Serial No. Code Data Entry Water and Sanitation Programme Consumer / Household Research Interviewer s Identification Interviewer s Name Interviewer s ID Card Number Respondent s Identification HOUSEHOLD ID Household Number Name of head of household District Domain Ward District code Village Ward code Date visited Village (Cluster) Code Time visited Result Codes for Result 1 - Completed 2 - No one (or no potential respondent) at home 3 - Entire household absent 4 - Refused 5 - Dwelling vacant 6 - Dwelling destroyed 7 - Dwelling not found 8 - Other Supervisor Field Editor Office Editor Entered By Name Date Name Date 1
Respondents should be over 18 years of age and be normally resident in the household. Section one - Respondent Clarification 1. How old are you? If under Age in completed years 18, or above 49. Verify that s/he is between 18 and 49 End Here. 2. What is your relationship to the Head of the Household? Head of Household 1 Wife 2 Mother 3 Mother-in-law 4 Grandmother 5 Father 6 Father-in-law 7 Grandfather 8 Son 9 Daughter 10 Brother 9 Sister 10 Niece 11 Nephew 12 Cousin 13 Not related 14 3. Do you normally live in this house? Yes 1 End Here 4. How many people currently live in your household? 5. How many of these are children under the age of 5? No 2 End Here If 0 end here 2
Section two - Respondent Characteristics 6. Have you ever attended school? No 0 Go to Yes 1 Q9 7. What is the highest level of education you have? Primary, secondary or higher Primary 1 Secondary 2 Higher 3 8. What is the highest class you completed at that level? 9. What is your religion? Christian 1 Muslim 2 African Traditional 3 Other (specify): 4 10. What primary activity do you do to earn money? Works on own farm 1 Paid work 2 Receives income from spouse/other 3 Family member 4 Unpaid in family business 5 Unpaid worker on family farm 6 Unemployed 7 Comment [SLC1]: Other 11. Do you do any other activity to earn money? 12. What is your primary source of income? No 0 Go to Q17 Yes 1 Own business 1 Family 2 Agriculture 3 Employed in private sector 4 Employed in public sector 6 Domestic work 7 Comment [SLC2]: Other 13. How many months of the year do you do these activities? 14. How much money do you earn from all sources per week? 15. How do you use this money? Food 1 Housekeeping 2 Work/farming/trading 3 Transport 4 Emergencies 5 Other (specify) 96 3
16. Who decides how the money will be Respondent 1 spent? 17. Where do you obtain money for oneoff emergencies e.g. medicine? 18. If you don t receive money for emergencies from household sources where else do you obtain this money from? 19. How long does it take to get the money? 20. Is there someone you could borrow from to obtain money to build a latrine? 21. Where could you borrow the money from? Head of household 2 Husband/wife 3 Respondent and husband/wife 4 Mother-in-law 5 Someone else 6 Respondent and someone else 7 Self 1 Spouse 2 Household head 3 Other member household/family 4 Borrow from friends/peers 5 Loan 6 Credit from retailer 7 Other (specify): 96 Borrow from friends or peers 1 Loan 2 Credit from retailer 3 Other (specify): 96 Immediate 1 A few hours 2 Same day 3 Next day 4 A few days 5 Yes 1 No 2 Family 1 Household member 2 Friends/peers 3 Business associate 4 Church member 5 Community organisation 6 Credit organisation 7 Other (specify): 96 Go to Q19? G to Q22 22. In the last 2 weeks, have any children under 5 years old in your household suffered from diarrhoea? 23. In the last 2 weeks have children in the household suffered from a Yes (how many) 1 No 2 Yes (how many) 1 4
respiratory infection e.g. coughing, flu? Section three Sanitation Questions No 2 24. What is the main reason for having a Privacy 1 latrine? (Do not read out responses) 25. Where do people from this household currently go to the toilet? (consider the place most often used) Avoid sharing with others 2 Avoid disturbing neighbours 3 Avoid embarrassment 4 Prestige/status 5 Convenience 6 Easy to keep clean 7 Every household must have a latrine 8 Avoid contaminating the environment 9 For good health/avoid disease 10 Other (specify): 11 Latrine for this household only 1 Latrine shared with other households 2 WC 3 Traditional pit latrine 4 Neighbour s latrine 5 Public latrine 6 26. What type of latrine do you have? Choose one for above ground structure Choose one for below ground structure Open defecation 7 Go to Flying toilets 8 Q33. Other (specify): 9 Above Ground Structure: WC 1 Traditional pit latrine - no slab 2 pit latrine with slab 3 Ventilated improved pit (VIP) latrine 4 Ceramic sink/bowl latrine/pour flush 5 Drum/tyre latrine 6 Ecosan latrine 7 Other (specify): 8 Below Ground Structure: Don t know 9 Unlined pit 9 Partially lined pit 10 Fully lined pit 11 Septic tank 12 5
