Demographic and Health Surveys

Demographic and Health Surveys

Overview
The MEASURE Demographic and Health Surveys (DHS) Project is responsible for collecting and disseminating accurate, nationally representative data on health and population in developing countries. The project is implemented by Macro International, Inc. (now ICF International
ICF International
ICF International , formerly known as ICF Consulting, is a management, technology, and policy consulting firm based in Fairfax, Virginia...

) and is funded by the United States Agency for International Development
United States Agency for International Development
The United States Agency for International Development is the United States federal government agency primarily responsible for administering civilian foreign aid. President John F. Kennedy created USAID in 1961 by executive order to implement development assistance programs in the areas...

 (USAID
United States Agency for International Development
The United States Agency for International Development is the United States federal government agency primarily responsible for administering civilian foreign aid. President John F. Kennedy created USAID in 1961 by executive order to implement development assistance programs in the areas...

) with contributions from other donors such as UNICEF, UNFPA, WHO
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...

, and UNAIDS.

The DHS is highly comparable to the Multiple Indicator Cluster Surveys and the technical teams developing and supporting the surveys are in close collaboration.

Since October 2003 Macro International has been partnering with four internationally experienced organizations to expand access to and use of the DHS data: Johns Hopkins Bloomberg School of Public Health Center for Communication Programs; Program for Appropriate Technology in Health (PATH
Program for Appropriate Technology in Health
The Program for Appropriate Technology in Health is an international, nonprofit global health organization based in Seattle, Washington , with 900+ employees in more than 30 offices around the world. Its president and CEO is Dr...

); Blue Raster; CAMRIS International; and The Futures Institute.

Since 1984, the MEASURE DHS Project has provided technical assistance to more than 260 demographic and health surveys in over 90 countries - advancing global understanding of health and population trends in developing countries.
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Quotations

My duty is not affected by what others may or may not do to discharge their own.

quote from Honor Harrington

But what kept them on their feet when there was no sane reason for hope were the bonds between them, loyalty to one another, the knowledge others depended on them even as they depended on those others. And sometimes, all too rarely, it came down to a single person it was simply unthinkable to fail. Someone they knew would never quit on them, never leave them in the lurch.

The world's best swordsman doesn't fear the second best; he fears the worst swordsman, because he can't predict what the idiot will do.

quote from Honor Harrington

But the universe wasn't really unfair, she thought, and her mouth quirked. It just didn't give much of a damn one way or the other.

I suppose I ought to think up some dramatic, quotable phrase for Public Information and the history books, but I'm damned if any of them come to mind. Besides, admitting the truth wouldn't sound too good (...) The truth, Russell, is that now the moment's here, I'm scared shitless. Somehow I don't think even Public Information could turn that into good copy.

quote from Havenite Admiral Amos Parnell, after ordering his fleet to depart for the opening attack of the Haven-Manticore War.

… Henke sensed her terrifying aptitude for destruction as never before. Henke had feared for her sanity; now she knew the truth was almost worse than that. Honor wasn't insane — she simply didn't care. She'd lost not only her sense of balance but any desire to regain it.

Michelle Henke considering Honor Harrington's state of mind

Perhaps his love for her made him less than impartial, but he also knew how deeply she'd been hurt and chided her for judging herself so much more harshly than she would have judged someone else…

"Oh, Christ! We're all gonna die. You seen the kinds'a casualty lists she comes up with?"

Encyclopedia
The MEASURE Demographic and Health Surveys (DHS) Project is responsible for collecting and disseminating accurate, nationally representative data on health and population in developing countries. The project is implemented by Macro International, Inc. (now ICF International
ICF International
ICF International , formerly known as ICF Consulting, is a management, technology, and policy consulting firm based in Fairfax, Virginia...

) and is funded by the United States Agency for International Development
United States Agency for International Development
The United States Agency for International Development is the United States federal government agency primarily responsible for administering civilian foreign aid. President John F. Kennedy created USAID in 1961 by executive order to implement development assistance programs in the areas...

 (USAID
United States Agency for International Development
The United States Agency for International Development is the United States federal government agency primarily responsible for administering civilian foreign aid. President John F. Kennedy created USAID in 1961 by executive order to implement development assistance programs in the areas...

) with contributions from other donors such as UNICEF, UNFPA, WHO
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...

, and UNAIDS.

The DHS is highly comparable to the Multiple Indicator Cluster Surveys and the technical teams developing and supporting the surveys are in close collaboration.

Since October 2003 Macro International has been partnering with four internationally experienced organizations to expand access to and use of the DHS data: Johns Hopkins Bloomberg School of Public Health Center for Communication Programs; Program for Appropriate Technology in Health (PATH
Program for Appropriate Technology in Health
The Program for Appropriate Technology in Health is an international, nonprofit global health organization based in Seattle, Washington , with 900+ employees in more than 30 offices around the world. Its president and CEO is Dr...

