Mott McDonald - Post Enrollment Survey - RSBY Haryana

Final Report
Pilot Post-enrolment Survey of the RSBY

Programme in Haryana
March 2011

Ministry of Labour & Employment
Confidential

267157 MCD ISA 1 0
C:\Documents and Settings\rud49027\Desktop\RSBY\RSBY
Haryana.doc
29 March 2011

Final Report
Pilot Post-enrolment Survey of the RSBY Programme in
Haryana
March 2011
Ministry of Labour & Employment
Confidential
Mott MacDonald, A20, Sector 2, Noida 201301, Uttar Pradesh, India
T +91 (0)12 0254 3582 F +91 (0)12 0254 3562, www.mottmac.com
Mrs. Urmila Goswami, Under Secretary, Ministry of Labour & Employment,
Jaisalmer house 26 Mansingh Road, New Delhi-110011

Final Report
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Mott MacDonald, A20, Sector 2, Noida 201301, Uttar Pradesh, India
T +91 (0)12 0254 3582 F +91 (0)12 0254 3562, www.mottmac.com
Revision Date Originator Checker Approver Description
A 30/11/2010 Priyanka
Bandopadhaya &
Bhaval Hemrajani
Nabaneeta Rudra Shoma Majumdar Draft Report
B 28/3/2011 Anisur Rahman &
Bhaval Hemrajani
Nabaneeta Rudra Shoma Majumdar Final Report

Issue and revision record
This document has been prepared for the titled
project or named part thereof and should not be
relied upon or used
for any other project without an independent check
being carried out as to its suitability and prior
written authority of
Mott MacDonald being obtained. Mott MacDonald
accepts no responsibility or liability for the
consequence of this document being used for a
purpose other than the purposes for which it was
commissioned. Any person using or relying on the
document for such other purpose agrees, and will
Mott MacDonald accepts no responsibility or
liability for this document to any party other than
the person by whom it was commissioned.
To the extent that this document is based on
information supplied by other parties, Mott
MacDonald accepts no liability for any loss or
damage suffered by the client, whether contractual
or tortious, stemming from any conclusions based
on data supplied by parties other than Mott
MacDonald and used by Mott MacDonald in
preparing this document.

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Chapter Title Page
1. Introduction 1
1.1 The Study Area ____________________________________________________________________ 1
1.2 The Client _________________________________________________________________________ 2
1.3 Project Brief _______________________________________________________________________ 2
1.4 Study objectives ____________________________________________________________________ 3
1.5 Scope of Work _____________________________________________________________________ 3
1.6 Approach & Methodology _____________________________________________________________ 4
1.7 Secondary Research ________________________________________________________________ 5
1.8 Primary Survey of Households_________________________________________________________ 9
1.9 Study Limitation ___________________________________________________________________ 12
2. Study Output 14
2.1 Socio-economic and demographic status of the household __________________________________ 14
2.2 Status of debts and poverty of the households____________________________________________ 17
2.3 Access to Information for Households __________________________________________________ 18
2.4 Consumption Pattern of the Households ________________________________________________ 20
2.5 Health and morbidity related information ________________________________________________ 21
2.6 Awareness about the Rashtriya Swasthya Bima Yojna _____________________________________ 22
2.7 Process of Enrolment _______________________________________________________________ 23
2.8 Satisfaction of Respondents to RSBY Scheme ___________________________________________ 24
2.9 Benefited Status of the Respondents ___________________________________________________ 24
2.10 Case Studies _____________________________________________________________________ 24
3. Key Issues and Suggestions 24
Appendix A. Study Tool _______________________________________________________________________ 24

Content

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1.1 The Study Area
The state of Haryana is bounded by Uttar Pradesh in the east, Punjab
in the west, Himachal Pradesh in the north and Rajasthan in the south.
The Union Territory of Delhi juts into Haryana and is encompassed by it
on three sides. The south west of the Haryana is dry sandy and barren.
The natural boundaries are: the Shivalik hills in the north, River
Yamuna in the east and river Ghaggar in the west. The south western
boundary is provided by the range of Aravalli hills, which run through
southern Delhi and the Gurgaon district up to Alwar. There are some
high ridges running from the north-west to south-east with numerous
spurs branching out in all directions. These hills are known as the Morni
and Tipra ranges. They belong to the outer ranges of the Himalayas.
With an area of 44,212 sq km, Haryana is home to 21.14 million. The
state has 20 districts, 119 blocks and 6,955 villages. The decadal
growth rate of the state is 28.43percent, and population density of 478
per sq km.
Haryana has the highest population of Hindus (84percent) followed by
Sikhs 15 percent, Muslims 1percent, Jains 0.3percent, Christians
0.1percent and Buddhists 0.03percent. Immigrants from Bihar, Bengal
and Nepal can also be seen in the state. The Total Fertility Rate of the
State is 2.6. The Infant Mortality Rate is 54 and Maternal Mortality Ratio
is 186 (SRS 2004 - 06) which are lower than the National average. The
Sex Ratio in the State is 861 (as compared to 933 for the country).
Comparative figures of major health and demographic indicators are
provided in table 1.1
Table 1.1: Demographic, Socio-economic and Health profile of Haryana as compared to all-India figures
S. No. Item Haryana India
1 Total population (Census 2001) (in million) 21.14 1028.61
2 Decadal Growth (Census 2001) (percent) 28.43 21.54
3 Crude Birth Rate (SRS 2008) 23.0 22.8
4 Crude Death Rate (SRS 2008) 6.9 7.4
5 Total Fertility Rate (SRS 2007) 2.6 2.7
6 Infant Mortality Rate (SRS 2008) 54 53
7 Maternal Mortality Ratio (SRS 2004 - 2006) 186 254
8 Sex Ratio (Census 2001) 861 933
9 Population below Poverty line (percent) 8.74 26.10
10 Schedule Caste population (in million) 4.09 166.64
11 Schedule Tribe population (in million) 0 84.33
12 Female Literacy Rate (Census 2001)
(percent)
55.7 53.7
1. Introduction

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Haryana is one of the most agrarian states in India. Famous for wheat
and milk production, it is hard to overlook the industrial revolution in the
state. The landlocked state also houses Indias largest automobile
manufacturer, Maruti Udyog Limited, and the worlds largest
manufacturer of two-wheelers, Hero Honda Limited. Besides
manufacturing, the states economy relies on retailing and information
outsourcing as well. A number of Special Economic Zones puts
Haryana in the list of the most industrialised states of India. The
contribution of primary, secondary and tertiary sectors for the Gross
State Domestic Product in 2007-08 was Rs 21,265.92 crore, Rs
30,919.95 crore and Rs 49,133.55 crore respectively (Source:
Economic Survey 2009).
1.2 The Client
The Ministry of Labour and Employment, Government of India has a
mandate to provide Safety, health, welfare and Social security to labour
class. With this mandate they have launched Rashtriya Swasthya Bima
Yojana (RSBY) on 1st April 2008. The scheme aims to provide health
insurance coverage for Below Poverty Line (BPL) families. The
objective of RSBY is to provide protection to BPL households from
financial liabilities arising out of health shocks that involve
hospitalization. Beneficiaries under RSBY are entitled to hospitalization
coverage up to Rs. 30,000/- for most of the diseases that require
hospitalization.
1.3 Project Brief
RSBY scheme involves both public and private sector insurers and
medical facilities and is proposed to be implemented through a
contractual arrangement with individual state governments. The
minimum guidelines are provided by the GOI, which would also bear
the majority of the costs of paying the insurance premium for BPL
households. These households would, in turn, be required to pay a
nominal registration fee (Rs 30) and would be issued a smart card that
would certify their eligibility and facilitate transactions. The scheme
would be rolled out over a five year period based on participation by
state governments and selection of districts.
A key role is envisaged for the insurers in order to register and service
the BPL households, many of whom will live in rural areas with limited
access to formal sector financial services. The insurers will in turn have
contract with the providers of the smart card technology solution as per

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the guidelines issued by the GOI. All the financial and non-financial
transactions will be processed and stored on the smart card using
special smart card reading devices. The insurers will be obliged to
share the sub-set of the data accumulated as part of the operation with
the GOI.
A dedicated team (the Cell) is being established within the Ministry to
project manage implementation of the program, including providing
guidance on operational issues, and planning, facilitating capacity
building, operationalizing monitoring and evaluation mechanisms, etc.
The Cell will include a team of technical experts in the range of the
related fields, including policy, operational, IT and legal. It will also
outsource various activities.
To support the work, the GoI and World Bank (WB) have agreed to
have an investment TA project to support RSBY roll-out. To this end, a
Project Preparation Facility (PPF) has been signed between GoI and
WB which will finance first year activities as an advance on the Project
credit. This will finance various consultancy services to Ministry of
Labour & Employment (Ministry).
The Ministry intends to undertake a post enrolment survey in Haryana
(Faridabad and Yamuna Nagar) and has awarded a consultancy for the
same. The Ministry has provided a list 2200 households in each of the
States, out of which 2000 households have been contacted for
collecting information related to socio-demographic, health and
morbidity issues under this study by the consultant team.
1.4 Study objectives
The following are the objectives of the post-enrolment survey;
Implementation of a post-enrolment survey in the select districts
Faridabad and Yamuna Nagar in Haryana.
Completion of an implementation report on the household survey
including cases of households not covered due to extenuating
circumstances (e.g. inability to locate or household unwilling).
Completion of the database detailing responses of all the household
surveys in appropriate format for subsequent analysis.
1.5 Scope of Work
Following is the scope of work for the proposed assignment:
Implementation of Post-Enrolment Survey of households eligible to
enrol in the RSBY scheme of GOI, which are carried out after the
completion of enrolment activities in the region surveyed.

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Collection of socio-demographics, health and morbidity, enrolment
status, after visiting sample households
Development of a questionnaire together with Ministry and the World
Bank;
The piloting of the questionnaire in a minimum of 20 households in
Haryana.
Locate households to be interviewed;
Completion of household interviews on a sample size as mentioned
in the ToR
Delivery of the implementation report and completed dataset, the
latter to be available in its entirety to the Ministry and the World
Bank.
Provide input for the RSBY on the characteristics of households who
are choosing to enrol under the RSBY scheme versus those who are
not. This will allow GOI and the state nodal agency to understand the
impediments to enrolment.
1.6 Approach & Methodology
In the present study both quantitative research methods have been
used. An efficient and effective plan has been formulated for collection
of primary and secondary information, analysis of data and report
preparation.
The detailed methodology adopted for the study is described below:
1.6.1 Team Mobilisation
A multi-disciplinary team of appropriate personnel with experience in
the relevant area and field research were deployed for undertaking this
assignment. The project implementation team comprised of Project
Director, Project Manager and key Researchers. The core team
included professionals with expertise in the field of Social & Rural
Development.
Meetings were organised with the Client and the World Bank team. In
the meeting, the study team of Mott MacDonald discussed their
understanding on sampling and other requirements for the proposed
assignment and also received feedback from them. This preliminary
meeting formed the basis for finalising the work plan, data collection
processes, study areas, reporting schedules and the associated
timelines. Based on the familiarity gained by us during meetings, our
approach & methodology was fine tuned and then revised one was
submitted in our Inception report.

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Figure 1.1: Approach & Methodology

`

The assignment was carried out in three major stages, viz.: (1)
Secondary/Desk Research; (2) Field Survey, i.e., Primary Data
Collection; and (3) Data Collation, Analysis and Report preparation.
1.7 Secondary Research
A desk review has been undertaken for collecting all background
information and documents available, including previous studies, all
these will be reviewed as well as our team visiting the study sites would
obtain the following documents for extraction of relevant information on
the training needs of the stakeholders and scope in the project area.
List of documents that were provided to the study team by The client is
given below.

List of BPL households in the study area
Methodology
Secondary Research
Plan of Action
Primary
Final Report
Analysis & Report Writing
Quantitative Data Qualitative Data

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List of BPL households enrolled in the study area
List of BPL households enrolled and availed benefit in the study
area;

The secondary research was used as a base for planning the primary
research, which includes its planning, coverage, identifying the study
sites, the stakeholders to be contacted, and designing the
questionnaires/checklist for data collection.
1.7.1 Sampling & Primary Research
As per ToR, the survey has been conducted using quantitative method
but semi- structured questionnaire enabling us to capture few
qualitative information.
The sampling was done in due consultation with The World Bank with
input from the Government of India.
As per the design, the survey has been conducted in 2000 households
designated as Below the Poverty Line (BPL) in Haryana using the
census of BPL households in the states. As per the Terms of Reference
(ToR), we expect the client to provide us the list of beneficiary
households in each state along with following:
the name of the head of household;
the name of the father of the head of household
RSBY card number of the households
Family ID of the households
We have then located the households using the address field in each
state. As per ToR, it was expected that the households would be
located in 100 villages in Haryana.
We found during the survey that certain sampled households could not
be found, either because they had moved away or because addresses
provided to us was wrong. Thus, the additional some extra (20%)
sample names in the list that were considered as buffer, have replaced
the original sample in case of missing households.
This is primarily a household survey and we have contacted the head of
the household. Our study team had both male and female field
investigators who were well versed in local language. The respondents
for this survey were the head of the household.

