Mini Demographic and Health Survey 2019 - Ethiopia

Abstract
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The 2019 Ethiopia Mini Demographic and Health Survey (EMDHS) is a nationwide survey with a nationally representative sample of 9,150 selected households. All women age 15-49 who were usual members of the selected households and those who spent the night before the survey in the selected households were eligible to be interviewed in the survey. In the selected households, all children under age 5 were eligible for height and weight measurements. The survey was designed to produce reliable estimates of key indicators at the national level as well as for urban and rural areas and each of the 11 regions in Ethiopia.

The primary objective of the 2019 EMDHS is to provide up-to-date estimates of key demographic and health indicators. Specifically, the main objectives of the survey are:
▪ To collect high-quality data on contraceptive use; maternal and child health; infant, child, and neonatal mortality levels; child nutrition; and other health issues relevant to achievement of the Sustainable Development Goals (SDGs)
▪ To collect information on health-related matters such as breastfeeding, maternal and child care (antenatal, delivery, and postnatal), children’s immunizations, and childhood diseases
▪ To assess the nutritional status of children under age 5 by measuring weight and height

Geographic coverage
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National coverage

Analysis unit
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- Household
- Individual
- Children age 0-5
- Woman age 15-49
- Health facility

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

Kind of data
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Sample survey data [ssd]

Sampling procedure
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The sampling frame used for the 2019 EMDHS is a frame of all census enumeration areas (EAs) created for the 2019 Ethiopia Population and Housing Census (EPHC) and conducted by the Central Statistical Agency (CSA). The census frame is a complete list of the 149,093 EAs created for the 2019 EPHC. An EA is a geographic area covering an average of 131 households. The sampling frame contains information about EA location, type of residence (urban or rural), and estimated number of residential households.

Administratively, Ethiopia is divided into nine geographical regions and two administrative cities. The sample for the 2019 EMDHS was designed to provide estimates of key indicators for the country as a whole, for urban and rural areas separately, and for each of the nine regions and the two administrative cities.

The 2019 EMDHS sample was stratified and selected in two stages. Each region was stratified into urban and rural areas, yielding 21 sampling strata. Samples of EAs were selected independently in each stratum in two stages. Implicit stratification and proportional allocation were achieved at each of the lower administrative levels by sorting the sampling frame within each sampling stratum before sample selection, according to administrative units in different levels, and by using a probability proportional to size selection at the first stage of sampling.

To ensure that survey precision was comparable across regions, sample allocation was done through an equal allocation wherein 25 EAs were selected from eight regions. However, 35 EAs were selected from each of the three larger regions: Amhara, Oromia, and the Southern Nations, Nationalities, and Peoples’ Region (SNNPR).

In the first stage, a total of 305 EAs (93 in urban areas and 212 in rural areas) were selected with probability proportional to EA size (based on the 2019 EPHC frame) and with independent selection in each sampling stratum. A household listing operation was carried out in all selected EAs from January through April 2019. The resulting lists of households served as a sampling frame for the selection of households in the second stage. Some of the selected EAs for the 2019 EMDHS were large, with more than 300 households. To minimise the task of household listing, each large EA selected for the 2019 EMDHS was segmented. Only one segment was selected for the survey, with probability proportional to segment size. Household listing was conducted only in the selected segment; that is, a 2019 EMDHS cluster is either an EA or a segment of an EA.

In the second stage of selection, a fixed number of 30 households per cluster were selected with an equal probability systematic selection from the newly created household listing. All women age 15-49 who were either permanent residents of the selected households or visitors who slept in the household the night before the survey were eligible to be interviewed. In all selected households, height and weight measurements were collected from children age 0-59 months, and women age 15-49 were interviewed using the Woman’s Questionnaire.

For further details on sample selection, see Appendix A of the final report.

Mode of data collection
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Computer Assisted Personal Interview [capi]

Research instrument
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Five questionnaires were used for the 2019 EMDHS: (1) the Household Questionnaire, (2) the Woman’s Questionnaire, (3) the Anthropometry Questionnaire, (4) the Health Facility Questionnaire, and (5) the Fieldworker’s Questionnaire. These questionnaires, based on The DHS Program’s standard questionnaires, were adapted to reflect the population and health issues relevant to Ethiopia. They were shortened substantially to collect data on indicators of particular relevance to Ethiopia and donors to child health programmes.

