Items:

Social Control
1. Your neighbors would intervene if children were skipping school and hanging out on a street corner?
2. Your neighbors would intervene if children were breaking windows on a local buildingdestroying public property?
3. Your neighbors would intervene if children were showing disrespect to an adult?
4. Your neighbors would intervene if a fight broke out at the pension point?
5. Your neighbors would intervene if the local school closed down the feeding scheme?
6. Your neighbors would intervene if a family didn’t have enough food?
7. Your neighbors would intervene if the neighborhood water tank was broken?
8. Your neighbors would intervene if an elderly person was robbed?

Response Options:
Very likely
Somewhat
Unlikely that

Social Cohesion
9. People in this village are willing to help their neighbors?
10. This is a close knit community?
11. People in this village can be trusted?
12. People in this village generally get along well with each other?
13. People in this village share the same values?
14. People in this village look out for each other?

Response Options:
Agree
Somewhat agree
Disagree that

Shared Concerns
15. People in your village are concerned about HIV?
16. People in your village consider HIVAIDS an important issue?
17. People in your village talk openly about HIV?
18. People in your village believe that HIV impacts the community?
19. People in your village talk about HIVAIDS at community meetings?
20. People in your village work together to prevent HIV from spreading?
21. People in your village work together to reduce the effects of HIV?
22. People in your village believe they can change the course of the HIVAIDS epidemic?
23. People in your village exchange information about HIVAIDS?
24. People in your village take HIVAIDS seriously?

Response Options:
Agree
Somewhat agree
Disagree that

Critical Consciousness
25. People work together to solve problems in the village?
26. People in your village talk to each other about how to solve village problems?
27. People in your village enjoy discussing different ways to solve village problems?
28. People in your village are open to hearing different views about community problems and solutions?
29. People in your village volunteer to help solve village problems?
30. People in your village think about WHY there are problems so they can address the cause of problems?
31. There is a lot of cooperation between groups in the village?
32. People in this village not only talk about problems but they also try to solve them?
33. If your community fails to resolve a community problem-they will try another-different approach to solving the problem?
34. If your community fails to resolve a community problem-they will learn from that experience and do a better job when they try to solve the problem in the future?
35. If leaders in the village fail to resolve a village problem-the villages will work together to find a solution?

Response Options:
Agree
Somewhat agree
Disagree that

Leadership
36. The village leaders represent your opinions?
37. The leaders are responsive to your concerns?
38. When you have a problem in your community-you can go and speak with your leaders about the problem?
39. The leaders in your community work effectively together?
40. The leaders in your village get a lot done for the community?
41. The leaders in your village represent all the different kinds of people who live in your community?
42. The leaders in your village encourage the people to participate in village decision making?
43. The power to make community decisions is shared among leaders and the people in this village?
44. There is strong leadership in my village?
45. The leaders in this village are trustworthy?
46. The leaders in this village act responsibly with the power they have?
47. The leaders in this village put the villagers’ needs first-before their own needs?
48. The leaders in this village can put aside their personal interests to act in the interests of the community?
49. The leaders in this village are honest; there is little corruption here?

Response Options:
Agree
Somewhat agree
Disagree that

Organizations and Networks
50. Are there any organizations or groups that help to make your community better in your village?
51. Are there groups with which you can volunteer to help people in your community?

Response Options:
Yes
No
I don’t know

52. How important are school organizations in this community?
53. How important are policesafety organizations in this community?
54. How important are youth organizations in this community?
55. How important are sport organizations in this community?
56. How important are women’s organizations in this community?
57. How important are men’s organizations in this community?
58. How important are religiouschurch organizations in this community?
59. How important are cultural organizations in this community?

Response Options:
Very important
A little important
Not importantno such organizations

Collective Action
60. How many community meetings were called in the last 3 months?
61. How many community members participate in community meetings on average in the last 3 months?
62. How many community meetings have you attended in the last 3 months?
63. How many times has the community worked together to fix a problem in the past 3 months?
64. How many community members participate in fixing community problems?
65. How many times have you worked to fix a community problem?

Response Options:

______ Numbers