Annex 3. Information from focus groups, institutional reviews and key informants.

Annex 3.1

Results of health focus group discussion

Note: more than three answers are allowed for some of the questions.

1.What are the main problems with the government health service?

1. Too far away 		46 (32.6)
2. Too expensive 		11 (7.8)
3. No staff 		19 (13.5)
4. No medicine/supply 	69 (48.9)
5. Bad attitude 		97 (68.8)
6. No female staff 		23 (16.3)
7. Bad condition 		42 (29.8)
8. Long waiting time 		16 (11.3)
9. No trained staff 		27 (19.7)
10. Lack good medicine 	31 (22.0)
11. Too few facilities 	22 (15.6)
2. What alternatives do people use in additional to the local available government health services?
1. Faith healer 		  54 (38.3)
2. Traditional healer 		124 (87.9)
3. Private clinic 		  98 (69.5)
4. NGO clinic 		    7 (5.0)
5. Friends/neighbours 	  15 (10.6)
6. Pharmacy 		  15 (10.6)
7. Hospital 		  43 (30.5)
8. SHP/HP/PH.C. 		  19 (13.3)
3. How to improve the government health service?
1. No suggestion 		31 (22.0)
2. More facilities 		20 (14.2)
3. More staff 		33 (23.4)
4. Female staff 		  8 (5.7)
5. Better attitude 		58 (41.4)
6. Better condition 		76 (53.9)
7. More medicine 		66 (46.8)
8. Trained HMP 		61 (36.2)
9. Free service 		32 (22.7)
10. Better medicine 		15 (10.6)
11. Health education 	12 (8.5)
4. Who should be responsible to improve the health service?
1. HMG 			68 (61.3)
2. VDC/DDC 		65 (58.6)
3. Community 		49 (44.1)
4. NGOs 			  2 (1.8)
5. Health workers 		12 (10.8)
5. Are people here able to get information on health care?
1. Yes 			139 (100)
6. What media people prefer to get information on health?
1. Radio/TV 		93 (66.9)
2. Newspaper 		31 (22.3)
3. Health facilities 		73 (52.5)
4. Female health workers 	73 (52.5)
5. Community leaders 	36 (25.9)
6. Local government 	20 (14.4)
7. Traditional healer 		  1 (0.7)
8. Trained health workers 	27 (19.4)
9. Family members 		19 (13.7)
10. Self 			16 (11.5)
11. Others individuals 	57 (41.0)
 
Annex 3.2
Results of agriculture focus group discussion
Annex 3.2
Results of agriculture focus group discussion

139 focus group discussions on agriculture and livestock service were carried out. Some questions have multiple responses.

1. How often do JT/JAS visit here and how often do people from here visit the Agricultural/Livestock Centre (or sub-centre) for this area?

1. Never 		111 (79.9)
2. Infrequently 	  28 (20.1)
1.1 How often do people visit the agriculture or livestock centers?
1. Never 		34 (25.2)
2. Whenever needed 31 (23.0)
3. Every month 	  2 (1.5)
4. Every year 	  4 (3.0)
5. Seasonal 	  4 (3.0)
6. Infrequently 	60 (44.4)
1.2 Why people visit the centers?
1. For technical advice 38 (40.4)
2. For fertilizer 	     9 (9.6)
3. For seeds 	   19 (20.2)
4. For pesticide 	  27 (28.7)
5. For livestock 	  48 (51.1)
2. What are the main problems with the agriculturel service?
1. JT/JTA never visit 	37 (26.6)
2. Too expensive 		14 (10.1)
3. Center too far 		12 (9.4)
4. Bad attitude 		11 (7.9)
5. Lack of hybrid seed 	64 (46.0)
6. Lack of fertilizer 		56 (40.3)
7. Lack of pesticide 		47 (33.8)
8. Lack of training 		36 (25.9)
9. Lack modern equipment 	10 (7.2)
10. Lack irrigation 		69 (49.6)
11. Lack of marketing 	23 (16.5)
2.1 How to improve the situation?
1. More JT/JTA visit 	59 (42.4)
2. Center nearby 		23 (16.5)
3. Training farmers 		48 (34.5)
4. Mobile team 		  2 (1.4)
5. More equipment 		51 (36.7)
6. More loans 		  4 (2.9)
7. Better irrigation 		26 (18.7)
8. Free service 		  5 (3.6)
9. Marketing facilities 	40 (28.8)
2.2 Who should be responsible for the improvement?
1. HMG 			70 (71.4)
2. VDC/DDC 		52 (53.1)
3. Community 		27 (27.6)
4. NGOs 			  4 (4.1)
3. What are the main problems with the livestock service?
1. MS never visit 		51 (36.7)
2. Too expensive 		43 (30.9)
3. Center too far 		71 (51.1)
4. Bad attitude 		40 (28.8)
5. Lack of vet medicine 	79 (56.8)
6. Lack of information 	23 (16.5)
7. Lack modern equipment 	30 (21.6)
8. Lack green pasture 	15 (10.8)
3.1 How to improve the situation?
1. More visit by Vet. Expert 	57 (50.0)
2. More vet medicine 	46 (40.0)
3. Center nearby 		44 (38.6)
4. Mobile team 		  2 (1.8)
5. Training in livestock 	30 (26.3)
6. More green pasture 	  7 (6.1)
7. More equipment 		23 (20.2)
8. Free service 		17 (14.9)
3.2 Who should be responsible for the improvement?
1. HMG 			74 (78.7)
2. VDC/DDC 		37 (39.4)
3. Community 		21 (22.3)
4. NGOs 			  2 (2.1)
4. Do people here have any difficulty getting the materials they need for farming?
Yes 			132 (95.0)
No 			    7 (5.0)
4.1 What are the difficulties?
1. Center too far away 		58 (41.7)
2. Too expensive 			92 (66.2)
3. Lack of information 		64 (46.0)
4. Lack of seeds/fertilizer/equipment 	16 (83.5)
5. How easy is it to get loans for agricultural schemes here?
1. Easy 				    4 (2.9)
2. Difficult 			116 (84.1)
3. Possible 			  10 (7.2)
4. Not necessary 			    8 (5.8)
5.1 Why is it difficult?
0. No difficulties 			  2 (1.6)
1. Center too far away 		14 (11.0)
2. Lack of mortgage 			  9 (7.1)
3. Time consuming process 		57 (44.9)
4. Lack of information 		11 (8.7)
5. High interest rate 			34 (26.8)


