Abstract

The 2005 Guyana HIV/AIDS Indicator Survey (GAIS) is the first household-based, comprehensive survey on HIV/AIDS to be carried out in Guyana. The 2005 GAIS was implemented by the Guyana Responsible Parenthood Association (GRPA) for the Ministry of Health (MoH). ORC Macro of Calverton, Maryland provided technical assistance to the project through its contract with the U.S. Agency for International Development (USAID) under the MEASURE DHS program. Funding to cover technical assistance by ORC Macro and for local costs was provided in their entirety by USAID/Washington and USAID/Guyana.

The 2005 GAIS is a nationally representative sample survey of women and men age 15-49 initiated by MoH with the purpose of obtaining national baseline data for indicators on knowledge/awareness, attitudes, and behavior regarding HIV/AIDS. The survey data can be effectively used to calculate valuable indicators of the President’s Emergency Plan for AIDS Relief (PEPFAR), the Joint United Nations Program on HIV/AIDS (UNAIDS), the United Nations General Assembly Special Session (UNGASS), the United Nations Children Fund (UNICEF) Orphan and Vulnerable Children unit (OVC), and the World Health Organization (WHO), among others. The overall goal of the survey was to provide program managers and policymakers involved in HIV/AIDS programs with information needed to monitor and evaluate existing programs; and to effectively plan and implement future interventions, including resource mobilization and allocation, for combating the HIV/AIDS epidemic in Guyana.

Other objectives of the 2005 GAIS include the support of dissemination and utilization of the results in planning, managing and improving family planning and health services in the country; and enhancing the survey capabilities of the institutions involved in order to facilitate the implementation of surveys of this type in the future.

The 2005 GAIS sampled over 3,000 households and completed interviews with 2,425 eligible women and 1,875 eligible men. In addition to the data on HIV/AIDS indicators, data on the characteristics of households and its members, malaria, infant and child mortality, tuberculosis, fertility, and family planning were also collected.

Geographic coverage

National

Analysis unit

• Individuals;
• Households.

Kind of data

Sample survey data [ssd]

Sampling procedure

The primary objective of the 2005 GAIS is to provide estimates with acceptable precision for important population characteristics such as HIV/AIDS related knowledge, attitudes, and behavior. The population to be covered by the 2005 GAIS was defined as the universe of all women and men age 15-49 in Guyana.

The major domains to be distinguished in the tabulation of important characteristics for the eligible population are: • Guyana as a whole • The urban area and the rural area each as a separate major domain • Georgetown and the remainder urban areas.

Administratively, Guyana is divided into 10 major regions. For census purposes, each region is further subdivided in enumeration districts (EDs). Each ED is classified as either urban or rural. There is a list of EDs that contains the number of households and population for each ED from the 2002 census. The list of EDs is grouped by administrative units as townships. The available demarcated cartographic material for each ED from the last census makes an adequate sample frame for the 2005 GAIS.

The sampling design had two stages with enumeration districts (EDs) as the primary sampling units (PSUs) and households as the secondary sampling units (SSUs). The standard design for the GAIS called for the selection of 120 EDs. Twenty-five households were selected by systematic random sampling from a full list of households from each of the selected enumeration districts for a total of 3,000 households. All women and men 15-49 years of age in the sample households were eligible to be interviewed with the individual questionnaire.

The database for the recently completed 2002 Census was used as a sampling frame to select the sampling units. In the census frame, EDs are grouped by urban-rural location within the ten administrative regions and they are also ordered in each administrative unit in serpentine fashion. Therefore, this stratification and ordering will be also reflected in the 2005 GAIS sample.

Based on response rates from other surveys in Guyana, around 3,000 interviews of women and somewhat fewer of men expected to be completed in the 3,000 households selected.

Several allocation schemes were considered for the sample of clusters for each urban-rural domain. One option was to allocate clusters to urban and rural areas proportionally to the population in the area. According to the census, the urban population represents only 29 percent of the population of the country. In this case, around 35 clusters out of the 120 would have been allocated to the urban area. Options to obtain the best allocation by region were also examined. It should be emphasized that optimality is not guaranteed at the regional level but the power for analysis is increased in the urban area of Georgetown by departing from proportionality. Upon further analysis of the different options, the selection of an equal number of clusters in each major domain (60 urban and 60 rural) was recommended for the 2005 GAIS. As a result of the nonproportionalallocation of the number of EDs for the urban-rural and regional domains, the household sample for the 2005 GAIS is not a self-weighted sample.

The 2005 GAIS sample of households was selected using a stratified two-stage cluster design consisting of 120 clusters. The first stage-units (primary sampling units or PSUs) are the enumeration areas used for the 2002 Population and Housing Census. The number of EDs (clusters) in each domain area was calculated dividing its total allocated number of households by the sample take (25 households for selection per ED). In each major domain, clusters are selected systematically with probability proportional to size.

The sampling procedures are more fully described in "Guyana HIV/AIDS Indicator Survey 2005 - Final Report" pp.135-138.

Mode of data collection

Face-to-face [f2f]

Research instrument

Two types of questionnaires were used in the survey, namely: the Household Questionnaire and the Individual Questionnaire. The contents of these questionnaires were based on model questionnaires developed by the MEASURE DHS program. In consultation with USAID/Guyana, MoH, GRPA, and other government agencies and local organizations, the model questionnaires were modified to reflect issues relevant to HIV/AIDS in Guyana. The questionnaires were finalized around mid-May.

The Household Questionnaire was used to list all the usual members and visitors in the selected households. For each person listed, information was collected on sex, age, education, and relationship to the head of the household. An important purpose of the Household Questionnaire was to identify women and men who were eligible for the individual interview.

The Household Questionnaire also collected non-income proxy indicators about the household's dwelling unit, such as the source of water; type of toilet facilities; materials used for the floor, roof and walls of the house; and ownership of various durable goods and land. As part of the Malaria Module, questions were included on ownership and use of mosquito bednets.

The Individual Questionnaire was used to collect information from women and men age 15-49 years and covered the following topics: • Background characteristics (age, education, media exposure, employment, etc.) • Reproductive history (number of births and—for women—a birth history, birth registration, current pregnancy, and current family planning use) • Marriage and sexual activity • Husband’s background • Knowledge about HIV/AIDS and exposure to specific HIV-related mass media programs • Attitudes toward people living with HIV/AIDS • Knowledge and experience with HIV testing • Knowledge and symptoms of other sexually transmitted infections (STIs) • The malaria module and questions on tuberculosis

Cleaning operations

The processing of the GAIS questionnaires began in mid-July 2005, shortly after the beginning of fieldwork and during the first visit of the ORC Macro data processing specialist. Questionnaires for completed clusters (enumeration districts) were periodically submitted to GRPA offices in Georgetown, where they were edited by data processing personnel who had been trained specifically for this task. The concurrent processing of the data—standard for surveys participating in the DHS program—allowed GRPA to produce field-check tables to monitor response rates and other variables, and advise field teams of any problems that were detected during data entry. All data were entered twice, allowing 100 percent verification. Data processing, including data entry, data editing, and tabulations, was done using CSPro, a program developed by ORC Macro, the U.S. Bureau of Census, and SERPRO for processing surveys and censuses. The data entry and editing of the questionnaires was completed during a second visit by the ORC Macro specialist in mid-September. At this time, a clean data set was produced and basic tables with the basic HIV/AIDS indicators were run. The tables included in the current report were completed by the end of November 2005.

Response rate

• From a total of 3,055 households in the sample, 2,800 were occupied. Among these households, interviews were completed in 2,608, for a response rate of 93 percent. • A total of 2,776 eligible women were identified and

The Demographic and Health Surveys (DHS) Program overseen by the US Agency for International AID (USAID) uses nationally representative surveys, biomarker testing, and geographic location to collect data on monitoring and impact evaluation indicators for individual countries and for cross-country comparisons.

Standardized DHS surveys include the Demographic and Health Survey, Service Provision Assessment, HIV/AIDS Indicator Survey, Malaria Indicator Survey, and Key Indicators Survey. The DHS Program also collects biomarkers and geographic data. Data availability varies by year and country. A table that lists all currently available data can be found here.

Abstract

The 2011 Uganda AIDS Indicator Survey (AIS) is a nationally representative, population-based, HIV serological survey. The survey was designed to obtain national and sub-national estimates of the prevalence of HIV and syphilis infection as well as information about other indicators of programme coverage, such as knowledge, attitudes, and sexual behaviour related to HIV/AIDS. Data collection took place from 8 February to the first few days of September 2011.

The UAIS was implemented by the Ministry of Health. ICF International provided financial and technical assistance for the survey through a contract with USAID/Uganda. Financial and technical assistance was also provided by the U.S. Centers for Disease Control and Prevention (CDC). Financial support was provided by the Government of Uganda, the U.S. Agency for International Development (USAID), the President’s Emergency Fund for AIDS Relief (PEPFAR), the World Health Organisation (WHO), the UK Department for International Development (DFID), and the Danish International Development Agency (DANIDA) through the Partnership Fund. The Uganda Bureau of Statistics also partnered in the implementation of the survey. Central testing was conducted at the Uganda Virus Research Institute, with CDC conducting CD4 counts, polymerase chain reaction (PCR) testing for children, and quality control tests.