Drum/ tyre latrine 13 Sewer 14 Other (specify) 15 Don t know 16 27. Do you share this facility with other households? 28. How many households do you share Yes 1 No 2 Go to Q30 with? 29. How many people share a latrine in total? 30. Do you have the facility for hand washing after using the latrine? 31. If you were able what would be the one most important thing you would do to improve the latrine? Yes 1 No 2 Add ceramic bowl/basin 1 New floor 2 Add tiles 3 Permanent superstructure 4 Add door 5 Lockable door 6 Iron roof 7 Improve ventilation 8 Add cleaning facilities 9 Other (specify): 10 Don t know 11 32. What is the main benefit of improving the latrine? Modernised latrine 1 Improve my/our status 2 Solids cannot be put down 3 Latrine easier to clean 4 More durable latrine 5 Increased privacy 6 Safer for children 7 Environmental protection 8 Improved health 9 Don t know 10 Other (specify): 11 33. Are you satisfied with your current place of defecation? Very satisfied 1 Satisfied 2 Neutral 3 6
(don t use the word latrine) Not satisfied 4 Very Unsatisfied 5 34. What is the most significant thing you are satisfied with in the place where you defecate now? Good floor 1 Affords privacy (full door and walls) 2 Provides shelter (roof) 3 (up to 3 responses) It is clean 4 Easy to clean 5 Minimal bad smells 6 Not shared 7 Good condition (no damage) 8 Safe for the children 9 Long-lasting/durable 10 Affordable 11 Modern 12 Nothing 13 Other (specify): 14 35. What are you dissatisfied with in the place where you defecate now? (up to 3 responses) Like everything/ nothing disliked 1 No roof 2 No door 3 Passport style 4 Poor condition 5 Full 6 Bad smells 7 Share with others 8 Unclean 9 Unsafe 10 Temporary 11 Other (specify): 12 36. What types of latrines have you tried? (multiple responses allowed) NB: WC= flush toilet with a seat; sink/bowl=ceramic bowl slab with no flush or seat None 1 Go to Q39 WC 2 Traditional pit latrine- no slab 3 Pit latrine with slab 4 Ventilated improved pit (VIP) latrine 5 Ceramic sink/bowl latrine/pour flush 6 Drum/tyre latrine 7 7
Ecosan latrine 8 Others (specify): 9 37. Among those you have tried which do you prefer most? WC Traditional pit latrine-no slab 1 2 Pit latrine with slab 3 Ventilated improved pit (VIP) latrine 4 Ceramic sink/bowl latrine/pour flush 5 Drum/tyre latrine 6 Ecosan latrine 7 Others (specify): 8 38. Why do you prefer that type? Modern/ good style 1 Easy to clean 2 Affordable 3 Easy to construct 4 No smell 5 No flies 6 Children can use 7 No need to empty for long time 8 Durable 9 Easy to improve 10 Don t See faeces 11 Don t know 12 Other (specify): 13 39. What do you think makes for a good latrine? (up to 3 responses) Tiled floor and/or wall 1 Full door 2 Roof 3 Full superstructure 4 Ceramic pan 5 Clean 6 Easy to clean 7 Unbreakable floor 8 Not full 9 No smell 10 Lined pit 11 Not shared 12 Permanent 13 8
Disinfectants & water available for cleaning 14 Other (Specify): 16 CONTINUE FOR THOSE THAT HAVE OR SHARE LATRINE - REFER BACK Q25 FOR THOSE WITH NO LATRINE GO TO Q51 40. Was there a time when your latrine Yes 1 was un-usable? No 2 41. What was the problem? It had collapsed 1 Poor Superstructure Lack of privacy 2 It was full 3 Unsafe 4 Unclean 5 Improvements were being made to t 6 Don t know 7 Other (Specify): 42. How long could you not use it for? Under 2 days 1 43. What alternative did you use at that time? 44. How did you feel when your latrine was not usable? 8 2-5days 2 6-13days 3 2weeks 1month 4 1-2months 5 Over 2months (Specify): 6 Used neighbour s latrine 1 Went to a local bar/restaurant 2 Public latrine 3 Open defecation 4 Flying latrine 5 Other (Specify): 6 Shame 1 Embarrassed - must use neighbour s latrine Inconvenienced - cannot use latrine at my leisure Uncomfortable as arguing with neighbours Disturbed by the bad smell 5 2 3 4 Go to Q46. At increased risk of disease (specify) 6 9
