Lot Quality Assurance Sampling (LQAS) survey techniques
Organisation: Liverpool School of Tropical Medicine
Partners: South Sudan Research, Monitoring and Evaluation Division of the Ministry of Health
Location: UK/South Sudan
Type of grant: Core – development
Summary: Lot Quality Assurance Sampling (LQAS) survey techniques will be developed to monitor performance and impact of health services provision in IDP settlement in Awerial county, Lakes State, South Sudan in order to provide an evidence base for adapting services to needs and views of users
• Currently there is no systematic procedure for quality data to monitor performance of health services and accountability of agencies in humanitarian settings.
• Right now there is not a method to provide information needed to adjust services to precise needs and to prevent deaths, diseases and disability. Planners and managers require key information to ensure efficient service provision
• Cluster surveys are the current gold standard practice to measure performance of health services of refugees. They require large samples and are costly and complex.
• Evaluations of monitoring systems in camps have found that stakeholder and end-users struggle to use the system and interpret data (Haskew et al, 2010).
Innovation Factor: Lot Quality Assurance Sampling (LQAS) methodology provides real-time planning and management information. It uses small sample sizes to classify health or administrative geographical areas , to inform if these areas have achieved or not a pre-determined target for a given indicator. LQAS can detect variation between camp sections and help adopt “proactive” targeted interventions and actions helping to increase coverage and reduce morbidity and mortality
Innovation Phases Description: The LQAS surveys have been adopted as the tool for measuring health indicators in South Sudan. Associating both surveys, health officers will be engaged in monitoring the performance of agencies providing care to host communities and refugees and will be able to participate in decision making. The final result should be improving care to refugees by providing services based on evidence and integration into the overall M&E framework of the host country.
Key Deliverables / Impact: The LQAS survey will measure access, quality, use, health seeking behaviour and perception of health services in camps by the refugees and provide information on their health status based on coverage of critical health outcomes.
The survey will measure performance of health providers and facilitate governance (accountability). The methodology based on small sample surveys will be more cost effective than cluster sampling surveys (five times cheaper) while providing statistically robust estimates. LQAS questionnaires can be administered using smartphones to improve data quality and facilitate analysis. Joint analysis of results immediately after data collection will advance ownership and action. The survey can be replicated at regular intervals to measure impact of health interventions. The interval length depends on the available financing (e.g., 6-months or yearly).