5.2 What are the sources of loan?
1. Institution 			67 (52.8)
2. Money lender 			36 (28.3)
3. Relatives/neighbours 		20 (15.7)
4. NGOs 				  4 (3.1)

Annex 3.3
INSTITUTIONAL REVIEW OF GOVERNMENT HEALTH FACILITY
1. How far is this Health Institution from the centre of the community? (In time)
Less than 0.5 hour 		59 (47.2)
Less than 1 hour 		31 (24.8)
Less than 2 hours 		27 (21.6)
More than 2 hours 		  8 (6.4)
2. We want to know about the opening times of this Health Facility:
2.1 How many hours/day?
4 hours 		51(39.5)
5 hours 		12 (9.3)
6 hours 		38 (29.5)
7 hours 		14 (10.9)
8 hours 		  7 ( 5.4)
24 hours 		  7 (5.4)
2.2 Number of days/week:
3 days 		    1 (0.8)
4 days 		    2 (1.6)
5 days 		    2 (1.6)
6 days 		104 (85.2)
7 days 		  13 (10.7)
3. Is it always open during these times?
Yes 		123 (93.9)
Missing 		    8 (6.1)


5. What is the clinical area like? <observe>
5.1. Size?
very small 		17 (13.3)
small 			28 (21.9)
reasonable size 		70 (54.7)
good size 			13 (10.2)
5.2. Is it separated from other areas in some way?
Yes 			78 (60.5)
No 			51 (39.5)

5.3. What is the state of cleanliness?
dirty 			  7 (5.4)
reasonable 		76 (58.9)
clean 			46 (35.7)


6. Is there any area for storage of drugs and other supplies?
Yes: 			79 (61.7)
No 			49 (38.3)
Is it stocked with:
Yes
Antibiotic (eg penicillin) 	  86 (67.2)
Antipyretic (eg aspirin) 	114 (88.4)
Sedative (eg diazepam) 	  44 (34.1)
7. Is there a fridge for vaccines etc?
Yes 			  23 (17.8)
No 			106 (82.2)
7.1 If yes, Is it working?
Yes 			21 (50)
No 			21 (50)
7.2 If not working, when was it last working?
2 months ago 		4 (80)
4 months ago 		1 (20)
8.0 Where does this Health Institute get its vaccines from?
SHP 			  3 (2.3)
HP 			50 (39.1)
Hospital 			  3 (2.3)
DHO 			72 (56.3)
9. Do you keep records of your service activities?
Yes 			125 (98.4)
No 			    2 (1.6)
9.1 Please show us the report or last week or last month:
incomplete 		  12 (9.5)
apparently complete 		114 (90.5)
10. What do you do with the reports of your service activities?
To authority 		118 (92.2)
Internal discussion 		    3 (2.3)
Planning 			    7 (5.5)
11. Do you use the records of your service activities locally to monitor or improve your service?
Yes 			106 (82.8)
No 			  22 (17.2)
11.1 If YES, please describe in what way:
planning 			54 (54)
supervision 		30 (30)
discussion 		  7 (7.0)
feedback 			  7 (7.0)
12. Do you receive feedback on your monthly reports?
Yes 			70 (55.6)
No 			56 (44.4)
13. What is the average number of patients seen per day in this Health Facility?
Median average
SHP 			  8
HP 			20
PHCC 			26
Hospital 			80
14. Do you make charges for services from this Health Institute?
Yes 			121 (94.5)
No 			    7 (5.5)
If Yes,
14.1 How much per visit?
	Median average: 2 Rupees
14.2 How much per activity (eg vaccination)
No charges 		106 (92.2)
Some charges 		    9 (7.8)
15. Are the community active in the management committee of this facility?
Yes 			76 (59.8)
No 			51 (40.2)
16. What are the main problems you have in providing a service?
Lack medicine/supply 		108 (84.4)
Lack staff 			  82 (64.1)
Poor facility condition 		  78 (60.9)
No water/electricity 			    2 (1.6)
Lack of supervision 			    2 (1.6)
Lack community support 		  17 (13.3)
Isolated 				    2 (1.6)
Lack of cash support 		    5 (3.9)
17. What services do you receive from the District Health Office?<write up to three>
Medicine/supply 			109 (90.1)
Training 				32 (26.4)
Supervision 			26 (21.5)
Feedback 			  3 (2.5)
Encouragement 			  7 (5.8)
Goods 				71 (58.7)
Financial support 			15 (12.4)
18. When did you last get a supervision visit from the DHO's office?
<how many months ago>
Never 				16 (13.0)
1 month ago 			60 (48.8)
3 months ago 			18 (14.6)
6 months ago 			15 (12.2)
1 year ago 			  7 (5.7)
more than one year ago 		  7 (5.7)
19. How do you find the support given to you by the DHO's office?
Helpful 				17 (13.7)
Not helpful 			17 (13.7)
Okay 				90 (72.6)
20. Do you hear complaints from the local community about your services?
Yes 				84 (65.1)
No 				45 (34.9)
20.1 If yes, what are their main complaints?
<write up to three>
Lack staff 		13 (15.7)
Lack medicine/supply 	71 (85.5)
Bad attitude 		29 (34.9)
Poor condition 		18 (21.7)
Too expensive 		12 (14.5)
Too far 			  1 (1.2)
Irregular hours 		  4 (4.8)
Long waiting time 		  2 (2.4)
21. What do you think could be done to improve your services?
<write up to 3 answers>
Improve condition 		  69 (54.3)
Training 			  28 (22.0)
Supervision 		  18 (14.2)
More cash support 		    7 (5.5)
More medicine/supply 	117 (92.1)
More staff 		  48 (37.8)

Annex 3.4
INSTITUTIONAL REVIEW OF AGRICULTURAL /LIVESTOCK SERVICE CENTRE (SUB-CENTRE)
1.How far is this office from the centre of the community? (In time)
Less than 0.5 hour 			16 (14%)
0.5 hours 				14 (12%)
1 hour 				25 (22%)
2 hours 				  9 ( 8%)
> 2 hours 				33 (29%)
missing 				17 (15%)
2. What is the staffing of this office?
Officers
no.post sanctioned 			47
no. Present today 			23
JT/JAS
no.post sanctioned 			281
no. Present today 			124
3. What are the main challenges you face in providing a service?
Lack staff 			34 (34%)
Lack resources 			54 (55%)
Lack new technology 		20 (20%)
Lack training 			  5 ( 5%)
Lack awareness 			13 (13%)
Lack of seed 			20 (20%)
Lack pesticides 			35 (35%)
More centers 			17 (17%)
Missing 				  3 ( 3%)
4. What services do you provide for the local community?
Nothing 				  1 (1%)
Provide seeds 			35 (37%)
New technology 			31 (32%)
Training 				15 (16%)
Community visit 			  3 (3%)
Soil test 				  2 (2%)
Information 			33 (34%)
Animal vaccination 			35 (36%)
Advice 				29 (30%)
5. Do you make charges to farmers for your services?
Yes 				  7 (7%)
No 				89 (93%)
Missing 				19 (17%)
6. What services do you receive from the District Agricultural/Livestock Development Office?
Nothing 			  2 (2%)
Supervision 		  7 (7%)
Training 			21 (22%)
New technology 		26 (27%)
Supplies 			22 (23%)
Improved seeds 		30 (31%)
Advice 			39 (41%)
Pesticides 		33 (34%)
Missing 			  5 (5%)
7. When did you last get support supervision from the DADO/DLDO office?
Never 			  2 (2%)
Less than one month 	27 (24%)
1 month ago 		37 (32%)
3 months ago 		15 (13%)
6 months ago 		  8 ( 7%)
1 year ago 		  3 ( 2%)
more than 	 1 year ago 4 (4%)
Missing 			19 (17%)
8. How do you find the service given to you by the DADO/DLDO office?
Helpful 			27 (24%)
Not helpful 		  7 (6%)
Average 			59 (51%)
Missing 			22 (19%)
9 Do you hear complaints from the local community about your services?
Yes 			58 (50%)
No 			37 (32%)
Missing 			20 (18%)
9.1 What are their main complaints?
Not enough visit 20 (35%)
Too expensive 5 (9%)
Bad attitude 2 (3%)
Lack new technology 11 (19%)
Lack seeds 28 (48%)
Lack pesticides 19 (33%)
Lack staff 3 (5%)
Lack medicine 16 (28%)
Missing 1 (2%)
10. What do you think could be done to improve your services?
More staff			 32 (33%)
More Centres 		  8 (8%)
More resources 		50 (52%)
More training 		37 (39%)
More supervision 		10 (10%)
More community visit 	10 (10%)
More pesticides 		32 (33%)
Missing 			  1 (1%)


Annex 3.5
INTERVIEW WITH COMMUNITY KEY INFORMANT
1. What government health facilities are available locally?
0 Nothing 		  1 (0.7)
1 HP 			40 (28.2)
2 SHP 			75 (52.8)
3 District hospital 		18 (12.7)
4 PH.C. 			  6 (4.2)
9 Missing 			  2 (1.4)
2. How far away is each one from the centre of the community?
Mean distance: 		50 minutes
Median distance: 		30 minutes
3. What are the opening hours of each one:
Median open time: 		10 am
Median close time: 		  3 pm
4. How much are the official charges per visit for each one?
Fixed fee: 	median 2 rupees
Other charges: 	median 0 rupee
5. How often are the drugs needed available in the government health facilities ?
1 Always 			3 (2.1)
2. Most of the time 		15 (10.6)
3. Sometimes 		46 (32.6)
4. Hardly available 		68 (48.2)
5. Never 			9 (6.4)
6. If not available from the health facility, where do people go to get them ?
1 No where 		    1 (0.7)
2 Pharmacy 		117 (83.6)
3 Market 			  21 (15)
4 Missing 			    1 (0.7)
7. Is there a medical shop in the community ?
1. Yes 			78 (55.3)
2. No 			63 (44.7)
8. What other health facilities are available locally (eg run by NGOs) ?
0 Nothing 		86 (58.1)
1 Clinic 			31 (20.9)
3 Nursing home 		  3 (2.0)
4 Medical shop 		12 (8.1)
5 Red cross 		12 (8.1)
6 FPAN 			  4 (2.7)
8.1 Who organizes the operation?
1 Private 			33 (48.5)
2 INGO/NGO 		18 (26.5)
3 DDC or VDC 		  4 (5.9)
5 FPAN 			  1 (1.5)
6 Health worker 		  2 (2.9)
9 DK+ Missing 		10 (14.7)
9. What is the main type of farming here?
0 Nothing 		    2 (1.4)
1 Agriculture 		134 (94.4)
2 Livestock 		    4 (2.8)
3 Fishery 			    1 (0.1)
4 Horticulture 		    1 (0.1)
10. Where do people here mainly go to get their supply of farming chemicals, fertilizers and veterinary drugs ?
0 Nowhere 		  2 (1.4)
1 Cooperation 		16 (11.3)
2 Agri. Center 		22 (15.6)
3 Private source 		96 (68.1)
9 Missing 			  5 (3.5)
11. What are the prices of these materials?
Price per 50 Kg bag of fertilizer urea?
median 		400 rupees
Price per Kg of cow/buffalo feed?
median 		9 rupees
Price per Kg of chicken feed?
Median 		11 rupees
12. What has happened to the prices of chemicals, fertilizer and veterinary drugs over the last year ?
1. Increased 		117 (83%)
9. DK and missing 		  24 (17%)
Fertilizer increased 		    5 Rs per 50 Kg
Pesticide increased 		    1 Rs/kg
Vetoed increased 		  10 rupees/kg
13. Is there a library in this community ?
1. Yes 			  27 (19%)
2. No 			115 (81%)
If so, what are the opening times ?
Median 			10 am
14. Is there a public telephone} in this community ?
1.yes 			49 (34.8%)
2. No 			91 (64.5%)
9. Missing 		  1 (0.9%)
Is the phone in working order <observe>
1. Yes 			46 (86.8)
2. No 			  6 (11.3)
9. Missing 		  1 (1.9)
15. Is there a post office in this community ?
1. Yes 			102 (71.8)
2. No 			  40 (28.2)
If Yes, what are the usual post opening hours ?
1. Median open hour: 	10 am
2. Median close hour: 	  4 pm
16. Can people here receive mail from other places in the district ?
1. Yes 			93 (65.5)
2. No 			49 (34.5)
From outside the district ?
1. Yes 			91 (64.1)
2. No 			51 (35.9)
17. How long does it usually take for mail to reach here from Kathmandu ?
Median: 			  9 days
 
