’s schooling, which of thefollowing is true?
6. Concerning your family’s total income over the past onemonth, which of the following is true?
7. IF THE ANSWER TO Q. 1 IS “1”, ASK:
Do you consider that you, or any member of your family eats too little food to live a healthy and active live? YES .. 1 NO... 2
71
1.
MAKE A COMPLETE LIST OFALL CONCERNED BEFOREGOING TO Q.2 - 10
IDENTIFICATION
CODE
A B
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
72
LIST OF CODESDISTRICT CODES ETHNICITY CODES EDUCATION CODES CROP CODES
TAPLEJUNG..........01PANCHTHAR..........02ILAM...............03JHAPA..............04MORANG.............05SUNSARI............06DHANKUTA...........07TEHRATHUM..........08SANKHUWASABHA......09BHOJPUR............10SOLUKHUMBU.........11OKHALDHUNGA........12KHOTANG............13UDAYAPUR...........14SAPTARI............15SIRAHA16DHANUSHA...........17MAHOTTARI..........18SARLAHI............19SINDHULI...........20RAMECHHAP..........21DOLAKHA............22SINDHUPALCHOK......23KAVREPALANCHOC.....24LALITPUR...........25BHAKTAPUR..........26KATHMANDU..........27NUWAKOT............28RASUWA.............29DHADING............30MAKWANPUR..........31RAUTAHAT...........32BARA...............33PARSA..............34CHITWAN............35GORKHA.............36LAMJUNG............37TANAHU.............38SYANGJA............39KASKI..............40MANANG.............41MASTANG............42
MYAGDI ............ 43PARBAT ............ 44BAGLUNG ........... 45GULMI ............. 46PALPA ............. 47NAWALPARASI ....... 48RUPANDEHI ......... 49KAPILBASTU ........ 50ARGHAKHANCHI ...... 51PYUTHAN ........... 52ROLPA ............. 53RUKUM ............. 54SALYAN ............ 55DANG .............. 56BANKE ............. 57BARDIYA ........... 58SURKHET ........... 59DAILEKHA .......... 60JAJARKOT .......... 61DOLPA ............. 62JUMLA ............. 63KALIKOT ........... 64MUGU .............. 65HUMLA ............. 66BAJURA ............ 67BAJHANG ........... 68ACHHAM ............ 69DOTI .............. 70KAILALI ........... 71KANCHANPUR ........ 72DADHELDHURA ....... 73BAITADI ........... 74DARCHULA .......... 75
OTHER COUNTRIES:
INDIA ............. 81BHUTAN ............ 82TIBET ............. 83BANGLADESH ........ 84MIDDLE EAST ....... 85OTHER COUNTRY ..... 86
CHHETRY .............. 01BRAHMIN .............. 02MAGAR ................ 03THARU ................ 04NEWAR ................ 05TAMANG ............... 06KAMI ................. 07YADAV/AHIR ........... 08MUSLIM ............... 09RAI .................. 10GURUNG ............... 11DAMAI ................ 12LIMBU ................ 13SARKI ................ 14OTHER ................ 15
MONTH CODES
BAISAKH .............. 01JESTHA ............... 02ASADH ................ 03SHRAWAN .............. 04BHADRA ............... 05ASHWIN ............... 06KARTIK ............... 07MARG ................. 08PAUSH ................ 09MAGH ................. 10FALGUN ............... 11CHAITRA .............. 12
