Questionnaire Text
Questionnaire form
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Household and living unit information
11. Water for other uses is from
[] Pipe
[] Pump
[] Well
[] Spring
[] River
[] Rain
[] Other
Questionnaire instructions
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6.14. Question 11: Water for other purposes
Procedure of asking question:
"For other needs, such as cooking, bathing and washing, do you use the same water as you use for drinking?"
If the answer is "Yes", answer the same box as in Question 9 above; if the answer is "No", then ask:
"So, what type of water is used for those other needs?"
Fill the answer in the pertinent box for this question.