Demographic and Health Survey 2013
Sierra Leone, 2013
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SLE_2013_DHS_v01_M
Demographic and Health Survey 2013
| Name | Country code |
|---|---|
| Sierra Leone | SLE |
Demographic and Health Survey (Standard) - DHS VI
The Demographic and Health Survey (DHS) is part of the worldwide MEASURE Demographic and Health Surveys program, which is designed to collect information on a variety of health-related topics including fertility, family planning, and maternal and child health. Detail overview of DHS program is availale in <a href='http://dhsprogram.com/What-We-Do/Survey-Types/DHS.cfm'>The DHS Program</a> website.
The 2013 Sierra Leone Demographic and Health Survey (SLDHS) is the second population and health survey that Sierra Leone has conducted. It was designed to provide data to monitor the population and health situation in Sierra Leone and also to be used as a follow-up to the first SLDHS survey, conducted in 2008.
The 2013 SLDHS collected information on fertility levels; marriage; sexual activity; fertility preferences; awareness and use of family planning methods; breastfeeding practices; nutritional status of women and young children; childhood and maternal mortality; maternal and child health; and awareness and behaviour regarding HIV/AIDS and other STIs. The 2013 SLDHS is the first survey to collect data on domestic violence.
The specific objectives of the 2013 SLDHS were to:
• Provide reliable data, at the national, regional, and district levels, on health and demographic indicators in the areas of fertility, mortality, family planning, maternal and child health, nutrition, malaria, and HIV/AIDS, which can be used by programme managers and policy makers to evaluate and improve existing programmes or develop new ones;
• Measure changes in fertility and contraceptive prevalence;
• Examine the basic indicators of maternal and child health in Sierra Leone, including nutritional status, use of antenatal and maternity services, treatment of recent episodes of childhood illness, use of immunisation services, use of mosquito nets and treatment of children and pregnant women for malaria;
• Describe the patterns of knowledge, attitudes, and behaviour related to the transmission of HIV/AIDS and other STIs;
• Ascertain the extent and pattern of domestic violence and female genital cutting in the country;
• Estimate the prevalence of HIV infection at the national, regional and district levels and by urban-rural residence.
The 2013 SLDHS provides data to assist policymakers and programme implementers as they monitor and evaluate existing programmes and design new strategies for demographic, social, and health policies in Sierra Leone.
As in 2008, the 2013 SLDHS survey was designed to cover the entire country. However, unlike the 2008 survey, where disaggregation of data was limited to regional levels, the 2013 SLDHS went further to disaggregate data at the district level. The survey collected information on demographic and health issues from a sample of women of reproductive age 15-49, and also from a sample of men age 15-59 in a subsample of households.
Sample survey data [ssd]
- Household
- Individual
- Children aged 0-5
- Children aged 5-14
- Women aged 15 to 49
- Men aged 15 to 59
Scope
The 2013 Sierra Leone Demographic and Health Survey covered the following topics:
HOUSEHOLD
• Usual members and visitors in the selected households
• Background information on each person listed, such as relationship to head of the household, age, sex, and highest educational attainment
• Characteristics of the household's dwelling unit, such as the source of water, type of toilet facilities, type of fuel used for cooking, materials used for the floor, roof and walls of the house, and ownership of various durable goods (these items are used as proxy indicators of the household's socioeconomic status)
• Child labor (for children aged 5 to 14)
• Inpatient health expenditures
• Outpatient health expenditures
• Weight, height and hemoglobin measurement for children age 0-5
• Weight, height, hemoglobin measurement and HIV testing for women age 15-49
• Weight, height, hemoglobin measurement and HIV testing for men age 15-59
INDIVIDUAL WOMAN
• Background characteristics
• Birth history
• Knowledge, attitudes, and practice of family planning, as well as exposure to family planning messages
• Maternal health, including antenatal, delivery, and postnatal care
• Immunisation and health of children under age 5
• Breastfeeding and infant feeding practices
• Marriage, sexual activity, and husband’s background characteristics
• Fertility preferences
• Employment and gender roles
• Knowledge of AIDS and other STIs
• Maternal mortality
• Female genital cutting
• Domestic violence
INDIVIDUAL MAN
• Background characteristics
• Reproduction
• Knowledge and attitudes related to family planning and exposure to family planning messages
• Marriage and sexual activity
• Fertility preferences
• Employment and gender roles
• Knowledge of HIV/AIDS and other STIs
• Miscellaneous health issues, including male circumcision
• Domestic violence
Coverage
National coverage
Producers and sponsors
| Name | Affiliation |
|---|---|
| Statistics Sierra Leone (SSL) | Government of Sierra Leone |
| Name | Affiliation | Role |
|---|---|---|
