EcowasHealthSurvey2026 | Africa Health & Wellbeing

Welcome to the Health & Wellbeing Survey

This study helps improve healthcare services across the continent.

⏱️ Estimated Time: 40–45 minutes
📋 Total Questions: 139
🔒 Privacy: Anonymous and confidential

Your participation helps us understand health needs better and improve healthcare services across Africa.

🧍‍♂️ 1. Demographics

Basic information to understand health disparities.

Full Name*

Email Address*

Phone Number*

How old are you? *

Who lives in your household? (Select all that apply)* Partner/Spouse Children < 18 Parents/Grandparents I live alone

What Gender are you?*

Marital Status?*

Religious Affiliation?*

🌍 2. Migration & Language

Language and background affect healthcare access.

Country of birth?*

First (mother) tongue?*

English Language Skills?*

Native Good Little/None

🎓 3. Education & Employment

Work and schooling data related to health quality.

Highest school qualification?*

Current Employment Status?*

Full-time Part-time Unemployed Self-employed

Do you earn enough to cover basic needs?

🍎 4. Nutrition & Dietary Habits

We ask about your eating habits – how often you consume certain foods, how regularly you eat, and whether you have access to healthy food.

How many meals do you usually eat per day?*

Which of the following best describes your nutrition habits? (Select all that apply)* Home-cooked meals Fast food Vegetarian Vegan Traditional diet Mixed diet

Do you regularly eat breakfast?*

Yes No

How would you describe your diet in general?

How often do you eat fruits and vegetables?

Do you find it easy to access healthy food in your area?

Do you snack between meals?

Do you have regular access to clean drinking water?

How often do you consume sugary drinks (e.g. soda, sweetened juices)?

Are there cultural or religious factors that influence your diet?*

🏃‍♂️ 5. Physical Health, Activity & Body Measures

This section covers your physical health, activity, weight, height, and general physical condition. This information helps assess health risks.

How often are you physically active (walking, sports, chores, etc.) for at least 30 minutes?*

How would you rate your physical fitness?

What is your current body weight (in kg)?*

What is your height (in cm)?*

Do you have any physical limitation (e.g. walking, lifting, climbing stairs)?

Have you experienced shortness of breath during the last 4 weeks?

Have you experienced changes in appetite during the last 4 weeks?

Do you use any assistive devices? (Select all that apply) Walking aid Wheelchair Hearing aid Visual aid None

🧠 6. Mental Health & Emotions

This section looks at your emotional well-being – whether you've felt stressed, exhausted, sad, or content. Such feelings have a strong impact on quality of life.

In the last 4 weeks, how often did you experience the following?*

	Never	Rarely	Sometimes	Often	Always
Felt anxious or nervous
Felt down or hopeless
Had trouble sleeping
Felt tired/no energy
Little interest/pleasure
Difficulty concentrating
Felt lonely/isolated
Felt happy

Have you experienced any of the following mental health conditions in the past year?* Depression Anxiety Burnout PTSD Hypochondria None

Have any of these mental health states led to increased use of alcohol or other substances?*

Have you received any mental health treatment in the past 12 months?*

Have emotional difficulties affected your work or social life in the past month?

In the past 12 months, have you taken any medication or herbal remedies for emotional issues?

Do you currently feel supported by family or friends?*

Have you experienced traumatic events in the past?*

Do you currently have access to mental health services if needed?*

Would you feel comfortable talking to a health worker about mental challenges?

🏥 7. Health Insurance & Chronic Conditions

We ask about your insurance coverage and whether you've experienced any problems related to chronic conditions. This information helps identify healthcare needs more clearly.

Do you currently have health insurance?*

Do you have one or more long-term, chronic diseases? (Select all that apply)* Hypertension Diabetes Heart disease Asthma or lung disease Mental illness Chronic pain Cancer None

Do you understand how to monitor your condition (e.g. blood pressure, sugar)?

💊 8. Medication & Treatment Use

This section explores which medications or treatments you currently use and how regularly you take them.

Are you currently taking any of the following medications?*

Do you take any prescribed medications regularly?

Yes No

Where do you usually get your medications?*

Do you take your medication regularly as prescribed?*

Have you ever stopped taking medicine because of side effects or fear?*

🍺 9. Substance Use (Alcohol, Tobacco, Drugs)

This section addresses your use of alcohol, tobacco, and other substances. These factors can significantly affect health.

Do you currently consume alcohol?

If yes, how often do you drink alcohol?*

Do you currently use any of the following tobacco or nicotine products?*

If yes, how many cigarettes do you usually smoke per day?*

Have you ever used any of the following substances for non-medical purposes?* Marijuana / Weed Tramadol / Oxycodon / Morphin (without prescription) Cocaine Inhalants / glue I have never used any of these

💉 10. Vaccination & Preventive Care

We ask whether you've participated in preventive screenings and received vaccinations. Prevention is a key part of maintaining good health.

Have you received any of the following in the past 12 months? (Select all that apply)* General health check-up Blood pressure check Blood sugar test Dental exam Cancer screening None

Is your vaccination status up to date?*

Have you received any vaccinations in the last 12 months?*

Yes No

Were you vaccinated against COVID-19?*

Have you ever had COVID-19?*

Would you accept vaccines in the future if offered for free?*

Do you believe traditional medicine is more effective than modern treatment?*

👪 11. Family & Children

This section relates to your family and your access to social support.

Do you have children under the age of 18?*

Yes No

Do you feel supported by your family when you are sick?*

Do you feel supported by your community?*

Are you a member of any local support group or religious fellowship?*

Yes No

Do you know where to go for non-medical needs (e.g. housing, food)?*

Have you ever received help from a social worker, NGO, or community project?*

Yes No

📱 12. Digital Health & Information

We want to know how you use digital devices to get health information.

Do you have access to a smartphone or internet device?*

Yes No

Do you feel confident understanding medical information from pros?*

Have you ever used a health app or online service?*

Yes No

Do you find it easy to understand health information online?*

Do you feel you have enough info to make health decisions?*

Have you ever participated in a health education session?*

Yes No

🏁 13. Health Perception & Final Questions

In the final section, we ask about your general well-being, satisfaction with the healthcare system, and your feedback on the survey itself. Your input helps us improve.

What is currently your biggest health concern?*

What would most help you to improve your health or access better care?*

In the last 12 months, how often did you feel that you had control over your health decisions?*

In general, how satisfied are you with your current health?*

In general, how satisfied are you with the healthcare you receive?*

Do you feel your background (language, religion, ethnicity, gender) influences how you are treated?*

How much do you trust healthcare providers in your community?*

Do you feel that healthcare in your area is fair and accessible to everyone?

If you became seriously ill, where would you prefer to receive care?*

Would you like more health info/education in your preferred language?*

Would you be willing to participate in future surveys?*

Survey length – was it appropriate?*

Survey experience – how did you feel about participating?*

Do you have any final comments, suggestions or concerns?

🌍 EcowasHealthSurvey2026

Welcome to the Health & Wellbeing Survey

🧍‍♂️ 1. Demographics

🌍 2. Migration & Language

🎓 3. Education & Employment

🍎 4. Nutrition & Dietary Habits

🏃‍♂️ 5. Physical Health, Activity & Body Measures

🧠 6. Mental Health & Emotions

🏥 7. Health Insurance & Chronic Conditions

💊 8. Medication & Treatment Use

🍺 9. Substance Use (Alcohol, Tobacco, Drugs)

💉 10. Vaccination & Preventive Care

👪 11. Family & Children

📱 12. Digital Health & Information

🏁 13. Health Perception & Final Questions