Demographic and Health Surveys Methodology - Measure DHS

More documents

Recommendations

Info

Handling of Missing ValuesSiblings whose maternal status at the time of death are unknown to the respondent or are missing in thedata set are allocated as maternal deaths in the proportion they have to all deaths (e.g., if unknown statusdeaths are 10% of all deaths in an age group of respondent, then the number of maternal deaths in that agegroup is increased by 10%).Siblings whose maternal status at the time of death is unknown to the respondent or is missing in the dataset are allocated to maternal deaths in the proportion they are to deaths of any maternal status. For eachage group of respondents, the number of deaths of known maternal status is divided by the number ofdeaths of any status to get the proportion of maternal deaths. This proportion is then multiplied by thenumber of deaths of unknown status to calculate the number of deaths to add to the known maternaldeaths to get the total number of maternal deaths in each respondent age group.Notes and ConsiderationsThe indirect method of calculating maternal mortality lifetime risk and the maternal mortality ratio isbased on applying models of fertility and maternal mortality rates. The number of sisters of respondentsis converted into “sister units of risk” equivalent to women-years of exposure to the risk of mortality inthe reproductive age (i.e. since age 15 years) by multiplication with adjustment factors calculated on amodel age-fertility distribution. The conversion from the lifetime risk of maternal mortality to thematernal mortality ratio assumes a model pattern of maternal mortality by age and by parity.“Because the method relies heavily on a number of assumptions about the relationshipsbetween fertility and age-specific maternal mortality, it should not be used in settingswhere levels of fertility are low (Total Fertility Rate below 3), or where there have beenrecent and marked declines in fertility, or where major migration has occurred. While themethod is relatively simple and inexpensive to use, the overall results relate to a pointaround 10-12 years prior to the survey, a major disadvantage. However, it is possible tocalculate estimates for more recent periods by limiting the upper age of the respondentsto, say, adults aged below 30 years old. In this case, the overall maternal mortalityestimate would relate to a period some seven years prior to the survey. The disadvantageof limiting the upper age of respondents is, however, that a large number of householdsneed to be visited to achieve the desired sample size of adult respondents”. [World HealthOrganisation, 1997. The sisterhood method for estimating maternal mortality:Guidance for potential users. WHO/RHT/97.28].The DHS maternal mortality module questionnaire collects information from respondents (female andmale) about the maternal status of the death of their sisters born to the same mother by asking if the sisterdied while pregnant, during delivery or within two months after the end of a pregnancy or a childbirth.Younger (and male) respondents may not know that their older sister was even pregnant if the sister wasseveral years older or died during pregnancy or from an induced abortion, thus biasing maternal mortalityrates downward. Women who intend to have an induced abortion may also not disclose their pregnancystatus to family members. On the other hand, deaths due to non-maternal causes, such as accidents andillnesses, will be included as maternal deaths if they occurred during pregnancy or within two monthsafter the end of the pregnancy or childbirth. Simulation models show that up to one-third of classified asmaternal may not be due to maternal causes, resulting in an upward bias. The final result of both thesebiases, which operate simultaneously, is unknown.Guide to DHS Statistics 159 Updated September 2006
