Category Archives: News

06 Aug 2019

DHS Program Analysis Highlights: Summer 2019

Many students and faculty are out of school at this time of year, but The DHS Program’s analysis team is busy at work. In addition to finalizing their annual analytical papers, the team continues to support country-specific further analysis, train Fellows, write code to share with other researchers, and support data quality improvements.

Here are some of the highlights of 2019 so far:

  • The DHS Program hosted a showcase of the major findings from a dozen further analysis papers based on the 2015-16 Myanmar Demographic and Health Survey in Yangon in early July. More than 50 population and health professionals in Myanmar participated in DHS data analysis trainings, resulting in the publication of 9 papers now available on The DHS Program website. Several more will be published in the coming months.
  • Another class of DHS Fellows has graduated! This year, 6 teams from universities in Afghanistan, Indonesia, Myanmar, Ethiopia, Ghana, and Senegal have prepared working papers in areas covering child vaccination, nutrition, malaria, contraceptive discontinuation, men’s family planning, and HIV testing.
2019 DHS Fellows Program facilitators and participants. © ICF
  • A recent analysis workshop in Ghana linked research to action by integrating policy brief writing with statistical analysis of data from the 2017 Ghana Maternal Health Survey. Proposed policy recommendations address inequalities and advocate for programs that protect and promote the health of women. Policy briefs will be published soon on The DHS Program website.
Participants from the policy brief writing workshop in Ghana. © ICF

Coming Soon in 2019!

  • By geographically linking SPA and DHS data, two upcoming working papers explore the relationship between the antenatal care service environment and maternal health behaviors including iron-folic acid consumption and early breastfeeding. Working Papers 160 and 161 will be published in mid-August.
  • What are the determinants of child marriage in Asia? In Bangladesh and Nepal, marriage by age 15 is more common in clusters where women’s acceptance of wife-beating is more prevalent. Find out more in Analytical Studies 69.
  • Do regional disparities in fertility preferences and family planning satisfied by modern methods persist when controlling for poverty? Analytical Report 7 will explore this question for 12 DHS Program countries and 3 groups of absolute poverty measurements.
  • The DHS Program explores strategies to identify potential data quality issues after data collection in Methodological Report 26.
  • For the first time, summary briefs will be available for almost all analytical studies and comparative reports published this year. Briefs will feature figures and maps and easily digestible bullets of key findings for a variety of audiences.

Featured photo: © 2014 C. Hanna-Truscott/Midwives for Haiti, Courtesy of Photoshare

25 Jul 2019

Mauritanian MOH Prepares for First Mauritania DHS Survey since 2001

After almost 20 years, The DHS Program is thrilled to be supporting the Mauritanian Ministry of Health in the implementation of a Demographic and Health Survey. On March 26, 2019, we were honored to welcome his Excellency the Minister of Health of the Islamic Republic of Mauritania, Pr. Kane Boubacar, along with Dr. Naceredine Ouldzeidoune of the World Health Organization (WHO) in Mauritania, and Dr. Moustapha Mohamedou, Director-General of the Mauritania Institut d’Hépato-Virologie to The DHS Program office in Rockville, Maryland.

The Minister and Dr. Ouldzeidoune provided opening remarks, highlighting the great demand for DHS data in Mauritania. Sunita Kishor, the Director of The DHS Program, presented the history, objectives, and methodology of The DHS Program. Other key staff presented on the survey design and biomarker collection aspects of the upcoming 2019-20 Mauritania DHS (L’Enquête Démographique et de Santé de Mauritanie or EDSM). Madeleine Short Fabic, Public Health Advisor at USAID, also participated in the meeting.

There is a high level of interest among health stakeholders in Mauritania in this survey, as it will provide an opportunity for trend analysis as well as several new indicators. In addition to the standard DHS indicators, the survey will include maternal mortality, hepatitis B testing among those age 1-59 years, and malaria prevalence among children age 6-59 months.

The DHS Program looks forward to working with the Government of Mauritania, WHO, and other survey stakeholders to support the 2019-20 EDSM.



