special questionnaire for caregivers of children … household module … · any questions you do...

Module B

SPECIAL QUESTIONNAIRE FOR CAREGIVERS OF CHILDREN

Section 1A: Meta data

ASSUMING THAT ALL BASIC INFORMATION ON THE HOUSEHOLD IS COLLECTED AND WITH UNIQUE IDENTIFIER LINKED TO THIS QUESTIONNAIRE

1 Region (prefilled)

2 District (prefilled)

3 Cluster (prefilled)

4 Structure number(prefilled)

5 Household number (prefilled)

6 Type of locality (prefilled)

Urban….1

Rural…..2

7 Enumerator

8 Supervisor

9 Name of head of household (prefilled)

Section 1B: Caregiver and Household Identification

1 2 3 4 5

Telephone

number

(prefilled)

Call attempt

Which attempt of

calling this

caregiver is this?

First time calling

this household … 1

Second time calling


Third time calling


Fourth time calling


Time and date of call attempt

[YYYY-MM-DD-HH-mm]

Answer phone

Did anyone answer the phone ?

Yes … 1

No, nobody answered … 2 >> NEXT

ATTEMPT

No, number does not exist … 3 >> NEXT

ATTEMPT

No, Phone switched off … 4 >> NEXT

ATTEMPT

Introduction (1)

Greetings! My name is [NAME INTERVIEWER]. I

am working for the GHANA STATISTICAL SERVICE

(GSS). We are currently doing a nationwide survey

about conditions in the country. This survey consists

of two parts. The first part is administered to the

head of household and the second part to the

caregiver of the children in the household. This is the

second part. You are invited to this interview,

because there is at least one child under the age of 18

in your household.

I am trying to reach [NAME OF CAREGIVER] am I

speaking with [NAME OF CAREGIVER]?

Yes … 1 >> Q7

No … 2

Cannot understand language ... 3 >> NEXT

ATTEMPT

6 7 8 8.1 9

Is caregiver available?

Is [NAME OF CAREGIVER]

currently available ?

Yes … 1 >> Ask to speak to

[NAME OF CAREGIVER]

No … 2 >> NEXT ATTEMPT

Introduction (2)

This interview would take around 30 minutes.

Any information you share with us will be

kept strictly confidential and only be used for

statistical purposes. If at any point there are

any questions you do not feel comfortable

answering, you can choose not to answer

them. You can also choose to stop the

interview at any point. This call will not cost

you any airtime. We will also transfer airtime

worth GHS5 to thank you for your time and

support. Are you willing to participate?

Yes … 1 >> SECTION 1C

No not now … 2

No, refused … 3 >> INTERVIEW RESULT

Call back (1)

Can I call you back

later at a time that

works better for you?

It is really important

for us to speak to you.

Yes … 1

No … 2 >>

INTERVIEW

RESULT

Call back (2)

What date/time can we call you

again to reschedule the interview

for?

[YYYY-MM-DD-HH] >> NEXT

ATTEMPT

Phone number

What would be the best phone

number to contact you next time?

Section 1C: Verification of household roster (members 17 years and younger)

1 2 3

Line ID

Child (Name,

Gender, Age)

Name

ENUMERATOR: ALL HOUSEHOLD MEMBERS

RECORDED DURING MODULE A ARE PRE-

FILLED IN

Please verify the NAMES of all children in the

household

Age



FILLED IN.

Please verify the AGE of all children in the

household

Sex



FILLED IN.

Please verify the SEX of all children in the household

ID 1 [NAME CHILD 1] [AGE CHILD 1] [SEX CHILD 1]



… … … …

ID N [NAME CHILD N] [AGE CHILD N] [SEX CHILD N]

Section 2A: Access to healthcare

1 2 3 4 5 6

Line ID

of most

recently

sick Child

NAME,

AGE, and

SEX as

recorded

in Section

1C are

given to

guarentee

the

answers

are linked

to the

correct

child

Filter (1)

THIS FILTER IS

AUTOMATICA

LLY APPLIED

BASED ON THE

INFORMATION

COLLECTED IN

THE

HOUSEHOLD

ROSTER IN

SECTION 1C

Is there any child

younger than 5

years in the

household

Yes … 1

No … 2 >> Q6

Child sick (1A)

In the last 7

days, has any of

the children in

this household

been ill and had

fever, diarrhoea,

cough, or fast,

short, rapid

breaths or

difficulty

breathing?

Yes, one child …

1 >> Q4

Yes, more than

one child … 2

No … 3 >> Q6

Child sick (1B)

Which of the

children was

sick most

recently?

Record

[CHILD ID]

ID 1 … 1

ID 2 … 2

ID 3 … 3

ID N ... N

Treatment (1)

RECORD

ONLY FOR

MOST

RECENTLY

SICK

Did you seek

medical

treatment for

him/her?

