VASyR 2026 Questionnaire

English version · v1.8
Survey start time: [start]

Section I: Enumerator details:

1. Enumerator name
Text answer

Section II: Consent and Enumerator Details

Introduction Script for Enumerator

Hello, my name is [enumerator_name_t]. I am an enumerator from CASN, the service provider supporting UNHCR, UNICEF, and WFP for this assessment.

We are conducting a survey on behalf of the United Nations High Commissioner for Refugees (UNHCR), UNICEF, and the World Food Programme (WFP).

The purpose of this survey is to gain a better understanding of the living conditions and vulnerabilities of Syrian and other refugees in Lebanon. You have been randomly selected to participate.

You will be asked a series of questions related to you and/or your family, including topics such as living conditions, income sources, debt, schooling, expenditures, and coping strategies. Some of the questions will involve personal information such as your name, the names of your dependents, your address, and your phone number in Lebanon.

Your participation is entirely voluntary. You may choose not to answer any question or stop the interview at any time. However, we hope you will take part, as the information you provide is crucial for informing humanitarian planning and improving assistance programs.

To ensure coordinated protection and assistance, some of the collected information — including personal data — may be shared with trusted humanitarian agencies. This will be done strictly for the purpose of meeting basic needs such as shelter, food, non-food items, medical care, education, and protection services.

Please note:

* The responses you provide will not affect your eligibility for humanitarian assistance in any way.
* All collected data will be handled confidentially and will not be shared beyond the scope of this assessment.
* Data protection measures are in place in line with international standards to prevent unauthorized use or disclosure.

Declaration:
To be signed by the Principal Applicant and all adult household members (via electronic signature or a checkbox):

> I hereby authorize UNHCR, UNICEF, and WFP to share my personal data with relevant humanitarian partners strictly for the purpose of improving humanitarian planning and assistance in Lebanon.

If you have no questions, may I begin the interview?
Select one

2.1 Location:

1. District:
Select one
2. Cluster number:
Text answer
3. Household Enumeration number within the cluster (1-8):
Whole number
4. UNHCR Case Number
Text answer
5. Additional Information 1 :
Text answer
6. Sample / population group
Select one

2.2 Identification

Ask who is the head of household and if it is possible to interview him/her. if not present , an adult included in the same registration case that is considered capable and reliable for the interview.
1. What is the gender of the head of household?
Select one
2. What is the marital status of the head of household?
Select one
3. What is the Head of household date of birth?
Date
4. What is the nationality of the Head of Household?
Select one
4.1 Please specify the nationality of the Head of Household
Text answer
5. What is the relationship of the interviewee with the head of the Household?
Select one
5.1 Please specify the relationship of the interviewee with the head of the Household
Text answer

2.3 Interviewee

1. What is the gender of the interviewee?
Select one
2. What is the Interviewee date of birth?
Date
3. What is the nationality of the interviewee?
Select one
4. Please specify the nationality of the interviewee
Text answer

Section III: Household Demographics and Bio-Data

Household Definition: A household is defined as a group of people who routinely eat out of the same pot, live in the same compound (or physical location), and share the same budget, managed by the head of household.
1. What is the total number of Household members?
Whole number
Definition of registration : Registration case is defined as a group of people who normally reside together, form a nuclear family, are dependent on one another and have been registered as a unit sharing a common registration number.
2. How many unique registered case numbers?
Example: If household has 2 registration numbers 245-13C00001 and 245-15C00123 than you enter 2
Whole number
3. Are all the Household members registered / known to UNHCR?
Select one
3.1 If not all the Household members registered / known to UNHCR, why?
Select all that apply
3.1.1. Please specify:
Text answer
4. How many Household members are not registered / not known to UNHCR?
Whole number
Definition: Post-December 2024 Arrivals (PDA):
Households or individuals who arrived in Lebanon from Syria after December 2024, following the fall of the Syrian regime, and who are included in the PDA sample. These households may or may not be registered with UNHCR, but their information is available through UNHCR or partner identification lists.
Enumerator note: Do not ask whether the household is “known to UNHCR” in general terms. Ask only about concrete steps the household can confirm.
1. Since arriving in Lebanon after December 2024, has any member of your household visited a UNHCR Registration Centre or UNHCR reception/recording point?
Select one
2. During that visit, was information collected for your household members, such as names, dates of birth, family composition, photos, iris scan, or other biodata?
Select one
3. How many household members had their information collected / were recorded by UNHCR after arrival?
Ask this only if only some members were recorded.
Whole number
4. What are the reasons why some or all household members have not been recorded by UNHCR after arrival?
Select all that apply
4.1 Please specify other reason
Text answer

4.1 Case bio-data repeated per member/case

Case #: [count_hh] out of [nbr_of_iterations]

UNHCR case number / PDA Sample reference

Please select:
Select one
1. UNHCR Case Number / PDA Reference number
Text answer

4.2 Registered/unregistered bio-data

1. Specify how many members are registered under [unhcr_case_number_t] case number within the household
Whole number

Individual Bio-data repeated per member/case

Individual #: [count_ind] out of [nbr_of_iterations_ind]

Biodata

1. First name
Text answer
2. Family name
Text answer
3. Gender (M/F)
Select one
4. Date of birth
Date
Please make sure you have made the right selection of the individual:
Name: [first_name_t]
Family name: [family_name_t]
Gender: [gender_s]
Date Of Birth: [birth_date_d]
Are those information correct?
Individual Age: [age]
5. Nationality
Name of the person: [full_name]
Select one
6. Please specify:
Name of the person: [full_name]
Text answer
7. Relationship to Head of Household
Name of the person: [full_name]
Select one
7.1 Please specify:
Name of the person: [full_name]
Text answer
8. Marital Status
Name of the person: [full_name]
Select one
9. Where did you get married (applies to most recent marriage)
Name of the person: [full_name]
Select one
9.1. Please specify:
Name of the person: [full_name]
Text answer
10. If married in Lebanon, what document do you have to prove your marriage? (applies to most recent marriage) (select highest option only)
Name of the person: [full_name]
Select one
10.1 Please specify:
Name of the person: [full_name]
Text answer
11. If not regsitered with foreigners Registery, what is the reason?
Name of the person: [full_name]
Select all that apply
11.1 Please specify:
Name of the person: [full_name]
Text answer
12. If married in Syria, what document do you have to prove your marriage? (applies to most recent marriage) (select highest option only)
Name of the person: [full_name]
Select one
13. Please specify the document you have to prove your marriage
Name of the person: [full_name]
Text answer
14. Where did you get divorced?
Name of the person: [full_name]
Select one
15.1 Please specify where did you get divorced
Name of the person: [full_name]
Text answer
15. If divorced in Lebanon, what documents do you have to prove your divorce? (select highest option only)
Name of the person: [full_name]
Select one
15.1 Please specify:
Name of the person: [full_name]
Text answer
16. If divorced in Syria, what documents do you have to prove your divorce? (select highest option only)
Name of the person: [full_name]
Select one
17. Does [full_name] have regularized legal residency in Lebanon?
Name of the person: [full_name]
Select one
18. Did the household member have regularized legal residency in Lebanon at any point in 2025?
Name of the person: [full_name]
Select one
19. Residency under which category?
Name of the person: [full_name]
Select one
19.1. Please specify Residency under which category?
Name of the person: [full_name]
Text answer
20. Did the [full_name] anytime in the past had a residency based on sponsorship, tourism, lease agreement, property owner or courtesy?
Name of the person: [full_name]
Select one
21. Did the household member anytime in the past exited and re-entered regularly to Lebanon after 2015?
Name of the person: [full_name]
Select one
22. Main reason for not getting regular residency
Name of the person: [full_name]
Select one
22.1. Please specify other reason for not getting regular residency
Name of the person: [full_name]
Text answer
23. Reasons for irregular residency
Name of the person: [full_name]
Select all that apply
23.1. Please specify other reasons for not getting regular residency
Name of the person: [full_name]
Text answer
24. What is the main impact of lack of legal residency
Name of the person: [full_name]
Select all that apply
24.1. Please specify other impacts of lack of legal residency
Name of the person: [full_name]
Text answer
25. When was the last time did [full_name] approached GSO to renew his/her residency?
Name of the person: [full_name]
Select one

4.3 Child birth details

1. In which country was [full_name] born?
Name of the person: [full_name]
Select one
1.2 Please specify
Name of the person: [full_name]
Text answer
2. Please specify where was [full_name] born?
Name of the person: [full_name]
Select one
2.1 Please specify
Name of the person: [full_name]
Text answer
3. Does [full_name] have any birth certification?
Name of the person: [full_name]
Select one
3.1 If no, Why?
Name of the person: [full_name]
Select all that apply
4. What document do you have to prove the birth of your child? (select only the highest option according to the last step completed)
Name of the person: [full_name]
Select one
4.1 Please specify:
Name of the person: [full_name]
Text answer
5. If birth certificate issued reached mukhtar level only, specify the reason why its not registered at Nofous:
Name of the person: [full_name]
Select all that apply
5.1. Specify other
Name of the person: [full_name]
Text answer
6. If birth certificate reached the nofous only, please specify the reason why the birth was not registered in the Foreigners’ Birth Register.
Name of the person: [full_name]
Select all that apply
6.1 Specify other
Name of the person: [full_name]
Text answer
7. What document do you have to prove the birth of [full_name]?
Name of the person: [full_name]
Select one
7.1 Please specify
Name of the person: [full_name]
Text answer

4.4 Work

1. Now I would like to ask about any work [full_name] may do.

Since last [last_seven_days_c], did [full_name] do any of the following activities, even for only one hour?
a.Did [full_name] do any work or help on (his/her) own or the household’s plot, farm, food garden or looked after animals? For example, growing farm produce, harvesting, or feeding, grazing or milking animals?
Select one
b.Did [full_name] help in a family business or a relative’s business with or without pay, or run (his/her) own business?
Select one
c.Did [full_name] produce or sell articles, handicrafts, clothes, food or agricultural products?
Select one
d.Since [last_seven_days_c], did [full_name] engage in any other activity in return for income in cash or in kind, even for only one hour?
Select one
2. Since [last_seven_days_c] about how many hours did [full_name] engage in (this activity/these activities), in total?
If less than one hour, record ‘0’.
Whole number
3. (Was the activity/Were the activities) that [full_name] engaged in taking place during the day or during the night?
Select one

