Ghana Demographic and Health Survey 2003
Round four
Ghana, 2003
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GHA-GSS-DHS-2003-v1.1
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Identification
Survey ID Number
GHA-GSS-DHS-2003-v1.1
Title
Ghana Demographic and Health Survey 2003
Subtitle
Round four
Translated Title
No translation
Country
| Name | Country code |
|---|---|
| Ghana | GHA |
Study type
Demographic and Health Survey, Round 4 [hh/dhs-4]
Series Information
The 2003 Ghana Demographic and Health Survey (GDHS), is a nationally representative survey of 5,691 women aged 15-49 and 5,015 men age 15-59. The primary purpose of the GDHS is to generate recent and reliable information on fertility, family planning, infant and child mortality, maternal and child health, and nutrition. In addition, the survey collected information on malaria treatment and prevention, anaemia and HIV prevalence.
This information is essential for making informed policy decisions, planning, monitoring, and evaluating programmes on health in general and reproductive health in particular, at both the national and regional levels. This survey is the fourth in a series of population and health surveys conducted in Ghana as part of the global Demographic and Health Surveys (DHS) programme. The first three GDHS were conducted in 1988, 1993 and 1998, giving a regular five year interval.
This information is essential for making informed policy decisions, planning, monitoring, and evaluating programmes on health in general and reproductive health in particular, at both the national and regional levels. This survey is the fourth in a series of population and health surveys conducted in Ghana as part of the global Demographic and Health Surveys (DHS) programme. The first three GDHS were conducted in 1988, 1993 and 1998, giving a regular five year interval.
Abstract
The principal objective of the 2003 Ghana Demographic and Health Survey (GDHS) is to provide data to monitor the population and health situation in the country. This is the fourth round in a series of national-level population and health surveys conducted in Ghana under the worldwide Demographic and Health Surveys Program.
The primary objective is to provide current and reliable data on fertility and family planning behaviour, infant and child mortality, breastfeeding, antenatal care, children's immunisations and childhood diseases, nutritional status of mothers and children, use of maternal and child health services, and awareness and behaviour regarding AIDS and other STIs. New features of the 2003 GDHS include the collection of information on female and male circumcision, information on malaria and ownership and use of insecticide-treated bed nets, and haemoglobin and HIV testing.
The long-term objective of the survey includes strengthening the technical capacity of major government institutions, including the Ghana Statistical Service (GSS). The 2003 GDHS also provides comparable data for long-term trend analyses in Ghana, since the surveys were implemented by the same organisation, using similar data collection procedures. It also contributes to the ever-growing international database on demographic and health-related information.
The primary objective is to provide current and reliable data on fertility and family planning behaviour, infant and child mortality, breastfeeding, antenatal care, children's immunisations and childhood diseases, nutritional status of mothers and children, use of maternal and child health services, and awareness and behaviour regarding AIDS and other STIs. New features of the 2003 GDHS include the collection of information on female and male circumcision, information on malaria and ownership and use of insecticide-treated bed nets, and haemoglobin and HIV testing.
The long-term objective of the survey includes strengthening the technical capacity of major government institutions, including the Ghana Statistical Service (GSS). The 2003 GDHS also provides comparable data for long-term trend analyses in Ghana, since the surveys were implemented by the same organisation, using similar data collection procedures. It also contributes to the ever-growing international database on demographic and health-related information.
Kind of Data
Sample survey data [ssd]
Unit of Analysis
Individuals
Version
Version Description
Version 1.0 was the uploaded version without external resources.
Version 1.1 (September, 2014 ) External resources attached and the literal questions provided with some editing done to other categories.
Version 1.1 (September, 2014 ) External resources attached and the literal questions provided with some editing done to other categories.
Version Date
2003-09-10
Version Notes
Version 1.0 was the uploaded version without external resources.
Version 1.1 (September, 2014 ) External resources attached and the literal questions provided with some editing done to other categories.
Version 1.1 (September, 2014 ) External resources attached and the literal questions provided with some editing done to other categories.
Scope
Notes
The scope of the 2003 Demographic and Health Survey includes:
- HOUSEHOLD: Household schedule, household characteristics, education, water and sanitation, salt iodization, housing characteristics, security of tenure and durability of housing.
- WOMEN(15-49): Respondent background, literacy, reproduction and birth history, pregnancy and breastfeeding, antenatal and post natal care, contraception, immunization and health, marriage, fertility preferences, women's work, husband's/partner's background, HIV/AIDS and anthropometrical measurement.
- MEN (15-59): Respondent's background, literacy, employment, reproduction, contraception, marriage, fertility preference and HIV/AIDS.
- HOUSEHOLD: Household schedule, household characteristics, education, water and sanitation, salt iodization, housing characteristics, security of tenure and durability of housing.
