Surveypoint

Q01

I confirm that I have read and understood the information sheet dated______________ for the above study. I have had the opportunity to consider the information, ask questions and have had these answered satisfactorily

Yes

No

Q02

I understand that my child’s participation in this study is voluntary and that my child can stop the interview at any time without giving a reason

Yes

No

Q03

I understand that if my child decides to stop the interview all data collected will be destroyed

Yes

No

Q04

I agree to allow my child to take part in the study

Yes

No

Q05

I understand that any information used in writing up the study findings will be used anonymously, and I give my consent to this

Yes

No

Q06

Name of the parent?

Q07

Sex of the parent

Male

Female

Transgender

Prefer not to say

Q08

What is your educational qualification?

No schooling

Only signature

Upto class 5

Class 6 to 8

Class 9 to 10

Class 11 to 12

Bachelors degree

Masters degree and above

Don’t know

Q09

What is your caste?

Brahmin, Chhettri, Sanyasi, Thakuri

Dalit

Newar

Janajati (Except Newar)

Madhesi

Muslim

Do not want to specify

Others (Specify)

Q10

Parents UID

A01

I confirm that I have read and understood the information sheet dated______________ for the above study. I have had the opportunity to consider the information, ask questions and have had these answered satisfactorily

Yes

No

A02

I understand that my participation is voluntary and that I can stop the interview at any time without giving a reason

Yes

No

A03

I understand that if I decide to stop the interview all data collected will be destroyed

Yes

No

A04

I understand that recording the interview is optional. By ticking this box, I agree to have this interview recorded

Yes

No

A05

I understand that any quotations used in writing up the study findings will be used anonymously, and I consent to this

Yes

No

B01

Date of Interview

B02

Name of the Interviewer

B03

Code of the Interviewer

C01

Name of the school

C02

Code of the school

C03

Name of the Village

C04

Code of the Village

C05

Name of the District

C06

Code of the District

C07

Type of School

Project

Comparison

D01

Grade of the student

D02

Name of the student

D03

Unique Identification Number of the student

D04

Sex of the student

Male

Female

Transgender

Prefer not to say

D05

Age of the student

D06

How long does it take for you to get to school?

D07

Do you have anyone at home to help you with reading?

Yes

No

D08

Do you take extra lessons after school?

Yes

No

D09

How many days per week do you take extra lessons after school?

D10

Do you have to work at home before going to school?

Yes

No

D11

How many hours in a day do you work at home before going to school?

D12

Do you have to work at home after coming home from school?

Yes

No

D13

How many hours in a day do you work at home after coming home from school?

D14

What language do you use at home?

Nepali Language

Tharu

Doteli

Achhami

Baitedeli

Bajhangi

Kham

Others (Specify)

D15

What language do you use at school?

Nepali Language

Tharu

Doteli

Achaami

Baitedeli

Bajhangi

Kham

Others(Specify)

E01

In the past 6 school days, how many days did you eat breakfast before going to school?

E02

In the past 6 school days, how many days did you eat a meal after going to school (and before going to bed)?

E03

Do you like coming to school because food is provided?

Yes

No

E04

If no meal is provided do you return home before the end of the school day?

I will return

I will not return

Not applicable

E05

Normally, if you become aware that the school food is finished, do you go to school the next day?

I will go to school

I will not go to school

Not applicable

E06

In the last 30 days have you missed any school days due to illness?

Yes

No

E07

How many school days have you missed?

F01

Why is it important to have a good and balanced diet?

Gives us energy

Helps us grow

Don’t Know

Other (Specify)

F02

Can you name 3 items that one should eat every day?

F03

Why is personal hygiene important?

Keeps us healthy

Prevents Diseases

Less Absenteeism from school

Other (Specify)

F04

Can you name 3 good practices on personal hygiene?

Regular and proper use of latrine at home and school

Hand washing with soap after using latrine, before eating / preparing food / feeding a child

Use and maintain tippy tap for hand washing

Drinking clean water from a safe source (e.g. tube well, or treated water collected from river/lake)

Maintain a waste disposal system (Water drainage, garbage pits, waste basket/dust bins)

Keep the School building and compounds clean

Maintaining hygienic environment during food preparation, handling and distribution

Using clean and hygienic utensils during food preparation, handling and distribution

Use and disposal of sanitary napkins during menstruation

Other (Specify)

Don’t Know

F05

Can you name a few local sources from where you can get information good health practices?