4.5 How would you describe the work environment of [full_name]?

4. How would you describe the work environment of [full_name]?
Name of the person: [full_name]
Select one
[A] Is [full_name] exposed to dust, fumes or gas?
Select one
[B] Is [full_name] exposed to extreme cold, heat or humidity?
Select one
[C] Is [full_name] exposed to loud noise or vibration?
Select one
[D] Is [full_name] required to work at heights?
Select one
[E] Is [full_name] required to work with chemicals, such as pesticides, glues and similar, or explosives?
Select one
[F] Is [full_name] required to work on the streets?
Select one
[G] Is [full_name] exposed to other things, processes or conditions bad for (his/her) health or safety?
Select one
5. Does the activity/Do these activities require carrying heavy loads?
Select one
6. Does the activity/Do these activities require working with dangerous tools such as knives and similar or operating heavy machinery?
Select one
7. Since last [last_seven_days_c], did [full_name] fetch water for household use?
Name of the person: [full_name]
Select one
8. In total, how many hours did [full_name] spend on fetching water for household use, during the last 7 days?
If less than one hour, record ‘0’.
Whole number
9. Since last [last_seven_days_c] , did [full_name] collect firewood for household use?
Name of the person: [full_name]
Select one
10. In total, how many hours did [full_name] spend on collecting firewood for household use, during the last 7 days?
If less than one hour, record ‘0’.
Whole number

11. During the last 7 days, did [full_name] do any of the following for this household?

11. During the last 7 days, did [full_name] do any of the following for this household?
Name of the person: [full_name]
Select one
a.Shopping for household
Select one
b.Cooking
Select one
c.Washing dishes/ cleaning house
Select one
d.Washing clothes
Select one
e.Caring for children
Select one
f.Caring for old / sick
Select one
g.Other household tasks
Select one
12. During the last 7 days, about how many hours did [full_name] engage in (this activity/these activities), in total?
If less than one hour, record ‘0’.
Whole number

4.6 Work and income

1. Last 7 days, did [full_name] work for someone else for pay, for one or more hours?
Name of the person: [full_name]
Select one
2. Last 7 days, did [full_name] run or do any kind of business, farming, or other activity to generate income?
Name of the person: [full_name]
Select one
3. Last 7 days, did [full_name] help in a family business or farm?
Name of the person: [full_name]
Select one
4. Even though [full_name] did not work, did they have a paid job or business last week that they were absent from (i.e. did not work because they were on sick leave, annual leave, maternity leave, weather, strike, etc.)?
Name of the person: [full_name]
Select one
5. Including the time [full_name] has been absent, will [full_name] return to that same job or business in 3 months or less(i.e. sick leave, annual leave, maternity leave, weather, strike, etc.)?
Name of the person: [full_name]
Select one
6. Does [full_name] continue to receive an income from [full_name] job or business during this absence?
Name of the person: [full_name]
Select one
7. Are the farming or animal products that [full_name] is working on intended…?
Name of the person: [full_name]
Select one
8. Did [full_name] earn from work in the last 7 days in USD or LBP?
Name of the person: [full_name]
Select all that apply
9. How much did [full_name] earn from work in the last 7 days? (in USD)
Amount in USD is only the amount paid/borrowed in USD
Number
10. How much did [full_name] earn from work in the last 7 days? (in LBP)
Amount in LBP is only the amount paid/borrowed in LBP
Number
11. What is the main activity of the place where [full_name] works?
Name of the person: [full_name]
Select one
11.1 Please specify
Name of the person: [full_name]
Text answer
12. How many years of experience do you have in that occupation?
Name of the person: [full_name]
Whole number
13. In the last 4 weeks, did [full_name] look for a paid job or try to start a business?
Name of the person: [full_name]
Select one
14. If a job or business opportunity became available, could [full_name] start working within the next 2 weeks?
Name of the person: [full_name]
Select one
15. If not continuously working in the last 30 days: why?
Name of the person: [full_name]
Select one
15.1 Please specify
Name of the person: [full_name]
Text answer
16. Which of the following best describes what [full_name] is mainly doing at present?
Name of the person: [full_name]
Select one
16.1 Please specify
Name of the person: [full_name]
Text answer
17. If working, How do you reach your place of work
Name of the person: [full_name]
Select one
18. Who covers the transportation cost
Name of the person: [full_name]
Select one
19. In the past 4 weeks, did you attend any courses, seminars, or other training to develop specific skills, for example languages, computer skills, or similar?
Name of the person: [full_name]
Select one
19.1. If no, what was the reason
Name of the person: [full_name]
Select all that apply
19.1.1 Please specify
Name of the person: [full_name]
Text answer
20. In the past 4 weeks, did you participate in any unpaid apprenticeship, internship, or similar training in a workplace?
Name of the person: [full_name]
Select one
20.1 If yes, what sector
Name of the person: [full_name]
Select all that apply
20.2 Please specify
Name of the person: [full_name]
Text answer
21. If no, what was the reason
Name of the person: [full_name]
Select all that apply
21.1 Please specify
Name of the person: [full_name]
Text answer
22. Which training would improve your livelihood opportunities?
Name of the person: [full_name]
Select all that apply
22.1 Please specify
Name of the person: [full_name]
Text answer
23. Were you able to find employment in the sector of training
Name of the person: [full_name]
Select one
24. How do usually look for jobs?
Name of the person: [full_name]
Select all that apply
24.1 Please specify
Name of the person: [full_name]
Text answer
25. Is [full_name] able to read and write?
Name of the person: [full_name]
Select one
26. Has [full_name] ever attended school or kindergarten?
Name of the person: [full_name]
Select one
27. What is the highest level and grade or year of school name has ever attended?
Name of the person: [full_name]
Select one
28. Did [full_name] ever complete that grade?
Name of the person: [full_name]
Select one

4.7 School details: to be asked from 3-24 years old.

4.7 School details: to be asked from 3-24 years old.
1. At any time during the current school year 2025-2026, did [full_name] attend school or any early childhood education programme?
Name of the person: [full_name]
Select one
2. If no, why?
Name of the person: [full_name]
Select all that apply
3. During this current school year 2025-2026, which level and grade or year is [full_name] attending?
Name of the person: [full_name]
Select one
4. At any time during the previous school year 2024-2025, did [full_name] attend school or any early childhood education programme?
Name of the person: [full_name]
Select one
5. During that previous school year 2024-2025, which level and grade or year did [full_name] attend?
Name of the person: [full_name]
Select one
6. During the 2025-2026 school year, was [full_name] education disrupted by any of the following events?
a. Natural disasters, such as flood, cyclone, epidemics or similar:
Select one
b. Human-made disasters, such as fire, building collapse, riots or similar
Select one
c. Teacher strike
Select one
d. Other (Specify)
Text answer
7. During the current school year, was [full_name] offered any online or remote learning by the school or learning programme?
Name of the person: [full_name]
Select one
8. Was [full_name] able to participate in online or remote learning when it was offered?
Name of the person: [full_name]
Select one
9. What was the main reason [full_name] could not participate regularly in online or remote learning?
Name of the person: [full_name]
Select all that apply
9.1 Please specify
Name of the person: [full_name]
Text answer

4.8 Specific Needs

Does this household member fall into any of the following specific needs categories?
1. Is [full_name] Pregnant or lactating
Name of the person: [full_name]
Select one
A disability is a long term or permanent condition that hinders the persons life partially or fully.
2. Does [full_name] have difficulty seeing, even when wearing glasses / contact lenses? Would you say…
Read the question exactly as it is, inserting name of individual, and present answer options 1 to 4 before response.
Answer options 5 and 6 ARE NOT READ ALOUD
Select one
3. Does [full_name] have difficulty hearing, even when using a hearing aid? Would you say…
Read the question exactly as it is, inserting name of individual, and present answer options 1 to 4 before response.
Answer options 5 and 6 ARE NOT READ ALOUD
Select one
4. Does [full_name] have difficulty walking or climbing steps? Would you say…
Read the question exactly as it is, inserting name of individual, and present answer options 1 to 4 before response.
Answer options 5 and 6 ARE NOT READ ALOUD
Select one
5. Compared with children of the same age does [full_name] have difficulty walking ? Would you say…
Read the question exactly as it is, inserting name of individual, and present answer options 1 to 4 before response.
Answer options 5 and 6 ARE NOT READ ALOUD
Select one
6. Compared with children of the same age does [full_name] have difficulty understanding you? Would you say…
Read the question exactly as it is, inserting name of individual, and present answer options 1 to 4 before response.
Answer options 5 and 6 ARE NOT READ ALOUD
Select one
7. When [full_name] speaks do you have difficulty understanding him / her? Would you say…
Read the question exactly as it is, inserting name of individual, and present answer options 1 to 4 before response.
Answer options 5 and 6 ARE NOT READ ALOUD
Select one
8. Using their usual language, does [full_name] have difficulty communicating, for example understanding or being understood? Would you say…
Read the question exactly as it is, inserting name of individual, and present answer options 1 to 4 before response.
Answer options 5 and 6 ARE NOT READ ALOUD
Select one
9. Compared with children with the same age does [full_name] have difficulty learning things? Would you say…
Read the question exactly as it is, inserting name of individual, and present answer options 1 to 4 before response.
Answer options 5 and 6 ARE NOT READ ALOUD
Select one
10. Does [full_name] have difficulty remembering or concentrating? Would you say…
Read the question exactly as it is, inserting name of individual, and present answer options 1 to 4 before response.
Answer options 5 and 6 ARE NOT READ ALOUD
Select one
11. Does [full_name] have difficulty with self care, such as washing all over or dressing? Would you say…
Read the question exactly as it is, inserting name of individual, and present answer options 1 to 4 before response.
Answer options 5 and 6 ARE NOT READ ALOUD
Select one
12. Does [full_name] have difficulty raising a 2 litre jug of water from waist to eye level? Would you say…
Read the question exactly as it is, inserting name of individual, and present answer options 1 to 4 before response.
Answer options 5 and 6 ARE NOT READ ALOUD
Select one
13. Compared with children of the same age, does [full_name] have difficulty picking up small objects with his/her hand?
Read the question exactly as it is, inserting name of individual, and present answer options 1 to 4 before response.
Answer options 5 and 6 ARE NOT READ ALOUD
Select one
14. Does [full_name] have difficulty using their hands and fingers, such as picking up small objects for example a button or pencil, or opening or closing containers or bottles? Would you say…
Read the question exactly as it is, inserting name of individual, and present answer options 1 to 4 before response.
Answer options 5 and 6 ARE NOT READ ALOUD
Select one
15. How often does [full_name] feel worried, nervous, or anxious? Would you say...
Read the question exactly as it is, inserting name of individual, and present answer options 1 to 5 before response.
Answer options 6 and 7 ARE NOT READ ALOUD
Select one
16. Thinking of the last time [full_name] felt worried, nervous, or anxious, how would you describe the level of these feeling? Would you say...
Read the question exactly as it is, inserting name of individual, and present answer options 1 to 3 before response.
Answer options 4 and 5 ARE NOT READ ALOUD
Select one
17. How often does [full_name] feel depressed? Would you say...
Read the question exactly as it is, inserting name of individual, and present answer options 1 to 5 before response.
Answer options 6 and 7 ARE NOT READ ALOUD
Select one
18. Thinking of the last time you/he/she/this person felt depressed, how would you describe the level of these feeling? Would you say...
Read the question exactly as it is, inserting name of individual, and present answer options 1 to 3 before response.
Answer options 4 and 5 ARE NOT READ ALOUD
Select one
20. Older person unable to care for self
Name of the person: [full_name]
Select one
21. Older person with children
Name of the person: [full_name]
Select one
22. Person with disabilities unable to care for self
Name of the person: [full_name]
Select one
23. Single parent
Name of the person: [full_name]
Select one
24. Single caregiver
Name of the person: [full_name]
Select one
25. Chronic illness
Name of the person: [full_name]
Select one
26. Is there a caregiver available?
Name of the person: [full_name]
Select one