- WOMEN(15-49): Respondent background, literacy, reproduction and birth history, pregnancy and breastfeeding, antenatal and post natal care, contraception, immunization and health, marriage, fertility preferences, women's work, husband's/partner's background, HIV/AIDS and anthropometrical measurement.
- MEN (15-59): Respondent's background, literacy, employment, reproduction, contraception, marriage, fertility preference and HIV/AIDS.
Topics
| Topic | Vocabulary |
|---|---|
| Social Development | World Bank |
| Children & Youth | World Bank |
| Gender | World Bank |
| Participation / Empowerment | World Bank |
Coverage
Geographic Coverage
National level Regional level
Geographic Unit
Regional l
Universe
All household members, all women 15-49 years, all men 15-59 years and children under 5 years living in Ghana except residence in Refugee camps.
Producers and sponsors
Primary investigators
| Name | Affiliation |
|---|---|
| Ghana Statistical Service (GSS) | Government of Ghana |
Funding Agency/Sponsor
| Name | Abbreviation | Role |
|---|---|---|
| Government of Ghana | GOG | Financial Assistance |
| U.S. Agency for International Development | USAID | Financial Assistance |
Other Identifications/Acknowledgments
| Name | Affiliation | Role |
|---|---|---|
| Ghana Health Service | Ministry of Health | Technical assistance, nurses for taking blood sample for HIV testing in the training of interviewers and vehicles |
| ORC Macro International Inc. | MEASURE DHS | Technical assistance in questionnaire design |
| Noguchi Memorial Institute for Medical Research | NMIMR | Technical assistance in HIV Testing |
| National Population Council | NPC | Provision of Vehicles for field work |
| Government of Ghana | GOG | Financial Assistance |
| U.S. Agency for International Development | USAID | Financial Assistance |
Sampling
Sampling Procedure
The sample for the 2003 GDHS covered the population residing in private households in the country. A representative probability sample of about 6,600 households was selected nationwide. The list of enumeration areas (EAs) from the 2000 Ghana Population and Housing Census was used as a frame for the sample.
The frame was first stratified into the 10 administrative regions in the country, then into rural and urban EAs. The sample was selected in such a manner as to allow for separate estimates for key indicators for the country as a whole, for each of the 10 regions in Ghana, as well as for urban and rural areas separately.
The 2003 GDHS used a two-stage stratified sample design.
At the first stage of sampling, 412 sample points or EAs were selected, each with probability proportional to size, based on the number of households. A complete household listing exercise was carried out between May and June 2003 within all the selected EAs (clusters).
The second stage of selection involved systematic sampling of households from this list. The sample selected per EA varied by region depending on the population size. Fifteen households per EA were selected in all the regions except in Brong Ahafo, Upper East, and Upper West regions, where 20 households per EA were selected, and in the Northern region, where 16 households per EA were selected.
The frame was first stratified into the 10 administrative regions in the country, then into rural and urban EAs. The sample was selected in such a manner as to allow for separate estimates for key indicators for the country as a whole, for each of the 10 regions in Ghana, as well as for urban and rural areas separately.
The 2003 GDHS used a two-stage stratified sample design.
At the first stage of sampling, 412 sample points or EAs were selected, each with probability proportional to size, based on the number of households. A complete household listing exercise was carried out between May and June 2003 within all the selected EAs (clusters).
The second stage of selection involved systematic sampling of households from this list. The sample selected per EA varied by region depending on the population size. Fifteen households per EA were selected in all the regions except in Brong Ahafo, Upper East, and Upper West regions, where 20 households per EA were selected, and in the Northern region, where 16 households per EA were selected.
Deviations from the Sample Design
There was no deviation
Response Rate
A total of 6,628 households were selected in the sample, of which 6,333 were occupied at the time of fieldwork. The difference between selected and occupied households is largely due to structures being vacant or destroyed. Successful interviews were conducted in 6,251 households, yielding a response rate of 99 percent.
In the households interviewed in the survey, a total of 5,949 eligible women age 15-49 were identified; interviews were completed with 5,691 of these women, yielding a response rate of 96 percent. In the same households, a total of 5,345 eligible men age 15-59 were identified and interviews were completed with 5,015 of these men, yielding a male response rate of 94 percent. The response rates are slightly lower for the urban than rural sample and among men than women. The principal reason for non-response among both eligible women and men was the failure to find individuals at home despite repeated visits to the household. The lower response rate for men reflects the more frequent and longer absences of men from the household, principally related to their employment and life style.
Response rates for the HIV testing component were lower than those for the interviews. In fact, the
coverage rate for testing among women is consistent across all age groups (88 to 91 percent). Response
rates are somewhat have more variations by age among men (77 to 83 percent).
