{"type":"survey","doc_desc":{"title":"DOM_2007_DHS_v01_M","idno":"DDI_DOM_2007_DHS_v01_M","producers":[{"name":"World Bank, Development Economics Data Group","abbreviation":"DECDG","affiliation":"","role":"Generation of DDI documentation"}],"prod_date":"2012-03-19"},"study_desc":{"title_statement":{"idno":"DOM_2007_DHS_v01_M","title":"Encuesta Demogr\u00e1fica y de Salud 2007","alt_title":"EDS 2007 \/ DHS 2007","translated_title":"Demographic and Health Survey 2007"},"authoring_entity":[{"name":"Centro de Estudios Sociales y Demogr\u00e1ficos (CESDEM)","affiliation":""}],"oth_id":[{"name":"Consejo Presidencial del SIDA (COPRESIDA)","affiliation":"","email":"","role":"Coordination"},{"name":"Comisi\u00f3n Ejecutiva para la Reforma del Sector Salud (CERSS)","affiliation":"","email":"","role":"Coordination"},{"name":"Direcci\u00f3n General de Control de Infecciones de Transmisi\u00f3n Sexual y SIDA","affiliation":"","email":"","role":"Technical assistance"},{"name":"Oficina Nacional de Estad\u00edstica","affiliation":"","email":"","role":"Technical assistance"}],"production_statement":{"producers":[{"name":"Macro International Inc.","affiliation":"","role":"Technical assistance"}],"funding_agencies":[{"name":"Agencia de los Estados Unidos para el Desarrollo Internacional","abbreviation":"USAID","role":"Funding"}]},"distribution_statement":{"contact":[{"name":"Centro de Estudios Sociales y Demogr\u00e1ficos, CESDEM","affiliation":"","email":"cesdem@codetel.net.do","uri":""},{"name":"General Inquiries","affiliation":"","email":"info@measuredhs.com","uri":"www.measuredhs.com"},{"name":"Data and Data Related Resources","affiliation":"","email":"archive@measuredhs.com","uri":"www.measuredhs.com"}]},"series_statement":{"series_name":"Demographic and Health Survey [hh\/dhs]","series_info":"Incluyendo una encuesta experimental en 1999, el CESDEM (Centro de Estudios Sociales y Demogr\u00e1ficos) ha levantado sexto encuestas nacionales de demograf\u00eda y salud 1986, 1991, 1996, 1999, 2002, 2007 ( y tres dentro del marco del programa DHS, la primera en 1996 y la m\u00e1s reciente en 2007)."},"study_info":{"abstract":"El Centro de Estudios Sociales y Demogr\u00e1ficos (CESDEM) pone a disposici\u00f3n de los dise\u00f1adores de pol\u00edticas y de programas de desarrollo a nivel nacional, regional y provincial, del sector p\u00fablico y privado, la Encuesta Demogr\u00e1fica y de Salud 2007 (ENDESA 2007), la m\u00e1s completa investigaci\u00f3n generadora de informaci\u00f3n sociodemogr\u00e1fica y de salud, para validar con cifras actualizadas y confiables los cambios recientes registrados en \u00e9stas \u00e1reas.\n\nA lo largo de las \u00faltimas d\u00e9cadas las Encuestas Demogr\u00e1ficas y de Salud realizadas en el pa\u00eds se han constituido en la principal fuente de informaci\u00f3n sobre m\u00faltiples aspectos relacionados con la salud materno-infantil y general, los comportamientos demogr\u00e1ficos, la situaci\u00f3n habitacional, el acceso a los servicios b\u00e1sicos, las caracter\u00edsticas educacionales y, en s\u00edntesis, las condiciones de vida de la poblaci\u00f3n.\n\nLas sucesivas investigaciones llevadas a cabo cada cinco o seis a\u00f1os\u2014las anteriores corresponden a 1986, 1991, 1996 y 2002\u2014han venido ampliando de manera sostenida la diversidad y el detalle de los temas investigados, respondiendo as\u00ed tanto a la demanda de m\u00e1s y mejor informaci\u00f3n con respecto a antiguos y nuevos problemas y desaf\u00edos en el campo de la salud, como a la necesidad de realizar an\u00e1lisis m\u00e1s exhaustivos sobre las relaciones entre los aspectos estudiados y los factores que inciden en ellos. Cabe destacar que a partir de la ENDESA 2002 se ha proporcionado informaci\u00f3n a nivel provincial para la mayor\u00eda de los indicadores estudiados, gracias al incremento sustancial del tama\u00f1o de las muestras, y adem\u00e1s se ha cuantificado la prevalencia del VIH a nivel nacional y regiones del pa\u00eds, a trav\u00e9s una prueba aplicada a una muestra representativa de mujeres y hombres registrados en el cuestionario de hogar.\n\nLas informaciones derivadas de las encuestas antes citadas han sido de extraordinaria utilidad para las instituciones nacionales e internacionales que trabajan en las \u00e1reas de salud, poblaci\u00f3n y desarrollo social, seg\u00fan se pone de manifiesto en algunas de sus principales aplicaciones resumidas en los p\u00e1rrafos siguientes.\n\n- La producci\u00f3n de estimaciones consistentes sobre las tendencias en los componentes del cambio demogr\u00e1fico durante las \u00faltimas d\u00e9cadas, en especial la fecundidad por edad y la mortalidad por sexo y edad, posibilitando as\u00ed la realizaci\u00f3n y actualizaci\u00f3n peri\u00f3dica de proyecciones detalladas de poblaci\u00f3n a nivel tanto nacional como subnacional.\n- La determinaci\u00f3n de los cambios en los diversos aspectos de las condiciones de vida en el pa\u00eds\u2014vivienda y servicios b\u00e1sicos, posesi\u00f3n de bienes durables, educaci\u00f3n, participaci\u00f3n en actividades econ\u00f3micas, entre otros\u2014informaci\u00f3n que a su vez ha servido de base para la producci\u00f3n de indicadores sobre los niveles de pobreza y las necesidades insatisfechas en las distintas \u00e1reas del territorio nacional (Mapas de Pobreza).