DATE: CODE: .

My name is Maureen Adhiambo Onyango, a PhD student in Clinical Psychology at Daystar University. This study aims to understand the prevalence of grief and to support in managing the consequences of grief among orphans in primary schools in Kenya. This information is confidential and will help in determining if you may be having problems coping with the loss of your parent(s). Please read carefully and tick (√) where applicable or write the response as required.

INTERVIEWER: .

Part A: BIODATA

1. Name of School .

2. Gender:

Male ☐ Female ☐

3. Age (years)

10 ☐ 11 ☐ 12 ☐ 13 ☐ 14 ☐ 15 ☐

4. Religion

Catholic ☐ Anglican ☐ Pentecostal ☐ Adventist ☐ Muslim ☐ Other ☐

5. I am in class

Class 3 ☐ Class 4 ☐ Class 5 ☐ Class 6 ☐ Class 7 ☐

6. How many siblings do you have?

One ☐ Two ☐ Three ☐ Four and above ☐

PART B: NATURE OF ORPHANHOOD/OTHER LOSSES/NATURE OF DEATH

The following questions will ask you more about the death of your parent, more information about how they died, and if you have lost any other loved one

7. Have you lost a parent through death?

YES ☐ NO ☐

8. If YES in 7, which parent did you lose through death?

Both Parents ☐ Mother ☐ Father ☐

9. In which year did your mother die?

2018 ☐ 2017 ☐ 2016 ☐ 2015 ☐ 2014 and below ☐ Alive ☐

10. In which year did your father die?

2018 ☐ 2017 ☐ 2016 ☐ 2015 ☐ 2014 and below ☐ Alive ☐

11. How close was your relationship with your mother? ( if mother dead)

Not close ☐ A bit close ☐ Very close ☐

12. How close was your relationship with your father (if father is dead)?

Not close ☐ Somewhat close ☐ Very close ☐

13. How close are you with the surviving parent?

Not close ☐ Somewhat close ☐ Very close ☐ Both dead ☐

14. How did your parent die?

Sickness ☐ Accident/Sudden ☐ I do not Know ☐ Old age ☐

15. Was your parent sick before they died?

YES ☐ NO ☐

16. Did you take care of your parent when they were sick?

YES ☐ NO ☐

17. Were you with your parent when he/she died?

YES ☐ NO ☐

18. Where did your parent die?

at home ☐ in the hospital ☐ I do not Know ☐ Other ☐

19. Apart from your parent, have you ever lost another loved one?

YES ☐ NO ☐

20. If YES in 19 above, which other loved one have you lost?

Sibling ☐ Friend ☐ Other close relative ☐