title: Measuring population health: costs of alternative survey approaches in the Nouna Health and Demographic Surveillance System in rural Burkina Faso.
abstract: BACKGROUND
  There are more than 40 Health and Demographic Surveillance System (HDSS) sites in 19 different countries. The running costs of HDSS sites are high. The financing of HDSS activities is of major importance, and adding external health surveys to the HDSS is challenging. To investigate the ways of improving data quality and collection efficiency in the Nouna HDSS in Burkina Faso, the stand-alone data collection activities of the HDSS and the Household Morbidity Survey (HMS) were integrated, and the paper-based questionnaires were consolidated into a single tablet-based questionnaire, the Comprehensive Disease Assessment (CDA).
  
  
  OBJECTIVE
  The aims of this study are to estimate and compare the implementation costs of the two different survey approaches for measuring population health.
  
  
  METHODS
  All financial costs of stand-alone (HDSS and HMS) and integrated (CDA) surveys were estimated from the perspective of the implementing agency. Fixed and variable costs of survey implementation and key cost drivers were identified. The costs per household visit were calculated for both survey approaches.
  
  
  RESULTS
  While fixed costs of survey implementation were similar for the two survey approaches, there were considerable variations in variable costs, resulting in an estimated annual cost saving of about US$45,000 under the integrated survey approach. This was primarily because the costs of data management for the tablet-based CDA survey were considerably lower than for the paper-based stand-alone surveys. The cost per household visit from the integrated survey approach was US$21 compared with US$25 from the stand-alone surveys for collecting the same amount of information from 10,000 HDSS households.
  
  
  CONCLUSIONS
  The CDA tablet-based survey method appears to be feasible and efficient for collecting health and demographic data in the Nouna HDSS in rural Burkina Faso. The possibility of using the tablet-based data collection platform to improve the quality of population health data requires further exploration.
authors.affiliation: Institute of Public Health, Heidelberg University, Heidelberg, Germany.
authors.forename: Henrike
authors.initials: H
authors.lastname: Lietz
authors.affiliation: Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso.
authors.forename: Moustapha
authors.initials: M
authors.lastname: Lingani
authors.affiliation: Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso.
authors.forename: Ali
authors.initials: A
authors.lastname: Sié
authors.affiliation: Institute of Public Health, Heidelberg University, Heidelberg, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Sauerborn
authors.affiliation: Institute of Public Health, Heidelberg University, Heidelberg, Germany.
authors.forename: Aurelia
authors.initials: A
authors.lastname: Souares
authors.affiliation: Institute of Public Health, Heidelberg University, Heidelberg, Germany.|Steinhardt School of Culture, Education and Human Development and College of Global Public Health, New York University, New York, NY, USA; tozan@nyu.edu.
authors.forename: Yesim
authors.initials: Y
authors.lastname: Tozan
mesh_terms: D002050:Burkina Faso / Q000453:epidemiology; D003365:Costs and Cost Analysis; D006306:Health Surveys / Q000191:economics* / Q000379:methods*; D006801:Humans; D017059:Models, Econometric; D011159:Population Surveillance / Q000379:methods*; D012959:Socioeconomic Factors
keywords: Burkina Faso; Health and Demographic Surveillance Systems; cost analysis; data collection; health surveys; survey approaches