Baseline study of WASHplus project to understand the

Terms of reference

Baseline study of WASHplus project to

understand the existing WASH situation

in Southwestern Bangladesh

2

Terms of Reference

Baseline study of WASHplus project to understand the existing

WASH situation in Southwestern Bangladesh

Background

Despite significant improvement in national water and sanitation coverage, there are certain pocket areas in Bangladesh which have received insufficient attention by all concerns. Due to geophysical, remoteness, socio-cultural and economic situation water and sanitation coverage in those hard to reach areas is worse than the national average.1 The Southwesterm Bangladesh constitutes a significant portion of these hard to reach areas, where both surface and ground water sources are affected by salinity intrusion and estuarine tidal action as well as anthropogenetic reasons. In addition, due to cyclone, tidal surge and inundation of low lands and off–shore islands the water and sanitation infrastructures are often damaged. Saline intrusion reduces agricultural production which in turn reduces household livelihood. In addition, as women and children of households need to travel faro collect water from safe freshwater source, their drudgery increases. As a result of poor sustainable WASH service provision the incidence of water related diseases is higher in these areas.

WaterAid, an international non-government organisation (NGO) started its operation in Bangladesh in 1986 and since then it has been working in improving access of the poor and marginalised population to safe drinking water, sanitation and hygiene. Recently WaterAid Bangladesh initiated a relationship with the USAID-funded WASHplus project as a key resource partner for field implementation to improve sustainable WASH facilities in two districts of the Southwestern Bangladesh. WASHplus is a cooperative agreement managed by FHI360 in partnership with CARE and Winrock International as well as a diverse set of NGO, university, and private sector resource partners. The WASHplus project supports healthy households and communities by creating and delivering interventions that lead to significant improvements in WASH and indoor air pollution (IAP). The project uses at-scale programming approaches to reduce diarrheal diseases and acute respiratory infections, the two top killers of children under five years of age globally.

In partnership with WASHplus, WaterAid Bangladesh will strengthen the capacity of local NGOs, local government institutes and service providers for ensuring services in the targeted communities. It will also enhance community empowerment to raise demand, operate and maintain WASH services. As project activities will be started shortly, a baseline study must be carried out in intervention areas to understand the present situation. The study findings will help set benchmarks to assess the project output and outcomes. A consultant (individual/firm) will be contracted out on behalf of WaterAid Bangladesh to carry out the baseline study as per this Terms of Reference (TOR).

1 GoB (2011), National strategy for water and sanitation hard to reach areas of Bangladesh.

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Project overview

The broad goal of WASHplus project is to contribute to the improvement of human well being and dignity through context-specific and scalable water supply, sanitation, and hygiene promotion in hard-to-reach areas of the Southwesterm Bangladesh. The project adapts its overarching approach to each country setting, based on best practices and grounded in tested behaviour change principles. However, to achieve consistent and proper WASH practices the Bangladesh, project design is guided by the USAID Hygiene Improvement Framework that ensures access to hardware, hygiene promotion, enabling environment and sustainability. The project objectives are in the following.

To reach poor and marginalised communities with comprehensive and sustainable safe water, sanitation, and hygiene promotion, the project will use locally appropriate technologies and approaches in Char Fasson, Daulatkhan, Galachipa and Kalapara Upazilas.

To build community and local government capacity to operate and maintain water and sanitation facilities, the project will support increased allocations and pro-poor targeting of national and local government funds, and community contributions to ensure sustainability of project interventions and impact.

It will also strengthen the evidence base and programming guidance for coordinated WASH-nutrition programming in Bangladesh.

The project will be implemented over a period of three year in four Upazilas of Bhola and Patuakhali districts. The total population of the targeted Upazilas is 1224353 and almost half of them do not have sustainable access to WASH services. The project areas and the number of targeted beneficiaries in targeted Upazilas are given in annex 1. In this project WaterAid Bangladesh will work with multilevel stakeholders that include FHI360, partners NGOs at local level, local government institutions, private service providers in the locality and community.

Study goals and objectives

The study will be conducted with to:

get an overall understanding of the existing WASH situation in project area pertinent to project objectives

define project targets associated with the indicators tracked

set the basis for tracking changes that may occur because of the intervention

The purpose of the study is to:

know to what extent households with children under five in the intervention area have access to safe drinking water, improved sanitation and hygiene

establish nutritional status and prevalence of diarrhoeal diseases among children of under five years in intervention area

understand the level of capacity of the local government and community in operating and maintaining WASH facilities in the locality

The indicators in annex 2 will be addressed in the baseline study.

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Methodology

Study area

The study will include all four Upazilas of Bhola and Patuakhali districts where the project will be implemented. These are: Daulatkhan and Char Fasson in Bhola and Kalapara and Galachipa in Patuakhali.

Study design and data collection method

This is a cross-sectional study using a pre-post design. The study will combine both quantitative and qualitative approaches. Various data collection methods will be employed in the study to gather information on different variables and themes. These are: survey in households and UPs, height and weight measurement of targeted children in visited households and key informant interview. These different data collection methods will be complementary to each other. Triangulation of different methods and sources will be done to maximise the validity and reliability of data and to reduce the chance of bias. While data collection will be going on the context or the setting will always be taken in to consideration.

The household survey will contain questions about household characteristics, access to water and sanitation, hand washing practices and exposure to programs promoting water, sanitation and hygiene improvements. It will also include questions about diarrheal disease and will be used to record height, weight and age in order to track the health outcomes of interest. A draft instrument is given in annex 3.

In terms of collecting anthropometric measures (e.g., height and weight) to track nutritional outcomes (stunting, wasting, underweight) instructions produced by UNICEF will be followed as those are used to track the same indicators through the Multiple Indicator Cluster Survey (MICS) implemented in several countries.

Study population and sampling

The study population will be primary caretakers/mothers of children under five as they deal with WASH issues within the household and are mainly responsible preparing food for the children and managing children’s diarrhoea. At least one child under five will be measured and weighed in each household in order to track nutritional outcomes.

The sample will be selected following a two-stage cluster sampling approach. In this study, a cluster will be represented by a village. At the first stage, villages will be randomly selected from the Upazilas described above. Participating households will be subsequently selected at random from the chosen villages.

The sample size calculations for this study using two-stage cluster sampling have been done by taking into account two criteria: first, the need to be able to estimate pre-intervention parameters with an adequate level of precision, and second, the need to have a sample large enough to detect a desired change from the baseline to the end line. The first criterion is referred as parameter estimation and the second one as hypothesis testing.

For parameter estimation purposes, both MICS (2009) and BDHS (2011) data for Bhola are used where improved sanitation coverage is the lowest among the two target districts considered. According to the MICS from 2009, improved sanitation is Bhola is

5

32.7% (UNICEF and BBS 2010) 2 . However, according to the BHDS (2011), this proportion is expected to be half of that among lower socio-economic groups. Since it is expected to reach all levels of the socio-economic ladder, it is anticipated that at project outset improved sanitation in the lower quintiles may only 16% (NIPORT et al, 2013)3. This figure will be strictly used for sample calculation purposes as it is not know how generalized poverty or even indigence will be in selected villages.

Version 2 of C-Survey indicated that to be able to have a sample where the attribute of interest (improved sanitation) is 16%, with a design effect of 2.0, a precision of more or less 3 percentage points and a 95% desired level of confidence, the minimum sample size should be 1274 cases. This may be obtained by collecting data from 26 households in 49 clusters. That said it is needed to point out that the project will have another opportunity to estimate the sample size prior to the implementation of the end line since it can count on baseline findings to know what the distribution of improved sanitation will be in villages visited and within socio-economic groups within the villages.

