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Shg Template 2 -Form Fill
Village Information
Q01
District Name
Q02
District Code
Q03
Block Name
Q04
Block Code
Q05
Gram Panchayat Name
Q06
Gram Panchayat Code
Q07
Village Name
Q08
Village Code
Q09
Village Unique ID
Survey Information
A01
Name of the respondent
A02
SHG identification code
A03
Interviewer name
A04
Interviewer code
A05
Date of the interview
A06
Result of the interview
Interview complete
Visit rescheduled
Interview incomplete
Refused
SHG not located
Respondent is out of station for extended period
Respondent is temporarily away
Other (specify)
A07
Record time when you start the interview
SHG Information
B01
Who formed this SHG?
Formed under MSRLM
Formed by NGO
Don’t know
Others (specify)
B02
When was the SHG brought under MSRLM?
B03
Please describe the status of this SHG?
SHG is functional
SHG is defunct (SHG was active at some point but group has dissolved and no activity at the time of this survey)
B04
When was this SHG formed?
B05
Has a bank account been opened in the name of the SHG?
Yes
No
B06
When was the bank account opened?
B07
What is the distance to the bank from the usual SHG meeting place office?
B08
Is your SHG a member of the village organization (VO)?
Yes
No
B09
What is the name of the VO of which this SHG is a member?
B10
When did the SHG join the VO?
B11
Has this SHG ever been graded?
Yes
No
B12
On what parameters was the SHG graded?
Homogeneity and conflict resolution ability among members
Average attendance
Regularity in savings
Frequency of inter-loaning
Timely repayment of loans
Maintenance of books of records
Timely and fair elections
Frequency of health and nutrition meetings in the SHG
Participation of pregnant and lactating mothers in Health and Nutrition meetings
Receipt of productive loans from commercial banks
Others (Specify)
Not aware
B13
How many times has the SHG been graded till now?
B14
When was the last time this SHG was graded?
B15
What is the latest grade awarded to the SHG?
B16
Who according to you is the most important community cadre who provides pivotal support to the daily functioning of your SHG?
SamuhSakhi
Bookkeeper
ICRP
ICRP-FNHW
Bank Sakhi
KrishiSakhi (only for MKSY block)
PashuSakhi (only for MKSY block)
AajeevikaSakhi
None of the community cadre is engaged with the SHG
Don’t know
Others (Specify)
B17
How many women are members of the SHG currently?
B18
How many members have permanently left this SHG?
B19
What are the reasons for members leaving this SHG?
Migration
Marriage
Old age/health
Ill health
Did not agree to group norms
Multiple membership
Loan amount by SHG was too small
No bank linkage
Expelled
Husband/family members did not allow to continue
Misuse of funds
Did not see any benefit in being a member of SHG
Don’t know
Others (Specify)
SHG Member Roster – Socio-Demographic Details
C01
Name of the current SHG member
C02
Whether included in household survey?
Yes
No
C03
When did the member join the SHG?
C04
In which hamlet/mohalladoes themember live?
C05
What is the religion of the member?
Hindu
Muslim
Christian
Jain
Sikh
Buddhist
Others (Specify)
C06
What is the socialcategoryof the member?
General
SC
ST
OBC
Others (Specify)
C07
What is the age of the member?
C08
What is the primary occupation of the member?
Agriculture on own land
Animal husbandry
Agriculture labor
MGNREGS labor
Own business / shop
Salaried government
Salaried private job
Not working/unemployed
Senior citizen
Others (Specify)
Don’t know
C09
What is the educational qualification of member?
Illiterate
No Schooling (But knows to read/ write)
Primary
Secondary
High Secondary
Diploma/ ITI
Graduation
Post Graduation
If other, please specify
C10
What type of ration card does the member’s household have?
Orange (APL)
Yellow (BPL)
White (Annual Income > Rs 1 Lakh)
Annapurna (Age above 65 years)
Antodaya Anna Yojana (AAY)
Priority Household (PHH)
Do not have any ration card
Do not know
If Other, please specify
C11
Is the member currently holding any of the following position with the VO?
VO accountant/ assistant
SamuhSakhi
Bookkeeper
ICRP
ICRP-FNHW
Bank Sakhi
KrishiSakhi (only for MKSY block)
PashuSakhi (only for MKSY block)
C12
Is the member currently holding any of the following position in the SHG?
President
Vice president
Treasurer
Secretary
Bookkeeper
Others (Specify)
Not holding any position
C13
What all trainings has the member received by the SHG?
SHG concept & management & leadership
SHG credit linkages
Micro credit plan training
Training on SHG books of records
Financial literacy training
Concept of VO, formation process and its functions
Livelihoods training
Training on health and nutrition module
Others (Specify)
Don’t know
C14
Who provided the training?
DRP
BRP
ICRP
ICRP-FNHW
SamuhSakhi
Bank Sakhi
Others (Specify)
Don’t know
SHG Formation, Training and Capacity Building
D01
What were the criteria followed for formation of SHG?
BPL Households
APL Households
Same Caste / Category
Different Caste / Category
Same locality (hamlet/ muhalla / tola)
Different locality (hamlet/ muhalla / tola)
If other(specify
D02
In how many stages your SHG was formed?
One
Two
Three
Four
More than Four
Don’t Know
D03
How the concept of SHG seeded?
Through corner/ ward meetings
Through orientation events
Through door to door interaction
Through exposure visits
Others (Specify)
D04
Were queries, conflict or anxieties among women for formation of SHG was addressed?
Yes
No
D05
Was individual’s interest was taken into consideration while forming group?
Yes
No
D06
How many meetings were organized to mobilize the people?
One
Two
Three
Four
More than Four
Don’t Know
D07
After conceptualizing, how you all proceeded further to shape your SHG functioning?
D08
On an average, how many members usually attend meetings?
Less than 5 members
5 to 10 members
11 to 15 members
16 to 20 members
More than 20 members
D09
Prior to forming SHG, was any training conducted to build capacity of community members to form SHG?
Yes
No
D10
What can you say about culture of your group?
Strong feeling of unity
Respect for others
Democratic decision-making
Freedom of expression of ideas and feelings
If Others (Specify___)
D11
How was your SHG incorporated?
In a meeting with to be member households
Incorporated by the key persons and later member households were informed
Incorporated by the MSRLM team and later member households were informed
If other, please specify
D12
Did you participate in the meeting in which your SHG was incorporated?
Yes
No
D13
Are the rules/ norms for your SHG formulated?
Yes
No
D14
Do you recall who formulated the rules/ norms for your SHG?
Only Mission staff
Only SHG office bearers
Mission staff and SHG office bearers
SHG office bearers and few members
SHG office bearers and all members
Mission staff, SHG office bearers and all members
If other, please specify
D15
Do you recall the rules/ norms formulated for functioning of your SHG?
D15_1
Rules for regular meeting
Yes
No
D15_2
Rules for regular savings
Yes
No
D15_3
Rules for regular internal lending
Yes
No
D15_4
Rules for regular repayment
Yes
No
D15_5
Rules for fund management
Yes
No
D15_6
Rules of book keeping
Yes
No
D15_7
Rules for selection and appointment of SHG office bearers
Yes
No
D15_8
Rules for penalty for absenteeism, non-deposit, non-repayment etc.
