DDI_GHA_2008_GSHS_v01_M_WBDevelopment Data Group2013-09-19NADAVersion 01 (September 2013)Global School-based Student Health Survey 2008GSHS 2008GHA_2008_GSHS_v01_MWorld Health OrganizationCenters for Disease Control and Prevention
Mrs. Cynthia Bosumtwi-Sam
United Nations Children's FundUnited Nations Educational, Scientific and Cultural OrganizationJoint United Nations Programme on HIV/AIDSNADAWorld Health OrganizationGhana Education ServiceMiddle Tennessee State UniversityMaria Tsakos FoundationDepartment of Chronic Diseases and Health PromotionThe World Bank Microdata LibraryWorld 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. The 2008 Ghana GSHS is the second national school health survey to comprehensively assess a range of health behaviours and protective factors among adolescent subgroups. The first was the 2007 Ghana GSHS (junior high school).In 2001, the World Health Organization (WHO), in collaboration with UNAIDS, UNESCO, and UNICEF, with technical assistance from the US Centers for Disease Control and Prevention (CDC), initiated development of the Global School-based Student Health Survey (GSHS). The GSHS is a part of the WHO STEPwise approach to Surveillance (STEPS). STEPS is a simple, standardized method for collecting, analyzing and disseminating data in WHO member countries (1). The GSHS is a survey conducted in different countries primarily among students aged 13-15 years.
The 2007 Ghana GSHS which was administered to junior high school students was adapted for use with senior high school students. The adapted instrument was called the 2008 Ghana GSHS. The purpose of the 2008 Ghana GSHS is to: 1) help Ghana develop priorities, establish programs, and advocate for resources for school health and youth health programs and policies, 2) to monitor trends in the prevalence of health risk behaviors and factors that influence those behaviors among senior high school students and 3) to allow other WHO member countries, international agencies, and others to make comparisons (same age group) across countries regarding the prevalence of health behaviors and protective factors.GhanaNational coverageStudents aged 13-17 yearsSample survey data [ssd]The 2008 Ghana GSHS measures alcohol use, dietary behaviors, drug use, hygiene, mental health, physical activity, protective factors, sexual behaviors that contribute to HIV infection, other sexually-transmitted infections, and unintended pregnancy, tobacco use, violence and unintentional injury.Middle Tennessee State UniversityThe 2008 Ghana GSHS employed a two-stage cluster sample design to produce a representative sample of students in senior high school (SHS) levels one, two and three. The first-stage sampling frame consisted of all schools containing any SHS class level. Schools were selected with probability proportional to school enrolment size. For sampling, Ghana was divided into 3 zones representing all 10 geographic regions. The geographic regions within each zone are:
South Zone: Greater Accra, Central, Volta, Eastern
Central Zone: Brong Ahafo, Ashanti, Western
North Zone: Northern, Upper East And Upper West
Twenty five schools were selected from each zone. Therefore a total of 75 schools were selected for the Ghana survey. The second stage of sampling consisted of randomly selecting intact classrooms (using a random start) from each school to participate. All classrooms in each selected school were included in the sampling frame. All students in the sampled classrooms were eligible to participate in the GSHS.Face-to-face [f2f]The 2008 Ghana GSHS is a modification of the generic GSHS. It was developed by school health personnel from School Health Education Programme (SHEP) at GES. It contained 84 questions representing 9 of 10 GSHS core modules. The WHO requires participating member countries to use at least 6 of the 10 core modules. The 9 core areas included in the 2008 Ghana GSHS were: 1) respondent demographics, 2) sexual behaviors that contribute to HIV infection, other STIs and unintended pregnancy, hygiene, 3) dietary behaviors, 4) alcohol and other drug use, 5) physical activity, 6) tobacco, 7) protective factors, 8) violence and unintentional injury and, 9) mental health. Twenty-three of the 84 questions were country specific questions on topics of interest for Ghanaian school health authorities. These questions fell under areas of family dynamics, general health, non-sport physical activity, protective factors and malaria.GSHS data collection procedures focused on 3 principles; student privacy, quality of data and minimization of burden on schools.
Student privacy was ensured through the following:
-protection of privacy at all times during the survey including height and weight check
-no names on the answer sheets
-data not collected if anonymity and privacy cannot be assured
-survey administrators did not look at answer sheets prior to students placing them in collection boxes.
Quality of data was ensured through the following:
-administering the Ghana GSHS in a consistent manner in each school and carefully completing all documentation forms
-encouraging students to answer the questions honestly
Minimization of burden on school through the following:
-minimizing the burden on schools by ensuring as little disruption to regular school activities as possible
Based on these 3 principles, survey administrators met with headmasters and mistresses of each selected school and were introduced to each class prior to survey administration. Class teachers excused themselves prior to the start of the survey administration to enhance privacy. Completed surveys were collected, labeled and packed according to WHO/CDC guidelines. Packaged materials were shipped to CDC for processing.Approximately 20 Survey Administrators were specially trained to conduct the GSHS.A weighting factor was applied to each student record to adjust for non-response and for the varying probabilities of selection. This was done to reflect the likelihood of sampling each student and to reduce bias by compensating for differing patterns of non-response. The weighting formula applied was:
W = W1 * W2 * f1 * f2 * f3
W1 = the inverse of the probability of selecting the school;
W2 = the inverse of the probability of selecting the classroom within the school;
f1 = a school-level non-response adjustment factor calculated by school size category (small, medium, large). The factor was calculated in terms of school enrolment instead of number of schools.
f2 = a student-level non-response adjustment factor calculated by class.
f3 = a post stratification adjustment factor calculated by Class Standard.
The 2008 Ghana GSHS had 84 questions and was administered in 73 schools.The data set was cleaned and edited for inconsistencies. Missing data were not statistically imputed. Software that takes into consideration the complex sample design was used to compute prevalence estimates and 95% confidence intervals. GSHS data for Ghana are representative of all students attending SHS level 1, 2 and 3. Students completed the self-administered questionnaire during one classroom period and recorded their responses directly on a computer-scannable answer sheet.The school response rate was 97%, and student response rate was 84%. Overall response rate 81%. A total of, 7137 students completed the survey. Of the latter number, 56.2% were male and 43.8% were female. Students between ages 16 - 18 (65.5%) made up the largest portion of the sample, followed by students 19 years old or older (22.7%) and 15 years or younger (11.8%).Department of Chronic Diseases and Health PromotionUse 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:
World Health Organization and Centers for Disease Control and Prevention. Ghana Global School-based Student Health Survey (GSHS) 2008, Ref. GHA_2008_GSHS_v01_M. Dataset downloaded from [url] on [date].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.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.