{"type":"survey","doc_desc":{"title":"MDG_2003_DHS_v01_M","idno":"DDI_MDG_2003_DHS_v01_M","producers":[{"name":"World Bank, Development Economics Data Group","abbreviation":"DECDG","affiliation":"","role":"Generation of DDI documentation"}],"prod_date":"2012-03-29"},"study_desc":{"title_statement":{"idno":"MDG_2003_DHS_v01_M","title":"Enqu\u00eate D\u00e9mographique  et de Sant\u00e9 2003-2004","alt_title":"EDS 2003-04 \/ DHS 2003-04","translated_title":"Demographic and Health Survey 2003-2004"},"authoring_entity":[{"name":"Institut National de la Statistique (INSTAT)","affiliation":"Minist\u00e8re de l\u2019\u00c9conomie, des Finances et du Budget"},{"name":"Minist\u00e8re de la Sant\u00e9 et du Planning Familial","affiliation":""}],"production_statement":{"producers":[{"name":"ORC Macro","affiliation":"","role":""}],"funding_agencies":[{"name":"Agence des \u00c9tats-Unis pour le D\u00e9veloppement International","abbreviation":"USAID","role":"Funding"},{"name":"Fonds des Nations Unies pour l\u2019Enfance","abbreviation":"UNICEF","role":"Funding"},{"name":"Banque Mondiale","abbreviation":"WB\/ CNLS\/PMPS & CRESAN-2","role":"Funding"},{"name":"Fonds des Nations Unies pour la Population","abbreviation":"UNFPA","role":"Funding"},{"name":"Gouvernement malgache","abbreviation":"","role":"Funding"}],"grant_no":"HRN-C-00-97-00019-00"},"distribution_statement":{"contact":[{"name":"General Inquiries","affiliation":"","email":"info@measuredhs.com ","uri":"www.measuredhs.com"},{"name":"Data and Data Related Resources","affiliation":"","email":"archive@measuredhs.com","uri":"www.measuredhs.com"},{"name":"Direction de la D\u00e9mographie et des Statistique Sociales","affiliation":"Institut National de la Statistique (INSTAT)","email":"dginstat@moov.mg","uri":"http:\/\/www.instat.mg\/"}]},"series_statement":{"series_name":"Demographic and Health Survey (standard) - DHS IV","series_info":"L'Enqu\u00eate D\u00e9mographique et de Sant\u00e9 Madagascar 2003-2004 est la troisi\u00e8me EDS r\u00e9alis\u00e9e \u00e0 Madagascar.Elle fait suite \u00e0 celles r\u00e9alis\u00e9es en 1992 et 1997."},"study_info":{"abstract":"L'Enqu\u00eate D\u00e9mographique et de Sant\u00e9 de Madagascar (EDSMD-III) est la troisi\u00e8me du genre. Il s'agit d'une enqu\u00eate par sondage, repr\u00e9\u00adsentative au niveau national ; elle a \u00e9t\u00e9 conduite par la Direction de la D\u00e9mographie et des Statistiques Sociales de l'Institut National de la Statistique en collaboration avec le Minist\u00e8re de la Sant\u00e9. Elle a b\u00e9n\u00e9fici\u00e9 de l'assistance technique de ORC Macro, institution de coop\u00e9ration am\u00e9ricaine en charge du programme international des Enqu\u00eates D\u00e9mographiques et de Sant\u00e9 (DHS).\n\nLa troisi\u00e8me Enqu\u00eate D\u00e9mographique et de Sant\u00e9 de Madagascar (EDSMD-III) a pour objectif d'estimer de nombreux indicateurs socio-\u00e9conomiques, d\u00e9mographiques et sanitaires au niveau de l'ensemble de la population et au niveau des sous-populations des femmes de 15-49 ans, des enfants de moins de 5 ans et des hommes de 15-59 ans. En particulier, l'EDSMD-III vise \u00e0 identifier et\/ou \u00e0 estimer : \n\nPour l'ensemble de la population : \n- Les niveaux de scolarisation ; \n- Les niveaux d'utilisation du sel iod\u00e9 ; \n- Certains indicateurs de bien-\u00eatre des m\u00e9nages. \n\nPour les femmes de 15-49 ans et les enfants de moins de cinq ans : \n- Divers indicateurs d\u00e9mographiques, en particulier les taux de f\u00e9condit\u00e9, de mortalit\u00e9 des enfants et de mortalit\u00e9 des adultes ; \n- Les facteurs directs et indirects qui d\u00e9terminent les niveaux et tendances de la f\u00e9condit\u00e9, tels que les comportements matrimoniaux, les comportements sexuels et l'utilisation de la contraception ; \n- Les cat\u00e9gories de femmes susceptibles d'avoir plus ou moins d'enfants et susceptibles d'utiliser la contraception ; \n- Les taux de connaissance et de pratique contraceptive par m\u00e9thode, selon diverses caract\u00e9ristiques socio-d\u00e9mographiques ; \n- Les facteurs directs et indirects qui d\u00e9terminent les niveaux et tendances de la mortalit\u00e9 ; \n- Diff\u00e9rentes composantes de la sant\u00e9 de la reproduction et de la sant\u00e9 des enfants : visites pr\u00e9natales et postnatales, conditions d'accouchement, allaitement, vaccinations, pr\u00e9valence et traitement de la diarrh\u00e9e et d'autres maladies chez les enfants de moins de cinq ans ; \n- L'\u00e9tat nutritionnel des femmes et des enfants de moins de cinq ans au moyen des mesures anthropom\u00e9triques (poids et taille) ;  \n- Le niveau de connaissance, les opinions et attitudes des femmes vis-\u00e0-vis des Infections Sexuellement Transmissibles (IST) et du VIH\/sida ; \n- Le taux d'an\u00e9mie chez les femmes et les enfants de moins de cinq ans ;  \n- Le taux de pr\u00e9valence de la syphilis chez les femmes de 15-49 ans ;  \n- La couverture vaccinale contre le t\u00e9tanos \u00e0 partir du test s\u00e9rologique chez les femmes de 15-49 ans et les enfants de moins de cinq ans ;  \n- La couverture vaccinale contre la rougeole \u00e0 partir du test s\u00e9rologique chez les enfants de moins de cinq ans ;  \n\nPour les hommes de 15-59 ans :\n- Les facteurs directs et indirects qui d\u00e9terminent les niveaux et tendances de la f\u00e9condit\u00e9, tels que les comportements matrimoniaux, les comportements sexuels et l'utilisation de la contraception ; \n- Les cat\u00e9gories d'hommes susceptibles d'avoir plus ou moins d'enfants et susceptibles d'utiliser la contraception ; \n- Le niveau de connaissance, les opinions et attitudes des hommes vis-\u00e0-vis des Infections Sexuellement Transmissibles (IST) et du VIH\/sida ; \n- Les taux d'an\u00e9mie et de pr\u00e9valence de la syphilis.  \n\nL'ensemble des informations collect\u00e9es constitue une base de donn\u00e9es qui facilitera la mise en place et le suivi de politiques et de programmes dans le domaine de la population et de la sant\u00e9 et, plus globalement, de politiques visant l'am\u00e9lioration des conditions de vie de la population malagasy. Par ailleurs, les donn\u00e9es ayant \u00e9t\u00e9 collect\u00e9es selon une m\u00e9thodologie similaire \u00e0 celle utilis\u00e9e dans les op\u00e9rations pr\u00e9c\u00e9dentes et dans de nombreux autres pays ayant particip\u00e9 au programme DHS, elles font partie, de ce fait, d'une base de donn\u00e9es utilisables et comparables avec les p\u00e9riodes ant\u00e9rieures et au niveau international.","coll_dates":[{"start":"2003-11","end":"2004-03","cycle":""}],"nation":[{"name":"Madagascar","abbreviation":"MDG"}],"geog_coverage":"National","analysis_unit":"- Household\n- Women age 15-49\n- Men age 15-59","universe":"L'univers de l'enqu\u00eate est l'ensemble de la population et au niveau des sous-populations des femmes de 15 \u00e0 49 ans (r\u00e9sidentes habituelles ou visiteuses) qui se trouvaient dans les m\u00e9nages la nuit pr\u00e9c\u00e9dent l'enqu\u00eate quelque soit le statut et les maris du m\u00e9nage ag\u00e9s de 15 \u00e0 59 ans.","data_kind":"Sample survey data","notes":"L'Enqu\u00eate Nationale D\u00e9mographique et Sanitaire 2003-2004 couvre les th\u00e8mes suivants :\n- Allaitement et alimentation de compl\u00e9ment\n- Anthropom\u00e9trie\n- Caract\u00e9ristiques socio-d\u00e9mographiques des enqu\u00eat\u00e9s\n- Cartographie \/ GPS\n- Contraception\n- Etat nutritionnel des enfants\n- F\u00e9condit\u00e9\n- Grossesse\n- Mariage et activit\u00e9 sexuelle\n- Mortalit\u00e9 maternelle et infantile\n- Mesures anthropom\u00e9triques\n- Micronutriments\n- Nuptialit\u00e9 et exposition au risque de grossesse\n- Plannification familiale\n- Reproduction\n- Sant\u00e9 et nutrition des femme\n- Services communautaires\n- Soins postnatals et nutrition des enfants\n- Tests tetanos, syphilis, an\u00e9mie, rougeole\n- Vaccination","study_scope":"L'Enqu\u00eate Nationale D\u00e9mographique et Sanitaire 2003-2004 couvre les th\u00e8mes suivants :\n- Allaitement et alimentation de compl\u00e9ment\n- Anthropom\u00e9trie\n- Caract\u00e9ristiques socio-d\u00e9mographiques des enqu\u00eat\u00e9s\n- Cartographie \/ GPS\n- Contraception\n- Etat nutritionnel des enfants\n- F\u00e9condit\u00e9\n- Grossesse\n- Mariage et activit\u00e9 sexuelle\n- Mortalit\u00e9 maternelle et infantile\n- Mesures anthropom\u00e9triques\n- Micronutriments\n- Nuptialit\u00e9 et exposition au risque de grossesse\n- Plannification familiale\n- Reproduction\n- Sant\u00e9 et nutrition des femme\n- Services communautaires\n- Soins postnatals et nutrition des enfants\n- Tests tetanos, syphilis, an\u00e9mie, rougeole\n- Vaccination"},"method":{"data_collection":{"data_collectors":[{"name":"Institut National de la Statistique (INSTAT)","abbreviation":"","affiliation":""}],"sampling_procedure":"La troisi\u00e8me enqu\u00eate d\u00e9mographique et de sant\u00e9 de Madagascar (EDSMD-III) fait suite \u00e0 celles r\u00e9alis\u00e9es en 1992 et 1997. Elle vise un \u00e9chantillon national d'environ 9000 femmes \u00e2g\u00e9es de 15 \u00e0 49 ans et de 3 000 hommes \u00e2g\u00e9s de 15 \u00e0 59 ans.\n\nL'\u00e9chantillon de l'EDSMD-III est un \u00e9chantillon ar\u00e9olaire, stratifi\u00e9 et tir\u00e9 \u00e0 2 degr\u00e9s. L'unit\u00e9 primaire de sondage est la grappe ou zone de d\u00e9nombrement (ZD) telle que d\u00e9finie dans l'\u00e9chantillon ma\u00eetre de Madagascar 1996. Chacune des 6 provinces du pays a \u00e9t\u00e9 s\u00e9par\u00e9e en parties urbaine et rurale pour former les strates. L'\u00e9chantillon a \u00e9t\u00e9 tir\u00e9 ind\u00e9pendamment dans chaque strate. \n\nAu premier degr\u00e9, 303 grappes ont \u00e9t\u00e9 tir\u00e9es avec une probabilit\u00e9 proportionnelle \u00e0 la taille. La taille est le nombre de m\u00e9nages estim\u00e9 dans la grappe pendant l'op\u00e9ration de cartographie de l'\u00e9chantillon ma\u00eetre. Un d\u00e9nombrement des m\u00e9nages dans chaque grappe s\u00e9lectionn\u00e9e a permis d'obtenir une liste de m\u00e9nages, \u00e0 partir de laquelle les m\u00e9nages de l'\u00e9chantillon ont \u00e9t\u00e9 tir\u00e9s au deuxi\u00e8me degr\u00e9. \n\nTous les membres des m\u00e9nages tir\u00e9s sont identifi\u00e9s \u00e0 l'aide d'un questionnaire m\u00e9nage. Chaque femme \u00e2g\u00e9e de 15 \u00e0 49 ans, identifi\u00e9e, sera \u00e9galement enqu\u00eat\u00e9e avec un questionnaire femme. Dans un sous-\u00e9chantillon des m\u00e9nages s\u00e9lectionn\u00e9s pour l'enqu\u00eate aupr\u00e8s des femmes, tous les hommes \u00e2g\u00e9s de 15 \u00e0 59 seront aussi interrog\u00e9s. Par ailleurs, c'est \u00e9galement dans ce sous-\u00e9chantillon de m\u00e9nages, qui repr\u00e9sente le tiers de l'ensemble, que le pr\u00e9l\u00e8vement de sang a \u00e9t\u00e9 effectu\u00e9 pour le test d'an\u00e9mie sur les femmes, les hommes et les enfants, et pour le test de la syphilis sur les femmes et les hommes. Dans un autre sous-\u00e9chantillon d'un tiers de l'\u00e9chantillon national, du sang a \u00e9t\u00e9 pr\u00e9lev\u00e9 aupr\u00e8s des enfants de moins de cinq ans pour le test du t\u00e9tanos et de la rougeole. Les femmes de ce sous-\u00e9chantillon ont \u00e9galement \u00e9t\u00e9 test\u00e9es pour le t\u00e9tanos.","coll_mode":"Face-to-face","research_instrument":"Afin d'atteindre les objectifs fix\u00e9s, trois types de questionnaires ont \u00e9t\u00e9 utilis\u00e9s : \n\na) Questionnaire m\u00e9nage. Il permet de collecter des informations sur le m\u00e9nage, telles que le nombre de personnes y r\u00e9sidant, par sexe, \u00e2ge, niveau d'instruction, la survie des parents, etc. En outre, il permet \u00e9galement de collecter des informations sur les caract\u00e9ristiques du logement (approvisionnement en eau, type de toilettes, etc.), et sur le sel utilis\u00e9 par les m\u00e9nages : ces informations sont recueillies afin d'appr\u00e9cier les conditions environnementales et socio\u00ad\u00e9conomiques dans lesquelles vivent les personnes enqu\u00eat\u00e9es. De plus, les femmes \u00e2g\u00e9es de 15\u00ad49 ans et les enfants \u00e2g\u00e9s de moins de 5 ans sont pes\u00e9s et mesur\u00e9s pour d\u00e9terminer leur \u00e9tat nutritionnel. En outre, le questionnaire m\u00e9nage permet d'\u00e9tablir l'\u00e9ligibilit\u00e9 des personnes \u00e0 interviewer individuellement. Il permet aussi de d\u00e9terminer les populations de r\u00e9f\u00e9rence pour le calcul de certains taux d\u00e9mographiques.  \n\nb) Questionnaire biomarkers du m\u00e9nage. Ce questionnaire est administr\u00e9 dans un tiers des m\u00e9nages. Il permet de collecter au niveau du m\u00e9nage, pour chaque membre \u00e9ligible, le statut de pr\u00e9l\u00e8vement du sang pour le test de l'an\u00e9mie, de la syphilis, du t\u00e9tanos et de la rougeole. \u00c0 la diff\u00e9rence des autres biomarkers test\u00e9s, Il permet aussi d'enregistrer les r\u00e9sultats du test de l'an\u00e9mie. Ainsi, on a pr\u00e9lev\u00e9 du sang aupr\u00e8s des femmes \u00e9ligibles de 15-49 ans et des hommes de 15-59 ans pour d\u00e9terminer les pr\u00e9valences de l'an\u00e9mie et de la syphilis. Chez les enfants de moins de cinq ans, on a pr\u00e9lev\u00e9 leur sang pour la mesure de la pr\u00e9valence de l'an\u00e9mie, la pr\u00e9valence de la protection s\u00e9rologique contre le t\u00e9tanos et contre la rougeole. Le sang des femmes \u00e9ligibles de 15-49 ans a \u00e9t\u00e9 \u00e9galement pr\u00e9lev\u00e9 pour mesurer la pr\u00e9valence de la protection s\u00e9rologique contre le t\u00e9tanos. \n\nc) Questionnaire femme. Il comprend les dix sections suivantes : \n- Caract\u00e9ristiques socio-d\u00e9mographiques des enqu\u00eat\u00e9es ; \n- Reproduction ; \n- Planification familiale ; \n- Grossesse, soins postnatals et allaitement ;  \n- Vaccination, sant\u00e9 et nutrition ; \n- Mariage et activit\u00e9 sexuelle ; \n- Pr\u00e9f\u00e9rences en mati\u00e8re de f\u00e9condit\u00e9 ; \n- Caract\u00e9ristiques du conjoint et travail de la femme ; \n- Sida et autres maladies sexuellement transmissibles ; \n- Mortalit\u00e9 maternelle. \n\nd) Questionnaire homme. Il s'agit \u00e9galement d'un questionnaire individuel comprenant les six sections suivantes : \n- Caract\u00e9ristiques socio-d\u00e9mographiques de l'enqu\u00eat\u00e9 ; \n- Reproduction ; \n- Contraception ; \n- Mariage et activit\u00e9 sexuelle ; \n- Pr\u00e9f\u00e9rences en mati\u00e8re de f\u00e9condit\u00e9 ; \n- Sida et Maladies sexuellement transmissibles ; \n\nCes instruments ont \u00e9t\u00e9 d\u00e9velopp\u00e9s \u00e0 partir des questionnaires de base du programme DHS+, adapt\u00e9s au contexte de Madagascar en tenant compte des objectifs de l'enqu\u00eate.","coll_situation":"Pour garantir une bonne r\u00e9alisation de l'enqu\u00eate, un comit\u00e9 technique a \u00e9t\u00e9 mis en place sous la responsabilit\u00e9 d'un Directeur national et d'un Directeur technique. Ils avaient en charge la supervision g\u00e9n\u00e9rale de l'enqu\u00eate, y compris les travaux informatiques. \n\nPar ailleurs, les cadres de la Direction de la D\u00e9mographie et des Statistiques Sociales ont assur\u00e9 la formation du personnel d'enqu\u00eate avec la participation d'autres personnes ressources du minist\u00e8re de la Sant\u00e9 et du Planning Familial. \n\nLes activit\u00e9s de collecte se sont d\u00e9roul\u00e9es en 3 \u00e9tapes principales : l'enqu\u00eate pilote, le d\u00e9nombrement des zones d'enqu\u00eate \u00e9chantillonn\u00e9es et l'enqu\u00eate principale. Pour chacune de ces \u00e9tapes, une formation a \u00e9t\u00e9 dispens\u00e9e aux personnes recrut\u00e9es. \n\nPour les op\u00e9rations de cartographie et de d\u00e9nombrement des zones de l'enqu\u00eate, 18 agents ont \u00e9t\u00e9 recrut\u00e9s pour former 9 \u00e9quipes. Cette phase a couvert la p\u00e9riode allant de juillet \u00e0 mi-septembre 2003. \n\nL'enqu\u00eate pilote a \u00e9t\u00e9 effectu\u00e9e du 15 au 25 Avril 2003 dans trois grappes, une en milieu urbain et deux en milieu rural. Aucune de ces grappes ne faisaient partie de l'\u00e9chantillon principal. Environ 60 m\u00e9nages, 80 femmes et 50 hommes ont \u00e9t\u00e9 interview\u00e9s par trois \u00e9quipes de deux enqu\u00eatrices, un enqu\u00eateur et une infirmi\u00e8re chacune pendant six jours. L'objectif de cet exercice \u00e9tait de tester, entre autres, l'acceptabilit\u00e9 des questionnaires m\u00e9nage, femme et homme. L'enqu\u00eate pilote a ainsi permis de r\u00e9viser et de finaliser les questionnaires ainsi que les autres documents m\u00e9thodologiques de l'enqu\u00eate. \n\nPour ce qui est de l'enqu\u00eate principale, le personnel de terrain, s\u00e9lectionn\u00e9 par la Direction de la D\u00e9mographie et des Statistiques Sociales a \u00e9t\u00e9 form\u00e9 sur une p\u00e9riode de quatre semaines, y compris la formation pour le test de l'an\u00e9mie, de la syphilis, de t\u00e9tanos et de la rougeole. La formation consistait d'une part, en des expos\u00e9s th\u00e9oriques concernant les techniques d'enregistrement des informations et d'autre part, en des exercices pratiques sur le remplissage des questionnaires. En outre, le Coordonnateur national en sant\u00e9, d\u00e9sign\u00e9 par le Minist\u00e8re de la Sant\u00e9 et du Planning Familial, participait \u00e0 la formation des infirmi\u00e8res et techniciens de laboratoire pour les tests biomarker. \n\nOnze (11) \u00e9quipes, compos\u00e9es chacune de deux infirmi\u00e8res (charg\u00e9es \u00e9galement de la prise de sang pour les tests d'an\u00e9mie, de syphilis, du t\u00e9tanos et de rougeole), d'une enqu\u00eatrice, d'un technicien de laboratoire, une contr\u00f4leuse, un chef d'\u00e9quipe et un chauffeur, ont \u00e9t\u00e9 constitu\u00e9es pour la collecte. Le chef d'\u00e9quipe \u00e9tait charg\u00e9 de mener l'enqu\u00eate homme. \n\nToutes les \u00e9quipes ont d'abord travaill\u00e9 dans des grappes r\u00e9elles aux alentours de la Capitale. Cette strat\u00e9gie a \u00e9t\u00e9 adopt\u00e9e afin de permettre aux \u00e9quipes de relater les diff\u00e9rents probl\u00e8mes rencontr\u00e9s (administratif, technique et autres) avant de rejoindre leur zone de travail respective. Etant donn\u00e9 que la collecte des donn\u00e9es s'est d\u00e9roul\u00e9e en pleine saison de pluie et pendant la p\u00e9riode cyclonique, toutes les \u00e9quipes ont \u00e9t\u00e9 d\u00e9ploy\u00e9es dans les provinces et surtout dans les zones enclav\u00e9es. Les grappes de la province d'Antananarivo et celles de la Capitale ont \u00e9t\u00e9 r\u00e9alis\u00e9es en dernier par l'ensemble des \u00e9quipes. La collecte des donn\u00e9es s'est d\u00e9roul\u00e9e du 23 novembre 2003 au 28 mars 2004.\n\nPERSONNEL ET ACTIVITES DE PRELEVEMENT DE SANG DANS L'EDSMD-III \n\nFORMATION POUR LE PRELEVEMENT DE SANG \nLa formation des infirmi\u00e8res\/m\u00e9decins et des techniciens de laboratoire, de l'enqu\u00eate principale a dur\u00e9 deux semaines, du 23 octobre au 6 novembre 2003. Trente-deux infirmi\u00e8res\/m\u00e9decins et 15 techniciens de laboratoire, certifi\u00e9s, avaient \u00e9t\u00e9 r\u00e9f\u00e9r\u00e9s par le Minist\u00e8re de la Sant\u00e9 et du Planning Familial, pour participer \u00e0 la formation de l'enqu\u00eate. La formation a port\u00e9 sur deux principaux aspects : la formation des infirmi\u00e8res sur les techniques de pr\u00e9l\u00e8vements des gouttes de sang sur papier filtre et du sang veineux, des tests de sang et du traitement de la syphilis dans le m\u00e9nage et, la formation des techniciens de laboratoire sur la centrifugation du sang veineux et les proc\u00e9dures du test Rapid Plasma Reagin (RPR) dont le but \u00e9tait de d\u00e9terminer les infections r\u00e9centes survenues au cours des 12 derniers mois en vue de les traiter. \n\nPROCEDURES DE PRELEVEMENT DE SANG \nAlors que pour le test de l'an\u00e9mie on a mesur\u00e9 le niveau d'h\u00e9moglobine dans le sang, pour le test de d\u00e9pistage de syphilis et les tests s\u00e9rologiques du t\u00e9tanos et de la rougeole, on a plut\u00f4t recherch\u00e9 la pr\u00e9sence d'anticorps dans le sang. En outre, contrairement au test d'an\u00e9mie et de syphilis, dont le r\u00e9sultat \u00e9tait communiqu\u00e9 imm\u00e9diatement aux participants au test, le r\u00e9sultat du test du t\u00e9tanos et de la rougeole n'\u00e9tait pas donn\u00e9 sur le terrain. Ces tests \u00e9taient anonyme-li\u00e9s et aucun nom ou toute autre caract\u00e9ristique individuelle ou g\u00e9ographique n'\u00e9tait li\u00e9 \u00e0 l'\u00e9chantillon de sang. Seulement, un \u00ab code \u00e0 barres \u00bb, g\u00e9n\u00e9r\u00e9 al\u00e9atoirement, \u00e9tait coll\u00e9 sur l'\u00e9chantillon de sang afin de pouvoir constituer un fichier anonyme de laboratoire contenant les r\u00e9sultats de test. Le m\u00eame code \u00e0 barres utilis\u00e9 sur l'\u00e9chantillon de sang de l'individu \u00e9tait \u00e9galement coll\u00e9 dans son questionnaire m\u00e9nage dont l'objectif est de pouvoir mener plus tard les analyses selon les caract\u00e9ristiques socio-d\u00e9mographiques, une fois les deux fichiers fusionn\u00e9s. \n\nPour le travail de terrain, chaque \u00e9quipe de l'EDSMD-III comprenait deux infirmi\u00e8res et un technicien de laboratoire. Le r\u00f4le des infirmi\u00e8res \u00e9tait de pr\u00e9lever les gouttes de sang pour le test d'an\u00e9mie, le test de t\u00e9tanos et celui de la rougeole, ainsi que le test de d\u00e9pistage de la syphilis. Comme on l'a pr\u00e9cis\u00e9 un peu plus haut, les tests des biomarkers ont \u00e9t\u00e9 r\u00e9alis\u00e9s dans un m\u00e9nage sur trois et selon la proc\u00e9dure adopt\u00e9e, deux infirmi\u00e8res \u00e9taient charg\u00e9es de mener l'enqu\u00eate dans les m\u00e9nages s\u00e9lectionn\u00e9s pour les tests. \n\nDans les m\u00e9nages s\u00e9lectionn\u00e9s pour le test de l'an\u00e9mie et de la syphilis, lorsqu'un enqu\u00eat\u00e9 acceptait de participer aux tests, le pr\u00e9l\u00e8vement de sang \u00e9tait r\u00e9alis\u00e9 de la mani\u00e8re suivante : \n- une \u00e9tiquette avec un code \u00e0 barres \u00e9tait coll\u00e9e sur le questionnaire pour chaque enqu\u00eat\u00e9 ayant accept\u00e9 de participer au test de syphilis ; \n- une autre \u00e9tiquette avec le m\u00eame code \u00e0 barres \u00e9tait coll\u00e9e sur la bandelette de test Abbott sur laquelle le sang de l'enqu\u00eat\u00e9 devait \u00eatre pr\u00e9lev\u00e9 pour le test ; \n- du sang capillaire \u00e9tait pr\u00e9lev\u00e9 au moyen d'une piq\u00fbre faite au bout du doigt \u00e0 l'aide d'une petite aiguille r\u00e9tractable (Tenderlette) ; \n- la premi\u00e8re goutte de sang \u00e9tait essuy\u00e9e \u00e0 l'aide d'un tampon st\u00e9rile ; \n- la deuxi\u00e8me goutte de sang \u00e9tait d\u00e9pos\u00e9es sur la bandelette de test Abbott (la troisi\u00e8me goutte \u00e9tant r\u00e9serv\u00e9e au test d'an\u00e9mie quand l'enqu\u00eat\u00e9 avait accept\u00e9 ce deuxi\u00e8me test) ; \n\nDans les m\u00e9nages s\u00e9lectionn\u00e9s pour le test de la rougeole et du t\u00e9tanos, lorsque la femme acceptait de participer aux tests pour elle-m\u00eame et pour les enfants de moins de cinq ans, le pr\u00e9l\u00e8vement de sang \u00e9tait r\u00e9alis\u00e9 de la mani\u00e8re suivante : \n- une \u00e9tiquette avec un code \u00e0 barres \u00e9tait coll\u00e9e sur