Since 2013, the Robert Wood Johnson Foundation (RWJF) has led the development of a pioneering national action framework to advance a "culture that enables all in our diverse society to lead healthier lives now and for generations to come." Accomplishing these principles requires a national paradigm shift from a traditionally disease and health care-centric view of health toward one that focuses on well-being. Recognizing that paradigm shifts require intentional actions, RWJF worked with RAND researchers to design an actionable path to fulfill the Culture of Health (CoH) vision. A central piece of this work is the development of measures to assess constructs underlying a CoH. The National Survey of Health Attitudes is a survey that RWJF and RAND analysts developed and conducted as part of the foundation's CoH strategic framework. The foundation undertook this survey to measure key constructs that could not be measured in other data sources. Thus, the survey was not meant to capture the full action framework that informs CoH, but rather just selected measure areas. The questions in this survey primarily addressed the action area: making health a shared value. The survey covers a variety of topics, including views regarding what factors influence health, such as the notion of health interdependence (peer, family, neighborhood, and workplace drivers of health), values related to national and community investment for health and well-being; behaviors around health and well-being, including civic engagement on behalf of health, and the role of community engagement and sense of community in relation to health attitudes and values. This study includes the results from the 2018 RWJF National Survey of Health Attitudes. This 2018 survey is considered the second wave, the first wave of the survey was conducted in 2015 (ICPSR 37405). In 2018, the study team fielded an updated version that included many of the same questions but added some new constructs that were of interest as part of the larger Culture of Health effort. This study complements the overview of the 2015 survey described in the RAND report Development of the Robert Wood Johnson Foundation National Survey of Health Attitudes (Carman et al., 2016).

The Washington State Department of Health presents this information as a service to the public. This includes information on the work status, practice characteristics, education, and demographics of healthcare providers, provided in response to the Washington Health Workforce Survey. This is a complete set of data across all of the responding professions. The data dictionary identifies questions that are specific to an individual profession and aren't common to all surveys. The dataset is provided without identifying information for the responding providers. More information on the Washington Health Workforce Survey can be found at www.doh.wa.gov/workforcesurvey This dataset has been federated from https://data.wa.gov/Health/Washington-Health-Workforce-Survey-Data/cvrw-ujje.

The National Health Examination Surveys, Cycle I (NHES I), conducted during the period 1959-1962, were designed to secure statistics on the health status of the population of the United States. More specifically, their purpose was to determine the prevalence of certain chronic diseases, the status of dental health, and the distributions of auditory and visual acuity and certain anthropometric measurements. This collection contains demographic, household, and personal information for each sample person including age, race, sex, income, region, size of residence, usual activity, and sampling weight. Also included are responses to 12 items from a medical history questionnaire that were selected as indicators of psychological distress. The items include past experiences with such symptoms as faintness, sleeping problems, and sweaty hands.

Abstract

The 1997 Jordan Population and Family Health Survey (JPFHS) is a national sample survey carried out by the Department of Statistics (DOS) as part of its National Household Surveys Program (NHSP). The JPFHS was specifically aimed at providing information on fertility, family planning, and infant and child mortality. Information was also gathered on breastfeeding, on maternal and child health care and nutritional status, and on the characteristics of households and household members. The survey will provide policymakers and planners with important information for use in formulating informed programs and policies on reproductive behavior and health.

Geographic coverage

National

Analysis unit

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

Kind of data

Sample survey data

Sampling procedure

SAMPLE DESIGN AND IMPLEMENTATION

The 1997 JPFHS sample was designed to produce reliable estimates of major survey variables for the country as a whole, for urban and rural areas, for the three regions (each composed of a group of governorates), and for the three major governorates, Amman, Irbid, and Zarqa.

The 1997 JPFHS sample is a subsample of the master sample that was designed using the frame obtained from the 1994 Population and Housing Census. A two-stage sampling procedure was employed. First, primary sampling units (PSUs) were selected with probability proportional to the number of housing units in the PSU. A total of 300 PSUs were selected at this stage. In the second stage, in each selected PSU, occupied housing units were selected with probability inversely proportional to the number of housing units in the PSU. This design maintains a self-weighted sampling fraction within each governorate.

