roster_sept20
Saturday, March 22, 2008, 12:30 PM
Questionnaire



QUESTIONNAIRE OPTIONS
Option Setting
Parent Namesingle item
Child Namemultiple items
Max user text length50
Min user text length0
Text ConversionNone

MAIN SECTION (Directed)
0. Roster number: Take from prompt sheet or use a new number (roster_id) - text, identifier
1. What is the name of this household member? (s1q0) - text, single item
2. What is {{s1q0}}'s relationship to the household head? (s1q2) - menu, single item
3. Please specify {{s1q0}}'s relationship to the household head. (s1q2s) - text, single item
4. What is {{s1q0}}'s gender? (s1q3) - menu, single item
5. How old is {{s1q0}}? (s1q4) - number, single item
6. What was the highest level of schooling attended by {{s1q0}}? [Interviewer: if other schooling, such as schooling for the blind, select closest equivalent to level completed.] (s1q6a) - menu, single item
7. What was the highest grade {{s1q0}} attained in that level? (Interviewer: this refers to the number of years completed within that level of schooling, for example, completed 2 years of middle school.) (s1q6b) - number, single item
8. What is the main occupation of {{s1q0}} now? (s1q7) - menu, single item
9. What is the secondary occupation of {{s1q0}}? (Interviewer: if only one occupation, then select "None" here.) (s1q8) - menu, single item
10. Did {{s1q0}} work on cocoa farms in the 2005/6 season? (s1q8a) - menu, single item
11. JUMP if a main student - jump, none
12. JUMP if a secondary student - jump, none
13. JUMP if not a student - jump, none
14. Has {{s1q0}} received a scholarship of any kind for their studies? (s1_scholar) - menu, single item
15. What is the source of this scholarship? (s1_scholsource) - menu, single item
16. What does this scholarship provide? (s1_scholprovide) - ticklist, single item
17. To which ethnic group does {{s1q0}} belong? (s1q10) - menu, single item
18. Please specify {{s1q0}}'s ethnic group: (s1q10s) - text, single item
19. Health questions - message, none
20. Health Consent - message, none
21. For how many days between September 2005 and August 2006 has this person had malaria? (s1_malaria) - number, single item
22. Does {{s1q0}} suffer from any physical disabilities? (s1q11) - menu, single item
23. What kind of physical disbability is this? (s1q12) - ticklist, single item
24. Does {{s1q0}} suffer from any long-term illnesses or disorders? (s1q13) - menu, single item
25. What kind of illness/disorders does {{s1q0}} suffer from? (Choose all that apply) (s1q14) - ticklist, single item
26. JUMP miss some health questions if less than 8 years old - jump, none
27. For how many days in NOVEMBER, DECEMBER, and JANUARY of the last MAJOR GROWING SEASON (2005-2006) was {{s1q0}} too sick to carry out his or her normal daily routine? (s1q16) - number, single item
28. Which of the following best applies: From September 2005 to August 2006, {{s1q0}} has been sick... (s1q17) - menu, single item
29. How difficult does {{s1q0}} find standing after sitting down? (s1q18) - menu, single item
30. How difficult would {{s1q0}} find sweeping the floor? (s1q19) - menu, single item
31. How difficult would {{s1q0}} find walking for five kilometres? (s1q20) - menu, single item
32. How difficult would {{s1q0}} find carrying 20 litres of water for 20 metres? (s1q21) - menu, single item
33. How difficult would {{s1q0}} find hoeing a field for a morning? (s1q22) - menu, single item
34. From September 2005 to August 2006, how much was spent on the heathcare of {{s1q0}} (includes medicine, dental care, visits to doctor, preventative drugs, etc)? (s1q23) - formatted, single item
35. Has {{s1q0}} EVER visited a clinic or hospital? (s1q24a) - menu, single item
36. How many months ago did {{s1q0}} last visit a clinic or hospital? (s1q24) - number, single item
37. Is {{s1q0}} registered for the National Health Insurance Scheme? (s1_nihs) - menu, single item

COMMON SECTION (Directed)



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