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1.7.2 Sampling process
After reviewing the BPL data and RSBY enrolment and transaction
data, it was evident that the sampling process needed to take into
account the three observations.
Only a small percentage of RSBY beneficiaries are hospitalized, so
these type of households was to be over sampled.
Secondly, only about a quarter of villages have RSBY beneficiaries
being hospitalized.
Thirdly there are about one tenth of villages having no BPL families
enrolled into RSBY.
The last two observations indicate that stratification on villages was
needed if the survey was to shed light on the second and third
observations.
As discussed above, the population- BPL households consisted of
three categories:
H
bpl
- bpl family not enrolled
H
enr
bpl family enrolled into RSBY, with no hospitalization
H
hosp
- bpl family enrolled and with hospitalization
Due to the difference in composition of the three categories of BPL
households, villages were classified into three types:
V
no
- no enrollment
V
enr
- with enrollment but no hospitalization
V
hosp
- with hospitalization;
If we denote N
i
the total number of bpl households in village i, N
i
bpl
,
N
i
enr
, and N
i
hosp
the total number of each category of bpl households in
the village respectively, then the following table summarizes the
definition of the three types of villages (Table 1.2).
Table 1.2: Category of Respondents
Type of village Total number of BPL
households
Number of H
bpl
Number of H
enr
Number of H
hosp

V
no
N
i
= N
i
bpl
N
i
bpl
0 0
V
enr
N
i
= N
i
bpl
+ N
i
enr
N
i
bpl
N
i
enr
0
V
hosp
N
i
= N
i
bpl
+ N
i
enr
+ N
i
hosp
N
i
bpl
N
i
enr
N
i
hosp

The sampling process had two stages. The first stage was to select
villages within each of three groups as defined in the above table. It
was decided in due discussion with the client that in each district a

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sample 50 villages and 20 bpl households were to be covered in each
sampled village. Based on our discussions with the World Bank and
The Ministry of Labour, the study team was told to select 5 villages from
Vno type of villages, 15 villages from Venr type of villages and 30
villages from Vhosp type of villages.
The table below gives the distribution of the number of villages under
different types in the first stage sampling process. For example within
group V
hosp
, 30 villages were selected out of Q
hosp
villages using PPS
(Population proportionate to sampling) with size being number of RSBY
households with hospitalization (Table 1.3), sampled villages are
attached in Appendix-1.
Table 1.3: Number of Villages Sampled Per Category
Type of village Number of villages Number of sampled villages PPS sampling method
V
no
Q
no
5 N
bpl

V
enr
Q
enr
15 N
enr

V
hosp
Q
hosp
30 N
hosp

The second stage was to select 20 BPL households under different
types within each of sampled villages. In case of Vhosp type of villages,
it was decided if there would be lesser than Vhosp households, then the
remaining samples would be distributed equally between the other two
household categories i.e. Vno and Venr type of households (Table 1.4).
Table 1.4: Calculation of Sample per Category
Type of
sampled
village
Total number
of sampled
BPL
households
Number of sampled
H
bpl

Number of sampled
H
enr

Number of
sampled H
hosp

V
no
20 20 0 0
V
enr
20 10 10 0
V
hosp
20 0.5*(20-
Min(20,N
i
hosp
))
0.5*(20-
Min(20,N
i
hosp
))
Min(20,N
i
hosp
)
The sampling parameters were adjusted to find a combination, which
gives sufficiently large number of sampled households for all three
household groups. Another activity before proceeding was to check
whether all villages have sufficiently large number of bpl households to
start with. If not, one option was to combine villages within Panchayat
until the accumulated unit has sufficiently large number of bpl
households.

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1.8 Primary Survey of Households
The main survey was carried out by visiting 2000 households in the
state of Haryana using semi- structured questionnaire, so that we could
capture few qualitative information. As per sampling plan discussed
with Client we have covered 1000 households in the district of
Faridabad and Yamunanagar each and contacted head of the
household or any other adult member of the household who was
available at the time of survey. In our sample we have covered three
following categories of households:
Category 1 - bpl family not enrolled
Category 2 bpl family enrolled into RSBY, with no hospitalization
Category 3 - bpl family enrolled and with hospitalization
The sampled households for each category as well as actual coverage
in district Jamnagar and Kutch is mentioned in table 1.5 and 1.6 below:

Table 1.5: Coverage of Survey in Haryana (Yamunanagar)

Village
CODE
Village
Name
SAMPLED ACTUALLY COVERED
Not
Enrolled
Enrolled
& Not
hospitali
sed
Enrolled
and
Hospital
ised
Total Not
Enrolled
Enrolled &
not
Hospitalised
Enrolled &
hospitalise
d
Total
119500 Amadal Pur 10 10 20
14 1 5 20
133900 Arian Wala 10 9 1 20
11 0 8 19
118900 Bibipur 9 8 3 20
9 0 11 20
120100 Buria 10 10 20
20 0 12 32
130800 Chuharpur
Kalan
8 9 3 20
6 0 13 19
103100 Ghillaur 10 10 20
1 0 14 15
110200 Hafiz Pur 9 9 2 20
1 0 19 20
114200 Harnaul 10 10 20
8 0 12 20
101000 Jhinwerheri 10 10 20
7 0 13 20
115300 Kail 10 9 1 20
12 0 11 23
130300 Karkauli 10 10 20
3 0 16 19
121100 Kharwan 7 6 7 20
6 0 13 19
85900 Manak Pur -
I
20 20
20 0 0 20
120200 Nabh 9 9 2 20
8 1 11 20
111900 Raipur 10 10 20
11 1 7 19
76200 Sadhaura 10 10 20
5 1 13 19

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Village
CODE
Village
Name
110501 Sasoli 8 8 4 20
0 0 14 14
121601 Shahzad
Pur
Tapprian
10 10 20
7 0 12 19
135900 Taharpur
Kalan
10 10 20
12 1 8 21
70000001 Ward No 1 8 7 5 20
8 1 19 28
80000010 Ward No 10 0 1 19 20
2 0 18 20
80000011 Ward No 11 9 9 2 20
5 1 14 20
80000012 Ward No 12 6 7 7 20
16 0 7 23
70000013 Ward No 13 2 2 16 20
3 0 18 21
70000014 Ward No 14 2 1 17 20
10 1 6 17
70000015 Ward No 15 0 10 10 20
8 0 10 18
70000015 Ward No 15 0 0 20 20
8 0 10 18
80000015 Ward No 15 8 8 4 20
8 0 16 24
70000016 Ward No 16 3 3 14 20
11 3 6 20
70000017 Ward No 17 20 20
7 5 0 12
70000017 Ward No 17 0 0 20 20
0 0 20 20
80000017 Ward No 17 0 0 20 20
0 0 9 9
70000018 Ward No 18 10 10 20
9 1 10 20
80000018 Ward No 18 5 5 10 20
0 35 35
80000019 Ward No 19 2 2 16 20
6 0 14 20
70000020 Ward No 20 6 5 9 20
18 0 2 20
80000021 Ward No 21 4 5 11 20
6 0 14 20
70000022 Ward No 22 0 0 20 20
10 0 10 20
80000022 Ward No 22 0 1 19 20
1 0 20 21
70000023 Ward No 23 3 3 14 20
17 0 3 20
80000024 Ward No 24 10 10 20
3 0 17 20
70000025 Ward No 25 4 3 13 20
5 1 13 19
70000027 Ward No 27 20 20
18 0 1 19
70000029 Ward No 29 7 7 6 20
4 0 7 11
80000003 Ward No 3 20 20
13 0 7 20
70000005 Ward No 5 10 10 20
12 0 8 20
80000006 Ward No 6 20 20
10 0 10 20
70000007 Ward No 7 3 3 14 20
0 0 20 20
70000008 Ward No 8 10 10 20
20 0 0 20
70000009 Ward No 9 4 3 13 20

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Village
CODE
Village
Name
Total 386 246 294 1000

0011180
1

ADDITIONAL VILLAGE COVERED

Kansapur
20 0 0 20
Total
419 18 556 993

Table 1.6: Coverage of Survey in Haryana (Faridabad)
Village
CODE
Village Name SAMPLED Total ACTUALLY COVERED Total
Not
Enrolled
Enrolled &
Not
hospitalised
Enrolled
and
Hospitalised
Not
Enrolled
Enrolled &
not
Hospitalised
Enrolled &
hospitalised

673600 Agwanpur 9 8 3 20 3 19 1 23
676700 Aherwan 8 8 4 20 2 16 2 20
672900 Alawalpur 10 10 20 13 4 0 17
690800
Aurangaba
d 10 10 20
8 12 0 20
672700 Baghola 7 7 6 20 6 11 4 21
681801
Bamni
Khera 10 10 20
14 6 0 20
692100 Banchari 10 10 20 7 12 0 19
682000 Behrola 10 10 20 7 12 0 19
680401 Bhawana 9 10 1 20 15 4 0 19
658200
Bhuapur(10
2) 3 4 13 20
8 13 0 21
665300 Chhainsa 8 8 4 20 6 12 0 18
691000 Deeghot 8 8 4 20 12 7 0 19
653200 Dhoj(17) 10 10 20 9 11 0 20
676900 Durgapur 10 10 20 10 9 0 19
653500
Fatehpur
Taga(29) 7 6 7 20
20 0 0 20
694700
Fatiskunag
ar 10 10 20
15 5 0 20
673400 Fazalpur 10 10 20 3 10 0 13
675600 Gailpur 7 7 6 20 0 18 0 18
692802 Garhi Patti 9 9 2 20 5 14 0 19
674000 Ghughera 6 5 9 20 17 3 0 20
671100 Harphali 6 6 8 20 0 17 3 20
1900210
Hodal Ward
10 10 10 20
12 8 0 20
1900206 Hodal Ward 9 9 2 20 11 9 0 20

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Village
CODE
Village Name SAMPLED Total ACTUALLY COVERED Total
6
676000 Kairaka 9 9 2 20 8 10 1 19
694100 Kawarka 10 10 20 21 1 0 22
678100 Kithwari 8 9 3 20 15 5 0 20
678000 Lohagarh 10 10 20 6 10 0 16
694800 Murtajabad 9 10 1 20 12 8 0 20
658400 Nimka(96) 9 9 2 20 7 8 0 15
693600 Pengaltu 10 10 20 6 14 0 20
693600 Pengaltu 7 7 6 20 0
677702 Rajiv Nagar 10 10 20 14 6 0 20
677000 Rajpura 0 0 20 20 10 9 1 20
677100 Ratipur 6 6 8 20 9 8 3 20
678200 Ronija 6 5 9 20 1 11 8 20
677701
Shamshab
ad 7 7 6 20
10 10 0 20
692400 Sondh 8 7 5 20 14 6 0 20
679100 Sujwari 5 5 10 20 9 12 2 23
658300 Tigaon(95) 7 7 6 20 21 1 0 22
1900102 Ward 02 20 20 16 5 0 21
1900104 Ward 04 20 20 20 1 0 21
1900113 Ward 13 5 5 10 20 14 5 2 21
1900320 Ward 20 20 20 20 0 0 20
1900320 Ward 20 9 9 2 20 9 12 21
1900128 Ward 28 20 20 19 1 0 20
1900329 Ward 29 5 5 10 20 9 11 0 20
1900131 Ward 31 0 0 20 20 19 1 0 20
1900132 Ward 32 10 10 20 19 1 0 20
1900135 Ward 35 20 20 18 2 0 20
675000 Yadupur 10 9 1 20 1 18 1 20
Total 456 354 190 1000
00691400 ADDITIONAL VILLAGE COVERED Siha 9 1 10 20
Total 539 418 29 986

Despite taking 25% buffer sample, the study team was able to contact
only 1980 households (986 in Faridabad and 994 in Yanunanagar) as
the households could not be located in the urban/wards due to non-
availability of/wrong address. Also, one additional village had to be
covered in each district to cover the overall sample size.

1.9 Study Limitation
Our team had to face difficulty in locating the households because of
unavailability of complete address of the households.

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In wards it was really difficult to locate households and some of the
villages were not located at all in the selected District thus, these
villages/wards were revisited and this caused manday loss and
delay in completing the study
The respondents were not available in the household during day
time thus, our team had to stay back in the villages and contact
them during late evening.
Though it was already informed by the study team to the client after
the pilot study that the study questionnaires were lengthy with
certain redundant questions making the respondents irritated to
answer, we were told to carry on with the same questionnaire for the
actual survey. Effectively due to this lengthy questionnaire, some
questions which were found totally irrelevant by the respondents.
This distracted respondents from giving interviews on actual facts
about the RSBY scheme. Due to this, the study team had to replace
many households as the survey work after the start could not be
terminated; the households were not willing to provide us
information even after three visits.
The database of this survey has been processed in due discussion with
the client and based on the client requirements. The attached report is
based on earlier report approved by the client in the pilot stage.

