RURAL WATER SUPPLY AND SANITATION FUND DEVELOPMENT BOARD
(RWSSFDB)
Maharajgunj, Kathmandu, Nepal
______
Monitoring and Evaluation of Development Phase Completion
and
Appraisal for Implementation Phase
(To be filled by SAs/ Board Staff)
(Please review Implementation Phase Proposal, Design Estimates, IInd payment SA monitoring visit report, SO Mid-term progress report, Development Phase Contract and Terms of Reference, Pre-feasibility study reports and other scheme related documents before proceeding to the field. Please fill the form and produce the report based on document review, discussion with SO personnel, WSUC members and Community Members along with site observations and verifications)
PART-A: Social Aspect
1. General Information
Scheme Code No: ______Name of SO: ______
Scheme Name: ______Region: ______
District: ______VDC ______Ward No/s______
Name of the Associate SO (if any):
Contract Date: ...... Contract End Date: ......
Report Submission Date: ......
Development Phase Duration ______Months. From ______to ______
If Development Phase duration has been changed from the original contract, please explain the reason and extent of change.
Summary of Final Progress Status
S.N / Activities / Progress / SA's Remarks on Work /Completed / Not Completed /
1 / Formation of Water and Sanitation User Group (WSUG)
2 / Formation of Water and Sanitation User Committee (WSUC)
3 / Registration of Water and Sanitation User Group (WSUG)
3 / Development of Layout Plan and agreed with undisputed source
4 / Detail Survey Design and Cost Estimate of Water Supply Scheme.
5 / Formation of Mother and Child Tap Stand Group (MCTG) and conduction of all Health and Sanitation Education class.
6 / Conduct of Healthy Home Survey two times
7 / Conduct Sanitation and HHS activities
8 / Regular meeting of WSUC .
9 / VMW Selection (If yes provide the name in Remarks)
VHP Selection(If yes provide the name in Remarks)
10 / Operation of Bank Account
10.1 / Opening of WSUC Bank Account for O&M
10.2 / Joint Account
11 / Collection of Cash
11.1 / Collection of required operation and maintenance (O & M) cash
11.2 / Collection of required joint account cash
12 / Conduct of Community level trainings/ Orientations
12.1 / Leadership, Community Action Planning and Jagaran Training to WSUC including Jagaran members
12.2 / WSUC Treasurer Account Keeping Training
12.3 / Village Health Promoter (VHP) Training on HHSE
12.4 / Teachers and Student Training on HHSE
13 / Formation of WTSS Group
14 / Formation of Jagaran Committee
15 / Has MACAPO been conducted for A1 to A15?
16 / Preparation of Social Map through mass meeting.
17 / Community Resource Mapping through mass meeting
18 / Staffs Salary payment through bank account
19 / Conduct Market Survey
SA/PM Verify (Refer to Development Phase Final Progress Report Part 1’s para’s 1(Completion of Activities)
2. Households and Population:
SN / Major Groups (LSI) / Pre-feasibility phase* / Development phase /Total HH / Population / Total HH / Population / Poor / People with Disabilities /
F / M / Total / F / M / Total / HH / Pop / F / M /
1 / Upper Caste
2 / Dalit
3 / Relatively Adv. Janajatis
4 / Relatively Disadvantage. Janajatis
5 / Other Excluded Castes
6 / Religious Minorities
Total
* please check the data in PF Report
If there is any change in the number of households or population, please give reasons how it evolved during development phase and provide your comments:Please explain the process and indicators adopted by the community to identify poor HHs.
3. Formation of WSUC and Registration of WSUG
Water Supply and Sanitation User Group (WSUG)
Does the Water Supply and Sanitation User Group include the entire households within the settlement/ scheme area?
Yes [ ] No [ ]
If No, please explain how many households are not included? Mention reason for non – inclusion and also provide your opinion whether this is justifiable and do not hamper the scheme sustainability.
Please explain the process adopted in deciding and forming the Water Supply and Sanitation User Group (WSUG) or beneficiaries.
Has WSUG been legally registered under the water resource act? Yes [ ] No [ ]
Date of Registration of WSUG______
Registration No. and Place______
Is WUG registered satisfactorily and registration certificate attached?
Water Supply and Sanitation User Committee (WSUC)
Has WSUC been formed by the WSUG? Yes [ ] No [ ]
(SA please mention the name of members)
S.N. / WSUC Members name / Post / Female/Male / Mobile Number / LSI Category / Poor HHsYes/No / PWD Yes/No
1
2
3
4
5
6
7
8
9
LSI- 1=Upper Caste 2= Dalits 3=Relatively Adv. Janajatis 4=Relatively Disadv. Janajatis 5=Other Excluded Castes 6=Religious Minorities
Note: PWD = People with Disabilities
Please explain the WSUC formation process and provide your views how much is it representative.
