Demographic and Health Survey 2019-2020
Gambia, 2019 - 2020
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Reference ID
GMB_2019_DHS_v01_M
Producer(s)
Gambia Bureau of Statistics (GBoS)
Collection(s)
Metadata
Created on
May 19, 2021
Last modified
Aug 26, 2021
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Identification
Survey ID number
GMB_2019_DHS_v01_M
Title
Demographic and Health Survey 2019-2020
Country/Economy
| Name | Country code |
|---|---|
| Gambia, The | GMB |
Study type
Demographic and Health Survey [hh/dhs]
Series Information
The 2019-20 GDHS is the second Demographic and Health Survey conducted in The Gambia and is a follow-on to the 2013 survey. The 2019-20 GDHS provides an opportunity to inform policy and provide data for planning, implementation, and monitoring and evaluation of national health programmes.
Abstract
The 2019-20 Gambia Demographic and Health Survey (2019-20 GDHS) is a nationwide survey with a nationally representative sample of residential households. The survey was implemented by The Gambia Bureau of Statistics (GBoS) in collaboration with the Ministry of Health (MoH).
The primary objective of the 2019-20 GDHS is to provide up-to-date estimates of basic demographic and health indicators. Specifically, the 2019-20 GDHS:
▪ collected data on fertility levels and preferences; contraceptive use; maternal and child health; infant, child, and neonatal mortality levels; maternal mortality; gender; nutrition; awareness about HIV/AIDS; self-reported sexually transmitted infections (STIs); and other health issues relevant to the achievement of the Sustainable Development Goals (SDGs)
▪ obtained information on the availability of, access to, and use of mosquito nets as part of the National Malaria Control Programme
▪ gathered information on other health issues such as injections, tobacco use, hypertension, diabetes, and health insurance
▪ collected data on women’s empowerment, domestic violence, fistula, and female genital mutilation/cutting
▪ tested household salt for the presence of iodine
▪ obtained data on child feeding practices, including breastfeeding, and conducted anthropometric measurements to assess the nutritional status of children under age 5 and women age 15-49
▪ conducted anaemia testing of women age 15-49 and children age 6-59 months
▪ conducted malaria testing of children age 6-59 months
The primary objective of the 2019-20 GDHS is to provide up-to-date estimates of basic demographic and health indicators. Specifically, the 2019-20 GDHS:
▪ collected data on fertility levels and preferences; contraceptive use; maternal and child health; infant, child, and neonatal mortality levels; maternal mortality; gender; nutrition; awareness about HIV/AIDS; self-reported sexually transmitted infections (STIs); and other health issues relevant to the achievement of the Sustainable Development Goals (SDGs)
▪ obtained information on the availability of, access to, and use of mosquito nets as part of the National Malaria Control Programme
▪ gathered information on other health issues such as injections, tobacco use, hypertension, diabetes, and health insurance
▪ collected data on women’s empowerment, domestic violence, fistula, and female genital mutilation/cutting
▪ tested household salt for the presence of iodine
▪ obtained data on child feeding practices, including breastfeeding, and conducted anthropometric measurements to assess the nutritional status of children under age 5 and women age 15-49
▪ conducted anaemia testing of women age 15-49 and children age 6-59 months
▪ conducted malaria testing of children age 6-59 months
Kind of Data
Sample survey data [ssd]
Unit of Analysis
- Household
- Individual
- Children age 0-5
- Woman age 15-49
- Man age 15 to 59
- Individual
- Children age 0-5
- Woman age 15-49
- Man age 15 to 59
Version
Version Notes
The data dictionary was generated from hierarchical data that was downloaded from the The DHS Program website (http://dhsprogram.com).
Scope
Notes
The 2019-20 Gambia Demographic and Health Survey covered the following topics:
HOUSEHOLD
• Identification
• Usual members and visitors in the selected households
• Background information on each person listed, such as relationship to head of the household, age, sex, marital status, educational attainment, birth registration, and survivorship and residence of biological parents
• Characteristics of the household's dwelling unit, such as the source of water, type of toilet facilities, type of fuel used for cooking, number of rooms, ownership of livestock, possessions of durable goods, mosquito nets, and main material for the floor, roof and walls of the dwelling.
