{"type":"survey","study_desc":{"title_statement":{"idno":"HTI_1994_DHS_v01_M","title":"Enqu\u00eate Mortalit\u00e9, Morbidit\u00e9 et Utilisation des Services 1994-1995","alt_title":"EMMUS 1994-95 \/ DHS 1994-95","translated_title":"Demographic and Health Survey 19941995"},"authoring_entity":[{"name":"Institut Ha\u00eftien de l'Enfance (IHE)","affiliation":"Minist\u00e8re de la Sant\u00e9 Publique et de la Population (MSPP)"}],"oth_id":[{"name":"Institut Ha\u00eftien de Statistique et d'Informatique (IHSI)","affiliation":"","email":"","role":""},{"name":"United Nations Children's Fund (UNICEF)","affiliation":"","email":"","role":""},{"name":"United Nations Population Fund (UNFPA)","affiliation":"","email":"","role":""},{"name":"United Nations Development Programme (UNDP)","affiliation":"","email":"","role":""},{"name":"Pan American Health Organization (PAHO)\/WHO","affiliation":"","email":"","role":""},{"name":"AIDS Control and Prevention Project (AIDSCAP)","affiliation":"","email":"","role":""}],"production_statement":{"producers":[{"name":"Macro International Inc.","affiliation":"","role":"Technical assistance"}],"funding_agencies":[{"name":"Bureau de Sant\u00e9, de Population et de Nutrition","abbreviation":"HPN","role":"Funding"},{"name":"Agence des Etats-Unis pour le D\u00e9veloppement International","abbreviation":"USAID","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 Mortalit\u00e9, Morbidit\u00e9 et Utilisation des Services (EMMUS-II) Ha\u00efti 1994\/95 est la seconde EDS r\u00e9alis\u00e9e en Ha\u00efti."},"study_info":{"abstract":"L'Enqu\u00eate Mortalit\u00e9, Morbidit\u00e9 et Utilisation des Services (EMMUS-II) a \u00e9t\u00e9 r\u00e9alis\u00e9e de juillet 1994 \u00e0 janvier 1995 par l'Institut Ha\u00eftien de l'Enfance (IHE) avec l'assistance technique du programme Demographic and Health Surveys (DHS) de Macro International Inc. Elle a b\u00e9n\u00e9fici\u00e9 du financement de 1' Agence des Etats-Unis pour le D\u00e9veloppement International (USAID) et du soutien logistique du Fonds des Nations Unies pour la Population (FNUAP), de l'Organisation Pan Americaine de la Sant\u00e9\/Organisation Mondiale de la Sant\u00e9 (OPS\/OMS) et du Fonds des Nations Unies pour l'Enfance (UNICEF). \n\nIl faut signaler que cette enqu\u00eate a d\u00e9marr\u00e9 en juillet 1994, au cours d'une p\u00e9riode particuli\u00e8rement troubl\u00e9e sur le plan socio-politique (embargo international, r\u00e9gime inconstitutionnel en place) et en pleine crise \u00e9conomique. M\u00eame si nous avons assist\u00e9 au retour du r\u00e9gime constitutionnel en octobre 1994, la situation socio-\u00e9conomique qui a pr\u00e9valu tout au long de la collecte des donn\u00e9es \u00e9tait toujours tr\u00e8s critique. \n\nPour les besoins de I'EMMUS-II, l'\u00e9chantillon-cible \u00e9tait de 5000 femmes en \u00e2ge de procr\u00e9er (15 \u00e0 49 ans) et 1600 hommes de 15 \u00e0 59 ans. L'\u00e9chantillon est repr\u00e9sentatif au niveau national et au niveau des milieux de r\u00e9sidence (Aire M\u00e9tropolitaine de Port-au-Prince, Autres Villes et milieu rural). \n\nL'EMMUS-II a pour objectifs d'estimer sur le plan national et selon le milieu de r\u00e9sidence (Aire M\u00e9tropolitaine de Port-au-Prince, Autres