title: Comparing two survey methods of measuring health-related indicators: Lot Quality Assurance Sampling and Demographic Health Surveys.
abstract: OBJECTIVE
  Two common methods used to measure indicators for health programme monitoring and evaluation are the demographic and health surveys (DHS) and lot quality assurance sampling (LQAS); each one has different strengths. We report on both methods when utilised in comparable situations.
  
  
  METHODS
  We compared 24 indicators in south-west Uganda, where data for prevalence estimations were collected independently for the two methods in 2011 (LQAS: n = 8876; DHS: n = 1200). Data were stratified (e.g. gender and age) resulting in 37 comparisons. We used a two-sample two-sided Z-test of proportions to compare both methods.
  
  
  RESULTS
  The average difference between LQAS and DHS for 37 estimates was 0.062 (SD = 0.093; median = 0.039). The average difference among the 21 failures to reject equality of proportions was 0.010 (SD = 0.041; median = 0.009); among the 16 rejections, it was 0.130 (SD = 0.010, median = 0.118). Seven of the 16 rejections exhibited absolute differences of <0.10, which are clinically (or managerially) not significant; 5 had differences >0.10 and <0.20 (mean = 0.137, SD = 0.031) and four differences were >0.20 (mean = 0.261, SD = 0.083).
  
  
  CONCLUSIONS
  There is 75.7% agreement across the two surveys. Both methods yield regional results, but only LQAS provides information at less granular levels (e.g. the district level) where managerial action is taken. The cost advantage and localisation make LQAS feasible to conduct more frequently, and provides the possibility for real-time health outcomes monitoring.
authors.affiliation: Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
authors.forename: Sarah C
authors.initials: SC
authors.lastname: Anoke
authors.affiliation: Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Mwai
authors.affiliation: Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK.
authors.forename: Caroline
authors.initials: C
authors.lastname: Jeffery
authors.affiliation: Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK.
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Valadez
authors.affiliation: Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
authors.forename: Marcello
authors.initials: M
authors.lastname: Pagano
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003365:Costs and Cost Analysis; D003695:Delivery of Health Care / Q000592:standards*; D005260:Female; D006306:Health Surveys / Q000379:methods* / Q000592:standards; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D055810:Lot Quality Assurance Sampling / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D015397:Program Evaluation / Q000379:methods*; D011785:Quality Assurance, Health Care / Q000379:methods*; D012111:Residence Characteristics; D012424:Rural Population; D011795:Surveys and Questionnaires; D014454:Uganda; D014505:Urban Population; D055815:Young Adult
keywords: Uganda; cluster sampling; demographic and health survey; lot quality assurance sampling; monitoring and evaluation; stratified sampling