ANNEXE II Household and Water-point Questionnaires

Annexe II

i

Treball realitzat per:

David Requejo Castro

Dirigit per:

Agustí Pérez Foguet

Màster en:

Enginyeria Ambiental

Barcelona, 23 de Juny de 2016

Departament de Enginyeria Civil i Ambiental

TR

EBA

LL F

INA

L D

E M

ÀST

ER

ANNEXE II

Household and Water-point

Questionnaires

Bayesian Networks as a Decision Support Tool for Rural

Water Supply and Sanitation sector

Annexe II

Bayesian Network as a Decision Support Tool for Rural Water and Sanitation Sector i

ANNEXE II. Household and Water-point questionnaires

In this Annexe, the methodology for data collection is described and the survey instruments are

attached.

The approach adopted for data this important process combined a water point mapping with a

household survey; both of them conducted in Kenya by Polytechnic University of Catalonia

(UPC) in close collaboration with government’s technicians. These processes for information

acquiring are detailed below:

i) Water-point Survey

In brief, the mapping methodology employed was based on the water point mapping (WPM),

which can be described as an “exercise whereby the geographical positions of all improved

water points in an area are gathered in addition to management and technical data” (WaterAid

and ODI, 2005). This WPM involves the presentation of this information in a spatial context

which enables a rapid visualisation of the distribution and status of water supplies. By linking

these point data with demographic information, WPM objectively demonstrates who is and is

not served; thus becoming a valuable analysis and planning tool for decentralised governments.

Nevertheless, and pointed out by Giné garriga, Jiménez and Pérez-Foguet (2013), this

methodology lacked of two important aspects that were introduced in the survey attached: i)

biological testing to ensure water quality; and ii) the inclusion of unimproved sources.

Regarding data collection methodology, once information from households was obtained

regarding drinking-water source, then the identified water-points were visited. The mapping of

water-points was exhaustive regardless functionality issues. At the same time, tackling equity

issues were highlighted from the viewpoint of human rights, as any exercise covering

unimproved water-points would provide inputs to elucidate the access pattern of the population.

In rural contexts, however, this type of water source might be common, thus increasing

significantly the budget and resources devoted to data collection in case of inclusion. Similarly,

where main water technology is piped systems with household connections, the idea of a

comprehensive audit of all these private points-of-use is practically impossible. A more

convenient solution was to visit the distribution tank and a reduced number of domestic taps,

which are taken as representative of the overall system.

i) Household Survey

Besides the mapping, a survey was conducted to assess sanitation and domestic hygiene in

which the household is taken as the basic sampling unit. The design and selection of the

sample draw on the Multiple Indicator Cluster Survey (MICS).

Since its inception in 1995, the MICS has become the largest source of statistically sound and

internationally comparable data on women and children worldwide. In countries as diverse as

Costa Rica, Mali and Qatar, trained fieldwork teams conduct face-to-face interviews with

household members on a variety of topics, focusing mainly on those issues that directly affect

the lives of children and women. MICS was a major source of data on the Millennium

Development Goals (MDG) indicators and will continue to be a major data source during the

2030 Sustainable Development Agenda to measure Sustainable Development Goals (SDGs)

indicators.

Annexe II

Bayesian Network as a Decision Support Tool for Rural Water and Sanitation Sector ii

In terms of methodology, a defined number of households is selected in a statistically random

manner from a comprehensive list of all households in the subunit of study. However, such a list

does often lack. Then, if the population size is small, the optimum alternative may be to create a

list by carrying out a quick census.

In terms of technique, the method relies on a variety of mechanisms to assure quality of

produced outcomes. Among the most important are:

Territorial delimitation of study area. As an exercise to support planning, administrative

subunits in which base data collection should play a relevant administrative role in

decentralised service delivery. Thus, they should be adequately delimited, unambiguous

and well-known by both decision-makers and local population;

Design of survey instruments. On the basis of a reduced set of reliable and objective

indicators, appropriate survey tools should be developed for an accurate assessment of

the WASH status. In this case, the survey instruments are a combination of quantitative

and qualitative study tools, which are specially designed to collect data from the water

point and the household. Field inspections at the source employ a standardized checklist

to evaluate the existence, quality and functionality of the facility and a water sample is

also collected for on-site bacteriological testing. At the dwelling, information related to

service level is captured through a structured interview administered to primary care-

givers. In addition, direct observation enables a complementary evaluation of domestic

hygiene habits that may not be otherwise assessed, as sanitary conditions of the latrine,

existence and adequacy of the hand-washing facility, etc;

Involvement and participation of local authorities. In this case, the process engaged in

various stages of the process with those government bodies with competences in

WASH. Specifically in data collection, the commitment of officers belonging to the

local government i) helped ensure a link between field workers and the local structures

at community level, and ii) promoted sense of ownership over the process, as

prerequisite for incorporating the data into decision-making;

Data processing: The data entry process needed to be supervised, and the produced

datasets needed to be validated on a regular basis. Various quality control procedures

were in place to ensure that the data reflected the true position as accurately as possible,

and routine analysis of database or random checks of a reduced number of

questionnaires helped detect data inconsistencies and improve database robustness.

Once information was collected, a daunting task of post-processing was carried out. In this case,

the author of the master thesis avoided this phase, as it had been done before. Nevertheless, the

decision, related to which information should be taken into consideration, was done by this

author.

In following pages, the survey instruments are attached, as the reader might find it useful for

further consultation.

Survey Instruments for the Baseline Survey

Waterpoint Questionnaire 1

Ref:

WATERPOINT QUESTIONNAIRE

Section A. INFORMATION ABOUT THE INTERVIEW

A1. Date of Interview / /20

A2. Name of Interviewer

A3. Name of respondent

A4. Sex of respondent Male ...................................................................... A

Female .................................................................. B

A5. Age of respondent

A6. Position of respondent (in relation with the

waterpoint)

Section B. GENERAL INFORMATION OF THE WATERPOINT (WP)

B1. Name of District

B2. Name of Location

B3. Name of Sub Location

B4. Name of Community (EA)

B5. Community Code (EA Code)

B6. Name of waterpoint / source

B7. Waterpoint / source code

B8. GPS Location - UTM of the waterpoint /

source

x-coordinate:

y-coordinate:

B9. Elevation (m.a.s.l.)

