Items:

Interviewer: Now I would like to know about adults and children who do not live in this household or household compound, but whom you provide supportcare.

1. Over the last 12 months, have there been any adults andor children living outside your household to whom you have provided care for any reason? This could include financial, physical, emotional, health or personal care or support?

Response Options:
Yes - 1
No - 2

2. How many people did this include?
3. What is your relationship to this person?

Response Options:
Spouse or partner - 2
Daughter or son - 3
Daughter- or son-in law - 4
Grandchild - 5
Brother or sister - 8
Other relative, child (e.g. cousin) - 11
Not related child - 12

4. What is the age of this person?

Response Options:
In years: ____

5. Who is the person primarily responsible for the support and care of this person?

Response Options:
Respondent - 1
Another person - 2

6. For how long havehad you been providing care? (over the last 12 months)

Response Options:
Less than 30 days - 1
1 to 3 months - 2
More than 3 months but less than 6 months - 3
6 months or more - 4

7. What type of support was provided?

Response Options:
Financial - 1
Social or emotional - 2
Health - 3
Physical - 4
Personal (choose all that apply) - 5

8. Iswas support and care generally provided

Response Options:
Daily - 1
Several days per week - 2
Once per week - 3
Once per month - 4
Occasionally, as needed - 5

9. About how much time per week on average diddo you spend providing supportcare for this adult?

Response Options:
By hours: ____
By minutes: ____
Don’t know – 88:88

10. How much difficulty did you have with providing this supportcare?

Response Options:
None - 1
Mild - 2
Moderate - 3
Severe - 4
Extreme or could not do - 5

11. What kind of help have you, as a caregiver, received?

Response Options:
Financial, such as cash, paying for bills, fees, food or medicines, clothing or other provisions - 1
Emotional, like social support, counseling, time with friends - 2
Health, including providing health care, administering medicines, changing bandages, arranging health care providers - 3
Physical including household or farming chores, transportation - 4
Personal care, help with bathing, eating, dressing, toileting, moving around - 5
Other – specify (choose all that apply) - 7

12. Who provided this help or assistance? Anyone else?

Response Options:
HH Family members – 1
Family outside the household - 2
Neighbours or community - 3
Government - 4
Church - 5
NGOs - 6