John Snow, Inc.
Health Impact Evaluation in Ghana
Every person deserves a healthy life. That’s the guiding principle for JSI Research & Training Institute Inc. (JSI), a public health consulting organization. To that end, JSI partnered with Innovations for Maternal, Newborn & Child Health, an initiative of Concern Worldwide. In an effort to improve maternal and child health, Innovations is introducing a non-financial incentive program in several community-based health planning and services zones in rural Ghana. The program is designed to improve antenatal care, postpartum care, and breastfeeding behavior. But prior to launch by ProNet North, Innovations’ in-country implementing partner, JSI was brought in to execute a critical first step on the way to a rigorous impact evaluation: a baseline assessment of 2,700 households and the men and women who live in them.
That’s where Emily Stammer came in. Emily, a monitoring and evaluation officer at JSI’s Center for Health Information, Monitoring, and Evaluation (CHIME), knew that selecting the right mobile platform was key to the success of baseline data collection. She needed a powerful and reliable software platform that would enable her team to:
- Develop complex surveys easily
- Deploy surveys in the field using mobile phones
- Collect data with minimal reliance on Internet availability
- Ensure high-quality data
- Access real-time data to identify issues
- Provide fast access to clean data
Emily chose SurveyCTO. As she explains, “We were comfortable with the software and found it to be incredibly beneficial.” The JSI team used SurveyCTO to:
- Develop a sophisticated survey for scale – Administered to 2,700 heads of households, including 1,600 female and 1,100 male respondents.
- Conduct the survey using mobile phones – Loaded onto 30 Samsung Galaxy Ace Plus phones, the survey was administered by 27 data collectors and three field supervisors.
- Create household rosters – Data collectors used SurveyCTO to create comprehensive rosters of household members, including each person’s age, gender, and reproductive history.
- Link individuals to households – SurveyCTO enabled the JSI team to link individual surveys to preexisting rosters and merge the data. “We relied on SurveyCTO identifiers to merge everything,” explains Emily. “It was an extremely helpful functionality – and it was really easy to do.”
- Build automated repeats – SurveyCTO made it easy to generate questions for repeat groups. Says Emily, “If we asked, ‘How many members of your household are there?’ and they answered ‘eight,’ then eight repeats would automatically be created.”
By using SurveyCTO, JSI raised the bar for data collection. The team is now able to:
- Work fast and flexibly – SurveyCTO dramatically reduced time-to-data. In fact, the team was able to review data nearly in real time, and identify problems and address issues in a timely manner. Says Emily, “During training, we came across several edits that needed to be made. It was great that the survey was built in Microsoft Excel so that I could edit and upload the new version to the phones.”
- Leave paper behind – SurveyCTO made it easy to transition to electronic data collection. Once data was collected, it was sent to the server for analysis whenever an Internet connection was available. Internet connectivity was only needed to download the surveys to the phone and to upload the data to the server. “Bringing mobile phones into rural Ghana has its own set of issues, but we didn’t have any problems with SurveyCTO. It went really well,” says Emily.
- Improve data quality – SurveyCTO reduced the error rate that occurs with pen-and-pencil methods – thanks to more accurate input, robust data capture ability, and built-in quality control. Emily says, “These were by far the best results we’ve seen on a survey and a lot of it has to do with SurveyCTO. We were able to restrict answers and force responses – and that really cut down on missing data and mistakes.”
So what’s the bottom line? According to Emily, “With SurveyCTO, we get more and better data than we’ve ever had before.”
TIPS FROM THE FIELD
In the process of honing her survey, Emily discovered that enumerators preferred when the survey dynamically adapted to repeat questions the correct number of times, based on earlier entries. To see a simple example of a survey form that employs this method, download this sample form.
* Photo credit: Kintampo Health Research Centre
- User: JSI Research & Training Institute Inc. (JSI)
- Project: Evaluation of maternal, newborn, and child health programs in Ghana
- Scope: 2,700 household surveys