Kagera Health and Development Survey 2004 (Wave 5 Panel)
Living Standards Measurement Study [hh/lsms]
Waves 1 to 4 of the Kagera Health and Development Survey were implemented in 1991-1994.
- Wave 1 September 1991 - May 1992
- Wave 2 April 1992 - November 1992
- Wave 3 November 1992 - May 1993
- Wave 4 June 1993 - January 1994
A national LSMS survey was implemented in 1993.
The Kagera Health and Development Survey 2004 (KHDS 2004) took place in 2004 as a fifth round following on the four rounds of the baseline Kagera Health and Development Survey 1991-1994 (KHDS 91-94). The KHDS 2004 was designed to provide data to understand economic mobility and changes in living standards of the sample of individuals interviewed 10-13 years ago. The KHDS 2004 attempted to reinterview all respondents ever interviewed in the KHDS 91-94. This entailed attempting to track these individuals, even if they had moved out of the village, region or country.
Kind of Data
Sample survey data [ssd]
Unit of Analysis
Section 0 Basic Survey information
Section 1 Household Roster
Section 2 Previous Children Residing Elsewhere
Section 3 Main Activities of the Household
Section 4 Information on Parents
Section 5 Education
Section 6 Health
Section 7 Activities and Non-Labor Income
Section 8 Individual Expenditures
Section 9 Migration
Section 10 Shocks Experienced in the Past 10 Years
Section 11 Farming
Section 11 Agriculture
Section 12 Livestock
Section 13 Non-Farm Self-Employment
Section 14 Housing
Section 15 Durable Goods, Expenditures, Inheritance, and Bride Price
Section 16 Food Consumption and Expenditures
Section 17 Informal Organizations, Ability to Cope, Assistance from Organizations
Section 18 Gifts and Loans Received/Sent
Separate Form Anthropometry
Separate Form Mortality of Previous Household Members
Section 0 Selecting respondents
Section 1 Demographic information
Section 2 Economy and Infrastructure
Section 3 Education
Section 4 Health
Section 5 Agriculture
Section 6 Culture
Section 7 Shocks in the past 10 years
Part I Food Prices
Part II Pharmaceutical Prices
Part III Non-Food Prices
Part A School characteristics, enrollment and fees
Part B Text books, Standard 7 completion, number of teachers employed and assistance or contributions
Kagera region of Tanzania
Domains: Agronomic zone (Tree Crop, Riverine, Annual Crop, Urban)
Producers and sponsors
Economic Development Initiatives
Danish Agency for Development Assistance
Knowledge for Change Trust Fund at the World Bank
Joachim De Weerdt
Management of data entry
University of Dar es Salaam
Sample size is 900 households
KHDS 91-94 Household Sample: First Stage
The KHDS 91-94 household sample was drawn in two stages, with stratification based on geography in the first stage and mortality risk in both stages. A more detailed overview of the sampling procedures is outlined in "User’s Guide to the Kagera Health and Development Survey Datasets." (World Bank, 2004).
In the first stage of selecting the sample, the 550 primary sampling units (PSUs) in Kagera region were classified according to eight strata defined over four agronomic zones and, within each zone, the level of adult mortality (high and low). A PSU is a geographical area delineated by the 1988 Tanzanian Census that usually corresponds to a community or, in the case of a town, to a neighborhood. Enumeration areas of households were drawn randomly from the PSUs in each stratum, with a probability of selection proportional to the size of the PSU.
Within each agronomic zone, PSUs were classified according to the level of adult mortality. The 1988 Tanzanian Census asked a 15 percent sample of households about recent adult deaths. Those answers were aggregated at the level of the "ward", which is an administrative area that is smaller than a district. The adult mortality rate (ages 15-50) was calculated for each ward and each PSU was assigned the mortality rate of its ward.
Because the adult mortality rates were much higher in some zones than others and the distribution was quite different within zones, "high" and "low" mortality PSUs were defined relative to other PSUs within the same zone. A PSU was allocated to the "high" mortality category if its ward adult mortality rate was at the 90th percentile or higher of the ward adult mortality rates within a given agronomic zone.
