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START TIME |____|____| : |____|____| KNOCK ON THE DOOR. GREET WITH A HANDSHAKE. ENDLINE Good morning/afternoon/evening, my name is ______and I come from an organization called IPA [SHOW CREDENTIAL]. We focus on administering studies about people’s opinions and general situation. We are administering a socioeconomic survey in this area. Could I ask you a few questions please?
FILTER 1. Does a woman who is a Mexican citizen and is between 18 and 60 years old live in this house? 1. YES 2. NO CONCLUDE 2. Who is the woman between 18 and 60 years old and Mexican citizen? 1. IF SHE SAYS IT’S HER SKIP TO #5 2. ANOTHER PERSON 3. Is she present? 1. YES ASK TO SPEAK TO HER AND SKIP TO #5 2. NO 4. At what time can I find her? (WRITE IN MILITARY TIME) BETWEEN |____|____| : |____|____| AND |____|____| : |____|____| Mon / Tues / Weds / Thurs / Fri / Sat / Sun Date |__|__|/|__|__|/|__|__|__|__| HOURS: MINUTES HOURS: MINUTES CIRCLE DAY(S) DD / MM / YYYY ONCE IN FRONT OF THE INFORMANT, ASK: 5. How old are you? |____|____| YEARS IF SHE IS LESS THAN 18 OR MORE THAN 60, ASK IF THERE IS ANOTHER WOMAN WHO IS MEXICAN AND BETWEEN 18 AND 60 LIVING IN THE HOUSE. IF THERE IS, RETURN TO #3; IF THERE IS NOT, CONCLUDE. 6. Are you Mexican? 1. YES 2. NO ASK IF THERE IS ANOTHER WOMAN WHO IS MEXICAN AND BETWEEN 18 AND 60 LIVING IN THE HOUSE. IF THERE IS RETURN TO #3; IF THERE IS NOT, CONCLUDE. 7. Do you have an economic activity or a business? This can be, for example, the sale of a product like cosmetics, clothes, or food, either through a catalogue, from a physical location or from your home, or any activity for which you receive some kind of income. 1. YES SKIP TO #10 2. NO 8. If you had money to start an economic activity or a business, would you do so in the next year? 1. YES SKIP TO #10 2. NO 9. If an institution were to offer you credit, would you consider taking it? 1. YES 2. NO ASK IF THERE IS ANOHER WOMAN WHO IS MEXICAN AND BETWEEN 18 AND 60 LIVING IN THE HOUSE. IF THERE IS, RETURN TO #3; IF THERE IS NOT, CONCLUDE.
10. READ THE “INFORMED CONSENT” CARD 11. Do you understand that you have the right to participate or not participate in the survey? 1. YES 2. NO EXPLAIN AGAIN AND ASK AGAIN 12. Do you agree to participate in the survey? 1. YES 2. NO CONCLUDE OR FIND ANOTHER WOMAN IN THE HOME WHO IS MEXICAN AND BETWEEN 18 AND 60 YEARS OLD. 13. What is your full name? How do you spell it? WRITE IN ALL-CAPS.
______FIRST NAME PATERNAL LAST NAME MATERNAL LAST NAME ENCUESTA:|__|__|__|__|__| Page 2
14. What is your complete address? WRITE IN ALL-CAPS. WRITE DESCRIPTION OF HOUSE IN CASE IT DOESN’T HAVE A NUMBER. Calle Avenida Andador Boulevard Callejón Calzada Carretera Cerrada Circuito Circunvalación Diagonal Privada Prolongación Otro SPECIFY ______STREET NAME ______EXT. NUM. INT. NÚM. BOROUGH DESCRIPTION ENCUESTA:|__|__|__|__|__| Page 3
1. PERSONAL CHARACTERISTICS AND HOUSEHOLD 1.1 What is your date of birth? ______/ ______/ ______(dd/mm/yyyy)]
1.2 What is your marital status? DON´T READ THE RESPONSE 1. Married 2. Common law marriage 3. Single (skip to 1.4) -99. NR 4. Divorced (skip to 1.4) 5. Widowed (skip to 1.4) 6. Separated (skip to 1.4)
1.3 Does your significant other currently live in the same house with you? 1. Yes 2. No -99. NR
1.4 Do you know how to read and write a message? 1. Yes 2. No -99. NR
1.5 What is the last level of school that you completed, if you ever attended school? (WAIT TO HEAR RESPONSE, AND CIRCLE THE OPTION THAT APPLIES) 1. Never attended school 5. Complete Middle School 9. Superior Technical Degree 2. Incomplete Primary School 6. Commercial or Technical Degree 10. Incomplete Bachelor’s Degree 3. Complete Primary School 7. Incomplete High School 11. Complete Bachelor’s Degree 4. Incomplete Middle School 8. Complete High School 12. Graduate Degree -99. NR
1.6 What do you primarily do? (CIRCLE ALL THAT APPLY) 1. Own business or economic activity 2. Employee 3. Retired or pensioned 4. Studies 5. Home-maker -99. NR 2. HOUSEHOLD Now, we are going to talk about your household. When I say “household” I am referring to all the people who normally live in this house. These people can be family members or not, who share food and contribute or make use of common resources (for example money, goods, etc.). It also includes people who are living away temporarily, such as children who are away studying or people who are away working but have the intention of returning.
2.1 Taking into account yourself and all members of this household, including small children and older adults, how many people live in your household? |___|___| PERSONS SURVEYOR: WHEN ANSWER IS “01”, SHE LIVES ALONE SKIP TO 3.1 2.2 Who is the head of household? 1. Me 3. My partner and I 5. Other relative (specify) ______-88. Doesn’t Know 2. Partner 4. Mother/Father 6. Other non-relative (specify) ______-99. NR
2.3 In your household, think of who makes the financial decisions and to what degree you participate in this decision-making. Would you say that you make all of the financial decisions, most, half, few, none of the financial decisions in your household? 1. All 2. Most 3. Half 4. Few 5. None -88. Doesn’t Know -99. NR
3. HEALTH 3.1 In general terms, how do you currently feel, health wise? (READ ALL OPTIONS OUT LOUD) 1. Very Good 2. Good 3. Regular 4. Bad 5. Very Bad -88. Doesn’t Know -99. NR ENCUESTA:|__|__|__|__|__| Page 4
4. HOUSEHOLD CHARACTERISTICS Now we’re going to talk about your principal house that is where you and the members of your family live most of the time. 4.1 In the last 2 years, have the members of this household made any changes to this house, such as painting or plastering the walls, changing the roof, laying new flooring, or building a new room? 1. Yes 2. No SKIP TO 4.3 -88. Doesn’t know SKIP TO 4.3 -99. NR 4.2 What change(s) was made to this house in the last 2 years? (CIRCLE ALL THAT APPLY) 1. Painted the interior or exterior of the house? 4. Laid new flooring? 2. Plastered the exterior or interior walls? 5. Built a new room? 3. Changed the roof? 6. Other home improvement? Specify: ______
4.3 During the last 30 days, due to lack of money or resources, how many nights did you or another member of this household go to bed hungry? |___| ___| Number of Nights -88. Doesn’t Know -99. NR
5. CHILDREN SURVEYOR: HOW MANY PEOPLE LIVE IN THIS HOUSEHOLD? ONE SKIP TO 6.1 MORE THAN ONE CONTINUE TO 5.1 Now I will ask you about the children in this household. When I talk about children, I don’t only refer to your own, but to any child who is a member of the household, such as nieces, nephews, and grandchildren.