4.9 Health

1. During the last 3 months, did [full_name] have a health problem and needed to access health care?
Name of the person: [full_name]
Select one
2. If yes, where was the healthcare was needed?(Note: choose both options of the person needed both types)
Name of the person: [full_name]
Select all that apply
3. If the need was related to Primary Health Care, then what was [full_name] health care need?
Name of the person: [full_name]
Select all that apply
3.1 Please specify:
Name of the person: [full_name]
Text answer
4. Was [full_name] able to obtain primary health care when they felt they needed it?
Name of the person: [full_name]
Select one
5. If the need was related to Secondary Health Care, then what was [full_name] health care need?
Name of the person: [full_name]
Select all that apply
5.1 Please specify:
Name of the person: [full_name]
Text answer
6. Was [full_name] able to obtain secondary health care when they felt they needed it?
Name of the person: [full_name]
Select one
7. Where did they go to seek health care?

INSTRUCTIONS TO ENUMERATOR: If person visited more than one healthcare location, select "highest" level of care (SHC then PHC then Other)
* The person asking this question should fully understand the difference and understand that people can be visiting multiple of the below in the same year so needs to stress on that to prevent confusion
Name of the person: [full_name]
Select all that apply
7.1 Please specify:
Name of the person: [full_name]
Text answer
8. Please select hospital name
Name of the person: [full_name]
Select one
8.1 Please specify
Name of the person: [full_name]
Text answer
9. Did you pay for your inpatient (secondary) health care services?
Name of the person: [full_name]
Select one
9.1 Please specify
Name of the person: [full_name]
Text answer
10. Did you pay for your outpatient care services?
Name of the person: [full_name]
Select one
10.1 Please specify
Name of the person: [full_name]
Text answer
11. Is the [full_name] given birth in the last two years?
Name of the person: [full_name]
Select one
12. Prior to delivery, how many antenatal care visits did [full_name] receive?
Name of the person: [full_name]
Select one
13. How did [full_name] gave birth?
Select one
14. Did [full_name] deliver in Lebanon or outside of Lebanon?
Select one
15. Where did [full_name] deliver?
Name of the person: [full_name]
Select one
15.1 Specify other:
Name of the person: [full_name]
Text answer
16. Did [full_name] receive postnatal care after birth?
Select one
17. In the last 3 months, was the [full_name] in need for family planning/contraceptives?
Name of the person: [full_name]
Select one
18. Was [full_name] able to obtain family planning services/ contraceptives when she felt it needed?
Name of the person: [full_name]
Select one
19. What type of contraception did the woman use?
Select one
20. Where did [full_name] go to seek Family planning services/ contraceptives?
Name of the person: [full_name]
Select one
20.1 Specify other:
Name of the person: [full_name]
Text answer
21. In the past year, did the woman want to delay a pregnancy and was not able to do so?
Select one
22. In the last 3 months, what barriers did [full_name] experience to prevent her from accessing needed family planning services.
Name of the person: [full_name]
Select one
22.1 Specify other:
Name of the person: [full_name]
Text answer

4.10 Child focused questions ONLY FOR CHILDREN under 5 years

1. Was the [full_name] sick in last 2 weeks?
Name of the person: [full_name]
Select one

4.11 [full_name] Sick

1. In the previous 2 weeks did the [full_name] have diarrhea?
Name of the person: [full_name]
Select one
2. During the past two weeks, did the [full_name] suffer from severe diarrhea which required hospitalization or a doctor's consultation?
Name of the person: [full_name]
Select one
3. Did you seek advice or treatment for the severe diarrhea at a hospital or clinic?
Name of the person: [full_name]
Select one
4. In the previous 2 weeks did the [full_name] have a cough?
Name of the person: [full_name]
Select one
5. During the past two weeks, did the [full_name] suffer from a respiratory infection which required hospitalization or a doctor's consultation?
Name of the person: [full_name]
Select one
5a. Did you seek advice or treatment for the respiratory infection at a hospital or clinic?
Name of the person: [full_name]
Select one
6. In the previous 2 weeks did the [full_name] have a fever?
Name of the person: [full_name]
Select one
7. In the previous 2 weeks did the [full_name] have any skin diseases?
Name of the person: [full_name]
Select one
8. In the previous 2 weeks did the [full_name] have other symptoms or illnesses that required hospitalization or doctor's consultation?
Name of the person: [full_name]
Select one

4.11a [full_name] Vaccination

1. Has your [full_name] recevied all the vaccinations appropriate for their age?
Select one
2. Where did you last vaccinate your [full_name]?
Select one
3. Specify
Text answer

4.12 [full_name] focused questions ONLY FOR [full_name]REN 2 (0 - 24 months)

1.Has the [full_name] ever been breastfed ?
Name of the person: [full_name]
Select one
2. Is the [full_name] still being breastfed?
Name of the person: [full_name]
Select one
3.Yesterday, during the day or night, did the [full_name] drink anything from a bottle with a nipple?
Name of the person: [full_name]
Select one
4.Did the [full_name] drink Oral Rehydration Salt solution (ORS) yesterday, during the day or night?
Name of the person: [full_name]
Select one
5.Did the [full_name] drink or eat vitamin or mineral supplements or any medicines yesterday, during the day or night?
Name of the person: [full_name]
Select one
6.Did the [full_name] receive yesterday any plain water?
Name of the person: [full_name]
Select one
7.Did the [full_name] receive yesterday any juices?
Name of the person: [full_name]
Select one
8.Did the [full_name] receive yesterday any broth water?
Name of the person: [full_name]
Select one
9.Did the [full_name] receive yesterday any infant formula?
Name of the person: [full_name]
Select one
10. How many times did the [full_name] drink infant formula?
Name of the person: [full_name]
Whole number
11.Did the [full_name] receive yesterday any milk from animals, such as fresh, tinned, or powdered milk?
Name of the person: [full_name]
Select one
12. How many times did the [full_name] drink milk?
Name of the person: [full_name]
Whole number
13.Did the [full_name] receive yesterday any other liquid?
Name of the person: [full_name]
Select one
14.Record all other liquids mentioned.
Name of the person: [full_name]
Text answer

4.13 Now I would like to ask you about everything that [full_name] ate yesterday during the day or the night. Please include foods consumed outside of your home.

Think about when [full_name] woke up yesterday. Did (he/she) eat anything at that time?
If ‘Yes’ ask: Please tell me everything [full_name] ate at that time. Probe: Anything else?

Record answers using the food groups below.

What did [full_name] do after that? Did (he/she) eat anything at that time?
Repeat this string of questions, recording in the food groups, until the respondent tells you that the child went to sleep until the next morning consumed outside of your home.

1.Yesterday, did [full_name] have yogurt made from animal milk?
Name of the person: [full_name]
Select one
2.How many times did [full_name] eat yogurt?
Name of the person: [full_name]
Whole number
3. Yesterday , did [full_name] have flavored milk ?( chocolate milk , strawberry milk..)
Name of the person: [full_name]
Select one
4.Yesterday, did [full_name] have any baby food, such as Cerelac?
Name of the person: [full_name]
Select one
5.Yesterday, did [full_name] have bread, rice, noodles, porridge, or other foods made from grains?
Name of the person: [full_name]
Select one
6.Yesterday, did [full_name] have Pumpkin, carrots, squash, or sweet potatoes that are yellow or orange inside?
Name of the person: [full_name]
Select one
7.Yesterday, did [full_name] have White potatoes, white yams, cassava, or any other foods made from roots?
Name of the person: [full_name]
Select one
8.Yesterday, did [full_name] have Any dark green, leafy vegetables, such as Spinach or Mloukhiye?
Name of the person: [full_name]
Select one
9.Yesterday, did [full_name] have Ripe mangoes or ripe papayas, appricot (fresh and dried), cantaloupe melon (ripe), passion fruit (ripe), peaches (dried), persimmon (ripe))?
Name of the person: [full_name]
Select one
10.Yesterday, did [full_name] have Any other fruits or vegetables, such as cucumber or banana?
Name of the person: [full_name]
Select one
11.Yesterday, did [full_name] have Liver, kidney, heart or other organ meats?
Name of the person: [full_name]
Select one
12. Sausages, hot dogs/frankfurters, ham, bacon, salami, canned meat or [insert other commonly consumed processed meats]?
Name of the person: [full_name]
Select one
13. Any other meat, such as beef, pork, lamb, goat, chicken, duck or [insert other commonly consumed meat]?
Name of the person: [full_name]
Select one
14.Yesterday, did [full_name] have Eggs?
Name of the person: [full_name]
Select one
15.Yesterday, did [full_name] have Fish or shellfish, either fresh or dried?
Name of the person: [full_name]
Select one
16.Yesterday, did [full_name] have Beans, peas, lentils or nuts, including any foods made from these?
Name of the person: [full_name]
Select one
17.Yesterday, did [full_name] have Cheese or other food made from animal milk?
Name of the person: [full_name]
Select one
18.Yesterday, did [full_name] have any Other solid, semi-solid, or soft food?
Name of the person: [full_name]
Select one
19.Record all other solid, semi-solid, or soft food that do not fit food groups above.
Name of the person: [full_name]
Text answer
20.How many times did the child eat any solid, semi-solid or soft foods yesterday during the day or night?
Name of the person: [full_name]
Whole number

4.14 Enumerator Comments/Observations

1. Would you like to add any comments/observations at this stage?
Select one
2. Please enter your comments
Text answer

Section IV: Household income, expenditure, and debt

5.1 Food Basket Expenditure

In the past MONTH, how much money have you spent on each of the following items or service?

