Presented by
Kioko Kiilu (KRCS)
Jenny Cervinskas (IFRC)
Nairobi, February 1st, 2011

Introduction to Rapid Mobile Phone-based (RAMP) survey

RAMP experience with KRCS volunteers
◦ Site and project identification
◦ Survey methods, training, fieldwork
◦ Lessons learnt

Preliminary results

Plenary

To provide a survey methodology and operations
protocol so that governments and NGOs can:
◦ conduct health surveys at reduced cost
◦ with limited external technical assistance
◦ and achieve high standards of data quality

Dramatically decrease the time from data collection
to having data available for decision making







Technical Reference Manual
Standardized questionnaires for malaria
Questionnaires designed on the internet using
EpiSurveyor
Data collected using cell phones
Training manual and tools adaptable to local settings
Standard survey methods
Rapid analysis and reporting of results
Questionnaire
Design
Weeks to Months (sometimes continuous)
Data Collection
Weeks to Months (sometimes continuous)
Data Entry
Weeks to Months to Years
Data Analysis
Weeks to Months to Years
Data Reporting
ACTION
Weeks to Months to Years (or never)
Mobile technology can drastically reduce the
time between data collection and action.
Questionnaire
Design

EpiSurveyor has:
◦ eliminated the need for data entry and is
now automating many analysis and
reporting functions
◦ shortened the time and reduced the costs
between collection and action
Data Collection
Data Entry
Data Analysis

Data Reporting
ACTION
Anyone can create a username and
password at www.episurveyor.org
and start using these tools for free







Questionnaire design in Episurveyor (internet)
Real-time data entry on cell phones
Daily upload of data from cell phone over 2G cell
network to internet database
Real-time data cleaning
Real-time data analysis
Rapid production of preliminary survey results bulletin
within 24 hours of last interview
Rapid production of preliminary feedback survey report
in 72 hours

Ongoing operational research project in malaria

Hard-to-reach areas/Long data cycle

Mobile network coverage

Project: Home Management of Malaria (HMM) in
Malindi district, Coast province

1st stage: standard probability-proportional-toestimated-size (PPES) selection of PSUs
◦ Sampling frame: 106 villages of the HMM project



2nd stage: segmentation of PSU; choose 1 segment
using PPES
SRS to choose 10 households
Precision:
 +/- 6% for each key indicator from household questions
 +/- 3% using roster/individual data

30 PSUs, 10 households per PSU, 1500 persons, all
ages

Household questionnaire
◦ Usual household characteristics (wealth asset questions,
distance to health facility, etc.)
◦ Summary questions (innovation)
 Duplicated nearly all key indicators that are in the person & net
register
 Eg., no. of persons: all ages & children <5 yo
 No. of any nets, ITNs
 No. of persons/children <5 yo slept under ITN last night


Person roster
Net roster
◦ Number of persons that slept under each net

HMM volunteers (Interviewers)

HMM Coaches /MOH Public Health Officers (PHOs)
(Supervisors)

Training – 4 days (January 19-22, 2011)


Content
◦
◦
◦
◦
◦
◦
◦
Cellphone basics
Questionnaires
Informed consent
Interview techniques
Field procedures
Field logistics/reporting
Supervisor training
Methodology
◦ Presentations, role play, group discussion, demonstrations,
field tests (2)

Survey teams:
◦ 6 teams
 1 Team supervisor and 2-4
interviewers/team)

Survey supervisory team
(KRC, IFRC, WHO, MOH,
DataDyne):
◦ Planning, logistic & financial
responsibilities, field support,
daily “quality” rounds, and
remote monitoring of data
quality

Morning briefing (“quality round”)

Meeting with community leaders, reviewing sketch
maps, segmentation, selection of HHs

Conduct interviews at HH level

Supervisor will send data to server

Debriefing at day’s end with support team in Malindi

Data cleaning and analysis




Data entry: worked well, all teams were able to collect
data using the cellphone and send to server
Survey conducted with reasonable adherence to correct
field procedures
KRC volunteers were able to prepare the sketch maps,
carry out segmentation, and apply SRS to select HHs
Preliminary results were available within 24 hrs. of the
return of the last team from the field
Percentage
100
90
80
70
60
79
78
77
69
68
65
55
50
40
30
20
14
10
0
HH ownership Access, % pop. Use, all persons Use, children Use in children Of <5y fever
Of <5y fever
Of <5y fever
at least one ITN with access to
<5 years
<5y, given at cases, treated cases, treated cases, blood
ITN
least 1 ITN
ACT
ACT within 24 taken (testing)
hr
Key indicators
Target population
Persons per net
ITNs needed
Survey-estimated ITNs in HH
of target pop
ITN/LLIN need/gap
68 753
2.47
27 835
18 931 (68%)
8 904 (32%)
Key indicators
Point
estimate
% ITNs that were slept under last night
87%
% ITNs that were hung last night
86%
ITN use, all ages
55%
ITN use, <5 yo
65%
* 47% of nets had 3 or 4 persons sleeping under them
100
90
80
70
60
50
40
30
20
10
0
<1y
1
2-4
5-9
10-14
Age groups (years)
15-24
25-44
45-59
60+
Age of ITNs
Age in months
Cumulative %
<12 months
28
12-23 months
59
24-36 months
80
* 88% of nets were LLINs
Key results from roster-only data
Number of persons sleeping under a single net
last night
%, nets
1 person
15
2 persons
39
3 persons
32
4 persons
15
Key indicators
%
Treated ACT, <5 yo
77
Treated ACT within 24 hours, <5 yo
69
Received finger/heal stick for blood
14
- Denominator for all indicators was % of children <5y with fever in the previous two weeks

No major problems: all cellphones were operational

No calls to the Datadyne “hotline”

Data entry: worked well

Data was sent to the server by all teams, every day

Daily/immediate upload of data if 2G/GPRS available

Potential difficulties: initial connection of cell phone to
data network


Conducted by secondary-school graduates with
no previous survey experience
Survey was completed within two weeks
◦ 1 week training, 4.5 days field work




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
Cost component
USD
Local operational costs (e.g., personnel costs:
avg. $40 per interviewer & supervisor/day * 20
persons * 10 days, training hall, stationary)
13 429
Phones + accessories
5 416
Transport (drivers, fuel)
3 950
Total
22 795
Approx Kshs 1.7m
Analysis + Report
Free
(WHO)
•
•
•
•
•
•
Kenya Red Cross Volunteers
Kenya Ministry of Public Health and Sanitation
IFRC
Datadyne
WHO
Kenya Bureau of Statistics
A special thanks to the survey team and the many
families who agreed to be interviewed for this survey
Thank-you for your attention