Field Staff Training in the DHS Health Metrics Network meeting Calverton, MD, 10-11 July 2007

1. Field Staff Training in the DHSHealth Metrics Network meeting Calverton, MD, 10-11 July 2007

2. DHS project generally provides extensive TA. In a few countries, DHS gave limited TA with mixed results. • DHD project is involved at the country level in the different phases of the survey: questionnaire’s adaptation, sample design, training, fieldwork monitoring, data processing, tabulation, report writing and dissemination. • DHS project generally has one country manager for every two DHS countries.

3. Producing reliable data is a hallmark of the DHS project • What does the DHS project do in order to collect reliable data?

4. Outline of Presentation Recruitment Training Quality Control

5. 1. Recruitment

6. Recruitment of Field Staff • Area that we have probably not paid sufficient attention to, partly because it happens quite often when we are not there • When jobs are in short supply, there may be a lot of pressure on survey managers to hire friends, etc.

7. Composition of Field Staff • Standard DHS team=1 supervisor or team leader, 1 female field editor, 3-4 female interviewers, possibly 1 male interviewer • Sometimes health technicians if complicated biomarkers or if country requires for blood sampling, • If vehicles are small, team may need to be reduced

8. Characteristics of Field Staff • Sex—DHS protocol=women interview women and men interview men • Language—categorize sample clusters by language to estimate number of field staff for each. • Education • Experience—prior field work a plus, but can be a minus • Physical fitness • Availability for entire period of field work • Personality

9. Logistics of Recruiting Field Staff • Sometimes use permanent staff of implementing organization • Advertise in papers—fairest method • Word of mouth—need to guard against hiring unqualified friends and relatives • Interview should include speaking and reading in the requisite local language • Short test for applicants becoming more and more the norm for pre selection

10. 2. Training

11. Size of Class • Smaller is better; DHS recommends 30-35 trainees per class; probably 50 is max • Regional trainings: reduces travel and per diem costs for trainees, but increases burden on trainers and reduces uniformity of training • Multiple classes at 1 venue: increases uniformity, eases logistics, can engender healthy competition between classes • Need at least 2 full-time trainers per class • Trainers need to meet every day or two to coordinate and plan for next day

12. Training Venue • Ideal is a residential training site so that trainees are a captive audience • Should have large room for plenary sessions and smaller classrooms if multiple classes • Electricity, ample light, good food, quiet, few distractions • Book the venue ahead of time

13. Training Schedule • Pretest training is usually 2-3 weeks; main training usually 3-4 weeks • Agenda depends on survey content, but first 8-12 days usually spent on questionnaires, next week on anthropometry and biomarkers, final few days on field practice. • Allow a day or two to practice local languages • Allow a day to train supervisors/field editors • Allow time to cover administrative issues, how to read maps, payment plans, develop itineraries for each team, etc.

14. Audio-visual Equipment Overhead projector with transparencies Computerized projector In either case, also need blackboard and/or flipcharts

15. Supplies for Training • Questionnaires, interviewer’s manuals, supervisor’s/editor’s manuals • Assignment sheets, other field forms • Samples of maps, listing forms • Samples of contraceptive methods • Vitamin A capsules, iron tablets, antimalarials, ORS packets • Samples of child vaccination cards • Sample of birth certificate • Scales and boards

16. List of HIV/Anemia Supplies • Gloves • Alcohol wipes • Self-retracting, non-reusable lancets • Sterile gauze pads • Bio-hazard bags • Filter paper card • Bar code labels (in triplicate) • Hemocue and microcuvettes • Drying rack and drying container • Gas impermeable, ziplock bags • Dessicants • Humidity indicator cards

17. Techniques of Training • Mock interviews • Demonstration interview • Front-of-class interview • Demonstration interview with real respondent • Anemia/HIV/anthropometry practice: on each other, with children brought into training class, in school/health center • Field practice

18. Field Practice • Minimum of 2 whole days with review session afterwards to discuss experience, problems • Teams can interview HHs that are available, no callbacks • Teams can interview in clusters not selected in survey, with maps and households marked • Senior staff should observe interviews • Final day should be as similar to final team composition as possible, with supervisors and field editors editing, then giving to senior survey staff to check

19. Tests • Tests are not always a good measure of trainees’ abilities—can be artificial and may depend on trainee’s English/French skills instead of interviewing skills • However, tests are useful as a means to emphasize specific issues • With large trainings, tests provide an objective measure in case we need to let some trainees go at end of training • ‘Find the errors’ test helps identify good field editors, but is difficult to grade

20. Training Tips • Name tags help • Intersperse lectures, guest lectures and mock interviews • Try to make it fun • Try to involve everyone in some activity, so trainees can’t fade into the background • If supervisors designated in advance, use them to help train

21. 3. Quality Control

22. Quality Control • Questionnaire editing • Observing interviews • Supervisor re-interviews • Quality control coordinators • Senior staff field visits • Field check tables

23. Questionnaire Editing • DHS recommends to be done same or next day after interview • Errors are discussed with each individual interviewer in private but also reviewed with whole team in a general, constructive manner

24. Observing Interviews • This is generally done by the field editor • Field editor can’t interrupt interview—this undermines the interviewer’s confidence; instead takes brief notes • Discuss observations with interviewer immediately afterwards

25. Supervisor Re-interviews • Ideally, supervisor re-interviews 5-10% of recently completed households with just HH questionnaire • Then checks against original questionnaire • Main purpose is to make sure interviewer conducted interview and to check for omission of eligible women/men/children

26. Quality Control Coordinators The roles of field coordinators are: • check on team’s progress and discuss problems • edit 2-3 questionnaires for each interviewer • observe each interviewer • conduct some re-interviews

27. WE ALSO URGE SENIOR STAFF TO GO TO THE FIELD OFTEN

28. Field Check Tables • 12-15 tables run as soon as 15-20 clusters have been entered • Usually produced every 2 weeks for duration of fieldwork • Indicate response rates, age displacement, missing values, underreporting for key indicators • Designed to provide an early warning system

29. The DHS country manager participates in selection of field staff, in training and in monitoring early fieldworkMidway through data collection, the DHS country manager generally returns to the country to monitor fieldwork.

30. In order to implement these QC measures, we make sure that field staff are paid on time and treated with respect