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2010
EXTENSION OF WATER SUPPLY AND SANITATION IN
KAMPOT DOWNTOWN PROJECT OF UN-HABITAT
COMMUNITY-BASED WATER SUPPLY AND
SANITATION PROJECT
Output Under The Cooperation Agreement Between
UN-HABITAT
and
Kampot Water Supply Utility
Report on
Questionnaire Field-tested and Modification
if necessary (D3)
K A M P O T W A T E R
S U P P L Y U T I L I T Y
K A M P O T , C A M B O D I A
B Y
S O R N S O M O L I N E
Mekong Regional Water and Sanitation Program (MEK-WATSAN)
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Table of Contents
1. Introduction............................................................................................................................. 3
2. Objective .................................................................................................................................3
3. Participations...........................................................................................................................4
4. Pre-test Venue and Date..........................................................................................................4
5. Field-test Works and Modification .............................................................................................4
5.1 Pre-test works ........................................................................................................................4
5.2 Problem and Solution ............................................................................................................6
5.3 Modification..........................................................................................................................6
6. Conclusion...............................................................................................................................6
Annex 1: List of participants
Annex 2: Detail training and field-tested agenda
Annex 3: Revised questionnaire on water and sanitation indicators
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1.IntroductionMEK-WATSAN is a collaborative effort between UN-HABITAT and Cambodia Government
has been implementing water and sanitation investment in Kampot town. The whole philosophy
of MEK-WATSAN is to support participating governments attain their water and sanitation
related MDGs agreed in 2000, to halve the proportion of people without access to improved
water supply and sanitation services by 2015.
The Royal Government of Cambodia has set out a CMDG which is compliant with the world
MDGs. The CMDG composes of many targets for year 2015 but two of them are focusing on
water and sanitation. MEK-WATSAN was initiated at the request of Governments of the
Mekong Region - the Royal Government of Cambodia, the People's Republic of China (Yunan
Province), the Lao People's Democratic Republic, and the Socialist Republic of Vietnam. MEK-
WATSAN program was developed to provide supports those governments in improving water
and sanitation condition in peri-urban or secondary towns in the above four countries by
expanding water supply infrastructure. The program focuses on improving the livelihood of low-
income urban population that lack adequate water facilities.
The primary purpose of Community-based Water Supply and Sanitation Project is to improve
water supply and environmental sanitation for at least 7,500 poor people or 75% of the poor in
Kampot Town.
Currently on 02 September 2010, MIME and Kampot Water Supply Utility have conducted
workshop that include stakeholder workshop and training on sampling and methodology of
baseline survey in Kampot Town.
2.ObjectiveThe overall objective of MEK-WATSAN program is to support the Royal Government of
Cambodia to attain its water and sanitation related MDGs agreed in 2000.
The purpose of the training is to explain the questionnaire for MDG monitoring, discuss about
sampling method and plan the MDG monitoring strategies for secondary towns follow the
framework of the Urban Inequities Survey (UIS). MIME will define the rationale and objectives
of the envisaged MDG monitoring; adapt relevant indicator categories to the situation of water
and sanitation in secondary town ; oversee the design and development of a survey for
monitoring the MDGs; define criteria for suitable enumerators from community, water utility,
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NGO and municipality; and develop an action plan. A follow up monitoring will take place at the
end of project implementation.
The field-tesed was held in Kampong Bay Tboung village, Sangkat Kampong Bay, Kampot
Municipality with the objective as following:
- To demonstrate the questionnaire to the enumerators- To explain about how to choose the sample for survey- To show the problem faced during the interview and- To find the solution to conduct the survey3.Participations
76 persons included 10 women were participated in the field-tested of data collections for water
and sanitation indicators. These participants come from Kampot Water Supply Utility and
Provincial Department of Industry, Mines and Energy, Toek Chhu District, Kampot
Municipality, Kampot Provincial Office, Provincial Department of Environment and local
authorities and two NGOs like GRET SWY, Theang Thnot Association. Detail list of
participants is attached in Annex 1.
