Kosovo Rapid Appraisal Survey Form
This document was uploaded by user and they confirmed that they have the permission to share it. If you are author or own the copyright of this book, please report to us by using this DMCA report form. Report DMCA
Overview
Download & View Kosovo Rapid Appraisal Survey Form as PDF for free.
More details
- Words: 683
- Pages: 2
Kosovo Rapid Village Assessment Municipality
Village
MGRS Grid Ref
Agency
Name of assessor
Date
Source of information (give as much detail as possible – give a telephone of someone in the village if possible)
ROAD ACCESS IN SUMMER
CURRENT POPULATION
Car
4WD
Light Truck
Heavy Truck
Y/N
Y/N
Y/N
Y/N
Persons
Albanian
Serb
INTERNALLY DISPLACED PERSONS (IDPs) Number of IDPs
from MUNICIPALITY (NAME)
ROAD ACCESS IN WINTER
Other
BREAKDOWN
Car
4WD
Light Truck
Heavy Truck
Y/N
Y/N
Y/N
Y/N
Locals
Returnees
IDPs
Refugees
– one record per village of former residence
from VILLAGE (NAME)
WHAT’S PREVENTING THEIR RETURN HOME? (See constraints to return box below for possible issues)
CONSTRAINTS TO RETURN: Transport / house damaged / house occupied / village empty / insecurity / fear of other ethnic groups / access to food and basic needs / healthcare / education / water / electricity / etc. COMMUNITY
MTS ACTIVIST
LEADERS
Name:
TEACHER
HEALTH WORKER
IMAM/PRIEST
OTHER
OTHER
PRESENT Tel: ASSISTANCE
Who is responsible for distribution? (circle or specify)
DISTRIBUTION
MTS
SECONDARY DISTRIBUTION
Is this village used for secondary distribution?
UCK
Mayors Office
Mosque/ Church
Local warehouse / storage facilities?
NGO (specify)
Other (specify)
Y/N
Type
Size (m2)
If so, which villages receive assistance from this village?
Y/N DAMAGE TO HOUSES
Total Houses in village
Category 1 (Undamaged / unfinished)
Category 2
Category 3
(see category guide below)
Was there any new war damage to buildings since JANUARY 1999?
DAMAGE TO
MTS WAREHOUSE
COMMUNITY BUILDINGS
None / Category
Was there any new war damage to buildings since NATO arrived? SCHOOL
MOSQUE/CHURCH
None / Category
None / Category
Note: Circle ‘None’ if no such building exists within the village
•
• Broken windows, door locks and hinges, roof tiles • Cut-off from electricity, water • Can be repaired
Ž
• Up to 30% roof damage • Light shelling or bullet impact on walls • Partial fire damage • Can be repaired
Category 4
Y / N Y / N SHOPS
BAKERY
None / Category
None / Category
• • • • • • •
Category 5
Over 30% roof damage Severe fire damage Need for replacement of floors Doors and windows destroyed All piping, wiring destroyed Can be repaired
HEALTH FAC. Category
• • Destroyed • Needs reconstruction • Cannot be repaired
ELECTRICITY
Working?
EDUCATION
School functioning?
WATER & SANITATION
% of Households using Pre-Conflict
Current
CURRENT STATUS*
Yes / No / Intermittent
If intermittent, approx. hours working per day
Yes / No
Number of classrooms
PERCEIVED WATER…
REMARKS
QUALITY
QUANTITY
Wells
Good / Bad
Adequate / Inadequate
Springs
Good / Bad
Adequate / Inadequate
Piped distribution
Good / Bad
Adequate / Inadequate
Electric Pumps
Good / Bad
Adequate / Inadequate
*STATUS (more than one if necessary): (W)orking / (D)amaged / (C)ontaminated / d(E)stroyed HEALTH (for TYPE, if Ambulanta circle one: MTS = Mother Theresa; S = State; P = Private; for Personnel: (D)octor, (N)urse, (M)ed. Tech for Drugs and Equipment: (A)dequate; (I)nadequate.) TYPE and NUMBER
Daily Consult’s
Working
Personnel (number)
Drugs
Equipment
Water
Sanitation
___ Hospital(s)
Number:
Y/N
_____D
_____N
_____M
A/I
A/I
Y/N
Y/N
___ Shtepia e Shendetit (DZ)
Number:
Y/N
_____D
_____N
_____M
A/I
A/I
Y/N
Y/N
___ Ambulanta: MTS / S / P
Number:
Y/N
_____D
_____N
_____M
A/I
A/I
Y/N
Y/N
FOOD AND COOKING % of dairy cattle remaining
% of farms expecting to harvest this summer
% of families with cooking facilities:
Is there a bakery?
Y/N
Is it operational?