Another important issue is location. The DHS does not collect information on the residence of neithersisters who died nor of the residence during the exposure period of both living and dead sisters. Theresidence at the time of interview of respondents is not necessarily the same as that of their sisters.Therefore, DHS usually does not publish maternal mortality rates and maternal mortality ratios by area.Maternal mortality rates and ratios are subject to high levels of relative sampling error due to theirrelatively rare occurrence. For example, a maternal mortality ratio of 500 maternal deaths per 100,000births has the same sampling error as an infant mortality rate of 5 infant deaths per 1000 births. For asample of about 15,000 respondents, the 95% confidence interval of the MMR would be about 406 to 594maternal deaths per 100,000 births.ReferencesGraham, W., Brass, W. and Snow, R.W. Indirect estimation of maternal mortality: the sisterhood method.Studies in Family Planning, 1989, 20 (3):125-135.Rutenberg, N. and Sullivan, J.M. Direct and indirect estimates of maternal mortality from the sisterhoodmethod. IRD/Macro International Inc., Washington DC, 1991.Hanley, J.A., Hagen, C.A. and Shiferaw, T. Confidence intervals and sample size calculations for thesisterhood method of estimating maternal mortality. Studies in Family Planning 27(4) July/August 1996.WHO/UNICEF. The Sisterhood method to estimate maternal mortality. Report of a technical meeting,5-6 December 1996.Stanton, C., Abderrahim, N. and Hill, K. DHS maternal mortality indicators: An assessment of dataquality and implications for data use. Demographic and Health Surveys Analytical Report No 4, MacroInternational Inc. Calverton, Maryland, USA, September 1997.Trussel J. and Rodriguez G. (1990) A Note On the Sisterhood Estimation of Maternal Mortality. Studiesin Family Planning, 21, 6: 344-346.Guide to DHS Statistics 160 Updated September 2006
Page 1 and 2:
Guide to DHS statisticsDemographic
Page 3 and 4:
GUIDE TO DHS STATISTICSShea Oscar R
Page 5 and 6:
Preferred Method of Contraception f
Page 7 and 8:
ForewordDHS surveys collect a wealt
Page 9 and 10:
MODEL QUESTIONNAIRESThe basic appro
Page 11 and 12:
The Guidelines for the Main Survey
Page 13 and 14:
The figure on the previous page ill
Page 15 and 16:
Before using an exported DHS data f
Page 17 and 18:
In this list “xx” represent dig
Page 19 and 20:
At data entry time, contrary to the
Page 21 and 22:
CalculationInitial sample weights a
Page 23 and 24:
DHS uses century month codes extens
Page 25 and 26:
AgeTotal ChildrenTotal ChildrenSmoo
Page 27 and 28:
All Women Ever-Married Women All Wo
Page 29 and 30:
it is not possible to merge the hou
Page 31 and 32:
ename = (HVIDX$01, HV101$01, HV102$
Page 33 and 34:
III. Guide to Individual Statistics
Page 35 and 36:
Births in the month of interview ar
Page 37 and 38:
Statistics: Total Fertility RateDef
Page 39 and 40:
Statistics: Crude Birth RateDefinit
Page 41 and 42:
CHILDREN EVER BORN AND LIVINGStatis
Page 43 and 44:
BIRTH INTERVALSStatistics: Percent
Page 45 and 46:
AGE AT FIRST BIRTHStatistics: Perce
Page 47 and 48:
TEENAGE PREGNANCY AND MOTHERHOODSta
Page 49 and 50:
4. Traditional methods: The number
Page 51 and 52:
CURRENT USE OF CONTRACEPTIVE METHOD
Page 53 and 54:
Changes over TimeThe list of specif
Page 55 and 56:
Median: Women with a missing value
Page 57 and 58:
KNOWLEDGE OF THE FERTILE PERIODStat
Page 59 and 60:
Statistics: Median Age at Contracep
Page 61 and 62:
INFORMED CHOICEStatistics:A. Percen
Page 63 and 64:
B. In the standard recode file, the
Page 65 and 66:
REASONS FOR DISCONTINUING CONTRACEP
Page 67 and 68:
FUTURE USE OF CONTRACEPTIONStatisti
Page 69 and 70:
PREFERRED METHOD OF CONTRACEPTION F
Page 71 and 72:
CONTACT OF NONUSERS WITH FAMILY PLA
Page 73 and 74:
ATTITUDES TOWARD FAMILY PLANNINGSta
Page 75 and 76:
NUMBER OF CO-WIVESStatistics: Perce
Page 77 and 78:
MEDIAN AGE AT FIRST MARRIAGEDefinit
Page 79 and 80:
Statistics: Median Age at First Sex
Page 81 and 82:
B. Denominator: Number of all birth
Page 83 and 84:
Notes and ConsiderationsAssumptions
Page 85 and 86:
FERTILITY PREFERENCESNEED FOR FAMIL
Page 87 and 88:
ii. Say they do not know whether th
Page 89 and 90:
NEED FOR FAMILY PLANNING—NOT CURR
Page 91 and 92:
5. Unmet need for spacing.a) Includ
Page 93 and 94:
AssumptionsWomen who are not curren
Page 95 and 96:
1. Higher age group: A woman’s ag
Page 97 and 98:
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 and 150: ReferencesCenters for Disease Contr
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
Page 161 and 162: . Denominator (exposure): [Example
Page 163 and 164: ADULT MORTALITY (DIRECT METHOD)Stat
Page 165: ADULT MORTALITY (INDIRECT METHOD)St
show all

Demographic and Health Surveys Methodology - Measure DHS

Create successful ePaper yourself

Delete template?

Save as template?