In the households interviewed in the survey, a total of 5,949 eligible women age 15-49 were identified; interviews were completed with 5,691 of these women, yielding a response rate of 96 percent. In the same households, a total of 5,345 eligible men age 15-59 were identified and interviews were completed with 5,015 of these men, yielding a male response rate of 94 percent. The response rates are slightly lower for the urban than rural sample and among men than women. The principal reason for non-response among both eligible women and men was the failure to find individuals at home despite repeated visits to the household. The lower response rate for men reflects the more frequent and longer absences of men from the household, principally related to their employment and life style.
Response rates for the HIV testing component were lower than those for the interviews. In fact, the
coverage rate for testing among women is consistent across all age groups (88 to 91 percent). Response
rates are somewhat have more variations by age among men (77 to 83 percent).
Weighting
The variable Sample weight was used to weight the data
Data Collection
Dates of Data Collection
| Start | End | Cycle |
|---|---|---|
| 2003-07 | 2003-10 | 3 months |
Time periods
| Start date | End date | Cycle |
|---|---|---|
| 2003 | 2008 | 5 years |
Data Collection Mode
Face-to-face [f2f]
Supervision
Fifteen teams were constituted for data collection. Each team was composed of a supervisor, an editor, four interviewer (two male & two females) a nurse and a driver. The supervisor was the team leader who had to oversea that team members follow and apply instructions. Interviewers had to edit their own work immediately after interview even before he/she leaves the household for onwards submission to the editor.
The editor then has to do thorough editing of the questionnaires before passing them on to the supervisor sample editing before questionnaires are sent to the project secretariat.
Ten Regional Statisticians, undertake regional monitoring exercise whereas zonal coordinators also embark on field monitoring to ensure data quality.
The editor then has to do thorough editing of the questionnaires before passing them on to the supervisor sample editing before questionnaires are sent to the project secretariat.
Ten Regional Statisticians, undertake regional monitoring exercise whereas zonal coordinators also embark on field monitoring to ensure data quality.
Data Collection Notes
A pretest of the Household, Women's, and Men's questionnaires used in the GDHS was conducted in May 2003 in English and five major local languages. The pretest training was conducted by GSS staff for two weeks from 5-17 May 2003. In addition, nurses recruited from the Ghana Health Service were trained in testing for haemoglobin and collecting blood samples for HIV/AIDS. Five teams were formed to conduct the pretest. Each team consisted of a supervisor, four interviewers, and a nurse. Urban and rural areas were chosen for the pretest to get a better overall sense of the response level and acceptance of HIV/AIDS testing.
The lessons learned from the pretest were used to finalize the survey instruments and logistical arrangements.
Training and Fieldwork
A total of 102 interviewers, 23 nurses, and 12 data entry operators participated in the main survey training that took place from 6-27 July 2003. All participants were trained in interviewing techniques and the contents of the GDHS questionnaires. The training was conducted following the standard DHS training procedures, including class presentations, mock interviews, and tests using the Household, Women's, and Men's Questionnaires. All interviewers were trained in taking height and weight measurements. In addition to interviewer training, 23 persons (most of whom were nurses from the Ghana Health Service) were trained for a period of 10 days in anaemia testing, collection of blood samples for the HIV testing, and in informed consent procedures. An additional 20 interviewers were also trained in blood collecting techniques. In addition to in-class practice, the nurses were taken to the local health clinic to practice blood-collecting techniques on women, men, and children.
Interviewers and nurses were selected based on their in-class participation, performance in the field practices, fluency in the Ghanaian languages, and assessment tests. The most experienced trainees, those who took part in the pretest, and those who did extremely well, were selected to be supervisors and editors. Trainees selected as supervisors and field editors were given an additional two-days training on how to supervise fieldwork and edit questionnaires. In addition, there was one standby supervisor and nine interviewers ready for relief assignment whenever necessary. Ten regional statisticians acted as regional coordinators, and GSS staff coordinated and supervised fieldwork activities.
Fifteen teams were constituted for data collection. Each team was made up of a supervisor, an editor, a nurse, four interviewers, and a driver. Fieldwork lasted for three months from late July to late October.
ORC Macro provided technical assistance on all aspects of the survey; staff from ORC Macro
participated in field supervision of interviews, height and weight measurements, and blood sample collection.
On average, 20 minutes was used to administer household questionnaire, about 50 minutes for women's questionnaire and about 30 minutes for men's questionnaire. Supervisors were provided with control forms to track the work done on the field. Members of the project implementing team also paid regular visits to the teams to ensure that they adhered to good data collection practices.
Women questionnaire collected information on the respondent's educational background, birth history, pregnancy and breasteeding, marriage, use of contraception and knowledge about HIV/AIDS.
The men questionnaire also collected information on the respondent educational background, marriage, fertility, use of contraception and knowledge of HIV/AIDS.
The lessons learned from the pretest were used to finalize the survey instruments and logistical arrangements.
