Category Archives: Video

13 Jan 2015

Harnessing Technology to Streamline Data Collection

By Guillermo Rojas

The survey process at The DHS Program takes an average of 18-20 months and goes through several steps: survey preparation and questionnaire design, training and fieldwork, data processing, and finally, writing the final report and dissemination. But how do the data get from respondents’ households into the tables you see in the final report?

We employ field interviewers to ask respondents the questions included in the DHS questionnaires – household, woman’s, man’s, and biomarkers. But the way we record their answers changes based on the data collection methodology. At The DHS Program, we employ three types of methodologies to collect data: paper questionnaires, Computer Assisted Field Editing (CAFE), and Computer Assisted Personal Interviews (CAPI).

DHS Model Household Questionnaire, Page 1

DHS Model Household Questionnaire, Page 1

The vast majority of DHS surveys in the past 30 years have used paper questionnaires to collect data. With physical paper questionnaires in hand, field interviewers go from house to house, ask the questions of the respondents, and manually fill out the questionnaires. After interviewers visit all households within a cluster, supervisors ship the questionnaires to the survey central office. Upon arrival, the data processing begins for that particular cluster.

The Computer Assisted Field Editing (CAFE) system allows for editing to happen as interviews are taking place. With CAFE, interviewers still use paper questionnaires, but Field Editors enter the questionnaires into computers while the team is still in the cluster. Essentially, questionnaires are fully field edited by an intelligent data entry program. With this type of data collection approach, Field Editors provide feedback to interviewers on any anomaly identified by the program such as interviewers missing full sections of the questionnaire or wrongly executing critical skip patterns. At this point in the survey process, it is relatively easy to send the interviewer back to the household to resolve any problems. With this approach, there is no need for main data entry as the data entered in the field is sent via the internet to the central office. Therefore, CAFE speeds up the survey process as cluster data files are available as soon as the data arrive to the central office for further processing.

The 2005 Colombia DHS was the first DHS survey to utilize the Computer Assisted Personal Interview (CAPI) methodology. CAPI does not involve any type of paper questionnaire—it is entirely digital. Back in 2005, field interviewers used bulky laptops, though nowadays we use lighter tablets and notebook computers.

Fieldwork in the 2005 Colombia DHS

Fieldwork in the 2005 Colombia DHS

The DHS CAPI data collection system consists of three comprehensive subsystems:

1. A system for interviewers to facilitate the interview process

2. A system for supervisors to centralize the data collected by interviewers

3. A system for the central office to monitor the fieldwork operation and to further process the data

The DHS CAPI system uses Bluetooth technology to transfer and share data among members of the same fieldwork team. Supervisors then send data to the central office headquarters using the Internet File Streaming System (IFSS), a cloud-based electronic file delivery system developed by The DHS Program. The primary objective of the service is to deliver files from one user to another in an exceptionally fast and secure way.

In the past 30 years, we’ve witnessed an incredible change in technology, especially with both hardware and software. When I first started at The DHS Program, running the program to impute the woman’s events dates could easily take more than six hours for a survey with a sample size of 2,000 to 3,000 households! Nowadays, with sample sizes of 20,000 to 30,000, this program takes just one to two minutes to run. CAFE and CAPI allow us to use the power of these newer innovations in technology to make sure that we carry out DHS surveys as efficiently and accurately as possible.

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Guillermo Rojas is Chief of Data Processing at The DHS Program. He has more than 35 years of experience in computer science and survey data processing, and has provided data processing technical assistance and training for more than 20 surveys. Since the early stages of The Demographic and Health Surveys (DHS) program, Mr. Rojas has been involved in the design and development of the data processing methodology currently being used to process and analyze DHS surveys. He is the primary writer of the master programs for implementing the evolving data processing methodology. Mr. Rojas coordinates all DHS data-processing activities and supervises personnel to ensure the accuracy and quality of the processes implemented.

07 Jan 2015

Video: Interview with Martin Vaessen, Former Director of The DHS Program

We sat down with Martin Vaessen, former director of The DHS Program, to hear his thoughts about the past 30 years of The DHS Program. Martin is a demographer and survey specialist with more than 35 years of experience providing technical assistance in all phases of survey implementation in developing countries. He was instrumental in achieving the incorporation of HIV testing in the  Demographic and Health Surveys (DHS), an innovation that led to a revision of the estimated number of people living with HIV from 40 million to 33 million in 2007.

