Demographic and Health Survey 1988 - Egypt, Arab Rep.

Abstract
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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
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National

Analysis unit
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- Household
- Children under five years
- Women age 15-49
- Men

Kind of data
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Sample survey data

Sampling procedure
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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
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Face-to-face

Research instrument
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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 randomly selected subsample of one in two households. 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 was administered to all ever-married women aged 15-49 present in the household during the night before the interviewer's visit. It obtained information on the following topics:
- Respondent's background;
- Reproductive behavior;
- Knowledge and use of contraception;
- Contraceptive use history;
- Family planning and childbearing attitudes;
- Husband's and parents' statuses;
- Maternal health and breastfeeding;
- Child health and cause of death;
- Weight and height of children.

The anthropometric data were collected in the same sample of households from which the maternal mortality data were obtained. Children age 3-36 months born to women interviewed in the individual survey were weighed and measured.

Cleaning operations
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Office Editing: The central office of the EDHS was responsible for collecting completed questionnaires from supervisors as soon as a cluster was completed. Questionnaires were coded and reviewed for consistency and completeness by office editors. To provide feedback for the field teams, the office editors were asked to write a summary report of problems for each PSU. The report was then reviewed by one of the two senior staff assigned to supervise the work of the office editors. When there were serious errors found in one or more questionnaires from a cluster, the team supervisor was contacted in order to ensure that the problem would not occur in other clusters in which the team was working.

Machine Entry and Editing: The data were entered and edited on microcomputers using the Integrated System for Survey Analysis (ISSA), a package program specially developed to process DHS data. ISSA allows range, skip and most consistency errors to be detected and corrected at the entry stage, substantially reducing the time required for the processing of data. The machine entry and editing phase began while interviewing teams were still in the field. The data entry personnel used six IBM-compatible microcomputers to process the EDHS questionnaires. Working six days per week in two shifts, they completed the machine entry and editing of the data in three months.

Response rate
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A total of 10,528 households were selected for the EDHS sample. 661 of the selected households were considered to be ineligible for interview because no household member had slept in the dwelling on the night before the interview, the dwelling in which the selected household had resided was vacant or destroyed or the household could not be contacted for other reasons. Among the remaining 9,867 eligible households, 9,805, or 99 percent, were successfully interviewed.

As noted, an eligible respondent for the individual survey was defined as an ever married woman between the ages of 15 and 49 years who was present in a sampled household during the night before the household interview. A total of 9,095 eligible respondents was identified, and 8,911 (98 percent) of these women were interviewed. The overall response rate, which is the product of the household and individual response rates, was 97 percent in the EDHS.

Note: See summarized response rates by place of residence in Table 1.5 of the survey Report.

Sampling error estimates
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Sampling error is defined as the difference between the actual value for any variable measured in a survey and the value estimated by the survey. The estimates from a sample survey are affected by two types of errors: (1) sampling error and (2) non-sampling error. Non-sampling error is the result of mistakes made in carrying out data collection and data processing, including the failure to locate and interview the correct household, errors in the way questions are asked, and data entry errors, etc. Although efforts were made during the implementation of the EDHS to minimize this type of error, non-sampling errors are impossible to avoid and difficult to evaluate statistically.

Sampling error is a measure of the variability between all possible samples that could have been selected from the same population using the same design and expected size. For the entire population and for large subgroups, the EDHS sample is generally sufficiently large to provide reliable estimates; for such populations, the sampling error is small. However, for small subgroups, sampling errors may be larger and, thus, affect the reliability of the data.

Sampling error is usually measured in terms of the standard error for a particular statistic (mean, percentage, ratio, etc.), i.e., the square root of the variance. The standard error can be used also 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 as measured in 95 percent of all possible samples with the same design will fall within a range of plus or minus two times the standard error for that statistic.

Note: See detailed estimate of sampling error calculation in APPENDIX C of the survey Report.

摘要
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1988年埃及人口与健康调查（EDHS）是全球人口与健康调查（DHS）计划的一部分，旨在收集有关生育率、家庭规划和母婴健康的数据。

1988年的EDHS是该系列调查中的最新一次，旨在为研究生育行为及其决定因素提供所需信息，特别是避孕药具的使用。EDHS的结果对于监测这些变量的趋势以及理解不同人口子群体在生育率和避孕药具使用方面的差异背后的因素具有重要意义。EDHS还提供了关于母亲及其儿童的大量与健康相关的信息，这些信息在早期的调查中并不存在。这些数据对于理解影响婴儿和幼儿健康与生存的因素尤为重要。除了为研究埃及的人口与健康问题提供洞见外，EDHS还有望提高全球对人口与健康问题的理解，因为它是由人口与健康调查计划赞助的35个国际可比调查之一。

