IMPACT ASSESSMENT SURVEY QUESTIONNAIRE

Respondent’s Name : Age :

Occupation : Gender :

No. of household members : Signature :

Organization : Citizens Foundation Surveyor :

(A) WATER HARVESTING

S.No QUESTIONS
(A) (B) (C) (D)
1. What is the increase in the production of paddy,
mustard and different variety of vegetables after
the construction of water harvesting structures like
low land well, pond, earthen dams etc.?

a) Less than 1 ton

b) 1-2 ton
c) 2-3 ton
d) More than 3 ton

2. Which of these water harvesting structures is/are

the most effective?

a) Low land well

b) Pond
c) Earthen dams
d) TCB

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 IMPACT ASSESSMENT SURVEY QUESTIONNAIRE

S.No QUESTIONS
(A) (B) (C) (D)
3. How many more water harvesting structures do
you need to fulfill the irrigation requirements
throughout the year?

a) Less than 5
b) Between 6-8
c) Between 9-11
d) More than 11

4. What is the increase in your annual income after

the formation of water harvesting structures?

a) Less than 10 percent

b) Between 10 to 30 percent

c) Between 30 to 40 percent

d) More than 40 percent

5. What changes have you introduced after the

availability of proper irrigation facilities?

a) Cash -crops have been taken

b) Vegetables have been taken

c) Fruits have been taken

d) Any other

6. The implementation of project is helping the

people around here both financially and socially.

a) Strongly Agree

b) Agree

c) Disagree

d) Strongly Disagree

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 IMPACT ASSESSMENT SURVEY QUESTIONNAIRE

(B) LAND IMPROVEMENT

S.No QUESTIONS
(A) (B) (C) (D)
7. Soil fertility on your farm is suitable for fruit and
vegetable cultivation.

a) Strongly Agree
b) Agree
c) Disagree
d) Strongly Disagree

8. How do you preserve soil fertility?

a) Chemical Fertilization
b) Organic Fertilization ( Animal Manure, Green
Manure)
c) Crop Rotation ( Dissimilar crops in sequential
seasons)
d) Intercropping ( Dissimilar crops in same area
and same season)

9. Producing fruits on your farm can improve soil

fertility and soil structure.
a) Strongly Agree
b) Agree
c) Disagree
d) Strongly Disagree

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 IMPACT ASSESSMENT SURVEY QUESTIONNAIRE

S.No QUESTIONS
(A) (B) (C) (D)
10. What is the expected increase in your annual
income after the plantation of trees?

a) Less than 10 percent

b) Between 10 to 20 percent

c) Between 20 to 30 percent

d) More than 30 percent

11. The implementation of project is helping the

people around here both financially and socially.

a) Strongly Agree

b) Agree

c) Disagree

d) Strongly Disagree

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 IMPACT ASSESSMENT SURVEY QUESTIONNAIRE

(C) GOATERY

S.No QUESTIONS
(A) (B) (C) (D)
12. What is the increase in no. of cattle with respect to
last year?

a) 0-2

b) 2-5

c) 5-7

d) More than 7

13. What is the range of your income per month?

a) Up to 5000

b) 5000-8000

c) 8000-12000

d) more than 12000

14. What is the range of your expenditure per month?

a) less than 1000

b) 1000-1500

c) 1500-2000

d) more than 2000

15. What difficulties do you face often?

a) Harsh environment leading to feed shortage

b) Improper Veterinary Care

c) Improper grazing management

d) Lack of training in Goatery Care

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 IMPACT ASSESSMENT SURVEY QUESTIONNAIRE
S.No QUESTIONS
(A) (B) (C) (D)
16. The implementation of project is helping the
people around here both financially and socially.

a) Strongly agree

b) Agree

c) Disagree

d) Strongly Disagree

S.No QUESTIONS (A) (B)

17. Do you have a subsidiary plot?

a) Yes

b) no

18. What type of income you and your family get from this activity?

a) Full time

b) Part time

19. Have you got any transportation facility?

a) Yes

b) No

20. Do you have any medical support for your cattle?

a) Yes

b) No

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