The survey provided information on knowledge, attitudes, and behaviour regarding HIV/AIDS and indicators of coverage and access to other programmes, for example, HIV testing, access to antiretroviral therapy, services for treating sexually transmitted infections, and coverage of interventions to prevent motherto-child transmission of HIV. The survey also collected information on the prevalence of HIV and syphilis and their social and demographic variations in the country. The overall goal of the survey was to provide programme managers and policymakers involved in HIV/AIDS programmes with strategic information to effectively plan, implement, and evaluate HIV/AIDS interventions.

The information obtained from the survey will help programme implementers to monitor and evaluate existing programmes and design new strategies for combating the HIV/AIDS epidemic in Uganda. The survey data will in addition be used to make population projections and to calculate indicators developed by the UN General Assembly Special Session (UNGASS), USAID, PEPFAR, the UNAIDS Programme, WHO, the Uganda Health Sector Strategic and Investment Plan, and the Uganda AIDS Commission.

The specific objectives of the 2011 UAIS were to provide information on: • Prevalence and distribution of HIV and syphilis • Indicators of knowledge, attitudes, and behaviour related to HIV/AIDS and other sexually transmitted infections • HIV/AIDS programme coverage indicators • Levels of CD4 T-lymphocyte counts among HIV-positive adults to quantify HIV treatment needs and to calibrate model-based estimates • HIV prevalence that can be used to calibrate and improve the sentinel surveillance system • Risk factors for HIV and syphilis infections in Uganda.

Geographic coverage

National coverage

Analysis unit

• Household
• Children age 0-4
• Women age 15-59
• Men age 15-59

Universe

The de facto population includes all residents and nonresidents who stayed in the household the night before the interview.

Kind of data

Sample survey data [ssd]

Sampling procedure

The sample for the 2011 UAIS covered the population residing in households. A representative probability sample of 11,750 households was selected for the survey. The sample was constructed to allow for separate estimates for HIV/AIDS indicators for each of 10 geographic regions. The regions were created for the survey and do not represent administrative units of the country. Other than Kampala, each region comprised between 8 and 15 contiguous administrative districts of Uganda that share similar languages and cultural characteristics. Because of its unique character as an entirely urban district and capital city of Uganda,

Kampala comprised a separate region. The 10 regions were comprised of the following districts1: • Central 1: Bukomansimbi, Gomba, Lwengo, Lyantonde, Kalangala, Kalungu, Masaka, Mpigi, Rakai, Ssembabule, and Wakiso. • Central 2: Buikwe, Buvuma, Kayunga, Kiboga, Kyankwanzi, Luwero, Mityana, Mubende, Mukono, Nakaseke, and Nakasongola. • Kampala: Kampala district. • East-Central: Bugiri, Buyende, Iganga, Jinja, Kaliro, Kamuli, Luuka, Mayuge, and Namutumba • Mid Eastern: Budaka, Bududa, Bukwa, Bulambuli, Busia, Butaleja, Kapchorwa, Kibuku, Kween, Manafwa, Mbale, Pallisa, Sironko, and Tororo. • North East: Abim, Amudat, Amuria, Bukedea, Kaabong, Kaberamaido, Katakwi, Kotido, Kumi, Moroto, Nakapiripirit, Napak, Nora, Serere, and Soroti. • West Nile: Arua, Adjumani, Koboko, Moyo, Nebbi, Maracha, Yumbe, and Zombo. • Mid Northern: Agago, Alebtong, Amolatar, Amuru, Apac, Dokolo, Gulu, Kitgum, Kole, Lamwo, Lira, Otuke, Oyam, and Pader. • South Western: Buhweju, Bushenyi, Ibanda, Isingiro, Kabale, Kanungu, Kiruhura, Kisoro, Mbarara, Mitooma, Ntungamo, Rubirizi, Rukungiri, and Sheema. • Mid Western: Buliisa, Bundibugyo, Hoima, Kabarole, Kamwenge, Kasese, Kibaale, Kiryandongo, Kyegegwa, Kyenjojo and Masindi.

The sample was allocated equally across all 10 regions, so as to allow a sufficient size to produce reliable estimates in each region. Since the sample was not allocated in proportion to the size of each region, the UAIS sample is not self-weighting at the national level. Consequently, weighting factors have been applied to the data to produce nationally representative estimates.

The survey utilised a two-stage sample design. The first stage involved selecting sample points or clusters from a list of enumeration areas (EAs) covered in the 2002 Population Census. A total of 470 clusters was selected (47 in each region), comprised of 79 urban and 391 rural points. The second stage of selection involved the systematic sampling of 25 households per cluster from a list of households in each cluster that was produced by the Uganda Bureau of Statistics prior to the UAIS data collection.

All women and men age 15-59 years who were either permanent residents of the households in the sample or visitors present in the household on the night before the survey were eligible for interviews. All women and men who were interviewed were asked to voluntarily give a blood sample for testing. In addition, blood samples were drawn from children under age 5 after obtaining consent from their parents or caretaker.

(Refer Appendix A of the final survey report for detail sample design and implementation)

Mode of data collection

Face-to-face [f2f]

Research instrument

Two questionnaires were used to collect data: the Household Questionnaire and the Individual Questionnaire for women and men age 15-59. The contents of the questionnaires were based on the model AIDS Indicator Survey questionnaires developed by the MEASURE DHS programme and on the questionnaires used in the 2004-05 Uganda HIV/AIDS Sero-Behavioural Survey (UHSBS). The two questionnaires were loaded onto personal digital assistants (PDAs) that were used to conduct the interviews.

In consultation with stakeholders from government agencies and local and international organisations, the questionnaires were revised to reflect HIV/AIDS issues relevant to Uganda. The questionnaires were then translated from English into six local languages—Ateso-Karamajong, Luganda, Lugbara, Luo, Runyankole-Rukiga, and Runyoro-Rutoro. They were further refined after the pretest and training of the field staff.

The Household Questionnaire on PDAs was used to list all the usual members and visitors in the selected households. Some basic information was collected on the characteristics of each person listed, including age, sex, education, relationship to the head of the household, and orphanhood among children under age 18. An important purpose of the Household Questionnaire was to identify women and men who were eligible for the individual interview. The Household Questionnaire was also used to collect information on characteristics of the household’s dwelling unit, such as the source of water, type of toilet facilities, materials used to construct the house, ownership of various durable goods, and ownership of land and farm animals. Information was also collected on adult chronic illness and deaths in the household during the 12 months before the survey.

The Individual Questionnaire on PDAs was used to collect information from all women and men age 15-59.

In addition to the questionnaires, two paper forms were used to record results of home-based testing: a Field Test Result Form for Adults and a Field Test Result Form for Children. These forms were used by the teams’ laboratory technicians to obtain informed consent and record the results of the home-based testing and any treatment provided to respondents.

All aspects of the UAIS data collection were pretested in October 2010. For this, four teams were formed, each with one supervisor, two female interviewers, two male interviewers, three laboratory technicians, and two HIV/AIDS counsellors. Team members were trained for two weeks and then proceeded to conduct the pretest in four locations: Hoima in the west, Lira in the north, Soroti in the east, and Wakiso, just outside of Kampala city. The four clusters were selected by the Uganda Bureau of Statistics to exclude clusters that had been selected for the main survey and to represent a range of languages. Interviews were conducted using the PDAs. The lessons learned from the pretest were used to finalise the survey

Abstract

This 2011-12 Tanzania HIV/AIDS and Malaria Indicator Survey (THMIS) was implemented by the National Bureau of Statistics (NBS) in collaboration with the Office of the Chief Government Statistician (OCGS-Zanzibar) from December 16, 2011, to May 24, 2012.The Tanzania Commission for AIDS (TACAIDS) and the Zanzibar AIDS Commission authorized the National Bureau of Statistics (NBS) to conduct the 2011-12 THMIS. The survey covers both the Tanzania Mainland and Zanzibar.

The objectives of the 2011-12 THMIS were to collect data on knowledge and behaviour regarding HIV/AIDS and malaria, measure HIV prevalence among women and men age 15-49, and measure the presence of malaria parasites and anaemia among children age 6-59 months. The 2011-12 THMIS follows up on the 2007-08 THMIS and the 2003-04 Tanzania HIV/AIDS Indicator Survey (THIS). The 2011-12 THMIS also updates estimates of selected basic demographic and health indicators covered in previous surveys, including the 1991-92 Tanzania Demographic and Health Survey (TDHS), the 1996 TDHS, the 1999 Reproductive and Child Health Survey, the 2004-05 TDHS, and the 2010 TDHS.

Geographic coverage

National coverage

Analysis unit

• Individuals
• Households

Universe

The survey covered all de jure household members (usual residents), all eligible men and women aged between 15-49 years, and all children age 6-59 months in the household.

Kind of data

Sample survey data [ssd]

Sampling procedure

The sampling frame used for the 2011-12 THMIS was developed by the National Bureau of Statistics (NBS) after the 2002 Population and Housing Census (PHC) and is the same as that used for the 2010 and 2004-05 Tanzania Demographic and Health Surveys (TDHS), the 2007-2008 THMIS, and the 2003-04 Tanzania HIV and AIDS Indicator Survey (THIS). The sampling frame excluded nomadic and institutional populations such as persons in hotels, barracks, and prisons.

