BACKGROUND: In the developing world, household surveys provide high-quality health behavior data integral to public health program management. The Expanded Program on Immunization Contact Method (EPI-CM) is a proposed, less resource-intensive method in which health center staff incorporate health behavior questions into routine vaccination activities. No systematic evaluation of EPI-CM validity has yet been conducted. METHODS: We used concurrent household survey and EPI-CM to collect data on 4 infant health behaviors in Mali at 2 time points (8 total comparisons). Studied health behaviors were bednet use, obtaining care for fever, obtaining care for a respiratory complaint, and using oral rehydration solution for diarrhea. Household survey and EPI-CM estimates were considered equivalent if a 95% confidence interval about the difference in estimated proportions fell within the interval (-.10, .10). RESULTS: EPI-CM estimates were higher than household survey estimates for 7 of 8 unadjusted paired estimates; estimates of bednet use in 2009 met a priori equivalence criteria in a setting of high bednet use (90.5%). When we restricted household survey data to infants up-to-date on vaccinations, estimates for behaviors other than bednet use remained substantially different. CONCLUSIONS: We were unable to demonstrate that EPI-CM, as implemented, consistently produces data comparable with household survey data.
BACKGROUND: In the developing world, household surveys provide high-quality health behavior data integral to public health program management. The Expanded Program on Immunization Contact Method (EPI-CM) is a proposed, less resource-intensive method in which health center staff incorporate health behavior questions into routine vaccination activities. No systematic evaluation of EPI-CM validity has yet been conducted. METHODS: We used concurrent household survey and EPI-CM to collect data on 4 infant health behaviors in Mali at 2 time points (8 total comparisons). Studied health behaviors were bednet use, obtaining care for fever, obtaining care for a respiratory complaint, and using oral rehydration solution for diarrhea. Household survey and EPI-CM estimates were considered equivalent if a 95% confidence interval about the difference in estimated proportions fell within the interval (-.10, .10). RESULTS: EPI-CM estimates were higher than household survey estimates for 7 of 8 unadjusted paired estimates; estimates of bednet use in 2009 met a priori equivalence criteria in a setting of high bednet use (90.5%). When we restricted household survey data to infants up-to-date on vaccinations, estimates for behaviors other than bednet use remained substantially different. CONCLUSIONS: We were unable to demonstrate that EPI-CM, as implemented, consistently produces data comparable with household survey data.
Authors: Jodi L Vanden Eng; Adam Wolkon; Anatoly S Frolov; Dianne J Terlouw; M James Eliades; Kodjo Morgah; Vincent Takpa; Aboudou Dare; Yao K Sodahlon; Yao Doumanou; William A Hawley; Allen W Hightower Journal: Am J Trop Med Hyg Date: 2007-08 Impact factor: 2.345
Authors: A K Rowe; M S Deming; B Schwartz; A Wasas; D Rolka; H Rolka; J Ndoyo; K P Klugman Journal: Pediatr Infect Dis J Date: 2000-05 Impact factor: 2.129
Authors: Stanley C Wei; Jodi L Vanden Eng; Amy E Patterson; Seydou Doumbia; David G Kleinbaum; Tove K Ryman; Mahamoudou B Touré; Meredith L McMorrow Journal: J Infect Dis Date: 2012-03 Impact factor: 5.226