Strengths and limitations of computer assisted telephone interviews (CATI) for nutrition data collection in rural Kenya.

Christine Lamanna,Suneetha Kadiyala,Todd S Rosenstock,Kusum Hachhethu,Arghanoon Farhikhtah,Beatrice Mwongela,Gaurav Singhal,Sabrina Chesterman,Silvia Passeri,Mary Ng’Endo,Jean-Martin Bauer,Brady T West

doi:10.1371/journal.pone.0210050

Abstract

Despite progress in fighting undernutrition, Africa has the highest rates of undernutrition globally, exacerbated by drought and conflict. Mobile phones are emerging as a tool for rapid, cost effective data collection at scale in Africa, as mobile phone subscriptions and phone ownership increase at the highest rates globally. To assess the feasibility and biases of collecting nutrition data via computer assisted telephone interviews (CATI) to mobile phones, we measured Minimum Dietary Diversity for Women (MDD-W) and Minimum Acceptable Diet for Infants and Young Children (MAD) using a one-week test-retest study on 1,821 households in Kenya. Accuracy and bias were assessed by comparing individual scores and population prevalence of undernutrition collected via CATI with data collected via traditional face-to-face (F2F) surveys. We were able to reach 75% (n = 1366) of study participants via CATI. Women’s reported nutrition scores did not change with mode for MDD-W, but children’s nutrition scores were significantly higher when measured via CATI for both the dietary diversity (mean increase of 0.45 food groups, 95% confidence interval 0.34–0.56) and meal frequency (mean increase of 0.75 meals per day, 95% confidence interval 0.53–0.96) components of MAD. This resulted in a 17% higher inferred prevalence of adequate diets for infants and young children via CATI. Women without mobile-phone access were younger and had fewer assets than women with access, but only marginally lower dietary diversity, resulting in a small non-coverage bias of 1–7% due to exclusion of participants without mobile phones. Thus, collecting nutrition data from rural women in Africa with mobile phones may result in 0% (no change) to as much as 25% higher nutrition estimates than collecting that information in face-to-face interviews.

Highlights

Undernutrition among mothers is one of the leading causes of neonatal death globally [1] and is responsible for the death of an estimated 3.5 million children under the age of five per year [2], as well as reduced educational attainment and economic productivity among adults [3]
We tested the utility of using computer assisted telephone interviewing (CATI) for cost effective, large scale nutrition data collection amongst women in rural Africa
We found that changing the data collection mode from traditional face-to-face (F2F) interviews to computer assisted telephone interviews (CATI) resulted in higher nutrition indicator scores, but not for all indicators tested among rural women in Kenya

Summary

Introduction

Undernutrition among mothers is one of the leading causes of neonatal death globally [1] and is responsible for the death of an estimated 3.5 million children under the age of five per year [2], as well as reduced educational attainment and economic productivity among adults [3]. Advances in reducing undernutrition depend on the ability to monitor nutritional status of at-risk populations in order to respond rapidly to crises and scale-up successful programming. Both require systematic data collection at a high spatial resolution and temporal frequency [8,9]; current approaches used to collect nutrition data do not meet the requisite demand [10]. New approaches that can generate information at the right time and places are critical to scale effective and efficient programming and to meet global goals on undernutrition [7]

Methods

Results

Conclusion