Yes
No
D15_9
Defining roles and responsibilities of SHG
Yes
No
D15_10
members and office bearers
Yes
No
D15_11
Dashasutri
Yes
No
D16
Do you think that the SHG rules / norms so formulated are pro-poor?
Yes
No
D17
Do the members and office bearer of your SHG follow its rules/ norms meticulously?
Yes
No
D18
Has any member of your SHG been penalized in past according to the set rule/ norm?
Yes
No
D19
Do you recall how the office bearers (i.e. president, secretary, treasurer and book keeper) for your SHG selected and appointed?
Only Mission staff
Mission staff and few members of SHG
If other, please specify
D20
Is your SHG saving account opened in bank?
Yes
No
D21
Do you recall procedure for opening your SHG saving account in bank?
D21_1
Preparing draft rules/ norms for SHG
Yes
No
D21_2
Passing resolution for opening a savings account in bank
Yes
No
D21_3
Getting a rubber stamp in name of SHG
Yes
No
D21_4
Comply with the KYC norms i.e. keep necessary documents (viz. duly filled SB A/C opening form, document relating to residential proof, identity proof and photographs of the office bearers) ready
Yes
No
D21_5
Authorization of the three office bearers to operate the bank account on behalf of all members with the condition that money can be withdrawn with signature of at least any two office bearers
Yes
No
D22
Whether any resolution was passed prior to opening the SHG savings account in bank?
Yes
No
D23
Was the SHG savings account in bank opened within 3 months of passing the resolution?
Yes
No
D24
Is the bank branch, in which your SHG has a savings account, near to your village?
Yes
No
D25
Did bank issue savings accounts passbook to your SHG?
Yes
No
D26
Who in your SHG are authorized to operate the saving account in bank and update the passbook?
President of SHG
Secretary of SHG
Treasurer of SHG
Book keeper of SHG
Member of SHG
If other, please specify
D27
Do you recall to whom and how was the authorization to operate the saving account in bank given?
Yes
No
D28
Was opening of the savings account in bank for your SHG facilitated by a financial inclusion specialist or bank sakhi or bank mitra from the MSRLM?
Yes
No
D29
Is there any signboard installed in your village which displays your SHG name?
Yes
No
D30
How the persons in leadership position elected in your SHG?
Through meeting followed by election
Through meeting followed by nomination
Elected by SHG office bearers
Elected by key persons in the village
Do not know
If other, please specify
D31
Do you think that there is enough transparency in selecting person for leadership position in your SHG?
Yes
No
D32
What was the process followed for your appointment asan office bearer?
Through meeting followed by election
Through meeting followed by nomination
Elected by other SHG office bearers
Elected by key persons in the village
Do not know
If other, please specify
D33
How many times a leader from household belong to SC, ST and most Vulnerable in village were appointed to leadership position?
D34
How many household belong to SC, ST and most Vulnerable in village got an opportunity for getting elected to leadership position?
D35
What is the status of training?
D35_1
SHG principle and Functioning (SM1)
Yes
No
D35_2
Books Keeping (Cadre) (SBKM1)
Yes
No
D35_3
Refresher SBKM1
Yes
No
D35_4
Financial Inclusion/Literacy & RF(SM2)
Yes
No
D35_5
CRM1 (Prerika/WardhiniPrashikshan)
Yes
No
D35_6
MCP/MIP Orientation and training
Yes
No
D35_7
Bank Linkage and Orientation
Yes
No
D35_8
VO Concept and Linkage
Yes
No
D35_9
Livelihood
Yes
No
D35_10
Convergence
Yes
No
D36
Date
D36_1
SHG principle and Functioning (SM1)
D36_2
Books Keeping (Cadre) (SBKM1)
D36_3
Refresher SBKM1
D36_4
Financial Inclusion/Literacy & RF(SM2)
D36_5
CRM1 (Prerika/WardhiniPrashikshan)
D36_6
MCP/MIP Orientation and training
D36_7
Bank Linkage and Orientation
D36_8
VO Concept and Linkage
D36_9
Livelihood
D36_10
Convergence
D37
Duration
D37_1
SHG principle and Functioning (SM1)
D37_2
Books Keeping (Cadre) (SBKM1)
D37_3
Refresher SBKM1
D37_4
Financial Inclusion/Literacy & RF(SM2)
D37_5
CRM1 (Prerika/WardhiniPrashikshan)
D37_6
MCP/MIP Orientation and training
D37_7
Bank Linkage and Orientation
D37_8
VO Concept and Linkage
D37_9
Livelihood
D37_10
Convergence
D38
Who facilitated the training?
D38_1
SHG principle and Functioning (SM1)
MSRLM team
External Trainer
ICRP/ECRP
CTC/Sanghatika
D38_2
Books Keeping (Cadre) (SBKM1)
MSRLM team
External Trainer
ICRP/ECRP
CTC/Sanghatika
D38_3
Refresher SBKM1
MSRLM team
External Trainer
ICRP/ECRP
CTC/Sanghatika
D38_4
Financial Inclusion/Literacy & RF(SM2)
MSRLM team
External Trainer
ICRP/ECRP
CTC/Sanghatika
D38_5
CRM1 (Prerika/WardhiniPrashikshan)
MSRLM team
External Trainer
ICRP/ECRP
CTC/Sanghatika
D38_6
MCP/MIP Orientation and training
MSRLM team
External Trainer
ICRP/ECRP
CTC/Sanghatika
D38_7
Bank Linkage and Orientation
MSRLM team
External Trainer
ICRP/ECRP
CTC/Sanghatika
D38_8
VO Concept and Linkage
MSRLM team
External Trainer
ICRP/ECRP
CTC/Sanghatika
D38_9
Livelihood
MSRLM team
External Trainer
ICRP/ECRP
CTC/Sanghatika
D38_10
Convergence
MSRLM team
External Trainer
ICRP/ECRP
CTC/Sanghatika
D39
Where was training conducted?
D39_1
SHG principle and Functioning (SM1)
At SHG meeting
At VO office
At Cluster office
At Block office
Any Other
D39_2
Books Keeping (Cadre) (SBKM1)
At SHG meeting
At VO office
At Cluster office
At Block office
Any Other
D39_3
Refresher SBKM1
At SHG meeting
At VO office
At Cluster office
At Block office
Any Other
D39_4
Financial Inclusion/Literacy & RF(SM2)
At SHG meeting
At VO office
At Cluster office
At Block office
Any Other
D39_5
CRM1 (Prerika/WardhiniPrashikshan)
At SHG meeting
At VO office
At Cluster office
At Block office
Any Other
D39_6
MCP/MIP Orientation and training
At SHG meeting
At VO office
At Cluster office
At Block office
Any Other
D39_7
Bank Linkage and Orientation
At SHG meeting
At VO office
At Cluster office
At Block office
Any Other
D39_8
VO Concept and Linkage
At SHG meeting
At VO office
At Cluster office
At Block office
Any Other
D39_9
Livelihood
At SHG meeting
At VO office
At Cluster office
At Block office
Any Other
D39_10
Convergence
At SHG meeting
At VO office
At Cluster office
At Block office
Any Other
D40
Was training material provided?
