Dagu project baseline survey
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Transcript of Dagu project baseline survey
Improving health worldwide www.lshtm.ac.uk
Dr.YemisrachB.Okwaraji
PresentedforDaguSupervisorsWorkshop
30-Jan-2017
Dagu Baseline Survey
Improving health worldwide www.lshtm.ac.uk
• ThefirstsetofprimarydatacollectedjustbeforethefullimplementaJonofOHEP
• Themainaimsinclude:(i)ToobtainbaselineinformaJononthecharacterisJcsofhealthproviders,households,womenaged13-49andtheirchildren;(ii)ToenableanexaminaJonofthedifferencesincharacterisJcsofthestudypopulaJonbetweentheeligibleindividualsintheintervenJonandcomparison,and(iii)ToprovideinformaJononoutcomesagainstwhichtheOHEPprojectimpactwillbeevaluated.
Aims
Study population • Forthehouseholdsurvey
• ArepresentaJvesampleofallhouseholdsinthestudyworeda• withparJcularfocusonwomenaged13to49years,and• Childrenundertheageof5years.
• Forthehealthprovidersurvey• HealthCentrestaffwhoprovidecareforneonatesandchildrenunder5yearsofageworkingatHealthCentreinselectedhouseholdclusters.
• HealthExtensionWorkersintheselectedhouseholdclusters.
• Women’sDevelopmentArmymemberswhoresideinselectedhouseholdclusters.
Designing the sample
• Samplingframe• WeusedexisJngsamplingframefromCSA• thelistsofenumeraJonAreas(EA)basedonthe2007EthiopianHousingandPopulaJonCensuswereused.
• 200enumeraJonareaswereselectedwithprobabilityproporJonaltosize(PPS).
• Stra6fica6on• StraJfiedbyintervenJonandcomparisonarea• Represen\aJvesampledrawnfromeachstratum
Designing the sample • Samplesize
Survey Interven6ongroup Comparisongroup Total
Household 3000 3000 6000
Childrenaged2-59months 1747 1747 3494
HealthPosts 100 100 200
Sickchildrenobservedathealthposts
400 400 800
Selection of comparison sites • ThecomparisonworedaswereidenJfiedbyOromia,Tigray,SNNPandAmharaRHBS
• SupportfromtheirrespecJvelocaluniversiJes-MU,HU,JUandUoG.
• Basedonallorsomeofthefollowingcriteria:1. WoredaswhicharesimilartointervenJonworedasin
• PopulaJonsizeandnumberofPHCUs• performancedatafrom2007/2008• LengthofWDAnetworkestablishment• LengthofJmesincestarJngICCMandCBNCprogram• SociodemographicstatusofthepopulaJon• Priorexposuretoothersimilarprograms• Burdenofdisease.Malariavs.non-Malariakebeles
2. WoredaswithnopresenceofpartnersworkingondemandgeneraJon.
3. Woreda’sproximitytotheintervenJonworedas
4. WoredasadjacenttointervenJonWoredas.
Selection of comparison sites • ForOromiaregion
• SimilarpopulaJonsizeandsociodemographiccharacterisJcs(forexampleAgrarianvspastoralist)
• DistancefromtheintervenJonsitetoavoidcontaminaJonofinformaJon.Sonearbydistrictswereexcluded.
• SimilarexposurewiththeintervenJondistrictintermsofspecificprogramssuchasiCCMandCBNCprogramsor
• SpecificburdenofdiseasesuchasMalaria.
