women survey questionnaire - PLOS

1

PROJECT PARIVARTAN

WOMEN SURVEY QUESTIONNAIRE

IDENTIFICATION OF VILLAGE DIST DISTRICT NAME ftyk DISTRICT CODE ftys dk dksM

BLOCK BLOCK NAME CykWd BLOCK CODE CykWWd dk dksM

VILLAGE VILLAGE NAME xkao VILLAGE CODE xkao dk dksM

GID GROUP ID lkeqnkfd lewg dk नाम और igpku dksM

LN LINE NUMBER OF THE WOMAN IN THE LIST OF GROUP lewg dh lwph esa efgyk dh ykbu uacj

TYPE TYPE OF THE GROUP समह का परकार

Parivartan ifjorZu1

Other अनयhelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip3

Jeevika thfodk2

INT_CODE INTERVIEWER NAME lkkkRdkjdrkZ dk

uke

INTERVIEWER ID lkkkRdkjdrkZ dk vkbZMh

VDAY दिन

VMONTH महीना

VYEAR साल

BLOCK 1SOCIO-DEMOGRAPHIC DETAILS

Question Answers Codes Skip to

101 How old are you now vkidh mez fdruh gS

Age in completed years mez iwkZ okksZa esa

102 What is your husbands age vkids ifr dh mez fdruh gS


103 What was your age at the time of

marriage kknh ds le vkidh mez Dk Fkh


104 What was your age at your first

child birth vkids igys cPps ds tUe ds le

vkidh mez Dk Fkh


105 Can you read and write

Dk vki ilt+-fy[k ldrh gSa

Cannot read and write ilt+ fy[k ugha ldrh

Can read only flQZ ilt+ ldrh gS

Can sign only dsoy nLr[kr dj ldrh gS Can read and write ilt+ o fy[k ldrh gS

1

2

3

4

107 यदि परशन सखया 105

CONFIDENTIAL

ONLY FOR RESEARCH PURPOSES

2

म 1 कोड हआ ह तो परशन सखया 107 पर जाए

106 What is the highest standard you

have completed vkius dgka rd ilt+kbZ dh gS

Standard dkk

107 Can your husband read and write

Dk vkids ifr ilt+-fy[k ldrs gSa

Cannot read and write ilt+ fy[k ugha ldrs

Can read only flQZ ilt+ ldrs gS

Can sign only dsoy nLr[kr dj ldrs gS Can read and write ilt+ o fy[k ldrs gS

1

2

3

4

109 यदि परशन सखया 107 म 1 कोड हआ ह तो परशन सखया 109 पर जाए

108 What is the highest standard your

husband has completed vkids ifr us dgka rd ilt+kbZ dh gS

Standard dkk

109 What is your

(womens) main

occupation vkidk frac14efgyk

dkfrac12 eq[ Oolk

Dk gS

Wage laborer nSfud etnwj

Skilled semi-skilled worker dqky vkZ dqrsquoky dkexkj

Service (Govt Private) ukSdjh frac14ljdkjhfuthfrac12

Self-employed Business Lojkstxkj Okikj

Agriculturecultivator dfkdkd

Unemployed-has intention to work but not working currently Cksjkstxkj-dkZ djuk

pkgrh gS] ij vHkh dksbZ dkZ Z ugha dj jgh gS

Housewife-has no intention to work xfgkh- dkZ djus dk dksbZ bjknk ugha gS

1

2

3

4

5

6

7

110 What is your husbands occupation vkids ifr dk Oolk Dk gS

Wage laborer nSfud etnwj Skilled semi-skilled worker dqkyvkZ dqrsquoky dkexkj


Self-employed Business LojkstxkjOkikj


Unemployed Cksjkstxkj

1

2

3

4

5

6

110a Where does your husband work आपक पतत कहा काम करत ह

Within our village हमार गाव म In the town but within district शहर म पर जजल क अनिर

Outside the district but within state जजल क बाहर लककन

बबहार परिश क अनिर Outside the state बबहार परिश क बाहर In MumbaiThane मबईठाण म

1

2

3

4

5

If lt3

skip

to

110c

यदि उततरिाता परशन सखया 110a

3

म 3 स कम कोड कर तो परशन सखया 110c पर जाए

110b How often does he visit here आपक पतत ककतन अतराल पर घर आत ह

Once in three months तीन महीन म एक बार Once in six months छ महीन म एक बार

Once a year साल म एक बार

More than a year एक साल स जयािा म No regular schedule (but visits every year) कोई तनजशित समय नही((पर हर साल आत ह) No regular schedule (hasnrsquot visited in the past year) कोई तनजशित समय नही (पपछल साल म एक बार भी नही आय)

1

2

3

4

5

6

110c What is your householdrsquos monthly

income (including your husbandrsquos

and your own earnings) आपक घर की (आपक पतत और आपकी) माससक आमिनी ककतनी ह

Write income

कमाई सलख

111 Do you belong to a scheduled caste

a scheduled tribe or other backward

caste Dk vki vuqlqfpr tkfr] vuqlfpr

tutkfr k vU fiNMs oxZ ls gS

Scheduled caste vuqlqfpr tkfr

Scheduled tribe vuqlfpr tutkfr

OBC fiNMk oxZ

Others vU

Pasmunda Muslims पासमिा मसलमान

1

2

3

4

5

112 What is your religion vkidk keZ Dk gS

Hindu fgUnq

Muslim eqfLye

Sikh ससख Christian इसाई Buddhist बदधिसट Jain जन Others अनय

1

2

3

4

5

6

7

113 How many children do you have vkids fdrus cPps gSa

lHkh thfor cPpksa dh la[k ntZ djsaA

A Total number of sons csVksa dh dqy la[k

B Total number of daughters csVhksa dh dqy la[k

4

mu cPpksa dks Hkh kkfey djsa tks

mRrjnkrk ds lkFk ugha jg jgs gSaAfrac12

C Total number of children dqy cPpksa dh la[k

113_1

Have you ever given birth to a boy

or girl who was born alive but later

died (Died within one year) कया आपन कभी लड़की अथवा लड़क को जनम दिया ह जो जीपवत पिा हआ पर बाि

म मर गया (ससरफ ऐस बचि जजनकी उमर

मतय क समय एक साल स कम थी उनक

बार म बताए

)

If NO PROBE Any baby who

cried or showed signs of life but did

not survive गहराई स पछ ऐसा बचिा जो रोया अथवा जीपवत होन क आसार थ पर बिा नही

Yes gka

No ugha

1

2

113_4

यदि परशन सखया 113_1म 2 कोड हआ ह तो परशन सखया 113_4 पर जाए

113_2

How many such births have you

given आपन ऐस ककतन बचि को जनम दिया

__ (Write down number) सखया सलखखए

113_3

What was the age of the last child

when heshe died सबस बाि म जजस बचि की मतय हई उसकी मतय क वक़त उमर कया थी

days (if age is in months convert to days and write)

(दिन म सखया सलखखए अथवा बचि की उमर अगर महीनो म ह तो दिन म बिल कर सलख)

113_4

Have you ever had a pregnancy that

miscarried was aborted or ended in

a stillbirth कया आपको कभी ऐसी गभाफवसथा हई ह जजसम बचिा धगर गया धगरा दिया गया अथवा मरा हआ पिा हआ

Yes gka

No ugha

1

2

11

4 यदि परशन सखया 113_4 म 2 कोड हआ ह तो परशन सखया

5

114 पर जाए

113_5

How many such pregnancies have

you had

आपको इस तरीक क ककतन गभफ हए ह

Write down number __ सखया सलखखए

114 Are you currently pregnant Dk vki vHkh xHkZorh gSa

Yes gka

No ugha

1

2


115 How many months pregnant are you now vki vHkh fdrus ekg ls xHkZorh gSa

Months eghus

_______

116 Are you registered for this pregnancy with

ANM ASHA or AWW कया आप इस गभाफवसथा क सलए एएनएम आशा और आगनवाडी कायफकताफ क साथ पजीकत ह

Yeshellipहा 1

Nohellipनही 2

Now I will ask you some questions about the pregnancy related to your youngest child as well as some questions about

other aspects related to your youngest child अब म आपस आपकी सबस छोटी आय की सतान क बार म कछ परशन पछगी

BLOCK 2 ANTENATAL CARE परसवपवफ िखभाल स समबधित परशन


201 Did you see any health provider (ASHAANM AWW

or some other heathcare provider) for antenatal care for

this pregnancy

Dk vkius पपछली xHkkZoLFkk ds fy izlo iwoZ ns[kHkky ds fy

fdlh Hkh LokLF iznkrk स eqykdkr dh

Yes gka

No ugha

1

2

205 यदि परशन सखया 201म 2 कोड हआ ह तो परशन सखया 205 पर जाए

202 Where did you receive antenatal care for the HOME

6

last pregnancy

vkius पपछली s xHkkZoLFkk ds fy izlo iwoZ ns[kHkky

dgka ls izkIr कीk थी

Your home vkidk kj

Parents home vkids ekrk firk dk kj Other home vU kj

PUBLIC MEDICAL SECTOR

Govtmunicipal hospital ljdkjhEqfufliy vLirky

Govt dispensary ljdkjh fMLisaljh

PHC izkbZejh LokLF dsUnz

Sub-center mi dsUnz

Anganwadi centre vkaxuokMh dsUnz

NGO PVT MEDICAL HOSPITAL

A

B

C

D

E

F

G

H

I

202a Whom did you see

परसवपवफ िखभाल क सलए vkius fdldks fn[kkk

Fkkeqykdkr dh MARK ALL THAT APPLY

PUBLIC DOCTOR ljdkjh mkdvj A

PRIVATE DOCTOR izkbosV MkDVj

helliphelliphelliphelliphelliphellipB

ANM u e C

NURSE ulZ

helliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellipD

LHV LFkkuh LokLF dkZdrkZ

helliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellipE

OTHER HEALTH PERSONNEL vU LokLF

dkZdrkZ F

DAITrained dai nkbZ ccedilfkfkr nkbZ G

ASHA vkrsquokk H

AWW vkaxuokMh dkZdrkZ

helliphelliphelliphelliphelliphelliphelliphelliphellip I OTHER (SPECIFY) vU LirdquoV djsasa X

203 How many months pregnant were you when you first received antenatal care (advisetreatment) for this pregnancy

पपछली गभाफवसथा क सलए जब आपको पहली बार परसव पवफ िखभाल समली तब आप ककतन महीन क गभफ स थी

Months eghus

______

204 How many times did you go for antenatal

check up during this pregnancy

vkidks पपछली xHkZoLFkk ds nkSjku fdruh ckj izlo

iwoZ ns[kHkky feyh Fkh

Number of times

izloiwoZ ns[kHkky dh la[k

______

205 Did any woman from your community group

accompany you during (any of) your

antenatal visits Dk vkids lkeqnkfd lewg dh dksbZ efgyk fdlh

Hkh izlo iwoZ ns[kHkky ds fy vkids lkFk xh Fkh

Yes gka

No ugha

There was no group at that time ml le dksbZ lewg ugha Fkk Respondent was not member of the group

at that time

1

2

3

4

208

208

208

7

ml le mRrjnkrk lewg dh lnL ugha Fkh

यदि परशन सखया 205 म 1 स ऊपर कोड हआ ह तो परशन सखया 208 पर जाए

206

206b

During your last

pregnancy did anyone

from your community

group tell you about the

following signs of

pregnancy complications fIkNys xHkkZoLFkk ds nkSjku Dk

fdlh us vkidks xHkkZoLFkk dh

fuEufyf[kr ijsrsquokkfuksa ds ckjs

esa crkk Fkk

Who told you about the

complications (Multiple

response question) आपको इन परशातनयो क बार म ककसन बताया

A Saheli सहली B Community

leaders समह क मखखया

C Community group

member समह क साथी मदहला न

D ASHA आशा E ANM ए एन एम

F AWW अनगवािी वकफ र

X Other अनय

Yes No 206b

A Swelling of hands feet and Face

gkFk iSj vkSj psgjs ij lwtu vkuk 1 2

B Palenessgiddinessweakness

ihykiupDdjdetksjh 1 2

C Visual disturbances kqakyk fn[kuk 1 2

D Excessive fatigue vRfkd Fkdku 1 2

E Weak or no movement of fœtus cPps dk

khjs kweuk k pDdj yxkuk 1 2

F Abnormal position of fœtus cPps dh vlkekU fLFkfr 1 2

G Excessive vomiting vRfkd myVh gksuk 1 2

H Hypertension High BP mPp CyM izsrsquokj 1 2

I Jaundice ihfyk 1 2

J Excessive bleeding vRfkd jDrlzko 1 2

K Convulsions didih vkuknkSjk iM+uk frac14cq[kkj okyk

ughafrac12 1 2

L Prolonged Labor izlo ds nkSjku Tknk nsj rd nnZ

gksuk 1 2

M Obstructed labour izlo ds nkSjku d d dj nnZ

gksuk 1 2

8

Mark All That Apply एए स जयादा उततर सभव ह

207 Did anyone from your community

group tell you where to go if you had

any pregnancy complications Dk vkids lewg es ls fdlh us vkidks g crkk Fkk fd xHkkZoLFkk ls lacafkr dksbZ

ijsrsquokkuh gksus ij dgkWa tkuk gSa

Yes gka

No ugha

There was no group at that time ml le dksbZ lewg ugha Fkk

Respondent was not member of the

group at that time ml le mRrjnkrk lewg dh lnL ugha Fkh

1

2

3

4

208 Did you experience any of the

pregnancy complications during your

last pregnancy

Dk vkius पपछली xHkkZoLFkk ds nkSjku fdlh

Hkh izdkj dh ijsrsquokkuh dk vuqHko fdk

Yes gka

No ugha

1

2


209

210

What complications did you

experience

vkius dkSu सी परशातनयो dk vuqHko

fdk

And did you receive treatment for

the problem

कया आपन इस दिककत का उपिार करवाया

209

Did you

have this

problem कया

आपको यह परशानी

हई

210

Did you

seek

treatment कया आपन इस

दिककत का उपिार करवाया

Yes

हाा No

नह ी Yes हाा

No नह ी

AA Swelling of hands feet and Face

gkFk iSj vkSj psgjs ij lwtu vkuk 1 2 1 2


ihykiupDdjdetksjh 1 2 1 2

C Visual disturbances

kqakyk fn[kuk 1 2 1 2

D Excessive fatigue

vRfkd Fkdku 1 2 1 2

E Weak or no movement of fœtus

cPps dk khjs kweuk k pDdj yxkuk 1 2 1 2

F Abnormal position of fœtus

cPps dh vlkekU fLFkfr 1 2 1 2

G Excessive vomiting 1 2 1 2

9

vRfkd myVh gksuk

H Hypertension High BP

mPp CyM izsrsquokj 1 2 1 2

I Jaundic ihfyk 1 2 1 2

J Excessive bleeding

vRfkd jDrlzko 1 2 1 2

K Convulsions

didih vkuknkSjk iM+uk frac14cq[kkj okyk ughafrac12 1 2 1 2

211 Where did you seek treatment (if

participant stated receiving

treatment for any of the

problems) vkius bykt dgka djokk (यदि इलाज कराया गया तो)

Government Hospital ljdkjh vLirky

Private hospital futh vLirky

Rural Medical Practioner gtksykNki fpfdRld

Other (specify) vU frac14LiV djsafrac12

A

B

C

X

212 During delivery did you

experience any of the following

problems izlo ds nkSjku Dk vkius bues ls

fdlh Hkh ijsrsquokkuh dk vuqHko fdk Fkk

Yes हाा No नह ी

A Premature labour le ls igys nnZ 1 2

B Excessive bleeding vRfkd jDrlzko 1 2

C Prolonged labour Tknk le rd nnZ 1 2

D Obstructed labour d d dj nnZ 1 2

E Breech presentation cPps dh vlkekU fLFkfr 1 2

F ConvulsionHigh BP kkjhfjd sBumPp

CyMizsrsquokj 1 2

Check Box A I ldquo rdquoA F ldquo rdquo ldquo rdquo

213 Did you discuss the complications

during pregnancy delivery with

any of your community group

members Dk vkius xHkkZoLFkk k izlo ds nkSjku

gqbZ fdlh Hkh ijsrsquokkuh ds ckjs esa lewg ds

lnLksa ls ppkZ की थी

Yes gka

No ugha

There was no group at that time

ml le dksbZ lewg ugha Fkk

Respondent was not member of the group at that time


1

2

3

4

216

216

216 यदि परशन सखया 213 म 1 स ऊपर कोड हआ ह तो परशन सखया 216 पर जाए

10

214 Did you receive any support from

community group members on the

problems that occured during

pregnancy dleivery

Dk आपको xHkkZoLFkk या परसव क िौरान

हई परशानी म lewg ds lnLksa ls fdlh

Hkh izdkj dh enn feyh

Yes gka

No ugha

1

2


215 What type of support did you

receive vkidks lewg ds lnLksa ls fdl izdkj

dk lgksx feyk

[Multiple responses possible]

Information about the problem leLk ds ckjs esa lwpuk feyh

Suggestion to see a qualified health professional dqky fpfdRld dks fn[kkus dh lykg feyh

Help in going to the health center and treatment lewg ds lnLksa us bykt ds fy LokLF dsUnz rd tkus] vkSj

bykt ysus esa enn fdk frac14tSls fd bykt ds fy iSls fnk]

LokLF dsanz rd tkus esa okgu dk bartke fdk] LokLF dsanz rd

lkFk esa x] bRkfnfrac12

Community members negotiated and convinced the

family members for treatment lewg ds lnLksa us ifjokj okyksa dks bykt djokus ds fy lger

fdk

Community group members informed the

ASHAANM and ensured referral समह क सिसयो न आशा अथवा ए एन एम को सधित ककया जजसस वह डॉकटर अथवा असपताल भज ि

Other vU frac14LiV djsafrac12

A

B

C

D

E

X

216 During this pregnancy were you

given an injection to prevent you

and the baby from getting tetanus xHkkZoLFkk ds kSjku vkidks vkSj vkids

cPps dks VsVusl ls cpkus ds fy Dk

dksbZ batsDrsquoku fnk xk Fkk

Yes gka

No ugha

1

2


217 During the pregnancy how many

times did you get a tetanus

injection xHkkZoLFkk ds kSjku fdruh ckj VsVusl

Number of times VsVusl ds batsDrsquoku dh la[k

_____

___

11

dk batsDrsquoku fyk Fkk

218 Did you receive any Iron Folic

Acid (IFA) tablets during this

pregnancy (Show tablets)

xHkkZoLFkk ds nkSjku vkidks vkju

Qksfyd flM frac14rkdr dh yky xksyhfrac12

VscysV feyh Fkh (गोली दिखाए)

Yes gka

No ugha

1

2 220 यदि परशन सखया 218 म 2 कोड हआ ह तो परशन सखया 220 पर जाए

218a How many tablets did you receive

in total during the whole of your

last pregnancy vkidh bl xHkkZoLFkk ds nkSjku vkidks vkju

Qksfyd flM frac14rkdr dh yky xksyhfrac12 dh dqy

fdruh VscysV feyh Fkh

____ (Write number received)

219 During the whole pregnancy for

how many days did you take the

tablets

अपनी इस परी गभाफवसथा क िौरान

टबलट का सवन आपन ककतन दिनो तक

ककया

Number of days

219a Other than the iron tablets that I

showed you did you take iron

syrup iron capsules or any other

iron formulation from a chemist or

doctor or anywhere else

कया आपन कोई अनय आयरन

ससरपआयरन कपसल या कोई अनय

आयरन की िीज़ ककसी मडडकल

डॉकटरमडडकल िकान स खरीिीसमली

Yes gka

No ugha

1

2

220 During the last pregnancy did you

get supplementary food from the

Anganwadi centre

पपछली गभाफवसथा क िौरान जब आपन िाहा तब आपको आगनवाडी क दर स राशन(पोषाहार) समला था

Yes gka

No ugha

1

2

12

220A In the last 3 months of the last

pregnancy how many times did an

FLW come and meet you in your

house

परसव क अततम 3 महीनो क िौरान FLW

ककतनी बार आपक घर पर आपस

समली

Number of times

Donrsquot knowdonrsquot rememberhellip 98

सखया पता नही याि नही 98

221 During the last

pregnancy did you

receive advice on the

following at least once

either from the health

workers (ASHA

ANM AWW Doctor)

or other women from

your community fiNyh xHkkZoLFkk ds nkSjku

Dk vkius fuEufyf[kr

ij de ls de d ckj

LokLF dkZdrkZvksa frac14vkrsquokk]

ue] vkaxuokMh

dkZdrkZ] MkDVjfrac12 k

vius leqnk dh vU

efgykvksa kjk lykg

izkIr की

Who provided the

information] vkidks g lykg fdlls

feyh

Health worker

(ASHA ANM

AWW Doctor) LokLF dkZdrkZ frac14vkrsquokk] ue]

MCYq MCYq]

MkDVjfrac12 1

Community group

member Lkeqnkfd lewg ds

lnL2

Both

Yes

हाा No

नह 222

Who gave you

this advice (1 ndash

HW 2 ndash

Community

group member

3 ndash Both)

एए सलाह आपको ककसन द (1 ndash हलथ काययकराय 2 समह क सदसय 3 दोनो न

A How to recognize danger signs of pregnancy xHkkZoLFkk ds [krjs dh igpku dSls djsaxs

1 2 1 2 3

B How to recognize the danger signs at the

time of delivery (for eg prolonged labor

excessive bleeding etc) izlo ds le [krjs ds

ladsr dh igpku dSls djsaxs frac14mnkgjk yach izlo ihMk vRfkd jDrlzko frac12

1 2

1 2 3

C Keeping the new born baby warm uotkr frsquokrsquokq

dks xeZ j[kuk 1 2

1 2 3

D Placing the infant unclothed on the mothers

chest with skin to skin contact under a blanket or

some clothing uotkr frsquokrsquokq dks fcuk dksbZ diM+k iguk]

eka dh Nkrh ls lVk dj fdlh dacy k vkslt+us ds vanj

j[kukA

1 2

1 2 3

E Keep soft clean cloth for drying the baby and a

separate clean cloth for wrapping the newborn baby lkQ lqFkjk diM+k uotkr frsquokrsquokq dks iksNus ds fy vkSj

vyx ls lkQ dIkM+k uotkr frsquokrsquokq dks yisVus ds fy

1 2

1 2 3 9

F Have a disposable delivery kit (DDK) d

fMfyojh fdV 1 2

1 2 3 9

G Use a clean blade to cut the cord uky dkVus ds

fy d lkQ CysM dk izksx 1 2 1 2 3 9

H Breastfeeding the child immediately within

half an hour uotkr frsquokrsquokq dks rqjarvkks kaVs ds

vanj Lruiku djkuk 1 2

1 2 3- 9

13

nksuks3

Other अनय 9

I Information about recommended vaccinations

to the child uotkr frsquokrsquokq ds fy crk xs Vhdkdjk ds ckjs esa tkudkjh

1 2 1 2 3 9

J Family planning for delaying your next child vxys cPps esa nsjh ds fy ifjokj fukstu

1 2 1 2 3 9

K Timings when you need to wash hands dcampdc gkFk kksus dh tjr gksrh gS

1 2 1 2 3 9

223 Did you attend any

Village Health

Nutrition Days

(VHNDs) during your

pregnancy

कया आपन अपनी गभफवसथा क िौरान गाव

क सवासय पोषण दिवस

म भाग सलया था

Yes gka

No ugha

1

2


224 When was the last

time that you attended

VHND meeting

आपन अततम बार गाव क

सवासय पोषण दिवस म कब

भाग सलया था

Number of months ago _____________

ककतन महीन पहल

BLOCK 3 BIRTH PREPAREDNESS

Now i would like to ask you about preparations or decisions you made for the delivery of [CHILD NAME]


301 Prior to delivery did you plan or intend to

deliver [CHILD NAME] at home or in a

healthcare facility cPps dks tUe nsus ls igys] Dk vkius g kstuk

cukbZ Fkh k lkspk Fkk fd tUe kj es k LokLF

lqfokk dsanz es gks

At home kj ij

In a healthcare facility LokLF lqfokk dsanz esa

Did not plan ugh lkspk Fkk

1

2

3

401 यदि परशन सखया 301 म 3 कोड हआ ह तो परशन सखया 401 पर

14

जाए 302 Did you discuss plans for your delivery with

anyone in your family If yes with whom Dk vkius vius izlo dh kstuk ds ckjs esa vius

ifjokj okyksa ls lkFk ckr dh Fkh fn gkWa] rks

fdlls

(CHECK ALL THAT RECORDED)

Yes with husband gkWa] ifr ls

Yes Mother-in-law gkWa] lkl ls

No ugha

1

2

3

303 Did you discuss plans for your delivery with

anyone in the community group Dk vkius vius izlofMyhojh dh kstuk ds ckjs

esa vkius lkeqnkfd lewg okyksa ls lkFk ckr dh Fkh

Yes gka

No ugha

1

2


304 If yes with whom did you discuss fn gkWa] rks fdlls vkius ppkZ fd

With Saheli only कवल Lkgsyh ds lkFk

With most members of our group gekjs lewg ds vfkdkarsquok lnLksa ds lkFk

Both saheli and group members

सहली और समह सिसयो िोनो क साथ

1

2

3

Check Box if 301 = 2 then skip to 306 1 ldquo2rdquo

अब म आपस कछ परशन घर पर परसव करन क सलए की गयी तयाररयो क बार म पछगी

305 Did you or anyone in your family make any preparations for delivery at home tohellip

vki k vkids ifjokj es ls fdlh us घर पर परसव क सलए dqN rSkfjk fd Fkh- - - -

Yes No

A Identify and arrange for a trained birth attendant such as an ANM DAI to be present

during childbirth

परसव ds fy d dqrsquoky lgkd tSls fd ue k nkbZ dh igpku dh vkSj OOkLFkk dh tks cPps ds tUe ds nkSjku

mifLFfr jgsa

1 2

B Obtain a clean delivery kit (Disposable Delivery Kit (DDK)) lkQ fMyhojh fdV izkIr djuk frac14fMLikstscy fMyhojh fdVfrac12

IF YES SKIP TO ldquoErdquo अगर ldquoहाrdquo तो ldquoErdquo पर जाए

1 2

C Obtain a new blade to cut the cord uky dkVus ds fys uk CysM ysuk

1 2

D Obtain a newclean thread to tie the cord uky dks ckakus ds fys uklkQ kkxk ysuk

1 2

E Obtain clean cloth for drying the baby cPps dks lq[kkus ds fys lkQ diMk ysuk

1 2

15

X Other (SPECIFY) vU (mYys[k djsa) 1 2

AFTER ASKING 305X SKIP TO 401

Now I would like to ask you about anything specific that you did to prepare for a delivery at a facility

अब म आपस कछ परशन सवासथय क दर पर परसव करान क सलए की गयी तयाररयो क बार म पछगी

306 Did you or anyone in your family make any preparation for delivery in a health facility

tohellip Dk vki k vkids ifjokj esa fdlh us Hkh dksbZ rSkjh fd-----

DO NOT READ LIST CODE ALL MENTIONS IN FIRST COLUMN सची को न पढ़ जो जवाब मदहला ि उस पहल कॉलम म नोट कर THEN READ EACH ITEM BELOW (A-E) THAT WASNrsquoT MENTIONED AND

CODE RESPONSE IN SECOND COLUMN

जब मदहला अपनी तरफ स सार जवाब ि चकी हो तो वह जवाब जो मदहला न ना दिया हो उस पछ

Yes हा

No नही

A Save money for the delivery fMyhojh ds fys iSlk cpk dj j[kk Fkk 1 2

B Identify health facility for the delivery fMyhojh ds fys LokLF lqfokk dh igpku dh Fkh 1 2

C Identify transportation to go to health facility LokLF lqfokk rd tkus ds fys krkkr dh

igpku dh Fkh

1 2

D Identify a person to accompany you to the healthcare facility LokLF lqfokk rd vkids

lkFk tkus ds fys fdlh OfDr dh igpku dh Fkh

1 2

X Other (SPECIFY) vU frac14mYys[k djsafrac12 1 2

BLOCK 4 DELIVERY AND POST NATAL CARE

अब म आपस कछ परशन परसव और बचि क जनम क समय आपक अनभवो क बार म पछगी

Question Answers Codes Skip

to

401 Where did you deliver [CHILD

NAME]

आपन बचि को कहा जनम दिया था

CODE ONE ONLY ससरफ एक ही उततर सभव ह

IF UNABLE TO

DETERMINE IF A

HOSPITAL HEALTH

CENTRE OR CLINIC IS

PUBLIC OR PRIVATE

MEDICAL SECTOR

WRITE THE NAME OF

THE PLACE

यदि यह नही पता कर पात की

HOME

Your home vkidk kj

Parents home vkids ekrk firk dk kj

Other home vU kj


Govtmunicipal hosp ljdkjhEqfufliy vLirky


UHCUHPUFWC kgjh LokLF dsUnzrsquokgjh LokLF

kstukrsquokgjh ifjokj dYkk dsUnz

CHCRural hospital dEwfuVh gsYFk lsUVjxzkehk vLirky


Sub-center mi dsUnz

AnganwadiICDS centre vkaxuokMhvk lh Mh l dsUnz

NGO SECTOR

NGOTrustClinic xSj ljdkjh laLFkkVordfLVDyhfud

PVT MEDICAL SECTOR

Pvthospital maternity home futh vLirky

1

2

3

4

5

6

7

8

9

10

11

12

16

असपताल हलथ सणटर अथवा जकलतनक (सरकारी या तनजी) गए थ तो जगह का नाम सलख ________________________

Other Pvt sector facility vU futh lsDVj LokLF

lqfokksa

13

402 Who assisted with the delivery

of [CHILDrsquoS NAME] frac14cPps dk ukefrac12 dh fMyhojh fdlus

djkh Fkh

CIRCLE ALLTHAT APPLY

एक स जयािा उततर सभव ह

Qualified doctor dqrsquoky MkDVj

Staff nurseLHV LVkQ ulZypoh

ANM u e

Untrained Dai अकशल nkbZ ASHA AWW vkrsquokkvkaxuokMh dkZdrkZ

Members of community leqnk ds lnL

Unqualified doctorRMP vfkfkr MkDVjvkj e ih

No one dksbZ ugha

Other vU Trained DAI कशल िाई

A

B

C

D

E

F

G

H

X

I

403 Who were all along with you at

the time of delivery izlo ds le vkids lkFk dkSu ls

yksx Fks


Husbandrelatives ifrfjrsquorsnkj

Friendsneighbours fe=iM+kslh

Front line workers QzaV ykbZu dkZdrkZ

Community group members lkewnkfd lewg ds lnL

No one dksbZ ugha

A

B

C

D

E

404 Was the delivery normal or caesarean or assisted

Dk izlo lkekU रप स हआ या ऑपरशन स हआ k करर vkStkj dh lgkrk ls gqvk Fkk

Normal lkekU Caesarean vkWijsrsquoku

Assistedforceps or vacuum

pump सहायता जस रोरसपस अथवा वचिम पप क साथ

1

2

3

Check Q401 परशनसीखया 401 की िख| परशनसीखया 405 स लकर 408 तक ससफफ उह मदहलायो स पछ जजनकापरसव ककसी सवासथय क दर

(सरकार या ननजी) म हआ था| अगर परसव घर पर हआ था तो 409 पर जाएा 405 Were you promised money or an incentive for

delivery of your baby in a healthcare facility through

the JSY program

Dk vkidks tuuh lqjkk kstuk ds vUrZxr LokLF dsUnz esa fMyhojh

djkus ij iSlk k iqjLdkj dk oknk fdk xk Fkk

Yes gka

No ugha

1

2

406 Did you get the amount Dk vkidks iSlk feyk

Yes gka

No ugha

1

2

409 यदि परशन सखया 406 म 2 कोड हआ ह तो परशन

17

सखया 409 पर जाए

407 How much was the payment received

vkidks fdrus iSls feys Fks

INR is _____

_

407a How was the payment made Was it by cash or

cheque or directly transferred to your bank or other

account

vkidks iSls dSls feys Fks Dk g udn esa gqvkpSdlhkk

vkids cSad esa k vU fdlh ds cSad esa gqvk

Cash udn 1

Cheque psd 2

Directly transferred to account Lhkk vkids [kkrs esa 3

Other (specify) 88

अनय (LirdquoV djsa)

408 How long after the delivery did you receive the

money fMyhojh ds fdrus fnuksa ds ckn vkidks iSls feys Fks

Number of days fnuksa dh la[k

_____

_

409 After delivery did anyone (health worker

comunity member) place [CHILD NAME]

unclothed in skin-to-skin contact to your chest or

abdomen izlo ds ckn Dk fdlh LokLF dkZdrkZ k lewg ds

lnLksa us frac14cPps dk ukefrac12 dks fcuk dksbZ diMk iguk

vkidh Nkrh k isV ij j[kk Fkk

Yes gka

No ugha

1

2

Check Q401 परशनसीखया 401को िख| परशनसीखया 409a स लकर 409c तक ससफफ उह मदहलायो स पछ जजनका परसव घर म हआ था|

409a Since you delivered at home did you make any

arrangments for money and transportation in case

there was an emergency कयोकक आपन घर म ही परसव करवाया कया आपन आपातकालीन जसथती क सलए पस अथवा वाहन का इतज़ाम ककया था

Yes हा No नही 410 यदि परशन सखया 409a म 2 कोड हआ ह तो परशन सखया 410 पर जाए

409b Made arrangements for money in case of

emergency आपातकालीन जसथती क सलए पस का इतज़ाम ककया

1 हा 2 नही

18

था 409c Made arrangemnets for transportation in case of

emergency आपातकालीन जसथधथ क सलए वाहन का इतज़ाम ककया


410 Who cut the unbilical cord ukfHk dh uky fdlus dkVh Fkh



ANM u e

Trained Dai कशल nkbZ Untrained dai अकशल िाई ASHA AWW vkrsquokkvkaxuokMh dkZdrkZ

Group members समह ds lnL


No one dksbZ ugha

Other अनय

1

2

3

4

10

5

6

7

9

8

411 What instrument was used to cut the

umbilical cord ukfHk dh uky dkVus ds fys fdl pht

dk izksx fdk xk Fkk

PROBE Was it new or used and

from where did you get it Dk og uk Fkk k mldks igys Hkh

bLrseky fdk xk Fkk vkSj vkius dgkWa

ls izkIr fdk Fkk

New blade from home kj ls uk CysM

New blade from DDK kit fMLikstscy fMyhojh fdV ls uk CysM

Used blade from home kj ls iqjkuk izksx fdk xk CysM

Blade from doctor nurse ANM MkDVjulZ ue kjk fnk xk CysM

Blade from TBA nkbZ kjk fnk xk CysM

Scissor dSaph

Other (specify) vU frac14mYys[k djsafrac12

Donrsquot know ekyqe ugha

1

2

3

4

5

6

8

9

412

What was used to tie the cord

ukYk dks ckakus ds fys Dk izksx fdk

xk Fkk


from where did you get it

Dk og uk Fkk k mldks igys Hkh

bLrseky fdk xk Fkk vkSj vkius dgkWa ls

izkIr fdk Fkk

CODE ONE ONLY ससरफ एक उततर सभव ह

New thread from home kj ls uk kkxk

New thread from DDK kit fMLikstscy fMyhojh fdV ls

uk kkxk

Used thread from home kj ls iqjkuk izksx fdk xk

kkxk

Thread from doctor nurse ANM MkDVjulZue

kjk fnk xk kkxk

Thread from TBA nkbZ kjk fnk xk kkxk

Cord clip dkWMZ fDyi



1

2

3

4

5

6

8

9

413 Was anything applied to the cord

after cutting and tying Dk dkVus vkSj ckakus ds rqjUr ckn uky

ij dqN yxkk xk Fkk

Yes gka

No ugha

1

2

414 Was anything applied to the

umbilicus after the cord dropped off Dk tc uky fxj xh Fkh rks ukHkh ij

dqN yxkk xk Fkk

Yes gka

No ugha

1

2

CHECK BOX IF answers to both 413 and 414 are 2 then skip to 416

19

अगर 413 और 414 िोनो म ldquoनहीrdquo जवाब ह तो 416 पर जाय

415 What was applied to the cord

after cutting and tying vkius uky dks dkVus vkSj ckakus ds ckn

uky ij Dk yxk Fkk

CODE ALL THAT

APPLY


Powderlotionointment (dettolsavoln etc) ikmMjyksrsquokueygefrac14MsVkylsoyku bRkfnfrac12

Alcoholspirit YdksgyfLifjV

Mustard oil ljlksa dk rsy

Sindoor flUnwj

Pure ghee rsquokq) kh

Boric powder cksfjd ikoMj

Gentian violet (neeli dawai) fuyh nokbZ

Talcum powder kjhj ij yxkk tkus okyk ikoMj

Chlorohexidine DyksjksgsfDlMkbu

Cowdung xk dk xkscj

Others (specify) vU frac14mYys[k djsafrac12

A

B

C

D

E

F

G

H

I

J

X

415a What was applied to the

umbilicus after the cord

dropped off vkius uky fxjus ds ckn ukfHk ij Dk

yxk Fkk




Sindoor flUnwj






Cowdung xk dk xkscj


A

B

C

D

E

F

G

H

I

J

X

416 After delivery was the baby

wiped dry wiped with a wet

cloth or bathed izlo ds ckn Dk cPps ds kjhj dks

iksaN dj lw[kk cukk xk] xhys diM+s

ls iksaNk xk k mls ugykk xk

Wiped dry iksN dj lq[kkk xk 1

Wiped with a wet clothhelliphelliphelliphelliphelliphelliphelliphelliphelliphellip2 xhys diM+s ls iksaNk xk

Bathed ugykk xk Fkk 3

Donrsquot know irk ugha 98

Question Answers

417 How soon after the delivery was [CHILD NAME] given (hisher) first bath frac14cPps dk ukefrac12 dks tUe ds fdrus le ckn igyh ckj ugykk xk Fkk

अगर एक घट स कम समय बताती ह तो घट म ldquo00rdquo कोड कर और अगल परशन पर जाए|

अगर 24 घट स कम समय बताती ह तो जवाब को घट म कोड कर और अगल परशन पर जाए

अगर 24 घट स जयािा समय बताती ह तो घट म 99 भरकर जवाब को दिन म िजफ कर|

Hours kVs

________________

Days fnu

_________________

418 Did you ever breastfeed [CHILD NAME] Dk vkius frac14cPps dk ukefrac12 dks dHkh viuk nwk

fiykk

Yes gka

No ugha

1

2

421 यदि परशन सखया 418 म 2 कोड हआ ह तो परशन सखया

20


419 How long after birth did you first put

[CHILD NAME] to the breast vkius frac14cPps dk ukefrac12 dks igyh ckj viuk nwk dc

fiykk Fkk

अगर एक घट स कम समय बताती ह ldquo00rdquo कोड कर और अगल परशन पर जाए|

अगर 24 घट स लम समय बताती ह तो जवाब को घट म कोड कर और अगल परशन पर जाए


ImmediatelyWithin half an

hour

तरत आि घट क अनिर

H Hours घट ___________

D Days दिन ____________

0

420 Was [CHILD NAME] given anything other

than breast milk within the first day Dk vkius frac14cPps dk ukefrac12 dks igys fnu esa vius nwk ds

vykok dqN vkSj Hkh fnk Fkk

Yes gka

No ugha

1

2

421A यदि परशन सखया 420 म 2 कोड हआ ह तो परशन सखया 421a पर जाए

421 What was [CHILD

NAME] given

frac14cPps dk ukefrac12 dks Dk

fnk xk Fkk

PROBE Anything

else

dqN vkSj

एक स जयािा जवाब सभव ह

Milk Other Than Breast Milk ekWa ds nwk ds vykok dksbZ vkSj nwk frac14tkuoj dk nwkfrac12

Plain Water lknk ikuh

Sugar Or Glucose Water phuh k Xywdkst dk ikuh

Gripe Water xzkbZi okVj Sugar-Salt-Water Solution phuh ued ikuh dk kksy

Fruit Juice Qyksa dk jl

Infant Formula uotkr QkewZyk

Tea pk Honey kgn Janam Ghutti tUe kqV~Vh

Others (Specify) vU frac14mYys[k djsa)

A

B

C

D

E

F

G

H

I

J

X

421A What is the age of this child [CHILD NAME] frac14cPpcent dk ukefrac12 dh mez Dk gS

Month efguk ___________

421B What is the sex of this child [CHILD NAME] बचि का सलग कया ह

Male परष सलग Female मदहला सलग

422 Are you still breastfeeding [CHILD NAME] Dk vki frac14cPps dk ukefrac12 dks vHkh Hkh viuk nwk fiyk jgh gS

Yes gka

No ugha

1

2


21

जाए 423 How many times did you breastfeed [CHILD

NAME] in the last 24 hours fiNys 24 kaVksa esa vkius frac14cPps dk ukefrac12 dks fdruh ckj viuk nwk fiykk

la[k Number__________

424 For how many months did you breastfeed [CHILD

NAME] vkius frac14cPps dk ukefrac12 fdrus eghuks rd viuk

nwk fiykk Fkk

Months eghus ______________

425 For how many months did you exclusively breastfeed

that is no other food or liquid was given to this child vkius frac14cPps dk ukefrac12 fdrus le rd dsoy viuk nwk

fiykk Fkk kfu mlds vykok dksbZ vkSj [kkus o ihus dh

pht ugha nh


See Q422 If in 422 answer is 1 then goto 426

425a Why did you stop breastfeeding the child

vkius frac14cPps dk ukefrac12 dks nwk fiykuk Dksa cUn dj fnk Fkk

PROBE Any others dqN vkSj CODE ALL THAT APPLY

Problem with breast (pain cracked nipples engorgement) (A) 1

Lruksa esa ijsrsquokkuh frac14nnZ njkj okyss fuIiy

Bwals fuIiy frac12

Child did not suck well (B) 2

cPpk lgh izdkj ls pwl ugha ikrk Fkk

Not enough time to feed (c) 3

nwk fiykus ds fys IkkZIr le ugha Fkk

Mother felt not enough breast milk (D) 4

ekWa dks yxk fd Lruksa esa IkkZIr nwk ugha

gS

Mother got pregnant new infant born (E) 5 ekWa xHkZorh gks xh Fkhuotkr cPPk iSnk

gqvk Fkk

Mother went back to work (F) 6

ekWa dke ij okfil pyh xh Fkh

Infant resisted breastfeeding (G) 7

uotkr ekW dk nwk ihus dk fojksk dj

jgk Fkk

Infant already grown up (H) 8

uotkr cMk gks xk Fkk

OTHER (SPECIFY) vU

(LirdquoV djsa) (X) 88

426 During the time that you exclusively breastfed did

you give water to the baby

tc rd vkius frac14cPps dk ukefrac12 dks viuk nwk fiykk Dk

Yes gka

No ugha

1

2

22

vkius mls ihus ds fy ikuh fnk Fkk

427 Now I would like to ask you about the liquids [CHILD NAME]

drank yesterday during the day or at night vc eSa g tkuuk pkgwaxh fd frac14cPps dk ukefrac12 us dy fnu vkSj jkr

feykdj dkSu dkSu lh phtsa ih

READ (a-h) BELOW AND CODE YES OR NO FOR

EACH

If child is younger than 5

months and 30 days and

option in 427=rdquonordquo

fn cPpk 5 eghus 30 fnu

ls de vkq dk gS vkSj

th19 dk mUgravekjfrac34^^ughaszlig gS rks

ldquoHave you ever given

[liquid] at any time to

[CHILDNAME]rdquo Dk vkius dHkh Hkh frac14cPps dk

ukefrac12 dks rjy inkFkZ

fiykk gS

If 427A_1 =2 skip to 427A_2

Liquids Yes हा

No नही

Yes हा

No नही

a Plain water Lkknk ikuh 1 2 1 2

b Commercially produced infant formula milk cktkj ls feyus

okyk uotkr dk QkeZwys okyk nwk

1 2 1 2

c Any other kind of milk (tinned powdered or fresh animal

milk) fdlh vU izdkj dk nwk frac14fVu okyk ikmMj okyk k rktk

tkuoj dk nwkfrac12

1 2 1 2

d Fruit juice Qy dk twl 1 2 1 2

e Tea or coffee pkdkQh 1 2 1 2

f Sodas like Pepsi Coke Orange drink lksMk tSls isIlh dksd]

vkWjsUt is

1 2 1 2

g Clear brothrice watersoupboiled water lksMk rsquokksjckpkoy

dk ikuhlwimcyk gqvk ikuh

1 2 1 2

X Other liquids (SPECIFY) vU rjy inkFkZ (mYys[k djsa 1 2 1 2

428 Does this child eat any solid semi-

solid or soft foods Dk frac14cPps dk ukefrac12 dksbZ elyk gqvk]

eqyke k Bksl [kkuk [kkrk gS

Yes gka

No ugha

1

2


429 When did this child begin eating

semi-solid soft foods frac14cPps dk ukefrac12 us slk Bksl elyk gqvk

lk eqyke Hkkstu [kkuk fdl vkq ls

kq fdk Fkk

Age in completed Months mez iwkZ eghuksa esa

_____

_

430 When the child falls sick how

regularly do you feed your child

semi-solid or solid food in

comparison to the childrsquos normal

Same as before dksbZ varj ugha 1

Less number of times than before igys ls de

ckj nsrh gSa 2

More than before igys ls Tknk nsrh gSa 3

23

intake tc cPpk chekj gksrk gS rks vki mls

rchr Bhd gksus dh rqyuk esa fdruh

ckj elyk gqvk eqyke k Bksl [kkuk

nsrh gSa

SINGLE CODING ONLY

Do not give semi-solid or solid food during

sickness rchr [kjkc gksus ij dksbZ elyk gqvk eqyke k

Bksl [kkuk ugha nsrh gS

4

Child did not fall sick dg ugha ldrh Dksafd

cPpk dHkh chekj ugha gqvk 9

431 After the delivery did a health

worker such as an ANM ASHA or

Anganwadi Worker come to your

home to check on you and your

baby izlo ds ckn Dk LokLF

dkZdrkZ tSls ue] vkrsquokk k

vkaxuokMh dkZdrkZ vkidks k uotkr

frsquokrsquokq dks ns[kus vkids kj vks Fks

Yes gka

No ugha

1

2


432 Who came to visit you and the

baby vkidks vkSj vkids cPps dks ns[kus dkSu

vkk Fkk कया य vkrsquokk] vkaxuokMh

dkZdrkZ k ue esa ls Fks


ASHA vkrsquokk

ANM ue

Aaganwadi worker vkaxuokMh dkZdrkZ

Other (Specify) vU dksbZ frac14mYys[k djsafrac12

A

B

C

X

433 How many days or weeks after the

delivery did the first home visit take

place izlo ds ckn] fdrus fnuksa k lIrkg ds

ckn igyh ckj ns[kus ds fy vkids kj

vks

Days Fnu

Weeks

_____

434 How many times did an ASHA

AWW ANM visit you at home

during the first week after you gave

birth to your child uotkr frsquokrsquokq dks tUe nsus ds ckn igys

lIrkg esa fdruh ckj vkrsquokk] vkaxuokMh

dkZdrkZ k ue vkids kj vks

Number of times fdruh ckj

435 After the delivery did any

community group member come to

your home to check you and your

baby izlo ds ckn Dk lkeqnkfd lewg ds

lnL vkidks k uotkr frsquokrsquokq dks ns[kus

vkids kj vks Fks

Yes gka

No ugha


ml le dksbZ lewg ugha Fkk Respondent was not member of the group at that

time ml le mRrjnkrk lewg dh lnL ugha Fkh

1

2

3

4

502

502

502 यदि परशन सखया 435 म 1 स ऊपर

24

कोड हआ ह तो परशन सखया 502 पर जाए


delivery did the first home visit by

such community members take


ckn समह क सिसय igyh ckj आपको और बचि को ns[kus ds fy vkids kj

vks

Days

437 Did the child [CHILD NAME]

suffer from

कया बचि को कभी तनमन बीमाररया हई ह Response categories उततर शरणी

1 = Yes हा 2 = No नही

The type of doctor from where

received treatment ककस परकार क डॉकटर स इलाज कराया A) Doctor in PHC or sub-center ndash पराथसमक सवासथय क दर या उप सवासथय क दर क डॉकटर स B) District hospital जजला असपताल स C) City doctor through Sky clinic सकाई जकलतनक क डॉकटर स D) Local private doctor तनजीपराइवट डॉकटर स E) Local jhola chaap ndash झोला झाप डॉकटर स

