1. CholeraWASH rapid assessment_Kobo file.xlsx

	A	B	C	D	E	F	G	H
1	type	name	label	hint	required	relevant	appearance	parameters
2	start	start
3	end	end
4	note	INTRODUCTION_It_is_spectful_as_possible	INTRODUCTION - Out of respect for the interviewee please complete this section before arriving at the household.		false
5	begin_group	group_lp9zi46	Preliminary Questions		false
6	select_one np1aq63	PRE1_County	PRE1. County		true
7	select_one ml3my17	PRE2_Subcounty	PRE2. Subcounty		false
8	text	PRE3_Admin_Level_3_Commune	PRE3. Ward (optional)		false
9	select_one nd3aw78	Data_Collector_ID	PRE5. Data Collector ID		false
10	date	PRE6_Date	PRE6 Date		false
11	end_group
12	begin_group	group_zc8nx66	Consent		false
13	note	IMPORTANT_Please_be_e_kind_of_disability	IMPORTANT. Please be aware of any disabilities the respondent might present. This questionnaire is made to be read out loud and the person should provide an answer. If the respondent is not able to do so, make sure you have at least one alternative like one copy of the printed questionnaire so the person can read it or the questionnaire printed in big letters. Don't discard a person as a possible responder due to some kind of disability.		false
14	note	The_following_statem_this_form_Thank_you	The following statement is to be read to the head of the household or, if they are absent, another adult member of the house before the interview. • Hello, my name is ______and I work with [organization/institution]. We would like to invite your household to participate in a survey that is looking at the needs related to water, sanitation and hygiene of people living in this [camp / survey area]. Taking part in this survey is totally your choice. You can decide to not participate, or if you do participate you can stop taking part in this survey at any time for any reason. If you stop being in this survey, it will not have any negative effects on how you or your household is treated or what assistance you receive. If you agree to participate, we will ask you some questions about your access to water, sanitation, hygiene and cholera. Be assured that any information that you will provide will be kept strictly confidential. You can ask me any question that you have about this survey before you decide to participate or not. If you do not understand the information or if your questions were not answered to your satisfaction, do not declare your consent on this form. Thank you.		false
15	select_one ou2cy94	I_agree_to_participate_and_giv	I agree to participate and give my consent that the data collected during this is being used for research purposes.		false
16	end_group
17	begin_group	group_vv7ev55	Survey		false	${I_agree_to_participate_and_giv} = 'yes'
18	begin_group	group_gy74z24	General		false
19	select_one qk44k94	GEN1_age	GEN1. What is the age of the person responding?	Keep in mind if the person is under age you might need a consent from the legal guardian	true
20	select_one nx4fw92	GEN2_gender	GEN2. What is the gender the persone identifies with?		true
21	begin_group	group_ur1dr78_header			false		w2
22	note	GEN3_disability	GEN3. Does anyone in the household have any problems with the following: Type the number of household member with the different disabilities		false		w1
23	note	group_ur1dr78_header_			false		w1
24	end_group
25	begin_group	group_ur1dr78_difficulty_hearing			false		w2
26	note	group_ur1dr78_difficulty_hearing_note	##### Difficulty hearing		false		w1
27	integer	group_ur1dr78_difficulty_hearing_	<span style="display:none">difficulty_hearing- </span>		false		w1 no-label
28	end_group
29	begin_group	group_ur1dr78_difficulty_walking_or_climbing_steps			false		w2
30	note	group_ur1dr78_difficulty_walking_or_climbing_steps_note	##### Difficulty walking or climbing steps		false		w1
31	integer	group_ur1dr78_difficulty_walking_or_climbing_steps_	<span style="display:none">difficulty_walking_or_climbing_steps- </span>		false		w1 no-label
32	end_group
33	begin_group	group_ur1dr78_difficulty_remembering_or_concentrating			false		w2
34	note	group_ur1dr78_difficulty_remembering_or_concentrating_note	##### Difficulty remembering or concentrating		false		w1
35	integer	group_ur1dr78_difficulty_remembering_or_concentrating_	<span style="display:none">difficulty_remembering_or_concentrating- </span>		false		w1 no-label
36	end_group
37	begin_group	group_ur1dr78_difficulty_with_self_care_such_as_washi			false		w2
38	note	group_ur1dr78_difficulty_with_self_care_such_as_washi_note	##### Difficulty with self-care, such as washing all over or dressing		false		w1
39	integer	group_ur1dr78_difficulty_with_self_care_such_as_washi_	<span style="display:none">difficulty_with_self_care_such_as_washi- </span>		false		w1 no-label
40	end_group
41	begin_group	group_ur1dr78_difficulty_communicating_for_example_un			false		w2
42	note	group_ur1dr78_difficulty_communicating_for_example_un_note	##### Difficulty communicating, for example understanding or being understood		false		w1
43	integer	group_ur1dr78_difficulty_communicating_for_example_un_	<span style="display:none">difficulty_communicating_for_example_un- </span>		false		w1 no-label
44	end_group
45	begin_group	group_ur1dr78_no_difficulties			false		w2
