Agincourt Integrated Family Survey 2002 - South Africa

Abstract
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The Agincourt Health and Population Unit (AHPU) is an educational and research unit located within the School of Public Health at the University of the Witwatersrand, South Africa. Since 1992, AHPU has been collecting information on birth, death and migration for all individuals identified as members of the approximately 11,700 households under surveillance in a rural sub-district in (what is now) Mpumalanga Province, South Africa. (For more information on the Agincourt Unit, see http://web.wits.ac.za/Academic/Health/PublicHealth/Agincourt/ .) The area is home to South Africans and Mozambicans, the latter group settling here legally during the civil war in Mozambique. Most Mozambicans here have permanent residency status which, according to the South African Constitutional Court, allows them access to government transfers. However, it is more difficult for Mozambicans to access government grants, largely because they lack the documents necessary to do so.

In 2002 a study team collected data in Limpopo Province, at the Agincourt Demographic Surveillance Site, through the auspices of Philani Nutrition and Development Project. The work was funded by the National Institute on Aging under grant numbers R01 AG20275-01, P01 AG05842-14, and P30 AG024361. The project used this integrated health and economic survey in South Africa to investigate the links between health status and economic status. The survey instruments collected data on a range of traditional and non-traditional measures of well-being including income and consumption, measures of health status (including mental health), morbidity, crime, social connectedness, intra-household relationships, and direct hedonic measures of well-being. Random household selection was stratified by age-eligibility for Old Age Pension and nationality. In 2004 there was a second cross-sectional study conducted in Agincourt. A random selection of households was stratified on the basis of (a) citizenship, (South African or Mozambican),(b) and whether or not a death had occurred in the household.

Geographic coverage
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The survey covered a rural sub-district in Mpumalanga Province, South Africa

Analysis unit
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Households and individuals

Universe
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The Agincourt Integrated Family Survey 2002 covered all household residents, Woman aged 60 and above and men aged 65 and above in the household

Kind of data
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Sample survey data

Sampling procedure
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Agincourt 2002:
Sample selection for the Agincourt Integrated Family Survey involved extracting a sample of households, stratified by age-eligibility for the Old Age Pension and nationality. Age eligibility is defined as having either a woman aged 60 and older or a man aged 65 and older in the household.
The frame from which the sampling was provided by the 2001 census round of the Agincourt demographic surveillance system.
The sampling design for Agincourt 2002 had the following characteristics:

1. The villages within the population were stratified into two: a set of "Mozambican villages" and a set of "South African" ones.

2. 11 villages were selected, 4 "Mozambican" and 7 "South African" ones. Villages were selected with probability proportional to number of households.

3. The households within each village were assigned to two strata: age-eligible households and non-age-eligible ones.

4. Within each selected Mozambican village twenty households were selected at random, ten from each stratum. In each South African village, thirty household were selected, twelve from the "age-eligible" stratum and eighteen from the "non-age-eligible" stratum.

The final sampling design was:
Strata SA villages Mozambican villages
age-eligible 84 40
not age-eligible 126 40

The project did not explicitly stratify on nationality, but did so implicitly via the villages. This was not only because of limited confidence in the "nationality" identifiers, but also because a clustered design seemed advisable in any event. Clustering was decided on because it would make the logistics of fieldwork easier and because cluster effects might be interesting in their own right. Location is related both to social factors ("Mozambican" villages are somewhat stigmatized) and to geographical ones (there are differences in microclimates and hence crop patterns and also in access to infrastructure). The design ensured that there were at least twenty households in each cluster which should ensure that some of these cluster effects could be taken into account. The final sample size was 290 households.

The sampling frame for the selection of the villages:
The Agincourt Demographic Surveillance System has information on 21 villages. These formed the initial population from which the sample was drawn. Prior to sampling four villages were excluded from consideration:

(1) The RDP Housing project - The reason for excluding this settlement was that the dwelling units are apparently not a "household" in the sense in which the project wanted to investigate. Apparently many households send one or two junior members to occupy the RDP house (to maintain a claim to the property), but most of the household activities remain centered on dwellings elsewhere within the study site. It seemed sensible, therefore, to exclude the housing project from consideration.

(2) Ireagh A, Ireagh B and Kildare A - The project team were requested by Mark Collinson, the fieldwork manager of the Agincourt Health and Population Unit, not to include these villages in the sample, since other studies would be run (or were currently running) in these villages. The grounds for exclusion were that overstressing villages might contaminate the field results from the studies and might make fieldwork in future studies more difficult.

