Category Archives: Uncategorized

22 Nov

Inside Angola’s First-ever DHS Survey

In 2017, three new countries joined the list of those who have implemented nationally representative and internationally comparable Demographic and Health Surveys, setting a baseline by which to measure progress on standardized health indicators. Earlier this year, Afghanistan and Myanmar released the results of their first DHS surveys, and as of June 30, Angola, too, could use the 2015-16 Angola DHS to make decisions based on comprehensive, reliable data.

Angola had previously implemented several Multiple Indicator Cluster Surveys (MICS). By 2015, however, stakeholders were especially interested in HIV and malaria biomarkers, and the donor community and the National Institute of Statistics (INE) decided to fund and implement a DHS survey, known in Angola as the Inquérito de Indicadores Múltiplos e de Saúde (IIMS).

Implementing a DHS survey is always an immense undertaking, but doing it for the first time heightens the level of challenges. As a first-time implementing agency, INE didn’t have the benefit of lessons learned from previous surveys. The indicators were new to them, and many pieces of DHS-7 documentation were not yet available in Portuguese. The lab had never conducted some of the assays necessary for the HIV testing algorithm. Each stakeholder had its own wish list regarding questionnaire modules, biomarkers, and timelines.

INE, together with The DHS Program, worked to overcome these challenges. The Minister of Health’s forward to the report states,

“This report is the result of nearly 18 months of continuous work, from the preparation of the IIMS to its implementation, which included fieldwork, data processing and analysis of indicators.”

Behind this statement lie scenes of compromise, creative problem solving, and many hours of hard work. Stakeholders decided to limit biomarkers collected in order to prioritize the most pressing questions and expedite the timeline. Cartographers were added to teams to accelerate fieldwork and to improve the quality of household listing. Multiple technical assistance visits were made during fieldwork and lab testing of blood samples for HIV to ensure data quality on the part of teams who were new to DHS procedures. Through these collaborative strategies, the capacity of both INE and the  Serology Lab at the National Institute of Public Health to implement nationally representative surveys was greatly strengthened, building on their already high-quality work.

In his comments at the national seminar, the Secretary of the Ministry of Planning and Territorial Development described the magnitude of the IIMS survey. “It is because of the size of this undertaking,” he continued, “that we are able to accurately show the results of our public policies that were designed to improve lives.” The USAID/Angola Mission Director followed, asking, “Why invest in a DHS survey? To have data of this quality for the first time, particularly HIV prevalence in all provinces. But data are only useful if they are used in decision making.”

While INE’s has finished implementing Angola’s first DHS survey, the work continues. Program managers and policymakers, for the first time, can dive into the fullness of DHS data to make decisions that will improve the lives of Angolans.

Photo Caption: Presentation from the Angola National Seminar in Luanda, Angola.

19 Mar

Getting data to you faster: The Key Indicators Report

In 2006 I was in Addis Ababa, Ethiopia, preparing for the release of the 2005 Ethiopia Demographic and Health Survey (EDHS). In the days leading up to the national seminar and launch of the EDHS report, two separate individuals approached me at my hotel, both looking for an “advance copy” of the report. One was writing a grant proposal for child health services and wanted to see how child health indicators had changed since 2000.  Another needed to know how to budget for family planning activities before his annual work plan was due, just days before the launch of the report. This is not a unique story, but rather an illustration of how much people rely on DHS survey data, how well they are used, and how much impact can be made by providing quality data in a timely fashion.

2014 Lesotho DHS Key Indicators Report

2014 Lesotho DHS Key Indicators Report

There is no survey manager at The DHS Program who has not been asked if data can be released in advance. We are always asking ourselves, “how can we get people the DHS survey data faster?” This month, we release the first Key Indicators Report:  a report of the most essential results from the DHS, published just three months after the completion of fieldwork. In this case, the lucky country is Lesotho.*

While The DHS Program has always published a “Preliminary Report”, the Key Indicators Report is more complete, including additional indicators, more background characteristics such as wealth quintile, and many more figures, primarily to highlight trends. In Lesotho, for example, the Key Indicators Report highlights progress towards reducing childhood mortality.

The full DHS final report will continue to be published on schedule. For Lesotho, this will likely be in late 2015. But for now, it is our hope that these key indicators provide the much needed data that policy makers and program managers need to plan, monitor, and evaluate their efforts.

Trends in Childhood Mortality in Lesotho

Trends in Childhood Mortality from the 2014 LDHS Key Indicators Report

 

*Lesotho is the first country to produce a KIR with the newly designed standard DHS KIR tabplan and cover.  Cambodia released a country-specific KIR in February 2015.  

