FrontLines: Demographic and Health Surveys Still Track Fertility and Health Trends After 30 Years

March 2004

When other countries or development agencies want to understand how to help poor families improve health, reduce family size, or prevent diseases such as HIV/AIDS, they often turn to USAID’s Demographic and Health Surveys (DHS).

During the past 30 years, the Agency supported more than 250 such surveys. They were done by the DHS and its predecessor, the World Fertility Surveys (WFS). Currently, 20 surveys are under way.

USAID’s survey support began in the early 1970s. Population and reproductive health surveys collected detailed maternal and family health statistics in five-year cycles in dozens of developing countries.

The surveys used standardized key questions and methodology, thus allowing policymakers to monitor population and health trends and understand what is behind them.

Surveys in a country are often repeated to observe trends. The 2002–03 Indonesia DHS was the seventh survey USAID has helped fund. The 2002–03 Indonesia DHS was cofunded by the Agency, but mainly by the Indonesian Government, which contributed with the help of a World Bank loan. Locally trained fieldworkers interviewed nearly 40,000 urban and rural families.

By tagging such information, DHS data can illustrate a problem, track its improvement or worsening, evaluate program effectiveness, and allow reliable cross-country comparisons.
The data help local governments and development organizations, said Richard Cornelius, senior policy advisor for health at USAID’s Bureau for Policy and Program Coordination. Cornelius, a demographer by training, joined USAID in 1974 to work on WFS and later designed and managed the DHS project until 1993.

“It highlights for national leaders the extent of population and health-related problems facing their countries. Often it’s one of the few sources of data that give a fully national picture on key indicators of health and social well-being,” Cornelius said.

“The data also help international development organizations like USAID see how one country compares to another, and get a sense of the impact of health interventions we’re funding,” he added.

The positive impact of birth spacing on the health of women and children is one of the global lessons learned from USAID’s investment in surveys over more than three decades.

A demographic survey costs about $750,000, though some cost more than $1 million. Most are done in countries where USAID has Missions.

As capabilities and economic conditions improved, countries such as Colombia, Mexico, and Thailand are performing their own demographic and health surveys.

Today, a demographic survey takes 12–18 months to complete. But when old mainframe computers were still in use, it took up to five years to complete the surveys under the WFS, the predecessor of DHS.

WFS, which ran from 1972–1984, completed surveys in 41 developing countries and 20 developed countries. At the time, the WFS was touted as the largest demographic research project ever undertaken.

Access the March 2004 edition of FrontLines [PDF, 2MB].