Africa RISING Baseline Evaluation Survey - 2014

CONSENT FORM My name is ____ and I work for a research program, called Africa Research in Sustainable Intensification for the Next Generation -Africa RISING-, which aims to alleviate hunger and poverty by increasing agricultural productivity. Your household is one of the over 600 households in southern Mali selected to be interviewed now and at the end of the program (after three years). Data collected from study households like yours will be used to determine and understand major constraints and opportunities for improving livelihood. Analysis of baseline and follow-up data will allow the research team to assess the effect of the Program on the livelihood of beneficiary farmers and help identify successful agricultural technologies and practices. Data to be collected from you will be coded and will be kept strictly confidential. All household identifying information will be held in strict confidence and used only for research purposes. No identifying information (e.g., respondent name) will appear in data report. Participation in this interview is voluntary and you may refuse to participate, discontinue the interview at any time, or skip any question you do not want to answer with no penalty or loss of benefits to which you are otherwise entitled. You are allowed to ask questions concerning the research, both before agreeing to participate in the interview, during, and after the interview. As head of the household or spouse of the head, I would like to ask you questions mainly about agricultural activities and consumption. I will also need to ask other household members about health status and labor, as well as measure the weight and height of all women of reproductive age and children under 5 years old. Answering these questions is expected to take around 2 hours. You may find some of the questions (for example about household asset ownership and consumption of food and non-food items) sensitive and you can refuse to answer any sensitive question without any consequence whatsoever. Please contact Patrice Howard at +223 7 483 3906 or [email protected] if you have questions about the research and your right as a research participant and Carlo Azzarri at [email protected] if you face injury as a result of your participation in this survey. Please contact Erick Boy, the chair of the International Food Policy Research Institute Institutional Review Board at +1 202 862-8141 or [email protected] if you need more information or have questions about this study. Before I start, do you have any questions or is there anything I have said on which you would like further clarification? May I proceed with interviewing you and other household members? Yes • No • ______Subject Name Subject Signature Consent form approved by IFPRI IRB on ______

Household location GPS coordinates Degree Minute Second

A1 A2 A3 A4 A5 GPS Latitude N

A6 GPS Longitude W

Circle Commune Village Household A7 Elevation (in meters) Enter 3-digit household code from the list of sampled See codes See codes See codes See codes households** Household information A13 Name of head of household

Survey Staff Details A14 Name of respondent (if not head)

A15 Relationship to head (if not head)

ENUMERATOR NAME: Was translator used? 1. Yes 2. No A23a Is the interview completed? A8 A16 Phone numbers (if available) A17 1 Yes Religion of the head A9a DATE OF INTERVIEW (FIRST VISIT): / / (SECOND VISIT): / / A10a 2 No 1 Muslim MM DD YYYY MM DD YYYY 2 Christian 3 Traditional INTERVIEW STARTING TIME (FIRST VISIT) / / A9b (SECOND VISIT): A10b 4 Animism A18 5 Other A23b Reason for non-completion HOUR MIN HOUR MIN 6 No religion 98 Refused A11 NAME OF SUPERVISOR: See Codes 1st inspection 2nd inspection

A12a DATE OF QUESTIONNAIRE INSPECTIONS BY SUPERVISOR: / / / / A12b MM DD YYYY MM DD YYYY Household recontact A19 Reference person within the community

A20 Relationship to the reference person within the community LIMIT OPEN RESPONSES TO 20 A21 Reference person outside the community CHARACTERS A22 Relationship to the reference person outside the community May 10 2014 VERSION COVER PAGE CODES CROPS Region Village codes Quantity unit codes* Cereals Root and tuber crops Maize variety Fonio Varieties Cowpea Variety Pepper Varities Code Region Name CodeVillage name CodeUnit 11 Corn 41 Onion 110 Similinyo 151 Finiba 250 Sangaranga 351 Nisondia 1 01 Dieba 1 Kilo 12 Millet 42 Potato 111 Denbamyuman 152 Tioi 251 Korobalen 359 Other pepper varieties 02 Flola 2 Gram 13 Wheat 43 Sweet potato 112 Sotubaka 153 Tamatioi 252 Wulibali Cercle/District codes 03 N'golonianasso 3 Liter 14 Sorghum 44 Garlic 113 T7-22 154 Tamabe 253 Sinzana Onion Variety Code District Name 04 M’pessoba 4 Unit or Piece 15 Fonio 45 Manioc 114 Sabara 155 Petama 254 Yerewolo 411 Jan Iri 1 05 Madina 5 100 Kilo Sack 16 Rice 46 Shallot 115 Sheduguni 156 Peazo 2 255 Dunanfana 412 PRIMA 2 06 Nampossela 6 200 Kilo Sack 19 Other Cereals 47 Yam 116 Tiematie 157 Pon de Madougou 256 Local Maradi(Niger) 413 Violet de Galmi 3 07 7 25 Kilo Sack 49 Other roots, tubers 117 Kogoni B 158 Sanogola 257 IAR96 419 Other onion variety 08 Sirakele 8 50 Kilo Sack Pulses and nuts 118 TZSER-W 1501 Pebe 259 Other cow-peas variety Communes 09 9 75 Kilo Sack 21 Green Bean Perennial crops 1101 EV8422SR 1502 Tamabe Potato Varieties Code Commune Name 10 10 Other 22 Soybean 51 Avocado 1102 Nieleni 1503 Kassangara Sweet Pea Variety 421 SAHEL 01 Wasselou- Balle 11 Goulala 1 11 Tub 23 Pigeon Pea 52 Banana 1103 Appolo 1504 Pon de Bore 261 Variété à tubercule long 422 CLAUSTAR 02 Danou 12 Siratogo 12 Ball 24 Chick Pea 53 Mango 1104 Jorobona 159 Other Fonio varieties 262 Variété à tubercule rond 423 SPUNTA 25 Cow Pea 54 Orange 1105 269 Other sweet pea varieties 424 03 Diouradougou-kafo 13 Sakoro Mali Hybrid 7 13 Box/Basket LOLA 04 Domba 14 Dossola 14 Bowl 26 Sweet Pea 55 Papaya 1106 Brico Rice Varieties 425 TROISE 05 15 Dialakoro 15 Ball/Sphere 27 Groundnut 56 Coco 1107 Tcheba 161 BG 90-2 Groundt Nut Variety 426 YASMINA 06 16 16 Bunch 28 Bambara Nut 57 Palm-oil 119 Other maize varieties 162 Kogoni 91-1 271 ICGV 86015 427 PAMINA 07 Gouadji-kao 17 Konina 17 Truckload 29 Other Pulses and Nuts 58 Sugar cane 163 Kogoni89-1 272 ICIAR 19BT 428 KERPONDY 08 18 Konseguela 18 Spoon (tea, table) 5101 Hibiscus Millet Variety 164 Leizong 273 ICGV 86124 4201 MARFONA 09 19 N'Togonasso 19 Bundle (of Firewood) Vegetables 5102 Sumbala 121 Djiguifa 165 AD 9216 274 ICGV 99241 4202 LISETA 10 Konina 20 Bobola- 20 Louche 31 Cabbage 59 Other perennial 122 Toroniou 166 ITA 333 275 ICGV 86024 4203 COSMOS 11 Konseguela 21 Round Loaf 32 Tomato 129 Other millet variety 167 IRAT 161 276 Tiga Huguni 4204 AGRIA 12 Kouroulamni Area unit codes* 22 Moure/Boite 33 Okra Other crops 168 ITA 335 277 Tiga Pegele 4205 AIDA 13 N'golonianasso CodeUnit 23 Paani 34 Amaranth 61 Cotton Wheat Variety 1601 Nerica 4 278 Tiga Kolodjan 4206 ATLAS 14 Sido 1 Hectare 24 Platter 35 Pepper (hot) 62 Coffee 131 Tetra 1602 Sahelika 2701 Tiga Jonami 4207 BINTJE 15 Sido 2 Meter squared (M2) 25 Trailor 36 Green or Red Pepper 63 Tobacco 132 Dire 12 1603 Bouake 189 2702 Tiga Ba 4208 MONDIAL 16 3 Other 26 Sachet/packet/tube 37 Carrot 64 Tea 133 Dire 15 1604 ITA 320 2703 Kalosabani 429 Other potato varieties 17 Zanfigue 27 Bucketful/Pail 38 Herbs 65 Shea Nut 134 Dire 16 1605 ITA 324 279 Other groundut variety 18 Syentoula 28 Heap 3101 European Eggplant 66 Baobab 139 Other wheat variety 1606 Jama Jigi Manioc Varieties 19 29 Cup 3102 African Eggplant 69 Other Plants 1607 Gambiaka Tomato Variety 451 Yace 20 M'Pessoba 30 Cart/Donkey Cart 3103 Squash/Zucchini Sorghum Varieties 1610 Sambala Malo 321 C20 - 5 452 Boucou 1 31 Cart/Donkey Cart 3104 Beets Other land use 141 Early Sorgho 1611 Nerica 8 322 Estrela 453 TMS(2)1425 Reason for non- Code 32 Glass 3105 Sorrel 71 Fallow 1616 Formosa 454 response 142 Late Sorgho Nerica 9 323 Manioc d'Attieke 1 Moved permanently 39 Other vegetables 72 Pasture/grazing 143 Sweent Sorghum 1613 Nerica 12 324 SF83 61 455 Manioc rouge 73 Planted fodder 169 Autre variété de riz ICRIZINA 456 2 Moved temporarily 144 Timinkala 325 Manioc Blanc 74 Planted trees Mongal F1 457 3 Could not be found 145 Keninke 326 Manioc bassa 4 Refused 75 Natural trees 146 Kende Soybean Varieties 329 Other tomato variety 459 Other manioc varieties 5 Other 79 Other uses 147 Gadiaba 221 G 196 148 Douaje 222 G 197 Okra Variety 1401 Village Check 223 Houla 331 Batoumabe Mango Varieties 1402 N'Golofing 224 Temoin 332 Sasilon 531 Amélie 1403 Pablo 225 TGX1908-8F 333 Kooni 532 Kent 1404 Yamassa 226 TGX1935-3F 339 Other okra variety 533 Keitt 1405 N'Tenimissa 227 SE 534 Brooks 1406 Seguetana Cinzana 229 Other soybean varieties Sorrel Variety 535 Julie 1407 CSM 388 31041 Wankooye 536 Irwin Other Sorghum 149 varieties 31042 Vimto 537 Palmer 31043 Senegal 538 Mango ou fibreuses 3199 Other sorrel varieties 539 Other mango varieties SECTION B. CHARACTERISTICS OF MEMBERS OF THE HOUSEHOLD* BEFORE STARTING TO COMPLETE QUESTION B1, READ TO THE RESPONDENT THE DEFINITION OF THE HOUSEHOLD. The household is defined as a group of people who share expenses, live and eat together most of the time (that is, at least 3 months in the past 12 months and at least three days in a typical week). The group may also share expenses and income with other groups (of individuals) living in the concession/compound. In addition to meals shared only by group members, the group may share communal meals. A newborn less than 3 months has to be considered a household member.

