HOUSEHOLD SURVEY QUESTIONNAIRE

Questionnaire №

Name of interviewer:

Code of interviewer: Household ID Add an "R" to the ID if this is a replacement Household

Name of Zone Code of Zone

Name of Rayon Code of Rayon

Name of Community Code of Community

Date of interview: Time - Begin: End:

INTRODUCTION

Hello, my name is: (Can be anonymous if preferred)____________________________

Thank you very much for your time and cooperation in our survey. The survey will enquire about living standards, conditions of
infrastructure, farm production and prices, banking facilities, etc.
This survey is being conducted to assess the conditions in rural Azerbaijan to inform the Ministry of Agriculture. It is being conducted across
Mughan-Salyan, Lower Shirvan, North, and North-West with more than thousand households taking part in each zone. Your family was
randomly selected to participate in this study.

You can be assured that your names and addresses will not be revealed to outside individuals or organizations. The information that you
give will remain absolutely confidential.

You do not have to answer any question you cannot or do not wish to answer.
 PART A. BASIC INFORMATION ABOUT THE RESPONDENT

ENTER NAME
A1 Name of Respondent
ENTER ADRESS
A2 Address of Respondent
ENTER PHONE NUMBER
A3 Phone number of respondent

A4 Is the respondent the Head of the Household? 1 Yes

2 No
A5 What is your marital status? 1 Married
2 Single
3 Divorced
4 Widowed

A6 What is your family's resident status? 1 Resident

2 Refugee
3 IDP
4 Other
ENTER NUMBER OF PEOPLE
How many people currently live in this household?
A7

HOUSEHOLD ROSTER (HR)(only the oldest 5 members of the household will respond to this section)

if not employed:
A12. Employment status
Person A9. Relationship to A11. Education (adult member) A13. Economically inactivity
A8. Gender A10. Age
Identification Respondent status (adult member)

Private company (1);

1. Household Commercial / trade (2);
LIST ALL WHO Housewife (1);
Head Primary (1); Government (3);
LIVE AND FEED IN Pensioner, non-worker (2);
2. Spouse of HH Uncompleted secondary (2); Agricultural (farmer, etc.) (4);
THAT Student, non-worker (3);
head Secondary (3); Military service (5);
HOUSEHOLD Invalids (4);
3. Child Vocational (4); Law enforcement personnel
THAT ARE OLDER (1=Male, Invalids (temporary) (5);
4. Grandparents Skip A11 - A13 for household Uncompleted higher (5); (6);
THAN 5 YEARS 2=Female) Unemployed, has profession
5. Uncle/Aunt members younger than 18 Higher (University) (6); Working on household farm
OLD STARTING (6);
6. In-law years old PhD (Candidate/Dr. of (7);
FROM THE HEAD Unemployed, has no
7. Nephew/Niece Science) (7); Student, working (8);
OF THE profession (7)
8. Non-relative Don’t know (99) Self-employment (9);
HOUSEHOLD Other (9) (specify) ______
9. Other (specify) Economically inactive (10);
Other (11) (specify)
RESPONDENT (1st
person)
2nd person selected
from list
3rd person selected
from list
4th person selected
from list
5th person selected
from list
 PART B. ECONOMIC ACTIVITY
[INTERVIEW THE HEAD OF THE HOUSEHOLD]
If self-employed:
If unemployed:
B1. What is your current B2. What is the type of business B3. Who owns the establishment that you are B6. How many workers do you employ
B4. Were you paid?
employment status? your are mainly working in? working in? B5. What is the main reason for your (excluding family members)?
current unemployment? ENTER NUMBER OF EMPLOYEES

