faecal sludge management performance …hotjobs.bdjobs.com/jobs/snv/impact questionnaire...

Faecal Sludge Management – Performance Monitoring Survey 2017

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‘000’ if no number

HOUSEHOLD SURVEY QUESTIONNAIRE (Annex-1) Code:

Date of interview: ..../ ...../ 2017 Time record: ................Hrs. (start of interview)

town

ward

sample number (ward-wise)

BUILDING INFORMATION

B1

Name of the Interviewee

B3

Total number of families

in the building:

B2 Position of the Interviewee:

Owner ...................1

Caretaker/guard ...................2

Tenant............. 3

Others (Specify)............. 4

B4

B5

Total Number of Containment in the building:

Septic Tank:

Pit:

HOUSEHOLD INFORMATION

HH1 Name of the Interviewee HH2

HH3

Age (Year) of the respondents

Sex: Male......1 Female....2 Other.... 3

HH4

HH5

HH6

Plot No.:____________

Holding No:___________

Name of the road or number ....................

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

Area ..............................................

HH7 Type of household:

Planned residential area ...................1

Unplanned residential area ...................2

Slum located on private land............. 3

Slum located on government land .........4

HH8 This floor: [for ground floor ‘1’] HH9 Total floor in this building/ house

[including ground floor]

HH10a

HH10b

Name of head of household:

----------------------------------------

Sex: Male......1 Female....2 Other.... 3

HH11 Relationship between the head and the

Interviewee

Self .................1 Spouse..........2

Son/daughter ......3 Others

..............4

HH12 Profession of the HH owner(Code)*:

HH13 Religion of the head of this household:

Islam ..........1 Hindu .........2

Christian .........3 Buddhist ..........4

Other religion ...5 No religion .......6

HH14 DO YOU OR SOMEONE IN THIS HOUSEHOLD

OWN THIS DWELLING, OR DO YOU RENT

THIS DWELLING?

Own (both land & house).................1

Rent (both land & house) ...................2

Land rented, but own house ............5

Rent free other ................................4

HH15 How many years do you live in this

property /land? Years

HH16 Width of the access road

to the dwelling (feet) :

HH17 Total household members

HH18a Number of male aged under 5 HH18b Number of female aged under 5

HH19a Number of male aged 5-18 HH19b Number of female aged 5-18

‘000’ if no number


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*Service ......1 Business (medium and large)........2 Small business ....3, Student........4, driver .......5,

Day labourer/ rickshaw pooler ......6, No regular job .....7, Housewife ......8, others ........9

SANITATION

1(S) Does your household have a

toilet?

No facility, practice open defecation ........1

No, use neighbour’s toilet .................2

Yes, have own toilet ............................3

Yes, have community toilet ................4

Yes, share a toilet by 2 - 3 households ...5

1,2 Next

Section

2(S) How many toilet cubicles does

the toilet have?

3(S) How many households in total use

this toilet facility, including your

own households?

Number of households

If reply ‘Don’t know’ please put (98)

4(S) Are all the toilet cubicles being

used as toilet?

<Question> and

observation>

Yes ……………………………………….......……………. 1

No……………………………………………….........…2

1 6(S)

5(S) How many of them are not

being used?

<Question> and

observation>

6(S) Are they segregated for male/

female users?

<Question> and

observation>

Yes ……………………………………….......……………. 1

No……………………………………………….........…2

2 8(S)

7(S) How many cubicles for female and

how many for male?

<Question> and observation>

Only for female:...

Only for male: ...............

Share by female and male: ...........

8(S) Do the excreta from your

toilet go to a covered pit or

septic tank?

<Question> and

observation>

Yes ............... ........... ........................1

No ........................................................2

Don’t know .........................................3

HH20 Number of male aged 18-60 HH21 Number of female aged 18-60

HH22 Number of male aged over 60 HH23 Number of female aged over 60

HH24 Does anyone in your household have difficulty in walking or climbing steps? Yes .....1 No .......2

(Physical disability)

HH25 Does anyone in your household have difficulty in seeing? Yes .....1 No .......2

HH26

HH27

Do you feel secure from eviction from this

dwelling?

Yes .....1 No .......2 Don’t know ......8

Not Applicable ......88

Have you been evicted from your home at

any time during the past 5 years?

