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National Sample Survey Organization

National Sample Survey Organization. Dr Jitendra. Framework. Introduction Divisions of NSSO Areas covered by NSSO Surveys Sample design adopted in NSS Subjects covered in different rounds Coverage of health related subjects in recent years Features of 60 th round

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National Sample Survey Organization

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  1. National Sample Survey Organization Dr Jitendra

  2. Framework • Introduction • Divisions of NSSO • Areas covered by NSSO Surveys • Sample design adopted in NSS • Subjects covered in different rounds • Coverage of health related subjects in recent years • Features of 60th round • Key findings of 60th round • Issues in health surveys

  3. Introduction • The Directorate of National Sample Survey (NSS)-1950 (data collection) • ISI (designing, analysis & reporting) ↓ NSSO- 1970 (All aspects of its work were brought under a single Government organization) • NSS 66th round survey- (July 2009-June 2010)

  4. Divisions of NSSO • Survey Design and Research Division (SDRD) • Field Operations Division (FOD) • Data Processing Division (DPD) • Co-ordination and Publication Division (CPD)

  5. Areas covered by NSSO Surveys • Consumer Expenditure • Household Wealth / Finance • Employment-Unemployment and Migration • Health & hygiene • Education • Unorganized economic enterprises • Land Holdings, Livestock Holdings and other agrarian issues • Others: Travel by Indian Households; Village facilities in India, Culture, Prices etc • NSSO conducted health related enquiries during different rounds- 12th, 17th, 28th, 42nd, 52nd, and 60th rounds • Disability survey- 36th, 47th and 58th

  6. Sample design adopted in NSS • Sample design- stratified two stage sample design • Sample units • First stage units: Villages (rural) Blocks (urban) • Second stage units: Households

  7. Methods of collecting data on illness • Usually from head of household • If individual information required (health surveys)- from individual Set of questions: - Feel anything wrong related to skin, head, eye, ear… or any other organ of body • Any chronic disease • Any disability: hearing, visual, speech or locomotor • Any medicine or medical advice • Hospitalized during last 365 days • Ailing during last 15 days (last 30 days in 42nd round) • Ailing the day before survey (to get an idea of PPM- point prevalence of mortality)

  8. 52nd Round (July 95-June 96) • Rural areas: each district treated as separate stratum, split into ≥ 2 strata if pop ≥ 2 million • Urban areas: strata formed according to pop size (As per 1991 census)- stratum 1: < 0.5 lakh stratum 2: 0.5- < 2 lakh stratum 3: 2-≤ 10 lakh stratum 4,5… each city with pop ≥10 lakh First stage units- All India level (13000 FSUs) both urban and rural selected as central sample ↓ 7663 rural and 4991 urban FSUs were surveyed

  9. Second stage units • In each selected FSU, 3 different enquiries were conducted on 3 independent sample of HHs (Survey on health care, participation in education and consumer expenditure) • For health survey, 10 HHs were selected from each FSU • For getting adequate no. of HHs, HHs were grouped into 3 second stage strata: Hence, 71284 rural and 49658 urban HH selected for detailed enquiry 1. HHs with at least 1 child < 1 year 2. HHs reporting any case of hospitalization (excluding 1) 3. All remaining HHs (excluding 1 and 2) ↓ 2 HH surveyed from 1 and 2 6 HH from 3

  10. 60th Round (Jan-June 2004) • Sample design similar to 52nd round (FSU- villages and blocks) • In FSU, for rural areas strata formed - Stratum 1: 0-50 • stratum2: > 15000 • Stratum 3: remaining • SSU- HHs formed into 4 strata HHs with at least one member hospitalized during last 365 days HHs having at least one child <5 years except in 1 HHs with at least one member of age≥ 60 years excluding those in 1 & 2 All remaining HHs ↓ 47302 HHs in rural & 26566 HHs in urban areas were selected

  11. Subjects covered in different rounds • Round 1 (Oct. 50 - Mar.51): Wages, land utilization, household enterprises, household assets and, consumer expenditure, prices • Round 2 (Apr. 51 - June 51): Village statistics, agriculture, • Round 12 (Mar. 57 -Aug.57): vital statistics, housing condition, employment and unemployment and indebtedness labour households, production of milk and production and utilisation of cattle dung • Round 17 (Sept. 61 -Aug.62): Population, births and deaths, family planning, morbidity • Round 28 (Oct. 73 – June 74): Population, births and deaths, morbidity, fertility, maternal and child care, family planning, housing condition, normal health facilities in rural areas, disability, number of physically and mentally affected persons

  12. Recent health surveys • Round 42 (Jul. 86 – June 87): Social consumption, problems of aged and Ex-servicemen, household consumer expenditure - study extent of social consumption i.e. assessment of benefits derived by various sections of population form public expenditure for education, public distribution and health care - Medical expenses included only curative costs • Round 52 (Jul. 95 – June 96): Survey on health care (more comprehensive) - covered utilization of MCH care services, morbidity and utilization of medical services, problems of aged persons • Round 60 (January –June 2004): Morbidity, Health Care and the Condition of the Aged (integrated questinnaire)

  13. Features of 60th round • Medical expenses in two components- for medical goods and for medical services • Ailments: 3 categories • All ailments for which persons were hospitalized during last 365 days (inpatient expenses) • All ailments for which persons were treated during 15 days before survey • All such ailments for which persons did not avail medical treatment Diseases were not classified as chronic/acute, but listed under broad categories (GI diseases, CVD, disability…)

  14. Some Key findings of 60th round

  15. Rural Urban

  16. Rural Urban

  17. Rural Urban

  18. Rural Urban

  19. Issues in health surveys • Problems of reference period • A person may fail to recall minor illness if reference period is long • A person recall major ailments especially those requiring hospitalization or surgery that actually happened beyond recall period 2. Identification of ailments • Survey done by permanent staff (non-medical), so in case of treated ailments- can know type of diseases but identification in untreated based on general perception

  20. Issues… 3. Effect of seasonality- 60th round was of 6 months duration while 52nd round was of 1year duration, so comparison of some diseases would be affected by seasonality factor 4. Reporting of morbidity- higher level of health awareness due to high literacy, so better reporting 5. Choice of respondents- Self reporting is not always possible for morbidity data, proxy reporting tends to under reporting

  21. Estimates of Disability in India by Census and NSSO Source: Census of India 2001 & NSS 58th Round 2002

  22. References • Mohanan PC, Santhoshi NK. National Sample Surveys on Health and Morbidity. Demography India 2008; 37: 1-11 • NNS 60th round (January- June 2004). Morbidity, Health Care and the Condition of the Aged. National Sample Survey Organization, Ministry of Statistics and Program Implementation, Government of India March 2006. • Bhanushali K. Defining Disabilities: NSSO v/s Census. Disability India Journal 2004 (04). • Concepts and Definitions Used in NSS. Golden jubilee publication. National Sample Survey Organization, Ministry of Statistics and Program Implementation, Government of India 2001.

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