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DRAFT – EMBARGOED until Finalized

October 31, 2015
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Copyright © 2015

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Contents
Foreword.....................................................................................................................................................4
Overview of the ISWSH Assessment............................................................................................................5
Tool 1. Integrated Household Assessment Tools on Safe Water, Sanitation and Hygiene..........................9
Tool 2. Water Supply Facilities and Systems..............................................................................................31
Tool 3. Sanitation Facilities and Systems...................................................................................................69
Tool 4. Assessing Disaster Preparedness...................................................................................................87
Tool 5. Gender Analysis Tools for Safe Water, Sanitation and Hygiene.....................................................95
Tool 6. Indigenous Peoples and Muslim Practices on Water, Sanitation and Hygiene............................106
Tool 7. Assessing Potentials for Public-Private Partnership.....................................................................116
Tool 8. Assessment of the Organizational Capacities of the Municipal Government Including Existing
Partnerships with Civil Society Stakeholders towards Improved Governance of Safe Water, Sanitation
and Hygiene..............................................................................................................................................121
Foreword
Overview of the ISWSH Assessment

1. Objective of the ISWSH Assessment

The ISWSH Assessment aims to establish the baseline data and other critical information requirements
of the Joint Programme on Pro-WATER. Specifically, it seeks to establish the existing conditions of target
beneficiaries, with focus on women and girls, in terms of access to safe water, sanitation, and hygiene
both at the municipal and household levels in the ten target municipalities. The baseline assessment will
also look into the physical and social impacts of Climate Change in the target sites.

2. Design of the ISWSH assessment at the municipal and household levels

2.1 Household Level

An Integrated Household Baseline Questionnaire was developed by the Joint Programme Technical
Working Group to gather data and information on the current situation of 3,629 households, with
focus on women and girls, in terms of access to safe water, sanitation, and hygiene, in ten
municipalities in Regions 5, 8, and 9.

a. Criteria for Site Selection: Working on Pilot Areas

Ten (10) municipalities in Regions 5, 8, and 9 were selected under the programme based on:
 Priority Provinces under the Philippine Development Plan (2011-2016), which is
further categorized as follows :
 Provinces with highest magnitude of poor households, 2010;
 Provinces with highest poverty incidence based on population, 2012; and,
 Provinces exposed to multiple hazards, 2012
 Government agencies (especially DILG and DOH) convergence areas; and
 Waterless municipalities (or less than 50% access to water and sanitation services)
 IP and Muslim populated areas
 Conflict areas
 Upland, low land, and coastal areas
 Areas with high open defecation
 b. Sampling Design per Pilot Site

 Sample Size Calculation:

Sample Size = (Distribution of 50%) / ((Margin of Error% / Confidence Level Score) = 384.160
Squared)

 Finite Population Correction: = 383.838

True Sample = (Sample Size X Population) / (Sample Size + Population – 1)

 Confidence Level and Margin of Error

It describes that the results are accurate based on a 95% confidence level with a margin of error of 5% (based on
standard survey)

 Distribution of True Sample by Municipality1

Pop
True Sample True Sample
Municipality 2010 HH Number (with estimated average
by HH by Population
5 members/ HH

Aroroy 14,581 374.3235143 72905 382.1515617

Cawayan 13,316 373.4151992 66580 381.9618548

Monreal 5,008 356.8570178 25040 378.3702105

Bobon 4,191 351.9803767 20955 377.261807

Mapanas 2,371 330.7154849 11855 372.1324774

Siayan 6,994 364.2072342 34970 379.9964473

Sindangan 19,808 376.8699411 99040 382.6795125

Basud 8283 367.1749979 41415 380.6384396

Capalonga 6627 363.1626553 33135 379.7685076

Milagros 10290 370.3688879 51450 381.3202205

3,629 3,796

2.2 Municipal Level

Assessment tools developed at the municipal level include the following:

Tool 1 - Integrated Household Assessment Tool on Safe Water, Sanitation and Hygiene

Tool 2 - Water Supply Facilities and Systems

Tool 3 - Sanitation Facilities and Systems

Tool 4 - Assessing Disaster Preparedness

1
computation from http://fluidsurveys.com/university/calculating-right-survey-sample-size/
Tool 5 - Gender Analysis Tools for Safe Water, Sanitation and Hygiene

Tool 6 - IP and Muslim Practices on Safe Water, Sanitation and Hygiene

Tool 7 - Public – Private Partnerships for Safe Water, Sanitation and Hygiene

Tool 8 - Governance and Institution Building

The assessment process will vary depending on the data and information requirements of the tool.
This can be conducted through Key Informant Interviews (KIIs), Focus Group Discussions (FGDs), and
Desk Reviews.

Respondents to the assessment at the municipal level include the following:

Tool 1 - Integrated Household Assessment Tool  Heads of Households

on Safe Water, Sanitation and Hygiene

Tool 2 - Water Supply Facilities and Systems  Municipal Engineers

 Municipal Health Officers
 Water Service Providers (Water
District/BWSA/LGU-managed and Barangay-
managed Facilities)
 Barangay Health Workers
 Barangay Officials
Tool 3 – Sanitation Facilities and Systems  Municipal Engineers
 Municipal Health Officers
 Municipal Sanitation Engineers
 Heads of General Services Division
 Barangay Health Workers
 Barangay Officials
Tool 4 - Assessing Disaster Preparedness  Disaster Coordinating Officers
 Municipal Engineers
 Municipal Sanitation Engineers
 Women’s Groups
 Senior Citizens
 Barangay Health Workers
 Barangay Officials
Tool 5 - Gender Analysis Tools for Safe Water,  Gender Focal Persons of the Municipal
Sanitation and Hygiene Government
 GAD Focal Point
 Women’s Groups
 GAD Experts
 Men’s Group – e.g. Men Oppose to Violence
Everywhere (MOVE)
Tool 6 - IP and Muslim Practices on Safe Water,
Sanitation and Hygiene
Tool 7 - Public – Private Partnerships for Safe
Water, Sanitation and Hygiene
Tool 8 - Governance and Institution Building
 IP Women and Men
 Muslim Women and Men
 Business Groups
 Local Chambers of Commerce
 Business Women and Men
 Municipal Officials – Elected and Heads of
Offices
 Representatives from CSOs
Tool 1. Integrated Household Assessment Tools on Safe Water, Sanitation
and Hygiene

Dear Respondent:

The Department of the Interior and Local Government (DILG), together with the partners of the Joint Programme on
PRO-WATER, would like to solicit some information on your household to determine the present situation on safe
water, sanitation, and hygiene in your locality. We assure you that all responses will be treated with utmost
confidentiality.

Thank you for your trust and cooperation.

Para sa respondent:

Ang Kagawaran ng Interyor at Pamahalaang Lokal, kasama ang mga partner sa Joint Programme on PRO-WATER, ay nais
na humingi ng ilang impormasyon mula sa inyong kabahayan upang malaman ang kasalukuyang kalagayan tungkol sa
ligtas na tubig, sanitasyon at kalinisan sa iyong lokalidad. Tinitiyak naming sa inyo na ang lahat ng mga tugon ay itinuturing
na kompidensyal.

Maraming Salamat po sainyong iyong pagtitiwala at kooperasyon.

REGION (Rehiyon): PROVINCE (Lalawigan)

MUNICIPALITY (Bayan):
BARANGAY: PUROK:
HOUSEHOLD NUMBER (Bilang ng kabahayan):

NAME OF HOUSEHOLD HEAD (Pangalan ng Puno ng Kabahayan):

NAME OF RESPONDENT (Pangalan ng respondent): RELATIONSHIP TO HH HEAD(if respondent is other than

household head) – Relasyon sa Puno ng Kabahayan:

HH SURVEY RECORD
DATE (Petsa):
TIME STARTED (Oras nagsimula): TIME COMPLETED (Oras natapos):
REMARKS:

CERTIFICATION
I hereby certify that the data set forth were obtained/reviewed by me personally in accordance withthe instructions
given.

SIGNATURE OVER PRINTED NAME OF ENUMERATOR DATE

SIGNATURE OVER PRINTED NAME OF ASSESSMENT FACILITATOR DATE

 Region Rehiyon Province Lalawigan Municipality Bayan

Barangay Purok Household Number (Bilang ng

kabahayan):

All questions with an [ ] requires a check mark. Lahat ng tanong na may [ ] ay dapat sagutan gamit ang

check .

I. HOUSEHOLD COMPOSITION (KOMPOSISYON NG KABAHAYAN)

1. Name of Head of HH*:
Pangalan ng pinuno ng kabahayan

1.1. Who is the main income earner of the HH?[ ] Male Lalaki [ ] FemaleBabae
Sino ang pangunahing kumikita sa kabahayan? pls. specify

1.2. Who is responsible for the day-to-day affairs of the HH?[ ] Male Lalaki [ ] Female Babae
Sino ang responsable sa pang-araw-araw na gawain sa kabahayan? pls. specify

1.3. Indicate Educational Attainment of the respondent:

Piliin ang pinakamataas na antas ng pinag-aralan ng respondent

[ ] No formal schooling walang pormal na pag-aaral [ ] Elementary elementarya o mababang antas

[ ] High School mataas na antas [ ] Vocational bokasyonal o pagsasanay

[ ] College level nakaabot ng kolehiyo [ ] Others, pls. specify

*Note: If the head of the family is not available, the next option is the spouse, the eldest child and so on. Please make
sure that the respondent is 18 years old and above. Kung ang pinuno ng kabahayan ay hindi maaaring maaaring
kausapin, maaring kausapin ang asawa, panganay na anak. Siguraduhin na ang respondent ay 18 taong gulang o higit pa.

2. How many families are in the HH?Ilan ang bilang ng pamilya na nasa kabahayan?

Note: 1 HH can have 3-or more families. Ang isang kabahayanay maaaring may 3 pamilya o higit pa.

3. How many individuals are there in the HH?Ilang tao o indibidwal ang nasa kabahayan?

4. How many FEMALES are living in the household?Ilan ang BABAE sakabahayan?
Indicate number of girls aged 15 and below who are in
Indicate number by age school, out of schooland working: Indicate number of women
group: Ilista ang bilang ng mga babae na 15 taong gulang o who are:
Ilista ang bilang ayon sa masmababa na nag-aaral, hindi nag-aaral o Ilista ang bilang ng mga babae
kanilang edad : nagtatrabaho: na:

0-4 5-9 in schoolnag-aaral pregnantbuntis

10-14 15-19 out of school hindi nag-aaral
20-24 25-29 working nagtatrabaho nursing/lactatingnagpapasuso
30-34 35-39 PWD may kapansanan
 40-44 45-49 Indicate number of women and girls above 15 years old (persons with disability)
50-54 55-59 who are in school , out of school and working: IP (indigenous
60-64 65-69 people)kabilang sa katutubo
Ilista ang bilang ng mga babae na higit sa 15 taong gulang
70-74 75-79
na nag-aaral, wala sa paaralan o nagtatrabaho:
80 +

in school nag-aaral
out of school hindi nag-aaral

working nagtatrabaho
5. How many MALES are living in the household?Ilan ang LALAKI sa kabahayan?
Indicate number of boys aged 15 below who are in Indicate number of MALES
Indicate number by age school, out of school and working: who are:
group: Ilista ang bilang ng mga lalaki na 15 taong gulang o mas Ilista ang bilang ng mga lalaki
Ilista ang bilang ayon sa mababa na nag-aaral, wala sa paaralan o nagtatrabaho: na may kapansanan o kabilang
kanilang edad : sa katutubo:
in school nag-aaral
0-4 5-9 out of school hindi nag-aaral IP (indigenous people)
10-14 15-19 working nagtatrabaho
20-24 25-29 PWD (persons with
30-34 35-39 disability)
40-44 45-49 Indicate number of men and boys aged 15 above who are
50-54 55-59 in school , out of school and working:
60-64 65-69 Ilista ang bilang ng mga lalaki na higit sa 15 taong gulang
70-74 75-79 na nag-aaral, wala sa paaralan o nagtatrabaho:
80 +
in school nag-aaral
out of school hindi nag-aaral
working nagtatrabaho
6. Is the HH a part of any indigenous group?[ ] Yes Oo [ ] No Hindi
Ang kabahayan ba ay kabilang/kasapi sa grupo ng mga katutubo (IP)?

If yes, kindly specify what IP group? Kung OO, isulat kung anong pangalan ng grupo ng katutubo?

I. SOCIAL AFFILIATIONS
7. Are you or any household members a member of [ ] Yes Oo [ ] No Hindi
a Community/People’s Organization (PO)?
Ikaw ba o kahit na sinong miyembro ng kabahayan ay
kabilang sa isangsamahan/organisasyon o community
organization o people’s organization? Samahang
pangtao/samahang pangkomunidad o samahang
pangpamayanan?

Please state name of the organization/PO

Andyour/his/her current position?
Ano ang pangalan ng organisasyon? Ano ang
iyong/kanyangkasalukuyang katungkulan?
 NOTE: Paalala:
Can include organizations organized by national government Maaaring isama ang mga samahan na binuo ng mga
agencies (e.g. 4Ps of DSWD, Agrarian Reform Communities, ahensya ng pamahalaang nasyonal tulad ng 4Ps ng
etc.) DSWD, Agrarian Reform Communities)

[ ] Yes Oo [ ] No Hindi
7.1. If YES, is the organization/PO
water/sanitation/hygiene/gender-related?
Kung OO, ang organisasyon bang ito ay may kinalaman sa
usaping tubig, sanitasyon, kalinisan o pangkasarian?

What is its advocacy or mission?

Ano ang adbokasiya or misyon nito?

I. HOUSEHOLD ECONOMIC FEATURES

8. Income Source, Income and Expenses: Pinagmumulan ng Kita, Kita at Gastos ng Kabahayan
8.2. Annual Family Income
8.1. Source of Family Income (Please check as many as Taunang Kita ng Pamilya
possible)
Pinagmumulan ng Kita ng Pamilya (Lagyan ng check lahat ng
posibleng sagot)

[ ]Farming Pagsasaka
[ ]less than P20,000 mas mababa sa P20,000

[ ]P20,000 to P40,000
[ ]Livestock/Poultry Pag-aalaga ng mga hayop/ baboy, baka o manok
[ ]Fishing Pangingisda
[ ]P40,001 to 60,000

[ ]Regular employment Regular na trabaho

[ ]P60,001 to P80,000

[ ]Seasonal employment Hindi regular na trabaho

[ ]P80,001 to P100,000

[ ]Small enterprise/business Pagnenegosyo

[ ]above P100,000 higit sa P100,000

[ ]Remittances/pensions padalang pera mula sa ibang bansa/pensyon

[ ]Subsidies Subsidiyaplease specify (source & amount)

[ ]Other income Ibang pinagkukunan ng kitaplease specify
 8.3. Monthly HH expenses Buwanang gastos ng kabahayan

Item Rank according to

Importance (1-4) Amount range
Iranggo ng 1-4 (Please check
ayon sa one) Ranggo ng
kahalagahan presyo
Water
[ ] less than P1000 [ ] P1000-P5000 [ ] P5001 – P10000 [
] more than P10000

Food
[ ] less than P1000 [ ] P1000-P5000 [ ] P5001 – P10000 [
] more than P10000

Health/Medication
Kalusugan/Paggamot [ ] less than P1000 [ ] P1000-P5000 [ ] P5001 – P10000 [
] more than P10000

Sanitation & Hygiene Supplies

&Toiletries – e.g. soap, toothbrush, [ ] less than P1000 [ ] P1000-P5000 [ ] P5001 – P10000 [
toothpaste, shampoo ] more than P10000

9. Is your present residence (Please check one)Ang inyo bang kasulukuyang tirahan ay

[ ] OwnedSariling pagmamay-ari[ ] Rented Nangungupahan[ ] Others, pls. specify

10. Where is the household located? (Please check one)Saan matatagpuan ang inyong tirahan?

[ ] formal settlement (e.g. subdivision) [ ] informal settlement (e.g. slum areas)

Title Rights May titulo at karapatan Impormal na lugar

11. Which of these do you own? (Please check as

many as possible) Alin sa mga ito ang inyong pag-aari?

[ ] Residential lot (other than residence)

[ ] Machinery mga gamit na makinaryang pangbukid
Sariling lupa (maliban sa tinitirahan)
[ ] Backyard animals Hayop na pambahay
[ ] Residential house (other than residence)
[ ] Horse Kabayo
Sariling bahay (maliban sa tinitirahan)
[ ] Transport vehicles Sasakyan
[ ] Farm Bukid
[ ] Others, pls. specify
[ ] Farm animals Mga hayop sa bukid

. HOUSEHOLD EXPOSURE TO NATURAL HAZARDS

12. Is the household exposed to natural hazards? [ ] Yes Oo [ ] No Hindi [ ] I do not know Hindi ko alam
(Please check one) Ang inyong bang kabahayan ay
nakalantad/lantad sa likas na panganib?
 If the answer is YES, please answer questions
12a – 12h. If the answer is No, please proceed to
Section V.
If the answer is I do not know, try to ask
question 12.a.
12.a. What type of natural hazards were
experienced in the last 3 years:
(Pls. check all appropriate answers)
Anong uri ng likas na panganib ang naranasan sa
nakaraang 3 taon
12.b. Is the water supply facility affected by these
natural hazards? (Please check one)
Ang mga pasilidad ba ng pinagkukuhanan ng tubig ay
lantad sa likas na panganib?
If yes, how is the water supply facility or
water service affected?
(Pls. check all appropriate answers)
Kung oo, paano naaapektuhan ang pasilidad ng
pinagkukuhanan ng tubig?
12.c. What economic, social and health-related
impacts are experienced by the HH due to the
natural hazard affecting WATER SUPPLY?
(Pls. check all appropriate answers)
Anong pang-ekonomiya, panlipunan at pang-
kalusugan na epekto ang naranasan ng kabahayan
dahil sa epekto ng likas na panganib sa supply ng
tubig?
12.d. If the water supply service was affected by the natural hazard, how long before the water supply service was
restored? (Please check one) Kung ang serbisyo na supply ng tubig ay naapektuhan ng mga natural na panganib, gaano
katagal bago naibalik ang serbisyo na supply ng tubig?
[ ] 1-2 days [ ] 3-5 days [ ] 1 week
1-2 araw 3-5 araw 1 linggo
Kung ang sagot ay OO, sagutan ang mga tanong bilang 12.a –
12.h.
Kung ang sagot ay Hindi, dumeretso sa Section V.
Kung ang sagot ay Hindi ko alam, subukang sagutin ang 12.a.
[ ] flooding - pagbabaha
[ ] landslide – paguho ng lupa
[ ] earthquake - lindol
[ ] El Niño/La Niña – matinding tagtuyot o tag-ulan
[ ] tsunamis daluyong
[ ] tropical cyclone e.g. typhoon - bagyo
[ ] intense rainfall e.g. amihan, habagat
[ ] others e.g. volcanic eruption – pagputok ng bulkan
[ ] Yes Oo [ ] No Hindi [ ] I do not know Hindi ko alam
[ ] water supply interruption – pagkaantala ng supply ng tubig
[ ] poor water quality – mababang kalidad ng tubig
[ ] water rationing – pagrarasyon ng tubig
[ ] deterioration or destruction of facility – pagkasira ng
pasilidad
[ ] others, pls. specify
[ ] rise in water borne diseases – pagtaas ng kaso ng mga sakit
na kaugnay sa tubig
[ ] increased time spent on water collection – panahon para
kumuha ng tubig
[ ] loss of livelihood – pagkawala ng pangkabuhayan
[ ] additional expenses on water – dagdag na bayarin sa tubig
[ ] others, pls. specify
[ ] more than 1 week [ ] I do not know
higit isang lingo Hindi ko alam
 12.e. How was the water supply service restored? Paano naibalik ang supply ng tubig?(Please check all appropriate
answers)

[ ] self-help (e.g. bayanihan) [ ] LGU initiated [ ] private sector [ ] CSO/PO/Interest groups

12.f. Is the sanitation facility of the household affected [ ] Yes Oo [ ] No Hindi [ ] I do not know Hindi ko alam
by these natural hazards? (Please check one)
Apektado ba ng mga natural na mga panganib ang
pasilidad na pansanitasyon ng kabahayan?