The 2011-12 THMIS was designed to allow estimates of key indicators for each of Tanzania's 30 regions. The sample was selected in two stages. The first stage involved selecting sample points (clusters) consisting of enumeration areas (EAs) delineated for the 2002 PHC. A total of 583 clusters were selected.On the Mainland, 30 sample points were selected in Dar es Salaam and 20 were selected in each of the other 24 regions.2 In Zanzibar, 15 sample points were selected in each of the five regions.

The second stage of selection involved the systemic sampling of households. A household listing operation was undertaken in all the selected areas prior to the fieldwork. From these lists, households to be included in the survey were selected. Approximately 18 households were selected from each sample point for a total sample size of 10,496 households.

The sampling procedures are more fully described in "Tanzania HIV/AIDS and Malaria Indicator Survey 2011-2012 - Final Report" pp.4-5.

Mode of data collection

Face-to-face [f2f]

Research instrument

Two questionnaires were used for the 2011-12 THMIS: the Household Questionnaire and the Individual Questionnaire. These questionnaires are based on the MEASURE DHS standard AIDS Indicator Survey and Malaria Indicator Survey questionnaires and were adapted to reflect the population and health issues relevant to Tanzania. Input was solicited from various stakeholders representing government ministries and agencies, nongovernmental organizations, development partners, and international donors. After the preparation of the definitive questionnaires in English, the questionnaires were translated into Kiswahili.

The Household Questionnaire was used to list all the usual members and visitors of selected households. Some basic demographic information was collected on the characteristics of each person, including his or her age, sex, education, and relationship to the head of the household. For children under age 18, survival status of the parents was determined. The data on age and sex of household members obtained in the Household Questionnaire was used to identify women and men who were eligible for the individual interview and HIV testing. The Household Questionnaire also collected information on characteristics of the household’s dwelling unit, such as the source of water, type of toilet facilities, materials used for the floor of the house, ownership of various durable goods, and ownership and use of mosquito nets. The Household Questionnaire was also used to record haemoglobin and malaria testing results for children age 6-59 months.

The Individual Questionnaire was used to collect information from all eligible women and men age 15-49. These respondents were asked questions on the following topics: - Background characteristics (education, media exposure, etc.) - Marriage and sexual activity - Employment - Awareness and behaviour regarding HIV/AIDS and other sexually transmitted infections (STIs) - Knowledge and awareness of malaria - Other health issues

Female respondents were asked to provide their birth history for the six years preceding the interview and information about recent fever and treatment of fever for children born since January 2006.

Response rate

A total of 10,496 households were selected for the sample, from both Mainland Tanzania and Zanzibar. Of these, 10,226 were found to be occupied at the time of the survey. A total of 10,040 households were successfully interviewed, yielding a response rate of 98 percent. In the interviewed households, 11,423 women were identified as eligible for the individual interview. Completed interviews were obtained for 10,967 women, yielding a response rate of 96 percent. Of the 9,388 eligible men identified, 8,352 were successfully interviewed (89 percent response rate).

The principal reason for nonresponse among both eligible women and men was the failure to find them at home despite repeated visits to the households. The lower response rate among men than among women was due to the more frequent and longer absences of men from the households.

Sampling error estimates

The estimates from a sample survey are affected by two types of errors: non-sampling errors and sampling errors. Non-sampling errors are the results of mistakes made in implementing data collection and data processing, such as failure to locate and interview the correct household, misunderstanding of the questions on the part of either the interviewer or the respondent, and data entry errors. Although numerous efforts were made during the implementation of the 2011-12 Tanzania HIV/AIDS and Malaria Indicator Survey (2011-12 THMIS) to minimize this type of error, non-sampling errors are impossible to avoid and difficult to evaluate statistically.

Sampling errors, on the other hand, can be evaluated statistically. The sample of respondents selected in the 2011-12 THMIS is only one of many samples that could have been selected from the same population, using the same design and expected size. Each of these samples would yield results that differ somewhat from the results of the actual sample selected. Sampling errors are a measure of the variability among all possible samples. Although the degree of variability is not known exactly, it can be estimated from the survey results.

Sampling error is usually measured in terms of the standard error for a particular statistic (mean, percentage, etc.), which is the square root of the variance. The standard error can be used to calculate confidence intervals within which the true value for the population can reasonably be assumed to fall. For example, for any given statistic calculated from a sample survey, the value of that statistic will fall within a range of plus or minus two times the standard error of that statistic in 95 percent of all possible samples of identical size and design.

If the sample of respondents had been selected as a simple random sample, it would have been possible to use straightforward formulas for calculating sampling errors. However, the 2011-12 THMIS sample is the result of a multi-stage stratified design, and, consequently, it was necessary to use more complex formulas. Sampling errors are computed by SAS, using programs developed by ICF International. These programs use the Taylor linearization method of variance estimation for survey estimates that are means, proportions, or ratios. The Jackknife repeated replication method is used for variance estimation of more complex statistics such as fertility and mortality rates.

The estimates of sampling error are more fully described in appendix B in document "Tanzania HIV/AIDS and Malaria Indicator Survey 2011-2012 - Final Report" pp.199-200.

Data appraisal

A series of data quality tables are available to review the quality of the data and include the following:

• Age distribution of the household population
• Age distribution of eligible and interviewed women
• Age distribution of eligible and interviewed men
• Completeness of reporting

The results of each of these data quality tables are shown in appendix C in document "Tanzania HIV/AIDS and Malaria Indicator Survey 2011-2012 - Final Report" pp.227-229.

AIS, AIDS Indicator Surveys; KIS, Key Indicator Surveys; MIS, Malaria Indicator Surveys; SPA, Service Provision Assessment Surveys.

Abstract

The UHSBS is a nationally representative, population-based survey designed to obtain national and sub-national data on the prevalence of HIV and other sexually transmitted infections (STIs) and their social and demographic variations in the country. The survey also obtained information on knowledge, attitudes, and behaviour regarding HIV/AIDS. Data collection took place from 14 August 2004 until late January 2005.

The overall goal of the survey was to provide programme managers and policymakers involved in HIV/AIDS programmes with strategic information needed to monitor and evaluate existing programmes and to effectively design new strategies for combating the epidemic in Uganda. The survey data will also be used to make population projections and to calculate indicators of the UN General Assembly Special Session (UNGASS), USAID, the President’s Emergency Plan for AIDS Relief, UNAIDS, WHO, the Uganda Health Sector Strategic Plan, and the HIV/AIDS National Strategic Framework.

The specific objectives of the 2004-05 UHSBS were the following: • To obtain accurate estimates of the magnitude and variation in HIV prevalence in Uganda • To obtain accurate information on behavioural and care indicators related to HIV/AIDS and other sexually transmitted infections • To obtain accurate information on other HIV/AIDS programme indicators • To provide information on HIV prevalence to calibrate and improve the sentinel surveillance system • To determine the magnitude and distribution of syphilis, herpes simplex 2, and hepatitis B infection.

Geographic coverage

National

Analysis unit

• Household
• Women aged 15-59
• Men aged 15-59

Kind of data

Sample survey data [ssd]

Sampling procedure

The sample for the 2004-05 UHSBS covered the population residing in households in the country. A representative probability sample of 10,425 households was selected for the UHSBS, and an additional 12 households were found during field work for a total of 10,437. The sample was constructed to allow for separate estimates for key indicators for each of nine regions created for the survey, consisting of eight groups of the (then) 56 districts in Uganda, and Kampala, the capital, as a region on its own. The regions were delineated as follows:

1 Central: Kalangala, Kiboga, Luwero, Masaka, Mpigi, Mubende, Nakasongola, Rakai, Sembabule, and Wakiso 2 Kampala 3 East Central: Bugiri, Iganga, Jinja, Kamuli, Kayunga, Mayuge, and Mukono 4 Eastern: Busia, Kapchorwa, Mbale, Pallisa, Sironko, and Tororo 5 Northeast: Kaberamaido, Katakwi, Kotido, Kumi, Moroto, Nakapiripirit, and Soroti 6 North Central: Apac, Gulu, Kitgum, Lira, and Pader 7 West Nile: Adjumani, Arua, Moyo, Nebbi, and Yumbe 8 Western: Bundibugyo, Hoima, Kabarole, Kamwenge, Kasese, Kibaale, Kyenjojo, and Masindi 9 Southwest: Bushenyi, Kabale, Kanungu, Kisoro, Mbarara, Ntungamo, and Rukungiri.

The sample was allocated roughly equally across all nine regions to allow a sufficient size in each to produce reliable results. Since the sample was not allocated in proportion to the size of each region, the UHSBS sample is not self-weighting at the national level. Consequently, weighting factors have been applied to the data to produce nationally representative results.

The survey utilised a two-stage sample design. The first stage involved selecting sample points or clusters from a list of enumeration areas (EAs) covered in the 2002 Population Census. A total of 417 clusters composed of 74 urban and 343 rural points were selected. The second stage of selection involved the systematic sampling of households from the census list of households in each cluster. Twenty-five households were selected in each EA.

All women and men aged 15-59 who were either permanent residents of the households in the sample or visitors present in the household on the night before the survey were eligible to be interviewed in the survey. Unlike most studies in which the age category reflects the reproductive age group 15-49, the upper age cutoff in this survey was extended to 59 years so as to include the segment of the population that remains sexually active up to that age. Nevertheless, since most of the internationally accepted HIV/AIDS indicators are based on the population aged 15-49, most of the results presented in this report reflect this age group.

