POPULATION HEALTH

SURVEYS: HEALTH AT A
GLANCE
Dr. Rasha Alfawaz
Public Health Consultant
Introduction
Although reliable and timely Health Information is the foundation of public health action, it
is often unavailable due to under-investment in systems for data collection, analysis,
dissemination, and use.
Consequently, decision-makers cannot identify problems and needs, track progress,
evaluate the impact of interventions, and make evidence-based decisions on health policy,
program design, and resource allocation.
Measuring health is conceptually and technically complex, requiring statistical, public
health, and biomedical knowledge and expertise unique to each disease or program area.
Accurate measurement depends upon the availability of disease-specific biometric tests,
clinical diagnoses, and the feasibility of measuring population behaviours and the
coverage of health services.
As a result, health statistics may vary greatly in terms of scientific soundness, usability,
and timeliness.
Health Information Systems

Are the set of data collection instruments, actors, resources, and institutions

whose primary purpose is to inform strategic decision-making, support

program management, monitor progress towards agreed targets, and

provide the basis for the evaluation of what works and what does not in

health systems.

A key aspect of health information systems is the mode through which

needed information is collected for a range of purposes, topics, and levels of

aggregation.
Health Statistics
❑ The main sources of health
statistics are:

✔ Health Surveys,
✔ Administrative and medical
records,
✔ Health care claims data,
✔ Vital records,
✔ Surveillance,
✔ Disease registries,
✔ Grey literature and
peer-reviewed literature.
Health survey

It is studying a population or particular segment of the population in order to

assess its health problems or to detect conditions to which preventive measures
may be applied.

It is related to any aspect of health (morbidity, mortality, nutritional status, risk

factors.. etc.)

Data are systematically collected through different aspects.

Health survey may be Cross-sectional or Longitudinal.

Multi-stage cluster sampling is often used (“area sampling”) to define the sample
in population-based surveys, where the sampling unit is a defined population
cluster - as a census tract - that is decomposed into sub-groups each stage until
Objectives of Health Surveys
❑ National health surveys, or the systematic collection of real-world data on health
and disease in a human population within a given geographic area, have
positively influenced population health through:

Gathering accurate, reliable, and standardized information about

disease/health problems.
Gathering information about the effectiveness and efficiency of a health
program
Informing Health strategies and National recommendations,
Planning and Evaluating Health programs and health promotion.
Obtaining new information about disease/health problems.
Clinical guidelines,
Health laws,
Research,
Methods of Health Survey

❑ The method employed for data collection can be broadly classified into four
types:

1. Health interview (face-to-face) survey.

Measuring subjective phenomena (perceived morbidity, disability,
behavior characteristics..etc.)

2. Health examination survey.

o Providing more valid objective information requires a technical team
(Dr. and technicians).
o Applied on subsamples from the Health Interview.

3. Health records survey.

4. Mailed questionnaire survey.
Limitation of Health Surveys

❑ Surveys can be a useful diagnosis tool, but they also have some drawbacks.
These include:

✔ Sampling error and non-response error

✔ The influence of question wording and format

✔ The survey can be affected by respondent motivation, availability, and

willingness.

✔ Surveys can be limited by the scope and depth of the questions, making
it difficult to capture complete or nuanced data.

✔ Finally, surveys can be misinterpreted or misused by stakeholders,

which can reduce the validity and usefulness of the data.
How to overcome Limitation
❑ To maximize the benefits

✔ The purpose, objectives, and scope of the survey should be defined clearly and
aligned with organizational goals and needs.

✔ The survey should be designed carefully and tested before launching to ensure
its validity, reliability, relevance, clearness, and consistency.

✔ Administering the survey ethically and professionally is essential; respondents

should be informed about the benefits, expectations, and feedback.

✔ Rigorous and objective analysis of data should be done with appropriate

statistical methods to account for errors and biases.

✔ Interpreting and presenting results accurately and transparently will ensure that
they are valid, useful, and impactful for dialogue, action, and learning with
stakeholders.
A good health survey is

Valid and reliable standardized instruments were available for a wide range of
topics.

When household survey instruments are designed to enhance the

comparability of responses across individuals within a population and across
different cultural groups, the utility of the information can be greatly
increased.

Valid, reliable, and comparable information can be used to benchmark

important health or health system outcomes, inputs, and processes.
INTERNATIONAL
EXPERIENCE
Leading international household surveys

Since the 1990s, the WHO has guided the production of population data to encourage
the production of information to guide health policy, especially among developing
countries, and to standardize indicators between different countries to make them
comparable.

The U.S. conducted its first national health survey in 1935-1936. Then, the National
Health Interview Survey (NHIS) started to be carried out in the mid-1950s continuing to
this day.

