IPA RECOVR Survey Instrument

	A	B	C	D	E	F	G
1	IPA RECOVR SURVEY Version: 11 May 2020 Note: CORE questions to be included in all samples in Round 1, OPTIONAL questions to be included as needed. Note: Must be adapted and piloted in each country
2	Module	Section	Variable	Question	Response set	IPA PI Notes	Programmer Notes

3		CONS. Introduction and Consent
4	core	CONS		GREETING/ INTRODUCTION TEXT TBD Good morning/afternoon/evening. My name is ______________________ from Innovations from Poverty Action, a [COUNTRY] research NGO. Today we are doing a survey about the effects of covid-19 on economic and social conditions in [COUNTRY]. Your phone number has been randomly selected from all possible phone numbers in [COUNTRY].
5	core	CONS	cons1	We can continue this call in [list available languages]. Which language would you prefer?	Available languages list, select one
6	core	CONS		If enumerator cannot speak that language fluently I am not able to continue in that language and will have a colleague who can call you soon.	[Hand-off tracking protocol, include preferable times]
7	core	CONS		If no language options work: end survey here Thank you for your response. We will end the survey now.	[End survey]
8	core	END	end4	What is your first name?
9	core	DEM	dem1	How old are you? alt: When were you born?	Enter age ### alt: Enter YYYY		Calculate and retain age if >17. If age<18, retain only 'ineligible'.
10	core	CONS		If DEM1<18 Thank you for your response. We will end the survey now.	[End survey]
11	core	CONS		CONSENT SCRIPT TBD We would like to invite you to participate in a survey of approximately 30 minutes about you and your household's lives during the covid-19 pandemic. If you are eligible for the survey we will compensate you [LCU AMOUNT] for completing your survey. Your responses will be kept anonymous. Answers to these questions will be combined with answers from other respondents and we will never identify you personally as a participant in this survey. Your participation in this survey is completely voluntary and you will not face any consequences if you decline to participate at any point during the survey. We will strive to maintain the privacy of your responses. Research, internal quality assurance, or research oversight teams working for IPA may have access to survey responses.
12	core	CONS	cons2	Do you agree to participate in this survey?	Y/N
13	core	CONS	cons3	During this interview you may be audio recorded. You and the enumerator will both not know when this recording may happen. The audio recording may only happen if you consent to it and you will not be recorded against your will. This recording will only be used for data quality assurance purposes only. Do you consent to a possible audio recording?	Y/N
14		DEM. Demographics and Household Characteristics
15	core	DEM	dem2	What is your gender?	M/F/Other/Refused
16	core	DEM	dem3	State/region/province [largest sub-national unit]	Do not ask, auto-populate	Adjust to ask at lowest unqiue level, auto-populate up PP1 Q1 where available
17	core	DEM	dem4	In which [2nd largest sub-national unit] are you currently living?	Drop-down options based on previous	Adjust to ask at lowest unqiue level, auto-populate up
18	core	DEM	dem5	In which city, town or village are you currently living? Is it [largest city/town in 2nd largest sub-national unit] or another place? Are you in [2nd largest sub-national unit largest town/capital], another town or a village?	Response options to minimize data entry Largest city/town in each 2nd largest sub-national unit Other (specify)	Adjust to ask at lowest unqiue level, auto-populate up
19	OPTION	DEM	dem6	Were you living in the same place before the coronavirus/ covid crisis/lockdowns/government closed the schools?	Y/N/Refused
20	OPTION	DEM	dem7	If N to DEM6 At the end of February 2020, were you living in the national capital, a state/province/regional capital, a district capital, another town/village in the country, or outside the country?	Single response National capital Regional/Provincial/State capital District/Local capital Another town/village Outside the country
21	core	DEM	dem8	A household is defined as a person or group of persons: who are related or unrelated; who live together in the same dwelling unit; who acknowledge one adult male or female as the head of household; who share the same living arrangements; who share food; and who are considered as one unit. What is your relationship with the head of your household? The head of your household is ….?	Do not read, code to fit me/respondent is the HoH spouse/ partner parent/ parent-in-law grandparent/ spouse's grandparent child/ adopted child/ step child son or daughter-in-law grandchild sibling/brother/sister other relative domestic worker other (specify)
22	core	DEM	dem9	How many people, including yourself, live in your current household?	##	PPI Q2 for most countries if PPI available
23	core	DEM	dem10	How many children who had been attending school this academic year (before government closed down the schools) live in your current household?	##		Link to household size
24	core	DEM	dem11	What is the highest level of education you have completed?	Single response, code to fit Less than primary Completed primary Completed secondary Completed tertiary No formal schooling	The response set should be modified for each country but we do not need a lot of detail here.
