
Countdown workshop builds analytical capacity in 9 Countdown countries
21 June 2013
One of Countdown’s key objectives is to build capacity and skills in Countdown countries for performing data analysis using Countdown methodologies, enabling researchers based in those countries to produce high-impact scholarly publications in the field of reproductive, maternal, newborn and child health (RMNCH). Two streams of work are included under this objective. First, country case-studies will document progress in RMNCH in selected countries. Second, cross-country analyses will compare the achievements of different countries regarding specific aspects of RMNCH indicators.
In June 2013 at the International Center for Equity in Health, at the Post-Graduate Program in Epidemiology of the Federal University of Pelotas (Brazil), representatives from Countdown countries attended a Capacity Building Workshop on the Analysis of Coverage and Equity Data. Researchers from eight countries — Afghanistan, Pakistan, Ethiopia, Malawi, Kenya, Rwanda, Tanzania, and Peru — participated in skill-building sessions designed to help them fulfill the following objectives:
- To understand the nature of Countdown-supported research and related activities, with emphasis on country-case studies, country Countdowns, and cross-country analyses
- To gain familiarity with the standardized data sets developed for Countdown analyses developed by the Equity technical working group and housed in Pelotas, Brazil, and be able to manipulate the data sets for analysis
- To carry out standardized analysis of coverage indicators at national level, as well as on equity analyses involving sub-national breakdowns
- To acquire skills in preparing manuscripts for publication in high-impact professional journals
Participants received training in Countdown equity and coverage analyses, and acquired skills that will be useful for conducting in-depth country case-studies and cross-country analyses. They were also trained in the Lives Saved Tool (LiST), so that estimates of lives saved may be included in their analyses. Training was provided by members of Countdown’s technical working groups on Equity and Coverage, based at the Federal University of Pelotas, Johns Hopkins University, and UNICEF.
At the close of the one-week workshop, attendees remarked on the quality of the training they had received, and on the impact it will have on their research. “It was,” wrote one participant from Afghanistan, “an amazing, productive, and memorable week. We learned so much.”
Presentations, practical exercises, and datasets presented at the workshop can be downloaded below:
Workshop agenda [77 KB]
Lecture 1: Countdown to 2015 & Countdown country case studies: Scope, objectives, audience, contents, dissemination
Introduction to Countdown and country case studies [2.3 MB]
How has Niger reduced deaths among children by 40% in a decade?: country case study presentation [514 KB]
- Amouzou A, Habi O, Bensaïd K, Reduction in child mortality in Niger: a Countdown to 2015 country case study. Lancet, 21 September 2012. DOI: 10.1016/S0140-6736(12)61376-2 (PDF)
Lecture 2: Data sources – surveys: DHS & MICS, contents, coverage (time and countries), technical issues, available resources
Presentation: Survey data — DHS & MICS [795 KB]
DHS6_Questionnaires [1 MB]
DHS Guide, DHS_Statistics [1 MB]
MICS4 Questionnaire for Children Under Five [246 KB]
MICS4 Questionnaire for Individual Men [250 KB]
MICS4 Questionnaire for Individual Women (With Birth History) [492 KB]
MICS4 Questionnaire for Individual Women (Without Birth History) [450 KB]
MICS4 Questionnaire Form For Child Disability [68 KB]
Lecture 3: Countdown coverage indicators: Description of indicators, definitions, sources, uses and limitations
Presentation: Countdown Coverage Indicators [706 KB]
- PLOS Medicine collection: Measuring Coverage in Maternal, Newborn, and Child Health
Lecture 4: Mortality data and estimation: Overview of IGME methods; importance of ensuring case studies use standard methods; options for technical assistance