Training and Fieldwork
A total of 102 interviewers, 23 nurses, and 12 data entry operators participated in the main survey training that took place from 6-27 July 2003. All participants were trained in interviewing techniques and the contents of the GDHS questionnaires. The training was conducted following the standard DHS training procedures, including class presentations, mock interviews, and tests using the Household, Women's, and Men's Questionnaires. All interviewers were trained in taking height and weight measurements. In addition to interviewer training, 23 persons (most of whom were nurses from the Ghana Health Service) were trained for a period of 10 days in anaemia testing, collection of blood samples for the HIV testing, and in informed consent procedures. An additional 20 interviewers were also trained in blood collecting techniques. In addition to in-class practice, the nurses were taken to the local health clinic to practice blood-collecting techniques on women, men, and children.
Interviewers and nurses were selected based on their in-class participation, performance in the field practices, fluency in the Ghanaian languages, and assessment tests. The most experienced trainees, those who took part in the pretest, and those who did extremely well, were selected to be supervisors and editors. Trainees selected as supervisors and field editors were given an additional two-days training on how to supervise fieldwork and edit questionnaires. In addition, there was one standby supervisor and nine interviewers ready for relief assignment whenever necessary. Ten regional statisticians acted as regional coordinators, and GSS staff coordinated and supervised fieldwork activities.
Fifteen teams were constituted for data collection. Each team was made up of a supervisor, an editor, a nurse, four interviewers, and a driver. Fieldwork lasted for three months from late July to late October.
ORC Macro provided technical assistance on all aspects of the survey; staff from ORC Macro
participated in field supervision of interviews, height and weight measurements, and blood sample collection.
On average, 20 minutes was used to administer household questionnaire, about 50 minutes for women's questionnaire and about 30 minutes for men's questionnaire. Supervisors were provided with control forms to track the work done on the field. Members of the project implementing team also paid regular visits to the teams to ensure that they adhered to good data collection practices.
Women questionnaire collected information on the respondent's educational background, birth history, pregnancy and breasteeding, marriage, use of contraception and knowledge about HIV/AIDS.
The men questionnaire also collected information on the respondent educational background, marriage, fertility, use of contraception and knowledge of HIV/AIDS.
Data Collectors
| Name | Abbreviation | Affiliation |
|---|---|---|
| Ghana Statistical Service | GSS | Government of Ghana |
Questionnaires
Questionnaires
Three questionnaires were used for the 2003 GDHS: the Household Questionnaire, the Women's Questionnaire, and the Men's Questionnaire. The contents of these questionnaires were based on the model questionnaires developed by the MEASURE DHS+ programme and were designed to provide information needed by health and family planning programme managers and policymakers. The questionnaires were adapted to the Ghanaian situation and a number of questions pertaining to ongoing health, HIV, and family planning programmes were added. These questionnaires were translated from English into the five major languages (Akan, Nzema, Ewe, Ga, and Dagbani). The questionnaires are attached to the main report which is in the External Resources (Appendix E).
The Household Questionnaire was used to list all the usual members and visitors in the selected households. Information was collected on the characteristics of each person listed, including the age, sex, education, and relationship to the head of household. The main purpose of the Household Questionnaire was to identify eligible women and men for the individual interview. The Household Questionnaire collected information on characteristics of the household's dwelling unit, such as the source of drinking water, type of toilet facilities, flooring materials, ownership of various consumer goods, and ownership and use of mosquito nets. It was also used to record height and weight measurements of women 15-49 and children under the age of 5, and to record the respondents' consent to the haemoglobin and HIV testing.
The Women's Questionnaire was used to collect information from all women age 15-49. These women were asked questions on the following topics: respondent's background characteristics, such as education, residential history, media exposure, knowledge and use of family planning methods, fertility
preferences, antenatal and delivery care, breastfeeding and infant and child feeding practices, vaccinations and childhood illnesses, childhood mortality, marriage and sexual activity, woman's work and husband's background characteristics, and awareness and behaviour regarding AIDS and other STIs.
The Men's Questionnaire was administered to all men age 15-59 in every household in the GDHS sample. The Men's Questionnaire collected much of the same information found in the Women's Questionnaire, but was shorter because it did not contain a reproductive history or questions on maternal and child health and nutrition.
Note:
The three questionnaires were merged together named GHS Questionnaires and attached to External Resources
The Household Questionnaire was used to list all the usual members and visitors in the selected households. Information was collected on the characteristics of each person listed, including the age, sex, education, and relationship to the head of household. The main purpose of the Household Questionnaire was to identify eligible women and men for the individual interview. The Household Questionnaire collected information on characteristics of the household's dwelling unit, such as the source of drinking water, type of toilet facilities, flooring materials, ownership of various consumer goods, and ownership and use of mosquito nets. It was also used to record height and weight measurements of women 15-49 and children under the age of 5, and to record the respondents' consent to the haemoglobin and HIV testing.
