Questionnaire Text

Questionnaire form view entire document:  text  image
Water source
15. Where does the water for washing, cleaning, bathing, etc., used in this household come from?

[] 1 Water conduit inside the house
[] 2 Water conduit in the yard of the house
[] 3 Public tap
[] 4 Spring, river, stream
[] 5 Well
[] 6 Rainfall
[] 7 Tanker truck
[] 8 Other
Questionnaire instructions view entire document:  text  image
Question 15: What is the principal source of water used to wash, scrub, shower, etc. in this household?

Fill in the correct given answer. If the household water source is more than one, record the one mainly used.

If the water source is not any of the options provided from 1-7, fill in option 8 (other).

If the interviewee tells you that the water source comes from a broken tube or pipe on the street, back yard, plot or other place, fill in option 3 (From water conduit, piped in water)