Behavioural Surveillance Surveys - The Wisdom of Whores
Behavioural Surveillance Surveys - The Wisdom of Whores Behavioural Surveillance Surveys - The Wisdom of Whores
2 Setting up BSS : steps in the process This chapter describes the process of setting up and conducting BSS. These steps include a preparatory phase of building up relationships with people who will be involved in collecting and using the data and defining their needs. Appropriate groups for surveillance must be chosen, the feasibility of quality data collection in these groups assessed, and sampling frames developed. Implementation of data collection follows, with the dataset analyzed and finally, the results disseminated and used to improve prevention programming. This chapter gives a preliminary overview of these processes. Individual steps are covered in far greater detail in subsequent chapters. It is important to recognize that the process of setting up behavioral surveys is not as linear as this series of steps might suggest. Rather, it is an iterative process. Information gathered or conclusions reached in one step, such as site selection and mapping, may lead to the review of decisions made at other steps, such as the definition of measurement objectives. The whole process seeks to established a delicate balance between what is most useful and what is most feasible. Step1 : Building partnerships In planning for behavioral data collection, it is important that a number of groups and individuals agree on the goals of the data collection as well as the practicalities. The following section outlines the groups who are most likely to be key to this process ; after that comes a discussion of the issues around which consensus is most important. B EHAV I OR A L S U R V EI L L A NC E SURV EY S CHAPTER 2 11
The process of building partnerships and agreement is fundamental to ensuring that BSS produces results that are both usable and used. The ideas and resources contributed by different partners greatly strengthen the value of the data collected. But it is worth noting here that this process can be time-consuming and occasionally frustrating, especially during the very first round of BSS. Those managing the process would do well to plan realistically for the time and resources consumed by this preparatory phase. Public health officials and other government agencies BSS is a core part of a second generation surveillance system for HIV. It is therefore most likely to occur under the leadership of the national AIDS program or a national epidemiological monitoring center. Besides managing the systems that generate HIV surveillance data (both behavioral and serological) public health officials are likely to be the prime users of the data. The whole point of surveillance systems is, after all, to provide information to improve the prevention and care programs led by these same officials. It should be noted that this leadership role does not mean that public health officials necessarily have to implement the surveys themselves. Staff in national AIDS programs are often overworked as it is, and experience with social and behavioral research may be limited among program staff. The surveys and the data analysis may be undertaken by a variety of institutions, ranging from local universities to market research firms to non-governmental development organizations. But if the results of the data collection are to meet their needs, program officials will want to maintain a leading role in overseeing the choice of respondent groups, indicators, etc., as well as in disseminating the data and lobbying for its effective use. Public health officials in the national AIDS program and elsewhere are also well placed to seek support from other quarters of government. Often, formal approval for research on human subjects must be sought from national authorities, often in a ministry of science and technology. Various other ministries may also be able to help facilitate access to groups to be included in surveillance. Education officials can help provide a sampling frame and work to secure head teacher support for surveys among students, for example, while the defense ministry might facilitate access to groups of soldiers. Agencies that might obstruct progress if they misunderstand the purpose and goals of behavioral surveillance should also be consulted early on. The support of the interior ministry or the police authorities can be crucial to the smooth implementation of BSS among groups such as drug injectors whose behavior is illegal. Once these authorities are fully informed of the purpose of BSS by their colleagues in the health ministry, they are often in a position to offer constructive suggestions which will improve the eventual outcome of the data collection exercise. Organizations providing services to communities at risk for HIV In many countries, the majority of services for members of sub-populations at especially high risk of exposure to HIV are provided by non-governmental organizations (NGOs). These NGOs have an important contribution to make in planning BSS activities for two main reasons. 12 C H A PTER 2 B EHAV I OR A L S U R V EI L L A NC E S U R V EY S
- Page 1 and 2: BEHAVIORAL SURVEILLANCE SURVEYS GUI
- Page 3 and 4: Family Health International (FHI) H
- Page 5 and 6: Chapter 7 Analysis and interpretati
- Page 7 and 8: 3. Choosing populations for behavio
- Page 9 and 10: G UIDELINES FOR REPEATED BEHAVIORAL
- Page 11 and 12: Recognizing that HIV surveillance d
- Page 13 and 14: Different approaches to collecting
- Page 15 and 16: The principal rationale for focusin
- Page 17 and 18: It is not possible to validate data
- Page 19: GUIDELINES FOR REPEATED BEHAVIORAL
- Page 23 and 24: Funders of HIV prevention activitie
- Page 25 and 26: What is to be measured ? Indicators
- Page 27 and 28: Step 7 : Constructing a sampling fr
- Page 29 and 30: Step 12 : Data collection and super
- Page 31 and 32: choosing population groups GUIDELIN
- Page 33 and 34: the spread of HIV. For this reason,
- Page 35 and 36: In some circumstances, public healt
- Page 37 and 38: GUIDELINES FOR REPEATED BEHAVIORAL
- Page 39 and 40: The majority of sub-populations of
- Page 41 and 42: In the end, the issue boils down to
- Page 43 and 44: In looking at behaviors of hard-to-
- Page 45 and 46: Maps derived from program planning
- Page 47 and 48: Selecting primary sampling units (c
- Page 49 and 50: ...when measures of size are not av
- Page 51 and 52: If there is no reason to believe th
- Page 53 and 54: Figure 3 : Decision tree for first-
- Page 55 and 56: Implications of alternative samplin
- Page 57 and 58: Table 5 : Values of Z 1-α and Z 1-
- Page 59 and 60: Table 6 : Sample size requirements
- Page 61 and 62: equired. In this case, the pros and
- Page 63 and 64: Should one- or two-tailed z-score v
- Page 65 and 66: Other measurement issues for BSS Th
- Page 67 and 68: A “low-tech” solution to the pr
- Page 69 and 70: 5 Weighting in multi-stage sampling
2<br />
Setting up<br />
BSS : steps in the process<br />
This chapter describes the process <strong>of</strong> setting up and conducting BSS.<br />
<strong>The</strong>se steps include a preparatory phase <strong>of</strong> building up relationships<br />
with people who will be involved in collecting and using the data and<br />
defining their needs. Appropriate groups for surveillance must be chosen,<br />
the feasibility <strong>of</strong> quality data collection in these groups assessed, and<br />
sampling frames developed. Implementation <strong>of</strong> data collection follows, with<br />
the dataset analyzed and finally, the results disseminated and used to<br />
improve prevention programming.<br />
This chapter gives a preliminary overview <strong>of</strong><br />
these processes. Individual steps are covered<br />
in far greater detail in subsequent chapters.<br />
It is important to recognize that the process <strong>of</strong><br />
setting up behavioral surveys is not as linear<br />
as this series <strong>of</strong> steps might suggest. Rather,<br />
it is an iterative process. Information gathered<br />
or conclusions reached in one step, such as<br />
site selection and mapping, may lead to the<br />
review <strong>of</strong> decisions made at other steps, such<br />
as the definition <strong>of</strong> measurement objectives.<br />
<strong>The</strong> whole process seeks to established a<br />
delicate balance between what is most useful<br />
and what is most feasible.<br />
Step1 : Building partnerships<br />
In planning for behavioral data collection,<br />
it is important that a number <strong>of</strong> groups and<br />
individuals agree on the goals <strong>of</strong> the data<br />
collection as well as the practicalities.<br />
<strong>The</strong> following section outlines the groups<br />
who are most likely to be key to this process ;<br />
after that comes a discussion <strong>of</strong> the issues<br />
around which consensus is most important.<br />
B EHAV I OR A L S U R V EI L L A NC E SURV EY S CHAPTER 2<br />
11