Abstract

The 2013 Turkey Demographic and Health Survey (TDHS-2013) is a nationally representative sample survey. The primary objective of the TDHS-2013 is to provide data on socioeconomic characteristics of households and women between ages 15-49, fertility, childhood mortality, marriage patterns, family planning, maternal and child health, nutritional status of women and children, and reproductive health. The survey obtained detailed information on these issues from a sample of women of reproductive age (15-49). The TDHS-2013 was designed to produce information in the field of demography and health that to a large extent cannot be obtained from other sources.

Specifically, the objectives of the TDHS-2013 included: - Collecting data at the national level that allows the calculation of some demographic and health indicators, particularly fertility rates and childhood mortality rates, - Obtaining information on direct and indirect factors that determine levels and trends in fertility and childhood mortality, - Measuring the level of contraceptive knowledge and practice by contraceptive method and some background characteristics, i.e., region and urban-rural residence, - Collecting data relative to maternal and child health, including immunizations, antenatal care, and postnatal care, assistance at delivery, and breastfeeding, - Measuring the nutritional status of children under five and women in the reproductive ages, - Collecting data on reproductive-age women about marriage, employment status, and social status

The TDHS-2013 information is intended to provide data to assist policy makers and administrators to evaluate existing programs and to design new strategies for improving demographic, social and health policies in Turkey. Another important purpose of the TDHS-2013 is to sustain the flow of information for the interested organizations in Turkey and abroad on the Turkish population structure in the absence of a reliable and sufficient vital registration system. Additionally, like the TDHS-2008, TDHS-2013 is accepted as a part of the Official Statistic Program.

Geographic coverage

National coverage

Analysis unit

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

Universe

The survey covered all de jure household members (usual residents), children age 0-5 years and women age 15-49 years resident in the household.

Kind of data

Sample survey data [ssd]

Sampling procedure

The sample design and sample size for the TDHS-2013 makes it possible to perform analyses for Turkey as a whole, for urban and rural areas, and for the five demographic regions of the country (West, South, Central, North, and East). The TDHS-2013 sample is of sufficient size to allow for analysis on some of the survey topics at the level of the 12 geographical regions (NUTS 1) which were adopted at the second half of the year 2002 within the context of Turkey’s move to join the European Union.

In the selection of the TDHS-2013 sample, a weighted, multi-stage, stratified cluster sampling approach was used. Sample selection for the TDHS-2013 was undertaken in two stages. The first stage of selection included the selection of blocks as primary sampling units from each strata and this task was requested from the TURKSTAT. The frame for the block selection was prepared using information on the population sizes of settlements obtained from the 2012 Address Based Population Registration System. Settlements with a population of 10,000 and more were defined as “urban”, while settlements with populations less than 10,000 were considered “rural” for purposes of the TDHS-2013 sample design. Systematic selection was used for selecting the blocks; thus settlements were given selection probabilities proportional to their sizes. Therefore more blocks were sampled from larger settlements.

The second stage of sample selection involved the systematic selection of a fixed number of households from each block, after block lists were obtained from TURKSTAT and were updated through a field operation; namely the listing and mapping fieldwork. Twentyfive households were selected as a cluster from urban blocks, and 18 were selected as a cluster from rural blocks. The total number of households selected in TDHS-2013 is 14,490.

The total number of clusters in the TDHS-2013 was set at 642. Block level household lists, each including approximately 100 households, were provided by TURKSTAT, using the National Address Database prepared for municipalities. The block lists provided by TURKSTAT were updated during the listing and mapping activities.

All women at ages 15-49 who usually live in the selected households and/or were present in the household the night before the interview were regarded as eligible for the Women’s Questionnaire and were interviewed. All analysis in this report is based on de facto women.

Note: A more technical and detailed description of the TDHS-2013 sample design, selection and implementation is presented in Appendix B of the final report of the survey.

Mode of data collection

Face-to-face [f2f]

Research instrument

Two main types of questionnaires were used to collect the TDHS-2013 data: the Household Questionnaire and the Individual Questionnaire for all women of reproductive age. The contents of these questionnaires were based on the DHS core questionnaire. 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 TDHS-2013 findings with previous demographic surveys carried out by the Hacettepe Institute of Population Studies. In the process of designing the TDHS-2013 questionnaires, national and international population and health agencies were consulted for their comments.

