Association between variables used in the field substitution and post-stratification adjustment in the Belgian health interview survey and non-response

Objectives

Field substitution and post-stratification adjustment have been proposed to reduce non-response bias in population surveys. We investigated if variables involved in those techniques in the Belgian health interview survey 2004 are associated with non-response and assessed the impact of field substitution and post-stratification adjustment on the survey results.

Methods

Data were obtained from all selected households (n = 12.204). The association between non-response and the selected variables was explored through multilevel logistic regression models with municipality and statistical sector as random effects.

Results

All investigated variables were significantly related with non-response. Especially households that could not be contacted differed substantially from those who participated. Only post-stratification had a clear impact on the survey results.

Conclusions

Even if variables used in the field substitution procedure of health surveys are strongly associated with non-response, the impact of field substitution on the survey results may be minimal, either because there was no bias of relevance or it was not captured. The usefulness of field substitution to correct for non-response bias in population health surveys seems to be quite limited.     

Adolescent survey non-response and later risk of death. A prospective cohort study of 78 609 persons with 11-year follow-up

Background  

Non-response in survey studies is a growing problem and, being usually selective, it leads to under- or overestimation of health outcomes in the follow-up. We followed both respondents and non-respondents by registry linkage to determine whether there is a risk of death, related to non-response at baseline.     

Response rates in postal surveys of healthcare professionals between 1996 and 2005: An observational study

Background  

Postal surveys are a frequently used method of data collection in health services research. Low response rates increase the potential for bias and threaten study validity. The objectives of this study were to estimate current response rates, to assess whether response rates are falling, to explore factors that might enhance response rates and to examine the potential for non-response bias in surveys mailed to healthcare professionals.     

The Oslo Health Study: The impact of self-selection in a large,population-based survey

Background  

Research on health equity which mainly utilises population-based surveys, may be hampered by serious selection bias due to a considerable number of invitees declining to participate. Sufficient information from all the non-responders is rarely available to quantify this bias. Predictors of attendance, magnitude and direction of non-response bias in prevalence estimates and association measures, are investigated based on information from all 40 888 invitees to the Oslo Health Study.     

Personally addressed hand-signed letters increase questionnaire response: a meta-analysis of randomised controlled trials

Background  

Postal questionnaires are commonly used to collect data for health studies, but non-response reduces study sample sizes and can introduce bias. Finding ways to increase the proportion of questionnaires returned would improve research quality. We sought to quantify the effect on response when researchers address participants personally by name on letters that accompany questionnaires.     

Psychosocial risk factors in home and community settings and their associations with population health and health inequalities: A systematic meta-review

Background  

The effects of psychosocial risk factors on population health and health inequalities has featured prominently in epidemiological research literature as well as public health policy strategies. We have conducted a meta-review (a review of reviews) exploring how psychosocial factors may relate to population health in home and community settings.     

"We're not short of people telling us what the problems are. We're short of people telling us what to do": An appraisal of public policy and mental health

Background  

There is sustained interest in public health circles in assessing the effects of policies on health and health inequalities. We report on the theory, methods and findings of a project which involved an appraisal of current Scottish policy with respect to its potential impacts on mental health and wellbeing.     

Community referral in home management of malaria in western Uganda: A case series study

Background  

Public health research is shifting focus to the role of socioeconomic indicators in the promotion of health. As such an understanding of the roles that socio-economic factors play in improving health and health-seeking behaviour is important for public health policy. This is because the share of resources devoted to different policy options should depend on their relative effectiveness.     

Challenges and opportunities for policy decisions to address health equity in developing health systems: case study of the policy processes in the Indian state of Orissa

Introduction  

Achieving health equity is a pertinent need of the developing health systems. Though policy process is crucial for planning and attaining health equity, the existing evidences on policy processes are scanty in this regard. This article explores the magnitude, determinants, challenges and prospects of 'health equity approach' in various health policy processes in the Indian State of Orissa - a setting comparable with many other developing health systems.     

