Survey : Page : 1 Ipsos_Synovate TANZANIA

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1 Location/Eneo SAUTI ZA WANANCHI 2012 Main household questionnaire 02 OCT SERIAL NO... FIELD SERIAL... Region/Mkoa District/Wilaya Ward/Kata Constituency/Jimbo Village/street/Kijiji/Mtaa Enumeration Area/Eneo la udadisi Household number/ Namba ya kaya... Unique Household Number Namba ya kipekee ya kaya Enumeration Area Code Nambari ya eneo la udadisi Household number Nambari ya kaya GPS Coordinates / Kipimo cha dira: ( iandikwe kutoka kwenye simu ya ideos) Latitude/Latitudo... Longitude/Longitudo... Setting/Eneo Rural/Kijijini Degree/Nyuzi Min/Dakika Sec/Sekunde Urban/Mjini Survey : Page : 1

2 Respondent Details/ Maelezo ya mhojiwa Respondents Name/Jina la mhojiwa... Respondents Common Name/Jina maarufu la mhojiwa... Type of Household / Aina ya kaya TYPE OF INTERVIEW HOUSEHOLD/ AINA YA KAYA YA MAHOJIANO Original Household/Kaya iliyochaguliwa kwanza Substitute household/ Kaya mbadala Control household/kaya ya kudhibitisha Treatment household/kaya ya utafiti Data Collection Team/Timu ya Kukusanya Takwimu Enumerator Name/Jina la mdadisi Enumerator Code/Nambari ya mdadisi... Supervisors Name/Jina la msimamizi Supervisor Code/Nambari ya msimamizi... Quality Checks/ Kuhakiki ubora Checks/Kuhakiki... Accompanied/Ambatana... Back Checked/Kurudi katika kaya... Office Editor/Mhakiki ubora wa ofisi... Data Entry/Uingizaji wa data... Yes/Ndiyo No/Hapana NAME/JINA Code/Namba D D D D D D D D D D / / / / / Date/Tarehe M M Y Y Y Y / M M Y Y Y Y / M M Y Y Y Y / M M Y Y Y Y / M M Y Y Y Y / Fill after completing the interview /jaza baada ya kukamilisha mahojiano Respondent mobile number/namba ya mhojiwa ya simu ya mkononi Prefered line/laini unayopendelea zaidi... Alternative line/laini mbadala... New line provided to respondent if any/ Laini mpya ya simu aliyopewa muhojiwa kama amepewa... Survey : Page : 2

3 INTERVIEW VISIT/MATEMBEZI YA MDADISI Record in 24 hours/ andika kwa masaa 24 Visits/Matembezi First Visit/Matembezi ya kwanza... Second Visit/ Matembezi ya pili... Third Visit/ Matembezi ya tatu... Date Month Year Time/Muda Tarehe Mwezi Mwaka Day of the week/ D D M M Y Y Y Y Siku ya wiki H H M M / / : D D M M Y Y Y Y H H M M / / : D D M M Y Y Y Y H H M M / / : Total Number of Visits/Jumla ya Idadi ya Matembezi... Results Code/Namba ya matokeo 1.Interview completed/mahojiano yamekalimika... First Visit/ Matembezi ya kwanza Second Visit/ Matembezi ya pili Third Visit/ Matembezi ya tatu 2.No household member at household even after 3rd Visit/Hakuna mtu kwenye kaya hata baada ya kutembelea kaya mara tatu... 3.Postponed/Imeahirishwa... 4.Selected Respondent is deaf or dumb or couldn t speak in the language of the interview/mhojiwa ni ni kiziwi au bubu au hawezi kuzungumza kwa lugha ya utafiti... 5.Refused to be interviewed/alikataa kuhojiwa... 6.Respondent was not at household after 3rd Visit/Mhojiwa hakuwepo kwenye kaya hata baada ya kutembelea kaya mara tatu... 7.Other Specify/Nyingine (elezea) INTERVIEWER DESCRIBE LOCATION OF HOUSEHOLD HERE/MHOJI ELEZEA MAHALI KAYA ILIPO Identity landmark next Household Survey : Page : 3

4 Introduction at the Household/Utambulisho kwenye kaya Good Morning / Good Afternoon/ Good Evening. My name is...from Ipsos Synovate an independent market and social research firm. Ipsos Synovate has been commissioned to carry out the Sauti ya wananchi by Twaweza, a not for profit organization that seeks to enhance information availability to the public. The voices of the citizens is the first nationwide mobile phone survey in Tanzania. Your household has been randomly selected to participate in this exercise Habari za asubuhi/mchana/jioni.jina langu ni..kutoka Ipsos Synovate ambayo ni kampuni binafsi inayoshugulika na utafiti wa masoko na maswala ya jamii. Ipsos Synovate imepewa jukumu la kukusanya takwimu za utafiti wa Sauti za Wananchi na asasi isiyo ya kiserikali itwayo Twaweza. Twaweza inakusudia kuboresha upatikanaji wa taarifa miongoni mwa jamii. Utafiti wa Sauti za Wananchi ni wa kwanza wa kukusanya takwimu kwa njia ya simu za mkononi nchini Tanzania. Kaya yako imechaguliwa kushiriki katika utafiti huu kwa njia ya bahati nasibu. SELECTION OF A RESPONDENT AT THE HOUSEHOLD/UCHAGUZI WA MHOJIWA KWENYE KAYA First, I need to randomly select one adult household member who i will talk to. Kindly give me the first names and ages of all household members aged 18 years and above who are living here at the moment. Let us start with the oldest to the youngest /Kwanza,nahitaji kuchagua mtu mzima mmoja kwenye kaya hii ambaye nitazungumza nae. Naomba uniambie majina na umri wa wanakaya wenye umri wa miaka 18 na zaidi wanaoishi kwenye hii kaya. Tafadhali anza na mwenye umri mkubwa zaidi kushuka chini. SELECTION OF ADULT RESPONDENT FOR INTERVIEWING. NOW SELECT AN INDIVIDUAL RESPONDENT TO INTERVIEW ACCORDING TO KISH GRID/UCHAGUZI WA MHOJIWA AMBAYE NI MTU MZIMA SASA CHAGUA MHOJIWA KUTOKANA NA JEDWALI LA KISH List all qualifying adults aged 18 years and above. Start with the oldest and work down to the youngest/orodhesha watu wazima wote wenye umri wa miaka 18 na zaidi.anza na mwenye umri mkubwa mpaka mdogo. 1.Take the last digit of the questionnaire number and find the same number in the top line of the Kish Grid below/chukua namba ya mwisho kwenye namba ya dodoso na tafuta namba kama hiyo kwenye mstari wa juu wa jedwali la Kish. 2.Drop a line along this column/shusha mstari unaoendana nao. 3.Look along the row of the last person in the list. Circle the number where the two lines intersect /Angalia kwenye mstari wa mtu wa mwisho kwenye orodha. Zungushia namba pale mistari miwili inapokutana 4.Where this meets the column of the last digit of the questionnaire number, is the number of the person on the list to be interviewed. /Ambapo inakutana na mstari wa tarakimu ya mwisho ya namba ya dodoso,ndio namba ya mtu kwenye orodha atakayehojiwa 5.Ask to speak to the person on the list whose number is the same as the one you have taken out of the Kish Grid./Omba kuzungumza na mtu aliye kwenye orodha ambaye namba yake ni sawa na namba uliyochukua kwenye jedwali la Kish 6.If that person is not at home, YOU MUST arrange to call a second time and a third time to interview that individual./kama hayupo nyumbani,hakikisha unapanga kumtembelea mara ya pili na mara ya tatu. 7.Record call details on the interviewer visit table./rekodi matokeo ya matembezi haya kwenye jedwali la matembezi ya mdadadisi. Survey : Page : 4

