Training Workshop – Module 2 Coverage Evaluation for Preventive Chemotherapy Description of the method Training Workshop – Module 2

Phases of a Coverage Evaluation Module 1: Planning (central level) Survey Area, Survey Population, Sample Size, Selection of Subunits Module 2: Implementation (local level) Creating segments, enumerating households, interviewing respondents Module 3: Interpretation and Action (central level) Interpretation of results, developing action plan

Coverage evaluation: MODULE 2: The implementation phase Note, this is the aspect of training that is relative to the survey enumerators

Coverage Evaluation Survey Team Survey Coordinator - leads survey planning and supervises the teams in the field Field teams – typically 3 people (not directly involved in MDA) Interviewer – interviewing respondents and completing the survey questionnaire Sampler - makes sure sampling plan is followed and determines which households are selected Driver – transports team to each subunit site *Local Guide – person from subunit identified to help team identify households in the segment It is helpful if one or more team members is familiar with the local area Must speak local language Team members should be independent of the MDA

Field Team Supplies List of selected subunits and the number of segments in each (from CSB) Lists A and B Chalk Questionnaire Sample of drug(s) Notebook (scrap paper to record HHs needing revisit and for selecting segments randomly) Map (optional)

Overview of Daily Sampling Flow Arrive at subunit, introduce team and purpose to local leaders Identify a local guide Familiarize team with the boundaries of the subunit Divide the subunit into the predetermined number of segments Randomly select one segment Work with the guide to enumerate houses and identify a path through the segment Flip a coin to determine if List A or B will be used Walk path through segment, enumerating each HH. Each HH that corresponds to a number on the selected list (A or B) will be included in the survey List all members of the survey population in each household and then interview each member on the list using the questionnaire Continue until all HHs in the segment have been enumerated

Upon Arrival in the Selected Subunit Introduce team and purpose to local leaders Identify a local guide Knows the areas and speaks the local language Not directly involved in the MDA Familiarize yourself with the boundaries of the subunit

Divide the Subunit into Segments 4. Divide the subunit into the predetermined number of segments and assign a number to each segment. Selected Subunits Subunit Names Estimated # Households # Segments to be formed per Subunit 1 Mbuwambuwa 49 2 Meleka 46 3 Garden 4 Zalimu 1 75 5 Njera 37 6 Chikaloza 158 7 Kamwendo 113 8 Khwalala 122

Divide Subunit into Segments Segmentation Pointers: Each segment should have approximately the same number of households. Ask local leaders to help divide their community into “X equal parts” (e.g. half, thirds, fourths) Use natural lines of division (e.g. roads, stream, path, or other landmarks) whenever possible If the subunit only has 1 segment, the entire subunit will serve as the segment; there is no need for segmentation Even if the estimated # households turns out to be very inaccurate, do not adjust the number of segments.

Divide the Subunit into Segments ● ⌂ Stream Path Imaginary line Large tree Household School ¤

Divide the Subunit into Segments ● ⌂ ¤ Walking route Stream Path Imaginary line Large tree Household School SEGMENT 1 SEGMENT 2

Divide the Subunit into Segments The goal of segmentation is to save time. If villages are not segmented then the team would have to enumerate all households in the village and then randomly pick those to sample. Instead, by segmenting the team only has to enumerate all the households in a single segment of the village.

Divide the Subunit into Segments

Maps (aka “sketch maps”) Sometimes the village leader or health post may have a map of the village. These maps are often helpful in determining the best boundaries for each segment and identifying a path through the selected segment.

Divide the Subunit into Segments Complete Exercise 2.1

Daily Sampling Flow Arrive at subunit, introduce team and purpose to local leaders Identify a local guide Familiarize team with the boundaries of the subunit Divide the subunit into the predetermined number of segments Randomly select one segment

Randomly Select One Segment If there is one segment… No selection needed Flip a coin If there are two segments… Draw numbers from a hat If there are >2 segments…

Select Households within the Segment 6. Work with the local guide to determine a route through the selected segment that will pass by each household Households within the segment are selected for the coverage survey by applying a set sampling interval (calculated in advance in order to reach the expected sample size). Revisit Exercise 1.3 – what was your sampling interval?

Select Households within the Segment List A List B 3 1 7 5 12 9 16 14 20 18 25 22 29 27 33 31 38 36 42 40 47 44 51 49 55 53 60 57 7. Flip a coin to determine if List A or List B will be used. The numbers on the list correspond to the household numbers (e.g., the 3rd, 7th, 12th households…) from which all individuals in the survey population should be sampled.

Select Households within the Segment Walk path through segment, enumerating each HH. Each HH that corresponds to a number on the selected list (A or B) will be included in the survey

3 4 39 38 6 people 40 41 2 5 5 people 42 1 33 2 people 7 6 4 people 4 people 8 43 12 29 11 10 3 people 8 people 9 20 25 16 9 people 6 people 5 people

Select Households within the Segment Complete Exercise 2.2

Interview all Members of the Survey Population List all members of the survey population in each household and then interview each member on the list using the questionnaire Introduce team and explain purpose of survey to the head of household Get the consent of the head of household List the names of everyone in the survey population on the questionnaire Interview each individual using the questionnaire (note: parents may be interviewed on behalf of children <10) Show each respondent an example of the drug(s) that were offered

Interview all Members of the Survey Population Key Coverage Questions: Were you offered the drug? Did you swallow the drug? Measures Programme Reach Coverage Measures Surveyed Coverage

Should be adjusted to reflect local norms and attitudes Explain importance of swallow vs. offer

Interview all Members of the Survey Population Absent Individuals If a survey respondent is absent but expected to return the same day, the survey team should make note of the household and return once the segment is complete. If the survey respondent is not expected to return, try to reach them via cell phone. If that is not possible, an adult in the household may serve as a proxy respondent and answer on behalf of the absent individual.

Interview all Members of the Survey Population Complete Exercise 2.3 and Exercise 2.4

Summary: Daily Sampling Flow Arrive at subunit, introduce team and purpose to local leaders Identify a local guide Familiarize team with the boundaries of the subunit Divide the subunit into the predetermined number of segments Randomly select one segment Work with the guide to enumerate HH and identify a path through the segment Flip a coin to determine if List A or B will be used Walk path through segment, enumerating each HH. Each HH that corresponds to a number on the selected list (A or B) will be included in the survey List all members of the survey population in each household and then interview each member on the list using the questionnaire Continue until all HHs in the segment have been enumerated