Embed
Email

arc_macedonia_survey_instrument

Document Sample

Shared by: Kerala g
Categories
Tags
Stats
views:
0
posted:
2/3/2012
language:
pages:
15
Macedonia Household Survey March 2001



***SURVEY COVER SHEET***

Introduction and request for verbal consent. Good Morning/Afternoon/Evening. May I speak with

the head of your family? Thank you. (Note to Interviewer: Head of Family may be replaced by

spouse only; not parents or grandparents).



I’m _____________ and I am working with the Red Cross. Today, we are conducting a survey with

families who recently participated in the Red Cross food supply program a) to understand how your

families situation may have changed from last year and b) to better understand how the project may

have helped your family. This survey relates only to the project that has just ended.



You are being invited to participate in this survey, however, your participation is strictly voluntary.

This survey in NO WAY affects your family’s eligibility to participate in any future Red Cross projects.

This survey is being conducted in rural, as well as urban areas.



We would appreciate your cooperation in answering some questions about your household. The

interview will take approximately 45 minutes. The information you provide will be kept confidential.

You will not be identified, or be able to be identified, in any of the reports we plan to write. This

information is ONLY being used to better understand the effectiveness of the previous Red Cross

Project.



Do you agree to participate? Yes / No







Today’s Date: _____________________ Start Time: _________ End Time: _______



Name of interviewer(s): __________________________ Code of interviewer: ___________



Name of supervisor: __________________________ Code of Supervisor: ___________



Respondent Address: ____________ City or Village: __________

Information

____________________ _______________________



Sampling Point/ Branch: ___________ District: _______________ District House #: ________

Respondent

Information ___________________ _______________________ _______________________



Household Selection

Original....................1

Replacement............2 /____/



Result Codes If refused, why:

Completed ..1 Survey too long, too much time ..1

Partly Completed ..2 Death or illness in the family ..2

Not at Home ..3 Worried information won’t be kept confidential ..3

Moved Away ..4 No reason stated ..4

House Abandoned ..5 Other ..5

Bad Address ..6 /___________________________________/ /_____/

Refused ..7

Other: /________________/ ..8 /________/

American Red Cross, International Federation of Red Cross and Red Crescent

Societies with support from the Macedonian Red Cross 1

Macedonia Household Survey March 2001



Question Codes Response Skip?

1.0 Gender of Respondent? Male ..1 None

Female ..2

Missing ..9999 /_____ /

2.0 What is the main Macedonian ..1 None

nationality of your Macedonian Muslim ..2

family? Albanian ..3

Turk ..4

Roma ..5

Serb ..6

Other /____________________________/ ..7

Don’t Know ..7777

Refused ..8888

Missing ..9999 /_____ /

3.0 What is the main Macedonian ..1 None

language spoken in Albanian ..2

your home? Turkish ..3

Roman ..4

Serbian ..5

Other /____________________________/ ..6

Don’t Know ..7777

Refused ..8888

Missing ..9999 /_____ /

4.0 Can you tell us about Rent ..1 None

where you live today? Own ..2

Do you… Live in unpaid/not owned home (e.g., parents) ..3

Other /__________________________/ ..4

Don’t Know ..7777

Refused ..8888

Missing ..9999 /_____ /

5.0 How long have you > 5 Years ..1 None

lived here? 2-5 Years ..2

1-<2 ..3

Less than 1 Year ..4 6

Don’t Know ..7777

Refused ..8888

Missing ..9999 /______/ 4 /___ /

6.0 Can you tell us how 6.1 Number of Infants 0–23 mths /____/ Enter None

many people live in 6.2 Number of Children 2–6 yrs /____/ total # of

your household today? 6.3 Number of Children 7–14 yrs /____/ family

6.4 Number of children/adults 15–19 yrs /____/ members

6.5 Number of adults 20–39 yrs /____/ here

6.6 Number of Adults 40–59 yrs /____/

6.7 Number of Adults 60 + yrs /____/ /_______/









American Red Cross, International Federation of Red Cross and Red Crescent

Societies with support from the Macedonian Red Cross 2

Macedonia Household Survey March 2001



Question Codes Response Skip?