(photo left to right): Mamadou Diallo (Data Processing Specialist), Guillermo Rojas (Chief of Data Processing), Cameron Taylor (Malaria Advisor), Dr. Moustapha Mohamedou (Director-General of the Mauritania Institut d’Hépato-Virologie), Hamdy Moussa (Survey Manager), Gisele Dunia (Capacity Strengthening Advisor), Dean Garrett (Senior Laboratory and Biomarker Advisor), Dr. Naceredine Ouldzeidoune (WHO Mauritania), Julia Fleuret (Survey Manager for Mauritania), Sunita Kishor (DHS Program Director), Leo Ryan (Senior Vice President, ICF), Pr. Kane Boubacar (Minister of Health of the Islamic Republic of Mauritania), Jose Miguel Guzman (Regional Coordinator), Madeleine Short Fabic (Public Health Advisor, USAID), and Peter Aka (Lead Epidemiologist). ©ICF

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.”

28 Feb 2018

DHS Data in the News

Journalists worldwide use DHS, MIS, and SPA surveys as source data for essential stories – stories about domestic violence, HIV prevention, and child survival. Coverage of these topics brings awareness to these critical issues and often prompts policy change.

In any given month, DHS Program data are cited in hundreds of print, television, radio, and digital media across the world. While we can’t possibly review and share every example of accurate DHS data coverage in the news, we do highlight some of the best examples in The DHS Program’s News Room. The results from India’s 2015-16 National Family Health Survey have been featured in India’s biggest newspapers, and topics range from anemia prevalence to child marriage. A recent article from the Midrand Report in South Africa cites condom use data from the 2016 South Africa Demographic and Health Survey as an argument for voluntary male circumcision, and a Ghana News Agency article highlights adolescents’ needs for reproductive health services.

Using data from a reputable source like a DHS survey adds credibility and context to journalistic reporting. But covering topics such as mortality, fertility, and disease prevalence is not simple, and journalists often struggle to interpret DHS survey results and write about demographic and health data in language that is accessible for their audiences. Following a survey’s national release, The DHS Program’s dissemination team facilitates a workshop to educate journalists on reading and understanding DHS tables, accessing comparable data, and using data in reporting. Learn more about these media trainings in this reflections piece on a Journalist Workshop in Togo.

The DHS Program also has user-friendly tools, such as STATcompiler and the mobile app that allow journalists to verify the accuracy of DHS data used in their reporting. In addition to featuring news that accurately cites DHS data, we have a Journalists’ Guide to the Demographic and Health Surveys, available in both English and French. This guide provides tips on how journalists can properly use DHS data in their stories.

Connect with us on Facebook, Twitter, LinkedIn, or email press@dhsprogram.com to share your accurate news story with DHS data for a chance to be featured in The DHS Program’s News Room.

Photo credits: 1) Officials from the Ethiopia Ministry of Health and Central Statistics Agency answer questions at the 2016 Ethiopia DHS National Seminar press conference © 2017, ICF; 2) Dr. Thet Thet Mu of the Myanmar Ministry of Health and Sports responds to questions from the press at the launch of the 2015-16 Myanmar DHS. © 2017, ICF

22 Feb 2018

A New Way to Interact with your Favorite Indicators

We are pleased to showcase a new mini-tool on our website that allows you to quickly interact with indicators for topics such as family planning, gender, malaria, and nutrition. We have preselected 10-15 key indicators per topic that you can view by country or globally.

Simply navigate to your favorite topic to see a trend visualization from the most recently released survey. Then, select either a country or indicator within the drop-down menus to instantly see results. To start over, click “Reset” to return to the featured trend graphic.

Indicators are pulled from The DHS Program Application Programming Interface (API). As you click on a country or indicator within the data table, hyperlinks direct you to STATcompiler. There, you can compare even more indicators over time and geographically.

With the 1,000s of demographic and health indicators available, grouping key indicators by topic allows you to quickly interact with DHS data. Visit The DHS Program Topics page for a list of the featured topic pages containing the mini-tool.

What other topics do you want to see? Let us know what you think in the comments section below! Don’t forget to subscribe to The DHS Program newsletter for more updates on our digital tools, surveys, and more.

Photo Credit: © 2001 Marcel Reyners, Courtesy of Photoshare

27 Dec 2017

The Best of DHS 2017

Another year has passed at The DHS Program, and we’re looking back at some of our best moments throughout the year! Just to name a few:

    

  • We introduced the first DHS Program online sampling course.

 Happy New Year from The DHS Program!

Watch the full video here:

16 Nov 2017

José Miguel Guzmán Elected 2017 IUSSP Laureate

We are honored to announce that The DHS Program’s Regional Coordinator, José Miguel Guzmán, was recently named the 2017 International Union for the Scientific Study of Population (IUSSP) Laureate. He was elected by the IUSSP Council in recognition of his lifetime achievements in population issues and influence on research, training, and public policy.