Villes et milieu rural) les indicateurs suivants : \n\nPour les enfants de moins de 5 ans : \n- la pr\u00e9valence de la diarrh\u00e9e, des infections respiratoires aigu\u00ebs et de la fi\u00e8vre au cours des \n- deux derni\u00e8res semaines pr\u00e9c\u00e9dant l'enqu\u00eate; le taux d'utilisation de la Th\u00e9rapie de R\u00e9hydratation Orale (TRO) chez les enfants atteints de diarrh\u00e9e; \n- la couverture vaccinale contre la tuberculose, la dipht\u00e9rie, le t\u00e9tanos, la coqueluche, la \n- poliomy\u00e9lite et la rougeole; le taux de suppl\u00e9mentation en vitamine A au cours de l'ann\u00e9e pr\u00e9c\u00e9dant l'enqu\u00eate et l'\u00e9tat nutritionnel par mesures anthropom\u00e9triques (poids et taille); \n- le niveau de mortalit\u00e9; \n- les principaux d\u00e9terminants des niveaux et tendances de la mortalit\u00e9; \n- les principales causes de d\u00e9c\u00e8s. \n\nPour les femmes de 15 \u00e0 49 ans : \n- les niveaux de f\u00e9condit\u00e9; les principaux d\u00e9terminants des niveaux et tendances de la f\u00e9condit\u00e9; le niveau de connaissance de la contraception, la pr\u00e9valence contraceptive, les diff\u00e9rentes \n- m\u00e9thodes utilis\u00e9es et leurs sources d'approvisionnement; les principaux d\u00e9terminants des niveaux d'utilisation de la contraception; le niveau d'utilisation des services de soins pr\u00e9natals; la couverture vaccinale contre le t\u00e9tanos des femmes en \u00e2ge de procr\u00e9er; l'\u00e9tat nutritionnel des m\u00e8res par mesures anthropom\u00e9triques (poids et taille); le niveau de connaissances des modes de transmission et de pr\u00e9vention des Maladies \n- Sexuellement Transmissibles (MST) et du SIDA, la perception du risque de contracter le \n- SIDA et les moyens de pr\u00e9vention utilis\u00e9s. \n\nPour les hommes de 15 \u00e0 59 ans : \n- la pr\u00e9valence de la contraception ainsi que les diff\u00e9rentes m\u00e9thodes utilis\u00e9es; \n- les principaux d\u00e9terminants des niveaux d'utilisation de la contraception; \n- le niveau de connaissances des modes de transmission et de pr\u00e9vention des Maladies Sexuellement Transmissibles (MST) du SIDA, la perception du risque de contracter le SIDA et les moyens de pr\u00e9vention utilis\u00e9s.","coll_dates":[{"start":"1994-07","end":"1995-01","cycle":""}],"nation":[{"name":"Haiti","abbreviation":"HTI"}],"geog_coverage":"National","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 des femmes de 15 \u00e0 49 ans, des enfants de moins de 5 ans et des hommes de 15 \u00e0 59 ans","data_kind":"Sample survey data","notes":"L'Enqu\u00eate Mortalit\u00e9, Morbidit\u00e9 et Utilisation des Services (EMMUS-II) Ha\u00efti 1994\/95 couvre les th\u00e8mes suivants :\n\n- Allaitement et alimentation de complement\n- Anthropometrie\n- Caracteristiques socio-demographiques des enquet\u00e9s\n- Cartographie \/ GPS\n- Contraception\n- Etat nutritionnel des enfants\n- Fecondite\n- Mortalite maternelle et infantile\n- Mesures anthropom\u00e9triques\n- Micronutriments\n- Nuptialite et exposition au risque de grossesse\n- Plannification familiale\n- Reproduction\n- Sante de la mere et de l'enfant\n- Services communautaires\n- SIDA \/ IST","study_scope":"L'Enqu\u00eate Mortalit\u00e9, Morbidit\u00e9 