UPDATING OF SAMPLING FRAME

Prior to the main fieldwork, mapping operations were carried out and the sample units/blocks were selected and then identified and located in the field. The selected blocks were delineated and the outer boundaries were demarcated with special signs. During this process, the numbers on buildings and housing units were updated, listed and documented, along with the name of the owner/tenant of the unit or household and the name of the household head. These activities took place between January 7 and February 28, 1997.

Note: See detailed description of sample design in APPENDIX A of the survey report.

Mode of data collection

Face-to-face

Research instrument

The 1997 JPFHS used two questionnaires, one for the household interview and the other for eligible women. Both questionnaires were developed in English and then translated into Arabic. The household questionnaire was used to list all members of the sampled households, including usual residents as well as visitors. For each member of the household, basic demographic and social characteristics were recorded and women eligible for the individual interview were identified. The individual questionnaire was developed utilizing the experience gained from previous surveys, in particular the 1983 and 1990 Jordan Fertility and Family Health Surveys (JFFHS).

The 1997 JPFHS individual questionnaire consists of 10 sections: - Respondent’s background - Marriage - Reproduction (birth history) - Contraception - Pregnancy, breastfeeding, health and immunization - Fertility preferences - Husband’s background, woman’s work and residence - Knowledge of AIDS - Maternal mortality - Height and weight of children and mothers.

Cleaning operations

Fieldwork and data processing activities overlapped. After a week of data collection, and after field editing of questionnaires for completeness and consistency, the questionnaires for each cluster were packaged together and sent to the central office in Amman where they were registered and stored. Special teams were formed to carry out office editing and coding.

Data entry started after a week of office data processing. The process of data entry, editing, and cleaning was done by means of the ISSA (Integrated System for Survey Analysis) program DHS has developed especially for such surveys. The ISSA program allows data to be edited while being entered. Data entry was completed on November 14, 1997. A data processing specialist from Macro made a trip to Jordan in November and December 1997 to identify problems in data entry, editing, and cleaning, and to work on tabulations for both the preliminary and final report.

Response rate

A total of 7,924 occupied housing units were selected for the survey; from among those, 7,592 households were found. Of the occupied households, 7,335 (97 percent) were successfully interviewed. In those households, 5,765 eligible women were identified, and complete interviews were obtained with 5,548 of them (96 percent of all eligible women). Thus, the overall response rate of the 1997 JPFHS was 93 percent. The principal reason for nonresponse among the women was the failure of interviewers to find them at home despite repeated callbacks.

Note: See summarized response rates by place of residence in Table 1.1 of the survey report.

Sampling error estimates

The estimates from a sample survey are subject to two types of errors: nonsampling errors and sampling errors. Nonsampling errors are the result of mistakes made in implementing data collection and data processing (such as failure to locate and interview the correct household, misunderstanding questions either by the interviewer or the respondent, and data entry errors). Although during the implementation of the 1997 JPFHS numerous efforts were made to minimize this type of error, nonsampling errors are not only impossible to avoid but also difficult to evaluate statistically.

Sampling errors, on the other hand, can be evaluated statistically. The respondents selected in the 1997 JPFHS constitute only one of many samples that could have been selected from the same population, given the same design and expected size. Each of those samples would have yielded results differing somewhat from the results of the sample actually 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.

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 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, since the 1997 JDHS-II sample resulted from a multistage stratified design, formulae of higher complexity had to be used. The computer software used to calculate sampling errors for the 1997 JDHS-II was the ISSA Sampling Error Module, which uses the Taylor linearization method of variance estimation for survey estimates that are means or proportions. The Jackknife repeated replication method is used for variance estimation of more complex statistics, such as fertility and mortality rates.

Note: See detailed estimate of sampling error calculation in APPENDIX B of the survey report.

Data appraisal

Data Quality Tables - Household age distribution - Age distribution of eligible and interviewed women - Completeness of reporting - Births by calendar years - Reporting of age at death in days - Reporting of age at death in months

Note: See detailed tables in APPENDIX C of the survey report.

