Rapid Mobile Phone-based
(RAMP) survey
Changing the way we collect data in Health
Surveys
Presented by Jenny Cervinskas
and Michael Charles
On behalf of the RAMP team for the Namibia
rollout
May 19th, 2011
IFRC, Johannesburg
www.ifrc.org
Saving lives, changing minds.
Outline
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Purpose of the RAMP
Key features of the RAMP
Traditional vs. mobile phone based surveys
RAMP
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How it works
How much it costs
Benefits of the tool
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Stakeholder benefits
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RAMP rollout in Namibia
Future steps
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Saving lives, changing minds.
Purpose of the Rapid Mobile Phone-based
(RAMP) survey

To 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
technical assistance, and achieve high standards of survey
design and quality
 To 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.org
Saving lives, changing minds.
Key Features of the RAMP
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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
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Saving 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
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Saving 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
from
a standard mobile
phone
Manage surveys, people and data
from your web-based server
www.ifrc.org
Saving lives, changing minds.
How does it work?
www.ifrc.org
Saving 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
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Design your questionnaire with
embedded logic and in multiple languages
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Monitor, manage and communicate with
your team
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Export data and analyze results in realtime.
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http://www.episurveyor.org/user/index
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Saving lives, changing minds.
Why use mobile phones to collect data?
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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
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Saving lives, changing minds.
Stakeholder benefits
Decision Makers
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No software licensing or subscriptions
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Optimizes resource usage and reduces environmental impact
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Maintain data security and respondent confidentiality
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Scalable solution for teams and studies of varying sizes
Researchers/Evaluators
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Incorporate a multitude of question types with custom logic and validation
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Manage and upload surveys in multiple languages
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Monitor staff work rate, productivity and quality
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Generate reports on responses as they arrive
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Export data for custom analysis with your favourite statistically analysis package
Fieldworkers
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Conduct surveys anywhere, even in areas with no network coverage
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Use standard and familiar mobile
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Minimal training requirements
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No more paper to collect, transport or return
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Automated submission of data when network reception is available
www.ifrc.org
Saving lives, changing minds.
RAMP Rollout in Namibia: Focus on Malaria
www.ifrc.org
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Partners

Namibia Red Cross Society
 IFRC
 MOHSS
 Namibia Bureau of Statistics
 Datadyne
www.ifrc.org
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RAMP survey site: Caprivi region, Namibia
Malaria is a major public health problem in Caprivi
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Site and project identification

Caprivi region (north eastern Namibia)
 Recently launched NRC project on Communities Fighting
Malaria

RAMP carried out in four of the five constituencies in the project

RAMP malaria indicators survey provides a baseline for some
of the project’s key indicators
 Mobile network coverage (MTC provider)
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Saving lives, changing minds.
Survey methods

Standard survey methodology used in an RAMP
survey
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1st stage: standard probability-proportional-toestimated-size (PPES) selection of clusters
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Sampling frame: PSUs from the 2001 national population census,
and 10 camps of people resettled due to flooding of the Zambezi
river
2nd stage: selection of households- simple random
sampling (SRS) to choose 10 households/cluster
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300 Households
30 clusters, 10 households/cluster, total of 300
households in the survey sample
Survey questionnaires

Modeled after the standardized MIS questionnaires
 Household questionnaire
 Person roster/Treatment and diagnosis of fever in U5S
 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 Silosi
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Recruitment of surveyors

NRC volunteers that serve as supervisors in the
CFM project (interviewers)
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NRC volunteers that serve as supervisors in another
project (field supervisors)
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Training – 5 days (May 2-6, 2011) in Katima Mulilo
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Saving lives, changing minds.
Training
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Content
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Cellphone basics
Questionnaires
Informed consent
Interview techniques
Field procedures
Field logistics/reporting
Supervisor training
Methods
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Presentations, role play, group
discussion, demonstrations, field
tests (2), energizers
Adapted the RAMP curriculum and guide
Red Cross volunteers carried out the interviews
Six teams- two interviewers per team
Three field supervisors
+Survey Supervisory Support Team
Fieldwork
Locating the households
Household interview
May 2-6, 2011
Real-time data editing and cleaning
Data is monitored remotely
Daily data editing and
cleaning
Survey Team Debriefing:
1 day after last interviews
Presentation and discussion of preliminary results
Award of certificates
“I feel happy knowing how to
collect data with the cellphone”
Organizers happy the survey was
completed successfully
Lessons learned