The Women's Questionnaire was used to collect information from all women age 15-49. These women were asked questions on the following topics: respondent's background characteristics, such as education, residential history, media exposure, knowledge and use of family planning methods, fertility
preferences, antenatal and delivery care, breastfeeding and infant and child feeding practices, vaccinations and childhood illnesses, childhood mortality, marriage and sexual activity, woman's work and husband's background characteristics, and awareness and behaviour regarding AIDS and other STIs.
The Men's Questionnaire was administered to all men age 15-59 in every household in the GDHS sample. The Men's Questionnaire collected much of the same information found in the Women's Questionnaire, but was shorter because it did not contain a reproductive history or questions on maternal and child health and nutrition.
Note:
The three questionnaires were merged together named GHS Questionnaires and attached to External Resources
Data Processing
Data Editing
The 2003 GDHS data editing was implemented at three levels:
1. Field editing by interviewers, field editors and supervisors
2. Office editing
3. Data cleaning and imputation
1. Field editing by interviewers, field editors and supervisors
2. Office editing
3. Data cleaning and imputation
Other Processing
The processing of the GDHS results began shortly after the fieldwork commenced. Completed questionnaires were returned periodically from the field to the GSS headquarters in Accra, where they were entered and edited by data processing personnel who were specially trained for this task. Twelve data entry operators from GSS were trained for one week on data entry procedures using CSPro. All data were entered twice (100 percent verification). In addition, tables were run periodically to monitor the quality of the data collected. The concurrent processing of the data was an advantage for data quality because field coordinators were able to advise teams of problems detected during the data entry. The data entry and editing phase of the
survey was completed in mid-December 2003.
Blood samples were periodically collected in the field along with the completed questionnaires and transported to the GSS headquarters in Accra for logging in, after which they were taken to the Noguchi Memorial Institute for Medical Research (NMIMR) at Legon, for HIV testing.
A dried blood spot methodology to test for HIV using two Enzyme-Linked Immunosorbent Assay (ELISA) tests from different manufacturers that would also allow for sero-typing were setup to test blood samples for HIV.
All specimens were tested with a screening test, Vironostika HIV Uni-Form Plus O (ELISA I). All
samples positive on the first screening test as well as 10 percent of the negatives were further tested in parallel with Wellcozyme HIV-1 Recombinant and Murex HIV-2 (ELISA II) for serotyping. Results for all the ELISAs were obtained by relating the absorbance value or optical density (OD) of a specimen to the OD of the serum controls.
According to the testing algorithm, samples positive on the first ELISA and positive on both the second ELISAs were regarded as postivie for HIV-1 and HIV-2; samples positive on the first ELISA and positive on Wellcozyme HIV-1 Recombinant and negative on Murex HIV-2 were categorized as positive for HIV-1; similarly, samples that were positive on the first ELISA and negative on Wellcozyme HIV-1 Recombinant and positive on Murex HIV-2 were categorized as positive for HIV-2. Samples negative on the first ELISA and negative on ELISAs for serotyping were regarded as negative. Samples that had discordant results on ELISA I and ELISA II were tested again with ELISA I and ELISA II.
survey was completed in mid-December 2003.
Blood samples were periodically collected in the field along with the completed questionnaires and transported to the GSS headquarters in Accra for logging in, after which they were taken to the Noguchi Memorial Institute for Medical Research (NMIMR) at Legon, for HIV testing.
A dried blood spot methodology to test for HIV using two Enzyme-Linked Immunosorbent Assay (ELISA) tests from different manufacturers that would also allow for sero-typing were setup to test blood samples for HIV.
All specimens were tested with a screening test, Vironostika HIV Uni-Form Plus O (ELISA I). All
samples positive on the first screening test as well as 10 percent of the negatives were further tested in parallel with Wellcozyme HIV-1 Recombinant and Murex HIV-2 (ELISA II) for serotyping. Results for all the ELISAs were obtained by relating the absorbance value or optical density (OD) of a specimen to the OD of the serum controls.
According to the testing algorithm, samples positive on the first ELISA and positive on both the second ELISAs were regarded as postivie for HIV-1 and HIV-2; samples positive on the first ELISA and positive on Wellcozyme HIV-1 Recombinant and negative on Murex HIV-2 were categorized as positive for HIV-1; similarly, samples that were positive on the first ELISA and negative on Wellcozyme HIV-1 Recombinant and positive on Murex HIV-2 were categorized as positive for HIV-2. Samples negative on the first ELISA and negative on ELISAs for serotyping were regarded as negative. Samples that had discordant results on ELISA I and ELISA II were tested again with ELISA I and ELISA II.
Data Appraisal
Estimates of Sampling Error
The estimates from a sample survey are affected by two types of errors: (1) non-sampling errors, and (2) sampling errors. Non-sampling errors are the results of mistakes made in implementing data collection and data processing, such as failure to locate and interview the correct household, misunderstanding of the questions on the part of either the interviewer or the respondent, and data entry errors. Although numerous efforts were made during the implementation of the 2003 Ghana Demographic and Health Survey (GDHS) to minimize this type of error, non-sampling errors are impossible to avoid and difficult to evaluate statistically. Sampling errors, on the other hand, can be evaluated statistically.
