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The Nielsen Company (Bangladesh) Ltd

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The Nielsen Company (Bangladesh) Ltd The Nielsen Company (Bangladesh) Ltd. House # 70 (2nd Floor), Road # 15A (new) Dhanmondi R/A, Dhaka-1209. Phone: 9125839 www.nielsen.com PROJECT – Sanglap JOB # MR0851208 INTERVIEW QUESTIONNAIRE Study ID (101-108) Resp. No. (109-116) Interviewer No. (120-123) Interview Length (124-127) No. Of Queries (128-129) Reference No. (130-131) NAME OF RESPONDENT: Mr./Mrs._________________________________________ SURNAME _______________________ ADDRESS IN FULL: BUILDING / Chawl NAME / NO.: ___________________________________FLAT / ROOM NO.: _______ FLOOR NO.:_______ STREET / ROAD NO./NAME: ___________________________ Locality Name ______________________________________ AREA NAME: ____________________ CITY: ________________ PIN CODE: LANDMARK: ___________________________________________________________________________________ ________ EMAIL ADDRESS DATA SUPPLIER NAME : _______________________________ DATA VERIFIER NAME : ____________________________ Q1 IDENTIFICATION NUMBER. CENTRE (R1) AREA (132-136) N O . (R2) G.C.No. (137-141) (R3) LISTING (142-146) N O . (R4) MAIN (147-151) N o . (R5) D.S. No. (152- 1 5 9 ) (R6) D.V. (160- N 1 o 6 . 7 ) 1 Q2 Q.C. [MA] RQ CB RQ CB RQ CB RQ CB RQ CB AC AC BC BC TBC TBC VC VC SCR SCR (168) (R1) D.V 1 2 3 4 5 6 7 8 9 0 SIGN. SIGN. SIGN. SIGN. SIGN. SIGN. SIGN. SIGN. SIGN. SIGN. ______ ______ ______ ______ ______ ______ ______ ______ ______ ________ __ __ __ __ __ __ __ __ __ DATE. DATE. DATE. DATE. DATE. DATE. DATE. DATE. DATE. DATE. ________ ______ ______ ______ ______ ______ ______ ______ ______ ______ __ __ __ __ __ __ __ __ __ (169) (R2) OC /OE / 1 2 3 4 5 6 7 8 9 0 SOE SIGN. SIGN. SIGN. SIGN. SIGN. SIGN. SIGN. SIGN. SIGN. SIGN. ______ ______ ______ ______ ______ ______ ______ ______ ______ ________ __ __ __ __ __ __ __ __ __ DATE. DATE. DATE. DATE. DATE. DATE. DATE. DATE. DATE. DATE. ________ ______ ______ ______ ______ ______ ______ ______ ______ ______ __ __ __ __ __ __ __ __ __ (170) (R3) OM/SM 1 2 3 4 5 6 7 8 9 0 SIGN. SIGN. SIGN. SIGN. SIGN. SIGN. SIGN. SIGN. SIGN. SIGN. ______ ______ ______ ______ ______ ______ ______ ______ ______ ________ __ __ __ __ __ __ __ __ __ DATE. DATE. DATE. DATE. DATE. DATE. DATE. DATE. DATE. DATE. ________ ______ ______ ______ ______ ______ ______ ______ ______ ______ __ __ __ __ __ __ __ __ __ 2 Q3a Date of Interview [dd/mm/yy] Please record using the short date format (dd/mm/yy). For example, if the date is 21 December 2008, record as 211208 Q3b RECORD TIME INTERVIEW STARTED / ENDED Please record using 24-hour format. For example, if the time is 2:47pm, record as 1447 Time Started (24-hour format) Q3c Time Ended (24-hour format) Q3a Q3b Q3c Date of Interview Time Started (24- Time Ended (24- [dd/mm/ hour hour yy] format) format) (171-176) (177-180) (220-223) (R1) INTERVIEW DETAILS Q4 Record Contact No: (R1) Telephone No. Resi (224-235) (R2) Telephone