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www.ifrc.orgSaving lives, changing minds.
Rapid Mobile Phone-based survey Tool
Changing the way we collect data in
health surveys Presented by Jenny Cervinskas
and Bong Duke
On behalf of the RAMP team for the Cross River State, Nigeria rollout
July 5, 2011
www.ifrc.orgSaving lives, changing minds.
Outline
① RAMP• Purpose and key features• How it works• How much it costs• Benefits of the tool
• Stakeholder benefits
② RAMP rollout in Cross River State
③What’s next?
www.ifrc.orgSaving lives, changing minds.
Purpose of the Rapid Mobile Phone-based (RAMP) survey
Provide a survey methodology in which Red Cross and Red Crescent National Societies, governments and other partners can: conduct health surveys at reduced cost with limited external technical assistance and achieve high standards of survey design and quality
Dramatically decrease the time that data is available for decision making
To use mobile phones and a web-based, freely accessible software domain as a data collection technique to conduct health surveys
www.ifrc.orgSaving lives, changing minds.
Traditional Paper and Pencil Questionnaire
The time and monetary 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
www.ifrc.orgSaving lives, changing minds.
Key Features of the RAMP
Allows for web based questionnaire design using EpiSurveyor Allows for questionnaire forms to be uploaded to standard mobile
phones Allows for data collection using low cost, familiar and widely
available mobile phones (e.g. Nokia, Samsung) Has an accompanying training manual, technical manual, and tools
adaptable to local settings Data can be exported to Microsoft Excel, as a text file, and in Mdb
format Allows for rapid analysis and reporting of survey results
www.ifrc.orgSaving lives, changing minds.
With the RAMP you can transform a standard mobile phone into an innovative evaluation or research tool
Conduct surveys and capture data
froma standard mobile
phone
Manage surveys, people and data from your web-based server
www.ifrc.orgSaving lives, changing minds.
Web Based Server
Create a free account using Datadyne’s EpiSurveyor 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
www.ifrc.orgSaving lives, changing minds.
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
www.ifrc.orgSaving lives, changing minds.
Stakeholder benefits
Decision Makers• No software licensing or subscriptions • Reduces environmental impact• Scalable solution for teams and studies of varying sizes
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 • No more paper to collect, transport or return• Automated submission of data when network reception is available
www.ifrc.orgSaving lives, changing minds.
RAMP Rollout in Cross River State, Nigeria:Focus on Malaria
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Partners
Roll Back Malaria (RBM)/MOH Nigerian Red Cross National Society IFRC (International Federation of Red Cross Red
Crescent Societies) WHO
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Site identification
Cross River State, Nigeria RAMP malaria survey to provide a post-campaign evaluation
of the NRC door-to-door LLIN distribution and hang-up campaign
10 of 18 LGAs in CRS LLIN distribution took place January-June 2011 Mobile network coverage
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Standard survey methodology used in an RAMP survey
Multi-stage cluster sampling 1st stage: standard probability-proportional-to-
estimated-size (PPES) selection of clusters Sampling frame: population of the 10 LGAs where the door-to-
door distribution took place 30 wards selected, then 30 settlements per ward, then 30 villages
per each selected settlement
2nd stage: selection of households- simple random sampling (SRS) to choose 10 households/cluster
Survey methods: Sampling
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Modeled after the standardized MIS questionnaires Household questionnaire Person roster/Treatment and diagnosis of fever in
under-5S Net roster◦ Types of bednets; source of nets; age of nets; who
slept under each net; number of people that slept under each net
Questionnaire administered in English
Survey questionnaires
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Selection panel established Surveyors recruited from pool of NRC volunteers
and RBM focal persons that served as supervisors or volunteers in the 2011 door-to-door campaign
To serve either as interviewers or team leaders Training: 5 days (June 20-24, 2011)
Recruitment of surveyors
Training
Adapted the RAMP curriculum and guide
Content Cellphone basics Questionnaires Informed consent Interview techniques Field procedures Field logistics/reporting Supervisor training
Methods Presentations, role play, group
discussion, demonstrations, field tests (2)
Red Cross volunteers carried out the interviews
Six teams: Two interviewers per team
Six team leaders
+Survey Supervisory Support Team
Fieldwork
Sketch mapping of clusterCreating and selecting segments for HH interviews
June 27-July 1, 2011
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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
A day’s schedule
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Results: key indicators
Access: % HH ≥1 ITN
Access: % pop. with access to
ITN**
Access: % HH with sufficient
ITNs***
ITN use, all persons
ITN use, chil-dren <5 years
ITN use in chil-dren <5y, given at least 1 ITN in
HH
% of ITNs used last night
Treated with ACT, children
with fever
Treated with ACT within 24
hr, children with fever
Blood taken (testing), chil-
dren with fever
0
10
20
30
40
50
60
70
80
90
100
87
66
5660
71
80
84
60
24
16
Percentage
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Other indicators
Key indicators
Target population 1.699.246
Persons per net 1.94
Estimated LLINs in households in all 10 LGAs
627.887
Estimated LLINs in all 10 LGAs from 2011 campaign
540.068
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Results: High percentage of ITNs were used last night. High ITN use, especially in children
Key indicators Point estimate
% ITNs that were slept under last night 84%
% ITNs that were hung last night 86%
ITN use, all ages 60%
ITN use, <5 yo 71%
* 99% of nets were ITNs & 99% of ITNs were LLINs
www.ifrc.orgSaving lives, changing minds.
ITN use by age group by gender
<1y 1
2-4
5-9
10-1
4
15-2
4
24-4
4
45-5
9
60+0
10
20
30
40
50
60
70
80
90
100
Male Female Both genders
Age groups (years)
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Age in months %
<12 months 85
12-23 months 1
24-36 months 5
36+ months 9
Age of ITNs
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Number of persons sleeping under ITN last night %, nets
1 person 33
2 persons 45
3 persons 18
4 persons 3
Number of persons under an ITN last night
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Treatment & diagnosis, <5 yo
Key indicators %
Treated ACT 60
Treated ACT within 24 hours 24
Received finger/heal stick for blood 16
- Denominator for all indicators was % of children <5y with fever in the previous two weeks
www.ifrc.orgSaving lives, changing minds.
So, does the RAMP “work”?
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
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Cost component USD
Training 9,053 (26%)
Survey operations: per diem, accommodation, technical assistance
13,604 (38%)
Transportation 9,698 (27%)
Cellphones and equipment 2,357 (7%)
Other 728 (2%)
Total 35,440
Local survey costs: CRS, Nigeria
www.ifrc.orgSaving lives, changing minds.
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
www.ifrc.orgSaving lives, changing minds.
What’s next? For IFRC…
Extract lessons learned from Nigeria and share for application in other surveys
Finalize and disseminate the IFRC RAMP technical manual and the training manual
Continue developing strategies for technical support in order to gradually reduce external support
Test the RAMP 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