There were no visible differences between the excluded villages and the other "South African" villages that did not fall within the range of sampling variability.

Stratification within villages by age-eligibility and selection of households:
All households within the selected villages were assigned to one of two strata: age-eligible and non-age-eligible. This was done on the basis of the information available in the data base. Age eligibility was calculated as at the 23rd January 2002 (the date on which the sampling was done). Sampling within each of the strata was done by means of simple random sampling, without replacement.

Mode of data collection
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Face-to-face [f2f]

Research instrument
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Household Questionnaire:
The most knowledgeable household member (khhm) was the initial person interviewed within the household. He or she would list all of the members of the household. This list of household members was then used as a guide for the entire interview process. The khhm first answered questions about the individual members of the household: age, gender, education, marital status, is that person?s partner in the household, is that person?s parent in the household. Additionally, the khhm was asked about the source and amount of income of each household member.
Summary information was gathered from the khhm about the household members who had died and the household members who had moved. In study years starting in 2003, detailed questions were posed about the effect the most recent death had on the household.
Detailed questions were asked of the khhm about the living conditions: access to toilet facilities and running water, a stove, a phone. Questions about household expenditure were asked

Adult Questionnaire:
In 2002, there were two separate adult questionnaires. One questionnaire was for adults whose ages fell between 18 and 54; the second questionnaire was for adults 55 years old and up. In subsequent study years there was one questionnaire for adults 18 and older. Every adult from the household, who was available and willing to, answered these questions. Questions about age, marital status, number of living children, and number of children who have died were included. Detailed questions were asked about their sources of income and their expenditures. For older adults, there were questions about pensions and grants, for mothers there were questions about childcare grants. Individuals described the type of jobs they held over the years, how much money they earned and how they spent that money. Detailed health questions were posed; both physical and mental health issues were covered. Physical measurements were taken of the individuals interviewed: their height, weight, waist size; blood pressure and pulse.

Child Questionnaire:
The parent or guardian of each child was questioned about the child. Questions included those on birth weight, history of breastfeeding and health of the child. With the parent's or guardian's permission the child?s height and weight were measured. Detailed information was recorded about the child?s immunization history.

摘要
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阿金库尔健康与人口单位（Agincourt Health and Population Unit，AHPU）是一家位于南非威特沃特斯兰德大学公共卫生学院的学术与研究机构。自1992年起，AHPU一直收集关于出生、死亡和移民的信息，这些信息涉及被监控的约11,700个家庭中的所有个人，这些家庭位于南非（现为）姆普马兰加省的一个农村次区。（有关阿金库尔单位的更多信息，请参阅http://web.wits.ac.za/Academic/Health/PublicHealth/Agincourt/。）该地区居住着南非人和莫桑比克人，后者在莫桑比克内战期间合法定居于此。大多数莫桑比克人拥有永久居留权，根据南非宪法法院的规定，这使他们有权获得政府转移支付。然而，莫桑比克人获取政府补助金更为困难，主要是因为他们缺乏必要的文件。

在2002年，一个研究团队在阿金库尔人口统计学监测点收集了林波波省的数据。这项工作由美国国家老龄化研究所资助，资助编号为R01 AG20275-01，P01 AG05842-14和P30 AG024361。该项目利用南非的综合健康与经济调查来探究健康状况与经济状况之间的联系。调查工具收集了关于福祉的传统和非传统指标数据，包括收入和消费、健康状况指标（包括心理健康）、发病率、犯罪、社会联系、家庭内部关系以及福祉的直接享乐性指标。随机家庭选择按照老年抚恤金资格和国籍进行分层。2004年，在阿金库尔进行了第二次横断面研究。家庭的选择是随机的，基于（a）公民身份（南非人或莫桑比克人），以及（b）家庭中是否发生了死亡。

地理覆盖范围
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调查覆盖了南非姆普马兰加省的一个农村次区。
分析单位
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家庭和个人

总体
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阿金库尔综合家庭调查2002年涵盖了所有家庭居民、60岁以上的女性和65岁以上的男性。
数据类型
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样本调查数据

抽样程序
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阿金库尔2002年：
阿金库尔综合家庭调查的样本选择涉及从按老年抚恤金资格和国籍分层的家庭中抽取样本。老年抚恤金资格定义为家庭中有一名60岁以上的女性或一名65岁以上的男性。抽样框架由2001年阿金库尔人口统计学监测系统的普查轮次提供。
阿金库尔2002年的抽样设计具有以下特点：