7.0 What is the main Centralized pipeline with taps inside house ..1 None

source of water for Centralized pipeline with taps outside house ..2

your household for Own system of water supply ..3

washing, bathing, etc? Standing Water Pipe or Well ..4

Spring ..5

River, Lake or Pond ..6

Rain Water ..7

Brought in (by truck) ..8

Other /____________________________/ ..9

Don’t Know ..7777

Refused ..8888

Missing ..9999 /_____ /

7.1 What is the main Centralized pipeline with taps inside house ..1 None

source of DRINKING Centralized pipeline with taps outside house ..2

water for your Own system of water supply ..3

household? Standing Water Pipe or Well ..4

Spring ..5

River, Lake or Pond ..6

Rain Water ..7

Brought in (by truck) ..8

Other /______________________________/ ..9

Don’t Know ..7777

Refused ..8888

Missing ..9999 /_____ /

8.0 What kind of toilet Indoor Toilet with central sewage/septic tank ..1 None

facility does your Outdoor Traditional Pit Latrine ..2

household have? Other /_______________________________/ ..3

Don’t Know ..7777

Refused ..8888

Missing ..9999 /_____ /

9.0 What was the last May/June 2000 ..1 None

month you received a November/December 2000 ..2

food package from the Other /______________________________/ ..3

Red Cross? Prompt: Don’t Know ..7777

1 person: 12 kgs of wheat Refused ..8888

flour; 1 kg beans; 1 ltr of Missing ..9999 /_____ /

oil; 1 kg sugar; 0.5 kg salt

2-4 persons: 25 kgs of

wheat flour; 3 kgs of

beans; 3 ltrs of oil; 2 kgs

sugar; 0.5 kgs salt

5+ persons: 30 kgs of

wheat flour; 3 ltrs of oil; 2

kgs sugar; 0.5 kgs salt









American Red Cross, International Federation of Red Cross and Red Crescent

Societies with support from the Macedonian Red Cross 3

Macedonia Household Survey March 2001



Question Codes Response Skip?

9.1 Was your family ever None

cut from the Red Cross

program because you No ..1

no longer met the Yes ..2

criteria, and then later Don’t Know ..7777

put back on the Refused ..8888

program? Missing ..9999 /_____ /

10.0 Can you tell us the 10.01 No jobs/opportunities available ..1 /_____ / If

main reason that you 10.02 Laid off; place of employment still open ..2 /_____ / employed,

and/or your spouse are 10.03 Laid off; place of employment closed ..3 /_____ / skip to

unemployed? 10.04 Health problems ..4 /_____ / Q11.0

(CHOOSE ALL 10.05 Transportation problems ..5 /_____ /

THAT APPLY)? 10.06 Lack required skills ..6 /_____ /

10.07 Other / _________________________ / ..7 /_____ /

10.08 Employed ..8 /_____/

Don’t Know ..7777

Refused ..8888

Missing ..9999 /_____/

10.1 Up to today, how long 0-6 months ..1 None

has your household 7-12 months ..2

(consecutively) been 13-23 months ..3

receiving un- 2 – 5 years ..4

employment social More than 5 years ..5

assistance? Don’t Know ..7777

Refused ..8888

Missing ..9999 /_____/



Transition Prompt. Thank you for answering these questions. Now, I would like to ask you some

questions about different things you have to get for your household each month like food, utilities and

medicines. We know the economy has been very bad, and answering these questions will help the Red

Cross better understand the needs of your family.



Question Codes Response Skip?

11.0 Last month in If 0, skip

February, how much to Q12.0

total rent/mortgage or

fees were DUE on your /__________ / (_____) ..1

apartment/house? (If Don’t Know ..7777

paying rent annually, Refused ..8888

divide by 12) Missing ..9999 /_____ /

11.1 Last month in None

February, how much /__________ / (____) ..1

rent/ mortgage or fees Annual Rent Paid in Full ..2

were you actually able Don’t Know ..7777

to PAY on your Refused ..8888

apartment/house? Missing ..9999 /_____ /







American Red Cross, International Federation of Red Cross and Red Crescent

Societies with support from the Macedonian Red Cross 4

Macedonia Household Survey March 2001



Question Codes Response Skip?

