Measurement and Health Information WHO Health Surveys Calverton, Maryland, 10-11 July 2007 Somnath Chatterji Measurement and Health Information Systems

Measurement and Health Information

WHO Health Surveys

Calverton, Maryland, 10-11 July 2007

Somnath ChatterjiSomnath ChatterjiMeasurement and Health Information SystemsMeasurement and Health Information Systems

World Health OrganizationWorld Health OrganizationGenevaGeneva


WHO Surveys

• WHS• WHS+ in GCC countries• SAGE• STEPS• GATS• School based surveys – GSHS, GYTS


WHO - World Health SurveysWHS 2002/03

70 SURVEYS in 70 countries 70 SURVEYS in 70 countries Household - long : 53Household - long : 53

Household - short: 13Household - short: 13

CATI :CATI : 4 4

The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement.

© WHO 2002. All rights reserved


WHS Objectives

• Low cost means of providing data

• Measures that are valid, relevant, reliable and comparable

• Measure outcomes, functions & inputs to health systems

• Supplement the information provided by HIS


WHS Objectives

• build the evidence base necessary for policy-makers

• to routinely monitor if health systems are achieving the desired goals

• and in some countries, to assess if the increase in health resources is having the desired effect


WHS Household Questionnaire

• Roster• Insurance• Indicator of permanent income

(assets)• Health Expenditure• Health Occupations


WHS Individual Questionnaire

• Socio Demographics

• Health State Description

• Health State Valuation

• Risk Factors

• Mortality

• Coverage

• Health System Responsiveness

• Health System Goals and Social Capital


WHS +

•Being implemented in GCC countries – Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, UAE and Yemen

•Building on WHS modules

•Incorporates health examinations and biomarkers


SAGE - WHO Study on Global Ageing and Adult Health

The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO 2005. All rights reserved

•Mexico•South Africa•Ghana

•China•India•Russia

•Kenya•Tanzania•Bangladesh

•Viet Nam•Indonesia


SAGE Objectives

• To obtain reliable, valid and comparable data on levels of health on a range of key domains for older adult populations

• To examine patterns and dynamics of age-related changes in health using a longitudinal design

• To supplement and cross-validate self-reported measures of health and the anchoring vignette approach to improving comparability of self-reported measures, through measured performance tests for selected health domains

• To collect data on health examinations and biomarkers to improve reliability of data on morbidity, risk factors and monitor effect of interventions


SAGE Objectives

• Follow-up to study intermediate outcomes, monitor trends,

examine transitions and life events, and address

relationships between determinants and health and health-

related outcomes;

• To develop a mechanism to link survey data to data from

demographic surveillance sites - INDEPTH

• To build linkages with other national and cross-national

ageing studies – SHARE, ELSA, KLoSA, MHAS, Chile, Argentina

• To provide a public-access information base for an evidence

based policy debate amongst all stakeholders


SAGE Household Questionnaire

• Coversheet – contact record – sampling – GPS – recontact information

• Roster• Housing• Household and family support/transfers• Assets and household income• Health Expenditure


SAGE Individual Questionnaire

• Socio Demographics• Work History and Benefits • Health State Descriptions• Anthropometrics, Biomarkers, Performance

Tests• Risk Factors and Preventive Health Behaviours• Chronic Conditions and Health Services

Coverage• Health Care Utilization• Social Capital• Subjective Well-Being and Quality of Life• Optional – Impact of HIV/AIDS


STEPS - Objectives

• Prevent chronic disease epidemics before they occur

• Collect consistent data across and within countries

• Develop standardized tools to enable comparisons over time and across countries/sites

• Help health services plan priority programmes and interventions

• Predict future caseloads of chronic diseases

• Monitor and evaluate population-wide interventions


Demographics & Health Behaviours

Basic Sociodemographic Tobacco Use Alcohol Consumption Fruit & Veg Consumption Physical Inactivity

WHO STEPS – Step 1 Core

11


Physical measures

Height Weight Waist circumference Blood Pressure


11

22



Biochemical measures

Fasting blood sugar Fasting total cholesterol

33


WHO STEPS – Step 1 expanded

Demographic and Health Behaviours

Smokeless tobacco use Tobacco use cessation Binge drinking Oil or Fat consumption History of high blood

pressure History of diabetes


WHO STEPS – Step 2 expanded

Physical Measures

Hip circumference Heart rate


WHO STEPS – Step 3 Expanded

Biochemical Measures

Triglycerides HDL Cholesterol


STEPS Optional Modules

• Mental health,

• Intentional and unintentional injury

• Oral health


STEPS Methodology

• Targets a scientific sample of adults aged 25 – 64

• Household surveys conducted using trained interviewers for Steps 1 (questionnaire) and Step 2 (physical measures)

• Clinic based for Step 3 biochemical measures


Completed STEPS Surveys

Regions

AFREMRSEARWPR

N° Countries

19 8 8 19


GSHS – Global School Health Survey Objectives

• Help countries develop priorities, establish programmes, and advocate for resources for school health and youth health programmes and policies

• Allow comparisons across countries regarding the prevalence of health behaviours and protective factors

• Establish trends in the prevalence of health behaviours and protective factors by country for use in evaluation of school health and youth health promotion.


GSHS Modules

• Alcohol• Drugs• Tobacco• Physical Activity• Diet – fruits and vegetables• Hygiene• Violence• Mental health• Sexual Behaviour


GYTS - Global Youth Tobacco Survey

• Knowledge and attitudes of young people

towards cigarette smoking • Prevalence of cigarette smoking and other

tobacco use among young people • Role of the media and advertising in young

people’s use of cigarettes • Access to cigarettes • Tobacco-related school curriculum • Environmental tobacco smoke (ETS) • Cessation of cigarette smokingCore questions + country specific questions


GATS – Global Adult Tobacco SurveyObjectives

• Develop a rigorous system to monitor the

status of global tobacco use

• 15 high burden countries where >2/3rds of

the world’s smokers live


GATS


GATS Content

• Smoking – current and past daily smoking• Smokeless tobacco• Cessation• Costs• Second hand smoke• Knowledge and attitude• Media


Lessons

• Multiple, often uncoordinated efforts• Varying coverage, items• Often focussed on special topics• Limited efforts at capacity building • Limited coordination with international

efforts• Limited dissemination of microdata and

metadata

Documents

Measurement and Health Information WHO Health Surveys Calverton, Maryland, 10-11 July 2007 Somnath Chatterji Measurement and Health Information Systems