APPENDICES
Appendix 1
QUESTIONNAIRE ADMINISTERED TO HEADS OF HOUSEHOLDS IN
GISAGARA DISTRICT
A. SURVEY QUALITY CONTROL
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QUESTIONNAIRE CODE
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ENUMERATOR
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SECTOR
_____________________________DENSITY__________HAB/KM2
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FAMILY NAME OF RESPONDENT
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B.1 Distance to the nearest market
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B.2. Number of persons in the household
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B.3. Sex of the head of household
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B.4. Age of the head of household
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B.5. Education level of the head of household
................................................ (Years spent in school)
B.6. Number of extension visits received last
season (Season A, 2008/09) ...................................
C1. Household farm land assets (NB: code
assigned to farm throughout sections F to G) [Record only for
Season A, 2008/09]
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Farm code/ID
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C1A. Specify location
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C1B. Distance to residence
(Km)
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C1C. Size (ha)
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C1D.
Title deed
0. No
1. Yes
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C1E. Mode of acquisition
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C1F. Cost (If rented in)
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1.
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2.
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3.
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4.
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5.
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6.
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7.
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8.
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Field codes for C1E:
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1. Own land - inherited
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2. Own land - Purchased
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3. Own land - Donated
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4. Rented in
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5. Borrowed in
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D5. Household farm land partitioning and use
[Record only for Season A,
2008/09]
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Farm code/ID
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D5G. Crop 1 (specify)
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D5H. Size
(ha)
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D5I. Crop 2 (specify)
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D5J. Size
(ha)
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D5K. Crop 3 (specify)
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D5L. Size
(ha)
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D45M. Grazing
(ha)
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D5N. Fallow (Ha)
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D5O. Forest (Ha)
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D5P. Rented out (Ha)
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D5Q. Specify income
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D5R. Borrowed out (Ha)
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1.
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2.
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3.
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4.
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5.
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6.
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7.
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8.
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E3. Crop production output
[Record only for Season A,
2008/09]
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Farm code
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Crop 1 (specify here...
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Crop 2 (specify here...
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Crop 3 (specify here...
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E3A. Unit of measurement
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E3B. Qtty
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E3C. Output in Kg
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E3D. Per unit Price
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E3E. Total revenue
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E3F. Major buyer
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E3G. Unit of measurement
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E3H. Qtty
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E3I. Output in Kg
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E3J. Price
per Kg
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E3K. Total revenue
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E3L. Major buyer
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E3M. Unit of measurement
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E3N. Qtty
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E3O. Output in Kg
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E3P. Price
per Kg
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E3Q. Total revenue
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E3R. Major buyer
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1.
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2.
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3.
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4.
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5.
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6.
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7.
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8.
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G6. Crop production non-labor input
[Record only for Season A,
2008/09]
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Farm
(Insert code)
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F6A.
Crop
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Seed
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Fertilizer
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Field pest chemical/pesticides
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Manure
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F6B. Own saved/gift
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Bought
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F6E. Improved variety
0. No
1. Yes
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NPK
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DAP
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Urea
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F6L. Litres
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F6M. Frw/litre
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F6N. Own (Tons)
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Bought
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F6C. Amount (kg)
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F6D. Frw/kg
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F6F. Quantity
(Kg)
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F6G. Value
(Frw)
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F6H. Quantity
(Kg)
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F6I. Value
(Frw)
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F6J. Quantity
(Kg)
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F6K. Value
(Frw)
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F6O. Tons
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F6P. Value (Frw)
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