If yes, how?
Kung oo, paano/papaano?
12.g. What economic, social and health-related impacts [ ] rise in open defecation – pagtaas ng kaso ng pagdumi sa
are experienced by the HH due to the natural hazard kung saan-saan
affecting SANITATION? (Please check all appropriate [ ] rise in water borne diseases – pagtaas ng kaso ng mga
answers)
sakit na kaugnay sa tubig
[ ] additional expenses on sanitation – dagdag na gastos sa
sanitasyon
Anong pang-ekonomiya, panlipunan at pang-kalusugan na [ ] loss of livelihood – pagkawala ng kabuhayan
epekto ang naranasan ng kabahayan dahil sa epekto ng [ ] others, pls. specify
likas na panganib sa pasilidad na pangsanitasyon?
12.h. How did the household cope with the supply / service interruption for:Paano kinaya ng kabahayan ang pagkaantala
ng supply o serbisyo sa tubig?

Water Supply facility:

Sanitation facility:

. HOUSEHOLD ACCESS TO WATER SUPPLY AND SERVICES

13. Where do you get water for the followingpurposes/uses:(Please check all appropriate answers)
Saan kayo kumukuha ng tubig para sa mga sumusunod na gawain/gamit:
Uses Level 1 Level 2 Level 3 Other
Gamit Read the Glossary of Terms (tap stand) (house Sources/Remarks
connection) e.g. water refilling,
Koneksyon ng bottled water
tubig diretso sa
bahay
Drinking [ ] shallow well
Pang-inom [ ] deep well
[ ] dug well
[ ] developed spring
[ ] others e.g. rainwater collector
Cooking [ ] shallow well
Pagluluto [ ] deep well
[ ] dug well
[ ] developed spring
[ ] others e.g. rainwater collector
Bathing [ ] shallow well
Paliligo [ ] deep well
[ ] dug well
[ ] developed spring
[ ] others e.g. rainwater collector
Cleaning [ ] shallow well
Paglilinis [ ] deep well
[ ] dug well
[ ] developed spring
[ ] others e.g. rainwater collector
Washing [ ] shallow well
Paglalaba [ ] deep well
[ ] dug well
[ ] developed spring
[ ] others e.g. rainwater collector
Farming activities [ ] shallow well
e.g. gardening, [ ] deep well
poultry, livestock [ ] dug well
Pagbubukid [ ] developed spring
[ ] others e.g. rainwater collector

14. How many containers* or cubic meters of waterare consumed by your household?Ilang
lalagyan o cubic meter ng tubig ang nagagamit ng kabahayan?
(*1 container is equivalent to 20 liters)Ang isang container ay may kapasidad na 20
litro.

During dry season:Sa panahon ng tag-tuyot During rainy season:Sa panahon ng tag-ulan
per day ORkada araw o per day ORkada araw o
per month kada buwan per month kada buwan

15. For Level 1 and 2 water users only. Para lamang sa gumagamit ng Level 1 at 2.
Distance and time spent in getting water?Layo at panahon na ginagamit para kumuha ng tubig?

Fetched by Any
Time Spent
(Please check all appropriate answers) Time of Day* constraints
Water for Distance (in minutes)
Kinukuha ng (Please check all /
Tubig para (in km)
Boys Girls appropriate challenges
sa Layo Men Women Panahon
Batang Batang answers) Oras sa (Please
Lalaki Babae (minuto)
lalaki babae isang araw specify)
Drinking [ ] 12:00 – 6:00 AM
Pang-inom [ ] 6 :00 – 11 :00 AM
[ ] 11 :00 – 1 :00 PM
[ ] 1 :00 – 5 :00 PM
[ ] 5 :00 – 7 :00 PM
[ ] 7 : 00 PM – 12:00
AM
Cooking [ ] 12:00 – 6:00 AM
Pagluluto [ ] 6 :00 – 11 :00 AM
[ ] 11 :00 – 1 :00 PM
[ ] 1 :00 – 5 :00 PM
 [ ] 5 :00 – 7 :00 PM
[ ] 7 : 00 PM – 12:00
AM
Bathing [ ] 12:00 – 6:00 AM
Paliligo [ ] 6 :00 – 11 :00 AM
[ ] 11 :00 – 1 :00 PM
[ ] 1 :00 – 5 :00 PM
[ ] 5 :00 – 7 :00 PM
[ ] 7 : 00 PM – 12:00
AM
Cleaning [ ] 12:00 – 6:00 AM
Paglilinis [ ] 6 :00 – 11 :00 AM
[ ] 11 :00 – 1 :00 PM
[ ] 1 :00 – 5 :00 PM
[ ] 5 :00 – 7 :00 PM
[ ] 7 : 00 PM – 12:00
AM
Washing [ ] 12:00 – 6:00 AM
Paglalaba [ ] 6 :00 – 11 :00 AM
[ ] 11 :00 – 1 :00 PM
[ ] 1 :00 – 5 :00 PM
[ ] 5 :00 – 7 :00 PM
[ ] 7 : 00 PM – 12:00
AM
Farming [ ] 12:00 – 6:00 AM
activities [ ] 6 :00 – 11 :00 AM
e.g. [ ] 11 :00 – 1 :00 PM
[ ] 1 :00 – 5 :00 PM
gardening,
[ ] 5 :00 – 7 :00 PM
poultry,
[ ] 7 : 00 PM – 12:00
livestock AM
Pagbubukid
16. For level 1 and 2 water users onlyPara sa mga gumagamit ng Level 1 at 2
On a scale of 1 to 3 where 1 is poor, 2 is fair, 3 is good, how would you rate the water supply facility in terms of
the following:(Please check all appropriate answers)Mula sa bilang na 1 – 3, 1 – hindi maayos, 2 – tama lang, 3 –
maayos, paano mo raranggohan ang mga pasilidad ng water supply ayon sa:
1 2 3
Particulars Reason(s)Mga dahilan

Accessibility (ease of access) – Dali sa pag-iigib ng tubig

Design of facility considered the needs of pregnant women/lactating

mothers, girls, senior citizens, PWDs – Disenyo ng pasilidad na
naaayon sa pangangailangan ng mga buntis, nagpapasusong mga ina,
batang babae, nakatatanda at may kapansanan

Safety - Kaligtasan
17. For all Level 1water users
On a scale of 1 to 3 where 1 is poor, 2 is fair, 3 is good, how would you rate the water supply services in
terms of the following:(Please check all appropriate answers)Mula sa bilang na 1 – 3, 1 – hindi maayos, 2 –
tama lang, 3 – maayos, paano mo raranggohan ang mga pasilidad ng water supply ayon sa:

1 2 3
Particulars Reason(s) Mga dahilan
Continuous or 24/7 service– tuluy-tuloy na serbisyo

Regular maintenance of facility (chlorination, leaks, change of gaskets.

Etc.) – Palagiang pagaayos ng pasilidad (pagkochlorinate, pagtingin
kung may sira)

Prompt action to complaints - mabilis na pagaksyon kung may

reklamo
Prompt/regular responses & feedback to users – regular na pagsagot
at pagbibigay ng feedback sa mga gumagamit
Affordability of fees – abot-kaya na bayarin

Special services e.g. priority lanes for pregnant women/lactating

mothers, senior citizens, PWDs, discounted rates for PWDs and senior
citizens, provision of complaints and action desk
May nakalaang serbisyo tulad ng priority lane para sa mga
kababaihan, buntis or nagpapasusong ina, nakatatanda at may
kapansanan, diskwento para sa mga may kapansanan at senior
citizen, pagkakaroon ng complaints at action desk
18. For all Level 2 & 3 water users.Para sa mga gumagamit ng Level 2 at 3.
On a scale of 1 to 3 where 1 is poor, 2 is fair, 3 is good, how would you rate the water supply services in
terms of the following: (Please check all appropriate answers) Mula sa bilang na 1 – 3, 1 – hindi maayos, 2 –
tama lang, 3 – maayos, paano mo raranggohan ang mga pasilidad ng water supply ayon sa:

1 2 3
Particulars Reason(s)

Continuous or 24/7 service – tuluy-tuloy na serbisyo

Prompt action to complaints - mabilis na pagaksyon kung may

reklamo
Prompt/regular responses & feedback to users – regular na pagsagot
at pagbibigay ng feedback sa mga gumagamit
Affordability of fees – abot-kaya na bayarin

Special services e.g. priority lanes for pregnant women/lactating

mothers, senior citizens, PWDs, discounted rates for PWDs and senior
citizens, provision of complaints and action desk
May nakalaang serbisyo tulad ng priority lane para sa mga
kababaihan, buntis or nagpapasusong ina, nakatatanda at may
kapansanan, diskwento para sa mga may kapansanan at senior
citizen, pagkakaroon ng complaints at action desk
19. Were there water quality problems encountered in the last six (6) [ ] Yes Oo [ ] No Hindi
months?(Please check one)Nagkaroon ba ng problema sa kalidad ng inyong tubig [ ] I do not know Hindi ko alam
sa nakaraang anim na buwan?
1 2
19.a. Observations (occasional) (most of the time) Please describe further the observation
(Please check one) Paminsan- Madalas Magbigay ng dagdag na obserbasyon
minsan
Turbid/unclear water
Hindi malinaw na tubig
Metallic taste
May lasang kalawang
na tubig
Salty water
Maalat na tubig
Bad smell
May amoy na tubig

20. Do you treat water at home?(Please check one)[ ] Yes Oo
Nililinis niyo ba ang inyong pang-inom na tubig?
21. What water treatment methods do you use?
(Please check all appropriate answers)
Paano ninyo nililinis ang inyong panginom na tubig?
[ ] No Hindi [ ] I do not know Hindi ko alam
[ ] boil the water – pagpapakulo ng tubig
[ ] chlorination/disinfection
[ ] filtration – paggamit ng filter
[ ] others, please specify

22. Where do you store your drinking water?

Saan ninyo inilalagay ang inyong tubig?

Note: Please inspect and describe actual storage condition

(container, location and possible sources of contamination).
Kung maaaring silipin at ilarawan kung ano ang kanilang
ginagamit na lagayan ng tubig, anong kondisyon at mga
posibleng
pinagmumulan ng kontaminasyon
23. Were there water service supply interruptions encountered [ ] Yes Oo [ ] No Hindi [ ] I do not know Hindi
in the last six (6) months?(Please check one) – Nagkaroon ko alam
ba ng pagkaantala sa supply ng inyong tubig sa nakaraang
anim na buwan?

If yes, specify the cause/reason for the interruption.

Kung OO, pakisulat ang dahilan sa pagkantala.

24. To whom or where do you go regarding complaints on [ ]Barangay

water service?(Please check all appropriate answers) – [ ] Municipal LGU
Kanino kayo lumalapit para magreklamo tungkol sa serbisyo [ ] Water Service Provider,
sa tubig?
Pleasespecify [ ] others, please

25. In case of service interruption, do you get prior notice? [ ] Yes Oo [ ] No Hindi [ ] I do not know Hindi
(Please check one) – Kung may pagkaantala, nakakatanggap ko alam
ba kayo ng babala?
[ ]written notice[ ] text message
If yes, how are you notified? (Please check all [ ] by word of mouth (verbal)
appropriate answers) [ ] barangay meeting [ ] community billboard
Kung OO, paano pinapaalam sa inyo?
[ ] public information system
[ ]others, pls. specify
VI. WATER FEES, POLICIES AND PROGRAMS
26. Name of Water Service Provider:
 (Please check all appropriate answers)
[ ] LGU-managed water facility (brgy,municipality) [ ] Water District
[ ] RWSA/BWSA [ ] Cooperative
[ ] Private [ ] Others, please specify:

27. Are you being charged for water fees?(Please check one) [ ] Yes Oo [ ] No Hindi
Nagbabayad ba kayo para sa tubig?

If yes, how much per month?Kung OO, magkano kada buwan?

per cubic meter per container/pail per HH (flat rate) others, pls. specify

28. Are you able to pay the water fees regularly?(Please check one) [ ] Yes Oo [ ] No Hindi
Regular ba kayong nakakabayad para sa tubig?

If No, please explain why? Kung hindi, maaari bang ipaliwanag?

29. Who provides the money for water fees?Sino ang nagbibigay ng bayad para sa tubig?

30. Are there penalties for non-payment of water fees? [ ] YesMeron[ ] None Wala
May mga parusa ba kung hindi nakakabayad ng tubig?

If Yes, what are the penalties?Kung Meron, ano ang mga parusa?
31. Are there incentive programs for good payers? [ ] Yes Oo [ ] None Wala
May mga insentibo ba kung nakakabayad ng tubig?

If Yes, what are these incentives?Kung Meron, ano ang mga

insentibo?

VII. HOUSEHOLD ACCESS TO SANITATION AND HYGIENE PRACTICES

32. Do you have a toilet? (Please check one)
Meron ba kayong kasilyas?

[ ] None Wala
[ ] Yes Oo If no, please proceed to Question 33
If yes, please answer Questions 32.a –32.f. Kung ang sagot ay WALA, pumunta sa tanong bilang
Kung ang sagot ay OO, pumunta sa tanong bilang 32.a – 32.f. 33.

32.a. Where is this located? Nasaan ang inyong kasilyas?

[ ] Inside the house Nasa loob ng bahay [ ] Outside the House Nasa labas ng bahay

32.b. What kind/type? Refer below. Note: Please inspect the actual toilet.
Anong klase ng kasilyas? Pumili sa listahan Kung maaaring inspeksyonin ang kasilyas.
 Description
[ ]Flush with septic tank [ ]Ventilated Improved Pit (VIP)
[ ]Pour flush with septic tank [ ]Pit Latrine* pls. answer #32.f.
[ ]Flush without septic tank [ ]Overhung
[ ]Pour flush without septic tank

32.c. Is the toilet used exclusively by HH?[ ] Yes Oo [ ] No Hindi

Ang kabahayan lang ba ang gumagamit ng kasilyas?

32.d. Is your toilet connected to a water source? (Please check [ ] Yes Oo [ ] No Hindi
one) Ang inyo bang kasilyas ay konektado sa isang water source?

32.e. If your toilet is connected to a septic tank, what do you [ ]de-sludge it – pagsipsip ng pozo
do when it is full? (Please check all appropriate) Kung negro
konektado ang inyong kasilyas sa septic tank, anong ginagawa
[ ]just leave it - hinahayaan na
ninyo kapag ito ay puno na?
lang
[ ] others, please specify

32.e. When was the last time you de-sludged your septic tank? Please specify month/year
(month/year) Kailan ninyo huling ipinalinis ang inyong septic Anong buwan at taon?
tank?
MM/YY

32.f. For pit latrines, what do you do when the pit is full? Para
sa mga pit latrine, ano ang ginagawa ninyo kapag ito ay puno
na?

33. Where do the household members defecate? (Please check all appropriate)
Saan kayo dumudumi?

[ ]public/communal toilet – pampubliko o pangmaramihang gamit na kasilyas

[ ]open field, pls. specify - parang
[ ]river/creeks/shores/canals – ilog/sapa/baybay/kanal
[ ]neighbor’s toilet – kasilyas ng kapitbahay
[ ]others, please specify
. For Public/Communal Toilet Users Para sa mga gumagamit ng pampubliko o communal na kasilyas?

On a scale of 1 to 3 where 1 is poor, 2 is fair, 3 is good, how would you rate the sanitation services in terms of the
following: (Please check all appropriate answers) Mula sa bilang na 1 – 3, 1 – hindi maayos, 2 – tama lang, 3 – maayos,
paano mo raranggohan ang mga pampubliko o communal na kasilyas ayon sa:

1 2 3
Particulars Reason(s)Dahilan

Accessibility (ease of access) – Dali sa paggamit ng mga pampubliko o

communal na kasilyas
Design of facility considered the needs of pregnant women/lactating mothers,
girls, senior citizens, PWDs – Disenyo ng pasilidad na naaayon sa
pangangailangan ng mga buntis, nagpapasusong mga ina, batang babae,
nakatatanda at may kapansanan

Safety - Kaligtasan
Continuous or 24/7 service – tuluy-tuloy na serbisyo

Prompt action to complaints - mabilis na pagaksyon kung may reklamo

Prompt/regular responses & feedback to users – regular na pagsagot at
pagbibigay ng feedback sa mga gumagamit
Affordability of fees – abot-kaya na bayarin

Special services e.g. priority lanes for pregnant women/lactating mothers,

senior citizens, PWDs, discounted rates for PWDs and senior citizens,
provision of complaints and action desk
May nakalaang serbisyo tulad ng priority lane para sa mga kababaihan, buntis or
nagpapasusong ina, nakatatanda at may kapansanan, diskwento para sa mga
may kapansanan at senior citizen, pagkakaroon ng complaints at action desk

[ ]before and after eating – bago at pagkatapos

35. In what instances or occasions do household members wash kumain
their hands? (Please check all appropriate)
[ ]after using the toilet – pagkatapos gumamit ng
Sa mga anong pagkakataon naghuhugas ng kamay ang
kasilyas
mga miyembro ng kabahayan?
[ ]after washing child’s bottom – pagkatapos
maglinis ng dumi ng bata
[ ]before and after handling food - bago at
pagkatapos maghanda ng pagkain
[ ]others, please specify

36. Do household members use soap when washing hands? [ ] Yes Oo [ ] No Hindi
Gumagamit ba ng sabon kapag naghuhugas ng kamay ang
mga miyembro ng pamilya?
If No, why are you not using soap?
Kung Hindi, bakit hindi sila gumagamit ng sabon?

37. Where do you usually wash your hands? Saan kayo naghuhugas ng inyong kamay
Note: Please ask permission if you can inspect condition of handwashing facility (distance from toilet, etc).
Magpaalam kung maaaring tingnan kung saan sila naghuhugas ng kamay.

38. Have you heard or received any messages about hygiene, [ ] Yes Oo [ ] No Hindi
cleanliness or hand washing? Meron ba kayong narinig na
mensahe tungkol sa hygiene, kalinisan o paghuhugas ng
kamay?
 38. a. If Yes, what is the message?
Kung OO, anong mensahe?
38. b. When was the message received?
Kelan natanggap ang mensahe?
38.c. From whom? Galing kanino?

39. Has anybody or any institution explained [ ] Yes Oo [ ] No Hindi

about sanitation issues to you? Mayroon bang ahensya o institusyon na nagpaliwanag sa inyo
tungkol sa sanitasyon?

VIII. INCIDENCES OF WATER AND SANITATION RELATED DISEASES

40. During the last six months, did any member of the family suffered from: (please put a check)
Sa nakaraang anim na buwan, may miyembro ba ng iyong pamilya ang nagkasakit ng:

Girls Women Pregnant Nursing/ Boys Men PWDs IPs

Diseases (0-21) (21 above) Lactating (0-21) (21
above)

Diarrhea

Schistosomiasis

Dengue Fever

Cholera

Typhoid and
Paratyphoid

Viral Hepatitis

Other water-borne
diseasesiba pang sakit
na nakukuha sa tubig
 IX. COMMUNICATION, INFORMATION AND PARTICIPATION

41. Please rank from 1-3 the top three sources where you acquire information on safe water, sanitation, and
hygiene practices. (Please read all the options)
Mula sa listahan, piliin kung saan kayo nakakakuha ng impormasyon tungkol sa malinis na tubig, sanitasyon, at hygiene o
gawaing pangkalinisan. Iranggo kung alin ang pinakamataas (1) hanggang pinakamababa (3) – Basahin ang mga
pagpipilian

family - pamilya (SMS) Text messaging

written notice from barangay/water service provider Social media (e.g. Twitter, Facebook, Instagram)
– notice mula sa barangay o water service provider friends and neighbors – mga kaibigan at kapitbahay
Barangay/BWSA/WSP meetings/assemblies barangay/family elders – mga nakakatanda
school, teachers, students - paaralan flyers,magazines, comics & other printed materials
children – mga bata community billboards, posters
NGOs, CSOs, POs Family Development Session (Municipal Link)
television - telebisyon Others, please specify
radio plugs - radyo
Barangay Health Workers

42. Have you seen posters, received brochures, heard [ ] Yes Oo [ ] No Hindi
something on the radio, and/or attended a
seminar/meeting/assembly on safe water, sanitation,
and hygiene practices in the past six months?
Nakakita na ba kayo ng mga poster, brochure, nakarinig sa radyo
o nakadalo sa mga pagpupulong tungkol sa ligtas na tubig,
sanitasyon at hygiene sa nakaraang anim na buwan?