4.Field-tested Venue and DateThe field-tested was heald on 03 September 2010 at Kampong Bay Tboung village, Sangkat
Kampong Bay, Kampot Municipality, Kampot Province. The field-tested started from 10:15 to
11:30 and after finished the pre-test survey, all participant came back to Kampot MunicipalOffice to show the result of the survey and raised the problem they have met during the survey
and the solution for the further survey. The detail field-tested agenda is attached in Annex 2.
5. Field-test Works and Modification
5.1 Pre-test works
The participants were divided into three groups working on pre-testing of the baseline survey.
The pre-test was done in Kampong Bay Khang Tboung village. Each group contains about 20
persons and leaded by a local consultant. The leader of the group has conducted a demonstration
on sampling selection and asking question of the water and sanitation indicator questionnaires
about two households for example. In the next step, each group interviewed 3 more households
by themselves. Each Group has to present their survey result and share about the difficulties they
have faced during the survey.
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5.2 Problem and Solution
After finished field-test, all groups has presented their survey result and raised the problem they
have faced during the survey as following:
- Difficult to get the answer on total monthly income because some household arelabor work and had paid by days ;
- Household tried to increase their exsense and decrese their income;- Question WS1: some household have many sources of water for drinking such as
piped, rain, and well. So how to write down the answer? It met the same problem
for all sources water use;
To refer to this problem, local consultant explained about how to ask about the monthly income
by asking all the occupation of all household family and calculate one by one then summed up
the total household income. Related to the increasing of expense and decrease income, the
interviwer should balance the income with the expense. About the sources of water use for every
purpose, the interviwer have to write which is the main source of water that family use.
5.3 Modification
There is no modification on the questionnaire after field-test. The questionnaire was already
modified during the stakeholder workshop as following:
- Added the note at the beginning of the questionnaire in order to explain thesurveyor to get more understanding about the objective of the project as well as
the purpose of survey.
-
The distance of latrine to water sources like well and pond. (added in SanitationSection)
- The reason of not having toilet (added in Sanitation Section, on question WS23A)
- Did your family get any awareness campaign on health care from the governmentor NGOs so far? (added in Health Section)
- Added the code (H1, H2, H3, H4) of each question in Health Section,The revised questionnaire is attached in Annex 3.
6.ConclusionAt the end of field testing, H. E Heng Sok Kong, gives the close remarks by summed up the
discussion of the training workshop on sampling and Methodology for Baseline Survey.
Excellency Heng Sokong recommended all authorities to cooperate with the base survey because
this program is important and will benefit poor household to improve their health and also their
livelihood in their communities. H.E also informed the entire surveyor to read the questionnaire
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few times more and try to understand the meaning of each questions clearly before the survey
activity will start.
All relevant stakeholders will cooperate with this baseline survey. The local authorities
especially commune/sangkat, village chiefs and village volunteers were happy to help the
program in surveying and implementing. They understood and knew about baseline survey
method and how to choose sample for conducting the survey.