\n- El seguimiento, monitoreo, orientaci\u00f3n y evaluaci\u00f3n de los avances en los programas nacionales, p\u00fablicos y privados, de planificaci\u00f3n familiar, no s\u00f3lo en cuanto a la oferta de servicios anticonceptivos y de salud reproductiva sino tambi\u00e9n en lo concerniente a los programas de informaci\u00f3n, educaci\u00f3n y comunicaci\u00f3n en estas \u00e1reas.\n- El establecimiento de l\u00edneas de base y el monitoreo de avances en el cumplimiento de objetivos y metas en materia de salud y desarrollo social, establecidos en planes y programas enmarcados o no dentro de cumbres y acuerdos internacionales. Entre estos planes y programas pueden mencionarse: el Plan Nacional de Acci\u00f3n en Favor de la Infancia, derivado de los acuerdos de la Cumbre Mundial en Favor de la Infancia (1990); el Programa Nacional de Atenci\u00f3n Materno-Infantil y los programas de Rehidrataci\u00f3n Oral y de Reducci\u00f3n de la Mortalidad Materna e Infantil ejecutados por la SESPAS; el Plan Nacional de Desarrollo Social (en especial los componentes de Salud, Nutrici\u00f3n, Planificaci\u00f3n Familiar y Pol\u00edticas de Poblaci\u00f3n), surgido de la Cumbre Mundial de Desarrollo Social (1995); y las metas nacionales correspondientes a los Objetivos de Desarrollo del Milenio, de la Cumbre del Milenio (2000).\n- Determinaci\u00f3n de la parte correspondiente al gasto en salud de los hogares dominicanos para la elaboraci\u00f3n de las Cuentas Nacionales de Salud 2002, bajo la responsabilidad institucional de la Unidad de Cuentas Nacionales de Salud (UCNS) de la SESPAS.\n- Por \u00faltimo, los datos de la ENDESA 2002 constituyeron la base fundamental para la creaci\u00f3n de un modelo estad\u00edstico para estimar los valores de la prevalencia de desnutrici\u00f3n infantil por cada municipio y distrito municipal, que conforman el \u201cAtlas del Hambre y la Desnutrici\u00f3n en la Rep\u00fablica Dominicana\u201d, realizado por la Universidad de Tufts con el auspicio del Programa Mundial de Alimentos (PMA) y que tiene por objetivo conocer los factores que inciden en la desnutrici\u00f3n infantil, focalizar las intervenciones en esta materia y servir de base al monitoreo del primer objetivo del milenio.\n\nEl presente informe contiene en detalle los avances y los retrocesos en relaci\u00f3n con un gran n\u00famero de indicadores que permiten a las autoridades nacionales y a los investigadores y acad\u00e9micos competentes realizar evaluaciones comparativas con estudios anteriores, formular planes y proyectos y tomar decisiones encaminadas a mejorar la salud y en general la calidad de vida de la poblaci\u00f3n dominicana.\n\nAl comparar los indicadores sociodemogr\u00e1ficos y de salud de la ENDESA 2007 con las anteriores encuestas encontramos que la Rep\u00fablica Dominicana ha mejorado gradualmente importantes \u00e1reas indispensables para elevar la calidad de vida de la poblaci\u00f3n; sin embargo, esta mejor\u00eda est\u00e1 permeada por apreciables desigualdades regionales y provinciales en relaci\u00f3n al acceso, calidad y disponibilidad de los servicios y los bienes de consumo, por lo que es imperativo que las autoridades gubernamentales y las instituciones privadas, que trabajan en beneficio de los sectores mas vulnerables, intensifiquen los esfuerzos encaminados a desarrollar planes y programas tendentes a reducir los niveles de pobreza y desigualdad existentes en el pa\u00eds.","coll_dates":[{"start":"2007-03","end":"2007-08","cycle":""}],"nation":[{"name":"Dominican Republic","abbreviation":"DOM"}],"geog_coverage":"National","analysis_unit":"- Household\n- Women age 15-49\n- Men age 15-64\n- Children under five","universe":"El universo poblacional para el cuestionario individual de mujeres de la ENDESA 2007 se defini\u00f3 como la poblaci\u00f3n femenina de 15 a 49 a\u00f1os de edad de todo el pa\u00eds.","data_kind":"Sample survey data","notes":"La Encuesta Demogr\u00e1fica y de Salud Rep\u00fablica Dominicana 2007  abarca los siguientes temas:\n\n- Accesibilidad, utilizaci\u00f3n y percepci\u00f3n de los servicios de salud\n- Anticoncepci\u00f3n\n- Antropometr\u00eda\n- Cartographia\n- Conocimiento y uso de anticonceptivos \n- Disponibilidad de servicios\n- Esterilizacion:\n- Enfermedades respiratorlas\n- Fecundidad\n- Gastos directos e indirectos en salud\n- Lactancia y nutricion\n- Mortalidad infantil y de la ni\u00f1ez\n- Nupcialidad  y Exposici\u00f3n al Riesgo de Embarazo\n- Preferencias Reproductivas\n- Planificaci\u00f3n familiar\n- Prevalencia y tratamiento de fiebre\n- Prevalencia y tratamiento de diarrea\n- Reproducci\u00f3n\n- Salud materno-infantil\n- Vacunaci\u00f3n y salud para los hijos menores de 5 a\u00f1os\n- Violencia dom\u00e9stica (en la mitad de los hogares)\n- SIDA y ETS\n- SIDA e infecciones de transmisi\u00f3n sexual: conocimiento y prevenci\u00f3n","study_scope":"La Encuesta Demogr\u00e1fica y de Salud Rep\u00fablica Dominicana 2007  abarca los siguientes temas:\n\n- Accesibilidad, utilizaci\u00f3n y percepci\u00f3n de los servicios de salud\n- Anticoncepci\u00f3n\n- Antropometr\u00eda\n- Cartographia\n- Conocimiento y uso de anticonceptivos \n- Disponibilidad de servicios\n- Esterilizacion:\n- Enfermedades respiratorlas\n- Fecundidad\n- Gastos