Annex 3.6
INTERVIEW WITH VDC CHAIRMAN

Note, all questions except 5 and 8 have multiple responses, up to 3 answers were allowed. 138 Village Development Committee were interviewed.

1. What does the VDC do for the community ?
Nothing 			    2 (1.5)
Set up community groups 	  14 (10.2)
Social development 		  55 (40.1)
Daily issues 		  23 (16.8)
Financial issues 		  22 (16.1)
Construction work 		120 (87.6)
Look after old people 	    5 (3.6)
2. What difficulties do you encounter in serving the community ?
No difficulties 		  2 (1.5)
Lack resources 		55 (40.4)
Lack information 		19 (14.0)
Lack community support 	44 (32.4)
Political interference 		30 (22.1)
Lack time 		  2 (1.5)
Lack of finance 		80 (58.8)
Lack of technician 		15 (11.0)
3. What services and support do you receive from the DDC ?
Nothing 			30 (22.1)
Financial support 		69 (50.7)
Supervision 		  5 (3.7)
Training 			  4 (2.9)
Political support 	 	  2 (1.5)
Project 			  8 (5.9)
Technical assistance 		36 (26.5)
Consultation  		12 (9.6)
Provide materials 		36 (26.5)
4. What services/support do you think you should get from the DDC ?
Financial support 		80 (59.7)
Supervision 		17 (12.7)
Training 			  7 (5.2)
Political support 		  8 (6.0)
Project 			14 (10.4)
Technical assistance 		60 (44.8)
Consultation 		53 (39.6)
Provide materials 		  2 (1.5)
5. What do you think of the service/support you receive from the DDC ?
Helpful 			13 (9.6)
Not helpful 		32 (23.5)
Average 			91 (66.9)
6. How do you get information about the needs of the community you serve ?
Community meeting 		81 (59.6)
Informal source 		37 (27.2)
Key informant 		73 (53.7)
Women groups 		  3 (2.2)
Line department 		  1 (0.7)
Village profile 		  4 (2.9)
Self 			67 (49.3)
7. What information do you think you need to help you plan your services to your community ?
Population 		23 (17.7)
Literacy 			  2 (1.5)
Income level 		14 (10.8)
Production/animal 		  2 (1.5)
Health 			  2 (1.5)
Need of people 		56 (43.1)
Children 			2 (1.5)
Women 			  1 (0.8)
Area statistics 		38 (29.2)
Technical advice 		56 (43.1)
8. Do you think VDC priorities are reflected in DDC (Council) decisions ?
Yes 			59 (43.4)
No 			65 (47.8)
Some 			12 (8.8)
9. If not, how could this situation be changed ?
Nothing 			  3 (3.9)
Involve VDC decision making 	48 (62.3)
More DDC visit 		16 (20.8)
Less political interference 	  9 (11.7)
Community information 	  7 (9.1)
Technical assistance 		  9 (11.7)
Regular funding 		11 (14.3)
Provide materials 		4 (5.2)

Note, all questions except 5 and 8 have multiple responses, up to 3 answers were allowed. 138 Village Development Committee were interviewed.

