Abstract

Different countries have different health outcomes that are in part due to the way respective health systems perform. Regardless of the type of health system, individuals will have health and non-health expectations in terms of how the institution responds to their needs. In many countries, however, health systems do not perform effectively and this is in part due to lack of information on health system performance, and on the different service providers.

The aim of the WHO World Health Survey is to provide empirical data to the national health information systems so that there is a better monitoring of health of the people, responsiveness of health systems and measurement of health-related parameters.

The overall aims of the survey is to examine the way populations report their health, understand how people value health states, measure the performance of health systems in relation to responsiveness and gather information on modes and extents of payment for health encounters through a nationally representative population based community survey. In addition, it addresses various areas such as health care expenditures, adult mortality, birth history, various risk factors, assessment of main chronic health conditions and the coverage of health interventions, in specific additional modules.

The objectives of the survey programme are to: 1. develop a means of providing valid, reliable and comparable information, at low cost, to supplement the information provided by routine health information systems. 2. build the evidence base necessary for policy-makers to monitor if health systems are achieving the desired goals, and to assess if additional investment in health is achieving the desired outcomes. 3. provide policy-makers with the evidence they need to adjust their policies, strategies and programmes as necessary.

Geographic coverage

The survey sampling frame must cover 100% of the country's eligible population, meaning that the entire national territory must be included. This does not mean that every province or territory need be represented in the survey sample but, rather, that all must have a chance (known probability) of being included in the survey sample.

There may be exceptional circumstances that preclude 100% national coverage. Certain areas in certain countries may be impossible to include due to reasons such as accessibility or conflict. All such exceptions must be discussed with WHO sampling experts. If any region must be excluded, it must constitute a coherent area, such as a particular province or region. For example if ¾ of region D in country X is not accessible due to war, the entire region D will be excluded from analysis.

Analysis unit

Households and individuals

Universe

The WHS will include all male and female adults (18 years of age and older) who are not out of the country during the survey period. It should be noted that this includes the population who may be institutionalized for health reasons at the time of the survey: all persons who would have fit the definition of household member at the time of their institutionalisation are included in the eligible population.

If the randomly selected individual is institutionalized short-term (e.g. a 3-day stay at a hospital) the interviewer must return to the household when the individual will have come back to interview him/her. If the randomly selected individual is institutionalized long term (e.g. has been in a nursing home the last 8 years), the interviewer must travel to that institution to interview him/her.

The target population includes any adult, male or female age 18 or over living in private households. Populations in group quarters, on military reservations, or in other non-household living arrangements will not be eligible for the study. People who are in an institution due to a health condition (such as a hospital, hospice, nursing home, home for the aged, etc.) at the time of the visit to the household are interviewed either in the institution or upon their return to their household if this is within a period of two weeks from the first visit to the household.

Kind of data

Sample survey data [ssd]

Sampling procedure

SAMPLING GUIDELINES FOR WHS

Surveys in the WHS program must employ a probability sampling design. This means that every single individual in the sampling frame has a known and non-zero chance of being selected into the survey sample. While a Single Stage Random Sample is ideal if feasible, it is recognized that most sites will carry out Multi-stage Cluster Sampling.

The WHS sampling frame should cover 100% of the eligible population in the surveyed country. This means that every eligible person in the country has a chance of being included in the survey sample. It also means that particular ethnic groups or geographical areas may not be excluded from the sampling frame.

The sample size of the WHS in each country is 5000 persons (exceptions considered on a by-country basis). An adequate number of persons must be drawn from the sampling frame to account for an estimated amount of non-response (refusal to participate, empty houses etc.). The highest estimate of potential non-response and empty households should be used to ensure that the desired sample size is reached at the end of the survey period. This is very important because if, at the end of data collection, the required sample size of 5000 has not been reached additional persons must be selected randomly into the survey sample from the sampling frame. This is both costly and technically complicated (if this situation is to occur, consult WHO sampling experts for assistance), and best avoided by proper planning before data collection begins.

All steps of sampling, including justification for stratification, cluster sizes, probabilities of selection, weights at each stage of selection, and the computer program used for randomization must be communicated to WHO

STRATIFICATION

Stratification is the process by which the population is divided into subgroups. Sampling will then be conducted separately in each subgroup. Strata or subgroups are chosen because evidence is available that they are related to the outcome (e.g. health, responsiveness, mortality, coverage etc.). The strata chosen will vary by country and reflect local conditions. Some examples of factors that can be stratified on are geography (e.g. North, Central, South), level of urbanization (e.g. urban, rural), socio-economic zones, provinces (especially if health administration is primarily under the jurisdiction of provincial authorities), or presence of health facility in area. Strata to be used must be identified by each country and the reasons for selection explicitly justified.

Stratification is strongly recommended at the first stage of sampling. Once the strata have been chosen and justified, all stages of selection will be conducted separately in each stratum. We recommend stratifying on 3-5 factors. It is optimum to have half as many strata (note the difference between stratifying variables, which may be such variables as gender, socio-economic status, province/region etc. and strata, which are the combination of variable categories, for example Male, High socio-economic status, Xingtao Province would be a stratum).

Strata should be as homogenous as possible within and as heterogeneous as possible between. This means that strata should be formulated in such a way that individuals belonging to a stratum should be as similar to each other with respect to key variables as possible and as different as possible from individuals belonging to a different stratum. This maximises the efficiency of stratification in reducing sampling variance.

MULTI-STAGE CLUSTER SELECTION

A cluster is a naturally occurring unit or grouping within the population (e.g. enumeration areas, cities, universities, provinces, hospitals etc.); it is a unit for which the administrative level has clear, nonoverlapping boundaries. Cluster sampling is useful because it avoids having to compile exhaustive lists of every single person in the population. Clusters should be as heterogeneous as possible within and as homogenous as possible between (note that this is the opposite criterion as that for strata). Clusters should be as small as possible (i.e. large administrative units such as Provinces or States are not good clusters) but not so small as to be homogenous.

In cluster sampling, a number of clusters are randomly selected from a list of clusters. Then, either all members of the chosen cluster or a random selection from among them are included in the sample. Multistage sampling is an extension of cluster sampling where a hierarchy of clusters are chosen going from larger to smaller.

In order to carry out multi-stage sampling, one needs to know only the population sizes of the sampling units. For the smallest sampling unit above the elementary unit however, a complete list of all elementary units (households) is needed; in order to be able to randomly select among all households in the TSU, a list of all those households is required. This information may be available from the most recent population census. If the last census was >3 years ago or the information furnished by it was of poor quality or unreliable, the survey staff will have the task of enumerating all households in the smallest randomly selected sampling unit. It is very important to budget for this step if it is necessary and ensure that all households are properly enumerated in order that a representative sample is obtained.

It is always best to have as many clusters in the PSU as possible. The reason for this is that the fewer the number of respondents in each PSU, the lower will be the clustering effect which

Abstract

Population censuses have been conducted in Ghana at approximately ten-year intervals since 1891 except in 1941, when the series was interrupted as a result of World War II but was resumed in 1948. The first post-independence census was conducted in 1960 and the next in 1970, with the expectation that a decennial census programme would be maintained. Due to circumstances beyond the control of the statistical organization, however, the third post-independence census could not be conducted until 1984. Similarly, the next census which was expected to have been conducted in 1994 was delayed. Only in 1995 was it possible to have the needed commitment to ensure the conduct of the fourth post-independence census which was scheduled for the year 2000.

The 2000 Population and Housing Census was undertaken to update current information on the size, sex, age, composition and other characteristics of Ghana's population and to ascertain the specific changes in these characteristics which had taken place since the last census was conducted in 1984. The Census was expected to ensure the continuation of a time series of demographic and socio-economic benchmark data at the national and sub-national levels and enhance the capability-building programme of the Statistical Service.

The main objective of the 2000 Population and Housing Census was to update the statistical information on the characteristics of the population of Ghana. The 2000 Population and Housing Census was the first time a full-scale housing census was conducted with a population census in one single operation.