et Utilisation des Services (EMMUS-II) Ha\u00efti 1994\/95 couvre les th\u00e8mes suivants :\n\n- Allaitement et alimentation de complement\n- Anthropometrie\n- Caracteristiques socio-demographiques des enquet\u00e9s\n- Cartographie \/ GPS\n- Contraception\n- Etat nutritionnel des enfants\n- Fecondite\n- Mortalite maternelle et infantile\n- Mesures anthropom\u00e9triques\n- Micronutriments\n- Nuptialite et exposition au risque de grossesse\n- Plannification familiale\n- Reproduction\n- Sante de la mere et de l'enfant\n- Services communautaires\n- SIDA \/ IST"},"method":{"data_collection":{"sampling_procedure":"L'Enqu\u00eate Mortalit\u00e9, Morbidit\u00e9 et Utilisation des Services en HaRi (EMMUS-II) a pr\u00e9vu un \u00e9chantillon de 5000 femmes \u00e2g\u00e9es de 15 \u00e0 49 ans. L'EMMUS-II a aussi interrog\u00e9 un \u00e9chantillon d'hommes de 15 \u00e0 59 ans dans un tiers des m\u00e9nages tir\u00e9s pour l'enqu\u00eate des femmes. \n\nTrois principaux domaines d'\u00e9tude ont \u00e9t\u00e9 d\u00e9finis pour I'EMMUS-II. Un domaine d'\u00e9tude correspond \u00e0 une sous-population pour laquelle on fera des analyses bas~es sur les informations recueillies par l'enqu\u00eate. En Ha\u00efti, ces trois domaines d'\u00e9tude sont l'aire m\u00e9tropolitaine de Port-an-Prince (P.A.P. M\u00e9tropolitaine), les autres centres urbains (Urbain) et le milieu rural (Rural). Pour I'EMMUS-II, P.A.P. M\u00e9tropolitaine a \u00e9t\u00e9 d\u00e9finie comme \u00e9tant constitu\u00e9e de la ville de Port-an-Prince, Delmas, Carrefour, P\u00e9tion Ville, le quartier des Croix des Missions, le quartier de Thomassin et le secteur Montagne Noire. Le quartier de Thomassin et le secteur Montagne Noire ne figuraient pas dans P.A.P. M\u00e9tropolitaine comme \u00e9tant d\u00e9finie par le recensement g\u00e9n\u00e9ral de 1982. Cependant, ces deux zones se sont beaucoup d\u00e9velopp\u00e9es depuis 1982, ont les m\u00eames caract\u00e9ristiques socio-\u00e9conomiques que Port-au-Prince et se sont m\u00eame int\u00e9gr\u00e9es dans P.A.P. M\u00e9tropolitaine. \n\nComme on a estim\u00e9 que les centres urbains d'Ha\u00efti, \u00e0 l'exception de P.A.P. M\u00e9tropolitaine, repr\u00e9sentaient moins de 10 pour cent de la population ha\u00eftienne en 1993, une allocation proportionnelle de l'\u00e9chantillon des 5000 femmes ne leur aurait accord\u00e9 qu'un \u00e9chantillon tr\u00e8s faible qui ne permettrait pas les analyses que l'on d\u00e9sirerait effectuer dans ces centres urbains. On a d\u00fb alors affecter un taux de sondage plus \u00e9lev\u00e9 aux centres urbains par rapport \u00e0 celui du reste du pays. Cependant, un taux de sondage homog\u00e8ne a \u00e9t\u00e9 appliqu\u00e9 \u00e0 l'int\u00e9rieur de chaque domaine afin que le sous-\u00e9chantillon du domaine soit auto-pond\u00e9r\u00e9. \n\nBASE DE SONDAGE \n\nHa\u00efti est divis\u00e9 en 9 d\u00e9partements administratifs et comptait 5 053 792 millions d'habitants en 1982, date du dernier recensement g\u00e9n\u00e9ral) La population de P.A.P. M\u00e9tropolitaine comptait 724 097 habitants, donc 14,33 pour cent de la population totale. Au moment de l'\u00e9laboration du plan de sondage de I'EMMUS-II, la seule base de sondage compl\u00e8te