title: A two-stage cluster sampling method using gridded population data, a GIS, and Google Earth(TM) imagery in a population-based mortality survey in Iraq.
abstract: BACKGROUND
  Mortality estimates can measure and monitor the impacts of conflict on a population, guide humanitarian efforts, and help to better understand the public health impacts of conflict. Vital statistics registration and surveillance systems are rarely functional in conflict settings, posing a challenge of estimating mortality using retrospective population-based surveys.
  
  
  RESULTS
  We present a two-stage cluster sampling method for application in population-based mortality surveys. The sampling method utilizes gridded population data and a geographic information system (GIS) to select clusters in the first sampling stage and Google Earth TM imagery and sampling grids to select households in the second sampling stage. The sampling method is implemented in a household mortality study in Iraq in 2011. Factors affecting feasibility and methodological quality are described.
  
  
  CONCLUSIONS
  Sampling is a challenge in retrospective population-based mortality studies and alternatives that improve on the conventional approaches are needed. The sampling strategy presented here was designed to generate a representative sample of the Iraqi population while reducing the potential for bias and considering the context specific challenges of the study setting. This sampling strategy, or variations on it, are adaptable and should be considered and tested in other conflict settings.
authors.affiliation: Faculty of Health Sciences, Simon Fraser University, Blusson Hall 8888 University Drive, Burnaby, B.C. Canada V5A 1 S6.
authors.forename: Lp
authors.initials: L
authors.lastname: Galway
authors.forename: Nathaniel
authors.initials: N
authors.lastname: Bell
authors.forename: Al Shatari
authors.initials: AS
authors.lastname: Sae
authors.forename: Amy
authors.initials: A
authors.lastname: Hagopian
authors.forename: Gilbert
authors.initials: G
authors.lastname: Burnham
authors.forename: Abraham
authors.initials: A
authors.lastname: Flaxman
authors.forename: Wiliam M
authors.initials: WM
authors.lastname: Weiss
authors.forename: Julie
authors.initials: J
authors.lastname: Rajaratnam
authors.forename: Tim K
authors.initials: TK
authors.lastname: Takaro
mesh_terms: D016000:Cluster Analysis; D005240:Feasibility Studies; D040362:Geographic Information Systems; D062306:Geography, Medical; D006801:Humans; D007493:Iraq / Q000453:epidemiology; D054542:Iraq War, 2003-2011; D009026:Mortality / Q000639:trends*; D011159:Population Surveillance / Q000379:methods*; D012494:Sampling Studies; D014584:User-Computer Interface