Geographic coverage

National

Analysis unit

• Households
• Individuals
• Dwellings

Kind of data

Sample survey data [ssd]

Mode of data collection

Face-to-face [f2f]

Research instrument

Consultation with Users Work on the census questionnaire started in 1998 bearing in mind the data needs of the country. A simple questionnaire was sent to the ministries, relevant government departments, research institutions, relevant departments in the universities, private business associations and other users seeking information on the following: · whether the organization had used any previous census data · the specific census data used · what use the census data were put · any data that were needed but had not been provided in previous censuses · general comments on population censuses. Response to the questionnaire was encouraging; some respondents sent in the completed forms while others came over to discuss their data needs.

Selection of Topics Selecting topics for inclusion in the questionnaire involved the review and consideration of the following: · topics covered in the 1984 population census, · recommended topics from the United Nations Principles and Recommendations for the 2000 round of Population and Housing Censuses, · data requests and suggestions from users based on the answers to the questionnaire sent to them, · list of users' requests compiled by the Statistical Service over a period of time.

A number of meetings were held at both the Census Secretariat and the Technical Advisory Committee levels to discuss the topics and requests. Decisions on topics for inclusion were based on the relevance of topics and the data needs of the country as well as practical considerations of application of concepts.

The final questionnaire consisted of 15 questions on housing characteristics and 20 questions on population covering the following areas: · household characteristics · geographical location and internal migration · demographic and social characteristics · economic characteristics · literacy and education · fertility and mortality.

All the population topics investigated in 1970 and 1984 censuses were maintained, because they were considered as still relevant to the country's data needs, especially in terms of maintaining a time series of socio-economic data.

The questionaires were published in English.

Cleaning operations

The Census data editing was implemented at three levels:

1. Field editing by interviewers and supervisors
2. Office editing and coding
3. Data cleaning and imputation

Data editing was partly manual and partly automatic.

Editing of the census data involved correcting errors from the field and those introduced during the capturing process. Both Structural Edits and Within Record Edits were used to clean the census data.

a) Structural Edits

• Structure edits check coverage and relationships between different units: persons, households, housing units, enumeration areas, etc. Specifically, they checked that: · all households and collective quarters records within an enumeration area were present and were in the proper order; · all occupied housing units have person records, but vacant units have no person records; · households have neither duplicate person records, nor missing person records; · enumeration areas have neither duplicate nor missing housing records.

• Each EA have the right geographic codes (region, district, locality, EA number, etc.)

• Every housing unit in an EA is entered and every record has a valid EA code

The Structural edit looked at the following situations:

· Geography edits · Hierarchy of records · Correspondence between housing and population records · Editing relationships in a household · Family nuclei

b) Within Record Edits: This consisted of validity checks and consistency edits.

· Validity checks: were performed to see if the values of individual variables are plausible or lie with a reasonable range.

· Consistency edits were performed to ensure that there is coherence between two or more variables.

The Top-down editing approach, which starts by editing top priority variables, (such as age, sex, etc.) and moves sequentially through all variables in decreasing priority was used to edit the census data.

The Hot Deck or Dynamic Imputation was also used for both missing data and inconsistent/invalid items.

The Census Secretariat carefully developed Editing and Imputation rules with written sets of consistency rules and corrections. These rules were translated into three CONCOR editing applications (Pop-Edit.exe, Hse-Edit.exe and Fertility.exe), which were used to 'clean' the data. This was done at the Regional level.

Data appraisal

A post Enumeration Survey (PES) was conducted to assess the extent of coverage and content error.

Abstract

Different countries have different health outcomes that are in part due to the way respective health systems perform. Regardless of the type of health system, individuals will have health and non-health expectations in terms of how the institution responds to their needs. In many countries, however, health systems do not perform effectively and this is in part due to lack of information on health system performance, and on the different service providers.

The aim of the WHO World Health Survey is to provide empirical data to the national health information systems so that there is a better monitoring of health of the people, responsiveness of health systems and measurement of health-related parameters.

The overall aims of the survey is to examine the way populations report their health, understand how people value health states, measure the performance of health systems in relation to responsiveness and gather information on modes and extents of payment for health encounters through a nationally representative population based community survey. In addition, it addresses various areas such as health care expenditures, adult mortality, birth history, various risk factors, assessment of main chronic health conditions and the coverage of health interventions, in specific additional modules.

The objectives of the survey programme are to: 1. develop a means of providing valid, reliable and comparable information, at low cost, to supplement the information provided by routine health information systems. 2. build the evidence base necessary for policy-makers to monitor if health systems are achieving the desired goals, and to assess if additional investment in health is achieving the desired outcomes. 3. provide policy-makers with the evidence they need to adjust their policies, strategies and programmes as necessary.

Geographic coverage

The survey sampling frame must cover 100% of the country's eligible population, meaning that the entire national territory must be included. This does not mean that every province or territory need be represented in the survey sample but, rather, that all must have a chance (known probability) of being included in the survey sample.

There may be exceptional circumstances that preclude 100% national coverage. Certain areas in certain countries may be impossible to include due to reasons such as accessibility or conflict. All such exceptions must be discussed with WHO sampling experts. If any region must be excluded, it must constitute a coherent area, such as a particular province or region. For example if ¾ of region D in country X is not accessible due to war, the entire region D will be excluded from analysis.

Analysis unit

Households and individuals

Universe

The WHS will include all male and female adults (18 years of age and older) who are not out of the country during the survey period. It should be noted that this includes the population who may be institutionalized for health reasons at the time of the survey: all persons who would have fit the definition of household member at the time of their institutionalisation are included in the eligible population.

If the randomly selected individual is institutionalized short-term (e.g. a 3-day stay at a hospital) the interviewer must return to the household when the individual will have come back to interview him/her. If the randomly selected individual is institutionalized long term (e.g. has been in a nursing home the last 8 years), the interviewer must travel to that institution to interview him/her.

The target population includes any adult, male or female age 18 or over living in private households. Populations in group quarters, on military reservations, or in other non-household living arrangements will not be eligible for the study. People who are in an institution due to a health condition (such as a hospital, hospice, nursing home, home for the aged, etc.) at the time of the visit to the household are interviewed either in the institution or upon their return to their household if this is within a period of two weeks from the first visit to the household.

Kind of data

Sample survey data [ssd]

Sampling procedure

SAMPLING GUIDELINES FOR WHS

Surveys in the WHS program must employ a probability sampling design. This means that every single individual in the sampling frame has a known and non-zero chance of being selected into the survey sample. While a Single Stage Random Sample is ideal if feasible, it is recognized that most sites will carry out Multi-stage Cluster Sampling.

The WHS sampling frame should cover 100% of the eligible population in the surveyed country. This means that every eligible person in the country has a chance of being included in the survey sample. It also means that particular ethnic groups or geographical areas may not be excluded from the sampling frame.

The sample size of the WHS in each country is 5000 persons (exceptions considered on a by-country basis). An adequate number of persons must be drawn from the sampling frame to account for an estimated amount of non-response (refusal to participate, empty houses etc.). The highest estimate of potential non-response and empty households should be used to ensure that the desired sample size is reached at the end of the survey period. This is very important because if, at the end of data collection, the required sample size of 5000 has not been reached additional persons must be selected randomly into the survey sample from the sampling frame. This is both costly and technically complicated (if this situation is to occur, consult WHO sampling experts for assistance), and best avoided by proper planning before data collection begins.

All steps of sampling, including justification for stratification, cluster sizes, probabilities of selection, weights at each stage of selection, and the computer program used for randomization must be communicated to WHO

STRATIFICATION

Stratification is the process by which the population is divided into subgroups. Sampling will then be conducted separately in each subgroup. Strata or subgroups are chosen because evidence is available that they are related to the outcome (e.g. health, responsiveness, mortality, coverage etc.). The strata chosen will vary by country and reflect local conditions. Some examples of factors that can be stratified on are geography (e.g. North, Central, South), level of urbanization (e.g. urban, rural), socio-economic zones, provinces (especially if health administration is primarily under the jurisdiction of provincial authorities), or presence of health facility in area. Strata to be used must be identified by each country and the reasons for selection explicitly justified.

