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Appendix 2: Questionnaire for the household survey <strong>of</strong> the baseline studyQUESTIONNAIRE FOR THE HOUSEHOLD SURVEY OFTHE BASELINE STUDY01. Country: 04. Questionnaire number:02. Village: 05. Name <strong>of</strong> respondent:03. Pilot/study area: 06. Street address <strong>of</strong> respondent:07. Name <strong>of</strong> interviewer:Date:Starting time:Finishing time:SECTION A: Household structure and livelihood assessmentThe aim <strong>of</strong> this section is to map out household characteristics, assets and ownership.I. HOUSEHOLD CHARACTERISTICS AND COMPOSITIONID Positionin HH1 Head <strong>of</strong>HH2 SpouseA1 1) A2 2) A3 A4a 3) A4b 4) A5 5) A6Sex Marital AgeMainstatus (yrs.)occupationEducation OtherskillstrainingHow longhave youlived here (no<strong>of</strong> yrs.)A7. Please indicate the number <strong>of</strong> permanent household members in each group:Sex1 Male2 FemaleAge group0 to 15 16 to 45 46 to 60 Above 60A8. What ethnic group or tribe to do you belongto?_________________________________A9. What religion do you practice?____________________________vi

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