INDIVIDUAL WOMAN
• Identification
• Background characteristics (including age, education, and media exposure)
• Reproduction and child mortality
• Contraception
• Antenatal, delivery, and postnatal care
• Vaccinations and childhood illnesses
• Maternal and child health and nutrition
• Marriage, sexual activity, and fistula
• Fertility preferences
• Women’s work and husbands’ background characteristics
• Knowledge, awareness, and behaviour regarding HIV/AIDS and other STIs
• Other health issues (e.g., injections, smoking, and health insurance)
• Noncommunicable diseases (e.g., hypertension and diabetes)
• Female genital mutilation/cutting
• Adult and maternal mortality
• Domestic violence
MAN
• Identification
• Background characteristics
• Reproduction
• Contraception
• Marriage and sexual activity
• Fertility preferences
• Employment and gender roles
• HIV/AIDS
• Other health issues (e.g., injections, smoking, female genital mutilation/cutting, hypertension, diabetes, and health insurance)
BIOMARKER
• Identification
• Weight, height, and hemoglobin measurement, and malaria testing for children age 0-5
• Weight, height, and hemoglobin measurement for women age 15-49
FIELDWORKER
• Background information on each fieldworkers
Coverage
Geographic Coverage
National coverage
Universe
The survey covered all de jure household members (usual residents), all women aged 15-49, all men age 15-59, and all children aged 0-5 resident in the household.
Producers and sponsors
Primary investigators
| Name | Affiliation |
|---|---|
| Gambia Bureau of Statistics (GBoS) | Government of the Republic of The Gambia |
Producers
| Name | Affiliation | Role |
|---|---|---|
| Ministry of Health | Government of the Republic of The Gambia | Collaborated in the implementation of the survey |
| ICF | Provided technical assistance through The DHS Program |
Funding Agency/Sponsor
| Name | Role |
|---|---|
| Government of the Republic of The Gambia | Funding the survey |
| United States Agency for International Development | Funding the survey |
| United Nations Population Fund | Funding the survey |
| United Nations Children’s Fund | Funding the survey |
| United Nations Development Programme | Funding the survey |
| World Health Organization | Funding the survey |
| ActionAid International The Gambia | Funding the survey |
| Network Against Gender Based Violence | Funding the survey |
| National Nutrition Agency |
Sampling
Sampling Procedure
The sampling frame used for the 2019-20 GDHS was based on an updated version of the 2013 Gambia Population and Housing Census (2013 GPHC) conducted by GBoS. The census counts were updated in 2015-16 based on district-level projected counts from the 2015-16 Integrated Household Survey (IHS). Administratively, The Gambia is divided into eight Local Government Areas (LGAs). Each LGA is subdivided into districts and each district is subdivided into settlements. A settlement, a group of small settlements, or a part of a large settlement can form an enumeration area (EA). These units allow the country to be easily separated into small geographical area units, each with an urban or rural designation. There are 48 districts, 120 wards, and 4,098 EAs in The Gambia; the EAs have an average size of 68 households.
The sample for the 2019-20 GDHS was a stratified sample selected in two stages. In the first stage, EAs were selected with a probability proportional to their size within each sampling stratum. A total of 281 EAs were selected.
In the second stage, the households were systematically sampled. A household listing operation was undertaken in all of the selected clusters. The resulting lists of households served as the sampling frame from which a fixed number of 25 households were systematically selected per cluster, resulting in a total sample size of 7,025 selected households. Results from this sample are representative at the national, urban, and rural levels and at the LGA levels.
For further details on sample selection, see Appendix A of the final report.
The sample for the 2019-20 GDHS was a stratified sample selected in two stages. In the first stage, EAs were selected with a probability proportional to their size within each sampling stratum. A total of 281 EAs were selected.
