Demographic and Health Survey 1995 - Egypt, Arab Rep.

Abstract
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The 1995 Egypt Demographic and Health Survey (EDHS-95) is part of the worldwide Demographic and Health Surveys project. It is the third survey in a series of Demographic and Health surveys that have been carried out in Egypt. The EDHS-95 collected information on fertility and child mortality, family planning awareness, approval and use, as well as basic information on maternal and child health.

The 1995 Egypt Demographic and Health Survey (EDHS-95) is aimed at providing policymakers and planners with important information for use in evaluating existing programs and formulating new programs and policies related to reproductive behavior and health. The survey was specifically designed to meet the following objectives:
(1) Collect data on fertility and desired family size;
(2) Monitor changes in family planning practice over time and investigate the availability and accessibility of family planning services in Egypt;
(3) Determine reasons for nonuse and intention to use family planning; and
(4) Measure the achievement of health policy objectives, particularly those concerning the GOE maternal and child health program.

In addition, because information on the status of women is of increasing interest to policymakers, the EDHS-95 included a special questionnaire to collect extensive data on the lives of Egyptian women. The questionnaire was administered to eligible women in one-third of the households in the EDHS-95 sample.

Geographic coverage
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National

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

Kind of data
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Sample survey data

Sampling procedure
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Sample Design

The primary objective of the sample design for the EDHS-95 is to provide estimates of key population and health indicators including fertility and child mortality rates for the country as a whole and for six major administrative regions (Urban Governorates, urban Lower Egypt, rural Lower Egypt, urban Upper Egypt, rural Upper Egypt, and the Frontier Governorates). In addition, in the Urban Governorates, Lower Egypt and Upper Egypt, the design allows for governorate-level estimates of most key variables, with the exception of fertility and mortality rates and women's status indicators. In the Frontier Governorates, the sample size for individual governorates is not sufficiently large to allow for separate governorate-level estimates. However, separate estimates are possible for the western Frontier Governorates (Matrouh and New Valley) and the eastern Frontier Governorates (North Sinai, South Sinai and Red Sea). Finally, Assuit and Souhag governorates were oversampled in the EDHS-95 in order to provide sufficient cases for a special follow-up study of the reasons for nonuse of family planning in those areas.

In order to meet the survey objectives, the number of households selected in the EDHS-95 sample from each governorate was disproportional to the size of the population in the governorate. As a result, the EDHS-95 sample is not self-weighting at the national level, and weights had to be applied to the data to obtain the national-level estimates presented in this report.

Sample Implementation

Selection of PSUs: The EDHS-95 sample was selected in three stages. At the first or primary stage, the units of selection were shiakhas/towns in urban areas, and villages in rural areas. Information from the 1986 Census was used in constructing the frame from which the primary sampling units (PSU) were selected. Prior to the selection of the PSUs, the frame was updated to take into account all of the administrative changes which had occurred since 1986. The updating process included both office work and field visits during a three-month period. After it was completed, urban and rural units were stratified by geographical location in a serpentine order from the northwest comer to the southeast within each governorate. Shiakhas or villages with less than 2,500 populations were grouped with contiguous shiakhas or villages (usually within the same kism or marquez) to obtain the minimum size required (5,000 population). During the primary stage selection, a total of 467 units (204 shiakhas/towns and 263 villages) were sampled.

Quick Count: The second stage of selection involved several steps. First, detailed maps of the PSUs chosen during the first stage were obtained and divided into parts of roughly equal size. In shiakhas/towns or villages with 20,000 or more population, two parts were selected. In the remaining smaller shiakhas/towns or villages, only one part was selected. Overall, a total of 656 parts were selected from the shiakhas/towns and villages in the EDHS-95 sample.

A quick count was then carded out to divide each part into standard segments of about 200 households. This operation was conducted in order to provide an estimate of the number of households in each part so that the part could be divided into segments of roughly equal size. A group of 36 experienced field workers participated in the quick count operation. They were divided into 12 teams, each consisting of one supervisor, one cartographer and one or two counters. A one-week training course conducted prior to the quick count included both classroom sessions and field practice in a shiakha/town and a village not covered in the survey. The quick-count operation took place between late April and late July 1995.