09 May

Spotlight on Implementing Agencies: Jordan

Ikhlas Aranki and Ahmad Abu Haidar.

Ikhlas Aranki and Ahmad Abu Haidar.

In October 2013, The DHS Program welcomed visitors from the Jordan Department of Statistics. This is the second in a series of interviews with visitors to DHS headquarters. Find the first post here.

Names:

Ikhlas Aranki (Assistant Director General, Department of Statistics) and Ahmad Abu Haidar (Social Statistics and Poverty Studies Advisor, Department of Statistics).

When not working, favorite place to visit:

Restaurants, shopping centers, and parks.

First time you worked with The DHS Program’s data:

Ikhlas: 1990

Ahmad: 2012

What has been the nicest surprise visiting The DHS Program headquarters? 

Meeting old friends.

2012 Jordan DHS

2012 Jordan DHS

What do you miss most about home when you are here?

We miss family.

What is your favorite DHS final report cover?

All covers from Jordanian DHS reports.

FavoriteDHS chapter or indicator, and why?

Domestic Violence and Early Childhood development, because these chapters focus on marginalized segments of the population.

How do you hope theDHS data from your country will be used?

  • Planning for health programs and evaluating and improving existing programs as well as analyzing trends in demographic parameters.
  • Shaping health related policy through providing decision information useful for informed policy choices.
07 Mar

Women’s Lives and Challenges

The Women’s Lives and Challenges: Empowerment and Equality since 2000 report assesses progress made toward gender equality and women’s empowerment since the Millennium Development Goals (MDGs) were adopted in 2000. It summarizes findings from 95 surveys conducted by DHS in 47 countries from 2000 to 2011. Data on trends are available for 33 countries that hosted 2 or more surveys in this time period.

Together these data give us an accurate picture of #WomensLives. They describe the current status of women around the world and show how much change, for better or worse, has occurred since 2000. While there have been improvements in some areas, overall progress towards women’s empowerment and gender equality is halting and inconsistent. Women worldwide continue to face special challenges throughout their lives, even though some countries—for example, Cambodia, Nepal, and Rwanda—have made great strides toward gender equality.

Resources for empowerment are distributed unequally between women and men, but women have made gains in education, employment, health care, and family life.

  • Access to primary education is expanding worldwide; in Cambodia and Nepal, which have made the greatest progress, the proportion of young women with primary education has more than doubled since 2000. Yet there are still 16 countries where less than half of women age 15-24 have finished primary school. More men than women can read and have completed primary school in nearly every country.
  • Over half of women are employed in 33 of 45 countries, but men are not only more likely to be employed than women, but also more likely to be paid in cash for the work they do.
  • At least half of births take place in health facilities in the majority of countries, and the proportion is also rising in most countries. Cambodia, Egypt, Nepal, and Rwanda have experienced the greatest improvements across all maternal health indicators. Yet more than half of women still face barriers to accessing health care in most countries.
  • Teenage pregnancy has declined modestly in many countries. In 36 of 47 countries, less than 25% of women begin childbearing before age 20. Yet child marriage— that is, marriage before age 18—persists in many countries. More than 40% of women marry before age 18 in 16 of 47 countries surveyed, including 3 countries where more than 60% of women marry before age 18: Bangladesh, Guinea, and Mali.

Women’s control over their own lives shows some encouraging trends, but substantial gender gaps remain.

  • Women generally do not play a major role in household decision making although participation levels have been rising, notably in Armenia, Kenya, Lesotho, and Nepal. Only in 12 of 43 countries do more than two-thirds of women participate in household decision making.
  • At least 90% of married employed women have a say in how their own cash earnings are used in 29 of 44 countries. Far fewer women have a say in how their husbands’ earnings are used.
  • Less than half of currently married women use modern contraception in 37 of 46 countries. Since 2000, modern contraceptive use has plateaued or increased modestly in most countries. Rwanda is an exception, with an increase of 40 percentage points in 10 years.
  • More than one-quarter of recent births are unplanned in 26 of 46 countries. Change has been minimal, except in Burkina Faso and Cambodia.

Violence in women’s lives remains disturbingly common, and progress has been limited. 

  • More than one-third of married women have experienced physical and/or sexual violence at the hands of an intimate partner in 14 countries. While levels of violence have fallen in some countries, they have risen in others.
  • Female genital cutting remains a problem for many women in Africa. In 6 of 14 countries, more than 60% of women were cut. Data on trends in eight countries show only modest declines.
  • Most women who experience violence do not seek help, and there has been little change since 2000. Colombia has the highest rate of help-seeking while Cambodia has made the greatest progress.

Check out our three infographics and other photos from the report on our #WomensLives Pinterest Board.

 

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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