CROSS-SECTIONAL HOUSEHOLD SURVEYS OF DIARRHEAL DISEASES - A COMPARISON OF DATA FROM THE CONTROL OF DIARRHEAL DISEASES AND DEMOGRAPHIC AND HEALTH SURVEYS PROGRAMS

Cross-sectional household surveys are extensively used for data collec tion, priority setting and programme evaluation in developing countrie s. They are now being promoted to assess a number of health care inter ventions such as Control of Diarrhoeal Diseases (CDD), Expanded Progra mme on Immunization (EPI), AIDS control and child survival programmes. Few field studies of the validity and precision of data generated fro m these surveys have been carried out, in part because such work is ra ther demanding of resources. The purpose of this study was to draw con clusions on validity and reliability of data from household surveys th rough a comparison of results from large-scale surveys on diarrhoea co nducted by CDD and Demographic and Health Surveys (DHS) programmes in developing countries. Diarrhoea prevalence and treatment were compared for nine surveys for which little time had passed in between the CDD and DHS survey. The variation in results between the surveys was in ma ny instances too large to be explained only by a true variation in the variable studied. A literature review suggested that validity problem s could be due to response and recall errors. The authors caution the use of frequent household surveys for programme impact evaluation. The ir costeffectiveness should be carefully assessed, especially when ser vices' evaluations already have provided evidence that a programme has had a positive effect on the behaviour of health workers and target g roups in the community. It is recommended that more research be carrie d out on how selection and training of surveyors can be improved to ma ke the quality of household surveys in developing countries better.