Assessing Child Survival Programs in Developing Countries: Testing Lot Quality Assurance Sampling

by Joseph J. Valadez

Overview

Throughout Africa, Asia, and Latin America public health professionals and paraprofessionals work to control serious, frequent and preventable causes of death and sickness among women and children. Despite international agreement about which health programs to implement and huge investments to support them, avoidable deaths remain high. One reason is the inadequate quality with which programs are implemented.

Assessing Child Survival Programs in Developing Countries provides local health system managers with basic principles for rapid precise program monitoring and evaluation in difficult tropical conditions. Joseph Valadez explains how to adapt Lot Quality Assurance Sampling (LQAS) as used in industrial quality control more than half a century ago, to assess health program coverage and technical quality of service providers. He shows that by examining no more than 19 children from a health facility catchment area a manager can judge whether coverage with child survival interventions has reached a minimal level, and how to observe health workers perform a task 6 times to judge their technical competency.

Joseph Valadez demonstrates that quick assessment is not necessarily dirty, and can provide the information needed to enhance child survival throughout the developing world. In that spirit Assessing Child Survival Programs in Developing Countries is a path breaking text book of modern health services research that both practitioners and students will find indispensable and understandable.

Product Details

ISBN-13:	9780674049956
Publisher:	Harvard University Press
Publication date:	01/01/1992
Series:	Harvard Series on Population and International Health , #1
Pages:	264
Product dimensions:	6.00(w) x 9.00(h) x 0.80(d)

About the Author

Joseph J. Valadez is Senior Monitoring and Evaluation Specialist in the Malaria Implementation Resources Team at the World Bank.

Table of Contents

Preface
Chapter 1: Assessing Health Services

• General Definition of Lot Quality Assurance Sampling
• Defining Decentralized Service Delivery
• Measurement Issues for Health Systems Managers
• Interventions Selected for Testing LQAS

Part 1: Principles for Health Program Assessment
Chapter 2: The Role of Program Assessment in Integrated Health Programs

• Defining Monitoring and Evaluation Activities
• Management Systems for Program Assessments
• A Brief Review of Monitoring and Evaluation Methods

Chapter 3: Models, Control and Validity

• Modeling Health Systems
• On the Importance of Controls When Assessing Integrated Health Programs
• Construct Validity
• Internal Validity
• Statistical Conclusion Validity
• External Validity

Part II: Lot Quality Assurance Sampling for Monitoring International Health Programs
Chapter 4: LQAS Principles

• Using EPI Cluster Sampling
• Using LQAS Using Binomials in LQAS
• Cumulative Probabilities
• Varying the Number of Permissible Inadequate Observations
• Varying Sample Size while Holding Consumer Risk Approximately Constant
• Defining Provider and Consumer Risks
• Calculating Coverage Proportions and Confidence
• Intervals with LQAS Data

Chapter 5: LQAS Field Methods for Assessing Child Survival Program Coverage

• Quality Control of Child Survival Interventions
• Choosing a Sample and Data Collection
• Alternative LQAS Designs
• Collecting Reliable Data
• A Review of the Information System
• Vaccination Coverage and Service Adequacy
• Quality of the Health System Information
• Quality of Integrated Health Interventions

Chapter 6: Assessing Technical Quality of Service Delivery

• LQAS
• Data Collection of Community Health Worker Technical Quality
• Judging Technical Quality

Chapter 7: A Cost Analysis of LQAS

• Costs of LQAS
• Data Collection through a Centralized Approach
• Data Collection through a Decentralized Approach
• An Economic Assessment of Risk and Its Association with Sample Size
• The Costs Associated with Provider Risk
• The Costs Associated with Consumer Risk
• Costs Associated with Consumer Risk in a Hypothetical
• Developing Country

Chapter 8: Aiding Policy Makers to Maintain Decentralized

• National Health Services
• Conceptualizing a Control System
• Decentralizing Health Systems
• Coordination and Policy Making
• How Much Decentralization?
• Thresholds of Health System Success and Failure
• Management and Bureaucracy in a Decentralized Health System

Chapter 9: Epilogue

• Limitations and Needed Improvements to Health Service Research
• LQAS Vis-à-Vis Other Monitoring Methods
• Post LQAS Activities
• Considerations for the Next Applications of LQAS
• Further Needed Developments of LQAS

Appendix
References