Rapid Joint Needs Assessment Phase 01- INDIA [VILLAGE / HAMLET]

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INDIA RAPID Needs Assessment Format Phase 1 Initial Days (1-25 days in the immediate aftermath of a disaster) Village Level Assessment Format An India Humanitarian Collective Action To be Used by the Humanitarian Agency/ NGO To be used at the Village/ Hamlet Level 1. Nature of disaster A. SPECIFIC LOCATION OF AFFECTED POPULATION 6. Village/ 2. State 3. District 4. Block 5. GP Hamlet/Ward 7. Total number of HH in village? 7. GPS North East 8. Total number of Hamlets/ Area? 9. Number of affected Hamlets/ Area? 10. Estimated HH affected? 11. Approximate no. of people dead? 12. Approximate no. of people missing? 13. Approximat e no. of people injured? 14. Approxi mate no. of people displace d? 15. Location of displaced people Public building Formal camps Other 16. Please provide the disaggregated data in numbers for the affected population (if possible- based on Secondary data etc) ensuring disaggregated data on gender, age caste which you need for policy advocacyetc) Children upto 14 years Wom en Men P/Cwd 1 Women Pregnant and nursing (0-6 months) Minorities SC ST 17. How high is the water logging (current situation) 1-3 ft above 3 ft No water logging 18. Accessibility to village B. WASH 19. Approximate number of HH in the Village without access to safe drinking water due to disaster? PWD SC ST Minorities 20. Access to water for all people including disabilities/st/sc/minorities (Post disaster)? 21. Is the water available at the source enough for short-term and longer-term needs for all groups in the population? 22. Do people have enough water containers for storage? 23. What are the excreta disposal practices? Yes No Sufficient for Short term (for 1 weeks) Long term sufficiency (beyond 3 weeks) Yes Pre disaster No Open Areas Household/ Community Latrines 24. Is the water source contaminated or at risk of contamination Post disaster Partly (for 2 weeks) Open Areas Household/ Community Latrines 1 People / Children with disabilities An India Humanitarian Collective Action Page 1 of 5 Jrna- Village Tool Revised

25. What was the practice on menstrual hygiene pre disaster? and do they still have access to them (ask women and girls/anm/aww/asha worker)? Pls give your suggestion/ recommendation or additional information Cloth Sanitary Napkins Any other Any Other C. SHELTER 26. Total number of Shelter Damage (approx.) Fully Partially No Damage 27. Are the relief camps accessible to Person with Disability, Transgenders, SC and STs? 28. Number of HH in need of immediate shelter? 29. What is the immediate exposure elements weather wise that concern you? 30. Availability of Non Food Items with families Rains/Snow Cold Mosquitos Darkness Heat Snakebites Wild Animals Any other (specify) Kitchen Utensils hygiene materials Sanitary Napkin Cloths ORS/Zinc Tablets/Basic Medicines Stove Fuel, Blankets Bedsheets Torch Lights and lighting solutions Any other(specify) D. FOOD, NUTRITION AND LIVELIHOODS 31. What is the food availability at HHs in the less than a week 1-3 weeks affected area? 1 month more than a month Female Male Children 32. Are there significant changes in the total Amount Amount decreased amount of food that people are eating since decreased the disaster, on average? 33. What are the govt. programs on food and nutrition available to the communities in post disaster scenario? 34. Are markets in the affected area functioning? 35. Are markets in the affected area accessible? AWC PDS MDM Community Kitchen Any other Fully Partly Not functioning Unavailable Fully Partly Not accessible Unavailable Amount decreased 36. Approximate number of HH whose livestock are affected 37. What is the availability of fodder in the affected area? less than a week 1-3 weeks 1 month more than a month For female Foe male 38. Which livelihoods are likely to be most affected? An India Humanitarian Collective Action Page 2 of 5 Jrna- Village Tool Revised