In the second stage, the households were systematically sampled. A household listing operation was undertaken in all of the selected clusters. The resulting lists of households served as the sampling frame from which a fixed number of 25 households were systematically selected per cluster, resulting in a total sample size of 7,025 selected households. Results from this sample are representative at the national, urban, and rural levels and at the LGA levels.
For further details on sample selection, see Appendix A of the final report.
Response Rate
All 6,985 households in the selected housing units were eligible for the survey, of which 6,736 were occupied. Of the occupied households, 6,549 were successfully interviewed, yielding a response rate of 97%. Among the households successfully interviewed, 1,948 interviews were completed in 2019 and 4,601 in 2020.
In the interviewed households, 12,481 women age 15-49 were identified for individual interviews; interviews were completed with 11,865 women, yielding a response rate of 95%, a 4 percentage point increase from the 2013 GDHS. Among men, 5,337 were eligible for individual interviews, and 4,636 completed an interview; this yielded a response rate of 87%, a 5 percentage point increase from the previous survey.
In the interviewed households, 12,481 women age 15-49 were identified for individual interviews; interviews were completed with 11,865 women, yielding a response rate of 95%, a 4 percentage point increase from the 2013 GDHS. Among men, 5,337 were eligible for individual interviews, and 4,636 completed an interview; this yielded a response rate of 87%, a 5 percentage point increase from the previous survey.
Weighting
Due to the non-proportional allocation of the sample to different LGAs and their urban and rural areas and the possible differences in response rates, sampling weights will be required for any analysis using the 2019-20 GDHS data to ensure the actual representativeness of the survey results at the national level as well as the domain level. Since the 2019-20 GDHS sample is a two-stage stratified cluster sample, sampling weights were calculated based on sampling probabilities separately for each sampling stage and for each cluster.
For further details on sampling weights, see Appendix A.4 of the final report.
For further details on sampling weights, see Appendix A.4 of the final report.
Survey instrument
Questionnaires
Five questionnaires were used for the 2019-20 GDHS: the Household Questionnaire, the Woman’s Questionnaire, the Man’s Questionnaire, the Biomarker Questionnaire, and the Fieldworker Questionnaire. These questionnaires, based on The DHS Program’s standard questionnaires, were adapted to reflect the population and health issues relevant to The Gambia. Suggestions were solicited from various stakeholders representing government ministries, departments, and agencies; nongovernmental organisations; and international donors. All questionnaires were written in English, and interviewers translated the questions into the appropriate local language to carry out the interview.
Data collection
Dates of Data Collection
| Start | End |
|---|---|
| 2019-11-21 | 2020-03-30 |
Data Collectors
| Name | Affiliation |
|---|---|
| Gambia Bureau of Statistics | Government of the Republic of The Gambia |
Data Collection Notes
Fieldwork was carried out from 21 November 2019 to 30 March 2020 by 15 teams. Each team consisted of six members, typically with the following composition: one supervisor, three female interviewers, one male interviewer, and one biomarker technician.
All 15 teams initially began work in and around the Banjul and Kanifing LGAs, followed by a short break from 15 December to 6 January to observe the holidays. A 1-day refresher training session was held on 7 January to ensure that all aspects of the survey were well understood by all, review team performance, discuss common mistakes and issues, highlight best practices, and clarify any questions. Teams were then deployed to the various LGAs to resume fieldwork.
Fieldwork monitoring was an integral part of the 2019-20 GDHS. Two quality control teams, each composed of one female monitor, one male monitor, and one biomarker monitor, were continuously in the field visiting teams to closely monitor data collection and quality, review their work, identify any issues, and provide feedback. In addition to quality control teams, fieldwork coordinators also visited teams regularly to monitor their work, resolve any issues that arose, and provide support as needed. During field visits, monitors provided the teams they visited with critical feedback to improve their performance. All monitors used the GDHS field-check tables, based on data from the completed clusters, to illustrate problems specific to each team visited.
All 15 teams initially began work in and around the Banjul and Kanifing LGAs, followed by a short break from 15 December to 6 January to observe the holidays. A 1-day refresher training session was held on 7 January to ensure that all aspects of the survey were well understood by all, review team performance, discuss common mistakes and issues, highlight best practices, and clarify any questions. Teams were then deployed to the various LGAs to resume fieldwork.
