BACKGROUND: The aim of this paper was to review the types of approaches currently utilized in the analysis of multi-country survey data, specifically focusing on design and modeling issues with a focus on analyses of significant multi-country surveys published in 2010.
METHODS: A systematic search strategy was used to identify the 10 multi-country surveys and the articles published from them in 2010. The surveys were selected to reflect diverse topics and foci; and provide an insight into analytic approaches across research themes. The search identified 159 articles appropriate for full text review and data extraction.
RESULTS: The analyses adopted in the multi-country surveys can be broadly classified as: univariate/bivariate analyses, and multivariate/multivariable analyses. Multivariate/multivariable analyses may be further divided into design- and model-based analyses. Of the 159 articles reviewed, 129 articles used model-based analysis, 30 articles used design-based analyses. Similar patterns could be seen in all the individual surveys.
CONCLUSION: While there is general agreement among survey statisticians that complex surveys are most appropriately analyzed using design-based analyses, most researchers continued to use the more common model-based approaches. Recent developments in design-based multi-level analysis may be one approach to include all the survey design characteristics. This is a relatively new area, however, and there remains statistical, as well as applied analytic research required. An important limitation of this study relates to the selection of the surveys used and the choice of year for the analysis, i.e., year 2010 only. There is, however, no strong reason to believe that analytic strategies have changed radically in the past few years, and 2010 provides a credible snapshot of current practice.
Matched MeSH terms: Health Surveys/methods*; Health Surveys/standards
Citation: National Health and Morbidity Survey 2019. Shah Alam: Institute for Public Health, Ministry of Health, Malaysia; 2020
Fact sheet: http://www.iku.gov.my/images/IKU/Document/REPORT/NHMS2019/FactSheet_BI_AUG2020.pdf
Infographics (key findings): http://www.iku.gov.my/images/IKU/Document/REPORT/NHMS2019/Infographic_Booklet_NHMS_2019-English.pdf
Technical Report Volume 1: http://www.iku.gov.my/images/IKU/Document/REPORT/NHMS2019/Report_NHMS2019-NCD_v2.pdf
Technical Report Volume 2: http://www.iku.gov.my/images/IKU/Document/REPORT/NHMS2019/Report_NHMS2019-HCD-eBook_p.pdf
Study name: National Health and Morbidity Survey (NHMS-2019)
Citation: National Health Morbidity Survey 2017: Adolescent Nutrition Survey. Kuala Lumpur: Institute for Public Health, Ministry of Health, Malaysia, 2017
Study name: National Health and Morbidity Survey (NHMS-2017)
Citation: National Health Morbidity Survey 2017: Adolescent Health Survey. Kuala Lumpur: Institute for Public Health, Ministry of Health, Malaysia, 2017
Study name: National Health and Morbidity Survey (NHMS-2017)
This paper introduces new forms of bivariate generalized Poisson (BGP) and bivariate negative binomial (BNB) regression models which can be fitted to bivariate and correlated count data with covariates. The BGP and BNB regression models can be fitted to bivariate count data with positive, zero or negative correlations. Applications of new BGP and BNB regression models are illustrated on Australian health survey data.
The third National Health Morbidity Survey was conducted in 2006 on a nationally representative sample of population in Malaysia in order to obtain community-based data and information on the prevalence of chronic illness. Of 57,500 eligible respondents 56710 (98.6%) participated in the study. Estimated overall prevalence of chronic illness in the Malaysian population within a recall period of one year was 15.5% (95% CI 15.1% - 15.9%). Chronic illness was reported significantly higher among the females, 16.8% (16.3 - 17.3). The most common chronic illness was hypertension (7.9%, 7.6 - 8.2), followed by diabetes mellitus (4.0%, 3.8 - 4.2) and highest reported by the Indians (19.7%, 18.4 - 21.0). Among the respondents who had sought treatment for chronic illness from government health facilities, Malays (65.8%) and those with monthly household income of less than RM400 (76.6%) were the highest. Chinese (44.5%) and those with household income of RM5000 and above (54.3%) were the highest groups who sought treatment from the private health facilities. Most of the respondents reported mild illness was the main reason for not seeking treatment for their chronic illness. It is hoped that the results of this survey will help the Ministry of Health Malaysia to enhance health programmes and planning resource allocation in order to improve health status of the population.
Study name: National Health and Morbidity Survey (NHMS-2006)
The authors describe the organization and results of an epidemiologic training program which formed part of a W.H.O. sponsored course in public health dentistry held in Malaysia in May-June 1975. Twenty-two participants from 16 countries took part. They had a wide variety of qualifications and training; only four had had previous experience in the conduct of an oral health survey. The method and criteria that were proposed for inclusion in the second edition of Oral Health Surveys - Basic Methods were tested in two calibration exercises and one field trial. The usefulness of most of the recommendations was confirmed. The main problem areas concern dentofacial anomalies, intense gingivitis and advanced periodontal involvement. A successful feature of the study was the practicability for public health planning of assessing requirements for treatment.
