Questionnaire

No.

Name of the
Ashutosh
interviewer
Dhamale and

Sujay Agarwal

UG

Changyachapada

Ashutosh
Dhamale and
Sujay Agrawal

UG

Changyachapada

Ashutosh
Dhamale and
Sujay Agrawal

ug

Changyachapada

Roll No.

UG/PG(dept.) pada name

Kharade

House
no./Address

Name

Age

84

Narayan Tukaram Vishe

55

Vanita Narayan Vishe

50

Sadanand narayan vishe

20

Madhukar Narayan vishe

Santosh Harane

41

Sarita Harane

36

Vishal Harane

16

Nilima Harane

18

Rohini Harane

14
13

Gajanan Panduran Vishe

47

Asha Gajanan Vishe

45

Uday Gajanan Vishe

27

Kiran Gajanan Vishe

25

Prakash Gajanan Vishe

23

Chaya Gajanan Vishe

Jyoti Uday Vishe
Sitabai Pandurang Vishe
Pooja Uday Vishe
Yash Uday Vishe

22
25
80
3
8 months

Dhondu Sawlaram Ghaiwat

Suwarna Dhondu Ghaiwat
Sagar Dhondu Ghaiwat
Prashant Dhondu Ghaiwat
Dipali Dhondu Ghaiwat
Aradhya Prashant Ghaiwat

54
48
24
26
23
3

Relation to the head of house Sex

Education

Martial Status Occupation

self

Agri

wife

house wife

son

12

Agri

Son

10

student

self

10

Agriculture

wife

10

Housewife

son

10

student

daughter

12

student

daughter

student

son

student

self

ITI

Farmer

wife

Housewife

son

B.A

Business

daughter

10

Business

son

ITI

Service

daughter
daughter-in-law``
Mother
Grand daughter
Grand-son

F
F
F
f
M

B.A
12

u
m
m

Study
Housewife
Housewife

self
wife
Son
Son
Daughter in law
Grand daughter

M
F
M
M
F
F

4th

m
m
u
10 m

12th
4th

Agriculturer
Labourer
House wife
Employed
Labourer
House wife

Addl. Info

pada
name
House No.
Changyachapad
a
Changyachapad
a
Changyachapad a

head of the house

84 Narayan tukaram Vishe
Santosh Harane
277 Gajanan Pandurang Vishe
Dhondu Ghaiwat

Residing in the village Since

>15
5 to 10
>15
>15

Ownership of the house Type of House

Religion

Social Class

Status

own

half pucca

Hindu

OBC

BPL

own

pucca

Hindu

OBC

BPL

own

pucca

Hindu

OBC

BPL

own

kacha

Buddhist

SC

BPL

Telephone/Mobile
yes
yes
yes
yes(mobile)

pada
name
House no.
ChangyachaPad
a
changyachaPada
ChangyachaPad a
Kharade

head of the
house
Narayan
84 Tukaram Vishe
Santosh Harane
277 Gajanan Vishe
Dhondu Ghaiwat

TV

Car

Refrigerator

1n

1n

1n

Fan

Inverter

Generator

Tractor

Water Pump

Gas
n

1n

1n

4n

2n

Water Heater

Mixie

n
1

Tubelights

CFLs

Solar Lights

2n

3n
4n

4n

pada name
House No.
Changyachapad
a
Changyachapad
a
Changyachapad
a
Kharade

head of the house

Type of employment

84 Narayan Tukaram Vishe Round the year

Santosh Harane
277 Gajanan Vishe
Dhondu Ghaiwat

Main Occupation in
the Household
agriculture

Round the year

agriculture

>100 days a year

>100 days a year

agriculture
agriculture labourer

If
Agriculture,lan Size of land
d details
holding
Main crop taken
own

5-10 acre

rice

Cropping
Cash crop taken Pattern
Vegetables like Single two
ladies finger
season

own

2.5-5 acre

rice

vegetables

own
labourer

2.5-5 acre
<1 acre

rice
rice

vegetables

single
single one
season
single

Soil
conservation
Check dam

Irrigation facility source

not available

River

not available

River

not available

River

Number of
labourers
employed /
season

No. of persons from households working in

farms

No. of days
employed

Average income
from agriculture
Self sufficient
0 75000(???)
8000

Month of
receiving the
money

Adequate

Is there a place outside the

house where animal/birds If no where do they
Number of livestock live
live
No

May

yes

No

no

no

Major Problems
regarding to
Dependency on
livestock
livestock for living

no

Average Income
from livestock

if labourer;
Month of encashing adequate?

