Date: 8/22/2014 Name and surname Position Gender From

District: Nong 1.Mr. Bounsieng Health Facilitator Male World vision

2.Mr. Bounlert DAFO faculty Male DAFO

2 0 2

level of agreement Comment

Questionn #of # of strongly

Questionnaire #of #of #of
aire strongly strongly disagree Disagree why? Unsure why?
group disagree Unsure agree
number disagree agree why?

PWD never come to get the service

Unsure why?
A1.1 1 1
PWD never come to get the service
A1.Availability
A1.2 1 1

A1.3 2
Sufficient staff a
A1.4 2
Generally focus on sanitary promotion for
children and women also DAFO focus on
Sufficient equipme
A2.1 2 livestock training, Afew PWD participate
Sometime there is PWD participate in
Generally focus oA2.2 2 group but project did not direct focus on
them

A2. Accessibility A2.3 2

On the training t A2.4 2

Never implemented, because the project
Because our staffA3.1 2 did not focus PWD
DAFO never implement There is no PWD come to get the service
Never implemente
A3.2 1 1

A3. Acceptability A3.3

A3.3 A3.4

A3.4 A4.1
There is no PWD come to get the service.
A4.1 A4.2 2 So never adapted the equipment for PWD
Never. Generally implement for normal
There is no PWD A4.3 2 people,we have no disability staff

A4. Adaptability A4.4

A4.4 A4.5

A4.5 A4.6

A4.6 A4.7 2
Never identify the training fee for PWD.
A5. Affordability A5.1 2 Just only the organization pay for them

Never identify th A5.2

Never implement and did not discuss
A5.2 A6.1 2 with PWD, just only conduct the general
training
Never implementA6.2
a 2
PWD never invited to the evaluation
A6. Accountabilit A6.3 2 meeting
DAFO never collect PWD info
PWD never invited
A6.4 1 1
DAFO did not coordinate to the section
concern for PWD need
Word vision just A6.5 1 1
Comment

strongly agree
Agree why?
why?

Project has the plan for PWD's activity

but did not implement

Generally word vision has awareness

concerning health,education for children
and women
Sufficient staff and different experient

Sufficient equipment to support the

trainee after finish

On the training there is

the photo of inclusive
learning between normal
people and PWD

Because our staff be able

to communicate in local
language also showing
the photo on the training

Field staff present to the organization

and then coordinate with the section that
relate

PWD have participate in the meeting in

their village

Word vision just submit the monitoring

info of health also the other payment
Word vision has
coordinate with the
section concern about
PWD need
Date: ### Name and surname Position Gender From

District: Nong Mr. Ketsamai

Mr. Sivone
Trainer

Program coordinat Male

Male DAFO

MCNV
Service providers
Mr. Bounsuan

Mr. Sixome
NFE

Office chief
Male

Male
GAA

PRF
Nong district
Mr. Sinnakhone Fiel staff Male PRF

5 0 4

level of agreement Comment

Questionn #of # of strongly

Questionnaire #of #of #of
aire strongly strongly disagree Disagree why? Unsure why?
group disagree Unsure agree
number disagree agree why?

Majority the project invited the trainer to

train them
Unsure why?
A1.1 1 4

A1.Availability
A1.2 5
There is not enough staff but they all
A1. Availability Unable to join when busy with the project complete with full knowledge
A1.3 1 3 1 meeting
There is only normal people but PWD not
There is not enou yet
A1.4 1 2 2
Generally the activity conducted in the
village,
There is only nor A2.1 2 3
The activities organize by district partner, Up to the real situation, Go to community
A2.Accessibility A2.2 2 3 the location prepare by village authority to conduct the activity
The activities organize by district Up to the real situation,
Up to the real si A2.3 3 1 1 partner,Up to PWD's situation
The activities organize by district partner, Service for general people Did not focus
Up to the real sit A2.4 1 2 2 any,up to the real situation
Just only representative of PWD to join in
the group discussion, General discussion
Service for genera
A3.1 4 1 with vulnerable,
Up to disability situation,service for some
Coordinate with pA3.2 2 3 PWD category