Ever

suffered कभी पीडड़त हआ

(A)

Currently

suffering इस समय पीडडत ह

(B)

Did the

child

recieve

treatment बचि का इलाज हआ

(C)

From whom ककस स इलाज हआ

(D)

Diarrohea

(with fever

lethargy

persistent

vomitting

and blood in

stool) िाररया (बखार क साथ ससती लगातार उजलटया और टटटी म खन)


1 हा

2 नही 1 हा 2 नही

A B C D E

Pneumonia

(Ill with

rapid short

breathing

fever amp

cough) तनमोतनया (सास का


1 हा


A B C D E

25

रलनाबखारबलगम)

Kala azar

काला अज़र


1 हा


A B C D E

BLOCK 5 IMMUNIZATION


502 Did [CHILD NAME] ever receive any vaccinations to

prevent (himher) from getting diseases including

vaccinations received in a Pulse Polio program Dk frac14cPpcent dk ukefrac12 dks dHkh fcekfjreg ls cpko ds fys dksbZ

Vhdk yxk gS blesa iYl iregyhreg dkZdze eas fn x Vhdksa dks

Hkh ldquokkfey djsaA

Yes gka

No ugha

1

2


503 Do you have a card where vaccination details are

written down

Dk vkids ikl जचिा-बचिा dkMZ gS ftl ij

frac14cPpcent dk ukefrac12 ds lHkh Vhds fy[ks o ntZ fd x gSa

(IF YES MAY I SEE IT PLEASE) fn gkW Dk eS dkMZ ns[k ldrk gWw

Yes Seen gkW] eSus ns[kk Yes Not seen gkW] eSus ugh ns[kk No Card dkMZ ugha

01

02

03

506

506


504 Investigator to record from the card all the

vaccinations child received vUoskd dkMZ ls ntZ dj fy[ksa fd cPps us dkSu dkSu lk

Vhdk yxokk gS

Yes हाा

No नह ी

BCG chlhth 1 2

P0 [Polio given at birth] iregyhreg 0 iregyhreg tUe ds

le fnk xk

1 2

Polio iregyhreg 1 1 2

DPT MhihVh 1 1 2


DPT MhihVh 2 1 2


DPT MhihVh 3 1 2

26

Measles [kljk 1 2

Vitamin A [First dose] foVkfeu frac14igyh [kqjkdfrac12

1 2

505 Has this child received any vaccinations that are

not recorded on this card cPps us Slk dksbZ Vhdk yxokk gS tks fd bl dkMZ ij

ntZ ugha gS

यदि उततरिाता हा कहती ह तो उसस या उसक पररवार क

ककसी सिसय स टीक क बार म जानकारी लन की कोसशश

कर | इस परशन म हा तभी िजफ कर जब बचि को तननमसलखखत म स कोई टीका लगा ह (जजसका पववरण

काडफ म िजफ नही हआ ह)

बीसीजी पोसलयो 0-3 डीपीट 1-3 खसरा

यदि इस परशनन सीखया म हाा कोड होता ह ह तो वापस परशनसीखया 505 म जाएा और लगाय गए ट को को कोड कर|

Yes gka

No ugha

1

2


Please tell me did the child receive कपया मझ बताए कक कया बचि को तनमनसलखखत टीका लगा ह

506 A BCG vaccination against tuberculosis that is

an injection in the arm or shoulder that usually

causes a scar chlhth dk Vhdk tks Vhch ls yMus ds fys fnk tkrk

gS vkSj gkFk k daks ij yxkk tkrk vkSj mlds yxus

ls fursquokku jg tkrk gS

Yes gka

No ugha

1

2

507 Any POLIO VACCINE that is drops in the

mouth including vaccine received in a Pulse

Polio campaign iksyhks Vhdk

Yes gka

No ugha

1

2

508 Was the first POLIO VACCINE received in the

first two weeks after birth or later Dk tUe ds nreg lIrkg ds chp cPps dreg iksfyks dk

igyk yxk Fkk

Yes gka

No ugha

1

2


509 How many times was the Polio vaccine given iregyhks dk Vhdk fdruh ckj yxk

(excluding Polio 0 and pulse polio)

frac14iregyhks 0 vkSj iYl iksyhks dks NksMdjfrac12

Number la[k

_____

510 A DPT vaccination that is and injection given in

the thigh or buttocks sometimes at the same time

as polio drops MhihVh dk Vhdk treg dh tkaAuml k dwYgreg ij fnk tkrk

Yes gka

No ugha

1

2

512 यदि परशन

27

gS vkSj dbZ ckj g iksfyks dh nokbZ ds lkFk Hkh fnk

tkrk gS सखया 510 म 2 कोड हआ ह तो परशन सखया 512 पर जाए

511 How many times was a DPT vaccination

received MhihVh dk Vhdk fdruh ckj yxk

Number la[k

_____

512 Was an injection against MEASLES given at

right armshoulder [kljs ls cpko dk Vhdk

Yes gka

No ugha

1

2

513 The first dose of Vitamin A

foVkfeu A dh igyh [kqjkd

Yes gka

No ugha

1

2

BLOCK 6 FAMILY PLANNING vxys dqN izrsquou ifjokj fukstu k vyxampvyx fofk ds ckjs esa gS tks d nEifr xHkZkkjk dks jksdus k nsj djus ds fys izksx dj

ldrs gSs

601 Which ways or methods have you heard about

कौन कौन सी पवधियो क बार म आपन सना ह

FOR METHODS NOT MENTIONED SPONTANEOUSLY ASK जो पवधिया खि स ना बताततए उनक सलए पछ Have you ever heard of (METHOD) Dk vkius dHkh frac14fofkfrac12 dk uke lquk gS

602 Have you ever used

[METHOD] Dk vkius dHkh frac14fofkfrac12 izksx fdk

gS

a FEMALE STERILIZATION Women can have an

operation to avoid having any more children

efgyk नलबिी ftlesa d efgyk को vkSj cPps u gks blds fys

vkijsrsquoku djk ldrh gS

Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

b MALE STERILIZATION Men can have an

operation to avoid having any more children d iqk vkSj cPps u gks blds fys

vkijsrsquoku djk ldrk gS

Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

If 602a=1 or 602b=1 skip to 605

c PILL Women can take a pill every day or every

week to avoid becoming pregnant

गभफतनरोिक tks d efgyk xHkZorh gksus ls cpus

ds fys izfrfnu k lIrkg esa d ckj [kk ldrh gSasa

Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

d IUD OR LOOP or Copper T Women can have a

loop or coil placed inside them by a doctor or a

nurse d efgyk MkWDVj k

ulZ kjk vius xHkkZrsquok ds vUnj yxok ldrh gSA

Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

28

e INJECTABLES Women can have an injection by a

health provider that stops them from becoming

pregnant for one or more months d efgyk fdlh LokLF iznkrk ls bUtsDrsquoku

yxok ldrh gS ftlls og d efgus k Tknk eghuss rd

xHkZorh gksus ls cp ldrh gSA

Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

f CONDOM OR NIRODH Men can put a rubber

sheath on their penis before sexual intercourse d iqk kSu lEcUk djus ls igys

vius fyax ij d jcj dk vkojk pltk ldrk gS A

Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

g FEMALE CONDOM Women can place a sheath in

their vagina before sexual intercourse d efgyk kSu lEcUk djus ls igys

viuh ksfu esa d jcj dk vkojk yxk ldrh gS A

Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

h RHYTHM METHOD Every month that a woman is

sexually active she can avoid pregnancy by not

having sexual intercourse on the days of the month

she is most likely to get pregnant izRsd eghus d efgyk mu fnuksa esa

kSu lEcUk ugha cuk dj xHkZkkjk ls cp ldrh gS tc

mlds xHkZkkjk dh laHkkouka lcls Tknk gksrh gSA

Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

i WITHDRAWAL Men can be careful and pull out

before climax iqk lkokkuh dj pjekoLFkk ij igqaPkus

ls igys viuk fyax ckgj fudky ysrk gS

Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

j EMERGENCY CONTRACEPTION Women can

take pills up to three days after sexual intercourse to

avoid becoming pregnant d efgyk kSu lEcUk cukus ds

rhu fnuksa ds vUnj xksyh ys xHkZkkjk ls cp ldrh gS

Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

k Have you heard of any other ways or methods that

women or men can use to avoid pregnancy Dk vkius fdlh vU mik vkSj fofkksa ds ckjs esa lquk gS

tks d efgyk k iqk xHkZkkjk gksus ls cpus ds fys

izksx dj ldrs gS

Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

603 Are you currently doing something or using any

method to delay or avoid getting pregnant Dk vki orZeku esa xHkZkkjk dks jksdus k mlesa nsjh djus

ds fy fdlh fofk dk izksx dj jgs gS

Yes gka 1

No ugha2 701 यदि परशन सखया 603 म 2 कोड हआ ह तो परशन सखया 701 पर जाए

29

604 Which method are you using vki dkSu lh fofk dk izksx dj

jgs gS


Female Sterilization मदहला नसबिी A

Male Sterilization रष नसबिी B

IUD or Loop आई य डी या लप C

Injectables इजकशन D

Birth Control Pills गभफतनरोिक परतयारोपण E

Male Condoms कडोम या तनरोि F

Female Condoms मदहला कडोम G

Diaphragm गभफतनरोिक टोपी H

Foamjelly रोमजली I

Rhythm method सरकषित कालापवधि J

Withdrawal बाहर तनकलना K

Emergency contraception इमरजसी गभफतनरोिक

L

Others (please specify) अनय (उललख कर) X

605 Was the current child

[CHILD NAME] wanted

thenlaternever इस बचि को कया आप पिा करना िाहत थ (जब हआ तबबाि मकभी नही

Then उस वकत Later बाि म Never कभी नही

1

2

3

606 Now I have some questions

about the future

Would you like to have

(aanother) child or would

you prefer not to have any

(more) children

vc eSa vkils Hkfordquo ds ckjs esa dqN izrsquou

iwNuk pkgwaxhA Dk vki vHkh dvkSj cPps

pkgsaxs k dksbZ vkSj cPPkk ugha pkgsaxs

Prefer another childhellip1

vkSj cPpk pkgsaxs

Prefer not to have another childhellip2

vkSj cPpk ugha gksuk ilUn djsaxs

Donrsquot knowcant get pregnanthellip3

irk ughaxHkZkkjk ugha dj ldrs

1

2

3

4

606b Whose decision will it be to

have or not have another

child और बचि करन ह या नही यह ककसका तनणफय होगा

Yours आपका Husbandrsquos आपक पतत का Joint decision िोनो Mother-in-lawका सास का Others अनय

1

2

3

4

5

30

607 Did you and your husband

ever discuss about the

following in the past one

year कया आपन और आपक पतत न तनमन पवसशओ पर पपछल एक साल म बात की ह

Response categories उततर शरणी 1 = Yes हा 2 = No नही

How many children to have ककतन बचि करन ह When to have children बचि कब करन ह Which contraceptive method to use कौन सी गभफ तनरोिक पवधि अपनानी िादहए When to go for antenatal check-up - xHkkZoLFkk म izlo iwoZ िकप (जाि) क सलए कब जाना िादहए Where to deliver a baby परसव कहा करना िादहए How to maintain good hygiene सवसय क सलए साफ़ सराई कस रखनी िादहए What to do for sanitation घर म साफ़ सराई क सलए कया करना िादहए

1 2

1 2

1 2

1 2

1 2

1 2

1 2

BLOCK 7 WATER HYGEINE AND SANITATION

vc eSa vkils ihus ds ikuh ds lkzsrks vkSj LoPNrklkQlQkbZ ds ckjs esaa vkils dqN izrsquou iqNuk pkgwaxh


701 Has any health worker ASHA AWW or ANM

ever demonstrated proper hand washing to you Dk fdlh LokLF dkZdrkZ tSls fd vkrsquokk] vkaxuokMh

dkdrkZ k ue us vkidks lgh rjhds ls gkFk dSls

kksrs gSa slk fn[kykk gS

Yes gka

No ugha

1

2

701

b

Has your Saheli ever demonstrated proper hand

washing to you

कया कभी सहली न आपको सही तरीक स हाथ कस िोत

ह दिखलाया ह

Yes

No

1

2

702 According to you what are the occasions before

which one should always wash hands with soap vkids vuqlkj] dkSu ls voljksa ls igys vkidks lkcqu ls

gesrsquokk gkFk अवशय kksuk pkfg

PROBE Anyone else


Before cooking [kkuk cukus ls igys

Before touching or eating [kkus k Nwus ls igys

Before feeding someone fdlh dks

f[kykus ls igys

Before Praying izkFkZuk ls igys


Donrsquot know irk ugha None dksbZ Hkh ugha

A

B

C

D

X

Y

Z

31

703 According to you what are the

occasions after which one should

always wash hands with soap vkids vuqlkj] dkSu ls voljksa ds ckn

vkidks lkcqu ls gesrsquokk gkFk kksuk

pkfg

PROBE Anyone else


After defecation kkSp ds ckn

After urinating iskkc djus ds ckn

After eating [kkus ds ckn

After sweepingmoppingdusting lkQ lQkbZgtkMw iksNk djus ds ckn

After touching pets or handling animals and their waste ikyrq tkuojksa

dks Nqus k mudh xkscjxanxh fudkyus ds ckn

After blowing nose orcoughing cgh gqbZ ukd lkQ djus ds ckn

After cleaning utensils crZu lkQ djus ds ckn

After cleaning a childrsquos bottom cPps ds uhps Hkkx ds lQkbZ ds ckn

After working in the field [ksr esa dke djus ds ckn

After playing [ksyus ds ckn

Others ( specify) vU frac14mYys[k djsafrac12

None dksbZ Hkh ugha

A

B

C

D

E

F

G

H

I

J

X

Y

704 In general do you wash your hands with soap

during a typical day

lkekU i esa] Dk vki viuk gkFk fnu esa साबन स kksrh gS

Yes gka

No ugha

1

2

706

यदि परशन सखया 704 म 2 कोड हआ ह तो परशन सखया 706 पर जाए

705 When do you usually

wash your hands with

soap and water during a

typical day lkekUrk d fnu esa vki

dcampdc vius gkFk साबन और पानी स kksrs gSa

PROBE Anyone else



After using the toilet kkSpky dk miksx djus ds ckn

After handling food Hkkstu ls fuiVus ds ckn

Before eating [kkus ls igys

Before praying izkFkZuk ls igys

Before feeding the infant frsquokrsquokq dks f[kykus ds igys

After cleaning infant feces fkrsquokq ey dh lQkbZ djus ds ckn

After dusting sweeping mopping lkQ lQkbZgtkMw iksNk djus ds

ckn

After touching pets or handling with animals and their waste ikyrq tkuojksa dks Nqus k mudh xkscjxanxh fudkyus ds ckn

After blowing nose or coughing cgh gqbZ ukd lkQ djus ds ckn



A

B

C

D

E

F

G

H

I

J

K

X

706 How do you wash your

hands after using the

toilet kkSpky dk miksx djus ds

ckn vki vius gkFkks dks

Tknkrj dSls kksrh gS

Using only water dsoy ikuh dk miksx

Using soap lkcwu dk miksx

Using mud soil fdpMfeV~Vh dk miksx

Using ash jk[k dk miksx

1

2

3

4

32

706a The last time you used

the toilet did you wash

your hands afterwards

fiNyh ckj tc vkius kkSpky

dk miksx fdk rks Dk mlds

ckn vius gkFk kkss Fks

Yeshellipहा helliphelliphellip1

Nohellipनहीhelliphelliphellip2

707

यदि परशन सखया 706a म 2 कोड हआ ह तो परशन सखया 706c पर जाए

706

b

If yes what did you use

(water onlywater and

soapwater and

surfashoilother)

fn gka rks vkius gkFk kksus

ds fy fdldk miksx fdk

frac14dsoy ikuhikuh vkSj

lkcquikuh vkSj

lQZjk[kfeV~VhvUfrac12

CODE ONE ONLY

ससरफ एक उततर कोड कर

Water onlyhelliphelliphellipकवल पानीhelliphelliphelliphelliphelliphelliphelliphelliphellip1

Water and soaphellipपानी और साबनhelliphelliphelliphelliphelliphelliphelliphelliphellip2

Water and surfhellipपानी और सरफ helliphelliphelliphelliphelliphelliphelliphelliphellip3

Ashhelliphelliphelliphelliphelliphellipराखhelliphelliphelliphelliphelliphelliphelliphellip4

Soilhelliphelliphelliphelliphelliphellipसमटटी helliphelliphelliphelliphelliphelliphelliphelliphellip5

Other (specify)hellip hellipअनय helliphelliphelliphelliphelliphelliphelliphellip6

706c

Yesterday after cleaning

the child (after hisher

stool) did you wash your

hands with soap

बचि की शौि साफ़ करन क

बाि कया आपन कल अपन

हाथ को साबन स िोया था

706

d

Is soap available in the

household Dk kj esa lkcqu miyCk gS

Yeshelliphellipहाhelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip1

Nohelliphellipनहीhelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip2

33

707 The last time [CHILD

NAME] passed stools

what was done to dispose

of the stools vfUre ckj tc frac14cPps dk

ukefrac12 us eyi[kkuk fdk

Fkk rc ey dks dgka Qsadk

xk Fkk

Child used toilet or latrine cPps us VkysV izksx fdk Fkk

Put rinsed into toilet or latrine VkysV k ysVfju esa kksk Fkk

Put rinsed into drain or ditch ukyh k uy ij kksk Fkk

Thrown into garbage dwMs esa Mky fnk Fkk

Buried tyk fnk Fkk

Left washed in the open [kqys esaa Mky दियाkks fnk Fkk

Other vU

1

2

3

4

5

6

7

708 What is the main source

of drinking water for

members of your

household

vkids ifjokj ds lnLrega ds

fys ihus ds ikuh dk eq[

lzregr Dk gS

Piped into dwelling Aumlj esa ikbi (नल) Piped to yardplot vkaxuIykkV dk ikbi (नल) Public tap standpipe सावफजातनक नल Tube well or borehole Vwocsycumljgumly िापाकल Protected well ltdk dqvk

Unprotected well [kqyk dqvk

Water from spring ecopyleh ikuh

Protected spring lqjfkr ecopyleh ikuh

Unprotected Spring vlqjfkr ecopyleh ikuh

Rainwater Ckjlkr dk ikuh

Tanker truck VSadj Vordfd

Cart with small tank NregVs VSad okyh xkMh

Surface water (river dam lake pond stream canal irrigation

channel) Lkrgh ikuh frac14unhcakkgthyrkykc EumlkkjkugjflapkAtilde

pSuyfrac12

Bottled water cksry dk ikuh

1

2

3

4

5

6

7

8

9

10

11

12

13

14

712


709 Where is the water source

located ikuh dk lzksr dgka ij fLFkfr

gS

In own yardplot [kqn ds kMZtehu ij

Elsewhere vU=

1

2

712


710 How long does it take to

go there get water and

come back in one trip d ckj esa ogka tkdj ikuh

ysus vkSj ikuh ysdj vkus esa

fdruk le yxrk gS

In Minutes fefuVksa esa __

__

__

711 Who usually goes to this

source to fetch water vkerkSj ij ikuh ykus ml

txg ij dkSu tkrk gS

Adult woman oLd efgyk Adult man oLd iqk Female child (under 15years) efgyk cPps frac1415 okZ ls defrac12 Male child (under 15years) iqk cPps frac1415 okZ ls defrac12

1

2

3

4

34

712 Do you store water for

future use (for use

beyond the day water is

collected) Hkfo esa miksx ds fy Dk vki

ihus ds ikuh dks lqjfkr j[krs gS

Yes gka

No ugha

1

2

715


713 For how long do you

store drinking water for

future use fdrus le ds fy vki ihus

ds ikuh dks Hkfo esa miksx

ds fy lqjfkr j[krs gS

One week d lIrkg ds fy

Two weeks nks lIrkg ds fy

One month d eghus ds fy

More than one month d eghus ls Tknk ds fy

1

2

3

4

714 How do you store

drinking water vki ihus ds ikuh dks laxzg

djds dgkWa j[krs gS

Stored in covered container ltads cjru esa laxzg djds

Stored in open Container [kqyss cjru esa laxzg djds

1

2

715 Do you treat your water

in any way to make it

safer to drink Dk vki ihus ds ikuh dreg

fdlh Ograveh ccedildkj ls lqjfkr

cukrh gSa

Yes gka

No ugha

1

2

717


716 What do you do to the

water to make it safer to

drink

lkekURkk IkkUkh Dkreg ihus

regX cukus ds fys vki Dk

djrs gS

पछ उततरिाता दवारा बताय गए जवाबो को करमवार तर क स िजफ कर| जस कक अगर मदहला जयािातर बार कफटककर का परयोग करती ह और कभी कभी पानी उबालती ह तो पहल ldquoBrdquo िजफ कर कफर ldquoArdquo िजफ कर

Boil mckyuk

Use Alum fQVfdjh dk miksx

Add bleach chlorine tablets CyhpDyregjhu dh xksfyka dreg feykuk

Strain through a cloth diMs ds eke ls Nkuuk

Use water filter (ceramic sand composite etc) Ikkuh ds fQYVj

dk bLrseky djukfrac14lsjsfedckywdEiregftVfrac12

Use electronic purifier fctyh ds IwfjQkj dk bLsrkeky djuk

Let it stand and settle Ikkuh duml Bgjs jgus nsuk vcopyj fLFkj gumlus nsuk

Other (specified) vU frac14mYys[k djsafrac12

A

B

C

D

E

F

G

X

35

717 What kind of toilet

facility do members of

your household usually

use fdl Aacutedkj dh kcopypky

lqfoEumlkk dk miksx vkidk

ifjokj dj jgs gS

Flush to piped sewer system Ikkbi lhoj flLVe ls Qyk

Flush to septic tank lsfIVd VSad ls Qyk

Flush to pit latrine xMlts okYks kcopypky ls Qyk

Flush to somewhere else dgha vcopyj Qyk

Flush donrsquot know where Qyk]irk ugh dgWk Ventilated improved pit (VIP) biogas latrine goknkj frac14csgrjfrac12 xMltkckregxSl kcopypky

Pit latrine with slab iIacutehokys xMlts okYks kcopypky

Pit latrine without slab open pit fcuk iIacutehokys xMlts okYks

kcopypky [kqyk xMltk

Twin pit composting toilet tqMs gqs xMlts dEiregftV kcopypky

Dry toilet lw[kh kcopypky

No facility uses open space or field dregb lqfoEumlkk ugh[kqys LFkku

k [ksr dk bLrseky

Other (specify) vU frac14mYys[k djsafrac12____________

1

2

3

4

5

6

7

8

9

10

11

12

721


718 Do you share this toilet

facility with other

household members Dk vU ifjokj Hkh kcopypky

dh lqfoEumlkk duml bLrseky djrs

gSa

Yes gka

No ugha

1

2

720


719 How many households

use this toilet facility bl kcopypky dk bLrseky

ककतन ifjokj करत gSa

Number la[k

720 In the past week has

anyone in your household

including children

defecated in the open- for

example in the field or in

the river fiNys lIrkg esa vkids kj

dk dksbZ lnL k cPpk kkSp

ds fy [kqys esa xk tSls fd

[kqys eSnku esa k unh ds

ikl

Yes gka

No ugha

1

2

36

721 Where do you dispose of

your household waste vki vius kj ds dpjs dks

dSls fuiVkrs gS

Outside the house kj ds ckgj In a public garbage dump lkoZtfud dwM+kkj esa

In a drain ukys esa

Garbage collecter collects garbage dwM+k ys tkus okyk kj ls ल tkrk gS

Any other (specify) vU frac14LiV djsafrac12

1

2

3

4

5

722 Is waste (eg heaps of

rubbish with household

andor human waste piled

up) a problem where you

live Dk dpjk (जस कड़ का ढर अथवा मानवअपसशषट) d leLk gS

vki tgka jgrs gSa

Yes gka

No ugha

1

2


722a What kind of waste

presents a problem in

your residential area ककस तरह की गीदिगी आपक घर क आस पास एक समसया ह

Household waste (eg vegetablefruits peals rotting

food polythene carry bags) घर का कड़ा किरा Human waste मानव अपसशषट Animal waste (cow dung waste from domestic

animals such as dogs cats goats etc) जानवरो का अपसशषट (जस कतत बबलली दवारा की गयी गदिगी) Drainage तनकासी (नाली का कड़ा) Other अनय

A B C D

723 What are the present

methods of waste water

disposal csdkj ty fuiVku ds orZeku

rjhds Dk gS

Pour it off outside the house kj ds ckgj cgk nsrs gSa

Pour in a drain ukyh esa cgk nsrs gSa

Dispose off in a farm [ksr esa cgk nsrs gSa

Pour in a nearby pond utnhd ds rkykc esa cgk nsrs gSa


1

2

3

4

5

BLOCK 8 SOCIAL NORMS ABOUT MNCHS BEHAVIORS

अब म मदहलाओ और बचिो क सवासथय स समबधित वयहवार क बार म कछ बयान पढगी| कपया मझ बताय की आप इन बयानो स ककतनी सहमत या असहमत ह|

Strongly

agree

Agree lger

Disagree

असहमत

Strongly

Disagree

ANC CHECK-UP परसव पवफ िखभाल स समबधित

801 Most women in my community think that 3 ANC

check-ups during pregnancy are necessary esjs leqnk esa Tknkrj efgykvksa dks yxrk gS fd xHkkZoLFkk ds

nkSjku 3 परसवपवफ tkap vkorsquod gS

1 2 3 4

37

802 Most women in my community think that 2 TT

intake during pregnancy is necessary esjs leqnk esa Tknkrj efgykvksa dks yxrk gS fd

xHkkZoLFkk ds nkSjku 2 VhVh lsou vkorsquod gS

1 2 3 4

803 Most women in my community think that 90 IFA


xHkkZoLFkk ds nkSjku 90 vkbQ lsou vkorsquod g

1 2 3 4

Delivery Preparedness and Safe Delivery परसव क सलए की गयी तयाररओ और सरकषित परसव क बार म

804 Most pregnant women in my community do not

prepare in advance for the delivery esjs leqnk esa Tknkrj xHkZorh efgyka izlo ds ckjs esa

igys ls rSkjh ugha djds j[krh

1 2 3 4

805 If I arrange for a skilled birth attendant for

conducting my home delivery people around me

will think I am being overcautious about my

delivery fn eSa esjs izlo ds fy d dqrsquoky lgkd dh OoLFkk

djrh gWaw rks esjs vkl ikl ds yksxks dks yxsxk fd eSa dqN

Tknk fg ijokg dj jgh gWaw

1 2 3 4

806 Most pregnant women in my community deliver

at home esjs leqnk esa Tknkrj xHkZorh efgykvksa dk izlo kj

ij gksrk gS

1 2 3 4

807 My mother-in-law will think I am a lsquodifficultrsquo

person if I ask to deliver at a facility esjh lkl dks yxrk gS fd eS ijsrsquokku djus okyh efgyk

gWaw vxj eSa izlo fdlh LokLF lqfokk ij djkus ds fy

dgrh gWawa

यदि सास की मतय हो गयी ह या सास साथ म नही रहती ह

तो ldquo9rdquo िजफ कर

1 2 3 4

PNC

808 Most people in my community do not consider a

post natal checkup (PNC) important esjs leqnk esa Tknkrj yksxksa dk Slk ekuuk gS fd

izlo ds ckn ns[kHkky egRoiwkZ ugha gS

1 2 3 4

809 It is common for women in my community to get

a complete set of PNC done esjs leqnk dh efgykvksa esa izlo ds ckn iwjh ns[kHkky

feyuk vke ckr gS

1 2 3 4

810 I fear the elder will not think well of me of me if I

insist on getting a PNC check-up eqgts bl ckr dk Mj gS fd esjs leqnk ds cM+sampcqtqxksZa

esjs ckjs esa cqjk lkspsaxs] vxj मsa izlo ds ckn gksus okyh

tkap ds fy tksj nsrh gWaw

1 2 3 4

Family Planning

38

811 Birth Spacing is considered to be a good thing

among most people I know esjh tkuampigpku esa Tknkrj yksx cPpksa esa varj j[kus

dks vPNk ekurs gSa

1 2 3 4

812 Women of my age in my community will

disapprove of me if they find out that we are

using family planning methods esjs lewg dh efgyka eqgts ilan ugha djsaxh vxj mUgsa

irk pysxk fd eSa ifjokj fukstu ds lkkuksa dk izksx

djrh gWaw

1 2 3 4

Newborn care (keeping baby warm bathing) नवजात सशश की िखभाल 813 In my community mother of newborn provides

direct body warmth to the newborn esjs lewg esa efgykWa uotkr frsquokrsquokq dks daxk fofk ls

cPpksa dks xeZ j[krh gSa

धयान ि उततरिाता को daxk fofk क बार म crk

1 2 3 4

814 People in my community usually apply

something on the childrsquos stump esjs leqnk esa] vke rkSj ij cPps ds uky k ukfHk ij

dqN yxkrs gS

1 2 3 4

815 Newborns are bathed immediately after birth in

my community esjs leqnk esa] tUe ds rqjar ckn cPps dks ugykrs gS

1 2 3 4

Breastfeeding नवजात सशश को माा क िध पपलान स समबीधधत

816 Most people in my community start breastfeeding

within 1 hour of birth esjs leqnk esa vfkdkarsquok yksx tUe ds 1 kaVs ds Hkhrj

बचि को Lruiku djkrs ह

1 2 3 4

817 Most newborns in my community are fed

homemade mixtures like honey and ldquotulsirdquo

(basil) esjs leqnk esa Tknkrj uotkr frsquokrsquokqvksa dks kj esa cuks

x feJk tSls fd kgn vkSj rqylh] k feJh vkSj ikuh

fiykk tkrk gS

1 2 3 4

818 A lot of women in my community feed their

children other things along with breast milk

before the age of 6 months esjs leqnk esa efgyka vius cPps dks 6 eghus mez ds

igys ekWa ds nwk ds vykok vU [kkus dh phts f[kykrh

gS

1 2 3 4

819 People in my community will think I am keeping

the child hungry if I feed the child just breast

milk up to the age of 6 months esjs leqnk ds yksx lksprs gS fd eSa vius cPps dks Hkw[kk j[krh gWaw fn eSa mls N eghus dh mez rd vius nwk ds

vykok dqN [kkus dh pht ugha nsrh

1 2 3 4

Age appropriate complementary feeding बचचो को बाहर स दिए जान वाल आहार क बार म

39

820 Most people in the community follow their

mother-in-lawrsquos advice on feeding newborns and

children esjs leqnk esa vfkdrj efgyka viuh lkl dh lykg

ij vius uotkr frsquokrsquokq vkSj cPpksa dks f[kykrh gS

1 2 3 4

Immunization बचचो क ट काकरण स समबीधधत

821 People in my community will think of me as

irresponsible if I do not take my child for

immunization esjs leqnk ds yksx eqgts xSj ftEesnkj legtsaxs fn esa

vius cPps dks Vhdkdjk ds fy ugha ys tkrh

1 2 3 4

822 Most people in my community get their children

fully immunized esjs leqnk ds vfkdkarsquok yksx vius cPPks dks chekfjksa ls

cpko ds lHkh Vhds yxokrs gSa

1 2 3 4

Sanitation साफ़ सराई स समबधित

823 Most people in my community prefer to wash

their hands with ash or mud esjs leqnk esa vfkdkarsquok yksx viuk gkFk kksus ds fy

jk[k k feV~Vh को पसि (पराथसमकता) करत gS

1 2 3 4

824 Most people in my community wash their hands

only after daily ablutions esjs leqnk ds vfkdkarsquok yksx flQZ nSfudfUkR

fdzkdeZ ds ckn gh viuk gkFk kksrs gS

1 2 3 4

825 Most people in my community do not boil water

before drinking esjs leqnk esa vfkdkarsquok yksx ihus ls igys ikuh ugha

mckyrs gSa

1 2 3 4

826 Most people in my community store potable

water in mud urns esjs leqnk esa vfkdkarsquok yksx ihus ds ikuh dks feV~Vh ds

crZu frac14kM+slqjkghfrac12 esa j[krs gS

1 2 3 4

827 Most people in my community perform daily

ablutions in public spaces esjs leqnk vfkdkarsquok yksx nSfudfuR fdzkdeZ

lkoZtfud LFkkuksa ij djrs gSa

1 2 3 4

828 Most people in the community would support

community toilet facilities leqnk ds vfkdkarsquok yksx lkeqnkfd kkSpky dh lqfokk

dk leFkZu djsaxs

1 2 3 4

829 Most people in my community follow age old

methods (such as throwing outside the house) of

waste disposal esjs leqnk esa Tknkrj yksx vifrsquokV inkFkZ tSls dh kjsyq dwM+k]

xkscj] kj ls fudyus okyk xUnk ikuh ds fuLrkjk ds iqjkus rjhdks dk ikyu djrs gS

1 2 3 4

BLOCK 9 COMMUNITY MOBILIZATION QUESTIONS

40

The next set of questions is about the community groups that exist in your village I would like to ask you some questions

regarding your participation access to community groups and their utility vxys izu vkids vkids xkao esa ekStwn leqnkfd leqgksa ds ckjs esa gSaA eSa vkils dqN loky lewg esa vkidh Hkkxhnkjh] lkeqnkfd lewgksa

rd igqWap] vkSj mudh miksfxrk ds ckjs esa iwNuk pkgrh gWaw


901 Since how long have you been member

of the community group dc ls vki leqnkfd lewg ds lnL jgsa gSa

Number of months eghuksa dh la[k

902 How many members are there in your

group vkids lewg esa dqy fdrus lnL gSa

Number of members lnLksa dh la[k

905 How often does your group meet for

discussions or activities fdruh ckj vkidk lewg ppkZvksa k

xfrfofkksa ds ckjs esa feyrs gSa

Weekly lIrkg esa d ckj

Bi-monthly eghus esa nks ckj

Monthly efgus esa d ckj

Occasionally dHkh dHkh

Never met so far dHkh ugha feys vc rd

1

2

3

4

5

911


906 How often do you participate in the

group meetings vki dcampdc lewg cSBd esa Hkkx ysrh gSa





Never dHkh बठक म भाग नही सलया

1

2

3

4

5

906 A When was the last time that you

participated in a group meeting

आपन आखखरी बार समह की मीदटगबठक म कब भाग

सलया था

Days ____

दिन______

907 Does your group ever discuss about any

of the health topics that are concerned

with pregnant women and young

mothers Dk lewg esa dHkh Hkh LokLF lacafkr fokksa

ij ppkZ gqbZ tks xHkZorh efgykvksa k qok

ekrvksa ls lacafkr gks

Yes gka

No ugha

1

2

909


908 Which topics were discussed in a recent

meeting fiNys lewg cSBd esa fdu eqn~nksa ij ppkZ gqbZ

What to do if a pregnant woman

has an emergency A

xHkZorh eghyk dks vejtsalhvpkud vkbZ

41

एक स जयािा उततर सभव ह fnDdrksa es Dk djUkk pkfgss

Antenatal care of mothers B

AacuteloiwoZ eghyk dh lsok

Preparation for delivery C

Aacutelo dh rSkjh

Healthcare facility services D

lsgr lEcUEumlkh lsok

Jsy jssk or other scheme E

tuuh lqjkk kstuktuuh frsquokrsquokq lqjkk

dkZdze k vU kstuk

Clean and safe deliveries F

lkQ vkSj lqjfkr tUe

Postpartum care of mothers G

Aacutelo ckn efgyk dh lsok

What to do when newborn babies have emergencies H Dk djuk

gS tc us tUes cPps dks ijskkuh gks

How to keep babies healthy I

cPps dks LoLFk dSls j[kuk gS

Breastfeeding J

Lruiku

Complementary feeding K

iwjd vkgkj

Immunizations L

Vhdkdjk

Family planning M

ifjokj fukstu

Sanitationhygiene N

LoPNrk

other (specify) X

vUfrac14 LirdquoV djsa)

908A Are there any women aged 15-49 in your

household who are not members of the

community group

कया आपक घर म 15-49 वषफ क बीि कोई मदहला ह जो समह की सिसय नही ह

Yes हा______________1

No नही_______________2

908B How many such women are there

ऐसी ककतनी मदहलाए आपक घर म ह

Number __________

सखया

908C Have you ever told or discussed health

related issues with this woman in your

household who is not a member of the

Yes हा______________1

No_ नही______________2

42

community group

कया आपन कभी आपक घर की उस मदहला स जो समह की सिसय नही ह उस सवासय समबधित बात बताई ह

909 Did any of the front line health workers

(eg ASHA ANM AWWs) attend any

of the meetings Dk LokLF dkZdrkZ tSls frac14 vkrsquokk] ue]

vkaxuokMh dkZdrkZfrac12 us dHkh lewg ppkZ esa Hkkx

fyk

Yes

No I am not aware of their attendance eqgts mudh mifLFkfr ds ckjs esa irk ugha

1

2

3

911

911

यदि परशन सखया 909 म 2 या 3 कोड हआ ह तो परशन सखया 911 पर जाए

910 Who attended recently gky ds le esa bu LokLF drkZvksa esa ls

fdlus lewg ppkZ esa Hkkx fyk


ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X

910b Have any of the FLWs (ANM ASHA

AWW) taught you about pregnancy or

child care through laquo mobile kunji raquo कया ककसी आशा ए एन एम या vkaxuokMh वकफ र न आपको परसव अथवा बचि की िखभाल क बार म मोबाइल कजी क दवारा समझाया ह

Yes हा No नही

1

2

911 Did you pay any membership fee for

joining the group Dk vkidks lewg esa kkfey gksus ds fy fdlh

lnLrk kqYd dk Hkqxrku djuk iM+k

Yes gka

No ugha

1

2

912 Do you contribute to savings scheme of

the group Dk vki lewg dh cpr kstuk esa ksxnku

djrh gSa

Yes gka

No ugha

No such scheme समह म पसा जमा नही होता ह

1

2

3

913 Have you taken any loan from the

community group Dk vkius leqnkfd lewg ls dksbZ dtZ fyk

gS

Yes gka

No ugha

1

2

916

यदि परशन सखया 913 म 2

43


914 How much loan did you take vkius lewg ls fdruk dtZ fyk gS

Amount in rupees jkfrsquok is esa

_________

915 What is the monthly interest rate ekfld Cktnj fdruk gS

Amount for 100 rupees loan

100 dtZ ds fy jkfrsquok

________

915a Did you repay (are repaying) the loan कया आपन यह क़ज़फ िका दियािका रह ह


1

2

916 Did you take any loan from an outside

money lender Dk vkius egktu k lkgwdkj ls dtZ fyk

gS

Yes gka

No ugha

1

2

919


917 How much did you take vkius egktu k lkgwdkj ls fdruk dtZ fyk

gS


________




________

919 Are you a member of any of the

following groups Dk vki fuEufyf[kr lewgksa esa ls fdlh ds

lnL gSa

VHSC oh p l lh (गराम सवासथय और सवछता कसमटी) Panchayat iapkr Rogi kalyan samiti jksxh dYkk lfefr

Reproductive health group iztuu

LokLF lewg

Other Self-help group Loa lgkrk

lewg

हा नही

1

1

1

1

1

2

2

2

2

2

919f Does any member of this household have

a bank account or post-office account Dk bl ifjokj ds fdlh Hkh lnL ds ikl

cSd esa k iksLV vkWfQl esa [kkrk

gS

Yes हा 1

No नही 0

Donrsquot know पता नही 98

44

919g Is any member of this household covered

by a health scheme or health insurance Dk bl ifjokj dk dksbZ lnL fdlh LokLF kstuk

k LokLF baUkksjsUlchek ls tqMk gqvk gS

Yes हा 1

No नही 0


Skip to 920

919h What type of health scheme or health

insurance fdl izdkj dh LokLF kstuk k LokLF

baUkksjsUlchek ls tqMs gS

PROBE Any others

dksbZ vU

CODE ALL THAT APPLY

Employees State Insurance1

Scheme (ESIS) 1 vU bEiykWh LVsV baUrsquoksjsUl LdhEl

Central Government

Health Scheme (CGHS) 2 2

baUrsquoksjsUl lSaVordfy xouZesUV gsYFk LdhEl

Community Health Insurance

Programme 3 3

dEwfuVh gsYFk baUrsquoksjsUl izksxke

Other Health Insurance

THROUGH EMPLOYER 4 4

fuksDrk kjk vU LokLF chek

Medical Reimbursement

From Employer 5 5

fuksDrk kjk eSfMdy [kpksZ dh vnkxh

Other Privately Purchased

Commercial Health Insurance 6 6

vU izkbosV [kjhns xs LokLF chek

Other (Specify) 8 vU frac14LirdquoV djsafrac12

Leadership समह क नततव स समबधित

920 Does your group have a leader

(President) Dk vids lewg esa dksbZ yhMj gS frac14izlhMsaVfrac12

Yes gka

No ugha

1

2

929


920A Who selected the leader yhMj fdlus pquk

Members of our own group vius Loa lewg ds lnL

Local NGO representative LFkkuh xSj ljdkjh laxBu ds izfrfufk

Government representative ljdkj ds izfrfufk


Do not know पता नही

1

2

3

8

9

921 Has the leadership of your group Yes gka 1

45

`changed anytime till today Dk usr`Ro esa vkt rd dHkh cnyko gqvk

No ugha 2

How do you rate the leader on the

following issues

Very poor cgqr [kjkc

Somewhat FkksMk cgqr

Good vPNk

Very

Good cgqr vPNk

922 Organising regular meetings fufer cSBdksa dk vkkstu

1 2 3 4

923 Ensuring regular attendance of the

members in meetings cSBdksa esa lnLksa fd fufer mifLFkfr

lqfufrsquopr djuk

1 2 3 4

924 Addressing the needsrequests of the

community group members lkeqnkfd lnLksa ds tjrksavuqjkskksa dks iwjk djus

dk izkl djuk

1 2 3 4

925 Encouraging group members to talk

about their concerns openly

leqg ds lnLksa dks mudh जररतोपरशातनयो sa ds

ckjs esa बात करन क सलए izksRlkfgr djuk

1 2 3 4

926 Presenting community groups concerns

to relevant external stakeholders

lkeqnkfd lewg ds मदिो dks ckgjh fgrkkjdksa tSls

fd iapkr] LokLF ds vfkdkfjksa] k fdlh vU

ljdkjhxSj ljdkjh laLFkk ds vfkdkfjksa ds lkeus

isrsquok djuk

1 2 3 4

927 Sharing of information she receives from

external resources at the meetings

ckgjh lalkkuksa ls feyh tkudkjh dks समह क सिसयो dks crkuk

1 2 3 4

928 Resolving conflicts between members of

the community group lewnkfd lewg ds lnLksa dh vkilh

erHksndyg dks gy djuk

1 2 3 4

Sense of ownership समह क परतत अपनी जजममिारी स समबधित

934 How responsible do you feel for achieving the objectives

of your group vius lewg ds mn~nsrsquoksaa dks izkIr djus ds fy vki vius vki

dks fdruk ftEesnkj eglwl djrh gSa

Not at all fcYdwy Hkh ugha

Somewhat dqN gn rd

Very much cgqr gn rd

Completely iwjh rjg ls

1

2

3

4

46

Social Cohesion Sense of belonging समह म और

How much do you agree or disagree with the following statements तनमनसलखखत वाकयो स आप ककतनी सहमत या असहमत ह