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2.1 Socio-economic and demographic status of the
household
The average size of the households covered is 4.2. In all 54 percent of
the members of the covered households were males while 46 percent
were females. Majority of the head of the households covered during
the survey (1980in nos.) and other household members were illiterates.
About half of the chief wage earners are working as unskilled workers.
Others are mainly unemployed, self employed or are working as
salaried employees in the private sectors. Very few of the covered
households are NREGA beneficiary.
As the following table reflects, about 42 percent of the covered
households are staying in semi-pucca houses, followed by 37.7 percent
residing in Kutcha houses. Remaining about 21 percent of the
household is staying in Pucca houses (Table 2.1).
Table 2.1: Type of Dwelling Units in Households
Types of Dwelling Units
Frequency Percent
Pucca 411 20.8
Semi-Pucca 822 41.5
Kuccha 747 37.7
Total 1980 100.0
Source MM survey

The ownership status indicates that the majority of the covered
households (1980 in nos.) are staying in their own houses (95.5%).
While 4.1 percent of the households are staying in rented houses, rest
0.4 percent are staying in rent free accommodation (table 2.2).
Table 2.2: Ownership status of the Households
Ownership status Frequency Percent
Rent 82 4.1
Own 1890 95.5
Rent Free House 8 .4
Total 1980 100.0
Source MM survey

2. Study Output

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In all 18 percent of the covered households (1980 in nos.) reported to
have a separate kitchen and 25 percent of the households have a
separate toilet. As mentioned in the following table, maximum
households (64.6%) have open kutcha drainage system, 24 percent
have underground drains, 8 percent have covered pucca drains and 2
percent have open pucca drainage system. Less than one percent of
the covered households also revealed that they do not have any
drainage system (table 2.3).
Table 2.3: Type of drainage system of the Households
Drainage system
Frequency Percent
Open Kutcha 1279 64.6
Under ground 484 24.4
Covered Pucca 158 8.0
Open Pucca 45 2.3
No Drainage 14 0.7
Total 1980 100.0
Source MM survey

Only 1.4 percent of the covered households (1980 in nos.) have
cultivable land and 12.7 percent of the respondent had livestock in their
houses (Table 2.4).

Table 2.4: Availability of Livestocks
Ownership of livestock
Frequency Percent
Yes 252 12.7
No 1728 87.3
Total 1980 100.0
Source MM survey

Majority of the respondents (61.1%) are dependent on public hand
pump, followed by 11.5 percent dependent on individual piped water
connection. Other sources of water supply include private hand pumps
(in their own residence) (11.3%), public tap (9.2%), covered private well
(2.4%), open private well (1.2%) etc (table 2.5). It was reported that
only 3.8 percent of the covered households are purifying water using
reverse osmosis (21.1%), filters (11.8%), any disinfectant (10.5%) and
half of the respondents revealed that they are boiling the water before
drinking.

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Table 2.5: Type of Water Connection at Household
Water Supply Sources Frequency Percent
Public Hand pump 1210 61.1
Piped Into Residence/Yard 227 11.5
Hand Pump In Residence 224 11.3
Public Tap 183 9.2
Covered Well In Residence 47 2.4
Open Private Well 24 1.2
Covered Public Well 23 1.2
Open Public Well 15 .8
Spring Water 15 .8
Tanker 7 .4
Others 3 .2
Pond Lake 2 .1
Total 1980 100.0
Source MM survey

Around 11 percent of the households covered did not have any home
appliances or assets. The rest of the households had assets which
include radio (41.8%), electric fan (30.8%), bicycle (29.9%), pressure
cookers (25.7%) etc.

The main source of lighting include electricity (69.3%), followed by
Kerosene (17.9%), oil (8.7%) and Gas (4.1%) (table 2.6)
Table 2.6: Main source of lighting in the Household
Main source of lighting Frequency Percent
Electricity 1372 69.3
Kerosene 355 17.9
Gas 81 4.1
Oil 172 8.7
Total 1980 100.0
Source MM survey

As high as 63 percent of the contacted households are using wood for
cooking while others are also using LPG (16.75), Kerosene (7.3%),
electricity (6.5%), dung cakes (5.2%) etc. The Chullah is mainly used
to cook food (table 2.7).

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Table 2.7: Type of fuel used by the households
Type of fuel Frequency Percent
Wood 1246 62.9
LPG/Gas 330 16.7
Kerosene 145 7.3
Electricity 128 6.5
Dung Cakes 102 5.2
Coal/Coke/Lignite 81 4.1
Crop residue 13 0.7
biogas 11 0.6
non timber forest products 9 0.5
Charcoal 8 0.4
Source MM survey
2.2 Status of debts and poverty of the households
The average per annum household income is about Rs.43,153/-. Only
about 3 percent of the households had borrowed money during the last
year (table 2.8).
Table 2.8: Borrowing of money in household
Borrowed money last year Frequency Percent
Yes 57 2.9
No 1914 96.7
Will not answer 3 .1
Don't Know 6 .3
Total 1980 100.0
Source MM survey

The respondent households who had borrowed money (57 in nos.) had
further asked about the major sources of borrowing, it was reported that
major source of borrowing are from money lenders (36.8%), followed by
friends and family with interest (28.1%). Some of them had also taken
loan from friends and family without interest (22.8%), from MFI (5.3%),
from banks (3.5%) etc. (table 2.9)
Table 2.9: Source of Borrowing of money for the household
Sources of borrowing Frequency Percent
From moneylender 21 36.8

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Sources of borrowing Frequency Percent
From friends and family with interest 16 28.1
From friends and family without interest 13 22.8
From MFI 3 5.3
From bank 2 3.5
From chit funds 1 1.8
From NGO 1 1.8
Total 57 100.0
Source MM survey

As the following table reflects there were various reasons of borrowing
for 57 respondents. The need of the borrowing varies from the reasons
like to meet health related expenditure (26.3%), for marriage (21.1%),
to purchase agricultural machineries or inputs (19.3%) etc. (table 2.10)
Table 2.10: Reason for Borrowing of money of the household
Reason of borrowing Frequency Percent
For health related expenses 15 26.3
Marriage 12 21.1
Acquire agricultural machinery or agricultural
inputs
11 19.3
Unemployment 4 7.0
Repay old debt 4 7.0
Start a new business 4 7.0
Home improvement/repair/construction 2 3.5
Purchase stock for existing business 2 3.5
Festival/Other Ceremony 1 1.8
Education 1 1.8
Buy livestock 1 1.8
Total 57 100.0
Source MM survey

2.3 Access to Information for Households
We have tried to assess the households access to information on
Government schemes. Table 2.11 indicates that 12.3 percent of the
respondents know the Sarpanch of their Gram Panchayts.

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Table 2.11: Proportion of Households Personally Know the Sarpanch
Personally Know the Sarpanch Frequency Percent
Yes 244 12.3
No 1702 86.0
Not replied 34 1.7
Total 1980 100.0
Source MM survey

About 19 percent of the respondents regularly watch TV and 28.5
percent listen to radio. The regular reading news papers were reported
by 4.6 percent of the respondents (table 2.12).
Table 2.12: Proportion of Households Regularly Acessing Media
Access to media on Regular Basis Frequency Percent
Watch TV
379 19.1
Listen Radio
565 28.5
Read newspaper
92 4.6
Not accessing media regularly
944 47.7
Source MM survey (multiple response answer)
The main source of information about Government programmes is
friends and family (78.3%), followed by media (7.8%), local Panchayat
workers/officials (6.3%) etc. (table 2.13).
Table 2.13: Main sources of information of the Government Programmes
Main sources of information of the
Government Programmes
Frequency Percent
Friends and family 1550 78.3
Media (print, visual or audio) 154 7.8
Local panchayat workers/officials 125 6.3
Other 73 3.7
Local NGO 68 3.4
religious leader 6 .3
MLA 4 .2
Total 1980 100.0
Source MM survey

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2.4 Consumption Pattern of the Households
As was observed during the study that most of the households do not
buy items on monthly basis; their consumption is mostly governed by
their day to day earning.
The average monthly household expenditure on food and other
consumer goods is about Rs.2600. Item wise consumption pattern and
amount of expenditure incurred has been summarized in table 2.14.

Table 2.14: Consumption pattern and the amount of expenditure
Items Total Monthly Consumption
Amount (in
Rs.)
Rice (kg) 13.89 215.34
Wheat (kg) 23.96 274.38
Pulses and pulse products (kg) 6.25 191.51
Milk (litre) 11.83 308.51
Edible oils (litre) 3.69 133.51
Vegetables (kg) 13.93 209.39
Fruits and nuts 4.75 178.62
Egg, fish, and meat (kg) 3.94 221.41
Sugar (kg) 4.79 141.12
Salt and spices (kg) 3.22 55.96
Tea (kg) 37.68 83.05
Other 45.63
Pan, tobacco & intoxicants 86.90
Fuel and light 278.03
Personal care (soap, toothpaste, etc.) 90.46
Transportation (km) 123.30 106.72
Source MM survey

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2.5 Health and morbidity related information
Table 2.15 reveals that about 1 percent of the households have one or
more members suffering from some serious disease which could not be
treated because of lack of money (table 2.15).
Table 2.15: Serious Illness could not be treated because of shortage of money
Serious Illness could not be treated
because of shortage of money
Frequency Valid Percent
Yes 21 1.1
No 1958 98.9
Total 1980 100.0
Source MM survey

Only one percent households reported that they had faced serious
health issues due to disease during the last one year. As analysis of the
data collected depicts there were instances where the person has died
because of disease (4.8%) or it has caused temporary inability to
perform normal daily activities (61.9%) (Table 2.16).
Table 2.16: Seriousness of the Disease
Seriousness of health event Frequency Percent
Caused Death 1 4.8
Caused permanent inability to perform normal daily activities 5 23.8
Caused temporary inability to perform normal daily activities but was an
inconvenience
13 61.9
Caused no inability to perform normal daily activities but was an inconvenience 2 9.5
Total 21 100.0
Source MM survey

About 14 percent of the head of the households smoke. About 42
percent of those who smoke normally consume 1-9 cigarettes in a day
Table 2.17.

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Table 2.17: Smoking Pattern of the Households
Smoking habit Frequency Percent
Yes 277 14.0
No 1703 86.0
Total 1980 100.0
Number of cigarettes consumed per day Frequency Percent
1-9 115 41.5
10-19 114 41.2
20-29 42 15.2
30 or more 6 2.2
Total 277 100.0
Source MM survey

2.6 Awareness about the Rashtriya Swasthya Bima Yojna
Slightly more than half (50.3%) of the sample household covered were
aware of the RSBY scheme and 38 percent had obtained the health
card. However, other BPL families who did not have RSBY cards were
not found aware of the RSBY scheme and card.
The sources of information about the enrolment were mainly friends
and Panchayat. About 80 percent of those who were aware of the
RSBY knew that only BPL families were eligible to avail the benefit of
the scheme (table 2.18).
Table 2.18: Awareness about RSBY scheme
Awareness about RSBY scheme Frequency Percent
Yes 995 50.3
No 985 49.7
Total 1980 100.0
Source MM survey
It was reported that 90 percent of the respondents who are aware of
RSBY scheme (995 in nos.) knew that it costs Rs.30 to enrol in the
RSBY scheme. Around 49 percent had realized that free treatment is
provided in hospitals under this scheme. Moreover, about 14 percent of
the respondents knew that the transportation allowances are paid to the
beneficiaries followed by 27.7 percent who knew that they do not have
to pay for medicines and drugs. Apart from that, about 63 percent knew

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that maximum 5 members in a family can be included in the RSBY
scheme (table 2.19).
Table 2.19: Awareness about different aspects of RSBY scheme
S. No. Aspects Percent of the people aware
1 Free treatment is provided in the hospitals 49.0
2 Transportation allowances are paid to the beneficiaries 13.6
3 They do not have to pay for medicines and drugs 27.7
4 At most 5 members can be enrolled 63.4
Source MM survey
2.7 Process of Enrolment
Around 45 percent of the respondents who were aware of the RSBY
Scheme had reported that the list of eligible families was publicly
displayed before enrolment began. About 57 percent reported that it
took them less than 20 minutes to reach the enrolment station.
It was reported that word of mouth was the major source of information.
Some of other information sources were Sarpanch of the Gram
Panchayat, posters displayed in the village etc. It is important to note
that even if there are more numbers enrolled under the RSBY scheme,
only a part of them are aware of the scheme- some of them consider
this as one of the cards they possess and hence do not know about the
scheme at all even if they have the card (Table 2.20 & 2.21).
Table 2.20: Process Practiced During Enrollment
Particulars
Eligible families name publicly displayed before Enrolment Began
Yes 447
44.9
No 295
29.7
Does not know 66
6.6
Not replied 187 18.8
Time taken to reach at the enrolment stations
5-10 min 194
19.5
10-20 min 368
37.0
20-30 min 151
15.2
>30 min 51
5.1
Don't know 44
4.4