ASK ALL HOUSEHOLD MEMBERS. RESPONDENTS 12 OR OLDER SHOULD RESPOND RELEVANT QUESTIONS FOR THEMSELVES ASK MEMBERS 14 YEARS OR OLDER ASK THESE QUESTIONS ONLY FOR MEMBERS 7 YEARS OR OLDER Please tell me the names of all members of What is the relationship of Is [NAME] How old is [NAME]? How many months of What is [NAME]'s marital status? What is the highest grade completed Can [NAME] read and write? If so, the household starting with the head of the [NAME] to the head of male or the past 12 months by [NAME]? in which language? concession. household? female? has [NAME] lived with 0. No formal education 1. Bambara the household? 1. Kindergarten 2. Sonrhaï IF 6 YEARS AND 11 MONTHS OR 1 Monogamous married 3. Tamasheq I 2. First grade OVER, GIVE YEARS ONLY. IF LESS 4. Peulh N 1 Head if the household 2 Polygamous married 3. Second grade THAN 6 YEARS AND 12 MONTHS, 1 Three months or 4. Third grade 5. Bozo D more (including the 6. Dogon 2 Spouse GIVE YEARS AND MONTHS. 3 Living together 5. Fourth grade I last three months) 7. Malinke 3 Son/daughter 4 Separated 6. Fifth grade V 2 Less than three 7. Sixth grade 8. Senoufo I 4 Son/daughter in law IF MONTH IS NOT KNOWN , ENTER - months ► NEXT LINE 5 Divorced 8. Seventh grade 9. Minianka 10. Multiple Local Languages D 5 Grandchild 99 6 Never married 9. Eigth grade U 10. Ninth grade 11. French LIST ONLY NAMES OF HOUSEHOLD 1 Male 12. French and multiple local languages A 6 Parent 7 Widow(er) 11. 1st Year HS/10th grade MEMBERS 2 Female 13. English L 12. 2nd Yr HS/11th grade 7 Parents in law 13. 3rd Yr HS/12th grade 14. English and French

8 Brother/sister IF AVAILABLE, ASK FOR THE 14. CAP 15. English, French, and multiple local I JOURNAL THE HOUSEHOLD 15. BT languages D 9 Other related (including in-laws) 16. Technical institute/Teacher/College 16. Arabic KEEPS TO VERIFY THE AGE OF 17. Arabic and multiple local languages 10 Other unrelated 17. University/Diploma/Polytechnic HOUSEHOLD MEMBERS. 18. University Degree 18. Others, specify 19, Post-graduate (Master or Doctorat) 19. None 20. Other, please specify Years Months ID B1 B2 B3 B4a B4b B5 B6 B7 B8 1 2 3 4 5 6 7 8 9 10 11 12 ISCO OCCUPATION CODE ISIC BUSINESS SECTOR CODE 1 Manager 1 Agriculture, forestry and fishing 2 Professional 2 Mining and quarrying 3 Technician and associate professional 3 Manufacturing 4 Clerical support worker 4 Electricity, gas, steam and air conditioning supply 5 Service and sales worker 5 Water supply; sewage, waste management and remediation activities 6 Skilled agricultural, forestry, and fishery workers 6 Construction 7 Craft and related trades worker 7 Wholesale and retail trade; repair of motor vehicles and motorcycles 8 Plant and machine operator, and assembler 8 Transportation and storage 9 Elementary occupation 9 Accommodation and food service activities 10 Armed forces 10 Information and communication 11 Other 11 Financial and insurance activities 12 Real estate activities 13 Professional, scientific and technical activities 14 Administrative and support service activities 15 Public administration and defence; compulsory social security 16 Education 17 Human health and social work activities 18 Arts, entertainment and recreation 19 Other SECTION B. CHARACTERISTICS OF MEMBERS OF THE HOUSEHOLD*

ASK ALL HOUSEHOLD MEMBERS 7 YEARS OR OLDER. RESPONDENTS 12 OR OLDER SHOULD RESPOND RELEVANT QUESTIONS FOR THEMSELVES What was the primary economic activity What is [NAME's] What kind of trade or What was the secondary economic activity ASK IF RESPONSE TO B9 OR B10 (OR BOTH) IS 5, 6, or 7. During the last 12 In those In those weeks In the last 7 days, Why was [NAME] not ASK IF RESPONSES TO What type of illness, symptoms or [NAME] was involved in during the last 12 occupation in his/her business is [NAME] [NAME] was involved in during the last 12 months, for how months that [NAME] worked, how many hours available for work in the last B17 IS 5,6,7 injury did cause [NAME] to be unable How much cash/in kind support did [NAME] receive in total (primary many months did [NAME] how many hours per did [NAME] work 12 months? During the last 12 months, to work? months? primary economic engaged in his/her months? I activity? primary economic and secondary, if any) for work he did during the last 12 months? [NAME] work on worked, how week, on average, did on these for how long was [NAME] LIST UP TO TWO What period did the payment cover or is expected to cover? [FOR IN- these activities? [NAME] usually work activities? unable to work as a result of N activity? many weeks per D KIND SUPPORT, ASK ESTIMATED VALUE ] month, on on these activities? an illness or injury? 1 FEVER 1 Self-employed in agriculture without employees 1 Self-employed in agriculture without employees I average, did 2 Self-employed in agriculture with employees 2 Self-employed in agriculture with employees IF RESPONDENT HAS NOT YET BEEN PAID, ASK: How much [NAME] usually MAX AMOUNT: 1 In school ►NEXT LINE WRITE 0 IF [NAME] WAS V 1 FEVER 3 Self-employed in non-agriculture-without 3 Self-employed in non-agriculture-without employees cash would [NAME] expect to get paid? [PROBE RESPONDENT work on these 168 HOURS 2 Household duties ►NEXT NOT PREVENTED FROM I 4 Self-employed in non-agriculture - with employees 2 MALARIA employees PLEASE] activities? LINE WORKING DUE TO 5 Hired in agriculture 3 STOMACH D 4 Self-employed in non-agriculture - with MAX AMOUNT: 3 Unable to work:Too young ILLNESS/INJURY AND ACHE/DIARRHEA 6 Hired in non-agriculture U employees MAX AMOUNT: MAX 168 HOURS ►NEXT LINE ►NEXT LINE 4 HEADACHE 7 Informal labor (paid) 1 HOUR A 12 MONTHS 5 HEART 5 Hired in agriculture 8 Unpaid family helper in agriculture 2 DAY AMOUNT: 4 Unable to work:Too old L 6 Hired in non-agriculture 3 WEEK 4 WEEKS ► NEXT LINE ►NEXT LINE 6 LUNG 9 Unpaid family helper in non-agriculture 7 MATERNITY 4 FORTNIGHT 5 Unable to work:Sick 7 Informal labor (paid) 10 None 1 Month 8 ULCER 5 MONTH I 8 Unpaid family helper in agriculture 6 Unable to work:Disabled 9 OTHER 9 Unpaid family helper in non-agriculture 6 TRIMESTER 7 Unable to work:Other 2 Week D SEE ISCO CODES SEE ISIC CODES 7 HALF YEAR 10 Unavailable to work ► B17 CHECK WHAT THE ANSWERS TO BOTH B9 ABOVE FOR ABOVE FOR 8 YEAR 3 Day 11 Looking for work ► NEXT LINE AND B11 ARE. IF B9 AND B11 ARE BOTH 9 OTHER OCCUPATION BUSINESS SECTOR NOT 5, 6, OR 7 ► B13 CFA UNIT MONTHS WEEKS HOURS HOURS TIME UNIT 1ST 2ND ID B9 B10a B10b B11 B12a B12b B13 B14 B15 B16 B17 B18a B18b B19a B19b 1 2 3 4 5 6 7 8 9 10 11 12 SECTION B. CHARACTERISTICS OF MEMBERS OF THE HOUSEHOLD*

I N D I V I D LIST ONLY NAMES OF HOUSEHOLD 1 Male Age U MEMBERS 2 Female A L

I D

Years ID B1 B3 B4a

1 2 3 4 5 6 7 8 9 10 11 12 SECTION C: CHILD ANTHROPOMETRY

ENUMERATOR: ASK PARENTS/CAREGIVERS OF CHILDREN BETWEEN THE AGES OF 0-59 MONTHS. ANTHROPOMETRY MEASUREMENT (HEIGHT, WEIGHT, AND MUAC) SHOULD BE TAKEN UP TO THREE TIMES. EACH ENUMERATOR MUST TAKE HEIGHT, WEIGHT, AND UMAC MEASURMENT TWICE. A THIRD MEASUREMENT OF EACH INDICATOR SHOULD BE TAKEN IF THERE IS A DIFFERENCE BETWEEN THE 1ST AND 2ND MEASUREMENT.

IS [NAME] 5 YEARS OR Has [NAME] had WAS [NAME] WHY WAS [NAME] NOT Where does [NAME]'s Where does [NAME]'s WEIGHT HEIGHT WAS HEIGHT/WEIGHT UPPER ARM CIRCUMFERENCE YOUNGER? diarrhea in the last MEASURED? MEASURED? MOTHER live? FATHER live? MEASURED WITH CHILD IF LESS THAN 10 KG, PUT TWO LEADING ZEROS 3 months? IF MOTHER LIVES IN THE STANDING OR LYING (8.5 KG = 008.5) . IF MORE THAN 10 KG AND LESS THAN 100KG, IF LESS THAN 100 CMS, PUT ONE LEADING ZERO (97.3 CM = 097.3 DOWN? PUT ONE LEADING ZERO (3.5 CM = 03.5 CM) HOUSE, COPY HER IF FATHER LIVES IN THE PUT ONE LEADING ZERO (15.5 KG = 015.5 KG) CM) HOUSEHOLD MEMBER ID. IF HOUSE, COPY HIS MOTHER DOES NOT LIVE HOUSEHOLD MEMBER INSIDE THE HOUSE, WRITE ID. IF FATHER DOES NOT Complete C7a and C7b for ALL eligible children. If C7a and C7b Complete C8a and C8b for ALL eligible children. If C8a and C8b 1 CURRENTLY NOT HOME Complete C10a and C10b for ALL eligible children. If C10a and 97. IF MOTHER IS DEAD, LIVE INSIDE THE HOUSE, disagree, ONLY THEN complete C7c. disagree, ONLY THEN complete C8c. 2 TOO ILL C10b disagree, ONLY THEN complete C10c. 3 UNWILLING WRITE 98. WRITE 99 IF NOT WRITE 97. IF FATHER IS 4 OTHER KNOWN. DEAD, WRITE 98. WRITE 99 IF NOT KNOWN.

1 YES 1 YES 1 YES ► C5 ►NEXT LINE WRITE MOTHER ID OR WRITE FATHER ID OR 1st measurement 2nd measurement 3rd measurement 1st measurement 2nd measurement 3rd measurement 1 Standing Up 1st measurement 2nd measurement 3rd measurement 2 NO 2 NO 2 NO ► NEXT LINE THE OTHER CODES (97, 98, THE OTHER CODES (97, (only if 1st and 2nd (only if 1st and 2nd 2 Lying down (only if 1st and 2nd 99) HERE 98, 99) HERE disagree) disagree) disagree) KG KG KG CM CM CM CM CM CM ID C1 C2 C3 C4 C5 C6 C7a C7b C7c C8a C8b C8c C9 C10 C10 C10 1 ______. ______. ______. ______. ______. ______. ______. ______. ______. __ 2 ______. ______. ______. ______. ______. ______. ______. ______. ______. __ 3 ______. ______. ______. ______. ______. ______. ______. ______. ______. __ 4 ______. ______. ______. ______. ______. ______. ______. ______. ______. __ 5 ______. ______. ______. ______. ______. ______. ______. ______. ______. __ 6 ______. ______. ______. ______. ______. ______. ______. ______. ______. __ 7 ______. ______. ______. ______. ______. ______. ______. ______. ______. __ 8 ______. ______. ______. ______. ______. ______. ______. ______. ______. __ 9 ______. ______. ______. ______. ______. ______. ______. ______. ______. __ 10 ______. ______. ______. ______. ______. ______. ______. ______. ______. __ 11 ______. ______. ______. ______. ______. ______. ______. ______. ______. __ 12 ______. ______. ______. ______. ______. ______. ______. ______. ______. __ SECTION D: WOMEN ANTHROPOMETRY

ENUMERATOR: ASK THESE QUESTIONS OF EACH WOMAN OF REPRODUCTIVE AGE (15-49 YEARS) IN THE HOUSEHOLD. GET WOMEN'S ID CODE FROM THE HOUSEHOLD ROSTER. WOMEN'S NUTRITIONAL STATUS In what year and month Are you CHECK MODULE "B MEMBERS": Are you currently pregnant or WAS [NAME] WHY WAS WEIGHT IN KILOGRAMS: WEIGH THE WOMAN HEIGHT IN CENTIMETERS: MEASURE THE WOMAN were you born? between 15 IS THE RESPONDENT breastfeeding? MEASURED? [NAME] NOT and 49 years BETWEEN THE AGES OF 15 MEASURED? IF LESS THAN 100 KG, PUT ONE LEADING ZERO old? AND 49 YEARS? 1 YES ►D7 IF LESS THAN 100 CMS, PUT ONE LEADING ZERO (97.3 CM = 097.3) IF YEAR IS NOT 50.5 KG = 050.5 KG) 1 YES, PREGNANT ► NEXT LINE 2 NO 1 CURRENTLY KNOWN, ENTER IF D1a and D1b CONFLICTS 2 YES, BREASTFEEDING NOT HOME 9999. WRITE WITH INFORMATION IN 3 NOT PREGNANT 2 TOO ILL 4 DO NOT KNOW NUMBER FOR MODULE B (B4a and 3 UNWILLING Complete D7a and D7b for ALL eligible women. If D7a and D7b Complete D8a and D8b for ALL eligible women. If D8a and D8b 1 YES B4b),DETERMINE WHICH IS 4 OTHER disagree, ONLY THEN complete D7c. disagree, ONLY THEN complete D8c. MONTH. 2 NO IF MONTH IS NOT MOST APPROPRIATE. KNOWN, ENTER - ►NEXT LINE 99. 1.YES 2 NO ► NEXT LINE 1st measurement 2nd measurement 3rd measurement 1st measurement 2nd measurement 3rd measurement YEAR MONTH 1 YES ► D7 (only if 1st and 2nd (only if 1st and 2nd disagree) disagree) 2 NO KG KG KG CM CM CM ID D1a D1b D2 D3 D4 D5 D6 D7a D7b D7c D8a D8b D8c 1 ______. ______. ______. ______. ______. ______. __ 2 ______. ______. ______. ______. ______. ______. __ 3 ______. ______. ______. ______. ______. ______. __ 4 ______. ______. ______. ______. ______. ______. __ 5 ______. ______. ______. ______. ______. ______. __ 6 ______. ______. ______. ______. ______. ______. __ 7 ______. ______. ______. ______. ______. ______. __ 8 ______. ______. ______. ______. ______. ______. __ 9 ______. ______. ______. ______. ______. ______. __ 10 ______. ______. ______. ______. ______. ______. __ 11 ______. ______. ______. ______. ______. ______. __ 12 ______. ______. ______. ______. ______. ______. __ SECTION E. AGRICULTURAL LAND

