The 1988 Egypt Demographic and Health Survey (EDHS) 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 1988 EDHS is the most recent in a series of surveys carried out in Egypt to provide the information needed to study fertility behavior and its determinants, particularly contraceptive use. The EDHS findings are important in monitoring trends in these variables and in understanding the factors which contribute to differentials in fertility and contraceptive use among various population subgroups. The EDHS also provides a wealth of health-related information for mothers and their children, which was not available in the earlier surveys. These data are especially important for understanding the factors that influence the health and survival of infants and young children. In addition to providing insights into population and health issues in Egypt, the EDHS also hopefully will lead to an improved global understanding of population and health problems as it is one of 35 internationally comparable surveys sponsored by the Demographic and Health Surveys program. The Egypt Demographic and Health Survey (EDHS) has as its major objective the provision of current and reliable information on fertility, mortality, family planning, and maternal and child health indicators. The information is intended to assist policy makers and administrators in Egyptian population and health agencies to: (1) assess the effect of ongoing family planning and maternal and child health programs and (2) improve planning for future interventions in these areas. The EDHS provides data on topics for which comparable data are not available from previous nationally representative surveys, as well as information needed to monitor trends in a number of indicators derived from earlier surveys, in particular, the 1980 Egypt Fertility Survey (EFS) and the 1980 and 1984 Egypt Contraceptive Prevalence Surveys (ECPS). Finally, as part of the worldwide Demographic and Health Surveys (DHS) program, the EDHS is intended to add to an international body of data, which can be used for cross-national research on these topics.

Abstract

The 1992 Egypt Demographic and Health Survey (EDHS) is the most recent in a series of surveys carded out in Egypt to provide information on fertility and child mortality levels, family planning awareness, approval and use and basic indicators of maternal and child health. The EDHS findings are important in monitoring trends in these variables and in understanding the factors which contribute to differentials in fertility and contraceptive use among various population subgroups. The EDHS also provides a wealth of health-related information for mothers and their children. These data are especially important for understanding the factors that influence the health and survival of infants and young children. In addition to providing insights into population and health issues in Egypt, the EDHS also hopefully will lead to an improved global understanding of population and health problems as it is one of more than 50 surveys implemented through the Demographic and Health Surveys program.

The primary objective of the EDHS is to provide data on fertility and mortality, family planning and maternal and child health. The survey obtained detailed information on these issues from a sample of ever-married women in the reproductive ages. In addition, a subsample of husbands was interviewed in an effort to obtain information on their fertility preferences and the role which they play in family planning decision making.

The EDHS information is intended to assist policymakers and administrators to evaluate existing programs and to design new strategies for improving family planning and health services in Egypt. A secondary objective is to enhance the capabilities of institutions in Egypt to collect process and analyze population and health data so as to facilitate the implementation of future surveys of this type.

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

The 1992 Egypt Demographic and Health Survey covered over 11,000 households, which were scattered in 21 governorates. One of the key concerns in the design of the sample was the need 1o provide reliable estimates of fertility levels and contraceptive use for Egypt as a whole, and for urban and rural areas separately. Other domains for which reliable estimates were desired included the Urban Governorates, Upper Egypt, and Lower Egypt. In addition, estimates of key indicators for the women's sample were needed at governorate level. In order to allow for the governorate-level estimates, the number of households selected from each governorate is disproportionate to the size of the population in the governorate; thus, the EDHS sample is not self-weighting at the national level.

The 1992 EDHS sample was selected in three stages. The sampling units at the first stage were shiakhas/towns in urban areas and villages in rural areas. The frame for the selection of these primary sampling units (PSUs) was based on 1986 census data, which were provided by the Central Agency for Public Mobilization and Statistics (CAPMAS). During the first stage selection, 377 PSUs were sampled (169 in urban areas and 208 in rural areas).

