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Stratified cluster sampling

Article  in  BMJ (online) · November 2013

DOI: 10.1136/bmj.f7016

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BMJ 2013;347:f7016 doi: 10.1136/bmj.f7016 (Published 22 November 2013)
Endgames
STATISTICAL QUESTION
Stratified cluster sampling
Philip Sedgwick reader in medical statistics and medical education
Centre for Medical and Healthcare Education, St George’s, University of London, London, UK
Researchers investigated the suitability of a newly developed
famine scale as an international definition of famine to guide
humanitarian response, funding, and accountability.1 The scale
had been proposed by Howe and Devereux, and it defined
famine on the basis of intensity and magnitude.2 The scale was
applied retrospectively to the humanitarian crisis during 2005
in Niger, west Africa, to determine whether famine had occurred.
A cross sectional study design was used. Households were
recruited using a stratified two stage cluster sampling method.
Niger was stratified into its eight regions. Within each region,
26 villages were randomly selected, with the probability of
selection proportional to the size of the village. Within each
village, 20 households were systematically randomly selected.
A census of the entire household was undertaken by
administering a questionnaire to the head of each selected
household.
The researchers concluded that on the basis of the famine scale
developed by Howe and Devereux, most regions in Niger in
2005 experienced food crisis conditions, and some areas
approached famine. Furthermore, it was suggested that the scale
afforded more objective criteria than did previous approaches
while providing early warning systems that might help guide
the level of response in future situations.
Which of the following statements, if any, are true?
a) Cluster sampling meant that resources could be
concentrated in a limited number of areas of the country
b) The stratified two stage cluster sampling approach
constituted a multistage sampling method with three stages
c) Systematic random sampling of households in each village
required the construction of a sampling frame
Answers
Statement a is true, whereas b and c are false.
The aim of the study was to assess whether the famine scale
proposed by Howe and Devereux provided a suitable definition
of famine to guide future humanitarian response, funding, and
accountability. A cross sectional study design was applied.
The scale and severity of the humanitarian crisis in Niger in
2005 would probably have varied across the country. It was
p.sedgwick@sgul.ac.uk
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ENDGAMES
therefore imperative that any sample was representative of the
population of Niger. Simple random sampling across the country
could have been used to recruit households. However, simple
random sampling would have produced a representative sample
only if enough households were recruited. The population of
Niger was geographically diverse. Therefore, random sampling
of households across the country would have been impractical
and too expensive. A stratified two stage cluster sampling
approach was therefore used to ensure the resulting sample was
representative of the country, while concentrating resources in
fewer areas (a is true).
The stratified cluster sampling approach incorporated a
combination of stratified and cluster sampling methods. Firstly,
Niger was stratified by region. The country consists of eight
regions—seven rural ones plus the capital, Niamey. Within each
region a simple random sample could have been taken to ensure
that each region was adequately represented. However, the
population of each region was geographically diverse. Therefore,
simple random sampling within each region or stratum would
have been impractical and expensive. To concentrate resources
in fewer places, a two stage cluster sampling process was
performed within each stratum.
A cluster is a natural grouping of people—for example, towns,
villages, schools, streets, and households. The sampling of
clusters in the above study was a two stage process. The first
stage of cluster sampling involved a random sample of 26
villages within each stratum or region. The probability of
selection was proportional to the population size of the
region—that is, larger villages had a greater probability of being
selected than smaller ones. Within each chosen village, a fixed
number of 20 households were selected using systematic random
sampling. The household was the unit of analysis, with a census
of each household achieved through a questionnaire.
The two stage cluster sampling process described above is
referred to as a multistage cluster sampling approach, or simply
multistage sampling. In multistage sampling, the resulting
sample is obtained in two or more stages, with the nested or
hierarchical structure of the members within the population
being taken into account. Population members are arranged in
clusters. The method is based on the random sampling of clusters
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 BMJ 2013;347:f7016 doi: 10.1136/bmj.f7016 (Published 22 November 2013)
at each stage, with the sampled clusters nested within the clusters
sampled at the previous stage. In the example above, a two stage
multistage sampling approach was used. The first stage involved
random sampling of 26 villages within each region. The second
stage involved the systematic random sampling of 20 households
in each chosen village. The division of the country into regions
was seen as stratification and not the first stage of a multistage
sampling process (b is false). This is because all regions in the
country were included and no random sampling of the regions
took place.
The cluster sampling of villages within each stratum involved
the construction of the sampling frame—that is, a list of all
villages within each region. However, presumably it was not
possible to list all the households in each chosen village.
Therefore, households in a village were selected using
systematic random sampling, which does not depend on a
sampling frame (c is false). This involved selecting a single
household in a village at random, with households then chosen
at regular intervals thereafter—for example, every fifth
household. Systematic sampling is typically considered to be a
random sampling method, as long as the starting point is random
and the periodic interval of selecting participants is determined
before sampling takes place.
There are two types of sampling methods—probability sampling
(also known as random sampling) and non-probability sampling
(also known as non-random sampling). By definition, probability
sampling methods involve some form of random selection of
the population members, with each population member having
a known and typically equal probability of being selected. For
a non-probability sampling method, the probability of selection
for each population member is not known. Although it is
debatable, the method of stratified cluster sampling used above
is probably best described as a non-probability sampling method.
The villages in each region, and the households in each village,
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ENDGAMES
were chosen at random. It was possible to count the number of
households in each chosen village. However, the number of
households in each of the clusters that were not selected was
not known. Hence the probability of selection of a household
in the population could not be determined. Samples resulting
from non-probability sampling methods are generally considered
not to be representative of the population. However, there is no
reason to think that the sample in the study above was not
representative of the population—the sampling approach ensured
that the resulting sample was representative of each region.
If a sampling approach involves only a single stage of sampling
of clusters it is referred to as cluster sampling. A random sample
of clusters from the population is obtained and all members of
the selected clusters are included in the resulting sample. After
the selection of clusters, no further sampling takes place. Cluster
sampling is often used to select participants for a trial—so
called, cluster trials. Cluster trials have been described in a
previous question.3 However, in such trials the clusters are
typically not selected at random from the population but by
using convenience sampling—that is, by selecting conveniently
located clusters. Convenience sampling has been described in
a previous question.4
Competing interests: None declared.
1 Reza A, Tomczyk B, Aguayo VM, Zagré NM, Goumbi K, Blanton C, et al. Retrospective
determination of whether famine existed in Niger, 2005: two stage cluster survey. BMJ
2008;337:a1622.
2 Howe P, Devereux S. Famine intensity and magnitude scales: a proposal for an
instrumental definition of famine. Disasters 2004;28:353-72.
3 Sedgwick P. Cluster randomised controlled trials. BMJ 2012;345:e4654.
4 Sedgwick P. Convenience sampling. BMJ 2013;347:f6304.
Cite this as: BMJ 2013;347:f7016
© BMJ Publishing Group Ltd 2013
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