QUESTIONNARE

Effect of recent price hikes on nutritional status of rich and poor women in Dhaka city

Date:

A. Socio Demographic Status:

1. Name:
2. Name of husband/father:
3. Date of birth:
4. Address:
5. Mobile No:
6. Educational level:
7. Occupation of husband/father:
8. Number of family member:
9. Number of children:
10. Monthly expenditure for family food (in taka):
11. Monthly expenditure for commercial food (in taka):

B. Nutritional Status of Women through Anthropometric Measurement:

13. Age of women:

14. Height (cm):

15: Weight (kg):

16: MUAC (mm):

C. Nutritional Knowledge of Nutritious Food (in taka):

17. Do you know about nutritious food?

Yes 1 No 2

18. Do you know about nutritious foods which are low in price but high in nutrition?

Yes 1 No 2

19. What do you think, is nutritious food important for us?

If yes, why?

20. What did you have for breakfast?

21. How many servings of fruits do you have per day?

 22. How often do you eat fish?

23. Can you still eat healthy food if you are on a budget?

24. How much you eat?

25. How often you eat?

26. How many glasses of water do you drink per day?

27. How many vegetables do you consume daily?

28. Do you have eggs in your daily diet?

29. Do you have milk in your daily diet?

30. Do you think you have a balanced diet every day?

31. What is the difference in your daily diet before and after the increase in food prices?

32. What does a balanced diet mean to you?

33. Are there any essential foods that you can’t buy because of the price hike?

D. Affect of Price Hikes in Food Intake :

34. Is there any change to intake food by price hikes?

Yes 1 No 2
35. What do you think the reason behind of price hikes?
Yes No
36. What are the amounts of food intake before price hikes?

37. What are the amounts of food intake after price hikes?

E. Information About Sanitation:

38. What do you use to wash your hands after toilet?

Only water 1, Soap & Water 2, Liquid & Water 3, mid/ash 4,
Don’t wash hands 5, Others 6
39. What is the source of drinking water of your family?
Tube well 1, Boiled water 2, Filtered water 3, Tap water 4, Pond water 5
40. Do you keep food covered at home?
Yes 1 No 2