BD_Rmg_Covid-19_Survey_V5

Field

Question

Answer

note_intro

Welcome to this SurveyCTO form! Designby Abdul Awal

In this form, the text is color-coded. When the text is RED, those are instructions not to be read out.
The text in BLACK during the interview is text to read out loud.
When the text is BLUE within the black text, that is dynamic and/or important text to read out loud, which is the most important to get right.

Swipe left on the screen to page forward.

no_case (required)

Note: You will not be able to proceed. Please open this form from the Manage Cases menu, not from Fill Blank Form.

This form has been designed to work with case management and will work only if it has been opened from the Manage Cases menu.

If you do not see the Manage Cases option on SurveyCTO Collect, open Admin Settings (tap on the 3 dot icon in the top left) and enable Manage Cases under the USER CAN ACCESS MAIN MENU ITEMS header.

Question relevant when: ${caseid} = null

uid (required)

UID_[uid_cal]

The uid consists of the factory code + worker tag number

Response constrained to: .= ${uid_cal}

q112 (required)

Interviewer‘s code

Interviewer‘s code should be 2 digit

Response constrained to: string-length(.)=2

q111 (required)

Interviewer‘s name

...

q113 (required)

Interviewer‘s gender

...

datetime_start (required)

Please verify the start date and time, and continue.

note_date1 (required)

Error:datetime start [datetime_start] cann't be a future date from today 2021-03-09.

Question relevant when: ${datetime_start} > ${starttime}

call_respondent

ENUMERATOR: DO NOT READ THIS ALOUD

Call number: 1
Last call status: None

Tap the button below to call [full_name] at 0.

If the respondent answers, read the following aloud, then go to the next field:

Hi, this is [[cal_enumname]] calling for [full_name]. Is this [full_name] at [address]?

Question relevant when: ${deviceid} != '(web)'

call_resp_webform

ENUMERATOR: DO NOT READ THIS ALOUD

Call number: 1
Last call status: None

Please call [full_name] at 0.

If the respondent answers, read the following aloud, then go to the next field:

Hi, this is [your name] calling for [full_name]. Is this [full_name] at [address]?

Question relevant when: ${deviceid} = '(web)'

try_alt (required)

Do you need try another phone number?

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

phone_number (required)

Please enter the phone number which you wish to call. 0 or [resp_pn1] or [resp_pn2] or [cal_q1210] or [cal_q1210_1] or [cal_q1210_3] or [cal_q1210_4]
Last time call number: [resp_pn3]

Question relevant when: ${try_alt} =1

Response constrained to: regex(.,'^[0-9][0-9][0-9][0-9][0-9][0-9][0-9][0-9][0-9][0-9][0-9]$') or (.=-66) or (.=-88) or (.=-99)

call_respondent2

Click the button to call

Question relevant when: ${try_alt} =1

phone_response (required)

ENUMERATOR: DO NOT READ THIS ALOUD

What was the response?

	1	Call Answered
	2	Wrong Number
	3	Switch off / out of coverage area
	4	Phone ringing - not answering
	5	Phone out of service

q2 (required)

Whom did you talk?

Question relevant when: selected( ${phone_response} , '1')

	1	Respondent
	2	Father/Mother
	3	Brother/Sister
	4	Aunt/Uncle
	5	Grandfather/Grandmother
	6	Other family member
	7	Husband/Wife
	8	Boyfriend/Girlfriend
	9	Son/Daughter
	10	Friend
	11	Other specify

q3 (required)

please specify

Question relevant when: selected( ${q2} , '11')

q4 (required)

Hand over to respondent or not?

Question relevant when: not(selected( ${q2} , '1')) and selected( ${phone_response} , '1')

	1	Yes - handed over to the respondent
	2	No - refused to handover to the respondent
	3	No - asked to reschedule

answered_response (required)

ENUMERATOR: Starting now, you will read the questions out loud.

I'm calling to conduct a survey about CORONA, and we would love your participation.Do you have time to complete the survey?

Question relevant when: selected( ${phone_response} , '1')

	1	Can complete the survey now
	2	Will complete the survey, but not now
	3	Refuses to participate/Call answered, hard refusal, do not re-attempt
	4	Call answered, soft refusal
	5	Poor quality, could not reschedule, try again

respondentcheck (required)

Please Check The respondent is Available or not

Question relevant when: selected( ${answered_response} , '1') and (not(selected( ${q2} , '1') or selected( ${q4} , '1')))

Start the form

Group relevant when: selected( ${answered_response} , '1')

note_consent1

Hello, my name is ([cal_enumname]). Am I speaking to ([full_name])?

(If, our desired respondent does not pick up the call then enumerator will ask the person speaking to hand the phone to the respondent. If this is not possible, please ask the person speaking when the respondent will be available, or ask for a new phone number of the respondent. Thank the person speaking and politely end the call if you cannot speak to the respondent. If we get our desired respondent, continue to the end.)
Could we speak to ([full_name])?

Hello, my name is ([cal_enumname]) and I am part of the IPA survey team who spoke to you at your factory or at your home. IPA is a non-governmental organization specializing in development research. As part of this research, we would like to invite you to participate in an interview to ask questions about your work, your family life, and your health. This is a research project coordinated by Christopher Woodruff and Hannah Uckat (University of Oxford) and Atonu Rabbani (University of Dhaka). The project is titled: Labour and Health Effects of Covid-19 on Ready-made Garment Sector Workers and aims to understand Coronavirus in Bangladesh and how it affects you and your family. The work is funded by grants from the European Research Council and the Growth in Labour Markets in Low-Income Countries (GLM-LIC) research program. The survey will take approximately 30 minutes of your time. We would therefore like to take your permission to ask some questions.

• Your participation is valuable to the project, but is voluntary and you can decide to stop at any time.
• All of your responses will be used for research purposes only and will be confidential and protected. Information identifying you will not be shared outside of research, internal quality assurance, or research oversight teams. This may include employees of IPA and Oxford responsible for these tasks. We will keep this information stored and destroy it 3 years after the study is finished. The project will be completed by 2021.
• Your participation will have no direct effect on the services or assistance that you receive.
• Participation is voluntary, and we will not force you to answer any of the questions.
• We do not anticipate that there will be any risk or discomfort due to study participation.
• If you have any problems, or if you feel uncomfortable answering any questions, you should feel free to stop talking with me at any time. If you have any questions or concerns tegarding surveys, please contact our Operations Manager Mr Alamgir Kabir, at +8801712121221 or If you have any concerns regarding safety, wellbeing and other issues, - please reach out to this helpline 01784188888 from any local number.. I will send his contact details via sms text after finishing the call.
• If you do agree to participate in the interview, you would receive a small gift, BDT 100 of airtime, as a token of our appreciation for your time.
• After today, we would like to call you and ask you questions once per month for the next year. You are free to decide every time whether you want to participate or not. If you participate today, you are not obliged to participate in further surveys. If you don’t participate today, you are welcome to participate in later surveys.

Do you understand this explanation? If so, may we continue with the interview? (continue with the survey if the respondent says “I agree”)

consent (required)

Do you understand this explanation? If so, may we continue with the interview? (continue with the survey if the respondent says “I agree”

Ask the respondent whether she has any questions or concerns. If she does not want to participate, please thank her and politely end the call. If she decides to participate, please select "YES".

Enumerator: Caution! This is a crucial question. The interview will be ended if you select 'NO'.

