03129nas a2200349 4500000000100000008004100001260003700042653005700079653002400136653003400160653004000194100001400234700001600248700001400264700001100278700001300289700001200302700001600314700001400330700001500344700001400359700001600373700001200389700001700401700001700418245016700435856009900602300001300701490000700714520204400721022001402765 2020 d bPublic Library of Science (PLoS) 10 aPublic Health, Environmental and Occupational Health 10 aInfectious Diseases 10 aTrachoma Impact Surveys (TIS) 10 aTrachoma Surveillance Surveys (TSS) 1 aSlaven RP 1 aStewart AEP 1 aZerihun M 1 aSata E 1 aAstale T 1 aMelak B 1 aChanyalew M 1 aGessese D 1 aEmerson PM 1 aTadesse Z 1 aCallahan EK 1 aNash SD 1 aMcFarland DA 1 aReithinger R 00 aA cost-analysis of conducting population-based prevalence surveys for the validation of the elimination of trachoma as a public health problem in Amhara, Ethiopia uhttps://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0008401&type=printable ae0008401 0 v14 3 aBackground
Trachoma prevalence surveys, including impact surveys (TIS) and surveillance surveys (TSS), provide information to program managers on the impact of the SAFE (surgery, antibiotics, facial cleanliness, and environmental improvement) strategy and current burden of disease, and they provide a crucial component of the evidence base necessary for the validation of the elimination of trachoma as a public health problem. The prevalence surveys included in this analysis are multi-level cluster random surveys that provide population-based estimates for program planning. This study conducted an analysis of the cost of 8 rounds of TIS/TSS executed in Amhara, Ethiopia, 2012–2016, comprising 232,357 people examined over 1,828 clusters in 187 districts.
Methodology and findings
Cost data were collected retrospectively from accounting and procurement records from the implementing partner, The Carter Center, and coded by survey activity (i.e. training and field work) and input category (i.e. personnel, transportation, supplies, venue rental, and other). Estimates of staff time were obtained from The Carter Center Ethiopia. Data were analyzed by activity and input category. The mean total cost per cluster surveyed was $752 (standard deviation $101). Primary cost drivers were personnel (39.6%) and transportation (49.2%), with costs increasing in the last 3 rounds of TIS/TSS.
Conclusion
Despite the considerable cost of conducting TIS and TSS, these surveys provide necessary information for program managers. Limited options are available to reduce the costs of TIS/TSS and gain economies of scale, as the surveys must be designed to achieve their designated sample size. However, surveys must also be designed in a way that is possible to be executed given the financial resources, personnel, and time required. Program managers can use these findings to improve estimates of the total cost of a survey and its components to ensure that sufficient resources are budgeted accordingly. a1935-2735