Time of interview start: _____________ Time of interview finish: _____________ GPS coordinates: ___________________ Enumerator name: _______________________________ POST DISTRIBUTION MONITORING (PDM) Unconditional cash grants survey template Introduction: to me about your experience with the Red Cross Red “Hello, do you have 30 minutes to speak Crescent relief programme? I would like to ask you some questions to help us improve our services. We ask for your honest answers we appreciate suggestions and your input will not be used against you in any way. – This interview is voluntary you do not have to answer a question if you and we can stop at – don’t want to, any time”. SURVEY INFORMATION Question Options Response Q1. Date of interview (day/month/year) A B Q2. District C D A B Q3. Community C D Male Q4. What is the gender of the respondent? Female Male Q5. What is the gender of the head of household? Female Q6. What is the age of the respondent? Q7. Are there any vulnerable people Yes (children under the age of 5, elderly, No pregnant or lactating mothers, in the household? Yes Q8. Is the respondent the person who received the cash at the distribution point? No Male 0-5 Male 6-17 Male 18-59 Q9. What is the total number of members of Male 60 + your household, including yourself, in each Female 0-5 age bracket? Female 6-17 Female 18-59 Female 60 +
Time of interview start: _____________ Time of interview finish: _____________ GPS coordinates: ___________________ Enumerator name: _______________________________ POST DISTRIBUTION MONITORING (PDM) Unconditional cash grants survey template Introduction: “Hello, do you have 30 minutes to speak to me about your experience with the Red Cross Red Crescent relief programme? I would like to ask you some questions to help us improve our services. We ask for your honest answers – we appreciate suggestions and your input will not be used against you in any way. This interview is voluntary – you do not have to answer a question if you don’t want to, and we can stop at any time”. SURVEY INFORMATION Question Options Response Q1. Date of interview (day/month/year) Q2. District A B C D Q3. Community A B C D Q4. What is the gender of the respondent? Male Female Q5. What is the gender of the head of household? Male Female Q6. What is the age of the respondent? Q7. Are there any vulnerable people (children under the age of 5, elderly, pregnant or lactating mothers, in the household? Yes No Q8. Is the respondent the person who received the cash at the distribution point? Yes No Q9. What is the total number of members of your household, including yourself, in each age bracket? Male 0-5 Male 6-17 Male 18-59 Male 60 + Female 0-5 Female 6-17 Female 18-59 Female 60 +