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Particulars
Not replied 187
18.8
Sources of information about enrolment
From Word of mouth 482
48.4
From Sarpanch 137
13.8
From posters displayed in the village 96
9.7
From NGO personnel 43
4.3
From loudspeaker announcement 19
1.9
From ANMs 10
1.0
From district/block officials 6
0.6
From AWWs 1
0.1
From ASHA 1
0.1
Do not know / Cant remember 200
20.1
Total ( who were aware of RSBY scheme) 995 100.0
Source MM survey

Table 2.21 provides details of the issue of cards on the spot and it has
been reported that about 47 percent of the respondents who have card
(total of 1027 nos.) have received them on the spot followed by 41
percent of the card holders who reported not having received the smart
card on the spot.
Table 2.21: Distribution of Card Holders by Card Issued on the Spot
Cards Issued on the Spot
Frequency Percent
Yes 486 47.3
No 420 40.9
Dont Know
121 11.8
Total (enrolled in RSBY scheme)
1027 100.0
Source MM survey

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2.8 Satisfaction of Respondents to RSBY Scheme
About 52 percent of the total households (i.e. 1027) had obtained the
health card. In all 71 percent of the households covered under the
scheme were satisfied with the scheme and about 53 percent also
revealed that they would like to enrol next year as well (table 2.22).
Table 2.22: Distribution of Enrolled Households by Level of Satisfaction to the Scheme
Satisfied with RSBY scheme
Frequency Percent
Yes 538 52.4
No 489 47.6
Total enrolled in RSBY scheme 1027 100.0
Source MM survey
2.9 Benefited Status of the Respondents
One member from 45 households out of 1027 having RSBY card
contacted during the survey was hospitalized during the last one year.
Out of them, 40 percent were admitted in the Private hospital while 30
percent were admitted in Public hospitals. Remaining 7 percent were
admitted in the public dispensary. However, about 33 percent had not
used RSBY cards because either it was a case of emergency or they
did not want to visit the enrolled hospital due to some bad prior
experience (table 2.23).
Table 2.23: Type of Hospitals where the persons were admitted
Hospitals Frequency Percent
Public Hospital 9 20
Public dispensary
3 6.7
Private Hospital
18 40
Not used card
15 33
Total hospitalised
30 100
Source MM survey

Majority of the patients who has use the facilities have rated the
services of hospital as good or average (table 2.24).

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Table 2.24: Patient Satisfaction Level
Satisfaction Level Frequency Valid Percent
Very Good 7 23.3
Good 11 36.7
Average 11 36.7
Poor 1 3.3
Total 30 100.0
Source MM survey

2.10 Case Studies
RSBY Card has been made for individuals in Fazalpur Village but with
without the enrolled member ID and name (see the inset photograph).
There are people with two to three RSBY cards but with no name and
member ID being embossed on the card. This has led to the perception
of the card holders that such card is of no use to them. The card with no
name and member ID was found with Mr. Jagbeer Singh son of Mr.
Raghubeer Singh in Fazalpur Haryana
It was observed that a few families are
having APL card as well as RSBY card
both (one example photo placed in
insert).
Mr. Dharmendra Singh was found
carrying two cards of same year (2009)
being issued in his name (Refer the
photo attached.

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Based on our findings, we have summarized the suggestions as under.

It was observed during the study that there is a gap between the
BPL list and the BPL card holders as the BPL survey data was
inaccurate. Thus, the Government can also provide cards to those
whose BPL card is still pending or else if the unique identification
number comes into being, that can be referred.
It was observed that in some cases the cards are manipulated thus,
close monitoring is suggested to eliminate such incidences.
It was interpreted from discussions with the beneficiaries that they
do not want to go to a hospital which has bad reputation. It was also
observed that the reputation of the hospital influences the utilisation
of the facility even if they are under the RSBY scheme. Thus, it is
recommended that while enrolling hospitals under the scheme, the
agencies should be extra cautious because if the hospital has bad
name then the beneficiary would not like to visit in spite of the fact
that the treatment is free of cost.
We have seen that District Kiosks have a defined role, however
additional resources are required for 100% enrolment in the
scheme.
It was also observed that the lists carrying a synopsis of benefits,
claims processing procedure and network hospitals were not
provided along with the RSBY card. This may have contributed
substantially to the lower utilization levels. This issue needs to be
looked into.
Involvement of reputed healthcare facilities appears to be low in the
State. Efforts need to be made to have many more number them on
board.
The awareness level of the scheme related details among the RSBY
enrolled beneficiaries was found be low. Thus, it is recommended
that district authority should organise frequent awareness
programmes for the same, this will also enable the improvement in
the enrolment rate.
Awareness is the main reason for low utilization levels. Evidently
there is a lack of structured IEC program. We suggest that detailed,
local-dialect based awareness campaigns aimed at maximizing
enrolments, making beneficiaries aware of benefits of RSBY and
claims procedures should be taken up. A combination of radio & TV
campaigns, wall paintings, distribution of pamphlets in weekly
bazaars and display of posters in all SCs /PHCs / CHCs can be
taken up.
3. Key Issues and Suggestions

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RSBY is slated to become a comprehensive healthcare scheme
after enhancement of scheme features in the Phase-II. However, our
findings suggest a strong need for Out Patient treatment coverage
as was expressed as the need by the beneficiaries. The
Government may consider including some OPD component in the
sums insured. This is currently being offered in other insurance
schemes being implemented at the state level.
Though data on various aspects of RSBY is readily available, there
is a need for setting up monitoring mechanism for progress and also
addressing grievances at the operational level. We suggest that
operational level MIS be prepared by the insurers and monitored by
the Government officials at district level, on monthly basis:
Village-wise / block-wise enrolments : target vs. actual
Inventory of cards-related issues and resolution thereof
IEC plans vs. actual performance
Mapping & empanelment of hospitals from the point of view of
adequacy & accessibility
Plans vs. actual performance.
Inventory of beneficiaries grievances and resolution thereof.
Inventory of hospitals grievances and resolution thereof
It also emanates from this study that there is a lack of knowledge
about the benefits, processes and system amongst the
implementers of the scheme. This is more pronounced in the claims
arena as a result of which there is a general lack of awareness as to
how to access benefits under the scheme. We recommend
structures, periodic training for block & district level officials, NGOs
and network hospitals to enable them to effectively guide the
beneficiaries.
There is also a need for measuring the effectiveness of RSBY now
that the Phase-I has completed one year. It is also advisable that the
key deliverables are benchmarked against other successful Health
Insurance schemes of the States. A study of this kind shall not only
help bring out qualitative & quantitative findings but will also help
incorporate the best practices in RSBY.

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Appendix A. Study Tool

Household ID : __ __ __ __ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

1

RSBY QUESTIONNAIRE
Post-enrolment Survey of the RSBY Programme

A 0 : CONSENT TO PARTICIPATE IN INTERVIEW / ; - - iin l r-ln ; - - iin l r-ln ; - - iin l r-ln ; - - iin l r-ln

INTERVIEWER - Read out: Namaskar. My name is (please say your name here). I am asked by the
Government of India, to conduct a survey with BPL people in Delhi to understand the penetration of Rashtriya
Swasthya Bima Yojana (RSBY). We will be asking you questions related to RSBY. We would appreciate your
participation in this survey. The information collected would be kept confidential. The survey should take a
short time to complete.
; - --i| -i i- ( i ri i r ) r | - n iin i i ,ii i-i -(i- i-i i i (i i (i; )
lni i r ; r r -n l l~i - i i i ni ii ( l ri ni r | r- i i i (i;
lin s n | r- ; ( - iin l i iiii r n | ln i n; iii i nr ni i ii i ni|
( i i - ii i - n ni|
Oral consent given (circle one): YES Continue NO -- Stop the survey
-i li r-ln i n; ( ) ri ii i , ri ( i

1. Signature of Investigator_____________________
;(--in - r-nii...........................................
2. Date Month Year
niii -rii i
A 1 : INTERVIEWER: COMPLETE (WHAT EVER APPLICABLE) BEFORE BEGINNING THE
MODULE / ; - -i i r (i ii in ri i r ) i ; - -i i r (i ii in ri i r ) i ; - -i i r (i ii in ri i r ) i ; - -i i r (i ii in ri i r ) i
Code
A1.1 State / i Gujarat n in..1
Haryana rliii ..2

A1.2 District / li
A1.3 Village / ni(

A1.4 Hamlet name /
r - - i-

A1.5 Block/Circle
i,

A1.6 Rural/Urban
ni-ii,iri

A1.7 Name of Gram
Panchayat
ni- in i i-

A1.8 Address / ni
A1.9 Family ID
l(i i ri

A1.10 RSBY Status
i i (i; -- -
RSBY household .1
i i (i; i
RSBY hospitalized household .2
i i (i; ril--i; i
Non RSBY household .3
n i i (i; i

3. Date of visit: Day Month Year
i i niii l -rii i
4. Interview starting time: Hours Minutes
; - i i - i - l--

Household ID : __ __ __ __ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

2
A.2.1 BPL card No. : write 0 if not available
A.2.2 Ration card No. : write 0 if not available
A.2.3 RSBY card No-2008 : , 0 if not
available
A.2.4 RSBY card No-2009 : 0 if not
available
SECTION B. HOUSEHOLD ROSTER
Is name member of the following?
i l-llin - - i- r `
Y 1, N ..2
B.1
Member ID
- i
ri
B.2.
Name
Enter the
names starting
with the
household head
i-
i - lii
i n r i-
li
B.3.
Relatio
nshipw
ith the
head
(use
codes)
- lii
ii
i
B.4.
Age
If less
than one
year
write
zero
-
n
i -
r ni i
l i
B.5
Sex
M.1
F..2
l n
i

-
lri

B.6.
Marital
status

(use
code)
((ilr
l-iln
B.7.
level
of
educa
tion
attain
ed
(use
code)
ri
n
i;
i r
B.8.
main
occupa
tion of
ID?
(use
codes)
- lii
i -
((i
`
B.9
Present
ly
living
in the
house
Y.1
N .2
i
i -
rn r
ri
ri
B.10
If no,
why
not
(use
code)
n
ri ,
i
ri
B.11
BPL
i i

B.12
Ratio
n
card
ii
i
B.13
RSBY
card
i
i (i;
i
B.1
4
NR
EG

i
;
i
B.15
No. of
days
worke
d in
NREG
(last
year)
i
; i -
ln
l i-
li
(ls
i)

Household ID : __ __ __ __ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

3
Relationship Codes
i i i i i i i i
Marital status
((ilr l-iln ((ilr l-iln ((ilr l-iln ((ilr l-iln
Education Codes
liii i liii i liii i liii i
Occupational Codes
(il i (il i (il i (il i
Presently not
living reasons
i ri rn r i ri rn r i ri rn r i ri rn r
ii ii ii ii
Head
- lii
1

Married
l((ilrn
1 Upto class 1
ri ii n

1 Farming
li

1 Living
separately
in the same
village
i ni( - n
rn r
1
Spouse
i( iii
2

Divorced
nii i

2 Upto class2
i ii n

2 Livestock Rearing
i i

2 Moved to
some other
village/town
li i
ni(,ir -
n r
2
Father
lni
3 Separated
n ri n r
3 Upto class 3
nii ii n

3 Salaried Job
(n l- (ii i i

3 Passed away
n r
3
Mother
-ini
4 Widowed
l(i(i
4 Upto class 4
i ii ii n
4 Currently not working
i i- ri n
4 Got married
l((ilrn r
4
Son

5 Never
Married.
ii l((ir ri
li
5 Upto class 5
i (i ii n

5 Enrolled full time in
School/Madrassa
- ,- - -i; - i-
lii r
5 Name was
never the part
of this family
i- ; l(i
i - ii
ri ii
5
Daughter
i
6

Upto class 6
s-i ii n
6 Self Employed/ Trader
~ ;-i,-
6
Brother
ii;
7 Upto class 7
in(i ii n
7 Employed Skilled Laborer
;-i i -
7
Sister
r
8 Upto class 8
i-(i ii n
8 Employed Unskilled Laborer
;-i i -
8
Father in law

9 Upto class 9
(i ii n
9 Too young to work
i- l rn si -i r
9
Mother in law
i
10 Upto class 10
(i ii n
10 Housewife/Housekeeping
n lrii,i i iii i
10
Grand son
ini
11 Upto class 11
ir(i ii n
11 Too Old to work
i- l rn n r
11
Grand daughter
ini
12 Upto class 12
ir(i ii n
12 Enrolled full time in College
i - -i; - lii r
12
Grand father
ii
13 Graduate and above
-in i ii
13 Other (Specify)
ni

13
Grand mother
ii
14 Other diploma
li -i
14 Does not work
i- ri n
14
Brother in law
iiii
15 Never attended
school
- ii ri n
15 Dont know
ni ri
15
Sister in law
ii
16 Nursery
i
16
Daughter-in-law
r
17 Dont know
ni ri
17
Other (Specify)
ni
18

Household ID : __ __ __ __ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

4

SECTION C. HOUSEHOLD CHARACTERISTICS

C.1 Which social group your family belongs
to?
ii l(i l i-il - r lin r `
General / i-i.1
SC / ln iln .2
ST / ln iln .3
OBC / ls i iln ...4
Others (specify) / ni ..-777