le questionnaire pour chaque femme de 15\u00ad49 ans et chaque enfant de moins de cinq ans du m\u00e9nage, pour lesquels le pr\u00e9l\u00e8vement de sang avait \u00e9t\u00e9 accept\u00e9 pour les tests du t\u00e9tanos et de la rougeole ; \n- une autre \u00e9tiquette avec le m\u00eame code \u00e0 barres \u00e9tait coll\u00e9e sur un papier filtre pr\u00e9par\u00e9 pour pr\u00e9lever les gouttes de sang de l'enqu\u00eat\u00e9e ou de l'enfant de moins de cinq ans ; \n- du sang capillaire \u00e9tait pr\u00e9lev\u00e9 au moyen d'une piq\u00fbre faite au bout du doigt \u00e0 l'aide d'une petite aiguille r\u00e9tractable (Tenderlette), la premi\u00e8re goutte de sang \u00e9tant essuy\u00e9e \u00e0 l'aide d'un tampon st\u00e9rile ; \n- on laissait tomber les gouttes suivantes, suffisamment grosses, dans chaque cercle du papier filtre de mani\u00e8re \u00e0 remplir deux \u00e0 trois cercles du papier filtre ; \n- un papier filtre \u00e9tait ainsi pr\u00e9par\u00e9 pour le test de t\u00e9tanos pour chaque femme avec son code \u00e0 barres coll\u00e9 dessus. Deux papiers filtres, un pour le t\u00e9tanos et l'autre pour la rougeole, \u00e9taient \u00e9galement pr\u00e9par\u00e9s pour chaque enfant avec son code \u00e0 barres sur chacun des deux papiers filtres ; \n- les pr\u00e9l\u00e8vements de sang sur les papiers filtres, \u00e9taient ensuite s\u00e9ch\u00e9s, puis collect\u00e9s dans deux bo\u00eetes de transport, l'une pour le t\u00e9tanos et l'autre pour la rougeole ; \n- la bo\u00eete de transport contenant les pr\u00e9l\u00e8vements s\u00e9ch\u00e9s sur papiers filtres pour le test de rougeole, \u00e9tait achemin\u00e9e au laboratoire central de l'Institut Pasteur \u00e0 Madagascar et, l'autre contenant les pr\u00e9l\u00e8vements pour le test de t\u00e9tanos, \u00e9tait envoy\u00e9e au laboratoire Baxter Health-Care, aux Etats-Unis.\n\nTEST DE LA SYPHILIS \n\nPROCEDURE DES TESTS POUR LA SYPHILIS \n- Les gouttes de sang sur bandelette Abbott \u00e9taient observ\u00e9es pendant 15 minutes au maximum, pour faire la lecture du test de syphilis ; \n- La caract\u00e9ristique du test Abbott est de d\u00e9terminer les anticorps aux tr\u00e9pon\u00e8mes sp\u00e9cifiques de la syphilis. Autrement dit, que l'infection soit r\u00e9cente ou ancienne, le test Abbott permet d'\u00e9tablir la pr\u00e9valence de toutes les infections anciennes ou actuelles de la syphilis ; \n- Lorsque l'enqu\u00eat\u00e9 est positif au test Abbott, l'infirmi\u00e8re lui demandait le consentement, ensuite pr\u00e9levait 5 cc de sang des veines dans un tube EDTA plac\u00e9 sur un portatif de tubes, qu'elle apportait imm\u00e9diatement au bout de 8 heures au maximum, au technicien de laboratoire pour effectuer le test Rapid Plasma Reagin (RPR) ;  \n- L'objectif du test RPR \u00e9tait de d\u00e9terminer la pr\u00e9valence des infections r\u00e9centes ou actuelles, qui se sont produites au cours des 12 derniers mois. La caract\u00e9ristique du test RPR est de d\u00e9tecter si le pr\u00e9l\u00e8vement contient des anticorps contre les substances lipidiques produites par les cellules infect\u00e9es ; par cons\u00e9quent, le RPR est un r\u00e9actif sensible aux anticorps tr\u00e9pon\u00e8mes et non \ntr\u00e9pon\u00e8mes. Les substances lipidiques produites par les cellules infect\u00e9es par la syphilis apparaissent dans le sang d\u00e8s les deux premi\u00e8res semaines suivant l'infection et disparaissent graduellement au bout de 12 mois. Par cons\u00e9quent, si le pr\u00e9l\u00e8vement est positif au RPR, l'infection est certainement une infection r\u00e9cente ; \n- \u00c0 la r\u00e9ception des tubes EDTA contenant les pr\u00e9l\u00e8vements de sang, le technicien de laboratoire proc\u00e9dait \u00e0 la centrifugation \u00e0 l'aide d'une centrifugeuse \u00e9lectrique fonctionnant sur batterie, extrayait le plasma et effectuait le test RPR. \n\nCONTROLE DE QUALITE DU TEST DE SYPHILIS \nApr\u00e8s avoir effectu\u00e9 les tests Rapid Plasma Reagin (RPR) sur le terrain, le technicien de laboratoire de l'\u00e9quipe r\u00e9cup\u00e8re le reste de tous les plasmas positifs et n\u00e9gatifs dans un micro-tube plac\u00e9 dans un conteneur r\u00e9frig\u00e9rant \u00ab dry-shipper \u00bb, pour \u00eatre achemin\u00e9e au laboratoire central Institut Pasteur \u00e0 Antananarivo pour effectuer des tests de confirmation. Ces plasmas ont ainsi servi \u00e0 effectuer un autre test de confirmation de tous les positifs et n\u00e9gatifs RPR \u00e0 l'Institut Pasteur \u00e0 l'aide du test sp\u00e9cifique Treponema Pallidum Hemagglutination Assay (TPHA). \nSur les 172 cas positifs Rapid Plasma Reagin (RPR) envoy\u00e9s au laboratoire Institut Pasteur, 80 % ont \u00e9t\u00e9 confirm\u00e9s positifs, donc 20 % s'\u00e9taient r\u00e9v\u00e9l\u00e9s des faux positifs (positif RPR et n\u00e9gatifs au TPHA). Par contre, sur les 73 cas RPR n\u00e9gatifs qui ont \u00e9t\u00e9 envoy\u00e9s au laboratoire, 29 % seulement ont \u00e9t\u00e9 confirm\u00e9s n\u00e9gatifs. En d'autres termes, 71 % de n\u00e9gatifs RPR se sont r\u00e9v\u00e9l\u00e9s des faux n\u00e9gatifs au TPHA en laboratoire. \n\nGlobalement, si l'on d\u00e9cidait de supprimer les faux positifs (35 cas) puis d'ajouter les faux n\u00e9gatifs (52 cas), on arriverait \u00e0 un taux de d\u00e9perdition final4 de cas de RPR positifs d'un peu moins de 10 % (9,88 %) ; ce qui est d'un bon niveau de qualit\u00e9 en mati\u00e8re de test s\u00e9rologique, en particulier sur le terrain. Compte tenu de ce faible taux de d\u00e9perdition de moins de 10 % de cas positif RPR et de la marge d'erreurs qui pourraient affecter les tests TPHA, aucune correction n'a \u00e9t\u00e9 jug\u00e9e n\u00e9cessaire quant aux r\u00e9sultats RPR obtenus initialement. \n\nTEST DE LA ROUGEOLE \n\nPROCEDURE DES TESTS POUR LA ROUGEOLE \nLes gouttes de sang pr\u00e9lev\u00e9es sur papiers filtres pour le test de la rougeole sur les enfants, ont \u00e9t\u00e9 achemin\u00e9es au laboratoire central de l'Institut Pasteur \u00e0 Madagascar. L'Institut Pasteur a utilis\u00e9 le kit de test ELISA lgG Rougeole de Calbiotech (Spring Valley, California), fourni par ORC Macro pour le d\u00e9pistage de l'anticorps de la rougeole dans les pr\u00e9l\u00e8vements de gouttes de sang s\u00e9ch\u00e9. La sensitivit\u00e9 et la sp\u00e9cificit\u00e9 de ce test de rougeole d\u00e9passent 97 %. \n\nCONTROLE DE QUALITE DU TEST DE LA ROUGEOLE \nAvant le d\u00e9marrage des activit\u00e9s d'enqu\u00eate sur le terrain, le laboratoire central a men\u00e9 des tests de validation de recherche d'anticorps de rougeole \u00e0 partir de pr\u00e9l\u00e8vements de sang s\u00e9ch\u00e9 sur papier filtre en utilisant deux m\u00e9thodes diff\u00e9rentes : la m\u00e9thode des s\u00e9rums et celle du sang entier obtenue \u00e0 partir du sang pr\u00e9alablement s\u00e9ch\u00e9 sur papier filtre. Des recrutements de participants ont \u00e9t\u00e9 effectu\u00e9s sur les sites de l'Institut Pasteur, dont les analyses de sang \u00e0 partir des deux m\u00e9thodes ont fourni des concordances de plus de 99 %. L'Assurance de Qualit\u00e9 Externe et Interne a \u00e9t\u00e9 bas\u00e9e sur les proc\u00e9dures internes du laboratoire en mati\u00e8re de protocole de tests biologiques. \n\nTEST DE TETANOS \n\nPROCEDURE DES TESTS POUR LE TETANOS \n\u00c9tant donn\u00e9 que le test de t\u00e9tanos est assez complexe et ne peut \u00eatre men\u00e9 que par un tr\u00e8s petit nombre de laboratoires, les gouttes de sang pr\u00e9lev\u00e9es sur papiers filtres pour le test de t\u00e9tanos sur les femmes et les enfants \u00e0 Madagascar, ont \u00e9t\u00e9 achemin\u00e9es au laboratoire Baxter Health-Care, aux Etats-Unis, qui avait d\u00e9j\u00e0 effectu\u00e9 les analyses de sang pour le test du t\u00e9tanos chez les femmes et les enfants en Namibie et au Togo en l'an 2000. Le laboratoire Baxter Health-Care a utilis\u00e9 la m\u00e9thode de la double Antig\u00e8nes ELISA pour le d\u00e9pistage des anticorps \u00e0 la toxine de t\u00e9tanos. La sensitivit\u00e9 et la sp\u00e9cificit\u00e9 du kit de test utilis\u00e9 par le laboratoire pour le d\u00e9pistage des anticorps \u00e0 la toxine de t\u00e9tanos d\u00e9passent 96 %. \n\nCONTROLE DE QUALITE DU TEST DE TETANOS \n\u00c9tant donn\u00e9 que le laboratoire Baxter Health-Care avait d\u00e9j\u00e0 effectu\u00e9 en 2000 les analyses de sang s\u00e9ch\u00e9 sur papier filtre pour le d\u00e9pistage des anticorps de t\u00e9tanos en Namibie et au Togo, le laboratoire n'a pas proc\u00e9d\u00e9 \u00e0 des tests de validation. Cependant, les Assurances Qualit\u00e9 Externe et Interne ont \u00e9t\u00e9 bas\u00e9es sur les proc\u00e9dures internes du laboratoire en mati\u00e8re de protocole de tests biologiques. \n\nCONSENTEMENT VOLONTAIRE \nAvant que le sang ne soit pr\u00e9lev\u00e9, l'infirmi\u00e8re lisait le texte de consentement5 volontaire pour le test de l'an\u00e9mie, puis elle demandait \u00e0 l'enqu\u00eat\u00e9 s'il acceptait volontairement de participer \u00e0 ce test. Ensuite, et quel que soit le consentement donn\u00e9 pour le test de l'an\u00e9mie par l'enqu\u00eat\u00e9, l'infirmi\u00e8re lui lisait un deuxi\u00e8me consentement volontaire pour l'inviter \u00e0 participer au test de d\u00e9pistage de la syphilis. Dans les m\u00e9nages o\u00f9 \u00e9tait men\u00e9 le test du t\u00e9tanos et celui de la rougeole, l'infirmi\u00e8re lisait le consentement volontaire \u00e0 la femme pour participer au test du t\u00e9tanos pour elle-m\u00eame et, aux tests du t\u00e9tanos et de rougeole pour chaque enfant de moins de cinq ans, s'il y en avait. Apr\u00e8s avoir rempli ces d\u00e9clarations de consentement volontaire, l'infirmi\u00e8re signait pour pr\u00e9ciser que les sujets interview\u00e9s avaient accept\u00e9 de participer aux tests. \n\nTRAITEMENT DE LA SYPHILIS \n\u00c0 la diff\u00e9rence du t\u00e9tanos et de la rougeole, les r\u00e9sultats du test de la syphilis \u00e9taient communiqu\u00e9s imm\u00e9diatement aux participants au test. Pour ceux dont le r\u00e9sultat au test de la syphilis avait \u00e9t\u00e9 positif, l'infirmi\u00e8re leur proposait imm\u00e9diatement un traitement sur place dans le m\u00e9nage. 5 Les textes des consentements volontaires ont t\u00e9t\u00e9 pr\u00e9par\u00e9s par ORC Macro sur la base du texte standard \u00e9labor\u00e9 par ORC Macro et CDC, puis, en m\u00eame temps que le protocole des tests, ils ont \u00e9t\u00e9 soumis au Comit\u00e9 d'\u00c9thique National du Minist\u00e8re de la Sant\u00e9 et du Planning Familial de Madagascar pour \u00eatre approuv\u00e9s.","cleaning_operations":"La saisie des donn\u00e9es sur micro-ordinateur a d\u00e9but\u00e9 un mois apr\u00e8s le d\u00e9marrage de l'enqu\u00eate sur le terrain, en utilisant les logiciels CSPRO et ISSA. Trois agents de bureau \u00e9taient charg\u00e9s de la r\u00e9ception, de la v\u00e9rification et du contr\u00f4le des questionnaires venus du terrain avant de les transmettre \u00e0 la saisie. Cette saisie a \u00e9t\u00e9 r\u00e9alis\u00e9e par dix agents, de janvier \u00e0 juin 2004 sous la supervision de deux programmeurs et de l'informaticienne de la DDSS. Tous les questionnaires ont fait l'objet d'une double saisie pour \u00e9liminer du fichier le maximum d'erreurs de saisie. Par ailleurs, un programme de contr\u00f4le de qualit\u00e9 permettait de d\u00e9tecter pour chaque \u00e9quipe et m\u00eame, dans certains cas, pour chaque enqu\u00eatrice\/enqu\u00eateur, certaines des principales erreurs de collecte. Ces informations \u00e9taient imm\u00e9diatement r\u00e9percut\u00e9es aux \u00e9quipes de terrain lors des missions de supervision, afin d'am\u00e9liorer la qualit\u00e9 des donn\u00e9es. \n \nA la suite de la saisie, les donn\u00e9es ont \u00e9t\u00e9 \u00e9dit\u00e9es en vue de v\u00e9rifier la coh\u00e9rence interne des r\u00e9ponses. La v\u00e9rification finale a \u00e9t\u00e9 r\u00e9alis\u00e9e par le service informatique de la DDSS avec l'assistance de l'\u00e9quipe technique de l'enqu\u00eate, y compris l'informaticien de ORC Macro."