Yes … 1

No … >> Q6

Where treatment (1)

RECORD ONLY FOR MOST RECENTLY

SICK

Where did you seek medical treatment for

him/her?

Government hospital/polyclinic … 1 >> Q7

Government health centre/clinic … 2 >> Q7

Government health post/CHPS … 3 >> Q7

Family planning clinic … 4 >> Q7

Mobile clinic … 5 >> Q7

Fieldworker/outreach/peer educator … 6 >> Q7

Private hospital/clinic … 7 >> Q7

Private doctor … 8 >> Q7

Pharmacy … 9 >> Q7

Chemical/drug store … 10 >> Q7

FP/PPAG clinic … 11 >> Q7

Maternity home … 12 >> Q7

Shop/market … 13 >> Q6

Community volunteer … 14 >> Q6

Friend/relative … 15 >> Q6

Other, specify ________ … 88 >> Q7

Refused to answer … 99 >> Q7

Why no treatment (1)


SICK

Why did you not seek medical treatment for

him/her at a nearby health facility?

It was not serious, treated at home … 1

Afraid to get infected by coronavirus at the

health facility … 2

Lack of money … 3

No public transport available … 4

Movement restricted during lockdown … 5

No medical personnel available at the health

facility … 6

Turned away because the facility was full … 7

Turned away because the facility is used for

management of coronavirus … 8

Other, specify ________ … 88

Don’t know /no response … 99

ID most

recently

sick child

7 8 9 10 11 12

Line ID

of most

recently

sick Child

NAME,

AGE, and

SEX as

recorded

in Section

1C are

given to

guarentee

the

answers

are linked

to the

correct

child

Filter (2)

THIS FILTER IS

AUTOMATICA

LLY APPLIED

BASED ON THE

INFORMATION

COLLECTED IN

THE

HOUSEHOLD

ROSTER IN

SECTION 1C

Is there any child

between the age

of 5 and 15 years

Yes … 1

No … 2 >> Q13

Child sick (2A)

In the last 7

days, has any of

the children in

this household

been ill and had

fever, diarrhoea,

cough, or fast,

short, rapid

breaths or

difficulty

breathing?

Yes, one child …

1 >> Q4

Yes, more than

one child … 2

No … 3 >> Q13

Child sick (2B)

Which of the

children was

sick most

recently?

Record

[CHILD ID]

ID 1 … 1

ID 2 … 2

ID 3 … 3

ID N ... N

Treatment (2)

RECORD

ONLY FOR

MOST

RECENTLY

SICK

Did you seek

medical

treatment for

him/her?

Yes … 1

No … >> Q13

Where treatment (2)


SICK

Where did you seek medical treatment for

him/her?

Government hospital/polyclinic … 1 >> Q13

Government health centre/clinic … 2 >> Q13

Government health post/CHPS … 3 >> Q13

Family planning clinic … 4 >> Q13

Mobile clinic … 5 >> Q13

Fieldworker/outreach/peer educator … 6 >>

Q13

Private hospital/clinic … 7 >> Q13

Private doctor … 8 >> Q13

Pharmacy … 9 >> Q13

Chemical/drug store … 10 >> Q13

FP/PPAG clinic … 11 >> Q13

Maternity home … 12 >> Q13

Shop/market … 13 >> Q12

Community volunteer … 14 >> Q13

Friend/relative … 15 >> Q12

Other, specify ________ … 88 >> Q13

Refused to answer … 99 >> Q13

Why no treatment (2)


SICK

Why did you not seek medical treatment for

him/her at a nearby health facility?

It was not serious, treated at home … 1

Afraid to get infected by coronavirus at the


Lack of money … 3



No medical personnel available at the health

facility … 6





Don’t know /no response … 99

ID most

recently

sick child

13 14 15 16 17

Line ID

youngest

Child

NAME,

AGE, and

SEX as

recorded in

Section 1C

are given to

guarentee

the answers

are linked

to the

correct

child

Filter (3)

THIS FILTER IS

AUTOMATICALL

Y APPLIED BASED

ON THE

INFORMATION

COLLECTED IN

THE HOUSEHOLD

ROSTER IN

SECTION 1C

Is there any child

younger than 25

months (2 years) in

the household..

Yes … 1

No … 2 >> Q18

Vaccine (1)

RECORD ANSWERS FOR ONLY

YOUNGEST CHILD OF HOUSEHOLD

What was the last vaccine that [CHILD ID]

took?