If there is no 33% of Women Member in WSUC, please give reason?
How are the Women Members included in the WSUC and are they participating effectively/ actively? Please explain whether the process is satisfactory.
Is there any change in WSUC composition since it has been formed? If yes, please give reasons with justifications and indicate how it is reflected in WSUG registration.
WSUC Meetings
To be completed by SA by interviewing WSUC members, Tap stand Mothers Group Leaders and few beneficiaries. (Verify that at least one WSUC meeting is conducted in a month)
SN / Date of Meeting / Decision / No of WSUC Members Present / No of SO Staff Present / RemarksM / F / Total
1
2
3
4
5
6
7
8
Note to SA: The M&E team has to verify this information by observation and random interview with Community People to ensure that Meeting are conducted properly and users are aware about the matter. If required check the WSUC minute Book.
Training Details
SN / Name of training / Training Date / Duration(Days) / Nos. of Trainees Participated / LSI
M / F / Total / 1 / 2 / 3 / 4 / 5 / 6 / Total
1 / Leadership, Community Action Planning and Jagaran Training to WSUC including Jagaran members
2 / WSUC Treasurer Account Keeping Training
3 / Village Health Promoter (VHP) Training on HHSE
4 / Teachers and Student Training on HHSE
5
6
LSI- 1=Upper Caste 2= Dalits 3=Relatively Adv. Janajatis 4=Relatively Disadv. Janajatis 5=Other Excluded Castes 6=Religious Minorities
Note: PWD = People with Disabilities
Provide your comment on the quality/effectiveness of the training imparted or reason for not conducting proposed training (if any).
Books of Account
Details of Joint Account
Has joint account fund collected as per requirement? Yes [ ] No [ ]
If yes,
Required / Collected / Remarks by SANote for SA: Please check the Bank’s statement Books (Statement and books of account) and WSUC minute Books.
Name of Bank / Branch, District / Account holders name / Bank Account Number / Total BalanceName of Joint Account operating members.
S.N. / Name of Joint Account operating members / Representative from SO/WSUCDetail of Operation and Maintenance Account
Have operation and Maintenance fund collected as per requirement? Yes [ ] No [ ]
If yes,
Required / Collected / Remarks by SANote for SA: Please check the Bank’s statement (Statement and books of account) and WSUC minute Books.
Name of Bank / Branch, Discrict / Bank Account Number / Total BalanceName of O & M Account operating members of WSUC.
1.
2.
3.
Has the SO maintained the account properly as per Fund Board Instruction? Yes [ ] No [ ]
If Yes, describe the details
If No please explain the reason for non-compliance. SA Verify (Refer to Development Phase Final Progress Report, Books of Account.
(Note: Please attach the detail of financial statement)
Bank Account Number ______Branch ______
Account holders name______
SN / Detail of expenditure / Amount / Remarks1. / What is the amount of total expenditure till date?
2. / What is the balance amount as per books of account?
3. / What is the balance amount as per bank statement
Signatory Members –
SN / Name / PositionDoes the SO furnish updated accounts to the Fund Board prior to each payment? (Yes / No), If No please mention the reason.
______
______
______
Has the SO accountant enabled WSUC treasurer to maintain books of accounts independently? (Yes / No), If No please mention the reason.
______
______
______
What is the reason of difference, if any in the balance amount as revealed by books of accounts and bank statement?
______
______
(Note: Please attach the detail of financial statement)
3. COMMUNITY ACTION PLAN – A1 to A15
A1. Scheme Layout Plan
Proposed type of Scheme (Please tick mark)
a. µ Gravity System
b. µ Surface water Lift System
c. µ Shallow Tube Well System
d. µ Ground water Lift System
e. µ Rain Water Harvesting System
f. µ Other
How community has been involved in making decision on technology/ies (i.e. gravity system or source protection or tube wells or mix of above systems etc. and multiple vs. single reservoir system wherever applicable), source/s to be tapped, technical options (type or design of intake, reservoir, tap stands, tube wells etc.)? Please give your comment whether the community / WSUG are fully aware of those technical choices, alternatives to it and satisfied with?
