By Ruth Levine
No one knows the value of household survey data more than the public health professionals at the World Health Organization. So, five months into a pandemic that threatens to drag on for years, we need the WHO to create guidelines for in-person survey data collection that minimize the health risks to survey workers, interviewees, and others with whom they might come into contact.
Household surveys are an essential element in the architecture of data for the public good. Household surveys provide analysts and decision makers with information about what work people are doing, how much income they have, where they get information, whether they have access to water, health care, and schooling, what health-promoting behaviors they engage in or forego, and much more. With the right sampling methods and sample size, household surveys can generate information that represents the whole population, and also can focus specifically on individuals and households that are at high risk of disease or are particularly affected by public health and economic relief policies. Fully one-third of all the monitoring indicators for the Sustainable Development Goals — the global priorities for human welfare — depend on household survey data.
Now, in the midst of this pandemic, just when we want and need more information of the type that household surveys can yield, virtually all in-person data collection activities are on hold. It simply isn’t considered safe in most countries for workers to travel to remote sites, and to move from house to house to interview people. While some data collection can be done using phone surveys, in settings where phone ownership is not universal and no statistically valid sampling frames designed for phone surveys exist, results are likely to be biased and exclude the most vulnerable. Phone surveys also make it harder to reach women. This means the data generated is in many cases a poor second-best for making consequential decisions. At some point, likely long before COVID-19 has been vanquished, governments, NGOs, and international agencies are going to need to return to in-person data collection.
The WHO should produce a set of reasonable, evidence-based guidelines that can be used by governments and other organizations that contract with survey data collection firms or collect data themselves. Here’s a head start, for others to improve upon:
To minimize risk among data collection workers:
● Screen prospective data collection workers for known health risks, such as comorbidities
● Add a “staying healthy” module to all trainings for data collectors and supervisors, with content around preventive behaviors (e.g., social distancing, hand washing, face covering)
● Provide masks or face coverings, including spares, with instructions for use
● Provide portable containers of hand sanitizer, with instructions for use
● Arrange for solo travel to field sites (e.g., motorcycles, privately chartered vehicles)
● Establish and enforce policies for 14-day quarantine after a known exposure, and isolation and testing before returning to work when sick; policies should include pay for time off due to health considerations to align individual workers’ incentives with good health practices
To minimize risk among interviewees:
● Include language in the informed consent information about the risks of exposure during the interview
● Provide masks or face coverings to interviewees (can serve as a token of appreciation for participation)
● Limit the questionnaire length to essential information that cannot be obtained from other sources and is needed for consequential decisions
● Conduct interviews outdoors
● Eliminate questions that require verifying conditions indoor (e.g., whether a bednet is in place)
● Maintain a six-foot distance from interviewees
● Avoid any touching or sharing of materials (paper, pens, electronic tables or styluses)
● Have supervisors check with a subset of households to make sure that protocols are being followed, and/or embed a question or two in the backcheck survey
This list is based on pure common sense. Improvements will surely come from this SurveyCTO discussion on safe data collection planned for early August. Far better, though, would be official guidelines vetted by the World Health Organization, which could then be used by organizations that collect and/or contract for the collection of data. Official guidelines could be referenced in contractual arrangements with data collection firms, and could also be used as the basis for negotiation with funding agencies about the extra costs associated with safe household survey data collection during this pandemic period.
WHO, it’s your move.