Identification

Survey ID Number

ZAF-WHO-SAGE-2007-v01

Title

Study on Global Ageing and Adult Health-2007/8, Wave 1

Subtitle

Wave 1

Country

Name	Country code
South Africa	ZAF

Study type

World Health Survey [hh/whs]

Series Information

The Study on Global Ageing and Adult Health is the second round of the survey. Data was collected for the World Health Survey (WHS/SAGE Wave 0) in 2003 but none of these respondents were followed up. For future waves of SAGE, attempts will be made to follow up respondents from wave 0. SAGE surveys are designed by the World Health Organization and implemented by national agencies in participating countries.

Abstract

Purpose:
The multi-country Study on Global Ageing and Adult Health (SAGE) is run by the World Health Organization's Multi-Country Studies unit in the Innovation, Information, Evidence and Research Cluster. SAGE is part of the unit's Longitudinal Study Programme which is compiling longitudinal data on the health and well-being of adult populations, and the ageing process, through primary data collection and secondary data analysis. SAGE baseline data (Wave 0, 2002/3) was collected as part of WHO's World Health Survey http://www.who.int/healthinfo/survey/en/index.html (WHS). SAGE Wave 1 (2007/10) provides a comprehensive data set on the health and well-being of adults in six low and middle-income countries: China, Ghana, India, Mexico, Russian Federation and South Africa.
Objectives:
To obtain reliable, valid and comparable health, health-related and well-being data over a range of key domains for adult and older adult populations in nationally representative samples
To examine patterns and dynamics of age-related changes in health and well-being using longitudinal follow-up of a cohort as they age, and to investigate socio-economic consequences of these health changes
To supplement and cross-validate self-reported measures of health and the anchoring vignette approach to improving comparability of self-reported measures, through measured performance tests for selected health domains
To collect health examination and biomarker data that improves reliability of morbidity and risk factor data and to objectively monitor the effect of interventions
Additional Objectives:
To generate large cohorts of older adult populations and comparison cohorts of younger populations for following-up intermediate outcomes, monitoring trends, examining transitions and life events, and addressing relationships between determinants and health, well-being and health-related outcomes
To develop a mechanism to link survey data to demographic surveillance site data
To build linkages with other national and multi-country ageing studies
To improve the methodologies to enhance the reliability and validity of health outcomes and determinants data
To provide a public-access information base to engage all stakeholders, including national policy makers and health systems planners, in planning and decision-making processes about the health and well-being of older adults
Methods:
SAGE's first full round of data collection included both follow-up and new respondents in most participating countries. The goal of the sampling design was to obtain a nationally representative cohort of persons aged 50 years and older, with a smaller cohort of persons aged 18 to 49 for comparison purposes. In the older households, all persons aged 50+ years (for example, spouses and siblings) were invited to participate. Proxy respondents were identified for respondents who were unable to respond for themselves. Standardized SAGE survey instruments were used in all countries consisting of five main parts: 1) household questionnaire; 2) individual questionnaire; 3) proxy questionnaire; 4) verbal autopsy questionnaire; and, 5) appendices including showcards. A VAQ was completed for deaths in the household over the last 24 months. The procedures for including country-specific adaptations to the standardized questionnaire and translations into local languages from English follow those developed by and used for the World Health Survey.
Content
Household questionnaire
0000 Coversheet
0100 Sampling Information
0200 Geocoding and GPS Information
0300 Recontact Information
0350 Contact Record
0400 Household Roster
0450 Kish Tables and Household Consent
0500 Housing
0600 Household and Family Support Networks and Transfers
0700 Assets and Household Income
0800 Household Expenditures
0900 Interviewer Observations
Individual questionnaire
1000 Socio-Demographic Characteristics
1500 Work History and Benefits
2000 Health State Descriptions and Vignettes
2500 Anthropometrics, Performance Tests and Biomarkers
3000 Risk Factors and Preventive Health Behaviours
4000 Chronic Conditions and Health Services Coverage
5000 Health Care Utilization
6000 Social Cohesion
7000 Subjective Well-Being and Quality of Life (WHOQoL-8 and Day Reconstruction Method)
8000 Impact of Caregiving
9000 Interviewer Assessment

Kind of Data

Sample survey data [ssd]

Unit of Analysis

households and individuals

Version

Version Description

v01: Edited, anonymous dataset for public distribution.

