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| Name of the community leader
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| Estimated household in the community | | |
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| Estimated polpulation in the community | | |
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| What are the main source(s) of livelihood for the community |
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| Which community asscociation and services has been in existence during the last four months (May-August)? |
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| Food accessability - Where do the community members usually source their commodities from? |
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| Has there been any change to the main source of livelihood within the last four months (May-August)? |
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| When did you notice these changes? |
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| What has led to the changes in livelihood ? (personal change) |
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| Please specify your personal income |
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| Have you observed any specific migration pattern for WOMEN in the past for month? |
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| How many WOMEN have migrated? | | |
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| Have you observed any specific migration pattern for ELDERS in the past for month? |
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| How many ELDERS have migrated? | | |
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| Have you observed any specific migration pattern for CHILDREN in the past for month? |
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| How many CHILDREN have migrated? | | |
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| Have you observed any specific migration pattern for YOUTHS in the past for month? |
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| How many YOUTHS have migrated? | | |
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| Have you observed any specific migration pattern for DISABLED in the past for month? |
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| How many DISABLED have migrated? | | |
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| Has there been any developmental programmes/activities implemented in this community this and last year? |
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| Please specify the type of programme in 2013 |
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| Please specify the type of programme in 2014 (Jan - Apr) |
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| Please specify the type of programme in 2014 (May - Aug) |
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| What are the main agricultural activities practiced in this community? |
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| Did households in this community farm this year the same as last year? |
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| How would you assess the agricultural workforce (employees) during the last four months as compared to this time last year for this community? |
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| Was there any support provided to this community in terms of input (seeds, fertilizers, tools, other inputs) for 2013/2014 planting season? |
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| What was the source of these inputs? |
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| Does the programme focus on gender/disable dimension in this community? |
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| LIVESTOCK/ WILD ANIMAL SECTION |
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| Does your household engage in any livestock/wild animals activity? |
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| Please specify the type of livestock |
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| For which porpose do you rear these livestocks? |
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| Do you/or your family members hunt/trap bush meat? (Last for months) |
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| Please specify the porpose. |
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| How often do you consume/sell livestock?
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| What are the main sources of finance in this community for your agricultural activities last year and now? |
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| Where there functional banks/financial houses in your community in the past four months? |
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| Are there currently functional banks/financial houses in your community? |
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| Are there money lenders operating in the community? |
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| In this community, are the women/disabled considered for access to (agricultural related) loans? |
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| What security needs to be provided to access these loan facilities? |
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| In the last four months, what has been the availability of food items in your community? |
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| What is the reason for your answer above? |
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| How do you rate the access to staple food in the last for months for this community? |
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| In this community how would you compare the food available before and now? |
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| Have you received complaints within the last four months on the accessability/availability/affordability of foods in this community? |
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| What is the extent knowledge of EVD (Ebola Virus Desease) in the community |
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