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Women Template -Form Fill
Demographics and HH size
Q01
How old are you?
Q02
What is your marital status?
Currently Married
Married, Gauna Not Performed
Widowed
Divorced/Separated/Deserted
Never Married
Not married, but live together
Q03
How many years of formal education do you have?
Q04
Can you read Hindi comfortably?
Cannot read
Able to read parts of sentence
Able to read whole sentence
Can’t read or write but can sign
Can’t read or write, neither can sign
Q05
Can your husband read and write Hindi?
Yes
No
Q06
How many years of education does your husband have?
Q07
What is your religion?
Hindu
Muslim
Sikh
Buddhist
Christian
Jain
Other [specify]
Q08
Do you belong to a scheduled caste, a scheduled tribe, other backward caste, economically backward class or none of these?
Scheduled Caste
Scheduled Tribe
Other backward caste
EBC
None of these
Q09
Besides yourself, how many people live here?
Q10
Line number
Q11
Name of the Person
Q12
Gender
male
female
other
Q13
Age
Q14
Relationship with HH head
HEAD OF THE HOUSEHOLD
SPOUSE
SON/DAUGHTER
SON/DAUGHTER IN LAW
GRANDCHILD
FATHER/MOTHER
FATHER/MOTHER IN LAW
BROTHER/SISTER
BROTHER/SISTER-IN-LAW
NIECE/NEPHEW
GRANDPARENT/GRANDPARENT-IN-LAW
OTHER RELATIVE
ADOPTED/FOSTER/STEPCHILD
DOMESTIC SERVANT
OTHER (SPECIFY)
NOT STATED
Q15
Marital Status
Currently Married
Married, Gauna Not Performed
Widowed
Divorced/Separated/Deserted
Never Married
Not married, but live together
Q16
Any physical disability
Yes
No
General Income Sources of the HH
A01
In the past 12 months (January 2022-Dec 2022), who among the following contributed to household income?
Only my husband
Only myself
Only other household members
My husband and other HH members
Myself and other HH members
My husband, Myself and other household members
A02
In the past 12 months (January 2022-Dec 2022), How many months was your husband employed/earning wages/Other income, it can be either partially for the year or for the full year?
A03
What work did your husband do?
Income from selling farm crop
Agriculture Day labour
Non-Agriculture Day labour
Agriculture Trading/Business
Non agriculture Business
Small Shop
Service/Salaried Worker
Self Employed (cook, driving etc)
Other (specify)
Don’t Know
Not applicable, husband didn’t contribute
A04
What was your husband’s approximate monthly income (monies coming from any and all sources) during the last year (January 2022 to Dec 2022)?
A05
In the past 12 months (January 2022-Dec 2022), How many months were you employed/earning wages/Other income, it can be either partially for the year or for the full year?
A06
What work did you do?
Income from selling farm crop
Agriculture Day labour
Non-Agriculture Day labour
Agriculture Trading/Business
Non agriculture Business
Small Shop
Service/Salaried Worker
Self Employed (cook, driving etc)
Other (specify)
Don’t Know
Not applicable, I didn’t contribute
A07
What was your approximate monthly income (monies coming from any and all sources) during the last year (January 2022 to Dec 2022)?
A08
In the past 12 months (January 2022-Dec 2022), How many months were other household member employed/earning wages/Other income, it can be either partially for the year or for the full year?
A09
What work did they do?
Income from selling farm crop
Agriculture Day labour
Non-Agriculture Day labour
Agriculture Trading/Business
Non agriculture Business
Small Shop
Service/Salaried Worker
Self Employed (cook, driving etc)
Other (specify)
Don’t Know
Not applicable, I didn’t contribute
A10
What was their approximate monthly income (monies coming from any and all sources) during the last year (January 2022 to Dec 2022)?
General awareness and Job card status
B01
Do you know or have heard about MGNREGA/ Job card scheme of the Government?
Yes
No
B01A
What have you heard?
Employment
Guaranteed Employment
100 days of employment
Unskilled manual work
None of the above
Others[Specify]
B02
Do you have a MGNREGA job card?
Yes
No
B02A
Who keeps the job card?
