Community identification
Region of residence
District
Day of Interview
Month of Interview
Year of Interview
Interviewer number
Community's Result
Sex of persons interviewed
Language of questionnaire
Language of interview
Language of respondent
Translator used
Supervisor
Field editor
Data entry clerk
Distance from district headquarter
Type of road to the district headqaurter
Distance from the road which goes to district headqaurter
Mode of transportation to reach the road which goes to district headquarter
Distance to the nearest city/town
Type of the most streets/galies
Type of transportation available
Transport available during the night
Place of treatment, when pregnant women have a serious problem
Mode of transportation used to reach that facility
Time to reach the health facility
Presence of Lady Health Worker in the village
Type of services provided by LHW
Community's LHW make house visits on a regular basis
Place of births register
Number of women that get financial support through BISP
Type of economic activities available for women
Social organization in this village
Women usually participate in these organizations
Any campaign for the use of mosquito nets
Medicines easily available
Any natural disaster during last 5 years
Type of facility/service
Availability of facility/service in this village
Distance of facility/service from this village
Type of health facility