Stratification is strongly recommended at the first stage of sampling. Once the strata have been chosen and justified, all stages of selection will be conducted separately in each stratum. We recommend stratifying on 3-5 factors. It is optimum to have half as many strata (note the difference between stratifying variables, which may be such variables as gender, socio-economic status, province/region etc. and strata, which are the combination of variable categories, for example Male, High socio-economic status, Xingtao Province would be a stratum).

Strata should be as homogenous as possible within and as heterogeneous as possible between. This means that strata should be formulated in such a way that individuals belonging to a stratum should be as similar to each other with respect to key variables as possible and as different as possible from individuals belonging to a different stratum. This maximises the efficiency of stratification in reducing sampling variance.

MULTI-STAGE CLUSTER SELECTION

A cluster is a naturally occurring unit or grouping within the population (e.g. enumeration areas, cities, universities, provinces, hospitals etc.); it is a unit for which the administrative level has clear, nonoverlapping boundaries. Cluster sampling is useful because it avoids having to compile exhaustive lists of every single person in the population. Clusters should be as heterogeneous as possible within and as homogenous as possible between (note that this is the opposite criterion as that for strata). Clusters should be as small as possible (i.e. large administrative units such as Provinces or States are not good clusters) but not so small as to be homogenous.

In cluster sampling, a number of clusters are randomly selected from a list of clusters. Then, either all members of the chosen cluster or a random selection from among them are included in the sample. Multistage sampling is an extension of cluster sampling where a hierarchy of clusters are chosen going from larger to smaller.

In order to carry out multi-stage sampling, one needs to know only the population sizes of the sampling units. For the smallest sampling unit above the elementary unit however, a complete list of all elementary units (households) is needed; in order to be able to randomly select among all households in the TSU, a list of all those households is required. This information may be available from the most recent population census. If the last census was >3 years ago or the information furnished by it was of poor quality or unreliable, the survey staff will have the task of enumerating all households in the smallest randomly selected sampling unit. It is very important to budget for this step if it is necessary and ensure that all households are properly enumerated in order that a representative sample is obtained.

It is always best to have as many clusters in the PSU as possible. The reason for this is that the fewer the number of respondents in each PSU, the lower will be the clustering effect which

Abstract

Different countries have different health outcomes that are in part due to the way respective health systems perform. Regardless of the type of health system, individuals will have health and non-health expectations in terms of how the institution responds to their needs. In many countries, however, health systems do not perform effectively and this is in part due to lack of information on health system performance, and on the different service providers.

The aim of the WHO World Health Survey is to provide empirical data to the national health information systems so that there is a better monitoring of health of the people, responsiveness of health systems and measurement of health-related parameters.

The overall aims of the survey is to examine the way populations report their health, understand how people value health states, measure the performance of health systems in relation to responsiveness and gather information on modes and extents of payment for health encounters through a nationally representative population based community survey. In addition, it addresses various areas such as health care expenditures, adult mortality, birth history, various risk factors, assessment of main chronic health conditions and the coverage of health interventions, in specific additional modules.

The objectives of the survey programme are to: 1. develop a means of providing valid, reliable and comparable information, at low cost, to supplement the information provided by routine health information systems. 2. build the evidence base necessary for policy-makers to monitor if health systems are achieving the desired goals, and to assess if additional investment in health is achieving the desired outcomes. 3. provide policy-makers with the evidence they need to adjust their policies, strategies and programmes as necessary.

Geographic coverage

The survey sampling frame must cover 100% of the country's eligible population, meaning that the entire national territory must be included. This does not mean that every province or territory need be represented in the survey sample but, rather, that all must have a chance (known probability) of being included in the survey sample.

There may be exceptional circumstances that preclude 100% national coverage. Certain areas in certain countries may be impossible to include due to reasons such as accessibility or conflict. All such exceptions must be discussed with WHO sampling experts. If any region must be excluded, it must constitute a coherent area, such as a particular province or region. For example if ¾ of region D in country X is not accessible due to war, the entire region D will be excluded from analysis.

Analysis unit

Households and individuals

Universe

The WHS will include all male and female adults (18 years of age and older) who are not out of the country during the survey period. It should be noted that this includes the population who may be institutionalized for health reasons at the time of the survey: all persons who would have fit the definition of household member at the time of their institutionalisation are included in the eligible population.

If the randomly selected individual is institutionalized short-term (e.g. a 3-day stay at a hospital) the interviewer must return to the household when the individual will have come back to interview him/her. If the randomly selected individual is institutionalized long term (e.g. has been in a nursing home the last 8 years), the interviewer must travel to that institution to interview him/her.

The target population includes any adult, male or female age 18 or over living in private households. Populations in group quarters, on military reservations, or in other non-household living arrangements will not be eligible for the study. People who are in an institution due to a health condition (such as a hospital, hospice, nursing home, home for the aged, etc.) at the time of the visit to the household are interviewed either in the institution or upon their return to their household if this is within a period of two weeks from the first visit to the household.

Kind of data

Sample survey data [ssd]

Sampling procedure

SAMPLING GUIDELINES FOR WHS

Surveys in the WHS program must employ a probability sampling design. This means that every single individual in the sampling frame has a known and non-zero chance of being selected into the survey sample. While a Single Stage Random Sample is ideal if feasible, it is recognized that most sites will carry out Multi-stage Cluster Sampling.

The WHS sampling frame should cover 100% of the eligible population in the surveyed country. This means that every eligible person in the country has a chance of being included in the survey sample. It also means that particular ethnic groups or geographical areas may not be excluded from the sampling frame.

The sample size of the WHS in each country is 5000 persons (exceptions considered on a by-country basis). An adequate number of persons must be drawn from the sampling frame to account for an estimated amount of non-response (refusal to participate, empty houses etc.). The highest estimate of potential non-response and empty households should be used to ensure that the desired sample size is reached at the end of the survey period. This is very important because if, at the end of data collection, the required sample size of 5000 has not been reached additional persons must be selected randomly into the survey sample from the sampling frame. This is both costly and technically complicated (if this situation is to occur, consult WHO sampling experts for assistance), and best avoided by proper planning before data collection begins.

All steps of sampling, including justification for stratification, cluster sizes, probabilities of selection, weights at each stage of selection, and the computer program used for randomization must be communicated to WHO

STRATIFICATION

Stratification is the process by which the population is divided into subgroups. Sampling will then be conducted separately in each subgroup. Strata or subgroups are chosen because evidence is available that they are related to the outcome (e.g. health, responsiveness, mortality, coverage etc.). The strata chosen will vary by country and reflect local conditions. Some examples of factors that can be stratified on are geography (e.g. North, Central, South), level of urbanization (e.g. urban, rural), socio-economic zones, provinces (especially if health administration is primarily under the jurisdiction of provincial authorities), or presence of health facility in area. Strata to be used must be identified by each country and the reasons for selection explicitly justified.

Stratification is strongly recommended at the first stage of sampling. Once the strata have been chosen and justified, all stages of selection will be conducted separately in each stratum. We recommend stratifying on 3-5 factors. It is optimum to have half as many strata (note the difference between stratifying variables, which may be such variables as gender, socio-economic status, province/region etc. and strata, which are the combination of variable categories, for example Male, High socio-economic status, Xingtao Province would be a stratum).

Strata should be as homogenous as possible within and as heterogeneous as possible between. This means that strata should be formulated in such a way that individuals belonging to a stratum should be as similar to each other with respect to key variables as possible and as different as possible from individuals belonging to a different stratum. This maximises the efficiency of stratification in reducing sampling variance.

