Farmer Name: ___________________________________

____________
OAF ID: ___________________________
________________________________________
Group: ____________________________
________________________________________
District: ___________________________
________________________________________

Survey Number:

Sub-Location:
FO:
Agent Name:

Date: _____________________________
Years with
OAF:______________________________________

Introduction
Introduce yourself and inform the farmer you are from One Acre Fund. Ask to speak to
the person that is registered with One Ace Fund by the name of _____________.
We are interested in surveying you, with some specific questions about your quality of
life following the irrigation pump program you are participating with One Acre Fund.

Increased Nutrition
1. How many meals per day does your household afford? ________________________
2. How many times in a month do you have to buy food from the market? ____________
3. How often do your children fall ill in a month? ________________
4. In the lean period, how often did your household go without food __________________

Asset Acquisition.
5. How many goats, chickens have you bought recently? _______
6. What other thing have you bought to increase your quality of life? ______

Affordability of Medical Care

7. How often were you able to take your family members to the hospital? _____________
8. How often did your family members fall ill?________________________________

Children in School
9. How many children do you have?_____________________
10.How many are enrolled in school?______________________
11.Have you struggled to pay school fees for your children lately? _____________