Endline Report

Water is Life International
Wa(SHG) Pilot Program
Endline Survey Report
March 2016
Report prepared by Elizabeth Poulsen | elizabeth.ann.poulsen@gmail.com
Wa(SHG) Project Manager: Stephenie Chatfield | stephenie.chatfield@waterislifeinternational.com
WiLi Executive Director: David Harding | david.harding@waterislifeinternational.com
Water is Life, International (WiLi) | P.O. Box 540318 | Orlando, FL 32854 | (407) 716-4214

iWa(SHG) Endline Survey Report – March 2016 | ii
Table of Contents
Introduction.......................................................................................................................................1
Methodology......................................................................................................................................1
Limitations.................................................................................................................................... 2
Summary of Results ......................................................................................................................... 2
Demographic Information about Survey Respondents ............................................................... 2
Personal Sanitation....................................................................................................................... 2
Water Treatment Knowledge and Practices............................................................................. 3
Hand-Washing Knowledge and Practices ................................................................................ 3
Incidence of Diarrheal Disease..................................................................................................... 4
Latrine Ownership........................................................................................................................ 5
Recommendations............................................................................................................................ 5
Conclusions....................................................................................................................................... 5
Appendix A: Program Logical Framework ...................................................................................... 6
Appendix B: Complete Baseline and Endline Survey Data ............................................................. 9
Appendix C: Survey Instrument (Questionnaire)...........................................................................21
Acronyms
CLA Cluster-Level Association
KAP Knowledge, Attitudes, and Practices
SHG Self-Help Group
WaSH Water, Sanitation, and Hygiene
Wa(SHG) Wili’s Water, Sanitation, and Hygiene Self-Help Group Program
WiLi Water is Life, International

iWa(SHG) Endline Survey Report – March 2016 | 1
Introduction
More than 70 percent of Ethiopia’s population lives without improved sanitation
coverage. This, coupled with poor sanitation behaviors, contributes to a high prevalence of
water-borne disease which disproportionately affects rural populations. Water is Life,
International (Wili) aims to address this health burden through their Wa(SHG) program, which
focuses primarily on changing personal sanitation and hygiene behaviors, with a secondary
focus on providing bio-sand water filters. Wili’s interventions will primarily be implemented to
and through an existing network of Self-Help Groups (SHGs), organized by Cluster-Level
Associations (CLAs). Partner organizations for the Wa(SHG) program include Tearfund,
Ethiopian Kale Heywet Church, Ethiopian Guenet Church, Desert Rose Consultancy, and the
Ethiopian Kale Heywet Church WET Center.
Wili conducted a pilot phase of the Wa(SHG) program from March 2015-February 2016
in the Dale and Shebedino Districts of the Awasa township in southern Ethiopia (see Figure 1).
The overall goal of this pilot phase was to test the effectiveness of the Wa(SHG) program, with a
focus on improving personal hygiene behaviors, alleviating the burden of water-borne diseases,
and improving the basic sanitation of program participants. A number of tools will assess
whether this pilot phase was successful; this report details the data uncovered through baseline
and endline KAP (knowledge, attitudes, and practices) surveys.
Figure 1: The Wa(SHG) project took place in the Dale and Shebedino districts of the Awasa township in southern
Ethiopia. (Image sources: commons.wikimedia.org, forecedmigration.org)
Methodology
The KAP surveys were designed to measure the overall project goal, as well as one of the
project’s four objectives; the full list of objectives are detailed in the program’s logical
framework, in Appendix A. This goal and objective (and their corresponding indicators) that this
report will discuss are as follows:
Program Goal/Impact: To test the implementation of a participatory WaSH training
program through the SHG network in order to improve personal hygiene behaviors,
alleviate the burden of water-borne diseases, and to improve the basic sanitation of
individuals in Ethiopia.
Indicator 1: Personal sanitation behaviors

Indicator 2: Incidence of diarrheal disease
Indicator 3: SHG members that have latrines
Program Objective 2: SHG members have an increased level of awareness and
knowledge of personal WaSH issues
Indicator 2.1: Knowledge of critical hand-washing times
Indicator 2.2: Awareness of disease-transmission and basic hygiene practices
A total of 219 baseline and 210 endline KAP surveys were conducted, representing about 20
percent of the total number of intended direct beneficiaries (1,000 people), and 5 percent of
total intended direct and indirect beneficiaries (4,500 people). The survey was conducted using
pen-and-paper questionnaires, by a team of enumerators who visited randomly selected
households in the program districts. All respondents indicated their consent to participate in the
survey after being informed about the survey purpose and their right to decline to participate.
Limitations
Much of the information gathered through the survey was self-reported: in many cases,
there was no way for the enumerator to verify whether the respondent was telling the truth (e.g.,
disease incidence, water treatment practices, personal hygiene practices, etc.). In these cases, it
is possible that the respondent may have wished to present the “right” answer, rather than the
truthful one, due to an (understandable) fear of judgment by the enumerator.
Additionally, English translations for open answers to survey questions (e.g.,
explanations for selecting “other”) were not available for the endline data. Fortunately, this did
not significantly limit analysis.
Summary of Results
This section will detail key results of the baseline and endline surveys, with a focus on
the program indicators previously outlined. For a detailed depiction of the answers to all of the
questions asked in the survey, including disaggregation by gender and rural/urban location
(when applicable), see Appendix B.
Demographic Information about Survey Respondents
In both the baseline and endline surveys, the majority of respondents were female (85%
and 68% in each respective survey). Most were married (77% and 81%), and between the ages of
18-40 (70% and 68%). About half of the households had between 4-6 people, while a third had
7-9 people, and around 15 percent had 1-3 people; 3 percent of households had over 10 people.
Between 77-86 percent of the households said that the male head of household could read, while
55-64 percent said that the female head of household could read.
Personal Sanitation
As outlined in the previous section of this report, the first indicator that will help to
measure the overall goal of the Wa(SHG) program is “personal sanitation behaviors.” The KAP
survey included a number of questions realting to this indicator, regarding water treatment and
hand-washing knowledge and practices.