qui existait pour le pays \u00e9tait la liste des sections d'\u00e9num\u00e9ration (SDE) cr\u00e9\u00e9es par l'Institut Ha\u00eftien de Statistique et d'Informatique (IHSI) pour les besoins du recensement. Cependant, depuis 1982, P.A.P. M\u00e9tropolitaine a connu une explosion d\u00e9mographique, repr\u00e9sent\u00e9e aussi bien par la croissance de la population dans les zones existantes que par les zones d'extension. L'ampleur de cette croissance d\u00e9mographique a \u00e9t\u00e9 jug\u00e9e sous-estim\u00e9e par les projections de population dont les effectifs de base utilis6s \u00e9taient ceux du recensement de 1982. Par cons\u00e9quent, la base de sondage existante \u00e9tait inad\u00e9quate pour P.A.P. M\u00e9tropolitaine. \n\nCependant, on a pu trouver aupr\u00e8s de Lavalin International des informations tr\u00e8s int\u00e9ressantes concernant un de leurs projets, 2 r\u00e9alis\u00e9 en 1988 et qui avait pour but de disposer d'une estimation de la population de P.A.P. M\u00e9tropolitaine. Leur m\u00e9thodologie consistait (1) en une analyse d\u00e9taill\u00e9e des photographies a\u00e9riennes de P.A.P. M\u00e9tropolitaine prises en 1986, (2) \u00e0 d\u00e9couper ensuite le territoire de \n\nP.A.P. M\u00e9tropolitaine en zones homog\u00e8nes selon les diff\u00e9rents types d'habitat trouv\u00e9s, (3) \u00e0 faire une enqu\u00eate par sondage (d\u00e9nombrement des m\u00e9nages et de la population) de chaque type de zone identifi\u00e9e et (4) \u00e0 extrapoler les r\u00e9sultats \u00e0 toute l'aire m\u00e9tropolitaine. Les r\u00e9sultats de ce projet ont donn\u00e9 une population estim\u00e9e \u00e0 1 567 880 pour P.A.P. M\u00e9tropolitaine en 1988. Ce qui \u00e9tait plus int\u00e9ressant encore, c'est que l'on a pu obtenir aupr\u00e8s de ce projet une carte de P.A.P. M\u00e9tropolitaine qui date de 1988 et qui montre les extensions de la zone m\u00e9tropolitaine de 1982 \u00e0 1988. Cette carte, une fois mise \u00e0 jour pour tenir compte des nouvelles zones d'extension depuis 1988, a \u00e9t\u00e9 utilis\u00e9e comme carte de base pour un \u00e9chantillonnage sur grille, proc\u00e9dure que l'on discutera ult\u00e9rieurement dans ce rapport. \n\nQuant aux autres centres urbains et au milieu rural, la liste des SDE a servi de base de sondage ar\u00e9olaire, sauf dans le cas du Cap Ha\u00eftien o\u00f9 l'on a trouv\u00e9 \u00e9galement des zones d'extension qui ont \u00e9t\u00e9 d\u00e9velopp\u00e9es depuis le recensement de 1982. On a appliqu\u00e9 la m\u00eame proc\u00e9dure d'\u00e9chantillonnage sur grille sur une carte mise \u00e0 jour du Cap Ha\u00eftien pour obtenir l'\u00e9chantillon ar\u00e9olaire de cette ville. \n\nCARACTERISTIQUES GENERALES DE L'ECHANTILLON \n\nL'\u00e9chantillon de I'EMMUS-II est bas\u00e9 sur un sondage ar\u00e9olaire stratifi\u00e9 et tir~ \u00e0 deux degr\u00e9s. Au premier degr\u00e9, 172 unit\u00e9s ar\u00e9olaires ont \u00e9t\u00e9 tir\u00e9es \u00e0 partir soit d'une carte (cas de P.A.P. M\u00e9tropolitaine et du Cap Ha\u00eftien) soit de l'ensemble des sections d'\u00e9num\u00e9ration (cas des autres centres urbains et du milieu rural). Un d\u00e9nombrement des m\u00e9nages dans chacune de ces unit\u00e9s 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 