},"analysis_info":{"response_rate":"Sur les 303 grappes s\u00e9lectionn\u00e9es, 300 ont pu \u00eatre enqu\u00eat\u00e9es au cours de l'EDSMD-III. Le nombre de m\u00e9nages s\u00e9lectionn\u00e9s dans chaque grappe urbaine \u00e9tait de 30 et de 33 dans chaque grappe rurale. Au total 9295 m\u00e9nages ont \u00e9t\u00e9 s\u00e9lectionn\u00e9s dont 8 571 ont \u00e9t\u00e9 identifi\u00e9s au moment de l'enqu\u00eate. Sur ces 8571 m\u00e9nages, 8420 ont pu \u00eatre enqu\u00eat\u00e9s avec succ\u00e8s, soit un taux de r\u00e9ponse de 98 %. \n\nDans ces 8420 m\u00e9nages enqu\u00eat\u00e9s, 8337 femmes \u00e2g\u00e9es de 15-49 ans ont \u00e9t\u00e9 identifi\u00e9es comme \u00e9tant \u00e9ligibles pour l'enqu\u00eate individuelle et pour 7949 d'entre elles, l'enqu\u00eate a pu \u00eatre men\u00e9e \u00e0 bien. Le taux de r\u00e9ponse s'\u00e9tablit donc \u00e0 95 % pour les interviews aupr\u00e8s des femmes. L'enqu\u00eate homme a \u00e9t\u00e9 r\u00e9alis\u00e9e dans un m\u00e9nage sur trois : au total 2685 hommes de 15-59 ans ont \u00e9t\u00e9 identifi\u00e9s dans les m\u00e9nages de l'\u00e9chantillon. Parmi ces 2685 hommes devant \u00eatre interview\u00e9s individuellement, 2432 ont \u00e9t\u00e9 enqu\u00eat\u00e9s avec succ\u00e8s, soit un taux de r\u00e9ponse de 91 %. \n\nQue ce soit au niveau des m\u00e9nages, des femmes ou des hommes, les taux de r\u00e9ponses sont plus que satisfaisants puisqu'ils sont sup\u00e9rieurs \u00e0 ceux qui avaient \u00e9t\u00e9 pr\u00e9vus au moment de la conception du plan de sondage. \n\nL'\u00e9chantillon est stratifi\u00e9 par province et repr\u00e9sentatif au niveau du milieu de r\u00e9sidence (urbain\u00adrural), de la Capitale et de chaque province administrative du pays. Compte tenu de la taille variable de chaque strate, constituant chacune un domaine d'\u00e9tudes, diff\u00e9rents taux de sondage ont \u00e9t\u00e9 appliqu\u00e9s initialement \u00e0 chaque strate. Finalement les r\u00e9sultats ont \u00e9t\u00e9 pond\u00e9r\u00e9s au niveau de chaque grappe3.","sampling_error_estimates":"Les erreurs de sondage peuvent \u00eatre \u00e9valu\u00e9es statistiquement. L'\u00e9chantillon s\u00e9lectionn\u00e9 pour l'EDSMD-III n'est qu'un parmi un grand nombre d'\u00e9chantillons de m\u00eame taille qui peuvent \u00eatre s\u00e9lectionn\u00e9s dans la m\u00eame population avec le m\u00eame plan de sondage. Chacun de ces \u00e9chantillons peut produire des r\u00e9sultats peu diff\u00e9rents de ceux obtenus avec l'\u00e9chantillon actuellement choisi. L'erreur de sondage est une mesure de cette variabilit\u00e9 entre tous les \u00e9chantillons possibles. Bien que cette variabilit\u00e9 ne peut pas \u00eatre mesur\u00e9e exactement, mais elle peut \u00eatre estim\u00e9e \u00e0 partir des donn\u00e9es collect\u00e9es. \n\nL'erreur-type (ET) est un indice particuli\u00e8rement utile pour mesurer l'erreur de sondage d'un param\u00e8tre (moyenne, proportion ou taux), elle est la racine carr\u00e9e de la variance du param\u00e8tre. L'erreur\u00adtype peut \u00eatre utilis\u00e9e pour calculer des intervalles de confiance dans lesquels nous consid\u00e9rons se trouver la vraie valeur du param\u00e8tre avec un certain niveau de confiance. Par exemple, la vraie valeur d'un param\u00e8tre se trouve dans les limites de sa valeur estim\u00e9e plus ou moins deux fois de son erreur-type, avec un niveau de confiance de 95 %. \n\nSi l'\u00e9chantillon avait \u00e9t\u00e9 tir\u00e9 d'apr\u00e8s un plan de sondage al\u00e9atoire simple, il aurait \u00e9t\u00e9 possible d'utiliser des formules simples pour calculer les erreurs de sondage. Cependant, l'\u00e9chantillon de l'EDSMD-III \u00e9tant un \u00e9chantillon stratifi\u00e9 et tir\u00e9 \u00e0 deux degr\u00e9s, des formules plus complexes ont \u00e9t\u00e9 utilis\u00e9es. Le module \u00ab erreurs de sondage \u00bb du logiciel ISSA a \u00e9t\u00e9 utilis\u00e9 pour calculer les erreurs de sondage suivant la m\u00e9thodologie statistique appropri\u00e9e. Ce module utilise la m\u00e9thode de lin\u00e9arisation (Taylor) pour des estimations telles que les moyennes ou proportions, et la m\u00e9thode de Jackknife pour des estimations plus complexes tels que l'indice synth\u00e9tique de f\u00e9condit\u00e9 et les quotients de mortalit\u00e9. \n\nLa m\u00e9thode de Jackknife d\u00e9rive les estimations des taux complexes \u00e0 partir de chacun des sous\u00ad\u00e9chantillons de l'\u00e9chantillon principal, et calcule les variances de ces estimations avec des formules simples. Chaque sous-\u00e9chantillon exclut une grappe dans les calculs des estimations. Ainsi, des sous\u00ad\u00e9chantillons pseudo-ind\u00e9pendants ont \u00e9t\u00e9 cr\u00e9\u00e9s. Dans l'EDSMD-III, parmi les 303 grappes s\u00e9lectionn\u00e9es, il y a 300 grappes enqu\u00eat\u00e9es. Par cons\u00e9quent, 300 sous-\u00e9chantillons ont \u00e9t\u00e9 cr\u00e9\u00e9s. \n\nIl existe un deuxi\u00e8me indice tr\u00e8s utile qui est la racine carr\u00e9e de l'effet du plan de sondage (REPS) ou effet de grappe : c'est le rapport de l'erreur-type observ\u00e9e sur l'erreur-type qu'on aurait obtenue si un sondage al\u00e9atoire simple avait \u00e9t\u00e9 utilis\u00e9. Cet indice r\u00e9v\u00e8le dans quelle mesure le plan de sondage qui a \u00e9t\u00e9 choisi se rapproche d'un \u00e9chantillon al\u00e9atoire simple de m\u00eame taille : la valeur 1 de la REPS indique que le plan de sondage est aussi efficace qu'un \u00e9chantillon al\u00e9atoire simple, alors qu'une valeur sup\u00e9rieure \u00e0 1 indique un accroissement de l'erreur de sondage d\u00fb \u00e0 un plan de sondage plus complexe et moins efficace au point de vue statistique. Le logiciel calcule aussi l'erreur relative et l'intervalle de confiance pour chaque estimation. \n\nLes erreurs de sondage pour l'EDSMD-III ont \u00e9t\u00e9 calcul\u00e9es pour certaines des variables les plus int\u00e9ressantes. Les r\u00e9sultats sont pr\u00e9sent\u00e9s en annexe du Rapport Final pour l'ensemble du pays, le milieu urbain, le milieu rural, la capitale et les six provinces administratives. \n\nL'effet du plan de sondage (REPS) est non-d\u00e9fini quand l'\u00e9cart type sous l'\u00e9chantillon al\u00e9atoire simple est z\u00e9ro (quand l'estimation est proche de 0 ou 1). Dans le cas de l'indice synth\u00e9tique de f\u00e9condit\u00e9, le nombre de cas non-pond\u00e9r\u00e9s n'est pas pertinent, car la valeur non-pond\u00e9r\u00e9e de femmes-ann\u00e9es d'exposition au risque de grossesse n'est pas connue. \n\nL'intervalle de confiance est interpr\u00e9t\u00e9 de la mani\u00e8re suivante : pour la variable Enfants n\u00e9s vivants, l'EDSMD-III a donn\u00e9 un nombre moyen d'enfants n\u00e9s vivants de 2,551 pour l'ensemble des femmes, auquel correspond une erreur-type de 0,052 enfants.  Dans 95 % des \u00e9chantillons de taille et caract\u00e9ristique identiques, la valeur r\u00e9elle du nombre moyen d'enfants n\u00e9s vivants des femmes \u00e2g\u00e9es de 15 \u00e0 49 ans se trouve entre 2,551 - 2\u00d70,052 et 2,551 + 2\u00d70,052, soit 2,448 et 2,654. \n\nLes erreurs de sondage ont \u00e9t\u00e9 analys\u00e9es pour l'\u00e9chantillon national de femmes et pour deux groupes d'estimations : (1) moyennes et proportions, et (2) taux d\u00e9mographiques. Les erreurs relatives (ET\/M) des moyennes et proportions se situent entre 1,9 % et 16,4 % avec une moyenne de 6,3 %. Les erreurs relatives les plus \u00e9lev\u00e9es sont g\u00e9n\u00e9ralement celles des estimations de tr\u00e8s faible valeur (par exemple, parmi les femmes actuellement en union qui Utilise actuellement la st\u00e9rilisation f\u00e9minine). Si on enl\u00e8ve les estimations de tr\u00e8s faible valeur (moins de 10 %), la moyenne tombe \u00e0 5,0 %. Ainsi, en g\u00e9n\u00e9ral, les erreurs relatives de la plupart des estimations pour l'ensemble du pays sont faibles, sauf dans le cas de tr\u00e8s faibles proportions. L'erreur relative de l'indice de f\u00e9condit\u00e9 est assez faible 3,7 %. Cependant, pour les taux de mortalit\u00e9, l'erreur relative moyenne est plus \u00e9lev\u00e9e 12,52 %. Il existe des diff\u00e9rences entre les erreurs relatives au niveau des sous-\u00e9chantillons. Par exemple, pour la variable Enfants n\u00e9s vivants des femmes \u00e2g\u00e9es de 40 \u00e0 49 ans, l'erreur relative pour l'\u00e9chantillon de femmes est respectivement de 2,8 %, 2,5 % et 3,6 % pour l'ensemble du pays, le milieu urbain et le milieu rural. \n\nPour l'\u00e9chantillon national de femmes, la moyenne de la racine carr\u00e9e de l'effet du plan de sondage (REPS) calcul\u00e9e pour l'ensemble des estimations est de 2,27 ce qui veut dire que, par rapport \u00e0 un \u00e9chantillon al\u00e9atoire simple, l'erreur de sondage est multipli\u00e9e en moyenne par un facteur de 2,27 parce qu'on utilise un plan de sondage complexe (par grappes et \u00e0 plusieurs degr\u00e9s) et moins efficace.","data_appraisal":"Les erreurs de mesure sont celles associ\u00e9es \u00e0 la mise en oeuvre de la collecte et de l'exploitation des donn\u00e9es telles que l'omission de m\u00e9nages s\u00e9lectionn\u00e9s, la mauvaise interpr\u00e9tation des questions de la part de l'enqu\u00eatrice ou de l'enqu\u00eat\u00e9e, ou les erreurs de saisie des donn\u00e9es. Bien que tout le possible ait \u00e9t\u00e9 fait pour minimiser ce type d'erreur pendant la mise en oeuvre de l'EDMD-III, il est difficile d'\u00e9viter et d'\u00e9valuer toutes les erreurs de mesure."}},"data_access":{"dataset_use":{"contact":[{"name":"MEASURE DHS, ICF Macro","affiliation":"","email":"archive@measuredhs.com","uri":"http:\/\/www.measuredhs.com"}],"cit_req":"L'utilisation des donn\u00e9es doit \u00eatre mentionn\u00e9e par l'inclusion d'une r\u00e9f\u00e9rence bibliographique contenant au minimum:\n- l'identification de l'enqu\u00eateur principal (agence ou personne ayant assur\u00e9 la responsabiit\u00e9 de la production des donn\u00e9es)\n- le titre exact de l'enqu\u00eate (y compris le pays, l'ann\u00e9e de l'enqu\u00eate et l'abbr\u00e9viation du titre de l'enqu\u00eate lorsque disponible)\n- le num\u00e9ro de r\u00e9f\u00e9rence de l'enqu\u00eate tel qu'indiqu\u00e9 dans notre catalogue\n- la source et la date du t\u00e9l\u00e9chargement des fichiers de donn\u00e9es pour les donn\u00e9es obtenues en ligne","disclaimer":"L'utilisateur des donn\u00e9es reconnait que le producteur des donn\u00e9es, le distributeur agr\u00e9\u00e9, ainsi que les bailleurs de fonds ayant contribu\u00e9 au financement de la production de ces donn\u00e9es, ne sont nullement responsables de l'utilisation qui sera faite de ces donn\u00e9es, ni des interpr\u00e9tations et conclusions d\u00e9riv\u00e9es de leur analyse et utilisation."}}},"data_files":[{"file_id":"F1","file_name":"RECH0","description":"HOUSEHOLD\n- Household Basic Data","case_count":"9295","var_count":"40","producer":null,"data_checks":null,"missing_data":null,"version":null,"notes":null},{"file_id":"F2","file_name":"RECH1","description":"HOUSEHOLD\n- Household Schedule","case_count":"38325","var_count":"30","producer":null,"data_checks":null,"missing_data":null,"version":null,"notes":null},{"file_id":"F3","file_name":"RECH2","description":"HOUSEHOLD\n- Household 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