The use of a lot quality assurance sampling methodology to assess and manage primary health interventions in conflict-affected West Darfur Sudan.

Monday, 7th of November 2016

Popul Health Metr. 2016 Oct 6;14:34. eCollection 2016.

The use of a lot quality assurance sampling methodology to assess and manage primary health interventions in conflict-affected West Darfur Sudan.

Pham K¹ Sharpe EC² Weiss WM³ Vu A¹.

Author information

Abstract

BACKGROUND:

Organizations working in conflict-affected areas have a need to monitor and evaluate their programs however this is often difficult due to the logistical challenges of conflict areas. Lot quality assurance sampling may be a suitable method of assessing programs in these situations.

METHODS:

We conducted a secondary data analysis of information collected during Medairs routine program management functions. Medairs service area in West Darfur Sudan was divided into seven supervisory areas. Using the available population information a sampling frame was developed and interviews were conducted from randomly selected caretakers of children in each supervisory area every six months over 19 months. A survey instrument with questions related to key indicators for immunizations and maternal newborn and child health was used for the interviews. Based on Medairs goals for each indicator decision rules were calculated for the indicators; these decision rules determined which supervisory areas and indicators performed adequately in each assessment period. Pearsons chi-squared tests adjusted for the survey design using STATA "svy: tab" commands were used to detect overall differences in coverage in this analysis.

RESULTS:

The coverage of tetanus toxoid vaccination among pregnant women increased from 47.2 to 69.7 % (p value = 0.046) and births attended by a skilled health professional increased from 35.7 to 52.7 % (p value = 0.025) from the first to last assessment periods. Measles vaccinations declined from 72.0 to 54.1 % (p value = 0.046). The estimated coverage for the proportion of women receiving a postpartum dose of vitamin A (54.7 to 61.3 % p value = 0.44); pregnant women receiving a clean delivery kit (54.6 to 47.1 % p value = 0.49); and pentavalent vaccinations (49.7 to 42.1 % p value = 0.28) did not significantly change.

CONCLUSIONS:

Lot quality assurance sampling was a feasible method for Medair staff to evaluate and optimize primary health programs in a conflict-affected area. Medair managers were able to collect analyze and disseminate data to staff alongside the routine work of the organization. These results suggest LQAS may be used in other complex humanitarian emergencies in which there are logistical challenges and limited resources.