[ ] Yes Oo [ ] No Hindi
42.a. Are there specific messages directed to WOMEN and
GIRLS being communicated by these materials or through
meetings/assemblies on safe waters, sanitation and hygiene?
Mayroon bang mensahe na patungkol sa mga KABABAIHAN sa
mga poster o pagpupulong na ito na may kaugnayan sa ligtas na
tubig, sanitasyon at hygiene?

If Yes, please specify content?

Kung OO, ano ang nilalaman ng mensaheng ito?

43. Are you aware of any laws, policies or ordinances [ ] Yes Oo [ ] No Hindi
on safe water, sanitation and hygiene?
May nalalaman ba kayong batas, polisiya o ordinansya tungkol sa
ligtas na tubig, sanitasyon at hygiene?

If Yes, please specify these laws, policies and ordinances?

Kung OO, ano ang mga batas, polisiya o ordinansyang ito?
44. Are youinformed about planned and on-going [ Yes Oo [ ] No Hindi
programs and projects on safe water, sanitation and hygiene?
Nalalaman mo ba kung may mga nakaplano o ipinatutupad na
programa o proyekto tungkol sa ligtas na tubig, sanitasyon at
hygiene?

If Yes, please specify these programs and projects?

Kung OO, ano ang mga programa at proyekto?

[ ] Yes Oo [ ] No Hindi
45. Do you participate in meetings and consultations
pertaining to the development and implementation (policy
making, planning, budgeting and monitoring) of programs
on safe water, sanitation and hygiene?
Nakikidalo ka ba sa mga pagpupulong o konsultasyon para sa
pagbuo at pagpapatupad ng mga programa tungkol sa ligtas na
tubig, sanitation at hygiene?

If Yes, in what capacity do you participate?

(Please check all appropriate answers) [ ]as a consumer – bilang konsumer
Kung OO, sa anong kapasidad ka dumadalo? [ ]as a member of CSO/PO – bilang miyembro ng
CSO/PO?
[ ]as an official of CSO/PO/barangay – bilang
opisyal ng CSO/PO/barangay
[ ]others, pls. specify
If No, why?
Kung hindi, bakit?

45.a. What issues and concerns do you usually raise during consultations and meetings on safe water, sanitation, and
hygiene?(Please check all appropriate answers)–Ano ang mga usapin at alalahanin ang kadalasan mong binabanggit
tuwing may mga pagpupulong o konsultasyon na tungkol sa ligtas na tubig, sanitasyon at hygiene?

[ ]affordability of service - abot-kayang halaga ng serbisyo [ ]water quality – kalidad ng tubig

[ ]accessibility – dali ng paggamit [ ]quality of service – kalidad ng serbisyo
[ ]consumer rights – karapatan ng mga konsumer [ ]water and sanitation policies- mga batas
[ ]others, pls. specify

45.b. Were any of your issues and concerns acted upon? [ ] Yes Oo [ ] No Hindi
Ang mga isyu bang ito ay nasolusyunan?

If Yes, what specific issues and concerns were acted

upon?
Kung OO, anong mga isyu ang na nasolusyunan?
What was the result?
Ano ang naging resulta?

If No, why?
Kung hindi, bakit?

46. At present, are you satisfied with the amount of [ ] Yes Oo [ ] No Hindi
information you receive on safe water, sanitation and
hygiene?
Sa kasalukuyan, nasisiyahan ka ba sa dami ng
impormasyon na natatanggap mo tungko sa ligtas na
tubig, sanitasyon at hygiene?

If No, why?
Kung hindi, bakit?

If the answer is No, what other information do you need on safe water, sanitation, and hygiene?(Please check all
appropriate answers) – Kung ang sagot ay Hindi, piliin kung anong impormasyon pa ang iyong kailangan tungkol sa ligtas
na tubig, sanitasyon at hygiene?

[ ]existing and recently concluded projects and programs on safe water, sanitation and hygiene
Mga kasalukuyan o katatapos pa lang na proyekto o programa tungkol sa ligtas na tubig, sanitasyon at hygiene
[ ]proper hand washing and other related hygiene practices
Tamang paghuhugas ng kamay at iba pang tamang gawain tungkol sa hygiene o kalinisan sa sarili
[ ] reports/updates on water borne diseases and other related health information
Mga report o update tungkol sa mga sakit na nakukuha sa tubig at iba pang impormasyon tungkol sa kalusugan
[ ] news/information on water service interruption and other related water supply information
Mga balita o impormasyon tungkol sa pagkaantala ng serbisyo sa tubig o iba pang impormasyon tungkol dito
[ ] notices of BWSA, Water District, LGU-managed Water Facility meetings
Mga paalala tungkol sa pagpupulong ng BWSA, water district, at pasilidad ng patubig
[ ] more news on BWSA, Water District, LGU-managed Water and water related issues in the barangay
Karagdagang balita tungkol sa mga usapin ng BWSA, water district, at patubig sa barangay
[ ] community-based activities and initiatives
Mga gawain sa komunidad na may kaugnayan sa ligtas na tubig, sanitasyon at hygiene
[ ]others, please specify

THANKYOUFORYOURTIMEANDCOOPERATION!
 General Guidelines on completing Tool 1 Integrated Household Baseline Questionnaire

1. The interviewer/enumerator should explain the reason, extent/coverage, and the duration of the survey in
simple and clear terms. Inform the interviewee that the survey will take around 30-45 minutes to finish.
Participation to the survey is voluntary, thus, the respondent has the right to refuse.
Dapatipaliwanag ng enumerator angdahilan, kabuuan at tagal ng survey sa simple at malinawnaparaan.
Ipaalamsaiinterbyuhinnaaabutin ng 30-45 minutoupangmataposang survey. Angpagsagotsa survey ay
hindisapilitan, kaya maaaringtumanggiangiinterbyuhin.

2. Once the respondent agrees to participate, make sure that he or she is the head of the household. In the
absence of the head of the family, the next option is the eldest child, relative, or other members of the
household living in the same household who are not below the age of 18.
Kapagpumayagangiinterbyuhin, siguraduhin na siya ay puno ngkabahayan. Kung walaang puno ngkabahayan,
maaaringinterbyuhinangpanganay na anak, kamag-anak o ibangmiyembrongkabahayan na hindi bababa sa
18 taonggulang.

3. Fill out the cover page of the questionnaire.

Sagutanangunangpahinang questionnaire

4. Interviews with respondents will be face-to-face using the HH baseline questionnaire. The questionnaire is in
English and Tagalog. The interviewer can translate it further to their local dialect.
Ang survey ay dapatgawinngharapangamitang Baseline Questionnaire. Ang questionnaire ay
nakasulatsaIngles at Tagalog. Maaaringmagtanonggamitanglokal na salita.

5. The interviewer/enumerator will read the questions, the options for possible responses (if provided), and
mark the respondent’s answers on the questionnaire. If respondents have difficulty comprehending some
questions, the interviewer/enumerator should further explain and/or cite examples or situations that the
respondents can relate to.
Babasahin ng interviewer angmgatanong, angmgapamimilian at sasagutanang questionnaire. Kung
nahihirapananginiinterbyunamaintindihanangtanong, maaaringipaliwanag o magbigay ng mgahalimbawa or
sitwasyonnanalalapitsainiinterbyu.

6. Majority of the questions in the tool is answerable by Yes or No, by putting a check mark in the appropriate
boxes. Some questions will require respondents to explain their answers, make sure that these are correctly
recorded in the space provided in the questionnaire.
Karamihansamgatanong ay masasagot ng OO at Hindi sapamamagitan ng paglalagay ng check sakahon. May
mgatanongnakailangan ng kanilangpaliwanag, kaya siguraduhinito ay naisulat ng tama sa questionnaire.

7. Ensure that respondents clearly understand questions that require numeric answers e.g. number of persons,
ranking, quantities of water, etc. to avoid discrepancies in survey results.
Siguraduhinnamalinawnanaiintindihan ng iniinterbyuangmgatanongnanangangailang ng sagotnabilangtulad
ng bilang ng mgatao, ranggo, dami ng tubig, atbp. upangmaiwasanangmgapagkakaibasasagot.

8. In completing each question of the tool, interviewer/enumerator should be guided by the following data to be
generated:
Sa pagsasagotng questionnaire, dapat na magsilbinggabayangmgaseksyon at datos na dapatmakuhamula sa
questionnaire:
 Section 1 – Household
Composition
Section 2 – Household Social
Affiliations
Section 3 – Household Economic
Features
Section 4 – Household Exposure
to Natural Hazards
Section 5 – Household Access to
Water Supply and Services
Section 6 – Water Fees, Policies,
and Programs
Section 7 – Household Access to
Sanitation and Hygiene Practices
Section 8 - Incidences of Water
and Sanitation related diseases
Section 9 – Communication,
Information, and Participation
9. Once the questionnaire is completed, record the time the interview ended. Thank the respondent for his/her
time and cooperation. Reassure the respondent that all the data and information gathered will be treated with
utmost confidentiality.
Questions 1-6  Demographic Profile of Households
Questions 7
Questions 8-11
Questions 12  Households’ vulnerability to
12a-12h potential climate and disaster
impacts related to damaged
facilities and interrupted water
supply and sanitation services.
Questions 13 - 25  Existing conditions of Households’
access to water supply and
services; challenges present and
coping mechanisms; level of
satisfaction on water supply
services.
Questions 26 - 31  Households’ capacity to pay water
fees; Policies/programs on water in
place.
Questions 32 - 39  Existing conditions of Households’
access to sanitation and hygiene
practices; level of satisfaction on
sanitation services
(public/communal sanitation
facilities)
Questions 40  Incidences of Water-borne
Diseases for the last six months
disaggregated by sex, age,
ethnicity, and other conditions e.g.
pregnant/lactating and disability.
Questions 41 - 46  Households’ level of awareness to
water and sanitation issues; access
to information on safe water,
sanitation and hygiene; level of
participation to water and
sanitation issues; opportunities for
participation; and information and
communication requirements on
safe water, sanitation, and
hygiene.
 Kapagnataposngsagutanang questionnaire, ilagayangoraskungkailannatapos. Pasalamatanangininterbyu sa
kanyapanahon at kooperasyon. Siguraduhinsaininterbyunalahat ng datos at impormasyonnanakalap ay
ituturingnakompidensyal.

10. The interviewer/enumerator will immediately report to theassessment facilitator/survey coordinator after the
completed surveys. The assessment facilitator will then check the filled-out household questionnaires for
completeness and quality.
Kailangangmagreportagadang interviewer sakanyang assessment facilitator/survey coordinator pagkatapos
ng survey. Kailangangi-check ng assessment facilitator angnasagutan ng household questionnaire kungito ay
kumpleto at naaayonsakalidad.

Guidelines for encoding

Reminder: The Regional Hub and LGUs must decide on who will encode the data into the online tool
from the paper questionnaire.

Paalala: Kailangangmagdesisyon ng Regional Hub at mga LGU kungsinoangmaglalagay ng

datosmulasa questionnaire papuntasa online tool.
1. Open your web browser.
Buksananginyong web browser.

2. Type in the link: https://goo.gl/SXm8SB.

I-type ang link naitosainyong browser: https://goo.gl/SXm8SB
3. The online tool is similar to the paper form. There are questions that need a check mark, choose from a
list or answer as how it was answered in the paper form.
Ang online tool ay katulad ng paper form. May mgatanongnakailanganglagyan ng check mark,
pumilisalistahan o sagutanayonsasagotsa paper form.
4. Items with a red asterisk * are required questions and must be completed.
May mgatanongsamayroongpulang asterisk * nakailangangsagutan at kumpletuhin.
5. Some questions require numerical answers. You will receive errors when you encode text instead of
numbers.
May ilangtanongnanangangailangan ng bilangnasagot. Makakakitaka ng paalalakapagletra at
hindinumeroangiyongisinagot.
6. Do not answer radio buttons if there are no answers in the paper form. Once you have clicked it, the
buttons will remain.
Huwagsagutanangmga radio button kungwalangsagotsa paper form. Kapagnalagyanito ng sagot,
hindinamatatanggalang button.
 7. At the end of the online tool, you will be prompted to check your responses before finally submitting the
form. Please make sure that you have encoded the responses accurately.

Sadulo ng online tool, may paalalanai-check muliangmgasagotbagoi-submit ang form.

Siguraduhing tama angmgasagotnainilagay
Tool 2. Water Supply Facilities and Systems

Tool 2A.1 - Level 1 Water Source Public Facility

(For Drinking and Cooking Purposes)

Municipality:
Name of Interviewer:
Date of Interview:
Name of Informant:
Position and Office of the Respondent:

Data Source/s2
Title of Source Document Date of Source Document Names of Persons/Institutions
who provided the Source
Documents

2
Data Source: From RHU, MHO and etc.

31
I. Information on Public Level 1 Water Source
Number of Public Level 1Water Sources
No. of No. of
No. of
No. of Sources Sources
Barangay Sources
Sources regularly with
with
with water tested for water
Water
treatment water quality
Permits
quality problems
Shallow
Covered/ Open Undeveloped
Deep Well / Developed Rain Water
Improved Dug Total
Well Jetmati Spring Spring Collector
Dug Well
c
Well
Pumps

(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13)
Note: Use additional Forms when necessary.
2. Information on Household Access to Level 1 Public Facility
Service
Fetching Fetching
Accessibility No. of REMARKS
Distance Time
Household
Barangay Total No. No. No. with access Indicate when applicable: common type of
Total
No. of of of of No. of to water 24 water treatment, water quality tests
No. of
Served HH HH HH HH hours/day conducted and its frequency, and water
House-
House- <250 >250 <30m >30mi quality problems at source; use additional
hold
hold m m in n sheets when necessary.
(1) (2) (3) (4) (5) (6) (7) (8) (9)

Use additional Forms when necessary

INSTRUCTIONS
1. Write the name of the Municipality
2. Write the name of the interviewer
3. Write the date of interview
4. Write the name of the informant
5. Write the position and department/office of the respondent
6. List the documents and sources of data, the dates of the document and the name of persons who provided the document.
7. Fill up the columns of the matrix on Information on Level 1 Water Source accordingly:
Column 1 - Names of Barangay
Column 2 - Number of public deepwell/s in the barangay.
Column 3 - Number of public shallow well / jetmatic pumps in the barangay.
Column 4 - Number of public covered/improved public dug well in the barangay.
Column 5 - Number of public developed spring in the barangay.
Column 6 - Number of public open dug well in the barangay.
Column 7 - Number of public undeveloped spring in the barangay.
Column 8 - Number of public rain water collectors in the barangay.
Column 9 - Total of Public Level 1 water systems in the barangay.
Column 10 - No. of Public Level 1 facilities with water treatment.
Column 11 - No. of Public Level 1 facilities regularly tested for water
quality. Column 12 – No. of Public Level 1 facilities with water quality
problems.
Column 13 - No. of Public Level 1 facilities with Water Permits.
8. Fill up the columns of the matrix on Information on Household Access to Level 1 Public Facility
accordingly: Column 1 - Names of Barangay
Column 2 - Total number of HH in the barangay
Column 3 - Total number of HH with access to Level 1 Public Facility
Column 4 - Total number of HH fetching water from Level 1 Public Facility less than (<) 250m away from water source
Column 5 - Total number of HH fetching water from Level 1 Public Facility more than (>) 250m away from water source
Column 6 - Total number of HH walking and fetching water from Level 1 Public Facility less than (<) 30 minutes from water source
Column 7 - Total number of HH walking and fetching water from Level 1 Public Facility more than (>) 30 minutes from water source
Column 8 - Total number of HH with access to water from Level 1 Public Facility 24 hours a day
Column 9 - Write additional comments and remarks as indicated: common type of water treatment, water quality tests conducted and its
frequency, and water quality problems at source
Tool 2A.2 - Individual Household Level 1 Water Facility
(For Drinking and Cooking Purposes)

Municipality:
Name of Interviewer:
Date of Interview:
Name of Informant:
Position and Office of the Respondent:

Data Source/s3
Title of Source Document Date of Source Document Names of Persons/Institutions
who provided the Source
Documents

3
Data Source: From RHU, MHO and etc.
 Number of Individual Household Level 1 Water Facility No. of No. of
No. of
No. of Facilities Facilities
Facilitie
Facilities regularly with
Barangay s with
with water tested for water
Water
treatment water quality
Permits
quality problems
Shallo
Covered/ Open Undeveloped Rain
Deep w Developed
Improved Dug Water Total
Well Well / Spring Spring
Dug Well Well Collector
Jetmati
c
Pumps

(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13)
Note: Use additional Forms when necessary.
INSTRUCTIONS
1. Write the name of the Municipality
2. Write the name of the interviewer
3. Write the date of interview
4. Write the name of the informant
5. Write the position and department/office of the respondent
6. List the documents and sources of data, the dates of the document and the name of persons who provided the document.
7. Fill up the columns of the matrix on Information on Individual Household Level 1 Water Facility
accordingly: Column 1 - Names of Barangay
Column 2 - Number of individual household deepwell/s in the barangay.
Column 3 - Number of individual household shallow well / jetmatic pumps in the barangay.
Column 4 - Number of individual household covered/improved public dug well in the barangay.
Column 5 - Number of individual household developed spring in the barangay.
Column 6 - Number of individual household open dug well in the barangay.
Column 7 - Number of individual household undeveloped spring in the barangay.
Column 8 - Number of individual household rain water collectors in the barangay.
Column 9 - Total of individual household Level 1 water systems in the barangay.
Column 10 - No. of individual household Level 1 facilities with water treatment.
Column 11 - No. of individual household Level 1 facilities regularly tested for water
quality. Column 12 – No. of individual household Level 1 facilities with water quality
problems.
Column 13 - No. of individual household Level 1 facilities with Water Permits.
Tool 2B - Level II Water Supply Facility/System
Municipality:
Form No. :

Name of Interviewer: Date of Interview:

Department/Office: Data Source/s :

Name/Position/Office:

Name of Level II Water Supply Service Provider:

Address : Year Designed / Constructed :

I. General Information
Population Served :
No. of HH Served :
Service Operation: □ 24/7 □ hours

Daily Water Demand: cmpd Served Area (%) during Peak Hour : □ 100% □ 75% □ 50%

List down technical personnel employed by the service provider Major equipment and tools to address emergencies including service
vehicles.
Position Number of Number of Total Equipment/Tools Quantity
Males Females
1. 1.
2. 2.
3. 3.
4. 4.
 List down major materials such as pipes, fittings, spare pump, generator,
water tanker (if any) for emergency purposes.
1. 5.
2. 6.
3. 7.
4. 8.

I. Water Source/s

□ Deepwell Casing ᴓ □ Spring □ River/Stream □ Others (specify) :

mm GPS Coordinates:
GPS Coordinates:
GPS Coordinates: GPS Coordinates:
w/ Water Permit? : Yes
w/ Water Permit? : Yes
No
w/ Water Permit? : Yes No w/ Water Permit? : Yes
No No
Max. Yield (lps) = Max. Yield (lps) = Max. Yield (lps) = Max. Yield (lps) =
Ave. Production (cmpd) = Ave. Production (cmpd) = Ave. Production (cmpd) = Ave. Production (cmpd) =

Method of construction: Spring Collection Box Intake Box & Treatment Plant
Method of Drilling: Please check Designed and constructed Designed and constructed
Rotary by qualified engr. by qualified engr.
Percussion / Cable Tool No technical design No technical design

Distance to Reservoir: Distance to Reservoir: Distance to Reservoir:

M M M
III. Transmission Line (if any: Total Length M)
REMARKS:
□ G.I. Pipes □ uPVC Pipes (Blue) □ HDPE / PB Pipes (Black)

Diameter = mm Diameter = mm Diameter = mm

Length = m Length = m Length = m
Buried Underground: Buried Underground: Buried Underground:
Yes No Yes No Yes No

IV. Pumping Machinery (if any)

REMARKS:
□ Submersible Pump □ Centrifugal Pump □ Vertical Turbine Pump

kW = TDH = kW = TDH = kW = TDH =

m m m
Q= lps Pumping Hrs. Q= lps Pumping Hrs. Q= lps Pumping Hrs.

Electric source: Pump Driven by: Pump Driven by:

Elect. Cooperative Electric Motor Electric Motor
Electric Generator Diesel Engine Diesel Engine
Solar Power Solar Power Solar Power
V. Reservoir

□ Elevated Concrete Reservoir □ Elevated Steel Reservoir □ Others (specify)

□ Ground Concrete Reservoir □ Ground Steel Reservoir

Capacity = cu.m. Capacity = cu.m. Capacity = cu.m.

