Abstract

The Bangladesh Demographic and Health Survey (BDHS) is the first of this kind of study conducted in Bangladesh. It provides rapid feedback on key demographic and programmatic indicators to monitor the strength and weaknesses of the national family planning/MCH program. The wealth of information collected through the 1993-94 BDHS will be of immense value to the policymakers and program managers in order to strengthen future program policies and strategies.

The BDHS is intended to serve as a source of population and health data for policymakers and the research community. In general, the objectives of the BDHS are to: - asses the overall demographic situation in Bangladesh, - assist in the evaluation of the population and health programs in Bangladesh, and - advance survey methodology.

More specifically, the BDHS was designed to: - provide data on the family planning and fertility behavior of the Bangladesh population to evaluate the national family planning programs, - measure changes in fertility and contraceptive prevalence and, at the same time, study the factors which affect these changes, such as marriage patterns, urban/rural residence, availability of contraception, breastfeeding patterns, and other socioeconomic factors, and - examine the basic indicators of maternal and child health in Bangladesh.

Geographic coverage

National

Analysis unit

• Household
• Children under five years
• Women age 10-49
• Men

Kind of data

Sample survey data

Sampling procedure

Bangladesh is divided into five administrative divisions, 64 districts (zillas), and 489 thanas. In rural areas, thanas are divided into unions and then mauzas, an administrative land unit. Urban areas are divided into wards and then mahallas. The 1993-94 BDHS employed a nationally-representative, two-stage sample. It was selected from the Integrated Multi-Purpose Master Sample (IMPS), newly created by the Bangladesh Bureau of Statistics. The IMPS is based on 1991 census data. Each of the five divisions was stratified into three groups: 1) statistical metropolitan areas (SMAs) 2) municipalities (other urban areas), and 3) rural areas. In rural areas, the primary sampling unit was the mauza, while in urban areas, it was the mahalla. Because the primary sampling units in the IMPS were selected with probability proportional to size from the 1991 census frame, the units for the BDHS were sub-selected from the IMPS with equal probability to make the BDHS selection equivalent to selection with probability proportional to size. A total of 304 primary sampling units were selected for the BDHS (30 in SMAs, 40 in municipalities, and 234 in rural areas), out of the 372 in the IMPS. Fieldwork in three sample points was not possible, so a total of 301 points were covered in the survey.

Since one objective of the BDHS is to provide separate survey estimates for each division as well as for urban and rural areas separately, it was necessary to increase the sampling rate for Barisal Division und for municipalities relative to the other divisions, SMAs, and rural areas. Thus, the BDHS sample is not self-weighting and weighting factors have been applied to the data in this report.

After the selection of the BDHS sample points, field staffs were trained by Mitra and Associates and conducted a household listing operation in September and October 1993. A systematic sample of households was then selected from these lists, with an average "take" of 25 households in the urban clusters and 37 households in rural clusters. Every second household was identified as selected for the husband's survey, meaning that, in addition to interviewing all ever-married women age 10-49, interviewers also interviewed the husband of any woman who was successfully interviewed. It was expected that the sample would yield interviews with approximately 10,000 ever-married women age 10-49 and 4,200 of their husbands.

Note: See detailed in APPENDIX A of the survey final report.

Sampling deviation

Data collected for women 10-49, indicators calculated for women 15-49. A total of 304 primary sampling units were selected, but fieldwork in 3 sample points was not possible.

Mode of data collection

Face-to-face

Research instrument

Four types of questionnaires were used for the BDHS: a Household Questionnaire, a Women's Questionnaire, a Husbands' Questionnaire, and a Service Availability Questionnaire. The contents of these questionnaires were based on the DHS Model A Questionnaire, which is designed for use in countries with relatively high levels of contraceptive use. Additions and modifications to the model questionnaires were made during a series of meetings with representatives of various organizations, including the Asia Foundation, the Bangladesh Bureau of Statistics, the Cambridge Consulting Corporation, the Family Planning Association of Bangladesh, GTZ, the International Centre for Diarrhoeal Disease Research (ICDDR,B), Pathfinder International, Population Communications Services, the Population Council, the Social Marketing Company, UNFPA, UNICEF, University Research Corporation/Bangladesh, and the World Bank. The questionnaires were developed in English and then translated into and printed in Bangla.

The Household Questionnaire was used to list all the usual members and visitors of selected households. Some basic information was collected on the characteristics of each person listed, including his/her age, sex, education, and relationship to the head of the household. The main purpose of the Household Questionnaire was to identify women and men who were eligible for individual interview. In addition, information was collected about the dwelling itself, such as the source of water, type of toilet facilities, materials used to construct the house, and ownership of various consumer goods.

The Women's Questionnaire was used to collect information from ever-married women age 10-49. These women were asked questions on the following topics: - Background characteristics (age, education, religion, etc.), - Reproductive history, - Knowledge and use of family planning methods, - Antenatal and delivery care, - Breastfeeding and weaning practices, - Vaccinations and health of children under age three, - Marriage, - Fertility preferences, and - Husband's background and respondent's work.

The Husbands' Questionnaire was used to interview the husbands of a subsample of women who were interviewed. The questionnaire included many of the same questions as the Women's Questionnaire, except that it omitted the detailed birth history, as well as the sections on maternal care, breastfeeding and child health.

The Service Availability Questionnaire was used to collect information on the family planning and health services available in and near the sampled areas. It consisted of a set of three questionnaires: one to collect data on characteristics of the community, one for interviewing family welfare visitors and one for interviewing family planning field workers, whether government or non-governent supported. One set of service availability questionnaires was to be completed in each cluster (sample point).

Cleaning operations

All questionnaires for the BDHS were returned to Dhaka for data processing at Mitra and Associates. The processing operation consisted of office editing, coding of open-ended questions, data entry, and editing inconsistencies found by the computer programs. One senior staff member, 1 data processing supervisor, questionnaire administrator, 2 office editors, and 5 data entry operators were responsible for the data processing operation. The data were processed on five microcomputers. The DHS data entry and editing programs were written in ISSA (Integrated System for Survey Analysis). Data processing commenced in early February and was completed by late April 1994.

Response rate

A total of 9,681 households were selected for the sample, of which 9,174 were successfully interviewed. The shortfall is primarily due to dwellings that were vacant, or in which the inhabitants had left for an extended period at the time they were visited by the interviewing teams. Of the 9,255 households that were occupied, 99 percent were successfully interviewed. In these households, 9,900 women were identified as eligible for the individual interview and interviews were completed for 9,640 or 97 percent of these. In one-half of the households that were selected for inclusion in the husbands' survey, 3,874 eligible husbands were identified, of which 3,284 or 85 percent were interviewed.

The principal reason for non-response among eligible women and men was failure to find them at home despite repeated visits to the household. The refusal rate was very low (less than one-tenth of one percent among women and husbands). Since the main reason for interviewing husbands was to match the information with that from their wives, survey procedures called for interviewers not to interview husbands of women who were not interviewed. Such cases account for about one-third of the non-response among husbands. Where husbands and wives were both interviewed, they were interviewed simultaneously but separately.

Note: See summarized response rates by residence (urban/rural) in Table 1.1 of the survey final report.

Sampling error estimates

The estimates from a sample survey are affected by two types of errors: non-sampling errors and sampling errors. Non-sampling errors are the results of mistakes made in implementing data collection and data processing, such as failure to locate and interview the correct household, misunderstanding of the questions