Annex 2: Instruments
Household questionnaire
Focus group discussion guide--health
Focus group discussion guide--agriculture
Health facility review schedule
Agriculture facility review schedule
Community key informant interview guide
VDC chairman interview guide
DDC chairman interview guide
DHO interview guide
DAO interview guide
LDO interview guide
Annex 2.1
1. What is the sex of the respondent and the relationship of the respondent to the household head?
2. What is the sex and age of the head of the household? <eg 45M, 50F>
3. What is the literacy of the head of the household?
4. What is the occupation of the head of the household?
5. What type of house is it? <kachi, Paki, mixed, hut>
6. How many people are there altogether in the household?
7. Note sex and age of each one, starting with the oldest. <eg 45M, 30M, 3F>
8. How many members of this household have used the government Health Services in the last month?
<If any member used any government service, for each contact use one separate page for question 9-16. If none, skip to question 17>
9. What is the sex and age of the person? <eg 7F>
10. Where did they/you go to get the service? <type of health facility>
11. What was the purpose of using the service?<eg immunisation>
12. Was there a health worker who attended to (examined) you the first time you went there?
13. How long did they/you have to wait for the service? <write down exact waiting time include figures and units>
14. Were the medicines and other materials that were needed available?
15.1 How much did you have to pay for the fixed fee? <Rs; if nothing write 0 >
15.2 How much did you have to pay for medicines? <Rs; if nothing write 0>
15.3 How much did you have to pay in total? <Rs; if nothing write 0>
16. <If not all medicines and materials available from govt health facility> Where did you get them from?
17. What do you think of the government health services provided in this area?
<good, average, bad>
18. What do you think are the main problems (if any) with the government Health Services in this area? <write up to 3 answers>
19. What do you think could be done to improve the government Health Services in this area? <write up to 3 answers>
20. 1 Do you think people here would be prepared to pay to get improved government Health Services?
20.2 If yes, how much for a single visit to a government health centre? <write amount in Rs>
21. How many members of this household have used any other kind of health care or treatment service in the last month, including traditional services or 'self-treatment'?
<Note sex and age of person, type of service used, and purpose of using for each one>
22.1 How much land, if any, does your household hold (own or rent):
22.2 Khet <write amount in ropani or local measure; if none write 0>
22.3 Bari <write amount in ropani or local measure; if none write 0>
22.4 Other <write amount in ropani or local measure; if none write 0>
<If household holds no land, skip to Q35>
23. When did you last have a professional visit from a JT/JTA? <write number of months ago; if never, write 'never'>
24. When did you last have a professional visit from a non-government agricultural adviser? <write number of months ago; if never, write 'never'>
25. When did you last visit the Agricultural/Livestock Service Centre (or sub-centre) for this area? <write number of months; if never, write 'never'>
<If 'never' to Q23 and Q25, skip to Q28>
26.1 Were you able to get all the service that you needed from the JT/JTA or the Service Centre?
<if not>
26.2 what kind of service were you not able to get? <up to 3 answers>
27.1 For this last agricultural service, how much did you pay? <write amount in Rs, if nothing write 0>
<If paid something>
27.2 What was the payment for?
27.3 Who did you pay?
28.1 What do you think of the Agricultural Service in this area? <good, average, bad>
28.2 What do you think of the Livestock Service in this area? <good, average, bad>
29. What do you think are the main problems (if any) with the Agricultural/Livestock Service in this area? <write up to 3 answers>
30. How do you think the Agricultural/Livestock Service could be improved? <write up to 3 answers>
31. 1 Do you think people here would be prepared to pay for visits from the JT/JTA to get an improved service?
If yes, how much per visit
31.2 for livestock advice? <Rs>
31.3 for fisheries advice? <Rs>
31.4 for general agricultural advice? <Rs>
31.5 for horticultural advice? <Rs>
32.1 Have you tried to get credit for agricultural/livestock purposes in the last year?
<If Yes>
32.2 Where did you approach for the loan?
32.3 Were you successful?
For the following farming inputs, where did you last go to buy them and were they available?
33.1 pesticides?
33.2 fertilizers?