MULTI-STAGE CLUSTER SELECTION

A cluster is a naturally occurring unit or grouping within the population (e.g. enumeration areas, cities, universities, provinces, hospitals etc.); it is a unit for which the administrative level has clear, nonoverlapping boundaries. Cluster sampling is useful because it avoids having to compile exhaustive lists of every single person in the population. Clusters should be as heterogeneous as possible within and as homogenous as possible between (note that this is the opposite criterion as that for strata). Clusters should be as small as possible (i.e. large administrative units such as Provinces or States are not good clusters) but not so small as to be homogenous.

In cluster sampling, a number of clusters are randomly selected from a list of clusters. Then, either all members of the chosen cluster or a random selection from among them are included in the sample. Multistage sampling is an extension of cluster sampling where a hierarchy of clusters are chosen going from larger to smaller.

In order to carry out multi-stage sampling, one needs to know only the population sizes of the sampling units. For the smallest sampling unit above the elementary unit however, a complete list of all elementary units (households) is needed; in order to be able to randomly select among all households in the TSU, a list of all those households is required. This information may be available from the most recent population census. If the last census was >3 years ago or the information furnished by it was of poor quality or unreliable, the survey staff will have the task of enumerating all households in the smallest randomly selected sampling unit. It is very important to budget for this step if it is necessary and ensure that all households are properly enumerated in order that a representative sample is obtained.

It is always best to have as many clusters in the PSU as possible. The reason for this is that the fewer the number of respondents in each PSU, the lower will be the clustering effect which

Release Date: 2016-05-24.Table Name All Sectors: Nonemployer Statistics by Legal Form of Organization and Receipts Size Class for the U.S., States, and Selected Geographies: 2014 Release Schedule The data in this file were released on May 24, 2016. Key Table Information Beginning with reference year 2005, Nonemployer data are released using the Noise Infusion methodology to protect confidentiality. See Survey Methodology for complete information on the coverage and methodology of the Nonemployer Statistics data series. Universe The universe of this file is all firms with no paid employees or payroll with receipts of $1,000 or more (or $1 for the construction sector) and are subject to federal income tax. The universe is limited to industries in approximately 450 of the 1,065 recognized North American Industry Classification System industries. The universe contains only those codes that are available through administrative records sources and are common to all four legal forms of organization applicable to nonemployer businesses. This is generally a broader level of detail than would typically be provided for employer data. For specific exclusions and inclusions, see Survey Methodology. Geographic Coverage The data are shown at the U.S. and State level for LFO and the U.S. level for Receipt Size Class. All other data is shown at the U.S., State, and County levels. Industry Coverage The data are shown at the 2- through 6-digit NAICS code levels for all sectors with published data. Data Items and Other Identifying Records This file contains data on the total number of firms and receipts. Sort Order Data are presented in ascending geography by NAICS code sequence then by Legal Form of Organization. FTP Download Download the entire table at https://www2.census.gov/programs-surveys/nonemployer-statistics/data/2014/NS1400NONEMP.zip. Contact Information U.S. Census Bureau Economy-Wide Statistics Division Tel: (301)763-2580 Email: ewd.nonemployer.statistics@census.gov .NOTE: Nonemployer Statistics originate from tax return information of the Internal Revenue Service. The data are subject to nonsampling error such as errors of self-classification by industry on tax forms, as well as errors of response, nonreporting and coverage. Values provided by each firm are slightly modified to protect the respondent's confidentiality. For further information about methodology and data limitations, see Survey Methodology..Symbols:D - Withheld to avoid disclosing data for individual companies; data are included in higher level totalsN - Not available or not comparableG - Low Noise; cell value was changed by less than 2 percent by the application of noiseH - Moderate Noise; cell value was changed by 2 percent of more but less than 5 percent by the application of noiseFor a complete list, see the Nonemployer Glossary.Source: U.S. Census Bureau, 2014 Nonemployer Statistics.

Release Date: 2015-02-27...Table Name.Island Areas: Industry Series: Selected Statistics by Employment Size of Manufacturing Establishments for Puerto Rico, Metropolitan Areas, and Municipios: 2012.....Key Table Information.Refer to Methodology for additional information......Universe.The universe includes all establishments with payroll at any time during 2012, and classified in NAICS sectors 31-33. Data for 2012 are based on the 2012 NAICS Manual......Geography Coverage.The data are shown at the following geographic levels for Puerto Rico:. . State-equivalent (ST - Puerto Rico). Combined Statistical Area (CSA). Metropolitan Statistical Area (MSA). County-equivalent (COUNTY - Municipio). .....Industry Coverage.The data are shown for 2- and 3- digit NAICS code levels.......Data Items and Other Identifying Records.This file contains data on:. . Number of establishments. Number of paid employees. Annual payroll. Value added. Value of shipments. .The data are shown for legal form of organization and employment size-of-establishments......Sort Order.Data are presented in ascending NAICS code by legal form of organization and employment size-of-establishments sequence......FTP Download.Download the entire table athttps://www2.census.gov/econ2012/IA/sector00/IA1200IPRM05.zip....Contact Information.U.S. Census Bureau, Economy-Wide Statistics Division.Island Areas and Business Owners Branch.Tel: (301)763-3314.csd.ia@census.gov...Note: Data for 2012 are based on the 2012 NAICS..Note: The level of geographic detail covered varies for Puerto Rico manufacturing. Refer to geography help for a detailed list of the geographies. Note that tables IA1200IPRM02 and IA1200IPRM05 include different geographic levels (combined statistical areas (CSA), metropolitan and micropolitan statistical areas (MSA), and municipios.) Tables IA1200IPRM12 - IA1200IPRM14 present data at the CSAs and MSAs level..Note: The "Not in metropolitan or micropolitan area, Puerto Rico" category includes Culebra, Las Marías, Maricao, and Vieques municipios which are not part of any CSA or MSA..Note: Includes only establishments with payroll. Data based on the 2012 Economic Census of Island Areas. Figures may not add to total due to rounding. For information on confidentiality protection, sampling error, nonsampling error, and definitions, see Methodology..Symbols:D - Withheld to avoid disclosing data for individual companies; data are included in higher level totalsN - Not available or not comparableFor a complete list of all economic programs symbols, see the Symbols Glossary.Source: U.S. Census Bureau, 2012 Economic Census of Island Areas.Note: The data in this file are based on the 2012 Economic Census of Island Areas. To maintain confidentiality, the U.S. Census Bureau suppresses data to protect the identity of any business or individual. The census results in this file contain sampling and nonsampling error. Data users who create their own estimates using data from this file should cite the U.S. Census Bureau as the source of the original data only. For the full technical documentation, see Methodology link in above headnote.

