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Table 1 Challenges encountered and mitigation measures during a survey of women in urban Karachi

From: Conducting household surveys on reproductive health in urban settings: lessons from Karachi, Pakistan

Challenges encountered Mitigation measures
1. Technical issues: GIS usage and computer assisted personal interviews (CAPI)
i. GIS Mapping: Difficulty in cluster boundary interpretation and household identification at each survey point, especially where dense structures are present. • Physically validating the boundaries through field visits.
ii. Low internet signals in ground floors of tower buildings sometimes made it difficult to sync data. • Having dedicated staff available during field activities to deal with unexpected tablet issues in real time.
• Being able to download data later upon returning to the office.
iii. Reporting a technical query and waiting for a solution from staff with access to central server was time consuming.
2. Household Listing issues
i. Long duration between household listing and survey: Enumerators forgot site details and landmarks, respondent migration was higher, door markings were more difficult to identify. • Started data collection soon after household listing.
3. Respondent issues
i. Sensitive information: Respondents’ perceptions and beliefs make it difficult to discuss some topics. Asking sensitive questions about sexuality can be controversial. • Refresher training sessions conducted on how to discuss sensitive topics with respondents.
ii. Security issues: Respondents’ fear about child kidnapping and theft and linked it with previous such incidents. • Took into confidence influential gate keepers in the community and district administration.
iii. Unwillingness to participation: Certain community sub-groups i.e. Urdu speaking and Pashto were reluctant to participate in the study. • Coordinated with community leaders (especially men) personally; used gatekeeper script.
iv. Language barriers: Some respondents expressed difficulties understanding Urdu language. • Assigned new enumerators who could communicate in their native language.
v. Length of questionnaire and participants’ schedules: Engaging the respondent for an hour or more in a busy personal schedule created barriers to successful data collection. • Rescheduled such cases as per the availability of the respondents, including weekends and after working hours.
vi. Participant expectations: Many participants expected extra healthcare services, or another way requested material benefits from enumerators. • Enumerators were trained to explain indirect benefits e.g. sharing research findings with key stakeholders and informing policies that may benefit the respondents in long run.
4. Field issues
i. Environmental issues: Interviews conducted in dark rooms with no electricity, bad odors, dirty streets, in extreme temperatures; enumerators reported feelings of isolation.
ii. Presence or nearness of family members
iii. Loud background noises outside
• Worked in groups in neighborhoods where enumerators felt uncomfortable.
• Supervisors waited nearby and were available to support if needed.
• Scheduled a revisit after confirming another time when most of the family members were away from the home.
iv. Ensuring privacy: Some interviews couldn’t be done inside the house (especially in joint family systems). • Revisit/reschedule cases as per respondent’s availability.