BCG (birth) … 1

DTP – Hep B (6,10,14 weeks) … 2

Polio (14 weeks) … 3

Measles (18 months) ... 4

MenA_conj (18 months) … 5

Measles and rubella (MR) (9, 18 months) … 6

Oral Polio Vaccine (6, 10, 14 weeks) … 7

Pneumo_conj (6,10,14 weeks) ... 8

Rotavirus vaccine (6, 10 weeks) … 9

RTS, S (6,7,9,24 months) … 10

Yellow fever vaccine (9 months) … 11

Don’t know … 88

Refused to answer … 99

Vaccine (2)

Did [NAME

YOUNGEST

CHILD] obtain

the next vaccine

in the schedule

over since

March 16 (when

schools were

closed down)?

Yes … 1

No … 2 >> Q17

No vaccination

due since March

16 … 3 >> Q18

Vaccine (3)

SELECT ALL THAT APPLY

Which vaccine(s) did [NAME YOUNGEST

CHILD] obtain since March 16?

BCG (birth) … A

DTP – Hep B (6,10,14 weeks) … B

Polio (14 weeks) … C

Measles (18 months) ... D

MenA_conj (18 months) … E

Measles and rubella (MR) (9, 18 months) … F

Oral Polio Vaccine (6, 10, 14 weeks) … G

Pneumo_conj (6,10,14 weeks) ... H

Rotavirus vaccine (6, 10 weeks) … I

RTS, S (6,7,9,24 months) … J

Yellow fever vaccine (9 months) … K

Don’t know … L

Refused to answer … M

Vaccine (4)

Why did [NAME

YOUNGEST CHILD] not get

vaccinated as per schedule?

Afraid to get infected by

coronavirus at the health

facility … 1

No public transport available

… 2

Movement restricted during

lockdown … 3

No medical personnel

available at the health facility

… 4

No vaccines available … 5

Turned away because facility

was full … 6

Turned away because the

facility is used for

management of coronavirus

… 7

Don’t Know … 99

ID

youngest

child

18 19 20 21 22

Line ID pregnant

women

Filter (4)

THIS FILTER IS

AUTOMATICALL

Y APPLIED

BASED ON THE

INFORMATION

COLLECTED IN

THE HOUSEHOLD

IN MODULE A

Is there any

pregnant woman in

the household

Yes … 1

No … 2 >> Q23

Pregnancy (1)

FOR ALL

PREGNANT

WOMEN IN THE

HOUSEHOLD.

PROGRAM CAN

CALCULATE THE

NUMBER OF

WEEKS IF

NUMBER OF

MONTHS IS GIVEN

INSTEAD

How many weeks

pregnant is [ID

pregnant woman]

currently?

Don’t Know…...99

ANC (1)

ANSWER FOR ONLY

ONE PREGNANT

WOMAN IN THE

HOUSEHOLD, SELECT

THE MOST ADVANCED

PREGNANT WOMAN

RECORD 0 IF THE

PREGNANT WOMAN

HAS NOT HAD ANY

ANC VISIT.

How many antenatal care

visits has [NAME MOST

PREGNANT WOMAN]

had until now?

Don’t Know .. .99

0 >>Q23

ANC (2)

ANSWER FOR ONLY

ONE PREGNANT

WOMAN IN THE

HOUSEHOLD,

SELECT THE MOST

ADVANCED

PREGNANT WOMAN

Did [NAME MOST

PREGNANT WOMAN]

have an ANC visit at

the health facility since

March 16?

Yes … 1 >> Q23

No … 2

ANC (3)

ANSWER FOR ONLY ONE PREGNANT WOMAN

IN THE HOUSEHOLD, SELECT THE MOST

ADVANCED PREGNANT WOMAN

Why did [NAME MOST PREGNANT WOMAN] not

have an ANC visit since March 16?

Afraid to get infected by coronavirus at the health

facility … 1

No (public) transport available … 2


Could not afford an ANC visit … 4

No medical personnel available at the health facility …

5




No local maternal health outreach … 8

Other (please specify) … 9

Don’t Know … 99

ID most pregnant

woman

ID pregnant woman 2

ID pregnant woman 3

….

ID pregnant woman

N

23 24 25 26 27 28

Line ID

Children

born after

March 16

2020

NAME,

AGE, and

SEX as

recorded in

Section 1C

are given to

guarentee

the answers

are linked

to the

correct

child

Filter (5)

THIS FILTER IS

AUTOMATICALLY

APPLIED BASED

ON THE

INFORMATION

COLLECTED IN

THE HOUSEHOLD

ROSTER IN

SECTION 1C

Is there any child

born after March 16

2020 in the

household..

Yes … 1

No … 2 >> Q29

Childbirth (1)

ASK FOR EACH

CHILD BORN

AFTER MARCH 16,

2020

Where was [NAME

CHILD] born?

