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Appendix 1 - Anthropometry: Survey Form
Village: ____________________________
Date of Interview: _____/ _____/ _____
Interviewer(s):___________________________
|
ID
|
First
Name |
Sex: |
Date
of Birth: |
Age
in Months: |
Height: |
Weight: |
|
|
__/ __/ __ |
__ __ |
__ __ __ .__ |
__ __ . __ |
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|
__/ __/ __ |
__ __ |
__ __ __ .__ |
__ __ . __ |
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__/ __/ __ |
__ __ |
__ __ __ .__ |
__ __ . __ |
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__/ __/ __ |
__ __ |
__ __ __ .__ |
__ __ . __ |
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__/ __/ __ |
__ __ |
__ __ __ .__ |
__ __ . __ |
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__/ __/ __ |
__ __ |
__ __ __ .__ |
__ __ . __ |
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__/ __/ __ |
__ __ |
__ __ __ .__ |
__ __ . __ |
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__/ __/ __ |
__ __ |
__ __ __ .__ |
__ __ . __ |
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__/ __/ __ |
__ __ |
__ __ __ .__ |
__ __ . __ |
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__/ __/ __ |
__ __ |
__ __ __ .__ |
__ __ . __ |
Download Survey Form (PDF Format)
Appendix 2: Calendar for Calculating Age in Months
[Example from a survey carried out in March 2000]
| Month of Birth: |
Age in Months: |
Calendar of Local Events: |
| 1999 |
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|
12 |
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13 |
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14 |
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| 1998 |
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|
15 |
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16 |
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17 |
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18 |
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19 |
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20 |
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21 |
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22 |
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23 |
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24 |
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25 |
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26 |
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| 1997 |
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|
27 |
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|
28 |
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29 |
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|
30 |
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31 |
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32 |
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|
33 |
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|
34 |
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|
35 |
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|
36 |
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|
37 |
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|
38 |
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| 1996 |
||
|
39 |
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|
40 |
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|
41 |
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|
42 |
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|
43 |
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|
44 |
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|
45 |
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46 |
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|
47 |
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|
48 |
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|
49 |
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|
50 |
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| 1995 |
||
|
51 |
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|
52 |
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|
53 |
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|
54 |
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|
55 |
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|
56 |
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57 |
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|
58 |
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|
59 |
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Too old |
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Too old |
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Too old |
|
Household Food Security and Gender Memory Checks |Practical Anthropometry 101 and 102 | Rapid Nutrition Surveys for Estimating Project Impact | Manual for Bottom-up Approach in Food Security Inverventions | Comprehensive Participatory Planning and Evaluation | Household food Security: Concepts, Indicators and Measurements
