Malaria Indicators Survey 2005
Liberia, 2005
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Identification
Survey ID Number
LBR_2005_MIS_v01_M
Title
Malaria Indicators Survey 2005
Country
| Name | Country code |
|---|---|
| Liberia | LBR |
Study type
Other Household Health Survey [hh/hea]
Series Information
In October 1998, WHO, UNICEF, WORLD BANK and UNDP launched Roll Back Malaria (RBM) as a catalyst for a renewed global commitment to tackle a disease that has been ignored by the world for far too long - a single disease that puts a brake on development, particularly in Africa”. Then after, the African Summit on RBM, held in April 2000 in Abuja, Nigeria, committed “to halve the malaria mortality for Africa's people by 2010” and adopted intermediate objectives to be achieved by 2005 regarding malaria case management and prevention particularly among pregnant women and children. Finally, the 6th goal of the UN Millennium Development Goals (MDGs) set up a target expressing to “have halted by 2015 and begun to reverse the incidence of malaria and other major diseases”.
Abstract
The overall objective of the Liberia Malaria Indicators Survey (LMIS) was to updae the baseline core indicators of malaria in Liberia.
Specific objectives were to:
1. Obtain data on malaria prevention in households (use of ITNs; IPT for Pregnant Women)
2. Obtain data on fever management in HH
3. Obtain data on prevalence of malaria, anemia
4. Explore Knowledge, Attitude, Practice (KAP)
5. Assess the performance of health workers in the management of malaria
6. Establish the proportion of malaria among patients
7. Establish malaria mortality rate among in-patients
The survey was conducted both in the community and in health facilities. Two types of questionnaires were developed.: the household questionaire and the woman's questionnaire. A portable photospectometer to detect anemia and a rapid diagnostic test to detect plasmodium falciparum malaria were used.
Specific objectives were to:
1. Obtain data on malaria prevention in households (use of ITNs; IPT for Pregnant Women)
2. Obtain data on fever management in HH
3. Obtain data on prevalence of malaria, anemia
4. Explore Knowledge, Attitude, Practice (KAP)
5. Assess the performance of health workers in the management of malaria
6. Establish the proportion of malaria among patients
7. Establish malaria mortality rate among in-patients
The survey was conducted both in the community and in health facilities. Two types of questionnaires were developed.: the household questionaire and the woman's questionnaire. A portable photospectometer to detect anemia and a rapid diagnostic test to detect plasmodium falciparum malaria were used.
Kind of Data
Sample survey data [ssd]
Unit of Analysis
- Household
- Children age 0-5
- Women age 15 to 49
- Health Facilities
- Children age 0-5
- Women age 15 to 49
- Health Facilities
Version
Version Description
Version 01: Edited, anonymous dataset for public distribution.
Version Date
2005-12
Scope
Notes
The scope of the Liberia Malaria Indicators Survey 2005 included:
Household information, Knowledge, attitude and practice, Preventive measures, Fever in children under 5 years old, Mortality data, Child biomarker data. Malaria and pregnancy, Women's consent knowledge and practice.
Household information, Knowledge, attitude and practice, Preventive measures, Fever in children under 5 years old, Mortality data, Child biomarker data. Malaria and pregnancy, Women's consent knowledge and practice.
Coverage
Geographic Coverage
National
Universe
All the 15 counties were included in the study, hence the entire population of Liberia constituted the study universe.
Health Facilities.
Health Facilities.
Producers and sponsors
Primary investigators
| Name | Affiliation |
|---|---|
| Ministry of Health and Social Welfare | Government of Liberia |
Producers
| Name | Affiliation | Role |
|---|---|---|
| World Health Organization | UN | Technical Assistance |
| Ministry of Planning and Economi Affairs | GOL | Technical Assistance |
| United Nations Population Fund | UN | Technical Assistance |
Funding Agency/Sponsor
| Name | Abbreviation | Role |
|---|---|---|
| World Health Organization | WHO | Funding |
| United Nations Development Programme | UNDP | Funding |
Other Identifications/Acknowledgments
| Name |
|---|
| The Mentor Initiative |
| The Global Fund |
Sampling
Sampling Procedure
The last Population and Housing Census for Liberia was conducted in 1984. At that time, a National Sampling Frame comprising of 4,800 EAs was constructed for the Census. Not only is this frame 20 years old, but there has also been many undocumented changes in the size, structure and distribution of population and dwellings. During the 20 years period, many new communities were established, while existing ones had expanded or contracted due to migration and changes in socio-economic development. Additionally, the civil war led to the destruction of many communities and dwellings and massive displacements of the population of certain communities, as well as the death of thousands of people. These new developments have not been documented, what makes the existing sampling frame to be outdated and obsolete to be used in selecting samples for the Liberia Malaria Indicators Survey (LMIS) without undertaking a major verification exercise.
