Demographic and Health Surveys Methodology - Measure DHS

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B. Similarly, an adjustment is made for women who smoke (if information was collected). Theadjustment is to be made in accordance with the following table:Cigarettes SmokedAdjust Hb (g/dl)Concentration byNo adjustmentLess than 10 per day10–19 per day –0.320–39 per day –0.540 or more per day –0.7Unknown quantity or noncigarettessmokingC. The percentage anemic, by category, is obtained by dividing the numerators by the denominatorand multiplying the quotient by 100.Handling of Missing ValuesWomen who were not tested and women whose values were not recorded are excluded from both thedenominator and the numerators.Notes and ConsiderationsPregnancy causes an increase in blood fluid diluting somewhat the concentration of hemoglobin.Therefore the cutoff for mild anemia is lowered for pregnant women. No adjustment is made for thecutoff values for either moderate or severe anemia. Because the availability of oxygen is less at higheraltitudes (lower partial pressures) and because smoking interferes with the blood’s capacity to transferoxygen, adjustments need to be made for both altitude and smoking.People residing at higher altitudes (greater than 1,000 meters (3,300 feet)) have higher Hb and Hct levelsthan those residing at sea level. This variation is due to the lower oxygen partial pressure at higheraltitudes, a reduction in oxygen saturation of blood, and a compensatory increase in red cell production toensure adequate oxygen supply to the tissues. Thus, higher altitude causes a generalized upward shift ofthe Hb distributions. This shift may be associated with the underdiagnosis of anemia for residents ofhigher altitudes when sea-level cutoffs are applied (CDC, unpublished data). Therefore, the properdiagnosis of anemia for those residing at higher altitudes requires an upward adjustment of Hb cutoffs.The values for altitude-specific adjustment of Hb are derived from data collected by the CDC PediatricNutrition Surveillance System on children residing at various altitudes in the mountain states. Altitudeaffects Hb levels throughout pregnancy in a similar way (Chatfield, unpublished data).The influence of cigarette smoking is similar to that of altitude; smoking increases Hb level substantially.The higher Hb of smokers is a consequence of an increased carboxyhemoglobin from inhaling carbonmonoxide while smoking. Because carboxyhemoglobin has no oxygen-carrying capacity, its presencecauses a generalized upward shift of the Hb distribution curves (CDC, unpublished data). Therefore, asmoking-specific adjustment to the anemia cutoff is necessary for the proper diagnosis of anemia insmokers.The adjustment for altitude can be substantial, but the adjustment for smoking is less substantial. Thus,where no smoking information is available, no adjustment is made. However, altitude data should alwaysbe obtained to adjust where the altitude of the dwelling is more than 1,000 meters. Substitution of clusteraltitude is usually accepted instead of altitude for each dwelling in the cluster.–0.3Guide to DHS Statistics 141 Updated October 2012
ReferencesCenters for Disease Control and Prevention. 1998. Recommendations to prevent and control irondeficiency in the United States. Morbidity and Mortality Weekly Report 47 (RR-3): 1–29.Centers for Disease Control and Prevention. 1989. Current trends CDC criteria for anemia in children andchildbearing-aged women. Morbidity and Mortality Weekly Report 38, (22): 400–404.Guide to DHS Statistics 142 Updated October 2012
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Guide to DHS statisticsDemographic
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GUIDE TO DHS STATISTICSShea Oscar R
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Preferred Method of Contraception f
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ForewordDHS surveys collect a wealt
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MODEL QUESTIONNAIRESThe basic appro
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The Guidelines for the Main Survey
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The figure on the previous page ill
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Before using an exported DHS data f
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In this list “xx” represent dig
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At data entry time, contrary to the
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CalculationInitial sample weights a
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DHS uses century month codes extens
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AgeTotal ChildrenTotal ChildrenSmoo
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All Women Ever-Married Women All Wo
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it is not possible to merge the hou
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ename = (HVIDX$01, HV101$01, HV102$
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III. Guide to Individual Statistics
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Births in the month of interview ar
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Statistics: Total Fertility RateDef
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Statistics: Crude Birth RateDefinit
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CHILDREN EVER BORN AND LIVINGStatis
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BIRTH INTERVALSStatistics: Percent
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AGE AT FIRST BIRTHStatistics: Perce
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TEENAGE PREGNANCY AND MOTHERHOODSta
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4. Traditional methods: The number
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CURRENT USE OF CONTRACEPTIVE METHOD
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Changes over TimeThe list of specif
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Median: Women with a missing value
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KNOWLEDGE OF THE FERTILE PERIODStat
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Statistics: Median Age at Contracep
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INFORMED CHOICEStatistics:A. Percen
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B. In the standard recode file, the
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REASONS FOR DISCONTINUING CONTRACEP
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FUTURE USE OF CONTRACEPTIONStatisti
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PREFERRED METHOD OF CONTRACEPTION F
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CONTACT OF NONUSERS WITH FAMILY PLA
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ATTITUDES TOWARD FAMILY PLANNINGSta
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NUMBER OF CO-WIVESStatistics: Perce
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MEDIAN AGE AT FIRST MARRIAGEDefinit
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Statistics: Median Age at First Sex
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B. Denominator: Number of all birth
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Notes and ConsiderationsAssumptions
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FERTILITY PREFERENCESNEED FOR FAMIL
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ii. Say they do not know whether th
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NEED FOR FAMILY PLANNING—NOT CURR
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5. Unmet need for spacing.a) Includ
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AssumptionsWomen who are not curren
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1. Higher age group: A woman’s ag
Page 97 and 98: INFANT AND CHILD MORTALITYEARLY CHI
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Page 101 and 102: MORTALITY RATE CALCULATIONNeonatal
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Page 107 and 108: MATERNAL AND CHILD HEALTHANTENATAL
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Page 111 and 112: ANTENATAL CAREPrenatal tetanus toxo
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Page 115 and 116: POSTNATAL CAREStatistics: Percent D
Page 117 and 118: Calculation5. All vaccinations—ch
Page 119 and 120: CHILD MORBIDITY PREVALENCE AND TREA
Page 125 and 126: CHILDHOOD MORBIDITY PREVENTION: DIA
Page 127 and 128: WOMEN’S USE OF SMOKING TOBACCOSta
Page 129 and 130: Handling of Missing ValuesExcluded
Page 131 and 132: Decisions on AlternativesAn alterna
Page 133 and 134: Respondents with missing reports fo
Page 135 and 136: C. Denominators:Calculation1. Numbe
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Page 139 and 140: B. Numerators:1. Number of days bre
Page 141 and 142: MICRONUTRIENT INTAKE AMONG CHILDREN
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Page 145 and 146: CHILDREN’S AND WOMEN’S NUTRITIO
Page 147: CHILDREN’S AND WOMEN’S NUTRITIO
Page 151 and 152: CalculationA. The assignment of ant
Page 153 and 154: ReferencesNational Center for Healt
Page 155 and 156: Changes Over TimeIn phases of the D
Page 157 and 158: HIV/AIDS/STDSHIV/AIDS PREVENTION KN
Page 159 and 160: CONDOM USE AT LAST SEXStatistics: P
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Page 163 and 164: ADULT MORTALITY (DIRECT METHOD)Stat
Page 165 and 166: ADULT MORTALITY (INDIRECT METHOD)St
Page 167: Another important issue is location
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