Earlier this month, IUSSP organized the International Population Conference in Cape Town, South Africa, drawing more than 2,000 scholars, policymakers, and government officials to discuss the latest in population research. Each year IUSSP honors one of their members by bestowing its laureate award. The laureate honoree is nominated by IUSSP council members and selected by secret ballot. The candidate must be a member of IUSSP for 20 years and be nominated by five or more IUSSP members from different countries.

The DHS Program is proud of José Miguel’s contribution to population and social policy, capacity strengthening, research and service for the last four decades.  Congratulations, José Miguel Guzmán!

Watch the full Facebook Live stream of the IUSSP award ceremony in Cape Town, South Africa. Click here to watch on the IUSSP Facebook page, or watch the video below.

International Union for the Scientific Study of Population – IUSSP award ceremony
IUSSP Laureate ceremony in honor of José Miguel Guzman Molina

Posted by International Population Conference on Monday, October 30, 2017



José Miguel Guzmán, Regional Coordinator
Before joining The DHS Program, Dr. Guzman was the Chief of the Population and Development Branch at UNFPA, New York. Dr. Guzman brings to the regional coordinator role more than 25 years of experience in research, capacity strengthening, and data collection on population and health issues, including population dynamics and interlinkages with poverty, environment and climate change, aging and other related issues. Dr. Guzman has more than 15 years of experience in managerial and supervisory roles in international programs. Dr. Guzman has provided technical assistance to more than 30 countries, in Latin America,  Africa, and Asia and has extensive experience in translating data for non-technical audiences. Guzman has received several awards, including the 2017 IUSSP Laureate Award.

Photo Credit: Courtesy of the International Population Conference Facebook Live Stream

26 Jul 2017

Five Ways IPUMS-DHS Can Simplify Your Life

Have you ever formatted what you thought were your final models only to discover that:

  • The survey question you used for your dependent variable had five rather than four variations across surveys?
  • There are two other samples (not in your analysis) in which respondents were asked precisely the question that interests you?
  • There is a better question on women’s employment than the one you’re currently using?
  • A key question was asked about all daughters under 14 in one country but all daughters under 19 in another?
  • The survey skip patterns differ significantly across surveys?

These are among the DHS equivalents of missing the nail and hammering your thumb. Ouch!

Fortunately, with IPUMS-DHS, you can put the metaphorical Band-Aids away. IPUMS-DHS, constructed at the Minnesota Population Center, is a web-based tool for accessing DHS data. It makes error-free comparative analysis (across time or countries) easy. IPUMS-DHS currently covers Africa and Asia and includes 23 countries, 101 samples, and 5000 variables. Why not give it a try?

1) See at a glance which surveys asked certain questions, how, and of whom.

Choose a topic from the drop-down list to see which samples include the groups of questions you want. Click on a variable name to see a comparison across countries. The tabs will guide you to codes and a description (which is especially great for constructed variables, like “Unmet Need”) and a discussion of comparability issues.

2) Compare the frequency of responses to questions and more without downloading a data file.

Clicking on the variable name will also bring up, for every sample, frequencies of responses, an explanation of who was asked the question (called the “Universe”) and an English-language version of the question text.

3) Trust that the same variable name and codes have same substantive content.

While the DHS standard variables simplify researchers’ work, even standard variables (such as V130, RELIGION) may have different responses or varying amounts of detail across samples. Non-standard variables’ names differ widely across DHS samples. IPUMS-DHS gives variables with the same substantive meaning consistent names and codes. This “integration” of the DHS data lets you analyze the data immediately, without investigating and resolving differences across samples.

 

4) Create a customized data file with multiple samples in minutes, and change it just as quickly.

With IPUMS-DHS, you can create a dataset tailored to your specific needs in a snap. Just log in using your existing DHS Program user ID and password, browse variables and samples, and add the ones you want to your “data cart.” (Despite the analogy, the data are completely free.) Indicate your preferred file format and, a minute or two later, your data will be ready to download, unzip, and analyze.

Did you forget a control variable? Want to add information from an additional sample? No problem. Just return to your data cart, click “Revise” and then “Change,” and you can instantly add or subtract variables and samples, and download the new, revised data file.

We encourage you to check out IPUMS-DHS. It could change your life (or at least your research).