Husband
Son
Daughter
Other Family member
Panchayat/Mukhiya
Panchayat Rojgar Sewak
It’s in my possession
Other [Specify]
Don’t know
B03
Last 4 digit of Job card ID
B04
Worked under MGNREGA during Jan 2022 to Dec 2022
Yes
No
B05
Total days of employment (During January 2022-Dec 2022)
B06
Total Money Received from MGNREGA
B07
Does anyone else in your family have a MGNREGA job card?
Yes
No
B08
Name
B09
Gender
B10
Age
B11
Worked under MGNREGA during Jan 2022 to Dec 2022
Yes
No
B12
Total Days of employment under MGNREGA during Jan 2022 to Dec 2022
B13
Did anyone help you in getting the Job Card?
Yes, Panchayat Rojgar Sewak
Yes, Another Panchayat person
Yes, Community Resource person or SHG members
Yes, Through VO/CLF forums
Yes, Nari Adhikar kendra
Yes, Family members
No one helped, Did on my own
Do not have job card
Don’t know/Don’t remember
Gram Rojgar Diwas
C01
Have you heard anything about Gram Rojgar Diwas in reference to MGNREGA employment?
Yes
No
C02
What is the objective of Gram Rojgar Diwas?
To make communities aware about MGNREGS employment opportunities in the concerned gram panchayat
To cater to the needs and requirements of the vulnerable groups of wage seekers
To facilitate Job Card registration process for inclusion of new families/ adult members
To receive work demand from members
To discuss potential work areas in the areas
To record grievances and forward to concerned authority
To discuss and resolve wage disbursement and backlog related issues
To raise awareness around various aspect of MGNREGA among job holders
Others not covered above [Specify]
Don’t Know
C03
Did any Gram Rozgar Diwas happen in your Panchayat in the past 6 months?
Yes
No
C03A
How many?
C04
Did you attend any Gram Rogjar Diwas in past 6 months, how many?
Yes
No
C05
Why did not attend Gram Rozgar Diwas?
Gram Rozgar Diwas was too far
I didn’t have any grievance to raise in GRD
I was not allowed to go there
I was not aware of the venue and time
I don’t have a job card
Occupied with household/agricultural work
I do not see any benefit in attending Gram Rojgar Diwas
Other (specify)
C06
Did you get any benefit by attending the Gram Rozgar Diwas? What?
Awareness of MGNREGS employment opportunities in the concerned gram panchayat
Job Card registration process for inclusion of new families/ adult members
Raised demand for work
Discussed potential area of work
To raise Grievances related to unfulfilled demand for work
To raise Grievances related to wage payments
Didn’t find it very useful
Others not covered above [Specify]
Don’t Know/Don’t remember
VPRP-GPDP Integration
D01
Are you aware of individual assets for vulnerable families that can be built under MGNREGA?
Yes
No
D02
What type of individual assets can be built under MGNREGA?
Improving productivity of lands: Providing suitable infrastructure for irrigation such as dug wells, farm ponds and other water harvesting structures
Improving livelihoods through horticulture, sericulture, plantation, and farm forestry
Development of fallow or wastelands of households to bring it under cultivation
Unskilled wage component in construction of houses sanctioned under the Indira Awaas Yojana or such other State or Central Government Scheme
Creating infrastructure for promotion of livestock such as, poultry shelter, goat shelter, piggery shelter, cattle shelter and fodder troughs for cattle
Creating infrastructure for promotion of fisheries such as, fish drying yards, storage facilities, and promotion of fisheries in seasonal water bodies on public land
Other [Specify]
Don’t Know [Exclusive option]
D03
Did you/any other household member apply and received/built any individual assets under MGNREGA in the past year?
Yes, Applied, approved and built
Yes, applied and received approval
Yes, Applied and under process
Didn’t get (but applied)
Not applied
Other (specify)
Don’t know
D04
What type of individual assets did you receive/Apply?