Disturbed by lack of privacy 7 Disgusted 8 Other (Specify): 9 Don t know 10 45. How did your neighbours react when They understood 1 your latrine was out of use? They looked down on us 2 They talked behind our backs 3 They argued with us 4 They informed local government 5 They informed Environmental Health 6 Officer 7 Don t Know 8 Other (Specify): 9 46. For how long are you comfortable sharing with your neighbours? Up to 2 days 1 3-7days 2 Up to 2weeks 3 Up to 1month 4 Up to 3months 5 Over 3months (specify): 6 47. How often is your latrine cleaned? More than once a day 1 Every day 2 2-3 times per week 3 Once a week 4 Fortnightly 5 Monthly 6 Less than once a month 7 Don t know 8 48. What do you use to clean the latrine? Multiple responses Water 1 Powder soap 2 Bar soap 3 Harpic/disinfectant 4 Brush 5 Don t know 6 Other, Specify: 7 49. Have you made any improvements in your latrine/place of defecation NO 1 Build new pit 2 10
during the last 6 months? Line pit 3 New slab 4 Add all that applies Add Ceramic bowl/basin 5 New floor 6 Add tiles 7 Permanent superstructure 8 Add door 9 Lockable door 10 Iron roof 11 Improve ventilation 12 Add cleaning facilities 13 50. For those who own/share latrine Do you have any plans to improve/replace the latrine? 51. For those with no latrine Do you have any plans for constructing a new latrine? 52. If NO to 50 or 51 Why 53. If YES to 50 Why 54. If YES to 51 Why No 1 Go to Q52 Yes (to improve or replace) 2 Go to Q53 No 1 Go to Q52 Yes build 3 Go to Q54 Financial constraints 1 Go to Landlord s responsibility 2 Happy with latrine for now 3 Difficult to get others to agree 4 Can t find Fundi 5 Can t find materials 6 Other (specify): 7 Q74 Poor condition of the latrine 5 Go to Latrine not safe 6 To modernise 7 Make easier to clean 8 Other 9 Q62 Need a latrine 1 Conti Landlord absent so we must build 2 Pressure from family 3 Pressure from community 4 Other 5 nue with 55 FOR THOSE PLANNING TO BUILD A LATRINE 55. What kind of latrine do you intend to Above Ground Structure: construct? WC 1 Traditional pit latrine no slab 2 11
Pit latrine with slab 3 VIP 4 Ceramic sink/bowl latrine/pour flush 5 Drum/tyre latrine 6 Ecosan latrine 7 Other (specify) 8 Don t Know 9 Below Ground Structure: Unlined pit 9 Partially lined pit 10 Fully lined pit 11 Septic tank 12 Drum/ tyre latrine 13 Sewer 14 Other, specify 15 Don t know 16 56. What are the main reasons for selecting that type? Up to 3 responses Modern / good style 1 Easy to clean 2 Affordable 3 Easy to construct 4 No smell 5 Children can use 6 No need to empty for long time 7 Durable 8 Easy to improve 9 Don t see faeces 10 Other, specify: 11 Don t know 12 57. What is the main benefit of having this new latrine? Increased status 1 Neighbourly respect 2 Higher room rental rate 3 Modern latrine 4 Privacy 5 Increased safety 6 Long-lasting latrine 7 12
More comfortable latrine 8 Odourless latrine 9 Other, specify: 10 58. How much will it cost you to construct this new latrine? Under US$50 1 US$51-100 2 US$101-150 3 US$151-200 4 US$201-250 5 US$251-300 6 US$301-350 7 Over US$350 8 Don t know 9 59. How are you going to pay for the construction of a new latrine? Save money 1 Borrow money from family 2 Go to Borrow from Friends 3 70 Borrow from employer 4 Borrow from credit organisation 5 Borrow from church 6 Borrow from other 7 Other 8 Don t know 9 60. How long will it take you to save the money to construct a new latrine? No Need to Save 1 Up to 1 Week 2 1-2weeks 3 Up to 1month 4 Up to 3months 5 Over 3months 6 61. Have you started to save money to construct a new latrine? Yes 1 Go to No 2 Q70 FOR THOSE PLANNING TO UPGRADE 13
