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Household Template 26 -Form Fill
Village Information
Q01
State
Q01A
code
Q02
District
Q02A
code
Q03
Block
Q03A
code
Q04
Village
Q04A
code
Q05
Hamlet
Q06
Structure No.
Q07
HH No.
Q08
UID
Q09
Is any member of your household part of an SHG?
Yes
No
Q10
Is she available for a one-hour interview right now?
Yes
No
Respondent Information
A01
Name of the head of the household
A02
Address
A03
Important Landmark nearest to the HH
A04
Phone Number
A05
Name of the respondent
A06
Age of the respondent
A07
Name of the Child
A08
Date of Birth of the Child
A09
Age of the Child
A10
Gender of child
MALE
FEMALE
TRANSGENDER
NO CHILD
Survey Information
B01
First Visit
B01_1
Interviewer name
B01_2
Interviewer code
B01_3
Date of the interview
B01_4
Result of the interview
Completed
Not at home
Postponed
Refused
Partly Completed
No Eligible Person
Eligible Person Incapacitated
Others (specify)
B02
Second Visit
B02_1
Interviewer name
B02_2
Interviewer code
B02_3
Date of the interview
B02_4
Result of the interview
Completed
Not at home
Postponed
Refused
Partly Completed
No Eligible Person
Eligible Person Incapacitated
Others (specify)
B03
Third Visit
B03_1
Interviewer name
B03_2
Interviewer code
B03_3
Date of the interview
B03_4
Result of the interview
Completed
Not at home
Postponed
Refused
Partly Completed
No Eligible Person
Eligible Person Incapacitated
Others (specify)
B03_5
RECORD TIME WHEN YOU START THE INTERVIEW.
HOUSEHOLD ROSTER
C01
Line Number
C02
Please tell me the names of all the persons who usually live in your household, starting with the head of the household.
C03
What is the relationship of [NAME] to the head of household?
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
GRAND PARENT/GRAND PARENT-IN-LAW
OTHER RELATIVE
ADOPTED/FOSTER/STEPCHILD
DOMESTIC HELP
OTHER (SPECIFY)
NOT STATED
C04
What is the sex of [NAME]?
MALE
FEMALE
TRANSGENDER
C05
How old is [NAME]?
C06
What is [NAME’s] marital status?
CURRENTLY MARRIED
MARRIED, GAUNA NOT PERFORMED
WIDOWED
DIVORCED
SEPARATED
DESERTED
NEVER MARRIED
NOT MARRIED, BUT LIVE TOGETHER
C07
What was your age when you got married?
C08
What was your age when you gave birth to your first child?
C09
How old was your husband when you got married?
HOUSEHOLD CHARACTERISTICS (ALL CATEGORIES)
D01
Name of the respondent
D02
Line Number of respondent
D03
What is your religion?
HINDU
MUSLIM
CHRISTIAN
SIKH
BUDDHIST/NEO-BUDDHIST
JAIN
JEWISH
PARSI/ZOROASTRIAN
NO RELIGION
SARNA
OTHER (SPECIFY)
D04
Which caste do you belong to?
D04A
Do you belong to a scheduled caste, scheduled tribe, other backward class or general class?
SCHEDULED CASTE
SCHEDULED TRIBE
OTHER BACKWARD
GENERAL
OTHER (SPECIFY)
D05
Does your household own this house or any other house?
Yes
No
D06
LOOK AT THE FLOOR AND CODE THE MAIN MATERIAL OF THE FLOOR
MUD/CLAY/EARTH
SAND
DUNG
RAW WOOD PLANKS
PALM/BAMBOO
BRICK
STONE
PARQUET OR POLISHED WOOD
VINYL OR ASPHALT
CERAMIC TILES
CEMENT
CARPET
POLISHED TONE/MARBLE/GRANITE
OTHER (SPECIFY)
D07
LOOK AT THE ROOF AND CODE THE MAIN MATERIAL OF THE ROOF
NO ROOF
THATCH/PALM LEAF/REED/GRASS
MUD
SOD/MUD AND GRASS MIXTURE
PLASTIC/POLYTHENE SHEETING
RUSTIC MAT
PALM/BAMBOO
RAW WOOD PLANKS/TIMBER
UNBURNT BRICK
LOOSELY PACKED STONE
METAL/GI
WOOD
CALAMINE/CEMENT FIBER
ASBESTOS SHEETS
RCC/RBC/CEMENT/CONCRETE
ROOFING SHINGLES
TILES
SLATE
BURNT BRICK
OTHER (SPECIFY)
D08
LOOK AT THE EXTERIOR WALLS AND CODE THE MAIN MATERIAL OF THE WALLS
NO WALLS
CANE/PALM/TRUNKS/BAMBOO
MUD
GRASS/REEDS/THATCH
BAMBOO WITH MUD
STONE WITH MUD
PLYWOOD
CARDBOARD
UNBURNT BRICK
RAW WOOD/REUSED WOOD
CEMENT/CONCRETE
STONE WITH LIME/CEMENT
BURNT BRICKS
CEMENT BLOCKS
WOOD PLANKS/SHINGLES
GI/METAL/ASBESTOS SHEETS
OTHER (SPECIFY)
D09
TYPE OF WINDOWS
D09_1
ANY WINDOWS
Yes
No
D09_2
WINDOWS WITH GLASS
Yes
No
D09_3
WINDOWS WITH SCREENS
Yes
No
D09_4
WINDOWS WITH CURTAINS OR SHUTTERS
Yes
No
D10
How many rooms in this house are used for sleeping?
D11
Do you have a separate room which is used as a kitchen?
Yes
No
D12
What type of fuel does your household mainly use for cooking?
ELECTRICITY
LPG/NATURAL GAS
BIOGAS
KEROSENE
COAL/LIGNITE
CHARCOAL
WOOD
STRAW/SHRUBS/GRASS
AGRICULTURAL CROP WASTE
DUNG CAKES
OTHER (SPECIFY)
D13
What is the main source of lighting in this household?
LANTERN
KEROSENE LAMP
CANDLE
ELECTRIC
LPG/BATTERY
SOLAR ENERGY
NONE
OTHERS (SPECIFY)
D14
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)
D14A
Is the main source of drinking water within the premises of the household?
Yes
No
D14B
How far is the main source of drinking water located?
D14C
How long does it take to go to the water source, get water, and come back during the rainy season?
D14D
How long does it take to go to the water source, get water, and come back during the dry season?
D15
Do you treat / do something special with the water that you fetch to make it safer to drink?
