9 A1 A4 B1 B2 B4 B5 B3 B6 B7 B8 B10 B11 B12 B13 B16 C1 C2 C3 C6/C4 C5 C7 C8

No Nama KK
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1 ARBA'A 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1
2 JAMHURI 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 1 0 0 1 0 1 1 1 1 1 1 1 1 1 1
3 HAMDANI 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
4 SYUKUR 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 1 0 0 1 1 1 1 1 1 1 1 1
5 M. AMIN 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 1 0 1 0 0 0 1 1 1 1 1 1 1 1 1
6 NASEB 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 1 0 0 1 0 0 1 1 1 1 1 1 1 1 1
7 RIDUAN 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
8 MUZAKIR 1 1 1 1 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 0 1 1 0 1 1 1 1 1 1 1 1 1
9 ASNAWI 1 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 1 0 1 0 0 0 1 0 0 1 1 1 1 1 1 1 1
10 M YUSUF S 1 1 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
11 MARYANI 1 1 1 1 0 0 0 0 1 0 1 0 0 1 0 1 1 0 1 0 0 0 1 0 1 1 1 1 1 1 1 1 1
12 KEMALA INTAN 1 1 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
13 BANTA SIDI 1 1 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
14 JULIANA 1 1 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
15 IRIANTO 1 1 1 1 0 1 0 1 0 0 1 1 0 1 0 1 1 0 1 0 0 1 1 0 0 1 1 1 1 1 1 1 1
16 CYARKAWI 1 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
17 M. IQBAL 1 1 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
18 AIDI 1 1 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
19 IBRAHIM 1 1 1 1 0 0 0 1 0 0 1 0 0 1 0 1 0 1 1 0 0 0 1 0 1 1 1 1 1 1 1 1 1
20 MUCHLIS 1 1 1 1 0 0 0 1 0 0 0 0 0 1 0 0 1 0 0 0 0 0 1 0 1 1 1 1 1 1 1 1 1
21 SAMIDAN 1 1 1 1 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 1 1 1 1 1 1 1 1 1
22 PANEUK 1 1 1 1 0 0 0 1 0 0 0 0 0 1 0 0 1 0 0 0 0 0 1 0 1 1 1 1 1 1 1 1 1
23 YUSDI 1 1 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
24 DEPRI 1 1 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
25 USMAN R 1 1 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
26 BANTA KAMANI 1 1 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
27 SUKUR HAMDI 1 1 1 0 1 0 0 1 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
28 MARIYADI 1 1 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
29 YUSUP ABI 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
30 USMAN 1 1 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
31 MURTALA 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
32 USMAN LK 1 1 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
33 SYA'RI 1 1 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
34 SYAHPUTRA 1 1 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
35 M. DAUD 1 1 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
36 DAUD ARAFAH 1 1 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
37 SULAIMAN 1 1 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
38 EHRI 1 1 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
39 MUSYAWARAH 1 1 1 0 0 0 0 0 1 0 1 0 0 1 0 1 0 1 1 0 0 1 0 0 1 1 1 1 1 1 1 1 1
40 KURNIA 1 1 1 1 0 1 0 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
41 MISWAR 1 1 1 1 0 1 0 0 0 0 1 1 0 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
42 HASANAH 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
43 ERWANSYAH 1 1 1 1 0 0 0 1 0 0 1 0 0 1 0 0 1 0 1 0 0 1 1 0 1 1 1 1 1 1 1 1 1
44 RISWAN SAHPUTRA 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
45 SAIDI 1 1 1 0 0 0 0 1 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
46 BUSIN 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
47 M. SANI 1 1 1 0 0 0 0 1 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
48 SUPENDI 1 1 1 0 0 0 0 0 1 0 1 0 0 1 0 1 0 0 1 0 0 1 0 1 1 1 1 1 1 1 1 1 1
49 ARIZAL 1 1 1 0 0 0 0 1 0 0 1 0 0 1 0 1 0 0 1 0 0 1 0 0 1 1 1 1 1 1 1 1 1
50 SAPRI 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
51 SARTIKA 1 1 1 0 0 0 0 1 0 0 1 0 0 1 0 1 0 0 1 0 0 1 0 0 1 1 1 1 1 1 1 1 1
52 SITI AMINAH 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 1 0 0 1 0 0 1 1 1 1 1 1 1 1 1
53 JUNIAR 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
54 SITI HAJAR 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
55 IRWANDI 1 1 1 0 0 0 0 1 0 0 1 0 0 1 0 1 1 0 1 0 0 1 0 0 1 1 1 1 1 1 1 1 1
56 M. DAUD 1 1 1 0 0 0 0 1 0 0 1 0 0 1 0 1 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1
57 AGUS SETIAWAN 1 1 1 0 0 0 0 1 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
58 NGA'TIMAN 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
59 EDI SANDIVA 1 1 1 0 0 0 0 1 0 0 1 0 0 1 0 1 0 0 0 0 0 1 0 0 1 1 1 1 1 1 1 1 1
60 HABIL 1 1 1 0 0 0 0 1 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
61 JUSKAHFI 1 1 1 0 0 0 0 1 0 0 0 0 0 1 0 1 0 0 1 0 0 1 0 1 1 1 1 1 1 1 1 1 1
62 RUHDI 1 1 1 0 0 0 0 1 0 0 0 0 0 1 0 1 0 0 1 0 0 1 0 0 1 1 1 1 1 1 1 1 1
63 PATMAWATI 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
64 NASIB 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
65 ISKANDAR 1 1 1 0 0 0 0 1 0 1 0 0 0 1 0 1 0 1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1
66 M INDRA SYAHPUTRA 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
67 SAMSUDIN 1 1 1 0 0 0 0 1 0 0 0 0 0 1 0 1 0 1 0 1 0 1 0 1 1 1 1 1 1 1 1 1 1
68 RASIDIN 1 1 1 0 0 0 0 1 0 0 1 0 0 1 0 1 0 1 1 0 0 1 0 0 1 1 1 1 1 1 1 1 1
69 SALIHIN 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
70 ISMAIL 1 1 1 0 0 0 0 0 1 1 0 0 0 1 0 1 0 1 0 1 0 1 0 1 1 1 1 1 1 1 1 1 1
71 SAIDI 1 1 1 0 0 0 0 1 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
72 BUKHARI 1 1 1 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
73 DAHLAN 1 1 1 0 0 0 0 1 0 0 1 0 0 1 0 1 0 0 1 0 0 1 0 0 1 1 1 1 1 1 1 1 1
74 DEDU EPYUNI 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
75 NURMILA 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
76 M. BAHAGIA 1 1 1 0 0 0 0 1 0 0 0 0 0 1 0 1 0 1 1 1 0 0 1 0 1 1 1 1 1 1 1 1 1
77 MUKLIS 1 1 1 0 0 0 0 1 0 0 1 0 0 1 0 1 1 0 1 0 0 0 0 1 1 1 1 0 1 1 1 1 1
78 ARES 1 1 1 0 0 0 0 1 0 0 1 0 0 1 0 1 0 1 1 0 1 0 1 0 1 1 1 1 1 1 1 1 1
79 WARDIMAN 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 1 0 0 1 0 0 1 1 1 1 1 1 1 1 1
80 ALYASIMMI 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
81 KASWANDI 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 1 0 0 0 0 0 1 1 1 1 1 1 1 1 1
82 RAHMADDI 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
 83 SOPIANTONI 1 1 1 0 0 0 0 1 0 0 1 0 0 1 0 1 1 0 1 0 0 1 1 0 1 1 1 1 1 1 1 1 1
84 SUWARDI 1 1 1 0 0 0 0 1 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
85 SYAMSUL BAHRI 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
86 ALAIKA SADEK 1 1 1 0 0 0 0 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
87 ZAITUN 1 1 1 0 0 0 0 1 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1
24 62 86 1 84 3 11 21 4 0 33 4 3 25 4 0 1 84 0 39 11 8 26 3 2 22 13 7 46 38 85 2 24 63 2 84 2 85 0 87 0 87 4 83 0 87