directos e indirectos en salud\n- Lactancia y nutricion\n- Mortalidad infantil y de la ni\u00f1ez\n- Nupcialidad  y Exposici\u00f3n al Riesgo de Embarazo\n- Preferencias Reproductivas\n- Planificaci\u00f3n familiar\n- Prevalencia y tratamiento de fiebre\n- Prevalencia y tratamiento de diarrea\n- Reproducci\u00f3n\n- Salud materno-infantil\n- Vacunaci\u00f3n y salud para los hijos menores de 5 a\u00f1os\n- Violencia dom\u00e9stica (en la mitad de los hogares)\n- SIDA y ETS\n- SIDA e infecciones de transmisi\u00f3n sexual: conocimiento y prevenci\u00f3n"},"method":{"data_collection":{"data_collectors":[{"name":"Centro de Estudios Sociales y Demogr\u00e1ficos (CESDEM)","abbreviation":"","affiliation":""}],"sampling_procedure":"Para el dise\u00f1o de la muestra de la Encuesta Demogr\u00e1fica y de Salud en la Rep\u00fablica Dominicana  (ENDESA 2007) se decidi\u00f3 seleccionar alrededor de 36,000 viviendas y se aplic\u00f3 el cuestionario de hogar en todos los hogares de esas viviendas. En cada hogar, todas las mujeres de 15-49 a\u00f1os y todos los hombres de 15-59 a\u00f1os fueron elegibles para un cuestionario individual y una prueba de VIH. En la mitad de las viviendas seleccionadas se aplic\u00f3 un cuestionario de hogar con el m\u00f3dulo de gastos de salud. En la otra mitad de las viviendas en los hogares encontrados se aplic\u00f3 el m\u00f3dulo de violencia dom\u00e9stica a s\u00f3lo una mujer en cada hogar.\n\nOBJETIVOS DEL DISE\u00d1O MUESTRAL\n\nEl universo o grupo principal de estudio para esta encuesta es la poblaci\u00f3n de todas las mujeres entre 15 y 49 a\u00f1os de edad y todos los hombres entre 15 y 59 a\u00f1os de edad (denominados elegibles) residentes en el territorio de la Rep\u00fablica Dominicana. Los principales objetivos del dise\u00f1o muestral fueron:\n(1) Obtener estimaciones representativas en los dominios de estudio de indicadores relevantes para la poblaci\u00f3n de mujeres de 15 a 49 a\u00f1os.\n(2) Obtener estimaciones representativas de indicadores de gastos en salud, en una muestra correspondiente a una mitad de los hogares seleccionados, que permita tener buenos niveles de confiabilidad para cada una de las regiones de salud, cada zona de residencia y el total del pa\u00eds.\n(3) Obtener estimaciones de indicadores para la poblaci\u00f3n masculina de 15 a 59 a\u00f1os, usando todos los hogares seleccionados de manera que permita tener estimaciones representativas para el total, zona urbana y rural, las regiones de salud y provincias.\n(4) Obtener estimaciones de la prevalencia de VIH para todas las mujeres y todos los hombres elegibles encontrados en cada hogar seleccionado, de manera que resulten representativas para la poblaci\u00f3n total de 15 a 49 a\u00f1os, zonas de residencia (urbano y rural), sexo y para cuatro grandes regiones del pa\u00eds.\n(5) Obtener estimaciones de violencia dom\u00e9stica para una mitad de los hogares seleccionados.\n(6) Obtener estimaciones de la mortalidad materna con el total de hogares seleccionados en todo el pais.\n(7) Los principales dominios a ser distinguidos en las tabulaciones de las caracter\u00edsticas m\u00e1s importantes son los siguientes:\n-  La Rep\u00fablica Dominicana como un todo.\n-  El total del \u00e1rea urbana y el total del \u00e1rea rural, cada uno como un dominio separado.\n-  Cada una de las nueve regiones de salud separadamente\n\nCada una de las 32 provincias separadamente para la encuesta de mujeres y hombres, con la excepci\u00f3n de la prevalencia del VIH. (8) El principal objetivo de la encuesta de la ENDESA 2007 es producir, para cada dominio, estimaciones de los diversos indicadores en consideracion, con niveles de confianza aceptables; como son los casos, de la fecundidad, mortalidad infantil, planificaci\u00f3n familiar y salud.\n\nMARCO MUESTRAL\n\nLa Rep\u00fablica Dominicana est\u00e1 dividida en 31 provincias y un Distrito Nacional. Un archivo computarizado de los sectores y segmentos para cada provincia y el Distrito Nacional, elaborado durante el Censo del 2002, fue prove\u00eddo por la Oficina Nacional de Estad\u00edstica (ONE). Se obtuvo una lista de segmentos censales (en su mayor\u00eda cada uno contiene entre 20 y 30 viviendas), y por intermedio de ellos la lista de sectores censales (en su mayor\u00eda cada sector contiene de 3 a 4 segmentos)1. Cada segmento y asimismo cada sector censal tiene una completa identificaci\u00f3n que corresponde a una combinaci\u00f3n de c\u00f3digos de provincia, municipio, secci\u00f3n, barrio o paraje y de pol\u00edgono censal donde se encuentra localizada. Adem\u00e1s, cada unidad tiene un levantamiento cartogr\u00e1fico de viviendas residenciales en ella.\n\nSe utiliz\u00f3 este marco censal de sectores censales como el marco muestral para la ENDESA 2007.\n\nESTRATIFICACION\n\nEn cada provincia, los sectores censales fueron estratificados en grupos de residencia urbana y rural. Los sectores tambi\u00e9n fueron estratificados de acuerdo a sus municipios, y dentro de cada municipio.