Mekong Regional Water and Sanitation Program (MEK-WATSAN)

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)

2010

KAMPOT WATER
SUPPLY UTILITY

K A M P O T , CAMBODIA

B Y
S O R N S O M O L I N E

1
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

2
 1. Introduction
MEK-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. Objective
The 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,

3
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 survey

3. 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 Date

The 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 Municipal
Office 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.

4
5
 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 are
labor 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 the
surveyor 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 Sanitation
Section)
- The reason of not having toilet (added in Sanitation Section, on question WS
23A)
- Did your family get any awareness campaign on health care from the government
or 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. Conclusion
At 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

6
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.

7
Annex 1: List of participants in Training and Field-tested
03 September 2010
No. Name Sex Position Organization Signature

1 Neak Sovannary M Chief of Kampot Municipality Kampot Municipality

Provincial department of Industry Mine
2 Te Chinarith M Deputy Chief
and Energy
3 Bun Chankong M Chief Kampot Water Supply Utility

4 Som Sethy M Officer MIME

5 Mak Chhorvannarey M Office Chief MIME

6 Bun Thorn M Network Chief Kampot Water Supply Utility

7 Chun SreyTouch F Staff Kampot Water Supply Utility

8 Thon Vannak M Staff Kampot Water Supply Utility

9 Long Sok M Staff Kampot Water Supply Utility

10 Un Sokdany M Staff Kampot Water Supply Utility

11 Sor Veasna M Staff Kampot Water Supply Utility

12 Ty Kean M Staff Kampot Water Supply Utility

13 Kong Ma Pulim M Staff Kampot Water Supply Utility

14 Vong Samon M Staff Kampot Water Supply Utility

15 Nun Vanny M Staff Kampot Water Supply Utility

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

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

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 Tbong

53 Pen Rotha M Construction Worker Kampong Bay Khang Cherng

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

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

Municipal Administration Office
70 Long Chy M Kampot Municipal
Chief
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 Community

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 Mr. Som Sith
Kong, Project Mr. Mak Chor Vanry
Manager
8:15-9:00 Presentation on MDG's water and Mr. Teang Sokhom, Mr. Som Sith
sanitation indicators and GIS Expert Mr. Mak Chor Vanry
discussion on questionnaires
9:45-10:00 Coffee break Mr. Som Sith
Mr. Mak Chor Vanry
9:00-9:30 Presentation on the process and Ms. Sorn Somoline, Mr. Som Sith
methodology of baseline survey Community Expert Mr. Mak Chor Vanry
Discussion the process in Kampot H.E. Heng Sokong,
town. Project Manager,

9:30-10:00 Formulation of working group for H.E. Heng Sokong, Mr. Som Sith
Field-tested Project Manager, Mr. Mak Chor Vanry
Ms. Sorn Somoline,
Community Expert
10:00-10:15 Coffee break

10:15-11:30 Field-test on baseline survey H.E. Heng Sokong, Mr. Som Sith
questionnaire Project Manager, Mr. Mak Chor Vanry
Ms. Sorn Somoline,
Community Expert
Mr. Teang Sokhom,
GIS Expert

11:30-12:00 Group presentation on pre-test of H.E. Heng Sokong, Mr. Som Sith
baseline survey and question and Project Manager, Mr. Mak Chor Vanry
answer Ms. Sorn Somoline,
Community Expert
Mr. Teang Sokhom,
GIS Expert

12:00 Closing speech H.E. Heng Sokong, Mr. Som Sith

Project Manager Mr. Mak Chor Vanry
 Baseline Data Collection on Water and Sanitation
The 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:………………………