25	core	DEM	dem12	How many functional mobile phone numbers including this one do you personally have?	#	For re-weighting the sample
26	OPTION	DEM	dem13	Does your household have access to the internet at home? Note: This could be via mobile phone , tablet or computer.	Y/N/DNK/Refused
27		PPI. Poverty Measurement - PPI or Alternative
28	core	POV	pov1	What was your approximate monthly personal income last month?	Response set: per capita income quintiles in LCUs from most recent data available	May also ask at household level
29	core	PPI	ppi1	PPI Q3		PPI Q3 or alternative, TBD by country
30	core	PPI	ppi2	PPI Q4		PPI Q4 or alternative, TBD by country
31	core	PPI	ppi3	PPI Q5		PPI Q5 or alternative, TBD by country
32		HLTH. Health Symptoms and Care
33	core	HLTH		Now I'm going to ask a few questions about health care for your household.
34	OPTION	HLTH	hlth1	How many pregnant women are living in your household?	#		Link to household size
35	OPTION	HLTH	hlth2	How many babies/ children less than two years of age are living in your household?	#		Link to household size
36	core	HLTH	hlth3	How many people living in your household are older than 60 years of age (born before 1960)?	#		Link to household size
37	core	HLTH	hlth4	Have you or any other person your household delayed, skipped or been unable to complete health care visits since [schools were closed by the government / the middle of March]?	Y/N/DNK/Refused
38	core	HLTH	hlth5	If YES to HLTH4 For what reasons have you or any other members of your household delayed or skipped needed health care [since schools were closed by the government (the middle of March)]?	Code to fit - do not read out since it might discourage health-seeking behaviors, prompt up to 3 Cost - Could not afford care Cost - Could not afford transportation Clinic was closed Clinic had a long wait time / was understaffed Concerns about covid-19/coronoavirus infection Appointment forgotten Too busy Had to work Other-specify
39	OPTION	HLTH	hlth6	Have you or any other member of your household been unable to obtain needed medications since schools were closed by the government/the middle of March?	Y/N/DNK/Refused
40	OPTION	HLTH	hlth7	In the past 7 days, have you or any other adults in your household experienced fever with a dry cough?	Y/N/DNK/Refused
41	OPTION	HLTH	hlth8	In the past 7 days, have you or any other adults in your household experienced fever with difficulty breathing or shortness of breath?	Y/N/DNK/Refused
42	OPTION	HLTH	hlth9	If Y to HLTH7 or HLTH8: The COUNTRY Ministry of Health has provided the following guidance. "GOVERNMENT TEXT"	No response
43	OPTION	HLTH	hlth10	Have you or anyone in your household developed any of the following symptoms since the quarantine began? Sleep difficulties, anxiety, aggressive behavior, sadness	Y/N/DNK/Refused	Symptoms must be new
44	OPTION	HLTH	hlth11	If Y to HLTH10: The COUNTRY Ministry of Health has provided the following guidance. "GOVERNMENT TEXT"	No response
45		COV. Covid Mitigation
46	core	COV	cov1	In the past 7 days, how many days have you stayed at home all day, without going out at all and without receiving any visits?	Read out Every day (7) Most days (4-6) Some days (2-3) Once (1) Never (0)	Training Note: Staying within your home unless you are using shared water/cooking/toilet/laundry facilities common to a compound or apartment building, or working on your farm or kitchen garden. Receiving visits would include others in the compound who do not live in your home.
47	OPTION	COV	cov2	In the past 7 days, have you attended church or mosque, or gathered with people from outside your household to pray?	Y/N/DNK/Refused
48	OPTION	COV	cov3	In the past 7 days, how often did members of your household go to a market or food store?	Read out Every day (7) Most days (4-6) Some days (2-3) Once (1) Never (0)
49	core	COV	cov4	In the past 7 days, have you washed your hands with soap and water more often, less often, or about the same as you did [before the end of February/ before government closed schools]?	Do not read More Less Same DNK	Benchmark: more or less often than a person's typical habits before covid-time (~mid-March)
50	OPTION	COV	cov5	In the last 7 days have you worn a face mask or other nose/mouth covering when going out in public?	Do not read YN N/A, Have not gone out Refused	keep?
