Rural Shelter Rapid Needs Assessment

(Settlement Level)

Location

Province/District (code) / Town/Villages (code)
Place name (code) + GPS coordinates: / Type of settlement (circle one):
Permanent Seasonal Spontaneous

Access

Access road (circle the most appropriate answer): Foot path Dirt road Asphalt road
Accessible by (circle the most appropriate answer):
Foot Animal boat/canoe Car 4WD Light truck Heavy truck
Location accessible until (dd/mm/yyyy): ____/____/______or all year

Affected Population

Population of affected zone before crisis / Population of affected zone after crisis
Females / Males / < 5yrs / > 60yrs / Total / Females / Males / < 5yrs / > 60yrs / Total
Estimated total number of crisis affected casualties
# of deaths caused by crisis: _____ # of missing persons: _____ # of injured persons: _____
Vulnerable persons
# of Unaccompanied elder (someone over 60 yrs): ______
# of Unaccompanied minor (someone under XXyrs): ______
# of Severely disabled persons: ______
# of Persons with a chronic illness: ______
# of Female headed household: ______
# of People from any ethnic minority: ______
# of People belonging to an indigenous groups: ______
# of People of lower casts: ______
Is the settlement hosting affected people from outside the delimitation of that settlement (IDPs)?
If yes, where is the place of origin, and the approximate distance from the place of origin (km)?
What is the nature of displacement? (check all corresponding and rank the 3 most prevalent)
  • <1 km from place of origin
  • <5 km from place of origin
  • >6 km displaced due to risk of potential hazard (example landslide, tsunami, etc.)
  • >6 km displaced due to conflict
  • Refugees (from outside of the country)
  • Nomadic population

Obstacles to return (circle all relevant answers)
Poor security Potential hazards Lack of shelter Lack of water Lack of livelihood Lack of food
If none of the above, than describe other:
Priority needs (circle most appropriate answer)
Health / WASH / Food/Nutrition / Shelter / Security
High
Medium
Low / High
Medium
Low / High
Medium
Low / High
Medium
Low / High
Medium
Low

Shelter

Total percentage of housing units in affected area / Uninhabitable / %
Inhabitable / %
If homes in affected area are severely damaged or destroyed, where are people living? (check all corresponding and rank the 3 most prevalent)
  • In the damaged housing units
  • In makeshift shelters
  • With friends/family
  • In collective centres/unused buildings
  • In camps/informal settlements

Are the affected persons paying rent for the following, and if so, how much?
  • Land: $ ______
  • Shelter: $ ______
  • Room: $ ______
  • Other services: ______, $ ______

Possible forthcoming hazards (check those which have a high potential of occurring)
Can the current shelters withstand the most possible hazard? (Yes / No)
What are the most probable forthcoming climatic conditions?
  • Sun/heat
  • Rain/strong winds
  • Cold/snow

Can the current shelter withstand the forthcoming climatic conditions? (Yes/No)
Can materials be salvaged from destroyed houses/buildings (circle the all relevant)
wood plank CGIs bricks rebar wood poles stones bamboo
Other (specify):

Housing Land and Property

Are tenancy and ownership agreements formal or informal? (documents)
If formal, are affected persons in possession of tenancy/ownership documents (post-crisis)? / (yes/no)
What is the affected peoples’ risk of eviction from current sites? (circle the most appropriate)
  • Low
  • Moderate
  • High
  • Unknown

Is the following real estate available?(Temporary sheltering solutions)
Free land (for the possibility of self-settled/planned camps) / (yes/no)
Unused public buildings (for the possibility of setting up collective centres) / (yes/no)
Spare rooms in homes (for the possibility of host family/community) / (yes/no)
Spare apartments units (for the possibility of setting rental schemes) / (yes/no)

Building damage assessment

Building typologies in affected area
What types of buildings exist in the settlement? (check all corresponding and rank the 3 most prevalent)
  • Temporary housing structures (ex: slums)
  • Huts (ex: archaic housing units)
  • Single story houses
  • Multiple story apartment buildings

What are the buildings in the settlement made from? (check all corresponding and rank the 3 most prevalent)
  • Mud/stone masonry
  • Wattle and daub
  • Timber/bamboo framed with panels
  • Brick/concrete masonry
  • Other (describe):

Housing damage assessment
What type of damage has occurred to housing in the settlement? (check all corresponding and rank the 3 most prevalent)
/ / /
___ / ___ / ___ / ___
Community resources (infrastructure and utilities)
Population with currently with shelter (circle one): 100% 75% 50% 25% 0%
Electricity (circle one): 24hrs some none
Storage area (m2):
Self-recovery
Plans for future
What are the affected persons’ future plans? (check all corresponding and rank the 3 most prevalent)
  • Repair/build in same location within settlement
  • Build in new location within settlement
  • Build in new location outside of settlement
  • Rent/buy in new location within settlement
  • Rent/buy in new location outside of settlement
  • Not sure what plans are as of yet

Priority perceived support needed (prioritize in ascending order)
  • Building materials
  • Skilled labour
  • Technical training
  • Financial assistance
  • Other (describe):

If financial assistance please explain what the cash is intended for:
Tools/materials/means needed for local repair or relocation (provide a short list):

NFIs

Do households have the following: / 2 containers to carry/store water / (yes/no)
Appropriate cooking + eating equipment / (yes/no)
Access to fuel (cooking/heating) / (yes/no)
Hygiene and sanitation items / (yes/no)
Bedding available / (yes/no)
2 full sets of clothing per person / (yes/no)
Additional winterization items / (yes/no)

Livelihoods / Food security

For what purpose other than sleeping do people use their homes (check all corresponding and rank the 3 most prevalent)
  • Storing tools and/or equipment
  • Business activities
  • Storing food/animals
  • Other (specify):

Food is available? (circle the most appropriate)
>3months 2months 1month 2weeks 1week 1-3days none
What ways do people obtain food?
  • Purchased
  • Bartered
  • Home grown
  • Other (specify):
Has this been disrupted (explain)?
WASH
Is there potable water available in the settlement? (circle the most appropriate)
  • Sufficient
  • Insufficient
  • None
/ Is there non-potable water available in the settlement? (circle the most appropriate)
  • Sufficient
  • Insufficient
  • None

Where do they collect water from? (circle the most appropriate)
water tower water tank rain harvesting Dug well Spring River
Other (specify):
What were the means of excretal disposal pre-crisis?(check all corresponding and rank the 3 most prevalent)
  • Latrines
  • Pit
  • Open air defecation
  • Other (specify):

What were the means of excretal disposal post-crisis?(check all corresponding and rank the 3 most prevalent)
  • Latrines
  • Pit
  • Open air defecation
  • Other (specify):

Gender

Amelia… Help!!!

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