Burkina Faso IPA RECOVR Survey

	A	B	C	D	E	F	G
1	IPA Burkina Faso RECOVR SURVEY Round 1, June 2020
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 Burkina Faso research NGO. Today we are doing a survey about the effects of covid-19 on economic and social conditions in Burkina Faso. Your phone number has been randomly selected from all possible phone numbers in Burkina Faso.
5	core	CONS	cons1	We can continue this call in Français, Mooré, Dioula, Gourmanctché, or Bissa. Which language would you prefer?	Available languages list, select one Français Mooré Dioula Gourmanctché Bissa
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]		make check with surveyors fluency language
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	What year were you born?	Enter YYYY
10	core	CONS		If DEM1<18 Thank you for your response. We will end the survey now.	[End survey]
11	core	CONS		CONSENT SCRIPT We would like to invite you to participate in a research survey. If you choose to participate, we will ask you questions about you and your household’s background, household items, children’s education, knowledge of and practices on coronavirus, employment and business, financial health, and government support. The survey will take about 30 minutes of your time. For participating in this survey, you will receive XX FCFA phone credit. Your participation in this survey is completely voluntary. If you decline to answer any questions or to withdraw at any point during the survey, your decision will not in any way affect you. There are no anticipated risks from study participation. 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. The research team will not share your personal information with anyone outside the study. We will strive to maintain the privacy of your responses and audio recordings. CONSENT VERSION 1 - researchers The information you provide may help researchers to understand people's needs during this difficult time. CONSENT VERSION 2 - policymakers The information you provide may help policymakers to understand people's needs during this difficult time and may also be used for academic research purposes. CONSENT VERSION 3 - government The information you provide may help your government and others to understand people's needs during this difficult time and may also be used for academic research purposes. If you have questions, comments, or concerns about the research, please contact XXXXX. If you have any questions about your rights as research participants, please contact IPA IRB at humansubjects@poverty-action.org.
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				First, I'm going to ask some basic questions about you and your household.
16	core	DEM	dem2	What is your gender?	M/F/Other/Refused
17	core	DEM	dem3	In which region are you currently living?	Do not ask, auto-populate	Adjust to ask at lowest unqiue level, auto-populate up PP1 Q1 where available
18	core	DEM	dem4	In which province are you currently living?	Drop-down options based on previous	Adjust to ask at lowest unqiue level, auto-populate up
19	core	DEM	dem5	In which commune or department are you currently living?	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
20	OPTION	DEM	dem6	Were you living in the same place before the covid crisis / at the end of February 2020?	Y/N/Refused
21	OPTION	DEM	dem7	If N to DEM6 At the end of February 2020, were you living in Ouagadougou, a regional capital, a provincial capital, another town/village in the Burkina Faso, or outside the Burkina Faso?	Single response Ouagadougou Another regional capital Another provincial capital Another town/village Outside the country
22	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)
23	core	DEM	dem9	How many people, including yourself, live in your current household?	##	PPI Q2 for most countries if PPI available
24	NEW	DEM	dem9a	How many people were living in your current household (where you are living now) in February 2020?	## the same DNK	PPI Q2 for most countries if PPI available
25	core	DEM	dem10a	How many children who had been attending primary school this academic year (before government closed down the schools) live in your current household?	##		Link to household size
26	core	DEM	dem10b	How many children who had been attending secondary school this academic year (before government closed down the schools) live in your current household?	##		Link to household size
27	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
28	core	DEM	dem12	How many functional mobile phone numbers including this one do you personally have?	#	For re-weighting the sample
29		PPI. Poverty Measurement - PPI or Alternative
30	core	PPI	ppi2	Did all children from 7-14 year old attend formal school during the last school year?	Y/N/DNK/Refused
31	core	PPI	ppi4	What is the main source of household lighting?	Battery Torch Network Electricity Solar Energy Other Refused
32	core	PPI	ppi6	Does a member of the household own a mattress in good working condition?	Y/N/DNK/Refused
33		HLTH. Health Symptoms and Care
34	core	HLTH		Now I'm going to ask a few questions about health care for your household.