All women and men who were interviewed were asked to voluntarily give a blood sample for testing. Blood samples were also drawn from children under age five years after obtaining consent from their parents or caretakers. Children aged 5-14 years were not enrolled in the survey because other studies have shown a very low HIV prevalence in this age group.

Mode of data collection

Face-to-face [f2f]

Research instrument

Two questionnaires were used in the survey, a Household Questionnaire and an Individual Questionnaire for women and men aged 15-59. The contents of these questionnaires were based on the model AIDS Indicator Survey questionnaires developed by the MEASURE DHS programme.

In consultation with a spectrum of government agencies and local and international organisations, the MOH and MEASURE DHS adapted the model questionnaires to reflect issues in HIV/AIDS relevant to Uganda. These questionnaires were then translated from English into six local languages—Ateso- Karamajong, Luganda, Lugbara, Luo, Runyankole-Rukiga, and Runyoro-Rutoro. The questionnaires were further refined after the pretest and training of the field staff.

The Household Questionnaire was used to list all the usual members and visitors in the selected households. Some basic information was collected on the characteristics of each person listed, including age, sex, education, relationship to the head of the household, and orphanhood among children under age 18 years. The main purpose of the Household Questionnaire was to identify women and men who were eligible for the individual interview. The Household Questionnaire also collected information on characteristics of the household’s dwelling unit, such as the source of water, type of toilet facilities, materials used for the floor of the house, ownership of various durable goods, and ownership of mosquito nets. Information was also collected on whether the household had received specific types of care and support in the preceding 12 months for any chronically ill adults, any household members who died, and any orphans and vulnerable children. The Household Questionnaire was also used to record respondents’ consent to volunteer to give blood samples. The blood collection and testing procedures are described in the next section.

The Individual Questionnaire was used to collect information from all women and men aged 15-59 and it covered the following topics: • Background characteristics (e.g., education, media exposure, occupation, religion) • Reproduction • Marriage and sexual activity • Husband’s background (for women) • Knowledge and attitudes towards HIV/AIDS • Knowledge and prevalence of other sexually transmitted infections (STIs)

All aspects of the UHSBS data collection were pretested in June 2004. For this, five teams were formed, each with 1 supervisor, 2 female interviewers, 2 male interviewers and 2 laboratory technicians. Team members were trained for ten days and then proceeded to conduct the survey in the various districts in which their native language was spoken. In total, 300 individual interviews were completed in the pretest. The lessons learnt from the pretest were used to finalise the survey instruments and logistical arrangements for the survey.

Cleaning operations

The processing of the UHSBS questionnaires began shortly after the fieldwork commenced. Completed questionnaires were returned periodically from the field to the UHSBS project office in Kampala, where they were entered and edited by data processing personnel specially trained for this task. Data were entered using ORC Macro’s CSPro computer programme. All data were entered twice (100 percent verification). The concurrent processing of the data was a distinct advantage for data quality, because UHSBS staff were able to advise field teams of errors detected during data entry. The data entry and editing phase of the survey was completed in early March 2005.

Laboratory testing at the HIV Reference Laboratory (HRL) at the UVRI began shortly after the data collection. Priority was given to the HIV testing, followed by syphilis testing, Hepatitis B testing and herpes simplex. Testing included quality control testing at the CDC laboratory in Entebbe.

Response rate

A total of 10,437 households were selected in the sample, of which 9,842 were found to be occupied at the time of the fieldwork. The shortfall is largely a result of structures that were vacant or destroyed. Of existing households, 9,529 were interviewed, yielding a household response rate of 97 percent.

In the households interviewed in the survey, a total of 11,454 eligible women aged 15-59 were identified, of whom 10,826 were interviewed, yielding a response rate of 95 percent. With regard to the male survey results, 9,905 eligible men aged 15-59 were identified, of whom 8,830 were successfully interviewed, yielding a response rate of 89 percent. The response rate for both sexes combined is 92 percent.

Sampling error estimates

The estimates from a sample survey are affected by two types of errors: 1) nonsampling errors, and 2) sampling errors. Nonsampling errors are the results of mistakes made in implementing data collection and data processing, such as failure to locate and interview the correct household,

BackgroundIn the generalised epidemics of sub-Saharan Africa (SSA), human immunodeficiency virus (HIV) prevalence shows patterns of clustered micro-epidemics. We mapped and characterised these high-prevalence areas for young adults (15–29 years of age), as a proxy for areas with high levels of transmission, for 7 countries in Eastern and Southern Africa: Kenya, Malawi, Mozambique, Tanzania, Uganda, Zambia, and Zimbabwe.Methods and findingsWe used geolocated survey data from the most recent United States Agency for International Development (USAID) demographic and health surveys (DHSs) and AIDS indicator surveys (AISs) (collected between 2008–2009 and 2015–2016), which included about 113,000 adults—of which there were about 53,000 young adults (27,000 women, 28,000 men)—from over 3,500 sample locations. First, ordinary kriging was applied to predict HIV prevalence at unmeasured locations. Second, we explored to what extent behavioural, socioeconomic, and environmental factors explain HIV prevalence at the individual- and sample-location level, by developing a series of multilevel multivariable logistic regression models and geospatially visualising unexplained model heterogeneity. National-level HIV prevalence for young adults ranged from 2.2% in Tanzania to 7.7% in Mozambique. However, at the subnational level, we found areas with prevalence among young adults as high as 11% or 15% alternating with areas with prevalence between 0% and 2%, suggesting the existence of areas with high levels of transmission Overall, 15.6% of heterogeneity could be explained by an interplay of known behavioural, socioeconomic, and environmental factors. Maps of the interpolated random effect estimates show that environmental variables, representing indicators of economic activity, were most powerful in explaining high-prevalence areas. Main study limitations were the inability to infer causality due to the cross-sectional nature of the surveys and the likely under-sampling of key populations in the surveys.ConclusionsWe found that, among young adults, micro-epidemics of relatively high HIV prevalence alternate with areas of very low prevalence, clearly illustrating the existence of areas with high levels of transmission. These areas are partially characterised by high economic activity, relatively high socioeconomic status, and risky sexual behaviour. Localised HIV prevention interventions specifically tailored to the populations at risk will be essential to curb transmission. More fine-scale geospatial mapping of key populations,—such as sex workers and migrant populations—could help us further understand the drivers of these areas with high levels of transmission and help us determine how they fuel the generalised epidemics in SSA.

Abstract

The 2005 Vietnam Population and AIDS Indicator Survey (VPAIS) was designed with the objective of obtaining national and sub-national information about program indicators of knowledge, attitudes and sexual behavior related to HIV/AIDS. Data collection took place from 17 September 2005 until mid-December 2005.

The VPAIS was implemented by the General Statistical Office (GSO) in collaboration with the National Institute of Hygiene and Epidemiology (NIHE). ORC Macro provided financial and technical assistance for the survey through the USAID-funded MEASURE DHS program. Financial support was provided by the Government of Vietnam, the United States President’s Emergency Plan for AIDS Relief, the United States Agency for International Development (USAID), and the United States Centers for Disease Control and Prevention/Global AIDS Program (CDC/GAP).

The survey obtained information on sexual behavior, and knowledge, attitudes, and behavior regarding HIV/AIDS. In addition, in Hai Phong province, the survey also collected blood samples from survey respondents in order to estimate the prevalence of HIV. The overall goal of the survey was to provide program managers and policymakers involved in HIV/AIDS programs with strategic information needed to effectively plan, implement and evaluate future interventions.

The information is also intended to assist policymakers and program implementers to monitor and evaluate existing programs and to design new strategies for combating the HIV/AIDS epidemic in Vietnam. The survey data will also be used to calculate indicators developed by the United Nations General Assembly Special Session on HIV/AIDS (UNGASS), UNAIDS, WHO, USAID, the United States President’s Emergency Plan for AIDS Relief, and the HIV/AIDS National Response.

The specific objectives of the 2005 VPAIS were: • to obtain information on sexual behavior. • to obtain accurate information on behavioral indicators related to HIV/AIDS and other sexually transmitted infections. • to obtain accurate information on HIV/AIDS program indicators. • to obtain accurate estimates of the magnitude and variation in HIV prevalence in Hai Phong Province.

Geographic coverage

National coverage

Analysis unit

• Household
• Women age 15-49
• Men age 15-49

Kind of data

Sample survey data [ssd]

Sampling procedure

The sampling frame for the 2005 Vietnam Population and AIDS Indicator Survey (VPAIS) was the master sample used by the General Statistical Office (GSO) for its annual Population Change Survey (PCS 2005). The master sample itself was constructed in 2004 from the 1999 Population and Housing Census. As was true for the VNDHS 1997 and the VNDHS 2002 the VPAIS 2005 is a nationally representative sample of the entire population of Vietnam.

The survey utilized a two-stage sample design. In the first stage, 251 clusters were selected from the master sample. In the second stage, a fixed number of households were systematically selected within each cluster, 22 households in urban areas and 28 in rural areas.

The total sample of 251 clusters is comprised of 97 urban and 154 rural clusters. HIV/AIDS programs have focused efforts in the four provinces of Hai Phong, Ha Noi, Quang Ninh and Ho Chi Minh City; therefore, it was determined that the sample should be selected to allow for representative estimates of these four provinces in addition to the national estimates. The selected clusters were allocated as follows: 35 clusters in Hai Phong province where blood samples were collected to estimate HIV prevalence; 22 clusters in each of the other three targeted provinces of Ha Noi, Quang Ninh and Ho Chi Minh City; and the remaining 150 clusters from the other 60 provinces throughout the country.

