Twaweza East AfricaPlot 77 Suwara Road, Naguru Go-down, P.O Box 40163, Kampala Tel:+256312112815, Email: uwezo.uganda@twaweza.org www.twaweza.org|www.uwezo.netUwezo Uganda

Annual Learning Assessment 2015

District:

Volunteer : Female Male

EA Code:(FILLED BY THE DC/ RA)

1.

2. School Data Sheet

3. Household Survey Sheets

(2) Pages

(20) Sheets

4.

SEXTelephone Number.

Secretariat (For use at the Data centre)

(2) Sheets

DC/RA:

DD/ MM /YY

DD/ MM /YY

DD/ MM /YY

DD/ MM /YY

DD/ MM /YY

Signature:

Signature:

Signature

Signature:

Signature:

Permission to use Tel:

Has this EA ever been visited by Uwezo?

V100

. Are

the

follo

win

g in

th

e E.

A

V102. Trading/ Shopping/ Market centre ?

V103. Police post?

V104. Tarmac road?

V200.

V301.

V302.

V305.

V306.

V303.

V304.

V501.

V502.

V503.V500

Heal

th S

tatu

s

Farming Fishing

Mining Trading

Pastoralism

Salary Earners

V601.

V603.V600

. Vill

age/

com

mun

ity

V602.

No

Ask the LC Chairperson/ Member or Village Elder

Yes No

Yes No

LC Chairperson LC Member Village Elder

Yes No

V105. All weather roads? (usable throughout the year) V106. A protected public water point? ( i.e shallow well,

borehole, tap water, spring)

Write the actual number of s in the EA Number

Yes

(hospitals, health centres,

clinics) run by

Government Religious Org. Private Org./ Individually owned

Is there a trained community health worker in the EA? Yes No

Yes NoHas any health worker visited the EA in the last 3 months?

How long ago was the last village/ community (If none end the interview here)

1-3 months 4-6 months Over 6 monthsNone Less than 1 month

No

No

Yes

Yes

Name of Respondent

name

V307.

Number of government primary schools

Number of private primary schools

Number of ECDE /nursery schools

Number of government secondary schools

Number of private secondary schools

(If none end the interview here)

is nothing please put 0. Where numbers are not required and the response is not applicable insert 999.

Do not leave any question unanswered, where numbers are required and there

Age of Respondent

Telephone

DistrictSub- county

Parish

of what was discussed?

Other (specify)

V401.

V402.

V403.V400

.

Yes No

Male Female

Adu

lt Li

tera

cypr

ogra

ms

Are there adult literacy learning classes in this village?

What is the gender of the adult literacy teacher? (Give Numbers)

Where do they meet?Nearby school Community Social Hall

ySomebod ’s houseUnder a tree Others (Specify)

Don’t Know

If yes, in which year was the last visit?

(if no, skip to V500)

V308.

Number of community primary schools

Date:

What is the

Male Female Male Female

rChu Mosquech /

..

............................

School Name

Does the school have a special needs unit?

Girls

Date: Time of Arrival: of the person

Answering Questions (Tick)

GO TO THE HEADTEACHER’S OFFICE

Headteacher Deputy Headteacher

Tel: Headteacher’s Name

EMIS No.

Respondents’ Tel:

F Sex M Permission to use telephone Yes No

District Sub-county ParishEA name

Note:

the Headteacher/ Deputy Headteacher/

S200. Children’s Enrollment 2015

P.7 P.1 P.2 P.3 P.4 P.5 P.6

Boys

Girls BoysGirls

BoysGirlsBoys

Class Stream

S 201. Children’s enrollment (takefrom register)

S 102. Number of streams

Pri

S 101 a. Type of school

Boys day and boarding

Girls day and boarding

Girls day

Mixed day

Boys day

Girls boarding

Boys boarding

Mixed boarding

Mixed day and boarding

1

2

34

5

6

7

Total Male Female

S407.

S408.

S401. srehcaet fo rebmun latoT

S402.

Total number of teachers present

S403. Number of teachers appointed bythe District Service Commission(Applicable to Gov’t schools only)

S404. Other trained teachers employed by parents, sponsors, donors, etc.

Other untrained teachers employedS405. by parents, sponsors, donors, etc.

Number of teachers trained on S406.

A

B

C

D

STEP 1

SCHOOL DATA SHEET

Number of non teaching staff

What is the required teacher establishment (staff ceiling)

NurseryBoysGirls

Boys

Boys

Boys

Girls

Girls

Girls

Class i. Visual

ii. Hearing

iii. Physical

iv. Mental

INSTRUCTIONSVisit one school (government/ private/ community) with classes1-7, that serves the community most. Meet the Headteacher of the school but in case he/she is absent meet

fo esoprup eht nialpxE .egrahc-ni tfel rehcaet eht ro rehcaetdaeH ytupeD ehtthe visit and request for an interview and documents if needed.

there is nothing please put 0. Where numbers are not required and the response is not applicable insert 999.