Yes
No
D16
What do you usually do to the water to make it safer to drink?
BOIL
USE ALUM
ADD BLEACH/CHLORINE TABLETS
STRAIN THROUGH A CLOTH
USE WATER FILTER (CERAMIC/SAND/COMPOSITE/ETC.)
USE ELECTRONIC PURIFIER
LET IT STAND AND SETTLE
OTHER (SPECIFY)
DO NOT KNOW
D16A
Does your household have a toilet?
Yes
No
D16B
What kind of toilet facilities does your household have?
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
OTHER (SPECIFY)
D17
What kind of toilet facility do members of your household usually 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)
D18
In the past week has anyone in your household including children defecated in the open for example in the field or in the river?
Yes
No
D19
The last time a child passed stools, what was done to dispose of the stools?
CHILD USED TOILET/ LATRINE
PUT/RINSED INTO TOILET OR LATRINE
PUT/RINSED INTO DRAIN OR DITCH
THROWN INTO GARBAGE
BURIED
LEFT/WASHED IN THE OPEN
NO CHILD IN HOUSEHOLD
OTHER (SPECIFY)
DO NOT KNOW
D19A
Does the household have soap and water immediately near the toilet facility?
Yes
No
D20
On what occasions did you wash your hands with soap since this time yesterday?
NO SOAP AVAILABLE IN THE HOUSEHOLD
SOAP AVAILABLE IN THE HOUSEHOLD BUT DID NOT USE IT TO WASH HANDS
BEFORE COOKING
AFTER HANDLING FOOD
BEFORE EATING
BEFORE FEEDING THE INFANT
AFTER CLEANING INFANT FECES
WHEN I WASH CLOTHES
WHEN I BATHE
WHEN I WASH DISHES
AFTER USING TOILET
OTHER SPECIFY
D21
Does your household have
D21_1
Electricity
Yes
No
D21_2
A mattress
Yes
No
D21_3
A pressure cooker
Yes
No
D21_4
A chair
Yes
No
D21_5
A cot or bed
Yes
No
D21_6
A table
Yes
No
D21_7
An electric fan
Yes
No
D21_8
A radio or transistor
Yes
No
D21_9
A black and white television
Yes
No
D21_10
A color television
Yes
No
D21_11
A sewing machine
Yes
No
D21_12
A mobile telephone
Yes
No
D21_13
Any other type of telephone
Yes
No
D21_14
A computer/laptop
Yes
No
D21_15
A refrigerator
Yes
No
D21_16
A watch or clock
Yes
No
D21_17
A bicycle
Yes
No
D21_18
A motorcycle or scooter
Yes
No
D21_19
An animal-drawn cart
Yes
No
D21_20
A car
Yes
No
D21_21
A water pump
Yes
No
D21_22
A thresher
Yes
No
D21_23
A tractor
Yes
No
D21_24
Internet
Yes
No
D21_25
Air Conditioner or Cooler
Yes
No
D21_26
Washing Machine
Yes
No
ACCESS TO AND KNOWLEDGE OF GOVERNMENT SCHEMES
E01
Have you ever heard about _?
E01_1
Indira Awas Yojna (IAY)
Yes
No
E01_2
Swajaldhara
Yes
No
E01_3
Swachh Bharat Abhiyan
Yes
No
E01_4
Janani Shishu Suraksh Karykaram
Yes
No
E01_5
Pradhanmantri Surakha Beema Yojana (accidental death insurance)
Yes
No
E01_6
Pradhan Mantri Jeevan Jyoti Beema Yojana (Life Insuarance)
Yes
No
E01_7
Atal Pension Yojana
Yes
No
E01_8
Pension for the disabled
Yes
No
E02
Is your household / anyone in your household eligible for this scheme?
E02_1
Indira Awas Yojna (IAY)
Yes
No
E02_2
Swajaldhara
Yes
No
E02_3
Swachh Bharat Abhiyan
Yes
No
E02_4
Janani Shishu Suraksh Karykaram
Yes
No
E02_5
Pradhanmantri Surakha Beema Yojana (accidental death insurance)
Yes
No
E02_6
Pradhan Mantri Jeevan Jyoti Beema Yojana (Life Insuarance)
Yes
No
E02_7
Atal Pension Yojana
Yes
No
E02_8
Pension for the disabled
Yes
No
E03
Has anyone in your household ever availed this scheme?
E03_1
Indira Awas Yojna (IAY)
Yes
No
E03_2
Swajaldhara
Yes
No
E03_3
Swachh Bharat Abhiyan
Yes
No
E03_4
Janani Shishu Suraksh Karykaram
Yes
No
E03_5
Pradhanmantri Surakha Beema Yojana (accidental death insurance)
Yes
No
E03_6
Pradhan Mantri Jeevan Jyoti Beema Yojana (Life Insuarance)
Yes
No
E03_7
Atal Pension Yojana
Yes
No
E03_8
Pension for the disabled
Yes
No
E04
When was the last time someone in your household used this scheme?
E04_1
Indira Awas Yojna (IAY)
Yes
No
E04_2
Swajaldhara
Yes
No
E04_3
Swachh Bharat Abhiyan
Yes
No
E04_4
Janani Shishu Suraksh Karykaram
Yes
No
E04_5
Pradhanmantri Surakha Beema Yojana (accidental death insurance)
Yes
No
E04_6
Pradhan Mantri Jeevan Jyoti Beema Yojana (Life Insuarance)
Yes
No
E04_7
Atal Pension Yojana
Yes
No
E04_8
Pension for the disabled
Yes
No
E05
Have you ever heard about Mahatma Gandhi rural Employment Guarantee Act?
Yes
No
E06
Does anyone in your household have a MGNREGA job card? If yes, please show me.
Yes
No
E07
In the past year, how many days did members of your household work for MGNREGA?
E08
For this total number of days worked by household members, how many days were worked by men and how many days were worked by women?
E09
When was the last time someone in your household worked for MGNREGA in last 1 year?
E10
Have you ever heard of Public Distribution System?
Yes
No
E11
Have you ever heard of Antyodaya Anna Yojana?
Yes
No
E12
Does your household have a ration card?
Yes
No
E12A
Is your name included in the ration card?
Yes
No
E13
Which card do you have?
ANTODAYA ANNA YOJANA
ANNAPURNA
BPL
APL
OTHER
DO NOT KNOW
E14
In the past 30 days, did you buy anything from a ration shop?
Yes
No
E15
Which items did you buy from the ration shop in the last 30 days and in what quantity?
