Global School-based Student Health Survey 2010
Mongolia, 2010
Identification
MNG_2010_GSHS_v01_M
Global School-based Student Health Survey 2010
| Name | Country code |
|---|---|
| Mongolia | MNG |
World Health Survey [hh/whs]
The GSHS is a collaborative surveillance project designed to help countries measure and assess the behavioural risk factors and protective factors in 10 key areas among young people aged 13 to 17 years. The GSHS is a relatively low-cost school-based survey which uses a self-administered questionnaire to obtain data on young people's health behaviour and protective factors related to the leading causes of morbidity and mortality among children and adults worldwide. The GSHS was developed by the World Health Organization (WHO) in collaboration with United Nations' UNICEF, UNESCO, and UNAIDS; and with technical assistance from CDC.
As of December 2011, representatives from more than 107 countries have been trained and 73 countries have completed a GSHS. Twenty-nine countries have been trained but have not conducted their surveys because of insufficient funds, staff turnover, or other in-country barriers. More than 420,000 students have participated in a GSHS survey.
In 2010, the Mongolian Ministry of Health and the Public Health Institute conducted the first nationwide Global School-based Student Health Survey (GSHS) in Mongolia. The GSHS methodology was discussed and approved by the Scientific Council Meeting of the Public Health School, Health Science University of Mongolia and the Committee on Ethics, Ministry of Health. The 2010 Mongolia GSHS employed a two-stage cluster sample design to produce a representative sample of all students in grades 7-12 aged 12-18 years old in Mongolia. The survey was organized nationwide with financial and technical assistance from the WHO and US CDC and Millennium Challenge Account of Mongolia, EPOS Health Management. The survey was conducted in Mongolia in March 2010.
The purpose of the GSHS is to provide accurate data on health behaviors and protective factors among students to:
- Help countries develop priorities, establish programs, and advocate for resources for school health and youth health programs and policies;
- Establish trends in the prevalence of health behaviors and protective factors for use in evaluation of school health and youth health promotion;
- Allow countries, international agencies, and others to make comparisons across and within countries regarding the prevalence of health behaviors and protective factors.
Sample survey data [ssd]
Students aged 12-18 years
Scope
The 2010 Mongolia GSHS measured alcohol use; dietary behaviors; drug use; hygiene; mental health; physical activity; protective factors; sexual behaviors; tobacco use; and violence and unintentional injury.
Coverage
National coverage
Producers and sponsors
| Name |
|---|
| Ministry of Health |
| Public Health Institute |
| World Health Organization |
| Centers for Disease Control and Prevention |
| Name |
|---|
| United Nations Children's Fund |
| United Nations Educational, Scientific and Cultural Organization |
| Joint United Nations Programme on HIV/AIDS |
| Name | Role |
|---|---|
| World Health Organization | Financial and technical assistance |
| Centers for Disease Control and Prevention | Financial and technical assistance |
| EPOS Health Management | |
| Millennium Challenge Account of Mongolia |
| Name | Affiliation | Role |
|---|---|---|
| Scientific Council Meeting of the Public Health School | Health Science University of Mongolia | GSHS methodology |
| Committee on Ethics | Ministry of Health | GSHS methodology |
Sampling
The 2010 Mongolia GSHS employed a two-stage cluster sample design to produce a representative sample of students in grades 7-12. In total, 60 schools (30 schools from urban and rural respectively) and 202 classes were selected to participate in the Mongolia GSHS.
School level: The first-stage sampling frame consisted of all schools (urban, rural, public, or private) containing any of grades 7-12. Schools were selected systematically with probability proportional to school enrollment size.
Class level: The second-stage sampling frame consisted of randomly selecting intact classrooms (using a random start) from each school to participate. All relevant classes in each selected school were included in the sampling frame. All students in the sampled classrooms were eligible to participate in the GSHS.