L.O.L. = meters above ground L.O.L. = meters above ground L.O.L. = meters above ground

Designed and constructed by qualified engineer. Designed and constructed by qualified engineer. Designed and constructed by qualified engineer.

Yes No, if No, Yes No, if No, Yes No, if No,

who prepared design and supervise construction? who prepared design and supervise construction? who prepared design and supervise construction?

Operation of Reservoir : □ Floating-on-the-Line □ Fill & Draw

VI. Distribution Lines : Total Length meters

□ uPVC Pipes □ Polyethylene Pipes □ G. I. Pipes □ Steel Pipes □ Others:

Pipes ᴓ : mm Pipes ᴓ : mm Pipes ᴓ : mm Pipes ᴓ : mm Pipes ᴓ : mm

Length : M Length : M Length : M Length : M Length : M

1. Pipes laid at least 600mm below ground. Yes 1. Pipes laid below ground. Yes No
No
 2. Steel encasement provided on exposed pipes and 2. Permanent pipe supports provided on hanging pipes.
canal crossings, etc. Yes No Yes No.

3. Sand bedding provided Yes No

VII. Level II Connections: Total Quantity units

w/ Water Meter w/ functional Drainage Canal □ Single Tap w/ Concrete Platform

□ Yes □ No □ Yes □ No □ Double Tap □ Yes □ No

Women , Children, PWD Needs

Washing & Bathing

Located in well lighted area: Accessible to PWD:

□ Easy to open/close tap □Yes
□No
□ Yes □ No □ Yes □ No □ Automatic shut-off tap □Yes □ □ Yes □ No

VIII. Water Service Coverage

PUBLIC FAUCETS FETCHING DISTANCE REMARK
S
No. Name of Barangay Served No. of No. of HH No. of HH
No. of HH Population
Public fetching fetching
Served Served
Faucets <25m >25m
1

3
4
IX. Water Treatment Process (Mark all applicable boxes)

□ Coagulation □ Sedimentation □ Filtration □ Disinfection □ Storage □ None

1. Coagulation removes dirt and other particles suspended in water. Alum and other chemicals are added to water to form tiny sticky particles called "floc"
which attract the dirt particles. The combined weight of the dirt and the alum (floc) become heavy enough to sink to the bottom during sedimentation.
2. Sedimentation - The heavy particles (floc) settle to the bottom and the clear water moves to filtration.
3. Filtration - The water passes through filters, some made of layers of sand, gravel, and charcoal that help remove even smaller particles.
4. Disinfection - A small amount of chlorine is added or some other disinfection method is used to kill any bacteria or microorganisms that may be in the water.
5. Storage - Water is placed in a closed tank or reservoir in order for disinfection to take place. The water then flows through pipes to homes and businesses in
the community.

X. Water Quality Problems (Mark all applicable boxes)

□ Coliform bacteria, □ Chloride (Cl) □ Manganese (Mn) □ Hardness (Ca & Mg) □ Iron (Fe)
Fecal bacteria, E. coli
bacteria
SYMPTOMS SYMPTOMS
Persistent gastrointestinal Salty taste, corrosion of Black specks or black stains, Grayish white film in sinks, Water which is initially clear
illnesses, odor may or may metals. metallic tasting water. tubs, dishes, reduced suds in but produces brown, orange
not be present. Standing water (tub or toilet laundry, scale in teapots. or red- dish stains or
tank) may appear gray or sediment, metallic tasting
black. water.
XI. Water Quality Test/s Being Conducted (Mark all applicable boxes)

□ Bacteriological □ Physical □ Chemical □ Mineral □ Others: □ No

Coliform bacteria, Fecal (Chlorine, Fluoride, (Magnesium, Calcium, Test
bacteria, E. coli bacteria Odor and color Pesticides, etc.) Sodium, etc.) Conducted
Frequency: Frequency: Frequency: Frequency: Frequency:
□ Daily □ Daily □ Daily □ Daily □ Daily

□ Weekly □ Weekly □ Weekly □ Weekly □ Weekly

□ Monthly □ Monthly □ Monthly □ Monthly □ Monthly

□ Quarterly □ Quarterly □ Quarterly □ Quarterly □ Quarterly

□ Yearly □ Yearly □ Yearly □ Yearly □ Yearly

□ Others □ Others □ Others □ Others □ Others

XII. Tariff Schedule (Fill-up only the appropriate tariff structure)

□ Tariff Imposed □ No Tariff Imposed

by Consumer ₱ / person
by Household ₱ / household
by Volume ₱ / cu.m.
XIII. Potential Contamination Risks Present in the System and Consumer Complaints
13.1 Contamination Risks Present at the Water Source(s)
13.1.A Spring Source

□ Damaged / unrepaired Spring Box □ Unscreened air vent of spring box □ Flood / run-off

□ Area not protected (guard / fence) □ □ Others (Specify)

13.1.B Deep Well / Shallow Well / Dug Well

□ Septic tanks □ Landfill, garbage dumpsite in nearby area □ Uncapped well / No proper cover

□ No platform / Grout seal / Sanitary Seal □ Unprotected Pumping Station □ Underground storage tank
(fence / guard)

13.1.C River / Stream

Are there human habitation upstream, Are there farm animals upstream, polluting Are there crop productions or industrial

polluting the source? □Yes the source? □Yes □No pollution upstream? □Yes □No
□No
□ Unprotected intake installation □ Unscreened intake □ Others (Specify)
(fence / guard)
13.2 Water Reservoir
Are there unrepaired leaks in the Is there manhole cover on access inside Is the reservoir area protected like

reservoir? □Yes □No the tank? □Yes □No fence or guarded? □Yes
□No
Is there regular cleaning /disinfection of Are Air Vents & Overflow pipes

the reservoir? □Yes □No provided with insects screen? □Yes

□No
13.3 Distribution Network
Are there unrepaired leaks along the Pipes laid along/across drainage canals Tapping from mainline is being done by

pipelines? □Yes □Yes □No authorized person? □Yes

□No □No
Regular flushing / disinfection done and
□ □
after any repair □Yes □No
13.4 Public Faucets

□ Leaks □ Stagnant Water – no proper drainage □ Unsanitary human practices

 13.5 Consumer Complaints on Water Quality (in the last 6 months)
(Mark appropriate boxes)

□ Taste □ Odor □ Color □ Other (Specify)

XIV. Risk from Natural Hazard

Impacts /
Potential Natural Solutions Done / to be Done List of Historical Natural
Damage/s by the results of
System Components Hazard to withstand natural hazards Hazard
Natural Hazards
(Select from list) (Use separate paper if needed)
(Use separate paper if needed)

1. Drought
14.1 Water Source
14.1.A Deep Well / Shallow 2. Flood

Well / Dug Well 3. Typhoon /

Hurricane
14.1.B Spring
4. Landslide

14.1.C Surface Water 5. Volcanic Activity

6. Earthquake
14.2 Pumping Machinery

14.3 Transmission Line

14.4 Reservoir
14.5 Distribution System

14.6 Connection (Public Taps)

INSTRUCTIONS FOR ACCOMPLISHING TOOL 2B - LEVEL II WATER SUPPLY FACILITY / SYSTEM

This form will be accomplished by a technical person/s from service provider.

I. General Information
- Population Served / Household Served – Current population / number of household served by the water service provider.
- Service Operation – Check (√) 24/7 if water is available 24 hours a day, or indicate how many hours water is available in a day.
- Daily Water Demand – 100 liters per capita per day for Level III and 60 liters per capita per day for Level II.
- Served Area during Peak Hour – Check (√) percentage of service area served during peak hour (time where almost every HH has open tap, usually occurs
in the morning).

II. Water Sources – Check (√) what water source is being used for the water system.
- Max. Yield - Maximum discharge of the source in liter/seconds (lps)
- Ave. Production - Average volume of water produced per day in cubic meters per day (cmpd)
- Method of drilling (for deepwells only) - Check (√) the method used
- Spring collection box and Intake box – indicate if it was designed and supervised construction by qualified technical person.

III. Transmission Line - Check (√) materials used for transmission line (if any)
- Indicate pipe diameters
- Estimated length per size / per kind
- Check (√) yes or no, if pipes are buried below ground or not
- Add additional information if any.

IV. Pumping Machinery (if any)

- Check (√) kind of pumped installed
- Indicate its capacity (kW, TDH, Q) and pumping hours
- Check (√) appropriate source of energy/power (elect coop, genset, solar, etc)

V. Reservoir
- Check (√) kind of reservoir
- Indicate its capacity and lower operational level, (vertical distance from ground to the reservoir’s minimum operational level).
- Indicate if the reservoir was designed and supervised construction by qualified technical person.
- Operation of Reservoir
 Floating-on-the-Line – Water is pumped into the reservoir and to the consumers simultaneously.
Fill and Draw – Water is pumped directly to the reservoir, and from reservoir, water supply is distributed to the consumers through gravity flow.

VI. Distribution Lines

- Check (√) kind pipes used, estimated length per size
- Check (√) yes or no, if pipes are buried below ground or not.
- Check (√) yes or n o, if encasement was provided on exposed portion of plastic pipes.
- Check (√) yes or no, if sand bedding was provided for plastic pipes buried on rocky areas.
- Check (√) yes or no, if hanging pipes are properly supported

VII. Level II Connections

- Indicate number of units of Level II Connections
- Check (√) yes or no, if water meter is installed
- Check (√) yes or no, if there is proper drainage canal
- Check (√) if Level II connection has single or two taps
- Check (√) yes or no, if concrete platform is provided
- Check (√) yes or no, if the Level II connections is located in easy to access area and well lighted location.
- Check (√) if taps are users friendly especially for children and PWDs
- Check (√) yes or no, if bathing and washing is allowed in public faucets.

Level III Connections

- Fill-out table

VIII. Water Service Coverage

- Fill-out the table

IX. Water Treatment Process

- Check (√) treatment process (if any). Process is explained in the form.

X. Water Quality Problems

- Check (√) water quality problem/s encountered, if any. Symptoms are explained in the form.

XI. Water Quality Test Being Conducted

 - Check (√) quality test being conducted and schedule of testing

XII. Tariff Schedule

- Fill-out appropriate tariff structure, if /person, /HH, /cu.m. Indicate the amount.

XIII. Potential Contamination Risks Present in the System and Consumer Complaint
Water Source:
- Spring
1. Damaged/unrepaired spring box – Spring box may have cracks, broken manhole cover, wherein, there is a chance of small animals such as rats,
snakes, insects, etc and rainwater run-off to get inside the structure which might contaminate the water.
2. Unscreened air vent – Screen on air vent will prevent small animals to get inside the spring box. Check if the vent is screened or not
3. Area not protected – The area should be well fenced to protect big animals and unauthorized person to get inside the protected area. Also, presence
of caretaker or guard is a must. Check if not protected.

- Wells:
1. Check if the well is near (15m or less) from the septic tank
2. Check if no platform, grout seal/sanitary seal on well.
3. Check if there is landfill, garbage dumpsite in nearby area.
4. Check if pumping station is not fenced and not guarded
5. Check if well is not properly covered.
6. Check if there is an underground storage (fuel) in nearby area.

- River/Stream
1. Check current situation in upstream of the river/stream. Check appropriate answer. Similar to spring box, is the area well protected?

- Water Reservoir
1. Similar to spring box, are there leaks, unscreened vent, etc.
2. Is there a regular cleaning and disinfection of the reservoir.

- Distribution Network
1. Check only appropriate answer.

- Public Faucets
 1. Check only appropriate answer.
2. Unsanitary practices – leaving waste, such as baby diapers, sanitary napkins, left-over food, etc. around the public standpost.

XIV. Historical Risk from Natural Hazard

- List of Natural Hazard is listed in the form for easy reference.
- Indicate possible impacts or damages by the result of these hazard
- Indicate solutions already done or to be done to withstand these hazards.
Tool 2C - Level III Water Supply Facility/System
Instructions: This form is intended for existing Level 3 Water Supply Facility/System operating within the Municipality.

One form per Water Supply Service Provider (i.e. Water District, LGU Run System, BWASA, Private System)

Municipality:
Form No. :

Name of Interviewer: Date of Interview:

Department/Office: Data Source/s :

Name/Position/Office:

Name of Level III Water Supply Service Provider:

Address : Year Designed / Constructed :

II. General Information

Population Served :
No. of HH Served :
Service Operation: □ 24/7 □ hours

Daily Water Demand: cmpd Served Area (%) during Peak Hour : □ 100% □ 75% □ 50%

List down technical personnel employed by the service provider Major equipment and tools to address emergencies including service
vehicles.
Position Number of Number of Total Equipment/Tolls Quantity
Males Females
 1. 1.
2. 2.
3. 3.
4. 4.
List down major materials such as pipes, fittings, spare pump, generator, water
tanker (if any) for emergency purposes.
1. 5.
2. 6.
3. 7.
4. 8.

II. Water Source/s

□ Deepwell Casing ᴓ □ Spring □ River/Stream □ Others (specify) :

mm GPS Coordinates:
GPS Coordinates:
GPS Coordinates: GPS Coordinates:
w/ Water Permit? : Yes
w/ Water Permit? : Yes
No
w/ Water Permit? : Yes No w/ Water Permit? : Yes
No No
Max. Yield (lps) = Max. Yield (lps) = Max. Yield (lps) = Max. Yield (lps) =
Ave. Production (cmpd) = Ave. Production (cmpd) = Ave. Production (cmpd) = Ave. Production (cmpd) =

Method of construction: Spring Collection Box Intake Box & Treatment Plant
Method of Drilling: Please check Designed and constructed Designed and constructed
Rotary by qualified engr. by qualified engr.
Percussion / Cable Tool No technical design No technical design
 Distance to Reservoir: Distance to Reservoir: Distance to Reservoir:
M M M

III. Transmission Line (if any: Total Length M)

REMARKS:
□ G.I. Pipes □ uPVC Pipes (Blue) □ HDPE / PB Pipes (Black)

Diameter = mm Diameter = mm Diameter = mm

Length = m Length = m Length = m
Buried Underground: Buried Underground: Buried Underground:
Yes No Yes No Yes No

IV. Pumping Machinery (if any)

REMARKS:
□ Submersible Pump □ Centrifugal Pump □ Vertical Turbine Pump

kW = TDH = kW = TDH = kW = TDH =

m m m
Q= lps Pumping Hrs. Q= lps Pumping Hrs. Q= lps Pumping Hrs.

Electric source: Pump Driven by: Pump Driven by:

Elect. Cooperative Electric Motor Electric Motor
Electric Generator Diesel Engine Diesel Engine
Solar Power Solar Power Solar Power
V. Reservoir

□ Elevated Concrete Reservoir □ Elevated Steel Reservoir □ Others (specify)

□ Ground Concrete Reservoir □ Ground Steel Reservoir

Capacity = cu.m. Capacity = cu.m. Capacity = cu.m.

L.O.L. = meters above ground L.O.L. = meters above ground L.O.L. = meters above ground

Designed and constructed by qualified engineer. Designed and constructed by qualified engineer. Designed and constructed by qualified engineer.

Yes No, if No, Yes No, if No, Yes No, if No,

who prepared design and supervise construction? who prepared design and supervise construction? who prepared design and supervise construction?

Operation of Reservoir : □ Floating-on-the-Line □ Fill & Draw

VI. Distribution Lines : Total Length meters

□ uPVC Pipes □ Polyethylene Pipes □ G. I. Pipes □ Steel Pipes □ Others:

Pipes ᴓ : mm Pipes ᴓ : mm Pipes ᴓ : mm Pipes ᴓ : mm Pipes ᴓ : mm

Length : M Length : M Length : M Length : M Length : M

4. Pipes laid at least 600mm below ground. Yes 3. Pipes laid below ground. Yes No
No
4. Permanent pipe supports provided on hanging pipes.
5. Steel encasement provided on exposed pipes and Yes No.
canal crossings, etc. Yes No
 6. Sand bedding provided Yes No

VII. Details of Water Service Coverage/Concession Area

CUSTOMER
DETAILS
Household Connections School Connections Commercial Connections

Ave. Ave.
No. Name of Barangay Served No. of Usage Ave. Usage
No. of
Individu Population per HH No. of Usage No. of comm’l per HH
Connection/s Population
al HH Served Schools per HH Establishment
w/ Meter (m3 / (m3 /
Served s
month) (m3 / month)
month)

4
VIII. Water Treatment Process (Mark all applicable boxes)

□ Coagulation □ Sedimentation □ Filtration □ Disinfection □ Storage □ None

6. Coagulation removes dirt and other particles suspended in water. Alum and other chemicals are added to water to form tiny sticky particles called "floc"
which attract the dirt particles. The combined weight of the dirt and the alum (floc) become heavy enough to sink to the bottom during sedimentation.
7. Sedimentation - The heavy particles (floc) settle to the bottom and the clear water moves to filtration.
8. Filtration - The water passes through filters, some made of layers of sand, gravel, and charcoal that help remove even smaller particles.
9. Disinfection - A small amount of chlorine is added or some other disinfection method is used to kill any bacteria or microorganisms that may be in the water.
10. Storage - Water is placed in a closed tank or reservoir in order for disinfection to take place. The water then flows through pipes to homes and businesses in
the community.

IX. Water Quality Problems (Mark all applicable boxes)

□ Coliform bacteria, □ Chloride (Cl) □ Manganese (Mn) □ Hardness (Ca & Mg) □ Iron (Fe)
Fecal bacteria, E. coli
bacteria
SYMPTOMS SYMPTOMS
Persistent gastrointestinal Salty taste, corrosion of Black specks or black stains, Grayish white film in sinks, Water which is initially clear
illnesses, odor may or may metals. metallic tasting water. tubs, dishes, reduced suds in but produces brown, orange
not be present. Standing water (tub or toilet laundry, scale in teapots. or red- dish stains or
tank) may appear gray or sediment, metallic tasting
black. water.

X. Water Quality Test/s Being Conducted (Mark all applicable boxes)

□ Bacteriological □ Physical □ Chemical □ Mineral □ Others: □ No

Coliform bacteria, Fecal (Chlorine, Fluoride, (Magnesium, Calcium, Test
bacteria, E. coli bacteria Odor and color Pesticides, etc.) Sodium, etc.) Conducted
Frequency: Frequency: Frequency: Frequency: Frequency:

□ Daily □ Daily □ Daily □ Daily □ Daily

 □ Weekly □ Weekly □ Weekly □ Weekly □ Weekly

□ Monthly □ Monthly □ Monthly □ Monthly □ Monthly

□ Quarterly □ Quarterly □ Quarterly □ Quarterly □ Quarterly

□ Yearly □ Yearly □ Yearly □ Yearly □ Yearly

□ Others □ Others □ Others □ Others □ Others

XI. Tariff Schedule (Fill-up only the appropriate tariff structure)

□ Tariff Imposed □ No Tariff Imposed

by Consumer ₱ / person
by Household ₱ / household
by Volume ₱ / cu.m.

