CHECK: Have you contacted your supervisor about starting with this type of household?

You MUST have completed with the R6 households before starting on stage 2 households.

A. How many times have you visited this household?

001a. Your name: [interviewer's name]

Is this your name?

001b. Enter your name below.

Please record your name

C. Current date and time.

Is this date and time correct?

D. Record the correct date and time.

D. Region

D. District

D. Sub-county

D. Enumeration area

E. Structure number

Please record the structure number from the household listing form.

F. Household number

Please record the household number from the household listing form.

O. Are you at the dwelling/structure where the Household interviewed in R6 lived?

This household had result: [interview result from Round 6] at round six.

Oa. Is at least one of the original Round 6 household occupants still living in this dwelling?

Can only have a member present if the roster was done at round six!!

Ob. What is the current status of the r6 household?

CHECK: Why are you resending this form?

Choose all that apply.

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

INFORMED CONSENT

Find a competent member of the household.

L. Provide a paper copy of the Consent Form to the respondent and explain it. Then, ask: May I begin the interview now?

M. Interviewer's name: [interviewer's name]

Mark your name as a witness to the consent process.

M. Interviewer's name

Please record your name as a witness to the consent process. You previously entered "[interviewer's name]."

That is not what you entered for your name earlier in this survey.

P. Respondent's first name.

Please record the first name of the respondent.

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.

This household had [number of household members] members in round 6 namely: ${r6names}

Lets first update their information before adding any new members to the list.

This household is not part of the 44 sampled and interviewed households at round 6 in 2018. You will have to complete a new roster.

Household member

What is the status of [household member's name] in the household?

Can Only update member information if they are still resident.

This member is not / no longer part of the round 6 roster. Please provide fresh details for them.

CHECK: Is ${firstname} the woman we are following up from the round six survey?

We mean the woman who moved from her original household but within the EA and is available for followup.

NOTE: Please note that for this type of household, where our round six household member was eligible and interviewed for the FQ, we shall only generate a form for them and not any of the other household members even if they would be eligible.

Please enter the structure number of the Household from which ${firstname} was interviewed at round 6.

Invalid response.

Please enter the household number of the Household from which ${firstname} was interviewed at round 6.

Invalid response.

HQ2. Relationship to head of household

Round 6 relationship was: ${r6relationship}

HQ2. Relationship to head of household

HQ3. Sex

HQ4. Age (years)

Round 6 age was: ${r6age}

HQ4. Age (years)
HQ4. Must be less than 130.

HQ5. Marital Status

If not married, probe to determine if they have ever been married and, if so, if they are divorced/separated or widowed.
Round 6 marital status was: ${r6marital_status}

HQ6. Does ${firstname} usually live here?

HQ7. Did ${firstname} stay here last night?

The member must either be a usual member in the household or must have slept last night. Please verify.

HQ9. Are there any other members of this household from the round 6 list?

This household had [number of household members] members in round 6 namely: ${r6names}

You have so far entered ${num_HH_members} namely ${names}.

HQ9. Are there any other usual members of your household or persons who slept in the house last night other than the one(s) we have already talked about?

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

HQ10. 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.

HQ11a. Does this household own any livestock, herds, other farm animals, or poultry?

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

HQ11b. 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.
Local Cattle:
Enter -88 for do not know.
Enter -99 for no response.
Exotic/Cross cattle:
Enter -88 for do not know.
Enter -99 for no response.
Horses, donkeys, or mules:
Enter -88 for do not know.
Enter -99 for no response.
Goats:
Enter -88 for do not know.
Enter -99 for no response.
Sheep:
Enter -88 for do not know.
Enter -99 for no response.
Pigs:
Enter -88 for do not know.
Enter -99 for no response.
Chickens:
Enter -88 for do not know.
Enter -99 for no response.

Section 3 Household Observation

Please observe the floors, roof and exterior walls.

HQ13. Main material of the floor

Observe.

HQ14. Main material of the roof

Observe.

HQ15. 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.

HQ16. Do you have a place to wash your hands?

HQ17. Can you show it to me?

HQ18. At the place where the household washes their hands, observe if:

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

HQ20. What is the main source of drinking water for members of your household?

HQ27. Do members of your household use any of the following toilet facilities?

Read out all types. Check all that are used. Scroll to bottom to see all choices.

Cannot select 'no response' with other options.

HQ28. What is the main toilet facility used by members of your household?

The main facility must be selected in HQ27.

You did not select that choice in the previous question.

HQ29. Do you share this toilet facility with other households or the public?

Thank the respondent for his/her time.

The respondent is finished, but there are still 2 more questions for you to complete outside the home.

Location and Questionnaire Result

Q. Location

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

S. In what language was this interview conducted?

T. Questionnaire result

Record the result of the household questionnaire.

Check answers to K, L, and the consent.