E16
Whether Purchased
E16_1
Rice
Yes
No
E16_2
Wheat
Yes
No
E16_3
Sugar
Yes
No
E16_4
Salt
Yes
No
E16_5
Kerosene
Yes
No
E16_6
Clothes
Yes
No
E16_7
Other
Yes
No
E17
Quantity Purchased
E17_1
Rice
E17_2
Wheat
E17_3
Sugar
E17_4
Salt
E17_5
Kerosene
E17_6
Clothes
E17_7
Other
E18
Have you ever heard of the ICDS scheme / Anganwadi centre?
Yes
No
E19
At present is there any ____ in your household?
E19_1
Pregnant Woman
Yes
No
E19_2
Lactating Woman
Yes
No
E19_3
Child aged 6-35 months
Yes
No
E19_4
Child aged 3-6 years
Yes
No
E20
Did the member receive supplementary nutrition / hot cooked food from the AWC in the last 12 months?
Yes
No
E21
How many times did the member receive food from the AWC in the last month?
E22
Have you ever heard about the Janani suraksha Yojana Scheme?
Yes
No
E23
Do you know how much money the beneficiary is supposed to get under the JSY scheme?
E24
Does the household avail the following?
E24_1
SAVINGS
Yes
No
E24_2
CREDIT
Yes
No
E24_3
INSURANCE
Yes
No
E24_4
REMITTANCE
Yes
No
E24_5
PENSION
Yes
No
E25
Where does the household save?
SHG
GOVERNMENT BANK
COOPERATIVE BANK
PRIVATE BANK
POST OFFICE
FRIENDS / RELATIVES
AT HOME
OTHERS (Specify)
E26
From what sources does the household avail credit?
SHG
GOVERNMENT BANK
COOPERATIVE BANK
PRIVATE BANK
POST OFFICE
FRIENDS / RELATIVES
AT HOME
OTHERS (Specify)
E27
What type of insurance does the household have?
LIFE INSURANCE
ASSET INSURANCE
LIVESTOCK INSURANCE
CROP INSURANCE
HEALTH INSURANCE
ACCIDENT INSURANCE
OTHER (SPECIFY)
E28
Does anyone in your household have a bank account opened under the Pradhan Mantri Jan Dhan Yojana?
Yes
No
E29
Has the account been operated in the last 3 months?
Yes
No
E30
What activity was performed on the account?
WITHDRAWL
DEPOSIT
OTHER (SPECIFY)
DO NOT KNOW
E31
Have you availed the overdraft facility from your account under the Jan Dhan Yojana in the last 1 year?
Yes
No
E32
If yes, what was the overdraft amount?
E33
Does any member of your household avail retirement pension?
Yes
No
E34
What are the pensions that the household members receive?
CENTRAL GOVERNMEN T PENSION
STATE GOVERNEMENT PENSION
PRIVATE COMPANY PENSION
CONTRIBUTARY PENSION FROM BANK (NATIONALIZED OR PRIVATE)
OTHER
E35
Have you ever heard of the old Age Pension Scheme?
Yes
No
E36
How many members in your household were eligible for the Old Age Pension Scheme in the last 1 year?
E37
How many members availed the Old Age Pension Scheme in the last 1 year?
E38
Have you ever heard of the widow pension scheme?
Yes
No
E39
How many members in your household were eligible for the Widow Pension Scheme in the last 1 year?
E40
How many members have availed the Widow Pension Scheme in the last 1 year?
E41
Have you ever heard about Rashtriya Swasth Bima Yojana (RSBY)?
Yes
No
E42
Does your Household have a RSBY smart card?
Yes
No
E43
Was the smart card updated in the last one year?
Yes
No
E44
Did anyone in your household use the smart card in last one year?
Yes
No
LAND OWNERSHIP AND USE OF LAND FOR FARMING
F01
Does any your household own, lease in any agricultural land?
Yes
No
F02
Does your household engage in agricultural activities?
Yes
No
F03
How much agricultural land does your household presently have access to:
F03A
unit
Decimal
Biswa
Katha
Bigha
Acre
Hectare
Other
F04
Out of this land how much is irrigated or rainfed?
F04A
unit
Decimal
Biswa
Katha
Bigha
Acre
Hectare
Other
Risk taking Behaviour and adoption of new crop varieties
G01
What is the main crop that your produce?
WHEAT
RICE
MAIZE
FINGER MILLET
OTHERS (SPECIFY)
G02
Now I would like to ask you whether you are completely dependent on your main crop or you also grow other crops or engage in livestock rearing or other non-farm activites.
OPT FOR DIFFERENT VARIETY OF SAME CROPS
GROW OTHER CROPS
ENGAGE IN LIVESTOCK REARING
ENGAGE IN OTHER NON-FARM ACTIVITIES
NO MEASURES TAKEN
OTHERs (SPECIFY)
G03
What type of crops do you choose to grow?
GROW OTHER VEGETABLE CROPS
GROW FRUIT CROPS
ENGAGE IN FLORICULTURE
OTHER CERIAL
OTHER PULSE
OTHERS (SPECIFY)
G04
What type of animals do you rear
COWS
BUFFALO
PIGS
POULTRY
FISHERY
GOAT
OTHERS (SPECIFY)
G05
What type of non-farm activities do you undertake?
SMALL SCALE ENTERPRISE
LARGE SCALE ENTERPRISE
LOCAL AGRI LABOUR
LOCAL NON-AGRI LABOUR
MIGRANT LABOUR
OTHERS (SPECIFY)
PRODUCTION TECHNOLOGY
H01
Main crop of household
H02
What type of seed was primarily used for production of ____?
Improved
Local
Don’t know
H03
When was the last time you purchased new seeds for this crop?
Within 12 months
12-24 months
24-36 months
Beyond 36 months
Never Purchased
Don’t know
H04
Do you treat the seeds in some way before planting?
Yes
No
H05
How long before transplantation/sowingdo you practice weeding?
H06
Do you use a germination test to check the seeds?
Yes
No
H07
Was any fertilizer used on the land during production of _______?
Organic
K (Potash)
P(Phosphate)
N (Nitrogen/ Urea)
Composite (DAP, N`PK, Gromor etc.)
Organic and chemical both
None
Other
Don’t know
H08
Do you apply anything else to improve the quality of the soil?
Apply Lime
Apply Dolomite
Apply anything else
Nothing
Don’t know
H09
For this crop, are you mostly using line planting/transplanting or do you broadcast the crop in the main field or both?