The National Survey of Healthcare Organizations and Systems (NSHOS) was developed by researchers at Dartmouth College in collaboration with Harvard University; University of California, Berkeley; Mayo Clinic and the High Value Healthcare Collaborative. The NSHOS was fielded from June 2017-August 2018 with funding from the Agency for Healthcare Research and Quality's Comparative Health System Performance Initiative. This suite of nationally representative surveys aimed to characterize the structure, ownership, leadership, and care delivery capabilities of health care systems, primary and multispecialty care physician practices, and hospitals. The surveys assess ownership, mental and behavioral health, information collection for quality improvement, and ACO participation, among other topics. Practice managers and physicians at practices and C-suite leaders at hospitals were contacted with up to four mailings with invitations to complete the survey on paper or electronically. Email and telephone outreach were conducted when possible. Most respondents completed the survey on paper. Up to three individuals in each practice were contacted for practices that had not already completed the survey.These public versions of the practice and hospital surveys include a subset of survey questions and scales to prevent identification of respondents.

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Abstract

The Turkey Demographic and Health Survey (DHS) 2008 has been conducted by the Haccettepe University Institute of Population Studies in collaboration with the Ministry of health General Directorate of Mother and Child Health and Family Planning and Undersecretary of State Planning Organization. The Turkey Demographic and Health Survey 2008 has been financed the scientific and Technological research Council of Turkey (TUBITAK) under the support program for Research Projects of Public Institutions.

The primary objective of the Turkey DHS 2008 is to provide data on fertility, contraceptive methods, maternal and child health. Detailed information on these issues is obtained through questionnaires, filled by face-to face interviews with ever-married women in reproductive ages (15-49).

Another important objective of the survey, with aims to contribute to the knowledge on population and health as well, is to maintain the flow of information for the related organizations in Turkey on the Turkish demographic structure and change in the absence of reliable vital registration system and ascertain the continuity of data on demographic and health necessary for sustainable development in the absence of a reliable vital registration system. In terms of survey methodology and content, the Turkey DHS 2008 is comparable with the previous demographic surveys in Turkey (MEASURE DHS+).

Geographic coverage

National

Analysis unit

• Household
• Women age 15-49
• Children under age of five

Kind of data

Sample survey data

Mode of data collection

Face-to-face

Research instrument

Two main types of questionnaires were used to collect the TDHS-2008 data: a) The Household Questionnaire; b) The Individual Questionnaire for Ever-Married Women of Reproductive Ages.

The contents of these questionnaires were based on the DHS Model "A" Questionnaire, which was designed for the DHS program for use in countries with high contraceptive prevalence. Additions, deletions and modifications were made to the DHS model questionnaire in order to collect information particularly relevant to Turkey. Attention also was paid to ensuring the comparability of the DHS-2008 findings with previous demographic surveys carried out by the Hacettepe Institute of Population Studies. In the process of designing the TDHS-2003 questionnaires, national and international population and health agencies were consulted for their comments.

a) The Household Questionnaire was used to enumerate all usual members of and visitors to the selected households and to collect information relating to the socioeconomic position of the households. In the first part of the Household Questionnaire, basic information was collected on the age, sex, educational attainment, recent migration and residential mobility, employment, marital status, and relationship to the head of household of each person listed as a household member or visitor. The objective of the first part of the Household Questionnaire was to obtain the information needed to identify women who were eligible for the individual interview as well as to provide basic demographic data for Turkish households. The second part of the Household Questionnaire included questions on never married women age 15-49, with the objective of collecting information on basic background characteristics of women in this age group. The third section was used to collect information on the welfare of the elderly people. The final section of the Household Questionnaire was used to collect information on housing characteristics, such as the number of rooms, the flooring material, the source of water, and the type of toilet facilities, and on the household's ownership of a variety of consumer goods. This section also incorporated a module that was only administered in Istanbul metropolitan households, on house ownership, use of municipal facilities and the like, as well as a module that was used to collect information, from one-half of households, on salt iodization. In households where salt was present, test kits were used to test whether the salt used in the household was fortified with potassium iodine or potassium iodate, i.e. whether salt was iodized.

b) The Individual Questionnaire for ever-married women obtained information on the following subjects: - Background characteristics - Reproduction - Marriage - Knowledge and use of family planning - Maternal care and breastfeeding - Immunization and health - Fertility preferences - Husband's background
- Women's work and status - Sexually transmitted diseases and AIDS - Maternal and child anthropometry.