If labourer,
Average no. of Whether on
days employed farm/MNREGS
no
no
yes
no

Did you get

employment as If factory
Whether job card is per required
worker,state
obtained
day
type of work

If factory
worker, average
income
daily/monthly
from salary

Any certificate
obtained

Job based on
traditional
knowledge

Part of any
Any PF/Gratituty trade union

If Govt
Job discription employees

If Govt
employee,
permanent or
temporary or
daily wage

job description Any PF/Gratituty

pada name

House No.

Changychapada
Changychapada Changychapada
Kharade

head of the
house
Narayan

Any member of
the household
migrated
If yes, No. of
seasonly
months

84 Tukaram Vishe

no

Santosh Hirane

no

277 Gajanan Vishe

no

Dhondu ghaiwat permanent

Who has
migrated
seasonly

Total number

If seasonal
migration,
migrating since

pada name
Changyachapad
a
Changyachapad
a
Changyachapad
a
Kharade

House No.
84

277

head of the
house
Narayan
Tukaram Vishe

No. of Children
anganwadi
attending
School No. of children
Management (G, PA, PU LB)
1

Santosh Harane

Gajanan vishe

Dhondu Ghaiwat

anganwadi
primary
Type (B, G, Co-ed)
Distance from home
Completed (Y/N) No. of children
Management (G, PA, PU
Type
LB)(B, G, Co-ed)
2
0

rimary

upper primary(class VI-X)

Distance from home
Completed (Y/N) No. of children
Management (G, PA, PU
Type
LB)(B, G, Co-ed)
Distance from home

Category

higher secondary(class XI-XII)

Completed (Y/N) No. of children
Management (G, PA, PU
Type
LB)(B, G, Co-ed)
Distance from home
Completed (Y/N)
1
n

ZP School

2 km

5 km

degree college
No. of children
Management (G, PA, PU
Type
LB)(B, G, Co-ed)
Distance from home
Completed (Y/N) No. of children

residential school
professional/ITI/vocational
Management (G, PA, PU
Type
LB)(B, G, Co-ed)
Distance from home
Completed (Y/N) No. of children
Management (G, PA, PU LB)

are you happy

what aspect of
professional/ITI/vocational training
with the school? education do you spend
Type (B, G, Co-ed)
Distance from home
Completed (Y/N)
(yes/no)
most money on?
yes

School Fee

yes

School Fee

yes

School Fee

if yes, which
child with diability does he attend school does he
in your family
school?
attend

availability of
mid day meal

does your
child's school
arrange annual
health
checkup?

medium of
instruction

Marathi

marathi

any school
dropout in your
house?

if yes, why?

status after
dropout

No. of children
who never
attended school

why?

head of the
pada
name
Household
No.
house
Changyachapad
Narayan tukaram Banking
a
84 Vishe
y
Changyachapad
a
Changyachapad a
Kharade

No. of Bank
Accounts in
family

Name
of Banks
Maharashtra
2 Bank
Maharashtra

Santosh Vishe

2 Bank
TDC Bank,

277 Gajanan vishe

2 Credit
Thane Society
grameen

1 bank

Dhondu Gh

used saving used loan

services
services

Functions in
Household in last 3
years

Mode of
arranging
finances
Savings Bank

1 marriage 1 death

loan

marriage/Hospitalization savings

1 Marriage 1 birth

savings

savings

Total amount of
rate
of
interest
0 if paid before 1 loan
year
50000
-

surity provided Total taxes paid property tax

Yes

water tax

health tax

other taxes

Electricity Bill
(Rs)

no meter

House
Maintenance

Health Bill

300

500

500

500

1000

650

700 only rainy season

pada
name
House No.
Changyachapad
a
Changyachapad
a
Changyachapad a
Kharade

head of the
house
Narayan

Do you purify
Main source of water before
Drinking water drinking

If
Yes,and
How do
Alum
you
do
straineditwith

84 Tukaram Vishe

well

yes

Santosh Vishe

well

yes

well river

yes

cloth
Alum and
Electrical
Device
strained with
cloth

yes

boiling

277 Gajanan Vishe

Dhondu Ghaiwat Private tap

Do you use
ladle/cups with
handles for
taking drinking
water

Where does the

water for
washing
utensils come Availability of
from
Drinking water

no

river

year long

yes

Pucca Well

year long

yes

river

year long

no

shallow tubewell year long

In case of
Hand Wash
Availability of
unavailability of practice(Before
Toilets
eating)
Inside the home toilets
used
family
Insideby
the
home
used
by
family
Inside the home

yes

used
family
Insideby
the
home
used by family

yes

yes
yes

Hand Wash
practice(After
defecation)