In 1999/2000, the Government of Liberia and its partners conducted a Demographic and Health Survey (DHS) using the 1984 National Sampling Frame to select and verify 600 EAs. Even though these 600 EAs are more than 5 years old now and were affected by recent civil wars, they have been considered a National Sampling Frame for the LMIS, since in fact they were nationally selected, verified and can be easily identified and verified at this point of time, thereby saving cost.
A two-stage (EAs at first stage and households at second stage) stratified sample design was developed for the 2005 LMIS. At the first stage, the 600 EAs were stratified by county and rural-urban residence. There are 15 counties and 2 rural-urban strata. The urban stratum comprised all county capitals/headquarters plus the City of Monrovia and was divided into 2 domains: (1) City of Monrovia and (2) the county capitals/headquarters. The rural stratum included the rest of the country, that is, all areas outside of the City of Monrovia and the county capitals/headquarters.
Hence, a total of 17 sampling strata were identified, that is, the City of Monrovia, all county capitals/headquarters grouped together as one stratum, and the reminder (rural parts) of the 15 counties. In view of the foregoing and based on the availability of funds, a total of 360 EAs (60%) were selected out of the 600 EAs with probability proportional to size, that is, to the number of households/structures in 1999/2000 DHS Sampling Frame.
In addition to identification and updating of EAs, a complete listing of dwellings/households in the EAs was necessary prior to the selection of households. The listing operation consisted of visiting each of the selected clusters, recording on listing forms a description of every structure together with the names of the heads of the households found in the structure, and drawing a location map of the cluster as well as a sketch map of the structures in the cluster. Twenty field workers (4 teams of 8 interviewers, 4 cartographers and 4 supervisors) completed household listing exercises of the 360 EAs in approximately 40 days (February 25-first week in April, 2005). At the end of the exercise a total of 9000 households were statistically selected for the LMIS from a total of 29,198 households
The selection of EAs within each stratum was undertaken through the following steps:
i) Assign measures of size (MoS) to sample EAs based on the 1999/2000 number of households/structures listed. Let the MoS for the ith EA in the hth stratum = Mhi
ii) Cumulate the Mhi values, i.e., = Mh
iii) Compute the sampling interval (I) as given in the formula below:
Where:
ah = assigned number of sample EAs (see column 3, table 1) for the hth strata,
iv) Using a random number table, find a random number, R, between one and I.
v) Compute the sequence of sampling numbers:
R; R+I; R+2I; R+3I; etc.
B. Cluster Selection Probabilities:
The cluster selection probability for the ith cluster in the hth stratum will be given by:
where: fhi = 1st stage selection probability for the ith PSU in the hth stratum
Since the EAs are sub-samples of the LDHS, the actual selection probability for the ith EA will be given by:
Where phi = LDHS selection probability for the ith Cluster in the hth stratum
See more on sampling in the final report.
In 1999/2000, the Government of Liberia and its partners conducted a Demographic and Health Survey (DHS) using the 1984 National Sampling Frame to select and verify 600 EAs. Even though these 600 EAs are more than 5 years old now and were affected by recent civil wars, they have been considered a National Sampling Frame for the LMIS, since in fact they were nationally selected, verified and can be easily identified and verified at this point of time, thereby saving cost.
A two-stage (EAs at first stage and households at second stage) stratified sample design was developed for the 2005 LMIS. At the first stage, the 600 EAs were stratified by county and rural-urban residence. There are 15 counties and 2 rural-urban strata. The urban stratum comprised all county capitals/headquarters plus the City of Monrovia and was divided into 2 domains: (1) City of Monrovia and (2) the county capitals/headquarters. The rural stratum included the rest of the country, that is, all areas outside of the City of Monrovia and the county capitals/headquarters.
Hence, a total of 17 sampling strata were identified, that is, the City of Monrovia, all county capitals/headquarters grouped together as one stratum, and the reminder (rural parts) of the 15 counties. In view of the foregoing and based on the availability of funds, a total of 360 EAs (60%) were selected out of the 600 EAs with probability proportional to size, that is, to the number of households/structures in 1999/2000 DHS Sampling Frame.