Line planting/ transplanting
Broadcast crop
Both
First broadcast then line planting/transplanting
Don’t know
H10
At what stage of the cropping practices do you usually apply urea?
Never
At the time of sowing
After irrigation
Before irrigation
After weeding
Before weeding
During Eartning up
Flowering stage
Don’t know
H11
How many days after planting do you irrigate the crop?
H12
After planting, when do you practice earthing-up?
Immediately
Within 7 days
Within 30 days
After 1month
Any time
Never
Do not need earthing
Don’t know
H13
Do you practice hoeing in fields where you grow _____?
Yes
No
H14
What inputs does your HH normally purchase for a cropping season
Yes
No
H14A
Do you ever go to purchase _____ for the crop?
Yes
No
H15
Who decides on the purchase of inputs required for farming?
self
husband
any other male member
other female members
both male and female members
other (specify)
H16
Where does your HH purchase the inputs from?
local weekly markets (haat)
local dealers
market in nearest town
market in block headquarters
market in district headquarters
Farmers cooperative/group
others (specify)
do not know
H17
What according to you is the best place to buy the agricultural inputs from?
local weekly markets (haat)
local dealers
market in nearest town
market in block headquarters
market in district headquarters
Farmers cooperative/group
others (specify)
do not know
H18
Why do you think ____ is the best place to buy the agricultural inputs?
easily accessible
cheaper inputs are available
better quality inputs are available
more stock availability
Get on credit
Because hh members/all villagers purchase from there
others (specify)
H19
Does your hh sell any of the agricultural produce in the market?
Yes
No
H19A
Do you ever go to sell _____?
Yes
No
H20
Who decides on the sale of the produce in the market?
self
husband
any other male member
other female members
both male and female members
other (specify)
H21
Where does your hh sell the produce?
local weekly markets (haat)
local dealers
market in nearest town
market in block headquarters
market in district headquarters
other villagers
do not know
H22
What according to you is the best place to sell the agricultural produce?
local weekly markets (haat)
local dealers
market in nearest town
market in block headquarters
market in district headquarters
other villagers
do not know
H23
Why do you think ____ is the best place to sell the agricultural produce?
Easily accessible/convenient
Better market price
Do not produce sufficient quantity to sell in larger markets
Because household members/all villagers sell there
Women’s space in agricultural decision making and gendered division of labor
I01
Did you participate in _____ in the past 12 months?
I01_1
Food crop farming: crops that are grown primarily for household food consumption
Yes
No
I01_2
Cash crop farming: crops that are grown primarily for sale in the market
Yes
No
I01_3
Livestock raising
Yes
No
I01_4
Poultry (e.g. chicken, duck, pigeon)
Yes
No
I01_5
piscicultue or fishpond culture
Yes
No
I02
How much input did you have in making decisions about_____?
I02_1
Food crop farming: crops that are grown primarily for household food consumption
NO INPUT
INPUT INTO VERY FEW DECISIONS
INPUT INTO SOME DECISIONS
INPUT INTO MOST DECISIONS
INPUTS INTO ALL DECISIONS
I02_2
Cash crop farming: crops that are grown primarily for sale in the market
NO INPUT
INPUT INTO VERY FEW DECISIONS
INPUT INTO SOME DECISIONS
INPUT INTO MOST DECISIONS
INPUTS INTO ALL DECISIONS
I02_3
Livestock raising
NO INPUT
INPUT INTO VERY FEW DECISIONS
INPUT INTO SOME DECISIONS
INPUT INTO MOST DECISIONS
INPUTS INTO ALL DECISIONS
I02_4
Poultry (e.g. chicken, duck, pigeon)
NO INPUT
INPUT INTO VERY FEW DECISIONS
INPUT INTO SOME DECISIONS
INPUT INTO MOST DECISIONS
INPUTS INTO ALL DECISIONS
I02_5
piscicultue or fishpond culture
NO INPUT
INPUT INTO VERY FEW DECISIONS
INPUT INTO SOME DECISIONS
INPUT INTO MOST DECISIONS
INPUTS INTO ALL DECISIONS
I03
Are you engaged in any of the agricultural activities?
Yes
No
I04
Are you engaged in ________?
I04_1
Tilling/ Ground preparation
Yes
No
I04_2
Sowing/Transplanting
Yes
No
I04_3
Intercultural operations (weeding, hoeing)
Yes
No
I04_4
Fertiliser application
Yes
No
I04_5
Irrigation application
Yes
No
I04_6
Harvesting
Yes
No
I05
Why do you think you should be involved in this activity?
I05_1
Tilling/ Ground preparation
IT’S MY RESPONSIBILITY
IT REQUIRES LESS LABOUR
THIS WORK IS BETTER SUITED FOR WOMEN
IT SAVES TIME OF OTHER MEMBERS
I05_2
Sowing/Transplanting
IT’S MY RESPONSIBILITY
IT REQUIRES LESS LABOUR
THIS WORK IS BETTER SUITED FOR WOMEN
IT SAVES TIME OF OTHER MEMBERS
I05_3
Intercultural operations (weeding, hoeing)
IT’S MY RESPONSIBILITY
IT REQUIRES LESS LABOUR
THIS WORK IS BETTER SUITED FOR WOMEN
IT SAVES TIME OF OTHER MEMBERS
I05_4
Fertiliser application
IT’S MY RESPONSIBILITY
IT REQUIRES LESS LABOUR
THIS WORK IS BETTER SUITED FOR WOMEN
IT SAVES TIME OF OTHER MEMBERS
I05_5
Irrigation application
IT’S MY RESPONSIBILITY
IT REQUIRES LESS LABOUR
THIS WORK IS BETTER SUITED FOR WOMEN
IT SAVES TIME OF OTHER MEMBERS
I05_6
Harvesting
IT’S MY RESPONSIBILITY
IT REQUIRES LESS LABOUR
THIS WORK IS BETTER SUITED FOR WOMEN
IT SAVES TIME OF OTHER MEMBERS
INCOME
J01
Did anyone in the household earn income from any of the following sources in the last 12 months?
J02
Whether earned from this activity?
J02_1
In last 12 months has anyone in your household engaged in agriculture labour
Yes
No
J02_2
In last 12 months has anyone in your household engaged in non-agricultural labour like construction of roads, carrying bricks, digging
Yes
No
J02_3
In last 12 months has anyone in your household engaged in skilled labour
Yes
No
J02_4
In last 12 months has anyone in your household engaged in Small business activities (street vending, shop keeping, handicrafts, sells liquor)
Yes
No
J02_5
In last 12 months has anyone in your household engaged in NTFP selling (Mohwa seeds, amla, honey, fruits, nuts, vegetables, medical plants, resins, rattans and other plants and grasses.)
