26 Dec 2018

35 Years of DHS…and 5 More to Come

What was happening in the world in 1984?

  • The AIDS virus was identified
  • Indira Gandhi was assassinated
  • Michael Jackson moonwalked and won awards for his “Thriller” album
  • Apple released the first MacIntosh computer
  • Famine in Ethiopia sparked worldwide attention

And…

A lot has changed in 35 years in the world and at the DHS project; what has not changed is that The DHS Program at ICF remains USAID’s flagship project for collecting data on population and health around the world. In September 2018, USAID awarded ICF and partners the 8th iteration of The Demographic and Health Surveys Program, which will run from 2018-2023.  Six internationally experienced organizations are partnering with ICF to expand access to and use of the DHS data including Avenir Health, Blue Raster, EnCompass, Johns Hopkins Center for Communication Programs, PATH, and Vysnova.

DHS-8 will build on the long history of DHS surveys, focusing on the collection of quality population and health data in approximately 50 countries while helping to strengthen the capacity of local implementing agencies to conduct population-based surveys.  DHS-8 also offers several enhancements, including a new Science Advisor position, who will focus on innovations in data collection and biomarkers (stay tuned for a new blog series on innovation!), an expanded virtual learning portfolio, and additional emphasis on sub-national dissemination to support evidence-based decision making.

“We are honored and eager to continue The Demographic and Health Surveys Program,” says Project Director, Dr. Sunita Kishor.  “Our staff are incredibly proud of the work we do, and we are grateful for the opportunity to continue to evolve by pursuing even greater data quality, new innovations, and deepening relationships with our valued colleagues across the globe.”

18 Dec 2018

Thermal Care and Umbilical Cord Care Practices and Their Associations with Newborn Mortality

The global public health agenda spotlight is increasingly focused on reducing preventable newborn deaths. Skilled care at birth and delivery in a health facility equipped with life-saving medical technologies is a clear path to prevention. However, many women continue to deliver at home, impeded by lack of access to a health facility, concerns of sub-par quality at nearby facilities, or financial constraints where healthcare is not well subsidized.

Steps can be taken immediately after birth that may improve the chance of newborn survival and can be applied with nominal costs. Keeping infants warm—thermal care—and preventing infection where the umbilical cord was cut—hygienic cord care—are two key practices.

The DHS Program undertook efforts in 2014 in order to improve the assessment of newborn care practices. They worked with the recommendations from the Newborn Care Technical Working Group to:

  1. Develop an optional Supplemental Module on Maternal Health Care with a standardized set of questions assessing newborn care. This module collects information on drying, bathing, cord cutting, and cord care including the application of chlorhexidine.
  2. Add questions to the DHS-7 core questionnaire regarding care at the time of birth, pre and post-discharge contacts for mothers and newborns, the content of postnatal care for newborns, and other essential newborn care practices (immediate skin-to-skin, early initiation of breastfeeding).

Questions related to thermal care and cord care have been included in some DHS surveys since 2003, a total of 16 surveys conducted between 2003-2016 in 10 countries: Bangladesh, Ethiopia, Ghana, India, Morocco, Nepal, Nigeria, Pakistan, Sierra Leone, and Timor Leste.

A Journal of Global Health Collection on Measuring Coverage of Essential Maternal and Newborn Care Interventions: An Unfinished Agenda issued a call for action to use these data to track progress over time and make comparisons between countries in order to assess whether newborns are receiving life–saving interventions, prompting The DHS Program to conduct further analyses.

This recent DHS Analytical Study (68) sought to explore three things: 1) what’s been happening with these practices over time; 2) is there an association between these practices and newborn deaths among home births; and 3) what factors predict these practices among home births?  The analysis includes an in-depth exploration of newborn care in three South Asian countries: Bangladesh, India, and Nepal.

Key Findings

  • In countries with more than one survey available, coverage of recommended thermal care and hygienic cord care practices increased over time, with more frequent application among facility births than home births.
  • Among home births in South Asia, skilled care during pregnancy and birth increased the odds of receiving the recommended practices.
  • In Bangladesh and Nepal, application of an antiseptic (chlorhexidine or an unspecified antibiotic or antiseptic) to the cord was highly protective against newborn mortality compared with dry cord care.
  • Among newborns who died, there was a high proportion of missing responses regarding recommended behaviors.

These findings highlight the importance of cord care in preventing newborn mortality as well as the importance of skilled care during pregnancy and birth for the implementation of recommended practices. Although thermal care did not predict newborn survival, sample size and missing cases limited the analyses. The findings also suggest that the recall or reporting of details around the traumatic event of newborn death may be incomplete.

While the analysis could not control for all potential cofactors of newborn mortality and receipt of care, this report provides additional insight on important predictors of these outcomes in several countries, including mothers’ education, household wealth, and maternal age as well as the sex of the baby.

A research article adapated from this report can be found on the BMC Pediatrics Journal.

Photo Credit: © 2011 Faisal Azim, Courtesy of Photoshare


Written by Jennifer Yourkavitch and Lindsay Mallick

Jennifer Yourkavitch, MPH, PhD, IBCLC is an epidemiologist whose research and program work focuses on documenting and addressing determinants of health, particularly in relation to lactation and breastfeeding practices; maternal and child health and nutrition; HIV/AIDS, malaria and other infectious diseases; gender; equity; health systems; and, service delivery around the world. In her 14 years with ICF, Dr. Yourkavitch has helped various clients to plan, implement, monitor and evaluate health programs, including WHO, USAID, PMI, CDC, and dozens of NGOs. She conducts population health research with the Demographic and Health Surveys Program and the University of North Carolina in Chapel Hill and Greensboro.

Lindsay Mallick joined The DHS Program via Avenir Health in 2014. As a Senior Research Associate for The DHS Program’s Analysis team, she conducts research using data from both DHS and SPA surveys on health services and outcomes related to reproductive, maternal, newborn, and child health. She has an MPH in International Health and Development from Tulane University and served in the Peace Corps in Mauritania, West Africa. Prior to joining The DHS Program, Ms. Mallick fulfilled two consecutive fellowship roles as an epidemiologist for the US Air Force and then the US Army.

03 Dec 2018

16 Days of Activism against Gender-based Violence

We are halfway through the 16 days of Activism against Gender-based Violence, but there is still time to get involved. The DHS Program has a variety of resources to help you learn about the prevalence of violence against women around the world.

Since 2000, The DHS Program has collected domestic violence data in more than 50 countries. Explore the domestic violence results in five recently released Demographic and Health Surveys from the Philippines, Senegal, Haiti, Timor-Leste, and Uganda in a new infographic developed for this year’s 16 Days of Activism against Gender-based Violence.

Share our infographic using the links below.  

Share the #16days infographic on Facebook

Tweet the #16days infographic

Additionally, try our easy-to-use mini tool to compare indicators of gender inequality, women’s empowerment, gender norms, and more. For even more domestic violence data, you can visualize these indicators by background characteristics, over time, and across countries using STATcompiler

Photo Credit: © 2004 Syed Ziaul Habib Roobon, Courtesy of Photoshare

 

The information provided on this Web site is not official U.S. Government information and does not represent the views or positions of the U.S. Agency for International Development or the U.S. Government.

The DHS Program, ICF
530 Gaither Road, Suite 500, Rockville, MD 20850
Tel: +1 (301) 407-6500 • Fax: +1 (301) 407-6501
dhsprogram.com

Anthropometry measurement (height and weight) is a core component of DHS surveys that is used to generate indicators on nutritional status. The Biomarker Questionnaire now includes questions on clothing and hairstyle interference on measurements for both women and children for improved interpretation.