Behavioural Surveillance Surveys - The Wisdom of Whores

Maps derived from program planning exercises
Mapping can also be an important part
of planning interventions. For example,
ethnographic mapping in the early stages
of a program in Nepal illustrated that long
distance drivers did not tend to congregate in
truck stops along major roads. The mapping
process included interviews with transport
workers where each respondent was asked to
draw the preferred locations for commercial
sex, on a road map of Nepal. The maps
identified small rest stops along the major
east-west and north-south transport routes
leading from India into Nepal. Transport
workers preferred remote, highway-based tea
shops, restaurants, and lodges as rest and
entertainment sites, over similar establishments
in large urban locations. In Nepal, truck
drivers and their assistants said they would
rather rest and relax at small roadside
locations where there is plenty of space to
park and maintain their trucks, and where
they are not bothered by police and others.
Given men’s preferences for remote,
out-of-the-way locations and sex workers’
identification with transient lifestyles, it was
determined that the Nepal program’s
geographical focus should expand beyond
Nepal’s major urban centers to include smaller
commercial centers, transport bazaars, and
small rest stops adjacent to Nepal’s major
highways. This mapping exercise ultimately
allowed the project to reach the target
population more effectively. The same type
of procedure may be used to create an
appropriate sampling frame.
In some cases, it may not be financially or
logistically feasible to create a sampling frame
for the entire population universe for a given
sub-population. In this case, the only option
that still meets the criteria for probability
sampling is to restrict the universe to one
part of the larger population, and to create a
sampling frame for that part alone.
For example, in a large country it might not be
feasible to develop a sampling frame for all
major cities, and thus a decision might be
made to limit a behavioral survey effort to
only the largest cities. In this event, it should
be made absolutely clear that the results
cannot be extrapolated to smaller cities or
rural areas.
Regardless of the process that is used to
help learn about where members of a
sub-population are located, the mapping of
groups in a particular geographic area is likely
to be an ongoing process in which maps are
continually refined as new information
becomes available. In addition, triangulation
of data from several sources is necessary to
obtain comprehensive and accurate information.
Basic two-stage sample design
Most sub-population surveys will use a
two-stage sample design. Primary sampling
units (PSUs) or clusters are chosen at the first
stage of sample selection, and individual
respondents are chosen from within each
of the selected PSUs at the second stage.
This sampling scheme, adapted to meet the
needs of the different sub-populations and
local conditions, will likely satisfy the needs
of most BSS efforts. The basic two-stage
cluster sample design and some of the major
design options are described in this chapter.
Examples of how these designs can practically
be adapted and applied to different respondent
groups appear in Appendix 2.
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C H A PTER 4 B EHAV I OR A L S U R V EI L L A NC E S U R V EY S