Version Date

2011-11-11

Scope

Notes

The scope of the Study on Global Ageing and Adult Health includes:
HOUSEHOLD: household characteristics, housing, household and family support, assets and household income, household expenditure.
INDIVIDUAL: socio demographic characteristics, work history, health state, anthropometrics, performance tests and biomarkers, risk factors, chronic conditions and health service coverage, health care utilisation, social cohesion, subjective well-being and quality of life, caregiving.

Topics

Topic	Vocabulary
Study on Global Ageing and Adult Health (SAGE)	Survey

Keywords

Keyword	Vocabulary	URI
Ageing, Alcohol, Asthma, Blindness, Cancer, Cataract, Cervical cancer, Chronic diseases, COPD, Depression, Diabetes, Diet, Disabilities, Epidemiology, Health financing, Health services, Health surveys, Health systems, Hearing impairment, Heart disease, Indoor air pollution, Injuries traffic, Mapping, Noncommunicable diseases, Nutrition, Obesity, Oral Health, Passive smoking, Physical activity, Poverty, Primary health care, Risk factors, Sanitation, Social determinants of health, Statistics, Stroke, Suicide, Tobacco, Visual impairment, Water	WHO Health topics	http://www.who.int/topics/en

Coverage

Geographic Coverage

National coverage

Universe

The household section of the survey covered all households in all nine provinces in South Africa. Institutionalised populations are excluded. The individual section covered all persons aged 18 years and older residing within individual households. As the focus of SAGE is older adults, a much larger sample of respondents aged 50 years and older were selected with a smaller comparative sample of respondents aged 18-49 years.

Producers and sponsors

Primary investigators

Name	Affiliation
Professor Nancy Phaswana-Mafuya	Human Science Research Council (HSRC)
Professor Karl F. Peltzer	Human Science Research Council (HSRC)

Funding Agency/Sponsor

Name	Abbreviation	Role
South African National Department of Health	NDOH	financial support
US National Institute on Aging	NIA	Financial support through Interagency Agreements (OGHA 04034785; YA1323-08-CN-0020; Y1-AG-1005-01) and Grants (R01-AG034479; IR21-AG034263-0182)

Other Identifications/Acknowledgments

Name	Affiliation	Role
Dr Richard Suzman	The National Institute on Aging's Division of Behavioral and Social Research	Dr Suzman was Instrumental in providing continuous intellectual and other technical support to SAGE and has made the entire endeavour possible.

Sampling

Sampling Procedure

South Africa used a stratified multistage cluster sample design. Strata were defined by the nine provinces:(Eastern Cape, Free State, Gauteng, Kwa-Zulu Natal, Limpopo, Mpumalanga, North West, Northern Cape and Western Cape), locality (urban or rural), and predominant race group (African/Black, White, Coloured and Indian/Asian), as not all combinations of stratification variables were possible, there were 50 strata in total.
The Human Science Research Council's master sample was used as the sampling frame which comprised 1000EAs.
A sample of 600 EAs was selected as the primary sampling units(PSU). The number of EAs to be selected from each strata was based on proportional allocation (determined by the number of EAs in each strataspecified on the Master Sample). EAs were then selected from each strata with probability proportional to size; the measure of size being the number of individuals aged 50 years or more in the EA.
In each selected EA 30 households were randomly selected from the Master Sample.
A listing of the 30 selected households was conducted to classify each household into one of two mutually exclusive categories:
(1) households with one or more members aged 50 years or more (defined as '50 plus households');
(2) households which did not include any members aged 50 years or more, but included residents aged 18-49 (defined as '18-49 households').
All 50 plus households were eligible for the household interview, and all 50 plus members of the household were eligible for the individual interview.
Two of the remaining 18-49 households were randomly selected for the household interview.
In each of these household one person aged 18-49 was eligible for the individual interview, and the individual to be included was selected using a Kish Grid.

