Addressing Unintentional Exclusion of Vulnerable and Mobile Households in Traditional Surveys in Kathmandu, Dhaka, and Hanoi: a Mixed-Methods Feasibility Study

Dana R. Thomson, Radheshyam Bhattarai, Sudeepa Khanal, Shraddha Manandhar, Rajeev Dhungel, Subash Gajurel, Joseph Paul Hicks, Duong Minh Duc, Junnatul Ferdoush, Tarana Ferdous, Nushrat Jahan Urmy, Riffat Ara Shawon, Khuong Quynh Long, Ak Narayan Poudel, Chris Cartwright, Hilary Wallace, Tim Ensor, Sushil Baral, Saidur Mashreky, Rumana HuqueHoang Van Minh, Helen Elsey

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1 Citation (Scopus)

Abstract

The methods used in low- and middle-income countries’ (LMICs) household surveys have not changed in four decades; however, LMIC societies have changed substantially and now face unprecedented rates of urbanization and urbanization of poverty. This mismatch may result in unintentional exclusion of vulnerable and mobile urban populations. We compare three survey method innovations with standard survey methods in Kathmandu, Dhaka, and Hanoi and summarize feasibility of our innovative methods in terms of time, cost, skill requirements, and experiences. We used descriptive statistics and regression techniques to compare respondent characteristics in samples drawn with innovative versus standard survey designs and household definitions, adjusting for sample probability weights and clustering. Feasibility of innovative methods was evaluated using a thematic framework analysis of focus group discussions with survey field staff, and via survey planner budgets. We found that a common household definition excluded single adults (46.9%) and migrant-headed households (6.7%), as well as non-married (8.5%), unemployed (10.5%), disabled (9.3%), and studying adults (14.3%). Further, standard two-stage sampling resulted in fewer single adult and non-family households than an innovative area-microcensus design; however, two-stage sampling resulted in more tent and shack dwellers. Our survey innovations provided good value for money, and field staff experiences were neutral or positive. Staff recommended streamlining field tools and pairing technical and survey content experts during fieldwork. This evidence of exclusion of vulnerable and mobile urban populations in LMIC household surveys is deeply concerning and underscores the need to modernize survey methods and practices.

Original languageEnglish
Pages (from-to)111-129
Number of pages19
JournalJournal of Urban Health
Volume98
Issue number1
Early online date27 Oct 2020
DOIs
Publication statusPublished - 1 Feb 2021
Externally publishedYes

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