ActionAid International Southern Africa Partnership Programme (SAPP-Zimbabwe) 6. APPENDIX 6.1 Questionnaire used in the survey Questionnaire ID: Prov Province: HARARE 0 1 Suburb/District: HARARE 0 1 Ward Name: District Ward Household Ward Number: Household number: Date of interview: Day Month 0 5 Year Name of Enumerator: Name of Supervisor: Name of Data Entry Clerk: Name of the respondent: First name: Sex of respondent: Surname: 1 = male 2 = female Physical address: What is your nationality? What is your citizenship? When were you affected by Operation Murambatsvina? 0 Day Month 5 Year HOUSEHOLD DEMOGRAPHICS 1. How old is the household head? 2. 3. What is the sex of the household head? Marital status of household head? 4. Total number of household members 5. How many are: years 1 = male 2 = female Married……………….….1 Widowed ………… ….….2 Separated…………………3 Divorced…………………4 Single/never married…….5 members Male Female Age range Below 18 years (0-17 years) Between 18 and 59 years Above 60 years 6. 1 = Yes 7. Are there any chronically ill members in your household? (a person who has been ill for more than 3 months with HIV/AIDS continuously) If yes, how many? 8. 9. Are there any orphans in your household? ( Circle 1) If yes, how many? 1 = Yes 10. 11. Are there any children below 18 years not attending school? ( Circle 1) If yes, how many? 1 = Yes 12. 13 Are there any mentally/physically challenged members in your household? If yes, how many? 1 = Yes 14. LIVELIHOODS What was this household’s primary source of income before Operation Zimbabwe Operation Murambatsvina/Restore Order National Survey Report 32 2 = No 99 = NA 2 = No 99 = NA 2 = No 99 = NA 2 = No 99 = NA