B10. When was the waterpoint constructed?

(if year is unknown, tick one option)

Year:

Less than one year ago .................................... 0001

1 – 5 years ago ................................................ 0002

6 – 10 years ago .............................................. 0003

11 – 15 years ago ............................................ 0004

16 – 20 years ago ............................................ 0005

More than 20 years ago ................................... 0006

Not applicable .................................................. 9995

DK .................................................................... 9999



B11. Who funded the waterpoint? Community ................................................................ A

NGO / Donor ............................................................. B

Municipality ............................................................... C

Government .............................................................. D

Other (specify) .......................................................... X

Not applicable ........................................................... Y

DK ............................................................................. Z

B12. Did the community contribute with an initial

contribution?

No, there was no initial contribution ........................... A

Yes, by cash ............................................................. B

Yes, by labour ........................................................... C

Yes, by cash + labour ................................................ D

Other (specify) .......................................................... X

Not applicable ........................................................... Y

DK ............................................................................. Z

Section C. TYPE OF WATER SUPPLY

C1. Type of waterpoint Gravity-fed piped system ........................................... A

Borehole with mechanised pumping .......................... B

Borehole with hand pump .......................................... C

Protected dug well with hand pump ........................... D

Protected dug well with windlass ............................... E

Protected dug well with no hand pump/windlass........ F

Unprotected dug well with hand pump .......................G

Unprotected dug well with windlass ........................... H

Unprotected dug well with no hand pump/windlass .... I

Protected spring .........................................................J

Unprotected spring .................................................... K

Rainwater collection .................................................. L

Tanker-truck ............................................................. M

Cart with small tank/drum .......................................... N

Surface water (river, stream, dam, lake, etc.) ............O

Other (specify) .......................................................... X



C2. For mechanised pump, specify how is it

powered.

Diesel .................................................................... A

Solar...................................................................... B

Wind ...................................................................... C

DK ......................................................................... Z

C3. For hand pump, specify model of the pump Afridev ................................................................... A

India Mark II .......................................................... B

India Mark III ......................................................... C

SWN80 .................................................................. D

Others (specify) ..................................................... X

DK ......................................................................... Z

C4. Type of waterpoint (within the community) Tank of a piped system .......................................... A

Private.................................................................... B

Communal waterpoint ............................................ C

School .................................................................... D

Health facility / Dispensary ..................................... E

Cattle trough .......................................................... F

Other (specify) ....................................................... X

C5. Is the waterpoint part of a piped system? Yes……...……...……………….............….......……..A

No……………………………….............………......…B

C8

C6. Name of the water piped system

C7. Is the water treated to make it safer to drink?

(record all items mentioned)

No treatment ......................................................... A

Chlorination ........................................................... B

Filtration ................................................................ C

Others (specify) ..................................................... X

DK ......................................................................... Z

C8. What is the total number of households served

by the waterpoint / system (roughly)?

No. of HH:

DK ...................................................................... 999

Section D. OPERATIONAL STATUS OF THE WATER SUPPLY

D1. What is the current functioning status of the

waterpoint?

Functional.............................................................. A

Non-functional ....................................................... B

Under rehabilitation ............................................... C

Others (specify) ..................................................... X

D3



D2. If non-operational, why?

(multiple answers allowed)

Low yield ................................................................ A

Equipment not-functional ........................................ B

Others (specify) ...................................................... X

D3. Last operational problem Year:

Never had a problem ....................................... 0001

DK ................................................................... 9999

E1

D5

D4. If last operational problem is known, specify

reason


Low yield ................................................................ A


Others (specify) ...................................................... X

D5. How often is this source non-operational? At least once per week ........................................... A

At least once per month ......................................... B

In the dry season .................................................... C

It is normally operational ........................................ D

Others (specify) ...................................................... X

DK .......................................................................... Z

Section E. MANAGEMENT AND OWNERSHIP

E1. Who owns the waterpoint? No-one ................................................................... A

Individual ................................................................ B

Community ............................................................. C

Municipality ............................................................ D

Government ........................................................... E

Institution (school, health facility, etc.) .................... F

Other (specify) ....................................................... X

DK .......................................................................... Z

E2. Who manages the waterpoint? No management..................................................... A

Water user association (WUA) ............................... B

Management committee ......................................... C

Individual ................................................................ D

Municipality ............................................................ E

Government ........................................................... F

Institution (school, health facility, etc.) ................... G

Other (specify) ....................................................... X

DK .......................................................................... Z

E10



E3. How many members does the committee or

WUA have?

Male:

Female:

DK .......................................................................... Z

E4. Is the committee or WUA legally registered? Yes ........................................................................ A

No ........................................................................ B

DK .......................................................................... Z

E5. Does the committee or WUA regularly meet? Yes ........................................................................ A

No ........................................................................ B

DK .......................................................................... Z

E6. Does the committee or WUA keep records? Yes ........................................................................ A

No ........................................................................ B

DK .......................................................................... Z

E8

E8

E7. Which types of records are kept?


Minutes .................................................................. A

Membership register .............................................. B

Correspondences ................................................... C

Other records (specify) ........................................... X

E8. Does the committee or WUA receive

appropriate support (training, capacity

building, technical assistance ...) from Water

Service Board / Local Authority to operate the

waterpoint?

Yes ........................................................................ A

No ........................................................................ B

DK .......................................................................... Z

E9. Has the committee or WUA received any

training/ capacity building during last two

years?


No ........................................................................ A

Yes, in technical issues .......................................... B

Yes, in management .............................................. C

Yes, in hygiene awareness..................................... D

Other (specify) ....................................................... X

E10. Who maintains the waterpoint at local level? No maintenance ..................................................... A

Water user association ........................................... B

Management committee ......................................... C

Individual ................................................................ D

Municipality ............................................................ E

Government ........................................................... F

Institution (school, health facility, etc.) ................... G

Other (specify) ....................................................... X

DK .......................................................................... Z

F1



E11. Are appropriate technical skills available at

local level to carry out maintenance of the

waterpoint?