Fieldwork monitoring was an integral part of the 2019-20 GDHS. Two quality control teams, each composed of one female monitor, one male monitor, and one biomarker monitor, were continuously in the field visiting teams to closely monitor data collection and quality, review their work, identify any issues, and provide feedback. In addition to quality control teams, fieldwork coordinators also visited teams regularly to monitor their work, resolve any issues that arose, and provide support as needed. During field visits, monitors provided the teams they visited with critical feedback to improve their performance. All monitors used the GDHS field-check tables, based on data from the completed clusters, to illustrate problems specific to each team visited.
Data processing
Data Editing
All electronic data files were transferred via the Internet File Streaming System (IFSS) to the GBoS central office. The IFSS automatically encrypts the data and sends the data to a server, and the server in turn downloads the data to the data processing supervisor’s password-protected computer in the central office. The data processing operation included secondary editing, which required resolution of computeridentified inconsistencies and coding of open-ended questions. The data were processed by two IT specialists and three secondary editors who took part in the main fieldwork training; they were supervised remotely by staff from The DHS Program. Data editing was accomplished using CSPro software. During the fieldwork, field-check tables were generated to check various data quality parameters, and specific feedback was given to the teams to improve performance. Secondary editing and data processing were initiated in November 2019 and completed in May 2020.
Data appraisal
Estimates of Sampling Error
The estimates from a sample survey are affected by two types of errors: nonsampling errors and sampling errors. Nonsampling errors are the results of mistakes made in implementing data collection and data processing, such as failure to locate and interview the correct household, misunderstanding of the questions on the part of either the interviewer or the respondent, and data entry errors. Although numerous efforts were made during the implementation of the 2019-20 Gambia Demographic and Health Survey (GDHS) to minimise this type of error, nonsampling errors are impossible to avoid and difficult to evaluate statistically.
Sampling errors, on the other hand, can be evaluated statistically. The sample of respondents selected in the 2019-20 GDHS is only one of many samples that could have been selected from the same population, using the same design and expected size. Each of these samples would yield results that differ somewhat from the results of the actual sample selected. Sampling errors are a measure of the variability among all possible samples. Although the degree of variability is not known exactly, it can be estimated from the survey results.
Sampling error is usually measured in terms of the standard error for a particular statistic (mean, percentage, etc.), which is the square root of the variance. The standard error can be used to calculate confidence intervals within which the true value for the population can reasonably be assumed to fall. For example, for any given statistic calculated from a sample survey, the value of that statistic will fall within a range of plus or minus two times the standard error of that statistic in 95% of all possible samples of identical size and design.
If the sample of respondents had been selected as a simple random sample, it would have been possible to use straightforward formulas for calculating sampling errors. However, the 2019-20 GDHS sample is the result of a multi-stage stratified design, and, consequently, it was necessary to use more complex formulas. Sampling errors are computed in SAS, using programs developed by ICF. These programs use the Taylor linearisation method to estimate variances for survey estimates that are means, proportions, or ratios. The Jackknife repeated replication method is used for variance estimation of more complex statistics such as fertility and mortality rates.
Note: A more detailed description of estimates of sampling errors are presented in APPENDIX B of the survey report.
Sampling errors, on the other hand, can be evaluated statistically. The sample of respondents selected in the 2019-20 GDHS is only one of many samples that could have been selected from the same population, using the same design and expected size. Each of these samples would yield results that differ somewhat from the results of the actual sample selected. Sampling errors are a measure of the variability among all possible samples. Although the degree of variability is not known exactly, it can be estimated from the survey results.
Sampling error is usually measured in terms of the standard error for a particular statistic (mean, percentage, etc.), which is the square root of the variance. The standard error can be used to calculate confidence intervals within which the true value for the population can reasonably be assumed to fall. For example, for any given statistic calculated from a sample survey, the value of that statistic will fall within a range of plus or minus two times the standard error of that statistic in 95% of all possible samples of identical size and design.
