Multiple Indicator Cluster Survey 2011 - Ghana

Abstract
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The Ghana Statistical Service, in collaboration with the National Malaria Control Programme (NMCP) and the Navrongo Health Research Centre of the Ghana Health Service, conducted the fourth round of the Multiple Indicator Cluster Survey (MICS 2011), with funding and technical support from UNICEF, USAID, US President’s Malaria Initiative (PMI) and ICF Macro in Calverton, Maryland, USA. The main objective of the survey was to provide up-to-date information for assessing the health situation of the population, particularly women and children in Ghana.

MICS 2011 is a nationally representative household sample survey of 12,150 households in 810 enumeration areas (EAs). The survey is expected to provide estimates of all key health indicators at the national and regional levels, as well as for urban and rural areas. Moreover, four of the 10 regions that are of particular importance for UNICEF’s programmes will be disproportionally oversampled so as to provide some data at the district level. The four oversampled regions are Central, Northern, Upper East, and Upper West.

MICS 2011 uses four main questionnaires: a Household Questionnaire, a Woman’s Questionnaire for women age 15-49, a Man’s Questionnaire for men age 15-59, and a Child’s Questionnaire for children under five year (with questions posed to the child’s primary caretaker). Major topics covered in these questionnaires include household characteristics, characteristics of respondents, child mortality, child nutritional status, breastfeeding, Vitamin A supplementation, birth registration, birth weight, immunization, salt iodization, oral rehydration treatment, care seeking and antibiotic treatment of pneumonia, , the proportion of households with insecticide treated nets (ITNs), the proportion of the population that sleep under ITNs, solid fuel use, water and sanitation, contraception, antenatal care, delivery and postnatal care, child ,school attendance, literacy, child discipline, female genital mutilation/cutting (FGM/C), domestic violence (DV), sexual behaviour, HIV/AIDS and the prevalence of malaria parasites and anaemia among children aged 6-59 months. Consequently, blood samples of all children age 6-59 months will be collected for the malaria and anaemia tests. Although malaria indicators (e.g., bednet ownership and use, coverage of intermittent preventive treatment and treatment of childhood fever) will be collected in all households, the malaria and anaemia testing components will be implemented in all households in six regions, but confined to every second household in the four over-sampled regions.

It is hoped that the findings from MICS 2011 would provide up-to-date information on progress made towards targets set by the Ghana Poverty Reduction Strategy (GPRS II), the Millennium Development Goals (MDGs) and other national and international programmes aimed at promoting the welfare of women and children. The results are also expected to help policy planners improve on access and quality of health-related services in the country.

The MICS 2011 data collection was carried out over a period of three months (September 15 -December 14, 2011) by 20 field teams spread across the country. In order to help achieve the objectives of the survey, enumeration areas (EAs) were selected in some towns and communities within the various districts. In each of these EAs, 15 households were visited and interviewed by a field team comprising of a Supervisor (team leader), 1 Field Editor, 3 Interviewers, 1 Biomarker Technician, and a driver.

Geographic coverage
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National
Regional

Analysis unit
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Households and Individuals

Universe
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The survey covered 810 enumeration areas and 12,150 households across the country. In terms of eligibility, it covered the following households members:

1. All women age 15-49 years
2. All men age 15-49 years
3. All children under 5 years
4. All household members

Kind of data
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Sample survey data [ssd]

Sampling procedure
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The sample for the MICS 2006 was designed to provide estimates on a large number of indicators on the health status of women, men, and children at the national level, for urban and rural areas, as well as for the 10 administrative regions in the country.

The list of enumeration areas (EAs) from the 2010 Ghana Population and Housing Census (PHC) served as a frame for the MICS sample. The frame was first stratified into the 10 administrative regions in the country, then into urban and rural EAs.

Sampling deviation
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No deviation from the original sample design was made

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

Research instrument
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Four main questionnaires were used for the MICS 2011 data collection:

1. Household information: Individual members, head of household, sex, age, marital
status, relation to head of household, education, water and sanitation, working
children, child discipline, disability and salt iodization
2. Children under 5 years: breastfeeding, care of illness, malaria, immunization, anthropometry, anaemia and malaria testing
3. Women 15-49 years: infant/child mortality, tetanus toxoid, maternal and newborn health, marriage/union, contraception, female genital mutilation, attitude towards domestic violence, sexual behavior, and HIV/AIDS
4. Men 15-49 years: reproduction, marriage, sexual behavior, HIV/AIDS, sexually transmitted infections and attitudes toward domestic violence

Cleaning operations
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Data editing is a very important measure to enhance data quality. In the MICS survey, data editing occured at three levels:

1. Field editing by editors and supervisors - In all the clusters that data were collected, ediors and supervisors revisited households and collected information which was either left out, uncompleted or responses which were not clear. Thus, data were validated in the field
2. Office editing-The purpose of office editing which was carried out under the MICS survey was to ensure that field data collection had conformed to the laid-down principles and procedures. Necessary codes, names, values were provided
3. Data cleaning and imputation - This stage offered the data processing personnel the opportunity to run further checks that ensured consistency. In a situation where inconsistencies were huge, field monitors were sent back to the field for verification of data that had been collected and thereafter, the necessary corrections made
4. Individual data files were also checked for completeness and consistency.

Data appraisal
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Using SPSS software, basic data consistency checks were made and the necessary gaps were filled.