For hypothesis testing purposes, we would like to be able to detect a drop in diarrheal disease from the baseline to the end line of 15 percentage points, e.g. from 35% to 20%. This drop is possible since the literature tells us that hand washing with soap among caretakers may reduce diarrhoea among children under 5 by 43% (Cairncross et. al., 2010)4 . A 15-point drop represents 42.8% of 35. Under the WASHplus predecessor project, the Hygiene Improvement Project, larger drops in sanitation uptake using CLTS were achieved than those expected here.

C-Survey calculations indicate that to be able to detect such a change from the baseline to the end line, with a design effect of 2.0, a precision (one-half width of confidence interval) of 5 percentage points and a 95% confidence interval, the minimum number of cases should be 1300. This may be obtained by collecting data from 26 households in 50 clusters. Based on these calculations, a sample 1300 then would meet both of our criteria: parameter estimation and hypothesis testing.

However, interviews may not be completed due to different reasons including the need to perform household chores that study participants may have to tend to once an interview has started. It is also possible that cases need to be eliminated from the analysis due to the inability to resolve data inconsistencies. We will assume a safeguard rate of 10%. . As a result, the sample size should be increased from 1300 to 1445 to compensate for it.

This sample may be obtained by collecting data from 27 households in 54 clusters. This breakdown is also acceptable based on C-survey calculations. All C-Survey calculations are given in annex 3.

Mapping will occur prior to the final selection of households in each village. A list of all eligible households in selected villages will be drawn, and participating household will

2 UNICEF and BBS, 2010. Multiple Indicator Cluster Survey 2009, Dhaka: UNICEF and BBS, Ministry of Planning, GOB.

3 NIPORT, Mitra and Associates, and ICF International, 2013, Bangladesh Demographic and Health Survey 2011, Dhaka,

Bangladesh and Calverton, Maryland, USA: NIPORT, Mitra and Associates, and ICF International.

4 Cairncross S., C. Hunt, S. Boisson, K. Boesten, V. Curtis, I. Fung y, and W. Schmidt. 2010. Water, sanitation and hygiene for

diarrhea prevention. International Journal of Epidemiology, 39: i193-i205

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be selected at random from that list. DHS data for Bangladesh suggests that about 48% of rural households are expected to have children under five. Official data from Bangladesh suggests that each village should have about 2000 people and that there is an average of about five people per household. With such a distribution, one would anticipate to find about 400 households per village. If almost half of the households should have a child under five, one would expect to have about 200 households per village that meet the eligibility criteria. As such, the 27 households that we need to identify in each village would represent about 14% of eligible households

The study will deal with the UPs in the project area and data will be collected from all 22 UPs in the study area. During data collection the UP Secretary will be interviewed as she/he is well aware of budget allocation, its utilisation and other necessary issues.

The village elite, UP Chairman, member of bazaar committee, government officials will be regarded as key informants and will be contacted to explain the objectives of the baseline and collect other information that is not human subject related about how WASH services operate in the community. They will be selected purposively.

Data management and quality control

One major step of quality control will be revisiting the interviewed households and conducting a partial interview again of 5% of the households. This visit will be done by the research team leader assigned to coordinate data collection in each district, and will be done prior to the enumerators leaving the area. In addition, at the end of each data collection day enumerators will check each other’s work as questionnaires will be swapped to ensure that all the questions are properly filled and skips respected. Correcting errors will require consulting with the interviewer who made the interview where the error was detected. This work will be coordinated and supervised by the field supervisor. The estimated number of interview per day is realistic, and it will allow for quality checks at the end of each data collection day.

The questionnaire will be pre coded to facilitate data collection and entry. Questionnaires will be entered twice to avoid data entry errors. Once data are entered, data files will be cleaned through range and logical checks. The data file will be entered with SPSS Data Entry and a syntax file will be created to run the inconsistency check.

Data analysis

The primary unit of analysis in the study will be the household, with results summarized at the Upazila level. Data will be analysed by using SPSS. Data analysis will take into account clustering effects. A hierarchical model may be used to take into account the cluster effect of children living in the same household and of different households belonging to the same cluster.

The analysis will be guided by a conceptual framework that assumes that exposure to the intervention will lead to changes in the determinants of behavioural outcomes the project is pursuing, changes in the determinants will influence the performance of these practices, and adoption of these practices will lead to health outcomes. The health outcomes in question will most likely change sequentially, with a reduction in diarrheal disease occurring first and with changes in nutritional status coming in second. It is

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assumed that changes in underweight and wasting may be observed more quickly than changes in stunting. It is also assumed that changes in some of the hygiene practices, especially hand washing will be facilitated by increased access to water services. Increased access to sanitation, of its own right, will also lead to reductions in diarrheal disease. Some of the pathways described are given in annex 4 developed by Dangour et. al (2011)5.

Scope of Work

Bidders are expected to complete the following tasks:

1. Translate, pretest, modify and reproduce the qualitative and quantitative instruments including a checklist for Key Informant Interview (KII) and survey questionnaire. The household survey questionnaire should be an adapted version of the instrument given in annex 3.

2. Administer data collection in study area that includes recruitment of research assistants and their training, quality control of data, and transcription of KIIs.

3. Survey data management and entry and undertake initiative for data cleaning. In terms of KII data should be compiled under different study themes.

4. Analyse data as described in data analysis section of the TOR.

5. Generate draft report and based on the feedback finalise the report. The structure of the report is in annex 5.

During the assignment period the contracted individual/firm will work in close contact

with WaterAid Bangladesh. In addition data collection will be carried out by involving the

stakeholders of the project.

Expected competency

Expected competency includes:

Expertise in conducting quantitative and qualitative study.

Experience in working in the area of water, sanitation and hygiene as well as health and nutrition.

Analytical skill in assessing WASH and nutrition intervention.

Capacity to provide necessary training to human resource for administering data collection, quality control of data, data entry and management.

Proposal submission and content of the proposal

Interested individual/firm will submit a work plan and detailed budget for the assignment. The proposal should contain the CV of the team leader and other relevant team members as well. The detailed budget should be submitted as per template provided in annex 6. The proposal (both hard and soft copy in a CD) should be submitted to the

5 Dangour. A.D, L. Watson, O. Cumming, S. Boisson, . Velleman, S. Cavill, E. Allen and R. Uauy. 2011. Interventions to improve

water quality and supply, sanitation and hygiene practices, and their effects on the nutritional stauts of children. The Cochrane Database of Systematic Review. Issue 10, Art. No, CD 009382. DOI: 10.1002/14651858. CD009382.

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following with a cover letter by the 2nd October 2013. Based on the merit of the proposal the individual/firm for the assignment will be selected on competitive basis.

The criteria and points allocation for each of the criteria for evaluating proposals are given in annex 7.

Head of Human Resource WaterAid Bangladesh House 97/B, Road 25, Banani, Dhaka 1213.

Timeframe and expected deliverables

The total assignment should be completed within 75 days after signing of the contract. The contracted individual/firm is expected to deliver the following.

An inception report containing final work plan and procedure of fieldwork.

Study instruments for survey and key informant interviews (both English and Bangla version) pretested, finalised and printed.

Draft report containing detailed findings (well blended with qualitative and quantitative findings).

The individual/firm will also present the key findings of the study in an agreed date with the presence of key stakeholders to receive instant feedback.

The final report should be submitted two copies with spiral binding along with soft copy in MS word (in a CD). The report should be delivered in acceptable English.

All field notes and the data should be submitted. The survey data should be submitted in a fully labelled SPSS file along with layout and code list.

Financial terms

Upon delivering the inception report 30 percent of the value of the contract will be paid and on submission of the first draft of the report 30 percent will be paid. Remaining 40 percent will be paid after acceptance of the final report. WaterAid Bangladesh will deduct income tax and VAT as per government regulation. Delay in completion of the assignment will be penalised as per rule of WaterAid Bangladesh.

