New Software Developed by Population Council Facilitates Field Research Available Free on the Internet
NEW YORK -- How can researchers tell whether a vaccine for malaria is preventing the disease? Has a pilot family planning program reduced unwanted pregnancies? Scientists cannot empirically assess the efficacy of these and other health measures if they lack the means to compare the effects of treatment in an experimental population to the results in an untreated population. Similarly, program planners cannot target services to those at greatest risk of unwanted pregnancy, disease, and death without data to identify who and where these people are. To investigate these issues, researchers rely on longitudinal population-based data generated by a demographic surveillance system (DSS). Yet in those developing countries where health and population issues are most acute, the financial, technical, and logistical requirements for using a DSS have been prohibitive.
A new software program called the Household Registration System (HRS) facilitates the collection, management, and analysis of data generated by demographic surveillance systems. As the first software system designed to function as a template for generating DSS computer programs, the HRS enhances the ability of researchers to carry out longitudinal population-based surveillance and related studies that track every member of a population over time. The HRS is described in a new publication, "The Household Registration System: A Point-and-Click Revolution in Health and Demographic Research," available on request and on the Population Council's Web site at http://www.
A Collaborative Venture
The HRS was conceived by Council researcher James Phillips and designed by computer scientist Bruce MacLeod, an expert in software engineering at the University of Southern Maine. Funding from several sources -- The Finnish International Development Agency, The Mellon Foundation, The Population Council, The Rockefeller Foundation, The Thrasher Research Fund, and the United Nations Population Fund -- has supported development, testing, and dissemination of the HRS.
The HRS was field tested in northern Ghana by the Navrongo Health Research Centre, an outpost of Ghana's Ministry of Health. The HRS serves as the engine of the Navrongo Demographic Surveillance System, which is regarded as a model DSS in the developing world. Several African scientists played key roles in developing and testing the HRS, including health scientist Fred Binka, former director of the Navrongo Centre; computer scientist Frank Indome, a former Population Council consultant; and demographer Pierre Ngom, a Population Council fellow.
Outside of Navrongo, the HRS is now in use at 11 sites: three in Tanzania, two in Kenya, and one each in Burkina Faso, The Gambia, Indonesia, Mali, Mozambique, and Uganda. Data from sites using HRS-based systems have yielded important public health findings--such as a correlation between HIV prevalence and adult mortality from malaria, a disease that is usually fatal only to children.
A key feature of the HRS is that it permits cross-country comparisons of DSS data. The system is designed to generate a "reference data set"--a core set of demographic data, presented in a standard format, that can be compared among HRS sites. This powerful--and previously unavailable--scientific tool allows researchers to conduct empirically rigorous, multi-site trials of vaccines and other medical technologies.
The HRS in Action
Longitudinal population-based surveillance involves tracking the members of a geographically defined population over time and collecting data on the core components of demographic change-births, deaths, and migration. Research projects linked to a DSS may focus on diverse topics (e.g., behavioral, social, economic, or epidemiological issues); may be quantitative, qualitative, or both; and may represent a range of study designs (e.g., panel surveys, cohort studies, randomized trials, and factorial experiments). Experimental interventions may be therapeutic (e.g., trials of new vaccines or reproductive health technologies); behavioral (e.g., pilot projects promoting healthy sexual and reproductive behaviors); or supply-side-oriented (e.g., experimental service-delivery strategies).
"The new software is unprecedented in the population field," say Phillips and MacLeod. "Programs generated by the HRS can be tailored in any number of ways to suit different study requirements. For example, the HRS can be adapted to studies of social structures other than (or in addition to) households, such as extended families and kinship networks; and it can be adapted to accommodate additional data, such as data on specific events or household/individual characteristics. Users can extend the basic program by adding to it small units, or modules, of computer code that correspond to specified functions."
The HRS can be adapted to different settings and study designs. The interactive, visual, menu-driven format of the HRS allows users to define study parameters, enter and edit data, and generate reports with the click of a mouse. Easy-to-read prompts and other messages guide users through the steps that must be taken to perform any function. The program can be operated by users who are not computer specialists.
The HRS significantly reduces the cost and complexity of longitudinal population-based surveillance. The program can run on moderately priced microcomputers housed in a field station and can be operated by nonspecialists with remote technical assistance; therefore, it eliminates the need for expensive computer hardware, off-site computer facilities, and computer experts to run DSS programs. But the biggest cost savings of the HRS is up front: the program is free, thereby eliminating the high cost of a custom-built DSS program.
The Population Council is an international, nonprofit, nongovernmental research organization that seeks to improve the reproductive health and wellbeing of current and future generations around the world and to help achieve a humane, equitable, and sustainable balance between people and resources. The Council conducts biomedical, social science, and public health research and helps build research capacities in developing countries. Established in 1952, the Council is governed by an international board of trustees. Its New York headquarters supports a global network of regional and country offices.