D40_1
SHG principle and Functioning (SM1)
Yes
No
D40_2
Books Keeping (Cadre) (SBKM1)
Yes
No
D40_3
Refresher SBKM1
Yes
No
D40_4
Financial Inclusion/Literacy & RF(SM2)
Yes
No
D40_5
CRM1 (Prerika/WardhiniPrashikshan)
Yes
No
D40_6
MCP/MIP Orientation and training
Yes
No
D40_7
Bank Linkage and Orientation
Yes
No
D40_8
VO Concept and Linkage
Yes
No
D40_9
Livelihood
Yes
No
D40_10
Convergence
Yes
No
D41
To whomthe training was imparted?
D41_1
SHG principle and Functioning (SM1)
To Group Leaders
To all members
To few members and group leaders
Book Keeper
Any other, please specify.
D41_2
Books Keeping (Cadre) (SBKM1)
To Group Leaders
To all members
To few members and group leaders
Book Keeper
Any other, please specify.
D41_3
Refresher SBKM1
To Group Leaders
To all members
To few members and group leaders
Book Keeper
Any other, please specify.
D41_4
Financial Inclusion/Literacy & RF(SM2)
To Group Leaders
To all members
To few members and group leaders
Book Keeper
Any other, please specify.
D41_5
CRM1 (Prerika/WardhiniPrashikshan)
To Group Leaders
To all members
To few members and group leaders
Book Keeper
Any other, please specify.
D41_6
MCP/MIP Orientation and training
To Group Leaders
To all members
To few members and group leaders
Book Keeper
Any other, please specify.
D41_7
Bank Linkage and Orientation
To Group Leaders
To all members
To few members and group leaders
Book Keeper
Any other, please specify.
D41_8
VO Concept and Linkage
To Group Leaders
To all members
To few members and group leaders
Book Keeper
Any other, please specify.
D41_9
Livelihood
To Group Leaders
To all members
To few members and group leaders
Book Keeper
Any other, please specify.
D41_10
Convergence
To Group Leaders
To all members
To few members and group leaders
Book Keeper
Any other, please specify.
D42
Was the training useful and content relevant?
D42_1
SHG principle and Functioning (SM1)
Very much
Somewhat
Not much
D42_2
Books Keeping (Cadre) (SBKM1)
Very much
Somewhat
Not much
D42_3
Refresher SBKM1
Very much
Somewhat
Not much
D42_4
Financial Inclusion/Literacy & RF(SM2)
Very much
Somewhat
Not much
D42_5
CRM1 (Prerika/WardhiniPrashikshan)
Very much
Somewhat
Not much
D42_6
MCP/MIP Orientation and training
Very much
Somewhat
Not much
D42_7
Bank Linkage and Orientation
Very much
Somewhat
Not much
D42_8
VO Concept and Linkage
Very much
Somewhat
Not much
D42_9
Livelihood
Very much
Somewhat
Not much
D42_10
Convergence
Very much
Somewhat
Not much
D43
Do you recall the training content?
D43_1
SHG principle and Functioning (SM1)
Able to recall well
Able to recall partly
Not able to recall
D43_2
Books Keeping (Cadre) (SBKM1)
Able to recall well
Able to recall partly
Not able to recall
D43_3
Refresher SBKM1
Able to recall well
Able to recall partly
Not able to recall
D43_4
Financial Inclusion/Literacy & RF(SM2)
Able to recall well
Able to recall partly
Not able to recall
D43_5
CRM1 (Prerika/WardhiniPrashikshan)
Able to recall well
Able to recall partly
Not able to recall
D43_6
MCP/MIP Orientation and training
Able to recall well
Able to recall partly
Not able to recall
D43_7
Bank Linkage and Orientation
Able to recall well
Able to recall partly
Not able to recall
D43_8
VO Concept and Linkage
Able to recall well
Able to recall partly
Not able to recall
D43_9
Livelihood
Able to recall well
Able to recall partly
Not able to recall
D43_10
Convergence
Able to recall well
Able to recall partly
Not able to recall
D44
Is the training session noted in book of records?
D44_1
SHG principle and Functioning (SM1)
Yes
No
D44_2
Books Keeping (Cadre) (SBKM1)
Yes
No
D44_3
Refresher SBKM1
Yes
No
D44_4
Financial Inclusion/Literacy & RF(SM2)
Yes
No
D44_5
CRM1 (Prerika/WardhiniPrashikshan)
Yes
No
D44_6
MCP/MIP Orientation and training
Yes
No
D44_7
Bank Linkage and Orientation
Yes
No
D44_8
VO Concept and Linkage
Yes
No
D44_9
Livelihood
Yes
No
D44_10
Convergence
Yes
No
SHG Operations – Adherence to Dashsutra
E01
Can you recall ten sutras of Dashsutra?
Regular meeting
Regular saving
Regular lending
Regular repayment
Regular book keeping
Ensuring participation in PRI
Ensuring good health
Ensuring quality education
Ensuring convergence
Ensuring sustainable livelihoods
Regular Meetings
F01
Does your SHG conduct meetings regularly?
Yes
No
F02
How many SHG meetings are planned in a month?
One
Two
Three
Four
If other (Specify____)
F03
How many SHG meetings happen in a month?
One
Two
Three
Four
If other (Specify____)
F04
How frequently does this meeting happen?
Weekly
Fortnightly
Some random day of month
If other (Specify___)
F05
How many members usually attend these meetings?
Less than 50% of members
50%-60% of members
61-75% of members
Greater than 75% members
F06
What all agendas do you discuss in SHG meetings?
Financial issues
Personal problems
Family problems
Livelihood related discussion
Savings and bookkeeping
Loan and repayment
If other (Specify___)
F07
Which procedures are followed in conducting the meeting?
Prayer, Introduction and attendance
Agenda for the meeting
Regular Savings and Repayments
Prioritization of loan demand discussion prior to sanctioning
Writing in the minutes and other books of records
Discussion on common topics
Reading out the proceedings written in minutes book
Signature of members and office bearers in minutes/other book
If other (Specify___)
F08
For how long these meetings happen?
One hour
Two hours
Three hours
More than three hours
Based on the agenda, no definite time
If others (Specify____)
F09
Who usually decides the schedule (i.e. place, date and time) for the meeting?
President
Vice-President
Treasurer
Secretary
Bookkeeper
Any member of SHG
If other (Specify___)
F10
Does your SHG maintain attendance register in every meeting?
Yes
No
Sometimes
Never
F11
Does your SHG take any action against or penalize those members who do not attend meetings?
Yes
No
F12
Whether decisions taken in SHG meeting are with consensus of all members?
Yes
No
Regular Savings
G01
Does your SHG save regularly?
Yes
No
G02
What is the frequency of savings in your SHG?
Weekly
Fortnightly
Monthly
If other (Specify___)
G03
How many members save regularly?
Less than 50% of members
50%-60% of members
61-75% of members
Greater than 75% members
G04
What is the prescribed limit of saving of your SHG?
G05
What is the average savings mobilized per week by your SHG?
G06
Is the saving amount same for all members?
