Demographic and Health Surveys Methodology - Measure DHS

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CHILDREN’S AND WOMEN’S NUTRITIONAL STATUSCHILDREN’S NUTRITIONAL STATUSStatistics: Percentages of Children Under 5 Years of Age, by Stunted, Wasted,and UnderweightDefinitionA. Coverage:1. Population base: Living children born 0 to 59 months before the survey.2. Time period: Current status at the time of the survey.B. Numerators:1. Severely stunted: Number of children whose height for age z-score is less than -3.0 standarddeviations (SD) below the mean on the NCHS/CDC/WHO international references standard.2. Moderately stunted: Number of children whose height for age z-score is between –2.0 and-2.99 standard deviations (SD) below the mean on the NCHS/CDC/WHO internationalreferences standard.3. Severely wasted: Number of children whose weight for height z-score is less than –3.0standard deviations (SD) below the mean on the NCHS/CDC/WHO international referencesstandard.4. Moderately wasted: Number of children whose weight for height z-score is between –2.0 and–2.99 standard deviations (SD) below the mean on the NCHS/CDC/WHO internationalreferences standard.5. Severely underweight: Number of children whose weight for age z-score is less than –2.0standard deviations (SD) below the mean on the NCHS/CDC/WHO international referencesstandard.6. Moderately underweight: Number of children whose weight for age z-score is between –2.0and –2.99 standard deviations (SD) below the mean on the NCHS/CDC/WHO internationalreferences standard.C. Denominator: Number of living children between ages 0 and 59 months before the survey.Guide to DHS Statistics 143 Updated September 2006
CalculationA. The assignment of anthropmetric z-scores based on the NCHS/CDC/WHO InternationalReference Standard is done through a complicated interpolation function that takes into accountsex, age (measured by difference in date of birth and date of interview, both precise to day ofmonth), height in centimeters, and weight in kilograms (precise to 100 grams). As part of acreation of a recode file variables with the z-scores are calculated and included in that file. In theprocess of assigning the z-scores, checks are made on their plausibility. Z-scores are assignedmissing to children with incomplete date of birth (month or year missing or “don’t know”). Thereason is because z-scores are very sensitive to changes in age. Children with height for agez-scores below –6 SD or above +6 SD, with weight for age z-scores below –6 SD or above +6SD, or with weight for height z-scores below –4 SD or above +6 SD are flagged as having invaliddata. Also invalid are combinations of z-scores where height for age is less than –3.09 SD andweight for age is more than +3.09 SD, or where height for age is more than +3.09 SD and weightfor age is less than –3.09 SD.B. The percentages of children stunted, wasted, and underweight are equal to the specific numeratorsdivided by the denominators and multiplied by 100.Handling of Missing ValuesChildren who were not weighed and measured and children whose values for weight and height were notrecorded are excluded from both the denominator and the numerators. Children whose day of month ofbirth is missing or unknown are assigned day 15. Children who are flagged for out-of-range z-scores orinvalid z-scores are excluded from both the denominator and the numerators. Children with missing datain the z-scores (date of birth incomplete or missing) are excluded from both the denominator and thenumerators.Notes and ConsiderationsStunting, based on a child’s height and age, is a measure of chronic nutritional deficiency. Wasting, basedon a child’s weight and height, is a measure of acute nutritional deficiency. Underweight, based on weightand age, is a composite measure of both acute and chronic statuses. The NCHS/CDC/WHO standard isbased on well-nourished children in the United States. Due to natural variations in a well nourishedpopulation, 2.2 percent of children will be between –2.0 and –2.99 SD below the mean, and 0.1 percentwill be –3.0 or more SD below the mean. The extent of malnutrition in a population should be taken bythe extent the proportions moderate and severe exceed these percentages that occur in a well-fedpopulation of children.The NCHS/CDC/WHO international reference standard is a combination of two reference standards: onefor children under 24 months and the other for children 24–216 months. The first standard, called the Felsstandard, is based on children whose height was taken while prone. The other standard, based onNHANES data, is derived from children 24 months and older whose height was measured while theywere standing. For children 24 months of age or over, whose height was measured while lying down, onecentimeter should be subtracted from their measured height before calculating the z-scores.Guide to DHS Statistics 144 Updated September 2006
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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
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INFANT AND CHILD MORTALITYEARLY CHI
Page 99 and 100: Statistics: Neonatal Mortality Rate
Page 101 and 102: MORTALITY RATE CALCULATIONNeonatal
Page 103 and 104: Statistics: Perinatal Mortality Rat
Page 105 and 106: HIGH-RISK FERTILITY BEHAVIOR RISK R
Page 107 and 108: MATERNAL AND CHILD HEALTHANTENATAL
Page 109 and 110: Handling of Missing Values“Don’
Page 111 and 112: ANTENATAL CAREPrenatal tetanus toxo
Page 113 and 114: DELIVERY CAREStatistics: Percent Di
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
Page 137 and 138: C. Denominators:Calculation1. Numbe
Page 139 and 140: B. Numerators:1. Number of days bre
Page 141 and 142: MICRONUTRIENT INTAKE AMONG CHILDREN
Page 143 and 144: MICRONUTRIENT INTAKE AMONG WOMENSta
Page 145 and 146: CHILDREN’S AND WOMEN’S NUTRITIO
Page 147 and 148: CHILDREN’S AND WOMEN’S NUTRITIO
Page 149: ReferencesCenters for Disease Contr
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
Page 161 and 162: . Denominator (exposure): [Example
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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