Yes .....1 No .......2 Don’t know ......8

Not Applicable ......88

HH28 Is the cooking usually done in the house, in

a separate building, or outdoors?

Own separate kitchen inside the house .....1

In the house, but no separate kitchen ........2

Kitchen outside the house but in a separate

building (own) ......................................3

In a common kitchen outside the house ....4

Other (specify) ................................ 9


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9(S) How do you flush to clean

your toilet pan after

defecation?

<Question> and

observation>

No flush required ..............................1

Pour flush .............................................2

Automatic flush .................................3

10(S) What type of toilet do you use?

<Observation>

Hanging latrine ..................................1

Direct open pit/ pit without cover .......2

Latrine conected to open spcae or drain ..3

Do’t know where it goes after flush ....4

Bucket latrine .....................................5

1-5 Next

section

Covered Pit latrine ..........................6

Pit latrine with covered slab and pan .......7

Ventilated Improved Pit Latrine ...........8

6-8

11(S)

Septic tank ............................................9 9 21(S)

Sewer system ...................................10

Composting toiulet (Eco-san toilet) ...11

DEWATS ...........................................12

Bio-gas plant .................................13

10-13

25(S)

Others (specify) ................................99

11(S) How many pits are there and

How are they placed?

<Observation>

Direct single pit ..................................1

Offset single pit ....................................2

Double pit (without ‘Y junction’)............3

More than 2 pits ..................................4

Twin pit (with ‘Y junction’) .................5

1-4

13(S)

12(S) Whether the ‘Y Junction’ of the

twin-pit latrine functional?

<Observation>

Yes ……………………………………….......……………. 1

No……………………………………………….........…2

13(S) Size of the pit

<Question> and <observation>

Diameter: ............ Inches

Total number of rings (of all pits): ..........

14(S) Materials of the rings Cement ................................................1

Clay ................................................2

No rings, only pit ....................................3

Don’t know ......................................8

15(S) When the pit was dug, was any

groundwater seeping in?

Yes .....................................................1

No ..........................................................2

Don’t know/ don’t remember ..................9

16(S) Are the walls of the Pit completely

sealed?

Wall not cement lining ...........................1

Part of wall cement lining ...................2

Wall cement lining ................................3

No ring ............................................4

Don’t know .............................................8

17(S) Are the bottom of the Pit

completely water sealed?

Only mud................................................1

Only brick soling................................2

Cement Concrete ....................................3

Don’t know .............................................8

18(S) Are all the rings of the pit placed

below ground? <Observation>

All rings above ground............................. 1

Partly above ground........................... 2

All rings below ground ............................ 3

No ring .............................................4


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19(S) Is there a Vent pipe from the

pit to the air outside?

<Observation>

Has a vent pipe 1

No vent pipe 2

20(S) Distance of nearest water

body from the pit (in feet)

<Observation>

feet

25(S)

21(S) How many chambers do the

Septic Tank have?

<Question> +

<Observation>

One chamber ..................................1

Two chambers ..............................2

More than two chambers....................3

Could not identify...........................8

22(S) What is the size of the Septic

Tank?

<Question> + <Observation>

Length (feet):

Width (feet):

Height (feet):

Could not measure .............................. 8

23(S) Is there any soak pit/well

connected to the septic tank?

<Question> + <Observation>

Yes ...................................................1

No..........................................................2

Don’t know ........................................8

1, 8

25(S)

24(S) If the soak pit/well is not

available, where does the

liquid/sludge go?

Pipe outlet to open ground .....................1

Pipe outlet to surface or grey water drain .....2

Pipe outlet to sewer ...............................3

Don’t know...............................................8

Others (mention) ....................................9

25(S) When was the Septic Tank/Pit/

treatment plant constructed?

Years ago

If ‘Don’t know’ please, mention ‘99’

If less than one year, mention ‘01’

26(S) Was your septic

tank/pit/treatment plant built

together with your building?

Yes ........................................................1

No ......................................................2

Don’t know...............................................8

27(S) Is your toilet have arrangement

for water seal?

<Observation>

Yes ........................................................1

No water seal, but toilet pan is covered.....2

No water seal, & toilet pan is not covered .....3

2,329(U)

28(S) Whether the water seal of the

latrine pan is functional?