Tech. skills are not available when needed ............ A

Tech. skills are available, but not for all repairs ...... B

Tech. skills are available for all repairs ................... C

DK .......................................................................... Z

E13

E12. List which maintenance / repairs cannot be

carried out at local level

E13. Are spare parts available at local level? Spare parts are not available when needed ............ A

Spare parts are available, but not for all repairs...... B

Spare parts are available for all repairs .................. C

DK .......................................................................... Z

E15

E14. List which spare parts / equipment are not

available at local level

E15. Is there any preventive maintenance

programme in place?

No preventive maintenance .................................... A

Some preventive maintenance, but not regularly .... B

Regular programme of preventive maintenance ..... C

DK .......................................................................... Z

F1

F1

F1

E16. Specify main aspects of the regular

programme of preventive maintenance (type

of activity and frequency)

Yes No Frequency

Cleaning the waterpoint .....A

On equipment ...................B

Other (specify) ..................X

1

1

1

2

2

2

........... months

........... months

........... months

SECTION F. FINANCIAL ISSUES

F1. Is a water payment system in place? No payment system is in place ............................... A

Yes, but many users don’t pay for the service ........ B

Yes, and almost all users pay for the service .......... C

G1

F2. Payment method 1. Method 2. Amount per payment

Per Month.................. A

Per Bucket ................. B

Per repair .................. C

Others (specify) ......... X

In KSch:

DK ............... 9999

F3. Are any households exempt from paying for

water?

Yes ........................................................................ A

No ........................................................................ B

DK .......................................................................... Z

F5

F5



F4. Which is the basis from exemption?


Poor household ...................................................... A

HH headed by female............................................. B

HH headed by child ................................................ C

Others (specify) ...................................................... X

F5. How are the revenues used?

Repair and maintenance ........................................ A

Paying workers / operators ..................................... B

System expansion .................................................. C

Allowances to management committee .................. D

Others (specify) ...................................................... X

F6. How are the revenues kept? Bank account ......................................................... A

Treasurer ............................................................... B

Others (specify) ...................................................... X

F7. Is there a financial control system1 in place? Yes ........................................................................ A

No ........................................................................ B

F8. In case there is a financial control system, do

you keep / have ...?

Yes No

Financial receipts ................................ A

Cash books ......................................... B

Other financial books (specify) ............ X

1

1

1

2

2

2

F9. In general, income is enough to face all

expenses?

No funds readily available ...................................... A

Some funds available but not sufficient for most

expensive repairs .............................................. B

Funds available and sufficient to cover all

expenses ........................................................... C

SECTION G. WATER QUANTITY AND RELIABILITY

G1. Water quantity at the source Always sufficient (for both domestic and other

non-domestic uses) ........................................... A

Only sufficient for domestic use .............................. B

Not sufficient even for domestic use ....................... C

G2. Average distance from dwellings to the

waterpoint (in minutes)

Minimum distance (min):

Average distance (min):

Maximum distance (min):

DK .......................................................................... Z

1 Financial control system means at least regular control of incomes / expenditures.



G3. Record of conflicts around the waterpoint


No conflicts ............................................................ A

Conflicts due to water availability ............................ B

Conflicts due to water use efficiency ...................... C

Conflicts due to different water uses ....................... D

Conflicts due to water tariffs / payments ................. E

Other conflicts (specify) .......................................... X

G4. Is this waterpoint seasonal? Yes, it is seasonal .................................................. A

No, it is a year-round waterpoint ............................. B

DK .......................................................................... Z

G6

G6

G5. Seasonality of the waterpoint

(circle all the months with low / no yield)

January ................... A

February ................. B

March ...................... C

April ........................ D

May ......................... E

June ........................ F

July ......................... G

August ..................... H

September ................ I

October ................... J

November ................ K

December ................ L

G6. How many days per week does the waterpoint

operate?

Less than 2 days per week ..................................... A

3 – 4 days per week ............................................... B

5 – 6 days per week ............................................... C

All 7 days per week ................................................ D

DK .......................................................................... Z

G7. How many hours per day does the waterpoint

operate?

Less than 6 hours per day ...................................... A

6 – 12 hours per day .............................................. B

12 – 18 hours per day ............................................ C

More than 18 hours per day ................................... D

DK .......................................................................... Z

Section H. SANITARY SURVEILLANCE

A “Sanitary Surveillance” is filled out for all waterpoints.

In addition to the sanitary surveillance, and for all waterpoints, ask for a drinking-water sample (and keep it

refrigerated until the analysis is carried out: pH, conductivity, turbidity, free chlorine, faecal coliforms, nitrates

and phosphates)

H1. GRAVITY-FED PIPED WATER

H1.1. Does the pipe leak between the source and storage tank? Yes ................................... A

No .................................. B



H1.2. Is the storage tank cracked, damaged or leak? Yes ................................... A

No .................................. B

H1.3. Are the vents and covers on the tank damaged or open? Yes ................................... A

No .................................. B

H1.4. Do any tapstands leak? Yes ................................... A

No .................................. B

H1.5. Does surface water collect around any tapstand? Yes ................................... A

No .................................. B

H1.6. Is the area uphill of any tapstand eroded? Yes ................................... A

No .................................. B

H1.7. Are pipes exposed close to any tapstand? Yes ................................... A

No .................................. B

H1.8. Is human excreta on the ground within 10m of any tapstand? Yes ................................... A

No .................................. B

H1.9. Has there been discontinuity n the last 10 days at any tapstand? Yes ................................... A

No .................................. B

H1.10. Are there signs of leaks in the main supply pipe in the system? Yes ................................... A

No .................................. B

H1.11. Does the community report any pipe breaks in the last week? Yes ................................... A

No .................................. B

H1.12. Is the main supply pipe exposed anywhere in the system? Yes ................................... A

No .................................. B

H2. BOREHOLE WITH HAND PUMP

H2.1. Is there a latrine within 10m of the borehole? Yes ................................... A

No .................................. B

H2.2. Is there a latrine uphill of the borehole? Yes ................................... A

No .................................. B

H2.3. Are there any other sources of pollution within 10m of borehole? (e.g.

animal breeding, cultivation, roads, industry etc)

