Making Pastoralists Count: Geospatial Methods for the Health Surveillance of Nomadic Populations
Making Pastoralists Count: Geospatial Methods for the Health Surveillance of Nomadic Populations
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DOI：
10.4269/ajtmh.18-1009
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发表时间：
2019-01-01
影响因子：
3.3
通讯作者：
Barry, Michele
中科院分区：
文献类型：
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作者：
Wild, Hannah;Glowacki, Luke;Barry, Michele
游牧民是世界上最难接触和最少得到服务的群体。牧民社区很难在住户调查中得到反映，原因包括他们在偏远地区的高度流动性、不稳定的家庭安排和文化障碍。大多数调查使用的是基于普查的抽样框架，不能准确地反映游牧人口的人口和健康参数。因此，在人口与健康调查等人口数据中，牧民是“看不见的”。通过结合遥感和地理空间分析，我们开发了一种采样策略，旨在捕捉游牧人口的当前分布。然后，我们实施了这一抽样框架，以调查人口的移动的牧民在埃塞俄比亚西南部，重点是孕产妇和儿童健康（MCH）指标。使用来自DHS问卷的标准化工具，我们与区域和国家数据进行比较，发现与DHS数据在核心妇幼保健指标方面存在差异，包括疫苗接种覆盖率，熟练助产士和营养状况。我们的实地验证表明，这种方法是一种逻辑上可行的替代传统的抽样框架，并可用于人口水平。地理空间抽样方法为移动的人口抽样提供了成本负担得起和后勤可行的战略，这是向这些群体提供保健服务的关键的第一步。
Nomadic pastoralists are among the world's hardest-to-reach and least served populations. Pastoralist communities are difficult to capture in household surveys because of factors including their high degree of mobility over remote terrain, fluid domestic arrangements, and cultural barriers. Most surveys use census-based sampling frames which do not accurately capture the demographic and health parameters of nomadic populations. As a result, pastoralists are "invisible" in population data such as the Demographic and Health Surveys (DHS). By combining remote sensing and geospatial analysis, we developed a sampling strategy designed to capture the current distribution of nomadic populations. We then implemented this sampling frame to survey a population of mobile pastoralists in southwest Ethiopia, focusing on maternal and child health (MCH) indicators. Using standardized instruments from DHS questionnaires, we draw comparisons with regional and national data finding disparities with DHS data in core MCH indicators, including vaccination coverage, skilled birth attendance, and nutritional status. Our field validation demonstrates that this method is a logistically feasible alternative to conventional sampling frames and may be used at the population level. Geospatial sampling methods provide cost-affordable and logistically feasible strategies for sampling mobile populations, a crucial first step toward reaching these groups with health services.