| ## |
WATER ACCESS AND QUALITY |
|
|
|
|
| 59 |
What is your household’s main source of drinking water? |
Sumber air bersih |
|
|
|
| * |
main |
utama |
PDAM |
PDAM |
|
| * |
additional |
tambahan |
purchased bottled water/ purified/ distilled water |
beli di toko atau pedagang air keliling |
|
| * |
|
|
purchased tanker truck/peddler |
|
|
| * |
relative importance |
|
piped water system -individual household access |
|
|
| * |
|
|
piped water system -access via other households (HHS) |
|
|
| * |
|
|
piped water system -access via single village / community sourcepoint |
|
|
| * |
|
|
dug/ shallow well - personal use / individual household access |
|
|
| * |
|
|
dug/ shallow well - shared access with other households (HHS) |
|
|
| |
|
|
dug/ shallow well -access via single village / community sourcepoint |
|
|
| * |
|
|
artesian shallow well - personal use / individual household access |
|
|
| * |
|
|
artesian shallow well - shared access with other households (HHS) |
|
|
| * |
|
|
artesian shallow well -access via single village / community sourcepoint |
|
|
| * |
|
|
artesian deep well - personal use / individual household access |
|
|
| * |
|
|
artesian deep well - shared access with other households (HHS) |
sumur umum |
|
| * |
|
|
artesian deep well -access via single village / community sourcepoint |
|
|
| * |
|
|
spring water, specify |
mata air, tentukan |
|
| * |
|
|
river, stream, lake, spring and/or other natural water sources |
sungai |
|
| * |
|
|
rainwater |
air hujan |
|
| * |
|
|
other (specify) |
lainnya (sebutkan) |
|
| 60 |
How far is it to this source? |
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|
|
|
| * |
|
|
under 100m |
|
|
| * |
|
|
100m to 1 km |
|
|
| * |
|
|
over 1 km |
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|
| 61 |
How long does it take for each return trip to gather water from this source? |
|
(minutes/hours) |
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|
| 62 |
How do you get there, on average? |
Bagaimana Anda sampai di sana, rata-rata? |
|
|
|
| * |
|
|
on foot |
berjalan kaki |
|
| * |
|
|
on foot, with hand trolley |
berjalan kaki, dengan tangan troli |
|
| * |
|
|
bicycle, self-owned |
sepeda, milik sendiri |
|
| * |
|
|
bicycle, borrowed |
sepeda, dipinjam |
|
| * |
|
|
bicycle, rented / hired |
sepeda, menyewa |
|
| * |
|
|
motorbike, self-owned |
sepeda motor, milik sendiri |
|
| * |
|
|
motorbike, borrowed |
sepeda motor, dipinjam |
|
| * |
|
|
motorbike taxi |
ojek |
|
| * |
|
|
car, self-owned |
mobil, milik sendiri |
|
| * |
|
|
car, rented / hired |
mobil, menyewa |
|
| * |
|
|
van, self-owned |
van, milik sendiri |
|
| * |
|
|
van, rented / hired |
van, disewa |
|
| * |
|
|
bus, hired |
bus, disewa |
|
| * |
|
|
non-motor boats: catamaran |
perahu tanpa motor: jukung |
|
| * |
|
|
non-motor boats: small |
perahu tanpa motor: kecil |
|
| * |
|
|
non-motor boats: medium |
perahu tanpa motor: sedang |
|
| * |
|
|
non-motor boats: large |
perahu tanpa motor: besar |
|
| * |
|
|
outboard motor boat |
perahu motor tempel |
|
| * |
|
|
onboard motor boat |
kapal motor |
|
| * |
|
|
public transportation |
transportasi umum |
|
| * |
|
|
others (specify) |
lainnya (sebutkan) |
|
| 63 |
How much does it cost to get there, if any? |
|
|
|
|
| * |
|
|
no cost |
|
|
| * |
|
|
(rupiah) |
|
|
| 64 |
What is your daily consumption of water for drinking? |
Apa konsumsi sehari-hari Anda air untuk minum / mandi? |
(liters/pails/gallons/tanks) |
|
|
| 65 |
How plentiful (quantity) is the availability of your water sources? |
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|
| * |
|
|
abundant |
|
|
| * |
|
|
adequate |
|
|
| * |
|
|
scarce |
|
|
| * |
|
|
unknown / uncertain |
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|
