| No. | QUESTIONS | RESPONSES | TICK/WRITE Yes/No |
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| Socio-Demographic Factors |
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| 1. | Age | …………………………..years |
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| 2. | Marital status | 1) Single |
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| 2) Married |
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| 3) Divorced/separated |
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| 4) Widowed |
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| 3. | Education level of respondent | 1) No formal education |
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| 2) Primary |
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| 3) Secondary |
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| 4) Tertiary |
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| 4. | Education level of spouse | 1) No formal education |
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| 2) Primary |
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| 3) Secondary |
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| 4) Tertiary |
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| 5. | Occupation of respondent | 1) Housewife/unemployed |
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| 2) Informal employment |
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| 3) Formal employment |
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| 6. | Occupation of husband/spouse | 1) Unemployed |
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| 2) Informal employment |
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| 3) Formal employment |
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| 7. | Religion of respondent | 1) Catholic |
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| 2) Anglican |
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| 3) Muslim |
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| 4) Others |
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| 8. | Average monthly income of the family | 50,000 - 100,000 UShs 100,000 - 200,000 Ushs 200,000 - 300,000 Ushs 400,000 - 500,000 |
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