Does your household engage in any agricultural activities (e.g 1 YES E1 farming, livestock)? 2 NO (►"MODULE "OTHER INCOME" L) 1 2012 (MAY 2012- DEC 2012) E2 When was your last completed cropping season? 2 2013 (MAY 2013- DEC 2013)

ENUMERATOR: ASK ABOUT PARCELS OF LAND OWNED, RENTED, FARMED USED BY THE HOUSEHOLD LAST COMPLETED CROPPING SEASON, WHETHER OWNED BY THE HOUSEHOLD OR NOT How large is the Does [PARCEL] Did your household [IF RENTED IN OR [IF How did your household land area of belong to your farm [PARCEL] OUT] How much did SHARECROPPED IN use the land area in [PARCEL] that you household? during [LAST your household OR OUT] [PARCEL] during [LAST P use? 1 Yes, only to this COMPLETED receive/pay in rent for COMPLETED a household CROPPING [PARCEL]? [IF What percentage of CROPPING SEASON]? r 2 Yes, communal SEASON]? RENTED OUT GO TO the harvest from [LIST UP TO TWO] c 3 No, we rent it from MODULE LIVESTOCK [PARCEL] was paid e others ►E6a J1] (in cash or in-kind)? l Area unit 4 No, we sharecrop 1 Yes ► E8a 1 Annual crops in ►E7 2. No, left fallow [IF 2 Seasonal crops 5 No, we borrow at SHARECROPPED i 1 Hectare ►E12 3 Tree crops 2 no cost ►E8 OUT GO TO THE d 2 M 3 No, we rent it out to Time unit 4 Livestock NEXT PARCEL OR 3 Other others 1 Per 5 Wood lots 4 No, we share- month MODULE 6 Multiple uses n (specify) Value in CFA cropped it out ►E7 2 Per LIVESTOCK J1] 7 Other u [if in-kind, 5 No, we lent it at no m estimate season cost ►GO TO 3 Per year b value] MODULE e LIVESTOCK J1" r

[Go to E8A] Percent Area Unit 1ST 2ND ID E3a E3b E4 E5 E6a E6b E7 E8a E8b 1 % 2 % 3 % 4 % 5 % 6 % 7 % 8 % 9 % 10 % ENUMERATOR: ASK ABOUT PARCELS OF LAND USED BY THE HOUSEHOLD IN EITHER SEASON OF 2012 OR 2013, WHETHER OWNED BY THE HOUSEHOLD OR NOT

What is the main What kind of What is the main What is the type What What is the What is the When was the last How long does it take to get source of water for irrigation do you use means of irrigating of the soil on proportion of color of the slope of time you experienced to [PARCEL] from your [PARCEL] during for [PARCEL]? [PARCEL]? [PARCEL]? the soil of [PARCEL]? waterlogging house by the usual mode of P [LAST COMPLETED [PARCEL] [PARCEL] problems on this transport (one way in a CROPPING has crusted [PARCEL]? [WRITE 0 minutes) r SEASON]? soils? IF NEVER c EXPERIENCED] e l 1 Rain ► E12 1 Ground water 1 Electric pump 1 Clay 1 Black 1 Flat 1 MAY’ 13 1 AdjacentAdjucent to homestead 2 Surface irrigation 2 River diversion 2 Diesel/fuel 2 Loam 2 Brown 2 Terraced 2 JUN’13 2 Less than 15 mins i 3 Groundwater 3 Pond diversion pump 3 Sand ► E14 3 Red 3 Gentile slope 3 JULY’13 3 15 -30 mins d irrigation 4 Shallow well 3 Solar pump 4 Sand/loam 4 Red/Brown 4 Moderate 4 AUG’13 4 30 - 60 mins 5 SEP’13 4 A combination (rain 5 Deep well 4 Gravity 5 Rocky soil 5 Grey/Brown slope 5 More than 1 hour and irrigation] 6 Water harvesting 5 Threaded 6 Sand AND clay 6 Grey 5 Steep slope 6 OCT’13 n 7 NOV’13 7 Water cans pumps 7 Clay AND 6 Depression u 8 DEC’13 8 Other 6 Other rocky soil Percent m 9 JAN’14 8 Silt b 10 FEB’14 9 Other e 11 MAR’14 12 APR’14 r 13 MAY’14 14 JUNE'14

ID E9 E10 E11 E12 E13 E14 E15 E16 E17 1 % 2 % 3 % 4 % 5 % 6 % 7 % 8 % 9 % 10 % SECTION F. CROP INPUTS (SOIL CONSERVATION)

ENUMERATOR: ENTER PLOT-LEVEL RESPONSE FOR EACH PARCEL LAST COMPLETED CROPPING SEASON LAST COMPLETED CROPPING SEASON Did you, in the past Did you in the past What year did For how many What was the main method of In what year did Did you practice How much manure did you How much If you bought the How often do Which type of When was the How much fertilizer was used in [LAST What type of other 5 years practice 5 years practice the fallow period years was ploughing [PLOT] during the you first begin contour apply to [PLOT] in [LAST manure for this manure for this you apply fertilizers did you fertilizer COMPLETED CROPPING SEASON] ? organic inputs did crop rotation in fallowing in begin, the last [PLOT] left [LAST COMPLETED to practice ploughing or pit COMPLETED CROPPING [PLOT] was [PLOT] how much manure to use during the applied? [IF A COMBINATION OF FERTILIZERS IS you apply on How many plots [PLOT] [PLOT]? time [PLOT] fallow, the last CROPPING SEASON] zero/minimum planting on SEASON] ? brought onto the did it cost in unit this [PLOT]? [LAST USED, QUANTITY AND VALUE SHOULD [PLOT] in [LAST does your was left fallow? time [PLOT] farming season? tillage on [PLOT]? farm from outside prices (Please use COMPLETED REFER TO THE QUANTITY AND VALUE COMPLETED Parcel number Plot number household have was left [PLOT]? (Please use the the unit expressed CROPPING 1 At planting OF ALL THE FERTILIZERS USED] CROPPING in [PARCEL]? fallow? unit expressed in in F7b)? SEASON] ? 2 Top dressing SEASON] ? F7b)? 1 Cotton Complex 3 At planting 1 Household waste 2 Cereal complex and top 2 Mulch/compost 3 NPK dressing 3 Crop residue 1 Hand hoe ►F6 1 Every year 4 Urée 4 Basal from this farm 2 Animal, mouldboard plough 2 Most years 5 DAP application* 4 Crop residue YEAR ►F6 3 Some years 6 Organic manure 5 At different from other farms

3 Animal, disc plough ►F6 4 Rarely 7 Compost stages 5 A combination of 1 Yes [4-DIGITS] 4 Tractor, mouldboard plough Quantity Unit price in CFA 5 Just once 8 Other organic inputs 6 2 No ►F5a [WRITE -99 IF WRITE ►F6 9 A combination Other [COPY PARCEL NUMBER YEAR [FOUR DO NOT [FOR EACH NUMBER OF 5 Tractor, disc plough ►F6 Quantity 10 None ► F12 7 None ► F14a FROM AGRICULTURAL [WRITE DIGITS] REMEMBER] PARCEL, YEARS 6 Ridge tillage ►F6 Unit MODULE. REPEAT PARCEL PLOT 1 Yes 7 Tied Ridge tillage ►F6 1 Yes WRITE THE [SEE PAGE NUMBER IF THERE ARE NUMBER/N 2 No 8 Planting pits ►F6 2. No NUMBER OF CODE] [WRITE 0 IF IT MULTIPLE PLOTS ON THE AME] 9 Zero/minimum tillage ►F5b PLOTS] WAS ALL PARCEL] 10 Strip/zonal tillage ►F6 Value GENERATED IFMANURE IS 11 Ripping ►F6 ON-FARM AND OBTAINED FOR Unit 12 Mixed method ►F6 FREE OR IS Quantity [SEE PAGE [WRITE 0 IF NO ►F9] [WRITE -99 IF [WRITE -99 IF 13 Other ►F6 COLLECTED CODE] MANURE IS DO NOT DO NOT WRITE 0 in CFA USED AND REMEMBER] REMEMBER] ►F10a ] F1a F1b F2 F3 F4a F4b F4c F5a F5b F6 F7a F7b F7c F8 F9 F10a F10b F11a F11b F11c F12 SECTION F. CROP INPUTS (SOIL CONSERVATION)