Improving productivity of lands: Providing suitable infrastructure for irrigation such as dug wells, farm ponds and other water harvesting structures
Improving livelihoods through horticulture, sericulture, plantation, and farm forestry
Development of fallow or wastelands of households to bring it under cultivation
Unskilled wage component in construction of houses sanctioned under the Indira Awaas Yojana or such other State or Central Government Scheme
Creating infrastructure for promotion of livestock such as, poultry shelter, goat shelter, piggery shelter, cattle shelter and fodder troughs for cattle
Creating infrastructure for promotion of fisheries such as, fish drying yards, storage facilities, and promotion of fisheries in seasonal water bodies on public land
Other [Specify]
Don’t Know
D05
Was the asset applied on your name?
Yes
No
D06
Did you ever use the asset to generate any income?
Yes
No
D07
Who was the custodian of income generated from the above asset?
Only myself
Jointly with other family member
Other family member
Don’t know/Remember
D08
Are you aware of any Common Infrastructure assets for NRLM Compliant Self-Help Groups that can be built under MGNREGA?
Yes
No
D09
Did your SHG/VO apply and got approved/built for any Common Infrastructure assets under MGNREGA in the past year?
Yes, applied and received approval
Yes, Applied, approved and built
Yes, Applied and under process
Didn’t get (but applied)
Not applied
Other (specify)
Don’t know
D10
What type of Common infrastructure assets did your SHG/VO receive?
Common Infrastructure for any kind of manure/Vermicompost/Other Compost pit
Work shed for livelihood
Agriculture produce storage shed
Other [Specify]
Don’t know
D11
Did you ever use the common asset to generate any income?
Yes
No
D12
Who was the custodian of any personal income generated from the above common asset?
Only myself
Jointly with other family member
Other family member
Don’t know/Remember
D13
Have you heard of a process called VPRP-GPDP, under which the demand for assets such as discussed above can be consolidated by the SHG/VO and take to the Gram panchayat for further action?
Yes
No
D14
Did your SHG/VO participate in any such process and submit a consolidated request to Gram Panchayat for inclusion in Gram panchayat development plan?
Yes
No
D15
Were any of your demands met by the Panchayat?
Yes
No
D16
Did anyone (CRP) collect information on demand for building income generating asset from you?
Yes
No
Mahila mate
E01
Are there any Mahila Mates in your village?
Yes
No
E02
How many mahila mates are in your village?
E03
Are you a mahila mate?
Yes
No
E04
Have you worked with a mahila mate supervisor in the past year (jan 2022-dec 2022)
Yes
No
E05
What would you prefer? working with a male mate supervisor or with a Mahila Mate supervisor?
Prefer Female mate
Prefer Male Mate
No Preference
Don’t Know
E06
You mentioned a preference for female MGNREGA Supervisor, Why
Women are generally more sensitive to other women
Women are more sensitive to providing worksite facilities for other women with little children
Women are more sensitive to providing general worksite with facilities such as water, shed from sun etc
Women mate take our demand for more work to appropriate forums
Others [Specify]
Don’t Know
Knowledge of MGNREGA provisions
F01
Did you receive all your MGNREGA wages for the work done during January 2022-Dec 2022?
Yes
No
F02
Did you receive MGNREGA work within 15 days of raising demand?
Yes, Always
Yes, Most of the time
Yes, A few times
No, never
Don’t Know/Remember
F03
Are you aware that you are eligible for unemployment benefits if you do not get work under MGNREGA?
Yes
No
F04
What is the daily wage rate under MGNREGA?
F05
How many days of employment are provided by MGNREGA?
Access and awareness to individual government scheme
G01
Have you ever heard about _?
G01_1
Pradhan Mantri Jan Dhan Yojana
Yes
No
G01_2
Pradhanmantri Surakha Beema Yojana (accidental death insurance)
Yes
No
G01_3
Pradhan Mantri Jeevan Jyoti Beema Yojana (Life Insurance)
Yes
No
G01_4
Old Age Pension
Yes
No
G01_5
Antyodaya Ann Yojana
Yes
No
G01_6
Satat Jeevikoparjan Yojana (SJY)
Yes
No
G01_7
PM Jan Arogya Bima Yojana
Yes
No
G01_8
Ujjwala Yojana
Yes
No
G01_9
Widow Pension
Yes
No
G01_10
Disability Pension
Yes
No
G02
Is your household / anyone in your household eligible for this scheme?
