3.5 Sampling TechniqueA list of the Rugas in each ward was used to select the houses to be visited. A Ruga is a settlement that includes several households often ranging from 1 – 20 households. A household (HH) is made up of parents and the children, and possibly any member of the extended family living with them. This list was compiled during the Nomads outreach project as part of the Global Polio Eradication Initiative. During that activity the population of children under the age of five (U5) was recorded.3.5.1 Multistage samplingStage 1: Selected 4 wards that had more nomadic settlements (? 50) out of 10 wards in Makarfi LGA Stage 2: Randomly selected 56 Rugas by proportionate distribution according to the number of Rugas in each ward from the sampling frame using the research randomizer application. Stage 3: Randomly selected households to be sampled in each Ruga, out of every 5 households, 4 were selected at random by balloting. This resulted in 4HH being selected in Rugas with 5 HH, 8 HH in Rugas with upto 10 HH and 12-16 HH being selected in Rugas with 15-20 HH. Stage 4: Randomly selected one participant from each household.The participants were selected from the households by balloting based on the criteria for inclusion (i.e., all consenting women of reproductive age, who had children and the youngest was U5 or women who were pregnant at the time of study). The first question that was asked in a selected household sought to know the number of women who were within reproductive age, who had children or were pregnant. These women were then made to ballot using pieces of paper24in which one yes and the rest with no were scribbled. The person who picked the paper with yes on it was chosen to participate in the study. If a person selected did not consent to participate, the balloting was repeated but the non-consenting individual was excluded in the balloting. If no one was at home at the time of visit, the house (Ruga) was revisited after which if no one was met in the house, that house was abandoned and the next house on the list was selected. If a house visited did not have any individual who met the criteria for inclusion, the next house on the list was selected until the desired sample size was achieved. Geographical Positioning System (GPS) readings were taken for the houses selected for the study to determine the distance between the houses and the health facilities providing services. The nature of roads, mode of transportation and the average distance to the nearest health facility was determined.