WATER AND SANITATION MODULE
This module is to be administered once for each household visited. Record only one response for each
question. If more than one response is given, record the most usual source or facility.
WS1A. WHAT IS THE MAIN SOURCE OF DRINKING
WATER FOR MEMBERS OF YOUR HOUSEHOLD?
* PLEASE ALSO ASK QUESTION WS1B BEFORE
SKIPPING TO OTHER QUESTIONS
WS1B. WHAT IS THE MAIN SOURCE OF WATER
USED BY YOUR HOUSEHOLD FOR OTHER
PURPOSES SUCH AS COOKING AND HAND
WASHING?
WS2A. HOW LONG DOES IT TAKE TO GO THERE,
GET WATER, AND COME BACK?
WS
Piped water
Piped into dwelling .................................... 11 11ÖWS5B
Piped into yard or plot ............................... 12
Public tap/standpipe .................................. 13
Tubewell/borehole ......................................... 21
Dug well
Protected well ............................................ 31
Unprotected well ........................................ 32
Water from spring
Protected spring ........................................ 41
Unprotected spring .................................... 42 ÖWS2A
Rainwater collection ...................................... 51
Vendors
Tanker-truck .............................................. 61
Cart with small tank/drum/buckets ............ 71
Power tiller with small
tank/drum/buckets ..................................... 72
Surface water (river, stream, dam, lake,
pond, canal, irrigation channel) ................. 81
Bottled water................................................ 91
Other (specify) _______________________96 96ÖWS3
Piped water
Piped into dwelling .................................... 11 11ÖWS5B
Piped into yard or plot ............................... 12
Public tap/standpipe .................................. 13
Tubewell/borehole ......................................... 21
Dug well
Protected well ............................................ 31
Unprotected well ........................................ 32
Water from spring
Protected spring ........................................ 41 ÖWS2A
Unprotected spring .................................... 42
Rainwater collection ...................................... 51
Vendors
Tanker-truck .............................................. 61
Cart with small tank/drum/buckets ............ 71
Power tiller with small
tank/drum/buckets ..................................... 72
Surface water (river, stream, dam, lake,
pond, canal, irrigation channel) ................. 81
Bottled water................................................ 91
Other (specify) _______________________96 96ÖWS3
Number of minutes .............................. __ __ __
Water on premises .......................................... 1 1ÖWS5B
DK ................................................................... 9
WS2B. HOW FAR IS THE WATER SOURCE FROM
THIS DWELLING?
WS3A. IS THERE A QUEUE WAITING TO GET WATER
DURING THE RAINY SEASON?
WS3B. HOW LONG DOES IT TAKE TO WAIT IN A
QUEUE TO GET WATER DURING THE RAINY
SEASON?
WS4A. IS THERE A QUEUE WAITING TO GET WATER
DURING THE DRY SEASON?
WS4B. HOW LONG DOES IT TAKE TO WAIT IN A
QUEUE TO GET WATER DURING THE DRY
SEASON?
WS5A. WHO PRIMARILY COLLECTS DRINKING
WATER FOR THE HOUSEHOLD?
IS THIS PERSON UNDER UNDER AGE 15? WHAT
SEX?
Circle the code that best describes this person.
WS5B. AT WHAT TIME OF THE DAY IS WATER MORE
READY AVAILABLE AT THE WATER SOURCE?
WS6. IS THE LOCATION OF THE SOURCE OF WATER
CONSIDERED SAFE FOR WOMEN AND
CHILDREN?
VOLUME AND PAYMENT FOR DRINKING WATER:
CONSUMERS WITH PIPED WATER CONNECTIONS
WS7A. DOES YOUR HOUSEHOLD HAVE PIPED
WATER CONNECTION?
WS7B. IS YOUR CONNECTION WORKING AT THE
PRESENT TIME?
WS7.1 IS YOUR PIPED WATER METERED?
WS8. WHAT WAS LAST MONTH’S WATER
CONSUMPTION ACCORDING TO THE METER
READING?
WS9. DO YOU PAY FOR YOUR WATER?
WS10. HOW DO YOU PAY FOR YOUR WATER?
WS11. AVERAGE MONTHLY BILL?
Distance in metres............................... __ __ __
DK ................................................................... 9
Yes .................................................................. 1
No .................................................................... 2 2ÖWS4A
Number of minutes .............................. __ __ __
DK ................................................................... 9
Yes .................................................................. 1
No .................................................................... 2 2ÖWS5A
Number of minutes .............................. __ __ __
DK ................................................................... 9
Adult woman.................................................... 1
Adult man ........................................................ 2
Female child (under 15) .................................. 3
Male child (under 15) ...................................... 4
No specific person ........................................... 5
NA or delivered to the house........................... 8
No answer or DK ............................................. 9
Early morning .................................................. 1
Midday ............................................................. 2
Afternoon ......................................................... 3
Late evening .................................................... 4
Anytime ........................................................... 5