Yes
No
J02_6
In last 12 months has anyone in your household earned from salaried job?
Yes
No
J02_7
In last 12 months has anyone in your household engaged in Other activity(specify)- – excluding Agriculture and livestock as we will talk about agriculture and livestock later
Yes
No
J03
Who in the household earned income over last 12 months?
MEN
WOMEN
BOTH MEN & WOMEN
CHILDREN
ALL HH MEMBERS
J04
How much did the household earn from [activity] ______ over the past 12 months?
J04_1
In last 12 months has anyone in your household engaged in agriculture labour
J04_2
In last 12 months has anyone in your household engaged in non-agricultural labour like construction of roads, carrying bricks, digging
J04_3
In last 12 months has anyone in your household engaged in skilled labour
J04_4
In last 12 months has anyone in your household engaged in Small business activities (street vending, shop keeping, handicrafts, sells liquor)
J04_5
In last 12 months has anyone in your household engaged in NTFP selling (Mohwa seeds, amla, honey, fruits, nuts, vegetables, medical plants, resins, rattans and other plants and grasses.)
J04_6
In last 12 months has anyone in your household earned from salaried job?
J04_7
In last 12 months has anyone in your household engaged in Other activity(specify)- – excluding Agriculture and livestock as we will talk about agriculture and livestock later
J05
In the last 12 months, has any member of the household or other relatives have sent you any money from outside?
Yes
No
J06
How often has your household received remittances in the last 12 months?
EACH MONTH
MANY TIMES / YEAR
TWICE A YEAR
ONCE A YEAR
LESS THAN ONCE A YEAR
DO NOT KNOW
J07
How much money did your household receive as remittances in the last 12 months?
J08
During the last 12 months, did anyone in the household own any animals including livestock, poultry, fish, etc.?
Yes
No
J09
How many _______ did you sell in the last 12 months?
J09_1
Buffalo
J09_2
Oxen
J09_3
Cow
J09_4
Goat
J09_5
Sheep
J09_6
Duck
J09_7
Poultry
J09_8
Pig
J09_9
Fish
J10
How much did your household receive for the sale of these _________ in the last 12 months?
J10_1
Buffalo
J10_2
Oxen
J10_3
Cow
J10_4
Goat
J10_5
Sheep
J10_6
Duck
J10_7
Poultry
J10_8
Pig
J10_9
Fish
J11
Did you produce any ___ during the last 12 months?
J11_1
Animal/Fish meat/offal
Yes
No
J11_2
Poultry meat/offal
Yes
No
J11_3
Milk (including that produced for milk products)
Yes
No
J11_4
Eggs
Yes
No
J12
Did your household sell any of the ___ produced?
J12_1
Animal/Fish meat/offal
Yes
No
J12_2
Poultry meat/offal
Yes
No
J12_3
Milk (including that produced for milk products)
Yes
No
J12_4
Eggs
Yes
No
J13
How much in total did your household receive for the sale of ________?
J13_1
Animal/Fish meat/offal
J13_2
Poultry meat/offal
J13_3
Milk (including that produced for milk products)
J13_4
Eggs
J14
Did your household engage in agricultural activities in the past 12 months?
Yes
No
J15
Crop Code
RICE
WHEAT
MAIZE
SORGHUM
MILLETS
BUCKWHEAT
BARLEY
GROUNDNUT
SOYBEANS
LENT
PEAS
CHICKPEAS
BEANS
SUGARCANE
COTTON
SUNFLOWER
TOBACCO
TEA
OIL SEEDS
SWEET POTATOES
POTATOES
CARROTS
CUCUMBER
CHILI
EGGPLANT
GREEN LEAFY VEGETABLES
OKRA / LADY FINGER
ONION
CAPSICUM
CABBAGE
CAULIFLOWER
BOTTLE GOURD
SPONGE GOURD
BITTER GOURD
GREEN BEANS
GARLIC
GINGER
PUMPKIN / ZUCHIMI
TOMATO
AVOCADO
GUAVA
MANGO
LEMON / LIME
ORANGE / TANGERINE
PAPAYA
MELON
LYCHEE
APPLE
BERRIES
BANANAS
SARSON
URAT DAL
MUSSOR DAL
ARHAR DAL
CHANA
OTHER (SPECIFY)
J16
What is the total quantity produced?
J17
How much of the harvested____was sold?
J18
What was the income from the sale of ___?
J19
Does your household receive any farm produce from the land that you lease out?
Yes
No
J20
Crop Code
RICE
WHEAT
MAIZE
SORGHUM
MILLETS
BUCKWHEAT
BARLEY
GROUNDNUT
SOYBEANS
LENT
PEAS
CHICKPEAS
BEANS
SUGARCANE
COTTON
SUNFLOWER
TOBACCO
TEA
OIL SEEDS
SWEET POTATOES
POTATOES
CARROTS
CUCUMBER
CHILI
EGGPLANT
GREEN LEAFY VEGETABLES
OKRA / LADY FINGER
ONION
CAPSICUM
CABBAGE
CAULIFLOWER
BOTTLE GOURD
SPONGE GOURD
BITTER GOURD
GREEN BEANS
GARLIC
GINGER
PUMPKIN / ZUCHIMI
TOMATO
AVOCADO
GUAVA
MANGO
LEMON / LIME
ORANGE / TANGERINE
PAPAYA
MELON
LYCHEE
APPLE
BERRIES
BANANAS
SARSON
URAT DAL
MUSSOR DAL
ARHAR DAL
CHANA
OTHER (SPECIFY)
J21
What is the total quantity received?
J22
How much of the received ____was sold?
J23
What was the income from the sale of ___?
J24
Are you or any other member from your household part of a producer group (PG) or FPO?
Yes
No
J25
Why did you (or your family member) join the PG/FPO?
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
Others (specify)
Don’t know/none of the above
J26
What all activities have you participated in as a member of this PG/FPO?
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
J27
Have these benefits of being part of a PG/FPO led to higher income?
Yes, increased significantly
Yes, increased marginally
unchanged
J28
What is the interval at which this PG/FPO meets?
Once a month
Once every four month
Every six months
Whenever required
Any other duration (please mention)
FOOD SECURITY
K01
How many meals did you eat yesterday during the day and night?
