Commission on Audit

Commonwealth Avenue, Quezon City

Gender and Development (GAD) Survey Questionnaire

Date

Dear Respondent,

In connection with the COA-GAD data build-up, may we request you to

provide the necessary data called for and answer the questions correctly and
truthfully.
Please return the accomplished survey form not later than

Thank you.
Very truly
yours,

----------------------------------------------------------------------------------------------------------------------------------------1. First Name:

Middle Name:

2. Sex: Male Female

Last Name:

Gender Preference:

3. Age:
Birthday
____________________
4. Civil Status: Single Married

Widow

Separated

5. Present Address:
6. Permanent Residence:
7. Position:
8. Designation SA

Eligibility________________________
SC/DC

ATL

ATM

9. Present Assignment:
10. Office Address:
11. Indigenous Group/ Cultural Identity/ Tribe:
12. Religion:
13. Solo Parent: Yes

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No

Others

(Specify)

14. Total Annual Family Income:

and fixed

(include income of spouse

financial support from

children and others)

15. Dependents: Father
No:

Mother

Uncles/Aunts

Children
No:

No:

Others

Brothers/Sisters
(Specify)

16. No. of Children:

Name

Date of
Birth

Employed
(Y/N)

Schoolin
g
(Y/N)

With
Disability
(Pls. Indicate)

17. Relatives in Government (up to the fourth degree of consanguinity or

affinity)
Name

Relationship

Office

18. Existing Health Problems:

Physically Challenged/Impaired
Hypertension/ High Blood Pressure
Heart Ailment
Cancer
Diabetes
Migraine
Eye Problem
Others (specify)
19. Gender Roles:
20.1. Economic Empowerment
a. Productive Role (activities/tasks which contribute to the
family income and

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economic welfare/advancement of the household or

community)
1. Are you a breadwinner of the family? Yes
No
If yes, what are your sources of income? (Check all that is
applicable to you)
COA Employment
Others, please specify:
Farming
Subsistence
Direct Selling
Financing
Buy and Sell
Food Processing/home-based industries
Refrigeration/Air-conditioning Services
2. Do you have access to your family financial resources? Yes
No
3. Do you participate in decision-making involving family finances?
Yes

No

b. Reproductive Role (activities carried out to reproduce and care for

the household)
1. Is your family at the child bearing/rearing stage? Yes
No
If yes, do you plan the number of children you want to have?
Yes

No
2. Does your spouse share in the responsibility of child

caring/rearing?
Yes

No

3. If child/children is/are in school age, do both of you attend to

his/her/their
school needs? Yes
No
If no, specify who takes the responsibility and why?

c. Household Managing Role (carried out to meet the family basic

needs)
1. Do your family members participate in the household tasks?
Yes

No
2. Do you make decision/s in the management of household

affairs? Yes

No
If no, please explain
3. Do you have a household help? Yes

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No

d. Community/ Politics Role

1. Are you actively involved in professional/
civic/religious/cultural/sports/
other community organizations or associations? Yes
State name/s of your organization:
2. Do you exercise your right of suffrage? Yes

No

No

3. Is there any cultural/religious/political barrier between:

You and your spouse?
Yes
No
You and your officemates? Yes
No
20.2 Social Development Rights and Protection
Yes

1. Do you live in a house/ property your family own?

No
2. Are the following available to you and your family:
a. Light/power

Yes

No
b. Clean Water

Yes

c. Telephone/mobile phone

Yes

d. Television/cable

Yes

No
No
No
e. Garbage collection by the LGU
Yes

No

Yes

No

f. Health care by the Government

3. Do you have a regular physical/medical/dental check-up?
Yes

No
4. Do you attend church or religious gathering with your
family?
Yes

No
5. Do you have any regular recreation activity by yourself?
Yes

No
With your family?

No
6. Do you have enough time to rest?
Yes

No
7. Do you manage your stress well?

Yes

No
8. Do you undertake activities that will enhance your

Yes

No
capabilities or empower you as an individual?
If yes, please give examples of these activities.

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Yes

9. Does your home environment provide you with opportunities

to grow and
Yes

reach your maximum potential as a person?

No
How about your office environment?

Yes

No
If no, cite reason/s:

10. Are you aware of the following Laws:

a. RA 6725: An act strengthening the prohibition on discrimination
against women with
respect to terms and conditions of employment, amending for the
purpose Article 135
of the Labor Code, as amended
Yes
No
b. RA 7192: Women In Development and Nation Building Act
An act promoting the integration of women as full and equal
partners of men
Yes

in development and nation building and for other purposes.

