Analysis

This paper examines the simulation study that was conducted to assess the sampling scheme designed for the World Health Organization (WHO) Injection Safety Assessment Survey. The objective of this assessment survey is to determine whether facilities in which injections are given meet the necessary safety requirements for injection administration, equipment, supplies and waste disposal. The main parameter of interest is the proportion of health care facilities in a country that have safe injection practices.

The objective of this simulation study was to assess the accuracy and precision of the proposed sampling design. To this end, two artificial populations were created based on the two African countries of Niger and Burkina Faso, in which the pilot survey was tested. To create a wide variety of hypothetical populations, the assignment of whether a health care facility was safe or not was based on the different combinations of the population proportion of safe health care facilities in the country, the homogeneity of the districts in the country with respect to injection safety, and whether the health care facility was located in an urban or rural district.

Using the results of the simulation, a multi-factor analysis of variance was used to determine which factors affect the outcome measures of absolute bias, standard error and mean-squared error.

A typical goal of health workers in the developing world is to ascertain whether or not a population meets certain standards, such as the proportion vaccinated against a certain disease. Because populations tend to be large, and resources and time available for studies limited, it is usually necessary to select a sample from the population and then make estimates regarding the entire population. Depending upon the proportion of the sample individuals who were not vaccinated, a decision will be made as to whether the coverage is adequate or whether additional efforts must be initiated to improve coverage in the population. Several sampling methods are currently in use. Among these is a modified method of cluster sampling recommended by the Expanded Programme on Immunization (EPI) of the World Health Organization. More recently, quality assurance sampling (QAS), a method commonly used for inspecting manufactured products, has been proposed as a potentially useful method for continually monitoring health service programs. In this paper, the QAS method is described and an example of how this type of sampling might be used is provided.

This paper examines the simulation study that was conducted to assess the sampling scheme designed for the World Health Organization (WHO) Injection Safety Assessment Survey. The objective of this assessment survey is to determine whether facilities in which injections are given meet the necessary safety requirements for injection administration, equipment, supplies and waste disposal. The main parameter of interest is the proportion of health care facilities in a country that have safe injection practices.

The objective of this simulation study was to assess the accuracy and precision of the proposed sampling design. To this end, two artificial populations were created based on the two African countries of Niger and Burkina Faso, in which the pilot survey was tested. To create a wide variety of hypothetical populations, the assignment of whether a health care facility was safe or not was based on the different combinations of the population proportion of safe health care facilities in the country, the homogeneity of the districts in the country with respect to injection safety, and whether the health care facility was located in an urban or rural district.

Using the results of the simulation, a multi-factor analysis of variance was used to determine which factors affect the outcome measures of absolute bias, standard error and mean-squared error.

A typical goal of health workers in the developing world is to ascertain whether or not a population meets certain standards, such as the proportion vaccinated against a certain disease. Because populations tend to be large, and resources and time available for studies limited, it is usually necessary to select a sample from the population and then make estimates regarding the entire population. Depending upon the proportion of the sample individuals who were not vaccinated, a decision will be made as to whether the coverage is adequate or whether additional efforts must be initiated to improve coverage in the population. Several sampling methods are currently in use. Among these is a modified method of cluster sampling recommended by the Expanded Programme on Immunization (EPI) of the World Health Organization. More recently, quality assurance sampling (QAS), a method commonly used for inspecting manufactured products, has been proposed as a potentially useful method for continually monitoring health service programs. In this paper, the QAS method is described and an example of how this type of sampling might be used is provided.