The DHS Program

Demographic and
Health surveys
A Project Funded by
The United States Agency for
International Development and
Implemented by ICF

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 What is The DHS Program?

A project that provides, at the global level,

assistance to developing countries in the areas of
Collection and use of data
to monitor and evaluate population, health, and nutrition programs

ICF International
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 © ICF International
History

Before the DHS:

1950-60s: Surveys on fertility
and family planning in
the US
1960-70s: KAP (Knowledge,
Attitudes and
Practice) Surveys on
family planning
1972-84: World Fertility
Survey
1977-85: Contraceptive
Prevalence Survey

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 © ICF International
History

The DHS started in 1984:

• DHS-I (DHS-1, 1984−1989)
• DHS-II (DHS-2, 1989−1993)
• DHS-III (DHS-3, 1992−1997)
• MEASURE DHS+
(DHS-4, 1997−2003)
• MEASURE DHS
(DHS-5, 2003−2008)
• MEASURE DHS Phase III
(DHS-6, 2008−2014)
• The DHS Program
(DHS-7, 2013−2018)

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To date, DHS has implemented more than 300 surveys in
over 90 countries.

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 Surveys in The DHS Program

Demographic and Health Survey (DHS): National survey that

includes fertility, mortality, family planning, maternal and child health,
nutrition, HIV/AIDS, and other health indicators.

Malaria Indicator Survey (MIS): Indicators include mosquito net

ownership and use, IPTp, prevalence and treatment of fever in children;
can include testing for malaria and/or anemia; shorter than full DHS to
allow for more frequent monitoring.

Service Provision Assessment (SPA) Survey: Survey of health

facilities, providers, and clients; indicators include service infrastructure,
service availability at facilities and providers’ practices toward clients.

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 © ICF International
Main Characteristics
of the DHS

• Generates data that are

comparable across
countries and over time
• Reinforces the institutional
capacities within participating
countries
• Develops new procedures and
methodologies
• Improves access to data for
dissemination and further
analysis

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 Basics of the DHS

• Cross-sectional, nationally representative sample of households

− Women and men interviewed in sample households
− Sample size: 3,000−100,000+ households
• Standardized sample design, questionnaires, and
implementation procedures
− Key indicators measured with the same approach over time

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 DHS Sample

The DHS sample is typically

representative at
• The national level
• For urban and rural areas
• The regional level
(sometimes groups of
regions)
• Some surveys are
representative at the
state/provincial, or district
level.
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 © ICF International
DHS Core
Questionnaires

‘Core’ questionnaires
• Core set of questions in each
type of questionnaire
implemented in every country
• Revised and updated every
5 years
• Provide trends in key
indicators
• Allow cross-country
comparisons
• Country needs met through
country-specific questions

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 © ICF International
Types of DHS
Questionnaires

Standard DHS surveys

generally include a:
• Household
questionnaire
• Woman’s
questionnaire
• Man’s questionnaire
• Biomarker
questionnaire

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 DHS Questionnaire Modules

Additional Modules
• Domestic Violence
• Female Genital Cutting
• Adult and Maternal Mortality
• Fistula
• Out-of-pocket Health Expenditures

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 © ICF International
Biomarkers

As of 2014, more than 10 million

biomarker tests have been
completed as part of The DHS
Program.
Most common biomarkers:
• Anemia
• Anthropometry
(height/weight)
• HIV prevalence
• Malaria prevalence

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 Other Biomarkers

Chronic conditions Nutrition

• Blood pressure • Iodine (salt and urine
test)
• Diabetes
• Iron
• Lipids
• Lead
STIs
• Vitamin A
• Chlamydia
Antibodies/immunity
• Hepatitis B
• Measles
• Hepatitis C
• Tetanus
• Herpes
Water testing
• Syphilis
• Arsenic, chlorine, E.coli
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 Main Characteristics
of the DHS

• Generates data that are

comparable across countries
and over time
• Reinforces the institutional
capacities within
participating countries
• Develops new procedures and
methodologies
• Improves access to data for
dissemination and further
analysis

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 © David Snyder, ICF International
DHS Strengthens
Capacity Through:
• Close collaboration with
implementing agencies and
partners throughout survey
design and implementation for
on-the-job skills transfer

• Workshops on data analysis, data

processing, report writing, data
use for decision making, and
more

• Distance learning and online

tools

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 DHS Fellows Program
• Annual program designed to increase in-country capacity to use DHS
data to conduct high-quality research
• Since 2011, the program has competitively recruited more than 80
faculty fellows in over 30 universities from DHS countries in sub-
Saharan Africa

© ICF International
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 © ICF International
Online Capacity
Strengthening Tools

• E-Learning courses
• Journalists’ Guide and training
course to better understand
and use DHS data in health
and population reporting
• YouTube tutorial videos on
reading tables, opening
datasets, and sampling and
weight, etc.

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 Main Characteristics of the DHS

• Generates data that are comparable across

countries and over time
• Reinforces the institutional capacities within
participating countries
• Develops new procedures and
methodologies
• Improves access to data for dissemination and
further analysis

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Collection and Analysis
of Geographic Data

As the result of the

implementation of Geographic
Information Systems (GIS), DHS
data can now be linked with a
number of databases (climatic,
agricultural, road network, etc.),
allowing
for mapping of indicators across
regions and countries.
The Spatial Data Repository
(spatialdata.dhsprogram.com)
warehouses GIS data and
provides tutorials for use.

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 Technological Advances in Data Collection

Computer Assisted Personal Interviewing (CAPI):

Tablets are now used to collect data in the field in some countries
• Advantages:
− Built-in quality control
− Field work is faster
− Less time needed for data entry and editing;
analysis comes faster
• Limitations:
− Need for regular power source to charge batteries daily
− Field work protocol needs to be adjusted
− More technical assistance needed

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 © ICF International
Main Characteristics
of the DHS

• Generates data that are

comparable across countries
and over time
• Reinforces the institutional
capacities within participating
countries
• Develops new procedures and
methodologies
• Improves access to data for
dissemination and further
analysis

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 Data Dissemination and Use
• Promotes evidence-based decisionmaking
• Leads to better health policies and
programs
• Improves health outcomes

Dissemination and use activities:

• Distribution of print materials (Final
Report, Key Indicators Report, Key
Findings report, factsheets)
• Survey datasets
• National seminar PowerPoint
presentations
• Further analysis of DHS results
• Data use seminars and workshops Web
and mobile dissemination
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 Digital Dissemination

The DHS mobile app: Put DHS data at

your fingertips!

Make your own charts, graphs, and

data tables at STATcompiler.com

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 User Forum
userforum.DHSProgram.com
• A web-based forum to ask and discuss DHS-related questions with the
larger user community.
• Get help with analysis, data use, and more from other data users
• Help others!!

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 Social Media

www.facebook.com/DHSProgram

Twitter: @DHSProgram

LinkedIn
http://www.linkedin.com/company/dhs-program

www.youtube.com/DHSProgram

www.pinterest.com/DHSProgram
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 www.DHSprogram.com
Email us at: info@dhsprogram.com

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