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Process Monitoring Template 15 -Form Fill
Identification Information
Q01
District Name
Q02
District Code
Q03
Block Name
Q04
Block Code
Q05
Village Name
Q06
Village Code
Q07
Interviewer name
Q08
Date of the interview
Q09
Record time when you start the interview
Q10
Record time when you end the interview
Q11
GPS coordinates
Q12
Result of the interview
Interview complete
Visit rescheduled
Interview incomplete
Refused
Not enough information from the meeting
Other (specify)
Profile of member
A01
Name of respondent
A02
Are you a SHG member?
Yes
No
A03
What is your relationship with SHG member?
Daughter
Mother
Niece
Daughter-in-law
Mother-in-law
Aunt
Son
Spouse
Father
Brother
No relation with SHG member
Others, specify(___)
A04
Gender of the respondent
Male
Female
Others
A05
Age of respondent
18-25 years
26-45 years
46-60 years
Above 60
A06
Social category of respondent
SC
ST
OBC
General
PVTG
Others, specify
A07
Education qualifications
Illiterate
Signature literature
No Schooling (But knows to read/ write)
Primary
Secondary
Higher secondary
Graduate
Postgraduate
Others, specify
A08
Please elaborate on your enterprise type
A09
Since how many years your enterprise has been operational?
Less than a year
One year
Two Years
Three years
More than 3 years
A10
Has this enterprise been set up through financial support from JEEVIKA?
Yes, a part of the investment has been done from JEEViKA fund
Yes, complete establishment has been done because of JEEViKA.
No, the enterprise has been established through my savings only.
A11
Is the enterprise operated by you majorly?
Yes
No
A12
If no who operates it other than you?
Husband
Son
Father-in-law
Mother -in-law
Daughter
Others, specify
Interlinkage with GRAMEEN BAZAAR
B01
How did you become aware of GRAMEEN BAZAAR?
CLF
VO
SHG
AC/CC
Block level staff
B02
What was the platform used for informing you?
Through SHG/CLF/VO meetings
Doorstep campaign
Pamphlet/ leaflet
Induction/ training
Others, specify
B03
What is the distance of nearest GRAMEEN BAZAAR from your location?
B04
What is the frequency of procuring material from GRAMEEN BAZAARs?
Daily
Weekly
B-monthly
Monthly
No determined frequency, as per requirement.
Others, specify
B05
What is the level of dependence on GRAMEEN BAZAAR for procurement?
We buy all the required materials from RRM.
We buy one-fourth of the material from GRAMEEN BAZAAR and rest from the open market.
We buy half from GRAMEEN BAZAAR and other half from the market.
B06
What is the other source of procurement of inputs/ raw material for your store?
Block market
District market
Inter district market.
No procurement from other sources
Others, specify
B07
What is the dependency on these sources?
Very high
High
Neutral
Low
Very low
B08
What is the reason for going to other market/ shops other than GRAMEEN BAZAAR to buy inputs/ raw material?
Variety of products
C01
How many different types of products do you procure from GRAMEEN BAZAAR?
C02
Please specify 5 major types products you procure.
C03
What is the quantity of product/ material you procure?
C04
Is the quality of product procured from GRAMEEN BAZAAR better than what you receive from other markets?
No, they are not better.
Yes, they are better.
No, both are of equal quality.
C05
Are your customers satisfied with the quality?
Yes, I believe the customers are satisfied.
No, I don’t think they are happy.
Yes, I believe they are happy and want to buy more frequently.
No, I believe they are dissatisfied and stopped purchasing
C06
What is the mode of procuring material?
Public transport
Personal vehicle
Rent vehicle.
Others, specify
C07
Do you receive any support from CBOs (VO/CLF) or CRPs in procurement/ transportation?
Yes
No
C08
Please elaborate
C09
Do you have a separate storehouse for storing products?
Yes
No
C10
If yes, what is the type of storehouse
Rented place.
Household
Shop itself.
Other’s specify
C11
Do you receive any support from CBOs (VO/CLF) or CRPs in storage?
Yes
No
C12
Please elaborate
Income and expenses
D01
Cost Price for materials from GRAMEEN BAZAAR
D02
Cost Price for materials from other sources
D03
Rent of the shop (if any)
D04
Transportation cost (to and fro journey)
D05
Storage cost (if any)
D06
Payment to staff
D07
Miscllaneous
D08
Monthly Total Expenditure
D09
What is the average monthly sales?
D10
Does the GRAMEEN BAZAAR give you a bill/ receipt on purchase?
Yes
No
D11
Do you generate a receipt to your customers when they purchase item from your store?
Yes
No
Benefits, Challenges and Expectations
E01
Have you started to buy more frequently after GRAMEEN BAZAARs started to operate?
Yes
No
E02
What are the reasons?
No specific reasons.
Because GRAMEEN BAZAARs are closer
Because GRAMEEN BAZAARs give products at better rates.
Because the quality and cost both are good.
E03
Do you still feel the need of visiting other markets?
Yes
No
E04
What are the reasons?
GRAMEEN BAZAARs do not offer a variety of products.
The high-quality products are to be procured from big markets.
There is no substantial difference in quality and price at GRAMEEN BAZAARs.
We do not want to rely on GRAMEEN BAZAARs completely.
Others, specify
E05
How do you think GRAMEEN BAZAAR has benefitted you?
It has decreased transportation costs substantially.
The bargaining power has increased.
The procurement cost has decreased.
There are no communication barriers since GRAMEEN BAZAARs are operated by community members.
The income and savings have increased due to lesser procurement costs.
The inventory is always sufficient due to frequent procurements.
E06
Do the GRAMEEN BAZAARs exchange damaged/rotten/defective products?
Yes
No
E07
Have you ever tried to replace/ exchange products?
Yes
No
E08
Please elaborate your experience
E09
What are the challenges with GRAMEEN BAZAARs?
Low quality products
Old stock
Same price as other markets
A variety of products is not available to attract customers.
Exchange/ replacement if not possible
They do not provide bills to us.
Others, specify
E10
What do you think can be done better to make your experience better?
We need product variety.
The product standard/ quality should be the same or better than what is available in other markets.
The distance of GRAMEEN BAZAARs could be decreased.
The prices offered could become better.
Exchange and replacement should be available.
Bill generation should be mandatory for exchange and replacement.
Others specify
E11
As of now if you ever faced a challenge what have been your next steps?
E12
How was the problem resolved?
E13
Did you receive adequate support from CBOs, blocks staff and project staff?
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