Noncommunicable diseases (NCDs) are the leading cause of death worldwide. Efficient monitoring and surveillance are cornerstones to track progress of NCD burden, related risk factors, and policy interventions. The systematic monitoring of risk factors to generate accurate and timely data is essential for a country’s ability to prioritize essential resources and make sound policy decisions to address the growing NCD burden.
With increasing access and use of mobile phones globally, opportunities exist to explore the feasibility of using mobile phone technology as an interim method to collect data and supplement household surveys. Such technologies have the potential to allow for efficiencies in producing timely, affordable, and accurate data to monitor trends, and augment traditional health surveys with new, faster mobile phone surveys.
The Bloomberg Data for Health initiative aims to strengthen the collection and use of critical public health information. One of the components of the initiative aims to explore innovative approaches to NCD surveillance, including the use of mobile phone surveys for NCDs. The main objectives of this component are to assess the feasibility, quality, and validity of nationally representative NCD Mobile Phone Surveys and propose a globally standardized protocol. The specific objectives are to:
- Implement mobile phone surveys in 10 countries and support face-to-face STEPS surveys in six overlapping countries
- Compare findings from the two methodologies
The NCD Mobile Phone Survey is a nationally representative stratified survey of adults 18 years of age and older. The survey uses standardized instruments and procedures reviewed and approved by international experts. This includes a core questionnaire with optional questions, sample design utilizing random digit dialing (RDD), data management procedures, and data collection using single or mixed-mode technology such as interactive voice response (IVR), short message service (SMS), computer-assisted telephone interviewing (CATI), or mobile web. The implementation process consists of five stages: 1) engagement and orientation; 2) mobile phone technology and pretesting; 3) data collection; 4) data management; and 5) data release and use. Details on each stage are presented in the NCD Mobile Phone Survey Process Chart (see Figure 1).
Figure 1: NCD Mobile Phone Survey Process Chart
This manual describes Surveda, a technology tool to collect data via SMS and IVR. This manual offers a high-level description of Surveda and links to complementary associated documentation such as “how-to” training briefs and videos. Future versions of this software will include mobile web and CATI as additional modes of data collection. Surveda documentation is available in the Bloomberg Philanthropies Data For Health Initiative Online Knowledge Base. Technical assistance for NCD mobile phone surveys is available from Centers for Disease Control and Prevention (CDC), in collaboration with RTI International and Innovative Support for Emergencies Diseases and Disasters (InSTEDD).
Surveda is designed to help Ministries of Health (MOH) conduct surveillance of noncommunicable diseases (NCDs) but is also a flexible tool that can be used for other purposes. Using Surveda, MOHs can collect individual-level data on NCD risk factors from respondents via SMS and IVR. In an SMS survey, respondents receive and answer questions via text messaging. In an IVR survey, respondents listen to prerecorded questions and select responses by pressing numbers on the mobile phone keypad.
Mobile phone surveys may offer several advantages relative to traditional household surveys. The primary benefits of mobile phone surveys are speed and low cost: MOHs can conduct NCD surveillance over a large geographic area quickly. Because of the low cost of mobile phone surveys, MOHs can conduct surveillance with larger sample sizes and greater frequency. Mobile phone surveys are a relatively new mode of data collection in low- and middle-income countries. As such, they cannot replace traditional face-to-face surveys for NCD surveillance. However, mobile phone surveys can be a useful supplement to face-to-face household surveys.
Key features of Surveda include the following:
Open source: The source code for Surveda is freely available online and can be modified as needed to support MOH goals.
Mixed mode: Surveda integrates SMS and IVR, allowing MOHs to contact a respondent via both SMS and IVR leveraging the strengths of both modes.
Easy-to-use interface: Surveda allows a wide range of users to create, deploy, and manage surveys. It provides a robust survey designer that supports multi-lingual and complex surveys.
Secure storage: The platform provides mechanisms to securely transport and store case level data. Data can be hosted locally at the MOH or in the cloud.
Time tested software: Surveda is built on existing software programs created by InSTEDD. This means the software is tested, reliable, and robust.
As shown in Figure 2, Surveda is a full-service survey design and implementation tool. Users upload a sample of mobile phone numbers, design a questionnaire, set schedule and modes, monitors survey progress and download data. Surveda sends surveys to respondents via mobile network operators (MNOs). Respondents send data back via MNOs and Surveda stores the data securely.