Yes ................................... A

No .................................. B

H2.4. Is the drainage faulty allowing ponding within 2m of the borehole? Yes ................................... A

No .................................. B

H2.5. Is the drainage channel cracked, broken or need cleaning? Yes ................................... A

No .................................. B



H2.6. Is the fence missing or faulty? Yes ................................... A

No .................................. B

H2.7. Is the apron less than 1m in radius? Yes ................................... A

No .................................. B

H2.8. Does spilt water collect in the apron area? Yes ................................... A

No .................................. B

H2.9. Is the apron cracked or damaged? Yes ................................... A

No .................................. B

H2.10. Is the hand pump loose at the point of attachment to apron? Yes ................................... A

No .................................. B

H3. BOREHOLE WITH MECHANISED PUMPING

H3.1. Is there a latrine or sewer within 100m of pump-house? Yes ................................... A

No .................................. B

H3.2. Is there any source of other pollution within 50m? Yes ................................... A

No .................................. B

H3.3. Is there an uncapped well within 100m? Yes ................................... A

No .................................. B

H3.4. Is the drainage around pump-house faulty? Yes ................................... A

No .................................. B

H3.5. Is the fencing damaged allowing animal entry? Yes ................................... A

No .................................. B

H3.6. Is the floor of the pump-house permeable to water? Yes ................................... A

No .................................. B

H3.7. Does water forms pools in the pump-house? Yes ................................... A

No .................................. B

H3.8. Is the well seal insanitary? Yes ................................... A

No .................................. B

H4. PROTECTED SPRING

H4.1. Is the spring unprotected? Yes ................................... A

No .................................. B

H4.2. Is the masonry protecting the spring faulty? Yes ................................... A

No .................................. B

H4.3. Is the backfill area behind the retaining wall eroded? Yes ................................... A

No .................................. B



H4.4. Does spilt water flood the collection area? Yes ................................... A

No .................................. B

H4.5. Is the fence absent or faulty? Yes ................................... A

No .................................. B

H4.6. Can animals have access within 10m of the spring? Yes ................................... A

No .................................. B

H4.7. Is there a latrine uphill and/or within 30m of the spring? Yes ................................... A

No .................................. B

H4.8. Does surface water collect uphill of the spring? Yes ................................... A

No .................................. B

H4.9. Is the diversion ditch above the spring absent or non-functional? Yes ................................... A

No .................................. B

H4.10. Are there any other sources of pollution uphill of the spring? (e.g. solid

waste)

Yes ................................... A

No .................................. B

H5. DUG WELL WITH HANDPUMP/WINDLASS

H5.1. Is there a latrine within 10m of the well? Yes ................................... A

No .................................. B

H5.2. Is the nearest latrine uphill of the well? Yes ................................... A

No .................................. B

H5.3. Is there any other source of pollution within 10m of well? (e.g. animal

breeding, cultivation, roads, industry etc)

Yes ................................... A

No .................................. B

H5.4. Is the drainage faulty allowing ponding within 2m of the well? Yes ................................... A

No .................................. B

H5.5. Is the drainage channel cracked, broken or need cleaning? Yes ................................... A

No .................................. B

H5.6. Is the fence missing or faulty? Yes ................................... A

No .................................. B

H5.7. Is the cement less than 1m in radius around the top of the well? Yes ................................... A

No .................................. B

H5.8. Does spilt water collect in the apron area? Yes ................................... A

No .................................. B

H5.9. Are there cracks in the cement floor? Yes ................................... A

No .................................. B

H5.10. Is the hand pump loose at the point of attachment to well head? Yes ................................... A

No .................................. B



H5.11. Is the well-cover insanity? Yes ................................... A

No .................................. B

H6. RAINWATER COLLECTION AND STORAGE

H6.1. Is rainwater collected in an open container? Yes ................................... A

No .................................. B

H6.2. Are there visible signs of contamination on the roof catchment? (e.g.

plants, excreta, dust)

Yes ................................... A

No .................................. B

H6.3. Is guttering that collects water dirty or blocked? Yes ................................... A

No .................................. B

H6.4. Are the top or walls of the tank cracked or damaged? Yes ................................... A

No .................................. B

H6.5. Is water collected directly from the tank (no tap on the tank)? Yes ................................... A

No .................................. B

H6.6. Is there a bucket in use and is this left where it can become

contaminated?

Yes ................................... A

No .................................. B

H6.7. Is the tap leaking or damaged? Yes ................................... A

No .................................. B

H6.8. Is the concrete floor under the tap defective or dirty? Yes ................................... A

No .................................. B

H6.9. Is there any source of pollution around the tank or water collection

area?

Yes ................................... A

No .................................. B

H6.10. Is the tank clean inside? Yes ................................... A

No .................................. B

H7. SURFACE WATER (river, dam, pond, lake, ...)

H7.1. Is there a latrine within 10 m of the point used for water collection? Yes ................................... A

No .................................. B

H7.2. Is the nearest latrine uphill of the point used for water collection? Yes ................................... A

No .................................. B

H7.3. Is there any other source of pollution within 10m of the point used for

water collection? (e.g. animal breeding, cultivation, roads, industry

etc)

Yes ................................... A

No .................................. B


Household Questionnaire 1

Ref:

HOUSEHOLD QUESTIONNAIRE

Section A. SITE INFORMATION

A1. Date of Interview / /20

A2. Name of Interviewer

A3. Name of District Garissa

Wajir

Mandera

Ijara

Tana River

Marsabit

Isiolo

Mwingi

Kitui

Kajiado

West Pokot

Turkana

Uasin Gishu

Kwale

Kieni

Rachuonyo

Kisumu

Nyando

Busia

Siaya

Molo

Bondo

A

B

C

D

E

F

G

H

I

J

K

L

M

N

O

P

Q

R

S

T

U

V

A4. Name of Location

A5. Name of Sub Location

A6. Community (EA)

A7: Community Code (EA Code)

A8: GPS Location - UTM x-coordinate:

y-coordinate:



Interviewer visit Date Day Time Results Next Visit

First visit

Second Visit

Third Visit

Total Number of visits

Result codes

1. Interview completed 7. Dwelling vacant or address not a dwelling

2. No household member at home 8. Dwelling destroyed

3. No competent respondent at home at time of the visit 9. Dwelling not found

4. Entire household absent for extended period of time 10. Selected person physically/mentally not fit to be interviewed

5. Postponed 11. Selected person cannot communicate in any interview language

6. Refused 12. Other (specify):

Start time Finish time

Section B. INFORMATION ABOUT THE RESPONDENT

B1. Name

B2. Sex Male

Female

A

B

B3. Age

B4. Relationship of Respondent to the

Household Head

Household head……………………………………………

Spouse………………………………………………………

Father……………………………………………………….