1. Permanent worker 1. Farm - livestock 1. Myself / self-employed --> go to B6 1. Yes 1. Illness

2. Temporary worker 2. Farm - crops 2. Family member 2. No 2. Maternity leave
3. Unemployed --> go to B5 3. Manufacturing 3. Privately owned 3. Paid in-kind (food, place to sleep) 3. Attending a sick person
4. Seasonal 4. Service provision 4. Government 4. Education/training
5. Casual worker 5. Administrative or legal 5. NGO/Non-profit 5. Weather conditions
6. Task-based 6. Teacher 6. Other, specify: 6. No work available
7. Other, specify: 7. Health care 7. Dismissed
8. Other, specify: 8. Incapability
9. Attending children
10. Other, specify:
 PART C. INCOME AND EXPENDITURE
C4. Source of household income in the past month in AZN amount:
C5. How do you estimate current level of expenditures of your family? C6. What do you usually use to heat/prepare
ENTER THE AMOUNT IN AZN FOR EACH SOURCE OF INCOME, IF NONE WRITE 0
C2. How did the financial C3. What is the average Prompt the categories and answers meals?
C1. What is the current financial Prompt the categories
status of your family change monthly income of your
situation of the family?
in the last year? household during the last
Prompt the answers Amount in Food
Prompt the answers year? № Source of Income Clothing Utilities 1. Electricity
AZN consumption

1. Able to meet all needs 1. Much Worse 1. Less than 50 AZN i. Agriculture (on-farm income) Much less than adequate 1 1 1 2. Gas

2. Do not have financial difficulties 2. Worse 2. 50 – 125 AZN 1 Crops Less than adequate 2 2 2 3. Wood
3. Barely make ends meet 3. The same 3. 126 – 225 AZN 2 Livestock Adequate 3 3 3 4. Kerosene

4. Suffering indigence 4. Improved 4. 226 – 325 AZN 3 Forestry income (wood, herbs, animal grazing, tree nuts, etc.) More than Adequate 4 4 4 5. Charcoal

5. Don’t know 5. Much improved 5. 326 – 500 AZN ii. Off-farm income Much more than adequate 5 5 5 6. Other fuel (specify)

6. 501 – 551 AZN 4 Regular income (wages or salary)

7. 551 – 1000 AZN 5 Irregular income (ex. (for example, bonuses, overtime, 13th month, etc.)

Social transfers:
Hardship (social) allowance (pension, disability grant, loss of breadwinner, etc.) or Benefits (to
8. 1001– 2000 AZN 6
children under 16, guardians of parentless children, low income families having children under one
year old,TSA, funeral or for unemployment etc.)

9. More than 2000 AZN 7 Rental (ex. land, apartment, house, store, shop, transport, etc.)

10. Don’t know 8 Foreign Remittances or Help from relatives (ex. transfer/gifts, non-foreign remittances)

9 Entrepreneurship - private businesses

10 Sale of property (land, real estate, durable goods, assets etc.)

11 Other

Drop question 4
5: agriculture, remittances, social transfers
Change 5 to monthly (easier to recall).
Check if 12 months works for 5 (when on the ground)
Cut "%" in 5.
Use ranges for 5? Or Amount?
Drop 6.

Drop 9.
 PART D. ASSET STRUCTURE FOR HOUSEHOLDS
D2. When did you acquire the
newest [item]? D3. How did you acquire the
D4. Value of item
1. Less than 3 months [item] ?
2. 3-6 months 1. purchased in full
D1. How many of the (If you bought it, how much money did you
Please specify whether each of the below 3. 6-12 months 2. purchased with credit/loan
[item] does the spend on?
listed items is present in your household. 4. 1-2 years 3. as a gift --> go to next
household own? or
Prompt the list one by one. 5. 2-4 years section
ENTER NUMBER If you had wanted to sell the item, how much
6. 4-6 years 4. provided by job/employer -->
would you be able to sell it for when you
7. 6-8 years go to next section
received it?)
8. 8-10 years 5. other (specify)
9. over 10 years
1. Agriculture land (hectares)
2. House
3. Trading depot (shop, etc.)
4. Car
5. Truck
6. Tractor
7. Agricultural equipments
8. Motorbike
9. Refrigerator
10. Dishwasher
11. Laundry Machine
12. Generator
13. Video/DVD / CD player
14. TV
15. Satellite dish
16. Computer
17. Cattle
18. Sheep
19. Poultry
20. Other livestock
 PART E. CURRENT PROBLEMS IN THE AREA
E1. Would you, please, indicate and rank three to five main
E3. Which problems with drinking water E4. How frequently do you or your family E5. When you or your family members was last sick with
problems, which you have in your area? (More than 1 answer
E2. What is your main source of drinking water? do you have currently, if any? (multiple members have water-related diseases during the water related diseases, where did you or your family E6. Which effluent disposal line (sewage system) do you have?
possible)
answers possible) last year? members get treated for the water related diseases?
DO NOT PROMPT RESPONDENTS
Rank
1, 2, 3, 4, 5
[ ] 1.Water pipeline into the house [ ] 1. Water pipeline is missing [ ] 1. Every week [ ] 1. Village clinics [ ] 1. Centralized effluent disposal line (sewage system)
ENTER NUMBER
OF RANK
[ ] 2. Sewage well in outside of the house – a. to the street; b. to the river; c. to
1. Insufficient income [ ] 2. Water pipeline outside of the house [ ] 2. Water provision is bad (irregular) [ ] 2. Every month [ ] 2. District Hospital
the sewer hole