12.0 Does anybody in your No ..1 If no, skip

household have Yes, rent ..2 to Q13.0

another house or Yes, own ..3

apartment? Don’t Know ..7777

Refused ..8888

Missing ..9999 /_____ /

12.1 Last month in February /__________ / (____) ..1 None

how much did you pay Don’t Know ..7777

for this OTHER place? Refused ..8888

Missing ..9999 /_____ /

12.2 Last month in No ..1 If no, skip

February, did you rent Yes ..2 to Q13.0

out this OTHER place Don’t Know ..7777

to anybody? Refused ..8888

Missing ..9999 /_____ /

12.3 Last month in /__________ / (____) ..1 None

February, how much Don’t Know ..7777

rent did you receive for Refused ..8888

this OTHER place? Missing ..9999 /_____ /

13.0 Does your household No ..1 If No,

have another small Yes, own ..2 skip to

piece of land (for your Yes, rent ..3 Q14.0

animals, for gardening, Don’t Know ..7777

etc.) Refused ..8888

Missing ..9999 /_____ /

13.1 Last month in /__________ / (____) ..1 None

February, how much Don’t Know ..7777

did you pay for this Refused ..8888

land? Missing ..9999 /_____ /

13.2 Last month in No ..1 If No,

February, did you rent Yes ..2 skip to

out this land to Don’t Know ..7777 Q14.0

anybody? Refused ..8888

Missing ..9999 /_____ /

13.3 Last month in /__________ / (____) ..1 None

February, how much Don’t Know ..7777

rent did you receive for Refused ..8888

this land? Missing ..9999 /_____ /

14.0 What is your primary Wood ..1 If NOT

source of heat? Electricity ..2 WOOD,

Coal ..3 skip to

Central Heat ..4 Q15.0

Gas ..5

No heating ..6

Don’t Know ..7777

Refused ..8888

Missing ..9999 /______/





American Red Cross, International Federation of Red Cross and Red Crescent

Societies with support from the Macedonian Red Cross 5

Macedonia Household Survey March 2001



Question Codes Response Skip?

14.1 IF WOOD, for winter None

2000/2001 how much /__________ / (_____) ..1

did you pay to heat Collected from forest, etc. Not paid. ..2

your home? Don’t Know ..7777

Refused ..8888

Missing ..9999 /_____/

14.2 How much of this was None

bought on loan? /_________/ (_______) ..1

Don’t Know ..7777

Refused ..8888

Missing ..9999 /_____/

15.0 Last month in None

February, how much

were your utility bills /__________ / (_____) ..1

(electricity/electric Don’t Know ..7777

heat, water, gas, Refused ..8888

phone)? Missing ..9999 /_____/

15.1 Last month in None

February, of the total

amount you owed for /__________ / (_____) ..1

your utilities; how Don’t Know ..7777

much were you able to Refused ..8888

actually pay? Missing ..9999 /_____/

16.0 Last month in If 0, skip

February, how much to Q17.0

did your household /__________ / (______) ..1

spend in the market on Don’t Know ..7777

food/food products/ Refused ..8888

beverages for your Missing ..9999 /_____ /

household?

16.1 How much of this None

amount IN /_________/ (_______) ..1

FEBRUARY was Don’t Know ..7777

bought on loan? Refused ..8888

Missing ..9999 /_____ /

17.0 Do you have a home No ..1 If No,

garden? Yes, specify type of garden (e.g., onions) ..2 skip to

/_________________________/ Q18.0

Don’t Know ..7777

Refused ..8888

Missing ..9999 /_____ /









American Red Cross, International Federation of Red Cross and Red Crescent

Societies with support from the Macedonian Red Cross 6

Macedonia Household Survey March 2001



Question Codes Response Skip?