SOURCES OF FOOD AVAILABLE IN VILLAGE
Food Item
Humanitarian distribution
Y / N
Wheat flour
Y / N
DM / Din
Kg
Household garden / farm
Y / N
Oil
Y / N
DM / Din
Litre
Household stores
Y / N
Sugar
Y / N
DM / Din
Kg
Shops or market
Y / N
Meat
Y / N
DM / Din
Kg
Fruit & vegetables
Y / N
DM / Din
Kg
Coffee
Y / N
DM / Din
Kg
Nearest village with market
AVAILABLE
Y/N
PRICE
ACTION TAKEN
REMARKS
Please return to UNHCR Pristina, attn: Inter Agency Coordination Unit
RVA03.DOC – UNHCR - 24 June 1999
Village
MGRS Grid Ref
Agency
Name of assessor
Date
Source of information (give as much detail as possible – give a telephone of someone in the village if possible)
ROAD ACCESS IN SUMMER
CURRENT POPULATION
Car
4WD
Light Truck
Heavy Truck
Y/N
Y/N
Y/N
Y/N
Persons
Albanian
Serb
INTERNALLY DISPLACED PERSONS (IDPs) Number of IDPs
from MUNICIPALITY (NAME)
ROAD ACCESS IN WINTER
Other
BREAKDOWN
Car
4WD
Light Truck
Heavy Truck
Y/N
Y/N
Y/N
Y/N
Locals
Returnees
IDPs
Refugees
– one record per village of former residence
from VILLAGE (NAME)
WHAT’S PREVENTING THEIR RETURN HOME? (See constraints to return box below for possible issues)
CONSTRAINTS TO RETURN: Transport / house damaged / house occupied / village empty / insecurity / fear of other ethnic groups / access to food and basic needs / healthcare / education / water / electricity / etc. COMMUNITY
MTS ACTIVIST
LEADERS
Name:
TEACHER
HEALTH WORKER
IMAM/PRIEST
OTHER
OTHER
PRESENT Tel: ASSISTANCE
Who is responsible for distribution? (circle or specify)
DISTRIBUTION
MTS
SECONDARY DISTRIBUTION
Is this village used for secondary distribution?
UCK
Mayors Office
Mosque/ Church
Local warehouse / storage facilities?
NGO (specify)
Other (specify)
Y/N
Type
Size (m2)
If so, which villages receive assistance from this village?
Y/N DAMAGE TO HOUSES
Total Houses in village
Category 1 (Undamaged / unfinished)
Category 2
Category 3
(see category guide below)
Was there any new war damage to buildings since JANUARY 1999?
DAMAGE TO
MTS WAREHOUSE
COMMUNITY BUILDINGS
None / Category
Was there any new war damage to buildings since NATO arrived? SCHOOL
MOSQUE/CHURCH
None / Category
None / Category
Note: Circle ‘None’ if no such building exists within the village
•
• Broken windows, door locks and hinges, roof tiles • Cut-off from electricity, water • Can be repaired
Ž
• Up to 30% roof damage • Light shelling or bullet impact on walls • Partial fire damage • Can be repaired
Category 4
Y / N Y / N SHOPS
BAKERY
None / Category
None / Category
• • • • • • •
Category 5
Over 30% roof damage Severe fire damage Need for replacement of floors Doors and windows destroyed All piping, wiring destroyed Can be repaired
HEALTH FAC. Category
• • Destroyed • Needs reconstruction • Cannot be repaired
ELECTRICITY
Working?
EDUCATION
School functioning?
WATER & SANITATION
% of Households using Pre-Conflict
Current
CURRENT STATUS*
Yes / No / Intermittent
If intermittent, approx. hours working per day
Yes / No
Number of classrooms
PERCEIVED WATER…
REMARKS
QUALITY
QUANTITY
Wells
Good / Bad
Adequate / Inadequate
Springs
Good / Bad
Adequate / Inadequate
Piped distribution
Good / Bad
Adequate / Inadequate
Electric Pumps
Good / Bad
Adequate / Inadequate
*STATUS (more than one if necessary): (W)orking / (D)amaged / (C)ontaminated / d(E)stroyed HEALTH (for TYPE, if Ambulanta circle one: MTS = Mother Theresa; S = State; P = Private; for Personnel: (D)octor, (N)urse, (M)ed. Tech for Drugs and Equipment: (A)dequate; (I)nadequate.) TYPE and NUMBER
Daily Consult’s
Working
Personnel (number)
Drugs
Equipment
Water
Sanitation
___ Hospital(s)
Number:
Y/N
_____D
_____N
_____M
A/I
A/I
Y/N
Y/N
___ Shtepia e Shendetit (DZ)
Number:
Y/N
_____D
_____N
_____M
A/I
A/I
Y/N
Y/N
___ Ambulanta: MTS / S / P
Number:
Y/N
_____D
_____N
_____M
A/I
A/I
Y/N
Y/N
FOOD AND COOKING % of dairy cattle remaining
% of farms expecting to harvest this summer
% of families with cooking facilities:
Is there a bakery?
Y/N
Is it operational?
SOURCES OF FOOD AVAILABLE IN VILLAGE
Food Item
Humanitarian distribution
Y / N
Wheat flour
Y / N
DM / Din
Kg
Household garden / farm
Y / N
Oil
Y / N
DM / Din
Litre
Household stores
Y / N
Sugar
Y / N
DM / Din
Kg
Shops or market
Y / N
Meat
Y / N
DM / Din
Kg
Fruit & vegetables
Y / N
DM / Din
Kg
Coffee
Y / N
DM / Din
Kg
Nearest village with market
AVAILABLE
Y/N
PRICE
ACTION TAKEN
REMARKS
Please return to UNHCR Pristina, attn: Inter Agency Coordination Unit
RVA03.DOC – UNHCR - 24 June 1999
Related Documents
Kosovo Rapid Appraisal Survey Form
October 2019 12
Using Rapid Appraisal Methods
October 2019 15
Rapid Rural Appraisal (rra)
October 2019 14
Appraisal Form
April 2020 7
Appraisal Form
November 2019 17