Prior to the VPAIS fieldwork, GSO conducted a listing operation in each of the selected clusters. All households residing in the sample points were systematically listed by teams of enumerators, using listing forms specially designed for this activity, and also drew sketch maps of each cluster. A total of 6,446 households were selected. The VPAIS collected data representative of: • the entire country, at the national level • for urban and rural areas • for three regions (North, Central and South), see Appendix for classification of regions. • for four target provinces: Ha Noi, Hai Phong, Quang Ninh and Ho Chi Minh City.

All women and men aged 15-49 years who were either permanent residents of the sampled households or visitors present in the household during the night before the survey were eligible to be interviewed in the survey. All women and men in the sample points of Hai Phong who were interviewed were asked to voluntarily give a blood sample for HIV testing. For youths aged 15-17, blood samples were drawn only after first obtaining consent from their parents or guardians.

(Refer Appendix A of the final survey report for details of sample implementation)

Mode of data collection

Face-to-face [f2f]

Research instrument

Two questionnaires were used in the survey, the Household Questionnaire and the Individual Questionnaire for women and men aged 15-49. The content of these questionnaires was based on the model AIDS Indicator Survey (AIS) questionnaires developed by the MEASURE DHS program implemented by ORC Macro.

In consultation with government agencies and local and international organizations, the GSO and NIHE modified the model questionnaires to reflect issues in HIV/AIDS relevant to Vietnam. These questionnaires were then translated from English into Vietnamese. The questionnaires were further refined after the pretest.

The Household Questionnaire was used to list all the usual members and visitors in the selected households. Some basic information was collected on the characteristics of each person listed, including age, sex, relationship to the head of the household, education, basic material needs, survivorship and residence of biological parents of children under the age of 18 years and birth registration of children under the age of 5 years. The main purpose of the Household Questionnaire was to identify women and men who were eligible for the individual interview. The Household Questionnaire also collected information on characteristics of the household’s dwelling unit, such as the source of drinking water, type of toilet facilities, type of material used in the flooring of the house, and ownership of various durable goods, in order to allow for the calculation of a wealth index. The Household Questionnaire also collected information regarding ownership and use of mosquito nets.

The Individual Questionnaire was used to collect information from all women and men aged 15-49 years.

All questionnaires were administered in a face-to-face interview. Because cultural norms in Vietnam restrict open discussion of sexual behavior, there is concern that this technique may contribute to potential under-reporting of sexual activity, especially outside of marriage.

All aspects of VPAIS data collection were pre-tested in July 2005. In total, 24 interviewers (12 men and 12 women) were involved in this task. They were trained for thirteen days (including three days of fieldwork practice) and then proceeded to conduct the survey in the various urban and rural districts of Ha Noi. In total, 240 individual interviews were completed during the pretest. The lessons learnt from the pretest were used to finalize the survey instruments and logistical arrangements for the survey and blood collection.

Cleaning operations

The data processing of the VPAIS questionnaire began shortly after the fieldwork commenced. The first stage of data editing was done by the field editors, who checked the questionnaires for completeness and consistency. Supervisors also reviewed the questionnaires in the field. The completed questionnaires were then sent periodically to the GSO in Ha Noi by mail for data processing.

The office editing staff first checked that questionnaires of all households and eligible respondents had been received from the field. The data were then entered and edited using CSPro, a software package developed collaboratively between the U.S. Census Bureau, ORC Macro, and SerPRO to process complex surveys. All data were entered twice (100 percent verification). The concurrent processing of the data was a distinct advantage for data quality, as VPAIS staff was able to advise field teams of errors detected during data entry. The data entry and editing phases of the survey were completed by the end of December 2005.

Response rate

A total of 6,446 households were selected in the sample, of which 6,346 (98 percent) were found to be occupied at the time of the fieldwork. Occupied households include dwellings in which the household was present but no competent respondent was home, the household was present but refused the interview, and dwellings that were not found. Of occupied households, 6,337 were interviewed, yielding a household response rate close to 100 percent.

All women and men aged 15-49 years who were either permanent residents of the sampled households or visitors present in the household during the night before the survey were eligible to be interviewed in the survey. Within interviewed households, a total of 7,369 women aged 15-49 were identified as eligible for interview, of whom 7,289 were interviewed, yielding a response rate to the Individual interview of 99 percent among women. The high response rate was also achieved in male interviews. Among the 6,788 men aged 15-49 identified as eligible for interview, 6,707 were successfully interviewed, yielding a response rate of 99 percent.

Sampling error

The 2004-2005 Tanzania Demographic and Health Survey (DHS) is the sixth in a series of national survey conducted in Tanzania to measure level, patterns and trends in demographics and health indicators. The first was the 1991-92 TDHS, which was followed by the Tanzania Knowledge, Attitudes and Practices Survey (TKAPS) in 1994, the 1996 TDHS, the 1999 Tanzania Reproductive and Child Health Survey (TRCHS) and the 2003-04 Tanzania HIV AIDS Indicator Survey (THIS)

The 2007 Zambia Demographic and Health Survey (ZDHS) is a national sample survey designed to provide up-to-date information on background characteristics of the respondents, fertility levels, nuptiality, sexual activity, fertility preferences, awareness and use of family planning methods; breastfeeding practices; nutritional status of mothers and young children; early childhood mortality and maternal mortality; maternal and child health; and awareness, behaviour, and prevalence regarding HIV/AIDS and other sexually transmitted infections. The target groups were men age 15-59 and women age 15-49 in randomly selected households across Zambia. Information about children age 0-5 was also collected, including weight and height. The survey collected blood samples for syphilis and HIV testing in order to determine national prevalence rates. While significantly expanded, the 2007 ZDHS is a follow-up to the 1992, 1996, and 2001-2002 ZDHS surveys and provides updated estimates of basic demographic and health indicators covered in the earlier surveys. The 2007 ZDHS is the second DHS that includes the collection of information on violence against women, and syphilis and HIV testing. In addition, data on malaria prevention and treatment were collected. The ZDHS was implemented by the Central Statistical Office (CSO) in partnership with the Ministry of Health, the Tropical Disease Research Centre (TDRC), and the Demography Division at the University of Zambia (UNZA) from April to October 2007. The TDRC provided technical support in the implementation of the syphilis and HIV testing. Macro International provided technical assistance as well as funding to the project through MEASURE DHS, a USAID-funded project providing support and technical assistance in the implementation of population and health surveys in countries worldwide. The main objective is to provide information on levels and trends in fertility, childhood mortality, use of family planning methods, and maternal and child health indicators including HIV/AIDS. This information is necessary for programme managers, policymakers, and implementers to monitor and evaluate the impact of existing programmes and to design new initiatives for health policies in Zambia. The primary objectives of the 2007 ZDHS project are: To collect up-to-date information on fertility, infant and child mortality, and family planning. To collect information on health-related matters such as breastfeeding, antenatal care, children’s immunisations, and childhood diseases. To assess the nutritional status of mothers and children. To support dissemination and utilization of the results in planning, managing, and improving family planning and health services in the country. To enhance the survey capabilities of the institutions involved in order to facilitate the implementation of surveys of this type in future. To document current epidemics of STIs and HIV/AIDS through use of specialized modules. For HIV/AIDS and syphilis in particular, the testing component of the 2007 Zambia DHS was undertaken to provide information to address the monitoring and evaluation needs of government and non-governmental organization programmes addressing HIV/AIDS and syphilis, and to provide programme managers and policy makers with the information that they need to effectively plan and implement future interventions. The overall objective of the survey was to collect high-quality and representative data on knowledge, attitudes, and behaviours regarding HIV/AIDS and other STIs, and on the prevalence of HIV and syphilis infection among women and men.

Abstract

The 2003-04 Tanzania HIV/AIDS Indicator Survey (THIS) is the first population-based, comprehensive survey on HIV/AIDS to be carried out in Tanzania. The survey was initiated by the Tanzania Commission for AIDS (TACAIDS) with the purpose of getting national baseline data on the prevalence of HIV infection. The survey was not meant to replace the sentinel surveillance system undertaken by the Ministry of Health under its National AIDS Control Programme (NACP), but rather to form a basis for monitoring the national HIV/AIDS response.

The survey obtained information on knowledge/awareness, attitudes, and behaviour regarding HIV/AIDS. The overall goal of the survey was to provide programme managers and policymakers involved in HIV/AIDS programmes with information needed to effectively plan and implement future interventions, including resource mobilisation and allocation. More specifically, the objectives of the 2003-04 THIS were: • To measure HIV prevalence among women and men aged 15-49; • To assess levels and trends in knowledge about HIV/AIDS, attitudes towards those infected with the disease, and sexual behavioral practices; • To collect information on the proportion of adults who are chronically sick, the extent of orphanhood, and care and support levels; • To gauge the extent to which these indicators vary by characteristics of the individual such as age, sex, region, education, marital status and poverty status.

The 2003-04 THIS information is intended to provide data to assist policymakers and programme implementers to monitor and evaluate existing programmes and to design new strategies for combating the HIV/AIDS epidemic in Tanzania. The survey data will also be used to make population projections and to calculate indicators developed by the United Nations General Assembly Special Session (UNGASS), the UNAIDS Programme, and the World Health Organisation (WHO). Questions on nonincome proxy indicators were also added to measure indicators developed for the Tanzania Poverty Monitoring Master Plan (United Republic of Tanzania, 2001).