Is there need of land acquisition? Yes [ ] No [ ]
If Yes
S.N. / Type of structure / Name of Land Owner / Approval given or not / Has MoU been signed?Please check the documents
Has the Design Estimate been endorsed by the mass meeting? Yes [ ] No [ ]
A2. ODF and Post ODF Program
Has Healthy Home Survey been carried out two times in development phase? Yes [ ] No [ ]
If Yes, please mention the status
S. N. / LSI / Total HH / 1st phase / 2nd phaseStatus of household survey / Status of household survey
G / Y / R / G / Y / R
1 / Upper Caste
2 / Dalit
3 / Relatively Adv. Janajatis
4 / Relatively Disadvantage. Janajatis
5 / Other Excluded Castes
6 / Religious Minorities
Total
G = Green card, R = Red card, Y = yellow card
If No, provide reasons for non-compliance
Number of toilets constructed:
S.N / Type of Toilets / Pre-Development Phase / Development Phase / TotalMid Term Progress Report / Development Phase completion report
1
2
3
Total
SA Verify (Refer to Development Phase Final Term Progress Report Part its para’s A-2 ODF/Post ODF (Total Sanitation) activities, if any differences in reporting or completion of Activities in Communities Please mention the differences.
A3. Health Education Support to the Mother and Child Tap- stand Groups.
Nos. of Mother and Child Tap-stand groups (MCTSGs) formed: ______
List the HHSE sessions conducted:
S.N. / HHSE session / Place / Nos. of traineesMale / Female / Total / Child / LSI
1 / 2 / 3 / 4 / 5 / 6
LSI- 1=Upper Caste 2= Dalits 3=Relatively Adv. Janajatis 4=Relatively Disadv. Janajatis 5=Other Excluded Castes 6=Religious Minorities
How effectively is the HHSE program conducted? Please justify indicating approximately the % of targeted beneficiaries having knowledge on faecal oral disease transmission routes, importance of personal, domestic and environmental sanitation and observation on present practices.
A4. Household and Village Environmental Sanitation Program
Number of waste disposal pits constructed during development phase: ______
Number of utensil washing platform constructed: ______
Number of utensil drying station(Chang) constructed: ______
Environmental Sanitation:
Please explain the Plan for wastewater use, drainage, Solid waste disposal plan, cleaning of village and structures etc.
Has the community involved in the village sanitation activities regularly? Yes [ ] No [ ]
If yes, provide the details,
If no, give the reason,
A5. School Sanitation and Hygiene Program
Is there school in the community? Yes [ ] No [ ]
If yes, please mention details:
S.N. / Name of School / No. of Boys / No. of Girls / Total Students / Is there toilet in school / Is there separate toilet for girls? / Is there women, child and disability friendly toilet? / Is there urinal?What types of latrine or urinals have been proposed for implementation phase? Are the latrines/ urinals user (child, gender and disabled) friendly? Are school teachers and students involved in this process?
A6. Women Technical Support Service (WTSS)
Have interested groups for WTSS program been formed? Yes [ ] No [ ]
If yes, mention the number of groups ...... and the following details
SN / Major Groups (LSI) / No of MembersGroup 1 / Group 2 / ......
1 / Upper Caste
2 / Dalit
3 / Relatively Adv. Janajatis
4 / Relatively Disadv. Janajatis
5 / Other Excluded Castes
6 / Religious Minorities
Total
How the groups are formed? Mention the process adopted and its appropriateness? Has group savings started?
How many Households are not included in the group? Please explain why all household are not included?
Has WTSS/Jeevika Committee been formed? Yes [ ] No [ ]
(SA please the details of members. If there are more than one group, please add a table for each group)
S.N. / Name / Position / Female/Male / Mobile Number / LSI Category / Poor HHsYes/No / PWD Yes/No
1
2
3
4
5
6
7
8
9
LSI- 1=Upper Caste 2= Dalits 3=Relatively Adv. Janajatis 4=Relatively Disadv. Janajatis 5=Other Excluded Castes 6=Religious Minorities
Note: PWD = People with Disabilities
Has capacity building program of WTSS/ Jeevika groups been initiated? Yes [ ] No [ ]
If Yes, please provide the details:
SN / Name of training / Date / Nos. of Trainees Participated / LSIM / F / 1 / 2 / 3 / 4 / 5 / 6
1
2
3
4
LSI- 1=Upper Caste 2= Dalits 3=Relatively Adv. Janajatis 4=Relatively Disadv. Janajatis 5=Other Excluded Castes 6=Religious Minorities
Provide your comment on the quality/effectiveness of the training imparted or reason for not conducting proposed training (if any).