DHS at Work

In Peru, the government has used the DHS stunting and anemia results to design child nutrition programs at the department level. The government of Peru also financed oversampling of the 2008 DHS to obtain nutrition and health results for each of its 24 departments. Peru’s Economics and Finance Ministry’s “Budgeting by Results” strategy requires that these data be used to set budget allocations among the departments and to evaluate each department’s progress in reducing child malnutrition and improving child health indicators.

Survey Process

The DHS Program surveys collect a wealth of information on widely different topics for a sample of the countries that participate in The DHS Program. The information is processed and presented in reports and data formats that describe the situation of the relevant country. Many steps are required to ensure that the data properly reflect the situations they intend to describe and that data are comparable across countries. The DHS Program has developed standard procedures, methodologies, and manuals to guide the survey process.

Survey Phases and Timelines

The time to complete a survey depends on survey type, survey instruments, and sample size. DHS surveys take on average 18-20 months, while AIS surveys take approximately 9 months. Each DHS Program survey is executed in four phases.

  1. Survey Preparation and Questionnaire Design: The first step involves preparatory activities, including designing the sample and developing the survey questionnaires to meet specific host-country needs.
  2. Training and Fieldwork: The second stage involves training field staff and conducting fieldwork. Eligible households and individual respondents are identified and interviewed. Fieldwork is carried out by a number of teams composed of female (and male) interviewers, female field editors and team leaders.
  3. Data Processing: The third stage involves data processing, including editing, coding, and entering and verifying the data as well as checking them for consistency. Data entry and editing take place simultaneously with data collection, allowing for quality control of the data collected and for the provision of preliminary results one month after the end of data collection.
  4. Final Report, Data Preparation and Dissemination: The final stage involves analyzing the data, preparing the final report, and disseminating the survey results in country. This stage usually begins following the completion of fieldwork.

National Implementing Agency

As a general rule, the overall responsibility for executing a DHS resides with a single implementing agency. This agency can be any bona-fide governmental, non-governmental, or private-sector organization such as: a National Statistical Office, a family planning organization, a Ministry of Health, a university, a government research group or a private research group.

National Statistical Offices are often selected because they usually are the source of the necessary sampling frame and because they frequently are the organization that has the most experience in the execution of surveys that are national in scope. Family planning organizations and Ministries of Health are usually the primary users of the information gathered through the survey. Involvement of Ministries of Health is becoming more important because of the increased health content of DHS surveys and the need to have access to specialized staff that can collect biological specimens such as blood samples.

The DHS Program Technical Assistance

The DHS Program staff provide technical assistance at critical stages of survey implementation in order to ensure that survey procedures are consistent with the technical standards set by DHS and to ensure that survey activities are progressing at a reasonable pace. Assistance is provided during visits to the country and throughout the whole survey process.

In-country visits are structured to provide technical back-up for the local staff, with the local staff actually carrying out survey activities. The first one or two visits to a country by DHS Program staff are usually for the purpose of assessing the feasibility of conducting a DHS survey. During these visits the national executing agency is identified, the survey objectives, work scope, timetable and budget are developed and a subcontract is written.

The precise number of technical assistance visits needed will vary depending on the skill and experience levels of the local staff. The trips will usually be related to the accomplishment of major survey tasks: questionnaire design and pretest, sample design, training of the field staff, fieldwork monitoring, data processing, analysis, report writing, and dissemination activities (particularly the national seminar).