MICS Survey Design Workshop Multiple Indicator Cluster Surveys Survey Design Workshop Questionnaires for Individual Women and Men

MICS Survey Design Workshop

Multiple Indicator Cluster SurveysSurvey Design Workshop

Questionnaires for IndividualWomen and Men

Overall session overview

• Objective is to understand, for each module, the flow, eligibility, indicators, and preparatory work for customizing the module

• Women = Men

First session

• Woman’s Information Panel [M]• Woman’s Background [M]• Access To Mass Media And Use of Information

and Communication Technology [M]• Fertility/Birth History [M*]• Desire For Last Birth• Unmet Need

Second session

• Maternal And Newborn Health• Post-Natal Health Checks• Illness Symptoms• Contraception• Unmet Need• Female Genital Mutilation/Cutting• Attitudes Toward Domestic Violence [M]

Third session

• Marriage/Union [M]• Sexual Behaviour [M]• HIV/AIDS [M]• Circumcision [M only]• Maternal Mortality• Tobacco And Alcohol Use [M]• Life Satisfaction [M]

Woman’s Information Panel

• Upper panel filled during Household Questionnaire (after completing List of Household Members)

• Lower Panel filled after interview ends



Interviewer Question Question


Pre-coded

Instruction

Instruction Instruction


Customise

Customise Customise

Customise

Woman’s Information PanelResponse categories

Pre-coded


Response rate of women

Woman’s Background

• First question “belongs” to Information Panel• Questions are few but critical:

Age: Background characteristicEducation: Background characteristicLiteracy: MDG



On age/DOB:

Critical for most indicatorsAge estimate is necessaryUse calendar of events


Woman’s Background Skip

Filter


MICS Indicator 7.1 (MDG 2.3):Literacy rate among young women [M] =

Number of women age 15-24 years who are able to read a short simple statement about everyday life or who attended secondary or higher education

Total number of women age 15-24 years


MICS Indicator 7.1 (MDG 2.3):Literacy rate among young women [M] =

WB4 = 2 or WB4 = 3 or WB7 = 3

WB2 <= 24



Access To Mass Media And Use of ICT

MICS Indicator 10.1: Exposure to mass media [M]

Percentage of women age 15-49 years who, at least once a week, read a newspaper or magazine, listen to the radio, and watch television

MICS Indicator 10.2: Use of computers [M]

Percentage of young women age 15-24 years who used a computer during the last 12 months

MICS Indicator 10.3: Use of internet [M]

Percentage of young women age 15-24 who used the internet during the last 12 months



Fertility/Birth History

Two versions of module:• Fertility (Summary Birth History)• Fertility/Birth History

Both are included in questionnaires: You must take out one

Fertility (Summary Birth History)

Purpose:• To measure infant and under-5 mortality rates• To estimate the adolescent birth rate and early

childbearing• To determine if any live births within the last 2

years – whether the woman is eligible for the maternal and newborn health module


Information collected:• Summary information on all live births, living

and deceased children• Timing of first live birth• Timing of last live birth


Mortality Estimation:• Indirect estimation method used (Brass)• Calculates average numbers of children ever

born and children deceased, and calculate proportion deceased

• Using proportion deceased and mortality models, estimate infant and under-5 mortality rates


Mortality Estimation:• Results not as detailed as those from birth histories

(neonatal rates etc.)• Estimated rates will refer to 3-6 years before the

survey on the average, depending on the variant of the method used

• The method provides estimates of mortality trends as retrospective estimates are obtained for a period of 3-15 years


Adolescent birth rate:• Normally, the indicator would be calculated by

collecting information on all births during a given period preceding the survey, including dates of birth of each

• The Summary Birth History only collects information on the date of birth of the first and last live birth

• However, the rate can be estimated


Early childbearing:• Proportion of women age 20-24 who had one or

more live births before age 18





Direct Mortality Estimation:• “Complete birth history” for every woman of

reproductive age (15-49 years)• Women are asked to report for each live birth the

date of birth and, if the child has died, the age at death

• Can directly estimate child mortality rate for defined time periods before the survey


Direct Mortality Estimation:• Relies heavily on the quality of information collected• Work best in populations where dates and durations

are well-known


Sources of errors:• Omission of births and deaths• Recall bias:

– Misreporting of age at death (age heaping at 12 months is common)

– Birth misplacement• Length of instrument

– Longer fieldworker training needed– Careful monitoring of data collection needed



Indirect/Summary

Direct/Full

Desire For Last Birth (and Unmet Need)

• Women with an unmet need for family planning are women who – are married or in union– are fecund – not using any method of contraception – report not wanting any more children or wanting

to delay the birth of their next child for at least two years


• And among those married or in union:– Those who are pregnant, but whose current

pregnancy was unwanted or mistimed

– Those who are Postpartum amenorrheic women (not using contraception) whose last birth was unwanted or mistimed