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Annex 1: List of participants in Training and Field-tested
03 September 2010
No. Name Sex Position Organiza
1 Neak Sovannary M Chief of Kampot Municipality Kampot Municipality
2 Te Chinarith M Deputy ChiefProvincial department o
and Energy
3 Bun Chankong M Chief Kampot Water Supply U
4 Som Sethy M Officer MIME
5 Mak Chhorvannarey M Office Chief MIME
6 Bun Thorn M Network Chief Kampot Water Supply U
7 Chun SreyTouch F Staff Kampot Water Supply U
8 Thon Vannak M Staff Kampot Water Supply U
9 Long Sok M Staff Kampot Water Supply U
10 Un Sokdany M Staff Kampot Water Supply U
11 Sor Veasna M Staff Kampot Water Supply U
12 Ty Kean M Staff Kampot Water Supply U
13 Kong Ma Pulim M Staff Kampot Water Supply U
14 Vong Samon M Staff Kampot Water Supply U
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15 Nun Vanny M Staff Kampot Water Supply U
16 Som Sorn F Sangkat Council Member Treuy Koh
17 Ser Mert M Village Chief Treuy Koh
18 Ung Kea M Village Deputy Chief Treuy Koh
19 Kheng Sakhon F Sangkat Council Ondong Khmer
20 Ou Sakhon M Village Deputy Chief Ondong Khmer
21 Hang Sean M Sangkat Council Ondong Khmer
22 Sem Sarath M Village Chief Kampong Bay
23 Mea Bunchhoeurn M Village Chief Treuy Koh
24 Svay Met M Provincial Department Chief Kampot Municipal
25 Ouk Chher M Office Chief Kampot Municipal
26 Ma Dol M Village Member Ondong Khmer
27 Kum Bun M Village Deputy Chief Ondong Khmer
28 Hem Saren M Village Deputy Chief Tvy Khang Cherng
29 Pov Sinat F Sangkat Council Kampong Kandal
30 Oun Somol F Village Deputy Chief Krang Ampel
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31 So Danavy F Village Member Krang Ampel
32 Mey Touch F Sangkat Council Krang Ampel
33 Sok Sopheap F Village Member Krang Ampel
34 Ouk San M Village Chief Krang Ampel
35 Dy Bunsang M Village Deputy Chief Kampong Bay
36 Pen Sophearith M Municipal Officer Kampot
37 Chhor Sorn M Public Work Office Chief Public Work Office
38 Prum Vanthoeurn M Public Work Office Deputy Chief Public Work Office
39 Phen Amrak M Provincial Department of Environment Kampot
40 Deng Pokanal M Provincial Department of Environment Kampot
41 Pheang Phanith M Administration Office Chief Tek Chhou
42 Kouy Vanthy F Social Affair Office Deputy Chief Tek Chhou
43 Keng Puthrea M District Officer Tek Chhou
44 Pronh Chhoun M Village Deputy Chief Chum Kreal
45 Hang Kuy Ngin M Village Chief Tropang Thom
46 Tet Nan M Commune Chief Kampong Krang
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47 Mei Yoeurn M Village Deputy Chief Chum Kreal
48 Mam Lida M Village Chief Kampong Krang
49 Thorng Chhel M Village Deputy Chief Tropang Thom
50 Bou Ery M Village Member Tropang Thom
51 Kong Kysral M Municipal Officer Kampot
52 Tem Keaty M Student Kampong Bay Khang T
53 Pen Rotha M Construction Worker Kampong Bay Khang C
54 Kum Chey M Student Sovann Sakor
55 Ouk Chhoeun M Municipal Officer Kampot Municipal
56 So Chhom M Village Chief Ondong Khmer
57 Hean Veasna M Village Chief Ondong Khmer
58 Nek Ser M Sangkat Deputy Chief Treuy Koh
59 Sot Soeurn M Commune Council Mak Prang
60 Mao Soeurn M Sangkat Deputy Chief Krang Ampel
61 Khoun Eat M Sangkat Council Kampong Bay
62 Koim Bunny M Village Chief Ondong Khmer
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63 Em Kimsophorn M Village Chief Ondong Khmer
64 Ty Veasna M Village Chief Sovann Sakor
65 Plov Pon M Village Chief Krang
66 Touch Bunleang M Village Chief Chum Kreal
67 Hong Horng M Village Chief Chum Kreal
68 Se Dang M District Deputy Chief Tek Chhou
69 Ty Komsan M Village Deputy Chief Kampong Kandal
70 Long Chy MMunicipal Administration Office
ChiefKampot Municipal
71 Sin Hak M Village Chief Kampong Bay
72 Ouch Thun M Village Chief Kampong Krang
73 Sam Si Em F Sangkat Council Kampong Bay
74 Yoy Sareth M Sangkat Representative Ondong Khmer
75 Bun Chy M Village Chief Tropang Thom
76 Nget Sothy M Officer Theang Thnot Commun
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Annex 2: Training and Field-tested Schedule
Friday, September 03
Time Program Responsible Coordinator
7:30-8:00 Registration Mr. Som Sith
Mr. Mak Chor Vanry
8:00-8:15 Training Objective H.E. Heng Sok
Kong, Project
Manager
Mr. Som Sith
Mr. Mak Chor Vanry
8:15-9:00 Presentation on MDG's water and
sanitation indicators and
discussion on questionnaires
Mr. Teang Sokhom,
GIS Expert
Mr. Som Sith
Mr. Mak Chor Vanry
9:45-10:00 Coffee break Mr. Som Sith
Mr. Mak Chor Vanry
9:00-9:30 Presentation on the process and
methodology of baseline survey
Discussion the process in Kampot
town.