XII. Potential Contamination Risks Present in the System and Consumer Complaints
12.1 Contamination Risks Present at the Water Source(s)
12.1.A Spring Source

□ Damaged / unrepaired Spring Box □ Unscreened air vent of spring box □ Flood / run-off

□ Area not protected (guard / fence) □ □ Others (Specify)

12.1.B Deep Well / Shallow Well / Dug Well

□ Septic tanks □ Landfill, garbage dumpsite in nearby area □ Uncapped well / No proper cover
 □ No platform / Grout seal / Sanitary Seal □ Unprotected Pumping Station □ Underground storage tank
(fence / guard)

12.1.C River / Stream

Are there human habitation upstream, Are there farm animals upstream, polluting Are there crop productions or industrial

polluting the source? □Yes the source? □Yes □No pollution upstream? □Yes □No
□No
□ Unprotected intake installation □ Unscreened intake □ Others (Specify)
(fence / guard)

12.2 Water Reservoir

Are there unrepaired leaks in the Is there manhole cover on access inside Is the reservoir area protected like

reservoir? □Yes □No the tank? □Yes □No fence or guarded? □Yes
□No
Is there regular cleaning /disinfection of Are Air Vents & Overflow pipes

the reservoir? □Yes □No provided with insects screen? □Yes

□No
12.3 Distribution Network
Are there unrepaired leaks along the Pipes laid along/across drainage canals Tapping from mainline is being done by

pipelines? □Yes □Yes □No authorized person? □Yes

□No □No
Regular flushing / disinfection done and
□ □
after any repair □Yes □No
12.4 Public Faucets

□ Leaks □ Stagnant Water – no proper drainage □ Unsanitary human practices

12.5 Consumer Complaints on Water Quality (in the last 6 months)

(Mark appropriate boxes)

□ Taste □ Odor □ Color □ Other (Specify)

XIV. Historical Risk from the Natural Hazard
Historical Natural
Hazard Possible Impacts /
Solutions Done / to be Done List of Potential
(Select from Damage/s by the results of
System Components to withstand natural hazards Natural Hazard
list, write only Natural Hazards
(Use separate paper if needed)
corresponding (Use separate paper if needed)
number))
14.1 Water Source
14.1.A Deep Well / Shallow 1. Drought
Well / Dug Well
2. Flood
14.1.B Spring
3. Landslide

14.1.C Surface Water 4. Typhoon

5. Volcanic Activity
14.2 Pumping Machinery
6. Earthquake

14.3 Transmission Line

14.4 Reservoir

14.5 Distribution System

14.6 Connection (Public Taps)

INSTRUCTIONS ON HOW TO accomplish TOOL 2C - LEVEL III WATER SUPPLY FACILITY / SYSTEM

This form will be accomplished by a technical person/s from service provider.

I. General Information
- Population Served / Household Served – Current population / number of household served by the water service provider.
- Service Operation – Check (√) 24/7 if water is available 24 hours a day, or indicate how many hours water is available in a day.
- Daily Water Demand – 100 liters per capita per day for Level III and 60 liters per capita per day for Level II.
- Served Area during Peak Hour – Check (√) percentage of service area served during peak hour (time where almost every HH has open tap, usually occurs
in the morning).

II. Water Sources – Check (√) what water source is being used for the water system.
- Max. Yield - Maximum discharge of the source in liter/seconds (lps)
- Ave. Production - Average volume of water produced per day in cubic meters per day (cmpd)
- Method of drilling (for deepwells only) - Check (√) the method used
- Spring collection box and Intake box – indicate if it was designed and supervised construction by qualified technical person.

III. Transmission Line - Check (√) materials used for transmission line (if any)
- Indicate pipe diameters
- Estimated length per size / per kind
- Check (√) yes or no, if pipes are buried below ground or not
- Add additional information if any.

IV. Pumping Machinery (if any)

- Check (√) kind of pumped installed
- Indicate its capacity (kW, TDH, Q) and pumping hours
- Check (√) appropriate source of energy/power (elect coop, genset, solar, etc)

V. Reservoir
- Check (√) kind of reservoir
- Indicate its capacity and lower operational level, (vertical distance from ground to the reservoir’s minimum operational level).
- Indicate if the reservoir was designed and supervised construction by qualified technical person.
- Operation of Reservoir
 Floating-on-the-Line – Water is pumped into the reservoir and to the consumers simultaneously.
Fill and Draw – Water is pumped directly to the reservoir, and from reservoir, water supply is distributed to the consumers through gravity flow.

VI. Distribution Lines

- Check (√) kind pipes used, estimated length per size
- Check (√) yes or no, if pipes are buried below ground or not.
- Check (√) yes or n o, if encasement was provided on exposed portion of plastic pipes.
- Check (√) yes or no, if sand bedding was provided for plastic pipes buried on rocky areas.
- Check (√) yes or no, if hanging pipes are properly supported

VII. Level II Connections

- Indicate number of units of Level II Connections
- Check (√) yes or no, if water meter is installed
- Check (√) yes or no, if there is proper drainage canal
- Check (√) if Level II connection has single or two taps
- Check (√) yes or no, if concrete platform is provided
- Check (√) yes or no, if the Level II connections is located in easy to access area and well lighted location.
- Check (√) if taps are users friendly especially for children and PWDs
- Check (√) yes or no, if bathing and washing is allowed in public faucets.

Level III Connections

- Fill-out table

VIII. Water Service Coverage

- Fill-out the table

IX. Water Treatment Process

- Check (√) treatment process (if any). Process is explained in the form.

X. Water Quality Problems

- Check (√) water quality problem/s encountered, if any. Symptoms are explained in the form.

XI. Water Quality Test Being Conducted

 - Check (√) quality test being conducted and schedule of testing

XII. Tariff Schedule

- Fill-out appropriate tariff structure, if /person, /HH, /cu.m. Indicate the amount.

XIII. Potential Contamination Risks Present in the System and Consumer Complaint
Water Source:
- Spring
4. Damaged/unrepaired spring box – Spring box may have cracks, broken manhole cover, wherein, there is a chance of small animals such as rats,
snakes, insects, etc and rainwater run-off to get inside the structure which might contaminate the water.
5. Unscreened air vent – Screen on air vent will prevent small animals to get inside the spring box. Check if the vent is screened or not
6. Area not protected – The area should be well fenced to protect big animals and unauthorized person to get inside the protected area. Also, presence
of caretaker or guard is a must. Check if not protected.

- Wells:
7. Check if the well is near (15m or less) from the septic tank
8. Check if no platform, grout seal/sanitary seal on well.
9. Check if there is landfill, garbage dumpsite in nearby area.
10. Check if pumping station is not fenced and not guarded
11. Check if well is not properly covered.
12. Check if there is an underground storage (fuel) in nearby area.

- River/Stream
2. Check current situation in upstream of the river/stream. Check appropriate answer. Similar to spring box, is the area well protected?

- Water Reservoir
3. Similar to spring box, are there leaks, unscreened vent, etc.
4. Is there a regular cleaning and disinfection of the reservoir.

- Distribution Network
2. Check only appropriate answer.

- Public Faucets
 3. Check only appropriate answer.
4. Unsanitary practices – leaving waste, such as baby diapers, sanitary napkins, left-over food, etc. around the public standpost.

XIV. Historical Risk from Natural Hazard

- List of Natural Hazard is listed in the form for easy reference.
- Indicate possible impacts or damages by the result of these hazard
- Indicate solutions already done or to be done to withstand these hazards.

-End of Tool 2-
 Tool 3. Sanitation Facilities and Systems
Tool 3A – Households and Communal Toilets
Name of Total Total No. Population Total No. of Households WITH No. of Household WITH No. of Number of Households SHARING Toilet Facility No. of Is there Remarks
Barangay No. of of No. of Sanitary Toilets Unsanitary Toilets HHs HHs OD
HHs Families4 Female WITHOUT using practices
Heade commu in the
d HHs Toilet nal barangay
toilet

♀ ♂ Pour Flush/Flush VIP Pit

latrine
Overh
ung
O
t
Flush/Pour Flush VIP Pit
Latrine
Overh
ung
O
t
With Without h With Without h Yes No
Septic Septic e Septic Septic e
Tank Tank r Tank Tank r
s s

4
Note that a household can have more than 1 family.
How to Administer Tool 3A: Household and Communal Toilets

Who will administer this tool?

 An ISWSH assessment facilitator or a team assigned to assess Households and Communal Toilets.

How will the facilitator and team gather the data?

 The assessment facilitator or the team is to do a desk review of secondary documents such as reports and inventories of household
and communal toilets. In carrying out a desk review, list the documents reviewed, clearly noting their sources and dates, and include
it in the matrix. Data sources and documents can be requested from the Environmental Sanitation desks of Municipal Health Offices
(MHOs)/Rural Health Units (RHUs), through the municipal health officers or assigned rural sanitary inspectors.
 It is highly recommended that interviews and consultations with municipal health officers and sanitary inspectors be conducted to
further support the desk review, i.e., validate information collected from the data sources and documents. If possible, spot checks of
sample household and communal toilet facilities in the barangays be done too.

How will the tool be accomplished?

 Form 3A will be filled up by the assessment facilitator and enumerator with information gathered from data sources and documents.
Tool 3B - Public Toilet Facilities
Instructions: Use this form to record the number of and categories of Public Toilet Facilities per Barangay. For additional information, see portion on “How to Administer Tool 3B” in
the succeeding pages.

Name of Data Encoder: Date Encoded :

Department/Office:

Data Source : Modality of Data Gathering, kindly check appropriate box. If both modalities were used,
check both boxes:

 Spot Checks  Desk Review of Documents

Date of Source :

Total Number of Public Facility Number of Public Sanitary Toilets

Bus/
Learning Parks/Play -
Health Centers Public Markets Jeepney Ports
Centers ground
Name of Bus/ Terminal
Barangay Learning Health Public s
Centers5 Centers Markets Jeepney Parks/ Ports
Terminals
Play- ♀ ♂ Shared ♀ ♂ Shared ♀ ♂ Shared ♀ ♂ Shared ♀ ♂ Shared ♀ ♂ Shared
ground

5
Other than schools (there is a separate tool for formal schools), e.g., day care centers, training centers.
 Tool 3B – Public Toilets cont’n

Number of Public Spaces without Toilets

Park/
Bus/
Learning Centers Health Centers Public Market Play- Ports
Jeepney Terminals
ground
How to Administer Tool 3B: Public Toilet Facilities

Legend
:
♀ - Female Toilets
♂ - Male Toilets
Shared – toilets shared by females and males

Using the Sanitation Categories:

Sanitation Categories – Use the codes “A1” or “A2” to describe the category of sanitary toilets.

Categories

[ v ] – hyperlinked to additional references

Codes This is based on the WHO and UNICEF JPM – Refining the Definitions: An Ongoing
Process and the Ladder Concept

http://www.wssinfo.org/definitions-methods/watsan-categories/

"Improved" sanitation:

 Flush toilet [ v ]
 Piped sewer system [ v ]
A1  Septic tank [ v ]
 Flush/pour flush to pit latrine [ v ]
 Ventilated improved pit latrine (VIP) [ v ]
 Pit latrine with slab [ v ]
 Composting toilet [ v ]
 Special case [ v ]
"Unimproved" sanitation:
A2
 Flush/pour flush to elsewhere [ v ]
 Categories

[ v ] – hyperlinked to additional references

Codes This is based on the WHO and UNICEF JPM – Refining the Definitions: An Ongoing
Process and the Ladder Concept

http://www.wssinfo.org/definitions-methods/watsan-categories/

 Pit latrine without slab [ v ]

 Bucket [ v ]
 Hanging toilet or hanging latrine [ v ]
 Shared sanitation [ v ]
 No facilities or bush or field [ v ]
Who will administer this tool?

 An ISWSH Assessment Facilitator/s or a team assigned to assess Public Toilets in the LGU.

How will the facilitator and team gather the data?

 The highly recommended modality is to conduct spot checks of the toilet facilities in the listed public spaces, especially the ones listed in the
form- schools, health centers, public markets, bus/jeepneys terminals, parks and playgrounds, ports.
 Another option is to do a desk review of documents, by looking at secondary materials such as reports and inventories. If the desk review of
documents is preferred, list the sources and the documents reviewed and include it in the matrix.

How will the tool be accomplished?

 See example of an accomplished Tool 3B Form, in the next page.

 Example of an Accomplished Tool 3B Form

Region X
Province of XY
Municipality of XYX
Name of Data Encoder: Divina Santo Tomas Date Encoded : August 18, 2015

Department/Office: XYX Water District (RHUB of Region X)

Data Source : MPDC Modality of Data Gathering, kindly check appropriate box. If both modalities were used, check both boxes:

Spot Checks  Desk Review of Documents

Date of Source : Secondary Data – CLUP 2000 - 2015

Name of
Total Number of Public Facility Number of Public Sanitary Toilets
Barangay

Bus/
Parks/Play -
Schools Health Centers Public Markets Jeepney Ports
Bus/ ground
Hea Publ Terminals
Scho lth ic Jeepn
ey Parks/ Po S
ols Cen Mar
Termi rts Sh Sh Sh h
ters kets
nals
Play-
♀ ♂ are ♀ ♂ Sha
red ♀ ♂ are ♀ ♂ are ♀ ♂ ar ♀ ♂ Shared
d d d e
groun
d
d

1
3 3 2 2 1 1
XYXY 1 1 1 2 1 0 0 0 0 A 0 0 0 0 0 0 0 0
A1 A1 A2 A2 A2 A2
1
 Tool 3B – Public Toilets cont’n

Number of Public Spaces without Toilets

Park/
Bus/
Schools Public Market Play- Ports
Jeepney Terminals
ground

0 0 0 1 0

The accomplished form above will show that in the Municipality of XYX, Barangay XYXY there is/are:
 1 School, and the school has 3 toilets for girls that are of A1 (improved sanitation) category; and, 3 toilets for boys that are of A1 (improved
sanitation) category.
 1 Health Center, no specific toilet for females and males but has 1 toilet that is shared by females and males that is of A1 (improved sanitation)
category.
 1 Public Market, with 2 toilets for females of A2 (unimproved sanitation) category; and, 2 toilets for males of A2 (unimproved sanitation)
category.
 2 Bus and Jeepney Terminals, with 1 toilet for females of A2 (unimproved sanitation) category; and, 1 toilet for males of A2 (unimproved
sanitation) category.
 1 Park and Playground with no toilets.
 No Ports
Tool 3C - School Toilet Facilities

Instructions: This form is intended for encoding School Toilet Facility present within the municipality.

Use this form to encode the number of School Toilet Facilities per Barangay

Name of Data Encoder: Date Encoded :

Department/Office:

Data Source :

Date of Source :

Number of Number of
Name of Type of School
Barangay Students toilets Remarks
School
Public Private Female Male Female Male Shared6

Use additional Forms when necessary

6
Used by both female and male students. For example, in most public elementary schools, classrooms are equipped with one toilet each used by both boys and girls.
How to Administer Tool 3AC:School Toilet Facilities

Who will administer this tool?

 An ISWSH assessment facilitator or a team assigned to complete the tool in coordination with the respective school division chiefs
and/or school principals for public and private schools.

How will the facilitator and team gather the data?

 Use this form to record the number of toilet facilities available to female and male students in schools in the barangay.
 The highly recommended modality is to conduct spot checks of toilet facilities in the schools, both private and public. However, if
the local schools division office already has a dataset on WASH facilities in schools, such as those found in the Basic Education
Information System (BEIS), then the facilitator or team can already refer to this dataset and complete the tool.
 When referring to already existing dataset, e.g., BEIS, it is still being encouraged that interviews and consultationswith school
division chiefs, school principals, even teachers, be conducted to further support the review of the dataset, i.e., check on the status
of the toilets, if water available for flushing, if handwashing facilities are present near the toilets, etc.

How will the tool be accomplished?

 Form 3C will be filled up by the assessment facilitator and enumerator with information gathered from existing dataset supported by
spot checks and ocular inspection, and interviews with school officials; see example below.
Sample completed form
Tool 3C - School Toilet Facilities

Name of Data Encoder: _Virginia Castro Date Encoded : _1 September 2015

Department/Office: Siayan DepEd Division Office

Data Source :

Date of Source :

Number of Number of
Name of Type of School
Barangay Students toilets Remarks
School
Public Private Female Male Female Male Shared

Most of the toilets are

Barangay XYZ ABC School x 1000 800 20 20 not being used because
of lack of water.
All toilets are functional
Barangay XYZ DEF School x 3000 2000 30 30 but without
handwashing facilities.
Tool 3D - Drainage Facilities
Instructions: This form is intended for encoding existing Drainage facilities present within the municipality.

Use this form to encodeinformation on Drainage Facilitiesper Barangay

Municipality:
Name of Data Encoder: Date Encoded :

Department/Office:

Data Source :

Date of Source :

Length Outfall/Discharge Point

(in Linear Meters) (check appropriate column)

Name of Barangay Remarks
Pipe Concrete Earth Creek/ Open
Lake
Culvert Lined (Unlined) River Land

Use additional Forms when necessary

How to Administer Tool 3D: Drainage Facilities

Who will administer this tool?

 An ISWSH assessment facilitator or a team assigned to assess drainage facilities in the barangay.

How will the facilitator and team gather the data?

 The assessment facilitator or the team is to do a desk review of secondary documents such as barangay or municipal plan on
drainage system, reports on drainage facilities, etc. In carrying out a desk review, list the documents reviewed, clearly noting sources
and dates of the document, and include it in the matrix. Data sources and documents can most likely be requested from barangay
officials, municipal planning offices, municipal public works offices, etc.
 It is highly recommended that interviews and consultations with barangay officials, municipal planning officers and municipal
engineers be conducted to further support the desk review, i.e., validate information collected from the data sources and
documents.

How will the tool be accomplished?

 Form 3C will be filled up by the assessment facilitator and enumerator with information gathered from data sources and documents
supported by key informant interviews.
Tool 3E - Septage Management
Instructions: This form is intended for encoding existing Septage Management System within the municipality.

Use this form to encode information on Septage Management Practices per Barangay

Municipality:

Name of Data Encoder: Date Encoded :

Department/Office:

Data Source :

Date of Source :

Name of Total Households with Septic Tanks Septic Tank Desludgers Does LGU have a Remarks
Barangay Number of Comprehensive
(Private and LGU)
Households Septage
Total no. of Total no. of With Septage Ave. Cost Management
HH who HH who Treatment Program
Total no. of HH (Php/HH/desludging)
regularly regularly Facility (STF)
who regularly
desludged desludged
desludge their (Yes/No)
their septic their septic
septic tanks c/o
tanks (every tanks c/o If no STF,
Private
3 years) LGU indicate other
Desludgers
Desludger systems for
septage disposal
and treatment

Use additional forms when necessary.

How to Administer Tool 3E: Septage Management

Who will administer this tool?

 An ISWSH assessment facilitator or a team assigned to assess septage management practices in the barangay.

How will the facilitator and team gather the data?

 The assessment facilitator or the team is to do a desk review of secondary documents such as reports and inventories of septage
management practices in the community. In carrying out a desk review, list the documents reviewed, clearly noting their sources
and dates, and include it in the matrix. Data sources and documents can most likely be requested from Municipal Environment and
Natural Resources Offices (MENROs) or Municipal Planning and Development Offices (MPDOs). Request for a copy of the Municipal
Septage Management Plan where the data can be sourced from.
 It is highly recommended that interviews and consultations with municipal environmental officers and planning officers be
conducted to further support the desk review, i.e., validate information collected from the data sources and documents.

How will the tool be accomplished?

 Form 3E will be filled up by the assessment facilitator and enumerator with information gathered from data sources and documents.
Tool 3F - Solid Waste Management Practices

Municipality:

Name of Data Encoder: Date Encoded :

Department/Office:

Data Source :

Date of Source :

Number of Households Practicing: Garbage Collection Service

Number of
Total Households
Name Number whose Garbage
Remarks
Barangay of is Being
Does the Average Does the Average
Household Collected by the
Municipality Cost Barangay Cost
LGU?
Have an MRF? In Php Have an MRF? In Php per
(Yes/No) per HH (Yes/No) HH per
per month
Segregating Composting Burying Burning month
If no MRF, If no MRF,
indicate other indicate other
systems of systems of
segregation and segregation and
disposal. disposal.
Use additional Forms when necessary.
How to Administer Tool 3F: Solid Waste Management Practices

Who will administer this tool?

 An ISWSH assessment facilitator or a team assigned to assess solid waste management practices in the barangay.

How will the facilitator and team gather the data?

 The assessment facilitator or the team is to do a desk review of secondary documents such as reports and inventories of solid waste
management practices in the community. In carrying out a desk review, list the documents reviewed, clearly noting their sources
and dates, and include it in the matrix. Data sources and documents can most likely be requested from Municipal Environment and
Natural Resources Offices (MENROs) or Municipal Planning and Development Offices (MPDOs). Request for a copy of the Municipal
Solid Waste Management Plan where the data can be sourced from.
 It is highly recommended that interviews and consultations with municipal environmental officers and planning officers be
conducted to further support the desk review, i.e., validate information collected from the data sources and documents.

How will the tool be accomplished?