C.2 What type of dwelling does this
household occupy?
r i l i i r `
Pucca/i....................................1
Semi-Pucca/ iii i..................2
Kuccha/ i ...............................3

C.3 Do you rent or own the house you live in?
i l i - rn r i (r li r i
ii i r `
Rent / li ...............1
Own / i.............................2
Rent Free house / lii - n i............ 3

C.4 Do you have a separate kitchen?
i i i n i ; r `
Yes / ri ..1
No / ri ...2

C.5 Do you have a separate toilet?
i i i n -i - r `
Yes / ri ..1
No / ri ...2

C.6

Excluding bathroom and kitchen, how
many rooms are there in the house?
ii- i i ; i(i i - ln - r `

C.7 Which type of roofing material does your
house have?
i i i sn l i i r `

Concrete / i-........1
Metal / iin ..........................2
Straw/thatch/sod ii ,ii...3
Tile / -i;..............................................4
Other, specify / ni .............-777

C.8 What is the source of drainage?
lii i i -in r
Open kutcha - 1, Open pucca - 2
i i i, i i i
Covered pucca - 3, Under ground 4;
i r i i, -i i
No drainage - 5
i ; lii ri

C.9 Does the family own any cultivable land?
(in the native village)
i l(i i in i -i r `
( ni( - )
Yes / ri ...1
No / ri ..2 C.12
Does Not Know/ ni ri ........-999 C.12

C.10 What is the total area of cultivable land?
in i -i i i lni r `

________Acres / .....................1
________Bighas / iii....................2
________Biswa / l-(i ....................3
Does Not Know / ni ri -999

C.11 How many units of this land is irrigated?
; -i lni l-i i l i; i ini r `

______________
C.12 Does the family own any house in the
native village?
i l(i i ni( - i i ; i r `
Yes/ ri ..............................1
No / ri ............................2 C.14
Dont know / ni ri ..-999

C.13 How many rooms (excluding kitchen and
bathroom) are there in that house?
i - (i ; i ii- i(i) ln
- r `

C.14

Does your household own any livestock,
cattle, birds etc? i i i - i ; i ,
i(, si il r `
Yes / ri .........1 , No / ri ..........2 C.18
Dont know / ni ri .....-999 C.18

Household ID : __ __ __ __ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

5

C.15 How many?
ln `
Cows/ni...1
Buffaloes / i ..2
Chickens/hens / - ni ,- n ..3
Camels / + - ..4
Sheep / i .....5
Goats / li ....6
Donkeys / ni ..7
Other (specify) / ni ..-777
_______________________

C.16 What is main source of drinking water for
members of your household?
i i -i l i i ii i
- -in i r `
Piped water / i; i ii i; i ii i; i ii i; i ii
Piped into residence/yard/plot.1
i,i n,i- - i; ni r
Public tap / ni .....2
Public hand pump/ ni r .......3
Hand pump in residence/yard/plot .4
i,i n,i- - r
Well water / i ii i ii i ii i ii
Covered well in residence/yard/plot...5
i,i n,i- - i r i i
Open private well/i i r i li i...6
Covered public well...7
i r i ni l i
Open public well/i i ni i.....8
Surface water / nr i ii nr i ii nr i ii nr i ii...9
Spring water /n i ii.10
Pond/Lake / nii,ni....11
Dam / -..12
Rainwater / ili i ii..13
Tanker truck / - -.14
Other (specify) / ni ni ni ni -777
_____________________________

C.17

Is Water Treated Before Drinking?
i i r ii i i , li ini r `
Yes / ri .. 1,
No / ri .2 C.19

C.18 If 1 in item , type of water treatment
(code)
n r ni ii i l i i i ,ii
li ini r
Ultra-violet/resin/reverse osmosis 1,
~-i (ii -, l ,l( i-il
Boiling / ii ----------------------- 2,
Filter / l~- -------------------------- 3,
Cloth / i -------------------------- 4,
Any disinfectant / i ; l; - -... 5,
Others / ------------------------ 777

C.19 INTERVIEWER: NARRATE THE
FOLLOWING LIST TO THE
RESPONDENT AND FILL IN THE
CODE OF ONES THE HOUSEHOLD
POSSESSES. (multiple options possible)

Yes ..1
No 2
B& W T.V/ ri;- -i (i.1
Electric fan / li i ii....2
Pressure cooker / i 3
Radio / li .4
Computer / - -...5
Telephone/ mobile / - ii ,-i i;6
Refrigerator / l........7
Colour T.V / ni -i (i...8
Electric kitchen appliances....9
; l- l i

Household ID : __ __ __ __ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

6
Bicycle / i;l..10
Mechanized 2 wheeler/ 3 wheeler...11
-iii z lri,: lri (ir
LMV/LCV (Car)......12
- (i, i (i (i)
Tractor / - -....13
Power tiller / i( l-~....14
Combined thresher/harvester........15
i i,ri(-- -i;

C.20

What is main source of lightening for
your household?
i i l ii i - -in i r `
Electricity / li1
Kerosene / l-;i i n .2
Gas / n ..3
Oil / n ...4
_____ _________________

C.21 What type of fuel does your household
mainly use for cooking?
ii i iii i l l i i
; i ;-n -i ni r `

Yes 1
No . 2
Wood / i....1
Crop residue / (i i....2
Dung cakes / .3
Coal/coke/lignite..4
i i,i ,lni;-
Charcoal / ii ..5
Kerosene / l-;i i n ..6
Electricity / li........................7
LPG/gas / i i,n ...8
Biogas / ii n ..9
Non timber forest products.10
ni i i(i i -
Other (specify) / ni -777

C.22 What is used to cook food?
iii i l i ;-n -i li ini r `
Stove / --i( ....1
Chullah / ~ri . 2
Open fire / i i in ...3
Other / -777

SECTION D: INCOME AND BORROWINGS

Nobody / i ; ri .1 D.2
ID
ri
Last month (in
Rs.)
ls -ri
Last year (in Rs.)
ls i
No. of days
worked in a month
-ri - ln l
i- li
No. of hours
worked in a
day
l -
ln i - i-
li

D.1 Who of the household
members work and how
much does each member
earn ?
(INDICATE
HOUSEHOLD BOARD
NUMBER)
i i i -
i- n r i -
- - lni -ini r
`

Household ID : __ __ __ __ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

7
D.2 Is there any other source
of income for the
family? (eg. Pension,
rent, remittances etc. )
i l(i l i-i
i i ; -in r ` (
i, lii, l( i i
(ii i)
Yes...1
ri
No....2 D.4
ri
Dont know....-999 D.4
ni ri
Will not answer.-888 D.4
(i ri li

D.3 If yes, how much did
you get from that source
last month? / n ri ni
ii -in ls
-ri lni l-i ii `
Source
-in

..
Income / i-i

D.4 In last one year have you
borrowed from
somewhere for some
purpose?
ls i - i i
li l li
ii li ii `
Yes / ri .1 give details
No / ri ...2 section E
Dont know / ni ri ..-999 section E
Will not answer..-888 section E
(i ri n

Details of borrowings
Sr No. / ii l((i
Amount borrowed
ii i n; ili
Source of borrowing (see codes below)
ii i -in
Reason of borrowing (see codes
below)
ii ii
1

, ,
2

, ,
3

, ,
D 5
4

, ,
Source of borrowing / ii -in ii -in ii -in ii -in

From friends and family without interest....1
i-ni i l(i i li
From friends and family with interest....2
i-ni i l(i i
From moneylender / ir i .....3
From bank / ...4
From MFI / - i; ...5
From chit funds / l- ...6
From other financial institutions / (ili -iii .7
From NGO / i i ....8
From SHG / i ....9
Others (specify) / ni - 777
Dont know / ni ri ...-999;
Will not answer / (i ri n ..-888

Reason of borrowing / ii ii ii ii ii ii ii ii

Start a new business / i ii i l ....1
Acquire agricultural machinery or agricultural inputs ..2
li l -ii l i li - l( i l
Purchase stock for existing business.3
(n -i ii l i-i ii l
Repay old debt / i i i i nni l...4
For health related expenses/ -(i- ii i l.5
Marriage / l((ir...6
Funeral / ln- -i..7
Festival/Other Ceremony / -i ri, (.........................8
Houseold consumption/Purchase household
durable...9
i - ni l,i i (-n ii l
Home improvement/repair/construction.10
i ii ,---n ,l-i i l
Unemployment / i nii.....11
Purchase land / -i ii l...12
Education / liii13
Purchase jewelry / ii ii ii l....14
Buy livestock / i ii l.....15
Other (specify) / ni ...-777
___________________________
Dont know / ni ri ...-999

Household ID : __ __ __ __ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

8
SECTION D.1: HOUSEHOLDS SOCIAL NETWORK

D.1.1
Is anyone in the family presently a
member of any of the following?
(multiple answers possible)
i l(i - i ; i l-llin -
li i - r `

SHG / i . 1
Cooperative / i i l-( .....2
Trade union / - l .......3
NGO/MFI client..4
i i ,- i; i; -
Village committees (e.g. VEC; ICDS) ... 5
ni ( i - l-i ( (i ; i, i; i i )
Political party / i ln i-i ... 6
Religious organization / iil- -ii ....7
RWA (urban areas) .8
i ~ (iri ;i )
Other membership-based organization . 9
-ni iiiln -ii
No / ri .... 22
Dont know / ni ri ...-999

, , ,
, , ,

D.1.2
Do you or your family members
personally know the sarpanch/ nigam
parishad/ MLA or any ward member for
your gram panchayat ?
i i i i l(i - ,ln-
li,- i ni- in l li
(i - i lnnn in r `
Yes.....................................1
ri
No .....................................2
ri
Dont Know.................-999
ni ri
.

D.1.3
Do you do any of the following once a
week? i i l-llin - i ; nir -
i n r `
Yes / ri 1 , No / ri ..2
Watch TV / -i (i ii
Listen Radio / li i
Read Newspaper / ii i

D.1.4
What is your main source of information
about government programs ?
ii i i -i i - iii i
- -in i i r `
Friends and family / i-n i l(i...1
Media (print, visual or audio) / -ili ..2
Local panchayat workers/officials ...3
-iii in - ii,illi~
Administration officials ...4
iil illi~-i
Religious leaders / iil- ni..5
MLA / - ....6
Local NGO / -iii i i 7
Other (specify) ni ______ .-777

, ,
, ,

D.1.5
How often does any member of your
family travel to -
1. block HQ
2. district HQ
i l(i i i ; - ini r
i - i
2. li - i
Every week / r nir..1
At least Once a month.2
-ri - - - i
At least once a quarter...3
ni -ri - - - i
At least once in Year..4
i - - - i
Never / ii ri .5

1.

2.

Household ID : __ __ __ __ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

9

SECTION E
E.1: FOOD & OTHER EXPENSES
E.1.1

ITEM
ID

i;--
i; i
E.1.2

ITEM

i;--
E.1.3

In the last
30 days,
have you
consumed
the
following?

1=Yes
2=No
(skipNe
xt item)
ls :a
li - i
i
l-llin
ii i r
`

E.1.4

In the LAST 30 DAYS,
how many units in total
have you purchased?
ls :a li - i
lni l- iii r `
UNIT CODES:
l- i
1=Kilogram
li ni-
2=Gram
ni-
3=Liter
l-
4=Bottle
-
5=Packet
-
6=Number
i
7=Dozen

E.1.5

How much
did you pay
in total?

(Please
enter the
total
expenditure
)

i
lni i nni
li ii `

E.1.6
Other than purchases, how much
did you consume of any of these
goods in the last 30 days, which
you PRODUCED ON YOUR
OWN, or you received as part of
PAYMENT FOR WORK (For e.g.,
as meals or crops), or you received
as GIFTS or ASSISTANCE from
individuals or from the government
or a private institution?
ls :a li - ii i(i, i
;- i lni (-n ii; i r i
i i ni; ii i ii i-
i nni - l-i ii ( ii i
) i ii li ln i i
i i;( - -ii ri i rini
ni l-i ii `
UNIT CODES: l- i
1=Kilogram li ni- li ni- li ni- li ni-
2=Gram nini- nini-
3=Liter l- l- l- l-
4=Bottle - - - -
5=Packet - - - -
6=Number i i i i
7=Dozen
E.1.7

If you
purchase
these
goods
from
market,
how
much
would
you have
to pay?

n i
(-n
ii
iin ni
ii
lni
i nni
i ni
`

NO. OF
UNITS
l- i i
UNIT
CODE
l-
i
RUPEES

NO. OF
UNITS
l- i i
UNIT
CODE
l- i
RUPEES

1 Rice / i(
2 Wheat / n r
3
Pulses and pulse
products i i
ii i -

4 Milk / i
5
Edible oils ii
n

6 Vegetables l i
7
Fruits and nuts
i - (

8
Egg, fish, and meat
, -si i -i

9 Sugar / ii
10
Salt and spices
- i -i

11 Tea / i
12 Other /
13
Pan, tobacco and
intoxicants i,
n-i i
;-ii -

14
Fuel and light ; i
i i;-

15 Personal care

Household ID : __ __ __ __ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

10
(soap, toothpaste
etc.) li iii
(i , - i-- il)
16
Transportation
l(r

E.2: OTHER EXPENSES
E.2.1

ITEM ID
i;-- i;
i
E.2.2

ITEM
i;--
E.2.3

In the last 365
days, did you
purchase the
following?