Special thanks to our guest blog contributors, Elizabeth Boyle and Miriam King!

Elizabeth Heger Boyle, is Professor of Sociology & Law at the University of Minnesota. She studies the role of international laws and policies on women and children’s health around the world. She has written extensively on the impetus for and impact of laws related to female genital cutting, including the book Female Genital Cutting: Cultural Conflict in the Global Community. Her current research focuses on abortion policies globally and their effects; this includes a 2015 article in the American Journal of Sociology. Professor Boyle is currently co-Principal Investigator (with Dr. Miriam King) on IPUMS-DHS, a National Institute for Child Health and Development grant that integrates Demographic and Health Surveys over time and across countries to make them more user-friendly for researchers. Professor Boyle has a Ph.D. in Sociology from Stanford University and a J.D. from the University of Iowa.

Miriam L. King is a Senior Research Scientist at the Minnesota Population Center at the University of Minnesota.  She has managed data integration projects on the U.S. Current Population Survey, the U.S. National Health Interview Survey, and, most recently, the Demographic and Health Surveys.  Her research has focused on the history of the U.S. census, data integration methods, U.S. historical fertility differences, living arrangements, and disparities in access to insurance for same-sex couples.  Dr. King has a Ph.D. jointly in Demography and History from the University of Pennsylvania.

24 Apr 2017

The DHS Program at the 2017 PAA Annual Meeting

The DHS Program research team at the 2016 PAA Annual Meeting

We are pleased to announce that The DHS Program and staff will be attending this year’s Population Association of America (PAA) Annual Meeting in Chicago from April 27-29.

PAA is a nonprofit, scientific, professional organization established to promote the improvement, advancement, and progress of the human race through research of problems related to human population.

The DHS Program has been participating in the PAA Annual Meeting over the last few years and we are excited to share our recent surveys and other publications.

If you plan to attend PAA, visit booth #200 for your copy of free survey publications and tours of our new web and mobile tools. Several DHS staff will also be presenting posters, sessions, and will be available to answer any questions you may have about DHS data and results.

View the full DHS staff participation schedule here.

We are looking forward to seeing you there!

11 Apr 2017

New Data Available from DHS-7 Questionnaire: Maternal and Pregnancy-Related Mortality

Baby Kabuche, 30 yrs old, 4 months pregnant, outside her house. Baby has 2 children: Eric, 12, living with granparents in Musoma and Judith, 6, living with her and her husband. She works in a factory manufacturing alluminium pots and iron rods. But as she becqme pregnant she took some unpaid leave as the factory uses acid and other toxic materials and she cares for the safety and health of her baby. Baby got malaria only once as she sleeps under mosquito net all the time. This new one makes her happy as it is treated with mosquito repellent and it is more effective.

© 2016 Riccardo Gangale/VectorWorks, Courtesy of Photoshare

In 2014, The DHS Program began the process of updating the standard DHS questionnaires. With input from stakeholders, feedback from in-country implementing agencies, and a host of lessons learned from the previous 5-year program, we added, modified, and, in some cases, deleted questions. For many indicators, the actual questionnaire did not require an adjustment, but the calculation of indicators or the tabulation of the data needed an update to reflect new international indicators and best practices.

While questionnaire revision started in 2014, it can take a long time to see this exercise bear fruit. The 2015-16 Malawi DHS, for example, went into the field with the DHS-7 updated questionnaires in October 2015. The final report and dataset for the 2015-16 Malawi DHS were released in March 2017, allowing us to explore the new data for the first time.

In this blog series, New Data Available from DHS-7 Questionnaire, we will be detailing, topic by topic, some of the key changes to the questionnaire, with a focus on why the changes were made, how the changes affect the tabulations, and some guidance on how the resulting data should be interpreted.

Part 1:  Maternal and Pregnancy-Related Mortality

DHS surveys now collect data to provide the maternal mortality ratio in line with the definition provided by WHO. For almost 30 years, The DHS Program has collected data on maternal mortality in a subset of countries. In previous DHS cycles, maternal mortality was defined as any death to a woman while pregnant, during childbirth, or within two months of delivery. The WHO definition of maternal mortality is more precise:  any death to a woman during pregnancy, childbirth, or within 42 days of delivery but not from accidental or incidental causes (see full WHO definition here). The new DHS-7 questionnaire allows us to calculate the maternal mortality ratio (MMR) in closer alignment with this more precise WHO definition.