 Form 3F will be filled up by the assessment facilitator and enumerator with information gathered from data sources and documents.
Tool 4. Assessing Disaster Preparedness

INTRODUCTION
The National Disaster Risk Reduction and Management Plan 2011-2028 defines disaster
preparedness as “the knowledge and capacities developed by governments, professional response
and recovery organizations, communities and individuals to effectively anticipate, respond to, and
recover from the impacts of likely imminent or current hazard events or conditions.”
Actions related to disaster preparedness aims to build the capacities needed to efficiently manage
all types of emergencies and achieve orderly transitions from response to sustained recovery. It
includes activities such as contingency planning, stockpiling of equipment and supplies, the
development of arrangements for coordination, evacuation and public information and associated
training and field exercises. These must be supported by formal, institutional, legal and budgetary
capacities.
Water supply system and sanitation facilities provide essential services to the community and
should be able to function, even at a diminished level, during and after an emergency. It is critical,
therefore, to ensure the sustained provision of integrated safe water, sanitation and hygiene
services. Service providers need to understand the potential risks to their operations and install
measures for disaster mitigation and preparedness and define tasks to be undertaken during the
response to and recovery from disasters.

PURPOSE OF THE TOOL

The tool is intended to assess the disaster preparedness of the locality by looking at the availability
of measures that enable communities to respond effectively and recover more quickly when
disasters strike.

OUTPUT
An assessment of the measures, resources (technical, financial) and capacities in place for disaster
preparedness.

METHODOLOGY
The tool will be administered through a three to four-hour Focused Group Discussion following a
desk review of relevant literature (e.g. DRRM Plan). Highlights of the discussion should be properly
documented.

TARGET PARTICIPANTS
The target participants are 12-15 representatives from the barangay officials, DRRMO staff, peoples
organization, partner NGO/academe (if any) and other relevant stakeholders

87
 Tool 4 – Assessing Disaster Preparedness
Instructions: This form is intended for assessing government disaster preparedness.

Use this form to encode historical data on natural disasters. Use one form per Barangay

Name of Data Encoder: Date Encoded :

Department/Office: Data Source/s :

Name of Barangay: _
Severity of Duration
Magnitude or Consequence / Coverage / Date of Major
Hazard Frequency Elements at Risk Remarks
Intensity Degree of Spatial Extent Event/s
Damage

GEOPHYSICAL

Earthquake

Earthquake-induced
Landslide

Sinkhole

Tsunami

Volcanic Activity

HYDRO-
METEOROLOGICAL

Flood*

Bank Erosion

Storm Surge

Rain-induced Landslide

88
 Tropical Cyclone
(Typhoon, Storm,
Depression)

Intense Rainfall (Extreme

rainfall event)

Extreme Temperature

Drought

ENSO (El Niño/La Niña)

BIOLOGICAL

Disease Epidemics

Insect/Animal Plagues

* For Flood, indicate on the Remarks column, the causes – river overflow, tide, storm surge; for bank overflow, indicate the river name.
DEFINITION OF TERMS

Frequency is the estimated likelihood or the average recurrence interval (expressed in years) that a hazard event may
happen.

Magnitude/Intensity is the estimated strength of the hazard that will impact an area (i.e. Flood can be expressed in
water depth, water fow velocity, and/or duration, storm surge expressed in wave heights, earthquake ground
shaking expressed as intensity scale).

Severity of Consequence is a measure of the degree of impact, such as injury, death, damage, interruption brought to the
sector of concern.

Duration is how long the hazard will occur (expressed in seconds, minutes, days, weeks etc.).

Coverage/Spatial Extent refers to the areas/barangay within the municipality/city that is likely to be affected by a
particular hazard.

Elements at risk refer to the critical point facilities and lifeline utilities/infrastructure, for the purposes of this survey
instrument, that are limited to facilities and utilities/infrastructure that are relevant to ISWSH. ISWSH-relevant
critical point facilities are health centers, municipal/barangay hall, senior citizen building, school buildings,
transportation hubs, public markets and other production areas frequented by women and children. Lifeline
utilities include transportation and road networks, water supply system (source, treatment facility,
distribution system), sanitation facility, drainage/sewerage system, and power distribution networks

90
GUIDE QUESTIONS FOR FOCUSED GROUP DISCUSSION

Selected Data on Disaster Preparedness

1. Does the Barangay LGU receive information about hazards and/or specific actions to
take? (Yes/No)

2. What types of information are received?

[ ] Hazard awareness [ ] Developing a sitio/purok or family
emergency plan
[ ] Government plans and procedures
[ ] Assistance programs [ ] Community outreach and engagement

[ ] Property protection measures [ ] Others, please specify:

3. From where does the BLGU get its information? Kindly enumerate official and unofficial
sources.

4. Does the Municipal LGU have a DRRM Plan? (Yes/No)

a. If yes, specify timeframe (effectivity)
b. What is the status of the plan (draft, approved, ratified, etc.)?
c. What is the level of involvement of the Barangay in the preparation of the MLGU
DRRM Plan?
d. What is the level of involvement of the Barangay in the implementation of the
MLGU DRRM Plan?

5. Does the Barangay LGU have a DRRM Plan? (Yes/No)

a. If yes, specify timeframe (effectivity)
b. What is the status of the plan (draft, approved, ratified, etc.)?
c. What is the level of involvement of the Municipal LGU in the preparation of the
BLGU DRRM Plan?
d. What is the level of involvement of the Municipal LGU in the implementation of
the BLGU DRRM Plan?

6. Which of the identified activities or projects in the BLGU DRRM Plan were funded and
implemented using LGU budget? Please enumerate.

91
 7. Which of the identified activities or projects were funded and implemented with other
resources (e.g., financial, technical resources from NGOs)? Please enumerate and
identify source of funds, technical assistance.

8. Does the Barangay have a designated Evacuation Center? (Yes/No)

9. If yes, what is the designated evacuation center (original use like school, multi-
purpose hall, etc.) and where is it located?

10. Is the site for the evacuation center already assessed by the MGB ? (Yes/No)

11. If Yes, what are the findings?

12. Description of the evacuation center in the site:

Type of Description Capacity Facilities Present – Separate facilities for

Structure availability of water women and men? Boys and
(Is it Single (No. of persons
Storey? that can be and sanitation Girls? Or Shared
Concrete? accommodated) facilities Indicate: Check () if Yes or
Multi- Indicate: Check () if (x) if No
Purpose Yes or (x) if No
Building?)
Water Sanitation Women Men Shared
Facilities Facilities and and
Girls Boys
 13. In case of disasters, what supplies, materials and equipment are prepositioned for safe
water sanitation and hygiene?
Inventory of Supplies, Quantity Location Remarks
Materials and Equipment,
e.g.
Tools:
 Pipe Wrench
Supplies:
 Pipes, Valves and
Fittings
 Water Disinfectant
Materials (e.g.
Aqua Tabs,
Hyposol)
 Hygiene Kits
Equipment:
 Generator Sets
 Mobile Water
Tanks
 Water Pumps
 Service Vehicles
 Portalets
 Squatting Places
 Solar Lamps
14. In case of disasters, are human resources for Safe Water, Sanitation and Hygiene
available?

Inventory of Quantity - How many Location Remarks

Human Males Females
Resource, e.g.
Water
Technicians
Public Health
Engineers
Public Health
Promoters
Tool 5. Gender Analysis Tools for Safe Water, Sanitation and Hygiene
Introduction
The United Nations Member States, including the Philippines, commit to “achieve universal and
equitable access to safe and affordable drinking water for all” and to “achieve access to adequate and
equitable sanitation and hygiene for all and end open defecation, paying special attention to the needs
of women and girls and those in vulnerable situations” by 2030 as well as other related targets under
the proposed Goal 6 of the Sustainable Development Goals.7

The vision is “A world where access to safe and affordable drinking water is a basic and universal human
right…where there is adequate and accessible sanitation”. 8

Access to safe, affordable, accessible, available and acceptable water and sanitation is a human right
already recognized by the General Assembly and the Human Rights Council, but is not a reality for
millions of people. The call is for world leaders to aim for a world where the human right to water and
sanitation is realized for all, and where hygiene is available to all.9

Women participation in development has been institutionalized in the Philippines since 1975 and further
strengthened in the first Framework Plan for Women formulated in 2004. It was in 2009 that the
hallmark law for women and gender equality, Republic Act 9710 or the Magna Carta of Women was
passed. The MCW is a comprehensive women’s human rights law that seeks to eliminate discrimination
against women by recognizing, protecting, fulfilling and promoting the rights of Filipino women,
especially those in the marginalized sectors. In particular, women’s’ right to food security, productive
resources and basic social services explicitly provides removal of social, political and economic barriers
to access to water and sanitation. This right also resonates the

However, water and sanitation programmes in the Philippines are traditionally viewed as infrastructure
projects and therefore attributed as the domain of men. In the actual implementation of project
activities relating to the MDGF 1919, eighty to ninety percent (80%-90%) of household attendance to
consultations, community mobilization, advocacy, and project/activity implementation have been
participated and attended by women in relation to their reproductive roles and tasks but not yet as
recognized equal players in the implementation of the project.

Women play various critical socio-economic and political roles in the family, community, government,
business and society in general. These different roles provide a wealth of information on how the need
for safe water, sanitation and hygiene can be rightly addressed and managed. In the past, several
women members have been engaged in significant duties on safe water, sanitation and hygiene. They
include WSP managers, bookkeepers, collectors, water integrity monitors, technical working group
members under their local governments, council members, among others. On sanitation, majority of
barangay health workers and some rural sanitary inspectors are women. However, water and sanitation
engineers

7
An Open Letter from the United Nations Special Rapporteur on the human right to safe drinking water and
sanitation to all the United Nations Member States on the final draft of the Post-2015 Development Goals. 21 July
2015
8
Ibid.
9
Ibid.
are mostly men10 and men still control and decide the utilization of government resources for water and
sanitation.

Gender mainstreaming will be the key strategy to ensure that PROWATER outcomes contribute
positively to gender equality using the Gender and Development (GAD) approach that has been
institutionalized in the Philippines. The GAD framework considers the advancement of the status of
women and girls, as well the roles and needs of both women and men – girls and boys, in water and
sanitation, contributing to gender equality as the ultimate goal.

Based on the Harmonized GAD Guidelines (HGG) a common (government and ODA) document for
monitoring gender equality markers in implementing programmes and projects in the Philippines, the
joint programme have identified the following gender issues to be addressed:

1. Participation of women and men.

a. Women are rarely considered for employment in water, sanitation and hygiene
construction projects, beyond areas in which women have traditionally been involved in
(e.g. administrative and financial). Most projects do not view women as potential
workers. Where women workers need to move close to the worksite, they require
secure and safe areas in construction camps.
b. Gender gaps are often found in women’s and men’s participation in water
consumers/concessionaires groups that are organized to operate and maintain domestic
water systems, irrigation systems and sanitation facilities as well as in decision-making
bodies for water, sanitation and hygiene.
2. Access to and control of resources for water, sanitation and hygiene.
a. Women and men have divergent requirements based on the seasonality and location of
their activities. Water, sanitation and hygiene projects are designed without considering
these variations and often have a great impact on women’s workload11.
b. Women and girls are rarely consulted on the design and implementation of water,
sanitation and hygiene projects.

It is being envisioned that by addressing the gender issues as mentioned above, the joint programme
will contribute in:

1. Reducing time, health, and care-giving burdens from improved water services giving women
more time for productive endeavors, adult education, empowerment activities and leisure.
2. Convenient access to water and sanitation facilities increasing privacy and reduce risk to women
and girls of sexual harassment/assault while gathering water and using sanitation facilities.
3. Higher rates of child survival becoming a precursor to having fewer children and thereby
reducing women’s household responsibilities and increases opportunities for women’s personal
development.

10
Although, it should be noted that substantial employment growth for women in 2006-2010 was registered in
sectors that have been perceived as male dominated such as fishing, electricity, gas and water supply,
construction, transport storage and communications, public administration and defense. Conversely, employment
share of women was low compared to men in male-dominated sectors. Source: Promoting Gender Equality in the
Labor Market for More Inclusive Growth Philippine Report.
11
In order to know these variations, gender analysis should be done on water, sanitation and hygiene at the local
level.
This tool envisions providing an entry point for mainstreaming gender equality and women
empowerment in designing, implementing and maintenance of safe water, sanitation and hygiene. Tool
5 consists of 3 tools:

 Tool 5A - GAD Mainstreaming in Project Identification, Planning and Implementation of Safe

Water Sanitation and Hygiene
 Tool 5B - Time Use Tool
 Tool 5C - Focus Group Discussion Guide on Sanitation and Hygiene

When applied collectively, these tools will show:

 The capacity of LGUs and WASH service providers and the quality of GAD mainstreaming in
project identification, planning and implementation of safe water sanitation and hygiene.
 Prevailing gender issues and gaps in access to water, sanitation and hygiene.

Purpose of the Tool

Tool 5A uses the Harmonized GAD Guidelines (HGG) as the assessment instrument. The HGG was jointly
developed by PCW and NEDA together with ODA and non-government partners to provide Philippine
government agencies and donors with a common set of analytical concepts and tools for integrating
gender concerns into development programs and projects. It further addresses management results of
integrating gender equality and women's empowerment concerns into key stages of the project cycle:
project identification and design, assessment of projects for funding; project implementation; and
monitoring and evaluation. In the context of ISWSH, this tool will look at the quality of gender
mainstreaming in water, sanitation and hygiene projects implemented by the LGU or service water
providers.

Tool 5B, is a “time-use” tool. This tool is one of the standard instruments for conducting gender analysis.
This will extract information on gender roles and gender division of labor in the context of water,
sanitation and hygiene. The information will reveal gender equality deficits, issues and gaps faced by
women and men on a daily basis as they access water, sanitation and hygiene.

At the technical infrastructure level, Tool 4A.2 will show the pattern of demands for water, sanitation
and hygiene by providing information and evidences on when water is in high demand at the household
level.

Tool 5C, is an FGD tool for surfacing gender issues specifically on sanitation and hygiene and access to
information.

Outputs of the Tool

Tool 5A - This tool will produce findings and conclusions on the quality of gender mainstreaming in
implementing safe water, sanitation and hygiene projects.
Tool 5B – This tool will reveal gender equality deficits, issues and gaps faced by women and men on a
daily basis as they access water, sanitation and hygiene as well as gender division of labor in the context
of water, sanitation and hygiene. This will also reveal the pattern of demands for water, sanitation and
hygiene
Tool 5C – This FGD tool will surface gender issues specifically on access to sanitation and hygiene.

How it’s done?

A Focus Groups Discussion or Workshop should be organized to administer this assessment instrument.
If preparations are done well, a half day workshop, 4-5 hours, will be enough to produce the intended
outputs.

FGD Participants
The participants of the FGD are the following:
1. Members of the GAD Focal Point System of the LGU
2. Representatives of CSOs and Women’s Groups
3. GAD advocates and experts in the locality

Preparations
Before the FGD, the facilitator will:
1. The FGD facilitator must be very familiar with this tool and is comfortable in facilitating
participatory activities.
2. Prepare a conducive venue for the FGD.
3. Reproduce Tool 5A as a handout and guide for the FGD participants.
4. Prepare Tool 5B in a large manila paper or flip chart.
5. Reproduce Tool 5C as a handout and guide for the FGD participants.
6. Prepare a presentation that will show the purpose, objective and expected outputs of the FGD,
if available, make an LCD available for the presentation.
Tool 5A - GAD Mainstreaming in Project Identification, Planning and
Implementation of Safe Water Sanitation and Hygiene
The topics and focus questions for the FGD are provided in Columns 1 and 2. The third column is provided
for the facilitator to record and document the responses of the FGD participants.

Topics Focus Questions FGD Responses, Findings and

Conclusions
(Note the differing responses of
women and men)
Project identification 1.0 Participation of women and men in
and planning of safe project identification
water, sanitation and 1.1 Did the project consulted women on the
hygiene projects problem or issue that the intervention must
solve and on the development of the
 Choose a project solution? If yes, how was this done and what
on water, sanitation were the issues?
and hygiene that 1.2 Were women’s inputs considered in the
was implemented design of the project? If yes, what particular
or being inputs were considered?
implemented by 1.3 Are women and men recognized as
the LGU. stakeholders, partners, or agents of change in
the project design? If yes, in what way?
2.0 Collection of sex-disaggregated data and
gender related information prior to project
design
Did the project tap sex-disaggregated data
and gender-related information from
secondary and primary sources at the project
identification stage? OR, the project
document includes sex disaggregated and
gender information in the analysis of the
development issue or problem?

If yes, what kind of sex disaggregated data

were tapped?
3.0 Conduct of gender analysis and
identification of gender issues
Did the project conduct gender analysis to
identify gender issues prior to project design?
If yes, who conducted the gender analysis
and what were the gender issues identified?

OR, the discussion of development issues in

the project document includes gender gaps
that the project must address?

Project design and 4.0 Gender equality goals, outcomes, and

implementation of safe outputs
 Topics Focus Questions FGD Responses, Findings and
Conclusions
(Note the differing responses of
women and men)
water, sanitation and 4.1 Does the project objectives explicitly refer
hygiene projects to women and men? If yes, what are the
objectives for women and for men?
4.2 Does the project have gender equality
outputs or outcomes?

Examples are:
- Greater gender parity in the distribution of
project resources (technology, training
opportunities)
- Increased participation of women and men
in project activities
- Improved representation of women in
decision-making bodies created by the
project
5.0 Matching of strategies with gender issues
5.1. Do the strategies match the identified
gender issues and gender equality goals?

5.2. Do the activities or interventions reduce

gender gaps and inequalities? How?
6.0 Gender analysis of the designed project
6.1 Gender division of labor
6.1.1 Does the project addresses the
array of women’s and men’s roles
and responsibilities in the productive
and reproductive spheres? How?
6.1.2 Does the project consider the
varying needs and priorities of
women and men in safe water,
sanitation and hygiene, and where
required, including needs and
priorities in environmental
management, resource use, and
conservation? How?
6.1.3 Does the project consider how
women and men fit their resource
management activities with their
other productive, reproductive, and
community tasks in scheduling
project
activities? How?

100
 6.2 Access to and control of resources
6.2.1 Do women and men have equal
access to extension services,
information, training, and technology
to be introduced by the project? Give
examples?

101
Topics Focus Questions FGD Responses, Findings and
Conclusions
(Note the differing responses of
women and men)
6.2.2 Did the project involve female
hydrologists, sanitation engineers,
foresters, fishery extension officers
(for projects in coastal areas),
community and sectoral leaders?
Who were involved? How many
women and how many men?
6.2.3 Were the agency/project
personnel capacitated or trained for
gender-responsive development? If
yes, what kind of trainings were
implemented? Who conducted the
trainings? When?
6.3 Constraints
6.3.1 Did the project devised
strategies to overcome the
constraints (including mobility and
time constraints for women) to
project participation by women and
by men? How?
6.3.2 The project considered that the
constraints to women’s participation
may require separate programming
(by way of separate groups, activities,
or components). IF NEEDED: Did the
project addresses this kind of
constraints? How?
7.0 Monitoring targets and indicators
Does the project include gender equality
targets and indicators for welfare, access,
consciousness raising, participation, and
control? If yes, what are these targets?
8.0 Sex-disaggregated database
Does the project monitoring framework or
plan include the collection of sex-
disaggregated data? If yes, what are these
data?
9.0 Resources
9.1 Does the budget allotted by the project
sufficient for gender equality promotion or
integration- at the minimum, the five percent
(5%) GAD budget is properly allocated to
ensure that the project is gender sensitive
and responsive?
Topics Focus Questions FGD Responses, Findings and
Conclusions
(Note the differing responses of
women and men)
9.2 Does the project have the expertise to
integrate GAD or to promote gender equality
and women’s empowerment? OR, does the
project commit to invest project staff time in
building capacity for integrating GAD or
promoting gender equality? How?
10.0 Relationship with the agency’s GAD
efforts
10.1 Will the project build on or strengthen
the LGUs commitment to the advancement of
women and girls? How?
10.2 Does the project have an exit plan that
will ensure the sustainability of GAD efforts
and benefits?
10.3 Will the project build on the initiatives or
actions of other organizations in the area?
OR, will it involve gender equality and women
empowerment institutions in the area (e.g.
GAD Resource Centers of PCW)?

How?
Tool 5B - Time Use Tool
What do women and girls do at certain hours of the day? How are these linked with water sanitation
and hygiene?

Time Activities Link with water sanitation and

hygiene
AM 4:00
5:00
6:00
7:00
8:00
9:00
10:00
11:00
PM 12:00
1:00
2:00
3:00
4:00
5:00
6:00
7:00
8:00
9:00
10:00
11:00
AM 12:00
1:00
2:00
3:00
What do men and boys do at certain hours of the day? How are these linked with water sanitation and
hygiene?