Release Date: N/A...Table Name.Island Areas: Geographic Area Series: General Statistics by Kind of Business and Legal Form of Organization for American Samoa, Commonwealth of the Northern Mariana Islands, Guam, Puerto Rico, and U.S. Virgin Islands: 2012....Release Schedule.The data in this file are scheduled for release on a flow basis beginning April 2014 through September 2015.....Key Table Information.Refer to Survey Methodology for additional information.....Universe.The universe includes all establishments with payroll at any time during 2012 and classified in NAICS sectors 21-81, except Puerto Rico that excludes establishments classified in NAICS sectors 23 and 31-33. Data for 2012 are based on the 2012 NAICS Manual......Geography Coverage.The data are shown at the state-equivalent level for:..American Samoa.Commonwealth of the Northern Mariana Islands.Guam.Puerto Rico.U.S. Virgin Islands......Industry Coverage.For American Samoa, Commonwealth of the Northern Mariana Islands, Guam, and the U.S. Virgin Islands, the data are shown for:..Total of all sectors (00) level.Selected 2-digit NAICS code level..For Puerto Rico, the data are shown for selected 2- through 4-digit NAICS code levels.......Data Items and Other Identifying Records.This file contains data for:. . Number of firms (Puerto Rico only). Number of establishments. Sales, receipts, revenue, or shipments. Annual payroll. First-quarter payroll. Number of paid employees. Number of unpaid family workers (American Samoa only). Operating expenses. Total inventories, beginning-of-year. Total inventories, end-of-year. . The data are shown for legal form of organization......Sort Order.The data are presented in ascending NAICS code by legal form-of-organization sequence.....FTP Download.Download the entire table athttps://www2.census.gov/econ2012/IA/sector00/IA1200A03.zip....Contact Information.U.S. Census Bureau, Economy-Wide Statistics Division.Island Areas and Survey of Business Owners Branch.Tel: (301)763-3314. ewd.outreach@census.gov...Note: For the island areas, inventory data for sectors 51, 48-49, and 55 are based on reported data and not adjusted for nonresponse. For Puerto Rico, inventory data were only collected for wholesale and retail sectors and adjusted for nonresponse..Note: Includes only establishments or firms with payroll. Data based on the 2012 Economic Census of Island Areas. Figures may not add due to rounding. For information on confidentiality protection, sampling error, nonsampling, and definitions, see Methodology..Symbols:D - Withheld to avoid disclosing data for individual companies; data are included in higher level totalsN - Not available or not comparableFor a complete list of all economic programs symbols, see the Symbols Glossary.Source: U.S. Census Bureau, 2012 Economic Census of Island Areas

Release Date: 2015-07-28...Table Name.Island Areas: Industry Series: Selected Statistics by Construction Industry and Legal Form of Organization for Puerto Rico: 2012...Key Table Information.Refer to Methodology for additional information......Universe.The universe includes all establishments with payroll at any time during 2012, and classified in NAICS sector 23. Data for 2012 are based on the 2012 NAICS Manual......Geography Coverage.The data are shown at the state-equivalent (ST) level for Puerto Rico.......Industry Coverage.The data are shown for 2- and 5- digit NAICS code levels.......Data Items and Other Identifying Records.This file contains data on:. . Number of establishments. Annual payroll. Number of employees. Value of business done. Value of construction work. Net value of construction work. Value added. Cost of construction work subcontracted out to others. Total capital expenditures. Total rental payments. End-of-year gross value of depreciable assets. .....Sort Order.Data are presented in ascending NAICS code and levels by legal form of organization and type of corporation sequence......FTP Download.Download the entire table athttps://www2.census.gov/econ2012/IA/sector00/IA1200IPRC03.zip....Contact Information.U.S. Census Bureau, Economy-Wide Statistics Division.Island Areas and Survey of Business Owners Branch.Tel: (301)763-3314.csd.ia@census.gov...Note: Data for 2012 are based on the 2012 NAICS..Note: Includes only establishments with payroll. Data based on the 2012 Economic Census of Island Areas. Figures may not add to total due to rounding. For information on confidentiality protection, sampling error, nonsampling error, and definitions, see Methodology..Symbols:D - Withheld to avoid disclosing data for individual companies; data are included in higher level totalsN - Not available or not comparableFor a complete list of all economic programs symbols, see the Symbols Glossary.Source: U.S. Census Bureau, 2012 Economic Census of Island Areas

Release Date: 2014-05-22.Table Name.All Sectors: Nonemployer Statistics by Legal Form of Organization and Receipts Size Class for the U.S., States, and Selected Geographies: 2012...Release Schedule.The data in this file were released on May 22, 2014.....Key Table Information..Beginning with reference year 2005, Nonemployer data are released using the Noise Infusion methodology to protect confidentiality. See Survey Methodology for complete information on the coverage and methodology of the Nonemployer Statistics data series.... .Universe.The universe of this file is all firms with no paid employees or payroll with receipts of $1,000 or more (or $1 for the construction sector) and are subject to federal income tax. The universe is limited to industries in approximately 300 of the nearly 1,200 recognized North American Industry Classification System industries. The universe contains only those codes that are available through administrative records sources and are common to all three legal forms of organization applicable to nonemployer businesses. This is generally a broader level of detail than would typically be provided for employer data. For specific exclusions and inclusions, see Survey Methodology... . .Geographic Coverage. The data are shown at the U.S. and State level for LFO and the U.S. level for Receipt Size Class. All other data is shown at the U.S., State, and County levels.. . .Industry Coverage..The data are shown at the 2- through 6-digit NAICS code levels for all sectors with published data... . .Data Items and Other Identifying Records. This file contains data on the total number of firms and receipts...Sort Order.Data are presented in ascending geography by NAICS code sequence then by Legal Form of Organization. ....FTP Download.Download the entire table at https://www2.census.gov/programs-surveys/nonemployer-statistics/data/2012/NS1200NONEMP.zip... . .Contact Information.U.S. Census Bureau.Economy-Wide Statistics Division.Tel: (301)763-2580.Email: ewd.nonemployer.statistics@census.gov. . .NOTE: Nonemployer Statistics originate from tax return information of the Internal Revenue Service. The data are subject to nonsampling error such as errors of self-classification by industry on tax forms, as well as errors of response, nonreporting and coverage. Values provided by each firm are slightly modified to protect the respondent's confidentiality. For further information about methodology and data limitations, see Survey Methodology..Symbols:D - Withheld to avoid disclosing data for individual companies; data are included in higher level totalsN - Not available or not comparableG - Low Noise; cell value was changed by less than 2 percent by the application of noiseH - Moderate Noise; cell value was changed by 2 percent of more but less than 5 percent by the application of noiseFor a complete list, see the Nonemployer Glossary.Source: U.S. Census Bureau, 2012 Nonemployer Statistics.

Abstract

In order to develop various methods of comparable data collection on health and health system responsiveness WHO started a scientific survey study in 2000-2001. This study has used a common survey instrument in nationally representative populations with modular structure for assessing health of indviduals in various domains, health system responsiveness, household health care expenditures, and additional modules in other areas such as adult mortality and health state valuations.

The health module of the survey instrument was based on selected domains of the International Classification of Functioning, Disability and Health (ICF) and was developed after a rigorous scientific review of various existing assessment instruments. The responsiveness module has been the result of ongoing work over the last 2 years that has involved international consultations with experts and key informants and has been informed by the scientific literature and pilot studies.

Questions on household expenditure and proportionate expenditure on health have been borrowed from existing surveys. The survey instrument has been developed in multiple languages using cognitive interviews and cultural applicability tests, stringent psychometric tests for reliability (i.e. test-retest reliability to demonstrate the stability of application) and most importantly, utilizing novel psychometric techniques for cross-population comparability.

The study was carried out in 61 countries completing 71 surveys because two different modes were intentionally used for comparison purposes in 10 countries. Surveys were conducted in different modes of in- person household 90 minute interviews in 14 countries; brief face-to-face interviews in 27 countries and computerized telephone interviews in 2 countries; and postal surveys in 28 countries. All samples were selected from nationally representative sampling frames with a known probability so as to make estimates based on general population parameters.

The survey study tested novel techniques to control the reporting bias between different groups of people in different cultures or demographic groups ( i.e. differential item functioning) so as to produce comparable estimates across cultures and groups. To achieve comparability, the selfreports of individuals of their own health were calibrated against well-known performance tests (i.e. self-report vision was measured against standard Snellen's visual acuity test) or against short descriptions in vignettes that marked known anchor points of difficulty (e.g. people with different levels of mobility such as a paraplegic person or an athlete who runs 4 km each day) so as to adjust the responses for comparability . The same method was also used for self-reports of individuals assessing responsiveness of their health systems where vignettes on different responsiveness domains describing different levels of responsiveness were used to calibrate the individual responses.

This data are useful in their own right to standardize indicators for different domains of health (such as cognition, mobility, self care, affect, usual activities, pain, social participation, etc.) but also provide a better measurement basis for assessing health of the populations in a comparable manner. The data from the surveys can be fed into composite measures such as "Healthy Life Expectancy" and improve the empirical data input for health information systems in different regions of the world. Data from the surveys were also useful to improve the measurement of the responsiveness of different health systems to the legitimate expectations of the population.