5.1 How many children between 0 and 3 years old live in this household? (How old are they?) |___|___| Children -99. NR SKIP TO 5.2 IF YOU MARKED “00” Skip to 5.2
5.1.1 Of these children, how many are yours? |___|___| Children -99. NR 5.2 How many children between 4 and 17 years old live in this household? (How old are they?) |___|___| Children -99. NR SKIP TO 6.1 IF YOU MARKED “00” Skip to 6.1 5.2.1 Of these children, how many are yours? |___|___| Children -99. NR 5.3 From all the children in the household, how many currently attend school? |___|___| Children -88. Doesn’t Know -99. NR 5.4 From all the children in the household, how many work in an economic activity inside or outside the household, with or without pay, at least two hours a week? |___|___| Children -88. Doesn’t Know -99. NR 6. MIGRATION INSIDE AND OUTSIDE MEXICO 6.1 Did someone who used to live in this household leave in the last 2 years and hasn’t returned? 1. Yes 2. No Skip to 7.1 -88. Doesn’t Know Skip to 7.1 -99. NR Skip to 7.1 ENCUESTA:|__|__|__|__|__| Page 5
6.2 What was the main reason why these people left? 1. Work? 1. Yes How many? |__|__| PERSONS 2. No -88. DK -99. NR 2. Study? 1. Yes How many? |__|__| PERSONS 2. No -88. DK -99. NR 3. Personal Conflict? 1. Yes How many? |__|__| PERSONS 2. No -88. DK -99. NR 4. Got married? 1. Yes How many? |__|__| PERSONS 2. No -88. DK -99. NR 5. Other? 1. Yes How many? |__|__| PERSONS 2. No -88. DK -99. NR (Specify): ______
6.3 In the last 6 months, has your household received any support from any of these people? This type of support could be money or in- kind (things, objects, gifts) 1. Yes 2. No (skip to 7.1) -88. Doesn’t Know (skip to 7.1) -99. NR (skip to 7.1) 6.4 Approximately what is the value in money of the support that your household has received in the last 6 months from these people? $|____|____|____| , |____|____|____| 1. PESOS 2. DOLLARS -88. Doesn’t Know -99. NR $|____|____|____| , |____|____|____| 1. PESOS 2. DOLLARS
7. CONSUMPTION AND HOUSEHOLD ACTIVITIES
7.1 Thinking about two weeks ago, how much did your household spend on groceries that week, including food and other household items? $|____|____|____| , |____|____|____| 1. PESOS 2. DOLLARS -88. Doesn’t Know -99. NR $|____|____|____| , |____|____|____| 1. PESOS 2. DOLLARS
7.2 Now thinking about this last week, how much did your household spend on groceries this week, including food and other household items? $|____|____|____| , |____|____|____| 1. PESOS 2. DOLLARS -88. Doesn’t Know -99. NR $|____|____|____| , |____|____|____| 1. PESOS 2. DOLLARS
7.3 Thinking of the last week, how much did your household spend on…? REGISTER ZERO IF NOT CONSUMED
REGISTER ONE ANSWER PER CATEGORY DOESN’T NR QUANTITY KNOW
1. Tortillas (How many kilos did you buy?) $ |__|,|__|__|__| 1. PESOS 2. DOLLARS -88 -99 $ |__|,|__|__|__| 1. PESOS 2. DOLLARS
2. Milk and dairy products, such as cheese, yogurt, cream, and butter $ |__|,|__|__|__| 1. PESOS 2. DOLLARS -88 -99 $ |__|,|__|__|__| 1. PESOS 2. DOLLARS
3. Fruits and Vegetables $ |__|,|__|__|__| 1. PESOS 2. DOLLARS -88 -99 $ |__|,|__|__|__| 1. PESOS 2. DOLLARS
4. Beef, pork, or chicken $ |__|,|__|__|__| 1. PESOS 2. DOLLARS -88 -99 $ |__|,|__|__|__| 1. PESOS 2. DOLLARS
5. Fish, shrimp or other seafood $ |__|,|__|__|__| 1. PESOS 2. DOLLARS -88 -99 $ |__|,|__|__|__| 1. PESOS 2. DOLLARS
6. Cold cuts and sausages $ |__|,|__|__|__| 1. PESOS 2. DOLLARS -88 -99 $ |__|,|__|__|__| 1. PESOS 2. DOLLARS ENCUESTA:|__|__|__|__|__| Page 6
7. Sweets, chips, cupcakes, cookies and other products of this kind $ |__|,|__|__|__| 1. PESOS 2. DOLLARS -88 -99 $ |__|,|__|__|__| 1. PESOS 2. DOLLARS
8. Sodas (How many sodas did you buy?) $ |__|,|__|__|__| 1. PESOS 2. DOLLARS -88 -99 $ |__|,|__|__|__| 1. PESOS 2. DOLLARS
9. Cigarettes (How many packs or boxes did you buy?) $ |__|,|__|__|__| 1. PESOS 2. DOLLARS -88 -99 $ |__|,|__|__|__| 1. PESOS 2. DOLLARS
10. Food eaten outside the home (How many times did you eat out?) $ |__|,|__|__|__| 1. PESOS 2. DOLLARS -88 -99 $ |__|,|__|__|__| 1. PESOS 2. DOLLARS
11. Transportation, either for gas, bus fare, or taxis for the children $ |__|,|__|__|__| 1. PESOS 2. DOLLARS -88 -99 to go to school, to go to work, to do groceries, or other trips $ |__|,|__|__|__| 1. PESOS 2. DOLLARS
Now I would like to ask you about expenses on services for the household. REGISTER ZERO IF NOT CONSUMED 7.4 In the last month, how much did your household spend on …? REGISTER FREQUENCY OF EXPENSE QUANTITY DOESN’T NR (MINIMUM MONTHLY) KNOW 1. Electricity 1. MONTHLY 4. SEMESTER 2. BIMONTHY 5. ANNUAL $ |__|,|__|__|__| 1. PESOS 2. DOLLARS 3. TRIMESTER 6. OTHER (SPECIFY): -88 -99 ______
2. Water 1. MONTHLY 4. SEMESTER 2. BIMONTHY 5. ANNUAL $ |__|,|__|__|__| 1. PESOS 2. DOLLARS 3. TRIMESTER 6. OTHER (SPECIFY): -88 -99 ______
3. Gas 1. MONTHLY 4. SEMESTER 2. BIMONTHY 5. ANNUAL $ |__|,|__|__|__| 1. PESOS 2. DOLLARS 3. TRIMESTER 6. OTHER (SPECIFY): -88 -99 ______
4. Telephone 1. MONTHLY 4. SEMESTER 2. BIMONTHY 5. ANNUAL (landline and 3. TRIMESTER 6. OTHER (SPECIFY): $ |__|,|__|__|__| 1. PESOS 2. DOLLARS -88 -99 cellular phone) ______5. Cable 1. MONTHLY 4. SEMESTER 2. BIMONTHY 5. ANNUAL $ |__|,|__|__|__| 1. PESOS 2. DOLLARS 3. TRIMESTER 6. OTHER (SPECIFY): -88 -99 ______
6. Internet 1. MONTHLY 4. SEMESTER 2. BIMONTHY 5. ANNUAL $ |__|,|__|__|__| 1. PESOS 2. DOLLARS 3. TRIMESTER 6. OTHER (SPECIFY): -88 -99 ______
7.5 In the last 2 months, how much did your household spend on…? REGISTER ZERO IF NOT CONSUMED
REGISTER ONE ANSWER FOR EACH CATEGORY QUANTITY DOESN’T NR KNOW
ONLY ASK IF THERE ARE CHILDREN IN THE HOUSEHOLD $ |__|,|__|__|__| 1. PESOS 2. DOLLARS 1. Shoes and clothes for the children of the household (either new $ |__|,|__|__|__| 1. PESOS 2. DOLLARS -88 -99 or used or materials to make clothes), including uniforms
2. Shoes and clothes for the adult women of the household $ |__|,|__|__|__| 1. PESOS 2. DOLLARS -88 -99 (either new or used or materials to make clothes) $ |__|,|__|__|__| 1. PESOS 2. DOLLARS 3. Shoes and clothes for the adult men of the household (either $ |__|,|__|__|__| 1. PESOS 2. DOLLARS -88 -99 new or used or materials to make clothes) $ |__|,|__|__|__| 1. PESOS 2. DOLLARS ENCUESTA:|__|__|__|__|__| Page 7
8. SAVINGS 8.1 In the last 6 months, would you say the household expenses have been greater than, the same, or less than the income received during this period of time? 1. Greater 2. The same 3. Less (Skip to 9.1) -88. DK (Skip to 9.1) -99. NR 8.2 Do these expenses include the purchase of a house, car, a big investment or debt? 1. Yes 2. No (Skip to 9.1) -99. NR (Skip to 9.1) 8.3 Putting aside these expenses, in the last 6 months, would you say the rest of the household expenses have been greater than, the same, or less than the income received? 1. Greater 2. The same 3. Less -88. DK -99. NR
9. HOUSEHOLD ASSETS Now I would like to ask you about items that are found in your household. Let me remind you that your answers are confidential and will only be used for the purpose of this study.
9.1 In the last 2 years, have APPLY 9.3 AND 9.4 TO EACH CATEGORY WHERE ANSWER TO 9.1 WAS “YES” you or another member of 9.2 Was it in 2011 or this household, bought or 2010? 9.3 ONLY IF “BOUGHT”: 9.4 SOLO SI “VENDIÓ”: sold…? (Which item?) Did you take out a loan to pay for [ITEM]? Did you sell [ITEM] to pay an outstanding READ OPTIONS FIRST, THEN loan? MARK EACH ONE THAT IS ANSWERED “YES” 2011 2010 2011 2010 2011 2010
1. Furniture or 1. YES appliances such 2. NO 1. YES How 1. YES How 1. YES How 1. YES How -88. DK much did you BUY much did you BUY much did you SELL much did you SELL as mattress, -99. NR 1. BOUGHT 1. BOUGHT table, sofa, 2. SOLD 2. SOLD it for? it for? it for? it for? microwave, 3. BOTH 3. BOTH $ |__|__|,|__|__|__| $ |__|__|,|__|__|__| $ |__|__|,|__|__|__| $ |__|__|,|__|__|__| 1.PESOS 2.DOLLARS 1.PESOS 2.DOLLARS 1.PESOS 2.DOLLARS 1.PESOS 2.DOLLARS washing machine, 4. NEITHER 4. NEITHER -88. DK -99. NR -88. DK -99. NR -88. DK -99. NR -88. DK -99. NR refrigerator, 2.NO 2.NO 2.NO 2.NO water boiler, -88. DK -88. DK -88. DK -88. DK heater, cooler, -99.NR -99.NR -99.NR -99.NR etc.
2. Electronics, such 1. YES 1. YES How 1. YES How 1. YES How 1. YES How as television, 2. NO much did you BUY -88. DK much did you BUY much did you SELL much did you SELL radio/stereo, -99. NR 1. BOUGHT 1. BOUGHT it for? it for? it for? it for? cellular phone, 2. SOLD 2. SOLD $ |__|__|,|__|__|__| $ |__|__|,|__|__|__| $ |__|__|,|__|__|__| $ |__|__|,|__|__|__| computer, video 3. BOTH 3. BOTH 1.PESOS 2.DOLLARS 1.PESOS 2.DOLLARS 1.PESOS 2.DOLLARS 1.PESOS 2.DOLLARS -88. DK -99. NR -88. DK -99. NR -88. DK -99. NR -88. DK -99. NR console/game, 4. NEITHER 4. NEITHER 2.NO 2.NO 2.NO 2.NO DVD player, etc. -88. DK -88. DK -88. DK -88. DK -99.NR -99.NR -99.NR -99.NR
3. Motorized 1. YES 1. YES How 1. YES How 1. YES How 1. YES How vehicles such as 2. NO much did you BUY much did you BUY much did you SELL much did you SELL -88. DK motorcycle, car, -99. NR 1. BOUGHT 1. BOUGHT it for? it for? it for? it for? truck, or van? 2. SOLD 2. SOLD $ |__|__|,|__|__|__| $ |__|__|,|__|__|__| $ |__|__|,|__|__|__| $ |__|__|,|__|__|__| 3. BOTH 3. BOTH 1.PESOS 2.DOLLARS 1.PESOS 2.DOLLARS 1.PESOS 2.DOLLARS 1.PESOS 2.DOLLARS 4. NEITHER 4. NEITHER -88. DK -99. NR -88. DK -99. NR -88. DK -99. NR -88. DK -99. NR 2.NO 2.NO 2.NO 2.NO -88. DK -88. DK -88. DK -88. DK -99.NR -99.NR -99.NR -99.NR ENCUESTA:|__|__|__|__|__| Page 8
4. Jewelry 1. YES 1. YES How 1. YES How 1. YES How 1. YES How 2. NO much did you BUY much did you BUY much did you SELL much did you SELL -88. DK -99. NR 1. BOUGHT 1. BOUGHT it for? it for? it for? it for? 2. SOLD 2. SOLD $ |__|__|,|__|__|__| $ |__|__|,|__|__|__| $ |__|__|,|__|__|__| $ |__|__|,|__|__|__| 3. BOTH 3. BOTH 1.PESOS 2.DOLLARS 1.PESOS 2.DOLLARS 1.PESOS 2.DOLLARS 1.PESOS 2.DOLLARS 4. NEITHER 4. NEITHER -88. DK -99. NR -88. DK -99. NR -88. DK -99. NR -88. DK -99. NR 2.NO 2.NO 2.NO 2.NO -88. DK -88. DK -88. DK -88. DK -99.NR -99.NR -99.NR -99.NR
5. Property such as 1. YES 1. YES How 1. YES How 1. YES How 1. YES How another house 2. NO much did you BUY much did you BUY much did you SELL much did you SELL -88. DK besides this one, -99. NR 1. BOUGHT 1. BOUGHT it for? it for? it for? it for? construction, 2. SOLD 2. SOLD $ |__|__|,|__|__|__| $ |__|__|,|__|__|__| $ |__|__|,|__|__|__| $ |__|__|,|__|__|__| building, premise 3. BOTH 3. BOTH 1.PESOS 2.DOLLARS 1.PESOS 2.DOLLARS 1.PESOS 2.DOLLARS 1.PESOS 2.DOLLARS -88. DK -99. NR -88. DK -99. NR -88. DK -99. NR -88. DK -99. NR or piece of land? 4. NEITHER 4. NEITHER 2.NO 2.NO 2.NO 2.NO -88. DK -88. DK -88. DK -88. DK -99.NR -99.NR -99.NR -99.NR