| Ministry of Health and Sanitation | Government of Sierra Leone | Collaborated in conducting the study |
| ICF International | The DHS Program | Provided technical assistance |
| Name | Role |
|---|---|
| Government of Sierra Leone | Funded the study |
| UK Department for International Development | Funded the study |
| United Nations Population Fund | Funded the study |
| World Bank | Funded the study |
| United Nations Development Programme | Funded the study |
| World Health Organization | Funded the study |
| Food and Agricultural Organization | Funded the study |
| World Food Programme | Funded the study |
| United Nations Children’s Fund | Funded the study |
| KfW Development Bank | Funded the study |
Sampling
The 2013 SLDHS sample was designed to produce reliable estimates for important variables for the country as a whole, for urban and rural areas, and for each of Sierra Leone's four regions and 14 districts. The sample was first stratified to provide adequate representation of urban and rural areas, as well as all regions and districts. Then, the sample was selected in two stages. The first stage involved selecting primary sampling units (PSUs), also called clusters, based on the list of enumeration areas (EAs) created in the 2004 Sierra Leone General Population and Housing Census. The enumeration areas provided the master frame for drawing 435 clusters (277 rural and 158 urban), selected with a probability proportional to their size. The sampling frame excluded the population living in collective housing units, such as hotels, hospitals, work camps, prisons, or boarding schools. In the second stage of selection, 30 households were systematically selected from each cluster.
All women age 15-49 who were usual household members or who spent the night before the survey in the selected households were eligible for individual interviews. In addition, in a subsample of every second household selected for the survey, all men age 15-59 were selected for interview. In this subsample, all women and men eligible for the individual survey were also eligible for the HIV test. In addition, in this subsample of households, all women and men eligible for the survey and all children age 6-59 months were eligible for the anaemia test. Finally, in the same subsample of households, all women and men eligible for the survey and all children under the age 5 were eligible for anthropometric (height and weight) measurements to determine their nutritional status.
See Appendix A in the final report for details
A total of 13,006 households were selected for the sample, of which 12,724 were occupied. Of the occupied households, 12,629 were successfully interviewed, yielding a response rate of 99 percent.
In the interviewed households, 17,132 eligible women were identified for individual interview; of these, complete interviews were conducted with 16,658 women, yielding a response rate of 97 percent. In the subsample of households selected for the men’s survey, 7,537 eligible men were identified and 7,262 were successfully interviewed, yielding a response rate of 96 percent.
Due to the non-proportional allocation of the sample to the different districts and to their urban-rural areas, sampling weights are required for any analysis using 2013 SLDHS data to ensure the actual representativeness of the survey results at the national as well as district level. Because the 2013 SLDHS sample was a two-stage stratified cluster sample, sampling weights were calculated based on sampling probabilities separately for each sampling stage and for each cluster.
The design weight is adjusted for household non-response and individual non-response to get the sampling weights for households and for women and men respectively. Non-response is adjusted at the sampling stratum level. For the household sampling weight, the household design weight is multiplied by the inverse of the household response rate, by stratum. For the women’s individual sampling weight, the household sampling weight is multiplied by the inverse of the women’s individual response rate, by stratum. For the men’s individual sampling weight, the household sampling weight for the male sub-sample is multiplied by the inverse of the men’s individual response rate, by stratum. After adjusting for non-response, the sampling weights are normalised to get the final standard weights that appear in the data files. The normalisation process is done to obtain a total number of unweighted cases equal to the total number of weighted cases at the national level, for the total number of households, women, and men separately. Normalisation is done by multiplying the sampling weight by the estimated sampling fraction obtained from the survey for the household weight, the individual woman’s weight, and the individual man’s weight. The normalised weights are relative weights that are valid for estimating means, proportions, ratios, and rates, but they are not valid for estimating population totals or pooled data. The sampling weights for HIV testing are calculated in a similar way, but the normalisation of the HIV weights is different. The individual HIV testing weights are normalised at the national level for women and men together so that HIV prevalence estimates calculated for women and men together are valid.