Kind of data

Sample survey data [ssd]

Sampling procedure

The sample was a nationally representative quota sampling of 5,000 respondents. The country was divided into strata provided by the State Planning Organization (SPO). The selection of sampling units was done by demographic variables such as SES, gender, and dwelling.

The sampling frame of the survey corresponded to the index of development of the cities in five strata of SPO; Istanbul, Antalya, Manisa, Trabzon, Yozgat, Adiyaman.

The sampling frame considered gender, dwellings and socioeconomic status. All respondents were identified in terms of socioeconomic status, phone numbers and addresses.

More males (57.2%) than females (42.8%) were interviewed.

Mode of data collection

Face-to-face [f2f]

Cleaning operations

Data Coding At each site the data was coded by investigators to indicate the respondent status and the selection of the modules for each respondent within the survey design. After the interview was edited by the supervisor and considered adequate it was entered locally.

Data Entry Program A data entry program was developed in WHO specifically for the survey study and provided to the sites. It was developed using a database program called the I-Shell (short for Interview Shell), a tool designed for easy development of computerized questionnaires and data entry (34). This program allows for easy data cleaning and processing.

The data entry program checked for inconsistencies and validated the entries in each field by checking for valid response categories and range checks. For example, the program didn’t accept an age greater than 120. For almost all of the variables there existed a range or a list of possible values that the program checked for.

In addition, the data was entered twice to capture other data entry errors. The data entry program was able to warn the user whenever a value that did not match the first entry was entered at the second data entry. In this case the program asked the user to resolve the conflict by choosing either the 1st or the 2nd data entry value to be able to continue. After the second data entry was completed successfully, the data entry program placed a mark in the database in order to enable the checking of whether this process had been completed for each and every case.

Data Transfer The data entry program was capable of exporting the data that was entered into one compressed database file which could be easily sent to WHO using email attachments or a file transfer program onto a secure server no matter how many cases were in the file. The sites were allowed the use of as many computers and as many data entry personnel as they wanted. Each computer used for this purpose produced one file and they were merged once they were delivered to WHO with the help of other programs that were built for automating the process. The sites sent the data periodically as they collected it enabling the checking procedures and preliminary analyses in the early stages of the data collection.

Data quality checks Once the data was received it was analyzed for missing information, invalid responses and representativeness. Inconsistencies were also noted and reported back to sites.

Data Cleaning and Feedback After receipt of cleaned data from sites, another program was run to check for missing information, incorrect information (e.g. wrong use of center codes), duplicated data, etc. The output of this program was fed back to sites regularly. Mainly, this consisted of cases with duplicate IDs, duplicate cases (where the data for two respondents with different IDs were identical), wrong country codes, missing age, sex, education and some other important variables.

Abstract

Different countries have different health outcomes that are in part due to the way respective health systems perform. Regardless of the type of health system, individuals will have health and non-health expectations in terms of how the institution responds to their needs. In many countries, however, health systems do not perform effectively and this is in part due to lack of information on health system performance, and on the different service providers.

The aim of the WHO World Health Survey is to provide empirical data to the national health information systems so that there is a better monitoring of health of the people, responsiveness of health systems and measurement of health-related parameters.

The overall aims of the survey is to examine the way populations report their health, understand how people value health states, measure the performance of health systems in relation to responsiveness and gather information on modes and extents of payment for health encounters through a nationally representative population based community survey. In addition, it addresses various areas such as health care expenditures, adult mortality, birth history, various risk factors, assessment of main chronic health conditions and the coverage of health interventions, in specific additional modules.

The objectives of the survey programme are to: 1. develop a means of providing valid, reliable and comparable information, at low cost, to supplement the information provided by routine health information systems. 2. build the evidence base necessary for policy-makers to monitor if health systems are achieving the desired goals, and to assess if additional investment in health is achieving the desired outcomes. 3. provide policy-makers with the evidence they need to adjust their policies, strategies and programmes as necessary.

Geographic coverage

The survey sampling frame must cover 100% of the country's eligible population, meaning that the entire national territory must be included. This does not mean that every province or territory need be represented in the survey sample but, rather, that all must have a chance (known probability) of being included in the survey sample.

There may be exceptional circumstances that preclude 100% national coverage. Certain areas in certain countries may be impossible to include due to reasons such as accessibility or conflict. All such exceptions must be discussed with WHO sampling experts. If any region must be excluded, it must constitute a coherent area, such as a particular province or region. For example if ¾ of region D in country X is not accessible due to war, the entire region D will be excluded from analysis.

Analysis unit

Households and individuals

Universe

The WHS will include all male and female adults (18 years of age and older) who are not out of the country during the survey period. It should be noted that this includes the population who may be institutionalized for health reasons at the time of the survey: all persons who would have fit the definition of household member at the time of their institutionalisation are included in the eligible population.

If the randomly selected individual is institutionalized short-term (e.g. a 3-day stay at a hospital) the interviewer must return to the household when the individual will have come back to interview him/her. If the randomly selected individual is institutionalized long term (e.g. has been in a nursing home the last 8 years), the interviewer must travel to that institution to interview him/her.

The target population includes any adult, male or female age 18 or over living in private households. Populations in group quarters, on military reservations, or in other non-household living arrangements will not be eligible for the study. People who are in an institution due to a health condition (such as a hospital, hospice, nursing home, home for the aged, etc.) at the time of the visit to the household are interviewed either in the institution or upon their return to their household if this is within a period of two weeks from the first visit to the household.

Kind of data

Sample survey data [ssd]

Sampling procedure

SAMPLING GUIDELINES FOR WHS

Surveys in the WHS program must employ a probability sampling design. This means that every single individual in the sampling frame has a known and non-zero chance of being selected into the survey sample. While a Single Stage Random Sample is ideal if feasible, it is recognized that most sites will carry out Multi-stage Cluster Sampling.

The WHS sampling frame should cover 100% of the eligible population in the surveyed country. This means that every eligible person in the country has a chance of being included in the survey sample. It also means that particular ethnic groups or geographical areas may not be excluded from the sampling frame.

The sample size of the WHS in each country is 5000 persons (exceptions considered on a by-country basis). An adequate number of persons must be drawn from the sampling frame to account for an estimated amount of non-response (refusal to participate, empty houses etc.). The highest estimate of potential non-response and empty households should be used to ensure that the desired sample size is reached at the end of the survey period. This is very important because if, at the end of data collection, the required sample size of 5000 has not been reached additional persons must be selected randomly into the survey sample from the sampling frame. This is both costly and technically complicated (if this situation is to occur, consult WHO sampling experts for assistance), and best avoided by proper planning before data collection begins.

All steps of sampling, including justification for stratification, cluster sizes, probabilities of selection, weights at each stage of selection, and the computer program used for randomization must be communicated to WHO

STRATIFICATION

Stratification is the process by which the population is divided into subgroups. Sampling will then be conducted separately in each subgroup. Strata or subgroups are chosen because evidence is available that they are related to the outcome (e.g. health, responsiveness, mortality, coverage etc.). The strata chosen will vary by country and reflect local conditions. Some examples of factors that can be stratified on are geography (e.g. North, Central, South), level of urbanization (e.g. urban, rural), socio-economic zones, provinces (especially if health administration is primarily under the jurisdiction of provincial authorities), or presence of health facility in area. Strata to be used must be identified by each country and the reasons for selection explicitly justified.

Stratification is strongly recommended at the first stage of sampling. Once the strata have been chosen and justified, all stages of selection will be conducted separately in each stratum. We recommend stratifying on 3-5 factors. It is optimum to have half as many strata (note the difference between stratifying variables, which may be such variables as gender, socio-economic status, province/region etc. and strata, which are the combination of variable categories, for example Male, High socio-economic status, Xingtao Province would be a stratum).

