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Collecting mortality data via mobile phone surveys: A non-inferiority randomized trial in Malawi

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Listed:
  • Michael Chasukwa
  • Augustine T Choko
  • Funny Muthema
  • Mathero M Nkhalamba
  • Jacob Saikolo
  • Malebogo Tlhajoane
  • Georges Reniers
  • Boniface Dulani
  • Stéphane Helleringer

Abstract

Despite the urgent need for timely mortality data in low-income and lower-middle-income countries, mobile phone surveys rarely include questions about recent deaths. Such questions might a) be too sensitive, b) take too long to ask and/or c) generate unreliable data. We assessed the feasibility of mortality data collection using mobile phone surveys in Malawi. We conducted a non-inferiority trial among a random sample of mobile phone users. Participants were allocated to an interview about their recent economic activity or recent deaths in their family. In the group that was asked mortality-related questions, half of the respondents completed an abridged questionnaire, focused on information necessary to calculate recent mortality rates, whereas the other half completed an extended questionnaire that also included questions about symptoms and healthcare. The primary trial outcome was the cooperation rate, i.e., the number of completed interviews divided by the number of mobile subscribers invited to participate. Secondary outcomes included self-reports of negative feelings and stated intentions to participate in future interviews. We called more than 7,000 unique numbers and reached 3,054 mobile subscribers. In total, 1,683 mobile users were invited to participate. The difference in cooperation rates between those asked to complete a mortality-related interview and those asked to answer questions about economic activity was 0.9 percentage points (95% CI = -2.3, 4.1), which satisfied the non-inferiority criterion. The mortality questionnaire was non-inferior to the economic questionnaire on all secondary outcomes. Collecting mortality data required 2 to 4 additional minutes per reported death, depending on the inclusion of questions about symptoms and healthcare. More than half of recent deaths elicited during mobile phone interviews had not been registered with the National Registration Bureau. Including mortality-related questions in mobile phone surveys is feasible. It might help strengthen the surveillance of mortality in countries with deficient civil registration systems. Registration: AEA RCT Registry, #0008065 (14 September 2021).

Suggested Citation

  • Michael Chasukwa & Augustine T Choko & Funny Muthema & Mathero M Nkhalamba & Jacob Saikolo & Malebogo Tlhajoane & Georges Reniers & Boniface Dulani & Stéphane Helleringer, 2022. "Collecting mortality data via mobile phone surveys: A non-inferiority randomized trial in Malawi," PLOS Global Public Health, Public Library of Science, vol. 2(8), pages 1-20, August.
    • Handle: RePEc:plo:pgph00:0000852
    DOI: 10.1371/journal.pgph.0000852
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    References listed on IDEAS

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    1. Jethro Banda & Georges Reniers & Stéphane Helleringer & Abena Amoah & Albert Dube & Sarah Brumfield & Amelia Crampin, 2021. "Knowledge, risk perceptions, and behaviors related to the COVID-19 pandemic in Malawi," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 44(20), pages 459-480.
    2. Bruno Masquelier & Georges Reniers & Gilles Pison, 2014. "Divergences in trends in child and adult mortality in sub-Saharan Africa: Survey evidence on the survival of children and siblings," Population Studies, Taylor & Francis Journals, vol. 68(2), pages 161-177, July.
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