In addition to identification and updating of EAs, a complete listing of dwellings/households in the EAs was necessary prior to the selection of households. The listing operation consisted of visiting each of the selected clusters, recording on listing forms a description of every structure together with the names of the heads of the households found in the structure, and drawing a location map of the cluster as well as a sketch map of the structures in the cluster. Twenty field workers (4 teams of 8 interviewers, 4 cartographers and 4 supervisors) completed household listing exercises of the 360 EAs in approximately 40 days (February 25-first week in April, 2005). At the end of the exercise a total of 9000 households were statistically selected for the LMIS from a total of 29,198 households
The selection of EAs within each stratum was undertaken through the following steps:
i) Assign measures of size (MoS) to sample EAs based on the 1999/2000 number of households/structures listed. Let the MoS for the ith EA in the hth stratum = Mhi
ii) Cumulate the Mhi values, i.e., = Mh
iii) Compute the sampling interval (I) as given in the formula below:
Where:
ah = assigned number of sample EAs (see column 3, table 1) for the hth strata,
iv) Using a random number table, find a random number, R, between one and I.
v) Compute the sequence of sampling numbers:
R; R+I; R+2I; R+3I; etc.
B. Cluster Selection Probabilities:
The cluster selection probability for the ith cluster in the hth stratum will be given by:
where: fhi = 1st stage selection probability for the ith PSU in the hth stratum
Since the EAs are sub-samples of the LDHS, the actual selection probability for the ith EA will be given by:
Where phi = LDHS selection probability for the ith Cluster in the hth stratum
See more on sampling in the final report.
Response Rate
Population type Targeted Actual Achieved
Household 9,000 8,226
Overall Sample size All members of sampled HH 40,757
Women (15-49) All wom. aged 15-49 in sampled HH 9,181
Pregnant women All Preg. women in sampled HH 755
Children <5 All children <5 in sampled HH 8,933
On 9,000 targeted HH only 8,226 representing 91, 4 % were reached.
Household 9,000 8,226
Overall Sample size All members of sampled HH 40,757
Women (15-49) All wom. aged 15-49 in sampled HH 9,181
Pregnant women All Preg. women in sampled HH 755
Children <5 All children <5 in sampled HH 8,933
On 9,000 targeted HH only 8,226 representing 91, 4 % were reached.
Data Collection
Dates of Data Collection
| Start | End |
|---|---|
| 2005-07-01 | 2005-08-09 |
Data Collection Mode
Face-to-face [f2f]
Data Collection Notes
From the 23rd May to 3rd June, 2005, a 10-day training workshop (5 days theory and 5 days practical) was held in Monrovia for 63 participants (Supervisors, Interviewers, Lab technicians/Nurses and Data Entry Clerks) plus an additional seven Sub-Recipients. At the end of the workshop, a total of 59 participants were selected for the LMIS field exercise (after WHO agreed to provide funding for 16 additional interviewers). All survey personnel, including supervisors, received few days training on general topics of the survey, such as consent statements, greetings, interview techniques, teamwork, rules and regulations of the survey, etc. Later in the week, specialized training sessions were conducted for interviewers, lab technicians, supervisors, etc. Various training techniques (lectures, presentations, role-plays, group works, etc) were used during the training sessions.
Once the theoretical training sessions were completed, all questionnaires, as well as anemia and malaria testing methods were field-tested. A 5-day field practice in non-sample households was conducted (May 30-June 3rd, 2005). The purpose of the field practice was two-fold: to allow fieldwork staff to practice survey methods in real life situation and to test the competency of the staff for selection purposes. After being proven to be working and after some minor modifications, the survey questionnaires were printed and ready for use. For this exercise, eight (8) teams, each comprising 4 interviewers, 2 lab technicians/nurses, a supervisor/editor, and 2 drivers, were recruited to cover 9,000 households in 33 days of fieldwork. Eight (8) teams were assigned each to approximately 45 EAs. Field staffs, particularly interviewers, were assigned to clusters in which they spoke or understood the local languages.
The LMIS interview phase started on July 1st, 2005 and ended in August, 2005. Four of the 8 teams completed their assignment within 33 days. Four teams (Nimba, Lofa, Sinoe and South Eastern) were delayed for an additional 7 days due to constant vehicle breakdown. A written informed consent of the head of household was sought from each selected house, using the information and consent forms in the household and women questionnaires.
Once the theoretical training sessions were completed, all questionnaires, as well as anemia and malaria testing methods were field-tested. A 5-day field practice in non-sample households was conducted (May 30-June 3rd, 2005). The purpose of the field practice was two-fold: to allow fieldwork staff to practice survey methods in real life situation and to test the competency of the staff for selection purposes. After being proven to be working and after some minor modifications, the survey questionnaires were printed and ready for use. For this exercise, eight (8) teams, each comprising 4 interviewers, 2 lab technicians/nurses, a supervisor/editor, and 2 drivers, were recruited to cover 9,000 households in 33 days of fieldwork. Eight (8) teams were assigned each to approximately 45 EAs. Field staffs, particularly interviewers, were assigned to clusters in which they spoke or understood the local languages.