Cleaning operations

The questionnaires were returned to the Hacettepe Institute of Population Studies by the fieldwork teams for data processing as soon as interviews were completed in a province. The office editing staff checked that the questionnaires for all the selected households and eligible respondents were returned from the field.

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

The Public Health Agency of Sweden annually conducts a national public health survey, Health on Equal Terms, including a sample of 20 000 people aged 16-84 years. The survey, which was conducted for the first time in 2004, is an on going collaboration between the The Public Health Agency of Sweden and county councils/regions in Sweden and is carried out with help from Statistics Sweden (SCB). All studies, since 2004, can be found under the tab Related studies.

The survey is voluntary and done with the purpose to investigate the health in the population and to show changes in the population's health over time as a follow up of the national health politics.

The sample is randomly drawn from the Statistics Sweden's population register and includes 20 000 people aged 16-84 years. The personal data is confidential and protected by law and those working with this survey are obliged to practice professional secrecy. Individual answers can not be identified in the results.

The study participants are since 2007 given the opportunity to answer the survey on the web. Since 2012, the web survey is also in English, and since 2014 also in Finnish.

The questionnaire includes about 85 questions. Each county council has its own introduction letter and the questions has been prepared in collaboration with representatives from a number of different community medicine units. The origin and quality of the questions are described in the report "Objective and background of the questions in the national public health survey". Most questions recur each year, but questions can in particular cases be replaced by other questions of good quality and national relevance.

The questions in the national public health survey cover physical and mental health, consumption of pharmaceuticals, contact with healthcare services, dental health, living habits, financial conditions, work and occupation, work environment, safety and social relationships. Data regarding education is collected from the education register, and data of income, economic support, sickness benefits and pensions from the income an taxation register.

Purpose:

The aim is to investigate the health in the population and to show changes in the population's health over time as a follow up of the national health politics.

The data collection is ongoing, during the year 2014.

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.

The Health Survey for England (HSE) is part of a programme of surveys commissioned by the Health and Social Care Information Centre. It has been carried out since 1994 by the Joint Health Surveys Unit of NatCen Social Research and the Research Department of Epidemiology and Public Health at UCL (University College London). The study provides regular information that cannot be obtained from other sources on a range of aspects concerning the public's health and many of the factors that affect health. The series of Health Surveys for England was designed to monitor trends in the nation's health, to estimate the proportion of people in England who have specified health conditions, and to estimate the prevalence of certain risk factors and combinations of risk factors associated with these conditions. The survey is also used to monitor progress towards selected health targets. Each survey in the series includes core questions and measurements (such as blood pressure, anthropometric measurements and analysis of blood and saliva samples), as well as modules of questions on specific issues that vary from year to year. In some years, the core sample has also been augmented by an additional boosted sample from a specific population subgroup, such as minority ethnic groups, older people or children; there was no boost in 2012. This is the 22nd annual Health Survey for England. All surveys have covered the adult population aged 16 and over living in private households in England. Since 1995, the surveys have included children who live in households selected for the survey; children aged 2-15 were included from 1995, and infants under two years old were added in 2001. Those living in institutions were outside the scope of the survey. This should be borne in mind when considering survey findings, since the institutional population is likely to be older and less healthy than those living in private households. The HSE in 2012 provided a representative sample of the population at both national and regional level. 9,024 addresses were randomly selected in 564 postcode sectors, issued over twelve months from January to December 2012. Where an address was found to have multiple dwelling units, a random selection was made and a single dwelling unit was included. Where there were multiple households at a dwelling unit, again one was selected at random. All adults and children in selected households were eligible for inclusion in the survey. Where there were three or more children aged 0-15 in a household, two of the children were selected at random to limit the respondent burden for parents. A nurse visit was arranged for all participants who consented. A total of 8,291 adults and 2,043 children were interviewed. A household response rate of 64 per cent was achieved. 5,470 adults and 1,203 children had a nurse visit. It should be noted that, as in 2011, there was no child boost sample in 2012. Thus the scope for analyses of some data for children may be limited by relatively small sample sizes.

