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  1. Surveys
  2. 2015
  3. June
  4. K
  5. Kokoda TVLLS
0%
Exit Survey
 
 
SECTION A: CONTROL
 
 
 
Enumerator Name:
   
 
 
Supervisor Name:
   
 
 
Date of Enumeration:
 
 
Village Name:
   
 
 
Time started:
Hrs.Mins.AM/PM
  
 
 
Time finished:
Hrs.Mins.AM/PM
  
 
 
House Identification (general location description):
   
 
 
SECTION B: RESPONDENT AND HOUSEHOLD OVERVIEW
 
 
 
* 1. Is the respondent the head of household?
 
Yes
 
No
 
 
 
* 2. Is the respondent male or female?
 
Male
 
Female
 
 
 
* 3. Do you consider yourself the main income-earne for the house?
 
Yes
 
No
 
 
 
4. How many people live in this house?
   
 
 
5. What do the people who live in this house normally do (eg go to school,
work at home, work in the garden)?
start with respondent as number 1 and include maximum of three for each person – IDENTIFY MAIN INCOME EARNER with **
Normal Daily Activity Age Gender (M/F)
1
2
3
4
5
6
7
8
9
10
start with respondent as number 1 and include maximum of three for each person – IDENTIFY MAIN INCOME EARNER with **
Normal Daily Activity Age Gender (M/F)
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
 
 
 
SECTION C: ECONOMIC ACTIVITY
 
 
6. Describe household activities in relation to Agricultural activity:
Activity? (crops / livestock) Main reason? (money | consumption | other) Income earned from activity? Associated assets (eg Land, seed, fences, shovels….)
1.
2.
3.
4.
5.
6.
7.
 
 
 
7. Main benefits from Agricultural activity? [list three maximum]
   
 
 
 
8. Main challenges with agricultural activity? [list five maximum]
   
 
 
9. What external resources do you have access to that support your agricultural activity?
What support? When, how often? Views on this service:
Government
Development Partner / Donor
Private Sector
Other
 
 
 
10. What do you think could be done better by you to improve your agricultural livelihood outcomes?
   
 
 
 
11. What do you think could be done better by others to improve your agricultural livelihood outcomes?
   
 
 
12. Describe household activities in relation to Tourism Activity:
Activity? (Describe tourism activities) Main reason for doing it? (money | consumption | other purpose) Income earned (if any)? Notes:
1.
2.
3.
4.
5.
6.
7.
 
 
 
13. Main benefits from Tourism activity? [list three maximum]
   
 
 
 
14. Main challenges with tourism activity? [list five maximum]
   
 
 
15. What external resources do you have access to that support your tourism activity?
What support? When, how often? Views on this service:
Government
Development Partner / Donor
Private Sector
Other
 
 
 
16. What do you think could be done better by you to improve your tourism livelihood outcomes?
   
 
 
 
17. What do you think could be done better by others to improve your tourism livelihood outcomes?
   
 
 
18. Describe household activities in relation to Other Livelihood Activity (not agriculture or tourism):
Activity? Main reason? (money | consumption | other) Income earned through activity? Notes:
1.
2.
3.
4.
5.
6.
7.
 
 
 
19. Main benefits from activity (not agriculture or tourism)? [list three maximum]
   
 
 
 
20. Main challenges with activity (not agriculture or tourism)? [list five maximum]
   
 
 
21. What external resources do you have access to that support your activity (not agriculture or tourism)?
What support? When, how often? Views on this service:
Government
Development Partner / Donor
Private Sector
Other
 
 
 
22. What do you think could be done better by you to improve your livelihood outcomes (not agriculture or tourism)?
   
 
 
 
23. What do you think could be done better by others to improve your livelihood outcomes (not agriculture or tourism)?
   
 
 
24. Describe household activities in relation to Employment
Where is the household member employed? What do they do? How much do they earn? Notes:
1.
2.
3.
4.
5.
6.
7.
 
 
 
25. Main benefits from employment? [list three maximum]
   
 
 
 
26. Main challenges with employment
   
 
 
27. Does any family member living and working in NCD or other provinces of PNG send money to you?
Location of relative: How much money do they send? How often do they send money? How do they get the money to you?
1.
2.
3.
4.
5.
6.
7.
 
