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Nigeria Phase 2 Household Questionnaire 2020

001b. Enter your name below.

Please record your name

002b. Record the correct date and time.

The date must be between 2020-11-01 and 2021-11-01.

003a. State
[] Kano
[] Lagos

003b. LGA

003c. Locality

004. Enumeration area

004a. Phase 1 Household list

005. Structure number

Please record the structure number from the household listing form.

Please record the structure number from the household listing form.

006. Household number

Please record the household number from the household listing form.

007a. Are you at the same dwelling unit location from Phase 1?

[] Yes
[] No

007b. Do people live in this dwelling unit?

[] Yes
[] No

007c. Is at least one of the original P1 members still living in the dwelling unit?

[] Yes
[] No

007d. Why are people not living in this dwelling unit?


[] P1 dwelling unit vacant or address not a dwelling unit
[] P1 dwelling unit destroyed
[] P1 dwelling unit not found

007e. What is the status of the original P1 household?

Confirm with the neighbors to know the status

[] Household moved out of EA
[] Household moved within EA
[] Household split with some members in EA and some out of EA
[] No information

008. Which woman from Phase 1 are you following up?
If you do not see any women in this list, double-check your answers to 004a and 007a

[] FQ_ODK_display_name

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

[] Yes
[] No


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

Hello. My name is _____ and I am working for the Center for Research, Evaluation Resources, and Development. We are conducting a local survey about various health issues. Your household has been selected for this survey. We would very much appreciate your participation in this survey. This information will help us inform the government to better plan health services. Whatever information you provide will be kept strictly confidential and will not be shown to anyone other than members of our survey team.

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 other household members. 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 years.

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

May I begin the interview now?

If yes continue with interview, if no thank the respondent and end the interview.

Hello. My name is _____ and I am working for the Center for Research, Evaluation Resources, and Development.

This research is being conducted by Drs. Scott Radloff and Phil Anglewicz of the Johns Hopkins University, and Dr. Funmilola OlaOlorun on behalf of the Center for Research Evaluation and Resource Development, Ile-Ife. This study is sponsored by the Bill and Melinda Gates Foundation through the Bill and Melinda Gates Institute for Population and Reproductive Health, Johns Hopkins University, Baltimore, MD.

The purpose of this research is to learn more about characteristics of your household, and your household has been impacted by the coronavirus pandemic, in order to provide government and other stakeholders with data to improve interventions and programs aimed at this population.

We are asking you to join our study because you were interviewed by a member of our team in December 2019/January 2020 for a similar survey, and agreed to be contacted again. If you agree to participate in the study, we will ask you some of the same questions we asked before, as well as how this virus has impacted your household. The questionnaire should take about 20 minutes to complete. After you complete the survey, you will be provided with recharge cards worth N300.

In total, we expect you to be involved in the original research for which we first contacted you for 3 years. Your participation in the study will only include annual or biannual surveys in-person or by phone.

There are no major risks to participating in the study, but you may get tired or bored when completing the questionnaire. Some questions may be personal or sensitive and may make you feel embarrassed or uncomfortable. Please let us know if you feel distressed.

There is a small risk that someone outside the study will see your information. We will do our best to keep your information safe by not including your name anywhere in the survey. Upon completion of the survey, data will be sent to and stored on a secure, password-protected server. Only authorized individuals will be able to access the data. All data are encrypted when transferred. When we share your information with other researchers, we will ask them to use the same protections.

Your participation in this research will not cost you anything, apart from some of your time.

There is no direct benefit to you from being in this study. We hope this knowledge will help us understand about characteristics of households in Lagos, and how the coronavirus is affecting their lives. The data collected from this study will provide information for future research, interventions, and programs.

All information collected in this study will be given code numbers, and no names will be recorded. Your responses cannot be linked to you in any way, and your name or any identifier will not be used in any publications or reports from this study.

Your participation in this research is entirely voluntary. You do not have to join, it is your choice. There will be no penalty if you decide not to join.

If you choose not to participate, this will not affect your ability to participate in other surveys or receive services in your community.

You will be given a small token for your time. You will receive recharge cards worth ?300 for participating in the study.

You can also choose to withdraw from the research at any time. Please note that any information that has been obtained from you before you choose to withdraw may have been used in data analysis or report writing. These cannot be removed, but the researchers will comply with your wish as much as it is practicable.

If you suffer any injury as a result of your participation in this research, the project will ensure you are referred to appropriate services.

What happens to research participants and communities when the research is over? The researchers will post the outcome of the research on the project website. During the course of this research, you will be informed about anything that may affect your continued participation, or your health.