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

Start the form > Start of actual questions

Group relevant when: selected( ${consent} , '1')

note1_2

Section 1.2: Identification of Worker Inside the Factory

fact_code (required)

Factory code

fact_code_error (required)

ERROR: You have entered the factory code as [fact_code] but it should be [cal_fact_code]

Question relevant when: ${fact_code} != ${cal_fact_code}

q122 (required)

Worker name

	1	...
	2	New participant's name

q122_spec (required)

Worker name

Record participant's new name which was not known to us

Question relevant when: selected( ${q122} , '2')

q129 (required)

Worker gender

	1	Male
	2	Female

q1210 (required)

Mobile number

Please enter -66 if the respondent doesn't have any mobile phone and enter -99, -88 if necessary.<br/> Last Phone Number just as Ref:0 or [resp_pn1] or [resp_pn2] or [resp_pn3] or [phone_number] or [cal_q1210] or [cal_q1210_1] or [cal_q1210_3] or [cal_q1210_4]

	1	...
	2	...
	3	...
	4	...
	5	...
	6	...
	7	The number has been changed

q1210_spec (required)

Please enter the mobile number

Please enter -66 if the respondent doesn't have any mobile phone and enter -99, -88 if necessary.

Question relevant when: selected( ${q1210} , '7')

Response constrained to: regex(.,'^[0-9][0-9][0-9][0-9][0-9][0-9][0-9][0-9][0-9][0-9][0-9]$') or (.=-66) or (.=-88) or (.=-99)

q1210_1 (required)

Secondary mobile phone number (e.g. from spouse or another household member)

Please enter -66 if the respondent doesn't have any mobile phone and enter -99, -88 if necessary.<br/>Last Phone Number just as Ref:0 or [resp_pn1] or [resp_pn2] or [resp_pn3] or [phone_number] or [cal_q1210] or [cal_q1210_1] or [cal_q1210_3] or [cal_q1210_4]

Response constrained to: .!= ${q1210} or (.= ${q1210} and ${q1210} =7)

	1	...
	2	...
	3	...
	4	...
	5	...
	6	...
	7	The number has been changed

q1210_1_spec (required)

Please enter the secondary mobile number

Please enter -66 if the respondent doesn't have any mobile phone and enter -99, -88 if necessary.

Question relevant when: selected( ${q1210_1} , '7')

Response constrained to: regex(.,'^[0-9][0-9][0-9][0-9][0-9][0-9][0-9][0-9][0-9][0-9][0-9]$') or (.=-66) or (.=-88) or (.=-99)

q1210_2 (required)

Third mobile phone number (from someone outside the household, e.g. neighbor or family living in village)

Please enter -66 if the respondent doesn't have any mobile phone and enter -99, -88 if necessary.<br/>Last Phone Number just as Ref:0 or [resp_pn1] or [resp_pn2] or [resp_pn3] or [phone_number] or [cal_q1210] or [cal_q1210_1] or [cal_q1210_3] or [cal_q1210_4]

Response constrained to: .!= ${q1210_1} or (.= ${q1210_1} and ${q1210_1} =7)

	1	...
	2	...
	3	...
	4	...
	5	...
	6	...
	7	The number has been changed

q1210_2_spec (required)

Please enter the third mobile number

Please enter -66 if the respondent doesn't have any mobile phone and enter -99, -88 if necessary.

Question relevant when: selected( ${q1210_2} , '7')

Response constrained to: regex(.,'^[0-9][0-9][0-9][0-9][0-9][0-9][0-9][0-9][0-9][0-9][0-9]$') or (.=-66) or (.=-88) or (.=-99)

airtime_number (required)

In which phone number would you like to 100 taka get air time?

	1	...
	2	...
	3	...
	4	...
	5	...
	6	...

airtime_mobilenum_check (required)

airtime_mobilenum_check

Question relevant when: string-length( ${airtime_mobilenum} )<8 or string-length( ${airtime_mobilenum} )>13

opetators (required)

Which operator's mobile number is it?

	1	Grameen Phone
	2	Robi
	3	Banglalink
	4	Airtel
	5	Teletalk

note_work

I first want to ask you some questions about your work in the garment industry

cv80 (required)

Are you currently employed by a garment factory? Employment means that you have a written or verbal agreement that you are their worker, even if you are not actually doing work for any reason.

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

cv81 (required)

What is the name of your current or last garment factory?

	1	...
	2	New factory name

cv82 (required)

If other, enter name of new garment factory

Question relevant when: selected( ${cv81} , '2')

c4 (required)

When was the last day you went to work in a garment factory? We are asking about the last day that you physically went to do work in the factory

Response constrained to: decimal-date-time(.) < decimal-date-time(now())

cv1 (required)

What is or was your most recent position in the garment industry?

	7	Line Operator
	13	Helper
	14	Input Man
	26	Iron Man
	24	Assistant line supervisor
	5	Line supervisor
	3	Line Chief
	17	Quality inspector
	8	Quality supervisor
	-55	Other
	-99	Don't know
	-88	Refuse to answer

cv1_spec (required)

Please specify

Question relevant when: selected( ${cv1} , '-55')

cv83 (required)

Why are you not employed in a garment factory anymore?

Question relevant when: selected( ${cv80} , '0')

	1	I was laid off because the factory closed
	2	I was laid off but the factory didn’t close
	3	I left because of my own illness or pregnancy
	4	I left voluntarily for other reasons
	-55	Others
	-99	Don't know
	-88	Refuse to answer

cv83_spec (required)

please specify

Question relevant when: selected( ${cv83} , '-55')

r35 (required)

Did you receive severance pay?

Question relevant when: selected( ${cv83} , '1') or selected( ${cv83} , '2')

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

r35_1 (required)

How much?

Question relevant when: selected( ${r35} , '1')

Response constrained to: (.>0 and .<=80000) or .=-99 or .=-88

cv84 (required)

Why are you currently not going to work in the factory?

Question relevant when: selected( ${cv80} , '1') and ((date(today())- ${c4} )>7)

	1	The factory stopped production
	2	The factory is operating but I was asked not to come into work
	3	Holidays/leave
	4	My own illness or pregnancy
	5	Illness or pregnancy of someone in my household
	-55	Other
	-88	Refused to answer
	-99	Don't know

cv84_spec (required)

please specify

Question relevant when: selected( ${cv84} , '-55')

c6 (required)

Were you told that you will still get paid for [[cal_month_l]], even though you are not working?

Question relevant when: selected( ${cv84} , '1') or selected( ${cv84} , '2')

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

cv85 (required)

Do you expect the factory to re-open or to call you back to work?

Question relevant when: selected( ${cv84} , '1') or selected( ${cv84} , '2')

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

c10 (required)

When?

Question relevant when: selected( ${cv85} , '1')

	1	In 1 week
	2	In 2 weeks
	3	In 1 month
	4	In 3 months
	5	In more than 3 months
	-99	Don't know
	-88	Refuse to answer

c11 (required)

Do you plan to return to work in [current_factory]?

Question relevant when: selected( ${cv85} , '1')

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

n1_1 (required)

In February 2021, how many days did you go to work in the factory?

between 0-28

Question relevant when: selected( ${cv80} , '1') or ${c4} >= date('2021-02-01')

Response constrained to: (.>=0 and .<=28) or .=-99 or .=-88

n1_2 (required)

In February 2021, how many hours did you work on average in the factory each day? Do not include the days that you were not working.

Question relevant when: selected( ${cv80} , '1') or ${c4} >= date('2021-02-01')

Response constrained to: (.>=0 and .<=24) or .=-99 or .=-88

n1_3 (required)

How much was your paycheck for February 2021 in Taka? Include payments you received when you were employed but not working, and wages paid by the government. Please also include any bonuses you might have received.

Question relevant when: selected( ${cv80} , '1') or ${c4} >= date('2021-02-01')

Response constrained to: (.>=0 and .<=50000) or .=-99 or .=-88

note_check4 (required)

Check for enumerator if income >20,000: Enumerator: You have entered household income of greater than 20,000 Taka. Is this correct?

Question relevant when: ${n1_3} > 20000

Response constrained to: .=1

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

n2_1 (required)

In January 2021, how many days did you go to work in the factory?

between 0-31

Question relevant when: selected( ${cv80} , '1') or ${c4} >= date('2021-01-01')

Response constrained to: (.>=0 and .<=31) or .=-99 or .=-88

n2_2 (required)

January 2021, how many hours did you work on average in the factory each day? Do not include the days that you were not working.

Question relevant when: selected( ${cv80} , '1') or ${c4} >= date('2021-01-01')

Response constrained to: (.>=0 and .<=24) or .=-99 or .=-88

n2_3 (required)

How much was your paycheck for January 2021 in Taka? Include payments you received when you were employed but not working, and wages paid by the government. Please also include any bonuses you might have received.

Question relevant when: selected( ${cv80} , '1') or ${c4} >= date('2021-01-01')

Response constrained to: (.>=0 and .<=50000) or .=-99 or .=-88

note_check4_a (required)

Check for enumerator if income >20,000: Enumerator: You have entered household income of greater than 20,000 Taka. Is this correct?

Question relevant when: ${n2_3} > 20000

Response constrained to: .=1

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

n3_1 (required)

In December 2020, how many days did you go to work in the factory?

between 0-31

Question relevant when: selected( ${cv80} , '1') or ${c4} >= date('2020-12-01')

Response constrained to: (.>=0 and .<=30) or .=-99 or .=-88

n3_2 (required)

In December 2020, how many hours did you work on average in the factory each day? Do not include the days that you were not working.

Question relevant when: selected( ${cv80} , '1') or ${c4} >= date('2020-12-01')

Response constrained to: (.>=0 and .<=24) or .=-99 or .=-88

n3_3 (required)

How much was your paycheck for December 2020 in Taka? Include payments you received when you were employed but not working, and wages paid by the government. Please also include any bonuses you might have received.

Question relevant when: selected( ${cv80} , '1') or ${c4} >= date('2020-12-01')

Response constrained to: (.>=0 and .<=50000) or .=-99 or .=-88

note_check4_b (required)

Check for enumerator if income >20,000: Enumerator: You have entered household income of greater than 20,000 Taka. Is this correct?

Question relevant when: ${n3_3} > 20000

Response constrained to: .=1

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

cv4 (required)

When you were last paid, how were you paid?

Question relevant when: selected( ${cv80} , '1') or ${c4} >= date('2020-12-01')

	1	Cash
	2	Mobile money, e.g. bKash
	3	Bank transfer
	-55	Other, specify
	-99	Don't know
	-88	Refuse to answer

cv4_spec (required)

please specify

Question relevant when: selected( ${cv4} , '-55')

cv5 (required)

When you were last paid, who paid you?

Question relevant when: selected( ${cv80} , '1') or ${c4} >= date('2020-12-01')

	1	Factory
	2	Government
	-99	Don't know
	-88	Refuse to answer

cv95 (required)

When you were last paid, were you paid on time?

Question relevant when: selected( ${cv80} , '1') or ${c4} >= date('2020-12-01')

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

cv8 (required)

Since the of February 2020, did your factory lay off any workers? Laying off means that they terminated their employment.

Question relevant when: selected( ${cv80} , '1') or ${c4} >= date('2020-12-01')

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

cv9 (required)

How Many?

Question relevant when: selected( ${cv8} , '1')

Response constrained to: .>=0 or .=-88 or .=-99

n4 (required)

In December 2020, January or February 2021, did your factory lay off any workers? Laying off means that they terminated their employment.

Question relevant when: selected( ${cv8} , '1')

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

n5 (required)

How Many?

Question relevant when: selected( ${n4} , '1')

Response constrained to: .<= ${cv9} or .=-88 or .=-99

n6 (required)

On a typical day in February 2021, were there more/the same/fewer workers in the factory compared to a typical day in February 2020?

Question relevant when: selected( ${cv80} , '1') or ${c4} >= date('2020-12-01')

	3	More
	2	The same
	1	Less
	-99	Don't know
	-88	Refuse to answer

c22 (required)

How worried are you about workers in your factory losing their job because of Coronavirus?

Question relevant when: selected( ${cv80} , '1')

	1	Very worried
	2	Somewhat worried
	3	A little worried
	4	Not worried at all
	-99	Don't know
	-88	Refuse to answer

cv71 (required)

Since end of February 2020, has your factory introduced new precautions against Coronavirus?

Question relevant when: selected( ${cv80} , '1') or ${c4} >= date('2020-12-01')

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

c18 (required)

How satisfied are you with the steps taken by your factory?

Question relevant when: selected( ${cv80} , '1') or ${c4} >= date('2020-12-01')

	1	Very dissatisfied
	2	Somewhat dissatisfied
	3	Somewhat satisfied
	4	Very satisfied
	-99	Don't know
	-88	Refuse to answer

n7 (required)

In December 2020, January or February 2021, has your factory changed its precautions against Coronavirus compared to November 2020?

Question relevant when: selected( ${cv80} , '1') or ${c4} >= date('2020-12-01')

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

Start the form > Start of actual questions > For each of the following measures, please tell me whether there are now more, the same or less precautions

Group relevant when: selected( ${n7} , '1')

n7_1 (required)

Given workers new protective equipment, e.g. face masks or gloves etc

	1	More
	2	Same
	3	Less
	-99	Don't know
	-88	Refuse to answer

n7_2 (required)

Encouraged or introduced more hygiene measures, e.g. more handwashing or cleaned work areas more often, etc

	1	More
	2	Same
	3	Less
	-99	Don't know
	-88	Refuse to answer

n7_3 (required)

Sending workers with symptoms home, e.g. by checking worker temperature etc

	1	More
	2	Same
	3	Less
	-99	Don't know
	-88	Refuse to answer

n7_4 (required)

Encouraged more distance between workers, e.g. by moving workstations, changing shifts, lunch in shifts etc

	1	More
	2	Same
	3	Less
	-99	Don't know
	-88	Refuse to answer

note_gap

I now want to ask you some questions about work outside the garment industry.

cv11 (required)

Are you currently a paid employee for someone else outside a garment factory?

Employment means that you have a written or verbal agreement that you are their worker, even if you are not actually doing work for any reason.

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

cv96 (required)

At the end of February 2020, were you a paid employee for someone else outside a garment factory but have stopped now?

Employment means that you have a written or verbal agreement that you are their worker, even if you are not actually doing work for any reason.

Question relevant when: selected( ${cv11} , '0')

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

cv12 (required)

Do you grow vegetables, fruit or tend animals that your household members eat?

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

cv13 (required)

Do you run your own business?

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

cv97 (required)

At the end of February 2020, did you run your own business but have stopped now?

Question relevant when: selected( ${cv13} , '0')

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

cv14 (required)

What is or was your occupation as a paid employee?

Question relevant when: selected( ${cv11} , '1') or selected( ${cv96} , '1')

	1	Rickshaw puller
	2	Other transport
	4	Construction worker
	7	Employee in other business or factory
	8	Servant/Maid
	9	Hawker
	10	Work on a farm or agricultural business
	12	Other day labour
	-99	Don't know
	-88	Refuse to answer

date_activity (required)

When did you start this activity?