Yes
No
G07
If saving amount is different, how do you decide on amount for each member?
Based on their income level and saving capacity of the member
Based on expenditure of the family
Based on family size
Based on length of membership in the group
If others (Specify___)
G08
Does your SHG revise savings amount for its members?
Yes
No
G09
Does your SHG revise period of savings?
Yes
No
G10
How do members deposit savings?
Collect house to house
Deposit in SHG account
Contribute to regular meeting
If other (Specify___)
G11
What is the purpose of saving?
To meet future requirements
To get economic stability
To repayment of loans
G12
Where does your SHG keep all the savings?
Deposit in Bank
Kept with any members
Give loan to any member
Don’t Know
Regularity in Meetings and Savings
H01
Please note details of last 5 meetings conducted by SHG
H02
Date of Meeting
H02_1
Meeting-1
H02_2
Meeting-2
H02_3
Meeting-3
H02_4
Meeting-4
H02_5
Meeting-5
H03
Number of members on date who attended meeting
H03_1
Meeting-1
H03_2
Meeting-2
H03_3
Meeting-3
H03_4
Meeting-4
H03_5
Meeting-5
H04
Attendance
H04_1
Meeting-1
H04_2
Meeting-2
H04_3
Meeting-3
H04_4
Meeting-4
H04_5
Meeting-5
H05
Number of Members who deposited saving amount
H05_1
Meeting-1
H05_2
Meeting-2
H05_3
Meeting-3
H05_4
Meeting-4
H05_5
Meeting-5
H06
Remarks
Regular Internal Lending
I01
Has SHG utilized internal savings for inter-loaning before receiving bank/external funds?
Yes
No
I02
After how many months of savings, has your SHG started lending internally?
After first month of saving
After 2 months of saving
After 3 months of saving
After 4 months of saving
More than 4 months of saving
I03
Why does your SHG promote internal lending?
To promote group activity
To utilize savings in accumulating more funds through interests
Individual economic activities
To provide hands on experience of loan and its repayment to its members
If other (Specify__)
I04
How many members have accessed internal loan at least once?
Less than 5 members
5 to 10 members
11 to 15 members
15 to 20 members
More than 20 members
I05
How many members have accessed internal loan multiple times?
Less than 5 members
5 to 10 members
11 to 15 members
15 to 20 members
More than 20 members
I06
Has any member in your SHG defaulted in repaying internal loan?
Yes
No
I07
If yes. how many members have defaulted in repaying internal loan at least once?
Less than 5 members
5 to 10 members
11 to 15 members
15 to 20 members
More than 20 members
I08
What is the maximum number of times any SHG member has defaulted in repaying internal loan?
Regular Repayment
J01
Do all members of your SHG regularly pay back their loans?
Yes
No
J02
How many members have paid loans on time?
Less than 5 members
5 to 10 members
11 to 15 members
15 to 20 members
More than 20 members
J03A
Name of Members
J03B
About Loan Availed
J03B1
Number of loans taken
J03B2
Last loan taken
J03B3
Purposeof loan
Livelihood/ Business Generation
Agriculture
Education
Health/Medical Expenses
To repay debt
Household Consumption/Daily Subsistence
Assets Purchase
Marriage/Social Function
Any other (Please specify)
J03B4
Cumulative Loan Amount
J03C
About Loan Repayment
J03C1
Number of repayments
J03C2
Last repayment
J03C3
Cumulative Repayment Amount
J03
Is member aware about his savings and outstanding amount?
Yes
No
Regular Book Keeping
K01
Does your SHG maintain record books?
Yes
No
K02
How regularly record books are maintained?
Daily
Once a week
Twice a week
Fortnightly
Once in a month
If other (Specify__)
K03
Which of the following record books are maintained by the SHG?
Attendance register
Savings register
Cash book
Loan ledger
Individual passbook
General ledger
Minutes book/Proceeding Book
K04
Whether records maintained in the books are verified with SHG members?
Yes
No
K05
Is there a system of audit/review/closing of account?
Yes
No
K06
Who undertakes the task of audit/review/closing of account?
Book keeper
ICRP
MSRLM
K07
How frequently task of audit/review/closing of account is done?
Weekly
Fortnightly
Monthly
Quarterly
After 6 months
K08
Is Monthly Progress Report (MPR) prepared regularly?
Yes
No
K09
Who undertakes the task of preparing MPR?
Book keeper
ICRP
MSRLM staff
K10
Is MPR submitted to VO regularly?
Yes
No
K11
Regularity in Book Keeping
K11A
Status of Book Availability
K11A_1
Cash Book
Available
Not available during meeting
Not provided
Not maintained in this block
K11A_2
Minute Book
Available
Not available during meeting
Not provided
Not maintained in this block
K11A_3
Individual Passbooks
Available
Not available during meeting
Not provided
Not maintained in this block
K11A_4
Loan Ledger/Register
Available
Not available during meeting
Not provided
Not maintained in this block
K11A_5
Saving Ledger/Register
Available
Not available during meeting
Not provided
Not maintained in this block
K11A_6
General Ledger
Available
Not available during meeting
Not provided
Not maintained in this block
K11A_7
Monthly progress report
Available
Not available during meeting
Not provided
Not maintained in this block
K11B
Status of Book Update
K11B_1
Cash Book
Updated till last meeting
Partly updated
Incomplete
K11B_2
Minute Book
Updated till last meeting
Partly updated
Incomplete
K11B_3
Individual Passbooks
Updated till last meeting
Partly updated
Incomplete
K11B_4
Loan Ledger/Register
Updated till last meeting
Partly updated
Incomplete
K11B_5
Saving Ledger/Register
Updated till last meeting
Partly updated
Incomplete
K11B_6
General Ledger
Updated till last meeting
Partly updated
Incomplete
K11B_7
Monthly progress report
Updated till last meeting
Partly updated
Incomplete
K11C
Reasons for Book Non-Update
K11C_1
Cash Book
Book keeper is not skilled to write the book despite training
Skilled but not getting time to fill
Book Keeping has stopped after unresolved issues of record or other matter
Feels updating is not necessary
Not trained - has not received any training
Needs new books of record (the existing record are filled)
Book of Records were given late to SHG
Book format has changed and training is yet to be given
Book Keeper has not been appointed
Book Keeper appointed but not interested/irregular
Any other
K11C_2
Minute Book
Book keeper is not skilled to write the book despite training
Skilled but not getting time to fill
Book Keeping has stopped after unresolved issues of record or other matter
Feels updating is not necessary
Not trained - has not received any training
Needs new books of record (the existing record are filled)
Book of Records were given late to SHG
Book format has changed and training is yet to be given
Book Keeper has not been appointed
Book Keeper appointed but not interested/irregular
Any other
K11C_3
Individual Passbooks
Book keeper is not skilled to write the book despite training
Skilled but not getting time to fill
Book Keeping has stopped after unresolved issues of record or other matter
Feels updating is not necessary
Not trained - has not received any training
Needs new books of record (the existing record are filled)
Book of Records were given late to SHG
Book format has changed and training is yet to be given
Book Keeper has not been appointed
Book Keeper appointed but not interested/irregular
Any other
K11C_4
Loan Ledger/Register
Book keeper is not skilled to write the book despite training
Skilled but not getting time to fill
Book Keeping has stopped after unresolved issues of record or other matter
Feels updating is not necessary
Not trained - has not received any training
Needs new books of record (the existing record are filled)
Book of Records were given late to SHG
Book format has changed and training is yet to be given
Book Keeper has not been appointed
Book Keeper appointed but not interested/irregular
Any other
K11C_5
Saving Ledger/Register
Book keeper is not skilled to write the book despite training
Skilled but not getting time to fill
Book Keeping has stopped after unresolved issues of record or other matter
Feels updating is not necessary
Not trained - has not received any training
Needs new books of record (the existing record are filled)
Book of Records were given late to SHG
Book format has changed and training is yet to be given
Book Keeper has not been appointed
Book Keeper appointed but not interested/irregular
Any other
K11C_6
General Ledger
Book keeper is not skilled to write the book despite training
Skilled but not getting time to fill
Book Keeping has stopped after unresolved issues of record or other matter
Feels updating is not necessary
Not trained - has not received any training
Needs new books of record (the existing record are filled)
Book of Records were given late to SHG
Book format has changed and training is yet to be given
Book Keeper has not been appointed
Book Keeper appointed but not interested/irregular
Any other
K11C_7
Monthly progress report
Book keeper is not skilled to write the book despite training
Skilled but not getting time to fill
Book Keeping has stopped after unresolved issues of record or other matter
Feels updating is not necessary
Not trained - has not received any training
Needs new books of record (the existing record are filled)
Book of Records were given late to SHG
Book format has changed and training is yet to be given
Book Keeper has not been appointed
Book Keeper appointed but not interested/irregular
Any other
Maintaining Good Health
L01
Does your SHG discuss health related matters in SHG meetings?
