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  1. 1

    The potential of national household survey programmes for monitoring and evaluating primary health care in developing countries. L'apport potentiel des enquetes nationales sur les menages a la surveillance et a l'evaluation des soins de sante primaires dans les pays en developpement.

    Carlson BA

    World Health Statistics Quarterly. Rapport Trimestriel de Statistiques Sanitaires Mondiales. 1985; 38(1):38-64.

    National programs of household sample surveys, such as those being encouraged through the National Household Survey Capability Program (NHSCP), are a principal source of information on primary health care in developing countries. Being representative of the total population, the major population subgroups and geographic subdivisions, they permit calculation of health status and utilization of health services. Household surveys have an important role to play in monitoring and evaluating primary health care since they sample directly the intended beneficiaries, and so can be used to judge the extent to which programs are meeting expected goals. Caution is necessary, however, since methodological problems have been experienced for many evaluation surveys. National surveys are especially appropriate for measuring many indicators of progress towards national goals within a broad socioeconomic perspective. Future directions in making the optimum use of household surveys for health program purposes are indicated. The NHSCP is a major undertaking of the UN system including WHO to collaborate with developing countries to establish a continuing flow of integrated statistics on a recurrent basis to support the national development process and information priorities. It brings together the principal users and producers of data to plan and conduct surveys which respond to national needs and priorities. The NHSCP encourages countries to employ a permanent national field organization for data collection. Areas of discussion are: the potential for monitoring and evaluation, the household survey as a source of health indicators, the demand for household surveys of health, followed by a summary of the health and health-related topics covered by 6 national health and nutrition surveys conducted in several developing countries. The special themes of infant and child mortality, morbidity and nutritional surveillance are also considered. The experience of many developed countries has been very positive with the use of nonmedically organized health surveys. Although the sample survey can be used in many settings to obtain population-based data, it must be carefully designed and implemented according to scientific procedures in order for the results to be validly extrapolated to the population or subgroups of primary concern.
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  2. 2

    Informal Meeting on the Development of a Methodology for the Surveillance of Breastfeeding, Geneva, 2-4 February, 1981.

    World Health Organization [WHO]

    [Unpublished] 1981. 58 p.

    A fundamental part of the World Health Organization's (WHO's) task of biannually reporting on the steps taken by the organization to promote breastfeeding and to improve infant and young child feeding will necessitate the regular collection of statistical information on the prevalence and duration of breastfeeding in the different Member States. The purpose of this document is to outline the following: the rationale for the collection of breastfeeding data; a summary of the scientific methods by which these data can be collected; a module which can be attached to ongoing surveys; and a protocol which can be used by national field workers in conducting surveys specifically on the subject of breastfeeding. Information on trends in breastfeeding is important because it can be used to provide a valuable insight into a variety of maternal and child health issues and serve as a useful health and social indicator. Changes in the prevalence and duration of breastfeeding reflect the attitudes of mothers toward infant care, their knowledge on infant feeding, their concept of family life, time, and work, and their relative exposure to different sources of information concerning the advantages and disadvantages of breastfeeding. There are 2 major ways of collecting epidemiological information--a tool for assessment of breastfeeding practices--surveillance and surveys. Potential sources of information are vital statistics, hospital records, postnatal clinic records, market research, national health/nutrition surveys, and fertility surveys. The core breastfeeding module should contain the minimum number of questions required to assess the prevalence and duration of exclusive and partial breastfeeding along with key demographic questions designed to describe breastfeeding in terms of time, place, and person. Suggested items are listed. The development of a standardized protocol/study design which, with modification, can be adapted to national conditions and needs, will facilitate surveys and permit the comparability of data. The details of survey development are reviewed.
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