Bindings

All documents, papers and data produced during the study are to be treated as WaterAid’s property and restricted for public use. The contracted individual/firm will submit all original documents, materials and data to WaterAid Bangladesh office. WaterAid will reserve every right to accept and reject any proposal without giving any verbal and/or written rationale. In addition WaterAid Bangladesh will reserve the right to monitor the quality and progress of the work.

Contact person

For any further quires please communicate to [email protected]

mailto:[email protected]

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Annexure

Annex 1. Unions and number targeted beneficiaries in project Upazilas

District Upazila Union Number of targeted beneficiaries in Upazila

Bhola Daulatkhan Charpata 50178

Saidpur

Dakkhin Joynagar

Char Khalifa

Madanpur

Char Fasson Aminabad 74764

Osmangonj

Char Manika

Kukri-Mukri

Dhalchar

Awajpur

Hazariganj

Rasulpur

Patuakhali Kalapara Dhulasor 57353

Chakamoiya

Lalua

Dhankali

Champapur

Galachipa Ratanditaltoli 90235

Kolagachia

Golkhali

Bakulbaria

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Annex 2. Indicators to be addressed in the baseline study

Level Issue Indicator

Household Water The proportion of households with children under five that have access to safe drinking water source and using minimum quantity of safe water6 per person per day.

The proportion of households with children under five spending up to 30 minutes to collect drinking water (by source, gender and age).

The average distance between water collection point and house.

Sanitation The proportion of households with children under five using hygienic7 latrine facilities.

The proportion of households with children under five practicing open defecation.

The proportion of households of children under five that practice safe disposal of child faeces.

Hygiene and hand washing

The proportion of households with children under five that are equipped with hand washing device and have hand washing supplies near the latrine

The proportion of households with children under five with a functional hand washing stations at or near the area for preparing complementary foods for children undergoing weaning

Health status The proportion of children under five are classified as malnourished as per three anthropometric indices of nutrition status considered separately: stunting, wasting and underweight.

The proportion of children under five are reported with diarrhoeal disease in the two weeks prior to the survey.

Union Parishad (UP)

WASH budget and use

Proportion of UP developed integrated WASH plan

Proportion of UP allocated budget accordingly

Community WASH operation and maintenance

Situation of sanitation facilities in public places i.e. bazaar in the community

Status of WASH fund generation in the community

6 Twenty litres per person per day (WAB protocol on calculating numbers of people).

7 An improved sanitation facility is defined as one that hygienically separates human excreta from human contact and includes:

a flush or pour/flush facility connected to a piped sewer system; a septic system or a pit latrine; pit latrines with a slab; composting toilets; or ventilated improved pit latrines.

11

Annex 3. Instrument for household survey

(DRAFT QUESTIONNAIRE TO BE ADAPTATED AS PER LOCAL CONTEXT)

Identification

Questions 00-10

NO. QUESTION CODING CATEGORIES SKIP

QUESTIONNAIRE NUMBER

(Use same number as household

identification number of sampling

framework maps.)

01 Are there any children under 5 that live

permanently in the household?

(IF THERE ARE NO CHILDREN UNDER 5,

TERMINATE THE INTERVIEW.)

Yes

……………………………….…….1

No

……………………………….……..2

STOP

SURVEY

02 Are you the (major) child caretaker in the

family?

(IF RESPONDENT IS NOT, TERMINATE

THE INTERVIEW.)

Yes

………………………………….…1

No

………………………………….….2

STOP

SURVEY

03 Are you currently married? Yes

……………………………….…….1

No ……………………………….……

2

04 Are you the (first) spouse of the head of the

household?

Yes

………………………………….….1

No ………………………………….…

2

05 Sex of respondent FEMALE …………. …… ………….

1

MALE ……………. ………………….

2

06 Date of Interview

____DAY __MONTH _____

YEAR

12

07 Code of the Interviewer 1.

2.

3.

4.

5.

Etc.

08 Upazilas Daulatkhan…………………………..1

Char

Fasson………………………….2

Kalapara…………………………….3

Galachipa……………………………4

09 Name of village/cluster

(Write name directly)

10 Name of District

Bhola ……………………………… 1

Pathuakhali……………………… 2

11

Supervisor

12

Date questionnaire reviewed

____Day ____Month

___Year

13

0100 – 121 Dwelling and Family Characteristics


101 What type of dwelling are you visiting?

OBSERVE: (Observe only.)

House located in a separate

compound

House located in a communal

compound

Other (Specify)_________________

1

2

102 What is the main material for the walls of the main

living area?


No walls …………………………

Cane/trunk/bamboo/reed…

Bamboo/wood with mud…

Stone with mud………………….

Uncovered adobe………………

Plywood……………………….

Carton…………………………….

Cement…………………………

Stone with lime/cement…..

Bricks……………………………

Cement Blocks…………………..

Other Specify)________________

1

2

3

4

5

6

7

8

9

10

11

12

103 What is the main material for the roof of the main

living area?


Grass/Thatch/Makuti……..…..

Rustic mat/Plastic sheets……

Roof tiles /…………………….

Wood planks……………….

Corrugated iron………………..

1

2

3

4

5

14

Tin cans…………………….

Calamine/Cement fiber………

Cement/concrete ……………….

Other (Specify)______________

6

7

8

9

104 What is the main material for the floor of the main

living area?


Earth/sand………………………

Dung………………………

Wood planks……………………

Reed/Bamboo ……………….

Polished wood ………………

Vinyl ………………………...

Ceramic tiles ………………

Cement brick ………………….

Other (Specify)_________

1

2

3

4

5

6

7

8

9

15


We would like to talk about your household. Let’s first start with some of the characteristics of the

family, including yourself.

105 How many people live

permanently in this house?

(Please write the number

directly).

106 Does your family own or rent the

house where you live?

Own…………………………….

Rent …………………….

1

2

107 Did access to water make you

come to live in this house?

No ……………………………………

Yes ………………………………….

Does not know……………………..

1

2

3

108 Did access to a toilet make you

come to live in this house?

No…………………………………..

Yes…………………………………..

Does not know …………………….

1

2

3

109 Does this house flood during

the rainy season?

No……………………………………

Yes…………………………………..

Does not know /remember………..

1

2

3

110 Since you live in this house,

have you ever had to move out

because of flooding?

No………………………………………

Yes……………………………………..

1

2

111 During the last twelve months,

did you carry out any type of

work that generated income?

No……………………………………..

Yes…………………………………….

1

2

112 Currently are you involved in

any activity that generates

income?

No……………………………………..

Yes…………………………………….

1

2

113 What is currently your main

occupation?

Industrial worker………………………

Worker in other village home(s)……,

Informal sector vendor ………………

1

2

3

16

Tailor/seamstress…….………………

Stitches quilts/makes handicrafts..…

Small shop owner……………………

Housewife…………………………….

Raises poultry or livestock…………..

Money lender …………………………

Trader (buys/sells grain)……………..

Teacher ……………………………….

Construction ………………………….

Other. Specify _______

Not involved in income generation….

4

5

6

7

8

9

10

11

12

13

14

114 During the last 12 months did

your spouse carry out any

activity that generated income?

No………………………………..

Yes……………………………….

1

2

115 Currently is your spouse

involved in any activity that is

generating income? If so, what

does your spouse do?

Industrial worker…………………….

Janitor, guard, peon…………………

Daily laborer construction…………..

Informal sector vendor ………..…….

Rickshaw driver………………………

Sharecropper…………………………

Leases out land…………………….

Small shop owner………………….

Teacher/tutor.....................................

NGO worker…………………………..

Money lender………………………….

Other. Specify ________

Not involved in income generation

1

2

3

4

5

6

7

8

9

10

11

12

13

116 How many family members

bring income to this family?