The sample of respondents selected in the 2003 GDHS is only one of many samples that could have been selected from the same population, using the same design and expected size. Each of these samples would yield results that differ somewhat from the results of the actual sample selected. Sampling errors are a measure of the variability between all possible samples. Although the degree of variability is not known exactly, it can be estimated from the survey results.
A sampling error is usually measured in terms of the standard error for a particular statistic (mean, percentage, etc.), which is the square root of the variance. The standard error can be used to calculate confidence intervals within which the true value for the population can reasonably be assumed to fall. For example, for any given statistic calculated from a sample survey, the value of that statistic will fall within a range of plus or minus two times the standard error of that statistic in 95 percent of all possible samples of identical size and design. If the sample of respondents had been selected as a simple random sample, it would have been possible to use straightforward formulas for calculating sampling errors. However, the 2003 GDHS sample is the result of a multi-stage stratified design, and, consequently, it was necessary to use more complex formulae.
The computer software used to calculate sampling errors for the 2003 GDHS is the ISSA Sampling Error Module. This module used the Taylor linearization method of variance estimation for survey estimates that are means or proportions. The Jackknife repeated replication method is used for variance estimation of more complex statistics such as fertility and mortality rates. The Taylor linearization method treats any percentage or average as a ratio estimate, r = y/x, where y represents the total sample value for variable y, and x represents the total number of cases in the group or subgroup under consideration. The variance of r is computed using the formula given below, with the standard error being the square root of the variance.
The sample of respondents selected in the 2003 GDHS is only one of many samples that could have been selected from the same population, using the same design and expected size. Each of these samples would yield results that differ somewhat from the results of the actual sample selected. Sampling errors are a measure of the variability between all possible samples. Although the degree of variability is not known exactly, it can be estimated from the survey results.
A sampling error is usually measured in terms of the standard error for a particular statistic (mean, percentage, etc.), which is the square root of the variance. The standard error can be used to calculate confidence intervals within which the true value for the population can reasonably be assumed to fall. For example, for any given statistic calculated from a sample survey, the value of that statistic will fall within a range of plus or minus two times the standard error of that statistic in 95 percent of all possible samples of identical size and design. If the sample of respondents had been selected as a simple random sample, it would have been possible to use straightforward formulas for calculating sampling errors. However, the 2003 GDHS sample is the result of a multi-stage stratified design, and, consequently, it was necessary to use more complex formulae.
The computer software used to calculate sampling errors for the 2003 GDHS is the ISSA Sampling Error Module. This module used the Taylor linearization method of variance estimation for survey estimates that are means or proportions. The Jackknife repeated replication method is used for variance estimation of more complex statistics such as fertility and mortality rates. The Taylor linearization method treats any percentage or average as a ratio estimate, r = y/x, where y represents the total sample value for variable y, and x represents the total number of cases in the group or subgroup under consideration. The variance of r is computed using the formula given below, with the standard error being the square root of the variance.
Data Appraisal
Series of data quality checks were done to ensure that the data met required standards
HAEMOGLOBIN AND HIV TESTING
In all households selected for the 2003 GDHS, women age 15-49 and children under age 5 were tested for anaemia. In addition, all eligible women and men were tested for HIV. Anaemia and HIV testing were only carried out if consent was provided by the respondents and in the case of a minor, by the parent or guardian. The protocol for haemoglobin and HIV testing was approved by the Ghana Health Service Ethical Review Committee in Accra and the ORC Macro Institutional Review Board in Calverton, Maryland, USA.
Haemoglobin testing is the primary method of anaemia diagnosis. In the GDHS, testing was done using the HemoCue system. A consent statement was read to the eligible woman and to the parent or responsible adult for young children and women age 15-17. This statement explained the purpose of the test, informed prospective subjects tested and/or their caretakers that the results would be made available as soon as the test was completed, and also requested permission for the test to be carried out, as well as the consent to report their names to health personnel in the local health facility if their haemoglobin level was low (severe).
Before the blood was taken, the finger was wiped with an alcohol prep swab and allowed to air-dry. Then the palm side of the end of a finger (in case of adults and children six months of age and older) was punctured with a sterile, non-reusable, self-retractable lancet and a drop of blood collected on a HemoCue microcuvette and placed in a HemoCue photometer, which displays the result. For children under six months of age (or for children under one year of age who were particularly undernourished and bony) a heel puncture was made to draw a drop of blood. The results were recorded in the Household Questionnaire, as well as on a brochure, which was given to each woman, parent, or responsible adult, that explained what the results meant. For each person whose haemoglobin level was low (severe), and who agreed to have the condition reported, a referral card was given to the respondent to be taken to a health facility.
