Comparison of three rapid household survey sampling methods for vaccination coverage assessment in a peri-urban setting in Pakistan

Wenfeng Gong, Mubarak Taighoon Shah, Sumera Firdous, Brooke A. Jarrett, Lawrence Hale Moulton, William J Moss, Kyla Hayford, Katherine L O'Brien, Subhash Chandir

Research output: Contribution to journalArticle

Abstract

Background: Household surveys are an essential tool for vaccine coverage monitoring in developing countries, and the World Health Organization (WHO) Expanded Program on Immunization (EPI) cluster survey design has been a default choice for decades. In response to methodological limitations of the traditional EPI sampling, alternative methods have been proposed, based on modern statistical and geographical techniques. This study compared the coverage estimates and the time efficiency of the EPI sampling design and two alternative methods: the compact segment sampling and innovative grid-based geographical information system (GIS) sampling. Methods: We conducted a series of equal-sized concurrent prospective vaccine coverage surveys in Karachi, Pakistan, from January to December 2016, using traditional EPI, compact segment and grid-based GIS sampling methods. Results: No differences in vaccine coverage estimates were identified across sampling methods in the peri-urban setting; however, due to stronger clustering effects and correct incorporation of sampling weights, the compact segment [design effect (DEFF) ¼ 2.03] and the grid-based GIS surveys (DEFF ¼ 1.72) had higher design effects and, therefore, appeared to have lower statistical precision than the traditional EPI surveys (DEFF ¼ 1.57). To achieve the same level of apparent precision, data collection activities in the compact segment surveys would require more than twice the implementation time needed compared with the traditional EPI surveys. Conclusions: The precision of the EPI surveys appeared higher than that of the alternative methods because, under a questionable self-weighting assumption, the estimated design effect did not account for variable sampling weights. The compact segment and grid-based GIS methods were designed to improve randomness and representativeness of sampling households. Although these alternative methods did not result in coverage estimates that differed from the EPI survey results in the peri-urban setting, they have a lower risk of selection bias and therefore may be preferred.

Original languageEnglish (US)
Pages (from-to)583-595
Number of pages13
JournalInternational journal of epidemiology
Volume48
Issue number2
DOIs
StatePublished - Jan 1 2019

Fingerprint

Pakistan
Immunization Programs
Vaccination
Geographic Information Systems
Vaccines
Organizational Efficiency
Surveys and Questionnaires
Weights and Measures
Selection Bias
Developing Countries
Cluster Analysis

Keywords

  • Epidemiological methods
  • Immunization programmes
  • Pakistan
  • Probability sample
  • Survey
  • Vaccine coverage

ASJC Scopus subject areas

  • Epidemiology

Cite this

Comparison of three rapid household survey sampling methods for vaccination coverage assessment in a peri-urban setting in Pakistan. / Gong, Wenfeng; Shah, Mubarak Taighoon; Firdous, Sumera; Jarrett, Brooke A.; Moulton, Lawrence Hale; Moss, William J; Hayford, Kyla; O'Brien, Katherine L; Chandir, Subhash.

In: International journal of epidemiology, Vol. 48, No. 2, 01.01.2019, p. 583-595.

Research output: Contribution to journalArticle

@article{b56a79a915e14b128c7b957bd6609e65,
title = "Comparison of three rapid household survey sampling methods for vaccination coverage assessment in a peri-urban setting in Pakistan",
abstract = "Background: Household surveys are an essential tool for vaccine coverage monitoring in developing countries, and the World Health Organization (WHO) Expanded Program on Immunization (EPI) cluster survey design has been a default choice for decades. In response to methodological limitations of the traditional EPI sampling, alternative methods have been proposed, based on modern statistical and geographical techniques. This study compared the coverage estimates and the time efficiency of the EPI sampling design and two alternative methods: the compact segment sampling and innovative grid-based geographical information system (GIS) sampling. Methods: We conducted a series of equal-sized concurrent prospective vaccine coverage surveys in Karachi, Pakistan, from January to December 2016, using traditional EPI, compact segment and grid-based GIS sampling methods. Results: No differences in vaccine coverage estimates were identified across sampling methods in the peri-urban setting; however, due to stronger clustering effects and correct incorporation of sampling weights, the compact segment [design effect (DEFF) ¼ 2.03] and the grid-based GIS surveys (DEFF ¼ 1.72) had higher design effects and, therefore, appeared to have lower statistical precision than the traditional EPI surveys (DEFF ¼ 1.57). To achieve the same level of apparent precision, data collection activities in the compact segment surveys would require more than twice the implementation time needed compared with the traditional EPI surveys. Conclusions: The precision of the EPI surveys appeared higher than that of the alternative methods because, under a questionable self-weighting assumption, the estimated design effect did not account for variable sampling weights. The compact segment and grid-based GIS methods were designed to improve randomness and representativeness of sampling households. Although these alternative methods did not result in coverage estimates that differed from the EPI survey results in the peri-urban setting, they have a lower risk of selection bias and therefore may be preferred.",
keywords = "Epidemiological methods, Immunization programmes, Pakistan, Probability sample, Survey, Vaccine coverage",
author = "Wenfeng Gong and Shah, {Mubarak Taighoon} and Sumera Firdous and Jarrett, {Brooke A.} and Moulton, {Lawrence Hale} and Moss, {William J} and Kyla Hayford and O'Brien, {Katherine L} and Subhash Chandir",
year = "2019",
month = "1",
day = "1",
doi = "10.1093/ije/dyy263",
language = "English (US)",
volume = "48",
pages = "583--595",
journal = "International Journal of Epidemiology",
issn = "0300-5771",
publisher = "Oxford University Press",
number = "2",

