Baseline Location Assessment Form [B3F] - BANGLADESH

Transcription

1 Baseline Location Assessment Form [B3F] - BANGLADESH FORM QUESTIONNAIRE i Version: 1 Locations include all villages, formal and informal camps and settlements, and all any other types of known locations in which the UMNs are living in. Please use the last page to collect demographic breakdown from 20 randomly chosen families out of the whole undocumented Myanmar migrants in this location. Date of Assessment d d - m m - y y y y Round No. Enumerator Name Location ID (SSID) Team Leader Name GPS Longitude Location Name can be village/ward name GPS Latitude Location Type Makeshift Camp/Settlement Formal Camp/Settlement Village/Ward (host communities) Other type, please specify Division Chittagong District Cox s Bazar Upazila Teknaf Uhkia Union Is there active registration exercise for the undocumented Myanmar nationals living in this location Yes No If Key informant agrees please provide name. Contact will be used for follow up assessment on populations, conditions and needs. For column Type, please use: 1.Local Community Leader 2.Humanitarian/Social Organization; 3. Representation of displaced groups; 4. Other representation from government office 6. Representatives of education facilities 7. Representatives of health facilities 8. Other, please specify in contact column. NAME Type Sex Contact Details if informant agrees, if not then mark XX and state the type and sex only M/F (Phone and Address) DESCRIPTION OF CURRENT POPULATION How many TOTAL UNDOCUMENTED MYANMAR NATIONALS LIVING in this Location: Time Period As of Today (Current ) As of end of December 2016 PRIOR to 9th October 2016 Majority of place of ORIGIN in MYANMAR STATE/REGION STATE/REGION STATE/REGION DISTRICT DISTRICT DISTRICT TOWNSHIP TOWNSHIP TOWNSHIP VILLAGE VILLAGE VILLAGE Second majority of place of ORIGIN in MYANMAR STATE/REGION STATE/REGION STATE/REGION DISTRICT DISTRICT DISTRICT TOWNSHIP TOWNSHIP TOWNSHIP VILLAGE VILLAGE VILLAGE # Children <18 # Female HoH # Elderly HoH # Children HoH # UASM # Pregnant # Lactating #PwD IOM Bangladesh Page 1 of 5

2 Baseline Location Assessment Form [B3F] - BANGLADESH IN FLOWS (ARRIVALS) How many TOTAL UNDOCUMENTED MYANMAR NATIONALS THAT HAVE ARRIVED in this Location: Time Period In the last 2 Weeks Since 9th Oct 2016 until Today Majority are arriving directly from: Second majority are arriving directly from: OUT FLOWS (DEPARTURES) How many TOTAL UNDOCUMENTED MYANMAR NATIONALS THAT HAVE DEPARTED from this Location: Time Period In the last 2 Weeks Since 9th Oct 2016 until Today Majority are departing to: Second majority are departing to: IOM Bangladesh Page 2 of 5

3 Baseline Location Assessment Form [B3F] - BANGLADESH BASIC NEEDS Basic Needs Level or urgency/priority requiring assistance Remarks Very High High Medium Low Very Low Shelter Non Food Items Medical Health Support Please include comment on mother and child health services if any Rehabilitation Support Assistive Device Support Psychosocial Support Water Sanitation and Hygiene Please include comment on both sanitation and hygiene if any Education Please include comment on education Maktoob, pre-primary and also which language they like Protection and Security Please include comment on issues like neglect, abuse, exploitation, discrimination and violence if any Food and Nutrition Please include comment on both food and nutrition if any Livelihood Information about basic services Comments, including on major risks and vulnerabilities of the target population groups in this location IOM Bangladesh Page 3 of 5

4 Baseline Location Assessment Form [B3F] - BANGLADESH SERVICE PROVIDERS Name of Organization Type (e.g. NGO; INGO; Government; Religious, UN) Type of assistance Targeted Beneficiaries Contact Person INFORMATION CREDIBILITY 1. Is the information provided by the different key informants consistent? 2. Is the information provided consistent with your own observations? 3. Does the information source have lists/proofs supporting it? 4. In overall, how credible do you think the information provided by key informants for this location? Very high High Medium Low Very Low IOM Bangladesh Page 4 of 5

5 Baseline Location Assessment Form [B3F] - BANGLADESH DEMOGRAPHIC CALCULATOR Please fill in household details, providing the total number of household members and marking the appropriate age range and sex for each household member. Randomly select 10 households (HH) from camp-like locations and 10 households from a host community type of location. If there are no camps in the ward take 20 Households from Host Community (HC). Example 1: A household has Father 41; Mother 38; daughter 15; son 17; grandmother 65. Example 2: A single-headed household has Mother 30: daughter 2; daughter 3; son 7. Record as follows: HHs 0 (less than 1) Male Female Male Female Male Female Male Female Male Female Male Female Ex Ex Provide the breakdown of 20 households, following the example above: HHs (less than 1) Male Female Male Female Male Female Male Female Male Female Male Female i One form questionnaire is to be use to document one particular location i.e. one form per block in the case of makeshift settlement or one form per village in the case of settlement within host community IOM Bangladesh Page 5 of 5