The World Health Survey was implemented by WHO in 2002–2004 in partnership with 70 countries to generate information on the health of adult populations and health systems. The total sample size in these cross-sectional studies includes over 300,000 individuals. Survey materials and data are available through the WHO World Health Survey Data Archive accessible from the WHS webpage. (From the WHO World Health Survey webpage).

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

The Service Delivery Indicators (SDI) are a set of health and education indicators that examine the effort and ability of staff and the availability of key inputs and resources that contribute to a functioning school or health facility. The indicators are standardized, allowing comparison between and within countries over time.

The Health SDIs include healthcare provider effort, knowledge and ability, and the availability of key inputs (for example, basic equipment, medicines and infrastructure, such as toilets and electricity). The indicators provide a snapshot of the health facility and assess the availability of key resources for providing high quality care.

The Mozambique SDI Health survey team visited a sample of 195 health facilities across Mozambique between April and June 2014. The survey team collected rosters covering 2,972 workers for absenteeism and assessed 694 health workers for competence using patient case simulations.

Geographic coverage

National

Analysis unit

Health facilities and healthcare providers

Universe

All health facilities providing primary-level care

Kind of data

Sample survey data [ssd]

Sampling procedure

The sampling strategy for SDI surveys is designed towards attaining indicators that are accurate and representative at the national level, as this allows for proper cross-country (i.e. international benchmarking) and across time comparisons, when applicable. In addition, other levels of representativeness are sought to allow for further disaggregation (rural/urban areas, public/private facilities, subregions, etc.) during the analysis stage.

The sampling strategy for SDI surveys follows a multistage sampling approach. The main units of analysis are facilities (schools and health centers) and providers (health and education workers: teachers, doctors, nurses, facility managers, etc.). The multi-stage sampling approach makes sampling procedures more practical by dividing the selection of large populations of sampling units in a step-by-step fashion. After defining the sampling frame and categorizing it by stratum, a first stage selection of sampling units is carried out independently within each stratum. Often, the primary sampling units (PSU) for this stage are cluster locations (e.g. districts, communities, counties, neighborhoods, etc.) which are randomly drawn within each stratum with a probability proportional to the size (PPS) of the cluster (measured by the location’s number of facilities, providers or pupils). Once locations are selected, a second stage takes place by randomly selecting facilities within location (either with equal probability or with PPS) as secondary sampling units. At a third stage, a fixed number of health and education workers and pupils are randomly selected within facilities to provide information for the different questionnaire modules.

Detailed information about the specific sampling process is available in the associated SDI Country Report included as part of the documentation that accompany these datasets.

Mode of data collection

Face-to-face [f2f]

Research instrument

The SDI Health Survey Questionnaire consists of four modules and weights:

Module 1: General Information - Administered to the health facility manager to collect information on equipment, medicines, infrastructure and other facets of the health facility.

Module 2: Provider Absence - A roster of healthcare providers is collected and absence measured.

Module 3: Clinical Vignettes – A selection of providers are given clinical vignettes to measure knowledge of common medical conditions.

Module 4: Facility finances – Information on facility revenue and expenditures is collected from the health facility manager.

Weights: Weights for facilities, absentee-related analyses and clinical vignette analyses.

Cleaning operations

Quality control was performed in Stata.

