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Q&A Reading Time: 5 minutes

Data is key for robust evidence-based decision making

For robust evidence-based decision making, data and statistics are essential. To ensure proper planning in reproductive health, the accuracy and availability of this data cannot be over emphasized. We spoke to Samuel Dupre, a statistician with the U.S. Census Bureau’s International Program, and Mitali Sen, the International Program’s Chief of Technical Assistance and Capacity Building, who shed light on how the U.S. Census Bureau is supporting data collection on reproductive health.

Lilian’s Question: From a bird’s-eye view, what work does the U.S. Census Bureau do outside of the typical surveys we think about occurring in the United States?

Samuel and Mitali’s Answer: We help countries through the entire census process, helping them especially in the lead-up to their census. We also assist countries with conducting the census themselves; we send experts in to train them to collect data. We assist the national statistics offices (NSOs) by helping to process and analyze the data in preparation for release. We help build statistical capacity, but also help with training in soft skills within those countries’ national systems. We’re in the Technical Assistance and Capacity Building Branch. Our group focuses on providing training, usually in-person in host countries, on various aspects related to the census. We offer technical assistance and capacity building. We also have a team that specializes in demographic analysis, and a team that helps countries do in-depth analysis on reproductive health issues, fertility, mortality, and migration, among other topics.

Question: What are ways in which the family planning and reproductive health community can work with you and access the census data you collect?

Answer: The main thing that local and international non-governmental organizations can do to support the production and use of this data is to build the capacity of NSOs. What the international community needs to do is help to build the abilities of these organizations, both in terms of data collection ability and the ability to find the compelling story in data that can capture the public interest.

Question: What would you say is the link between census data and health interventions? And how can governments leverage on population census data to ensure proper planning in the health sector, particularly in reproductive health?

Answer: Censuses are the only time a country collects information on its residents down to the lowest levels of geography. These population numbers disaggregated by age and sex at various administrative levels (like cities, municipalities, towns and villages) are then used to evaluate the size of the population that the administrative area has to serve, determine number of health clinics required, medical personnel needed to serve the community, calculate indicators like mortality, child and maternal mortality, and to create the sampling frame for all the health surveys between two censuses so that the results are representative of the population.

Question: What has worked well in establishing relationships and nurturing collaborations with your partners?

Answer: Understanding our role in the process. We seek to build the capacity and ability of these national systems to produce credible data that public health decisions are based on. We do this in a way that is respectful. We bring decades of experience to the topic of national census and we are good at what we do. We do everything we can to earn our partners’ trust. We are cognizant of the need for privacy of the data we deal with. You could, for instance, find some excitement around making some reproductive health data open whereas people’s privacy needs to be respected. In this case, we offer capacity building to these countries, to allow them to understand the balance between data privacy and the need to make it public.

“We seek to build the capacity and ability of these national systems to produce credible data that public health decisions are based on.”

Question: How has your team adapted certain activities and procedures in light of travel challenges related to COVID-19?

Answer: It’s been massive. Normally, most of our work is international. We typically go for training trips, and we have had to cancel a number of them. We have been adapting to doing remote trainings on Zoom and Skype. For the last few months, we have been figuring out, for example, what to do in countries where their internet cannot allow screen sharing, and how to deal with situations where attendees are operating from mobile hotspots. It has been a learning experience, but we are figuring out how we can continue to make it work.

Question: What are some of the notable trends you see in data generation across the globe?

Answer: Our data ecosystem is becoming increasingly complex as various technologies we use daily gather information. All countries are struggling to comprehend and use all the data being generated. The challenge is to harness the data for good decisions. Development in all these countries depends on it.

“The challenge is to harness the data for good decisions.”

Question: Based on the capacity building in Malawi (by helping the country adopt the use of tablets in the population census exercise), what lessons do you think this milestone presents to other lower- and middle-income countries? How is the U.S. Census Bureau helping to build the capacity of these countries?

Answer: The 2018 population and housing census in Malawi was remarkable because it was one of the first times a digital census using tablets was conducted in a country where electricity and telecommunications infrastructure are not always robust. It proved that such technology could be adapted to work.