DK ................................................................... 9
Yes .................................................................. 1
No, risk of crime .............................................. 2
No, risk of accident……………………………...3 2ÖWS11
No, risk of both crime and accident
Yes .................................................................. 1
No .................................................................... 2 2ÖWS12
Yes ................................................................. 1
No, service has been disconnected
because I did not pay my bill, ...................... 2 2ÖWS12
No, the connection is faulty and we are
waiting to have it repaired ........................... 3 3ÖWS12
No, but there is some other reason why
its not working, (specify) .............................. 4 4ÖWS12
Yes .................................................................. 1
Yes, but not working ........................................ 2 2ÖWS9
No .................................................................... 3 3ÖWS9
No. of cubic meters ............................. __ __ __
Meter is not read/inoperative........................... 8
DK ................................................................... 9
Yes .................................................................. 1
No .................................................................... 2 2ÖWS16
Flat rate per month ......................................... 1
According to monthly consumption ................. 2
Other (Specify) ............................................... 9
Amount (Riels) ............................... __ __ __ __ RIELS
Meter is not read/inoperative....................... 888 ÖWS16
WHO PAYS FOR THE WATER BILL?
CONSUMERS WITHOUT PIPED WATER CONNECTIONS
WS12. HOW MANY BUCKETS OF WATER DO YOU
USE EACH DAY?
Observ the bucket and convert to liter
WS13. DO YOU PAY FOR YOUR WATER?
WS14. HOW DO YOU PAY FOR YOUR WATER?
WHO PAYS FOR THE WATER:
WS15. AMOUNT PAID PER DRUM (200 LITER) OR
DRUM EQUIVALENT?
DISRUPTIONS TO THE WATER SUPPLY
WS16. DID YOU HAVE ANY DISRUPTIONS FROM
YOUR MAIN SOURCE OF DRINKING WATER
DURING THE PAST 2 WEEKS?
WS17. HOW FREQUENT WERE THESE
DISRUPTIONS?
HOUSEHOLD TREATMENT OF DRINKING WATER
WS18A. WHAT IS THE COLOUR OF YOUR DRINKING
WATER?
WS18B. DOES YOUR DRINKING WATER SMELL?
WS19. WHAT DO YOU DO TO THE WATER TO MAKE
IT SAFER TO DRINK?
Ask the respondent to recall the primary and
secondary methods used to make the water
safe to drink.
SOURCE OF WATER FOR CLEANING, WASHING AND BATHING
WS20. IS YOUR SOURCE OF WATER FOR
CLEANING, WASHING, AND BATHING DIFFERENT
FROM YOUR SOURCE OF DRINKING WATER?
Mother:_______________
Father:_______________
Other_____________
Number of buckets ................................... __ __
Yes .................................................................. 1
No .................................................................... 2 2ÖWS16
Pay per drum (200 liter) ................................. 1
Flat rate each week ......................................... 2
Flat rate each month ....................................... 3
Other (specify) ________________________4
Mother:…………………….
Father:……………………..
Other:……………………….
Amount (Riels) .................................... __ __ __
Other forms of payment .............................. 888
Yes .................................................................. 1
No .................................................................... 2 2ÖWS19A
Daily ................................................................ 1
Intermittent most days ..................................... 2
Intermittent several days ................................. 3
Occasional....................................................... 4
Several hours at a time ................................... 5
More than a day .............................................. 2
More than a week ............................................ 6
No water in the past two weeks ...................... 7
NA ................................................................... 8
DK ................................................................... 9
Clear ................................................................ 1
Not clear .......................................................... 2
Other ............................................................... 3
DK ................................................................... 9
Yes, smells of chlorine .................................... 1
Yes, smells bad ............................................... 2
No .................................................................... 3
DK ................................................................... 9
Primary Method: Secondary:
Boil .................................................................. 1 .................. 1
Add bleach/chlorine ......................................... 2 .................. 2
Sieve it through a cloth .................................... 3 .................. 3
Use water filter (ceramic, sand, composite,
etc.) ........................................................... 4 .................. 4
Solar disinfection ............................................. 5 .................. 5
Let it stand and settle ...................................... 6 .................. 6
Other (specify) ________________________7 _________ 7