 

16 Dec 2014

The Nutrition Landscape in India

This post is part of a series commemorating 30 years of The DHS Program.

By Fred Arnold

Historically, India has suffered through devastating periods of famine, but due to the Green Revolution, improved food storage and distribution, and other factors, famine has been all but eradicated in the country. However, malnutrition continues to threaten the health of India’s population.

NFHS-3

NFHS-3

The National Family Health Surveys (as DHS surveys are known in India) have been documenting the nutrition situation in India since 1992 (by measuring the height, weight, and anemia status of children and adults, and by assessing infant and young child feeding practices). These surveys have brought to the nation’s consciousness the excessively high levels of stunting, wasting, underweight, and anemia that young children in India continue to suffer from. The most recent NFHS survey (NFHS-3) found that nearly half of children under five are stunted, 43% are underweight, 20% are wasted, and 7 out of every 10 children are anemic. Stunting among children was as high as 60% in the lowest wealth quintile, but was still considerable (25%) even in the highest wealth quintile. These findings were widely reported in the media, were agonized over by international organizations and NGOs, and were prominently discussed at the highest levels of government. In two national addresses, Prime Minister Manmohan Singh revealed that he had seen the results of the National Family Health Survey, and he declared the poor nutrition of India’s children to be “a national shame.” He immediately responded by writing a letter to the Chief Ministers of every state in the country, ordering them to take up the fight against malnutrition “on a war footing” and to report back to him every quarter on the progress that had been made.

Based on the NFHS-3 findings, that same year I wrote a paper on the nutrition landscape in India, which was published in Demography India and presented as the keynote speech at the Annual Meeting of the Indian Association for the Study of Population. That reached yet another important constituency that joined the national dialogue on nutrition.

Another aspect of nutrition that was documented in that paper was the emerging dual burden of simultaneous undernutrition and overnutrition among Indian adults. About one-third of women and men were abnormally thin and about 1 in 8 were overweight or obese, meaning that only about half of adults had a normal nutritional status. The figures are even more alarming in certain segments of the population. Thirty to forty percent of women were overweight or obese in some of India’s largest cities, and even in urban slums, 20-30% of women fell in that category.

Since NFHS-3, there have been encouraging signs of improvements in nutrition in some places, but discouraging signs of stagnation or deterioration in others. The results of the NFHS-4 survey, which is just about to go into the field, are eagerly awaited to provide more definitive information on the current nutrition situation. And when the next chapter in India’s nutrition history is written, NFHS will be there to monitor trends and provide vital information to guide informed policymaking and program planning.

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Fred Arnold, Technical Deputy Director—Dr. Arnold is responsible for setting the overall technical direction for The DHS Program and coordinating the design of DHS questionnaires. He has coordinated technical assistance to four large-scale National Family Health Surveys in India, which have included interviews with more than one million women and men, working with more than 40 organizations (government ministries, funding agencies, international organizations, and implementing agencies) in the conduct of the surveys. He has been involved in the design and implementation of surveys in 15 additional countries. Dr. Arnold has a Ph.D. in economics/demography from the University of Michigan. He has authored more than 150 publications in areas such as malaria; HIV; maternal, newborn and child health; nutrition; son preference; international migration; and the value of children.

10 Dec 2014

Gender in the Demographic & Health Surveys: Past, Present, & Future

This post is part of a series commemorating 30 years of The DHS Program.

When I first started at The DHS Program in late 1993 as a Women-in-Development Specialist, the survey questionnaires contained few questions that could shed light on the impact of gender on demographic behavior and health. While the questionnaires were designed to collect all kinds of information on women’s and children’s health, women’s use of contraception, fertility, mortality and nutrition, there was virtually no information on the status of the women themselves other than information on their education and employment. In other words, there was little information that provided insights into the gendered context within which the health and demographic behavior of women and households was being determined.