35	OPTION	HLTH	hlth1	How many pregnant women are living in your household?	#		Link to household size
36	OPTION	HLTH	hlth2	How many babies/ children less than two years of age are living in your household?	#		Link to household size
37	core	HLTH	hlth3	How many people living in your household are older than 60 years of age (born before 1960)?	#		Link to household size
38	core	HLTH	hlth4	Have you or any other person your household delayed, skipped or been unable to complete health care visits since the middle of March]?	Y/N/DNK/Refused
39	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 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
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 Burkina Faso Ministry of Health has provided the following guidance. 1- Stay at home (do not go to a health center) 2- Wear the mask 3- call for free 3535	No response
43		COV. Covid Mitigation
44	core	COV		Now, I will ask you questions about measures you and your household are taking to prevent covid-19.
45	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.
46	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
47	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)
48	Burkina Faso	COV	cov4a	In the past 7 days, has your household had to limit handwashing due to lack of access to clean water or soap?	Prompt after Y Yes, lack of water Yes, lack of soap Yes, lack of both water and soap No DNK
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 in February 2020, before the covid crisis?	Do not read More Less Same DNK
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
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)
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 the Government of Burkina Faso 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 Burkinabe?	Read out, select one Health Lack of money Increases in violence in the country Not concerned (N/A) DNK
56		EDU. Education
57	core	EDU		If DEM10a>0 or DEM10b>0 (children in household) Now I'm going to ask some questions about the school-aged children living in your household.
58	core	EDU	edu2	If DEM 10a>0 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)
59	core	EDU	edu3	If DEM 10b>0 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)
60	OPTION	EDU	edu5	If YES to EDU 2 or 3 What have children in the household done to spend time on education while 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
61	OPTION	EDU	edu6	What are the challenges children in your household face that limit the time they spend on education?	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
62	FWA	EDU	edu12_fwa	If DEM 10a>0 On average over the past 7 days, other than education/school which of the following activities are primary school aged children spending the most time on?	Household chores / domestic work Helping on a family farm Helping in another family business Paid work with a family business Paid work for someone outside the family or household Other income-generating activity (specify) None of these activities
63	FWA	EDU	edu13_fwa	If DEM 10b>0 On average over the past 7 days, other than education/school which of the following activities are secondary school aged children spending the most time on?	Household chores / domestic work Helping on a family farm Helping in another family business Paid work with a family business Paid work for someone outside the family or household Other income-generating activity (specify) None of these activities
64	OPTION	EDU	edu10	If DEM 10a>0 or If DEM 10b>0* How likely is it that all primary and secondary school age children in your household who were attending school in February 2020 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
65		INC. Work and Income
66	core	INC		Now I'm going to ask some questions about work and income.
67	core	INC	inc1	During February 2020, did you work for someone else for pay, for one or more hours?	Y/N/Refused
68	core	INC	inc2	During February 2020, did you run or do any kind of business, farming or other activity to generate income (other than working for someone else)?	Y/N/Refused
69	core	INC	inc3	During February 2020, did you help in a family business or farm?	Y/N/Refused
70	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? alt: What sector best describes your employer/your business/ the family business you helped in at 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
71	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
72	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
73	core	INC	inc6	If YES to INC1 or INC2 or INC3 Is the business/place of work you worked at in February 2020 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.
74	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
75	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
76	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
77	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
78	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
79	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
80	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
81	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
82	OPTION	INC	sme10	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...? Increase in non-pecuniary (non-pay) benefits (like meals, transportation, allowances, loans) offered	Y/N/Refused
83	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
84	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 in February 2020/ before the covid crisis?	More Same Fewer None
85	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 in February 2020 / before the covid crisis?	More Same Less None
86	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
87	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
88	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
89	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
90	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
91	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
92	FWA	SME	sme16	If YES to INC2 AND SME1>1 Over the past 30 days, has your business been unable to pay benefits to the state tax and/or has postponed payments??	Y/N/Not certain at this time/Business exempt/ Business closed (N/A)/DNK/Refused
93		NET. Social Safety Net
94	core	NET		Now I'm going to ask some questions about access to food and social protection programs.
95	core	NET	net1	Do you usually receive a regular transfer from any cash transfer or other social assistance program? HINT: Social safety net programs include cash transfers and in-kind food transfers (food stamps and vouchers, food rations, and emergency food distribution).	Y N Refused
96	(core)	NET	net2	If YES to NET1 Since February 2020, have you experienced any delays or difficulties in receiving any cash transfers? 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)
97	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 Reduction in utility charges (electricity and/or water) Other (specify)	Respondents may not know the names of new programs but those names should be included as needed.
98	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)
99		FSEC. Food and Market Security
100	OPTION	FSEC	fsec1	In the past 7 days, how many days have you or someone in your household had to… Limit portion size at meal-times?	0-7