DK .................................................................. 9 .................. 9
Yes .................................................................. 1
No .................................................................... 2 2ÖWS21B
WS21A. WHAT IS THE MAIN SOURCE OF WATER
USED FOR CLEANING, WASHING, AND BATHING
BY MEMBERS OF YOUR HOUSEHOLD?
WS21B. WHERE DO MEMBERS OF YOUR
HOUSEHOLD BATHE?
WS22. HOW DO YOU DISPOSE OF WATER, WHICH
HAS BEEN USED FOR COOKING, WASHING
DISHES, DOING LAUNDRY AND BATHING?
SANITATION
WS 23 A. DO YOUR FAMILY MEMBERS USE
TOILET?
Piped water
Piped into dwelling .................................... 11
Piped into yard or plot ............................... 12
Public tap/standpipe .................................. 13
Tube-well/borehole ........................................ 21
Dug well
Protected well ............................................ 31
Unprotected well ........................................ 32
Water from spring
Protected spring ........................................ 41
Unprotected spring .................................... 42
Rainwater collection ...................................... 51
Vendors
Tanker-truck .............................................. 61
Cart with small tank/drum/buckets ............ 71
Power tiller with small
tank/drum/buckets ..................................... 72
Surface water (river, stream, dam, lake,
pond, canal, irrigation channel) ................. 81
Bottled water ................................................. 91
Other (specify) _______________________96
No answer or DK ........................................... 99
Private bathroom ............................................. 1
Other’s bathroom............................................. 2
Open air ........................................................... 3
At the stream, river, lake ................................. 4
Other (specify) ________________________5
Piped into soak-away ...................................... 1
Piped into storm drain ..................................... 2
Piped onto street surface or empty space ...... 3
Piped directly to garden .................................. 4
Throw onto street surface or empty space ...... 5
Carry to garden ............................................... 6
Other (specify) ________________________8
Yes………………………………………………1
No………………………………………………..2 Ö SW1
WS23B. WHAT KIND OF TOILET FACILITY DOES
YOUR HOUSEHOLD USE?
If “flush” or “pour flush,” probe:
WHERE DOES IT FLUSH TO?
If necessary, ask permission to observe the
facility.
WS23C. HOW DO YOU EMPTY YOUR PIT LATRINES?
WS24A. IS THIS FACILITY LOCATED WITHIN YOUR
DWELLING, YARD, OR COMPOUND?
WS24B. HOW FAR OUTSIDE THE DWELLING, YARD,
OR COMPOUND IS THIS?
WS24C. HOW FAR FROM THE WELL
WS25. DO CHILDREN UNDER 5 USE THIS
SANITATION FACILITY?
WS26. WHAT HAPPENS WITH THE STOOLS OF
CHILDREN UNDER 5 WHEN THEY DO NOT USE
THE SANITATION FACILITY?
SEWAGE TREATMENT
WS27. WHAT TYPE OF SEWAGE TREATMENT
METHOD 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.
WS28. IS THERE ANY VISIBLE EFFLUENT BEING
DISCHARGED FROM YOUR SANITATION
FACILITY?
Modern latrine with septic tank...................... 11
Pour flush latrine with septic tank.................. 12
Pour flush latrine with no septic tank............. 13
Pit latrine with slab ........................................ 21
Pit latrine without slab/open pit ..................... 22
No facilities or bush or field ........................... 23 23ÖSW1A
Other (specify) _______________________96 96ÖWS24A
No facilities but use public or others’ facilities97 97ÖWS28
Manually .......................................................... 1
Commercial Exhauster .................................... 2
Abandone ........................................................ 3
DK ................................................................... 4
Other (specify) ________________________5
Yes, inside dwelling/yard/compound ............... 1 1ÖWS25
No, outside dwelling/yard/compound .............. 2
Less than 20 metres ........................................ 1
20-50 metres ................................................... 2
50-100 metres ................................................. 3
More than 100 metres ..................................... 4
Less than 30 metres or on the water source... 1
More than 30 metres ....................................... 2
Yes .................................................................. 1 1ÖWS27
No .................................................................... 2 1ÖWS26
NA, no children under 5 .................................. 3 3ÖWS27
Thrown into the latrine ..................................... 1
Thrown outside in the yard .............................. 2
Buried outside in the yard ............................... 3
Not disposed of or left on the ground .............. 4
Other (specify) ________________________5
Soak-away (seepage pit, unlined pit) .............. 1
Cesspit (sealed tank, no effluent).................... 2
Septic system .................................................. 3
Other (specify) ________________________4
Yes .................................................................. 1
No .................................................................... 2 2ÖSW1A
WS29. DOES YOUR SANITATION FACILITY CAUSE
ANY PROBLEMS FOR YOU OR YOUR
NEIGHBOURS?
WS30. WHAT SPECIFIC PROBLEMS ARE CAUSED
