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Village health survey format

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Village health survey format

  1. 1. Department of Community Medicine VMCH & RI, Madurai Village health Survey S.No. Question Options 1. Name of the village 2. Location 1. Near main road 2. Away from main road 3. Streets 1. Pucca 2. Kutcha 3. Mixed 4. Drainage 1. Underground drains 2. Open drains 3. No drains 5. Major source water supply 1. Wells 2. Hand pumps 3. Tubewells 4. Ponds 5. Taps 6. Others 6. Water supply type 1. Individual 2. Community type 7. Refuse disposal 1. Within house 2. Thrown indiscriminately 3. Public dust bin 4. Community waste disposal 8. Latrine usage 1. Community latrines 2. House latrines 3. Fields 4. Streets 5. Ponds 6. Others
  2. 2. 9. Houses situation 1. Compact 2. Clustered 3. Widely scattered 10. Rodents and insects a. Flies 1. Summer 2. Winter 3. Rain 11. b. Mosquitoes 1. Summer 2. Winter 3. Rain 12. c. Rats 1. Summer 2. Winter 3. Rain 13. d. Cockroaches 1. Summer 2. Winter 3. Rain 14. Total number of houses 15. Total area of the village (in Sq.ft) 16. Total Population 17. Total no. of Males 18. Total no. of Females 19. General composition of families 1. Single 2. Joint 3. Extended 20. Planning of the village 1. Planned 2. Unplanned 21. Recreational places 1. None 2. Park 3. Community centre 4. Others___________ 22. School 1. Yes 2. No 23. Type of school 1. Government 2. Private 24. Voluntary agencies working in the area Other comments:

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