| S. No. | Questions | Category | Remark |
| 101 | Age in years | _______ |
|
| 102 | Religion | 1. Orthodox 2. Muslim 3. Protestant 4. Catholic 5. Other (specify) |
|
| 103 | Ethnicity | 1. Kefa 2. Gurage 3. Oromo 4. Amhara 5. Other specify ____ |
|
| 104 | Marital status | 1. Married 2. Never married 3. Divorced 4. Widowed 5. Unmarried couples |
|
| 105 | Educational status | 1. Illiterate 2. Read and write 3. Grade1-6 4. Grade 7-12 5. College/university |
|
| 106 | Occupation | 1. House wife 2. Farmer 3. Civil servant 4. Student 5. Merchant 6. No job Others (specify) ____ |
|
| 107 | Place of residence | 1. Urban 2. Rural |
|
| 108 | Gravidity |
|
|
| 109 | Average monthly income |
|
|