Dari Female Shura NRVA 2007 English
1 / 5
NRVA 2007-2008
Survey No
Community Questionnaire
Block No
Survey Month
1654373559
(Female Shura)
Cluster Code
District Name
Interviewer Code
Province Name
Village
Name/City
Kuchi
Code
Cluster
No
/
/
Date of
Interview
Interviewer
Name
SubVillage/Guzar/
Mosque
SECTION 1: COMMUNITY INFORMATION
What is the highest grade you have
completed in school? In which level?
YEARS
1 2 3 4 5 6 7
1.5
1.4
How many What position do
you have in this
years
have you community?
held
this posi
tion in
this
community
?
1.1
1.3
1.2
How many
How old What is
years
your name?
have you are you?
lived in
this
village
or urban
block?
Person
Number
LEVEL
1 2 3 4 5 6 7 8 9
1 2 3 4 5 6 7 8
01
1 2 3 4 5 6 7
1 2 3 4 5 6 7 8 9
1 2 3 4 5 6 7 8
02
1 2 3 4 5 6 7
1 2 3 4 5 6 7 8 9
1 2 3 4 5 6 7 8
1 2 3 4 5 6 7
1 2 3 4 5 6 7 8 9
1 2 3 4 5 6 7 8
03
04
1 2 3 4 5 6 7
1 2 3 4 5 6 7
1 2 3 4 5 6 7 8 9
1 2 3 4 5 6 7 8
1 2 3 4 5 6 7 8 9
1 2 3 4 5 6 7 8
05
06
2 / 5
5186373553
SECTION 2: HEALTH ACCESS
What is the cost of one
way transport from your
community to this service
provider by private
vehicle/taxi in the last
month (cost of one-way
transportation only)?
How long does it take to reach
the nearest ________ by
private vehicle/taxi in the
last month? (Based on one
person one-way travel)
What is the
cost of one way
transport from
your community
to this service
provider by
shared public
transport in
the last month
(cost per
person of one
way
transportation
only)?
How long does it take to
reach the nearest ________
by shared/public transport
in the last month? (Based
on one way travel)
1
2
3
4
5
6
7
2.1 How long does it take
to reach the nearest
________ by foot/animal in
the last month? (Based on
one way travel)
Type of
service
provider
No time - in community >>2.6
Near community - 1 hr or less
Less than 1/4 day (1 - 3 hrs)
1/4 to 1/2 day (3 - 6 hrs)
1/2 to one full day (6-12 hrs)
More than one full day (>12 hrs)
Not applicable>>2.4
1 2 3 4 5 6 7
1 2 3 4 5 6 7
1 2 3 4 5 6 7
1 2 3 4 5 6 7
1 2 3 4 5 6 7
1 2 3 4 5 6 7
1 2 3 4 5 6 7
1 2 3 4 5 6 7
1 2 3 4 5 6 7
1 2 3 4 5 6 7
1 2 3 4 5 6 7
1 2 3 4 5 6 7
1 2 3 4 5 6 7
1 2 3 4 5 6 7
1 2 3 4 5 6 7
Health
post
(house of
community
health
worker)
Public
Clinic (may
be Basic or
Comprehens
ive Health
Center)
District or
Provincial
Hospital
Private
doctor's
office or
private
hospital
Private
pharmacy
3 / 5
6484373555
Are the following types of staff present in the nearest _________?
Yes
1
1
NO
2
2
Don't
Know
3
3
NO
Yes
Female doctor
1
Don't
Know
3
Private
pharmacy
Male doctor
Where do most community members get medicines when they
are sick?
1
2
3
4
2
Type of
service
provider
Female CHW
1
2
3
1
2
3
Female doctor
1
2
3
Female nurse
1
2
3
Female midwife
1
2
3
Male doctor
1
2
3
Male nurse
1
2
3
1
2
3
Male CHW
Health
post
(house of
community
health
worker)
Public
Clinic (may
be Basic or
Comprehens
ive Health
Center)
Female doctor
Female nurse
1
2
3
1
2
3
1
2
3
1
2
3
Female doctor
1
2
3
Female nurse
1
2
3
Female midwife
1
2
3
Male doctor
1
2
3
Male nurse
Female midwife
District or
Provincial
Hospital
Male doctor
Male nurse
Private
doctor's
office or
private
hospital
4 / 5
1725373558
SECTION 3: COMMUNITY ROLES AND GOVERNANCE
How many times does this CDC or village
shura meet per year?
Are the NSP representatives
to these bodies elected by
secret ballot?
Are any of the following
decision-making cimmittee in
this community?
1 2
1 2
Male NSP CDC
1 2
1 2
Female NSP CDC
1 2
1 2
Male and female
NSP CDC
1 2
Male Shura
1 2
Female Shura
1 2
Male and female
Shura
If women only or joint female/male decision-making committees exist in question 3.1
If there are no women’s decision-making committees
in the community, do women participate or have their
views taken into consideration in male
decision-making committees?
1
2
3
If women have their views taken into consideration
in male decision-making committee, by what means?
1
2
3
4
>>Section 4
5 / 5
5619373554
SECTION 4: COMMUNITY PRIORITIES
What are the main priorities that this community would like to see the Afghan Government address?
priority as 1, second priority as 2 and third priority as 3)
(Mark first
1
7
13
19
25
2
8
14
20
26
3
9
15
21
27
First
Second
Third
4
10
16
22
28
5
11
17
23
29
6
12
18
24
30
1
7
13
19
25
2
8
14
20
26
3
9
15
21
27
4
10
16
22
28
5
11
17
23
29
6
12
18
24
30
1
7
13
19
25
2
8
14
20
26
3
9
15
21
27
4
10
16
22
28
5
11
17
23
29
6
12
18
24
30
NRVA 2007-2008
Survey No
Community Questionnaire
Block No
Survey Month
1654373559
(Female Shura)
Cluster Code
District Name
Interviewer Code
Province Name
Village
Name/City
Kuchi
Code
Cluster
No
/
/
Date of
Interview
Interviewer
Name
SubVillage/Guzar/
Mosque
SECTION 1: COMMUNITY INFORMATION
What is the highest grade you have
completed in school? In which level?