62. Are you planning to upgrade your latrine/place of defecation in the next 1 year? 63. What have you planned to improve? Multiple responses allowed Yes actually in process 1 Yes planning to do it 2 Yes thinking about it 3 No 4 Build new pit 1 Line pit 2 New slab 3 Add ceramic bowl/basin 4 New floor 5 Add tiles 6 Permanent superstructure 7 Add door 8 Lockable door 9 Iron roof 10 Improve ventilation 11 Add cleaning facilities 12 Other (specify): 13 Don t know 14 64. Why do you want that improvement? Make latrine more modern 1 Improve latrine appearance 2 Improve safety 3 Afford better privacy 4 Slab damaged in emptying 5 Reduce contamination 6 Improve health 7 Reduce smell 8 Make cleaning easier 9 Don t know 10 65. What is benefit of improving the latrine? Other, specify: 11 Modernised latrine 1 Improve my/our status 2 Solids cannot be put down 3 Latrine easier to clean 4 More durable latrine 5 14
Increased privacy 6 Safer for children o 7 Environmental conservation 8 Improved health 9 Don t know 10 Other, Specify: 11 66. How much do you think it will cost to make the improvement? Under US$20 1 US$21-50 2 US$51-100 3 US$101-150 4 US$151-200 5 US$201-250 6 US$251-300 7 US$301-350 8 Over US$350 9 Don t know 10 67. How will you pay for the improvements? Save money 1 Borrow money from family 2 Go to Borrow from friends 3 Q70 Borrow from employer 4 Borrow from credit organisation 5 Borrow from church 6 Borrow from other 7 Other 8 Don t know 9 68. How long will it take you to save the money? No need to save 1 Up to 1 week 2 1-2weeks 3 Up to 1month 4 Up to 3months 5 Over 3months 6 69. Have you started saving the money? Yes 1 No 2 All those planning to upgrade or build new latrine: 70. Where will you get the information on improving the latrine? Landlord 1 Neighbours 2 15
Tick all that apply 71. Do you know a fundi/builder who can help with the construction/improvement of the latrine? 72. How far away is the fundi? (respond in time) 73. What is the main constraint you think you will encounter in building/improving the latrine? Up to 3 responses 74. If I come after one year how likely is it that that latrine will be improved? Friends 3 Service providers visit 4 Used mobile phone 5 Mason/Fundi/service provider direct 6 Building suppliers 7 Local Government 8 Health Committee Members 9 Environmental Health Officer 10 Radio 11 Other (Specify): 12 Don t know 13 Yes 1 No 2 Land type 1 Lack of space 2 No one to sdvise 3 No one to build 4 High cost of latrines 5 Unable to save or access credit 6 Accessing the necessary building 7 Materials 8 Persuading landlord to invest 9 Persuading tenants to invest 10 Cost of the latrine 11 Difficult to find a mason /builder/fundi 12 Difficult to find the materials 13 Water table/soil conditions 14 Tenancy issues 15 No access to credit 16 Technical complexity of the work 17 Nothing 18 Don t know 19 Other (Specify): 20 Very high 1 High 2 Neither high or low 3 16
(5 point scale: high to low) Low 4 Very low 5 NOTE TO INTERVIEWER. ONCE RESPONDENT HAS SAID AGREE OR DISAGREE PROBE TO FIND OUT WHETHER THAT IS STRONGLY. FOR EXAMPLE IF RESPONDENT SAYS AGREE THEN ASK THEM Is that somewhat agree or strongly agree? NB: and shaded grey responses denotes reverse coded (as statement is negative towards the construct) and should be reversed for analysis. DO NOT READ OUT SCALE TITLES IN ITALICS Section Four Q# Statement Response Strongly Agree Agree Disagree Strongly Disagree Don t Know 75. In this community it is normal for people to defecate in the open 76. Some people have a latrine but prefer to defecate in the open 77. In this community people do not look after their latrines 78. It is not normal for people to defecate in the open 79. People in this village would disapprove of anyone who defecates in the open 80. Families in this community cannot expect any help from others to improve their latrine 81. In this community it is easy to get good information on how to build a good latrine 82. There are community organisations who can assist people in building an improved latrine 83. In this community it is easy to find financial support to build a good latrine 84. People in this village support one another to build better latrines 85. People in your family know how to build a latrine 86. Someone in your households would know how to build a pit for a latrine but not know how to build the slab 87. Nobody in your household knows how to 17