The basic purpose of the Health Interview Survey is to obtain information about the amount and distribution of illness, its effects in terms of disability and chronic impairments, and the kinds of health services people receive. There are five types of records in this core survey, each in a separate data file. The variables in the Household File (Part 1) include type of living quarters, size of family, number of families in household, and geographic region. The variables in the Person File (Part 2) include sex, age, race, marital status, veteran status, education, income, industry and occupation codes, and limits on activity. These variables are found in the Condition, Doctor Visit, and Hospital Episode Files as well. The Person File also supplies data on height, weight, bed days, doctor visits, hospital stays, years at residence, and region variables. The Condition (Part 3), Doctor Visit (Part 4), and Hospital Episode (Part 5) Files contain information on each reported condition, two-week doctor visit, or hospitalization (twelve-month recall), respectively. A sixth, seventh, eighth, and ninth file have been added, along with the five core files. The Alcohol/Health Practices Supplement File (Part 6) includes information on diet, smoking and drinking habits, and health problems. The Bed Days and Dental Care Supplement File (Part 7) contains information on the number of bed days, the number of and reason for dental visits, treatment(s) received, type of dentist seen, and travel time for visit. The Doctor Services Supplement File (Part 8) supplies data on visits to doctors or other health professionals, reasons for visits, health conditions, and operations performed. The Health Insurance Supplement File (Part 9) documents basic demographic information along with medical coverage and health insurance plans, as well as differentiates between hospital, doctor visit, and surgical insurance coverage.

The New York City Community Mental Health Survey (CMHS) was a one-time telephone survey conducted by the DOHMH. The CMHS was conducted in conjunction with the annual 2012 Community health Survey (CHS). The CMHS provides robust data on the mental health of New Yorkers, including neighborhood, borough, and citywide estimates. The data are analyzed and disseminated to influence mental health program decisions, and increase the understanding of the mental health among New Yorkers.

The New York City Community Health Survey (CHS) is a telephone survey conducted annually by the DOHMH, Division of Epidemiology, Bureau of Epidemiology Services. CHS provides robust data on the health of New Yorkers, including neighborhood, borough, and citywide estimates on a broad range of chronic diseases and behavioral risk factors. The data are analyzed and disseminated to influence health program decisions, and increase the understanding of the relationship between health behavior and health status.
For more information see EpiQuery, https://a816-health.nyc.gov/hdi/epiquery/visualizations?PageType=ps&PopulationSource=CHS

Population Health (BRFSS: HRQOL)

Examining Trends, Disparities and Determinants of Health in the US Population

By Health [source]

About this dataset

The Behavioral Risk Factor Surveillance System (BRFSS) offers an expansive collection of data on the health-related quality of life (HRQOL) from 1993 to 2010. Over this time period, the Health-Related Quality of Life dataset consists of a comprehensive survey reflecting the health and well-being of non-institutionalized US adults aged 18 years or older. The data collected can help track and identify unmet population health needs, recognize trends, identify disparities in healthcare, determine determinants of public health, inform decision making and policy development, as well as evaluate programs within public healthcare services.

The HRQOL surveillance system has developed a compact set of HRQOL measures such as a summary measure indicating unhealthy days which have been validated for population health surveillance purposes and have been widely implemented in practice since 1993. Within this study's dataset you will be able to access information such as year recorded, location abbreviations & descriptions, category & topic overviews, questions asked in surveys and much more detailed information including types & units regarding data values retrieved from respondents along with their sample sizes & geographical locations involved!

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How to use the dataset

This dataset tracks the Health-Related Quality of Life (HRQOL) from 1993 to 2010 using data from the Behavioral Risk Factor Surveillance System (BRFSS). This dataset includes information on the year, location abbreviation, location description, type and unit of data value, sample size, category and topic of survey questions.

Using this dataset on BRFSS: HRQOL data between 1993-2010 will allow for a variety of analyses related to population health needs. The compact set of HRQOL measures can be used to identify trends in population health needs as well as determine disparities among various locations. Additionally, responses to survey questions can be used to inform decision making and program and policy development in public health initiatives.

Research Ideas

• Analyzing trends in HRQOL over the years by location to identify disparities in health outcomes between different populations and develop targeted policy interventions.
• Developing new models for predicting HRQOL indicators at a regional level, and using this information to inform medical practice and public health implementation efforts.
• Using the data to understand differences between states in terms of their HRQOL scores and establish best practices for healthcare provision based on that understanding, including areas such as access to care, preventative care services availability, etc

Acknowledgements

If you use this dataset in your research, please credit the original authors. Data Source

License

See the dataset description for more information.