Rapid Joint Needs Assessment Phase 01- INDIA [VILLAGE / HAMLET] E. EDUCATION 39. Are children going to school/ educational institutional post disaster? No teachers No students Infrastructure damage No Midday Meal 40. If No pls specify the reason (tick all Study materials damaged School not accessible that apply) Schools used as shelter Unavailable Any other.. 41. How soon will the schools become functional? within 15 days within 30 days Beyond 30 days 42. Medical/ health facilities/ service providers in the Village are functional? F. HEALTH Pre disaster Post disaster Health Sub-Centers (HSC) Primary Health Centers (PHC) Health camps 43. What are the main reasons for health facilities not functioning post disaster? (If other, please specify) 44. Are there any health concerns as a result of the disaster? (If other, please specify) 45. Do people have access to the following health services post disaster? Doctors/Medical In-charge VHND ANM ASHA Anganwadi Centres Informal providers Shortage of staffs Lack of Supplies/medicine Medical equipment/ instruments Others (please specify) 46. No of pregnant women in 7-8 th month of pregnancy? Damage to building Fully functional Location if not accessible People injured Dead bodies (people/animals) Communicable disease Ante-natal Care Malaria Diarrhoea Psycho social Measles Other. Outpatient consultations Antenatal /post natal check ups Routine Immunization Basic essential obstetric care Emergency essential obstetric care/ Institutional delivery Don t know An India Humanitarian Collective Action Page 3 of 5 Jrna- Village Tool Revised

G. PROTECTION 47. Are there major protection concerns (post disaster) (select all that apply)- Note: ( NA) What are the risks? Sexual abuse domestic violence Harmful traditional practices Trafficking of women and children Child abuse and exploitation Discrimination (Caste based, related to HIV, gender etc.) NA Breakdown of law and order (looting crime, theft NA Presence of armed non-state actors NA Violence(s) between members of displaced community NA and/or host community Threat from host community NA Forced return or relocation to your own location NA Loss of legal documents(s) 2 NA Do you have threat from other community group in your previous location, in case you return back? Are there functional institutions/children homes in this area that provide care for orphans or separated children? Are there any children in this community who are involved in types of work that are harsh and dangerous for them NA If yes what kind of services do they provide Day care Residential care Recreational activities Child labour Other (specify Where do you think the risks of abuse are high/highest for children At home in camp in school on the way to school Presence/ increase of risk of human trafficking NA Split families (family members separated from others) NA Unaccompanied children (registration, family tracing?) NA on the way to market Are the persons with special needs more at risk. NA (i.e. disabilities, elderly, single-headed household, single women) Discrimination against ethnicity (indigenous peoples) Discrimination against caste Arrangements for the disposal of remains of the deceased/ carcasses NA Are Safe and private facilities available for women and girls Latrines Bathing Living spaces NA Whether people have freedom of movement or are forced to stay in danger zones NA 2 Ration card, voter id, land documents, insurance, immunization cards, ANC cards, health cards (birth registration, marriage, etc.) An India Humanitarian Collective Action Page 4 of 5 Jrna- Village Tool Revised

H. INFORMATION SOURCES (please indicate the sources of information used in compiling this report) Please tick all that apply Name Phone Number Affected community respondent(male) Affected community respondent (female) Affected community respondent (PWD) Village Parishad Chairman(Mukhiya) Village / GP Secretary /Sarpanch Ward Member Anganwadi Worker I/NGOs (please name organization) Direct Observations of assessment team Philanthropists (please name agency/ Group) Other 48. Name of Interviewer 49. Interviewer Organization Female Male Contact Number: 50. Date and time of Interview 51. Choose Interview type Female FGD Male FGD Children FGD Elderly FGD 52. Type of Community SC ST General Minority Mixed group 53. Number of Volunteers available in village 54. Task Force available in village Suggestions and recommendation of Interviewer End of Document An India Humanitarian Collective Action Page 5 of 5 Jrna- Village Tool Revised