| 66 |
How is the quality of your water sources? |
|
|
|
|
| * |
|
|
good |
|
|
| * |
|
|
bad |
|
|
| * |
|
|
unknown / uncertain |
|
|
| 67 |
color |
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|
|
|
| * |
|
|
opaque |
|
|
| * |
|
|
colored / tinted |
|
|
| * |
|
|
clear |
|
|
| 68 |
taste |
|
|
|
|
| * |
|
|
has good taste |
memiliki selera yang baik |
|
| * |
|
|
has bad taste |
memiliki rasa yang buruk |
|
| * |
|
|
tasteless |
hambar |
|
| 69 |
odor |
|
|
|
|
| * |
|
|
has odour |
memiliki bau |
|
| * |
|
|
odourless |
tanpa bau |
|
| 70 |
Has the water been tested for chemicals/microbiological contents? |
|
|
|
|
| * |
|
|
yes (results) |
ya (hasil) |
|
| * |
|
|
no (note reason, if given) |
tidak ada (catatan alasan, jika diberikan) |
|
| * |
|
|
unknown / uncertain |
tidak diketahui / tidak pasti |
|
| 71 |
Are you aware if your water is treated with any purification process before consuming it? |
|
|
|
|
| * |
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|
no purification, drink directly |
tidak ada pemurnian, minum langsung |
|
| * |
|
|
sedimentation |
pengendapan |
|
| * |
|
|
filtration |
penyaringan |
|
| * |
|
|
distillation |
distilasi |
|
| * |
|
|
flocculation |
flokulasi |
|
| * |
|
|
chlorination |
klorinasi |
|
| * |
|
|
UV lights/ozon |
lampu UV / ozon |
|
| * |
|
|
others (specify) |
lainnya (sebutkan) |
|
| 72 |
Do you sterilize / disinfect your water before consuming it? |
|
|
|
|
| * |
|
|
no desinfection, drink directly |
|
|
| * |
|
|
boiled |
|
|
| * |
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|
others (specify) |
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|
| 73 |
What is your primary clean water source for bathing? |
Apa sumber air utama Anda bersih untuk minum / mandi? |
|
|
|
| * |
main |
utama |
PDAM |
PDAM |
(if multiple answers given, record order of priority) |
| * |
additional |
tambahan |
purchased tanker truck/peddler |
|
|
| * |
relative importance? |
|
piped water system -individual household access |
|
|
| * |
|
|
piped water system -access via other households (HHS) |
|
|
| * |
|
|
piped water system -access via single village / community sourcepoint |
|
|
| * |
|
|
dug/ shallow well - personal use / individual household access |
pribadi sumur gali |
|
| * |
|
|
dug/ shallow well - shared access with other households (HHS) |
tetangga ‘sumur gali |
|
| * |
|
|
dug/ shallow well -access via single village / community sourcepoint |
tetangga ‘sumur gali |
|
| * |
|
|
artesian shallow well - personal use / individual household access |
sumur bor |
|
| * |
|
|
artesian shallow well - shared access with other households (HHS) |
sumur bor |
|
| * |
|
|
artesian shallow well -access via single village / community sourcepoint |
sumur bor |
|
| * |
|
|
artesian deep well - personal use / individual household access |
sumur umum |
|
| * |
|
|
artesian deep well - shared access with other households (HHS) |
sumur umum |
|
| * |
|
|
artesian deep well -access via single village / community sourcepoint |
sumur umum |
|
| * |
|
|
spring water, specify |
mata air, tentukan |
|
| * |
|
|
river, stream, lake, spring and/or other natural water sources |
sungai, tentukan |
|
| * |
|
|
rainwater |
air hujan |
|
| * |
|
|
other (specify) |
lainnya (sebutkan) |
|
| 74 |
How long does it take to get to your primary water source? |
Berapa lama waktu yang diperlukan untuk sampai ke sumber air utama Anda? |
|
|
|
| * |
|
|
(meters/kilometers) |
|
|
| * |
|
|
(minutes / hours) |
|
|
| 75 |
How do you get there, on average? |
Bagaimana Anda sampai di sana, rata-rata? |
|
|
|
| * |
|
|
on foot |
berjalan kaki |
|
| * |
|
|
on foot, with hand trolley |
berjalan kaki, dengan tangan troli |
|
| * |
|
|
bicycle, self-owned |
sepeda, milik sendiri |
|