• Therefore, the indicator is based on information from multiple modules:– Marital status [Marriage/Union]– Current and ever use of contraception (any method)

[Contraception]– Fecundity [Unmet Need]– Pregnant or amenorrheic [Contraception][UN][MN]– Desire for last birth [Desire for last birth]– Desire for future births [Unmet Need]







Maternal And Newborn Health

• Eligibility is: Live birth in the two years preceding interview

• Questions refer to the last live birth• Module covers:

– Maternal health• Antenatal care, Delivery characteristics

– Newborn health• Birthweight, Initiation of breastfeeding, Tetanus

protection


• Response categories to be customised in country:• Type of provider for antenatal care • Type of provider for delivery care • Place of delivery• Prelacteal feed

• For a comparable indicator, some question series may not be adapted:• Birthweight• Tetanus Toxoid

Provider:Maintain broadcategories











Post-Natal Health Checks

• Eligibility is: Live birth in the two years preceding interview

• Questions refer to the last live birth• Measures contact with a provider not content of

care.

• Focus of data collection on PNC visit:– In the case of facility deliveries contact occurring after discharge. – In the case of home deliveries, the focus will be on any contact with a

care provider after the TBA/birth attendant leaves the home.– Note that structure of module allows for addition of questions on

content, if desired.


MICS Indicator 5.10: Post-partum stay in health facility

MICS Indicator 5.11: Post-natal health check for the newborn

MICS Indicator 5.12: Post-natal health check for the mother

Institutional deliveries

Post partum stay in facility

Health check in facility1) Baby 2) Mother

Health check after discharge (with info on timing, location, and provider)1) Baby 2) Mother


Period after birth

PNC visit

Institutional deliveries





Period after birth

PNC visit

Counts as a post-natal health check if yes to either one (or both)

Institutional deliveries Non-institutional deliveries with attendant



Health check from birth attendant1) Baby 2) Mother


Health check after attendant leaves home (with info on timing, location, and provider)1) Baby 2) Mother


Period after birth

PNC visit

Counts as a post-natal health

check if yes to either one (or both)


Non-institutional deliveries without

attendant






Health check (with info on timing, location, and provider)1) Baby 2) Mother


Period after birth

PNC visit

Counts as a post-natal health

check if yes to PNC visit


Non-institutional deliveries without

attendant






Health check (with info on timing, location, and provider)1) Baby 2) Mother


Period after birth

PNC visit

Counts as healthchecks for mother

and newborn








Illness Symptoms

• No specific indicator; programmatically useful information; table relates to recognising the two danger sign of pneumonia

• All mothers and caretakers (of children <5) asked this question

• Answers must be spontaneous• Refine response codes after pretest (keep

pneumonia signs)

Illness Symptoms

Contraception

MICS Indicator 5.3 (MDG 5.3): Contraceptive prevalence rate =

Number of women age 15-49 years currently married or in union who are using (or whose partner is using) a (modern or

traditional) contraceptive method Total number of women age 15-49 years who are currently

married or in union

Contraception

Attitudes Toward Domestic Violence

• Attitudinal questions used to assess the acceptance of certain social norms on gender roles

• Positive attitudes do not necessarily signify approval by women of wife-beating, but they signify women’s acceptance of such norms

• Option to add country specific prevalent or emerging circumstances. Please keep standard

Attitudes Toward Domestic Violence

Female Genital Mutilation/Cutting

# 8.10 - Prevalence of FGM/C among womenProportion of women age 15-49 years who report to

have undergone any form of FGM/C

# 8.11 - Prevalence of FGM/C among girlsNumber of daughters age 0-14 years who have

undergone any form of FGM/C, as reported by mothers age 15-49 years

Female Genital Mutilation/Cutting

# 8.9 - Approval for FGM/C Proportion of women age 15-49 years who state

that FGM/C should be continued

FGM/C Questions

Three sets of questions:

1) Questions for women 15-49 years of age

• If FGM/C has happened to her• The type of procedure: if flesh was removed, nicked

without removing flesh, sewn closed• Age at circumcision• Performer: traditional person, health professional

FGM/C Questions

2) Questions for women 15-49 years of age with at least one living daughter age below 15 years of age

• Circumcision status of all daughters • The type of procedure: if flesh was removed, nicked

without removing flesh, sewn closed• Age at circumcision• Performer: traditional person, health professional

3) Attitudes regarding the continuation of the practice

Marriage/Union

MICS Indicator 8.4: Marriage before age 15 [M]

MICS Indicator 8.5: Marriage before age 18 [M]

MICS Indicator 8.6: Young women age 15-19 years currently married or in union [M]

MICS Indicator 8.7: Polygyny [M]

MICS Indicator 8.8a/b: Spousal age difference

Marriage/Union

• Used for background characteristics in many tables

• In countries where dates are not culturally important and/or little documentation, precise information is difficult to obtain