A3. Acceptability A3.3 5

Service for the queue or work plan Follow up the work plan and real
situation, Some time service on time,Up
to the real situation
Did not separate A3.4 2 3
Did not adapted, Focus for general Adapted some part of the location
Follow up the worA4.1 3 2 people, The activities conducted in the
village Up to the real situation,Just some tool
Adapted some part
A4.2 3 2 adapted
The the activity also the tool did not There is less benificiary who is the PWD,
support only PWD
Up to the real si A4.3 2 1 2
Unknown enable to use all or not,
Prepared the info for general only, All the
A4. Adaptability A4.4 4 1 tool and info not focus only PWD
Prepared for general, Did not focus only
PWD, All the tool and info not focus only
Unknown enable A4.5
to 4 1 PWD
Never do nothing, Never focus on public
health
Prepared for geneA4.6 3 2
Never do nothing,

Advise to the relaA4.7 1 4

Training fee paid by project,

A5. Affordability A5.1 1 4

The activities conduct in the village and
. transfer people who far away by project
car
Always inform befA5.2 1 4
The activity did not conduct for PWD Did not focus for PWD
Always inform befA6.1 2 1 2 only, Never do nothing concerning PWD
Never invite to join Meeting with village authority PWD
included

Did not focus for A6.2 1 1 3

Never invite to join Meeting with village authority PWD
included

A6. Accountabilit A6.3 1 1 3

Collect general info

Meeting with vill A6.4 1 4

Majority plan manage by project, Just Did not focus for PWD
only vulnerable not for PWD
All activities ha A6.5 3 1 1
ce providers
ng district

Comment

strongly agree
Agree why?
why?

The service have provided for PWD and

other people with some grant to build the
school and accommodation for PWD

Announce by distict to village, General

Announce via the village, Up to the PWD
situation to share the info
The district partner respond to organize
the activities supported by project

The service tool supported by the project,

there is wheelchair road for PWD in
school
There is service center in the community
up to PWD situation,the school radder
design for PWD's wheelchair

The curriculum provide by the project

Up to the real situation of PWD

Coordinate with project to collecting the

PWD needed

Service for general people non specify

Did not separate the service, Training

participate determine by The project

There are some grant for this, Training

tool provide by project
Because the project had some grant for
this, If PWD can not do the any activity
we changed them to suitable
The project provide all tool,

Up to the real situation some staff can

talk local language

Advise to the relate section, Advise to

district or province stimulate room by
project
Directly discuss with relate section,
Present to the project, Discuss with relate
section for PWD
Always inform before provide the service,
Provide for more detail every time,
Provided the service fee
Always inform before provide the service,
Provide for more detail every time,
Provided the service fee also
transportation
The activities conduct in community for a
group so they could show the comment
Participated in the beginning and the end
of the year, The activities conduct in
community for a group so they could
show the idea

Participated in the beginning and the end

of the year, The activities conduct in
community for a group so they could
show the idea

All activities had recorded the whole

benificiaries, recorded personal info, The
activities conduct in community for a
group so the record needed

Discussed with local authority for general

but not focus only PWD,
Date: 22-08-14/21-10-14 #service provider #Participant Female From

District: Nong 5 7 0 2 DAFOs

1 World vision

1 GAA

2 PRFs

1 MCNV

level of agreement
#of #of Strongly
Questionnaire Questionnair #of
strongly #of disagree #of Unsure strongly disagree
group e number agree
disagree agree why?

Strongly disag 0 2 0 5 0 (),()

A1.1

A1.Availability 0 1 0 6 0 (),()

A1.2

(),() 0 1 3 3 0 (),()

A1.3

(),() 0 1 2 4 0 (),()

A1.4

0 2 2 3 0 (),()

(),() A2.1

0 2 5 0 0 (),()

(),() A2.2

0 3 1 1 2 (),()
A2. AccessibilitA2.3

0 1 2 2 2 (),()
(),() A2.4

0 4 2 1 0 (),()
(),() A3.1
 0 3 4 0 0 (),()

A3.2

0 0 0 5 0 (),()
A3. AcceptabiliA3.3

0 2 3 0 0 (),()
(),() A3.4

0 3 2 0 0 (),()
(),() A4.1

0 2 3 2 0 (),()
(),() A4.2

0 4 1 2 0 (),()

(),() A4.3

0 0 4 1 0 (),()
A4. AdaptabilityA4.4

0 0 4 1 0 (),()
(),() A4.5

0 3 0 2 0 (),()
(),() A4.6

0 1 0 6 0 (),()

(),() A4.7

0 3 0 4 0 (),()
A5. AffordabilitA5.1

0 1 0 4 0 (),(.)