2. Insufficient land [ ] 3. Artificial well (pit) [ ] 3. Water quality is bad [ ] 3. Every 3 months [ ] 3. Home treatment [ ] 3. Other _____

3. Insufficient farming field and arable land [ ] 4. Artesian well [ ] 4. We do not have any problems [ ] 4. Every 6 months [ ] 4. Self-treatment
4. Harvest failure [ ] 5. Spring [ ] 5. Don’t know [ ] 5. Once in a year [ ] 5. No treatment
[ ] 6. Water brought by trucks
5. Many livestock died [ ] 7. Water is bought [ ] 6. Do not know [ ] 6. No answer
6. Insufficient marketing conditions [ ] 8. Other_____________
7. Environmental problems [ ] 9. Don’t know [ ] 7. Never - skip to E6
8. Health problems
E13. Could you please rate
E7. By car, how much time did it take you in your last visit E10. In the last 12 months, did you E11. Could you please rate the E12. Could you please rate the
E8. Could you please rate the quality of the following items in your area ? E9. How often do you visit a the accessibility to primary
9. Education problems to reach...? (if not access, put “0”) go to doctor for a preventative check accessibility to Village Clinics? village clinic building?
Prompt the response. CIRCLE THE ANSWER village health clinic? schools ?
Prompt answers ? Prompt the answers Prompt the answers
Prompt the answers
10. Social environment problems Minutes Not existing Poor Satisfactory Good 1. Once every week 1. Yes 1. No access 1. Highly deteriorated 1. No access

1. Paved Access Road (fastest route to

11. Flood problems 1. Access roads 2. Once every month 2. No 2. Poor 2. Deteriorated 2. Poor
access it)
1 2 3 4
12. Bad road access 2. Pre-School/kindergarten 2. Bridges 1 2 3 4 3. Once every 3 months 3. Average 3. Little deterioration 3. Average
3. Public
13. Insufficient electricity 3. Secondary School 4. Once in 6 months 4. Satisfactory 4. Fairly good condition 4. Satisfactory
transportation 1 2 3 4
14. Insufficient gas 4. Community Center 4. Market 1 2 3 4 5. Once in an year 5. Very satisfactory 5. Very good condition 5. Very satisfactory
5. Healthcare
15. Not enough materials for heating 5. Village Clinic 1 2 3 4 6. Never visited 6. Do not know 6. Do not know 6. Do not know
facilities

16. Insufficient Water (quantity and 6. Community

6. District Hospital 7. Do not know
availability of, and access to, and clean water) Centers
1 2 3 4
7. Preschool/
17. Insufficient irrigation water 7. Central Transportation Point
kindergartens 1 2 3 4
18. Problems with sewage system 8. Domestic Water Supply Point 8. Primary Schools
1 2 3 4
19. Bad or inadequate schools and 9. Secondary
9. Park you usually visit
kindergartens Schools 1 2 3 4
10. Market where you buy most of your 10. Potable water at
20. Unemployment related 1 2 3 4
products home
11. Water supply
21. No problems
regularity 1 2 3 4
12. Electricity
22. Other 1 2 3 4
connection
13. Regularity of
electricity 1 2 3 4
14. Gas 1 2 3 4
15. Heating 1 2 3 4
PART F – ASSOCIATIONS / SOCIETIES