1. What does the VDC do for the community ?
Nothing 			    2 (1.5)
Set up community groups 	  14 (10.2)
Social development 		  55 (40.1)
Daily issues 		  23 (16.8)
Financial issues 		  22 (16.1)
Construction work 		120 (87.6)
Look after old people 	    5 (3.6)
2. What difficulties do you encounter in serving the community ?
No difficulties 		  2 (1.5)
Lack resources 		55 (40.4)
Lack information 		19 (14.0)
Lack community support 	44 (32.4)
Political interference 		30 (22.1)
Lack time 		  2 (1.5)
Lack of finance 		80 (58.8)
Lack of technician 		15 (11.0)
3. What services and support do you receive from the DDC ?
Nothing 			30 (22.1)
Financial support 		69 (50.7)
Supervision 		  5 (3.7)
Training 			  4 (2.9)
Political support 		  2 (1.5)
Project 			  8 (5.9)
Technical assistance 		36 (26.5)
Consultation 		12 (9.6)
Provide materials 		36 (26.5)
4. What services/support do you think you should get from the DDC ?
Financial support 		80 (59.7)
Supervision 		17 (12.7)
Training 			  7 (5.2)
Political support 		  8 (6.0)
Project 			14 (10.4)
Technical assistance 		60 (44.8)
Consultation 		53 (39.6)
Provide materials 		  2 (1.5)
5. What do you think of the service/support you receive from the DDC ?
Helpful 			13 (9.6)
Not helpful 		32 (23.5)
Average 			91 (66.9)
6. How do you get information about the needs of the community you serve ?
Community meeting 		81 (59.6)
Informal source 		37 (27.2)
Key informant 		73 (53.7)
Women groups 		  3 (2.2)
Line department 		  1 (0.7)
Village profile 		  4 (2.9)
Self 			67 (49.3)
7. What information do you think you need to help you plan your services to your community ?
Population 		23 (17.7)
Literacy 			  2 (1.5)
Income level 		14 (10.8)
Production/animal 		  2 (1.5)
Health 			  2 (1.5)
Need of people 		56 (43.1)
Children 			  2 (1.5)
Women 			  1 (0.8)
Area statistics 		38 (29.2)
Technical advice 		56 (43.1)
8. Do you think VDC priorities are reflected in DDC (Council) decisions ?
Yes 			59 (43.4)
No 			65 (47.8)
Some 			12 (8.8)
9. If not, how could this situation be changed ?
Nothing 			  3 (3.9)
Involve VDC decision making 	48 (62.3)
More DDC visit 		16 (20.8)
Less political interference 	  9 (11.7)
Community information 	  7 (9.1)
Technical assistance 		  9 (11.7)
Regular funding 		11 (14.3)
Provide materials 		  4 (5.2)
 
Annex 3.7
INTERVIEW WITH DDC Chairman
1. What do you think of the government services provided in this district?
		Good 		Bad 		Average
Health 				5 (18.5) 		22 (81.5)
Agriculture 	1 (3.7) 		11 (40.7) 		15 (55.6)
Education 	4 (14.8) 		8 (29.6) 		15 (55.6)
Water 				4 (14.8) 		23 (85.2)
Sanitation 				22 (81.5) 		5 (18.5)
Postal 		9 (33.3) 		2 (7.4) 		16 (59.3)
Telephone 	4 (14.8) 		6 (22.2) 		17 (63)
Roads 				15 (55.6) 		12 (44.4)
Electricity 				12 (44.4) 		15 (55.6)
2. What are the difficulties of providing public services in this district ?
Lack resources 		16 (59.3)
Lack information 		10 (37.5)
Lack community support 	  5 (18.5)
Lack time 		  1 (3.7)
Political interference 		  3 (11.1)
Bad service delivery 		15 (55.6)
Construction work 		17 (63.0)
3. What services and support do you receive from the central government ?
Nothing 			  1 (3.7)
Financial support 		20 (74.1)
Policy 			  6 (22.2)
Project 			  6 (22.2)
Training 			  2 (7.4)
Supervision 		  1 (3.7)
Planning 			15 (55.6)
Autonomous body 		  2 (7.4)
4. What services/support do you think you should get from central government ?
Financial support 		13 (48.1)
Policy 			  8 (29.6)
Planning 			12 (44.4)
Supervision 		  3 (11.1)
Project 			23 (85.2)
Create awareness 		  5 (18.5)
5. What do you think of the service/support received from the central government ?
Not helpful 		10 (37)
Average 			17 (63)
6. How could your service to the district be improved ?
More VDC supervision 	  8 (29.6)
More VDC training 		  5 (18.5)
More information 		14 (51.9)
More resources 		16 (59.3)
More listening 		  4 (14.8)
More project 		  6 (22.2)
Financial support 		  6 (22.2)
Autonomous body 		  3 (11.1)
7. How could the service you receive from the central government be improved ?
No suggestion 		  1 (3.7)
More resources 		20 (74.1)
More supervision 		  6 (22.2)
More training 		  6 (22.2)
More information 		  2 (7.4)
More community meeting 	  1 (3.7)
Financial support 		15 (55.6)
Autonomous body 		  2 (7.4)
8. How do you get information about the needs of the district you serve ?
From VDCC 		16 (59.3)
From district department 	  6 (22.2)
From people 		15 (55.6)
From media 		  1 (3.7)
From key informant 		13 (48.1)
From district profile 		  6 (22.2)
9. What information do you think you need to help you plan your services to your district?
VDC need 		  5 (18.5)
Production level 		  2 (7.4)
Planning 			  9 (33.3)
People's need 		  2 (7.4)
Resources 		15 (55.6)
Community need 		15 (55.6)
District profile 		20 (74.1)
10. Is it easy to co-ordinate the activities of different line ministries in the district?
Easy 			  4 (14.8)
Difficult 			14 (51.9)
Possible 			  9 (33.3)
11. How are VDC priorities reflected in the DDC's plans ?
In project 			  2 (7.4)
In training 			  4 (14.8)
Lack of source 		  7 (25.9)
People's need 		11 (40.7)
Information sharing 		16 (59.3)
Income generation project 	  4 (14.8)
District profile 		  5 (18.5)
Development work 		  1 (3.7)
12. How are DDC priorities reflected in VDC plans in this district ?
Not reflected 		  1 (3.7)
District profile 		  2 (7.4)
Community groups 		  6 (22.2)
people's need 		  4 (14.8)
Plan and programme 	17 (63)
Information sharing 		  9 (33.3)
Coordination 		18 (66.7)
Income generation programme 	  1 (3.7)