No. PP (236-247) (C/O) (R3) Telephone No. Office (248-259) (R4) Mobile No. Self (260-271) Q5 TYPE OF INTERVIEW [SA] Code (272) Route Random 1 Booster 2 DATA SUPPLIER DECLARATION Avwg ¯^xKvi KiwQ †h, DËi`vZv hvi bvg Ges wVKvbv Dc‡i †`qv Av‡Q, B›UviwfD ïi“ nIqvi AvM ch©š— Avgvi Kv‡Q ARvbv wQj| Avwg cÖkœcÎ (†Kv‡qðvbvqvi) wU †`qvi Av‡M Avk¦¯— KiwQ †h, GwU MRSI (gv‡K©U wimvP© cÖ‡dkbvj †KvW Ad KÛv± tGB †`‡ki) Gi wbqgvbymv‡i Ges GB M‡elYvi wbqgvejx i¶v K‡i m¤úbœ Kiv n‡q‡Q| Avwg eywS, †h Z_¨vejx Avgv‡K mv¶vrKvi PjvKvjxb †`qv n‡q‡Q Zv †Mvcb ivL‡Z n‡e| SIGNED __________________________________________ DATE ______________ THANA CODE PSU NO QNTR. SLNO The Nielsen Company (Bangladesh) Ltd. House # 70 (2nd Floor), Road # 15A (new) Dhanmondi R/A, Dhaka-1209 Phone: +88 02 9125839 Job Number : MR0851208 Urban 1 PROJECT Sanglap Rural 2 NAME OF ESPONDENT CENTRE (optional) ADDRESS IN FULL Code (optional) Necessary Information: District and Upazilla in which they reside. 3 INTERVIEW TIME START END LANDMARKS MAHALLA THANA/UPAZI NAME/VILLAGE LA DISTRICT DIVISION W TELEPHONE O ( IF ANY MOBILE HOME R (optional) K 4 Household Number evwo bs: ____________________________ INTERVIEWER: Ask the following questions to the head of the household or the knowledgeable person in the household to get information about the household members. /cwiev‡ii m`m¨‡`i m¤ú‡K© Rvb‡Z cwiev‡ii cÖavb ev ‡h Rv‡b, Ggb KvD‡K wb‡Pi cÖkœ¸‡jv wR‡Ám Kiæb| Good morning/afternoon/evening. My name is __________. I am here on behalf of The Nielsen Company (Bangladesh) Limited, a Research Agency in Bangladesh. I am here to learn about how people in this neighbourhood feel about some important social issues and current affairs and also to understand people’s media habits and needs. We would like to talk to you and other people in your community about these issues. The information will be used to improve television and radio shows about social issues. Everything you say will be confidential. Could you help me answer some questions? / mvjvg/Av`ve| Avgvi bvg ...................... | Avwg †bjmb-Gi c¶ †_‡K G‡mwQ| Avgiv GKwU M‡elYv cÖwZôvb Ges Avgiv evsjv‡`‡ki wewfbœ ¯’v‡b Avgv‡`i M‡elYv Pvwj‡q _vwK| Avwg AvR‡K GLv‡b G‡mwQ Av‡kcv‡ki gvby‡liv wewfbœ mvgvwRK I mv¤úªwZK mg‡q N‡U hvIqv welq wb‡q wK wPšÍv Ki‡Q Zv Rvb‡Z| †mB mv‡_ GLvbKvi gvbyl †iwWI, wUwfi g‡Zv gva¨g¸‡jv Kxfv‡e e¨envi K‡ib ev GB gva¨g¸‡jv †_‡K Zviv Kx Rvb‡Z ev †`L‡Z Pvb †mwUI Avgiv Rvbe| welq¸‡jv m¤ú‡K© Avgiv Avcbvi I Avcbvi GjvKvi gvbyl‡`i mv‡_ K_v ej‡Z PvB| Avcbv‡`i †`Iqv Z_¨ I gZvgZ mvgvwRK wewfbœ welq wb‡q Kiv wUwf I †iwWIÕi Abyôv‡bi gvb Dbœq‡bi Rb¨ e¨envi Kiv n‡e| Avcbvi †`Iqv Z_¨¸‡jv m¤ú~b©fv‡e †Mvcb ivLv n‡e| Avcwb wK Avgv‡`i wKQy cÖ‡kœi DËi w`‡q mvnvh¨ Ki‡eb? 5 SCREENER QUESTIONS/evQvB cÖkœgvjv Q# Question Codes S1 Please let us know how many people live in your household?