As a quality control measure, the quick count was repeated in 10 percent of the parts. If the difference between the results of the first and second quick count were within 2 percent, then the first count was accepted. There were no major discrepancies between the two counts in most of the areas for which the count was repeated; however, in a few cases in Kafr El-Sheikh govemorate, a third visit was made to the field in order to resolve discrepancies between the counts.

Household Listing: Following the quick count, a total of 934 segments was chosen from the parts in each shiakha/town and village in the EDHS-95 sample (i.e., two segments were selected from each of the 467 PSUs). A household listing operation was then implemented in each of the selected segments. To conduct this operation, 16 supervisors and 32 listers were organized into 16 teams. Generally, each listing team consisted of a supervisor and two listers. A training course for the listing staff was held at the end of August for one week. The training involved classroom lectures and two days of field practice in two urban and rural locations. The listing operation began at the end of August and continued for about 40 days.

Around 10 percent of the segments were relisted. Two different criteria were used to select segments for relisting. First, segments were relisted when the number of households in the listing differed markedly from that expected according to the quick count information. Second, a number of segments were randomly selected to be relisted as an additional quality control test. Overall, few major discrepancies were found in comparisons of the two listings. However, a third visit to the field was necessary in a few segments in Gharbia governorate because of significant discrepancies between the results of the original listing and the relisting operation.

Selection of the Household Sample: Using the household lists for each segment, a systematic random sample of households was chosen to be interviewed in the EDHS-95. A subsample of one-third of these households was also selected for the woman's status survey, except in Assuit and Souhag governorates, where all households were included in the women's status survey. All ever-married women 15-49, who were usual residents or present in the household on the night before the interview, were eligible for the survey.

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-95 involved three types of questionnaires: a household questionnaire, an individual questionnaire, and a women's status questionnaire. The household and individual questionnaires were based on the model survey instruments developed by the Demographic and Health Surveys program for high contraceptive prevalence countries. Additional questions on a number of topics not covered in the DHS mode/questionnaires were included in EDHS-95 questionnaires. In some cases, those items were drawn from the questionnaires used for the 1988 EDHS and the 1992 EDHS. In other cases, the questions were intended to collect information on topics not covered in the earlier surveys (e.g., schooling of children and female circumcision). The women's status questionnaire was based on a special set of modules developed in the DHS program to explore a number of dimensions of the status of women. The modules were modified to obtain data of interest in understanding the position of women in Egyptian society.

The household questionnaire consisted of two parts: a household schedule and a series of questions relating to the health and socioeconomic status of the household. The household schedule was used to list all usual household members and visitors and to identify those present in the household during the night before the interviewer's visit. For each of the individuals included in the schedule, information was collected on the relationship to the household head, age, sex, marital status (for those fifteen years and older), educational level and work status (for those six years and older). The second part of the household questionnaire included questions on characteristics of the physical and social environment of the household (e.g., type of dwelling, availability of electricity, source of drinking water, household possessions, and type of salt the household uses for cooking).

The individual questionnaire was administered to all ever-married women age 15-49 who were usual residents or who were present in the household during the night before the interviewer's visit. It obtained information on the following topics:
• Respondent's background
• Reproduction
• Contraceptive knowledge and use
• Fertility preferences and attitudes about family planning.
• Pregnancy and breastfeeding
• Immunization and health
• Schooling of children
• Female circumcision
• Marriage and husband's background
• Woman's work and residence

The individual questionnaire included a monthly calendar, which was used to record a respondent's fertility, contraceptive use, and marriage status during each month of nearly a six-year period beginning in January 1990. Height and weight data were obtained during the individual interview for children born since January 1990 and mothers of these children, as well as other women who had had a live birth since January 1990.