51	OPTION	COV	cov6	If NO to COV5 In the last 7 days why have you not worn a face mask or other nose/mouth covering when going out in public?	Multiple responses allowed, do not read, do not prompt for multiple Not necessary Too expensive Not available locally Afraid to be stigmatized/ People will think I am sick Don't have one Uncomfortable Employer does not provide Employer does not allow Other (specify)	keep, possibly separate to ask re private life vs employer aspects
52	core	COV	cov7	Do you feel that you or anyone in your household is at risk of contracting covid-19?	Y/N/DNK/Refused
53	core	COV	cov8	If NO to COV7 Why do you feel that your household is protected from covid-19?	Code to fit, do not read out Belief in God Follow preventive/protective measures (handwashing, social distancing or masks) Does not exist where I live Does not exist at all We are strong and healthy We are not elderly Hot weather Because my racial or ethnic group is not affected Government is protecting us We do not go out We live in a rural area It is curable/treatable Other (specify)
54	OPTION		cov9	Do you think the reaction of your country’s government to the current coronavirus outbreak is appropriate, too extreme, or not sufficient?	Much too extreme Somewhat too extreme Appropriate Somewhat insufficient Not sufficient
55	OPTION		cov10	What is your main source of concern related to the effects of the Coronavirus crisis on [COUNTRY RESIDENTS]??	Read out, select one Health Lack of money N/A, Not concerned DNK
56		EDU. Education
57	core	EDU		If DEM11>0 (children in household) Now I'm going to ask some questions about the school-aged children living in your household.
58	OPTION	EDU	edu1	In the past 7 days, what have you been MOST concerned about in relation to school-aged children?	Do not read, code to fit Children having enough to eat Children falling behind in their education Children not being able to take their exams (eg. high stakes primary leaving exams) Children getting sick Children loitering, not being occuppied Children being safe Children getting into trouble because they are not in school Children being disobedient Other (specify) (I have not been concerned)
59	core	EDU	edu2	Are primary school-age children in your household currently spending time on education since schools were closed? Note: Education includes any learning activities, not just formal distance education.	Prompt for all/most/some if YES Y, all of them Y, most of the them Y, some of them N, none of them (There are no primary school aged children in my household)
60	core	EDU	edu3	Are secondary school-age children in your household currently spending time on education? Note: Education includes any learning activities, not just formal distance education.	Prompt for all/most/some if YES Y, all of them Y, most of the them Y, some of them N, none of them (There are no secondary school aged children in my household)
61	OPTION	EDU	edu4	If YES to EDU 2 or 3 On average over the past week, how many hours a day do children in the household spend on education since schools have been closed?	Code to fit, prompt as needed More than two hours each day (10+ hours/week) About one hour each day (~5 hrs/ week) About a half hour each day (~3hrs/week) A few minutes each day (<1 hr/week) None (0)
62	OPTION	EDU	edu5	If YES to EDU 2 or 3 What are children in the household doing to spend time on education since schools have been closed?	Read, select all that apply [Country Educational] TV Other educational TV programs Radio Books provided by school Their own school books Books we have in the household I/Others in my household are teaching them Educational content on the internet Official educational content - courses, audiobooks, or lessons Other
63	OPTION	EDU	edu6	What are the main reasons children in your household are not spending more time on education during this time while schools are closed?	Code to fit, prompt for multiple responses, up to 3 Lack of access to television Lack of access to radio Lack of access to internet Lack of access to educational programs Lack of access to textbooks or learing materials Lack of motivation Lack of support from teachers and schools Children are working to earn money Children are taking care of their siblings Children are doing housework Lack of supervision from adults in the household There is not a good/quiet place to study Children need to spend their time doing other things Other (specify) x3
64	OPTION	EDU	edu7	What are the main actions you are taking to support children's education while schools are closed?	Code to fit, prompt for multiple responses Nothing Talk to children about school Read to children Pay for tutoring Tell children to review their books Help with homework Call child's teacher/headteacher/school Play-based learning activities Encourage children to do distance learning (radio, television, phone, etc) Other
65	OPTION	EDU	edu8	Have you or any other adult in the household received any communication from the [COUNTRY MINISTRY OF EDUCATION, EDUCATION AGENCY] since schools have been closed?	Y/N/DNK/Refused
66	OPTION	EDU	edu9	Have you or any other adult in the household been contacted by anyone from your children's schools since schools have been closed? (e.g. headteacher, teacher)	Y/N/DNK/Refused
67	OPTION	EDU	edu10	How likely is it that school age children in your household will return to school once the schools are re-opened? Will they...?	Read all but DNK/Refused, select one Definitely return Most likely return Not likely/ probably not return Definitely NOT return DNK/Refused
68	OPTION	EDU	edu11	What do you think the [COUNTRY MINISTRY OF EDUCATION, EDUCATION AGENCY] could do to most support children during this time?	Code to fit, prompt for up to 3 responses Provide distance education programs through the media Provide rural communities with facilities to particiate in the distance education program Launching TV/radio channels to broadcast lessons to students Communicate to parents about government’s plans about reopening schools under different scenarios Ensure continuity of meal programs to students in school feeding programs Other (specify) x3 DNK Nothing	Include only upon specific policy request, pilot to generate response set
69		INC. Work and Income
70	core	INC		Now I'm going to ask some questions about work and income.
