Prof
Ward…………………………………………..Mtaa………………………………..
Name of Interviewer…………………………………………………………………
Date………………………………………..
General Information 1. Name of respondent………………………………………… 2. Sex………………… age…………………………... 3. Education…………………………………………………….
QUESTION 1 – Community respondents
Households’ characteristics
|No |Name |Sex |Age |Education |Skills |employment |
|1 | | | | | | |
|2 | | | | | | |
|3 | | | | | | |
|4 | | | | | | |
|5 | | | | | | |
|6 | | | | | | |
|7 | | | | | | |
|8 | | | | | | |
|9 | | | | | | |
|10 | | | | | | |
4. Household size…………………………………………..
Number of working persons