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 C9/C11 C10 C12 D2 D3/D4 D8 D9 D11 D13 D19 D21 E1 E2 E3 E4 E5 E13 E7 E8 E9 E16
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24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44
 REKAP HASIL SURVEY MAWAS DIRI (SMD)
DESA KUALARAWA KECAMATAN RUSIP ANTARA TAHUN 2023
Jumlah
No Indikator Keterangan
Ya Tidak

A Akses Pelayanan dan Pembiayaan

Kesehatan
1 Penghasilan mencukupi 24 62 86
2 Berobat Ke nakes/pkm 86 1 87
3 Kepemilikan BPJS 84 3 87
4 Memiliki Balita_ibu_hamil 11 21 32
5 Rencana melahirkan di polindes 4 0 4
6 Freq_periksa_hamil min 4 x 33 4 37
7 Gangguan_kehamilan 3 25 28
8 Penolong_persalinan nakes 4 0 4
9 Kematian ( 5 thn trakhir) 1 84 85
10 BBLR ( 5 thn trakhir) 0 39 39
11 Imunisasi lgkap(Usia 0-11 bln) 6 4 10
12 Balita ditimbang ( min 8x sethn) 26 3 29
13 Balita BGM 2 22 24
14 ASI_eks (0-6 bln) 13 7 20
15 Memakai Kontrasepsi 46 38 84
16 Mengkonsumsi Garam beryodium 85 2 87
17 Batuk pilek 24 63 87
18 Diare 2 84 86
19 Hipertensi 2 85 87
20 Demam Tipoid/tifus dan DBD 0 87 87
21 TBC 0 87 87
22 Gatal gatal 4 83 87
23 Campak 0 87 87
24 Hepatitis/Diabetes Mellitus/gula 2 85 87
25 Cacar air 0 87 87
26 Sesak nafas,panas,batuk 1 86 87
27 Kepemilikan jamban 59 28 87
28 Air bersih dan kualitas air bersih baik 85 2 87

29 Pembuangan_limbah kamar mandi sesuai 7 80 87

standar
30 Pembuangan_sampah sesuai standar 51 36 87
31 Pembuangan_limbah_dapur sesuai standar 54 33 87
32 Ventilasi rumah cukup 85 2 87
33 Kandang_ternak tidak menempel kerumah 45 42 87
34 Toga 45 42 87
35 Tidak Merokok di dalam Rumah 74 13 87
36 CTPS Seblum mkan 34 53 87
37 Gosok_gigi 80 7 87
38 Miras 0 87 87
39 PSN (Pemberantasan sarang nyamuk) 79 8 87
40 Melakukan Aktivitas fisik 33 54 87
41 Air_minum Dimasak 84 3 87
42 BAB di jamban 65 22 87
43 CTPS sesudah BAB 71 16 87
44 Sampah Dipilah( organik_non organik) 32 55 87