PMID- 28789627 OWN - NLM STAT- MEDLINE DCOM- 20180228 LR - 20181202 IS - 1471-2458 (Electronic) IS - 1471-2458 (Linking) VI - 17 IP - 1 DP - 2017 Aug 8 TI - Using lot quality assurance sampling to assess access to water, sanitation and hygiene services in a refugee camp setting in South Sudan: a feasibility study. PG - 643 LID - 10.1186/s12889-017-4656-2 [doi] LID - 643 AB - BACKGROUND: Humanitarian agencies working in refugee camp settings require rapid assessment methods to measure the needs of the populations they serve. Due to the high level of dependency of refugees, agencies need to carry out these assessments. Lot Quality Assurance Sampling (LQAS) is a method commonly used in development settings to assess populations living in a project catchment area to identify their greatest needs. LQAS could be well suited to serve the needs of refugee populations, but it has rarely been used in humanitarian settings. We adapted and implemented an LQAS survey design in Batil refugee camp, South Sudan in May 2013 to measure the added value of using it for sub-camp level assessment. METHODS: Using pre-existing divisions within the camp, we divided the Batil catchment area into six contiguous segments, called 'supervision areas' (SA). Six teams of two data collectors randomly selected 19 respondents in each SA, who they interviewed to collect information on water, sanitation, hygiene, and diarrhoea prevalence. These findings were aggregated into a stratified random sample of 114 respondents, and the results were analysed to produce a coverage estimate with 95% confidence interval for the camp and to prioritize SAs within the camp. RESULTS: The survey provided coverage estimates on WASH indicators as well as evidence that areas of the camp closer to the main road, to clinics and to the market were better served than areas at the periphery of the camp. This assumption did not hold for all services, however, as sanitation services were uniformly high regardless of location. While it was necessary to adapt the standard LQAS protocol used in low-resource communities, the LQAS model proved to be feasible in a refugee camp setting, and program managers found the results useful at both the catchment area and SA level. CONCLUSIONS: This study, one of the few adaptations of LQAS for a camp setting, shows that it is a feasible method for regular monitoring, with the added value of enabling camp managers to identify and advocate for the least served areas within the camp. Feedback on the results from stakeholders was overwhelmingly positive. FAU - Harding, Elizabeth AU - Harding E AD - Medecins Sans Frontieres, Plantage Middenlaan 14, 1018 DD, Amsterdam, Netherlands. AD - Liverpool School of Tropical Medicine, Pembroke Pl, Liverpool, Merseyside, L3 5QA, UK. FAU - Beckworth, Colin AU - Beckworth C AD - Liverpool School of Tropical Medicine, Pembroke Pl, Liverpool, Merseyside, L3 5QA, UK. cbeckworth74@gmail.com. FAU - Fesselet, Jean-Francois AU - Fesselet JF AD - Medecins Sans Frontieres, Plantage Middenlaan 14, 1018 DD, Amsterdam, Netherlands. FAU - Lenglet, Annick AU - Lenglet A AD - Medecins Sans Frontieres, Plantage Middenlaan 14, 1018 DD, Amsterdam, Netherlands. FAU - Lako, Richard AU - Lako R AD - Ministry of Health, Juba, South Sudan. FAU - Valadez, Joseph J AU - Valadez JJ AD - Liverpool School of Tropical Medicine, Pembroke Pl, Liverpool, Merseyside, L3 5QA, UK. LA - eng PT - Journal Article DEP - 20170808 PL - England TA - BMC Public Health JT - BMC public health JID - 100968562 RN - 059QF0KO0R (Water) SB - IM MH - Diarrhea/*epidemiology MH - Feasibility Studies MH - Female MH - Humans MH - Hygiene/*standards MH - Lot Quality Assurance Sampling/*methods MH - Prevalence MH - *Refugee Camps MH - Sanitation/*standards MH - South Sudan/epidemiology MH - Surveys and Questionnaires MH - Water/*standards PMC - PMC5549393 OTO - NOTNLM OT - Humanitarian assistance OT - LQAS OT - Lot quality assurance sampling OT - Maban county OT - Monitoring and evaluation OT - Refugee health OT - Sanitation and hygiene OT - South Sudan OT - Water COIS- AUTHORS' INFORMATION: LH: RN, MSc, Head of Mission, MSF South Sudan Country office. CB: RN, MSc, M&E specialist, LSTM. JF: WatSan unit Coordinator, Public Health Department, MSF-OCA/Artsen Zonder Grenzen. AL: MSc, Epidemiology Advisor MSF-OCA/Artsen Zonder Grenzen. RL: MD, MSc, Director General for Policy, Monitoring, Evaluation and Research, Ministry of Health of South Sudan. JJV: PhD, DSc, MPH, Professor of International Health, LSTM. ETHICS APPROVAL AND CONSENT TO PARTICIPATE: The study was approved by the Ministry of Health for South Sudan, and ethical approval was provided by the Liverpool School of Tropical Medicine's ethics review committee. Verbal consent was obtained from all participants. CONSENT FOR PUBLICATION: Not applicable. COMPETING INTERESTS: The authors declare that they have no competing interests. PUBLISHER'S NOTE: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. EDAT- 2017/08/10 06:00 MHDA- 2018/03/01 06:00 PMCR- 2017/08/08 CRDT- 2017/08/10 06:00 PHST- 2015/09/18 00:00 [received] PHST- 2017/07/31 00:00 [accepted] PHST- 2017/08/10 06:00 [entrez] PHST- 2017/08/10 06:00 [pubmed] PHST- 2018/03/01 06:00 [medline] PHST- 2017/08/08 00:00 [pmc-release] AID - 10.1186/s12889-017-4656-2 [pii] AID - 4656 [pii] AID - 10.1186/s12889-017-4656-2 [doi] PST - epublish SO - BMC Public Health. 2017 Aug 8;17(1):643. doi: 10.1186/s12889-017-4656-2.