If this research leads to commercial products, the Johns Hopkins University shall own it. There is no plan to contact any participant now or in the future about such commercial benefits.

Any apparent or potential conflict of interest: We are not aware of anything that may prevent the researchers from conducting the research in a manner that will be fair.

Statement of person giving verbal consent: The description of the research has been read to me, or translated into language I understand. I have also talked it over with the interviewer to my satisfaction. I understand that my participation is voluntary. I know enough about the purpose, methods, risks and benefits of the research study to judge that I want to take part in it. I understand that I may freely stop being part of the study at any time. I am willing to participate.

This research has been approved by the Lagos State University Health Research Ethics Committee (LASUTH HERC) and the committee can be contacted at Health Research and Ethics Committee, Lagos State University Teaching Hospital, Lagos State. In addition, if you have any question about your participation in this research, you can contact the local principal investigator, Dr. OlaOlorun, at her office in the Department of Community Medicine, College of Medicine, University of Ibadan.

010a. May I begin the interview now?

[] Yes
[] No

010b. Respondent's signature

Please ask the respondent to sign or check the box in agreement of their participation.


[] NA

011. Interviewer's name: ${your_name}

Mark your name as a witness to the consent process.

[] NA

Household Roster Updating

ODK will display the summary of all household members listed in Phase 1. You will then update their information to indicate any changes including births and deaths

Section 1 ? Household Roster

Household member

PL102. P1 Household Member

Below are the Phase 1 details for member ${P_pos}:

First name: ${hq_firstname_auto}
Relationship to HH head: ${hq_relationship_lab}
Gender: ${hq_gender_lab}
Age: ${hq_age_auto}
Marital Status: ${hq_marital_status_lab}

Is this person the respondent?

If yes, check this box.

[] NA

PL103. What is the status of this member in the household?

[] Resident
[] Moved elsewhere in the EA
[] Moved out of the EA
[] Moved out of the EA to attend school
[] Deceased
[] Unknown

PL104. Household Member

First name: ${hq_firstname_auto}
Relationship to HH head: ${hq_relationship_lab}
Gender: ${hq_gender_lab}
Age: ${hq_age_auto}
Marital Status: ${hq_marital_status_lab}

Do you wish to update any of this information?

[] Yes
[] No

Section 1 ? Household Roster

I am now going to ask a series of questions about each usual member of the household or anyone who slept in the house last night.

101. Name of household member / visitor

Start with the head of the household.

101a. Is this person the respondent?

If yes, check this box.

[] NA

102. What is ${firstname}'s relationship to the head of household?

[] Head
[] Wife/Husband
[] Son/Daughter
[] Son/Daughter-in-law
[] Grandchild
[] Parent
[] Parent in law
[] Brother/Sister
[] House help
[] Other
[] Do not know
[] No response

103. Is ${firstname} male or female?

[] Male
[] Female

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

If less than one year old, record 0

Age must be less than 130 and greater than 0.

105. 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/separated, or widowed.

[] Married
[] Living with a partner
[] Divorced / separated
[] Widow / widower
[] Never married
[] No response

106. Does ${firstname} usually live here?

[] Yes
[] No
[] No response

107. Did ${firstname} stay here last night?

[] Yes
[] No
[] No response

LCL_101. What is the religion of ${firstname}?

Only recorded for the head of the household.

[] Catholic
[] Other Christian
[] Islam
[] Traditionalist
[] Other
[] No religion
[] No response

LCL_102. What is the ethnicity of ${firstname}?

Only recorded for the head of the household.

[] Afo/Gwandara
[] Alago
[] Eggon
[] Fufulde
[] Hausa
[] Igbo
[] Izon/Ijaw
[] Katab/Tyap
[] Mada
[] Mambila
[] Mumuye
[] Ogoni
[] Rundawa
[] Wurkum
[] Yoruba
[] Other
[] No response

108. Are there any other usual members of your household or persons who slept in the house last night that I have not listed here?

[] Yes
[] No

Section 2 ? Household Characteristics

Now I would like to ask you a few questions about the characteristics of your household.

201. Is this structure/house newly built in the last 12 months?

[] Yes
[] No
[] No response

202. Please tell me about items that 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.

[] Electricity?
[] A radio?
[] A television?
[] A mobile telephone?
[] A non-mobile telephone?
[] A refrigerator?
[] A cable TV?
[] A small generating set?
[] A big generating set
[] An air conditioner?
[] A computer?
[] An electric iron?
[] A fan?
[] A watch?
[] A bicycle?
[] A motorcycle or motor scooter?
[] An animal-drawn cart?
[] A car or truck?
[] A canoe?
[] A boat with a motor?
[] A microwave oven?
[] A washing machine?
[] A grain grinder?
[] A food blender?
[] A mattress?
[] None of the above
[] No response

Check here to acknowledge you considered all options.

