RAMP
Rapid Mobile Phone-based (RAMP)
survey
Changing the way we plan and manage health
and development surveys
Version September 10th 2012
www.ifrc.org
Saving lives, changing minds.
RAMP
Presentation overview
Introducing RAMP: an overview
2) How does RAMP work?
3) Stakeholder benefits
4) RAMP survey sampling approach
5) How much does a RAMP survey cost?
6) Costs of the RAMP pilot surveys
7) RAMP malaria survey
8) Reporting and dissemination of results
9) RAMP survey toolkit
1)
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RAMP
Introducing RAMP: an overview
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Purpose of RAMP

To provide a survey methodology with which
Red Cross Red Crescent National Societies,
governments, NGOs and other partners can
conduct health and development surveys:
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at reduced cost
with limited technical assistance
to achieve high standards of survey design and quality
To decrease dramatically the time and effort
needed to complete data collection and have
results available for decision-making
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RAMP
Background


IFRC and partners (WHO, CDC) developed
and refined the RAMP methodology and tools
over several years
Based on:
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improvements to the EPI survey method (WHO EPI)
improvements based on scientific article published by
Donna Brogan, Emory professor of biostatistics, Emory
U, Atlanta, USA, specialist in survey methods and
analysis, and Emory and CDC colleagues in 1994
public-domain mobile phone software
Pilot tested in four surveys in Africa 2011-2012
(Kenya, Namibia and Nigeria)
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Improvement over old EPI method
RAMP
Survey activity
Old EPI method
Improved
RAMP method
Choosing start point (first
household) in the cluster
Biased: “Spin the bottle method” Simple random
random direction
sampling
Choosing subsequent
households (2nd, 3rd, etc.)
Often biased in practice: next
nearest door
Fixed number of households
visited per cluster
Biased: quota sampling without
weight adjustment
Simple random
sampling
Yes
Attempt to re-interview missing
households
No
Yes
Adjusts for non-response,
household and individual
No
Yes
Adjusts for inaccurate population
estimate of clusters
No
Yes (as option)
Analysis based on weight
adjustments
No
Yes
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Key features of RAMP
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Simplicity of sampling design to facilitate survey
implementation and reduce field costs
Use of standard survey sampling methods
Use of mobile phones and internet for data collection
that enables:
 web-based questionnaire design
 downloading of questionnaires onto standard mobile
phones
 data collection using low-cost mobile phones
Real-time, web-based dataset that can be easily
accessed and exported for rapid analysis and reporting
Availability of many tools to guide survey planning and
implementation
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RAMP
Changing the way we work
The “old”

Paper questionnaires filled out in
the field
 Data entered into a computer at a
central location
 Data analysis and reporting often
takes months to complete
 Local capacity is often underutilized and there is a dependence
on external experts
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The “new”

Mobile and internet-based
technologies are used to reduce
the time taken from data collection
to reporting
 RAMP changes the way that data
are collected and enables rapid
reporting of results
 RAMP empowers local ownership
of evaluation and research
RAMP
When might a RAMP survey be suitable?
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Surveys where rapid results are key
Surveys where cost is a significant issue
Sub-district surveys involving multiple villages that are
typically carried out by non-governmental organizations
(NGOs)
National, provincial or district-level surveys carried out
by Ministry of Health (MoH) or government departments
(immunization, maternal and child health, malaria,
HIV/AIDS, nutrition, water and sanitation, etc.) to collect
intervention coverage data quickly and at low cost
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RAMP
When might a RAMP survey be suitable?
(cont’d)
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District-level surveys conducted by the district health
management team
Baseline and endline surveys for donor-funded
projects/programmes
Repeated surveys to track time trends for key indicators
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RAMP
When might a RAMP survey be suitable?
Flexibility
Items that can be adjusted
Comments
Adjust precision
±10%, 5%, 3%, etc.
Adjust indicator type (denominator of
indicator) including mixtures of indicator
types
-
Adjust number of domains
- 1 domain with 30 clusters
- 2 domains with 30 clusters to
compare statistically
- 10 domains with 30 clusters each to
compare
Adjust overall sample size
-
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Person all ages
Children <5 years old
Pregnant women
Households
Schools
200 to 5000 households
RAMP
When might a RAMP survey not be suitable:
limitations?