The second stage of selection involved several steps. First, maps were obtained for each shiakha and village that had been selected at the first stage and divided into a number of roughly equal-sized parts. One of the pans was then selected from each PSU. In both urban and rural PSUs, a quick-count operation was carried out in the field to provide the information which was used to divide the selected pan into a number of segments of roughly equal size. Two segments from urban areas and one segment from rural areas were then chosen as the secondary sampling units.

After the secondary sampling units (SSUs) were selected, a household listing was obtained for each SSU. Using the household listing, a systematic random sample of households was chosen for the EDHS. A subsample of one-third of the households in every segment was selected for the husband survey. All ever-married women 15-49 who were present in the household on the night before the interview were eligible for the survey. The husbands' sample covered men who were currently married to eligible women.

Sample Implementation

Two different field operations were conducted during the sample implementation phase of the 1992 EDHS. A quick count for the PSUs selected in shiakhas/towns and villages was the first field operation. The objective of the quick count was to obtain an estimate of the number of households in the part to serve as the measure of size for the second stage selection.

Experience in the 1988 EDHS, in which a quick-count operation was carried out in only the urban PSUs, indicated that there was frequently significant variation between the target and the actual number of households in rural areas. This variation was largely due to the imprecision in assigning measures of size in some rural PSUs, which involved measuring the residential area on a map, many of which were out of date. Therefore, it was decided to carry out a quick count in both urban and rural areas. Prior to the quick-count operation, maps were obtained for each shiakha or town selected for the urban sample and for villages included in the rural sample that had more than 20,000 populations. These maps were divided into approximately equal-sized parts, and one part was randomly selected for the quick-count operation. For villages with less than 20,000 populations, the quick count was carried out for the entire village. It should be noted that the quick count for a rural area covered both the main village and all associated hamlets.

The one-week training course held prior to the quick-count field operation included both classroom instruction and practical training in shiakhas and villages not covered in the survey. The quick-count operation, which covered all 377 PSUs, was carried out between mid-May and mid-July 1993. A group of 52 field staff participated in the quick-count operation. The staff was divided into 15 teams, each composed of one supervisor, one cartographer and one counter.

As a quality control measure, 10 percent of the parts were selected, and a second count obtained. If the difference between the first and second counts was within 2 percent, the first count was accepted; otherwise, another visit was made to the field to resolve the discrepancy between the two counts. There were only a few cases in which a third visit was required.

The second field operation during the sample implementation phase involved a complete listing of all of the households living in the 546 segments chosen during the second stage of the sample selection. Prior to the household listing, 38 listing staff attended a one week training course, which involved both classroom lectures and field practice. After the training, 11 listing teams were formed. Each team consisted of a supervisor and two listers.

The listing operation started on September 10th and was completed by mid-October. Segments were relisted when the number of household in the listing differed markedly from that expected based on the quick count figures.

Note: See detailed description of sample design in APPENDIX B of the report which is presented in this documentation.

Mode of data collection

Face-to-face

Research instrument

The 1992 EDHS involved three types of questionnaires: a household questionnaire, an individual questionnaire for women, and an individual questionnaire for husbands. These questionnaires were based on the model survey instruments developed for the international Demographic and Health Surveys program. In particular, the household and women's questionnaires were built on the DHS model "A" questionnaire for high contraceptive prevalence countries. Additional questions on a number of topics not covered in the DHS model questionnaire were included in both the household and individual questionnaires.

The questionnaires were pretested in May 1992, following a two-week training course for supervisors and interviewers. Two supervisors, two field editors and ten interviewers participated in the pretest. Interviewer comments and tabulations of the pretest results were reviewed during the process of modifying the questionnaires.

The household questionnaire obtained a listing of all usual household members and visitors and identified those present in the household during the night before the interviewer's visit. For each of the individuals included in the listing, information was collected on the relationship to the household head, age, sex, marital status, educational level, occupation and work status. Finally, the household questionnaire also included questions on characteristics of the physical and social environment of the household (e.g., availability of electricity, source of drinking water, household possessions, etc.), which are assumed to be related to the health and socioeconomic status of the household.