6. Any other item 1. YES that has a value 2. NO -88. DK 1. YES How 1. YES How 1. YES How 1. YES How of more than -99. NR much did you BUY much did you BUY much did you SELL much did you SELL $2,000 pesos? 1. BOUGHT 1. BOUGHT it for? it for? it for? it for? (Specify item and 2. SOLD 2. SOLD $ |__|__|,|__|__|__| $ |__|__|,|__|__|__| $ |__|__|,|__|__|__| $ |__|__|,|__|__|__| value) 3. BOTH 3. BOTH 1.PESOS 2.DOLLARS 1.PESOS 2.DOLLARS 1.PESOS 2.DOLLARS 1.PESOS 2.DOLLARS 4. NEITHER 4. NEITHER -88. DK -99. NR -88. DK -99. NR -88. DK -99. NR -88. DK -99. NR ______2.NO 2.NO 2.NO 2.NO $|__|__|,|__|__| -88. DK -88. DK -88. DK -88. DK __| -99.NR -99.NR -99.NR -99.NR 1.PESOS 2.DOLLARS -88. DK -99. NR
10. INFORMATION ABOUT BUSINESSES
10.1 Now we will talk about businesses. How many businesses or economic activities do you currently have? It can be, for example, the sale of a product or food, either through catalogue, in an establishment or in your home. 1. |_____| BUSINESSES NONE Skip to 11.1 ENCUESTA:|__|__|__|__|__| Page 9 10.2 10.3 10.4 10.5 10.6 10.7 10.8 10.9 10.10
What type of business In the last 6 Talking about this business or Of these How Have you Now, thinking of the And thinking of the In the next 6 months, months, would economic activity, who helps do you have? people, many ever taken two weeks, how much two weeks, how would you (SURVEYOR: CHOOSE you say that this you? What is each person’s how people out a loan to money did you much did you predict that ONE OF THE particular relationship to you? approximately sell? this particular many do work full- improve or approximately spend CATEGORIES BASED ON business has REGISTER NUMBER OF PEOPLE BY business will ANSWER FOR EACH expanded, RELATIONSHIP. you pay time? to make a or invest in the expand, BUSINESS) contracted, or IF NO ONE HELPS HER, WRITE “00” for their part of your business or economic WRITE FIGURE IN contract, or 1. Corner Store stayed the IN BOX #1 AND SKIP TO 10.6 work? business activity? THE BOXES stay the same? WRITE 2. Food Vendor same? 1. PARTNER / SPOUSE grow, BELOW SILLAS 3. Vendor through 2. SON / DAUGHTER WRITE NUMBER including to Catalogue 3. BROTHER / SISTER NU 4. FATHER / MOTHER IN THE Please include the 4. Product Vendor MB buy 5. FATHER/MOTHER IN-LAW BOXES purchase of machinery through Store ER 6. GRAND FATHER/MOTHER materials 5. Arts/Crafts; Tailoring; BELOW or merchandise, the 7. BROTHER/SISTER IN-LAW IN with the Decorations; Fashion TH salary of employees 8. SON/DAUGTHER IN-LAW loan? 6. Beauty Salon 9. COUSIN E and other expenses 7. Child Care/Day Care 10. UNCLE / AUNT BO 8. Jewelry like electricity, water, 11. NEPHEW / NIECE XE 9. Services 12.GRAND SON/DAUGTHER etc. 10. Liquor Store 13.FRIEND S 11. Rental Services 14.NEIGHBOR BEL WRITE FIGURE IN 12. Other 15. EMPLOYEE, NOT A FRIEND O THE BOXES BELOW 16. OTHER PERSON W
BUSINESS / ACTIVITY PAST CODE FOR HELPERS PEOPLE PEOPLE CREDIT QUANTITY QUANTITY FUTURE
BUSINESS/ACTIVITY 1 1.EXPANDED 1.EXPAND ______$|__|__|,|__|__|__| $|__|__|,|__|__|__| 2.CONTRACTED 1. YES 2.REDUCE CATEGORY: |__|__ | 1.PESOS 1.PESOS 3. SAME |__|__|__| |__|__|__| 2. NO 2. DOLLARS 2. DOLLARS 3. SAME -88. DK -99. NR -88. DK -88. DK -88. DK -99. NO RESPONSE -99. NR -99. NR -99. NR -99. NR
BUSINESS/ACTIVITY 2 1.EXPANDED 1.EXPAND ______$|__|__|,|__|__|__| $|__|__|,|__|__|__| 2.CONTRACTED 1. YES 2.REDUCE CATEGORY: |__|__ | 1.PESOS 1.PESOS 3. SAME |__|__|__| |__|__|__| 2. NO 2. DOLLARS 2. DOLLARS 3. SAME -88. DK -99. NR -88. DK -88. DK -88. DK -99. NO RESPONSE -99. NR -99. NR -99. NR -99. NR
BUSINESS/ACTIVITY 3 1.EXPANDED 1.EXPAND ______2.CONTRACTED $|__|__|,|__|__|__| $|__|__|,|__|__|__| 1. YES 1.PESOS 1.PESOS 2.REDUCE CATEGORY: |__|__ | 3. SAME |__|__|__| |__|__|__| 2. NO 2. DOLLARS 2. DOLLARS 3. SAME -88. DK -99. NR -88. DK -88. DK -88. DK -99. NO RESPONSE -99. NR -99. NR -99. NR -99. NR
BUSINESS/ACTIVITY 4 1.EXPANDED 1.EXPAND ______2.CONTRACTED $|__|__|,|__|__|__| $|__|__|,|__|__|__| 1. YES 1.PESOS 1.PESOS 2.REDUCE CATEGORY: |__|__ | 3. SAME |__|__|__| |__|__|__| 2. NO 2. DOLLARS 2. DOLLARS 3. SAME -88. DK -99. NR -88. DK -88. DK -88. DK -99. NO RESPONSE -99. NR -99. NR -99. NR -99. NR ENCUESTA:|__|__|__|__|__| Page 10
10.11 If you have to make a decision on whether to take up a loan for your business, who do you consult? (READ OPTIONS OUT LOUD) 1. Spouse/partner 2. Other relative 3. Friend or acquaintance with business experience 4. Friend or acquaintance without business experience 5. TV 6. Radio 7. Other (Specify) ______8. Don’t consult any source -99. NR 11. BUSINESS EXPERIENCE SURVEYOR: HOW MANY BUSINESSES OR ECONOMIC ACTIVITIES DOES THE INFORMANT HAVE (QUESTION 10.1)? NONE (SKIP TO 11.1) ONE OR MORE (SKIP TO 11.2) 11.1 Did you used to have a business or economic activity before? 1. YES 2. NO (Skip to 12) -99. NR (Skip to 12) 11.2 For how long have you had (did you have) your latest (last) business or economic activity? 1. |__|__| YEARS 2. |__|__| MONTHS 3. |__|__| WEEKS 4. |__|__| DAYS -88. DK -99. NR