F5. What is the total time your

F4. What is the value of money and/or household spent for the
F1. Do you have any non-political F3. If “Yes” above, could you F6. What is the main
F2. Over the last 2 months, have materials your household gave to the association named in Question F3
organizations, NGOs, associations, or specify which organization you purpose/activity of the
you been active in these? association named in Question F3 in the in the past 3 months?
societies in your area? have been most active in? association?
past three months? Recorded in days
ENTER NUMBER OF DAYS

1. Yes 1. Yes
1. Seda Project (USAID) 1. Humanitarian services

2. No -> skip to question F12 2. No -> skip to question F5

2. AzRIP 2. Infrastructure upgrading

3. Don’t know -> skip to question № F5 3. Japanese Embassy

3. Food security improvements
4. BP funded projects 4. Agricultural productivity improvements

5. EU funded projects 5. Health improvements

6. Community group 6. Education improvements
7. Others: _____ 7. Other, specify:
PART G - Social Capital
[INTERVIEW THE HEAD OF THE HOUSEHOLD]

G3. If you
G4. According to G5. To whom do you
suddenly had to
G2. Agree or disagree. your experience, if usually seek G6. To whom do
go away for a
In this village it is safe someone forgets to advice/suggestions for you usually seek
G1. What is the maximum monthly amount you would contribute to day or two, G7. How much do you trust your municipal government in:
to leave your house to lock the processing your advice/suggestions
keep a newly built access road well-maintained? could you think Prompt the categories and answer options
your neighbor when bicycle/motorcycle harvested when you need a
of at least one
you are travelling. at night, it will be commodities or other financial loan?
person from the
stolen? tradable goods?
folllowing
[ ] 1. Members of [ ] 1. Regional Branch of
ENTER NUMBER FROM 1-4 BELOW a. Improving the welfare of your household
AZN (maximum) AZN__________ my extended [ ] 1. Yes the Ministry of [ ] 1. Credit Unions b. Enforcing laws and regulations c. Managing crime and theft d. Managing conflict
[ ] 1. Agree EACH ACTIVITY A-D and community
family/relatives Agriculture
[ ] 2. Friends
[ ] 2. Neither agree nor disagree [ ] 2. No [ ] 2. Municipality [ ] 2. Banks 1. A lot
[ ] 3. Community [ ] 3. Local Executive [ ] 3. Friends and
[ ] 3. Disagree [ ] 4. Don't know 2. Somewhat
leaders Committee (ExCom) Family
[ ] 4. Members of [ ] 4. Other lending
my religious [ ] 4. Others (specify) entities or individuals 3. A little
[ ] 4. Do not own a house organization (specify)
[ ] 5. IDPs [ ] 5. "Lombard" 4. Not at all
[ ] 6. Neighbors [ ] 5. Does not apply to me

G8. How do the following groups benefit from community decisions?

G9. How influential are you when
Prompt the answer categories
decisions are made on issues that G11. If you had concerns about how things were going in your village, there are some things that you might
affect all villagers, do you feel that G10. Generally, what would happen if a be able to do to make things better. I will read out a list of actions that you could take to try to change the
you personally play and influential household chose not to participate in situation in your village. For each one, I would like you to tell me whether or not you think these things would
role in affecting the outcome, for community activities? help?
PUT options 1-3 for each Doing better than the Doing worse than the instance when you speak at village (multiple answers are possible) Prompt the list of answers
Average
row a-f average person average person meetings or trying to persuade prompt the answers
others?
Prompt the answer categories
a. The relatively poor Put options 1-2 for each row a-g 1. Yes 2. No
1. Nothing, this work is purely done on a
b. Older people 1. Never influential a. Complain to a village leader
voluntary basis
c. Friends or family of the local 2. They would be critized by members of the
2. Somewhat influential b. Complain to a municipal official
leader community
d. People that are well
3. They would be critized by the municipal
connected to the municipal 3. Usually influential c. Complain to a rayon official
government
government
4. They would not be helped in the future if
e. IDPs 4. Always influential d. Complain to a religious leader
they needed help from their community
f. Women headed
e. Appeal to local NGOs for assistance
households 5. Other, specify:

f. Take part in community-wide meetings

g. Express my opinions during elections

 PART H – FOR HEAD WOMEN IN THE HOUSEHOLD
For the spouse or woman household head only. Explain to the respondent that the information obtained in this section will not be shared with anyone