1=Yes
2=No
(skipNext
item)

ls :cr li
- i i
l-llin ii
i `

E.2.4

RUPEE
S

E.2.5
Other than purchases,
did you obtain any of
these goods in the last
365 days, which you
PRODUCED ON
YOUR OWN, or you
received as part of
PAYMENT FOR
WORK, or you received
as GIFTS or
ASSISTANCE from
individuals or from the
government or a private
institution?1=Yes
2=No
(skipNext item)
ls :a li - ii
i(i, i ;- i
lni (-n ii; i r i
i i ni; ii i
ii i- i nni
- l-i ii ( ii
i ) i ii li
ln i i i i;( -
-ii ri i rini
ni l-i ii `
E.2.6
If you purchase
these goods
from market,
how much
would you have
to pay?
n i (-n
i i iin
ni ii lni
i nni i ni
`

RUPEES

1
Tuition fees and other fees
- i i i i

2
School supply and other
educational expenses
- i; i i li
i

3
Clothing & footwear
i n

4
Other personal goods
lnnn (-n

5
Gifts to others
i l ri

6

Spending on special events
(marriage,death, birth etc.)
l(i i (i i i
(l((ir, - - , - il)

Household ID : __ __ __ __ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

11
SECTION F: F.1 - HOUSEHOLD HEALTH (FOR ALL INDIVIDUALS FROM
HOUSEHOLD BOARD)(INTERVIEWER: SHOW THE LADDER TO THE RESPONDENT
WHERE EVER REQUIRED)
F.1.6 How comfortable (name) is in carrying out the following activities by
him/herself right now?
(i-) l-llin nlnl(lii ; - i - lni,lni ii-i r `
Can do very comfortably/ ii- n ,ni r ...1
Can do but with little difficulty / n ,ni r l ii i l-i; .2
Can do only with help.3
l - ii n ,ni r
No absolutely cannot/ ri l ri n ,ni .............................4
Dont know / ni ri .........-999
Cant say / r ri n .........-888
F.1.1

ID codes
i; i
i
F.1.3

Is he/she
facing any
recurrent
medical
problem that
has lasted for
more than
one month?
Yes.1
No..2
F.1.6
Dont
know.-99
F.1.6
i (r li
- l --i
i i-i
r ,ri r i
-ri
ii ri r `
F.1.4

If yes,
describ
e the
conditi
on?
n ri
ni rin
i
`

F.1.5

Is he/she
taking
medicine
s
regularly
for this
problem
?
Yes.1
No..2
Dont
know.
-999
i ( ;
--i
l
ll-n

(i; i
r ,ri r
`
F.1.6a
Dressin
g
n i
ri i
F.1.6b
Eating
iii
F.1.6c
Doing light
work in or
around the
house
i - i
ii r~i
i- i
F.1.6d
Lifting or
carrying a bag
or bucket
weighing 5 kg
r li ( i
i~-i i -ni
-ii i ii
F.1.6e
Walking
200-300
meters
zaa:aa
-i- i
F.1.6f
Standing up
from sitting on
the floor
i - ri
i ri i

F.2 HOUSEHOLD HEALTH EVENT AND HOSPITALISATION

F.2.1

Does any of your family member have some
health related problem that may need
hospitalization in the next 6 months?
i i l(i li - i -(i- ii
i --i r l ii n c -ri - -ni
- ini ri i n ri ni r `
Yes / ri ...1
No / ri ...2 F.2.3
Will Not Answer / (i ri n ..-888 F.2.3
Does Not Know / ni ri -999 F.2.3

Household ID : __ __ __ __ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

12
F.2.2 Who you think would require hospitalization
and for what?
i l(i -ni - ini ri i l n
ri ni i l l `
HH board no / i -

..

F.2.3 Was anyone in your family very sick or
severly injured in the last two years?
ls z ii - i i l(i - i ; rn ii
i-i i ni( -i r i ii `
Yes / ri ..1
No / ri ..2 F.3
Does Not Know / ni ri -999 F.3

F.2.4 How many cases like these happened in the last two years? ls z i - ln r r `

F.3 DESCRIPTION OF HEALTH EVENTS
Interviewer: ask the respondent if any one in the household suffered from major health event in last two
years. Fill the details of all the members of the household who had/ are having major health event in
following table:
F.3.1.

ID Codes
of those
who had
major
health
event
i; i
i lr
i -(i-
--i r ;
ii
F.3.2.

What was the
major health
event that
[name]
suffered?
i i i -
-(i- --i r ;
ii l (i-)
iln ii `
Disease.1
i-ii
Accident2
i -i
Complicated
birth.3
l- i;i
Other-specify
ni
-777
Dont
know.999
ni ri
Cant say..-555
r ri n
F.3.4.

How serious was this
health event / condition?
r -(i- --i,rin
lni n ii ii `
Caused death1 F.3.7
- - ri n; ii
Caused permanent
inability to perform
normal daily activities.2
F.3.6
i-i l nlnl(lii
- -ii; i- ri n i
Caused temporary
inability to perform
normal daily activities.3
i-i l nlnl(lii
- -ii; i- ri n i
Caused no inability to
perform normal daily
activities, but was an
inconvenience4
i-i l nlnl(lii
- i- ri r l
l(ii rini ii
No inability was
caused....5 F.3.6
i ; i-ni ri r ; ii
Dont know...-999 F.3.6
ni ri
F.3.5.

For how long did
this health event /
condition cause a
temporary inability
OR inconvenience
to perform normal
daily activities?
; -(i-
--i,rin ii
i-i l
nlnl(lii -
-ii; i-ni i
l(ii ln -
n ri ii `
Days .1
l
Weeks2
nir
Months ..3
-ri
Dont know..-999
ni ri
F.3.6.

Is he/she still
taking a
treatment for
this
condition?
i ( ii ii
; rin
l ; i
(i r ,ri r
`
Yes..1
ri
N....2
ri
Dont
know....-999
ni ri

F.3.7.

Was [name]
hospitalized as
a result of this
major health
event?
i ; -(i-
--i lii-
-( (i-)i
-ni - ini
(ii ii `
Yes...1
ri
No..2
ri
Dont
know....-999
ni ri

F.3.8

Which
type of
hospital
was
[name]
admitted?
(i-) l
i
-ni -
ini r i `
Governme
nt1
ii
Private2
i;( -
Dont
know-
999
ni ri

F.3.9

Did [name]
have surgery as
a result of this
major health
event?
i ; i
-(i- --i
lii- -(
(i-) i i
r ; ii `
Yes.......1
ri
No.2
ri
Dont know
.-999
ni ri
F.3.10

How many
days the
[name]
was
admitted to
the hospital
for more
than 24
hrs?
(i-) -ni
- z i -
ii ln
li l
ini li ni
ii `

Household ID : __ __ __ __ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

13
F.3a Has it ever happened that a very serious illness/death
could not be treated at hospital because of lack of money?
i iiii i r i r l li rn n ii i-ii,- - i -ni
- ; i i i -i ii ri ii ri `
Yes / ri ............................................1
No / ri ............................................2 F.4
Dont Know / ni ri ...............-999

F.3b Mention the member ID of that person from the
above table / + - ln i - i; i ni

F.4. HEALTH-RELATED BEHAVIOR (head of the family)

F.4.1 Do you or anyone in the family smoke? __
i i i i l(i - i ; i - i ni r `
Yes.....................................1
ri
No ......................................2 F.4.3
ri

F.4.2 Indicate number of cigarettes smoked per
day? lnl i i (ii ln - i i ni
(1-9) .... 1
(10-19) .... 2
(20-29) .... 3
(30 OR MORE) / (:a i ii)..4

F.4.3 Do you drink alcoholic beverages?
i i ~i ril ( in r `
Yes................................1
ri
No ................................2 F.4.5
ri

F.4.4 How would you rate your consumption?
i i in i - n `
Daily / i ii1
3-5 days a week / nir - :r l.. 2
Less than 3 days a week .... 3
nir - : l -
Occasionally / iiii .. 4

F.4.5 Are your kids vaccinated for pulse polio?
i i i i ~ i li -i n r `
Yes / ri .....................................1
No / ri .................................2

F.4.6 Have your kids got any other vaccination?
i i ii i i ; -ii ni r `
Yes / ri .....................................1
No / ri ..................................2

SECTION G: RSBY

INTERVIEWER: FOLLOWING SECTION SHOULD BE FILLED IN ONLY FOR HOUSEHOLDS WHO
ARE AWARE OF RSBY CARD/SCHEME. FOR THOSE WHO ARE NOT AWARE, DIRECTLY JUMP TO
SECTION H.
G.5 Awareness of RSBY
G.5.1 Are you aware of RSBY scheme?
i ii i i (i; -i- i - iii r
Yes ..1
ri
No ..2 SECTION H
ri

G.5.2 Where did you get to know about
the scheme?
ii -i- i - iii ri l-i `
Through friends / neighbours .1
i-ni , i li
Through Radio / TV / newspaper ..........2
li ,-i (i,ii
Through leaflets/brochure ...3
i ,ii
Through Health Staff ...4
-(i- - ili
Area Committee members/ Community
Educators... 5
li - -i -i ,i- il liii
Panchayat/ in ..6
Ration shop keeper/ ii ii ...7
NGO personnel/ i i i ... 8
Survey people/ ( (i i ni ....9
Others (specify)/ ni ...-777

Household ID : __ __ __ __ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

14
G.5.3 Do you know who is eligible for the scheme?
i i in r l i i l i i r `
Everyone / r i ; ....1
Only BPL families / l i i l(i..2
Only AAY families / l (i; l(i..3
Only NREGA card holders 4
l i ; i i ri ~
Others(specify) / ni ........................-777
Dont know / ni ri ....-999

G.5.4 Is your family eligible for the
scheme?
i ii l(i i i l i r `

Yes / ri ...1
No / ri .2
Dont know / ni ri ....-999

G.5.5 How much does it cost to enroll in this
scheme? ( in Rs.)
; i i - i- li(i l lni i rini r `
Zero / i 0
Rs 30 / :a ......................................30
Others (specify)/ ni ..................-777
Dont know / ni ri .-999

G.5.6 What is the maximum amount per
year that can be spent? ( in Rs.)
lin- ili lni r i ln (i i i i
ni r `
Dont know.-999
ni ri

G.5.7 Is free treatment provided in the hospitals
under this scheme?
i ; i i nnn -nii - - n ; i i li
ini r `
Yes / ri ...1
No / ri ...2
Dont know / ni ri -999

G.5.8 Are transportation allowances
provided to the patient?
i -i i l(r iii i li ini r `

Yes / ri ...1
No / ri ...2

G.5.9 Do you have to pay for the medical tests if
you enroll in this scheme?
n ii ; i i - i- li(ii ri ni i ii
- l i l i nni i ni r `
Yes / ri ...1
No / ri ...2

G.5.10 Do you have to pay for medicines
and drugs if you enrol in this scheme?
n i ; i i - i- li(in r ni i
ii (i; i l i nni i ni r `
Yes / ri ...1
No / ri ...2

G.5.11 How many household members can be
enrolled?
i ln -i i i- li(ii i ni r `
At most 5 members ...1
lin- r -
All household members .2
i ii -
Others (specify) / ni ... -777
Dont know / ni ri .-999

G.5.12 Which year did enrolment take
place? (multiple answers possible)
l i - i- li(ii ii `
2008 (1
st
round) ..1
2009 (2
nd
round) .2
2008 & 2009 both (1
st
& 2
nd
round) ..3
zaas i zaas i i
Dont know-999
ni ri

G.6 Which year did you apply to obtain the card?
i i l l i - i; li ii
2008......1 G.7.2
2009 .2 G.7.1
Both (2008 & 2009)..........3 G.7.3
zaas i zaas i i
Didnt apply at all ............ 4 G.7
l i; ri li ii

G.7 Why didnt you apply? (multiple
answers possible)
i i; i ri li ii `
Booth too far away.......1
i rn ii ii
Its of no use/ ;i i ; ii ri r ..2
Get similar facilities in government
hospitals................................................3
i l(ii ii -nii - l- ini r
Didnt find any hospital in the list which
is closer to my place...4
i - i i ; -ni ri l-i i - i
i ii
Distrust in scheme...5
i i - l((i
Did not have proper documents to support
familys identity..............................6
, ,
, ,

Household ID : __ __ __ __ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

15
l(i i ri i i - l ri
in in ri i
Did not feel comfortable with the
Technology involved (eg. Use of smart
cards)...................................... ...7
;- iil- ni ii l(ii -r
ri r i ( --i- i i ;-n -i)
Didnt understand the scheme...8
i i -n ri i;
Not eligible for the scheme ............ 9
i i l i ri i
Others (specify)/ ni .................-777
Section H
G.7.1 Why didnt you apply in the first round?
i r i - i i; ri li ii `
Booth too far away.................................1
i rn ii
Didnt know about the scheme at that time............ 2
- i i i - iii ri ii
Didnt get to know about enrolments .. ................ 3
i- li(i i - iii ri l-i ii
Didnt find any hospital in the list which is closer to
my place............................................................4
i - i ; i -ni ri l-i i - i i ii
Did not have proper documents to support familys
identity..............................................................5
l(i i ri i i - l ri inin ri i
Didnt understand the scheme........................6
i i -n ri i; ii

