Harmonized Household Health Survey, HHHS 2006 - Sudan

Abstract --------------------------- The Sudan Household Health Survey (SHHS), conducted in 2006, is the first household survey covering Northern and Southern Sudan in two decades. The primary objectives of the 2006 Sudan Household Health Survey were: - To provide up-to-date information for assessing the situation of children and women in Sudan. - To furnish data needed for monitoring progress toward goals established by the Millennium Development Goals: the goals of “A World Fit For Children”, “Programme of Action” adopted at the “International Conference on Population and Development (ICPD)”, and other internationally agreed upon goals, as a basis for action. - To contribute to the improvement of data and monitoring systems in Sudan and to strengthen technical expertise in the design, implementation, and analysis of such systems. - To strengthen and build the institutional capacity of government partners for the upcoming 2008 Census and large scale surveys. The raw survey data provided by the Statistical Office were then harmonized by the Economic Research Forum, to create a comparable version with the 2010 Household Health Survey in Sudan. Harmonization at this stage only included unifying variables' names, labels and some definitions. See: Sudan 2006 & 2010- Variables Mapping & Availability Matrix.pdf provided in the external resources for further information on the mapping of the original variables on the harmonized ones, in addition to more indications on the variables' availability in both survey years and relevant comments. Geographic coverage --------------------------- Covering a representative sample on both the national and regional levels. The sample for the Sudan Household Health Survey (SHHS) was designed to provide estimates of some key indicators on the situation of children and women at the national level and for the 25 states (Northern , River Nile, Red Sea, Kassala, Gedarif, Khartoum, Gezira, Sinnar, Blue Nile, White Nile, North Kordofan, South Kordofan, North Darfur, West Darfur, South Darfur, Jonglei, Upper Nile, Unity, Warap, Northern Bahr El Ghazal (NBG), Western Bahr El Ghazal (WBG), Lakes, Western Equatoria, Central Equatoria and East Equatoria) of Sudan. Analysis unit --------------------------- 1- Household/family. 2- Individual/person. 3- Woman. 4- Child. Universe --------------------------- The target universe for the SHHS includes the households and members of individual households, including nomadic households camping at a location/place at the time of the survey. The population living in institutions and group quarters such as hospitals, military bases and prisons, were excluded from the sampling frame. Kind of data --------------------------- Sample survey data [ssd] Sampling procedure --------------------------- ---> Sample Design: The sample for the Sudan Household Health Survey (SHHS) was designed to provide estimates on some key indicators on the situation of children and women at the national level and for 25 states. The states constituted the main sampling domains and in each state a two stage cluster sampling design was employed to draw the sample for the SHHS. The villages or quarters (in the case of urban areas) constituted the Primary Sampling Units (PSUs) for the SHHS. The PSU represented the smallest area or administrative unit which could be identified in the field with commonly recognized boundaries. The sampling frame for 12 states (Northern, River Nile, Red Sea, Kassala, Gedarif, Khartoum, Gezira, Sinnar, Blue Nile, White Nile, North Kordofan and South Kordofan) was compiled using the list of villages and quarters and estimated population updated by the Central Bureau of Statistics on the basis of the updated frame from the pre-census field operations for the year 2005. In the case of these 12 states the clusters were distributed to urban and rural areas, proportional to the size of urban and rural populations in these states. The urban and rural clusters in each of these states were selected randomly with probability of selection proportional to size. The sampling frames for three states of North Darfur, West Darfur and South Darfur and for all the ten states in Southern Sudan were compiled using the list of villages and estimated population developed by the Expanded Programme of Immunization (EPI) for the National Immunization Days (NIDs) campaign. In the case of these states, stratification on the urban and rural level was not done and the clusters were selected with probability proportional to size. ---> Sample size and Sample selection procedures: The sample size for the survey was determined by the accuracy and degree of precision required for the survey estimates for each state. It was judged that a minimum sample of 900 households would be necessary to make estimates/results with some degree of precision at the state level. Allowing for some non-response in the survey, it was decided to take a sample of 1,000 households in each state. Since a similar level of precision was required for the survey results from each state, it was decided to draw 40 clusters from each state and 25 households from each cluster. The sampling frame of villages/quarters was compiled separately for each state based on the best available population measures. In cases where a selected village/quarter could not be reached because of security or access problems, it was replaced by a neighbouring