Date, enter 1st of month if exact day is unknown

Question relevant when: selected( ${cv11} , '1') or selected( ${cv96} , '1')

Response constrained to: decimal-date-time(.) < decimal-date-time(now())

n8_1 (required)

How much did you earn from these activities in Taka in December 2020?

Question relevant when: selected( ${cv11} , '1') or selected( ${cv96} , '1') and ${date_activity} <= date('2020-12-01')

Response constrained to: (.>=0) or .=-88 or .=-99

n8_2 (required)

How much did you earn from these activities in Taka in January 2021?

Question relevant when: selected( ${cv11} , '1') or selected( ${cv96} , '1') and ${date_activity} <= date('2021-01-01')

Response constrained to: (.>=0) or .=-88 or .=-99

n8_3 (required)

How much did you earn from these activities in Taka in February 2021?

Question relevant when: selected( ${cv11} , '1') or selected( ${cv96} , '1') and ${date_activity} <= date('2021-02-01')

Response constrained to: (.>=0) or .=-88 or .=-99

date_stop (required)

When did you stop this activity?

Date, enter 1st of month if exact day is unknown

Question relevant when: selected( ${cv96} , '1')

Response constrained to: decimal-date-time(.) < decimal-date-time(now())

cv98 (required)

Why did you stop this activity?

Question relevant when: selected( ${cv96} , '1')

	1	I was laid off because the firm closed
	2	I was laid off but the firm didn’t close
	3	I left because of my own illness or pregnancy
	4	I left voluntarily for other reasons
	-55	Others
	-99	Don't know
	-88	Refuse to answer

cv98_spec (required)

please specify_cv98

Question relevant when: selected( ${cv98} , '-55')

cv17 (required)

How much did you earn from these activities in Taka in

[date_stop_month]?"

Question relevant when: selected( ${cv96} , '1')

Response constrained to: (.>=0) or .=-88 or .=-99

note_check6 (required)

Check for enumerator if income >20,000: Enumerator: You have entered household income of greater than 20,000 Taka. Is this correct?

Question relevant when: ${cv17} > 20000

Response constrained to: .=1

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

cv15 (required)

What type of business do or did you run?

Question relevant when: selected( ${cv13} , '1') or selected( ${cv97} , '1')

	1	Running retail or wholesale shop
	2	Sewing clothes or textiles
	3	Selling your own agricultural produce
	4	Providing transportation (e.g. Rickshaw, CNG)
	5	Running restaurant, selling prepared food
	6	Running a construction business
	7	Providing craftsman services, e.g. electrician, carpenter, mechanic, painter, etc
	-55	Other
	-99	Don't know
	-88	Refuse to answer

cv16 (required)

please specify

Question relevant when: selected( ${cv15} , '-55')

date_start (required)

When did you start this activity?

Date, enter 1st of month if exact day is unknown

Question relevant when: selected( ${cv13} , '1') or selected( ${cv97} , '1')

Response constrained to: decimal-date-time(.) < decimal-date-time(now())

n9_1 (required)

How much did you earn from these activities in Taka in December 2020?

Question relevant when: selected( ${cv13} , '1') or selected( ${cv97} , '1') and ${date_start} <= date('2020-12-01')

Response constrained to: (.>=0) or .=-88 or .=-99

n9_2 (required)

How much did you earn from these activities in Taka in January 2021?

Question relevant when: selected( ${cv13} , '1') or selected( ${cv97} , '1') and ${date_start} <= date('2021-01-01')

Response constrained to: (.>=0) or .=-88 or .=-99

n9_3 (required)

How much did you earn from these activities in Taka in February 2021?

Question relevant when: selected( ${cv13} , '1') or selected( ${cv97} , '1') and ${date_start} <= date('2021-02-01')

Response constrained to: (.>=0) or .=-88 or .=-99

date_stopthis (required)

When did you stop this activity?

Question relevant when: selected( ${cv97} , '1')

Response constrained to: decimal-date-time(.) < decimal-date-time(now())

cv100 (required)

Why did you stop this activity? [Select all that apply]

Question relevant when: selected( ${cv97} , '1')

Response constrained to: if(selected(., -99) or selected(., -88), count-selected(.) = 1, count-selected(.) >= 1)

	1	Difficulties in accessing customers due to mobility restrictions imposed by government
	2	Loss in demand due to other reasons (e.g., regular customers can no longer afford our products or services or have cancelled orders)
	3	Difficulties in accessing suppliers due to mobility restrictions imposed by government
	4	Reduction in the availability and/or price increases for the main inputs
	5	Difficulties with worker absenteeism arising from mobility restrictions imposed by the government
	6	Difficulties with worker absenteeism arising from other reasons
	7	Difficulties in securing access to finance (e.g. banks or MF institutions are closed or operate at restricted capacity)
	8	Difficulties tending to my business because I have to take care of a family member (e.g. children, sick relative, etc)
	9	Depreciation of productive capital due to inactivity
	-99	Don't know
	-88	Refuse to answer

cv101 (required)

How much did you earn from these activities in Taka in

[date_stopthis_month]"

Question relevant when: selected( ${cv97} , '1')

Response constrained to: (.>=0) or .=-88 or .=-99

note_check10 (required)

Check for enumerator if income >20,000: Enumerator: You have entered household income of greater than 20,000 Taka. Is this correct?

Question relevant when: ${cv101} > 20000

Response constrained to: .=1

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

note_income

Income, spending and consumption

I now want to ask you some questions about your household, what your household eats and your household’s finances.

q314 (required)

Please select your current marital status

In last round your current marital status was [cal_q314]

	1	Unmarried
	2	Married
	3	Widowed
	4	Divorced
	5	Separated
	-88	Refused to answer

cv23 (required)

Do you live with your spouse in the same household?

Household: Someone is a member of your household if they have spent at least 6 months out of the last year living in the same house and eating from the same kitchen.
If you share a house with other households or families, we are only interested in the primary household/family.

Question relevant when: selected( ${q314} , '2')

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

cv24 (required)

How many members does your household have, including yourself?

Household: Someone is a member of your household if they have spent at least 6 months out of the last year living in the same house and eating from the same kitchen.
If you share a house with other households or families, we are only interested in the primary household/family.

Last round's responds was [cal_cv24]

Response constrained to: (.>=0) or (.=-99 or .= -88)

cv25 (required)

How many men of 18 years or older are in your household?

Response constrained to: (.>=0) or (.=-99 or .= -88)

cv26 (required)

How many women of 18 years or older are in your household?

Response constrained to: (.>=0) or (.=-99 or .= -88)

cv27 (required)

How many boys younger than 18 years are in your household?

Response constrained to: (.>=0) or (.=-99 or .= -88)

cv28 (required)

How many girls younger than 18 years are in your household?

Response constrained to: (.>=0) or (.=-99 or .= -88)

note_cv24_error (required)

Please check your total Household member.

Question relevant when: ${cv24} !=( ${cv25} + ${cv26} + ${cv27} + ${cv28} )

n10_1 (required)

What was your household’s total income from economic activity in February 2021 in Taka?

Count monthly salaries or wages, all bonuses, allowances and overtime pay as well as all other income from farming, casual labour, businesses, rents paid to you etc. Make sure that you include income for all people in the household, including yourself. Also include payments of wages directly received from the government.

Please read: Count monthly salaries or wages, all bonuses, allowances and overtime pay as well as all other income from farming, casual labour, businesses, rents paid to you etc. Make sure that you include income for all people in the household, including yourself. Also include payments of wages directly received from the government.