Yes
No
L02
Which health-related issues are discussed in meetings?
L03
DoSHG members also discuss about remedies to health related issues?
Yes
No
L04
What type of remedies do members suggest for health issues?
Traditional remedies
Medical checkups
If other (Specify____)
L05
Is your village open defecation free?
Yes
No
L06
Does all members of your SHG free from malnutrition?
Yes
No
L07
How does your SHG sensitize its members about health related issues?
Discussion during meetings
Through training
If other (Specify____)
L08
Do all SHG members have toilets in their households?
Yes
No
L09
Doall SHG members have access to pure drinking water?
Yes
No
L10
Are there any camps or trainings conducted to promote good health habits?
Yes
No
L11
Do you observe any behavioral change among the SHG members especially regarding health related issues?
Yes
No
L12
Does your SHG encourage use of sanitary napkins among women members?
Yes
No
Quality Education for All
M01
Does your SHG discuss education related matters in SHG meetings?
Yes
No
M02
Which matters related to education are discussed in meetings?
M03
DoSHG members also discuss about remedies to education related issues?
Yes
No
M04
Does your SHG encourage parents to admit their child (6-16 years of age) in school?
Yes
No
M05
Do you ensure 100% enrollment and retention of admitted child in school?
Yes
No
M06
Does your SHG provide education loan?
Yes
No
M07
If no, do you assist your SHG members in availing such loans from banks?
Yes
No
M08
Does any member of your SHG actively participate in school management committee?
Yes
No
M09
About how many members in your SHG are able to read and write?
M10
About how many members in your SHG still use thumb impression in place of signature?
Ensuring Participation in PRI
N01
Do members of your SHG attend Gram Sabha?
Yes
No
N02
On an average, how many members of your SHG attend Gram Sabha meetings?
N03
Do they raise any issues in Gram Sabha?
Yes
No
N04
What kinds of issues are raised?
Access to Entitlements in Other Government Schemes
O01
Number of SHG members who have MGNREGS Job card
O02
Number of SHG members satisfied with MGNREGS accessibility (in terms of demand based accessibility, fair wage payment, timeliness etc)
O03
Number of SHG members who avail benefits under Micro Insurance Schemes
O03A
Pradhanmantri Jeevan JyotiYojana
O03B
Pradhanmantri Suraksha BimaYojana
O04
Are members of SHG availing benefits under any other scheme/ Entitlement?
O04_1
Indira Gandhi National Widow Pension Scheme
Yes
No
O04_2
Indira Gandhi National Old Age Pension Scheme
Yes
No
O04_3
Indira Gandhi National Disabled Pension Scheme
Yes
No
O04_4
National Family Benefit Scheme
Yes
No
O04_5
AamAadmiBimaYojana
Yes
No
O04_6
Sanjay Gandhi NiradharYojana
Yes
No
O04_7
Rajiv Gandhi JivandayiArogyaYojana
Yes
No
O04_8
PDS/Ration Card
Yes
No
O04_9
Voter ID
Yes
No
O04_10
Indira AwasYojana
Yes
No
O05
Eligibility
O05_1
Indira Gandhi National Widow Pension Scheme
Yes
No
O05_2
Indira Gandhi National Old Age Pension Scheme
Yes
No
O05_3
Indira Gandhi National Disabled Pension Scheme
Yes
No
O05_4
National Family Benefit Scheme
Yes
No
O05_5
AamAadmiBimaYojana
Yes
No
O05_6
Sanjay Gandhi NiradharYojana
Yes
No
O05_7
Rajiv Gandhi JivandayiArogyaYojana
Yes
No
O05_8
PDS/Ration Card
Yes
No
O05_9
Voter ID
Yes
No
O05_10
Indira AwasYojana
Yes
No
O06
Number of beneficiaries
O06_1
Indira Gandhi National Widow Pension Scheme
O06_2
Indira Gandhi National Old Age Pension Scheme
O06_3
Indira Gandhi National Disabled Pension Scheme
O06_4
National Family Benefit Scheme
O06_5
AamAadmiBimaYojana
O06_6
Sanjay Gandhi NiradharYojana
O06_7
Rajiv Gandhi JivandayiArogyaYojana
O06_8
PDS/Ration Card
O06_9
Voter ID
O06_10
Indira AwasYojana
O07
Was support received from SHG?
O07_1
Indira Gandhi National Widow Pension Scheme
Yes
No
O07_2
Indira Gandhi National Old Age Pension Scheme
Yes
No
O07_3
Indira Gandhi National Disabled Pension Scheme
Yes
No
O07_4
National Family Benefit Scheme
Yes
No
O07_5
AamAadmiBimaYojana
Yes
No
O07_6
Sanjay Gandhi NiradharYojana
Yes
No
O07_7
Rajiv Gandhi JivandayiArogyaYojana
Yes
No
O07_8
PDS/Ration Card
Yes
No
O07_9
Voter ID
Yes
No
O07_10
Indira AwasYojana
Yes
No
SHG Grading Process
P01
Have your SHG undergone grading process?
Yes
No
P02
If yes, when was the first time your SHG was graded after formation?
After 3 months
After 6 months
After 12 months
If other (Specify__)
P03
When it was first graded?
P04
How frequently your SHG has been graded?
Quarterly
Every six months
Annually
If other (Specify)
P05
Who graded your SHG for the first time?