Water Treatment Knowledge and Practices
As seen in Figure 2, there was a clear
increase in the number of respondents who
could identify at least one way to treat water.
Interestingly, the most-commonly cited
method for treating water changed from
baseline to endline, with solar disinfection
mentioned most commonly in the baseline,
and settling mentioned most frequently in the
endline (see Appendix B for more details).
There was a slight increase in the number of
respondents who said that they did something
to make their water safer to drink (58% to
64%), though this number is still relatively low.
There was a dramatic decrease in the number of
respondents who said that household members always drink
untreated water (see Figure 3), indicating that water
treatments practices are, in fact, probably increasing. There
were no major age or gender differences in the reported
frequency of drinking untreated water, but it is still much more
common in rural areas (70%) than urban areas (2%). Of
respondents who sometimes do not treat their water, this lack
of treatment is most likely to occur during the rainy season, or
when there is a lack of money (this was more commonly
mentioned in the endline survey than the baseline). There was
a drastic decrease in the number of respondents who said they
did not know how to treat their water (42% to 2%), that they
did not have a method to (41% to 3%), or that they forgot (26%
to 3%). However, nearly a third of respondents in the endline
survey said that they sometimes did not treat their water
because of a bad taste or a bad smell.
Hand-Washing Knowledge and Practices
In both the baseline and endline
surveys, most respondents named several
instances in which they usually wash their
hands, including before and after eating, before
preparing food, and after handling trash. There
was a noticeable increase in those who said they
washed their hands after latrine use (as seen in
Figure 4); reporting hand-washing after
defecation also increased noticeably.
Encouragingly, there was also a dramatic
increase in the number of respondents who
reported washing their hands with soap (36% to
76%), though 31 percent of respondents in rural
areas still do not wash their hands with soap.
0%
20%
40%
60%
80%
100%
Female Male Rural Urban
Baseline Endline
Figure 2: Percent of respondents who can identify at
least one way to treat water. (Overall: Baseline, 83%;
Endline, 95%)
0%
20%
40%
60%
80%
100%
Baseline Endline
Always Sometimes Never
Figure 3: Reported frequency with
which household members drink
untreated water
0%
20%
40%
60%
80%
100%
Female Male Rural Urban
Baseline Endline
Figure 4: Percent of respondents who say they wash
their hands after latrine use. (Overall: Baseline, 59%;
Endline, 88%)

As seen in Figure 5, there was also a dramatic
increase in the number of households that had soap
present in a hand-washing area or near their latrine. This
data was based on first-hand observation by the survey
enumerators, and thus is likely to be even more reliable
than the self-reported hygiene behaviors.
For those who said that they don’t wash their
hands with soap, the most commonly cited reasons for
this were that it’s “not a common practice here,” or
“negligence/laziness.”
Incidence of Diarrheal Disease
The second goal-level indicator for the Wa(SHG) program is incidence of diarrheal
disease; incidence of malaria will also be discussed briefly, even though it is not a major focus of
the program.
There was a decrease in the percent of respondents who
reported that a family member had experienced diarrhea in the two
weeks proceeding the baseline survey (23%) versus the endline
survey (10%), indicating that the Wa(SHG) program activities were
indeed successful in achieving their goal. However, there is a
possibility that this change is attributable to something other than
Wili’s programming, for instance if there were other related
interventions occurring in the program region, or if there are
normally seasonal fluctuations in diarrheal disease incidence, etc.
There was also an increase in the percentage of respondents who correctly identified
causes of diarrhea; interestingly though, there was not much increase in those who mentioned
“dirty water” as a cause of diarrhea, and the percentage of those who mentioned dirty water in
rural areas actually went down. In the endline survey, knowledge for all causes of diarrhea was
higher in urban areas, and was higher among women as compared to male respondents.
Similarly, knowledge regarding prevention of
diarrhea increased from baseline to endline, with
especially noticeable increases among those who
mentioned “wash hands with soap” (45% to 64%) and
“treat water” (38% to 55%). However, as with many
other indicators, disaggregating these figures by rural
versus urban area provides a more nuanced view: while
nearly all respondents in urban areas connected hand-
washing and water treatment with diarrheal disease, less
than half of those in rural areas did so (see Figure 6).
Covering food and preparing food properly were also
mentioned frequently in the endline survey.
The reported incidence of malaria decreased slightly from baseline to endline (9% to
3%). Knowledge regarding malaria causes and prevention did not change dramatically, although
respondents were less likely to name incorrect causes of malaria in the endline survey, and they
were slightly more likely to mention eliminating breeding sites and using oil/lotion/herbs on
0%
50%
100%
Baseline Endline
Rural Urban
Figure 5: Soap is present in household.
(Overall: Baseline, 23%; Endline, 81%)
57%
Decrease in diarrheal
disease incidence
0%
50%
100%
"Wash hands
with soap"
"Treat water"
Rural Urban
Figure 6: Two named ways of preventing
diarrheal disease (from endline survey)