17.1 Of the food you will/ Home consumption ..1 None

(have) harvested Sold ..2

was/(is) it being used Bartered or Traded ..3

primarily for… Other ..4

/__________________________________/ ..7777

Don’t Know ..8888

Refused ..9999

Missing /_____ /

18.0 Do you have any No ..1 None

animals like chickens Yes (specify) ..2

or goats (PROMPT; Type Number of Animals

NOT domestic pets like 18.1.a _________ 18.1.b __________

cats or dogs)? 18.2.a. _________ 18.2.b. __________

18.3.a. _________ 18.3.b. __________

18.4.a. _________ 18.4.b. __________

18.5.a. _________ 18.5.b. __________

Don’t Know ..7777

Refused ..8888

Missing ..9999 /_____ /

19.0 Last month in 19.1 No ..1 /______/ None

February, can you think 19.2 Yes, Barter or Trade your services (e.g., ..2 /______/

of any other place you work in a friends shop, in return you can take

were able to GET home some small foods)

FOOD for your family 19.3 Yes, Barter or Trade something you own ..3 /______/

(CHOOSE ALL (e.g., trade a TV for vegetables from

THAT APPLY). somebody’s garden or for one of their animals)

19.4 Yes, Other charity organizations (specify) ..4 /______/

/_______________________________/

19.5 Yes, Other (specify) ..5 /_____ /

/_______________________________/

Don’t Know ..7777

Refused ..8888

Missing ..9999 /_____ /

20.0 Last month in If 0, skip

February, how much /__________ / (_____) ..1 to Q21.0

did spend to buy Don’t Know ..7777

clothes for your Refused ..8888

household? Missing ..9999 /_____ /

20.1 How much of this None

amount IN /__________ / (_____) ..1

FEBRUARY was Don’t Know ..7777

bought on loan? Refused ..8888

Missing ..9999 /_____ /









American Red Cross, International Federation of Red Cross and Red Crescent

Societies with support from the Macedonian Red Cross 7

Macedonia Household Survey March 2001



Question Codes Response Skip?

21.0 Last month in If 0, skip

February, how much to Q22.0

did you spend on

schooling for your /__________ / (_____) ..1

children (prompt: Don’t Know ..7777

include tuition fees, Refused ..8888

school uniforms and Missing ..9999 /_____ /

school supplies)

21.1 How much of this None

amount IN /__________ / (_____) ..1

FEBRUARY was Don’t Know ..7777

bought on loan? Refused ..8888

Missing ..9999 /_____ /

22.0 Last month in No ..1 If No,

February, were you or Yes ..2 skip to

anyone else in your Don’t Know ..7777 Q23.0

household sick enough Refused ..8888

to need to see a doctor? Missing ..9999 /_____ /

22.1 Last month in If 0, skip

February, how much /_________/ (_______) ..1 to Q23.0

did your household pay Don’t Know ..7777

for medical Refused ..8888

consultations? Missing ..9999 /_____ /

22.2 How much of this None

amount IN /_________/ (_______) ..1

FEBRUARY was taken Don’t Know ..7777

on loan? Refused ..8888

Missing ..9999 /_____ /

23.0 Last month in If 0, skip

February, how much /_________/ (_______) ..1 to Q23.2

did your household pay Don’t Know ..7777

for prescriptions or Refused ..8888

analyses? Missing ..9999 /_____ /

23.1 How much of this IN None

FEBRUARY was /_________/ (_______) ..1

bought on loan? Don’t Know ..7777

Refused ..8888

Missing ..9999 /_____ /

23.2 Last month in No ..1 If yes,

February, did you get Yes ..2 skip to

all of the medicines Don’t Know ..7777 24.0

prescribed by a doctor Refused ..8888

for your household? Missing ..9999 /_____ /









American Red Cross, International Federation of Red Cross and Red Crescent

Societies with support from the Macedonian Red Cross 8

Macedonia Household Survey March 2001



Question Codes Response Skip?

