Mali Africa RISING Baseline Evaluation Survey - 2014
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Mali 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 Sikasso 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 Bougouni 05 Madina 5 100 Kilo Sack 16 Rice 46 Shallot 115 Sheduguni 156 Peazo 2 255 Dunanfana 412 PRIMA 2 Koutiala 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 Yanfolila 07 Sibirila 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 Yorobougoula 9 75 Kilo Sack 21 Green Bean Perennial crops 1101 EV8422SR 1502 Tamabe Potato Varieties Code Commune Name 10 Zansoni 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 Faradiele 15 Dialakoro 15 Ball/Sphere 27 Groundnut 56 Coco 1107 Tcheba 161 BG 90-2 Groundt Nut Variety 426 YASMINA 06 Faragouaran 16 Tiere 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 Gouanan 18 Konseguela 18 Spoon (tea, table) 5101 Hibiscus Millet Variety 164 Leizong 273 ICGV 86124 4201 MARFONA 09 Keleya 19 N'Togonasso 19 Bundle (of Firewood) Vegetables 5102 Sumbala 121 Djiguifa 165 AD 9216 274 ICGV 99241 4202 LISETA 10 Konina 20 Bobola-zangasso 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 Sincina 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 Songoua 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).