The KHDS 1991-1994 selected 51 communities as primary sampling units (also referred to as enumeration areas or clusters). In actuality, 2 pairs of enumeration areas were within the same community (in the sense of collecting community data on infrastructure, prices or schools). This, for community-level surveys, there are 49 areas to interview.
KHDS 91-94 Household Sample: Second Stage
The household selection at the second stage (with enumeration areas) was a stratified random sample. That is, households expected to experience an adult death were over-sampled. In order to stratify the population, an enumeration of all households was undertaken. Between March 15 and June 13, 1991, 29,602 households were enumerated in the 51 areas. In addition to recording the name of the head of each household, the number of adults in the household (15 and older), and the number of children, the enumeration form asked: "Are any adults in this household ill at this moment and unable to work? If so, the age of the sick adult and the number of weeks he/she has been too sick to work were also noted."
"Has any adult 15-50 in this household died in the past 12 months? If so, the age of each adult and the cause of death (illness, accident, childbirth, other) were also noted. The enumeration form asked explicitly about illness and death of adults between the ages of 15-50 because this is the age group disproportionately affected by the HIV/AIDS epidemic; it is the impact of these deaths that was of research interest. Out of over 29,000 households enumerated, only 3.7 percent, or 1,101, had experienced the death of an adult aged 15-50 caused by illness during the twelve months before the interview and only 3.9 percent, or 1,145, contained a primeage adult too sick to work at the time of the interview. Only 77 households had both an adult death due to illness and a sick adult. This supports the point that, even with some stratification based on community mortality rates and in an area with very high adult mortality caused by an AIDS epidemic, a very large sample would have had to have been selected to ensure a sufficient number of households that would experience an adult death during the two-year survey.
Using data from the enumeration survey, households were stratified according to the extent of adult illness and mortality. It was assumed that in communities suffering from an HIV epidemic, a history of prior adult death or illness in a household might predict future adult deaths in the same household. The households in each enumeration area were classified into two groups, based on their response to the enumeration:
- "Sick" huseholds: Those that had either an adult death (aged 15-50) due to illness in the past 12 months, an adult too sick to work at the time of the survey, or both (n=2,169).
- "well" households: Those that had neither an adult death (aged 15-50) due to illness nor an adult (aged 15-50) too sick to work (n=27,433).
In selecting the sixteen households to be interviewed in each enumeration area from which a enumeration area was drawn, fourteen were selected at random from the "sick" households in that enumeration area and two were selected at random from the "well" households. In one enumeration area, where the number of "sick" households available was less than fourteen, all available sick households were included in the sample; the numbers were balanced using well households. The final sample drawn for the first passage consisted of 816 households in 51 enumeration areas.
KHDS 2004 sampling strategy was to reinterview all individuals who were household members in any round of the KHDS 1991-1994 and who were alive in the last interview. [One serious problem that is side-stepped by this approach is constructing a definition of what makes a household the same household as 10 years ago, especially if there are individuals who have migrated, split-off or the household has dissolved.] The household in which these individuals live would be administered the full household questionnaire. For all household members alive during the last interview in 1991-1994, but found to be deceased by 2004, information about the deceased would be collected in the mortality questionnaire. This questionnaire intended to collect data on the circumstances of their death, as well as on their living arrangements and limited information on health seeking behavior prior to death. The respondents for this questionnaire were typically panel respondents who were previous household members with the deceased, other relatives, neighbors or close friends.
Although the KHDS is a panel of respondents and the concept of a 'household' after 10-13 years is a vague notion, it is common in panel surveys to consider recontact rates in terms of households. Table 7 shows the rate of recontact of the baseline households, where a recontact is defined as having interviewed at least one person from the household.3 In this case, the term household is defined by the baseline KHDS survey which spans a period of 2.5 years. Due to movements in and out of the household, some household members may have not, in fact, lived together in the household at the same time in the 1991-1994 rounds (for example, consider one sibling of the household head moving into the household for 1 year and then moving out, followed by another sibling moving into the household).