Ms. Sorn Somoline,
Community Expert
H.E. Heng Sokong,
Project Manager,
Mr. Som Sith
Mr. Mak Chor Vanry
9:30-10:00 Formulation of working group for
Field-tested
H.E. Heng Sokong,
Project Manager,
Ms. Sorn Somoline,
Community Expert
Mr. Som Sith
Mr. Mak Chor Vanry
10:00-10:15 Coffee break
10:15-11:30 Field-test on baseline survey
questionnaire
H.E. Heng Sokong,
Project Manager,
Ms. Sorn Somoline,
Community Expert
Mr. Teang Sokhom,
GIS Expert
Mr. Som Sith
Mr. Mak Chor Vanry
11:30-12:00 Group presentation on pre-test of
baseline survey and question and
answer
H.E. Heng Sokong,
Project Manager,
Ms. Sorn Somoline,
Community Expert
Mr. Teang Sokhom,
GIS Expert
Mr. Som Sith
Mr. Mak Chor Vanry
12:00 Closing speech H.E. Heng Sokong,
Project Manager
Mr. Som Sith
Mr. Mak Chor Vanry
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Baseline Data Collection on Water and SanitationThe Mekong Region Water and Sanitation Initiative (MEK-WATSAN)
Province:
Downtown:
Commune:
Village:
Name of the Lead of Family: Male Female
Number of People in the family:. Male:.Female:
HH. total monthly income:. HH. total annual income:...
HH. total monthly expenditure:. HH. total annual expenditure:..
HH. total water related monthly expenditure:..
HH. total water related annual expenditure:
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WATER AND SANITATION MODULE WS
This module is to be administered once for each household visited. Record only one response for eachquestion. If more than one response is given, record the most usual source or facility.
WS1A. WHAT IS THE MAIN SOURCE OF DRINKINGWATER FOR MEMBERS OF YOUR HOUSEHOLD?
*PLEASE ALSO ASK QUESTION WS1B BEFORESKIPPING TO OTHER QUESTIONS
Piped waterPiped into dwelling .................................... 11Piped into yard or plot ............................... 12Public tap/standpipe .................................. 13
Tubewell/borehole ......................................... 21Dug well
Protected well ............................................ 31Unprotected well ........................................ 32
Water from springProtected spring ........................................ 41Unprotected spring .................................... 42
Rainwater collection ...................................... 51Vendors
Tanker-truck .............................................. 61Cart with small tank/drum/buckets ............ 71
Power tiller with smalltank/drum/buckets ..................................... 72
Surface water (river, stream, dam, lake,pond, canal, irrigation channel) ................. 81
Bottled water ................................................ 91Other (specify) _______________________ 96
11WS5B
WS2A
96WS3WS1B. WHAT IS THE MAIN SOURCE OF WATER
USED BY YOUR HOUSEHOLD FOR OTHER
PURPOSES SUCH AS COOKING AND HAND
WASHING?
Piped waterPiped into dwelling .................................... 11Piped into yard or plot ............................... 12Public tap/standpipe .................................. 13
Tubewell/borehole ......................................... 21
Dug wellProtected well ............................................ 31Unprotected well ........................................ 32
Water from springProtected spring ........................................ 41Unprotected spring .................................... 42
Rainwater collection ...................................... 51Vendors
Tanker-truck .............................................. 61Cart with small tank/drum/buckets ............ 71Power tiller with smalltank/drum/buckets ..................................... 72
Surface water (river, stream, dam, lake,pond, canal, irrigation channel) ................. 81
Bottled water ................................................ 91Other (specify) _______________________ 96
11WS5B
WS2A
96WS3
WS2A. HOW LONG DOES IT TAKE TO GO THERE,GET WATER, AND COME BACK?
