A Brief Overview of A Brief Overview of Lot Quality Assurance Lot Quality Assurance
Sampling (LQAS) Sampling (LQAS) and its application in the and its application in the
Health SectorHealth Sector
Joseph Valadez, PhD, ScD, MPHJoseph Valadez, PhD, ScD, MPH
Liverpool School of Tropical MedicineLiverpool School of Tropical Medicine
January 2010January 2010
A
B
C
DE
F G
Good
Below Averageor EstablishedBenchmark
Good
Below Average or Established Benchmark
Identify the reasons for program problems
Develop targeted solutions
Maintain the program at the current level
Identify Supervisors and Health Workers that can help other HealthWorkers improve their performance
What is LQAS?What is LQAS?An analysis method that can be used locally toAn analysis method that can be used locally to– identify health administrative units that identify health administrative units that fail to reach fail to reach an an
established established performance benchmark performance benchmark for an indicatorfor an indicator– support local management decision making support local management decision making by sharing by sharing
information across different health administrative units.information across different health administrative units.
Estimate Estimate coverage at an aggregate levelcoverage at an aggregate level (e.g., district or state or nation) Catchment Area (e.g., district or state or nation) Catchment Area– Suitable for Reporting PurposesSuitable for Reporting Purposes
LQAS uses LQAS uses small samplessmall samples– Most frequently used size = <20 per one admin unitMost frequently used size = <20 per one admin unit
Examples of countries using LQAS Examples of countries using LQAS M&E DataM&E Data
NigeriaNigeria
Eritrea Eritrea
Kenya Kenya
UgandaUganda
Advantages of LQAS for Local Program Advantages of LQAS for Local Program ManagementManagement
Can be used at a local level as it requires only Can be used at a local level as it requires only modest supervisionmodest supervision
Identifies where the successes and challenges Identifies where the successes and challenges are located using rigorous sampling theoryare located using rigorous sampling theory
Produces information that can be rapidly Produces information that can be rapidly interpreted by local managersinterpreted by local managers
Paper/pencil analyses rather than requiring Paper/pencil analyses rather than requiring computer analyses computer analyses
Data can be used for local management as well Data can be used for local management as well as for national reportingas for national reporting
Quality
Benchmark :
At least 65% (10 out of 19) Infants
sampled must have slept under
an ITN in the night preceding survey in each
health administration
unit
Children 0-11 Months Slept Under ITN Last Night
Anseba, Eritrea 2004Area Yes No Total1 9 10 192 13 6 193 18 1 194 3 16 195 11 8 196 12 7 197 18 1 198 12 7 19
Total 96 152
Insecticide TreatedBednets
Distribution of Project States by estimated coverage for ITN use by children and IPT by Pregnant Women
The small sample and pen & paper analysis make LQAS accessible to local public health practitioners: NGOs and public sector
1212
Afghanistan: Tracking ProgressAfghanistan: Tracking Progress
Recap:•LQAS is a M&E tool based on robust sampling.•Generally simple to administer once sampling frame is available and tools are standardized.•Can help to identify local health administrative units failing to reach pre-determined performance benchmarks and learning from those which achieved the benchmarks•Pooled data from different units can also be used to estimate coverage levels at sub national and national levels