\n\nMINIMO TAMA\u00d1O MUESTRAL PARA CADA DOMINIO\n\nEn general, el dise\u00f1o de la muestra para una encuesta del tipo de la ENDESA 2007 es estratificado, por conglomerado y en general en dos etapas. El error muestral para este dise\u00f1o tiene dos componentes: el primero corresponde a la variaci\u00f3n entre los sectores censales y el segundo a la variaci\u00f3n de los hogares dentro de los sectores censales. La variabilidad entre sectores censales es mucho mayor para las \u00e1reas urbanas que en las \u00e1reas rurales, pero la variabilidad dentro del sector censal seleccionado es menor en lo urbano que en lo rural. Por lo tanto, un importante factor en cuanto al control del error muestral es reducir el mayor componente de variabilidad que es la variaci\u00f3n entre sectores, el cual es inversamente proporcional al n\u00famero de sectores (especialmente en el \u00e1rea urbana).\n\nLa pol\u00edtica del programa internacional de encuestas DHS, dentro del cual est\u00e1 enmarcada la ENDESA 2007, es la de recomendar seleccionar un m\u00ednimo de alrededor de 40 sectores por dominio de estudio para el an\u00e1lisis adecuado de la informaci\u00f3n. Tambi\u00e9n es bien conocido que un aumento del n\u00famero de sectores en la muestra reduce el error muestral pero no en raz\u00f3n proporcional al incremento de ese n\u00famero. Espec\u00edficamente, si se doblara el n\u00famero de sectores, el error muestral se reduce s\u00f3lo un 30 por ciento del valor original.\n\nBasado en las consideraciones anteriores, para evitar altos costos de implementaci\u00f3n y de poner en compromiso la calidad de la informaci\u00f3n, se ha recomendado mantener ese m\u00ednimo de sectores (40 por dominio) para las estimaciones por dominio en la ENDESA 2007. En esta encuesta fueron seleccionados 1,428 sectores censales, cada uno de los cuales fue sometido a un proceso de actualizaci\u00f3n cartogr\u00e1fica.\n\nASIGNACION DE LA MUESTRA\n\nCon el objetivo de obtener un total aproximado de 28,000 entrevistas completas de mujeres elegibles, se utiliz\u00f3 informaci\u00f3n de la encuesta ENDESA 2002, como un instrumento de ayuda para estimar ciertos par\u00e1metros del dise\u00f1o. En dicha encuesta se seleccionaron 35,013 viviendas para conseguir un total de 23,384 entrevistas completas de mujeres elegibles que durmieron la noche anterior en el hogar. Con dicha informacion, para la ENDESA 2007 se estim\u00f3 que se necesitar\u00eda un total aproximado de alrededor de 36,000 viviendas a ser seleccionadas para obtener las 28,000 entrevistas completas. Ese total fue distribuido por provincias pero no proporcionalmente al tama\u00f1o poblacional sino para poder cumplir con los objetivos requeridos de la encuesta, tal como se puede observar en el Cuadro A.1. En consecuencia, la muestra resultante no es autoponderada, requiri\u00e9ndose factores de ponderaci\u00f3n por provincia cuando se produzcan estimaciones a un nivel diferente al provincial.\n\nSELECCION DE LA MUESTRA\n\nLa muestra resultante para la ENDESA 2007 en cada provincia es el resultado de dos etapas: en la  primera se hace una selecci\u00f3n sistem\u00e1tica de sectores censales con probabilidad proporcional a su tama\u00f1o, con el n\u00famero de viviendas en cada sector como su medida de tama\u00f1o. En una segunda etapa se seleccionaron 25 viviendas dentro de cada sector censal.\n\nPara la selecci\u00f3n de sectores en cada provincia, en la primera etapa se siguieron los siguientes pasos:\n- El n\u00famero de conglomerados a ser seleccionados en cada provincia fue calculado como la divisi\u00f3n entre el tama\u00f1o de muestra esperado en la provincia y el tama\u00f1o promedio de muestra esperado de 25 en el conglomerado. \n- La selecci\u00f3n de los sectores censales fue hecha con probabilidad proporcional a su tama\u00f1o:\n\nP1i = (a * mi) \/ ( Smi )\ndonde\na : es el n\u00famero de sectores censales a ser seleccionados en la provincia. mi : es el n\u00famero de viviendas en el i-\u00e9simo sector censal seg\u00fan el censo del 2002, a excepci\u00f3n de Santo Domingo que utilizo un marco mas reciente.\n\nSmi: es el total de viviendas en la provincia seg\u00fan censo del 2002, a excepci\u00f3n de Santo Domingo.\n- En la segunda etapa de selecci\u00f3n, 25 viviendas fueron seleccionadas dentro de cada sector muestral con una seleccion aleatoria-sistem\u00e1tica.\n- La probabilidad de selecci\u00f3n de la i-\u00e9sima vivienda est\u00e1 dado como:\nP1i = { a * mi } \/ { Smi }\nP2i = b \/ Li\ndonde\nb : es el n\u00famero de viviendas, 25 y\nLi : es el n\u00famero de viviendas actualizadas en el i-\u00e9simo sector censal.\n\nDentro de cada provincia y para cada sector censal urbano, la selecci\u00f3n se hizo en forma sistem\u00e1tica con un intervalo de selecci\u00f3n de Ii =Li \/ b. La primera selecci\u00f3n es hecha al azar dentro del rango del intervalo de selecci\u00f3n y donde b es el n\u00famero de viviendas en el sector censal a ser seleccionado.\n\nPara cada conglomerado rural, la selecci\u00f3n de los hogares se hizo en dos grupos compactos de b\/2 viviendas contiguas sobre el listado total de viviendas del sector censal..\n- Finalmente cada una de las estimaciones se calcula con un estimador de raz\u00f3n\nr = ( S wj*yj ) \/ ( S wj*xj )\ndonde la suma es llevada sobre todas las unidades de an\u00e1lisis y wj es la ponderaci\u00f3n asignada a cada unidad de an\u00e1lisis. En general yj es el valor de la variable bajo consideraci\u00f3n y xj es una variable de conteo.","coll_mode":"Face-to-face","research_instrument":"La ENDESA 2007 utiliz\u00f3 4 cuestionarios para la recolecci\u00f3n de la informaci\u00f3n: un cuestionario de hogar aplicado en 32,431 hogares; un cuestionario individual de mujeres aplicado a 27,195 mujeres de 15 a 49 a\u00f1os de edad en esos hogares, un cuestionario individual de hombres aplicado a 27,975 hombres de 15 a 59 a\u00f1os; y un cuestionario de morbilidad y gastos en salud, aplicado en la mitad de los hogares totales visitados.