Government hospital

… 1 >> Go to Q26

Government health

centre … 2 >> Go to

Q26

Government health

post … 3 >> Go to

Q26

Private hospital … 4

>> Go to Q26

Private health centre

… 5 >> Go to Q26

Private health post …

6 >> Go to Q26

At home … 7

Elsewhere, specify

________ … 8

Childbirth (2)

ASK FOR EACH CHILD BORN

AFTER MARCH 16, 2020

Why was [NAME CHILD] not

delivered at the nearest health

facility?

Afraid to get infected by

coronavirus at the health facility

… 1


Movement restricted during

lockdown … 3

Could not afford to deliver in a


No medical personnel available at

the health facility … 5

Turned away because the facility

was full … 6

Turned away because the facility

is used for management of

coronavirus … 7


Don’t Know … 99

Childbirth (3)

ASK FOR EACH

CHILD BORN

AFTER MARCH 16,

2020

Who assisted with

[NAME CHILD]’s

birth?

Doctor … 1

Nurse/Midwife … 2

Traditional birth

attendant … 3

Relative/friend … 4

No one … 5

Other, specify

________ … 88

Birth registration (1)

ASK FOR EACH

CHILD BORN AFTER

MARCH 16, 2020

Has [NAME CHILD]’s

birth been registered

with the civil

authorities? // Does

[NAME CHILD]] have

a birth certificate?

Yes … 1 >> Q29

Registered, but not yet

received a birth

certificate … 2 >> Q29

No … 3

Birth registration (2)

ASK FOR EACH CHILD BORN

AFTER MARCH 16, 2020

Why has [NAME CHILD] not yet

been registered?

Afraid to get infected with

coronavirus…1

Civil authority / registration/

administration offices are

closed…2

Restricted movement during

lockdown…3

Cannot afford (public)

transportation to get there…4

It is not necessary…5

Name not officially decided...6

Not yet time to register..7


Don’t know ...99

ID Child 1

ID Child 2

ID Child 3

... ... ... ... ... ...

ID Child N

29 30 31

Line ID

Children with

disabilities

NAME, AGE,

and SEX as

recorded in

Section 1C are

given to

guarentee the

answers are

linked to the

correct child

Filter (6)

THIS FILTER IS

AUTOMATICALLY APPLIED

BASED ON THE INFORMATION

COLLECTED IN THE

HOUSEHOLD ROSTER IN

MODULE A

Is there any child with disabilities in

the household

Yes … 1

No … 2 >> NEXT SECTION

Difficulties (1)

SELECT ALL THAT APPLY

Since March 16th, has [NAME CHILD] experienced

more difficulty than usual in the following?

Access to rehabilitation services … A

Access to medical treatment … B

Access to information … C

Access to basic assistance (water, shelter, food or

health) … D

Access to assistive devices … E

Access to social workers and trained staff … F

Increased physical impairment … G

Increased psychological impairment … H

Other, Specify _______ …I

Difficulties (2)

RECORD FOR EVERY DIFFICULTY THAT WAS SELECTED

IN Q24, FOR EVERY CHILD WITH DISABILITIES

How often did issues with [DIFFICULTY] occur for [NAME

CHILD] ?

Rarely (once or twice in the past four weeks) … 1

Sometimes (three to ten times in the past four weeks) … 2

Often (more than ten times in the past four weeks) … 3

ID Child 1 Child 1, Difficulty A

ID Child 2 Child 1, Difficulty B

ID Child 3 Child 2, Difficulty A

... ... ... ... ...

ID Child N Child N, Difficulty H

Section 2B: Access to education

1 2 3 4 5 6

Filter (7)

THIS FILTER IS

AUTOMATICAL

LY APPLIED

BASED ON THE

INFORMATION

COLLECTED IN

THE

HOUSEHOLD

ROSTER IN

SECTION 1C

Is there any child

between 4 and 18

years in the

household

Yes … 1

No … 2 >>

NEXT SECTION

Looking after child (1)

While the schools are closed who

looks mainly after the children

Parents … 1

Grandparents … 2

Siblings … 3

Extended family … 4

Children look after themselves … 5

House help ...6

Other, Specify _______ … 88

Type of school

(1)

How many

children in your

household were

attending

Kindergarten

school prior to

March 16?

0 >> Q10

Education (1A)

Have the children

(Kindergarten only)

been engaged in any

education or

learning activities

since the schools

closed?

Yes … 1

No … 2 >> Q8

Education (1B)

READ OPTIONS. SELECT ALL THAT

APPLY

In what types of education or learning activities

have the children (Kindergarten only) been

engaged since the schools closed?

Completed assignments provided by the teacher

… A

Used mobile learning apps …B

Watched educational TV programs …C

Listened to educational programs on radio …D

Session/meeting with Lesson Teacher (tutor)

…E

Other, Specify _______ … F

Education (1C)

THIS IS A TOTAL

OVER ACTIVITIES IN

Q5

How many times during

the last 7 days did the

Kindergarten school

children participate in

these activities?