<Observation>

Yes, functional ......................................1

No, water seal broken/ no water is visible.....2

No, Water seal is blocked ........................3

29(S) Is the cover of the pit or manhole

of the septic tank open?

<Observation>

Yes ............... ....... ....... ..................1

No ................................. ....... ....... .......2

30(S) How close is the water supply to

the latrine?

<Observation>

Running water inside the cubicle ............1

Stored water inside the cubicles .................2

Within (community) latrine block ............3

At (community) latrine block perimeter........4

Within plot/ yard..................................5

Beyond plot/ yard ...............................6

Carry from home house............................7

Others (mention) .................................9

31(S) Can you use this toilet facility at

all hours of the day and night?

Yes ....................................................1

No..........................................................2

133(U)


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32(S) What are the reasons for not

getting access to toilet at all

hours of the day and night?

Feel insecure in the night ..................... 1

Far away from houshold ...........................2

Pathway become sleepy during rain .......3

Long queue ............................................4

Others (specify) .................................9

33(S) Is the door lock of the toilet

(inside) functional?

<Observation>

Yes .......................................................1

No ....................................................2

34(S) Do you feel secure while you are

in the toilet?

Yes .......................................................1

No.................................... .................2

35(S) How often does the latrine get

cleaned?

Everyday ................................................1

Every week, often (4-6 times) ...............2

Every week, seldom (1-3 times) ................3

Not every week ...................................4

Almost never .............. ...........................5

Do not know .......................................8

36(S) Who usually does the cleaning of

the latrine?

Male family members ............ .................1

Female family members ...... ................2

Male and Female together ................. ......3

Female house servant ..........................4

Male house servant ..................................5

Paid cleaner/ caretaker .........................6

Don’t know .............................................8

37(S) Are there any cleansing / sanitary

materials left on the floor?

<Observation>

Yes .......................................................1

No ...........................................................2

38(S) Is there any faecal smears visible

in/on pan or floor of the toilet?

<Observation>

Yes .......................................................1

No ...........................................................2

39(S) [For the HHs who have child under

5]

Where are the children’s excreta

disposed off?

Defecated in the toilet ...............................1

Dispose into the toilet .............................2

Dispose with the solid waste .......................3

Through in the drain or nearby places .......4

Don’t know ...............................................8

Others (specify) ......................................9

40(S) Is excreta seeping (visible) from

the pit/ septic tank/ sewerage/

DEWATS/ Biogas plant?

<Observation>

Yes .......................................................1

No ...................................................2

41(S) Is bad smell come out from the pit/

septic tank/ sewerage/

DEWATS/Biogas plant?

<Observation>

Yes ...............................................1

No ...........................................................2

42(S) Can everyone in the household

presently use the toilet easily and

conveniently unassisted?

Ring all that apply

Yes No N/A

A. Old age .......................1 .........2 ........3

B. Physically disabled........ 1 .........2 ........3

C. Can’t see ................... 1 .........2 ........3

D. Pregnant women .........1 .........2 ........3

E. Menstruating women..... 1 .....2 ........3

F. Small children ............. 1......2 ......3


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G. Other (specify) ........... 1 .........2 ........3

43(S) Do you have any problems using

your toilet?

Ring all those that apply

No problems .......................................... 00

Not clean.......................................... 01

Smelly ................................................. 02

No water inside the toilet ................... 03

Not easy to reach toilet (long distance) ..... 04

Not easy to squat/ afraid of falling or slipping

....................................................... 05

Not easy to wash yourself................. 06

Not easy to flush.................................. 07

Too small....................................... 08

Too dark.............................................. 09

No privacy......................................10

Insects and animals inside .....................11

Other (specify)................................99

44(S) Do you have any problems

cleaning and maintaining your

toilet?

Ring all those that apply

No problem .................. ..................00

Excreta in the toilet pan .........................01

Toilet blocks often ............................02

Water not available to clean ...................03

Cleaning materials not available ...........04

Don’t know how to clean ........................05

Other users don’t know how to use........06

Too many users, difficult to keep clean .....07

Other users don’t take their turn to clean.....08

Design is difficult to clean.......................09

Other (specify) ............................... 99

45(S) How much do you spend for O&M

of toilet per month and for what

purposes (excluding pit/ tank

emptying)?

