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The use of a lot quality assurance sampling methodology to assess and manage primary health interventions in conflict-affected West Darfur, Sudan.
Popul Health Metr. 2016; 14:34.PH

Abstract

BACKGROUND

Organizations working in conflict-affected areas have a need to monitor and evaluate their programs, however this is often difficult due to the logistical challenges of conflict areas. Lot quality assurance sampling may be a suitable method of assessing programs in these situations.

METHODS

We conducted a secondary data analysis of information collected during Medair's routine program management functions. Medair's service area in West Darfur, Sudan was divided into seven supervisory areas. Using the available population information, a sampling frame was developed and interviews were conducted from randomly selected caretakers of children in each supervisory area every six months over 19 months. A survey instrument with questions related to key indicators for immunizations and maternal, newborn, and child health was used for the interviews. Based on Medair's goals for each indicator, decision rules were calculated for the indicators; these decision rules determined which supervisory areas and indicators performed adequately in each assessment period. Pearson's chi-squared tests, adjusted for the survey design using STATA "svy: tab" commands, were used to detect overall differences in coverage in this analysis.

RESULTS

The coverage of tetanus toxoid vaccination among pregnant women increased from 47.2 to 69.7 % (p value = 0.046), and births attended by a skilled health professional increased from 35.7 to 52.7 % (p value = 0.025) from the first to last assessment periods. Measles vaccinations declined from 72.0 to 54.1 % (p value = 0.046). The estimated coverage for the proportion of women receiving a postpartum dose of vitamin A (54.7 to 61.3 %, p value = 0.44); pregnant women receiving a clean delivery kit (54.6 to 47.1 %, p value = 0.49); and pentavalent vaccinations (49.7 to 42.1 %, p value = 0.28) did not significantly change.

CONCLUSIONS

Lot quality assurance sampling was a feasible method for Medair staff to evaluate and optimize primary health programs in a conflict-affected area. Medair managers were able to collect, analyze, and disseminate data to staff alongside the routine work of the organization. These results suggest LQAS may be used in other complex humanitarian emergencies in which there are logistical challenges and limited resources.

Authors+Show Affiliations

Department of Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, MD USA ; Department of International Health, Center for Refugee and Disaster Response, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA.Global Health, HIV/AIDS, and Nutrition Consultant, Charlotte, NC USA.Department of International Health, Center for Refugee and Disaster Response, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA.Department of Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, MD USA ; Department of International Health, Center for Refugee and Disaster Response, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

27757070

Citation

Pham, Kiemanh, et al. "The Use of a Lot Quality Assurance Sampling Methodology to Assess and Manage Primary Health Interventions in Conflict-affected West Darfur, Sudan." Population Health Metrics, vol. 14, 2016, p. 34.
Pham K, Sharpe EC, Weiss WM, et al. The use of a lot quality assurance sampling methodology to assess and manage primary health interventions in conflict-affected West Darfur, Sudan. Popul Health Metr. 2016;14:34.
Pham, K., Sharpe, E. C., Weiss, W. M., & Vu, A. (2016). The use of a lot quality assurance sampling methodology to assess and manage primary health interventions in conflict-affected West Darfur, Sudan. Population Health Metrics, 14, 34.
Pham K, et al. The Use of a Lot Quality Assurance Sampling Methodology to Assess and Manage Primary Health Interventions in Conflict-affected West Darfur, Sudan. Popul Health Metr. 2016;14:34. PubMed PMID: 27757070.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The use of a lot quality assurance sampling methodology to assess and manage primary health interventions in conflict-affected West Darfur, Sudan. AU - Pham,Kiemanh, AU - Sharpe,Emily Chambers, AU - Weiss,William M, AU - Vu,Alexander, Y1 - 2016/10/06/ PY - 2016/02/17/received PY - 2016/09/22/accepted PY - 2016/10/21/pubmed PY - 2017/9/14/medline PY - 2016/10/21/entrez KW - Complex humanitarian emergency KW - Conflict KW - Lot quality assurance sampling KW - Monitoring and evaluation SP - 34 EP - 34 JF - Population health metrics JO - Popul Health Metr VL - 14 N2 - BACKGROUND: Organizations working in conflict-affected areas have a need to monitor and evaluate their programs, however this is often difficult due to the logistical challenges of conflict areas. Lot quality assurance sampling may be a suitable method of assessing programs in these situations. METHODS: We conducted a secondary data analysis of information collected during Medair's routine program management functions. Medair's service area in West Darfur, Sudan was divided into seven supervisory areas. Using the available population information, a sampling frame was developed and interviews were conducted from randomly selected caretakers of children in each supervisory area every six months over 19 months. A survey instrument with questions related to key indicators for immunizations and maternal, newborn, and child health was used for the interviews. Based on Medair's goals for each indicator, decision rules were calculated for the indicators; these decision rules determined which supervisory areas and indicators performed adequately in each assessment period. Pearson's chi-squared tests, adjusted for the survey design using STATA "svy: tab" commands, were used to detect overall differences in coverage in this analysis. RESULTS: The coverage of tetanus toxoid vaccination among pregnant women increased from 47.2 to 69.7 % (p value = 0.046), and births attended by a skilled health professional increased from 35.7 to 52.7 % (p value = 0.025) from the first to last assessment periods. Measles vaccinations declined from 72.0 to 54.1 % (p value = 0.046). The estimated coverage for the proportion of women receiving a postpartum dose of vitamin A (54.7 to 61.3 %, p value = 0.44); pregnant women receiving a clean delivery kit (54.6 to 47.1 %, p value = 0.49); and pentavalent vaccinations (49.7 to 42.1 %, p value = 0.28) did not significantly change. CONCLUSIONS: Lot quality assurance sampling was a feasible method for Medair staff to evaluate and optimize primary health programs in a conflict-affected area. Medair managers were able to collect, analyze, and disseminate data to staff alongside the routine work of the organization. These results suggest LQAS may be used in other complex humanitarian emergencies in which there are logistical challenges and limited resources. SN - 1478-7954 UR - http://www.nlm.medscape.idmu.unboundmedicine.unboundmedicine.com/medline/citation/27757070/The_use_of_a_lot_quality_assurance_sampling_methodology_to_assess_and_manage_primary_health_interventions_in_conflict_affected_West_Darfur_Sudan_ L2 - https://pophealthmetrics.biomedcentral.com/articles/10.1186/s12963-016-0103-3 DB - PRIME DP - Unbound Medicine ER -