Geographic coverage

Tanzania Mainland only (Zanzibar excluded)

Analysis unit

• Individuals
• Households

Kind of data

Sample survey data [ssd]

Sampling procedure

The sample for the 2003-04 THIS covered the population residing in households in Tanzania Mainland only. Zanzibar was excluded from the survey because of a recent survey that included HIV/AIDS indicators. A representative probability sample of 6,900 households was selected for the THIS. This sample was constructed to allow separate estimates for some indicators for each of the 21 regions on the mainland, as well as for urban and rural areas separately. As a result of disproportionate sampling, the THIS sample is not self-weighting at the national level and weighting factors have been applied to the data in all tables, unless otherwise specified.

The THIS utilised a two-stage sample design. The first stage involved selecting sample points (clusters), consisting of enumeration areas delineated for the 2002 Population and Housing Census. A total of 345 clusters (87 urban and 258 rural) were selected. Sixteen clusters were selected in each region except Dar es Salaam, where 25 clusters were selected. NBS carried out a field operation in which all households living in the selected clusters were listed.

The second stage of selection involved the systematic sampling of households from these lists. A sample of 20 households was drawn from each cluster. All women and men aged 15-49 years who were either usual residents of the households in the sample or visitors present in the household on the night before the survey were eligible to be interviewed in the survey. In addition to the data collected through interviews, respondents were asked to provide few drops of blood for subsequent testing for HIV in the laboratory.

Mode of data collection

Face-to-face [f2f]

Research instrument

Two types of questionnaires were used in the survey, namely: the Household Questionnaire and the Individual Questionnaire. The contents of these questionnaires were based on model questionnaires developed by the MEASURE Demographic and Health Surveys (DHS) programme. In consultation with TACAIDS, NACP and other government agencies and local organisations, NBS modified the DHS model questionnaires to reflect relevant issues on HIV/AIDS in Tanzania. The questionnaires were then translated from English into Kiswahili and were further refined after the pretest and training of the field staff.

The Household Questionnaire was used to list all the usual members and visitors in the selected households. Some basic information was collected on the characteristics of each person listed, including age, sex, education and relationship to the head of the household. The main purpose of the Household Questionnaire was to identify women and men who were eligible for the individual interview. The Household Questionnaire also collected non-income proxy indicators about the household's dwelling unit, such as the source of water, type of toilet facilities, materials used for the floor, roof and walls of the house, ownership of various durable goods and land, and household food insecurity. The Household Questionnaire also included questions as to whether household members were seriously ill and whether anyone in the household had died in the past 12 months. In such cases, interviewers asked whether the household had received various kinds of care and support, such as financial assistance, medical support, or social or spiritual support.

The Individual Questionnaire was used to collect information from women and men aged 15-49 years and covered the following topics: • Background characteristics (age, education, media exposure, employment, religion, etc.) • Reproductive history (number of births and—for women—date of last birth, birth registration, current pregnancy, and current family planning use) • Marriage and sexual activity • Husband’s background • Knowledge about HIV/AIDS and exposure to specific HIV-related mass media programmes • Attitudes towards people living with HIV/AIDS • Knowledge and experience with HIV testing • Knowledge and symptoms of other sexually transmitted infections (STIs) • Circumcision All aspects of the THIS data collection were pre-tested in September 2003. A small team of field staff were trained for two weeks; the field staff then proceeded to conduct interviews in 180 households.

The lessons learned from the pretest were used to finalise the survey instruments and logistical arrangements for the survey.

Response rate

91.3

Response rate and HIV prevalence.

Abstract

The main objective of a demographic household survey (DHS) is to provide estimates of a number of basic demographic and health variables. This is done through interviews with a scientifically selected probability sample that is chosen from a well-defined population.

The 2007 Nauru Demographic and Health Survey (2007 NDHS) was one of four pilot demographic and health surveys conducted in the Pacific under an Asian Development Bank ADB/ Secretariat of the Pacific Community (SPC) Regional DHS Pilot Project. The primary objective of this survey was to provide up-to-date information for policy-makers, planners, researchers and programme managers, for use in planning, implementing, monitoring and evaluating population and health programmes within the country. The survey was intended to provide key estimates of Nauru's demographics and health situation. The findings of the 2007 NDHS are very important in measuring the achievements of family planning and other health programmes. To ensure better understanding and use of these data, the results of this survey should be widely disseminated at different planning levels. Different dissemination techniques will be used to reach different segments of society.

The primary purpose of the 2007 NDHS was to furnish policy-makers and planners with detailed information on fertility, family planning, infant and child mortality, maternal and child health, nutrition, and knowledge of HIV and AIDS and other sexually transmitted infections.

NOTE: The only dissemination used was wide distribution of the report. A planned data use workshop was not undertaken. Hence there is some misconceptions and lack of awareness on the results obtained from the survey. The report is provided on the NBOS website free for download.

Geographic coverage

National Coverage - Districts

Analysis unit

• Households
• Children (0-14yrs)
• Individual women of reproductive age (15-49 yrs)
• Individual men of reproductive age (15yrs+)
• Facilities providing reproductive and child health services

Universe

The survey covered all household members (usual residents), - All children (aged 0-14 years) resident in the household - All women of reproductive age (15-49 years) resident in all household - All males (15yrs and above) in every second household (approx. 50%) resident in selected household

Results: The 2007 Nauru Demographic Health Survey (2007 NDHS) is a nationally representative survey of 655 eligible women (aged 15-49) and 392 eligible men (aged 15 and above).

Kind of data

Sample survey data [ssd]

Sampling procedure

IDG NOTES: Locate sampling documentation with SPC (Graeme Brown) and internal files. Add in this sections. Or second option dilute appendix A Sampling and extract key issues.

ESTIMATES OF SAMPLING ERRORS - Refer to Appendix A of final NDHS2007 report or; - External Resources - 2007 DHS- Appendix A and B Sampling (to be created separatedly by IDG progress ongoing)

Sampling deviation

IDG NOTES: Locate sampling documentation with Macro and internal files. Add in this section. Or second option dilute appendix B Sampling and extract key issues.

ESTIMATES OF SAMPLING ERRORS - Refer to Appendix B of final NDHS2007 report or;

• External Resources
  • 2007 DHS- Appendix A and B Sampling (to be created separatedly by IDG progress ongoing)

Extract:

In the 2007 NDHS Report of the survey results, sampling errors for selected variables have been presented in a tabular format. The sampling error tables should include:

.. Variable name

R: Value of the estimate; SE: Sampling error of the estimate; N: Unweighted number of cases on which the estimate is based; WN: Weighted number of cases; DEFT: Design effect value that compensates for the loss of precision that results from using cluster rather than simple random sampling; SE/R: Relative standard error (i.e. ratio of the sampling error to the value estimate); R-2SE: Lower limit of the 95% confidence interval; R+2SE: Upper limit of the 95% confidence interval (never >1.000 for a proportion).

Mode of data collection

Face-to-face [f2f]

Research instrument

DHS questionnaire for women cover the following sections:

• Background characteristics (age, education, religion, etc)
• Reproductive history
• Knowledge and use of contraception methods
• Antenatal care, delivery care and postnatal care
• Breastfeeding and infant feeding
• Immunization, child health and nutrition
• Marriage and recent sexual activity
• Fertility preferences
• Knowledge about HIV/AIDS and other sexually transmitted infections
• Husbands background and women's work

The men's questionnaire covers the same except for sections 4, 5, 6 which are not applicable to men.

It was also recognized that some countries have a need for special information that is not contained in the core questionnaire. Separate questionnaire modules were developed on a series of topics. These topics are optional and include:

• maternal mortality
• pill-taking behaviour
• sterilization experience
• children's education
• women's status
• domestic violence
• health expenditures
• consanguinity

The Papua New Guinea (PNG) questionnaire was proposed for Nauru to adapt as in comparison to the existing DHS model, this is not as lengthy and time-consuming. The PNG questionnaire also dealt with high incidence of alcohol and tobacco in Nauru. Questions on HIV/AIDS and STI knowledge were included in the men's questionnaire where it was not included in the PNG questionnaire.

Response rate

IDG NOTES: Locate response rate documentation with SPC (Graeme Brown) and internal files. Add in this sections.

ART coverage, testing, and estimated knowledge of HIV status among PLHIV.

Adjusted socio-demographic and risk factors associated with ever being tested for HIV among PLHIV, by country.

Abstract

The primary objective of the 2022 Tanzania Demographic and Health Survey and Malaria Indicator Survey (2022 TDHSMIS) is to provide current and reliable information on population and health issues. Specifically, the 2022 TDHS-MIS collected information on marriage and sexual activity, fertility and fertility preferences, family planning, infant and child mortality, maternal health care, disability among the household population, child health, nutrition of children and women, malaria prevalence, knowledge, and communication, women’s empowerment, women’s experience of domestic violence, adult maternal mortality via sisterhood method, awareness and behaviour regarding HIV/AIDS and other sexually transmitted infections (STIs), female genital cutting, and early childhood development. Other information collected on health-related issues included smoking, blood pressure, anaemia, malaria, and iodine testing, height and weight, and micronutrients.