\n\na) En el cuestionario del hogar se investigaron, entre otros, los siguientes temas:\n-  Residentes habituales y visitantes del hogar\n-  Relaci\u00f3n de parentesco, sexo y edad de cada miembro del hogar\n-  Supervivencia de los padres de los miembros menores de 15 a\u00f1os\n-  Peso y talla de los ni\u00f1os\n-  Datos de la vivienda y del hogar\n-  Caracter\u00edsticas educativas de la poblaci\u00f3n de 5 a\u00f1os y m\u00e1s\n\nb) El contenido del cuestionario individual de mujeres comprende los siguientes grandes temas:\n-  Antecedentes de la mujer entrevistada\n-  Reproducci\u00f3n e historia de nacimientos\n-  Anticoncepci\u00f3n\n-  Embarazo y lactancia para los ni\u00f1os y ni\u00f1as menores de 5 a\u00f1os\n-  Vacunaci\u00f3n y salud para los ni\u00f1os y ni\u00f1as menores de 5 a\u00f1os\n-  Nupcialidad\n-  Preferencias de fecundidad\n-  Antecedentes del marido, residencia y trabajo de la mujer\n-  SIDA: conocimiento y prevenci\u00f3n\n- Violencia dom\u00e9stica\n- Mortalidad materna\n\nc) El cuestionario individual de hombres contiene las siguientes secciones:\n- Antecedentes de los entrevistados\n- Nupcialidad y actividad sexual\n- SIDA y enfermedades de transmisi\u00f3n sexual: conocimiento y prevenci\u00f3n\n- Otros asuntos de salud\n- Actitudes hacia la mujer\n\nd) El cuestionario de morbilidad y gastos en salud comprende los siguientes temas:\n- Caracter\u00edsticas econ\u00f3micas de los miembros del hogar de 10 a\u00f1os o m\u00e1s\n- Morbilidad y atenci\u00f3n en salud\n- Utilizaci\u00f3n de los servicios de salud\n- Gastos directos e indirectos en salud\n- Coberturas de los seguros de salud\n- Discapacidades o deficiencias de la poblaci\u00f3n","coll_situation":"Todos los hombres de 15-59 y las mujeres de 15-49 a\u00f1os en los hogares seleccionados fueron elegibles para una prueba de VIH. El protocolo para la recolecci\u00f3n y an\u00e1lisis de las muestras de sangre fue desarrollado por Macro International Inc. y se basa en una prueba an\u00f3nima y vinculada. Este protocolo se revis\u00f3 y aprob\u00f3 por el Consejo de Bio\u00e9tica de Macro International Inc. y por el Consejo Nacional de Bio\u00e9tica en Salud (CONABIOS). Se destaca en este instrumento la posibilidad de relacionar el resultado de la prueba de VIH con las caracter\u00edsticas de la persona entrevistada, teniendo en cuenta que ha de excluirse de la base de datos toda la informaci\u00f3n de identificaci\u00f3n individual, antes de vincular los datos del cuestionario con el resultado del an\u00e1lisis del VIH.\n\nToda la muestra de sangre recolectada para la prueba de VIH cont\u00f3 con su respectiva aprobaci\u00f3n, a trav\u00e9s de la firma de un consentimiento informado preparado para tal fin. Los entrevistadores(as) explicaron a los entrevistados(as) la manera de recolectar la sangre para la muestra, que los resultados ser\u00edan confidenciales y an\u00f3nimos y que ellos no sabr\u00edan el resultado de su prueba. Adicionalmente, se les entregaba un cup\u00f3n gratuito para que las personas que quisieran saber el resultado pudieran hacerse una prueba en Centros de Salud seleccionados con consejer\u00eda pre y post prueba.\nA trav\u00e9s de este procedimiento se recolectaron muestras de sangre seca en tarjetas de papel filtro, por medio a una peque\u00f1a incisi\u00f3n en un dedo, usando lancetas est\u00e9riles y auto-destructibles. En cada muestra se colocaba un c\u00f3digo de barras. Otro c\u00f3digo id\u00e9ntico se pegaba en el cuestionario de hogar en la columna correspondiente a ese entrevistado, y un tercer c\u00f3digo en una hoja de control de transmisi\u00f3n de muestras, para ayudar en el rastreo del campo al laboratorio.\n\nLas tarjetas de papel filtro se secaban durante la noche en una caja pl\u00e1stica cerrada y se empacaban individualmente en la ma\u00f1ana en fundas pl\u00e1sticas zip-loc, con un desecante y una tarjeta para monitorear la humedad. Los Jefes de Campo recolectaban las muestras secas y empacadas de los equipos de trabajo y las llevaban a la oficina del CESDEM en Santo Domingo, donde se revisaban y verificaban, para posteriormente ser enviadas al Laboratorio Nacional de Salud P\u00fablica Dr. Defill\u00f3 para ser analizadas.\n\nEn el laboratorio, los c\u00f3digos de barra eran ingresados en una base de datos, asignando a cada muestra un n\u00famero secuencial para facilitar su rastreo en los diferentes an\u00e1lisis. Las muestras se mantuvieron refrigeradas o congeladas, dependiendo del tiempo que habr\u00eda que esperar antes del an\u00e1lisis. Para analizar las muestras, primero los t\u00e9cnicos esperaban que \u00e9stas alcanzaran la temperatura ambiental.