skin as prevention measures in the endline survey. Interestingly, as with knowledge regarding
diarrhea prevention, female endline survey respondents were more likely to name correct causes
and prevention measures for malaria than were male respondents.
Latrine Ownership
Unfortunately, both in the baseline and endline surveys, there are inconsistencies in the
data relating to latrine ownership. For example, even though 99 percent of endline survey
respondents stated that their family owns a latrine, half of the respondents stated that they
share a latrine with at least one other family, with many respondents sharing latrines with over
seven families. It is possible that respondents still considered a latrine to be under their
ownership even if it is shared, but this is not clear.
Additionally, there is variation in the recorded type of latrine owned by respondents: in
the baseline survey, 97 percent of respondents in urban areas stated that they had a pit latrine
with a slab, while 90 percent of urban respondents in the endline survey reported having a flush
or pour flush latrine. This could be due to an error in data entry, or (less likely) due to a very
different sampling strategy used in the baseline versus endline survey. Of course, it is also
possible (though also not likely) that nearly all households in the urban areas constructed a flush
latrine within the last year.
Recommendations
While the endline survey shows a similar magnitude of improvement in rural and urban
areas, it clearly indicates that the biggest gap in knowledge, practices, and health outcomes
remains in the rural areas. Therefore, future programming may wish to focus primarily or
exclusively on rural regions.
Additionally, since levels of knowledge relating to hygienic practices and water-borne
diseases are consistently higher among women than men, future programming could aim to
target men and women equally, rather than placing a heavier focus on women (as is a common
practice in many development programs). However, if it is determined that focusing on women
would help the program benefits to reach a higher number of people (e.g., children), then
focusing on women may in fact be appropriate.
Conclusions
Without further information regarding other programming taking place in the region
and other contextual details, it is difficult to definitively state that the positive trends outlined in
this report are due to Wili’s Wa(SHG) program. However, this assessment does provide strong
evidence that this is probably the case. Not only are Wili’s (probable) program effects diverse—
spanning knowledge, practices, and health outcomes—but the magnitude of change is also
remarkable, especially given the limited timeframe of the pilot phase. The project team and Wili
leadership should be congratulated for a job well done, and should regard their plans for future
programming with increased confidence.

Appendix A: Program Logical Framework
Objectives Indicators Evidence Risks or Assumptions
Goal/Impact
To test the implementation of
a participatory WaSH training
program through the SHG
network in order to improve
personal hygiene behaviors,
alleviate the burden of water-
borne diseases, and to
improve the basic sanitation of
individuals in Ethiopia

• Personal sanitation
behaviors
• Incidence of diarrheal
disease
• SHG members that
have latrines

KAP Survey

Purpose(s)/Outcome(s)
1.Improved facilitation skills
and capacity of 12 FLFs and
members of 12 CLA
members

1.1 Individual
performance during
program
implementation

Program Records

• Discovery/participatory
learning model will be more
effective than didactic
learning model
• FLFs and CLA members will
be effective facilitators
2.SHG members have an
increased level of
awareness and knowledge
of personal WaSH issues
2.1 Knowledge of critical
handwashing times
2.2 Awareness of disease
transmission and
basic hygiene
practices
KAP Survey,
Participant Surveys,
Facilitator Reflections

• SHG members want to learn
about WaSH
• SHG members consistently
attend group meetings and
receive trainings
3.SHG members take
meaningful action to
improve the WaSH
condition of their families,
homes, and communities
3.1 Presence of tippy-
taps in homes
3.2 Presence of soap
3.3 Presence of latrines
in homes
3.4 Change in personal
sanitation and
hygiene behaviors
Individual Actions
Plans, Participant
Surveys
• SHG members are
empowered within their
household to take action
• SHG members have access to
financial resources to make
changes
4.Bio-sand filters are locally
available and purchased by
SHG members
4.1 Presence of BSFs in
homes
4.2 Intention to purchase
BSF
BSF M&E, Individual
Action Plans
• SHG members are interested
in buying a bio-sand filter
• SHG members have the
financial resources to buy bio-
sand filters

Outputs
1. Twelve FLFs and twelve
CLA members are
trained in participatory
facilitation skills

Certificate in
Foundational
Facilitation Skills

Program Records

Participants will be interested
and complete the entire
course

2. One thousand SHG
members are supported
and trained in WaSH
Awareness and
implementing actions
plans
Attendance at weekly
trainings

Desire to learn WaSH
Awareness

Completed and
implemented Action
Plans
Weekly Attendance
Sheets, Participant
Surveys, Facilitator
Reflections, Individual
Action Plans

Water-borne diseases are a
health burden
Sanitation and hygiene
resources (eg. Soap, bottles,
chlorines tabs, etc.) locally
available and affordable
Individuals and SHGs have the
capacity to take community
action (eg. Building latrines)
3. Two locally established
bio-sand filter
manufacturers serving
the communities and
SHGs
Presence of bio-sand
filter manufacturing
shop

Sales record
BSF M&E, Individual
Action Plans

SHG members have the
financial resources to buy
bio-sand filters
Materials necessary for
manufacturing locally
available and affordable
4. Program successfully
monitored and
evaluated in a manner
that promotes
excellence and learning
Baseline and terminal
KAP survey report

Weekly monitoring
booklets kept and
completed
KAP Survey,
Monitoring materials

Activities
Output 1
1. Develop and produce a Foundational
Facilitation Skills module
2. Provide the training module to 12 identified
FLFs and 12 CLA representatives

Output 2
1. Adapt WaSH Awareness training curriculum to
the SHG context and produce materials
2. Identify 12 FLFs and 12 CLA representatives to
be trained
3. Train 12 FLFs in ToT of WaSH curriculum,
building on the foundational facilitation skills
training
4. Support the training of CLA members in WaSH
curriculum
5. Support the training of SHG members in
WaSH curriculum
6. Track the establishment and implementation
of Action Plans

Output 3
1. Identify and capacitate two local
manufacturers to produce bio-sand filters
2. Include household water treatment options,
including bio-sand filters, in WaSH curriculum

Output 4
1. Design monitoring and evaluation tools and
formats
2. Translate materials to Amharic
3. Train program staff on monitoring plan
4. Conduct baseline and terminal KAP surveys
5. Analyze monitoring and evaluation data
Necessary resources available in Ethiopia

FLFs and CLA members schedules accommodate a
multiple day training


Proper permissions allow for editing of WaSH
Awareness materials

Strongly established CLAs exist in target area

FLFs have time to receive this training

FLFs have time to give training to CLA members

CLA members have time to give training to SHGs over
a period of 12 weeks

Effective monitoring system established

Local manufacturer will want to learn a new skill and
commit to developing a new business


Monitoring formats are practical for intended
purposes

Staff makes time to do regular monitoring

Appendix B: Complete Baseline and Endline Survey Data
Household Demographics
Baseline Endline
Total
(n=219)
Female
(n=186)
Male
(n=33)
Rural
(n=129)
Urban
(n=90)
Total
(n=210)
Female
(n=158)
Male
(n=44)
Rural
(n=140)
Urban
(n=70)
Gender of the respondent
Female 85% 78%
Male 15% 22%
What is your marital status?
Single 9% 7%
Married 77% 81%
Separated/Divorced 4% 2%
Widow/er 10% 9%
How old are you now? (average) 37 36
Age bracket of the respondent
12-17 3% 2%
18-40 70% 68%
41-59 20% 25%
60+ 7% 5%
Who is the respondent? (relationship
within the household)