If Yes,with

Where do you
Where is waste go to dump
water disposed garbage

yes

soap

open, Soak pits

Open, Burning

yes

soap

soak pits

open

yes

soap

soak pits

burning

yes

soap

open drains

open

Kh

head of the
house
Narayan

pada
name
house number
Changyachapad
a
84 TukaramVishe
Changyachapad
a
Changyachapad a
Kharade

Maximum
amount of
money is spent
on
medicines

Santosh Harane medicines

277 Gajanan Vishe

For how long

has this
expense
continued

medicines

Dhondu Ghaiwat doctor

Incidence of
Malariya in last
3 years
n

n
y
y

Were you ever

diagonised with
Incidence of
(.....) diseases
Dengue in last 3 by a medical
years
doctor

If yes, do you
still take the
prescribed
medicine?

If yes, what?

diabetes
liver problem
(alcoholic)

Any life
threatening
disease in the
If no, why not? last one year
n

yes

yes
no

typhoid

Major health
Distance of the
complaint in the
health facility
Pregnant
family in the
Where do you from your
woman in the
last one month go
for
treatment
home(kms)
govt. hospital,
23 km (Shahapur family
Private
Hospitals Hospital)
govt. hospital,
Private Hospitals 8 km

Private
Hospitals 9 km
Government
hospitals.
4 km

no
no

Antenantal
checkup
available

Availed Janani
Suraksha
Yojana

yes

no

Birth in the
family in the
last one year

Delivery

If safe, place of Postnatal care

delivery
available

Availability of
Immunization
care for the
child

yes

safe

hospital

yes

yes

pada
name
House No.
Changyachapad
a
Changyachapad
a
Changyachapad a
Kharade wadi

head of the
house
Narayan
84 Tukaram Vishe

Average
household
expenditure on
food every
Staple food
month in Rs.
taken

Santosh Harane

2000 rice

lunch,dinner
Breakfast,lunch,d
inner

277 Gajanana Vishe

7500 rice

lunch,dinner

1500 rice

lunch

Dhondu Ghaiwat

2000 Rice

Most important
meal in a day

frequency of
frequency of
vegetable intake milk intake

Frequency of
fruit intake

Frequency of
non-veg food
intake

alternative days

alternative days

alternative days

once a week

How many
people
what kind of
consume
nonveg do you alcohol in your
eat
egg,chicken,fish, house
meat
no

everyday

everyday

everyday

no

n0

no

once a week

everyday

once a week

once a week

all

once a week

once a week

rarely

rarely

all

no
no quit drinking
since 2 years

people take
tobacco
(Masheri, bidi,
cigaratte,
gutkha) in your
family:
Yes
n0
no
no

pada
name
House No.
Changyachapad
a
Changyachapad
a
Changyachapad a
Kharade wadi

head of the
house
Narayan
84 Tukaram Vishe

Electrified

Energy
consumption
If yes,
for agricultural
Electricity
purpose in
consumption at Rupees per
household level month

20 units

Santosh Harane y
277 Gajanan Vishe

Dhondu Ghaiwat y

n
40 n

70-80
no meter

Pump sizing

Hp (Diesel or
Kerosene)

Usage ............
Hour/Day.........D Fuel used for
ays/Year
Cooking

Petrol

firewood

Diesel

firewood/LPG
firewood
firewood

inside wall of
Where
is the
house
with
inside wall
of
cooking
area?
doorway
and
house
with
inside
wall
of
window
doorway
and
house
with
inside
wall of
window
doorway
and
house with
window
doorway and
window

If firewood, how
much firewood
is collected per
day
5
5
6
4

How much do
you consume
per day

If LPG, how
many days a
If charcoal, how Kerosene
Do you collect it cylinder last(in much
consumption(in Biogas facility
everyday?
months)
consumption
L/month)
available
5y

4-5 kg

1 no

1y

30

3 no

6y

60

no

60 days

1 no

Size of biogas

Additional Information/ Feedback

Dhondu lives in kharade village.