E-USAGE INDEX BASELINE SURVEY: 2007
PILOT QUESTIONNAIRE
MODULE 1: QuestionnaireIDENTIFICATION and INTERVIEWER VISITSQ.1 Questionnaire Number
Q.2 Country Name
Q.3 Country Research Organization
Q.4 Survey Location (Major Towns = 1, Other Urban = 2, Rural = 3)
Q.5 EA Number (selected cluster number)
Q.6 Household Number (Listing ID)
Q.7 Interviewer ID
INTERVIEWER TO COMPLETE THE FOLLOWING FOR EACH VISIT AND THE SUPERVISOR TO COMPLETE THE CHECKBACK
VISIT 1 / VISIT 2 / FINAL VISIT / CHECK BACK
Day / Day / Day / Day
Month / Month / Month / Month
*resultQ.8.1 / *resultQ.8.2 / *resultQ.8.3 / **findingQ.9
*result codes:
1 = completed / 2 = not at home
3 = postponed / 4 = refused
5 = partly completed / 6 = incapacitated
7 = vacant / ** finding code
1 = interview acceptable in-field
2 = interview acceptable in-office
3 = interview need further visit
4 = interview to be rejected
Next visit / Next visit / Total no. Of Visits
Date / Date / Q.10
Time / Time
office administration
Interviewer / Field leaders / Field manager / Coders / Data capturer
Date of completion
____ / ____ /2004
dd mm yy / Date of completion
____ / ____ /2004
dd mm yy / Date of completion
____ / ____ /2004
dd mm yy / Date of completion
____ / ____ /2004
dd mm yy / Date of completion
____ / ____ /2004
dd mm yy
Signature / Signature / Signature / Signature / Signature
1
Pilot Version (August 2005)
MODULE 2: DEMOGRAPHICSMODULES 2, 3 & 4 ARE TO BE ASKED TO ONE PERSON BUT INFORMATION IS COLLECTED FOR EACH HOUSEHOLD MEMBER
LINE
NO.
RESP MUST BE IN LINE 1 / ALL HOUSEHOLD MEMBERS / ONLY 18 +YRS H/HOLD MEMBERS / ONLY 5+YRS HOUSEHOLD MEMBERS / ONLY 18 +YRS H/HOLD MEMBERS
First name of family member / Is
(name)
male
or
female?
1 = male
2 = female / How old
was (name)
on his/her
last
birthday?
Record in
completed
years
If the child is under the age of 1 year, then record a zero = 0
-98 don’t know. / How are the household members related to the household head?
1 = head
2 = wife/husband/partner
3 = son or daughter
4 = son or daughter-in-law
5 = grandchild
6 = parent
7 = parent-in-law
8 = brother or sister
9 = adopted/foster/stepchild
10 = other relative
11 = not related
-98 =don’t know. / What is the
marital
status
of (of (name)?
1 = currently married
1 = cohabitate
2 = single
3 = widowed
4 = divorced
5 = separated / Is (name)
currently
attending
school?
1 = yes
2 = no / What is the highest level of School (name)
COMPLETED or is CURRENTLY in?
Level:
0 = none
1 = preschool
2 = primary
3 = secondary
4 = higher (tertiary)
5 = traditional
6 = vocational
7 = remedial / Which highest grade/class
Passed?
Enter the grade, e.g.
4 = 4th grade / class
12 = 12th grade / class
If less than first grade/class, enter 0.
If in higher education then:
21 = 1st year post secondary
22 = 2nd year post secondary
23 = 3rd year post secondary
24 = 4th year post secondary
25 = 5th year post secondary
26 = 6th year post secondary
27 = 7th year post secondary
31 = masters
32 = PhD / Can (name) read a letter or
newspaper
easily, with
difficulty
or not at
all?
1 = easily
2 = difficult
3 = not at all
d.1 / d.2 / d.3 / d.4 / d.5 / d.6 / d.7 / d.8 / d.9
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
MODULE 3: Member VOCATION & INCOME / MODULE 4: COMMUNICATIONS
LINE # / ALL RSPONDENTS / EMPLOYED ONLY / ONLY 15 +YRS RESPS / ONLY 5 +YRS HOUSEHOLD MEMBERS
What was [name] main activity during last 6 months? / What sector was (name) employed in?
01 = Private formal - manufacturing
02 = Private formal - service
03 = Private formal - retail
04 = Private informal - manufacturing
05 = Private informal - service
06 = Private informal - retail
07 = Private agricultural
08 = Public government
09 = Parastatal
10 = NGO / Community
11 = Religious / What does (name) Earn every month?