identifi\u00e9e a \u00e9t\u00e9 enqu\u00eat\u00e9e avec un questionnaire femme plus d\u00e9taill\u00e9. L'enqu\u00eate homme a port\u00e9 sur un tiers des m\u00e9nages s\u00e9lectionn\u00e9s pour l'enqu\u00eate principale. Le tirage des m\u00e9nages pour l'enqu\u00eate homme a \u00e9t\u00e9 effectu\u00e9 au m\u00eame moment que le tirage des m\u00e9nages pour l'enqu\u00eate femme, de fa\u00e7on syst\u00e9matique et avec une probabilit\u00e9 \u00e9gale \u00e0 un m\u00e9nage sur trois.","coll_mode":"Face-to-face","research_instrument":"Afin d'atteindre les objectifs fix\u00e9s, quatre s\u00e9ries de questionnaires ont \u00e9t\u00e9 utilis\u00e9s : \n\na) Questionnaire communautaire, portant sur les infrastructures socio-\u00e9conomiques et sanitaires des 172 grappes visit\u00e9es. \nb) Questionnaire m\u00e9nage, permettant de collecter des informations d\u00e9mographiques sur le m\u00e9nage, tel que le nombre de personnes vivant sous le toit, leur sexe, leur \u00e2ge, leur \u00e9tat matrimonial, leur niveau d'instruction, ainsi que quelques informations sur les caract\u00e9ristiques du logement. Ce questionnaire permet d'\u00e9tablir l'\u00e9ligibilit\u00e9 des personnes \u00e0 interviewer individuellement et il fournit \u00e9galement les informations permettant d'\u00e9tablir le d\u00e9nominateur pour le calcul des taux d\u00e9mographiques (natalit\u00e9 et f\u00e9condit\u00e9). \nc) Questionnaire femme : il s'agit d'un questionnaire individuel comprenant dix sections et portant sur les indicateurs mentionn\u00e9s plus haut pour les femmes de 15 \u00e0 49 ans. \nd) Questionnaire homme : il s'agit \u00e9galement d'un questionnaire individuel comprenant six sections et portant sur les indicateurs mentionn\u00e9s plus haut pour les hommes de 15 \u00e0 59 ans. \n\nCes instruments ont \u00e9t\u00e9 d\u00e9velopp\u00e9s \u00e0 partir des questionnaires de base du programme Demographic and Health Survey (DHS), pr\u00e9alablement adapt\u00e9s au contexte ha\u00eftien et en tenant compte des objectifs de l'enqu\u00eate. Ces questionnaires ont \u00e9t\u00e9 traduits en cr\u00e9ole et, apr\u00e8s contre-traduction de la version cr\u00e9ole en vue de v\u00e9rification, ils ont \u00e9t\u00e9 pr\u00e9-test\u00e9s avant leur utilisation. Ces questionnaires, dans leur version cr\u00e9ole, figurent int\u00e9gralement \u00e0 l'Annexe E et ils sont suivis de leur traduction en fran\u00e7ais.","coll_situation":"Le personnel de terrain, s\u00e9lectionn\u00e9 sur concours, a \u00e9t\u00e9 form\u00e9 sur une p\u00e9riode de quatre semaines. La formation, men\u00e9e en fran\u00e7ais et en cr\u00e9ole, \u00e9tait th\u00e9orique et pratique. Elle a comport\u00e9 une pr\u00e9sentation du questionnaire et des techniques d'interview et d'enregistrement des informations, et elle a \u00e9t\u00e9 compl\u00e9t\u00e9e par des discussions sur les principaux th\u00e8mes abord\u00e9s par l'enqu\u00eate. Cette formation th\u00e9orique a \u00e9t\u00e9 compl\u00e9t\u00e9e par des exercices pratiques sur la fa\u00e7on de remplir le questionnaire, des jeux de r\u00f4les entre enqu\u00eateurs et superviseurs et une pratique de terrain. La formation a \u00e9t\u00e9 assur\u00e9e par le personnel de I'IHE et les consultants