Local health clinic / hospital

School Health and hygiene Brochures

NGO/GoN Community health workers

Poster and Pamphlet

Notice board/ wall magazine / Wall paintings/hording board

Local Radio

Video/Documentary Street Drama Show

Food Fair/Food making competition

Other (specify)

Don’t Know

G01

Sickness can be caused by eating healthy food

1

Not True

Don’t Know

G02

You can prevent some of diseases by wearing shoes

1

Not True

Don’t Know

G03

There is no way to prevent children from getting diarrhoea or dying from diarrhoea diseases

1

Not True

Don’t Know

G04

Food gives us energy, immunity and helps us to grow

1

Not True

Don’t Know

G05

We shouldn’t wash our hands with water and soap

1

Not True

Don’t Know

G06

We should wash our hands with water and soap before cooking

1

Not True

Don’t Know

G07

We shouldn’t wash our hands with water and soap before eating

1

Not True

Don’t Know

G08

We should wash our hands with water and soap after using toilet

1

Not True

Don’t Know

G09

We, students, can keep our school clean, safer and healthy

1

Not True

Don’t Know

H01

For how many days from 1st July 2021 and 31st December 2021 was the school open?

H02

During the period of 1st July 2021 and 31st December 2021, how many days has the child attended school?

H03

For how many days from 1st July 2021 and 31st December 2021, was the child absent from school?

H04

How many numbers of days, between 1st July 2021 and 31st December 2021 was the child not able to attend school because of illness?

H05

Did the child fall sick the same number of days as last year (2020)?

Less this year than last year

Same number of days

More this year than last year

Don’t know/Don’t have an answer

H06

Student Template 5 -Form Fill

I confirm that I have read and understood the information sheet dated______________ for the above study. I have had the opportunity to consider the information, ask questions and have had these answered satisfactorily

I understand that my child’s participation in this study is voluntary and that my child can stop the interview at any time without giving a reason

I understand that if my child decides to stop the interview all data collected will be destroyed

I agree to allow my child to take part in the study

I understand that any information used in writing up the study findings will be used anonymously, and I give my consent to this

Name of the parent?

Sex of the parent

What is your educational qualification?

What is your caste?

Parents UID

I confirm that I have read and understood the information sheet dated______________ for the above study. I have had the opportunity to consider the information, ask questions and have had these answered satisfactorily

I understand that my participation is voluntary and that I can stop the interview at any time without giving a reason

I understand that if I decide to stop the interview all data collected will be destroyed

I understand that recording the interview is optional. By ticking this box, I agree to have this interview recorded

I understand that any quotations used in writing up the study findings will be used anonymously, and I consent to this

Date of Interview

Name of the Interviewer

Code of the Interviewer

Name of the school

Code of the school

Name of the Village

Code of the Village

Name of the District

Code of the District

Type of School

Grade of the student

Name of the student

Unique Identification Number of the student

Sex of the student

Age of the student

How long does it take for you to get to school?

Do you have anyone at home to help you with reading?

Do you take extra lessons after school?

How many days per week do you take extra lessons after school?

Do you have to work at home before going to school?

How many hours in a day do you work at home before going to school?

Do you have to work at home after coming home from school?

How many hours in a day do you work at home after coming home from school?

What language do you use at home?

What language do you use at school?

In the past 6 school days, how many days did you eat breakfast before going to school?

In the past 6 school days, how many days did you eat a meal after going to school (and before going to bed)?

Do you like coming to school because food is provided?

If no meal is provided do you return home before the end of the school day?

Normally, if you become aware that the school food is finished, do you go to school the next day?

In the last 30 days have you missed any school days due to illness?

How many school days have you missed?

Why is it important to have a good and balanced diet?

Can you name 3 items that one should eat every day?

Why is personal hygiene important?

Can you name 3 good practices on personal hygiene?

Can you name a few local sources from where you can get information good health practices?

Sickness can be caused by eating healthy food

You can prevent some of diseases by wearing shoes

There is no way to prevent children from getting diarrhoea or dying from diarrhoea diseases

Food gives us energy, immunity and helps us to grow

We shouldn’t wash our hands with water and soap

We should wash our hands with water and soap before cooking

We shouldn’t wash our hands with water and soap before eating

We should wash our hands with water and soap after using toilet

We, students, can keep our school clean, safer and healthy

For how many days from 1st July 2021 and 31st December 2021 was the school open?

During the period of 1st July 2021 and 31st December 2021, how many days has the child attended school?

For how many days from 1st July 2021 and 31st December 2021, was the child absent from school?

How many numbers of days, between 1st July 2021 and 31st December 2021 was the child not able to attend school because of illness?

Did the child fall sick the same number of days as last year (2020)?

Do you think the child is inattentive in the class? If so, how?