Annexe 8: Questionnaire for
Household Interview
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Date:
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___ ___ / ___ ___ / 2014
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County : ___________________
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Team ID:____________
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Village:____________
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Questionnaire No!____ ! !____ !
!____ !
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INTRODUCTION
I am a student at the University of Lome , Togo pursuing a
Masters in Climate Change and Human Security. I am collecting data for a
research study in Yoto District. The study focuses on assessing population
vulnerability to flood in the area. I would like to ask you some questions
about your family. The data that you provide is for academic purpose and it
will be kept strictly confidential. This is voluntary, you can refuse to answer
to some of the questions but I hope you will accept as your views are very
important.
Section 1: Exposure
1.What are the main climate hazards that have affected your
community during the last ten years?
1. Flooding |__| 2. Drought |__|; 3. Storm |__|; 4.
Bushfire |__|
2.Among those hazard, what was the most damageous?
1. flooding |__|; 2. drought |__|; 3. Storm |__|; 4.
Bushfire |__|
3.What are the causes of flood in your locality?
1. heavy rainfall |__|; 2. overflow of Mono river |__|; 3.
Other, specify..... ........................|__|
4.Do you think the frequency of occurrence and impacts of
flooding have increased during this decade compared to previous decades ?
1. Yes |__|; 2. No |__|
5. Number of flood event during the past ten years
..................................................................
..................................................................................
6. Was your household affected by the 2010 flood?
1. Yes |__|; 2. No |__|
7. Flood duration (the number of flood days during the 2010
flood)
..............................................................................................................................................
8. What is the height of the 2010 flood in your household?
(Flood depth)
............................................................................................................................................
9.How could you appreciate the 2010 flood magnitude compared
to the others floods?
|__| 1. Less; 2. Equal |__| ; 3. more |__|
10. The size of household's agricultural land
.............................................................................................................................................
11. Does your household's farmlands often affected by
floods?
1. Yes |__|; 2. No |__|
12. Proximity of the farmland to the water body
1. <1km |__|; 2. 1-2km |__|; 3. >2km |__|
13. Number of women in your household
................................................................................................................................................
14. Number of children under 15 years in your household
................................................................................................................................................
15. Number of elderly in your household
..............................................................................................................................................
Section 2 : Susceptibility
14.Sex of household head
|__| 1. Male; 2. Female |__|
15.Age of head of household
1. <20ans |__|; 2. 20-39 |__|; 3. 40-59 |__|; 4. 60+ |__|
16.Marietal Status of household head
1. Single|__|; 2. Married |__|; 3. Widowed |__|
17.Education status: highest level of education attained
1. No schooling |__| ; 2. Functional literacy |__|; 3. Primary
schooling |__|; 4. Secondary schooling |__|; 5. Tertiary schooling|__|; 6.
University |__|
18.Household size
.................................................................................................................................................................
19.Type of dwelling for the household
1. brick walls with iron/tiles sheet roof |__|; 2. Mud walls with
iron/tiles sheet roof |__|;
3. Mud walls with thatched roof |__| ; 4. hurdle walls with
thatched roof |__|
20. What are the main sources of income for the household?
1. None |___|; 2. Agriculture |___|; 3. breeding |___| ; 4.
fishing |___|; 5. handcraft |___|
6. Palm oil production |___|; 7. Trading |___| other specify
...................................... |___|
21. What are the secondary source of income of the household?
1. None |___|; 2. Agriculture |___|; 3. breeding |___| ; 4.
fishing |___|; 5. handcraft |___|
6. Palm oil production |___|; 7. Trading |___| other specify
.................................. |___|
22.Are you aware of the risk of floods in your locality?
1. yes |__|; 2. No |__|
23.if yes why do you still live in such an area?
......................................................................................................................................................
24.Was there any information or announcement or warning about the
threat of floods?
1. yes |__|; 2. No |__|
25.if yes, from which ways the information is passed
1. TV|__|; 2. Radio|__|; 3. traditional ways|__|; 4.
volunteers|__|
26. Were you aware of the 2010 flood:
1. yes |__|; 2. No |__|
27. Were you affected by the 2010 flood or any other flood in
your locality?
1. yes |__|; 2. No |__|
27.Are you prepared for floods?
1. Yes |__|; 2. No |__|
28.If yes what are the methods used?
29. Do you use any method to reduce the effect of flood
disasters to your household when they occur?
1. yes |__|; 2. No|__|
30.If yes, what are those methods?
..................................................................................................................................................................
31.Do you get help from the government or other institutions
during floods?
|__| 1. yes; |__| 2. No
32.If yes what type of help?
....................................................................................................................................................................
33.How do you value the government response during and after the
flooding in your area?
1. belated|__| ; 2. immediat|__|; 3. inadequate|__|; 4.
adaquate|__|, other specify.................. |__|
Section 3: Resilience
34.Did you attend any training on flood management?
1. yes |__|; 2. No |__|
35.If yes, what information did you receive during the
training?
..............................................................................................................................................................
36.Which structures provide the information/warning/training?
|__| 1. Croix rouge; |__| 2. NGOs; |__| 3. locale
government
37.Was the information you received useful during and after flood
disaster?
1. yes |__|; 2. No|__|
38. Is there a committee of flood management in your
community?
1. yes; |__| 2. No|__|
39.if yes, are you member?
1. yes; |__| 2. No |__|
40.Are you able to anticipate the occurrence of the floods?
1. yes |__|2. No|__|
41.if yes how?
1. Local indicators|__|; 2. early warning system |__|; 3 other
specify................................................ |__|
42.Is your household able to evacuate, in case of a flood?
1. yes|__|; 2. No|__|
43.Are there any place where you can seek shelter during
flood?
1. yes; |__| 2. No |__|
44.If yes where is that area?
1. Public school building |__|; 2. Neighbours or relatives in
non flooded area |__|;
3. church building|__| 4. public evacuation site |__|; 5.
migrate temporarily to other areas less vulnerable |__|; 6. Other
Specify......................................................................................
|__|
45.Does the government or others institutions provide prevention
and protection measures?
1. yes |__| ; 2. No |__|
46.if yes what are those measures?
.......................................................................................................................................................
47.How do you value the ability of anticipation and preparation
of the government or other institution to floods?
1. bad|__|; 2. inadequate|__|; 3. Good|__|
48.Do you get help from the government or other institution after
the flood?
1. Yes|__|; 2. No|__|
49.If yes what type of help?
..................................................................................................................................................................
50.Do you have community's support mechanisms to address the
flood risks?
1. yes |__|; 2. No |__|
51.If yes what are those mechanisms?
................................................................................................................................................................
52.Are you able to recover to the previous efficient state
1. yes |__|; 2. No |__|
53.Do experience environment recovery after flood ? ( positive
effect of flood on the environment)?
1. yes |__|; 2. No|__|
54.if yes what are those effects
...................................................................................................................................................................
55.What do you think the government or NGOs should do as
prevention measures to reduce flood impacts on your community?
................................................................................................................................................................
56.What do you think the government or NGOs should do to respond
to flood during flood disaster
.................................................................................................................................................................
57.What do you think government or NGOs should to after flood to
help you recover?
....................................................................................................................................................................
58.What do you think the government or other institution should
do to control flood disaster
....................................................................................................................................................................
59.What do you think your community itself should do to reduce
flood impact on your locality?
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