Once … 1

Twice … 2

Three times … 3

Four times … 4

Five times … 5

More than five times … 6

Don't know … 99

7 8 9

Education (1D)

PLEASE SELECT ALL THAT APPLY

What learning difficulties do your kindergarten school-age

children face at home in this period of school closure, if any?

Lack of access to internet … A

Poor Internet connectivity … B

Lack of access to basic tools like computers or phones … C

Children’s lack of interest in taking learning lessons … D

Lack of learning materials including textbooks … E


Don’t know … G

Return to school (1A)

Do you think it is likely that

your children who were

attending kindergarten

will go back to school after

the mobility restrictions?

Yes…1 >> Q10

No…2

Return to school (1B)

PLEASE SELECT ALL THAT APPLY

Why do you think that your children will not yet return to kindergarten?

Loss of income from lost jobs, household unable to pay for fees and other

expenses…A

Loss of income from lost jobs, child will have to engage in economic activity…B

Loss of household member (head or caretaker), child will have to engage in

economic activity to help…C

Loss of household member (head or caretaker), child will have to help out with

caretaking of younger siblings…D

I expect that children will not be motivated to go to school … E


10 11 12 13 14 15 16

Type of school

(2)

How many

children in

your household

were attending

primary and

junior high

school prior to

March 16?

0 >> Q17

Education (2A)

Have the children

(primary and

junior high school

only) been

engaged in any

education or

learning activities

since the schools

closed?

Yes … 1

No … 2 >> Q15

Education (2B)

READ OPTIONS. SELECT

ALL THAT APPLY

In what types of education

or learning activities have

the children (primary and

junior high school only)

been engaged since the

schools closed?

Completed assignments

provided by the teacher …

A

Used mobile learning apps

…B

Watched educational TV

programs …C

Listened to educational

programs on radio …D

Session/meeting with

Lesson Teacher (tutor) …E

Other, Specify _______ …

F

Education (2C)

THIS IS A TOTAL OVER

ACTIVITIES IN Q5

How many times during the

last 7 days did the primary

and junior high school


these activities?

Once … 1

Twice … 2

Three times … 3

Four times … 4

Five times … 5


Don't know … 99

Education (2D)

PLEASE SELECT ALL

THAT APPLY

What learning difficulties

do your primary and

junior high school

school-age children face

at home in this period of

school closure, if any?

Lack of access to internet

… A

Poor Internet

connectivity … B

Lack of access to basic

tools like computers or

phones … C

Children’s lack of

interest in taking learning

lessons … D

Lack of learning

materials including

textbooks … E

Other, Specify _______

… F

Don’t know … G

Return to school

(2A)

Do you think it is

likely that your

children who were

attending primary

and junior high

school will go back

to school after the

mobility restrictions?

Yes…1 >> Q17

No…2


PLEASE SELECT ALL THAT

APPLY

Why do you think that your

children will not yet return to

primary and junior high school?

Loss of income from lost jobs,

household unable to pay for fees

and other expenses…A


child will have to engage in

economic activity…B

Loss of household member

(head or caretaker), child will

have to engage in economic

activity to help…C



have to help out with caretaking

of younger siblings…D

I expect that children will not be

motivated to go to school … E


17 18 19 20 21 22 23

Type of school

(3)

How many

children in

your household

were attending

Senior High

School (SHS) l

prior to March

16?

0 >> Q24

Education (3A)

Have the children

(Senior High

School (SHS)

only) been

engaged in any

education or

learning activities

since the schools

closed?

Yes … 1

No … 2 >> Q22

Education (3B)

READ OPTIONS. SELECT

ALL THAT APPLY

In what types of education

or learning activities have

the children (Senior High

School (SHS) only) been

engaged since the schools

closed?

Completed assignments

provided by the teacher …

A

Used mobile learning apps

…B

Watched educational TV

programs …C

Listened to educational

programs on radio …D

Session/meeting with

Lesson Teacher (tutor) …E

Other, Specify _______ …

F

Education (3C)

THIS IS A TOTAL OVER

ACTIVITIES IN Q5

How many times during the

last 7 days did the Senior

High School (SHS)


these activities?

Once … 1

Twice … 2

Three times … 3

Four times … 4

Five times … 5


Don't know … 99

Education (3D)

PLEASE SELECT ALL

THAT APPLY

What learning difficulties

do your Senior High

School (SHS) age

children face at home in

this period of school

closure, if any?