The women's status questionnaire obtained more detailed information from a subsample of women on the following topics:
• Parent's background
• Marriage
• Relations with the husband and other household members
• Women's workload and eating practices
• Employment
• Financial Autonomy
• Treatment of women in the household.

Pretest

The household and individual questionnaires were pretested in June 1995 following a two-week training course. Two supervisors, two assistant supervisors and eight interviewers participated in the pretest. The pretest was conducted in Gharbia and Beni-Suef governorates. A total of 303 household and 260 individual interviews were completed during the pretest, out of which 140 household and 126 individual interviews were in urban areas, with the remaining interviews being conducted in rural areas.

The women's status questionnaire was pretested in July 1995 following a one-week training course for supervisors and interviewers. Two supervisors and six interviewers participated in the pretest. It was conducted with the same individuals who were interviewed in the pretest of the main survey questionnaires. A total of 229 questionnaires were completed, out of which 103 were in urban areas and 126 were in rural areas.

The questionnaires from the EDHS-95 were finalized following the pretest. Both interviewer comments and tabulations of the pretest results were reviewed during the process of modifying the questionnaires.

Cleaning operations
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Office Editing

The central office of the EDHS-95 was responsible for collecting questionnaires from supervisors as soon as a cluster completed. Questionnaires were reviewed for consistency and completeness by office editors, and a few questions (e.g., occupation) were coded in the office prior to data entry. To provide feedback for the field teams, the office editors were instructed to report any problems detected while editing the questionnaires. These reports were reviewed by the senior staff. If serious errors were found in one or more questionnaires from a cluster, the supervisor of the team working in the cluster was notified and advised of the steps to be taken to avoid these problems in the future.

Machine Entry and Editing

The machine entry and editing phase began while interviewing teams were still in the field. The data from the questionnaires were entered and edited on microcomputers using the Integrated System for Survey Analysis (ISSA), a software package developed especially for the Demographic and Health Surveys program.

Eleven data entry personnel used eight IBM-compatible microcomputers to process the EDHS-95 survey. During the machine entry, one-third of each segment was reentered for verification. One of the computers was assigned solely for this purpose. By working two shifts six days per week, the data processing staff completed the entry and editing of data by the end of February 1996.

Response rate
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A total of 14,879 women were identified as eligible to be interviewed. Questionnaires were completed for 14,779 of those women, which represents a response rate of 99.3 percent. A total of 7,223 respondents were in the subsample selected for the women's status interview. Questionnaires were completed for 7,121 of these women, which represents a response rate of 98.6 percent.

There was almost no difference between urban and rural areas in response rates for the household, individual and women's status interviews. Looking at place of residence, the response rate for the household and individual interviews exceeds 98 percent, and the response rate for the women's status interviews exceeds 97 percent, in all areas.

Note: See summarized response rates by place of residence in Table 1.3 of the report which is presented this documentation.

Sampling error estimates
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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 EDHS-95 to minimize this type of error, non-sampling 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 EDHS-95 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 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, the EDHS-95 sample is the result of a multi-stage stratified design, and, consequently, it was necessary to use more complex formulae. The computer software used to calculate sampling errors for the EDHS-95 is the ISSA Sampling Error Module (ISSAS). This module used the Taylor linearization method of variance estimation for survey estimates that are means or proportions. The Jacknife 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 C of the report which is presented in this documentation.

Data appraisal
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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 D of the report which is presented in this documentation.

摘要
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1995年埃及人口与健康调查（EDHS-95）是全球人口与健康调查项目的一部分。它是埃及一系列人口与健康调查中的第三次调查。EDHS-95收集了关于生育和儿童死亡率、计划生育意识、接受度和使用情况，以及关于母亲和儿童健康的基本信息。

1995年埃及人口与健康调查（EDHS-95）旨在为政策制定者和规划者提供评估现有项目以及制定与生殖行为和健康相关的新项目和新政策的重要信息。调查特别设计以满足以下目标：
(1) 收集关于生育和理想家庭规模的数据；
(2) 监测计划生育实践随时间的变化，并调查埃及计划生育服务的可用性和可及性；
(3) 确定非使用计划生育的原因和意向使用；
(4) 衡量卫生政策目标实现情况，特别是关于埃及政府（GOE）的母亲和儿童健康计划的目标。