Presentation: Measuring Child Mortality [2.3 MB]
Levels and Trends in Child Mortality, 2012
- A Promise Renewed: 2012 Progress Report
Lecture 5: Non-survey coverage data used in the Countdown profiles: Issues related to non-survey data used in the Countdown profile (registration, interagency estimates, adjustments, etc.) for each topic: HIV, immunization, nutrition, WASH, health
Presentation: Inter-Agency Estimates — Immunization, Vitamin A, HIV/AIDS, Water and Sanitation, Maternal Health, Malaria [913 KB]
Lecture 6: The role of equity analyses in case studies
Presentation: Inter-Agency Estimates — Immunization, Vitamin A, HIV/AIDS, Water and Sanitation, Maternal Health, Malaria [974 KB]
- Victora et al, Applying an equity lens to child health and mortality: more of the same is not enough. Lancet, 19 July 2003, Volume 362, Issue 9379, 233 – 241
Lecture 7: Health equity: concept, measurement and interpretation — Defining health equity, absolute vs. relative, measures, interpretation, limitations
Presentation: What is Health Equity? [1.1 MB]
Presentation: Measuring Health Inequalities [587 KB]
- Victora et al, Co-coverage of preventive interventions and implications for child-survival strategies: evidence from national surveys. The Lancet, Volume 366, Issue 9495, Pages 1460 – 1466, 22 October 2005
- Selected Comparisons of Measures of Health Disparities: A Review Using Databases Relevant to Healthy People 2010 Cancer-Related Objectives
- Countdown 2008 Equity Analysis Group, Mind the gap: equity and trends in coverage of maternal, newborn and child health services in 54 Countdown countries. Lancet. 371 (9620): 1259-1267.
- O’Donnell et al, Analyzing Health Equity Using Household Survey Data: A Guide to Techniques and their Implementation
- Barros A, Ronsmans C, Axelson H, et al., Equity in maternal, newborn, and child health interventions in Countdown to 2015: a retrospective review of survey data from 54 countries. Lancet, 31 March 2012. 379 (9822), 1225-1233.
- A Barros, C Victora, Measuring Coverage in MNCH: Determining and Interpreting Inequalities in Coverage of Maternal, Newborn, and Child Health Interventions. PLOS Medicine: published 07 May 2013
Lecture 8: Disseminating results of country studies
Lecture 9: Time trends in equity analyses: Interpreting changes in absolute and relative inequalities, the 4-quadrant graph
Lecture 10: Next steps in country case studies
Practicum 1: Coverage: First approach to Stata and datasets; Prepare descriptive analysis of selected indicators along the continuum of care
- Practice exercise [448 KB]
- Definitions of Countdown indicators:
PDF and detailed Excel spreadsheet
- Template for graph on CoC coverage [190 KB]
- Template spreadsheet [706 KB]
- Working spreadsheet [796 KB]
Practicum 2: Coverage and equity: Working with the equity database in Excel and Stata, graphs by subgroups and the 5-dot equity plot
- Practice exercise [30 KB]
- Practice template [35 KB]
Practicum 3: Main equity indicators: Calculation of the concentration index and SII from individual and aggregated data
- Practice exercise, part 1 [25 KB] and part 2 [172 KB]
- Table for median coverage [27 KB]
Concentration index: description/formula [139 KB]
- Concentration index: worksheet [41 KB]
Practicum 4: Time trend analyses
- Practice exercise [311 KB]
- Template for equity profile [36 KB]
- Working spreadsheet [20 KB]
Equity Country Profiles – June 2012 [2.1 MB]
Country presentations
- Afghanistan:
Ethiopia: Countdown capacity building [169 KB]
Malawi: Countdown case study [566 KB]
- Pakistan:
Pakistan case study concept [603 KB]
Pakistan case study findings [544 KB]
- Peru:
Peru: Countdown Case Study [1 MB]
Peru: Exploratory Analyses [88 KB]
Rwanda: Tables and graphs [276 KB]
Tanzania: Countdown training presentation [255 KB]
Note: Additional tools developed for the Country Countdown capacity-building workshop held at the Women Deliver conference in Kuala Lumpur, Malaysia in June 2013 are available for download here.