Food Consumption Patterns Part 2
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160<br />
Boutik (neighborhood store) Questionnaire<br />
Enumerators initials*<br />
Location-<br />
PAP<br />
Gonaives<br />
Okap<br />
other<br />
Neighborhood*Number of Sample Cluster*<br />
Hi. My name is_______. We are conducting a survey about foods, particularly snack foods and<br />
fortified foods. The information you share with us is confidential. We will not share your name<br />
with anyone. Do you consent to respond to the questions?* Required<br />
refuse<br />
accept<br />
absent<br />
Respondent's name*Sex*<br />
female<br />
male<br />
Does the boutique have a name?*<br />
yes<br />
no<br />
do you own the business?*<br />
yes<br />
no<br />
Telephone numbers<br />
*What kind of drink to they most buy?*<br />
Regarding snacks that you sell, do clients more often buy something to drink or a snack?*<br />
Snack<br />
Drink<br />
Same<br />
Tell me 5 non staple foods that you sell most frequently?*<br />
(PRODUCT LIST)<br />
Now I would like to ask you some questions about snacks that are good for people, that have<br />
vitamins, that are good for the health*<br />
Ok<br />
Tell me three things that you sell that are most fortifying for babies*<br />
(PRODUCT LIST)<br />
Tell me three things that you sell that are most fortifying for children?*<br />
(PRODUCT LIST)<br />
Tell me three things that you sell that are most fortifying for adults?*<br />
(PRODUCT LIST)