K02
How many meals did the adult members (18+) of your household eat yesterday during the day and night?
K03
How many meals did the children 6 to18 years in this household eat yesterday during the day and night?
K04
Over the last 7 days, how many days were the following food groups consumed by
K05
YOU AND OTHER FEMALE MEMBERS OF THE HH
K05_1
Rice, Wheat, Maize, maize porridge, Other cereal (sorghum, millet, etc), Roots and Tubers (cassava, potatoes, sweet potatoes)
K05_2
Beans and peas, pulses groundnuts and cashew nuts`
K05_3
Vegetables (including leaves)
K05_4
Fruits
K05_5
Egg, meat, fish etc.
K05_6
Milk/yogurt/other dairy product
K05_7
Sugar or sugar products, honey
K05_8
Oils/fats/butter
K06
CHILDREN AGE 6-18 YRS.
K06_1
Rice, Wheat, Maize, maize porridge, Other cereal (sorghum, millet, etc), Roots and Tubers (cassava, potatoes, sweet potatoes)
K06_2
Beans and peas, pulses groundnuts and cashew nuts`
K06_3
Vegetables (including leaves)
K06_4
Fruits
K06_5
Egg, meat, fish etc.
K06_6
Milk/yogurt/other dairy product
K06_7
Sugar or sugar products, honey
K06_8
Oils/fats/butter
K07
OTHER MALE MEMBERS
K07_1
Rice, Wheat, Maize, maize porridge, Other cereal (sorghum, millet, etc), Roots and Tubers (cassava, potatoes, sweet potatoes)
K07_2
Beans and peas, pulses groundnuts and cashew nuts`
K07_3
Vegetables (including leaves)
K07_4
Fruits
K07_5
Egg, meat, fish etc.
K07_6
Milk/yogurt/other dairy product
K07_7
Sugar or sugar products, honey
K07_8
Oils/fats/butter
K08
What was the main source(s) of the food?
K08_1
Rice, Wheat, Maize, maize porridge, Other cereal (sorghum, millet, etc), Roots and Tubers (cassava, potatoes, sweet potatoes)
OWN PRODUCTION
CASUAL LABOR
BORROWED
GIFT
PURCHASED
FOOD ASSISTANCE
BARTER
HUNTING/ GATHERING/ CATCHING
TAKE HOME RATION
MID-DAY MEAL
RATION SHOP
NOT CONSUMED IN THE LAST 7 days
K08_2
Beans and peas, pulses groundnuts and cashew nuts`
OWN PRODUCTION
CASUAL LABOR
BORROWED
GIFT
PURCHASED
FOOD ASSISTANCE
BARTER
HUNTING/ GATHERING/ CATCHING
TAKE HOME RATION
MID-DAY MEAL
RATION SHOP
NOT CONSUMED IN THE LAST 7 days
K08_3
Vegetables (including leaves)
OWN PRODUCTION
CASUAL LABOR
BORROWED
GIFT
PURCHASED
FOOD ASSISTANCE
BARTER
HUNTING/ GATHERING/ CATCHING
TAKE HOME RATION
MID-DAY MEAL
RATION SHOP
NOT CONSUMED IN THE LAST 7 days
K08_4
Fruits
OWN PRODUCTION
CASUAL LABOR
BORROWED
GIFT
PURCHASED
FOOD ASSISTANCE
BARTER
HUNTING/ GATHERING/ CATCHING
TAKE HOME RATION
MID-DAY MEAL
RATION SHOP
NOT CONSUMED IN THE LAST 7 days
K08_5
Egg, meat, fish etc.
OWN PRODUCTION
CASUAL LABOR
BORROWED
GIFT
PURCHASED
FOOD ASSISTANCE
BARTER
HUNTING/ GATHERING/ CATCHING
TAKE HOME RATION
MID-DAY MEAL
RATION SHOP
NOT CONSUMED IN THE LAST 7 days
K08_6
Milk/yogurt/other dairy product
OWN PRODUCTION
CASUAL LABOR
BORROWED
GIFT
PURCHASED
FOOD ASSISTANCE
BARTER
HUNTING/ GATHERING/ CATCHING
TAKE HOME RATION
MID-DAY MEAL
RATION SHOP
NOT CONSUMED IN THE LAST 7 days
K08_7
Sugar or sugar products, honey
OWN PRODUCTION
CASUAL LABOR
BORROWED
GIFT
PURCHASED
FOOD ASSISTANCE
BARTER
HUNTING/ GATHERING/ CATCHING
TAKE HOME RATION
MID-DAY MEAL
RATION SHOP
NOT CONSUMED IN THE LAST 7 days
K08_8
Oils/fats/butter
OWN PRODUCTION
CASUAL LABOR
BORROWED
GIFT
PURCHASED
FOOD ASSISTANCE
BARTER
HUNTING/ GATHERING/ CATCHING
TAKE HOME RATION
MID-DAY MEAL
RATION SHOP
NOT CONSUMED IN THE LAST 7 days
COPING STRATEGY
L01
Usually, does your household has sufficient food available for the whole year?
Yes
No
L02
If no, in a year how many months / days, the household has insufficient food?
L03
In a year, how frequently do you have to do ________ because of insufficient food in the household
L03_1
Skip entire days without eating?
NEVER
SELDOM
SOMETIMES
OFTEN
DAILY
L03_2
Limit portion size at mealtimes?
NEVER
SELDOM
SOMETIMES
OFTEN
DAILY
L03_3
Reduce number of meals eaten per day?
NEVER
SELDOM
SOMETIMES
OFTEN
DAILY
L03_4
Borrow food or rely on help from friends or relatives?
NEVER
SELDOM
SOMETIMES
OFTEN
DAILY
L03_5
Rely on less expensive or less preferred foods?
NEVER
SELDOM
SOMETIMES
OFTEN
DAILY
L03_6
Purchase/borrow food on credit?
NEVER
SELDOM
SOMETIMES
OFTEN
DAILY
L03_7
Gather unusual types or amounts of wild food / hunt?
NEVER
SELDOM
SOMETIMES
OFTEN
DAILY
L03_8
Send household members to eat elsewhere?
NEVER
SELDOM
SOMETIMES
OFTEN
DAILY
L03_9
Send household members to beg?
NEVER
SELDOM
SOMETIMES
OFTEN
DAILY
L03_10
You or other female members eat less?
NEVER
SELDOM
SOMETIMES
OFTEN
DAILY
L04
Have you sold any household assets to buy food?