VO
CLF
Mission staff
Don’t know
If other (Specify___)
P06
When was the last time your SHG was graded?
3 months back
6 months back
Before 1 year
Don’t know
P07
What grade was assigned to your SHG in last grading process?
P08
What parameters were taken in account for grading your SHG?
Adherence to Dashsutra
MCP preparation
If other (Specify___)
P09
Were book of records checked by VO before grading process?
Yes
No
P10
Is grading result and status has been shared among the SHG members?
Yes
No
Micro Investment/ Credit Planning (MIP/ MCP) Process
R01
Does your SHG involve its member in micro credit investment planning?
Yes
No
R02
How do SHG members prepare their household investment plan?
Discussing with family members
Discussion with SHG members
Based on livelihood activity
If others, please specify
R03
Does SHG members discuss investment plan with their family members?
Yes
No
R04
Was 2nd meeting for micro plan conducted within 7 days of 1st meeting?
Yes
No
R05
What was the reason for delay in the second meeting?
Members did not turn up for meeting
Micro plan was not prepared appropriately in first meeting
Bank official did not turn up
Unprecedented situation come up
Ignorance by the office bearers
If other(Specify___)
R06
On criteria, are micro investment plan prepared in your SHG?
SHG comprehensive profile
Member wise Socio-Economic profiles
Members individual income and expenditure statements
Preparation of MCP
Prioritization plan
Rotation plan
Terms of partnership
If other(Specify__)
R07
Who estimated the support requirement based on analysis of credit and repayment ability of SHG members?
Bank officials
VO/CLF staff
SHG office bearers
SHG members
MSRLM staff
If other(Specify__)
R08
How prioritization of needs was done among member households?
Based on their income level and saving capacity of the member
Based on expenditure of the family
Based on family size
Based on length of membership in the group
If others (Specify___)
R09
Was micro plan filled in a specific format?
Yes
No
R10
If no, what was reason of difference in format?
R11
If yes, in which format micro credit planning was filled?
BRLPS format
If other (Specify__)
R12
Who appraise MIPs/ MCPs of SHG?
Loan committee of VO
Loan committee of BMMU level
Bank official
If other(Specify__)
R13
On what criteria,does speedy approval of MIPs/ MCPs depend?
Availability of officials
Easily approachable
Distance of office
Cooperation of staffs
If other(Specify__)
R14
Are community representatives involved in appraisal process?
Yes
No
R15
Number of SHG member households whose micro-credit plans are approved
R16
Number of SHG member households who repaid micro credit loans and again re-accessed
SHG Finances and Fund Management
S01
Does your SHG applied for funding (either revolving or community investment) to VO?
Yes
No
S02
Who prepares the application for funding to VO?
President
Vice President
Treasurer
Secretary
Any SHG member
If other (Specify__)
S03
On what criteria the VO reallocates the funds to member SHG?
Percentage of vulnerable households in SHG
No. of ‘A’ grade received by SHG
Regular meeting of VO
Attendance in VO meeting
Repayment performance from member SHG to VO
No. of Training Received by SHG
Assessing overall performance of SHG
If Others (Specify__)
S04
On what criteria the SHG disburse its funds to members?
Vulnerability status of member households
As per the micro plan developed
With consensus among SHG members
As per the need by any SHG member
If other (Specify___)
S05
How are the grievances pertaining to disbursement of funds among SHG members resolved?
S06
Does SHG submit fund utilization certificate to VO?
Yes
No
S07
If yes, was that form submitted within one month of fund disbursement?
Yes
No
S08
If no, what was the reason for non-submission of fund utilization certificate to VO?
Fund not received fully
Delay in document work
Negligence from office bearers of SHG
Unaware about any such form
S09
Does loan committee at VO level verified the fund utilization form submitted by SHG?
Yes
No
S10
Did your SHG receive any RF?
Yes
No
S11
What was the reason for not getting any RF?
S12
How much fund was received and how many times?
S13
How was the RF distributed among SHG members?
Distributed equally among the members
Preference was given to the poorer members
Given to members who have asked for it
S14
How was the RF utilized by SHG?
Initial consumption purpose
Income generation activity
S15
Did your SHG receive any CIF for livelihood?
Yes
No
S16
What was the reason for not getting any CIF?
S17
How much fund was received and how many times under CIF?
S18
Did your SHG receive any CIF for vulnerability reduction?
Yes
No
S19
If no, what was the reason for not getting fund?
S20
How was CIF fund used by the SHG?
From Banks
T01
Who performed internal assessment of SHG for checking its eligibility for bank credit?
SHG Members
VO
If other (Specify__)
T02
Is any resolution passed by SHG to avail bank loan?
Yes
No
T03
If no, what reason for not passing any resolution?
T04
If yes, how resolution was passed within the group?
With discussion among SHG members
Decided by the SHG office bearers
If others, please specify
T05
Who facilitates the formality of application?
T06
Are Bank managers invited for grading of SHGs?
Yes
No
T07
If no, what was the reason for inviting them?
T08
If yes, in which phase of grading they were invited?
T09
Who visits the bank branch for completing the formality?
Any member of SHG
Any office bearer of SHG
An official from VO
MSRLM staff
If other (Specify)
T10
RF/ CIF/ Bank Funding received by SHG
T11
Status of Funds Received
T11_1
RF
Yes
No
T11_2
CIF
Yes
No
T11_3
Bank Loan
Yes
No
T12
Number of Bank Loan
T12_1
RF
T12_2
CIF
T12_3
Bank Loan
T13
Reason for non-receipt
T13_1
RF
T13_2
CIF
T13_3
Bank Loan
T14
Amount Received/ Sanctioned (Total till date)
T14_1
RF
T14_2
CIF
T14_3
Bank Loan
T15
Date of Receiving first amount and number of months after formation/joining MSRLM
T15_1
RF
T15_2
CIF
T15_3
Bank Loan
T16
Has SHG Started Repaying
Yes
No
T17
Amount Repaid till date
T18
Monthly Repayment
Yes
No
T19
Was MCP/MIP followed before disbursement
Yes
No
T20
Please tally whether the funds were disbursed as per the MCP/MIP and respond below
T20A
Was there any deviation?
Yes
No
T20B
If Yes, please specify reason
Yes
No
T21
Was the CIF Fund distributed equally amongst the SHG members?
Yes
No
T22
Was the BL Fund distributed equally amongst the SHG members?
Yes
No
T23
Was the RF fund distributed equally amongst the SHG members?
Yes
No
Livelihood Mission
U01
Does your SHG promote livelihood activities?
Yes
No
U02
Which livelihood activities does your SHG promote among its members?
Farming
Livestock
Fisheries/ Inland fisheries
NTFP Cultivation
If other(Specify___)
U03
How many SHG member householdsare involved in these livelihood activities?
U04
What kind of support SHG provide to its member household?
Create awareness
Capacity building through trainings
Providing funds to start business
Helping in terms of providing resources
Continuousmonitoring of their performance
If other (Specify___)
U05
How do SHG decide on which livelihood activity a member household will work?
Based on MIP/ MCP developed
Discussion in SHG meeting
Assessing the skill set of members
Based on funds and resource available
If other (Specify___)
U06
Have your SHG conducted trainings to build capacity of member households for livelihood activities?