BY YOUR SANITATION FACILITY?
Read out the responses. One answer only.
SOLID WASTE DISPOSAL
SW1A. HOW DOES THIS HOUSEHOLD PRIMARILY
DISPOSE OF HOUSEHOLD WASTE THAT IS NOT
COMPOSTED, RECYCLED, OR FED TO THE
ANIMALS?
SW1B. HOW OFTEN IS WASTE COLLECTED?
SW2. ESTIMATE THE AMOUNT OF HOUSEHOLD
WASTE YOU DISPOSE OF EACH DAY (INCLUDE
FOOD WASTE, PLASTICS, PAPER, TINS).
[Estimate volume in terms of plastic bag and
covert to kg]
SW3A. . DOES YOUR HOUSEHOLD CURRENTLY PAY
FOR THE REMOVAL OF SOLID WASTE / RUBBISH
/ GARBAGE?
SW3B. AVERAGE MONTHLY FEE FOR SOLID WASTE
COLLECTION?
SW4. WOULD YOUR HOUSEHOLD WILLING TO PAY
FOR SOLID WASTE COLLECTION?
SW5. HOW MUCH ARE YOU WILLING TO PAY FOR
MONTHLY COLLECTION?
SW6A. DO YOU RECYCLE SOLID WASTE?
SW6B. PLEASE IDENTIFY THE TYPES OF ITEMS
THAT YOU RECYCLE.
Circle all that apply.
SW6C. DO RECYCLING GROUPS/COMPANIES
COLLECT ANY OF YOUR WASTE FOR
Yes .................................................................. 1
No .................................................................... 2 2ÖSW1A
Pooled sewage around the house................... 1
Odors from the facilities are unpleasant to
residents ...................................................... 2
Both pooled sewage and odors....................... 3
SW
Collected by local government/authority ......... 1
Collected by community association ............... 2
Collected by private company ......................... 3
Dumped in the compound ............................... 4
Dumped in the street/vacant plot/drain ........... 5
Burnt in the open ............................................. 6
Buried .............................................................. 7
Other (specify) _______________________ 8
…………times/week
………….times/month
No. of plastic bag each time .......... __ __ .__ __
Yes .................................................................. 1
No .................................................................... 2 2ÖSW4
Amount in Riels…………………..
DK ................................................................... 9 ÖSW6A
Yes .................................................................. 1
No .................................................................... 2 ÖSW6A
Amount in Riels…………………..
DK ................................................................... 9
Yes .................................................................. 1
No .................................................................... 2 2ÖSW6C
Food waste (composting) ................................ 1
Food waste (feed to animals ........................... 2
Plastic bags ..................................................... 3
Plastic (water bottles, containers) ................... 4
Paper items ..................................................... 5
Cardboards...................................................... 6
Textile .............................................................. 7
Tins .................................................................. 8
Garden waste .................................................. 9
Wood/charcoal .............................................. 10
Other (specify) _______________________99
Yes .................................................................. 1
No .................................................................... 2 2ÖSW7
 RECYCLING?
SW6D. WHAT TYPE OF WASTE DO THEY COLLECT?
Circle all that apply.
SW7. DOES THE NEIGHBOURHOOD HAVE SMOKE,
GAS, OR BAD SMELLS ASSOCIATED WITH
BURNING RUBBISH?
SW8. ARE YOU CONCERNED ABOUT THE POSSIBLE
HEALTH CONSEQUENCES OF BREATHING THE
SMOKE AND POLLUTED AIR?
SW9. OBSERVATION: DOES THE FRONT OF THE
2
HOUSE WITHIN AN AREA OF 100M HAVE A
LITTER PROBLEM?
HEALTH
H1. HAVE YOU OR YOUR FAMILY MEMBERS
SUFFERED FROM WATER-BORNE DISEASES
SUCH AS DIARRHOEA, DENGUE?
H2. FREQUENCY OF ILLNESS PER PERSON PER
YEAR?
H3. HOW MUCH MONEY DO YOU SPEND ON
TREATMENT OF ILLNESS PER YEAR?
H4. DID YOUR FAMILY GET ANY HEALTH
AWARENESS RAISING?
Date:
Signature of supervisor
Food waste (composting) ................................ 1
Food waste (feed to animals ........................... 2
Plastic bags ..................................................... 3
Plastic (water bottles, containers) ................... 4
Paper items ..................................................... 5
Cardboards...................................................... 6
Textile .............................................................. 7
Tins .................................................................. 8
Garden waste .................................................. 9
Wood/charcoal .............................................. 10
Other (specify) _______________________99
Yes .................................................................. 1
No .................................................................... 2 2ÖSW9
Yes .................................................................. 1
No .................................................................... 2
Yes, lots of litter visible .................................... 1
Yes, some paper and plastic bags .................. 2
No litter visible ................................................. 3
Yes………………………………………………..1
No…………………………………………………2 2ÖSW9
How many time………………………….
Amount spent……………………………Riel
Yes………………………………………………..1
No…………………………………………………2
Date:
Signature of intherviewer