Behavioural Surveillance Surveys - The Wisdom of Whores

It is also useful to develop a guide for
interviewers and supervisors, which goes
through the questionnaire one question at a
time, explaining in full the rationale behind a
question and its intended meaning. This can
be used in training and in the field, to clarify
any ambiguities or misunderstandings that
may arise. An example of one such set of
guidelines is provided in Appendix 2. This is
relevant only to the questionnaire that was
used in Zambia; other countries will have to
develop their own guidelines to accompany
locally adapted questionnaires.
Among the many items that can help
ensure quality, the following check list can
be used to improve the instrument:
• Qualitative research before the survey
to learn about the characteristics of the
sub-populations and how best to approach
them;
• Comprehensive adaptation and pre-testing
of the questionnaires that are suited to the
local context;
• Verification that the language in the
questionnaires is clear to the people being
interviewed, and that the questions are
answerable;
• Taking the time to do translation and
back-translation, to make sure that complex
concepts are interpretable in a commonly
understood manner;
• Use of self-administered questionnaires
when surveying literate populations
Time frames of key behaviors
One of the most potentially confusing
aspect of questionnaire design can be the time
frames of behaviors asked of respondents.
For example, when asking a male respondent
about whether he has had sex with a sex
worker, should the time frame for this behavior
be the past month, the past six months, or the
past year?
People tend to remember recent behaviors
more accurately and this argues for shorter
time frames. However, if the behaviors are
not extremely common and frequent, then too
short a time frame will yield few respondents,
making it difficult to track trends in the
behavior over time with any degree of statistical
confidence. The time frames of the indicators
contained in this document and the questions
in the questionnaires are the product of trying
to marry these two diverging factors so that
the time frame is convenient to the respondent
and analyzable to the researcher.
Note that changing the time frame of
behaviors in the questionnaires will yield
radically different results. This may be
appropriate because of the local context,
but it will also mean that analysis comparisons
with other surveys using different time frames
will be difficult, if not impossible.
70
C H A PTER 6 B EHAV I OR A L S U R V EI L L A NC E S U R V EY S