学校洗手行为调查问卷（英）School handwash and toilet survey      

Dear Handwashing Champion,

Thanks for participating in this survey!   Fill out the information in Part 1 for your school, then observe (Part 2) and ask questions (Part 3) for the rest of the survey.   The results of this survey can help convince decision-makers that we need places to wash our hands along with good toilets in our school!            

                          

1.           Basic School Information

Name of school ­­­­­­­­­­­_______________________________________________________

Location of school _____________________________________________________

Primary or secondary school? ___________________________________________________

Number of students enrolled:

Boys___________________

Girls ___________________

  

2.           OBSERVE:   Handwashing and toilet facilities at this school

We are interested in how you can wash your hands at your school.   Having a place to do this is often forgotten, and we need to change that! Also, sometimes school toilets can be really gross and you don’t want to go in there, or the school toilet can be really clean and tidy. In many places in the world children don’t have a nice place to use the toilet.   Sometimes there aren’t any toilets at all!   We are interested in the toilets at your school and how they match up against others in the world.

  

Walk around your school, observe and answer these questions:

1. Does this school have toilets?      

¨   Yes          

¨   No

  

3.                                   How many?

  

4.                                   What kind? (latrines, flush toilets etc)

  

  

5.                                   Are there separate toilets for boys and girls?

¨   Yes          

¨   No

  

6.                                   If no toilets, where do students and teachers go to pee?  

  

___________________________________________________________________________

7.                                   To poo?

  

___________________________________________________________________________

8.                                   Do boys and girls go to the same places?            

¨   Yes          

¨   No

9.                                   Do the toilets have a place to wash hands?

¨   Yes          

¨   No

10.                           What kind of place (sink with running water, jug, tippy tap etc)?

___________________________________________________________________________

___________________________________________________________________________

11.                           Is there soap available?            

¨   Yes          

¨   No

  

12.                           How would you evaluate the school’s handwashing facilities? (Check one):

Pretty good	Needs improvement	Not so great	What handwashing facilities?

  

13.                           How would you “evaluate” the school’s toilets? (Check all that apply):

In good shape	Easy to use	Clean	Not enough	Broken down		Stinky	Gross

  

3. ASK:   Questions for fellow students

Ask these questions of 10 fellow students (5 girls, 5 boys) and write down their answers.   Make sure you get their permission to ask these questions first, and explain why you are doing this survey (to help your school get better toilets and handwashing facilities!)

  

1.           How old are you? ___________________

2.           Are you a boy or a girl?

¨   Boy

¨   Girl

3.           Is your school all boys, all girls or mixed?

¨   All boys

¨   All girls

¨   Mixed

  

When you are at school

4.           Do you wash your hands after going to the toilet?

¨   Yes, always

¨   Sometimes

¨   No, never

  

5.           Do you wash your hands before you eat?

a.           Yes, always

b.           Sometimes

c.             No, never

  

6.           Do you use soap when you wash your hands?

a.           Yes, always

b.           Sometimes

c.             No, never

Think of your school toilets (if you have them!)

7.           Is there always soap and water available to wash your hands?

a.           Yes, always

b.           Sometimes

c.             No, never

  

8.           Is there always wiping material available?

a.           Yes, always

b.           Sometimes

c.             No, never

  

9.           Are the toilets at your school clean?

a.           Yes, the area looks pretty clean

b.           No, there is filth all around

c.             I don’t know

  

10.   How would you describe the smell of the toilets at your school

a.           Smells clean!

b.           Sometimes a bit gross but usually fine

c.             It smells bad enough that I go in and out as fast as possible!

d.           I have to hold my nose!

e.           I don’t know

  

11.   How do you feel about the quality of your school’s toilets? (can select multiple responses)

a.           I dread going in there

b.           Sometimes I hold it so that I don’t have to go in the toilets

c.             I feel disgusted by my school’s toilets

d.           They’re nice and clean

e.           They have all the soap and wiping material I need

f.               I don’t think about my school’s toilets much

  

  

12.   If you could change one thing about your school’s toilets what would it be?

  

________________________________________________________________________

  

________________________________________________________________________

  

________________________________________________________________________

  

________________________________________________________________________

  

________________________________________________________________________

  

_______________________________________________________________________­_

  

  

  

  

  

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