Wife 80% 72%
Husband 13% 20%
Daughter 3% 4%
Son 2% 4%
Grandparent 1% 0%
Other 1% 0%
How many people are living in the
household? (average)

1-3 15% 16%
4-6 51% 49%
7-9 31% 32%
10-12 3% 2%
Male head of household can read 77% 70% 94% 86% 84% 91%
Female head of household can read 55% 36% 82% 64% 56% 82%

Household Water Supply and Practices
Baseline Endline
Total
(n=219)
Female
(n=186)
Male
(n=33)
Rural
(n=129)
Urban
(n=90)
Total
(n=210)
Female
(n=158)
Male
(n=44)
Rural
(n=140)
Urban
(n=70)
Who usually collects water for the
family?

Adult women 41% 55% 21% 56% 69% 30%
Girls 33% 34% 32% 34% 27% 48%
Boys 13% 5% 23% 7% 2% 16%
Adult men 7% 3% 12% 3% 2% 6%
Delivered 4% 1% 8% 0% 0% 0%
Other 2% 2% 3% 0% 0% 0%
Distance between dwelling and source
of drinking water

Within 500m 58% 27% 95% 77% 66% 98%
500m-1km 22% 36% 5% 18% 26% 1%
1km-3km 11% 21% 0% 5% 8% 0%
More than 3km 9% 17% 0% 0% 0% 0%
Minutes spent collecting water (round-
trip)

Under 30 53% 24% 94% 71% 57% 99%
30 mins - 1 hour 13% 18% 5% 17% 25% 1%
1-2 hours 21% 36% 0% 7% 10% 0%
2+ hours 13% 22% 1% 5% 8% 0%
Household Water Treatment and
Storage
Baseline Endline
Total
(n=219)
Female
(n=186)
Male
(n=33)
Rural
(n=129)
Urban
(n=90)
Total
(n=210)
Female
(n=158)
Male
(n=44)
Rural
(n=140)
Urban
(n=70)
Number of large jerry cans collected
each day for entire household

1 1% 1%
2 39% 42%
3-4 29% 35%
4+ 31% 22%

Named ways of making water safer
Solar disinfection 36% 16%
Boiling 35% 51%
Settling 23% 61%
Liquid chlorine 20% 46%
Other 19% 14%
Cloth filter 16% 34%
None 16% 1%
Chlorine tablets 13% 38%
Ceramic filter 8% 9%
Membrane filter 7% 22%
Bio-sand filter 1% 12%
Coagulant/flocculent 0% 7%
Can identify at least one way to treat
water
83% 82% 84% 71% 99% 95% 96% 91% 92% 100%
Respondent gave permission for
enumerator to observe them getting a
cup of drinking water normally served
to children

Yes 96% 97%
No 3% 2%
Didn't have 1% 1%
(Observed) Sample was collected safely 63% 62% 65% 57% 70% 83% 81% 86% 74% 100%
Source of water sample
Public standpipe 61% 72% 44% 69% 91% 27%
Piped connection to hh 19% 6% 38% 28% 3% 73%
Protected dug well 8% 13% 0% 0% 0% 0%
Borehole 2% 4% 0% 1% 2% 0%
Bottled water 2% 3% 1% 1% 1% 0%
Rainwater 2% 1% 0% 0% 0% 0%
Protected spring 1% 0% 1% 0% 0% 0%
Tanker 1% 0% 1% 0% 0% 0%
Unprotected dug well 0% 0% 0% 0% 0% 0%
Unprotected spring 0% 0% 0% 0% 0% 0%

Other 16% 0% 16% 2% 3% 0%
(Observed) Water container was
covered/closed
81% 95%
(Observed) Water container was clean 67% 87%
(Observed) Water container was out of
reach of animals
68% 87%
Water was collected safely (no hands)
and was stored in a container that was
clean, covered, and out of reach of
animals
44% 31% 62% 75% 65% 96%
(Observed) Type of container used
Jerry can with lid 74% 90%
Jerry can 18% 4%
Bucket 3% 1%
Gallon jug 2% 1%
Ceramic pot 1% 1%
Bucket with tap 1% 4%
Large drum 0%
Other 0%
Respondent said they did something to
make water safer to drink

Yes 58% 64%
No 35% 35%
Do not know 7% 1%
How respondent says they made water
safer to drink (only respondents who
responded "yes" to previous question)

Solar disinfection 33% 8%
Boiling 22% 13%
Settling 19% 26%
Chlorine tablets 11% 11%
Liquid chlorine 6% 22%
Other 3% 1%
Ceramic filter 3% 1%
Membrane filter 2% 3%

Cloth filter 1% 5%
Biosand filter 0% 5%
Coagulent/flocculant 0% 4%
(Observed, if there is a filter) Filter is
assembled correctly
83% 100%
wet
5% 71%
clean
83% 88%
Frequency that adult men drink
untreated water

Always 52% 50% 55% 10% 14% 3%
Sometimes 32% 36% 26% 37% 55% 1%
Never 16% 14% 19% 53% 32% 96%
Frequency that adult women drink
untreated water

Always 52% 49% 56% 9% 13% 0%
Sometimes 32% 38% 25% 37% 56% 0%
Never 16% 13% 19% 54% 31% 100%
Frequency that children drink untreated
water

Always 52% 49% 57% 9% 13% 0%
Sometimes 29% 41% 9% 40% 60% 0%
Never 19% 9% 35% 51% 27% 100%
Frequency that sick/elderly drink
untreated water

Always 47% 50% 41% 9% 13% 0%
Sometimes 37% 41% 29% 38% 56% 1%
Never 17% 9% 30% 53% 31% 99%
Average frequency of drinking
untreated water