Excluding households in which all previous members are deceased (17 households and 27 people), the field team managed to recontact 93 percent of the baseline households. Not all 912 households received four interviews. Not surprisingly, households that were in the baseline survey for all four rounds had the highest probability of being reinterviewed. Of these 746 households, 96 percent were reinterviewed.
Because people have moved out of their original household, the new sample in KHDS 2004 consists of over 2,700 households from the baseline 832, which were recontacted. Much of the success in recontacting respondents was due to the effort to track people who had moved out of the baseline villages. One-half of all households interviewed were tracking cases, meaning they did not reside in the baseline communities. Of those households tracked, only 38 percent were located nearby the baseline community. Overall, 32 percent of all households were not located near the baseline communities. While tracking is costly, it is an important exercise because migration and dissolution of households are often hypothesized to be important responses to hardship. Excluding these households in the sample raises obvious concerns regarding the selectivity of attrition. In particular, out-migration from the village, dissolving of households, and even marriage, may be responses to adult mortality. At the same time, tracking will provide a unique opportunity to study these coping mechanisms: who uses them, what is the effect, do they get people out of poverty or do they themselves constitute a poverty trap.
Turning to recontact rates of the sample of 6,204 respondents, Reinterview rates are monotonically decreasing with age, although the reasons (deceased or not located) vary by age group. The older respondents were much more likely to be located if living, which is consistent with higher migration rates among the young adults in the sample. Among the youngest respondents, over three-quarter were successfully re-interviewed. Excluding people who died, 82 percent of all respondents were re-interviewed. Without tracking, re-interview rates of surviving respondents would have fallen from 82 percent to 52 percent. Non-local migration is not trivial; restricting the tracking to nearby villages would have resulted in 63 percent recontact of survivors. Migration proved to be an important factor in determining whether someone was recontacted. Respondents who were untraced were much more likely to be residing outside Kagera (52 percent) compare to their counterparts who were re-interviewed (9 percent).
KHDS 2004 tracked international migrants for Uganda only. Although the location of those in other countries was known, they were not traced. For those respondents who were not reinterviewed, the KHDS 2004 gives some information about their interactions with the reinterviewed respondents. Survey modules on the frequency of contact with all previous household members inform on the cash, in-kind and labor interactions between former household members.
Dates of Data Collection
Data Collection Mode
Data Collection Notes
Organization of Field Work
The project headquarters of KHDS 2004 were at the EDI (Economic Development Initiatives) offices in Bukoba Town. Here the human resources and finances of the project were managed, legal and contractual matters were taken care of, transport arrangements for field teams were made, the stock of field equipment was managed, future work was planned and all other activities necessary for the successful completion of the project were implemented. Details on recruitment, pre-fieldwork tracking, main field work, and tracking are given below. In addition to these activities, the questionnaire itself was piloted by supervisors in non-sampled households in Kibeta and Kitendaguro areas in Bukoba District prior to training.
Field staff recruitment started in spring 2003 with field supervisors. Four supervisors were recruited. After training, supervisors were involved in developing the survey instruments, planning field work, piloting the questionnaire, and preparing interviewer training manuals and materials. In November 2003, 36 interviewers were recruited; they were trained for three weeks. Interviewers were trained on the household questionnaire, mortality questionnaire, anthropometrics and basic communication methods with respondents. The training included actual household interviews in one rural area for all trainees. After training, an assessment of each interviewer on and off the field was conducted; the best 28 interviewers were retained. The field teams consisted of 4 teams of 7 interviewers and 1 supervisor. The final field team included one supervisor and 5 interviewers had worked on the KHDS 91-94.
In order to facilitate the field work and prepare for tracking of movers, the KHDS 2004 had a pre-fieldwork tracking phase. Field management, supervisors and three interviewers did the prefield work tracking in October 2003. The team visited all 51 baseline communities with rosters from the 1991-1994 survey to complete a Household Tracking Form. This form identified the status and location of all panel respondents (all previous household members). When possible, panel respondents still residing in baseline communities were contacted in order to collect information on the status (alive/deceased) and location of all surviving panel respondents with whom the respondent resided in KHDS 91-94. When none of the panel respondents could be located in the baseline community, this information was collected by an informant (either a neighbor, relative or village leader).