Interviewer to probe for:
Wage Income
Self Employment Income
Transfer Income
Property Income
Other Income
Enter to nearest 10 units
Enter in local currency.
Calculate daily or weekly earnings to monthly equivalent.
Average out seasonal, occasional earnings to monthly equivalent. / Does (name) posses any assets such as livestock? If yes, what is the approximate value of them? / Does (name) have an Email Address?
1 = Yes
0 = No / Does (name) have a mobile phone?
1 = Yes
0= No
0 pre-school children
1 = full time scholar/ student
2 = housewife / unpaid work
3 = retired / pensioner
4 = unemployed
5 = disabled cannot work / TO Q D.12
6 = employed by non-family - all year: full time
7 = employed by non-family - all year: part-time
8 = employed by non-family - occasional/seasonally
9 = employed by family - all year: full time
10 employed by family - all year: part-time
11 employed by family - occasional/seasonally
12 self-employed - all year: full time
13 self-employed - all year: part-time
14 self-employed - occasional/seasonally / TO Q D.11
d.10 / d.11 / d.12 / d.13 / d.14 / D.15
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
1
Pilot Version (August 2005)
MODULE 5: HOUSEHOLD ATTRIBUTES (Is ASKED TO ONE PERSON BUT THE INFORMATION IS COLLECTED TO REPRESENT THE HOUSEHOLD)W.4 OBSERVATION please describe the type of house the respondent lives in. [record observation] / 1 = Permanent formal structure
2 = Permanent informal structure / 3 = Traditional structure
4 = Temporary structure
W.7 Does this house have a GRID ELECTRICITY CONNECTION? / 1 = Yes 2 = No / IF NO Q.W.9
W.8 What type of GRID ELECTRICITY CONNECTION is it? / 1 = Mains – exclusive to the household
2 = Mains - shared with other households
3 = Pre-paid - exclusive to the household
4 = Pre-paid - shared with other households
W.12 Does anybody living in your household have a working RADIO? / 1 = Yes 2 = No
W.15 Does anybody living in your household have a working TELEVISION? / 1 = Yes 2 = No
X.1 Does anybody living in your household have a working COMPUTER, PC (Desktop) or Laptop? / 1 = Yes 2 = No
X.3 Does any person in this household have a currently working INTERNET connection at home? / 1 = Yes 2 = No / IF NO Q.X8
X.10 From your home, how long does it take you to reach the nearest POST OFFICE, by foot? / mins
X.11 Other than a post office, how long does it take you to reach the nearest place where you can POST A LETTER by foot? That is a shop, school, office, etc. / mins
X.12 Do you have access to a POSTAL BOX? / 1 = Yes, personal family box
2 = Yes, communal box
3= Yes at work
4 = No
MODULE 6: HOUSEHOLD TELEPHONE (Is ASKED TO ONE PERSON BUT THE INFORMATION IS COLLECTED TO REPRESENT THE HOUSEHOLD)
H.1 Do you have a working HOUSEHOLD Fixed-line or a fixed-wireless PHONE at your home? (located on the premises) / 1 = Yes
2 = No / IF NO Q.H20
H.3 How many years ago did you get this phone? That is when did you get a HOUSEHOLD PHONE at home? (to calculate answer in months) / years
H.7 Could you tell me whether the HOUSEHOLD PHONE is contracted on a billing system (account at month end) or whether it is pre-paid? / 1 = Monthly billing
2 = Pre-paid
H.8 Could you tell me how much the HOUSEHOLD PHONE account came to, for the last month for which you have bill or how much you spent on pre-paid cards.