Response constrained to: (.>=0) or (.=-99 or .= -88)

note_check (required)

Enumerator: You have entered household income of greater than 50,000 Taka. Is this correct?

Question relevant when: ${n10_1} > 50000

Response constrained to: .=1

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

cv30 (required)

Is this less/the same/more than in February 2020?

Question relevant when: selected( ${n10_1} , '-99')

	1	less
	2	same
	3	more
	-99	Don't know
	-88	Refuse to answer

n10_2 (required)

What was your household’s total income from economic activity in January 2021 in Taka?

Count monthly salaries or wages, all bonuses, allowances and overtime pay as well as all other income from farming, casual labour, businesses, rents paid to you etc. Make sure that you include income for all people in the household, including yourself. Also include payments of wages directly received from the government

Response constrained to: (.>=0 and .<=150000 ) or (.=-99 or .= -88)

r50 (required)

Is this less/the same/more than in February 2020?

Question relevant when: selected( ${n10_2} , '-99')

	1	less
	2	same
	3	more
	-99	Don't know
	-88	Refuse to answer

note_check2 (required)

Enumerator: You have entered household income of greater than 50,000 Taka. Is this correct?

Question relevant when: ${n10_2} > 50000

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

n10_3 (required)

What was your household’s total income from economic activity in December 2020 in Taka?

Count monthly salaries or wages, all bonuses, allowances and overtime pay as well as all other income from farming, casual labour, businesses, rents paid to you etc. Make sure that you include income for all people in the household, including yourself. Also include payments of wages directly received from the government.

Response constrained to: (.>=0 and .<=150000 ) or (.=-99 or .= -88)

r52 (required)

Is this less/the same/more than in February 2020?

Question relevant when: selected( ${n10_3} , '-99')

	1	less
	2	same
	3	more
	-99	Don't know
	-88	Refuse to answer

note_check3 (required)

Enumerator: You have entered household income of greater than 50,000 Taka. Is this correct?

Question relevant when: ${n10_3} > 50000

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

n11 (required)

Did you receive any transfers from the government in December 2020, January or February 2021?

Do not include payments of wages by the government.

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

n11_1 (required)

How much did you receive in December in Taka?

Question relevant when: selected( ${n11} , '1')

Response constrained to: (.>=0) or .=-88 or .=-99

check_n11_1 (required)

Enumerator: You have entered household income of greater than 20,000 Taka. Is this correct?

Question relevant when: ${n11_1} > 20000

Response constrained to: .=1

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

n11_2 (required)

How much did you receive in January in Taka?

Question relevant when: selected( ${n11} , '1')

Response constrained to: (.>=0) or .=-88 or .=-99

check_n11_2 (required)

Enumerator: You have entered household income of greater than 20,000 Taka. Is this correct?

Question relevant when: ${n11_2} > 20000

Response constrained to: .=1

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

n11_3 (required)

How much did you receive in February in Taka?

Question relevant when: selected( ${n11} , '1')

Response constrained to: (.>=0) or .=-88 or .=-99

check_n11_3 (required)

Enumerator: You have entered household income of greater than 20,000 Taka. Is this correct?

Question relevant when: ${n11_3} > 20000

Response constrained to: .=1

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

note_days

I now want to ask you some questions about the food that your household ate in February 2021. For each type of food, please indicate whether your household ate more, the same or less in February 2021 compared to February 2020, before any impact of coronavirus. Please make sure to include the consumption of everyone who is part of the household. Note that I am not asking how much money you spent, but how much your household actually ate

n12 (required)

Staple foods such as rice, wheat, maize, atta, noodles etc: Did your household eat more, the same or less in February 2021 compared to February 2020?

	1	More
	2	Same
	3	Less
	-99	Don't know
	-88	Refuse to answer

n12_1 (required)

Whose consumption increased the most?

Question relevant when: selected( ${n12} ,'1')

	1	Yours
	2	Your spouse’s
	3	Female children’s
	4	Male children’s
	5	Other household member’s
	-99	Don't know
	-88	Refuse to answer

n12_2 (required)

Whose consumption decreased the most?

Question relevant when: selected( ${n12} ,'3')

	1	Yours
	2	Your spouse’s
	3	Female children’s
	4	Male children’s
	5	Other household member’s
	-99	Don't know
	-88	Refuse to answer

n13 (required)

Pulses such as lentils, chick pea, gram, mung, pea etc: Did your household eat more, the same or less in February 2021 compared to February 2020?

	1	More
	2	Same
	3	Less
	-99	Don't know
	-88	Refuse to answer

n13_1 (required)

Whose consumption increased the most?

Question relevant when: selected( ${n13} ,'1')

	1	Yours
	2	Your spouse’s
	3	Female children’s
	4	Male children’s
	5	Other household member’s
	-99	Don't know
	-88	Refuse to answer

n13_2 (required)

Whose consumption decreased the most?

Question relevant when: selected( ${n13} ,'3')

	1	Yours
	2	Your spouse’s
	3	Female children’s
	4	Male children’s
	5	Other household member’s
	-99	Don't know
	-88	Refuse to answer

n14 (required)

Vegetables, including leaf vegetables: id your household eat more, the same or less in February 2021 compared to February 2020?

	1	More
	2	Same
	3	Less
	-99	Don't know
	-88	Refuse to answer

n14_1 (required)

Whose consumption increased the most?

Question relevant when: selected( ${n14} ,'1')

	1	Yours
	2	Your spouse’s
	3	Female children’s
	4	Male children’s
	5	Other household member’s
	-99	Don't know
	-88	Refuse to answer

n14_2 (required)

Whose consumption decreased the most?

Question relevant when: selected( ${n14} ,'3')

	1	Yours
	2	Your spouse’s
	3	Female children’s
	4	Male children’s
	5	Other household member’s
	-99	Don't know
	-88	Refuse to answer

n15 (required)

Fruits and nuts: Did your household eat more, the same or less in February 2021 compared to February 2020?

	1	More
	2	Same
	3	Less
	-99	Don't know
	-88	Refuse to answer

n15_1 (required)

Whose consumption increased the most?

Question relevant when: selected( ${n15} ,'1')

	1	Yours
	2	Your spouse’s
	3	Female children’s
	4	Male children’s
	5	Other household member’s
	-99	Don't know
	-88	Refuse to answer

n15_2 (required)

Whose consumption decreased the most?

Question relevant when: selected( ${n15} ,'3')

	1	Yours
	2	Your spouse’s
	3	Female children’s
	4	Male children’s
	5	Other household member’s
	-99	Don't know
	-88	Refuse to answer

n16 (required)

Meat, fish, eggs, milk and milk products: Did your household eat more, the same or less in February 2021 compared to February 2020?

	1	More
	2	Same
	3	Less
	-99	Don't know
	-88	Refuse to answer

n16_1 (required)

Whose consumption increased the most?

Question relevant when: selected( ${n16} ,'1')

	1	Yours
	2	Your spouse’s
	3	Female children’s
	4	Male children’s
	5	Other household member’s
	-99	Don't know
	-88	Refuse to answer

n16_2 (required)

Whose consumption decreased the most?

Question relevant when: selected( ${n16} ,'3')

	1	Yours
	2	Your spouse’s
	3	Female children’s
	4	Male children’s
	5	Other household member’s
	-99	Don't know
	-88	Refuse to answer

n17 (required)

Tobacco and alcohol: Did your household consume more, the same or less in February 2021 compared to February 2020?