For respondents who had moved out of the baseline community, tracking information was collected on the Individual Tracking Form. The form contained information on the name, age, and sex of the person tracked. It also included area of residence, which was divided into country, region, district, ward, village and sub-village. In addition, their marital status, name of spouse, contact details, professional details, hang out places, other names used and physical characteristics were noted. Furthermore, information on potential informants was collected on the Informant Tracking Form, in the event that tracking information appeared unreliable or insufficiently detailed to allow for the tracking of the panel respondent. Upon completion of the pre-field work tracking, data collected consisted of:
- Household Tracking Form which recorded the status of all panel respondents. If a panel respondent was reported to be alive, basic information on current location (same community, nearby community, district, region etc…) was recorded
- Individual Tracking Form for panel respondents who did not reside in or nearby the baseline community
- Informant Tracking Form for potential informants in the event that information on the individual tracking form proved insufficient to locate panel respondents who lived far from baseline communities.
The data collected were entered in the headquarters in Bukoba. These data were used to estimate the total number of households expected to be interviewed in KHDS 2004, considering migration and splitting of households. These data also allowed for careful planning of the main and tracking phases of the field work.
Main Field Work
The main field work started in January 2004. It consists of field team visits to the 51 baseline communities, as well as tracking of panel respondents who had moved to villages nearby the baseline communities. It excluded the tracking of panel respondents who had moved far either within the region or outside the region.
The field teams were divided into four groups of seven. One supervisor led each group. For the first two enumeration areas, teams were paired up in order to ensure data quality and consistency, as well as identify any over-sights in field procedures. For the remaining field work, each enumeration area was assigned one field team. When the survey team arrived in a community, the supervisor met with the village chairman to introduce the team, and, if necessary, explain about the survey in more detail. The supervisor also collaborated with the village chairman to find accommodation and guides who are familiar with household locations in the village. They also compiled a list of respondents for the community questionnaire and planned actual dates for administering the questionnaire.
Households in the village were grouped according to sub-villages. Appointments for administering the household questionnaire were then made with the household members. The interviewers completed the household questionnaire in two to three separate interviews depending on the size of the household and the number of sections that applied to the household. Fieldwork supervision was done in several stages to ensure high quality data collection. Supervision included revisits to households and direct observation during interviews by field supervisors and management team. During the revisits, the supervisor re-administered some of the sections in the household questionnaire, took anthropometric measurements and crosschecked clinic cards for children under the age six to verify the validity of the data. This also enabled collection of missing household data and anthropometric measurements for household members who had not been available during the initial interview.
Questionnaire checks were done in four stages:
- First, interviewers checked their own questionnaire after every household interview.
- Second, interviewers exchanged questionnaires among themselves for further checking.
- Third, the supervisor checked the questionnaires.
- Finally, field management occasionally checked the questionnaires.
For the field work, each team was given pre-printed 1991-1994 Household Rosters and 1991-1994 Children Living Elsewhere Rosters. They used these to check and confirm identities, relations and identification codes of respondents, which link them to the 1991-1994 survey (including completion of Section 1 question 10 in the household questionnaire, Section 2, and the Network Roster Card ).
Supervisors reported to the main office once a week to give an update of the work. They also reported any problems or queries that arose which enabled the field management to develop addendums. Addendums to the field manual were produced and distributed in the first few months of the fieldwork to clarify some aspects of the fieldwork and questionnaires. The field teams returned to the main office after completion in every enumeration area.
The tracking phase started in June 2004 and ended in August 2004. During this phase, the teams were sub-divided into smaller teams of about three people. The size of the teams changed according to the location and number of panel respondents who needed to be tracked. A team leader led each team, while a supervisor was responsible for monitoring several teams located close to each other.
During the tracking phase, field staff tracked panel respondents who migrated to areas far away from their baseline 1991-1994 dwelling. Panel respondents who had migrated to nearby villages were visited during the main fieldwork. In some cases, when the field team arrived at the location on the Individual Tracking Form, the panel respondent had re-located. In this case, a second (or third, etc..) Individual Tracking Form would be completed and entered at operation headquarters.