\n\nDespu\u00e9s se perforaba un c\u00edrculo de 6.3 mm de sangre seca en cada tarjeta de papel filtro, usando un instrumento especial. Cada c\u00edrculo se colocaba en su respectivo hoyo en una bandeja con 200\u00b5l de eluato (PBS - phosphate buffered saline - con 0.05 por ciento Tween 20). Las muestras en el eluato se almacenaron refrigeradas (2-8\u00baC) por una noche. En la ma\u00f1ana, estos eluatos fueron diluidos y analizados con Vironostika HIV Uniform II plus O (BioMerieux). Todas las muestras positivas y un 10 por ciento de las negativas fueron analizadas con Enzygnost Anti-HIV 1\/2 Plus (Dade-Behring). Para las muestras discordantes se repitieron ambas pruebas: Vironostika y Enzygnost. Si una muestra resultaba discordante nuevamente, se analizaba con Western Blot 2.2 (Abbott) para obtener el resultado final.\n\nAntes de la encuesta, el Laboratorio Nacional usaba ELISA (\u201cEnzyme Linked Immunoabsorbent Assay\u201d) como prueba de anticuerpos al VIH, pero no ten\u00eda experiencia con gotas de sangre seca.\n\nTampoco ten\u00eda la capacidad de procesar el n\u00famero de muestras requeridas para la encuesta. El programa MEASURE DHS proporcion\u00f3 neveras, suministros y otros equipos. Asimismo, desarroll\u00f3 un intenso entrenamiento sobre c\u00f3mo ejecutar el protocolo de an\u00e1lisis, para seis t\u00e9cnicos del laboratorio.\n\nEn su momento se vinculan los resultados del an\u00e1lisis de VIH y los datos de los cuestionarios. Sin embargo, este paso no se efect\u00faa hasta que los c\u00f3digos de barra en los cuestionarios de hogar han sido destruidos, y la informaci\u00f3n de identificaci\u00f3n (n\u00famero de conglomerado) ha sido mezclada (\u201cscrambled\u201d). Una vez que la base de datos est\u00e1 en esta situaci\u00f3n, no es posible hacer correcciones a los datos de los cuestionarios, y por eso la base de datos tiene que ser revisada y limpiada cuidadosamente primero.\n\nENTRENAMIENTO DEL PERSONAL DE CAMPO\n\nPara la formaci\u00f3n del personal de campo se organizaron dos entrenamientos: uno para el personal de supervisi\u00f3n y otro para los entrevistadores. El entrenamiento de supervisores se inici\u00f3 el 9 de enero del 2007 y cont\u00f3 con la participaci\u00f3n de 49 candidatos, que fueron formados en un curso de 10 d\u00edas. Como parte de este entrenamiento se realiz\u00f3 la primera prueba piloto de la encuesta, en \u00e1reas urbana y rural del municipio de Bayaguana, durante los d\u00edas 19 y 20 de enero.\n\nEl segundo taller de entrenamiento fue a candidatos a entrevistadores y entrevistadoras. Se inici\u00f3 el 31 de enero y se prolong\u00f3 durante 5 semanas hasta el 5 de marzo, para garantizar el dominio total de los cuestionarios y proporcionar las capacitaciones complementarias requeridas para el \u00f3ptimo desempe\u00f1o del personal de campo. El taller cont\u00f3 con la participaci\u00f3n de 200 candidatos y candidatas, divididos en dos grupos de trabajo.\nEl taller consisti\u00f3 en la presentaci\u00f3n y discusi\u00f3n de las diferentes secciones del cuestionario por los instructores, aclaraciones y consultas a los manuales, entrevistas de pr\u00e1ctica entre los participantes, y discusi\u00f3n de la pr\u00e1ctica. Durante el taller, se aplicaron ex\u00e1menes para asegurar el progreso de las candidatas y los candidatos.\n\nLa parte final del entrenamiento consisti\u00f3 en una pr\u00e1ctica en terreno, con todo el personal de campo, de manera que pudiesen asimilar todo lo relativo a las preguntas del cuestionario, flujo de informaci\u00f3n, comprensi\u00f3n por parte del entrevistado, dominio de la cartograf\u00eda, entre otros aspectos relevantes. Se formaron equipos de trabajo coordinados por candidatos a supervisores, previamente entrenados, quienes ayudaron en la gu\u00eda del equipo y la evaluaci\u00f3n del personal. Las pruebas piloto se realizaron el viernes 23 de febrero en el barrio Las Caobas y el s\u00e1bado 3 de marzo en la comunidad de Hacienda Estrella de la provincia de Santo Domingo.\n\nPara ambos entrenamientos se adaptaron manuales preparados por el Programa MEASURE DHS para esta ronda de encuestas, as\u00ed como el utilizado en la ENDESA 2002. Se prepararon manuales diferenciados para entrevistadoras y entrevistadores sobre los cuestionarios de hogar, morbilidad y gastos en salud, y los cuestionarios individuales para las mujeres y los hombres. Otro manual incluy\u00f3 instrucciones para la recolecci\u00f3n, manejo y almacenamiento de las muestras de sangre. Adicionalmente, se prepar\u00f3 tambi\u00e9n un manual para supervisi\u00f3n y cr\u00edtica y se dise\u00f1aron un conjunto de formularios de control para la entrega y recepci\u00f3n de asignaciones de trabajo y para el monitoreo diario del rendimiento de los encuestadores y encuestadoras.\n\nEl 24 de febrero se inici\u00f3 el entrenamiento para la prueba de VIH que se extendi\u00f3 por espacio de una semana. En este entrenamiento, impartido por expertos del programa MEASURE DHS, se explic\u00f3 y mostr\u00f3 el procedimiento para obtener las muestras de sangre seca en la poblaci\u00f3n a entrevistar. El taller cubri\u00f3 la importancia del consentimiento informado y de responder cualquier duda o pregunta de la poblaci\u00f3n entrevistada, c\u00f3mo manejar y almacenar las muestras en el campo, protegerse de infecciones que se transmiten por la sangre y a desechar basura biol\u00f3gica peligrosa.