Draft data collection instrument
General information
/ / 2024
Date of Interview [DD/MM/YYYY] :
Enumerator (agent) Name:
Did the household consent to the interview? [0= NO; 1=YES]
District [1= District 1; 2 = District 2] 3 = District 3]
Kebele’s name 1 = Kebele 1; 2 = Kebele 2; 3 = Kebele 3; 4= Kebele 4]
Altitude (meter Latitude Longitude (E/W):
Household GPS Coordinates:
above sea level) (N/S):
Respondent household details
The households should be those above 18 years old.
(Household Members: Persons who live together and eat together from the same pot (share food),
including hired labour, students and spouse living and working in another location but excluding visitors)
Farmer information
Name of the respondent?
Age of the respondent in years:
Gender of the respondent [0=Female,1=Male]
Farm experience of the respondent [ ]
Number of family members Male Female Number of Children: (Boys/girls)
NB: Number of children (boys/girls) are those whose ages are below 12 years old
Higher level of education completed 1; None (illiterate); 2=Primary; 3=Junior high school;
4=Senior high school; 5=Tertiary education (University and other post-secondary training colleges);
6= other (specify)
Primary occupation of the respondent [1=Farming (crop+ livestock); 2=Salaried employment;
3=Self-employed off-farm; 4=Casual labourer on-farm; 5=Casual labourer off-farm;
6=School/college child;7=Non-school child; 8. Other, specify……]
Social network status of the respondent
- Membership (status)
Are you a member to farmer’s cooperative association? 0. NO 1. YES
Are you a member to RuSACCO? 0. NO 1. YES
Are you a member to local Eder? 0. NO 1. YES
Are you a member to Ekub in your village? 0. NO 1. YES
Do you have leadership role in one of the above associations? 0. NO 1. YES
Access to financial service, saving habit and credit history?
Do you have access to farm mechanization services? 0. No | 1. Yes
Do you have access to community health insurance services? 0. No | 1. Yes
Do you have a mobile phone to use for your farming business? 0. No | 1. Yes
Do you use tele birr 0. No | 1. Yes
Did you have bank account 0. No | 1. Yes
Have you received any extension visits in the last 12 months? 0. No | 1. Yes
Do you have access to credit services, for the last 12 months? 0. No | 1. Yes
Do you have savings account from bank or MFI? 0. No | 1. Yes
1. If you have access to agricultural credit:
with whom did you borrow? How much?
2. 1. Amount _____________ purpose ____________
How much is an outstanding loan? And its purpose?
How much is outstanding bad debt?
3. Do you have Access to water reserve in your area? 0. No | 1. Yes
Farm-related information (ownership)
What is the total size of your farm? [Including owned, shared, and [______ha]
rented land]
Land tenure of total landholding in Own: [______ha]
hectare (ha) Sharecropping: [______ha]
Rented: [______ha]
Total land dedicated for wheat Own: [______ha]
cultivated area (ha): Sharecropping: [______ha]
Rented: [______ha]
Do you have land tittle for your own land 0. NO 1. YES
Farming tool ownership:
1= Traditional (oxen ploughing) owned.
2= Traditional (oxen ploughing) rented.
3= Modern machinery owned.
4= Modern machinery rented;
How much livestock do you own? Please indicate the number of animals you own:
No livestock at all
_____ farm bull
_____ dairy cows
_____ fattening calves and bulls
_____ chicken & laying hens
_____ horse and mules
_____ sheep and goats
_____ donkeys
Other: [ ]
Income and Expenses (costs)
A. Income and expense from farming
cost Income (revenue)
Area/ Seed Pric Fertilizer COST/ Agro- pric Expecte Tota % Averag
Planne
hecto required e required/ Q chem e d Yield l yield e sales
d Crop
r (Hr) Hr/ etb/ Hr/ required (hr/Q) yield for price
farmin
Quantal Q Q (Q) market
g
(Q)
local Urea
Wheat
seed
Improve
d DAP
local Urea
crop 2.
seed
Improve
d DAP
crop 3 local Urea
seed
Improve
d DAP
crop 4 local Urea
seed
Improve
d DAP
B. Livestock Income & Income from Livestock By-
Livestock expenses
products
1. Animal fattening 1
2 2
3 3
Total Livestock Income & Income from Livestock
By-products
C. Other Non-agricultural income Other Non-agricultural expenses
1. “equb” receivable 1. “equb” payable
2 2
3 3