935 I feel that I belong to this community group eqgts yxrk gS fd eSa bl lkewnkfd lewg ls gWaw

Strongly agree iwjh rjg ls lger

Agree lger

Disagree vlger Strongly disagree iwjh rjg ls vlger

1

2

3

4

936 I would rather go with a different community group

eqgt yxrk gS fd ewgts nwljs lkewnkfd lewg स जड़ना िादहए Strongly agree iwjh rjg ls lger

Agree lger


1

2

3

4

937 I would rather prefer this community group than any

others I know of eSa blh lkewnkfd lewg dks ilan daxh vU lewgks ds eqdkcys


Agree lger


1

2

3

4

938 Members in this community group are all striving for the

same goals bl lkewnkfd lewg ds lnL lc d gh y ds fy izkl

dj jgs gSaA


Agree lger


1

2

3

4

939 Everyone in our community group wants to pursue their

own goals rather than working for the good of the

community gekjs lkewnkfd lewg ds lHkh lnL leqnk dh HkykbZ ds fy dke djus

ds ctk vius yksa dks vkxs ykus dh dksfrsquokrsquok djrs gSA


Agree lger


1

2

3

4

940 I can count on fellow community group members if I

need to borrow money

eSa vius lkeqnkfd leqg ds lkFkhksa ij Hkjkslk dj सकती gwWa fn eqgts iSls

mkkj ysus dh tjr iMh rks-


Agree lger


1

2

3

4

941 I can count on fellow community group members to

accompany me to the doctor or hospital

eSa vius lkeqnkfd leqg ds lkFkhksa ij Hkjkslk dj सकती gwWa os esjs lkFk

MkDVj k vLirky vk ldrs gS


Agree lger


1

2

3

4

942 I can count on fellow community group members to talk

about my problems

eSa vius lkeqnkfd leqg ds lkFkhksa ij Hkjkslk dj सकती gwWa vkSj eSa mudks esjh leLkvksa ds ckjs esa crk सकती gWaw


Agree lger


1

2

3

4

943 Community group members worry about themselves

only

lkeqnkfd lewg ds lnLksa dks ससरफ [kqn ds ckjs esa fpark gS


Agree lger


1

2

3

4


need advice eSa vius lkeqnkfd leqg ds lkFkhksa ij Hkjkslk dj ldrh gwWa fn eqgts fdlh lykg dh tjr gS


Agree lger


1

2

3

4

Social Cohesion Network cohesion

951 With how many different members of your community

47

group did you talk separately about the issue that was

discussed in the last meeting vkius vius lkeqnkfd lewg ds dqy fdrus lnLksa ls fiNyh

cSBd esa ppkZ fd gq eqn~nksa ij vyx vyx ckrphr की

Number la[k

_______

_

952 When you have a problem or worry how often do you

let someone else in the community group know about it tc vkidks fdlh izdkj dh leLk k fpark gksrh gS rks fdruh

ckj vki सामिातयक समह की fdlh vkSj सिसय dks bl ckjs esa

crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5

953 How often can you rely on someone in your community

group for help when you have a serious problem

fdruh ckj vki enn ds fy अपन समह की सिसयो ij Hkjkslk

dj ldrs gS tc vki xaHkhj leLk ls ijsrsquokku gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5

Enabling environment

954 Do you have equal access to a health facility

like everyone else (for eg the women from

forward castes) vkids fglkc ls Dk vki LokLF lqfokkvksa dk izksx

ckdh dh efgykvksa ds tSls gh dj ldrh gSa frac14mnkgjk

ds fy lkekU k AringWaph tkfr dh efgykafrac12

Yes gka

No ugha

1

2

48

955 Would you say the following people treat you

fairly like they do other people (for eg

women from forward castes) Dk vki dgasxh fd fuEufyf[kr yksx vkils oSlk gh

Oogkj djrs gSa tSlk vU yksxksa ds lkFk djrs gSa

frac14mnkgjk ds fy lkekU k AringWaph tkfr dh

efgykafrac12

Not at all

fairly

बबलकल नही

Somewhat

fairly

कछ हि तक

Very

fairly

कारी हि तक

Complete

ly fairly

बबलकल वसा ही वयवहार

NA ykxw ugha

A Doctors in government hospital ljdkjh vLirky esa MkDVj

1 2 3 4 9

B ASHAs in your village vius xkao esa vkrsquokk

1 2 3 4 9

C AWWs at the anganwadi centers vkaxuokMh dkZdrkZ vkaxuokMh dsUnz esa

1 2 3 4 9

D ANM ue

1 2 3 4 9

E Nurses in government hospital ljdkjh vLirky esa ulZ

1 2 3 4 9

F Doctors in private hospital futh vLirky esa MkDVj

1 2 3 4 9

G Members of a panchayat iapkr ds lnL

1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9

956 Irsquod now like to ask you about the ASHA Would you say the ASHA

| कया कहगी

A Treats you with respect vkids lkFk vknjiwoZd Oogkj djrh gS

Yes gka

No ugha

1

2

B Directs you to appropriate health service providers vkidks mfpr LokLF lsok izrknkvksasa ds ikl Hkstrh gS

Yes gka

No ugha

1

2

C Responds quickly to emergency situations vkikr fLFkfr esa rqjar miyCk gksrh gS

Yes gka

No ugha

1

2

D Is available when you need her miyCk jgrh gS tc vkidks tjr gksrh gS

Yes gka

No ugha

1

2

957 Irsquod now like to ask you about the AWW Would you say the AWW



Yes gka

No ugha

1

2

B Directs you to appropriate health service providers vkidks mfpr LokLF lsok iznkvksa ds ikl Hkstrh gS

Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49

958 How much do you think the activities of your

community group have contributed to a positive

change in

आपक दहसाब स तनमनसलखखत क सवासथय सपविाओ क

इसतमाल पररवार तनयोजन और साफ़-सराई स समबधित वयवहार क अचछ

Not at

all


Somew

hat

थोडा बहत

Very

much


Completel

y

बहत जयािा

A You आप म 1 2 3 4

B Members of your group समह क सिसयो म 1 2 3 4

C Members of other groups in your village गाव क िसर समहो क सिसयो म

1 2 3 4

D People who are not members

उन लोगो म जो समह क सिसय नही ह 1 2 3 4

Collective Efficacy

959 If there were problems that affected all or some of the

community members how many women would work

together to deal with the problem fn xkWao esa slh dksbZ leLka gks ftldk vlj lewg ds dqy k dqN

lnLksa ij iM ldrk gks---तो आपक अपन समह स कल fdruh

efgyka d lkFk feydj ml leLk dks lqygtkus ds fy dke djsaxh

A From your own community group vkids vius lewg ls

No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4

B Women in the village but not from community groups xkWao dh vU efgyka tks lewg dh lnL ugha gSa

No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4

960 How confident are you that the members of your community can work together to achieve the following

goals

A Speaking up against the existing norms imposed by

elderly or other groups on issues around mother and

child health

eka vkSj cPps ds LokLF स सबधित मदिो ij बजगो या अनय लोगो दवारा बनाय x fueksa ds f[kykQ आवाज उठाना

Not at all confident fcYdwy fookl ugha

Somewhat confident FkksM+k forsquookl gS

Very confident cgqr forsquookl gS

Completely confident iwjh rjg ls forsquookl gS

1

2

3

4

B Demanding services from healthcare facilities when

they refuse support LokLF lqfokkvksa ls lsokvksa dh ekax djuk] tc os vkidks

lqfokkWa ugha ns jgs gksa





1

2

3

4

50

C Claiming rightsschemes from the government ljdkj ls vius vfkdkj vkSj vius fy kstukvksa dh ekax

djuk





1

2

3

4

D Increase safe practices around mother and child health

(for eg ensuring the delivery at hospital

immunization of children seeking antenatal care) ekWa vkSj cPps ds LokLF ls lacafkr lqjfkr Oogkjksa dks clt+kok

nsuk frac14 mnkgjk dss fy cPPkks dk Vhdkdjk] vLirky esa

izlo lqfufrsquopr djuk] izlo iwoZ ns[kHkkyfrac12





1

2

3

4

Collective agency

961 In the past 6 months have you negotiated with the following in order to help a fellow community member

A Healthcare center staff eg doctor nurse LokLF dsUnz ds deZpkjh tSls dh MkDVj] ulZ

Yes gka

No ugha

NA ykxw ugha

1

2

3

B Frontline workers eg ASHA AWW ANM

सवासथय कायफकताफओ जस कक vkrsquokk] vkaxuokMh deZpkjh] u e

Yes gka

No ugha

NA ykxw ugha

1

2

3

C Local administration (eg police civil supplies etc) LFkkuh izrsquokklu frac14tSls fd iqfyl] vke yksxksa dh vkorsquodrkvksa dh pht

dk forjk djus okys laLFkku bRkfnfrac12

Yes gka

No ugha

NA ykxw ugha

1

2

3

962 In the past 6 months have you participated in any of the

community groups protests or demands that concerned the

women like you

fiNys 6 eghuks esa] Dk vkius lkewnkfd lewg दवारा ककय गए ककसी ऐस कायफ म भाग सलया जजसम आप जसी मदहलाओ स समबधित मदिो पर ककसी का पवरोि ककया गया था या कछ माग की गयी थी

Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action

963 Has your group come together in the past 6 months to demand the following

आपक समह की मदहलाए एकजट होती ह

A Better health services for mother and child from local

health center LFkkuh LokLF dsUnz ls Ekk vkSj cPPks ds fy csgrj LokLF lsok

Yes gka

No ugha

1

2

B Servicesschemes meant for poor eg for the JSY scheme xjhcks vkSj tjreanksa ds fy cuh kstukvksa ds fy frac14tSls fd

vkaxuokMh dsanz ls feykus okyh ikskkgkj kstukfrac12

Yes gka

No ugha

1

2

51

C On-time delivery of incentives from the government ljdkj dh vksj ls izksRlkgu jkfrsquok dk le ij Hkqxrku frac14tSls fd

tuuh ao cky lqjkk kstukfrac12

Yes gka

No ugha

1

2

D Opening of bank accounts cSad [kkrks dks [kksyuk

Yes gka

No ugha

1

2

E Availability of family planning services ifjokj fukstu lsokvksa dh miyCkrk

Yes gka

No ugha

1

2

F Supply of safe drinking water lqjfkr ihus ds ikuh dh vkiwfrZ

Yes gka

No ugha

1

2

G Supply of sufficient water for household purposes kjsyw dkeksa ds fy IkkZIRk ikuh dh vkiwfrZ

Yes gka

No ugha

1

2

H Supply of sanitation services eg latrine facilities LoPNrk lsokvksa dh vkiwfrZ mnkgjk ds fy kkSpky dh lqfokk

Yes gka

No ugha

1

2

964 The last time you had some problem during pregnancy or

child birth did the other women from your group help you fiNyh ckj xHkkZoLFkk k cPps ds tUe ds nkSjku gqbZ fdlh leLk

esa Dk vkidks leqg ds efgykvksa ls dskbZ enn feyh Fkh

Yes gka

No ugha

Never had a problem dksbZ leLk ugha gqbZ Fkh

Not Applicable ykxw ugha

1

2

3

9

965 Did the other women from your group help you when you

needed specific services for your or your childs health tc vkidks vius vkSj cPps ds LokLF ds fy fdlh izdkj dh

enn dh tjr Fkh rks Dk vkids leqg ds efgykvksa us vkidh

enn की थी

Yes gka

No ugha



1

2

3

9

966 Did any women from the villagepanchayat (but not from

your community) help you when you needed specific

services during pregnancy or child birth Dk vkids xkao dh fdlh efgyk tks vkids lewg dh lnL ugha

Fkh] us xHkkZoLFkk k cPps ds tUe ds nkSjku vkidh enn की थी

Yes gka

No ugha



1

2

3

9

SELF EFFICACY AND SELF CONFIDENCE

967 How confident do you feel speaking your

opinion in the community group vki fdrus forsquookl ls viuh jk vius lkewnkfd

lewg ds lkeus j[krh gSa





1

2

3

4

968 How confident are you in recognizing the

danger signs of pregnancy delivery vki fdrus forsquookl ls xHkkZoLFkk vkSj izlo ds [krjs

ds ladsr dks igpkurh gSa





1

2

3

4

969 How confident are you that you can go to the

government health centers to get reproductive

health services vkidks fdruk forsquookl gS fd vki ljdkjh LokLF

dsUnz tkdj LokLF lsokvksa frac14EkkWa vkSj cPPkksa ds LokLF

ls lacafkr] ifjokj fukstu ls lacafkr lqfokkaWafrac12 dk

ykHk ys ldrh gS





1

2

3

4

970 How confident do you feel in giving advice to

women from your own community on the steps



1

2

52

towards safe practices during and after

pregnancy vki fdrus forsquookl क साथ vius leqnk की मदहलाओ dks

xHkkZoLFkk ds nkSjku vkSj xHkkZoLFkk क ckn की िखभाल ds ckjs esa

lykg ि सकती gS



3

4


women in the village (who do not belong to

your caste on the steps towards safe practices

during and after pregnancy vki fdrus forsquookl क साथ ऐसी मदहलाओ को जो आपक leqnk की सिसय नही ह xHkkZoLFkk ds nkSjku vkSj

xHkkZoLFkk ckn की िखभाल ds ckjs esa lykg िती gS





1

2

3

4

INDIVIDUAL AGENCYCONTROL

972 Do you need permission (from your

husband or in-laws) for each of the

following Dk vkidks fuEufyf[kr dkksZ ds fy vuqefr

ysuh iMrh gS

Yes No

Go to a movie fQYe ns[kus tkus ds fy

1 2

Go to the doctor MkDVj ds ikl tkus ds fy

1 2

Buy new clothes for yourself vius fy uk dIkMk [kjhnus ds fy

1 2

Travel to the town kgj tkus ds fy

1 2

To participate in group meetings lewg dh cSBdksa esa Hkkx ysus ds fy

1 2

To take child to health care center CkPps dks सवासथय क दर ल जानs ds fy

1 2

To use family planning methods contraception ifjokj fukstu dh fofkksaxHkZfujksk ds miksx ds fy

1 2

MENTAL HEALTH STATUS

973 Do you make an effort to take care of your health (for example do you eat

well sleep well go to the doctor when sick etc) Dk vki viuh lsgr dk [ky j[kus ds fy izkl djrs gS frac14उिाहरण - ds fy vPNh

rjg ls [kkuk] vPNh rjg ls lksuk] tc vki fcekj gksrs gS rc MkDVj ds ikl tkuk]

vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5

974 Over the last 2 weeks how often have you

been bothered by any of the following

problems fiNys 2 lIrkg esa] fdruh ckj vki fuEu leLkvksa

es ls d ckj Hkh ijsrsquokku gqbZ

Not at all dHkh ijsrsquokkuh

ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu

A Little or no interest or pleasure in doing

things dkZ djus esa FkksM+h fp k dkZ djus esa fcYdqy

[kqrsquokh ugha

1 2 3 4

B Feeling down depressed or hopeless mnkl k fujkrsquok eglwl djuk

1 2 3 4

Now

FOOD SECURITY

53

Now I will ask some questions about food available to eat in your household vc eS bl ifjokj ds fy miyCk [kkus ds fy Hkkstu ds ckjs es dqN loky iwNqiexclxh

1001 In the past four weeks did your household ever run out of

money to buy food fiNys pkj gpararksa esa Dk vkids ifjokj esa dHkh Hkkstu [kjhnus ds fy iSls

dh deh gqbZ gS

Yes हा 1

No नही 0

1002 In the past four weeks did you ever limit the types of food

you fed your children because you did not have enough

money to buy food for a meal fiNys pkj lIrkg esa Dk vkius Hkkstu ds izdkj de dh gS tks vki

vius cPpksa dks f[kykrh gSa Dksafd vkids ikl Hkkstu k [kkuk [kjhnus ds

fy iSls ugha Fks

Yes हा 1

No नही 0

1003 In the past four weeks did you cut the size of meals or skip

meals because there was not enough money for food fiNys pkj lIrkg esa Dk vkius Hkkstu ds fy ikZIr iSlk u gksus ds

dkjk dHkh vius vkgkj dh ek=k dks de fdk gSa k fQj vkgkj ugha

fyk gS

Yes हा 1

No नही 0

1004 In the last four weeks did you or any household member

go to sleep at night hungry because there was not enough

food Dk fiNys 4 lIrkg es vki k vkids ifjokj dk dksbZ lnL [kkuk

IkkZIr ugh gksus ds dkjk ls jkr es Hkw[kk lksk Fkk

Yes हा 1

No नही 0

54

MARITAL VIOLENCE

Now I would like to ask you questions about some other important aspects of a womans life I know that some of these

questions are very personal However your answers are crucial for helping to understand the condition of women in India

Let me assure you that your answers are completely confidential and will not be told to anyone and no one else will know

that you were asked these questions vc eSa vkils efgykvksa ds thou ls lacafkr dqN egRoiqkZ igyqvksa ds ckjs esa dqN izu iqNqaxhA eSa tkurh gqWa fd buesa ls dqN izu cgqr

OfDrxr gSaA vkids mRrj gesa Hkkjrh efgykvksa dh fLFkfr dks igpkuus ds fy dkQh egRoiqkZ gSaA eSa vkidks g fookl fnykuk pkgrh

gqa fd vkids mRrj iqjh rjg xksifu gSa vkSj og fdlh dks Hkh ugh crks tksaxs vkSj fdlh dks g Hkh irk ugh pysxk fd vkils g izu

iqNs xs Fks

1101 First I am going to ask you about some

situations which happen to some women

Please tell me if these apply to your

relationship with your (last) husband igys eSa vkils dqN fLFkfrksa ds ckjs esa iwNwaxk tks

efgykvksa ds lkFk kVrh gSaA eqgts crksa fd Dk g

vkids ifr (fiNys) ds lacakksa ds ekeys esa Hkh slk

gh gksrk gS

Yes Gka

No Ugha

Dk मालम ugha

a He (doesdid) not permit you to meet your

female friends - og vkidks vkidh lgsfyksa ls ugha feyus

nsrkfeyus nsrk FkkA

Notmeetfriends fe=ksa ls feyus ij jksd

1 2 98

b He (triestried) to limit your contact with

your family ch- og vkids ifjokj ds lkFk vkids laidZ ij

jksd yxkus dh dksfkk djrk gSdjrk FkkA

No family ifjokj ls laidZ ugha

1 2 98

c He (doesdid) not trust you with any

money lh- iSls dks ysdj og vki ij Hkjkslk ugha

djrkdjrk Fkk

Money iSlk

1 2 98

d He (insistsinsisted) on knowing where

you (arewere) at all times Mh og g tkuus ij frac14tksj nsrk gSnsrk Fkkfrac12 fd

vki gj le dgka jghadgka Fkha

Where you are vki dgka Fkha

1 2 98

e He frequently (accusesaccused) you of

being unfaithful bZ- og vDlj vki ij csoQk gksus dk vkjksi yxkrk

gSyxkrk Fkk

Accuses vkjksi yxkuk

1 2 98

1102 Does (did) your husband drink alcohol YES gka helliphelliphelliphellip1

NOhellipugha helliphelliphelliphellip0 1104


1103 How often does (did) he get drunk often

only sometimes or never

Often 1

Sometimes 2

Never 3

1104 Now if you will permit me I need to ask

some more questions about your relationship

Yes gka

No Ugha

Ask if yes in 1104 यह परशन तभी पछ

55

with your (last) husband

(Doesdid) your (last) husband ever vc vxj vki eqgts btktr nsa rks eSa vkils vkids

ifr frac14fiNys ifrfrac12 ds lkFk vkids lacakksa ds ckjs esa

dqN loky iwNuk pkgwaxhA

Dk vkidk orZeku ifr frac14fiNyk ifrfrac12 fuEufyf[kr

dkZ djrk gSFkk

यदि 1104 म उततर ldquoहाrdquo हो 1104aHow often did this happen

during the last 12 months often

only sometimes or not at all fiNys 12 eghuksa esa slk dcampdc gqvk(

vDlj] dHkhampdHkh] dHkh ugha

Often1 Sometimes2 Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3

a Say or do something to humiliate you in

front of others - nwljksa ds lkeus vkidks viekfur djus ds fy

dqN dgrk k djrk Fkk

1 2 |___|

b Threaten to hurt or harm you or someone

close to you ch- vkidks k vkids fdlh fudV ds OfDr dks

pksV k uqdlku igqapkus dh kedh nsrk Fkk

1 2 |___|

c Insult you or make you feel bad about

yourself lh- vkidh csbTtrh djrk Fkk k vkidks cqjk

eglwl djokrk Fkk

1 2 |___|

1105 (Doesdid) your (last) husband ever do any

of the following things to you Dk vkids orZeku k fiNys ifr us vkids

fuEufyf[kr esa dqN fdkfdk Fkk

Yes No Ask if yes in 1105 यह परशन तभी पछ यदि 1105 म उततर ldquoहाrdquo हो 1105aHow often did this happen


only sometimes or not at all oh3- fiNys 12 eghuksa esa slk dcampdc

gqvk( vDlj] dHkhampdHkh] dHkh ugha

Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3

aSlap you - vkidks FkIiM+ ekjk

1 2 |___|

b Twist your arm or pull your hair ch- vkidh ckag ejksM+h] cky [khaps

1 2 |___|

c Push you with his fist shake you or

throw something at you lh- vkidks gkFk ls kDdk fnk] gtdgtksjk k vki

ij dqN Qsad dj ekjk

1 2 |___|

d Kick you drag you or beat you up bZ- vkidks ykr ekjh] [khapk k ekjkihVk

1 2 |___|

56

e Try to choke you or burn you on purpose Q- vkidk xyk nckus] vkidks tykus dh dksfkk

dh

1 2 |___|

f Physically force you to have sexual

intercourse with him even when you did not

want to p- vkids u pkgus ij Hkh vkids lkFk tcnZLrh

kSu laidZ fdk

1 2 |___|

1106 Ask if yes in 1105 else go to 1201

Have you ever tried to seek help to stop your

husband from doing this to you again Dk vkius ifr dks nksckjk sls djus ls jksdus ds

fy lgkrk izkIr djus dh dksfkk dh gSa

Yeshelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip1 gka

Noनहीhelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip2 1201


1107 From whom have you sought help to stop

this

Anyone else

vkius g jksdus ds fy fdlls lgkrk ekaxh

dksbZ vU

RECORD ALL MENTIONED

Own familyA viuk ifjokj

Husbands familyB ifr dk ifjokj

Currentlast husbandC orZekufiNyk ifr

Currentformer boyfriendD orZekufiNyk CokYacuteSaM

FriendE nksLr

NeighbourF iM+kSlh

Religious leaderG kkfeZd usrk

Doctormedical personnelH MkDVjfpfdRlkdehZ

PoliceI iqfyl

LawyerJ odhy

Social service organizationK lkekftd lsok laxBu

Other (specify)X vU frac14mYys[k djsafrac12

1108 Did you report to someone about the

violence that you have experienced आप पर जो दहसा हई कया आपन उसकी कभी ररपोटफ की

Yes gk

No ugha

1109 Have you ever hit slapped kicked or done

anything else to physically hurt your

husband at times when he was not already

beating or physically hurting you

Yes gka

No ugha 1201


57

कया आपन कभी अपन पतत को मारा िाटा मारा लात मारी अथवा ककसी और तरह स शारीररक नकसान पहिाया जबकक वह आपको मार नही रह थ या कोई शारीररक नकसान नही पहिा रह थ

1110 In the last six months how often have you

done this to your husband पपछल 6 माह म आपन ककतनी बार अपन पनत को मारा 1= often अकसर 2= sometimes कभी कभी 3=not at all कभी भी नही

1 2 3

SOCIAL ENTITLEMENTS

I will now ask you some questions related to government schemes Please answer these questions as best as you can

1201 Does this household have a

BPL cardcoupon Dk bl ifjokj ds ikl ch ih y

dkMZ (लाल काडफ)dwiu gS

DESCRIBE BPL FOR CLARITY

Yes हा 1

No नही 0

Donrsquot Know पता नही 98


RSBY card (also called

Smart Card or Health

Insurance Card) कया इस पररवार क पास आर एस बी वाय काडफ (समाटफ काडफ अथवा हलथ इनसरास या सवासथय बीमा काडफ) ह DESCRIBE RSBY FOR

CLARITY

आर एस बी वाय

Yes हा 1

No नही 0

Donrsquot Know पता नही98


NREGA card Dk bl ifjokj ds ikl ujsxk dk

tkWc dkMZ gS

DESCRIBE NREGA FOR

CLARITY नरगा

Yes हा 1 1

No नही 2 0


58

Have you or your family

members availed of the

following government

schemes आपन अथवा आपक पररवार न तनमन सरकारी योजना का लाभ उठाया ह


Aware but

not availed it पता ह पर इसतमाल नही ककया

Not aware of

the scheme योजना क बार म पता नही

1204 Mukhyamantri Balika

Poshak Yojana मखयमतरी बासलका पोषक योजना

1 2 3

4

1205 Mukhyamantri Balika Cycle

Yojana मखयमतरी बासलका साइककल योजना

1 2 3

4

1206 Mukhyamantri Kanya

Suraksha Yojana मखयमतरी कनया सरिा योजना

1 2 3

4

1207 Mukhyamantri Kanya Vivah

Yojna मखयमतरी कनया पववाह योजना

1 2 3

4

1208 Mamta Scheme ममता योजना

1 2 3 4

1209 Sabla scheme (for girls 10-

18 years old) सबला योजना (10-18 साल की लड़ककयो क सलए)

1 2 3

4

1210 Saksham Scheme (for boys

10-18 years old) सिम योजना (10-18 साल क लडको क सलए)

1 2 3

4

1211 Indira Awas Yojana इदिरा आवास योजना 1 2 3

4

1212 Aam Aadmi bima yojana आम आिमी बीमा योजना 1 2 3

4

1213 Indira Gandhi Matritiva

Sahyog Yojana इदिरा गािी मबतरततव योजना

1 2 3

4

1214 AnganwadiSupplementay Nutrition Support (ICDS) अनागवािीपररपषत पोषक सहायता

1 2 3

4

1215 Pradhan mantri Aadarsh Gram Yojana 1 2 3

4

59

परिान मतरी आिशफ गराम योजना 1216 Sampoorna Grameen

Rozgar Yojana सपणफ गरामीण रोज़गार योजना

1 2 3

4

1217 Swabhiman सवासभमान योजना

1 2 3 4

I will now ask you some questions about the saheli associated with your community group अब आपस आपक समह (गरप) की सहली क बार म कछ सवाल पछग

Did you receive advise from your saheli about the following आपको सहली न कभी तनमन क बार म सलाह िी ह


1301a Early (within 3 months) registration of pregnancy

परसव क सलए शीघर (3 महीन क अनिर)पजीकरण

1301b Importance of at least 3 ANC visits

परसव क पहल िखभाल क सलए तीन बार िकप का महतव

1301c Importance of consuming 90 IFA tablets during pregnancy

गभाफवसथा म ९० (90) आई ऍफ़ ए (IFA) गोसलया लन का महतव

1301d Importance of delivering your baby in a health facility

असपताल म परसव का महतव

1301e Complete immunization of child

बचि को सभी टीक लगवान का महतव

1301f Giving ORS (oral rehydration solvent) to your child during diarrhoea डायररया क समय बचि को ओ र स िन का महतव

1301g Family planning

पररवार तनयोजन

1302 Last year we asked some

women from your group some

questions related to their

pregnancy other health aspects

and their youngest child Did

you answer such questions for

us last year पपछल साल भी हमन आपक समह की कछ औरतो स गभाफवसथा और िसर सवासय क बार म और सबस छोट बचि क बार म सवाल पछ थ कया आपन ऐस सवालो क जवाब दिए थ पपछल साल

Yes gka

No ugha

1

2

Thank you for your time आपक समय क सलए िनयवाि

2

म 1 कोड हआ ह तो परशन सखया 107 पर जाए

106 What is the highest standard you

have completed vkius dgka rd ilt+kbZ dh gS

Standard dkk

107 Can your husband read and write

Dk vkids ifr ilt+-fy[k ldrs gSa

Cannot read and write ilt+ fy[k ugha ldrs

Can read only flQZ ilt+ ldrs gS

Can sign only dsoy nLr[kr dj ldrs gS Can read and write ilt+ o fy[k ldrs gS

1

2

3

4


108 What is the highest standard your

husband has completed vkids ifr us dgka rd ilt+kbZ dh gS

Standard dkk

109 What is your

(womens) main

occupation vkidk frac14efgyk

dkfrac12 eq[ Oolk

Dk gS

Wage laborer nSfud etnwj

Skilled semi-skilled worker dqky vkZ dqrsquoky dkexkj


Self-employed Business Lojkstxkj Okikj


Unemployed-has intention to work but not working currently Cksjkstxkj-dkZ djuk

pkgrh gS] ij vHkh dksbZ dkZ Z ugha dj jgh gS

Housewife-has no intention to work xfgkh- dkZ djus dk dksbZ bjknk ugha gS

1

2

3

4

5

6

7

110 What is your husbands occupation vkids ifr dk Oolk Dk gS

Wage laborer nSfud etnwj Skilled semi-skilled worker dqkyvkZ dqrsquoky dkexkj


Self-employed Business LojkstxkjOkikj


Unemployed Cksjkstxkj

1

2

3

4

5

6

110a Where does your husband work आपक पतत कहा काम करत ह

Within our village हमार गाव म In the town but within district शहर म पर जजल क अनिर

Outside the district but within state जजल क बाहर लककन

बबहार परिश क अनिर Outside the state बबहार परिश क बाहर In MumbaiThane मबईठाण म

1

2

3

4

5

If lt3

skip

to

110c

यदि उततरिाता परशन सखया 110a

3






1

2

3

4

5

6




Write income








OBC fiNMk oxZ

Others vU


1

2

3

4

5


Hindu fgUnq

Muslim eqfLye


1

2

3

4

5

6

7





4




113_1







)




Yes gka

No ugha

1

2

113_4


113_2




113_3





113_4




Yes gka

No ugha

1

2

11


5


113_5


you had




Yes gka

No ugha

1

2



Months eghus

_______



Yeshellipहा 1

Nohellipनही 2







this pregnancy



Yes gka

No ugha

1

2



6

last pregnancy



Your home vkidk kj






Sub-center mi dsUnz



A

B

C

D

E

F

G

H

I







ANM u e C

NURSE ulZ





dkZdrkZ F


ASHA vkrsquokk H





Months eghus

______





Number of times


______





Yes gka

No ugha


at that time

1

2

3

4

208

208

208

7



206

206b

During your last


from your community


following signs of




esa crkk Fkk






C Community group




X Other अनय

Yes No 206b















ughafrac12 1 2


gksuk 1 2


gksuk 1 2

8






Yes gka

No ugha




1

2

3

4



last pregnancy



Yes gka

No ugha

1

2


209

210


experience


fdk


the problem


209

Did you

have this

problem कया


हई

210

Did you

seek



Yes

हाा No


No नह ी







D Excessive fatigue

vRfkd Fkdku 1 2 1 2






9

vRfkd myVh gksuk






K Convulsions










A

B

C

X












CyMizsrsquokj 1 2








Yes gka

No ugha





1

2

3

4

216

216


10




pregnancy dleivery




Yes gka

No ugha

1

2




dk lgksx feyk










fdk




A

B

C

D

E

X






Yes gka

No ugha

1

2






_____

___

11








Yes gka

No ugha

1










tablets



ककया

Number of days










Yes gka

No ugha

1

2



Anganwadi centre


Yes gka

No ugha

1

2

12




house



समली

Number of times



221 During the last

pregnancy did you




workers (ASHA

ANM AWW Doctor)

or other women from


Dk vkius fuEufyf[kr

ij de ls de d ckj


ue] vkaxuokMh


vius leqnk dh vU

efgykvksa kjk lykg

izkIr की

Who provided the


feyh

Health worker

(ASHA ANM


MCYq MCYq]

MkDVjfrac12 1

Community group


lnL2

Both

Yes

हाा No

नह 222

Who gave you


HW 2 ndash

Community

group member

3 ndash Both)



1 2 1 2 3





1 2

1 2 3


dks xeZ j[kuk 1 2

1 2 3





j[kukA

1 2

1 2 3




1 2

1 2 3 9


fMfyojh fdV 1 2

1 2 3 9






1 2 3- 9

13

nksuks3

Other अनय 9



1 2 1 2 3 9


1 2 1 2 3 9


1 2 1 2 3 9


Village Health

Nutrition Days

(VHNDs) during your

pregnancy




Yes gka

No ugha

1

2




VHND meeting













lqfokk dsanz es gks

At home kj ij



1

2

3


14




fdlls




No ugha

1

2

3




Yes gka

No ugha

1

2







1

2

3





Yes No


during childbirth


mifLFfr jgsa

1 2



1 2


1 2


1 2


1 2

15










Yes हा

No नही




igpku dh Fkh

1 2



1 2





to


NAME]



IF UNABLE TO

DETERMINE IF A

HOSPITAL HEALTH

CENTRE OR CLINIC IS

PUBLIC OR PRIVATE

MEDICAL SECTOR

WRITE THE NAME OF

THE PLACE


HOME

Your home vkidk kj


Other home vU kj








Sub-center mi dsUnz


NGO SECTOR


PVT MEDICAL SECTOR


1

2

3

4

5

6

7

8

9

10

11

12

16



lqfokksa

13



djkh Fkh





ANM u e




No one dksbZ ugha


A

B

C

D

E

F

G

H

X

I



yksx Fks






No one dksbZ ugha

A

B

C

D

E






1

2

3




the JSY program



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


17




INR is _____

_



account



Cash udn 1

Cheque psd 2


Other (specify) 88





_____

_







Yes gka

No ugha

1

2









18







ANM u e




No one dksbZ ugha

Other अनय

1

2

3

4

10

5

6

7

9

8



dk izksx fdk xk Fkk




ls izkIr fdk Fkk






Scissor dSaph



1

2

3

4

5

6

8

9

412



xk Fkk





izkIr fdk Fkk




uk kkxk


kkxk


kjk fnk xk kkxk





1

2

3

4

5

6

8

9



ij dqN yxkk xk Fkk

Yes gka

No ugha

1

2



dqN yxkk xk Fkk

Yes gka

No ugha

1

2


19




uky ij Dk yxk Fkk

CODE ALL THAT

APPLY





Sindoor flUnwj






Cowdung xk dk xkscj


A

B

C

D

E

F

G

H

I

J

X




yxk Fkk




Sindoor flUnwj






Cowdung xk dk xkscj


A

B

C

D

E

F

G

H

I

J

X










Question Answers





Hours kVs

________________

Days fnu

_________________


fiykk

Yes gka

No ugha

1

2


20




fiykk Fkk





hour


H Hours घट ___________

D Days दिन ____________

0




Yes gka

No ugha

1

2


421 What was [CHILD

NAME] given


fnk xk Fkk

PROBE Anything

else

dqN vkSj










A

B

C

D

E

F

G

H

I

J

X






Yes gka

No ugha

1

2


21






nwk fiykk Fkk





pht ugha nh








Bwals fuIiy frac12







gS


gqvk Fkk





jgk Fkk



OTHER (SPECIFY) vU





Yes gka

No ugha

1

2

22






EACH











fiykk gS

If 427A_1 =2 skip to 427A_2

Liquids Yes हा

No नही

Yes हा

No नही




1 2 1 2



tkuoj dk nwkfrac12

1 2 1 2




vkWjsUt is

1 2 1 2



1 2 1 2





Yes gka

No ugha

1

2





kq fdk Fkk


_____

_







ckj nsrh gSa 2


23




nsrh gSa

SINGLE CODING ONLY




4











Yes gka

No ugha

1

2







ASHA vkrsquokk

ANM ue



A

B

C

X





vks

Days Fnu

Weeks

_____













vkids kj vks Fks

Yes gka

No ugha




1

2

3

4

502

502


24







vks

Days


suffer from





Ever


(A)

Currently


(B)

Did the

child

recieve


(C)


(D)

Diarrohea

(with fever

lethargy

persistent

vomitting

and blood in



1 हा


A B C D E

Pneumonia

(Ill with

rapid short

breathing

fever amp



1 हा


A B C D E

25


Kala azar



1 हा


A B C D E








Yes gka

No ugha

1

2



written down





01

02

03

506

506




Vhdk yxokk gS

Yes हाा

No नह ी

BCG chlhth 1 2


le fnk xk

1 2


DPT MhihVh 1 1 2


DPT MhihVh 2 1 2


DPT MhihVh 3 1 2

26

Measles [kljk 1 2


1 2



ntZ ugha gS







Yes gka

No ugha

1

2








Yes gka

No ugha

1

2




Yes gka

No ugha

1

2



igyk yxk Fkk

Yes gka

No ugha

1

2





Number la[k

_____




Yes gka

No ugha

1

2


27





Number la[k

_____



Yes gka

No ugha

1

2



Yes gka

No ugha

1

2


ldrs gSs






gS





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

If 602a=1 or 602b=1 skip to 605





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

28






Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2







Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




izksx dj ldrs gS

Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1


29


jgs gS














L



[CHILD NAME] wanted



1

2

3


about the future




(more) children





vkSj cPpk pkgsaxs





1

2

3

4





1

2

3

4

5

30







1 2

1 2

1 2

1 2

1 2

1 2

1 2








Yes gka

No ugha

1

2

701

b


washing to you



Yes

No

1

2




PROBE Anyone else





f[kykus ls igys




A

B

C

D

X

Y

Z

31





pkfg

PROBE Anyone else














None dksbZ Hkh ugha

A

B

C

D

E

F

G

H

I

J

X

Y




Yes gka

No ugha

1

2

706







PROBE Anyone else










ckn





A

B

C

D

E

F

G

H

I

J

K

X










1

2

3

4

32









707


706

b



soapwater and

surfashoilother)




lkcquikuh vkSj


CODE ONE ONLY








706c




hands with soap




706

d





33


NAME] passed stools





xk Fkk





Buried tyk fnk Fkk


Other vU

1

2

3

4

5

6

7



members of your

household



lzregr Dk gS











pSuyfrac12


1

2

3

4

5

6

7

8

9

10

11

12

13

14

712




gS


Elsewhere vU=

1

2

712






fdruk le yxrk gS


__

__



txg ij dkSu tkrk gS


1

2

3

4

34


future use (for use




Yes gka

No ugha

1

2

715











1

2

3

4



djds dgkWa j[krs gS



1

2





cukrh gSa

Yes gka

No ugha

1

2

717




drink



djrs gS


Boil mckyuk









A

B

C

D

E

F

G

X

35






ifjokj dj jgs gS












k [ksr dk bLrseky


1

2

3

4

5

6

7

8

9

10

11

12

721



facility with other



gSa

Yes gka

No ugha

1

2

720





Number la[k



including children







ikl

Yes gka

No ugha

1

2

36



dSls fuiVkrs gS


In a drain ukys esa



1

2

3

4

5






vki tgka jgrs gSa

Yes gka

No ugha

1

2








A B C D




rjhds Dk gS






1

2

3

4

5



Strongly

agree

Agree lger

Disagree

असहमत

Strongly

Disagree





1 2 3 4

37




1 2 3 4




1 2 3 4





1 2 3 4







1 2 3 4



ij gksrk gS

1 2 3 4




dgrh gWawa



1 2 3 4

PNC




1 2 3 4



feyuk vke ckr gS

1 2 3 4





1 2 3 4

Family Planning

38



dks vPNk ekurs gSa

1 2 3 4





djrh gWaw

1 2 3 4





1 2 3 4



dqN yxkrs gS

1 2 3 4



1 2 3 4





1 2 3 4





fiykk tkrk gS

1 2 3 4





gS

1 2 3 4





1 2 3 4


39





1 2 3 4






1 2 3 4




1 2 3 4





1 2 3 4




1 2 3 4



mckyrs gSa

1 2 3 4




1 2 3 4




1 2 3 4



dk leFkZu djsaxs

1 2 3 4





1 2 3 4


40



















1

2

3

4

5

911









1

2

3

4

5




सलया था

Days ____

दिन______







Yes gka

No ugha

1

2

909





has an emergency A


41





Aacutelo dh rSkjh





dkZdze k vU kstuk


lkQ vkSj lqjfkr tUe







Breastfeeding J

Lruiku


iwjd vkgkj

Immunizations L

Vhdkdjk

Family planning M

ifjokj fukstu

Sanitationhygiene N

LoPNrk

other (specify) X




community group


Yes हा______________1

No नही_______________2



Number __________

सखया




Yes हा______________1

No_ नही______________2

42

community group






fyk

Yes


1

2

3

911

911





ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X





1

2




Yes gka

No ugha

1

2



djrh gSa

Yes gka

No ugha


1

2

3



gS

Yes gka

No ugha

1

2

916


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


3






1

2

3

4

5

6




Write income








OBC fiNMk oxZ

Others vU


1

2

3

4

5


Hindu fgUnq

Muslim eqfLye


1

2

3

4

5

6

7





4




113_1







)




Yes gka

No ugha

1

2

113_4


113_2




113_3





113_4




Yes gka

No ugha

1

2

11


5


113_5


you had




Yes gka

No ugha

1

2



Months eghus

_______



Yeshellipहा 1

Nohellipनही 2







this pregnancy



Yes gka

No ugha

1

2



6

last pregnancy



Your home vkidk kj






Sub-center mi dsUnz



A

B

C

D

E

F

G

H

I







ANM u e C

NURSE ulZ





dkZdrkZ F


ASHA vkrsquokk H





Months eghus

______





Number of times


______





Yes gka

No ugha


at that time

1

2

3

4

208

208

208

7



206

206b

During your last


from your community


following signs of




esa crkk Fkk






C Community group




X Other अनय

Yes No 206b















ughafrac12 1 2


gksuk 1 2


gksuk 1 2

8






Yes gka

No ugha




1

2

3

4



last pregnancy



Yes gka

No ugha

1

2


209

210


experience


fdk


the problem


209

Did you

have this

problem कया


हई

210

Did you

seek



Yes

हाा No


No नह ी







D Excessive fatigue

vRfkd Fkdku 1 2 1 2






9

vRfkd myVh gksuk






K Convulsions










A

B

C

X












CyMizsrsquokj 1 2








Yes gka

No ugha





1

2

3

4

216

216


10




pregnancy dleivery




Yes gka

No ugha

1

2




dk lgksx feyk










fdk




A

B

C

D

E

X






Yes gka

No ugha

1

2






_____

___

11








Yes gka

No ugha

1










tablets



ककया

Number of days










Yes gka

No ugha

1

2



Anganwadi centre


Yes gka

No ugha

1

2

12




house



समली

Number of times



221 During the last

pregnancy did you




workers (ASHA

ANM AWW Doctor)

or other women from


Dk vkius fuEufyf[kr

ij de ls de d ckj


ue] vkaxuokMh


vius leqnk dh vU

efgykvksa kjk lykg

izkIr की

Who provided the


feyh

Health worker

(ASHA ANM


MCYq MCYq]

MkDVjfrac12 1

Community group


lnL2

Both

Yes

हाा No

नह 222

Who gave you


HW 2 ndash

Community

group member

3 ndash Both)



1 2 1 2 3





1 2

1 2 3


dks xeZ j[kuk 1 2

1 2 3





j[kukA

1 2

1 2 3




1 2

1 2 3 9


fMfyojh fdV 1 2

1 2 3 9






1 2 3- 9

13

nksuks3

Other अनय 9



1 2 1 2 3 9


1 2 1 2 3 9


1 2 1 2 3 9


Village Health

Nutrition Days

(VHNDs) during your

pregnancy




Yes gka

No ugha

1

2




VHND meeting













lqfokk dsanz es gks

At home kj ij



1

2

3


14




fdlls




No ugha

1

2

3




Yes gka

No ugha

1

2







1

2

3





Yes No


during childbirth


mifLFfr jgsa

1 2



1 2


1 2


1 2


1 2

15










Yes हा

No नही




igpku dh Fkh

1 2



1 2





to


NAME]



