[Background information for consultation. Vaccinations in tropical and travel medicine].
Available from Pharmazie In Unserer Zeit
Page 1
[Background information for consultation. Vaccinations in tropical and travel medicine].
Enum ID: ______ Survey #:__________
1
Sierra Leone Ex-Combatant Survey #1
Name of Interviewer ____________________ Time Start: _______
Province _____________________________ Time End: _______
District ______________________________
Village _______________________________
Date _________________________________
Number of Randomization Form : _________
1
Sierra Leone Ex-Combatant Survey #1
Name of Interviewer ____________________ Time Start: _______
Province _____________________________ Time End: _______
District ______________________________
Village _______________________________
Date _________________________________
Number of Randomization Form : _________
Page 2
Enum ID: ______ Survey #:__________
2
1 Background Information
) This section asks general questions about the interviewee -- it does not ask questions about involvement in any particular faction or at any point in time.
Q 1
|NA
|RF [Enter the Respondent’s Sex] 1. | Male 2. | Female
Q 2
|NA
|RF
What year were you born?
[If the respondent does not know, ask him/her to
estimate his/her age]
19 __ __ or __ __ years
Q 3
|NA
|RF
Where were you born?
Reg/Dis/Chiefdom ___-___-______ [# from codebook]
Q 4
|NA
|RF
Where were you living before the war
began?
Reg/Dis/Chiefdom ___-___-______ [# from codebook]
Q 5
|NA
|RF
What is your marital status?
1. | single, never married
2. | divorced / separated
3. | widowed
4. | Married, monogamous
5. | Married, polygamous
Q 6
|NA
|RF
What is your religion?
[Do NOT Prompt]
[Choose One]
1. |None 2 | Christian
3. |Adventist 4. | Muslim
5. |Traditional Religion: ____________________[Specify]
6. |Other: ____________________[Specify]
Q 7
|NA
|RF
What languages do you speak?
[Do NOT Prompt]
Which of these languages do you speak
best? [Circle Language Spoken best)
____ ____ ____ ____ ____ ____ [Enter # from codebook]
Q 8
|NA
|RF
What is your tribe?
[Do NOT Prompt]
____ and also ____ [Enter maximum of 2 numbers from codebook]
__________________ [Other]
Q 9
|NA
|RF
What is your highest level of education?
Class I – VI = Primary School
Form I – VI = Secondary School
Codes For Colonial Educ System
1) |No school
2) | Some primary school 3) | Completed primary
4) | Some secondary school 5) |Completed secondary
6) |Some university 7) | Completed university
8) | Some Institute/Polytechnic 9) | Completed Institute/Poly
Q 10
|NA
|RF
What was the highest level of education of
your father?
[Do NOT Prompt]
[Choose One]
0) |No school 1) | Don’t Know
2) | Some primary school 3) | Completed primary
4) | Some secondary school 5) |Completed secondary
6) |Some university 7) | Completed university
8) | Some Institute/Polytechnic 9) | Completed Institute/Poly.
Q 11
|NA
|RF
What was the highest level of education of
your mother?
[Do NOT Prompt]
[Choose One]
0) |No school 1) | Don’t Know
2) | Some primary school 3) | Completed primary
4) | Some secondary school 5) |Completed secondary
6) |Some university 7) | Completed university
8) | Some Institute/Polytechnic 9) | Completed Institute/Poly
Q 12
|NA
|RF
How many brothers and sisters did you
have at the beginning of the war?
Brothers ___ ___ Sisters___ ___
[ “Brothers and sisters” includes those not of the same mother and father]
Q 13
|NA
|RF
How many of them died because of
violence during the war?
Brothers ___ ___ Sisters ___ ___
Q 14
|NA
|RF
Were your mother and father alive at the
beginning of the war?
Mother: 1. | Yes 2. | No
Father: 1. | Yes 2. | No
Q 15
|NA
|RF
Did your mother or father die because of
violence during the war?
Mother: 1. | Yes 2. | No
Father: 1. | Yes 2. | No
2
1 Background Information
) This section asks general questions about the interviewee -- it does not ask questions about involvement in any particular faction or at any point in time.
Q 1
|NA
|RF [Enter the Respondent’s Sex] 1. | Male 2. | Female
Q 2
|NA
|RF
What year were you born?
[If the respondent does not know, ask him/her to
estimate his/her age]
19 __ __ or __ __ years
Q 3
|NA
|RF
Where were you born?
Reg/Dis/Chiefdom ___-___-______ [# from codebook]
Q 4
|NA
|RF
Where were you living before the war
began?
Reg/Dis/Chiefdom ___-___-______ [# from codebook]
Q 5
|NA
|RF
What is your marital status?
1. | single, never married
2. | divorced / separated
3. | widowed
4. | Married, monogamous
5. | Married, polygamous
Q 6
|NA
|RF
What is your religion?
[Do NOT Prompt]
[Choose One]
1. |None 2 | Christian
3. |Adventist 4. | Muslim
5. |Traditional Religion: ____________________[Specify]
6. |Other: ____________________[Specify]
Q 7
|NA
|RF
What languages do you speak?
[Do NOT Prompt]
Which of these languages do you speak
best? [Circle Language Spoken best)
____ ____ ____ ____ ____ ____ [Enter # from codebook]
Q 8
|NA
|RF
What is your tribe?
[Do NOT Prompt]
____ and also ____ [Enter maximum of 2 numbers from codebook]
__________________ [Other]
Q 9
|NA
|RF
What is your highest level of education?
Class I – VI = Primary School
Form I – VI = Secondary School
Codes For Colonial Educ System
1) |No school
2) | Some primary school 3) | Completed primary
4) | Some secondary school 5) |Completed secondary
6) |Some university 7) | Completed university
8) | Some Institute/Polytechnic 9) | Completed Institute/Poly
Q 10
|NA
|RF
What was the highest level of education of
your father?
[Do NOT Prompt]
[Choose One]
0) |No school 1) | Don’t Know
2) | Some primary school 3) | Completed primary
4) | Some secondary school 5) |Completed secondary
6) |Some university 7) | Completed university
8) | Some Institute/Polytechnic 9) | Completed Institute/Poly.
Q 11
|NA
|RF
What was the highest level of education of
your mother?
[Do NOT Prompt]
[Choose One]
0) |No school 1) | Don’t Know
2) | Some primary school 3) | Completed primary
4) | Some secondary school 5) |Completed secondary
6) |Some university 7) | Completed university
8) | Some Institute/Polytechnic 9) | Completed Institute/Poly
Q 12
|NA
|RF
How many brothers and sisters did you
have at the beginning of the war?
Brothers ___ ___ Sisters___ ___
[ “Brothers and sisters” includes those not of the same mother and father]
Q 13
|NA
|RF
How many of them died because of
violence during the war?
Brothers ___ ___ Sisters ___ ___
Q 14
|NA
|RF
Were your mother and father alive at the
beginning of the war?
Mother: 1. | Yes 2. | No
Father: 1. | Yes 2. | No
Q 15
|NA
|RF
Did your mother or father die because of
violence during the war?
Mother: 1. | Yes 2. | No
Father: 1. | Yes 2. | No
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