de DHS. Une formation de m\u00eame type avait \u00e9t\u00e9 men\u00e9e plusieurs mois plus t\u00f4t avant de r\u00e9aliser le pr\u00e9-test. \n\nL'enqu\u00eate d\u00e9buta tout de suite apr\u00e8s cette formation, avec sept \u00e9quipes compos\u00e9es de trois enqu\u00eatrices, un enqu\u00eateur, une contr\u00f4leuse, un chef d'\u00e9quipe et un chauffeur. \n\nLa collecte des donn\u00e9es s'est \u00e9tal\u00e9e de juillet 1994 \u00e0 janvier 1995, avec plusieurs courtes p\u00e9riodes d'arr\u00eat dues aux troubles socio-politiques. La contr\u00f4leuse devait v\u00e9rifier sur place tous les questionnaires avant de les envoyer \u00e0 Port-au-Prince pour traitement informatique. De plus, des superviseurs visitaient fr\u00e9quemment les \u00e9quipes et participaient \u00e9galement au contr\u00f4le des questionnaires sur le terrain.","cleaning_operations":"La saisie des donn\u00e9es sur micro-ordinateur d\u00e9buta deux semaines apr\u00e8s le d\u00e9marrage de l'enqu\u00eate sur le terrain, en utilisant le logiciel ISSA (Integrated System for Survey Analysis), d\u00e9velopp\u00e9 par DHS. Cette saisie a \u00e9t\u00e9 r\u00e9alis\u00e9e par quatre op\u00e9rateurs, assist\u00e9s de deux contr\u00f4leurs et supervis\u00e9s par un programmeur. A signaler que ces op\u00e9rateurs et superviseurs avaient aussi particip\u00e9 \u00e0 la formation donn\u00e9e aux enqu\u00eateurs - \u00e0 l'exception du pr\u00e9-test. Le programmeur avait \u00e9galement assist\u00e9 \u00e0 cette formation. Avant de d\u00e9marrer la saisie, les questionnables \u00e9taient une seconde fois contr\u00f4l\u00e9s par des agents de v\u00e9rification. Tout au long de cette phase de saisie, un programme de contr\u00f4le de qualit\u00e9 permettait de d\u00e9tecter les erreurs de collecte et le personnel de terrain en \u00e9tait avis\u00e9 imm\u00e9diatement. De m\u00eame, le programme d'entr\u00e9e des donn\u00e9es \u00e9tait con\u00e7u de mani\u00e8re \u00e0 d\u00e9tecter les erreurs au cours de la saisie. Et tout au long du travail, le contr\u00f4leur s'assurait de la qualit\u00e9 de la saisie. \n\nA la suite de la saisie, les donn\u00e9es ont \u00e9t\u00e9 dites en vue de v\u00e9rifier la coh\u00e9rence interne des questions. La v\u00e9rification finale a \u00e9t\u00e9 r\u00e9alis\u00e9e par le programmeur de IHE, puis par celui de DHS, utilisant une technique \u00e9prouv\u00e9e au cours de dizaines d'enqu\u00eates similaires."},"analysis_info":{"response_rate":"Toutes les 172 grappes s\u00e9lectionn\u00e9es ont pu \u00eatre enqu\u00eat\u00e9es au cours de I'EMMUS-II. Au total, 5433 m\u00e9nages ont \u00e9t\u00e9 s\u00e9lectionn\u00e9s, parmi lesquels 4944 ont \u00e9t\u00e9 identifi\u00e9s, et 4 818 ont \u00e9t\u00e9 effectivement enqu\u00eat\u00e9s, soit un taux de r\u00e9ponse de 97,5 pour cent. Parmi les 5709 femmes \u00e9ligibles, 5356 ont \u00e9t\u00e9 effectivement interview\u00e9es avec succ\u00e8s, soit un taux de r\u00e9ponse de 93,8 pour cent. Parmi les 1767 hommes \u00e9ligibles, 1610 ont \u00e9t\u00e9 interview\u00e9s avec succ\u00e8s, soit un taux de r\u00e9ponse de 91,1 pour cent.","sampling_error_estimates":"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. 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