Version 5 –14/7/14
WSUP INFRASTRUCTURE SURVEY QUESTIONNAIRE
This questionnaire is designed for survey of WASH services in urban areas. It is primarily designed for evaluation of the function of shared/communal facilities for water
supply (waterpoints, kiosks, etc.) and sanitation (shared/communal toilets, public toilets); it is not designed for evaluation of other types of facility (e.g. laundry blocks,
sludge transfer stations). This is a print version, but the questionnaire will typically be delivered using a smartphone platform (e.g. DoForms). The questionnaire is
associated with a Survey Analysis Workbook for automated data analysis. It is essential that you read WSUP’s guidance on (1) how to design your survey and (2) how to use
this questionnaire. Contact erl@wsup.com.
1.00
1.01
1.02
1.03
1.04
1.05
1.06
1.07
1.08
Identifier information (date, location, infrastructure)
Interviewer
Survey date (dd/mm/yy)
Survey district
Additional infrastructure identifiers
Type of infrastructure? [select one]
1 - shared/compound toilet
2 - public toilet
3 - sanitation block
4 - waterpoint/kiosk/standpipe
5 - shared water network connection (into shared plot/compound)
6 - household network connection
7 - other Laundry block, WASH block, school latrine, site de décharge d’ordures, site de traitement de boue de vidange, etc…
Who built it?
1 – WSUP
2 - other NGO
3 - municipality/government
4 – other
In what year was it built? [yyyy e.g. 2007]
Interview respondent [select one: ideally should be 1, 2 or 3]
1 - infrastructure attendant [i.e. day-to-day operator]
2 - infrastructure manager
3 - community member with involvement in infrastructure management
4 - community member not involved in infrastructure management
5 – other
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2.00
2.01
2.02
2.03
Water infrastructure + service
INTERVIEWER ASSESSMENT: What is the type of water facility? [select one]
1 - individual household connection (indoors or in-plot)
2 - shared yard connection
3 - meter cluster
4 - flexible pipe from meter cluster
5 - staffed standpipe/kiosk
6 - group connection: metered standpost
7 - group connection: storage tank
8 - pre-paid metered standpost
9 - standpost attached to communal sanitation facility
10 – other
INTERVIEWER ASSESSMENT: Is the facility functioning at time of visit? [Y or N]
INTERVIEWER ASSESSMENT: What is the status of the facility in terms of…
2.04
2.03a - built structure/super-structure?
2.03b - tap condition and function?
2.03c - adequate drainage for spilled water?
2.03d - apparent water quality (clear/odourless or dirty/smelly)?
How happy are you with the water source in terms of…
very good
2.05
2.06
2.07
2.08
2.09
2.10
2.11
very happy
2.04a - price?
2.04b - water quality (taste, colour, etc.)?
2.04c - water pressure?
2.04d - queuing time?
2.04e - availability (continuity of supply, opening hours, etc.)?
2.04f - cleanliness of infrastructure?
How many people use water from this facility (as their main HH supply) on a typical day?
2.05a - HH users
2.05b - HH users via resellers (can be estimated if no accurate data available)
INTERVIEWER ASSESSMENT: Are good sales/usage records maintained? [Y or N]
INTERVIEWER ASSESSMENT (based on questioning and records): How much water is sold on a typical day? (litres per day)
Typical length of time per day that water is available? (hours per day)
How many days in the past month has the facility NOT functioned?
If 2.09 > zero: What were the reasons for non-functioning? [select the most important reason]
1 - no water reaching facility
2 - facility broken
3 - operator not working
4 - public holiday or general strike
5 – other
If 2.10 = 1 or 2, who fixed it?
1 - water utility
2
good
poor
very poor
happy
unhappy
very unhappy
Version 5 –14/7/14
2.12
2.13
2.14
2.15
2.16
2.17
2.18
2.19
2.20
2.21
2 - local operator (or sub-contractor paid by local operator)
3 - user/s (or sub-contractor paid by user/s)
4 - other
5 - not fixed yet
Have any other modifications or renovations been made since construction?
1 - no
2 - yes, minor improvements
3 - yes, major improvements (e.g. ramp, add. taps)
What is the total amount of user fees collected in a typical month?
How much is spent on operation and maintenance in a typical month?
INTERVIEWER ASSESSMENT: Do you suspect significantly corrupt/monopolistic practices by operator and/or management committee that are not in the interest of users? [Y or N]
How many times per year is water quality tested?
1 - two or more times per year
2 - one or fewer times per year
3 - water has not been tested up to now
What were the findings of the water quality test? [If possible, obtain copy of water quality report]
1 - good, safe
2 - contaminated, unsafe
INTERVIEWER ASSESSMENT (based on conversation with 1 or more women users not involved in facility management): Are there significant issues around access? [Y or N for each item]
2.18a - security for women (e.g. at night)
2.18b - physical accessibility for people with disabilities
2.18c - accident risks (e.g. crossing road)
2.18d - other
INTERVIEWER ASSESSMENT (based on conversation with 1 or more women users not involved in facility management): Typical length of time per day that water is available? (hours per day)
INTERVIEWER ASSESSMENT (based on conversation with 1 or more women users not involved in facility management): How many days in the past month has the facility NOT functioned?