Schools - 60 schools were selected and all participated in the survey. Response rate: 100%
Classes - 202 classes were selected and all participated in the survey. Response rate: 100%
Students - 6,066 students were eligible to participate in this survey. 5,238 students completed the survey questionnaire (6% of students had an excused absence due to illness, 5% had an excused absence due to extracurricular activities or sports, and 2.7% had an unexcused absence). four students refused to complete the survey or sign the consent form. Response rate: 86%
Overall response rate - 100% 100% 86% = 86%
Certain questions were prone to non-response, and warrant further investigation for future Mongolian GSHS to determine if confusing question wording resulted in high non-response. Such questions likely contribute to nonsampling error.
All prevalence estimates and other percentages reported in this study were adjusted, weighted percentages. They were adjusted for age and grade level. Weighted percents were calculated by applying a weighting factor to each student record to adjust for non-response and for the varying probabilities (likelihood) of selection. The following formula was used to calculate the weighting factor, W:
W = W1 x W2 x f1 x f2 x f3
W1 = the inverse probability of selecting the school;
W2 = the inverse probability of selecting the classroom within the school;
f1 = a school-level nonresponse adjustment factor calculated by school size category (small, medium, large). The factor was calculated in terms of school enrollment instead of number of schools;
f2 = a student-level nonresponse adjustment factor calculated by class;
f3 = a post-stratification adjustment factor calculated by grade.
The weighted percentages used in this report are a more accurate reflection of the total Mongolian adolescent population than if the results were to be used in their non-weighted form. The weighted results can be used to make inferences concerning the priority health-risk behaviors of all students in grades 7-12 in Mongolia and permit comparisons of findings across points in time and different locations, ages, and genders.
Survey instrument
The GSHS uses a standardized scientific sample selection process; common school-based methodology; and core questionnaire modules, core-expanded questions, and country-specific questions that are combined to form a self-administered questionnaire that can be administered during one regular class period.
The Mongolian GSHS questionnaire contained 84 questions addressing the following topics:
- Demographics
- Dietary behaviors
- Hygiene
- Violence and unintentional injury
- Mental health
- Tobacco use
- Alcohol use
- Drug use
- Sexual behaviors
- Physical activity
- Protective factors
Of the 84 questions, 58 questions were from the core questionnaire modules and 26 questions were expanded GSHS and country-specific questions. GSHS questions had been formulated by a group of experts including members from WHO, UNAIDS, UNICEF, UNESCO and US CDC.
In addition, two anthropometric measurements (height and weight) were taken. "UNISCALE" electrical scales with 150 kg maximum and 0.1 kg precision were used to measure weight. Student height was measured with a special foldable device. Student growth was assessed using the anthropometric measurements in accordance with age and gender specific percentiles formulated by WHO.
Data collection
| Start | End |
|---|---|
| 2010-03-09 | 2010-03-25 |
| Name |
|---|
| Ministry of Health |
| Public Health Institute |
Training
Training was conducted by the School of Public Health, Health Science University of Mongolia, from March 3rd to 5th, 2010. Twenty national field workers were trained. The project supervisor introduced and explained the GSHS administration, including how to organize taking questionnaires at the selected schools, how to measure weight and height of students, and other researcher responsibilities. The survey coordinator explained in detail the questionnaire administration protocol for the field, including how to fill out the answer sheet and how to obtain informed consent for weight and height measurement. Researchers practiced taking anthropometric measurements. They also discussed each questionnaire question, carried out pilot testing, and revised the questionnaire.
Survey administration and consent
A total of 11 teams (2 researchers and 1 survey assistant in each local area) collected nationwide data from March 9th to 25th, 2010. Two days prior to the survey, the consent form was distributed and the survey aim was introduced. The consent forms were signed by students, as is customary for high school aged students in Mongolia. The consent form informed the students about the purpose of the survey and problems in adolescent health. The consent form asked for the voluntary participation of students and reminded them that:
- Completing the survey would improve their health education program
- Their name would not be written on the survey, and responses would remain anonymous and confidential
- They would not be paid for completing the survey
- Their grade would not be affected by choosing not to participate in the survey
- Nothing bad would happen if they chose to participate
In rare cases, surveys had nonsensical answers and survey administrators offered students a second chance to complete the survey.