ENUMERATOR: ENTER PLOT-LEVEL RESPONSE FOR EACH PARCEL LAST COMPLETED CROPPING SEASON Did you, in the past Did you in the past How much [other organic input] did you How much of other If you bought the other How many How many trees How many Do you What types of measures are you 5 years practice 5 years practice apply on [PLOT] during the [LAST organic fertilizer for organic fertilizer for this trees, herbs, have you trees did have soil using to control soil erosion? crop rotation in fallowing in COMPLETED CROPPING SEASON] [PLOT] was brought [PLOT] how much did it shrubs, etc planted on you remove erosion on [LIST UP TO THREE How many plots [PLOT] [PLOT]? ? onto the farm from cost in unit prices does the [PLOT] within from [PLOT] [PLOT]? MEASURES] does your household the past 2 last year? Parcel number Plot number outside? (expressed in F13b)? household have [IF MORE THAN ONE TYPE OF currently years? [ENTER in [PARCEL]? 'OTHER ORGANIC INPUT' IS USED, have on [ENTER NUMBER] ENTER TOTAL QUANTITY OF [PLOT]? NUMBER] OTHER ORGANIC INPUTS USED] [ENTER NUMBER] 1 Stone terraces 2 Other terrace (shrubs, tree branches) 3 Grass strips/barriers (e.g. 1 Yes vetiver grass) 2 No ►F5a 4 Drainage/ditches [COPY PARCEL NUMBER [FOR EACH 5 Trash lines FROM AGRICULTURAL [WRITE PARCEL, Unit 6 Planting trees MODULE. REPEAT PARCEL PLOT 1 Yes WRITE THE Quantity [SEE PAGE 7 Ripping NUMBER IF THERE ARE NUMBER/N 2 No 8 Contour bands NUMBER OF CODE] MULTIPLE PLOTS ON THE AME] 9 Ditche/swales PLOTS] PARCEL] Quantity Unit price in GHC 10 Other 1 Yes 11 None [WRITE 0 [WRITE 0 IF [WRITE 0 2 No ► IFMANURE IS IF NONE] NONE] IF NONE] NEXT [WRITE 0 IF IT WAS OBTAINED FOR FREE PLOT ALL GENERATED ON- OR IS COLLECTED FARM AND ►F14a] WRITE 0 1ST 2ND 3RD F1a F1b F2 F3 F4a F13a F13b F13c F13d F14a F14b F14c F15 F16a F16b F16c CROPS Quantity unit codes* Cereals Root and tuber crops Maize variety Fonio Varieties Cowpea Variety Pepper Varities Code Unit 11 Corn 41 Onion 110 Similinyo 151 Finiba 250 Sangaranga 351 Nisondia 1 Kilo 12 Millet 42 Potato 111 Denbamyuman 152 Tioi 251 Korobalen 359 Other pepper varieties 2 Gram 13 Wheat 43 Sweet potato 112 Sotubaka 153 Tamatioi 252 Wulibali 3 Liter 14 Sorghum 44 Garlic 113 T7-22 154 Tamabe 253 Sinzana Onion Variety 4 Unit or Piece 15 Fonio 45 Manioc 114 Sabara 155 Petama 254 Yerewolo 411 Jan Iri 5 100 Kilo Sack 16 Rice 46 Shallot 115 Sheduguni 156 Peazo 2 255 Dunanfana 412 PRIMA 6 200 Kilo Sack 19 Other Cereals 47 Yam 116 Tiematie 157 Pon de Madougou 256 Local Maradi(Niger) 413 Violet de Galmi 7 25 Kilo Sack 49 Other roots, tubers 117 Kogoni B 158 Sanogola 257 IAR96 419 Other onion variety 8 50 Kilo Sack Pulses and nuts 118 TZSER-W 1501 Pebe 259 Other cow-peas variety 9 75 Kilo Sack 21 Green Bean Perennial crops 1101 EV8422SR 1502 Tamabe Potato Varieties 10 Other 22 Soybean 51 Avocado 1102 Nieleni 1503 Kassangara Sweet Pea Variety 421 SAHEL 11 Tub 23 Pigeon Pea 52 Banana 1103 Appolo 1504 Pon de Bore 261 Variété à tubercule long 422 CLAUSTAR 12 Ball 24 Chick Pea 53 Mango 1104 Jorobona 159 Other Fonio varieties 262 Variété à tubercule rond 423 SPUNTA 13 Box/Basket 25 Cow Pea 54 Orange 1105 Mali Hybrid 7 269 Other sweet pea varieties 424 LOLA 14 Bowl 26 Sweet Pea 55 Papaya 1106 Brico Rice Varieties 425 TROISE 15 Ball/Sphere 27 Groundnut 56 Coco 1107 Tcheba 161 BG 90-2 Groundt Nut Variety 426 YASMINA 16 Bunch 28 Bambara Nut 57 Palm-oil 119 Other maize varieties 162 Kogoni 91-1 271 ICGV 86015 427 PAMINA 17 Truckload 29 Other Pulses and Nuts 58 Sugar cane 163 Kogoni89-1 272 ICIAR 19BT 428 KERPONDY 18 Spoon (tea, table) 5101 Hibiscus Millet Variety 164 Leizong 273 ICGV 86124 4201 MARFONA 19 Bundle (of Firewood) Vegetables 5102 Sumbala 121 Djiguifa 165 AD 9216 274 ICGV 99241 4202 LISETA 20 Louche 31 Cabbage 59 Other perennial 122 Toroniou 166 ITA 333 275 ICGV 86024 4203 COSMOS 21 Round Loaf 32 Tomato 129 Other millet variety 167 IRAT 161 276 Tiga Huguni 4204 AGRIA 22 Moure/Boite 33 Okra Other crops 168 ITA 335 277 Tiga Pegele 4205 AIDA 23 Paani 34 Amaranth 61 Cotton Wheat Variety 1601 Nerica 4 278 Tiga Kolodjan 4206 ATLAS 24 Platter 35 Pepper (hot) 62 Coffee 131 Tetra 1602 Sahelika 2701 Tiga Jonami 4207 BINTJE 25 Trailor 36 Green or Red Pepper 63 Tobacco 132 Dire 12 1603 Bouake 189 2702 Tiga Ba 4208 MONDIAL 26 Sachet/packet/tube 37 Carrot 64 Tea 133 Dire 15 1604 ITA 320 2703 Kalosabani 429 Other potato varieties 27 Bucketful/Pail 38 Herbs 65 Shea Nut 134 Dire 16 1605 ITA 324 279 Other groundut variety 28 Heap 3101 European Eggplant 66 Baobab 139 Other wheat variety 1606 Jama Jigi 29 Cup 3102 African Eggplant 69 Other Plants 1607 Gambiaka Manioc Varieties 30 Cart/Donkey Cart 3103 Squash/Zucchini Sorghum Varieties 1610 Sambala Malo Tomato Variety 451 Yace 31 Cart/Donkey Cart 3104 Beets Other land use 141 Early Sorgho 1611 Nerica 8 321 C20 - 5 452 Boucou 1 32 Glass 3105 Sorrel 71 Fallow 142 Late Sorgho 1616 Nerica 9 322 Estrela 453 TMS(2)1425 39 Other vegetables 72 Pasture/grazing 143 Sweent Sorghum 1613 Nerica 12 323 Formosa 454 Manioc d'Attieke 73 Planted fodder 144 Timinkala 169 Autre variété de riz 324 SF83 61 455 Manioc rouge 74 Planted trees 145 Keninke 325 ICRIZINA 456 Manioc Blanc 75 Natural trees 146 Kende Soybean Varieties 326 Mongal F1 457 Manioc bassa 79 Other uses 147 Gadiaba 221 G 196 329 Other tomato variety 459 Other manioc varieties 148 Douaje 222 G 197 1401 Village Check 223 Houla Okra Variety 1402 N'Golofing 224 Temoin 331 Batoumabe Mango Varieties 1403 Pablo 225 TGX1908-8F 332 Sasilon 531 Amélie 1404 Yamassa 226 TGX1935-3F 333 Kooni 532 Kent 1405 N'Tenimissa 227 SE 339 Other okra variety 533 Keitt 1406 Seguetana Cinzana 229 Other soybean varieties 534 Brooks 1407 CSM 388 Sorrel Variety 535 Julie 149 Other Sorghum varieties 31041 Wankooye 536 Irwin 31042 Vimto 537 Palmer 31043 Senegal 538 Mango ou fibreuses 3199 Other sorrel varieties 539 Other mango varieties SECTION G1. CROP PRODUCTION ENUMERATOR: FIRST ASK WHICH CROPS WERE GROWN BY THE HOUSEHOLD ON EACH PARCEL AND EACH PLOT THEN ASK G1_4a-G1_9. NOTE THAT THE INFORMATION TO BE COLLECTED IN THIS MODULE IS AT PARCEL-PLOT-CROP LEVEL FOR LAST COMPLETED CROPPING SEASON. Parcel number Plot number What crop was What was the area [APPLY/PLAY THE '50 BEANS GAME' How much [CROP] Which family How was the yield of What is the main reason [number within planted on this planted with [CROP] on ONLY FOR MULTIPLE CROPS IN A was harvested from member had your harvest in 2013 for this difference in yield parcel] plot during the this plot during the PLOT] this [PLOT] during the main compared with compared with yield the [LAST [LAST COMPLETED WRITE 100 IF SINGLE CROP PER [LAST COMPLETED responsibility harvest your normal year? COMPLETED CROPPING SEASON] PLOT. CROPPING for farming this household collects in CROPPING farming season? SEASON] farming plot? a normal year? SEASON] What was the % of area planted with season? farming [CROP] on this plot during [LAST season? STOP AND COMPLETED CROPPING SEASON] ? COMPLETE Area unit 1 Good rainfall THE G COPY PARCEL ID 1 Much higher 2 Bad rain fall CROP FLAP 1 Hectare NUMBER FROM [REPEAT PLOT 2 1 Head 2 Little higher 3 Fertilizer use MODULE "E LAND" NUMBER IF 2 M ENTER THE % OF AREA PLANTED 2 Spouse of 3 Roughly the same 4 Improved seed use Unit [REPEAT PARCEL THERE ARE Crop code 3 Other (MULTIPLY THE NUMBER OF BEANS head ►NEXT LINE 5 Other chemical Area Quantity [SEE PAGE NUMBER IF THERE MULTIPLE [SEE ABOVE] (specify) BY 2) CORRESPONDING TO EACH 3 Both head and 4 Little lower 6 Soil degradation CODE] ARE MULTIPLE CROPS ON CROP IN AN INTERCROPPED PLOT. spouse 5 Much lower 7 Pests or disease PLOTS ON THE THE PLOT] 4 Other 6 Don't know►NEXT 8 Multiple reasons PARCEL] LINE 9 Other

G1_1 G1_2 G1_3 G1_4a G1_4b G1_5 G1_6a G1_6b G1_7 G1_8 G1_9 % % % % % % % % % % % % Note: For tree crops, record all information in the rainy season, leaving the dry (dimba) season row empty (to avoid double-counting). Note: For mixed cropping or more than one crop in a plot, record plot number in more than one row and each crop in a separate row. SECTION G2. CROP INPUTS (COSTS) ENUMERATOR: COMPLETE G2_1A TO G2_7 FOR EACH CULTIVATED CROP IN THE LAST COMPLETED CROPPING SEASON. Crop For [CROP] grown in [LAST COMPLETED CROPPING SEASON], how much [INPUT TYPE] did your household use? codes INPUT TYPE ...seed saved from the previous ...seed obtained for free or in barter. ...traditional seed that was purchased. ... improved seed that was ...pesticides,herbic ...other non- labor harvest [WRITE 0 IF NO [WRITE 0 IF NO TRADITIONAL purchased. ides expenses (e.g., crop [WRITE 0 IF NO SAVED SEED] FREE/BARTER SEED] SEED IS PURCHASED ] [WRITE 0 IF NO IMPROVED SEED [WRITE 0 IF NO residues, off-farm (WRITE -99 IF VALUE IS NOT (WRITE -99 IF VALUE IS NOT IS PURCHASED] PESTICIDES/HER manure, animal or KNOWN) KNOWN) BICIDES] (WRITE equipments rental [COPY CROP -99 IF VALUE IS cost) CODES NOT KNOWN) [WRITE 0 IF NO FROM CROP OTHER NON-LABOR FLAP] EXPENSES] Estimated Estimated Unit Unit Unit Value Unit Value Value Value [SEE value [SEE value [SEE [SEE Quantity Quantity Quantity Quantity PAGE PAGE PAGE PAGE in CFA in CFA in CFA in CFA in CFA in CFA CODE] CODE] CODE] CODE] G2_1 G2_2a G2_2b G2_2c G2_3a G2_3b G2_3c G2_4a G2_4b G2_4c G2_5a G2_5b G2_5c G2_6 G2_7 Note: Person-days are calculated as the number of workers times the number of days they worked. Person-days calculation should include children. For example, if 5 people work for 3 days and 2 people continue for 6 more days, the total number of person-days is 5x3 + 2x6 = 27.

Number of days worked by each Number of workers worker Person-days land preparation -male x = land preparation -female x = planting -male x = planting -female x = fertilizing -male x = fertilizing -female x = weeding -male x = weeding -female x = harvesting -male x = harvesting- female x = other -male x = other- female x = SECTION G3. CROP INPUTS (LABOR)

ENUMERATOR: COMPLETE G3_2_1m TO G3_7b FOR EACH CULTIVATED CROP. WRITE 0 IF NO LABOR IS USED FOR [ACTIVITY] FOR [CROP]

For the [CROP] grown in [LAST COMPLETED CROPPING SEASON] , how many person-days of FAMILY, HIRED AND EXCHANGE LABOR were What was the average daily Which used on [ACTIVITY] ? How much of How much of this How much of wage paid to the hired Crop percentage of this labor was labor was this labor was laborers? WRITE codes the hired labor ACTIVITY family labor? exchange labor? hired labor? ESTIMATED VALUE IF IN- was females? KIND

land preparation 1. All (100%) ► 1. All (100%) ► 1. All (100%) 1. All (100%) ► [COPY (including harrowing & planting fertilizing weeding harvesting other NEXT LINE NEXT LINE 2. Most (~75%) G3_7b CROP ridging) 2. Most (~75%) 2. Most (~75%) 3. About half 2. Most (~75%) CODES 3. About half 3. About half (~50%) 3. About half MALE FEMALE FROM Person- Person- Person- Person- Person- Person- (~50%) (~50%) 4. Some (~25%) (~50%) Person- Person- Person- Person- Person- Person- CROP days days days days days days 4. Some (~25%) 4. Some (~25%) 5. None (0%) ► 4. Some (~25%) days (Male) days (Male) days (Male) days (Male) days (Male) days (Male) FLAP] (Female) (Female) (Female) (Female) (Female) (Female) 5. None (0%) 5. None (0%) NEXT LINE 5. None (0%) CFA per day CFA per day G3_1 G3_2_1m G3_2_1f G3_2_2m G3_2_2f G3_2_3m G3_2_3f G3_2_4m G3_2_4f G3_2_5m G3_2_5f G3_2_6m G3_2_6f G3_3 G3_4 G3_5 G3_6 G3_7a G3_7b G CROP FLAP

Parcel number Plot number Crop codes

[COPY PARCEL [COPY PLOT [COPY CROP NUMBERS NUMBERS CODES FROM FROM G1] FROM G1] G1]

