Household Water Access and Quality Survey

A long field instrument for enumerators visiting homes around a water point: household composition, dry and wet season sources, treatment habits, spending, salinity experience and the adaptation measures already in place. The data guides water and sanitation programmes.

Use this template

Page 1

Household record ID

Handpump code

Is the water point delivering water today?

Did the handpump deliver water over the past year?

Is the amount of water sufficient?

Has the water point worked in the last 30 days?

Is an adult over 18 present in the household?

Has the respondent agreed to take part?

Respondent profile

Respondent's gender

Female Male Other Prefer not to say

Respondent's age in years

Highest level of education completed

How many other people live in the household, excluding you?

How many men?

How many women?

How many children under 18?

Household spending

If you chose other expenses, describe them here

How does the household rate its own income and assets?

Well off Average Not well off

Does the household own the land under the dwelling?

Owned by the household Rented Communal land No

If owned, how many acres does the household hold?

Page 2

Drinking water sources

If other, specify the source and the season of use

If another groundwater source is used, name that handpump

If other, please specify

If a different groundwater source, give its ID or location

If other, please specify

Does the household treat water before drinking it?

Yes Sometimes No

If yes, which treatment methods are used? Select all that apply

Does the household grow crops?

Yes No

Does the household keep livestock?

Yes No

What worries you most about your water? Select all that apply

Water quality concerns

Page 3

Salinity impacts and adaptation

In the last ten years, has the groundwater you collect tasted salty?

Yes No Don't know

How often is the water from this handpump salty?

How has the change in salinity affected your drinking water? Select all that apply

Bad taste Health problems Having to buy water Travelling further Drinking less water No impact

How has the change in salinity affected your harvest? Select all that apply

How has the change in salinity affected your livestock? Select all that apply

Animals refuse the water Animal illness Lower production Loss of animals No impact

Any other general impact linked to groundwater salinity? Select all that apply

Damage to pumps and pipes Higher household spending People moving away Conflict over water No other impact

Have you received emergency financial aid during salty periods?

Yes No

Has the household or community set up measures against salty water?

The household only The community only Both Neither

If yes, which measures has the household put in place? Select all that apply

Rainwater harvesting Water filter Deeper borehole Buying water Storage tank Using another source

If not, why has the household not adopted any measure yet? Select all that apply

Cost Lack of information No technology available Not a priority Waiting for outside support Land constraints

In which year were the measures put in place?

If measures were adopted, what were the main reasons?

Protecting health Better taste Protecting crops Livestock needs Advice from others Support or subsidy available

What share of yearly household income would you spend on adaptation measures?

Nothing Up to 5% Between 5% and 10% Between 10% and 20% More than 20%

Have you received funding for these measures?

From government From an NGO From a community fund From family No funding received

Does the household plan a new measure in the coming months?

Yes No Not sure

With no limits at all, would you add another way to treat the water?

Yes No Not sure

Today, which of these activities is the groundwater still good for? Select all that apply

General comments

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