17

(Write directly the number

reported.)

_______________

117 How many dependents do you have?

(Write the number reported.)

118 In a typical month, who earns

more, you, your husband or

another family member?

Head of household…………………..

Spouse………………………………..

Another family member …………….

1

2

3

Q120

Q120

119 What does that person do? Industrial worker…………………….

Janitor, guard, peon…………………

Daily laborer construction…………..

Informal sector vendor ………..…….

Rickshaw driver………………………

Sharecropper…………………………

Leases out land…………………….

Small shop owner………………….

Teacher/tutor.....................................

NGO worker…………………………..

Money lender………………………….

Other. Specify ________

Not involved in income generation

1

2

3

4

5

6

7

8

9

10

11

12

13

120 Does your household have:

(Read choices and circle

answer provided)

No

Yes

Electricity……………………. 1

2

Solar panel…………………. 1

2

Radio…………… ………….. 1

2

Television …………………. 1

2

18

Mobile phone ………………. 1

2

Landline phone ……………. 1

2

Kerosene lamp……………….1

2

Improved fixed stove …...…. 1

2

(Bondhu Chula or other fixed such

stove)

Improved movable stove 1

2

(Grameen Greenway stove)

121 Does your household:


answer provided)

No Yes

Own crop land 1 2

Own cattle/ 1 2

Own horses/mules/donkeys 1 2

Own sheep/goats 1 2

Own an animal drawn cart 1 2

Grow cash crops 1 2

122 Does any member of your

household own:


answer provided)

No

Yes

A bicycle? 1

2

A motorcycle or scooter 1

2

A car or truck? 1

2

Horse/mule for human transport only 1

2

123 How old are you?

(Write directly the age)

19

124 Did you ever attend school? No……………………………

….

Yes…………………………

…….

1

2

Q 126

125 What was the last grade of school that you

completed?

(Write in the number.)

126 Can you please read these sentences for me?

“The man always jumps when he sees the big cat.”

“Please sing a lullaby to the girl so she falls

asleep.”

Read it with no difficulty………………… 1

Read it with difficulty……………………. 2

Could not read it …………………………. 3

DECLINED TO PARTICIPATE………… 4

1

2

3

20

Anthropometric Measures for Children

Questionnaire Id Number

_ __________________

Upazila

Daulatkhan……………….. 1

Char Fasson………………..2

Kalapara…………………….3

Galachipa……………………4

Districts:

Bhola …………… 1

Pathuakhal…… 2

Now, I will need to weigh and measure each one of your children under five. I am going to start with the

oldest of those children. Could you bring them in one at a time, letting me some time to get ready for the

following child. We will start the oldest and work our way to the youngest.

I am going to weigh the children first

(Enumerators: Please fall instructions to conduct the anthropometric measures provided in the

training.)

Child 1 Child 2 Child

3

Child

4

214. What is the child’s first name?

215. Sex of the child

1. Boy

2. Girl

216. Please tell me when was this

child born?

217. If the child is under six months,

ask:

Is the child currently breastfed?

1. No 2. Yes 3. NA

1. No 2. Yes 3. NA

1. No 2. Yes 3. NA

1. No 2. Yes 3. NA

21

218. If the child is under six months,

ask:

In the past 24 hours what else did

(s)he eat besides breastmilk?

219. I am now going to weigh

him/her.

(Weigh child following instructions

provided in the training and write

down weight in kilograms.)

220. And measure him

(Follow instructions, measure

child, and write his /her height in

centimeters.)

221. Measured Lying Down or

Standing Up?

1. Lying down 2. Standing up

222. Did this child pass a soft/liquid

stool in the last two weeks? That is

since __(add a time reference

that makes sense.)

1. No

2. Yes

1. No

2.Yes.

1. No

2.Yes.

1. No

2.Yes.

223. How many days did this

condition last?

(Write directly the number

provided.)

224. How many soft/liquid stools did

(s)he passed a day? (Write directly

the number provided.)

22

0301 - 0330 Drinking Water

Tell the participants:

Thank you very much for that. I would like to resume and talk about water. Could we please sit down again?

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

301

What is (currently) the main source of drinking water for

your family?

PIPED WATER

Piped Water Into

Dwelling………….........

Piped Water From A

Neighbor………..

Piped Water Into

Yard/Plot……………

Public

Tap/Standpipe……………………

TUBE WELL OR

BOREHOLE…………..

DUG WELL

Protected Dug

Well……………….........

Unprotected Dug

Well……………

WATER FROM SPRING

Water From Protected Spring….

Water From Unprotected Spring

Rainwater…………………………

Tanker

Truck……………………………..

Cart With Small

Tank……………….

Surface Water

(River/Dam/Lake/Ponds/Stream/

Canal/Irrigation Channel) ……

Bottled Water……………..

Other (Specify)

________________

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

23

303

How long does it take to go there, get water, and come

back?

Minutes:

On premises .................................. ………..

1

304

If there no water source on premises, who usually goes to

the source to fetch the water for the household?

Probe. Is this person under 15 years of age? What is that

person’s sex?

(Circle the code that best describes this person.)

Men 15 years old or older …

1

Women 15 years old or

older 2

Boys under to 15 years old

3

Girls under to 15 years old

4

305

On a typical day, how many trips do family members take

to haul water?

(Write the number of trips provided.)

306 How many containers are carried per trip?

(Write the amount of containers provided.)

307

May I see one of those containers? Not allowed

…………………………..1

Allowed

…………………………………..2

Q30

9

308

What type of container is it?

(Observe and if mobiles phones are used take a

picture)

Jerrycan…………………………

…………1

Clay

pot…………………………………

….2

Bucket……………………………

…………3

Other. Specify _____________

4

309

How much water can a typical water hauling container

hold?

(Estimate it. Write the amount in liters.)

24

310

What are the sources of water you use for other purpose

than drinking (such as cooking, handwashing, and other

household chores)? Anything else?

(MULTIPLE RESPONSES ARE POSSIBLE.)

Piped Water Into

Dwelling………...

Piped Water From A

Neighbor……..

Piped Water Into

Yard/Plot………..

Public

Tap/Standpipe……………….

Tube Well Or Borehole…………

.

Protected Dug

Well………………..

Unprotected Dug Well………..

Water From Protected

Spring………

Water From Unprotected Spring

….

Rainwater……………………….

Tanker Truck…………………….

Cart With Small Tank…………..

Surface Water

(River/Dam/Lake/Ponds/Stream/

Canal/Irrigation Channel)

………………

Bottled

Water………………………..

Other (Specify)

_______________

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

311

Could you please serve me a cup of drinking water from

the source commonly used for satisfy children’s thirst?

NOT OBSERVED ……… ……1

OBSERVED ……… ……………2

25

Use the time to make some observations about how water is obtained from the container and characteristics

of the container.

312

Can you tell me all the ways you know to make water

safer to drink in your home? [Multiple answer, ask “Any

others?”]

Boiling ……………………… 1

Liquid chlorine …………….2

Chlorine tablets ……………3

Coagulant/ flocculant …. 4

Solar disinfection……… 5

Ceramic filter…………… 6

Biosand filter ………………. 7

Membrane filter …….. 8

Cloth filter ………………. 9

Settling ……………………10

None ………………………11

Other, Specify _________ 12

313

OBSERVE

Was sample collected safely with a ladle (not touching

water with hands)?

NO ........................................................ …..

YES………………..........

1

2

314

OBSERVE

What container is used for drinking-water?

Bucket ……………………… 1

Jerry can …………………. 2

Collapsible bucket ………… 3

Gallon jug …………………… 4

Bucket with tap ……………… 5

Ceramic pot ……………….. 6

Large drum ………………… 7

Other , Specify_______________ 8

315 Is the container covered/closed?

OBSERVE

NO ........................................................ …..