IF UNABLE TO

DETERMINE IF A

HOSPITAL HEALTH

CENTRE OR CLINIC IS

PUBLIC OR PRIVATE

MEDICAL SECTOR

WRITE THE NAME OF

THE PLACE


HOME

Your home vkidk kj


Other home vU kj








Sub-center mi dsUnz


NGO SECTOR


PVT MEDICAL SECTOR


1

2

3

4

5

6

7

8

9

10

11

12

16



lqfokksa

13



djkh Fkh





ANM u e




No one dksbZ ugha


A

B

C

D

E

F

G

H

X

I



yksx Fks






No one dksbZ ugha

A

B

C

D

E






1

2

3




the JSY program



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


17




INR is _____

_



account



Cash udn 1

Cheque psd 2


Other (specify) 88





_____

_







Yes gka

No ugha

1

2









18







ANM u e




No one dksbZ ugha

Other अनय

1

2

3

4

10

5

6

7

9

8



dk izksx fdk xk Fkk




ls izkIr fdk Fkk






Scissor dSaph



1

2

3

4

5

6

8

9

412



xk Fkk





izkIr fdk Fkk




uk kkxk


kkxk


kjk fnk xk kkxk





1

2

3

4

5

6

8

9



ij dqN yxkk xk Fkk

Yes gka

No ugha

1

2



dqN yxkk xk Fkk

Yes gka

No ugha

1

2


19




uky ij Dk yxk Fkk

CODE ALL THAT

APPLY





Sindoor flUnwj






Cowdung xk dk xkscj


A

B

C

D

E

F

G

H

I

J

X




yxk Fkk




Sindoor flUnwj






Cowdung xk dk xkscj


A

B

C

D

E

F

G

H

I

J

X










Question Answers





Hours kVs

________________

Days fnu

_________________


fiykk

Yes gka

No ugha

1

2


20




fiykk Fkk





hour


H Hours घट ___________

D Days दिन ____________

0




Yes gka

No ugha

1

2


421 What was [CHILD

NAME] given


fnk xk Fkk

PROBE Anything

else

dqN vkSj










A

B

C

D

E

F

G

H

I

J

X






Yes gka

No ugha

1

2


21






nwk fiykk Fkk





pht ugha nh








Bwals fuIiy frac12







gS


gqvk Fkk





jgk Fkk



OTHER (SPECIFY) vU





Yes gka

No ugha

1

2

22






EACH











fiykk gS

If 427A_1 =2 skip to 427A_2

Liquids Yes हा

No नही

Yes हा

No नही




1 2 1 2



tkuoj dk nwkfrac12

1 2 1 2




vkWjsUt is

1 2 1 2



1 2 1 2





Yes gka

No ugha

1

2





kq fdk Fkk


_____

_







ckj nsrh gSa 2


23




nsrh gSa

SINGLE CODING ONLY




4











Yes gka

No ugha

1

2







ASHA vkrsquokk

ANM ue



A

B

C

X





vks

Days Fnu

Weeks

_____













vkids kj vks Fks

Yes gka

No ugha




1

2

3

4

502

502


24







vks

Days


suffer from





Ever


(A)

Currently


(B)

Did the

child

recieve


(C)


(D)

Diarrohea

(with fever

lethargy

persistent

vomitting

and blood in



1 हा


A B C D E

Pneumonia

(Ill with

rapid short

breathing

fever amp



1 हा


A B C D E

25


Kala azar



1 हा


A B C D E








Yes gka

No ugha

1

2



written down





01

02

03

506

506




Vhdk yxokk gS

Yes हाा

No नह ी

BCG chlhth 1 2


le fnk xk

1 2


DPT MhihVh 1 1 2


DPT MhihVh 2 1 2


DPT MhihVh 3 1 2

26

Measles [kljk 1 2


1 2



ntZ ugha gS







Yes gka

No ugha

1

2








Yes gka

No ugha

1

2




Yes gka

No ugha

1

2



igyk yxk Fkk

Yes gka

No ugha

1

2





Number la[k

_____




Yes gka

No ugha

1

2


27





Number la[k

_____



Yes gka

No ugha

1

2



Yes gka

No ugha

1

2


ldrs gSs






gS





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

If 602a=1 or 602b=1 skip to 605





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

28






Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2







Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




izksx dj ldrs gS

Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1


29


jgs gS














L



[CHILD NAME] wanted



1

2

3


about the future




(more) children





vkSj cPpk pkgsaxs





1

2

3

4





1

2

3

4

5

30







1 2

1 2

1 2

1 2

1 2

1 2

1 2








Yes gka

No ugha

1

2

701

b


washing to you



Yes

No

1

2




PROBE Anyone else





f[kykus ls igys




A

B

C

D

X

Y

Z

31





pkfg

PROBE Anyone else














None dksbZ Hkh ugha

A

B

C

D

E

F

G

H

I

J

X

Y




Yes gka

No ugha

1

2

706







PROBE Anyone else










ckn





A

B

C

D

E

F

G

H

I

J

K

X










1

2

3

4

32









707


706

b



soapwater and

surfashoilother)




lkcquikuh vkSj


CODE ONE ONLY








706c




hands with soap




706

d





33


NAME] passed stools





xk Fkk





Buried tyk fnk Fkk


Other vU

1

2

3

4

5

6

7



members of your

household



lzregr Dk gS











pSuyfrac12


1

2

3

4

5

6

7

8

9

10

11

12

13

14

712




gS


Elsewhere vU=

1

2

712






fdruk le yxrk gS


__

__



txg ij dkSu tkrk gS


1

2

3

4

34


future use (for use




Yes gka

No ugha

1

2

715











1

2

3

4



djds dgkWa j[krs gS



1

2





cukrh gSa

Yes gka

No ugha

1

2

717




drink



djrs gS


Boil mckyuk









A

B

C

D

E

F

G

X

35






ifjokj dj jgs gS












k [ksr dk bLrseky


1

2

3

4

5

6

7

8

9

10

11

12

721



facility with other



gSa

Yes gka

No ugha

1

2

720





Number la[k



including children







ikl

Yes gka

No ugha

1

2

36



dSls fuiVkrs gS


In a drain ukys esa



1

2

3

4

5






vki tgka jgrs gSa

Yes gka

No ugha

1

2








A B C D




rjhds Dk gS






1

2

3

4

5



Strongly

agree

Agree lger

Disagree

असहमत

Strongly

Disagree





1 2 3 4

37




1 2 3 4




1 2 3 4





1 2 3 4







1 2 3 4



ij gksrk gS

1 2 3 4




dgrh gWawa



1 2 3 4

PNC




1 2 3 4



feyuk vke ckr gS

1 2 3 4





1 2 3 4

Family Planning

38



dks vPNk ekurs gSa

1 2 3 4





djrh gWaw

1 2 3 4





1 2 3 4



dqN yxkrs gS

1 2 3 4



1 2 3 4





1 2 3 4





fiykk tkrk gS

1 2 3 4





gS

1 2 3 4





1 2 3 4


39





1 2 3 4






1 2 3 4




1 2 3 4





1 2 3 4




1 2 3 4



mckyrs gSa

1 2 3 4




1 2 3 4




1 2 3 4



dk leFkZu djsaxs

1 2 3 4





1 2 3 4


40



















1

2

3

4

5

911









1

2

3

4

5




सलया था

Days ____

दिन______







Yes gka

No ugha

1

2

909





has an emergency A


41





Aacutelo dh rSkjh





dkZdze k vU kstuk


lkQ vkSj lqjfkr tUe







Breastfeeding J

Lruiku


iwjd vkgkj

Immunizations L

Vhdkdjk

Family planning M

ifjokj fukstu

Sanitationhygiene N

LoPNrk

other (specify) X




community group


Yes हा______________1

No नही_______________2



Number __________

सखया




Yes हा______________1

No_ नही______________2

42

community group






fyk

Yes


1

2

3

911

911





ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X





1

2




Yes gka

No ugha

1

2



djrh gSa

Yes gka

No ugha


1

2

3



gS

Yes gka

No ugha

1

2

916


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


4




113_1







)




Yes gka

No ugha

1

2

113_4


113_2




113_3





113_4




Yes gka

No ugha

1

2

11


5


113_5


you had




Yes gka

No ugha

1

2



Months eghus

_______



Yeshellipहा 1

Nohellipनही 2







this pregnancy



Yes gka

No ugha

1

2



6

last pregnancy



Your home vkidk kj






Sub-center mi dsUnz



A

B

C

D

E

F

G

H

I







ANM u e C

NURSE ulZ





dkZdrkZ F


ASHA vkrsquokk H





Months eghus

______





Number of times


______





Yes gka

No ugha


at that time

1

2

3

4

208

208

208

7



206

206b

During your last


from your community


following signs of




esa crkk Fkk






C Community group




X Other अनय

Yes No 206b















ughafrac12 1 2


gksuk 1 2


gksuk 1 2

8






Yes gka

No ugha




1

2

3

4



last pregnancy



Yes gka

No ugha

1

2


209

210


experience


fdk


the problem


209

Did you

have this

problem कया


हई

210

Did you

seek



Yes

हाा No


No नह ी







D Excessive fatigue

vRfkd Fkdku 1 2 1 2






9

vRfkd myVh gksuk






K Convulsions










A

B

C

X












CyMizsrsquokj 1 2








Yes gka

No ugha





1

2

3

4

216

216


10




pregnancy dleivery




Yes gka

No ugha

1

2




dk lgksx feyk










fdk




A

B

C

D

E

X






Yes gka

No ugha

1

2






_____

___

11








Yes gka

No ugha

1










tablets



ककया

Number of days










Yes gka

No ugha

1

2



Anganwadi centre


Yes gka

No ugha

1

2

12




house



समली

Number of times



221 During the last

pregnancy did you




workers (ASHA

ANM AWW Doctor)

or other women from


Dk vkius fuEufyf[kr

ij de ls de d ckj


ue] vkaxuokMh


vius leqnk dh vU

efgykvksa kjk lykg

izkIr की

Who provided the


feyh

Health worker

(ASHA ANM


MCYq MCYq]

MkDVjfrac12 1

Community group


lnL2

Both

Yes

हाा No

नह 222

Who gave you


HW 2 ndash

Community

group member

3 ndash Both)



1 2 1 2 3





1 2

1 2 3


dks xeZ j[kuk 1 2

1 2 3





j[kukA

1 2

1 2 3




1 2

1 2 3 9


fMfyojh fdV 1 2

1 2 3 9






1 2 3- 9

13

nksuks3

Other अनय 9



1 2 1 2 3 9


1 2 1 2 3 9


1 2 1 2 3 9


Village Health

Nutrition Days

(VHNDs) during your

pregnancy




Yes gka

No ugha

1

2




VHND meeting













lqfokk dsanz es gks

At home kj ij



1

2

3


14




fdlls




No ugha

1

2

3




Yes gka

No ugha

1

2







1

2

3





Yes No


during childbirth


mifLFfr jgsa

1 2



1 2


1 2


1 2


1 2

15










Yes हा

No नही




igpku dh Fkh

1 2



1 2





to


NAME]



IF UNABLE TO

DETERMINE IF A

HOSPITAL HEALTH

CENTRE OR CLINIC IS

PUBLIC OR PRIVATE

MEDICAL SECTOR

WRITE THE NAME OF

THE PLACE


HOME

Your home vkidk kj


Other home vU kj








Sub-center mi dsUnz


NGO SECTOR


PVT MEDICAL SECTOR


1

2

3

4

5

6

7

8

9

10

11

12

16



lqfokksa

13



djkh Fkh





ANM u e




No one dksbZ ugha


A

B

C

D

E

F

G

H

X

I



yksx Fks






No one dksbZ ugha

A

B

C

D

E






1

2

3




the JSY program



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


17




INR is _____

_



account



Cash udn 1

Cheque psd 2


Other (specify) 88





_____

_







Yes gka

No ugha

1

2









18







ANM u e




No one dksbZ ugha

Other अनय

1

2

3

4

10

5

6

7

9

8



dk izksx fdk xk Fkk




ls izkIr fdk Fkk






Scissor dSaph



1

2

3

4

5

6

8

9

412



xk Fkk





izkIr fdk Fkk




uk kkxk


kkxk


kjk fnk xk kkxk





1

2

3

4

5

6

8

9



ij dqN yxkk xk Fkk

Yes gka

No ugha

1

2



dqN yxkk xk Fkk

Yes gka

No ugha

1

2


19




uky ij Dk yxk Fkk

CODE ALL THAT

APPLY





Sindoor flUnwj






Cowdung xk dk xkscj


A

B

C

D

E

F

G

H

I

J

X




yxk Fkk




Sindoor flUnwj






Cowdung xk dk xkscj


A

B

C

D

E

F

G

H

I

J

X










Question Answers





Hours kVs

________________

Days fnu

_________________


fiykk

Yes gka

No ugha

1

2


20




fiykk Fkk





hour


H Hours घट ___________

D Days दिन ____________

0




Yes gka

No ugha

1

2


421 What was [CHILD

NAME] given


fnk xk Fkk

PROBE Anything

else

dqN vkSj










A

B

C

D

E

F

G

H

I

J

X






Yes gka

No ugha

1

2


21






nwk fiykk Fkk





pht ugha nh








Bwals fuIiy frac12







gS


gqvk Fkk





jgk Fkk



OTHER (SPECIFY) vU





Yes gka

No ugha

1

2

22






EACH











fiykk gS

If 427A_1 =2 skip to 427A_2

Liquids Yes हा

No नही

Yes हा

No नही




1 2 1 2



tkuoj dk nwkfrac12

1 2 1 2




vkWjsUt is

1 2 1 2



1 2 1 2





Yes gka

No ugha

1

2





kq fdk Fkk


_____

_







ckj nsrh gSa 2


23




nsrh gSa

SINGLE CODING ONLY




4











Yes gka

No ugha

1

2







ASHA vkrsquokk

ANM ue



A

B

C

X





vks

Days Fnu

Weeks

_____













vkids kj vks Fks

Yes gka

No ugha




1

2

3

4

502

502


24







vks

Days


suffer from





Ever


(A)

Currently


(B)

Did the

child

recieve


(C)


(D)

Diarrohea

(with fever

lethargy

persistent

vomitting

and blood in



1 हा


A B C D E

Pneumonia

(Ill with

rapid short

breathing

fever amp



1 हा


A B C D E

25


Kala azar



1 हा


A B C D E








Yes gka

No ugha

1

2



written down





01

02

03

506

506




Vhdk yxokk gS

Yes हाा

No नह ी

BCG chlhth 1 2


le fnk xk

1 2


DPT MhihVh 1 1 2


DPT MhihVh 2 1 2


DPT MhihVh 3 1 2

26

Measles [kljk 1 2


1 2



ntZ ugha gS







Yes gka

No ugha

1

2








Yes gka

No ugha

1

2




Yes gka

No ugha

1

2



igyk yxk Fkk

Yes gka

No ugha

1

2





Number la[k

_____




Yes gka

No ugha

1

2


27





Number la[k

_____



Yes gka

No ugha

1

2



Yes gka

No ugha

1

2


ldrs gSs






gS





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

If 602a=1 or 602b=1 skip to 605





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

28






Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2







Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




izksx dj ldrs gS

Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1


29


jgs gS














L



[CHILD NAME] wanted



1

2

3


about the future




(more) children





vkSj cPpk pkgsaxs





1

2

3

4





1

2

3

4

5

30







1 2

1 2

1 2

1 2

1 2

1 2

1 2








Yes gka

No ugha

1

2

701

b


washing to you



Yes

No

1

2




PROBE Anyone else





f[kykus ls igys




A

B

C

D

X

Y

Z

31





pkfg

PROBE Anyone else














None dksbZ Hkh ugha

A

B

C

D

E

F

G

H

I

J

X

Y




Yes gka

No ugha

1

2

706







PROBE Anyone else










ckn





A

B

C

D

E

F

G

H

I

J

K

X










1

2

3

4

32









707


706

b



soapwater and

surfashoilother)




lkcquikuh vkSj


CODE ONE ONLY








706c




hands with soap




706

d





33


NAME] passed stools





xk Fkk





Buried tyk fnk Fkk


Other vU

1

2

3

4

5

6

7



members of your

household



lzregr Dk gS











pSuyfrac12


1

2

3

4

5

6

7

8

9

10

11

12

13

14

712




gS


Elsewhere vU=

1

2

712






fdruk le yxrk gS


__

__



txg ij dkSu tkrk gS


1

2

3

4

34


future use (for use




Yes gka

No ugha

1

2

715











1

2

3

4



djds dgkWa j[krs gS



1

2





cukrh gSa

Yes gka

No ugha

1

2

717




drink



djrs gS


Boil mckyuk









A

B

C

D

E

F

G

X

35






ifjokj dj jgs gS












k [ksr dk bLrseky


1

2

3

4

5

6

7

8

9

10

11

12

721



facility with other



gSa

Yes gka

No ugha

1

2

720





Number la[k



including children







ikl

Yes gka

No ugha

1

2

36



dSls fuiVkrs gS


In a drain ukys esa



1

2

3

4

5






vki tgka jgrs gSa

Yes gka

No ugha

1

2








A B C D




rjhds Dk gS






1

2

3

4

5



Strongly

agree

Agree lger

Disagree

असहमत

Strongly

Disagree





1 2 3 4

37




1 2 3 4




1 2 3 4





1 2 3 4







1 2 3 4



ij gksrk gS

1 2 3 4




dgrh gWawa



1 2 3 4

PNC




1 2 3 4



feyuk vke ckr gS

1 2 3 4





1 2 3 4

Family Planning

38



dks vPNk ekurs gSa

1 2 3 4





djrh gWaw

1 2 3 4





1 2 3 4



dqN yxkrs gS

1 2 3 4



1 2 3 4





1 2 3 4





fiykk tkrk gS

1 2 3 4





gS

1 2 3 4





1 2 3 4


39





1 2 3 4






1 2 3 4




1 2 3 4





1 2 3 4




1 2 3 4



mckyrs gSa

1 2 3 4




1 2 3 4




1 2 3 4



dk leFkZu djsaxs

1 2 3 4





1 2 3 4


40



















1

2

3

4

5

911









1

2

3

4

5




सलया था

Days ____

दिन______







Yes gka

No ugha

1

2

909





has an emergency A


41





Aacutelo dh rSkjh





dkZdze k vU kstuk


lkQ vkSj lqjfkr tUe







Breastfeeding J

Lruiku


iwjd vkgkj

Immunizations L

Vhdkdjk

Family planning M

ifjokj fukstu

Sanitationhygiene N

LoPNrk

other (specify) X




community group


Yes हा______________1

No नही_______________2



Number __________

सखया




Yes हा______________1

No_ नही______________2

42

community group






fyk

Yes


1

2

3

911

911





ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X





1

2




Yes gka

No ugha

1

2



djrh gSa

Yes gka

No ugha


1

2

3



gS

Yes gka

No ugha

1

2

916


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


5


113_5


you had




Yes gka

No ugha

1

2



Months eghus

_______



Yeshellipहा 1

Nohellipनही 2







this pregnancy



Yes gka

No ugha

1

2



6

last pregnancy



Your home vkidk kj






Sub-center mi dsUnz



A

B

C

D

E

F

G

H

I







ANM u e C

NURSE ulZ





dkZdrkZ F


ASHA vkrsquokk H





Months eghus

______





Number of times


______





Yes gka

No ugha


at that time

1

2

3

4

208

208

208

7



206

206b

During your last


from your community


following signs of




esa crkk Fkk






C Community group




X Other अनय

Yes No 206b















ughafrac12 1 2


gksuk 1 2


gksuk 1 2

8






Yes gka

No ugha




1

2

3

4



last pregnancy



Yes gka

No ugha

1

2


209

210


experience


fdk


the problem


209

Did you

have this

problem कया


हई

210

Did you

seek



Yes

हाा No


No नह ी







D Excessive fatigue

vRfkd Fkdku 1 2 1 2






9

vRfkd myVh gksuk






K Convulsions










A

B

C

X












CyMizsrsquokj 1 2








Yes gka

No ugha





1

2

3

4

216

216


10




pregnancy dleivery




Yes gka

No ugha

1

2




dk lgksx feyk










fdk




A

B

C

D

E

X






Yes gka

No ugha

1

2






_____

___

11








Yes gka

No ugha

1










tablets



ककया

Number of days










Yes gka

No ugha

1

2



Anganwadi centre


Yes gka

No ugha

1

2

12




house



समली

Number of times



221 During the last

pregnancy did you




workers (ASHA

ANM AWW Doctor)

or other women from


Dk vkius fuEufyf[kr

ij de ls de d ckj


ue] vkaxuokMh


vius leqnk dh vU

efgykvksa kjk lykg

izkIr की

Who provided the


feyh

Health worker

(ASHA ANM


MCYq MCYq]

MkDVjfrac12 1

Community group


lnL2

Both

Yes

हाा No

नह 222

Who gave you


HW 2 ndash

Community

group member

3 ndash Both)



1 2 1 2 3





1 2

1 2 3


dks xeZ j[kuk 1 2

1 2 3





j[kukA

1 2

1 2 3




1 2

1 2 3 9


fMfyojh fdV 1 2

1 2 3 9






1 2 3- 9

13

nksuks3

Other अनय 9



1 2 1 2 3 9


1 2 1 2 3 9


1 2 1 2 3 9


Village Health

Nutrition Days

(VHNDs) during your

pregnancy




Yes gka

No ugha

1

2




VHND meeting













lqfokk dsanz es gks

At home kj ij



1

2

3


14




fdlls




No ugha

1

2

3




Yes gka

No ugha

1

2







1

2

3





Yes No


during childbirth


mifLFfr jgsa

1 2



1 2


1 2


1 2


1 2

15










Yes हा

No नही




igpku dh Fkh

1 2



1 2





to


NAME]



IF UNABLE TO

DETERMINE IF A

HOSPITAL HEALTH

CENTRE OR CLINIC IS

PUBLIC OR PRIVATE

MEDICAL SECTOR

WRITE THE NAME OF

THE PLACE


HOME

Your home vkidk kj


Other home vU kj








Sub-center mi dsUnz


NGO SECTOR


PVT MEDICAL SECTOR


1

2

3

4

5

6

7

8

9

10

11

12

16



lqfokksa

13



djkh Fkh





ANM u e




No one dksbZ ugha


A

B

C

D

E

F

G

H

X

I



yksx Fks






No one dksbZ ugha

A

B

C

D

E






1

2

3




the JSY program



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


17




INR is _____

_



account



Cash udn 1

Cheque psd 2


Other (specify) 88





_____

_







Yes gka

No ugha

1

2









18







ANM u e




No one dksbZ ugha

Other अनय

1

2

3

4

10

5

6

7

9

8



dk izksx fdk xk Fkk




ls izkIr fdk Fkk






Scissor dSaph



1

2

3

4

5

6

8

9

412



xk Fkk





izkIr fdk Fkk




uk kkxk


kkxk


kjk fnk xk kkxk





1

2

3

4

5

6

8

9



ij dqN yxkk xk Fkk

Yes gka

No ugha

1

2



dqN yxkk xk Fkk

Yes gka

No ugha

1

2


19




uky ij Dk yxk Fkk

CODE ALL THAT

APPLY





Sindoor flUnwj






Cowdung xk dk xkscj


A

B

C

D

E

F

G

H

I

J

X




yxk Fkk




Sindoor flUnwj






Cowdung xk dk xkscj


A

B

C

D

E

F

G

H

I

J

X










Question Answers





Hours kVs

________________

Days fnu

_________________


fiykk

Yes gka

No ugha

1

2


20




fiykk Fkk





hour


H Hours घट ___________

D Days दिन ____________

0




Yes gka

No ugha

1

2


421 What was [CHILD

NAME] given


fnk xk Fkk

PROBE Anything

else

dqN vkSj










A

B

C

D

E

F

G

H

I

J

X






Yes gka

No ugha

1

2


21






nwk fiykk Fkk





pht ugha nh








Bwals fuIiy frac12







gS


gqvk Fkk





jgk Fkk



OTHER (SPECIFY) vU





Yes gka

No ugha

1

2

22






EACH











fiykk gS

If 427A_1 =2 skip to 427A_2

Liquids Yes हा

No नही

Yes हा

No नही




1 2 1 2



tkuoj dk nwkfrac12

1 2 1 2




vkWjsUt is

1 2 1 2



1 2 1 2





Yes gka

No ugha

1

2





kq fdk Fkk


_____

_







ckj nsrh gSa 2


23




nsrh gSa

SINGLE CODING ONLY




4











Yes gka

No ugha

1

2







ASHA vkrsquokk

ANM ue



A

B

C

X





vks

Days Fnu

Weeks

_____













vkids kj vks Fks

Yes gka

No ugha




1

2

3

4

502

502


24







vks

Days


suffer from





Ever


(A)

Currently


(B)

Did the

child

recieve


(C)


(D)

Diarrohea

(with fever

lethargy

persistent

vomitting

and blood in



1 हा


A B C D E

Pneumonia

(Ill with

rapid short

breathing

fever amp



1 हा


A B C D E

25


Kala azar



1 हा


A B C D E








Yes gka

No ugha

1

2



written down





01

02

03

506

506




Vhdk yxokk gS

Yes हाा

No नह ी

BCG chlhth 1 2


le fnk xk

1 2


DPT MhihVh 1 1 2


DPT MhihVh 2 1 2


DPT MhihVh 3 1 2

26

Measles [kljk 1 2


1 2



ntZ ugha gS







Yes gka

No ugha

1

2








Yes gka

No ugha

1

2




Yes gka

No ugha

1

2



igyk yxk Fkk

Yes gka

No ugha

1

2





Number la[k

_____




Yes gka

No ugha

1

2


27





Number la[k

_____



Yes gka

No ugha

1

2



Yes gka

No ugha

1

2


ldrs gSs






gS





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

If 602a=1 or 602b=1 skip to 605





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

28






Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2







Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




izksx dj ldrs gS

Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1


29


jgs gS














L



[CHILD NAME] wanted



1

2

3


about the future




(more) children





vkSj cPpk pkgsaxs





1

2

3

4





1

2

3

4

5

30







1 2

1 2

1 2

1 2

1 2

1 2

1 2








Yes gka

No ugha

1

2

701

b


washing to you



Yes

No

1

2




PROBE Anyone else





f[kykus ls igys




A

B

C

D

X

Y

Z

31





pkfg

PROBE Anyone else














None dksbZ Hkh ugha

A

B

C

D

E

F

G

H

I

J

X

Y




Yes gka

No ugha

1

2

706







PROBE Anyone else










ckn





A

B

C

D

E

F

G

H

I

J

K

X










1

2

3

4

32









707


706

b



soapwater and

surfashoilother)




lkcquikuh vkSj


CODE ONE ONLY








706c




hands with soap




706

d





33


NAME] passed stools





xk Fkk





Buried tyk fnk Fkk


Other vU

1

2

3

4

5

6

7



members of your

household



lzregr Dk gS











pSuyfrac12


1

2

3

4

5

6

7

8

9

10

11

12

13

14

712




gS


Elsewhere vU=

1

2

712






fdruk le yxrk gS


__

__



txg ij dkSu tkrk gS


1

2

3

4

34


future use (for use




Yes gka

No ugha

1

2

715











1

2

3

4



djds dgkWa j[krs gS



1

2





cukrh gSa

Yes gka

No ugha

1

2

717




drink



djrs gS


Boil mckyuk









A

B

C

D

E

F

G

X

35






ifjokj dj jgs gS












k [ksr dk bLrseky


1

2

3

4

5

6

7

8

9

10

11

12

721



facility with other



gSa

Yes gka

No ugha

1

2

720





Number la[k



including children







ikl

Yes gka

No ugha

1

2

36



dSls fuiVkrs gS


In a drain ukys esa



1

2

3

4

5






vki tgka jgrs gSa

Yes gka

No ugha

1

2








A B C D




rjhds Dk gS






1

2

3

4

5



Strongly

agree

Agree lger

Disagree

असहमत

Strongly

Disagree





1 2 3 4

37




1 2 3 4




1 2 3 4





1 2 3 4







1 2 3 4



ij gksrk gS

1 2 3 4




dgrh gWawa



1 2 3 4

PNC




1 2 3 4



feyuk vke ckr gS

1 2 3 4





1 2 3 4

Family Planning

38



dks vPNk ekurs gSa

1 2 3 4





djrh gWaw

1 2 3 4





1 2 3 4



dqN yxkrs gS

1 2 3 4



1 2 3 4





1 2 3 4





fiykk tkrk gS

1 2 3 4





gS

1 2 3 4





1 2 3 4


39





1 2 3 4






1 2 3 4




1 2 3 4





1 2 3 4




1 2 3 4



mckyrs gSa

1 2 3 4




1 2 3 4




1 2 3 4



dk leFkZu djsaxs

1 2 3 4





1 2 3 4


40



















1

2

3

4

5

911









1

2

3

4

5




सलया था

Days ____

दिन______







Yes gka

No ugha

1

2

909





has an emergency A


41





Aacutelo dh rSkjh





dkZdze k vU kstuk


lkQ vkSj lqjfkr tUe







Breastfeeding J

Lruiku


iwjd vkgkj

Immunizations L

Vhdkdjk

Family planning M

ifjokj fukstu

Sanitationhygiene N

LoPNrk

other (specify) X




community group


Yes हा______________1

No नही_______________2



Number __________

सखया




Yes हा______________1

No_ नही______________2

42

community group






fyk

Yes


1

2

3

911

911





ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X





1

2




Yes gka

No ugha

1

2



djrh gSa

Yes gka

No ugha


1

2

3



gS

Yes gka

No ugha

1

2

916


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


6

last pregnancy



Your home vkidk kj






Sub-center mi dsUnz



A

B

C

D

E

F

G

H

I







ANM u e C

NURSE ulZ





dkZdrkZ F


ASHA vkrsquokk H





Months eghus

______





Number of times


______





Yes gka

No ugha


at that time

1

2

3

4

208

208

208

7



206

206b

During your last


from your community


following signs of




esa crkk Fkk






C Community group




X Other अनय

Yes No 206b















ughafrac12 1 2


gksuk 1 2


gksuk 1 2

8






Yes gka

No ugha




1

2

3

4



last pregnancy



Yes gka

No ugha

1

2


209

210


experience


fdk


the problem


209

Did you

have this

problem कया


हई

210

Did you

seek



Yes

हाा No


No नह ी







D Excessive fatigue

vRfkd Fkdku 1 2 1 2






9

vRfkd myVh gksuk






K Convulsions










A

B

C

X












CyMizsrsquokj 1 2








Yes gka

No ugha





1

2

3

4

216

216


10




pregnancy dleivery




Yes gka

No ugha

1

2




dk lgksx feyk










fdk




A

B

C

D

E

X






Yes gka

No ugha

1

2






_____

___

11








Yes gka

No ugha

1










tablets



ककया

Number of days










Yes gka

No ugha

1

2



Anganwadi centre


Yes gka

No ugha

1

2

12




house



समली

Number of times



221 During the last

pregnancy did you




workers (ASHA

ANM AWW Doctor)

or other women from


Dk vkius fuEufyf[kr

ij de ls de d ckj


ue] vkaxuokMh


vius leqnk dh vU

efgykvksa kjk lykg

izkIr की

Who provided the


feyh

Health worker

(ASHA ANM


MCYq MCYq]

MkDVjfrac12 1

Community group


lnL2

Both

Yes

हाा No

नह 222

Who gave you


HW 2 ndash

Community

group member

3 ndash Both)



1 2 1 2 3





1 2

1 2 3


dks xeZ j[kuk 1 2

1 2 3





j[kukA

1 2

1 2 3




1 2

1 2 3 9


fMfyojh fdV 1 2

1 2 3 9






1 2 3- 9

13

nksuks3

Other अनय 9



1 2 1 2 3 9


1 2 1 2 3 9


1 2 1 2 3 9


Village Health

Nutrition Days

(VHNDs) during your

pregnancy




Yes gka

No ugha

1

2




VHND meeting













lqfokk dsanz es gks

At home kj ij



1

2

3


14




fdlls




No ugha

1

2

3




Yes gka

No ugha

1

2







1

2

3





Yes No


during childbirth


mifLFfr jgsa

1 2



1 2


1 2


1 2


1 2

15










Yes हा

No नही




igpku dh Fkh

1 2



1 2





to


NAME]



IF UNABLE TO

DETERMINE IF A

HOSPITAL HEALTH

CENTRE OR CLINIC IS

PUBLIC OR PRIVATE

MEDICAL SECTOR

WRITE THE NAME OF

THE PLACE


HOME

Your home vkidk kj


Other home vU kj








Sub-center mi dsUnz


NGO SECTOR


PVT MEDICAL SECTOR


1

2

3

4

5

6

7

8

9

10

11

12

16



lqfokksa

13



djkh Fkh





ANM u e




No one dksbZ ugha


A

B

C

D

E

F

G

H

X

I



yksx Fks






No one dksbZ ugha

A

B

C

D

E






1

2

3




the JSY program



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


17




INR is _____

_



account



Cash udn 1

Cheque psd 2


Other (specify) 88





_____

_







Yes gka

No ugha

1

2









18







ANM u e




No one dksbZ ugha

Other अनय

1

2

3

4

10

5

6

7

9

8



dk izksx fdk xk Fkk




ls izkIr fdk Fkk






Scissor dSaph



1

2

3

4

5

6

8

9

412



xk Fkk





izkIr fdk Fkk




uk kkxk


kkxk


kjk fnk xk kkxk





1

2

3

4

5

6

8

9



ij dqN yxkk xk Fkk

Yes gka

No ugha

1

2



dqN yxkk xk Fkk

Yes gka

No ugha

1

2


19




uky ij Dk yxk Fkk

CODE ALL THAT

APPLY





Sindoor flUnwj






Cowdung xk dk xkscj


A

B

C

D

E

F

G

H

I

J

X




yxk Fkk




Sindoor flUnwj






Cowdung xk dk xkscj


A

B

C

D

E

F

G

H

I

J

X










Question Answers





Hours kVs

________________

Days fnu

_________________


fiykk

Yes gka

No ugha

1

2


20




fiykk Fkk





hour


H Hours घट ___________

D Days दिन ____________

0




Yes gka

No ugha

1

2


421 What was [CHILD

NAME] given


fnk xk Fkk

PROBE Anything

else

dqN vkSj










A

B

C

D

E

F

G

H

I

J

X






Yes gka

No ugha

1

2


21






nwk fiykk Fkk





pht ugha nh








Bwals fuIiy frac12







gS


gqvk Fkk





jgk Fkk



OTHER (SPECIFY) vU





Yes gka

No ugha

1

2

22






EACH











fiykk gS

If 427A_1 =2 skip to 427A_2

Liquids Yes हा

No नही

Yes हा

No नही




1 2 1 2



tkuoj dk nwkfrac12

1 2 1 2




vkWjsUt is

1 2 1 2



1 2 1 2





Yes gka

No ugha

1

2





kq fdk Fkk


_____

_







ckj nsrh gSa 2


23




nsrh gSa

SINGLE CODING ONLY




4











Yes gka

No ugha

1

2







ASHA vkrsquokk

ANM ue



A

B

C

X





vks

Days Fnu

Weeks

_____













vkids kj vks Fks

Yes gka

No ugha




1

2

3

4

502

502


24







vks

Days


suffer from





Ever


(A)

Currently


(B)

Did the

child

recieve


(C)


(D)

Diarrohea

(with fever

lethargy

persistent

vomitting

and blood in



1 हा


A B C D E

Pneumonia

(Ill with

rapid short

breathing

fever amp



1 हा


A B C D E

25


Kala azar



1 हा


A B C D E








Yes gka

No ugha

1

2



written down





01

02

03

506

506




Vhdk yxokk gS

Yes हाा

No नह ी

BCG chlhth 1 2


le fnk xk

1 2


DPT MhihVh 1 1 2


DPT MhihVh 2 1 2


DPT MhihVh 3 1 2

26

Measles [kljk 1 2


1 2



ntZ ugha gS







Yes gka

No ugha

1

2








Yes gka

No ugha

1

2




Yes gka

No ugha

1

2



igyk yxk Fkk

Yes gka

No ugha

1

2





Number la[k

_____




Yes gka

No ugha

1

2


27





Number la[k

_____



Yes gka

No ugha

1

2



Yes gka

No ugha

1

2


ldrs gSs






gS





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

If 602a=1 or 602b=1 skip to 605





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

28






Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2







Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




izksx dj ldrs gS

Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1


29


jgs gS














L



[CHILD NAME] wanted



1

2

3


about the future




(more) children





vkSj cPpk pkgsaxs





1

2

3

4





1

2

3

4

5

30







1 2

1 2

1 2

1 2

1 2

1 2

1 2








Yes gka

No ugha

1

2

701

b


washing to you



Yes

No

1

2




PROBE Anyone else





f[kykus ls igys




A

B

C

D

X

Y

Z

31





pkfg

PROBE Anyone else














None dksbZ Hkh ugha

A

B

C

D

E

F

G

H

I

J

X

Y




Yes gka

No ugha

1

2

706







PROBE Anyone else










ckn





A

B

C

D

E

F

G

H

I

J

K

X










1

2

3

4

32









707


706

b



soapwater and

surfashoilother)




lkcquikuh vkSj


CODE ONE ONLY








706c




hands with soap




706

d





33


NAME] passed stools





xk Fkk





Buried tyk fnk Fkk


Other vU

1

2

3

4

5

6

7



members of your

household



lzregr Dk gS











pSuyfrac12


1

2

3

4

5

6

7

8

9

10

11

12

13

14

712




gS


Elsewhere vU=

1

2

712






fdruk le yxrk gS


__

__



txg ij dkSu tkrk gS


1

2

3

4

34


future use (for use




Yes gka

No ugha

1

2

715











1

2

3

4



djds dgkWa j[krs gS



1

2





cukrh gSa

Yes gka

No ugha

1

2

717




drink



djrs gS


Boil mckyuk









A

B

C

D

E

F

G

X

35






ifjokj dj jgs gS












k [ksr dk bLrseky


1

2

3

4

5

6

7

8

9

10

11

12

721



facility with other



gSa

Yes gka

No ugha

1

2

720





Number la[k



including children







ikl

Yes gka

No ugha

1

2

36



dSls fuiVkrs gS


In a drain ukys esa



1

2

3

4

5






vki tgka jgrs gSa

Yes gka

No ugha

1

2








A B C D




rjhds Dk gS






1

2

3

4

5



Strongly

agree

Agree lger

Disagree

असहमत

Strongly

Disagree





1 2 3 4

37




1 2 3 4




1 2 3 4





1 2 3 4







1 2 3 4



ij gksrk gS

1 2 3 4




dgrh gWawa



1 2 3 4

PNC




1 2 3 4



feyuk vke ckr gS

1 2 3 4





1 2 3 4

Family Planning

38



dks vPNk ekurs gSa

1 2 3 4





djrh gWaw

1 2 3 4





1 2 3 4



dqN yxkrs gS

1 2 3 4



1 2 3 4





1 2 3 4





fiykk tkrk gS

1 2 3 4





gS

1 2 3 4





1 2 3 4


39





1 2 3 4






1 2 3 4




1 2 3 4





1 2 3 4




1 2 3 4



mckyrs gSa

1 2 3 4




1 2 3 4




1 2 3 4



dk leFkZu djsaxs

1 2 3 4





1 2 3 4


40



















1

2

3

4

5

911









1

2

3

4

5




सलया था

Days ____

दिन______







Yes gka

No ugha

1

2

909





has an emergency A


41





Aacutelo dh rSkjh





dkZdze k vU kstuk


lkQ vkSj lqjfkr tUe







Breastfeeding J

Lruiku


iwjd vkgkj

Immunizations L

Vhdkdjk

Family planning M

ifjokj fukstu

Sanitationhygiene N

LoPNrk

other (specify) X




community group


Yes हा______________1

No नही_______________2



Number __________

सखया




Yes हा______________1

No_ नही______________2

42

community group






fyk

Yes


1

2

3

911

911





ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X





1

2




Yes gka

No ugha

1

2



djrh gSa

Yes gka

No ugha


1

2

3



gS

Yes gka

No ugha

1

2

916


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


7



206

206b

During your last


from your community


following signs of




esa crkk Fkk






C Community group




X Other अनय

Yes No 206b















ughafrac12 1 2


gksuk 1 2


gksuk 1 2

8






Yes gka

No ugha




1

2

3

4



last pregnancy



Yes gka

No ugha

1

2


209

210


experience


fdk


the problem


209

Did you

have this

problem कया


हई

210

Did you

seek



Yes

हाा No


No नह ी







D Excessive fatigue

vRfkd Fkdku 1 2 1 2






9

vRfkd myVh gksuk






K Convulsions










A

B

C

X












CyMizsrsquokj 1 2








Yes gka

No ugha





1

2

3

4

216

216


10




pregnancy dleivery




Yes gka

No ugha

1

2




dk lgksx feyk










fdk




A

B

C

D

E

X






Yes gka

No ugha

1

2






_____

___

11








Yes gka

No ugha

1










tablets



ककया

Number of days










Yes gka

No ugha

1

2



Anganwadi centre


Yes gka

No ugha

1

2

12




house



समली

Number of times



221 During the last

pregnancy did you




workers (ASHA

ANM AWW Doctor)

or other women from


Dk vkius fuEufyf[kr

ij de ls de d ckj


ue] vkaxuokMh


vius leqnk dh vU

efgykvksa kjk lykg

izkIr की

Who provided the


feyh

Health worker

(ASHA ANM


MCYq MCYq]

MkDVjfrac12 1

Community group


lnL2

Both

Yes

हाा No

नह 222

Who gave you


HW 2 ndash

Community

group member

3 ndash Both)



1 2 1 2 3





1 2

1 2 3


dks xeZ j[kuk 1 2

1 2 3





j[kukA

1 2

1 2 3




1 2

1 2 3 9


fMfyojh fdV 1 2

1 2 3 9






1 2 3- 9

13

nksuks3

Other अनय 9



1 2 1 2 3 9


1 2 1 2 3 9


1 2 1 2 3 9


Village Health

Nutrition Days

(VHNDs) during your

pregnancy




Yes gka

No ugha

1

2




VHND meeting













lqfokk dsanz es gks

At home kj ij



1

2

3


14




fdlls




No ugha

1

2

3




Yes gka

No ugha

1

2







1

2

3





Yes No


during childbirth


mifLFfr jgsa

1 2



1 2


1 2


1 2


1 2

15










Yes हा

No नही




igpku dh Fkh

1 2



1 2





to


NAME]



IF UNABLE TO

DETERMINE IF A

HOSPITAL HEALTH

CENTRE OR CLINIC IS

PUBLIC OR PRIVATE

MEDICAL SECTOR

WRITE THE NAME OF

THE PLACE


HOME

Your home vkidk kj


Other home vU kj








Sub-center mi dsUnz


NGO SECTOR


PVT MEDICAL SECTOR


1

2

3

4

5

6

7

8

9

10

11

12

16



lqfokksa

13



djkh Fkh





ANM u e




No one dksbZ ugha


A

B

C

D

E

F

G

H

X

I



yksx Fks






No one dksbZ ugha

A

B

C

D

E






1

2

3




the JSY program



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


17




INR is _____

_



account



Cash udn 1

Cheque psd 2


Other (specify) 88





_____

_







Yes gka

No ugha

1

2









18







ANM u e




No one dksbZ ugha

Other अनय

1

2

3

4

10

5

6

7

9

8



dk izksx fdk xk Fkk




ls izkIr fdk Fkk






Scissor dSaph



1

2

3

4

5

6

8

9

412



xk Fkk





izkIr fdk Fkk




uk kkxk


kkxk


kjk fnk xk kkxk





1

2

3

4

5

6

8

9



ij dqN yxkk xk Fkk

Yes gka

No ugha

1

2



dqN yxkk xk Fkk

Yes gka

No ugha

1

2


19




uky ij Dk yxk Fkk

CODE ALL THAT

APPLY





Sindoor flUnwj






Cowdung xk dk xkscj


A

B

C

D

E

F

G

H

I

J

X




yxk Fkk




Sindoor flUnwj






Cowdung xk dk xkscj


A

B

C

D

E

F

G

H

I

J

X










Question Answers





Hours kVs

________________

Days fnu

_________________


fiykk

Yes gka

No ugha

1

2


20




fiykk Fkk





hour


H Hours घट ___________

D Days दिन ____________

0




Yes gka

No ugha

1

2


421 What was [CHILD

NAME] given


fnk xk Fkk

PROBE Anything

else

dqN vkSj










A

B

C

D

E

F

G

H

I

J

X






Yes gka

No ugha

1

2


21






nwk fiykk Fkk





pht ugha nh








Bwals fuIiy frac12







gS


gqvk Fkk





jgk Fkk



OTHER (SPECIFY) vU





Yes gka

No ugha

1

2

22






EACH











fiykk gS

If 427A_1 =2 skip to 427A_2

Liquids Yes हा

No नही

Yes हा

No नही




1 2 1 2



tkuoj dk nwkfrac12

1 2 1 2




vkWjsUt is

1 2 1 2



1 2 1 2





Yes gka

No ugha

1

2





kq fdk Fkk


_____

_







ckj nsrh gSa 2


23




nsrh gSa

SINGLE CODING ONLY




4











Yes gka

No ugha

1

2







ASHA vkrsquokk

ANM ue



A

B

C

X





vks

Days Fnu

Weeks

_____













vkids kj vks Fks

Yes gka

No ugha




1

2

3

4

502

502


24







vks

Days


suffer from





Ever


(A)

Currently


(B)

Did the

child

recieve


(C)


(D)