23.3 If no, what is the ONE Not available ..1 None

MAIN REASON why Too expensive ..2

not? Difficult to find ..3

Don’t think they are needed ..4

Other ..5

/___________________________________/

Don’t Know ..7777

Refused ..8888

Missing ..9999 /_____ /

24.0 Last month in No ..l If No,

February, did you have Yes, specify ..2 skip to

any other household /_____________________________/ Q25.0

expenses other than Don’t Know ..7777

those we just talked Refused ..8888

about? Missing ..9999 /_____ /

24.1 If yes, last month in None

February how much did /_________/ (_______) ..1

your household spend Don’t Know ..7777

on these other expenses Refused ..8888

Missing ..9999 /_____ /

24.2 Of this amount, how None

much of this IN /_________/ (_______) ..1

FEBRUARY was Don’t Know ..7777

bought on loan? Refused ..8888

Missing ..9999 /_____ /

25.0 25.1 Now, can you None

think of the TOTAL

amount of money that

your household owes

for TOTAL unpaid /_________/ (_______) ..1

rent, utilities, and all of Don’t Know ..7777

your loans for food, etc. Refused ..8888

How much is this? Missing ..9999 /_____ /



25.2 Now, can you also

think of other places

where you borrowed

money (the bank, /_________/ (_______) ..1

unofficial sources, Don’t Know ..7777

etc.). How much is Refused ..8888

this? Missing ..9999 /_____ /



25.3 If we add these

together, we get ___. /_________/ (_______) ..1

Is this the total amount Don’t Know ..7777

of money your Refused ..8888

household owes today? Missing ..9999 /_____ /







American Red Cross, International Federation of Red Cross and Red Crescent

Societies with support from the Macedonian Red Cross 9

Macedonia Household Survey March 2001



Transition Prompt. Thank you for answering these questions. Now, I just have a few

questions for you about how your household has tried to meet all of your many needs.



Question Codes Response Skip?

26.0 Last month in February 26.01 No ..1 /_____/ If NOT

did your household 26.02 Yes, financial/money ..2 /_____/ MONEY,

receive any support 26.03 Yes, non-food/material ..3 /_____/ skip to

from friends/relatives Specify /_________________________/ Q27.0

(in Macedonia or 26.04 Yes, food ..4 /_____/

Abroad (CHOOSE 26.05 Yes, other (specify) ..5 /_____/

ALL THAT APPLY). /_________________________________/

Don’t Know ..7777

Refused ..8888

Missing ..9999 /_____ /

26.1 If money, how much? None

/______________________/ (_________) ..1

Don’t Know ..7777

Refused ..8888

Missing ..9999 /_____ /



(a) (b)

Source No=1 Total Cash Skip?

Yes=2 From this source

27.0 Last month in February, did anybody in None

your house get any social money

assistance? /_______/ (______)

28.0 Last month in February, did anybody in None

your house get any pension such as

elderly, orphan, handicapped/invalid,

other)? /_______/ (______)

7777-Don’t Know

8888=Refused

9999=Missing





Question Codes Response Skip?

29.0 Last month in 29.01 No ..1 /______ / If No,

February, did your 29.02 Yes, sold personal possessions ..2 /______ / Skip to

household find any 29.03 Yes, casual/temporary day-to-day work ..3 /______ / Q30.0

other way to get money 29.04 Yes, full-time employment ..4 /______ /

to pay for the expenses 29.05 Yes, other (specify) ..5 /_______/

we just discussed /___________________________________/

(CHOOSE ALL Don’t Know ..7777

THAT APPLY)? Refused ..8888

Missing ..9999 /______ /

29.1 If yes, IN FEBRUARY None

how much were you /_________/ (_______) ..1

able to get? Don’t Know ..7777

Refused ..8888

Missing ..9999 /_____ /

American Red Cross, International Federation of Red Cross and Red Crescent

Societies with support from the Macedonian Red Cross 10

Macedonia Household Survey March 2001



30.0 Last month in 30.1 No ..1 /_____ / None

February, 30.2 Yes, Other charity organizations ..2 /_____ /

Other than the things (specify) /___________________/

we have already 30.3 Yes, help from my local church (specify) ..3 /_____ /

talked about did your /_______________________/

household receive any 30.4 Yes, Other /_______________________/ ..4 /_____ /

other help or support Don’t Know ..7777

(CHOOSE ALL Refused ..8888

THAT APPLY)? Missing ..9999 /_____/



Transition Prompt to Food Expenditure and Consumption. Thank you. Now, we would like to ask

you a few final questions about your family’s food consumption. Are you the person responsible for

buying and cooking food in your household? If yes, go to Q17. If no probe “Do you think _____(your

wife) could join us to answer the last few questions of the survey”? Thank you very much.