}

TY - JOUR

T1 - Comparison of three rapid household survey sampling methods for vaccination coverage assessment in a peri-urban setting in Pakistan

AU - Gong, Wenfeng

AU - Shah, Mubarak Taighoon

AU - Firdous, Sumera

AU - Jarrett, Brooke A.

AU - Moulton, Lawrence Hale

AU - Moss, William J

AU - Hayford, Kyla

AU - O'Brien, Katherine L

AU - Chandir, Subhash

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Household surveys are an essential tool for vaccine coverage monitoring in developing countries, and the World Health Organization (WHO) Expanded Program on Immunization (EPI) cluster survey design has been a default choice for decades. In response to methodological limitations of the traditional EPI sampling, alternative methods have been proposed, based on modern statistical and geographical techniques. This study compared the coverage estimates and the time efficiency of the EPI sampling design and two alternative methods: the compact segment sampling and innovative grid-based geographical information system (GIS) sampling. Methods: We conducted a series of equal-sized concurrent prospective vaccine coverage surveys in Karachi, Pakistan, from January to December 2016, using traditional EPI, compact segment and grid-based GIS sampling methods. Results: No differences in vaccine coverage estimates were identified across sampling methods in the peri-urban setting; however, due to stronger clustering effects and correct incorporation of sampling weights, the compact segment [design effect (DEFF) ¼ 2.03] and the grid-based GIS surveys (DEFF ¼ 1.72) had higher design effects and, therefore, appeared to have lower statistical precision than the traditional EPI surveys (DEFF ¼ 1.57). To achieve the same level of apparent precision, data collection activities in the compact segment surveys would require more than twice the implementation time needed compared with the traditional EPI surveys. Conclusions: The precision of the EPI surveys appeared higher than that of the alternative methods because, under a questionable self-weighting assumption, the estimated design effect did not account for variable sampling weights. The compact segment and grid-based GIS methods were designed to improve randomness and representativeness of sampling households. Although these alternative methods did not result in coverage estimates that differed from the EPI survey results in the peri-urban setting, they have a lower risk of selection bias and therefore may be preferred.

AB - Background: Household surveys are an essential tool for vaccine coverage monitoring in developing countries, and the World Health Organization (WHO) Expanded Program on Immunization (EPI) cluster survey design has been a default choice for decades. In response to methodological limitations of the traditional EPI sampling, alternative methods have been proposed, based on modern statistical and geographical techniques. This study compared the coverage estimates and the time efficiency of the EPI sampling design and two alternative methods: the compact segment sampling and innovative grid-based geographical information system (GIS) sampling. Methods: We conducted a series of equal-sized concurrent prospective vaccine coverage surveys in Karachi, Pakistan, from January to December 2016, using traditional EPI, compact segment and grid-based GIS sampling methods. Results: No differences in vaccine coverage estimates were identified across sampling methods in the peri-urban setting; however, due to stronger clustering effects and correct incorporation of sampling weights, the compact segment [design effect (DEFF) ¼ 2.03] and the grid-based GIS surveys (DEFF ¼ 1.72) had higher design effects and, therefore, appeared to have lower statistical precision than the traditional EPI surveys (DEFF ¼ 1.57). To achieve the same level of apparent precision, data collection activities in the compact segment surveys would require more than twice the implementation time needed compared with the traditional EPI surveys. Conclusions: The precision of the EPI surveys appeared higher than that of the alternative methods because, under a questionable self-weighting assumption, the estimated design effect did not account for variable sampling weights. The compact segment and grid-based GIS methods were designed to improve randomness and representativeness of sampling households. Although these alternative methods did not result in coverage estimates that differed from the EPI survey results in the peri-urban setting, they have a lower risk of selection bias and therefore may be preferred.

KW - Epidemiological methods

KW - Immunization programmes

KW - Pakistan

KW - Probability sample

KW - Survey

KW - Vaccine coverage

UR - http://www.scopus.com/inward/record.url?scp=85067586144&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85067586144&partnerID=8YFLogxK

U2 - 10.1093/ije/dyy263

DO - 10.1093/ije/dyy263

M3 - Article

C2 - 30508112

AN - SCOPUS:85067586144

VL - 48

SP - 583

EP - 595

JO - International Journal of Epidemiology

JF - International Journal of Epidemiology

SN - 0300-5771

IS - 2

ER -