\n\nEn este taller resultaron seleccionados 21 supervisoras, 21 cr\u00edticos, 84 entrevistadoras, 42 entrevistadores y 3 jefes del campo. Entre ellos, todos los supervisores y 20 entrevistadores se entrenaron y se estandarizaron en antropometr\u00eda de ni\u00f1os(as). La pr\u00e1ctica final de campo, incluyendo la toma de muestras para prueba de VIH, y fue realizada el 3 de marzo.\n\nTRABAJO DE CAMPO\n\nEl trabajo de campo para la ENDESA 2007 inici\u00f3 el 15 de marzo y finaliz\u00f3 el 8 de agosto. En su ejecuci\u00f3n se conformaron 21 equipos, supervisados por tres jefes de campo y una coordinadora general.\n\nCada equipo cont\u00f3 con una supervisora, un cr\u00edtico o editor de campo, 4 entrevistadoras, 2 entrevistadores y un chofer.\n\nEl trabajo se inici\u00f3 por las provincias de la regi\u00f3n sur del pa\u00eds, especialmente por Azua, Peravia, seguidas por Pedernales, Barahona, Bahoruco, Independencia, San Juan y El\u00edas Pi\u00f1a. Las \u00faltimas provincias donde se recolectaron los datos fueron las de la regi\u00f3n este. Durante las labores de campo los equipos recibieron las visitas de seguimiento del personal directivo de la encuesta, de Macro Internacional, USAID y COPRESIDA. Al t\u00e9rmino de la primera semana del trabajo de campo se realiz\u00f3 una reuni\u00f3n de retroalimentaci\u00f3n con las supervisoras y cr\u00edticos, para compartir las observaciones de monitoreo del equipo directivo e incorporar sugerencias. Todas las semanas se condujeron reuniones de seguimiento con los jefes de campo y cuando el caso lo ameritaba, con supervisores y cr\u00edticos.","cleaning_operations":"La primera etapa para el procesamiento de los datos se implement\u00f3 en el terreno por las supervisoras y el personal de cr\u00edtica, y consisti\u00f3 en detecci\u00f3n de posibles errores de llenado del cuestionario y en la verificaci\u00f3n de la consistencia y flujo entre diferentes preguntas de los mismos. Ya en la oficina central los formularios fueron verificados de forma manual y codificados. Posteriormente se digitaron, sometiendo las bases de datos a un proceso de cr\u00edtica mediante microcomputadoras. La entrada de datos se realiz\u00f3 mediante una red bajo Windows para el almacenamiento interactivo de datos y se efectu\u00f3 doble digitaci\u00f3n en el 100 por ciento de los cuestionarios. Para la digitaci\u00f3n y cr\u00edtica por computadora se utiliz\u00f3 el Sistema de Procesamiento para Censos y Encuestas (CSPro), versi\u00f3n para 3.3 para Windows. Tambi\u00e9n se elaboraron tabulaciones para el monitoreo y evaluaci\u00f3n de la calidad de los datos, como forma de controlar y retroalimentar el trabajo del personal de campo.\n\nLa digitaci\u00f3n y verificaci\u00f3n computarizada fue realizada por 30 digitadores y digitadoras en dos turnos de seis horas, apoyados por 9 codificadores-editores y un supervisor por turno. El trabajo se inici\u00f3 a mediados de abril y se complet\u00f3 a mediados de octubre del 2007, incluyendo el procesamiento de la encuesta en Bateyes."},"analysis_info":{"response_rate":"Los resultados de la implementaci\u00f3n de la muestra, tanto en hogares como para personas elegibles. De un total de 35,700 viviendas seleccionadas en los 1,428 conglomerados de la ENDESA 2007, fueron encontrados 33,437 hogares, excluyendo de \u00e9ste c\u00e1lculo los hogares ausentes, las viviendas desocupadas, destruidas y no encontradas. De ese total de hogares encontrados se realizaron entrevistas completas en 32,431, lo que corresponde a una tasa de respuesta del 97 por ciento.\n\nLas mujeres elegibles que durmieron en el hogar la noche anterior (de \u201checho\u201d) fueron 29,203, logrando entrevistar un total de 27,195, para una tasa de respuesta del 93 por ciento. A su vez, los hombres elegibles \u201cde hecho\u201d encontrados fueron 33,028, de los cuales se entrevistaron 27,975, para una tasa de respuesta total del 85 por ciento. El principal motivo de no respuesta en mujeres, pero especialmente en hombres, fue por ausencia al momento de la entrevista, a pesar de la cantidad de visitas realizadas para lograr la entrevista. No obstante, la tasa de respuesta en hombres alcanzada en esta oportunidad representa una apreciable mejor\u00eda respecto a la obtenida en la ENDESA 2002 que fue alrededor del 80 por ciento.","sampling_error_estimates":"Por tratarse de una encuesta por muestreo, los resultados de la ENDESA 2007 que se incluyen en el presente informe son estimaciones que est\u00e1n afectadas por dos tipos de errores: aquellos que se producen durante las labores de recolecci\u00f3n y procesamiento de la informaci\u00f3n (que se denominan usualmente errores no muestrales) y los llamados errores de muestreo, que resultan del hecho de haberse entrevistado s\u00f3lo una muestra y no la poblaci\u00f3n total.