Multiple Indicator Survelliance 1997-1998
Nepal, 1997
Identification
NPL_1998_NMIS_v01_M
Multiple Indicator Survelliance 1997-1998
Sixth Cycle
| Name | Country code |
|---|---|
| Nepal | NPL |
Other Household Survey [hh/oth]
The Nepal Multiple Indicator Surveillance (NMIS) began in 1994, with a first cycle in early 1995 on Health and Nutrition that covered a number of indicators necessary to assess progress toward development goals. The NMIS was designed as an-ongoing monitoring scheme rather than a one-off survey.
The NMIS process comprises repeated cycles of data collection, analysis, interpretation, and communication of results to stimulate action. Each cycle focuses on a set of priority issues for the health, well-being and rights of children also for the whole population of Nepal. A steering group from the National Planning Commission, Central Bureau of Statistics and relevant line ministries agrees the focus of each cycle. The Steering Group nominates a technical group to develop and agree the cycle plan and instruments of data collection for each cycle as well as to play a key role in interpreting NMIS results and ensuring their use.
The five cycles of NMIS that have taken place so far are:
Cycle 1 on Health and Nutrition in early 1995;
Cycle 2 on Primary Education in spring/summer 1995;
Cycle 3 on Diarrhoea, Water and Sanitation in the first half of 1996;
Cycle 4 on Early Childhood Feeding, Nutrition and Development in the autumn of 1996; and
Cycle 5 on Care during Pregnancy and Delivery in spring 1997.
The findings of the first five cycles of the NMIS incidentally demonstrate that there are problems with delivery of public services in Nepal. Access to services is very limited in some parts of the country and the quality of services that are available is often poor. For example, access to primary education has been explored in NMIS cycle 22 and found to be poor in some areas, especially for girls, and access to and quality of antenatal and delivery services has been shown to be poor in NMIS cycle 5.
This sixth cycle of the NMIS is a Service Delivery Survey. It focuses particularly on the delivery of government health and agriculture services. These services were chosen as essential basic services in a country whose population are mainly subsistence farmers. Less detailed information about other public services is also collected and the survey also provides information about perceptions and functions of District Administrations and Village Development Committees.
This sixth cycle of the NMIS is a Service Delivery Survey. It focuses particularly on the delivery of government health and agriculture services. These services were chosen as essential basic services in a country whose population are mainly subsistence farmers. Less detailed information about other public services is also collected and the survey also provides information about perceptions and functions of District Administrations and Village Development Committees.
Service Delivery Surveys
Effective provision of key public services is recognised as an important part of development. The old method of central planning of services, with little reference to local conditions and no reference at all to the population being 'served', has clearly not worked. New ideas of partnership with civil society as part of good governance are gaining wide acceptance as the way forward. Ideally, services should be responsive to the needs and wishes of the population, who should have a say in the planning and delivery of services. This new paradigm means asking the population about their views and experience of present services, and about their suggestions and preferences for services in the future. Of course, the budget for public services is always limited, especially in countries such as Nepal. But this is all the more reason for ensuring that what money there is is spent on services that are acceptable to the intended users and considered likely to be effective, on the basis of evidence. This implies that planning of services should be based on evidence of impact, coverage and costs6. Information about these factors has to come from asking the population for whom the services are intended. This is the basis for service delivery surveys - asking the population in a given area about their use, experience and perceptions of services. Such surveys have been carried out in a number of countries, using the method of Sentinel Community Surveillance, and focusing on different key public services.
The Nepal Multipie Indicator Surveillance (NMIS) uses a methodology known as Sentinel Community Surveillance (SCS). It has the underlying aim of 'building the community voice into planning'. In NMIS cycle six, the focus is on factors associated with access to and experience and perceptions of health and agriculture services. NMIS is being conducted to collect community based information for the monitoring the National Programme of Action for the Children and Development for the 1990s set in line with the World Summit for Children, 1990. Data are collected from cluster sites, selected to be representative of a district, a region or a country.
Sample survey data [ssd]
Household
Version
Version 03: Cleaned, edited, anonymized, final data set.
1998-12
Scope
NMIS Cycle 6 covers the following:
- HOUSEHOLDS: Government health services and agriculture services; role of VDCs. Questions on health services include experiences with health services, based on family members who used government health services during the month prior to the survey.