Survey teams operated in the following aimags/regional areas (see Appendix 3 for a list of selected schools):
1st team: Khovd
2nd team: Uvs, Bayan-Ulgii
3rd team: Bayankhongor, Uvurkhangai, Dundgobi, Umnugobi
4th team: Sukhbaatar, Khentii, Dornod, Dornogobi, Baganuur
5th team: Arkhangai, Khuvsgul, Bulgan, Оrkhon, Kharkhorin
6th team: Тuv, Selenge, Darkhan-Uul
7th team: Gobi-Altai
8-11th teams: Ulaanbaatar city: Chingeltei, Sukhbaatar, Bayanzurkh, Songinokhairkhan, Bayangol, and Khan-Uul districts
Data processing
Responses were read and data coded at the US CDC in Atlanta, Georgia, USA. Processed data was analyzed using MS Excel 2007, EpiInfo 2000, and SPSS 16.0.
The sampling method was a two-stage cluster sample, rather than a simple random sample. Consequently, sampling error cannot be computed using simple statistics. The CDC used the SUDAAN software package to compute standard errors for prevalence values obtained from the data collected in the multistage, clustered sample. The statistical approach used for computing the standard errors is a first-order Taylor Series linear approximation of the deviations of estimates from their expected values.
In addition to the standard errors, SUDAAN estimates the design effect for each statistic, which is the standard error using the given sample design, divided by the standard error that would result if a simple random sample of the same size had been used. A design effect value of one indicates that the sample design is as efficient as a simple random sample; a value greater than one indicates a tendency for greater sampling error due to the use of a more complex and less statistically efficient design. Since the GSHS uses clusters of students in schools and classes to lower survey costs and reduce survey burden, it is not surprising that the design effect for estimates generated from GSHS data is greater than one.
Using standard errors and design effect values, 95% confidence intervals were computed for each prevalence estimate. Any mention of "statistical significance" in this report refers to hypothesis tests resulting in p-values below 0.05; that is, significance at or above 95% confidence.
Data Access
| Name | Affiliation | URL | |
|---|---|---|---|
| Department of Chronic Diseases and Health Promotion | World Health Organization | http://www.who.int/chp/gshs/en/ | chronicdiseases@who.int |
GSHS data release and publication policies and procedures are based on the following guiding principles:
- GSHS data are owned by the official country-level agency (ex. Ministry of Health) conducting or sponsoring the survey.
- Public health and scientific advancement are best served by an open and timely exchange of data and data analyses.
- The privacy of participating schools and students must be protected.
- Data quality must be maintained.
Use of the dataset must be acknowledged using a citation which would include:
- the Identification of the Primary Investigator
- the title of the survey (including country, acronym and year of implementation)
- the survey reference number
- the source and date of download
Example:
Ministry of Health and Public Health Institute of Mongolia, World Health Organization and Centers for Disease Control and Prevention. Mongolia Global School-based Student Health Survey (GSHS) 2010, Ref. MNG_2010_GSHS_v01_M. Dataset downloaded from [url] on [date].
Disclaimer and copyrights
The user of the data acknowledges that the original collector of the data, the authorized distributor of the data, and the relevant funding agency bear no responsibility for use of the data or for interpretations or inferences based upon such uses.
Contacts
| Name | Affiliation | URL | |
|---|---|---|---|
| Department of Chronic Diseases and Health Promotion | World Health Organization | chronicdiseases@who.int | http://www.who.int/chp/gshs/en/ |
Metadata production
DDI_MNG_2010_GSHS_v01_M_WB
| Name | Affiliation | Role |
|---|---|---|
| Development Data Group | The World Bank | Documentation of the DDI |
2013-11-20
Metadata version
Version 01 (November 2013)