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Calculate Care-Seeking Behavior from DHS Data ( Methodology)

Source: R/indicator_csb.R
calc_csb_dhs_core.Rd

Estimates care-seeking behavior for febrile children under 5 using the WHO World Malaria Report methodology with overlapping indicators.

Usage

calc_csb_dhs_core(
  dhs_kr,
  survey_vars = list(cluster = "v021", weight = "v005", stratum = "v022", age = "hw1",
    fever = "h22", alive = "b5"),
  csb_priority_method = c("all", "first", "public", "private"),
  source_config = NULL,
  region_var = NULL,
  gps_data = NULL,
  gps_vars = list(cluster = "DHSCLUST", lat = "LATNUM", lon = "LONGNUM"),
  shapefile = NULL,
  admin_level = NULL,
  join_nearest = TRUE,
  custom_csb_indicator = NULL
)

Arguments

dhs_kr

DHS children's recode (KR) dataset in tidy format (data.frame or tibble).

survey_vars

Named list mapping DHS variable names. Required keys:

  • cluster: Cluster ID (default: "v021")

  • weight: Survey weight (default: "v005")

  • stratum: Stratum variable (default: "v022")

  • age: Child's age in months (default: "hw1")

  • fever: Had fever in last 2 weeks (default: "h22")

  • alive: Child survival status (default: "b5"). NOTE: methodology assumes filtering to living children (b5 == 1) is done upstream. This function does NOT filter by alive status.

csb_priority_method

Character, one of "all" (default), "first", "public", or "private". Controls how overlapping care-seeking records are resolved so each child is assigned to at most one sector.

  • "all": WHO default. Overlaps allowed; csb_public + csb_private may exceed 100%.

  • "first": Take the first h32 source (alphabetical order) visited per child.

  • "public": Public/CHW priority when a child sought both sectors.

  • "private": Private priority when a child sought both sectors.

With non-"all" values, csb_public + csb_private + csb_none sums to 100%.

source_config

Deprecated. No longer used. Legacy parameter for backwards compatibility. Named list with:

  • public: Character vector of h32 codes for public sector

  • private: Character vector of h32 codes for private sector

  • excluded: Character vector of h32 codes to exclude

region_var

Optional column name (character string) in dhs_kr to use as the grouping variable (e.g., "v024" for region). When provided, this takes precedence over GPS/shapefile-based grouping and the column appears first in the output.

gps_data

Optional DHS GPS dataset with cluster coordinates.

gps_vars

Named list for GPS variables (cluster, lat, lon).

shapefile

Optional sf object with administrative boundaries.

admin_level

Character vector of admin columns from shapefile (e.g., c("adm1", "adm2")). If NULL, uses existing admin variables in data.

join_nearest

Logical; if TRUE, assigns clusters outside polygons to nearest admin unit.

custom_csb_indicator

Optional named list defining a user-specified, mutually-exclusive care-seeking partition fitted in addition to the built-in CSB indicators. When supplied, three derived indicators are produced: <name>_dhis (sought care at any user-listed DHIS source), <name>_nondhis (sought care at any user-listed non-DHIS source and not at any DHIS source), and <name>_untreat (did not seek care at any user-listed source). The list must have four character fields: name (alphanumeric prefix matching pattern ^csb_[a-z0-9_]+$), dhis_locs, nondhis_locs, and untreat_locs. Each *_locs vector may contain either h32 variable names (e.g. "h32a", "h32e") which are matched as columns in dhs_kr, or haven label strings which are matched case-insensitively against the label attribute of each h32 column. The two styles can be mixed in the same vector. Variable-name matches take precedence over label matches, which is useful when two h32 columns share an identical haven label (e.g. h32e and h32n both labelled "comm.health wrkr"). The custom triple is always mutually exclusive at the child level (priority dhis > nondhis > untreat). Default: NULL (disabled).

Value

Tibble with CSB estimates by administrative level, with confidence intervals and sample sizes.

Details

Methodology: https://github.com/ahadi-analytics/sntmethods/blob/master/inst/methods/csb_dhs.yml

This function implements the WHO World Malaria Report methodology for care-seeking behavior analysis.

5-Category Classification:

  • public: Government health facilities (hospitals, health centers, posts)

  • chw: Community health workers (often NGO sector in DHS-8)

  • private_formal: Private hospitals, clinics, and doctors

  • private_informal: Traditional practitioners and other informal sources

  • pharmacy: Pharmacies and drug shops

Derived Indicators (OVERLAPPING): These indicators are NOT mutually exclusive. A child can be counted in multiple categories if they visited multiple source types.

  • dhs_csb_public: Public sector care (public OR chw)

  • dhs_csb_private: Any private sector care (private_formal OR private_informal OR pharmacy)

  • dhs_csb_trained: Trained provider (public OR private_formal OR pharmacy)

  • dhs_csb_any: Any treatment sought (public OR private)

  • dhs_csb_none: No treatment sought (NOT any)

Important: Only dhs_csb_any and dhs_csb_none are mutually exclusive. The equation dhs_csb_any + dhs_csb_none = 1 always holds. However, dhs_csb_public + dhs_csb_private + dhs_csb_none may exceed 1.0 when children visit both public and private sources.

References

WHO. World Malaria Report. Geneva: World Health Organization. https://www.who.int/teams/global-malaria-programme/reports