Community-Facility Surveys: IFLS1 and IFLS2

It is often hypothesized that the characteristics of communities affect individual behavior, but rarely are household survey data accompanied by detailed data about the communities from which households are sampled. The IFLS is an exception. For each IFLS community in which we interviewed households, extensive information was collected from community leaders and from staff at schools and health facilities available to community residents. We refer to this component of the IFLS as the Community-Facility Survey (CFS).

Sample Design and Response Rates

The CFS sought information about the communities of HHS respondents. Most of the information was obtained in the following ways:

IFLS2 gathered data from three new sources in each community:

In addition, IFLS2 constructed a list of all available health facilities and schools. For each facility, information on the travel times, prices, and transportation modes to that facility from the community center was collected from community informants.

Sample Selection for Facilities

To cover the major sources of public and private outpatient health care and school types, we defined six strata of facilities to survey and set a quota per community for each strata:

IFLS1 and IFLS2 used the same protocol for selecting facilities. We wanted the specific schools and health providers targeted for detailed interviews to reflect facilities available to the communities from which HHS respondents were drawn. Rather than selecting facilities based solely on information from the village leader or on proximity to the community center, we sampled schools and health care providers from information provided by HHS respondents. In IFLS2, we decided not to simply go back to the same facilities that we visited in 1993, because we judged it important to refresh the sample in 1997 to allow for new facilities. Refreshing the sample was consistent with the goal of the CFS, which is intended to portray the current nature of the communities and the facilities in which IFLS households resided.

Response Rates

The tables below show the number of respondents and facilities covered in IFLS1 and IFLS2 and the fraction of IFLS1 facilities that was reinterviewed in IFLS2, the number of facilities interviewed in IFLS2 for which IFLS1 data also exist, and the number of new facilities interviewed only in IFLS2.

 

CFS Interviews Completed in IFLS1 and IFLS2, by Respondent and Facility Types

 

IFLS1

 

IFLS2

 

Average per EA

Total

 

Average per EA

Total

Respondent type:

         

Community leaders (book 1)

1

312

 

1

313

Women’s group head (book PKK)

1

312

 

1

310

Community records (book 2)

1

312

 

1

312

Village head or women’s group head (book SAR)

NA

NA

 

1

313

Traditional law expert (book Adat)

NA

NA

 

.88

277

Community activist (book PM)

NA

NA

 

.97

303

           

Facility type:

         

Government health center, subcenter

3.1

993

 

2.9

919

Private doctor, clinic

1.7

549

 

NA

NA

Private nurse, midwife, paramedic

2.8

892

 

NA

NA

Any private practitioner

NA

NA

 

5.7

1832

Traditional practitioner

2.0

624

 

NA

NA

Community health post (posyandu)

2.8

899

 

1.9

619

Elementary school

1.8

944

 

3.0

964

Junior high school

2.8

900

 

2.9

945

Senior high school

3.0

584

 

1.9

618

 

CFS Cross-Wave Interviews, by Facility Type

Facility Type

IFLS1 Facilities Reinterviewed in IFLS2 (%)

IFLS2 Facilities Also Interviewed in IFLS1

New Facilities in IFLS2

Government health centers

66.5

660

259

Private practitioners

40.4

582

1250

Elementary school

64.9

613

351

Junior high school

55.3

498

447

Senior high school

44.2

258

360

 

 

Survey Instruments

As with the HHS, the CFS questionnaire was divided in books (addressed to different respondents) and subdivided into topical modules. Community-level information was collected in six books: book 1, book 2, book PKK, book SAR, book Adat, and book PM. Health facility information was collected in book PUSK, book PP, and book Posyandu. Each level of school was covered in a separate book, whose contents were nearly identical: book SD, book SMP, and book SMU.

Community Questionnaires

Book 1. This book collected a wide range of information about the community. It was addressed to the head of the community in a group interview. Ideally the group included the village/township leader, one or two of his staff members, and one or two members of the Village Elders Advisory Board, but the composition varied across villages, reflecting who was available and whom the village leader wanted to participate. Respondents were asked about available means of transportation, communications, sanitation infrastructure, agriculture and industry, history of the community, credit opportunities, community development activities, and the availability of schools and health facilities.