1. 人口中的村庄被分为两类：一组“莫桑比克村庄”和一组“南非村庄”。

2. 选择11个村庄，其中4个“莫桑比克”村庄和7个“南非”村庄。村庄的选择与家庭数量成比例。

3. 每个村庄内的家庭被分配到两个层次：有资格的家庭和无资格的家庭。

4. 在每个选定的莫桑比克村庄中，随机选择20户家庭，每个层次10户。在每个南非村庄中，选择30户家庭，其中“有资格”层次12户，“无资格”层次18户。

最终的抽样设计如下：
层次 SA村庄 莫桑比克村庄
有资格 84 40
无资格 126 40

项目没有明确按国籍分层，但通过村庄隐式地进行了分层。这不仅是因为对“国籍”标识的信心有限，而且因为集群设计似乎在任何情况下都是可取的。集群的决定是因为它将使现场工作的后勤工作更容易进行，并且集群效应本身可能也很有趣。位置与社会因素（“莫桑比克”村庄在一定程度上受到歧视）和地理因素（微气候的差异以及作物模式和基础设施获取的差异）相关。该设计确保每个集群至少有20户家庭，这应该可以确保考虑到一些这些集群效应。最终的样本量是290户。

村庄选择的抽样框架：
阿金库尔人口统计学监测系统有关于21个村庄的信息。这些构成了样本抽取的初始总体。在抽样之前，有四个村庄被排除在外：

（1）RDP住房项目 - 排除这个定居点的理由是住宅单元显然不是项目想要研究的那种意义上的“家庭”。显然，许多家庭派遣一个或两个年轻成员居住在RDP房屋中（以维持对财产的所有权），但大多数家庭活动仍然集中在研究区域内其他地方的住宅中。因此，似乎有道理排除住房项目。

（2）Ireagh A、Ireagh B和Kildare A - 阿金库尔健康与人口单位现场工作经理马克·科林森要求项目团队不要包括这些村庄在样本中，因为将在这些村庄进行（或目前正在进行的）其他研究。排除的理由是过度关注村庄可能会污染研究的现场结果，并可能使未来研究的现场工作更加困难。

排除的村庄与其他不在抽样范围内的“南非”村庄之间没有明显的差异。

村庄内按资格年龄和选择家庭的分层：
所有选定的村庄内的家庭都被分配到两个层次之一：有资格和无资格。这是基于数据库中可用的信息进行的。资格年龄是根据2002年1月23日（抽样日期）计算的。每个层次内的抽样是通过简单随机抽样，不重复进行的。

数据收集方式
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面对面 [f2f]
研究工具
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家庭问卷：
最了解家庭情况的家庭成员（khhm）是家庭中最初接受采访的人。他会列出家庭中的所有成员。这个家庭成员名单随后被用作整个采访过程的指南。khhm首先回答有关家庭每个成员的问题：年龄、性别、教育、婚姻状况、该人是家庭中的伴侣吗、该人是家庭中的父母吗。此外，khhm还被问及每个家庭成员的收入来源和金额。
从khhm那里收集有关已故家庭成员和已搬迁家庭成员的摘要信息。在从2003年开始的研究年份中，对最近一次死亡对家庭的影响提出了详细问题。
对khhm就生活条件提出了详细问题：厕所设施和流动水的获取、炉灶、电话。询问了有关家庭支出的情况。

成人问卷：
2002年，有两个分开的成人问卷。一个问卷是针对18至54岁的成年人；第二个问卷是针对55岁及以上的成年人。在随后的研究年中，有一个针对18岁及以上成年人的问卷。每个家庭中可用的、愿意回答的成年人都会回答这些问题。包括有关年龄、婚姻状况、存活子女数量和已故子女数量的问题。对他们的收入来源和支出提出了详细问题。对于老年成年人，有关于养老金和补助的问题，对于母亲，有关于育儿补助的问题。个人描述了他们多年来所从事的工作类型、他们赚了多少钱以及他们如何花费这些钱。提出了详细的健康问题；涵盖了身体和心理健康问题。对受访者的个体进行了身体测量：他们的身高、体重、腰围；血压和脉搏。

儿童问卷：
每个儿童的父母或监护人都会被问及该儿童。问题包括有关出生体重、母乳喂养史和儿童健康状况的问题。在父母或监护人的同意下，测量了儿童的身高和体重。记录了有关儿童免疫接种史的详细信息。