The information collected through the 2022 TDHS-MIS is intended to assist policymakers and programme managers in evaluating and designing programmes and strategies for improving the health of Tanzania’s population. The 2022 TDHS-MIS also provides indicators to monitor and evaluate international, regional, and national programmes, such as the Global Agenda 2030 on Sustainable Development Goals (2030 SDGs), Tanzania Development Vision 2025, the Third National Five-Year Development Plan (FYDP III 2021/22–2025/26), East Africa Community Vision 2050 (EAC 2050), and Africa Development Agenda 2063 (ADA 2063).

Geographic coverage

National coverage

Analysis unit

• Household
• Individual
• Children age 0-5
• Woman age 15-49
• Man age 15-49

Universe

The survey covered all de jure household members (usual residents), all women aged 15-49, men aged 15-49, and all children aged 0-4 resident in the household.

Kind of data

Sample survey data [ssd]

Sampling procedure

The sample design for the 2022 TDHS-MIS was carried out in two stages and was intended to provide estimates for the entire country, for urban and rural areas in Tanzania Mainland, and for Zanzibar. For specific indicators such as contraceptive use, the sample design allows for estimation of indicators for each of the 31 regions—26 regions in Tanzania Mainland and 5 regions in Zanzibar.

The sampling frame excluded institutional populations, such as persons in hospitals, hotels, barracks, camps, hostels, and prisons. The 2022 TDHS-MIS followed a stratified two-stage sample design. The first stage involved selection of sampling points (clusters) consisting of enumeration areas (EAs) delineated for the 2012 Tanzania Population and Housing Census (2012 PHC). The EAs were selected with a probability proportional to their size within each sampling stratum. A total of 629 clusters were selected. Among the 629 EAs, 211 were from urban areas and 418 were from rural areas.

In the second stage, 26 households were selected systematically from each cluster, for a total anticipated sample size of 16,354 households for the 2022 TDHS-MIS. A household listing operation was carried out in all the selected EAs before the main survey. During the household listing operation, field staff visited each of the selected EAs to draw location maps and detailed sketch maps and to list all residential households found in each EA with addresses and the names of the heads of the households. The resulting list of households served as a sampling frame for the selection of households in the second stage. During the listing operation, field teams collected global positioning system (GPS) data—latitude, longitude, and altitude readings—to produce one GPS point per EA. To estimate geographic differentials for certain demographic indicators, Tanzania was divided into nine geographic zones. Although these zones are not official administrative areas, this classification system is also used by the Reproductive and Child Health Section of the Ministry of Health. Grouping of regions into zones allows for larger denominators and smaller sampling errors for indicators at the zonal level.

For further details on sample design, see APPENDIX A of the final report.

Mode of data collection

Computer Assisted Personal Interview [capi]

Research instrument

Five questionnaires were used for the 2022 TDHS-MIS: the Household Questionnaire, the Woman’s Questionnaire, the Man’s Questionnaire, the Biomarker Questionnaire, and the Micronutrient Questionnaire. The questionnaires, based on The DHS Program’s Model Questionnaires, were adapted to reflect the population and health issues relevant to Tanzania. In addition, a self-administered Fieldworker’s Questionnaire collected information about the survey’s fieldworkers.

Cleaning operations

In the 2022 TDHS-MIS survey, CAPI was used during data collection. The devices used for CAPI were Android-based computer tablets programmed using a mobile version of CSPro. Programming of questionnaires into the android application was done by ICF, while configuration of tablets was done by NBS and OCGS in collaboration with ICF. All fieldwork personnel were assigned usernames, and devices were password protected to ensure the integrity of the data collected. Selected households were assigned to CAPI supervisors, whereas households were assigned to interviewers’ tablets via Bluetooth. The data for all interviewed households were sent back to CAPI supervisors, who were responsible for initial data consistency and editing, before being sent to the central servers hosted at NBS Headquarters via Syncloud.

The data processing of the 2022 TDHS-MIS ran concurrently with the data collection exercise. The electronic data files from each completed cluster were transferred via Syncloud to the NBS central office server in Dodoma. The data files were registered and checked for inconsistencies, incompleteness, and outliers. Errors and inconsistencies were communicated to the field teams for review and correction. Secondary central data editing was done by NBS and OCGS survey staff at the central office. A CSPro batch editing tool was used for cleaning data and included coding of open-ended questions and resolving inconsistencies.

The Biomarker paper questionnaires were collected by field supervisors and compared with the electronic data files to check for any inconsistencies that may have occurred during data entry. The concurrent data collection and processing offered an advantage because it maximised the likelihood of having error-free data. Timely generation of field check tables allowed effective monitoring. The secondary data editing exercise was completed in October 2022.

Response rate

A total of 16,312 households were selected for the 2022 TDHS-MIS sample. This number is slightly less than the targeted sample size of 16,354 because one EA could not be reached due to security reasons, while a few EAs had less than the targeted 26 households. Of the 16,312 households selected, 15,907 were found to be occupied. Of the occupied households, 15,705 were successfully interviewed, yielding a response rate of 99%. In the interviewed households, 15,699 women age 15–49 were identified as eligible for individual interviews. Interviews were completed with 15,254 women, yielding a response rate of 97%. In the subsample (50% of households) of households selected for the male questionnaire, 6,367 men age 15–49 were identified as eligible for individual interviews, and 5,763 were successfully interviewed, yielding a response rate of 91%.

Sampling error estimates

The estimates from a sample survey are affected by two types of errors: (1) nonsampling errors and (2) sampling errors. Nonsampling errors are the results of mistakes made in implementing data collection and in data processing, such as failure to locate and interview the correct household, misunderstanding of the questions on the part of either the interviewer or the respondent, and data entry errors. Although numerous efforts were made during the implementation of the 2022 Tanzania Demographic and Health Survey and Malaria Indicator Survey (2022 TDHS-MIS) to minimize this type of error, nonsampling errors are impossible to avoid and difficult to evaluate statistically.

Sampling errors, on the other hand, can be evaluated statistically. The sample of respondents selected in the 2022 TDHS-MIS is only one of many samples that could have been selected from the same population, using the same design and identical size. Each of these samples would yield results that differ somewhat from the results of the actual sample selected. Sampling errors are a measure of the variability between all possible samples. Although the degree of variability is not known exactly, it can be estimated from the survey results.

A sampling error is usually measured in terms of the standard error for a particular statistic (mean, percentage, etc.), which is the square root of the variance. The standard error can be used to calculate confidence intervals within which the true value for the population can reasonably be assumed to fall. For example, for any given statistic calculated from a sample survey, the value of that statistic will fall within a range of plus or minus two times the standard error of that statistic in 95% of all possible samples of identical size and design.

If the sample of respondents had been selected as a simple random sample, it would have been possible to use straightforward formulas for calculating sampling errors. However, the 2022 TDHS-MIS sample was the result of a multistage stratified design, and,

percentage distribution of selected characteristics among PLHIV Age 15–49, by country.

The 2011 Ethiopia Demographic and Health Survey (EDHS) was conducted by the Central Statistical Agency (CSA) under the auspices of the Ministry of Health. The principal objective of the 2011 Ethiopia Demographic and Health Survey (EDHS) is to provide current and reliable data on fertility and family planning behaviour, child mortality, adult and maternal mortality, children’s nutritional status, use of maternal and child health services, knowledge of HIV/AIDS, and prevalence of HIV/AIDS and anaemia. The specific objectives are these: Collect data at the national level that will allow the calculation of key demographic rates; Analyse the direct and indirect factors that determine fertility levels and trends; Measure the levels of contraceptive knowledge and practice of women and men by family planning method, urban-rural residence, and region of the country; Collect high-quality data on family health, including immunisation coverage among children, prevalence and treatment of diarrhoea and other diseases among children under ge five, and maternity care indicators, including antenatal visits and assistance at delivery; Collect data on infant and child mortality and maternal mortality; Obtain data on child feeding practices, including breastfeeding, and collect anthropometric measures to assess the nutritional status of women and children; Collect data on knowledge and attitudes of women and men about sexually transmitted diseases and HIV/AIDS and evaluate patterns of recent behaviour regarding condom use; Conduct haemoglobin testing on women age 15-49 and children 6-59 months to provide information on the prevalence of anaemia among these groups; Carry out anonymous HIV testing on women and men of reproductive age to provide information on the prevalence of HIV. This information is essential for informed policy decisions, planning, monitoring, and evaluation of programmes on health in general and reproductive health in particular at both the national and regional levels. A long-term objective of the survey is to strengthen the technical capacity of the Central Statistical Agency to plan, conduct, process, and analyse data from complex national population and health surveys. Moreover, the 2011 EDHS provides national and regional estimates on population and health that are comparable to data collected in similar surveys in other developing countries and to Ethiopia’s two previous DHS surveys, conducted in 2000 and 2005. Data collected in the 2011 EDHS add to the large and growing international database of demographic and health indicators. The survey was intentionally planned to be fielded at the beginning of the last term of the MDG reporting period to provide data for the assessment of the Millennium Development Goals (MDGs). The survey interviewed a nationally representative population in about 18,500 households, and all women age 15-49 and all men age 15-59 in these households. In this report key indicators relating to family planning, fertility levels and determinants, fertility preferences, infant, child, adult and maternal mortality, maternal and child health, nutrition, women’s empowerment, and knowledge of HIV/AIDS are provided for the nine regional states and two city administrations. In addition, this report also provides data by urban and rural residence at the country level. Major stakeholders from various government, non-government, and UN organizations have been involved and have contributed in the technical, managerial, and operational aspects of the survey.

