Chapter-1 Introduction

Questionnaire

Name and Address of Respondent : ……………………………………

1. 
   District : ………………………………………
   
2. 
   Backward / Non Backward : …………………………………………
   
3. 
   Rural/ Semi-Urban/ Remote: ………………………………………
   

17. 
    What is respondent’s gender?
    

1. 
   Male
   
2. 
   Female
   

17. 
    What is the marital status of respondent?
    

1. 
   Married
   
2. 
   Unmarried
   
3. 
   Divorced/ Separated
   
4. 
   Widow (er)
   

17. 
    What is the caste of respondent?
    

1. 
   General
   
2. 
   SC (Scheduled Caste)
   
3. 
   ST(Scheduled Tribe)
   
4. 
   Other Backward Castes
   

17. 
    Can the respondent read and write?
    

1. 
   No
   
2. 
   Yes
   

17. 
    What is highest grade level attained in school for the respondent more than 5 yrs old. (I.e. currently enrolled in or grade when left school)
    

1. 
   No schooling
   
2. 
   Did not complete primary
   
3. 
   Primary
   
4. 
   Secondary
   
5. 
   High school
   
6. 
   Inter
   
7. 
   Graduate
   
8. 
   Post graduate
   
9. 
   Others (specify)
   

17. 
    For children 6-15 years old only, are they currently enrolled in school? No/ Yes
    

17. 
    What is the respondent’s main occupation?
    

1. 
   Nothing
   
2. 
   Farming
   
3. 
   Animal rearing
   
4. 
   Wage labour (farm)
   
5. 
   Wage labour (non-farm)
   
6. 
   Salaried job (service)
   
7. 
   Business
   
8. 
   Education
   
9. 
   Pensioned
   
10. 
    Household tasks
    

17. 
    What is the poverty status of the respondent?
    

1. 
   Above Poverty Level (APL)
   
2. 
   Below Poverty Level (BPL)
   

17. 
    How many members are there in respondent’s family?
    

1. 
   1
   
2. 
   2-3
   
3. 
   4-5
   
4. 
   More than 5
   

17. 
    Does the respondent has members who live and/or work elsewhere (married daughters and married sisters not to be included)? No/ Yes
    

17. 
    Please give the details of the respondent’s members & migrated members:
    

1. 
   Relation with the respondent:
   
2. 
   Gender:
   
3. 
   Age:
   
4. 
   Marital status:
   
5. 
   Main occupation:
   
6. 
   Literacy level:
   
7. 
   Last qualification:
   
8. 
   Location (in case of migrated member only): Nearby village/ Nearby town/ Town in the state/ Town outside state/ State Capital/ Capital of another state/ National Capital/ Abroad
   

17. 
    If the respondent’s members are illiterate then rank in order of importance up to 2 reasons for non enrolment or lack of attendance?
    

1. 
   School too far away/ no school to enroll in
   
2. 
   Works at home or nearby
   
3. 
   Did not like school/ was not learning anything
   
4. 
   Went as far in school as they need to learn useful skills/ education not a priority
   
5. 
   Poor health/ disability
   
6. 
   Not allowed to enroll by family
   
7. 
   Not allowed to enroll by school
   
8. 
   Marriage during school age
   
9. 
   Cost of schooling
   

1. 
   First reason :
   
2. 
   Second reason:
   

17. 
    Please fill the following details by listing average annual income of respondent and/ his family (estimated) against different occupations.
    

1. 
   Wage labour (Agriculture):
   
2. 
   Wage labour (Non Agriculture):
   
3. 
   Salaried job (Service):
   
4. 
   Business:
   
5. 
   Pension:
   

17. 
    If the household is involved in any of the following economic activities, please list the average estimated expenditure and revenue (gross income)
    