H1. Head Woman: How often are you H2. If you compare YOUR situation to 2 years H3. If you compare the situation of ALL
consulted by your father, son, brother or ago, would you say that your financial women within your community to 2 years ago,
in-laws on financial matters? independence within the household has would you say that your financial H4. How many minutes a day do you spend on? (if not, put “0”)
improved: independence within the household has ENTER THE MINUTES SPENT
improved:

[ ] 1. Often 1. Worsened substantially 1. Worsened substantially Minutes

[ ] 2. Sometimes 2. Not improved at all or slightly worsened 2. Not improved at all or slightly worsened Fetching water
[ ] 3. Never 3. Stayed the same 3. Stayed the same Marketing products

4. Improved just a bit 4. Improved just a bit Working for agricultural production:
Crops

5. Improved a lot 5. Improved a lot Working for agricultural production:

Animals
Spending time with children
Household chores like cooking,
cleaning the house etc.
Community activities

H5. Enumerator: Was there a man present at 1. Yes

the time of the interview? 2. No
 PART J – BANKING FACILITIES
[INTERVIEW THE HEAD OF THE HOUSEHOLD]

J5. What interest rate were

J2. Have you taken a loan from any of these institutions in the last 3 years or do you J6. What are main the difficulties faced by
you charged fot this loan?
J1. How far is it to reach the consider taking out a loan? households or small entrepreneurs in
J3. What was the purpose of the loan? In percent
closest commercial bank or Prompt table options J4. What are the loan details? obtaining a loan or credit from financial J7. How do you save money?
(more than one option possible)
credit union? institutions?
if the person doesn't know, write
If no to all "current borrowing", skip to next section (K) Do not prompt, multiple answers possible
"don't know"

For future needs, where will you a. When did you take it out? ____
__________ KM Current Borrowing [ ] 1. Agriculture [ ] 1. Excessive interest rates [ ] 1. At home
borrow? (year)

__________ Minutes by car 1. Commercial Banks [ ] 2. Food consumption [ ] 2. No facilities in the area [ ] 2. At a commercial bank

[ ] 3. Don’t know 2. Credit Unions [ ] 3. Education b. For how many years is the loan? [ ] 3. Cannot get approved for a loan [ ] 3. Rotational savings group

3. Relatives/friends [ ] 4. Marriage / Death [ ] 4. Insufficient collateral [ ] 4. Friends/Family

4. Money lenders [ ] 5. Health related [ ] 5. Other, specify:

c. What was the size of the loan?

5. Others [ ] 6. Buying/constructing house [ ] 5. Extraperson (Co-Signer) can't be found
_____________ AZN

6. No borrowing at all [ ] 7. Buying machinery [ ] 6. Lack of bank account

[ ] 8. Investment in the farm [ ] 7. Other (specify)

[ ] 9. Others
 PART K. ECONOMIC DISRUPTION in the LAST 12 MONTHS
[INTERVIEW THE HEAD OF THE HOUSEHOLD]

Economic Disruption in the Last 12 Months

Now I would like to ask about economic disorder in this household in the last 12 months

K1. Total loss/reduction of income due to the event

Type of economic disruption in the last 12 months? (in AZN)
Prompt the list (POTENTIAL LOST/REDUCED INCOME, K2. What was done by this household to cope with
FOR EACH OF THE OPTIONS 1- EXCLUDING THE MEDICAL EXPENSE, FUNERAL, the loss of income cause by this event?
7 ASK QUESTIONS K1-K2 REPAIR)
PROMPT THE LIST
Write "don't know" if no knowledge

1. Sell household asset

2. Use savings
1. Serious illness of a household 3. Loan money from parties outside of the household
member that required 4. Loan from Bank
hospitalization or frequent 5. Loan or gift from Friends/Family
medications 6. Loan or gift Community members
7. Other: ______
8. Nothing

1. Sell household asset

2. Use savings
3. Loan money from parties outside of the household
2. Loss of job or business failure
4. Loan from Bank
experienced by a household
5. Loan or gift from Friends/Family
member
6. Loan or gift Community members
7. Other: ______
8. Nothing

