Www.ifrc.org Saving lives, changing minds. Rapid Mobile Phone-based (RAMP) survey Changing the way we collect data in Health Surveys Presented by Jenny

www.ifrc.orgSaving lives, changing minds.

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


Outline

• Purpose of the RAMP• Key features of the RAMP• Traditional vs. mobile phone based surveys• RAMP

• How it works• How much it costs• Benefits of the tool

• Stakeholder benefits • RAMP rollout in Namibia • Future steps


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.


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


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


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


How does it work?


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

http://www.episurveyor.org/user/index


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


Stakeholder benefits

Decision Makers• No software licensing or subscriptions • Optimizes resource usage and reduces environmental impact• Maintain data security and respondent confidentiality• Scalable solution for teams and studies of varying sizes

Researchers/Evaluators• 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• Generate reports on responses as they arrive• Export data for custom analysis with your favourite statistically analysis package

Fieldworkers• Conduct surveys anywhere, even in areas with no network coverage• Use standard and familiar mobile • Minimal training requirements• No more paper to collect, transport or return• Automated submission of data when network reception is available


RAMP Rollout in Namibia: Focus on Malaria


Partners

Namibia Red Cross Society IFRC MOHSS Namibia Bureau of Statistics Datadyne

RAMP survey site: Caprivi region, Namibia


Malaria is a major public health problem in Caprivi

Click icon to add picture


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)

Site and project identification


Standard survey methodology used in an RAMP survey 1st stage: standard probability-proportional-to-

estimated-size (PPES) selection of clusters 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

Survey methods

300 Households30 clusters, 10 households/cluster, total of 300 households in the survey sample


Modeled after the standardized MIS questionnaires Household questionnaire Person roster/Treatment and diagnosis of fever in U-

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 Silosi

Survey questionnaires


NRC volunteers that serve as supervisors in the CFM project (interviewers)

NRC volunteers that serve as supervisors in another project (field supervisors)

Training – 5 days (May 2-6, 2011) in Katima Mulilo

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), energizers

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 remotelyDaily 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


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

Lessons learned


Preliminary Results


Survey results bulletin & report

Survey Report


Results: key indicators, HH questionnaire

HH ownership at least one ITN

ITN access, % pop. with

access to ITN

ITN use, all persons

ITN use, chil-dren <5 years

ITN use in chil-dren <5y, given

at least 1 ITN

HH ITN own-ership or IRS

IRS 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

59

52

3842

65

80

40

71

61

31

Percentage


Access: Just 52% of ITNs needed to reach universal coverage are present. Gap is 48%.

Key indicators

Target population 47,932

Persons per net 2.13

ITNs needed 22.503

Survey-estimated ITNs in HH of target pop

11.676 (52%)

ITN/LLIN need/gap 10.828 (48%)


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%


ITN use by age group

<1y 1 2-4 5-9 10-14 15-24 24-44 45-59 60+0

10

20

30

40

50

60

70

80

90

100

Age groups (years)


Age in months %

<12 months 50

12-23 months 11

24-36 months 3

36+ months 36

Age of ITNs

* 87% of nets were LLINs


Number of persons sleeping under ITN last night %, nets

1 person 30

2 persons 42

3 persons 18

4 persons 10

Number of persons under a ITN last night


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


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

How much does the RAMP cost?


So, does the RAMP “work”?

Conducted by secondary-school graduates with no previous survey experience

Survey was completed within two weeks 5 days training, 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


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


What’s next?

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


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.


Thank youAny questions?


Extra Photos & Information

49% of households are headed by women


Morning briefing (“quality round”)

Locating the chosen cluster and selecting the

households to be interviewed

Conduct interviews at HH level

Supervisor sends data to server

Data cleaning and analysis

A day’s schedule

Documents

Www.ifrc.org Saving lives, changing minds. Rapid Mobile Phone-based (RAMP) survey Changing the way we collect data in Health Surveys Presented by Jenny