INTERVIEWER ASSESSMENT (based on conversation with 1 or more women users not involved in facility management): If 2.20 > zero: What were the reasons for non-functioning? [select one]
1 - no water reaching facility
2 - facility broken
3 - operator not working
4 - public holiday or general strike
5 - other
3.00
Sanitation infrastructure + service
3.01
INTERVIEWER ASSESSMENT: What is the facility’s usage arrangement? [select one]
1 - household toilet (single household)
2 - communal/shared toilet (used by defined group of HH, NOT pay-per-use; including school or hospital)
3 - public toilet (can be used by anyone, free or pay-per-use)
4 - other including open defecation
INTERVIEWER ASSESSMENT: What is the facility’s technology type? [select one]
1 - unimproved pit latrine (no slab, or non-cleanable wooden slab)
2 - pit latrine with cleanable slab
3 - flush to open cesspit or open drain
3.02
3
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3.03
3.04
3.05
3.06
3.07
3.08
3.09
3.10
3.11
3.12
3.13
3.14
3.15
4 - flush to septic tank or pit
5 - flush to sewer
6 - portable toilet with emptying service
7 - other
INTERVIEWER ASSESSMENT: Is the facility functioning at time of visit? [Y or N]
INTERVIEWER ASSESSMENT: What is the status of the facility in terms of…
very good
good
3.04a - cleanliness?
3.04b - superstructure/built structure?
3.04c - general condition (anything broken, bad quality, smelly, presence of insects or rodents etc.)?
3.04d - sludge management (septic tank, emptying service etc.)?
3.04e - handwashing facilities?
INTERVIEWER ASSESSMENT: Are detailed usage records maintained? (i.e. dated record of each visit, disaggreaged by gender and vulnerability) [Y or N]
How many people use this facility on a typical day? [if data is available, calculate average for the last 7 full days, i.e. ending yesterday]
3.06a - urination only
3.06b - defecation
Typical length of time per day that facility is readily accessible for users? (hours per day)
How many days in the past month has the facility NOT functioned?
If 3.08 > zero: What were the reasons for non-functioning? [select one]
1 - no water reaching facility
2 – facility/sewage broken
3 - operator not working
4 - public holiday or general strike
5 - other
If 3.09 = 1 or 2, who fixed it?
1 - sanitation service provider
2 - local operator (or sub-contractor paid by local operator)
3 - user/s (or sub-contractor paid by user/s)
4 - other
5 - not fixed yet
Have any other modifications or renovations been done since construction?
1 - no
2 - yes, minor improvements
3 - yes, major improvements (e.g. ramp, add. cubicals or basins, bigger cubicals etc.)
What is total amount of user fees collected in a typical month?
How much is spent on operation and maintenance in a typical month?
How many times has the pit been emptied over the past 3 years?
1 - never [or question irrelevant, e.g. for sewered toilet]
2 - between 1 and 3 times
3 - more than 3 times
4 - don’t know, no answer
When was the last time the pit was emptied? (mm/yy)
4
poor
very poor
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3.16
3.17
3.18
3.19
3.20
3.21
3.22
3.23
3.24
3.25
3.26
3.27
3.28
Who emptied the pit/tank the last time? [select one]
1 - members of household using it or informal manual emptier
2 - formal small business using manual or automated tool (e.g. pump)
3 - formal larger business (vacuum tanker etc.)
4 - other
Who paid for emptying of the pit/tank the last time it was emptied? [select one]
1 - only my household
2 - all households that share this toilet
3 - landlord
4 - other
How much did the last emptying cost in total? (local currency)
How much sludge was removed? ( litres)
Have operator/ users started to save money to pay for the next pit emptying? [Y] or [N]
Where was the sludge disposed of?
1 - buried locally, dumped to waste ground; or to sewer/drain
2 - disposed of appropriately to authorised local or remote point
INTERVIEWER ASSESSMENT: Is the facility likely to be emptied by a WSUP-supported pit-emptying service? [Y] or [N]
INTERVIEWER ASSESSMENT: Do you have good reason to suspect misuse (e.g. inappropriate/corrupt use of revenues, inappropriate restrictions of service to particular people, etc)? [Y or N]
INTERVIEWER ASSESSMENT: Is soap available for handwashing? [Y] or [N]
INTERVIEWER ASSESSMENT: Is clean water available for handwashing? [Y] or [N]
INTERVIEWER ASSESSMENT: Is there evidence of disposal of garbage in the toilet/pit?
1 - No
2 - Yes, minor (some items disposed, but not major problem for function or emptying)
3 - Yes, serious (items disposed, and these are a serious problem for function and/or emptying)
INTERVIEWER ASSESSMENT: Are there significant issues around access? [Y or N for each item]
3.27a - Security for women (e.g. at night)
3.27b - Physical accessibility for people with disabilities
3.27c - Accident risks (e.g. crossing road)
3.27d - Other
INTERVIEWER ASSESSMENT: Do you suspect significantly corrupt/monopolistic/exclusionary practices (by operator and/or management committee) that are not in the interest of users?
5