5 Names of household members aged 18 years and above/ Majina ya wanakaya wenye umri wa miaka 18 na zaidi LAST DIGIT ON QUESTIONNAIRE NUMBER/TARAKIMU YA MWISHO KWENYE DODOSO Age/Umri Total No. of adults household/jumla ya watu wazima kwenye kaya... INTERVIEWER INSTRUCTIONS. /MAELEKEZO YA MHOJI ONCE YOU HAVE SELECTED THE RESPONDENT, REINTRODUCE YOURSELF AND THE EXERCISE TO HIM OR HER IF THEY ARE DIFFERENT FROM THE FIRST CONTACT RESPONDENT/UKISHAMCHAGUA MHOJIWA, JITAMBULISHE NA UTAMBULISHE ZOEZI ZIMA TENA KAMA MTU HUYU NI TOFAUTI NA MTU ULIOKUTANA NAYE MARA YA KWANZA. Name of Selected Adult Respondent/Jina la mhojiwa mtu mzima aliyechaguliwa SCREENING THE RESPONDNET S1. Is (INSERT NAME OF RESPONDENT) in the household at the moment?/je mhojiwa (WEKA JINA LA MHOJIWA) yupo nyumbani muda huu? Yes/Ndiyo No/Hapana Survey : Page : 5

6 S2. Is (INSERT NAME OF THE RESPONDENT) Tanzanian?/Je mhojiwa (WEKA JINA LA MHOJIWA)ni mtanzania? Yes/Ndiyo... No/Hapana... >CONTINUE/ENDELEA >Replace the respondent with another respondent in the household using the list of adult respondents in the household according to instructions on respondent replacement / Badilisha mhojiwa na mhojiwa mwingine kutoka kaya hii ukitumia orodha ya watu waliohitimu kwenye kaya kulingana na maelekezo ambayo umepewa ya kubadilisha mhojiwa. S3. Sometimes Tanzanians relocate to other districts, regions and countries in search for work or education. Does (INSERT NAME OF SELECTED RESPONDENT) intend to relocate within the next 6 months?/wakati mwingine watanzania wanahama kwenda kwenye wilaya,mikoa na nchi nyingine kutafuta kazi au elimu.je(weka JINA LA MHOJIWA ALIYECHAGULIWA) una mpango wa kuhama ndani ya miezi sita ijayo? Yes/Ndiyo No/Hapana >>>>Skip to S5/ Nenda S5 S4. Does the place he/she is relocating to have mobile network? Je sehemu anayo tarajia kuhamia ina mtandao wa simu za mkononi? Yes/Ndiyo No/Hapana >>>>>>>>>>Replace the respondent/ Badilisha Muhojiwa S5. INTERVIEWER OBSERVATION IS (INSERT NAME OF SELECTED RESPONDENT) the 1ST, 2ND, 3RD OR 4TH randomly selected respondent./mtazamo WA MHOJIWA.Je(JINA LA MHOJIWA ALIYECHAGULIWA) ni wa kwanza,pili,tatu au wanne katika watu waliochaguliwa bila mpangilio maalum? 1ST/KWANZA 2ND/PILI 3RD/TATU 4TH/NNE OTHERS SPECIFY/NYINGINE(ELEZEA) H H M M Start time/muda wa kuanza mahojiano... : Record in 24 hours/ Andika kwa masaa 24 Introduction to the Wananchi Survey /Utambulisho wa utafiti wa Wananchi [INSERT NAME OF THE RESPONDENT] you have been randomly selected to participate in an innovative data collection program known as the Voices of the Citizen. The survey has the potential to improve the availability of information to the public and contribute to the development of better public services and life in Tanzania. Voices of the citizens is divided into two phases, the first phase is known as the baseline survey in which we seek to collect data by having a face to face interview. This is what we are just about to do. The second phase of the voices of citizens is a bi weekly Mobile Phone survey. Immediately after the interview, we will call a number at our call center based in Dar es Salaam, Tanzania. The importance of this initial contact is to verify network connection at your household or close to your household and in case the network connection is not clear we will then move to a location where the network signal will be clearer. In the mobile phone survey our team at call center in Dar es Salaam will call you and interview you between 1 to 4 times a month fo two (2) years, the interview will last between 15 to 20 minutes and there after we will send a [INSERT AMOUNT ACCORDING TO THE INCENTIVE CATEGORY] shillings airtime recharge to your mobile phone. The questions that we will ask you in the mobile phone survey will be more less the same as the questions that we ask you in the interview we are about to start. We expect that sometimes the responses will be reported on websites, radio, TV or newspapers. I would like to assure you that nobody will ever know what your responses were and you will never be identified in any way as a participant in the survey. The reports might say for example, 90% of Tanzania s are not connected to the Nation Electric grid. No personal information will ever be shared. I have given you highlights of the Wananchi Survey, are you willing to participate in this survey? Survey : Page : 6

7 (WEKA JINA LA MHOJIWA) umechaguliwa kushiriki katika utafiti wa kipekee unaoitwa Sauti za Wananchi. Utafiti huu una malengo ya kuboresha upatikanaji wa habari kwa jamii na kuchangia kwenye maendeleo ya huduma bora na maisha bora Tanzania. Sauti za Wananchi imegawanywa katika sehemu mbili. Sehemu ya kwanza inajulikana kama taarifa za awali ambapo tunajaribu kukusanya taarifa kwa kutumia mahojiano ya ana kwa ana. Hii ndiyo tunaenda kuifanya sasa. Sehemuya pili ni Mahojiano mafupi kwa njia ya simu kila baada ya wiki mbili. Baada tu ya kumaliza mahojiano, tutapiga simu ofisi zetu za Dar es salaam, Tanzania..Umuhimu wa hii ni kuhakikisha kwamba tunapata mawasiliano tukiwa karibu na kaya yako na kama hatutatapata mawasiliano na ofisi yetu, tutasogea sehemu ambapo mawasiliano yatakuwa yanapatikana vizuri. Katika utafiti wa njia ya simu ya mkononi, timu yetu iliyo Dar es salaam itakupigia simu na kukuhoji mara moja kwa kila wiki mbili kwa muda wa miaka miwili. Mahojiano yatakuwa ya dakika 15 hadi 20 na baada ya hapo tutatuma kiasi cha [WEKA KIASI CHA MOTISHA KULINGANA NA KIASI KITAKACHO TOLEWA ] ya muda wa maongezi kwenye simu yako.maswali tutakayokuuliza kwenye simu yatakuwa yanafanana na maswali ambayo tutakayokuuliza kwenye mahojiano ambayo tunayaanza. Tunategemea wakati mwingine majibu yatakuwa yanaripotiwa kwenye tovuti, redio, runinga au magazeti. Ningependa kukuhakikishia kwamba hakuna mtu atakayejua majibu yako na hautajulikana kwa njia yoyote kama mshiriki wa huu tafiti. Ripoti inaweza kusema kwa mfano Asilimia 90 ya watanzania hawajaunganishwa na gridi ya umeme ya taifa.hakuna taarifa ya mtu binafsi itakayotolewa. Nimeshakuelezea kwa ufupi utafiti wa Wananchi, Je upo tayari kushiriki? Yes/Ndiyo... No/Hapana... >THANK THE RESPONDENT AND CONTINUE/MSHUKURU MHOJIWA NA ENDELEA >THANK THE RESPONDENT AND PICK ANOTHER HOUSEHOLD ACCORDING TO INSTRUCTIONS GIVEN. RECORD REASONS FOR REFUSAL IN REFUSAL SHEET/MSHUKURU MHOJIWA NA CHAGUA MWANAKAYA MWINGINE KULINGANA NA MAELEKEZO. NAKILI SABABU ZA KUKATAA KATIKA SHEET YA WALIOKATAA I am about to start the first phase of the Baseline questionnaire. Do you want to ask me anything about voice of the citizens? [INTERVIEWER POSE FOR QUESTIONS] May I begin now? Disclaimer: Sometimes in Household surveys people are not well informed about some of the household related activities for example the health of a child, in such cases feel free to call in any other household member who is well informed to help you in responding to household activities that you are not very much familiar with. Karibu naanza sehemu ya kwanza ya dodoso la awali. Una swali lolote kuhusu sauti za wananchi? (MHOJI TULIA KWA MASWALI) Ninaweza kuanza sasa? ANGALIZO : Wakati mwingine katika tafiti za kaya,watu hawana taarifa kamili za baadhi ya vitu vya kaya kama afya ya mtoto.katika hali kama hiyo,kuwa huru kumuita mwanakaya mwingine ambaye ana taarifa kamili akusaidie katika kujibu shughuli za kaya ambazo hauzifahamu vizuri. Survey : Page : 7