HIV/AIDS Testing
All eligible women and men who were interviewed were asked to voluntarily provide a few drops of
blood for HIV testing. The protocol for the blood specimen collection and analysis was based on the anonymous linked protocol developed for DHS. The protocol allows for the merging of the HIV results to the socio-demographic data collected in the individual questionnaires, provided that information that could potentially identify an individual is destroyed before the linking takes place. This required that identification codes be deleted from the data file and that the back page of the Household Questionnaires that contain the bar code labels and names of respondents be destroyed prior to merging the HIV results with the individual data file.
If, after explaining the procedure, the confidentiality of the data, and the fact that the test results
would not be made available to the subject, a respondent consented to the HIV testing, a dried blood spot (DBS) specimen was obtained from a finger prick. Each respondent who consented to being tested for HIV was given an information brochure on AIDS, a list of fixed sites providing voluntary counseling and testing (VCT) services throughout the country, and a voucher to access free VCT services at any of these sites for the respondent and/or the partner.
HAEMOGLOBIN AND HIV TESTING
In all households selected for the 2003 GDHS, women age 15-49 and children under age 5 were tested for anaemia. In addition, all eligible women and men were tested for HIV. Anaemia and HIV testing were only carried out if consent was provided by the respondents and in the case of a minor, by the parent or guardian. The protocol for haemoglobin and HIV testing was approved by the Ghana Health Service Ethical Review Committee in Accra and the ORC Macro Institutional Review Board in Calverton, Maryland, USA.
Haemoglobin testing is the primary method of anaemia diagnosis. In the GDHS, testing was done using the HemoCue system. A consent statement was read to the eligible woman and to the parent or responsible adult for young children and women age 15-17. This statement explained the purpose of the test, informed prospective subjects tested and/or their caretakers that the results would be made available as soon as the test was completed, and also requested permission for the test to be carried out, as well as the consent to report their names to health personnel in the local health facility if their haemoglobin level was low (severe).
Before the blood was taken, the finger was wiped with an alcohol prep swab and allowed to air-dry. Then the palm side of the end of a finger (in case of adults and children six months of age and older) was punctured with a sterile, non-reusable, self-retractable lancet and a drop of blood collected on a HemoCue microcuvette and placed in a HemoCue photometer, which displays the result. For children under six months of age (or for children under one year of age who were particularly undernourished and bony) a heel puncture was made to draw a drop of blood. The results were recorded in the Household Questionnaire, as well as on a brochure, which was given to each woman, parent, or responsible adult, that explained what the results meant. For each person whose haemoglobin level was low (severe), and who agreed to have the condition reported, a referral card was given to the respondent to be taken to a health facility.
HIV/AIDS Testing
All eligible women and men who were interviewed were asked to voluntarily provide a few drops of
blood for HIV testing. The protocol for the blood specimen collection and analysis was based on the anonymous linked protocol developed for DHS. The protocol allows for the merging of the HIV results to the socio-demographic data collected in the individual questionnaires, provided that information that could potentially identify an individual is destroyed before the linking takes place. This required that identification codes be deleted from the data file and that the back page of the Household Questionnaires that contain the bar code labels and names of respondents be destroyed prior to merging the HIV results with the individual data file.
If, after explaining the procedure, the confidentiality of the data, and the fact that the test results
would not be made available to the subject, a respondent consented to the HIV testing, a dried blood spot (DBS) specimen was obtained from a finger prick. Each respondent who consented to being tested for HIV was given an information brochure on AIDS, a list of fixed sites providing voluntary counseling and testing (VCT) services throughout the country, and a voucher to access free VCT services at any of these sites for the respondent and/or the partner.
Access policy
Contacts
| Name | Affiliation | URL | |
|---|---|---|---|
| The Government Statistician | Ghana Statistical Service | gs@statsghana.gov.gh | www.statsghana.gov.gh |
Confidentiality
Ghana Statistical Service (GSS) requires all users to keep information and microdata strictly confidential. In this regard, before being granted access to microdatasets, all users have to formally agree to observe the following:
1. Not to make copies of any files or portions of files to which access has been granted except with the authorization by GSS
2. Not to willfully identify any individual or household or establishment in the microdataset
3. To hold in strictest confidence, the identity of any individual or household or establishment that may be inadvertently revealed in any documents or discussion, or analysis. Such unintended identification revealed should be immediately brought to the attention of GSS.
4. Microdata obtained from GSS are protected by copyright law and therefore not for re-distribution or sale
5. Prospective clients or data users may be required to submit and sign an affidavit of confidentiality of microdata they access
Access conditions
The Ghana Statistical Service as a public institution has the obligation to promote data dissemination to facilitate national development. Making mcrodata available will enable students and the academia to conduct research works, assist investors to take business decision, help the individual to evaluate and take appropriate decisions. It will also assist the government to formulate appropriate policies and programmes to facilitate national development. GSS' policy framework provides access to data through:
1. Public use files. These categories of data sets are accessible by all without any payment. They are available on-line to all interested users, for research and statistical purposes only.
