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Making Pastoralists Count: Geospatial Methods for the Health Surveillance of Nomadic Populations

Hannah Wild, Luke Glowacki, Stace Maples, Iván Mejía-Guevara, Amy Krystosik, Matthew H. Bonds, Abiy Hiruy, A. Desiree LaBeaud, Michele Barry
doi: https://doi.org/10.1101/572685
Hannah Wild
1Stanford University School of Medicine, Stanford, CA, USA
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  • For correspondence: hwild@stanford.edu glowacki@psu.edu
Luke Glowacki
2Department of Anthropology, Pennsylvania State University
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  • For correspondence: hwild@stanford.edu glowacki@psu.edu
Stace Maples
3Stanford Geospatial Center, Stanford University, Stanford, CA, USA,
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  • For correspondence: stacemaples@stanford.edu
Iván Mejía-Guevara
4Department of Biology, Stanford University; Stanford Center for Population Health Sciences, Stanford University School of Medicine, Stanford, CA, USA,
5Department of Pediatrics, Division of Infectious Disease, Stanford University School of Medicine, Stanford, CA, USA,
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  • For correspondence: imejia@stanford.edu akrystos@stanford.edu
Amy Krystosik
6Department of Global Health & Social Medicine, Harvard Medical School, Boston, MA, USA,
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  • For correspondence: matthew_bonds@hms.harvard.edu
Matthew H. Bonds
7Pathfinder International, Addis Ababa, Ethiopia,
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  • For correspondence: ahiruy@pathfinder.org
Abiy Hiruy
8Department of Pediatrics, Division of Infectious Disease, Stanford University School of Medicine, Stanford, CA, USA,
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  • For correspondence: dlabeaud@stanford.edu
A. Desiree LaBeaud
6Department of Global Health & Social Medicine, Harvard Medical School, Boston, MA, USA,
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  • For correspondence: matthew_bonds@hms.harvard.edu
Michele Barry
9The Center for Innovation in Global Health, Stanford University, Stanford, CA, USA,
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  • For correspondence: michele.barry@stanford.edu
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Abstract

Nomadic pastoralists are among the world’s hardest-to-reach and least-served populations. Pastoralist communities are notoriously difficult to capture in household surveys due to factors including their high degree of mobility, the remote terrain they inhabit, fluid domestic arrangements, and cultural barriers. Most surveys utilize census-based sampling frames which do not accurately capture the demographic and health parameters of nomadic populations. As a result, pastoralists are largely “invisible” in population data such as the Demographic and Health Surveys (DHS). By combining remote sensing and geospatial analysis, we developed an alternative 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 assessed the MCH status of this population in order to draw comparisons with regional and national data. We find substantial disparities between our data collected using a geospatial sampling frame and regional DHS data in core MCH indicators including vaccination coverage, skilled birth attendance, and nutritional status. Census-based measures do not adequately capture population-level characteristics, risking substantial misreporting of the health status of mobile populations. Our study is the first to employ a geospatial survey of a nomadic group at the population level, and our field validation demonstrates that this methodology is a logistically feasible alternative to conventional sampling frames. Geospatial sampling methods open up cost-affordable and logistically feasible strategies for sampling pastoralists and other mobile populations, which is a crucial first step towards reaching these underserved groups with health services.

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Posted March 15, 2019.
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Making Pastoralists Count: Geospatial Methods for the Health Surveillance of Nomadic Populations
Hannah Wild, Luke Glowacki, Stace Maples, Iván Mejía-Guevara, Amy Krystosik, Matthew H. Bonds, Abiy Hiruy, A. Desiree LaBeaud, Michele Barry
bioRxiv 572685; doi: https://doi.org/10.1101/572685
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Making Pastoralists Count: Geospatial Methods for the Health Surveillance of Nomadic Populations
Hannah Wild, Luke Glowacki, Stace Maples, Iván Mejía-Guevara, Amy Krystosik, Matthew H. Bonds, Abiy Hiruy, A. Desiree LaBeaud, Michele Barry
bioRxiv 572685; doi: https://doi.org/10.1101/572685

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