# Sampling for Drug Use Indicators Study

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Sampling for Drug Use Indicators Study: Objectives
• Describe the principles upon which sampling is based. • Identify and describe different sampling methods. • Select a sample of health facilities from a list of such facilities using at least two different methods. • Compare the the results of the methods. • Instruct others how to sample for drug use studies.
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What is Sampling?
• Sampling is a process by which we study a small part of a population to make judgements about the entire population.

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Sampling involves selecting a number of units from a defined population.

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Sampling Definitions
• Sampling Unit - The thing which is sampled, for example, a person, a clinical episode, or a health facility • Study Population - All the sampling units which could possible be included in the sample • Sampling Frame - A list of all the available sampling units in the study population

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A Representative Sample

A representative sample has all the important characteristics of the study population from which it is drawn.

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Sampling Methods
• Two categories of sampling methods: - Non probability sampling - Probability sampling

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Non Probability Sampling Methods
• Convenience Sampling
- study units available at the time of data collection are selected for the sample

• Quota Sampling
- different categories of sample units are included until a certain number has been reached in each category
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Probability Sampling Methods
• • • • • Simple Random Sampling Systematic Sampling Stratified Sampling Cluster Sampling Multistage Sampling

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Simple Random Sampling
• Used in situations where the number of sampling units is relatively small • Process:
- Identify all possible units available for sampling - Decide on the size of the sample - Choose units by a lottery method
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Systematic Sampling With Equal Probability
• Numbered list of all possible units. • # units ÷ desired sample size = sampling interval.
– For example, to select 20 health centers from a list of 46, the sampling interval is 46/20 = 2.3

• Random # x sampling interval = random start.
– For example, if the random number is 0.183 calculate 0.183 × 2.3 = 0.421, which rounds upward to 1

• Round number up to choose sample unit. • Add sampling interval to random start for subsequent units.
– For example, 0.421 + 2.3 = 2.721 or Facility 3 2.721 + 2.3 = 5.021 or Facility 6 5.021 + 2.3 = 7.321 or Facility 8 and so forth.
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Systematic Sampling With Probability Proportional To Size
• List where the units are sorted in decreasing order by some measure of size (like population or number of visits) • Calculate the cumulative total. • Cumulative total ÷ sample size = sampling interval. • Random # x sampling interval = random start. • Choose first unit with cumulative total result. • Add sampling interval to previous total for subsequent units.
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Stratified Sampling
• Used when the sampling frame contains clearly different categories (strata).
–For example:
• Urban and rural facilities • Facilities with and without doctors • Government and mission facilities

• Process: - Organize the list of sampling units by stratum
- Select units within each stratum using a random method (simple random sampling or systematic sampling)
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Cluster Sampling
• Used when for logistic reasons it is easier to select sample units in groups • Process - Select a cluster of sample units– Example: health center with multiple prescribers

• Include the entire cluster or select a sub- sample
– OR - Select a random sample unit to start each cluster (a

house, a patient, etc.) - Include neighboring sample units until a certain cluster size is reached
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Multistage Sampling
• Randomly select primary sampling units at the first stage: – specific communities – specific health facilities • Within the primary sampling units, randomly select the final sampling units at the second stage: – drug use encounters – patients – households • Sometimes in complex samples, additional stages are needed
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Sample Size
• The optimal sample size is often a compromise between what is statistically Desirable and what is practically Feasible.

In general, a minimum sample size is 30.

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Sample Size
Confidence Intervals If the real figure is 50% • Sample size 50 100 200 500 1000 • Range of Confidence 36 - 64% 40 - 60% 43 - 57 % 45 - 55 % 47 - 53 %
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Conclusion
• Principles of sampling should be understood by everyone involved in drug use studies. • Eumerators and supervisors should understand that any facility, any prescription, or any patient should have a chance to be included. • Make every effort to avoid bias in selecting units for study.
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Activity One
Sample Selection In this exercise, groups will use the different sampling methods on a real data set to select a sample. The results of the different sampling methods will be compared.
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