YEARS
1 2 3 4 5 6 7
1.5
1.4
How many What position do
you have in this
years
have you community?
held
this posi
tion in
this
community
?
1.1
1.3
1.2
How many
How old What is
years
your name?
have you are you?
lived in
this
village
or urban
block?
Person
Number
LEVEL
1 2 3 4 5 6 7 8 9
1 2 3 4 5 6 7 8
01
1 2 3 4 5 6 7
1 2 3 4 5 6 7 8 9
1 2 3 4 5 6 7 8
02
1 2 3 4 5 6 7
1 2 3 4 5 6 7 8 9
1 2 3 4 5 6 7 8
1 2 3 4 5 6 7
1 2 3 4 5 6 7 8 9
1 2 3 4 5 6 7 8
03
04
1 2 3 4 5 6 7
1 2 3 4 5 6 7
1 2 3 4 5 6 7 8 9
1 2 3 4 5 6 7 8
1 2 3 4 5 6 7 8 9
1 2 3 4 5 6 7 8
05
06
2 / 5
5186373553
SECTION 2: HEALTH ACCESS
What is the cost of one
way transport from your
community to this service
provider by private
vehicle/taxi in the last
month (cost of one-way
transportation only)?
How long does it take to reach
the nearest ________ by
private vehicle/taxi in the
last month? (Based on one
person one-way travel)
What is the
cost of one way
transport from
your community
to this service
provider by
shared public
transport in
the last month
(cost per
person of one
way
transportation
only)?
How long does it take to
reach the nearest ________
by shared/public transport
in the last month? (Based
on one way travel)
1
2
3
4
5
6
7
2.1 How long does it take
to reach the nearest
________ by foot/animal in
the last month? (Based on
one way travel)
Type of
service
provider
No time - in community >>2.6
Near community - 1 hr or less
Less than 1/4 day (1 - 3 hrs)
1/4 to 1/2 day (3 - 6 hrs)
1/2 to one full day (6-12 hrs)
More than one full day (>12 hrs)
Not applicable>>2.4
1 2 3 4 5 6 7
1 2 3 4 5 6 7
1 2 3 4 5 6 7
1 2 3 4 5 6 7
1 2 3 4 5 6 7
1 2 3 4 5 6 7
1 2 3 4 5 6 7
1 2 3 4 5 6 7
1 2 3 4 5 6 7
1 2 3 4 5 6 7
1 2 3 4 5 6 7
1 2 3 4 5 6 7
1 2 3 4 5 6 7
1 2 3 4 5 6 7
1 2 3 4 5 6 7
Health
post
(house of
community
health
worker)
Public
Clinic (may
be Basic or
Comprehens
ive Health
Center)
District or
Provincial
Hospital
Private
doctor's
office or
private
hospital
Private
pharmacy
3 / 5
6484373555
Are the following types of staff present in the nearest _________?
Yes
1
1
NO
2
2
Don't
Know
3
3
NO
Yes
Female doctor
1
Don't
Know
3
Private
pharmacy
Male doctor
Where do most community members get medicines when they
are sick?
1
2
3
4
2
Type of
service
provider
Female CHW
1
2
3
1
2
3
Female doctor
1
2
3
Female nurse
1
2
3
Female midwife
1
2
3
Male doctor
1
2
3
Male nurse
1
2
3
1
2
3
Male CHW
Health
post
(house of
community
health
worker)
Public
Clinic (may
be Basic or
Comprehens
ive Health
Center)
Female doctor
Female nurse
1
2
3
1
2
3
1
2
3
1
2
3
Female doctor
1
2
3
Female nurse
1
2
3
Female midwife
1
2
3
Male doctor
1
2
3
Male nurse
Female midwife
District or
Provincial
Hospital
Male doctor
Male nurse
Private
doctor's
office or
private
hospital
4 / 5
1725373558
SECTION 3: COMMUNITY ROLES AND GOVERNANCE
How many times does this CDC or village
shura meet per year?
Are the NSP representatives
to these bodies elected by
secret ballot?
Are any of the following
decision-making cimmittee in
this community?
1 2
1 2
Male NSP CDC
1 2
1 2
Female NSP CDC
1 2
1 2
Male and female
NSP CDC
1 2
Male Shura
1 2
Female Shura
1 2
Male and female
Shura
If women only or joint female/male decision-making committees exist in question 3.1
If there are no women’s decision-making committees
in the community, do women participate or have their
views taken into consideration in male
decision-making committees?
1
2
3
If women have their views taken into consideration
in male decision-making committee, by what means?
1
2
3
4
>>Section 4
5 / 5
5619373554
SECTION 4: COMMUNITY PRIORITIES
What are the main priorities that this community would like to see the Afghan Government address?
priority as 1, second priority as 2 and third priority as 3)
(Mark first
1
7
13
19
25
2
8
14
20
26
3
9
15
21
27
First
Second
Third
4
10
16
22
28
5
11
17
23
29
6
12
18
24
30
1
7
13
19
25
2
8
14
20
26
3
9
15
21
27
4
10
16
22
28
5
11
17
23
29
6
12
18
24
30
1
7
13
19
25
2
8
14
20
26
3
9
15
21
27
4
10
16
22
28
5
11
17
23
29
6
12
18
24
30