The South Sudan Household Health Survey (SHHS 2) marks the second household and health study in post-conflict South Sudan.
The first Sudan Household Health survey (SHHS) was conducted in 2006. It was the first nationwide survey in two decades that covered key social development indicators including child mortality, nutrition, reproductive health and HIV/AIDS.It also covered other basic social services such as education, and water and sanitation. The survey was jointly conducted by the Ministry of Health (MOH) and the Central Bureau of Statistics (CBS). It was modeled on the structure of the Multiple Indicator Cluster Surveys (MICS), and Pan Arab Project for Family (PAPFAM) methodologies.
The second South Sudan Household Health Survey (SHHS 2) was conducted in 2010 by the Ministry of Health and National Bureau of Statistics.
The primary objectives of the second South Sudan Household Health Survey (SHHS 2) were:
- To provide up-to-date information for assessing the situation of children and women in South Sudan;
- To furnish data needed for monitoring progress toward goals established in the Millennium Declaration and other internationally agreed upon goals, as a basis for future action;
- To contribute to the improvement of data and monitoring systems in South Sudan and to strengthen technical expertise in the design, implementation, and analysis of such systems.
- To generate data on the situation of children and women, including the identification of vulnerable groups and of disparities, to inform policies and interventions.
- To provide up-to-date information on the health status of children and women of South Sudan in order to understand differences related to determinants of health, such as poverty, education, gender, residence type (rural/urban), and the State of residence;
- To generate data that assist in monitoring progress towards achieving the MDGs and WFFC’s goals; and
- To contribute to essentially desired improvements of data collection, quality, and analysis in South Sudan.
Sudan Household Health Survey is modelled on MICS, an international household survey programme developed by UNICEF. SHHS 2 was conducted as part of the fourth global round of MICS surveys (MICS4). MICS provides up-to-date information on the situation of children and women and measures key indicators that allow countries to monitor progress towards the Millennium Development Goals (MDGs) and other internationally agreed upon commitments. Additional information on the global MICS project may be obtained from www.childinfo.org.
The scope of the South Sudan Household Health Survey 2010 includes:
- HOUSEHOLD: Household characteristics; household listing; education; water and sanitation; insecticide treated nets; salt iodization
- WOMEN: Women’s background; child mortality; live birth history; desire for last birth (results not available); maternal and newborn health; contraception; unmet need; attitudes towards domestic violence; marriage/union; female genital mutilation/cutting (results not available); sexual behaviour; HIV/AIDS; sexually transmitted infections (results not available)
- MEN: Men’s characteristics; attitudes towards domestic violence; marriage/union; sexual behaviour; HIV/AIDS; sexually transmitted infections
- CHILDREN: Children's characteristics; age; birth registration; breastfeeding; early child development (Results not available); care of illness; malaria; immunization; anthropometry.
The ten states of South Sudan: Upper Nile, Jonglei, Unity, Warap Northern Bahr El Ghazal, Western Bahr El Ghazal, Lakes, Western Equatoria, Central Equatoria, and Eastern Equatoria.
Producers and sponsors
Ministry of Health
Government of Southern Sudan
National Bureau of Statistics
Government of Southern Sudan
United Nations Children’s Fund
World Food Programme
United Nations Population Fund Activities
United States Agency for International Development
World Health Organization
Joint United Nations Programme on HIV/AIDS
The sample for the second South Sudan Household Health Survey (SHHS 2) was designed to provide estimates for a large number of indicators on the situation of children and women at the national level, for urban and rural areas, and for the 10 states across the country: The said States are Upper Nile, Jonglei, Unity, Warap Northern Bahr El Ghazal, Western Bahr El Ghazal, Lakes, Western Equatoria, Central Equatoria, Eastern Equatoria.
The sampling frame used for the SHHS 2 is the 2008 Sudan Population and Housing Census. States were identified as the sampling domains or domains of analysis. The sample uses 20 urban and rural strata, two per State.
The sample size for the survey was determined by the degree of precision required for survey estimates for each state: 1,000 households in each state. Since a similar level of precision was required for the survey results from each state, it was decided to draw 40 clusters from each state and 25 households from each cluster. However, in each of Unity and Jonglei states only 39 clusters were selected and that yields 975 households by state. The total sample was finally 9,950 households or 398 clusters (enumeration areas).
The sample was selected in two stages: within each State, enumeration areas were randomly selected with probability proportional to size as primary sampling units. After a household listing was carried out within the selected enumeration areas, a sample of 25 households was drawn in each sampled enumeration area.
