{"type":"survey","doc_desc":{"title":"TCD_1996_DHS_v01_M","idno":"DDI_TCD_1996_DHS_v01_M","producers":[{"name":"World Bank, Development Economics Data Group","abbreviation":"DECDG","affiliation":"","role":"Generation of DDI documentation"}],"prod_date":"2012-04-23"},"study_desc":{"title_statement":{"idno":"TCD_1996_DHS_v01_M","title":"Enqu\u00eate D\u00e9mographique et de Sant\u00e9 1996-1997","alt_title":"EDS 1996-97 \/ DHS 1996-97","translated_title":"Demographic and Health Survey 1996-1997"},"authoring_entity":[{"name":"Bureau Central du Recensement (BCR), Direction de la Statistique, des \u00c9tudes \u00c9conomiques et D\u00e9mographiques (DSEED)","affiliation":"Minist\u00e8re du Plan et de 1'Am\u00e9nagement du Territoire"}],"oth_id":[{"name":"Universit\u00e9 de N'Djam\u00e9na","affiliation":"","email":"","role":"Translation"}],"production_statement":{"producers":[{"name":"Macro International Inc.","affiliation":"","role":"Technical assistance"}],"funding_agencies":[{"name":"Gouvernement du Tchad","abbreviation":"","role":"Main Funding"},{"name":"Banque mondiale","abbreviation":"","role":"Funding through a loan"},{"name":"United Nations Population Fund","abbreviation":"UNFPA","role":"Funding"},{"name":"United Nations Children's Fund","abbreviation":"UNICEF","role":"Funding"}]},"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"}]},"series_statement":{"series_name":"Demographic and Health Survey (standard) - DHS III","series_info":"L'Enqu\u00eate D\u00e9mographique et de Sant\u00e9 1996 est la premi\u00e8re EDS r\u00e9alis\u00e9e au Tchad."},"study_info":{"abstract":"L'enqu\u00eate D\u00e9mographique et de Sant\u00e9 au Tchad (EDST) a \u00e9t\u00e9 ex\u00e9cut\u00e9e par le Bureau Central du Recensement (BCR), Direction de la Statistique, des \u00c9tudes \u00c9conomiques et D\u00e9mographiques (DSEED) avec l'assistance technique de Macro International Inc. Il s'agit de la premi\u00e8re enqu\u00eate par sondage, r\u00e9alis\u00e9e au niveau national, dont les objectifs \u00e9taient de fournir des informations d\u00e9taill\u00e9es sur la f\u00e9condit\u00e9, la planification familiale, la sant\u00e9 de la m\u00e8re et de l'enfant, l'\u00e9tat nutritionnel des enfants de moins de cinq ans, la mortalit\u00e9 infanto-juv\u00e9nile, la mortalit\u00e9 maternelle et sur la disponibilit\u00e9 des services communautaires. Ces informations donnent un \u00e9clairage de la situation d\u00e9mographique et sanitaire du Tchad. \n\nAu cours de I'EDST, r\u00e9alis\u00e9e sur le terrain de d\u00e9cembre 1996 \u00e0 juillet 1997, 6840 m\u00e9nages, 7454 femmes en \u00e2ge de procr\u00e9er ( 15-49 ans) et 2320 hommes de 15-59 ans ont \u00e9t\u00e9 enqu\u00eat\u00e9s avec succ\u00e8s, avec des taux de couverture respectif de 98,7 %, 96,7 % et 94 %. \n\nL'Enqu\u00eate D\u00e9mographique et de Sant\u00e9 du Tchad (EDST) vise \u00e0 atteindre un certain nombre d'objectifs dont les principaux sont : \n- recueillir des donn\u00e9es \u00e0 l'\u00e9chelle nationale et par milieu de r\u00e9sidence permettant de calculer divers indicateurs d\u00e9mographiques, en particulier les taux de f\u00e9condit\u00e9 et de mortalit\u00e9 infantile et juv\u00e9nile; \n- mesurer le niveau de mortalit\u00e9 maternelle au niveau national; \n- analyser les facteurs directs et indirects qui d\u00e9terminent les niveaux et tendances de la f\u00e9condit\u00e9, tels que les structures du mariage et l'utilisation de la contraception; \n- identifier les cat\u00e9gories de femmes susceptibles d'avoir plus ou moins d'enfants et susceptibles d'utiliser la contraception; \n- mesurer les taux de connaissance et de pratique contraceptive par m\u00e9thode, selon diverses caract\u00e9ristiques socio-d\u00e9mographiques des femmes et des hommes; \n- analyser les facteurs directs et indirects qui d\u00e9terminent les niveaux et tendances de la mortalit\u00e9; \n- recueillir des donn\u00e9es d\u00e9taill\u00e9es sur les causes de d\u00e9c\u00e8s des enfants de moins de cinq ans; \n- recueillir des donn\u00e9es d\u00e9taill\u00e9es sur la sant\u00e9 maternelle et infantile: visite pr\u00e9natale, assistance \u00e0 l'accouchement, allaitement, vaccinations, suppl\u00e9mentation en Vitamine A, pr\u00e9valence et traitement de la diarrh\u00e9e et d'autres maladies chez les enfants de moins de cinq ans; \n- \u00e9valuer le niveau d'utilisation de sel iod\u00e9; \n- d\u00e9terminer l'\u00e9tat nutritionnel des m\u00e8res et des enfants de moins de cinq ans au moyen des mesures anthropom\u00e9triques (poids et taille); \n- recueillir des donn\u00e9es d\u00e9taill\u00e9es sur la connaissance, les opinions et attitudes des femmes et des hommes vis-\u00e0-vis des Maladies Sexuellement Transmissibles (MST) et du Sida. \n\nDe plus, I'EDST fournit des informations sur la disponibilit\u00e9 et l'accessibilit\u00e9 des services socio- \u00e9conomiques et sanitaires au niveau des communaut\u00e9s. \n\nL'ensemble des donn\u00e9es collect\u00e9es constitue une base de donn\u00e9es qui facilitera le suivi et l'\u00e9valuation \u00ec long terme des programmes de Sant\u00e9 Maternelle et Infantile et du Bien-]~tre Familial au Tchad (SMI\/BEF). \nEnfin, la r\u00e9alisation de cette enqu\u00eate contribue au renforcement du cadre institutionnel et au renforcement des comp\u00e9tences des cadres nationaux n\u00e9cessaires pour entreprendre la collecte et l'analyse de donn\u00e9es d\u00e9mographiques, soeio-\u00e9conomiques et sanitaires. \n\nPRINCIPAUX RESULTATS\n\nLa structure de la population par \u00e2ge r\u00e9v\u00e8le une extr\u00eame jeunesse de la population du Tchad dont la moiti\u00e9 est \u00e2g\u00e9e de moins de 15 ans. Par ailleurs, la r\u00e9partition de cette population par milieu de r\u00e9sidence indique que la population tchadienne est essentiellement rurale : 76 % des personnes enqu\u00eat\u00e9es vivent en milieu rural contre 24 % en milieu urbain. \n\nLa f\u00e9condit\u00e9 des femmes tchadiennes est l'une des plus \u00e9lev\u00e9e en Afrique : en fin de vie f\u00e9conde, elles ont, en moyenne, 6,6 enfants. L'une des caract\u00e9ristiques de cette f\u00e9condit\u00e9 est sa pr\u00e9cocit\u00e9 : une femme sur deux donne naissance \u00e0 son premier enfant \u00ec 18,3 ans. Les r\u00e9sultats de l'enqu\u00eate ont mis en \u00e9vidence des variations du niveau de f\u00e9condit\u00e9 selon le milieu de r\u00e9sidence. Les femmes du milieu rural (6,8 enfants par femme) donnent naissance, en moyenne, \u00e0 1 enfant de plus que celles de N'Djam\u00e9na (5,8) et \u00e0 0,5 enfant de plus que celles des Autres Villes (6,3). \n\nParmi les femmes de 15-49 ans, 78 % \u00e9taient mari\u00e9es au moment de l'enqu\u00eate et, \u00e0 partir de 30 ans, moins de 1% des femmes \u00e9taient toujours c\u00e9libataires : ainsi, le mariage qui demeure le cadre presque exclusif de la procr\u00e9ation, est quasi universel au Tchad. En outre, pr\u00e8s de deux femmes mari\u00e9es sur cinq (39 %) vivent en union polygame. L'\u00e2ge d'entr\u00e9e en union est tr\u00e8s pr\u00e9coce : \u00e0 18 ans, pr\u00e8s des trois quarts des femmes (73 %) sont d\u00e9j\u00e0 mari\u00e9es et l'\u00e2ge m\u00e9dian au premier mariage est de 15,8 ans. Les premiers rapports sexuels se produisent \u00e9galement tr\u00e8s t\u00f4t (\u00e2ge m\u00e9dian de 15, 5 ans). En outre, aucune tendance ne semble se dessiner dans le sens d'une modification de r \u00e2ge d'entr\u00e9e en union, m\u00eame si les jeunes g\u00e9n\u00e9rations semblent se marier moins pr\u00e9cocement que les g\u00e9n\u00e9rations les plus \u00e2g\u00e9es (16,4 ans parmi les g\u00e9n\u00e9rations de 20-24 ans contre 15,6 ans parmi celles de plus de 40 ans). On constate d'autre part que le calendrier de la primo-nuptialit\u00e9 n'est gu\u00e8re influenc\u00e9 par le milieu de r\u00e9sidence (16,0 en urbain contre 15,8 ans en rural). Le niveau d'instruction, par contre, influe sur l'\u00e2ge au premier mariage, les femmes sans instruction (15,7 ans) se mariant plus pr\u00e9cocement que celles ayant un niveau d'instruction primaire (16,4 ans) et surtout que celles ayant un niveau d'instruction secondaire ou plus (18,0). Cette pr\u00e9cocit\u00e9 des premiers rapports sexuels et du mariage expliquent la pr\u00e9cocit\u00e9 de la f\u00e9condit\u00e9. \n\nLes hommes contractent leur premi\u00e8re union \u00e0 un \u00e2ge plus tardif que celui des femmes, leur \u00e2ge m\u00e9dian au mariage \u00e9tant estim\u00e9 \u00e0 22,6 ans. Cet \u00e2ge m\u00e9dian au premier mariage est plus \u00e9lev\u00e9 \u00e0 N'Djam\u00e9na et dans les Autres Villes qu'en milieu rural. De m\u00eame que chez les femmes, un niveau d'instruction \u00e9lev\u00e9 retarde l'entr\u00e9e en union des hommes. De plus, la polygamie est relativement r\u00e9pandue puisqu'elle concerne un quart des hommes mari\u00e9s. \n\nLe niveau de connaissance contraceptive est extr\u00eamement faible au Tchad : seulement 45 % des femmes et 72 % des hommes ont d\u00e9clar\u00e9 conna\u00eetre une m\u00e9thode de contraception. Les m\u00e9thodes modernes sont mieux connues que les m\u00e9thodes traditionnelles. En outre, tr\u00e8s peu de femmes tchadiennes utilisent une m\u00e9thode contraceptive (4 %). Les m\u00e9thodes modernes sont utilis\u00e9es par 1,2 % des femmes, essentiellement la pilule (0,6 % ) et le condom (0,3 %); quant aux m\u00e9thodes traditionnelles ou populaires, 2,6 % des femmes y ont recours; la continence p\u00e9riodique est la m\u00e9thode la plus utilis\u00e9e (2,0). Les niveaux d'utilisation de la contraception varient fortement selon le milieu de r\u00e9sidence et le niveau d'instruction. A. N'Djam\u00e9na, 11,8 % des femmes mari\u00e9es utilisent la contraception et environ la moiti\u00e9 d'entre elles utilisent une m\u00e9thode moderne (6,7 %), alors que la pr\u00e9valence contraceptive n'est que de 2,7 % en milieu rural o\u00f9 les femmes utilisent surtout les m\u00e9thodes traditionnelles\/populaires (2,4 %). De m\u00eame, 24 % des femmes ayant un niveau d'instruction secondaire ou plus utilisent une m\u00e9thode de contraception, et surtout une m\u00e9thode moderne (13 %), alors que la pr\u00e9valence n'atteint pas 3 % parmi les femmes sans instruction. De m\u00eame, les hommes vivant \u00e0 N'Djam\u00e9na (27,5 %) et ceux qui ont un niveau d'instruction secondaire ou plus (12,6 %) sont ceux qui ont la pr\u00e9valence contraceptive la plus \u00e9lev\u00e9e. \n\nPlus des trois quarts des femmes et des hommes n'ont pas l'intention d'utiliser la contraception dans l'avenir (79 %). Le d\u00e9sir d'enfants est la raison principale avanc\u00e9e par les hommes et les femmes (41% des femmes et 53 % des hommes) pour ne pas utiliser la contraception dans l'avenir. Les hommes et les femmes tchadiens restent attach\u00e9s \u00e0 une descendance nombreuse puisque pour les femmes, le nombre id\u00e9al d'enfants est de 8,3; il est de 13,4 enfants pour les hommes. \n\nL'EDST fournit \u00e9galement un ensemble d'informations tr\u00e8s importantes sur la sant\u00e9 et l'\u00e9tat nutritionnel de la m\u00e8re et de l'enfant. Concernant les soins pr\u00e9natals et les conditions d'accouchement, on constate que pour 32 % seulement des naissances des cinq derni\u00e8res ann\u00e9es, la m\u00e8re a re\u00e7u des soins pr\u00e9natals dispens\u00e9es par du personnel form\u00e9; dans 31% des cas seulement, elle a re\u00e7u, au moins, une injection antit\u00e9tanique pendant la grossesse; l'accouchement n'a eu lieu dans une formation sanitaire que pour 11% des naissances; un professionnel de la sant\u00e9 a assist\u00e9 24 % des accouchements et pr\u00e8s d'une naissance sur trois s'est d\u00e9roul\u00e9e avec l'aide d'une accoucheuse traditionnelle non form\u00e9e; en outre, 7 % des femmes ont accouch\u00e9 seule, sans aucune aide. D'autre part, on constate d'\u00e9normes diff\u00e9rences du point de vue du niveau d'instruction de la m\u00e8re et surtout du point de vue du milieu de r\u00e9sidence : pour 72 % des naissances, les m\u00e8res de N'Djam\u00e9na ont b\u00e9n\u00e9fici\u00e9 de soins pr\u00e9natals contre 64 % dans les Autres Villes et seulement 23 % en milieu rural. De m\u00eame, \u00e0 N'Djam\u00e9na, 57 % des accouchements ont \u00e9t\u00e9 assist\u00e9s par des professionnels de la sant\u00e9 contre 45 % dans les Autres Villes et seulement 16 % en milieu rural. \n\nLa vaccination contre les maladies-cible du Programme \u00c9largi de Vaccination (PEV), \u00e0 savoir la tuberculose, la dipht\u00e9rie, le t\u00e9tanos, la coqueluche, la polio, la rougeole et la fi\u00e8vre jaune, est un facteur cl\u00e9 d'am\u00e9lioration du taux de survie des enfants. D'apr\u00e8s I'EDST, parmi les enfants de 12 \u00e0 23 mois qui, selon les recommandations de l'OMS, devraient \u00eatre tous vaccin\u00e9s contre les maladies-cible du PEV, 39 % seulement sont vaccin\u00e9s contre la tuberculose, 20 % ont re\u00e7u les trois doses de DTCoq, 18 % les trois doses de polio, 23 % seulement sont vaccin\u00e9s contre la rougeole et 20 % contre la fi\u00e8vre janne. Seulement 1 enfant tchadien sur 10 a re\u00e7u toutes les vaccinations du PEV et, \u00e0 l'oppos\u00e9, plus de deux enfants sur cinq (44 %) n'ont re\u00e7u aucune de ces vaccinations. Ces taux de couverture vaccinale d\u00e9j\u00e0 tr\u00e8s faibles au niveau national, masquent d'importantes disparit\u00e9s selon le milieu de t\u00e9sidence et le niveau d'instruction des m\u00e8res: en milieu rural, plus d'un enfant sur deux (51%) n'a