Yes
No
SELF-HELP GROUPS AND LEADERSHIP
M01
Are you a member of any Self-help group (SHG)?
Yes
No
M01A
In which year did you become an SHG member?
M01B
Is your SHG supported by PRADAN?
Yes
No
M02
Are you a panchayat member?
Yes
No
M03
What position do you hold as a panchayat member?
SARPANCH
SECRETARY
WARD MEMBER
OTHERS (SPECIFY)
M04
Are you a member of any committee associated with Gram Panchayat?
Yes
No
M05
Which committees are you associated with?
VHSNC
MGNREGA
FRC
LAND RIGHTS COMMITTEE
ICDS
SCHOOL MANAGEMENT COMMITTEE
OTHERS (SPECIFY)
M06A
Are you a member of the Village Organization?
Yes
No
M06B
Do you hold any position in the VO?
Yes
No
M06C
Which position do you hold in the VO?
President
Vice-President
Secretary
General Body Member
Executive Committee Member
Others (please specify)
M06D
Are you a member of the CLF, Executive Committee or Board of Directors?
CLF
EXECUTIVE COMMITTEE
BOARD OF DIRECTORS
MORE THAN ONE OF THESE (SPECIFY)
NO
M06E
Do you hold any position in the CLF?
Yes
No
M06F
Which position do you hold in the CLF?
President
Vice president
Secretary
Joint Secretary
Treasurer
M06G
Are you a member of any sub committees in the CLF?
Yes
No
M07
What crop have you taken up as an FPO member?
GENDER
N01
Did you engage in any income generating activities in last 12 months?
Yes
No
N02
Was it usually at home or away from home?
HOME
AWAY
N03
Was it usually throughout the year, seasonal or once in a while?
THROUGHOUT THE YEAR
SEASONALLY / PART OF THE YEAR
ONCE IN A WHILE
N04
Were you usually paid in cash or kind for this work?
CASH ONLY
CASH AND KIND
KIND ONLY
NOT PAID
N05
According to you, what share of household income do you contribute to?
LESS THAN HALF
HALF
MORE THAN HALF
N06
Who decided how to use the money you earn?
Self
Husband
Jointly
OTHERS (SPECIFY)
N07
Do you save any of the income that you earn?
Yes
No
N08
Where do you save?
SHG
GOVERNMENT BANK
COOPERATIVE BANK
PRIVATE BANK
POST OFFICE
FRIENDS / RELATIVES
AT HOME
OTHERS (Specify)
N09
Do you have any money of your own that you can decide how to spend?
Yes
No
N10
Does your household have any bank account?
Yes
No
N11
Who does the account belong to?
IN THE NAME OF MALE MEMBER
IN THE NAME OF BOTH MALE AND FEMALE MEMBER
IN THE NAME OF FEMALE MEMBER ONLY
N12
Is there an account in your name?
Yes
No
N13
If yes, have you operated it in the last 3 months?
Yes
No
N14
What is your role in buying or selling of land or other similar assets?
INFORMED OF THE PURCHASE/SALE TO BE MADE
INFORMED OF THE PURCHASE/SALE ALREADY MADE
CONSULTED ON THE PURCHASE/SALE
DECIDE THE PURCHASE/SALE
NO ROLE
N15
What is your role in buying, selling OR mortgaging of gold or other jewelry?
INFORMED OF THE PURCHASE/SALE TO BE MADE
INFORMED OF THE PURCHASE/SALE ALREADY MADE
CONSULTED ON THE PURCHASE/SALE
DECIDE THE PURCHASE/SALE
NO ROLE
N16
What is your role in buying or selling of livestock?
INFORMED OF THE PURCHASE/SALE TO BE MADE
INFORMED OF THE PURCHASE/SALE ALREADY MADE
CONSULTED ON THE PURCHASE/SALE
DECIDE THE PURCHASE/SALE
NO ROLE
N17
What is your role in buying or selling of farm produce?
INFORMED OF THE PURCHASE/SALE TO BE MADE
INFORMED OF THE PURCHASE/SALE ALREADY MADE
CONSULTED ON THE PURCHASE/SALE
DECIDE THE PURCHASE/SALE
NO ROLE
N18
How easy it is for you to go to the following places?
N18_1
To go out and work
NOT ALLOWED TO GO ALONE
ALLOWED TO GO WITH OTHER FAMILY MEMBERS / FRIENDS
ALLOWED TO GO ONLY WITH SPOUSE
ALLOWED TO GO ALONE AFTER SEEKING PERMISSION
DO NOT NEED ANY PERMISSION
OTHERS (SPECIFY)
N18_2
Ration Shop
NOT ALLOWED TO GO ALONE
ALLOWED TO GO WITH OTHER FAMILY MEMBERS / FRIENDS
ALLOWED TO GO ONLY WITH SPOUSE
ALLOWED TO GO ALONE AFTER SEEKING PERMISSION
DO NOT NEED ANY PERMISSION
OTHERS (SPECIFY)
N18_3
Paternal Home
NOT ALLOWED TO GO ALONE
ALLOWED TO GO WITH OTHER FAMILY MEMBERS / FRIENDS
ALLOWED TO GO ONLY WITH SPOUSE
ALLOWED TO GO ALONE AFTER SEEKING PERMISSION
DO NOT NEED ANY PERMISSION
OTHERS (SPECIFY)
N18_4
Weekly Market
NOT ALLOWED TO GO ALONE
ALLOWED TO GO WITH OTHER FAMILY MEMBERS / FRIENDS
ALLOWED TO GO ONLY WITH SPOUSE
ALLOWED TO GO ALONE AFTER SEEKING PERMISSION
DO NOT NEED ANY PERMISSION
OTHERS (SPECIFY)
N18_5
Government Offices
NOT ALLOWED TO GO ALONE
ALLOWED TO GO WITH OTHER FAMILY MEMBERS / FRIENDS
ALLOWED TO GO ONLY WITH SPOUSE
ALLOWED TO GO ALONE AFTER SEEKING PERMISSION
DO NOT NEED ANY PERMISSION
OTHERS (SPECIFY)
N18_6
Banks
NOT ALLOWED TO GO ALONE
ALLOWED TO GO WITH OTHER FAMILY MEMBERS / FRIENDS
ALLOWED TO GO ONLY WITH SPOUSE
ALLOWED TO GO ALONE AFTER SEEKING PERMISSION
DO NOT NEED ANY PERMISSION
OTHERS (SPECIFY)
N18_7
Gram Sabha
NOT ALLOWED TO GO ALONE
ALLOWED TO GO WITH OTHER FAMILY MEMBERS / FRIENDS
ALLOWED TO GO ONLY WITH SPOUSE
ALLOWED TO GO ALONE AFTER SEEKING PERMISSION
DO NOT NEED ANY PERMISSION
OTHERS (SPECIFY)
N18_8
Jati Panchayat
NOT ALLOWED TO GO ALONE
ALLOWED TO GO WITH OTHER FAMILY MEMBERS / FRIENDS
ALLOWED TO GO ONLY WITH SPOUSE
ALLOWED TO GO ALONE AFTER SEEKING PERMISSION
DO NOT NEED ANY PERMISSION
OTHERS (SPECIFY)
N18_9
Police Station
NOT ALLOWED TO GO ALONE
ALLOWED TO GO WITH OTHER FAMILY MEMBERS / FRIENDS
ALLOWED TO GO ONLY WITH SPOUSE
ALLOWED TO GO ALONE AFTER SEEKING PERMISSION
DO NOT NEED ANY PERMISSION
OTHERS (SPECIFY)
N18_10
Meeting/training in the village
NOT ALLOWED TO GO ALONE
ALLOWED TO GO WITH OTHER FAMILY MEMBERS / FRIENDS
ALLOWED TO GO ONLY WITH SPOUSE
ALLOWED TO GO ALONE AFTER SEEKING PERMISSION
DO NOT NEED ANY PERMISSION
OTHERS (SPECIFY)
N18_11
Meeting / training outside village
NOT ALLOWED TO GO ALONE
ALLOWED TO GO WITH OTHER FAMILY MEMBERS / FRIENDS
ALLOWED TO GO ONLY WITH SPOUSE
ALLOWED TO GO ALONE AFTER SEEKING PERMISSION
DO NOT NEED ANY PERMISSION
OTHERS (SPECIFY)
N19
Do you usually go to the local market place?