Taka:

Purpose :

Cleansing materials ............................1

Minor repair ...................................2

Others (mention) ...............................9

46(S) Who in the household makes

decisions about building,

upgrading or maintenance of the

toilet pit which you use?

Landlord / office (staff quarter) ..............1

Landlord/ office and tenants together......... 2

Tenants only ..................................... 3

Others (mention) .....................................9

47(S) What gender are the main

decision makers about building,

up-gradation or maintenance of

the toilet pit?

Women ................................................. 1

Men.................................................. 2

Women and men together....................... 3

48(S) Did you or any one requires any

permission for construction of the

septic tank?

Yes permission taken ............................1

No permission taken .........................2

No Permission required ...........................3

Don’t know ..............................................8

2,3,8

50(S)

49(S) If yes, from which Authority? KCC/Paurashava .....................................1

KDA .........................................................2

Don’t know ...........................................8

Others (specify)........................................9


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50(S) Whether any one visited your

house to inspect the Septic Tank

during or after construction of

toilet?

Yes .....................................................1

No ..........................................................2

Don’t know ............................................9

HANDWASHING

1(H) Where members of your

household most often wash their

hands after defecation?

No specific station for hand washing ...........1

Inside the toilet ....................................2

Outside toilet cubicle but inside toilet

(community) block ............................3

Outside toilet but inside the house ............4

Outside the toilet (community) block, at water

points ...............................................5

Other place (specify) .............................9

1 Go to

Next

Section

2(H) How far is the Hand washing

station from Toilet?

<Observation>

feet [‘ooo’ if it is inside the cubicle)

3(H) Is there a hand washing devise at

the hand washing station for

washing hands after defecation?

<Observation>

Have a basin ........................................1

Have a pot specified for hand washing after

defecation ..............................................2

No basin or pot ..........................................3

4(H) Presence of soap or detergent (or

other locally used Ash/Mud/Sand)

at the hand washing station?

<Observation>

Yes, Have soap/detergent ...........................1

Yes, Have ash/mud/sand .......................2

No, Nothing for hand washing .....................3

5(H) Is running water (piped supply)

available at the specific place for

hand-washing?

<Observation>

No provision of running water ....................1

Yes, there is provision for running water, but no

water is available during the visit .........2

Running water is available during the visit ....3

38(H)

6(H) How water for hand washing is

stored?

<Observation>

In an open bowls/ container/ bucket ........1

Revered in a protected container ..................2

Water is stored in a protected container fitted

with a tap ...........................................3

Water is not stored ...............................4

7(H) Is there a possibility of hand

touching the water in the

container while taking water for

hand washing (e.g. by mug, other

utensils)?

<Observation>

Yes ..........................................................1

No

...............................................................2

8(H) Who makes decisions for setting

up of the hand washing facilities

which you use?

Landlord/ office (staff quarter) owner ..........1

Tenants ................................................2

Both (if in rented house) .........................3


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9(H) Who in the household makes

decisions of the hand washing

facilities which you use?

Women .............................................. 1

Men........................................................ 2

Women and men together..................... 3

10(H) Have you attended any training,

orientation on good hand washing

practice in the past 12 months?

Yes ..................................................1

No ......................................................2

11(H) How did you get the message on

hand washing?

Multiple responses

Radio ............................................1

TV .....................................................2

Newspaper .............................................3

Billboard ...............................................4

Training / orientation .........................5

Family members ....................................7

Educational institute ...........................6

Health centre ........................................8

Others (mention) .....................................9

Faecal Sludge Management

For Households practice open

defecation or have toilet

without covered pit/ septic

tank– GO TO Question 24(F)

1(F) Do you think we need to empty

pit/septic tank?

Yes ....................................1

No ............................................2

1 3(F)

2(F) Please mention reasons why you

think so

Soak in the ground .......................1

Size of pit/ septic tank is too big ..........2

It is connected to drain/ open place ....3

Others (specify) ............................... 9

3(F) Have you ever emptied pit/ septic

tank?