re\u00e7u aucune vaccination; cette proportion est de 18 % dans les Autres Villes et de 17 % \u00e0 N'Djam\u00e9na. De m\u00eame, 38 % des enfants dont la m\u00e8re a un niveau d'instruction secondaire ou plus sont compl\u00e8tement vaccin~s, contre 17 % de ceux dont la m\u00e8re a un niveau primaire et 8 % seulement de ceux dont la m\u00e8re est sans instruction. \n\nD'apr\u00e8s les d\u00e9clarations des m\u00e8res, pendant les deux semaines ayant pr\u00e9c\u00e9d\u00e9 l'enqu\u00eate, 13 % des enfants de moins de 5 ans ont souffert de toux et de respiration courte et rapide, sympt\u00f4mes d'infections respiratoires aigu\u00ebs; du point de vue de la r\u00e9sidence, les enfants vivant \u00e0 N'Djam\u00e9na ( 16 %) sont sensiblement plus touch\u00e9s qu ceux du milieu rural (13 %) et que ceux des Autres Villes (10 %); 32 % des enfants ont souffert de fi\u00e8vre qui peut, dans de nombreux cas, \u00eatre un sympt\u00f4me du paludisme; comme pour la toux, ce sont les enfants de N'Djam\u00e9na qui sont les plus touch\u00e9s; enfin, 22 % des enfants ont eu un ou plusieurs \u00e9pisodes diarrh6iques et on ne constate pas de diff\u00e9rence de pr\u00e9valence selon les milieux d'habitat. Quelle que soit la maladie, seulement un enfant sur cinq (19 %) a \u00e9t\u00e9 men\u00e9 en consultation lorsqu'il \u00e9tait malade. Parmi les enfants ayant eu la diarrh\u00e9e, un sur trois (33 %) n'a b\u00e9n\u00e9fici\u00e9 d'aucune forme de Th\u00e9rapie de R\u00e9hydratation par voie Orale ('FRO), alors que 66 % des femmes ont d\u00e9clar\u00e9 conna\u00eetre les sachets de SRO. \n\nLa quasi-totalit\u00e9 des enfants tchadiens n\u00e9s au cours des cinq ann\u00e9es ayant pr\u00e9c\u00e9d\u00e9 l'enqu\u00eate (98 %) ont \u00e9t\u00e9 allait\u00e9s, mais une tr\u00e8s faible proportion d'entre eux (24 %) ont \u00e9t\u00e9 mis au sein d\u00e8s la naissance. Alors que jusqu'\u00e0 l'\u00e2ge de 6 mois, tous les enfants ne devraient recevoir rien d'autre que le sein, d\u00e8s 0-1 mois, 56 % des nouveau-n\u00e9s re\u00e7oivent de l'eau en plus du lait et 39 % des compl\u00e9ments au lait maternel, ce qui affecte leur \u00e9tat nutritionnel et augmente leur risque de contracter des maladies infectieuses. En moyenne, et quelles que soient les caract\u00e9ristiques de la m&e, les enfants sont allait\u00e9s pendant environ 21,4 mois. \n\nDeux enfants sur cinq (40 %) sont atteints d'un retard de croissance qui r\u00e9v\u00e8le un \u00e9tat de malnutrition chronique, et pr\u00e8s de la moiti\u00e9 de ces enfants sont affect\u00e9s par la forme s\u00e9v\u00e8re de cette malnutrition. Un enfant sur sept (14 %) est \u00e9maci\u00e9, c'est-\u00e0-dire atteint de malnutrition aigu\u00eb. Cette situation nutritionnelle des enfants, d\u00e9j\u00e0 tr\u00e8s pr\u00e9occupante au niveau national, est encore plus alarmante au niveau de certaines sous- populations : ainsi, le retard de croissance atteint 42 % des enfants du milieu rural et en ce qui concerne la forme s\u00e9v\u00e8re de la malnutrition chronique, il y a environ deux fois plus d'enfants atteints en milieu rural qu'\u00e0 N'Djam\u00e9na; la pr\u00e9valence de l'\u00e9maciation est beaucoup plus \u00e9lev\u00e9e dans les Autres Villes et en milieu rural qu'\u00e0 N'Djam\u00e9na (9 % contre 14 %). \nCons\u00e9quence d'une situation sanitaire d\u00e9ficiente et d'un mauvais \u00e9tat nutritionnel, la mortalit\u00e9 des enfants tchadiens est l'une des plus \u00e9lev\u00e9e au monde. Sur mille enfants qui naissent, 103 d\u00e9c\u00e8dent avant le premier anniversaire et, 194 d\u00e9c\u00e8dent avant l'\u00e2ge de 5 ans. Globalement, 1 enfant sur 5 d\u00e9c\u00e8de entre la naissance et le cinqui\u00e8me anniversaire. Cette tr\u00e8s forte mortalit\u00e9 qui semble n'avoir que peu \u00e9volu\u00e9 durant les quinze derni\u00e8res ann\u00e9es, ne pr\u00e9sente que peu de diff\u00e9rence entre les diff\u00e9rents milieux de r\u00e9sidence, la mortalit\u00e9 infantile variant de 99 %o \u00e0 N'Djam\u00e9na et dans les Autres Villes \u00e0 113 %o en milieu rural; quant \u00e0 la mortalit\u00e9 juv\u00e9nile, elle ne pr\u00e9sente pratiquement aucune variation (101%o en milieu urbain contre 103 %, en milieu rural). En outre, les r\u00e9sultats ont mis en \u00e9vidence de fortes variations selon les caract\u00e9ristiques des m\u00e8res. La probabilit\u00e9 de mourir avant cinq ans des enfants survivants \u00e0 1 an est de 104 %~ quand leur m\u00e8re n'a aucune instruction contre 93 %o lorsqu'il a fr\u00e9quent\u00e9 l'\u00e9cole. \n\nAutre cons\u00e9quence de cette situation sanitaire d\u00e9ficiente, les femmes courent un risque \u00e9lev\u00e9 de d\u00e9c\u00e9der par cause maternelle. Pour la p\u00e9riode 1991-1997, parmi l'ensemble des d\u00e9c\u00e8s de femmes en \u00e2ge de procr\u00e9ation, 2 d\u00e9c\u00e8s sur 5 (41%) \u00e9taient imputables \u00e0 des causes maternelles. Pour la m\u00eame p\u00e9riode, on estime que le taux de mortalit\u00e9 maternelle se situait \u00e0 environ 827 d\u00e9c\u00e8s maternels pour 100 000 naissances : exprim\u00e9 diff\u00e9remment, cela signifie qu'une femme court un risque de 1 sur 18 de d\u00e9c\u00e9der par cause maternelle durant sa vie f\u00e9conde. \n\nLa majorit\u00e9 des hommes (88 %) ont entendu parler du sida contre 60 % des femmes. Or, un tiers des hommes (30 %) et pr\u00e8s d'une femme sur deux (44 %) ne connaissent pas de moyens pour \u00e9viter de contracter cette maladie. De plus, seulement 13 % des hommes et 3 % des femmes ont d\u00e9clar\u00e9 utiliser le condom pour \u00e9viter de contracter le sida ou une autre MST au cours des rapports sexuels qu'ils ont eus dans les 2 mois pr\u00e9c\u00e9dant l'enqu\u00eate. \n\nLes r\u00e9sultats de l'enqu\u00eate sur la disponibilit\u00e9 des services communautaires ont mis en \u00e9vidence non seulement le manque de disponibilit\u00e9 de certaines infrastructures socio-\u00e9conomiques, mais aussi les difficult\u00e9s d'acc\u00e8s \u00e0 certains \u00e9tablissements du fait de l'\u00e9loignement et des temps de trajet importants. Ainsi, en milieu rural, la distance m\u00e9diane qu'il faut parcourir pour atteindre une pharmacie est de 15,7 kilom\u00e8tres; pour atteindre un h\u00f4pital public, la moiti\u00e9 des femmes du milieu rural doivent parcourir 70,5 kilom\u00e8tres. De m\u00eame, seulement un quart des Tchadiennes vivent \u00e0 proximit\u00e9 d'un \u00e9tablissement de sant\u00e9 offrant des services de PF alors que pr\u00e8s de la moiti\u00e9 (47 %) en sont tr\u00e8s \u00e9loign\u00e9es. En ce qui concerne les \u00e9tablissements de sant\u00e9 offrant des services de sant\u00e9 maternelle et infantile, on constate que 24 % des femmes mettent moins d'une demi-heure pour atteindre ce type