Healthcare Utilization Survey in the Hybrid Model of the Surveillance for Enteric Fever in India (SEFI) Study: Processes, Monitoring, Results, and Challenges

Healthcare Utilization Survey (HCUS) aimed to determine the percentage of utilization of study facilities by the catchment population for hospitalizations due to febrile illness.

Data Collection
After obtaining informed consent, data were collected on socioeconomic and demographic variables, mortality and morbidity profile, and health-seeking behavior based on 2-week and 12-month recall. Data were gathered electronically using Survey Solutions, a survey data capture software developed by the World Bank. The questionnaire was translated into 5 regional languages and then back-translated to check for accuracy. Training modules were developed to train 84 field workers and 12 supervisors (14 field workers and 2 supervisors per site) responsible for data collection. The monitoring and evaluation team were trained separately.

Monitoring Process
The National Institute of Epidemiology (ICMR-NIE), Chennai, was responsible for the on-site field monitoring and validation of the survey. The intrinsic hierarchical workflow of the software allowed quality checks at different points during data collection: fieldworkers formed the lowest tier interviewers), and the data they collected were checked by the supervisors (second tier); the headquarters consisted of the ICMR-NIE team who performed a final check on the data collected for any quality issues (Supplementary Figure 1). If any were found at either the supervisor or headquarters level, the forms were rejected until query resolution.

The Journal of Infectious Diseases 2021;224(S5):S529–39

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