(),() A5.2

0 4 1 2 0 (),()

(),(.) A6.1

0 1 1 5 0 (),()

(),() A6.2

0 3 1 3 0 (),()

A6. AccountabilA6.3
 0 2 0 5 0 (),()

A6.4

0 4 1 1 1 (),()

(),() A6.5
 Service providers
Nong district

Comment

Disagree why? Unsure why? Agree why?

(Project has the plan for PWD's

activity but did not implement),(The
(PWD never come to get the
service have provided for PWD and
service ),(Majority the project invited (),()
other people with some grant to build
the trainer to train them )
the school and accommodation for
PWD )

(Generally word vision has awareness

concerning health,education for
(PWD never come to get the children and women),(Announce by
(),()
service ),() distict to village, General Announce
via the village, Up to the PWD
situation to share the info )

(Sufficient staff and different

(),(Unable to join when busy with the (),(There is not enough staff but they experient),(The district partner
project meeting) all complete with full knowledge ) respond to organize the activities
supported by project)

(Sufficient equipment to support the

(),(There is only normal people but trainee after finish),(The service tool
(),()
PWD not yet) supported by the project, there is
wheelchair road for PWD in school)

(Generally focus on sanitary (),(There is service center in the

(),(Generally the activity conducted in promotion for children and women community up to PWD situation,the
the village,) also DAFO focus on livestock training, school radder design for PWD's
Afew PWD participate),() wheelchair)
(Sometime there is PWD participate
(),(The activities organize by district in group but project did not direct
partner, the location prepare by focus on them),(Up to the real (),()
village authority) situation, Go to community to
conduct the activity)

(),(The activities organize by district (),(The curriculum provide by the

(),(Up to the real situation,)
partner,Up to PWD's situation) project)

(),(The activities organize by district (),(Service for general people Did not
(),(Up to the real situation of PWD)
partner,) focus any,up to the real situation )

(),(Just only representative of PWD to

(Never implemented, because the (),(Coordinate with project to
join in the group discussion, General
project did not focus PWD),() collecting the PWD needed )
discussion with vulnerable, )

(DAFO never implement),()
(),()
(),(Service for the queue or work
plan)
(),(Did not adapted, Focus for general
people, The activities conducted in (),(Adapted some part of the location)
the village )
(There is no PWD come to get the
service. So never adapted the
equipment for PWD),()
(Never. Generally implement for
normal people,we have no disability (),(There is less benificiary who is the grant for this, If PWD can not do the
staff ),(The the activity also the tool
did not support only PWD )
(),()
(),()
(),(Never do nothing, Never focus on
public health)
(),(Never do nothing, )
(Never identify the training fee for
PWD. Just only the organization pay
for them),(Training fee paid by
project, )
(),(The activities conduct in the
village and transfer people who far
away by project car)
(Never implement and did not discuss
with PWD, just only conduct the
general training),(The activity did not
conduct for PWD only, Never do
nothing concerning PWD)
(),(Never invite to join)
(PWD never invited to the evaluation (),(Meeting with village authority PWD the end of the year, The activities
meeting),(Never invite to join)
(There is no PWD come to get the
service),(Up to disability (),(Service for general people non
situation,service for some PWD specify)
category)
(),(Did not separate the service,
(),() Training participate determine by The
project )
(),(Follow up the work plan and real
situation, Some time service on (),()
time,Up to the real situation )
(),()
(),(Up to the real situation,Just some (),(There are some grant for this,
tool adapted) Training tool provide by project )
(),(Because the project had some
PWD, ) any activity we changed them to
suitable)
(),(Unknown enable to use all or not,
Prepared the info for general only, All (),(The project provide all tool, )
the tool and info not focus only PWD)
(),(Prepared for general, Did not focus
(),(Up to the real situation some staff
only PWD, All the tool and info not
can talk local language)
focus only PWD)
(),(Advise to the relate section,
(),() Advise to district or province
stimulate room by project)
(Field staff present to the
organization and then coordinate
with the section that relate),(Directly
(),()
discuss with relate section, Present
to the project, Discuss with relate
section for PWD)
(),(Always inform before provide the
(),() service, Provide for more detail every
time, Provided the service fee)
(),(Always inform before provide the
service, Provide for more detail every
(),()
time, Provided the service fee also
transportation )
(),(The activities conduct in
(),(Did not focus for PWD) community for a group so they could
show the comment)
(PWD have participate in the meeting
in their village),(Participated in the
(),(Meeting with village authority PWD beginning and the end of the year,
included) The activities conduct in community
for a group so they could show the
idea)
(),(Participated in the beginning and
included) conduct in community for a group so
they could show the idea)
 (Word vision just submit the
monitoring info of health also the
other payment ),(All activities had
(DAFO never collect PWD info),
(),() recorded the whole benificiaries,
(Collect general info)
recorded personal info, The activities
conduct in community for a group so
the record needed )
(DAFO did not coordinate to the
section concern for PWD need), (),(Discussed with local authority for
(),(Did not focus for PWD)
(Majority plan manage by project, general but not focus only PWD, )
Just only vulnerable not for PWD)
World vision
DAFO
0
0
DAFO
MCNV
GAA
PRF
PRF

Strongly agree why?