	1	More
	2	Same
	3	Less
	-99	Don't know
	-88	Refuse to answer

note_30days_n

I now want to ask you some questions about your household’s expenditures in December 2020, January and February 2021. For each type of expenditures, please indicate the amount your household spent in Taka. Please make sure to include the expenditures of everyone who is part of the household.

Start the form > Start of actual questions > Food expenditure

n18 (required)

Food Expenditures in February

Response constrained to: (.>=0 and .<=50000 ) or (.=-99 or .= -88)

n18_1 (required)

Is this less/the same/more than in February 2020?

Question relevant when: selected( ${n18} ,'-99')

	1	less
	2	same
	3	more
	-99	Don't know
	-88	Refuse to answer

n19 (required)

Food Expenditures in January

Response constrained to: (.>=0 and .<=50000 ) or (.=-99 or .= -88)

n19_1 (required)

Is this less/the same/more than in February 2020?

Question relevant when: selected( ${n19} ,'-99')

	1	less
	2	same
	3	more
	-99	Don't know
	-88	Refuse to answer

n20 (required)

Food Expenditures in December

Response constrained to: (.>=0 and .<=50000 ) or (.=-99 or .= -88)

n20_1 (required)

Is this less/the same/more than in February 2020?

Question relevant when: selected( ${n20} ,'-99')

	1	less
	2	same
	3	more
	-99	Don't know
	-88	Refuse to answer

n21 (required)

Washing and cleaning items such as soap, shampoo, toothpaste, laundry powder, toilet paper, dishwashing soap etc:

Expenditures in February 2021

Response constrained to: (.>=0 and .<=50000 ) or (.=-99 or .= -88)

n21_1 (required)

Is this less/the same/more than in February 2020?

Question relevant when: selected( ${n21} ,'-99')

	1	less
	2	same
	3	more
	-99	Don't know
	-88	Refuse to answer

Start the form > Start of actual questions > Transfers or gifts sent or given to your relatives or your friends outside the household, including cash, goods, or payments made on behalf of these relatives:

n22 (required)

Transfers or gifts sent to your relatives: Expenditures in February 2021

Response constrained to: (.>=0 and .<=50000 ) or (.=-99 or .= -88)

n22_1 (required)

Is this less/the same/more than in February 2020?

Question relevant when: selected( ${n22} ,'-99')

	1	less
	2	same
	3	more
	-99	Don't know
	-88	Refuse to answer

n23 (required)

Transfers or gifts sent to your relatives: Expenditures in January 2021

Response constrained to: (.>=0 and .<=50000 ) or (.=-99 or .= -88)

n23_1 (required)

Is this less/the same/more than in February 2020?

Question relevant when: selected( ${n23} ,'-99')

	1	less
	2	same
	3	more
	-99	Don't know
	-88	Refuse to answer

n24 (required)

Transfers or gifts sent to your relatives: Expenditures in December 2020

Response constrained to: (.>=0 and .<=50000 ) or (.=-99 or .= -88)

n24_1 (required)

Is this less/the same/more than in February 2020?

Question relevant when: selected( ${n24} ,'-99')

	1	less
	2	same
	3	more
	-99	Don't know
	-88	Refuse to answer

Start the form > Start of actual questions > Transfers or gifts sent or given to your spouse’s relatives or friends outside the household, including cash, goods, or payments made on behalf of these relatives:

Group relevant when: selected( ${q314} , '2')

n25 (required)

Transfers or gifts sent your spouse’s relatives: Expenditures in February 2021

Response constrained to: (.>=0 and .<=100000 ) or (.=-99 or .= -88)

n25_1 (required)

Is this less/the same/more than in February 2020?

Question relevant when: selected( ${n25} ,'-99')

	1	less
	2	same
	3	more
	-99	Don't know
	-88	Refuse to answer

n26 (required)

Transfers or gifts sent your spouse’s relatives: Expenditures in January 2021

Response constrained to: (.>=0 and .<=100000 ) or (.=-99 or .= -88)

n26_1 (required)

Is this less/the same/more than in February 2020?

Question relevant when: selected( ${n26} ,'-99')

	1	less
	2	same
	3	more
	-99	Don't know
	-88	Refuse to answer

n27 (required)

Transfers or gifts sent your spouse’s relatives: Expenditures in December 2020

Response constrained to: (.>=0 and .<=100000 ) or (.=-99 or .= -88)

n27_1 (required)

Is this less/the same/more than in February 2020?

Question relevant when: selected( ${n27} ,'-99')

	1	less
	2	same
	3	more
	-99	Don't know
	-88	Refuse to answer

Start the form > Start of actual questions > Savings of all kind, e.g. in bank, at home or with NGO:

n28 (required)

Savings in February 2021

Response constrained to: (.>=0 and .<=100000 ) or (.=-99 or .= -88)

n28_1 (required)

Is this less/the same/more than in February 2020?

Question relevant when: selected( ${n28} ,'-99')

	1	less
	2	same
	3	more
	-99	Don't know
	-88	Refuse to answer

n29 (required)

Savings in January 2021

Response constrained to: (.>=0 and .<=100000 ) or (.=-99 or .= -88)

n29_1 (required)

Is this less/the same/more than in February 2020?

Question relevant when: selected( ${n29} ,'-99')

	1	less
	2	same
	3	more
	-99	Don't know
	-88	Refuse to answer

n30 (required)

Savings in December 2020

Response constrained to: (.>=0 and .<=100000 ) or (.=-99 or .= -88)

n30_1 (required)

Is this less/the same/more than in February 2020?

Question relevant when: selected( ${n30} ,'-99')

	1	less
	2	same
	3	more
	-99	Don't know
	-88	Refuse to answer

Start the form > Start of actual questions > Health and medical expenditures

n31 (required)

Health and medical expenditures in February 2021

Response constrained to: (.>=0 and .<=100000 ) or (.=-99 or .= -88)

n31_1 (required)

Is this less/the same/more than in February 2020?

Question relevant when: selected( ${n31} ,'-99')

	1	less
	2	same
	3	more
	-99	Don't know
	-88	Refuse to answer

n32 (required)

In December 2020, January and February 2021, have you or any household member experienced any of the following cases?

Response constrained to: if(selected(., -99) or selected(., -88) or selected(., 6), count-selected(.) = 1, count-selected(.) >= 1)

	1	Difficulties in going to food markets due to mobility restrictions imposed by government
	2	Difficulties in buying food due to most food markets being closed
	3	Unable to buy the amount of food I usually consume because of shortages in the markets I buy from
	4	Unable to buy the amount of food I usually consume because the price of food was too high
	5	Had to reduce the number of meals and/or the portion of each meal I would usually eat
	6	None of above
	-99	Don't know
	-88	Refuse to answer

cv57 (required)

Is it currently difficult to feed everyone in your household?

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

cv58 (required)

How do you cope with it?

response options not to be read out, tick all that apply

Question relevant when: selected( ${cv57} , '1')

Response constrained to: if(selected(., -99) or selected(., -88), count-selected(.) = 1, count-selected(.) >= 1)

	1	We reduce other expenses.
	2	We don’t save or use our savings to pay for food.
	3	Everyone eats a bit less or fewer meals.
	4	Only some members in the household eat less.
	5	We send children to live with relatives.
	6	We have taken on new work, work more hours, or started a business.
	7	We grow food or rear animals.
	8	We ask family, friends or neighbours for help.
	9	We ask the government for help.
	10	We sell assets.
	-55	Other
	-99	Don't know
	-88	Refuse to answer

cv59 (required)

Please specify

Question relevant when: selected( ${cv58} , '-55')

cv42 (required)

Who eats less? Choose all that apply

Question relevant when: selected( ${cv58} , '4')

Response constrained to: if(selected(., -99) or selected(., -88), count-selected(.) = 1, count-selected(.) >= 1)

	1	Yours
	2	Your spouse’s
	3	Female children’s
	4	Male children’s
	5	Other household member’s
	-99	Don't know
	-88	Refuse to answer

cv60 (required)

On a scale from 1 to 10, how worried are you about not being able to feed everyone in your household because of money next month?