G CROP FLAP SECTION G4. CROP INPUTS (SEEDS) ENUMERATOR: ASK G4_3 TO G4_10B FOR EACH CROP GROWN IN THE LAST COMPLETED CROPPING SEASON. Did your How much of……………………………………………...ASK the THESE QUESTIONS ONLY IF G4_4=2, 3 OR 4 (I.E. IF USED SEED IS NOT FROM OWN HARVEST)………………………… household seed you used in [LAST Where did you How did you How many What was the name of the Did you have any problems with What are the two most grow [CROP] COMPLETED obtain the seed pay for this minutes does main variety of [CROP] seed this variety/these varieties? important characteristics during the CROPPING that was not seed? it take to get used by your household? [LIST UPTO THREE MAIN that the [CROP] seed [LAST SEASON] was saved from 1 Free to this supplier [LIST UPTO THREE MAIN PROBLEMS] variety should have? saved from COMPLETED previous harvest? 2 Cash using the VARIETIES] 1 No problems 2 1 Grain yield CROPPING previous harvest? 1 All ►GO TO 1 Farmer 3 Credit usual mode of [WRITE -99 IF NAME OF Needs inputs 3 2 Grain size SEASON] NEXT LINE 2 Grain trader 4 Subsidy transport? SEED VARIETY IS NOT Low quality 4 3 Disease/pest resistance farming 2 Small amount 3 Input dealer 5 Labor (one way in KNOWN] Poor taste 5 4 Drought tolerance season? 3 Large amount Crop Crop 4 Cooperative exchange minutes) Poor feed 6 5 Flood tolerance 1 Yes 4 None name code 5 Extension 6 A [WRITE - 99 if Too costly 7 6 Low labor needs 2 No ►NEXT service combination G4_5 = 9] Can't save 8 7 Low input needs LINE 6 NGO 9 Other Vulnerable to drought 8 Ease of processing 7 Research 9 Vulnerable to flooding 9 Market demand institute 10 Poor straw 10 Good taste 8 Seed company 11 Shelf life 12 11 Good color 9 Multiple sources Poor germination 13 12 Fodder quality 10 Other Multiple problems 14 13 Other Other 1st 2nd 3rd 1st 2nd 3rd 1st 2nd G4_1 G4_2 G4_3 G4_4 G4_5 G4_6 G4_7 G4_8a G4_8b G4_8c G4_9a G4_9b G4_9c G4_10a G4_10b Maize 11 Wheat 12 Pearl millet 13 Sorghum 14 Finger millet 15 Rice 16 Bean 21 Soyabean 22 Pigeonpea 23 Chick-peas 24 Cow-peas 25 Peas 26 Groundnut 27 Bambara nuts 28 Cabbage 31 Tomatoes 32 Okra 33 Amaranthus 34 Red papper 35 Green papper 36 Onion 41 Irish potato 42 Sweet potato 43 Garlic 44 Cassava 45 Cotton 61 Tobacco 63 SECTION H. CROP SALES - QUANTITIES ENUMERATOR: THIS TABLE IS AT THE CROP LEVEL, NOT PLOT LEVEL, FOR LAST COMPLETED CROPPING SEASON

What crops were grown How much failure in [CROP] did you incur before the harvest What is the reason How much [CROP] How much stover of [CROP] How much of the total harvest How much was left on the field as How much was saved for seed? during [LAST [LAST COMPLETED CROPPING SEASON] ? of the crop failure? without stover was was harvested during [LAST (including stover) was used for crop residue (but not burned)? CROPPING SEASON]? harvested during [LAST COMPLETED CROPPING animal feed? [COPY CROP CODES COMPLETED SEASON] ? FROM MODULE G1 CROPPING SEASON] ? CROP CODE]

Estimated % of the usual Quantity Unit value harvest

1 Drought/little rain Quantity Quantity 2 Excessive Quantity Quantity [WRITE 0 IF [WRITE 0 IF Quantity rains/floods Unit [WRITE 0 IF Unit [WRITE 0 IF Unit Unit NO Unit NOT USED Estimated Estimated [WRITE 0 IF Estimated WRITE 0 IF NO Unit 3 Pests/diseases [SEE NO HARVEST [SEE NO CROP [SEE [SEE HARVEST [SEE CODE FOR Value Value SEED IS NOT Value CROP [SEE 4 Late planting CODE WITHOUT CODE RESIDUE CODE CODE CFA Percent WITHOUT PAGE] ANIMAL (CFA) (CFA) SAVED AND CFA FAILURE AND CODE 5 Poor quality soil PAGE] STOVER AND PAGE] AND PAGE] PAGE] STOVER FEED AND ► H9a] ►H5a PAGE] 6 Multiple reasons ► H6a] ► H8a] AND ► H5a] ► H7a] 7 Other

H1 H2a H2b H2c H2d H4 H5a H5b H5a H5b H6a H6b H6c H7a H7b H7c H8a H8b H8c % % % % % % % % % % % SECTION H. CROP SALES - QUANTITIES ENUMERATOR: THIS TABLE IS AT THE CROP LEVEL, NOT PLOT LEVEL, FOR LAST COMPLETED CROPPING SEASON

What crops were grown How much was used for gifts and How much of the harvest How much of the total harvest was How much of this What UNIT What was the Who in the household How long does it Who was the Did the buyer during [LAST exchange (except own consumption and was used for own used for other purposes (e.g., harvest was sold? price did you main place where has the main take you to go main buyer of contract you to CROPPING SEASON]? sales)? consumption? burned as crop residue, mulching, receive when it was sold? responsibility for making from your house to [CROP]? grow [CROP]? [COPY CROP CODES building material, cooking selling this sales-related decisions get to the main FROM MODULE G1 purposes) crop? (e.g.,timing, amount, place where the CROP CODE] location) ? crop was sold (in minutes using the 1 On farm or home usual mode of 1 Farmer or ► H17 transport) consumer 2 Local market 2 Trader 3 Regulated 3 Processor market 4 4 Cooperative TIME ONE Quantity Quantity Roadside 1 Head of compound WAY ONLY 5 Government Quantity Quantity Unit [WRITE 0 IF [WRITE 0 Unit 5 Cooperative 2 Head of household 6 Other Unit [WRITE 0 IF NO Unit [WRITE 0 IF NO Estimated [SEE NOT USED FOR IF NO [SEE CFA per 6 Processor 3 Spouse of head 1 Yes [SEE CODE OWN [SEE CODE GIFT/EXCHANGE Value CODE OTHER SALE AND CODE quantity unit 7 Other 4 Both head and 2 No PAGE] CONSUMPTION PAGE] AND ► H10a] PAGE] PURPOSES ► NEXT PAGE] spouse 5 AND ► H11a] AND ► H12a] LINE] Other

H1 H9a H9b H9c H10a H10b H11a H11b H12a H12b H13 H14 H15 H16 H17 H18 SECTION I. CROP STORAGE ENUMERATORS: THIS SECTION REFERS TO UNPROCESSED CROPS. BE SURE NOT TO INCLUDE CROPS THAT HAVE UNDERGONE ANY TRANSFORMATION INTO SECONDARY PRODUCTS.

Did you have any What is the total quantity of [CROP] that What type of storage facility did How much of the What was/is the Which method do you use to Do you know if unprocessed [CROP] in you had in storage one month after [THE you use to store [CROP]? [CROP] you stored was main cause of dry [CROP]? Aflatoxin can affect storage one month after LAST CROPPING SEASON'S] harvest, lost before you could sell these losses? [CROP] negatively? [THE LAST CROPPING excluding crop corpuses? or consume it? SEASON'S] harvest?

1 Granary 1 Piles of cobs/pods on the 2 Sacks/bags ground - without cover Crop Crop 3 Roof 1 Rodents 2 Piles of cobs/pods on the code name 4 Raised open platforms 2 Insects ground - with cover 3 Dry, shell and dry 1 Yes 5 Raised roofed platforms 3 Mold Percent 4 Dry and store 2 No 1 Yes Unit 6 Open ground-covered 4 Theft Quantity 7 Open ground-uncovered [WRITE 0 IF NONE 5 Lay on tarpaulin for sun 3 Never heard of 2 No ► NEXT LINE [SEE CODE PAGE] 5 Harvested too 8 Commercial storage AND ► I8] drying Aflatoxin early 6 9 Multiple methods 6 Dry at commercial facility 4 Do not know 10 Other Multiple reasons 7 Not applicable 7 Other 8 Other

I1 I2 I3 I4a I4b I5 I6 I7 I8 I9 11 Maize % 12 Wheat % 13 Pearl millet % 14 Sorghum % 15 Finger millet % 16 Rice % 21 Bean % 22 Soyabean % 23 Pigeonpea % 24 Chick-peas % 25 Cow-peas % 26 Peas % 27 Groundnut % 28 Bambara nuts % 42 Potato % 43 Sweet potato % 45 Cassava % 61 Cotton % 63 Tobacco % SECTION J1. LIVESTOCK OWNERSHIP ASK THE HOUSEHOLD HEAD OR OTHER KNOWLEDGEABLE MEMBER

In the past 12 What type of Which family How many What is the Over the past Over the Over the Over the Over the Over the On average, how Over the past 12 months, months, have management system member had [ANIMAL estimated 12 months, past 12 past 12 past 12 past 12 past 12 much was the how much have you earned members of your does the household main TYPE] total value how many of months, months, months, months, months, unit price of in total from the following household raised or use for [ANIMAL responsibility for does your of [ANIMAL your [ANIMAL how many how many how many how many how many each of [ANIMAL activities...? produced [ANIMAL TYPE]? taking care of household TYPE] your TYPE] have [ANIMAL [ANIMAL [ANIMAL of your of your TYPE] (or TYPE]? the [ANIMAL currently household been TYPE] were TYPE] were TYPE] were [ANIMAL [ANIMAL carcasses) sold? TYPE]? own? currently slaughtered born? bought? given as TYPE] did TYPE] owns? to be gift or you lose have you 1 Head consumed In stolen? due to sold? 2 Spouse of the illness? Code Animal type head household? 1. Yes 1.Grazing/open air 3 Both head 2. No ►NEXT LINE only and spouse [WRITE 0 2.Intensive/Caging 4 Other IF NONE IF RESPONDENT only AND ► DOES NOT HAVE 3. Mixed J1_15a] ANY OF THE ANIMAL TYPES LISTED ►END OF Number CFA total Number Number Number Number Number Number CFA per animal Activity CFA total FIRST VISIT J1_1 J1_2 J1_3 J1_4 J1_5 J1_6 J1_7 J1_8 J1_9 J1_10 J1_11 J1_12 J1_13 J1_14 J1_15a J1_15b 100 Draught cattle Rental 101 Bulls -local- Rental 102 Bulls -improved- Rental 103 Fattening cattle -local- Meat products 104 Fattening cattle -improved- Meat products 105 Cows -local- Dairy products 106 Cows -improved- Dairy products 107 Heifers -local- 108 Heifers -improved- 109 Calves -local- 110 Calves -improved- 111 Horse/donkey/mule Rental 112 Goats -local- Goat milk 113 Goats -improved- Goat milk 114 Sheep Wool/skins 115 Pigs -local- 116 Pigs -improved- 117 Chickens Egg sales 118 Fish 119 Other livestock 120 Honey bees* * * * * Honey/Wax sales SECTION J2. LIVESTOCK FEED ASK THE HOUSEHOLD HEAD OR OTHER KNOWLEDGEABLE MEMBER

Over the last 12 months… ...have …how much labor time did …how much labor time …which ...what was the ...which of the following feed for [ANIMAL members of your household spend on from hired workers was percentage of the source of feed for CATEGORY] have you used? your [ANINAL CATEGORY}? spent on [ANINAL hired labor was [ANIMAL [LIST UP TO THREE SOURCES] household CATEGORY}? females? CATEGORY]? raised or produced [ANIMAL 1. All (100%) 1. Off farm 1 Crop residue CATEGORY]? 2. Most (~75%) (purchased) 2 Green forages 3. About half 2.Off-farm (non- 3 Grazing/open air [WRITE 0 (~50%) purchased) 4 Concentrate feeds Code Animal category [WRITE 0 1 Days IF NO 1 Days 4. Some (~25%) 3. On-farm 5 Legumes, fodder trees, shrubs IF NO 2 Weeks HIRED 2 Weeks 5. None (0%) 4. Multiple sources 6 Multiple HIOUSEHO 3 Months LABOR ► 3 Months 7 Other LD LABOR] J2_6] IF RESPONSE IS 3 (GRAZING/OPEN AIR) ONLY, ► J2_10. IF 3 AND ADDITIONAL RESPONSE OPTIONS ►TO J2_8.