Diarrohea

(with fever

lethargy

persistent

vomitting

and blood in



1 हा


A B C D E

Pneumonia

(Ill with

rapid short

breathing

fever amp



1 हा


A B C D E

25


Kala azar



1 हा


A B C D E








Yes gka

No ugha

1

2



written down





01

02

03

506

506




Vhdk yxokk gS

Yes हाा

No नह ी

BCG chlhth 1 2


le fnk xk

1 2


DPT MhihVh 1 1 2


DPT MhihVh 2 1 2


DPT MhihVh 3 1 2

26

Measles [kljk 1 2


1 2



ntZ ugha gS







Yes gka

No ugha

1

2








Yes gka

No ugha

1

2




Yes gka

No ugha

1

2



igyk yxk Fkk

Yes gka

No ugha

1

2





Number la[k

_____




Yes gka

No ugha

1

2


27





Number la[k

_____



Yes gka

No ugha

1

2



Yes gka

No ugha

1

2


ldrs gSs






gS





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

If 602a=1 or 602b=1 skip to 605





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

28






Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2







Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




izksx dj ldrs gS

Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1


29


jgs gS














L



[CHILD NAME] wanted



1

2

3


about the future




(more) children





vkSj cPpk pkgsaxs





1

2

3

4





1

2

3

4

5

30







1 2

1 2

1 2

1 2

1 2

1 2

1 2








Yes gka

No ugha

1

2

701

b


washing to you



Yes

No

1

2




PROBE Anyone else





f[kykus ls igys




A

B

C

D

X

Y

Z

31





pkfg

PROBE Anyone else














None dksbZ Hkh ugha

A

B

C

D

E

F

G

H

I

J

X

Y




Yes gka

No ugha

1

2

706







PROBE Anyone else










ckn





A

B

C

D

E

F

G

H

I

J

K

X










1

2

3

4

32









707


706

b



soapwater and

surfashoilother)




lkcquikuh vkSj


CODE ONE ONLY








706c




hands with soap




706

d





33


NAME] passed stools





xk Fkk





Buried tyk fnk Fkk


Other vU

1

2

3

4

5

6

7



members of your

household



lzregr Dk gS











pSuyfrac12


1

2

3

4

5

6

7

8

9

10

11

12

13

14

712




gS


Elsewhere vU=

1

2

712






fdruk le yxrk gS


__

__



txg ij dkSu tkrk gS


1

2

3

4

34


future use (for use




Yes gka

No ugha

1

2

715











1

2

3

4



djds dgkWa j[krs gS



1

2





cukrh gSa

Yes gka

No ugha

1

2

717




drink



djrs gS


Boil mckyuk









A

B

C

D

E

F

G

X

35






ifjokj dj jgs gS












k [ksr dk bLrseky


1

2

3

4

5

6

7

8

9

10

11

12

721



facility with other



gSa

Yes gka

No ugha

1

2

720





Number la[k



including children







ikl

Yes gka

No ugha

1

2

36



dSls fuiVkrs gS


In a drain ukys esa



1

2

3

4

5






vki tgka jgrs gSa

Yes gka

No ugha

1

2








A B C D




rjhds Dk gS






1

2

3

4

5



Strongly

agree

Agree lger

Disagree

असहमत

Strongly

Disagree





1 2 3 4

37




1 2 3 4




1 2 3 4





1 2 3 4







1 2 3 4



ij gksrk gS

1 2 3 4




dgrh gWawa



1 2 3 4

PNC




1 2 3 4



feyuk vke ckr gS

1 2 3 4





1 2 3 4

Family Planning

38



dks vPNk ekurs gSa

1 2 3 4





djrh gWaw

1 2 3 4





1 2 3 4



dqN yxkrs gS

1 2 3 4



1 2 3 4





1 2 3 4





fiykk tkrk gS

1 2 3 4





gS

1 2 3 4





1 2 3 4


39





1 2 3 4






1 2 3 4




1 2 3 4





1 2 3 4




1 2 3 4



mckyrs gSa

1 2 3 4




1 2 3 4




1 2 3 4



dk leFkZu djsaxs

1 2 3 4





1 2 3 4


40



















1

2

3

4

5

911









1

2

3

4

5




सलया था

Days ____

दिन______







Yes gka

No ugha

1

2

909





has an emergency A


41





Aacutelo dh rSkjh





dkZdze k vU kstuk


lkQ vkSj lqjfkr tUe







Breastfeeding J

Lruiku


iwjd vkgkj

Immunizations L

Vhdkdjk

Family planning M

ifjokj fukstu

Sanitationhygiene N

LoPNrk

other (specify) X




community group


Yes हा______________1

No नही_______________2



Number __________

सखया




Yes हा______________1

No_ नही______________2

42

community group






fyk

Yes


1

2

3

911

911





ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X





1

2




Yes gka

No ugha

1

2



djrh gSa

Yes gka

No ugha


1

2

3



gS

Yes gka

No ugha

1

2

916


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


8






Yes gka

No ugha




1

2

3

4



last pregnancy



Yes gka

No ugha

1

2


209

210


experience


fdk


the problem


209

Did you

have this

problem कया


हई

210

Did you

seek



Yes

हाा No


No नह ी







D Excessive fatigue

vRfkd Fkdku 1 2 1 2






9

vRfkd myVh gksuk






K Convulsions










A

B

C

X












CyMizsrsquokj 1 2








Yes gka

No ugha





1

2

3

4

216

216


10




pregnancy dleivery




Yes gka

No ugha

1

2




dk lgksx feyk










fdk




A

B

C

D

E

X






Yes gka

No ugha

1

2






_____

___

11








Yes gka

No ugha

1










tablets



ककया

Number of days










Yes gka

No ugha

1

2



Anganwadi centre


Yes gka

No ugha

1

2

12




house



समली

Number of times



221 During the last

pregnancy did you




workers (ASHA

ANM AWW Doctor)

or other women from


Dk vkius fuEufyf[kr

ij de ls de d ckj


ue] vkaxuokMh


vius leqnk dh vU

efgykvksa kjk lykg

izkIr की

Who provided the


feyh

Health worker

(ASHA ANM


MCYq MCYq]

MkDVjfrac12 1

Community group


lnL2

Both

Yes

हाा No

नह 222

Who gave you


HW 2 ndash

Community

group member

3 ndash Both)



1 2 1 2 3





1 2

1 2 3


dks xeZ j[kuk 1 2

1 2 3





j[kukA

1 2

1 2 3




1 2

1 2 3 9


fMfyojh fdV 1 2

1 2 3 9






1 2 3- 9

13

nksuks3

Other अनय 9



1 2 1 2 3 9


1 2 1 2 3 9


1 2 1 2 3 9


Village Health

Nutrition Days

(VHNDs) during your

pregnancy




Yes gka

No ugha

1

2




VHND meeting













lqfokk dsanz es gks

At home kj ij



1

2

3


14




fdlls




No ugha

1

2

3




Yes gka

No ugha

1

2







1

2

3





Yes No


during childbirth


mifLFfr jgsa

1 2



1 2


1 2


1 2


1 2

15










Yes हा

No नही




igpku dh Fkh

1 2



1 2





to


NAME]



IF UNABLE TO

DETERMINE IF A

HOSPITAL HEALTH

CENTRE OR CLINIC IS

PUBLIC OR PRIVATE

MEDICAL SECTOR

WRITE THE NAME OF

THE PLACE


HOME

Your home vkidk kj


Other home vU kj








Sub-center mi dsUnz


NGO SECTOR


PVT MEDICAL SECTOR


1

2

3

4

5

6

7

8

9

10

11

12

16



lqfokksa

13



djkh Fkh





ANM u e




No one dksbZ ugha


A

B

C

D

E

F

G

H

X

I



yksx Fks






No one dksbZ ugha

A

B

C

D

E






1

2

3




the JSY program



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


17




INR is _____

_



account



Cash udn 1

Cheque psd 2


Other (specify) 88





_____

_







Yes gka

No ugha

1

2









18







ANM u e




No one dksbZ ugha

Other अनय

1

2

3

4

10

5

6

7

9

8



dk izksx fdk xk Fkk




ls izkIr fdk Fkk






Scissor dSaph



1

2

3

4

5

6

8

9

412



xk Fkk





izkIr fdk Fkk




uk kkxk


kkxk


kjk fnk xk kkxk





1

2

3

4

5

6

8

9



ij dqN yxkk xk Fkk

Yes gka

No ugha

1

2



dqN yxkk xk Fkk

Yes gka

No ugha

1

2


19




uky ij Dk yxk Fkk

CODE ALL THAT

APPLY





Sindoor flUnwj






Cowdung xk dk xkscj


A

B

C

D

E

F

G

H

I

J

X




yxk Fkk




Sindoor flUnwj






Cowdung xk dk xkscj


A

B

C

D

E

F

G

H

I

J

X










Question Answers





Hours kVs

________________

Days fnu

_________________


fiykk

Yes gka

No ugha

1

2


20




fiykk Fkk





hour


H Hours घट ___________

D Days दिन ____________

0




Yes gka

No ugha

1

2


421 What was [CHILD

NAME] given


fnk xk Fkk

PROBE Anything

else

dqN vkSj










A

B

C

D

E

F

G

H

I

J

X






Yes gka

No ugha

1

2


21






nwk fiykk Fkk





pht ugha nh








Bwals fuIiy frac12







gS


gqvk Fkk





jgk Fkk



OTHER (SPECIFY) vU





Yes gka

No ugha

1

2

22






EACH











fiykk gS

If 427A_1 =2 skip to 427A_2

Liquids Yes हा

No नही

Yes हा

No नही




1 2 1 2



tkuoj dk nwkfrac12

1 2 1 2




vkWjsUt is

1 2 1 2



1 2 1 2





Yes gka

No ugha

1

2





kq fdk Fkk


_____

_







ckj nsrh gSa 2


23




nsrh gSa

SINGLE CODING ONLY




4











Yes gka

No ugha

1

2







ASHA vkrsquokk

ANM ue



A

B

C

X





vks

Days Fnu

Weeks

_____













vkids kj vks Fks

Yes gka

No ugha




1

2

3

4

502

502


24







vks

Days


suffer from





Ever


(A)

Currently


(B)

Did the

child

recieve


(C)


(D)

Diarrohea

(with fever

lethargy

persistent

vomitting

and blood in



1 हा


A B C D E

Pneumonia

(Ill with

rapid short

breathing

fever amp



1 हा


A B C D E

25


Kala azar



1 हा


A B C D E








Yes gka

No ugha

1

2



written down





01

02

03

506

506




Vhdk yxokk gS

Yes हाा

No नह ी

BCG chlhth 1 2


le fnk xk

1 2


DPT MhihVh 1 1 2


DPT MhihVh 2 1 2


DPT MhihVh 3 1 2

26

Measles [kljk 1 2


1 2



ntZ ugha gS







Yes gka

No ugha

1

2








Yes gka

No ugha

1

2




Yes gka

No ugha

1

2



igyk yxk Fkk

Yes gka

No ugha

1

2





Number la[k

_____




Yes gka

No ugha

1

2


27





Number la[k

_____



Yes gka

No ugha

1

2



Yes gka

No ugha

1

2


ldrs gSs






gS





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

If 602a=1 or 602b=1 skip to 605





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

28






Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2







Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




izksx dj ldrs gS

Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1


29


jgs gS














L



[CHILD NAME] wanted



1

2

3


about the future




(more) children





vkSj cPpk pkgsaxs





1

2

3

4





1

2

3

4

5

30







1 2

1 2

1 2

1 2

1 2

1 2

1 2








Yes gka

No ugha

1

2

701

b


washing to you



Yes

No

1

2




PROBE Anyone else





f[kykus ls igys




A

B

C

D

X

Y

Z

31





pkfg

PROBE Anyone else














None dksbZ Hkh ugha

A

B

C

D

E

F

G

H

I

J

X

Y




Yes gka

No ugha

1

2

706







PROBE Anyone else










ckn





A

B

C

D

E

F

G

H

I

J

K

X










1

2

3

4

32









707


706

b



soapwater and

surfashoilother)




lkcquikuh vkSj


CODE ONE ONLY








706c




hands with soap




706

d





33


NAME] passed stools





xk Fkk





Buried tyk fnk Fkk


Other vU

1

2

3

4

5

6

7



members of your

household



lzregr Dk gS











pSuyfrac12


1

2

3

4

5

6

7

8

9

10

11

12

13

14

712




gS


Elsewhere vU=

1

2

712






fdruk le yxrk gS


__

__



txg ij dkSu tkrk gS


1

2

3

4

34


future use (for use




Yes gka

No ugha

1

2

715











1

2

3

4



djds dgkWa j[krs gS



1

2





cukrh gSa

Yes gka

No ugha

1

2

717




drink



djrs gS


Boil mckyuk









A

B

C

D

E

F

G

X

35






ifjokj dj jgs gS












k [ksr dk bLrseky


1

2

3

4

5

6

7

8

9

10

11

12

721



facility with other



gSa

Yes gka

No ugha

1

2

720





Number la[k



including children







ikl

Yes gka

No ugha

1

2

36



dSls fuiVkrs gS


In a drain ukys esa



1

2

3

4

5






vki tgka jgrs gSa

Yes gka

No ugha

1

2








A B C D




rjhds Dk gS






1

2

3

4

5



Strongly

agree

Agree lger

Disagree

असहमत

Strongly

Disagree





1 2 3 4

37




1 2 3 4




1 2 3 4





1 2 3 4







1 2 3 4



ij gksrk gS

1 2 3 4




dgrh gWawa



1 2 3 4

PNC




1 2 3 4



feyuk vke ckr gS

1 2 3 4





1 2 3 4

Family Planning

38



dks vPNk ekurs gSa

1 2 3 4





djrh gWaw

1 2 3 4





1 2 3 4



dqN yxkrs gS

1 2 3 4



1 2 3 4





1 2 3 4





fiykk tkrk gS

1 2 3 4





gS

1 2 3 4





1 2 3 4


39





1 2 3 4






1 2 3 4




1 2 3 4





1 2 3 4




1 2 3 4



mckyrs gSa

1 2 3 4




1 2 3 4




1 2 3 4



dk leFkZu djsaxs

1 2 3 4





1 2 3 4


40



















1

2

3

4

5

911









1

2

3

4

5




सलया था

Days ____

दिन______







Yes gka

No ugha

1

2

909





has an emergency A


41





Aacutelo dh rSkjh





dkZdze k vU kstuk


lkQ vkSj lqjfkr tUe







Breastfeeding J

Lruiku


iwjd vkgkj

Immunizations L

Vhdkdjk

Family planning M

ifjokj fukstu

Sanitationhygiene N

LoPNrk

other (specify) X




community group


Yes हा______________1

No नही_______________2



Number __________

सखया




Yes हा______________1

No_ नही______________2

42

community group






fyk

Yes


1

2

3

911

911





ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X





1

2




Yes gka

No ugha

1

2



djrh gSa

Yes gka

No ugha


1

2

3



gS

Yes gka

No ugha

1

2

916


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


9

vRfkd myVh gksuk






K Convulsions










A

B

C

X












CyMizsrsquokj 1 2








Yes gka

No ugha





1

2

3

4

216

216


10




pregnancy dleivery




Yes gka

No ugha

1

2




dk lgksx feyk










fdk




A

B

C

D

E

X






Yes gka

No ugha

1

2






_____

___

11








Yes gka

No ugha

1










tablets



ककया

Number of days










Yes gka

No ugha

1

2



Anganwadi centre


Yes gka

No ugha

1

2

12




house



समली

Number of times



221 During the last

pregnancy did you




workers (ASHA

ANM AWW Doctor)

or other women from


Dk vkius fuEufyf[kr

ij de ls de d ckj


ue] vkaxuokMh


vius leqnk dh vU

efgykvksa kjk lykg

izkIr की

Who provided the


feyh

Health worker

(ASHA ANM


MCYq MCYq]

MkDVjfrac12 1

Community group


lnL2

Both

Yes

हाा No

नह 222

Who gave you


HW 2 ndash

Community

group member

3 ndash Both)



1 2 1 2 3





1 2

1 2 3


dks xeZ j[kuk 1 2

1 2 3





j[kukA

1 2

1 2 3




1 2

1 2 3 9


fMfyojh fdV 1 2

1 2 3 9






1 2 3- 9

13

nksuks3

Other अनय 9



1 2 1 2 3 9


1 2 1 2 3 9


1 2 1 2 3 9


Village Health

Nutrition Days

(VHNDs) during your

pregnancy




Yes gka

No ugha

1

2




VHND meeting













lqfokk dsanz es gks

At home kj ij



1

2

3


14




fdlls




No ugha

1

2

3




Yes gka

No ugha

1

2







1

2

3





Yes No


during childbirth


mifLFfr jgsa

1 2



1 2


1 2


1 2


1 2

15










Yes हा

No नही




igpku dh Fkh

1 2



1 2





to


NAME]



IF UNABLE TO

DETERMINE IF A

HOSPITAL HEALTH

CENTRE OR CLINIC IS

PUBLIC OR PRIVATE

MEDICAL SECTOR

WRITE THE NAME OF

THE PLACE


HOME

Your home vkidk kj


Other home vU kj








Sub-center mi dsUnz


NGO SECTOR


PVT MEDICAL SECTOR


1

2

3

4

5

6

7

8

9

10

11

12

16



lqfokksa

13



djkh Fkh





ANM u e




No one dksbZ ugha


A

B

C

D

E

F

G

H

X

I



yksx Fks






No one dksbZ ugha

A

B

C

D

E






1

2

3




the JSY program



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


17




INR is _____

_



account



Cash udn 1

Cheque psd 2


Other (specify) 88





_____

_







Yes gka

No ugha

1

2









18







ANM u e




No one dksbZ ugha

Other अनय

1

2

3

4

10

5

6

7

9

8



dk izksx fdk xk Fkk




ls izkIr fdk Fkk






Scissor dSaph



1

2

3

4

5

6

8

9

412



xk Fkk





izkIr fdk Fkk




uk kkxk


kkxk


kjk fnk xk kkxk





1

2

3

4

5

6

8

9



ij dqN yxkk xk Fkk

Yes gka

No ugha

1

2



dqN yxkk xk Fkk

Yes gka

No ugha

1

2


19




uky ij Dk yxk Fkk

CODE ALL THAT

APPLY





Sindoor flUnwj






Cowdung xk dk xkscj


A

B

C

D

E

F

G

H

I

J

X




yxk Fkk




Sindoor flUnwj






Cowdung xk dk xkscj


A

B

C

D

E

F

G

H

I

J

X










Question Answers





Hours kVs

________________

Days fnu

_________________


fiykk

Yes gka

No ugha

1

2


20




fiykk Fkk





hour


H Hours घट ___________

D Days दिन ____________

0




Yes gka

No ugha

1

2


421 What was [CHILD

NAME] given


fnk xk Fkk

PROBE Anything

else

dqN vkSj










A

B

C

D

E

F

G

H

I

J

X






Yes gka

No ugha

1

2


21






nwk fiykk Fkk





pht ugha nh








Bwals fuIiy frac12







gS


gqvk Fkk





jgk Fkk



OTHER (SPECIFY) vU





Yes gka

No ugha

1

2

22






EACH











fiykk gS

If 427A_1 =2 skip to 427A_2

Liquids Yes हा

No नही

Yes हा

No नही




1 2 1 2



tkuoj dk nwkfrac12

1 2 1 2




vkWjsUt is

1 2 1 2



1 2 1 2





Yes gka

No ugha

1

2





kq fdk Fkk


_____

_







ckj nsrh gSa 2


23




nsrh gSa

SINGLE CODING ONLY




4











Yes gka

No ugha

1

2







ASHA vkrsquokk

ANM ue



A

B

C

X





vks

Days Fnu

Weeks

_____













vkids kj vks Fks

Yes gka

No ugha




1

2

3

4

502

502


24







vks

Days


suffer from





Ever


(A)

Currently


(B)

Did the

child

recieve


(C)


(D)

Diarrohea

(with fever

lethargy

persistent

vomitting

and blood in



1 हा


A B C D E

Pneumonia

(Ill with

rapid short

breathing

fever amp



1 हा


A B C D E

25


Kala azar



1 हा


A B C D E








Yes gka

No ugha

1

2



written down





01

02

03

506

506




Vhdk yxokk gS

Yes हाा

No नह ी

BCG chlhth 1 2


le fnk xk

1 2


DPT MhihVh 1 1 2


DPT MhihVh 2 1 2


DPT MhihVh 3 1 2

26

Measles [kljk 1 2


1 2



ntZ ugha gS







Yes gka

No ugha

1

2








Yes gka

No ugha

1

2




Yes gka

No ugha

1

2



igyk yxk Fkk

Yes gka

No ugha

1

2





Number la[k

_____




Yes gka

No ugha

1

2


27





Number la[k

_____



Yes gka

No ugha

1

2



Yes gka

No ugha

1

2


ldrs gSs






gS





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

If 602a=1 or 602b=1 skip to 605





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

28






Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2







Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




izksx dj ldrs gS

Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1


29


jgs gS














L



[CHILD NAME] wanted



1

2

3


about the future




(more) children





vkSj cPpk pkgsaxs





1

2

3

4





1

2

3

4

5

30







1 2

1 2

1 2

1 2

1 2

1 2

1 2








Yes gka

No ugha

1

2

701

b


washing to you



Yes

No

1

2




PROBE Anyone else





f[kykus ls igys




A

B

C

D

X

Y

Z

31





pkfg

PROBE Anyone else














None dksbZ Hkh ugha

A

B

C

D

E

F

G

H

I

J

X

Y




Yes gka

No ugha

1

2

706







PROBE Anyone else










ckn





A

B

C

D

E

F

G

H

I

J

K

X










1

2

3

4

32









707


706

b



soapwater and

surfashoilother)




lkcquikuh vkSj


CODE ONE ONLY








706c




hands with soap




706

d





33


NAME] passed stools





xk Fkk





Buried tyk fnk Fkk


Other vU

1

2

3

4

5

6

7



members of your

household



lzregr Dk gS











pSuyfrac12


1

2

3

4

5

6

7

8

9

10

11

12

13

14

712




gS


Elsewhere vU=

1

2

712






fdruk le yxrk gS


__

__



txg ij dkSu tkrk gS


1

2

3

4

34


future use (for use




Yes gka

No ugha

1

2

715











1

2

3

4



djds dgkWa j[krs gS



1

2





cukrh gSa

Yes gka

No ugha

1

2

717




drink



djrs gS


Boil mckyuk









A

B

C

D

E

F

G

X

35






ifjokj dj jgs gS












k [ksr dk bLrseky


1

2

3

4

5

6

7

8

9

10

11

12

721



facility with other



gSa

Yes gka

No ugha

1

2

720





Number la[k



including children







ikl

Yes gka

No ugha

1

2

36



dSls fuiVkrs gS


In a drain ukys esa



1

2

3

4

5






vki tgka jgrs gSa

Yes gka

No ugha

1

2








A B C D




rjhds Dk gS






1

2

3

4

5



Strongly

agree

Agree lger

Disagree

असहमत

Strongly

Disagree





1 2 3 4

37




1 2 3 4




1 2 3 4





1 2 3 4







1 2 3 4



ij gksrk gS

1 2 3 4




dgrh gWawa



1 2 3 4

PNC




1 2 3 4



feyuk vke ckr gS

1 2 3 4





1 2 3 4

Family Planning

38



dks vPNk ekurs gSa

1 2 3 4





djrh gWaw

1 2 3 4





1 2 3 4



dqN yxkrs gS

1 2 3 4



1 2 3 4





1 2 3 4





fiykk tkrk gS

1 2 3 4





gS

1 2 3 4





1 2 3 4


39





1 2 3 4






1 2 3 4




1 2 3 4





1 2 3 4




1 2 3 4



mckyrs gSa

1 2 3 4




1 2 3 4




1 2 3 4



dk leFkZu djsaxs

1 2 3 4





1 2 3 4


40



















1

2

3

4

5

911









1

2

3

4

5




सलया था

Days ____

दिन______







Yes gka

No ugha

1

2

909





has an emergency A


41





Aacutelo dh rSkjh





dkZdze k vU kstuk


lkQ vkSj lqjfkr tUe







Breastfeeding J

Lruiku


iwjd vkgkj

Immunizations L

Vhdkdjk

Family planning M

ifjokj fukstu

Sanitationhygiene N

LoPNrk

other (specify) X




community group


Yes हा______________1

No नही_______________2



Number __________

सखया




Yes हा______________1

No_ नही______________2

42

community group






fyk

Yes


1

2

3

911

911





ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X





1

2




Yes gka

No ugha

1

2



djrh gSa

Yes gka

No ugha


1

2

3



gS

Yes gka

No ugha

1

2

916


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


10




pregnancy dleivery




Yes gka

No ugha

1

2




dk lgksx feyk










fdk




A

B

C

D

E

X






Yes gka

No ugha

1

2






_____

___

11








Yes gka

No ugha

1










tablets



ककया

Number of days










Yes gka

No ugha

1

2



Anganwadi centre


Yes gka

No ugha

1

2

12




house



समली

Number of times



221 During the last

pregnancy did you




workers (ASHA

ANM AWW Doctor)

or other women from


Dk vkius fuEufyf[kr

ij de ls de d ckj


ue] vkaxuokMh


vius leqnk dh vU

efgykvksa kjk lykg

izkIr की

Who provided the


feyh

Health worker

(ASHA ANM


MCYq MCYq]

MkDVjfrac12 1

Community group


lnL2

Both

Yes

हाा No

नह 222

Who gave you


HW 2 ndash

Community

group member

3 ndash Both)



1 2 1 2 3





1 2

1 2 3


dks xeZ j[kuk 1 2

1 2 3





j[kukA

1 2

1 2 3




1 2

1 2 3 9


fMfyojh fdV 1 2

1 2 3 9






1 2 3- 9

13

nksuks3

Other अनय 9



1 2 1 2 3 9


1 2 1 2 3 9


1 2 1 2 3 9


Village Health

Nutrition Days

(VHNDs) during your

pregnancy




Yes gka

No ugha

1

2




VHND meeting













lqfokk dsanz es gks

At home kj ij



1

2

3


14




fdlls




No ugha

1

2

3




Yes gka

No ugha

1

2







1

2

3





Yes No


during childbirth


mifLFfr jgsa

1 2



1 2


1 2


1 2


1 2

15










Yes हा

No नही




igpku dh Fkh

1 2



1 2





to


NAME]



IF UNABLE TO

DETERMINE IF A

HOSPITAL HEALTH

CENTRE OR CLINIC IS

PUBLIC OR PRIVATE

MEDICAL SECTOR

WRITE THE NAME OF

THE PLACE


HOME

Your home vkidk kj


Other home vU kj








Sub-center mi dsUnz


NGO SECTOR


PVT MEDICAL SECTOR


1

2

3

4

5

6

7

8

9

10

11

12

16



lqfokksa

13



djkh Fkh





ANM u e




No one dksbZ ugha


A

B

C

D

E

F

G

H

X

I



yksx Fks






No one dksbZ ugha

A

B

C

D

E






1

2

3




the JSY program



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


17




INR is _____

_



account



Cash udn 1

Cheque psd 2


Other (specify) 88





_____

_







Yes gka

No ugha

1

2









18







ANM u e




No one dksbZ ugha

Other अनय

1

2

3

4

10

5

6

7

9

8



dk izksx fdk xk Fkk




ls izkIr fdk Fkk






Scissor dSaph



1

2

3

4

5

6

8

9

412



xk Fkk





izkIr fdk Fkk




uk kkxk


kkxk


kjk fnk xk kkxk





1

2

3

4

5

6

8

9



ij dqN yxkk xk Fkk

Yes gka

No ugha

1

2



dqN yxkk xk Fkk

Yes gka

No ugha

1

2


19




uky ij Dk yxk Fkk

CODE ALL THAT

APPLY





Sindoor flUnwj






Cowdung xk dk xkscj


A

B

C

D

E

F

G

H

I

J

X




yxk Fkk




Sindoor flUnwj






Cowdung xk dk xkscj


A

B

C

D

E

F

G

H

I

J

X










Question Answers





Hours kVs

________________

Days fnu

_________________


fiykk

Yes gka

No ugha

1

2


20




fiykk Fkk





hour


H Hours घट ___________

D Days दिन ____________

0




Yes gka

No ugha

1

2


421 What was [CHILD

NAME] given


fnk xk Fkk

PROBE Anything

else

dqN vkSj










A

B

C

D

E

F

G

H

I

J

X






Yes gka

No ugha

1

2


21






nwk fiykk Fkk





pht ugha nh








Bwals fuIiy frac12







gS


gqvk Fkk





jgk Fkk



OTHER (SPECIFY) vU





Yes gka

No ugha

1

2

22






EACH











fiykk gS

If 427A_1 =2 skip to 427A_2

Liquids Yes हा

No नही

Yes हा

No नही




1 2 1 2



tkuoj dk nwkfrac12

1 2 1 2




vkWjsUt is

1 2 1 2



1 2 1 2





Yes gka

No ugha

1

2





kq fdk Fkk


_____

_







ckj nsrh gSa 2


23




nsrh gSa

SINGLE CODING ONLY




4











Yes gka

No ugha

1

2







ASHA vkrsquokk

ANM ue



A

B

C

X





vks

Days Fnu

Weeks

_____













vkids kj vks Fks

Yes gka

No ugha




1

2

3

4

502

502


24







vks

Days


suffer from





Ever


(A)

Currently


(B)

Did the

child

recieve


(C)


(D)

Diarrohea

(with fever

lethargy

persistent

vomitting

and blood in



1 हा


A B C D E

Pneumonia

(Ill with

rapid short

breathing

fever amp



1 हा


A B C D E

25


Kala azar



1 हा


A B C D E








Yes gka

No ugha

1

2



written down





01

02

03

506

506




Vhdk yxokk gS

Yes हाा

No नह ी

BCG chlhth 1 2


le fnk xk

1 2


DPT MhihVh 1 1 2


DPT MhihVh 2 1 2


DPT MhihVh 3 1 2

26

Measles [kljk 1 2


1 2



ntZ ugha gS







Yes gka

No ugha

1

2








Yes gka

No ugha

1

2




Yes gka

No ugha

1

2



igyk yxk Fkk

Yes gka

No ugha

1

2





Number la[k

_____




Yes gka

No ugha

1

2


27





Number la[k

_____



Yes gka

No ugha

1

2



Yes gka

No ugha

1

2


ldrs gSs






gS





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

If 602a=1 or 602b=1 skip to 605





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

28






Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2







Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




izksx dj ldrs gS

Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1


29


jgs gS














L



[CHILD NAME] wanted



1

2

3


about the future




(more) children





vkSj cPpk pkgsaxs





1

2

3

4





1

2

3

4

5

30







1 2

1 2

1 2

1 2

1 2

1 2

1 2








Yes gka

No ugha

1

2

701

b


washing to you



Yes

No

1

2




PROBE Anyone else





f[kykus ls igys




A

B

C

D

X

Y

Z

31





pkfg

PROBE Anyone else














None dksbZ Hkh ugha

A

B

C

D

E

F

G

H

I

J

X

Y




Yes gka

No ugha

1

2

706







PROBE Anyone else










ckn





A

B

C

D

E

F

G

H

I

J

K

X










1

2

3

4

32









707


706

b



soapwater and

surfashoilother)




lkcquikuh vkSj


CODE ONE ONLY








706c




hands with soap




706

d





33


NAME] passed stools





xk Fkk





Buried tyk fnk Fkk


Other vU

1

2

3

4

5

6

7



members of your

household



lzregr Dk gS











pSuyfrac12


1

2

3

4

5

6

7

8

9

10

11

12

13

14

712




gS


Elsewhere vU=

1

2

712






fdruk le yxrk gS


__

__



txg ij dkSu tkrk gS


1

2

3

4

34


future use (for use




Yes gka

No ugha

1

2

715











1

2

3

4



djds dgkWa j[krs gS



1

2





cukrh gSa

Yes gka

No ugha

1

2

717




drink



djrs gS


Boil mckyuk









A

B

C

D

E

F

G

X

35






ifjokj dj jgs gS












k [ksr dk bLrseky


1

2

3

4

5

6

7

8

9

10

11

12

721



facility with other



gSa

Yes gka

No ugha

1

2

720





Number la[k



including children







ikl

Yes gka

No ugha

1

2

36



dSls fuiVkrs gS


In a drain ukys esa



1

2

3

4

5






vki tgka jgrs gSa

Yes gka

No ugha

1

2








A B C D




rjhds Dk gS






1

2

3

4

5



Strongly

agree

Agree lger

Disagree

असहमत

Strongly

Disagree





1 2 3 4

37




1 2 3 4




1 2 3 4





1 2 3 4







1 2 3 4



ij gksrk gS

1 2 3 4




dgrh gWawa



1 2 3 4

PNC




1 2 3 4



feyuk vke ckr gS

1 2 3 4





1 2 3 4

Family Planning

38



dks vPNk ekurs gSa

1 2 3 4





djrh gWaw

1 2 3 4





1 2 3 4



dqN yxkrs gS

1 2 3 4



1 2 3 4





1 2 3 4





fiykk tkrk gS

1 2 3 4





gS

1 2 3 4





1 2 3 4


39





1 2 3 4






1 2 3 4




1 2 3 4





1 2 3 4




1 2 3 4



mckyrs gSa

1 2 3 4




1 2 3 4




1 2 3 4



dk leFkZu djsaxs

1 2 3 4





1 2 3 4


40



















1

2

3

4

5

911









1

2

3

4

5




सलया था

Days ____

दिन______







Yes gka

No ugha

1

2

909





has an emergency A


41





Aacutelo dh rSkjh





dkZdze k vU kstuk


lkQ vkSj lqjfkr tUe







Breastfeeding J

Lruiku


iwjd vkgkj

Immunizations L

Vhdkdjk

Family planning M

ifjokj fukstu

Sanitationhygiene N

LoPNrk

other (specify) X




community group


Yes हा______________1

No नही_______________2



Number __________

सखया




Yes हा______________1

No_ नही______________2

42

community group






fyk

Yes


1

2

3

911

911





ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X





1

2




Yes gka

No ugha

1

2



djrh gSa

Yes gka

No ugha


1

2

3



gS

Yes gka

No ugha

1

2

916


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


11








Yes gka

No ugha

1










tablets



ककया

Number of days










Yes gka

No ugha

1

2



Anganwadi centre


Yes gka

No ugha

1

2

12




house



समली

Number of times



221 During the last

pregnancy did you




workers (ASHA

ANM AWW Doctor)

or other women from


Dk vkius fuEufyf[kr

ij de ls de d ckj


ue] vkaxuokMh


vius leqnk dh vU

efgykvksa kjk lykg

izkIr की

Who provided the


feyh

Health worker

(ASHA ANM


MCYq MCYq]

MkDVjfrac12 1

Community group


lnL2

Both

Yes

हाा No

नह 222

Who gave you


HW 2 ndash

Community

group member

3 ndash Both)



1 2 1 2 3





1 2

1 2 3


dks xeZ j[kuk 1 2

1 2 3





j[kukA

1 2

1 2 3




1 2

1 2 3 9


fMfyojh fdV 1 2

1 2 3 9






1 2 3- 9

13

nksuks3

Other अनय 9



1 2 1 2 3 9


1 2 1 2 3 9


1 2 1 2 3 9


Village Health

Nutrition Days

(VHNDs) during your

pregnancy




Yes gka

No ugha

1

2




VHND meeting













lqfokk dsanz es gks

At home kj ij



1

2

3


14




fdlls




No ugha

1

2

3




Yes gka

No ugha

1

2







1

2

3





Yes No


during childbirth


mifLFfr jgsa

1 2



1 2


1 2


1 2


1 2

15










Yes हा

No नही




igpku dh Fkh

1 2



1 2





to


NAME]



IF UNABLE TO

DETERMINE IF A

HOSPITAL HEALTH

CENTRE OR CLINIC IS

PUBLIC OR PRIVATE

MEDICAL SECTOR

WRITE THE NAME OF

THE PLACE


HOME

Your home vkidk kj


Other home vU kj








Sub-center mi dsUnz


NGO SECTOR


PVT MEDICAL SECTOR


1

2

3

4

5

6

7

8

9

10

11

12

16



lqfokksa

13



djkh Fkh





ANM u e




No one dksbZ ugha


A

B

C

D

E

F

G

H

X

I



yksx Fks






No one dksbZ ugha

A

B

C

D

E






1

2

3




the JSY program



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


17




INR is _____

_



account



Cash udn 1

Cheque psd 2


Other (specify) 88





_____

_







Yes gka

No ugha

1

2









18







ANM u e




No one dksbZ ugha

Other अनय

1

2

3

4

10

5

6

7

9

8



dk izksx fdk xk Fkk




ls izkIr fdk Fkk






Scissor dSaph



1

2

3

4

5

6

8

9

412



xk Fkk





izkIr fdk Fkk




uk kkxk


kkxk


kjk fnk xk kkxk





1

2

3

4

5

6

8

9



ij dqN yxkk xk Fkk

Yes gka

No ugha

1

2



dqN yxkk xk Fkk

Yes gka

No ugha

1

2


19




uky ij Dk yxk Fkk

CODE ALL THAT

APPLY





Sindoor flUnwj






Cowdung xk dk xkscj


A

B

C

D

E

F

G

H

I

J

X




yxk Fkk




Sindoor flUnwj






Cowdung xk dk xkscj


A

B

C

D

E

F

G

H

I

J

X










Question Answers





Hours kVs

________________

Days fnu

_________________


fiykk

Yes gka

No ugha

1

2


20




fiykk Fkk





hour


H Hours घट ___________

D Days दिन ____________

0




Yes gka

No ugha

1

2


421 What was [CHILD

NAME] given


fnk xk Fkk

PROBE Anything

else

dqN vkSj










A

B

C

D

E

F

G

H

I

J

X






Yes gka

No ugha

1

2


21






nwk fiykk Fkk





pht ugha nh








Bwals fuIiy frac12







gS


gqvk Fkk





jgk Fkk



OTHER (SPECIFY) vU





Yes gka

No ugha

1

2

22






EACH











fiykk gS

If 427A_1 =2 skip to 427A_2

Liquids Yes हा

No नही

Yes हा

No नही




1 2 1 2



tkuoj dk nwkfrac12

1 2 1 2




vkWjsUt is

1 2 1 2



1 2 1 2





Yes gka

No ugha

1

2





kq fdk Fkk


_____

_







ckj nsrh gSa 2


23




nsrh gSa

SINGLE CODING ONLY




4











Yes gka

No ugha

1

2







ASHA vkrsquokk

ANM ue



A

B

C

X





vks

Days Fnu

Weeks

_____













vkids kj vks Fks

Yes gka

No ugha




1

2

3

4

502

502


24







vks

Days


suffer from





Ever


(A)

Currently


(B)

Did the

child

recieve


(C)


(D)

Diarrohea

(with fever

lethargy

persistent

vomitting

and blood in



1 हा


A B C D E

Pneumonia

(Ill with

rapid short

breathing

fever amp



1 हा


A B C D E

25


Kala azar



1 हा


A B C D E








Yes gka

No ugha

1

2



written down





01

02

03

506

506




Vhdk yxokk gS

Yes हाा

No नह ी

BCG chlhth 1 2


le fnk xk

1 2


DPT MhihVh 1 1 2


DPT MhihVh 2 1 2


DPT MhihVh 3 1 2

26

Measles [kljk 1 2


1 2



ntZ ugha gS







Yes gka

No ugha

1

2








Yes gka

No ugha

1

2




Yes gka

No ugha

1

2



igyk yxk Fkk

Yes gka

No ugha

1

2





Number la[k

_____




Yes gka

No ugha

1

2


27





Number la[k

_____



Yes gka

No ugha

1

2



Yes gka

No ugha

1

2


ldrs gSs






gS





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

If 602a=1 or 602b=1 skip to 605





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

28






Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2







Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




izksx dj ldrs gS

Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1


29


jgs gS














L



[CHILD NAME] wanted



1

2

3


about the future




(more) children





vkSj cPpk pkgsaxs





1

2

3

4





1

2

3

4

5

30







1 2

1 2

1 2

1 2

1 2

1 2

1 2








Yes gka

No ugha

1

2

701

b


washing to you



Yes

No

1

2




PROBE Anyone else





f[kykus ls igys




A

B

C

D

X

Y

Z

31





pkfg

PROBE Anyone else














None dksbZ Hkh ugha

A

B

C

D

E

F

G

H

I

J

X

Y




Yes gka

No ugha

1

2

706







PROBE Anyone else










ckn





A

B

C

D

E

F

G

H

I

J

K

X










1

2

3

4

32









707


706

b



soapwater and

surfashoilother)




lkcquikuh vkSj


CODE ONE ONLY








706c




hands with soap




706

d





33


NAME] passed stools





xk Fkk





Buried tyk fnk Fkk


Other vU

1

2

3

4

5

6

7



members of your

household



lzregr Dk gS











pSuyfrac12


1

2

3

4

5

6

7

8

9

10

11

12

13

14

712




gS


Elsewhere vU=

1

2

712






fdruk le yxrk gS


__

__



txg ij dkSu tkrk gS


1

2

3

4

34


future use (for use




Yes gka

No ugha

1

2

715











1

2

3

4



djds dgkWa j[krs gS



1

2





cukrh gSa

Yes gka

No ugha

1

2

717




drink



djrs gS


Boil mckyuk









A

B

C

D

E

F

G

X

35






ifjokj dj jgs gS












k [ksr dk bLrseky


1

2

3

4

5

6

7

8

9

10

11

12

721



facility with other



gSa

Yes gka

No ugha

1

2

720





Number la[k



including children







ikl

Yes gka

No ugha

1

2

36



dSls fuiVkrs gS


In a drain ukys esa



1

2

3

4

5






vki tgka jgrs gSa

Yes gka

No ugha

1

2








A B C D




rjhds Dk gS






1

2

3

4

5



Strongly

agree

Agree lger

Disagree

असहमत

Strongly

Disagree





1 2 3 4

37




1 2 3 4




1 2 3 4





1 2 3 4







1 2 3 4



ij gksrk gS

1 2 3 4




dgrh gWawa



1 2 3 4

PNC




1 2 3 4



feyuk vke ckr gS

1 2 3 4





1 2 3 4

Family Planning

38



dks vPNk ekurs gSa

1 2 3 4





djrh gWaw

1 2 3 4





1 2 3 4



dqN yxkrs gS

1 2 3 4



1 2 3 4





1 2 3 4





fiykk tkrk gS

1 2 3 4





gS

1 2 3 4





1 2 3 4


39





1 2 3 4






1 2 3 4




1 2 3 4





1 2 3 4




1 2 3 4



mckyrs gSa

1 2 3 4




1 2 3 4




1 2 3 4



dk leFkZu djsaxs

1 2 3 4





1 2 3 4


40



















1

2

3

4

5

911









1

2

3

4

5




सलया था

Days ____

दिन______







Yes gka

No ugha

1

2

909





has an emergency A


41





Aacutelo dh rSkjh





dkZdze k vU kstuk


lkQ vkSj lqjfkr tUe







Breastfeeding J

Lruiku


iwjd vkgkj

Immunizations L

Vhdkdjk

Family planning M

ifjokj fukstu

Sanitationhygiene N

LoPNrk

other (specify) X




community group


Yes हा______________1

No नही_______________2



Number __________

सखया




Yes हा______________1

No_ नही______________2

42

community group






fyk

Yes


1

2

3

911

911





ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X





1

2




Yes gka

No ugha

1

2



djrh gSa

Yes gka

No ugha


1

2

3



gS

Yes gka

No ugha

1

2

916


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


12




house



समली

Number of times



221 During the last

pregnancy did you




workers (ASHA

ANM AWW Doctor)

or other women from


Dk vkius fuEufyf[kr

ij de ls de d ckj


ue] vkaxuokMh


vius leqnk dh vU

efgykvksa kjk lykg

izkIr की

Who provided the


feyh

Health worker

(ASHA ANM


MCYq MCYq]

MkDVjfrac12 1

Community group


lnL2

Both

Yes

हाा No

नह 222

Who gave you


HW 2 ndash

Community

group member

3 ndash Both)



1 2 1 2 3





1 2

1 2 3


dks xeZ j[kuk 1 2

1 2 3





j[kukA

1 2

1 2 3




1 2

1 2 3 9


fMfyojh fdV 1 2

1 2 3 9






1 2 3- 9

13

nksuks3

Other अनय 9



1 2 1 2 3 9


1 2 1 2 3 9


1 2 1 2 3 9


Village Health

Nutrition Days

(VHNDs) during your

pregnancy




Yes gka

No ugha

1

2




VHND meeting













lqfokk dsanz es gks

At home kj ij



1

2

3


14




fdlls




No ugha

1

2

3




Yes gka

No ugha

1

2







1

2

3





Yes No


during childbirth


mifLFfr jgsa

1 2



1 2


1 2


1 2


1 2

15










Yes हा

No नही




igpku dh Fkh

1 2



1 2





to


NAME]



IF UNABLE TO

DETERMINE IF A

HOSPITAL HEALTH

CENTRE OR CLINIC IS

PUBLIC OR PRIVATE

MEDICAL SECTOR

WRITE THE NAME OF

THE PLACE


HOME

Your home vkidk kj


Other home vU kj








Sub-center mi dsUnz


NGO SECTOR


PVT MEDICAL SECTOR


1

2

3

4

5

6

7

8

9

10

11

12

16



lqfokksa

13



djkh Fkh





ANM u e




No one dksbZ ugha


A

B

C

D

E

F

G

H

X

I



yksx Fks






No one dksbZ ugha

A

B

C

D

E






1

2

3




the JSY program



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


17




INR is _____

_



account



Cash udn 1

Cheque psd 2


Other (specify) 88





_____

_







Yes gka

No ugha

1

2









18







ANM u e




No one dksbZ ugha

Other अनय

1

2

3

4

10

5

6

7

9

8



dk izksx fdk xk Fkk




ls izkIr fdk Fkk






Scissor dSaph



1

2

3

4

5

6

8

9

412



xk Fkk





izkIr fdk Fkk




uk kkxk


kkxk


kjk fnk xk kkxk





1

2

3

4

5

6

8

9



ij dqN yxkk xk Fkk

Yes gka

No ugha

1

2



dqN yxkk xk Fkk

Yes gka

No ugha

1

2


19




uky ij Dk yxk Fkk

CODE ALL THAT

APPLY





Sindoor flUnwj






Cowdung xk dk xkscj


A

B

C

D

E

F

G

H

I

J

X




yxk Fkk




Sindoor flUnwj






Cowdung xk dk xkscj


A

B

C

D

E

F

G

H

I

J

X










Question Answers





Hours kVs

________________

Days fnu

_________________


fiykk

Yes gka

No ugha

1

2


20




fiykk Fkk





hour


H Hours घट ___________

D Days दिन ____________

0




Yes gka

No ugha

1

2


421 What was [CHILD

NAME] given


fnk xk Fkk

PROBE Anything

else

dqN vkSj










A

B

C

D

E

F

G

H

I

J

X






Yes gka

No ugha

1

2


21






nwk fiykk Fkk





pht ugha nh








Bwals fuIiy frac12







gS


gqvk Fkk





jgk Fkk



OTHER (SPECIFY) vU





Yes gka

No ugha

1

2

22






EACH











fiykk gS

If 427A_1 =2 skip to 427A_2

Liquids Yes हा

No नही

Yes हा

No नही




1 2 1 2



tkuoj dk nwkfrac12

1 2 1 2




vkWjsUt is

1 2 1 2



1 2 1 2





Yes gka

No ugha

1

2





kq fdk Fkk


_____

_







ckj nsrh gSa 2


23




nsrh gSa

SINGLE CODING ONLY




4











Yes gka

No ugha

1

2







ASHA vkrsquokk

ANM ue



A

B

C

X





vks

Days Fnu

Weeks

_____













vkids kj vks Fks

Yes gka

No ugha




1

2

3

4

502

502


24







vks

Days


suffer from





Ever


(A)