Q# Statement Response Strongly Agree Agree Disagree Strongly Disagree Don t Know build an improved latrine 88. People in your family would be confident in improving a latrine to have a safe slab 89. People who defecate in the open are disgusting 90. People who share latrines are more at risk of getting diarrhoea 91. It is important to improve your latrine to stay healthy 92. People who defecate in the open put the whole community at risk of disease 93. Families that improve their latrines are good members of the community 94. Families who share latrines with others put their children at risk of disease 95. People in this community would be ashamed if a visitor stepped in human shit in the fields near the village 96. Shitting is natural it does not matter where you do it. 97. People in this community improve their latrines to be healthy 98. People in this community get more comfort from a using a clean, safe latrine 99. People in this village feel uncomfortable if they have to use a dirty, smelly latrine 100. If people in this community continue to defecate in the open then everyone is at risk of getting sick 101. People in this village will be able to relax once they know everyone has improved their latrines 102. People in this community are worried about children getting sick from poor sanitation 103. People in this community are improving their latrines so that everyone can be healthy 104. There is nothing people can do to improve their health, it is up to God whether they are healthy 105. It is important for people to try to be hygienic and clean so they can stay healthy 106. Fate will decide whether people get sick 107. It is important to take control of your health 18
Q# Statement Response by doing those things that will stop you getting sick 108. People in this community would feel ashamed if they did not have a latrine 109. People in this community are proud once they have improved their latrine 110. People will think badly of someone who does not keep their latrine clean 111. In this community people would rather buy a mobile phone than build a latrine 112. School fees are more important than improving a latrine 113. Building a latrine that keeps a family healthy is the best use of a families resources 114. A household needs a bicycle more than a latrine 115. In this community people would rather buy animals than build a latrine Strongly Agree Agree Disagree Strongly Disagree Don t Know 19
Section Five Community Sanitation 116. What are the main sanitation problems relating to this community? Poor drainage Poor environment 1 2 Poor sanitation 3 Lack of clean water 4 Security 5 Poverty 6 Diseases/ poor health 7 Garbage 8 Unemployment 9 Other (specify): 10 117. What do you think of the situation in relation to sanitation in this community/village? Very poor 1 Poor 2 Fair 3 Very good 4 Excellent 5 118. What is the main problem with sanitation at the household level in this area? Full latrines 1 Flooding latrines 2 Lack of emptying services 3 Collapsing latrines 4 Lack of cleaning materials 5 Lack of clean water 6 Poor latrines 7 Poor security in latrines 8 Open defecation 9 Other, specify: 10 Don t know 11 119. What mechanisms exist to check that households have and maintain a good latrine? Multiple responses Health Committee inform us Health Officer informs us Health Officer fines people with full latrine 1 2 3 10 cell leader informs us 4 Local Government informs us 5 20
Neighbour s complain 7 None I know of 8 Don t know 9 Other, specify: 10 Source Trust 120. Where do you think people can get information on latrine building/improvements? Multiple response 121. What information source is the most reliable? Women s groups Youth groups Religious groups TV Radio Newspaper Magazine 10 cell leader Ward leader Local government Neighbours Landlord Service providers pass through here Use mobile phones Building suppliers Local government Health Committee members Environmental Health Officer Friends Family/relatives Other (Specify) Don t know 21