Census workers in Malawi use tablets for data collection. Image source: www.census.gov
Census workers in Malawi use tablets for data collection. Image source: www.census.gov

This is important because the quality of data is superior when using tablets for data collection. There are built-in edits that stop an enumerator [a person who collects census data] from entering information incorrectly. For instance, if a household has said early in the interview that they have a child who is 9 years old, and then when answering questions on education of household members, the parents say the person is in college, the enumerator will be stopped from entering that information by the census application—they will be forced to go back and verify the age of the child and until they correct it, they cannot proceed. Similarly, enumerators do not have to remember the skip patterns on the questions once the household roster is complete. The census application will automatically display questions appropriate for the age or sex universe. So, for example for all women between ages 15-49 the census application will guide enumerators to ask fertility questions. Similarly, the literacy question may be displayed for all people 5 years of age and above.

Malawian NSO experts worked with the U.S. Census Bureau team to provide actionable lessons-learned retrospectives that have already been applied in other censuses, including the Zambia 2020 Census pilot. U.S. Census Bureau staff worked with the Zambian team to improve enumerator tablet training exercises based on the Malawian experience. This retrospective also allowed the Zambian NSO to design tablet data export procedures to avoid specific challenges that the Malawians had already encountered and solved.

The U.S. Census Bureau’s International Programs helps build the capacity of NSOs across all census operations—planning and management, mapping, questionnaire design and testing, publicity, field operations, data capture, data processing, data analysis, dissemination and sampling, and post-census evaluation.

Question: What is the extent of support by the U.S. Census Bureau to the countries you work with?

Answer: Our engagement with countries depends on the support (funds) we receive, since our work is entirely reimbursable. Our scope of assistance depends on the request by the country for training and the availability of resources to support our technical assistance. USAID country missions are one of our major sponsors, especially in USAID global health priority countries.

Question: Any final thoughts on the work of the U.S. Census Bureau in Malawi, Mozambique, Zambia, Madagascar, Tanzania, Nigeria, Ethiopia, Mali, and Namibia?

Answer: All these countries can build their capacity to collect high quality data with case-specific tailored support and technical assistance that considers their strengths and the areas where there are opportunities for growth. The importance of “soft” skills including program management, institutional knowledge building, and training are all just as important as highly technical statistical techniques. Along with those skills, acknowledgement of governance issues—and transparently addressing any issues—is critical to the success of a census. The Malawi census worked well because of strong leadership at the NSO and commitment from the government in the face of the myriad normal challenges that will always appear during an undertaking as massive as a national census.

“All these countries can build their capacity to collect high quality data with case-specific tailored support and technical assistance…”

Question: How about countries facing political instability?

Answer: Political instability stalled censuses in Ethiopia, Mali, and Nigeria. NSOs, supported by domestic and foreign institutions including the U.S. Census Bureau, are actively looking into novel methods for collecting data under these circumstances. Building on the success of partner countries like Malawi, Zambia, and Namibia as they move through different stages of a tablet-based census, the U.S. Census Bureau remains committed to supporting Ethiopia, Mali, Nigeria, and any other of our partners as they merge time-tested techniques with new data collection and dissemination possibilities.

Read more about the U.S. Census Bureau’s work: Family planning, reproductive health, and population census: How are they linked?

Lilian Kaivilu

Founder & Editor, Impacthub Media

Lilian is an award-winning multimedia journalist with over 10 years of experience in Health and Development Communication. Lilian is the founder and editor at Impacthub Media, a solutions journalism media platform amplifying positive stories of changemakers in Africa. She has worked as a reporter for local and international media and as a communications consultant for United Nations and the WorldBank. Lilian is currently pursuing a Master of Arts Degree in Development Communication at the University of Nairobi. She is a Linguistics, Media and Communications graduate from Moi University Kenya; a Journalism graduate from the Kenya Institute of Mass Communication; and has completed other short courses including Civic Leadership, Data Journalism, Business Journalism, Health Reporting, and Financial Reporting (at Strathmore Business School and the University of Nebraska-Lincoln, among others). She is the Vice President for the Africa Media Network on Health (AMNH), which is a network of health journalists from Kenya, Uganda, Zambia, Tanzania, and Malawi. Lilian is a Fellow of Mandela Washington, Bloomberg Media Initiative Africa, Safaricom Business Journalism, HIV Research Media, and Reuters Malaria Reporting.