G02_1
Pradhan Mantri Jan Dhan Yojana
Yes
No
G02_2
Pradhanmantri Surakha Beema Yojana (accidental death insurance)
Yes
No
G02_3
Pradhan Mantri Jeevan Jyoti Beema Yojana (Life Insurance)
Yes
No
G02_4
Old Age Pension
Yes
No
G02_5
Antyodaya Ann Yojana
Yes
No
G02_6
Satat Jeevikoparjan Yojana (SJY)
Yes
No
G02_7
PM Jan Arogya Bima Yojana
Yes
No
G02_8
Ujjwala Yojana
Yes
No
G02_9
Widow Pension
Yes
No
G02_10
Disability Pension
Yes
No
G03
Has anyone in your household ever availed this scheme?
G03_1
Pradhan Mantri Jan Dhan Yojana
Yes
No
G03_2
Pradhanmantri Surakha Beema Yojana (accidental death insurance)
Yes
No
G03_3
Pradhan Mantri Jeevan Jyoti Beema Yojana (Life Insurance)
Yes
No
G03_4
Old Age Pension
Yes
No
G03_5
Antyodaya Ann Yojana
Yes
No
G03_6
Satat Jeevikoparjan Yojana (SJY)
Yes
No
G03_7
PM Jan Arogya Bima Yojana
Yes
No
G03_8
Ujjwala Yojana
Yes
No
G03_9
Widow Pension
Yes
No
G03_10
Disability Pension
Yes
No
G04
Have you ever heard about _?
G04_1
National Family Support Scheme(MP) only to be asked if coded 2 in I.a.B in Module A
Yes
No
G04_2
Land Right :- (MP) only to be asked if coded 2 in I.a.B in Module A
Yes
No
G04_3
Ayushman Card Scheme :- (MP) only to be asked if coded 2 in I.a.B in Module A
Yes
No
G04_4
Absolute Pension Scheme :- (MP) only to be asked if coded 2 in I.a.B in Module A
Yes
No
G04_5
Tribal Scholarship:- (MP) only to be asked if coded 2 in I.a.B in Module A
Yes
No
G04_6
Chief Minister Fund
Yes
No
G04_7
Chief Minister Self Employment Scheme :- only to be asked if coded 2 in I.a.B in Module A
Yes
No
G04_8
Deendayal Upadhyay Rural Skills :- only to be asked if coded 2 in I.a.B in Module A
Yes
No
G04_9
Prime Crop Insurance Scheme :- only to be asked if coded 2 in I.a.B in Module A
Yes
No
G04_10
Farm Pond Scheme :- only to be asked if coded 2 in I.a.B in Module A
Yes
No
G04_11
Ration Card :- only to be asked if coded 2 in I.a.B in Module A
Yes
No
G04_12
Livelihood Mission :- only to be asked if coded 2 in I.a.B in Module A
Yes
No
G05
Is your household / anyone in your household eligible for this scheme?
G05_1
National Family Support Scheme(MP) only to be asked if coded 2 in I.a.B in Module A
Yes
No
G05_2
Land Right :- (MP) only to be asked if coded 2 in I.a.B in Module A
Yes
No
G05_3
Ayushman Card Scheme :- (MP) only to be asked if coded 2 in I.a.B in Module A
Yes
No
G05_4
Absolute Pension Scheme :- (MP) only to be asked if coded 2 in I.a.B in Module A
Yes
No
G05_5
Tribal Scholarship:- (MP) only to be asked if coded 2 in I.a.B in Module A
Yes
No
G05_6
Chief Minister Fund
Yes
No
G05_7
Chief Minister Self Employment Scheme :- only to be asked if coded 2 in I.a.B in Module A
Yes
No
G05_8
Deendayal Upadhyay Rural Skills :- only to be asked if coded 2 in I.a.B in Module A
Yes
No
G05_9
Prime Crop Insurance Scheme :- only to be asked if coded 2 in I.a.B in Module A
Yes
No
G05_10
Farm Pond Scheme :- only to be asked if coded 2 in I.a.B in Module A
Yes
No
G05_11
Ration Card :- only to be asked if coded 2 in I.a.B in Module A
Yes
No
G05_12
Livelihood Mission :- only to be asked if coded 2 in I.a.B in Module A
Yes
No
G06
Has anyone in your household ever availed this scheme?