No

c. RA 7877: Anti-Sexual Harassment Act of 1995

An act declaring sexual harassment unlawful in the employment,
education, or training
environment and for other purposes.
Yes
No
d. RA 8972: Solo Parents Welfare Act of 2000
An act providing for benefits and privileges to solo parents and their
children,
appropriating funds therefore and for other purposes.
Yes
No
e. RA No. 9710: An Act Providing for the Magna Carta of
Women
Yes

No

f. RA No. 9262: Anti-Violence against Women and their

Children Act of 2004
An act defining violence against women and their children, providing
for protective
measures for victims, prescribing penalties therefore, and for other
purposes.
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Yes

No

11. Are these laws implemented in your COA office? Yes

By your auditees (client agencies)? Yes
No
If no, pls. give details:

No

12. Aside from the regular GAD Trainings undertaken by COA, what other
trainings do you still
need?
Disaster Preparedness and Risk Reduction Management
Women Empowerment and Development Towards Gender Equality
(WEDGE) by PWC
Human Rights-Based Approach (HRBA) to Development Planning
and Basic Human Rights by CHR
Harmonized Gender and Development Guidelines (HGDG) by NEDA for
Project Development, Implementation, Monitoring and Evaluation
Others, pls. specify

20.3. Security, Justice and Peace

1. Have you experienced any of the following:
a. Physical harm? Yes

No

b. Threats of physical harm? Yes

c. Attempts of physical harm? Yes

No
No

d. Fear due to an imminent physical harm? Yes

No

e. Compulsion or attempts to compel to engage in conduct to which

you and your
child/ children have the right to desist from? Yes

No

f. Deprivation or threats to deprive you of your childs custody? Yes

No
g. Deprivation or threats to deprive you or your child/ children of any
financial
support? Yes

No

h. Deprivation or threats to deprive you or your child/ children of any

legal
right? Yes

No

I. Threats to inflict or inflicting of physical harm for purpose of

controlling your
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actions or decisions? Yes

No

j. Causing or attempting to cause you and your child/ children to

engage in any
sexual activity? Yes

No

k. Emotional distress? Yes

No

l. Being stalked in public and private places? Yes

m. Being harassed? Yes

No

n. Verbal and Emotional abuse? Yes

o. Mental and Emotional anguish? Yes
p. Public humiliation? Yes

No

No
No

No

q. Sexual favors made as a condition in the hiring or in the

employment, reemployment or continued employment, or in granting of favorable
compensation
terms of conditions, promotions or privileges? Yes
No
r. DIscrimination and intimidation in the work office due to a refusal to
grant any
sexual favor to a person with influence or moral ascendancy? Yes
No
s . Being subjected to malicious or sexual (green) jokes? Yes
t. Sexual advances by a co-worker? Yes

No

No

2. Are you willing to discuss this experience/s with a guidance

counselor/expert?
Yes
No
3. Do you see the need for a crisis/ counseling room manned by a
guidance counselor/
expert in your office? Yes
No
4. Do you have Violence Against Women (VAW) desk or Crisis/ Counseling
room at
COA Regional Office or Central Office? Yes
5. Is legal assistance provided by your office? Yes

No
No

20.4. Environmental Climate Change

1. Does your COA office have GAD Program/Activities/Projects (PAPs)
related to:
a. environmental protection and sustainable development? Yes
No
b. disaster reduction? Yes
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No

2. Do you personally know what to do during disaster? Yes

As a group, together with your: family members? Yes
Officemates? Yes
No

No
No

3. Does your office or official station undertake disaster drills like:

a. fire drill?
Yes
No
b. earthquake drill? Yes
No
4. Do you have office personnel specially assigned and trained to act as
marshals,
first-aiders/paramedics, etc? Yes

No

5. Do you have the basic emergency equipment and necessities like

flashlight,
whistle, rope, water, food, medicines, matches, etc. prepared at
home?
Yes

No

20.5 Gender Responsive Governance

1. Do you have access to the resources of your office? Yes
If yes, do you have control over its use/utilization? Yes

No
No

2. Are ATMs or staff involved in the decision-making process of your

office?
Yes

No

3. At the workplace, are you consulted regarding:

a. work assignments
Yes
No
b. work area
Yes
No
c. work equipment/facilities Yes
No
4. Is your immediate superior considerate of your personal circumstance
and respect
your basic rights? Yes

No

5. As a subordinate/peer are you treated with respect and recognized

with dignity
as a person in your day-to-day dealings? Yes

-THANK YOU-

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No