H.9 Are you aware of ways you can reduce the cost of HOUSEHOLD PHONE calls? / 1 = Yes 0 = No
H.10 Do you deliberately plan calls during off-peak times to save on the cost of calls? / 1 = Yes 0 = No
H.11 Do you deliberately avoid calling mobile phones to save on the cost of calls? / 1 = Yes 0 = No
H.12 Of your last 10 calls on your HOUSEHOLD PHONE, both in-coming and out-going, how many were outgoing? (apply to respondent only and not rest of household) / out of 10
H.13 Can any family member in the household use the HOUSEHOLD PHONE if they want to? / 1 = Yes
2 = No
H.14 Who uses the HOUSEHOLD PHONE most? (if the respondent uses this most, then the response should correspond to the respondents position in the household in relation to the household head) / 1 = head / wife / husband / partner
2 = own child or grandchild
3 = other relative
4 = other non-relative
H.18.1 – The current service of your phone, in terms of the clarity of the lines? / 1 2 3 4 5 -98 / 1 = very poor 2 = poor
3 = average
4 = good 5 = very good
H.18.2 – The current service of your phone, in terms of the dropped calls? / 1 2 3 4 5 -98
H.18.3 – The billing service for your phone – e.g. are the accounts correct? / 1 2 3 4 5 -98
H.19.1 – Is the current cost of local calls to other household phones during peak time? / 1 2 3 -98 / 1 = reasonably low
2 = OK
3 = unreasonably high
H.19.2 – I the current cost of the monthly rental of your household phone? / 1 2 3 -98
H.20Ask the appropriate question. / Have you previously had a fixed or fixed wirelesshousehold phone? / 1 = Yes
0 = No / IF NO Q.H.24
H.22 What is the main reason why you no longer have this HOUSEHOLD PHONE? / 1 = Poor Service
2 = Could not afford it
3 = Billing problems
4 = Did not use it often enough / 5 = Old technology
6 = Have mobile phone/s
7 = Corruption, bribes wanted
x = Other (specify)
H.23 How long ago did you do away with the previous HOUSEHOLD PHONE / months
H.24 Have you ever applied for any type of HOUSEHOLD PHONE and never received it? / 1=Yes 0=No / IF NO Q.H.26
H.25 Do you know why you never received the phone? / 1 = Telecom company never delivered
2 = Telecom company came very late
3 = Cancelled – got mobile phone / 4 = Corruption – bribe wanted
5 = Still Waiting
x = Other
H.26 If there were MORE LINES available by the FIXED LINE telecom operator, and the PRICE REMAINS THE SAME, would you (re)consider applying (for a second line)? / 1=Yes 2=No
H.27 If there were MORE LINES available by the FIXED LINE telecom operator, but the PRICE DROPS, would you (re)consider applying (for a second line)? / 1=Yes 2=No
Which of the FIXED LINE PHONE costs, would have to decrease for you to consider applying for a PHONE for this household? MULTIPLE RESPONSE. / H.28.1 / Connection / 1=Yes 2=No / IF NO SKIP H.29.1
H.28.2 / Monthly rental / 1=Yes 2=No / IF NO SKIP H.29.2
H.28.3 / Handset / 1=Yes 2=No 3/N/A / IF NO SKIP H.29.3
H.28.4 / Calls / 1=Yes 2=No / IF NO SKIP H.29.4
By how much would the FIXED LINE PHONE costs have to decrease for you to apply? (Please refer to current cost and enter response as a percentage OR monetary amount). MULTIPLE RESPONSE. / H.29.1 / Connection / %
H.29.2 / Monthly rental / %
H.29.3 / Handset / %
H.29.4 / Calls / %
MODULE 8: MOBILE Phone Users
MODULE 8 IS ASKED TO all HOUSEHOLD MEMBER THAT CURRENTLY EITHER OWN OR USES A MOBILE PHONE
T.0 From D1 in MODULE 2 - please enter the line number of the person WITH the MOBILE PHONE answering
T.1 How long ago did YOU get first MOBILE PHONE? (response in number of years ago)
T.2 What kind of phone does (name) have?
1 = Contract, 2 = Pre-paid, 3 = Work related, 4 = Combination
T.3 How many ACTIVElocal MOBILE PHONE numbers (SIM cards) DO you have? (raw number)
T.4 Do Family members USE your MOBILE PHONE on a Regular, Occasional or Not at All? 1 = regular 2 = occasional 3 = never
T.5 Do Friends USE your MOBILE PHONE on a Regular, Occasional or Not at All? 1 = regular 2 = occasional 3 = never
T.6 Do Neighbours USE your MOBILE PHONE on a Regular, Occasional or Not at All? 1 = regular 2 = occasional 3 = never
T.7 Do Work Colleagues USE your MOBILE PHONE on a Regular, Occasional or Not at All? 1 = regular 2 = occasional 3 = never
T.8 Could you calculate on average how many SMS or text messages you send weekly? 1 = Yes, 0 = No
T.9 Could you calculate on average how many SMS or text messages you receive weekly? 1 = Yes, 0 = No
T.10 Do you ever let others use your mobile phone to send SMS or text messages? 1 = Yes, 0 = No
T.11 Do you make and receive calls or just receive calls?
1 = Make and receive, 2 = Receive only, 3 = Make only
T.12 Do you ever BEEP, FLASH, BUZZ or send a MISSED CALL people in order that they call you back, and if so, is it regular or occasional?
1 = regular 2 = occasional 3 = never
T.13 Does anybody BEEP, FLASH, BUZZ or send you a MISSED CALL, so that you can call them back, and if so, is it regular or occasional?
