Surveypoint

Q01

Province Code

Q02

Province Name

Q03

District Code

Q04

District Name

Q05

Village/Town Code

Q06

Village/Town Name

Q07

Replaced Village/Town Name

Q08

Household Structure Number

Q09

Name of the Household Head

Q10

Address of the Household (Mention the Landmark)

Q11

Supervisor’s Code

Q12

Supervisor’s Name

Q13

Date of Data Entry

Q14

Date of Interview

A01

Name of the respondent (Full Name with Surname)

A02

Age of the household head

A03

What is the gender of the household head?

Male

Female

A04

What is the marital status of the household head?

Married

Unmarried

Divorce

Widow

A05

How many members reside in your household?

A06

Details of children in the age group 5-21 years in the household

A07

Number of children attending school/college?

A08

What is the level of education of the head of the household?

Less than Grade 1 Completed

Grade 1

Grade 2

Grade 3

Grade 4

Grade 5

Grade 6

Grade 7

Grade 8

Grade 9

Grade 10

Grade 11

Grade 12

Bachelor’s and Above

Madrasa

Don’t Know

A09

What is the principal occupation of the Household members?

Agriculture

Unskilled Labor

Skilled Worker

Salaried Employee (Government/Private)

Small/petty shop/business

Business

Self-Employed (Professional Service)

Other (specify)

A10

Does your household use a generator?

Yes

No

A11

Does any member of this household own a mobile phone?

Yes

No

A12

Does any member of this household use any digital finance services such as Mobile Money, M-Paisa, M-Hawala, etc.?

Yes

No

B01

How are you billed for electricity consumed from grid source?

Fixed Monthly Amount

Billed on the Units Consumed

Others (Specify)

B02

How much do you spend monthly on grid electricity?

B03

Does your household experience frequent black-outs/disruptions in supply?

Yes

No

B04

What are the current sources of lighting in your household?

Government Grid Electricity (DABS)

Hydro-Grids/Mini-Hydro Grid/Pico Grid

Solar Based Mini-Grid/Micro/Pico Grid

Solar Home Systems

Diesel Generator Powered Electricity (Owned)

Diesel Generator Powered Electricity (Shared)

Diesel Generator Powered Electricity (Rented)

Diesel Generator Powered Electricity (Provider)

Kerosene Lantern/Lamps

LED Lights with dry Battery Cells

Gas

Candles

No Lighting

Others

B04A

Primary Source (Select only one)

Government Grid Electricity (DABS)

Hydro-Grids/Mini-Hydro Grid/Pico Grid

Solar Based Mini-Grid/Micro/Pico Grid

Solar Home Systems

Diesel Generator Powered Electricity (Owned)

Diesel Generator Powered Electricity (Shared)

Diesel Generator Powered Electricity (Rented)

Diesel Generator Powered Electricity (Provider)

Kerosene Lantern/Lamps

LED Lights with dry Battery Cells

Gas

Candles

No Lighting

Others

B04B

Average daily supply of the following (out of 24 Hours)

B04C

Average daily usage (out of 24 hours)

B04D

Average supply of the following (out of 24 Hours)

B04E

Average daily usage (out of 24 hours)

C01

Does your household own a water heater?

Yes

No

C02

How many solar heaters do you own?

C03

Does your household own any kind of solar products?

Yes

No

C04

Details of the Solar Device owned

C04A

Name of the Product (Model)

C04B

Type of Equipment

D01

Would you be willing to pay AFN 2,760 for this solar device? (120% Price)

Yes, Upfront

Yes, with installments (3 Months) – AFN 920

Yes, with installments (6 Months) – AFN 460

No

D02

Why would you not buy this solar device?

Cannot afford the price

Maintenance/Service problems

Satisfied with my current situation

D03

Would you be willing to pay AFN 2,300 for this solar device? (100% Price)

Yes, Upfront

Yes, with installments (3 Months) – AFN 920

Yes, with installments (6 Months) – AFN 460

No

D04

Would you be willing to pay AFN 1,840 for this solar device? (80% Price)

Yes, Upfront

Yes, with installments (3 Months) – AFN 920

Yes, with installments (6 Months) – AFN 460

No

D05

Back Check Template 1 -Form Fill

Province Code

Province Name

District Code

District Name

Village/Town Code

Village/Town Name

Replaced Village/Town Name

Household Structure Number

Name of the Household Head

Address of the Household (Mention the Landmark)

Supervisor’s Code

Supervisor’s Name

Date of Data Entry

Date of Interview

Name of the respondent (Full Name with Surname)

Age of the household head

What is the gender of the household head?

What is the marital status of the household head?

How many members reside in your household?

Details of children in the age group 5-21 years in the household

Number of children attending school/college?

What is the level of education of the head of the household?

What is the principal occupation of the Household members?

Does your household use a generator?

Does any member of this household own a mobile phone?

Does any member of this household use any digital finance services such as Mobile Money, M-Paisa, M-Hawala, etc.?

How are you billed for electricity consumed from grid source?

How much do you spend monthly on grid electricity?

Does your household experience frequent black-outs/disruptions in supply?

What are the current sources of lighting in your household?

Primary Source (Select only one)

Average daily supply of the following (out of 24 Hours)

Average daily usage (out of 24 hours)

Average supply of the following (out of 24 Hours)

Average daily usage (out of 24 hours)

Does your household own a water heater?

How many solar heaters do you own?

Does your household own any kind of solar products?

Details of the Solar Device owned

Name of the Product (Model)

Type of Equipment

Would you be willing to pay AFN 2,760 for this solar device? (120% Price)

Why would you not buy this solar device?

Would you be willing to pay AFN 2,300 for this solar device? (100% Price)

Would you be willing to pay AFN 1,840 for this solar device? (80% Price)

How much can you pay for this device?