Multiple Indicator Cluster Surveys Survey Design Workshop

1. Multiple Indicator Cluster SurveysSurvey Design Workshop Household Questionnaire: Insecticide Treated Nets and Indoor Residual Spraying MICS4 Survey Design Workshop

2. Global goals and targets • MDG 6: Combat HIV/AIDS, malaria and other diseases • Target 6.C By 2015 have halted and begun to reverse the incidence of malaria and other major diseases • Indicator 6.6 Incidence and death rates associated with malaria • Indicator 6.7 % of children under five sleeping under ITNs (MICS) • Indicator 6.8 % of children under five treated with anti-malarials(MICS) • RBM Global Malaria Action Plan (2008) • Achieve universal coverage…with interventions for prevention and case management by 2010 (MICS) • Halve the malaria burden between 2000 and 2010 • Eliminate malaria in 8-10 countries by 2015…and in the long-term eradicate malaria worldwide… MICS4 Survey Design Workshop

3. Background • WHO estimates 190-330 million malaria episodes in 2006, resulting in nearly 1 million deaths • About 90 per cent of all malaria deaths occur in sub-Saharan Africa, most among children under five • Significant funding toward malaria control, and significant progress in scaling up ITNs in recent years • Major focus by RBM partners on achieving universal coverage targets by end-2010 MICS4 Survey Design Workshop

4. Mosquito net background • Net roster added to MICS4 questionnaire to measure availability and usage of mosquito nets • Streamlines questions related to mosquito nets throughout MICS questionnaire; improves accuracy of responses • Allows for calculation of “universal coverage” indicators and ITN use by pregnant women MICS4 Survey Design Workshop

5. MICS Indicators #3.12 - Household availability of ITN % households with at least one insecticide-treated net #3.15 - Children sleeping under ITNs % under fives sleeping under an ITN the previous night #3.14 - Children sleeping under any net % under fives sleeping under any net the previous night MICS4 Survey Design Workshop

6. MICS Indicators #3.19 - Pregnant women sleeping under ITNs % pregnant women sleeping under an ITN the previous night MICS4 Survey Design Workshop

7. ITN module • Total number of nets • For each net: • - Observe net • - ITN status • - Usage of nets MICS4 Survey Design Workshop

8. Methodological issues – Nets • May be difficult to observe nets • Important to strictly follow questionnaire flow when nets are being observed • Does not measure net quality (e.g. holes or rips in net) • If more than 3 nets in a household, use a new questionnaire to record information about additional nets MICS4 Survey Design Workshop

9. Indoor residual spraying • Separate module; only include if programs exist • IRS questions added to calculate indicator: households protected by a vector control method # 3.13 - Households protected by a vector control method % households with at least one ITN and/or received spraying through an IRS campaign in past 12 months MICS4 Survey Design Workshop

10. Methodological issues – IRS • IRS spraying often limited to small target areas in countries – not recommended to report national-level IRS coverage alone (report indicator: HH protected by a vector control method) • Correspondence of IRS target areas with survey sampling areas • Important to capture only IRS organized as part of campaign, and to exclude spraying conducted by a household member • Confusion over the wording of “interior walls” in IRS question. Does spraying outside the house count? MICS4 Survey Design Workshop

11. Methodological issues General considerations: • MICS often carried out in the dry season for logistical reasons; not during times of peak malaria transmission • Even if only sub-national populations are at risk for malaria transmission, these modules can be included • Become familiar with main types of nets locally available • Become familiar with ongoing local IRS programs MICS4 Survey Design Workshop