YES……………………………

1

2

26

316 Does it have a tight fitting lid?

OBSERVE

NO ........................................................ …..

YES……………………………

1

2

317 Does it have a spigot?

OBSERVE

NO ........................................................ …..

YES……………………………

1

2

318

Is container clean (smeared with sticky substance or mud)

on the outside?

OBSERVE

NO ........................................................ …..

YES……………………………

1

2

319

Is container out of the reach of animals?

OBSERVE

NO ........................................................ …..

YES…………………………...

1

2

Thank you for the water. Let me proceed with the questions.

320 Did you do anything to make the water safer to drink? No……………………………….

Yes……………………………….

1

2

-> q329

321

How did you make this water safer to drink? Boiling …………………… 1

Liquid chlorine solutio… ……. 2

Chlorine tablets ……… ………….. 3

Coagulant/flocculant………………..

5

Ceramic filter …………..…… . .6

Biosand filter …………………….. 7

Membrane filter ………………….8

Cloth filter ……………………….9

Settling ………………… 10

Other. Specify _____________ 11

27

322

What motivated you to treat the water to drink? Health promotion received

(School, health centre, CHW,

mass media etc)

Standard practice in household

to treat water

I had water treatment kit this

time

The source makes it unsafe for

drinking without treating it

Someone is currently sick in the

family so we must use treated

water

Other (specify)

______________.

1

2

3

4

5

6

7

323 How many hours ago was it treated?

(WRITE NUMBER OF HOURS)

324

Did you mix treated water with any other drinking water

that had not been treated?

NO……………………………………...1

YES…………………………………….

1

2

1

2

325

How often do you treat drinking water this way? Daily

Weekly

When there is somebody ill in

the house

During emergencies

Others. Specify ____________

1

2

3

4

5

326

How many days do you keep drinking water that you have

treated?

(WRITE NUMBERS DIRECTLY)

28

327

If chlorine was used, test for chlorine and report:

CHLORINE LEVEL IN MG/L

328 Do you know where to buy more chlorine? NO ........................................................ …..

YES…………………………….

1

2

329

What hindered you from treating your drinking water?

Anything else?

(Multiple responses are possible).

Not aware water should be

treated

Standard practice in household

not to treat water

I lacked water treatment kit this

time

The source is safe for drinking

without treating it

Nobody fell sick so we are just

OK using this water

Other (specify)

______________.

1

2

3

4

5

6

330

How often do children under five years of age drink

treated water? Always, sometimes or never?

Always……………………………… 1

Sometimes………………………. 2

Never ………………………………. 3

29

0401-0405 Soap and other Cleaning Materials

401

Do you have any type of soap in your house?

NO…………………………………………

YES………………………………………..

1

2

Q407

402

Who in the family decided to buy the soap?

Wife………………………………………..

Daughter…………………………………..

Husband…………………………………..

Son………………………………………..

Somebody else, specify________________

1

2

3

4

5

403

For what purpose do you commonly use soap for?

Washing

Clothes…………………………………

Washing My Body ……………………….......

Washing My Children ……………………

Washing Child’s

Bottoms……………………….

Washing My Children’s

Hands………………….

Washing My Hands After Defecating

………….

Washing My Hands After Cleaning A Child

….

Washing My H Ands Before Feeding A

Child…

Washing My Hands Before Preparing

Food......

Washing My Hands Before

Eating……………..

Other. Specify __________________

1

2

3

4

5

6

7

8

9

10

11

404 Do you use the same bar of soap for everything? NO…………………………………………1

YES……………………………………….. 2

30

0405- 0420 Handwashing

405.

I am going to read to you different circumstances when people may RINSE their hands and you will tell me

during which ones do you wash your hands. For each one of those circumstances I will need you to tell me if

you engage in that practice: never, sometimes, often or always

Never Some

Times Often Always

When washing your face after you get up

1 2 3 4

When taking a shower

1 2 3 4

After going to the toilet

1 2 3 4

Before eating

1 2 3 4

Before cooking

1 2 3 4

Before feeding a child

1 2 3 4

After any form of work with my hands

1 2 3 4

After touching an animal

1 2 3 4

After cleaning a child’s bottom

1 2 3 4

After cleaning a toilet

1 2 3 4

After handling a sick person

1 2 3 4

Other times (indicate which)___________________________ 1 2 3 4

31

406. Now, I am going to read the same list and this time you will tell me how frequently would you WASH your

hands using soap at each one of those occasions. Here we go.

Never

Some

Times Often Always

When washing your face after you get up

1 2 3 4

When taking a shower

1 2 3 4

After going to the toilet

1 2 3 4

Before eating

1 2 3 4

Before cooking

1 2 3 4

Before feeding a kid

1 2 3 4

After work

1 2 3 4

After touching an animal

1 2 3 4

After cleaning a kid’s bottom

1 2 3 4

After cleaning a toilet

1 2 3 4

After taking care of a sick person

1 2 3 4

Other times (indicate which)___________________________

1 2 3 4

32

407

Can you show me where you

usually wash your hands and what

you use to wash hands?

ASK TO SEE AND OBSERVE

(Indicate all that are mentioned, if

more than one)

INSIDE/NEAR TOILET FACILITY……

INSIDE/NEAR COOKING PLACE..

ELSEWHERE IN YARD …………

OUTSIDE YARD ………………………

NO SPECIFIC PLACE ………………

NO PERMISSION TO SEE……….

1

2

3

4

5

6

Q411

Great. Thank you. Let me take a couple of notes to remember what you are showing me.

408

(OBSERVE)

WHAT IS THE HAND WASHING DEVICE USED?

Faucet .....................................................

Tippy tap .................................................

Basin/bucket ............................................

Other (specify)___________________

1

2

3

4

409 (OBSERVE)

Was water available at time of interview?

NO ...........................................................

YES .........................................................

1

2

410

OBSERVATION ONLY:

IS THERE SOAP OR DETERGENT OR OTHER

LOCALLY USED CLEANSING AGENT?

THIS ITEM SHOULD BE EITHER IN PLACE OR

BROUGHT BY THE INTERVIEWEE WITHIN 2

MINUTES. IF THE ITEM IS NOT PRESENT

WITHIN THAT TIME CHECK NONE, EVEN IF

PROVIDED LATER.

None ........................................................

Soap ........................................................

Detergent ................................................

Ash ..........................................................

Mud ……………………………………………..

Sand…………………………………………….

Other (specify) ___________________

1

2

3

4

5

6

7

OK. Let me ask some other questions.

33

411

Who in the family makes sure that there is water at

this hand washing station?

Wife…………………………………………

Daughter……………………………………

Husband……………………………………

Son…………………………………………

Somebody else, specify________________

1

2

3

4

5

412 Do you have a handwashing station here or near

the area where you cook?

NO ........................................................ …..

YES…………………………………………...

1

2

->

Q418

413 May I see this station? NO ........................................................ …..

YES…………………………………………...

1

2

->

Q418

414

(Observe) What is the hand washing device used? Pail/Bucket (movable)

……………………………

Tippy tap (fixed)

…………………………………..

Handwashing station introduced by

WASHplus.

Other device, Explain

___________________

1

2

3

4

415

(Observe) Was water available at the time of the

interview?

NO........................................................ …..

YES…………………………………………...

1

2

1

2

416

(Observe) Was there soap or detergent or other

locally used cleansing agent?

NO........................................................ …..

YES…………………………………………...

1

2

1

2

417

How many months ago did you set up this

handwashing station?

(Write the amount of time in months. If

respondent does not know, write 99)

34

When/How Wash

418

Sometimes people wash their hands before or after

doing certain activities. What do you think are the

most important occasions to wash your hands?