Lack of access to internet

… A

Poor Internet

connectivity … B

Lack of access to basic

tools like computers or

phones … C

Children’s lack of

interest in taking learning

lessons … D

Lack of learning

materials including

textbooks … E

Other, Specify _______

… F

Don’t know … G

Return to school

(3A)

Do you think it is

likely that your

children who were

attending Senior High

School (SHS) will go

back to school after

the mobility

restrictions?

Yes…1 >> Q24

No…2


PLEASE SELECT ALL THAT

APPLY

Why do you think that your

children will not yet return to

Senior High School (SHS?


household unable to pay for fees

and other expenses…A


child will have to engage in

economic activity…B



have to engage in economic

activity to help…C



have to help out with caretaking

of younger siblings…D

I expect that children will not be

motivated to go to school … E


24 25 26 27 28 29

Contact teacher (1)

IF MORE THAN 1 CHILD

TAKE AN AVERAGE

How often are children/

parents/ caregivers in contact

with the teachers?

Every school day ….1

More than 3 times per week….2

Between 1 and 3 times per

week….3

Once per week…4

Never...5 >> Go to 28a

Don’t know…9

Contact teacher (2)

SELECT ALL THAT

APPLY PLEASE READ

OPTIONS

How are children/ parents/

caregivers in contact with

their teachers?

SMS … A

online applications … B

email … C

telephone (audio) … D

whatsapp … E

facebook … F

Other, Specify _______ … G

Learning devices (1)

SELECT ALL THAT

APPLY.

PLEASE READ OPTIONS

What devices do children

in the household use for

learning?

TV… A

Radio… B

Smartphone… C

Tablet … D

Laptop … E

Desktop Computer… F

Learning devices (2)

FOR ALL DEVICES

GIVEN IN Q26

How many [DEVICE]s

are used by children

for learning?

Assisting children (1)

Do you generally assist the

children with their

schoolwork since March 16th

(when schools closed)?

Yes, to a large extent … 1

Yes, to some extent … 2

Yes, but not as much as I

would wish/like to … 3

Yes, Hardly … 4

No … 5

Assisting children (2)

How frequently do you help

children with their

schoolwork since March

16th when the mobility

restrictions/new learning

measures were instituted?

Very frequently … 1

Frequently … 2

Somewhat frequently… 3

Not so frequently… 4

Not at all… 5

DEVICE A

DEVICE B

…

DEVICE F

Section 3: Food Insecurity Experience Scale

1 2 3 4 5 6 7

Filter (8)

THIS FILTER IS

AUTOMATICA

LLY APPLIED

BASED ON THE

INFORMATION

COLLECTED IN

THE

HOUSEHOLD

ROSTER IN

SECTION 1C

Are there any

children between

6 months and 14

years in the

household?

Yes … 1

No … 2 >> Q4

Fewer

meals (1)

In the past 4

weeks, did

the children

under 15

years old

have fewer

meals than

usual?

Yes … 1

No … 2 >>

Q4

Fewer meals (2)

THIS REFERS BACK TO THE

PREVIOUS QUESTION ( Q2)

How often did this happen?

Rarely: only a couple of times … 1

Sometimes but fewer than once per

week on average … 2

Sometimes; on average once or

twice per week … 3

Regularly; 3 or 4 times per week

… 4

Often: nearly every day over the

past weeks … 5

Filter (9)

THIS FILTER IS

AUTOMATICALLY

APPLIED BASED ON

THE INFORMATION

COLLECTED IN THE

HOUSEHOLD ROSTER

IN SECTION 1C

Are there any children

younger than 6 months

Yes … 1

No … 2 >> Q9

Breast milk (1)

IF MORE

THAN 1

CHILD, JUST

ANSWER FOR

THE

YOUNGEST

In the past 4

weeks, did the

child receive

breastmilk?

Yes … 1

No… 2 >> Q7

Breast milk (2)

IF MORE THAN 1 CHILD,

JUST ANSWER FOR THE

YOUNGEST

How was the child fed?

Exclusively breastfed … 1

Exclusively given bottled milk

… 2

Given mixture of breastmilk and

bottled milk … 3

Partially breastfed/Introduced

supplementary feeding … 4

Other, Specify _______ … 5

Feeding difficulties (1)

IF MORE THAN 1

CHILD, JUST ANSWER

FOR THE YOUNGEST

In the past 4 weeks, did

you have difficulties

feeding your child and if

so, how often?

Very Often … 1

Often … 2

Somewhat often … 3

Not often … 4

Not at all … 5 >> Q9

8a 8.1 8.2 8.3

Feeding difficulties (2)

IF MORE THAN 1 CHILD, JUST

ANSWER FOR THE YOUNGEST

What is the main reason you had

difficulty feeding your child?