8 SECTION 1: LIST OF HOUSEHOLD MEMBERS/SEHEMU 1:ORODHA YA WANAKAYA Household Member Number/Namba ya mwanakaya Whenever you are asked to write the household list number besides a name, we refer to this number/unapoulizwa kuandika namba ya mwanakaya katika orodha pembeni ya jina,rejea namba hii Qn 1.1.Name of household member/jina la mwanakaya PROBE: Make sure the name of the respondent is put down first, followed by the other household members starting from the oldest to the youngest./dadisi:hakikisha jina la mhojiwa linaandikwa kwanza likifuatiwa na jina la mwanakaya mwingine kuanzia mkubwa mpaka mdogo Qn 1.2.Gender/.Jinsia (1 Male/Me 2 Female/Mwanamke) Qn 1.3.Relationship to head of household/uhusiano na mkuu wa kaya 1 Head of household/ mkuu wa kaya 2 Partner/Mwenza 3 Child of head of household/mtoto wa kiongozi wa kaya 4 - Child of partner/mtoto wa mwenza 5 - Grandchild / partner s grandchild/mjukuu/mjukuu wa mwenza 6 - Parent or partner s parent/mzazi au mzazi wa mwenza 7 - Other relative/ndugu wengine 8 domestic servant/msaidizi wa kazi za ndani 9 - Other, not related/mwingine,hatuna undugu Qn 1.4.Age/Umri (enter exact age/weka umri kamili) Qn 1.5.Marital status/hali ya ndoa 1 Not married/hajaolewa/oa 2 Married/Ameolewa/oa 3 Divorced/Ametalakiana 4 Separated/Wametengana 5 Widow(er)/Mjane/mgane 6 Living together, unmarried/wanaishi pamoja bila ndoa Qn 1.6 What was the main occupation of [name] for the past 12 months (for those above 7 years old)/ Je kazi kuu ya (JINA) kwa miezi 12 iliyopita(kwa WALE WALIO NA UMRI WA ZAIDI YA MIAKA 7) 1 Farming/lifestock/Ukulima/ufugaji 2 Fishing/Uvuvi 3 Mining/Uchimbaji wa madini 4 Tourism/Utalii Employee/ Mwajiriwa 5 Government/ Serikalini 6 Parastatal/ Shirika la uma 7 Private company/ kampuni binafsi 8 NGO / religion/taasisi isiyo ya serikali/ dini self employed (not farming)/ Kajiajiri (sio kilimo) 9 Employs other workers/ameajiri wafanyakazi wengine 10 Works alone/anafanya peke yake 11 Unpaid family helper/msaidizi wa familia asiyelipwa 12 Paid family helper/ Msaidizi wa familia anayelipwa Others/ Nyingine 13 Searching for job / anatafuta kazi 14 Student/mwanafunzi 15 incapable of working/ hana uwezo wa kufanya kazi 16 Unemployed and not looking for work/ hajajiriwa na hatafuti kazi 17- House wife/mama wa nyumbani 18 Other/nyingine Survey : Page : 8

9 Qn. 1.7.Highest Level of schooling (grade) completed by (name)?/je ni kiwango kipi cha juu cha elimu alichowahi kusoma na kumaliza (JINA) 1 -Has not attanined school going age/hajafikisha umri wa kwenda shule 2 no schooling/ Hakuenda shule 3 Nursery school/elimu ya awali 4 grade1/darasa la grade2/darasa la 2 6 grade3/darasa la 3 7 grade4/darasa la 4 8 grade5/darasa la 5 9 grade6/darasa la 6 10 grade7/darasa la Technical school/shule za ufundi10 form1/kidato cha 1 12 form2/kidato cha 2 13 form3/kidato cha form4/kidato cha 4 15 form5/kidato cha 5 16 form6/kidato cha 6 17 College / chuo 18 - university first year/chuo kikuu mwaka wa kwanza 19 university second year/chuo kikuu mwaka wa pili 20 - university 3rd year/chuo kikuu mwaka wa tatu 21 - University year 4&5/chuo kikuu mwaka wa 4&5 22 second university degree(masters Degree)/Shahada ya pili ya chuo kikuu 23 other, specify/nyingine,elezea Qn 1.8.What is [name] religion?/je (JINA) ni dini gani? 1-Muslim/Muislam 2- Christian ( Roman catholic)/mkristu mkatoliki 3-Christain (Protestant)/Mkristu mprotestanti 4- Hindu/ Dini ya kihindi 5- African Traditionist/Dini ya asili 6- Aerthist-Pagani 7-Others/Nyingine Qn 1.9 Does [name] own his/her own mobile pone/je (JINA) ana simu yake binafsi ya mkononi?(1 Yes/Ndiyo 2 No/Hapana) Qn 1.10 Is (Name) the selected respondent?/je (Jina ) ndiye muhojiwa aliye chaguliwa?(1 Yes/Ndiyo 2 No/Hapana) Survey : Page : 9

10 Household Member Number/ Namba ya mwana kaya Qn 1.1.Jina la mwanakaya../dadisi:hakikisha jina la mhojiwa linaandikwa kwanza likifuatiwa na jina la mwanakaya mwingine kuanzia mkubwa mpaka mdogo. Qn1.2..Jinsia 1 Mume 2 Mke 1 2 Qn1.3 Uhusiano na mkuu wa kaya Qn 1.4 Umri andika 00 kama ni chini ya mwaka 1 Qn 1.5 Hali ya ndoa Qn1.6. Kazi kuu Qn. 1.7 Kiwango cha juu cha elimu Qn1.8. Dini Qn 1.9 Ana Simu ya mkononi 1 /Ndiyo 2 Hapana Qn 1.10 ndiye alikuwa mhojiwa Survey : Page : 10

11 SECTION 1.1: LIST OF CHILDREN(ASK CHILDREN BETWEEN 6 AND 16 YEARS)/SEHEMU 1.1:ORODHA YA WATOTO(ULIZA WATOTO WENYE UMRI KATI YA MIAKA 6-16) -Copy names from list of household members, i.e. names of all those aged between 6 years and 16 years)/andika majina kutoka kwenye orodha ya wanakaya wenye umri wa kati ya miaka 6 hadi 16 -Number on the list of HH Members/Namba kwenye orodha ya wanakaya -Age (Enter exact age as per QN 1.4)/Umri(Ingiza umri kutokana na swali 1.4) Qn 1.11.Does (name) go to school?/je(jina) anaenda shule? 1 Yes/ndiyo 2 No /Hapana >> GO TO NEXT LINE/NEXT NAME/ NENDA KWA MTOTO ANAYEFUATA Qn1.12.What class is (name) currently enrolled in?/je(jina) yupo darasa la ngapi? 1 Nursery school/elimu ya awali 2 grade1/darasa la grade2/darasa la 2 4 grade3/darasa la 3 5 grade4/darasa la 4 6 grade5/darasa la 5 7 grade6/darasa la 6 8 grade7/darasa la 7 9 form1/kidato cha 1 10 form2/kidato cha 2 11 form3/kidato cha form4/kidato cha 4 13 form5/kidato cha 5 14 form6/kidato cha 6 Qn 1.13.Which kind of school does (name) go to? Is it (READ OUT RESPONSES)/Je (jina) anasoma shule ya aina gani?ni (SOMA MAJIBU) 1 Government or publicly run/shule ya serikali/umma au inayo endeshwa na umma 2 Ward/Kata 3 Private/Binafsi Qn 1.14.What type of school does (name) go to? Is it day or boarding school?/je (jina) anasomea shule ya aina gani?ni ya kutwa au ya bweni? 1 Day school/kutwa 2- Boarding school/bweni QN 1.15.Does (name) receive tuition or attend extra classes, other than the ones provided at school/je (jina) anahudhuria masomo ya ziada (tuition)? 1 yes/ndiyo 2 no/hapana Qn 1.16 Normally, how does (name) get to school.read OUT/ Kwa kawaida (jina) anaendaje shule?msomee 1 Walking/anatembea 2 Bicycle/baiskeli 3 School bus/basi la shule 4 Public bus/usafiri wa jamii 5 Guardian s / parent s car/gari la mzazi 6 Transport organised by parents or guardians group/usafiri uliopangwa na wazazi Qn.1.17.How long does it take (name) to get to school from home? (including waiting time)record IN MINUTES//Inamchukua muda gani (jina) kufika shule kutoka nyumbani (pamoja na muda wa kusubiri)? REKODI KWA DAKIKA Survey : Page : 11