Always 51% 50% 52% 9% 13% 1%
Sometimes 34% 39% 22% 38% 57% 1%
Never 15% 11% 26% 53% 30% 98%

When respondent says they do not treat
water (multiple answers allowed)

Rainy season 28% 43% 7% 24% 32% 9%
Never 22% 5% 48%
Other 19% 15% 21% 12% 14% 9%
Dry season 16% 16% 17% 15% 19% 7%
Respondent always treats water 16% 13% 28% 23% 4% 42% 45% 30% 28% 71%
When no time 9% 4% 17% 1% 0% 3%
When no money 2% 2% 2% 18% 16% 20%
Reasons respondent gives for not
treating water (multiple answers
allowed)

Does not know how 42% 44% 34% 7% 50% 2% 1% 5% 3% 0%
Do not have a method to 41% 3%
Forgot 26% 6%
Bad taste 16% 34%
Other 12% 28%
Bad smell 12% 31%
Thinks water is clean 8% *
Requires too much money 8% 1%
Requires too much time 5% 1%
Broken 1% 0%
Reasons respondent gives for treating
water (multiple answers allowed)

Prevents disease 75% 87%
Makes water safe 69% 81%
Other 17% 3%
Free 2% 0%
Someone told me to 1% 2%

Sanitation Practices
Baseline Endline
Total
(n=219)
Female
(n=186)
Male
(n=33)
Rural
(n=129)
Urban
(n=90)
Total
(n=210)
Female
(n=158)
Male
(n=44)
Rural
(n=140)
Urban
(n=70)
Family owns latrine 98% 99%
Who helped construct latrine
Self 68% 65%
Local authority/Gov't 27% 25%
NGO 3% 16%
SHG 1% 2%
Other 1% 1%
Type of latrine
Pit latrine with slab 70% 51% 97% 48% 67% 9%
Pit latrine without slab 28% 48% 1% 20% 29% 0%
Flush/pour flush 1% 2% 0% 30% 1% 90%
Composting 1% 0% 1% 1% 1% 1%
Latrine draining to canal/creek/river 1% 0% 1% 1% 1% 0%
Other 0% 0% 0% 1% 0% 0%
Distance between latrine and house
Less than 50m 88% 82% 97% 92% 87% 100%
More than 50m 12% 18% 3% 8% 13% 0%
Number of families sharing latrine (if no
latrine in household)

2-4 32% 31% 33% 36% 21% 45%
5-7 28% 52% 19% 27% 36% 22%
7+ 40% 17% 49% 37% 46% 33%
Where family members go for
defecation (if no latrine)

Public latrine 37% 41%
Creek/canal/river 32% 0%
Neighbor's latrine 11% 0%
Other 11% 45%
Plastic bag 5% 0%
Dig a hole, bush/backyard/field 5% 14%


Main reason why family cannot
construct a latrine (if no latrine)

Not a priority 56% 0%
Defecation is not an issue 17% 6%
Other 17% 83%
Too expensive 6% 6%
A lot of space to defecate here 6% 0%
No space for construction 0% 6%
Disease Morbidity/Mortality and
Management
Baseline Endline
Total
(n=219)
Female
(n=186)
Male
(n=33)
Rural
(n=129)
Urban
(n=90)
Total
(n=210)
Female
(n=158)
Male
(n=44)
Rural
(n=140)
Urban
(n=70)
Someone in family has had diarrhea in last
two weeks
23% 35% 7% 10% 13% 2%
Age of family member who had diarrhea
0-5 years old 17% 25%
6-17 years old 31% 25%
18-59 years old 42% 50%
60+ years old 10% 0%
Someone in hh died within last 6 months
due to diarrhea
2% 3% 0% 1% 1% 0%
Age of member of hh who died
0-5 years old 0% 0%
6-17 years old 25% 100%
18-59 years old 75% 0%
60+ years old 0% 0%
Causes of diarrhea named by respondents
(multiple answers allowed)

Dirty food 60% 63% 47% 41% 38% 76% 76% 73% 67% 94%
Dirty water 59% 60% 53% 57% 63% 64% 66% 59% 50% 92%
Poor hygiene 48% 49% 41% 44% 54% 64% 68% 48% 57% 77%
Flies 47% 45% 56% 40% 57% 70% 68% 70% 62% 84%

Germs 43% 42% 47% 43% 43% 50% 54% 30% 31% 89%
Dirty hands 39% 38% 47% 34% 47% 56% 58% 41% 41% 87%
Open defecation 21% 22% 16% 18% 26% 45% 49% 32% 26% 81%
Other 6% 6% 6% 9% 2% 3% 4% 0% 5% 0%
Rain 5% 3% 16% 9% 0% 7% 8% 2% 4% 14%
Part of child's growth 2% 2% 3% 2% 2% 5% 4% 5% 2% 11%
Witchcraft 0% 0% 0% 0% 0% 1% 1% 0% 0% 1%
Do not know 0% 0% 0% 0% 0% 0% 0% 0% 0% 0%
Respondent correctly identifies at least
one cause of diarrhea (dirty food, dirty
water, flies, germs, dirty hands, or open
defecation)
92% 92% 91% 89% 96% 98% 98% 98% 97% 100%
Ways of preventing diarrhea named by
respondents (multiple answers allowed)

Cover food 58% 54% 75% 60% 54% 71% 75% 52% 57% 99%
Drink clean water 55% 54% 59% 53% 57% 74% 78% 57% 65% 93%
Wash hands with soap 45% 47% 34% 28% 69% 64% 66% 52% 46% 99%
Latrine use 44% 40% 66% 47% 40% 73% 71% 80% 68% 84%
Prepare food properly (cooking, washing) 42% 42% 44% 36% 50% 51% 54% 34% 30% 94%
Treat water 38% 35% 56% 42% 33% 55% 55% 48% 36% 94%
Store water safely 38% 40% 28% 21% 63% 60% 66% 36% 41% 99%
No open defecation 30% 31% 25% 22% 41% 54% 58% 34% 34% 94%
Prayer 12% 12% 16% 14% 10% 3% 4% 0% 2% 4%
Go to traditional healer 8% 8% 13% 12% 2% 2% 2% 0% 1% 3%
Other 7% 8% 3% 10% 2% 1% 2% 0% 2% 0%
Do not know 1% 1% 3% 2% 0% 1% 1% 3% 2% 0%
one way of preventing diarrhea (cover
food, drink clean water, wash hands with
soap, latrine use, prepare food properly,
treat water, store water safely, no open
defecation)
98% 97% 100% 96% 100% 99% 98% 100% 98% 100%
Someone in family has had malaria in last
two weeks
9% 2% 19% 3% 2% 3%

