baseline_household_survey
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ABCDEFGHIJ
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typenamelabelhintrelevantconstraint
constraint_message
repeat_countcalculationrequired
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startstart_time
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endend_time
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deviceiddevice_id
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subscriberidsubscriber_id
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simserialsim_serial
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phonenumberphone_number
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textinterviewerInterviewer nameyes
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begin grouphh_infoHousehold information
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integerhh_idHousehold number
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texthh_addressAddress or landmark of household
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geopointhh_locationCollect the GPS coordinates of this householdStand directly in front of the household main entrance.
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imagehh_photoTake a picture of the front of the householdStand far enough back to include the entire structure.
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end group
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begin grouprespondent_infoRespondent / Head of Household information
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textrespondent_nameFull name of the respondentyes
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select_one yes_nodob_knownDoes respondent know his/her date of birth?yes
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daterespondent_dobDate of birth of the respondent
${dob_known} = 'yes'
yes
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integerrespondent_ageAge of the respondentIf respondent does not know, put 999
${dob_known} = 'no'
(.>=0 and .<=150) or .=999
Age has to be between 0 and 150, enter 999 if unknown
yes
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select_one sexrespondent_genderSex of the respondentyes
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select_one yes_nohh_headIs the respondent the head of the household?
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texthh_head_nameEnter the name of the head of household
${hh_head} = 'no'
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integerhh_head_ageAge of the head of householdIf respondent does not know, put 999
${hh_head} = 'no'
(.>=0 and .<=150) or .=999
Age has to be between 0 and 150, enter 999 if unknown
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select_one sexhh_head_sexSex of the head of the household
${hh_head} = 'no'
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integercontact_number1Contact phone number where head of household can be reached
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integercontact_number2Alternative contact phone number (1)
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integercontact_number3Alternative contact phone number (2)
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end group
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begin grouphh_member_infoHousehold member information
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integernum_hh_membersHow many people live in this household?Including the respondent
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integernum_hh_adultsHow many adults live in this household?
.<= ${num_hh_members}
Number of adults cannot exceed number of people in the household.
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calculatenum_hh_children
${num_hh_members} - ${num_hh_adults}
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notehh_summary
The household is composed of ${num_hh_adults} adult(s) and ${num_hh_children} child(ren)
If this is incorrect, please adjust the number of people and adults in the household.
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begin repeathh_member_names_repeatHousehold member names${num_hh_members}
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calculatename_numberposition(..)
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texthh_member_nameName of household member #${name_number}?
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end repeat
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begin repeathh_member_info_repeatHousehold member age and sex
count(${hh_member_name})
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calculatename_from_earlier
indexed-repeat(${hh_member_name}, ${hh_member_names_repeat}, position(..))
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integerhh_member_ageAge of ${name_from_earlier}
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select_one sexhh_member_sexSex of ${name_from_earlier}
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end repeat
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end group
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begin grouphh_dem_infoHousehold demographic information
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select_one ownership
hh_ownershipThis house is …
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texthh_ownership_otherPlease specify other
${hh_ownership} = 'other'
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select_one religionhh_religionPrimary religion of the household
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texthh_religion_otherPlease specify other
${hh_religion} = 'other'
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select_one incomehh_incomeOccupation of primary income earner in household
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texthh_income_otherPlease specify other
${hh_income} = 'other'
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select_one language
hh_languagePrimary language spoken in the household
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texthh_language_otherPlease specify other
${hh_language} = 'other'
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end group
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