5.1 Food Items

5.1.1 Cereals

Bread and Pasta

1. In the past 30 days, how much money have you spent on Bread and Pasta?
a. Cash and Credit (in LBP):
Write 0 if no expenditure
Number
b. In the last 30 days, did your household consume any Bread and Pasta from in-kind gifts and/or assistance?
If yes, please estimate the value:
If no consumption, please put 0
Number
c. In the last 30 days, did your household consume any Bread and Pasta that you produced, gathered or received in exchange of labor?
If yes, please estimate the value:
If no consumption, please put 1
Number

Other Cereals

2. In the past 30 days, how much money have you spent on other CEREALS (rice, wheat, bulgur, other cereals)?
Rice, wheat, bulgur, other cereals
a. Cash and Credit (in LBP):
Write 0 if no expenditure
Number
b. In the last 30 days, did your household consume any Cereals from in-kind gifts and/or assistance?
If yes, please estimate the value:
Write 0 if no expenditure
Number
c. In the last 30 days, did your household consume any Cereals you produced, gathered or received in exchange of labor?
If yes, please estimate the value :
If no consumption, please put 0
Number

Tubers (potatoes)

3. In the past 30 days, how much money have you spent on Tubers (potatoes)?
a. Cash and Credit (in LBP):
Write 0 if no expenditure
Number
b. In the last 30 days, did your household consume any Tubers (potatoes) from in-kind gifts and/or assistance?
If yes, please estimate the value:
If no consumption, please put 0
Number
c. In the last 30 days, did your household consume any Tubers (potatoes)you produced, gathered or received in exchange of labor?
If yes, please estimate the value:
If no consumption, please put 0
Number

5.1.2 Pulses , nuts, beans, peas, lentils

1. In the past 30 days, how much money have you spent on Pulses & nuts, legumes, beans, peanuts, peas, green peas, lentils, nut, chick peas, and / or other nuts?
a. Cash and Credit (in LBP):
Write 0 if no expenditure
Number
b. In the last 30 days, did your household consume any Pulses & nuts, legumes, beans, peanuts, peas, green peas, lentils, nut, chick peas, and / or other nuts from in-kind gifts and/or assistance?
If yes, please estimate the value:
If no consumption, please put 0
Number
c. In the last 30 days, did your household consume any Pulses & nuts, legumes, beans, peanuts, peas, green peas, lentils, nut, chick peas, and / or other nuts you produced, gathered or received in exchange of labor?
If yes, please estimate the value:
If no consumption, please put 0
Number

5.1.3 Vegetables

Vegetables (carrot, red pepper, spinach, broccoli, mulukhiyi, onion, cucumber, radish, tomatoes, eggplants, zucchini)

1. In the past 30 days, how much money have you spent on vegetables (carrot, red pepper, spinach, broccoli, mulukhiyi, onion, cucumber, radish, tomatoes, eggplants, zucchini)?
a. Cash and Credit (in LBP):
Write 0 if no expenditure
Number
b. In the last 30 days, did your household consume any vegetables from in-kind gifts and/or assistance?
If yes, please estimate the value:
If no consumption, please put 0
Number
c. In the last 30 days, did your household consume any vegetables you produced, gathered or received in exchange of labor?
If yes, please estimate the value:
If no consumption, please put 0
Number

5.1.4 Fruits

Fruits (apricot, peach, apple, banana, watermelon, cherry, dates, plum)

1. In the past 30 days, how much money have you spent on fruits (apricot, peach, apple, banana, watermelon, cherry, dates, plum)?
a. Cash and Credit (in LBP):
Write 0 if no expenditure
Number
b. In the last 30 days, did your household consume any Fruits from in-kind gifts and/or assistance?
If yes, please estimate the value:
If no consumption, please put 0
Number
c. In the last 30 days, did your household consume any Fruits you produced, gathered or received in exchange of labor?
If yes, please estimate the value:
If no consumption, please put 0
Number

5.1.5 Meat

Flesh meat

1. In the past 30 days, how much money have you spent on Flesh meat ?
beef, lamb, goat, rabbit, chicken, duck, turkey, other birds
a. Cash and Credit (in LBP):
Write 0 if no expenditure
Number
b. In the last 30 days, did your household consume any Flesh meat from in-kind gifts and/or assistance?
If yes, please estimate the value:
If no consumption, please put 0
Number
c. In the last 30 days, did your household consume any Flesh meat you produced, gathered, hunted or received in exchange of labor?
If yes, please estimate the value:
If no consumption, please put 0
Number

Organ meat

2. In the past 30 days, how much money have you spent on Organ meat?
liver, kidney, heart and / or other organ meats
a. Cash and Credit (in LBP):
Write 0 if no expenditure
Number
b. In the last 30 days, did your household consume any Organ meat from in-kind gifts and/or assistance?
If yes, please estimate the value:
If no consumption, please put 0
Number
c. In the last 30 days, did your household consume any Organ meat you produced, gathered, hunted or received in exchange of labor?
If yes, please estimate the value:
If no consumption, please put 0
Number

Fish/shellfish

3. In the past 30 days, how much money have you spent on Fish/shellfish?
dried, fresh and smoked fish, including canned tuna, and / or other seafood
a. Cash and Credit (in LBP):
Write 0 if no expenditure
Number
b. In the last 30 days, did your household consume any Fish/shellfish from in-kind gifts and/or assistance?
If yes, please estimate the value:
If no consumption, please put 0
Number
c. In the last 30 days, did your household consume any Fish/shellfish you produced, gathered, hunted or received in exchange of labor?
If yes, please estimate the value:
If no consumption, please put 0
Number

5.1.6 Milk/Dairy products and other

Oil/Fat/Butter

1. In the past 30 days, how much money have you spent on Oil/Fat/Butter ?
Vegetal oil, butter, margarin, palm oil, shea butter, other fats / oil
a. Cash and Credit (in LBP):
Write 0 if no expenditure
Number
b. In the last 30 days, did your household consume any Oil/Fat/Butter from in-kind gifts and/or assistance?
If yes, please estimate the value:
If no consumption, please put 0
Number
c. In the last 30 days, did your household consume any Oil/Fat/Butter you produced, gathered or received in exchange of labor?
If yes, please estimate the value:
If no consumption, please put 0
Number

Milk/Dairy products

2. In the past 30 days, how much money have you spent on Milk/Dairy products ?
Milk, cheese, yogurt, powdered milk, fresh milk / sour, yogurt, cheese, other dairy products
a. Cash and Credit (in LBP):
Write 0 if no expenditure
Number
b. In the last 30 days, did your household consume any Milk/Dairy products from in-kind gifts and/or assistance?
If yes, please estimate the value:
If no consumption, please put 0
Number
c. In the last 30 days, did your household consume any Milk/Dairy products you produced, gathered or received in exchange of labor?
If yes, please estimate the value:
If no consumption, please put 0
Number

Egg

3. In the past 30 days, how much money have you spent on Egg?
a. Cash and Credit (in LBP):
Write 0 if no expenditure
Number
b. In the last 30 days, did your household consume any Egg from in-kind gifts and/or assistance?
If yes, please estimate the value:
If no consumption, please put 0
Number
c. In the last 30 days, did your household consume any Egg you produced, gathered or received in exchange of labor?
If yes, please estimate the value:
If no consumption, please put 0
Number

Sugar or sweets

4. In the past 30 days, how much money have you spent on Sugar ?
Sugar, confectionery, desserts, honey, jam, cakes, candy, cookies, pastries, cakes and other sweet (sugary drinks)
a. Cash and Credit (in LBP):
Write 0 if no expenditure
Number
b. In the last 30 days, did your household consume any Sugar or sweets from in-kind gifts and/or assistance?
If yes, please estimate the value:
If no consumption, please put 0
Number
c. In the last 30 days, did your household consume any Sugar or sweets you produced, gathered or received in exchange of labor?
If yes, please estimate the value:
If no consumption, please put 0
Number

Condiment

5. In the past 30 days, how much money have you spent on Condiment ?
Salt, spices, cubes, baking powder, tomatoe sauce, ketchup, Maggy cubes
a. Cash and Credit (in LBP):
Write 0 if no expenditure
Number
b. In the last 30 days, did your household consume any Condiment from in-kind gifts and/or assistance?
If yes, please estimate the value:
If no consumption, please put 0
Number
c. In the last 30 days, did your household consume any Condiment you produced, gathered or received in exchange of labor?
If yes, please estimate the value:
If no consumption, please put 0
Number

Beverages (non-alcoholic, NOT water)

6. In the past 30 days, how much money have you spent on Beverages (non-alcoholic, NOT water including bottled water) ?
Coffee, tea, soft-drinks and juices
a. Cash and Credit (in LBP):
Write 0 if no expenditure
Number
b. In the last 30 days, did your household consume any Beverages (non-alcoholic, NOT water) from in-kind gifts and/or assistance?
If yes, please estimate the value:
If no consumption, please put 0
Number
c. In the last 30 days, did your household consume any Beverages (non-alcoholic, NOT water) you produced, gathered or received in exchange of labor?
If yes, please estimate the value:
If no consumption, please put 0
Number

Snacks consumed outside the home

7. In the past 30 days, how much money have you spent on Snacks consumed outside the home?
Take away, snacks consumed outside the home
a. Cash and Credit (in LBP):
Write 0 if no expenditure
Number
b. In the last 30 days, did your household consume any Snacks consumed outside the home from in-kind gifts and/or assistance?
If yes, please estimate the value:
If no consumption, please put 0
Number
c. In the last 30 days, did your household consume any Snacks consumed outside the home you produced, gathered or received in exchange of labor?
If yes, please estimate the value:
If no consumption, please put 0
Number
You spent the following amount [total_food_dec] in LBP on food items, out of this amount please estimate the total amount spent on credit on all the food items listed above ?
The estimated total value of food consumed by your household during the last 30 days was [total_food_all_dec] LBP. This amount includes:

Food purchased in cash or on credit;
The estimated value of food received through in-kind assistance or gifts;
The estimated value of food produced, gathered, or received in exchange for labour.

Of this total amount, please estimate how much was spent in cash or on credit for food.