12 Andika majina kutoka kwenye orodha ya wanakaya wenye umri wa kati ya miaka 6 hadi 16 Namba kwenye orodha ya wanakaya QN 1.4) /Umri(Ingiza umri kutokana na swali 1.4) Qn1.11./Je(JINA anaenda shule? 1 Ndiyo 2 Hapana >> NENDA KWA MTOTO ANAYEFUATA Qn1.12. Je (JINA) yupo darasa la ngapi? Qn 1.13 Je (jina) anasoma shule gani?ni (SOMA MAJIBU) 1 /Shule ya serikali/umma 2 /Kata 3 Binafsi Qn 1.14 Je (jina) anasomea shule ya aina gani?ni ya kutwa au ya bweni? 1 Shule ya kutwa 2- Shule ya bweni QN 1.15 Je (jina) anahudhuria masomo ya ziada (tuition)? 1 Ndiyo 2 Hapana Qn 1.16 Kwa kawaida (jina) anaendaje shule?mso MEE Qn.1.17 Inamchukua muda gani (jina) kufika shule kutoka nyumbani (pamoja na muda wa kusubiri)? REKODI KWA DAKIKA Survey : Page : 12

13 SECTION1.3: LIST OF CHILDREN (ASK CHILDREN AGED 5 YEARS AND BELOW)LIST THE NAMES OF THE CHILDREN AGED 5 YEARS AND BELOW, THEN ASK THE SELECTED RESPONDENT TO EITHER CALL THE MOTHER OR CARE GIVER TO THE CHILDREN LISTED/SEHEMU 1.3: ORODHA YA WATOTO. (ULIZA WATOTO WENYE MIAKA 5 NA CHINI)ORODHESHA MAJINA YA WATOTO WENYE UMRI WA MIAKA 5 KWENDA CHINI,HALAFU MUOMBE MHOJIWA AMUITE MAMA AU MTU ANAYEWAANGALIA WATOTO WALIOORODHESHWA -Copy names from list of household members, i.e. names of all those aged 5 years and below) )/Andika majina kutoka kwenye orodha ya wanakaya wenye umri wamiaka 5 kwenda chini -Number on the list of HH Members/Namba kwenye orodha ya wanakaya -Qn 1.18 What year and month was (name) born in?/ Je ni mwaka gani na mwezi gani (JINA) alizaliwa? -Qn 1.19 Did (name) sleep under a bed net last night, was the bed net treated? /Je (JINA) alilala ndani ya chandarua usiku wa jana. Na je hicho chandarua kimewekwa dawa? 1- Yes-bednet treated/ Ndiyo- chandurua chenye dawa 2. Yes bed net not treated / Ndiyo- chandurua bila dawa>>skip to Qn.1.21 /NENDA SWALI LA No/Hapana>>skip to Qn.1.21/NENDA SWALI LA Don't Know / Sijui >>>> SKIP TO Qn 1.21/ NENDA SWALI LA Qn Was the net a insecticide treated net or a long life insecticide net?/chandarua kilikua kimewekewa dawa ya muda mfupi au kina dawa ya muda mrefu? 1-ITN/kimewekewa dawa ya muda mfupi 2-LLIN/dawa ya muda mrefu 3-Dont know/ Sijui -Qn 1.21.ASK FOR VACCINATION CARD Record how many times (name) recieved a DPT Vaccination based on vaccination card or parents recollection/ OMBA KADI YA CHANJO rekodi ni mara ngapi (jina) amepata chanjo ya DPT kwa kutumia kadi ya chanjo au kumbukumbu za mlezi 1-DPT1 (4wks)/ Wiki 4 2-DPT 2 (8wks)/ Wiki 8 3-DPT 3(12 wks)/ wiki 12 4.Can`t remember/siwezi kukumbuka -Qn 1.22 when was the last time (name) was vaccinated against measles? RECORD IN MONTHS /Ni lini (jina) alipewa chanjo ya surua kwa mara ya mwisho? ANDIKA KWA MIEZI -Qn 1.23 When was the last time (Name) received Vitamin A? RECORD IN MONTHS /Ni lini (jina) alipokea vitamin A mara ya mwisho? ANDIKA KWA MIEZI -Qn 1.24When was the last time (name) dewormed?record IN MONTHS /Ni lini mara ya mwisho (jina) alipewa dawa ya minyoo? ANDIKA KWA MIEZI -Qn 1.25 ONLY MEASURE THOSE CHILDREN WHO ARE 5 BELOW AND YEARS conduct anthropometric measurement ( Record colour on anthropometry tape)/pima WATOTO WENYE UMRI WA MIEZI 6 HADI MIAKA 5. Pima kipimo cha anthropometry (rekodi rangi kwenye mkanda wa anthropometry 1 = red area/nyekundu 2 = yellow area/njano 3 = green area/kijani -Qn 1.26 conduct anthropometric measurement( Record the size of the circumference as indicated on the anthropometry tape) RECORD IN CM/Fanya kipimo cha anthropometry (rekodi saizi ya mzingo kama ilivyoelekezwa kwenye mkanda wa anthropometry)rekodi KATIKA SM Survey : Page : 13

14 Andika majina kutoka kwenye orodha ya wanakaya wenye umri wamiaka 5 kwenda chini /Namba kwenye orodha ya wana kaya Qn 1.18.Je ni mwaka gani na mwezi gani (JINA) alizaliwa? Qn 1.19 /Je (JINA) alilala ndani ya chandarua usiku wa jana. Na je hicho chandarua kimewekwa dawa? Qn chandarua kina dawa ya muda mfupi au ya muda mrefu? Qn1.21Ni mara ngapi (jina) amepata chanjo ya DPT hawezi kukumbuka Qn 1.22 Ni lini (jina) alipewa chanjo ya surua kwa mara ya mwisho? ANDIKA KWA MIEZI Qn Ni lini (jina) alipokea vitamin A mara ya mwisho? ANDIKA KWA MIEZI Qn Ni lini mara ya mwisho (jina) alipewa dawa ya minyoo? ANDIKA KWA MIEZI Qn 1.25.kipimo cha anthropo metry Qn1.26. /kipimo cha anthropo metry month mwezi year mwaka DPT1 DPT2 DPT3 Can`t remember/ dk/nr/sijui sikumbuki dk/nr/sijui sikumbuki dk/nr/sijui sikumbuki Survey : Page : 14

