Precision, time, and cost: a comparison of three sampling designs in an emergency setting

The conventional method to collect data on the health, nutrition, and food security status of a population affected by an emergency is a 30 × 30 cluster survey. This sampling method can be time and resource intensive and, accordingly, may not be the most appropriate one when data are needed rapidly for decision making. In this study, we compare the precision, time and cost of the 30 × 30 cluster survey with two alternative sampling designs: a 33 × 6 cluster design (33 clusters, 6 observations per cluster) and a 67 × 3 cluster design (67 clusters, 3 observations per cluster). Data for each sampling design were collected concurrently in West Darfur, Sudan in September-October 2005 in an emergency setting. Results of the study show the 30 × 30 design to provide more precise results (i.e. narrower 95% confidence intervals) than the 33 × 6 and 67 × 3 design for most child-level indicators. Exceptions are indicators of immunization and vitamin A capsule supplementation coverage which show a high intra-cluster correlation. Although the 33 × 6 and 67 × 3 designs provide wider confidence intervals than the 30 × 30 design for child anthropometric indicators, the 33 × 6 and 67 × 3 designs provide the opportunity to conduct a LQAS hypothesis test to detect whether or not a critical threshold of global acute malnutrition prevalence has been exceeded, whereas the 30 × 30 design does not. For the household-level indicators tested in this study, the 67 × 3 design provides the most precise results. However, our results show that neither the 33 × 6 nor the 67 × 3 design are appropriate for assessing indicators of mortality. In this field application, data collection for the 33 × 6 and 67 × 3 designs required substantially less time and cost than that required for the 30 × 30 design. The findings of this study suggest the 33 × 6 and 67 × 3 designs can provide useful time- and resource-saving alternatives to the 30 × 30 method of data collection in emergency settings

Biological, Programmatic and Sociopolitical Dimensions of Child Undernutrition in Three States in India

The recently developed India State Hunger Index 2008 highlights the continuing sorry state of hunger in India, and shows that children underweight makes the largest contribution to hunger index scores for most of India. In this article, we apply an assessment framework developed by the Mainstreaming Nutrition Initiative to understand three dimensions of child undernutrition in India: (1) the biological/epidemiological aspects of the nutrition situation, (2) the programmatic interventions and environment and (3) the sociopolitical environment for nutrition. We conduct this assessment for three states in India, each of which offers a distinct typology: (a) Bihar, an extremely poor northern state with high levels of undernutrition; (b) Karnataka, a southern state with high economic growth, but high child undernutrition rates; (c) Tamil Nadu, a southern state portrayed as an example of successful health and nutrition programming, but with rates of undernutrition that are still very high