For over 30 years, CDC’s Division of Reproductive Health (CDC/DRH) has helped countries around the world to develop and implement national reproductive, maternal, and infant health surveys, as well as analyze and use the resulting data to improve reproductive and health services.
As a current partner in Phase II of USAID’s MEASURE Program*, MEASURE CDC contributes to the scientific foundation on which USAID, other donors, and host country institutions can make evidence-based decisions to improve reproductive health programs.

What are population-based health surveys?

These surveys are usually national in scope interviewing thousands of reproductive age-women on reproductive, maternal, and infant health topics. The surveys provide high quality, scientific, population-based data about key health indicators that Ministries of Health and non-governmental organization (NGOs) can use to improve and more effectively target their health care services. Countries usually conduct these surveys every five years or so and thus can also document  progress toward achieving development and health objectives, such as the Millennium Development Goals.

What kind of support does CDC provide?

CDC/DRH’s scientific and technical support with surveys is designed to complement and increase the existing in-country capacity to carry out all aspects of a population-based health survey. The needs of each individual country guides the content of its survey, and the extent of the in-country technical capacity determines how much, and what kind of, assistance CDC/DRH provides.

CDC/DRH staff are internationally recognized experts in population-based surveys and have extensive experience with

• Statistical design
• Questionnaire development
• Data entry and management
• Complex analysis

Beyond conducting these scientific surveys, CDC/DRH staff can also provide guidance and training in disseminating and using the survey data to maximize their impact and utility. Through technical seminars and workshops, secondary analyses, and special publications, CDC/DRH staff focus their efforts on ensuring that the survey findings are used to improve programs and inform policies in the countries that conduct the surveys.

What are the steps in conducting a survey, and how does CDC help?

CDC/DRH technical assistance is intended to guide partner countries through the highly technical aspects of designing, implementing, and analyzing surveys. The CDC/DRH model of technical assistance assumes that the implementing organization—the “Country Survey Team”—has staff with the necessary basic training and experience in survey research or public health. Counterpart survey implementing organizations have included National Statistical Offices (NSOs), NGOs and universities.

The level of technical assistance from CDC is negotiated in advance and is designed to meet the needs of the Country Survey Team. Those with greater experience with surveys may need less technical assistance.

Surveys usually take between two and a half and three years from start to finish (from survey planning to data dissemination and use).

The typical role and responsibilities of CDC/DRH, and associated travel to the host country anticipated for the survey, include

1. Planning—CDC/DRH conducts a planning visit to meet counterparts, review and finalize the scope of work, review and comment on field budgets, and discuss the questionnaire design, sample design, and timeline for the survey. In some cases, CDC/DRH can help the country survey team develop fundraising strategies. Before and after the visit, CDC participation includes frequent e-mail and telephone contact with the country survey team.
2. Questionnaire Design—CDC/DRH works with the country survey team to ensure that the questionnaire is well designed and to include questions on topics of particular interest to the country.
3. Pretest—CDC/DRH staff members participate with the country survey team in the pretest of the questionnaires. The pretest generally lasts 5–7 days, including training of pretest field staff. CDC then participates in meetings with the country survey team and stakeholders to review and incorporate changes and finalize the questionnaire.
4. Data Entry Set-Up—CDC/DRH CSPro specialists prepare the data entry/cleaning programs in CSPro after the pretest is completed and the final questionnaire is available.
5. Initiation of Survey Fieldwork—CDC/DRH staff members collaborate with the country survey team in training the survey personnel, including interviewers, supervisors, nutritionists, and data entry specialists. In addition to training data entry personnel, CDC will install the software for performing data entry/editing.
6. Data Cleaning and Analysis File Definition—Throughout the process of fieldwork (which is monitored primarily by the Country Survey Team), CDC/DRH receives and reviews the quality of data coming in from the field. From Atlanta, the CDC/DRH technical assistance team remains in constant communication with the Country Survey Team. As the fieldwork comes to an end, CDC/DRH staff members typically travel to the country to assist with creating analysis files and to work on the analysis plan for the survey. This assistance includes exporting the data to SAS or SPSS, creating all the variables needed for weighting the data and producing basic tabulations, performing any additional data cleaning required, and producing basic tables needed for a summary report (an advance report that provides data just on the key indicators only).
7. Data Analysis—Typically, members of the county survey team come to Atlanta to work intensively on the analysis for the final report. During this phase, activities focus on the tabulation plan for the final report or reports.
8. Final Report Writing—CDC/DRH collaborates with the country survey team to produce the final report, write the text of selected chapters of the report, and review drafts. The level of CDC/DRH’s involvement and responsibility depends on the available expertise in the host country and is negotiated in advance.
9. Final Dissemination Seminar—Typically, CDC/DRH staff participate in a national seminar presenting the principal survey findings to invited participants.
10. Data Dissemination—To facilitate further use of the data, CDC prepares a final analysis data set that is put on a CD-ROM in various formats along with documentation on how to use it. Web availability of the data set is frequently included.
11. Follow-On Activities—To disseminate the data widely and ensure its use, CDC/DRH leads or co-leads data-use workshops, produces secondary analyses of the data, and conducts or co-conducts specialized presentations. The level of CDC/DRH’s involvement in these activities is negotiated in advance.

What other survey assistance is available from CDC/DRH?

CDC/DRH welcomes the opportunity to provide assistance with additional survey data dissemination activities. Funds for technical and scientific support on such activities are usually negotiated separately from the survey technical assistance budget, as follow-on activities. Examples of activities which CDC/DRH has undertaken include assistance with:

• Topic-specific workshops for targeted audiences (e.g. gender, nutrition, family planning, reproductive health epidemiology)
• Design of Web site with the implementing organization to include the report and/or datasets.
• Data utilization workshops to train analysts in how to use the data.

CDC/DRH can also provide expert technical assistance in health surveillance (including maternal mortality surveillance), reproductive health epidemiology research and training, and reproductive health assessment for refugee and other displaced populations.

How do you budget for a survey?

When budgeting for a survey, a country needs to not only take into account the cost of CDC/DRH’s Technical Assistance but must also prepare field budgets. Field budgets are separate, and funds are administered through a local organization, usually directly by the survey-implementing organization. Funding for CDC’s technical assistance can be allocated up front or staggered over the life of the project. CDC/DRH will provide a budget for its technical assistance upon request and can provide guidance in developing a field budget.

How does a country access CDC’s assistance?

CDC/DRH’s Reproductive Health Survey activities are funded by the United States Agency for International Development. In developing countries, government agencies such as ministries of health, national statistics institutes, and universities, as well as non-governmental family planning and reproductive health organizations, are potentially eligible for CDC technical assistance. To request assistance, contact the Health, Population and Nutrition Officer at The United States Agency for International Development Mission in your country to determine whether the mission is willing to support the activity.

Page last reviewed: 5/13/09
Page last modified: 5/13/09
Content source: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion