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CHN Family Survey Form PDF Free
CHN Family Survey Form PDF Free
CHN Family Survey Form PDF Free
A2. Family Members not residing in the household but affect family resource generation and use
Unsanitary
( ) “ballot system” others ________________
Distance from house: _______________________________________________________________________
Sanitary condition: _________________________________________________________________________
5. Food storage:
( ) covered ( ) uncovered
( ) refrigerated
6. Background gardening:
( ) vegetables ( ) herbal
( ) fruit-bearing others _______________
7. Domestic animals:
Kind Number Where kept
D. Health:
_______________________________________________________________________________________________________________
E. Folk Diseases:
_______________________________________________________________________________________________________________
F. Traditional healers:
_______________________________________________________________________________________________________________
V. Family Dynamics
A. Emotional bonding of Family members:
_______________________________________________________________________________________________________________
B. Distribution of authority and power:
_______________________________________________________________________________________________________________
C. Degree of individual autonomy:
_______________________________________________________________________________________________________________