6 FORM QUESTIONNAIRE i Version: 1 Locations include all villages, formal and informal camps and settlements, and all any other types of known locations in which the UMNs are living in. Please use the last page to collect demographic breakdown from 20 randomly chosen families out of the whole undocumented Myanmar migrants in this location. Date of Assessment d d - m m - y y y y Round No. Enumerator Name Location ID (SSID) Team Leader Name GPS Longitude Location Name can be village/para name GPS Latitude Location Type Makeshift Camp/Settlement Formal Camp/Settlement Village/Ward (host communities) Other type, please specify Division Chittagong District Cox s Bazar Upazila Teknaf Uhkia Union Is there active registration exercise for the undocumented Myanmar nationals living in this location Yes No SITE INFORMATION Access to site a. Footpath b. Limited access/small vehicles c. Yes with large vehicles (van/4x4/ pickup) Ownership of site a. Public/Government b. Private land c. Don t know d. Other : Type of shelter (select all that apply) a. Makeshift shelter b. Long house c. Mud house d. Host community e. Other : Is there a site management structure in the settlement? a. Yes a.1. CMC/BMC a.2. Host community a.3. NGO/CSO a.4. Other : b. No How is the site/block management structure set up? a. Volunteer basis b. Appointed by local authority c. Elected by community d. Other Are female UMNs involved in the site/block management structure? If Key informant agrees please provide name. Contact will be used for follow up assessment on populations, conditions and needs. For column Type, please use: 1.Local Community Leader 2.Humanitarian/Social Organization; 3. Representation of displaced groups; 4. Other representation from government office 6. Representatives of education facilities 7. Representatives of health facilities 8. Other, please specify in contact column. NAME Type Sex Contact Details if informant agrees, if not then mark XX and state the type and sex only M/F (Phone and Address) DESCRIPTION OF CURRENT POPULATION Time Period As of Today (Current ) As of end of January 2017 IOM Bangladesh Page 1 of 6

7 Majority of place of ORIGIN in MYANMAR Second majority of place of ORIGIN in MYANMAR STATE/REGION DISTRICT TOWNSHIP VILLAGE STATE/REGION DISTRICT TOWNSHIP VILLAGE STATE/REGION DISTRICT TOWNSHIP VILLAGE STATE/REGION DISTRICT TOWNSHIP VILLAGE # Children <18 # Female HoH # Elderly HoH # Children HoH #UASM # Pregnant # Lactating #PwD IN FLOWS (ARRIVALS) How many TOTAL UNDOCUMENTED MYANMAR NATIONALS THAT HAVE ARRIVED in this location in the last 2 weeks: Time Period Majority are arriving directly from: Second majority are arriving directly from: Once crossing the border, any stay longer than 4 days are considered a transit and should be recorded as coming from other location in BD MY - VILLAGE TRACT MY - VILLAGE TRACT OUT FLOWS (DEPARTURES) How many TOTAL UNDOCUMENTED MYANMAR NATIONALS THAT HAVE DEPARTED from this location in the last 2 weeks: Time Period Majority are arriving directly from: Second majority are arriving directly from: Consider possibility that population are leaving to other countries. BASIC NEEDS FOOD & NFI Assistance received to date in this block/village Shelter materials Plastic sheet Bamboos Bedding materials Blankets Mats Kitchen set pots & pans plates & Hygiene Kit bath soap/shampoo toothbrush/toothpaste Dignity kit Clothing Hygiene pads IOM Bangladesh Page 2 of 6

8 (select all that apply) Assistance by provided (select all that apply) Priority needs Second priority Third priority WASH Main source of water (not for drinking) Main source of drinking water How is the drinking water treated at HH level? # of latrine in block/village # of functioning latrine # of washroom in block/village # of functioning washroom FOOD & NUTRITION Sources of food (select all that apply) Fixing materials Mosquito nets utensils detergent Others ne Government/local authorities Military/Police Shelter materials Bedding materials Mosquito nets Shelter materials Bedding materials Mosquito nets Shelter materials Bedding materials Mosquito nets UN/INGO/NGO BDRCS Charities Kitchen set Hygiene Kit Dignity kit Kitchen set Hygiene Kit Dignity kit Kitchen set Hygiene Kit Dignity kit comb/nail clipper Religious institutions Host community Private individuals Clothing Other: Other: ne Clothing Other: ne Clothing Other: ne water pump/well water tap canal/river water reserve/pond water truck none other: water pump/well water tap canal/river water reserve/pond water truck none Cooking facilities on block/village chlorine tab/powder boiled filtered don t know not treated other: # Are male/female latrines available? other: # of water points in block/village: # of wells # of hand pumps Latrines installed by? # of tap stands UMN # of functioning water points in block/village: host community # of wells # of hand pumps # of tap stands UN/INGO/NGO don t know other: # # of male latrines # # of handwashing station? # # female latrines # # of functioning handwashing station # # Are male/female washroom available? # # of male washroom # female washroom Government UN/I/NGO distribution Host community Common kitchen Cooking inside shelter Cooking outside shelter Other Is there waste management system in place? # Who manages the waste management # system? Charities Own kitchen garden Foraging (field/forest) Source of cooking fuel UMN host community UN/INGO/NGO don t know other Fishing Local market Other local forest local market other IOM Bangladesh Page 3 of 6

