PDM Form For WASH NFI 2024

Post-Distribution Monitoring (PDM) Toolkit for
WASH NFI Assistance in Dambe wereda,

Kamashi Zone, Benishangul Gumuz Region.
Household questionnaire
Introduction:
Hello, my name is [Enumerators name] and I work for the Development Expertise Center (DEC). We
have been providing WASH NFIs to assist with your urgent needs. Today, I would like to ask you some
questions about the WASH NFIs assistance you received from DEC by EHF fund through ASDEPO in
Dambe wereda, 2024.
Please note:
 You can stop the interview at any time.

 You can refuse to answer any questions you do not wish to answer.
 All information will be kept confidential.
 This survey aims to help us improve our response and is not an assessment for providing additional
assistance.
 We are not collecting names for another distribution.
I. PROFILE OF INTERVIEWED HOUSEHOLD (Age, Gender, Diversity)
1. Sex of the respondent A. Male B female

2. What is the marital status of the respondent?
A. Single B Married B Divorce C Widowed D Other
3. How many people are living in your household?
A. 1-3; B. 4-6; C. 7-9; D. > 10
4. Are you the head of household? A. Yes; B. No
5. How old are you?
a. 12-17 years old c. 31-50 years old e. above 60 year
b. 18-30 years old d. 51-60 years old
6. POC type
A. IDP Returnees C. IDP in Host Communities
B. IDP in Collective Centers D. Affected Host Community
7. Does your household have members with any of the following vulnerabilities?
a. Difficulties seeing e. Difficulties f. Difficulties
b. Difficulties hearing focusing, speaking;
c. Physical disability; remembering, g. None of the above;
d. Mental disability concentrating for a
period of time;
II. QUALITY CONTROL OF PROCESS (Assessment, target selection, and verification)
8. Were the selection criteria followed during the implementation of the programme? A. Yes; B. No
9. Do you know if the DEC came here to ask about your needs? A. Yes; B. No
10. Was the WASH NFI you received and the pre-determined amount is the same? A. Yes; B. No
III. Accountability and Information Provision Mechanisms
11. How did you hear about the intervention?

A. Community leader; B. Camp committee member; C. Family member; D. neighbors; E. DEC staff;
12. Did you know when the WASH NFI distribution was going to
take place?A Yes B No
13. Did you know where the WASH NFI distribution was going to take place?
A Yes B No
14. Did you know what was going to be distributed?
A. Yes B No
15. What items you received?
16. Were the distributed items in good condition? e.g. Broken, Destroyed or Expired items, Broken packaging
A. Yes B. No C. Partially
17. If No or partially, please list the items in bad conditions
18. Were the distributed items of good quality?

A. Yes B No C Partially.
19. If No or partially, please list the items in poor quality
20. Was there a complaint desk, person or place where you can give your feedback/complaints/questions
about the distribution? A. Yes; B. No;
21. Did you share/report a complaint? A. Yes; B. No; if yes, how did you give a complaint, how did
you receive the response/feedback?
IV. TIMELINESS
22. Did you receive WASH NFI as the right time when you needed it most? A. Yes; B. No
If no, please explain
V. Resilience and coping mechanisms
23. If the NFI Assistance had not happened, do you have another way to get WASH NFI?
VI. Protection and safety risks
24. Did you face any issues or difficulties during the process of WASH NFI assistance?
a. Location B. safety concerns, C. Did not have necessary documentation D. others
25. Were you asked to pay someone to be selected for the WASH NFI assistance? A. Yes B. No
26. If yes, who did you have to pay? how much did you have to pay?
27. Did you experience or witness any form of violence, extortion, abuse or exploitation related to enrolment
and registration in order to receive the support?
A. Yes B. No
VII. Appropriateness and usage of the assistance
Did you sell or give away any of the items you received?
A. Yes B. No
28. If yes, which items?
29. Why did you give or sell the items?

A. To buy food D. To buy items of a better quality
B. To Buy Medicines E. Other Reasons
C. To Buy Other Useful items
30. other reason for giving or selling items:
31. Were the distributed items enough?

A. Yes B. No
32. If No, explain
33. Did the material distributed meet your needs?

A. Yes B. No
34. If No, explain
35. Were all of the Beneficiaries included in the distribution list?

A. Yes B. No
36. If No, explain
VIII. Distribution Impact
37. Do what extent has the WASH NFI assistance improved your living condition?
A. Very High B. High C. Moderate D. Low E. Not at all
38. What changed in your life after the WASH NFI assistance?
A. Better sense of feeding B. Low dependency C. Improved health D. Other
39. Current major needs or difficulties of the

beneficiary_ _ _
_
_

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Post-Distribution Monitoring (PDM) Toolkit for

WASH NFI Assistance in Dambe wereda,

 You can stop the interview at any time.

I. PROFILE OF INTERVIEWED HOUSEHOLD (Age, Gender, Diversity)

1. Sex of the respondent A. Male B female

III. Accountability and Information Provision Mechanisms

11. How did you hear about the intervention?

17. If No or partially, please list the items in bad conditions

18. Were the distributed items of good quality?

19. If No or partially, please list the items in poor quality

VII. Appropriateness and usage of the assistance

29. Why did you give or sell the items?

31. Were the distributed items enough?

33. Did the material distributed meet your needs?

35. Were all of the Beneficiaries included in the distribution list?

VIII. Distribution Impact

39. Current major needs or difficulties of the

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