Professional Documents
Culture Documents
Barangay SI Form
Barangay SI Form
Region:
Province:
Municipality:
Barangay:
IDENTIFICATION AND OTHER INFORMATION
Region:
______________________________
Province: ______________________________
Municipality: _____________________________
Barangay: ______________________________
No. of Sitios/Purok: ________________________
Is this a Poblacion Barangay? _______________
If not, how many hours does it take to travel to poblacion? _______
What is the geographic characteristic of the Barangay? (i.e upland, lowland, island,
coastal)? ______________________
Is the barangay isolated from the rest of the municipality? ____________
POPULATION PROFILE
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
IP group
Location/
Sitio
Total
households
Total
population
Total
male
Total
female
Total
male
IP
leader
Total
female
IP
leader
Total
24. Is the barangay affected by armed conflict? ______
25. If yes, please give additional details of the armed conflict in the area ____________
___________________________________________________________________
26. What are the recent community activities in the area?
Activity
Month Conducted
Types of Road
Dirt
Gravel
Asphalted
Cemented/All Weather Road
100%
2. What are the modes of transportation available _________________________
_______________________________________________________________
3. Establishments and Services
a. What establishments and services are in your barangay? If there is none, how far is
your barangay to the nearest establishment? Please indicate if it is in minutes or kms.
Establishments/Services
Please
check
If none, distance
to nearest facility
Mode of
Transport
Barangy hall
Multi-purpose building
Tribal hall
Evacuation center
Market place/bagsakan center
Mini port
Daycare center
Elementary School
Secondary School
College or university
Public Library
Church
Plaza
Health Center
Hospital
Waterworks System
Drainage System
Irrigation
Pre/Post Harvest Facilities
Cemetery
Sanitation facility
Environmental protection
Electricity
Telecommunication Access
Postal Service
Housing Projects
Stores
Financing Institution
Peace and Order/tanod/police
Emergency services
Skills training
Capability building training
Agri-enterprise Development
Training
PRESENCE OF ORGANIZED SECTOR
Organization
1
Name
Type of Organization
Formal?
Membership Exclusive?
Date established
Years operating in brgy
Advocacy
Area of operation
Active or inactive
organization?
Activities and cost
Organization
2
Organization
3
Organization
4
Organization
5
Total members
Total male
Total female
Total members from brgy
Total male members from
brgy
Total female members
from brgy
Total IP members
Male IP members
Female IP members
Location
Scope
Proponent
Cost of
project
Cost
Sharing
(%)
Source
of funds
Decision
Mechanism
When
proposed
When
Completed
When
approved
ACCESS TO SERVICES
1. Which of the following do you think are the main problems in your barangay? Select the
top three (3). Please check box.
Check if
mentioned
Are these
Problems being
addressed
properly?
Problems
1
2
YES
No
ENTER
Access/ Mobility
Benef
M
2. Over the past six months, how many times did the following personnel visit your
barangay either to consult with the community or provide services?
Number
of visits
Government Official
Mayor
Vice Mayor
Councilor
Municipal Planning Officer
Municipal Agrarian Reform Officer/Development
Facilitator
Municipal Social Worker
Agriculture Extension Worker
Government doctor
Municipal Health Officer
Government midwife
BARANGAY GOVERNANCE
BLGU Officials Profile
Nam
Se Age Civil
IP
Education
Positio
Inclusiv
Membershi
KC
Statu
s
group
al
Attainme
nt
e Date
(Start
and
End
Date)
p in
Organizati
ons
Committe
e
Membersh
ip (to be
updated
once the
Project
started)
Amount
6. How do you disseminate the information on the financial situation of the barangay to the
residents of your barangay? What information were disseminated? How often is the
reporting done? (Identify all) ____________________________________________
___________________________________________________________________
___________________________________________________________________
7. Is there a Barangay Development Council? _______
Barangay Development Council Profile
Nam
Se Age Civil Education Positio
e
x
Statu
al
n
s
Attainme
nt
Inclusiv
e Date
(Start
and
End
Date)
Membershi
p in
Organizati
ons
Sector
Represent
ed
8. During the past year, how many times did the BDC meet? _________
9. How many,on the average, attend the BDC meetings? ________
10. Who are the regular attendees of the BDC meetings? ___________________________
______________________________________________________________________
11. During the past year, what activities did the BDC undertake?
12. During the past year, how many times were the BAs conducted? ____
13. On the average, how many barangay households are present during the meetings?
____
14. On the average, how many barangay residents are present during the meetings? ____
15. On the average, how many male residents are present? _____
16. On the average, how many female residents are present? _____
17. On average, how many male IPs were present? _____
18. On average, how many female IPs were present? _____
POVERTY PROFILE
Health
1. Proportion of children aged 0-5 years old who died to the sum of children aged 0 -5 years
old during the previous year:
a) Number of children aged 0-5 years old who died
b) % of total children aged 0 -5 years old
2. Proportion of women who died due to pregnancy-related causes (a/b)
a) Number of pregnant women who died due to pregnancy-related causes
b) % of total pregnant women
Nutrition
3. Proportion of children aged 0-5 years old who are malnourished to the total number of
children 0- 5 years old
a) Number of children aged 0-5 years old who are malnourished
b) % of total children aged 0 -5 years old
Access to Basic Amenities
4. Proportion of households with access to safe water
a) Number of households with access to potable water (within 250m)
b) % of total number of households
5. Proportion of households with access to sanitary toilet facilities
a) Number of households with access to sanitary toilet facilities
b) % of total number of households
Shelter
6. Proportion of households who are squatting
a) Number of households who are squatting
b) % of total number of households
7. Proportion of households living in makeshift housing
a) Number of households living in makeshift housing
b) % of total number of households
Peace and Order
8. Proportion of households with members victimized by crimes
a) Number of households members victimized by crimes
b) % of total number of households
Income
9. Proportion of households with income less than the poverty threshold
a) Number of households with income less than the poverty threshold
b) % of total number of households
10. Proportion of households with income less than the food threshold
a) Number of households with income less than the food threshold
b) % of total number of households
11. Proportion of households who eat less than three (3) meals a day
a) Number of households who eat less than three (3) meals a day
b) % of total number of households
Basic Education
12. Proportion of 6-12 years old children who are not in elementary school
a) Number of children 6-12 years old who are not in elementary school
b) % of total number of children 6-12 years old
13. Proportion of 13-16 years old children who are not in secondary school
a) Number of children 13-16 years old who are not in secondary school
b) % of total number of children 13-16 years old
Employment
14. Proportion of the members of the labor force (persons aged 15 years and above who are
actively seeking work) who are not working
a) Number of labor force who are not working
b) % of total number of labor force
Attachments:
a. Barangay Appropriations Report
b. Barangay Development Plan/Annual investment Plan
c. Other Sources of data