RAPID SMART METHODOLOGY GNC Meeting, September 16-18 th, 2014.
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Transcript of RAPID SMART METHODOLOGY GNC Meeting, September 16-18 th, 2014.
RAPID SMART
METHODOLOGY
GNC Meeting, September 16-18th, 2014
What is Rapid SMART?
To RAPIDLY measure the nutritional status:
Emergency programming
Limited time/access for data collection
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A standardised and simplified field survey methodology which produces a snapshot of the current situation on the ground.
Rapid SMART Feasibility
Geographic area is clearly delimited (village, camps, settlements, urban slums, etc.) AND;
The target population is at maximum homogenous (shares the same living conditions, agro-ecological zone, etc.)
Results are valid only after its representativeness, accuracy and precision are evaluated
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Indicators: Advised to only measure anthropometry
(mortality for the case of South Sudan). Sample size:
Fixed sample sizes are used depending on the scope of the survey.
Time for data collection: Should not take more than 1 week.
Data quality checks: Still uses ENA for SMART for the Plausibility
Check.
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Key differences
ONE settlement to assess (1 camp, 1 block of houses in city, 1 village etc.) and:
Population is less than 200 households Exhaustive assessment of all eligible children.
Population is above 200 households Select a random sample of children using simple or
systematic random sampling A sample size of 150 children would be enough to gather
relatively meaningful prevalence. Assume DEFF=1; Convert # children to # households
Sample size: One Settlement
Sample size: One Settlement
Expected GAM Sample size Precision
20% 150 children +/- 6.4%15% 150 children +/- 5.7%10% 150 children +/- 4.8%5% 150 children +/- 3.5%
Cluster sampling must be used. At least 25 Clusters must be selected using PPS.
A sample size of 200 households (25 Clusters x 8 households) would be enough to gather relatively meaningful prevalence.
Assume DEFF=1.5; Convert # children to # households
Sample size: > 1 Settlement
Expected GAM Sample size Precision
20% 200 children +/- 7.1%15% 200 children +/- 6.3%10% 200 children +/- 5.3%5% 200 children +/- 3.9%
4-5 Teams comprising of 2 surveyors with 3 days for training if a standardization test is needed.
Inclusion of children based on age: Age of children between 6-59 months determined by
official documents or events calendar. Variables: Age, Sex, MUAC, Edema, weight
and height
1 week maximum to complete a Rapid SMART Even shorter if 2 Clusters per day can be done. Same recommendations for Reserve Clusters.
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Data Collection
Pilot Tests – only with MUAC9
Country Inclusion Criteria
Clusters
Planned
Second Stage
Sampling
Additional Variables
1 Afghanistan Age (6-59 months) 25
Simple or Systematic None
2 Afghanistan Height (65 to 110) 25
Simple or Systematic None
3 India Height 25 Systematic None4 India Height
(60 to 110) 25 Systematic None5 India Height
(60 to 110) 25 Systematic None6 Madagascar
Height(60 to 110) 25
Modified EPI
Measles Vaccination, Vitamin A, Sickness
7 MyanmarHeight 25
Modified EPI None
8 MyanmarHeight 23
Modified EPI None
Rapid SMART SMART
Design • 201 children • 97
households• 25 clusters x
8 households
• 575 children • 570 households
• Desired precision (±3%), design effect (1.7), prevalence (7.9%)
• 30 clusters x 18 households
Achieved
• 329 children surveyed
• Visited 396 households • 473 children surveyed
Both estimated average household size: (9.7), children U5 ( 15.6) Non Response (8%)
A SMART survey and a Rapid SMART were conducted concurrently in Kabul, Afghanistan in November 2012
Independent selection of the sample.
SMART vs. Rapid SMART
Similar Sampling Procedures
Rapid SMART SMART
• SMART two-stage cluster sampling method
• Selected 25 clusters using PPS method
• Simple random sampling where household listing could be done quickly i.e. ≤50 households
• Systematic sampling for clusters where listing was not feasible
• SMART two-stage cluster sampling method
• Selected 30 using PPS method• 3 clusters inaccessible;
used reserve clusters (3 of 4 accessible)
• Simple random sampling where household listing could be done quickly i.e. ≤50 households
• Systematic sampling for clusters where listing was not feasible
Variables Included
Rapid SMART SMART
• Age• Sex• MUAC • Bilateral oedema
• Age• Sex• MUAC • Bilateral oedema• Weight• Height• Vitamin A• Measles vaccination• Mortality (census)
Time / Logistics Required
Rapid SMART SMART
• Training:• 1-day training
session (Nov. 26)• Data collection:
• 2-day data collection • (Nov. 27-28)
• Staffing• 5 teams x 2 people
each
• Training: • 5-day training
• Data collection: • 5-day data collection • (Nov. 18-22)
• Staffing• 6 teams x 4 people
each
Rapid SMART completed in 3 days
Representativeness
Rapid SMART
SMART
Sample Sex Ratio 0.91 1.0
Age Ratio:6-29 months to 30-59 months
0.63 0.94 Sex ratio for sampling was very similar for
SMART and Rapid SMART
Age ratio for Rapid SMART was imbalanced Underrepresentation of age group of 6 to 29
months.
Survey Results
GAM
Rapid SMART SMART MUAC (6-59 months) 4.6% (2.5-8.5) 5.4% (3.8-8.5)
MUAC (65-110 cm) 4.3% (2.5-7.2) 4.3% (2.6-7.3)
SAMMUAC (6-59 months) 0.4% (0.1-2.8) 0.7% (0.1-3.2)
MUAC (65-110 cm) 0.3% (0.0-2.3) 0.5% (0.1-2.1)
• The GAM and SAM prevalence estimates from the Rapid SMART are similar to the findings of the SMART survey
• Non-significant differences in confidence intervals
Case of South Sudan
Based on the IPC workshop outcome and analysis in May 2014 recommendation
Urgently work with relevant agencies and clusters to ensure that nutrition, mortality and morbidity data needed for the IPC are being consistently collected.
Standardized validation process with ACF and CDC.
Why Rapid SMART? Sustained conflict in the target Counties Constrained Humanitarian access (flooding,
security, Limited time, Logistics challenges…)
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Based on the IPC, certain counties were prioritized.
3 rounds of surveys in Leer, Mayendit and Fashoda during July, Sept and Nov 2014.
Anthropometry: 250 households (25 Clusters x 10 households). Mortality: 420 households (30 Clusters x 14 households).
Survey Design: With Mortality
Round 1 Rapid SMART Results
County Date Settlement
Clusters Planned
2nd stage sampling
Modules Covered
Leer June 24-29 Rural 25 Systematic
Anthropometry
Mayendit July 15-27 Rural 25 Systematic
Anthropometry
Fashoda Aug 9-19 Rural 25 Systematic
Anthropometry & Mortality
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County Children (Measured)
Plausibility Score
GAM Results
Leer 425 13% 34.1%(28.0-40.6,95 % CI)
Mayendit 410 9% 16.9%(13.4-21.0,95 % CI)
Round 2 Rapid SMART
Expected / tentative SET planning: Leer round 2 from 5th to 12th of Sept Mayendit round 2 from 17th to 23rd of Sept Fashoda round 2 form 8th to 16th of Oct
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ACF-CA: SMART Project ConvenorThe SMART Project at ACF-CA, a core member of the GNC, in collaboration with the SMART Technical Advisory Group and Centers for Disease Control and Prevention (CDC Atlanta) establishes and maintains:
New training curriculums of field tools for survey managers and surveyors
Newly re-vamped SMART www.smartmethodology.org website.
Partnerships with other agencies in trainings & survey support.