Yes
No
U07
Does your SHG provide financial assistance for taking up livelihood activity?
Yes
No
U08
Does a SHG member take up multiple livelihood activity?
Yes
No
Sustainable Agriculture Practices
V01
Do SHG member households own Nutri Gardens/ Kitchen gardens?
Yes
No
V02
On an average, how much area is under cultivation?
V03
How many CRPs assist households in farming practices?
V04
What all primary processing units are available in your village?
Primary grading
Sorting units
Cold storage
If other (Specify___)
V05
Does your SHG promote using primary processing unit among SHG members?
Yes
No
V06
What is the annual income generated from farming activities?
V07
Has income of household has increased after adopting sustainable practices in Farming?
Yes
No
V08
On an average, how much increase has been observed in income per household?
V09
How many households from this SHG are involved in livestock rearing?
V10
Which among the following livestock options are the member household involved?
Goatry
Poultry
Dairy
If other (Specify___)
V11
Which of the following livestock practices have been promoted among households?
Deworming
Vaccination
Shed
Fodder Management
None
If other (Specify___)
V12
How many member households have adopted above mentioned practices?
V13
Which of the following value addition units have been established?
Community livestock business centre
Goat Club
Nursery
Online Trading
Small Processing unit
Goat Milk
Soap
Hand wash
If other (Specify__)
Sustainable Dairy Agriculture Practices
W01
Has linkage of farm and dairy products of member household to the main market established?
Yes
No
W02
Does MSRLM encourage value chain approach?
Yes
No
W03
If yes, how it has benefited to your member households?
Provided good value for the product
Access to larger market
Provided facilities in storing and transporting products
If other (Specify__)
W04
How many value chains have been identified for this SHG?
W05
Which commodities are linked with value chain?
W06
How many MahilaKisan of this SHG has been involved in this activity?
W07
How many vendors are identified for trading in your village?
W08
How many value added products are promoted in your village?
W09
List the value added products of NTFP promoted in your village.
Custard Apple
Jamun
Charoli
Mahuwa Collection
TenduPatta
If other (Specify____)
W10
Does your SHG support any Non- Farm enterprise activity/trade?
Yes
No
W11
Is there any non-farm trade cluster promoted in your village?
Yes
No
W12
Is this SHG linked with non-farm trade cluster?
Yes
No
W13
How many enterprises have been established under non-farm trade clusters?
W14
How many SHG member households are engaged with these enterprises?
W15
How many types of products are handled under this enterprise?
W16
What different types of products are handled under this enterprise?
W17
What kind of support was given to member household?
Training
Financial support
Providing facilities to start a business
If other (Specify__)
W18
How many trainings has been conducted in last 12 months for non-farm clusters?
W19
Who provided training to build capacity of the member households?
CRP
MSRLM staff
An experienced member of community
If other (Specify__)
W20
Was any exposure visit in market organized in last 12 months?
Yes
No
W21
How frequently these visits are organized?
W22
Was any support extended in partnership mode or with NGOs?
Yes
No
W23
Does MSRLM helped in providing better technology and skillsets on ground?
Yes
No
Public-Private-Community Partnership
X01
Does your SHG involved in Public-Private-Community Partnership?
Yes
No
X02
How this partnership benefitted SHG member household?
Helped in gaining knowledge
Providing assistance in scaling up business
Providing better access to market
Improving quality of products
No benefits at all
X03
In which livelihood activity PPCP has been implemented?
Farming
Livestock
Fisheries/ Inland fisheries
NTFP Cultivation
If other(Specify___)
X04
Are there any products which are produced under partnership with some external production unit?
Yes
No
X05
What is the quantity of production and sale of the produce in last financial year?
X06
With how many other government departments has your SHG established convergence?
X07
What is the annual turnover and profit earned by your SHG in economic activities carried out through partnerships?
X08
Has partnership led to gaining incremental income by member households?
Yes
No
X09
On an average how much is the gain in the household income?
Collectives and Producer Organization
Y01
Is there a producer group present in your village?
Yes
No
Y02
Are you or any other member from this SHG part of a producer group (PG)?
Yes
No
Y03
When was this PG formed?
Y04
Why did members of SHG join the PG?
Better access to input market
Better access to output market
To gain access to improved farm technology
To gain access to improved non-farm technology
To get training in livelihood activities
Access to better livelihood infrastructure facilities
For additional income to HH
Don’t know/none of the above
If Other (Specify__)
Y05
Does the PG meet on a regular basis?
Yes
No
Y06
What is the interval at which this PG meets?
Once a month
Once a four month
Every six months
Whenever required
If other (Specify___)
Y07
Does your PG have a bank account?
Yes
No
Y08
What type of activities are carried out in this PG?
Collection of money for corpus generation
Discussion about the livelihood opportunities
Preparing a business plan for the PG
Value addition (processing and/or packaging)
Procurement of inputs
Aggregation of produce for selling
Connecting to relevant markets
PG has been formed but no activity takes places
Trainings
Don’t Know
If Others (Specify_____)
Y09
What all activities have household members participated in as a member of this PG?
Contributed towards the corpus
Created a business plan
Aggregation of produce in the village
Processing of agriculture produce
Selling collectively to traders or outside markets
Discussing about livelihoods
Attended training
Accessed veterinary services
Not participated or PG not fully functional
Y10
Does household member of SHG received any training as a member of PG?
Yes
No
Y11
What type of trainings did SHG members receive?
Training on PoP (Package of Practices)
Exposure visit to show better livelihood practices adopted by farmers
Training on how to prepare a business plan
Financial management
Organizational management
Procurement management
If Others (Specify)
Y12
Does this SHG received any service/facility from MSRLM?
Yes
No
Y13
What facility have you received?
Common equipment for production
Common facility for housing the equipment
Common facility centers for storage
Common facility centers for demonstration
Green house for vegetable cultivation
Common processing center for farm and non-farm produce
If Others (Specify____)
Y14
What services does SHG members received?
Access to hybrid seeds or improved seeds, fertilizers
Livestock vaccination campaign
Veterinary services through para vet
Access to quality feed and fodder
If others (Specify___)
Y15
Do you feel member households have been benefited from this service/facility?
Yes, very much benefitted
Yes, somewhat benefitted
Not benefitted
Y16
How have household members been benefitted from this service/facility?
Improved access to technology/equipment, agri-based services
Increase in productivity of crops/livestock/ non-farm business
Improved input market linkages
Improved output market linkages
Access to storage facilities
Access to extension services by paraprofessionals engaged by the project
Awareness on package of practices
Improved market price for the produce (farm/non-farm)
Reasonable prices of inputs (seed, fertilizer, pesticides, animal feed)
Fixed place to sell product
If others (Specify____)
Y17
Have these benefits led to higher income of member households?
Yes, increased significantly
Yes, increased marginally
Unchanged
Y18
Why have member households not benefited?
Did not receive any training
PG has not received project fund
No work has been done so far under PG
If Other (Specify___)
Y19
Why does your SHG not have a PG member?