Stages of selection
Strata: Province, Predominant Race Group, Locality=50
PSU: EAs=408 surveyed
SSU: Households=4020 surveyed
TSU: Individual=4227 surveyed

Deviations from the Sample Design

Originally 600 EAs were drawn into the sample. However due to time and financial contraints only 396 EAs were visited.

Response Rate

Household
Response rate=67%
Cooperation rate=99%

Individual:
Response rate=77%
Cooperation rate=99%

Weighting

Household weights for analysis at household level and individual weights for analysis at person level were calculated. These were based on the selection probability at each stage of selection.
Household weights were post-stratified by province and locality according to the South African Community Survey 2007. Individual weights were post-stratified by province, sex and age-groups (18-49, 50-59, 60-69, 70+) according to the 2009 Medium Mid-Year population estimates from Statistics South Africa. Weights are not normalised.

Data Collection

Dates of Data Collection

Start	End
2007-01	2008-11

Data Collection Mode

Face-to-face [f2f] PAPI

Data Collection Notes

The SAGE instrument was pre-tested in 2005 in India, Ghana and Tanzania. Just over 1500 persons were interviewed in total. Fieldworker training workshop was held the week of 15 January 2007 at the HSRC in Pretoria. The field work team consisted of 9 Field Coordinators from the HSRC who provided overall field coordination and supervision, 13 Supervisors and 50 interviewers. Each of the 9 provinces had a field coordinator. With the exception of Gauteng and Kwa-Zulu Natal which had 2 supervisors, the remaining 7 provinces had a single supervisor. Supervisors were responsible for teams ranging from 3-6 persons. A pilot study was conducted in eight provinces (Mpumalanga was excluded) from 29th January to 2nd February 2007 with an additional week’s extension from 5th to 9th February 2007, Eastern Cape, Limpopo and Western Cape.

Data Collectors

Name	Abbreviation
Human Science Research Council	HSRC

Questionnaires

The questionnaires were based on the WHS Model Questionnaire with some modification and many new additions. A household questionnaire was administered to all households eligible for the study. A Verbal Autopsy questionnaire was administered to households that had a death in the last 24 months. An Individual questionnaire was administered to eligible respondents identified from the household roster. A Proxy questionnaire was administered to individual respondents who had cognitive limitations. The questionnaires were developed in English and were piloted as part of the SAGE pretest in 2005. All documents were translated into six of the major languages in South Africa: Afrikaans, IsiZulu, IsiXhosa, Sepedi, Setswana and Xitsonga. All SAGE generic questionnaires are available as external resources.

Data Processing

Data Editing

Data editing took place at a number of stages including:
(1) office editing and coding
(2) during data entry
(3) structural checking of the CSPro files
(4) range and consistency secondary edits in Stata

Access policy

Access authority

Name	Affiliation	Email
Nirmala Naidoo, Health Statistics and Information Systems	World Health Organization	[email protected]

Contacts

Name	Affiliation	Email	URL
Nirmala Naidoo, Health Statistics and Information Systems	World Health Organization	[email protected]	http://apps.who.int/healthinfo/systems/surveydata

Access conditions

The user undertakes:
(1) to keep confidential any information concerning individual persons or households.
(2) not to distribute the data to any other user.
(3) to use the data for scientific research only.
(4) to share any planned publications with WHO prior to publication.

Citation requirements

Publications based on SAGE data should use the following acknowledgement: "This paper uses data from the WHO Study on Global AGEing and Adult Health (SAGE)."

Disclaimer and copyrights

Disclaimer

The data is being distributed without warranty of any kind. The responsibility for the use of the data lies with the user. In no event shall the World Health Organization be liable for damages arising from its use.

Metadata production

DDI Document ID

DDI-ZAF-WHO-SAGE-2007-V01

Producers

Name	Affiliation	Role
Nirmala Naidoo	World Health Organization	Supervision and review of metadata and documentation of study
Yunpeng Huang	World Health Organization	Documentation of the data

Date of Metadata Production