); Blue Raster; CAMRIS International; and The Futures Institute.

About MEASURE DHS


Since 1984, the MEASURE DHS Project has provided technical assistance to more than 260 demographic and health surveys in over 90 countries - advancing global understanding of health and population trends in developing countries. More specifically, the DHS surveys collect information on fertility
Fertility
Fertility is the natural capability of producing offsprings. As a measure, "fertility rate" is the number of children born per couple, person or population. Fertility differs from fecundity, which is defined as the potential for reproduction...

 and total fertility rate
Total Fertility Rate
The total fertility rate of a population is the average number of children that would be born to a woman over her lifetime if she were to experience the exact current age-specific fertility rates through her lifetime, and she...

 (TFR), reproductive health
Reproductive health
Within the framework of the World Health Organization's definition of health as a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity, reproductive health, or sexual health/hygiene, addresses the reproductive processes, functions and system...

, maternal health
Maternal health
Maternal health refers to the health of women during pregnancy, childbirth, and the postpartum period. It encompasses the health care dimensions of family planning, preconception, prenatal, and postnatal care in order to reduce maternal morbidity and mortality.Preconception care can include...

, child health, immunization
Immunization
Immunization, or immunisation, is the process by which an individual's immune system becomes fortified against an agent ....

 and survival
Child survival
Child survival is a field of public health concerned with reducing child mortality. Child survival interventions are designed to address the most common causes of child deaths that occur, which includes diarrhea, pneumonia, malaria, and neonatal conditions...

, HIV
HIV
Human immunodeficiency virus is a lentivirus that causes acquired immunodeficiency syndrome , a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive...

/AIDS
AIDS
Acquired immune deficiency syndrome or acquired immunodeficiency syndrome is a disease of the human immune system caused by the human immunodeficiency virus...

; maternal mortality
Maternal death
Maternal death, or maternal mortality, also "obstetrical death" is the death of a woman during or shortly after a pregnancy. In 2010, researchers from the University of Washington and the University of Queensland in Brisbane, Australia, estimated global maternal mortality in 2008 at 342,900 , of...

, child mortality
Child mortality
Child mortality, also known as under-5 mortality, refers to the death of infants and children under the age of five. In 2010, 7.6 million children under five died , down from 8.1 million in 2009, 8.8 million in 2008, and 12.4 million in 1990. About half of child deaths occur in Africa....

, malaria
Malaria
Malaria is a mosquito-borne infectious disease of humans and other animals caused by eukaryotic protists of the genus Plasmodium. The disease results from the multiplication of Plasmodium parasites within red blood cells, causing symptoms that typically include fever and headache, in severe cases...

, and nutrition among women and children stunted. The strategic objective of MEASURE DHS is to improve and institutionalize the collection and use of data by host countries for program monitoring and evaluation and for policy development decisions.

MEASURE DHS is one of four components of the “Monitoring and Evaluation to Assess and Use Results” (MEASURE) effort begun in 1997. The other three MEASURE partner projects are MEASURE Evaluation, MEASURE U.S. Census Bureau-SCILS, and MEASURE CDC/DRH in cooperation with the CDC
Centers for Disease Control and Prevention
The Centers for Disease Control and Prevention are a United States federal agency under the Department of Health and Human Services headquartered in Druid Hills, unincorporated DeKalb County, Georgia, in Greater Atlanta...

.

Surveys


MEASURE DHS supports a range of data collection options:
  • Demographic and Health Surveys (DHS): provide data for a wide range of monitoring and impact evaluation indicators in the areas of population, health, and nutrition.
  • AIDS Indicator Surveys (AIS): provide countries with a standardized tool to obtain indicators for the effective monitoring of national HIV/AIDS programs.
  • Service Provision Assessment (SPA) Surveys: provide information about the characteristics of health and family planning services available in a country.
  • Malaria Indicators Surveys (MIS): Provide data on bednet ownership and use, prevention of malaria during pregnancy, and prompt and effective treatment of fever in young children. In some cases, biomarker testing for malaria and anemia are also included.
  • Key Indicators Survey (KIS): provide monitoring and evaluation data for population and health activities in small areas—regions, districts, catchment areas—that may be targeted by an individual project, although they can be used in nationally representative surveys as well.
  • Other Quantitative Data: include Geographic Data Collection, and Benchmarking Surveys.
  • Biomarker Collection: in conjunction with surveys, more than 2 million tests have been conducted for HIV, anemia, malaria, and more than 25 other biomarkers.
  • Qualitative Research: provides informed answers to questions that lie outside the purview of standard quantitative approaches.