For most of this interview, we’ve been talking about the last month. Now -- can you just think of

yesterday.



31. Yesterday, (During the previous 24-hour period), did you or anyone in your household eat…

EATING OCCASION NO (1)

YES (2)

31.1 Any food before a morning meal

31.2 A morning meal

31.3 Any food between morning and midday meals

31.4 A midday meal

31.5 Any food between midday and evening meals

31.6 An evening meal

31.7 Any food after the evening meal

7777-Don’t Know; 8888=Refused; 9999=Missing



32. Yesterday, during the previous 24-hour period), did you or anyone in your household eat any kind of …

FOOD GROUP NO (1)

YES (2)

32.1 Any kind of Bread or macaroni

32.2 Any kind of roots such as (potatoes, etc).

32.3 Pulses/Legumes (beans, nuts or lentils)

32.4 Milk, Yoghurt, cheese or other milk products

32.5 Eggs

32.6 Any kind of meats/offal like chicken, salami, canned meat (pasteta)

32.7 Fish/Riverfish

32.8 Any Oil/butter or fats

32.9 Any Fruits (oranges, apples, etc)

32.10 Any kind of fresh or canned vegetables, cucumber, lettuce, cabbage, carrots, etc.

32.11 Turkish Coffee, Coffee or Tea

32.12 Any sugar or honey

32.13 Condiments (kecthup or mayonnaise)

32.14 Other Foodstuffs (specify) /________________________________________/

7777-Don’t Know; 8888=Refused. 9999=Missing

American Red Cross, International Federation of Red Cross and Red Crescent

Societies with support from the Macedonian Red Cross 11

Macedonia Household Survey March 2001



Question Codes Response Skip?

33.0 What, if anything, is Medical Assistance ..1 None

the SINGLE most Employment ..2

urgent need for your Food ..3

household today? Do Housing ..4

Utility Assistance ..5

no prompt; do not

Skills/job training ..6

read list; single Higher Education ..7

selection only. Other /________________________________/ ..8

Don’t Know ..7777

Refused ..8888

Missing ..9999 /______/



End. On behalf of the Red Cross, I would like to thank you for all of your time today. Your

thoughtful answers will help the Red Cross to design better programs in the future.









American Red Cross, International Federation of Red Cross and Red Crescent

Societies with support from the Macedonian Red Cross 12

Macedonia Household Survey March 2001





INTERVIEWER WORKSHEET/NOTES: ________________________________________________



_____________________________________________________________________________________



_____________________________________________________________________________________



_____________________________________________________________________________________



_____________________________________________________________________________________



_____________________________________________________________________________________



_____________________________________________________________________________________



_____________________________________________________________________________________



_____________________________________________________________________________________



_____________________________________________________________________________________



_____________________________________________________________________________________



_____________________________________________________________________________________



_____________________________________________________________________________________



_____________________________________________________________________________________



_____________________________________________________________________________________



_____________________________________________________________________________________



_____________________________________________________________________________________



_____________________________________________________________________________________



_____________________________________________________________________________________



_____________________________________________________________________________________



_____________________________________________________________________________________



_____________________________________________________________________________________



_____________________________________________________________________________________



_____________________________________________________________________________________





American Red Cross, International Federation of Red Cross and Red Crescent

Societies with support from the Macedonian Red Cross 13

Macedonia Household Survey March 2001









American Red Cross, International Federation of Red Cross and Red Crescent

Societies with support from the Macedonian Red Cross 15



Other docs by Kerala g
union-budget-2012-13-highlights
Views: 103  |  Downloads: 0
notification M.Tech_05-03-09
Views: 60  |  Downloads: 0
India_Customs Regulation 1
Views: 57  |  Downloads: 0
CE Notification 39-2011-12.9.2011
Views: 55  |  Downloads: 0
STATISTICS
Views: 73  |  Downloads: 0
A Hero (R.K. Narayan)
Views: 92  |  Downloads: 6
RRBPatna-Info-HN
Views: 117  |  Downloads: 0
RRB-Notice-Para
Views: 114  |  Downloads: 0
By registering with docstoc.com you agree to our
privacy policy

You are almost ready to download!

You are almost ready to download!