71	core	INC	inc1	During February 2020, did you work for someone else for pay, for one or more hours?	Y/N/Refused
72	core	INC	inc2	If N to INC1 During February 2020, did you run or do any kind of business, farming or other activity to generate income?	Y/N/Refused
73	core	INC	inc3	If N to INC2 During February 2020, did you help in a family business or farm?	Y/N/Refused
74	core	INC	inc4	If YES to INC1, INC2 or INC3 Which sector best describes your main job/activity as of the end of February 2020?	Read to clarify as needed, choose one Agriculture Fishing or mining Manufacturing Construction or utilities Retail or Wholesale (Street) Vendor Transportation and storage Accomodation and food services Information and communication Financial activities or real estate Education Health Other services
75	core	INC	inc5	If INC4=Agriculture Since February 2020, has the farm you run or work on experienced any of the following?	Read each, all are Y/N/DNK Could not mange to buy required inputs (seed, fertilizer, or other inputs) Could not manage to carry out farming activities as usual Could not manage to sell crops or livestock as planned	Need to adjust to agricultural season by country Question still being refined
76	OPTION	INC	sme1	If YES to INC1 or INC2 How many paid employees did your employer/ business have at the end of February 2020 , to the best of your knowledge? Please include both full-time and part-time employees, including family members and yourself.	##	Identifies SMEs vs sole proprietors
77	core	INC	inc6	If YES to INC1 or INC2 Is that business/place of work currently open?	After YES/NO, prompt with the relevant categories DNK No, temporarily closed by government mandate No, temporarily closed due to challenges related to the COVID-19 outbreak No, temporarily or permanently closed due to factors unrelated to the COVID 19 outbreak No, permanently closed due to challenges related to the COVID-19 outbreak Yes, Business remains open but some/many people are working from home Yes, Business remains open but operations have been reduced Yes, Business remains open but some or many workers have been laid off Yes, Business remains open as usual Yes, Farming work has not changed	Note: If the business is closed to the public but operates it should be considered open.
78	OPTION	INC	sme2	If YES to INC1 or INC2 and SME1>1 In the past 30 days, to the best of your knowledge have employees of the business where you worked in February 2020 experienced any of the following because of Covid-19/coronavirus or related restrictions...? Temporary layoffs/suspension of work (without pay)	Y/N/Refused
79	OPTION	INC	sme3	If YES to INC1 or INC2 and SME1>1 In the past 30 days, to the best of your knowledge have employees of the business where you worked in February 2020 experienced any of the following because of Covid-19/coronavirus or related restrictions...? Permanent layoffs/suspension of work (without pay), including closure of contracts	Y/N/Refused
80	OPTION	INC	sme4	If YES to INC1 or INC2 and SME1>1 In the past 30 days, to the best of your knowledge have employees of the business where you worked in February 2020 experienced any of the following because of Covid-19/coronavirus or related restrictions...? Reductions in working hours	Y/N/Refused
81	OPTION	INC	sme5	If YES to INC1 or INC2 and SME1>1 In the past 30 days, to the best of your knowledge have employees of the business where you worked in February 2020 experienced any of the following because of Covid-19/coronavirus or related restrictions...? Increases in working hours	Y/N/Refused
82	OPTION	INC	sme6	If YES to INC1 or INC2 and SME1>1 In the past 30 days, to the best of your knowledge has your employer or business experienced any of the following because of Covid-19/coronavirus or related restrictions...? Reductions in wages, salary or piece rates	Y/N/Refused
83	OPTION	INC	sme7	If YES to INC1 or INC2 and SME1>1 In the past 30 days, to the best of your knowledge has your employer or business experienced any of the following because of Covid-19/coronavirus or related restrictions...? Increases in wages, salary or piece rates	Y/N/Refused
84	OPTION	INC	sme8	If YES to INC1 or INC2 In the past 30 days, to the best of your knowledge has your employer or business experienced any of the following because of Covid-19/coronavirus or related restrictions...? Delays in wage, salary or piece rate payments	Y/N/Refused