Yes ...........................................1

No .................................................2

Don’t know .....................................8

215(F)

816(F)

4(F) When was the last time? Month ago [mention 98 if it is more

than 8 years; mention 99 if could not

remember]

Ask the following two

questions 5(F) and 6(F) to the

Households have twin pit

latrine with Y-junction

5(F) Did you extract the waste in

order to use as compost fertiliser?

Yes ...........................................1

No .................................................2

don’t know ...................................8

2,87(F)

6(F) How long did you keep the

manure in one pit of a functional

twin-pit latrine separated before

withdrawal?

Duration (months)

If not used manure or do not have twin pit

latrine, mention 99


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7(F) How is the pit/ septic tank

emptied?

Manually/ Sweepers ..................1

Combination of manual & mechanical ....2

100% Mechanically .........................3

Self .................................................4

8(F) Who provided the emptying

services?

KCC/ Kushtia/ Jhenaidah Paurashava ....1

CBOs/ NGOs .................................2

Individual Sweeper ...........................3

Self ..............................................4

Other (specify) ..................................9

9(F) Did anyone enter into the septic tank/pit to clean/empty?

Yes ..................................................1

No ............................................2

Don’t remember/ don’ know ................8

2,811(F)

10(F) Why they entered into the pit/ septic tank?

To empty the pit ...........................1

To empty the solid part of the pit/ tank............................................2

To set the Vacu-Tug pipe ................3

Don’t know .................................8

Others (mention) ............................. 9

11(F) Did they empty your septic tank/pit Safely (using mask,

gloves, boot etc. and without contacting their body)?

Yes ...................................................1

No .....................................2


12(F) Whether the excreta touches the human body while the pit/ septic tank was cleaning?

Yes ...................................................1

No .....................................2


13(F) How much time did you require to

get the Emptying service Hours

14(F) How much did you pay for

empting last time?

Including all costs – rent, fuel,

labor, etc.

Tk.____________

18(F)

15(F) Why have you never emptied

your pit/septic tank?

It never gets full/overflowing ............1

I don’t have such money ...............2

Other (specify) ..................................9

16(F) Do you know the cost for

emptying your pit/ septic tank? Yes ..................................................1

No ............................................2

218(F)

17(F) How much? Tk.............................

18(F) Do you know where the Emptiers

(sweepers or Vacutug) dump the

sludge after collection?

Don’t know ..................................1

Yes know .................................2 220(F)

19(F) Please mention where they dump.

Dumped in open space near house ........1

Dumped in river/ drain/ watercourse .....2

Dumped in open space away from house

................................................... ....3


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Dumped into KCC/ Paurashava specified place

.......................... ....................4

Dumped into treatment plant ..........5

Other (specify) ________________ 9

20(F) Is there any emptying service

provider in your Ward?

Yes ...............................................1

No ..........................................2

Don’t know .....................................8

2,822(F)

21(F) Who are they? Sweeper only ....................................1

Vacutug only ................................2

Both sweeper and Vacutug ..................3

22(F) If it requires to empty your

pit/Septic tank once a year,

would you be willing to pay the

Service Provider to empty it for

you?

Yes ...............................................1

No ..........................................2

224(F)

23(F) If yes, how much would you be

willing to pay each year?

Tk …………………………………………./Year

24(F) Do you know the fecal sludge can

be treated as resource and

reused?

Yes .................................................1

No ..............................................2

2next

section

25(F) Do you use any of the pit

contents for other uses?

Yes .................................................1

No ..............................................2

2next

section

26(F) For what purpose? Fish feed ...................................1

Poultry feed......................................2

Kitchen garden ............................3

Agriculture .......................................4

Producing biogas...........................5

Other (specify) ___________________9

BANGLADESH 2011 WEALTH INDEX QUESTIONNAIRE – PLEASE DO NOT CHANGE THE QUESTION CODES, RESPONSES

OR RESPONSE CODES

Code Question Response codes

URBRUR NOTE WHETHER THE PERSON

LIVES IN AN URBAN OR RURAL

AREA

Urban ………………………

Rural …………………………

1

2

W01 What is the main source of

drinking water for members of

your household?