Number of minutes .............................. __ __ __Water on premises .......................................... 1DK ................................................................... 9
1WS5B
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WS2B. HOW FAR IS THE WATER SOURCE FROMTHIS DWELLING?
Distance in metres............................... __ __ __DK ................................................................... 9
WS3A. IS THERE A QUEUE WAITING TO GET WATERDURING THE RAINY SEASON? Yes .................................................................. 1
No .................................................................... 2 2WS4AWS3B. HOW LONG DOES IT TAKE TO WAIT IN A
QUEUE TO GET WATER DURING THE RAINYSEASON?
Number of minutes .............................. __ __ __DK ................................................................... 9
WS4A. IS THERE A QUEUE WAITING TO GET WATERDURING THE DRY SEASON?
Yes .................................................................. 1No .................................................................... 2 2WS5A
WS4B. HOW LONG DOES IT TAKE TO WAIT IN AQUEUE TO GET WATER DURING THE DRY
SEASON?
Number of minutes .............................. __ __ __DK ................................................................... 9
WS5A. WHO PRIMARILY COLLECTS DRINKINGWATER FOR THE HOUSEHOLD?
IS THIS PERSON UNDER UNDER AGE 15? WHATSEX?
Circle the code that best describes this person.
Adult woman .................................................... 1Adult man ........................................................ 2Female child (under 15) .................................. 3Male child (under 15) ...................................... 4No specific person ........................................... 5NA or delivered to the house ........................... 8
No answer or DK ............................................. 9
WS5B. AT WHAT TIME OF THE DAY IS WATER MOREREADY AVAILABLE AT THE WATER SOURCE?
Early morning .................................................. 1Midday ............................................................. 2Afternoon ......................................................... 3Late evening .................................................... 4Anytime ........................................................... 5DK ................................................................... 9
WS6. IS THE LOCATION OF THE SOURCE OF WATERCONSIDERED SAFE FOR WOMEN AND
CHILDREN?
Yes .................................................................. 1No, risk of crime .............................................. 2No, risk of accident...3No, risk of both crime and accident
2WS11
VOLUME AND PAYMENT FOR DRINKING WATER:CONSUMERS WITH PIPED WATER CONNECTIONS
WS7A.DOES YOUR HOUSEHOLD HAVE PIPEDWATER CONNECTION?
Yes .................................................................. 1No .................................................................... 2
2WS12
WS7B. IS YOUR CONNECTION WORKING AT THEPRESENT TIME?
Yes ................................................................. 1No, service has been disconnected
because I did not pay my bill, ...................... 2No, the connection is faulty and we are
waiting to have it repaired ........................... 3No, but there is some other reason why
its not working, (specify).............................. 4
2WS12
3WS12
4WS12
WS7.1 IS YOUR PIPED WATER METERED? Yes .................................................................. 1Yes, but not working ........................................ 2No .................................................................... 3
2WS93WS9
WS8. WHAT WAS LAST MONTHS WATERCONSUMPTION ACCORDING TO THE METER
READING?
No. of cubic meters ............................. __ __ __Meter is not read/inoperative ........................... 8DK ................................................................... 9
WS9. DO YOU PAY FOR YOUR WATER? Yes .................................................................. 1No .................................................................... 2 2WS16
WS10. HOW DO YOU PAY FOR YOUR WATER? Flat rate per month ......................................... 1According to monthly consumption ................. 2Other (Specify) ............................................... 9
WS11.AVERAGE MONTHLY BILL? Amount (Riels) ............................... __ __ __ __Meter is not read/inoperative ....................... 888
RIELSWS16
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WHOPAYSFORTHEWATERBILL? Mother:_______________Father:_______________Other_____________
CONSUMERS WITHOUT PIPED WATER CONNECTIONS
WS12. HOW MANY BUCKETS OF WATER DO YOUUSE EACH DAY?
