NEPAL LIVING STANDARDS SURVEY - web.worldbank.org

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NEPAL LIVING STANDARDS SURVEY HOUSEHOLD QUESTIONNAIRE WARD SERIAL NUMBER HOUSEHOLD HEAD OF HOUSEHOLD _______________________________ ADDRESS ________________________ VILLAGE / MUNICIPALITY ______________________________ DISTRICT ________________________ CENTRAL BUREAU OF STATISTICS

Transcript of NEPAL LIVING STANDARDS SURVEY - web.worldbank.org

Page 1: 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

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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

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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

03

04

05

06

07

08

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

01

02

03

04

05

06

07

08

09

10

11

12

13

14

15

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

01

02

03

04

05

06

07

08

09

10

11

12

13

14

15

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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:

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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)

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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:

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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

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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)

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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)

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

Page 74: NEPAL LIVING STANDARDS SURVEY - web.worldbank.org

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

Page 75: NEPAL LIVING STANDARDS SURVEY - web.worldbank.org

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

Page 76: NEPAL LIVING STANDARDS SURVEY - web.worldbank.org

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