Columns

File: rows.csv | Column name | Description | |:-------------------------------|:----------------------------------------------------------| | Year | Year of survey. (Integer) | | LocationAbbr | Abbreviation of location. (String) | | LocationDesc | Description of location. (String) | | Category | Category of survey. (String) | | Topic | Topic of survey. (String) | | Question | Question asked in survey. (String) | | DataSource | Source of data. (String) | | Data_Value_Unit | Unit of data value. (String) | | Data_Value_Type | Type of data value. (String) | | Data_Value_Footnote_Symbol | Footnote symbol for data value. (String) | | Data_Value_Std_Err | Standard error of the data value. (Float) | | Sample_Size | Sample size used in sample. (Integer) | | Break_Out | Break out categories used. (String) | | Break_Out_Category | Type break out assessed. (String) | | **GeoLocation*...

Abstract

The 1995 Kazakstan Demographic and Health Survey (KDHS) is part of the worldwide Demographic and Health Surveys (DHS) program, which is designed to collect data on fertility, family planning and maternal and child health. The 1995 KDHS was the first national level population and health survey in Kazakstan. The purpose of the survey was to provide the Ministry of Health of Kazakstan with information on fertility, reproductive practices of women, maternal care, child health and mortality, child nutrition practices, breastfeeding, nutritional status and anemia. This information is important for understanding the factors that influence the reproductive health of women and the health and survival of infants and young children. It can be used in planning effective policies and programs regarding the health and nutrition of women and their children. This is especially important now during this the time of economic transition which involves virtually all aspects of life for the people of Kazakstan. The survey provides data important to the assessment of the overall demographic situation in the country. It is expected that the findings of the KDHS will become a useful source of information necessary for the ongoing health care reform in Kazakstan.

Geographic coverage

National

Analysis unit

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

Kind of data

Sample survey data

Sampling procedure

The 1995 KDHS employed a nationally representative probability sample of women age 15-49. The country was divided into five survey regions. Four survey regions consisted of groups of contiguous oblasts (except the East Kazakstanskaya oblast which is not contiguous). Almaty City constituted a survey region by itself although it is part of the Almatinskaya oblast. The five survey regions were defined as follows:

I) Almaty City 2) South Region: Taldy-Korganskaya, Almatinskaya (except Almaty city), Dzhambylskaya, South Kazakstanskaya, and Kzyl-Ordinskaya 3) West Region: Aktiubinskaya, Mangistauskaya, Atyrauskaya, and West Kazakstanskaya 4) Central Region: Semipalatinskaya, Zhezkazganskaya, and Tourgaiskaya 5) North and East Region: East Kazakstanskaya, Pavlodarskaya, Karagandinskaya, Akmolinskaya, Kokchetauskaya, North Kazakstanskaya, and Koustanaiskaya

It is important to note that the oblast composition of regions outside of Almaty City was determined on the basis of geographic proximity, and in order to achieve similarity with respect to reproductive practices within regions. The South and West Regions are comprised of oblasts which traditionally have a high proportion of Kazak population and high fertility levels. The Central Region contains three oblasts in which the fertility level is similar to the national average. The North and East Region contains seven oblasts situated in northern Kazakstan in which a relatively high proportion of the population is of Russian origin, and the fertility level is lower than the national average.

In Almaty City, the sample for the 1995 KDHS was selected in two stages. In the first stage, 40 census counting blocks were selected with equal probability from the 1989 list of census counting blocks. A complete listing of the households in the selected counting blocks was carried out. The lists of households served as the frame for second-stage sampling; i.e., the selection of the households to be visited by the KDHS interviewing teams. In each selected household, women age 15-49 were eligible to be interviewed.

In the rural areas, the primary sampling units (PSUs) were the raions which were selected with probability proportional to size, the size being the 1993 population published by Goskomstat (1993). At the second stage, one village was selected in each selected raion, from the 1989 Registry of Villages. This resulted in 50 rural clusters being selected. At the third stage, households were selected in each cluster following the household listing operation as in Almaty City.