d'\u00e9tablissement le plus proche mais que plus de la moiti\u00e9 des femmes (51%) ont une dur\u00e9e de d\u00e9placement de deux heures ou plus pour atteindre ce type de service; en milieu rural, le temps m\u00e9dian de trajet est de trois heures. Par ailleurs, en ce qui concerne les principaux probl\u00e8mes pour se soigner, le manque d'\u00e9tablissement sanitaire et le manque d'eau sont les deux probl\u00e8mes qui ont \u00e9t\u00e9 cit\u00e9s le plus fr\u00e9quemment, cela quel que soit le milieu de r\u00e9sidence.","coll_dates":[{"start":"1996-12","end":"1997-07","cycle":""}],"nation":[{"name":"Chad","abbreviation":"TCD"}],"geog_coverage":"National sauf les zones non-recens\u00e9es de la pr\u00e9fecture du Ouaddai.","analysis_unit":"- Household\n- Women age 15-49\n- Men age 15-59\n- Children under five","universe":"L'univers de l'enqu\u00eate est l'ensemble de la population et au niveau des sous-populations toutes les femmes \u00e2g\u00e9es de 15 \u00e0 49 ans (r\u00e9sidentes habituelles ou visiteuses) qui se trouvaient dans les m\u00e9nages ont \u00e9t\u00e9 enqu\u00eat\u00e9es. De plus, dans un m\u00e9nage sur trois, tous les hommes de 15 \u00e0 59 ans (r\u00e9sidents habituels ou visiteurs) ont \u00e9t\u00e9 enqu\u00eat\u00e9s.\n\nL'Enqu\u00eate D\u00e9mographique et de Sant\u00e9 couvre seulement la population s\u00e9dentaire et n'inclue pas les zones non-recens\u00e9es de la pr\u00e9fecture du Ouaddai.","data_kind":"Sample survey data","notes":"L'Enqu\u00eate D\u00e9mographique et Sant\u00e9 1996 du Tchad couvre les th\u00e8mes suivants :\n\n- Antropom\u00e9trie\n- Cartographie\n- Caract\u00e9ristiaues socio-d\u00e9mographiques\n- Caract\u00e9ristiques du conjoint et activit\u00e9s \u00e9conomiques de la femme\n- Contraception\n- Grossesse et allaitement\n- Mariage\n- Mortalit\u00e9 infantile\n- Mortalit\u00e9 maternelle\n- Pr\u00e9f\u00e9rences en mati\u00e8re de f\u00e9condit\u00e9\n- Polygamie\n- Reproduction\n- Services\n- Sida et autres maladies sexuellement transmissibles\n- Traitement de la fi\u00e8vre, de la toux et de la diarrh\u00e9e\n- Vaccination et sant\u00e9","study_scope":"L'Enqu\u00eate D\u00e9mographique et Sant\u00e9 1996 du Tchad couvre les th\u00e8mes suivants :\n\n- Antropom\u00e9trie\n- Cartographie\n- Caract\u00e9ristiaues socio-d\u00e9mographiques\n- Caract\u00e9ristiques du conjoint et activit\u00e9s \u00e9conomiques de la femme\n- Contraception\n- Grossesse et allaitement\n- Mariage\n- Mortalit\u00e9 infantile\n- Mortalit\u00e9 maternelle\n- Pr\u00e9f\u00e9rences en mati\u00e8re de f\u00e9condit\u00e9\n- Polygamie\n- Reproduction\n- Services\n- Sida et autres maladies sexuellement transmissibles\n- Traitement de la fi\u00e8vre, de la toux et de la diarrh\u00e9e\n- Vaccination et sant\u00e9"},"method":{"data_collection":{"data_collectors":[{"name":"Bureau Central de Recensement","abbreviation":"BCR","affiliation":"Minist\u00e8re du Plan et de 1'Am\u00e9nagement du Territoire"}],"sampling_procedure":"L'Enqu\u00eate D\u00e9mographique et de Sant\u00e9 au Tchad (EDST) a pr\u00e9vu un \u00e9chantillon de 7000 femmes \u00e2g\u00e9es de 15 \u00e0 49 ans. Elle couvre seulement la population s\u00e9dentaire et n'inclue pas les zones non-recens\u00e9es de la pr\u00e9fecture du Ouaddai. La population non-recens\u00e9e de cette pr\u00e9fecture a \u00e9t\u00e9 estim\u00e9e \u00e0 2 035, donc 0,03 % de la population s\u00e9dentaire, proportion tr\u00e8s n\u00e9gligeable. Cependant, les zones non-recens\u00e9es dans les six cantons du Logone Oriental ont \u00e9t\u00e9 couvertes par l'EDST. \n\nTrois principaux domaines d'\u00e9tude ont \u00e9t\u00e9 identifi\u00e9s pour I'EDST. Ils correspondent \u00e0 la capitale N'Djam\u00e9na, l'ensemble des autres centres urbains et l'ensemble des milieux ruraux. Une premi\u00e8re allocation proportionnelle de l'\u00e9chantillon des 7 000 femmes aux trois domaines d'\u00e9tude a montr\u00e9 qu'un \u00e9chantillon assez faible (moins de 1 000 femmes) a \u00e9t\u00e9 accord\u00e9 aux deux domaines urbains, N'Djam\u00e9na et les autres villes. Effectivement, ces deux domaines ne repr\u00e9sentent respectivement qu'environ 9,7 et 13,3 % de la population s\u00e9dentaire. Ces sous-\u00e9chantillons relativement faibles ne permettaient pas les analyses approfondies que l'on d\u00e9sirait effectuer au niveau de ces deux domaines. L'analyse des autres enqu\u00eates du projet Enqu\u00eate D\u00e9mographique et de Sant\u00e9 a montr\u00e9 que, pour obtenir des r\u00e9sultats sur la f\u00e9condit\u00e9 et la mortalit\u00e9 avec des marges d'erreur acceptables, il devait y avoir un minimum de I 000 femmes dans chaque domaine d'\u00e9tude. On a propos\u00e9 alors d'affecter un taux de sondage plus \u00e9lev\u00e9 \u00e0 ces deux domaines par rapport au domaine rural. Cependant, un taux de sondage homog\u00e8ne a \u00e9t\u00e9 appliqu\u00e9 \u00e0 l'int\u00e9rieur de chaque domaine afin que l'\u00e9chantillon de chaque domaine soit auto-pond\u00e9r\u00e9. \n\nPour pouvoir \u00e9tudier \u00e9galement l'attitude des hommes envers la planification familiale ainsi que leurs pratiques contraceptives et leur connaissance sur le SIDA, I'EDST a aussi interrog\u00e9 un \u00e9chantillon d'hommes de 15 \u00e0 59 ans dans un sous-\u00e9chantillon des m\u00e9nages tir\u00e9s pour l'enqu\u00eate des femmes. \n\nBASE DE SONDAGE \n\nAdministrativement, le Tchad est divis\u00e9 en 14 pr\u00e9fectures et la capitale N'Djam\u00e9na qui, elle aussi, a un statut pr\u00e9fectoral. Le pays comptait 6.279.931 habitants d'apr\u00e8s le Premier Recensement G\u00e9n\u00e9ral de la Population et de l'Habitation d'Avril 1993 (RGPH), dont 5,6 % \u00e9taient des nomades. \u00c0 l'int\u00e9rieur de chaque pr\u00e9fecture, on trouve des sous.pr\u00e9fectures qui se composent de cantons. \n\nLe Bureau Central de Recensement (BCR) de la Direction de la Statistique, des \u00c9tudes \u00c9conomiques et D\u00e9mographiques dispose d'un fichier informatique de plus de 6732 zones de d\u00e9nombrement (ZD) qui ont \u00e9t\u00e9 cr\u00e9\u00e9s pour les besoins du RGPH.