Nursery

6.P 7.P 5.P 4.P 3.P 2.P 1.P

Nursery

S 300. Children with special needs (Add the totals from all the streams)

What is the average to and from the main source of water?

S505. Buy into tank

S503

S504.

S506.

S507.

S508.

NoneSpring

No

No

Yes

Yes

30 min - 1hr20 minutesLess than 20 - 30

Minutes1 hour or more

Is there a school feeding program ?

Is there a library service?

Well Rain water Pipe

Yes No

No

Malaria Diarrhea Cough & Flu Other(specify)

Yes No

Borehole

S500. Health and other services S501 .

S502. Is there a stocked first aid kit? Yes

What is the biggest health problem that makes childrenmiss school?

What is the main source of water for the school?

Dam River/ Lake

Is safe and clean drinking water available in the school?

2015

Government

PrivateCommunity

S 101 b. Status of the school

S100 School Details

:

S601

How do you discipline children when they misbehave?

S600.

Cane/ slap/ kick/ hit them

Suspend them

Talk to them

We give them work as punishment

Tick method used Tick method used in the last two weeks

Require them to formally apologise

Other ( Specify)

S 101c.

..................................

Is there a staff trained in first aid?

there is nothing please put 0. Where numbers are not required and the response is not applicable insert 999.

S800.

S702.

S704.

S705.

S706.

S703.

S701.

S801.

S803.

PRESENCE IN CLASS

S1000: Head Count

S1001.

S1002.

S1100.

S1101.

S1102.

S1103.

S1104.

S1105.

S1106.

S1108.

S1107. Number of usable pupils’ toilet stances in the school

loohcs eht ni nerdlihc rof steliot detpada ytilibasid fo rebmuN

S1110. Yes No

S700.

S707 .

S708.

S900.

S901

Primary 2 classteacher’s bio data

S903

S904

S905

S906

S908

S909

S907 If no, skip to S910

STEP 4

ABCD

RANDOMLY SELECT ONE PRIMARY TWO CLASSROOM/ STREAM

Ask S800 to a P.2 classteacher or the teacher who regularly teaches the class

Ask S900 to the P.2 classteacher only. If the P.2 classteacher is absent Skip to Step 3.

Less than a year

Less than a year

English Kiswahili Local Language

Class and stream

Gender of the class teacher Male Female

Yes No

Total number of children in class

S802. How many text books are available for the following subjects?

Local languageEnglishMaths

(Tick where appropriate) If the class teacher is absent skip to Step 3

Male FemaleSex

Highest academic level

Highest professional level

Years served as a teacherYears as lower primary teacher(P.1- P.3) in current school

S.4

Grade 3

Other (specify)

1- 2years

1- 2years

Degree

3 - 6years

3 - 6years

Masters

More than 10yrs

More than 10yrs

Other(specify)

Less than a week 1 week3 weeks or more

LocalGovernmentNGO/Private Who organised the training?

DO A HEAD COUNT AND OBSERVE TEACHER

Children's

(Do a head count)

A

B

C

D

Stream Sex P.1 P.2 P.3 P.4

Was the teacher present in theclassroom? if yes if no

Boys

Boys

Boys

Boys

Girls

Girls

Girls

Girls

Does the school have a “talking compound”?

Yes No

Female

Tick the appropriate

Do the majority of children (75%) have a book to write on?(Ask them to show you their exercise books for that lesson)Do the majority of children (75%) have a pencil or something to write with?Ask them to show you

NoYes

Observe the school

S1109.

Number of usable ces in the schoolIf Yes in S907, what was the

P 5 P.6 P.7

Shared

Have you a ended any in-service training in the last 2 years?

Tick the appropriate

Total number of usable and safe classrooms in the school

Is the school connected to electricity?

Is there a playfield/ space for children in the school?

Is the school compound fenced?

State the number (If nothing put 0)

204

Male

What is the main

Are there charts and/ or other supplementary materials like readers displayed in the classroom? (Observe)

S709.

and soap?

Male

What is the main

Are there charts and/ or other supplementary materials like readers displayed in the classroom? (Observe)

Yes

NoS709.

‘

2015

‘

A trained teacher An untrained teacherS902. Are you?

S710.

unanswered, where numbers are required and there is nothing please put 0.

Where numbers are not required and the response is not applicable insert 999.

Min. of Educ, Science, Technology and Sports

S910

S911

.

Ask ONLY if the school is government Aided Yes

Would you say children’s reading competencies have improved in the last one year?