In the urban areas other than Almaty City, the PSUs were the cities and towns themselves. In the second stage, one health block was selected from each town except in self-representing cities (large cities that were selected with certainty) where more than one health block was selected. The selected health blocks were segmented prior to the household listing operation which provided the household lists for the third stage selection of households. In total, 86 health blocks were selected.

On average, 22 households were selected in each urban cluster, and 33 households were selected in each rural cluster. It was expected that the sample would yield interviews with approximately 4,000 women between the ages of 15 and 49.

Note: See detailed description of sample design in APPENDIX B of the survey report.

Mode of data collection

Face-to-face

Research instrument

Two questionnaires were used for the 1995 KDHS: the Household Questionnaire and the Individual Questionnaire. The questionnaires were based on the model survey instruments developed in the DHS program. They were adapted to the data needs of Kazakhstan during consultations with specialists in the areas of reproductive health, child health and nutrition in Kazakhstan.

The Household Questionnaire was used to enumerate all usual members and visitors in tile sample households and to collect information relating to the socioeconomic position of a household. In the: first part of the Household Questionnaire, information was collected on age, sex, educational attainment, marital status, and relationship to the head of household of each person listed as a household member or visitor. A primary objective of the first part of the Household Questionnaire was to identify women who were eligible for the individual interview. In the second part of the Household Questionnaire, questions were included on the dwelling unit, such as the number of rooms, the flooring material, the source of water, the type of toilet facilities, and on the availability of a variety of consumer goods.

The Individual Questionnaire was used to collect information from women age 15-49. These women were asked questions on the following major topics: - Background characteristics - Pregnancy history - Outcome of pregnancies and antenatal care - Child health and nutrition practices - Child immunization and episodes of diarrhea and respiratory illness - Knowledge and use of contraception - Marriage and fertility preferences - Husband's background and woman's work - Anthropometry of children and mothers - Hemoglobin measurement of women and children

One of the major efforts of the 1995 KDHS was testing women and children for iron-deficiency anemia. Testing was done by measuring hemoglobin levels in the blood using the Hemocue technique. Before collecting the blood sample, each woman was asked to sign a consent form giving permission for the collection of a finger-stick blood droplet from herself and her children. Results of anemia testing were kept confidential (as are all KDHS data); however, strictly with the consent of respondents, local health care facilities were informed of women and children who had severely low levels of hemoglobin (less than 7 g/dl).

Cleaning operations

Questionnaires were returned to the Institute of Nutrition in Almaty for data processing. The office editing staff checked that the questionnaires for all selected households and eligible respondents were returned from the field. The few questions which had not been pre-coded (e.g., occupation, type of chronic disease) were coded at this time. Data were then entered and edited on microcomputers using the ISSA (Integrated System for Survey Analysis) package, with the data entry software translated into Russian. Office editing and data entry activities began in May 1995 (i.e., the same time that fieldwork started) and were completed in September 1995.

Response rate

A total of 4,480 households were selected in the sample, of which 4,241 were occupied at the time of fieldwork. The main reason for the difference was that some dwelling units which were occupied at the time of the household listing operation were either vacant or the household members were away for an extended period at the time of interviewing. Of the 4,241 occupied households, 4,178 were interviewed, yielding a household response rate of 99 percent.

In the interviewed households, 3,899 women were eligible for the individual interview (i.e., all women 15-49 years of age who were either usual residents or visitors who had spent the previous night in the household). Interviews were successfully completed with 3,771 of these women, yielding a response rate of 97 percent. The principal reason for non-response was the failure to find an eligible woman at home after repeated visits to the household. The overall response rate for the survey--the product of the household and the individual response rates--was 95 percent.

Note: See summarized response rates by place of residence in Table 1.1 of the survey report .

Sampling error estimates

The estimates from a sample survey are affected by two types of errors: (1) non-sampling errors, and (2) 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 KDHS to minimize this type of error, non-sampling errors are impossible to avoid and difficult to evaluate