Currently


(B)

Did the

child

recieve


(C)


(D)

Diarrohea

(with fever

lethargy

persistent

vomitting

and blood in



1 हा


A B C D E

Pneumonia

(Ill with

rapid short

breathing

fever amp



1 हा


A B C D E

25


Kala azar



1 हा


A B C D E








Yes gka

No ugha

1

2



written down





01

02

03

506

506




Vhdk yxokk gS

Yes हाा

No नह ी

BCG chlhth 1 2


le fnk xk

1 2


DPT MhihVh 1 1 2


DPT MhihVh 2 1 2


DPT MhihVh 3 1 2

26

Measles [kljk 1 2


1 2



ntZ ugha gS







Yes gka

No ugha

1

2








Yes gka

No ugha

1

2




Yes gka

No ugha

1

2



igyk yxk Fkk

Yes gka

No ugha

1

2





Number la[k

_____




Yes gka

No ugha

1

2


27





Number la[k

_____



Yes gka

No ugha

1

2



Yes gka

No ugha

1

2


ldrs gSs






gS





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

If 602a=1 or 602b=1 skip to 605





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

28






Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2







Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




izksx dj ldrs gS

Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1


29


jgs gS














L



[CHILD NAME] wanted



1

2

3


about the future




(more) children





vkSj cPpk pkgsaxs





1

2

3

4





1

2

3

4

5

30







1 2

1 2

1 2

1 2

1 2

1 2

1 2








Yes gka

No ugha

1

2

701

b


washing to you



Yes

No

1

2




PROBE Anyone else





f[kykus ls igys




A

B

C

D

X

Y

Z

31





pkfg

PROBE Anyone else














None dksbZ Hkh ugha

A

B

C

D

E

F

G

H

I

J

X

Y




Yes gka

No ugha

1

2

706







PROBE Anyone else










ckn





A

B

C

D

E

F

G

H

I

J

K

X










1

2

3

4

32









707


706

b



soapwater and

surfashoilother)




lkcquikuh vkSj


CODE ONE ONLY








706c




hands with soap




706

d





33


NAME] passed stools





xk Fkk





Buried tyk fnk Fkk


Other vU

1

2

3

4

5

6

7



members of your

household



lzregr Dk gS











pSuyfrac12


1

2

3

4

5

6

7

8

9

10

11

12

13

14

712




gS


Elsewhere vU=

1

2

712






fdruk le yxrk gS


__

__



txg ij dkSu tkrk gS


1

2

3

4

34


future use (for use




Yes gka

No ugha

1

2

715











1

2

3

4



djds dgkWa j[krs gS



1

2





cukrh gSa

Yes gka

No ugha

1

2

717




drink



djrs gS


Boil mckyuk









A

B

C

D

E

F

G

X

35






ifjokj dj jgs gS












k [ksr dk bLrseky


1

2

3

4

5

6

7

8

9

10

11

12

721



facility with other



gSa

Yes gka

No ugha

1

2

720





Number la[k



including children







ikl

Yes gka

No ugha

1

2

36



dSls fuiVkrs gS


In a drain ukys esa



1

2

3

4

5






vki tgka jgrs gSa

Yes gka

No ugha

1

2








A B C D




rjhds Dk gS






1

2

3

4

5



Strongly

agree

Agree lger

Disagree

असहमत

Strongly

Disagree





1 2 3 4

37




1 2 3 4




1 2 3 4





1 2 3 4







1 2 3 4



ij gksrk gS

1 2 3 4




dgrh gWawa



1 2 3 4

PNC




1 2 3 4



feyuk vke ckr gS

1 2 3 4





1 2 3 4

Family Planning

38



dks vPNk ekurs gSa

1 2 3 4





djrh gWaw

1 2 3 4





1 2 3 4



dqN yxkrs gS

1 2 3 4



1 2 3 4





1 2 3 4





fiykk tkrk gS

1 2 3 4





gS

1 2 3 4





1 2 3 4


39





1 2 3 4






1 2 3 4




1 2 3 4





1 2 3 4




1 2 3 4



mckyrs gSa

1 2 3 4




1 2 3 4




1 2 3 4



dk leFkZu djsaxs

1 2 3 4





1 2 3 4


40



















1

2

3

4

5

911









1

2

3

4

5




सलया था

Days ____

दिन______







Yes gka

No ugha

1

2

909





has an emergency A


41





Aacutelo dh rSkjh





dkZdze k vU kstuk


lkQ vkSj lqjfkr tUe







Breastfeeding J

Lruiku


iwjd vkgkj

Immunizations L

Vhdkdjk

Family planning M

ifjokj fukstu

Sanitationhygiene N

LoPNrk

other (specify) X




community group


Yes हा______________1

No नही_______________2



Number __________

सखया




Yes हा______________1

No_ नही______________2

42

community group






fyk

Yes


1

2

3

911

911





ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X





1

2




Yes gka

No ugha

1

2



djrh gSa

Yes gka

No ugha


1

2

3



gS

Yes gka

No ugha

1

2

916


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


13

nksuks3

Other अनय 9



1 2 1 2 3 9


1 2 1 2 3 9


1 2 1 2 3 9


Village Health

Nutrition Days

(VHNDs) during your

pregnancy




Yes gka

No ugha

1

2




VHND meeting













lqfokk dsanz es gks

At home kj ij



1

2

3


14




fdlls




No ugha

1

2

3




Yes gka

No ugha

1

2







1

2

3





Yes No


during childbirth


mifLFfr jgsa

1 2



1 2


1 2


1 2


1 2

15










Yes हा

No नही




igpku dh Fkh

1 2



1 2





to


NAME]



IF UNABLE TO

DETERMINE IF A

HOSPITAL HEALTH

CENTRE OR CLINIC IS

PUBLIC OR PRIVATE

MEDICAL SECTOR

WRITE THE NAME OF

THE PLACE


HOME

Your home vkidk kj


Other home vU kj








Sub-center mi dsUnz


NGO SECTOR


PVT MEDICAL SECTOR


1

2

3

4

5

6

7

8

9

10

11

12

16



lqfokksa

13



djkh Fkh





ANM u e




No one dksbZ ugha


A

B

C

D

E

F

G

H

X

I



yksx Fks






No one dksbZ ugha

A

B

C

D

E






1

2

3




the JSY program



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


17




INR is _____

_



account



Cash udn 1

Cheque psd 2


Other (specify) 88





_____

_







Yes gka

No ugha

1

2









18







ANM u e




No one dksbZ ugha

Other अनय

1

2

3

4

10

5

6

7

9

8



dk izksx fdk xk Fkk




ls izkIr fdk Fkk






Scissor dSaph



1

2

3

4

5

6

8

9

412



xk Fkk





izkIr fdk Fkk




uk kkxk


kkxk


kjk fnk xk kkxk





1

2

3

4

5

6

8

9



ij dqN yxkk xk Fkk

Yes gka

No ugha

1

2



dqN yxkk xk Fkk

Yes gka

No ugha

1

2


19




uky ij Dk yxk Fkk

CODE ALL THAT

APPLY





Sindoor flUnwj






Cowdung xk dk xkscj


A

B

C

D

E

F

G

H

I

J

X




yxk Fkk




Sindoor flUnwj






Cowdung xk dk xkscj


A

B

C

D

E

F

G

H

I

J

X










Question Answers





Hours kVs

________________

Days fnu

_________________


fiykk

Yes gka

No ugha

1

2


20




fiykk Fkk





hour


H Hours घट ___________

D Days दिन ____________

0




Yes gka

No ugha

1

2


421 What was [CHILD

NAME] given


fnk xk Fkk

PROBE Anything

else

dqN vkSj










A

B

C

D

E

F

G

H

I

J

X






Yes gka

No ugha

1

2


21






nwk fiykk Fkk





pht ugha nh








Bwals fuIiy frac12







gS


gqvk Fkk





jgk Fkk



OTHER (SPECIFY) vU





Yes gka

No ugha

1

2

22






EACH











fiykk gS

If 427A_1 =2 skip to 427A_2

Liquids Yes हा

No नही

Yes हा

No नही




1 2 1 2



tkuoj dk nwkfrac12

1 2 1 2




vkWjsUt is

1 2 1 2



1 2 1 2





Yes gka

No ugha

1

2





kq fdk Fkk


_____

_







ckj nsrh gSa 2


23




nsrh gSa

SINGLE CODING ONLY




4











Yes gka

No ugha

1

2







ASHA vkrsquokk

ANM ue



A

B

C

X





vks

Days Fnu

Weeks

_____













vkids kj vks Fks

Yes gka

No ugha




1

2

3

4

502

502


24







vks

Days


suffer from





Ever


(A)

Currently


(B)

Did the

child

recieve


(C)


(D)

Diarrohea

(with fever

lethargy

persistent

vomitting

and blood in



1 हा


A B C D E

Pneumonia

(Ill with

rapid short

breathing

fever amp



1 हा


A B C D E

25


Kala azar



1 हा


A B C D E








Yes gka

No ugha

1

2



written down





01

02

03

506

506




Vhdk yxokk gS

Yes हाा

No नह ी

BCG chlhth 1 2


le fnk xk

1 2


DPT MhihVh 1 1 2


DPT MhihVh 2 1 2


DPT MhihVh 3 1 2

26

Measles [kljk 1 2


1 2



ntZ ugha gS







Yes gka

No ugha

1

2








Yes gka

No ugha

1

2




Yes gka

No ugha

1

2



igyk yxk Fkk

Yes gka

No ugha

1

2





Number la[k

_____




Yes gka

No ugha

1

2


27





Number la[k

_____



Yes gka

No ugha

1

2



Yes gka

No ugha

1

2


ldrs gSs






gS





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

If 602a=1 or 602b=1 skip to 605





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

28






Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2







Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




izksx dj ldrs gS

Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1


29


jgs gS














L



[CHILD NAME] wanted



1

2

3


about the future




(more) children





vkSj cPpk pkgsaxs





1

2

3

4





1

2

3

4

5

30







1 2

1 2

1 2

1 2

1 2

1 2

1 2








Yes gka

No ugha

1

2

701

b


washing to you



Yes

No

1

2




PROBE Anyone else





f[kykus ls igys




A

B

C

D

X

Y

Z

31





pkfg

PROBE Anyone else














None dksbZ Hkh ugha

A

B

C

D

E

F

G

H

I

J

X

Y




Yes gka

No ugha

1

2

706







PROBE Anyone else










ckn





A

B

C

D

E

F

G

H

I

J

K

X










1

2

3

4

32









707


706

b



soapwater and

surfashoilother)




lkcquikuh vkSj


CODE ONE ONLY








706c




hands with soap




706

d





33


NAME] passed stools





xk Fkk





Buried tyk fnk Fkk


Other vU

1

2

3

4

5

6

7



members of your

household



lzregr Dk gS











pSuyfrac12


1

2

3

4

5

6

7

8

9

10

11

12

13

14

712




gS


Elsewhere vU=

1

2

712






fdruk le yxrk gS


__

__



txg ij dkSu tkrk gS


1

2

3

4

34


future use (for use




Yes gka

No ugha

1

2

715











1

2

3

4



djds dgkWa j[krs gS



1

2





cukrh gSa

Yes gka

No ugha

1

2

717




drink



djrs gS


Boil mckyuk









A

B

C

D

E

F

G

X

35






ifjokj dj jgs gS












k [ksr dk bLrseky


1

2

3

4

5

6

7

8

9

10

11

12

721



facility with other



gSa

Yes gka

No ugha

1

2

720





Number la[k



including children







ikl

Yes gka

No ugha

1

2

36



dSls fuiVkrs gS


In a drain ukys esa



1

2

3

4

5






vki tgka jgrs gSa

Yes gka

No ugha

1

2








A B C D




rjhds Dk gS






1

2

3

4

5



Strongly

agree

Agree lger

Disagree

असहमत

Strongly

Disagree





1 2 3 4

37




1 2 3 4




1 2 3 4





1 2 3 4







1 2 3 4



ij gksrk gS

1 2 3 4




dgrh gWawa



1 2 3 4

PNC




1 2 3 4



feyuk vke ckr gS

1 2 3 4





1 2 3 4

Family Planning

38



dks vPNk ekurs gSa

1 2 3 4





djrh gWaw

1 2 3 4





1 2 3 4



dqN yxkrs gS

1 2 3 4



1 2 3 4





1 2 3 4





fiykk tkrk gS

1 2 3 4





gS

1 2 3 4





1 2 3 4


39





1 2 3 4






1 2 3 4




1 2 3 4





1 2 3 4




1 2 3 4



mckyrs gSa

1 2 3 4




1 2 3 4




1 2 3 4



dk leFkZu djsaxs

1 2 3 4





1 2 3 4


40



















1

2

3

4

5

911









1

2

3

4

5




सलया था

Days ____

दिन______







Yes gka

No ugha

1

2

909





has an emergency A


41





Aacutelo dh rSkjh





dkZdze k vU kstuk


lkQ vkSj lqjfkr tUe







Breastfeeding J

Lruiku


iwjd vkgkj

Immunizations L

Vhdkdjk

Family planning M

ifjokj fukstu

Sanitationhygiene N

LoPNrk

other (specify) X




community group


Yes हा______________1

No नही_______________2



Number __________

सखया




Yes हा______________1

No_ नही______________2

42

community group






fyk

Yes


1

2

3

911

911





ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X





1

2




Yes gka

No ugha

1

2



djrh gSa

Yes gka

No ugha


1

2

3



gS

Yes gka

No ugha

1

2

916


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


14




fdlls




No ugha

1

2

3




Yes gka

No ugha

1

2







1

2

3





Yes No


during childbirth


mifLFfr jgsa

1 2



1 2


1 2


1 2


1 2

15










Yes हा

No नही




igpku dh Fkh

1 2



1 2





to


NAME]



IF UNABLE TO

DETERMINE IF A

HOSPITAL HEALTH

CENTRE OR CLINIC IS

PUBLIC OR PRIVATE

MEDICAL SECTOR

WRITE THE NAME OF

THE PLACE


HOME

Your home vkidk kj


Other home vU kj








Sub-center mi dsUnz


NGO SECTOR


PVT MEDICAL SECTOR


1

2

3

4

5

6

7

8

9

10

11

12

16



lqfokksa

13



djkh Fkh





ANM u e




No one dksbZ ugha


A

B

C

D

E

F

G

H

X

I



yksx Fks






No one dksbZ ugha

A

B

C

D

E






1

2

3




the JSY program



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


17




INR is _____

_



account



Cash udn 1

Cheque psd 2


Other (specify) 88





_____

_







Yes gka

No ugha

1

2









18







ANM u e




No one dksbZ ugha

Other अनय

1

2

3

4

10

5

6

7

9

8



dk izksx fdk xk Fkk




ls izkIr fdk Fkk






Scissor dSaph



1

2

3

4

5

6

8

9

412



xk Fkk





izkIr fdk Fkk




uk kkxk


kkxk


kjk fnk xk kkxk





1

2

3

4

5

6

8

9



ij dqN yxkk xk Fkk

Yes gka

No ugha

1

2



dqN yxkk xk Fkk

Yes gka

No ugha

1

2


19




uky ij Dk yxk Fkk

CODE ALL THAT

APPLY





Sindoor flUnwj






Cowdung xk dk xkscj


A

B

C

D

E

F

G

H

I

J

X




yxk Fkk




Sindoor flUnwj






Cowdung xk dk xkscj


A

B

C

D

E

F

G

H

I

J

X










Question Answers





Hours kVs

________________

Days fnu

_________________


fiykk

Yes gka

No ugha

1

2


20




fiykk Fkk





hour


H Hours घट ___________

D Days दिन ____________

0




Yes gka

No ugha

1

2


421 What was [CHILD

NAME] given


fnk xk Fkk

PROBE Anything

else

dqN vkSj










A

B

C

D

E

F

G

H

I

J

X






Yes gka

No ugha

1

2


21






nwk fiykk Fkk





pht ugha nh








Bwals fuIiy frac12







gS


gqvk Fkk





jgk Fkk



OTHER (SPECIFY) vU





Yes gka

No ugha

1

2

22






EACH











fiykk gS

If 427A_1 =2 skip to 427A_2

Liquids Yes हा

No नही

Yes हा

No नही




1 2 1 2



tkuoj dk nwkfrac12

1 2 1 2




vkWjsUt is

1 2 1 2



1 2 1 2





Yes gka

No ugha

1

2





kq fdk Fkk


_____

_







ckj nsrh gSa 2


23




nsrh gSa

SINGLE CODING ONLY




4











Yes gka

No ugha

1

2







ASHA vkrsquokk

ANM ue



A

B

C

X





vks

Days Fnu

Weeks

_____













vkids kj vks Fks

Yes gka

No ugha




1

2

3

4

502

502


24







vks

Days


suffer from





Ever


(A)

Currently


(B)

Did the

child

recieve


(C)


(D)

Diarrohea

(with fever

lethargy

persistent

vomitting

and blood in



1 हा


A B C D E

Pneumonia

(Ill with

rapid short

breathing

fever amp



1 हा


A B C D E

25


Kala azar



1 हा


A B C D E








Yes gka

No ugha

1

2



written down





01

02

03

506

506




Vhdk yxokk gS

Yes हाा

No नह ी

BCG chlhth 1 2


le fnk xk

1 2


DPT MhihVh 1 1 2


DPT MhihVh 2 1 2


DPT MhihVh 3 1 2

26

Measles [kljk 1 2


1 2



ntZ ugha gS







Yes gka

No ugha

1

2








Yes gka

No ugha

1

2




Yes gka

No ugha

1

2



igyk yxk Fkk

Yes gka

No ugha

1

2





Number la[k

_____




Yes gka

No ugha

1

2


27





Number la[k

_____



Yes gka

No ugha

1

2



Yes gka

No ugha

1

2


ldrs gSs






gS





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

If 602a=1 or 602b=1 skip to 605





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

28






Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2







Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




izksx dj ldrs gS

Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1


29


jgs gS














L



[CHILD NAME] wanted



1

2

3


about the future




(more) children





vkSj cPpk pkgsaxs





1

2

3

4





1

2

3

4

5

30







1 2

1 2

1 2

1 2

1 2

1 2

1 2








Yes gka

No ugha

1

2

701

b


washing to you



Yes

No

1

2




PROBE Anyone else





f[kykus ls igys




A

B

C

D

X

Y

Z

31





pkfg

PROBE Anyone else














None dksbZ Hkh ugha

A

B

C

D

E

F

G

H

I

J

X

Y




Yes gka

No ugha

1

2

706







PROBE Anyone else










ckn





A

B

C

D

E

F

G

H

I

J

K

X










1

2

3

4

32









707


706

b



soapwater and

surfashoilother)




lkcquikuh vkSj


CODE ONE ONLY








706c




hands with soap




706

d





33


NAME] passed stools





xk Fkk





Buried tyk fnk Fkk


Other vU

1

2

3

4

5

6

7



members of your

household



lzregr Dk gS











pSuyfrac12


1

2

3

4

5

6

7

8

9

10

11

12

13

14

712




gS


Elsewhere vU=

1

2

712






fdruk le yxrk gS


__

__



txg ij dkSu tkrk gS


1

2

3

4

34


future use (for use




Yes gka

No ugha

1

2

715











1

2

3

4



djds dgkWa j[krs gS



1

2





cukrh gSa

Yes gka

No ugha

1

2

717




drink



djrs gS


Boil mckyuk









A

B

C

D

E

F

G

X

35






ifjokj dj jgs gS












k [ksr dk bLrseky


1

2

3

4

5

6

7

8

9

10

11

12

721



facility with other



gSa

Yes gka

No ugha

1

2

720





Number la[k



including children







ikl

Yes gka

No ugha

1

2

36



dSls fuiVkrs gS


In a drain ukys esa



1

2

3

4

5






vki tgka jgrs gSa

Yes gka

No ugha

1

2








A B C D




rjhds Dk gS






1

2

3

4

5



Strongly

agree

Agree lger

Disagree

असहमत

Strongly

Disagree





1 2 3 4

37




1 2 3 4




1 2 3 4





1 2 3 4







1 2 3 4



ij gksrk gS

1 2 3 4




dgrh gWawa



1 2 3 4

PNC




1 2 3 4



feyuk vke ckr gS

1 2 3 4





1 2 3 4

Family Planning

38



dks vPNk ekurs gSa

1 2 3 4





djrh gWaw

1 2 3 4





1 2 3 4



dqN yxkrs gS

1 2 3 4



1 2 3 4





1 2 3 4





fiykk tkrk gS

1 2 3 4





gS

1 2 3 4





1 2 3 4


39





1 2 3 4






1 2 3 4




1 2 3 4





1 2 3 4




1 2 3 4



mckyrs gSa

1 2 3 4




1 2 3 4




1 2 3 4



dk leFkZu djsaxs

1 2 3 4





1 2 3 4


40



















1

2

3

4

5

911









1

2

3

4

5




सलया था

Days ____

दिन______







Yes gka

No ugha

1

2

909





has an emergency A


41





Aacutelo dh rSkjh





dkZdze k vU kstuk


lkQ vkSj lqjfkr tUe







Breastfeeding J

Lruiku


iwjd vkgkj

Immunizations L

Vhdkdjk

Family planning M

ifjokj fukstu

Sanitationhygiene N

LoPNrk

other (specify) X




community group


Yes हा______________1

No नही_______________2



Number __________

सखया




Yes हा______________1

No_ नही______________2

42

community group






fyk

Yes


1

2

3

911

911





ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X





1

2




Yes gka

No ugha

1

2



djrh gSa

Yes gka

No ugha


1

2

3



gS

Yes gka

No ugha

1

2

916


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


15










Yes हा

No नही




igpku dh Fkh

1 2



1 2





to


NAME]



IF UNABLE TO

DETERMINE IF A

HOSPITAL HEALTH

CENTRE OR CLINIC IS

PUBLIC OR PRIVATE

MEDICAL SECTOR

WRITE THE NAME OF

THE PLACE


HOME

Your home vkidk kj


Other home vU kj








Sub-center mi dsUnz


NGO SECTOR


PVT MEDICAL SECTOR


1

2

3

4

5

6

7

8

9

10

11

12

16



lqfokksa

13



djkh Fkh





ANM u e




No one dksbZ ugha


A

B

C

D

E

F

G

H

X

I



yksx Fks






No one dksbZ ugha

A

B

C

D

E






1

2

3




the JSY program



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


17




INR is _____

_



account



Cash udn 1

Cheque psd 2


Other (specify) 88





_____

_







Yes gka

No ugha

1

2









18







ANM u e




No one dksbZ ugha

Other अनय

1

2

3

4

10

5

6

7

9

8



dk izksx fdk xk Fkk




ls izkIr fdk Fkk






Scissor dSaph



1

2

3

4

5

6

8

9

412



xk Fkk





izkIr fdk Fkk




uk kkxk


kkxk


kjk fnk xk kkxk





1

2

3

4

5

6

8

9



ij dqN yxkk xk Fkk

Yes gka

No ugha

1

2



dqN yxkk xk Fkk

Yes gka

No ugha

1

2


19




uky ij Dk yxk Fkk

CODE ALL THAT

APPLY





Sindoor flUnwj






Cowdung xk dk xkscj


A

B

C

D

E

F

G

H

I

J

X




yxk Fkk




Sindoor flUnwj






Cowdung xk dk xkscj


A

B

C

D

E

F

G

H

I

J

X










Question Answers





Hours kVs

________________

Days fnu

_________________


fiykk

Yes gka

No ugha

1

2


20




fiykk Fkk





hour


H Hours घट ___________

D Days दिन ____________

0




Yes gka

No ugha

1

2


421 What was [CHILD

NAME] given


fnk xk Fkk

PROBE Anything

else

dqN vkSj










A

B

C

D

E

F

G

H

I

J

X






Yes gka

No ugha

1

2


21






nwk fiykk Fkk





pht ugha nh








Bwals fuIiy frac12







gS


gqvk Fkk





jgk Fkk



OTHER (SPECIFY) vU





Yes gka

No ugha

1

2

22






EACH











fiykk gS

If 427A_1 =2 skip to 427A_2

Liquids Yes हा

No नही

Yes हा

No नही




1 2 1 2



tkuoj dk nwkfrac12

1 2 1 2




vkWjsUt is

1 2 1 2



1 2 1 2





Yes gka

No ugha

1

2





kq fdk Fkk


_____

_







ckj nsrh gSa 2


23




nsrh gSa

SINGLE CODING ONLY




4











Yes gka

No ugha

1

2







ASHA vkrsquokk

ANM ue



A

B

C

X





vks

Days Fnu

Weeks

_____













vkids kj vks Fks

Yes gka

No ugha




1

2

3

4

502

502


24







vks

Days


suffer from





Ever


(A)

Currently


(B)

Did the

child

recieve


(C)


(D)

Diarrohea

(with fever

lethargy

persistent

vomitting

and blood in



1 हा


A B C D E

Pneumonia

(Ill with

rapid short

breathing

fever amp



1 हा


A B C D E

25


Kala azar



1 हा


A B C D E








Yes gka

No ugha

1

2



written down





01

02

03

506

506




Vhdk yxokk gS

Yes हाा

No नह ी

BCG chlhth 1 2


le fnk xk

1 2


DPT MhihVh 1 1 2


DPT MhihVh 2 1 2


DPT MhihVh 3 1 2

26

Measles [kljk 1 2


1 2



ntZ ugha gS







Yes gka

No ugha

1

2








Yes gka

No ugha

1

2




Yes gka

No ugha

1

2



igyk yxk Fkk

Yes gka

No ugha

1

2





Number la[k

_____




Yes gka

No ugha

1

2


27





Number la[k

_____



Yes gka

No ugha

1

2



Yes gka

No ugha

1

2


ldrs gSs






gS





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

If 602a=1 or 602b=1 skip to 605





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

28






Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2







Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




izksx dj ldrs gS

Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1


29


jgs gS














L



[CHILD NAME] wanted



1

2

3


about the future




(more) children





vkSj cPpk pkgsaxs





1

2

3

4





1

2

3

4

5

30







1 2

1 2

1 2

1 2

1 2

1 2

1 2








Yes gka

No ugha

1

2

701

b


washing to you



Yes

No

1

2




PROBE Anyone else





f[kykus ls igys




A

B

C

D

X

Y

Z

31





pkfg

PROBE Anyone else














None dksbZ Hkh ugha

A

B

C

D

E

F

G

H

I

J

X

Y




Yes gka

No ugha

1

2

706







PROBE Anyone else










ckn





A

B

C

D

E

F

G

H

I

J

K

X










1

2

3

4

32









707


706

b



soapwater and

surfashoilother)




lkcquikuh vkSj


CODE ONE ONLY








706c




hands with soap




706

d





33


NAME] passed stools





xk Fkk





Buried tyk fnk Fkk


Other vU

1

2

3

4

5

6

7



members of your

household



lzregr Dk gS











pSuyfrac12


1

2

3

4

5

6

7

8

9

10

11

12

13

14

712




gS


Elsewhere vU=

1

2

712






fdruk le yxrk gS


__

__



txg ij dkSu tkrk gS


1

2

3

4

34


future use (for use




Yes gka

No ugha

1

2

715











1

2

3

4



djds dgkWa j[krs gS



1

2





cukrh gSa

Yes gka

No ugha

1

2

717




drink



djrs gS


Boil mckyuk









A

B

C

D

E

F

G

X

35






ifjokj dj jgs gS












k [ksr dk bLrseky


1

2

3

4

5

6

7

8

9

10

11

12

721



facility with other



gSa

Yes gka

No ugha

1

2

720





Number la[k



including children







ikl

Yes gka

No ugha

1

2

36



dSls fuiVkrs gS


In a drain ukys esa



1

2

3

4

5






vki tgka jgrs gSa

Yes gka

No ugha

1

2








A B C D




rjhds Dk gS






1

2

3

4

5



Strongly

agree

Agree lger

Disagree

असहमत

Strongly

Disagree





1 2 3 4

37




1 2 3 4




1 2 3 4





1 2 3 4







1 2 3 4



ij gksrk gS

1 2 3 4




dgrh gWawa



1 2 3 4

PNC




1 2 3 4



feyuk vke ckr gS

1 2 3 4





1 2 3 4

Family Planning

38



dks vPNk ekurs gSa

1 2 3 4





djrh gWaw

1 2 3 4





1 2 3 4



dqN yxkrs gS

1 2 3 4



1 2 3 4





1 2 3 4





fiykk tkrk gS

1 2 3 4





gS

1 2 3 4





1 2 3 4


39





1 2 3 4






1 2 3 4




1 2 3 4





1 2 3 4




1 2 3 4



mckyrs gSa

1 2 3 4




1 2 3 4




1 2 3 4



dk leFkZu djsaxs

1 2 3 4





1 2 3 4


40



















1

2

3

4

5

911









1

2

3

4

5




सलया था

Days ____

दिन______







Yes gka

No ugha

1

2

909





has an emergency A


41





Aacutelo dh rSkjh





dkZdze k vU kstuk


lkQ vkSj lqjfkr tUe







Breastfeeding J

Lruiku


iwjd vkgkj

Immunizations L

Vhdkdjk

Family planning M

ifjokj fukstu

Sanitationhygiene N

LoPNrk

other (specify) X




community group


Yes हा______________1

No नही_______________2



Number __________

सखया




Yes हा______________1

No_ नही______________2

42

community group






fyk

Yes


1

2

3

911

911





ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X





1

2




Yes gka

No ugha

1

2



djrh gSa

Yes gka

No ugha


1

2

3



gS

Yes gka

No ugha

1

2

916


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


16



lqfokksa

13



djkh Fkh





ANM u e




No one dksbZ ugha


A

B

C

D

E

F

G

H

X

I



yksx Fks






No one dksbZ ugha

A

B

C

D

E






1

2

3




the JSY program



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


17




INR is _____

_



account



Cash udn 1

Cheque psd 2


Other (specify) 88





_____

_







Yes gka

No ugha

1

2









18







ANM u e




No one dksbZ ugha

Other अनय

1

2

3

4

10

5

6

7

9

8



dk izksx fdk xk Fkk




ls izkIr fdk Fkk






Scissor dSaph



1

2

3

4

5

6

8

9

412



xk Fkk





izkIr fdk Fkk




uk kkxk


kkxk


kjk fnk xk kkxk





1

2

3

4

5

6

8

9



ij dqN yxkk xk Fkk

Yes gka

No ugha

1

2



dqN yxkk xk Fkk

Yes gka

No ugha

1

2


19




uky ij Dk yxk Fkk

CODE ALL THAT

APPLY





Sindoor flUnwj






Cowdung xk dk xkscj


A

B

C

D

E

F

G

H

I

J

X




yxk Fkk




Sindoor flUnwj






Cowdung xk dk xkscj


A

B

C

D

E

F

G

H

I

J

X










Question Answers





Hours kVs

________________

Days fnu

_________________


fiykk

Yes gka

No ugha

1

2


20




fiykk Fkk





hour


H Hours घट ___________

D Days दिन ____________

0




Yes gka

No ugha

1

2


421 What was [CHILD

NAME] given


fnk xk Fkk

PROBE Anything

else

dqN vkSj










A

B

C

D

E

F

G

H

I

J

X






Yes gka

No ugha

1

2


21






nwk fiykk Fkk





pht ugha nh








Bwals fuIiy frac12







gS


gqvk Fkk





jgk Fkk



OTHER (SPECIFY) vU





Yes gka

No ugha

1

2

22






EACH











fiykk gS

If 427A_1 =2 skip to 427A_2

Liquids Yes हा

No नही

Yes हा

No नही




1 2 1 2



tkuoj dk nwkfrac12

1 2 1 2




vkWjsUt is

1 2 1 2



1 2 1 2





Yes gka

No ugha

1

2





kq fdk Fkk


_____

_







ckj nsrh gSa 2


23




nsrh gSa

SINGLE CODING ONLY




4











Yes gka

No ugha

1

2







ASHA vkrsquokk

ANM ue



A

B

C

X





vks

Days Fnu

Weeks

_____













vkids kj vks Fks

Yes gka

No ugha




1

2

3

4

502

502


24







vks

Days


suffer from





Ever


(A)

Currently


(B)

Did the

child

recieve


(C)


(D)

Diarrohea

(with fever

lethargy

persistent

vomitting

and blood in



1 हा


A B C D E

Pneumonia

(Ill with

rapid short

breathing

fever amp



1 हा


A B C D E

25


Kala azar



1 हा


A B C D E








Yes gka

No ugha

1

2



written down





01

02

03

506

506




Vhdk yxokk gS

Yes हाा

No नह ी

BCG chlhth 1 2


le fnk xk

1 2


DPT MhihVh 1 1 2


DPT MhihVh 2 1 2


DPT MhihVh 3 1 2

26

Measles [kljk 1 2


1 2



ntZ ugha gS







Yes gka

No ugha

1

2








Yes gka

No ugha

1

2




Yes gka

No ugha

1

2



igyk yxk Fkk

Yes gka

No ugha

1

2





Number la[k

_____




Yes gka

No ugha

1

2


27





Number la[k

_____



Yes gka

No ugha

1

2



Yes gka

No ugha

1

2


ldrs gSs






gS





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

If 602a=1 or 602b=1 skip to 605





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

28






Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2







Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




izksx dj ldrs gS

Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1


29


jgs gS














L



[CHILD NAME] wanted



1

2

3


about the future




(more) children





vkSj cPpk pkgsaxs





1

2

3

4





1

2

3

4

5

30







1 2

1 2

1 2

1 2

1 2

1 2

1 2








Yes gka

No ugha

1

2

701

b


washing to you



Yes

No

1

2




PROBE Anyone else





f[kykus ls igys




A

B

C

D

X

Y

Z

31





pkfg

PROBE Anyone else














None dksbZ Hkh ugha

A

B

C

D

E

F

G

H

I

J

X

Y




Yes gka

No ugha

1

2

706







PROBE Anyone else










ckn





A

B

C

D

E

F

G

H

I

J

K

X










1

2

3

4

32









707


706

b



soapwater and

surfashoilother)




lkcquikuh vkSj


CODE ONE ONLY








706c




hands with soap




706

d





33


NAME] passed stools





xk Fkk





Buried tyk fnk Fkk


Other vU

1

2

3

4

5

6

7



members of your

household



lzregr Dk gS











pSuyfrac12


1

2

3

4

5

6

7

8

9

10

11

12

13

14

712




gS


Elsewhere vU=

1

2

712






fdruk le yxrk gS


__

__



txg ij dkSu tkrk gS


1

2

3

4

34


future use (for use




Yes gka

No ugha

1

2

715











1

2

3

4



djds dgkWa j[krs gS



1

2





cukrh gSa

Yes gka

No ugha

1

2

717




drink



djrs gS


Boil mckyuk









A

B

C

D

E

F

G

X

35






ifjokj dj jgs gS












k [ksr dk bLrseky


1

2

3

4

5

6

7

8

9

10

11

12

721



facility with other



gSa

Yes gka

No ugha

1

2

720





Number la[k



including children







ikl

Yes gka

No ugha

1

2

36



dSls fuiVkrs gS


In a drain ukys esa



1

2

3

4

5






vki tgka jgrs gSa

Yes gka

No ugha

1

2








A B C D




rjhds Dk gS






1

2

3

4

5



Strongly

agree

Agree lger

Disagree

असहमत

Strongly

Disagree





1 2 3 4

37




1 2 3 4




1 2 3 4





1 2 3 4







1 2 3 4



ij gksrk gS

1 2 3 4




dgrh gWawa



1 2 3 4

PNC




1 2 3 4



feyuk vke ckr gS

1 2 3 4





1 2 3 4

Family Planning

38



dks vPNk ekurs gSa

1 2 3 4





djrh gWaw

1 2 3 4





1 2 3 4



dqN yxkrs gS

1 2 3 4



1 2 3 4





1 2 3 4





fiykk tkrk gS

1 2 3 4





gS

1 2 3 4





1 2 3 4


39





1 2 3 4






1 2 3 4




1 2 3 4





1 2 3 4




1 2 3 4



mckyrs gSa

1 2 3 4




1 2 3 4




1 2 3 4



dk leFkZu djsaxs

1 2 3 4





1 2 3 4


40



















1

2

3

4

5

911









1

2

3

4

5




सलया था

Days ____

दिन______







Yes gka

No ugha

1

2

909





has an emergency A


41





Aacutelo dh rSkjh





dkZdze k vU kstuk


lkQ vkSj lqjfkr tUe







Breastfeeding J

Lruiku


iwjd vkgkj

Immunizations L

Vhdkdjk

Family planning M

ifjokj fukstu

Sanitationhygiene N

LoPNrk

other (specify) X




community group


Yes हा______________1

No नही_______________2



Number __________

सखया




Yes हा______________1

No_ नही______________2

42

community group






fyk

Yes


1

2

3

911

911





ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X





1

2




Yes gka

No ugha

1

2



djrh gSa

Yes gka

No ugha


1

2

3



gS

Yes gka

No ugha

1

2

916


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


17




INR is _____

_



account



Cash udn 1

Cheque psd 2


Other (specify) 88





_____

_







Yes gka

No ugha

1

2









18







ANM u e




No one dksbZ ugha

Other अनय

1

2

3

4

10

5

6

7

9

8



dk izksx fdk xk Fkk




ls izkIr fdk Fkk






Scissor dSaph



1

2

3

4

5

6

8

9

412



xk Fkk





izkIr fdk Fkk




uk kkxk


kkxk


kjk fnk xk kkxk





1

2

3

4

5

6

8

9



ij dqN yxkk xk Fkk

Yes gka

No ugha

1

2



dqN yxkk xk Fkk

Yes gka

No ugha

1

2


19




uky ij Dk yxk Fkk

CODE ALL THAT

APPLY





Sindoor flUnwj






Cowdung xk dk xkscj


A

B

C

D

E

F

G

H

I

J

X




yxk Fkk




Sindoor flUnwj






Cowdung xk dk xkscj


A

B

C

D

E

F

G

H

I

J

X










Question Answers





Hours kVs

________________

Days fnu

_________________


fiykk

Yes gka

No ugha

1

2


20




fiykk Fkk





hour


H Hours घट ___________

D Days दिन ____________

0




Yes gka

No ugha

1

2


421 What was [CHILD

NAME] given


fnk xk Fkk

PROBE Anything

else

dqN vkSj










A

B

C

D

E

F

G

H

I

J

X






Yes gka

No ugha

1

2


21






nwk fiykk Fkk





pht ugha nh








Bwals fuIiy frac12







gS


gqvk Fkk





jgk Fkk



OTHER (SPECIFY) vU





Yes gka

No ugha

1

2

22






EACH











fiykk gS

If 427A_1 =2 skip to 427A_2

Liquids Yes हा

No नही

Yes हा

No नही




1 2 1 2



tkuoj dk nwkfrac12

1 2 1 2




vkWjsUt is

1 2 1 2



1 2 1 2





Yes gka

No ugha

1

2





kq fdk Fkk


_____

_







ckj nsrh gSa 2


23




nsrh gSa

SINGLE CODING ONLY




4











Yes gka

No ugha

1

2







ASHA vkrsquokk

ANM ue



A

B

C

X





vks

Days Fnu

Weeks

_____













vkids kj vks Fks

Yes gka

No ugha




1

2

3

4

502

502


24







vks

Days


suffer from





Ever


(A)

Currently


(B)

Did the

child

recieve


(C)


(D)

Diarrohea

(with fever

lethargy

persistent

vomitting

and blood in



1 हा


A B C D E

Pneumonia

(Ill with

rapid short

breathing

fever amp



1 हा


A B C D E

25


Kala azar



1 हा


A B C D E








Yes gka

No ugha

1

2



written down





01

02

03

506

506




Vhdk yxokk gS

Yes हाा

No नह ी

BCG chlhth 1 2


le fnk xk

1 2


DPT MhihVh 1 1 2


DPT MhihVh 2 1 2


DPT MhihVh 3 1 2

26

Measles [kljk 1 2


1 2



ntZ ugha gS







Yes gka

No ugha

1

2








Yes gka

No ugha

1

2




Yes gka

No ugha

1

2



igyk yxk Fkk

Yes gka

No ugha

1

2





Number la[k

_____




Yes gka

No ugha

1

2


27





Number la[k

_____



Yes gka

No ugha

1

2



Yes gka

No ugha

1

2


ldrs gSs






gS





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

If 602a=1 or 602b=1 skip to 605





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

28






Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2







Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




izksx dj ldrs gS

Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1


29


jgs gS














L



[CHILD NAME] wanted



1

2

3


about the future




(more) children





vkSj cPpk pkgsaxs





1

2

3

4





1

2

3

4

5

30







1 2

1 2

1 2

1 2

1 2

1 2

1 2








Yes gka

No ugha

1

2

701

b


washing to you



Yes

No

1

2




PROBE Anyone else





f[kykus ls igys




A

B

C

D

X

Y

Z

31





pkfg

PROBE Anyone else














None dksbZ Hkh ugha

A

B

C

D

E

F

G

H

I

J

X

Y




Yes gka

No ugha

1

2

706







PROBE Anyone else










ckn





A

B

C

D

E

F

G

H

I

J

K

X










1

2

3

4

32









707


706

b



soapwater and

surfashoilother)




lkcquikuh vkSj


CODE ONE ONLY








706c




hands with soap




706

d





33


NAME] passed stools





xk Fkk





Buried tyk fnk Fkk


Other vU

1

2

3

4

5

6

7



members of your

household



lzregr Dk gS











pSuyfrac12


1

2

3

4

5

6

7

8

9

10

11

12

13

14

712




gS


Elsewhere vU=

1

2

712






fdruk le yxrk gS


__

__



txg ij dkSu tkrk gS


1

2

3

4

34


future use (for use




Yes gka

No ugha

1

2

715











1

2

3

4



djds dgkWa j[krs gS



1

2





cukrh gSa

Yes gka

No ugha

1

2

717




drink



djrs gS


Boil mckyuk









A

B

C

D

E

F

G

X

35






ifjokj dj jgs gS












k [ksr dk bLrseky


1

2

3

4

5

6

7

8

9

10

11

12

721



facility with other



gSa

Yes gka

No ugha

1

2

720





Number la[k



including children







ikl

Yes gka

No ugha

1

2

36



dSls fuiVkrs gS


In a drain ukys esa



1

2

3

4

5






vki tgka jgrs gSa

Yes gka

No ugha

1

2








A B C D




rjhds Dk gS






1

2

3

4

5



Strongly

agree

Agree lger

Disagree

असहमत

Strongly

Disagree





1 2 3 4

37




1 2 3 4




1 2 3 4





1 2 3 4







1 2 3 4



ij gksrk gS

1 2 3 4




dgrh gWawa



1 2 3 4

PNC




1 2 3 4



feyuk vke ckr gS

1 2 3 4





1 2 3 4

Family Planning

38



dks vPNk ekurs gSa

1 2 3 4





djrh gWaw

1 2 3 4





1 2 3 4



dqN yxkrs gS

1 2 3 4



1 2 3 4





1 2 3 4





fiykk tkrk gS

1 2 3 4





gS

1 2 3 4





1 2 3 4


39





1 2 3 4






1 2 3 4




1 2 3 4





1 2 3 4




1 2 3 4



mckyrs gSa

1 2 3 4




1 2 3 4




1 2 3 4



dk leFkZu djsaxs

1 2 3 4





1 2 3 4


40



















1

2

3

4

5

911









1

2

3

4

5




सलया था

Days ____

दिन______







Yes gka

No ugha

1

2

909





has an emergency A


41





Aacutelo dh rSkjh





dkZdze k vU kstuk


lkQ vkSj lqjfkr tUe







Breastfeeding J

Lruiku


iwjd vkgkj

Immunizations L

Vhdkdjk

Family planning M

ifjokj fukstu

Sanitationhygiene N

LoPNrk

other (specify) X




community group


Yes हा______________1

No नही_______________2



Number __________

सखया




Yes हा______________1

No_ नही______________2

42

community group






fyk

Yes


1

2

3

911

911





ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X





1

2




Yes gka

No ugha

1

2



djrh gSa

Yes gka

No ugha


1

2

3



gS

Yes gka

No ugha

1

2

916


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


18







ANM u e




No one dksbZ ugha

Other अनय

1

2

3

4

10

5

6

7

9

8



dk izksx fdk xk Fkk




ls izkIr fdk Fkk






Scissor dSaph



1

2

3

4

5

6

8

9

412



xk Fkk





izkIr fdk Fkk




uk kkxk


kkxk


kjk fnk xk kkxk





1

2

3

4

5

6

8

9



ij dqN yxkk xk Fkk

Yes gka

No ugha

1

2



dqN yxkk xk Fkk

Yes gka

No ugha

1

2


19




uky ij Dk yxk Fkk

CODE ALL THAT

APPLY





Sindoor flUnwj






Cowdung xk dk xkscj


A

B

C

D

E

F

G

H

I

J

X




yxk Fkk




Sindoor flUnwj






Cowdung xk dk xkscj


A

B

C

D

E

F

G

H

I

J

X










Question Answers





Hours kVs

________________

Days fnu

_________________


fiykk

Yes gka

No ugha

1

2


20




fiykk Fkk





hour


H Hours घट ___________

D Days दिन ____________

0




Yes gka

No ugha

1

2


421 What was [CHILD

NAME] given


fnk xk Fkk

PROBE Anything

else

dqN vkSj










A

B

C

D

E

F

G

H

I

J

X






Yes gka

No ugha

1

2


21






nwk fiykk Fkk





pht ugha nh








Bwals fuIiy frac12







gS


gqvk Fkk





jgk Fkk



OTHER (SPECIFY) vU





Yes gka

No ugha

1

2

22






EACH











fiykk gS

If 427A_1 =2 skip to 427A_2

Liquids Yes हा

No नही

Yes हा

No नही




1 2 1 2



tkuoj dk nwkfrac12

1 2 1 2




vkWjsUt is

1 2 1 2



1 2 1 2





Yes gka

No ugha

1

2





kq fdk Fkk


_____

_







ckj nsrh gSa 2


23




nsrh gSa

SINGLE CODING ONLY




4











Yes gka

No ugha

1

2







ASHA vkrsquokk

ANM ue



A

B

C

X





vks

Days Fnu

Weeks

_____













vkids kj vks Fks

Yes gka

No ugha




1

2

3

4

502

502


24







vks

Days


suffer from





Ever


(A)

