Department of Global Health and Population, Harvard School of Public Health, Boston, MA, USA.
Int J Epidemiol. 2010 Feb;39(1):72-9. doi: 10.1093/ije/dyp363.
Large investments and increased global prioritization of malaria prevention and treatment have resulted in greater emphasis on programme monitoring and evaluation (M&E) in many countries. Many countries currently use large multistage cluster sample surveys to monitor malaria outcome indicators on a regional and national level. However, these surveys often mask local-level variability important to programme management. Lot Quality Assurance Sampling (LQAS) has played a valuable role for local-level programme M&E. If incorporated into these larger surveys, it would provide a comprehensive M&E plan at little, if any, extra cost.
The Mozambique Ministry of Health conducted a Malaria Indicator Survey (MIS) in June and July 2007. We applied LQAS classification rules to the 345 sampled enumeration areas to demonstrate identifying high- and low-performing areas with respect to two malaria program indicators-'household possession of any bednet' and 'household possession of any insecticide-treated bednet (ITN)'.
As shown by the MIS, no province in Mozambique achieved the 70% coverage target for household possession of bednets or ITNs. By applying LQAS classification rules to the data, we identify 266 of the 345 enumeration areas as having bednet coverage severely below the 70% target. An additional 73 were identified with low ITN coverage.
This article demonstrates the feasibility of integrating LQAS into multistage cluster sampling surveys and using these results to support a comprehensive national, regional and local programme M&E system. Furthermore, in the recommendations we outlined how to integrate the Large Country-LQAS design into macro-surveys while still obtaining results available through current sampling practices.
疟疾预防和治疗的大量投资以及全球优先地位的提高，使得许多国家更加重视规划监测和评价（M&E）。许多国家目前使用多阶段聚类抽样调查来监测区域和国家一级的疟疾结果指标。然而，这些调查往往掩盖了对规划管理很重要的地方一级的可变性。批量质量保证抽样（LQAS）在地方一级的规划 M&E 中发挥了宝贵作用。如果将其纳入这些更大的调查中，将以很少的（如果有的话）额外成本提供全面的 M&E 计划。
莫桑比克卫生部于 2007 年 6 月至 7 月进行了疟疾指标调查（MIS）。我们应用 LQAS 分类规则对 345 个抽样的计数区进行分类，以展示两个疟疾规划指标（“家庭拥有任何蚊帐”和“家庭拥有任何经杀虫剂处理的蚊帐（ITN）”）方面的高低绩效地区。
正如 MIS 所显示的那样，莫桑比克没有一个省达到家庭拥有蚊帐或 ITN 的 70%覆盖率目标。通过对数据应用 LQAS 分类规则，我们确定了 345 个计数区中的 266 个区域的蚊帐覆盖率严重低于 70%的目标。另有 73 个地区被确定为 ITN 覆盖率低。
本文展示了将 LQAS 纳入多阶段聚类抽样调查并利用这些结果支持全面的国家、区域和地方规划 M&E 系统的可行性。此外，在我们提出的建议中，我们概述了如何将大国-LQAS 设计纳入宏观调查，同时仍能获得当前抽样实践提供的结果。