The community questionnaire was administered in all KHDS baseline communities. There are 49 unique communities; as noted above, the sample has 51 enumeration areas but 2 pairs are in the same community (areas 44 and 45; areas 46 and 47). In 2004, the community questionnaire was administered in the same manner as in 1991-1994. The respondents for this questionnaire are people who are well informed about the activities, events and infrastructure of the community being surveyed. The group of respondents consists of the following people: chairman of education committee, secretary of development committee, one person from the community leadership, someone familiar with the health problems of the community, and someone familiar with agricultural and livestock practices of the community There were two other questionnaires included in the 1991-1994 survey which were dropped in the 2004 survey. These were the health facility questionnaire (administered in all four waves of KHDS 91-94) and the traditional healer questionnaire (administered only in wave 3 of KHDS 91-94).
Primary School Survey
The school questionnaire was completed for every primary school in the enumeration area, both public and private. In 2004, the school questionnaire was administered in the same manner as in 1991-1994. The number of schools per enumeration area ranged from one to three schools per enumeration area. A total of 72 school questionnaires were administered in 49 baseline communities.
Price questionnaires were completed for markets and shops in every enumeration area. In 2004, the price questionnaire was administered in the same manner as in 1991-1994. Where possible two questionnaires were completed per enumeration area. In most enumeration areas one questionnaire was done in shops and one in markets, although some enumeration areas have only one questionnaire and one enumeration area has three questionnaires. A total of 90 price questionnaires were administered, 47 from markets and 43 from shops.
The KHDS 2004 mainly consists of a household survey covering a wide range of topics. The KHDS 2004 also includes three community questionnaires to accompany the household survey (community, price, and primary school questionnaires).
The KHDS 2004 project used the original questionnaires from the KHDS 91-94 as the foundation of the survey instruments. The household questionnaire collects information on a wide range of topics, including: housing amenities, consumption, income, assets, time allocation of individuals, business activities, remittances, support from organizations, education, and health, including anthropometric measures. The community questionnaire collects data on the physical, economic and social infrastructure of the baseline communities. The primary school questionnaire collects information on the amenities at schools, composition of the student body, and assistance to schools. Finally, up to three price observations are collected in each community from local markets/stalls on a list of commonly purchased food and non-food items.
Where possible, comparability is maintained with the KHDS 91-94 survey instruments. However, the questionnaires for the KHDS 2004 were revised to reflect changes in the region since 1994. Further, the household questionnaire was redesigned in an effort to capture key transitions that have occurred since the previous survey. These revisions included:
- Inclusion of a module on the incidence of economic shocks from the last 10 years (both positive and negative) for all panel respondents.
- Inclusion of a module on migration for respondents who relocated since the KHDS 91-94.
- Inclusion of a module on informal insurance groups.
- Expansion of questions on the circumstances of deaths.
- Inclusion of information on the remittances, loans, bride price payments, social communication and labor transfers between previous members of the KHDS 91-94.
This section of the Basic Information Document reviews the 4 surveys of the KHDS 2004. For each survey, substantial differences are highlighted between the survey instrument used in the 1991-1994 rounds and in 2004.
Users are encouraged to use this as a general guide to understand the questionnaires; however, this should not substitute for looking at the actual questionnaires directly. Users are encouraged to look directly at the survey instruments for literal question wording and to identify differences between survey instruments. The household questionnaires are available in Swahili (as used in the field) and English (a translated version of the Swahili field questionnaire); the community surveys were produced only in English.
Household Questionnaire: Review of Sections
The household questionnaire is divided into numerous sections, each of which covers a fairly distinct aspect of household activities. Anthropometric measurements and the questionnaire on mortality of household members are administered in separate forms attached to the household questionnaire.
Each section of the household questionnaire has four types of respondents selected according to the content of the section: the interviewer, household head, most knowledgeable person in the household and individual household members. The only section for which household members are not respondents is the first section covering basic survey information (household location, GPS Coordinates, interviewing language, completion status of section, etc…).