Annex 3.8
INTERVIEW WITH DISTRICT HEALTH OFFICER
35 DHOs were interviewed in total.
Some of the questions have multiple answers.
1. What are the main challenges facing your service in this District ?
Lack of resources 		30 (88.2)
Lack staff 		26 (76.5)
Lack female staff 		  2 (5.9)
Lack supervision/training 	  8 (23.5)
Lack information 		  5 (14.7)
Poor health/nutrition 		  1 (2.9)
Low literacy 		  5 (14.7)
Poor environment 		  1 (2.9)
2. When did you last have direct contact with the central Ministry of Health ?
Never 			  1 (2.9)
less than one month ago 	10 (29.4)
more than 1 month ago 	  6 (17.6)
3 months ago 		17 (50.0)
3. How does the ministry of health keep you informed about matters of importance ?
Meeting 			  5 (11.4)
Training 			  1 (2.9)
Letters/orders 		34 (100)
Supervision 		  4 (11.8)
3.1 Does this system work well?
Yes 			23 (67.3)
No 			11 (32.4)
4. What services do you receive from the central ministry of health?
Nothing 			  1 (3.1)
Supervision 		19 (59.4)
Training 			  5 (15.6)
Information 		  3 (9.4)
Feedback 		  3 (9.4)
Projects 			  2 (6.3)
Medical instruction 		17 (53.1)
Trained staff 		  7 (21.9)
5. What do you think of the service you receive from the Ministry of health
Helpful 			  8 (23.5)
Not helpful 		12 (35.3)
Average 			14 (41.2)

6. Which of the services you receive from the central ministry of health (apart from financial support) is of most use to you?

Nothing 			  6 (17.6)
Supervision 		11 (32.4)
Training 			  3 (8.8)
Information 		  5 (14.7)
Feedback 		  1 (2.9)
Project 			  2 (5.9)
Trained staff 		  8 (23.5)
Medical instrument 		  3 (8.8)
7. Which of the services is of least use to you?
Nothing 			8 (29.6)
Supervision 		4 (14.8)
Training 			1 (3.7)
Information 		3 (11.1)
Feedback 		5 (18.5)
Project 			1 (3.7)
Political posting 		8 (29.6)
PHC clinic 		2 (7.4)
8. What do you suggest for improving the service you receive from the central ministry of health?
Nothing 			  1 (3.0)
More resources 		10 (30.3)
Better planning 		20 (60.6)
More supervision 		13 (39.4)
More training 		10 (30.3)
More project 		14 (42.4)
More supplies 		  1 (3.0)
9. Which aspects of the health services in this District are you most satisfied with?
MCH project 		16 (48.5)
Curative care 		  3 (9.1)
Hospital service 		  4 (12.1)
Mobile clinic 		  1 (3.0)
Community project 		  6 (18.2)
Vitamin A distribution 	  3 (9.1)
NIDs 			  2 (6.1)
9.1 Why are you most satisfied ?
Good coverage 		25 (86.2)
Good quality 		  7 (24.1)
Easy 			  3 (10.3)
Budget in time 		  1 (3.4)
Supervision 		  1 (3.4)
10. Which aspects are you least satisfied with ?
Nothing 			3 (9.1)
MCH project 		8 (24.2)
Curative care 		7 (21.2)
Hospital service 		2 (6.1)
Emergency care 		4 (12.1)
Community project 		3 (9.1)
HP/SHP 			4 (12.1)
10.1 Why are you least satisfied?
Not effective 		  3 (11.1)
Low coverage 		  8 (29.6)
High cost 			  1 (3.7)
Time consuming 		  3 (11.1)
Difficult 			17 (63.0)
Mobility of staff 		  2 (7.4)
11. How could you improve the delivery of health services in this district ?
More resources 		15 (46.9)
More staff 		18 (56.3)
More supervision 		  9 (28.1)
More training 		  8 (25.0)
More information 		  5 (15.6)
More facilities 		16 (50.0)
Better facility condition 	  2 (6.3)

Annex 3.9

INTERVIEW WITH DISTRICT AGRICULTURAL DEVELOPMENT OFFICER OR DISTRICT LIVESTOCK DEVELOPMENT OFFICER

(to answer on behalf of both services)
In total, 39 DAOs or DLOs were interviewed.
1. What are the main challenges facing your service in this District ?
1. Lack of resources 	30 (76.9)
2. Lack of information 	  7 (17.9)
3. Lack of new technology 	23 (59.0)
4. Lack of staff 		21 (53.8)
5. Lack of water source 	  4 (10.3)
6. Poor soil 		  3 (7.7)
7. Lack of supervision/training     3 (7.7)
2. How many SMSs do you have (livestock and agricultural)
Mean: 	14 SMSs
Median: 	13 SMSs
3. How many {JT/JAS} do you have (livestock and agricultural)
Mean: 	24 JT/JAS
Median: 	26 JT/JAS
3. When did you last have direct contact with the central Ministry and Departments of Agriculture?
0. Never 			  1 (2.6)
1. Less than one month ago 	21 (53.8)
1. More than one month ago 	16 (41.0)
2. Three months ago 	  1 (2.6)
4. How does the Ministry and departments of Agriculture keep you informed about matters of importance ?
1. Meeting 		  1 (2.6)
2. Supervision visit 		  1 (2.6)
3. Training 		  1 (2.6)
4. Letter/order 		33 (84.6)
5. Feedback 		  2 (5.1)
6. Media 			33 (84.6)
4.1 Does this system work well?
Yes 			25 (64.1)
No 		 	  2 (5.1)
Okay 			12 (30.8)
5. What services do you receive from the central Ministry and departments of Agriculture?
1. Supervision 		17 (43.6)
2. Training 		  7 (17.9)
3. Finance/supply 		  6 (15.4)
4. Information 		27 (69.2)
5. Feedback 		30 (76.9)
6. What do you think of the service you receive from the central ministry and departments?
Helpful 			16 (41.0)
Not helpful 		  1 (2.6)
Oaky 			22 (56.4)