PRE-SCHOOL /KINDERGARTEN ......... 00 CLASS 1 ................ 01 CLASS 2 ................ 02 CLASS 3 ................ 03 CLASS 4 ................ 04 CLASS 5 ................ 05 CLASS 6 ................ 06 CLASS 7 ................ 07 CLASS 8 ................ 08 CLASS 9 ................ 09 CLASS 10 ............... 10 INTERMEDIATE CLASS 11 .. 11 INTERMEDIATE CLASS 12 .. 12 B.A./B.Sc .............. 13 M.A./M.Sc .............. 14 PROFESSIONAL DEGREE .... 15 OTHER .................. 16
QUANTITY CODES
KILOGRAM ............... 01 GRAM ................... 02 MAUND .................. 03 LITER .................. 04 MURI ................... 05 PATHI .................. 06 MANNA .................. 07 KURUWA ................. 08 NUMBER/PIECES .......... 09 DOZEN .................. 10
CEREALS:
EARLY PADDY............. 01MAIN PADDY.............. 02UPLAND PADDY............ 03WHEAT................... 04SPRING/WINTER MAIZE..... 05SUMMER MAIZE............ 06MILLET.................. 07BARLEY.................. 08BUCKWHEAT............... 09OTHER CEREALS........... 10
PULSES AND LEGUMES:
SOYBEANS................ 11BLACK GRAM.............. 12RED GRAM................ 13GRASS PEA............... 14LENTIL.................. 15GRAM.................... 16PEA..................... 17GREEN GRAM.............. 18COARSE GRAM............. 19COW PEA................. 20OTHER LEGUMES........... 21
TUBER AND BULB CROPS:
WINTER POTATO........... 22SUMMER POTATO........... 23SWEET POTATO............ 24COLOCASIA............... 25OTHER TUBERS............ 26
OILSEED CROPS
MUSTARD................. 27GROUND NUT.............. 28LINSEED................. 29SESAME.................. 30OTHER OILSEED........... 31
CASH CROPS:
SUGARCANE............... 32JUTE.................... 33TOBACCO................. 34OTHER................... 35
SPICES:
CHILIES ................ 36ONIONS ................. 37GARLIC ................. 38GINGER ................. 39TURMERIC ............... 40CARDAMOM ............... 41CORIANDER SEED ......... 42OTHER SPICES ........... 43
VEGETABLES:
WINTER VEGETABLES ...... 44SUMMER VEGETABLES ...... 45
CITRUS FRUITS:
ORANGE ................. 46LEMON .................. 47LIME ................... 48SWEET LIME ............. 49OTHER CITRUS ........... 50
NON-CITRUS FRUITS:
MANGO .................. 51BANANA ................. 52GUAVA .................. 53JACK FRUIT ............. 54PINEAPPLE .............. 55LICHEE ................. 56PEAR ................... 57APPLE .................. 58PLUM ................... 59PAPAYA ................. 60POMEGRANATE ............ 61OTHER FRUIT ............ 62
OTHER:
TEA .................... 63THATCH ................. 64FODDER TREES ........... 65BAMBOO ................. 66OTHER TREES ............ 67
73
OCCUPATION AND INDUSTRY CODES
OCCUPATION CODES INDUSTRY CODES
PROFESSIONAL AND TECHNICAL WORKERS
PHYSICAL SCIENTISTS AND TECHNICIANS...... 01ARCHITECTS, ENGINEERS.................... 02ENGINEERING TECHNICIANS.................. 03AIRCRAFT AND SHIP OFFICERS............... 04LIFE SCIENTISTS AND TECHNICIANS.......... 05DOCTORS, DENTISTS, ETC................... 06MEDICAL, DENTAL, ETC. TECHNICIANS........ 07STATISTICIANS, MATHEMATICIANS............ 08ECONOMISTS............................... 09ACCOUNTANTS AND AUDITORS................. 11JURISTS.................................. 12TEACHERS................................. 13RELIGION WORKERS......................... 14AUTHORS AND WRITERS...................... 15ARTISTS.................................. 16MUSICIANS AND PERFORMING ARTISTS......... 17ATHLETES AND SPORTSMEN................... 18OTHER PROFESSIONAL AND TECHNICAL WORKERS. 19