| * |
|
|
bicycle, borrowed |
sepeda, dipinjam |
|
| * |
|
|
bicycle, rented / hired |
sepeda, menyewa |
|
| * |
|
|
motorbike, self-owned |
sepeda motor, milik sendiri |
|
| * |
|
|
motorbike, borrowed |
sepeda motor, dipinjam |
|
| * |
|
|
motorbike taxi |
ojek |
|
| * |
|
|
car, self-owned |
mobil, milik sendiri |
|
| * |
|
|
car, rented / hired |
mobil, menyewa |
|
| * |
|
|
van, self-owned |
van, milik sendiri |
|
| * |
|
|
van, rented / hired |
van, disewa |
|
| * |
|
|
bus, hired |
bus, disewa |
|
| * |
|
|
non-motor boats: catamaran |
perahu tanpa motor: jukung |
|
| * |
|
|
non-motor boats: small |
perahu tanpa motor: kecil |
|
| * |
|
|
non-motor boats: medium |
perahu tanpa motor: sedang |
|
| * |
|
|
non-motor boats: large |
perahu tanpa motor: besar |
|
| * |
|
|
outboard motor boat |
perahu motor tempel |
|
| * |
|
|
onboard motor boat |
kapal motor |
|
| * |
|
|
public transportation |
transportasi umum |
|
| * |
|
|
others (specify) |
lainnya (sebutkan) |
|
| 76 |
How much does it cost to get there, if any? |
|
|
|
|
| * |
|
|
no cost |
|
|
| * |
|
|
(rupiah) |
|
|
| 77 |
For what other purposes do you use water? |
|
|
|
|
| * |
|
|
irrigation for agriculture |
|
|
| * |
|
|
irrigation for plantations |
|
|
| * |
|
|
water for livestock |
|
|
| 78 |
How much water would you estimate that you consume on average each day? |
|
(liters/pails/gallons/tanks) |
|
|
| 79 |
Have your ever experienced any water shortage? |
|
|
|
|
| * |
|
|
yes (duration in month/season) |
ya (durasi bulan / musim) |
|
| * |
|
|
yes (duration in days/weeks/months) |
ya (durasi dalam beberapa hari / minggu / bulan) |
|
| * |
|
|
no / have not experienced |
tidak / belum mengalami |
|
| * |
|
|
cannot recall |
tidak ingat |
|
| 80 |
How do you find an alternate for water resources? |
|
|
|
|
| * |
|
|
never have needed alternative source |
pernah diperlukan sumber alternatif |
|
| * |
|
|
look for other water resources (distance / km) |
mencari sumber air lainnya (jarak / km) |
|
| * |
|
|
purchase water (cost /liter/pail/gallon/tank etc.) |
air pembelian (biaya / liter / pail / galon / tangki dll) |
|
| * |
|
|
use rainwater |
menggunakan air hujan |
|
| * |
|
|
others (specify) |
lainnya (sebutkan) |
|
| ## |
RESIDENCE / DWELLING LIVING CONDITIONS |
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|
|
|
| 81 |
What is the main source of fuel for household cooking? |
|
|
|
|
| * |
|
|
wood fuel |
kayu |
|
| * |
|
|
charcoal |
arang |
|
| * |
|
|
coal |
batubara |
|
| * |
|
|
kerosene |
gas (minyak tanah / kompor minyak tanah) |
|
| * |
|
|
LPG (or bottled gas) -non-subsidy |
LPG (atau gas botol) -Non-subsidi |
|
| * |
|
|
LPG (or bottled gas) -subsidized green gas tank |
LPG (atau gas botol) -subsidized tangki bensin hijau |
|
| * |
|
|
LPG (or bottled gas) -subsidized blue gas tank |
LPG (atau gas botol) -subsidized tangki bensin biru |
|
| * |
|
|
electricity |
listrik |
|
| * |
|
|
other (specify) |
lainnya (sebutkan) |
|
| 82 |
Are cooking activities conducted indoor? |
|
|
|
|
| * |
|
|
yes |
ya |
|
| * |
|
|
no |
tidak |
|
| 83 |
condition of air circulation |
|
|
|
(filled in based on observation) |
| * |
|
|
bad |
buruk |
|
| * |
|
|
moderate |
moderat |
|
| * |
|
|
good |
baik |
|
| 84 |
Does the residence / structure / house have adequate ventilation? |
Apakah rumah bapak/ibu memiliki ventilasi udara yang cukup memadai? |
|
|
|
| * |
|
|
yes |
ya |
|
| * |
|
|
no |
tidak |
|
| * |
|
|
do not know |
tidak tahu |
|
| 85 |
Type of existing ventilation? |
Jika ya, bagaimana kondisi ventilasi rumah yang bapak/ibu tempatin sekarang? |
|
|
(filled in based on observation) |
| * |
|
|
window |
jendela |
|
| * |
|
|
the open roof |
atap terbuka |
|
| * |
|
|
spaces between plaited bamboo/rattan wall |