15 SECTION 1. B: GENERAL LITERACY ASK ALL/ULIZA WOTE 1.27.This may sound very basic to you, but this is just a routine question for us and I will appreciate your cooperation. Please read each question on this card out loud to me and write the answer to each. If you are unable to read please tell me. It is okay and I understand. Maswali mengine yanaweza kuonekana ya kawaida sana. Haya ni baadhi ya maswali tunayouliza katika utafiti huu. Naomba ushirikiano wako. Tafadhali nisomee maswali yote kwenye kadi hii kwa sauti na uniandikie jibu kwa kila swali. Hebu tuanze na swali la kwanza. Ikiwa huwezi kusoma niambie tu na usione ugumu nitaelewa. SHOW CARD GL 1 (KISWAHILI SHOW CARD). DO NOT HELP THE RESPONDENT TO READ SHOW CARD GL 1: KISWAHILI SHOW CARD i) Je unaitwa nani? ii) Je unapenda chakula gani? iii) Shule iliyopo karibu na nyumbani kwenu inaitwaje? SHOW CARD GL 2 (ENGLISH SHOW CARD). DO NOT HELP THE RESPONDENT TO READ SHOW CARD GL 2: ENGLISH SHOW CARD i) How old are you? ii) Do you own a car? iii) What is the name of the health centre closest to your home? SINGLE ANSWER PER LANGUAGE Can read and write the answers/anaweza kusoma na kuelewa... Kiswahili English Can read but cannot write the answer to the question/ Anaweza kusoma lakini hawezi kuandika jibu la swali... Cannot read or write answer to the question/ Hawezi kusoma wala kuandika... Refused to read/amekataa kusoma... Survey : Page : 15

16 1.28.Which languages do you speak and understand? Whih other? MULTIPLE RESPONSES. Je lugha gani unazoziongea na kuzielewa? Nyingine? MAJIBU MENGI 1.29.Which languages do you write in? Which other? MULTIPLE RESPONSES. Je lugha gani ambazo unaweza kuziandika? Nyingine? MAJIBU MENGI 1.30.Which language do you speak most frequently at home? SINGLE RESPONSE Ni lugha gani unayoongea mara nyingi zaidi ukiwa hapa nyumbani?jibu MOJA 1. Swahili English Kisukuma Arabic Other Specify)/Nyingine fafanua DK/NR /'Sijui/hakuna jibu... Cannot write/hawezi kuandika SECTION 2: HOUSEHOLD ASSETS/: MALI ZA KAYA Qn 2.1 & Qn2.2 How many [ITEMS] does your household own? [IF NONE WRITE '0'] Swali 2.1na 2.2 Ni...(jina la kifaa)ngapi kaya hii inamiliki? (KAMA HAMNA ANDIKA 0 ) code Radio and Radio Cassette/redio yenye kaseti Telephone(landline)/Simu ya mezani Telephone(mobile)/Simu ya mkononi Refrigerator or freezer/jokofu Sewing Machine/Cherehani Television/Runinga Video / DVD/Video/Deki Chairs/Viti Sofas/Makochi Tables/Meza Watches/Saa... Number/Idadi Survey : Page : 16

17 code Number/Idadi 412 Beds/Vitanda Cupboards, chest-of-drawers, boxes, wardrobes, bookcases/makabati Lanterns/ Taa ya chemli Computer/Kompyuta Cooking pots, cups, jars and pans/sufuria, vikombe, vyombo vya kuhifadihia bidhaa nfano sukari, kikaangio Mosquito net/chandarua Iron (Charcoal or electric)/pasi(ya mkaa au umeme) Electric/gas stove/jiko la umeme au gesi Other stove/majiko mengine Water-heater/Kifaa cha kuchemsha maji Record/cassette player, tape recorder/kifaa ya kurekodi mikanda(deki ya kurekodi) Complete music system/muziki mkubwa Books (not school books)/vitabu ( ambavyo sio vya shule) Motor Vehicles/Magari Motor cycle/pikipiki Bicycle/Baiskeli... Qn Carts/Mkokoteni Animal-drawn cart/mkokoteni wa mnyama Boat/canoe/Boti/mtumbwi Wheel barrow/toroli Livestock/Wanyama(mifugo) Poultry/Mifugo(ndege) Outboard engine/injini ya boti ambayo inatolewa Donkeys/Punda Fields/Land/Kiwanja/shamba... Survey : Page : 17

18 code 437 House(s)/Nyumba Fan/Air conditioner/feni Dish antenna/decoder/antenna ya ungo Hoes/Majembe Spraying machine/pampu ya kunyunyizia dawa Water pumping set/mashine ya kuvuta maji Reapers/kifaa cha kuvunia Tractor/Trekta Trailer for tractors etc./trela la trekta Plough etc./mashine ya kulima /jembe la kukokotwa Harrow/ Jembe la kusawazicha ardhi Milking machine/mashine ya kukamua maziwa Harvesting and threshing machine/mashine ya kuvunia Hand milling machine/mashine ya mkono ya kukoboa au kusaga au kukamua Coffee pulping machine/mashine ya kubangulia kahawa Fertilizer distributor/mashine ya kusambaza mbolea... Number/Idadi SECTION 3: INFORMATION ABOUT HOUSING SITUATION/SEHEMU 3:TAARIFA KUHUSU KAYA Qn 3.1.Does the household live in this location during the whole year/je kaya inaishi kwenye eneo hili kwa mwaka mzima? 1- Yes/Ndiyo... >SKIP TO 3.3/RUKA HADI No/Hapana... >CONTINUE/ENDELEA Qn 3.2.If not whole year, how many months of the year does the household live here/kama sio mwaka mzima,ni miezi mingapi wanakaya wanaishi kwenye nyumba hii? 1 6 months or more/miezi sita au zaidi 2 less than 6 months/chini ya miezi sita Survey : Page : 18

19 Qn 3.3.Does the household occupy a compound with more than one buildings/houses?/je kaya inamiliki eneo lenye zaidi ya nyumba au jengo moja? 1- Yes/Ndiyo 2 No/Hapana Qn 3.4.How many habitable rooms does this household occupy including the sitting room? / Kaya ina vyumba vya kulala vingapi ikijumulisha sebule? (WRITE THE NUMBER OF ROOMS)DO NOT COUNT BATHROOMS, TOILETS, STOREROOMS, OR GARAGE/(ANDIKA IDADI YA VYUMBA)USIHESABU MABAFU,VYOO,STOO AU GEREJI Qn 3.5.I would like to know the household tenure status of main residence? Who owns this building?/ningependa kujua umiliki wa makazi makuu, Je nani anamiliki hili jengo? 1.Owner occupied/anamiliki mwenyewe 2.Employer provided - subsidized/amepewa na mwajiri kwa makato madogo 3.Employer provided - free/amepewa bure na mwanjiri 4.Rented/ Imepangwa 5.Free/bure 6.Nomads /Makazi ya muda (wanahama hama) 7.Other, specify/nyingine(elezea) Qn 3.6.What are the walls of the main building made of?/kuta za jengo kuu zimetengenezwa kwa kutumia nini? 1 concrete, cement, Stone/zege,saruji,mawe 2 branches, poles, grass, mud/majani,udongo,matawi ya miti 3 baked/burnt mud bricks/matofali ya kuchoma ya udongo 4 unbaked mud bricks /matofali yasiyo ya kuchoma ya udongo 5 timber/mbao 6 metal sheets/mabati 7 other, specify:/nyingine(elezea) Qn 3.7.What is the roof of the main building made of?/paa la nyumba linatengenezwa kwa nini? 1 - metal sheets /Mabati 2 - asbestos sheets/ Mabati ya asbestos 3 grass, leaves, bamboo/majani/mianzi/nyasi 4 mud & grass/majani na udongo 5 tiles/vigae 6 concrete/cement/zege,saruji 7 other, specify/nyingine,elezea Survey : Page : 19

20 Qn 3.8.What is the floor of this household made of? [Observation or ask respondent]/sakafu ya nyumba imetengenezwa na nini?(tazama au muulize mhojiwa) 1-Earth/ sand/ dung/ardhi/mchanga/kinyesi cha ng'ombe 2- Cement/saruji 3- Tiled/Malumalu/vigae 4-Wood Planks/mbao 5-Others, specify/nyingine,elezea Qn 3.9.Is this building connected to the national electric grid system or to a local network?/jengo hili limeunganishwa na umeme wa grid ya taifa au mtambo wa umeme? 1 Yes/Ndiyo... >CONTINUE/ENDELEA 3 No, but generator is used/hapana ila jenereta linatumika... >SKIP TO Q3.11/RUKA HADI Q No/Hapana... >SKIP TO Q3.11/RUKA HADI Q No, but solar power is used/hapana ila nishati ya jua inatumika... >SKIP TO Q3.11/RUKA HADI Q3.11 Other specify/nyingine fafanua >SKIP TO Q3.11/RUKA HADI Q3.11 Qn 3.10.IF THE ANSWER FOR Q 3.9 IS YES, how many days during last 7 days did the power cut?/kama JIBU LA SWALI 3.9 NI NDIYO; Ni siku ngapi katika siku 7 zilizopita umeme ulikatika?(write NUMBER OF DAYS BETWEEN 0-7)/ANDIKA IDADI YA SIKU KATI YA 0-7 Qn 3.11.During the rainy season, is this building affected by the water (flooding)?/wakati wa mvua,hili jengo linaathiriwa na mafuriko? 1 No/hapana 2 Yes, sometimes during heavy rains/ndiyo,wakati mwingine kukiwa na mvua kubwa 3 Yes, most times when it rains/ndiyo,mara nyingi mvua ikinyesha SECTION 4: WATER AND SANITATION/SEHEMU 4: MAJI NA USAFI WA MAZINGIRA Qn 4.1.Please confirm if we are currently in the dry season in your community (village / street)?/tafadhali niambie kama kipindi hiki ni kipindi cha kiangazi katika eneo hili 1 yes /Ndiyo 2 no/hapana Don't Know/Sijui Survey : Page : 20

21 I would like us to discuss more about your sources of drinking water during the dry season I would like you to focus on household drinking water during dry season// Ningependa tujadiliane zaidi kuhusu vyanzo vya maji vya kaya hii kipindi cha kiangazi.ningetaka tuangalie maji ya kunywa moja kwa moja wakati wa kiangazi Qn 4.2.What is the household's main source of drinking water in the dry season?/ni kipi chanzo kikuu cha maji ya kunywa kwenye kaya hii kipindi cha kiangazi? Tap water (private)/maji ya bomba 1 - piped water inside household dwelling/maji ya bomba ndani ya nyumba 2 - private outside standpipe/tap/maji ya bomba nje ya nyumba Water collected by household members (public)/maji yanayochotwa na wanakaya 3 - Public standpipe/tap.3/bomba la maji la jamii,/ umma/ jumuiya ya kijiji 4 - neighbour s tap/bomba la maji la jirani 5 hand- or foot pump/pampu ya mguu au mkono 6 protected dug well/kisima cha kuchimbwa kilicho funikwa/kilicho jengewa 7 unprotected (open) dug well/kisima cha wazi cha kuchimba 8 spring/chemi chemi 9 surface water: lake, pond, river/maji ya ardhini/ziwa,bwawa,mto 10 rain wáter/maji ya mvua Water delivered /Maji yanayoletwa 11- Water vendor/wauza maji 12-water truck/tanker service/maji yanayobebwa na kusambazwa na magari au bajaji 13 other, specify/nyingine(elezea) Qn 4.3.How satisfied are you in terms of the quality of wáter from main source during the dry season (taste, smell, color, etc)? Would you say---- READ /Ni kwa kiasi gani unaridhika na ubora wa maji ya kunywa kutoka kwenye chanzo kikuu wakati wa kiangazi (ladha, harufu, rangi nk). Unaweza kusema ----MSOMEE 1. Very satisfied/nimeridhika kabisa 2. Somewhat satisfied/nimeridhika kiasi 3. Somewhat unsatisfied/sijaridhika kiasi 4. Very unsatisfied/sijaridhika kabisa Survey : Page : 21

22 Qn 4.4.What do you normally do if any to make water from this source safe for drinking?/ kwa kawaida huwa unafanya nini kufanya maji kutoka kwenye chanzo hiki kuwa salama kwa kunywa? USIMSOMEE 1 Boiling/ kuchemsha 2-Add chemical trietment/kuweka dawa mf. water guard 3-Sieving/ kuyachuja 4-Other specify /Nyingine fafanua Qn 4.5.During the dry season, do you use an alternative source for drinking water besides your main source?/kipindi cha kiangazi, Je unatumia chanzo mbadala cha maji ya kunywa zaidi ya chanzo chako kuu? 1 yes/ndiyo... >CONTINUE/ENDELEA 2 no/hapana... >GO TO Q4.9/NENDA SWALI 4.9 Qn 4.6.What is the household's alternative source of drinking water in the dry season?/ni chanzo gani mbadala cha maji ya kunywa katika kaya hii kipindi cha kiangazi? SINGLE RESPONSE/ JIBU MOJA Tap water (private)/maji ya bomba 1 - piped water inside household dwelling /maji ya bomba ndani ya nyumba 2 - private outside standpipe/tap / Maji ya bomba nje ya nyumba/ kaya Water collected by household members (public)/maji yanayochotwa na wanakaya (jamii) 3 - Public standpipe/tap/bomba la maji la umma/jamii/jumuiya/kijiji 4 - neighbour s tap/bomba la maji la jirani 5 hand- or foot pump/pampu ya miguu/mkono 6 protected dug well/kisima cha kuchimba ambacho kimefunikwa 7 unprotected (open) dug well/kisima cha wazi cha kuchimba 8 spring/chemi chemi 9 surface water: lake, pond, river/maji ya ardhini,ziwa,bwawa,mto 10 rain wáter/maji ya mvua Water delivered /Maji yanawoletwa 11- Water vendor/wauza maji 12-water truck/tanker service/maji yanayochotwa na kusambazwa na magari/ bajaji 13 other, specify/nyingine(elezea) Survey : Page : 22

23 Qn 4.7.How satisfied are you in terms of the quality of this alternative source of wáter during the dry season (taste, smell, color, etc)? Would you say...read / Ni kwa kiasi gani unaridhika na ubora wa maji kutoka kwenye chanzo hiki mbadala cha maji ya kunywa kipindi cha kiangazi (ladha, harufu, rangi nk). Unaweza kusema ----MSOMEE 1. Very satisfied/nimeridhika kabisa 2. Somewhat satisfied/nimeridhika kiasi 3. Somewhat unsatisfied/sijaridhika kiasi 4. Very unsatisfied/sijaridhika kabisa Qn 4.8.What do you normally do if any to make water from this source safe for drinking?/ kwa kawaida huwa unafanya nini kufanya maji kutoka kwenye chanzo hiki kuwa salama kwa kunywa? 1 Boiling/ kuchemsha 2-Add chemical trietment/kuweka dawa nf. water guard 3-Sieving/ kuchuja 4-Others specify /Nyingine fafanua Now I would like to continue talking about your main source of drinking water that is (READ OUT DRINKING WATER SOURCE MENTIONED IN Qn 4.2)/Ningependa kuendelea kuzungumzia chanzo chako kikuu cha maji ya kunywa ambacho ni (SOMA CHANZO CHA MAJI YA KUNYWA KILICHOTAWA KATIKA SWALI 4.2) ulichonitajia Qn 4.9.Do you use this source as your main drinking water source during the rainy season too?/je unatumia chanzo hiki kama chanzo kikuu cha maji ya kunywa kipindi cha mvua? 1 yes/ndiyo... >GO TO Q 4.11/NENDA SWALI no/hapana... >CONTINUE/ENDELEA Qn 4.10.If you use a different main source for drinking water during the rainy season, which one?/kama unatumia chanzo kingine cha maji kipindi cha mvua,ni kipi? Tap water (private)/maji ya bomba 1 - piped water inside household dwelling/maji ya bomba ndani ya nyumba 2 - private outside standpipe/tap/ Maji ya bomba nje ya nyumba/ kaya Water collected by household members (public)/maji yanayochotwa na wanakaya (jamii) 3 - Public standpipe/tap./bomba la maji la umma/jamii/jumuiya/kijii 4 - neighbour s tap/bomba la maji la jirani 5 hand- or foot pump/pampu ya mi guu/mikono 6 protected dug well/kisima cha kuchimba ambacho kimefunikwa 7 unprotected (open) dug well/kisima kilichochibwa kilicho wazi 8 spring/chemi chemi 9 surface water: lake, pond, river/maji ya ardhini,ziwa,bwawa,mto 10 rain wáter/maji ya mvua Water delivered /Maji yanayoletwa 11- Water vendor/wauza maji 12-water truck/tanker service/maji yanayochotwa na kusambazwa na magari au bajaji 13 other, specify/nyingine(elezea) Survey : Page : 23

24 Qn 4.11.For non-drinking purposes, which source do you mainly use/kwa matumizi ambayo sio ya kunywa,ni chanzo kipi huwa unatumia? Tap water (private)/maji ya bomba 1 - piped water inside household dwelling/maji ya bomba ndani ya nyumba 2 - private outside standpipe/tap/maji ya bomba nje ya nyumba/ Kaya Water collected by household members (public)/maji yanayochotwa na wanakaya (jamii) 3 - Public standpipe/tap/bomba la maji la umma/jamii/kijiji/jumuiya 4 - neighbour s tap/bomba la maji la jirani 5 hand- or foot pump/pampu ya miguu/mikono 6 protected dug well/kisima cha kuchimba ambacho kimefunikwa 7 unprotected (open) dug well/ Kisima kilichochibwa kilicho wazi 8 spring/chemi chemi 9 surface water: lake, pond, river/maji ya ardhini,ziwa,bwawa,mto 10 rain wáter/maji ya mvua Water delivered /Maji yanayoletwa 11- Water vendor/wauza maji 12-water truck/tanker service/maji yanayo sambazwa kwenye magari au bajaji 13 other, specify/nyingine(elezea) SKIP INSTRUCTION/ MAELEKEZO YA KURUKA MASWALI ENUMERATOR REFER TO QUESTION (Qn 4.2: What is the main source of water this household uses for drinking?)/ Depending on the answer to Qn 4.2, ask the appropriate questions from the sections MDADISI REJEA KWENYE SWALI LA 4.2:Ni chanzo kipi kikuu cha maji kaya hii inatumia kwa kunywa. Kulingana na majibu ya hili swali, uliza maswali yanayoendana. TAP WATER / MAJI YA BOMBA (CODE 1-2) >>>>>>>ASK/ULIZA Q WATER COLLECTED BY HOUSEHOLD MEMBERS MAJI YANAYOCHOTWA NA WANAKAYA (CODE3-10) >>>>>>>>>>>>>>>>>>>>>>> ASK/ULIZA Q WATER DELIVERED / MAJI YANAYOLETWA (Code 11-12) >> ASK/ULIZA Q Survey : Page : 24

25 TAP WATER: IF THE SOURCE IS TAP WATER INSIDE THE BUILDING OR TAP WATER IN THE BUILDING PLOT, ANSWER THE FOLLOWING QUESTIONS/MAJI YA BOMBA:KAMA CHANZO NI BOMBA NDANI YA JENGO AU ENEO LA KAYA,JIBU MASWALI YAFUATAYO Qn 4.12.Who supplies you with tap water? Nani anakusambazia maji ya bomba? 1 Zonal/Regional Water body eg DAWASCO, MUWASA,/mamlaka ya maji ya kanda mf Dawasco,Muwasa 2 Other Government bodies/mashirika mengine ya serikali 3 Private company/kampuni binafsi 4 NGO/ Taasisi isiyo ya kiserikali 5 Church, Mosque, religious org/ /Kanisa,msikiti,shirika la kidini 6. community project/ Mradi wa jamii 7. Own bore hole /Kisima changu binafsi 8 Other specify/nyingine elezea Qn 4.13.For the past 7 days, how many days did water flow from your tap? /Kwa siku 7 zilizopita,ni siku ngapi maji yalitoka kwenye bomba?tick THE RESPECTIVE NUMBER/TIKI NAMBA HUSIKA 0 days/siku 0 4 days/siku 4 1 day/siku 1 5 days/siku 5 2 days/siku 2 6 days/siku 6 3 days/siku 3 7 days/siku 7 Qn 4.14.When tap water is available, for how long does the water flow normally last in a day or a night?/wakati maji ya bomba yanatoka,huwa yanakuwa kwa muda gani ukijumuisha mchana na usiku? 1 less tan 1 hour/chini ya saa moja hours/saa hours/saa more than 12 hours/zaidi ya saa 12 Survey : Page : 25

26 Qn 4.15.What is the size of the container/bucket you collect tap water in? / Je, ndoo au chombo unachochotea maji mara kwa mara kutoka kwenye bomba kina ujazo wa kiasi gani? (write number of liters)/andika namba za ujazo kwa lita Just open the tap/ nafungulia bomba tu Use different containers /Anatumia vyombo mbalimbali Qn 4.16a.How many of these containers/buckets did you collect/fetch/store the last day you collected water?/ni vyombo au ndoo ngapi ulichota siku ya mwisho ulipoweka/ kuchota maji? (write number of buckets)/andika idadi ya ndoo >>>Skip to QN 4.17/ Nenda Q 4.17 Just open the tap/ Nafungulia bomba tu Use different containers /Anatumia vyombo mbalimbali Qn 4.16b.If using different containers.how many litres of water did you collect/fetch the last day you collected water?/kama unatumia vyombo mbalimbali.ni lita ngapi za maji ulichota /teka siku ya mwisho ulipoteka /kuchota maji? 4.16c. If Just open a tap" What is the estimate amount of water you use per day/ Kama anafungua bomba tu" kwa kukadiria ni lita ngapi za maji unatumia kwa siku? Estimated amount of water (in litres) used per day/ Kiasi cha maji kinacho tumika kwa siku (kwa lita) Qn 4.17.What is the cost of this water per container/bucket? /Gharama ya maji kwa kila ndoo chombo ni kiasi gani?(write AMOUNT IN TSHS)/ANDIKA KIASI KATIKA TSHS Pay a monthly bill/nalipa Ankara ya maji kwa mwezi... Don t pay for wáter(free)/silipi maji (bure)>>skip to q4.37/ruka hadi swali la 4.37 Qn Is a water metre installed? If yes does the meter work?/ Je umefungiwa mita ya maji? Kama ipo, je inafanya kazi? 1 yes, and it works/ndiyo na inafanya kazi 2 - yes, but it doesnt work/ndiyo ila haifanyi kazi 3 no/hapana Qn 4.19.How often do you receive water bills from your water supplier? Ni mara ngapi unapokea bili/ Ankara ya matumizi ya maji kutoka msambazaji wako wa maji? 1 every month/kila mwezi... >CONTINUE/ENDELEA 2 once every several months/mara moja kila miezi kadhaa... >CONTINUE/ENDELEA 3 no fixed intervals of billing/hamna muda maalumu wa kupokea bili/ankara.. >CONTINUE/ENDELEA 4 - never received a bill even once/sijawahi kupokea bili hata mara moja..... >SKIP TO QN 4.37/RUKA HADI QN Water is free/ Maji ni bure... > SKIP TO QN 4.37/RUKA HADI QN 4.37 Qn To what extent would you rate the accuracy of the last water bill? Would you say it was-----read OUT?/ Unaweza kuthaminishaje usahihi wa bili ya maji ya mwisho uliyopokea? Unaweza kusema -----MSOMEE 1 not correct/sio sahihi... >CONTINUE/ENDELEA 2 fairly accurate/sahihi kiasi... >CONTINUE/ENDELEA 3 very accurate/sahihi Kabisa... >GO TO Q.4.23/NENDA Q DONT READ/USISOME Don t know/sifahamu... >GO TO Q.4.23/NENDA Q4.23 Survey : Page : 26