MULTIPLE RESPONSES ARE

POSSIBLE. RECORD ALL

MENTIONED

After any toilet visit

After defecation ....................................

Before eating ........................................

After cleaning a child/washing a diaper

After cleaning the latrine .......................

After handling any materials for

household chores

After cleaning a potty ............................

Before food preparation ........................

Before feeding a child ...........................

After handling a sick person

After eating ...........................................

Other (specify)____________________

Does not know

1

2

3

4

5

6

7

8

9

10

11

12

13

419

What are the reasons for washing hands with

Soap/Ash?

RECORD ALL MENTIONED

Prevent diarrhea ...................................

Prevent other diseases .........................

Remove germs .....................................

Prevent dirt getting into mouth .............

Prevent dirt from getting into food ........

Smells good ..........................................

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

1

2

3

4

5

6

7

35

420 Do you wash your hands using water treated with

bleach?

No…………………………………………

…..

Yes…………………………………………

….

1

2

421 What is the main cause of diarrhea in children?

Does not know

………………………………

No handwashing with soap after fecal

contact……………………………………

…..

No handwashing with soap before food

handling……………………………………

…

Drinking contaminated water

………………

Eating contaminated

food………………….

Sucking/putting dirty fingers in your

mouth

Other reasons. Specify

______________

1

2

3

4

5

6

7

36

0501-0526 Management of Human Feces

502

The last time the youngest child passed a stool, where did he/she defecate?

Used sanitation facility ...............................

Used potty .................................................

Used washable diapers .............................

Used disposable diapers ...........................

Went in house/yard ....................................

Went outside the premises ........................

Went in his/her clothes ..............................

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

Other

(Specify)________________________

1

2

3

4

5

6

7

8

9

503

The last time your youngest child under your

care passed stools, where were the feces

disposed of?

Dropped into toilet facility ..........................

Buried ........................................................

Solid waste/trash .......................................

In yard ........................................................

Outside premises .......................................

Public latrine………………………………..

Into sink or tub ...........................................

Thrown into waterway……………………….

Thrown elsewhere

(specify)______________

1

2

3

4

5

6

7

8

9

37

504

Who disposed of the child feces?

Wife…………………………………………..

Daughter……………………………………

Husband………………………………………

Son…………………………………………..

Somebody else,

specify________________

1

2

3

4

5

505

Where do members of your household usually

go to defecate?

None, field bush, plastic bag……………

FLUSH OR POUR FLUSH TOILET

FLUSHED TO:

PIPED SEWER

SYSTEM……………………

SEPTIC

TANK…………………………………

SOAK PIT

LATRINE…………………………

SOMEWHERE

ELSE………………………….

VENTILATED IMPROVED PIT

LATRINE…..

PIT LATRINE WITH

SLAB……………………...

PIT LATRINE WITHOUT SLAB/OPEN

PIT…….

COMPOSTING

TOILET……………………….

BUCKET TOILET……………………………

HANGING

TOILET/LATRINE……………….

OTHER. SPECIFY

___________________

1

2

3

4

5

6

7

8

9

10

11

Q524

38

506

Who in the family decided to install the

toilet/latrine?

Wife………………………………………….

Daughter……………………………………..

Husband……………………………………..

Son……………………………………………

Somebody else,

specify________________

Does not know ………………………………

1

2

3

4

5

6

507

Who installed the latrine?

Husband …………………………………….

Mason……………………………………….

Other. Specify ____________________

Does not know ……………………………..

1

2

3

4

508

Who decided where to locate the latrine?

Wife………………………………………….

Daughter……………………………………..

Husband……………………………………..

Son………………………………………….

Somebody else,

specify________________

Does not know

1

2

3

4

5

6

509

Where is your toilet facility?

Inside/attached to dwelling ........................

Elsewhere on premises .............................

Outside premises .......................................

Public latrine………………………………….

1

2

3

4

510

How long have you had that toilet?

(WRITE INFORMATION IN MONTHS)

511

Did you get a loan to install this latrine? NO…………………………………………..

YES………………………………………….

Does not know …………………………….

1

2

3

39

512

a

Did you get a subsidy to install the latrine NO…………………………………………..

YES………………………………………….

Does not know

1

2

3

512

b

Do you share this facility with other

households?

NO…………………………………………..

YES………………………………………….

1

2

-> Q514

513

How many households share this facility?

(WRITE NUMBER OF HOUSEHOLDS)

Number of households

514

What were the top three reasons for building

the facility?

(Multiple choice, Do not read answers,

record all answers - Up to 3 - provided.)

Status/Pride

…………………………………

Comfort………………………………………

Convenience………………………………

….

Privacy……………………………………….

Avoid sharing with

others……………………

Security………………………………………

Disease

prevention…………………………..

Shame of environmental contamination

…….

Do help develop my community

Other. (Specify)

_____________________

1

2

3

4

5

6

7

8

9

10

40

515

Do you add any product to the pit to control the

smell or the flies?

NO……………………………………………

YES………………………………………….

1

2

Q517

516

What do you add?

Ash…………………………………………..

Bleach………………………………………..

Insecticide…………………………………….

Motor oil……………………………………..

Other. Specify_____________________

1

2

3

4

5

517 Did you do any recent maintenance work on

this toilet since it was constructed?

NO……………………………………………

YES…………………………………………..

1

2

Q519

518

What did you do?

Changed an element of the structure

above the

ground……………………………………… 1

Changed to a new

pit………………………..2

Emptied the pit …………………………….

3

Other __________________

519

Was your toilet emptied since it was

constructed?

NO……………………………………………

YES…………………………………………..

Does not know ……………………………..

1

2

3

Q528

Q528

520

If emptied pit, where did you dispose of the

contents of the pit?

Disposed in waterway……………………….

Disposed in field far away from

house………

Buried it elsewhere……………………...

Burned it…………………………………….

Used it for composting…………………..

Other. (Specify) -

_______________________

1

2

3

4

5

6

41

521

If emptied pit, is that emptied pit still being

used?

NO…………………………………………

YES…………………………………………

1

2

522

Have you closed it permanently or temporarily?

Permanently…………………………………

Temporarily…………………………………

Not closed

1

2

523

How long has it been closed for?

(Write answer in months)

524

What were the top three reasons for your

household for not having/building the toilet

facility?

(Multiple choice, Do not read answers,

record up to 3 answers provided.)

Not havinga dequate polt of land/no land to

cosntruct the toilet ………………………….

Soil is loose …………………………..…….

Not having adequate construction

materials .

No one to construct the toilet (No mason)

…

Construction cost is expensive

……………….

Not having knweodge on how to construct

latrine

Not being able to get permssion from local

authorities to construct the toilet

…………….

We have other priorities

…………………………

Other. (Specify) -

_______________________

1

2

3

4

5

6

7

8

9

42

525

How satisfied are you with the place where

your family defecates?

(Read answers)

Very unsatisfied………………………………

Somewhat

unsatisfied………………………..

No opinion……………………………………

Somewhat

satisfied…………………………...

Very satisfied…………………………………

Other. (Specify) _____________________

1

2

3

4

5

6

526

What would you like to do to change your

current sanitation situation?

Build a private

latrine………………………

Improve the current private latrine family

has.

Help build a community

latrine……………

Request government/outside assistance

for

Improving situation………………………

Nothing,

satisfied……………………………

Other.Specify_____________________

___

Do not

know…………………………………….

1

2

3

4

5

6

7

8

527

Do you intend to install/change a sanitation

facility in the next six months?

NO……………………………………………

……..

YES……………………………………………

….

1

2

527

a

Did you ever have a latrine that collapsed? NO…………………………………………..

YES………………………………………….

1

2

->Q529

527

b

If so, did you rebuild it? NO…………………………………………..