G06_1
National Family Support Scheme(MP) only to be asked if coded 2 in I.a.B in Module A
Yes
No
G06_2
Land Right :- (MP) only to be asked if coded 2 in I.a.B in Module A
Yes
No
G06_3
Ayushman Card Scheme :- (MP) only to be asked if coded 2 in I.a.B in Module A
Yes
No
G06_4
Absolute Pension Scheme :- (MP) only to be asked if coded 2 in I.a.B in Module A
Yes
No
G06_5
Tribal Scholarship:- (MP) only to be asked if coded 2 in I.a.B in Module A
Yes
No
G06_6
Chief Minister Fund
Yes
No
G06_7
Chief Minister Self Employment Scheme :- only to be asked if coded 2 in I.a.B in Module A
Yes
No
G06_8
Deendayal Upadhyay Rural Skills :- only to be asked if coded 2 in I.a.B in Module A
Yes
No
G06_9
Prime Crop Insurance Scheme :- only to be asked if coded 2 in I.a.B in Module A
Yes
No
G06_10
Farm Pond Scheme :- only to be asked if coded 2 in I.a.B in Module A
Yes
No
G06_11
Ration Card :- only to be asked if coded 2 in I.a.B in Module A
Yes
No
G06_12
Livelihood Mission :- only to be asked if coded 2 in I.a.B in Module A
Yes
No
Financial Inclusion and savings
H01
An account can be used to save money, to make or receive payments, or to receive wages or financial help. Do you, either by yourself or together with someone else, currently have an account at a bank or another financial institution?
Yes, Have my own personal account
Yes, Have a joint account with another family member
No, do not have any account in bank or another financial institution
H02
An ATM is a card from a bank card that allows you to withdraw money, and the money is withdrawn from that account immediately. Do you personally have an ATM debit card?
Yes
No
H03
Please tell me whether each of the following is A REASON why you, personally, DO NOT have an account at a bank or another type of formal financial institution. Is it:
H03_1
Because financial institutions are too far away
Yes
No
H03_2
Because financial services are too expensive
Yes
No
H03_3
Because you don’t have the necessary documentation (identity card, wage slip, etc.)
Yes
No
H03_4
Because you don’t trust financial institutions
Yes
No
H03_5
Because of religious reasons
Yes
No
H03_6
Because you don’t have enough money to use financial institutions
Yes
No
H03_7
Because someone else in the family already has an account
Yes
No
H03_8
Because you have no need for financial services at a formal institution
Yes
No
Savings
I01
In the PAST 12 MONTHS, have you, personally, saved or set aside any money to start, operate, or grow a business or farm?
Yes
No
I02
In the PAST 12 MONTHS, have you, personally, saved or set aside any money FOR OLD AGE?
Yes
No
I03
In the PAST 12 MONTHS, have you, personally, saved or set aside any money by _________?
I03_1
Using an account at a bank or another type of formal financial institution (This can include using another person’s account)
Yes
No
I03_2
Using an informal savings group such as SHG
Yes
No
I03_3
In the PAST 12 MONTHS, have you, personally, saved or set aside any money for any reason?
Yes
No
Loan, decision making and utilisation
J01
Have you ever taken a loan from either your SHG or VO?
Yes
No
J02
Have you ever taken a loan from a bank?
Yes
No
J03
Whose idea was it to take the loan?
My own
Husband
Mother-in-law
Father-in-law
Female head of the family (anybody else than MIL)
Male head of the family (Anybody else than FIL)
Not applicable
Don't know
J04
Who majorly determined the amount of the loan you requested?
My own
Husband
Jointly with husband
Jointly with mother-in-law
Mother-in-law
Father-in-law
Female head of the family (anybody else than MIL)
Male head of the family (Anybody else than FIL)
Not applicable
Don't know
J05
Who majorly decided how to spend the loan?
My own
Husband
Jointly with husband
Jointly with mother-in-law
Mother-in-law
Father-in-law
Female head of the family (anybody else than MIL)
Male head of the family (Anybody else than FIL)
Not applicable
Don't know
J06
For what purpose have you used the loan?