11.3 Do (Did) you keep, at any time, a written account of the money that you spend and receive for this business or economic activity? 1. YES 2. NO -99. NR 11.4 In what month and year did you start your first business? (Did you start it during the first or second half of the year? Did you start it before or after your birthday that year?) 1. MONTH |__|__| 2. YEAR |__|__|__|__| -88. Doesn’t Remember -99. NR 12. OVERALL SATISFACTION Now I would like to ask you about your general satisfaction with different aspects of your life. SHOW CARD 1 12.1 In general, how satisfied are you with ….? 1. VERY SATISFIED 2. SATISFIED 3. NEITHER SATISFIED NOR UNSATISFIED 4. UNSATISFIED 5. VERY UNSATISFIED 1. The life you lead …………………………………………………………………………………………………………….. |__| -88. DOESN’T KNOW -99. NR 2. Your household’s economic situation.…………………………………………………………………………….. |__| -88. DOESN’T KNOW -99. NR 3. Your access to financial services…………………………………………………………………………..………… |__| -88. DOESN’T KNOW -99. NR 4. Your sense of harmony with other (family, friends, neighbors) ………………….………….…….. |__| -88. DOESN’T KNOW -99. NR
SURVEYOR: DOES THE INFORMANT HAVE A BUSINESS OR ECONOMIC ACTIVITY? YES SKIP TO 12.3 NO SKIP TO 12.2 12.2 Have you worked in the last 30 days? YES SKIP TO 12.3 NO SKIP TO 13.1 ENCUESTA:|__|__|__|__|__| Page 11
(SHOW CARD 2) 12.3 During the last 30 days, how often… 1. Never 2. Almost never 3. Sometimes, 4. Almost always 5. Always -88. DOESN’T KNOW -99. NR 1. Did you feel stressed by your job or economic 1 2 3 4 5 -88 -99 activity? 2. Did you find your job or economic activity prevented 1 2 3 4 5 -88 -99 you from giving time to your partner or family? 3. Did you feel too tired after work to enjoy the things 1 2 3 4 5 -88 -99 you would like to do at home? 13. INCOME Now I am going to ask you some questions regarding your household’s income. In the last month, how much did your household receive from …?
13.1 All salaried jobs with a fixed schedule that pays a regular salary. $|____|____|____| , |____|____|____| PESOS $|____| (Who works?) ____|____| , |____|____|____| DOLLARES SURVEYOR: SOME OF THE POSSIBLE EXAMPLES ARE AN ASSEMBLY PLANT, JOB IN A STORE -88. DK --99. NR (NOT OWNED), RECEPTIONIST, ETC.
13.2 All jobs without a fixed salary, that is worked occasionally or without a fixed $|____|____|____| , |____|____|____| PESOS $|____| schedule that pays according to the work done? ____|____| , |____|____|____| DOLLARES (Who works?) -88. DK --99. NR
13.3 All the income of businesses or productive activity? $|____|____|____| , |____|____|____| PESOS $|____| SURVEYOR: THIS CAN BE ANY ECONOMIC ACTIVITY SUCH AS SELLING A CERTAIN PRODUCT OR ____|____| , |____|____|____| DOLLARES FOOD, WHETHER IT’S THROUGH A CATALOGUE, FROM A PHYSICAL LOCATION OR FROM THE -88. DK -99. NR HOUSE, SMALL OR LARGE.
13.4 All the gifts or help from a family member, neighbor, or friend that is not a $|____|____|____| , |____|____|____| PESOS $|____| member of the household. This includes money or the value of in-kind (things, ____|____| , |____|____|____| DOLLARES objects, gifts)? -88. DK -99. NR
13.5 In the last 2 months, how much has your household received from government $|____|____|____| , |____|____|____| PESOS $|____| subsidies or aid, such as Oportunidades, Sumate, 70 y Mas, and scholarships? ____|____| , |____|____|____| DOLLARES -88. DK -99. NR
14. SOCIAL NETWORKS (SHOW CARD 3) 14.1 Now I will read to you a few phrases. Can you please tell me, how strongly you agree or disagree with each phrase? 1. STRONGLY AGREE 2. AGREE 3. NEITHER AGREE NOR DISAGREE 4. DISAGREE 5. STRONGLY DISAGREE 1. I do not trust banks with my savings 2. I would never buy something from someone whom I do not personally know 3. In the long run, hard work will bring you a better life 4. In dealing with strangers one is better off to be cautious until they have provided evidence that they are trustworthy 14.2 (SHOW CARD 4) In a scale from 1 to 10, do you think most people would try to take advantage of you if they got a chance, or would they try to be fair? Please use this scale, where 1 means that “people would try to take advantage of you,” and 10 means that “people would try to be fair”: | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | -88. DK -99. NR ENCUESTA:|__|__|__|__|__| Page 12
15. COMMUNITY
15.1 How long have your lived in your community? SURVEYOR: A COMMUNITY IS DEFINED BY A 20 MINUTE RADIUS ON FOOT. 1. |____|____| YEARS 2. |____|____| MONTHS 3. |____|____| WEEKS 4. |____|____| DAYS -99. NR 15.2 For each group, please tell me how much trust do you have in…? NEITHER REGISTER ONE ANSWER COMPLETE SOME SOME COMPLETE TRUST NOR NR PER CATEGORY TRUST TRUST DISTRUST DISTRUST DISTRUST 1. Your family 1 2 3 4 5 -99 2. Your neighbors 1 2 3 4 5 -99 3. People you know personally 1 2 3 4 5 -99 4. People you meet for the first time 1 2 3 4 5 -99 5. People you do business with 1 2 3 4 5 -99 6. People who work for financial 1 2 3 4 5 -99 institutions 7. People who borrow money 1 2 3 4 5 -99 8. People who work in the government 1 2 3 4 5 -99
16.WHO DECIDES SURVEYOR: IS THE INFORMANT THE HEAD OF THE HOUSEHOLD AND LIVES WITHOUT HER SPOUSE/PARTNER? YES SKIP TO 17.1 NO CONTINUE TO 16.1 Now I would like to ask you a few questions on household decisions.
16.1 In your household, who decides …? 16.2 If the decision that you and [THE OTHER PERSON] COMPLETE THE PHRASE WITH THE OPTIONS BELOW take are not the same, who has the final word?
1. Whether to buy an 1. You, by yourself appliance or not for the 2. Your partner/spouse, by himself home (such as televisions, 3. You and your partner/spouse >>> 1. You, by yourself microwave, etc)? 4. You and another person >>> 2. Your partner/spouse or Other Person SPECIFY ______3. Both 5. Another person 4. There is never a conflict SPECIFY ______-99. NR 6. Each one for themselves -88. Doesn’t know -99. NR 2.In what way household 1. You, by yourself members may work outside 2. Your partner/spouse, by himself the home (how many hours, 3. You and your partner/spouse >>> 1. You, by yourself where, type of job, etc)? 4. You and another person >>> 2. Your partner/spouse or Other Person SPECIFY ______3. Both 5. Another person 4. There is never a conflict SPECIFY ______-99. NR 6. Each one for themselves -88. Doesn’t know -99. NR 3.Whether to financially 1. You, by yourself 1. You, by yourself support family members, 2. Your partner/spouse, by himself 2. Your partner/spouse or Other Person ENCUESTA:|__|__|__|__|__| Page 13
such as your parents, your 3. You and your partner/spouse >>> in-laws, your siblings, etc? 4. You and another person >>> SPECIFY ______3. Both 5. Another person 4. There is never a conflict SPECIFY ______-99. NR 6. Each one for themselves -88. Doesn’t know -99. NR 4.Whether to save for the 1. You, by yourself future? 2. Your partner/spouse, by himself 3. You and your partner/spouse >>> 1. You, by yourself 4. You and another person >>> 2. Your partner/spouse or Other Person SPECIFY ______3. Both 5. Another person 4. There is never a conflict SPECIFY ______-99. NR 6. Each one for themselves -88. Doesn’t know -99. NR
ONLY ASK IF THE INFORMANT HAS A PARTNER / SPOUSE 16.3 When you have an argument with your partner/spouse, who normally starts the reconciliation? 1. Me 2. Partner/Spouse 3. Both -99. NR 17.LOCUS OF CONTROL SCALE
17.1 Now I will read to you 4 pairs of phrases and I would like you to choose which phrase you agree with the most. If you agree with both, please choose the one you agree with the most. Please respond according to your way of thinking and not what you think most people would say. There are no right or wrong answers. FIRST PHRASE: What happens to me is my own doing. 17.1 -99. NR SECOND PHRASE: Sometimes I feel that I dont have enough control over the direction my life is taking. FIRST PHRASE: When I make plans, I am almost certain that I can make them work. SECOND PHRASE: 17.2 -99. NR It is not always wise to plan too far ahead, because many things turn out to be a matter of good or bad fortune anyhow
FIRST PHRASE: In my case, getting what I want has little or nothing to do with luck. 17.3 -99. NR SECOND PHRASE: Many times we might just as well decide what to do by flipping a coin.
FIRST PHRASE: Many times I feel that I have little influence over the things that happen to me 17.4 -99. NR SECOND PHRASE: It is impossible for me to believe that chance or luck plays an important role in my life. ENCUESTA:|__|__|__|__|__| Page 14
18. UNEXPECTED EXPENSES AND EVENTS
Now I would like to ask you about the different needs in your life.
18.3 How were you able to get the money? DON’T READ OPTIONS OUT LOUD, MARK ALL THAT APPLY 1. Used savings 2. Reduced consumption expenses 3. Worked more in own job/business 18. 1 During the last 12 months, did your household 18.2 In total, how 4. Worked more in other activities have to cover…? much did you spend 5. Another household member worked more on [ITEM] in the last 6. Sold an asset from the business 12 months? 7. Sold an asset from their home 8. Pawned an item from their home 9. Loan from a financial institution 10. Loan from a moneylender 11. Loan from employer 12. Loan from friend/relative/neighbor/colleague 13. Gift from friend/relative/neighbor/colleague 14. Gift from church or other organization 15. Sent children to the house of a friend or relative
1. School expenses such as 1. YES >>> $|__|__|,|__|__|__| |__|__| FIRST ANSWER -88. NS tuition, books or supplies? 2. NO 1.PESOS |__|__| SECOND ANSWER -99. NR -88. NS |__|__|THIRD ANSWER -99. NR 2. DOLLARS Other (Specify): ______-88. DK -99. NR
2. Medical expenses such as 1. YES >>> $|__|__|,|__|__|__| |__|__| FIRST ANSWER -88. NS hospital or doctor visits or 2. NO 1.PESOS |__|__| SECOND ANSWER -99. NR medicines? -88. NS |__|__|THIRD ANSWER -99. NR 2. DOLLARS Other (Specify): ______--88. DK -99. NR
3. Expense for important events 1. YES >>> $|__|__|,|__|__|__| |__|__| FIRST ANSWER -88. NS such as weddings and 2. NO 1.PESOS |__|__| SECOND ANSWER -99. NR quinceañera (baptism, -88. NS |__|__|THIRD ANSWER birthday, graduation) or a -99. NR 2. DOLLARS Other (Specify): ______funeral -88. DK -99. NR ENCUESTA:|__|__|__|__|__| Page 15
Now I would like to ask you about unexpected events in your life:
18.5 How were you able to get the money to recover from this unexpected event? DON’T READ OPTIONS OUT LOUD, MARK ALL THAT APPLY 1. Used savings 2. Reduced consumption expenses 3. Worked more in own job/business 4. Worked more in other activities 18.4 During the last 12 months, did your household face…? 5. Another household member worked more 6. Sold an asset from the business 7. Sold an asset from their home 8. Pawned an item from their home 9. Loan from a financial institution 10. Loan from a moneylender 11. Loan from employer 12. Loan from friend/relative/neighbor/colleague 13. Gift from friend/relative/neighbor/colleague 14. Gift from church or other organization 15. Sent children to the house of a friend or relative 16. Did not recover or repair damage/loss
1. Any job loss? 1. YES >>> |__|__| FIRST ANSWER -88. NS 2. NO |__|__| SECOND ANSWER -99. NR -88. DK |__|__|THIRD ANSWER -99. NR Other (Specify): ______
2. Financial problems with managing own 1. YES >>> |__|__| FIRST ANSWER -88. NS business? 2. NO |__|__| SECOND ANSWER -99. NR -88. DK |__|__|THIRD ANSWER -99. NR Other (Specify): ______
3. A loss or damage to your main house? (due to 1. YES >>> |__|__| FIRST ANSWER -88. NS theft, flooding, extreme temperature, wear and 2. NO |__|__| SECOND ANSWER -99. NR tear, etc) -88. DK |__|__|THIRD ANSWER -99. NR Other (Specify): ______
4. A loss or damage to a household car? (due to 1. YES >>> |__|__| FIRST ANSWER -88. NS theft, flooding, extreme temperature, wear and 2. NO |__|__| SECOND ANSWER -99. NR tear, etc) -88. DK |__|__|THIRD ANSWER -99. NR Other (Specify): ______
5. Any other unexpected event 1. YES >>> |__|__| FIRST ANSWER -88. NS 2. NO |__|__| SECOND ANSWER -99. NR -88. DK |__|__|THIRD ANSWER -99. NR Other (Specify): ______
18.6 Thinking about other things besides money that are necessary to get through a family crisis, do you think you have friends, relatives and neighbors who support you when bad things happen? 1. YES 2. NO -88. DK -99.NR ENCUESTA:|__|__|__|__|__| Page 16
19. SOURCES OF CREDIT Now, I’m going to ask you about different places to get a loan
19.1 If you need a credit or loan of $6,000 pesos for tomorrow, where would you go to get the money? 1. Caja or cooperative 2. Bank or financial institution 3. Money lender 4. Pawnshop 5. Employer 6. Family member 7. Friend 8. Other (specify): ______-88. Doesn’t know skip to 19.4 -99. NR skip to 19.4 19.2 Do you think you would have problems in obtaining the credit from [THE SOURCE]?
1. YES 2. NO -88. DK -99.NR
19.3 What percentage interest rate do you think you would have to pay [SOURCE]?
|___|___|.|___|% -88. Doesn’t know -99. NR CIRCLE TIME UNIT: 1. DAILY 2. WEEKLY 3. MONTHLY 4. ANNUAL 5. DURATION OF CREDIT
SURVEYOR: IF INFORMANT ANSWERED FRIEND OR FAMILY IN 19.1 SKIP TO 19.6 19.4 In case of emergency, could you get money from friends or family? 1. Yes 2. No Skip to 19.6 -88. Doesn’t know Skip to 19.6 -99. NRSkip to 19.6 19.5 If it were necessary, how much money do you think you could get from family and friends? $|____|____|____| , |____|____|____| 1. PESOS 2. DOLLARS -88. NS -99. NR $|____|____|____| , |____|____|____| 1. PESOS 2. DOLLARS
19.6 Please tell me if you know any of ASK QUESTION 19.7 TO 19.9 FOR EVERY INSTITUTION THE the following credit institutions. INFORMANT KNOWS
Do you know …? 19.7 19.8 Do 19.9 If you were to need a loan, 19.10 Do you think you would you how likely is it that you would ask have problems so that [CREDIT Have you know for more information from…? INSTITUTION] approves your READ THE OPTONS AND MARK A ever taken anyone ASK QUESTION 19.10 loan? RESPONSE FOR EACH INSTITUTION a loan ONLYPREGUNTAR IF THE ANSWER 16.8 IS who has SI MENCIONÓ1 OR 2 BEFORE PASSING TO 19.7 from…? taken a CÓDIGOS 1 O 2 loan from …?
Y N N N N N N INSTITUTION YES YES E VERY NOT D N YES NO DK NR O R O R O R LIKELY S LIKELY LIKELY K R
01. Financiera 1 2 9 1 2 9 1 2 9 1 2 3 8 9 1 2 8 9 Independencia?
02. Banco Azteca? 1 2 9 1 2 9 1 2 9 1 2 3 8 9 1 2 8 9
03. Compartamos 1 2 9 1 2 9 1 2 9 1 2 3 8 9 1 2 8 9 Banco?
04. Coppel? 1 2 9 1 2 9 1 2 9 1 2 3 8 9 1 2 8 9 ENCUESTA:|__|__|__|__|__| Page 17
05. Micronegocio 1 2 9 1 2 9 1 2 9 1 2 3 8 9 1 2 8 9 Azteca?
20. BANK ACCOUNT 20. 1 in the past 2 years, do you have, or have you had, any account, like a savings or checking account, from a bank or cooperative? 1.Yes 2.No -99. NR 20.2 In the past 2 years, have you participated in an informal savings group (“cundina”)? 1.Yes 2.No -99. NR
21. CREDITS
21.1 How many loans, in total, have members of this household had in the last 2 years, including any that are still active or that are under your name? Please include loans from a caja or cooperative, a bank or financial institution, the government, employer, a moneylender, a friend or relative, a pawn shop, or any other source. |____|____| CREDITS -99. NR Skip to 22.1
21.2 How many of these loans are in your name, including any that you currently have? |____|____| CREDITS -99. NR
Now we’re going to talk more about your last three loans. We Loan 1 Loan 2 Loan 3 will start with your most recent.
21.3 Who gave you the 1. Caja or cooperative 1. Caja or cooperative 1. Caja or cooperative 2. Bank or financial institution 2. Bank or financial institution 2. Bank or financial institution loan? 3. Merchandise not paid in the 3. Merchandise not paid in the 3. Merchandise not paid in the SURVEYOR: START moment of purchase moment of purchase moment of purchase 4. Government 4. Government 4. Government WITH THE 5. Employer 5. Employer 5. Employer INFORMANT’S LOANS. 6. Money lender 6. Money lender 6. Money lender IF SHE HAS HAD LESS 7. Pawnshop 7. Pawnshop 7. Pawnshop THAN 3 BUT THE 8. Relative 8. Relative 8. Relative HOUSEHOLD HAS 9. Friend 9. Friend 9. Friend ADDITIONAL LOANS, 10. Other 10. Other 10. Other SPECIFY______SPECIFY______SPECIFY______CONTINUE WITH THOSE. -99. NR -99. NR -99. NR
IF THE INFORMANT 1. FINANCIERA INDEPENDENCIA 1. FINANCIERA INDEPENDENCIA 1. FINANCIERA INDEPENDENCIA 2. BANCO AZTECA 2. BANCO AZTECA 2. BANCO AZTECA ANSWERED “BANK 3. COMPARTAMOS BANCO 3. COMPARTAMOS BANCO 3. COMPARTAMOS BANCO OR FINANCIAL 4. BANCOPPEL 4. BANCOPPEL 4. BANCOPPEL INSTITUTION”, 5. MICRONEGOCIO AZTECA 5. MICRONEGOCIO AZTECA 5. MICRONEGOCIO AZTECA 21.3.1 Which bank or 6. FAMSA 6. FAMSA 6. FAMSA financial institution 7. EN COMUN DE LA FRONTERA 7. EN COMUN DE LA FRONTERA 7. EN COMUN DE LA FRONTERA gave you the loan? 8. OTRO (ESPECIFIQUE): 8. OTRO (ESPECIFIQUE): 8. OTRO (ESPECIFIQUE): ______
-88. DK -99. NR -88. DK -99. NR -88. DK -99. NR ENCUESTA:|__|__|__|__|__| Page 18
21.4 Are you still 1. YES 2. NO 1. YES 2. NO 1. YES 2. NO paying off this -88. DK -99. NR -88. DK -99. NR -88. DK -99. NR loan?
21.5 What is (was) the $|___|___|___|,|___|___|___| $|___|___|___|,|___|___|___| $|___|___|___|,|___|___|___| loan amount? 1.PESOS 2. DOLLARS 1.PESOS 2. DOLLARS 1.PESOS 2. DOLLARS -88. DK -99. NR -88. DK -99. NR -88. DK -99. NR
21.6 PERIOD PERIOD PERIOD 1. |____|____| DAYS 1. |____|____| DAYS 1. |____|____| DAYS If loan paid off ask: 2. |____|____| WEEKS 2. |____|____| WEEKS 2. |____|____| WEEKS For how long did you 3. |____|____| MONTHS 3. |____|____| MONTHS 3. |____|____| MONTHS have the loan? 4. |____|____| YEARS 4. |____|____| YEARS 4. |____|____| YEARS If still paying ask: For -55. UNDEFINED -55. UNDEFINED -55. UNDEFINED how long will you have -88. DOESN’T KNOW -88. DOESN’T KNOW -88. DOESN’T KNOW the loan, from the -99. NR -99. NR -99. NR moment you got it until you finish paying?
21.7 How often are 1. Daily 1. Daily 1. Daily 2. Every week 2. Every week 2. Every week (were) the 3. Every two weeks 3. Every two weeks 3. Every two weeks payments? 4. Every month 4. Every month 4. Every month 5. Every year 5. Every year 5. Every year 6. One payment at the end 6. One payment at the end 6. One payment at the end 7. Not defined 7. Not defined 7. Not defined 8. Other (specify) ______8. Other (specify) ______8. Other (specify) ______-88. -88. Doesn’t know -88. Doesn’t know Doesn’t know -99. NR -99. NR -99. NR
21.8 How much is $|___|___|___|,|___|___|___| $|___|___|___|,|___|___|___| $|___|___|___|,|___|___|___| (was) each 1.PESOS 2. DOLLARS 1.PESOS 2. DOLLARS 1.PESOS 2. DOLLARS payment? -88. DK -99. NR -88. DK -99. NR -88. DK -99. NR
21.9 What is (was) the |__|__|__|•|__| % |__|__|__|•|__| % |__|__|__|•|__| % interest rate in 1. DAILY 1. DAILY 1. DAILY 2. WEEKLY 2. WEEKLY 2. WEEKLY percentage 3. MONTHLY 3. MONTHLY 3. MONTHLY points? 4. ANNUAL 4. ANNUAL 4. ANNUAL 5. DURATION OF CREDIT 5. DURATION OF CREDIT 5. DURATION OF CREDIT -88. DK -99. NR -88. DK -99. NR -88. DK -99. NR
21.10 How much will $|___|___|___|,|___|___|___| $|___|___|___|,|___|___|___| $|___|___|___|,|___|___|___| you pay (did you 1.PESOS 2. DOLLARS 1.PESOS 2. DOLLARS 1.PESOS 2. DOLLARS pay) in total -88. DK -99. NR -88. DK -99. NR -88. DK -99. NR interests? ENCUESTA:|__|__|__|__|__| Page 19
22. THE LAST WEEK SHOW CARD 6 I am going to read you some phrases. Please tell me, during the last week, how many days…
ZERO OR LESS 1 TO 2 3 TO 4 5 TO 7 THAN ONE NS NR SELECT ONLY ONE OPTION DAYS DAYS DAYS DAY
22.1 Were you bothered by things that usually don’t bother 0 1-2 3-4 5-7 -88 -99 you?
22.2 Did you not feel like eating, your appetite was poor? 0 1-2 3-4 5-7 -88 -99
22.3 Did you feel like you could not shake off the blues, even 0 1-2 3-4 5-7 -88 -99 with the help of family and friends?
22.4 Did you feel you were just as good as other people? 0 1-2 3-4 5-7 -88 -99
22.5 Did you have trouble keeping your mind on what you were 0 1-2 3-4 5-7 -88 -99 doing?
22.6 Did you feel depressed? 0 1-2 3-4 5-7 -88 -99
22.7 Did you feel that everything you did required extra effort? 0 1-2 3-4 5-7 -88 -99
22.8 Did you feel hopeful about the future? 0 1-2 3-4 5-7 -88 -99
22.9 Did you think your life had been a failure? 0 1-2 3-4 5-7 -88 -99
22.10 Did you feel fearful? 0 1-2 3-4 5-7 -88 -99
22.11 Was your sleep restless? 0 1-2 3-4 5-7 -88 -99
22.12 Were you happy? 0 1-2 3-4 5-7 -88 -99
22.13 Did you talk less than usual? 0 1-2 3-4 5-7 -88 -99
22.14 Did you feel lonely? 0 1-2 3-4 5-7 -88 -99
22.15 Did you feel people were unfriendly? 0 1-2 3-4 5-7 -88 -99
22.16 Did you have crying spells? 0 1-2 3-4 5-7 -88 -99
22.17 Did you enjoy life? 0 1-2 3-4 5-7 -88 -99
22.18 Did you feel sad? 0 1-2 3-4 5-7 -88 -99
22.19 Did you feel people dislike you? 0 1-2 3-4 5-7 -88 -99
22.20 Did you feel you couldn’t keep going on? 0 1-2 3-4 5-7 -88 -99 ENCUESTA:|__|__|__|__|__| Page 20
23. INVITATION FOR FOLLOW-UP PHONE SURVEYS Thank you very much. We are almost done with the questions.
We will be conducting short follow-up phone surveys every 2 weeks for the next two months. These surveys will take 5 minutes of your time to ask you simple questions about your expenses during the previous two weeks. Your participation in these 4 follow-up surveys qualifies you to enter a raffle for a $2,000 pesos grocery voucher at the end of the two months. 23.1 Would you be willing to participate in these phone surveys every two weeks for the next two months? 1. YES 2. NO SKIP TO FAREWELL SECTION
23.2 Could you please provide me with a landline number where we could contact you? I remind you that this information is confidential. |___|___|___|- |___|___|-|___|___|-|___|___|___| -77. DOESN’T HAVE LANDLINE -88. DOESN’T KNOW -99. NR
23.3 And do you have a cellular phone where we could contact you? |___|___|___|- |___|___|-|___|___|-|___|___|___| -77. DOESN’T HAVE ONE -88. DOESN’T KNOW -99. NR
SURVEYOR: IF THE INFORMANT DOESN’T PROVIDE A TELEPHONE NUMBER (EITHER LANDLINE OR CELLULAR PHONE) TO CONTACT HER SKIP TO FAREWELL SECTION
23.4 At what time would you be available to participate in the phone survey? (WRITE IN MILITARY TIME) BETWEEN |____|____| : |____|____| AND |____|____| : |____|____| HOURS : MINUTES HOURS : MINUTES
23.5 What days are you available to participate in the follow-up phone surveys? CIRCLE DAY(S) MON / TUES / WEDS / THURS / FRI / SAT / SUN / ANY DAY
24. FAREWELL
24.1 Thank you very much for your time and participation. I am going to give you a PROOF OF PARTICIPATION that includes our contact information. HAND INFORMANT PROOF OF PARTICIPATION
Again, thank you very much for your support.
SAY GOOD-BYE WITH HANDSHAKE.
25. OTHER ADULTS
25.1 SURVEYOR: WERE THERE OTHER ADULTS (OLDER THAN 12 YEARS) PRESENT DURING THE SURVEY? 1. YES 2. NO SKIP TO OBSERVATIONS
25.2 SURVEYOR: WHAT GENDER WAS(WERE) THE OTHER PEOPLE PRESENT DURING THE SURVEY? 1. MALE 2. FEMALE 3. BOTH
25.3 SURVEYOR: DID THE OTHER PEOPLE PRESENT CONTRIBUTE TO THE ANSWERS DURING THE SURVEY? 1. YES 2. NO