1 is not worried at all and 10 is extremely worried

Response constrained to: (.>=1 and .<=10) or .=-99 or .=-88

note_coronaimpact

I now want to ask you some questions about how Coronavirus has impacted you and your family

n33 (required)

If you compare December 2020, January and February 2021 to the period of Se]ptember, October and November 2020, did you and your family take more, the same or fewer precautions to avoid an infection with coronavirus?

	3	More
	2	The same
	1	Less
	-99	Don't know
	-88	Refuse to answer

n34_8 (required)

During the past 24 hours, how many hours did you sleep?

Response constrained to: .=0 or .<=15

n34_11 (required)

How many hours per day did you work, on average, in the days you worked during the past 2 weeks.

Response constrained to: .=0 or .<=18

n35 (required)

Compared to before the COVID-19 pandemic, do you think that your workload in household activities has gone up or down?

	1	Gone down by a large amount
	2	Gone down by a small amount
	3	Stayed about the same
	4	Gone up by a small amount
	5	Gone up by a large amount
	-99	Don't know
	-88	Refuse to answer

n35_1 (required)

Comparing how much your workload has changed in relation to how much your spouses’ workload has changed, do you think the changes to your workload are fair?

Question relevant when: selected( ${q314} , '2')

	1	Yes, it is fair
	2	Neutral, it is neither fair or unfair
	3	No, it is unfair
	4	Not applicable
	-99	Don't know
	-88	Refuse to answer

n35_2 (required)

Do you think that the workload in household activities is divided fairly between you and your spouse?

Question relevant when: selected( ${q314} , '2')

	1	Yes, it is fair
	2	Neutral, it is neither fair or unfair
	3	No, it is unfair
	4	Not applicable
	-99	Don't know
	-88	Refuse to answer

vac1 (required)

Over the last month, have you received any news regarding the development of any vaccine against COVID-19?

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

vac6 (required)

Have you received a vaccine against COVID-19?

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

vac3 (required)

how confident are you that you and your immediate family members will have access to the vaccine during the next six months?

Question relevant when: selected( ${vac6} , '0')

	1	Not confident at all
	2	A little confident
	3	Somewhat confident
	4	Completely confident
	-99	Don't know
	-88	Refuse to answer

vac4 (required)

If a vaccine is available over the next six months, how likely are you to attempt to access it for yourself and your immediate family members?

	1	Very likely
	2	Somewhat likely
	3	Not very likely
	4	Not likely at all
	-99	Don't know
	-88	Refuse to answer

vac5 (required)

If a vaccine is available over the next six months, how likely are you to recommend to your friends and neighbours to get vaccinated?

	1	Very likely
	2	Somewhat likely
	3	Not very likely
	4	Not likely at all
	-99	Don't know
	-88	Refuse to answer

vac_note

Please note that we ask these questions for research purposes only, and that we are not going to provide, distribute, or sell any vaccinations or treatments. The information you just provided us will be kept anonymous and only be used for research purposes.

note_anxiety

Generalized Anxiety

Start the form > Start of actual questions > General_anxiety

note5

Please tell me, over the LAST TWO WEEKS, how often have you been bothered by the following problems?

q3_1_1 (required)

Feeling nervous, anxious, or on edge

	0	not at all (0 days)
	1	several days (1-5 days)
	2	more than half the days (6-10 days)
	3	nearly every day (11-14)
	-88	refuse to answer
	-99	don't know

q3_1_2 (required)

Not being able to sleep or control worrying

	0	not at all (0 days)
	1	several days (1-5 days)
	2	more than half the days (6-10 days)
	3	nearly every day (11-14)
	-88	refuse to answer
	-99	don't know

q3_1_3 (required)

Worrying too much about different things

	0	not at all (0 days)
	1	several days (1-5 days)
	2	more than half the days (6-10 days)
	3	nearly every day (11-14)
	-88	refuse to answer
	-99	don't know

q3_1_4 (required)

Trouble relaxing

	0	not at all (0 days)
	1	several days (1-5 days)
	2	more than half the days (6-10 days)
	3	nearly every day (11-14)
	-88	refuse to answer
	-99	don't know

q3_1_5 (required)

Being so restless that it is hard to sit still

	0	not at all (0 days)
	1	several days (1-5 days)
	2	more than half the days (6-10 days)
	3	nearly every day (11-14)
	-88	refuse to answer
	-99	don't know

q3_1_6 (required)

Becoming easily annoyed or irritable

	0	not at all (0 days)
	1	several days (1-5 days)
	2	more than half the days (6-10 days)
	3	nearly every day (11-14)
	-88	refuse to answer
	-99	don't know

q3_1_7 (required)

Feeling afraid, as if something awful might happen

	0	not at all (0 days)
	1	several days (1-5 days)
	2	more than half the days (6-10 days)
	3	nearly every day (11-14)
	-88	refuse to answer
	-99	don't know

n36 (required)

In February 2021, has anyone in your household been ill with a fever, cough or shortness of breath? I am asking about being so ill that they could not do their normal activities, for example going to work, going to school or doing work at home?
House hold: Someone is a member of your household if they have spent at least 6 months out of the last year living in the same house and eating from the same kitchen.
If you share a house with other households or families, we are only interested in the primary household/family

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

n36_1 (required)

In February 2021 has anyone in your neighbourhood been ill with a fever, cough or shortness of breath? I am asking about being so ill that they could not do their normal activities, for example going to work, going to school or doing work at home?

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

n37 (required)

In January 2021 has anyone in your household been ill with a fever, cough or shortness of breath? I am asking about being so ill that they could not do their normal activities, for example going to work, going to school or doing work at home?

House hold: Someone is a member of your household if they have spent at least 6 months out of the last year living in the same house and eating from the same kitchen.
If you share a house with other households or families, we are only interested in the primary household/family.

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

n37_1 (required)

In January 2021 has anyone in your neighbourhood been ill with a fever, cough or shortness of breath? I am asking about being so ill that they could not do their normal activities, for example going to work, going to school or doing work at home?

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

n38 (required)

In December 2020, has anyone in your household been ill with a fever, cough or shortness of breath? I am asking about being so ill that they could not do their normal activities, for example going to work, going to school or doing work at home?

House hold: Someone is a member of your household if they have spent at least 6 months out of the last year living in the same house and eating from the same kitchen.
If you share a house with other households or families, we are only interested in the primary household/family.

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

n38_1 (required)

In December 2020 has anyone in your neighbourhood been ill with a fever, cough or shortness of breath? I am asking about being so ill that they could not do their normal activities, for example going to work, going to school or doing work at home?

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

Start the form > Start of actual questions > Please tell me, over the last two weeks, how often have you been bothered by any of the following problems?

interest_level (required)

Little interest or pleasure in doing things

	0	not at all (0 days)
	1	several days (1-5 days)
	2	more than half the days (6-10 days)
	3	nearly every day (11-14)
	-88	refuse to answer
	-99	don't know

depressed (required)

Feeling down, depressed, or hopeless

	0	not at all (0 days)
	1	several days (1-5 days)
	2	more than half the days (6-10 days)
	3	nearly every day (11-14)
	-88	refuse to answer
	-99	don't know

note3_1

Section 2.1: Demographics

We are nearly at the end of the survey. I now want to ask you some questions about yourself.

c12_1_spec (required)

Your current division

	1	Barisal
	2	Chittagong
	3	Dhaka
	4	Khulna
	5	Rajshahi
	6	Rangpur
	7	Sylhet
	8	Mymensingh

c12 (required)

In which district are you currently?