Age of family member who had malaria
0-5 years old 16% 25%
6-17 years old 37% 50%
18-59 years old 42% 25%
60+ years old 5% 0%
Someone in family died within last 6
months due to malaria
0% 1% 1% 0%
Age of hh member who died due to
malaria

0-5 years old 0% 0%
6-17 years old 100% 0%
18-59 years old 0% 100%
60+ years old 0% 0%
Causes of malaria named by respondents

Mosquito bites 78% 78% 78% 87% 64% 87% 92% 77% 88% 86%
Dirty water 44% 48% 25% 22% 74% 27% 31% 11% 9% 63%
Rain/water 21% 18% 41% 35% 1% 9% 9% 5% 4% 19%
Sunshine 17% 18% 13% 10% 27% 15% 18% 5% 1% 43%
Dirty food 17% 20% 3% 7% 32% 15% 18% 5% 2% 41%
Flies 14% 16% 6% 8% 23% 23% 21% 30% 19% 31%
Bush/grasses 12% 13% 6% 6% 21% 26% 32% 7% 9% 60%
Other 12% 12% 9% 14% 9% 2% 3% 0% 4% 0%
Witchcraft 1% 2% 0% 0% 3% 0% 0% 0% 0% 0%
Ways of preventing malaria named by
respondents (multiple answers allowed)

Use of bednets 89% 88% 97% 88% 91% 90% 92% 80% 89% 91%
Eliminate mosquito breeding site 72% 72% 75% 77% 64% 85% 91% 66% 88% 86%
Use of smoke 39% 38% 44% 35% 44% 26% 27% 25% 27% 24%
Proper hygiene 37% 38% 28% 26% 52% 39% 40% 25% 22% 71%
Not taking dirty water/food 27% 31% 6% 16% 44% 19% 22% 2% 3% 51%
Other 6% 7% 3% 10% 1% 4% 4% 2% 6% 0%
Use oil/lotion/herbs on skin 1% 1% 0% 0% 3% 10% 11% 5% 0% 30%

Stop witchcraft 0% 1% 0% 1% 0% 1% 1% 0% 0% 3%
way of preventing malaria (using bednet,
eliminating breeding sites, use of smoke,
using oil/lotion/herbs on skin)
95% 95% 97% 93% 98% 95% 97% 84% 94% 97%
Hand-washing Practices
Baseline Endline
Total
(n=219)
Female
(n=186)
Male
(n=33)
Rural
(n=129)
Urban
(n=90)
Total
(n=210)
Female
(n=158)
Male
(n=44)
Rural
(n=140)
Urban
(n=70)
Times that respondents say they usually
wash hands

Before eating 97% 97% 94% 95% 100% 90% 91% 84% 86% 99%
After eating 88% 89% 84% 80% 100% 68% 72% 50% 54% 97%
Before food preparation 79% 82% 59% 80% 82% 78% 83% 55% 69% 93%
After handling trash 63% 63% 63% 64% 62% 65% 70% 41% 55% 84%
After latrine use 59% 56% 75% 61% 57% 88% 88% 84% 82% 99%
After defecation 39% 35% 59% 46% 29% 60% 63% 43% 43% 94%
Before feeding child 31% 30% 34% 31% 30% 47% 49% 34% 31% 0%
After handling animals 19% 19% 13% 28% 6% 31% 31% 25% 20% 54%
After handling baby's diaper/feces 13% 12% 19% 12% 14% 37% 39% 20% 19% 74%
Other 5% 5% 3% 7% 1% 6% 7% 5% 9% 0%
What respondents say they usually use
when washing hands

Water only 61% 66% 32% 58% 66% 10% 12% 7% 15% 1%
Water and soap 36% 32% 58% 37% 34% 76% 75% 80% 69% 91%
Water and ash 3% 2% 10% 6% 0% 13% 13% 12% 16% 7%
Water and sand/leaves 0% 0% 0% 0% 0% 0% 0% 0% 0% 0%
Other 0% 0% 0% 0% 0% 0% 0% 0% 0% 0%
Main factor that prevents family from
using soap (only respondents who said
they don't use soap)

Not a common practice here 44% 45% 30% 41% 48% 27% 30% 18% 32% 0%
Negligence/laziness 30% 30% 30% 25% 36% 40% 38% 55% 45% 13%

Too expensive 8% 6% 30% 14% 0% 13% 15% 9% 14% 13%
Water alone cleanses the hands 8% 9% 0% 3% 16% 0% 0% 0% 0% 0%
Other 5% 5% 0% 8% 0% 17% 15% 18% 9% 63%
Takes time 5% 4% 10% 8% 0% 2% 3% 0% 0% 13%
(Observed) House has a hand-washing
facility

No 61% 65% 57% 16% 22% 2%
Water and soap at hand-washing area 16% 13% 20% 40% 36% 48%
Only water (no soap) at hand-washing
area
12% 14% 9% 2% 1% 3%
Water and soap in or near latrine 7% 4% 11% 41% 38% 47%
Only water (no soap) in or near latrine 4% 4% 3% 2% 1% 0%
Soap is present in household (water and
soap at hand-washing area or near
latrine)
23% 17% 31% 81% 74% 95%

Appendix C: Survey Instrument (Questionnaire)
SuSurvey

Post Office Box 540318 | Orlando, FL 32854 | 407.716.4214 | www.waterIslifeinternational.org

KAP Survey on WaSH and Household Water Treatment Methods

INFORMED CONSENT

Good morning/good afternoon. My name is __________________. I am part of a team of people who
are assessing water practices in your community. Our team will be interviewing different
households in your area. Your local leaders have granted us permission to conduct this study,
and your house has been randomly selected to participate. You have been asked to participate
in this study because your personal views and experiences as a community member are
important to us. If you participate, I will ask you questions about your drinking water and
water use habits. The interview will take approximately 30 minutes. No one except me will
know that it was you who answered these questions. Would you like to participate?