\n\nPour que ce fichier de ZD puisse servir de base de sondage pour I'EDST, on l'a apur\u00e9 de telle sorte qu'il r\u00e9ponde aux conditions suivantes : \n1 - Le fichier ne devait pas inclure les ZD qui ne comptent pas de m\u00e9nages ordinaires (cas de 12 ZD). \n2 - Le fichier ne devait pas inclure les ZD qui comptent moins de l0 m\u00e9nages ordinaires (cas de 9 ZD avec une population totale de 194), ceci pour des raisons pratiques de terrain 2. \n3 - Pour chaque ZD, le fichier devait inclure le code d'identification du canton qui lui est attach\u00e9 selon le Manuel de Codification du RGPH. Comme les ZD ont \u00e9t\u00e9 num\u00e9rot\u00e9es de fa\u00e7on s\u00e9quentielle \u00e0 l'int\u00e9rieur de chaque canton, le code d'identification du canton \u00e9tait n\u00e9cessaire pour retrouver la ZD dans les documents cartographiques du RGPH. Dans quelques cas particuliers, les ZD ont \u00e9t\u00e9 num\u00e9rot\u00e9es \u00e0 l'int\u00e9rieur de la sous-pr\u00e9fecture; le code de canton ne s'appliquait donc pas. On s'est aussi trouv\u00e9 en pr\u00e9sence de cas o\u00f9 une seule ZD \u00e9tait attach\u00e9e \u00e0 plusieurs cantons administratifs (et apparaissait donc plusieurs fois dans le fichier) alors que physiquement elle \u00e9tait une seule ZD g\u00e9ographique; on a cherch\u00e9 \u00e0 grouper ces sous-ZD administratives pour qu'elles apparaissent ensemble dans une seule ZD g\u00e9ographique.\n4 - Le fichier devait \u00eatre reclass\u00e9 par ordre g\u00e9ographique : pr\u00e9fectures et sous-pr\u00e9fectures au sein de chaque pr\u00e9fecture; arrondissements au sein de N'Djam\u00e9na. \n\nLe fichier apur\u00e9 devait donc fournir une bonne base de sondage pour I'EDST si on adoptait les r\u00e8gles de sondage suivantes : \n   1 - Au premier degr\u00e9 de sondage, on tirait un certain nombre de ZD avec des probabilit\u00e9s proportionnelles \u00e0 la taille des ZD, \u00e9tant donn\u00e9 que les coefficients de variation sont assez \u00e9lev\u00e9s. \n   2 - Avant le tirage des ZD, on regroupait les ZD de petite taille avec les ZD voisines sur le terrain. \n   3 - Apr\u00e8s le tirage, on scindait les grandes ZD tir\u00e9es en segments et un seul segment \u00e9tait retenu pour I'EDST. Dans la pratique, le regroupement des ZD pouvait aussi se faire apr\u00e8s le tirage : chaque ZD tir\u00e9e, ayant moins de 40 m\u00e9nages, serait group\u00e9e avec la ZD suivante dans la liste sauf si la ZD tir\u00e9e \u00e9tait la derni\u00e8re dans la liste; dans ce dernier cas, on la regrouperait avec celle qui la pr\u00e9c\u00e8de dans la liste. Apr\u00e8s avoir reclass\u00e9 la base par ordre g\u00e9ographique, on pouvait \u00eatre s\u00fbr que les ZD avoisinantes sur la liste \u00e9taient aussi avoisinantes sur le terrain. \n\nCARACTERISTIQUES GENERALES DE L'ECHANTILLON \n\nL'\u00e9chantillon de I'EDST est bas\u00e9 sur un sondage ar\u00e9olaire stratifi\u00e9 et tir\u00e9 \u00e0 deux degr\u00e9s. Le tirage a \u00e9t\u00e9 fait ind\u00e9pendamment \u00e0 l'int\u00e9rieur de chaque domaine. Dans chaque domaine, on a tir\u00e9 au premier degr\u00e9 un certain nombre de ZD \u00e0 partir de l'ensemble des ZD dans le fichier apur\u00e9. On a examin\u00e9 ensuite les ZD tir\u00e9es pour voir si un regroupement (de ZD de petite taille) ou une segmentation (d'une ZD de grande taille) \u00e9tait n\u00e9cessaire. On a trouv\u00e9 que dans l'ensemble des ZD tir\u00e9es, il n'existe pas de ZD ayant moins de 40 m\u00e9nages et il existe une seule ZD qui comptait 407 m\u00e9nages en 1993. On a d\u00e9cid\u00e9 de ne pas segmenter cette ZD \u00e9tant donn\u00e9 que c'est une ZD urbaine qui n'est pas excessivement grande. \n\nUn d\u00e9nombrement des m\u00e9nages dans chacune des ZD tir\u00e9es a fourni une liste de m\u00e9nages \u00e0 partir de laquelle on a tir\u00e9, au deuxi\u00e8me degr\u00e9, un \u00e9chantillon de m\u00e9nages. Tous les membres de ces m\u00e9nages ont \u00e9t\u00e9 d\u00e9nombr\u00e9s \u00e0 l'aide d'un questionnaire m\u00e9nage et chaque femme \u00e2g\u00e9e de 15 \u00e0 49 ans \n\nUne allocation proportionnelle de l'\u00e9chantillon-cible de 7000 femmes aux trois domaines a donn\u00e9 seulement 682 femmes \u00e0 N'Djam\u00e9na et 934 femmes aux autres centres urbains, ce qui n'\u00e9tait pas suffisant pour permettre des estimations fiables dans ces deux domaines. On a donc sur-\u00e9chantillonn\u00e9 N'Djam\u00e9na et les autres centres urbains par rapport aux milieux ruraux. \n\nLe nombre de grappes \u00e0 tirer d\u00e9pend du nombre de femmes \u00e0 enqu\u00eater dans chaque grappe. On entend par grappe l'unit\u00e9 de sondage ar\u00e9olaire finale retenue pour l'enqu\u00eate. Ainsi, dans le cadre de I'EDST, la grappe correspond \u00e0 la ZD. Les analyses men\u00e9es apr\u00e8s d'autres enqu\u00eates analogues indiquent que le nombre optimal de femmes \u00e0 enqu\u00eater par grappe est de l'ordre de 30-35 femmes dans le milieu rural et de 20-25 femmes dans le milieu urbain. Si l'on d\u00e9cide d'enqu\u00eater 30 femmes, en moyenne, dans chaque grappe rurale et de 25 femmes, en moyenne, dans chaque grappe urbaine, on aboutirait \u00e0 un nombre total de 253 grappes. On a propos\u00e9 d'arrondir le nombre de grappes rurales \u00e0 130 pour des raisons budg\u00e9taires et logistiques de terrain. Ce qui revenait \u00e0 enqu\u00eater en moyenne environ 31 femmes rurales par grappe au lieu de 30 femmes. Le nombre total de grappes tir\u00e9es a donc \u00e9t\u00e9 de 250. \n\nLe nombre de m\u00e9nages \u00e0 tirer pour parvenir \u00e0 l'\u00e9chantillon cible de femmes a \u00e9t\u00e9 calcul\u00e9 de la mani\u00e8re suivante: \n\n   Nombre de m\u00e9nages = Nombre de femmes 15 -49 Nombre de femmes 15 -49 par m\u00e9nage x Taux de r\u00e9ponse \n\nD'apr\u00e8s le RGPH, le nombre de femmes \u00e2g\u00e9es de 15 \u00e0 49 ans par m\u00e9nage est de 1,09 \u00e0 N'Djam\u00e9na et 1,14 dans les autres centres urbains et dans les milieux ruraux. Comme taux de r\u00e9ponse, on a utilis\u00e9 un taux global de 90%; ceci en supposant que, parmi l'ensemble des m\u00e9nages tir\u00e9s pour l'enqu\u00eate, l'on en trouverait seulement 95 % sur le terrain pour des raisons diverses (logement non trouv\u00e9, refus de r\u00e9pondre, m\u00e9nage absent, etc...). On a suppos\u00e9 \u00e9galement un taux de r\u00e9ponse de 95 % pour les femmes. Ce qui revenait \u00e0 tirer en moyenne environ 25 m\u00e9nages dans chaque grappe de N'Djam\u00e9na, environ 24 m\u00e9nages dans chaque grappe des autres centres urbains et environ 29 m\u00e9nages dans chaque grappe rurale. \n\nA cause de la r\u00e9partition non-proportionnelle de l'\u00e9chantillon parmi les domaines, des taux de pond\u00e9ration an niveau des domaines ont \u00e9t\u00e9 n\u00e9cessaires pour assurer la repr\u00e9sentativit\u00e9 actuelle de l'\u00e9chantillon au niveau national.","sampling_deviation":"Trois grappes, habit\u00e9es par des nomades, avaient pu \u00eatre d\u00e9nombr\u00e9es au cours des op\u00e9rations de cartographie; cependant, au moment de l'enqu\u00eate principale, la population de ces grappes s'\u00e9tant d\u00e9plac\u00e9e, aucun questionnaire n'a pu y \u00eatre rempli. \n\nPour des raisons d'ins\u00e9curit\u00e9, cinq villages du canton Signal dans la sous-pr\u00e9fecture Goz-B\u00e9\u00efda, n'ont pas \u00e9t\u00e9 recens\u00e9s","coll_mode":"Face-to-face","research_instrument":"L'Enqu\u00eate