T6 ROMACTED Baseline Survey Template

Please use this table to define the baseline of the ROMACTED process.

ROMACT Baseline Survey Tool

DEMOGRAPHY

What is the population of the municipality?

provide the number

How many inhabitants are at risk of poverty?

provide an (estimated) number or %

How many Roma live in the municipality?

provide an (estimated) number or %

How many Roma communities live in the municipality?

provide the number

EDUCATION

How many Roma children between 3 and 5 years old live in the municipality?

provide at least an estimate

How many Roma children between 3 and 5 years old attend preschool/kindergarten?

provide at least an estimate

How many Roma children between 6 and 15 years old live in the municipality?

provide at least an estimate

How many Roma children between 6 and 15 years old attend school?

provide at least an estimate

If school attendance is low among Roma children, explain the main reasons

What is the school dropout rate in the Roma community?

provide at least an estimate

Is the school infrastructure adequate?

YES/NO and explain why

Is the quality of education adequate?

YES/NO and explain why

EMPLOYMENT

How many Roma do have a job?

provide an (estimated) number or %

What are the typical jobs of Roma in the municipality?

Do most Roma know how to look for and apply for jobs?

YES/NO

If YES, please explain how they look for jobs?

Is discrimination a major obstacle for Roma in finding a job?

YES/NO

If YES, please explain

How many Roma have an income from work?

provide an (estimated) number or %

How many Roma benefit from welfare, excluding child allowances?

provide an (estimated) number or %

HOUSING & UTILITIES

What is the average size of Roma households?

provide an (estimated) number

Is illegal housing a major issue in the municipality?

YES/NO

if YES, how many households are concerned?

provide an (estimated) number or %

How many Roma dwellings are not connected to utilities?

provide an (estimated) number or %

How many Roma households are not able to pay for utilities?

provide an (estimated) number or %

Are roads/streets leading to Roma dwellings paved?

YES/NO

What is the state of roads/streets leading to Roma dwellings paved?

Please detail

Do Roma have access to public transport? Can they afford using it?

YES/NO

HEALTH

Is there any health centre within 5 km of the Roma community?

YES/NO

If YES, is this health centre properly equipped?

YES/NO

If YES, how is the health centre financed?

Are there family doctors or healthcare professionals accessible within 5 km of the Roma community?

YES/NO

Does the Roma community receive outreach medical services? (doctors or nurses coming in the community for check-ups, treatment or prevention services)

YES/NO

How many Roma are registered with a family doctor?

provide an (estimated) number or %

OTHER

How many Roma left the municipality in the last five years?

provide an (estimated) number or %

How many Roma lack identity documents?

provide an (estimated) number or %