PIPED WATER

PIPED INTO DWELLING . . . . . . . . . . ….. . 11

PIPED TO YARD/PLOT . . . . . . . . . . . . …. . 12

PUBLIC TAP/STANDPIPE . . . . . . . . . . . ….. 13

TUBE WELL OR BOREHOLE . . . . . . . . . . . . 21

DUG WELL

PROTECTED WELL . . . . . . . . . . . . …. . . . 31

UNPROTECTED WELL . . . . . . . . . . …. . . . 32

WATER FROM SPRING

PROTECTED SPRING . . . . . . . . . . …. . . . 41

UNPROTECTED SPRING . . . . . . . . ….. . . . 42


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RAINWATER . . . . . . . . . . . . . . . . . . . . . . . . . 51

TANKER TRUCK . . . . . . . . . . . . . . . . . . .. . 61

CART WITH SMALL TANK . . . . . . . . . . . . 71

SURFACE WATER (RIVER/DAM/

LAKE/POND/STREAM/CANAL/

IRRIGATION CHANNEL) . . . . . . . . …. . . . 81

BOTTLED WATER . . . . . . . . . . . . . . . . . . . . 91

OTHER 96

W02 What kind of toilet facility

do members of your

household

usually use?

FLUSH OR POUR FLUSH TOILET

FLUSH TO PIPED SEWER SYSTEM . . . 11

FLUSH TO SEPTIC TANK . . . . . . . . . . . . 12

FLUSH TO PIT LATRINE . . . . . . . . . . . . 13

FLUSH TO SOMEWHERE ELSE . . . . . . . . 14

FLUSH, DON'T KNOW WHERE . . . . . . . . 15

PIT LATRINE

VENTILATED IMPROVED PIT LATRINE .. 21

PIT LATRINE WITH SLAB . . . . . . . . . . . . 22

PIT LATRINE WITHOUT SLAB/ OPEN PIT …23

COMPOSTING TOILET . . . . . . . . .. . . . . 31

BUCKET TOILET . . . . . . . . . . . . . . . . . 41

HANGING TOILET/HANGING LATRINE . . ..51

NO FACILITY/BUSH/FIELD . . . . . . . . . 61

OTHER ………………………………………….. 96

W03 Do you share this toilet facility

with other households?

YES ………………………………………………...1

NO .............................................................. 2

Does your household have: YES NO

W04 Electricity? ELECTRICITY . . . . . 1 2

W05 A radio? RADIO . . . . . . . . . . . . 1 2

W06 A television? TELEVISION . . . . . . 1 2

W07 A mobile telephone? MOBILE TELEPHONE . 1 2

W08 A non-mobile telephone? NON-MOBILE PHONE 1 2

W09 A refrigerator? REFRIGERATOR …... 1 2

W10 An almirah/wardrobe? ALMIRAH/WARDROBE 1 2

W11 A table? TABLE……………....... 1 2

W12 A chair? CHAIR ………………... 1 2

W13 An electric fan? ELETRIC FAN………... 1 2

W14 A DVD/VCD player? DVD/VCD PLAYER. .. . 1 2

W15 A water pump? WATER PUMP. . . . . . . 1 2

Faecal Sludge Management – Monitoring Survey 2017

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W16

What type of fuel does

your household mainly use

for cooking?

ELECTRICITY . . . . . . . . . .. . . . . . . . . 01

LPG . . . . . . . . . . . . . . .. . . . . . . . . . 02

NATURAL GAS . . . . . . . . . .... . . . . . 03

BIOGAS . . . . . . . . . . . . . . . . .. . . . . . 04

KEROSENE . . . . . . . . . . . .. . . . . . . 05

COAL, LIGNITE . . . . . . . . .. . . . . . . . 06

CHARCOAL . . . . . . . . . . . . .. . . . . . 07

WOOD . . . . . . . . . . . . . . . . .. . . . . . 08

STRAW/SHRUBS/GRASS . . .. . . . . 09

AGRICULTURAL CROP . . . .. . . . . . 10

ANIMAL DUNG . . . . . . . . . ... . . . . . . 11

NO FOOD COOKED IN HOUSEHOLD 95

W17 What is the main material of the floor in your household?