,
,
,
,

G.7.2 Why didnt you reapply?
i l i; i ri li ii `
Booth too far away.................1
i rn ii
Didnt get to know about enrolments......2
i- li(i i - iii ri l-i ii
Had bad experience with hospital ..........3
-ni ii ii i( ii
Was not satisfied in first round .............5
r i - n - ri r i ii
Didnt get chance to use card in first
round .....................................................6
r i - i ;-n -i i -i i ri
l-i ii
Didnt find any hospital in the list which
is closer to my place this time.............7
; i i - i ; i -ni ri l-i i
- i i ii
Name on on the list ............................. 8
i - i-
, ,
, ,

Interviewer: select whichever year family has enrolled in. choose the latest year if family has enrolled both
the times.
G.8 For those who applied
G.8.1 Was any list of eligible families
publicly displayed before enrolment began?
i i- li(ii i i l(ii i i ;
i ni i- l i n; ii `
Yes / ri ...1
No / ri ...2

G.8.2 When did enrolment happen?
i- li(ii ni ii `

Dont know ..999
ni ri

G.8.4 How much time did it take to reach
enrolment station?
i- li (i -- i n r - lni - ni
ii `
5-10 mins / ra l-- 1
10-20 mins / aza l-- ....2
20-30 mins / za:a l--.3
>30 mins / :a l-- ii4

G.8.5 How far was the enrollment
station from your house? (in kms)
i i i- li (ii -- i lni
ii `
Within 2 km/ z li -i- 1
2-5 kms ......2
5-8kms 3
More than 8 kms ...4
s li -i- ii

Household ID : __ __ __ __ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

16
G.8.6 How did you get to know when and
where enrolment was happening?
ii ni i ii l i- i ri
li(ii i ri ii `
From Posters displayed in the
village.............................................. 1
ni( - l l n i--
From Word of mouth...................... 2
i
From NGO personnel..................... 3
i i i
From Sarpanch/ ................. 4
From ANMs / - ...............5
From AWWs / ~ ~ ................6
From ASHA / iii .............................7
From district/ block officials.................8
li,i illi~
From Loudspeaker announcement........9
i-i i ii iii
From Wall writings..............................10
i(i li
From Nukkad natak .............................11
i-
From Aanganwadi Worker... . 12
i n(i i - ii
Others (pl. specify) / ni .......... 999

G.9 Did you obtain the health card?
i ii -(i- i l-i ii `
Round 1. ...........................................
ri i
Round 2 ..
i i
Yes .1 Section G.10
ri
No ...2 G.9.1
ri

G.9.1 Why didnt you obtain it?
(multiple answers possible)
ii r i ri l- ii `
- In First round / r i -
- In Second round / i -

Household head died ..1
- lii i - - ri n; ii
Household not on the BPL list 2
i i i i - ri ii
Didnt have required documents .3
i in in ri i
Wait was too long 4
rn ii -i ; n i
Were asked to come again 5
ii i l ri ii
Refused without any reason 6
li li ii -i li ii
There were problems at enrolment
station......7
i- li (i -- i - --i ii
Didnt apply/i; ri li ii........ 8
Other ( specify )/ ni 999
Section H

, , ,

, , ,

G.10 For RSBY card holders
G.10.1 PLEASE SHOW YOUR RSBY
CARD / i i i i (i; i lii
Showed it / r liii....1
Did not want to show/liii ri irn i ...2
Lost it / r ii ni ii.....3
Someone has taken it (is with some one) .4
; i ; i ni ii (li i i r )
Its with hospital/ r -ni - r 5
Other (specify) ni .-777

G.10.2 What problems did you face in
obtaining the card?
( Add extra sheets if required)
i i - l --ii i i-i li ii `

Household ID : __ __ __ __ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

17
G.10.3 How many members of the family
are covered?
l(i ln - ( l n r `

G.10.4 How long did it take you to complete
the whole enrolment process?
ii i- li(i i i li i i -
lni - ni ii `
Less than one hour/ i - -..1
1-2 hours ...2
2-4 hours.3
4-6 hours ...4
more than a day/ l ii ...5

G.10.5 Did you get smart card on the spot?
i ii --i- i rii rii l- ni ii `
Yes / ri ..1
No / ri ..2

G.10.8 Did you make any payments to get
hold of it? ii ; l i i ; i nni
i i ii `
Zero / i ..0
Rupees 30 / :a .................30

G.10.7 Which of the following pieces of
information did you get along with the card?
ii i ii l-llin - i i
iii l-i ii `
List of hospitals/ -nii i i....1
How to use the card/i ;-n -i ..2
Who to contact in case of any query..3
li snis l l -
Information about district kiosk ........... 4
li li- i - iii
Didnt get any / i ; ri l-i ii................. 5

, ,
,
G.10.6 Were you told about the date when
you could start using the smart card?
i ii niii i - nii ni ii l i
--i- i ;-n -i i i n r `

Yes . 1 No . 2
ri ri

G.10.8 Which is the nearest RSBY
empanelled hospital? / i i (i; i
ii ii -ni i i r `
Dont know / ni ri ...................-999

_________
G.10.9 Are you satisfied with the scheme?
i i i i n - r `
Yes / ri ..1
No / ri ..2

G.10.10 Would you like to enrol next year
also? / i i n i ii i- li(ii ir n `
Yes / ri ..1
No / ri ..2

G.11 INDIVIDUAL ENROLMENT

G.11.1
ID
i; i
G.11.2Is ID
enrolled in
RSBY scheme?
i i i
(i; i i - i;
i li(i; r `
Yes ...1
ri
No...2 G.11.3
ri
G.11.3 If no, why not? / n ri , i ri `

Five person limit/ i -i i i-i..1;
At school at the time of enrolment....2
i- li(i - - - ii
At work at the time of enrolment..3;
i- li(in - in ri i ilr
Out of village at the time of enrolment.4
i- li(i - ni( ir ii
Was not well on the day of enrolment......5;
i- li(i l nln -i ri ii
Not eligible by relationship ..6
ln i ri ii
Name is not on the ration card .7;
ii i i- ri r

Name not on the BPL list .....8
i i i - i- ri ii
Refused by enrolment team ..9
i- li (ii -i- -i li ii
Did not know that name needed to show up ...10
ni ri ii l i- lii i n ni
Was not at home at the time of enrolment ..11
i- li(i - i ri ii
Not required ( person is healthy enough) ....12
n ri ii (ln ii -(-i r )
Married / l((ilrn.. 13
Passed away n n ..................... 14
Others (specify) / ni .....-777

SECTION H: MEDICAL TREATMENT (inpatient/outpatient)
Interviewer: Ask respondent who in their family needed outpatient services in the last 30days.
(explain properly what OPD is- that they were not hospitalized but had consulted the doctor, chemist, quack, local vaidya, and
had bought medicine/ paid consultation fee etc.)

H.1. Particulars of medical treatment received as Outpatient during the last 30 days
ls :a li - iri -i ni l- (i ; i i l((i
H.1.1 sr1. no. of the OPD case
i i i i - i
1 2 3 4 5
H.1.2 Name & srl. no. of member (as in
col. 1, block 4/5) hospitalised
-ni - ini l n - i i-
i - i

H.1.3 Age (years) (as in col. 5, block 4 /
col. 4, block 5) / - (i)

H.1.4

Date of First Visit/
ri i i i niii

H.1.5 Number of visits / lni i n i
H.1.6

Total Expenditure during the OPD
visit (in Rs.) / i i i i ii
i (i - )

H.1.7 Medicine (in Rs.) / (i; i (i - )
H.1.8 Diagnostic test (in Rs.) / i-ii i
ni ni l i (i - )

H.1.9 Transportation (in Rs.) /
l(r (i - )

H.1.10 Whether the person was Covered
by RSBY?(Yes -1, No 2)
i ln i i (i; ,ii (
li ni ii `

H.2a: Maternity experience
-i i i(

Last
Pregnancy
lsi nii(-ii
Next to Last
Pregnancy
lsi nii(-ii
ni nii i-ii
Second from
Last pregnancy
lsi nii(-ii
i nii (-ii
H.2a.1 Who in your family got pregnant in the last 5 years? (starting with
the most recent ones) ( continue with the same lady if she has successive birth
histories otherwise switch to another)
ls r ii - i l(i - i ni (ni r ; ii `( ri ri - r ; i ) (n
-lri i nini i i - li r ni i -lri ii ii i
ii i in )
No-one H.3

H.2a.2 Member id from roster / i -- - i; i

H.2a.3 Date of Birth / - i niii
If dead / n -n r .. 88 H.2a.6

H.2a.5 What is the present age of child born? / i (n -i - lni r `
Living / il(n ...1, Dead / -n . 2

H.2a.6 Where did birth take place?
i - ri r i ii `
Home / i 1
Govt/Munic Hospital.2
ii,- l -ni
GovtDispensary ii li..3
PHC/CHC / i i,i i...4
Sub- Centre ....5
Anganwadi Centre i n(ii ..6

Village clinic at ANM....7
- - ni( i ll
Other Public Health Facility...8
ni -(i- l(ii
NGO/Trust Hospital..9
i i ,--- -ni
Pvt Hosp/Maternity Home.10
i;( - -ni,- -l-i ri -
Other private / i;( -11
Other/ ..999

H.2a.7 If the delivery did not take
place in a health facility then what
was the reason?
n li(i -(i- l(ii -ii
ri r ; ii ni ;i i ii ii `
Costs too much..1
rn ii i
Facility not open.......2
l(ii i i ri ii
No nearby centre......3
i - i ; ri ii
Dont trust facility/ Poor
Service...4
l(ii l((i ri ,ii (i

No Female Provider at Service.5
(i - i ; -lri i(i; ri ii
Husband/ Family did not allow6
ln,l(i ;i n ri i
Not Necessary ....7
i ri ii
Not Customary....8
l(i ri ii
Other(Specify) / ni 999

Ask respondent about all hospitalization cases in the family in the last two years ( including maternity hospitalization)

H.2. Particulars of medical treatment received as Inpatient of a hospital during the last two years
ls z i - -ni i -i ri ni l- (i ; i i l((i
H.2.1 sr1. no. of the hospitalisation case /-ni i - i 1 2 3 4 5
H.2.2 Name & srl. no. of member (as in col. 1, block 4/5)
hospitalised / -ni - ini l n - i i- i - i

H.2.3 Type of hospital: Public hospital(PHC/sub centres/CHC)..1,
public dispensary(incl. CGHS/ESI) .2,
private hospital..3
Add hospital name
-ni i i l -ni (i i, ,i i)
l l i (i i ,; i; )
i;( - -ni
-ni i i- li

H.2.4 When was patient admitted? (month/ year)
-i ini r i ii ` (-rii,i)

H.2.5 Duration of stay in hospital (days)

-ni - r i (li (l)
H.2.6 Whether patient was hospitalized using RSBY card?
(Yes -1, No 2) / i -i i i i (i; i ;-n -i
ini (ii ni ii `

H.2.7 If no, why not? / n ri , i ri `
Name not on RSBYcard ..1;
i i (i; i i- ri
Name is there but it was an emergency . 2;
- i- r l r iinii l-iln l ii
Bad experience with RSBY...3 ;
i i (i; ii ii i(
Neighbors had bad experience with RSBY... 4
ii i i i (i; ii ii i( ii
No nearby hospital/ -ni i - ri ii...... 5 ;
Card didnt work in hospital ..6
-ni - i i- ri li
No balance in the card/ i - ii ili ri ii7 ;
Hospital refused/ -ni -i li.... 8
this disease was not covered/ r i-ii ( ri ii.9;
didnt know disease was covered..10
ni ri ii l i-ii ( ii
Others(specify) / ni ....999

H.3 Details of medical services received / in i - l (ii i l((i in i - l (ii i l((i in i - l (ii i l((i in i - l (ii i l((i
H.3.1 srl. no. of hospitalization
case / -ni - ini ri (i i
- i

H.3.2 Name and srl. no. of
member hospitalized
-ni - ini l n - i i-
i - i

H.3.3 Why this particular hospital
was chosen for treatment? ; i
l r -ni i i ni ii `
Close to homei i..1,
Reputation is good/si ii r ...2,
Suggested by relative/friends.....3,
ln i,i-ni ir i
Referred by doctors..4,
i- ,ii lili i n;
Always go to this hospital.5,
r- ii ; -ni - in r
There is no other RSBY
empanelled hospitals nearby.6,
; i(i i - i i (i; i
i i ; -ni ri ii
Other (specify)/ ni .....999