1. Sell household asset

2. Use savings
3. Loss of business of a 3. Loan money from parties outside of the household
household member because of a 4. Loan from Bank
dire, earthquake, or other 5. Loan or gift from Friends/Family
disasters 6. Loan or gift Community members
7. Other: ______
8. Nothing
Harvest failure of a household
member due to
1. Sell household asset
2. Use savings
3. Loan money from parties outside of the household
4. Loan from Bank
4. Weather
5. Loan or gift from Friends/Family
6. Loan or gift Community members
7. Other: ______
8. Nothing
 1. Sell household asset
2. Use savings
3. Loan money from parties outside of the household
4. Loan from Bank
5. Pest
5. Loan or gift from Friends/Family
6. Loan or gift Community members
7. Other: ______
8. Nothing

1. Sell household asset

2. Use savings
3. Loan money from parties outside of the household
6. Reduced household income
4. Loan from Bank
due to the very low prices of
5. Loan or gift from Friends/Family
crops/products
6. Loan or gift Community members
7. Other: ______
8. Nothing

1. Sell household asset

2. Use savings
3. Loan money from parties outside of the household
4. Loan from Bank
7. Other________________
5. Loan or gift from Friends/Family
6. Loan or gift Community members
7. Other: ______
8. Nothing
 PART I – FARM PRODUCTIONS AND PRICES
[INTERVIEW THE HEAD OF THE HOUSEHOLD]
I1. Specify the size of your land I4. Where do you usually sell your products? (There may be more
I2. If you own farm land, did you sell I3. How is the farm land used?
Prompt categories than one answer)
your land in the past 2 years? (Don’t fill this section if there is no land)
Indicate if the person does not know Mark "yes" in the cell that applies for each column

Type of land Size in Hectares 1. Sold the land completely Land use Place Crops Livestock Product

Major crops Directly to consumers in

Household plot 2. Sold the land partially Area (in ha) Estimated Value village / urban center (at
ENTER AREA AND the farm gate)
ESTIMATED VALUE FOR
EACH ROW ENTER YIELD AND
Non- Non- Yield (last year) To wholesale buyer at
Farm land (privatized land) 3. Did not sell the land Irrigated Irrigated AREA FOR EACH Area in ha's
irrigated irrigated measured in tons farm gate
ROW

To wholesale at village /
Purchased farm land 4. Not owning farm land Crop land Wheat
urban center

Sell products out of the

Inherited Orchard (fruits) Maize
country

Rented land from neighbor Vineyard Alfalfa Other (specify)

Pasture Potato
Other land (specify)
___________ Farm building Cotton

Idle Barley

Other (specify) Tobacco

Tomato

Cucumber

Other
 PART L – QUESTIONS ON COMMUNITY PROJECTS

L2. Did you participate in a L8. Has someone from the

L1. Does your community have L4. When was the community
mobilization meeting as part of L3. Did you vote in the L5. Is the community group still L6. Does the community have a L7. How much is currently in the community group been
experience in implementing a group started?
the community involvement for mobilization meeting? functioning? maintenance/sustainability fund? fund? selected/elected to the municipal
small/micro project? Enter year
this project. government or the ExComm?

[ ] 1. Yes 1. Yes 1. Yes 1. Yes 1. Yes ______________

1. ExComm
[ ] 2. No 2. No 2. No 2. No 2. No 2. I don't know 2. Municipal Government/Council
[ ] 3. Do not know 3. No

For COMPLETED projects only:

