Institution: ESAF Microfinance and Investments Pvt. Ltd.

(EMFIL)

Document Name: Client Transformation Assessment Questionnaire

How the Document Is Used:

EMFIL uses this questionnaire on all new clients, at the time of their entry, to assess their
socioeconomic status. Many of the indicators correspond to the institution’s social goals and targets
(e.g. Household income per day; Access to drinking water), and the data collected help EMFIL determine
whether they are meeting their targets. The questionnaire is also administered to clients during their
fourth loan cycle, to measure change in the client’s socioeconomic status over time. EMFIL uses the
results from these questionnaires to share it with the senior management committee and also the board
of EMFIL so as to enable them to take strategic decisions.

How Other Institutions May Use This Document: Institutions can use this as an example of a client data
collection tool.

Corresponding Universal Standards Section: Section 1, Define and Monitor Social Goals

Corresponding Essential Practices:

(1a) In the institution’s strategy, the institution has defined social indicators—the indicators it will use to
measure its progress toward achieving each of its social goals.

(1b.1) The institution collects data using at least one indicator for each of its social goals (defined in 1a).

(1b.5) If the institution states poverty reduction as one of its social goals, it monitors the poverty levels
of its clients using a poverty assessment tool (e.g., per capita household expenditure, food security
survey, Participatory Wealth Ranking, Progress out of Poverty Index, gender audit tools, etc.)
 ESAF MICROFINANCE & INVESTMENTS PVT. LTD
CLIENT TRANSFORMATION ASSESSMENT SHEET
Sl.No
1 Name of the client 7 Client ID
2 Sangam Name 8 District
3 Branch 9 No. of loans taken
4 No. of years with ESAF 10 Age
5 Last loan amount taken 11 Category SC/ST OBC General
6 Ph. No 12 Economic status APL BPL
13 Religion Hindu Muslim Christian Others
14 Social status Married Unmarried Divorced Separated Widow.
15 Employment status Housewife Daily wages Own production unit Service (Tailoring, repairing)
Grocery shop Street vendors Others
16 Do you have any major physical disabilities? Yes No
17 Type of housing Kucchha (Thatched, Built up of Weak materials) Pucca (Work Completed, Tiled, Terraced)
Semi-pucca (Built up of strong materials but not decorated / completed)
18 Ownership of house Own house Rented Others
19 Children’s schooling status Private school Govt. school N.A
20 Household income per day Less than 100 100 to 200 200 to 300 300 to 400 More than 400
21 Sanitation facility
Own toilet with septic Own toilet with no septic tank Community toilet No access to toilet
22 Access to drinking water Own well Own Bore well Community well Own pipe connection
Community hand pump/Water pump Any other
23 Do you follow any of these for clean drinking water? Pure it water purifier (Supplied by ESAF) Boil water Other water purifiers
Not purify Filtration with Chlorine
24 Do you have a life insurance in your name? Yes No If yes, Name
25 Do you have a health insurance in your name? Yes No If yes, Name

26 Have you accessed any pension policy? Yes No If yes, Name

27 How do you save your money? Bank Post Office Chit funds ESAF Other MFI/Private money lenders
Relatives / Friends At home Any other
28 Which of the following non-financial services of ESAF have you accessed?
Skill development training Leadership development training Financial Literacy training Health awareness Any other
29 Your attendance in the sangam meeting Regular attendance Irregular Do not attend

30 Awareness about the sangam procedure Full aware Partially aware Not aware

31 Awareness level on the rights and responsibilities of a sangam member Full aware Partially aware Not aware
31 Awareness about the rate of interest on ESAF loans Full aware Partially aware Not aware
33 Awareness about grievance redressal mechanisms Full aware Partially aware Not aware

34 Where do you borrow money from to meet your financial needs? ESAF Co-Operative Banks Other Banks Friends / Relatives
Mortgage gold Chit funds Moneylenders Never accessed credit before
35 Have you taken part in any civic election by giving your vote? Yes No

36 Have you contested in local body election? Yes No

37 Do you have clash with your husband due to financial stress? Yes No

38 Your present level of financial debt outside ESAF? Very High Low No debt
39 Do you have a say in the important decisions in your home? Yes No

40 Have you taken the role of a sangam leader at least once? Yes No
41 Have you invested the loan amount in your own business any time? Yes No
42 Have you employed others in your business? Yes No
43 Have you bought any HH item like fridge, TV, Utensils, washing machine etc... In the past one year Yes No
44 Do you go out to public places on your own? Yes No
If yes, Nearby places To very far places Anywhere

Thank You