- KEY INFORMANTS of the communities, DHO, DAO, LDO, VDC, DDC: health services; agriculture services
- GOVERNMENT HEALTH FACILITY: Institutional reviews
- AGRICULTURE/ LIVESTOCK SERVICES CENTRES: Institutional reviews
- MEMBERS OF FOCUS GROUP DISCUSSIONS: health services and agricultural services
Coverage
National Urban/ Rural Areas Development Regions Ecological Zones Eco-Development Regions
Households and Household members
Producers and sponsors
| Name | Affiliation |
|---|---|
| National Planning Commission Secreteriat | His Majesty's Government |
| Name | Affiliation | Role |
|---|---|---|
| United Nations Children's Fund Nepal | Technical assistance | |
| Central Bureau of Statistics | National Planning Commission Secretariat | Field work and analysis of findings |
| Name | Role |
|---|---|
| His Majesty's Government | Funding |
| United Nations Children's Fund Nepal | Financial support |
| Name | Affiliation | Role |
|---|---|---|
| Dr. Ann Cockroft, Consultant | CIET International | Instrument Design |
| Mrs. Savitri Singh, Project Director | Central Bureau of Statistics | |
| Mr. Krishna Prasaf Shrestha, Project Coordinator | Central Bureau of Statistics | |
| Mr. Stewart McNab, Representative | UNICEF Nepal | Facilitation |
| Mr. Fikre Y. Menkir, Planning Officer | UNICEF Nepal | Facilitation |
Sampling
The NMIS uses a methodology known as Sentinel Community Surveillance (SCS). It has the underlying aim of 'building the community voice into planning'. SCS can be described as a multi-sectoral community-based information management system. There are a number of particular features of the SCS methodology:
- Data are collected from cluster sites, selected to be representative of a district, a region or a country.
- Typically, cluster sites are communities of around 120 households, and all households in the site are included in data collection.
- SCS is a repeated cyclical process, with each cycle including planning and instrument design, data collection, data analysis and interpretation, and communication of results.
- Each cycle focuses on a particular area or problem, rather than trying to collect data on a wide range of problems.
- Quantitative data from household questionnaires are combined with qualitative data from focus groups, key informant interviews and institutional reviews from the same communities (that is, the data are coterminous) to allow a better understanding of the quantitative data. This combined analysis is called mesoanalysis11.
- Data analysis is not only in terms of indicators (for example, rate of childhood diarrhoea) but also in terms of risk (for example the risk of diarrhoea in a child with access to safe water compared with a child who does not have access to safe water).
- Data analysis, and especially risk analysis, is intended to produce results in a form that can be useful for planning at household, community, district and national levels.
- The same sites are revisited in subsequent cycles of data collection, allowing easy estimation of changes over time or as a result of intervention.
- Each cycle of data collection and analysis requires a communication strategy to get the information to those who need it for planning.
Transfer of skills of data collection, analysis and communication over a number of cycles is an explicit aim of the methodology.
A key feature of SCS is the ability to do risk analysis to look at causes. In NMIS cycle six the focus is on factors associated with access to and experience and perceptions of health and agriculture services.
SCS is deliberately designed to concentrate data collection efforts: in time (a series of cycles in the sentinel sites, at approximately 6 monthly intervals); in space (representative communities are surveyed rather than collecting data from all communities); and in subject matter (each cycle focuses on one area at a time, rather than trying to collect all possible data on every occasion). SCS employs a type of cluster survey methodology, but the clusters are larger than in many cluster surveys: typically 100-120 households per site, rather than the 10-50 used in most cluster surveys. And in the SCS method, there is no sampling within each site; every household is included. This gives greater statistical power in the data analysis and also allows the linkage of data from the household questionnaires to other, mainly qualitative, data from the same sites. This data relating to the whole site is combined with the household data in a mesoanalysis11.