Household consumption
Business purpose
Loan Repayment
Agriculture related
Others [Specify]
Not applicable
Don't know
J07
What is the total amount of loan you have taken in the past 2 years January 2021 to Dec 2022
Income sources, asset ownership, SHG meetings
K01
Is your name or the name of another female of the HH on the ownership or rental papers for your home?
Yes, on my name
Yes, Joint ownership with husband
No, but on name of another female
No, on name of a male member
Papers are not made
Not applicable (do not own any house and live without rental papers)
Don’t Know/Can’t say
K02
Is your name on the ownership of any agricultural land?
Yes, on my name
Yes, Joint ownership with husband
No, but on name of another female
No, on name of a male member
Papers are not made
Not applicable (do not own any house and live without rental papers)
Don’t Know/Can’t say
K03
Is your name on the ownership of any non-agriculture land?
Yes, on my name
Yes, Joint ownership with husband
No, but on name of another female
No, on name of a male member
Papers are not made
Not applicable (do not own any house and live without rental papers)
Don’t Know/Can’t say
SHG meetings
L01
How often does/did your group meet for discussions or activities in a month?
Weekly
Bi-monthly
Monthly
Occasionally
Never met so far
Don’t know/Can’t say
L02
How often did you participate in group meetings in a month?
Weekly
Bi-monthly
Monthly
Occasionally
Never met so far
Don’t know/Can’t say
L03
Do/did you personally participate in the savings activities (periodic contribution of a fixed amount by all members)?
Yes
No
L04
How often do/did you deposit\save?
Weekly
Bi-monthly
Monthly
Occasionally
Never met so far
Don’t know/Can’t say
L05
How much do you contribute every time?
Economic agency
M01
Are you able to spend the money you earn how you want yourself, or do you have to give all or part of the money to your husband/partner/other family member?
Able to spend how I want
Have to give some to husband/other family member
Have to give All to husband/Other family member
M02
Who do you think should have control over the money that a woman earns?
Woman herself
Husband
Other Family members
Parents
Other [Specify]
M03
Do you have access to any cash available with you now for buying HH food or medicine if you suddenly needed something?
Yes
No
M03A
Who makes most decisions about whether to buy clothing items?
Woman herself
Husband
Jointly with husband
FIL/MIL
Parents
Other [Specify]
Not applicable
Don’t know
M03B
Who makes most decisions about consumer durable items
Woman herself
Husband
Jointly with husband
FIL/MIL
Parents
Other [Specify]
Not applicable
Don’t know
M03C
Who makes most decisions about what health expenditures
Woman herself
Husband
Jointly with husband
FIL/MIL
Parents
Other [Specify]
Not applicable
Don’t know
M03D
Who makes most decisions about expenses for home
Woman herself
Husband
Jointly with husband
FIL/MIL
Parents
Other [Specify]
Not applicable
Don’t know
Right to employment
N01
When jobs are scarce, men should have more right to a job than women.
Agree, men should have more right
Neither Agree Nor disagree
Disagree, no way should men have more right
N02
If a woman earns more money than her husband, it’s almost certain to cause problems
Agree, it will cause problem
Neither Agree Nor disagree
Disagree, many time it doesn’t cause problem
N03
Having a job is the best way for a woman to be an independent person.
Agree, it is the best way for women to be independent
Neither Agree Nor disagree
Disagree, no it is not the best way
Decision making on labour market choices of a women
O01
Pooja, a 21-year-old girl, belongs to a village in Bihar. Since childhood, she has had aspirations of becoming a police officer. After graduating she is selected for a job as a police officer. Her parents are worried about her job as they think that is not suitable for a woman. They also believe that it is her age to get married and they have found a prospective groom for her from a good family. Pooja, however, wants to take up the job and does not wish to get married. According to her parents, Pooja would not need to work after she gets married as her husband will take care of her. Pooja should instead focus on household work, help out her mother-in-law and eventually have children. Finally, her parents decide that instead of taking up the job, she should get married.