Data


MEASURE DHS works to put survey data into the hands of program managers, health care providers, policymakers, country leaders, researchers, members of the media, and others who can act to improve public health. MEASURE DHS distributes unrestricted survey data files for legitimate academic research at no cost.

Online databases include: STATcompiler, STATmapper, HIV/AIDS Survey Indicators Database, HIV Spatial Data Repository, HIVmapper, and Country QuickStats.

Publications


MEASURE DHS produces a variety of publications that provide country specific and comparative data on population, health, and nutrition in developing countries. Most publications are available online for download, but if an electronic version of the publication is not available, a hard copy may be available.

Countries


The MEASURE DHS Project has been active in over 90 countries in Africa
Africa
Africa is the world's second largest and second most populous continent, after Asia. At about 30.2 million km² including adjacent islands, it covers 6% of the Earth's total surface area and 20.4% of the total land area...

, Asia
Asia
Asia is the world's largest and most populous continent, located primarily in the eastern and northern hemispheres. It covers 8.7% of the Earth's total surface area and with approximately 3.879 billion people, it hosts 60% of the world's current human population...

, Central Asia
Central Asia
Central Asia is a core region of the Asian continent from the Caspian Sea in the west, China in the east, Afghanistan in the south, and Russia in the north...

; West Asia; and Southeast Asia
Southeast Asia
Southeast Asia, South-East Asia, South East Asia or Southeastern Asia is a subregion of Asia, consisting of the countries that are geographically south of China, east of India, west of New Guinea and north of Australia. The region lies on the intersection of geological plates, with heavy seismic...

, Latin America
Latin America
Latin America is a region of the Americas where Romance languages  – particularly Spanish and Portuguese, and variably French – are primarily spoken. Latin America has an area of approximately 21,069,500 km² , almost 3.9% of the Earth's surface or 14.1% of its land surface area...

 and the Caribbean
Caribbean
The Caribbean is a crescent-shaped group of islands more than 2,000 miles long separating the Gulf of Mexico and the Caribbean Sea, to the west and south, from the Atlantic Ocean, to the east and north...

. A list of the publications for each country is available online at the Measure DHS web site.

The MEASURE DHS Project has been active in the following countries:
A
 Afghanistan  Albania  Armenia
 Angola  Azerbaijan

B
 Bangladesh  Botswana  Burundi
 Benin  Brazil
 Bolivia

C
 Cape Verde  Central African Republic  Chad  Republic of the Congo
 Cambodia  Colombia  Democratic Republic of the Congo
 Cameroon  Comoros  Côte d'Ivoire

D
 Dominican Republic

E
 Ecuador  El Salvador  Ethiopia
 Egypt  Eritrea

G
 Gabon  Guatemala  Guyana
 Ghana  Guinea

H
 Haiti  Honduras

I
 India  Indonesia

J
 Jordan

K
 Kazakhstan  Kenya  Kyrgyzstan

L
 Lesotho  Liberia

M
 Madagascar  Mauritania  Morocco
 Malawi  Maldives  Mexico  Mozambique
 Mali  Moldova  Myanmar

N
 Namibia  Nicaragua  Nigeria
 Nepal  Niger

O
Ondo State
Ondo State
Ondo State, Nigeria was created on 3 February 1976 from the former Western State. It originally included what is now Ekiti State, which was split off in 1996. Akure is the state capital.-Government and society:...


P
 Pakistan  Peru
 Paraguay  Philippines

R
 Rwanda

S
 Samoa  São Tomé and Príncipe  South Africa  Sudan
 Senegal  Sierra Leone  Sri Lanka  Swaziland

T
 Tanzania  Trinidad and Tobago  Turkmenistan
 Thailand  East Timor  Tunisia
 Togo  Turkey

U
 Uganda  Ukraine  Uzbekistan

V
 Vietnam

Y
 Yemen

Z
 Zambia  Zimbabwe

HIV/AIDS


Since 2001, MEASURE DHS has helped more than 15 countries in Africa, Asia and Latin America and Caribbean conduct population-based HIV testing. By collecting blood for HIV testing from representative samples of the population of men and women in a country, MEASURE DHS can provide nationally representative estimates of HIV rates. The testing protocol provides for anonymous, informed, and voluntary testing of women and men.

