Toward a Principled Workflow for Prevalence Mapping Using Household Survey Data

Understanding the prevalence of key demographic and health indicators in small geographic areas and domains is of global interest, especially in low- and middle-income countries (LMICs), where vital registration data is sparse and household surveys are the primary source of information. Recent advances in computation and the increasing availability of spatially detailed datasets have led to much progress in sophisticated statistical modeling of prevalence. As a result, high-resolution prevalence maps for many indicators are routinely produced in the literature. However, statistical and practical guidance for producing prevalence maps in LMICs has been largely lacking. In particular, advice in choosing and evaluating models and interpreting results is needed, especially when data is limited. Software and analysis tools are also usually inaccessible to researchers in low-resource settings to conduct their own analysis or reproduce findings in the literature. In this paper, we propose a general workflow for prevalence mapping using household survey data. We consider all stages of the analysis pipeline, with particular emphasis on model choice and interpretation. We illustrate the proposed workflow using a case study mapping the proportion of pregnant women who had at least four antenatal care visits in Kenya. The workflow is implemented using the R package surveyPrev, and all reproducible code is provided in the Supplementary Materials. It can be readily extended to a wide range of indicators.