In the 1970s, the UK started to apply a national longitudinal survey, the General Health
Survey (GHS), which was followed by other similar studies, such as in Canada, which,
since the 2000s, has carried out annually the Canadian Community Health Survey
(CCHS)

In 2006, the European Union (EU) started to conduct an extensive household survey
USA population survey
Survey Data source and methods Selected data items Targeted sample size Frequency

National Health Interview Survey Personal interviews • Chronic conditions 30,000 sample adults and Annual
(NHIS) • Health status 10,000 sample children
• Functioning and disability
• Health insurance
• Health care access and use
• Health-related behaviors

National Health and Nutrition • Personal interviews • Selected diseases and conditions 5,000 persons per year, all Continuous since 1999,
Examination Survey (NHANES) • Physical examinations • Nutrition monitoring ages 2-year survey cycles
• Laboratory tests • Environmental exposure monitoring
• Children's growth and development
• Infectious disease monitoring
• Overweight and diabetes
• Hypertension and cholesterol
• Health behaviors
• Oral health
• Hearing and balance
• Cognitive functioning
• Prescription drug use
• Dietary supplement use

National Survey of Family Growth Personal interviews • Contraception and sterilization 5,000 men and women aged Continuous
• Pregnancy and birth history 15–49 years per survey year
• Teenage sexual activity and pregnancy
• Family planning and services and other reproductive
health care
• Unintended pregnancy
• Infertility, adoption, and breastfeeding
• Marriage, divorce, and cohabitation
• Fatherhood involvement
• HIV/STD risk behavior

Research and Development Survey Primarily web surveys from • RANDS is fielded to support different methodological Sample size varies by round As needed
(RANDS) commercially recruited studies, including question-response patterns, so most with a target between 2,000
panels with telephone mode content varies among rounds and 5,000 per round
surveys • Selected chronic conditions fielded each round
UK Population Survey

UK Data Service: Trusted access and training

to use the UK's largest collection of economic,
UK DATA ARCHIVE: Home to the UK's population and social research data for
largest collection of social, economic, teaching, learning, and public benefit.
and population data for over 50 years,
they provide researchers with training,
support, and data access as the lead
partner of the UK Data Service.
Data on health and health behaviour can cover not
only a person’s status, behaviour, attitudes, and
expectations but also the provision of health care,
including the mechanics of policymaking,
government expenditure, and service coverage.
SAUDI ARABIA
HEALTH DATA
Health Statistics in Saudi Arabia

❑ Saudi Arabia’s commitment to the global health security agenda and Sustainable
Developmental Goals is in-line with the strategic orientation of the KSA Vision 2030.

❑ The national focus on improving the quality of life and well-being of the population
supports the need for analysis of mega-data in order to learn from the past,
understand the current situation, and plan for the future.
 2010 2024
World Health Survey World Health Survey
2023
2017 2018 National Health
2005 Family Health Family Health Survey
STEPwise 2013 Survey Survey
Saudi Health Interview
Survey (SHIS)
Challenges of Health data at the population level in KSA

The lack of local statistics in general.

The lack of awareness of potential sources where such statistics can be found.

The lack of data storing and archiving.

The absence of relevant policies on the linkage of different population datasets.

The absence of a unified methodology and the resulting challenges in national,

regional, and global comparisons.

Lack of translation of the evidence, survey results, and data in informing policies and
practices.

Lack of support for researchers and academic bodies in obtaining raw data and
utilizing it in research.
Way of improvement

Provide enough support in the improvement and development of the health

information system, including disease registries, surveillance systems, vital

registries (Death registries), and population health surveys.

Significant investment in establishing population health data infrastructure to

ensure high-quality data.

Support data availability and accessibility.

Support data linkage between several population datasets and across national

entities.

Place more support and efforts in standardizing survey methods.

CONCLUSION
Health statistics now: are we making the right investments?

Worldwide interest in the monitoring of development, as exemplified in the (SDGs),

generates pressure for high-quality and timely data for reporting on country progress.

provides major opportunities to increase the supply and use of sound health
statistics.

This emphasizes the need to be refocused on systematic investments in data

generation and analysis.

The risk of inadequate or poorly targeted investments can be kept to a minimum by

understanding the causes of poor availability of health statistics, including lack of
accurate measurement instruments, application of suboptimum methods of data
collection, and inadequate use of methods and analyses to produce comparable
estimates.
Now Is The Time To Accelerate The Production And Use Of Accurate, Complete,
And Timely Health Statistics For Decision-making By Investing In Country
Health Information Systems That Should Be Based On An Efficient And
Effective Mix Of Standardized Methods Of Data Collection And Analysis That
Meet Country And International Needs.
THANK YOU