\n\nEl primer tipo de error incluye la falta de cobertura de todas las mujeres seleccionadas, errores en la formulaci\u00f3n de las preguntas y en el registro de las respuestas, confusi\u00f3n o incapacidad de las mujeres para dar la informaci\u00f3n y errores de codificaci\u00f3n o de procesamiento. Al igual que para las encuestas anteriores de 1991\/92, 1996 y 2002, para la ENDESA 2007 se trat\u00f3 de reducir a un m\u00ednimo este tipo de errores a trav\u00e9s de una serie de procedimientos que se emplean en toda encuesta bien dise\u00f1ada y ejecutada, como son: el dise\u00f1o cuidadoso y numerosas pruebas del cuestionario, intensa capacitaci\u00f3n de as entrevistadoras, supervisi\u00f3n intensa y permanente del trabajo de campo, revisi\u00f3n de los cuestionarios en el campo por parte de las cr\u00edticas, supervisi\u00f3n apropiada en la etapa de codificaci\u00f3n, y procesamiento de los datos y limpieza cuidadosa del archivo con retroalimentaci\u00f3n a las supervisoras, cr\u00edticas y entrevistadoras a partir de los cuadros de control de calidad. Los elementos de juicio disponibles se\u00f1alan que este tipo de errores se mantuvo dentro de m\u00e1rgenes razonables en la ENDESA 2007. En lo que sigue no se har\u00e1 m\u00e1s referencia a los errores ajenos al muestreo sino \u00fanicamente a los llamados errores de muestreo.\n\nLa muestra de hogares visitados para la ENDESA 2007 no es sino una de la gran cantidad de muestras del mismo tama\u00f1o que ser\u00eda posible seleccionar de la poblaci\u00f3n de inter\u00e9s utilizando el dise\u00f1o empleado. Cada una de ellas habr\u00eda dado resultados en alguna medida diferentes de los arrojados por la muestra usada. La variabilidad que se observar\u00eda entre todas las muestras posibles constituye el error de muestreo, el cual no se conoce pero puede ser estimado a partir de los datos suministrados por la muestra realmente seleccionada. El error de muestreo se mide por medio del error est\u00e1ndar. El error est\u00e1ndar de un promedio, porcentaje, diferencia o cualquier otra estad\u00edstica calculada con los datos de la muestra se define como la ra\u00edz cuadrada de la varianza de la estad\u00edstica y es una medida de su variaci\u00f3n en todas las muestras posibles. En consecuencia, el error est\u00e1ndar mide el grado de precisi\u00f3n con que el promedio, porcentaje, o estad\u00edstica basado en la muestra, se aproxima al resultado que se habr\u00eda obtenido si se hubiera entrevistado a todas las mujeres de la poblaci\u00f3n bajo las mismas condiciones.\n\nEl error est\u00e1ndar puede ser usado para calcular intervalos dentro de los cuales hay una determinada confianza de que se encuentra el valor poblacional. As\u00ed, si se toma cierta estad\u00edstica calculada de la muestra (un porcentaje, por ejemplo) y se le suma y resta dos veces su error est\u00e1ndar, se obtiene un intervalo al cual se le asigna una confianza de 95 por ciento de que contiene, en este caso, el porcentaje poblacional.\n\nSi las personas entrevistadas en la ENDESA 2007 hubieran sido seleccionadas en forma simple al errores de muestreo de ISSA (Integrated System for Survey Analysis), apropiado para el an\u00e1lisis estad\u00edstico de muestras complejas como la de la ENDESA 2007.\n\nazar, podr\u00edan utilizarse directamente las f\u00f3rmulas muy conocidas que aparecen en los textos de estad\u00edstica para el c\u00e1lculo de errores est\u00e1ndar y l\u00edmites de confianza y para la realizaci\u00f3n de pruebas de hip\u00f3tesis. Sin embargo, como se ha se\u00f1alado, el dise\u00f1o empleado es complejo, por lo cual se requiere utilizar f\u00f3rmulas especiales que consideran los efectos de la estratificaci\u00f3n y la conglomeraci\u00f3n.\n\nHa sido posible realizar estos c\u00e1lculos para un cierto grupo de variables de inter\u00e9s especial, empleando la metodolog\u00eda de la aproximaci\u00f3n de Taylor, actualmente incorporada en el modulo de  En el Cuadro B.1 se listan las variables para las cuales se han calculado los errores de muestreo.\n\nSe indica all\u00ed el tipo de estimador utilizado y la poblaci\u00f3n de referencia. Los errores de muestreo para las estimaciones de los indicadores para hombres y mujeres por zona de residencia, regi\u00f3n y provincia se presentan en los Cuadros B.2 a B.45 En algunos cuadros, \u201cna\u201d indica que el correspondiente valor no es aplicable. Para cada variable se incluye el correspondiente valor estimado V (sea un promedio o un porcentaje), el error est\u00e1ndar y el n\u00famero de casos (sin ponderar y ponderados) para los cuales se investig\u00f3 la caracter\u00edstica considerada. Adem\u00e1s del error est\u00e1ndar, en el cuadro aparecen tambi\u00e9n el efecto del dise\u00f1o (EDIS), el error relativo (EE\/V) y el intervalo con 95 por ciento de confianza que contenga el verdadero valor.\n\nEl examen de los cuadros revela que, en general y especialmente para la muestra de mujeres, los errores est\u00e1ndar son peque\u00f1os y que por ello esa muestra puede calificarse como bastante precisa; esto es especialmente claro en la antepen\u00faltima columna donde aparecen los errores relativos. N\u00f3tese que los efectos del dise\u00f1o tienden a aumentar para las clasificaciones geogr\u00e1ficas y a disminuir para clasificaciones que cruzan toda la muestra, como es la edad.\n\nPara ilustrar el uso de las cifras en este Ap\u00e9ndice, consid\u00e9rese la variable \u201cactualmente usa anticonceptivo\u201d, que tiene un valor estimado de 0.729 con un error est\u00e1ndar de 0.005 para la poblaci\u00f3n de mujeres de la Republica Dominicana en el Cuadro B.2. Si se desea un intervalo de confianza del 95 por ciento, lo que se hace es sumarle y restarle al valor estimado dos veces el error est\u00e1ndar: 0.729 +\/- 2 x 0.005 lo que produce el intervalo de 0.718 a 0.739 de las dos \u00faltimas columnas. 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