[] NA

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

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

[] Yes
[] No
[] No response

202b. How many of the following animals does this household own?

The household can keep the livestock anywhere, but must own the livestock recorded here.

Zero is a possible answer. Enter -88 for do not know. Enter -99 for no response.

Milk cows/bulls:
Horses, donkeys, or mules:

Section 3 ? Household Observation

Please observe the floors, roof and exterior walls.

301. Main material of the floor


[] Earth/Sand
[] Dung
[] Wood Planks
[] Palm/Bamboo
[] Parquet or polished wood
[] Vinyl or Asphalt Strips
[] Ceramic Tiles
[] Cement
[] Carpet/Rug
[] Other
[] No response

302. Main material of the roof


[] No roof
[] Thatch/Palm Leaf
[] Rustic Mat
[] Palm/Bamboo
[] Wood planks
[] Cardboard
[] Metal/Zinc
[] Wood
[] Ceramic Tiles
[] Cement
[] Roofing Shingles
[] Other
[] No response

303. Main material of the exterior walls


[] No Walls
[] Cane/Palm Trunks
[] Dirt/Mud
[] Bamboo with Mud
[] Stone with Mud
[] Plywood
[] Cardboard
[] Reused Wood
[] Cement
[] Stone with Lime/Cement
[] Bricks
[] Cement Blocks
[] Wood Planks/Shingles
[] Other
[] No response

Section 4 ? Water Sanitation and Hygiene

Now I would like to ask you a few questions about water, sanitation and hygiene.

401. 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?

[] Fixed facility observed (sink/tap) in dwelling
[] Fixed facility observed (sink/tap) in yard/plot
[] Mobile object (bucket/jug/kettle) observed
[] Not observed, facility in dwelling/yard/plot but no permission to see
[] Not observed, not in dwelling/yard/plot
[] Not observed, other reason
[] No Response

402. At the place where the household washes their hands, observe availability of water

[] Water is available
[] Water is not available
[] No Response

403. At the place where the household washes their hands, observe availability of soap or detergent:

[] Soap is available
[] Soap is not available
[] No Response

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

[] Piped Water: Piped into dwelling/indoor
[] Piped Water: Pipe to yard/plot
[] Piped Water: Public tap/standpipe
[] Tube well or borehole
[] Dug Well: Protected Well
[] Dug Well: Unprotected Well
[] Water from Spring: Protected Spring
[] Water from Spring: Unprotected Spring
[] Rainwater
[] Tanker Truck
[] Cart with Small Tank
[] Surface water (River / Dam / Lake / Pond / Stream / Canal / Irrigation Channel)
[] Bottled Water
[] Sachet Water
[] No response

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

[] Flush/pour flush toilets connected to: Piped sewer system
[] Flush/pour flush toilets connected to: Septic tank
[] Flush/pour flush toilets connected to: Pit Latrine
[] Flush/pour flush toilets connected to: Elsewhere
[] Flush/pour flush toilets connected to: Unknown / Not sure / Do not know
[] Ventilated improved pit latrine
[] Pit latrine with slab
[] Pit latrine without slab / open pit
[] Composting toilet
[] Bucket
[] Hanging toilet /Hanging latrine
[] Other
[] No facility / bush / field
[] No response

501. Thank you for the time you have kindly granted us.

Are you willing to provide a phone number for this household where we may reach you in the future to follow up for future research?

[] Yes
[] No
[] No response

502. What is the phone number?

Enter an 11-digit number without the country code. Do not include spaces or dashes.

503. Can you repeat the number again?

Enter an 11-digit number without the country code. Do not include spaces or dashes.

Number entered must match previously entered number.

504. What is the name of the person who normally answers this phone?

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

096. Location

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

097. How many times have you visited this household?

[] 1st time
[] 2nd time
[] 3rd time

098. In what language was this interview conducted?

[] English
[] Hausa
[] Yoruba
[] Pidgin
[] Other

099. Questionnaire Result

Record the result of the questionnaire.

Check answer to 009 and the consent.

[] Completed
[] No household member at home or no competent respondent at home at time of visit
[] Postponed
[] Refused
[] Partly completed
[] Dwelling vacant or address not a dwelling
[] Dwelling destroyed
[] Dwelling not found
[] Entire household absent for extended period