A key issue in the SCS methodology and in the NMIS is the selection of sites so as to be representative. In some countries, random sampling is not a possibility because no adequate sampling frame exists. In these situations, purposive selection is used, drawing on local knowledge of conditions to choose sites as representative as possible of the situation in a district, region or country. When possible, random sampling methods are used and this is the case in Nepal, where a reasonably good census sampling frame exists. In both cases, stratification is first used to ensure that certain types of sites are included in proportion to their occurrence in the population. For example, stratification can be by urban and rural sites, or by ecological zones. In the NMIS, the sample sites for the NMIS were drawn by the Central Bureau of Statistics (CBS), after stratification into development regions, ecological zones and urban/rural sites. The details of the sampling method and the selected sites are given in the report of the first NMIS cycle and the annexes to that report.
THE NMIS SAMPLE SITES
The same sites for the first five NMIS cycles, are selected by a multistage random sampling method for NMIS six cycle. The sites are representative of the country, of the 5 development regions, of the 3 ecological zones, of the 15 eco-development regions, and of urban and rural situations. The rural sites were selected primarily to give representation of the 15 eco-development regions but in 18 districts there are sufficient sites (4 or more) to ensure reasonable district representativeness. In a further 19 districts, only 1-2 sites were selected so they cannot be relied upon to be representative of that district. Note that representation of the 15 eco-development regions is among the rural sites only; the urban sites are stratified separately and are not intended to be part of the representation of the different eco-development regions. This reflects the high proportion of the population living in rural communities (around 90%) and the difficulty of having a large enough urban samples to stratify separately among the 15 eco-development regions.
There are a total of 144 sites in the sample: 126 rural and 18 urban. The location of the sites is shown on the map in Annex 1 of the report titled: Service Delivery Survey: Health and Agriculture Services, Nepal Multiple Indicator Surveillance, Sixth Cycle (November 97 - January 98). Annex 1 also gives the names of the districts in the NMIS sample, with the number of sites in each. It also includes a list of all Districts in Nepal grouped into the 15 eco-development regions. This is intended for officials from non-NMIS Districts who read the report to find which results most nearly approximate to their situation (the results for the relevant eco-development region).
Household information was collected from:
- 18,580 households
- 108,899 people
- 2,778 people who used government health services in the last month
A total of 18,770 households were visited. Information was available from 18,580 (99%) households. There were 188 (1%) households had no one at home at the time of the visit and only two households refused to provide information. The survey included 108,899 people.
The sample sizes of Districts were not proportional to the populations of the Districts and weights were calculated to take this into account when producing national indicators. These weights are used when giving national level indicators.
The Epi Info programme CSAMPLE was used to calculate weighted values of key indicators. In practice, the weighted values are close to the unweighted values.
For details on the weighted estimates, See the Report on Service Delivery Survey: Health and Agriculture Services, Nepal Multiple Indicator Surveillance, Sixth Cycle (November 97 - January 98). The weighted and unweighted values for key indicators are shown in annex 4. Unless stated otherwise, values of indicators quoted in the results section of the report for the whole of Nepal are weighted. Values of indicators at subnational levels (such as eco development regions and in urban and rural sites separately) given in Annex 5 are not shown weighted. The weights give the correct balance of individual areas in national figures, for example taking into account the relative over sampling of mountain eco development regions and urban sites.
Survey instrument
The following instruments were used for data collection for NMIS Six cycle surveillance:
- Household questionnaire
- Focus group discussion on health services
- Focus group discussion on agriculture/ livestock services
- Government Health facility institutional review
- Agriculture/ Livestock facility institutional review
- Community key informant interview
- VDC (Village Development Committee) chairman interview
- DDC (District Development Committee) chairman interview
- DHO (District Health Officers) interview
- DAO (District Agricultural Officers) interview
- LDO (Local Development Officers) interview
The questionnaire and guides for interview were published in Nepali language. An English version is provided in the Report on Service Delivery Survey: Health and Agriculture Services, Nepal Multiple Indicator Surveillance, Sixth Cycle (November 97 - January 98).
Data collection
| Start | End | Cycle |
|---|---|---|
| 1997-10-01 | 1997-11-30 | Six |
| Name | Affiliation |
|---|---|
| Central Bureau of Statistics | National Planning Commission Secretariat |
The role of the supervisor was to coordinate field data collection activities, including management of the field teams, supplies and equipment, maps and listings, coordinate with local authorities concerning the survey plan and make arrangements for accomodation and travel. Additionally, the field supervisor assigned the work to the interviewers, spot checked work, and sent completed questionnaires and progress reports to the central office.