ADMINISTRATIVE AND MANAGERIAL WORKERS
LEGISLATIVE AND ADMINISTRATIVE........... 20MANAGERS................................. 21
CLERICAL WORKERS AND OPERATORS
CLERICAL SUPERVISORS..................... 31TYPISTS AND PUNCH-MACHINE OPERATORS...... 32BOOK-KEEPERS, CASHIERS, ETC.............. 33COMPUTING MACHINE OPERATORS.............. 34TRANSPORT AND COMMUNICATION SUPERVISORS.. 35TRANSPORT CONDUCTORS, GUARDS, ATTENDANTS. 36MAIL DISTRIBUTION CLERKS................. 37TELEPHONE AND TELEGRAPH OPERATORS........ 38OTHER CLERICAL AND RELATED WORKERS....... 37
SALES WORKERS
MANAGERS................................. 40WORKING PROPRIETORS...................... 41SALES SUPERVISORS AND BUYERS............. 42TECHNICAL SALESMEN AND COMMERCIAL TRAVELERS......................................... 43INSURANCE, REAL ESTATE, ETC. SALESMEN.... 44SALES PERSONNEL AND SHOP ASSISTANTS...... 45OTHER SALES WORKERS...................... 46
MANAGERS (CATERING AND LODGING SERVICES)
WORKING PROPRIETORS ......................51HOUSEKEEPING & RELATED SERVICES SUPERVISORS.........................................52COOKS, WAITERS, ETC. .....................53MAID, VALETS, ETC. .......................54CARETAKERS, CHARWORKERS, ETC. ............55LAUNDRY WORKERS. .........................56BARBERS AND HAIRDRESSERS .................57PROTECTIVE SERVICE WORKERS ...............58OTHER SERVICES WORKERS ...................59
AGRICULTURE AND FORESTRY WORKERS
FARM MANAGERS AND SUPERVISORS ............60FARMERS ..................................61AGRICULTURAL AND ANIMAL HUSBANDRY WORKERS 62FORESTRY WORKERS .........................63FISHERMEN ................................64HUNTERS AND TRAPPERS .....................65
PRODUCTION WORKERS
WORKING PROPRIETORS ......................70LABORERS .................................71MINERS, QUARRYMEN, ETC. ..................72METAL PROCESSORS .........................73WOOD PREPARATION WORKERS AND PAPER MAKERS 74CHEMICAL PROCESSORS ......................75SPINNERS, WEAVERS, KNITTERS AND DYERS ....76HIDE AND SKIN PROCESSORS .................77FOOD AND BEVERAGE PROCESSORS .............78TOBACCO PRODUCTS WORKERS .................79TAILORS, DRESSMAKERS, UPHOLSTERERS .......80SHOEMAKERS AND LEATHER GOODS MAKERS ......81CABINET MAKERS AND WOODWORKERS ...........82STONE CUTTERS AND CARVERS ................83BLACKSMITHS, TOOLMAKERS, ETC. ............84MACHINERY FITTERS AND INSTRUMENT MAKERS ..85ELECTRICAL AND ELECTRONICS WORKERS .......86BROADCASTING STATIONS, SOUND EQUIPMENT, ETC..........................................87PLUMBERS, WELDERS, SHEET METAL WORKERS ...88JEWELRY AND PRECIOUS METAL WORKERS .......89GLASS AND POTTERY WORKERS ................90RUBBER AND PLASTICS PRODUCT MAKERS .......91PAPER AND PAPERBOARD PRODUCT MAKERS ......92
OTHER NOT ELSEWHERE CLASSIFIED ...........96STUDENT ..................................97NOT WORKING (HOUSEWIFE, ETC) .............98MILITARY .................................99
AGRICULTURE, HUNTING, FORESTRYETC.