Very long questionnaires with a large quantity
of skip patterns

Paper method or commercial mobile phone software
might work better
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RAMP
How does RAMP work?
(Short version)
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RAMP
With RAMP you can transform a standard
mobile phone into a cutting-edge evaluation
and research tool
Conduct surveys
and capture data
from
a standard mobile
phone
Manage surveys, people and data
from your web-based server
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RAMP
How does it work?
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RAMP
Web-based server
Create a free account using
Datadyne’s Episurveyor software
 Access EpiSurveyor’s webbased 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 analyse results
in real-time
www.episurveyor.org/user/index

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RAMP
Why use mobile phones to collect data?
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Real-time data entry on mobile phones
Daily upload of data from mobile phone over 2G mobile
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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RAMP
Mobile phone application
Transforms complex logic into an effortless step-by-step
process
• Install Java application onto a
standard mobile phone
• Log in to EpiSurveyor using
user name and password, and
download form
• Capture data in the field, even
without network coverage
• Enter data using the interface
of the mobile phone
• Automated submission of data
when 2G reception is available
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RAMP
How does RAMP work?
(Longer version)
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RAMP
RAMP takes advantage of two
technologies
Low-cost, standard mobile
phones
Web-based, easily
accessible software
application
(EpiSurveyor) that
enables mobile
phones to become a
data collection
platform
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RAMP
How does it work?
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RAMP
Web-based server
•
Get started and set
up your team to work
with the EpiSurveyor
software
• Create a free
account using
EpiSurveyor
• Assign privileges
• Access the webbased server from
anywhere in the
world
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RAMP
 Design your questionnaire
•
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•
•
•
Collaborate with others to design the web-based
questionnaire
Easy to master
Supports multiple languages
Embedded logic and skip patterns
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RAMP
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RAMP
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RAMP
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RAMP
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•
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 Store questionnaire on phone
Survey questionnaire
is downloaded onto
the mobile phone
Install Java application
onto a standard mobile
phone
Log in to EpiSurveyor
using a user name and
password and
download the forms
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RAMP
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 Collect data in the field
Fieldworker retrieves the questionnaires on the mobile phone
Enters data directly into the mobile phone during interviews
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RAMP
 Data sent to web-based server
…
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Fieldworker submits data when 2G reception is available
Data are available immediately for processing and
analysis
Can transfer data from phone to computer if 2G cell
network is not available
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RAMP
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 Data monitoring and analysis
Real-time data monitoring
Real-time data cleaning
Real-time analysis
Allows for preliminary
analysis even before the
data collection is complete
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RAMP
 Produce survey results, rapidly
RAMP deceases the
time between data
collection and the
production of the
survey results
The results can be
available within days
of the last interviews
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RAMP
So, why use mobile phones to collect
data?
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Real-time data entry on mobile phones
Daily upload of data from mobile phone over
2G cell network to internet database
(eliminates paper-to- electronic database
transfer)
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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RAMP
Stakeholder benefits
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RAMP
Stakeholders

<Insert a photo collage illustrating the various
stakeholders (decision-makers; programme
managers; evaluators/researchers; fieldworkers)>
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RAMP
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•
•
•
•
•
Stakeholder benefits: decision-makers
Scalable solution for studies of
varying sizes
Optimizes resource usage and
reduces environmental impact
No software licensing or
subscriptions
No consultants needed
Maintain control of data; data
not analysed by third party
Data rapidly available for
dissemination and decisionmaking
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RAMP
•
•
Stakeholder benefits: programme
managers
Do not have to reinvent the wheel. The RAMP
toolkit offers a variety of knowledge and tools to
use and adapt for needs and context of programme
managers
Enables monitoring of survey team work rate,
productivity and quality
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RAMP
Stakeholder benefits: evaluators and
researchers
•
Incorporate a multitude of
question types with custom
logic and validation
• Manage and upload
surveys in multiple
languages
• Export data for custom
analysis using any
statistical analysis package
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RAMP
•
•
•
•
Stakeholder benefits: fieldworkers
Builds local capacity for
monitoring and evaluation
Use standard and familiar
mobile phones
No more paper to collect,
transport or return
Automated submission of
data when network
reception is available
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RAMP
RAMP survey sampling approach
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RAMP
RAMP survey sampling approach
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Simplicity of sampling design to facilitate
survey implementation and reduce field costs
Uses standard survey sampling methodologies
Uses segmentation to break clusters into small
pieces
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makes fieldwork more manageable
lowers the cost of field surveys
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Households are selected by simple random
sampling at the last stage
 Described in detail in the RAMP toolkit
(Volumes 1 and 2)
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RAMP
RAMP: a two-stage cluster survey