A Interviewer
B Survey Number
C Date
D Time
E Location (Woreda, Kebele, Sub City, Village)

Section 1: HOUSEHOLD DEMOGRAPHICS
1. Gender of the respondent 1[ ] Female 2[ ] Male
2. What is your marital status? 1[ ] Single 2[ ] Married
3[ ] Separated/Divorced 4[ ] Widow/er
3. How old are you now? ________ years
4. Age bracket of the respondent 1[ ] 12-17 yo 2[ ] 18-40 yo
3[ ] 41-59 yo 4[ ] 60 yo and above
5. Who is the respondent? (relationship within
the household)
1[ ] Wife 2[ ] Husband
3[ ] Daughter 4[ ] Son
5[ ] Grandparent 6[ ] Other:
6. How many people are living in the household?
________ people
Age Bracket Male Female Total
7. 0 – 5 years old
10. 60+ years old
11. Can the male head of household read? 1[ ] Yes 2[ ] No
12. Can the female head of household read? 1[ ] Yes 2[ ] No
13. What is your educational background? 1[ ] Can’t read/write 2[ ] 1 – 6 years
3[ ] 7 – 9 years 4[ ] 10 – 12 years
5[ ] College and above

Section 2: HOUSEHOLD WATER SUPPLY AND PRACTICES
14. Who usually collects water for the family? 1[ ] Adult men 2[ ] Boys 3[ ] Delivered
4[ ] Adult women 5[ ] Girls 6[ ] Other:
15. How far from your dwelling is the source of 1[ ] within 500 m 2[ ] 500m – 1km

SuSurvey


your drinking water? 3[ ] 1km – 3 km 4[ ] More than 3 km
16. How many minutes do you spend collecting
water from the source (round-trip)?
1[ ] within 30 mins 2[ ] 30 mins – 1 hour
3[ ] 1 hour – 2 hours 4[ ] More than 2 hours
17. How many large jerry cans of water are
collected each day for the entire household?
(Jerry can=20 L)
1[ ] 1 jerry can 2[ ] 2 jerry cans
2[ ] 3 – 4 jerry cans 4[ ] more than 4 jerry
cans

Section 3: HOUSEHOLD WATER TREATMENT AND STORAGE
18. Can you tell me all the ways you know to
make water safe to drink in your home?
(Multiple answer, ask “Any others?”)
1[ ] Boiling 2[ ] Settling 3[ ] Solar
disinfection
4[ ]Chlorine
tablets
5[ ] Membrane
filter
6[ ] Ceramic
filter
7[ ] Liquid
Chlorine
8[ ] Biosand
filter
9[ ]Coagulant/
flocculent
10[ ] Cloth filter 11[ ] None 12[ ] Other:
19. May I observe you giving me a cup of your
current drinking water for children from this
household?
1[ ] Yes 2[ ] No
3[ ] Do not have
20. OBSERVE: Was sample collected safely (not
touching water with hands)?
1[ ] Yes 2[ ] No
21. What source did this water come from? 1[ ] Piped
connection in hh
2[ ] Public
standpipe
3[ ] Protected
dug well
4[ ] Borehole 5[ ] Rainwater 6[ ] Tanker
7[ ] Protected
spring
8[ ] Unprotected
dug well
9[ ] Bottled
water
10[ ]
Unprotected
spring
11[ ] Other:
22. OBSERVE: Is the container covered/closed? 1[ ] Yes 2[ ] No
23. OBSERVE: Is the container clean? 1[ ] Yes 2[ ] No
24. OBSERVE: Is the container out of reach of
animals?
1[ ] Yes 2[ ] No
25. OBSERVE: What container is used for
drinking water?
1[ ] Bucket 2[ ] Jerry can
3[ ] Jerry can with lid 4[ ] Gallon jug
5[ ] Bucket with tap 6[ ] Ceramic pot
7[ ] Large drum 8[ ] Other:
26. Did you do anything to make the water safer
to drink?
1[ ] Yes 2[ ] No (if NO, proceed to Q31)
3[ ] Do not know
27. How did you make this water safer to drink? 1[ ] Boiling 2[ ] Settling 3[ ] Solar
disinfection
4[ ]Chlorine
tablets
5[ ] Membrane
filter
6[ ] Ceramic
filter
7[ ] Liquid
Chlorine
8[ ] Biosand
filter
9[ ]Coagulant/
flocculent
10[ ] Cloth filter 11[ ] Other:
28. If filter, OBSERVE: is the filter assembled
correctly?
1[ ] Yes 2[ ] No
29. If filter, OBSERVE: is the filter wet? 1[ ] Yes 2[ ] No

SuSurvey


30. If filter, OBSERVE: is the filter clean? 1[ ] Yes 2[ ] No
How often do:
31. -adult men drink untreated water? 1[ ] Always 2[ ] Sometimes 3[ ] Never
32. -adult women drink untreated water? 1[ ] Always 2[ ] Sometimes 3[ ] Never
33. -children drink untreated water? 1[ ] Always 2[ ] Sometimes 3[ ] Never
34. -sick/elderly drink untreated water? 1[ ] Always 2[ ] Sometimes 3[ ] Never
35. When do you NOT treat your water?
1[ ] Dry season 2[ ] Rainy season 3[ ] When no
money
4[ ] When no
time
5[ ] I always
treat water
6[ ] Other:
36. Why do you NOT treat your water?
1[ ] Bad taste 2[ ] Bad smell 3[ ] Forgot
4[ ] Requires
too much money
5[ ] Do not know
how
6[ ] Takes too
much time
7[ ] Broken 8[ ] Do not have
a method to
9[ ] Other:
37. Why do you treat your water?
1[ ] Makes
water safe
2[ ] Prevents
disease
3[ ] Someone
told me to
4[ ] Free 5[ ] Other:

Section 4: SANITATION PRACTICES
38. Does your family own a latrine? 1[ ] Yes 2[ ] No (if NO, proceed to Q42)
39. If YES, who helped you construct the latrine? 1[ ] Self 2[ ] Local authority/Govt
3[ ] NGO 4[ ] SHG
5[ ] Other:
40. If YES, which type of latrine do you have? 1[ ] Flush/pour flush 2[ ] Composting latrine
3[ ] Pit latrine with slab 4[ ] Pit latrine without slab
5[ ] Latrine draining to
canal/creek/river
6[ ] Other:
41. If YES, how far is the latrine from your house?
(Then, proceed to Q45)
1[ ] Within 50
meters
2[ ] More than 50 meters
42. If sharing latrine with others, how many
families are sharing?
1[ ] 2-4 families 2[ ] 5-7 families
3[ ] More than 7 families
43. If NO latrine, where do your family members
go for defecation? (Tick the one that the family
usually practices)
1[ ] Neighbor’s latrine 2[ ] Public latrine
3[ ] Plastic bag 4[ ] Dig a hole
4[ ] Bush/backyard/field 5[ ] Creek/canal/river
6[ ] Other:
44. If NO latrine, what could be the MAIN reason
why your family cannot construct a latrine?
(Tick the one main reason)
1[ ] Too expensive 2[ ] Not a priority
3[ ] No space for
construction
4[ ] A lot of space to
defecate here
5[ ] Defecation is not an
issue
6[ ] Other:

Section 5: DISEASE MORBIDITY/MORTALITY AND MANAGEMENT
45. In the last 2 weeks, has anyone in your family
had diarrhea? (Note that diarrhea is defined as
the passing of stool 3 times or more in 24 hours
whether it is watery, bloody, mucoid, or water-
1[ ] Yes 2 [ ] No (If no, go straight
to Q47)

SuSurvey


wash like)
46. If YES, how old is the family member who had
diarrhea? ___________
1[ ] 0-5 years old 2[ ] 6-17 years old
3[ ] 18-59 years old 4[ ] 60 and above
47. Has anyone in your household died due to
diarrhea for the last 6 months?
1[ ] Yes 2[ ] No (If no, proceed to
Q49)
48. If YES, how old was that member of the
household? __________
49. What do you think can be the cause of
diarrhea? (Tick all that the respondent
mentions but do not influence his/her response)
1[ ] Rain 2[ ] Dirty hands 3[ ] Witchcraft
4[ ] Flies 5[ ] Dirty food 6[ ] Dirty water
7[ ] Germs 8[ ] Part of
child’s growth
9[ ] Poor
hygiene
10[ ] Open
defecation
11[ ] Do not
know
12[ ] Other:
50. How do you think diarrhea can be prevented?
(Tick all that the respondent mentions but
never influence his/her responses)
1[ ] Prayer 2[ ] Latrine use 3[ ] Treat water
4[ ] Do not
know
5[ ] Covering
food
6[ ] Drink clean
water
7[ ] No open
defecation
8[ ] Store water
safely
9[ ] Wash hands
with soap
10[ ] Prepare
food properly
(cooking,
washing)
11[ ] Go to
traditional
healer
12: Other:
51. In the last 2 weeks, has anyone in your family
had malaria?
1[ ] Yes 2 [ ] No (If no, go straight
to Q53)
52. If YES, how old is the family member who had
malaria? ___________
53. Has anyone in your household died due to
malaria for the last 6 months?
1[ ] Yes 2[ ] No (If no, proceed to
Q55)
54. If YES, how old was that member of the
household? __________
55. What do you think is the cause of malaria?
(Tick all that the respondent mentions but do
not influence)
1[ ] Rain/water 2[ ] Sunshine 3[ ] Witchcraft
4[ ] Flies 5[ ] Dirty food 6[ ] Dirty water
7[ ] Mosquito
bites
8[ ] Bush/
grasses
9[ ] Other:
56. What do you think is the best way to protect
yourself from malaria? (Tick all that the
respondent mentions but never influence
his/her responses)
1[ ] Proper
hygiene
2[ ] Use of
smoke
3[ ] Stop
witchcraft
4[ ] Use oil/
lotion/herbs on
skin
5[ ] Not taking
dirty
water/food
6[ ] Eliminate
mosquito
breeding site
7[ ] Use of bed
nets
8[ ] Other:

Section 6: HANDWASHING PRACTICES
57. Please tell me the times you usually wash your
hands? (ONLY tick what the respondent says.)
1[ ] Before
eating
2[ ] After
latrine use
3[ ] Before
feeding child
4[ ] After eating 5[ ] After
defecation
6[ ] After
handling trash
7[ ] Before food 8[ ] After 9[ ] After

SuSurvey


preparation handling baby’s
diaper/feces
handling
animals
10[ ] Other:
58. What do you usually use in washing hands?
(Tick the most commonly practiced)
1[ ] Water only 2[ ] Water
and soap
3[ ] Water and
sand/leaves
4[ ] Water and ash 5[ ] Other:
59. If the answer is 1 (water only), What is the
MAIN factor that prevents your family from
using soap?
1[ ] Washing with soap
takes time
2[ ] Soap is not a
common practice here
3[ ] Negligence/laziness 4[ ] Too expensive
5[ ] Water alone cleanses
the hand
6[ ] Other:
60. OBSERVATION ONLY: Is there any hand
washing facility available around the home?
1[ ] There are water and
soap near or within the
latrine
2[ ] There is ONLY water
near or within the latrine
3[ ] There are water and
soap at a designated hand
washing area
4[ ] There is ONLY water
at a designated hand
washing area
5[ ] There is no available washing station

NOTES:
ü Review the questionnaire
ü Ensure that you did not skip/forget any of the required fields
ü Thank the respondent for this/her participation

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