As always, women interviewed in the DHS are asked to list their siblings. The interviewer then collects information about the siblings’ survival status. In the case of female siblings who have died at age 12 or older, the interviewer inquires whether or not the sister died during pregnancy, childbirth, or within the 2 months following delivery. If the sister died within 2 months after childbirth, the interviewer asks how many days after childbirth the sister died. This clarification on the number of days is a new addition to the DHS-7 questionnaire. The interviewer then asks additional questions to determine if the death was accidental or due to violence. In DHS-7 these deaths are excluded from the calculation of the MMR per the WHO definition.

Why?  These changes were made to improve the precision of the MMR, as well as to align the DHS estimation of the MMR with the standard definition provided by the WHO.

Implications:  While the newly added questions allow for a more precise and up-to-date measure of maternal mortality, the change does present challenges for interpretation. DHS has reported on maternal mortality for 30 years, but estimates obtained using the new definition of maternal mortality cannot be directly compared to the old definition of maternal mortality which included deaths up to 2 months after delivery and did not exclude deaths due to accidents and violence.

And yet, one of the main objectives for conducting DHS surveys is to provide trend data. Fortunately, the old definition of maternal mortality can still be applied to calculate the mortality ratio estimate comparable to estimates from previously collected mortality data. This less precise measure of mortality is referred to as the pregnancy-related mortality ratio (PRMR).

DHS reports that include the maternal mortality module will now contain both the maternal mortality ratio and the pregnancy-related mortality ratio. The maternal mortality ratio will be used as the primary point estimate, but the pregnancy-related mortality ratio will be shown in an additional table and in figures to illustrate the trend. Keep in mind that the new measure of maternal mortality, by definition, will result in a lower maternal mortality ratio than the old measure because the accidental and violence-related deaths to women during the maternal period and deaths occurring between 42 days and 2 months after childbirth are being excluded from maternal deaths while using the new definition but included while using the old definition.

Summary of Maternal Mortality and Pregnancy-related Mortality:

Maternal Mortality Ratio The number of maternal deaths to any woman during pregnancy, childbirth, or within 42 days of delivery excluding accidents and acts of violence per 100,000 live births More precise Not comparable to surveys before DHS-7
Pregnancy-related Mortality Ratio The number of pregnancy-related deaths (deaths to a woman during pregnancy or delivery or within 2 months of the termination of a pregnancy, from any cause, including accidents or violence per 100,000 live births Less precise Comparable to previous surveys; shown to allow for trend  interpretation

The DHS-7 questionnaire includes additional prompts to fully capture more siblings and siblings’ deaths. In previous DHS questionnaires, women were asked to list their siblings in order and then were asked follow-up questions about their survival status. In the DHS-7 adult mortality module, respondents are asked to list their siblings without worrying about their order but are then asked a list of probing questions to ensure that all siblings have actually been recorded. This change is likely to produce a more complete list of siblings for which information on adult and maternal mortality is collected. Once a complete list is produced they are then ordered and the questions on their survival status and age or age at death and years since death, as well as the maternal mortality related questions, are then asked as applicable. 

Why?  Several studies have suggested that respondents’ lists of siblings are not always complete. This often happens when the sibling is a half-brother or sister, when the sibling did not live with the respondent as a child, or when the sibling has died. A pre-test in Ghana indicated that the addition of these probing questions resulted in capturing additional siblings for about 10% of women.

Implications:  Omissions in the sibling history can affect the adult and maternal mortality ratios in different ways. The inclusion of more siblings tends to increase the adult mortality rate. This is because often the siblings who were previously omitted were not spontaneously mentioned because they have already died. However, studies suggest that these deaths are not disproportionately maternal deaths, so a more complete sibling listing might result in a lower maternal mortality ratio.

Key Take-Aways

The changes described above may sound confusing for non-demographers.  The major points to remember for DHS data users include:

  • The new Maternal Mortality Ratio is not comparable with previous measures of maternal mortality in DHS surveys
  • For trends, look at Pregnancy-related Mortality Ratio
  • Despite the different names, both measures include deaths during pregnancy. The MMR is a more precise measure as it excludes some of the deaths during pregnancy that were not related to pregnancy (i.e. accidents and acts of violence).
  • Maternal mortality is still a relatively rare event, and therefore both MMR and PRMR have wide confidence intervals. Both measures are always presented with their confidence interval so that the user can draw their own conclusions about the relative certainty of the point estimate.

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.

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