此外，鉴于女性状况信息越来越受到政策制定者的关注，EDHS-95还包括一份特别问卷，收集了关于埃及女性生活的广泛数据。问卷被发放给EDHS-95样本中三分之一的家庭的合格女性。

地理覆盖范围
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全国

分析单位
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- 家庭
- 五岁以下儿童
- 15-49岁女性

数据类型
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样本调查数据

抽样程序
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样本设计

EDHS-95样本设计的首要目标是提供关于整个国家以及六个主要行政区域（城市省政府、城市下埃及、农村下埃及、城市上埃及、农村上埃及和边疆省）的关键人口和健康指标估计，包括生育率和儿童死亡率。在城镇省政府、下埃及和上埃及，设计允许对大多数关键变量进行省级估计，但生育率和死亡率以及女性状况指标除外。在边疆省，由于单个省份的样本量不足以进行单独的省级估计，因此无法进行单独的估计。然而，可以为西部边疆省（马特鲁赫和新 valley）和东部边疆省（北西奈、南西奈和红海）进行单独的估计。最后，阿斯苏安和索哈格省在EDHS-95中被过度抽样，以便为这些地区家庭计划非使用原因的特殊后续研究提供足够的案例。

为了满足调查目标，EDHS-95样本中每个省份选定的家庭数量与该省份人口规模不成比例。因此，EDHS-95样本在全国层面不是自加权，必须应用权重以获得本报告中呈现的国家层面估计。

样本实施

选择PSU：EDHS-95样本在三个阶段进行选择。在第一阶段或初级阶段，选择单位为城市地区的谢赫/城镇和农村地区的村庄。1986年人口普查的信息被用于构建框架，从中选择初级抽样单位（PSU）。在选择PSU之前，框架被更新以考虑自1986年以来发生的所有行政变化。更新过程包括在三个月期间进行的办公室工作和实地考察。完成后，城市和农村单位在每个省份内按地理位置以螺旋顺序从西北角到东南角进行分层。人口少于2,500的谢赫或村庄与相邻的谢赫或村庄（通常在同一kism或marquez内）合并，以获得所需的最小规模（5,000人口）。在初级阶段选择中，共抽样467个单位（204个谢赫/城镇和263个村庄）。

快速计数：选择的第二阶段涉及几个步骤。首先，获得第一阶段选择的PSU的详细地图，并将其分成大致相等的部分。在人口20,000人或以上的谢赫/城镇或村庄中，选择了两个部分。在较小的谢赫/城镇或村庄中，只选择一个部分。总体而言，从EDHS-95样本中的谢赫/城镇和村庄中选择了656个部分。

随后进行快速计数，将每个部分分成大约200户的标准段。这一操作是为了提供一个关于每个部分中家庭数量的估计，以便可以将该部分分成大致相等的段。一支由36名经验丰富的实地工作人员组成的团队参与了快速计数操作。他们被分成12个小组，每个小组由一名主管、一名制图员和一名或两名计数员组成。在快速计数之前，为期一周的培训课程包括课堂课程和在一个不在调查范围内的谢赫/城镇和村庄的实地练习。快速计数操作于1995年4月下旬至7月下旬进行。

作为一种质量控制措施，在10％的部分中重复了快速计数。如果第一次和第二次快速计数的差异在2％以内，则接受第一次计数。在大多数重复计数的地区，两次计数之间没有发现重大差异；然而，在卡夫尔谢赫省的一些案例中，为了解决计数之间的差异，进行了第三次现场访问。

