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Shg Template 4 -Form Fill
Interview Details
Q01
GPS Coordinates
Q02
State / Union Territory
Q03
District Name
Q04
Mandal/Block Name
Q05
GP Name
Q06
Village name
Q07
Project code
Q08
Name of Implementing Agency
Q09
Interviewer code
Q10
Interviewer Name
Q11
Supervisor Name
Q12
Date of Interview
Q13
Interview Start Time
Q14
Interview End Time
Respondent profile
A01
Name of the respondent
A02
Respondent’s phone number
A03
What is your age? (in completed years)
A04
How many members are there in your household?
A05
What is the highest level of education that you have completed?
No formal education
Has attended primary school (up to grade 6)
Has attended up to grade 10
Matriculate (10th pass)
Passed school (10+2)
Graduate
Postgraduate
ITI/ Diploma/ similar vocational course
Others (Specify)
A06
Which ID is used to verify the identity of the respondent?
Aadhar Card
Ration Card
Others (Specify)
A07
Please specify which card you have.
Above Poverty Line (APL)
Below Poverty Line (BPL)
Antyodaya Anna Yojana (AAY)
Don’t know/can’t say
A08
What is your social category?
Scheduled caste (SC)
Scheduled tribe (ST)
Backward caste (BC)
Minority (Muslim, Christian, Jain etc.)
General caste
Others
A09
What is your household’s main source of income?
Farming (on own land)
Farming on leased or rented-in land
Wage or salaried work (agricultural)
Wage or salaried work (non-agricultural)
Agri-business
Non-agri-business
Others (Specify)
A10
What is your annual income range?
Less than 50,000
50,000-100,000
100,000 -200,000
200,000 – 350,000
350,000 – 500,000
More than 500, 000
Don’t want to share
A11
Which state/UT were you born in?
A12
Where did you live before you moved here?
A13
How long have you been living in your current Village/Town/City of residence?
0 for less than 1 year
0-4 years
5 years or more
Livelihood
B01
Are you part of a Self-Help Group, supported by ITC?
Yes
No
B02
What are the sources of income in your household?
Agriculture
Animal husbandry
Private job
Government job
Daily wage worker
Business/self-employed
Maid/household help
Others (Specify)
B03
From which occupation does your household earn maximum money?
Agriculture
Animal husbandry
Private job
Government job
Daily wage worker
Business/self-employed
Maid/household help
Others (Specify)
B04
What is your primary occupation?
Agriculture
Animal husbandry
Private job
Government job
Daily wage worker
Business/self-employed
Maid/household help
SHG leader
Involved in SHG business
Others (Specify)
B05
How much income does your household earn annually in total (inclusive of all earnings from all sources)
Less than 50,000
50,000-100,000
100,000 -200,000
200,000 – 350,000
350,000 – 500,000
More than 500, 000
Don’t want to share
B06
How much income do you earn annually in total? (Earning of beneficiary only)
Less than 50,000
50,000-100,000
100,000 -200,000
200,000 – 350,000
350,000 – 500,000
More than 500, 000
Don’t want to share
B07
Would you say your family income has improved past two years?
Yes, it has evidently improved
Maybe
No, it is the same
No, it has declined
Training and Capacity Building
C01
Did you and other SHG members receive any training?
Yes
No
C02
Which organization provided trainings to the SHG?
NGO volunteers under the ITC MSK programme
Government officials
NABARD officials
Another NGO programme
Others (Specify)
C03
Which trainings were provided to you and SHG members?
Entrepreneurship skills
Vocational skills (artisanal products, stitching etc.)
Financial literacy
Savings
Leadership development
Health workshops
Government scheme awareness
Digital literacy
Others (Specify)
C04
Did you learn essential skills through these trainings?
Yes
No
C05
Do you require more trainings?
Yes
No
C06
If yes, in which area do you require additional training?
Entrepreneurship skills
Vocational skills (artisanal products, stitching etc.)
Financial literacy
Savings
Leadership development
Health workshops
Government scheme awareness
Digital literacy
Others (Specify)
Savings
D01
Do you have any savings?
Yes
No
D02
Why don’t you save?
Low income
Irregular income
D03
How do you save?
At regular intervals
At irregular intervals
D04
At what intervals do you save?
Once a week
Twice a month
Once a month
Once in 3 months
Once in 6 months
Others (Specify)
D05
What is the purpose of your savings?
Business expansion
Education expense
Health related expense
Emergency Fund
Agriculture
Animal Husbandry
Others (Specify)
Loans
E01
Have you taken a loan from the SHG?
Yes
No
E02
For what purpose did you take the loan?
Business expansion
Asset purchase
Education expense
Health related expense
Marriage expense
Agriculture
Animal Husbandry
Others (Specify)
E03
What amount loan did you take?
Less than Rs. 5,000
Rs. 5,000 – 10,000
Rs. 10,000 – 15,000
Rs. 15,000 – 20,000
More than Rs. 20,000
Social Security Scheme linkage
F01
What all government schemes are you availing?