Time Activities Link with water sanitation and

hygiene
AM 4:00
5:00
6:00
7:00
8:00
9:00
10:00
11:00
PM 12:00
1:00
2:00
3:00
4:00
5:00
6:00
7:00
8:00
9:00
10:00
11:00
AM 12:00
1:00
2:00
3:00
Tool 5C - FGD on Sanitation and Hygiene
The topics and focus questions for the FGD are provided in Columns 1 and 2. The third column is provided
for the facilitator to record and document the responses of the FGD participants.
Topics Focus Questions FGD Responses, Findings and Conclusions
(Note the differing responses of women and men)
Sanitation Are you familiar with the term “open
defecation”? Have you heard of this term
before? Where? And How?

How is this “term” translated in your

language? What do you call “open
defecation” in your language?

Is such a practice being done in your

community? Elsewhere?

Why is this being practiced? What could

be some of the reasons for this practice?

How does this impact on the lives of

women and girls?

How does this impact on the lives of men

and boys?
Hygiene Is hand washing a standard practice in
your community?

Are you aware of the standard procedure

for hand washing?

When is hand washing usually done?

Are there other issues concerning hygiene

that is affecting your community? What
are some of its negative effects?
Access to
information Have you heard or received any messages
on sanitation about hygiene, cleanliness or hand
and hygiene washing?

What is the message?

When was the message received?

From whom?
Tool 6. Indigenous Peoples and Muslim Practices on Water, Sanitation
and Hygiene

Tool 6A - IP Practices on Water, Sanitation and Hygiene - Barangay Level

How to Administer the Tool
The data and information required by this tool can be derived through a desk review of
documents, FGD or Key Informant interview, if an FGD is not possible.
This tool has 2 parts:

 Part 1. IP Population Data – this will be accomplished by transferring data and

information from existing documents into the matrix, as provided in the tool.
 Part 2. FGD on IP Traditional and Spiritual Practices that are Linked with Water,
Sanitation and Hygiene – this will accomplished by conducting an FGD or KII using the
focus questions, as provided in the tool.

Purpose of the Tool

This tool will gather 2 major sets of information and data at the Barangay Level:

1. Population data on the IP Groups that is disaggregated by sex; number of households;

number of families.
2. IP traditional and spiritual practices that are linked with water, sanitation and hygiene.

These data and information will be useful in designing programmes on water, sanitation and
hygiene that is responsive and sensitive to the traditions and needs of indigenous women and
girls, men and boys.
Outputs
The following information can be derived from this tool:

1. Population data on the IP Groups that is disaggregated by sex; number of households;

number of families.
2. IP traditional and spiritual practices that are linked with water, sanitation and hygiene.
Who will administer the tool?
The ISWSH Assessment Facilitator together with a documentor/enumerator.
How it’s done?
1) For Part 1 - desk review of documents, the facilitator/enumerator:
 a) Gathers the necessary documents from the Office of the Barangay Council, Municipal
Planning and Development Office and the Provincial Office of the National Commission
on Indigenous Peoples (Provincial NCIP)
b) Fills up the first page of the tool. The titles of the gathered documents; date of the
documents and the names of persons/institutions who provided the source documents
are listed in the data source matrix, provided in the tool.
c) Will record the necessary information that is required by the matrix on Part 1. -
population data on the IP Groups that is disaggregated by sex; number of households;
number of families; and, records the date that these data was gathered as reflected in
the source document.
2) For Part 2 - FGD or KII, the facilitator and documentor will:
a) Read and be familiar with the Free Prior Informed Consent (FPIC); as established based
on the Indigenous Peoples’ Rights Act of 1997 or Republic Act No. 8371. As provided by
law, permission should be sought from the NCIP and IP elders and leaders prior to
conducting any research or study that will require information relating to indigenous
peoples practices to avoid wrongful use and piracy of IP knowledge systems. This law
can be accessed in:
i) http://www.gov.ph/1997/10/29/republic-act-no-8371/
ii) A quick background on FPIC practices in the Philippines can also be downloaded in
http://www.oxfamamerica.org/static/media/files/fpic-in-the-philippines-september-
2013.pdf
b) Set an appointment with the IP leader and asks permission to conduct the FGD. If the IP
leaders and elders so require, request for an FPIC clearance from the NCIP Provincial
Office. For purposes of quick and rapid assessments, this can be negotiated; in most
cases, it takes time to require for an FPIC clearance.
c) Provide a conducive venue for the FGD and right timing. Remember to set a good time
to ensure that women can participate. Avoid scheduling the FGD during hours when
women are usually busy with household concerns; especially in the morning hours- 8:00
AM – 12:00 PM and towards evening, 4:00 PM onwards. The best time to hold an FGD in
rural communities are from 1:00 – 3:00 PM.
d) Once permission is granted transfer the matrices in large manila papers or flip charts
using the local/vernacular languages.
e) Conduct in simple, non-threatening ways the FGD, guided by the focus questions
provided in the matrix.
f) The documentor records the responses of the FGD participants in the 3rd column
provided in the matrix.
g) The documentor records the names of FGD participants, indicating if they are women or
men (male/female).
h) Do not forget to write down the name of the IP Group/s who attended the FGD.

Participants to the FGD

Equal number of IP women and men in the community.
Name of Data Encoder:
Date Encoded :
Department/Office:

Data Source:

Title of Source Document Date of Source Names of Persons/Institutions who

Document provided the Source Documents

Part 1. IP Population Data

Modality: Desk Review of Documents

Data on Indigenous People Year when

data on
Name of Population population
Name of Indigenous
was recorded
Barangay Tribe/s No. of No. of – as reflected
Females Males HHs Families in the source
document
 Data on Indigenous People Year when
data on
Name of Population population
Name of Indigenous
was recorded
Barangay Tribe/s No. of No. of – as reflected
Females Males HHs Families in the source
document
Part 2. FGD on IP Traditional and Spiritual Practices that are Linked with Water, Sanitation
and Hygiene
Name of IP Group/s:

Topics Focus Questions Responses

A. Worldview How does the IP group regard or

view water, sanitation and hygiene?
 What belief systems are
associated with water?
 What belief systems are
associated with sanitation?
 What belief systems are
associated with hygiene?
B. Practices What are the current traditional
practices?
 What belief systems on water
are still being practiced
today?
 What belief systems on
sanitation are still being
practiced today?
 What belief systems on
hygiene are still being
practiced today?
C. Issues,  What are some of the issues
Gaps and that the community is facing
Challenges now and in the future
regarding water, sanitation
and hygiene?
 How do these issues affect
women and girls?
 How do these issues affect
men and boys?

110
Tool 6B - Muslim Practices on Water, Sanitation and Hygiene - Barangay Level

How to Administer the Tool

The data and information required by this tool can be derived through a desk review of
documents, FGD or Key Informant interview, if an FGD is not possible.

This tool has 2 parts:

 Part 1. Muslim Population Data – this will be accomplished by transferring data and
information from existing documents into the matrix, as provided in the tool.
 Part 2. FGD on Muslim Spiritual Practices that are Linked with Water, Sanitation and
Hygiene – this will accomplished by conducting an FGD or KII using the focus questions,
as provided in the tool.

Purpose of the Tool

This tool will gather 2 major sets of information and data at the Barangay Level:

3. Population data on Muslims that is disaggregated by sex; number of households;

number of families.
4. Spiritual practices that are linked with water, sanitation and hygiene.

These data and information will be useful in designing programmes on water, sanitation and
hygiene that is responsive and sensitive to the traditions and needs of Muslim women and girls,
men and boys.

Outputs
The following information can be derived from this tool:
3. Population data on Muslims that is disaggregated by sex; number of households;
number of families.
4. Muslim spiritual practices that are linked with water, sanitation and hygiene.

Who will administer the tool?

The ISWSH Assessment Facilitator together with a documentor/enumerator.

How it’s done?

3) For Part 1 - desk review of documents, the facilitator/enumerator:

 a) Gathers the necessary documents from the Office of the Barangay Council, Municipal
Planning and Development Office and the Regional/Provincial Office of the National
Commission on Muslim Filipinos.
b) Fills up the first page of the tool. The titles of the gathered documents; date of the
documents and the names of persons/institutions who provided the source documents
are listed in the data source matrix, provided in the tool.
c) Will record the necessary information that is required by the matrix on Part 1. -
population data on the Muslims that is disaggregated by sex; number of households;
number of families; and, records the date that these data was gathered as reflected in
the source document.

4) For Part 2 - FGD or KII, the facilitator and documentor will:

a) Set an appointment with the community Muslim leader and asks permission to conduct
the FGD.
b) Provide a conducive venue for the FGD and right timing. Remember to set a good time
to ensure that women can participate. Avoid scheduling the FGD during hours when
women are usually busy with household concerns; especially in the morning hours- 8:00
AM – 12:00 PM and towards evening 4:00 PM onwards. The best times to hold an FGD
in rural communities are from 1:00 – 3:00 PM.
c) In Muslim communities, hold separate FGDs for women and men. Cultural practices
seldom allow women and men who are not husbands and wives to sit together in one
gatherings.
d) Once permission is granted transfer the matrices in large manila papers or flip charts
using the local/vernacular languages.
e) Conduct in simple, non-threatening ways the FGD, guided by the focus questions
provided in the matrix.
f) The documentor records the responses of the FGD participants in the 3rd column
provided in the matrix.
g) The documentor records the names of FGD participants, indicating if they are women or
men (male/female).

Participants to the FGD

Equal number of Muslim women and men in the community – reminder again: hold FGDs for
women and men, separately.
Name of Data Encoder:
Date Encoded :
Department/Office:

Data Source:

Title of Source Document Date of Source Names of Persons/Institutions who

Document provided the Source Documents

Part 1. Muslim Population Data

Modality: Desk Review of Documents

Data on Muslim Population Year when data

Name of on population
Population was recorded – as
Barangay No. of No. of
reflected in the
Females Males Households Families
source document
 Data on Muslim Population Year when data
Name of on population
Population was recorded – as
Barangay No. of No. of
reflected in the
Females Males Households Families
source document
Part 2. FGD on Muslim Practices that are Linked with Water, Sanitation and Hygiene

Topics Focus Questions Responses

D. Worldview How does Muslims regard or view

water, sanitation and hygiene?
 What spiritual knowledge is
associated with water?
 What spiritual knowledge is
associated with sanitation?
 What spiritual knowledge is
associated with hygiene?
E. Practices What are the current practices on:
 Water?
 Sanitation?
 Hygiene?
F. Issues,  What are some of the issues
Gaps and that the community is facing
Challenges now and in the future
regarding water, sanitation
and hygiene?
 How do these issues affect
women and girls?
 How do these issues affect
men and boys?
Tool 7. Assessing Potentials for Public-Private Partnership

Purpose of the Tool

The PRO-WATER Joint Programme intends to maximise opportunities for public-private partnership
(PPP) in delivering safe water, sanitation and hygiene (WASH) services in an integrated manner to its
target municipalities and communities. However as water and sanitation is a basic human right, any
partnership entered into with the private and business sector will have to seriously subscribe to a rights-
based approach and abide by the United Nations’ “Protect, Respect and Remedy” Framework for
Business and Human Rights.

Currently there are three main options being considered in collaborating with the private and business
sector under the PRO-WATER Joint Programme:

1) Engaging private water service providers and private schools and academies in the provision of
technical and advisory assistance, serving as mentors/coach in good governance of integrated
WASH, as well as in the development and sharing of relevant tools, technologies, and best practices
in local water governance, including development of business models for sustainability;
2) Mobilising resources and supplies from private suppliers and companies with Corporate Social
Responsibility (CSR) programmes to finance investment requirements of the local WASH sector;
3) Soliciting support from the private sector in the development of low cost technologies.

This tool is simply intended to identify existing PPPs and to initially map out potential partnerships with
private and business corporations engage in WASH in the PRO-WATER programme areas following a
rights-based approach. It is intended to support and corroborate the other assessment tools, especially
those developed on Governance.

Outputs
With the use of this tool, a basic mapping of private and business corporations engage in the provision
of WASH services, directly or indirectly, wholly or partially, in the target municipalities will hopefully be
generated. From this, key business enterprise could be identified and examined further to initially
determine potentials of establishing partnershipswith them on integrated and safe WASH service
delivery.

Methodology
The tool will be administered through desk review, supported by some key informant interviews (KIIs)
and Focus Group Discussions (FGDs).

Desk Review
The assessment facilitators need to obtain a listing of private and business corporations engaged directly
or indirectly, wholly (i.e., the corporation is fully engage on water, sanitation or hygiene) or partially (i.e.,
only a section of the corporation is engage on water, sanitation or hygiene), in the provision of WASH
services in the target municipalities. Understandably, such listingmay turn out to be very varied, as it
could include private water districts, water concessionaires (water vendors), hardwares(supplying
sanitation construction materials), local desludging services, private schools that have outreach
programmes on sanitation and hygiene, private academic institutions that have research programmes
on water, sanitation and hygiene, even purely business corporations but are known to be supporting
WASH projects as part of their CSR programmes.

The listing of private corporations engaged in WASH will most likely be available from the Business
Permit and Licensing Offices (BPLOs) in the target municipalities. Some information may also be
accessible from the Municipal Planning and Development Offices (MPDOs).

KIIs
While obtaining a listing of private and business corporations engaged in WASH service delivery in the
municipalities, the assessment facilitators are also advised to initiate short interviews with key BPLO and
MPDO officials to gather insights on the following issues on private sector engagement:

 Are there current policies (such as laws, ordinances, resolutions) that support and promote
business partnerships and enterprise development, including PPP, at the local level (provincial,
municipal)?

 Does the local government unit(LGU) currently have PPPs? What is the nature of these
partnerships (may not be related to WASH)? Does the LGU have existing PPPs specifically related
to water, sanitation or hygiene?

 In issuing permits and allowing private and business enterprise to operate in the municipality or
province, does the LGU require human rights due diligence 12 from these corporations (in other
words, compliance with national and international human rights laws and declarations)? Are
there policies (such as laws, ordinances, resolutions), functions (e.g., agencies on human rights)
and structures (e.g., local committee on human rights) that support human rights due diligence
from the private sector?

The assessment facilitators to triangulate results of the brief KIIs with results of the FGDs.

FGDs
From the listing of business enterprise obtained and results of the KIIs, the “more significant” private
corporations will be identified—in terms of the size and reach of their operations, the degree of their
involvement in WASH service delivery, the relative value of their products and services (i.e., how
important) they are providing to the consumers, the extent of their partnership with respective LGUs,
government agencies, civil society organisations, etc. Representatives of these “more significant” private
corporations and business enterprise will be invited to an FGD.

FGD Participants
Whenever present in the target municipalities (or respective provinces), the following are
recommended to be included in the FGDs:
12
Human rights due diligence is the process of assessing actual and potential human rights impact, integrating and acting upon findings, tracking
responses, and communicating how impacts are being addressed. Human rights due diligence:
 Should cover adverse human rights impacts that the business enterprise may cause or contribute to through its own activities, or
which may be directly linked to its operations, products or services by its business relationships;
 Will vary in complexity with the size of the business enterprise, the risk of severe human rights impacts, and the nature and context
of its operations;
 Should be ongoing, recognising that the human rights risk may change over time as the business enterprise’s operations and
operating context evolve.
  Private water district
 Major water concessionaires (water vendors)
 Local enterprise on septage management
 Hardwares in the municipality known to be major suppliers of water and sanitation construction
materials
 Local construction companies on water and sanitation, e.g., toilet bowl manufacturers
 Private schools and academies that have outreach and research programmes on WASH
 Business corporations that have CSR programmes, either on WASH or non-WASH initiatives

Focus Questions
QUESTIONS RESPONSES

Background Information
When was your company or enterprise
established? Who established the company or
enterprise; who owns it?

How would you classify the size of your

company or enterprise (small-, medium-, large-
scale business enterprise)?

What are your company’s vision, mission and

goals? What are your thrust and targets?
(noting thrust and targets related to addressing
needs of the more vulnerable sectors of the
population; note also specific thrust and targets
related to needs of women and girls)?

Does your company have CSR programme?

When was such programme initiated? What
was the motivation in putting up the
programme? What are the nature of projects
and initiatives being implemented under the
programme (noting projects and initiatives
related to WASH)?

Products and Services

What are the main product/s and service/s
being provided by your company or enterprise
(noting product/s and service/s related to
WASH)?
What is the geographical reach of your
product/s and service/s, e.g., within the
barangay/municipality/province only, within
the region only, across regions, nationwide,
international?

Who are the main target consumers of your

product/s and services/s? Are women-
consumers specifically targeted?

How would you regard the marketing of your

product/s and service/s, especially those
related to WASH? Do you feel your company is
earning significantly, earning just fine, not really
earning (break-even), or losing?

What are the factors positively and negatively

affecting the marketing of your product/s and
service/s, e.g., politics and government
bureaucracy, income and purchasing power of
target consumers, competitions, etc?

Partnership with Government

Did you previously have, or do you currently
have, business partnership with the
Government (i.e., LGU)? When did the business
partnership start? How was it initiated?

What is the nature of your past and present

business partnerships with the Government
(noting partnerships related to the delivery of
WASH services)? What are particular conditions
of the business partnerships?

What has been your experience in partnering

with the Government? Were/Are you satisfied
with your previous/present business
partnerships with the Government? Why or
why not?

How can partnerships between the public and

private sector be improved? Do you have any
recommendation on how to have a more
effective PPP?

Is your company a member of any of the

Government’s policy-making body, e.g., local
development council? Is your company a
member of any Government body related to
 WASH, e.g., water and sanitation task force?
How do you find membership in these
Government bodies?

Human Rights Due Diligence

Are there policies, functions or programmes
within your company or enterprise that address
respect for basic human rights? At the very
least, are there statements of commitment on
respecting basic human rights?

Do you get complaints on the product/s and

service/s your company provides? What is the
nature of these complaints (please give
examples? How are these complaints handled
and addressed?Is your company aware of basic
consumers’ rights?

Does your company or enterprise regularly

undergo human rights due diligence? Is such
process coordinated with the Government (i.e.,
LGU)?

Has your company or enterprise encountered

internal (e.g., labour unrest) or external (e.g.,
consumer dissatisfaction) protests? How were
such protests managed? Did the Government
extended support in the resolution of these
protests?

PDR

120
Tool 8. Assessment of the Organizational Capacities of the Municipal
Government Including Existing Partnerships with Civil Society
Stakeholders towards Improved Governance of Safe Water, Sanitation
and Hygiene
Introduction

UNDP has defined governance as the “exercise of economic, political, and administrative authority to
manage a country’s affairs at all levels. It comprises mechanisms, process and institutions, through
which citizens and groups articulate their interests, exercise their legal rights, let their legal obligations
and mediate their difference (UNDP, 1997). The following are the elements of good governance:

 Transparency
 Accountability
 Predictability
 Accountability
 Efficiency
 Community owned
 Results oriented
 Decentralized Decision Making

Institution building on the other hand entails reforming institutions to achieve a desired goal. In the
context of reform, institution building entails capacity development which is more comprehensive i.e.,
looking at the individual, organizational, network/ sectoral and overall policy for a more conducive
enabling environment in relation to the desired goal.

The Joint Programme has recognized that promoting good governance towards an integrated approach
to safe water, sanitation and hygiene can result to positive impact in the lives of the poor especially
women and girls. By pursuing interventions that will infuse elements of good governance into the LGU
administrative systems, the problem which emanates from fragmentation of structures, policies,
budgeting and resource use for programs/ activities/ projects resulting to inefficiencies and less optimal
impact in envisaged program interventions will be properly addressed.