D\u00e9mographique et de Sant\u00e9 a utilis\u00e9 4 types de questionnaires : a) le questionnaire m\u00e9nage; b) le questionnaire individuel femme; c) le questionnaire individuel homme; et d) le questionnaire communautaire sur la disponibilit\u00e9 des services. \n\nAfin d'atteindre les objectifs de l'enqu\u00eate, environ 80 expressions et termes relatifs aux parties sensibles des questionnaires (en particulier les questions sur la reproduction, l'activit\u00e9 sexuelle, la contraception et les maladies) ont \u00e9t\u00e9 traduits en 14 langues parl\u00e9es au Tchad de fa\u00e7on \u00e0 ce qu'au cours de l'enqu\u00eate, les enqu\u00eatrices traduisent les questions le plus fid\u00e8lement possible. Ces lexiques ont \u00e9t\u00e9 test\u00e9s et am\u00e9lior\u00e9s au cours de la formation et du pr\u00e9-test avant leur utilisation pour l'enqu\u00eate principale. \n\na) Questionnaire m\u00e9nage \n\nIl permet d'\u00e9tablir la liste de tous les membres du m\u00e9nage et des visiteurs et de collecter \u00e0 leur sujet un certain nombre d'informations telles que le nom, le lien de parent\u00e9 avec le chef de m\u00e9nage, la situation de r\u00e9sidence, le sexe, l'\u00e2ge, le niveau d'instruction. En outre, par le biais du questionnaire m\u00e9nage, sont collect\u00e9es quelques caract\u00e9ristiques des logements devant servir \u00e0 \u00e9valuer les conditions socio-\u00e9conomiques et environnementales dans lesquelles vivent les femmes et les hommes qui seront enqu\u00eat\u00e9s individuellement. Enfin, la page de garde du questionnaire, comprend des informations relatives \u00e0 la localisation du m\u00e9nage (Pr\u00e9fecture, Sous-Pr\u00e9fecture, Canton, Village), au nombre de visites effectu\u00e9es par l'enqu\u00eatrice, au r\u00e9sultat de l'interview ainsi qu'une partie r\u00e9serv\u00e9e au contr\u00f4le de terrain et de bureau. \nL'objectif principal de ce questionnaire est de permettre l'identification des femmes \u00e9ligibles (\u00e2g\u00e9es de 15-49 ans) et, dans un tiers des m\u00e9nages, celle des hommes \u00e9ligibles (\u00e2g\u00e9s de 15-59 ans). Le questionnaire m\u00e9nage fournit \u00e9galement les informations permettant d'\u00e9tablir le d\u00e9nominateur pour le calcul \ndes taux d\u00e9mographiques. \n\nb) Questionnaire individuel femme \n\nLe questionnaire individuel femme constitue le document principal de I'EDST. Il a \u00e9t\u00e9 \u00e9labor\u00e9 sur la base du questionnaire Mod\u00e8le B du programme DHS (Questionnaire pour les pays \u00e0 faible pr\u00e9valence contraceptive). Il comprend une page similaire \u00e0 celle du questionnaire m\u00e9nage sur laquelle sont enregistr\u00e9s les informations d'identification et les r\u00e9sultats des interviews. Les onze sections qui composent le questionnaire femme servent \u00e0 recueillir des informations sur les diff\u00e9rents domaines suivants : \n- Caract\u00e9ristiaues socio-d\u00e9mographiques. Cette section porte sur le lieu et la dur\u00e9e de r\u00e9sidence, l'\u00e2ge et la date de naissance, la scolarisation, l'alphab\u00e9tisation, la nationalit\u00e9, la religion, l'ethnie, l'acc\u00e8s aux m\u00e9dia ainsi que sur les caract\u00e9ristiques des logements des femmes qui sont en visite dans le m\u00e9nage enqu\u00eat\u00e9. \n- Reproduction. Cette section permet de collecter des informations sur les naissances vivantes que la femme a eues durant sa vie ainsi que sur leur \u00e9tat de survie an moment de l'enqu\u00eate, sur l'\u00e9tat de grossesse au moment de l'enqu\u00eate, les dates des demi\u00e8res r\u00e8gles et sur la connaissance de la p\u00e9riode f\u00e9conde au cours du cycle menstruel. \n- Contraception. Cette section porte sur la connaissance, spontan\u00e9e ou non, des diverses m\u00e9thodes contraceptives, sur leur utilisation ainsi que sur les diverses sources d'approvisionnement. Des questions concernant les raisons de non utilisation de la contraception figurent \u00e9galement dans cette section. \n- Grossesse et allaitement. Cette section porte uniquement sur les naissances ayant eu lieu au cours des cinq ann\u00e9es pr\u00e9c\u00e9dant l'enqu\u00eate. Le questionnaire permet d'obtenir des informations sur la p\u00e9riode de la grossesse, les soins pr\u00e9natals y compris la vaccination antit\u00e9tanique, le lieu d'accouchement et la qualification de la personne ayant assist\u00e9 la femme pendant l'accouchement, le retour des r\u00e8gles et la reprise des rapports sexuels apr\u00e8s la naissance de l'enfant. Concernant l'allaitement, les questions portent sur sa fr\u00e9quence et sa dur\u00e9e, sur le type d'allaitement (maternel ou artificiel), ainsi que sur l'utilisation des diff\u00e9rents compl\u00e9ments nutritionnels. \n- Vaccination et sant\u00e9. Cette section porte \u00e9galement sur les naissances ayant eu lieu an cours des cinq ann\u00e9es pr\u00e9c\u00e9dant l'enqu\u00eate. La section porte sur les vaccinations incluses dans le \nProgramme Elargi de Vaccination (PEV), sur la sant\u00e9 des enfants de moins de cinq ans et, plus particuli\u00e8rement, sur la pr\u00e9valence et le traitement de la fi\u00e8vre, de la toux et de la diarrh\u00e9e. \n- Causes de d\u00e9c\u00e8s des enfants n\u00e9s dans les cinq derni\u00e8res ann\u00e9es. Cette section porte sur les causes de d\u00e9c\u00e8s d'enfants n\u00e9s vivants au cours des cinq derni\u00e8res ann\u00e9es. Les questions permettent de d\u00e9terminer quelles sont les principales maladies responsables de la mortalit\u00e9 des enfants de moins de cinq ans dans le pays. \n- Mariage. Cette section permet de recueillir des informations sur l'\u00e9tat matrimonial, le r\u00e9gime de mariage (monogamie ou polygamie), l'\u00e2ge au premier mariage et aux premiers rapports sexuels ainsi que sur l'activit\u00e9 sexuelle. \n- Pr\u00e9f\u00e9rences en mati\u00e8re de f\u00e9condit\u00e9. Cette section recueille des informations sur le d\u00e9sir d'enfants suppl\u00e9mentaires, l'intervalle entre les naissances et l'attitude concernant la taille de la famille. \n- Caract\u00e9ristiques du conjoint et activit\u00e9s \u00e9conomiques de la femme. Dans cette section, les questions pos\u00e9es portent sur les caract\u00e9ristiques socioprofessionnelles du conjoint des femmes en union et sur l'activit\u00e9 professionnelle des femmes. \n- Sida et autres maladies sexuellement transmissibles. Cette section permet d'obtenir des informations sur la connaissance et la pr\u00e9valence des maladies sexuellement transmissibles ainsi que sur les modes de transmission et de pr\u00e9vention du sida. \n- Mortalit\u00e9 maternelle. Au niveau de cette section, on enregistre des informations sur l'\u00e2ge et l'\u00e9tat de survie des fr\u00e8res