Cleaning operations
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All electronic data files were transferred via the secure internet file streaming system (IFSS) to the EPHI central office in Addis Ababa, where they were stored on a password-protected computer. The data processing operation included secondary editing, which required resolution of computer-identified inconsistencies and coding of open-ended questions. The data were processed by EPHI staff members and an ICF consultant who took part in the main fieldwork training. They were supervised remotely by staff from The DHS Program. Data editing was accomplished using CSPro System software. During the fieldwork, field-check tables were generated to check various data quality parameters, and specific feedback was given to the teams to improve performance. Secondary editing, double data entry from both the anthropometry and health facility questionnaires, and data processing were initiated in April 2019 and completed in July 2019.

Response rate
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A total of 9,150 households were selected for the sample, of which 8,794 were occupied. Of the occupied households, 8,663 were successfully interviewed, yielding a response rate of 99%.

In the interviewed households, 9,012 eligible women were identified for individual interviews; interviews were completed with 8,885 women, yielding a response rate of 99%. Overall, there was little variation in response rates according to residence; however, rates were slightly higher in rural than in urban areas.

Sampling error estimates
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The estimates from a sample survey are affected by two types of errors: nonsampling errors and 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 2019 Ethiopia Mini Demographic and Health Survey (EMDHS) 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 2019 EMDHS 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 among all possible samples. Although the degree of variability is not known exactly, it can be estimated from the survey results.

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% 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 2019 EMDHS sample is the result of a multi-stage stratified design, and, consequently, it was necessary to use more complex formulas. Sampling errors are computed in SAS, using programs developed by ICF. These programs use the Taylor linearization method to estimate variances for survey estimates that are means, proportions, or ratios. The Jackknife repeated replication method is used for variance estimation of more complex statistics such as fertility and mortality rates.

Note: A more detailed description of estimates of sampling errors are presented in APPENDIX B of the survey report.

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
- Height and weight data completeness and quality for children
- Number of enumeration areas completed by month, according to region, Ethiopia Mini-DHS 2019

See details of the data quality tables in Appendix C of the final report.

摘要
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2019年埃塞俄比亚微型人口与健康调查（EMDHS）是一项全国性调查，采用了9,150个代表性家庭的全国样本。所有15-49岁的女性，无论是所选家庭的常驻成员还是调查前一天晚上在所选家庭过夜的女性，均有资格接受调查访谈。在所选家庭中，所有5岁以下的儿童均有资格进行身高和体重测量。该调查旨在产生关键指标在国家级、城市和农村地区以及埃塞俄比亚11个地区的可靠估计。

2019年EMDHS的主要目标是提供关键人口与健康指标的最新估计。具体而言，调查的主要目标包括：
▪ 收集关于避孕使用、孕产妇健康、婴儿、儿童和新生儿死亡率水平、儿童营养以及其他与健康目标可持续发展目标（SDGs）相关的健康问题的优质数据；
▪ 收集有关母乳喂养、孕产妇护理（产前、分娩和产后）、儿童免疫接种和儿童疾病等与健康相关事项的信息；
▪ 通过测量体重和身高来评估5岁以下儿童的营养状况。

地理覆盖范围
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全国覆盖范围

分析单元
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- 家庭
- 个人
- 0-5岁儿童
- 15-49岁女性
- 医疗机构

总体
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调查覆盖了所有法定家庭成员（常住居民）、所有15-49岁的女性和所有居住在家庭中的0-5岁儿童。

数据类型
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样本调查数据 [ssd]

抽样程序
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2019年EMDHS使用的抽样框架是中央统计局（CSA）为2019年埃塞俄比亚人口和住房普查（EPHC）创建的所有人口普查区（EAs）的框架。普查框架是2019年EPHC创建的149,093个EAs的完整清单。EAs是一个覆盖平均131个家庭的地理区域。抽样框架包含有关EAs位置、居住类型（城市或农村）和估计的住宅家庭数量的信息。

行政上，埃塞俄比亚分为九个地理区域和两个行政城市。2019年EMDHS的样本旨在为整个国家、城市和农村地区以及每个九个地区和两个行政城市的关键指标提供估计。

2019年EMDHS样本分为两个阶段进行分层和选择。每个地区都被分为城市和农村地区，产生了21个抽样层。在各个层中独立选择EAs样本，以实现隐含分层和在每个较低行政级别上的成比例分配。在样本选择的第一阶段，根据不同级别的行政单位，对每个抽样层内的抽样框架进行排序，并使用成比例大小的概率选择。

为了确保各地区调查精度的可比性，样本分配是通过等量分配进行的，其中从八个地区中选择了25个EAs。然而，从三个较大的地区：阿姆哈拉、奥罗莫和南方民族、民族和人民地区（SNNPR）中各选择了35个EAs。

