Nepal Multiple Indicator Cluster Survey 2014

Household Information Panel: HH

HH1. Cluster number: _ _ _

HH2. Household number: _ _

HH3. Interviewer's name and number

HH4. Supervisor's name and number:

HH5. Day/month/year of interview in Bikram Sambat (Nepali Calendar)

HH6. Area

HH7. Sub-Region

HH8A. Is the household selected for water quality?

HH8B. Is the household selected for source water testing?

We are from Cantal Bureau of Statistics (a bureau of Nepal Government under the National Planning Commission), in Kathmandu. We are conducting a survey about the situation of children, families and households. I would like to talk to you about these subjects. The interview will take about 25 minutes. All the information we obtain will remain strictly confidential and anonymous. May I start now?

HH9. Result of household interview:

After the household questionnaire has been completed, fill in the following information:

HH10. Respondent to household questionnaire:

After the household questionnaire has been completed, fill in the following information:

HH11. Total number of household members: _ _

After the household questionnaire has been completed, fill in the following information:

HH12. Number of women age 15-49 years: _ _

After all questionnaires for the household have been completed, fill in the following information:

HH13. Number of women's questionnaires completed: _ _

After the household questionnaire has been completed, fill in the following information:

HH14. Number of children under age 5: _ _

After all questionnaires for the household have been completed, fill in the following information:

HH15. Number of under-5 questionnaires completed: _ _

HH15A. If the household was selected for water quality testing (HH8A=1), Is the water quality questionnaire complete?

HH16. Field editor's name and number:

HH17. Main data entry clerk's name and number:

HH18 Record the time

List of Household Members: HL

First, please tell me the name of each person who usually lives here, starting with the head of the household.
List the head of the household in line 01. List all household members (HL2), their relationship to the household head (HL3), and their sex (HL4)

Then ask: Are there any others who live here, even if they are not at home now?

If yes, complete listing for questions HL2-HL4. Then, ask questions starting with HL5 for each person at a time. Use an additional questionnaire if all rows in the List of Household Members have been used.

HL1. Line number: _ _

HL2. Name: ____

HL3. What is the relationship of (name) to the head of household?

HL4. Is (name) Male or Female?

HL5. What is (name's) date of birth?

HL6. How old is (name)?

Record in completed years. If age is 95 or above '95':

For women age 15-49
HL7. Circle line no. if woman age 15-49

For children age 0-4
HL7B. Circle line no. if age 0-4

HL11. Is (name)'s natural mother alive
For children age 0-17 years

HL12. Does (name)'s natural mother live in this household? _ _
If "Yes", record line no. of mother and go to HL13. Record 00 for "no".

HL12A. Where does (name)'s natural mother live?

HL13. Is (name)'s natural father alive

HL14. Does (name)'s natural father live in this household? _ _
If "Yes", record line no. of father and go to HL15 Record 00 for "no".

HL14A. Where does (name)'s natural father live?

For children age 0-14
HL15. Record line no. of mother from HL12 if indicated. If HL12 is blank or '00' ask: who is the primary caretaker of (name)?

[] Tick here if additional questionnaire used [After HL1 to HL4 questions]

Probe for additional household members. Probe especially for any infants or small children not listed, and others who may not be members of the family (such as servants, friends) but who usually live in the household. Insert names of additional members in the household list and complete form accordingly.

Now for each woman age 15-49 years, write her name and line number and other identifying information in the information panel of a separate individual women's questionnaire.

For each child under age 5, write his/her name and line number and the line number of his/her mother or caretaker in the information panel of a separate under-5 questionnaire.

You should now have a separate questionnaire for each eligible woman, and each child under five in the household.

Codes for HL3 Relationship to head of household

Education: ED

ED1. Line number: _ _

ED2. Name and age
Copy from HL2 and HL6.

For household members age 5 and above
ED2A. Does (name) know how to read and write?

For household members age 5 and above
ED3. Has (name) ever attended school or pre-school?

For household members age 5 and above
ED3A. Has (name) ever participated in literacy program or any other program that involved learning to read and write?

For household members age 5 and above
ED4B. What is the highest grade (name) completed at this level?
Grade codes:
00 = Less than 1 grade completed
01 - 10 = Grades 1 - 10
11 = SLC
12 = +2 (11 and 12 grade)
13 = Bachelor
14 = Masters and above
94 = Preschool
98 = DK

For household members age 5-24 years
ED5. During the 2013-2014 / 2014-2015 school year, did (name) attend school or preschool at any time?

For household members age 5-24 years
ED6. During this/that school year, which grade is/was (name) attending?
Grade codes:
01 - 10 = Grades 1 - 10
11 = SLC
12 = +2 (11 and 12 grade)
13 = Bachelor
14 = Masters and above
94 = Preschool
98 = DK

For household members age 5-24 years
ED7. During the previous school year, that is 2012-2013 / 2013-2014, did (name) attend school or preschool at any time?