The LMIS interview phase started on July 1st, 2005 and ended in August, 2005. Four of the 8 teams completed their assignment within 33 days. Four teams (Nimba, Lofa, Sinoe and South Eastern) were delayed for an additional 7 days due to constant vehicle breakdown. A written informed consent of the head of household was sought from each selected house, using the information and consent forms in the household and women questionnaires.
Data Collectors
| Name | Abbreviation | Affiliation |
|---|---|---|
| Ministry of Health | MOE | GOL |
Questionnaires
Questionnaires
The LMIS technical committee used existing DHS, WHO & MACRO Survey instruments (manuals, questionnaires, etc references to add) to produce the LMIS survey tools. Two types of structured questionnaires were developed in english: the Household questionnaire and the women's questionnaire.
It comprises 6 sections :
- Section 0 : Introduction and the interviewee's consent
- Section 1: HH information
- Section 2 : Knowledge , Attitude and Practice
- Section 3: Preventive measures
- Section 4: Fever in children under 5 years old
- Section 5: Mortality data
The women's questionnaire was aimed at collecting information on the use of IPT as part of antenatal service during the last pregnancy that ended in a life birth, prevalence of fever/convulsion among children under five years of age and type/promptness of anti-malarial treatment given to these children. Three sections are noted:
- Section 6: Introduction and woman's consent
- Section 7: Malaria and pregnancy
- Section 8: Fever in children under five years old
It comprises 6 sections :
- Section 0 : Introduction and the interviewee's consent
- Section 1: HH information
- Section 2 : Knowledge , Attitude and Practice
- Section 3: Preventive measures
- Section 4: Fever in children under 5 years old
- Section 5: Mortality data
The women's questionnaire was aimed at collecting information on the use of IPT as part of antenatal service during the last pregnancy that ended in a life birth, prevalence of fever/convulsion among children under five years of age and type/promptness of anti-malarial treatment given to these children. Three sections are noted:
- Section 6: Introduction and woman's consent
- Section 7: Malaria and pregnancy
- Section 8: Fever in children under five years old
Data Processing
Data Editing
The entire filled out questionnaire forms were collected and centralized atthe National Malaria Control Programme in Monrovia. The cleaning process consisted of verifying that sampled HH were visited, that all forms were fully and correctly filled out and that responses were relevant to questions. A control of coherance of variables within a section and between different sections of the questionaires was performed.
Access policy
Contacts
| Name | Affiliation | |
|---|---|---|
| Head, RMEU | Ministry of Health, National Malaria Control Programme | Yzolia@yahoo.com |
| Acting Program Manager | Ministry of Health, National Malaria Control Programme | tgnyenswah@yahoo.com |
| Data Manager | Ministry of Health, National Malaria Control Programme | tgnyenswah@yahoo.com |
Confidentiality
LISGIS (MOH) encourages the sharing and use of survey data. However, users must meet the conditions as specified in the Access Conditions and requirement areas. Please do not redistribute data to other institutes without the explicit consent from MOH, malaria control prograammr authorities.
Access conditions
LISGIS (MOH) data is free to use but is available for only non-commercial research purposes. To obtain access to the data, please contact the relevant persons listed. All publication, from the use of the data must include an acknowledgement to the survey and LISGIS. Guidelines for the form of such an acknowledgement are given under citation requirement.
Citation requirements
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
- 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
Access authority
| Name | Affiliation | |
|---|---|---|
| Head, RMEU | Ministry of Health, National Malaria Control Programme | Yzolia@yahoo.com |
| Acting Program Manager | Ministry of Health, National Malaria Control Programme | tgnyenswah@yahoo.com |
| Data Manager | Ministry of Health, National Malaria Control Programme | gabthompson@yahoo.com |
Disclaimer and copyrights
Disclaimer
Liberia Institute of Statistics and Geo-Information Services, (LISGIS) provides these data to external users without any warranty or responsibility implied. LISGIS accepts no responsibility for the results and/or implications of any actions resulting from the use of these data.
Metadata production
DDI Document ID
DDI_LBR_2005_MIS_v02_M
Producers
| Name | Abbreviation | Affiliation | Role |
|---|---|---|---|
| Ivo Njosa | IN | Consultant | Producer of CDROM |
Date of Metadata Production
2008-03-18
DDI Document version
Version 02: Adopted from "DDI-LBR-Consultant--2005-v01." DDI.