Mother……………………………………………………….

Other relation (specify)………..………......……………….

A

B

C

D

X

B5. Name of Household Head



Section C. INFORMATION ABOUT SAMPLE HOUSEHOLD (HH)

Always start with the household head

C1.

Sex

C2.1

Age

C2.2

Age band

C3.

Marital status

C4.

Education completed

C5.

Currently

enrolled

C6.

Is ... head

of HH?

Household

member

code

Male or

Female Age

In years

A = < 18 years

B = 18 - 24

C = 25 - 34

D = 35 - 44

E = 45 - 55

F = 56 - 65

G = > 66 years

A = Single

B = Married

C = Divorced

D = Separated

E = Widowed

A = No formal education

B = Some primary

C = Primary complete

D = Some secondary

E = Secondary completed

F = Post secondary

Yes No

M F Yes No

HH Head A B A B C D E F G A B C D E A B C D E F A B A B

2 A B A B C D E F G A B C D E A B C D E F A B A B
















Section D. WATER SUPPLY

D1. What is the main source of drinking-water for

members of your household for most part of

the year?

Piped water

Piped into dwelling ............................................ A

Piped into yard or plot ........................................ B

Public tap/standpipe .......................................... C

Borehole ................................................................ D

Protected dug well .................................................. E

Protected spring ..................................................... F

Rainwater collection .............................................. G

Unprotected dug well.............................................. H

Unprotected spring .................................................. I

Tanker-truck ........................................................... J

Cart with small tank/drum ....................................... K

Surface water (river, stream, dam, lake,

pond, canal, irrigation channel) .......................... L

Other (specify)........................................................ X

D2. Code of the main drinking waterpoint / source

(link with the waterpoint code)

D3. Why do you choose to get water from this

waterpoint / source?


Distance ................................................................. A

Cost (water is free) ................................................. B

Cost (water is cheap) ............................................. C

Quality of water ...................................................... D

Reliability of the source (there is always water) ...... E

This is the only operational source ......................... F

Other (specify) ....................................................... X

D4. In case this source is not only for drinking

purposes, what do you use this water for?


Only for drinking ..................................................... A

Cooking .................................................................. B

Bathing ................................................................... C

Laundry .................................................................. D

Livestock ................................................................ E

Gardening .............................................................. F

Other (specify) ....................................................... X

D5. How long does it take to go to source, get

water, and come back?

No. of minutes:

Water on premises ............................................. 995

DK ...................................................................... 999



D6. Are you satisfied with the distance between

your dwelling and the main water source?

(check answer with question D5)

Satisfied...…………...……………....………….……..A

Unsatisfied……….…………………....……...….……B

DK…….……………………………....………….……..Z

D7. How long does it take queuing at this source? No. of minutes:

Water into dwelling ............................................. 995

DK ...................................................................... 999

D8. Are you satisfied with the time queuing at the

source?

(check answer with question D7)

Satisfied...…………...……………....………….……..A

Unsatisfied……….…………………....……...….……B

DK…….……………………………....………….……..Z

D9. Are there times when you cannot use this

waterpoint?

Yes……...……...……………….............….......……..A

No, the waterpoint is always accessible...…........…B

D12

D10. Which are the reasons why you cannot use

this source?


Low yield ................................................................ A


Cost of water .......................................................... C

Conflicts at / on the way to the waterpoint .............. C

Others (specify) ...................................................... X

D11. How often can’t you use this source? At least once per week ........................................... A

At least once per month ......................................... B

In the dry season .................................................... C

Rarely, the waterpoint is normally accessible ......... C

Others (specify) ...................................................... X

D12. Are your satisfied with the reliability of main

water source?

(check answer with question D9 and D11)

Satisfied...…………...……………....………….……..A

Unsatisfied……….…………………....……...….……B

DK…….……………………………....………….……..Z

D13. Are there any other sources where members

of your household get water from?

Yes……………...……………….............……….....A

No……...……………………….............……...……B

D15



D14. What is the alternative source of water for members of your household? (list them according to their importance)

D14.1.

Name of the alternative source

(waterpoint / source)

D14.2.

Type of waterpoint

D14.3.

Seasonality

D14.4.

Reasons to choose this

source

D14.5.

Time to fetch water

(in min)

D14.6.

Water Uses

A B C D E

F G H I J X A B

A B C D

E F G X

A B C D

E F X

A B C D E

F G H I J X A B

A B C D

E F G X

A B C D

E F X

A B C D E

F G H I J X A B

A B C D

E F G X

A B C D

E F X

A B C D E

F G H I J X A B

A B C D

E F G X

A B C D

E F X

Type of waterpoint Seasonality Why do you choose to get water from

this source?

What do you use this water for?

Piped water ........................................ A

Borehole ............................................ B

Protected well .................................... C

Protected spring ................................. D

Rainwater collection ........................... E

Unprotected dug well .......................... F

Unprotected spring ............................. G

Tanker-truck ....................................... H

Cart with small tank/drum ..................... I

Surface water (river, stream, etc.) ....... J

Other (specify) ................................... X

Perennial ............................. A

Seasonal ............................. B

Main source is dry / not operational..... A

Distance.............................................. B

Cost (water is free).............................. C

Cost (water is cheap) .......................... D

Quality of water ................................... E

Reliability of the source ........................ F

This is the only operational source ...... G

Other (specify) .................................... X

Drinking ..................... A

Cooking ..................... B

Bathing ...................... C

Laundry ...................... D

Livestock .................... E

Gardening ................... F

Other (specify) ........... X



D15. Who usually fetches the water for your household?