(),()

(),()

(),()

(),()

(),()

(),()

(On the training there is the photo of

inclusive learning between normal
people and PWD ),()
(Because our staff be able to
communicate in local language also
showing the photo on the training),()

(),()
(),()

(),()

(),()

(),()

(),()

(),()

(),()

(),()

(),()

(),()

(),()

(),()

(),()

(),()

(),()
 (),()

(Word vision has coordinate with the

section concern about PWD need ),()
 Date: 22-08-14/21-10-14 Number & Service provider name Distant from village(km/m)

District: Nong 2 DAFOs

1 World vision

1 GAA

2 PRFs

1 MCNV

level of agreement

#of strongly #of strongly

6A QUESTIONAIR disagree #of disagree #of Unsure #of agree agree

Select question
number here

6As question detail

Barrier Assessm
No
Distant from village(km/m)

Coment
strongly strongly agree
disagree Disagree why? Unsure why? Agree why? why?
why?

r Assessment for service provider

Nong district
A1.1

A1.2

A1.3

A1.4

A2.1
 ສຳມະນາກອນລົງທະບຽນເຂົ້າປະຊຸມ/Barrier Assessment Regitration Form

ຄັ້ງວັນທີ/ Date : 20-26/08/14 ເມືອງ/ບ້ານ/District /village: Nalongkao/Paroi/Poontong/Hinsawang/Nongvilai

ປະເພດພິການ/ຜູ້ຫຼອດຊີວິດ/ຜູ້ເຄາະ
ຮ້າຍ/ Types of ສາຍເຫດພິການ/Case of
ລ/ດ ວ.ດ.ປ/Date ລາຍຊື່ participants name ພາກສ່ວນ From ຊັ້ນ, ຕຳແໜ່ງ Title ເບີໂທ/ Tel
impairment/Survivors/ impairment
Victims
01 8/22/2014 Mr. Bounsieng Worlld vision Health Facilitator
02 8/22/2014 Mr. Bounlert DAFO DAFO faculty
03 10/21/2014 Mr. Ketsamai DAFO Trainer 309495898
04 10/21/2014 Mr. Sivone MCNV Program coodinator 2056076556
05 10/21/2014 Mr. Bounsuan nedthongsavanGAA NFE 2096783398
06 10/21/2014 Mr. Sixom chansuvannee PRF Office chief 2098248000
07 10/21/2014 Mr. Sinnakhone PRF Community staff 2022271498
08
09
10
11
12
13
14
15
16
17
18
19
20
ang/Nongvilai

ລາຍເຊັນ/ Signature
 ສຳມະນາກອນລົງທະບຽນເຂົ້າປະຊຸມ/Barrier Assessment Regitration Form

ຄັ້ງວັນທີ/ Date : 22 Aug 14 and 21 Aug 14 ເມືອງ/ບ້ານ/District /village:

ປະເພດພິການ/ຜູ້ຫຼອດຊີວິດ/ຜູ້ ສາຍເຫດ
ເຄາະຮ້າຍ/ Types of ພິການ/Case of ເບີໂທ/ Tel ລາຍເຊັນ/
ລ/ດ ວ.ດ.ປ/Date ລາຍຊື່ participants name Sex ພາກສ່ວນ From ຊັ້ນ, ຕຳແໜ່ງ Title
impairment/Survivors/ impairment Signature
Victims
01 8/22/2014 Mr. Bounsieng M World vision Health Facilitator
02 8/22/2014 Mr. Bounlert M DAFO DAFO faculty
03 21-102014 Mr. Ketsamai M DAFO Trainer
04 21-102014 Mr. Sivone M MCNV Program coordinator
05 21-102014 Mr. Bounsuan M GAA NFE
06 21-102014 Mr. Sixome M PRF Office chief
07 21-102014 Mr. Sinnakhone M PRF Fiel staff