WHOQOL-100, a 100 items quality of life assessment by WHO is too lengthy to be applicable in researches where the quality of life is one of the many variables of interest. The abbreviated version with 26 items is more acceptable by subjects, especially those with illness. The generic and the abbreviated Malay version were given to subjects who were healthy and with illness. Results showed that the domain scores produced by WHOQOL-BREF correlate highly with that of WHOQOL-100. WHOQOL-BREF domain scores demonstrated good discriminant validity, construct validity, internal consistency and test-retest reliability. The study indicates that WHOQOL-BREF in its brevity offers a valid and reliable assessment of quality of life.
A survey was carried out using a medical examination format that was prepared by the Malaysian Medical Association. The findings of the survey show that of the 266 cases surveyed, 64 drivers (24% of cases surveyed) are either totally unfit to drive or temporarily unfit to drive heavy goods and passenger vehicles. This is clear indication that the current format that is being used by the Road Transport Department is inadequate and needs to be reviewed. It must also be stressed that all the above 64 drivers have been certified fit using the existing Road Transport Department format and are currently driving in our highways and roads. Heavy vehicle goods and passenger vehicle drivers if not properly examined and medically certified are not only be endangering their own lives but also that of others. It is therefore recommended that based on the data available from this survey, the Road Transport Department should seriously consider adopting the medical examination format that was formalised by the Malaysian Medical Association and used in this survey.
To meet the current diversified health needs in workplaces, especially in nonindustrial workplaces in developing countries, an indoor air quality (IAQ) component of a participatory occupational safety and health survey should be included.
Health care services are not often accessible and available for all people in one country due to multiple reasons such as the geographical barrier, affordability, etc. The aim of this study was to analyse willingness to pay (WTP) for healthcare services user fees among Malaysian population and determine its’ influencing factors. Structured interviews were conducted involving 774 households in 4 states represents Peninsular Malaysia. Validated questionnaires with open ended, followed by bidding games were applied to elicit maximum amount of WTP. The study was analysed descriptively and with multivariate regression method to adjust for potential confounding factors. More than half of respondents WTP more than current fee for the government clinic outpatient registration fee with mean MYR3.76 (SD2.71). Majority of respondents not WTP more than usual for private clinic simple outpatient treatment charges with the mean MYR38.76 (SD5.45). Factors that were found to have significant associations with WTP for both government and private clinic were income and having health insurance. Community willing to pay for healthcare services user fees and charges but at certain amount. The healthcare services user fees and charges can be increased up to community WTP level to avoid from catastrophic expenditure.
Citation: Hitchman SC, Fong GT. The Bad With the Good? The Relation Between Gender Empowerment and Female-to-Male Cigarette Smoking Rates Across 74 Countries. ITC Project Working Paper Series. University of Waterloo, Waterloo, Ontario, Canada.; 2010
Objective: Worldwide it is estimated that men smoke at nearly five times the rate of women. However, there is wide variation across countries in the gender smoking ratio (ratio of female-to-male smoking prevalence rates). Lower smoking rates among women have been attributed to social norms against women smoking, and women’s lower social status and economic resources. We tested the hypothesis that in countries with higher gender empowerment, the gender smoking ratio would be closer to 1.
Methods: We correlated the gender smoking ratio (calculated from the 2008 WHO Global Tobacco Control Report) and the United Nations Development Programme’s Gender Empowerment Measure (GEM). Because a country’s progression through stages of the tobacco epidemic and its gender smoking ratio has been attributed to its level of development, we also examined this relation partialling on economic development (Gross National Income (GNI) per capita), and income inequality (Gini).
Findings: The gender smoking ratio was significantly and positively correlated with the GEM. GEM was also the strongest predictor of the gender smoking ratio when controlling for GNI per capita and Gini in a multiple regression analysis.
Key Conclusions: The findings identify a challenge for countries undergoing economic development and greater gender equality: can such progress take place without a corresponding increase in smoking rates among women? These findings thus highlight the need for strong tobacco control in countries in which gender equality is increasing.
Sivasampu S, Lim Y, Abdul Rahman N, Hwong WY, Goh PP, Abdullah NH
Citation: Sivasampu S, Lim Y, Abdul Rahman N, Hwong WY, Goh PP, Abdullah NH. National Medical Care Statistics: Primary Care, 2012. Kuala Lumpur: National Clinical Research Centre, Ministry of Health, Malaysia; 2014