Survey Questionnaire on the Implementation of Schistosomiasis Program in Barangay Vintar
Respondent #:
Date:
TO THE RESPONDENT:
Good day!
We are currently conducting a study that focuses on Assessing the Implementation of
Schistosomiasis Program in Barangay Vintar. We would like to ask your participation by taking
your time to answer this questionnaire. Please read the questions carefully and answer them
accurately.
REST ASSURED THAT ALL INFORMATION GATHERED FROM THIS STUDY WILL
BE TREATED WITH UTMOST CONFIDENTIALITY.
Please rate each statement from 1 to 5, where:
1 = Strongly Disagree
2 = Disagree
3 = Neutral
4 = Agree
5 = Strongly Agree
Effectiveness of the Schistosomiasis Program 4 3 2 1
The Schistosomiasis control program has
significantly reduced the incidence of
Schistosomiasis in Barangay Vintar.
The health outcomes related to Schistosomiasis have
noticeably improved since the program’s
implementation.
The program effectively reaches the majority of the
residents in Barangay Vintar.
Program activities such as drug administration are
conducted regularly and are well-organized.
The Schistosomiasis control program is effective in
promoting preventive health practices.
Awareness and Knowledge of Schistosomiasis 4 3 2 1
and Its Prevention
I am aware of the symptoms and risks associated
with Schistosomiasis.
The program has provided sufficient information
about the ways to prevent Schistosomiasis.
I understand how Schistosomiasis is transmitted and
the importance of preventing it.
Information on Schistosomiasis is readily available in
our community through the program.
Educational sessions on Schistosomiasis prevention
have improved my knowledge on the topic.
Challenges in the Program’s Implementation 4 3 2 1
The program faces challenges related to insufficient
funding or resources.
There is a lack of adequate healthcare facilities and
professionals to effectively control Schistosomiasis.
Some residents do not participate in the program
due to lack of awareness or interest.
Community Participation and Influence on 4 3 2 1
Program Effectiveness
Community involvement plays a critical role in the
success of the Schistosomiasis control program.
I actively participate in the Schistosomiasis control
program activities.
Community leaders are supportive and encourage
residents to participate in the program.
Increased community participation has led to a more
successful implementation of the program.
Name and Signature of Respondent