O01_1
What do you think, is it the right time for Pooja to get married
Yes
No
O01_2
Should Pooja work after marriage
Yes
No
O01_3
After Pooja is married, do you think it’s her husband’s responsibility to take care of her
Yes
No
O01_4
Do you think Marriage should be more important for Pooja than her job
Yes
No
O01_5
Pooja will not be a good police officer after marriage
Yes
No
O01_6
Do you think Pooja should follow her parents’ wishes and not take the police job
Yes
No
O01_7
Would being a teacher be a more suitable job for Pooja
Yes
No
Work Choices Decisions
P01
Who has the most say in decisions about your work?
Self
Husband
Senior male
Senior female
Others
P02
If you found a suitable job, would you be willing to work?
Yes
No
P03
If you found a suitable job, would you be allowed to work?
Yes
No
Independent mobility
R01
In the past 30 days, how many time have you visited the following
R01_1
Bank/Credit Cooperative
never visited
1 to 5 times
6 to 10 times
11 to 15 times
16 to 20 times
more than 20 times
R01_2
Post office
never visited
1 to 5 times
6 to 10 times
11 to 15 times
16 to 20 times
more than 20 times
R01_3
Local health centre
never visited
1 to 5 times
6 to 10 times
11 to 15 times
16 to 20 times
more than 20 times
R01_4
Market/ Bazaar
never visited
1 to 5 times
6 to 10 times
11 to 15 times
16 to 20 times
more than 20 times
R02
Are you allowed to go to any place using public transport such as bus or rickshaw or train?
Never
Yes, but never alone
Yes, alone, with permission
Yes, alone, do not need permission
Not applicable
Refuse to answer
R03
Are you permitted to visit women in other neighbourhoods to talk with them?
Never
Yes, but never alone
Yes, alone, with permission
Yes, alone, do not need permission
Not applicable
Refuse to answer
R04
Can you go unescorted to your parents’ house/village?
Never
Yes, but never alone
Yes, alone, with permission
Yes, alone, do not need permission
Not applicable
Refuse to answer
R05
Can you go unescorted to the next village?
Never
Yes, but never alone
Yes, alone, with permission
Yes, alone, do not need permission
Not applicable
Refuse to answer
R06
Are you allowed to go alone to a relative’s house inside the village?
Never
Yes, but never alone
Yes, alone, with permission
Yes, alone, do not need permission
Not applicable
Refuse to answer
Gender based violence
S01
If a women goes out without telling her husband, is the husband justified in beating her?
Yes
No
S02
Has this happened in your community in the last 12 months?
Yes
No
S03
And If she argues with him, is the husband justified in beating her?
Yes
No
S04
Has this happened in your community in the last 12 months?
Yes
No
S05
And If she refuses to have sex with him, is the husband justified in beating her?
Yes
No
S06
Has this happened in your community in the last 12 months?
Yes
No
Public participation/speaking and, assembly
T01
Have you participated at the Gram Sabha in the last few years?
Yes
No
T02
When you did not attend the Gram Sabha because. I was not interested in going... (please answer agree or disagree or don’t know)
Agree, I was not interested
Disagree
No response/Don’t know
T03
Do you think that women from your community usually participate in the Gram Sabha?
Yes
Mostly Yes
Mostly No
No
No response/Don’t know
T04
Have you, in the last few years, spoken in public at the Gram Sabha or other similar village level forums regarding a problem or an issue that you or your community had?
Yes
No
T05
I have not spoken out in public in the last few years because I had nothing to say
Agree, I was not interested
Disagree
No response/Don’t know
T06
Do you think that, generally speaking, women from your community speak at the Gram Sabha?
Yes
Mostly Yes
Mostly No
No
No response/Don’t know
Section H: Poverty Index (PPI)
U01
What is the general education level of the female head/spouse?
Primary (class 5th) or below or literate
Middle (class 6th to 8th)
Secondary or higher (class 9th and above)
No female head/Spouse
U02
Does your household have a Refrigerator
Yes
No
U03
Does your household have a Stove/Gas burner
Yes
No
U04
Does your household have a LPG gas cylinder
Yes
No
U05
Does your household have a Pressure Cooker
Yes
No
U06
Does your household have a Television
Yes
No
U07
Does your household have a Electric Fan
Yes
No
U08
Does your household have a Almirah/Dressing table
Yes
No
U09
Does your household have a Motorcycle/Scooter/Car/Jeep
Yes
No
U10
Does your household have a Color Television
Yes
No
U11
Does your household have a Basic mobile phone
Yes
No
U12
Does your household have a smartphone
Yes
No
U13
Does your household have access to Internet
Yes
No
U14
What type of fuel does your household mainly use for cooking?