27 Qn 4.21.Did you file a complaint?/je ulipeleka malalamiko yako? 1 yes/ndiyo... >CONTINUE/ENDELEA 2 no/hapana... > GO TO Q.4.23a/NENDA Q4.23a Qn 4.22.To what extent would you say your complaints were addressed.would you say...(read SCALE)/Ni kwa kiasi gani unaweza kusema malalamiko yako yalishughulikiwa.unaweza kusema...msomee 1 very well/vizuri sana 2 well/vizuri 3 Poorly/vibaya 4- very badly/vibaya sana Qn 4.23a.Can you show me your last bill?/unaweza kunionesha ankara/bili ya maji ya mara ya mwisho? 1.Yes, shown/ndiyo,imeoneshwa... >CONTINUE/ENDELEA 2.No, can't find or refused/hapana,siioni au amekataa... >SKIP TO QN 4.23c/RUKA MPAKA SWALI 4.23c Qn 4.23b.RECORD INFORMATION FROM BILL/REKODI TAARIFA KUTOKA KWENYA ANKARA D D / Date/tarehe TSH/kiasi katika tshs Units/ kiasi>> ikiwa na point andika kiasi kamili M M Y Y Y Y / Fixed bill/bili ya kiwango fulani Qn 4.23c Do you sell tap water to other people?je unauza maji ya bomba kwa watu wengine? Yes/Ndiyo No/Hapana >>>>Skip to q4.37/nenda 4.37 Qn 4.23d At how much do you sell the container./je unauza chombo bei gani? Container/chombo Litre/ujazo Cost/Bei SKIP TO Q 4.37 /NENDA Q4.37 WATER COLLECTED BY HOUSEHOLD MEMBERS.(QUESTION 4.2 CODE 3-10):/MAJI YANACHOTWA NA WANAKAYA(SWALI LA 4.2 NAMBA 3-10) if household members collect water themselves from a public water point, answer the following questions./kama wanakaya wanachota maji kutoka katika sehemu ya jamii,jibu maswali yafuatayo Q4.24.Who in your household is the person responsible for collecting water? /Nani katika kaya yako anajukumu la kuchota maji?multiple RESPONSES/MAJIBU MENGI 1- house maid/mfanyakazi wa ndani 2 - male children/watoto wa kiume 3 female children/watoto wa kike 4 both male and female children /watoto wa kiume na wa kike 5 male head of household/ Mkuu wa kaya wa kiume 6 Wife to HH/ Female head of household/ mke wa mkuu wa kaya/ mkuu wa kaya wa kike 7 other household member, specify/wanakaya wengine,elezea Survey : Page : 27

28 Qn 4.25.How long does it take to get water from drinking water source to this dwelling in the dry season? /Inachukua muda gani kuchota maji kutoka kwenye chanzo cha maji ya kunywa mpaka kwenye kaya kipindi cha kiangazi? CLARIFY: GO AND RETURN TRIP INCLUDE WAITING TIME /FAFANUA: MUDA WA KWENDA NA WA KURUDI PAMOJA NA MUDA WA KUSUBIRI Minutes/dakika... Qn 4.26.Out of these [READ] minutes, how long did you spend waiting the last time you went? / Kati ya hizi dakika (SOMA) ni muda gani ulitumia kungoja kuteka maji mara ya mwisho ulipoenda kuteka maji? Minutes/dakika... Qn 4.27.How long do you spend waiting with water scarcity?/ Kipindi cha uhaba wa maji kwa kawaida unatumia muda gani kusubiria kuchota maji? Minutes/dakika... Qn 4.28.What type of container do you use mostly to transport the water in? [ENUMERATOR ASK TO SHOW IT]/Unatumia chombo gani mara nyingi kubebea maji?(mdadisi OMBA KUONESHWA) Single response/jibu moja 1 bucket/container with wide opening (not covered)/ndoo/chombo chenye mdomo mkubwa (isiyo na kufuniko) 2 plastic bucket/container with wide opening (covered)/ndoo ya plastiki au chombo chenye mdomo mkubwa (yenye kifuniko) 3 - jerrycan/container with narrow opening/chombo chenye mdomo mdogo/ dumu Qn 4.29.ENUMERATOR ESTIMATE: What is the size of the container/bucket used for water transport?/mdadisi KADIRIA:Ndoo/chombo kinachotumika kwa ajili ya kubebea maji kina ujazo gani? (litres)/lita... Qn 4.30.How many of these containers did your household collect the last day you collected water? / Mara ya mwisho kaya hii kuchota maji ni ndoo au vyombo vingapi mlichota? (number of containers)/idadi ya vyombo... Qn 4.31.Normally how much do you pay per container / bucket?/ Kwa kawaida huwa unalipa kiasi gani cha fedha kwa kila ndoo/chombo? (Tshs per bucket)/kiasi gani kwa kila ndoo/chombo... Free/ Silipi chochote Qn 4.32.On a day with water scarcity, how much do you pay per bucket?/kwa siku za uhaba wa maji,unalipa kiasi gani kwa kila ndoo/chombo?.. (Tshs per bucket )/Kiasi gani kwa kila ndoo/chombo... Free/ Silipii chochote SKIP TO QUESTION 4.37/RUKA HADI SWALI LA 4.37 Survey : Page : 28

29 WATER TANKER TRUCK OR WHEEL BARROW/GARI LA MAJI AU MKOKOTENI AU BAJAJI If the household gets water through water tanker truck or wheelbarrow, ask the following questions/kama kaya inapata maji kutoka kwenye gari la maji au toroli, uliza maswali yafuatayo Qn 4.33.How many times in a month is wáter delivered to your house?/ni mara ngapi kwa mwezi maji yanaletwa nyumbani kwako? Qn 4.34.How is the water delivered?/je,ni usafiri gani unatumika kuleta maji? 1 by wheel barrow (in containers / buckets)/kwa toroli(kutumia dumu,vyombo) 2 by truck/kwa lori 3 by car /kwa gari 4. by Bajaji/ Tanka ya bajaji 5 other, specify/nyingine,elezea Qn 4.35.How many litres of water does your household receive per delivery?/ni lita ngapi za maji kaya yako inapokea kwa wakati mmoja? Qn 4.36.How much do you pay per delivery?/unalipa kiasi gani cha fedha unapo letewa maji? Free/ silipii chochote ASK ALL:STORAGE/ULIZA WOTE/UHIFADHI Qn 4.37.Do you store the drinking water you get from the main source? (If yes is it inside the house or outside)/je, unahifadhi maji ya kunywa unayotoa/pokea kutoka chanzo hiki kikuu? (Kama ndiyo ndani ya kaya aun je ya kaya) 1 yes, inside the house/ndiyo,ndani ya nyumba 2 yes, outside the house/ndiyo,nje ya nyumba 3 no/hapana IF NO CONTINUE WITH QN 4.44KAMA HAPANA,ENDELEA NA SWALI 4.44 Qn 4.38.What is the most important type of storage the household uses to store drinking water?/ni chombo kipi cha muhimu cha kuhifadhia maji ya kunywa yanayotumika na kaya? 1 plastic bucket (wide opening)/ndoo ya plastiki(mdomo mkubwa) 2-Plastic buckets with cover(wide opening)ndoo iliyofunikwa ya plastiki(mdomo mkubwa) 3 plastic jerry can (narrow opening)/dumu la plastiki(mdomo mdogo) 4 clay pot/chungu 5- Clay pot with cover/ Mtungi wenye mfuniko 6 other specify /nyingine,elezea Survey : Page : 29