Observ the bucket and convert to literNumber of buckets ................................... __ __
WS13. DO YOU PAY FOR YOUR WATER? Yes .................................................................. 1No .................................................................... 2 2WS16
WS14. HOW DO YOU PAY FOR YOUR WATER? Pay per drum (200 liter) ................................. 1Flat rate each week ......................................... 2Flat rate each month ....................................... 3Other (specify) ________________________4
WHOPAYSFORTHEWATER: Mother:.Father:..Other:.
WS15. AMOUNT PAID PER DRUM (200 LITER) ORDRUM EQUIVALENT?
Amount (Riels) .................................... __ __ __Other forms of payment .............................. 888
DISRUPTIONS TO THE WATER SUPPLY
WS16. DID YOU HAVE ANY DISRUPTIONS FROMYOUR MAIN SOURCE OF DRINKING WATER
DURING THE PAST 2 WEEKS?Yes .................................................................. 1No .................................................................... 2 2WS19A
WS17. HOW FREQUENT WERE THESEDISRUPTIONS?
Daily ................................................................ 1Intermittent most days ..................................... 2Intermittent several days ................................. 3Occasional ....................................................... 4Several hours at a time ................................... 5More than a day .............................................. 2More than a week ............................................ 6No water in the past two weeks ...................... 7NA ................................................................... 8DK ................................................................... 9
HOUSEHOLD TREATMENT OF DRINKING WATER
WS18A. WHAT IS THE COLOUR OF YOUR DRINKINGWATER?
Clear ................................................................ 1Not clear .......................................................... 2Other ............................................................... 3DK ................................................................... 9
WS18B. DOES YOUR DRINKING WATER SMELL? Yes, smells of chlorine .................................... 1Yes, smells bad ............................................... 2No .................................................................... 3DK ................................................................... 9
WS19. WHAT DO YOU DO TO THE WATER TO MAKEIT SAFER TO DRINK?
Ask the respondent to recall the primary and
secondary methods used to make the watersafe to drink.
Primary Method:Boil .................................................................. 1Add bleach/chlorine ......................................... 2Sieve it through a cloth .................................... 3Use water filter (ceramic, sand, composite,
etc.) ........................................................... 4Solar disinfection ............................................. 5Let it stand and settle ...................................... 6Other (specify) ________________________7DK .................................................................. 9
Secondary:.................. 1.................. 2.................. 3
.................. 4
.................. 5
.................. 6_________ 7.................. 9
SOURCE OF WATER FOR CLEANING, WASHING AND BATHING
WS20. IS YOUR SOURCE OF WATER FORCLEANING, WASHING, AND BATHING DIFFERENTFROM YOUR SOURCE OF DRINKING WATER?
Yes .................................................................. 1No .................................................................... 2 2WS21B
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WS21A. WHAT IS THE MAIN SOURCE OF WATERUSED FOR CLEANING, WASHING, AND BATHINGBY MEMBERS OF YOUR HOUSEHOLD?
Piped waterPiped into dwelling .................................... 11Piped into yard or plot ............................... 12Public tap/standpipe .................................. 13
Tube-well/borehole ........................................ 21Dug well
Protected well ............................................ 31Unprotected well ........................................ 32
Water from springProtected spring ........................................ 41Unprotected spring .................................... 42
Rainwater collection ...................................... 51Vendors
Tanker-truck .............................................. 61Cart with small tank/drum/buckets ............ 71Power tiller with smalltank/drum/buckets ..................................... 72
Surface water (river, stream, dam, lake,pond, canal, irrigation channel) ................. 81
Bottled water ................................................. 91
Other (specify) _______________________ 96No answer or DK ........................................... 99
WS21B. WHERE DO MEMBERS OF YOURHOUSEHOLD BATHE?
Private bathroom ............................................. 1Others bathroom ............................................. 2Open air ........................................................... 3At the stream, river, lake ................................. 4Other (specify) ________________________5
WS22. HOW DO YOU DISPOSE OF WATER, WHICHHAS BEEN USED FOR COOKING, WASHINGDISHES, DOING LAUNDRY AND BATHING?