5.2 Non-food items

Hygiene items

1. In the past 30 days, how much money have you spent on Hygiene items?
Soap, toothbrush, toothpaste, toilet paper, detergents/laundry soap/dish detergent, menstrual hygiene items, shampoo, diapers
a. Cash or Credit (in LBP):
Write 0 if no expenditure
Number

Transport

2. In the past 30 days, how much money have you spent on Transportation (except transport to school)?
Fuel, public transportation, taxi
a. Cash or Credit (in LBP):
Write 0 if no expenditure
Number

School Transportation

3. In the past 30 days, how much money have you spent on Transportation to school?
Fuel, public transportation, taxi
a. Cash or Credit (in LBP):
Write 0 if no expenditure
Number

Housing

Gas (for cooking not for heating)

4. In the past 30 days, how much money have you spent on Gas (for cooking not for heating)?
a. Cash or Credit (in LBP):
Write 0 if no expenditure
Number

Other sources of energy for cooking

5. In the past 30 days, how much money have you spent on Other sources of energy for cooking?
kerosene, wood – NOT electricity, NOT gas
a. Cash or Credit (in LBP):
Write 0 if no expenditure
Number

Services related to Shelter

6. In the past 30 days, how much money have you spent on Services related to Shelter? (this should not include electricity and gas )
Refuse collection, seweage collection, maintenance charge in collective buildings, security services
a. Cash or Credit (in LBP):
Write 0 if no expenditure
Number

Communications (mobile, internet, satellite)

7. In the past 30 days, how much money have you spent on Communication?
Mobile, internet, satellite
a. Cash or Credit (in LBP):
Write 0 if no expenditure
Number

Others

Tobacco and Alcohol

8. In the past 30 days, how much money have you spent on Tobacco and Alcohol?
a. Cash or Credit (in LBP):
Write 0 if no expenditure
Number

Medicine and health products

9. In the past 30 days, how much money have you spent on Medicine and health products?
Medicine, other medical products, medical equipment
a. Cash or Credit (in LBP):
Write 0 if no expenditure
Number

Entertainment

10. In the past 30 days, how much money have you spent on Entertainment?
a. Cash or Credit (in LBP):
Write 0 if no expenditure
Number

5.3 Non-Food items (6 months)

Health services

1. In the last 6 months, how much money have you spent on health services (except medicine)?
Outpatient and hospital services
a. Cash or Credit (in LBP):
Write 0 if no expenditure
Number

Clothing and footwear

2. In the last 6 months, how much money have you spent on Clothing and footwear?
Clothing, shoes (purchase and repair) – school uniforms excluded
a. Cash or Credit (in LBP):
Write 0 if no expenditure
Number

Household non-durable furniture

3. In the last 6 months, how much money have you spent on Household non-durable furniture?
Textiles, cooking pots/utensils, goods (do NOT include durable furniture, equipment and appliances)
a. Cash or Credit (in LBP):
Write 0 if no expenditure
Number

Savings

4. In the last 6 months, how much savings did you have?
Cash saved
a. Cash (in LBP):
Write 0 if no expenditure
Number

Diesel/Fuel for heating, etc. (not for transport)

6. In the last 6 months, how much money have you spent on Diesel/Fuel for heating, etc. (not for transport) ?
For heating or other uses
a. Cash or Credit (in LBP):
Write 0 if no expenditure
Number

5.4 Non-Food items (12 months)

5.4.1 Education

Education services

1. In the last 12 months, how much money have you spent on Education services (tuituion fees)?
Tuitions fees
a. Cash or Credit (in LBP):
Write 0 if no expenditure
Number

Education goods

2. In the last 12 months, how much money have you spent on Education goods ?
Other education costs (uniform, school materials, transport)
a. Cash or Credit (in LBP):
Write 0 if no expenditure
Number

Legal and Registration fees (Cost of registration/legalizing stay in Lebanon/ birth and marriage registration/ other legal fees)

3. In the last 12 months, how much money did your household spend on legal and registration fees, including costs related to residency or legal stay in Lebanon, birth or marriage registration, work permit fees, and other legal fees?
a. Cash or Credit (in LBP):
Write 0 if no expenditure
Number

5.5 Income

5.5.1 Income sources

1. In the last 30 days, what were the top 3 sources of cash/income used to sustain your household?
2. Main sources of cash/income used to sustain your household
Select one
3. Specify first other sources of cash/income used to sustain your household
Text answer
4. Second most relied sources of cash/income used to sustain your household
Select one
5. Specify second other sources of cash/income used to sustain your household
Text answer
6. Third most relied sources of cash/income used to sustain your household
Select one
7. Specify third other sources of cash/income used to sustain your household
Text answer
8. In the past 30 days, what was the total income (from employment) of all the household members? (USD)
Amount in USD is only income earned in USD
Number
9. In the past 30 days, what was the total income (from employment) of all the household members? (LBP)
Amount in LBP is only income earned in LBP
Number

5.6 Borrowing, credit, and debt:

1. During the last 3 months (90 days), did any member of the household borrow money and/or receive credit?
Select one
2. What were the primary reasons for borrowing or receiving credit?
Select all that apply
3. Specify other primary reasons for borrowing:
Text answer
4. From whom did you get the credit or borrow the money?
Select all that apply
4.1 What are the nationalities of the person(s) from whom you borrowed money?
Select all that apply
4.1.1 Please specify:
Text answer
5. Specify other source whom did you get the credit or borrow the money:
Text answer
6. Do you feel safe when asking for money
Select one
7. Are you asked for any favour in exchange
Select one
8. Do you face any challenges from debtors as a result of you debts?
Select all that apply
8.1 Please specify:
Text answer
9. What is the current debt up to now from borrowing money (informal and formal debt) (from friends, relatives, landlord, bank etc) that has not yet been paid back and is expected to be paid back? (In USD)
(If the HH is not in debt, put 0)
Amount in USD is only the amount paid/borrowed in USD
Number
10. What is the current debt up to now from borrowing money (informal and formal debt) (from friends, relatives, landlord, bank etc) that has not yet been paid back and is expected to be paid back? (In LBP)
(If the HH is not in debt, put 0)
Amount in LBP is only amount paid / borrowed in LBP
Number
11. What is the amount of new debt from borrowing or crediting (formal and informal debt) in the last 30 days? (In USD)
Amount in USD is only the amount paid/borrowed in USD
Number
12. What is the amount of new debt from borrowing or crediting (formal and informal debt) in the last 30 days? (In LBP)
Amount in LBP is only amount paid / borrowed in LBP
Number

Debt repayment

1. In the last 6 months, how much money have you spent on Debt repayment?
Debt repayment
a. Cash (in USD):
Write 0 if no expenditure
Amount in USD is only the amount paid/borrowed in USD
Number
a. Cash (in LBP):
Write 0 if no expenditure
Amount in LBP is only amount paid / borrowed in LBP
Number

Enumerator Comments/Observations

Enumerator Comments/Observations
Select one
Enumerator Comments/Observations comments details
Text answer

Section V: Dietary Diversity and Food Consumption

Household Consumption and Diet

1. How many meals (warm and cooked or prepared) did the adults of this household eat yesterday?
Whole number
2. How many meals (warm and cooked or prepared) did the children under 5 of this household eat yesterday?
Whole number

Consumption details

How many days over the last 7 days, did members of your household eat the following food items, prepared and/or consumed at home, and what was their source?
1. How many days over the last 7 days, did members of your household eat: Tubers (potatoes) and Cereals (bread, rice, pasta, wheat, bulgur, other cereals)
Whole number
Money was spent on pulses/legumes, but none were eaten in the last 7 days. Please confirm.
The household reported consuming this food item during the last 7 days, while all expenditure and acquisition values for the last 30 days are zero. Please verify the responses.
2. How many days over the last 7 days, did members of your household eat: Cereals (bread, rice, pasta, wheat, bulgur, other cereals)
Whole number
3. How many days over the last 7 days, did members of your household eat: Tubers (potatoes)
Whole number
Warning: Number of sub Tubers and Cereal less than the total [num_days_cereals_i]
4. How many days over the last 7 days, did members of your household eat: Legumes / nuts : beans, cowpeas, peanuts, lentils, nut, soy, pigeon pea, chick peas, Groundnut; Ground Bean; green peas, Cow Pea; and / or other nuts
Whole number
Money was spent on pulses/legumes, but none were eaten in the last 7 days. Please confirm.
The household reported consuming this food item during the last 7 days, while all expenditure and acquisition values for the last 30 days are zero. Please verify the responses.
5. How many days over the last 7 days, did members of your household eat: Milk and other dairy products: fresh milk / sour, yogurt, lebneh, cheese, other dairy products
(Exclude margarine / butter or small amounts of milk for tea / coffee)
Whole number
Money was spent on milk/dairy products, but none were eaten in the last 7 days. Please confirm.
The household reported consuming this food item during the last 7 days, while all expenditure and acquisition values for the last 30 days are zero. Please verify the responses.
6. How many days over the last 7 days, did members of your household eat: Meat, fish and eggs: goat, beef, chicken, pork, blood, fish, turkey, including canned tuna, escargot, and / or other seafood, eggs (meat and fish consumed in large quantities and not as a condiment).
Whole number
Money was spent on meat, fish, or eggs, but none were eaten in the last 7 days. Please confirm.
The household reported consuming this food item during the last 7 days, while all expenditure and acquisition values for the last 30 days are zero. Please verify the responses.
7. How many days over the last 7 days, did members of your household eat: Flesh meat: beef, pork, lamb, goat, rabbit, chicken, duck, turkey other birds
Whole number
Money was spent on meat, fish, or eggs, but none were eaten in the last 7 days. Please confirm.
The household reported consuming this food item during the last 7 days, while all expenditure and acquisition values for the last 30 days are zero. Please verify the responses.
8. How many days over the last 7 days, did members of your household eat: Organ meat: liver, kidney, heart and / or other organ meats
Whole number
Money was spent on meat, fish, or eggs, but none were eaten in the last 7 days. Please confirm.
The household reported consuming this food item during the last 7 days, while all expenditure and acquisition values for the last 30 days are zero. Please verify the responses.
9. How many days over the last 7 days, did members of your household eat: Fish/shellfish: dried, fresh and smoked fish, including canned tuna, and / or other seafood (fish in large quantities and not as a condiment)
Whole number
Money was spent on meat, fish, or eggs, but none were eaten in the last 7 days. Please confirm.
The household reported consuming this food item during the last 7 days, while all expenditure and acquisition values for the last 30 days are zero. Please verify the responses.
10. How many days over the last 7 days, did members of your household eat: Eggs
Whole number
Money was spent on eggs, but none were eaten in the last 7 days. Please confirm.
The household reported consuming this food item during the last 7 days, while all expenditure and acquisition values for the last 30 days are zero. Please verify the responses.
Warning: Number of sub food groups less than the total [num_days_meat_fish_i]
11. How many days over the last 7 days, did members of your household eat: Vegetables and leaves: spinach, onion, tomatoes, carrots, bell peppers, lettuce, cucumber, radish, cabbage etc.
Whole number
Money was spent on vegetables, but none were eaten in the last 7 days. Please confirm.
The household reported consuming this food item during the last 7 days, while all expenditure and acquisition values for the last 30 days are zero. Please verify the responses.
12. How many days over the last 7 days, did members of your household eat: Orange vegetables (vegetables rich in Vitamin A): carrot, red bell pepper, pumpkin, squash, orange sweet potatoes
Whole number
13. How many days over the last 7 days, did members of your household eat: Green leafy vegetables:, spinach, broccoli, amaranth and / or other dark green leaves, wild leaves, chicory, rockets, mulukhiyi
Whole number
14. How many days over the last 7 days, did members of your household eat: Other vegetables: onion, cucumber, radish, tomatoes, eggplants, zucchini etc…
Whole number
Warning: Number of sub vegetables groups less than the total [total_sub_veg_group]
15. How many days over the last 7 days, did members of your household eat: Fruits: banana, apple, lemon, apricot, peach, waterlemon, cherries, etc. (If 0 skip to section r)
Whole number
Money was spent on fruits, but none were eaten in the last 7 days. Please confirm.
The household reported consuming this food item during the last 7 days, while all expenditure and acquisition values for the last 30 days are zero. Please verify the responses.
16. How many days over the last 7 days, did members of your household eat: Orange fruits (Fruits rich in Vitamin A): mango, papaya, apricot, peach
Whole number
17. How many days over the last 7 days, did members of your household eat: Other fruits: Banana, Apple, watermelon, cherry, orange, plum, dates
Whole number
Warning: Number of sub fruits groups less than the total [num_days_fruits_i]
18. How many days over the last 7 days, did members of your household eat: Oil / fat / butter: olive oil, other vegetable oil, gee, Butter, margarine, other fats / oil
Whole number
Money was spent on oil/fats, but none were eaten in the last 7 days. Please confirm.
The household reported consuming this food item during the last 7 days, while all expenditure and acquisition values for the last 30 days are zero. Please verify the responses.
19. How many days over the last 7 days, did members of your household eat: Sugar, or sweet: sugar, honey, jam, cakes, candy, cookies, pastries, cakes and other sweet (sugary drinks)
Whole number
Money was spent on sugar/sugary products, but none were eaten in the last 7 days. Please confirm.
The household reported consuming this food item during the last 7 days, while all expenditure and acquisition values for the last 30 days are zero. Please verify the responses.
20. How many days over the last 7 days, did members of your household eat: Condiments / Spices: tea, coffee / cocoa, salt, garlic, spices, yeast / baking powder, lanwin, tomato / sauce, meat or fish as a condiment, ketchup/hot sauce; u.Maggy cubes, powder; other condiments including small amount of milk / tea coffee
Whole number
Money was spent on condiments/beverages, but none were eaten in the last 7 days. Please confirm.
The household reported consuming this food item during the last 7 days, while all expenditure and acquisition values for the last 30 days are zero. Please verify the responses.
Warning: Number of all food groups can not be equal to ZERO! Kindly go back the questionnaire and make sure to collect the right information