N20
Was any Gram Sabha meeting held during the last one year?
Yes
No
N21
How many Gram Sabha meetings were held in the last one year?
N22
Did you attend any of the Gram Sabha meetings that were held in the last one year?
Yes
No
N23
How many meetings did you attend in the last one year?
N24
Did you raise any issue in the meetings that you attended?
Yes
No
N25
Was any Jati Panchayat meeting held during the last one year?
Yes
No
N26
How many Jati Panchayat meetings were held in the last one year?
N27
Did you attend any of the Jati Panchayat meetings that were held in the last one year?
Yes
No
N28
How many meetings did you attend in the last one year?
N29
Did you vote in any of the elections in last 5 years?
Yes
No
N30
Who decides who will you cast your vote to?
SELF
HUSBAND
ELDER FAMILY MEMBER
INFLUENTIAL PEOPLE IN THE VILLAGE
REPRESENTATIVES OF POLITICAL PARTIES
OTHERS (SPECIFY)
N31
Have you ever wathched TV in the last one year?
Yes
No
N32
How often do you watch TV?
DAILY
2 TO 6 DAYS IN A WEEK
ONCE A WEEK
ONCE EVERY FORTNIGHT
ONCE A MONTH
RARELY
N33
Have you ever listened to the radio in the last one year?
Yes
No
N34
How often do you listen to the radio?
DAILY
2 TO 6 DAYS IN A WEEK
ONCE A WEEK
ONCE EVERY FORTNIGHT
ONCE A MONTH
RARELY
N35
Do you think that girls should be given equal opportunities for employment outside the house or may be to work in another village as boys?
NOT AGREE
PARTIALLY AGREE
AGREE
N36
What do you think should be ideal age for girls to get married?
COVID-19 PANDEMIC: MANAGEMENT AND RESILIENCE
O01
Was anyone in your family affected by COVID-19?
Yes
No
O02
Did the affected persons receive proper and timely treatment?
YES AT HOME
AT A HOSPITAL
O03
Were you able to purchase all necessary medicines for home treatment?
Yes
No
O04
Were you able to keep them isolated in a corner of your house to minimize spread of infection?
Yes
No
O05
Did the VO help you in access to necessary medicines?
Yes
No
O06
Did you receive any form of food relief and support from the VO?
Yes
No
O07
Did your family avail of services from the community kitchen during lockdown?
Yes
No
O08
Did your family receive enough masks for daily usage during the height of the pandemic?
Yes
No
O09
Did you receive awareness messages from the VO on safety measures like social distancing and hand washing?
Yes
No
O10
Did your family receive enough hygiene products like hand soap and sanitizer from the VO ?
Yes
No
O11
Did the SHG you are a part of take up mask making as a livelihood activity?
Yes
No
O12
How much income was earned from such an activity?
O13
Did you make use of quarantine or isolation facilities in your Panchayat?
Yes
No
O14
Did these facilities have adequate food and water provisioning?
Yes
No
O15
What is the status of food availability in your village?
Sufficiently available in most households
Sufficiently available in some households
Sufficiently available in in none of the households
O16
Did frontline health workers (ASHA/ANM/AWC) come to your house to regularly check your temperature and monitor other symptoms of coronavirus infection?
Yes
No
O17
What are the initiatives that your VO took to fight against COVID-19 in your cluster?
Provide information on symptoms and prevention from CORONA (COVID-19) to the VO and SHG members through mobile messaging
CLF members helped ASHA/ ANM/ AWW in distribution of face masks and sanitizers
Others (specify)
No initiative taken
O18
What are the preventive measures VO members are adopting while helping with the CORONA situation at the community level?
Wash hands frequently
Wash hands frequently with soap
Clean hands with sanitizer
Cover nose and mouth with handkerchief/ tissue/elbow while coughing or sneezing
Don't touch eyes, nose, or mouth
Don't be in close physical contact with anyone
Avoid crowded places
Be at least 1 meter away from everyone
Don't spit in public
Wear a mask if sick
Avoid physical contact with infected individuals
Avoid touching common surfaces, items or sharing plates/utensils
Avoid touching what sick persons have touched such as surfaces, items, plates/utensils
Keep cleaning common surfaces
Don't shake hands with others
Others (specify)
Don’t Know
O19
Were there problems in being able to have regular SHG/VO meetings due to the lockdown?
Yes
No
O20
How many times did your SHG meet in the last year?
O21
When was the last meeting conducted?
O22
When did you attend the last SHG meeting?
In the last one month
In the past three months
In the past six months
More than six months ago
Don’t remember
O23
Were regular FPO/PG meetings disrupted due to the pandemic?
Yes
No
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