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Demographic research and program evaluation are the cornerstones of the longstanding collaboration between CDC's Division of Reproductive Health (DRH) and the U.S. Agency for International Development, Population/Reproductive Health Office (USAID/PRH) in pursuit of the common objective of: “reducing unintended pregnancy and promoting healthy reproductive health behavior” in less developed countries. To achieve this objective, public health leaders, medical professionals and policymakers need accurate and timely information about their country’s population and health status, including contraceptive use and need, fertility, infant mortality, behavioral risk factors, HIV/AIDS awareness and prevalence, maternal and child health, gender equity, and gender-based violence.

As a member organization of the USAID-supported MEASURE II Project, CDC's Division of Reproductive Health provides information on these key public health topics as part of the MEASURE CDC project through technical leadership, innovation and support to host country institutions and partners in less developed countries worldwide. MEASURE II partner organizations also include the International Programs Center of the Census Bureau, MEASURE/Evaluation (implemented by the Carolina Population Center, University of North Carolina), and MEASURE/DHS (implemented by Macro International Inc. (ORC Macro)). Projects are often conducted in collaboration with these partners as well as with a broad spectrum of international donor organizations, including the UN Agencies, the World Bank, and the Inter-American Development Bank. Key stakeholders typically include USAID field missions, Ministries of Health, Ministries of Youth, statistical offices or bureaus, private research organizations, universities, policymakers (legislative, presidential), and non-governmental health organizations.

MEASURE CDC employs a variety of scientific approaches —population-based surveys, qualitative research, rapid assessment tools — to generate information vital to understanding complex public health issues. Technical assistance encompasses state-of-the-art survey instruments that can be adapted to the country’s need, efficient sampling techniques, user-friendly data processing software, and expert support for analyzing the data. MEASURE CDC works hand-in-hand with the host country institutions and partners to strengthen local skills in every aspect of conducting a survey, starting with survey design and data collection and including analysis, interpretation, and dissemination of the survey findings.

CDC also has a history of collaboration with the Indian Health Service (IHS), and since 1987 has provided IHS with technical assistance in collecting baseline behavioral risk factor and reproductive health data from adult American Indians. Surveys have been conducted on more than 20 reservations and in four non-reservation urban and rural areas.

Program Impact
Family planning and reproductive health programs use the survey data to define program priorities and to evaluate progress toward meeting health or program goals. The first survey done in a country is primarily used for raising awareness of reproductive health issues. Countries usually conduct subsequent surveys (generally every five years) to track trends in reproductive health indicators and incorporate new topics, depending on the needs of the country.

Equally important to gathering and analyzing data is translating findings to define health program priorities and facilitate action by key stakeholders who share responsibility for improving health programs and services. Follow-on activities to surveys include the design and implementation of data use and dissemination workshops, training, and capacity-building among staff in stakeholder institutions.

Program Area Highlights
CDC's Division Reproductive Health has a long history of supporting population-based surveys, with over 75 surveys conducted in 45 countries since 1975. In most of these countries, the RHS data serve as official statistics and are adopted as such by the government’s statistical bureaus and Ministries of Health.

Future Directions
Under the MEASURE CDC project, population-based surveys are scheduled to continue in 2007/2008 in Eastern Europe and Latin America. Also, heightened concern over maternal mortality, how to measure it, and the need to improve surveillance systems is on the rise. The CDC is pursuing new opportunities to respond to technical assistance needs on these and other key maternal and child health topics. Drawing on the wealth of information available from the more recent Reproductive Health Surveys, MEASURE CDC seeks to increase the availability of country data sets for greater use within counties by researchers and health planners alike. For example, data sets, standard recode files and data dictionaries will be made available on the web and on CD-ROM.

The output of the MEASURE CDC research serves as input to other work at the policy and program level. Emphasis will be placed on facilitating the use of data and information through secondary analysis, training, and making sure that information is passed onto potential collaborators. The long history of conducting population-based surveys has led to the formation of many partners. With the expansion of topics included in population-based surveys, such as Intimate Partner Violence and HIV, greater effort is required to cultivate non-traditional collaborators from the education and cultural government ministries, faith-based institutions and grass-roots organizations.

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Page last reviewed: 8/17/07
Page last modified: 9/26/06
Content source: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion