Data from Conflict-affected Regions: Filling in the Blanks Mohamed Ali WHO Regional office, Cairo

Collecting data from the field: Nation-wide surveys Coverage, size, questionnaires or different respondents Complex design and the cost

Surveys always needed Survey vs. routine data Imposing a survey on the national authority Bilateral agreement or international organizations (country initiative)

Challenges at different stages Design Implementation Analysis and dissemination

Design stage: Stakeholders/funders influence – Agreeing with the stakeholders and the funding agencies what to include is not always easy, in emergency situation it is even worse, sometime the questionnaire end up with irrelevant question or key questions were dropped – Implementers role Definition of outcome and set of questions used (child mortality): – real vs. synthetic cohorts and direct or indirect

Some tools are not yet fully developed or field tested tested Most CSO/MoH do not have enough trained interviewers and recruitment of short term inexperienced field staff increases the cost, attrition problem and impact the data quality

Implementation: Security and safety of the field staff (government employee use of GPS) Access to household is not always granted Coverage and Response rates Matching the interviewer and respondents gender and ethnic background Categorical vs. continuous measure (present or absence of disease vs anthropometric)

Recall period Invasive procedures (blood sample or measuring hip or waist) Personal and sensitive questions (income and sexual behaviour to single un married women) Exaggeration and concealing (mortality, behaviour, chronic illness) Supervision and data quality checks in the field are lacking

Data analysis and reporting How do you handle missing and incomplete data, what adjustment and imputation methods to be used. Reporting crude or adjusted estimates Politically charged results usually generate rumours and counter rumours, how do you handle such a situation?

Last but not least Did we build local capacity after all???