Section Six Household Characteristics # Question Response Code Skip 122. What are the main sources of Piped into dwelling 1 Go to drinking water for your household? Q124 Piped into compound 2 Go to Q124 Public tap/standpipe 3 Tube well or borehole 4 Protected well 5 Unprotected well 6 Rainwater 7 Tanker truck 8 Cart with small tank 9 Surface water (river, dam, stream) 10 Bottled water 11 Other (specify) 123. How long does it take you to collect water and come back? Hours Minutes 96 124. What material is mainly used to construct the walls of your house? 125. What material is mainly used to construct the floor of your house? 126. What material is mainly used to construct the roof of your house? 127. What type of energy is mainly used by your household for cooking? Stones /bricks /cement 1 Clay /mud 2 Wood 3 Iron sheet 4 Other (specify) 96 Natural Floor (earth/sand/dung) 1 Wooden planks 2 Palms/bamboo 3 Parquet or polished wood 4 Vinyl or lino/ asphalt 5 Tiles 6 Cement 7 Carpet 8 Other (specify) 96 Grass 1 Iron sheets 2 Tiles 3 Other (specify) 96 Dung Firewood / straw 22
Charcoal 128. Do you or a member of your household own any of the following? 129. Do you own this house? Read options enter one answer 130. Do you own the land? Read options enter one answer 131. If land is owned - how many acres do you own? 132. For the past week how much money was used for food by your household? (not include alcohol, cigarettes and restaurant meals) 133. For the past 4 weeks, how much was spent by your household in total Coal Kerosene Biogas LPG / Natural Gas Electricity Other (specify) Y N Electricity 1 0 Radio 1 0 Television 1 0 Landline 1 0 Refrigerator 1 0 Cows/sheep/goats/donkeys 1 0 Chickens/ducks 1 0 Bicycle 1 0 Motorcycle/moped 1 0 Car/Truck 1 0 Mobile telephone 1 0 Owns 1 Pays rent 2 No rent with consent of the owner 3 No rent (squatting) 4 Other (specify) 96 Owns 1 Pays rent 2 No rent with consent of the owner 3 No rent (squatting) 4 Other (specify) 96 Comment [SLC3]: Section Seven General Media Exposure # Question Response Code Skip 134. Do you listen to the radio? Yes 1 23
135. 136. 137. No 2 How often do you listen? Less than once a week 1 About once a week 2 2-3 days a week 3 4-5 days a week 4 Every day 5 Which station is your favourite? Do you watch the TV? Yes 1 Go to Q137 138. No 2 Go to Q140 How often do you watch TV? About once a week 1 2-3 days a week 2 4-5 days a week 3 Every day 4 139. _ Which TV station is your favourite? 140. Do you read newspapers? Yes 1 141. 142. How often do you read newspapers? What is your favourite newspaper? No 2 Less than once a week 1 About once a week 2 2-3 days a week 3 4-5 days a week 4 Every day 5 Go to Sectio n 8 24
Section Eight - Observations Thank you for answering my questions, your comments were most informative and interesting. Before I leave would you mind if I took at look at your latrine? Yes 01 No 02 1) Special features: Latrine elevated (built above ground) 01 Foot rests 02 Seat 03 Floor tiles 04 Wall tiles 05 Other, note: 06 2) Condition of latrine cleanliness Is there? Yes Visible faeces on floor? 01 Visible cleaning materials on floor? 02 Latrine cover? 03 Brush? 04 Is there any water in or close to the latrine? 05 Is there any soap in or close to the latrine? If yes, circle which type: Powder; Liquid; Bar 06 3) State of repair of the latrine? Completely smooth, unbroken slab 01 Slightly cracked slab 02 Very cracked slab 03 Collapsing slab 04 State of collapse prohibits use 05 4) Fullness of pit Shine torch into pit to see Is it? Yes No Within 1m If within 1m is it within 0.25m Totally full Solid waste visible in pit Cannot see down 25
5) Superstructure Presence of Yes No Roof Full Wall Half wall Full door Half door Lockable door 6) What are the construction materials? Cement Blocks Polythene paper Grass Iron Sheets Bricks Others (specify) Nothing Roof Wall Doors 7) Position of latrine accessibility: open access versus in closed courtyard Open access 01 Closed courtyard 02 Plot accessible by car Plot accessible by Tanker Yes/ No Yes/ No 8) Is there space for new (permanent) latrine construction in the compound? Yes 01 No 02 Thank respondent for taking the time and effort to participate in this survey. Close interview I confirm that this questionnaire was completed according to the standards set out during my training. Signed Date 26