2. Licensed datasets. These categories of data sets are accessible under certain conditions. Thus, prospective clients/data users may access any data based on certain conditions set by the GSS
3. Datasets only accessible on location. We consider this category as a data enclave where some data sets are only accessible at GSS offices and prospective data users and researches have to physically be available at GSS offices for further discussions before data are released. Thus, data enclave would not be linked to the outside world through our web site or other medium.
The following terms and conditions apply:
Before being granted access to the dataset, all users have to formally agree:
1. To make no copies of any files or portions of files for which access has been granted, except those authorized by GSS.
2. Not to use any technique in an attempt to identify any person, establishment, or sampling unit.
3. To hold in strictest confidence, the identification of any establishment or individual that may be inadvertently revealed in any documents or discussion, or analysis. Such inadvertent identification revealed in her/his analysis will be immediately brought to the attention of the GSS.
4. The data and other materials will not be redistributed or sold to other individuals, institutions, or organizations without the written agreement of GSS.
5. The data will be used for statistical and scientific research purposes only.
6. The data will be used solely for reporting of aggregated information, and not for investigation of specific individuals or organizations.
7. No attempt will be made to identify respondents, and no use will be made of the identity of any person or establishment discovered inadvertently. Any such discovery would immediately be reported to the GSS.
8. No attempt will be made to produce links among datasets provided by the GSS with other datasets that could identify individuals or organizations.
9. Any books, articles, conference papers, theses, dissertations, reports, or other publications that employ data obtained from the GSS would cite the source of data in accordance with the citation statement provided with the dataset
10. An electronic copy of all reports and publications based on the requested data will be sent to the GSS.
1. Public use files. These categories of data sets are accessible by all without any payment. They are available on-line to all interested users, for research and statistical purposes only.
2. Licensed datasets. These categories of data sets are accessible under certain conditions. Thus, prospective clients/data users may access any data based on certain conditions set by the GSS
3. Datasets only accessible on location. We consider this category as a data enclave where some data sets are only accessible at GSS offices and prospective data users and researches have to physically be available at GSS offices for further discussions before data are released. Thus, data enclave would not be linked to the outside world through our web site or other medium.
The following terms and conditions apply:
Before being granted access to the dataset, all users have to formally agree:
1. To make no copies of any files or portions of files for which access has been granted, except those authorized by GSS.
2. Not to use any technique in an attempt to identify any person, establishment, or sampling unit.
3. To hold in strictest confidence, the identification of any establishment or individual that may be inadvertently revealed in any documents or discussion, or analysis. Such inadvertent identification revealed in her/his analysis will be immediately brought to the attention of the GSS.
4. The data and other materials will not be redistributed or sold to other individuals, institutions, or organizations without the written agreement of GSS.
5. The data will be used for statistical and scientific research purposes only.
6. The data will be used solely for reporting of aggregated information, and not for investigation of specific individuals or organizations.
7. No attempt will be made to identify respondents, and no use will be made of the identity of any person or establishment discovered inadvertently. Any such discovery would immediately be reported to the GSS.
8. No attempt will be made to produce links among datasets provided by the GSS with other datasets that could identify individuals or organizations.
9. Any books, articles, conference papers, theses, dissertations, reports, or other publications that employ data obtained from the GSS would cite the source of data in accordance with the citation statement provided with the dataset
10. An electronic copy of all reports and publications based on the requested data will be sent to the GSS.
Citation requirements
Ghana Statistical Service (GSS), Noguchi Memorial Institute for Medical Research (NMIMR), and ORC Macro. 2004. Ghana Demographic and Health Survey (DHS-2003), v1.1
Access authority
| Name | Affiliation | URL | |
|---|---|---|---|
| The Government Statistician | Government Statistician | info@statsghana.gov.gh | www.statsghana.gov.gh |
Disclaimer and copyrights
Disclaimer
The original collector of the data, GSS and any producers or sponsors cited in this document bear no responsibility for use of the data or for interpretations or inferences based upon such uses.
Copyright
© 2014, Ghana Statistical Service
Metadata production
DDI Document ID
DDI-GHA-GSS-DHS-2003-v1.1
Producers
| Name | Abbreviation | Affiliation | Role |
|---|---|---|---|
| Ghana Statistical Service | GSS | Government of Ghana | Metadata Producer |
Date of Metadata Production
2014-09-13
DDI Document version
Version 1.0 was the uploaded version without external resources.
Version 1.1 (September 2014 ) External resources attached and the literal questions provided with some editing done to other categories.
Version 1.1 (September 2014 ) External resources attached and the literal questions provided with some editing done to other categories.