village/quarter in the sampling frame. All selected clusters (villages/quarters) in each state were fully covered with the exception of only 12 clusters in two states in Southern Sudan (seven clusters in Upper Nile and five in Western Bahr El Gazal states) and two clusters in South Kordofan that had to be substituted due to insecurity influencing accessibility during the fieldwork period. After a household listing was carried out within the selected clusters, a sample of 25 households was drawn from each selected cluster using the method of systematic random sampling. Mode of data collection --------------------------- Face-to-face [f2f] Research instrument --------------------------- Five sets of questionnaires were used in the Sudan Household Health Survey. The first three questionnaires are based on the MICS3 and PAPFAM model questionnaires, and were subject to harmonization. 1) Household questionnaire which was used to collect information on all de jure household members and the household. It included the following modules: - Household information panel - Household listing - Education - Female Genital Mutilation/Cutting (FGM/C) (used in 15 states, excluding all ten states in Southern Sudan) - Prevalence of chronic diseases (used in 15 states, excluding all ten states in Southern Sudan) - Water and sanitation - Household characteristics - Household income and resources - Insecticide treated nets - Salt iodization - Maternal mortality (during the listing phase using a separate form for data collection) 2) Women's questionnaire administered to all women aged 15-49 years in each household. It included the following modules: - Women's information panel - Live birth history/Child mortality - Tetanus toxoid - Maternal and newborn health - Marriage and union - Contraception - Female Genital Mutilation/Cutting (FGM/C) (used in 15 states, excluding those in Southern Sudan) - HIV/AIDS knowledge 3) Under-five questionnaire administered to mothers. In cases the mother is not listed in the household list/roster, a primary caretaker for the child was identified and interviewed. The Questionnaire for Children under Five included the following modules: - Under-five children information panel - Birth registration - Vitamin A supplementation - Breastfeeding - Care of illness - Immunization - Malaria - Anthropometry 4) Community Questionnaire. It included the following modules: - Demographics (Socio-economic classification) - Access to services - Seasonal calendar - Food aid and priorities 5) Food Security Questionnaire. It included the following modules: - Household circumstances - Household belongings and livestock - Livelihoods and agricultural production - Household expenditures - Food consumption and sources - Shocks and coping mechanisms - Food aid In addition to the administration of questionnaires, fieldwork teams tested the salt used for cooking in the households for iodine content, and measured the weights and heights of children under five years of age. Cleaning operations --------------------------- ---> Raw Data: Data entry and editing began simultaneously with data collection. Data entry took place in two locations – in Khartoum from March to May 2006, and in Rumbek from June to August 2006. Using CSPro software, the Khartoum team comprising 40 data entry operators, 6 data entry supervisors, 10 data editors and 6 programmers entered the data for the 15 northern states into 40 microcomputers. The Rumbek team comprising 26 data entry operators in two shifts (morning and afternoon shifts), 4 data entry supervisors, 7 data editors and 2 programmers entered the data for the ten southern states into 13 microcomputers. In order to ensure quality control, all questionnaires were double entered for the first six states that were completed (100 percent double entry). This was followed by double entry of questionnaires from five clusters randomly selected from the remaining 19 states. Internal consistency checks were also performed. Procedures and standard programs developed under the global MICS3 project and PAPFAM and adapted to the Sudan questionnaire were used throughout. Data were analysed using the Statistical Package for Social Sciences (SPSS) software programme (Version 14), and the model syntax and tabulation plans developed by UNICEF, WHO, WFP, and Pan-Arab Project for Family Health (PAPFAM). ---> Harmonized Data: - The SPSS package is used to harmonize the SHHS 2006 with SHHS 2010. - The harmonization process starts with raw data files received from the Statistical Office. - A program is generated for each dataset to create harmonized variables. - Data is saved on the household, individual, women, as well as the children level, in SPSS and then converted to STATA, to be disseminated. Response rate --------------------------- Of the 24,527 households selected for the sample, 24,507 households were found to be occupied. Of these, 24,046 households were successfully interviewed for a household response rate of 98.1 percent. Of the 32,599 women (age 15-49 years) identified in the selected households, 26,923 were successfully interviewed, yielding a response rate of 82.6 percent. Of the 22,512 children under age five listed in the households, questionnaires were completed for 19,870 children, which correspond to a response rate of 88.3 percent. Overall response rates of 81 percent and 86.6 percent were calculated for the women’s and under-5 children’s interviews respectively.