If the sample of respondents had been selected as a simple random sample, it would have been possible to use straightforward formulas for calculating sampling errors. However, the 2019-20 GDHS sample is the result of a multi-stage stratified design, and, consequently, it was necessary to use more complex formulas. Sampling errors are computed in SAS, using programs developed by ICF. These programs use the Taylor linearisation method to estimate variances for survey estimates that are means, proportions, or ratios. The Jackknife repeated replication method is used for variance estimation of more complex statistics such as fertility and mortality rates.
Note: A more detailed description of estimates of sampling errors are presented in APPENDIX B of the survey report.
Data Appraisal
Data Quality Tables
- Household age distribution
- Age distribution of eligible and interviewed women
- Age distribution of eligible and interviewed men
- Completeness of reporting
- Births by calendar years
- Reporting of age at death in days
- Reporting of age at death in months
- Standardisation exercise results from anthropometry training
- Height and weight data completeness and quality for children
- Height measurements from random subsample of measured children
- Number of enumeration areas completed by month, according to Local Government Area, The Gambia DHS 2019-20
- Percentage of children age 6-59 months classified as having malaria according to RDT, by month and Local Government Area, The Gambia DHS 2019-20
- Completeness of information on siblings
- Sibship size and sex ratio of siblings
See details of the data quality tables in Appendix C of the final report.
- Household age distribution
- Age distribution of eligible and interviewed women
- Age distribution of eligible and interviewed men
- Completeness of reporting
- Births by calendar years
- Reporting of age at death in days
- Reporting of age at death in months
- Standardisation exercise results from anthropometry training
- Height and weight data completeness and quality for children
- Height measurements from random subsample of measured children
- Number of enumeration areas completed by month, according to Local Government Area, The Gambia DHS 2019-20
- Percentage of children age 6-59 months classified as having malaria according to RDT, by month and Local Government Area, The Gambia DHS 2019-20
- Completeness of information on siblings
- Sibship size and sex ratio of siblings
See details of the data quality tables in Appendix C of the final report.
access_policy
Access conditions
Request Dataset Access
The following applies to DHS, MIS, AIS and SPA survey datasets (Surveys, GPS, and HIV).
To request dataset access, you must first be a registered user of the website. You must then create a new research project request. The request must include a project title and a description of the analysis you propose to perform with the data.
The requested data should only be used for the purpose of the research or study. To request the same or different data for another purpose, a new research project request should be submitted. The DHS Program will normally review all data requests within 24 hours (Monday - Friday) and provide notification if access has been granted or additional project information is needed before access can be granted.
DATASET ACCESS APPROVAL PROCESS
Access to DHS, MIS, AIS and SPA survey datasets (Surveys, HIV, and GPS) is requested and granted by country. This means that when approved, full access is granted to all unrestricted survey datasets for that country. Access to HIV and GIS datasets requires an online acknowledgment of the conditions of use.
Required Information
A dataset request must include contact information, a research project title, and a description of the analysis you propose to perform with the data.
Restricted Datasets
A few datasets are restricted and these are noted. Access to restricted datasets is requested online as with other datasets. An additional consent form is required for some datasets, and the form will be emailed to you upon authorization of your account. For other restricted surveys, permission must be granted by the appropriate implementing organizations, before The DHS Program can grant access. You will be emailed the information for contacting the implementing organizations. A few restricted surveys are authorized directly within The DHS Program, upon receipt of an email request.
When The DHS Program receives authorization from the appropriate organizations, the user will be contacted, and the datasets made available by secure FTP.
GPS/HIV Datasets/Other Biomarkers
Because of the sensitive nature of GPS, HIV and other biomarkers datasets, permission to access these datasets requires that you accept a Terms of Use Statement. After selecting GPS/HIV/Other Biomarkers datasets, the user is presented with a consent form which should be signed electronically by entering the password for the user's account.
Dataset Terms of Use
Once downloaded, the datasets must not be passed on to other researchers without the written consent of The DHS Program. All reports and publications based on the requested data must be sent to The DHS Program Data Archive in a Portable Document Format (pdf) or a printed hard copy.