The questionnaires were developed in Turkish and translated into English.

Cleaning operations

TDHS-2013 questionnaires were returned to the Hacettepe University 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 selected households and eligible respondents were returned from the field. A total of 29 data entry staff were trained for data entry activities of the TDHS-2013. The data entry of the TDHS-2013 began in late September 2013 and was completed at the end of January 2014.

The data were entered and edited on microcomputers using the Census and Survey Processing System (CSPro) software. CSPro is designed to fulfill the census and survey data processing needs of data-producing organizations worldwide. CSPro is developed by MEASURE partners, the U.S. Bureau of the Census, ICF International’s DHS Program, and SerPro S.A. CSPro allows range, skip, and consistency errors to be detected and corrected at the data entry stage. During the data entry process, 100% verification was performed by entering each questionnaire twice using different data entry operators and comparing the entered data.

Response rate

In all, 14,490 households were selected for the TDHS-2013. At the time of the listing phase of the survey, 12,640 households were considered occupied and, thus, eligible for interview. Of the eligible households, 93 percent (11,794) households were successfully interviewed. The main reasons the field teams were unable to interview some households were because some dwelling units that had been listed were found to be vacant at the time of the interview or the household was away for an extended period.

In the interviewed 11,794 households, 10,840 women were identified as eligible for the individual interview, aged 15-49 and were present in the household on the night before the interview. Interviews were successfully completed with 9,746 of these women (90 percent). Among the eligible women not interviewed in the survey, the principal reason for nonresponse was the failure to find the women at home after repeated visits to the household.

Sampling error estimates

The estimates from a sample survey are affected by two types of errors: (1) nonsampling errors, and (2) sampling errors. Nonsampling errors are the results of mistakes made in implementing data collection and data processing, such as failure to locate and interview the correct household, 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 TDHS-2013 to minimize this type of error, nonsampling errors are impossible to avoid and difficult to evaluate statistically.

Sampling errors, on the other hand, can be evaluated statistically. The sample of respondents selected in the TDHS-2013 is only one of many samples that could have been selected from the same population, using the same design and expected size. Each of these samples would yield results that differ somewhat from the results of the actual sample selected. Sampling errors are a measure of the variability between all possible samples. Although the degree of variability is not known exactly, it can be estimated from the survey results.

A sampling error is usually measured in terms of the standard error for a particular statistic (mean, percentage, etc.), which is the square root of the variance. The standard error can be used to calculate confidence intervals within which the true value for the population can reasonably be assumed to fall. For example, for any given statistic calculated from a sample survey, the value of that statistic will fall

The 2013 Turkey Demographic and Health Survey (TDHS-2013) is a nationally representative sample survey. The primary objective of the TDHS-2013 is to provide data on socioeconomic characteristics of households and women between ages 15-49, fertility, childhood mortality, marriage patterns, family planning, maternal and child health, nutritional status of women and children, and reproductive health. The survey obtained detailed information on these issues from a sample of women of reproductive age (15-49). The TDHS-2013 was designed to produce information in the field of demography and health that to a large extent cannot be obtained from other sources. Specifically, the objectives of the TDHS-2013 included: Collecting data at the national level that allows the calculation of some demographic and health indicators, particularly fertility rates and childhood mortality rates, Obtaining information on direct and indirect factors that determine levels and trends in fertility and childhood mortality, Measuring the level of contraceptive knowledge and practice by contraceptive method and some background characteristics, i.e., region and urban-rural residence, Collecting data relative to maternal and child health, including immunizations, antenatal care, and postnatal care, assistance at delivery, and breastfeeding, Measuring the nutritional status of children under five and women in the reproductive ages, Collecting data on reproductive-age women about marriage, employment status, and social status The TDHS-2013 information is intended to provide data to assist policy makers and administrators to evaluate existing programs and to design new strategies for improving demographic, social and health policies in Turkey. Another important purpose of the TDHS-2013 is to sustain the flow of information for the interested organizations in Turkey and abroad on the Turkish population structure in the absence of a reliable and sufficient vital registration system. Additionally, like the TDHS-2008, TDHS-2013 is accepted as a part of the Official Statistic Program.