
Proximity of Care Design Guide
Survey Sheet
This tool can be used to organise and conduct surveys with caregivers, community members, educational & healthcare staff, NGO staff and city government officials.
Aim: Conduct Surveys in target neighbourhood, using either paper-based forms or Kobo app as a data recording tool.
Tasks:
- Identify and contact local community representatives or institutional (NGO, school, healthcare or faith organisation) personnel best placed to facilitate household survey
- Determine HS location, route, and any safety and ethical issues (paper vs digital collection, prohibited areas, gender/nationality/religious considerations for staff involved)
- Prepare consent form, for privacy and data management
- Agree dates & times for conducting HS