埃及人口与健康调查（EDHS）的主要目标是提供关于生育率、死亡率、家庭规划和母婴健康指标的最新和可靠信息。这些信息旨在协助埃及人口与健康机构的政策制定者和行政管理人员：（1）评估持续的家庭规划和母婴健康计划的影响，（2）改进未来干预措施的计划。EDHS提供了以前的国家代表性调查中不可比的数据，以及监测从早期调查中得出的许多指标趋势所需的信息，特别是1980年埃及生育率调查（EFS）和1980年及1984年埃及避孕药具普及率调查（ECPS）。最后，作为全球人口与健康调查（DHS）计划的一部分，EDHS旨在为国际数据集做出贡献，这些数据可用于跨国家对这些主题的研究。

地理覆盖范围
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全国

分析单位
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- 家庭
- 5岁以下儿童
- 15-49岁女性
- 男性

数据类型
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样本调查数据

抽样程序
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地理覆盖范围：EDHS在埃及的26个省份中的21个进行了调查。代表埃及总人口的约2%的前沿省份（红海、新 valley、matrouh、北西奈和南西奈）被排除在外，因为这些省份人口分散，需要过多的EDHS资源来调查这些地区。

EDHS样本的设计旨在为以下各级别提供所有主要参数的单独估计：国家层面、城市省份、下埃及（总计、城市和农村）和上埃及（总计、城市和农村）。此外，样本的选择方式旨在从每个省份选出足够数量的受访者，以便进行当前避孕药具使用省份层面的估计。为了实现这一目标，在选拔过程中增加了以下省份的样本量：Port Said、Suez、Ismailia、Damietta、Aswan、Kafr El-Sheikh、Beni Suef和Fayoum。

抽样计划：抽样计划要求EDHS样本在三个阶段进行选择。第一阶段的选择单元为城市地区的sheikhas/towns和农村地区的村庄。选择一级抽样单位（PSU）的框架基于1986年埃及人口普查的初步结果，这些结果由公共动员和统计中央局提供。在第一阶段的选择过程中，共抽取了228个一级抽样单位（108个sheikhas/towns和120个村庄）。

第二阶段的选择要求将第一阶段选择的一级抽样单位（PSU）分割成更小的区域单位，并从每个PSU中选择两个区域单位进行抽样。在城市PSU中，进行快速计数操作以提供选择二级抽样单位（SSU）所需的信息，而在农村PSU中，使用显示选定村庄内住宅区的地图。

在选择了SSU之后，为每个选定的单位获取了家庭名单。使用家庭名单，对EDHS选择了系统的随机家庭样本。在访问者访问的前一晚，所有曾经结婚的、年龄在15-49岁之间并出现在抽样家庭中的女性都有资格接受个人访谈。

快速计数和列表：如抽样计划讨论中所述，在EDHS样本实施阶段进行了两项独立的现场操作。第一项现场操作涉及对作为PSU选定的城市地区的sheikhas/towns进行快速计数。在快速计数操作之前，为每个选定的sheikhas/towns获取了地图，并将其划分为大小大致相等的部分，每个部分都有明确的边界。快速计数操作的目标是从每个部分中获得家庭数量的估计值，作为第二阶段选择的测量标准。

对选定sheikhas/towns的初步1986年人口普查人口总数进行了审查，发现它们的总规模差异很大，从不到10,000到超过275,000居民。1984年埃及避孕药具普及率调查（ECPS）中的经验表明，在人口众多的sheikhas/towns中获得家庭计数非常耗时。为了减少EDHS中的快速计数工作量，从人口超过50,000的sheikhas/towns中选择了部分样本段。样本段的数量取决于sheikhas的人口规模。只有被抽样的部分段在大型sheikhas/towns的快速计数操作中被覆盖。对于人口少于50,000的sheikhas，所有部分段都在快速计数中被覆盖。

在快速计数之前，进行了一周的训练，包括课堂指导和在调查中未涵盖的sheikhas/towns的实地训练。1988年6月至8月，对108个城市PSU进行了快速计数操作。62名现场工作人员参与了快速计数操作。现场工作人员分为十个小组，每个小组由一名监督员和三到四名计数员组成。

作为质量控制措施，对10%的sheikhas进行了快速计数的重复操作。在将第二次快速计数操作的结果与原始计数进行比较时，发现了差异。在匹配过程中，大多数差异归因于对部分边界识别的问题。

调查的第二项现场操作涉及对在样本选择第二阶段选出的456个部分中居住的所有家庭进行完全列表。在家庭列表之前，列表人员参加了一周的训练课程，该课程包括课堂讲座和实地练习。训练结束后，14名监督员和32名列表员被组织成小组；在Damietta和Ismailia，列表员单独工作，除了Damietta和Ismailia外，每个列表小组由一名监督员和两名列表员组成。列表操作于1988年9月中旬开始，并于10月完成。

当列表中的家庭数量与根据以下内容预期的情况存在明显差异时，对部分进行了重新列表：（1）城市地区的快速计数或（2）根据选定农村部分居住区规模的估计家庭数量。对于城市部分，发现了少量差异。不出所料，农村部分的问题更多，因为部分的估计规模不是基于与城市部分相同的最新计数。为了解决匹配过程中的问题，所有在匹配过程中发现主要差异的部分都进行了重新列表。