Of the 9,950 households selected for the sample, 9,760 were found to be occupied. Of these, 9,369 were successfully interviewed for a household response rate of 96 percent. In the interviewed households, 11,568 women (age 15-49 years) were identified. Of these, 9,069 were successfully interviewed, yielding a response rate of 78 percent within interviewed households. In addition, 8,656 men (age 15-49 years) were listed in the household questionnaire. Questionnaires were completed for 4,345 of eligible men, which corresponds to a response rate of 50 percent within interviewed households. There were 10,040 children under age five listed in the household questionnaire. Questionnaires were completed for 8,338 of these children, which corresponds to a response rate of 83 percent within interviewed households. Overall response rates of 75, 48, and 80 are calculated for the women’s, men’s and under-5’s interviews respectively. See Table HH.1 of the survey report.
Across the 10 States, women’s response rates, except Northern Bahr el Ghazal, are below 85 percent. The results for these States should thus be interpreted with some caution, as their response rates are low. The response rates for the children under five years of age in 5 of the 10 States were equally low. These are Western Equatoria, Central Equatoria, Unity, Upper Nile and Lakes States. These results are low, and therefore interpretation in these States should also be handled with caution. Response rates for urban and rural areas for the three categories (women, men and children under-five) are also below 85 percent; this as well requires some caution in the interpretation of the results. Crucially, response for the men’s module was exceedingly low, as their overall response rate is 48. Accordingly, all analysis on men was dropped from the survey report.
The sample is not self-weighting; for reporting national level results, sample weights are used.
Dates of Data Collection
Data Collection Mode
Data Collection Notes
Training for the fieldwork was conducted from February to March 2010. Training included lectures on interviewing techniques and the contents of the questionnaires, and mock interviews between trainees to gain practice in asking questions. Towards the end of the training period, trainees spent 2 days in practice interviewing in Juba Payam, Central Equatoria State. Field work staff and data analysts were selected across the ten states. A total of 677 field staffs were recruited and trained in January, February and March 2010. The data were collected by these staffs, comprising 40 teams. Each team was comprised of 3 interviewers, one driver, one editor, one measurer and a supervisor. Fieldwork began in last week of March and concluded by the end of June 2010.
Information gathered using the men's questionnaire is not included due to high level of non-response.
In addition to the administration of questionnaires, fieldwork teams tested the salt used for cooking in the households for iodine content, and measured the weights and heights of children age under 5 years.
Four sets of questionnaires were used in the survey:
1) a household questionnaire which was used to collect information on all de jure household members (usual residents), the household, and the dwelling;
2) a women’s questionnaire administered in each household to all women aged 15-49 years;
3) a men’s questionnaire administered in each household to all men aged 15-49 years; and
4) an under-5 questionnaire, administered to mothers or caretakers for all children under 5 living in the household.
The questionnaires included the following modules:
The household questionnaire included the following modules:
- Household information panel
- Household Listing Form and Education
- Water and Sanitation (country specific tables were produced for use of improved water sources, Household water treatment, Time to source of drinking water; and Drinking water and sanitation ladders)
- Household Characteristics
- Insecticide Treated Nets (Results are only available for household possession of at least one mosquito net and one long-lasting treated net)Salt Iodization
The questionnaire for individual women was administered to all women aged 15-49 years living in the households, and included the following modules:
- Woman’s Information Panel
- Women’s Background
- Child Mortality
- Live Birth History
- Desire for Last Birth (Results not available)
- Maternal and Newborn Health
- Unmet Need
- Attitudes Towards Domestic Violence
- Female Genital Mutilation/Cutting (Results not available)
- Sexual Behaviour
- Sexually Transmitted Infections (Results not available)
The questionnaire for individual men was administered to all men aged 15-49 years living in the households, and included the following modules:
- Men’s information panel
- Men’s Background
- Attitudes Towards Domestic Violence
- Sexual Behaviour
- Sexually Transmitted Infections
The questionnaire for children under five was administered to mothers or caretakers of children under 5 years of age1 living in the households. Normally, the questionnaire was administered to mothers of under-5 children; in cases when the mother was not listed in the household roster, a primary caretaker for the child was identified and interviewed. The
questionnaire included the following modules:
- Under five Child Information Panel
- Birth Registration
- Early Child Development (Results not available)
- Care of Illness
The questionnaires are based on the MICS4 model questionnaire2. Based on the results of the pre-test, modifications were made to the wording and translation of the questionnaires.
Data were entered using the CSPro software. The data were entered on 20 microcomputers and carried out by 40 data entry operators and 4 data entry supervisors. In order to ensure quality control, all questionnaires were double entered and internal consistency checks were performed. Procedures and standard programs developed under the global MICS4 programme and adapted to the South Sudan questionnaire were used throughout. Data processing began after the end of data collection and was completed in July 2010. Data were analysed using the Statistical Package for Social Sciences (SPSS) software program, Version 18, and the model syntax and tabulation plans developed by UNICEF were used for this purpose.
Users of the data agree to keep confidential all data contained in these datasets and to make no attempt to identify, trace or contact any individual whose data is included in these datasets.
Public use files, accessible to all
Ministry of Health and National Bureau of Statistics, 2010. South Sudan Household Survey 2010, Final Report. Juba, South Sudan.
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.