Further details on the sample weight calculation are given in Appendix A.4 in the final report.
Survey instrument
The 2013 SLDHS used three questionnaires, namely, a Household Questionnaire, a Woman’s Questionnaire, and a Man’s Questionnaire. These questionnaires were based on the models developed by the MEASURE DHS Program, but additions and modifications were made to the model questionnaires to adapt them to specific situations and the lexicon of Sierra Leone.
The Household Questionnaire was used to list all usual household members, as well as non-members who spent the night preceding the interview in the selected households. Some basic information was collected on the characteristics of each person listed, including age, sex, education, and relationship to the head of household. The Household Questionnaire also included a module on child labour. In addition, several questions were included to determine the physical characteristics of the dwelling, such as source of water, presence of sanitation facilities, and availability of durable goods. The Household Questionnaire was also used to identify people eligible for the individual interview, that is, women age 15-49 and men age 15-59. In addition, the Household Questionnaire was used to register people eligible for anthropometric measurements and the collection of blood samples for anaemia and HIV testing.
The Woman’s Questionnaire was used to collect information from all women of reproductive age (15-49). The set of questions on domestic violence sought to obtain information on women’s experience of violence. The questions were administered to one woman per household in the subsample households that were not selected for the men’s survey. In households with more eligible women, special procedures (use of a ‘Kish grid’) were followed to ensure that the woman interviewed about domestic violence was randomly selected.
The Man’s Questionnaire was administered to all men age 15-59 living in every second household in the sample. In every household selected for the Man’s Questionnaire, one man was randomly selected to be administered the set of questions on domestic violence.
Data collection
| Start | End |
|---|---|
| 2013-06 | 2013-10 |
| Name | Affiliation |
|---|---|
| Statistics Sierra Leone | Government of Sierra Leone |
Training and Pretest
All field personnel were trained for the pretest for four weeks, between April and May 2013, at SSL’s central office in Freetown. After the training, pretest fieldwork was conducted over a one-week period in two urban clusters and two rural clusters. Even though more than 150 men and women received training, only 10 were selected for the pretest exercise.
As part of the pretest, health technicians practiced weighing and measuring men, women, and children, as well as collecting and handling blood samples for anaemia and HIV testing. The training course consisted of instructions regarding interviewing techniques and field procedures, a detailed review of items on the questionnaires, instruction and practice in weighing and measuring children and in the collection of blood samples, mock interviews between participants in the classroom, and practice interviews. A two-week refresher training class was conducted between May and June 2013, prior to launching the fieldwork.
Fieldwork
Fieldwork was launched in June 2013 and completed in October 2013. There were a total of 24 field teams, each consisting of one supervisor, one field editor, one health technician, two female interviewers, and one male interviewer. Each team was provided with a vehicle. After a few weeks of fieldwork, the SSL restructured the field personnel and reduced the number of teams from the initial 24 to 18.
SSL, through the Publicity Subcommittee, organised and implemented a series of publicity activities, including radio discussions across the country before the beginning of fieldwork. SSL also developed brochures on HIV/AIDS and anaemia, which were given to survey respondents during the fieldwork.
Data processing
All questionnaires for 2013 SLDHS were sent to the SSL central office in Freetown, where office editors reviewed them and manually recorded the codes to the few questions without pre-coded answers. The data were processed using CSPro (Census and Survey Processing computer package). Data entry and editing were initiated almost immediately after the beginning of fieldwork. Data processing, consisting of editing, data entry, 100 percent double entry, final editing, and verification, was completed in November 2013.
Data appraisal
The estimates from a sample survey are affected by two types of errors: nonsampling errors and sampling errors. Nonsampling errors are the result 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 2013 Sierra Leone Demographic and Health Survey (SLDHS) to minimize this type of error, nonsampling errors are impossible to avoid and difficult to evaluate statistically.