/ AbyMÖn K‡i ejyb, Avcbvi cwiev‡i KZ Rb †jvK evm K‡ib? Please exclude any servants/ maids or guests that might be staying with you currently./ evwo‡Z hw` eZ©gv‡b †Kv‡bv Kv‡Ri †jvK ev †gngvb _v‡K Z‡e Zv‡`i ev` w`‡q ejyb| (write number in box)/ev‡· msL¨v †iKW© Kiæb S2 Please give us the name(s), age and sex of each person of 15 or above years of age in the household STARTING FROM THE YOUNGEST ONE (15 years, going up). Do not forget to include yourself if you are 15 or more. `qv K‡i Avcbvi cwiev‡ii †hme m`‡m¨i eqm 15 ev Zvi †P‡q †ewk Zv‡`i bvg ejyb| me‡P‡q Kgeqmx m`m¨ †_‡K ïiæ K‡i µgvš^‡q Ab¨‡`i bvg, eqm Ges wZwb cyiæl bv gwnjv Zv D‡jL Ki“b| Avcbvi eqm hw` 15 ev Zvi †P‡q †ewk nq Zvn‡j wb‡Ri bvg D‡j•L Ki‡Z fzj‡eb bv| (New SL Kjv‡g, cyi“l mv¶vrKviMÖnYKvixi †¶‡Î cyi“l m`m¨‡`i Ges gwnjv mv¶vrKviMÖnYKvixi †¶‡Î gwnjv‡`i bZzb µwgK †iKW© Ki“b) No. New Name/bvg Sex wj½ Age /eqm µwgK SL Male/ Female/ †Q‡j †g‡q 1 1 2 2 1 2 3 1 2 4 1 2 5 1 2 6 1 2 7 1 2 8 1 2 9 1 2 10 1 2 11 1 2 12 1 2 13 1 2 14 1 2 15 1 2 6 Kish-Grid Matrix (as per instruction below and circle the serial number of respondents selected for interview) / wKk wMªW g¨vwUª· (wb‡Pi wb‡`©kbv Abyhvqx mv¶vZKv‡ii Rb¨ wbe©vwPZ DËi`vZvi wmwiqvj b¤^i mv‡K©j Kiyb)| KISH GRID / wKk wMªW Instructions: Look up the column for the last digit in the household serial number and the row for the number of eligible people The number in the cell where the column and row meet is the Person No. to interview. For example, if household serial ending in ‘2’ has ‘3’ adults, interview the household member listed as Person No. 2 in the Household List at Q.S2 Circle the chosen respondent and if available explain to them the purpose of the interview, obtain consent and proceed If the selected respondent will be available that day, but is not available/ not at home at the time the interviewer calls, the interviewer should make 2 return calls to see if that person is available/ has returned before selecting another household. If the selected respondent is not going to be available that day, the interviewer should go to the next household. Do not select another respondent within the household.] . wb‡`©kbv: mvwi‡Z cwiev‡ii m`m¨ msL¨v Ges Kjv‡g ‡hvM¨ DËi`vZvi msL¨v †iKW© Kiæb| †h msL¨v‡Z G‡m mvwi Ges Kjvg wgwjZ n‡q‡Q, †mB e¨vw³i mvÿvrKvi wb‡Z n‡e| †hgb, hw` mvÿvrKvi MÖnYKvix cyiyl nq Ges evwo‡Z evwo bs 2 G 3 Rb ‡hvM¨ DËi`vZv _v‡K, Zvn‡j 2q me© Kwbô e¨vw³i mvÿvrKvi MÖnY Kiyb| wbe©vwPZ DËi`vZvi bv‡g mv‡K©j Ki“b Ges hw` wZwb evwo‡Z _v‡Kb Z‡e Zv‡K B›Uvwf©D Gi D‡Ïk¨ eY©bv Ki“b, Zvi AbygwZ wb‡q B›Uvwf©D ïi“ Ki“b | hw` wbe©vwPZ DËi`vZv IB mgq Dcw¯’Z bv _v‡K wKš‘ w`‡bi Ab¨ mgq Avm‡e, Z‡e B›Uvwf©Dqvi‡K AviI `yBevi IB evwo‡Z †h‡Z n‡e wZwb Av‡Qb wKbv †`Lvi Rb¨ hw` wbe©vwPZ DËi`vZv‡K IB w`b bv cvIqv hvq, Z‡e cieZ©x evwo‡Z †h‡Z n‡e wKš‘ IB evwoi Ab¨ KvI‡K B›Uvwf©D Kiv hv‡e bv 7 wKk †Uwe‡ji mvnv‡h¨ DËi`vZv wbe©vPb Kiæb| ‡QvU †_‡K µgvbymv‡i µwgK bs w`b Take last digit of house serial number †hvM¨ cyi“l/gwnjvi msL¨v eqm 0 1 2 3 4 5 6 7 8 9 1 1 1 1 1 1 1 1 1 1 1 2 1 2 1 2 1 2 1 2 1 2 3 3 1 2 3 1 2 3 1 2 3 4 1 2 3 4 1 2 3 4 1 2 5 4 5 1 2 3 4 5 1 2 3 6 2 3 4 5 6 1 2 3 4 5 7 1 2 3 4 5 6 7 1 2 3 8 6 7 8 1 2 3 4 5 6 7 9 5 6 7 8 9 1 2 3 4 5 1 1 2 3 4 5 6 7 8 9 10 0 K1.
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