NATURAL FLOOR

EARTH/SAND . . . . . . . . . . . . . . . . . . . . 11

RUDIMENTARY FLOOR

WOOD PLANKS . . . . . . . . . . . . . . . . . . 21

PALM/BAMBOO . . . . . . . . . . . . . . . . . . 22

FINISHED FLOOR

PARQUET OR POLISHED WOOD …......... . 31

CERAMIC TILES . . . . . . . . . . . . . . . . . . 33

CEMENT . . . . . . . . . . . . . . . . . . . . . . . . . 34

CARPET . . . . . . . . . . . . . . . . . . . . . . . .. . . . 35

OTHER 96

W18 What is the main material of the roof in your household?

NATURAL ROOFING

NO ROOF . . . . . . . . . . . . . . . . . . . . . . . . . 11

THATCH/PALM LEAF . . . . . . . . . . . . . . . . 12

RUDIMENTARY ROOFING

PALM/BAMBOO . . . . . . . . . . . . . . . . . . . . 22

WOOD PLANKS . . . . . . . . . . . . . . . . . . . . 23

CARDBOARD . . . . . . . . . . . . . . . . . . . . 24

FINISHED ROOFING

TIN . . . . . . . . . . . . . . . . . . . . . . . . . . . 31

WOOD . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

CERAMIC TILES . . . . . . . . . . . . . . . . . . . . 34

CEMENT . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

ROOFING SHINGLES . . . . . . . . . . . . . . . . 36

OTHER 96


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W19 What is the main material of the external walls in your household?

NATURAL WALLS

NO WALLS . . . . . . . . . . . . . . . . . . . . . . . . . 11

CANE/PALM/TRUNKS . . . . . . . . . . . . . . 12

DIRT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

RUDIMENTARY WALLS

BAMBOO WITH MUD . . . . . . . . . . . . . . . . 21

STONE WITH MUD . . . . . . . . . . . . . . . . 22

PLYWOOD . . . . . . . . . . . . . . . . . . . . . . . 24

CARDBOARD . . . . . . . . . . . . . . . . . . . . 25

FINISHED WALLS

TIN . . . . . . . . . . . . . . . . . . . . . . . . . 31

CEMENT (Plaster) . . . . . . . . . . 32

STONE WITH LIME/CEMENT . . . . . . . . . . 33

BRICKS (exposed) . . . . . . . . . . . . . . . . . . . . 34

WOOD PLANKS/SHINGLES . . . . . . . . . . 36

OTHER 96

W20 How many rooms in this household are used for sleeping?

ROOMS _______________________________

Does any member of this household own:

YES NO

W21

An autobike?

AUTOBIKE . . . . . . . . . . . . . . . . . 1 2

W22

A bicycle?

RICKSHAW . . . . . . . . . . . . . . . . 1 2

W23

A rickshaw/van?

BICYCLE . . . . . . . . . . . . . . . . . . 1 2

W24 A motorcycle or motor

scooter/tempo/CNG?

MOTORCYCLE/SCOOTER . . . 1 2

W25 How much land does your

household own (other

than the homestead

land)?

AMOUNT SPECIFY UNIT

IF 95 OR MORE CIRCLE '9995'

ACRES _________________________________

95 OR MORE ACRES . . . . . . . . . . . . . . 95

W26 Does any member of this household have a bank account?

YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2


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Telephone number (optional) .............................................

Thank you. Time record: ....................hrs (end of interview)

Signature of Enumerator Signature of Supervisor

Name of Enumerator: Name of Supervisor

W27 How many people live in your household?

PEOPLE ________________________________

W28 Are there any domestic servants (non-family members) working in your household?

YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

W29 Does this household own any livestock, herds, other farm animals, or poultry?

YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

How many of the following animals does this household own?

IF NONE, ENTER '00'.

IF 95 OR MORE, ENTER '95'.

W30 Buffaloes? Cows? BULLS/BUFFALOES . . . . . . . . .

W31 Milk cows or bulls? MILK COWS/BULLS . . . . . . . . . . . .

W32 Goats or sheep? GOAT/SHEEP . . . . . . . . . . . . . . . .

W33 Chickens or ducks? CHICKENS/DUCKS . . . . . . . . . . . .

faecal sludge management performance …hotjobs.bdjobs.com/jobs/snv/impact questionnaire...

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