2 weeks

Other (specify)

Water

Soap

No

Nur

Don’t Know

School

(If No skip to S1000)

Time of Departure: _____:_____

7 - 10 years

7 - 10 years

Grade5/Dip.

S.6

School Health and Reading Program (SHRP)

School focus on improving reading ............................................

.............................

........................................

Household Head (name)

Sex Male Female

Univ.Sec. Pri. None

Respondents’ Tel:Permission to use TelName of school surveyed

Where numbers are not required and the response is not applicable insert 999

HH Head Spouse Other Adult

HH No. tsi oNLEA

Has this household ever been visited by Uwezo Volunteers? Yes No

H100. Number of household members ( who eat from the same pot and live regularly together)

Total Female Male Polythene Iron sheet Timber Stone/Bricks saG raloS yticirtcelE Yes No 1 2 3 or more

H101. what kind of walls does the main house H103. Does the household have a toilet/latrine

H104. How many meals are eaten in the HH per day?

H107. How many of these do you have as a household? (write numbers)

TV Radio Computer Mobile Bicycle Motor Sheep/Vehicle Goats

HOUSEHOLD SURVEY SHEET2015

Telephone

Date of Interview

H302

in a week?

H108 a.What is your H108 b. What is theaverage walking

the Main water source?

H109. What treatment is given to water before drinking?

main source of water? (Tick one)

Borehole Well Rain water Pipe

Buy into tankSpring

River/Lake

Agree

Boiling

NoneChlorine(Any water pufier)

When a child misbehaves, the best response is to talk to that child

English Local Language

Kiswahili

students to make them learn

Main language spoken at home?

Name of Respondent

Other(Tick)

Dam

For each of the following statements, I would like you to tell me whether you agree, disagree, strongly agree or strongly disagree

there is nothing please put 0.

Cycle

the respondent.Yes No

BicycleOther (specify)

Age of Respondent

If Yes, in which year was the last visit?

have?

Protectedhousehold in a week?

H201

H200. Parents’ of the importance of learning (Ask in all households with or without children)

To give them a good future

So that they learn

If they are of school going age If other children go to school

It is a requirement by law to take them to school

dlo ma I nehw em pleh oT

Others (Specify)Because it is free

Why would you send a child/ children to school?

DisagreeStronglyagree

Stronglydisagree

It is important for students to fear their teachers

Schools must never allow teachers to hit or cane students for any reason

H301

Disciplining Children (Ask in HHs with children)

How do you discipline your children when they misbehave?

H300.

Cane them

Deny them a meal

Talk to them

I do nothing

Deny them things they love

I give them work as punishment

Tick method used

Tick method used in the last two weeks

H303

Newspapers

At a community event

Can you please name

TV

Radio

In the past one year, have you heard any messages YesNo

Where have you heard these messages? H304

H305 1 2 3 or more

H306Do you know who created the messages you heard? Yes No

NoYesH307

H308 Raising Voices

Save the Children

PlanUNICEF

Other(Specify)

Tick all applicable)

Do not

beat their children to make them listen

(Tick all that apply)

If No, skip to H400

If No, skip to H400

If No, skip to H400

in a week?

Daily 4 - 6times

2 - 3times

once a week Never

Daily 4 - 6times

2 - 3times

once a week Never

Other (specify)

in the household

FilterDaily 4 - 6times

2 - 3times

once a week Never

DD / MM/ YY

.

.

.

.

.......................................

..........................................................................................................................

.......................................

messages in the last year?

< 20 30 min- 1Hour

20 - 30

1Hour or more

minutes

to

minutes

Right Eye Eye

Was instant feedback given to the household?

H400. Child’s Bio data

Questions H400 - H1000 to be answered by the Household head/ spouse or other adultH800. Biological

H900.

mother’s

(Fill for each child)

H1000.

H150

0.

Basic Learning Levels

Visu

al a

cuity

(For all children

)sry 61 -6

Bonus (For all children

)sry 61 - 6G

oing

H50

0 N

umbe

r of b

iolo

gica

l par

ents

livi

ng in

the

HH

Can

the

child

poi

nt to

the

dis

faci

ng

?

No

disa

bilit

y?H7

00. D

oes t

he c

hild

hav

e an

y kn

own

NB:

if deceased

D

and

move on

Nur

seryEver gone

to school?

Out of School children 6-16 years (currently not in school)

Not

Goi

ng

Frid

ay o

f the

wee

k of

ass

essm

ent

Assess all children of years 6 to 16 only for reading in literacy (Eng lish and local language) and the bonus test and measure visual acuity.

Where numbers are not required and the response is not applicable insert 999

List names of ALL children of 0 - 16 years regularly living in this Household

(STARTING with the youngest child)

- Below 3 years: list and record bio details- 3 - 5years: list, record bio details and preschooling status.- 6 - 16 years list, record bio details, schooling status and assess the child.

