ANNEX 2
Questionnaires (Contd.)

Module B: Living quarters and facilities in the house ((acting) head of household)

Let us look at the house your household lives in, and see what the main building materials are that have been used for the construction of the roof, walls, floor.

Bricks

Cement

Clay

Wood

Leaves

Iron/tin

Sand

Other

Roof

B1a

Walls

B1b

Floor

B1c

Is the dwelling owned, rented, or lived in free?

Owned

Rented

Lived in free (not owned, but no rent being paid)

Other: specify,

What is the main source of drinking water for members of your household?

Piped into residence/yard/plot

Private well/tube well in residence/yard/plot

Public tap or well

Spring/River/Stream/Pond/Lake

Private water tank

Other: specify,

How many minutes does it take to go there, get drinking water, and come back?

Interviewer: enter 96, if drinking water is available on the premise.

How many rooms do you have in your dwelling (compound, apartment) which are for the exclusive use of your household?

Number of rooms:-------→

Does your household own any buildings or rooms that are rented out?

Yes

-------→

B6a
During the past year, about how much was earned by renting out buildings or rooms?
Amount in national currency, for a 12 months period: -------→

B6a

↓

What type of toilet is used in this household?

Own flush toilet

Shared or public flush toilet

Own traditional pit toilet/latrine

Shared or public traditional pit toilet/latrine

No toilet facility, nearby bush/field is used

Other: specify,

What type of fuel does your household mainly use for cooking?

Wood

Cow/animal dung cakes

Coal/Charcoal/Coke/Lignite

Kerosene

Electricity

LPG (Liquid Petroleum Gas)/Methan

Other: specify,

End of module B, go to module C

Module C: General, income, savings & debt situation of the household ((acting) head of household)
General:
C1.	What is the main religion practiced in this household?
	1.	Muslim			C1
	2.	Hindu
	3.	Christian
	4.	Buddhist
	5.	Other: specify:
	6.	No religion practiced
C2.	Do all persons in the household practice the same religion?
	1.	Yes			C2
	2.	No
C3.	Does the head of the household belong to a tribe or ethnic group?				C3
	1.	Yes	-------→	C3a.
	2.	No		What is the name of the tribe?	(office)C3a
				Name:
C4.	Does the head of the household belong to a caste?				C4
	1.	Yes	-------→	C4a.
	2.	No		What is the name of the caste?	(office)C4a
				Name:
Household income:
Interviewer:			As you know, posing questions to respondents on income is a sensitive activity. Mention to the respondent that the income information provided by him/her will be kept strictly confidential and shall only be used to give researchers insight in well-fare levels in rural communities. The insight is used to develop appropriate development projects in rural areas.



C5.	Regarding satisfying all basic needs (food, clothes, goods, services) for the household, would you rate the financial situation of the household as,
	1.	More than sufficient			C5
	2.	Sufficient
	3.	Barely sufficient
	4.	Insufficient
C6.	If you compare the financial situation of this household to other households in your neighbourhood would you say that your household is;
C6.
	1.	Better off			C6
	2.	About the same
	3.	Worse off

C7.	Please, specify from which sources you and your household members earned an income and tell me how much was earned from each source.
	*Income source*	*Amount in national currency over 12 month period*

a.	Catching fish (and selling catch after landing)	a.

b.	Operation of fish ponds	b

c.	Renting out fish ponds to others	c.

d.	Renting out fishing boats/engines/gear to others	d.

e.	Processing of Fish, e.g. smoking, frying	e.

f.	Marketing of fish, e.g. fish monger	f.

g.	Farming of crops and selling the harvest to others	g.

h.	Buying crops from farmers and selling to others for profit	h.

i.	Herding and raising cattle (livestock)	i.

j.	Income from homestead (e.g. vegetable gardening)	j.

k.	Buying and selling cattle	k.

l.	Raising/selling poultry, goose, sheep, pigs and other small farm animals	l.

m.	Income from business other than fishing/farming/forestry	m

n.	Income from wage labour (all types)	n.

o.	Income from salaried employment (service sector)	o.

p.	Income from doing domestic work for others	p.

q.	Income from remittances from relatives/friends/family members (incl. foreign)	q.

r.	Income from lending money to others	r.

s.	Income from savings (bank, insurance)	s.

t.	Income from pension	t.

u.	Other sources not listed above	u.

C8	Now, could you give me an estimate of the total household income earned in the past 12 months by all household member taken together?		C8
	Amount in national currency is:---------→

Savings:

Do you or members of your household save money

Yes -------→

C9a

How often do you save money?

↓

1. Daily

C9a

2. Weekly

3. Monthly

Go to C10

4. Yearly

5. Don't know exactly

↓

C9b

For what purpose do the members of your household save money?

Interviewer: 1=yes, 2=no, 8=does not know.

a. Buying new household goods

C9ba

b. Replacement of old household goods in future

C9bb

c. Buying new goods/equipment for fishing, farming or other business

C9bc

d. Replacement of old goods/equipment for fishing, farming, or other business

C9bd

e. business in future

C9be

f. Dowry or bride price for marriage of daughter/son

C9bf

g. Education of children

C9bg

h. Social security or income for later when old

C9bh

i. To earn interest/accumulate capital

C9bi

j. Other, specify:

C9bj

↓

C9c

Where does your household save money?

Interviewer: 1=yes, 2=no, 8=does not know/not applicable

a. Banking institutions (firm)

C9ca

b. Cooperation (Co-op)

C9cb

c. Post office

C9cc

d. At home

C9cd

e. With a trustworthy fellow-villager/friend

C9ce

f. With family member who lives elsewhere

C9cf

g. Other, specify:

C9cg

↓

C9d

What has been the approximate amount of money that your household saved over the last 12 months?

C9d

Amount in national currency is: -------→

Borrowing:

C10

Have you or the members of your household borrowed money in the past 12

months?

C10

1. Yes -------→
2. No

C10a

What were the three main reasons for which you and/or your household borrowed money?

↓

Interviewer:

Ask for the three most important reasons. List the most important one first (C10a1). Use code 88 if "not applicable".

1. Buying new consumer goods

C10aa

End of Module C, go to Module D.

2. Replacement of household goods in future

C10ab

3. Buying goods/equipment for business

C10ac

4. Dowry or bride price for marriage of daughter/son

5. Education children

6. To repay other loans

7. To meet expenses of social ceremonies and festivals

8. Other, specify:

↓

C10b

From which sources did your household borrow money?

Interviewer:

Probe for the three most important ones and list the most important one first (i.e. C10b1), etc. Enter code 88 if not applicable.

1. Banking institutions (firm)

C10ba

2. Cooperation (Co-ops)

C10bb

3. Post office

C10bc

4. Relatives/friends

5. With a trustworthy villager

6. Through a development project implemented here

7. Boat owner(s)

8. Traders/middlemen

9. Private money lender

10. Shopkeeper

11. Other, specify:

↓

C10c

What was the approximate total amount of money that was borrowed by the members of your household, in the last 12 months?

C10c

Amount, in national currency is: -------→

↓

C10d

What is the approximate amount of loan that was repaid during the last 12 months?

C10d

Amount, in national currency is: -------→

↓

End of Module C, go to Module D

ANNEX 2 Questionnaires (Contd.)

ANNEX 2
Questionnaires (Contd.)