1995 Egypt DHS

1995 Egypt DHS

So I had a lot of work to do. My challenge was to develop a parsimonious module of questions that in the future could potentially be used by DHS surveys across the world to better understand the role that gender plays in demographic and health outcomes. To this end I put together a set of questions on women’s status based on a thorough literature review and an examination of several studies that used questionnaires to measure women’s status and gender relations in the household. Once ready we managed to include this module of questions in the 1995 Egypt DHS. Preparing the module was challenging since the literature provided mostly proxy indicators of women’s status at the household level, but few that could directly measure empowerment. Additionally, since one of the key features of The DHS Program is that it provides comparable data across countries, I needed questions that had similar meaning across cultures with widely varying perceptions of women’s roles. The pilot of the Women’s Status Module in the Egypt DHS yielded a lot of useful information and helped determine the key indicators that would be useful to have for most countries such as the questions on women’s role in household decision making, their attitudes towards spousal violence, and barriers to accessing health care for themselves.

1998 Nicaragua DHS

1998 Nicaragua DHS

Another gender-related topic that really increased in importance during my tenure as the Senior Gender Advisor to The DHS Program is domestic violence. The women’s status module implemented in Egypt contained only a couple of questions on women’s experience of domestic violence and the 1990 and the 1995 Colombia DHS surveys included country-specific questions on domestic violence. Then in 1998, a module of questions that utilized a modified conflict tactics scale approach (Strauss 1990) to the measurement of violence was implemented in the Nicaragua DHS. It was this module that became the foundation for the core DHS Domestic Violence Module which was finalized and piloted around 2000. Overtime we also developed a protocol for the ethical collection of data on violence, particularly for the protection of female respondents and field interviewers. However, having a standardized module and protocols for its implementation, did not mean that countries were immediately interested in collecting information on domestic violence. There was first a need to try and overcome commonly held beliefs that domestic violence was not a State concern and had no place in a demographic and health survey. Additionally few believed that women would be willing to talk about their experiences of violence.

The 1995 Egypt DHS marked a new chapter in the life of The DHS Program. Questions on women’s empowerment are now part of the core questionnaire and asked in most countries. The Domestic Violence Module has been included in more than 95 surveys in over 50 countries. Survey data have been used for major legislation, advocacy efforts, and national programs to protect women in their own homes in countries as diverse as Moldova, Uganda, Timor Leste, and Zimbabwe. Analysis of DHS data has convincingly linked violence with negative reproductive health outcomes and HIV, showing that violence is an important public health issue as well as a violation of individual rights.

In the coming years, The DHS Program will continue to collect more information on women’s empowerment. The 2014 revised survey instruments now include questions on women’s ownership of mobile phones, personal bank accounts, and ownership and co-ownership of property. We have come a long way since the first pilot module on women’s status, and we will continue to be on the forefront of research into women’s lives.

Reference

Straus, M.A. 1990. Measuring intrafamily conflict and violence: the conflict tactic (CT) scales. In M.A. Straus and R.J. Gelles (eds.) Physical Violence in American families: Risk Factors and Adaptations to Violence in 8,145 Families. 29-47. New Brunswick: Transaction Publishers.

24 Oct 2014

Introducing: Sampling & Weighting at DHS

In my travels as a DHS sampling statistician, I have met countless people who want to hear about the sampling techniques and procedures we use in DHS surveys. Recognizing this fact, we are working to incorporate more sampling-related capacity strengthening activities at The DHS Program. The feedback we get after these activities has only encouraged us to produce more learning tools highlighting basic sampling-related concepts and topics used in DHS surveys.

2012 Tajikistan DHS

2012 Tajikistan DHS

We created a 4-part video series (the next two will be coming within the year) designed to introduce DHS sampling concepts, two of which were launched around World Development Information Day. In the videos, we present the sampling design and procedures used in the 2012 Tajikistan DHS survey as an example of sampling procedures in DHS surveys.

The first video, Introduction to DHS Sampling Procedures, explains the basic concepts of sampling, introduces the stages of designing a sample in a DHS survey, and discusses the key factors to consider when calculating sample sizes for a DHS survey.







The second video, Introduction of Principles of DHS Sampling Weights, introduces the concept of weighting survey data.  You will understand the goals and the importance of weighting as well as the concepts of over- and under-sampling.






Both videos introduce you to the basic sampling definitions, concepts, and procedures followed in a standard DHS survey. If you are interested in more information about the sampling procedures in the DHS surveys, you can check out the DHS Sampling and Household Listing Manual. If you have more questions, check out the user forum!

What did you learn from the sampling & weighting videos? What would you like to explore further? Comment below!

07 Mar 2014

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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