The project also collects data on internationally recognized AIDS indicators. Currently, the main sources of HIV/AIDS indicators in the database are the Demographic and Health Surveys (DHS), the Multiple Indicator Cluster Survey
Multiple Indicator Cluster Survey
The Multiple Indicator Cluster Surveys are a survey program developed by the United Nations Children's Fund to provide internationally comparable, statistically rigorous data on the situation of children and women. The first round of surveys was carried out in over 60 countries in 1995 in...

s (MICS), the Reproductive Health Surveys (RHS), the Sexual Behavior Surveys (SBS), and Behavioral Surveillance Surveys (BSS). Eventually it will cover all countries for which indicators are available. Finally, the project also collects data on the capacity of health care facilities to deliver HIV prevention and treatment services.

Malaria


Since 2000, DHS (and some AIS) surveys have collected data on ownership and use of mosquito nets, treatment of fever in children, and intermittent preventive treatment of pregnant women. In recent years, additional questions on indoor residual spraying, as well as biomarker testing for anemia and malaria have been conducted.

Gender


The MEASURE DHS program is a major source of gender data, research and training for integrating gender into population, health and nutrition programs and HIV/AIDS-related activities in the developing world. Gender is a fundamental dimension of societal stratification. MEASURE DHS underscores the importance of providing accurate and useful data on gender and emphasizes the need to identify and develop meaningful indicators of gender relations and women's empowerment.

Questions on gender roles and empowerment are integrated into most DHS questionnaires. For countries interested in more in-depth data on gender, modules of questions are available on special topics such as status of women, domestic violence
Domestic violence
Domestic violence, also known as domestic abuse, spousal abuse, battering, family violence, and intimate partner violence , is broadly defined as a pattern of abusive behaviors by one or both partners in an intimate relationship such as marriage, dating, family, or cohabitation...

, and female genital cutting
Female genital cutting
Female genital mutilation , also known as female genital cutting and female circumcision, is defined by the World Health Organization as "all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons."FGM...

.

Youth


MEASURE DHS has interviewed thousands of young people and gathered valuable information about their education, employment, media exposure, nutrition, sexual activity, fertility, unions, and general reproductive health, including HIV prevalence.
The Youth Corner in the MEASURE DHS website presents findings about youth and features in-depth profiles of young adults ages 15–24 from more than 30 countries worldwide. The Youth Corner is part of the broader effort by the Interagency Youth Working Group (IYWG) to help program managers, donors, national and local governments, teachers, religious leaders, and nongovernmental organizations (NGOs) plan and implement strong, relevant programs to improve the reproductive health of young adults.

Geographic Information


Geographic location affects peoples’ health, nutrition, and access to health care services. The MEASURE DHS project can now analyze the impact of location using DHS data and geographic information systems (GIS). MEASURE DHS routinely collects geographic information in all surveyed countries. Using GIS, researchers can link DHS data with routine health data, health facility locations, local infrastructure such as roads and rivers, and environmental conditions.

MEASURE DHS is a recognized leader in training local interviewers to collect geographic information. The GPS data collection standards and manual prepared by MEASURE DHS are now being used for the World Bank
World Bank
The World Bank is an international financial institution that provides loans to developing countries for capital programmes.The World Bank's official goal is the reduction of poverty...

’s Living Standards and Measurement studies and the World Health Organization’s World Health Surveys. UNICEF has also adapted the DHS manual for their Multiple Indicator Cluster Survey
Multiple Indicator Cluster Survey
The Multiple Indicator Cluster Surveys are a survey program developed by the United Nations Children's Fund to provide internationally comparable, statistically rigorous data on the situation of children and women. The first round of surveys was carried out in over 60 countries in 1995 in...

s in the upcoming round of data collection.

Biomarkers


Now, using field-friendly technologies, MEASURE DHS is able to collect biomarker data relating to a wide range of conditions and infections. DHS surveys have tested for anemia
Anemia
Anemia is a decrease in number of red blood cells or less than the normal quantity of hemoglobin in the blood. However, it can include decreased oxygen-binding ability of each hemoglobin molecule due to deformity or lack in numerical development as in some other types of hemoglobin...

 (by measuring hemoglobin
Hemoglobin
Hemoglobin is the iron-containing oxygen-transport metalloprotein in the red blood cells of all vertebrates, with the exception of the fish family Channichthyidae, as well as the tissues of some invertebrates...

), HIV infection, sexually transmitted diseases such as syphilis and the herpes simplex virus, serum retinol (Vitamin A
Vitamin A
Vitamin A is a vitamin that is needed by the retina of the eye in the form of a specific metabolite, the light-absorbing molecule retinal, that is necessary for both low-light and color vision...

), lead exposure, high blood pressure, and immunity from vaccine-preventable diseases like measles and tetanus. Traditionally, much of the data gathered in DHS surveys is self-reported. Biomarkers complement this information by providing an objective profile of a specific disease or health condition in a population. Biomarker data also contribute to the understanding of behavioral risk factors and determinants of different illnesses.

External links