1. 
   Agriculture:
   
2. 
   Milk, milk products, animal product sale:
   
3. 
   Horticulture/ vegetable:
   
4. 
   Minor forest produce:
   
5. 
   Wood:
   
6. 
   Regular animal sale for income generation:
   
7. 
   Family remittances:
   
8. 
   Rent:
   
9. 
   Other income:
   

17. 
    Does the migrant member of resident’s family assist them financially? No/ Yes (specify)
    

17. 
    How the respondent would define his house?
    

1. 
   Single family house
   
2. 
   Part or shared house
   
3. 
   Tent
   
4. 
   Temporary shelter/ shack
   
5. 
   Others
   

17. 
    How the respondent acquired this house?
    

1. 
   Inherited
   
2. 
   Purchased
   
3. 
   Occupied mortgaged dwelling
   
4. 
   Tenant
   
5. 
   Caretaker
   
6. 
   Relative or friend of owner
   
7. 
   Squatter
   
8. 
   Other
   

17. 
    How many rooms does respondent’s house have?
    

1. 
   1 room
   
2. 
   2-3 rooms
   
3. 
   4-5 rooms
   
4. 
   More than five rooms
   

17. 
    What is the current main source of drinking water for respondent?
    

1. 
   Tap
   
2. 
   Hand Pump ( within/ outside)
   
3. 
   Shallow open wells – Public
   
4. 
   Shallow open wells – in compound
   
5. 
   Pipe scheme-gravity
   
6. 
   Rain water harvesting
   
7. 
   Piped-municipal
   
8. 
   River/ Lake
   
9. 
   Canal/ pond
   

17. 
    What is the respondent’s most important source of cooking fuel?
    

1. 
   Animal dung
   
2. 
   Bushes
   
3. 
   Crop residues or sawdust
   
4. 
   Firewood
   
5. 
   Charcoal
   
6. 
   Kerosene oil
   
7. 
   Gas
   
8. 
   Electricity
   
9. 
   Other (specify)
   

17. 
    How much time does it take to collect water and return?
    

1. 
   No time – in community
   
2. 
   Near community – 1 hour or less
   
3. 
   < ¼ day (1-3hrs)
   
4. 
   ¼ to ½ day (3-6 hrs)
   

17. 
    What kind of toilet facility does your household use?
    

1. 
   Non /open field /bush
   
2. 
   Open pit
   
3. 
   Improved latrine
   
4. 
   Flush latrine
   

17. 
    Has the respondent the following assets?
    

1. 
   Audio Medium- Radio/ Tape recorder/ None/ Others (specify)
   
2. 
   Video Medium - TV/ VCR/ DVD/ None/ Others (specify)
   
3. 
   Transport Medium - Bicycle/ Bullock cart/ Horse cart/ Motorcycle/ Car/ Lorry/ None/ Others (specify)
   
4. 
   Communication Medium - Telephone land line/ Wireless land line (WLL)/ Mobile phone/ None
   

17. 
    Do the respondent/ his family own any livestock, including poultry? No/ Yes (specify)
    

17. 
    If the respondent is engaged in agricultural activities then what kind of land holdings the respondent has?
    

1. 
   Marginal land holdings
   
2. 
   Small land holdings
   
3. 
   Medium land holdings
   
4. 
   Large land holdings
   

17. 
    How many months of respondent’s food requirement are met by his own farm produce?
    

1. 
   1 month or less
   
2. 
   2-3 months
   
3. 
   4-6 months
   
4. 
   7-9 months
   
5. 
   10 months or more
   

17. 
    Where does the respondent sell the surplus farm produce?
    

1. 
   No surplus
   
2. 
   Within the village
   
3. 
   Nearby village
   
4. 
   Nearby town
   
5. 
   Distant town
   
6. 
   To food merchants from outside
   

17. 
    What is the main source of irrigation used by the respondent?
    

1. 
   Canal
   
2. 
   Tank (Public)
   
3. 
   Tank (Pvt.)
   
4. 
   Open well
   
5. 
   Bore well
   
6. 
   Lift Irrigation
   

17. 
    If the respondent is engaged in non-farm activities then define the type of that activity?
    

1. 
   Manufacturing Industry
   
2. 
   Construction Industry
   
3. 
   Storage Industry
   
4. 
   Tourism Industry
   
5. 
   Mining and Quarrying
   
6. 
   Floriculture Related Industry
   
7. 
   Horticulture and Agro based Industry
   
8. 
   Food Processing Industry
   
9. 
   Sericulture Related Industry
   
10. 
    Transportation related Industry
    
11. 
    Communication related Industry
    
12. 
    Forests’ products related Industry
    
13. 
    Medicinal herbs and aromatic herbs etc. processing
    
14. 
    Others (specify)
    

17. 
    What is/are the most persisting problem/(s) the respondent facing in pursuing his industrial activities? Rank them.
    