Strata should be as homogenous as possible within and as heterogeneous as possible between. This means that strata should be formulated in such a way that individuals belonging to a stratum should be as similar to each other with respect to key variables as possible and as different as possible from individuals belonging to a different stratum. This maximises the efficiency of stratification in reducing sampling variance.

MULTI-STAGE CLUSTER SELECTION

A cluster is a naturally occurring unit or grouping within the population (e.g. enumeration areas, cities, universities, provinces, hospitals etc.); it is a unit for which the administrative level has clear, nonoverlapping boundaries. Cluster sampling is useful because it avoids having to compile exhaustive lists of every single person in the population. Clusters should be as heterogeneous as possible within and as homogenous as possible between (note that this is the opposite criterion as that for strata). Clusters should be as small as possible (i.e. large administrative units such as Provinces or States are not good clusters) but not so small as to be homogenous.

In cluster sampling, a number of clusters are randomly selected from a list of clusters. Then, either all members of the chosen cluster or a random selection from among them are included in the sample. Multistage sampling is an extension of cluster sampling where a hierarchy of clusters are chosen going from larger to smaller.

In order to carry out multi-stage sampling, one needs to know only the population sizes of the sampling units. For the smallest sampling unit above the elementary unit however, a complete list of all elementary units (households) is needed; in order to be able to randomly select among all households in the TSU, a list of all those households is required. This information may be available from the most recent population census. If the last census was >3 years ago or the information furnished by it was of poor quality or unreliable, the survey staff will have the task of enumerating all households in the smallest randomly selected sampling unit. It is very important to budget for this step if it is necessary and ensure that all households are properly enumerated in order that a representative sample is obtained.

It is always best to have as many clusters in the PSU as possible. The reason for this is that the fewer the number of respondents in each PSU, the lower will be the clustering effect which

Abstract

A primary objective of the national Time Use Survey in Pakistan is to account for the 24 hours time in term of the full spectrum of activities carried out during the duration. The objectives of the survey are specified as under:- - To profile the quantum and distribution of paid/unpaid work as a means to infer policy/programme implications from the perspective of gender equity. - To collect and analyze the time use pattern of the individuals in order to help draw inferences for employment and welfare programmes. - To collect and analyze the comprehensive information about the time spent by people on marketed and non-marketed economic activities covered under the 1993-SNA, non-marketed non-SNA activities within the General Production Boundary and personal care and related activities that cannot be delegated to others. - To use the data in generating more reliable estimates on work force.

Geographic coverage

The survey covers all urban and rural areas of the four provinces of Pakistan defined as such by 1998 Population Census excluding Federally Administered Tribal Areas (FATA) and certain administrative areas of NWFP. The population of geographic areas excluded from the survey constitutes about 2 percent of the total population as enumerated in 1998 Population Census. The population excluded is located in difficult terrain and its enumeration through personal interview is not possible within the given constraints of time, access and cost.

Analysis unit

Households Individuals

Universe

The universe consists of all urban and rural areas of the four provinces of Pakistan, defined as such by Population Census 1998, excluding FATA & Military Restricted Areas. The population of excluded area constitutes about 3% of the total population and is located in different terrain.

Sampling procedure

Sampling Frame Federal Bureau of Statistics has developed its own sampling frame for all urban areas of the country. Each city/town has been divided into a number of enumeration blocks. Each enumeration block consists of 200-250 households on the average with well-defined boundaries and maps. The sampling frame i.e. lists of enumeration blocks as up-dated through Economic Census 2003-04 and the lists of villages/mouzas/dehs published by Population Census Organization as a result of 1998 Population Census have been taken as sampling frame. Enumeration blocks and villages are considered as primary sampling unites (PSUs) for urban and rural domain respectively.

Stratification a) Urban Domain i) Large Sized Cities Karachi, Lahore, Gujranwala, Faisalabad, Rawalpindi, Multan, Sialkot, Sargodha, Bahawapur, Hyderabad, Sukkur, Peshawar, Quetta and Islamabad are considered as large sized cities. Each of these cities constitutes a separate stratum which is further sub-stratified according to low, middle, high income groups based on the information collected in respect of each enumeration block at the time of demarcation/up-dating of urban area sampling frame. ii) Remaining urban areas After excluding the population of large sized cities from the population of respective administrative division, the remaining urban population of administrative division of four provinces is grouped together to form a stratum called other urban. Thus ex-division in remaining urban areas in the four provinces constitutes a stratum. b) Rural Domain In rural domain, each administrative district in the Punjab, Sindh and NWF Provinces is considered as independent and explicit stratum whereas, in Balochistan, each administrative division constitutes a stratum.

Sample size and its Allocation Keeping in view the resources available, a sample size of 19600 sample households has been considered appropriate to provide estimates of key characteristics at the desired level. The entire sample of households (SSUs) has been drawn from 1388 Primary Sampling Units (PSUs) out of which 652 are urban and 736 are rural. In order to control seasonal variation etc. sample has been distributed evenly over four quarters. This has facilitated to capture the variation due to any seasonal activity as urban population is more heterogeneous therefore, a higher proportion of sample size has been allocated to urban domain. Similarly NWFP and Balochistan being the smaller province, have been assigned higher proportion of sample in order to get reliable estimates. After fixing the sample size at provincial level, further distribution of sample PSUs to different strata in rural and urban domains in each province has been made proportionately.

Sample Design A three-stage stratified sample design has been adopted for the survey. Sample Selection Procedure a) Selection of Primary Sampling Unites (PSUs) Enumeration blocks in urban domain and mouzas/dehs/villages in rural domain are taken as primary sampling unites (PSUs). In the urban domain, sample PSUs from each ultimate stratum/sub-stratum is selected with probability proportional to size (PPS) method of sampling scheme. In urban domain, the number of households in enumeration block as up-dated through Economic Census 2003-04 and population of 1998 Census for each village/mouza/deh are considered as measure of size. b) Section of Secondary Sampling Units (SSUs) Households within sample PSUs are taken as secondary sampling unites (SSUs). A specified number of households i.e. 12 from each urban sample PSU and 16 from each rural sample PSU are selected with equal probability using systematic sampling technique with a random start. Different households are selected in each quarter. c) Selection of Third Stage Sampling Units i.e. Individuals/Persons (TSUs) From the sample households, individuals/persons aged 10+ years within each sample households (SSUs) have been taken as third stage sampling units (TSUs). Two individuals aged 10 years and above among the eligible individuals/persons from each sample household have been interviewed using a selection grid.The grid and selection steps are detailed on p13 of the survey report available under external resources.

Mode of data collection

Face-to-face [f2f]

Research instrument

The questionnaire has been framed in the light of contemporary precedents and practices in vogue in the developing countries. The recommendations of Gender Responsive Budgeting Initiatives (GRBI) expert who visited Pakistan in June 2006 have been taken into account. Further, the advice of local experts hailing both from data producing and using agencies has also been considered. Survey Questionnaire and Manual of Instructions, for the Supervisors & Enumerators, was finalized jointly by Federal Bureau of Statistics and GRBI Project staff. The questionnaire was also pre-tested and reviewed accordingly. The questionnaire adopted for the survey is given at Annexure-A. All the households selected in the sample stand interviewed. Diary part of the questionnaire is filled-in from two respondents selected from each of the enumerated households. The questionnaire consists of the following six parts. Section-1: Identification of the area, respondents, detail of field visits and staff entrusted with supervision, editing and coding. Section-2: Detailed information about the socio-economic and demographic particulars of the selected households and individuals. Some of the important household characteristics i.e. ownership status and type of the household, earthquake damage, household items, sources of energy, drinking water, transport, health & education facilities, sources of income, monthly income, age and sex composition of the population. Section-3: Demographic detail such as age, sex, marital status, educational level, having children, employment status, source of income etc. of the selected respondent of that household Section-4: Comprised of diary to record the activities performed by the first selected respondent through the 24 hours period between 4.00 a.m. of the day preceding the day of interview and 3.00 a.m. on the day of the interview. Section-5 and 6 pertain to the second selected respondent of the selected household. The diary which is the core instrument of the time use study is divided into forty eight half-hour slots. An open ended question about the activities performed during the thirty minutes was asked from the respondent. Provision for minimum of recording three activities through half hour slot was made. In case of reporting more than one activity, the respondent was probed whether these activities were carried out simultaneously or one after the other. Similarly, the two locations of performing the activities were also investigated in the diary part of the questionnaire. The activities recorded in the diary are then coded by the field enumerator according to the activity classification given at Annex-B.