YES………………………………………….

1

2

->Q529

43

527

c

What prevented you from rebuilding it? No one to do it in family

………………………..

No money to rebuild

……………………………

Other reasons, Specify

_________________

1

2

528 Did you opt to defecate in the open after it

collapsed?

NO…………………………………………..

YES………………………………………….

1

2

0528 – 0562 Sanitation Observations and Gender Roles

(Only for Families with a Facility on the Premises)

529

Can I see the sanitation facility?

Not allowed ................................................

Allowed to see it ........................................

1

2

>Q60

0

530 Did you construct this facility in the past 12

months?

NO……………………………………………

YES…………………………………………

1

2

531

(OBSERVE)

Distance of the facility from the house?

Within house ………………………………..

In yard……………………………………….

1-20 meters from house……………………

21+ meters from house ……………………

1

2

3

4

532 Is path clear to the latrine?

(OBSERVE)

NO……………………………………………

YES…………………………………………

1

2

533 If mobile phones or tablets are used, take a

picture of the sonitation facility.

534

(OBSERVE)

Does the toilet superstructure have walls?

NO ...........................................................

YES .........................................................

1

2

535 (OBSERVE)

Does the toilet have a roof?

NO ...........................................................

YES .........................................................

1

2

44

536

(OBSERVE)

Does toilet allow privacy?

(It has a curtain or door or entrance is L shaped)

NO ...........................................................

YES .........................................................

1

2

537

(OBSERVE)

Is the toilet kept shut ?

NO ...........................................................

YES .........................................................

1

2

539

(OBSERVE)

Does it have any of these child friendly features:

Pit latrine with smaller hole .....................

Lower seat ...............................................

Cannot determine ....................................

None of the above ...................................

1

2

3

0

540

(OBSERVE)

Does it have a raised seat?

NO………………………………………………

…

YES……………………………………………

…..

1

2

541

(OBSERVE)

Is there a rope or pole to permit squatting?

NO………………………………………………

…

YES……………………………………………

…..

1

2

542

(OBSERVE)

Is the pit covered?

NO ...........................................................

YES .........................................................

1

2

543

(OBSERVE)

Is it being used?

(OBSERVE IF THERE ARE FECES IN THE PIT,

THROW A ROCK AND LISTEN IF IT SEEMS

WET, IF THERE IS EVIDENCE OF ANAL

CLEANSING, AND/OR IF THE PATH TO THE

LATRINE SEEMS TO HAVE BEEN WALKED

ON. CHECK ALL THAT APPLY.)

Detected feces in pit using a

flashlight………

Observed anal cleansing materials in

latrine..

Detectable path to the latrine………………..

Slab is wet…………………………………..

Slab is grey color……………………………

Smelly……………………………………….

Flies around it……………………………….

1

2

3

4

5

6

7

45

544

(Cleaning and operation—for dry latrines only. Observe conditions, first circling

characteristics and subsequently reporting corresponding points in score column of

table provided below. Add points to arrive at total score.)

Latrine

Component

No Cleaning/ Operation

(Score of 0)

Limited

Cleaning/Operation

(Score of 1)

Adequate

Cleaning/Operation

(Score of 2)

Scores

Floor

(concrete,

soil, plastic,

tile, wood,

etc.)

Abundant fecal

matter/used anal

cleansing material on

floor to the extent that

entering facility without

stepping on feces is

difficult. Dried fecal

matter is present.

Limited amount of fecal

matter or used anal

cleansing material on floor.

Smeared feces may be

present.

No fecal matter or used

anal cleansing material on

floor.

Hole

Cover/Lid (if

clearly part of

original

facility)

No hole cover present. Hole cover defective,

broken, or not used.

Hole cover placed over hole

and tight fitting.

Anal

Cleansing

Material

Soiled anal cleansing

material accumulated on

floor of latrine.

Some soiled anal cleansing

material on latrine floor.

No soiled anal cleansing

material visible.

545 (OBSERVE)

Is there a broom nearby?

NO ...........................................................

YES .........................................................

1

2

546

(OBSERVE)

Is there hand washing station inside or near the latrine

(not more than 10 paces away from the latrine)?

NO ...........................................................

YES .........................................................

1

2

Q550

547

(OBSERVE)

Is there water at that hand washing station near the

latrine?

NO ...........................................................

YES .........................................................

1

2

Q549

46

548

(OBSERVE)

What container is used for water at the HW station?

Tap ............................................................

Tippy tap ...................................................

Bucket .......................................................

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

_______________

1

2

3

4

549

(OBSERVE)

Is there a cleansing agent at this hand washing station

inside/near the latrine?

RECORD ALL PRESENT

None .........................................................

Soap ..........................................................

Detergent ..................................................

Ash ............................................................

Other

(specify)_________________

0

1

2

3

4

550

ASK:

Who cleans the latrine?

Wife…………………………….

Daughter………………………..

Husband………………………..

Son……………………………..

Somebody else,

specify_____________

1

2

3

4

5

551

ASK

Who brings the water the hand washing station here?

Wife……………………………….

Daughter…………………………..

Husband…………………………..

Son…………………………….

Somebody else,

specify___________

1

2

3

4

5

47

552

ASK:

Who makes sure there is a cleansing agent available?

No such

agent……………………...

Wife……………………………….

Daughter…………………………..

Husband…………………………..

Son……………………………….

Somebody else, specify________

1

2

3

4

5

6

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

0600-0616 Psycho social determinants of latrine ownership

Now, I am going to ask a series of questions to get a sense of your opinions. I would appreciate it if you answered

by telling me if you agree, if you disagree or if you have no opinion on the matter. However, if you agree or disagree,

I would like you to let me know if you totally or partially agree or if you totally disagree or you are Partially disagree.

What about if I say to you: XXXXX

OK. Let’s get started. Tell me how your opinion about the following statements.

Having a latrine:

600

Makes owners be modern

Totally agree ...................................... ..

Partially agree .......................................

Partially

disagree…………………………………

Totally

disagree………………………………..

Indifferent, no

opinion…………………………….

4

3

2

1

0

48

601

Makes owners be respected members of their

communities

Totally agree ...................................... ..

Partially agree .......................................

Partially

disagree………………………………

Totally

disagree………………………………..

Indifferent, no

opinion…………………………….

4

3

2

1

0

602

Makes owners be respected by visitors that come to

their house

Totally agree ...................................... ..

Partially agree .......................................

Partially


Totally

disagree………………………………..

Indifferent, no

opinion……………………….

4

3

2

1

0

603

Makes owners popular

Totally agree ...................................... ..

Partially agree .......................................

Partially

disagree……………………………

Totally

disagree……………………………..

Indifferent, no

opinion…………………………….

4

3

2

1

0

604

Makes family members proud

Totally agree ...................................... ..

Partially agree .......................................

Partially

disagree……………………………

Totally

disagree…………………………………

…..

Indifferent, no

opinion…………………………….

4

3

2

1

0

49

605

Allow women to have privacy any time of the day

Totally agree ...................................... ..

Partially agree .......................................

Partially


Totally

disagree………………………………..

Indifferent, no


4

3

2

1

0

606

Helps keep the family compound clean

Totally agree ...................................... ..

Partially agree .......................................

Partially disagree…… …………

Totally disagree…………………

……………..

Indifferent, no


4

3

2

1

0

607

Does not help to reduce the number of flies in the

house

Totally agree ...................................... ..

Partially agree .......................................

Partially disagree…………

……………………

Totally disagree…………

……………………..

Indifferent, no opinion……

………………….

4

3

2

1

0

608

Allows you to defecate easily when you are sick

Totally agree ...................................... ..

Partially agree .......................................

Partially


Totally

disagree………………………………..