摘要
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加纳统计局与国家疟疾控制计划（NMCP）以及加纳卫生服务纳瓦罗戈健康研究中心合作，在联合国儿童基金会（UNICEF）、美国国际开发署（USAID）、美国总统疟疾倡议（PMI）以及美国马里兰州卡弗顿的ICF Macro公司提供的资金和技术支持下，开展了第四次多项指标集群调查（MICS 2011）。调查的主要目标是提供最新的信息，以评估加纳人群的健康状况，特别是妇女和儿童的健康状况。

MICS 2011是对810个普查区（EAs）中12,150个家庭的全国代表性家庭样本调查。调查预计将提供国家及区域层面的所有关键健康指标的估计值，以及城市和农村地区的估计值。此外，为了提供一定程度的区县级数据，UNICEF项目特别关注的10个地区中的4个地区将进行不成比例的过采样。这四个过采样的地区为中央、北部、上东和上西。

MICS 2011使用了四种主要问卷：家庭问卷、15-49岁妇女问卷、15-59岁男性问卷以及5岁以下儿童问卷（问题由儿童的主要照护者回答）。这些问卷涵盖的主要内容包括家庭特征、受访者特征、儿童死亡率、儿童营养状况、母乳喂养、维生素A补充、出生登记、出生体重、免疫接种、食盐加碘、口服补液治疗、肺炎的寻求护理和抗生素治疗、拥有和使用杀虫剂处理蚊帐（ITNs）的家庭比例、在ITNs下睡眠的人口比例、固体燃料使用、水和卫生设施、避孕、产前护理、分娩和产后护理、儿童上学、识字、儿童纪律、女性生殖器割礼（FGM/C）、家庭暴力（DV）、性行为、HIV/AIDS以及6-59个月大儿童中疟原虫和贫血的流行率。因此，将收集所有6-59个月大儿童的血液样本进行疟疾和贫血测试。尽管将在所有家庭中收集疟疾指标（例如，蚊帐所有权和使用、间歇性预防治疗覆盖率和儿童发热的治疗），但疟疾和贫血测试部分将在六个地区所有家庭中实施，但在四个过采样地区的每第二个家庭中实施。

期望MICS 2011的调查结果能够提供关于加纳减贫战略（GPRS II）、千年发展目标（MDGs）以及其他旨在促进妇女和儿童福利的国家和国际项目目标进展的最新信息。结果还预计有助于政策制定者提高国家卫生相关服务的可及性和质量。

MICS 2011的数据收集在2011年9月15日至12月14日的三个月内由20个遍布全国的现场团队进行。为了帮助实现调查的目标，在一些城镇和社区中选择了各个区的普查区（EAs）。在这些EAs中，每个区域都访问了15个家庭，并由一个包括监督员（团队负责人）、1名现场编辑、3名访谈员、1名生物标志技术员和一名司机的现场团队进行访谈。

地理覆盖范围
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全国
区域

分析单位
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家庭和个人

总体
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调查覆盖了全国810个普查区和12,150个家庭。在资格方面，它涵盖了以下家庭成员：
1. 所有15-49岁的妇女
2. 所有15-49岁的男性
3. 所有5岁以下的儿童
4. 所有家庭成员

数据类型
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样本调查数据 [ssd]

抽样程序
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MICS 2006的样本设计旨在为国家层面、城市和农村地区以及国家10个行政区域提供大量指标，以估计妇女、男性和儿童的健康状况。

2010年加纳人口和住房普查（PHC）中的普查区列表为MICS样本提供了一个框架。该框架首先按国家10个行政区域分层，然后按城市和农村普查区分层。

抽样偏差
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没有对原始样本设计进行偏差

数据收集方式
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面对面 [f2f]

研究工具
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MICS 2011数据收集使用了四种主要问卷：

1. 家庭信息：个人成员、户主、性别、年龄、婚姻状况、与户主的关系、教育、水和卫生、工作儿童、儿童纪律、残疾和食盐加碘
2. 5岁以下儿童：母乳喂养、疾病护理、疟疾、免疫接种、人体测量学、贫血和疟疾测试
3. 15-49岁妇女：婴儿/儿童死亡率、破伤风类毒素、母亲和新生儿健康、婚姻/伴侣、避孕、女性生殖器割礼、对家庭暴力的态度、性行为和HIV/AIDS
4. 15-49岁男性：生殖、婚姻、性行为、HIV/AIDS、性传播感染和对家庭暴力的态度

数据清理操作
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数据编辑是提高数据质量的重要措施。在MICS调查中，数据编辑在三个级别上发生：

1. 现场编辑由编辑和监督员进行 - 在所有收集数据的集群中，编辑和监督员重新访问家庭，收集遗漏、未完成或回答不清楚的信息。因此，数据在现场得到验证
2. 办公室编辑 - MICS调查中进行的办公室编辑的目的是确保现场数据收集符合既定的原则和程序。提供了必要的代码、名称和值
3. 数据清理和插补 - 此阶段提供了数据处理人员的机会，以确保数据的一致性。在存在重大不一致的情况下，将派遣现场监控人员返回现场以验证收集的数据，并进行必要的纠正
4. 个人数据文件也进行了完整性和一致性检查。

数据评估
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使用SPSS软件进行了基本的数据一致性检查，并填补了必要的差距。