Enumerator Comments/Observations

1. Would you like to add any comments/observations at this stage?
Select one
2. Please enter your comments
Text answer
3. During the last 7 days, did you experience lack of food or money to buy enough food to meet the needs of all your household members?
Select one

Section VI: Coping Strategies

Food Coping Strategies

During the last 7 days, how many days did your household had to use one of the following strategies to cope with a lack of food and/or money to buy food:
1. During the last 7 days, Strategy to cope with a lack of food or money to buy it: Relied on less expensive/less preferred food
Answer should be between 0 and 7 days
Whole number
2. During the last 7 days, Strategy to cope with a lack of food or money to buy it: Borrowed food and/or relied on help from friends/relatives
Answer should be between 0 and 7 days
Whole number
3. During the last 7 days, Strategy to cope with a lack of food or money to buy it: Reduced the number of meals eaten per day
Answer should be between 0 and 7 days
Whole number
4. During the last 7 days, Strategy to cope with a lack of food or money to buy it: Reduced portion size of meals
Answer should be between 0 and 7 days
Whole number
5. During the last 7 days, Strategy to cope with a lack of food or money to buy it: Restricted consumption of adults/mothers in order for young children to eat
Answer should be between 0 and 7 days
Whole number

Food and Non-Food Coping Strategies

1. During the past 30 days, did anyone in your household have to sell household assets/goods (radio, furniture, television, jewellery, etc.) due to a lack of resources to access essential needs (e.g., food, shelter, education, health services, etc.)?
Select one
2. During the past 30 days, did anyone in your household have to spend savings fully or partially due to a lack of resources to access essential needs (e.g., food, shelter, education, health services, etc.)?
Select one
3. During the past 30 days, did anyone in your household have to borrow money to access essential needs (e.g., food, shelter, education, health services, etc.)?
Select one
4. During the past 30 days, did anyone in your household have to reduce or cease payments on essential utilities and bills due to a lack of resources to access other essential needs (e.g., food, shelter, education, health services, etc.)?
Select one
5. During the past 30 days, did anyone in your household have to reduce expenses on education due to a lack of resources to access essential needs (e.g., food, shelter, education, health services, etc.)?
Select one
6. During the past 30 days, did anyone in your household have to sell productive assets or means of transport (sewing machine, wheelbarrow, bicycle, car, etc.) due to a lack of resources to access essential needs (e.g., food, shelter, education, health services, etc.)?
Select one
7. During the past 30 days, did anyone in your household have to reduce expenses on essential health (including medicines) due to a lack of resources to access other essential needs (e.g., food, shelter, education, etc.)?
Select one
8. During the past 30 days, did anyone in your household have to reduce expenses on non-essential health due to a lack of resources to access other essential needs (e.g., food, shelter, education, etc.)?
Select one
9. During the past 30 days, did anyone in your household have to move to less expensive accommodation due to a lack of resources to access essential needs (e.g., food, shelter, education, health services, etc.)?
Select one
10. During the past 30 days, did anyone in your household have to send one or more household members to live elsewhere due to a lack of resources to access essential needs (e.g., food, shelter, education, health services, etc.)?
Select one
11. During the past 30 days, did your household have to withdraw children from school (compulsory education) due to a lack of resources to access essential needs (e.g., food, shelter, education, health services, etc.)?
Select one
12. During the past 30 days, did anyone in your household have to migrate informally/ irregularly due to a lack of resources to access essential needs (e.g., food, shelter, education, health services, etc.)?
Select one
13. During the past 30 days, did any children (under 15 years old) in your household work to contribute to the household income (e.g., casual labour) due to a lack of resources to access essential needs (e.g., food, shelter, education, health services, etc.)?
Select one
14. During the past 30 days, did any minor household members (under 15) migrate informally due to a lack of resources to access essential needs (e.g., food, shelter, education, health services, etc.)?
Select one
15. During the past 30 days, did anyone in your household have to engage in socially degrading, high-risk, exploitive or life-threatening jobs or income-generating activities (e.g., smuggling, theft, joining armed groups, prostitution) due to a lack of resources to access essential needs (e.g., food, shelter, education, health services, etc.)?
Select one
16. During the past 30 days, did anyone in your household have to beg (i.e., ask strangers on the streets for money, food, or other goods) and/or scavenge due to a lack of resources to access essential needs (e.g., food, shelter, education, health services, etc.)?
Select one
17. During the past 30 days, was any female child member (under 15) married off due to a lack of resources to access essential needs (e.g., food, shelter, education, health services, etc.)?
Select one
18. What are the main reasons - i.e. to access which essential needs – that you or other members in your household applied these coping strategies? Note to enumerator: do not list the below as options to the respondent. Instead, mark all those that apply based on the answer provided.
Select all that apply
18.1 Please specify:
Text answer

Enumerator Comments/Observations

1. Would you like to add any comments/observations at this stage?
Select one
2. Please enter your comments
Text answer

Section VII: Household Shelter/Facilities/Assets:

8.1 Housing/Shelter:

1. Type of housing:
Select one
1.1 Is this household currently living in a collective shelter?
Select one
2. Type of occupancy:
Select one
2.1 Please specify:
Text answer
3. Payments are covered through:
Select all that apply
3.1 Please specify:
Text answer
4. How many days worked in exchange of rent per month, please specify:
Whole number
4.1 Please specify:
Text answer
5. How long is the period covered by one rental payment?
Read the options
Select one
6. Is your rent set in USD or LBP?
Select one
7. How much do you pay for your accommodation per month? (in LBP)
Amount in LBP is only amount paid / borrowed in LBP
Number
8. How much do you pay for your accommodation per month? (in USD)
Amount in USD is only amount paid / borrowed in USD
Number
9. Are you late on paying rent ?
Select one
10. How much back rent do you currently owe (rent debt to landlord)(in LBP)?
Amount in LBP is only amount paid / borrowed in LBP
Number
11. How much did you pay rent in the last 30 days? (LBP)
Amount in LBP is only amount paid / borrowed in LBP
Number
12. How much back rent do you currently owe (rent debt to landlord)(in USD)?
Amount in USD is only amount paid / borrowed in USD
Number
13. How much did you pay rent in the last 30 days? (in USD)
Amount in USD is only amount paid / borrowed in USD
Number
14. How many total months of rent would your landlord allow you to incur as debt?
Select one
19. Do you have written proof of rental payment in the past 6 months (Rental cotract, electricity / telephone / water bill)
Select one
20. How many rooms (excluding bathrooms and toilets) are occupied by your household?
Select one
21.How many people are sharing this living space?
Whole number
22. Estimate living space in m2, occupied by Household (excluding toilet and bathroom)?
Number

8.2 Mobility status and determinants

1. Have you changed accommodation in the last 12 months?
Select one
2. How many times have you changed your accommodation?
Whole number
3. Last time you changed your accommodation, please specify the main reason
Select one
3.1 Please specify :
Text answer
4. In case of eviction, what was the given reason?
Select all that apply
4.1 Please specify:
Text answer
5. Did you receive an eviction notice before being evicted?
Select one
6.Who issued the eviction order or notice?
Select one
6.1 Please specify:
Text answer
7. What was the notice period you were given before eviction?
Select one
8. What was the impact of your eviction?
Select all that apply
8.1 Please specify:
Text answer

8.3 Previous type of accommodation:

1. In what accommodation were you living? (previous type of accomodation)
Select one
2. In which district you were living in?
Select one
3. Have you ever been evicted during your stay in Lebanon?
Select one
4. Have you been evicted more than once during your stay in Lebanon?
Select one

8.4 Plan to move and reasons :

1. Have you ever had an incident with your current landlord in the past 6 months?
Select one
2. If yes, specify the incident(s)
Select all that apply
2.1. Please specify - incident with your current landlord
Text answer
3. Do you plan to stay in the same accommodation in the coming 6 months?
Select one
4. If no plan to stay in the same accommodation, specify the main reason:
Select one
4.1. Please specify:
Text answer
5. Are you planning to move in with other relatives
Select one
6. What accommodation do you plan to move to ?
Select one

8.5 WASH Facilities

Water

1. What is the main source of household drinking water?
Select one
2. Please specify main source of household drinking water
Text answer
3. Aside from this main source, does your household use other sources of water for drinking?
Select one
4. if yes, which one
Select one
4.1 Please specify other source of household drinking water
Text answer
5. If the main water source for your household is a piped connection did you receive any water from it in the past week
Select one
6. For main source of household drinking water; how long does it take to go there, collect water, and come back?
Select one
7. If “don’t know” then read the following options:
Select one
8. Please specify number of minutes
Whole number
9. In the last 30 days, has there been any time when your household did not have sufficient quantities of drinking water?
Select one
10. If Yes, Why?
Select all that apply

11. In the last 30 days, has there been any time when your household did not have sufficient quantities of water for the following domestic uses?