9 Availability of nutritional supplement for pregnant and lactating women HEALTH Main health issues in block/village Access to nearest health facility PwD have access to Rehabilitation Support? EDUCATION Access to formal education Availability of nutritional supplement for children IOM Bangladesh Page 4 of 6 Watery diarhea Bloody diarhea Skin infection Fever Malaria Respiratory problem Measles Lice ne Other On site (< 30 min) On site (> 30 min) Off site (< 30 min) Off site (> 30 min) Mobile clinic Other On site (< 30 min) On site (> 30 min) Off site (< 30 min) Off site (> 30 min) ne PROTECTION (ask the question to the relevant gender or age group) # of child friendly spaces # of women friendly spaces Does women have access to dignity kits? Any friction within community? # Does children feel safe in and around block/village? # Does women feel safe in and around block/village? Don t know Does men feel safe in and around block/village?, within block/village, between blocks in site, with host community Other SAFETY & SECURITY Is there a security arrangement in block/village?, organized by UMN, organized by host community, organized by local authority ne Is there a protection incident reporting mechanism on site? Other Priority safety and security concern in block/village. Second priority safety and security concern in block/village. Access to Antenatal care? Availability of Psychosocial support PwD have access to Assistive device support? Access to informal education If no, where do they not feel safe If no, where do they not feel safe If no, where do they not feel safe Do you know where to report security incident? On site (< 30 min) On site (> 30 min) Off site (< 30 min) Off site (> 30 min) ne Latrine Washroom Waterpoints Distribution site off site other Latrine Washroom Waterpoints Distribution site off site other Latrine Washroom Waterpoints Distribution site off site other Is there a GBV reporting mechanism on site?, to CMC/BMC, to Community/ Religious leaders, to local authority ne Other Petty crime/theft Missing family members Kidnapping Violence among UMN Friction with host community Accidents ne Other Petty crime/theft Missing family members Kidnapping Violence among UMN Friction with host community Accidents

10 Second priority safety and security concern in block/village. INFORMATION & COMMUNICATION Does everyone know that all services/ assistance provided by humanitarian agencies are free? How does UMN get information What are the three main topics of information that is most needed by UMN population? Comments/Observations : ne Other Petty crime/theft Missing family members Kidnapping Violence among UMN Friction with host community Accidents ne Other UN/I/NGO local authorities CMC/BMC Host communities UMN community Community/religious leaders Media (print/radio/tv) Others How to access services/assistance Do UMN how to communicate feedback on conditions and services in block/village? livelihood opportunities Distribution Status/documentation Situation/condition at place of origin ne Other SERVICE PROVIDERS Name of Organization Type (e.g. NGO; INGO; Government; Religious, UN) Type of assistance Targeted Beneficiaries Contact Person INFORMATION CREDIBILITY 1. Is the information provided by the different key informants consistent? 2. Is the information provided consistent with your own observations? 3. Does the information source have lists/proofs supporting it? 4. In overall, how credible do you think the information provided by key informants for this location? Very high High Medium Low Very Low IOM Bangladesh Page 5 of 6

11 DEMOGRAPHIC CALCULATOR Please fill in household details, providing the total number of household members and marking the appropriate age range and sex for each household member. Randomly select 10 households (HH) from camp-like locations and 10 households from a host community type of location. If there are no camps in the ward take 20 Households from Host Community (HC). Example 1: A household has Father 41; Mother 38; daughter 15; son 17; grandmother 65. Example 2: A single-headed household has Mother 30: daughter 2; daughter 3; son 7. Record as follows: HHs 0 (less than 1) Male Female Male Female Male Female Male Female Male Female Male Female Ex Ex Provide the breakdown of 20 households, following the example above: HHs (less than 1) Male Female Male Female Male Female Male Female Male Female Male Female i One form questionnaire is to be use to document one particular location i.e. one form per block in the case of makeshift settlement or one form per village in the case of settlement within host community IOM Bangladesh Page 6 of 6