et s\u0153urs de l'enqu\u00eat\u00e9e. Pour les s\u0153urs d\u00e9c\u00e9d\u00e9es \u00e0 l'\u00e2ge de 12 ans ou plus, des questions suppl\u00e9mentaires permettent de d\u00e9terminer si le d\u00e9c\u00e8s est en rapport avec la maternit\u00e9. Des questions suppl\u00e9mentaires sur le nombre d'enfants de la s\u0153ur (d\u00e9, c\u00e9d\u00e9e ou non) sont aussi pos\u00e9es. \n- Taille et poids des m\u00e8res et des enfants. Cette section est consacr\u00e9e aux mesures anthropom\u00e9triques des femmes enqu\u00eat\u00e9es et de leurs enfants \u00e2g\u00e9s de moins de cinq ans. \n\nc) Questionnaire individuel homme \n\nLe questionnaire homme qui est une forme all\u00e9g\u00e9e du questionnaire individuel femme permet de collecter des informations sur la connaissance et l'utilisation de la contraception par les hommes ainsi que sur leurs opinions en mati\u00e8re de f\u00e9condit\u00e9, de taille de la famille et de planification familiale ainsi que sur les MST et le sida. \n\nd) Questionnaire sur la disponibilit\u00e9 des services \n\nLe questionnaire communautaire a pour objectif de recueillir quelques informations sur les infrastructures socio-\u00e9conomiques (\u00e9coles, march\u00e9s, services de transport, etc.) et sanitaires (h\u00f4pitaux, centres de sant\u00e9 communantaire, etc.) disponibles dans chacune des grappes de l'enqu\u00eate.","coll_situation":"CARTOGRAPHIE \n\nLes travaux de mise \u00e0 jour de 250 grappes \u00e9chantillons ont \u00e9t\u00e9 r\u00e9alis\u00e9s par une \u00e9quipe de 12 agents cartographes. Ces travaux se sont d\u00e9roul\u00e9s d'avril \u00e0 novembre 1996. Ils consistaient sp\u00e9cifiquement \u00e0 d\u00e9terminer avec exactitude les limites des grappes, faire leur croquis, indiquer les positions relatives de chaque structure occup\u00e9e par les m\u00e9nages et dresser la liste de ces m\u00e9nages. \n\nENQUETE PILOTE \n\nLes questionnaires et autres instruments de l'enqu\u00eate (manuels des enqu\u00eateurs, des superviseurs, guides de formation, lexiques en langues nationales, etc.) ont \u00e9t\u00e9 test\u00e9s dans le cadre d'une pr\u00e9-enqu\u00eate \u00e0 laquelle ont particip\u00e9 18 enqu\u00eateurs et enqu\u00eatrices devenus superviseurs et contr\u00f4leuses dans le cadre de l'enqu\u00eate principale. Cette pr\u00e9-enqu\u00eate a dur\u00e9 une semaine et s'est d\u00e9roul\u00e9e sur deux zones de la ville de N'Djam\u00e9na et une zone rurale. Cette op6ration a permis d'identifier certaines erreurs dans les questionnaires, certaines impr\u00e9cisions dans les traductions ainsi que des lacunes dans la formation; \u00e0 partir de ces enseignements, il a \u00e9t\u00e9 possible de pr\u00e9parer la version finale des questionnaires, des traductions et des Instructions de l'enqu\u00eate. \n\nFORMATION ET COLLECTE \n\nEn novembre 1996, a commenc\u00e9 la formation pour l'enqu\u00eate principale qui a dur\u00e9 quatre semaines. Outre l'\u00e9quipe technique du BCR, cette formation a vu l'intervention des diff\u00e9rents consultants nationaux et internationaux pour pr\u00e9senter au personnel de collecte un panorama complet de l'\u00e9tat sanitaire du pays et leur expliquer l'importance de I'EDST. \u00c0 l'issue de la formation, huit \u00e9quipes, chacune compos\u00e9e de trois enqu\u00eatrices, d'un enqu\u00eateur charg\u00e9 de l'enqu\u00eate aupr\u00e8s des hommes, d'une contr\u00f4leuse, d'un chauffeur et d'un chef d'\u00e9quipe, ont visit\u00e9 les grappes s\u00e9lectionn\u00e9es pour proc\u00e9der \u00e0 la collecte des informations.\n \nLa collecte des donn\u00e9es a commenc\u00e9 en d\u00e9cembre 1996 et a pris fin dans le courant du mois de juillet 1997. Toutes les grappes ont pu \u00eatre visit\u00e9es. Trois grappes, habit\u00e9es par des nomades, avaient pu \u00eatre d\u00e9nombr\u00e9es au cours des op\u00e9rations de cartographie; cependant, au moment de l'enqu\u00eate principale, la population de ces grappes s'\u00e9tant d\u00e9plac\u00e9e, aucun questionnaire n'a pu y \u00eatre rempli.","cleaning_operations":"La saisie des donn\u00e9es sur micro-ordinateur a d\u00e9but\u00e9 une semaine apr\u00e8s le d\u00e9but de la collecte et a \u00e9t\u00e9 r\u00e9alis\u00e9e par dix op\u00e9rateurs de saisie r\u00e9partis en deux groupes. Chacun des deux groupes \u00e9tait assist\u00e9 d'un contr\u00f4leur. La supervision technique a \u00e9t\u00e9 assur\u00e9e par les deux informaticiens du BCR. \n\nTout au long de la saisie, les donn\u00e9es ont \u00e9t\u00e9 \u00e9dit\u00e9es par un informaticien et un d\u00e9mographe du BCR. L'\u00e9dition des donn\u00e9es a permis de v\u00e9rifier la coh\u00e9rence interne des r\u00e9ponses. La v\u00e9rification finale a \u00e9t\u00e9 r6alis\u00e9e par un informaticien et un d\u00e9mographe de Macro International.","method_notes":"Les travaux d'analyse ont \u00e9t\u00e9 r\u00e9alis\u00e9s en collaboration avec Macro International. Sur les douze chapitres que comporte le rapport final, huit ont \u00e9t\u00e9 analys\u00e9s par les cadres nationaux et cinq par les experts de Macro. Un s\u00e9minaire d'harmonisation d'une dur\u00e9e de sept jours a \u00e9t\u00e9 organis\u00e9 au Tchad avant la finalisation du rapport final. Le s\u00e9minaire a regroup\u00e9 d'une part les auteurs des diff\u00e9rents chapitres (\u00e0 l'exception des experts de Macro) et, d'autre part, les techniciens du Minist\u00e8re de la Sant\u00e9 Publique. Ce s\u00e9minaire a permis aux participants de faire des observations sur les diff\u00e9rents chapitres afin de pr\u00e9parer leur version finale. La version finale des rapports (rapport principal et rapport de synth\u00e8se) a \u00e9t\u00e9 r\u00e9alis\u00e9e au si\u00e8ge de Macro International par deux cadres du BCR et par deux experts de cette institution."