Once the goals of the assessment have been defined, the resources available must be carefully considered to determine the full scope of the activities planned. Planning must include all phases of the project, from design, data collection and analysis, through report writing and dissemination.
Operational considerations
Budget: The first step in planning for a surveillance assessment is to identify the budget available to design and implement activities. Identify what costs are allowable in the budget based on the source of funding and carefully consider the personal and operational costs. This can also be an opportunity to advocate for assessment pieces that might not be included in an initial budget, such as ongoing stakeholder engagement, thoughtful dissemination of results, and collection and analysis of qualitative data. If you are not able to advocate for these activities in the initial budget, you can outline the activities you recommend conducting in the future if more funding is obtained. Budget_Template
Timeline and Logistics: Budget, government, and funder priorities, as well as resource availability will be key factors in determining the timeline for implementation. Creating a workplan with a clear breakdown of activities, timeline, and human resources allocated to each activity will support careful planning and resource allocation. A Workplan template can be adapted to the needs of each project and to support program management. It can also be used weekly/monthly to track program progress and identify any gaps or obstacles to implementation. Some considerations on timeline and logistics can include:
- Is this a national, regional, or local assessment?
- How many days will be needed at each location to collect the data?
- Consider transportation time and costs, especially for hard-to-reach remote locations.
- Who will be involved besides dedicated staff?
- When are the results of the assessment needed?
- Consider the time needed to clean and analyze your data and prepare for dissemination.
- Are there safety considerations that need to be planned for?
- What approvals will be needed ahead of time to conduct assessment?
- Will translation be needed?
- How many people will be needed to collect the data at each location? How about data analysis?
- Are there expectations for when the results need to be disseminated? How does this impact the timeline for data collection and analysis?
Human Resources: Each phase may require different levels of support and expertise. Breaking down the type of support and expertise needed at each phase will ensure that a well-rounded team is able to deliver a high-level assessment. See Example Job Descriptions.
Ethical Considerations
Ethical and regulatory approvals and consent may be needed before conducting surveillance assessments. The degree of review and approval is usually related to the type and sensitivity of data that will be collected and analyzed for the assessment, how that data will be stored and protected, as well as who will be doing the data collection and analysis. Each government has different processes for obtaining formal approval before conducting any sort of data collection or study. Consult stakeholders to ensure that you are following government rules and regulations.
Research processes and outcomes should benefit the community where assessments are implemented. They must also be culturally appropriate and ethical. Program implementers are often excluded from ethical review boards, but they can add real depth to the process. Ethical review of program activities with country-based institutional review boards including surveillance system assessments can help ensuring appropriate approvals are in place to according to local standards and to ensure cultural compliance and community awareness of the assessment. Often a non-research determination is received for surveillance assessments, but the process can link your activities to local partner organizations and ensure government awareness. Types of ethical approvals include human subjects, vertebrae animal subjects, and/or other governmental approvals.
- Human Subjects: Depending on legal standards in the country or setting of the assessment, surveillance system assessments may be considered research and require approval from an institutional review board for human subjects. In general, an activity which seeks to assess a program rather than produce generalizable evidence is not considered to be research, and activities which do not constitute research. To determine if a surveillance assessment requires human subjects review, consider whether your project is research and then follow your host institution’s human subjects review process.
- Vertebrate Animal Subjects: It is rare that a surveillance system assessment would involve vertebrate animal subjects research as no direct handling occurs; in contrast with human subjects, for vertebrate animal subjects the research vs. non-research designation is irrelevant. Regardless, Institutional Animal Care and Use Committees in the assessment country should be consulted to ensure no approval is needed.
- Other Approvals: Other ethical approvals may be needed depending on the scope of data collection and the countries involved. For instance, many countries require additional approvals for research involving Indigenous peoples or data collection that involves accessing genetic heritage or traditional knowledge.
Sources of Data for Assessment
Data collection can use either primary or secondary data.
Primary Data Collection: Primary data collection gathers data and information directly from original sources. When conducting surveillance assessments, methods for primary data collection could include administering a questionnaire, in-depth interviews, focus group discussions, community mapping, and direct observations.
- Primary Data Collection Example: In Peru, the team used primary data collection methods to assess the public health surveillance systems using a One Health approach. The qualitative and quantitative survey tool was administered to over 200 respondents in-person and virtually.
Secondary data analysis: Secondary data collection refers to analysis of data that has been collected previously and which may or may not be publicly available. Secondary data analysis can include use of existing surveillance data and reports, government databases, health records, public health reports, social media data, and other data collected as part of routine or non-routine surveillance. Data can be open or restricted.
- Example Of Secondary Data Collection: In Peru, the team conducted a secondary data analysis of priority pathogens including COVID-19 data from surveillance systems.
Key Considerations
Within this, methods and indicators should be guided by the scope and goals of the assessment and the available resources: which components you will be assessing and which aspects of those components you will assess. Considerations that can guide these decisions include:
Availability of Data for Secondary Analysis: What data sources are available? Are they available for all components that you want to assess? Do the variables contained in these data sources capture all the aspects you plan to assess? If there is more than one data source, are the variables defined in the same manner across all of them? What will be missing from the assessment if you rely only on secondary data?
Resources to Conduct Primary Data Collection: Do you have sufficient resources (budget, personnel, time) to develop data collection instruments, acquire all necessary ethical approvals, hire and train data collectors, and implement data collection activities? How much would primary data collection add that secondary data analysis cannot provide? When primary data will be collected, we generally advocate for a mixed-methods approach, detailed below.
Planning Data Analysis: Do you want to characterize the state of the surveillance system currently (descriptive statistics or qualitative data), or evaluate why certain deficiencies may exist or improvements were observed (hypothesis testing)? Do you have longitudinal data (generally secondary analyses only)? Are you able to geolocate data to subnational areas or locations? Do you need to estimate data that weren’t observed, for instance missing time points or missing geographic locations (modeling)?
Planning for Primary Data Collection: What sample size is needed to answer your assessment question? How will data be disaggregated or stratified? How long will you have for data collection? If using a survey, how long should the instrument be based on time available with respondents? How will data be collected: electronically by phone, tablet or computer, or paper based? If electronic, what licenses or software are needed?