L10. Who initiated the project?
L.17 Is a part of the
DO NOT PROMPT THESE L11. Who financed the project L12. What proportion of people in the
government involved
ANSWERS you implemented? (Multiple community contributed material support L15. How satisfied were you with L16. Is the
in the MAINTENANCE
answers possible) (time, labor or money) to the project? the quality of the project? community L18. If there was a ROAD upgrading as part of the L19. As a result of the
or further improvement
Projects implemented L9. What was project's type? 1. The community 1. Foreign donor 1. Everyone L13. Is this infrastructure still L14. Do you use this 1. Not satisfied currently involved community implementing the project: ROAD improvement
of the project?
ask the next 4 questions for each [ ] 1. Contruction 2. The municipal government 2. Local donor (sponsor) 2. Half functional? infrastructure? 2. Somewhat unsatisfied in the project, how did traffic
1. Yes, Excomm
project implemented [ ] 2. Rehabilitation 3. The central government 3. Central Government 3. More than half 1.Yes / 2.No 1.Yes / 2.No 3. Average MAINTENANCE of By how much was the traveling time reduced to the change?
2. Yes, Municipal
4. Other organization (provide the 4. Local government 4. Less than half 4. Somewhat satisfied the project? following places? Mark one
government
name) 5. Others (name) 5. No one 5. Very Satisfied 1.Yes / 2.No
3. No
5. Azrip 6. Don't know 6. Don't know
4. I don't know.
6. Don't know

1. Water supply System (potable)

Place Travel time (in minutes) 1. Traffic increased

2. Sewerage and drainage system

Market 2. Traffic stayed the same

3. Secondary roads and bridges

Hospital 3. Traffic was reduced
4. Small scale local electricity
distribution School 4. I don't know

5. Schools and kindergarten

Safe water source

6. Health Centers
Cemetary

7. Community centers

8. Parks

9. Market places

10. Small-scale Irrigation

11. Soil and water conservation

12. Other, specify:

L20. Is there public L24. Where did you hear about the Rural
L21. Have you ever heard about L23. For how many small/micro L26. In what type of project would you be interested in participating?
transportation connecting your L22. Did this community received Investment Project (AzRIP) for the first L25. Are you interested in
the Rural Investment Project projects was support from Please rank your top 4 priorities
village/community to the city? support from AzRIP/AzKIL? time (multiple answers possible)? preparing another micro-project?
(AzRIP/AzKIL) in your area? AzRIP/AzKIL received? RANK PREFERENCE FROM 1-4
(Bus etc)

[ ] 1. Yes [ ] 1. Yes [ ] 1. Yes [ ] 1. 1 project [ ] 1. Government [ ] 1 Yes Type Put numbers 1- 4 for the ranking

[ ] 2. No [ ] 2. No - Skip to question L17 [ ] 2. No -- Skip to next section [ ] 1. Water supply system

[ ] 2. No - Skip to question L17 [ ] 2. 2 projects [ ] 2. Municipality

[ ] 3. More than 2 projects [ ] 3. Mobilization team [ ] 2. Sewerage and drainage system

[ ] 3. Do not know now
[ ] 4. Do not know [ ] 4. Relatives [ ] 3. Secondary roads and bridges
[ ] 4. Small scale local electricity
[ ] 5. Neighbors
distribution

[ ] 6. Newspaper [ ] 5. Schools and kindergarten

[ ] 7. Radio [ ] 6. Health centers

[ ] 8. TV [ ] 7. Community centers
[ ] 9. Project group [ ] 8. Parks
[ ] 10. Other:_____ [ ] 9. Market places
[ ] 11. Don't remember [ ] 10. Small-scale irrigation

[ ] 11. Soil and water conservation

[ ] 12. Livelihoods
[ ] 13. Others _______________
 PART M – CLOSENESS TO RAYON ADMINISTRATION

M2. What type of support did this community receive from the M3. Please name a representative of your Rayon administration and
M1. How many kilometers and
Rayon Administration in the last 2 years? her/his position.
minutes do you need to reach the
Prompt the response. Please enter 1 or 2 in ech row. Write "Don't know" if the person does not know.
capital of the Rayon by road/car?

Name of ExComm representative

Kilometers ____________
1. Yes 2. No in the municipality

Name of ExComm representative

Minutes ___________ Infrastructure project
in the city (head of the Rayon)

Agriculture project

Business support project

Other type of in-kind support
[ ] 3. Do not know Financial support
 PART N. MIGRATION TO AND FROM
CITIES/TOWNS TO/FROM VILLAGES

N1. How many of your family members migrated within the last 12
months?
ENTER NUMBER IN ROW THAT APPLIES

Number of family members

Within Azerbaijan
From a city to a village/rural area
From a village/rural area to a city
From another country to Azerbaijan
From Azerbaijan to another country

Space for additional comments on the survey

THANK YOU FOR THIS INTERVIEW!