| Enumerator |
| Country |
| Region/province |
| Village |
| Household |
| Date |
| Women | Men | Children | Family | |
|---|---|---|---|---|
| Ownership | ||||
| Labour profile | ||||
| Shelter construction | ||||
| Cleaning chicken house | ||||
| Supplementary feeding | ||||
| Providing water | ||||
| Selling chicken | ||||
| Selling eggs | ||||
| Treatment | ||||
| Decision making | ||||
| Selling eggs | ||||
| Selling chicken | ||||
| Home consumption of eggs | ||||
| Home consumption of chicken | ||||
| Purchase of drugs | ||||