Unable to produce breast milk…1

Not able to access milk or infant

formula…2

Too expensive …3

Shops are closed …4

Stress and anxiety …5

Breast feeding (1)


JUST ANSWER FOR THE

YOUNGEST

How long after birth did you first

put [NAME CHILD ]to the

breast?

Less than 1 hour … 00

If less than 24 hours … record

hours.

Otherwise … record days.

Breast feeding (2)


JUST ANSWER FOR THE

YOUNGEST.

In the first three days after

delivery, was [NAME CHILD]

given anything to drink other

than breast milk?

Yes … 1

No … 2 >> Q8e

Breast feeding (3)

SELECT ALL THAT APPLY. PLEASE READ OPTIONS

What was [NAME CHILD] given to drink?

Milk (other than breast milk) ... A

Plain water … B

Sugar or glucose water … C

Gripe water ... D

Sugar-salt-water solution ...E

Fruit juice ... F

Infant formula ...G

Tea / Infusions / Traditional herbal preparations … H

Honey ...I

Prescribed medicine ... J

Other (specify)____________ ... K

8.4 8.5 8.6 8.7

Breast feeding (4)



Is [NAME CHILD] still being breastfed?

Yes … 1

No … 2

Don't know .. 3

Breast feeding (5)



Yesterday, during the day or night, did

[NAME CHILD] drink anything from a

bottle with a nipple?

Yes … 1

No … 2

Don't know .. 3

Breast feeding (6)



Did [NAME CHILD] drink Oral

Rehydration Salt solution (ORS)

yesterday, during the day or night?

Yes … 1

No … 2

Don't know .. 3

Breast feeding (7)



Did [NAME CHILD] drink or eat vitamin

or mineral supplements or any medicines

yesterday, during the day or night?

Yes … 1

No … 2

Don't know .. 3

9 10 11 12 13

Filter (10)

THIS FILTER IS

AUTOMATICALLY APPLIED

BASED ON THE

INFORMATION COLLECTED

IN THE HOUSEHOLD ROSTER

IN SECTION 1C

Are there any children between 6

and 14 years old?

Yes … 1


School meals (1)

Do the children between 6 and 14

normally receive meals from the

school feeding program of the

government or any other

organisation?

Yes, government … 1

Yes, other………….2

(If more than one child), yes for

Some, no for others … 3


School meals (2)

FOR CHILDREN THAT

NORMALLY RECEIVE MEALS

FROM THE SCHOOL FEEDING

PROGRAM (government)

Have they been receiving meals

over the past four weeks (from

delivery or collection station)?

Yes … 1


School meals (3)

THIS REFERS BACK TO Q11

How often did this happen?

Rarely: only a couple of times …

1

Sometimes but fewer than once

per week on average… 2

Sometimes; on average once or

twice per week … 3

Regularly; 3 or 4 times per week

… 4

Often: nearly every day over the

past weeks … 5

School meals (4)

THIS REFERS BACK TO Q11

How often have they been having

fewer meals than usual?

Very Often … 1

Often … 2

Somewhat Often… 3

Not often … 4

Not at all … 5

Section 4: Mental Health

1 2 3 4 5 6

Filter (11)

THIS FILTER IS

AUTOMATICALLY

APPLIED BASED ON THE

INFORMATION

COLLECTED IN THE

HOUSEHOLD ROSTER IN

SECTION 1C

Are there any children

between 4 and 17 years old?

Yes … 1


Emotion (1: Sad)

Compared to the period before

March 16th – when schools

were closed down – how often

would you say your children

feel sad?

Much more Often … 1

More Often … 2

Somewhat Often … 3

Less often … 4

Much Less often … 5

Emotion (2: Anxious)

Compared to the period before

March 16th – when schools

were closed down – how often

would you say your children

feel Anxious?


More Often … 2


Less often … 4


Emotion (3: Afraid)

Compared to the period

before March 16th – when

schools were closed down

– how often would you say

your children feel Afraid?


More Often … 2


Less often … 4


Emotion (4: Irritated)



schools were closed down –

how often would you say

your children feel Irritated?


More Often … 2


Less often … 4


Emotion (5: Distressed)



schools were closed down

– how often would you say

your children feel

Distressed?


More Often … 2


Less often … 4


7 8 9 10 11

Behaviour

SELECT ALL THAT APPLY.

PLEASE READ OPTIONS

Have you noticed that since March

16th – when schools were closed down

– children have more often been:

Crying … A

Fighting/arguing with each-other … B

Fighting/arguing with other household

members (parents/caregivers) … C

Feeling bored at home in absence of

school … D

Missing their friends and school … E

Concerns

How concerned are the

children about the

current

situation/pandemic

circumstances?

Very concerned … 1

Concerned … 2

Somewhat concerned …

3

Mostly unconcerned …

4

Not concerned at all … 5

Dealing with situation


PLEASE READ OPTIONS

How do you deal with situations when you notice that your

children are experiencing negative emotions about the

situation?