celah-celah dinding kayu (bambu atau rotan) |
|
| * |
|
|
other (specify) |
lainnya (sebutkan): ……… |
|
| 86 |
Condition of lighting/illumination? |
“pencahayaan rumah” |
|
|
(filled in based on observation) |
| * |
|
|
dark |
gelap |
|
| * |
|
|
moderate |
moderat |
|
| * |
|
|
bright |
cerah |
|
| * |
|
|
|
|
|
| 87 |
Does adequate sunlight get into the house? |
Apakah rumah bapak/ibu mendapatkan sinar matahari yang cukup? |
|
|
|
| * |
|
|
yes |
ya |
|
| * |
|
|
no |
tidak |
|
| * |
|
|
do not know |
tidak tahu |
|
| 88 |
What kind of lighting is used? (may give more than one answer) |
Jenis penerangan apa yang digunakan? |
|
(may give more than one answer) |
|
| * |
|
|
electricity |
listrik |
|
| * |
|
|
oil/petromax |
|
|
| * |
|
|
oil/kerosene/petromax light |
lampu petromax |
to combine with secondary data or socio-economic survey |
| * |
|
|
|
lampu minyak tanah |
|
| * |
|
|
solar cell lamps |
|
|
| * |
|
|
candle / paraffin |
lilin / parafin |
|
| * |
|
|
others (specify) |
lainnya (sebutkan) |
|
| 89 |
Is there any difficulty in getting the energy source? |
Apakah ada kesulitan dalam mendapatkan sumber energi tersebut? |
(if not, go to qX) |
(jika tidak, lanjutkan ke pertanyaan X) |
|
| * |
|
|
yes |
ya |
|
| * |
|
|
do not |
tidak |
|
| * |
|
|
do not know |
tidak tahu |
|
| 90 |
If yes, type of difficulties faced in what form? |
Jika ya, jenis kesulitan yang dihadapi dalam bentuk apa? |
|
|
|
| 91 |
How the father / mother face difficulties? |
Bagaimana bapak/ibu menghadapi kesulitan tersebut? |
|
|
|
| 92 |
Is there electricity in the house/ building? |
|
|
|
|
| * |
|
|
if yes, proceed to qX, |
|
|
| * |
|
|
if not proceed to qY |
|
|
| 94 |
What is the main source of electricity to the dwelling? |
sumber energi |
|
|
|
| * |
main |
utama |
electric company (name?) |
|
|
| * |
additional |
tambahan |
government electricity (PLN) -direct connection |
listrik pemerintah (PLN) |
|
| * |
|
|
government electricity (PLN) -connected from neighbours |
listrik pemerintah (PLN), yang dihubungkan dari tetangga |
|
| * |
|
|
personal generator |
generator pribadi |
|
| * |
|
|
generator, connected from neighbours |
|
|
| * |
|
|
gas generator |
gas generator |
|
| * |
|
|
kerosene generator |
minyak tanah |
|
| * |
|
|
solar |
Tenaga Surya |
|
| * |
|
|
battery |
|
|
| * |
|
|
|
obor |
|
| * |
|
|
|
lampu minyak tanah |
|
| * |
|
|
others (specify) |
lainnya (sebutkan) |
|
| ## |
RESIDENCE / DWELLING STRUCTURAL CONDITIONS |
|
|
|
|
| 95 |
Does your household own the dwelling in which you are currently living? |
Status kepemilikan tempat tinggal / struktur / rumah yang sekarang ditempati? |
|
|
|
| * |
|
|
yes -personally owned |
dimiliki secara pribadi |
|
| * |
|
|
no -rented/contracted |
menyewa / kontrak |
|
| * |
|
|
no -boarding with others |
asrama dengan orang lain |
|
| * |
|
|
no -living in others’ yard |
tinggal di halaman orang lain |
|
| 96 |
Permanency of the residence/ structure/ house currently occupied? |
Pekerjaan tetap tempat tinggal / struktur / rumah yang sekarang ditempati? // Bagaimana kondisi rumah bapak/ibu? |
|
|
|
| * |
|
|
permanent |
permanen |
|
| * |
|
|
semi permanent |
semi permanen |
|
| * |
|
|
shack/temporary shelter |
sementara |
|
| 97 |
What is the size of the house? |
|
(area in m2) |
|
|
| 98 |
How many rooms does the house have? |
|
|
|
|
| 99 |
From what materials was the residence / household / structure built? |
Dari bahan apa yang kediaman / rumah tangga / struktur dibangun? |
|
|
|
| * |
|
Apa kondisi fisik dari rumah bapak/ibu? |
wooden simple house |
|
|
| * |
|
|
wooden stilt house |
(rumah panggung) |
|
| * |
|
|
brick |
|
|
| * |
|
|
concrete |
|
|
| * |
|
|
other (specify) |
lainnya (sebutkan) |
|
| 100 |
What is the wall material for your house? |
