RT Journal Article
SR Electronic
T1 Making Pastoralists Count: Geospatial Methods for the Health Surveillance of Nomadic Populations
JF bioRxiv
FD Cold Spring Harbor Laboratory
SP 572685
DO 10.1101/572685
A1 Hannah Wild
A1 Luke Glowacki
A1 Stace Maples
A1 Iván Mejía-Guevara
A1 Amy Krystosik
A1 Matthew H. Bonds
A1 Abiy Hiruy
A1 A. Desiree LaBeaud
A1 Michele Barry
YR 2019
UL http://biorxiv.org/content/early/2019/03/15/572685.abstract
AB 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.