33.3 Seeds, saplings?
33.4 Fingerlings, new breeds?
33.5 Animal feed?
33.6 Veterinary medicines?
33.7 Agriculture tools34. When you last bought pesticide, what advice were you given about how to use it? <write up to 3 answers>
35. How do you get information about government services available in your area? <write up to 3 answers>
36. What do you think of the following government services as they operate in your area?
<for each one, rate as good, average or bad or 'none' if does not operate at all>
36.1 Education
36.2 water
36.3 sanitation
36.4 postal service
36.5 telephone service
36.6 roads provision and maintenance
36.7 electricity
37. What does the VDC of this community do? <write up to 3 answers>
38. What do you think the VDC should do? <write up to 3 answers>
39. What activities do you help the VDC to carry out? <write up to 3 answers>
Annex 2.2
FOCUS GROUP GUIDE - HEALTH SERVICES
This is intended to be a group of 6-8 women from the community.
Warm up
Introduce the moderator and recorder. Explain that this meeting is to discuss issues about the government and other health services provided here.
Ask participants to introduce themselves and give their age and level of education.
Discussion guide
1. What problems are there with the government health services available near to this community?
2. What sort of alternatives to the government health services do people here use?
3. What do you think could be done to improve the government health services in this area and who would need to do this?
4. Are people here able to get information about how to be healthy and what sort of information would you like to get?
Annex 2.3
FOCUS GROUP GUIDE - AGRICULTURAL/LIVESTOCK SERVICES
This is intended to be a group of 6-8 farmers (mainly men) from the community, reasonably homogeneous in terms social standing.
Warm up
Introduce the moderator and recorder. Explain that this meeting is to discuss issues about the agricultural extension services provided here.
Ask participants to introduce themselves and give their age and level of education.
Discussion guide
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?
What are the main problems with the agricultural service?
What are the main problems with the livestock service?
Do people here have any difficulty getting the materials they need for farming?
How easy is it to get loans for agricultural schemes here?
Annex 2.4
INSTITUTIONAL REVIEW OF GOVERNMENT HEALTH FACILITY
Visiting team to note facilities and interview the officer in charge.
District: VDC: Ward: Cluster no.:
Name of Health Facility:
Type of health facility:
Note date, day and time of visit:
1. How far is this Health Institution from the centre of the community? (In time)
2. We want to know about the opening times of this Health Facility:2.1 How many hours/day?
2.2 Number of days/week:3. Is it always open during these times?
4. What is the staffing?Staff type No. Posts No. Present today
5. What is the clinical area like? <observe>
5.1 Size? <very small, small, reasonable size, good size>
5.2 Is it separated from other areas in some way? <yes, no>
5.3 What is the state of cleanliness? <dirty, reasonable, clean>
6. Is there any area for storage of drugs and other supplies?
Is it stocked with: <check>
6.1 Antibiotic (eg penicillin)?
6.2 Antipyretic (eg aspirin)?
6.3 Sedative (eg diazepam)?
7. Is there a fridge for vaccines etc?
7.1 If yes, Is it working?
7.2 If not working, when was it last working?
Other questions for the officer in charge:
8. Where does this Health Institute get its vaccines from?
9. Do you keep records of your service activities?
9.1 Please show us the report or last week or last month:
<write if report is missing, incomplete, apparently complete>
10. What do you do with the reports of your service activities?
11. Do you use the records of your service activities locally to monitor or improve your service?
11.1 If YES, please describe in what way:
12. Do you receive feedback on your monthly reports?
13. What is the average number of patients seen per day in this Health Facility?
<Check daily register for the last week>14. Do you make charges for services from this Health Institute?
If Yes,
14.1 How much per visit?
14.2 How much per activity (eg vaccination)
15. Are the community active in the management committee of this facility?
16. What are the main problems you have in providing a service?
17. What services do you receive from the District Health Office?
<write up to three>18. When did you last get a supervision visit from the DHO's office?
<how many months ago>19. How do you find the support given to you by the DHO's office?
<good, average, bad>20. Do you hear complaints from the local community about your services?
20.1 If yes, what are their main complaints?
<write up to three>21. What do you think could be done to improve your services?
<write up to 3 answers>
Annex 2.5
INSTITUTIONAL REVIEW OF AGRICULTURAL /LIVESTOCK SERVICE CENTRE (OR SUB-CENTRE)
Visiting team to note facilities (if appropriate) and interview an agricultural extension worker.