(circle code that best describes this person)

Adult woman ............................................. A

Adult man .................................................. B

Female child (under 15) ............................. C

Male child (under 15) ................................. D

DK ............................................................. Z

D16.1. What kinds of container

do your household use to fetch

and carry water during the

rainy season?


A. Jerry can ................................ A

B. Bucket ................................... B

C. Clay pot ................................. C

C. Bottles ................................... D

D. Others (specify) ..................... X

D16.2. How big are the

containers?

(visually check the size)

Approximate litres

……………….. DK

……………….. DK

……………….. DK

……………….. DK

……………….. DK

D16.3. How many containers does your

household fetch every day in rainy

season for domestic purposes? (if less

than one per day, specify per week)

No. of containers:

Per day Per week

………….. ……………

………….. ……………

………….. ……………

………….. ……………

………….. ……………

D17.1. What kinds of container

do your household use to fetch

and carry water during the dry

season?


A. Jerry can ................................ A

B. Bucket ................................... B

C. Clay pot ................................. C

C. Bottles ................................... D

D. Others (specify) ..................... X

D17.2. How big are the

containers?

(visually check the size)

Approximate litres

……………….. DK

……………….. DK

……………….. DK

……………….. DK

……………….. DK

D17.3. How many containers does your

household fetch every day in dry

season for domestic purposes? (if less

than one per day, specify per week)

No. of containers:

Per day Per week

………….. ……………

………….. ……………

………….. ……………

………….. ……………

………….. ……………



Section E. WATER QUALITY INSPECTION

In addition to the inspection, ask for a drinking-water sample (and keep it refrigerated until the analysis is

carried out: pH, conductivity, turbidity, free chlorine, faecal coliforms, nitrates and phosphates)

E1. Is drinking water kept in a separate container?

(ask to be shown this)

Yes……......………………………………….....……..A

No…………………………………………...….......… B

E2. Is drinking water container away from

contamination?

(check through observation)

Yes……......………………………………….....……..A

No…………………………………………...….......… B

E3. Do containers have a lid/cover, and this is in

place in time of visit?


Yes……......………………………………….....……..A

No…………………………………………...….......… B

E4. How is water taken from the container? Poured ................................................................... A

Cup ........................................................................ B

Jug ......................................................................... C

Other utensil (specify) ............................................ X

E5. Is the utensil used to draw water from the

container clean and stored in a hygienic

manner?


Yes……......………………………………….....……..A

No…………………………………………...….......… B

E6. How often is the container cleaned? Every time before it is refilled with fresh water ........ A

Once a week .......................................................... B

When it looks dirty .................................................. C

Never ..................................................................... D

Others (specify) ...................................................... X

E7. How do you usually wash the water container

in the house before filling?


Wipe with a damp cloth .......................................... A

Using soap/detergent ............................................. B

Rinse with water only ............................................. C

Others (specify) ...................................................... X

E8. Do you do anything to your water to make it

safer to drink?

Yes……...……...……………….............…….......…..A

No……………………………….............……......……B

DK………...…………………….............……......……Z

F1

F1



E9. What do you usually do to the water to make it

safer to drink?


Boil ......................................................................... A

Boil (at least 10 minutes) ........................................ A

Add waterguard/bleach/chlorine ............................. B

Use water filter (ceramic, sand, composite) ............ C

Solar disinfection (at least six hours) ...................... D

Strain it through a cloth .......................................... E

Let it stand and settle/Sedimentation ...................... F

Others (specify) ..................................................... X

DK ......................................................................... Z

SECTION F. WATERPOINT MANAGEMENT AND PAYMENTS FOR WATER1

F1. Has any household member being involved in

waterpoint management in the last five

years?

Yes………...…...………………....................………..A

No……………………………….............….............…B

DK….…………...……………….............…….......…..Z

F2. Do you pay for your water? Yes………...…...………………....................………..A

No……………………………….............….............…B

DK….…………...……………….............…….......…..Z

F4

F4

F3. How do you pay for your water? 1. Method 2. Amount per payment

Per Month............................ A

Per Bucket ........................... B

Others (specify) ................... X

In KSch:

DK ............... 9999

F4. Do you pay to maintain / repair the

waterpoint?

Yes………...…...………………....................………..A

No……………………………….............….............…B

DK….…………...……………….............…….......…..Z

F7

F7

F5. How do you pay to maintain / repair the

waterpoint?

1. Method 2. Amount per payment

Per Month............................ A

Per repair ............................ B

Per month and per repair .... C

Others (specify) ................... X

In KSch:

DK ............... 9999

1 Section F should be answered based on the main water source



F6. In case you pay per repair, when was the last

time you paid for a repair?

Less than a month ago .......................................... A

Between one month and a year ago ...................... B

More than a year ago ............................................ C

Not applicable ....................................................... Y

DK ......................................................................... Z

F7. How much did you spend for water in the last

month?

(summation of the amount paid per water “F3”

and the amount paid per maintenance “F5”)

In KSch:

Not applicable .................................................. 9995

DK .................................................................... 9999

F8. How do you find the amount you spend on

water currently?

(check answer with question F7)

Cheap ................................................................... A

Fair ........................................................................ B

Expensive.............................................................. C

Not applicable ....................................................... D

DK ......................................................................... Z

Section G. USER SATISFACTION

This section assesses overall user satisfaction with the water supply service (other questions throughout the

questionnaire might complement this section: D6, D8, D12 and F8)

G1. Are your satisfied with the amount of water

available for your household?

(domestic purposes include drinking, cooking,

hygiene and laundry)

Yes, it is always sufficient (for all different uses) ..... A

No, it is only sufficient for domestic purposes ......... B

No, not sufficient even for domestic purposes ........ C

DK…….……………………………...………….……..Z

G2. Are you satisfied with management of the

waterpoint?

Satisfied...…………...……………....………….……..A

Unsatisfied……….…………………....……...….……B

Not applicable ....................................................... D

DK…….……………………………....………….……..Z

G3. What is your perception of water quality? Good ..................................................................... A

Bad ....................................................................... B

DK ......................................................................... Z



Section H. SANITATION

H1. What kind of sanitation facility does this

household have?