},"analysis_info":{"response_rate":"Au total, 7345 m\u00e9nages ont \u00e9t\u00e9 s\u00e9lectionn\u00e9s pour l'enqu\u00eate m\u00e9nage : 6930 ont \u00e9t\u00e9 identifi\u00e9s et parmi ceux- l\u00e0, 6840 ont pu \u00eatre enqu\u00eat\u00e9s avec succ\u00e8s, soit un taux de r\u00e9ponse de 98,7 % (tableau 1.2). En ce qui concerne les femmes de 15-49 ans, sur les 7705 \u00e9ligibles pour une enqu\u00eate individuelle, 7454 ont pu \u00eatre enqu\u00eat\u00e9es, soit un taux de r\u00e9ponse de 96,7 %. Ce taux de r\u00e9ponse est satisfaisant puisqu'il est sup\u00e9rieur \u00e0 celui propos\u00e9 dans le plan de sondage (95 %). En ce qui concerne les hommes, le taux de r\u00e9ponse de 94,0 % est \u00e9galement sup\u00e9rieur \u00e0 celui pr\u00e9vu par le plan de sondage (90 %) pour l'enqu\u00eate homme.","sampling_error_estimates":"Les erreurs de sondage peuvent \u00eatre \u00e9valu\u00e9es statistiquement. Les estimations qui figurent dans ce rapport ont \u00e9t\u00e9 obtenues \u00e0 partir d'un \u00e9chantillon de 7 454 femmes \u00e2g\u00e9es de 15 \u00e0 49 ans et de 2 320 hommes \u00e2g\u00e9s de 15 \u00e0 59 ans. Si l'enqu\u00eate avait \u00e9t\u00e9 effectu\u00e9e aupr\u00e8s d'autres enqu\u00eat\u00e9s, il y a tout lieu de penser que les fr\u00e9quences des r\u00e9ponses auraient \u00e9t\u00e9 tr\u00e8s peu diff\u00e9rentes de celles que r on a pr\u00e9sent\u00e9es. C'est l'incertitude de cette assomption que refl\u00e8te l'erreur de sondage; celle-ci permet donc de mesurer le degr\u00e9 de variation des r\u00e9ponses suivant l'\u00e9chantillon. \n\nL'erreur-type (ET) est un indice particuli\u00e8rement utile pour mesurer l'erreur de sondage d'un param\u00e8tre (moyenne ou proportion). Elle est estim\u00e9e \u00e0 partir de la variance des r\u00e9ponses dans l'\u00e9chantillon m\u00eame : l'erreur-type est la racine carr\u00e9e de la variance. Cet indice a pour propri\u00e9t\u00e9 que dans 95 % des \u00e9chantillons de taille et de caract\u00e9ristique identiques, la valeur r\u00e9elle d'un param\u00e8tre pour l'ensemble d'une population se trouve \u00e0 l'int\u00e9rieur de l'intervalle de \u00b1 2 ET. \n\nSi l'\u00e9chantillon des femmes ou des hommes 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 I'EDST \u00e9tant un \u00e9chantillon stratifi\u00e9 \u00e0 deux degr\u00e9s, des formules plus complexes ont \u00e9te 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 telles que l'indice synth\u00e9tique de f\u00e9condit\u00e9 et les quotients de mortalit\u00e9. \n\nLes erreurs de sondage pour I'EDST ont \u00e9t\u00e9 calcul\u00e9es pour certaines des variables les plus int\u00e9ressantes. Les r\u00e9sultats sont pr\u00e9sent\u00e9s dans une annexe du Rapport Final pour l'ensemble du pays, le milieu urbain, le milieu rural, la capitale Ndjam\u00e9na, et l'ensemble des autres villes. Pour chaque variable, le type de statistique (moyenne ou proportion) et la population de base sont pr\u00e9sent\u00e9s dans le tableau B.1 du Rapport Final. Les tableaux B.2 \u00e0 B.6 pr\u00e9sentent la valeur de la statistique (M), l'erreur-type (ET), le nombre de cas non-pond\u00e9r\u00e9s (N) et pond\u00e9r\u00e9s (N'), la racine carr\u00e9e de l'effet du plan de sondage (REPS), l'erreur relative (ET\/M), et l'intervalle de confiance \u00e0 95 % (M+2ET) pour chaque variable. L'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\u00e9e de la mani\u00e8re suivante : pour la variable Enfants n\u00e9s vivants des femmes 15-49 ans, I'EDST a donn\u00e9 un nombre moyen d'enfants n\u00e9s vivants de 3,505 pour l'ensemble des femmes, auquel correspond une erreur-type de 0,038 enfant. La fourchette dans laquelle se place la moyenne :e 2 ET est donc 3,430 et 3,580. La probabilit\u00e9 que la valeur r\u00e9elle du nombre moyen d'enfants n\u00e9s vivants des femmes \u00e2g\u00e9es de 15 \u00ec 49 ans appartienne \u00e0 cet intervalle est de 95 %. \n\nLes erreurs de sondage ont \u00e9t\u00e9 produites pour l'\u00e9chantillon national de femmes et pour deux groupes d'estimations : (1) moyennes et proportions de valeur sup\u00e9rieure ou \u00e9gale \u00e0 1%, et (2) taux d\u00e9mographiques. Les erreurs relatives (ET\/M) des moyennes et proportions se situent entre 0,7 % et 11,9 % avec une moyenne de 5 %. Les erreurs relatives les plus \u00e9lev\u00e9es sont g\u00e9n\u00e9ralement celles des tr\u00e8s faibles estimations (par exemple, parmi les femmes actuellement en union qui Utilisent la continence p\u00e9riodique). Si on enl\u00e8ve les estimations de tr\u00e8s faible valeur (moins de 10 %), la moyenne tombe \u00e2 4,2 %. 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 (1,5 %). Cependant, pour les taux de mortalit\u00e9, l'erreur relative moyenne est un peu plus \u00e9lev\u00e9 (5,2 %). \n\nIl 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 15 \u00e0 49 ans, l'erreur relative pour l'\u00e9chantillon des femmes est respectivement de 1,1%, 1,8 % et 3 % pour l'ensemble du pays, l'ensemble du milieu urbain et la capitale Ndjam\u00e9na. \n\nPour l'\u00e9chantillon national de femmes, la moyenne de l'effet du plan de sondage (REPS) calcul\u00e9e pour l'ensemble des estimations est de 1,42 ce qui veut dire que, par rapport \u00e0 un \u00e9chantillon al\u00e9atoire simple, la variante est multipli\u00e9e par un facteur de 1,422 = 2,01 parce qu'on utilise un plan de sondage complexe (par grappes et \u00e0 plusieurs degr\u00e9s).","data_appraisal":"Les erreurs de mesure sont les biais imputables \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 I'EDST, 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":"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's Basic Data","case_count":"7345","var_count":"34","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":"37213","var_count":"20","producer":null,"data_checks":null,"missing_data":null,"version":null,"notes":null},{"file_id":"F3","file_name":"RECH2","description":"HOUSEHOLD\n- Household Characteristics","case_count":"6840","var_count":"23","producer":null,"data_checks":null,"missing_data":null,"version":null,"notes":null},{"file_id":"F4","file_name":"RECH3","description":"HOUSEHOLD\n- Country specific - Household Variable","case_count":"7345","var_count":"12","producer":null,"data_checks":null,"missing_data":null,"version":null,"notes":null},{"file_id":"F5","file_name":"RECH4","description":"HOUSEHOLD\n- Country specific - Household Schedule","case_count":"37213","var_count":"3","producer":null,"data_checks":null,"missing_data":null,"version":null,"notes":null},{"file_id":"F6","file_name":"REC01","description":"WOMAN\n- Respondent's Basic Data","case_count":"7705","var_count":"37","producer":null,"data_checks":null,"missing_data":null,"version":null,"notes":null},{"file_id":"F7","file_name":"REC11","description":"WOMAN\n- Respondent's Basic Data (continued)","case_count":"7454","var_count":"52","producer":null,"data_checks":null,"missing_data":null,"version":null,"notes":null},{"file_id":"F8","file_name":"REC21","description":"WOMAN\n- Reproduction (Birth History)","case_count":"25739","var_count":"20","producer":null,"data_checks":null,"missing_data":null,"version":null,"notes":null},{"file_id":"F9","file_name":"REC22","description":"WOMAN\n- Reproduction","case_count":"7454","var_count":"40","producer":null,"data_checks":null,"missing_data":null,"version":null,"notes":null},{"file_id":"F10","file_name":"REC31","description":"WOMAN\n- Contraceptive Table","case_count":"59632","var_count":"8","producer":null,"data_checks":null,"missing_data":null,"version":null,"notes":null},{"file_id":"F11","file_name":"REC32","description":"WOMAN\n- Contraceptive 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