1. Yes 2. No ►NEXT duration unit duration unit % 1st 2nd 3rd LINE

ID J2_1 J2_2 J2_3a J2_3b J2_4a J2_4b J2_5 J2_6 J2_7a J2_7b J2_7c

81 Large ruminants (cattle)

Equines (e.g., horses, 82 donkeys, and mule) Small ruminants (e.g,, sheep, 83 goats,…)

84 Chicken and poultry

85 Pigs SECTION J2. LIVESTOCK FEED ASK THE HOUSEHOLD HEAD OR OTHER KNOWLEDGEABLE MEMBER

Over the last 12 months… …how much did ...how frequently did ...how much manure …where did your …for how many Which was the ...how much you pay for feed your household did [ANIMAL TYPE] household store weeks have you main use of this have you earned ...how much feed for [ANIMAL for [ANIMAL face shortage of produce that the manure coming stored manure manure coming in total from CATEGORY] have you used CATEGORY]? drinking water for household was able to from [ANIMAL coming from from [ANIMAL manure sales per day, on average? [animal category] collect? TYPE]? [ANIMAL TYPE]? TYPE]? from [ANIMAL TYPE]? WRITE 0 IF 1 Stored open 1 Recycled in the WRITE 0 IF NO THERE WAS NO 2 Roofed field SALE OF PURCHASE OF 1. Always 3 Sealed 2 Sold MANURE; FEED 2. Often 4 Other 3 Source of energy WRITE -99 IF Code Animal category WRITE 0 IF NO 3. Sometimes 5 No storage ► 4 Plastering DON'T KNOW MANURE WAS 4. Rarely J2_14 5 Multiple uses COLLECTED AND ► 5. Never 6 Other J2_16] 7 None

Unit Unit Quantity [SEE CFA per [SEE CFA Quantity weeks CFA total per day CODE unit CODE PAGE] PAGE] ID J2_1 J2_8 J2_9a J2_9b J2_9c J2_10 J2_11a J2_11b J2_12 J2_13 J2_14 J2_15

81 Large ruminants (cattle)

Equines (e.g., horses, 82 donkeys, and mule) Small ruminants (e.g,, sheep, 83 goats,…)

84 Chicken and poultry

85 Pigs ENUMERATOR: PLEASE THANK THE RESPONDENT AND SET UP DATE AND TIME FOR NEXT VISIT

CHECKLIST

G1_5. HAVE YOU DONE THE "50 BEANS GAME" TO CALCULATE INTERCROPPED AREA? QUESTION G1_5 IN CROP PRODUCTION SECTION G1 1 Yes 2 No

INTERVIEW END TIME A9c : HOUR MIN SECTION K. INTERACTION WITH AGRICULTURAL EXTENSION AGENTS AND AFRICA RISING ASK THE HEAD OF THE HOUSEHOLD OR OTHER KNOWLEDGEABLE MEMBER Have you received Is [SOURCE] among the three During the [LAST CROPPING SEASON] how often did you interact advice/information on most important sources you with {SOURCE] to give you advice on farming/raising livestock? vegetable gardens, crops, would prefer to ask/seek S livestock, or soil and natural advice/information? o resource management from u [SOURCE] in the last 12 1 At least once every week r months? 2 Not weekly but at least once c Source Name every month e 3 Not every month but at least once during the cropping season I 1 Yes, 1st most important 4 Just once D 2 Yes, 2nd most important 5 Never 1 Yes 3 Yes, 3rd most important 6 Other 2 No ► NEXT LINE 4 Not among the three important sources ID K1 K2 K3 K4 1 Friend/neighbor 2 Model farmer 3 Other farmer 4 Farmer's group 5 Agricultural development/ extension agent 6 Other

K5 How far is your local Farmer Training Center (one way and in minutes) using the K15 Have you heard of Africa RISING program? usual mode of transport? [WRITE -98 IF DO NOT KNOW IF THERE IS ONE ►K7] min 1 Yes [WRITE -99 IF DO NOT KNOW THE DISTANCE] 2 No ► GO TO OTHER INCOME MODULE L K6 Have you ever participated in the activities of your Farmer Training Center? K16 Have you ever participated in any activity as part of/organized by Africa RISING program? 1 Yes 2 No 1 Yes 2 No ►K20 K7 Think of the agricultural extension/development agent you interact with the most. K17 Which Africa RISING-related activity did you get involved in? [LIST UP TO THREE] How long have you known that agent? 1 Community meetings 1st K17a [WRITE YEAR] years 2 Trainings 2nd K17b 3 On-farm experimentation of new or improved [WRITE -99 IF YOU DON'T KNOW ANY AGENT] agricultural technology 3rd K17c 4 Demonstration field days 5 Other

K8 Did you try any new agricultural technologies/management practices K18 Are you happy with the quality and quantity of Afica RISING activites you have been engaged in? during [LAST CROPPING SEASON]? 1 Yes 1 Yes 2 No ►K10 2 No K9 Have these been new activities your agent has demonstrated to you? K19 Do you plan to continue participating in Africa RISING activities in this [2014] planting season? 1 Yes 1 Yes ► GO TO OTHER INCOME MODULE L 2 No 2 No K10 Are you a member of your community's farmer research group? K20 What are your reasons for not participating in Africa RISING activities? [LIST UP TO THREE] 1 Yes 2 No ►K12 1 Not relevant to my activities 1st K20a WRITE -99 IF NOT APPLICABLE 2 Technology not appropriate 2nd K20b K11 Have you ever used a new technology that you have seen at your research 3 Too expensive 3rd K20c group activity or field day? 4 Too risky 1 Yes 5 Prefer to be on my own 2 No 6 Not enough information WRITE -99 IF NOT APPLICABLE 7 No time K12 Do you/your household participate in any group that focuses on the conservation 8 I was turned down of natural resourceS? 9 Other 1 Yes 2 No K13 Do you/your household currently participate in any social organization?

1 Yes 2 No K14 Are you/your household satisfied with quantity, quality and timeliness of extension and input supply services? 1 Yes 2 No SECTION L. OTHER INCOME ASK THE HEAD OF THE HOUSEHOLD OR OTHER KNOWLEDGEABLE MEMBER

In the past 12 months, Who in the household is How many months out of For each of these months that your How important is [ACTIVITY] have members of your mainly responsible for the past 12 months did household earned income from to meeting household household received any [ACTIVITY]? members of this household [ACTIVITY], how much MONTHLY expenses? Other income from [ACTIVITY]? receive income from INCOME, on average, did your Income [ACTIVITY]? household make? Other income activity name Activity Code 1 Head 1 Very important 1 Yes 2 Spouse of head 2 Important Months CFA per month 2 No ► NEXT LINE 3 Both head and spouse 3 Somehow important 4 Other 4 Not very important ID L1 L2 L3 L4 L5 L6 100 Family/Household non-farm enterprise income 101 Firewood & other forest products (excluding charcoal ) 102 Sale of charcoal 103 Sale of wild foods/bushmeat 104 Grain milling 105 Local beer brewing & malting 106 Other agricultural processing business* (e.g., packaging) 107 Pension 108 Remittances from family members or friends 109 Other assistance SECTION M. CREDIT ENUMERATOR: ASK THE HOUSEHOLD HEAD OR OTHER KNOWLEDGEABLE MEMBER

1. Yes M1 During the last 12 months, did anyone in this household apply for credit or ask for a loan of at least 2,500 CFA? 2. No ►M3

1. Yes M2 During the last 12 months, did the household receive a loan? 2. No

1. Yes During the last 12 months, did you receive any crop inputs or agricultural equipment on M3 2. No ► MODULE N: credit? HOUSING

ENUMERATOR: FOR EACH CROP INPUT OR EQUIPMENT RECEIVED ON CREDIT, FILL IN ONE LINE Did you obtain [INPUT Who offered you these What was the value How much time is the TYPE] on credit during goods on credit? of these inputs? credit for? the last 12 months?

1 Input supplier 2 Trader 3 Processor Input 4 Cooperative 1 Yes type Input type name 5 Farmer CFA Months 2 No►NEXT LINE code 6 Min of Agric. 7 NGO 8 Multiple sources 9 Other ID M4 M5 M6 M7 M8 1 Seed 2 Fertilizer 3 Pesticides* 4 Farm machinery 5 Animals 6 Other input * Y compris insecticides, herbicides, fungicides, etc. SECTION N. HOUSING AND ASSETS ASK THE HEAD OF THE HOUSEHOLD OR OTHER KNOWLEDGEABLE MEMBER

What is the main material used for the outer walls of the house? N1 What is the main source of drinking water for your household? N7

1 Piped into 5 Spring 6 dwelling 2 Pond/Lake/Dam Public tap 3 7 River 8 Borehole, well & Rainwater 9 pump 4 Sachet or bottled Well without water 10 Other pump 1 Mud/mud brick/clay 4 Cement/sandcrete bloc 2 Wood/bamboo 5 Thatch/cardboard 3 Stone/burned bricks 6 Corrugated Metal What is the main type of toilet used by your household? 7 Other 1 Private KVIP 4 Shared latrine N8 2 Shared KVIP 5 Bush or field What is the main material used for the floor in your house? 3 Private latrine 6 Other N2 1 Earth/mud/mud brick 4 Cement/concrete What is the main type of lighting used by your household? 2 Wood 5 Ceramic/tiles 1 Electric lights 4 Oil or kerosene lamp N9 3 Stone 6 Other 2 Torch 5 Other 3 Candles 6 Solar panel What is the main material used for the roof on your house? 7 None N3 What is the main type of cooking fuel used by your household? 1 Leaves/raffia/thatch 5 Asbestos/slate/tiles 1. Wood 4. Electricity N10 2 Wood 6 Mud/earth roof (tembe) 2. Charcoal 5 Kerosene/paraffin 3 Corrugated metal 7 Plastic sheeting 3. Gas/LPG 6. Other 4 Cement/concrete 8 A combination 9 Other How many loads of firewood do family members collect per day? How many distinct rooms does the household occupy WRITE 0 IF NO FIREWOOD HAS BEEN COLLECTED N11 located in the same or different places?(number) N4 (exclude toilet, kitchen, & bath rooms) In the last year, do you have to walk farther to gather enough firewood? N12 How many windows does the housing unit have? N5 1 Yes 2 No

(number)

How much monthly rent are you paying [IF N6 RENTING IN] or how much monthly rent would you receive if you were to rent out this house? [ENTER -99 IF RESPONDENT DOES NOT KNOW] (CFA/month) SECTION N. HOUSING AND ASSETS ASK THE HEAD OF THE HOUSEHOLD OR OTHER KNOWLEDGEABLE MEMBER. READ ALOUD EACH ASSET TYPE.

How many units of When did your household acquire How much did you [HOUSEHODL ASSET TYPE] [HOUSEHOLD ASSET TYPE]? pay for How long does it take to get to does your household currently [HOUSEHOLD [SERVICE TYPE], from your Asset own? WRITE FOUR DIGIT YEAR AND -99 IF DO ASSET TYPE]? Service house, using the usual form/s of Household asset type Service type code [WRITE 0 IF NONE ► NEXT LINE] NOT REMEMBER. IF MULTIPLE PIECES OF code transport? [one way in AN ASSET ARE ACQUIRED AT DIFFERENT WRITE 0 IF ITEM minutes] TIMES, WRITE YEAR OF THE MOST WAS OBTAINED FOR ENTER -99 IF NOT APPLICABLE RECENT PURCHASE. FREE

ID N13 N14 N15 N16 ID N13 N17 100 Improved charcoal/wood stove 300 the nearest motorable road? 101 Kerosene stove 301 the nearest all-season road? 102 Gas stove 302 the nearest asphalt road? 103 Wooden bed - modern 303 the nearest weekly market place? 104 Metal bed - modern 304 the nearest daily market place? 105 Sofa chair 305 the district capital? 106 Modern chair 306 the nearest place with daily bus 107 Modern table 307 thestop nearest or taxi service?health care facility? 108 Radio 308 primary school? 109 Television 309 secondary school? 110 Electric fan 111 Refrigerator 112 Land-line phone 113 Mobile phone 114 Bicycle 115 Motorbike 116 Car or truck 117 Satellite dish 118 Solar panel 119 Wooden cabinets 120 CD/DVD Player

How many units of [FARM When did your household acquire [FARM ASSET TYPE]? How much did you pay for [FARM ASSET TYPE] does your ASSET TYPE]? WRITE 0 IF ITEM Asset Farm asset type household currently own? WRITE FOUR DIGIT YEAR AND -99 IF DO NOT REMEMBER. IF MULTIPLE WAS OBTAINED FOR FREE code [WRITE 0 IF NONE ► NEXT PIECES OF AN ASSET ARE ACQUIRED AT DIFFERENT TIMES, WRITE LINE] YEAR OF THE MOST RECENT PURCHASE.

