Part 1: Introduction of the Farmer and Household Head
1. Farmer Demographics:
o Name:
o Age:
o Gender:
o Education Level (None, Primary, Secondary, Higher):
o Primary Occupation:
o Secondary Occupation (if any):
o Household Size:
o Number of dependents:
2. Household Head:
o Is the farmer the household head? (Yes/No)
o If no, relation to household head:
o Age of household head:
o Gender of household head:
o Education level of household head:
3. Socio-Economic Information:
o Total annual household income (in local currency):
o Sources of household income (Farming, Livestock, Other):
o Main sources of household expenses (Food, Education, Healthcare, etc.):
4. Land and Farming Details:
o Total land owned (in hectares):
o Land tenure (Owned/Leased/Shared):
o Type of farming (Subsistence/Commercial):
o Years of farming experience:
o Main crops grown:
o Livestock owned (Specify type and number):
Part 2: Farmer’s Knowledge and Perception of Climate Change
1. Awareness:
o Are you aware of climate change? (Yes/No)
o If yes, how did you learn about climate change? (Media, Government programs,
NGOs, Community discussions, Other):
2. Perception of Climate Variability:
o Have you noticed changes in the weather patterns over the past 10 years? (Yes/No)
o What changes have you observed? (Increased drought, More floods, Unpredictable
rainfall, Temperature changes, Other):
3. Climate-Related Challenges:
o What are the main climate challenges affecting your farming? (Select all that apply):
Drought
Floods
Change in rainfall patterns
Pests and diseases
Soil erosion
o How have these challenges affected your crop production? (Decrease in yield, Crop
failure, Loss of livestock, etc.):
4. Impact on Agriculture:
o Have these changes in climate affected your farming productivity? (Yes/No)
o If yes, how significant is the impact? (No impact, Slight, Moderate, Severe):
Part 3: Adaptation Strategies to Climate Change
1. Changes in Farming Practices:
o Have you made changes to your farming practices in response to climate change?
(Yes/No)
o If yes, what changes have you made? (Improved crop varieties, Crop rotation,
Mulching, Drip irrigation, Others):
2. Water Management:
o What measures do you take to conserve water on your farm? (Rainwater harvesting,
Irrigation systems, Use of drought-resistant crops, Other):
3. Technology Use:
o Do you use any technology or modern equipment to adapt to climate challenges?
(Yes/No)
o If yes, what type of technology do you use? (Mobile apps for weather updates,
Mechanized equipment, Other):
4. Support for Adaptation:
o Have you received any support to help you adapt to climate change? (Yes/No)
o If yes, what type of support? (Government programs, NGOs, Local groups, Financial
support, Training):
o How effective was the support? (Not effective, Slightly effective, Very effective):
5. Barriers to Adaptation:
o What are the main barriers you face in adapting to climate change? (Financial
constraints, Lack of knowledge, Lack of access to technology, Other):
Part 4: Multidimensional Poverty and Sub-Dimensional Variables
1. Access to Basic Services:
o Does your household have access to clean drinking water? (Yes/No)
o Does your household have access to electricity? (Yes/No)
o Does your household have access to proper sanitation facilities? (Yes/No)
o How far is the nearest healthcare facility from your home? (in kilometers):
2. Education:
o How many children in the household are currently attending school?
o What is the highest education level attained by any household member?
3. Housing Conditions:
o What type of housing do you live in? (Temporary, Semi-permanent, Permanent):
o What material is the house made of? (Mud, Brick, Cement, etc.):
o Does your household own the house or rent it?
4. Asset Ownership:
o Does your household own any of the following assets? (Select all that apply):
Radio/TV
Bicycle/Motorbike
Mobile phone
Agricultural tools (Specify):
5. Food Security:
o In the past 12 months, has your household experienced food shortages? (Yes/No)
o How often do you worry about food running out before you have money to buy
more? (Never, Sometimes, Often):
o Do you feel your household is food secure? (Yes/No)
6. Market Access:
o How far is the nearest market from your home? (in kilometers):
o Do you face any difficulties in accessing markets? (Yes/No):
o If yes, what are the difficulties? (High transportation costs, Poor road conditions,
Low prices for products, etc.):
7. Vulnerability to Shocks:
o Has your household experienced any major shocks in the past five years? (Climate
shocks, Economic shocks, Health crises, etc.):
o How have these shocks affected your household's income and food security?
8. Livelihood Diversification:
o Does your household have any non-farming sources of income? (Yes/No)
o If yes, what are the sources? (Business, Casual labor, Remittances, etc.):