SF - 1 Infrastructure in the Communities Communities Infrastructure A B C D Schools Health post/center Shopping facilities Police station Postal service Energy supply Drinking water supply Sewage disposal Transportation School Shopping Facilities PS - Primary School M - Market (*) SS - Second. School S - Shop SM - Supermarket Energy Supply Drinking Water Supply E - Electricity OT - Own piped water tap G - Gas CT - Community tap K - Kerosene OW - Own Well W - Wood CW - Commun.well/spring D - Dung WT - Water tank R - River/lake Health facilities HP - Health post HC - Health center Sewage Disposal Transportation L - Latrine B - Bus (*) F - Field open air T - Truck, lorry (*) R - River V - Ship/boat (*) Codes marked with (*) 2 - Existent, permanent 1 - Existent, but not permanent (e.g. 1-2 times a week, e.g. health service, not frequently, e.g. transportation) 0 - Non-existent SF - 2 Living Conditions Building material No. Com Type of Food Lux- SES Hous muni hous bed Food Short ury Class e ty/ho e/No. room Kit- stor- Wa-- Main (mth) good ificati con- use Pers Walls Floors Roof s chen age ter Food s on dition A/1 A/2 A/3 B/1 B/2 B/3 C/1 C/2 C/3 D/1 D/2 D/3 E/1 E/2 E/3 Type of house Building material S - Single family house WO - Wood M - Multiple family house CM - Clay/mud ST - Stone Kitchen (location/energy source for cooking) CE - Cement I - Kitchen in house TI - Tiles H - Kitchen outside house SB - Straw/bamboo P - Cooking with petroleum based fuel F - Cooking with firewood Luxury goods G - Cooking with gas BI - Bicycle MO - Motorcycle Food storage SW - Sewing machine R - Refrigerator RA - Radio V - Ventilated closed cupboard TV - Television A - Open air WA - Watch Water SES Classific OT - Own piped water tap RI - Rich CT - Community tap MI - Middle class OW - Own well PO - Poor CW - Community well/spring PP - Poorest WT - Water tank R - River/lake Ranking of house conditions 3 - well maintained 2 - more or less 1 - poorly maintained SF - 3 Demographic/Socio-economic Data Communities Indicators A B C D 2 Population density/km Population growth Birth rate Death rate Migration rate Seasonality Gender specificity Ethnic groups Religion Major problems perceived by * - community members (FGD) - representatives of community Solutions to solve the major problems* - community members (FGD) - representatives of community Economic activities Income situation * opinions obtained from community members during focused group discussions (FGD) and from representatives of the community, like community leader, teacher etc. both opinions are of equal value SF - 4 Health Services in the 5 Communities Communities A B C D Health Infrastructure Health centers/inhabit. Health posts/inhabitants Personnel Doctors/inhabitants Nurses/inhabitants Health assist/inhabitants Health services implementation (observation) Weight check cards Immunization cards ORS Packages Sales of drugs Disease statistics reporting Preventative health services Mother/child advisory Nutrition advisory Family planning Suppl. feeding program Feeding program Total points 1 - Existent 0 - Non existent SF - 5 Educational Situation Communities A B C D Number of schools in the community Coverage area of school of interviewed teacher(s) (time/distance/inhabitants), Number of teachers/children Number of schoolchildren 1-3 grade 4-6 grade further education Rate of school beginners (%; girls/boys) Rate of school beginners who do not attend school (%; girls/boys) Rate of drop out /grade (%; girls/boys) Rate of grade repeaters / grade (%; girls/boys) Literacy in the community (%) Women < 3 years 3-6 years > 6 years Men < 3 years 3-6 years > 6 years Literacy ethnic/religious groups (%) Adult education School feeding program Judgement of school situation Number of Schools Judgement of school situation PS - Primary School, SS - Secondary School 4 - Excellent 3 - Good Existence of school feeding programs/Adult education 2 - Suficient 1 - Existent 1 - Deficient 0 - Non existent 0 - No access to school Reasons for repeating grades/freaquent absences/dropping out: for girls for boys SF - 6 Survey Form Agriculture * Calendar (Please fill in one form for each community) Community............................................... Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Crops (4 main crops) - - - - Labor needs for each crop (gender specific) - - - - Food availability at household level (most important foods) - - - - - - Food prices (most important foods) - - - - - The calendar should be completed by the farmers (invited for group discussion), utilizing the "mapping" technique Labor needs (during?