Cleaning operations

Soon after data collection, the field supervisors manually clean, edit and check the filled in questionnaire and refer back to field where necessary. This does not take much time since most of the manual editing is done in the field. Further editing is done by the subject matter section at the Headquarter. Also during data entry, further editing of error identified by applying computer edit checks is done. In edit checks, data ranges in numerical values are used to eliminate erroneous data as a result of mistakes made during coding. Thus, the survey records are edited and corrected through a series of computer processing stages.

Abstract

Different countries have different health outcomes that are in part due to the way respective health systems perform. Regardless of the type of health system, individuals will have health and non-health expectations in terms of how the institution responds to their needs. In many countries, however, health systems do not perform effectively and this is in part due to lack of information on health system performance, and on the different service providers.

The aim of the WHO World Health Survey is to provide empirical data to the national health information systems so that there is a better monitoring of health of the people, responsiveness of health systems and measurement of health-related parameters.

The overall aims of the survey is to examine the way populations report their health, understand how people value health states, measure the performance of health systems in relation to responsiveness and gather information on modes and extents of payment for health encounters through a nationally representative population based community survey. In addition, it addresses various areas such as health care expenditures, adult mortality, birth history, various risk factors, assessment of main chronic health conditions and the coverage of health interventions, in specific additional modules.

The objectives of the survey programme are to: 1. develop a means of providing valid, reliable and comparable information, at low cost, to supplement the information provided by routine health information systems. 2. build the evidence base necessary for policy-makers to monitor if health systems are achieving the desired goals, and to assess if additional investment in health is achieving the desired outcomes. 3. provide policy-makers with the evidence they need to adjust their policies, strategies and programmes as necessary.

Geographic coverage

The survey sampling frame must cover 100% of the country's eligible population, meaning that the entire national territory must be included. This does not mean that every province or territory need be represented in the survey sample but, rather, that all must have a chance (known probability) of being included in the survey sample.

There may be exceptional circumstances that preclude 100% national coverage. Certain areas in certain countries may be impossible to include due to reasons such as accessibility or conflict. All such exceptions must be discussed with WHO sampling experts. If any region must be excluded, it must constitute a coherent area, such as a particular province or region. For example if ¾ of region D in country X is not accessible due to war, the entire region D will be excluded from analysis.

Analysis unit

Households and individuals

Universe

The WHS will include all male and female adults (18 years of age and older) who are not out of the country during the survey period. It should be noted that this includes the population who may be institutionalized for health reasons at the time of the survey: all persons who would have fit the definition of household member at the time of their institutionalisation are included in the eligible population.

If the randomly selected individual is institutionalized short-term (e.g. a 3-day stay at a hospital) the interviewer must return to the household when the individual will have come back to interview him/her. If the randomly selected individual is institutionalized long term (e.g. has been in a nursing home the last 8 years), the interviewer must travel to that institution to interview him/her.

The target population includes any adult, male or female age 18 or over living in private households. Populations in group quarters, on military reservations, or in other non-household living arrangements will not be eligible for the study. People who are in an institution due to a health condition (such as a hospital, hospice, nursing home, home for the aged, etc.) at the time of the visit to the household are interviewed either in the institution or upon their return to their household if this is within a period of two weeks from the first visit to the household.

Kind of data

Sample survey data [ssd]

Sampling procedure

SAMPLING GUIDELINES FOR WHS

Surveys in the WHS program must employ a probability sampling design. This means that every single individual in the sampling frame has a known and non-zero chance of being selected into the survey sample. While a Single Stage Random Sample is ideal if feasible, it is recognized that most sites will carry out Multi-stage Cluster Sampling.

The WHS sampling frame should cover 100% of the eligible population in the surveyed country. This means that every eligible person in the country has a chance of being included in the survey sample. It also means that particular ethnic groups or geographical areas may not be excluded from the sampling frame.

The sample size of the WHS in each country is 5000 persons (exceptions considered on a by-country basis). An adequate number of persons must be drawn from the sampling frame to account for an estimated amount of non-response (refusal to participate, empty houses etc.). The highest estimate of potential non-response and empty households should be used to ensure that the desired sample size is reached at the end of the survey period. This is very important because if, at the end of data collection, the required sample size of 5000 has not been reached additional persons must be selected randomly into the survey sample from the sampling frame. This is both costly and technically complicated (if this situation is to occur, consult WHO sampling experts for assistance), and best avoided by proper planning before data collection begins.

All steps of sampling, including justification for stratification, cluster sizes, probabilities of selection, weights at each stage of selection, and the computer program used for randomization must be communicated to WHO

STRATIFICATION

Stratification is the process by which the population is divided into subgroups. Sampling will then be conducted separately in each subgroup. Strata or subgroups are chosen because evidence is available that they are related to the outcome (e.g. health, responsiveness, mortality, coverage etc.). The strata chosen will vary by country and reflect local conditions. Some examples of factors that can be stratified on are geography (e.g. North, Central, South), level of urbanization (e.g. urban, rural), socio-economic zones, provinces (especially if health administration is primarily under the jurisdiction of provincial authorities), or presence of health facility in area. Strata to be used must be identified by each country and the reasons for selection explicitly justified.

Stratification is strongly recommended at the first stage of sampling. Once the strata have been chosen and justified, all stages of selection will be conducted separately in each stratum. We recommend stratifying on 3-5 factors. It is optimum to have half as many strata (note the difference between stratifying variables, which may be such variables as gender, socio-economic status, province/region etc. and strata, which are the combination of variable categories, for example Male, High socio-economic status, Xingtao Province would be a stratum).

Strata should be as homogenous as possible within and as heterogeneous as possible between. This means that strata should be formulated in such a way that individuals belonging to a stratum should be as similar to each other with respect to key variables as possible and as different as possible from individuals belonging to a different stratum. This maximises the efficiency of stratification in reducing sampling variance.

MULTI-STAGE CLUSTER SELECTION

A cluster is a naturally occurring unit or grouping within the population (e.g. enumeration areas, cities, universities, provinces, hospitals etc.); it is a unit for which the administrative level has clear, nonoverlapping boundaries. Cluster sampling is useful because it avoids having to compile exhaustive lists of every single person in the population. Clusters should be as heterogeneous as possible within and as homogenous as possible between (note that this is the opposite criterion as that for strata). Clusters should be as small as possible (i.e. large administrative units such as Provinces or States are not good clusters) but not so small as to be homogenous.

In cluster sampling, a number of clusters are randomly selected from a list of clusters. Then, either all members of the chosen cluster or a random selection from among them are included in the sample. Multistage sampling is an extension of cluster sampling where a hierarchy of clusters are chosen going from larger to smaller.

In order to carry out multi-stage sampling, one needs to know only the population sizes of the sampling units. For the smallest sampling unit above the elementary unit however, a complete list of all elementary units (households) is needed; in order to be able to randomly select among all households in the TSU, a list of all those households is required. This information may be available from the most recent population census. If the last census was >3 years ago or the information furnished by it was of poor quality or unreliable, the survey staff will have the task of enumerating all households in the smallest randomly selected sampling unit. It is very important to budget for this step if it is necessary and ensure that all households are properly enumerated in order that a representative sample is obtained.

It is always best to have as many clusters in the PSU as possible. The reason for this is that the fewer the number of respondents in each PSU, the lower will be the clustering effect which