Behavioural Surveillance Surveys - The Wisdom of Whores

Behavioural Surveillance Surveys - The Wisdom of Whores Behavioural Surveillance Surveys - The Wisdom of Whores

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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

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

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