AGRICULTURE AND HUNTING...... 11FORESTRY AND LOGGING......... 12FISHING...................... 13
MINING AND QUARRYING
COAL MINING.................. 21PETROLEUM, GAS PRODUCTION.... 22METAL ORE MINING............. 23OTHER MINING................. 24
MANUFACTURING
FOOD, BEVERAGES, TOBACCO..... 31TEXTILES, APPAREL, LEATHER... 32WOOD, FURNITURE.............. 33PAPER/PRINTING/PUBLISHING.... 34CHEMICAL/PETROLEUM/PLASTICS.. 35OTHER NON-METALLIC........... 36BASIC METALLIC............... 37FABRICATED METALLIC/MACHINERY 38HANDICRAFTS AND OTHER........ 39
ELECTRICITY/GAS/WATER
ELECTRICITY/GAS/WATER........ 41WATER WORKS AND SUPPLIES..... 42
CONSTRUCTION
BUILDING..................... 51STREETS/HIGHWAYS/BRIDGES..... 52IRRIGATION/HYDROELECTRIC..... 53SPORTS PROJECTS.............. 54DOCKS/COMMUNICATIONS......... 55SEWERS/WATER MAINS/DRAINS.... 56PIPELINES.................... 57OTHER CONSTRUCTION ACTIVITIES 58
TRADE/RESTAURANTS/HOTELS
WHOLESALE.................... 61RETAIL....................... 62RESTAURANTS/HOTELS........... 63
TRANSPORT/STORAGE/COMMUNICATIONS
TRANSPORT/STORAGE............ 71COMMUNICATION................ 72
FINANCE AND BUSINESS
FINANCE...................... 81INSURANCE.................... 82REAL ESTATE/BUSINESS......... 83
COMMUNITY/SOCIAL/PERSONALSERVICES
PUBLIC ADMINISTRATION/DEFENSE 91SANITARY, ETC................ 92SOCIAL, ETC.................. 93RECREATION/CULTURE........... 94PERSONAL/HOUSEHOLD........... 95INTERNATIONAL AND OTHER...... 96
OTHER NON-DEFINED............ 00
SECTION 18. ARUN VALLEY PART A COMPENSATION
1. Has any of your land and/or buildings been acquired by the Arun III Project?
YES .................. 1NO .................. 2 (è9)
2.
What was acquired?
3.
What was thearea of theland or plotor number oftrees?
4.
What was thequality ofthe land?
PAKHO/BARI. 1KHET....... 2UNCULTIVABLE.3
5.
How muchcompensationdid youreceive?
NO YES QUANT UNIT RUPEES
LAND
TREES
HOUSE ANDSTRUCTURES
SQ.MT.
OTHER
6.
What did you do with the money you received?
7.
How muchdid youspend?
8.
COPY PLOTCODE FROM12.A1 ORENTERPRISECODE FROM13.A
NO YES RUPEES
BOUGHT LANDBOUGHT ANIMALSBOUGHT/STARTED BUSINESSBUILT/FIXED HOUSECONSUMPTION (FOOD, CLOTHING,ETC..)
WEDDINGSAVEDREPAYMENT OF LOANOTHER
SECTION 18. ARUN VALLEY PART A COMPENSATION (CONT.)
9. Do you know the proposed valley alignment for the Arun III Accessroad?
YES .................. 1NO ................... 2 (è14)
10. How far is the proposed valley alignment from your house?
(WALKING TIME, ONE WAY, SHORTEST WAY)
HOURS MINUTES
11. Do you own any land or houses along the proposed valley alignment?
YES .................. 1NO .................. 2 (è14)
12. Do you know about the rules of compensation?
YES .................. 1NO .................. 2
13. What do you plan to do with the money you will receive ascompensation?
BUY LAND ............. 1BUY ANIMALS .......... 2BUY/START BUSINESS ... 3BUILD/FIX HOUSE ...... 4CONSUMPTION .......... 5WEDDING .............. 6SAVE ................. 7REPAYMENT OF LOAN .... 8OTHER ................ 9
14. Do you think the construction of the Arun III Access road willchange your living standards?
YES, IMPROVE ......... 1YES, WORSEN .......... 2NO CHANGE ............ 3
SECTION 18. ARUN VALLEY PART B GROUPPARTICIPATION
1.
Are you or any members of yourhousehold members of any of thesegroups or organizations?
2.
Who is a member?
NO YES IDCODE
IDCODE
IDCODE
IDCODE
IDCODE
IDCODE
Forestry User Group
Irrigation User Group
Vegetable Producer Group
Vegetable Seed ProducerGroup
Potato Seed ProducerGroup
Women in DevelopmentGroup
Village DevelopmentCommittee
Ward Committee
Other groups