The individual questionnaire for women was administered to all ever-married women age 15-49. It obtained information on the following topics: - Background characteristics - Reproduction - Knowledge and use of family planning - Other issues relating to contraception - Fertility preferences - Maternal care and breastfeeding - Immunization and health - Marriage - Husband's background, residence and women's work

The women's questionnaire included a monthly calendar, which was used to record fertility, contraceptive use, marriage, spousal absence, migration, and employment histories for a nearly six-year period beginning in January 1987. In addition, the interviewing teams measured the

Abstract

The 1988 Egypt Demographic and Health Survey (EDHS) 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 1988 EDHS is the most recent in a series of surveys carried out in Egypt to provide the information needed to study fertility behavior and its determinants, particularly contraceptive use. The EDHS findings are important in monitoring trends in these variables and in understanding the factors which contribute to differentials in fertility and contraceptive use among various population subgroups. The EDHS also provides a wealth of health-related information for mothers and their children, which was not available in the earlier surveys. These data are especially important for understanding the factors that influence the health and survival of infants and young children. In addition to providing insights into population and health issues in Egypt, the EDHS also hopefully will lead to an improved global understanding of population and health problems as it is one of 35 internationally comparable surveys sponsored by the Demographic and Health Surveys program.

The Egypt Demographic and Health Survey (EDHS) has as its major objective the provision of current and reliable information on fertility, mortality, family planning, and maternal and child health indicators. The information is intended to assist policy makers and administrators in Egyptian population and health agencies to: (1) assess the effect of ongoing family planning and maternal and child health programs and (2) improve planning for future interventions in these areas. The EDHS provides data on topics for which comparable data are not available from previous nationally representative surveys, as well as information needed to monitor trends in a number of indicators derived from earlier surveys, in particular, the 1980 Egypt Fertility Survey (EFS) and the 1980 and 1984 Egypt Contraceptive Prevalence Surveys (ECPS). Finally, as part of the worldwide Demographic and Health Surveys (DHS) program, the EDHS is intended to add to an international body of data, which can be used for cross-national research on these topics.

Geographic coverage

National

Analysis unit

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

Kind of data

Sample survey data

Sampling procedure

Geographical Coverage: The EDHS was carried out in 21 of the 26 governorates in Egypt. The Frontier Governorates (Red Sea, New Valley, Matrouh, North Sinai and South Sinai), which represent around two percent of the total population in Egypt, were excluded from coverage because a disproportionate share of EDHS resources would have been needed to survey the dispersed population in these governorates.

The EDHS sample was designed to provide separate estimates of all major parameters for: the national level, the Urban Governorates, Lower Egypt (total, urban and rural) and Upper Egypt (total, urban and rural). In addition, the sample was selected in such a fashion as to yield a sufficient number of respondents from each governorate to allow for governorate-level estimates of current contraceptive use. In order to achieve the latter objective, sample takes for the following governorates were increased during the selection process: Port Said, Suez, Ismailia, Damietta, Aswan, Kafr El-Sheikh, Beni Suef and Fayoum.

Sampling Plan: The sampling plan called for the EDHS sample to be selected in three stages. The sampling units at the first stage were shiakhas/towns in urban areas and villages in rural areas. The frame for the selection of the primary sampling units (PSU) was based on preliminary results from 1986 Egyptian census, which were provided by the Central Agency for Public Mobilization and Statistics. During the first stage selection, 228 primary sampling units (108 shiakhas/towns and 120 villages) were sampled.

The second stage of selection called for the PSUs chosen during the first stage to be segmented into smaller areal units and for two of the areal units to be sampled from each PSU. In urban PSUs, a quick count operation was carried out to provide the information needed to select the secondary sampling units (SSU) while for rural PSUs, maps showing the residential area within the selected villages were used.