Currently


(B)

Did the

child

recieve


(C)


(D)

Diarrohea

(with fever

lethargy

persistent

vomitting

and blood in



1 हा


A B C D E

Pneumonia

(Ill with

rapid short

breathing

fever amp



1 हा


A B C D E

25


Kala azar



1 हा


A B C D E








Yes gka

No ugha

1

2



written down





01

02

03

506

506




Vhdk yxokk gS

Yes हाा

No नह ी

BCG chlhth 1 2


le fnk xk

1 2


DPT MhihVh 1 1 2


DPT MhihVh 2 1 2


DPT MhihVh 3 1 2

26

Measles [kljk 1 2


1 2



ntZ ugha gS







Yes gka

No ugha

1

2








Yes gka

No ugha

1

2




Yes gka

No ugha

1

2



igyk yxk Fkk

Yes gka

No ugha

1

2





Number la[k

_____




Yes gka

No ugha

1

2


27





Number la[k

_____



Yes gka

No ugha

1

2



Yes gka

No ugha

1

2


ldrs gSs






gS





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

If 602a=1 or 602b=1 skip to 605





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

28






Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2







Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




izksx dj ldrs gS

Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1


29


jgs gS














L



[CHILD NAME] wanted



1

2

3


about the future




(more) children





vkSj cPpk pkgsaxs





1

2

3

4





1

2

3

4

5

30







1 2

1 2

1 2

1 2

1 2

1 2

1 2








Yes gka

No ugha

1

2

701

b


washing to you



Yes

No

1

2




PROBE Anyone else





f[kykus ls igys




A

B

C

D

X

Y

Z

31





pkfg

PROBE Anyone else














None dksbZ Hkh ugha

A

B

C

D

E

F

G

H

I

J

X

Y




Yes gka

No ugha

1

2

706







PROBE Anyone else










ckn





A

B

C

D

E

F

G

H

I

J

K

X










1

2

3

4

32









707


706

b



soapwater and

surfashoilother)




lkcquikuh vkSj


CODE ONE ONLY








706c




hands with soap




706

d





33


NAME] passed stools





xk Fkk





Buried tyk fnk Fkk


Other vU

1

2

3

4

5

6

7



members of your

household



lzregr Dk gS











pSuyfrac12


1

2

3

4

5

6

7

8

9

10

11

12

13

14

712




gS


Elsewhere vU=

1

2

712






fdruk le yxrk gS


__

__



txg ij dkSu tkrk gS


1

2

3

4

34


future use (for use




Yes gka

No ugha

1

2

715











1

2

3

4



djds dgkWa j[krs gS



1

2





cukrh gSa

Yes gka

No ugha

1

2

717




drink



djrs gS


Boil mckyuk









A

B

C

D

E

F

G

X

35






ifjokj dj jgs gS












k [ksr dk bLrseky


1

2

3

4

5

6

7

8

9

10

11

12

721



facility with other



gSa

Yes gka

No ugha

1

2

720





Number la[k



including children







ikl

Yes gka

No ugha

1

2

36



dSls fuiVkrs gS


In a drain ukys esa



1

2

3

4

5






vki tgka jgrs gSa

Yes gka

No ugha

1

2








A B C D




rjhds Dk gS






1

2

3

4

5



Strongly

agree

Agree lger

Disagree

असहमत

Strongly

Disagree





1 2 3 4

37




1 2 3 4




1 2 3 4





1 2 3 4







1 2 3 4



ij gksrk gS

1 2 3 4




dgrh gWawa



1 2 3 4

PNC




1 2 3 4



feyuk vke ckr gS

1 2 3 4





1 2 3 4

Family Planning

38



dks vPNk ekurs gSa

1 2 3 4





djrh gWaw

1 2 3 4





1 2 3 4



dqN yxkrs gS

1 2 3 4



1 2 3 4





1 2 3 4





fiykk tkrk gS

1 2 3 4





gS

1 2 3 4





1 2 3 4


39





1 2 3 4






1 2 3 4




1 2 3 4





1 2 3 4




1 2 3 4



mckyrs gSa

1 2 3 4




1 2 3 4




1 2 3 4



dk leFkZu djsaxs

1 2 3 4





1 2 3 4


40



















1

2

3

4

5

911









1

2

3

4

5




सलया था

Days ____

दिन______







Yes gka

No ugha

1

2

909





has an emergency A


41





Aacutelo dh rSkjh





dkZdze k vU kstuk


lkQ vkSj lqjfkr tUe







Breastfeeding J

Lruiku


iwjd vkgkj

Immunizations L

Vhdkdjk

Family planning M

ifjokj fukstu

Sanitationhygiene N

LoPNrk

other (specify) X




community group


Yes हा______________1

No नही_______________2



Number __________

सखया




Yes हा______________1

No_ नही______________2

42

community group






fyk

Yes


1

2

3

911

911





ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X





1

2




Yes gka

No ugha

1

2



djrh gSa

Yes gka

No ugha


1

2

3



gS

Yes gka

No ugha

1

2

916


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


19




uky ij Dk yxk Fkk

CODE ALL THAT

APPLY





Sindoor flUnwj






Cowdung xk dk xkscj


A

B

C

D

E

F

G

H

I

J

X




yxk Fkk




Sindoor flUnwj






Cowdung xk dk xkscj


A

B

C

D

E

F

G

H

I

J

X










Question Answers





Hours kVs

________________

Days fnu

_________________


fiykk

Yes gka

No ugha

1

2


20




fiykk Fkk





hour


H Hours घट ___________

D Days दिन ____________

0




Yes gka

No ugha

1

2


421 What was [CHILD

NAME] given


fnk xk Fkk

PROBE Anything

else

dqN vkSj










A

B

C

D

E

F

G

H

I

J

X






Yes gka

No ugha

1

2


21






nwk fiykk Fkk





pht ugha nh








Bwals fuIiy frac12







gS


gqvk Fkk





jgk Fkk



OTHER (SPECIFY) vU





Yes gka

No ugha

1

2

22






EACH











fiykk gS

If 427A_1 =2 skip to 427A_2

Liquids Yes हा

No नही

Yes हा

No नही




1 2 1 2



tkuoj dk nwkfrac12

1 2 1 2




vkWjsUt is

1 2 1 2



1 2 1 2





Yes gka

No ugha

1

2





kq fdk Fkk


_____

_







ckj nsrh gSa 2


23




nsrh gSa

SINGLE CODING ONLY




4











Yes gka

No ugha

1

2







ASHA vkrsquokk

ANM ue



A

B

C

X





vks

Days Fnu

Weeks

_____













vkids kj vks Fks

Yes gka

No ugha




1

2

3

4

502

502


24







vks

Days


suffer from





Ever


(A)

Currently


(B)

Did the

child

recieve


(C)


(D)

Diarrohea

(with fever

lethargy

persistent

vomitting

and blood in



1 हा


A B C D E

Pneumonia

(Ill with

rapid short

breathing

fever amp



1 हा


A B C D E

25


Kala azar



1 हा


A B C D E








Yes gka

No ugha

1

2



written down





01

02

03

506

506




Vhdk yxokk gS

Yes हाा

No नह ी

BCG chlhth 1 2


le fnk xk

1 2


DPT MhihVh 1 1 2


DPT MhihVh 2 1 2


DPT MhihVh 3 1 2

26

Measles [kljk 1 2


1 2



ntZ ugha gS







Yes gka

No ugha

1

2








Yes gka

No ugha

1

2




Yes gka

No ugha

1

2



igyk yxk Fkk

Yes gka

No ugha

1

2





Number la[k

_____




Yes gka

No ugha

1

2


27





Number la[k

_____



Yes gka

No ugha

1

2



Yes gka

No ugha

1

2


ldrs gSs






gS





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

If 602a=1 or 602b=1 skip to 605





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

28






Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2







Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




izksx dj ldrs gS

Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1


29


jgs gS














L



[CHILD NAME] wanted



1

2

3


about the future




(more) children





vkSj cPpk pkgsaxs





1

2

3

4





1

2

3

4

5

30







1 2

1 2

1 2

1 2

1 2

1 2

1 2








Yes gka

No ugha

1

2

701

b


washing to you



Yes

No

1

2




PROBE Anyone else





f[kykus ls igys




A

B

C

D

X

Y

Z

31





pkfg

PROBE Anyone else














None dksbZ Hkh ugha

A

B

C

D

E

F

G

H

I

J

X

Y




Yes gka

No ugha

1

2

706







PROBE Anyone else










ckn





A

B

C

D

E

F

G

H

I

J

K

X










1

2

3

4

32









707


706

b



soapwater and

surfashoilother)




lkcquikuh vkSj


CODE ONE ONLY








706c




hands with soap




706

d





33


NAME] passed stools





xk Fkk





Buried tyk fnk Fkk


Other vU

1

2

3

4

5

6

7



members of your

household



lzregr Dk gS











pSuyfrac12


1

2

3

4

5

6

7

8

9

10

11

12

13

14

712




gS


Elsewhere vU=

1

2

712






fdruk le yxrk gS


__

__



txg ij dkSu tkrk gS


1

2

3

4

34


future use (for use




Yes gka

No ugha

1

2

715











1

2

3

4



djds dgkWa j[krs gS



1

2





cukrh gSa

Yes gka

No ugha

1

2

717




drink



djrs gS


Boil mckyuk









A

B

C

D

E

F

G

X

35






ifjokj dj jgs gS












k [ksr dk bLrseky


1

2

3

4

5

6

7

8

9

10

11

12

721



facility with other



gSa

Yes gka

No ugha

1

2

720





Number la[k



including children







ikl

Yes gka

No ugha

1

2

36



dSls fuiVkrs gS


In a drain ukys esa



1

2

3

4

5






vki tgka jgrs gSa

Yes gka

No ugha

1

2








A B C D




rjhds Dk gS






1

2

3

4

5



Strongly

agree

Agree lger

Disagree

असहमत

Strongly

Disagree





1 2 3 4

37




1 2 3 4




1 2 3 4





1 2 3 4







1 2 3 4



ij gksrk gS

1 2 3 4




dgrh gWawa



1 2 3 4

PNC




1 2 3 4



feyuk vke ckr gS

1 2 3 4





1 2 3 4

Family Planning

38



dks vPNk ekurs gSa

1 2 3 4





djrh gWaw

1 2 3 4





1 2 3 4



dqN yxkrs gS

1 2 3 4



1 2 3 4





1 2 3 4





fiykk tkrk gS

1 2 3 4





gS

1 2 3 4





1 2 3 4


39





1 2 3 4






1 2 3 4




1 2 3 4





1 2 3 4




1 2 3 4



mckyrs gSa

1 2 3 4




1 2 3 4




1 2 3 4



dk leFkZu djsaxs

1 2 3 4





1 2 3 4


40



















1

2

3

4

5

911









1

2

3

4

5




सलया था

Days ____

दिन______







Yes gka

No ugha

1

2

909





has an emergency A


41





Aacutelo dh rSkjh





dkZdze k vU kstuk


lkQ vkSj lqjfkr tUe







Breastfeeding J

Lruiku


iwjd vkgkj

Immunizations L

Vhdkdjk

Family planning M

ifjokj fukstu

Sanitationhygiene N

LoPNrk

other (specify) X




community group


Yes हा______________1

No नही_______________2



Number __________

सखया




Yes हा______________1

No_ नही______________2

42

community group






fyk

Yes


1

2

3

911

911





ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X





1

2




Yes gka

No ugha

1

2



djrh gSa

Yes gka

No ugha


1

2

3



gS

Yes gka

No ugha

1

2

916


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


20




fiykk Fkk





hour


H Hours घट ___________

D Days दिन ____________

0




Yes gka

No ugha

1

2


421 What was [CHILD

NAME] given


fnk xk Fkk

PROBE Anything

else

dqN vkSj










A

B

C

D

E

F

G

H

I

J

X






Yes gka

No ugha

1

2


21






nwk fiykk Fkk





pht ugha nh








Bwals fuIiy frac12







gS


gqvk Fkk





jgk Fkk



OTHER (SPECIFY) vU





Yes gka

No ugha

1

2

22






EACH











fiykk gS

If 427A_1 =2 skip to 427A_2

Liquids Yes हा

No नही

Yes हा

No नही




1 2 1 2



tkuoj dk nwkfrac12

1 2 1 2




vkWjsUt is

1 2 1 2



1 2 1 2





Yes gka

No ugha

1

2





kq fdk Fkk


_____

_







ckj nsrh gSa 2


23




nsrh gSa

SINGLE CODING ONLY




4











Yes gka

No ugha

1

2







ASHA vkrsquokk

ANM ue



A

B

C

X





vks

Days Fnu

Weeks

_____













vkids kj vks Fks

Yes gka

No ugha




1

2

3

4

502

502


24







vks

Days


suffer from





Ever


(A)

Currently


(B)

Did the

child

recieve


(C)


(D)

Diarrohea

(with fever

lethargy

persistent

vomitting

and blood in



1 हा


A B C D E

Pneumonia

(Ill with

rapid short

breathing

fever amp



1 हा


A B C D E

25


Kala azar



1 हा


A B C D E








Yes gka

No ugha

1

2



written down





01

02

03

506

506




Vhdk yxokk gS

Yes हाा

No नह ी

BCG chlhth 1 2


le fnk xk

1 2


DPT MhihVh 1 1 2


DPT MhihVh 2 1 2


DPT MhihVh 3 1 2

26

Measles [kljk 1 2


1 2



ntZ ugha gS







Yes gka

No ugha

1

2








Yes gka

No ugha

1

2




Yes gka

No ugha

1

2



igyk yxk Fkk

Yes gka

No ugha

1

2





Number la[k

_____




Yes gka

No ugha

1

2


27





Number la[k

_____



Yes gka

No ugha

1

2



Yes gka

No ugha

1

2


ldrs gSs






gS





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

If 602a=1 or 602b=1 skip to 605





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

28






Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2







Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




izksx dj ldrs gS

Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1


29


jgs gS














L



[CHILD NAME] wanted



1

2

3


about the future




(more) children





vkSj cPpk pkgsaxs





1

2

3

4





1

2

3

4

5

30







1 2

1 2

1 2

1 2

1 2

1 2

1 2








Yes gka

No ugha

1

2

701

b


washing to you



Yes

No

1

2




PROBE Anyone else





f[kykus ls igys




A

B

C

D

X

Y

Z

31





pkfg

PROBE Anyone else














None dksbZ Hkh ugha

A

B

C

D

E

F

G

H

I

J

X

Y




Yes gka

No ugha

1

2

706







PROBE Anyone else










ckn





A

B

C

D

E

F

G

H

I

J

K

X










1

2

3

4

32









707


706

b



soapwater and

surfashoilother)




lkcquikuh vkSj


CODE ONE ONLY








706c




hands with soap




706

d





33


NAME] passed stools





xk Fkk





Buried tyk fnk Fkk


Other vU

1

2

3

4

5

6

7



members of your

household



lzregr Dk gS











pSuyfrac12


1

2

3

4

5

6

7

8

9

10

11

12

13

14

712




gS


Elsewhere vU=

1

2

712






fdruk le yxrk gS


__

__



txg ij dkSu tkrk gS


1

2

3

4

34


future use (for use




Yes gka

No ugha

1

2

715











1

2

3

4



djds dgkWa j[krs gS



1

2





cukrh gSa

Yes gka

No ugha

1

2

717




drink



djrs gS


Boil mckyuk









A

B

C

D

E

F

G

X

35






ifjokj dj jgs gS












k [ksr dk bLrseky


1

2

3

4

5

6

7

8

9

10

11

12

721



facility with other



gSa

Yes gka

No ugha

1

2

720





Number la[k



including children







ikl

Yes gka

No ugha

1

2

36



dSls fuiVkrs gS


In a drain ukys esa



1

2

3

4

5






vki tgka jgrs gSa

Yes gka

No ugha

1

2








A B C D




rjhds Dk gS






1

2

3

4

5



Strongly

agree

Agree lger

Disagree

असहमत

Strongly

Disagree





1 2 3 4

37




1 2 3 4




1 2 3 4





1 2 3 4







1 2 3 4



ij gksrk gS

1 2 3 4




dgrh gWawa



1 2 3 4

PNC




1 2 3 4



feyuk vke ckr gS

1 2 3 4





1 2 3 4

Family Planning

38



dks vPNk ekurs gSa

1 2 3 4





djrh gWaw

1 2 3 4





1 2 3 4



dqN yxkrs gS

1 2 3 4



1 2 3 4





1 2 3 4





fiykk tkrk gS

1 2 3 4





gS

1 2 3 4





1 2 3 4


39





1 2 3 4






1 2 3 4




1 2 3 4





1 2 3 4




1 2 3 4



mckyrs gSa

1 2 3 4




1 2 3 4




1 2 3 4



dk leFkZu djsaxs

1 2 3 4





1 2 3 4


40



















1

2

3

4

5

911









1

2

3

4

5




सलया था

Days ____

दिन______







Yes gka

No ugha

1

2

909





has an emergency A


41





Aacutelo dh rSkjh





dkZdze k vU kstuk


lkQ vkSj lqjfkr tUe







Breastfeeding J

Lruiku


iwjd vkgkj

Immunizations L

Vhdkdjk

Family planning M

ifjokj fukstu

Sanitationhygiene N

LoPNrk

other (specify) X




community group


Yes हा______________1

No नही_______________2



Number __________

सखया




Yes हा______________1

No_ नही______________2

42

community group






fyk

Yes


1

2

3

911

911





ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X





1

2




Yes gka

No ugha

1

2



djrh gSa

Yes gka

No ugha


1

2

3



gS

Yes gka

No ugha

1

2

916


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


21






nwk fiykk Fkk





pht ugha nh








Bwals fuIiy frac12







gS


gqvk Fkk





jgk Fkk



OTHER (SPECIFY) vU





Yes gka

No ugha

1

2

22






EACH











fiykk gS

If 427A_1 =2 skip to 427A_2

Liquids Yes हा

No नही

Yes हा

No नही




1 2 1 2



tkuoj dk nwkfrac12

1 2 1 2




vkWjsUt is

1 2 1 2



1 2 1 2





Yes gka

No ugha

1

2





kq fdk Fkk


_____

_







ckj nsrh gSa 2


23




nsrh gSa

SINGLE CODING ONLY




4











Yes gka

No ugha

1

2







ASHA vkrsquokk

ANM ue



A

B

C

X





vks

Days Fnu

Weeks

_____













vkids kj vks Fks

Yes gka

No ugha




1

2

3

4

502

502


24







vks

Days


suffer from





Ever


(A)

Currently


(B)

Did the

child

recieve


(C)


(D)

Diarrohea

(with fever

lethargy

persistent

vomitting

and blood in



1 हा


A B C D E

Pneumonia

(Ill with

rapid short

breathing

fever amp



1 हा


A B C D E

25


Kala azar



1 हा


A B C D E








Yes gka

No ugha

1

2



written down





01

02

03

506

506




Vhdk yxokk gS

Yes हाा

No नह ी

BCG chlhth 1 2


le fnk xk

1 2


DPT MhihVh 1 1 2


DPT MhihVh 2 1 2


DPT MhihVh 3 1 2

26

Measles [kljk 1 2


1 2



ntZ ugha gS







Yes gka

No ugha

1

2








Yes gka

No ugha

1

2




Yes gka

No ugha

1

2



igyk yxk Fkk

Yes gka

No ugha

1

2





Number la[k

_____




Yes gka

No ugha

1

2


27





Number la[k

_____



Yes gka

No ugha

1

2



Yes gka

No ugha

1

2


ldrs gSs






gS





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

If 602a=1 or 602b=1 skip to 605





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

28






Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2







Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




izksx dj ldrs gS

Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1


29


jgs gS














L



[CHILD NAME] wanted



1

2

3


about the future




(more) children





vkSj cPpk pkgsaxs





1

2

3

4





1

2

3

4

5

30







1 2

1 2

1 2

1 2

1 2

1 2

1 2








Yes gka

No ugha

1

2

701

b


washing to you



Yes

No

1

2




PROBE Anyone else





f[kykus ls igys




A

B

C

D

X

Y

Z

31





pkfg

PROBE Anyone else














None dksbZ Hkh ugha

A

B

C

D

E

F

G

H

I

J

X

Y




Yes gka

No ugha

1

2

706







PROBE Anyone else










ckn





A

B

C

D

E

F

G

H

I

J

K

X










1

2

3

4

32









707


706

b



soapwater and

surfashoilother)




lkcquikuh vkSj


CODE ONE ONLY








706c




hands with soap




706

d





33


NAME] passed stools





xk Fkk





Buried tyk fnk Fkk


Other vU

1

2

3

4

5

6

7



members of your

household



lzregr Dk gS











pSuyfrac12


1

2

3

4

5

6

7

8

9

10

11

12

13

14

712




gS


Elsewhere vU=

1

2

712






fdruk le yxrk gS


__

__



txg ij dkSu tkrk gS


1

2

3

4

34


future use (for use




Yes gka

No ugha

1

2

715











1

2

3

4



djds dgkWa j[krs gS



1

2





cukrh gSa

Yes gka

No ugha

1

2

717




drink



djrs gS


Boil mckyuk









A

B

C

D

E

F

G

X

35






ifjokj dj jgs gS












k [ksr dk bLrseky


1

2

3

4

5

6

7

8

9

10

11

12

721



facility with other



gSa

Yes gka

No ugha

1

2

720





Number la[k



including children







ikl

Yes gka

No ugha

1

2

36



dSls fuiVkrs gS


In a drain ukys esa



1

2

3

4

5






vki tgka jgrs gSa

Yes gka

No ugha

1

2








A B C D




rjhds Dk gS






1

2

3

4

5



Strongly

agree

Agree lger

Disagree

असहमत

Strongly

Disagree





1 2 3 4

37




1 2 3 4




1 2 3 4





1 2 3 4







1 2 3 4



ij gksrk gS

1 2 3 4




dgrh gWawa



1 2 3 4

PNC




1 2 3 4



feyuk vke ckr gS

1 2 3 4





1 2 3 4

Family Planning

38



dks vPNk ekurs gSa

1 2 3 4





djrh gWaw

1 2 3 4





1 2 3 4



dqN yxkrs gS

1 2 3 4



1 2 3 4





1 2 3 4





fiykk tkrk gS

1 2 3 4





gS

1 2 3 4





1 2 3 4


39





1 2 3 4






1 2 3 4




1 2 3 4





1 2 3 4




1 2 3 4



mckyrs gSa

1 2 3 4




1 2 3 4




1 2 3 4



dk leFkZu djsaxs

1 2 3 4





1 2 3 4


40



















1

2

3

4

5

911









1

2

3

4

5




सलया था

Days ____

दिन______







Yes gka

No ugha

1

2

909





has an emergency A


41





Aacutelo dh rSkjh





dkZdze k vU kstuk


lkQ vkSj lqjfkr tUe







Breastfeeding J

Lruiku


iwjd vkgkj

Immunizations L

Vhdkdjk

Family planning M

ifjokj fukstu

Sanitationhygiene N

LoPNrk

other (specify) X




community group


Yes हा______________1

No नही_______________2



Number __________

सखया




Yes हा______________1

No_ नही______________2

42

community group






fyk

Yes


1

2

3

911

911





ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X





1

2




Yes gka

No ugha

1

2



djrh gSa

Yes gka

No ugha


1

2

3



gS

Yes gka

No ugha

1

2

916


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


22






EACH











fiykk gS

If 427A_1 =2 skip to 427A_2

Liquids Yes हा

No नही

Yes हा

No नही




1 2 1 2



tkuoj dk nwkfrac12

1 2 1 2




vkWjsUt is

1 2 1 2



1 2 1 2





Yes gka

No ugha

1

2





kq fdk Fkk


_____

_







ckj nsrh gSa 2


23




nsrh gSa

SINGLE CODING ONLY




4











Yes gka

No ugha

1

2







ASHA vkrsquokk

ANM ue



A

B

C

X





vks

Days Fnu

Weeks

_____













vkids kj vks Fks

Yes gka

No ugha




1

2

3

4

502

502


24







vks

Days


suffer from





Ever


(A)

Currently


(B)

Did the

child

recieve


(C)


(D)

Diarrohea

(with fever

lethargy

persistent

vomitting

and blood in



1 हा


A B C D E

Pneumonia

(Ill with

rapid short

breathing

fever amp



1 हा


A B C D E

25


Kala azar



1 हा


A B C D E








Yes gka

No ugha

1

2



written down





01

02

03

506

506




Vhdk yxokk gS

Yes हाा

No नह ी

BCG chlhth 1 2


le fnk xk

1 2


DPT MhihVh 1 1 2


DPT MhihVh 2 1 2


DPT MhihVh 3 1 2

26

Measles [kljk 1 2


1 2



ntZ ugha gS







Yes gka

No ugha

1

2








Yes gka

No ugha

1

2




Yes gka

No ugha

1

2



igyk yxk Fkk

Yes gka

No ugha

1

2





Number la[k

_____




Yes gka

No ugha

1

2


27





Number la[k

_____



Yes gka

No ugha

1

2



Yes gka

No ugha

1

2


ldrs gSs






gS





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

If 602a=1 or 602b=1 skip to 605





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

28






Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2







Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




izksx dj ldrs gS

Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1


29


jgs gS














L



[CHILD NAME] wanted



1

2

3


about the future




(more) children





vkSj cPpk pkgsaxs





1

2

3

4





1

2

3

4

5

30







1 2

1 2

1 2

1 2

1 2

1 2

1 2








Yes gka

No ugha

1

2

701

b


washing to you



Yes

No

1

2




PROBE Anyone else





f[kykus ls igys




A

B

C

D

X

Y

Z

31





pkfg

PROBE Anyone else














None dksbZ Hkh ugha

A

B

C

D

E

F

G

H

I

J

X

Y




Yes gka

No ugha

1

2

706







PROBE Anyone else










ckn





A

B

C

D

E

F

G

H

I

J

K

X










1

2

3

4

32









707


706

b



soapwater and

surfashoilother)




lkcquikuh vkSj


CODE ONE ONLY








706c




hands with soap




706

d





33


NAME] passed stools





xk Fkk





Buried tyk fnk Fkk


Other vU

1

2

3

4

5

6

7



members of your

household



lzregr Dk gS











pSuyfrac12


1

2

3

4

5

6

7

8

9

10

11

12

13

14

712




gS


Elsewhere vU=

1

2

712






fdruk le yxrk gS


__

__



txg ij dkSu tkrk gS


1

2

3

4

34


future use (for use




Yes gka

No ugha

1

2

715











1

2

3

4



djds dgkWa j[krs gS



1

2





cukrh gSa

Yes gka

No ugha

1

2

717




drink



djrs gS


Boil mckyuk









A

B

C

D

E

F

G

X

35






ifjokj dj jgs gS












k [ksr dk bLrseky


1

2

3

4

5

6

7

8

9

10

11

12

721



facility with other



gSa

Yes gka

No ugha

1

2

720





Number la[k



including children







ikl

Yes gka

No ugha

1

2

36



dSls fuiVkrs gS


In a drain ukys esa



1

2

3

4

5






vki tgka jgrs gSa

Yes gka

No ugha

1

2








A B C D




rjhds Dk gS






1

2

3

4

5



Strongly

agree

Agree lger

Disagree

असहमत

Strongly

Disagree





1 2 3 4

37




1 2 3 4




1 2 3 4





1 2 3 4







1 2 3 4



ij gksrk gS

1 2 3 4




dgrh gWawa



1 2 3 4

PNC




1 2 3 4



feyuk vke ckr gS

1 2 3 4





1 2 3 4

Family Planning

38



dks vPNk ekurs gSa

1 2 3 4





djrh gWaw

1 2 3 4





1 2 3 4



dqN yxkrs gS

1 2 3 4



1 2 3 4





1 2 3 4





fiykk tkrk gS

1 2 3 4





gS

1 2 3 4





1 2 3 4


39





1 2 3 4






1 2 3 4




1 2 3 4





1 2 3 4




1 2 3 4



mckyrs gSa

1 2 3 4




1 2 3 4




1 2 3 4



dk leFkZu djsaxs

1 2 3 4





1 2 3 4


40



















1

2

3

4

5

911









1

2

3

4

5




सलया था

Days ____

दिन______







Yes gka

No ugha

1

2

909





has an emergency A


41





Aacutelo dh rSkjh





dkZdze k vU kstuk


lkQ vkSj lqjfkr tUe







Breastfeeding J

Lruiku


iwjd vkgkj

Immunizations L

Vhdkdjk

Family planning M

ifjokj fukstu

Sanitationhygiene N

LoPNrk

other (specify) X




community group


Yes हा______________1

No नही_______________2



Number __________

सखया




Yes हा______________1

No_ नही______________2

42

community group






fyk

Yes


1

2

3

911

911





ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X





1

2




Yes gka

No ugha

1

2



djrh gSa

Yes gka

No ugha


1

2

3



gS

Yes gka

No ugha

1

2

916


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


23




nsrh gSa

SINGLE CODING ONLY




4











Yes gka

No ugha

1

2







ASHA vkrsquokk

ANM ue



A

B

C

X





vks

Days Fnu

Weeks

_____













vkids kj vks Fks

Yes gka

No ugha




1

2

3

4

502

502


24







vks

Days


suffer from





Ever


(A)

Currently


(B)

Did the

child

recieve


(C)


(D)

Diarrohea

(with fever

lethargy

persistent

vomitting

and blood in



1 हा


A B C D E

Pneumonia

(Ill with

rapid short

breathing

fever amp



1 हा


A B C D E

25


Kala azar



1 हा


A B C D E








Yes gka

No ugha

1

2



written down





01

02

03

506

506




Vhdk yxokk gS

Yes हाा

No नह ी

BCG chlhth 1 2


le fnk xk

1 2


DPT MhihVh 1 1 2


DPT MhihVh 2 1 2


DPT MhihVh 3 1 2

26

Measles [kljk 1 2


1 2



ntZ ugha gS







Yes gka

No ugha

1

2








Yes gka

No ugha

1

2




Yes gka

No ugha

1

2



igyk yxk Fkk

Yes gka

No ugha

1

2





Number la[k

_____




Yes gka

No ugha

1

2


27





Number la[k

_____



Yes gka

No ugha

1

2



Yes gka

No ugha

1

2


ldrs gSs






gS





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

If 602a=1 or 602b=1 skip to 605





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

28






Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2







Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




izksx dj ldrs gS

Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1


29


jgs gS














L



[CHILD NAME] wanted



1

2

3


about the future




(more) children





vkSj cPpk pkgsaxs





1

2

3

4





1

2

3

4

5

30







1 2

1 2

1 2

1 2

1 2

1 2

1 2








Yes gka

No ugha

1

2

701

b


washing to you



Yes

No

1

2




PROBE Anyone else





f[kykus ls igys




A

B

C

D

X

Y

Z

31





pkfg

PROBE Anyone else














None dksbZ Hkh ugha

A

B

C

D

E

F

G

H

I

J

X

Y




Yes gka

No ugha

1

2

706







PROBE Anyone else










ckn





A

B

C

D

E

F

G

H

I

J

K

X










1

2

3

4

32









707


706

b



soapwater and

surfashoilother)




lkcquikuh vkSj


CODE ONE ONLY








706c




hands with soap




706

d





33


NAME] passed stools





xk Fkk





Buried tyk fnk Fkk


Other vU

1

2

3

4

5

6

7



members of your

household



lzregr Dk gS











pSuyfrac12


1

2

3

4

5

6

7

8

9

10

11

12

13

14

712




gS


Elsewhere vU=

1

2

712






fdruk le yxrk gS


__

__



txg ij dkSu tkrk gS


1

2

3

4

34


future use (for use




Yes gka

No ugha

1

2

715











1

2

3

4



djds dgkWa j[krs gS



1

2





cukrh gSa

Yes gka

No ugha

1

2

717




drink



djrs gS


Boil mckyuk









A

B

C

D

E

F

G

X

35






ifjokj dj jgs gS












k [ksr dk bLrseky


1

2

3

4

5

6

7

8

9

10

11

12

721



facility with other



gSa

Yes gka

No ugha

1

2

720





Number la[k



including children







ikl

Yes gka

No ugha

1

2

36



dSls fuiVkrs gS


In a drain ukys esa



1

2

3

4

5






vki tgka jgrs gSa

Yes gka

No ugha

1

2








A B C D




rjhds Dk gS






1

2

3

4

5



Strongly

agree

Agree lger

Disagree

असहमत

Strongly

Disagree





1 2 3 4

37




1 2 3 4




1 2 3 4





1 2 3 4







1 2 3 4



ij gksrk gS

1 2 3 4




dgrh gWawa



1 2 3 4

PNC




1 2 3 4



feyuk vke ckr gS

1 2 3 4





1 2 3 4

Family Planning

38



dks vPNk ekurs gSa

1 2 3 4





djrh gWaw

1 2 3 4





1 2 3 4



dqN yxkrs gS

1 2 3 4



1 2 3 4





1 2 3 4





fiykk tkrk gS

1 2 3 4





gS

1 2 3 4





1 2 3 4


39





1 2 3 4






1 2 3 4




1 2 3 4





1 2 3 4




1 2 3 4



mckyrs gSa

1 2 3 4




1 2 3 4




1 2 3 4



dk leFkZu djsaxs

1 2 3 4





1 2 3 4


40



















1

2

3

4

5

911









1

2

3

4

5




सलया था

Days ____

दिन______







Yes gka

No ugha

1

2

909





has an emergency A


41





Aacutelo dh rSkjh





dkZdze k vU kstuk


lkQ vkSj lqjfkr tUe







Breastfeeding J

Lruiku


iwjd vkgkj

Immunizations L

Vhdkdjk

Family planning M

ifjokj fukstu

Sanitationhygiene N

LoPNrk

other (specify) X




community group


Yes हा______________1

No नही_______________2



Number __________

सखया




Yes हा______________1

No_ नही______________2

42

community group






fyk

Yes


1

2

3

911

911





ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X





1

2




Yes gka

No ugha

1

2



djrh gSa

Yes gka

No ugha


1

2

3



gS

Yes gka

No ugha

1

2

916


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


24







vks

Days


suffer from





Ever


(A)

Currently


(B)

Did the

child

recieve


(C)


(D)

Diarrohea

(with fever

lethargy

persistent

vomitting

and blood in



1 हा


A B C D E

Pneumonia

(Ill with

rapid short

breathing

fever amp



1 हा


A B C D E

25


Kala azar



1 हा


A B C D E








Yes gka

No ugha

1

2



written down





01

02

03

506

506




Vhdk yxokk gS

Yes हाा

No नह ी

BCG chlhth 1 2


le fnk xk

1 2


DPT MhihVh 1 1 2


DPT MhihVh 2 1 2


DPT MhihVh 3 1 2

26

Measles [kljk 1 2


1 2



ntZ ugha gS







Yes gka

No ugha

1

2








Yes gka

No ugha

1

2




Yes gka

No ugha

1

2



igyk yxk Fkk

Yes gka

No ugha

1

2





Number la[k

_____




Yes gka

No ugha

1

2


27





Number la[k

_____



Yes gka

No ugha

1

2



Yes gka

No ugha

1

2


ldrs gSs






gS





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

If 602a=1 or 602b=1 skip to 605





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

28






Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2







Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




izksx dj ldrs gS

Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1


29


jgs gS














L



[CHILD NAME] wanted



1

2

3


about the future




(more) children





vkSj cPpk pkgsaxs





1

2

3

4





1

2

3

4

5

30







1 2

1 2

1 2

1 2

1 2

1 2

1 2








Yes gka

No ugha

1

2

701

b


washing to you



Yes

No

1

2




PROBE Anyone else





f[kykus ls igys




A

B

C

D

X

Y

Z

31





pkfg

PROBE Anyone else














None dksbZ Hkh ugha

A

B

C

D

E

F

G

H

I

J

X

Y




Yes gka

No ugha

1

2

706







PROBE Anyone else










ckn





A

B

C

D

E

F

G

H

I

J

K

X










1

2

3

4

32









707


706

b



soapwater and

surfashoilother)




lkcquikuh vkSj


CODE ONE ONLY








706c




hands with soap




706

d





33


NAME] passed stools





xk Fkk





Buried tyk fnk Fkk


Other vU

1

2

3

4

5

6

7



members of your

household



lzregr Dk gS











pSuyfrac12


1

2

3

4

5

6

7

8

9

10

11

12

13

14

712




gS


Elsewhere vU=

1

2

712






fdruk le yxrk gS


__

__



txg ij dkSu tkrk gS


1

2

3

4

34


future use (for use




Yes gka

No ugha

1

2

715











1

2

3

4



djds dgkWa j[krs gS



1

2





cukrh gSa

Yes gka

No ugha

1

2

717




drink



djrs gS


Boil mckyuk









A

B

C

D

E

F

G

X

35






ifjokj dj jgs gS












k [ksr dk bLrseky


1

2

3

4

5

6

7

8

9

10

11

12

721



facility with other



gSa

Yes gka

No ugha

1

2

720





Number la[k



including children







ikl

Yes gka

No ugha

1

2

36



dSls fuiVkrs gS


In a drain ukys esa



1

2

3

4

5






vki tgka jgrs gSa

Yes gka

No ugha

1

2








A B C D




rjhds Dk gS






1

2

3

4

5



Strongly

agree

Agree lger

Disagree

असहमत

Strongly

Disagree





1 2 3 4

37




1 2 3 4




1 2 3 4





1 2 3 4







1 2 3 4



ij gksrk gS

1 2 3 4




dgrh gWawa



1 2 3 4

PNC




1 2 3 4



feyuk vke ckr gS

1 2 3 4





1 2 3 4

Family Planning

38



dks vPNk ekurs gSa

1 2 3 4





djrh gWaw

1 2 3 4





1 2 3 4



dqN yxkrs gS

1 2 3 4



1 2 3 4





1 2 3 4





fiykk tkrk gS

1 2 3 4





gS

1 2 3 4





1 2 3 4


39





1 2 3 4






1 2 3 4




1 2 3 4





1 2 3 4




1 2 3 4



mckyrs gSa

1 2 3 4




1 2 3 4




1 2 3 4



dk leFkZu djsaxs

1 2 3 4





1 2 3 4


40



















1

2

3

4

5

911









1

2

3

4

5




सलया था

Days ____

दिन______







Yes gka

No ugha

1

2

909





has an emergency A


41





Aacutelo dh rSkjh





dkZdze k vU kstuk


lkQ vkSj lqjfkr tUe







Breastfeeding J

Lruiku


iwjd vkgkj

Immunizations L

Vhdkdjk

Family planning M

ifjokj fukstu

Sanitationhygiene N

LoPNrk

other (specify) X




community group


Yes हा______________1

No नही_______________2



Number __________

सखया




Yes हा______________1

No_ नही______________2

42

community group






fyk

Yes


1

2

3

911

911





ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X





1

2




Yes gka

No ugha

1

2



djrh gSa

Yes gka

No ugha


1

2

3



gS

Yes gka

No ugha

1

2

916


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


25


Kala azar



1 हा


A B C D E








Yes gka

No ugha

1

2



written down





01

02

03

506

506




Vhdk yxokk gS

Yes हाा

No नह ी

BCG chlhth 1 2


le fnk xk

1 2


DPT MhihVh 1 1 2


DPT MhihVh 2 1 2


DPT MhihVh 3 1 2

26

Measles [kljk 1 2


1 2



ntZ ugha gS







Yes gka

No ugha

1

2








Yes gka

No ugha

1

2




Yes gka

No ugha

1

2



igyk yxk Fkk

Yes gka

No ugha

1

2





Number la[k

_____




Yes gka

No ugha

1

2


27





Number la[k

_____



Yes gka

No ugha

1

2



Yes gka

No ugha

1

2


ldrs gSs






gS





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

If 602a=1 or 602b=1 skip to 605





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

28






Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2







Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




izksx dj ldrs gS

Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1


29


jgs gS














L



[CHILD NAME] wanted



1

2

3


about the future




(more) children





vkSj cPpk pkgsaxs





1

2

3

4





1

2

3

4

5

30







1 2

1 2

1 2

1 2

1 2

1 2

1 2








Yes gka

No ugha

1

2

701

b


washing to you



Yes

No

1

2




PROBE Anyone else





f[kykus ls igys




A

B

C

D

X

Y

Z

31





pkfg

PROBE Anyone else














None dksbZ Hkh ugha

A

B

C

D

E

F

G

H

I

J

X

Y




Yes gka

No ugha

1

2

706







PROBE Anyone else










ckn





A

B

C

D

E

F

G

H

I

J

K

X










1

2

3

4

32









707


706

b



soapwater and

surfashoilother)




lkcquikuh vkSj


CODE ONE ONLY








706c




hands with soap




706

d





33


NAME] passed stools





xk Fkk





Buried tyk fnk Fkk


Other vU

1

2

3

4

5

6

7



members of your

household



lzregr Dk gS











pSuyfrac12


1

2

3

4

5

6

7

8

9

10

11

12

13

14

712




gS


Elsewhere vU=

1

2

712






fdruk le yxrk gS


__

__



txg ij dkSu tkrk gS


1

2

3

4

34


future use (for use




Yes gka

No ugha

1

2

715











1

2

3

4



djds dgkWa j[krs gS



1

2





cukrh gSa

Yes gka

No ugha

1

2

717




drink



djrs gS


Boil mckyuk









A

B

C

D

E

F

G

X

35






ifjokj dj jgs gS












k [ksr dk bLrseky


1

2

3

4

5

6

7

8

9

10

11

12

721



facility with other



gSa

Yes gka

No ugha

1

2

720





Number la[k



including children







ikl

Yes gka

No ugha

1

2

36



dSls fuiVkrs gS


In a drain ukys esa



1

2

3

4

5






vki tgka jgrs gSa

Yes gka

No ugha

1

2








A B C D




rjhds Dk gS






1

2

3

4

5



Strongly

agree

Agree lger

Disagree

असहमत

Strongly

Disagree





1 2 3 4

37




1 2 3 4




1 2 3 4





1 2 3 4







1 2 3 4



ij gksrk gS

1 2 3 4




dgrh gWawa



1 2 3 4

PNC




1 2 3 4



feyuk vke ckr gS

1 2 3 4





1 2 3 4

Family Planning

38



dks vPNk ekurs gSa

1 2 3 4





djrh gWaw

1 2 3 4





1 2 3 4



dqN yxkrs gS

1 2 3 4



1 2 3 4





1 2 3 4





fiykk tkrk gS

1 2 3 4





gS

1 2 3 4





1 2 3 4


39





1 2 3 4






1 2 3 4




1 2 3 4





1 2 3 4




1 2 3 4



mckyrs gSa

1 2 3 4




1 2 3 4




1 2 3 4



dk leFkZu djsaxs

1 2 3 4





1 2 3 4


40



















1

2

3

4

5

911









1

2

3

4

5




सलया था

Days ____

दिन______







Yes gka

No ugha

1

2

909





has an emergency A


41





Aacutelo dh rSkjh





dkZdze k vU kstuk


lkQ vkSj lqjfkr tUe







Breastfeeding J

Lruiku


iwjd vkgkj

Immunizations L

Vhdkdjk

Family planning M

ifjokj fukstu

Sanitationhygiene N

LoPNrk

other (specify) X




community group


Yes हा______________1

No नही_______________2



Number __________

सखया




Yes हा______________1

No_ नही______________2

42

community group






fyk

Yes


1

2

3

911

911





ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X





1

2




Yes gka

No ugha

1

2



djrh gSa

Yes gka

No ugha


1

2

3



gS

Yes gka

No ugha

1

2

916


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


26

Measles [kljk 1 2


1 2



ntZ ugha gS







Yes gka

No ugha

1

2








Yes gka

No ugha

1

2




Yes gka

No ugha

1

2



igyk yxk Fkk

Yes gka

No ugha

1

2





Number la[k

_____




Yes gka

No ugha

1

2


27





Number la[k

_____



Yes gka

No ugha

1

2



Yes gka

No ugha

1

2


ldrs gSs






gS





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

If 602a=1 or 602b=1 skip to 605





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

28






Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2







Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




izksx dj ldrs gS

Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1


29


jgs gS














L



[CHILD NAME] wanted



1

2

3


about the future




(more) children





vkSj cPpk pkgsaxs





1

2

3

4





1

2

3

4

5

30







1 2

1 2

1 2

1 2

1 2

1 2

1 2








Yes gka

No ugha

1

2

701

b


washing to you



Yes

No

1

2




PROBE Anyone else





f[kykus ls igys




A

B

C

D

X

Y

Z

31





pkfg

PROBE Anyone else














None dksbZ Hkh ugha

A

B

C

D

E

F

G

H

I

J

X

Y




Yes gka

No ugha

1

2

706







PROBE Anyone else










ckn





A

B

C

D

E

F

G

H

I

J

K

X










1

2

3

4

32









707


706

b



soapwater and

surfashoilother)