If “flush” or “pour flush” probe where does it

flush to.

(ask permission to observe the facility)

Flush

Flush to a septic tank ......................................... B

Flush to pit (latrine) ............................................ C

Poor Flush

Flush to somewhere else .................................. G

Flush to unknown place / not sure / DK.............. H

Ventilated Improved Pit latrine (VIP) ....................... D

Pit latrine with slab ................................................. E

Pit latrine without slab / open pit .............................. I

Bucket .................................................................... J

Hanging latrine ....................................................... K

No facility, bush or field .......................................... K

Other (specify)........................................................ X

H2. If your household doesn’t have a latrine, what

are major reasons why your household does

not have a latrine in your house?


Do not have enough money ................................... A

Do not know how to construct ................................ B

Do not have enough physical space ..................... C

Terrain is not appropriate (sandy or rocky terrain).. D

The family does not own the terrain ....................... E

It’s not part of our culture ....................................... F

Lack of habit to use it ............................................ G

Other (specify) ....................................................... X

H3. If your household has a latrine, where is it

located?

Inside the house ..................................................... A

In this compound .................................................... B

In the neighbour’s compound ................................. C

In a public place ..................................................... D

H4. Is the latrine being used?


Yes, it is in use ....................................................... A

It is not in use ......................................................... B

H6

H5. Why the latrine is not being used? The latrine is collapsed / fear of collapsing ............. A

The pit is already filled ............................................ B

Poor privacy. .......................................................... C

Poor cleanliness (insects, bad smell, etc). .............. D

Other (specify)........................................................ X

H14

H14

H14

H14

H14



H6. Does the latrine hygienically separate human

excreta from human contact?


Yes ........................................................................ A

No. ......................................................................... B

H7. Does the interviewer observe presence or

absence of a convenient source of water and

soap around the latrine (< 3 metres)?

(tick all items observed)

Hand washing device (with water) .......................... A

Soap / ash .............................................................. B

Clean towel or cloth ................................................ C

Other (specify)........................................................ X

H8. Does the interviewer observe the presence of

insects?


No, there are no insects ......................................... A

Yes, a few .............................................................. B

Yes, a lot ................................................................ C

H9. Does the interviewer notice an unpleasant

smell?


No smell ................................................................. A

Yes, a slight unpleasant smell ................................ B

Yes, a strong unpleasant smell............................... C

H10. Does the latrine present adequate conditions

of privacy?


Adequate privacy ................................................... A

Poor privacy ........................................................... B

No privacy .............................................................. C

H11. Does the latrine present adequate conditions

of cleanliness?


Adequately clean (no faeces or urine) .................... A

Poorly clean (some dirt, but no faeces or urine) ...... B

No clean (faeces or urine on the floor) .................... C

H12. How many times does your household clean

the latrine per week?

Every day ............................................................... A

4-6 times a week .................................................... B

2-3 times a week .................................................... C

Once a week .......................................................... D

Only when the dirtiness is recognized .................... E

Other (specify)........................................................ X

H13. If required, do you have access to adequate

skills and materials for repairing the latrine?

No, skills and materials are not accessible ............. A

Yes, but access only to skills .................................. B

Yes, but access only to materials ........................... C

Yes, access to both skills and materials ................. D

DK .......................................................................... Z



H14. What kind of sanitation facility do members of

your household usually use?

If “flush” or “pour flush” probe where does it

flush to.

(ask permission to observe the facility)

Flush

Flush to a septic tank ......................................... B

Flush to pit (latrine) ............................................ C

Poor Flush

Flush to somewhere else .................................. G

Flush to unknown place / not sure / DK.............. H

Ventilated Improved Pit latrine (VIP) ....................... D

Pit latrine with slab ................................................. E

Pit latrine without slab / open pit .............................. I

Bucket .................................................................... J

Hanging latrine ....................................................... K

No facility, bush or field .......................................... K

Other (specify)........................................................ X

H15. Do members of your household share the

sanitation facility that is currently being used?

Yes, it is a shared facility.................…..................…B

No, the facility is for this household only.............…..A

No facility, bush or field...…..................…….......…..C

H17

I1

H16. With how many households do you share the

sanitation facility?

Less than 3 ............................................................ A

More than 3 but less than 10 .................................. B

More than 10 .......................................................... C

DK .......................................................................... Z

H17. Can any member of the public use this

sanitation facility?

Yes ........................................................................ A

No. ......................................................................... B

H18. Overall, how many people use the sanitation

facility?

No. of people (roughly):

DK .......................................................................... Z

Section I. HYGIENE

I1. When was the last time you or one of your

household members has been to a meeting

or training on water, sanitation or health?

Less than a month ago .......................................... A

Between a month and one year ago ...................... B

More than a year ago ............................................ C

More than 5 years ago ........................................... D

Never .................................................................... E

DK ......................................................................... Z



I2. Who organized the meeting / training? NGO / CBO (specify) ............................................. A

Community health group........................................ B

Health worker ........................................................ C

Community leader ................................................. D

Other (specify) ....................................................... X

I3. If you have a child of less than 3 years old,

how did you dispose of the faeces the last

time she/he passed stools?

Child used latrine ................................................... A

Put / rinsed into latrine ........................................... B

Buried the faeces .................................................. C

Put / rinsed into drain or ditch ................................ D

Faeces thrown into garbage .................................. E

Faeces left or buried in the open ........................... F

Others (specify) ..................................................... X

N/A (no children aged 0 – 3 years in household) ... Y

DK ......................................................................... Z

I4. Is there a drying rack for plates and cups?


Yes ........................................................................ A

No. ......................................................................... B

I5. Does the compound present adequate

conditions of cleanliness?


Yes No

Presence of human / animal faeces

Animals running around freely

Compound swept on day of visit

A

A

A

B

B

B



Section I (cont). Hand washing matrix (appropriate hand washing behaviour)2

I6. Are household members present at dwelling

in time of visit?


Yes No

Child caregivers

Other Adults

School-going children

Other children

A

A

A

A

I6

I6

I6

I6

B

B

B

B

J1

J1

J1

J1

For household members available at time of visits:

Would you explain and show me what you do when you wash your hands?


I7.