For household members age 5-24 years
ED8. During that previous school year, which grade did (name) attend?
Grade codes:
01 - 10 = Grades 1 - 10
11 = SLC
12 = +2 (11 and 12 grade)
13 = Bachelor
14 = Masters and above
94 = Preschool
98 = DK

Selection of One Child For Child Labour/Child Discipline: SL

SL1. Check HL6 in the list of household members and write the total number of children age 1-17 years.

SL2. Check the number of children age 1-17 years in SL1:

SL2A. List each of the children age 1-17 years below in the order they appear in the List of household members. Do not include other household members outside of the age range 1-17 years. Record the line number, name, sex, and age for each child.

SL3. Rank number: _

SL4. Line number from HL1: _ _

SL5. Name from HL2: ____

SL6. Sex from HL4

SL7. Age from HL6: _ _

SL8. Check the last digit of the household number (HH2) from the cover page. This is the number of the row you should go to in the table below.

Check the total number of children age 1-17 years in SL1 above. This is the number of the column you should go to in the table below.

Find the box where the row and the column meet and circle the number that appears in the box. This is the rank number (SL3) of the selected child.

SL9. Record the rank number (SL3), line number (SL4), name (SL5) and age (SL7) of the selected child.

Child Labor: CL

CL1. Check selected child's age from SL9:

CL2. Now I would like to ask about any work children in this household may do.
Since last (day of the week), did (name) do any of the following activities, even for only one hour?

A. Did (name) do any work or help on his/her own or the household's plot/farm/food garden or looked after animals? For example, growing farm produce, harvesting, or feeding, grazing, milking animals?

B. Did (name) help in family business or relative's business with or without pay, or run his/her own business?

C. Did (name) produce or sell articles, handicrafts, clothes, food or agricultural products?

D. Since last (day of the week), did (name) engage in any other activity in return for income in cash or in kind, even for only one hour?

If "No", Probe: Please include any activity (name) performed as a regular or casual employee, self-employed or employer; or as an unpaid family worker helping out in household business or farm.

CL3. Check CL2, A to D

CL4. Since last (day of the week) about how many hours did (name) engage in this activity/these activities, in total?
If less than one hour, record "00"

CL5. Does the activity/do these activities require carrying heavy loads?

CL6. Does the activity/do these activities require working with dangerous tools (knives etc.) or operating heavy machinery?

CL7. How would you describe the work environment of (name)?

[A] Is (name) exposed to dust, fumes or gas?

[B] Is (name) exposed to extreme cold, heat or humidity?

[C] Is (name) exposed to loud noise or vibration?

[D] Is (name) required to work at heights?

[E] Is (name) required to work with chemicals (pesticides, glues, etc.) or explosives?

[F] Is (name) exposed to other things, processes or conditions bad for (name)'s health or safety?

CL8. Since last (day of the week), did (name) fetch water or collect firewood for household use?

CL9. In total, how many hours did (name) spend on fetching water or collecting firewood for household use, since last (day of the week)?
If less than one hour, record "00"

CL10. Since last (day of the week), did (name) do any of the following for this household?

[A] Shopping for household?

[B] Repair any household equipment?

[C] Cooking or cleaning utensils or the house?

[D] Washing clothes?

[E] Caring for children?

[F] Caring for the old or sick?

[G] Other household tasks?

CL11. Check CL10, A to G

CL12. Since last (day of the week), about how many hours did (name) engage in this activity/these activities, in total?
If less than one hour, record "00"

Child Discipline: CD

CD1. Check selected child's age from SL9

CD2. Write the line number and name of the child from SL9.

CD3. Adults use certain ways to teach children the right behaviour or to address a behaviour problem. I will read various methods that are used. Please tell me if you or anyone else in your household has used this method with (name) in the past month.

[A] Took away privileges, forbade something (name) liked or did not allow him/her to leave the house.

[B] Explained why (name)'s behaviour was wrong.

[C] Shook him/her.

[D] Shouted, yelled at or screamed at him/her.

[E] Gave him/her something else to do.

[F] Spanked, hit or slapped him/her on the bottom with bare hand.

[G] Hit him/her on the bottom or elsewhere on the body with something like a belt, hairbrush, stick or other hard object.

[H] Called him/her dumb, lazy, or another name like that.

[I] Hit or slapped him/her on the face, head or ears.

[J] Hit or slapped him/her on the hand, arm, or leg.

[K] Beat him/her up, that is hit him/her over and over as hard as one could.

CD4. Do you believe that in order to bring up, raise, or educate a child properly, the child needs to be physically punished?

Household Characteristics: HC

HC1A. What is the religion of the head of this household?