|
|
|
|
| 101 |
Roof typed of occupied house? |
Bagaimana kondisi atap rumah bapak/ibu? |
|
|
(filled in based on observation) |
| * |
|
|
thatched roof |
atap rumbia/alang-alang |
|
| * |
|
|
shingle roof |
atap sirap - ulin |
|
| * |
|
|
tile |
genteng |
|
| * |
|
|
pottery |
tembikar |
|
| * |
|
|
zinc |
seng |
|
| * |
|
|
galvanized corrugated roof |
|
|
| * |
|
|
asbestos |
asbes |
|
| * |
|
|
asbestos corrugated roof |
|
|
| * |
|
|
wood/plywood |
kayu/triplek |
|
| * |
|
|
other (specify) |
lainnya (sebutkan) |
|
| 102 |
Floor typed of occupied house (filled in based on observation) |
Bagaimana kondisi lantai rumah bapak/ibu? |
|
|
|
| * |
|
|
hard soil |
tanah keras (lantai tanah) |
|
| * |
|
|
plywood |
triplek |
|
| * |
|
|
wood |
kayu |
|
| * |
|
|
cemented floor |
semen |
|
| * |
|
|
tile/ceramic tile (lantai ubin) |
ubin/keramik (lantai ubin) |
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| * |
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others (specify) |
lainnya (sebutkan) |
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| 103 |
What are the characteristics of traditional housing? |
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| 104 |
What materials are commonly used in creating shelters? |
Bahan apa yang lazim digunakan dalam membangun bivak? |
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| 105 |
Are any building materials hard to come by? |
Apakah ada bahan bangunan yang sulit diperoleh? |
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| 106 |
What is the average value for different types of houses in this area? |
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| 107 |
Do you estimate there is an active market for renting houses in this area? |
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| 108 |
Can you please help us try to estimate the rent different house types in this area? |
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| 109 |
Can you estimate the rent for a single room? |
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| ## |
SANITATION AND PERSONAL HYGENE |
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| 110 |
What facilities does your family use for bathing? |
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| * |
season: |
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bucket, in own home |
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|
| * |
dry |
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bucket, in neighbour’s home |
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|
| * |
rainy |
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personal bath, indoors |
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| * |
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personal bath, outdoors |
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| * |
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neighbours’ bath, indoors |
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| * |
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neighbours’ bath, outdoors |
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| * |
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public MCK (bathing, washing & latrine) |
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| * |
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river |
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| * |
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mangrove |
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| * |
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ocean |
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| * |
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other (specify) |
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