Book 2. This book provided a place to record statistical data about the community. Generally the data were extracted from the community’s Statistical Monograph or from a copy of its PODES questionnaire. If neither source was available, the village head was asked to estimate the answer, which was recorded as an estimate. Separate modules asked the interviewer to make direct observations about community conditions and to visit up to three markets or sales outlets and record the prices of various foods.

Book PKK. Administered to the head of the village women’s group, this book asked about the availability of health services and schools in the community, including outreach activities; changes in the community over time; and in detail about the prices of foods and other items.

Book SAR. The Service Availability Roster was new for IFLS2. It was added after analysis of the IFLS1 data showed that community informants provided incomplete listings of the facilities to which HHS respondents had access. The SAR gathered in one place information on all the schools and health facilities available to residents of IFLS communities. It included

For each facility mentioned, the head of the village/township or the women’s group head was asked to estimate the distance, travel time, and travel cost to the facility. In addition, the interviewer went to the facility to obtain a GPS reading of latitude and longitude. These readings were used to construct measures of distance to the facilities from the center of the IFLS cluster and from the office of the village/township leader.

Book Adat. This book, new in IFLS2, was administered to someone the village head identified as a local expert in the adat (traditional law) of the community. After questions about the respondent’s own religious, educational, and ethnic background, he/she was asked about village characteristics, e.g., the most important changes to occur in the past 5 years. Then, he/she was asked detailed questions about traditional laws and customs relating to marriage, childbirth, divorce, gender roles, living arrangements for the elderly, and death and inheritance. A final set of questions probed about community organization, governance, mutual aid, and decision-making practices.

Book PM. This book, new in IFLS2, was administered to someone the village head identified as a community resident actively involved in a community development project, preferably one designed to improve the water supply or sanitation facilities. After a obtaining a profile of the respondent, the main module probed the background of the particular development project, its prospective benefits, and project planning, management, implementation, and funding. Finally, the respondent was asked about the history of development activities in the community.

Health Facility Questionnaires

Separate books were designed for each health facility stratum:

The contents of books PUSK and PP were very similar to maximize comparability while reflecting that different types of facilities provide different types of services. Book PUSK was the most comprehensive, and the director of the government health center was asked to designate an appropriate respondent for each module.

Both books collected data on the availability and prices of services, lab tests, and drugs, and on the availability of equipment and supplies. Both provided space for the interviewer to record direct observations about the facility’s cleanliness and other features that might influence its attractiveness to patients. Five hypothetical patient scenarios or "vignettes" probed the respondents’ knowledge of process in patient care. The vignettes concerned the provision of IUDs, provision of oral contraceptives, prenatal care, treating a child with vomiting and diarrhea, and treating an adult with a respiratory illness.

Books PUSK and PP were designed to indicate the facility’s functional capacity (adequacy of the laboratory, pharmacy, equipment, staff, the physical environment) and the adequacy of specific services for outpatient care, care for pregnant women, well-baby care, and family planning.

The contents of book Posyandu reflected the different role this facility plays in providing health services. It asked about the characteristics of the volunteer staff (including general education and health training) and their frequency of contact with outreach workers from the government health center. In addition to questions about services offered at the post, there were general questions about health problems in the village. Finally, questions about prices from book PKK, module H, were repeated here to provide another data source for that topic.

School Questionnaires

The questionnaires for the three levels of schools (elementary, junior high school, and senior high school) had similar contents. In most of the modules, the principal or designee answered questions about the staff, school characteristics, and student population. One module, investigating teacher characteristics, was addressed to teachers of Indonesian language and mathematics. Another module had the interviewer answer specific questions based on direct observation about the quality of the classroom infrastructure. The final sections recorded student expenditures, math and language scores on the EBTANAS tests for a random sample of 25 students, and counts of teachers and students.


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