/ by whom?) Crops (mark utilization of inputs after name of crops) P - Planting F - Fertilizer H - Harvesting I - Insecticide F - Preparing of field B - Slashing and burning W - Weeding Food availability (most import.foods/ each month) 4 - Abundant Me - Men 3 - Enough Wo - Women 2 - Insufficient FCh - Female Children 1 - Starvation MCh - Male Children SF - 7 Survey Form Agriculture * Cultivation Comm Crops Land Area Yield Pla- Harvest Storage Utiliza Credit Agric. unity Te- ning tion Exten- nure sion A B C D * Summary of interviews of representatives of community and group discussion ** Area: convert local measurements in ha Utilization Land tenure Planting CN - Consumption O - Own H - By hand CO - Commercialization L - Lease A - With animals CC - Consumption C - Community M - With machine + commercialization Thrashing Storage Credits and TH - By hand S - On stalk agric.extens.serv. TA - By animals IH - Inside house 1- existent TM - By machine SH - Separate storage house/hut 0 - non existent SF - 8 Survey Form Agriculture * Domestic animals Villages Domestic animals Property Respon- Feeding Utiliza Credit Exten- sibility -tion sion A B C D * Summary of interviews of representatives of community and group discussion Utilization Property Responsibility CN - Consumption O - Own F - Husband CO - Commercialization L - Lease M - Wife CC - Consumption C - Community G - Grandmother/-father + commercialization FCh - Female Child MCh - Male Child Feeding Credits/Agric CF - confined, food provided extens.service GF - grazing/foraging 1 - existent 0 - non existent SF - 9 Food Consumption Habits (Please take further forms for other communities) Commu- Type of Food Frequen Daily Avai- Source Impor- Food nity Con- Con- labilit tance Sec- sump- sump- y urity tion tion Status A B C D Frequency of consumption Daily consumption Source of food 4 - daily 4 - More frequently 4- Purchased 3 - several times weekly 3 - 3 x daily 3 - Own prod.+pur. 2 - once weekly 2 - Twice daily 2 - Own production 1- once a month or less 1 - Once daily 1 - Donation Availability of food Importance of food Food Security Status 4 - Abundant 3 - Very important 4 - Food secure 3 - Enough 2 - Important 3 - Low food insecure 2 - Insufficient 1 - Not important 2 - Moderate Food ins. 1 - Starvation 1 - High food insecure The classification of Current Food Security Status should be based on the following criteria a) Food grouping used to determine current status - Staples includes tubers and roots - Vegetables includes fruits - Meats includes fish and poultry b) Criteria used to determine current food insecurity Food secure all food items were described as sufficient by the household Low food insecurity at least one food item from each grouping (stables, vegetables, meats) are identified as sufficient, but other insufficiencies in food items are identified Moderate food insecurity All food items making up one of three groupings (stables, vegetables, meats) are identified as insufficient High food insecurity All food items making up two or three groupings (stables, vegetables, meats) are identified as insufficient. SF - 10 Breast-feeding, Supplementary Feeding, and Weaning Practices* Commu Colo- Start Type first Daily*** Daily*** Taboo Bottle End Food Food nity strum Comple- comple- consumptn consumptn foods feeding Breast- taboo taboo Behav mentary mentary times/ food times/ food feeding ior ** feeding feeding 6 month 12 month Baby (mo) Pregnan Breast- (mo) old old Women feeding Women A B C D * Summary : Representatives of the Community and Results of Group Discussion ** Colostrum Behavior 1 - Colostrum fed exclusively during the first hour after birth 2 - Colostrum fed exclusively during the first day after birth 3 - Colostrum fed with additional liquid/food during the first day after birth 4 - Colostrum feeding initiated after the first day (pre-lactal feeding) 5 - Colostrum not fed *** Daily consumption (Type of food and times feeding - independent of breast milk) F - Fruits V - Vegetables C - Cereals A - Animal food (e.g. milk products, egg, meat) SF - 11 Anthropometric Data Collected from Schoolchildren (Please fill in a separate form for each community) Community:_______________________________________ Child (Name) Sex (m/f) Age* (months) Height (cm) * Date of birth, if available SF - 12 Analysis of Groups and Institutions Potentially Participating in the Project (Please fill in a separate form for each community) Community:_______________________________________ Name of the group Category Potential Ranking of Importance The group matrix gives an overview of all groups, organizations and institutions that could influence the performance of a project. The matrix helps to identify potential supporters for achieving the proposed project goal and barriers that could risk the project success. The first column lists the names of project-relevant groups, organizations and institutions which are located in the community, hold an influential position or may be affected. In the second column the listed parties are categorized according to their social background (gender, age, occupation, religion, ethnicity, etc.), status (formal, informal, etc.) and structure (institution, organization, leaders, etc.). The third column describes the potential for the project considering the strengths (experiences and resources), weaknesses and shortcomings. In the forth column the groups, organizations and institutions are ranked by the Target Population according to their perceived actual importance for the people. This analysis can be used to determine whether the cooperation with second parties is necessary and follows the project strategy and, if so, which collaborations are feasible; with the understanding that the analysis is based on only a one day visit in the community.