Abstract

The 2006 Azerbaijan Demographic and Health Survey (2006 AzDHS) is a nationally representative sample survey designed to provide information on population and health issues in Azerbaijan. The primary goal of the survey was to develop a single integrated set of demographic and health data pertaining to the population of the Republic of Azerbaijan.

The 2006 AzDHS was conducted from July to November by the State Statistical Committee (SSC) of the Republic of Azerbaijan. Macro International Inc. provided technical support for the survey through the MEASURE DHS project. USAID Caucasus, Azerbaijan provided funding for the survey through the MEASURE DHS project. MEASURE DHS is sponsored by the United States Agency for International Development (USAID) to assist countries worldwide in obtaining information on key population and health indicators. The UNICEF/Azerbaijan country office was instrumental for political mobilization during the early stages of the 2006 AzDHS negotiation with the Government of Azerbaijan and also supported the survey through in-kind contributions.

The 2006 AzDHS collected national- and regional-level data on fertility and contraceptive use, maternal and child health, adult health, tuberculosis, and HIV/AIDS and other sexually transmitted diseases. The survey obtained detailed information on these issues from women of reproductive age and, on certain topics, from men as well.

The 2006 AzDHS results are intended to provide the information needed to evaluate existing social programs and to design new strategies for improving the health of Azerbaijanis and health services for the people of Azerbaijan. The 2006 AzDHS also contributes to the growing international database on demographic and health-related variables.

Geographic coverage

The 2006 Azerbaijan Demographic and Health Survey (2006 AzDHS) is a nationally representative sample survey.

Analysis unit

• Household
• Children under five years
• Women age 15-49
• Men age 15-49

Kind of data

Sample survey data

Sampling procedure

The sample was designed to permit detailed analysis, including the estimation of rates of fertility, infant/child mortality, and abortion, for the national level, for Baku, and for urban and rural areas separately. Many indicators are available separately for each of the economic regions in Azerbaijan except the Autonomous Republic of Nakhichevan (conducting the survey in Nakhichevan was complicated, since this region is in the blockade).

A representative probability sample of households was selected for the 2006 AzDHS sample. The sample was selected in two stages. In the first stage, 318 clusters in Baku and 8 other economic regions were selected from a list of enumeration areas from the master sample frame that was designed for the 1999 Population Census. In the second stage, a complete listing of households was carried out in each selected cluster. Households were then systematically selected from each cluster for participation in the survey. This design resulted in a final sample of 7,619 households.

Because of the non-proportional allocation of the sample to the different economic regions, sampling weights will be required in all analysis using the DHS data to ensure the actual representativity of the sample at both the national and regional levels. The sampling weight for each household is the inverse of its overall selection probability with correction for household non-response; the individual weight is the household weight with correction of individual non-response. Sampling weights are further normalized in order to give the total number of unweighted cases equal to the total number of weighted cases at the national level, for both household weights and individual weights.

All women age 15-49 who were either permanent residents of the households in the 2006 AzDHS sample or visitors present in the household on the night before the survey were eligible to be interviewed. In addition, all men age 15-59 in one-third of the households selected for the survey were eligible to be interviewed if they were either permanent residents or visitors present in the household on the night before the survey. Interviews were completed with 8,444 women and 2,558 men.

Note: See detailed description of sample design in APPENDIX A of the Final Report.

Mode of data collection

Face-to-face [f2f]

Research instrument

Three questionnaires were used in the AzDHS: Household Questionnaire, Women’s Questionnaire, and Men’s Questionnaire. The household and individual questionnaires were based on model survey instruments developed in the MEASURE DHS program. The model questionnaires were adapted for use by experts from the SSC and Ministry of Health (MOH). Input was also sought from a number of nongovernmental organizations. Additionally, at the request of UNICEF, the Multiple Indicator Cluster Survey (MICS) modules on early child education and development, birth registration, and child discipline were adapted for the 2006 AzDHS instrument. The questionnaires were prepared in English and translated into Azerbaijani and Russian. The household and individual questionnaires were pretested in May 2006.

The Household Questionnaire was used to list all usual members of and visitors to the selected households and to collect information on the socioeconomic status of the household. The first part of the Household Questionnaire collected information on the age, sex, educational attainment, and relationship of each household member or visitor to the household. This information provides basic demographic data for Azerbaijan households. It also was used to identify the women and men who were eligible for the individual interview (i.e., women age 15-49 and men age 15-59). In the second part of the Household Questionnaire, there were questions on housing characteristics (e.g., the flooring material, the source of water, and the type of toilet facilities), on ownership of a variety of consumer goods, and other questions relating to the socioeconomic status of the household. In addition, the Household Questionnaire was used to obtain information on child discipline, education, and development; to record height and weight measurements of women, men, and children under age five; and to record hemoglobin measurements of women and children under age five.

The Women’s Questionnaire obtained information from women age 15-49 on the following topics:- - Background characteristics - Pregnancy history - Abortion history - Antenatal, delivery, and postnatal care - Knowledge, attitudes, and use of contraception - Reproductive and adult health - Vaccinations, birth registration, and childhood illness and treatment - Breastfeeding and weaning practices - Marriage and recent sexual activity - Fertility preferences - Knowledge of and attitudes toward AIDS and other sexually transmitted diseases - Knowledge of and attitudes toward tuberculosis - Hypertension and other

The Men’s Questionnaire, administered to men age 15-59, covered the following topics: - Background characteristics - Reproductive health - Marriage and recent sexual activity - Attitudes toward and use of condoms - Fertility preferences - Employment and gender roles - Attitudes toward women’s status - Knowledge of and attitudes toward AIDS and other sexually transmitted diseases - Knowledge of and attitudes toward tuberculosis - Hypertension and other adult health issues - Smoking and alcohol consumption

Blood pressure measurements of women and men were recorded in their individual questionnaires.

Cleaning operations

The processing of the Azerbaijan DHS results began shortly after the fieldwork commenced. Completed questionnaires were returned regularly from the field to SSC headquarters in Baku, where they were entered and edited by data processing personnel who were specially trained for this task. The data processing personnel included a supervisor, a questionnaire administrator, several office editors, 10 data entry operators, and a secondary editor. The concurrent processing of the data was an advantage since the survey technical staff was able to advise field teams of problems detected during the data entry using tables generated to check various data quality parameters. As a result, specific feedback was given to the teams to improve their performance. The data entry and editing phase of the survey was completed in late January 2007.

Response rate

A total of 7,619 households were selected for the sample, of which 7,341 were found at the time of fieldwork. The main reason for the difference is that some of the dwelling units that were occupied during the household listing operation were either vacant or the household was away for an extended period at the time of interview. Of the households that were found, 98 percent were successfully interviewed.

In these households, 8,652 women were identified as eligible for the individual interview. Interviews were completed with 98 percent of the women. Of the 2,717 eligible men identified, 94 percent were successfully interviewed.

Note: See summarized response rates by residence (urban/rural) in Table 1.1 of the Final Report.

Sampling error estimates

The estimates from a sample survey are affected by two types of errors: nonsampling errors and sampling errors. Nonsampling errors are the results of mistakes made in implementing data collection and data processing, such as failure to locate and interview the correct household, misunderstanding of the questions on the part of either the interviewer or the respondent, and data entry errors. Although numerous efforts were made during the

This dataset compromises all country data included in the UN Inter-agency Group for Child Mortality Estimation (IGME) database (https://childmortality.org/data, downloaded June 2019).

It includes:

Reference area: name of the country

Indicator: child mortality indicator (neonatal mortality, infant mortality, under-5 mortality and mortality rate age 5 to 14)

Sex: sex of the child (male, female and total)

Series name: name of survey/census/VR [note: UN IGME estimates, i.e. not source data, are identified as "UN IGME estimate" in this field]

Series year: year of survey/census/VR series

Observation value: value of indicator from survey/census/VR

Observation status: indicates whether the data point is included or excluded for estimation [status of "normal" indicates UN IGME estimate, i.e. not source data]

Series Category: category of survey/census/VR, and can be:

• DHS [Demographic and Health Survey]
• MIS [Malaria Indicator Survey]
• AIS [AIDS Indicator Survey]
• Interim DHS
• Special DHS
• NDHS [National DHS]
• WFS [World Fertility Survey]
• MICS [Multiple Indicator Cluster Survey]
• NMICS [National MICS]
• RHS [Reproductive Health Survey]
• PAP [Pan Arab Project for Child or Pan Arab Project for Family Health or Gulf Famly Health Survey]
• LSMS [Living Standard Measurement Survey]
• Panel [Dual record, multiround/follow-up survey and longitudinal/panel survey]
• Census
• VR [Vital Registration]
• SVR [Sample Vital Registration]
• Others [e.g. Life Tables]

Series type: the type of calculation method used to derive the indicator value (direct, indirect, household deaths, life table and vital records)

Standard error: sampling standard error of the observation value

Series method: data collection method, and can be:

• Survey/census with Full Birth Histories
• Survey/census with Summary Birth Histories
• Survey/census with Household death
• Vital Registration
• Other

Lower and upper bound: the lower and upper bounds of 90% uncertainty interval of UN IGME estimates (for estimates only, i.e., not source data).

The dataset is used in the following paper:

Ezbakhe, F. and Pérez-Foguet, A. (2019) Levels and trends in child mortality: a compositional approach. Demographic Research (Under Review)