No one approached us for forming PG
Unaware what PG is
We don’t practice the activity taken-up by the PG
Don’t feel the need or have the time
If Other (Specify___)
Y20
Is your group part of a producer organization
Yes
No
Y21
If yes, when was the PO formed?
In the last 3 months
3-6 months back
6-12 months back
12-18 months back
More than 18 months back
Y22
What type of PO is your group a member of?
Feed Mill
Slaughterhouse
Vegetable packhouse
Seed processing
Fruit processing (including passion fruit, lemon and other fruit)
Ginger processing
Cardamom processing
Hatchery
CLBRC plus central production/aggregation unit
Tea processing
If Other (Specify____)
Y23
What are some of the activities carried out by the PO?
Meetings and discussion about livelihood
Trainings on livelihood
Processing of agriculture produce
Procurement of inputs for livelihood
Packaging and marketing of products of members
Setting up a common place for selling of produce
The PO is newly registered and has not started functioning fully
If Other (Specify____)
Y24
How has the PO been beneficial to your group?
It improves access to inputs
It improves access to market
It ensures better price of the produce
It helps access better technical know-how through trainings and exposure visits
It helps us become more organized in terms of systems and processes within the group
It helps us become more transparent and accountable
It helps us scale our activities
The PO is too young for us to realize any benefits
It serves as a marketing platform for our produce
Increased knowledge and skill for livelihood enhancement
We get better quality inputs for our livelihood
Learned about best practices related to our livelihood
Increased our interaction with the community
If others (Specify___)
Y25
How do you think the PO would be beneficial to you?
It will improve access to inputs
It will improve access to market
It will ensure better price of the produc
It will help access better technical know-how through trainings and exposure visits
It will help us become more organized in terms of system and processes within the group
It will help us become more transparent and accountable
It helps us scale our activities
If others (specify__)
Y26
Why is your group not a member of PO?
Not aware of what is a PO
We are in the process of forming a PO with the help of the project
We wanted to start of PO, but the project has not helped us yet
We the members do not feel the need
If others (Specify__)
Y27
How many SHG members are involved in your FPO?
Y28
What is total Share Capital or Cumulative amount collected from them?
Y29
How many directors are appointed for your FPO?
Y30
Have you identified any promoters for your FPO?
Yes
No
Y31
If yes. how many promoters are identified?
Y32
At what frequency do the directors and promoters meet?
Weekly
Fortnightly
Monthly
Bi-monthly
Once in a 6 month
If others (Specify)
Y33
How many review meetings are held in past 6 months?
Y34
What are the criteria for selection and appointment of Hon. CEO / CA for your FPO?
Y35
List the types of commodities handled by your FPO.
Y36
Please specify the number of commodities under each type.
Y37
Is your FPO registered?
Yes
No
Y38
What is the reason for not getting registered?
Y39
Have your FPO obtained necessary licenses and adhere to legal compliance for operation of its business?
Yes
No
Y40
Since formation of your FPO, how many financial audits are conducted?
Y41
Since formation of your FPO, how many Annual General Meetings (AGMs) are conducted?
Y42
Does your FPO maintain the book of records regularly?
Yes
No
Y43
What is the reason for irregularity in maintaining book of records?
Y44
How many vendors have your FPO identified for trading?
Y45
How many market linkages have your FPO identified for promotion of commodities?
Y46
How many farmer field schools are conducted in your village?
Y47
What is the annual turnover of your FPO in last financial year?
Y48
How much profit has your FPO earned in last financial year?
Y49
At what frequency, your FPO repays the loan?
Weekly
Fortnightly
Monthly
Bi- Monthly
Bi- Annually
Annually
If other (Specify_____)
Y50
List the capital assess owned by your FPO
Innovative Livelihood Projects
Z01
Does your SHG received any unique/ innovative livelihood idea that helped member households to increase their income?
Yes
No
Z02
Is there any Floriculture initiative taken in your village?
Yes
No
Z03
How many SHG members are involved in this project?
Z04
How were members selected for this livelihood project?
Based on Micro plan prepared
Discussion in SHG meeting
Office bearers decide whom to select
Based on some assessment
Based on available skill set/ Knowledge
If other (Specify__)
Z05
How many sales outlets are supported by your SHG for marketing?
Z06
How many bazaar hats are promoted by your SHG?
Z07
Till date, how much loan/ grant is sanctioned by your SHG as support fund for undertaking livelihood activities?
Z08
What is the status of repayment of those loans/ grants?
Fully repaid
Paying installments
No repayment
Z09
How much a profit has your SHG earned from marketing activities in last financial year?
Z10
How many CLBCs are established in your village?
Z11
List the types of nutri snacks produced in your village
Z12
How much quantity is produced under each type?
Z13
For ensuring the staff for supporting livelihoods projects, how many CRPs are appointed in your village?
Z14
For training, how many field visits are conducted for CRPs?
Z15
How many livelihood projects demo is conducted in your village?
Z16
How many collectives are promoted in your village?
Skill Development and Entrepreneurship
AA01
Does your SHG promote entrepreneurship among member households?
Yes
No
AA02
How many ventures have been initiated by members of this SHG?
AA03
How many member households are involved in these venture/s?
AA04
Does this SHG provide training to members to take such initiative?
Yes
No
AA05
How frequently these trainings are organized?
Monthly
Quarterly
Bi-Annually
Annually
AA06
On an average, how many members attend these trainings?
AA07
How initiating business changed the life of women in your SHG?
Economic empowerment
Improved standard of living
Self-confidence
Enhance awareness
Sense of achievement
Increased social interaction
Engaged in political activities
Increased participation level in gram sabha meeting
Improvement in leadership qualities
Involvement in solving problems related to women and community
Decision making capacity in family and community
AA08
What problems are they facing in taking up business?
Social barriers
Lack of self-confidence and risk bearing capacity
Psychological factors
Lack of family support
Lack of technical and practical knowledge
Financial issues
Middle-man exploitation
Marketing problems
Lack of Information
AA09
How many training sessions under DDUGKY/ RSETI were conducted for your SHG?
AA10
How many youths were identified for these training sessions?
AA11
How many youths have attended these training sessions?
AA12
How many youths have completed these training sessions?
AA13
How many youths were entitled for certification and placement after receiving training?
AA14
How many youths were provided business development services after receiving training?
AA15
How many youths were provided support for placement after receiving training?
AA16
How many youths were provided support for availing loan from RSETI after receiving training?
Village Organic Clusters
BB01
How many Organic Clusters are promoted in your village?
BB02
On an average, how many villages are covered under one organic cluster?
BB03
How many Local Groups (LGs) are formed and registered in your village?
BB04
On an average, how many woman farmers are involved in one LG?
BB05
How much of total land (in acre) is covered under Organic Clusters in your village?
BB06
Is any dedicated staff appointed for handholding support?
Yes
No
BB07
How many personnel are appointed?
BB08
For developing organic clusters, how many training and demonstration sessions were conducted in your village?
BB09
What type of organic practices are introduced in your village?
Vermicomposting
decomposer
NADAP
JIvamrut
If other (Specify___)
BB10
How many farmer field schools were conducted in your village?
BB11
List the organic products produced in your village.
BB12
What is the production (in Qt) and Sale (INR) quantity under each of them?
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