H.3.4 Did surgery take place?
i i r ; ii `
Yes/ ri .. 1 , No / ri .2

H.3.5 Did patient take medicine ?
i -i (i; i ii `
Yes/ ri .. 1 , No / ri .2

H.3.6 Were X-ray/ ECG/ EEG/
Scan/ Diagnostic tests
conducted?
i ,; i i,- ,i-ii i
ni ni l i i n; ii `
Yes/ ri .. 1 , No / ri .2

H.3.7 Whether treatment availed
before hospitalisation?

i -ni - ini ri r ; i
r i ii `
Yes/ ri .. 1 , No / ri .2
H.3.8 If yes above, what is the
source of treatment -
Public hospital (incl. PHC/ sub-
centres/CHC).. 1,
n ri ni ; i i i -in ii,
l -ni (i i,
,i i -n)
Public dispensary (incl.
CGHS/ESI)...2,
l l i (i i ,;
i; -n)
Private hospital/ i;( - -ni.. 3,
Private doctor/ i;( - i- ... 4

H.3.9 Whether treatment
continued after discharge from
hospital ?
i -ni s - i ; i ii
ri ii `
Yes/ ri .. 1 , No / ri .2

H.3.9a What was the source of
treatment?
; i i - in i ii `
Public hospital (incl. PHC/ sub-
centres/CHC) 1,
l -ni (i i,
,i i -n)
public dispensary (incl.
CGHS/ESI)...2,
l l i (i i ,;
i; )
Private hospital/ i;( - -ni ...3,
Private doctor/ i;( - i-.... 4

H.3.9b Duration of treatment
; i i (li

H.3.10 Did you buy medicine
on your own?
i i (i; i i iii ii `
Yes/ ri .. 1 , No / ri .2

H.3.11 If yes, how much did
you spend on medicine?(in Rs.)
n ri , ni i (i; i lni i
li ii ` (i - )

H.3.12 Did you spend anything
for getting diagnostic tests done?
i i i-ii i ni ni l
ri (ii i ; i (i - s i
li ii `
Yes/ ri .. 1 , No / ri .2

H.3.13 If yes, how much? (in
Rs.) / n ri ni ln ` (i - )

H.3.14 Any other amount that is
incurred on this health event
besides medicine and tests? (in
Rs.) (mention the cause also)
; -(i- ;( - - (i; i i i i
i(i i ; i i r i ii` (i - )

H.3.15 What is the total cost
incurred by the household for this
health event? (in Rs.)

; -(i- ;( - l i ,ii
lni i li ni ii ` (i - )
H.3.16 What was the source of
this expenditure?
; i i -in i ii `
Household savings/ income ..1
i n,i-i
Contribution from
friends/relatives ..2
i-ni ,ln ii i ni
Borrowings / ii... 3
Sale of assets/ ornaments. 4
i,ii ii i

H.3.17 Received any
reimbursement (Rs) from any
source such as government,
employer, insurance company, or
other agencies?
i li -in i ; l- - - in
r ; ii ii - ii, i-i -i
i li `
Yes/ ri .. 1 , No / ri .2

H.4: Transportation / l(r l(r l(r l(r
H.4.1 How far is the hospital
from your house(Approximately)?
i i -ni (nin) lni
r `

H.4.2 How did the patient go to
the hospital?
-i -ni ni ii `
Bus/ ...1
Metro/ - -i ...2 ;
Rickshaw/ lii...3;
Two wheeler/ i lri ....4
Three wheeler/ ni lri ...5;
Car/ i .....6;
Others (please specify)....999
i ni

H.4.3 What was the estimated
cost to reach the hospital?
-ni n r i i i
lni ii `

H.4.4 Did the hospital
reimburse the cost of transport?
i -ni l(r i i li `
Yes/ ri .. 1 , No / ri .2

H.4.5 How much was the
reimbursement? (in Rs.)
lni i (il li ii `(i - )

H.5: Inpatient experience
ini ri (i -i i i( ini ri (i -i i i( ini ri (i -i i i( ini ri (i -i i i(

H.5.1 Was there a separate
RSBY help desk at the hospital or
it was at the reception only?
i -ni - i i (i; i
n r ~ - ii i r l l i
ii `
Yes/ ri .. 1 , No / ri .2

H.5.2 How long did the patient

have to wait before he/she was
attended by the staff?
-i i --i ,ii - l i
r lni ;ni i i ii `
Less than 15 minute1
r l-- -
15 to 30 minutes....2
r :a l--
30 to 60 minutes3
:a ca l--
More than 60 minutes...4
ca l-- ii
Others, specify/ ni ....999
H.5.3 Was fingerprint
verification done through a
fingerprint scanner?
i l nl - i l- l nl - -
i n; ii `
Yes/ ri .. 1 , No / ri .2

H.5.4 Was the family told about
the cost involved for treating the
patient in advance? i l(i i
-i ; i - ri (i i i
- r ni li ii `
Yes/ ri .. 1 , No / ri .2

H.5.5 If yes, what was the cost?
(in Rs.) n ri , ni i lni ii `

H.5.6 Was the family told about
the money left in the smart card?
i l(i i --i- i - i r ;
ili i - nii ni ii `
Yes/ ri .. 1 , No / ri .2

H.5.7 Was the money in the card
sufficient to pay for this
treatment? / i i - ; ; i i
i nni l i n i `
Yes/ ri .. 1 , No / ri .2

H.5.8 If the money in the card
was not sufficient was the patient
told that he would have to pay the
difference?
n i - i n ri i ni i
-i i nii ni ii l il
i i i nni i i ni `
Yes/ ri .. 1 , No / ri .2

H.5.9 How much was the
shortfall in the card from the
package/ treatment rate? (in Rs.)
i - ,; i - ln
i -i ii ` (i - )

H.5.10 How was the admission
advised through?
ili i ir i n; ii `
Emergency/ iinii (i..1
OPD / i i i .2;
Referral / .....3;
Other (Please Specify) . 999
i ni

H.5.11 Was the staff at the
RSBY help-desk polite and
helpful? i i i (i; r ~

- --i l(- i ri ii `
Yes/ ri .. 1 , No / ri .2
H.5.12 What was the condition
of the patient at the time of
admission? / ini (in - -i
i rin ii `
Able to Walk by own....1;
i i
Severe / ii ..2;
Very severe / rn ii ..3

H.5.13 Was the patient provided
with food during stay at the
hospital?
i -ni - r ii -i i
ii li ni ii `
Yes/ ri .. 1 , No / ri .2

H.6: Discharge / li li li li
H.6.1 On discharge was
discharge summary provided to
the family?
i li l(i i
li -iii i i n; ii `
Yes/ ri .. 1 , No / ri .2

H.6.2 Was the fingerprint
verification done at the time of
discharge? / i li -
l nl - l- i n; ii `
Yes/ ri .. 1 , No / ri .2

H.6.3 When did you get the
RSBY card back?
ii i i (i; i (il
l-i ii `
On discharge ...............1 H.6.6
li ri
Next day / n l..................2;
Two days later / i l i ..3
Others specify) / ni ......999

H.6.5 What was the reason for
holding back the card?
i i i i i ii ii `
Staff wanted money for returning
the card....1
--i i (il l
irni ii
Staff wanted to keep the card till
insurance claims were
settled..2;
--i i- i i(i - ri n i
i ii ir-ii ii
Staff said the card will stay
deposited at the hospital 3
--i ri l i -ni - -i
r ni
Others, specify/ ni .999

H.6.6 Were you told about the
amount of money left in the card
at the time of discharge?
i ii li - i -
r i i - nii ii `
Yes/ ri .. 1 , No / ri .2

H.6.7 Do you know about 5 day

post hospitalization expenses
coverage in RSBY?
i ii i i (i; - r l i
-ni - ini ri i (
i - ni r `
Yes/ ri .. 1 , No / ri .2
H.6.8 Was the patient prescribed
any medicines after the discharge?
i li i -i i i ; (i;
ni; n; ii `
Yes/ ri .. 1 , No / ri .2

H.6.9 For how many days the
medicines needed to be taken after
discharge? / li i ln
li n (i; i n ii

H.6.10 Were these medicines
provided by the hospital?
i (i; i -ni ,ii i i
n; ii `
Yes/ ri .. 1 , No / ri .2

H.6.11 These medicines were for
how many days?
(i; i ln li l ii `

H.6.12 Was the patient
prescribed any tests after
discharge? / i -i i li
i i ; --- (i l ri ni
ii `
Yes/ ri .. 1 , No / ri .2

H.6.13 Within how many days
of discharge those tests were
supposed to be done?
( --- li ri i ln li
- (i i (i i `

H.6.14 Were facilities for those
tests organized by the hospital
free of cost?
i ---i l -ni ,ii - n
l(iii i (-ii i n; ii `
Yes/ ri .. 1 , No / ri .2

H.6.15 How is health of patient
now comparing when he was
admitted to the hospital?
-i i -ni - ini (ii
ni ii i n i - i
-(i- i r `
Has died / - ni...1;
No improvement ..2
i ; ii ri
Partially improved ...3;
i li ii
Has improved completely ....4
i nr ii ri ni r

H.6.17. Diagnosis
i-ii i ni nii i-ii i ni nii i-ii i ni nii i-ii i ni nii

.

.

.

.

H.6.17a. Treatment given
; i li ni
Medical / - l
Surgical / l ..
Duration of stay
r i (li

.

If surgical ,surgery type .
n l , l i i i
If the investigator is unable to find
specific answers please get a
photocopy of the discharge
summary

H.6.18 Was there a suggestion
for follow-up? / i i i l
i ; ir i n; ii
Yes/ ri .. 1 , No / ri .2

H.7 : Details of patients who died after receiving treatment
-ii i l((i i ; i l- i - n i -ii i l((i i ; i l- i - n i -ii i l((i i ; i l- i - n i -ii i l((i i ; i l- i - n i
H.7.1 When did the patient die?
-i i - - r ; ii `
During the Hospital Stay..-1
-ni - r ii
Immediately after discharge.-2
li nn i
Within a week after discharge..-3
li i nir
Within a fortnight.-4
r li
Within a month-5
-ri
Others, specify-999
ni

H.7.2 Probable cause of death
from hospital documents if any?
.
-ni in in - - i iil(n
ii `

No documents available-77
i ; in in i ri i

H.7.3 Did the patient receive any
medical care before he/she died?
i -i i - r i ; - l
iii l-i ii `
Yes/ ri .. 1 , No / ri .2

H.8: Patient Satisfaction / -i i n l- -i i n l- -i i n l- -i i n l-
H.8.1 Were all your patient
related queries answered during
your visit to hospital for treatment
under RSBY? / i i i (i;
nnn ; i (i - i
-ni i -i ii i ii
i (i l- i `

Yes/ ri .. 1 , No / ri .2

H.8.2 How would you rate your
satisfaction about the treatment
provided at the hospital?
i -ni - i l n ; i
i - i n l- i - n `
Excellent/(i i- -1
Very good/ rn si -2
Good/ si -3
Average/ i n -4
Poor / ii -5

H.8.3 Where would you have
gone if scheme had not been
there? / n r -i- rini ni i
ri n rin `
To the same hospital..1
i -ni -
To any other private hospital.2
li i;( - -ni -
To government hospital.3
ii -ni -
Doctors private clinic4
i- i i;( - ll
Nowhere / ri ri ....5
Other ( specify) .999
ni
Dont know/ ni ri ..777

H.8.4 Were you forced to give
money to any staff member?
i i --i li - i
l i( ii ni ii `
Yes ..1
ri
No ..2 H.8.6
ri

H.8.5 if yes, how much did you
pay? (in Rs.) / n ri ni i

H.8.6 Will you recommend your
relatives/friends to take treatment

lni i nni li ii ` (i - )
from the same hospital?
i i ln ii ,i-ni i i
-ni ; i (i i lili
n `
Yes/ ri ..1 section I
No/ ri ..2
H.8.7. If no Why?/n ri ni i `
Treated badly.-1
ii ; i li ii
Poor quality care-2
ii (il-i i iii
Not receptive to RSBY patients -3
i i (i; -ii i ii ri r i
No money in RSBYcard-4
i i (i; i - ri r

I: RESPONDENT DETAILS
li - i l((i
I.1 Who answered the survey?
( (i l l i `
(INDICATE Household board number)
Name / i-
_________________

I.2 Was there another respondent present
during the interview?
i ; - ii i ; li -
l-in ii `
Yes..1
ri
No2 J
ri

I.3 What is the name of this respondent?
(INDICATE Household board number)
; li - i i i- r `
Name / i-
______________________

Name not on the board..990
i i- ri r

SECTION J

THANK THE RESPONDENT FOR TAKING HIS TIME OUT FOR THE INTERVIEW.

MAKE SURE TO GET THE SIGNATURE ON THIS SHEET.

INTERVIEW ENDING TIME: HOURS MINUTES

COMMENTS

_______________________________________________________________________________

______________________________________________________________________________

Signature of the respondent
___________________________

Mott McDonald - Post Enrollment Survey - RSBY Haryana

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Mott McDonald - Post Enrollment Survey - RSBY Haryana

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Final Report

Pilot Post-enrolment Survey of the RSBY

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