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FORMATTING DATE:
14 September, 2018
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ENGLISH LANGUAGE:
14 September, 2018
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FEED THE FUTURE [COUNTRY] [YEAR] HOUSEHOLD SURVEY QUESTIONNAIRE
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HOUSEHOLD IDENTIFICATION
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8
9
10
01
HOUSEHOLD NUMBER (HH)
.
11
12
02
CLUSTER NUMBER
.
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14
03
VILLAGE NAME AND CODE
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16
04
COUNTY
.
17
18
05
DISTRICT
.
19
20
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REGION
.
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22
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GPS COORDINATES OF HOUSEHOLD
23
◦`"
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07a
LATITUDE
.
25
26
◦`"
27
07b
LONGITUDE
.
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30
31
08 INTERVIEWER VISITS
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FIRST VISITSECOND VISITTHIRD VISITFINAL VISIT
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37
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DATE
DAY
39
40
MONTH
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INTERVIEWER'S
2018
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NAME
YEAR
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RESULT*
INT. NO.
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USE CODES BELOW
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RESULT*
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48
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NEXT VISIT:
DATE
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TOTAL NUMBER
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TIME
OF VISITS
52
53
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*RESULT CODES:
09
TOTAL PERSONS
55
01
COMPLETED
IN HOUSEHOLD
56
02
NO HOUSEHOLD MEMBER AT HOME
57
03
ENTIRE HOUSEHOLD ABSENT FOR EXTENDED PERIOD OF TIME
10
TOTAL ELIGIBLE
58
04
POSTPONED/UNAVAILABLE
WOMEN AGE
59
05
REFUSED
15-49 YEARS
60
06
DWELLING VACANT
61
07
ADDRESS NOT A DWELLING
11
TOTAL ELIGIBLE
62
08
DWELLING DESTROYED
CHILDREN AGE
63
09
DWELLING NOT FOUND
UNDER 6 YEARS
64
10
HOUSEHOLD MEMBER TOO ILL TO RESPOND/COGNITIVELY IMPAIRED
65
11
PARTIAL COMPLETE
66
96
OTHER
12
PRIMARY ADULT
67
(SPECIFY)
DECISIONMAKER
68
(1=YES, 2=NO)
MALE
FEMALE
69
70
71
72
13 SUPERVISOR
14 FIELD EDITOR
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NAME
NUMBER
NAME
NUMBER
76
77
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15 OFFICE EDITOR
16 DATA ENTRY OPERATOR/MANAGER
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NAME
NUMBER
DAY
MONTH
YEAR
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84
85
86
LANGUAGE OF
01
LANGUAGE OF
NATIVE LANGUAGE
TRANSLATOR USED
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QUESTIONNAIRE**
INTERVIEW**
OF RESPONDENT**
(YES = 1, NO = 2)
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LANGUAGE OF
ENGLISH
**LANGUAGE CODES:
90
QUESTIONNAIRE**
01 ENGLISH
03 LANGUAGE 3
05 LANGUAGE 5
91
02 LANGUAGE 2
04 LANGUAGE 4
06 LANGUAGE 6
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93
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NOTE: DEFINITION OF PRIMARY MALE/FEMALE DECISIONMAKER
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PRIMARY MALE DECISIONMAKER: AMONG ALL MEN AGE 18 OR OLDER IN THE HOUSEHOLD, THE PRIMARY MALE DECISIONMAKER IS THE MAN WHO MAKES MORE SOCIAL AND ECONOMIC DECISIONS THAN OTHER MEN IN THE HOUSEHOLD.
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PRIMARY FEMALE DECISIONMAKER: AMONG ALL WOMEN AGE 18 OR OLDER IN THE HOUSEHOLD, THE PRIMARY FEMALE DECISIONMAKER IS THE WOMAN WHO MAKES MORE SOCIAL AND ECONOMIC DECISIONS THAN OTHER WOMEN IN THE HOUSEHOLD.