ActionAid International - Combined Harare Residents’ Association - A Study on the impact of “Operation Murambatsvina/Restore Order” 5. APPENDICES 5.1 Questionnaire used in the survey Questionnaire ID: Prov District Ward Province: HARARE 0 1 Suburb/District: HARARE 0 1 Ward Name: 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. 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? 1 = Yes 2 = No 99 = NA 14