Download Datasets
Datasets are made available for download by survey. You will be presented with a list of surveys for which you have been granted dataset access. After selecting a survey, a list of all available datasets for that survey will be displayed, including all survey, GPS, and HIV data files. However, only data types for which you have been granted access will be accessible. To download, simply click on the files that you wish to download and a "File Download" prompt will guide you through the remaining steps.
The following applies to DHS, MIS, AIS and SPA survey datasets (Surveys, GPS, and HIV).
To request dataset access, you must first be a registered user of the website. You must then create a new research project request. The request must include a project title and a description of the analysis you propose to perform with the data.
The requested data should only be used for the purpose of the research or study. To request the same or different data for another purpose, a new research project request should be submitted. The DHS Program will normally review all data requests within 24 hours (Monday - Friday) and provide notification if access has been granted or additional project information is needed before access can be granted.
DATASET ACCESS APPROVAL PROCESS
Access to DHS, MIS, AIS and SPA survey datasets (Surveys, HIV, and GPS) is requested and granted by country. This means that when approved, full access is granted to all unrestricted survey datasets for that country. Access to HIV and GIS datasets requires an online acknowledgment of the conditions of use.
Required Information
A dataset request must include contact information, a research project title, and a description of the analysis you propose to perform with the data.
Restricted Datasets
A few datasets are restricted and these are noted. Access to restricted datasets is requested online as with other datasets. An additional consent form is required for some datasets, and the form will be emailed to you upon authorization of your account. For other restricted surveys, permission must be granted by the appropriate implementing organizations, before The DHS Program can grant access. You will be emailed the information for contacting the implementing organizations. A few restricted surveys are authorized directly within The DHS Program, upon receipt of an email request.
When The DHS Program receives authorization from the appropriate organizations, the user will be contacted, and the datasets made available by secure FTP.
GPS/HIV Datasets/Other Biomarkers
Because of the sensitive nature of GPS, HIV and other biomarkers datasets, permission to access these datasets requires that you accept a Terms of Use Statement. After selecting GPS/HIV/Other Biomarkers datasets, the user is presented with a consent form which should be signed electronically by entering the password for the user's account.
Dataset Terms of Use
Once downloaded, the datasets must not be passed on to other researchers without the written consent of The DHS Program. All reports and publications based on the requested data must be sent to The DHS Program Data Archive in a Portable Document Format (pdf) or a printed hard copy.
Download Datasets
Datasets are made available for download by survey. You will be presented with a list of surveys for which you have been granted dataset access. After selecting a survey, a list of all available datasets for that survey will be displayed, including all survey, GPS, and HIV data files. However, only data types for which you have been granted access will be accessible. To download, simply click on the files that you wish to download and a "File Download" prompt will guide you through the remaining steps.
Citation requirements
Use of the dataset must be acknowledged using a citation which would include:
- the Identification of the Primary Investigator
- the title of the survey (including country, acronym and year of implementation)
- the survey reference number
- the source and date of download
- the Identification of the Primary Investigator
- the title of the survey (including country, acronym and year of implementation)
- the survey reference number
- the source and date of download
Disclaimer and copyrights
Disclaimer
The user of the data acknowledges that the original collector of the data, the authorized distributor of the data, and the relevant funding agency bear no responsibility for use of the data or for interpretations or inferences based upon such uses.
Contacts
Contacts
| Name | Affiliation | |
|---|---|---|
| Information about The DHS Program | The DHS Program | reports@DHSprogram.com |
| General Inquiries | The DHS Program | info@dhsprogram.com |
| Data and Data Related Resources | The DHS Program | archive@dhsprogram.com |
Metadata production
DDI Document ID
DDI_GMB_2019_DHS_v01_M
Producers
| Name | Affiliation | Role |
|---|---|---|
| Development Economics Data Group | The World Bank | Documentation of the DDI |
Date of Metadata Production
2021-05-19
Metadata version
DDI Document version
Version 01 (May 2021). Metadata is excerpted from "The Gambia Demographic and Health Survey 2019-20" Report.