家庭登记：在快速计数之后，从EDHS-95样本中每个谢赫/城镇和村庄的部分中选择了934个部分（即从每个467个PSU中选择了两个部分）。然后在每个选定的部分中实施了家庭登记操作。为了进行此操作，16名主管和32名登记员被组织成16个小组。一般来说，每个登记小组由一名主管和两名登记员组成。在8月底举行了一周的培训课程，对登记人员进行了培训。培训包括课堂讲座和在城市和农村地点进行两天的实地练习。登记操作于8月底开始，并持续了大约40天。

大约10％的段被重新登记。使用两个不同的标准选择了重新登记的段。首先，当登记中的家庭数量与根据快速计数信息预期的家庭数量有显著差异时，段被重新登记。其次，选择了一些段进行重新登记，作为额外的质量控制测试。总体而言，在比较两次登记时发现的大多数差异很小。然而，由于原始登记和重新登记操作之间的结果存在显著差异，在加尔比亚省的一些段中，有必要进行第三次现场访问。

选择家庭样本：使用每个部分的家庭名单，从EDHS-95中选择系统随机样本的家庭进行访谈。其中三分之一的家庭的子样本也被选入女性状况调查，但在阿斯苏安和索哈格省，所有家庭都被纳入女性状况调查。所有曾经结婚的15-49岁女性，在访谈前一夜是常住居民或在家庭中，都有资格参加调查。

注意：有关样本设计的详细描述，请参阅本文档中提供的报告附录B。

数据收集方式
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面对面

研究工具
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EDHS-95涉及三种类型的问卷：家庭问卷、个人问卷和女性状况问卷。家庭和个人问卷基于人口与健康调查项目为高避孕普及率国家开发的模型调查工具。EDHS-95问卷中还包括了DHS模式/问卷未涵盖的一些主题的附加问题。在某些情况下，这些项目是从1988年EDHS和1992年EDHS中使用的问卷中抽取的。在其他情况下，问题旨在收集早期调查（例如，儿童教育和女性割礼）未涵盖的主题的信息。女性状况问卷基于DHS项目开发的一套特别模块，用于探讨女性状况的多个维度。这些模块经过修改，以收集理解埃及社会中女性地位所需的数据。

家庭问卷由两部分组成：家庭日程和家庭与社会经济状况相关问题的一系列问题。家庭日程用于列出所有常住家庭成员和访客，并确定在访谈员访问之夜在家庭中的人。对于日程表中包括的每个人，收集了与家庭户主的关系、年龄、性别、婚姻状况（15岁及以上的人）、教育水平和工作状况（6岁及以上的人）的信息。家庭问卷的第二部分包括关于家庭物理和社会环境特征的问题（例如，住房类型、电力供应、饮用水来源、家庭财产和烹饪用的盐的类型）。

个人问卷被发放给所有曾经结婚的15-49岁女性，她们是常住居民或访谈员访问前一晚在家庭中的人。它获得了以下主题的信息：
• 响应者背景
• 再生产
• 避孕知识和使用
• 生育偏好和关于计划生育的态度
• 妊娠和母乳喂养
• 免疫和健康
• 儿童教育
• 女性割礼
• 婚姻和配偶背景
• 妇女工作和居住地

个人问卷包括一份月历，用于记录从1990年1月开始近六年的每个月份的响应者的生育、避孕使用和婚姻状况。自1990年1月以来出生的儿童以及这些孩子的母亲，以及其他自1990年1月以来有过活产的女性，在个人访谈期间获得了身高和体重数据。

女性状况问卷从女性子样本中获得了关于以下主题的更详细的信息：
• 父母背景
• 婚姻
• 与配偶和其他家庭成员的关系
• 妇女劳动量和饮食习惯
• 就业
• 财务自主
• 家庭中女性的待遇。

预测试

在为期两周的培训课程之后，于1995年6月对家庭和个人问卷进行了预测试。两名主管、两名助理主管和八名访谈员参与了预测试。预测试在加尔比亚和本尼-苏夫省进行。在预测试期间，共完成了303个家庭和260个个人访谈，其中140个家庭和126个个人访谈在城市地区进行，其余访谈在农村地区进行。

