HHQ001. Enter the three digits of your Phone?s ID

If it contains only two digits start with 0 followed by two digits, Example: 014. FOR TESTING PURPOSE ENTER 371.

Invalid ID format.

HHQ001a. Your name: {your_name}
Is this your name?

Check the button next to the name if that is your name and select ?yes? here. Do not check the button if that is not your name and select ?no? here (long press to remove response next to the name if needed).

HHQ001b. Enter your name below.

Please record your name

HQ002a.Current date

HQ002a.Current time

Is this date and time correct?

HHQ002b. Record the correct date and time.

HHQ003a. Region

HHQ003b. Zone

HHQ003c. District

HHQ003d. Locality Name

HHQ004. Enumeration area

HHQ005. Structure number

Please record the structure number from the household listing form.

Invalid response.

HHQ006. Household number

Please record the household number from the household listing form.

Invalid response.

HHQ009.Is a member of the household and competent respondent present and available to be interviewed today?

HHQ009a.Is this a cross-section household?

INFORMED CONSENT Find a competent member of the household. Read the greeting on the following screen.

Hello. My name is {re_name} and I am working for the Addis Ababa University, and Federal Ministry of Health. We are conducting a local survey about various health issues using a smartphone. We would very much appreciate your participation in this survey. This information will help us inform the government to better plan health services. The survey usually takes only 15 minutes. Your data will not be linked to your identity when conducting analyses, presenting results, or sharing data.

Participation in this survey is voluntary, and if we should come to any question you don?t want to answer, just let me know and I will go on to the next question; or you can stop the interview at any time. However, we hope that you will participate in this survey since your views are important.

I am going to ask you questions about your family and information about this household. We would then like to ask a different set of questions to female members of this household who are between the ages of 15 and 49.

If you have any questions about the study and your right as a research participant, you may ask me now or you may also contact the principal investigators of the study, Dr. Solomon Shiferaw or Dr. Assefa at Addis Ababa University in Addis Ababa, Ethiopia. For any ethical issues, please call Dr. Adamu Addissie, the IRB chairperson at the Addis Ababa University, College of Health Sciences.

At this time, do you want to ask me anything about the survey?

HHQ010a. Explain the consent form to the respondent. Then, ask: May I begin the interview now?

HHQ010c. Interviewer?s name

Please record your name as a witness to the consent process. You previously entered "{name_typed}."

SECTION 1 ? Household Roster I am now going to ask you a series of questions about each usual member of the household or anyone who slept in the house last night and pregnant or Postpartum women who are currently staying at their parental home?

Household member

HHQ101.Name of HH member/visitor

Start with the head of the household.

Please use only alphabets to enter the name of the HH member

HHQ101a. Is this person the respondent?

HHQ102. What is {firstname}?s relationship to the head of the household?

HHQ103. Is {firstname} male or female?

HHQ104. How old was {firstname} at their last birthday?

If less than one year old, enter 0

Invalid response.

HHQ105. What is {firstname}?s current marital status?

If not married, probe to determine if they have ever been married and, if so, if they are divorced, widowed, or have never been married.

HHQ106. Does {firstname} usually live here?

HHQ107. Did {firstname} stay here last night?

If the person does not live in the house and did not spend last night in the house, please go back and remove him/her from the HH roster.

HHQ-Panel1. Is {firstname} enrolled in the panel study?

HHQ-Panel2.Scan QR Code
Confirm that the scanned code matches the code on the card before advancing.

If you are unable to scan the QR code enter the number on the next screen.

CHECK: Are the last 4 digits the same as the two digit EA number and the two digit number on the ID card?"

If no, enter the 2-digit ID number on the next screen

If you select ?Yes? here, please make sure the QR code field IS NOT EMPTY. If you select ?No? here, please make sure the QR code field IS EMPTY.

HHQ-panel3. Record the correct number on the ID card

Please enter a two digit number.

Confirm that the QR code matches the code on the card before advancing.

QR Code - {qr_lab}

Please go back and correct this.

HHQ-panel4. Does the QR code match what is on the paper?

Please go back and correct this.

LCL101. What is the religion of {firstname}?

Only recorded for the head of the household.

This person IS NOT eligible for the female respondent questionnaire.

This person IS eligible for the female respondent questionnaire.

Cross section HH - {cross_section_hh}

HHQ108. Are there any other usual members of your household or persons who slept in the house last night?

There are other members of the household. Move forward and select "Add Group"

There are no other members of the household. Move forward and select "Do Not Add"

There is no household head selected in the roster, please go back and select a head.

There are multiple household heads selected in the roster, please go back and select a single head.

There is no respondent selected in the household roster.

There is more than one respondent selected in the household roster.

HHQ109. READ THIS CHECK OUT LOUD: There are {num_HH_members} household members who are named ${names}. Is this a complete list of the household members and pregnant or Postpartum women who are currently staying at thier parental home?

Remember to include all children in the household.

Go back and update the roster.

Section 2 ? Household Characteristics Now I would like to ask you a few questions about the characteristics of your household.

