Income-Generating Activities - Action Against Hunger

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APPENDIX 18: EXAMPLE OF A PDM QUESTIONNAIRE
KUISIONER KELOMPOK
MONITOR PASCA DISTRIBUSI UNTUK IGA
Aceh Province – Indonesia
Questionnaire #: ________
1. Date ________ 2. Monitor: ________ 3. Sub District ________ 4. Village ________
5. Beneficiary name:________________________________________________
6. If a group, name of group members:
____________________________________________________________________
7. Type of HH: 8. Type of Area:
1) IDP in Settlement 1) Totally Destroyed with IDPs
2) IDP in Host Family 2) Partially Destroyed with IDPs and Local Population
3) IDP in Barracks 3) Non-Destroyed Area with IDPs and Local Population
4) Returnee in Settlement
5) Local with house but lost livelihood
9. HH Composition, Family Status & Activity (of each member of the HH, even if
without income and/or regular activity)
1 –
Name
2 -
Age
3 -
Family
Status
4 -
Head
of the
HH
(M/F)
5 - #
Members
in the
HH
6 - # of
School Aged
Children
7 - # of
Children Non-
School Age
8 – Profession
F M F M F M
Head
of
HH
Spouse
HH
Member
1
HH
Member
2
HH
Member
3
a)
b)
c)
d)
e)
f)
g)
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INCOME GENERATING ACTIVITIES: A KEY CONCEPT IN SUSTAINABLE FOOD SECURTIY