	6	Borguna
	3	Barisal
	4	Bhola
	24	Jhalokati
	51	Patuakhali
	52	Pirojpur
	2	Bandarban
	7	BrahmanBaria
	8	Chandpur
	10	Chittagong
	12	Comilla
	13	Cox's Bazar
	17	Feni
	27	Khagrachari
	33	Laxmipur
	42	Noakhali
	55	Rangamati
	14	Dhaka
	16	Faridpur
	19	Gazipur
	20	Gopalganj
	22	Jamalpur
	29	Kishoreganj
	34	Madaripur
	36	Manikganj
	39	Munshiganj
	40	Mymenshing
	45	Narayanganj
	44	Narshingdi
	47	Netrokona
	53	Rajbari
	58	Sariatpur
	59	Sherpur
	63	Tangail
	1	Bagerhat
	11	Chuadanga
	23	Jessore
	25	Jinaidah
	28	Khulna
	31	Kustia
	35	Magura
	38	Meherpur
	43	Narail
	57	Satkhira
	5	Bogra
	9	ChapaiNawabganj
	26	Joypurhat
	41	Naogaon
	46	Natore
	49	Pabna
	54	Rajshahi
	60	Sirajganj
	15	Dinajpur
	18	Gaibandha
	30	Kurigram
	32	Lalmonirhat
	48	Nilphamari
	50	Panchagar
	56	Rangpur
	64	Thakurgaon
	21	Hobiganj
	37	Moulovibazar
	61	Sunamganj
	62	Sylhet

c13 (required)

When do you plan to return to Dhaka division?

Question relevant when: ${c12_1_spec} !=3

	1	In 1 week
	2	In 2 weeks
	3	In 1 month
	4	In 3 months
	5	In more than 3 months
	-99	Don't know
	-88	Refuse to answer

cv70 (required)

Do you have a mobile money account?

[cal_cv70]

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

cm1 (required)

Over the last three months , have you received any support for your mental health or psychological well-being (e.g. to alleviate, sleeplessness, anxiety, depression, feeling down, among others)?

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

cm2 (required)

Then what?

Question relevant when: ${cm1} =1

	1	Talked to therapist/psychologist at the factory
	2	Talked to therapist/psychologist privately or in the community
	3	Talked to a therapist over phone
	4	Took prescribed drugs
	5	Talked to friends or family members
	6	Talked to coworkers at the factory
	7	Talked to supervisors or higher management at the factory
	-55	Other
	-99	Don't know
	-88	Refuse to answer

cm2_spec (required)

Please specify

Question relevant when: selected( ${cm2} , '-55')

cm3 (required)

Then who?

Question relevant when: ${cm2} =3

	1	Moner bondhu
	-55	Other
	-99	Don't know
	-88	Refuse to answer

cm3_spec (required)

Please specify

Question relevant when: selected( ${cm2} , '-55')

cm4 (required)

How many times did you call?

Question relevant when: ${cm2} =3

cm5 (required)

How many minutes did you talk on average on a call?

Question relevant when: ${cm2} =3

cm6 (required)

How would you rate your experience

Question relevant when: ${cm1} =1

	1	Very Helpful
	2	Somewhat helpful
	3	Nothing special
	4	It was not good
	-99	Don't know
	-88	Refuse to answer

cm7 (required)

Then would you be interested to receive any support or counsceling?

Question relevant when: ${cm1} =0

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

cm8 (required)

No, then why not?

Question relevant when: ${cm7} =0

cm9 (required)

Yes, then by whom?

Question relevant when: ${cm7} =1

	1	Counseling at the factory
	2	In-person counseling by somebody outside the factory
	3	Over the phone counseling
	-55	Other
	-99	Don't know
	-88	Refuse to answer

sms (required)

Would you like to send an SMS from survey tab?

	1	Yes
	0	No
	-99	Don't know
	-88	Refuse to answer

phones_sms (required)

To which phone number would you like to send an SMS?

Question relevant when: ${sms} =1

	1	...
	2	...
	3	...
	4	...
	5	...
	6	...

launch_sms

Click the button to send a text message.

Start the form > Start of actual questions > Interviewer_Comments

note7

Section 7: Interviewer Comments

q711 (required)

What is your impression of how well the respondent understood the questions being asked?

	1	Excellent
	2	Good
	3	Average
	4	Not so good
	5	Very bad

q712 (required)

What is your impression of the seriousness with which the respondent answered questions?

	1	Excellent
	2	Good
	3	Average
	4	Not so good
	5	Very bad

q713 (required)

What is your overall impression of the preciseness/accuracy with which questions were answered?

	1	Excellent
	2	Good
	3	Average
	4	Not so good
	5	Very bad

comments

Do you have any comments you would like to record regarding this survey?

completed_questions

We have completed the survey. Thank you so much for your time!

Respondent will not complete the form right now

Group relevant when: ${caseid} != null

reschedule (required)

ENUMERATOR, read this out loud:

When would you like to reschedule the survey?

ENUMERATOR INSTRUCTIONS:

When scheduling the callback, check the calendar to make sure you are available for that time. It may take up to five minutes before the event is published to the calendar.

Question relevant when: selected( ${answered_response} , '2')

Response constrained to: decimal-date-time(.) > decimal-date-time(now())

refused

ENUMERATOR, read this out loud:

Okay, thank you for your time, and have a great day.

Question relevant when: selected( ${answered_response} , '3') or selected( ${consent} , '0')

Respondent will not complete the form right now > ans_wr_num_gr

Group relevant when: selected( ${phone_response} , '2')

answer_wrong_num

ENUMERATOR, read this aloud, then politely end the call:

Oh, I'm so sorry for the trouble! You have a great day.

ans_wr_num_note2

ENUMERATOR INSTRUCTIONS:

If you dialed the wrong phone number by accident (you needed to call 0), go back to the last field, and call the correct phone number. If you correctly dialed the number you were given, go to the next field.

Question relevant when: ${consent} !=1

Respondent will not complete the form right now > reschedule_gr

Group relevant when: ${callback_time} != null

callback_disp

EMUMERATOR:

An appointment to call [full_name] will be set for [callback_time]. when you submit this form

callback_note

ENUMERATOR: Read the following out loud, and then politely end the call.

Excellent, we will call you at that that time. Have a great day!

Question relevant when: selected( ${answered_response} , '2')

datetime_end (required)

Please verify the end time

Response constrained to: decimal-date-time(.) > decimal-date-time( ${datetime_start} )

completed_note

ENUMERATOR:

You [cal_enumname] have completed the form. No matter if you spoke to the respondent or not, finalize and submit this form on the next page.

Question relevant when: ${caseid} != null

designer_notes

JUST AS INFORMATION: No need to read this field.

num_calls: [num_calls]
call_num: 1
phone_response_short: [phone_response_short]
now_complete: No
call_datetime: [call_datetime]
pub_to_users: [pub_to_users]
callback_time: [callback_time]
new_sortby: [new_sortby]

Question relevant when: ${caseid} != null

thankyou

Thank you for completing this form! Please submit this form as soon as you get a chance, then move on to the next case.

Cases will not get updated until you submit and download updated case data from the server.

Question relevant when: ${caseid} != null