First stage: selection of clusters using
probability proportionate to estimated
size (PPES)
 Second stage: selection of households
 segmentation
of clusters into smaller segments using
PPES (if there are too many households for simple
random sampling [SRS])
 SRS of a fixed number of households in a selected
segment
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RAMP
How is the RAMP method different
from MIS/DHS?
MIS/DHS
RAMP
Complex design, uses external consultants
to design survey
Simple design, external consultants not
needed
Listing of all households is done in all
clusters; expensive, often taking several
days in each cluster
Divides clusters into manageable-sized
segments using standard survey methods;
takes <1/2 day
Simple random sampling of households
(from the cluster list)
Simple random sampling of households
(from the final segment list)
Real-time data cleaning not possible
Real-time data cleaning during the survey
Real-time data analysis not possible; results
take several months
Real-time data analysis and results/draft
report finished within 3 days of last
interview
Data analysis done by third-party
consultants
Organization performs analysis, building
capacity and maintaining control of data
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RAMP
Accuracy of the estimates
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Sampling bias
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Very, very small theoretical bias

related to potential errors in the estimated sizes of clusters (there
is an option showing how to eliminate this potential bias)
 related to potential errors in the estimated sizes of segments (bias
likely to be nearly non-existent)

Potential non-sampling bias generally more
important than sampling issues

Examples including non-response, information bias
including social desirability, faulty questionnaires,
interviewer recording errors, data processing errors
and others
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RAMP
The RAMP survey team
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RAMP
RAMP survey team
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Programme manager
Survey coordinator
Local data manager/data analyst
Field survey team
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field supervisor, interviewers, drivers, local guide
Supervisory support and monitoring team
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RAMP
How much does a RAMP survey cost?
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RAMP
Cost of a RAMP survey (average)
Description
Training (4 or 5 days) including two facilitators
Cost (US $)
10,623
Field survey, including transportation, daily allowances
12,415
and accommodation
Mobile phones, accessories and air time
3,806
Survey administration
2,243
Total in-country expenditure (US $)
US $ 29,087
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Costs of the RAMP pilot surveys
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Cost of the Kenya RAMP survey
Description
Cost (US $)
Training (4 days) including two facilitators
8,792
Number of trainees
20
Field survey, including transportation, daily
allowances and accommodation (vehicles provided
free of charge by KRC)
6,767
Number of survey teams
6
Mobile phones, accessories and air time
3,261
Survey administration
3,355
Total in-country expenditure (US $)
US $ 22,175
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RAMP
Cost of the Namibia RAMP survey
Description
Training (5 days) including two facilitators
Number of trainees
Field survey, including transportation, daily
allowances and accommodation (vehicles rented)
Number of survey teams
Mobile phones, accessories and air time
Survey administration
Total in-country expenditure (US $)
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Cost (US $)
12,425
18
17,134
6
3,433
1,782
US $ 34,774
RAMP
Cost of the Namibia II RAMP survey
Description
Training (4 days) including two facilitators
Number of trainees
Field survey, including transportation, daily
allowances and accommodation (vehicles rented)
Number of survey teams
Mobile phones, accessories and air time
Survey administration
Total in-country expenditure (US $)
www.ifrc.org
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Cost (US $)
10,912
18
14,531
6
6,203
3,247
US $ 34,893
RAMP
Cost of the Nigeria RAMP survey
Description
Cost (US $)
Training (5 days) including two facilitators
10,362
Number of trainees
20
Field survey, including transportation, daily
allowances and accommodation (vehicles rented)
11,229
Number of survey teams
6
Mobile phones, accessories and air time
2,326
Survey administration (includes locally hired data
manager)
3,943
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Total in-country expenditure (US $)
US $ 27,860
RAMP
RAMP malaria survey
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RAMP
Initial focus of the RAMP survey tool:
malaria
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First RAMP surveys were done to evaluate malaria bed
net mass distribution programmes
Sample size was calculated to provide results to guide
management decision-making
Questionnaires created based on alignment with
MIS/RBM; core RBM/WHO indicators related to nets are
measured
Training curriculum and fieldwork procedures have been
developed and can be adapted to the local needs and
situation
Rapid reporting of results (a survey bulletin and a survey
report are produced)
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RAMP
Survey methods
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Cross-sectional, population-based survey
Sampling frame:
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First stage: selection of 30 clusters/PSUs using
probability proportional to estimated size (PPES)
sampling
Second stage: segmentation of the cluster/PSU; one
segment chosen using PPES
Simple random sampling (SRS) to choose 10
households in the segment
Sample size: 300 households
Precision:

+/- 7-8% for each key net indicator
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Questionnaires

Survey questionnaires (modelled and adapted from MIS/RBM)
 Household questionnaire
 number of sleeping spaces
 IRS
 household characteristics (wealth asset questions, etc.)
 Person roster
 number and age of persons slept in household last
night
 diagnosis of malaria/fever in children under five and
its treatment
 Net roster
 type of nets, source of nets
 who slept under each net last night
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Recruitment and training
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Interviewers and field supervisors recruited and trained
Training: 4 to 5 days
RAMP toolkit: Volume 3, Guide for trainers, provides
sample agenda, curriculum, tools and forms
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Content
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Training content and methods
survey background and purpose
questionnaires
informed consent
mobile phone basics
interview techniques
field procedures
field logistics/reporting
supervisor training
Methods

presentations, role play, group discussion,
demonstrations, field practice (2 outings), review of
data collected
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Household questionnaire

v
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RAMP
Persons roster
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RAMP
Bed net roster
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RAMP
RAMP malaria questionnaires: job aid
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RAMP
RAMP malaria questionnaires: job aid
(cont’d)
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RAMP
Fieldwork

Most surveys can be
finished in one week (5
days)!

6 teams, 1 cluster per
day per team, 30 clusters
in 5 days
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RAMP
Fieldwork

Survey teams:
6
teams of 1 team supervisor and 2
interviewers per team

Survey supervisory support and
monitoring team (eg., RCRC, IFRC,
MoH):
 Planning,
logistic and financial
responsibilities, field support, daily “quality”
rounds, and remote monitoring of data quality
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A typical day’s schedule

Morning briefing and travel to cluster

Meeting with community leader and guide, preparation
of sketch maps, segmentation, selection of households
to be interviewed

Conduct household interviews

Fieldworker sends data to server

Debriefing at day’s end with supervisory support and
monitoring team

Data monitoring, cleaning and preliminary analysis
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Survey results bulletin and report
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Precision <slide to be updated>
Key indicators
Point estimate
Width of
confidence interval,
±%
ITN use, all ages
60
6
ITN use, children <5 years
old
71
6
Percentage of ITNs
hanging
% households with > 1 ITN
79
4
82
6
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RAMP
Reporting and dissemination of results
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Survey bulletin
A brief, spreadsheetbased results bulletin can
be produced 24 hours
from last interview
Visually displays the data
from analysis tables
contained in the analysis
plan
Shows main indicators
and the results
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RAMP
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Survey report
Full survey report
provides a detailed
description of
background, methods,
results, and discussion
of results
Disseminate report to
stakeholders and others
to prompt action on the
survey findings
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RAMP survey toolkit
www.ifrc.org
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RAMP

The RAMP survey toolkit
Three linked publications plus files on the website
(www.ifrc.org/ramp) make up the RAMP toolkit

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Volume 1: Designing a RAMP survey: technical considerations
Volume 2: Implementing a RAMP survey: practical field guide
Volume 3: Training a RAMP survey team: guide for trainers
Files on the website: dynamic and kept up to date

Example database and STATA files for data cleaning and analysis of a sample
malaria survey
 Latest up-to-date malaria questionnaires and STATA files for data cleaning and
analysis
 Country reports and results bulletins, information, useful links

Together these provide a methodology, operations
protocol and numerous tools to carry out a RAMP survey
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RAMP
RAMP website: a dynamic resource
<Insert images of the RAMP website, with “www.
ifrc.org/ramp superimposed in large font over
the images”>
• See key documents from RAMP surveys being
done around the world. Survey questionnaires,
training curricula, fieldwork tools and forms,
survey reports—and more!
• Become part of a network of those using
RAMP for development work
www.ifrc.org
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FOR FURTHER INFORMATION ON RAMP, PLEASE
CONTACT:
IFRC HEALTH DEPARTMENT
JASON PEAT, SENIOR OFFICER, MALARIA
TEL. : +41 022 730 4419
EMAIL: jason.peat@ifrc.org
THIS PRESENTATION IS PUBLISHED BY
INTERNATIONAL FEDERATION OF
RED CROSS AND RED CRESCENT SOCIETIES
P.O. BOX 372
CH-1211 GENEVA 19
SWITZERLAND
TEL.: +41 22 730 42 22
FAX.: +41 22 733 03 95