1. 
   Finance
   
2. 
   Human resource
   
3. 
   Non-availability of raw materials
   
4. 
   Power
   
5. 
   Transportation
   
6. 
   Communication
   
7. 
   Low access to markets
   
8. 
   Others (specify)
   

17. 
    Does the respondent have a bank account or post office account? Yes/ No
    

17. 
    What prompted the respondent to open an account?
    

1. 
   Faith in banks
   
2. 
   Official requirement
   
3. 
   Bank officials approached the village
   
4. 
   Encouraged by family/ village members
   
5. 
   Other (specify)
   

17. 
    Why does not the respondent have a bank account or post office account?
    

1. 
   No bank/ PO nearby
   
2. 
   Too much paper work
   
3. 
   Difficult to open
   
4. 
   Not accessible
   
5. 
   Don’t trust them
   
6. 
   Tried but did not get one
   

17. 
    Does the respondent have any savings? Yes/ No
    

17. 
    Where does the respondent keep his savings?
    

1. 
   At home
   
2. 
   SHGs
   
3. 
   Bank
   
4. 
   Post office
   
5. 
   Co-operative
   
6. 
   Loans to others
   
7. 
   NGOs
   
8. 
   LIC
   
9. 
   Others (specify)
   

17. 
    What is most important thing when the respondent decides where to save? Rank each on a scale of 1-5, 1 being least important and 5 being the most important.
    

1. 
   Access
   
2. 
   Ease of withdrawal
   
3. 
   Interest rate
   
4. 
   Safety and security
   
5. 
   Trust
   

17. 
    Does the respondent have an insurance policy? No/ Yes
    

17. 
    What kind of insurance does the respondent have?
    

1. 
   Life
   
2. 
   Product and asset
   
3. 
   Livestock
   
4. 
   Crop
   
5. 
   Other (specify)
   

17. 
    Why does the respondent not have insurance?
    

1. 
   No need for insurance
   
2. 
   No provider
   
3. 
   Very costly
   
4. 
   It is difficult to get money from company
   
5. 
   It is not of much use most of the times
   
6. 
   There is no suitable insurance available
   
7. 
   Tried but did not get one
   
8. 
   Other (specify)
   

17. 
    Use of the loan by the respondent?
    

1. 
   Housing
   
2. 
   Agricultural Input
   
3. 
   Land
   
4. 
   Livestock
   
5. 
   Small business
   
6. 
   Manufacturing
   
7. 
   Marriage
   
8. 
   Education
   
9. 
   Health
   
10. 
    Food
    
11. 
    Repay earlier loans
    
12. 
    Litigation
    
13. 
    Others (specify)
    

17. 
    Source of the loan
    

1. 
   Friends
   
2. 
   Relative
   
3. 
   Moneylender
   
4. 
   Employer
   
5. 
   SHGs
   
6. 
   Bank
   
7. 
   Government Department or scheme
   
8. 
   Co-operative
   
9. 
   Other (specify)
   

17. 
    Why do you use the source of credit that you use? Rank each on a scale of 1-5, 1 being the least important and 5 being the most important
    

1. 
   Ease of access (paper work)
   
2. 
   Low rate of interest
   
3. 
   Trust and faith
   
4. 
   Long association
   
5. 
   Fewer restrictions on loan use and supervision
   
6. 
   Other reason (specify)
   

17. 
    Were some of your credit needs left unfulfilled in the last twelve months? Yes/ No
    

17. 
    In the last 12 months has the respondent been negatively affected by any of the following? Rank the top 3 in order of importance.
    

1. 
   No shocks experienced
   
2. 
   Water shortage
   
3. 
   Unusually high level of crop pests and diseases
   
4. 
   Unusually high level livestock diseases
   
5. 
   Reduced availability of grazing areas
   
6. 
   Landslides/ avalanches
   
7. 
   Heavy rains
   
8. 
   Unusually high level of human disease
   
9. 
   Unusually high increases in food prices.
   
10. 
    Unusual decrease in farm gate prices
    
11. 
    Loss of employment by a household member
    
12. 
    Reduced income of a household member
    
13. 
    Serious illness accident for working household member
    
14. 
    Death of a working household member
    
15. 
    Death of other household member
    
16. 
    Involuntary loss of house/ land
    
17. 
    Involuntary loss of livestock
    

Second: .....…………………………………...

Third: ………………………………………

Part-K (Others)

17. 
    Mention four most important needs of the village and/or district?
    

1. 
   First Need:
   
2. 
   Second Need:
   
3. 
   Third Need:
   
4. 
   Fourth Need:
   

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