注意：有关样本设计的详细描述，请参阅报告附录B，该报告包含在本文档中。

数据收集方式
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面对面

研究工具
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EDHS涉及家庭和个人问卷。这些问卷基于DHS模型"A"问卷，适用于高避孕药具普及率国家。在家庭和个人问卷中都包含了DHS问卷未涵盖的一些主题的附加问题。问卷于1988年6月进行了预测试，当时对监督员和访谈员进行了一周的训练。三名监督员和七名访谈员参与了预测试。在修改问卷的过程中，审查了访谈员的评论和预测试结果的整理。

EDHS家庭问卷获取了所有经常居住的家庭成员和访客的名单，并确定了在访问者访问的前一晚出现在家庭中的成员。对于名单中的每个人，收集了与家庭户主的关系、年龄、性别、婚姻状况、教育水平、职业和工作状况等信息。此外，还包括关于所有15岁及以上家庭成员姐妹的死亡率问题，以获取估计孕产妇死亡率所需的数据。孕产妇死亡率问题是在每两户家庭中随机选择的一户家庭中进行的。最后，家庭问卷还包括关于家庭物理和社会环境特征的问题（例如，电力供应、饮用水来源、家庭财产等），这些特征被认为与家庭的健康状况和社会经济状况有关。

个人问卷针对在访问者访问的前一晚出现在家庭中的所有曾经结婚的、年龄在15-49岁之间的女性进行。它获取以下主题的信息：
- 响应者的背景；
- 生殖行为；
- 避孕知识的获取和使用；
- 避孕药具使用历史；
- 家庭规划和生育态度；
- 丈夫和父母的情况；
- 孕产妇健康和母乳喂养；
- 儿童健康和死亡原因；
- 儿童的体重和身高。

体格测量数据是从获取孕产妇死亡率数据的相同家庭样本中收集的。3-36个月大的儿童是由个人调查中采访的妇女所生的，对这些儿童进行了称重和测量。

清理操作
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办公室编辑：EDHS的中央办公室负责在完成一个集群后尽快从监督员那里收集完成的问卷。办公室编辑对问卷进行编码，并检查其一致性及完整性。为了为现场团队提供反馈，要求办公室编辑为每个PSU编写一份问题总结报告。报告经负责监督办公室编辑工作的两名高级工作人员之一审查。当发现一个或多个问卷存在严重错误时，会联系团队监督员，以确保不会在其他团队工作的集群中发生此类问题。

机器输入和编辑：使用集成调查分析系统（ISSA）在微计算机上输入和编辑数据，ISSA是一个专门为处理DHS数据开发的软件包程序。ISSA允许在输入阶段检测和纠正范围、跳过和大多数一致性错误，从而大大减少了数据处理所需的时间。机器输入和编辑阶段在访谈团队仍在现场时开始。工作人员使用六台IBM兼容的微计算机处理EDHS问卷。每周工作六天，分两班次，他们在三个月内完成了数据的机器输入和编辑。

响应率
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总共选择了10,528个家庭作为EDHS样本。661个选定的家庭被认为不适合接受访谈，因为在前一晚的访谈中，没有家庭成员在住所中过夜，选定的家庭居住的住所为空或被毁，或者由于其他原因无法联系到家庭。在剩余的9,867个有资格的家庭中，9,805个，即99%，成功接受了访谈。

如前所述，个人调查的有资格受访者被定义为在前一晚的家庭访谈中出现在抽样家庭中的、年龄在15-49岁之间并曾经结婚的女性。总共确定了9,095名有资格的受访者，其中8,911名（98%）的女性接受了访谈。EDHS的整体响应率，即家庭和个人响应率的乘积，为97%。

抽样误差估计
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抽样误差定义为调查中测量的任何变量的实际值与调查估计值之间的差异。样本调查的估计值受两种类型的误差的影响：（1）抽样误差和（2）非抽样误差。非抽样误差是执行数据收集和数据处理过程中所犯错误的结果，包括未能找到和访谈正确的家庭、提问方式错误和数据输入错误等。尽管在实施EDHS过程中采取了措施来最大限度地减少此类错误，但非抽样误差是无法避免的，并且难以进行统计分析。

抽样误差是衡量从同一总体中按相同设计和预期规模使用相同设计选择的所有可能样本之间的变异性的指标。对于整个总体和大型子群体，EDHS样本通常足够大，可以提供可靠的估计；对于此类群体，抽样误差很小。然而，对于小型子群体，抽样误差可能较大，从而影响数据的可靠性。

抽样误差通常以特定统计量（平均值、百分比、比率等）的标准误差来衡量，即方差的平方根。标准误差也可以用来计算包含真实人口值的置信区间。例如，对于从样本调查中计算出的任何给定统计量，该统计量在所有可能样本中的值，在相同设计的情况下，有95%的概率将落在该统计量的标准误差的两倍范围内。

注意：有关抽样误差计算的详细估计，请参阅报告附录C。