Questionnaire Text

Questionnaire form view entire document:  text  image
G. Housing characteristics
Distance to water source?
[] 1 On premises
[] 2 Less than 500 m
[] 3 Between 500 m and 1 km
[] 4 More than 1 km
Questionnaire instructions view entire document:  text  image
Section G: Housing characteristics
Responses to questions 20 to 22 and 24 to 26 are pre-coded. Circle the correct response. Write a "9" for not known.

Question 24: Water for drinking and cooking
The question asks for information on:

- main water source
- distance to that water source
- indirectly also whether water source is safe or not

The response alternatives are:

- Piped water, inside or outside
- Well/borehole, protected
- Well/borehole, unprotected
- River/stream/dam
- Rain water from tank/jar
- Other

If the main source of water varies during the year, record the source that supplies the largest quantity of water.