7. Which of the services you receive from the central ministry and departments of agriculture is of most use to you?

0. Nothing 		  1 (2.6)
1. Finance 		19 (48.7)
2. Supply 			10 (25.6)
3. Supervision 		  7 (17.9)
4. Information 		  1 (2.6)
5. Technology 		21 (55.3)
8. Which of the services is of least use to you ?
0. Nothing 		12 (35.3)
1.training 			  1 (2.9)
2. Supervision 		  8 (23.5)
3. Information 		  5 (14.7)
4. Technology 		  2 (5.9)
5. Transfer of staff 		  6 (17.6)

9. What do you suggest for improving the service you receive from the central Ministry and departments of Agriculture ?

1. More resources 		10 (26.3)
2. More staff 		  9 (23.7)
3. More supervision 		15 (39.5)
4. More training 		  6 (15.8)
5. More information 		17 (44.7)
6. New technology 		10 (26.3)
7. More feedback 		21 (55.3)
10. Which aspects of agricultural services in this District are you most satisfied with?
0. Nothing 		  1 (2.6)
1. Extension service 		19 (48.7)
2. Information sharing 	10 (25.6)
3. New technology 		  7 (17.9)
4. New seeds 		  1 (2.6)
5. Training 		  5 (12.8)
6. Horticulture 		11 (28.2)
10.1 Why are you satisfied with these services?
1. Good coverage 		11 (28.2)
2. Improve production 	  9 (23.1)
3. Low cost 		  4 (10.3)
4. Liked by people 		  6 (15.4)
5. Suit local situation 	  2 (5.1)
6. Easy to apply 		  1 (2.6)
7. Information sharing 	18 (46.2)
8. Control diseases of hort 	  1 (2.6)
11. Which aspects are you least satisfied with?
0. Nothing 		  5 (13.2)
1. Information 		  7 (18.4)
2. Technology 		  6 (15.8)
3. Extension service 		12 (31.6)
4. Irrigation 		  1 (2.6)
5. Tools 			  1 (2.6)
6. Seeds 			  4 (10.5)
7. Transfer of staff 		  1 (2.6)
8. Credit/loan 		  1 (2.6)
11.1 Why are you least satisfied with this service?
0. No reason 			  4 (11.4)
1. High cost 			  3 (8.6)
2. Difficult to apply 			  7 (20.0)
3. Low coverage 			18 (51.4)
4. Not suitable for local situation 	  2 (5.7)
5. Disliked by people 		  1 (2.9)
12. How do you think you could improve delivery of agricultural and livestock services in this district?
1. More resources 			24 (63.2)
2. More staff 			10 (26.3)
3. More community visit 		  9 (23.7)
4. New technology 			23 (60.5)
5. Better tools 			  2 (5.3)
6. More information 			17 (44.7)
7. More training/supervision 		16 (42.1)
In total, 39 DAOs or DLOs were interviewed.
1. What are the main challenges facing your service in this District ?
1. Lack of resources 		30 (76.9)
2. Lack of information 		  7 (17.9)
3. Lack of new technology 		23 (59.0)
4. Lack of staff 			21 (53.8)
5. Lack of water source 		  4 (10.3)
6. Poor soil 			  3 (7.7)
7. Lack of supervision/training 		  3 (7.7)
2. How many SMSs do you have (livestock and agricultural)
Mean: 	14 SMSs
Median: 	13 SMSs
3. How many {JT/JAS} do you have (livestock and agricultural)
Mean: 	24 JT/JAS
Median: 	26 JT/JAS
3. When did you last have direct contact with the central Ministry and Departments of Agriculture?
0. Never 			  1 (2.6)
1. Less than one month ago 	21 (53.8)
1. More than one month ago 	16 (41.0)
2. Three months ago 	  1 (2.6)
4. How does the Ministry and departments of Agriculture keep you informed about matters of importance ?
1. Meeting 		  1 (2.6)
2. Supervision visit 		  1 (2.6)
3. Training 		  1 (2.6)
4. Letter/order 		33 (84.6)
5. Feedback 		  2 (5.1)
6. Media 			33 (84.6)
4.1 Does this system work well?
Yes 			25 (64.1)
No 			  2 (5.1)
Okay 			12 (30.8)
5. What services do you receive from the central Ministry and departments of Agriculture?
1. Supervision 		17 (43.6)
2. Training 		  7 (17.9)
3. Finance/supply 		  6 (15.4)
4. Information 		27 (69.2)
5. Feedback 		30 (76.9)

6. What do you think of the service you receive from the central ministry and departments?

Helpful 			16 (41.0)
Not helpful 		  1 (2.6)
Oaky 			22 (56.4)

7. Which of the services you receive from the central ministry and departments of agriculture is of most use to you?

0. Nothing 		  1 (2.6)
1. Finance 		19 (48.7)
2. Supply 			10 (25.6)
3. Supervision 		  7 (17.9)
4. Information 		  1 (2.6)
5. Technology 		21 (55.3)
8. Which of the services is of least use to you ?
0. Nothing 		12 (35.3)
1.training 			  1 (2.9)
2. Supervision 		  8 (23.5)
3. Information 		  5 (14.7)
4. Technology 		  2 (5.9)
5. Transfer of staff 		  6 (17.6)

