Latent profile analysis of challenges and facilitators in implementing integrated multi-prong surveys in post conflict settings of Tigray, Ethiopia

Despite the need for comprehensive, integrated studies examining health service utilization and access in the aftermath of conflicts, little research has been done to identify the challenges and facilitators of integrated surveying. Therefore, this study aims to identify the challenges and facilitators of implementing an integrated multi-pronged survey in post-conflict settings in Tigray, northern Ethiopia . A cross-sectional study was conducted from September 15 to 30, 2023, involving data collectors and supervisors from 19 randomly selected districts that participated in the integrated survey data collection. The study involved 134 participants in all, including 15 supervisors and 119 data collectors. The primary outcomes of the study were challenges, facilitators, level of understanding, and the implementation process of the integrated multi-prong survey. Latent profile analysis was used to classify participants based on challenges, facilitators, level of understanding, and the implementation process of the integrated multi-prong survey in post-conflict settings in Tigray, Ethiopia. R software version 4.4.2 was used to analyze the data. Among 134 participants, 67.9% were male, and 71.6% were data collectors. Major challenges in conducting the integrated multi-prong survey included various outcome indicators, complex sampling strategies, collecting the data during the rainy season, infrastructure disruptions, financial constraints, and the sensitivity of survey topics. Facilitators included pretesting tools, providing training, linking suspected cases of pelvic organ prolapse and obstetric fistula for confirmation and better management, recruiting and employing data collectors from the study sites, and using self-owned mobile devices to collect data. Thus, profile 1 had the lowest mean scores for understanding, facilitators, and challenges. The challenges in Profile 2 had the lowest mean score, while the other indicator factors had moderate values. Profile 3 had the highest mean scores for facilitators and understanding. It also had a moderate mean score for challenges. Also, collecting integrated data posed greater challenges for females, older individuals, and diploma holders. This study highlights the significant challenges and facilitators encountered in conducting an integrated, multi-pronged survey in a conflict-affected region. Despite numerous challenges, such as logistical constraints, resource limitations, and the complexities of working in a post-conflict setting, several facilitators contributed to the successful implementation of the survey. The application of latent profile analysis identified three distinct participant profiles, each reflecting varying levels of challenges, facilitators, understanding, and implementation. Ultimately, incorporating the lessons learned from this research into future survey designs will be instrumental in building resilient health systems and enhancing health outcomes in post-conflict settings.