Following the selection of the SSUs, a household listing was obtained for each of the selected units. Using the household lists, a systematic random sample of households was chosen for the EDHS. All ever-married women 15-49 present in the sampled households during the night before the interviewer's visit were eligible for the individual interview.

Quick Count and Listing: As noted in the discussion of the sampling plan, two separate field operations were conducted during the sample implementation phase of the EDHS. The first field operation involved a quick count in the shiakhas/towns selected as PSUs in urban areas. Prior to the quick count operation, maps for each of the selected shiakhas/towns were obtained and divided into approximately equal-sized segments, with each segment having well-defined boundaries. The objective of the quick count operation was to obtain an estimate of the number of households in each of the segments to serve as the measures of size for the second stage selection.

A review of the preliminary 1986 Census population totals for the selected shiakhas/towns showed that they varied greatly in total size, ranging from less than 10,000 to more than 275,000 residents. Experience in the 1984 Egypt Contraceptive Prevalence Survey, in which a similar quick count operation was carried out, indicated that it was very time-consuming to obtain counts of households in shiakhas/towns with large populations. In order to reduce the quick count workload during the EDHS, a subsample of segments was selected from the shiakhas/towns, with 50,000 or more population. The number of segments sub-sampled depended on the size of the shiakha. Only the sub-sampled segments were covered during the quick count operation in the large shiakhas/towns. For shiakhas with less than 50,000 populations, all segments were covered during the quick count.

Prior to the quick count, a one-week training was held, including both classroom instruction and practical training in shiakhas/towns not covered in the survey. The quick count operation, which covered all 108 urban PSUs, was carried out between June and August 1988. A group of 62 field staff participated in the quick count operation. The field staff was divided into ten teams each composed of one supervisor and three to four counters.

As a quality control measure, the quick count was repeated in 10 percent of the shiakhas. Discrepancies noted when the results of the second quick count operation were compared with the original counts were checked. No major problems were discovered in this matching process, with most differences in the counts attributed to problems in the identification of segment boundaries.

The second field operation during the sample implementation phase of the survey involved a complete listing of all of the households living in the 456 segments chosen during the second stage of the sample selection. Prior to the household listing, the listing staff attended a one-week training course, which involved both classroom lectures and field practice. After the training, the 14 supervisors and 32 listers were organized into teams; except in Damietta and Ismailia, where the listers work on their own, each listing team was composed of a supervisor and two listers. The listing operation began in the middle of September and was completed in October 1988.

Segments were relisted when the number of households in the listing differed markedly from that expected based on: (1) the quick count in urban areas or (2) the number of households estimated from the information on the size of the inhabited area for rural segments. Few discrepancies were noted for urban segments. Not surprisingly, more problems were noted for rural segments since the estimated size of the segment was not based on a recent count as it was for the urban segments. All segments where major differences were noted in the matching process were relisted in order to resolve the problems.

Note: See detailed description of sample design in APPENDIX B of the report which is presented in this documentation.

Mode of data collection

Face-to-face

Research instrument

The EDHS involved both a household and an individual questionnaire. These questionnaires were based on the DHS model "A" questionnaire for high contraceptive prevalence countries. Additional questions on a number of topics not covered in the DHS questionnaire were included in both the household and individual questionnaires. The questionnaires were pretested in June 1988, following a one-week training for supervisors and interviewers. Three supervisors and seven interviewers participated in the pretest. Interviewer comments and tabulations of the pretest results were reviewed during the process of modifying the questionnaires.

The EDHS household questionnaire obtained a listing of all usual household members and visitors and identified those present in the household during the night before the interviewer's visit. For each of the individuals included in the listing, information was collected on the relationship to the household head, age, sex, marital status, educational level, occupation and work status. In addition, questions were included on the mortality experience of sisters of all household members age 15 and over in order to obtain data to estimate the level of maternal mortality. The maternal mortality questions were administered in a