在第一阶段，总共选择了305个EAs（城市地区93个，农村地区212个），这些EAs是根据2019年EPHC框架以EAs大小成比例的概率选择的，并在每个抽样层中进行独立选择。从2019年1月到4月，在所有选定的EAs中进行了家庭清单操作。结果的家庭清单成为第二阶段选择家庭的抽样框架。一些为2019年EMDHS选定的EAs很大，有超过300个家庭。为了最大限度地减少家庭清单的任务，每个为2019年EMDHS选定的较大EAs都被分割。每个选定的EAs只有一个部分被选中，以部分大小成比例的概率。只在选定的部分中进行家庭清单。也就是说，2019年EMDHS的集群要么是一个EAs，要么是一个EAs的部分。

在选择的第二阶段，每个集群选择了30个家庭，以等概率的系统选择从新创建的家庭清单中选择。所有15-49岁的女性，无论是所选家庭的永久居民还是调查前一天晚上在家庭过夜的人，均有资格接受访谈。在所有选定的家庭中，从0-59个月的儿童中收集了身高和体重测量数据，并使用女性问卷对15-49岁的女性进行了访谈。

有关样本选择的更多详细信息，请参阅最终报告附录A。

数据收集方式
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计算机辅助个人访谈 [capi]

研究工具
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2019年EMDHS使用了五份问卷：（1）家庭问卷，（2）女性问卷，（3）人体测量学问卷，（4）医疗机构问卷和（5）调查员问卷。这些问卷基于DHS项目标准问卷，并根据与埃塞俄比亚相关的人口与健康问题进行了调整。它们被大大缩短，以收集与埃塞俄比亚和捐赠者对儿童健康计划特别相关的指标。

清理操作
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所有电子数据文件都通过安全的互联网文件流系统（IFSS）传输到亚的斯亚贝巴的EPHI中央办公室，并在受密码保护的计算机上存储。数据处理操作包括二级编辑，需要解决计算机识别的不一致性，以及开放式问题的编码。数据处理由EPHI工作人员和参与主要实地工作培训的ICF顾问进行。他们由DHS项目的工作人员远程监督。数据编辑使用CSPro系统软件完成。在实地工作期间，生成了各种数据质量参数的实地检查表，并给出了具体反馈以改进团队的表现。二级编辑、从人体测量学和医疗机构问卷的双向数据输入以及数据处理于2019年4月开始，并于7月完成。

回应率
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共选择了9,150个家庭作为样本，其中8,794个被占用。在占用的家庭中，8,663个家庭被成功访谈，回应率为99%。在访谈的家庭中，确定了9,012名符合条件的女性进行个别访谈；完成了8,885名女性的访谈，回应率为99%。总体而言，回应率在居住地之间没有太大差异；然而，农村地区的回应率略高于城市地区。

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：非抽样误差和抽样误差。非抽样误差是实施数据收集和数据处理时出现的错误的结果，例如未能找到和访谈正确的家庭、访谈员或受访者对问题的误解，以及数据输入错误。尽管在实施2019年埃塞俄比亚微型人口与健康调查（EMDHS）期间做出了众多努力以最大限度地减少此类错误，但非抽样误差无法避免且难以从统计上进行评估。

另一方面，抽样误差可以统计评估。2019年EMDHS中选定的受访者样本只是从同一人口中可能选择的许多样本之一，使用相同的设计和预期大小。这些样本中的每一个都会产生与实际选定的样本结果略有不同的结果。抽样误差是所有可能样本之间变异性的度量。虽然变异的程度无法准确知道，但它可以从调查结果中估计。

抽样误差通常以特定统计量（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的真实值将落在这个区间内。例如，对于从样本调查中计算的任何给定统计量，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，落在该统计量的标准误差的两倍范围内。

如果受访者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，2019年EMDHS样本是多层次分层设计的产物，因此有必要使用更复杂的公式。抽样误差使用由ICF开发的程序在SAS中计算。这些程序使用Taylor线性化方法来估计均值、比例或比率等调查估计的方差。使用Jackknife重复复制方法来估计如生育率和死亡率等更复杂统计量的方差。

注意：抽样误差估计的更详细描述见调查报告附录B。

数据评估
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数据质量表

- 家庭年龄分布
- 符合条件和被访谈的女性年龄分布
- 报告的完整性
- 按日历年份的出生数
- 死亡年龄以天为单位报告
- 死亡年龄以月为单位报告
- 儿童身高和体重数据完整性和质量
- 按地区和月份完成的普查区数量，埃塞俄比亚微型DHS 2019

有关数据质量表的详细信息，请参阅最终报告附录C。