The Effect of Improper Waste Disposal
among the Health of the Children age 0-6 years old
in Barangay Bagacay Purok-2
Name of the Respondent: (optional) ______________
Age:_________
Relationship with the child:_______________
Name of the Interviewer:________________
Date:_______
General Information
1.Gender
● 1.1 Male
● 1.2 Female
2.Age
● 2.1 zero to two
● 2.2 three to four
● 2.3 five to six
3.Educational Attainment
● 3.1 Primary
● 3.2 High School Graduate
● 3.3 Alternative Learning System (ALS)
● 3.4 Technical Education and Skills Development Authority (TESDA)
● 3.5 University Graduate
● 3.6 Never Schooled
4.What is your major occupation?
● 4.1 Farmer
● 4.2 Business
● 4.3 Government Servant
● 4.4 Unemployed
Questionnaires
5.Where do you usually put away your wastes ?
● In the public bin
● By the road or street side
● By the valley lake or river
● In an open space
● In a hole
6. Are there any public bins near your house?
● Yes
● No
7. Does anyone collect garbage here?
● Yes
● No
8. Do you burn your garbage?
● Yes
● No
9. Do you think improper waste disposal has a negative effect to the environment?
● Yes
● No
10. Do you notice the presence of the following in and around the dumping land?
● Dark flowing water
● Mosquitoes
● Cockroaches
● Rats
11. Do you think improper waste disposal has a negative effect on the health of your child?
● Yes
● No
12. Does your child often play in dumping sites?
● Yes
● No
13. How many hours does your child play in the dumping site?
● 1 to 2 hours
● 2 to 3 hours
● 3 to 4 hours
● Whole day
14. Does your child experience different diseases because of the garbage that is not properly
disposed of ?
● Diarrhea
● Dengue
● Malaria
● Pneumonia
15. Does improper waste disposal affect the physical growth of your child?
● Yes
● No