Marriage/Union

Marriage/Union

Marriage/Union

Marriage/Union

Sexual Behaviour

Methodological Issues:• Position of this module is important• Sexual behavior module should be asked after

marriage/union module so rapport is built but before HIV module to avoid biasing responses

• Interviews must be conducted in private• Must assure respondent that answers are

completely confidential

Sexual Behaviour

Methodological Issues:• Most of the indicators derived from this module are

dependent on each other; care should be taken not to delete questions that contribute to the calculation of related indicators

• Data Quality: Very sensitive information. Even with perfect rapport, complete privacy, and every other best circumstances, some respondents will not provide truthful answers

Sexual Behaviour

Summary of questions/indicators:• Age at sexual debut• Higher-risk sexual partnerships• Condom use during higher-risk sex• Age of sexual partners• Number of recent sexual partners• Number of lifetime sexual partners

Sexual BehaviourEnsure privacy!

Sexual Behaviour

Sexual Behaviour

Sexual Behaviour

Sexual Behaviour

HIV/AIDS

Summary of questions/indicators:• Knowledge of HIV or AIDS• Knowledge of HIV prevention• Misconceptions about HIV and AIDS• Attitudes towards people living with HIV• Knowledge of mother-to-child transmission of HIV• Knowledge of HIV testing services• HIV testing for the general population• HIV testing for pregnant women at antenatal clinics

HIV/AIDS

• A large number of indicators and tables• Questions are rather straight-forward• No customisation necessary, except the

option of doing so in one subset of questions

• Some questions/indicators require the CM and MN modules (for women)

HIV/AIDS

Comprehensive knowledge is constructed from the following set of questions:HA2. Can people reduce their chance of getting the AIDS virus by having just

one uninfected sex partner who has no other sex partners?HA4. Can people reduce their chance of getting the AIDS virus by using a

condom every time they have sex?HA7. Is it possible for a healthy-looking person to have the AIDS virus?HA5. Can people get the AIDS virus from mosquito bites?HA6. Can people get the AIDS virus by sharing food with a person who has

AIDS?HA3. Can a person get HIV through supernatural means?

HIV/AIDS

• The first three questions [HA2 - HA4 - HA7] should not be altered; the correct answers are “Yes”

• The next three questions [HA5 - HA6 – HA3] ask about local misconceptions; the correct answers are “No” and additional questions about local common misconceptions can be added in your country

• Example: “Can a person get HIV by hugging or shaking hands with a person who is infected?”

• Indicator is constructed using the two most prevalent misconceptions

HIV/AIDSEnsure privacy!

HIV/AIDS

HIV/AIDS

HIV/AIDS

HIV/AIDS

Circumcision

• The only module specifically for men• Use is in relation to HIV/AIDS, as circumcision is

known to significantly reduce the risk of men contracting STDs, incl. HIV

• Translation is very important as terms may not be precisely described in various languages

• General understanding of concept may be necessary to expand on in question, as some population groups may be completely unfamiliar

Circumcision

Maternal Mortality

• The module is based on the direct sisterhood method – Maternal mortality– Adult mortality (male and female)

• Sisterhood method is *not* appropriate for countries….– Likely to have low maternal mortality ratio– With low levels of fertility– Where other source of maternal mortality data available

Maternal Mortality

Maternal Mortality

Maternal Mortality

Tobacco And Alcohol Use

MICS Indicator 12.1: Tobacco use [M]

MICS Indicator 12.2: Smoking before age 15 [M]

MICS Indicator 12.3: Use of alcohol [M]

MICS Indicator 12.4: Use of alcohol before age 15 [M]






Life Satisfaction

• Subjective perceptions of well-being play an important role, autonomously from objective conditions, such as income, health

• Can help create a fuller picture of well-being• Life satisfaction: summation of evaluation regarding a person’s

life as a whole• Happiness – a fleeting, transient condition that can be

affected by numerous current factors (weather, recent incident)

• Perceptions of a better life is also an important correlate of both life satisfaction and happiness

Life Satisfaction

• Questions used to assess feelings of satisfaction, happiness and sense of belonging

• Individual items reported

• Responses on a scale out of 5, ranging from 'very satisfied‘ to 'very dissatisfied‘

Life Satisfaction

Life Satisfaction

• Vulnerable to the:– Item order– Current mood– Other contextual factors

• Careful interpretation of cultural comparisons: – Different scale use across cultural groups– Different item functioning– Cultural differences in self presentation, reference group and standard of

comparison; or memory or positivity bias when making life satisfaction judgments

• Life satisfaction Indicator – Highly associated with the economic well-being– However, economic growth alone is necessary but insufficient factor for

growing life satisfaction

Closing the questionnaire

• Record time, return to cover page and mark result of interview

• Remember to use the last page for comments

Thank you

Documents

MICS Survey Design Workshop Multiple Indicator Cluster Surveys Survey Design Workshop Questionnaires for Individual Women and Men