Indifferent, no


4

3

2

1

0

50

609

Allows you to defecate easily when you are old

Totally agree ...................................... ..

Partially agree .......................................

Partially


Totally

disagree………………………………..

Indifferent, no


4

3

2

1

0

610

Reduces the possibility of disease in your family

Totally agree ...................................... ..

Partially agree .......................................

Partially


Totally

disagree………………………………..

Indifferent, no


4

3

2

1

0

611

Gives latrine users more privacy

Totally agree ...................................... ..

Partially agree .......................................

Partially


Totally

disagree………………………………..

Indifferent, no


4

3

2

1

0

612

It is a nuisance to go to the latrine all the time to

defecate.

Totally agree ...................................... ..

Partially agree .......................................

Partially


Totally

disagree………………………………..

Indifferent, no


4

3

2

1

0

51

613

Avoids the dangers of defecating in the bush at night

Totally agree ...................................... ..

Partially agree .......................................

Partially


Totally

disagree………………………………..

Indifferent, no


4

3

2

1

0

614

It requires a lot of effort to maintain a latrine

operational

Totally agree ...................................... ..

Partially agree .......................................

Partially

disagree………………………………….

Totally

disagree…………………………………

….

Indifferent, no

opinion……………………………..

4

3

2

1

0

615

It requires a lot of effort to keep it clean

Totally agree ...................................... ..

Partially agree

Partially disagree……………………

Totally

disagree…………………………………..

Indifferent,No

opinion…………………….

4

3

2

1

0

52

0700-0713 Psycho social determinants of handwashing

Now, I am going to ask similar questions about handwashing. As before, I would appreciate it if you answered by

telling me if you agree, if you disagree or if you have no opinion on the matter. However, if you agree or disagree, I

would like you to let me know if you totally or partially agree or if you totally disagree or you are Partially disagree.

700 You only need to wash your hands with soap if they look dirty or smell bad (reverse coding)

Totally agree ...................................... .. 4

Partially agree ....... ………… 3

Partially

disagree………………………………….

2

Totally

disagree…………………………………….

1

Indifferent, no

opinion…………………………….. 0

701 Soap and water are always available in your house to wash hands after going to the toilet.

Totally agree ...................................... .. 4


Partially disagree……………………. 2

Totally disagree………………………. 1

Indifferent, no

opinion…………………………….. 0

702 Soap and water are always available in your house to wash hands before eating.

Totally agree ...................................... .. 4


Partially disagree…………………. 2

Totally disagree………………………. 1

Indifferent, no opinion…………….. 0

703 You don’t need to wash your hands with soap if you have not touched anything dirty (reverse coding)

Totally agree ...................................... .. 4


Partially disagree………………. 2

Totally disagre……………………. 1

Indifferent, no opinion……………….. 0

53

704 Only soap can remove the smell of fish or stubborn hand stains

Totally agree ...................................... .. 4



Totally disagree……………………. 1


705 I hate the smell of my hands if I do not wash them with soap after defecating.

Totally agree.. .................................... 4

Partially agr……… 3

Partially disagre……………………. 2



706 I like how my hands smell after I wash them with soap. Totally agree ...................................... .. 4


Partially disagree………………2

Totally disagree………………. 1


707 People who don’t wash their hands with soap deserve to be criticized

Totally agree ...................................... .. 4



Totally disagree…………………. 1


708 In most homes in your community, soap and water are available to wash hands after going to the toilet

Totally agree ...................................... .. 4





54

709 It is shameful to be eating with dirty hands in front of your friends.

Totally agree ...................................... .. 4


Partially disagree……………………2



710 Good mothers make sure to wash their hands with soap before preparing food.

Totally agree ...................................... .. 4


Partially disagree………………. 2



711 Good mothers make sure to wash their hands with soap after going to the toilet

Totally agree ...................................... .. 4




Indifferent, no opinion……………… 0

712 My children are my pride and joy and I wash my hands with soap to protect them.

Totally agree ...................................... .. 4





55

0801-0813 Exposure Information

Please let us talk about something else now

801 In the past month, have you heard or seen any

information on hand washing?

NO ........................................................

YES .......................................................

1

2

802

What was the source of that information?

Anywhere else?


Through health center ..........................

Through village health

educator…………

Through the area chiefs public

meeting…

Through children that go to

school……….

Through the radio ................................

Through other channels

(specify)________

1

2

3

4

5

6

803 In the past month, have you heard or seen any

information about treating the water you drink?

NO .......................................................

YES ......................................................

1

2

804

Where did you see it or hear it?

Anywhere else?




educator………….


meeting…

Through children that go to school ……


Through other channels (specify) ___

1

2

3

4

5

6

805 In the past month have you heard or seen anything

about sanitation?

NO .......................................................

YES ......................................................

1

2

56

806

What was the source of the information?

Anywhere else?


Through health center ...........................


educator…………


meeting…

Through children that go to school ......

Through the radio .................................

Through other channels (specify)

_____________________

1

2

3

4

5

6

807 And in the past year, have you heard or seen anything

about sanitation?

NO .......................................................

YES .......................................................

1

2

808

What was the source of the information?

Anywhere else?


Through health center ...........................

Through village health educator ………


meeting…

Through children that go to school

…….

Through the radio .................................


________________

1

2

3

4

5

6

809 Did your village participate in any activity to stop open

defecation?

NO ........................................................

YES ......................................................

1

2

810 Did your village participate in the Walk of Shame? NO ........................................................

YES ......................................................

1

2

811 Has your community ever been granted Open

Defecation Free Status?

NO ........................................................

YES ......................................................

1

2

812 Have you ever been visited by a village health educator

to stop open defecation?

NO ........................................................

YES ......................................................

1

2

57

813 Have you ever been visited by s village health educator

to improve your toiler?

NO ........................................................

YES ......................................................

1

2

814 In the past month, have you received information about

diarrhea?

NO ........................................................

YES ......................................................

1

2

815

What was the source of that information?

Anywhere else?



Through village health educator ..........


meeting…

Through children that go to school ......



_____________________

1

2

3

4 5 6

816

What issues did that information cover? How to avoid diarrhea

How to treat diarrhea at home

The danger signs associated with

diarrhea

When to seek help at a health facility

Others.

Specify_____________________

1

2

3

4

5

58

Annex 4. Conceptual framework showing how poor water, sanitation and hygiene might directly influence child nutritional status (From Dangour et. al., 2011)

59

Annex 5. Structure of the report

The report should have the following structure:

a. Title page

b. Acknowledgments

c. List of acronyms

d. Table of contents and lists of figures and tables

e. Executive summary

f. Introduction

g. Background

h. Objectives

i. Methodology

j. Results (it should be organised as per study objectives)

k. Discussion and conclusions with recommendations.

l. References

m. Annexes

60

Annex 6. Budget template

The following illustrative budget template should be used (lines may be added if

needed).

Unit Price

(In BDT)

Units Total in BDT (Unit Price x

Unit)

Total in USD

Personnel

Lead Consultant

Person 1

Person 2, etc

Sub total

Field work

Accommodation and meals of lead consultant

Accommodation and meals of enumerators

Train/Bus/taxi/local transport for lead consultant

Train/Bus/taxi/local transport for enumerators

Sub total

Training of enumerators

Training allowance

Food during training

Transportation for field exercise

Sub total

Data analysis

Layout, coding, entry, editing and cleaning

Sub total

Others

Height scale

Weight scale

Questionnaire printing

Stationeries, office supplies and photocopy

Sub total

Grand total

61

Annex 7. Criteria for evaluation of the proposals and points

Criteria for evaluation Points

Detailed and realistic work plan 40

Team composition and relevant competency of the team leader

40

Budget justification and amount 20

Total 100

Documents

Baseline study of WASHplus project to understand the