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Data Collection Instrument CBTP Phase I (2)

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Jimma University
College of business and economics
CBE AND PARTNERSHIP MANAGEMENT UNIT
Community Based Training Programme (CBTP)
DATA COLLECTION INSTRUMENT FOR PROBLEM IDENTIFICATION
Year: I, CBTP Phase: I
Region: _________________________ Zone ____________ Woreda ________________ Kebele _____________________
Part I: - Questionnaire at Household Level
1. Family Details
1.1 Number of Family Members (including relatives, servant maids and any other
person living in the house).
1.1.1 Male ____________
1.1.2 Female ____________
1.1.3 Total _____________
1.2 Head of the Family
1.2.1 Wife ____________ Husband ____________ Others, Specify ________________________
1.2.2 Age ____________
1.2.3 Occupational Status ______________________________
1.2.4 Educational Status ______________________________
1.2.5 Marital Status: Married __________ Unmarried ___________
Divorced __________ Widowed ___________
1.3 Age Group of Family Members in Number
1.3.1.
0 – 6: Male ___________ Female ____________
1.3.2.
7 – 14: Male ___________ Female ____________
1.3.3.
15 – 64: Male ___________ Female ____________
1.3.4. 65 & above: Male ___________ Female ____________
1.4 Educational Levels of Family Members (Excluding Pre-School Children)
1.4.1. Illiterate: Male ___________ Female ____________
1.4.2. Literate:
1.4.2.1. Only Read and Write:
Male ________ Female ________
1.4.2.2. Elementary (1 – 6) Grade:
Male ________ Female ________
1.4.2.3. Junior High (7 – 8) Grade:
Male ________ Female ________
1.4.2.4. High School (9 – 10) Grade:
Male ________ Female ________
1.4.2.5. Preparatory Class:
Male ________ Female ________
1.4.2.5. Technical & Vocational Level: Male ________ Female ________
1.4.2.6. College/ University:
Male ________ Female ________
1.5 Culture
1.5.1 Language (Write 1 for the first language and 2 for the Second language etc.)
Afan Oromo____Amharic____Keffai____Yem____Dawaro_____Gurage_____Other_______
1.5.2 Ethnic Category: ___________________________
1.5.3 Religion:
Muslim _________ Christian _________ Other, Specify ___________________________
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2.
3.
4.
5.
Source of Income
2.1
How many of the family members have permanent employment in organizations? ______
Male ______________
Female _________________
2.2
How many of the family members have temporary employment options from time to
time? _______
Male ______________
Female _________________
2.3
How many of the family members earn a pension? ___________________
2.4
Regular salary/wage per month/annual earnings adjusted for month from employment
2.4.1
1 – 50
Male ___________ Female ____________
2.4.2 51 – 150 Male ___________ Female ____________
2.4.3 151 – 300 Male ___________ Female ____________
2.4.4 301 – 450 Male ___________ Female ____________
2.4.5 451 – 600 Male ___________ Female ____________
2.4.6 601 – 1000 Male ___________ Female ____________
2.4.7
> 1000 Male ___________ Female ____________
2.4.8 Total Income for the Household _________________
2.5
How many of the household members are involved in trade activities?
2.5.1
Retailing:
Male ___________ Female ____________
Capital: ________________
2.5.2 Wholesale:
Male ___________ Female ____________
Capital: ________________
2.5.3
Both:
Male ___________ Female ____________
Capital: ________________
2.5.4 Total income/month from trade for the household ____________________
2.6
How many of the household members are involved in production activity?
2.6.1 Service (Service for example includes barber shop, tele–center, hotel, & cafeteria):
Male ______________
Female _________________
What type of service? ____________________________________________________________
2.6.2 Agriculture:
 Farming:
________
 Animal Husbandry: ________
 Mixed Farming:
________
2.6.3 Cottage Industry: _______________
2.6.4 Medium Scale Industry: ________
2.6.5 Large Scale Industry: ___________
2.7
How do you market your products? To:
2.7.1 Consumers (direct) _______
2.7.2 Wholesalers _______________
2.7.3 Retailers ___________________
2.7.4 Others _____________________
Is your income sufficient (just for subsistence) to support your family?
Yes
No
How many of your family members do not have any job at all?
Male _______________
Female _______________
Do you have a habit of saving money? Yes
No
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6.
7.
8.
9.
10.
11.
If ‘YES’ for Q#5, what facilities do you use for saving?
Formal: Banks______ Insurance ______ Microfinance (MFI) ______ Other, Specify ___________________
Informal: Idir ______ Iqub ____________ Other, Specify __________________________
Do you have any intention to invest outside of the area you are active now?
Yes
No
If ‘YES’ for Q#7, in what area of investment? Please, specify the particular type as well.
Agriculture……………………………
Particularly in: ______________________________________
Service …………………………………
Particularly in: ______________________________________
Trade (Retailing or wholesale)
Particularly in: ______________________________________
Industry………………………………..
Particularly in: ______________________________________
Others ………………………………….
Particularly in: ______________________________________
Do you have problems associated with investment?
Yes
No
9.1 In what areas do you encounter problems?
a. Lack of Resources:
 Finance ……………………………………………………………..
 Labor (State whether skilled, semi-skilled, unskilled)
________________________
 Energy (power interruption)……………………………..
 Materials……………………………………………………………
 Government Regulations……………………………………
 Personal Problems ……………………………………………
b. Environmental & Natural Problems (e.g. plants and animal disease, unfavorable whether condition)
_________________________________________________________________________________________________
________________________________________________________________________________________________
c. Others: Please, specify: _____________________________________________________________________
___________________________________________________________________________________
9.2 What do you recommend to solve these problems, if any? (Mention as much as possible.)
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
______________________________________________________________________________________________________
Do you have problems related to saving?
Yes
No
If ‘YES’, please, mention some of them. ________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Are there investment opportunities in your area?
Yes
No
If ‘YES’, what are the promising sectors for the investment? Rank them.
1st ____________________________
3rd _________________________________
2nd ____________________________
4th _________________________________
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12.
13.
14.
15.
16.
17.
18.
Do you have proper know how on how to start new businesses (small scale, large-scale)?
Yes
No
12.1. If ‘NO’, in what areas do you lack the skills, or what are the common problems you
confront?
1. _____________________________________ 4. _____________________________________
2. _____________________________________ 5. _____________________________________
3. _____________________________________ 6. _____________________________________
12.2. How do you think the know-how can be improved? Recommend some.
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
What are the major problems associated with the start up and running of business entities in
your area? Mention as many points as possible in order of their severity.
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
What do you generally suggest to alleviate these problems? Cite the possible options.
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Are there sources of credit in your kebele? Yes
No
If ‘YES’, what are they?
Formal: Banks_____ Saving & Credit Associations/MFIs _____ NGOs _____ Other, Specify ___________
Informal: Idir ________ Iqub ______________ Other, Specify __________________________
What basic problems are associated with formal credit? ____________________________________________
____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
Are there any post–sanction visits made by the banks (i. e. visits made by the bank officials to
check whether the money is used for the intended purposes)?
Yes
No
Mention all the parties or stakeholders that you think can take part in alleviating the problems
you have cited above.
1. ____________________________________________
5. ____________________________________________
2. ____________________________________________
6. ____________________________________________
3. ____________________________________________
7. ____________________________________________
4. ____________________________________________
8. ____________________________________________
_______________________
________________________________________________________________________________
_________________________________________________________________________________
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