46	note	group_ur1dr78_no_difficulties_note	##### No difficulties (add total number of household members)		false		w1
47	integer	group_ur1dr78_no_difficulties_	<span style="display:none">no_difficulties- </span>		false		w1 no-label
48	end_group
49	end_group
50	begin_group	group_sl1ob41	Water		false
51	begin_group	group_rg79p27	Main drinking water source		false
52	select_one dj1wb97	W1_main_watersource	W1. What is the main source of DRINKING water for members of your household?	Please emphasize that you are interested in the source for DRINKING WATER, not other purposes.	true
53	text	W1a_please_specify	W1a. Please specify		false	${W1_main_watersource} = 'other__specify'
54	select_one fb5sc25	W2_problems_water	W2. Do you find any problems accessing your main drinking water source?		true
55	select_multiple ue71q90	W2a_If_Yes_specify	W2a. If Yes, specify		true	${W2_problems_water} = 'yes'
56	text	W2b_Please_specify	W2b. Please specify		false	selected(${W2a_If_Yes_specify}, 'other')
57	end_group
58	begin_group	group_rx5wo87	Location of drinking water source		false
59	select_one lz9ez33	W3_Where_is_that_water_collected_from	W3. Where is that water collected from?		true	${W1_main_watersource} != 'water_truck_distribution' and ${W1_main_watersource} != 'water_kiosk' and ${W1_main_watersource} != 'bottled_water'
60	end_group
61	begin_group	group_nd34d45	Collect drinking water		false
62	select_multiple jq0so11	W4_Who_is_responsib_for_collecting_water	W4. Who is responsible in the household for collecting water?		false
63	select_one ft4kg31	W4_How_long_does_it_take	W5. How long does it take to go there (walking), get water, and come back?		true
64	select_one eg3yc82	W4a_Please_specify_if_not_walk	W5a. Please specify if the time is not walking distance and it is with another transport method		true
65	end_group
66	begin_group	group_im1on09	Availability of drinking water		false
67	select_one js4ht19	W5_sufficient_water	W6. In the LAST MONTH, has there been any time when your household did not have sufficient quantities of DRINKING WATER when needed?	Please emphasize that you are interested in the DRINKING WATER, not water for other purposes.	true
68	end_group
69	begin_group	group_cm0kq27	Household water treatment and safe storage		false
70	select_one wm2qk86	W6_make_water_safe	W7. Have you or any other household members done anything to the water to make it safer to drink?		true
71	select_one ni23q13	W6a_treat_water_what	W7a. What do you usually do to the water to make it safer to drink?		true	${W6_make_water_safe} = 'yes'
72	text	W6b_please_specify	W7b. Please specify		false	${W6a_treat_water_what} = 'other__specify'
73	select_multiple nc5ja43	W7_water_transport	W8. What do you use to transport water?		true
74	text	W7a_please_specify	W8a. Please specify		false	selected(${W7_water_transport}, 'other')
75	select_multiple lx68d79	W8_storage_water	W9. How do you or other members of your household store the drinking water?		false
76	text	W8a_please_specify	W9a. Please specify		false	selected(${W8_storage_water}, 'other')
77	end_group
78	end_group
79	begin_group	group_ov9os78	Sanitation		false
80	begin_group	group_bz3uy43	Sanitation facility		false
81	select_one zq95j52	S1_where_defecate	S1. Where do you go to defecate?	Adapt to context	true
82	text	S1a_please_specify	S1a. Please specify		false	${S1_where_defecate} = 'other__specify'
83	select_one re2py03	S1b_shared_latrine	S1b. Is the latrine/toilet in your household shared with other people from the community?		true	${S1_where_defecate} = 'latrine_household'
84	end_group
85	begin_group	group_hs3af86	Location of sanitation facility		false
86	select_one bt4ba87	S2_access_latrine	S2. Do you find any problems to access the latrine/toilet?		true
87	select_multiple hy14q77	S2a_If_yes_specify	S2a. If Yes, specify		true	${S2_access_latrine} = 'yes'
88	text	S2b_please_specify	S2b. Please specify		false	selected(${S2a_If_yes_specify}, 'other')
89	select_one yn5mr32	S3_problems_rain	S3. Do you experience problems regarding the latrine/toilet when it rains?		true
90	text	S3a_If_yes_specify	S3a. If Yes specify		true	${S3_problems_rain} = 'yes'
91	select_one dq8sf90	S4_Observation_Is_source_at_least_30m	S4. (Observation) Is the distance between the latrines/toilets and a ground water source at least 30m?	You can assess this distance by walking big steps 30 times	false
92	text	S4a_Please_specify	S4a. Please specify		false	${S4_Observation_Is_source_at_least_30m} = 'other'
93	end_group
94	end_group
95	begin_group	group_bu3fg05	Waste Management		false
96	text	WM1_observation_stagnantwater	WM1. (Observation) Can you observe stagnant water around the household? Are there appropriate drainages? Is there enough slope to act as drainage?		true		multiline
97	select_one dn8ld00	WM2_observation_waste	WM2.(Observation) Can you observe waste around the household? Inadequate smell?		true
98	text	WM2a_Comment	WM2a. If Yes please specify what type and what you can observe		true	${WM2_observation_waste} = 'yes'
99	select_multiple ff16n74	WM3_waste_disposal	WM3. What do you do with the waste disposal?		true
100	text	WM3a_please_specify	WM3a. Please specify		false	selected(${WM3_waste_disposal}, 'other')