Sampling errors, in contrast, can be evaluated statistically. The sample of respondents selected in the 2013 SLDHS 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 formulae for calculating sampling errors. However, the 2013 SLDHS 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 2013 SLDHS is a SAS procedure. This procedure 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.
Further details on sampling errors calculation are given in Appendix B of the final report.
Tables were produced to review the quality of the data:
- Household age distribution
- Age distribution of eligible and interviewed women
- Age distribution of eligible and interviewed men
- Completeness of reporting
- Births by calendar years
- Reporting of age at death in days
- Reporting of age at death in months
- Nutritional status of children based on the NCHS/CDC/WHO International Reference Population
- Completeness of information for dead sisters
- Sibship size and sex ratio of siblings
Note: The tables are presented in APPENDIX C of the final report.
Data Access
| Name | URL | |
|---|---|---|
| The DHS Program | http://www.DHSprogram.com | archive@dhsprogram.com |
Request Dataset Access
The following applies to DHS, MIS, AIS and SPA survey datasets (Surveys, GPS, and HIV).
To request dataset access, you must first be a registered user of the website. You must then create a new research project request. The request must include a project title and a description of the analysis you propose to perform with the data.
The requested data should only be used for the purpose of the research or study. To request the same or different data for another purpose, a new research project request should be submitted. The DHS Program will normally review all data requests within 24 hours (Monday - Friday) and provide notification if access has been granted or additional project information is needed before access can be granted.
DATASET ACCESS APPROVAL PROCESS
Access to DHS, MIS, AIS and SPA survey datasets (Surveys, HIV, and GPS) is requested and granted by country. This means that when approved, full access is granted to all unrestricted survey datasets for that country. Access to HIV and GIS datasets requires an online acknowledgment of the conditions of use.
Required Information
A dataset request must include contact information, a research project title, and a description of the analysis you propose to perform with the data.
Restricted Datasets
A few datasets are restricted and these are noted. Access to restricted datasets is requested online as with other datasets. An additional consent form is required for some datasets, and the form will be emailed to you upon authorization of your account. For other restricted surveys, permission must be granted by the appropriate implementing organizations, before The DHS Program can grant access. You will be emailed the information for contacting the implementing organizations. A few restricted surveys are authorized directly within The DHS Program, upon receipt of an email request.
When The DHS Program receives authorization from the appropriate organizations, the user will be contacted, and the datasets made available by secure FTP.
GPS/HIV Datasets/Other Biomarkers
Because of the sensitive nature of GPS, HIV and other biomarkers datasets, permission to access these datasets requires that you accept a Terms of Use Statement. After selecting GPS/HIV/Other Biomarkers datasets, the user is presented with a consent form which should be signed electronically by entering the password for the user's account.
Dataset Terms of Use
Once downloaded, the datasets must not be passed on to other researchers without the written consent of The DHS Program. All reports and publications based on the requested data must be sent to The DHS Program Data Archive in a Portable Document Format (pdf) or a printed hard copy.
Download Datasets
Datasets are made available for download by survey. You will be presented with a list of surveys for which you have been granted dataset access. After selecting a survey, a list of all available datasets for that survey will be displayed, including all survey, GPS, and HIV data files. However, only data types for which you have been granted access will be accessible. To download, simply click on the files that you wish to download and a "File Download" prompt will guide you through the remaining steps.
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
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 | |
|---|---|---|---|
| Information about The DHS Program | The DHS Program | reports@DHSprogram.com | http://www.DHSprogram.com |
| General Inquiries | The DHS Program | info@dhsprogram.com | http://www.DHSprogram.com |
| Data and Data Related Resources | The DHS Program | archive@dhsprogram.com | http://www.DHSprogram.com |
Metadata production
DDI_SLE_2013_DHS_v01_M_WB
| Name | Affiliation | Role |
|---|---|---|
| Development Data Group | The World Bank | Metadata preparation |
2014-09-30
Metadata version
Version 01 (September 2014). Metadata is excerpted from "Sierra Leone Demographic and Health Survey 2013" Report.