9. What do you suggest for improving the service you receive from the central Ministry and departments of Agriculture ?

1. More resources 		10 (26.3)
2. More staff 		  9 (23.7)
3. More supervision 		15 (39.5)
4. More training 		  6 (15.8)
5. More information 		17 (44.7)
6. New technology 		10 (26.3)
7. More feedback 		21 (55.3)
10. Which aspects of agricultural services in this District are you most satisfied with?
0. Nothing 		  1 (2.6)
1. Extension service 		19 (48.7)
2. Information sharing 	10 (25.6)
3. New technology 		  7 (17.9)
4. New seeds 		  1 (2.6)
5. Training 		  5 (12.8)
6. Horticulture 		11 (28.2)
10.1 Why are you satisfied with these services?
1. Good coverage 		11 (28.2)
2. Improve production 	  9 (23.1)
3. Low cost 		  4 (10.3)
4. Liked by people 		  6 (15.4)
5. Suit local situation 	  2 (5.1)
6. Easy to apply 		  1 (2.6)
7. Information sharing 	18 (46.2)
8. Control diseases of hort 	  1 (2.6)
11. Which aspects are you least satisfied with?
0. Nothing 		  5 (13.2)
1. Information 		  7 (18.4)
2. Technology 		  6 (15.8)
3. Extension service 		12 (31.6)
4. Irrigation 		  1 (2.6)
5. Tools 			  1 (2.6)
6. Seeds 			  4 (10.5)
7. Transfer of staff 		  1 (2.6)
8. Credit/loan 		  1 (2.6)
11.1 Why are you least satisfied with this service?
0. No reason 			  4 (11.4)
1. High cost 			  3 (8.6)
2. Difficult to apply 			  7 (20.0)
3. Low coverage 			18 (51.4)
4. Not suitable for local situation 	  2 (5.7)
5. Disliked by people 		  1 (2.9)
12. How do you think you could improve delivery of agricultural and livestock services in this district?
1. More resources 			24 (63.2)
2. More staff 			10 (26.3)
3. More community visit 		  9 (23.7)
4. New technology 			23 (60.5)
5. Better tools 			  2 (5.3)
6. More information 			17 (44.7)
7. More training/supervision 		16 (42.1)
Annex 3.10
INTERVIEW WITH LDO
1. What do you think of the government services provided in this district?
			   	good 	    Bad 	       Average
Health 			  1(3.0) 	        5(15.2) 	27(81.8)
Agriculture 		  6(18.2) 	       4(12.1) 	23(81.8)
Education 		  7(21.1) 	       6(18.2) 	20(60.6)
Water 			  9(27.3) 	       3(9.1) 	  2(63.6)
Sanitation 			  1(2.9) 	     25(73.5) 	  8(23.5)
Postal 				     16(48.5) 	17(51.5)
Telephone 		12(35.3) 	       7(20.6) 	15(44.1)
Roads 			  1 (2.9) 	     16(47.1) 	17(50.0)
Electricity 			  7(20.6) 	       9(26.5) 	18(52.9)
2. What are the difficulties of providing public services in this district ?
Lack resources 		22 (68.8)
Lack information 		  1 (3.1)
Lack community support 	  4 (12.5)
Lack time 		  2 (6.3)
Political interference 		  4 (12.5)
Bad service delivery 		15 (46.9)
Lack awareness 		16 (50)
Construction work 		19 (59.4)
3. What services and support do you receive from the central government ?
Nothing 			  1 (2.9)
Financial support 		25 (73.5)
Policy 			14 (41.2)
Project 			  2 (5.9)
Training 			  1 (2.9)
Supervision 		  5 (14.7)
Planning 			18 (52.9)
Autonomous body 		  5 (14.7)
4. What services/support do you think you should get from central government ?
Nothing 			  1 (2.9)
Financial support 		17 (50)
Policy 			12 (35.3)
Planning 			10 (29.4)
Supervision 		  5 (14.7)
Training 			  5 (14.7)
Project 			24 (70.6)
Create awareness 		11 (32.4)
5. What do you think of the service/support received from the central government ?
Helpful 			  3 (9.1)
Not helpful 		  4 (12.1)
Average 			26 (78.8)
6. How could your service to the district be improved ?
No suggestion 		  1 (2.9)
More VDC supervision 	10 (29.4)
More VDC training 		13 (38.2)
More information 		13 (38.2)
More resources 		16 (47.1)
More listening 		  9 (26.5)
More project 		  5 (14.7)
Financial support 		10 (29.4)
Autonomous body 		  4 (11.8)
7. How could the service you receive from the central government be improved ?
No suggestion 		  1 (2.9)
More supervision 		  6 (17.6)
More training 		  3 (8.8)
More information 		  9 (26.5)
More resources 		  9 (26.5)
More community meeting 	  1 (2.9)
Better planning 		26 (76.5)
Financial support 		20 (58.5)
Autonomous body 		  4 (11.8)
8. How do you get information about the needs of the district you serve ?
From DVCC 		26 (81.3)
From district department 	13 (40.6)
From people 		  9 (28.1)
From media 		  4 (12.5)
From NGOs 		  7 (21.9)
From key informant 		19 (59.4)
District profile 		  5 (15.6)
9. What information do you think you need to help you plan your services to your district?
VDC need 		  4 (12.5)
Production level 		  2 (6.3)
Info. On Children/women 	  1 (3.1)
Planning 			13(40.6)
People's need 		  6 (18.8)
Resources 		  8 (25.0)
Community need 		10 (31.3)
District profile 		26 (81.3)
10. Is it easy to co-ordinate the activities of different line ministries in the district?
Easy 			  9 (28.1)
Difficult 			  5 (15.6)
Possible 			18 (53.6)
11. How are VDC priorities reflected in the DDC's plans ?
Not reflected 		  1 (3.0)
In project 			  1 (3.0)
In training 			  1 (3.0)
Lack of source 		10 (30.3)
People's need 		13 (39.4)
Information sharing 		23 (69.7)
Income generation project 	  3 (9.1)
District profile 		12 (36.4)
Development work 		10 (30.3)
12. How are DDC priorities reflected in VDC plans in this district ?
Not reflected 		  2 (6.1)
District profile 		  2 (6.1)
Community groups 		  5 (15.2)
people's need 		  4 (12.1)
Plan and programme 	26 (78.8)
Information sharing 		11 (33.3)
Coordination 		25 (75.8)
Income generation programme 	  2 (6.1)
Autonomous body 		  2 (6.1)


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