| A. Geographical Location | |
|---|---|
| A1. Village: | A2. Union: |
| A2. Upazila: | A4. District: |
| A5. Mobile No.: | |
| B. Personal details | |
|---|---|
| B1. Name of the Participant: | |
| B2. Age (in Year): | B3. Sex: 1 Male 2 Female |
| B4. Religion: 1 Islam 2 Sanatan/Hindu 3 Others _____________________________ | |
| B5. Education (in Year): _______________________ | |
| B6. Ethnicity: 0 Bengali 1 Munda 2 Others____________________________ | |
| B7. Marital Status: 1 Unmarried 2 Married 3 Divorced 4 Widowed/Widower | |
| B8. Occupation: | B8.1 Primary Occupation: ______________________ |
| B8.2 Secondary Occupation: ____________________ | |
| B8.3 Other Occupation: ________________________ | |
| C. Details about Earning Family Members | ||||
|---|---|---|---|---|
| Sl. No. | Relation with Respondent | Education | Occupation | Income |
| C.1 | ||||
| C.2 | ||||
| C.3 | ||||
| C.4 | ||||
| C.5 | ||||
| C.6 | ||||
| C.7 | ||||
| C.8 | ||||
| C.9 | ||||
| C.10 | ||||
| D. Information about Household Assets | |||||
|---|---|---|---|---|---|
| Items | Pre-COVID-19 |
During COVID-19 |
|||
| Response | Quantity/Amount | Response | Quantity/Amount | Sell Assets | |
| Radio | |||||
| Television | |||||
| Electric Fan | |||||
| Sewing Machine | |||||
| Wooden furniture | |||||
| Bi-cycle | |||||
| Motorcycle | |||||
| Boat | |||||
| Mobile | |||||
| Cow | |||||
| Goat/Sheep | |||||
| Poultry | |||||
| Land (in Decimal) | |||||
| Loan | |||||
| Others | |||||
| E. Other Socioeconomic Indicators | |
|---|---|
| Construction Materials of House: | 1 Earth 2 Wood/Bamboo 3 Corrugated Teen 4 Brick/Concrete 5 Straw/Golpata |
| Sources of Water: | 1 Pond/Lake/River 2 Well 3 Bottled/Jar 4 Piped |
| Sanitation Facility: | 1 Open/Bush/Field 2 Pit Latrine 3 Toilet 4 Others _________________________________ |
| Sources of Power: | 1 Kerosene 2 Solar Energy 3 Electricity 4 Others _________________________ |
| Number of Room: | 1 One 2 Two 3 Three 4 Four 5 Five and more |
| F. Sundarbans Forest-related Income | ||
|---|---|---|
| Questions | Pre-COVID-19 (Six Months Prior March 2020) | During COVID-19 (After March 2020) |
| F.1 What are the resources you collect from the SMF ecosystem that contribute to your livelihood? | ||
| F.2 Resource (See Code) | ||
| F.3 Duration of permit (BLC) in each season or year for resource collection (days or months/season) | ||
| F.4 Name the month of resource collection | ||
| F.5 Average distance of collection point from your HH (km) | ||
| F.6 Number of trips per season (trips/season) | ||
| F.7 Average stay in SMF ecosystem per trip (days/ trip) | ||
| F.8 Expenditure (BDT/ trip) | ||
| F.9 Major heads of expenditure with % of expenditure | ||
| F.10 Quantity of collected resources per trip (Unit) | ||
| F.11 Challenges in collection of resources (challenges in decreasing order of ranking) | ||
| F.12 Ways to overcome the challenges in resource collection | ||
| F.13 Selling/ trading point | ||
| F.14 Quantity of sold resources (Unit) | ||
| F.15 Unit price (BDT/unit) | ||
| F.16 Income (BDT/ trip) | ||
| F.17 Challenges in selling/ trading of resources (challenges in decreasing order of ranking) | ||
| F.18 Ways to overcome the challenges in resource selling/ trading | ||
| Code: F.2 01 – Fishing, 02 –Crab & Shrimp Fry | ||
| G. Coping strategies in livelihood of SMF dependent communities | ||
|---|---|---|
| Questions | Pre-COVID-19 (Six Months Prior March 2020) | During COVID-19 (After March 2020) |
| G.1 What are the strategies you sought to cope with? | ||
| G.2 Who is mainly responsible for the work? | ||
| G.3 Area for cultivation (Decimal)/farming/rearing | ||
| G.4 Own land (Dec)/livestock/poultry | ||
| G.5 Lease land (Dec) | ||