女性状况问卷在7月进行了预测试，当时为主管和访谈员举行了一周的培训课程。两名主管和六名访谈员参与了预测试。它是在主要调查问卷预测试中接受访谈的同一个人中进行的。共完成了229份问卷，其中103份在城市地区，126份在农村地区。

EDHS-95的问卷在预测试后最终确定。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汇编。

数据清理操作
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办公室编辑

EDHS-95的中心办公室负责尽快从主管那里收集问卷，一旦一个集群完成。办公室编辑通过审查问卷的一致性和完整性来检查问卷，并在数据录入之前在办公室对少数问题（例如职业）进行编码。为了为实地团队提供反馈，指示办公室编辑报告在编辑问卷过程中发现的任何问题。这些报告被高级人员审查。如果在集群的一个或多个问卷中发现严重错误，则通知该集群工作的团队主管，并建议采取措施避免未来出现这些问题。

机器录入和编辑

机器录入和编辑阶段在访谈团队仍在实地时开始。使用专为人口与健康调查项目开发的集成调查分析系统（ISSA）软件包在微计算机上录入和编辑了问卷数据。

11名数据录入人员使用8台IBM兼容型微计算机处理EDHS-95调查。在机器录入过程中，每个部分的1/3被重新录入以进行验证。一台计算机专门用于此目的。通过每周工作两天、每天工作六天，数据处理人员于1996年2月底完成了数据的录入和编辑。

应答率
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共确定了14,879名有资格接受访谈的女性。为其中14,779名女性完成了问卷，这代表99.3％的应答率。共有7,223名响应者被选入女性状况访谈的子样本。其中7,121名女性的问卷得到了完成，这代表98.6％的应答率。

家庭、个人和女性状况访谈的应答率在城市和农村地区几乎没有任何差异。从居住地来看，家庭和个人访谈的应答率超过98％，所有地区的女性状况访谈的应答率超过97％。

注意：请参阅本文档中提供的报告中表1.3中按居住地汇总的应答率。

抽样误差估计
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样本调查的估计受两种类型的误差的影响：（1）非抽样误差，和（2）抽样误差。非抽样误差是实施数据收集和数据处理过程中所犯错误的结果，例如未能找到和访谈正确的家庭、访谈员或受访者的误解，以及数据录入错误。尽管在实施EDHS-95期间做出了许多努力来最大限度地减少此类错误，但非抽样误差是无法避免且难以从统计上进行评估的。

另一方面，抽样误差可以统计评估。EDHS-95中选定的受访者样本只是从同一人口中，使用相同的设计和预期规模可以选出的许多样本之一。每个样本都会产生与实际选定样本的结果有所不同的一些结果。抽样误差是衡量所有可能样本之间差异的指标。虽然变异的程度无法确切知道，但可以从调查结果中估计。

抽样误差通常用特定统计量（均值、百分比等）的标准误差来衡量，这是方差的平方根。标准误差可用于计算置信区间，其中可以合理地假设真实人口值的范围。例如，对于从样本调查计算出的任何给定统计量，该统计量的值将在95％的所有可能样本相同大小和设计的情况下，在加减两倍标准误差的范围内。

如果受访者的样本被选为简单随机样本，则可以使用简单的公式来计算抽样误差。然而，EDHS-95样本是分层多阶段设计的产物，因此有必要使用更复杂的公式。用于计算EDHS-95抽样误差的计算机软件是ISSA抽样误差模块（ISSAS）。该模块使用泰勒线性化方法估计调查估计的方差，用于均值或比例。使用Jackknife重复复制方法用于更复杂统计量（如生育率和死亡率）的方差估计。

注意：请参阅本文档中提供的报告中附录C中的抽样误差计算详细估计。

数据评估
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数据质量表
- 家庭年龄分布
- 合格和接受访谈的女性的年龄分布
- 报告的完整性
- 按日历年出生
- 死亡年龄的月报告
- 死亡年龄的日报告

注意：请参阅本文档中提供的报告中附录D中的详细表格。