Abstract
BackgroundIn developing countries, population estimates and assessments of progress towards the Millennium Development Goals are based increasingly on household surveys. It is not recognised that they are inappropriate for obtaining information about the poorest of the poor. This is because they, typically, omit by design: those not in households because they are homeless; those who are in institutions; and mobile, nomadic or pastoralist populations. In addition, in practice, because they are difficult to reach, household surveys will typically under-represent: those in fragile, disjointed or multiple occupancy households; those in urban slums; and may omit certain areas of a country deemed to pose a security risk. Those six sub-groups constitute a pretty comprehensive ostensive definition of the ‘poorest of the poor’.MethodsThis paper documents these omissions in general, drawing on worldwide literature about the theory and practice of implementing censuses and household surveys; and shows how substantial proportions are missing from both censuses and the sample frames of surveys.ResultsThis paper suggests that between 300 and 350 million will effectively be missed worldwide from the sampling frames of such surveys and from most censuses. The impact on the health MDGs is illustrated for the five republics of the former Soviet Union making up Central Asia: Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan.ConclusionsIt is impossible to assess progress towards or away from the MDGS in both the Central Asian Republics and worldwide. It is urgent to find solutions to the problem of the ‘missing’ poor population sub-groups.
Highlights
For several decades, and in some countries for centuries, populations have been counted through national, usually decennial, censuses in which enumerators go to households
Many countries run national economic and social surveys to provide detailed information on consumer prices, income and employment, and other relevant data for planning. This move away from censuses to relying on surveys raises the obvious problem that drawing a sample for a survey depends on having a sampling frame in the first place which is frequently based on the census
In assessing the absolute level of poverty or the absolute levels of illness household surveys are an inappropriate instrument for obtaining information about the poorest of the poor, especially in developing countries. This is because household surveys, with rare exceptions, typically omit by design: 1. those not in households because they are homeless; 2. those who are in institutions, including refugee camps; 3. mobile, nomadic, or pastoralist populations
Summary
In some countries for centuries, populations have been counted through national, usually decennial, censuses in which enumerators go to households. The few surveys that have been conducted in those slums show sharp gradients according to income quintiles within urban populations.[25] But given the very high levels of mobility, it would seem reasonable to assume that a substantial minority of those households in the slum areas of developing country cities are uncounted in any census. Even where they are counted in censuses, many would (because of interviewer reluctance) in practice be excluded from sampling frames. Given the security situation – or difficulty of transport - in many countries, it can often be difficult for the implementing institutions to carry out a fully representative survey or census
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