Cooking / food preparation
Select one
Personal hygiene, such as handwashing or bathing
Select one
Household cleaning, such as mopping or washing clothes
Select one
Toilet use
Select one
12. Can you please show me where members of your household most often wash their hands?
Select one
13. Observe availability of water at the place for handwashing
Select one
14. Observe availability of soap or detergent at the place for handwashing
Select one
14.1 Please specify
Text answer
15. Do you share a handwashing facility with other households?
Select one
16. In the last month, did you pay for drinking water?
Select one

Drinking Water

17. how much money have you spent on drinking water?
a. Cash and Credit (in LBP):
Number
18. In the last month, did you pay for bottled drinking water?
Select one

Bottled Drinking Water

19. how much money have you spent on bottled drinking water?
a. Cash and Credit (in LBP):
Number
20. In the last month, did you pay for private water trucking?
Select one

Private water trucking

21. how much money have you spent on private water trucking?
a. Cash and Credit (in LBP):
Number
22. In the last 12 months, did you pay for public water network (water authority)?
Select one

Public water network

23. In the last 12 months, how much did you pay for public water network (water authority - in LBP)?
a. Cash and Credit (in LBP):
Number
24. In the last month, did you pay for private borehole?
Select one

Private borehole

25. how much money have you spent on private borehole ?
a. Cash and Credit (in LBP):
Number
25. Do you treat your water in any way to make it safer to drink?
Select one
26. What do you usually do to the water to make it safer to drink?
Select all that apply
26.1 Please specify what do you usually do to the water to make it safer to drink
Text answer
27. What is the main source of water used by members of your household for other purposes than drinking?
Select one
27.1 Please specify the primary source of water used for washing and other household uses
Text answer
28. Did you have sufficient water for washing and domestic purposes in the last month?
Select one
29. If barely or not, Why?
Select all that apply
29.1 Please specify
Text answer
30. What kind of toilet/latrine does the household use?
Select one
30.1. Please specify
Text answer
31. Has your [type_of_toilet_s] ever been emptied?
Select one
32. How many bathrooms (or washrooms) does your household have access to?
Whole number
33. How many individuals in total use this toilet facility, including yourself?
Whole number
34. How many toilets/latrines does your household have access to?
Whole number
35. Do you share this facility with others who are not members of your household?
Select one
36. If Yes, How many households use this sanitation facility (latrine/toilet)?
Respond with 999 if refuse to answer
Whole number
37. What is the volume of water tank? (in liter, 1 barrel is 200 liters)
Whole number
38. Do you have sufficient bins for disposing solid waste in your area?
Select one
39. Is the municipality collecting the solid waste on a regular basis in the last month (The waste doesn’t pile up at the location)?
Select one
40. How is the household waste managed?
Select one
41. Please specify how is the household waste managed:
Text answer

8.6 Sanitary:

1. Does the household have enough access to the following?
2. Personal hygiene items (soap, toothbrush/paste, other personal hygiene items):
Select one
3. Cleaning/hygiene items (laundry detergent, cleaning products etc):
Select one
4. Female Hygiene items (pads / Sanitary pads)
Select one
5. Do female members have problems related to accessing menstrual materials? If yes, which ones?
Select all that apply
5.1 Please specify:
Text answer
6. Baby care items (diapers etc):
Select one

8.7 Energy

1. Do you have access to electricity for your household purposes such as lighting, refrigerator, AC and other electronics?
Select one
2. Which of the following sources of electricity are used for power in this household?
Select all that apply

8.7.1 Energy Source

3. During 24 hours how many hours do you have electricity from the following sources?
3.1 Electricity (EDL or Zahle electricity)
Whole number
3.2 Diesel generator (private generator service):
Whole number
3.3 Solar PV :
Whole number
3.4 Other renewable power (batteries, solar lamps, etc):
Whole number
The sum of hours captured from the different electricity sources above are more than 24 hours (total now : [elect_tot_hours])

Electricity (EDL or Zahle electricity)

4. In the past 30 days, how much money have you spent on Electricity (EDL or Zahle Electricity)?
a. Cash or Credit (in LBP):
Write 0 if no expenditure
Number

Electricity (Private Generators)

5. In the past 30 days, how much money have you spent on Electricity (Private Generators)?
a. Cash or Credit (in LBP):
Write 0 if no expenditure
Number

Electricity (other source: battery, lighting, solar power, etc.)

6. In the past 30 days, how much money have you spent on Electricity (other source: battery, lighting, solar power, etc.) ?
a. Cash or Credit (in LBP):
Write 0 if no expenditure
Number
7. Who is collecting your bills for electricity grid?
Select one
7.1. Please specify:
Text answer
8. How often do you pay your electricity bills?
Select one
9. Who is collecting your bills for diesel generator?
Select one
9.1 Please specify:
Text answer
10. How often do you pay your bill for diesel generator?
Select one
11. In the past winter what was your energy sources for heating?
Select all that apply
12. Please specify energy sources for heating:
Text answer
13. Did your household have sufficient supply of heating energy during the last winter?
Select one
14. What are your energy sources for cooking?
Select all that apply
15. Please specify energy sources for cooking:
Text answer
16. Did your household have sufficient supply of energy for cooking in the last month?
Select one
17. Please observe and select the assets owned by the household
Select all that apply
18. Please select the list of the assets you use for work or income generation?
Select all that apply

8.8 Shelter/WASH Conditions/Referral (Observation):

Are any of the following observable Inside/outside the household shelter/property?
Select one
1. Shelter collapsed or partially collapsed:
Select one
2. Damaged roof
Select one
3. Damaged columns
Select one
4. Damaged walls
Select one
5. Windows/doors are not sealed to natural elements
Select one
6. Leaking roof
Select one
7. Leakage / rottenness in the walls / floors
Select one
8. Water pipes not functional
Select one
9. Sanitation pipes not functional
Select one
10. Latrine/toilet is not useable (damaged, full, no handwashing facilities, etc.)
Select one
11. Bathing/washing facilities are not useable (damaged, no privacy, etc.)
Select one
12. Electricity installation/connection are not adequately installed or not safe
Select one

Enumerator Comments/Observations:

1. Would you like to add any comments/observations at this stage?
Select one
2. Please enter your comments:
Text answer

Section VIII: Critical Information

A. Health

1. If anyone in the Household requires urgent medical attention, do you know how to access medical services/assistance?
Select one
2. In the last 3 months, what barriers did the household members experience to prevent from accessing primary health care needed, excluding medication? (Select up to 3 most important).
Select all that apply
3. In the last 3 months, what barriers did the household members experience to prevent from accessing secondary health care needed, excluding medication? (Select up to 3 most important).
Select all that apply
4. Was there any death in the last 3 months in your Household ?
Select one
5. How many deaths have occurred in your household in the past 3 months?
Whole number
6. How many deaths have occurred in your household inside hospitals?
Whole number
7. How many deaths have occurred in your household outside hospitals?
Whole number

Medical Barriers

8. Did any of your household members need medication?
Select one
9. If YES, what type of medication?
Select one
10. If yes, were you able to access the medication needed?
Select one
11. What barriers if any did your household experience that prevented you from accessing the medication you needed in the past 3 months? (Select up to 3 most important)
Select all that apply

Coping Mechanisms

12. If your household needed to access medication in the past 3 months, what coping mechanisms has your household employed to adjust to the inaccessibility of medication in Lebanon? (Select up to 3 most frequently used)
Select all that apply
13. If your household needed to access healthcare in the past 3 months, what coping mechanisms has your household employed to adjust to barriers in accessing healthcare in Lebanon?
Select all that apply

B. Safety & Security

1. How safe do women and girls in your household feel about walking alone in your area or neighborhood at night? (ask adult women if present in household)
Select one
2. How safe do men and boys in your household feel about walking alone in your area or neighborhood at night?
Select one
The next couple of questions will pertain to your household's SAFETY and SECURITY
3. What do you think are the main safety and security concerns for women in this area? (Select all that apply)
Select all that apply
3.1 If other, please specify
Text answer
4. What do you think are the main safety and security concerns for girls (<18) in this area? (Select all that apply)
Select all that apply
4.1 If other, please specify
Text answer
5. Are there any areas in your location that women and girls avoid because they feel unsafe?
Select one
6. What areas (or places) do women and girls in your community avoid or feel unsafe about?
Select all that apply
6.1 If other, please specify
Text answer
7. What do you think are the main safety and security concerns for boys (<18) in this area? (Select all that apply)
Select all that apply
7.1 If other, please specify
Text answer
8. What do you think are the main safety and security concerns for men in this area? (Select all that apply)
Select all that apply
8.1 If other, please specify
Text answer
9. Are there any areas in your location that men and boys avoid because they feel unsafe?
Select one
10. What areas (or places) do men and boys in your community avoid or feel unsafe about?
Select all that apply
10.1 If other, please specify
Text answer
11. What do you think are the main safety and security concerns for women and girls (<18) with a disability in this area? (Select all that apply)
Select all that apply
11.1 If other, please specify
Text answer
12. What do you think are the main safety and security concerns for men and boys (<18) with a disability in this area? (Select all that apply)
Select all that apply
12.1 If other, please specify
Text answer
13. In the past three months, have you or a family member experienced the inability to enter stores or buy food because of nationality
Select one

Sexually exploited

15. Do you agree that a husband is justified in hitting or beating his wife for the below reasons
Select one
[A] If she goes out without telling him?
Select one
[B] If she neglects the children?
Select one
[C] If she argues with him?
Select one
[D] If she refuses to have sex with him?
Select one
[E] If she burns the food?
Select one

