APPENDIX

Appendix I – Monitoring & Evaluation Questionnaire

Appendix II – Community Monitoring Results

BONGO
A Balungu
B Aliba
C Gowrie

TALENSI NABDAM
D Pwalugu
E Baluugu
F Arigu

BOLGATANGA
G Soe Yipala
H Dachio
I Kumbosco
J Kumbangli

GARU TEMPANE
K Buarboka
L Namboko

KASSENA NANKANA
M Gorum
N Nyaganya
O Kanonia
P Agrumaloko
Q Dusidoma
R Kayoro
S Kayavio
T Gonsa

BUILSA
U Logvuusa
V Kaasa
W Yamkpansa
APPENDIX I – Monitoring & Evaluation Questionnaire

CERAMIC FILTER END USER MONITORING CHECKLIST

DISTRICT____________________________ COMMUNITY______________________________

1. NAME OF HOUSEHOLD________________________________________________________

2. NAME OF BENEFICIARY________________________________________________________

3. SOURCE OF WATER stream / river/ dam/ lake/ pond HDW(protected)

HDW(unprotected) BH other_______________________________

4. WHO USUALLY FETCHES THE WATER woman child man

5. WHO CONTROLS USE OF FILTERED WATER woman man

6. FILTER IN USE yes no

7. NUMBER FILTERS IN HOUSEHOLD 1 2 3 4 5

other_________

8. WHAT VESSEL USED TO FILL CERAMIC FILTER cup calabash other

9. WHAT VESSEL USED TO ACCESS FILTERED WATER cup calabash other

10. WHAT IS CONDITION OF DRINKING CUP? Hygienic Non Hygienic

11. WHERE IS DRINKING VESSEL KEPT top of CF beside CF bottom of CF

other_____________________________________________________

12. HOW OFTEN FILTER FILLED DAILY one twice three

more_______

13. WHEN IS IT FILLED morning afternoon evening

14. IS FILTETRED WATER STORED ANYWHERE IN HSHOLD yes no

15. Location Room Veranda Inner Court Outside Household

other_______________________

16. TASTE OF WATER Sweet Sour Salty Other__________________________

17. DO YOU CLEAN FILTER? yes No

18. HOW DO YOU KNOW WHEN TO CLEAN FILTER? _________________________________

19. HOW OFTEN IS IT CLEANED 1 x week 2 x week 3 x week other__________

20. WHAT DO YOU USE TO CLEAN It Brush Other______________________________

21. DEMONSTRATE FILTER CLEANING Correct Not Correct

 22. DEMONSTRATE CLEANING OF PLASTIIC CONTAINER Correct Not Correct

23. LOCATION OF CF IN HOUSEHOLD ___________________________________________________

24. WHAT IS FILTERED WATER USED FOR drinking bath cooking

other__________

25. HOW MANY PEOPLE USE THIS WATER FROM ONE UNIT 1 2 3 4 5 6 7 8
other_______

26. ANY PROBLEMS IN USE, MAINTENANCE OF FILTETR leakage breakage

-
Other______________________________ NONE

27. LEVEL OF WATER IN PLASTIC CONTAINER ¼ ½ ¾ FULL

28. REPLACEMENT PARTS REQUIRED FILTER TAP PLASTIC BUCKET

WASHERS OTHER____________________________________

29. DO YOU USE ANY OTHER METHOD FOR TREATING YOUR WATER?

YES_________________________________________________________ NO

30. WHAT DO YOU THINK ARE THE BENEFITS OF USING THIS FILTERED WATER?

31. ANY QUESTIONS?

32. OBSERVATIONS:

NAME OF OFFICER:_____________________________SIGNATURE -
___________________________gftnju64

DATE:_________/_____________/___________

GPS COORDINATES NORTH WEST / EAST

A BALUNGU (BONGO DISTRICT) – COMMUNITY MONITORING RESULTS
B ALIBA (BONGO DISTRICT) – COMMUNITY MONITORING RESULTS
C GOWRIE (BONGO DISTRICT) – COMMUNITY MONITORING RESULTS
D PWALUGU (TALENSI NABDAM DISTRICT) – COMMUNITY MONITORING RESULTS
E BALUUGU (TALENSI NABDAM DISTRICT) – COMMUNITY MONITORING RESULTS
F ARIGU (TALENSI NABDAM DISTRICT) – COMMUNITY MONITORING RESULTS
G SOE YIPALA (BOLGATANGA DISTRICT) – COMMUNITY MONITORING RESULTS
H DACHIO (BOLGATANGA DISTRICT) – COMMUNITY MONITORING RESULTS
I KUMBOSCO (BOLGATANGA DISTRICT) – COMMUNITY MONITORING RESULTS
J KUMBANGLI (BOLGATANGA DISTRICT) – COMMUNITY MONITORING RESULTS
K BUARBOKA (GARU TEMPANE DISTRICT) – COMMUNITY MONITORING RESULTS
L NAMBOKO (GARU TEMPANE DISTRICT) – COMMUNITY MONITORING RESULTS
M GORUM (KASSENA NANKANA DISTRICT) – COMMUNITY MONITORING RESULTS
N NYAGANYA (KASSENA NANKANA DISTRICT) – COMMUNITY MONITORING RESULTS
O KANONIA (KASSENA NANKANA DISTRICT) – COMMUNITY MONITORING RESULTS
P AGRUMALOKO (KASSENA NANKANA DISTRICT) – COMMUNITY MONITORING RESULTS
Q DUSIDOMA (KASSENA NANKANA DISTRICT) – COMMUNITY MONITORING RESULTS
R KAYORO (KASSENA NANKANA DISTRICT) – COMMUNITY MONITORING RESULTS
S KAYAVIO (KASSENA NANKANA DISTRICT) – COMMUNITY MONITORING RESULTS
T GONSA (KASSENA NANKANA DISTRICT) – COMMUNITY MONITORING RESULTS
U LOGVUUSA (BUILSA DISTRICT) – COMMUNITY MONITORING RESULTS
V KAASA (BUILSA DISTRICT) – COMMUNITY MONITORING RESULTS
W YAMKPANSA (BUILSA DISTRICT) – COMMUNITY MONITORING RESULTS