A new test of the construct validity of the CarerQol instrument: measuring the impact of informal care giving

Purpose  

Most economic evaluations of health care programmes do not consider the effects of informal care, while this could lead to suboptimal policy decisions. This study investigates the construct validity of the CarerQol instrument, which measures and values carer effects, in a new population of informal caregivers.     

Young and vulnerable: Spatial-temporal trends and risk factors for infant mortality in rural South Africa (Agincourt), 1992-2007

Background  

Infant mortality is an important indicator of population health in a country. It is associated with several health determinants, such as maternal health, access to high-quality health care, socioeconomic conditions, and public health policy and practices.     

An integrated framework for the geographic surveillance of chronic disease

Background  

Geographic public health surveillance is concerned with describing and disseminating geographic information about disease and other measures of health to policy makers and the public. While methodological developments in the geographical analysis of disease are numerous, few have been integrated into a framework that also considers the effects of case ascertainment bias on the effectiveness of chronic disease surveillance.     

Sex,drugs and gender roles: mapping the use of sex and gender based analysis in pharmaceutical policy research

Background  

Sex and gender sensitive inquiry is critical in pharmaceutical policy due to the sector's historical connection with women's health issues and due to the confluence of biological, social, political, and economic factors that shape the development, promotion, use, and effects of medicinal treatments. A growing number of research bodies internationally have issued laws, guidance or encouragement to support conducting sex and gender based analysis (SGBA) in all health related research.     

A retrospective analysis of health systems in Denmark and Kaiser Permanente

Background  

To inform Danish health care reform efforts, we compared health care system inputs and performance and assessed the usefulness of these comparisons for informing policy.     

Implications of the HIV testing protocol for refusal bias in seroprevalence surveys

Background  

HIV serosurveys have become important sources of HIV prevalence estimates, but these estimates may be biased because of refusals and other forms of non-response. We investigate the effect of the post-test counseling study protocol on bias due to the refusal to be tested.     

A technical framework for costing health workforce retention schemes in remote and rural areas

Background  

Increasing the availability of health workers in remote and rural areas through improved health workforce recruitment and retention is crucial to population health. However, information about the costs of such policy interventions often appears incomplete, fragmented or missing, despite its importance for the sound selection, planning, implementation and evaluation of these policies. This lack of a systematic approach to costing poses a serious challenge for strong health policy decisions.     

Assessing capacity for health policy and systems research in low and middle income countries*

Background  

As demand grows for health policies based on evidence, questions exist as to the capacity of developing countries to produce the health policy and systems research (HPSR) required to meet this challenge.     

Reversing the trend of weak policy implementation in the Kenyan health sector? – a study of budget allocation and spending of health resources versus set priorities

Background  

Policy implementation in the context of health systems is generally difficult and the Kenyan health sector situation is not an exception. In 2005, a new health sector strategic plan that outlines the vision and the policy direction of the health sector was launched and during the same year the health sector was allocated a substantial budget increment. On basis of these indications of a willingness to improve the health care system among policy makers, the objective of this study was to assess whether there was a change in policy implementation during 2005 in Kenya.     

Health financing in Malawi: Evidence from National Health Accounts

Background  

National health accounts provide useful information to understand the functioning of a health financing system. This article attempts to present a profile of the health system financing in Malawi using data from NHA. It specifically attempts to document the health financing situation in the country and proposes recommendations relevant for developing a comprehensive health financing policy and strategic plan.     

The decentralisation-centralisation dilemma: recruitment and distribution of health workers in remote districts of Tanzania

Background  

The implementation of decentralisation reforms in the health sector of Tanzania started in the 1980s. These reforms were intended to relinquish substantial powers and resources to districts to improve the development of the health sector. Little is known about the impact of decentralisation on recruitment and distribution of health workers at the district level. Reported difficulties in recruiting health workers to remote districts led the Government of Tanzania to partly re-instate central recruitment of health workers in 2006. The effects of this policy change are not yet documented. This study highlights the experiences and challenges associated with decentralisation and the partial re-centralisation in relation to the recruitment and distribution of health workers.