 
 
28. What do you think could be done better to improve employment opportunities for your household?
   
 
 
 
SECTION D: HOUSEHOLD ASSETS
 
 
 
29. What type of house is this? [Record from observation]
 
Traditional material
 
Permanent material
 
Combination of both
 
 
 
30. What is the main source of drinking water for this household?
 
Rainwater
 
Well with pump
 
Well with no pump
 
Natural water source
 
Other (specify)
 
 
 
 
31. Does the household pay for the water?
 
Yes
 
No
 
Don’t know
 
 
 
32. How much does the household pay for the water, on average, each month (K)
   
 
 
 
33. What kind of toilet facility does your household have?
 
Flush toilet
 
Modern pit latrine
 
Traditional pit latrine
 
Over the lake/river
 
Bush
 
Other (specify)
 
 
 
34. Does your household have any of the following durable goods?
Quantity How old?
Television
Radio
Stove
Mobile phone
Vehicle/Car
Generator
Sewing machine
Other 1
Other 2
Other 3
Other 4
Other 5
 
 
 
35. How much kina does this household receive on average over a fortnight, from all sources?
 
Don’t know
 
Less than K100
 
Between K100 - K500
 
Between K501 - K1,000
 
More than K1,000
 
 
 
36. How much kina does your household spend on average each fortnight?
 
Don’t know
 
Less than K100
 
Between K100 - K500
 
Between K501 - K1,000
 
More than K1, 000, specifiy amount
 
 
 
 
37. What were the main areas of your household expenditure over the past 12 months?
Rank most the main household expenses as first (1st), second (2nd), third (3rd), fourth (4th) and fifth (5th)
Rent
Food
Compensation
Medical costs
Education/school fees, uniforms
Water
Transport
Electricity
Loan/debt repayment
Customary obligations (funerals, celebrations, bride price, etc)
Other household expenses
Alcohol or tobacco
Clothing, shoes
Other
 
 
37 (b). Specify if "Other" selected above
   
 
 
38. List the types of skills members of the household have at the current moment?
# of household members with this skill
Farming
Trade (carpentry, welding, bricklaying, electrics, mechanic, heavy machinery...)
Administration (management, computing, clerk, sales jobs)
Facilitation (church worker, community worker, politics)
Business (trade stores...)
Other
 
 
38b. Specify if "Other" selected above:
   
 
 
 
39. What is the highest qualification in the household?
 
Post graduate – Masters, Phd
 
Graduate - degree
 
Diploma
 
Grade 12
 
Grade 10
 
Grade 8
 
Lower than Grade 8
 
 
 
40. Do you or anyone in the household have a bank account?
 
Yes
 
No
 
Don’t know
 
 
 
41. Has this person used the bank account in the last three months to deposit or withdraw money?
 
Yes
 
No
 
Don’t know
 
 
 
42. Does this household have a savings or investment fund or plan?
 
Yes
 
No
 
Don’t know
 
 
 
SECTION E: PHYSICAL ENVIRONMENT AND SOCIO-CULTURAL INFLUENCES
 
 
43. Are your household members part of any Community Organisation? (eg Sports group or church group or business group?
Name of Group Purpose of Group Hours spent with Group per month
1.
2.
3.
4.
5.
 
 
 
44. Which of these community services does your household benefit most from?

Rank most the benefited services as first (1st), second (2nd), third (3rd) fourth (4th) and fifth (5th)
School
Health
Bank/microfinance
Market and retail stores
Post office/ telecommunication
Law and justice service
Housing
Electricity
Education
Roads and bridges
Boat/dingy/PMV services
Water and sewage supply
None
 
 
45. How many of the following events did you have in the last year?
How many times in last year? How much money did this household spend on these events?
Bride price
Funeral
Peace ceremonies / compensation event
Other
 
 
 
46. What are one or two of your dreams for the young boys in the house when they grow up?
   
 
 
 
47. What are one or two of your dreams for the young girls in the house when they grow up?