Washing the

hands

I8.

Clean

water?

I9.

Use of soap

/ ashes?

I10.

Both

hands?

I11.

Drying the hands after

washing

yes or no

(where answer is

no, skip the

other questions)

yes or no yes or no yes or no

A = Air drying

B = Use clean towel or cloth

C = Use unclean towel or cloth

D = Use clothes you are wearing Yes No Yes No Yes No Yes No

1. Child caregivers A B A B A B A B A B C D

2. Other Adults A B A B A B A B A B C D

3. School-going children A B A B A B A B A B C D

4. Other children A B A B A B A B A B C D

I12. When do you wash your hands?3

Before eating Before food

preparation After defecation

Before feeding

children

After handling

children's faeces

Yes No Yes No Yes No Yes No Yes No

1. Child caregivers A B A B A B A B A B

2. Other Adults A B A B A B A B A B

3. School-going children A B A B A B A B A B

4. Other children A B A B A B A B A B

2 Instead of direct questioning, it is suggested to assess hand washing behaviour through observation. The interviewer asks an

open-ended question without prompting and checks off all the items mentioned by the interviewee: “Would you explain and show me

what you do when you wash your hands?”

3 Instead of direct questioning, it is suggested to assess critical times of hand washing behaviour through an open-ended question:

“When do you wash your hands?” The interviewer checks off all the items mentioned by the interviewee.



Section J. HEALTH STATUS

J1. Record information about household sample

(Section C)4.

Male Female

No. of children <36 months old:

No. of children 36 months – 5 years old:

No. of children 5 – 15 years old:

J2. Has any child in the household had diarrhoea

within the last two weeks (diarrhoea is defined

as more than three loose stools passed in a

twenty-four hour period)?

(specify no. of episodes of diarrhoea)

Male Female

No. of children <36 months old:

No. of children 36 months – 5 years old:

No. of children 5 – 15 years old:

J3. How many school days were missed by

children in the last 6 months due to diarrhoea

or cholera?

(specify code of household member, from

Section C)

No. days Children 1:





HH member:

HH member:

HH member:

HH member:

HH member:

Not applicable (no school-going children) .............. Y

DK ......................................................................... Z

J4. What kind of treatment was given the last time

a child of less than 3 years old was affected by

diarrhoea?


No treatment ......................................................... A

Medicine ................................................................ B

Oral rehydration solution (ORS) ............................. C

Maternal milk ......................................................... D

Traditional solution (salty water) ............................ E

Traditional herbs .................................................... F

Soup or gruel made from cereals .......................... G

Other (specify) ....................................................... X

Not applicable (no children aged 0 - 3 years) ......... Y

DK ......................................................................... Z

K1

K1

J5. Who treated the child? Household member ............................................... A

Medical staff at clinic ............................................. B

Traditional healer ................................................... C

Other (specify) ....................................................... X

DK ......................................................................... Z

4 Check from Section C number of children <36 months of age, number of children <15 years of age and number of adults



Section K. HEALTH KNOWLEDGE AND AWARENESS

Do you agree or disagree with the following statements?

K1. Human faeces are a principle source of

diarrhoea.

Agree .................................................................... A

Don’t agree ............................................................ B

DK ......................................................................... Z

K2. Children’s faeces are not dangerous. Agree .................................................................... A

Don’t agree ............................................................ B

DK ......................................................................... Z

K3. Wash our hands once a day everyday is

sufficient to avoid the diarrhoea.

Agree .................................................................... A

Don’t agree ............................................................ B

DK ......................................................................... Z

K4. Washing hands with ash is almost same as

effective as washing hands with soap.

Agree .................................................................... A

Don’t agree ............................................................ B

DK ......................................................................... Z

K5. Using the soap/ash is not necessarily

effective to reduce diarrhoea diseases.

Agree .................................................................... A

Don’t agree ............................................................ B

DK ......................................................................... Z

K6. Hot weather causes diarrhoea disease. Agree .................................................................... A

Don’t agree ............................................................ B

DK ......................................................................... Z

K7. The only cause of malaria is mosquitoes. Agree .................................................................... A

Don’t agree ............................................................ B

DK ......................................................................... Z

K8. Poor drinking-water quality causes diarrhoea

disease.

Agree .................................................................... A

Don’t agree ............................................................ B

DK ......................................................................... Z



Section L. SOCIO-ECONOMIC CHARACTERISTICS

L1. What are the principle livelihoods sources for

your household?

(rank them according to their importance)

Most

important 2

nd 3

rd

Agriculture……………………..........…

Fisheries…………………….................

Small livestock……………...............…

Small trade………………….............…

Temporary work…..………..............…

Permanent employment…...............…

Pension…………………………....……

Remittances from family elsewhere....

Other (specify).....................................

A

B

C

D

E

F

G

H

I

A

B

C

D

E

F

G

H

I

A

B

C

D

E

F

G

H

I

L2. What assets does the household own?


Yes No

Electricity…………..…………...………..…..

Radio…………………….....……....……..….

Television…………………....…..…………...

Mobile phone………......……………...…….

Bicycle………………………...…......……....

Motorbike………………....…………......…...

Ox cart………………........………..…..........

Livestock…………………………..........…...

A

A

A

A

A

A

A

A

B

B

B

B

B

B

B

B

L3. Housing Type (Roof Material)


Thatch / Grass / Makuti .......................................... A

Corrugated Iron (mabati) ........................................ B

Asbestos sheets ..................................................... C

Tiles ....................................................................... D

Concrete ................................................................ E

Others (specify) ...................................................... X

L4. Housing Type (Floor Material)


Earth / Mud / Dung / Sand ...................................... A

Wood planks .......................................................... B

Cement .................................................................. C

Ceramic tiles .......................................................... D

Bamboo / Palm ...................................................... E

Others (specify) ...................................................... X



L5. Housing Type (Wall Material)


Bamboo / Palm ...................................................... A

Mud and wood ....................................................... B

Mud / Mud bricks .................................................... C

Timber with iron sheets .......................................... D

Concrete blocks ..................................................... E

Burnt bricks ............................................................ F

Others (specify) ...................................................... X

Documents

ANNEXE II Household and Water-point Questionnaires