I tell them that this situation is temporary … A

I tell them that they will return to school … B

I try to distract them through games, activities, asking for

help on the chores in the house, etc. … C

I allow them to take care of each other … D

I ask the older children to take care of the younger ones … E

I allow them to interact with each-other under normal

circumstances … F

Not applicable ... G

Other, specify ______ … H

Irritation (1)

Before March 16

when schools closed,

how often did parents

in your household get

irritated with their

children.

Very Often … 1

Often … 2

Somewhat Often… 3

Not often … 4

Not at all … 5

Irritation (2)

In the last 30 days, how

often do parents in your

household get more

irritated with their

children?

Very Often … 1

Often … 2

Somewhat Often… 3

Not often … 4

Not at all … 5

12 13 14 15 16 17 18

Punishment (1)

Before March 16, when

schools closed, how

often did children in

this household

experience physical

punishment?

Very Often … 1

Often … 2

Somewhat Often… 3

Not often … 4

Not at all … 5

Punishment (2)

In the last 30 days,

how often do children

in this household

experience physical

punishment?

Very Often … 1

Often … 2

Somewhat Often… 3

Not often … 4

Not at all … 5

Chores (1)

Before March 16,

when schools

closed, how often

did children in this

household help

with chores ?

Very Often … 1

Often … 2

Somewhat Often…

3

Not often … 4

Not at all … 5

Chores (2)



this household help

with chores ?

Very Often … 1

Often … 2

Somewhat Often…

3

Not often … 4

Not at all … 5

Work (1)

Before March 16, when

schools closed, how


this household work or

sell things ?

Very Often … 1

Often … 2

Somewhat Often… 3

Not often … 4

Not at all … 5

Work (2)


often children in this

household work or

sell things ?

Very Often … 1

Often … 2

Somewhat Often… 3

Not often … 4

Not at all … 5

Marriage


PLEASE READ OPTIONS

Since March 16, has there any

pressure on your children to get

married?

NO … A

Yes, among the children of 18 years

and older … B

Yes, among the girls between 12 and

17 years old … C

3. Yes, among the boys between 12

and 17 years old … D

Section 5: Violence

1 2 3 4 5 6

Filter (12)

May we have your

permission to ask you

questions related to

domestic violence, and

are you willing to

participate?

Yes … 1

No … 2 >> END

MODULE

Later … 3 END

MODULE AND

SCHEDULE CALL

Crime (1)

Since March 16th, your

community has seen an

increase of serious crime

(including theft, assault,

harassment)

Strongly Agree … 1

Agree … 2

Neither Agree nor

Disagree … 3

Disagree … 4

Strongly Disagree … 5

Don’t know … 99

Crime (2)

Did you or any

member of your

household experience

any serious crime

since March 16th?

Yes … 1

No … 2

Don’t know… 99

Domestic Violence (1)

Since March 16th, your

community has seen an

increase of violence

between members of the

same household.

Strongly Agree … 1

Agree … 2

Neither Agree nor

Disagree … 3

Disagree … 4

Strongly Disagree … 5

Don’t know … 99


SELECT ALL THAT

APPLY.

PLEASE READ OPTIONS

Did you or any member of

your household experience

[VIOLENCE] with other

household members since

March 16th?

Physical assault … A

Verbal assault … B

Defilement … C

Rape … D

Sexual Harassment … E

Cursing … F


FOR ANY VIOLENCE INDICATED IN

Q5, ASK

Who experienced the [VIOLENCE]?

Wife … 1

Husband … 2

Female Child under 18 … 3

Male Child under 18 … .4

Adult Daughter/Daughter-in-law … 5

Adult Son/Son-in-law … 6

House Help … 7

Other relative … 8

Non-relative … 9

Refuse to answer ... 99

VIOLENCE A

VIOLENCE B

VIOLENCE C

…

VIOLENCE F

7 8

Helpline (1)

Do you know where and how to get help and

support if you or someone in your family

experience abuse or violence?

Yes….1 >> END MODULE

No......2 >> Q8

Helpline (2)

“Thank you for participating. To report domestic and child abuse at

home call these number: DOVVSU Hotline: +233 55 100 0900 or

MoGCSP Helpline for Hope 0900 800 800 (Toll free)”

END OF INTERVIEW

1 2 3

INTERVIEWER: PLEASE SELECT

THE ID OF THE RESPONDENT

INTERVIEWER: in which language did

you mainly conduct the interview?

INTERVIEWER: do you have any

notes that are relevant when calling this

household in the future?

DATE …………………………………………………

TIME………………………………………………….

special questionnaire for caregivers of children … household module … · any questions you do...

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