• ForSNNPregion• SimilariJesinlengthofJmesinceiCCMandCBNCprogramstarted;• LengthofJmesinceWDAnetworkestablished;• PopulaJonsizeandnumberofPHCUs• PerformanceonserviceuJlizaJon(e.g.ANC,facilitydelivery,PNCandimmunizaJon)
• ForTigrayregion• SimilariJesinperformanceoniCCMandCBNCprograms,• LocaJonoftheWoredas(ifWoredaisadjacenttointervenJonWoreda),and• ProximityoftheWoredafromtheintervenJonWoredas
• ForAmhararegion• SimilariJesinserviceutlisaJonratebasedonperformancedatafromEFY2008(LAFP,
MaternityservicecoverageincludingANC4+,SBA,earlyPNC,immunizaJoncoverage,accesstolatrine,modelHHsgraduated);
• HowaccessibletheWoredaisand• NopresenceofacJvepartnersworkingondemandgeneraJonprograms
Survey tools Ques6onnairedesign
• DevelopedbyLSHTMresearchteam• OthersourcesalsoprovidedguidestothequesJonnaires;
• DemographicandHealthSurvey,• IDEASCBNCandHouseholdSurvey.
• Thesevarioussourcesensured• Acomprehensivecoverage• PracJcalityandvalidityofquesJonnaires.
Ques6onnairetransla6on• FinaldraitranslatedbypartneruniversiJes• Threelocallanguages.
• Amharic,OromifiaandTigrigna
Survey tools • Wehave8tools:
1. HouseholdSurvey2. WomanDevelopmentArmySurvey3. HealthExtensionWorkerSurvey4. HealthProviderAssessmentSurvey5. HealthCentreStaffSurvey6. HealthCentreSurvey7. HealthPostSurvey8. WoredaContextualSurvey
Study settings • Thesurveywascarriedoutin52woredas,10zonesinfourregions.• SNNP:• SegenandDawurozones
• Tigray:• SouthEast,Eastern,SouthernandCentralzones
• Amhara:• AwiandNorthGondarzones
• Oromia:• GujiandWestHarargezones
StraJfythesamplingframebyintervenJonandcomparisonarea
Selectclustersfromeachstrata
STAGE1 STAGE2
Listhouseholdsinselectedcluster
Atwo-stagestraJfiedclustersamplingtechnique
Household Sampling
Selecthouseholdstobeinterviewed
Household listing
• Firststage• 200clustersselectedfrom2007censusframe.• -SystemaJcallyselectedwithprobabilityproporJonaltosize
• Secondstage• AcompletehouseholdlisJngwascarriedoutineachselectedcluster(EA)• BasedonthehouseholdlisJng,30householdsareselectedfromeachclustersystemaJcally.
Health Providers Sampling • Foreveryclusterof30households:
• TheWDAleaderservingthehouseholdclusterwereselected• Thehealthpostservingthesehouseholdswereselected.• ThetwoHEWsservingtheselectedhealthpostwereselected.• Thehealthcentreservingtheselectedhealthpostwereselected.• WithintheHC,wecollectinformaJononeachmemberofhealthcenterstaffwhoworkonsickchildserviceswhetherornottheyhavebeentrainedinIMNCIandICCM.
• Theworedaservingtheselectedhealthcentrewereselected
Sick Children Sampling Toiden6fysickchildren,foreverycluster:• Interviewerswillconductcommunitymobiliza6on• Interviewerscontacted1to30WDAleaders,• Kebelefocalpersonand• Otherkeyfiguresinthecommunity• Wesampledonaverage4sickchildrenperhealthpost.
Field Staff by Region
Region NumberofTeams Clusters NumberofHHs
Amhara 6 73 2190
Oromia 5 69 2070
SNNP 2 29 870
Tigray 2 29 870
Survey Field Staff • Recruitment
• 45Interviewers• 15Teamleaders• 1Datamanager• 1CentralCoordinator• 4RegionalCoordinators(PhDStudents)
• Training• Twoweekstraining• 3daysfieldpiloJng
• Fieldmaterials• FieldManual• Tablets• GPS• Other
Data Transfer to Central Office
Datatransfermechanisms1. IFSS(EVDO)
2. 3Gmodem
3. USBflashdisksentbyregionalcoordinators
Quality Control • Atthefield
• Welltrainedinterviewersandteamleaders• Teamleadersrepeatinterview• Regionalcoordinatorssupervision• WeeklyProgressreportRegionalcoordinators
• AtCentralOffice• WeeklyQualityControlreport
• Internalinconsistenies• FeedbackloopfromCentralOffice
• Frequencycheck