ID N13 N14 N15 N16 200 Cutlass 201 Axe/pick-axe 202 Sprayer 203 Sickle 204 Ox-plough 205 Yoke 206 Harrow 207 Shovel 208 Hoe 209 Winnower 210 Animal cart 211 Power tiller 212 Tractor 213 Disc Plough 214 Ox-ridger 215 Ripper SECTION O. SUBJECTIVE WELFARE AND FOOD SECURITY ENUMERATOR: ASK THE WOMAN IN THE HOUSEHOLD In the past 7 In the past 7 days, how many days have you or someone in your household had to: How many meals, including breakfast What did your children What did your days, did you are taken per day… below 5 years old (0-4 children between 5 worry that your IF NO DAYS, RECORD ZERO. years) have for to 13 years old have household breakfast yesterday? for breakfast would not have yesterday? Restrict Borrow food, or Have no food Harvest and …among children enough food? Rely on less Limit the Limit portion Reduce number of Go a whole day USE CODES BELOW. consumption by rely on help of any kind in collect wild foods ..in the (6-59 months)? preferred variety of size at meal- meals eaten in a and night without IF NO CHILDREN USE CODES adults for small from a friend or your (e.g., vegetables, household? LEAVE BLANK IF foods? foods eaten? times? day? eating anything? UNDER AGE 5, BELOW. IF NO 1 YES children to eat? relative? household? birds) NO CHILDREN 2 NO RECORD "0" CHILDREN 5-13, RECORD "0" DAYS DAYS DAYS DAYS DAYS DAYS DAYS DAYS DAYS NUMBER NUMBER O1 O2a O2b O2c O2d O2e O2f O2g O2h O2i O3a O3b O4 O5

Do all Which and how many members of the In the last 12 Did you experience shortage of food in [MONTH], [YEAR]? household household usually eat a more diverse or months, have you members eat a less diverse variety of foods, (including been faced with a 1 YES roughly the food consumed utside the house)? situation when you 2 NO same diet? did not have enough quantity of food to feed the What was the cause of this household? situation? 1 MORE DIVERSE 2 LESS DIVERSE [LIST UP TO 3 IN OR DER OF 2013 IMPORTANCE] USE CODES AT THE BOTTOM 1 YES ►O8 Jan Feb Mar Apr May June July Aug Sep Oct Nov Dec 2 NO O9a O9b O9c O9d O9e O9f O9g O9h O9i O9j O9k O9l

1 YES 2 NO ► Children NEXT 2014 Men Women (6-59 MODULE months) Jan Feb Mar Apr May June July Aug Sep Oct Nov Dec 1ST 2ND 3RD O6 O7a O7b O7c O8 O10a O10b O10c O10d O10e O10f P10g P10h P10i O11a O11b O11c

CODES FOR O4, O5 CODES FOR O11A, O11B, & O11C

1 TEA/DRINK WITH SUGAR 1 INADEQUATE HOUSEHOLD STOCKS DUE TO DROUGHT/POOR RAINS 2 MILK/MILK TEA WITH SUGAR 2 INADEQUATE HOUSEHOLD FOOD STOCKS DUE TO CROP PEST DAMAGE 3 SOLID FOOD ONLY (CASSAVA, SWEET POTATO, BANANA, RICE) 3 INADEQUATE HOUSEHOLD FOOD STOCKS DUE TO SMALL LAND SIZE 4 TEA/DRINK WITH SOLID FOOD (AS IN RESPONSE OPTION 3) 4 INADEQUATE HOUSEHOLD FOOD STOCKS DUE TO LACK OF FARM INPUTS 5 PORRIDGE WITH GROUNDNUT FLOUR 5 FOOD IN THE MARKET WAS VERY EXPENSIVE 6 PORRIDGE WITH SOLID FOOD (AS IN RESPONSE OPTION 3) 6 NOT ABLE TO REACH THE MARKET DUE TO HIGH TRANSPORTATION COSTS 7 PORRIDGE WITH SUGAR 7 NO FOOD IN THE MARKET 8 PORRIDGE WITH MILK 8 FLOODS/WATER LOGGING/HAILSTORM 9 PORRIDGE WITHOUT SUGAR 9 NO MONEY 10 BREASTMILK 10 THEFT 11 NOTHING 11 FIRE 12 OTHER 12 OTHER SECTION P: FOOD CONSUMPTION OVER THE PAST WEEK ENUMERATOR: ASK THE HOUSEHOLD HEAD AND THE SPOUSE (TOGETHER AND AS APPROPRIATE). FIRST ASK WHETHER EACH ITEM WAS CONSUMED BY THE HOUSEHOLD (QUESTION P1), THEN COMPLETE P3a TO P7b. IF FOOD IS CONSUMED OUTSIDE THE HOUSEHOLD BUT NOT PURCHASED, ASK MARKET VALUE. Within the past 7 days, did members of this household consume [ITEM] within How much [ITEM] in total did your household How much [ITEM] came How much did you How much [ITEM] came How much [ITEM] came the household? consume in the past 7 days? from purchases? spend to purchase from own-production? communal meal, gifts and 1 Kilogramme 19 Fagot [ITEM] in total? other sources? PLEASE LIST NOT ONLY ITEMS CONSUMED WITHIN THE 2 Gramme 20 Louche I HOUSEHOLD BUT ALSO FOOD CONSUMED OUTSIDE THE 3 Litre 21 Miche T HOUSEHOLD.. 4 Unité ou Pièce 22 Moure/Boite E 7 Sac de 25 Kilo 23 Paani THIS QUESTION EXCLUDE FOOD TAKEN M ASK THIS QUESTION FOR ALL ITEMS, BEFORE MOVING ON 10 Autre 24 Plateau REFERS TO THE OUTSIDE THE TO THE NEXT QUESTIONS FOR ITEMS WITH YES 11 Baignoire 26 Sachet/tube IF NONE, WRITE 0 FOR QUANTITY IF NONE, WRITE 0 FOR HOUSEHOLD QUANTITY AND ►P6a REPORTED IN QUANTITY and ►P7a C 13 Boîte/panier 27 Seau/Pot QUESTION P4a IF NONE, WRITE 0 FOR O 14 Bol 28 Tas QUANTITY AND GO TO NEXT ITEM D 15 Boule 29 Tasse E 16 Bouquet 30 Tour de charrette 17 Camion 31 Tour de charrette 1 YES 18 Cuillere 32 Verre Food item 2 NO ►NEXT LINE QUANTITY UNIT QUANTITY UNIT CFA total QUANTITY UNIT QUANTITY UNIT ID P1 P2 P3a P3b P4a P4b P5 P6a P6b P7a P7b Cereals and Cereal products

0101 Rice (paddy)

0102 Maize (green, cob)

0103 Maize (grain)

0104 Maize (flour)

0105 Millet and sorghum (grain)

0106 Millet and sorghum (flour)

0107 Wheat, barley grain and other cereals

0108 Bread

0109 Buns and biscuits

0110 Macaroni, spaghetti

0199 Other cereal products Starches

0201 Cassava fresh

0202 Cassava dry/flour

0203 Sweet potatoes

0204 Yams/cocoyams

0205 Irish/round potatoes

0206 Cooking bananas, plantains

0299 Other starches Within the past 7 days, did members of this household consume [ITEM] within How much [ITEM] in total did your household How much [ITEM] came How much did you How much [ITEM] came How much [ITEM] came the household? consume in the past 7 days? from purchases? spend to purchase from own-production? communal meal, gifts and 1 Kilogramme 19 Fagot [ITEM] in total? other sources? PLEASE LIST NOT ONLY ITEMS CONSUMED WITHIN THE 2 Gramme 20 Louche I HOUSEHOLD BUT ALSO FOOD CONSUMED OUTSIDE THE 3 Litre 21 Miche T HOUSEHOLD.. 4 Unité ou Pièce 22 Moure/Boite E 7 Sac de 25 Kilo 23 Paani THIS QUESTION EXCLUDE FOOD TAKEN M ASK THIS QUESTION FOR ALL ITEMS, BEFORE MOVING ON 10 Autre 24 Plateau REFERS TO THE OUTSIDE THE TO THE NEXT QUESTIONS FOR ITEMS WITH YES 11 Baignoire 26 Sachet/tube IF NONE, WRITE 0 FOR QUANTITY IF NONE, WRITE 0 FOR HOUSEHOLD QUANTITY AND ►P6a REPORTED IN QUANTITY and ►P7a C 13 Boîte/panier 27 Seau/Pot QUESTION P4a IF NONE, WRITE 0 FOR O 14 Bol 28 Tas QUANTITY AND GO TO NEXT ITEM D 15 Boule 29 Tasse E 16 Bouquet 30 Tour de charrette 17 Camion 31 Tour de charrette 1 YES 18 Cuillere 32 Verre Food item 2 NO ►NEXT LINE QUANTITY UNIT QUANTITY UNIT CFA total QUANTITY UNIT QUANTITY UNIT ID P1 P2 P3a P3b P4a P4b P5 P6a P6b P7a P7b Sugar and Sweets

0301 Sugar

0302 Sugarcane

0303 Sweets

0304 Honey, syrups, jams, marmalade, jellies, canned fruits

0399 Other sweets Pulses 0401 Peas, beans, lentils 0499 Other pulses Nuts and Seeds 0501 Groundnuts in shell/shelled

0502 Coconuts mature 0503 Coconuts immature 0504 Bambara nuts

0505 Seeds and products from nuts/seeds (excl. cooking oil)

0506 Wild nuts and seeds

0599 Other nuts and seeds Vegetables

0601 Onions, tomatoes, carrots and green pepper, other viungo

0602 Spinach, cabbage and other green vegetables 0603 Canned, dried and wild vegetables 0604 Wild vegetables 0699 Other vegetables Within the past 7 days, did members of this household consume [ITEM] within How much [ITEM] in total did your household How much [ITEM] came How much did you How much [ITEM] came How much [ITEM] came the household? consume in the past 7 days? from purchases? spend to purchase from own-production? communal meal, gifts and 1 Kilogramme 19 Fagot [ITEM] in total? other sources? PLEASE LIST NOT ONLY ITEMS CONSUMED WITHIN THE 2 Gramme 20 Louche I HOUSEHOLD BUT ALSO FOOD CONSUMED OUTSIDE THE 3 Litre 21 Miche T HOUSEHOLD.. 4 Unité ou Pièce 22 Moure/Boite E 7 Sac de 25 Kilo 23 Paani THIS QUESTION EXCLUDE FOOD TAKEN M ASK THIS QUESTION FOR ALL ITEMS, BEFORE MOVING ON 10 Autre 24 Plateau REFERS TO THE OUTSIDE THE TO THE NEXT QUESTIONS FOR ITEMS WITH YES 11 Baignoire 26 Sachet/tube IF NONE, WRITE 0 FOR QUANTITY IF NONE, WRITE 0 FOR HOUSEHOLD QUANTITY AND ►P6a REPORTED IN QUANTITY and ►P7a C 13 Boîte/panier 27 Seau/Pot QUESTION P4a IF NONE, WRITE 0 FOR O 14 Bol 28 Tas QUANTITY AND GO TO NEXT ITEM D 15 Boule 29 Tasse E 16 Bouquet 30 Tour de charrette 17 Camion 31 Tour de charrette 1 YES 18 Cuillere 32 Verre Food item 2 NO ►NEXT LINE QUANTITY UNIT QUANTITY UNIT CFA total QUANTITY UNIT QUANTITY UNIT ID P1 P2 P3a P3b P4a P4b P5 P6a P6b P7a P7b Fruits 0701 Ripe bananas 0702 Citrus fruits (oranges, lemon, tangerines, etc.)