Field visits were also made by a team of central staff on a periodic basis during fieldwork.The senior staff of Central Bureau of Statistics also made frequent visits to field teams to provide support and to review progress.
TRAINING AND FIELDWORK
Field staffs were recruited in October 1997. They were recruited from and trained in five regional centres: Kathmandu, Birgunj, Nepalgunj, Pokhara and Sunsari. Twenty-six (26) teams, each containing 4 or 5 members were recruited. The 30 field supervisors were trained in Kathmandu.
The field survey was carried out over a period of 2 months from October to November 1997.
When communities were revisited during cycle 6, the opportunity was taken to give them a summary of the results of cycle 5 and conduct focus groups to discuss the implications of the key findings and the ways in which important messages might best be disseminated.
The Social Section of the Central Bureau of Statistics provided overall fieldwork coordination and supervision.
Data processing
Data editing took place at a number of stages throughout the processing, including:
- Office editing and coding
- During data entry
- Structure checking and complete double entry validation
The household data were entered twice and validated using Epi Info.
Data appraisal
Standard deviations and 95% Confidence Intervals were calculated for specific variables. These estimates are provided in the Report on Service Delivery Survey: Health and Agriculture Services, Nepal Multiple Indicator Surveillance, Sixth Cycle (November 97 - January 98).
The questionnaires and other data collection instruments, after translation into Nepali, were piloted several times to ensure that they were appropriate to the households, health facility workers and focus groups concerned and that the coding and data entry arrangements were satisfactory.
Data Access
| Name | Affiliation | URL | |
|---|---|---|---|
| Director General | Central Bureau of Statistics | http://cbs.gov.np/?page_id=17 | archive@cbs.gov.np |
| Is signing of a confidentiality declaration required? | Confidentiality declaration text |
|---|---|
| yes | Confidentiality of the respondents is guaranteed by Article 8 of Statistics Act 1958. "Any information or details relating to any person, family, firm or company, which has been supplied, obtained or prepared pursuant to section 3, section 4, section 5, section 6 ot section 7, or any part of such information or details, shall not be disclosed or published directly except to the Director General or to any officer of the Bureau without the written person or of his authorised representative supplying such information or details." |
The dataset has been anonymized and is available as a Public Use Dataset. It is accessible to all users for statistical and research purposes only, under the following terms and conditions:
- The data and other materials will not be redistributed or sold to other individuals, institutions, or organizations without the written agreement of the Central Bureau of Statistics (CBS).
- The data will be used for statistical and scientific research purposes only. They will be used solely for reporting of aggregated information, and not for investigation of specific individuals or organizations.
- No attempt will be made to re-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 CBS.
- No attempt will be made to produce links among datasets provided by the CBS or among data from the CBS and other datasets that could identify individuals or organizations.
- Any books, articles, conference papers, theses, dissertations, reports, or other publications that employ data obtained from the CBS will cite the source of data in accordance with the Citation Requirement provided with each dataset.
- An electronic copy of all reports and publications based on the requested data will be sent to the CBS.
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:
Central Bureau of Statistics (CBS), Nepal. Nepal Multiple Indicator Surveillance 1997/98. Ref. NPL_1998_v01_M. Dataset downloaded from http://cbs.gov.np/nada/index.php/catalog on [date].
Disclaimer and copyrights
The Central Bureau of Statistics, Nepal bears no responsibility for any outcomes or for interpretations or inferences arising from the use of the dataset.
Contacts
| Name | Affiliation | URL | |
|---|---|---|---|
| National Data Archive, Publication, Distribution and Library Section | Central Bureau of Statistics | archive@cbs.gov.np | http://cbs.gov.np/?page_id=17 |
Metadata production
DDI_NPL_1998_NMIS_v01_M
| Name | Affiliation | Role |
|---|---|---|
| Social Statistics Section | Central Bureau of Statistics | Metadata Documentation |
| Accelerated Data Program | International Household Survey Network | Editing for IHSN Survey Catalog |
2012-03-12
Metadata version
Version 1.0 - Central Bureau of Statistics - Original documentation of the study.
Version 2.0 - Edited version by ADP based on Version 1.0 of CBS downloaded from http://cbs.gov.np/nada/index.php/catalog on 12 March 2013.