Sexually exploited in the past 3 months

16. Have you heard of any case where a refugee (woman, girl, boy, man) was sexually exploited/abused in the past 3 months in accessing any of the below?
Select one
a. Housing (in relation to rent)
Select one
b. Food (in relation to higher price/limited availability)
Select one
c. Other commodities in the market (in relation to higher price/limited availability)
Select one
d. Health services (in relation to higher price/limited availability)
Select one
e. Jobs (in relation to limited availability)
Select one
f. Legal documents (in relation to higher needs)
Select one
g. Any other humanitarian assistance (in relation to bigger needs)
Select one
g.1 Others (please indicate what it is and also rate it)
Text answer
17.How frequently do refugees in this town/village interact with host communities?
Select one
18.In the last three months, have you personally witnessed a physical confrontation in your area involving at least one Syrian refugee?
Select one
19. If yes, select the type of confrontation:
Select one

Gender Base Violence

Introduction: we will now ask you a few questions about gender-based violence in your communities. This refers to all types of violence against women and girls as well as sexual violence against men and boys.
20. If Women or a girl in your community experienced violence and asked you for help, would you know where to safely refer them for confidential support?
Select one
20.1 What type(s) of support would you be able to refer them to? (Select all that apply)
Select all that apply

Interaction with Syrians

21. I am going to read you a list of locations where you might interact with Syrians.
For each, will you please tell me how often over the last 3 months you have had contact with Syrians in each area?
21.1. At work
Select one
21.2. Social circles
Select one
21.3. Paying rent
Select one
21.4. In the street
Select one
21.5. In the shop
Select one
21.6. Religious events
Select one
21.7. Activities organized by NGOs or local organizations
Select one
22. how would you describe current relations between Lebanese and Syrians who live in this area? Would you say they are positive or negative?
Select one

Host community - refugee community tensions

23. What are the three main sources of tensions between Lebanese and Syrians in your community, or do you think there are no real tensions?
First
Select one
Specify other:
Text answer
Second
Select one
Specify other:
Text answer
Third
Select one
Specify other:
Text answer
24. What kind of assistance do you think drive community tensions
Select all that apply
24.1 Please specify:
Text answer
25. What can be done to mitigate this?
Select all that apply
25.1 Please specify:
Text answer
26. What do you think would improve refugee host community relations in this area?
Select all that apply
26.1. Please specify:
Text answer
27. How would you describe relations between refugees in this area?
Select one
28. Are there any curfews currently imposed in the area where you live?
Select one
28. Is there any curfews specifically imposed on Syrians in the area you are living?
Select one
30. Who is imposing the curfew?
Select all that apply
30.1. Please specify Who is imposing the curfew:
Text answer
31. What actions are being applied when the curfew is breached?
Select all that apply
31.1 Please specify What sanctions are being applied when the curfew is breached:
Text answer
32. What is the impact of the curfew on your household?
Select all that apply
32.1. Please specify
Text answer
33. is this curfew timebound or continuous?
Select one
34. Are there any assosciated reasons for the curfews in your area?
Select all that apply
34.1. Please specify
Text answer

C. Child Discipline

Adults use certain ways to teach children the right behaviour or to address a behaviour problem. I will read various methods that are used. Please tell me if you or anyone else in your household has used this method with in the past month with any of the children.
Select one
1. Child Discipline: Took away privileges, forbade something he/she liked or did not allow him/her to leave the house
Select one
2. Child Discipline: Explained why persons behaviour was wrong.
Select one
3. Child Discipline: Shook him/her
Select one
4. Child Discipline: Shouted, yelled at or screamed at him/her
Select one
5. Child Discipline: Gave him/her something else to do
Select one
6. Child Discipline: Spanked, hit or slapped him/her on the bottom with bare hand
Select one
7. Child Discipline: Hit him/her on the bottom or elsewhere on the body with something like a belt, hairbrush, stick or other hard object
Select one
8. Child Discipline: Called him/her dumb, lazy, or another name like that
Select one
9. Child Discipline: Hit or slapped him/her on the face, head or ears
Select one
10. Child Discipline: Hit or slapped him/her on the hand, arm, or leg
Select one
11. Child Discipline: Beat him/her up, that is hit him/her over and over as hard as one could
Select one
12. Do you believe that in order to bring up, raise, or educate a child properly, the child needs to be physically punished?
Select one

D. Critical household Information

1. Did all household members arrive in Lebanon at the same time?
Select one
2. When did all household members arrive in Lebanon?
If you do not know the exact day and month, please enter 01.01.YYYY.
Date
3. When did the FIRST household members arrive in Lebanon?
If you do not know the exact day and month, please enter 01.01.YYYY.
Date
4. When did the LAST household members arrive in Lebanon?
If you do not know the exact day and month, please enter 01.01.YYYY.
Date

Returns

1. What is your household’s preferred durable solution?
Select one
2. Is anyone in your household intending to return to Syria within 12 months?
Select one
3. In the last 6 months, what concrete actions did you take regarding return?
Select all that apply
4. What are the three main barriers in your area of origin that prevent your household from returning?
Select all that apply
5. Please specify the other barrier in Syria / area of origin.
Text answer
6. What are the three main barriers in Lebanon that prevent your household from returning?
Select all that apply
7. Please specify the other barrier in Lebanon.
Text answer
8. Do you have any relatives in Syria in the intended return area?
Select one
9. In the last 12 months, have you spent money on assets or repairs intended for Syria?
Select one
10. In the last 12 months, have any household members travelled to Syria?
Select one
Has your household had to leave its usual place of residence because of the war in Lebanon?
Select one

Section IX Displacement

When was the most recent time you have been displaced from your usual place of residence?
Date
Have you returned to your usual place of residence? (Village)
Select one
What are the main reasons why your household has not returned to your usual place of residence?
Select all that apply
Please specify:
Text answer

Accountability to affected people (AAP)

1. Has your household received any humanitarian aid in the past 12 months?
Definition of aid: Any humanitarian assistance and/or protection provided by the ongoing humanitarian response. The recall period recommended is 30 days. However, for more dynamic contexts, a shorter recall period can be considered if needed.
Select one
2. If yes, was your household satisfied with the aid you received?
Select one
3.If you were not satisfied, why were you not satisfied with the aid received? (select all that apply)
Select all that apply
3.1 Please specify:
Text answer
4. Did the agency explain how to report a complaint to them or how to provide feedback about the assistance to them?
Select one
4.1 Were you able to report a complaint?
Select one
5. What barriers (if any) has your household experienced in trying to access assistance in the past three months?
Select all that apply
6. Are you and other members of your household satisfied with the way aid workers generally behave in your area?
Select one
6.1 If not satisfied, why not?
Select all that apply
6.1.1 Please specify:
Text answer
7. What are the top three priority needs of your household? (select up to 3)
Select all that apply
7.1 Please specify:
Text answer
8. Do you know how to report a feedback on a humanitarian program or a complaint against a humanitarian staff?
Select one
9. Do you know how to provide feedback on a humanitarian programme?
Select one
10. Do you know how to report a complaint against humanitarian staff?
Select one
11. What challenges (if any) do you face in lodging a complaint or providing feedback on assistance you recieved? (Select all that apply)
Select all that apply
11.1 Specify other:
Text answer
12. How would your household prefer to give feedback to aid agencies about the aid you are receiving and bad behaviour/misconduct of aid workers ? (select up to 3)
Select all that apply
12.1 Please specify:
Text answer
13. What is your household's preferred means (channel) of receiving information?
Select all that apply
13.1 Please specify:
Text answer
14. What type of Information would your household prefer to receive from humanitarian aid actors?
Select all that apply
15. Are the following services available in your community?
Select all that apply
16. Do you have an active card on which you are receiving cash assistance?
Select one
17. If yes, how much money has your household redeemed or spent from your Card in the past 30 days?
a. in USD:
Write 0 if no expenditure
Amount in USD is only the amount paid/borrowed in USD
Number
b. in LBP:
Write 0 if no expenditure
Amount in LBP is only amount paid / borrowed in LBP
Number

17. Have you ever used your assistance card – whether cash or food e-card – as collateral? This means leaving your card with another person in order to assure a debt you owe would be repaid.

17.1 Kept with the shop owner?
Select one
17.2 Kept with money lender?
Select one
17.3 Kept with landlord?
Select one
17.4 Is your card currently physically with someone to whom you owe money?
Select one
17.5 Please specify:
Text answer

Communication means

1. Does any member of your household have a smart mobile phone (one that can connect to the internet, ex: has whatsapp etc..?)
Select one
2. Do they have a valid Lebanese SIM card?
Select one
3. Do you have an active data plan on the smartphone ?
Select one
4. Does your household have access to internet at home through WiFi?
Select one
5. Are you active on social media?
Select one
6. If yes, what means do you use?
Select all that apply
6.1 Specify other:
Text answer
7. How active are you on those platforms?
Select one
8. Would any member of your family prefer to receive a voice message instead of a text message through whatsapp?
Select one
9. What barriers do older persons or persons with disabilities in the household face in accessing information?
Select all that apply

Section X: Household Address and Contact Information

1. Are updates to household contact details/address required? (Confirm all current details; If yes, go to questions below)
Select one

Contact Information

UNHCR, UNICEF, and WFP will be conducting a phone survey about the situation of children, families and households in the future. We would like to invite you to participate in this phone survey. If you agree to participate, we will ask you to share a phone number we can reach you at and convenient times to contact you. The phone interview will take about 20 minutes, and we may call you a few times over a period of a few months. Participation in this phone survey is voluntary, and even if you agree to participate now, you may decide to withdraw from participation in the future. There will be no costs to you for participating in the phone survey. Please know that all the information you share during future phone interviews will remain strictly confidential, and your phone number will not be shared with anyone outside our team. Would you like to share your number?
Select one
2. What is your current phone number?
Phone number should have the following format: XXXXXXXX (example: 03123456)
Text answer
3. Are there any other phone numbers you can be contacted on?
Select one
4. What is the other phone number you can be contacted on?
Phone number should have the following format: XXXXXXXX (example: 03123456)
Text answer
5. Updated/additional address information:
6. Confirm address:
Select one
7. Please enter new address:
Text answer
8. Description of location (landmarks, main/cross roads, permanent physical features etc)
Text answer
9. Closest municipality:
Text answer

Final Section

1. Household comments if any (comment box)
Text answer
2. Who were the main respondent(s) of the questionnaire?
This question should be answered by the data collector
Select one
3. Specify other:
Text answer
4. Add enumerators comments if any (comment box)
This question should be answered by the data collector
Text answer