Piped into soak-away ...................................... 1Piped into storm drain ..................................... 2Piped onto street surface or empty space ...... 3
Piped directly to garden .................................. 4Throw onto street surface or empty space ...... 5Carry to garden ............................................... 6Other (specify) ________________________8
SANITATION
WS23A.DO YOUR FAMILY MEMBERS USETOILET?
Yes1No..2 SW1
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WS23B. WHAT KIND OF TOILET FACILITY DOESYOUR HOUSEHOLD USE?
If flush or pour flush, probe:
WHERE DOES IT FLUSH TO?
If necessary, ask permission to observe thefacility.
Modern latrine with septic tank ...................... 11Pour flush latrine with septic tank .................. 12Pour flush latrine with no septic tank ............. 13Pit latrine with slab ........................................ 21Pit latrine without slab/open pit ..................... 22No facilities or bush or field ........................... 23Other (specify) _______________________ 96No facilities but use public or others facilities97
23SW1A
96WS24A97WS28
WS23C. HOW DO YOU EMPTY YOUR PIT LATRINES? Manually .......................................................... 1Commercial Exhauster .................................... 2Abandone ........................................................ 3DK ................................................................... 4
Other (specify) ________________________5
WS24A. IS THIS FACILITY LOCATED WITHIN YOURDWELLING, YARD, OR COMPOUND?
Yes, inside dwelling/yard/compound ............... 1No, outside dwelling/yard/compound .............. 2
1WS25
WS24B. HOW FAR OUTSIDE THE DWELLING, YARD,OR COMPOUND IS THIS?
Less than 20 metres ........................................ 120-50 metres ................................................... 250-100 metres ................................................. 3More than 100 metres ..................................... 4
WS24C.HOW FAR FROM THE WELL Less than 30 metres or on the water source ... 1More than 30 metres ....................................... 2
WS25. DO CHILDREN UNDER 5 USE THISSANITATION FACILITY?
Yes .................................................................. 1No .................................................................... 2NA, no children under 5 .................................. 3
1WS271WS263WS27
WS26. WHAT HAPPENS WITH THE STOOLS OF
CHILDREN UNDER 5 WHEN THEY DO NOT USETHE SANITATION FACILITY?
Thrown into the latrine ..................................... 1Thrown outside in the yard .............................. 2Buried outside in the yard ............................... 3Not disposed of or left on the ground .............. 4Other (specify) ________________________5
SEWAGE TREATMENT
WS27. WHAT TYPE OF SEWAGE TREATMENTMETHOD DOES THIS HOUSEHOLD USE?
A SEPTIC SYSTEM HAS A SEALED TANK WITH
EFFLUENT TO SOME KIND OF SOAK-AWAY.
Read out the responses. One answer only.
Soak-away (seepage pit, unlined pit) .............. 1Cesspit (sealed tank, no effluent) .................... 2Septic system .................................................. 3Other (specify) ________________________4
WS28. IS THERE ANY VISIBLE EFFLUENT BEINGDISCHARGED FROM YOUR SANITATION
FACILITY?Yes .................................................................. 1No .................................................................... 2 2SW1A
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WS29. DOES YOUR SANITATION FACILITY CAUSEANY PROBLEMS FOR YOU OR YOUR
NEIGHBOURS?Yes .................................................................. 1No .................................................................... 2 2SW1A
WS30. WHAT SPECIFIC PROBLEMS ARE CAUSEDBY YOUR SANITATION FACILITY?
Read out the responses. One answer only.
Pooled sewage around the house ................... 1Odors from the facilities are unpleasant to
residents ...................................................... 2Both pooled sewage and odors ....................... 3
SOLID WASTE DISPOSAL SW
SW1A. HOW DOES THIS HOUSEHOLD PRIMARILYDISPOSE OF HOUSEHOLD WASTE THAT IS NOT
COMPOSTED, RECYCLED, OR FED TO THEANIMALS?