0703 Mangoes, avocadoes

0704 Wild Fruits 0799 Other fruits Meat, meat products, fish 0801 Goat meat

0802 Beef including minced sausage 0803 Pork including sausages and bacon 0804 Chicken and other poultry 0805 Wild birds, insects, mice 0806 Other domestic/wild meat products 0807 Eggs

0808 Fresh fish and seafood

0809 Dried/salted fish and seafood 0810 Package/Canned fish 0899 Other meat Within the past 7 days, did members of this household consume [ITEM] within How much [ITEM] in total did your household How much [ITEM] came How much did you How much [ITEM] came How much [ITEM] came the household? consume in the past 7 days? from purchases? spend to purchase from own-production? communal meal, gifts and 1 Kilogramme 19 Fagot [ITEM] in total? other sources? PLEASE LIST NOT ONLY ITEMS CONSUMED WITHIN THE 2 Gramme 20 Louche I HOUSEHOLD BUT ALSO FOOD CONSUMED OUTSIDE THE 3 Litre 21 Miche T HOUSEHOLD.. 4 Unité ou Pièce 22 Moure/Boite E 7 Sac de 25 Kilo 23 Paani THIS QUESTION EXCLUDE FOOD TAKEN M ASK THIS QUESTION FOR ALL ITEMS, BEFORE MOVING ON 10 Autre 24 Plateau REFERS TO THE OUTSIDE THE TO THE NEXT QUESTIONS FOR ITEMS WITH YES 11 Baignoire 26 Sachet/tube IF NONE, WRITE 0 FOR QUANTITY IF NONE, WRITE 0 FOR HOUSEHOLD QUANTITY AND ►P6a REPORTED IN QUANTITY and ►P7a C 13 Boîte/panier 27 Seau/Pot QUESTION P4a IF NONE, WRITE 0 FOR O 14 Bol 28 Tas QUANTITY AND GO TO NEXT ITEM D 15 Boule 29 Tasse E 16 Bouquet 30 Tour de charrette 17 Camion 31 Tour de charrette 1 YES 18 Cuillere 32 Verre Food item 2 NO ►NEXT LINE QUANTITY UNIT QUANTITY UNIT CFA total QUANTITY UNIT QUANTITY UNIT ID P1 P2 P3a P3b P4a P4b P5 P6a P6b P7a P7b Milk and milk products 0901 Fresh milk 0902 Milk products 0903 Canned milk/milk powder 0999 Other dairy products Oil and fats 1001 Cooking oil 1002 Butter, margarine, ghee 1099 Other fat products Spices and other foods 1101 Salt 1199 Other spices Beverages 1201 Tea dry 1202 Coffee and cocoa 1203 Other raw materials for drinks 1204 Bottled/canned soft drinks (soda, juice, water) 1205 Prepared tea, coffee 1206 Bottled beer 1207 Local brews 1208 Wine and spirits 1299 Other Food outside the household

1301 Full meals (breakfast, lunch or dinner) 1302 Barbecued meat, chips, roast bananas

1303 Samosa, cake and other snacks 1399 Other foods SECTION Q1: NON-FOOD EXPENDITURES – PAST ONE WEEK & ONE MONTH ENUMERATOR: ASK THE HOUSEHOLD HEAD AND THE SPOUSE (TOGETHER AND AS APPROPRIATE). ONE WEEK RECALL ONE MONTH RECALL Over the past 7 days, did you How much did Over the past 30 days, did you purchase or pay for any [ITEM]? How much did you purchase any [ITEM]? you pay in total pay in total for for [ITEM]? [ITEM]? Item 1 YES Item 1 YES code code 2 NO ►NEXT LINE 2 NO ►NEXT LINE

CFA CFA ID Q1_1 Q1_2 Q1_3 ID Q1_1 Q1_4 Q1_5 101 Cigarettes or tobacco 207 Charcoal

102 Matches 208 Firewood 103 Public transport 209 Milling fees, grain

210 Bar soap (for body or clothes) 211 Laundry soap (powder) ONE MONTH RECALL 212 Toothpaste, toothbrush Over the past 30 days, did you purchase or pay for any [ITEM]? How much 213 Toilet paper did you pay in 214 Glycerine, Vaseline, skin creams total? Item Personal care products for women (shampoo, cosmetics, code 1 YES 215 hair products, etc.) 2 NO ►NEXT ITEM Personal care products for men (shampoo, razor blades, CFA 216 hair products, etc.) Household cleaning products (dish soap, ID Q1_1 Q1_4 Q1_5 217 toilet cleansers, etc.) 201 Kerosene 218 Light bulbs/candles/torch batteries 202 Electricity, including electricity vouchers Phone, internet, postage stamps or other postal fees 219 203 Gas (for lighting/cooking) 220 Donation - to church, mosque, charity, beggar, etc. 204 Water 221 Motor vehicle service, repair, or parts 205 Petrol or diesel 222 Fuel for motor cycle 206 Cell phone voucher 223 Bicycle service, repair, or parts 224 Wages paid to servants

225 Repair cost to farm implements

226 Mortgage (regular payment to purchase house) or rent Repairs to household and personal items 227 (radios, watches, etc.) 228 Lotteries and raffles SECTION Q2: NON-FOOD EXPENDITURES – PAST TWELVE MONTHS

ENUMERATOR: ASK THE HOUSEHOLD HEAD AND THE SPOUSE (TOGETHER AND AS APPROPRIATE).

Over the past 12 months, did you purchase or pay for any [ITEM]? How much did you pay Over the past 12 months did What was the cost of [ITEM] What was the estimated total value of in total? you gather, purchase, or pay for that you purchased? [ITEM] consumed, from what you have any [ITEM]? gathered? WRITE 0 IF NO GATHERING 1 YES 1 YES ITEM 2 NO ►NEXT ITEM 2 NO ►NEXT ITEM NAME CFA ITEM NAME CODE ITEM CODE ITEM CFA CFA ID Q2_1 Q2_2 Q2_3 ID Q2_1 Q2_2 Q2_3 Q2_4

301 Carpet, rugs, drapes, curtains 400 Wood poles, bamboo Grass for thatching roof or other 302 Linen - towels, sheets, blankets 401 use 303 Mat - sleeping or for drying maize flour 402 Mud bricks 304 Mosquito net 403 River sand 305 Mattress 404 Stones 306 Farm implements (e.g., cutlass, hoe) Building items - cement, bricks, timber, 307 iron sheets, tools, etc. 308 Health insurance fee (NHIS, etc.)

309 Losses due to theft (value of items or cash lost) 310 Fines or legal fees 311 Bride price /Marriage costs 312 Funeral costs

313 Repairs to consumer durables (e.g., repair cost for TV, Radio)

314 Taxes for income, property, etc.

315 Construction, repairs & maintenance to dwelling (human) (e.g., roofing sheet)

316 Construction, repairs & maintenance to housing for animals 317 Garments for men 318 Garments for women 319 Garments for children and babies 320 Footwear for men 321 Footwear for women 322 Footwear for children and babies

323 Membership fees (e.g., christian mothers association, funeral associations)

324 School fees 325 Motor bike 326 Cooking utensils /jerry cans 327 Medical expense (excluding health insurance fee) 328 Other costs not stated elsewhere SECTION R: RECENT SHOCKS TO HOUSEHOLD WELFARE ENUMERATOR: ASK THE HOUSEHOLD HEAD OR THE MOST KNOWLEDGEABLE HOUSEHOLD MEMBER

Over the past five years, was your household Rank the three most Did [SHOCK] How dispersed was this In which year How long did the last What did your household do in 1 RELIED ON OWN-SAVINGS S severely affected negatively by any of the significant shocks you cause a reduction shock? It affected... and month did episode of [SHOCK] last? response to this [SHOCK] to try to H following events? experienced in household this [SHOCK] regain your former welfare level? 2 RECEIVED UNCONDITIONAL HELP O 1 ONLY THIS FROM RELATIVES/FRIENDS 1 MOST SEVERE income and/or occur/start? C HOUSEHOLD GO THROUGH ENTIRE LIST assets? [ENTER -99 IF USE CODES ON RIGHT K BEFORE PROCEEDING TO R3. 2 SECOND MOST SEVERE 2 SOME OTHER 3 RECEIVED UNCONDITIONAL HELP HOUSEHOLDS DO NOT FROM GOVERNMENT 3 THIRD MOST SEVERE 3 MOST HOUSEHOLDS IN 1 INCOME LOSS 1 Months LIST UP TO 3 IN ORDER OF MOST I 1 YES THIS COMMUNITY IF THE HOUSEHOLD DID NOT EXPERIANCE ANY 2 ASSET LOSS 2 Weeks RECENT INCIDENT 4 RECEIVED UNCONDITIONAL HELP 2 NO 4 ALL HOUSEHOLDS IN D OF THE FOLLOWING SHOCKS, GO TO 'END THE 3 LOSS OF BOTH 3 Days FROM NGO/RELIGIOUS INSTITUTION PUT CODE OF 3 THE THIS COMMUNITY INTERVIEW' MODULE ►NEXT 4 NEITHER ITEM BIGGEST SHOCKS QUESTIONS YEAR MONTH DURATION UNIT 1ST 2ND 3RD TO THE RIGHT 5 CHANGED EATING PATTERNS (RELIED id R1 R2 R3 SHOULD ONLY R4 R5 R6a R6b R7a R7b R8a R8b R8c ON LESS PREFERRED FOOD OPTIONS, BE ASKED REDUCED THE 101 Drought or floods CONCERNING PROPORTION OR NUMBER OF MEALS THE THREE PER DAY, OR HOUSEHOLD MEMBERS 102 Strong winds/storms MOST SEVERE SKIPPED DAYS OF 103 Crop disease or pests SHOCKS, AS EATING, ETC.) NOTED IN 104 Livestock died or stolen QUESTION R3. 6 EMPLOYED HOUSEHOLD MEMBERS TOOK ON MORE EMPLOYMENT 105 Household business failure, non-agricultural LEAVE ALL OTHER ROWS Loss of salaried employment or non-payment of BLANK. 7 ADULT HOUSEHOLD MEMBERS WHO 106 WERE PREVIOUSLY NOT WORKING salary HAD TO FIND WORK 107 Large fall in sale prices for crops 8 HOUSEHOLD MEMBERS MIGRATED 108 Large rise in price of food

109 Large rise in agricultural input prices 9 REDUCED EXPENDITURES ON HEALTH AND/OR EDUCATION 110 Severe water shortage 111 Loss of land 10 OBTAINED CREDIT

Chronic/severe illness or accident of household 112 11 SOLD AGRICULTURAL ASSETS member

113 Death of a member of household 12 SOLD DURABLE ASSETS 114 Death of other family member 13 SOLD LAND/BUILDING 115 Break-up of the household 14 SOLD CROP STOCK 116 Jailed

117 Fire 15 SOLD LIVESTOCK

118 Hijacking/robbery/burglary/assault 16 INTENSIFY FISHING 119 Dwelling damaged, destroyed 17 SENT CHILDREN TO LIVE ELSEWHERP Immediate needs of money and selling crop at 120 lowest price 18 ENGAGED IN SPIRITUAL EFFORTS - 121 Political, tribal, and farmers' livestock conflict PRAYER, SACRIFICES, DIVINER CONSULTATIONS 122 Other 123 None ► End of Survey END TIME A24b : HOUR MIN

Thank you very much for participating in this survey and for your time!

DESCRIPTION OF LOCATION OF HOUSEHOLD - INCLUDE ANY IDENTIFYING CHARACTERISTICS OF DWELLING, NAME OF NEIGHBOURING HOUSEHOLDS & KEY PERMANENT CONTACTS, PHONE NUMBER (IF ANY). MAKE A SKETCH OF A MAP OF THE HOUSEHOLD'S LOCATION IN THE SPACE BELOW.

PLEASE PROVIDE MOBILIZATION FUNDS TO THE CHEF DE MENAGE

PLEASE GIVE THE INCENTIVE TO THE HOUSEHOLD HEAD CONVERSION FROM YEAR OF BIRTH TO AGE

YEAR OF YEAR OF YEAR OF YEAR OF AGE AGE AGE AGE BIRTH BIRTH BIRTH BIRTH

1906 108 1933 81 1960 54 1987 27 1907 107 1934 80 1961 53 1988 26 1908 106 1935 79 1962 52 1989 25 1909 105 1936 78 1963 51 1990 24 1910 104 1937 77 1964 50 1991 23 1911 103 1938 76 1965 49 1992 22 1912 102 1939 75 1966 48 1993 21 1913 101 1940 74 1967 47 1994 20 1914 100 1941 73 1968 46 1995 19 1915 99 1942 72 1969 45 1996 18 1916 98 1943 71 1970 44 1997 17 1917 97 1944 70 1971 43 1998 16 1918 96 1945 69 1972 42 1999 15 1919 95 1946 68 1973 41 2000 14 1920 94 1947 67 1974 40 2001 13 1921 93 1948 66 1975 39 2002 12 1922 92 1949 65 1976 38 2003 11 1923 91 1950 64 1977 37 2004 10 1924 90 1951 63 1978 36 2005 9 1925 89 1952 62 1979 35 2006 8 1926 88 1953 61 1980 34 2007 7 1927 87 1954 60 1981 33 2008 6 1928 86 1955 59 1982 32 2009 5 1929 85 1956 58 1983 31 2010 4 1930 84 1957 57 1984 30 2011 3 1931 83 1958 56 1985 29 2012 2 1932 82 1959 55 1986 28 2013 1