Age

Sex

Schooling Status

Yes

No

Yes

If ye

s, w

hat c

lass

H 1

100.

In w

hich

Cla

ss w

ere

you

last

yea

r?

Gov

ernm

ent

Priv

ate

Yes

NoNo

Yes

com

mun

ity surv

eyed

sch

ool?

Does

the

child

go

for p

rivat

e

coac

hing

?

P.7

S.4

Com

plet

ed

Nev

er e

nrol

led

Drop

out

Year

Drop outyear & class

Stor

y

Can

do

Cann

ot d

o

Cann

ot d

o

Wor

d

Stor

yCa

n do

Cann

ot d

o

Cann

ot d

oCa

n do

Sylla

bles

ycaretiL hsilgnE(Tick the highest

level)

Comprehension

For those reading

story only

Q1 Q2

egaugnal lacoL

........................(Tick the highest level)

Comprehension For those readingstory only

Numeracy(Tick the highest level)

Non

- num

erat

e

Num

Rec

. 10

- 99

Divi

sion

Ye

s

No

Yes

No

Clas

s

Yes

Yes

NoNo

Yes No

Yes No

Sam

ple

of te

st u

sed to

ass

ess th

e ch

ild (1

,2,3

,4)

Non

- rea

der

Wor

d

2015HOUSEHOLD DATA SHEET

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

Total

Don’

t kno

w

List ALL Household members from 0 - 16 years regulary living in the Household.

Do not leave any question unanswered. Where numbers are required and there is nothing please put 0.

D

Q1 Q2

you

Mat

chin

g

Ethno Math

H1700.

figur

e E

Can

do

Seria

l No.

H1600.

B1

H13

00. W

as y

our m

aths

teac

her

in

cla

ss t

each

ing

o

n Fr

iday

? (Fr

iday

of t

he w

eek

of a

sses

smen

t)

H1400.

Clas

sQ1 Q2

B2 B3

Can

do

Can

do

Can

do

Cann

ot d

o

Cann

ot d

o

Cann

ot d

o

Cann

ot d

o

Cann

ot d

o

Can

do

Can

do

Non

- re

ader

Para

grap

h

Para

grap

h

Tick

- Primary write P (Class) e.g P1

- Diploma write Dip - Degree write Uni

, Numeracy....

Local Language

....................................

Sub- county

Parish

EA name

Comprehension For those reading story only

( total number)

( total number)

H1200.

Total number of locked Households

Don

’t kn

ow

Goi

ng

Not

Goi

ng

Gov

ernm

ent

H800.BiologicalMother’s

H60

0. H

700.

Doe

s th

e ch

ild h

ave

any

know

n di

sabi

lity?

H50

0. N

umbe

r of b

iolo

gica

l par

ents

livi

ng in

the

HH

2015

H400. Household Bio Data

Name of Household Head

H900.

(Frid

ay o

f the

wee

k of

ass

essm

ent)

Schooling Status

H11

00. W

as y

our m

aths

teac

her i

n cl

ass

teac

hing

on F

riday

? (F

riday

of t

he w

eek

of a

sses

smen

t)

H14

00.

VisualAcuity

Age

Sex

Seria

l No.

Total

Gone to School

Priv

ate D

eos

the

child

go

for

arra

ngem

ent?

Yes No Yes No Yes No

the

surv

eyed

sch

ool?

Nev

er e

nrol

led

Dro

pout

Drop out

Year and class

Year

Clas

s

Yes Yes No

Right Eye Eye

Stor

y

Can

do

Can

not

do

Can

not

do

Non

- re

ader

Wor

d

Stor

y

Can

do

Can

not

do

Can

not

do

Can

do

Sylla

bles

Non

- nu

mer

ate

Yes

No

Yes

No

Num

Rec

. 10

- 99

D

ivis

ion

Sam

ple o

f te

st u

sed

to a

sses

s th

e ch

ild (1

,2,3

,4)

Non

- re

ader

Wor

d

Comprehension For those reading story only

English LiteracyNumeracy

Bonus ( For all Children 6 - 16yrs

Q1 Q2

Total number of households surveyed

Total number of "No response households"

Total number of Volunteers

Date

Name of surveyed School

School type

ENUMERATION AREA COMPILATION SHEET

District

Basic Learning Levels

Yes No

Total number of children aged 6-16 assessed

Can

the

child

poi

nt

to t

he d

i

Mat

chin

g

Nur

sery

Ethno Math

B1Q1 Q2 B2 B3

Can

do

Can

do

Can

do

Cann

ot d

o

Cann

ot d

o

Cann

ot d

o

Cann

ot d

o

Cann

ot d

o

Can

do

Can

do

Q2Q1

Can

do

NoCom

mun

ity

Para

grap

h

Para

grap

h