Management Survey Tool Changing the way we collect data in health surveys

1. Management Survey ToolChanging the way we collect data in health surveys Presented by Jenny Cervinskas and Bong Duke On behalf of the MST team for the Cross River State, Nigeria rollout July 6, 2011

2. Partners • Roll Back Malaria (RBM)/MOH • Nigerian Red Cross National Society • IFRC (International Federation of Red Cross Red Crescent Societies) • WHO

3. Outline ① MST • Purpose and key features • How it works • How much it costs • Benefits of the tool • MST rollout in Cross River State ③ What’s next?

4. Purpose of the Management Survey Tool (MST) • Provide a survey methodology in which Red Cross societies, government and other partners can: • conduct health surveys at reduced cost • with limited external technical assistance • achieve high standards of survey design and quality • MST aims to simplify and improve the timeliness of the entire data collection cycle • To use mobile phones and a web-based, freely accessible software domain as a data collection technique to conduct health surveys

5. Rapid spread & technology of cellphones opens up new possibilities What can you do with a phone? The same things you can do with any other computer. Talk Count Photograph Teach Reward Analyse Monitor Assist

6. Traditional Paper and Pencil Questionnaire The time and costs of data collection can be substantially reduced if mobile phone data collection is used in place of the traditional paper and pencil method that has been the best practice in health surveys for decades

7. Key Features of the MST • Has an accompanying training manual, technical manual, and tools adaptable to local settings • Allows for: • web based questionnaire design using EpiSurveyor • questionnaire forms to be uploaded to standard mobile phones • data collection using low cost, familiar and widely available mobile phones (e.g. Nokia, Samsung) • Data can be exported to Microsoft Excel, as a text file, and in Mdb format • Enables rapid analysis and reporting of survey results

8. With the MST you can transform a standard mobile phone into an innovative evaluation or research tool Conduct surveys and capture data from a standard mobile phone Manage surveys, people and data from your web-based server

9. How does it work?

10. Data is entered and saved in cellphone, sent to the server…

11. There is 2G/GPRS coverage in almost all villages in CRS

12. Survey Bulletin within 24 hours Survey Report within 72 hours

13. Web Based Server • Create a free account using Datadyne’sEpiSurveyor software • Access your web based server from a web browser anywhere in the world • Design your questionnaire with embedded logic and in multiple languages • Monitor, manage and communicate with your team • Export data and analyze results in real-time. • http://www.episurveyor.org/user/index

14. Why use mobile phones to collect data? • Real-time data entry on cell phones • Daily upload of data from cell phone over 2G cell network to internet database • Real-time data monitoring and data quality checks • Real-time data cleaning • Real-time data analysis • Rapid production of survey results within hours or days of last interview

15. Stakeholder benefits Decision Makers • No software licensing or subscriptions • Reduces environmental impact • Scalable solution for teams and studies of varying sizes • Get data and information rapidly for decision-making and planning Evaluators/Researchers • Incorporate a multitude of question types with custom logic and validation • Manage and upload surveys in multiple languages • Monitor staff work rate, productivity and quality • Export data for custom analysis with your favourite statistical analysis package Fieldworkers • Conduct surveys anywhere, even in areas with no network coverage • Use standard and familiar mobile phone • No more paper to collect, transport or return • Automated submission of data when network reception is available

16. MST Rollout in Cross River State, Nigeria:Focus on Malaria

17. Site identification • Cross River State, Nigeria • 10 of 18 LGAs in CRS • LLIN distribution took place January-June 2011 • MST malaria survey to provide a post-campaign evaluation of the NRC door-to-door LLIN distribution and hang-up campaign • Mobile network coverage

18. MST survey focus: Malaria Data collected on key indicators

19. A rainy season survey

20. Survey methods: Sampling • Standard survey methodology used in an MST survey • Multi-stage cluster sampling • 1st stage: standard probability-proportional-to-estimated-size (PPES) selection of clusters • 2nd stage: selection of households- simple random sampling (SRS) to choose 10 households/cluster

21. 300 households 30 clusters, 10 households per cluster

22. Survey questionnaires • Modeled after the standardized MIS questionnaires • Household questionnaire • Person roster/Treatment and diagnosis of fever in under-5S • Net roster • Questionnaire administered in English

23. Red Cross volunteers carried out the interviews Six teams: Two interviewers per team Six team leaders +Survey Supervisory Support Team

24. Training(June 20-24) • Content • Cellphone basics • Questionnaires • Informed consent • Interview techniques • Field procedures • Field logistics/reporting • Supervisor training • Methods Adapted the MST curriculum and guide

25. Fieldwork (June 27-July1)

26. A day’s schedule • Locating the chosen cluster, preparing the sketch map, segmentation and selecting the households to be interviewed • Conduct household interviews • Team leader/interviewers send data to server • Evening briefing (“quality round”) • Data cleaning, editing and analysis

27. Real-time data editing and cleaning Daily data monitoring, editing and cleaning

28. Preliminary Results

29. Results: key indicators

30. Other indicators

31. Results: High percentage of ITNs were used last night. High ITN use, especially in children * 99% of nets were ITNs & 99% of ITNs were LLINs

32. ITN use by age group by gender

33. Age of ITNs

34. Number of persons under an ITN last night

35. Treatment & diagnosis, <5 yo - Denominator for all indicators was % of children <5y with fever in the previous two weeks

36. So, does the MST “work”? • Field methods followed • Daily data monitoring and cleaning accomplished • Preliminary survey results bulletin finished within 24 hours • Preliminary report finished within 72 hours • Provided excellent management information on the key indicators

37. Local survey costs: CRS, Nigeria

38. Cellphone-based Surveys: Summary Points REAL-TIME DATA AVAILABILITY AND ANALYSIS • Via your web-based server, responses may be viewed, monitored and exported instantly IMPROVED DATA INTEGRITY • The removal of paper from the research process reduces the number of points at which error can be introduced FIELDWORKER MONITORING/MANAGEMENT • Monitor the productivity and quality of work conducted by field staff (GPS, time and date stamp) ENHANCED MOBILITY • Do not need network coverage to conduct surveys, responses are stored securely on the mobile phone, thus can reach even the most remote communities OPTIMISED RESOURCE USAGE • Save on survey printing, distribution and collection costs

39. What’s next? For IFRC… • Extract lessons learned from Kenya, Namibia and Nigeria and share for application in other surveys • Finalize and disseminate the IFRC MST technical manual and the training manual • Continue developing strategies for technical support in order to gradually reduce external support • Test the MST in other sectors and disciplines if appropriate • Continue searching for innovative ways to collect data in a timely fashion in order to better serve the communities we work in

40. Thank-you for your attention

41. What’s next?