The use of epidemiological tools in conflict-affected populations: open-access educational resources for policy-makers

Table of Contents

1. Welcome
2. Introduction: Epidemiology in crises
3. Ethical issues in data collection
4. Need for epidemiologic competence
5. Surveys - Introduction
6. Surveys - Description of sampling methods
7. Surveys - Sampling error, bias, accuracy, precision, & sample size
8. Surveys - Resources required for surveys
9. Surveys - Critiquing survey reports
10. Surveillance - When to do surveillance
11. Surveillance - Methods
12. Surveillance - Common problems
13. Programme data
14. Rapid assessment
15. Mortality - Indicators and their measurement
16. Mortality - Data sources
17. Mortality - Interpretation and action
18. Nutrition - Introduction and background
19. Nutrition - Indicators and their measurement
20. Nutrition - Data sources
21. Nutrition - Interpretation and action
22. Health services
23. Vaccination programmes
24. Water supply, sanitation, and shelter
25. Violence
26. Presentation of results
27. Formulating conclusions and recommendations
    1. Over-interpreting results
    2. Extrapolating results to other populations
    3. Knowing background information
    4. Interpreting in context
    5. Targeting recommendations
28. Dissemination and action

Interpreting in context

(go to Outline)

Always interpret survey results in context

Surveys are limited in what they can tell you. (See section on Limitations of surveys). Therefore, in order to formulate the best conclusions and the most useful recommendations, you should gather additional information about the causes and risk factors for the health outcomes measured in the survey. This will allow you to make recommendations which address specific problems in that specific population.

A corollary of this principle is that recommendations should be as specific as possible so that readers know exactly what interventions or program revisions you are recommending. At the same time, recommendations should be realistic. It is of no use recommending that all children in a refugee population of 200,000 eat fresh fruit and vegetables every day. This is virtually impossible because relief agencies could not possibly provide sufficient quantities nor could most refugees afford to buy such food for themselves.

To place conclusions in context and make useful, detailed, realistic recommendations, whoever formulates the conclusions and recommendations must be very familiar with the population and programmes concerned. This usually means the consultant epidemiologist must meet with program managers and community leaders to present the results and cooperatively formulate conclusions and recommendations.