Take time to prepare cellphones prior to the survey
 Establish strong working partnership
 Criterion for selection of survey teams needs to be clear,
and adhered to for recruitment
 Data entry: worked well, all teams were able to collect
data using the cellphone and send to server
 Red Cross volunteers with secondary school education
can collect data in the field
 Survey conducted with reasonable adherence to correct
field procedures; need to further refine some methods
and tools
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Saving lives, changing minds.
Preliminary Results
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Survey results bulletin & report
Survey Report
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Results: key indicators, HH questionnaire
Percentage
100
90
80
80
71
70
60
65
61
59
52
50
42
40
38
40
31
30
20
10
0
HH ownership ITN access, %
at least one ITN
pop. with
access to ITN
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Saving lives, changing minds.
ITN use, all
persons
ITN use,
children <5
years
ITN use in
HH ITN
children <5y, ownership or
given at least 1
IRS
ITN
IRS
Treated with
ACT, children
with fever
Treated with
ACT within 24
hr, children
with fever
Blood taken
(testing),
children with
fever
Access: Just 52% of ITNs needed to reach
universal coverage are present. Gap is 48%.
Key indicators
Target population
Persons per net
ITNs needed
47,932
2.13
22.503
Survey-estimated ITNs in HH of
target pop
11.676 (52%)
ITN/LLIN need/gap
10.828 (48%)
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Results: High percentage of ITNs are being
used. Use gap is due to insufficient ownership
of ITNs
Key indicators
Point
estimate
% ITNs that were slept under last night
86%
% ITNs that were hung last night
82%
ITN use, all ages
38%
ITN use, <5 yo
42%
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ITN use by age group
100
90
80
70
60
50
40
30
20
10
0
<1y
1
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2-4
5-9
10-14
Age groups (years)
15-24
24-44
45-59
60+
Age of ITNs
Age in months
%
<12 months
50
12-23 months
11
24-36 months
3
36+ months
36
* 87% of nets were LLINs
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Number of persons under a ITN last night
Number of persons sleeping under ITN last night
%, nets
1 person
30
2 persons
42
3 persons
18
4 persons
10
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Saving lives, changing minds.
Treatment & diagnosis, <5 yo
Key indicators
%
Treated ACT, <5 yo
71
Treated ACT within 24 hours, <5 yo
61
Received finger/heal stick for blood
31
- Denominator for all indicators was % of children <5y with fever in the previous two weeks
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Saving lives, changing minds.
How much does the RAMP cost?
Cost component
USD
Training
11,498 (32%)
Survey operations: personnel
10,515 (29%)
Survey operations: transportation 10,993 (30%)
Cell phones
2,788 (8%)
Other
749 (2%)
Total
36,449
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Saving lives, changing minds.
So, does the RAMP “work”?

Conducted by secondary-school graduates with
no previous survey experience
 Survey was completed within two weeks
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5 days training, 5 days field work
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Daily data 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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Saving 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 research 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.org
Saving lives, changing minds.
What’s next?
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Extract lessons learned from Namibia and apply in next survey
Implement RAMP in one other country (Cross River State,
Nigeria in June 2011)
Finalize and disseminate the RAMP technical manual and the
training manual
Continue developing training manuals and 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
www.ifrc.org
Saving lives, changing minds.
Mobile Phone Application
 Install this tiny Java application onto a
standard mobile phone
 Login to EpiSurveyor using your user
name & password and download form
 Capture data in the field, even without
network coverage
 Enter data using the interface of the
mobile phone.
 Transforms complex logic into an
effortless step-by-step process.
 Automated submission of data when
2G reception is available.
www.ifrc.org
Saving lives, changing minds.
Thank you
Any questions?
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Saving lives, changing minds.
Extra Photos & Information
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Saving lives, changing minds.
49% of households are headed by
women
A day’s schedule
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Morning briefing (“quality round”)

Locating the chosen cluster and selecting the
households to be interviewed
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Conduct interviews at HH level
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Supervisor sends data to server
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Data cleaning and analysis
www.ifrc.org
Saving lives, changing minds.