Multiple Indicator Cluster Surveys Survey Design Workshop

1
Multiple Indicator Cluster SurveysSurvey Design
Workshop

• Household Questionnaire
• Insecticide Treated Nets
• and
• Indoor Residual Spraying

2
Global goals and targets

• MDG 6 Combat HIV/AIDS, malaria and other
  diseases
• Target 6.C By 2015 have halted and begun to
  reverse the incidence of malaria and other major
  diseases
• Indicator 6.6 Incidence and death rates
  associated with malaria
• Indicator 6.7 of children under five sleeping
  under ITNs (MICS)
• Indicator 6.8 of children under five treated
  with anti-malarials (MICS)
• RBM Global Malaria Action Plan (2008)
• Achieve universal coveragewith interventions for
  prevention and case management by 2010 (MICS)
• Halve the malaria burden between 2000 and 2010
• Eliminate malaria in 8-10 countries by 2015and
  in the long-term eradicate malaria worldwide

3
Background

• WHO estimates 190-330 million malaria episodes in
  2006, resulting in nearly 1 million deaths
• About 90 per cent of all malaria deaths occur in
  sub-Saharan Africa, most among children under
  five
• Significant funding toward malaria control, and
  significant progress in scaling up ITNs in recent
  years
• Major focus by RBM partners on achieving
  universal coverage targets by end-2010

4
Mosquito net background

• Net roster added to MICS4 questionnaire to
  measure availability and usage of mosquito nets
• Streamlines questions related to mosquito nets
  throughout MICS questionnaire improves accuracy
  of responses
• Allows for calculation of universal coverage
  indicators and ITN use by pregnant women

5
MICS Indicators

• 3.12 - Household availability of ITN
• households with at least one
  insecticide-treated net
• 3.15 - Children sleeping under ITNs
• under fives sleeping under an ITN the previous
  night
• 3.14 - Children sleeping under any net
• under fives sleeping under any net the
  previous night

6
MICS Indicators

• 3.19 - Pregnant women sleeping under ITNs
• pregnant women sleeping under an ITN the
  previous night

7
ITN module
Total number of nets For each net - Observe
net - ITN status - Usage of nets
8
Methodological issues Nets

• May be difficult to observe nets
• Important to strictly follow questionnaire flow
  when nets are being observed
• Does not measure net quality (e.g. holes or rips
  in net)
• If more than 3 nets in a household, use a new
  questionnaire to record information about
  additional nets

9
Indoor residual spraying

• Separate module only include if programs exist
• IRS questions added to calculate indicator
  households protected by a vector control method
• 3.13 - Households protected by a vector control
  method
• households with at least one ITN and/or
  received spraying through an IRS campaign in past
  12 months

10
Methodological issues IRS

• IRS spraying often limited to small target areas
  in countries not recommended to report
  national-level IRS coverage alone (report
  indicator HH protected by a vector control
  method)
• Correspondence of IRS target areas with survey
  sampling areas
• Important to capture only IRS organized as part
  of campaign, and to exclude spraying conducted by
  a household member
• Confusion over the wording of interior walls in
  IRS question. Does spraying outside the house
  count?

11
Methodological issues

• General considerations
• MICS often carried out in the dry season for
  logistical reasons not during times of peak
  malaria transmission
• Even if only sub-national populations are at risk
  for malaria transmission, these modules can be
  included
• Become familiar with main types of nets locally
  available
• Become familiar with ongoing local IRS programs