Household Questionnaire: Highlights of Substantial Differences
Many changes were made in the KHDS 2004 household questionnaire compared to the KHDS 91-94 household questionnaire. Some questions were added and some dropped. Section 4 arrangement was also revised to provide better continuity during interviews. The following are the main changes included in the 2004 questionnaire:
- Section 9 (Fertility) and Section 11C (Age of tree crops) from the 1991-1994 questionnaire were dropped in 2004.
- Section 13 (Fishing) from 1991-1994 was incorporated in Section 13 (non-farm business) in 2004.
- In 1991-1994, information in Section 7 was collected on the main job and secondary job done in the past 12 months, while in 2004 data was collected only on the main job done.
- In 1991-1994, Section 20b collected information on deaths of deceased relatives who were not household members. In 2004, the mortality questionnaire covered only deceased household members from the 1991-1994 survey.
- The following were new sections introduced in 2004: Section 10 (Shocks experienced in the past 10 years), Section 15C (Household Two-Week Expenditures), Section 15D (Inheritance and Bride Price), Section 17B (Ability to cope) and Section 18A (Interactions with Network Members).
Detailed information on the key changes, section-by-section, between the KHDS 91-94 household questionnaire and the KHDS 2004 household questionnaire are provided in Kathleen Beegle, Joachim De Weerdt and Stefan Dercon, March, 3 2006, "Kagera Health and Development Survey 2004 - Basic Information Document".
Community Questionnaire: Highlights of Substantial Differences
The substantial changes to the community questionnaire include:
• A new section was included on shocks experienced in the past 10 years (Section 7).
• Data was collected on population share of ethnic groups.
• GPS coordinates were taken in each community for all enumeration areas.
• Questions on access to roads, electricity and water were introduced.
• Questions on the culture of mourning were asked for three different periods: the time of the survey, 10 years prior to the interview and 20 years prior to the interview.
• Information was collected on access to vocational training and secondary education.
• Information was also collected on temporary migration and seasonal employment of community members.
See details in Kathleen Beegle, Joachim De Weerdt and Stefan Dercon, March, 3 2006, "Kagera Health and Development Survey 2004 - Basic Information Document".
Price Questionnaire: Highlights of Substantial Differences
Overall there were no substantive changes; a few items were added to the list.
See details in Kathleen Beegle, Joachim De Weerdt and Stefan Dercon, March, 3 2006, "Kagera Health and Development Survey 2004 - Basic Information Document".
Data entry was done at the main office in Bukoba, concurrent with the main fieldwork. The data entry team consisted of seven data entry operators and one data entry supervisor. Data was entered in CsPro then transformed to Stata format. Questionnaires were entered and verified after each entry. Although internal consistency checks were performed in CsPro, in addition to more elaborate checks for inconsistency and outliers were done in Stata.
All responses obtained from individual, household, and community level interviews were recorded in questionnaires. In cases where the respondent did not know the answer, the interviewers recorded "DK" (Don't know) in the questionnaires. Data entry were trained to input this as nine (9) which represents missing information in the datasets. In cases where nine was an eligible code, the highest value for the number of digits was entered. For example, DK's for questions with up to two eligible digit codes were entered as 99; 999 was entered for DKs for questions with eligible three digit codes (assuming 999 was not otherwise an eligible response). For the mortality questionnaire, in some cases, multiple informants were interviewed. The data were consolidated such that each baseline household has one mortality questionnaire in the data files (with, perhaps, multiple deceased therein).
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1. The data are supplied solely for the use described in this form and will not be made available to other organizations or individuals. Other organizations or individuals may request the data directly.
2. Three copies of all publications, conference papers, or other research reports based entirely or in part upon the requested data will be supplied to:
The World Bank
Development Economics Research Group
LSMS Database Administrator
1818 H Street, NW
Washington, DC 20433, USA
tel: (202) 473-9041
fax: (202) 522-1153
3. The researcher will refer to the 2004 Kagera, Tanzania Health and Development Survey as the source of the information in all publications, conference papers, and manuscripts. At the same time, the World Bank is not responsable for the estimations reported by the analyst(s).
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Kagera Health and Development Survey 2004. Ref. TZA_2004_KHDS_v01_M. The World Bank.
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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.