Collected by local government/authority ......... 1Collected by community association ............... 2Collected by private company ......................... 3Dumped in the compound ............................... 4Dumped in the street/vacant plot/drain ........... 5Burnt in the open ............................................. 6Buried .............................................................. 7Other (specify) _______________________ 8
SW1B. HOW OFTEN IS WASTE COLLECTED? times/week.times/month
SW2. ESTIMATE THE AMOUNT OF HOUSEHOLDWASTE YOU DISPOSE OF EACH DAY (INCLUDEFOOD WASTE, PLASTICS, PAPER, TINS).
[Estimate volume in terms of plastic bag andcovert to kg]
No. of plastic bag each time .......... __ __ .__ __
SW3A.. DOES YOUR HOUSEHOLD CURRENTLY PAYFOR THE REMOVAL OF SOLID WASTE/RUBBISH
/GARBAGE?Yes .................................................................. 1No .................................................................... 2 2SW4
SW3B.AVERAGE MONTHLY FEE FOR SOLID WASTE
COLLECTION?
Amount in Riels..
DK ................................................................... 9 SW6ASW4.WOULD YOUR HOUSEHOLD WILLING TO PAY
FOR SOLID WASTE COLLECTION?Yes .................................................................. 1No .................................................................... 2
SW6A
SW5.HOW MUCH ARE YOU WILLING TO PAY FORMONTHLY COLLECTION? Amount in Riels..
DK ................................................................... 9
SW6A.DO YOU RECYCLE SOLID WASTE?Yes .................................................................. 1No .................................................................... 2
2SW6C
SW6B. PLEASE IDENTIFY THE TYPES OF ITEMSTHAT YOU RECYCLE.
Circle all that apply.
Food waste (composting) ................................ 1Food waste (feed to animals ........................... 2Plastic bags ..................................................... 3Plastic (water bottles, containers) ................... 4
Paper items ..................................................... 5Cardboards ...................................................... 6Textile .............................................................. 7Tins .................................................................. 8Garden waste .................................................. 9Wood/charcoal .............................................. 10Other (specify) _______________________99
SW6C. DO RECYCLING GROUPS/COMPANIESCOLLECT ANY OF YOUR WASTE FOR
Yes .................................................................. 1No .................................................................... 2 2SW7
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RECYCLING?SW6D. WHAT TYPE OF WASTE DO THEY COLLECT?
Circle all that apply.
Food waste (composting) ................................ 1Food waste (feed to animals ........................... 2Plastic bags ..................................................... 3Plastic (water bottles, containers) ................... 4Paper items ..................................................... 5
Cardboards ...................................................... 6Textile .............................................................. 7Tins .................................................................. 8Garden waste .................................................. 9Wood/charcoal .............................................. 10Other (specify) _______________________ 99
SW7. DOES THE NEIGHBOURHOOD HAVE SMOKE,GAS, OR BAD SMELLS ASSOCIATED WITHBURNING RUBBISH?
Yes .................................................................. 1No .................................................................... 2 2SW9
SW8. ARE YOU CONCERNED ABOUT THE POSSIBLEHEALTH CONSEQUENCES OF BREATHING THE
SMOKE AND POLLUTED AIR?
Yes .................................................................. 1No .................................................................... 2
SW9.OBSERVATION:DOES THE FRONT OF THEHOUSE WITHIN AN AREA OF 100M
2HAVE A
LITTER PROBLEM?
Yes, lots of litter visible .................................... 1Yes, some paper and plastic bags .................. 2No litter visible ................................................. 3
HEALTHH1.HAVE YOU OR YOUR FAMILY MEMBERS
SUFFERED FROM WATER-BORNE DISEASESSUCH AS DIARRHOEA, DENGUE?
Yes..1No2 2SW9
H2. FREQUENCY OF ILLNESS PER PERSON PERYEAR?
How many time.
H3. HOW MUCH MONEY DO YOU SPEND ONTREATMENT OF ILLNESS PER YEAR?
Amount spentRiel
H4.DID YOUR FAMILY GET ANY HEALTHAWARENESS RAISING?
Yes..1No2
Date:Signature of intherviewer
Date:Signature of supervisor