HC1B. What is the mother tongue/native language of the head of this household? Write both name and code

HC1C. To what ethnic group does the head of this household belong? Write both name and code

HC2. How many rooms in this household are used for sleeping?

HC3. Main material of the dwelling floor.
Record observation.

HC4. Main material of the roof.
Record observation.

HC5. Main material of the exterior walls.
Record observation

HC6. What type of fuel does your household mainly use for cooking?

HC7. Is the cooking usually done in the house, in a separate building, or outdoors?
If 'In the house', probe: is it done in a separate room used as a kitchen?

HC8. Does your household have:

[A] Electricity?

[B] A radio?

[C] A television?

[D] A non-mobile telephone?

[E] A refrigerator?

[F] An improved cooking stove (ICS)

[G] Table

[H] Chair

[I] Bed/cot

[J] Sofa

[K] Wardrobe

[L] Computer-desktop

[M] Wall clock

[N] Electric fan

[O] Dhiki/Jato

[P] Microwave oven

[Q] Washing machine

HC9. Does any member of your household own:

[A] A watch?

[B] A mobile telephone?

[C] A bicycle/rikshaw?

[D] A motorcycle or scooter?

[E] An animal-drawn cart?

[F] A car or truck?

[G] A boat?

[H] A laptop computer

HC10. Do you or someone living in this household own this dwelling?
If "No", then ask: Do you rent this dwelling from someone not living in this household?
If "Rented from someone else", circle "2". For other responses, circle "6".

HC11. Does any member of this household own any land that can be used for agriculture?

HC12. How many ropanis or bighas of agricultural land do members of this household own?
If respondent answer in Ropani, circle"1" and enter the value and if answer in Bigha, circle "2" and inter the value. If unknown, circle '998'.

HC13. Does this household own any livestock, herds, other farm animals, or poultry?

If none, record '00'. If 95 or more, record '95'. If unknown, record '98'.

[A] Milk cows, or bulls?

[B] Horses, donkeys, or mules?

[C] Goats?

[D] Sheep?

[E] Chickens/ducks/pigeon?

[F] Pigs/swine?

[G] Yak Nak or Chauri

[H] Buffalo

HC15. Does any member of this household have a bank account including cooperatives?

Water and Sanitation: WS

WS1. What is the main source of drinking water used by members of your household?

WS2. What is the main source of water used by your household for other purposes such as cooking and handwashing?

WS3. Where is that water source located?

WS4. How long does it take to go there, get water, and come back?

WS5. Who usually goes to this source to collect the water for your household?
Probe: is this person under age 15? What sex?

WS6. Do you do anything to the water to make it safer to drink?

WS7. What do you usually do to make the water safer to drink?
Probe: Anything else?
Record all items mentioned

WS7A. Check WS1 or WS2: Main source of water

WS7B. Since last (day of the week) did you have water coming from the pipe or tap for at least one hour a day?

WS8. What kind of toilet facility do members of your household usually use?
If "flush" or "pour flush", probe: Where does it flush to?
If not possible to determine, ask permission to observe the facility.

WS9. Do you share this facility with others who are not members of your household?

WS10. Do you share this facility only with members of other households that you know, or is the facility open to the use of the general public?

WS11. How many households in total use this toilet facility, including your own household?

Handwashing: HW

HW0. We would like to collect information on handwashing knowledge. Please mention all the occasions when you think it is important to wash your hand. Circle all mentioned. Kep probing.

HW1. 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?

HW2. Observe presence of water at the place for handwashing. Verify by checking the tap/pump, or basin, bucket, water container or similar objects for presence of water

HW2. Check the distance of the handwashing place from the toilet in paces and circle appropriate code.

HW3A. Is soap, detergent or ash/mud/sand present at the place for handwashing?

HW3B Record you observation
Circle all that apply

HW4 Do you have any soap or detergent or ash/mud/sand in your house for washing hands?

HW5A. Can you please show it to me?

HW5B Record your observation
Circle all that apply

HH19. Record the time

Salt Iodization: SI

SI1. We would like to check whether the salt used in your household is iodized. May I have a sample of the salt used to cook meals in your household?
Once you have tested the salt, circle number that corresponds to test outcome.

SI2. Can I please observe the actual package or container from where you just collected this salt?

SI3. Observe packet or container and record the type of salt. If packed salt is shown by respondent check if it has the logo of a girl and a boy child and tick the appropriate answer.

HH20. Thank the respondent for his/her cooperation and check the list of household members:

Check HH8A. If the household is selected for water quality testing:

Return to the cover page and make sure that all information is entered, including the number of eligible women (HH12), under-5s (HH14) and water quality testing (HH8A)

Make arrangements for the administration of the remaining questionnaire(s) in this household.

Interviewer's Observations ________

Field Editor's Observations ________

Supervisor's Observations ________