lkcquikuh vkSj


CODE ONE ONLY








706c




hands with soap




706

d





33


NAME] passed stools





xk Fkk





Buried tyk fnk Fkk


Other vU

1

2

3

4

5

6

7



members of your

household



lzregr Dk gS











pSuyfrac12


1

2

3

4

5

6

7

8

9

10

11

12

13

14

712




gS


Elsewhere vU=

1

2

712






fdruk le yxrk gS


__

__



txg ij dkSu tkrk gS


1

2

3

4

34


future use (for use




Yes gka

No ugha

1

2

715











1

2

3

4



djds dgkWa j[krs gS



1

2





cukrh gSa

Yes gka

No ugha

1

2

717




drink



djrs gS


Boil mckyuk









A

B

C

D

E

F

G

X

35






ifjokj dj jgs gS












k [ksr dk bLrseky


1

2

3

4

5

6

7

8

9

10

11

12

721



facility with other



gSa

Yes gka

No ugha

1

2

720





Number la[k



including children







ikl

Yes gka

No ugha

1

2

36



dSls fuiVkrs gS


In a drain ukys esa



1

2

3

4

5






vki tgka jgrs gSa

Yes gka

No ugha

1

2








A B C D




rjhds Dk gS






1

2

3

4

5



Strongly

agree

Agree lger

Disagree

असहमत

Strongly

Disagree





1 2 3 4

37




1 2 3 4




1 2 3 4





1 2 3 4







1 2 3 4



ij gksrk gS

1 2 3 4




dgrh gWawa



1 2 3 4

PNC




1 2 3 4



feyuk vke ckr gS

1 2 3 4





1 2 3 4

Family Planning

38



dks vPNk ekurs gSa

1 2 3 4





djrh gWaw

1 2 3 4





1 2 3 4



dqN yxkrs gS

1 2 3 4



1 2 3 4





1 2 3 4





fiykk tkrk gS

1 2 3 4





gS

1 2 3 4





1 2 3 4


39





1 2 3 4






1 2 3 4




1 2 3 4





1 2 3 4




1 2 3 4



mckyrs gSa

1 2 3 4




1 2 3 4




1 2 3 4



dk leFkZu djsaxs

1 2 3 4





1 2 3 4


40



















1

2

3

4

5

911









1

2

3

4

5




सलया था

Days ____

दिन______







Yes gka

No ugha

1

2

909





has an emergency A


41





Aacutelo dh rSkjh





dkZdze k vU kstuk


lkQ vkSj lqjfkr tUe







Breastfeeding J

Lruiku


iwjd vkgkj

Immunizations L

Vhdkdjk

Family planning M

ifjokj fukstu

Sanitationhygiene N

LoPNrk

other (specify) X




community group


Yes हा______________1

No नही_______________2



Number __________

सखया




Yes हा______________1

No_ नही______________2

42

community group






fyk

Yes


1

2

3

911

911





ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X





1

2




Yes gka

No ugha

1

2



djrh gSa

Yes gka

No ugha


1

2

3



gS

Yes gka

No ugha

1

2

916


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


27





Number la[k

_____



Yes gka

No ugha

1

2



Yes gka

No ugha

1

2


ldrs gSs






gS





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

If 602a=1 or 602b=1 skip to 605





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2

28






Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2







Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




izksx dj ldrs gS

Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1


29


jgs gS














L



[CHILD NAME] wanted



1

2

3


about the future




(more) children





vkSj cPpk pkgsaxs





1

2

3

4





1

2

3

4

5

30







1 2

1 2

1 2

1 2

1 2

1 2

1 2








Yes gka

No ugha

1

2

701

b


washing to you



Yes

No

1

2




PROBE Anyone else





f[kykus ls igys




A

B

C

D

X

Y

Z

31





pkfg

PROBE Anyone else














None dksbZ Hkh ugha

A

B

C

D

E

F

G

H

I

J

X

Y




Yes gka

No ugha

1

2

706







PROBE Anyone else










ckn





A

B

C

D

E

F

G

H

I

J

K

X










1

2

3

4

32









707


706

b



soapwater and

surfashoilother)




lkcquikuh vkSj


CODE ONE ONLY








706c




hands with soap




706

d





33


NAME] passed stools





xk Fkk





Buried tyk fnk Fkk


Other vU

1

2

3

4

5

6

7



members of your

household



lzregr Dk gS











pSuyfrac12


1

2

3

4

5

6

7

8

9

10

11

12

13

14

712




gS


Elsewhere vU=

1

2

712






fdruk le yxrk gS


__

__



txg ij dkSu tkrk gS


1

2

3

4

34


future use (for use




Yes gka

No ugha

1

2

715











1

2

3

4



djds dgkWa j[krs gS



1

2





cukrh gSa

Yes gka

No ugha

1

2

717




drink



djrs gS


Boil mckyuk









A

B

C

D

E

F

G

X

35






ifjokj dj jgs gS












k [ksr dk bLrseky


1

2

3

4

5

6

7

8

9

10

11

12

721



facility with other



gSa

Yes gka

No ugha

1

2

720





Number la[k



including children







ikl

Yes gka

No ugha

1

2

36



dSls fuiVkrs gS


In a drain ukys esa



1

2

3

4

5






vki tgka jgrs gSa

Yes gka

No ugha

1

2








A B C D




rjhds Dk gS






1

2

3

4

5



Strongly

agree

Agree lger

Disagree

असहमत

Strongly

Disagree





1 2 3 4

37




1 2 3 4




1 2 3 4





1 2 3 4







1 2 3 4



ij gksrk gS

1 2 3 4




dgrh gWawa



1 2 3 4

PNC




1 2 3 4



feyuk vke ckr gS

1 2 3 4





1 2 3 4

Family Planning

38



dks vPNk ekurs gSa

1 2 3 4





djrh gWaw

1 2 3 4





1 2 3 4



dqN yxkrs gS

1 2 3 4



1 2 3 4





1 2 3 4





fiykk tkrk gS

1 2 3 4





gS

1 2 3 4





1 2 3 4


39





1 2 3 4






1 2 3 4




1 2 3 4





1 2 3 4




1 2 3 4



mckyrs gSa

1 2 3 4




1 2 3 4




1 2 3 4



dk leFkZu djsaxs

1 2 3 4





1 2 3 4


40



















1

2

3

4

5

911









1

2

3

4

5




सलया था

Days ____

दिन______







Yes gka

No ugha

1

2

909





has an emergency A


41





Aacutelo dh rSkjh





dkZdze k vU kstuk


lkQ vkSj lqjfkr tUe







Breastfeeding J

Lruiku


iwjd vkgkj

Immunizations L

Vhdkdjk

Family planning M

ifjokj fukstu

Sanitationhygiene N

LoPNrk

other (specify) X




community group


Yes हा______________1

No नही_______________2



Number __________

सखया




Yes हा______________1

No_ नही______________2

42

community group






fyk

Yes


1

2

3

911

911





ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X





1

2




Yes gka

No ugha

1

2



djrh gSa

Yes gka

No ugha


1

2

3



gS

Yes gka

No ugha

1

2

916


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


28






Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2







Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1 No ugha 2

Yes gka 1 No ugha 2





Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




izksx dj ldrs gS

Yes gka 1 No ugha 2

Yes gka 1 No ugha 2




Yes gka 1


29


jgs gS














L



[CHILD NAME] wanted



1

2

3


about the future




(more) children





vkSj cPpk pkgsaxs





1

2

3

4





1

2

3

4

5

30







1 2

1 2

1 2

1 2

1 2

1 2

1 2








Yes gka

No ugha

1

2

701

b


washing to you



Yes

No

1

2




PROBE Anyone else





f[kykus ls igys




A

B

C

D

X

Y

Z

31





pkfg

PROBE Anyone else














None dksbZ Hkh ugha

A

B

C

D

E

F

G

H

I

J

X

Y




Yes gka

No ugha

1

2

706







PROBE Anyone else










ckn





A

B

C

D

E

F

G

H

I

J

K

X










1

2

3

4

32









707


706

b



soapwater and

surfashoilother)




lkcquikuh vkSj


CODE ONE ONLY








706c




hands with soap




706

d





33


NAME] passed stools





xk Fkk





Buried tyk fnk Fkk


Other vU

1

2

3

4

5

6

7



members of your

household



lzregr Dk gS











pSuyfrac12


1

2

3

4

5

6

7

8

9

10

11

12

13

14

712




gS


Elsewhere vU=

1

2

712






fdruk le yxrk gS


__

__



txg ij dkSu tkrk gS


1

2

3

4

34


future use (for use




Yes gka

No ugha

1

2

715











1

2

3

4



djds dgkWa j[krs gS



1

2





cukrh gSa

Yes gka

No ugha

1

2

717




drink



djrs gS


Boil mckyuk









A

B

C

D

E

F

G

X

35






ifjokj dj jgs gS












k [ksr dk bLrseky


1

2

3

4

5

6

7

8

9

10

11

12

721



facility with other



gSa

Yes gka

No ugha

1

2

720





Number la[k



including children







ikl

Yes gka

No ugha

1

2

36



dSls fuiVkrs gS


In a drain ukys esa



1

2

3

4

5






vki tgka jgrs gSa

Yes gka

No ugha

1

2








A B C D




rjhds Dk gS






1

2

3

4

5



Strongly

agree

Agree lger

Disagree

असहमत

Strongly

Disagree





1 2 3 4

37




1 2 3 4




1 2 3 4





1 2 3 4







1 2 3 4



ij gksrk gS

1 2 3 4




dgrh gWawa



1 2 3 4

PNC




1 2 3 4



feyuk vke ckr gS

1 2 3 4





1 2 3 4

Family Planning

38



dks vPNk ekurs gSa

1 2 3 4





djrh gWaw

1 2 3 4





1 2 3 4



dqN yxkrs gS

1 2 3 4



1 2 3 4





1 2 3 4





fiykk tkrk gS

1 2 3 4





gS

1 2 3 4





1 2 3 4


39





1 2 3 4






1 2 3 4




1 2 3 4





1 2 3 4




1 2 3 4



mckyrs gSa

1 2 3 4




1 2 3 4




1 2 3 4



dk leFkZu djsaxs

1 2 3 4





1 2 3 4


40



















1

2

3

4

5

911









1

2

3

4

5




सलया था

Days ____

दिन______







Yes gka

No ugha

1

2

909





has an emergency A


41





Aacutelo dh rSkjh





dkZdze k vU kstuk


lkQ vkSj lqjfkr tUe







Breastfeeding J

Lruiku


iwjd vkgkj

Immunizations L

Vhdkdjk

Family planning M

ifjokj fukstu

Sanitationhygiene N

LoPNrk

other (specify) X




community group


Yes हा______________1

No नही_______________2



Number __________

सखया




Yes हा______________1

No_ नही______________2

42

community group






fyk

Yes


1

2

3

911

911





ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X





1

2




Yes gka

No ugha

1

2



djrh gSa

Yes gka

No ugha


1

2

3



gS

Yes gka

No ugha

1

2

916


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


29


jgs gS














L



[CHILD NAME] wanted



1

2

3


about the future




(more) children





vkSj cPpk pkgsaxs





1

2

3

4





1

2

3

4

5

30







1 2

1 2

1 2

1 2

1 2

1 2

1 2








Yes gka

No ugha

1

2

701

b


washing to you



Yes

No

1

2




PROBE Anyone else





f[kykus ls igys




A

B

C

D

X

Y

Z

31





pkfg

PROBE Anyone else














None dksbZ Hkh ugha

A

B

C

D

E

F

G

H

I

J

X

Y




Yes gka

No ugha

1

2

706







PROBE Anyone else










ckn





A

B

C

D

E

F

G

H

I

J

K

X










1

2

3

4

32









707


706

b



soapwater and

surfashoilother)




lkcquikuh vkSj


CODE ONE ONLY








706c




hands with soap




706

d





33


NAME] passed stools





xk Fkk





Buried tyk fnk Fkk


Other vU

1

2

3

4

5

6

7



members of your

household



lzregr Dk gS











pSuyfrac12


1

2

3

4

5

6

7

8

9

10

11

12

13

14

712




gS


Elsewhere vU=

1

2

712






fdruk le yxrk gS


__

__



txg ij dkSu tkrk gS


1

2

3

4

34


future use (for use




Yes gka

No ugha

1

2

715











1

2

3

4



djds dgkWa j[krs gS



1

2





cukrh gSa

Yes gka

No ugha

1

2

717




drink



djrs gS


Boil mckyuk









A

B

C

D

E

F

G

X

35






ifjokj dj jgs gS












k [ksr dk bLrseky


1

2

3

4

5

6

7

8

9

10

11

12

721



facility with other



gSa

Yes gka

No ugha

1

2

720





Number la[k



including children







ikl

Yes gka

No ugha

1

2

36



dSls fuiVkrs gS


In a drain ukys esa



1

2

3

4

5






vki tgka jgrs gSa

Yes gka

No ugha

1

2








A B C D




rjhds Dk gS






1

2

3

4

5



Strongly

agree

Agree lger

Disagree

असहमत

Strongly

Disagree





1 2 3 4

37




1 2 3 4




1 2 3 4





1 2 3 4







1 2 3 4



ij gksrk gS

1 2 3 4




dgrh gWawa



1 2 3 4

PNC




1 2 3 4



feyuk vke ckr gS

1 2 3 4





1 2 3 4

Family Planning

38



dks vPNk ekurs gSa

1 2 3 4





djrh gWaw

1 2 3 4





1 2 3 4



dqN yxkrs gS

1 2 3 4



1 2 3 4





1 2 3 4





fiykk tkrk gS

1 2 3 4





gS

1 2 3 4





1 2 3 4


39





1 2 3 4






1 2 3 4




1 2 3 4





1 2 3 4




1 2 3 4



mckyrs gSa

1 2 3 4




1 2 3 4




1 2 3 4



dk leFkZu djsaxs

1 2 3 4





1 2 3 4


40



















1

2

3

4

5

911









1

2

3

4

5




सलया था

Days ____

दिन______







Yes gka

No ugha

1

2

909





has an emergency A


41





Aacutelo dh rSkjh





dkZdze k vU kstuk


lkQ vkSj lqjfkr tUe







Breastfeeding J

Lruiku


iwjd vkgkj

Immunizations L

Vhdkdjk

Family planning M

ifjokj fukstu

Sanitationhygiene N

LoPNrk

other (specify) X




community group


Yes हा______________1

No नही_______________2



Number __________

सखया




Yes हा______________1

No_ नही______________2

42

community group






fyk

Yes


1

2

3

911

911





ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X





1

2




Yes gka

No ugha

1

2



djrh gSa

Yes gka

No ugha


1

2

3



gS

Yes gka

No ugha

1

2

916


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


30







1 2

1 2

1 2

1 2

1 2

1 2

1 2








Yes gka

No ugha

1

2

701

b


washing to you



Yes

No

1

2




PROBE Anyone else





f[kykus ls igys




A

B

C

D

X

Y

Z

31





pkfg

PROBE Anyone else














None dksbZ Hkh ugha

A

B

C

D

E

F

G

H

I

J

X

Y




Yes gka

No ugha

1

2

706







PROBE Anyone else










ckn





A

B

C

D

E

F

G

H

I

J

K

X










1

2

3

4

32









707


706

b



soapwater and

surfashoilother)




lkcquikuh vkSj


CODE ONE ONLY








706c




hands with soap




706

d





33


NAME] passed stools





xk Fkk





Buried tyk fnk Fkk


Other vU

1

2

3

4

5

6

7



members of your

household



lzregr Dk gS











pSuyfrac12


1

2

3

4

5

6

7

8

9

10

11

12

13

14

712




gS


Elsewhere vU=

1

2

712






fdruk le yxrk gS


__

__



txg ij dkSu tkrk gS


1

2

3

4

34


future use (for use




Yes gka

No ugha

1

2

715











1

2

3

4



djds dgkWa j[krs gS



1

2





cukrh gSa

Yes gka

No ugha

1

2

717




drink



djrs gS


Boil mckyuk









A

B

C

D

E

F

G

X

35






ifjokj dj jgs gS












k [ksr dk bLrseky


1

2

3

4

5

6

7

8

9

10

11

12

721



facility with other



gSa

Yes gka

No ugha

1

2

720





Number la[k



including children







ikl

Yes gka

No ugha

1

2

36



dSls fuiVkrs gS


In a drain ukys esa



1

2

3

4

5






vki tgka jgrs gSa

Yes gka

No ugha

1

2








A B C D




rjhds Dk gS






1

2

3

4

5



Strongly

agree

Agree lger

Disagree

असहमत

Strongly

Disagree





1 2 3 4

37




1 2 3 4




1 2 3 4





1 2 3 4







1 2 3 4



ij gksrk gS

1 2 3 4




dgrh gWawa



1 2 3 4

PNC




1 2 3 4



feyuk vke ckr gS

1 2 3 4





1 2 3 4

Family Planning

38



dks vPNk ekurs gSa

1 2 3 4





djrh gWaw

1 2 3 4





1 2 3 4



dqN yxkrs gS

1 2 3 4



1 2 3 4





1 2 3 4





fiykk tkrk gS

1 2 3 4





gS

1 2 3 4





1 2 3 4


39





1 2 3 4






1 2 3 4




1 2 3 4





1 2 3 4




1 2 3 4



mckyrs gSa

1 2 3 4




1 2 3 4




1 2 3 4



dk leFkZu djsaxs

1 2 3 4





1 2 3 4


40



















1

2

3

4

5

911









1

2

3

4

5




सलया था

Days ____

दिन______







Yes gka

No ugha

1

2

909





has an emergency A


41





Aacutelo dh rSkjh





dkZdze k vU kstuk


lkQ vkSj lqjfkr tUe







Breastfeeding J

Lruiku


iwjd vkgkj

Immunizations L

Vhdkdjk

Family planning M

ifjokj fukstu

Sanitationhygiene N

LoPNrk

other (specify) X




community group


Yes हा______________1

No नही_______________2



Number __________

सखया




Yes हा______________1

No_ नही______________2

42

community group






fyk

Yes


1

2

3

911

911





ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X





1

2




Yes gka

No ugha

1

2



djrh gSa

Yes gka

No ugha


1

2

3



gS

Yes gka

No ugha

1

2

916


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


31





pkfg

PROBE Anyone else














None dksbZ Hkh ugha

A

B

C

D

E

F

G

H

I

J

X

Y




Yes gka

No ugha

1

2

706







PROBE Anyone else










ckn





A

B

C

D

E

F

G

H

I

J

K

X










1

2

3

4

32









707


706

b



soapwater and

surfashoilother)




lkcquikuh vkSj


CODE ONE ONLY








706c




hands with soap




706

d





33


NAME] passed stools





xk Fkk





Buried tyk fnk Fkk


Other vU

1

2

3

4

5

6

7



members of your

household



lzregr Dk gS











pSuyfrac12


1

2

3

4

5

6

7

8

9

10

11

12

13

14

712




gS


Elsewhere vU=

1

2

712






fdruk le yxrk gS


__

__



txg ij dkSu tkrk gS


1

2

3

4

34


future use (for use




Yes gka

No ugha

1

2

715











1

2

3

4



djds dgkWa j[krs gS



1

2





cukrh gSa

Yes gka

No ugha

1

2

717




drink



djrs gS


Boil mckyuk









A

B

C

D

E

F

G

X

35






ifjokj dj jgs gS












k [ksr dk bLrseky


1

2

3

4

5

6

7

8

9

10

11

12

721



facility with other



gSa

Yes gka

No ugha

1

2

720





Number la[k



including children







ikl

Yes gka

No ugha

1

2

36



dSls fuiVkrs gS


In a drain ukys esa



1

2

3

4

5






vki tgka jgrs gSa

Yes gka

No ugha

1

2








A B C D




rjhds Dk gS






1

2

3

4

5



Strongly

agree

Agree lger

Disagree

असहमत

Strongly

Disagree





1 2 3 4

37




1 2 3 4




1 2 3 4





1 2 3 4







1 2 3 4



ij gksrk gS

1 2 3 4




dgrh gWawa



1 2 3 4

PNC




1 2 3 4



feyuk vke ckr gS

1 2 3 4





1 2 3 4

Family Planning

38



dks vPNk ekurs gSa

1 2 3 4





djrh gWaw

1 2 3 4





1 2 3 4



dqN yxkrs gS

1 2 3 4



1 2 3 4





1 2 3 4





fiykk tkrk gS

1 2 3 4





gS

1 2 3 4





1 2 3 4


39





1 2 3 4






1 2 3 4




1 2 3 4





1 2 3 4




1 2 3 4



mckyrs gSa

1 2 3 4




1 2 3 4




1 2 3 4



dk leFkZu djsaxs

1 2 3 4





1 2 3 4


40



















1

2

3

4

5

911









1

2

3

4

5




सलया था

Days ____

दिन______







Yes gka

No ugha

1

2

909





has an emergency A


41





Aacutelo dh rSkjh





dkZdze k vU kstuk


lkQ vkSj lqjfkr tUe







Breastfeeding J

Lruiku


iwjd vkgkj

Immunizations L

Vhdkdjk

Family planning M

ifjokj fukstu

Sanitationhygiene N

LoPNrk

other (specify) X




community group


Yes हा______________1

No नही_______________2



Number __________

सखया




Yes हा______________1

No_ नही______________2

42

community group






fyk

Yes


1

2

3

911

911





ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X





1

2




Yes gka

No ugha

1

2



djrh gSa

Yes gka

No ugha


1

2

3



gS

Yes gka

No ugha

1

2

916


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


32









707


706

b



soapwater and

surfashoilother)




lkcquikuh vkSj


CODE ONE ONLY








706c




hands with soap




706

d





33


NAME] passed stools





xk Fkk





Buried tyk fnk Fkk


Other vU

1

2

3

4

5

6

7



members of your

household



lzregr Dk gS











pSuyfrac12


1

2

3

4

5

6

7

8

9

10

11

12

13

14

712




gS


Elsewhere vU=

1

2

712






fdruk le yxrk gS


__

__



txg ij dkSu tkrk gS


1

2

3

4

34


future use (for use




Yes gka

No ugha

1

2

715











1

2

3

4



djds dgkWa j[krs gS



1

2





cukrh gSa

Yes gka

No ugha

1

2

717




drink



djrs gS


Boil mckyuk









A

B

C

D

E

F

G

X

35






ifjokj dj jgs gS












k [ksr dk bLrseky


1

2

3

4

5

6

7

8

9

10

11

12

721



facility with other



gSa

Yes gka

No ugha

1

2

720





Number la[k



including children







ikl

Yes gka

No ugha

1

2

36



dSls fuiVkrs gS


In a drain ukys esa



1

2

3

4

5






vki tgka jgrs gSa

Yes gka

No ugha

1

2








A B C D




rjhds Dk gS






1

2

3

4

5



Strongly

agree

Agree lger

Disagree

असहमत

Strongly

Disagree





1 2 3 4

37




1 2 3 4




1 2 3 4





1 2 3 4







1 2 3 4



ij gksrk gS

1 2 3 4




dgrh gWawa



1 2 3 4

PNC




1 2 3 4



feyuk vke ckr gS

1 2 3 4





1 2 3 4

Family Planning

38



dks vPNk ekurs gSa

1 2 3 4





djrh gWaw

1 2 3 4





1 2 3 4



dqN yxkrs gS

1 2 3 4



1 2 3 4





1 2 3 4





fiykk tkrk gS

1 2 3 4





gS

1 2 3 4





1 2 3 4


39





1 2 3 4






1 2 3 4




1 2 3 4





1 2 3 4




1 2 3 4



mckyrs gSa

1 2 3 4




1 2 3 4




1 2 3 4



dk leFkZu djsaxs

1 2 3 4





1 2 3 4


40



















1

2

3

4

5

911









1

2

3

4

5




सलया था

Days ____

दिन______







Yes gka

No ugha

1

2

909





has an emergency A


41





Aacutelo dh rSkjh





dkZdze k vU kstuk


lkQ vkSj lqjfkr tUe







Breastfeeding J

Lruiku


iwjd vkgkj

Immunizations L

Vhdkdjk

Family planning M

ifjokj fukstu

Sanitationhygiene N

LoPNrk

other (specify) X




community group


Yes हा______________1

No नही_______________2



Number __________

सखया




Yes हा______________1

No_ नही______________2

42

community group






fyk

Yes


1

2

3

911

911





ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X





1

2




Yes gka

No ugha

1

2



djrh gSa

Yes gka

No ugha


1

2

3



gS

Yes gka

No ugha

1

2

916


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


33


NAME] passed stools





xk Fkk





Buried tyk fnk Fkk


Other vU

1

2

3

4

5

6

7



members of your

household



lzregr Dk gS











pSuyfrac12


1

2

3

4

5

6

7

8

9

10

11

12

13

14

712




gS


Elsewhere vU=

1

2

712






fdruk le yxrk gS


__

__



txg ij dkSu tkrk gS


1

2

3

4

34


future use (for use




Yes gka

No ugha

1

2

715











1

2

3

4



djds dgkWa j[krs gS



1

2





cukrh gSa

Yes gka

No ugha

1

2

717




drink



djrs gS


Boil mckyuk









A

B

C

D

E

F

G

X

35






ifjokj dj jgs gS












k [ksr dk bLrseky


1

2

3

4

5

6

7

8

9

10

11

12

721



facility with other



gSa

Yes gka

No ugha

1

2

720





Number la[k



including children







ikl

Yes gka

No ugha

1

2

36



dSls fuiVkrs gS


In a drain ukys esa



1

2

3

4

5






vki tgka jgrs gSa

Yes gka

No ugha

1

2








A B C D




rjhds Dk gS






1

2

3

4

5



Strongly

agree

Agree lger

Disagree

असहमत

Strongly

Disagree





1 2 3 4

37




1 2 3 4




1 2 3 4





1 2 3 4







1 2 3 4



ij gksrk gS

1 2 3 4




dgrh gWawa



1 2 3 4

PNC




1 2 3 4



feyuk vke ckr gS

1 2 3 4





1 2 3 4

Family Planning

38



dks vPNk ekurs gSa

1 2 3 4





djrh gWaw

1 2 3 4





1 2 3 4



dqN yxkrs gS

1 2 3 4



1 2 3 4





1 2 3 4





fiykk tkrk gS

1 2 3 4





gS

1 2 3 4





1 2 3 4


39





1 2 3 4






1 2 3 4




1 2 3 4





1 2 3 4




1 2 3 4



mckyrs gSa

1 2 3 4




1 2 3 4




1 2 3 4



dk leFkZu djsaxs

1 2 3 4





1 2 3 4


40



















1

2

3

4

5

911









1

2

3

4

5




सलया था

Days ____

दिन______







Yes gka

No ugha

1

2

909





has an emergency A


41





Aacutelo dh rSkjh





dkZdze k vU kstuk


lkQ vkSj lqjfkr tUe







Breastfeeding J

Lruiku


iwjd vkgkj

Immunizations L

Vhdkdjk

Family planning M

ifjokj fukstu

Sanitationhygiene N

LoPNrk

other (specify) X




community group


Yes हा______________1

No नही_______________2



Number __________

सखया




Yes हा______________1

No_ नही______________2

42

community group






fyk

Yes


1

2

3

911

911





ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X





1

2




Yes gka

No ugha

1

2



djrh gSa

Yes gka

No ugha


1

2

3



gS

Yes gka

No ugha

1

2

916


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


34


future use (for use




Yes gka

No ugha

1

2

715











1

2

3

4



djds dgkWa j[krs gS



1

2





cukrh gSa

Yes gka

No ugha

1

2

717




drink



djrs gS


Boil mckyuk









A

B

C

D

E

F

G

X

35






ifjokj dj jgs gS












k [ksr dk bLrseky


1

2

3

4

5

6

7

8

9

10

11

12

721



facility with other



gSa

Yes gka

No ugha

1

2

720





Number la[k



including children







ikl

Yes gka

No ugha

1

2

36



dSls fuiVkrs gS


In a drain ukys esa



1

2

3

4

5






vki tgka jgrs gSa

Yes gka

No ugha

1

2








A B C D




rjhds Dk gS






1

2

3

4

5



Strongly

agree

Agree lger

Disagree

असहमत

Strongly

Disagree





1 2 3 4

37




1 2 3 4




1 2 3 4





1 2 3 4







1 2 3 4



ij gksrk gS

1 2 3 4




dgrh gWawa



1 2 3 4

PNC




1 2 3 4



feyuk vke ckr gS

1 2 3 4





1 2 3 4

Family Planning

38



dks vPNk ekurs gSa

1 2 3 4





djrh gWaw

1 2 3 4





1 2 3 4



dqN yxkrs gS

1 2 3 4



1 2 3 4





1 2 3 4





fiykk tkrk gS

1 2 3 4





gS

1 2 3 4





1 2 3 4


39





1 2 3 4






1 2 3 4




1 2 3 4





1 2 3 4




1 2 3 4



mckyrs gSa

1 2 3 4




1 2 3 4




1 2 3 4



dk leFkZu djsaxs

1 2 3 4





1 2 3 4


40



















1

2

3

4

5

911









1

2

3

4

5




सलया था

Days ____

दिन______







Yes gka

No ugha

1

2

909





has an emergency A


41





Aacutelo dh rSkjh





dkZdze k vU kstuk


lkQ vkSj lqjfkr tUe







Breastfeeding J

Lruiku


iwjd vkgkj

Immunizations L

Vhdkdjk

Family planning M

ifjokj fukstu

Sanitationhygiene N

LoPNrk

other (specify) X




community group


Yes हा______________1

No नही_______________2



Number __________

सखया




Yes हा______________1

No_ नही______________2

42

community group






fyk

Yes


1

2

3

911

911





ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X





1

2




Yes gka

No ugha

1

2



djrh gSa

Yes gka

No ugha


1

2

3



gS

Yes gka

No ugha

1

2

916


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


35






ifjokj dj jgs gS












k [ksr dk bLrseky


1

2

3

4

5

6

7

8

9

10

11

12

721



facility with other



gSa

Yes gka

No ugha

1

2

720





Number la[k



including children







ikl

Yes gka

No ugha

1

2

36



dSls fuiVkrs gS


In a drain ukys esa



1

2

3

4

5






vki tgka jgrs gSa

Yes gka

No ugha

1

2








A B C D




rjhds Dk gS






1

2

3

4

5



Strongly

agree

Agree lger

Disagree

असहमत

Strongly

Disagree





1 2 3 4

37




1 2 3 4




1 2 3 4





1 2 3 4







1 2 3 4



ij gksrk gS

1 2 3 4




dgrh gWawa



1 2 3 4

PNC




1 2 3 4



feyuk vke ckr gS

1 2 3 4





1 2 3 4

Family Planning

38



dks vPNk ekurs gSa

1 2 3 4





djrh gWaw

1 2 3 4





1 2 3 4



dqN yxkrs gS

1 2 3 4



1 2 3 4





1 2 3 4





fiykk tkrk gS

1 2 3 4





gS

1 2 3 4





1 2 3 4


39





1 2 3 4






1 2 3 4




1 2 3 4





1 2 3 4




1 2 3 4



mckyrs gSa

1 2 3 4




1 2 3 4




1 2 3 4



dk leFkZu djsaxs

1 2 3 4





1 2 3 4


40



















1

2

3

4

5

911









1

2

3

4

5




सलया था

Days ____

दिन______







Yes gka

No ugha

1

2

909





has an emergency A


41





Aacutelo dh rSkjh





dkZdze k vU kstuk


lkQ vkSj lqjfkr tUe







Breastfeeding J

Lruiku


iwjd vkgkj

Immunizations L

Vhdkdjk

Family planning M

ifjokj fukstu

Sanitationhygiene N

LoPNrk

other (specify) X




community group


Yes हा______________1

No नही_______________2



Number __________

सखया




Yes हा______________1

No_ नही______________2

42

community group






fyk

Yes


1

2

3

911

911





ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X





1

2




Yes gka

No ugha

1

2



djrh gSa

Yes gka

No ugha


1

2

3



gS

Yes gka

No ugha

1

2

916


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


36



dSls fuiVkrs gS


In a drain ukys esa



1

2

3

4

5






vki tgka jgrs gSa

Yes gka

No ugha

1

2








A B C D




rjhds Dk gS






1

2

3

4

5



Strongly

agree

Agree lger

Disagree

असहमत

Strongly

Disagree





1 2 3 4

37




1 2 3 4




1 2 3 4





1 2 3 4







1 2 3 4



ij gksrk gS

1 2 3 4




dgrh gWawa



1 2 3 4

PNC




1 2 3 4



feyuk vke ckr gS

1 2 3 4





1 2 3 4

Family Planning

38



dks vPNk ekurs gSa

1 2 3 4





djrh gWaw

1 2 3 4





1 2 3 4



dqN yxkrs gS

1 2 3 4



1 2 3 4





1 2 3 4





fiykk tkrk gS

1 2 3 4





gS

1 2 3 4





1 2 3 4


39





1 2 3 4






1 2 3 4




1 2 3 4





1 2 3 4




1 2 3 4



mckyrs gSa

1 2 3 4




1 2 3 4




1 2 3 4



dk leFkZu djsaxs

1 2 3 4





1 2 3 4


40



















1

2

3

4

5

911









1

2

3

4

5




सलया था

Days ____

दिन______







Yes gka

No ugha

1

2

909





has an emergency A


41





Aacutelo dh rSkjh





dkZdze k vU kstuk


lkQ vkSj lqjfkr tUe







Breastfeeding J

Lruiku


iwjd vkgkj

Immunizations L

Vhdkdjk

Family planning M

ifjokj fukstu

Sanitationhygiene N

LoPNrk

other (specify) X




community group


Yes हा______________1

No नही_______________2



Number __________

सखया




Yes हा______________1

No_ नही______________2

42

community group






fyk

Yes


1

2

3

911

911





ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X





1

2




Yes gka

No ugha

1

2



djrh gSa

Yes gka

No ugha


1

2

3



gS

Yes gka

No ugha

1

2

916


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


37




1 2 3 4




1 2 3 4





1 2 3 4







1 2 3 4



ij gksrk gS

1 2 3 4




dgrh gWawa



1 2 3 4

PNC




1 2 3 4



feyuk vke ckr gS

1 2 3 4





1 2 3 4

Family Planning

38



dks vPNk ekurs gSa

1 2 3 4





djrh gWaw

1 2 3 4





1 2 3 4



dqN yxkrs gS

1 2 3 4



1 2 3 4





1 2 3 4





fiykk tkrk gS

1 2 3 4





gS

1 2 3 4





1 2 3 4


39





1 2 3 4






1 2 3 4




1 2 3 4





1 2 3 4




1 2 3 4



mckyrs gSa

1 2 3 4




1 2 3 4




1 2 3 4



dk leFkZu djsaxs

1 2 3 4





1 2 3 4


40



















1

2

3

4

5

911









1

2

3

4

5




सलया था

Days ____

दिन______







Yes gka

No ugha

1

2

909





has an emergency A


41





Aacutelo dh rSkjh





dkZdze k vU kstuk


lkQ vkSj lqjfkr tUe







Breastfeeding J

Lruiku


iwjd vkgkj

Immunizations L

Vhdkdjk

Family planning M

ifjokj fukstu

Sanitationhygiene N

LoPNrk

other (specify) X




community group


Yes हा______________1

No नही_______________2



Number __________

सखया




Yes हा______________1

No_ नही______________2

42

community group






fyk

Yes


1

2

3

911

911





ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X





1

2




Yes gka

No ugha

1

2



djrh gSa

Yes gka

No ugha


1

2

3



gS

Yes gka

No ugha

1

2

916


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


38



dks vPNk ekurs gSa

1 2 3 4





djrh gWaw

1 2 3 4





1 2 3 4



dqN yxkrs gS

1 2 3 4



1 2 3 4





1 2 3 4





fiykk tkrk gS

1 2 3 4





gS

1 2 3 4





1 2 3 4


39





1 2 3 4






1 2 3 4




1 2 3 4





1 2 3 4




1 2 3 4



mckyrs gSa

1 2 3 4




1 2 3 4




1 2 3 4



dk leFkZu djsaxs

1 2 3 4





1 2 3 4


40



















1

2

3

4

5

911









1

2

3

4

5




सलया था

Days ____

दिन______







Yes gka

No ugha

1

2

909





has an emergency A


41





Aacutelo dh rSkjh





dkZdze k vU kstuk


lkQ vkSj lqjfkr tUe







Breastfeeding J

Lruiku


iwjd vkgkj

Immunizations L

Vhdkdjk

Family planning M

ifjokj fukstu

Sanitationhygiene N

LoPNrk

other (specify) X




community group


Yes हा______________1

No नही_______________2



Number __________

सखया




Yes हा______________1

No_ नही______________2

42

community group






fyk

Yes


1

2

3

911

911





ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X





1

2




Yes gka

No ugha

1

2



djrh gSa

Yes gka

No ugha


1

2

3



gS

Yes gka

No ugha

1

2

916


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


39





1 2 3 4






1 2 3 4




1 2 3 4





1 2 3 4




1 2 3 4



mckyrs gSa

1 2 3 4




1 2 3 4




1 2 3 4



dk leFkZu djsaxs

1 2 3 4





1 2 3 4


40



















1

2

3

4

5

911









1

2

3

4

5




सलया था

Days ____

दिन______







Yes gka

No ugha

1

2

909





has an emergency A


41





Aacutelo dh rSkjh





dkZdze k vU kstuk


lkQ vkSj lqjfkr tUe







Breastfeeding J

Lruiku


iwjd vkgkj

Immunizations L

Vhdkdjk

Family planning M

ifjokj fukstu

Sanitationhygiene N

LoPNrk

other (specify) X




community group


Yes हा______________1

No नही_______________2



Number __________

सखया




Yes हा______________1

No_ नही______________2

42

community group






fyk

Yes


1

2

3

911

911





ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X





1

2




Yes gka

No ugha

1

2



djrh gSa

Yes gka

No ugha


1

2

3



gS

Yes gka

No ugha

1

2

916


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


40



















1

2

3

4

5

911









1

2

3

4

5




सलया था

Days ____

दिन______







Yes gka

No ugha

1

2

909





has an emergency A


41





Aacutelo dh rSkjh





dkZdze k vU kstuk


lkQ vkSj lqjfkr tUe







Breastfeeding J

Lruiku


iwjd vkgkj

Immunizations L

Vhdkdjk

Family planning M

ifjokj fukstu

Sanitationhygiene N

LoPNrk

other (specify) X




community group


Yes हा______________1

No नही_______________2



Number __________

सखया




Yes हा______________1

No_ नही______________2

42

community group






fyk

Yes


1

2

3

911

911





ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X





1

2




Yes gka

No ugha

1

2



djrh gSa

Yes gka

No ugha


1

2

3



gS

Yes gka

No ugha

1

2

916


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


41





Aacutelo dh rSkjh





dkZdze k vU kstuk


lkQ vkSj lqjfkr tUe







Breastfeeding J

Lruiku


iwjd vkgkj

Immunizations L

Vhdkdjk

Family planning M

ifjokj fukstu

Sanitationhygiene N

LoPNrk

other (specify) X




community group


Yes हा______________1

No नही_______________2



Number __________

सखया




Yes हा______________1

No_ नही______________2

42

community group






fyk

Yes


1

2

3

911

911





ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X





1

2




Yes gka

No ugha

1

2



djrh gSa

Yes gka

No ugha


1

2

3



gS

Yes gka

No ugha

1

2

916


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


42

community group






fyk

Yes


1

2

3

911

911





ASHA vkrsquokk

ANM ue


Other अनय

A

B

C

X





1

2




Yes gka

No ugha

1

2



djrh gSa

Yes gka

No ugha


1

2

3



gS

Yes gka

No ugha

1

2

916


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


43




_________




________



1

2



gS

Yes gka

No ugha

1

2

919



gS


________




________



lnL gSa



LokLF lewg


lewg

हा नही

1

1

1

1

1

2

2

2

2

2




gS

Yes हा 1

No नही 0


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


44




Yes हा 1

No नही 0


Skip to 920




PROBE Any others

dksbZ vU

CODE ALL THAT APPLY



Central Government




Programme 3 3






From Employer 5 5









Yes gka

No ugha

1

2

929








1

2

3

8

9


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


45


No ugha 2


following issues



Good vPNk

Very

Good cgqr vPNk


1 2 3 4



lqfufrsquopr djuk

1 2 3 4



dk izkl djuk

1 2 3 4





1 2 3 4






isrsquok djuk

1 2 3 4




1 2 3 4




1 2 3 4






Somewhat dqN gn rd



1

2

3

4

46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


46





Agree lger


1

2

3

4



Agree lger


1

2

3

4




Agree lger


1

2

3

4



dj jgs gSaA


Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4






Agree lger


1

2

3

4


about my problems



Agree lger


1

2

3

4


only



Agree lger


1

2

3

4




Agree lger


1

2

3

4



47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


47




Number la[k

_______

_




crkrs gS

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5





Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always geskk

1

2

3

4

5







Yes gka

No ugha

1

2

48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


48






efgykafrac12

Not at all

fairly


Somewhat

fairly


Very

fairly


Complete

ly fairly


NA ykxw ugha


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

D ANM ue

1 2 3 4 9


1 2 3 4 9


1 2 3 4 9


1 2 3 4 9

H Sarpanch Ljiap

1 2 3 4 9




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2

49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


49



change in



Not at

all


Somew

hat


Very

much


Completel

y


A You आप म 1 2 3 4



1 2 3 4



Collective Efficacy







No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


No one dksbZ ugha

Some dqN

Most vfkdkarsquok

All lc

1

2

3

4


goals



child health






1

2

3

4








1

2

3

4

50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


50


djuk





1

2

3

4










1

2

3

4

Collective agency



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



Yes gka

No ugha

NA ykxw ugha

1

2

3



women like you


Yes gka

No ugha

NA ykxw ugha

1

2

3

Collective action





Yes gka

No ugha

1

2



Yes gka

No ugha

1

2

51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


51



Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2


Yes gka

No ugha

1

2




Yes gka

No ugha



1

2

3

9




enn की थी

Yes gka

No ugha



1

2

3

9





Yes gka

No ugha



1

2

3

9









1

2

3

4








1

2

3

4






ykHk ys ldrh gS





1

2

3

4





1

2

52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


52







3

4










1

2

3

4





ysuh iMrh gS

Yes No


1 2


1 2


1 2


1 2


1 2


1 2


1 2





vkfnfrac12

Never dHkh ugha

Rarely kkn gh dHkh

Sometimes dHkh dHkh

Usually vkerkSj ij

Always gesrsquokk

1

2

3

4

5






ugha gqbZa

Several

days dbZ fnu

More than

half days vkkk fnu

ls vfkd

Nearly

every day yxHkx gj

fnu



[kqrsquokh ugha

1 2 3 4


1 2 3 4

Now

FOOD SECURITY

53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


53




dh deh gqbZ gS

Yes हा 1

No नही 0





fy iSls ugha Fks

Yes हा 1

No नही 0




fyk gS

Yes हा 1

No नही 0





Yes हा 1

No नही 0

54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


54

MARITAL VIOLENCE







iqNs xs Fks







gh gksrk gS

Yes Gka

No Ugha




nsrkfeyus nsrk FkkA


1 2 98





1 2 98



djrkdjrk Fkk

Money iSlk

1 2 98





1 2 98



gSyxkrk Fkk


1 2 98






Often 1

Sometimes 2

Never 3



Yes gka

No Ugha


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


55






dkZ djrk gSFkk






dHkhampdHkh------------------2

dHkh ugha-------------------3



dqN dgrk k djrk Fkk

1 2 |___|




1 2 |___|



eglwl djokrk Fkk

1 2 |___|








Often1

Sometimes2

Not at all3 vDlj-------------------------1

dHkhampdHkh------------------2

dHkh ugha-------------------3


1 2 |___|


1 2 |___|



ij dqN Qsad dj ekjk

1 2 |___|


1 2 |___|

56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


56


dh

1 2 |___|




kSu laidZ fdk

1 2 |___|









this

Anyone else


dksbZ vU






FriendE nksLr

NeighbourF iM+kSlh



PoliceI iqfyl

LawyerJ odhy





Yes gk

No ugha





Yes gka

No ugha 1201


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


57




1 2 3

SOCIAL ENTITLEMENTS






Yes हा 1

No नही 0






CLARITY


Yes हा 1

No नही 0




tkWc dkMZ gS

DESCRIBE NREGA FOR


Yes हा 1 1

No नही 2 0


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


58






Aware but


Not aware of




1 2 3

4



1 2 3

4



1 2 3

4



1 2 3

4


1 2 3 4



1 2 3

4



1 2 3

4


4


4



1 2 3

4


1 2 3

4


4

59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


59



1 2 3

4


1 2 3 4
























Yes gka

No ugha

1

2


women survey questionnaire - PLOS

Documents

Transcript of women survey questionnaire - PLOS