| G.6 Period of alternative activities (example: June to December) | ||
| G.7 Expenditure (BDT/season) | ||
| G.8 Major heads of expenditure with % of expenditure | ||
| G.9 Quantity of the produced (Unit) | ||
| G.10 Challenges in alternative activities (challenges in decreasing order of ranking) | ||
| G.12 Selling/ trading point | ||
| G.13 Quantity of sold resources (Unit) | ||
| G.14 Unit price (BDT/unit) | ||
| G.15 Income (BDT/ season) | ||
| G.16 Ways to overcome the challenges in resource selling/ trading | ||
| Codes: G.1 01 – Agro-farming, 02 – Home gardening, 03 – Aqua-farming, 04 – Livestock rearing, 05 – Poultry farming, G2: 1 Self, 2 Spouse 3 Children, 4 Father, 5 Mother, 6 Siblings 7 Others; G4. 1 Own, 2 Lease, 3 Both | ||
| H. Impact of COVID-19 on Livelihood (The following are the questions on the impact of COVID-19 on the livelihood opportunities. The answers are in a Two-point Thurstone scale – ‘1’ = ‘Yes’ to ‘0’ ‘No.’ Read the questions carefully and record the response) | ||||
|---|---|---|---|---|
| Questions | Pre-COVID-19 (Six Months Prior March 2020) |
During COVID-19 (After March 2020) |
||
| Yes | No | Yes | No | |
| Lost job permanently | ||||
| Lost business | ||||
| Lost key resources | ||||
| Fewer family members able to work | ||||
| Income reduced | ||||
| Changed occupation | ||||
| Stopped working | ||||
| Sold assets | ||||
| Borrowed money | ||||
| Reduced consumption | ||||
| More family members working | ||||
| Split the household to reduce the burden | ||||
| Married off children | ||||
| Worked for other persons | ||||
| Stopped funding educational expenditure | ||||
| I. Household's Capacity to Maintain Livelihoods (The following are the questions on the capacity of the household to maintain the livelihood. Read the questions carefully and record the response) | |||||
|---|---|---|---|---|---|
| Items | Affordability |
Changes in Quantity during COVID-19 |
|||
| Yes | No | More | Less | No Change | |
| Staple foods (Rice, Oil, Lentils, Vegetables, Onion, Sugar etc.) | |||||
| Other foods (Milk, Meat, Fish etc.) | |||||
| Household items (Soap, Washing Powder, Shampoo etc.) | |||||
| Fuel (Wood, Kerosene) | |||||
| Electricity | |||||
| Water | |||||
| Rent | |||||
| Education (School and Tuition Fees, Uniforms etc.) | |||||
| Transport | |||||
| Communication | |||||
| Street meals | |||||
| Health expenses (Medicine, Doctor/Quack etc.) | |||||
| Support to Relatives | |||||
| J. Health Status and Care-seeking Behavior (The following are the questions on health status and care-seeking behavior. Read the questions carefully and record the response) | |||
|---|---|---|---|
| Pre-COVID-19 | During COVID-19 | ||
| J.1.1 Illness | J.1.2Illness | ||
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| J.2.1 Duration________________________ | J.2.2 Duration____________________ | ||
| J.3.1 Care-sought: 0 No 1 Yes | J.3.2 Care-sought: 0 No 1 Yes | ||
J.4.1 Nature of Treatment
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J.4.2 Nature of Treatment
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J.5.1 Place of Treatment
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J.5.2 Place of Treatment
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| J.6.1 Cost of Treatment ______________ | J.6.2 Cost of Treatment ______________ | ||
| J.7.1 Sources of Treatment Cost _________ | J.7.2Sources of Treatment Cost ________ | ||
| Codes: Response – Yes/No; Duration – in days; Care-sought – Yes/No; Treatment - Self-care/Traditional/Unqualified Allopath/Qualified Allopath/Para Professional; Place - 1 Private Clinic/Government Hospital/Pharmacy/Drugstore/Home; Cost – in BDT; Sources of Treatment – Income/Borrowed Money | |||