Community: <write name and code number>
Location of Centre or sub-centre:
Note date, day and time of visit:
1. How far is this office from the centre of the community? (In time)
2. What is the staffing of this office?
Name of the post no.post sanctioned no. Present today
JT/JTAs <number>
SMSs <number>Other questions for the officer in charge:
3. What are the main challenges you face in providing a service?
4. What services do you provide for the local community?
5. What charges do you make to farmers for your services?
Fixed fee - how much?
Other charges for services6. What services do you receive from the District Agricultural/Livestock Development Office?
7. When did you last get support supervision from the DADO/DLDO office?
8.. How do you find the service given to you by the DADO/DLDO office?
<good, average, bad>9. Do you hear complaints from the local community about your services?
<if yes> what are their main complaints?10. What do you think could be done to improve your services?
Visiting team to note facilities and interview the officer in charge.
District: VDC: Ward: Cluster no.:
Name of Health Facility:
Type of health facility:
Note date, day and time of visit:
1. How far is this Health Institution from the centre of the community? (In time)
2. We want to know about the opening times of this Health Facility:
2.1 How many hours/day?
2.2 Number of days/week:
3. Is it always open during these times?
4. What is the staffing?
Staff type No. Posts No. Present today
5. What is the clinical area like? <observe>
5.1 Size? <very small, small, reasonable size, good size>
5.2 Is it separated from other areas in some way? <yes, no>
5.3 What is the state of cleanliness? <dirty, reasonable, clean>
6. Is there any area for storage of drugs and other supplies?
Is it stocked with: <check>
6.1 Antibiotic (eg penicillin)?
6.2 Antipyretic (eg aspirin)?
6.3 Sedative (eg diazepam)?
7. Is there a fridge for vaccines etc?
7.1 If yes, Is it working?
7.2 If not working, when was it last working?
Other questions for the officer in charge:
8. Where does this Health Institute get its vaccines from?
9. Do you keep records of your service activities?
9.1 Please show us the report or last week or last month:
<write if report is missing, incomplete, apparently complete>10. What do you do with the reports of your service activities?
11. Do you use the records of your service activities locally to monitor or improve your service?
11.1 If YES, please describe in what way:
12. Do you receive feedback on your monthly reports?
13. What is the average number of patients seen per day in this Health Facility?
<Check daily register for the last week>14. Do you make charges for services from this Health Institute?
If Yes,
14.1 How much per visit?
14.2 How much per activity (eg vaccination)
15. Are the community active in the management committee of this facility?
16. What are the main problems you have in providing a service?
17. What services do you receive from the District Health Office?
<write up to three>18. When did you last get a supervision visit from the DHO's office?
<how many months ago>19. How do you find the support given to you by the DHO's office?
<good, average, bad>20. Do you hear complaints from the local community about your services?
20.1 If yes, what are their main complaints?
<write up to three>21. What do you think could be done to improve your services?
<write up to 3 answers>
Annex 2.6
INTERVIEW WITH COMMUNITY KEY INFORMANT
1. What government health facilities are available locally?
2. How far away is each one from the centre of the community?
How long does it take to reach it from the community ?
3. What are the opening hours of each one: official?
practice?
4. How much are the official charges per visit for each one?
Fixed fee?
Other charges?
5. How often are the drugs needed available in the government health facilities ?
6. If not available from the health facility, where do people go to get them ?
7. Is there a medical shop in the community ?
8. What other health facilities are available locally (eg run by NGOs) ?
9. What is the main type of farming here?
10. Where do people here mainly go to get their supply of farming chemicals, fertilizers and veterinary drugs ?
11. What are the prices of these materials?
Price per 50 Kg bag of fertilizer urea? <Rs>
Price per Kg of cow/buffalo feed? <Rs>
Price per Kg of chicken feed?
12. What has happened to the prices of chemicals, fertilizer and veterinary drugs over the last year ?
13. Is there a library in this community ?
If so, what are the opening times ?
14. Is there a public telephone} in this community ?
Is the phone in working order <observe>
15. Is there a post office in this community ?
If Yes, what are the usual post opening hours ?
16. Can people here receive mail from other places in the district ?
From outside the district ?