85	OPTION	INC	sme9	If YES to INC1 or INC2 and SME1>1 In the past 30 days, to the best of your knowledge has your employer or business experienced any of the following because of Covid-19/coronavirus or related restrictions...? Reductions in non-pecuniary (non-pay) benefits (like meals, transportation, allowances) offered	Y/N/Refused
86	core	INC	inc7	If YES to INC1 or INC2 In the past 7 days, did you spend at least one hour working? Please consider day labor, work for wages or in-kind, and working on your own account or your own business, including an agricultural business (farm).	Y/N/Refused
87	core	INC	inc8	If YES to any INC1, INC2 or INC3* In the past 7 days, did you spend more, the same, fewer or no hours (working for pay/ running a business/ helping on a family business) than you did in a typical week before government closed the schools?	More Same Fewer None
88	core	INC	inc9	If YES to If YES to INC1 or INC2 During the past 7 days, did you earn more, the same, or less pay than you did in a typical week before government closed the schools?	More Same Less None
89	OPTION	INC	inc10	If YES to any INC1, INC2 or INC3* In the past 7 days, are you still working for the same employer/ running the same business / helping in the same family business you did in February 2020, before government closed the schools?	Y/N/Refused
90	OPTION	SME	sme11	If YES to INC2 In the past 30 days, to the best of your knowledge, has your business faced any of the following challenges due to the coronavirus/COVID-19 outbreak and related restrictions? Decrease in demand due to mobility restrictions or other reasons	Y/N/DNK/Refused
91	OPTION	SME	sme12	If YES to INC2 In the past 30 days, to the best of your knowledge, has your business faced any of the following challenges due to the coronavirus/COVID-19 outbreak and related restrictions? Difficulties in accessing suppliers or reduction in the availability and/or price increases for the main inputs	Y/N/DNK/Refused
92	OPTION	SME	sme13	If YES to INC2 In the past 30 days, to the best of your knowledge, has your business faced any of the following challenges due to the coronavirus/COVID-19 outbreak and related restrictions? Difficulties with worker absenteeism arising from mobility restrictions or other reasons	Y/N/DNK/Refused
93	OPTION	SME	sme14	If YES to INC2 In the past 30 days, to the best of your knowledge, has your business faced any of the following challenges due to the coronavirus/COVID-19 outbreak and related restrictions? Difficulties in securing access to finance (e.g. banks or MF institutions are closed or operate at restricted capacity)	Y/N/DNK/Refused
94	OPTION	SME	sme15	If YES to INC2 In the past 30 days, to the best of your knowledge, has your business faced any of the following challenges due to the coronavirus/COVID-19 outbreak and related restrictions? Depreciation of productive capital due to inactivity	Y/N/DNK/Refused
95		NET. Social Safety Net
96	core	NET	net1	Do you usually receive a regular transfer from [names of cash transfer programs]? HINT: Social safety net programs include cash transfers and in-kind food transfers (food stamps and vouchers, food rations, and emergency food distribution). Example includes XXX cash transfer programme.	Y/N/DNK	Adjust to fit context, list multiple programs if applicable in separate questions.
97	(core)	NET	net2	If YES to NET1 Since February 2020, have you experienced any delays or difficulties in receiving [names of cash transfer programs] payments? If so, what are they?	None Delays Difficulty receiving cash from banks Difficulty receiving cash from mobile money or banking agents Unable to travel to pick up cash Location/bank I pick up cash is closed Location/bank I pick up cash has no cash Other (specify)	Adjust to fit context, list multiple programs if applicable in separate questions.
98	core	NET	net3	Have you received any food, cash or other support from the government in the past month that you do NOT usually receive? If so, which type of support?	Multiple responses possible, prompt No, none Food Cash PPEs Other (specify)	Respondents may not know the names of new programs but those names should be included as needed.
99	core	NET	net4	Have you received any food, cash or other support from anyone else in the past month, that you do NOT usually receive? If so, from which source?	No Yes --> Multiple responses possible, prompt Church/mosque Relatives in country Relatives outside the country MP or other politicians Celebrity NGO/CSO Other (specify)
100		FSEC. Food and Market Security