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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
www.ifrc.orgSaving lives, changing minds.
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
www.ifrc.orgSaving lives, changing minds.
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.
www.ifrc.orgSaving lives, changing minds.
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
www.ifrc.orgSaving lives, changing minds.
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
www.ifrc.orgSaving lives, changing minds.
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
www.ifrc.orgSaving lives, changing minds.
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
www.ifrc.orgSaving lives, changing minds.
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
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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
www.ifrc.orgSaving lives, changing minds.
Partners
Namibia Red Cross Society IFRC MOHSS Namibia Bureau of Statistics Datadyne
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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
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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
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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
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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
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
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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
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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
www.ifrc.orgSaving lives, changing minds.
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%)
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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%
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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)
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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
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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
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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
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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?
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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
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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
www.ifrc.orgSaving lives, changing minds.
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
www.ifrc.orgSaving lives, changing minds.
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.