17. How long does it usually take for mail to reach here from Kathmandu ?
Annex 2.7
INTERVIEW WITH VDC CHAIRMAN
1. What does the VDC do for the community ?
2. What difficulties do you encounter in serving the community ?
3. What services and support do you receive from the DDC ?
4. What services/support do you think you should get from the DDC ?
5. What do you think of the service/support you receive from the DDC ?
<good, average, bad>
6. How do you get information about the needs of the community you serve ?
7. What information do you think you need to help you plan your services to your community ?
8. Do you think VDC priorities are reflected in DDC (Council) decisions ?
9. If not, how could this situation be changed ?
Annex 2.8
INTERVIEW WITH DDC CHAIRMAN
1. What do you think of the government services provided in this district?
<good, average, bad>
Health
Agriculture
Education
Water
Sanitation
Postal service
Telephone service
Roads provision and maintenance
Electricity2. What are the difficulties of providing public services in this district ?
3. What services and support do you receive from the central government ?
4. What services/support do you think you should get from central government ?
5. What do you think of the service/support received from the central government ?
6. How could your service to the district be improved ?
7. How could the service you receive from the central government be improved ?
8. How do you get information about the needs of the district you serve ?
9. What information do you think you need to help you plan your services to your district?
10. Is it easy to co-ordinate the activities of different line ministries in the district?
11. How are VDC priorities reflected in the DDC's plans ?
12. How are DDC priorities reflected in VDC plans in this district ?
Annex 2.9
INTERVIEW WITH DISTRICT HEALTH OFFICER
1. What are the main challenges facing your service in this District ?
2. When did you last have direct contact with the central Ministry of Health ?
3. How does the ministry of health keep you informed about matters of importance ?
Does this system work well?
4. What services do you receive from the central ministry of health?
5. What do you think of the service you receive from the Ministry of health
<good, average, bad>
6. Which of the services you receive from the central ministry of health (apart from financial support) is of most use to you?
6.1 in the last fiscal year, how much medicine and goods were received in Rs?
6.2 in the last fiscal year, how much good in Rs were received?
6.3 in the last fiscal year, how much cash (in Rs) were received?
how much did you allocate the distribute the resources?
6.4 to hospital?
6.5 to phc?
6.6 to hp?
6.7 to shp?
6.8 to others (specify)?
7. Which of the services is of least use to you?
8. What do you suggest for improving the service you receive from the central ministry of health?
9. Which aspects of the health services in this District are you most satisfied with? Why?
10. Which aspects are you least satisfied with ? Why?
11. How could you improve the delivery of health services in this district ?
Annex 2.10
INTERVIEW WITH DISTRICT AGRICULTURAL DEVELOPMENT OFFICER OR DISTRICT LIVESTOCK DEVELOPMENT OFFICER (to answer on behalf of both services)
1. What are the main challenges facing your service in this District ?
2. How many SMSs do you have (livestock and agricultural)
How many {JT/JTAs} do you have (livestock and agricultural)
3. When did you last have direct contact with the central Ministry and Departments of Agriculture?
4. How does the Ministry and departments of Agriculture keep you informed about matters of importance ?
Does this system work well?
5. What services do you receive from the central ministry and departments of Agriculture?
6. What do you think of the service you receive from the central ministry and departments? <good, average, bad>
7. Which of the services you receive from the central ministry and departments of agriculture (apart from financial support) is of most use to you?
8. Which of the services is of least use to you ?
9. What do you suggest for improving the service you receive from the central Ministry and departments of Agriculture ?
10. Which aspects of agricultural services in this District are you most satisfied with? Why??
11. Which aspects are you least satisfied with? Why?
12. How do you think you could improve delivery of agricultural and livestock services in this district?
Annex 2.11
NMIS CYCLE 6 (SDS) - INTERVIEW WITH LOCAL DEVELOPMENT OFFICER
1. What do you think of the government services provided in this district?
<good, average, bad>
Health
Agriculture
Education
Water
Sanitation
Postal service
Telephone service
Roads provision and maintenance
Electricity2. What are the difficulties of providing public services in this district ?
3. What services and support do you receive from the central government ?
4. What services/support do you think you should get from central government ?
5. What do you think of the service/support you receive from the central government ?
6. How could your service to the district be improved ?
7. How could the service you receive from the central government be improved ?
8. How do you get information about the needs of the district you serve ?
9. What information do you think you need to help you plan services to your district?
10. Is it easy to co-ordinate the activities of different line ministries in this district ?
11. How are VDC priorities reflected in the DDC' plans ?
12. How are DDC priorities reflected in VDC plans in this district ?