HHQ011. Please tell me about the items your household owns. Does your household have:

Read out all types and select all that apply. Scroll to bottom to see all choices. If an item is reported broken but said to be out of use only temporarily, select the item. Otherwise do not select the item.

Cannot select ?no response? or ?none of the above? with other options.

Have you considered all item options in HHQ011 (the previous question)?

Please go back and correct this.

HHQ012. What type of fuel does your household mainly use for cooking?

HHQ013. Where does your cooking take place?

HHQ014. Do you have an insecticide treated net in your household?

The net must be treated. The number of insecticide treated nets in the household does not matter, as long as the household owns at least one insecticide treated net.

HHQ015a. Does this household own any livestock, herds, other farm animals, or poultry?

These livestock can be kept anywhere, not necessarily on the homestead.

015b.How many of the following animals does this household own? Zero is a possible answer. Enter -88 for do not know. Enter -99 for no response

The household can keep the livestock anywhere, but must own the livestock recorded here.
Zero is a possible answer.

Milk Cows/Bulls/Oxen ___
Horses/Donkeys/Mules ___
Camels ___
Goats ___
Sheep ___
Chickens ___
Beehives ___

Enter -88 for do not know.Enter -99 for no response.

You have indicated the household owns livestock in HHQ015a, however you have entered zero (0) for all quantities owned on HHQ015b. Please go back and correct this.

Section 3 ? Household Observation Please observe the floors, roof and exterior walls.

HHQ016. Main material of the floor

Observe.

HHQ017. Main material of the roof

Observe.

HHQ018. Main material of the exterior walls

Observe.

Section 4 ? Water, Sanitation and Hygiene Now I would like to ask you a few questions about water, sanitation and hygiene.

HHQ019a. We would like to learn about the places that households use to wash their hands. Can you please show me where members of your household most often wash their hands?

HHQ019b. At the place where the household most often washes their hands, observe if:

Check all that apply.

Cannot select ?none of the above? with other options.

HHQ020. What is the main source of drinking water for members of your household?

HHQ021. What is the main toilet facility used by members of your household?

IF NOT POSSIBLE TO DETERMINE, ASK PERMISSION TO OBSERVE THE TOILET FACILITY.

HHQ022. Where is your toilet facility located?
{sanitation_main_lab}

HHQ023. How often does your household typically use:
{sanitation_main_lab}

Regular practices at the household only.

HHQ024. Do you share this toilet facility with other households or the public?
{sanitation_main_lab}

HHQ025. Enter the number of households that share this facility (including your own).
{sanitation_main_lab}

Hint: Please record the number of households not the number of people. Must be between 2 and 9. If 10 or greater, swipe back to HHQ024 and choose "shared with ten or more households OR with the Public" when applicable. Enter -99 for no response.

Invalid response.

HHQ026. For all children under age five: what methods, if any, does your household use to dispose of children?s waste?
PROBE: Other methods?

Do not read the possible responses out loud.
Check all that apply.

Invalid response.

Section 5 ?Occurrence and Frequency of Household Food Insecurity
Now I would like to ask you a few questions about experience and frequency of food insecurity ever occurred during the previous four weeks (30 days)

HFI033. In the past four weeks, did you worry that your household would not have enough food?

HFI033a. How often did this happen?

HFI034. In the past four weeks, were you or any household member not able to eat the kinds of foods you preferred because of a lack of resources?

HFI034a. How often did this happen?

HFI035. In the past four weeks, did you or any household member have to eat a limited variety of foods due to a lack of resources?

HFI035a.How often did this happen?

HFI036.In the past four weeks, did you or any household member have to eat some foods that you really did not want to eat because of a lack of resources to obtain other types of food?

HFI036a.How often did this happen?

HFI037.In the past four weeks, did you or any household member have to eat a smaller meal than you felt you needed because there was not enough food?

HFI037a.How often did this happen?

HFI038.In the past four weeks, did you or any other household member have to eat fewer meals in a day because there was not enough food?

HFI038a.How often did this happen?

HFI039.In the past four weeks, was there ever no food to eat of any kind in your household because of lack of resources to get food?

HFI039a.How often did this happen?

HFI040.In the past four weeks, did you or any household member go to sleep at night hungry because there was not enough food?

HFI040a.How often did this happen?

HFI041.In the past four weeks, did you or any household member go a whole day and night without eating anything because there was not enough food?

HFI041a.How often did this happen?

Thank the respondent for his/her time.

The respondent is finished, but there is still more for you to complete outside the home.

LOCATION AND QUESTIONNAIRE RESULT

HHQ027. Location Take a GPS point near the entrance to the household. Record location when the accuracy is smaller than 6m.

HHQ028. Did you have to move away from the household to take the GPS reading?

HHQ029. How many times have you visited this household?

HHQ030. In what language was this interview conducted?

HHQ031. Was a translator used for this interview?

HHQ032. Questionnaire result

Record the result of the questionnaire.

The result must correspond to the response values.

HHQ033. Take a photo of the QR code.

Make sure you have taken a picture of the full page and not just the QR code image and number