Electricity
Lpg/Natural
Biogas
Kerosene
Coal/Lignite
Charcoal
Wood
Straw/Shrubs/Grass
Agricultural Crop Waste
Dungcakes
Other (Specify)
U15
What is the main source of drinking water for members of your household?
Piped Into Dwelling
Piped To Yard/Plot
Public Tap/Standpipe
Tube Well/Borehole
Protected Well
Unprotected Well
Protected Spring
Unprotected Spring
Rainwater
Tanker Truck
Cart With Small Tank
Surface Water (River/Dam/Lake/Pond/ Stream/Canal/Irrigation Channel)
Bottled Water
Government Hand Pump
Hand Pump at Home
Neighbour’s Hand Pump
Other [Specify]
U16
What kind of toilet facility do members of your household majorly use?
Flush To Piped Sewer System
Flush To Septic Tank
Flush To Pit Latrine
Flush To Somewhere Else
Flush, Don't Know Where
Ventilated Improved Pit (Vip)/Biogas Latrine
Pit Latrine with Slab
Pit Latrine Without Slab/ Open Pit
Twin Pit/Composting Toilet
Dry Toilet
No Facility/Uses Open Space or Field
Other [Specify]
U17
Do you/your household have a BPL card?
Yes
No
Skilling, employment and migration
V01
Display name of all women (option 2 in A12) who are above 18 years of age (A13) and asked if they went through any training in the past 1 year
Yes
No
V02
Did you go through any tests or assessments before you were enrolled for a particular training?
Yes
No
V03
What kind of training you have gone through?
Tailoring
Poultry/goat rearing
Dairy Farming
Vermicomposting
Pisciculture
Mushroom cultivation
Horticulture
Computer Basics
Beauty Parlor courses
Handicraft manufacturing
Food processing (papad, pickle, processing of spices)
FMCG products(Agarbathi, soap making etc)
Others(Specify)
V04
Were you offered any choices on the type of training?
Yes
No
V05
Were you given any employment/job post-training?
Yes
No
V06
Are you currently employed by the same employer for which you have first employed post-training?
Yes
No
V07
How has this training supported you?
Assisted in getting Job
Provided me with the primary source of income
Provided me an additional source of income
Gained a skill set which I use in my domestic work
V08
Who provided the training?
RSETI
NAK
Specialized skilled trainer
V09
Has any member of your household migrated out of the village in search of work?
Yes
No
V10
Who has migrated in search of work?
Woman herself
Husband
Daughter in law
FIL/MIL
Other [Specify]
V11
What was the nature of migration? (Select all that apply)
Moved to a different location within the state
Moved to a different state
Moved to different country
Other [Specify]
Don’t know
V12
What was the most important reason for migrants’ most recent migration
Better work opportunities
Job transfer
Lack of work opportunities within/around the village
Higher wage rate in migrated location
Family/friends took them to get work outside
Other (specify)
V13
Are you aware of the Naari Adhikaar Kendra?
Yes
No
V14
What are some of the activities that NAARI ADHIKAR KENDRA can help a woman with?
Awareness generation on government schemes/ individual social entitlements such as scholarships etc
A detailed survey on access to government schemes
Providing access to government schemes/entitlements
Support in case of gender-based violence
Facilitating in SHG/CLF/VO meetings and drafting the Village Development Plan
Help in Job Mela and getting training for jobs
Other (specify)
Don’t know
V15
Have you or someone in your family have taken any kind of support from the NAARI ADHIKAR KENDRA, which ones?
Awareness generation on government schemes/ individual social entitlements such as scholarships etc
A detailed survey on access to government schemes
Providing access to government schemes/entitlements
Support in case of gender-based violence
Facilitating in SHG/CLF/VO meetings and drafting the Village Development Plan
Help in Job Mela and getting training for jobs
Other (specify)
Don’t know/ Can’t say for sure
No support taken by myself or in immediate family
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