1 = regular 2 = occasional 3 = never
T.14 Who pays your mobile expenses or bill?
1 = Self, 2 = Partner, 3 = Parent 4 = Other Family, 5 = Work, 6 = Others
T.15 Could you tell me how much you spent last MONTH? That is what did your account come to if contract or air-time did you purchased if pre-paid.
T.16 Is this expenditure, last month / week on your mobile phone more or less than usual, or the same?
1 = Above average, 2 = On average, 3 = Below Average
T.17 What prevents you from making more phone calls, from your mobile?
1 = Nothing – currently on optimum use, 2 = Cost of calls, 3 = People I want to call have no phones, 4 = other
T.18 If call were cheaper would you: 1 = make more calls, 2 = make the same amount of calls and use the saved money for somehing else
T.19 Does using a mobile phone make your life easier? 0=No, 1=Yes
T.20 Do you use the mobile phone for business purposes? 0=No, 1=Yes
T.21 Does using a mobile phone hlp you making a living (earn money, find a job etc.)? 0=No, 1=Yes
Public Phone
T. 22 Have you used any of the following PUBLIC PHONES during the past three months? 1 = Yes 0 = occasional = No
T.23 On average how much do you spend monthly on using any combination of PUBLIC PHONES
T.24 What means of transport do you use to reach the nearest working PUBLIC PHONES from your house? (enter the most frequently used means of transport) 1 = Walk or Horse, 2 = Bicycle, 3 = Motor bike or vehicle
Phone at Work
T.25 Do you have access to a telephone at work, on which you can receive calls?
T.26 Can you use this telephone for personal use, to make calls to fixed line phones?
T.27 Do you save up on personal calls, so that you can use them from the WORK PHONE?
T28 On average, how many personal calls did you make last week from this WORK PHONE?
MODULE 9: Members withou a MOBILE Phone
MODULE 9 IS ASKED TO all HOUSEHOLD MEMBER THAT CURRENTLY NEITHER OWN OR USES A MOBILE PHONE
N.0 From D1 in MODULE 2 - please enter the line number of the person WITHout a MOBILE PHONE answering
N.1 Would you get a mobile phone if: 0=I would not anyway
1=hand-sets were cheaper, 2=calls would cost less or 3=only if both apply / If 0 N.3
N.2 Which form of mobile would you get?
1 = Contract, 2 = Pre-paid
Public Phone
N. 3 Have you used any of the following PUBLIC PHONES during the past three months? 1 = Yes 0 = occasional = No
N.4 On average how much do you spend monthly on using any combination of PUBLIC PHONES
N.5 What means of transport do you use to reach the nearest working PUBLIC PHONES from your house? (enter the most frequently used means of transport) 1 = Walk or Horse, 2 = Bicycle, 3 = Motor bike or vehicle
Phone at Work
N.6 Do you have access to a telephone at work, on which you can receive calls?
N.7 Can you use this telephone for personal use, to make calls to fixed line phones?
N.8 Do you save up on personal calls, so that you can use them from the WORK PHONE?
N.9 On average, how many personal calls did you make last week from this WORK PHONE?
MODULE 10: Members with Email
MODULE 10 IS ASKED ONLY TO A HOUSEHOLD MEMBER THAT Have an Email Address
C.0 From D1 in MODULE 2 - please enter the line number of the person USING the INTERNET answering MODULE 10
C.1 Do you use the internet (if applicable) 1= at home, 2= at work, 3= cybercafe /Internet, Café 4 = at another persons HOME
C.12 On average, how many HOURS, A WEEK, do you spend on-line, for the purposes of EMAILING or BROWSING? (enter number of hours)
C.13 Would you say that compared to SIX MONTHS AGO, the number of HOURS A WEEK has 1 = Increased
2 = Stayed same, 3 = Decreased
C.14 On average, how much money do you SPEND PER WEEK for the purposes of EMAILING or BROWSING? (in local currency please)
C.23 What is the main reason keeping you from using or spending more time on the internet? 1 = affordability 2 = time 3 = access 4 = quality of service
X = other
MODULE 11: Members with no Email
MODULE 10 IS ASKED ONLY TO A HOUSEHOLD MEMBER THAT Do not Have an Email Address
Is the main reason why you do not use Email that: / S.1 you do not have access to Computers 0=No, 1= Yes
s.2 you do not know how to use Computers 0=No, 1= Yes
S.3 you don’t want to use email
s.4 You have noone to email to
1
Pilot Version (August 2005)