Design a Health Household Survey

You are a senior MEAL specialist with expertise in health survey design and epidemiological data collection. Your task is to design a comprehensive Health Household Survey for a health program.

Survey Context:

• Program name: the health program requiring a survey
• Survey purpose: the reason for conducting the survey
• Target population: the survey respondent groups
• Geographic scope: the survey coverage area
• Sample size estimate: the approximate number of households
• Donor: the primary funding agency
• Comparable data sources: existing surveys or data for benchmarking

Deliverables:

1. Survey Objectives and Design

• Primary and secondary survey objectives
• Survey type (cross-sectional, repeated cross-section, panel)
• Analytical framework: which indicators require comparison to baseline, which to national benchmarks
• Hypothesis statements for key outcome indicators

2. Sampling Strategy

• Sampling frame and source (census data, beneficiary lists, community registers)
• Multi-stage cluster sampling design: stage 1 (cluster/village selection using PPS), stage 2 (household selection using random walk or listing)
• Stratification variables (urban/rural, intervention/comparison, district)
• Sample size calculation showing assumptions: confidence level, margin of error, design effect, expected response rate, key indicator prevalence
• Oversampling provisions for subgroups if needed
• Inclusion and exclusion criteria for respondent eligibility

3. Questionnaire Modules Design the following validated modules with specific question references:

Module A: Household Identification and Demographics

• Household roster (age, sex, relationship to head, education, disability using Washington Group Short Set)
• Socioeconomic status (asset-based wealth index questions aligned to DHS)

Module B: Maternal Health

• Antenatal care visits (number, timing, content of care per WHO ANC guidelines)
• Place and type of delivery (facility vs. home, skilled birth attendant presence)
• Postnatal care (timing and content of PNC visits per WHO recommendations)
• Knowledge of obstetric danger signs (spontaneous recall with probe list)
• Family planning (current use, method mix, unmet need per DHS standard questions)

Module C: Child Health and Immunization

• Vaccination status by antigen (BCG, OPV, Penta/DPT, measles, rotavirus) using card verification plus maternal recall per WHO/UNICEF coverage survey methodology
• Recent illness (diarrhea, fever, ARI in past 2 weeks per MICS standard module)
• Care-seeking behavior for child illness (timing, provider, treatment received)
• Vitamin A supplementation and deworming

Module D: Nutrition

• Infant and Young Child Feeding: Early initiation of breastfeeding, exclusive breastfeeding, minimum dietary diversity, minimum meal frequency, minimum acceptable diet (WHO IYCF indicators)
• Anthropometry protocols: weight-for-age, height-for-age, weight-for-height, MUAC (measurement procedures, equipment specifications, standardization protocol)
• Maternal nutrition: dietary diversity, MUAC

Module E: WASH

• Drinking water source and treatment (JMP classification questions)
• Sanitation facility type (JMP classification)
• Handwashing facility observation (soap and water availability)
• Menstrual hygiene management (if age-appropriate)

4. Quality Assurance Protocols

• Enumerator selection criteria and training plan (content, duration, practice interviews)
• Piloting plan: number of pilot interviews, locations, feedback incorporation
• Supervisor-to-enumerator ratio and supervision checklist
• Daily data quality checks: completeness, skip logic verification, outlier detection
• Back-check interviews (minimum 10% resurvey on key questions)
• Anthropometry standardization test (TEM calculation for weight and height measurers)

5. Ethical Considerations

• Informed consent script (verbal, written, or both)
• Respondent confidentiality protections
• Referral protocols for identified health concerns
• IRB or ethical review board requirements
• Data protection and storage protocols

6. Data Management Plan

• Digital data collection platform (KoboToolbox, ODK, SurveyCTO)
• Skip logic and validation rules
• Data cleaning protocol and timeline
• Analysis plan outline: descriptive statistics, bivariate analysis, logistic regression for key outcomes
• Indicator calculation specifications aligned to DHS/MICS definitions

Align questionnaire modules to DHS-8, MICS6, and WHO standard survey tools. Include question numbering and skip patterns.