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首页> 外文学位 >When Quality Matters: Linking the Reliability of Demographic and Health Survey Data to Biases in International Mortality, Fertility, and Family Planning Estimates.
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When Quality Matters: Linking the Reliability of Demographic and Health Survey Data to Biases in International Mortality, Fertility, and Family Planning Estimates.

机译：当质量很重要时：将人口统计和健康调查数据的可靠性与国际死亡率，生育力和计划生育估计中的偏差联系起来。

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摘要

In countries without reliable vital registration systems -- the majority of low- and middle-income countries -- most vital statistical estimates are based on nationally representative household survey data. Such surveys are usually implemented under the USAID-funded Demographic and Health Surveys (DHS) project. Because DHS data are so widely used, the quality of these data is paramount to enable countries to monitor their population growth and health and track progress towards international development goals. This dissertation aims to provide a careful, detailed interrogation of DHS data quality in the areas of fertility, child mortality, and contraceptive use.;The first chapter examines linkages between questionnaire length and data quality. I analyze 238 DHS Surveys to ascertain whether changes in the DHS survey instrument -- predominantly increases in length and complexity of the core questionnaire over time -- have led to poorer data quality and thus biased fertility and child mortality rates. I explain the likely causes and consequences of one measure of data quality: birth displacement, disaggregated by child survival status. I examine differences in displacement by DHS survey characteristics, including the average number of non-missing variables per woman interviewed in each survey (a proxy measure of questionnaire length) and modules including HIV biomarker testing. Results indicate substantial birth displacement in the majority of DHS surveys, and disproportionate displacement of dead children compared to surviving children. Increases in birth displacement, and differential displacement of deceased children, are associated with increases in questionnaire length. This differential displacement likely biases recent estimates of infant and under-five mortality rates downward which in turn overestimates recent declines in these indicators.;The second chapter focuses on the quality data acquired through one section of the DHS questionnaire: the reproductive calendar, in which women are asked to recall their births, pregnancies, terminations, and episodes of contraceptive use for the last 5-7 years. I compare retrospective contraceptive prevalence rates (CPR) tabulated from the calendar to independently estimated current status CPR from a prior survey for the same point in time among women in the same age groups. The chapter compares estimates of the total CPR as well as the prevalence of each specific contraceptive method for 106 pairs of surveys conducted in 37 countries. I find that calendar data appear to underestimate contraceptive use in most comparisons, often substantially. Total contraceptive prevalence is reported at statistically significantly different levels in 74 percent of survey pairs analyzed. The average difference in CPR was 4.1 percentage points, resulting in an average discrepancy of 15 percent between the current use CPR and that estimated from retrospective calendar data for the same point in time.;The third chapter builds on the findings from Chapter 2, using the comparisons between retrospective calendar data and current status data and other data quality indicators, to select 16 surveys in which reproductive calendar data appear to be reliable. Contraceptive use data from these 16 countries were pooled together for a sample of 140,529 episodes of contraceptive use collected from 97,094 women's reproductive histories. I use this pooled dataset to estimate cumulative 12-month contraceptive failure rates for each of the most widely-used contraceptive methods. Correlates of contraceptive failure are examined using multilevel survival models. I find that contraceptive failure rates are generally higher when calculated from surveys with reliable data compared to median estimates across all DHS surveys, suggesting that surveys with unreliable calendars underestimate contraceptive failure rates. Contraceptive failure rates vary widely by age, with adolescent women experiencing the highest failure rates. Failure also appears associated with socio-economic status, suggesting that the youngest and poorest women are at highest risk of experiencing unintended pregnancy.
机译：在没有可靠的生命登记系统的国家（大多数低收入和中等收入国家）中，最重要的统计估计是基于具有全国代表性的家庭调查数据。这种调查通常是在美国国际开发署资助的人口与健康调查（DHS）项目下实施的。由于国土安全部数据的使用如此广泛，因此这些数据的质量对于使各国能够监测其人口增长和健康状况以及追踪实现国际发展目标的进展至关重要。本文旨在对生育，儿童死亡率和避孕药具使用方面的DHS数据质量进行仔细，详细的询问。第一章研究问卷长度与数据质量之间的联系。我分析了238项DHS调查，以确定DHS调查工具的变化（主要是随着时间的推移，核心问卷长度和复杂性的增加）是否导致数据质量较差，从而导致生育率和儿童死亡率出现偏差。我解释了一种数据质量度量的可能原因和后果：出生移位，按儿童生存状况分类。我通过DHS调查特征研究了位移的差异，包括每次调查中每位受访妇女平均无遗漏变量的数量（问卷长度的代理度量）以及包括HIV生物标志物检测在内的模块。结果表明，在大多数DHS调查中，出生人口大量流离失所，而死亡儿童与存活儿童相比，流动人口比例不成比例。出生位移的增加和死者的不同程度的位移与问卷长度的增加有关。这种差异性位移可能会使对婴儿和五岁以下儿童死亡率的最新估计值产生偏差，从而反过来又高估了这些指标的近期下降趋势。第二章着眼于通过DHS调查表的一部分获得的质量数据：生殖历法，其中要求女性回忆过去5到7年的出生，怀孕，解雇和避孕事件。我比较了日历中的回顾性避孕普及率（CPR）和来自同一年龄组女性在同一时间点的先前调查得出的独立估计的当前状态CPR。本章比较了在37个国家/地区进行的106对调查的总CPR估算值以及每种特定避孕方法的普遍性。我发现日历数据似乎在大多数比较中经常低估了避孕药具的使用。据统计，在74％的调查对中，避孕药具的总使用率在统计学上存在显着差异。 CPR的平均差异为4.1个百分点，导致当前使用的CPR与同一时间点的回顾性日历数据估计的平均差异为15％。第三章基于第2章的发现，使用回顾性日历数据与当前状态数据和其他数据质量指标之间的比较，以选择16个调查，其中生殖日历数据似乎是可靠的。来自这16个国家的避孕使用数据汇总在一起，收集了97,094名妇女生殖史中140,529次避孕使用的样本。我使用此汇总数据集来估算每种使用最广泛的避孕方法的累计12个月避孕失败率。使用多级生存模型检查避孕失败的相关性。我发现，从具有可靠数据的调查中计算出的避孕失败率通常要比所有DHS调查中的中位数估计值高，这表明日历不可靠的调查低估了避孕失败率。避孕失败率因年龄而异，青春期妇女失败率最高。失败也与社会经济状况有关，这表明最年轻和最贫穷的妇女遭受意外怀孕的风险最高。

著录项

  • 作者

    Bradley, Sarah Elizabeth.;

  • 作者单位

    University of California, Berkeley.;

  • 授予单位 University of California, Berkeley.;
  • 学科 Demography.
  • 学位 Ph.D.
  • 年度 2016
  • 页码 153 p.
  • 总页数 153
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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