Mudra Yojana
Atal Pension Yojana
Pradhan Mantri Suraksha Bima Yojana
Pradhan Mantri Jeevan Jyoti Bima Yojana
Pradhan Mantri Awas Yojana
Pradhan Mantri Garib Kalyan Yojana
National social assistance program
National food security act
Swachh Bharat
Pradhan mantri ujwala yojana
Others (Specify)
F02
To what extent did the SHG help you avail these schemes?
To a large extent
To some extent
To little extent
Did not help
SHG Leader
G01
Are you the Leader of a Self-Help Group?
Yes
No
G02
When did you become the leader of the SHG?
G03
What encouraged you to be the leader of the SHG?
Desire for leadership
Commitment to community
Skill utilization (communication, business etc.)
Empowerment of women
Recognition and respect in community
Personal development
Networking Opportunities
Others (Specify)
G04
What vision do you have for your SHG?
Consistent savings among members
Financial resilience of SHG
Connect with government schemes
Develop SHG level entrepreneurial ventures
Promote businesses among members
Others (Specify)
G05
Are SHG members aware of the importance of savings?
Yes
No
G06
What proportion of SHG members actively save?
0-25%
26%-50%
51%-75%
76%-90%
91%-100%
G07
How do SHG members prefer to save money?
Individual savings account
Group savings fund
Rotating savings and credit practice
Others, please specify
G08
What is the saving corpus currently?
G09
Where is the money kept?
Bank accounts
At home locker
Others (Specify)
G10
Who maintains the SHG books?
SHG leader
Treasury personnel
Member of the Implanting Agency
Others (Specify)
G11
Is this corpus increasing month-on-month?
Yes
No
G12
Does the SHG lend money to members?
Yes
No
G13
Does your SHG have any entrepreneurial venture?
Yes
No
G14
Who helped you set up a business?
NGO volunteers under the ITC MSK programme
Government officials
NABARD officials
Another NGO programme
No one, we did it ourselves
Others (Specify)
G15
What entrepreneurial venture does your SHG have?
Handicraft and artisanal products
Agribusiness such as collective sale of organic farm produce and poultry farm produce
Nursery
Food processing enterprise such as pickle making, jams, snacks etc.
Tailoring and garment manufacturing
Dairy products
Microfinance and credit services
Others (Specify)
Self Help Group Members
H01
When did you become a member of self-help group (SHG)?
H02
Who encouraged you to become a SHG member?
NGO volunteers under the ITC MSK programme
Community leaders
Other women in the community joined together
Saw other women progressing due to SHGs
Government officials
Others (Specify)
H03
How many members are in your SHG?
H04
What all roles exist within your SHG?
Leader/President of SHG, who provides overall direction and guidance to the group
Secretary of SHG who handles record keeping/documentation and assists in organizing meetings
Treasurer who manages financial aspects of the SHGs and keeps records of contributions, savings, and loans
SHG members
Others (Specify)
H05
What is your role within the SHG?
President/ Leader
Secretary
Treasurer
Member
Others (Specify)
H06
How is the SHG leader selected?
Elections
Random allocation
Nominated/selected by SHG members
Volunteer role
Don’t know.
Others (Specify)
H07
What is the role of SHG leader?
Facilitator of meetings
Decision maker
Guidance and support to members to achieve their goals
Represents SHG to govt. and other external entities
Record keeping
Monitor savings, loans, and financial records
Conflict resolution between members
Capacity building of members
H08
What is the role of members in the SHG?
To participate in meetings actively
To regularly contribute to group savings
To ensure timely loan repayments
Engage in skill development activities facilitated by SHGs
Initiate and participate in income generating activities proposed by SHG
Provide support to other members
Maintain record of personal financial transactions within SHGs
Adhere to group rules
Participate in community development initiatives of government
Support from Self Help Group to Members
I01
Has the SHG been able to support in your livelihood/income generation?
Yes, to great extent.
Yes, to some extent
No
I02
Why has the SHG not been able to support in livelihood/income generation?
SHG is inactive
I have just joined the SHG
I don’t work
Others (Specify)
I03
In what areas has the SHG supported you?
Growing my own existing business
Setting up my own new business
Working with SHG members on SHGs business ventures
Expanding Agriculture
Expanding Animal Husbandry
Others (Specify)
I04
What business do you own?
Handicraft and artisanal products
Small shop
Food processing enterprise such pickle making, jams, snacks etc.
Tailoring and garment manufacturing
Dairy products
Livestock
Others (Specify)
I05
How has the SHG supported you?
Provided financial assistance
Provided skill development
Facilitated market linkage
Helped to save to invest in business
Improved networking in the village
Provided access to government schemes to benefit business
Expanding Agriculture
Expanding Animal Husbandry
I06
Has your business income increased after joining SHG?
Yes
No
I07
If Yes, then how have you spent the income from your business?
Purchased jewelry
Purchased insurance for self or girls
Purchased bike for self/family members
Any other such investments
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