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Does adjusting for recall in trend analysis affect coverage estimates for maternal and child health indicators? An analysis of DHS and MICS survey data
BACKGROUND: The Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS) are the major data sources in low- and middle-income countries (LMICs) for evaluating health service coverage. For certain maternal and child health (MCH) indicators, the two surveys use different reca...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Co-Action Publishing
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5102105/ https://www.ncbi.nlm.nih.gov/pubmed/27829489 http://dx.doi.org/10.3402/gha.v9.32408 |
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author | Ngandu, Nobubelo K. Manda, Samuel Besada, Donela Rohde, Sarah Oliphant, Nicholas P. Doherty, Tanya |
author_facet | Ngandu, Nobubelo K. Manda, Samuel Besada, Donela Rohde, Sarah Oliphant, Nicholas P. Doherty, Tanya |
author_sort | Ngandu, Nobubelo K. |
collection | PubMed |
description | BACKGROUND: The Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS) are the major data sources in low- and middle-income countries (LMICs) for evaluating health service coverage. For certain maternal and child health (MCH) indicators, the two surveys use different recall periods: 5 years for DHS and 2 years for MICS. OBJECTIVE: We explored whether the different recall periods for DHS and MICS affect coverage trend analyses as well as missing data and coverage estimates. DESIGNS: We estimated coverage, using proportions with 95% confidence intervals, for four MCH indicators: intermittent preventive treatment of malaria in pregnancy, tetanus vaccination, early breastfeeding and postnatal care. Trends in coverage were compared using data from 1) standard 5-year DHS and 2-year MICS recall periods (unmatched) and 2) DHS restricted to 2-year recall to match the MICS 2-year recall periods (matched). Linear regression was used to explore the relationship between length of recall, missing data and coverage estimates. RESULTS: Differences in coverage trends were observed between matched and unmatched data in 7 of 18 (39%) comparisons performed. The differences were in the direction of the trend over time, the slope of the coverage change or the significance levels. Consistent trends were seen in 11 of the 18 (61%) comparisons. Proportion of missing data was inversely associated with coverage estimates in both short (2 years) and longer (5 years) recall of the DHS (r=−0.3, p=0.02 and r=−0.4, p=0.004, respectively). The amount of missing information was increased for longer recall compared with shorter recall for all indicators (significant odds ratios ranging between 1.44 and 7.43). CONCLUSIONS: In a context where most LMICs are dependent on population-based household surveys to derive coverage estimates, users of these types of data need to ensure that variability in recall periods and the proportion of missing data across data sources are appropriately accounted for when trend analyses are conducted. |
format | Online Article Text |
id | pubmed-5102105 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Co-Action Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-51021052016-11-18 Does adjusting for recall in trend analysis affect coverage estimates for maternal and child health indicators? An analysis of DHS and MICS survey data Ngandu, Nobubelo K. Manda, Samuel Besada, Donela Rohde, Sarah Oliphant, Nicholas P. Doherty, Tanya Glob Health Action Original Article BACKGROUND: The Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS) are the major data sources in low- and middle-income countries (LMICs) for evaluating health service coverage. For certain maternal and child health (MCH) indicators, the two surveys use different recall periods: 5 years for DHS and 2 years for MICS. OBJECTIVE: We explored whether the different recall periods for DHS and MICS affect coverage trend analyses as well as missing data and coverage estimates. DESIGNS: We estimated coverage, using proportions with 95% confidence intervals, for four MCH indicators: intermittent preventive treatment of malaria in pregnancy, tetanus vaccination, early breastfeeding and postnatal care. Trends in coverage were compared using data from 1) standard 5-year DHS and 2-year MICS recall periods (unmatched) and 2) DHS restricted to 2-year recall to match the MICS 2-year recall periods (matched). Linear regression was used to explore the relationship between length of recall, missing data and coverage estimates. RESULTS: Differences in coverage trends were observed between matched and unmatched data in 7 of 18 (39%) comparisons performed. The differences were in the direction of the trend over time, the slope of the coverage change or the significance levels. Consistent trends were seen in 11 of the 18 (61%) comparisons. Proportion of missing data was inversely associated with coverage estimates in both short (2 years) and longer (5 years) recall of the DHS (r=−0.3, p=0.02 and r=−0.4, p=0.004, respectively). The amount of missing information was increased for longer recall compared with shorter recall for all indicators (significant odds ratios ranging between 1.44 and 7.43). CONCLUSIONS: In a context where most LMICs are dependent on population-based household surveys to derive coverage estimates, users of these types of data need to ensure that variability in recall periods and the proportion of missing data across data sources are appropriately accounted for when trend analyses are conducted. Co-Action Publishing 2016-11-07 /pmc/articles/PMC5102105/ /pubmed/27829489 http://dx.doi.org/10.3402/gha.v9.32408 Text en © 2016 Nobubelo K. Ngandu et al. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for any purpose, even commercially, provided the original work is properly cited and states its license. |
spellingShingle | Original Article Ngandu, Nobubelo K. Manda, Samuel Besada, Donela Rohde, Sarah Oliphant, Nicholas P. Doherty, Tanya Does adjusting for recall in trend analysis affect coverage estimates for maternal and child health indicators? An analysis of DHS and MICS survey data |
title | Does adjusting for recall in trend analysis affect coverage estimates for maternal and child health indicators? An analysis of DHS and MICS survey data |
title_full | Does adjusting for recall in trend analysis affect coverage estimates for maternal and child health indicators? An analysis of DHS and MICS survey data |
title_fullStr | Does adjusting for recall in trend analysis affect coverage estimates for maternal and child health indicators? An analysis of DHS and MICS survey data |
title_full_unstemmed | Does adjusting for recall in trend analysis affect coverage estimates for maternal and child health indicators? An analysis of DHS and MICS survey data |
title_short | Does adjusting for recall in trend analysis affect coverage estimates for maternal and child health indicators? An analysis of DHS and MICS survey data |
title_sort | does adjusting for recall in trend analysis affect coverage estimates for maternal and child health indicators? an analysis of dhs and mics survey data |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5102105/ https://www.ncbi.nlm.nih.gov/pubmed/27829489 http://dx.doi.org/10.3402/gha.v9.32408 |
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