The Joint Programme has focused on the municipal government as a critical actor in pursuing an
integrated approach to safe water, sanitation and hygiene through good governance. In this regard, Tool
7, divided into 7A, 7B and 7C, assesses the current capacities and financial resources of the LGU for
potentially pursuing an integrated approach to safe water, sanitation and hygiene as well as its existing
partnerships with civil society organizations. The results from the tools will be the basis for designing
interventions that will lead towards enhancing the capacities of the LGU for effectively promoting a
more cohesive and harmonized approach to safe water, sanitation, and hygiene with women and girls as
ultimate beneficiaries.
Tool 8A: Assessing the Organizational Capacity of the Municipal Government in Promoting an
Integrated Approach to Safe Water, Sanitation, and Hygiene through Good Governance
Purpose of the Tool:

The tool is intended to determine the extent to which the municipal governments are able to pursue a
well-coordinated and synchronized approach to planning, budgeting, resource use, service delivery, and
monitoring and evaluation of programs/ activities/ projects related to safe water, sanitation and
hygiene. The assessment will inform the following areas of concern:

 Debates and Issues related to safe water, sanitation, and hygiene

 Policies, strategies and structure
 Planning and Budgeting Systems
 Programs and Projects
 Expertise
 Monitoring and Evaluation
 Information and knowledge Management
 Organizational Culture
 Leadership Style and Decision Making
 Choice of Partners

Outputs

The tool will determine current state of affairs of the municipal government in promoting a participatory
approach to providing access to poor families on safe water, sanitation, and hygiene. The findings that
the tool will generate will be the basis for designing interventions that will lead towards improving the
capacity of the municipal governments for promoting an integrated approach to safe water, sanitation
and hygiene through good governance.

Methodology

The tool will be administered through a Focused Group Discussion which can be done in half a day. It is
advisable that the facilitator undertakes a desk review of pertinent data/ information prior to the
conduct of the FGD for him/ her to be informed of the current state of the municipal government’s
initiatives related to safe water, sanitation and hygiene. However, should this be not possible, pertinent
secondary can be secured after the FGD has been undertaken.

The tool is designed to identify the documents that need to be secured in order to further the analysis
resulting from the FGD. Supplementary tables are also provided after each area of concern to facilitate
the listing/ initial processing of information generated from secondary sources.

FGD Participants

The participants of the FGD are the following:

4. Municipal Planning and Development Officer (MPDO)
5. Municipal Social Welfare Development Officer (MSWDO)
6. GAD focal person in the municipality
7. Municipal Health Officer
8. Municipal Budget Officer
9. Municipal Treasurer
10. Municipal Human Resource Development Officer
 11. Representative from the Bids and Awards Committee (BAC)
12. Representatives from the local special bodies on water, sanitation and hygiene other than the
above participants and CSOs

Focus Questions

A. Debates and Issues

Focus Questions FGD Responses Evidences (documents to back

up FGD responses. Refer to
Table A.1 below to document
evidences)
1. What are the current  Minutes of meetings/
issues in relation to discussions highlighting issues
promoting access to and concerns
safe water, sanitation
and hygiene at the  Related Studies/ evaluations
municipal level? done to highlight issues

2. Who are the

stakeholders affected by
the issues being raised?

3. What are your views

regarding the issues
being raised in relation to
promoting access to safe
water, sanitation, and
hygiene by poor families?
Table A. 1: Documenting evidences in relation to Promoting Access to Safe Water, Sanitation and
Hygiene

Document Title Date the document was Brief Description of Name of Provider of
formulated/ published document Information

B. Polices, Strategies and Structure

Focus Questions FGD Responses Evidences (documents to back

up FGD responses. Refer to
Tables below to document
evidences)
1. Policies

a. What are the current  Refer to Table B.1 to

policies at the generate list of existing
provincial, municipal policies. The policies should
and barangay levels include those issued by the
(such as ordinances, provincial government and
resolutions, etc.) the barangays.
which promotes
access of poor families
to safe water,
sanitation and hygiene
?

b. What are the  Get copy of the municipality’s

municipality’s development objectives/
development goals in relation to providing
objectives/ goals in access to safe water,
relation to safe water, sanitation and hygiene
sanitation and
hygiene?
c. Do you think these
goals/ objectives are
sufficient? Why or
why not?
2. Strategies

a. Does the municipality  Get a copy of the strategies.

have defined strategies for Use table B.2 to document
enabling access of poor strategies. Note: Strategies
 families to safe water, maybe mentioned in several
sanitation and hygiene? documents.
What are these strategies?
b. Are stakeholders involved
in developing the
document? Who are
stakeholders?
3. Structure

a. Organizational Structure of  Get a copy of the

the Municipality:
a.1 What is the current
organizational set up of
the LGU in relation to safe
water, sanitation, and
hygiene?
organizational structure of the
Municipality and staffing
pattern of the LGU related to
safe water, sanitation, and
hygiene.

a.2 Do you think the

LGU’s organizational
structure is
appropriate? Why or
why not?

a.3 Are there specific

positions dedicated to  Get copy of roles and
handing tasks related to responsibilities of positions
safe water, sanitation, assigned. Use Table B.3 to
document roles and
and hygiene? What are
responsibilities
these positions? What is
the nature of their
employment?

a.3 If none are there

plans to fill up these
positions?

a.4 Are there clear lines  Please get a copy of

any manual or
of communication
guideline in reference
among units in relation to this.
a more integrated
approach to planning,
budgeting and resource
use for safe water,
 sanitation and hygiene?
Please cite examples.

b. Local Development
Committees:
b.1 What are the
existing development
committees or
structures dedicated to
promoting safe water,
sanitation and hygiene?

b.2 What are the

committees roles and
responsibilities? Who
are the members of the
Committees? Are they
functional? Why or why
not?
Table B. 1: Policies Issued in Relation to Providing Access to Safe Water, Sanitation and Hygiene

Title of Policy Brief Description Date of Source Name of Provider of

Document Information

Table B. 2: Documenting municipal strategies for safe water, sanitation and hygiene

Development Title of Source Date of Source Name of Provider of

Strategies document Document Information

Table B.3: Documenting Roles and Responsibilities of Staff Positions assigned

Name of Staff Position Brief Description of Title of Source Name of Provider of

Tasks Document and Date Information
 C. Planning and Budgeting Systems

Focus Questions FGD Responses Evidences to Back Up FGD

responses
1. Are there existing  Use Table C.1 to generate list
development plans which of existing plans
emphasize access of poor
families to safe water,
sanitation and hygiene?
2. How were the plans
generated? ( Ask
respondents to
describe the actual
process of
generating the plans)
3. How are plans
harmonized/ synchronized
with the budget process of
the LGU?
4. Is there a planning and
budgeting calendar being
observed by the LGU?
How are plans and
budgets approved? Who
approves them?
5. Are stakeholders part of
the development of the
plans? Who were the
stakeholders involved?
6. Are there rules and
procedures of engaging
CSOs and other
stakeholders in the
LGU planning and
budgeting
processes?
Table C.1: Plans Emphasizing Access to Safe Water, Sanitation and Hygiene

Name of Plan Brief Description/ Content of the Date Plans were formulated
Plan

D. Programs and Projects

Focus Questions FGD Responses Evidences in Relation to

Responses
1. What are the municipality’s  Get copy of existing programs
existing programs and and projects. Use Table D.1 to
projects in relation to safe generate inventory of existing
water, sanitation, and programs and projects
hygiene?
2. How are these programs
and projects identified?
3. Who are the Target
Beneficiaries? Were the
beneficiaries involved in
the identification/
finalization of these
projects? How?
4. Are they also part of
program/ project
implementation? How?

Table D.1: Inventory of Existing Programs and Projects

Name of Project Location Date Started End Date Target

Beneficiaries
 E. Expertise

Focus Questions FGD Responses Evidences in Relation to

Responses
1. Are there experts in the
LGU which act as resource
persons for handling the
technical aspects of water,
sanitation and hygiene
programs/ projects?

2. Are they enough? If not,

how does the
municipality source out
additional expertise
needed?

3. What other competencies

are needed by the various
units to enhance skills in
pursuing programs/
activities/ projects related
to safe water, sanitation
and hygiene?

F. Monitoring and Evaluation

Focus Questions FGD Responses Evidences to back up responses

from FGD
1. Is there a system for If there is a monitoring
monitoring and evaluating guideline, please get a copy.
programs/ activities/
projects related to safe
water, sanitation and
hygiene? Please describe
the system in brief

2. How does the information

feed into the policy
formulation process,
planning, budgeting and
resource use of the LGU?

G. Information and Knowledge Management

Focus Questions FGD Responses Evidences to back up responses

from FGD

130
 1. Are there current IEC  Please get sample of materials
materials which promote
safe water sanitation and
hygiene to target
beneficiaries?
2. What are the key
messages that these
materials communicate
to
the target audience?
3. How often are these
materials updated? Is
there a systematic
approach to evaluating/
updating these materials?
If so, please describe.

H. Organizational Culture

Focus Questions FGD Responses Evidences to back up responses

from FGD
1. What is the municipality’s  Please get copy of the vision
vision and mission? and mission statement of the
LGU
2. What is the LGU’s overall
culture/ principle in
encouraging transparency
in promoting safe water,
sanitation and hygiene?

3. What do you think are the

ways in which a more
open and participative
approach to stakeholder
involvement can be better
fostered/ improved
specifically in the planning,
budgeting and resource
use for promoting safe
water, sanitation and
hygiene?

I. Leadership Style and Decision Making

Focus Questions FGD Responses Evidences to Back up FGD

Responses
1. How participative and
supportive is
management/ leadership
for ensuring access of
safe
water, sanitation, and
 hygiene? (Note: leadership
refers to local chief
executive, heads of various
councils/ committees
involved in safe water,
sanitation and hygiene)

2. What about in promoting

Transparency and
accountability?
 J. Choice of Partners

Focus Questions FGD Responses Evidences to Back up FGD

Responses
1. Who are the current  Use Table J.1 to generate list
stakeholder partners of of partners
the LGU for safe water,
sanitation and hygiene?
2. How are these
partners chosen? What
are the
criteria adopted?

Table J.1: List of Municipal Partners in Promoting Access to Safe Water, Sanitation and Hygiene

Name of Type of Legal Instrument Services / Geographic

Organization Organization (NGO, to Formalize Programs Area of
cooperative, etc) Engagement with Offered Operations
LGU (MOA,
Contract, etc)

K. Promoting an Integrated Approach to Safe Water, Sanitation and Hygiene

Focus Questions Responses Evidences to Back up

FGD Responses
1. Do you think that promoting access to
safe water, sanitation and hygiene should
be
undertaken in an integrated manner? How?
2. What do you think are specific areas for
improvement to move towards an integrated
approach? Give specific details in reference
to:
 Policy formulation
 Planning
 Budgeting
 Administration of contracts
(service delivery)
 Actual Service Delivery
 Monitoring and Evaluation
Tool 8B: Assessing the Participation of Civil Society Stakeholders in Promoting Safe Water,
Sanitation and Hygiene through Good Governance

Purpose of the Tool:

The tool is intended to determine the extent to which civil society and other stakeholders are able to
participate in the planning, policy formulation, resource planning, implementation and monitoring and
evaluation of programs/ activities/ projects related to safe water sanitation and hygiene. The tool should
corroborate the responses which will be generated from tool 7a in order to have a more objective
analysis as to the extent of civil society/ stakeholder participation in the LGU’s governance processes.

Outputs

The tool is expected to generate information regarding the extent of civil society stakeholder
engagement the LGU governance processes for promoting access of poor families to safe water,
sanitation and hygiene.

Methodology

The tool will be administered through desk review and Focused Group Discussions.

FGD Participants

CSO Partners of the LGU and those CSOs advocating for access to safe water, sanitation and hygiene:

 NGOs
 POs
 Cooperatives
 Federation, Council, Consortium of CSOs
 BAWASA
 Private for Profit service providers

Focus Questions for CSO stakeholders

Focus Questions Responses Documents to back up FGD

responses
A. Background Information Get organizational profile
of the CSO/ stakeholder
1. When was your organization established?

2. What is the organization’s vision and mission?

3. What are the organization’s programs/projects
in relation to safe water, sanitation and
hygiene?

4. In which geographic areas/ barangays do you

operate?
 Focus Questions Responses Documents to back up FGD
responses

5. If a federation, who are the members of Get a list of the federation

the federation? How do you get to select members
the members?

B. Debates/ issues on Safe Water Sanitation and

Hygiene
1. Is your group/ organization involved in
debates/ issues regarding safe water,
sanitation, and hygiene?

2. What is the main issue of the CSO in regard

to safe water sanitation and hygiene?

3. Who is your main partner at the provincial or

municipal government as regards your
advocacy for promoting access of poor families
(especially women and girls) to safe water,
sanitation and hygiene?

4. How long have you been working with the

LGU in this effort? What was your main reason
for working with the LGU?

C. Participation in Policy Formulation

1. Is your organization a member of any of the

LGU’s policy making body specific to safe
water, sanitation, and hygiene (i.e. Local
Development Council, Local Health Board,
Local School Board)? If yes, when did you
become a member? How were you selected? If
not, any particular reason why not?
2. Does your organization actively participate in Ask respondents to
any of the policy discussions/ deliberations of enumerate the various
the municipal government especially in policies in which they were
matters relating to promoting access to safe involved/ get to
water sanitation and hygiene? Which policies
participate.
(i.e. ordinances, and resolutions) are these?

3. If not, what are the challenges that deter

you from doing so?

D. Participation in Planning, Design, and Resource

Allocation of Programs/ activities/ projects
 Focus Questions Responses Documents to back up FGD
responses
1. Do your organizations get to be involved in the
planning, design, and allocation of resources
by the municipal government in relation to
programs/ activities/ projects related to
promoting access to safe water, sanitation and
hygiene? In what way? If so, in which specific
venues that you get to participate? (Venues
can be the following:
 Local Development Council
 Local Poverty Reduction Action Teams
(LPRAT)
 Annual Investment Planning
 In other special bodies such Watsan
committees, Local Health Boards, etc.
2. If not, why?

E. Collaboration with the LGU in implementing

specific programs/ activities/ projects:

1. Are any of your organizations or members (for

federation, consortium or council) accredited
by the municipal government as service
provider for safe water, sanitation and
hygiene?

2. Do you have any existing contract or any form

of agreement with the LGU as a service
provider for such undertakings? If so what are
these?

3. How was the contracting arrangement

between your group and the LGU forged?
What are your specific roles and
responsibilities? What about the LGU? What is
the pricing scheme?
4. How many projects have you undertaken with
the LGU in this regard?

5. Do you have specific experts to work with the

LGU in regard to the technical requirements
of projects related to safe water, sanitation
and hygiene?

F. Monitoring and Evaluation

a. Have any of your organizations been involved
in the monitoring and evaluation of programs/
activities/ projects? If yes, in what way? If not,
why?
b. What is the mechanism for feedbacking? What
types of information do you furnish the LGU in
 Focus Questions Responses Documents to back up FGD
responses
regard to tracking progress of programs/
projects?

G. How is the LGU’s receptiveness in regard to the

issues raised and specific recommendations? Were
actions taken based on your recommendations?
Can you cite examples? How are issues and
problems resolved?
H. Knowledge Management
1. Does any of your organizations actively
involved in disseminating information
regarding access to safe water, sanitation and
hygiene? Do you have IEC materials
developed particularly for this?

I. Overall Effectiveness regarding the Participation

of the organization in LGU governance affairs
3. On the overall, do you think the organization
has been effective in collaborating with the
LGU in efficiently and effectively governing
programs/activities/ projects related to
promoting access of poor families to safe
water, sanitation and hygiene?
4. What do you think are the facilitating and
hindering factors?
5. What do you think are specific areas for
improvement (give specific details in reference
to:
 Policy formulation
 Planning
 Budgeting
 Administration of contracts
(service delivery)
 Actual Service Delivery
 Monitoring and Evaluation
Tool 8C: Local Government Unit Financial Capacity

Purpose of the Tool

This tool will gather information on and data on the LGU Income for the years 2012, 2013 and 2014;
LGU Expenditure Profile on water, sanitation and hygiene for the years 2012, 2013 and 2014, and
Information on Existing LGU Loan/s. The data and information will be useful in knowing the amount that
the LGU is investing for safe water, sanitation and hygiene.

Outputs

The tool will generate the following information:

 LGU Income for the years 2012, 2013 and 2014;

 LGU Expenditure Profile on water, sanitation and hygiene for the years 2012, 2013 and 2014,
 Information on Existing LGU Loan/s

Methodology

The data and information required by this tool can be derived through a desk review of documents or
secondary sources of information. This tool will be accomplished by transferring data and information
from the gathered documents into the matrices provided in this tool. In gathering information using the
tool, the following steps shall be done by the assessment facilitator:

1. The assessment facilitator/enumerator sets an appointment with the head of the Budget and
Finance Department of the LGU and seek permission to look at existing financial reports
covering the years 2012, 2013 and 2014.
2. The assessment facilitator/enumerator lists all the gathered documents in Matrix 1 – Sources
and Dates of Documents
3. The assessment facilitator/enumerator reviews all the required documents and transfers the
data and information in the matrix provided in this tool.

Sources of Information

The documents needed to complete this form can be gathered from the Budget and Finance
Department of the LGU.
Municipality:
Name of Data Encoder: Date Encoded:

Department/Office:

Matrix 1 - List of Sources and Dates of the Documents:

Title of the Documents Year Sources – Name of Offices and Persons who
provided the document
(Documents from years 2012, 2013, 2014
only)

140
Matrix 2- Income Profile

Local Sources

Tax Revenue Non-Tax Revenue

Fiscal
Year Receipts from
Real Property Regulatory Service /User Other
Business Tax Other Taxes Economic Toll Fees
Tax Fees Charges Receipts
Enterprise

2014

2013

2012

Shares from National Tax Other Sources

Fiscal
Total Income
Year
Internal Revenue Extra- ordinary Inter-Local
Other Shares Loans & Borrowings
Allotment Receipts/ Aids Transfers

2014

2013

2012

141
Matrix 3- Expenditure Profile

Debt Service
Sanitation (Toilets,
Fiscal Waste Water, Solid Health and (For loans on Total
Water DRRM GAD PPP water,
Year Waste Hygiene Expenditures
Management) sanitation
and hygiene)

PS:
PS: PS: PS: PS: PS: PS:
MOOE:
MOOE: MOOE: MOOE: MOOE: MOOE: MOOE:
_
2014 CO: CO: CO: CO: CO: CO:
CO:

Total: Total: Total: Total: Total: Total:

Total:

PS: PS: PS:

PS: PS: PS: PS:
MOOE: MOOE: MOOE:
MOOE: MOOE: MOOE: MOOE:
2013 _
CO: CO: CO: CO:
CO: CO: CO:
Total: Total: Total: Total:
Total: Total: Total:

PS: PS: PS: PS: PS: PS: PS:

MOOE: MOOE: MOOE: MOOE: MOOE: MOOE: MOOE:

2012
CO: CO: CO: CO: CO: CO: CO:

Total: Total: Total: Total: Total: Total: Total:

 PS – Personnel Services; MOOE – Maintenance and Other Operating Expenses; CO – Capital Outlay. Sources of information – Annual
expenditure reports.
Matrix 4. Information on Existing LGU Loan/s

Amount of Grace End of

Purpose of Existing Annual Repayment Interest Funding
Loan Details Existing Period Repayment
Loan Amortization Period Rate Institution
Loan (Years) Period
Glossary of Terms

Term Definition
Business Tax The tax on business is an annual tax imposed on the act
of doing business within the LGU

Extra ordinary Receipts Income which does not regularly accrue to the
government, the collection for which is indefinite or
does not depend entirely on the authority of the
government.

Fiscal Year Non-calendar year use for accounting or financial

reporting

Internal Revenue Allotment The account created under PD 144, as amended,

representing the portion of total national government
revenues which accrue to the local governments.
Includes the local government share in the specific tax
on oil products authorized by PD 436, as amended. This
share has been revised under the Local Government
Code of 1991 and is now termed as internal revenue
allotment.

Non-tax Revenue Financial charges in the form of fees for the rent of
Government property, and purchase of Government
permits and forms

Real Property Tax this account is used to record the ad valorem tax
imposed on real properties and their improvements.
Real Property includes land, buildings, machinery and
other improvements affixed or attached to the real
property.

Regulatory Fees fees derived from the exercise of the regulatory powers
of local governments (police power) such as Mayor’s
Permit, Slaughter Permit Fees, etc

Tax Revenue Are compulsory contributions to finance government

operations. Taxes are computed at the rate established
by law to a defined base such as income, estate, imports,
exports, foreign exchange, etc., without any direct
relation to the services rendered to the individual
assessed

144
 Toll Fees Toll fees or charges for the use of any public road, pier or
wharf, waterway, bridge or telecommunications system.

Reference:

www.dbm.gov.ph

www.blgf.gov.ph